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Rehab directory submissions

Description: Organisation Dorset Brain Injury Service Contact Name John Burn Email Address John.burn@poole.nhs.uk Telephone 01202448070 Website Address Poole Hospital Long Fleet Road Poole Dorset Further Information Specialist (2a) inpatient rehab unit for patients with brain injury. Priority given to traumatic brain injury and younger patients with complex therapy needs. The service constitutes part of the Neurological Rehabilitation Service. Service provides specialist assessment, psychological interventions and management. Helping survivors and their families regain some quality of life through a wide range of services, e.g. Cognitive rehabilitation programmes, carer support, and community outreach. Services are provided to people with Brain Hampshire Hospitals NHS Foundation Trust- Clinical Health Psychology Service Samuel Bastone Samuel.bastone@hhft.nhs.uk 01962824351 www.hampshirehospitals.nhs.uk Royal Hampshire County Hospital Winchester SO22 5DG Headway Basingstoke Heather Jury hjury@headwaybasingstoke.org.u k 01256314969 www.headwaybasingstoke.org.uk Headway BasingstokeHeadway Place Basingstoke RG24 9SP Headway Dorset office@headwaydorest.org.uk 01202 606562 www.headwaydorset.org.uk Headway Dorset Unit 22, Albany Park Dorset BH17 7BX Injury, their family members, carers and interested professionals. Cognitive, physical and social rehabilitation programmes are provided to support recovery specifically improving selfesteem and confidence. Headway Isle of Wight Joy.headway@gmail.com In Construction Headway (National) Sue Gillard Sue.gillard@headway.org.uk 01159240800 0782685581 www.headway.org.uk Headway Isle of Wight c/o 17 Beachfield Road PO35 5TN Bradbury House Nottingham NG6 8SF Headway Portsmouth and SE Hampshire info@headwayportsmouth.org.uk 02392664972 www.headwayportsmouth.org.uk Twyford Avenue Portsmouth PO2 9QA Headway provides a range of frontline services to help those affected by brain injury, including: A free phone helpline (0808 800 2244) and email, a comprehensive website. Local centre-based and outreach services are provided by Headway groups across the region. Helping survivors and their families regain some quality of life through a wide range of services e.g. Cognitive rehabilitation programmes, carer support, social reintegration. Headway Salisbury and South Wiltshire Headway Southampton Info@headwaysalsibury.co.uk 07725827869 www.salisburyheadway.co.uk Fountain Way Salisbury SP2 7FD 120 Commercial Road Totton SO40 3AD St Mary's Hospital Newport Isle of Wight PO30 5TG manager@headwaysouthampton.org.uk 02380862948 www.headway-southampton.org.uk Isle of Wight NHS TrustThe Rehabilitation Unit Mehran Maanoosi Mehran.maanoosi@iow.nhs.uk 01983524081 www.iow.nhs.uk Traumatic and other categories of Brain Injured patients excluding stroke perhaps occupying 56 beds out of 26 beds. Multiple injuries following Road Traffic accidents, sporting injuries, falls. Rehabilitation of patients with various neurological conditions. Phoenix Rehabilitation Mike Homer- Mike.homer- 02392283258 Queen Alexandra Centre (F1) Neurological Rehabilitation Portsmouth Prosthetic and Amputee Rehabilitation Service Ward ward@porthosp.nhs.uk Alison Hatfield Alison.hatfield@porthosp.nhs.uk Mike.homerward@porthosp.nhs.uk 02392680150 Hospital Portsmouth PO2 3LY Portsmouth Enablement Centre St Marys Community Health Campus PO3 6BR Salisbury NHS Foundation Trust- The duke of Cornwall Spinal Treatment Centre Wendy Slater Wendy.slater@salisbury.nhs.uk 01722336262 Salisbury District Hospital SP2 8BJ Solent NHS Trust- Solent Neurological Rehabilitation Services- Mary Vincent Mary.vincent@solent.nhs.uk 02380608031 www.solent.nhs.uk Adelaide Health Centre Millbrook This service provides outpatient rehabilitation to patients with congenital limb deficiency or acquired amputation from a range of cases including vascular/diabetes melitus, trauma or malignancy. Specialises in the total management of patients paralysed following spinal cord injury or nonprogressive spinal cord