Excellent care at the heart of the community

1Excellent care at the heart of the community

Annual report and strategic report 2014/15

Excellent care at the heart of the community

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You can view this report online at: www.sussexcommunity.nhs.uk/annualreport

For additional print copies of this report please contact:Nick Fairclough on 01273 [email protected]

For a copy of the 2014/15 annual accounts, which include the chief executive’s annual governance statement, please contact:Jonathan Reid on 01273 696011 extension [email protected]

Please call 01273 242096: ■ To get this report in large print or in Braille.

■ For help to understand this report in a language that isn’t English.

You can also contact us via social media:twitter.com/nhs_sctfacebook.com/sussexcommunitynhs

Sussex Community NHS TrustBrighton General Hospital, Elm GroveBrighton BN2 3EW01273 696011www.sussexcommunity.nhs.uk



ContentsAnnual report

Introduction 4

Our year of achievement and success 6

The people we serve 18

Who we are, what we do 21

Engaging with our communities 31

Engaging with our staff 36

Managing the trust 42

Strategic report 48

Annual governance statement 51

Remuneration report 64

Sustainability report 70

Social, community and human rights 74

Business Information 77

■ Financial review 77

■ Performance 79

4 Excellent care at the heart of the community

Welcome to our annual report and strategic report for 2014/15.

Introduction

It has been an exceptionally busy year for us as we respond to the ever-increasing demand

for our services and map out our future direction.

We used to speak about ‘winter pressures’ but in fact the pressures never relent. The

population is growing, people are living longer and there are higher levels of ill-health,

especially long-term conditions.

More care is now provided in the community – in people’s homes where they prefer to be cared

for, when just a few years ago they would have more likely been cared for in an acute hospital.

As the largest community health and care provider in the area we’ve risen and continue to

rise to these multiple challenges. We’ve strengthened our teams to provide more care to

more patients across the communities we serve in West Sussex and Brighton & Hove, whilst

ensuring that we provide care which is safe, caring, effective, responsive and well-led. Quality

is always our top priority.

In the Five Year Forward View, published in October 2014, the chief executive of NHS England

Simon Stevens described how and why the NHS needs to change, what this change might

involve and how we can achieve it.

The shift of care into the community is central to his vision, yet in fact around 90 per cent of

people’s contact with the NHS is already in the community rather than the acute or specialist

hospitals. This contact is either with primary care – for example, someone’s GP or local

pharmacy – or with services run by community organisations like us.

This annual report gives you a snapshot of our achievements and successes throughout the

year (see pages 6 to 17). With award winning teams and services that are held up by NHS

England as models of best practice we truly live and breathe our values as we deliver our

vision of excellent care at the heart of the community.

Our annual report is an expression of our commitment to be open and accountable to the

communities we serve.

For the people who use our services: In December we were inspected by the Care Quality

Commission (CQC), the independent health and social care regulator in England. In March

the chief inspector of hospitals published his report and overall we achieved a Good rating.

The process was described as “One of the best inspections seen in NHS trusts in the South”

by the NHS Trust Development Authority (TDA) who provide support, oversight and governance

for all NHS trusts.


Our Good CQC rating can give confidence to the communities we serve that we provide

a high standard of care, and gives us added momentum as we move towards the

achievement of our objective to become an NHS foundation trust.For our staff: They have risen to the challenge of managing pressures and delivering safe

and effective care whilst ensuring every penny of taxpayers’ money is spent wisely. Our teams

are working efficiently and effectively to provide better outcomes and experience of care.

Our CQC Good rating is an independent recognition of the quality of care we provide and

our staff can be immensely proud of how much we’ve achieved and of the services we deliver.

The CQC commented how effectively our staff live and express our values.

For our partners and commissioners: We have demonstrated our success and

innovation through the awards we have won and our sustained good performance.

A prime example is our work in partnership with Docobo. By using online technology

we have managed to reduce admissions to hospital by 75 per cent, supporting people’s

independence and wellbeing in the community and delivering value for money for the

wider health and care system.Our end of life care services were rated Outstanding by the CQC for their responsiveness,

and in particular, enabling up to 80 per cent of people to die in their place of choice.

For our members: We keep in touch with our 4,200+ public members on our latest

news and developments in our journey to become a community NHS foundation trust.

We aim to be authorised by Monitor, the regulator of NHS foundation trusts, in 2015/16.

More information about becoming a member is available from our website:

www.sussexcommunity.nhs.uk/ft.We hope you enjoy reading this annual report, and always welcome your comments

on our work.

With best wishes

Sue SjuveChair Paula HeadChief executive


APRIL MAY

Our year of achievement and success

‘T hank you’ volunteers

The trust and the people we serve benefit hugely from the commitment of more than 550 people

who volunteer to support our work.

So during National Volunteers’ Week our teams hosted a

number of events to

thank them for their ongoing

dedication and support.

Proud to careOur Brighton & Hove community neurological

rehabilitation team secured the annual Proud

to Care award for their drive to improve the

way they communicate with service users,

how they provide information and use patient

feedback to continuously improve.

Living our values

We launched our core values to underpin and shape the way we all behave and

interact with our colleagues, patients and the public. They help us to achieve our

overall vision: excellent care at the heart of the community.


SPRINGAPRIL TO JUNE 2014

JUNE

Hearing the patient’s story

Anne-Marie’s fear of dental treatment

makes accessing care a big problem for

her. She finds ‘high street’ dentists don’t

give her the time or the attention she

needs, and after struggling for years she

sought advice from her GP, who referred

her to our Special Care Dental Service.

When she came to talk to our trust board

in April she praised the ‘exceptionally

friendly, reassuring’ manner and ‘calm

professionalism’ of the team. She

describes the service as ‘wonderful’ and

the nurses as ‘absolutely outstanding’. She

feels that the service has ‘empowered’ her

and that she has ‘learned to be strong.’

Caring for carersA growing number of carers living in West Sussex are enjoying the support of our innovative carers’

health team.

This unique service is led by a team of clinicians who visit carers in their own home to check their health and wellbeing. The team offers advice and enables carers to maintain or improve their health.

Developing our leadersGood leadership is central to our progress. We looked at how to strengthen our culture at our annual leadership conference, hearing from national speakers and arranging development workshops to improve knowledge and skills. And we have developed a quarterly leadership exchange programme to bring our leaders together, explore national and local priorities and take part in learning and development sessions.


JULY AUGUST


Investing in the futureWe’re proud to pioneer care certificate training

to enable healthcare assistants to become

nursing assistants. Launched in response to

the 2013 Cavendish review, our programme

includes a five-day taught course and

practice-based assessment, and has supported

over 100 staff to progress in their career.

Community nursing at it’s best

In our magazine

Trust Talk we

highlighted the work

of our community

nursing teams.

They play a crucial role caring for some of the most

vulnerable people in our communities – housebound

patients who have a long-term health condition

and/or are frail elderly. We support patients to

care for themselves and promote their health and

wellbeing, helping them stay out of hospital and retain

independence in their own homes.

More health visiting

As part of the NHS England health visitor implementation

plan we have trained over 100 health visitors in West Sussex since

2011, reinforcing our work to give young children the best possible

start in life.

Health visiting is part of the Healthy Child Programme, provided

to all families with children under the age of five.


SUMMERJULY TO SEPTEMBER 2014

SEPTEMBER

New MSK contractWe’re pleased to be part of the newly formed Sussex musculoskeletal (MSK) partnership

designed to transform care for patients with joint, bone and muscle pain in Horsham, Mid Sussex

and Brighton & Hove.

By working in partnership we aim to ensure patients access the right

service for them at the right time. And in the Coastal area of

West Sussex we have been working with our clinical commissioners

as they consider options for the future

of these services in their area.

Join our FT club Our foundation trust (FT) team has been actively recruiting members of

the public to become FT members, for example by mingling with the throng at the annual Crawley MELA.

More than 5,000 people attended along with other

community groups and partners.

Our current public FT membership figure stands at around 4,300. See details on how to join for free: www.sussexcommunity.nhs.uk/ft.

Nursery celebrations

Our Hilltop nursery in Brighton

achieved the Healthy Choice award for the second time.

And in Crawley, our Rainbow

nursery received a ‘Good’ rating in their latest Ofsted report.

Hearing the patient’s story

Mrs Stokes spoke to the trust board in September about her experiences when her father was on our Viking ward at Crawley Hospital. She praised our team for their sensitivity to the family’s needs, their professionalism when her father needed emergency care and for managing the discharge process so well. “They were fantastic. Nothing was too much trouble, and care at all times was delivered with happy good grace.”


OCTOBER


A top place to workWe’re proud to be ranked by the Health Service

Journal amongst the best 100 places to work in

the health sector in England, especially because

this achievement is based upon the feedback

from our staff in the confidential annual NHS

staff survey.

One Call One Team winOur innovative One Call One

Team service won the Kent, Surrey and Sussex (KSS) Leadership

Collaborative award.

One Call offers a single point of access for professionals and the

public via a 24/7 telephone service. Made up of nurses, therapists, admission avoidance matrons and social workers One Team

then offers urgent and safe care to patients at home to help avoid hospital admission.

Largest study In the largest study of its type, our

multiple sclerosis team is doing a great

job to support lead researchers from

Liverpool to identify factors that affect

the quality of life in patients who have

neurological conditions and how we

can improve their care.


