Our strategy 2017 - 2022

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Our corporate strategy

West London NHS Trust has developed this strategy to outline our plans for the organisation for the next five years. It sets out the vision of the Board and other senior leaders in the Trust for WLMHT to be a leading provider of outstanding health and social care in West London and beyond, and outlines our medium term plans for what we need to do to achieve this vision and the benefits we hope will be delivered for our patients, carers, staff and local populations. Why review the Trust strategy now? In 2014, West London NHS Trust launched a review of our purpose and goals, with an aim to ensure that our vision and objectives were relevant to our service users and meet national and local ambitions and challenges. The review provided an opportunity for a far-reaching discussion and generated 4,900 comments on a web-based platform to influence a new mission, vision and values framework for the organisation. Since then, the NHS has sought to tackle sustained financial pressures and demand related to an aging population, and published a Five Year Forward View (2014), and a Five Year Forward View for Mental Health (2016) and locally commissioners and providers in North West London have defined their Sustainability and Transformation Plan (STP)

(2016) to tackle whole system pressures and the health and wellbeing, care and quality, and finance and efficiency gaps. During this time, West London NHS Trust has also been successful in its ambition to diversify beyond only delivering comprehensive mental health care, and we are now the lead provider for public health services in Ealing (One You Ealing), intermediate care services in Ealing (Home ward Ealing), as well as delivering intermediate care and reablement services in Hammersmith and Fulham as part of the Community Independence Service partnership. We have constructed new inpatient facilities for our specialist services in West London and at Broadmoor Hospital. We have also been successful in our bids to pioneer New Models of Care, taking on the management of commissioning budgets on behalf of NHS England for children and young people’s specialist mental health care as lead provider, and for forensic services in partnership with other North London NHS trusts. It is timely therefore for us to review our strategy, to recommit to our vision and values, and to refresh our organisational aims, with an eye on the timeframes and plans set out in the five year forward view and local STP.

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The challenges North West London faces

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Our corporate strategy

How has this strategy been developed? This strategy has been developed following an assessment of the Trust and our local context, taking into account work done previously with service users and external stakeholders to steer our values and objectives, as well as considering what is likely to change externally in the years to come. Our recent successes and challenges have been considered, including successful acquisition of new and diverse services, the completion (or near-completion) of new facilities at Thames Lodge and Broadmoor Hospital, and feedback from our recent inspections by the Care Quality Commission. Over the last eighteen months, we have undertaken engagement with staff at Leadership Forums and members of the Trust Board over away days and development sessions, and we have shared our early ideas with some service users and external stakeholders to produce the proposals in this document.

At a recent leadership forum (May 2017) fifty five senior leaders in the Trust: • strongly agreed with the statement “WLMHT should

develop a broader range of services, including community physical health services”

• strongly disagreed with the statement “WLMHT should stick only to mental health”

• One hundred per cent of those present supported the idea that the Trust should change its name to reflect a wider range of services beyond Mental Health.

In addition to feedback about what we should do, we have also heard from staff and leaders within the Trust what we should not do: • Should not expand only for expansion’s sake – but grow

where we believe we can add value or quality to new services or our existing services

• Should not diversify or expand at the expense of our existing comprehensive and specialist mental health services, including Broadmoor and the Cassel.

• Should not expand into geographical areas which are not contiguous with our existing services.

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Our corporate strategy

Next steps This document sets out what we want to achieve at a high level over the next five years, and provides a framework linking existing work across the organisation, including: • Our CQC and Quality Improvement Plans • Transformation plans in the Clinical Service Units • Integrated Business Plan (2017-2019) • Redevelopment and Estates Strategy (2017-2022) • Information Technology Strategy • Human Resources Strategy • Communications and Engagement Strategy • Research and Development Strategy • Nursing Strategy • Allied Health Professionals Strategy

Together these plans will incrementally move us towards the delivery of vision, and will be the method by which we are able to determine priorities and track progress. The strategy has been developed based upon our assessment of the current context, and we will revisit it on an annual basis to confirm that it remains the right direction of travel and to reassess priorities for implementation.