disease. The teams enable an individual to optimise their physical and psychological ability to achieve independence appropriate to their level of disability. Physiotherapists with a specialist interest in neurology and Community Neurological Rehabilitation Gym Southampton SO16 4XE Solent NHS Trust- Solent Neurological Rehabilitation ServicesCommunity Stroke Team Samantha Hemingway Samantha.hemingway1@solent.n hs.uk 07833401748 www.solent.nhs.uk Western Community Hospital Millbrook Southampton SO16 4XE Solent NHS Trust- Solent Neurological Rehabilitation ServicesNeuro Gym/Neurological Outpatient Physiotherapy Department Sally Ann Smith Sallyann.smith@solent.nhs.uk 02392286509 www.solent.nhs.uk Neuro Gym Physiotherapy Queen Alexandra Hosptial Portsmouth PO6 3LY Rehabilitation Assistants providing individual neurological assessment and treatment sessions. Promoting self management for people living with long term neurological conditions, working alongside other healthcare professionals. The community Stroke Team offer a specialist service to people over the age of 18 who have had a stroke. To support independence and improve quality of life by setting rehabilitation goals. Physiotherapists and technicians offering specialist adult neurological assessment and rehabilitation to people with neurological Solent NHS Trust- Solent Neurological Rehabilitation ServicesNeuropsychology East Jane McNeil Jane.mcneil@solent.nhs.uk 02392286000 www.solent.nhs.uk Neuropshycology department Queen Alexandra Hosptial PO6 3LY Solent NHS Trust- Solent Neurological Rehabilitation ServicesNeuropsychology West Jane McNeil Jane.mcneil@solent.nhs.uk 02380296273 www.solent.nhs.uk Western Community Hospital Southampton SO16 4XE conditions. Patients are assessed and personal treatment plans developed to work towards specific goals. Clinical psychologists who provide specialist assessment, rehabilitation and psychological therapy for the cognitive emotional and behavioural sequelae of Acquired Brain Injury. The service aims to minimise the negative effects, and maximise positive outcomes in terms of independence. Clinical psychologists who provide specialist assessment, rehabilitation and psychological therapy for the cognitive emotional and behavioural sequelae of Acquired Brain Injury. The service Solent NHS Trust- Solent Neurological Rehabilitation ServicesSnowdon at Home Samantha Hemingway Samantha.hemingway1@solent.n hs.uk 07788407076 www.solent.nhs.uk Western Community Hospital Southampton SO16 4XE Solent NHS Trust- Solent Neurological Rehabilitation ServicesSnowdon Neurological Rehabilitation Ward Sally-Ann Smith Sallyann.smith@solent.nhs.uk 07825733106 www.solent.nhs.uk Western Community Hospital Southampton SO16 4XE Solent NHS Trust- Solent Neurological Sally-Ann Smith Sallyann.smith@solent.nhs.uk 02380296222 www.solent.nhs.uk Western Community aims to minimise the negative effects, and maximise positive outcomes in terms of independence. A community neurological therapy team specialising in the treatment of people with a neurological diagnosis or symptoms such as head injury, multiple sclerosis, GuillainBarre Syndrome. Intensive rehabilitation in the home and community. A 14 bedded purpose built ward which specialises in the treatment of people with physical and cognitive limitations following a recent neurological event or a long term neurological condition. A registered nurse with additional Rehabilitation ServicesSpecialist Epilepsy Nurse Hospital Southampton SO16 4XE Solent NHS Trust- Solent Neurological Rehabilitation ServicesThe Kite Unit Tre Daughtery Tre.daughtery@solent.nhs.uk 02392684990 www.solent.nhs.uk The Kite Unit Nelson Drive St James Hospital Portsmouth PO4 8GD qualifications in supporting people with epilepsy provides a community service for adults with epilepsy. Supporting individuals to manage their epilepsy as best possible giving advice and guidance around seizures, treatment and lifestyle. A neuro psychiatric rehabilitation service for individuals with a brain injury whose impairments are largely in the cognitive, behavioural or