AUTUMNOCTOBER TO DECEMBER 2014

NOVEMBER

Getting going

Sandy was housebound due to weakness

in her knee, but our falls team facilitated

practical exercises to deal with the

problem and referred her to our Time to

Talk talking therapies service to help her

overcome a fear of falling. Six months later

Sandy was enjoying a 45 minute walk with her dog!

See how we do it!Our West Sussex family nurse partnership

(FNP) team hosted a visit by Kate Billingham CBE, the international

ambassador for FNP at the University of Colorado with three senior health

ministers from Norway.

The Norwegian’s government’s health department were keen to see

our service in action as it plans to launch its own programme.

Care environments amongst the bestThe quality of the care environment at our eight community hospitals ranks with the best, said the patient-led assessment of the care environment report (PLACE) published by the Health and Social Care

Information Centre.

The review covers four key areas: 1) cleanliness 2) food & hydration 3) privacy, dignity & wellbeing, and 4) condition, appearance & maintenance. In three of the four areas our scores are above the national average, exceeding 99 per cent in the cleanliness category.


Brilliant staff

Our annual staff achievement awards scheme celebrates the brilliant work of our staff and recognises long-term commitment to the NHS. The 2014 chair’s award went to our estates and facilities team, made up of over 300 staff. Other awards included: excellence in customer service, initiative, quality, outstanding commitment and behind the scenes.

Proactive care at its best!Two elderly sisters both aged 100+

were referred to our proactive care

service when one was admitted to

hospital leaving the other alone and

at risk. We quickly arranged emergency

care for the sister still at home and then

co-ordinated a temporary placement

for her at a local nursing home.

Both sisters were later able to return

home thanks to the ongoing support of our team. Our therapists assessed their

home for new equipment and have helped them regain strength and balance to

help avoid falls. We have plans in place for both sisters and these are made

available to the ambulance service which helps the sisters remain at home and

in control of their health.

The success of our innovative proactive care approach has been confirmed

by a 30 percent reduction in the number of people that need to go to hospital

during a crisis when a proactive care plan is in place.



DECEMBER

Hearing from our users

Alfie has complex health needs and uses a range of

our services including paediatrics, children’s nursing, occupational therapy, speech

and language therapy, physiotherapy, specialist

dental services and wheelchair services.

He came with his mother to speak with the trust board in

November. His mother praised the quality of Alfie’s care, but

she said it’s increasingly difficult to access some treatments and facilities as he grows

up. However, they feel well supported and had built a

good, friendly rapport with our services. In response we’ve reviewed the ways patients have a ‘named clinician’ to

coordinate care and invested to improve the environment

at Horsham Hospital.

National acclaim for sustainability

Working in partnership with Capita we won the sustainability achievement award at the annual Institute of Healthcare Engineering and Estate Management Awards, followed later by a triple win at the NHS Sustainability Awards, where our innovative sustainability strategy, Care Without Carbon, and its staff engagement campaign, Dare to Care, scooped awards in three categories: human resources, clinical and behaviour change.We’re making great progress towards our goal to achieve a 34 percent reduction in CO2 emissions by 2020, and aim ultimately to be carbon neutral.

Support for stammeringTo mark International Stammering Day our West Sussex speech

and language therapy teams worked to raise awareness of the

need for early referral to their service for children who stammer.

Stammering commonly starts between the ages of two to five

years but it can occur earlier or later in life.

Early intervention at a young age has the best outcome and can

help prevent a lifetime of stammering. Our team have helped

Ollie who used to be reluctant

to ask questions at school. He

is now a very confident little boy

who is comfortable talking to

people and is happy to put up

his hand in class.

AUTUMNOCTOBER TO DECEMBER 2014


JANUARY


We’re GOOD!

The quality of our care was rated as Good by the

independent Care Quality Commission (CQC)

following their inspection of our work.

This confirms that our services are safe, effective,

caring, responsive and well-led. The NHS Trust

Development Authority which supports NHS trusts

in their development said: “It is one of the best

inspections that we have seen in NHS trusts

in the South.”

As part of their inspection the CQC rated our

end of life care as Outstanding. These services

were also commended at the national Quality

in Care Oncology Awards and are highlighted

by NHS England as a model that other

organisations can learn from and follow.

Most improvedWe won the most improved

community provider award at the prestigious Kent, Surrey and Sussex Academic Health Science Network Awards in recognition of our patient

experience programme and the work of our matrons and community

teams to provide better care.

Innovate to succeed

Our pilot project with eight care

homes in West Sussex and in

collaboration with the digital

telehealth company Docobo used

online technology to improve

care for the patients involved

and cut hospital admissions

by 75 per cent. Our success

secured the enhancing innovation

through collaboration award at

the prestigious Kent, Surrey and

Sussex Academic Health Science

Network Awards.


WINTERJANUARY TO MARCH 2015

FEBRUARY

Winter wondersOur teams worked exceptionally hard to manage the unprecedented surge in demand for health

and care services last winter.

In line with our winter plans we invested to strengthen our community teams and admission

avoidance and rapid response services. We also put in place new systems to monitor and manage the daily pressures. Our staff did a

magnificent job and we’re grateful to them for their commitment and dedication.

T ime to Talk successOur talking therapies service Time to Talk in Horsham and Mid Sussex was identified by NHS England as a national good practice site for others to look to and learn from.

We also developed the service across West Sussex so that people can now refer themselves directly rather than going via a GP. The service has some of the best rates in England for supporting people to get back to work after a period of sickness absence associated with anxiety or depression.

Best for breastfeeding

Brighton & Hove is the best place in

England for children who are exclusively

breastfed at 6-8 weeks of age. This

success reflects the hard work of our

breastfeeding teams and health visitors

along with other partners in the city –

and of course of local parents!


MARCH

Good staff survey resultsNearly 1,700 staff completed the

confidential staff survey. Our scores

are better than average in 25 of the

survey’s 29 key findings and have

improved each year since 2010.

Our staff engagement and

satisfaction measures rank

amongst the best in England.

Staff at our leadership exchange event enthusiastically backed the campaign

launched by Dr Kate Granger, a terminally ill doctor, to encourage

health workers to introduce themselves to patients.

New approach makes a difference

Our Brighton & Hove integrated primary care teams are part of a new Better Care Fund approach to look after the city’s most frail and vulnerable patients. The aim is to provide better coordinated care for people with multiple long-term conditions in their own homes.



Caring for looked after children

Our Trust Talk magazine explored our amazing team in West Sussex who ensure children and young people who do not live with their birth parents receive the right health and care support. Many have special needs.

Bognor hosts the mayorThe town’s mayor visited us

at Bognor Hospital to see how

we either support people to live

healthy, independent lives at

home or provide quality care

in an inpatient bed in our eight

community hospitals across

West Sussex. The visit was

supported by the Friends of

Bognor Hospital who generously

support our work.

Hearing the patient’s

story Each trust board meeting

hears directly from a patient about their experience of our work. In January Kerry spoke about her care at our Sussex

Rehabilitation Centre. She said our staff are “welcoming

and kind” and have guided her carefully through the process. “It’s not easy,” she said. “So

being included and reassured is very empowering!” The team has done a great job to produce

her prosthesis and Kerry is delighted with the outcome.

The team were runners-up in the best prosthetist category at the Limbless Association Prosthetics and Orthotics

annual award.

WINTERJANUARY TO MARCH 2015


Around 1.1 million people live in the area we serve in West Sussex and Brighton & Hove. Our main population lives in the following clinical commissioning group (CCG) areas:

■ NHS Coastal West Sussex CCG, covering Arun, Adur, Bognor Regis, Chanctonbury, Chichester and Worthing, and including 56 GP surgeries and more than 482,100 residents.

■ NHS Horsham and Mid Sussex CCG, covering Burgess Hill, East Grinstead, Haywards Heath, Horsham and the surrounding area, and including 23 GP practices and approximately 225,000 residents.

■ NHS Crawley CCG, covering Crawley and the surrounding area, and including 13 GP practices and approximately 120,000 residents.

■ NHS Brighton & Hove CCG, covering the city and including 47 GP practices and approximately 300,000 residents.

■ We also provide services to people living outside of these areas, including those in East Sussex.

Given the length and breadth of our work, it is very likely that most of our local population will come into contact with our services in some way at some time – as a patient; as a patient’s carer, relative, neighbour or friend; or through a link with one of our staff members or volunteers.

Measuring health and wellbeingHow long people can expect to live for – life expectancy - is often used as a way to measure the health and wellbeing of a community, and life expectancy has generally been increasing over recent years. However, figures published by Public Health England, early in 2015, show:

■ Over the last 30 years there has been an upward trend in life expectancy at older ages in England. Life expectancy among those aged 65 has increased at an average rate of 1.2 per cent per year for men and 0.7 per cent per year for women.

■ Within England, female life expectancy at age 65, 75, 85 and 95 fell in 2012, and for males it fell at ages 85 and 95, and remained static at ages 65 and 75.

■ It is too early to say whether this represents a slowing down in the upward trend or the start of a downward trend.

We know as well that life expectancy is going up faster among people who are financially better off, which means health inequalities between rich and poor are widening. This affects us as we work in some of the wealthiest parts of England, but also some of the most deprived.

Headlines from the Public Health England profile for West Sussex 2014Health in summary

■ The health of people in West Sussex is generally better than the England average.

■ Deprivation is lower than average, however about 13.5 per cent (19,100) children live in poverty.

Living longer ■ Life expectancy for both men and women is higher than the England average.