Dr Chris Hilton Director of Business and Strategy

Carolyn Regan Chief Executive

Tom Hayhoe Chairman

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WLMHT in 2017

Where we are today? WLMHT is one of the UK’s most diverse providers of NHS mental health and community services with 3,308 directly employed staff providing care and treatment to 62,576 people in 2016/17 and serving a population of over 700,000. Our services include a range of local, specialist and forensic mental health services, including personality disorder services in the Cassel Hospital, and high secure services at Broadmoor Hospital. We are the primary and acute mental health provider in the London boroughs of Ealing, Hammersmith & Fulham, and Hounslow. We are a teaching trust with links to numerous universities and academic institutions; WLMHT has a strong dementia research portfolio and one of the UK’s first clinical trials units for mental health research.

In the past few years, the Trust has expanded into delivering public health services and community physical healthcare services within our London boroughs in partnership with acute, community, local authority, third sector and primary care partners.

Our interfaces with the North West London Sustainability & Transformation Partnership are a key driver for our corporate strategy. The STP has identified that in North West London there will be a £1.3 billion financial gap by 2021 in our health system if changes are not made to improve specialisation, localisation and integration of services.

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WLMHT in 2017 • Public health services

– One You Ealing – Smoke Free Ealing

• Intermediate and community care – Ealing (Home ward partnership) – Hammersmith and Fulham Westminster

Kensington & Chelsea (CIS partnership) – NWL Care Homes Telemedicine (with LCW) – Hounslow Primary Care Fellowship

• Comprehensive local mental health services – all ages and tiers – 700,000 residents

– Ealing – Hounslow – Hammersmith & Fulham

• National and regional specialist mental health services – Broadmoor Hospital – West London Forensic Service – New Care Models (CAMHS / Forensic) – The Cassel Hospital

• Other mental health services – Harrow / Hillingdon – Brent – Kensington & Chelsea – Westminster – City of London – Richmond

• Primary care services – For our secure inpatients in Ealing and Broadmoor

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Our mission, values, vision and objectives

The aim of this document is not to reinvent the mission, values, vision and objectives that were developed in 2014, but to recommit to them, and to refresh our understanding of what they mean in our current context. Our mission:

Promoting hope and wellbeing together

Our values:

• Togetherness • Responsibility • Excellence • Caring

Our vision:

To be an outstanding provider of health and social care, committed to improving quality and caring with compassion. Our objectives are to:

• Be outstanding (we collaborate and innovate)

• Improve quality (we invest, we listen and learn)

• Care with compassion (we work together, we are recommended)

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Accountable care partnerships

Partnership working and accountable care WLMHT’s mission statement (Promoting hope and wellbeing together), and objectives (“we collaborate…”) reflect the wide range of formal relationships the Trust has with a large number of partner organisations. It is our strategy to continue to nurture partnerships to deliver care over the next five years.

Nationally, providers are being encouraged to form more formal strategic Accountable Care Partnerships, contractually joining forces to tackle the current fragmented commissioning and provision of care, duplication of efforts, numerous access points, poorly aligned incentives and financial unsustainability. WLMHT is already working in a number of formal partnerships to deliver care, and we are seeking to develop these, and to work with partner providers in our other boroughs over the coming years to support delivery of accountable care for our populations.

Hammersmith and Fulham Health and Care Partnership HF GP Federation, Imperial College Healthcare NHS Trust, Chelsea and Westminster Hospital NHS FT, WLMHT, Central London Community Healthcare NHS Trust, with London Borough of Hammersmith and Fulham and third sector partners

CAMHS Tier 4 New Models of Care WLMHT (Lead Provider), Central and North West London NHS FT, Priory Group, NHS England, NHS North West London

Forensic Mental Health New Models of Care Barnet, Enfield and Haringey NHS Trust (Lead Provider), WLMHT, East London NHS FT (with Central and North West London NHS FT and North East London NHS FT).

Home ward Ealing WLMHT (Lead Provider), Ealing Council, Central and North West London NHS FT, London Central and West Unscheduled Care Collaborative, Chelsea and Westminster Hospital NHS FT,

Community Independence Service partnership Central and North West London NHS FT (Lead Provider), WLMHT, London Central and West Unscheduled Care Collaborative, London Borough of Hammersmith and Fulham, Royal Borough of Kensington and Chelsea, Westminster City Council, Central London Healthcare, London Medical Associates.