mental health spectrum. Assessment, treatment and rehab for people requiring slow stream rehabilitation that may not be available from other services. Solent NHS Trust- Solent Neurological Rehabilitation ServicesTransition Therapy Team Sally-Ann Smith Sallyann.smith@solent.nhs.uk 02380296210 www.solent.nhs.uk Western Community Hospital Southampton SO16 4XE Solent NHS Trust- Solent Neurological Rehabilitation ServicesVocational Rehabilitation Service Sally-Ann Smith Sallyann.smith@solent.nhs.uk 02380716592 www.solent.nhs.uk Unit 12 9-19 Rose Road Southampton SO14 6TE Solent NHS Trust- Solent Neurological Rehabilitation ServicesCommunity Neurological Rehabilitation Team Sally-Ann Smith Sallyann.smith@solent.nhs.uk 02380296222 www.solent.nhs.uk Western Community Hospital Southampton SO16 4XE Offering occupational therapy and physiotherapy input to young people between the ages of 14-25 who have complex physical disabilities. The disabilities are predominantly neurological and some young people also have learning disabilities. This service can help people with neurological conditions identify the barriers that prevent them from returning to work. Provide treatment programmes with specific goals to help reduce or overcome those identified barriers. Specialising in the treatment of people with neurological conditions. The team consists of occupational UHS-Facial Rehabilitation Service WFNC@uhs.nhs.uk 02381203012 www.uhs.nhs.uk Therapy Department Southampton General Hospital SO16 6YD UHS- General Intensive Care/ Neurological Intensive Care Zoe Van Willigen Zoe.vanwilligen@uhs.nhs.uk Julie.buckley@uhs.nhs.uk 02381204184 www.uhs.nhs.uk Southampton General Hospital SO16 6YD therapists, physiotherapists, rehabilitation assistants, doctors, dieticians and speech and language therapists. The Wessex Facial Nerve Centre is a regional service dedicated to the treatment of facial nerve disorders and injuries. The Wessex Facial Nerve Centre brings together the skills, expertise and experience of a team of medical, surgical and rehabilitation specialists. All patients admitted to a critical care environment following Major Trauma will receive acute rehabilitation and early mobilisation as appropriate by specialist therapists. We have specialists in complex UHS- Lower Limb Amputee Rehabilitation Marie Hulse Marie.hulse@uhs.nhs.uk 02381203662 www.uhs.nhs.uk Small Gym, Therapies Department Southampton General Hospital SO16 6YD UHS- Orthopaedic Trauma Service- Musculoskeletal Inpatient Therapy Amanda Pike Amanda.pike@uhs.nhs.uk 02381204452 www.uhs.nhs.uk F Level Orthopaedics Southampton General Hospital SO16 6YD polytrauma, chest and thorax trauma, acute head and spinal injury. This service is provided on a Monday 10-1 and Thursday 10-2 with a band 7 specialist physiotherapist and a band 4 therapy technician. It is based in the small gym at UHS with access to early walking aidsPPAM aid and Femuret, parallel bars, balance equipment and multi-gym. The unit will accept and rehabilitate all forms of orthopaedic trauma, including Major Trauma patients. The orthopaedic therapy team offers a 7 day service covering 1 elective ward, 1 major trauma ward, 1 dementia friendly ward, 1 trauma ward, UHS- Musculoskeletal Outpatient Therapy Service Amanda Pike Amanda.pike@uhs.nhs.uk 02381206459 www.uhs.nhs.uk Therapy Department Southampton General Hospital SO16 6YD Wessex Rehabilitation Centre Peter Wareham Peter.wareham@salisbury.nhs.uk 01722336262 www.salisburu.nhs.uk/informationfor patients/departments/pages/wessexr ehab.aspx Musculoskeletal Rehabilitation Salisbury District Hospital Salisbury SP2 8BJ day surgery and 1 step down care ward. The outpatient musculoskeletal service is a MonFriday 7.30-5.30 service and accepts referrals from UHS Consultants. Service takes various musculo-skeletal injured patients who are not progressing as expected, or need more input than can be provided, by outpatient services. Service includes physiotherapy, occupational therapy, nursing and consultant input.
Url: /Media/SUHTExtranet/WessexTraumaNetwork/Rehab-directory-submissions.pdf