■ Life expectancy is 8 years lower for men and 6.7 years lower for women in the most deprived areas of West Sussex, such as Littlehampton, than in the least deprived areas, such as Chichester.

Child health ■ In Year 6, although 14.7 per cent (997) of children are classified as obese, this is better than the average for England.

■ Levels of teenage pregnancy, breastfeeding and smoking at time of delivery are better than the England average.

Adult health ■ In 2012, 20.1 per cent of adults were classified as obese, better than the average for England.

THE PEOPLE WE SERVE


■ The rate of self-harm hospital stays was worse than the average for England.

■ The rate of smoking related deaths (1,363 per year) is better than the average for England.

■ Estimated levels of adult physical activity are better than the England average.

■ Rates of sexually transmitted infections and TB are better than average.

■ Rates of new cases of malignant melanoma and excess winter deaths are worse than average.

Local priorities ■ Priorities in West Sussex include children and families, workplace health and dementia.

■ For more information see www.westsussex.gov.uk or jsna.westsussex.gov.uk.

Headlines from the Public Health England profile for Brighton & Hove 2014Health in summary

■ The health of people in the city is varied compared with the England average.

■ Deprivation is higher than average and about 19.7 per cent (8,600) children live in poverty.

Living longer ■ Life expectancy for men is lower than the England average, for women it is about the same as the average.

■ Life expectancy is 8.7 years lower for men and 6 years lower for women in the most deprived areas of the city than in the least deprived areas.

Child health ■ In Year 6, 13.6 per cent (289) of children are classified as obese, better than the average for England.

■ The rate of alcohol specific hospital stays among under 18s was worse than the average for England.

■ Levels of breastfeeding and smoking at time of delivery are better than the England average.

Adult health ■ In 2012, 12.8 per cent of adults were classified as obese, better than the average for England.

■ The rate of self-harm hospital stays is worse than the average for England.

■ The rate of smoking related deaths (391 deaths per year) is worse than the average for England.


■ Estimated levels of adult smoking are worse than the England average. Estimated levels of adult excess weight and physical activity are better than the England average.

■ Rates of sexually transmitted infections are worse than average.

Local priorities ■ Priorities in Brighton & Hove include alcohol and substance misuse, deaths from cancer, and mental health and wellbeing.

■ For more information see: www.brightonhove.gov.uk or www.bhlis.org.

Improving health and wellbeingCirculatory diseases including heart disease and stroke are the main cause of death in our area. Smoking, poor diet, sedentary lifestyle/lack of exercise and drinking alcohol at unsafe levels are lifestyle risk factors associated with these diseases.

Cancers are the second largest cause of death, followed by respiratory diseases including chronic obstructive pulmonary disease (COPD). This is caused by long-term damage to the lungs, usually associated with smoking.

There has been a gradual decline in deaths caused by these main diseases. This may be a reflection of general improvements in health, people living healthier lifestyles and improved healthcare treatments. But many deaths could be prevented through interventions within the health system and by people changing their lifestyle – stopping smoking, for example and diagnosing cancers earlier.

We continue to work closely with our local health and care partners to help improve the health and wellbeing of the communities we jointly serve. In the process, we support the priorities set by the two local health and wellbeing boards (HWBs) in the area we serve:

■ The West Sussex HWB is focusing on three key areas: dementia, children and families, and workplace health.

■ The Brighton & Hove HWB is focusing on delivering an integrated model of care for frailty across the city, taking a broad definition of frailty to mean ‘a state of high vulnerability for adverse health outcomes, including disability, dependency, falls, need for long-term care, and mortality.’


IntroductionIn the Five Year Forward View, published in October 2014, the chief executive of NHS England Simon Stevens described how and why the NHS needs to change, what this change might involve and how we can achieve it.

His prognosis built upon his first observations as he started his new job with NHS England in April 2014 when he said: “An ageing population with more chronic health conditions, but with new opportunities to live as independently as possible, means we’re going to have to radically transform how care is delivered outside hospitals.”

His summary reflects what we know about people’s preferences. If they’re unwell people generally want to be cared for in or near their own homes, close to family and friends and the things they are familiar with. They prefer not to go to hospital if this can be avoided, and if they need a hospital stay they want support to return to home as quickly as possible.

In fact around 90 per cent of people’s contact with the NHS is in the community rather than the acute or specialist hospitals that so often dominate the news and political agendas. This contact is either with primary care – for example someone’s GP or local pharmacy – or with services run by community organisations like us - Sussex Community NHS Trust (SCT).

Who we areWe’re the main provider of community NHS health and care across West Sussex and Brighton & Hove.

Our teams deliver essential medical, nursing and therapeutic care to over 8,000 adults, children and families a day.

We employ 4,420 staff (3,422 wte) as at 31 March 2015. Most of them are expert clinicians (doctors, dentists, nurses and therapists), and

they get great support from specialists in areas such as governance, medicines management, information technology, human resources, finance, facilities and estates.

Amongst our teams we have: ■ Health visitors working with families with young children.

■ School nurses caring for the school-age population.

■ Specialist doctors, nurses and therapists looking after children, young people and adults with complex health needs, mobility problems and long-term health conditions.

■ Multidisciplinary and multi-agency community teams caring for the frail elderly.

■ Specialist clinicians caring for people at the end of their lives.

What we doWe care for some of the most vulnerable people in our communities across the entire age range. We aim to support them to manage and adjust to changes in their health and to enable them to live as healthily and independently as possible. In our vision – the goal that guides us in all we do – we speak about excellent care at the heart of the community.

We care for people mostly in their own homes or as close to home as possible in settings such as our community hospitals, and the clinics and centres we work in and from. In all cases we put the people we care for at the centre of everything we do, wrap care around them and work closely with local GPs, hospital trusts, local authority social care partners and voluntary organisations to ensure they get the support they need.

Our strategic goalsOur three strategic goals guide our work and help set our agenda. They offer the people we care for and our other stakeholders a clear idea of what to expect from us:

WHO WE ARE, WHAT WE DO


■ We’ll provide excellent care every time to reinforce wellbeing and independence.

■ Working with our partners we’ll personalise services for the individual.

■ We’ll be a strong and sustainable business, grounded in our communities and led by excellent staff.

To guide our work as we seek to achieve our strategic goals we’ve adopted a set of core values and behaviours. We work hard to make them part of our everyday culture – simply put, they describe the ways in which we do things:

■ Compassionate care – caring for people in ways we would want for our loved ones.

■ Working together – forging strong links with the people we care for, the wider public and our health and care partners, so we can rise to the challenges we face together.

■ Achieving ambitions – for our users, our staff, our teams, our organisation.

■ Delivering excellence – because the people we care for and our partners deserve nothing less.

We’re pleased the CQC inspectors commented how our staff have engaged and embraced our values as well as the outcomes from our “Sit & See” process. Through our “Sit & See” we can observe acts of kindness that can make a big difference to a patient. Feedback has been encouraging with regard to the positive behaviour of our staff. The method has been developed locally and successfully piloted in our services. Our inpatient wards now carry out a “Sit & See” observation twice a year.

We know we need to continue to transform the ways we work to be sustainable going forward, and to maintain the support and confidence of the people we serve. We need to continue to provide top quality, personalised services whilst becoming more efficient in the ways we work so as to get best value from the money we receive from our commissioners.

In the process we believe we can show how the community services we provide are a crucial part of the answer to the problems the health and

care sector faces as mapped out in the Five Year Forward View – rising demand; more people living with multiple, complex conditions and financial constraints. Providing care at home and in other community settings is what service users say they need and want, and is the only way the system as a whole will deal with the demands it faces.

Our clinical care strategyCentral to everything we do is our clinical care strategy. This sets the direction for the clinical care we provide over the next five years, presents our vision, values and objectives, describes our place in the wider networks of care locally, shows how we will maintain and improve accountability and offers an overview of our plans for service development. Above all else, it shows how our commitment to clinical quality overrides all other commitments.

As one of the largest community trusts in England – and in line with our vision of excellent care at the heart of the community – we aim to provide excellent services for our local communities.

Our clinical care strategy shows our ambitions to be seen as a centre of excellence for the delivery of community health and care, to maintain high standards, to continuously improve and to respond to changes led by our commissioners and patients. Our intention is to provide - and be proud of - high quality clinical care, delivered by highly skilled staff across the three dimensions of quality: safety; clinical effectiveness; and the care experience of the people who use our services.

In the early months of 2015 we reviewed the strategy and refreshed its scope and structure, with specific focus on care pathways – looking at our patients as individuals and meeting their whole health and care needs in a personalised way, by our multidisciplinary and multi-agency teams.

Further engagement with our staff and the communities we serve will continue during 2015. This work will bring our strategy up-to-date with national developments such as NHS England’s Five Year Forward View and local requirements, such as the annual plans of our commissioners. Health and care will be built around the needs of


our local populations to ensure we continue to adapt, meet local needs effectively and provide care which is excellent.

Clinical pathways – how people will be supported with their health and care needsUrgent careWe’ll work effectively with the wider urgent care network. Our key specialist emergency centres in our partner acute trusts will be supported by our full range of community services e.g. urgent treatment centre and minor injury units. We’ll continue to work hard to prevent unnecessary hospital admissions through our admission avoidance, falls prevention and rapid assessment teams.

We’ll be more coordinated in urgent out of hours care. We’ll work with commissioners to streamline the range of services on offer to people so that there is one single point of access for all community and primary care needs out of normal working hours.