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Values based growth

The Trust Management Team has previously (2013) endorsed a Values Based Growth approach to the assessment of commercial opportunities. In light of this strategy we will refine our approach to making decisions about tendering for new business, to ensure that opportunities continue to be assessed critically and in line with our values. The proposed revised decision framework is illustrated below: Nature of the opportunity • Geography: are new opportunities located in or linked to our

existing services • Core business: is the new opportunity for a service which we

already provide, or aligned with this overall strategy? • Regulation: Can this service fall within our existing regulation /

governance frameworks

Due diligence • Financial viability and workforce capacity: is the existing

service financially sustainable and adequately staffed • Quality and performance: is the existing service known for

quality and performing on target? • Partnerships: is the service currently delivered by a strategic

partner and does bidding pose a risk to partnerships elsewhere • Stakeholders: do we have existing positive relationships with

key stakeholders (eg commissioners, interfacing services, STP) WLMHT proposal • Our capacity: do we have leadership / expertise available to

mobilise / deliver the service? • Our model - viability: can we offer a model which is financially

viable and which we can successfully deliver (including workforce)?

• Our model – quality: does our model offer improved quality of care for users of the service and/or for our other service users

• Partnerships: Can we identify partners to work with us to support successful delivery of a new model

Overall assessment Overall decision based on global impression and recommendation to TMT / F&P / Board

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Where we will be in 2022

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Organisational identity

WLMHT was formed in 2001 from a number of predecessor organisations (West London Healthcare NHS Trust / Ealing Hammersmith and Fulham Mental Health NHS Trust, Riverside Mental Health NHS Trust, Hounslow and Spelthorne Community and Mental Health NHS Trust) and Broadmoor Special Hospital Authority). Whole person care In this document we have outlined a plan to broaden the range of services the Trust provides, to include a range of (non-mental health) community and public health services and, whilst maintaining our position as major provider of comprehensive mental health services, our wish to position ourselves as a leading provider and partner in the provision of integrated whole person care. Renaming the Trust will reflect this ambition and improve our ability to bid successfully for non-mental health services. Recruitment Managers in our existing physical health services also report challenges recruiting non-mental health staff due to the Trust’s identity, and it is not unusual for our advertisements for registered general nurses or physical health allied health

professionals to attract fewer appropriate candidates than expected, whilst receiving applications from mental health professionals who are not qualified for the roles. Renaming the Trust will improve our ability to attract a greater range of staff. Minimising costs Undertaking an exercise to rename the Trust during 2017-18 will allow us to minimise costs by doing this in parallel with our existing plans to adopt NHS Mail (in place of our own email server) and the requirement from NHS Identity to adopt new branding, making changes to online publications by the end of 2017-18 and to printed materials and physical signage when practical. A working group has been established by the Trust Management Team and early engagement with staff has identified two possible names which will be put forward for wider consultation:

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Next steps

We would like your feedback: on the two proposed names for the organisation (with an option also to suggest alternatives, however we will be constrained by strict rules contained within the NHS Identity Guidelines.

What about our overall strategy? - Are there any significant gaps in the strategy?

- Do you agree with the principles by which we select the

new services we might wish to bid for?

- Please send your feedback to: strategy.consultation@wlmht.nhs.uk

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Glossary of abbreviations

• BEH: Barnet, Enfield and Haringey Mental Health Trust • CATT: Crisis, Assessment and Treatment Team • CIDS: Cognitive Impairment and Dementia Services • CIS: Community Independence Service • CNWL: Central and North West London NHS Foundation Trust • ELFT: East London Foundation Trust • IAPT: Improving Access to Psychological Therapies • NMOC: New Models of Care • NWL: North-West London • PCMH: Primary Care Mental Health • SPA: Single Point of Access – The Trust’s 24/7 Helpline for patients, carers and referrers: 0300 1234 244 • STP: Sustainability and Transformation Partnership

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References

• Five Year Forward View for Mental Health A report published in 2016 by the Independent Mental Health Taskforce setting out plans to transform services across England to achieve the ambition of parity of esteem between mental and physical health.

• Like Minded

A programme in North-West London intended to improve the experience of people with mental health needs.

• Shaping a Healthier Future

A programme to reshape hospital and out of hospital health and care services in North-West London, with a focus on care that is delivered closer to home and better coordinated between different organisations.

• Sustainability and Transformation Partnerships (STPs)

Partnerships between the NHS and local authorities to transform local services to address both quality and financial viability to be able to deliver integrated care that meets the needs of the whole population in the area.