STRATEGY MEMORANDUM
VISION, MISSION AND VALUES:
The current vision and mission were developed by the Board of Directors several years ago,
and reviewed in 2014. The Lincolnshire Community Health Services (LCHS) vision is to be
the first choice for commissioners of integrated neighbourhood services, and our mission is
to provide high quality lifelong personalised care within local communities. Our values are
summarised as “Putting patients first”:
Focus: on improving clinical outcomes
Impact – make a difference to the lives of those in our care
Respect your decisions and listen and respond to preference as well as need
Safety Create a safety culture throughout the organisation
Teamwork – Be proud to be part of team LCHS
The vision, mission and values are regularly shared with staff, and stakeholders, and form a
strong part of the current LCHS brand, with the strapline “Putting you first is at the heart of
everything we do”.
Staff engage with the mission, vision and values from their induction session, where they are
presented as part of the Director’s welcome slot, which also takes place on a yearly basis
when staff return for their mandatory training.
The mission, vision and values are due for a refresh; this will take place over the next few
months and the process will engage a range of stakeholders, including staff, service users
and carers and the developing membership. The current set of staff conferences are being
used to engage staff in considering how everyone in the organisation personally delivers on
the strategic objectives, through the development, currently underway of “The LCHS Way”.
STRATEGY:
In line with good practice, and Monitor’s strategy development toolkit, LCHS works through
four key stages of the planning process:
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Strategic Planning Cycle:
Review of
Delivery
Review
Implementation
Strategy
Formulation
Detailed
planning &
Design
Trust plans have been informed by an extensive situation review which provides an
analysis of the Trust’s service portfolio, as well as the current market environment and local
health economy. This is refreshed on an annual basis.
The LCHS approach to the formulation of strategy has been inclusive. The process to
develop the current strategies began in the autumn of 2014, with series of workshop
meetings for the Board, focussing on their ambitions for the Trust, future direction,
parameters, what success looks like, and Board members’ risk appetite. At this time, the
Board developed a set of overarching strategic objectives, which are shown in the diagram
below (from the IBP), together with the associated priorities for action aimed at delivering on
these objectives.
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Strategic Objectives and Related Priorities:
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Planning and Design:
As part of this service-driven and clinically led approach, clinical engagement planning
workshops were held in October and November 2014 which focused on :
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Planned Care
Neighbourhood team provision
Specialist Nursing
Bed-based services (community hospitals & intermediate care beds)
Urgent Care
Family & Healthy Lifestyles
These workshops considered three main questions: Where are we now? Where do we want
to be? How are we going to get there?
Key themes
While many of the points were service-specific, there were a number of fundamental
recurring themes:
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Agreeing pathways with commissioners, providers and other key stakeholders
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Standardising LCHS’s proactive, urgent and Family and Healthy Lifestyle services
across the county, in terms of clinical models, pathways, skill mix, defined packages
of care for defined patient cohorts, based on demand and capacity modelling plus
best practice
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Integrating LCHS services and developing multi-functional teams where they are
overly fragmented, while retaining specialist skills
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Agreeing the future role of key functions/hubs i.e. contact centre; community
hospitals
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Working with commissioners to ensure that money follows the shift of service
demand from hospital to community
A number of follow up actions were agreed to take this on to the next stage to develop the
strategy and the detailed plans to implement it:
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Scrutinise and synthesise these outputs
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Bolster/edit where appropriate e.g. add any missing strategic opportunities
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Prioritise work streams in terms of clinical quality, financial efficiency potential and
strategic importance
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Develop an operational work programme, which integrates both operational and
corporate roles, links design with delivery and has a granular level of detail
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Agree roles & responsibilities plus timescales for the ‘Detailed Planning’ stage of the
planning process
The outcome was the development of an integrated business plan which has been shared
across the Trust, is robust and deliverable, and integrated across operational and corporate
functions, so that the enabling strategies, e.g. estate, information technology, people
strategy, all support the delivery of the clinical strategy and commercial strategy.
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Within those plans, we are aiming to:
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Deliver personalised, joined-up care
Keep people healthier and at home
Give children the best start in life
Help to keep older people as well and as independent as possible
Our key transformation areas are:
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Proactive care: Integrated Community Teams – the LCHS contribution to Neighbourhood
Teams
Urgent care – contributing to a highly responsive and effective urgent care network in
Lincolnshire
Transitional Care – bridging the gap between hospital and home to maximise recovery
and promote independence
Community Hospitals: hubs for proactive, urgent and transitional care
Children’s services – giving children the best possible start in life
All of these have common priorities in how we will transform, by:
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Integrating services around the patient
Increasing our efficiency
More partnership working
Engagement:
There has been a strong emphasis on stakeholder engagement, ownership and coproduction throughout the strategy formulation and the detailed planning and design stages.