As recognised in the Keogh review of Urgent Care (2014), those people with urgent but non-life threatening needs must receive highly responsive, effective and personalised services outside of acute hospitals. We will deliver this care in or as

close to people’s homes as possible, minimising disruption and inconvenience for patients, their families and carers.

Long-term conditionsFor people with long-term conditions i.e. diabetes, heart failure and respiratory conditions, we’ll provide general and specialist help and support right from diagnosis including support for their carers and their families. We’ll ensure they have a comprehensive plan that addresses all their physical, psychological and spiritual needs. We’ll provide regular contact as agreed and provide education on the condition(s) to fully empower them to manage their condition themselves and overcome hurdles along the way to avoid deterioration.

We’ll ensure that the pathway between initial diagnosis in secondary care i.e. at hospital, through to on-going care in the community is seamless and led by what matters to the person and not what diagnostic category they fit into. Organisational boundaries will be less important as we move towards one health record shared between organisations and is owned by the patient.

Short-term conditionsFor people with short-term conditions e.g. musculoskeletal injuries, infections, mental health

24 Excellent care at the heart of the community24

deterioration, we’ll assess them in a timely and coordinated way, involving a range of professionals as required based on their individual needs. We’ll agree an individual care plan and explain who is coordinating their care. They’ll be provided with a named point of contact for all queries. The care plan will have their views included and they will own the plan.

Supporting residential and nursing homesThis area is under increasing pressure. The care provided by some struggling providers is substandard and we’ll work with our partners to challenge poor practice but also increase their skills and confidence. By working in partnership we’ll provide training, support and expertise to improve the care of residents and up-skill the workforce. A recent example is our work with care homes and Docobo – together we’ve reduced admissions to hospital by 75 per cent. See page 14 for further details.

DementiaOne in three people over 65 years will develop dementia before they die. We’ll re-focus our work

to ensure that the growing needs of people with dementia are well planned and clearly defined. We’ll develop mental health services to care for people in their own homes. This will require up-skilling of staff to be able to deal with these complexities.

PreventionThe Wanless Social Care Review in 2002 warned if we didn’t take prevention seriously we’d end up with a significant number of frail people with a wide range of preventable health conditions. Nationally, we spend 70 per cent of the health budget on people with long-term conditions, most of which are preventable.

In our clinical pathways, we’ll use every interaction as an opportunity to educate people, promote wellbeing and prevention to avoid illness. This will range from advice on how to stop smoking, through to reminders to undertake age related screening tests, and provide support around diet and fitness. Our staff will not only focus on the medical condition they’re treating but will look at the whole person in front of them and provide health and care advice and support to promote independence.


Proactive managementWe’ll continue to develop our focus on proactively identifying people who are becoming unwell through our multidisciplinary and multi-agency teams to avoid deterioration in their health and unnecessary admissions to hospital. We’ll use our local knowledge, our relationship with GPs and other partners, by using technology to accurately target our attention on people as they start to become unwell and ensure we have robust care plans in place to prevent them deteriorating.

SafeguardingSafeguarding of vulnerable adults and children will be embedded in the work of all our staff. In line with the Care Act 2014, we’ll increase our awareness of safeguarding of vulnerable adults and develop our training and recognition of child protection in our communities.

Providing care when people need itPeople don’t just become unwell or need extra care and support between Monday to Friday, so we’ll develop services that meet the needs of people when they need them seven days a week. We’ll work efficiently to make sure our efforts are focused on the times of the week when the need is greatest and move away from the model that people’s needs must fit in with the traditional weekday working model.

Delivering our careAround local populationsWe’ve divided the area we serve into 17 local populations which we call localities. We’ll deliver our individual focused health and care through these local populations which will include a number of GP surgeries. Each locality contains between 50,000 to 100,000+ adults and children.

Every person will be supported by primary care e.g. GP, dentist, optometrist, pharmacist and more generally supported by community services e.g. community nursing, domiciliary care, health visiting, mental health and social care. They’ll be supported by our integrated care teams including the voluntary sector and specialist community services.

For each group of localities (c.100,000 people) there is a local community hospital supporting and caring for people. And we’ll be working alongside acute hospitals who each support a group of our towns and cities.

Organisational structure and consistency of careOur organisational structure will be reshaped and developed to ensure we have the right staff, with the right skills, to meet the needs of the population of each locality. There will be


local joined-up management of these services which will be fully coordinated with our partners in social care, mental health, the voluntary sector and other health and private providers. Working together with adults and children we’ll reduce or eliminate the problems associated with transitioning between children and adult services.

We’ll ensure there is consistency of professional practice and standards of our staff across our localities. This will be achieved from peer support across the organisation, opportunities for professional practice training and development, supervision from staff in different localities and the flexibility to move our staff between localities to develop their skills and competencies.

More care closer to homeThe aim of the model is to deliver excellent care at home or as close to home as possible. By structuring our services around the needs of each locality we will be in a better position to respond quicker to changes in people’s health and care needs but also to ensure we have the right services nearby to prevent health and social care deterioration.

Carers, care coordinators and care planningAs more people are now living on their own or in residential and care homes, we’ll develop services that support local carers to look after people but also to look after themselves. We have a large number of unpaid carers (there are 1.2 million full-time unpaid carers nationally) and the needs of those carers is currently unmet. We’ll focus our services on identifying carers, recognising their needs and supporting them, together with our partners, to energise them to continue caring in a supportive manner. An example of this is our carers health team in West Sussex, launched in 2013. See our website for further information: www.sussexcommunity.nhs.uk/carers.

All the people whom we care for will have a dedicated care coordinator. This member of our team will be the named contact for the person and they’ll be the key point of contact for other professionals who wish to gain and share information about the individual. In some situations the patient themselves, or the carer or parent will become the care coordinator.

Not only will care be coordinated between professionals and the individual, but it will also be coordinated along the length of the person’s journey over time. People will only have to tell their story once instead of having to explain again and again to different services and organisations what they need every time.

Care planning will focus on the needs of the person. They will be involved in designing and agreeing their plan throughout. People will be asked what really matters to them, rather than what is the matter – as the focus of our assessments move from identifying a ‘diagnosis’ to discovering what the ideas, concerns and expectations are of the person themselves. People will be equal partners in assessments and the holistic view of their physical, mental and spiritual health will be addressed.

Working together Increasingly we’ll be looking to partner with other organisations to provide true holistic individualised care. One important partnership is with primary care – which includes GPs, practice nurses and local pharmacies and optometrists. The benefit of grouping our services around local GP surgeries is that we can work in partnership with primary care staff to deliver joined up and coordinated person-centred care.

Benefits will include our ability to train practice nurses in community healthcare tasks e.g. chronic skin condition management and practice nurses can train our staff in management of chronic diseases. This will allow greater flexibility in caring for people as professionals will be able to work together to address the needs of each patient in a holistic manner supporting those that visit the surgery and those that are at home.

Improved patient recordsEnabling different professionals, different teams and different organisations to be able to work together will help develop our information technology capability so that information can be shared easily and quickly. We’ll use IT to enable us to deliver care in a more coordinated way.

As we increasingly move towards a shared patient record, it will become easier for all health and


care staff to fully support each person. Using mobile devices such as tablet computers, the person’s full records will be available at each visit so professionals have access to up-to-date information. This will provide a more responsive service to patients and free up more time to spend with patients as admin work is reduced.

Our CQC inspectionIn March 2015 England’s chief inspector of hospitals rated the overall quality of services provided by SCT as Good.

The rating follows the inspection last year by the CQC, the independent regulator of all health and social care services in England, and offers compelling evidence to the communities we serve that our services are safe, effective, caring, responsive and well-led.

The CQC inspects the quality of work delivered by health and care providers like us and publishes a rating to describe this quality. As well as rating the overall quality of services we provide as Good, the CQC:

■ Rated our end of life care as Outstanding for how it responds to people’s needs.

■ Said some elements of our inpatient care services require improvement, including medicines’ management, training in the care of people with dementia, record keeping and care planning.

A summary table of the results is shown below.

The inspectors looked at quality of care in four of our main services areas: community health services for adults; community health services for children and young people; end of life care and community inpatient care.

In the process they found: ■ Good practice to ensure safe and responsive care, and some exceptional and innovative practice.

■ Caring staff who consistently provide good care.

■ Clear leadership, a positive culture and good engagement.

■ Partnership working that protects vulnerable people from abuse.

■ Staff that feel valued and supported by their managers, supervisors and the trust board.

The CQC equally said they found a committed and caring workforce that was meeting the needs of all those people safely and effectively. However, as part of the CQC’s recommendations, the inspectors advised us to:

■ Take new steps to boost recruitment and increase staffing levels.

■ Work with our partners to improve the quality of parts of the estate we work from.

■ Review the roll-out of IT systems that support patient care.


We’ll work hard to maintain the momentum that helped us achieve a Good rating and helps show the people we serve that our services are safe, effective, caring, responsive and well-led. We’ll build on our strengths and address with extra clarity and energy the inspectors’ recommendations for improvement. This process is already well underway.

During the inspection itself individual comments made by CQC inspectors include:

■ I would be happy for my mother to be looked after on this ward…

■ Staff saw the inspection as part of a journey of quality improvement and not a tick box process…

■ All of your hospitals I have visited are very clean…

Our plans to become an NHS foundation trustCentral to our vision of excellent care at the heart of the community is our plan to become an independent community NHS foundation trust (FT).

We’re well on the journey and following our CQC rating in March we’re aiming to become an FT in 2015/16.

As an FT, we’ll have more independence from government and more freedom to set our own priorities through discussion with our staff, our public FT members and our governors. This makes FTs directly accountable to their communities and staff, and so becoming an FT will enable us to become more responsive to our communities in new ways.

We’ve recruited over 4,200 members so far (we aim to have at least 5,000 members by the autumn) and have produced three members’ newsletters.

Join today: members are at the heart of the FT idea. By being a member you can have a say in how the trust is run.

■ Call us on 01273 242127 ■ Visit our website www.sussexcommunity.nhs.uk/ft

■ Email us [email protected] ■ Write to us FREEPOST RSXG XTCJ BBBT, Foundation Trust Membership Office, Brighton General Hospital,Elm Grove, Brighton BN2 3EW.

Accommodating our future We provide health and care services mostly in people’s own homes, but we also work from a number of locations in West Sussex and Brighton & Hove, including 60 main sites, and there is inevitably variations in the age and quality of these buildings. Most of our sites are owned by other organisations, such as the national body NHS Property Services.

Our five-year estates strategy aims to improve the quality of our accommodation, be more efficient with the space we use, improve options for flexible working and at the same time save money.

Part of our plan is implementing a ‘hub and spoke’ model, with the ‘hub’ a central administrative space where staff can base themselves. We aim to have six hubs in key geographical areas.


Linking to each hub will be a series of ‘spokes’, such as a health centre or GP surgeries, where staff are based and can access support and resources at the hub nearest to them, based on population need. Our spoke sites will ensure we maintain local access to our services in smaller rural towns and villages.

We have already identified four of our six main hubs:

■ Brighton General Hospital (trust headquarters and covering the Brighton & Hove area).

■ The Quadrant, Lancing Business Park (supporting the Lancing and Shoreham area).

■ Southfield House (covering the Worthing area).

■ Southgate House (covering the Chichester and Bognor Regis area).

Other hubs will be found for the Haywards Heath and Burgess Hill area and the Crawley and Horsham area.

Our estates strategy is not just about buildings but is also about how we use our space to best advantage to strengthen team working, to provide a better experience for patients and to make the most of technology to support our work. View our estates strategy from our website: www.sussexcommunity.nhs.uk/trustreports.

A-Z of services

■ Abdominal Aortic Aneurysm (AAA) Screening Programme

■ Arthritis/Musculoskeletal Service

■ Back Care Support Service for Carers

■ Bladder and Bowel Service

■ Breastfeeding Teams

■ Cancer - Health Promotion Cancer Team

■ Carers Health Team

■ Chailey Heritage Clinical Services (CHCS)

■ Child Development Centres

■ Child Death Service

■ Child Health Bureau

■ Child Health Records Unit

■ Children’s Audiology

■ Children’s Community Nursing

■ Children’s Continence Team

■ Children’s Continuing Care and Health led Short Breaks

■ Children’s Enuresis/Bedwetting Clinic

■ Children’s Hearing Team

■ Children’s Specialist Nursing

■ Chlamydia Screening Programme

■ Chronic Fatigue Syndrome/ME Service (CFS/ME Service) - Sussex Wide

■ Chronic Pain Service

■ Clinical Assessment Unit (CAU)

■ Community Equipment Services

■ Community Hospitals and Beds

■ Community Nursing

■ Community Paediatrics

■ Community Rapid Response Service

■ Community Short Term Services

■ Contraception and Sexual Health Clinic (CASH)

■ Dermatology Nurse Specialist

■ Community Adult Diabetes Specialist Nursing Service (DSN)

■ Community Diabetes Teams

■ Diabetes Education and Self Management for Ongoing and Newly Diagnosed (Desmond) Courses

■ Diagnostic Imaging Department for X-ray, Ultrasound and Bone Densitometry Services

■ Emergency Dental Service

■ End of Life Care/Palliative Care Teams

■ Expert Patients Programme

■ Falls, Osteoporosis and Fracture Prevention Services

■ Family Nurse Partnership Teams

■ Health Visiting Teams

■ Heart Failure Services

■ HIV - Community HIV Specialist Service

■ HPV Vaccination in Schools Programme


■ Immunisation Teams

■ Infection Prevention and Control

■ Integrated Primary Care Teams

■ Integrated Response Team

■ Intermediate Care Teams (ICTs)

■ Intravenous (IV) Therapy Services

■ Learning Disabilities Health Facilitation Team

■ Looked After Children Teams

■ Lymphoedema Service

■ Male Sexual Problem Clinic

■ Minor Injuries Units (MIUs)

■ Motor Neurone Disease Nurse (MND)

■ MSK (Musculoskeletal) Service

■ Multiple Sclerosis (MS) Specialist Nurse Service

■ Neurological Rehabilitation Teams

■ Night Sitting Service

■ Occupational Therapy Services – Adults and Children

■ One Call

■ One Team (North) Admission Avoidance

■ Outpatient Physiotherapy Service

■ Overnight Community Nursing Service

■ Parkinsons Disease Nurse Specialists

■ Phlebotomy Service

■ Physiotherapy for Adults and Children

■ Planned Treatment Centre

■ Podiatry Service

■ Prevention Assessment Teams (PATs)

■ Proactive Care Teams

■ Prosthetic Service at Sussex Rehabilitation Centre Brighton (SRCB)

■ Rapid Assessment and Intervention Team

■ Respiratory Services

■ Safeguarding Adults and Children

■ Saturn Centre, Sexual Assault Referral Centre (SARC) for Sussex

■ School Nursing Teams

■ Snowdrop Care at Home Team (Community Children’s Nursing Service)

■ Special Care Dental Services (SCDS)

■ Specialist Dementia Care Service

■ Specialist Health Visiting Teams – Children with Complex and Additional Needs

■ Speech and Language Therapy for Adults and Children

■ Sussex Rehabilitation Centre Outpatient Service

■ Time to Talk – Talking Therapies Service

■ Tissue Viability Service/Pressure Damage

■ Urgent Treatment Centre (UTC)

■ Venous Leg Ulcer Service

■ Wheelchair and Special Seating Services

Full information on all of our services including what they do, contact details and locations is available from our website: www.sussexcommunity.nhs.uk/services.

30

Working with organisations who speak on behalf of the people we serveHealthwatch Healthwatch England is the independent consumer champion for health and social care in England – to ensure the voice of the consumer is heard by the people that commission, deliver and regulate health and care services.

Healthwatch England works across a broad range of organisations from local and specialist partners to national health and care bodies and the government. It actively seeks views from all sections of the community, and has close ties with the many organisations that represent the public, both at a local and national level.

Healthwatch England also supports the range of local Healthwatch bodies across the country. We work closely with our local bodies, Healthwatch West Sussex and Healthwatch Brighton & Hove, welcoming their input as ‘critical friends’. As part of our ongoing relationship:

■ Local liaison representatives from Healthwatch attend our regular meetings with patient representatives hosted by our chair, Sue Sjuve.

■ We welcome Healthwatch to our events, such as our annual general meeting and meetings of the trust board in public.

■ We consulted Healthwatch about our plans to become an NHS foundation trust and obtained their support.

ENGAGING WITH OUR COMMUNITIES

Excellent care at the heart of the community 31


■ We send regular news items about the trust for inclusion in their communications.

■ We engage with Healthwatch about service changes, and seek their comments e.g. with regard to our Brighton podiatry service and our estates strategy.

Scrutiny committeesWe have equally strong relationships with our two health and overview scrutiny committees – West Sussex Health and Adult Social Care Select Committee (HASC) and Brighton & Hove Overview Scrutiny Committee (OSC).

These bodies are made up of local councillors and hold NHS organisations to account for the quality of their services on behalf of their local public.

We’ve had discussions with West Sussex HASC on many issues, delivered presentations about our work including proactive care, contributed to their themed focus on A&E highlighting the work we do to avoid unnecessary admissions to hospital, and formed part of the wider discussions and consultation on review of stroke services in West Sussex.

We have explained to Brighton & Hove OSC our estates strategy and engaged with them on several service relocations including podiatry, special care dental services and our community specialist HIV service.

Equality and diversity Improving health and reducing health inequalities is central to our work. We have a duty to recognise and meet the diverse needs and human rights of service users, local communities and staff.

Effective engagement with our more marginalised communities will help us develop a better understanding of their needs and wants, but must be done in ways that are appropriate to and sensitive of their needs and does not inadvertently serve to reinforce their marginalisation. This will both express our commitment to reduce health inequalities and support our work in this area.

A key to our success in promoting equality and equity is the strength of our partnerships with local authority partners and with local voluntary and community sector (VCS) groups that play a key role in advocating on behalf of marginalised groups.

In 2014 we appointed our equality and diversity lead who is championing our equality and diversity engagement plan with staff and our local communities. A programme of events have started, working in partnership with other NHS providers across our area, to engage with our communities to get their views about our services and to identity and eliminate any form of discrimination.

Our partnershipsWe work with a range of different people and partner organisations to offer the right care, in the right place, at the right time, by the right professional.

Foremost of course are the people who use our services, their families and/or carers. Our other key partners in 2014/15 included:

■ NHS England.

■ NHS Trust Development Authority (TDA).

■ NHS Providers.

■ Our main NHS clinical commissioning groups: Brighton & Hove CCG, Coastal West Sussex CCG, Crawley CCG and Horsham & Mid Sussex CCG.

■ Our two main council partners: West Sussex County Council and Brighton & Hove City Council.

■ GPs across our area.