Clinicians have been involved from the outset and there has been regular dialogue with
commissioners to ensure plans are in line with the needs of the population served. The
delivery of the document which articulates the clinical strategy was led by the Deputy Chief
Nurse, who was also engaged in presentations to CCG councils and contracting meetings.
The strategy was considered by the Trust Clinical Senate and discussed at staff conferences
and team meetings, and by the County Council Health Scrutiny Committee. The Clinical and
Commercial strategies and all enabling strategies were reviewed and discussed at the
relevant Board subcommittees and at full board meetings, where they were approved.
The development of detailed plans, and implementation has been the responsibility of a set
of Programme Boards, these being:
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Integrated Community Teams
Urgent Care
Community hospitals and Transitional Care
0 – 19s services
Back office functions
Each has a programme manager, and an executive sponsor, and the chair of each
programme board reports in to the Business Planning Group, chaired by the Director of
Strategy.
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Governance:
The enabling strategies all link to particular Board subcommittees, e.g. the People Strategy
is overseen by the Workforce Committee. Progress against the strategic objectives for the
Trust is monitored through the Board Assurance Framework (BAF), which is reviewed each
month by the relevant subcommittee, and quarterly by the Board of Directors. Challenges to
achieving the strategy, including local health economy factors are identified as risks to
delivery in the BAF, together with mitigations, so Board members are all aware of, and
understand these risks. Actions designed to mitigate the risks are reported on, at Board and
subcommittees. The Trust Board receives regular updates with regard to Strategic and
corporate risks, and Clinical risks.
In addition, the LCHS Audit Committee co-ordinates and oversees the organisational
processes of risk management and reports on a quarterly basis to the Trust Board. The
LCHS Quality and Risk Committee is a sub-committee of the Board and works closely with
the Audit Committee with regard to the processes for the management of clinical risk.
The Executive Leadership Team has the responsibility to consider, monitor, and review the
significant organisational risks which are incorporated into the Trust’s Strategic Risk Profile
and which are shared with the board on a monthly basis. The Executive Leadership Team
also considers, monitors, and reviews identified risks within the organisational risk register.
The Executive Leadership Team and the Quality and Risk Committee are responsible for the
development and approval of associated policies, procedures and guidelines to assist staff
and others in the elimination or control of risks. The Trust Board confers final ratification. The
Audit Committee, Quality and Risk Committee and Executive Leadership Team are
responsible for the oversight of training, learning and development in order to integrate risk
management into everyday organisational activities. There is a regular overview of lessons
learnt considered by the Quality and Risk Committee.
The strategy and service plans were developed with considerable clinical input. In addition,
the business plans for all proposed service changes are assessed by clinicians, for their
impact on the quality of care, this process being led by the Directors of Nursing and
Medicine. Their impact on quality and financial sustainability is monitored through the Quality
and Risk Committee and the Finance, Investment and Planning Committee. Financial
pressures are managed so that they do not compromise the quality of care.
The strategic objectives are communicated, and operationalised across the organisation in a
number of ways:
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Through induction and mandatory training
Strategic objectives are translated into the plans set out by the business units, with
business units performance managed through the Performance Management Review
process.
Teams are set objectives to support the achievement of the business unit
Individuals have a set of objectives within their appraisal, which relate to the strategic
objectives, and they are assessed against these within management supervision and
the annual appraisal.
Most recently, a set of storyboards has been developed to communicate the strategy with
the whole range of stakeholders. An example is attached (see pdf LCHS Storyboards).
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Future improvement:
Feedback from the staff working in the services was that the process for the development of
the current strategy was more service focussed and clinically driven than in the past, and
that there was greater ownership of the clinical strategy. The strategy was also shared with
commissioners, through CCG councils and was developed in line with the Lincolnshire
Health and Care intentions. LHAC had a significant engagement programme which included
service users and carers as well as commissioners and provider organisations, so the
development of the LCHS strategy reflected the direction of travel agreed through this
process. In addition there was engagement with stakeholders in relation to particular
services, e.g. the 0 – 19s work received over 1000 responses from staff, service users,
carers and other stakeholders.
However, there were no specific events organised to engage a range of stakeholders directly
in the development of the overall LCHS clinical strategy. This is now being addressed,
beginning with a stakeholder session immediately before the annual public meeting to seek
views of the current strategy, and on the future direction of services. Future development of
strategy will engage a wider range of stakeholders during the course of the process.
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