■ Local NHS trusts (notably Brighton and Sussex University Hospitals NHS Trust, Western Sussex Hospitals NHS Foundation Trust, Surrey and Sussex Healthcare NHS Trust, Sussex Partnership NHS Foundation Trust and South East Coast Ambulance NHS Foundation Trust).

■ Our care partners, notably West Sussex County Council, Brighton & Hove City Council, local hospices and local residential and nursing homes.


■ Groups that can speak on behalf of people who use our services, including local Healthwatch, organised patient groups and scrutiny committees.

We thank them all for their continued and committed support in helping us deliver quality services to the communities we jointly serve.

Developing our digital communications During the year we’ve developed our social media presence, primarily on Twitter twitter.com/nhs_sct and Facebook facebook.com/sussexcommunitynhs.

For many of our service users who use or interact with our children’s, wellbeing and neurodisability services, social media is their preferred method of communication. We’ve worked with our nurseries to develop sister social media sites linked to our main sites to enable them to communicate effectively with parents.

By March 2015 we had over 900 followers and published over 920 tweets. Tweets include promoting free NHS health checks and stop smoking support, being shortlisted and winning national and local awards, and receiving a Good rating from the CQC.

We also use social media to share online videos to help people manage their own health and raise awareness of the services we provide.

Engaging with our MPsWe held our second annual meeting in Westminster with our MPs in January. It’s an opportunity for our MPs to meet with our chair and chief executive face-to-face, to hear about our plans for the future and significant work we’ve done over the past year, our response to support wider system pressures especially during the winter, and for MPs to ask us questions.

We also hosted a visit by Tim Loughton, MP for East Worthing and Shoreham, in March for him to hear about the work of our children’s services including our family nurse partnership, health visiting and school nursing teams.

A visit to 10 Downing StreetIn October our head of children’s community nursing was invited to meet David Cameron and Michael Gove at 10 Downing Street to celebrate nursing, carers and health professionals. She was nominated by the Department of Health for her involvement in maximising excellent health and wellbeing outcomes for children cared for in community settings.

She discussed with David Cameron that she wanted to see equal focus given to the younger generation in the government’s vision for the future of health services and the significant shortage of registered children’s nurses to deliver care closer to home.

Our teams host a visit with councillors at Horsham HospitalCouncillors from the Health Provision Working Group of Horsham District Council met our community, nursing and therapy teams in June to learn how we help support people to live healthy, independent lives in their own homes or in our inpatient wards.

Councillors Frances Haigh later tweeted: “Did you know 90 per cent of NHS services are provided in the community by dedicated staff such as SCT? Unsung heroes keeping us all well.”

Art students display work at Horsham HospitalCollyer’s College students visited Horsham Hospital to display their artwork at our Horizon Unit, the intermediate and rehabilitation care ward for adults recuperating after serious illness or surgery. The stunning work comprised pieces created by talented second year BTEC Art and Design students.

Dawn, ward manager at our Horizon Unit, said: “The art cheers up the ward. And it’s great to have youngsters mixing with our older patients on the ward.”


Student Sarah said: “The pieces are a good conversation starter, which I hope will encourage a positive atmosphere, helping people to recover from their illness/injury.”

See more details about our Horizon Unit: www.sussexcommunity.nhs.uk/horizon.

A Cancer Landscape – new exhibition A ground-breaking exhibition, A Cancer Landscape, hosted by us, ran in February at the ONCA gallery in Brighton during the Brighton Science Festival.

Featuring vivid and compelling representations of emotional responses to cancer by acclaimed Brighton artist Michele Angel Petrone together with bio-medical images from Wellcome Images, the exhibition aimed to promote a better understanding of cancer and our response to it.

Margaret Felton, our health promotion specialist said: “Cancer is a major part of all our lives, making it visible, talking about it and expressing our individual experience of cancer helps us to deal with it in all its forms. As part of our work in the health promotion cancer team we communicate how to reduce risks, get screened, recognise early symptoms and live with cancer.”

Find out more about our health promotion cancer screening team: www.sussexcommunity.nhs.uk/cancer.

£600 raised to improve experience of Sussex Rehabilitation CentreCoasting Together, the support group for people who use Sussex Rehabilitation Centre (SRC), including amputees and people who need a wheelchair to improve mobility, handed over a cheque for £612.

Dr Tom Farsides, friend and colleague of the late Dr Sue Eckstein and user of SRC, raised the money by running the Boston Marathon in the USA. The money has been used to provide a Wi-Fi facility to help improve patient experience for users of SRC.

SRC is based at Brighton General Hospital and provides artificial limb and other rehabilitation services to people living in Sussex. Ann, service manager, said “This is a lovely tribute to Sue and we would like to extend our sincere thanks to Tom. The installation of Wi-Fi in the waiting room benefits many patients, carers and their families whilst receiving treatment.”


View more information about SRC: www.sussexcommunity.nhs.uk/src.

Friends of The Kleinwort Centre improve the experience for our patients and staffThe Friends of the Kleinwort Centre was set up in 2013 to improve the experience for patients and staff at The Kleinwort Centre in Haywards Heath. Kleinwort is highly regarded for the intermediate care it provides to people following a period of acute hospital stay due to illness, or after surgery.

The Mayor of Haywards Heath, Councillor Sandy Ellis, visited in October. She said “My visit to The Kleinwort Centre was specifically to thank staff who established the shop for patients. Being away from home can be very difficult, so having access to some home comforts from the shop can bring real benefits. I very much enjoyed my visit and to see the wonderful care and facilities it provides for patients.”

Our physiotherapists were keen to encourage patients to improve the use of their hands before they returned home. The Friends have kindly purchased sensory balls which patients now use as well as activities such as games and crossword puzzle books to improve hand movement and the patient experience.

The Friends have also purchased garden equipment. The gardens are much appreciated by the patients – some of whom volunteer to help with some of the smaller jobs.

Read further information about care at The Kleinwort Centre: www.sussexcommunity.nhs.uk/kleinwort.

Bognor Regis War Memorial Hospital host a visit from the mayor Our staff hosted a visit from the mayor of Bognor Regis, Tony Gardiner, in February, to highlight the good work of the hospital. He saw how our community, nursing and therapy teams help support people to live healthy, independent lives in their own homes or who need a stay at one of the inpatient wards before returning home.

Brian Knight, chairman and with the Friends of the hospital since 1980, also attended. They have raised significant monies since 1953 to support and improve the experience for patients and staff at the hospital.

The tour included a visit to our rheumatology service, an opportunity to meet with staff – tea and cake provided, as well as seeing the work of the outpatients department.

The mayor said: “What a fantastic visit – to see everything the hospital has to offer. It was great to learn about the work at the hospital and to meet the staff. Their work makes a real difference to peoples’ lives.”


We’re named as one of the UK’s best places to workWe’ve been ranked by the Health Service Journal (HSJ) amongst the best 100 places to work in the health sector in England.

To select the top 100, HSJ and Best Companies Group used feedback from the annual NHS staff survey with a particular focus across seven core areas: leadership and planning, culture and communications, role satisfaction, work environment, relationship with supervisor, training and development, and employee engagement and satisfaction.

We’ve additionally been praised in the Best Place to Work report for the quality of staff supervision – a key to good quality clinical care – and for staff development and training opportunities. Our annual leadership conference and quarterly

leadership exchange events are highlighted as examples of positive engagement.

Our chief executive said: “We’ve been pleased over recent years to see distinct improvement in our staff survey results, particularly in areas such as staff engagement and satisfaction, the percentage of staff saying they would recommend the trust as a place to work or receive treatment and how far they feel staff saying they feel able to make suggestions and improvements at work.”

This recognition also builds upon our commitment as the first NHS organisation in Sussex during 2013 to adopt the Living Wage and via the work of our healthier workforce group to promote the health and wellbeing of our staff.

Positive feedback in the 2014 national NHS staff surveyWe’re pleased that the results of our annual NHS staff survey published in February 2015 have sustained improvements over the past few years.

ENGAGING WITH OUR STAFF


Our staff responded more positively than the average for the NHS across England in 25 of the survey’s 29 key findings.

Nearly 1,700 of our staff responded, offering significant insight into what it feels like to work at the trust and providing feedback that will help our board consider what works well and what needs to be improved.

Where we did well Our staff engagement measure went up again and is significantly above the average. This is a particularly important score given independent research evidence that links high levels of staff engagement in the NHS with better patient care.

Our highest scores include our staff saying: ■ They feel able to contribute to improvements at work.

■ They see effective team working.

■ They get good support from their immediate managers.

■ They are satisfied with their job.

Our staff are also more likely than the national average to say that:

■ Their role makes a difference to patients.

■ They would recommend the trust as a place to work or receive treatment.

■ Feedback from patients is used to inform decisions.

■ They would feel secure raising concerns about unsafe clinical practice.

Our results are something we should feel proud of and support what we know about the passion our staff feel about delivering excellent patient care in line with our vision and values.

Our staff have told us that there’s plenty to feel good about but also that there’s more to do to improve their experience – and in turn the experience of the people we serve. We’ll focus on those areas that need to be improved.

Where we need to do betterWe know that our staff continue to feel under pressure and the survey’s ranking in this area is worse than the national average. We equally know staff work extra hours, in common with staff across the NHS – our figure of 72 per cent reporting this is the same as the national rate.

Other issues for concern include the percentage of staff experiencing bullying, harassment or abuse from patients’ relatives or the public. This stands at 27 per cent, two per cent above the national average.

Staff communicationsTo strengthen staff engagement, we continue to improve the ways we communicate with staff, and promote good dialogue between staff and the senior team.

■ We deliver a monthly team briefing system to carry messages from the executive leadership team to frontline staff, encourage discussion in teams and generate feedback.

■ We send out a weekly message from our chief executive to all staff, linking what’s going on within the trust and locally to the bigger national picture.

■ We publish our staff magazine and employee of the month scheme, showcasing best practice and recognising achievement.

■ Members of the board and executive leadership get out across the trust visiting services.

■ Our intranet provides up-to-date information, tools and guidance to help them do their job.

■ We’re running surveys and other audit measures to evaluate the effectiveness of our internal communication channels.

Supporting our leadersWe’re committed to strengthening the skills of our leaders:

■ We have introduced training sessions to help managers with a range of management tasks, including sickness and attendance, conduct and capability, managing difficult conversations, and general recruitment training and values based interview training.


■ Launched our quarterly leadership exchange meetings for leaders across the trust to come together and hear from our chief executive through to exchanging ideas.

■ We support managers to benefit from external training programmes – for example via the Institute of Leadership and Management award delivered in cooperation with Sussex Downs College and the Kent Surrey and Sussex leadership academy.

■ We held our annual leadership conference in June 2014 with over 150 leaders enjoying lectures, workshops on managing your stakeholders through a change, quality and service transformation.

■ We hold quarterly leadership development days to help managers update their skills and improve how they manage their team’s performance.

Recruiting new talentThroughout the year we’ve been very proactive in recruiting new talent to the trust, particularly nurses.

We’ve held a number of recruitment open days at Bognor Regis War Memorial Hospital, Brighton General Hospital, Crawley Hospital and The Kleinwort Centre in Haywards Heath. We’ve also recruited nurses from Italy, Portugal and Spain.

We have a wide variety of vacancies from nursing and therapies staff to facilities and office workers. We offer both permanent and temporary positions. Call us on 01273 242227 (permanent) or 01273 696011 ext. 5008 (temporary) for our latest vacancies.

Two TicksWe are proud to be a Two Ticks employer, demonstrating our commitment to employ, retain and develop the abilities of disabled staff. This symbol is recognition by Jobcentre Plus employers who have agreed to meet five commitments regarding recruitment, training, retention, consultation and disability awareness. As an employer we guarantee an interview for all disabled applicants who meet the minimum criteria for a job vacancy. Each candidate is then considered on their ability and skill to do the job.

Recognising staff achievement and long service Our annual staff achievement awards took place in December where over 130 members of staff and partners attended. A panel of judges, including members of the public, picked our winners from nominations submitted by colleagues or people who use our services in the following categories:

■ Victoria May, senior dental nurse, special care dental services, won excellence in customer service award.

■ Our initiative award went to Elizabeth Barnes, team lead physiotherapy, Chanctonbury.

■ Bethany Robson, physiotherapist at Arundel & District Community Hospital, received two nominations and won the quality award.

■ Staff engagement award went to Rachel Field, team leader, health visiting, Haywards Heath.

■ Christine Morris, team leader, children’s community nursing team, North West Sussex, received five nominations and won the outstanding commitment award.

■ Behind the scenes award went to Richenda Tite, medical staffing manager, human resources.

■ Chair’s award went to our estates and facilities team. They were chosen as they’re often unsung heroes who work right across the whole territory that we cover; and have contributed to some external accolades throughout the year including the PLACE report which ranks quality of care environment at our community hospitals alongside the best in the country.

We also recognised over 100 staff with 40, 30 and 20 years’ NHS service.


VolunteeringWe’re delighted that we and the people we care for benefit from the passion and varied experiences, background and skills of 550+ volunteers. At the same time, some of our volunteers gain valuable workplace experience that can strengthen their employment prospects.

Volunteers play an important role in the NHS. They bring valuable skills and enthusiasm to the people we care for, their families and carers, and our staff. They make a real difference and improve patient experience.

We have an enormous diversity of volunteering programmes and we clearly recognise their role in building a healthier and more resilient community.

One of our volunteers said: “I am really proud to wear my NHS volunteer badge. I’m really excited now I can volunteer and help where I can. I get such a morale boost volunteering.”

See www.sussexcommunity.nhs.uk/volunteering for further information.

Workforce information and key performance indicators (KPIs)Good quality information helps us manage our workforce and support our staff more effectively in the workplace. Our regular workforce KPI report provides assurance to the trust board with regard to workforce matters and supports effective decision-making. You can see our papers at www.sussexcommunity.nhs.uk/board.

We use information from our workforce KPIs to drive improvement, especially in areas such as appraisals, sickness absence and use of agency and bank staff.

Overall numbersAt the end of March 2015, we had 4,420 staff in post, representing 3,422 whole-time equivalent (WTE). We recorded an annual staff turnover rate of 13.6 per cent (our target was 12 per cent).

Appraisal rates In March 2015 85 per cent of staff had an annual appraisal, with some areas recording 100 per cent success. An effective appraisal is a vital expression of staff engagement and helps equip staff to do their job.


During the year we’ve been able to assure the board about the quality of our appraisals, for example, ensuring our values are demonstrated by our staff with the behaviours and competencies we expect, and ensuring objectives that are set contribute in delivering our corporate goals and objectives.

Staff sicknessWe’re working hard to support staff and reduce our staff sickness absence rate. Our overall rate for the year was 6.3 per cent, against a target of 4 per cent. The main causes of sickness are musculoskeletal problems, stress and cough and cold illnesses. Over the year we have supported our managers to help them better manage sickness absence and adopted a range of initiatives via our healthier workforce group to strengthen the resilience of our staff, including producing a Steps to Health and Wellbeing handbook and CD.

Use of agency and bank staffWe’re redoubling our efforts to reduce our use of agency staff by working hard to fill available posts with the minimum of delay and making best use of our in-house bank staff service, Staff Direct. Our year-end agency figure as a percentage of overall pay expenditure (4.2 per cent) was above our target of 3.5 per cent.

Nationally the NHS is facing a shortage of Band 5 nurses. And we’re finding it particularly difficult to recruit permanent nurses to work in our community hospitals. We have undertaken

some overseas recruitment and appointed nurses from Spain, Portugal and Italy. We’re also using Medacs as an alternative, approved agency for sourcing temporary nurses to fill vacancies.

Off-payroll engagementsFollowing the Review of Tax Arrangements of Public Sector Appointees (May 2012) published by the chief secretary to the Treasury, we’re publishing information relating to off-payroll engagements (people who work for the trust and invoice for the work they have done).

The table below relates to all off-payroll engagements as of 31 March 2015 for more than £220 per day which lasts for longer than six months:

NumberNumber of existing engagements 7Of which the number that have existed:For less than one year at the time of reporting 6

For between one and two years at the time of reporting 0

For between two and three years at the time of reporting 1

For between three and four years at the time of reporting 0

For more than four years at the time of reporting 0


All existing off-payroll engagements have at some point been subject to a risk-based assessment as to whether assurance needs to be sought that the individual is paying the right amount of tax and, where necessary, assurance has been sought.

The table below relates to all new off-payroll engagements, or those reaching six months in duration, between 1 April 2014 and 31 March 2015, for more than £220 per day which last for longer than six months:

NumberNumber of new engagements, or those that reached six months in duration

8

Number of new engagements which include contractual clauses giving the trust the right to request assurance in relation to income tax and National Insurance obligations

8

Number for whom assurance has been requested 5

Of which:Assurance has been received 5Assurance has not been received 0Engagements terminated as a result of assurance not being received

0

The table below relates to off-payroll engagements of board members and senior officials with significant financial responsibility between 1 April 2014 and 31 March 2015:

Number of off-payroll engagements of board members and/or senior officers with significant financial responsibility

0

Number of individuals deemed “board members, and/or senior officers with significant financial responsibility”. This figure includes both off-payroll and on-payroll engagements

15


The boardSussex Community NHS Trust is run by a board of directors, who set strategic direction and then monitor performance and progress.

The board regularly meets in public, and you can see details of the board meetings, including the public papers on our website: www.sussexcommunity.nhs.uk/board.

The board is made up of: ■ Non-executive directors, who use skills and experience gained from the private, public and voluntary sectors to help run the trust, but who do not have day-to-day managerial responsibilities within the trust.

■ Executive directors, who are paid employees with clear areas of work responsibility within the trust.

We saw changes in the composition of the board in the year:

■ David Standfast stood down as non-executive director and we welcomed our new non-executive directors, David Parfitt and Elizabeth Woodman.

■ We welcomed our new chief nurse, Susan Marshall, replacing interim chief nurse Nancy Barber.

■ Chakravarthi Rajkumar, previously non-executive designate became board advisor and we welcomed Janice Needham as non-executive designate.

We thank David Standfast and Nancy Barber for their substantial contributions to our development. Since the year-end Martin Sambrook has stepped down as a non-executive director.

The members of the board as at April 2015 were:Sue Sjuve, ChairAppointed June 2012 to May 2016

Brings director level experience in strategic, operational and change management in commercial and not-for-profit bodies. Has

expertise in managing significant budgets, risk management and regulatory compliance. Previously a non-executive director at NHS Surrey. A non-executive board member at Saxon Weald Homes Ltd.

Chairs meetings of the board, our FT programme board, Nominations Committee and Remuneration Committee.

Paula Head, Chief executiveJoined us in April 2013

Trained as a pharmacist and started with the NHS in 1989. Moved into management at Kingston Hospital and became director of strategy and public accountability and deputy chief executive at Kingston PCT. Worked with NHS Berkshire East as director of commissioning and service redesign and subsequently became deputy chief executive. Before taking up the appointment at SCT was director of transformation at Frimley Park Hospital NHS Foundation Trust.

Maggie Ioannou, Senior independent directorAppointed December 2013 to November 2017

A nurse by background, with extensive professional leadership experience in community nursing, including at board level. In her last post was director of nursing, quality and safety for Surrey PCT, where she provided leadership on clinical quality and safety during a time of significant change.

Chairs our Quality Committee, and serves as senior independent director and whistleblowing director.

Stephen Lightfoot, Non-executive director and deputy chairAppointed September 2013 to August 2017

Started his career as a nutritionist with Colborn-Dawes Nutrition, a subsidiary of the Roche global vitamin business. In 1986 moved to the global pharmaceutical company Schering AG, rising to

MANAGING THE TRUST


become commercial director with Schering Health Care in the UK. Became UK managing director with the global pharmaceutical company Daiichi Sankyo, before becoming general manager of the global medical diagnostics business with GE Healthcare.

Chairs our Finance and Investment Committee; deputises in the absence of our trust chair.

Janice Needham, Non-executive designateAppointed February 2015 to February 2016

Independent management consultant working primarily in the not-for-profit sector, including the Big Lottery Fund and the Carers Trust. Brings extensive and wide-ranging management and senior level experience gained across government, local council and the voluntary sectors. Has served on the management boards of three national charities, held a director level position with Voluntary Services Overseas (VSO) and worked as a statistician with the Department of Health.

David Parfitt, Non-executive directorAppointed July 2014 to June 2016

A chartered accountant with broad commercial experience in complex and customer-orientated organisations undergoing significant change including the Granada Group, TSB Group and Lloyds Banking Group, where he became risk, control and accounting director (retail). Has direct experience of the NHS, first as a non-executive director of Luton primary care trust (PCT) and latterly as a lay member (audit and governance) of NHS Luton clinical commissioning group.

Chairs the Charitable Funds Committee and leads for the non-executives on procurement.

Professor Chakravarthi Rajkumar, Board advisorAppointed November 2013 and reviewed annually

A clinical academic with an international reputation in hypertension and stroke

management. He has trained and worked in Australia, India and the UK. Since 2005, he has been Chair of Geriatrics & Stroke Medicine at the Brighton & Sussex Medical School, based at the University of Sussex. Since 2007 has held the position of director of the comprehensive local research network (CLRN), Surrey and Sussex.

Advises the board and head of research on academic and research matters.

Martin Sambrook, Non-executive directorAppointed October 2012 to September 2016

An associate chartered management accountant and member of the Chartered Institute of Management Accountants (CIMA). Previously finance director/company secretary with CAE UK, a global leader in modelling, simulation and training. Before that held director-level positions in finance and strategic management in other leading companies. Parish councillor for Cuckfield Parish Council.

Chairs our Audit Committee.

Elizabeth Woodman, Non-executive directorAppointed February 2015 to January 2017

A lawyer by background and recently vice-president customer segments and strategy at Thomson Reuters Legal UK & Ireland, which provides best practice information and software services for businesses and legal professionals.

Jonathan Reid, Executive director of finance, facilities and estates and deputy chief executiveA chartered accountant with 20 years’ experience in public finance. Held senior finance roles with NHS Brighton and at Brighton and Sussex University Hospitals NHS Trust. Has accounting and treasury management qualifications.


Richard Curtin, Chief operating officerA registered nurse with qualifications in leadership and business administration. Worked at Guy’s and St Thomas’ NHSFT (GSTT) from 1997, where in his last role he led the clinical services strategy that underpins the successful integration of community services in Lambeth and Southwark into GSTT.

Susan Marshall, Chief nurse30 years’ experience in both acute and community settings, Susan joined us from the Black Country Partnership NHSFT, where she was director of nursing and professional practice.

Susan is a registered general nurse, with qualifications in midwifery and health visiting. She offers a record of achievement in clinical leadership, operational management and governance, including the development of a clinical competency framework to strengthen nursing standards and enhanced professional leadership to drive patient safety.

Richard Quirk, Executive medical directorA GP practicing in West Sussex, with special interests in child health and safeguarding, family planning, obstetrics and gynaecology. Trained in London and was previously clinical governance lead at the trust’s urgent treatment centre in Crawley. Experience in governance in the education field and spent ten years providing medical advice to a television production company.

The following members of the executive leadership team also attend and report at our board meetings:

■ Gareth Baker, Director of transformation and commercial development.

■ Caroline Beardall, Director of human resources, organisational development and communications.

Board committeesThe board is supported in its work by a number of sub-committees which include:

■ Audit Committee, chaired by non-executive director, Martin Sambrook.

■ Charitable Funds Committee, chaired by non-executive director, David Parfitt.

■ Finance and Investment Committee, chaired by non-executive director, Stephen Lightfoot.

■ Nominations Committee, chaired by trust chair, Sue Sjuve.

■ Quality Committee, chaired by non-executive director, Maggie Ioannou.

■ Remuneration Committee, chaired by trust chair, Sue Sjuve.

To see details of the board, their responsibilities and to view past board papers, please visit our website: www.sussexcommunity.nhs.uk/board.


Name Role Interests declared Other information

Gareth Baker

Director of transformation and commercial development

■ Member of the Institute of Civil Engineers ■ Member of the Institute of Royal Engineers

Declared 10/04/2015

Caroline Beardall

Director of human resources and organisational development

None Declared 17/04/2014

Richard Curtin

Chief operating officer

None Declared 10/05/2015

Paula Head Chief executive

■ Freelance consultant to businesses which work for the pharmaceutical industry

Declared 10/04/2015

Maggie Ioannou

Non-executive director

■ Owner and Managing Director of MIBSD Ltd ■ Director of Inveresk Ltd ■ Trustee of the Betty Wivell Academy Trust ■ Member of the Royal College of Nursing ■ Registered with the Nursing and Midwifery Council

Declared 10/04/2015

Stephen Lightfoot


■ Director Gainsborough Property Development UK Ltd ■ Non-executive director Microtex Products Ltd

Declared 28/04/2015

Susan Marshall

Chief nurse ■ Member/registered with Nursing and Midwifery Council Declared 28/04/2015

Janice Needham

Non-executive designate

■ Trustee of Asylum Aid ■ Consultant to Carers Trust

Declared 10/04/2015

David Parfitt Non-executive director

■ Lay member Luton Clinical Commissioning Group ■ Fellow of Institute of Chartered Accountants in England and Wales

Declared 11/04/2015

Richard Quirk

Executive medical director

■ Also works as a General Practitioner in Crawley, West Sussex

■ Wife works on the trust temporary bank system – Staff Direct

Declared 10/04/2015

Register of interestsAt the time of their appointment, all directors are required to declare any significant financial or controlling interests they, or a close relative have, in organisations or companies which could compete for the supply of goods or services to the trust and to declare any such interests that may arise after their appointment. These are recorded in the register of interests and updated regularly. The register is available for inspection by members of the public at any time via the trust’s website: www.sussexcommunity.nhs.uk/board or by contacting Trust Management, J3 Jevington Building, Brighton General Hospital, Elm Grove, Brighton BN2 3EW.


Professor Chakravarthi Rajkumar

Board advisor ■ Chair of Geriatrics & Stroke Medicine at Brighton and Sussex Medical School

■ Divisional Director – Local Comprehensive Research Network

■ Stroke Lead, Kent Surrey and Sussex ■ Fellow of Royal College of Physicians and British Hypertension Society

■ Member of International Society for Vascular Health; European Society for Hypertension; British Society for Heart Failure; British Medical Association and British Geriatric Society

■ Research funding: research for patient benefit (National Institute for Health Research); Dunhill Medical Trust; Danone Health Care; British Heart Foundation; Health Technology Assessment; British Geriatric Society and Kleinwort Foundations.

■ Wife works as a consultant at the trust

Declared 01/06/2015

Jonathan Reid

Executive director of finance, facilitates and estates

■ Member of the Institute of Chartered Accountants for England and Wales

Declared 09/05/2015

Martin Sambrook


■ Member of the Disciplinary Committee for the Chartered Institute of Management Accountants

■ Councillor – Cuckfield Parish Council ■ Associate Member of the Chartered Institute of Management Accountants

Declared 18/04/2014

Left 02/04/2015

Sue Sjuve Chair ■ Non-executive director and chair of audit committee Saxon Weald Homes Ltd

■ Managing Director, Power of Difference (executive coaching company)

■ Associate of Inaccord (London and Kent based corporate communications consultancy)

■ Director Drovers Lane Residents Association Ltd ■ Member of the South East England ACCEA Panel ■ Adviser to the Board of Gay Star News Ltd ■ Fellow of Chartered Institute of Insurers ■ Member of the Institute of Risk Management ■ Owner Power of Difference and Powerofdifference.com

Declared 10/04/2015

David Standfast


■ Chief executive of Saxon Weald Homes Ltd ■ Member of the Chartered Institute of Management ■ Member of the Royal Town Planning Institute

Declared 17/04/2014

Left 31/08/2014

Elizabeth Woodman


■ Director of Campden Professional Publishing Ltd ■ Investments in Schoolora Ltd (50% owner)

Declared 13/04/2015

Excellent care at the heart of the community

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