UHS support timeline for fellowships_2021

Description: UHS personal fellowship submissions Guidance on where to start, timelines and finding support Up to 1 year • Pre-submission preparations •decide
Url: /Media/Southampton-Clinical-Research/Grants/Download/UHS-support-timeline-for-fellowships-2021.pdf

UHS support timeline for fellowships

Description: UHS personal fellowship submissions Guidance on where to start, timelines and finding support ? Pre-submission preparations ?decide which sch
Url: /Media/Southampton-Clinical-Research/Grants/Download/UHS-support-timeline-for-fellowships.pdf

UHS AR 21-22 Quality Account

Description: QUALITY ACCOUNT 2021/22 Part 1: QStaUteAmeLnItToYn qAuaClitCy fOroUm NtheTchief executive 2021/22 1.1 Chief executive’s statement and welcome
Url: /Media/UHS-website-2019/Docs/About-the-Trust/Annual-reports-and-quality-accounts/UHS-AR-21-22-Quality-Account.pdf

Annual report 2021-2022

Description: 2021/22 Incorporating the quality report University Hospital Southampton NHS Foundation Trust Annual Report and Accounts 2021/22 Presented to Parliament pursuant to Schedule 7, paragraph 25(4)(a) of the National Health Service Act 2006 © 2022 University Hospital Southampton NHS Foundation Trust Table of contents Welcome from our chair and chief executive 6 Overview and performance 8 Performance report 9 Overview 10 Accountability report 36 Directors’ report 37 Remuneration report 59 Staff report 72 Annual governance statement 94 Quality report 105 Statement on quality from the chief executive 106 Priorities for improvement and statements of assurance from the board 109 Other information 182 Annual accounts 210 Statement from the chief financial officer 211 Auditor’s report 212 Auditor’s report including audit certificate 218 Foreword to the accounts 220 Statement of Comprehensive Income 221 Statement of Financial Position 222 Statement of Changes in Taxpayers’ Equity 223 Statement of Cash Flows 224 Notes to the accounts 225 5 Welcome from our chair and chief executive As we emerged from the most severe phase of the COVID-19 pandemic, 2021/22 was another challenging year for everyone at University Hospital Southampton NHS Foundation Trust (UHS). It was also a year on which we can look back with pride at what we achieved together in unprecedented circumstances. Amongst many notable achievements over the past twelve months, we have: • Led on globally ground-breaking research trials to inform the country’s COVID-19 vaccine booster strategy, including the world’s first COVID-19 vaccine booster study of mixed schedules. • Successfully managed infection prevention and control, putting us amongst the best in the country for minimising nosocomial spread. This was against a backdrop of, at times, R-rates in our local community that were amongst the highest in the country. • Published new strategies for digital and sustainability, which respectively set out how we are revolutionising our technical capability to meet changing patient needs and responding to the growing threat posed by climate change as part of the NHS-wide commitment to reaching carbon net zero by 2045. The pandemic also highlighted the vital importance of our staff’s wellbeing so we could continue to meet the needs of the most vulnerable and sick within our community and beyond. In response, we launched and have sustained a comprehensive programme of support to help our staff recognise and address the physical and emotional burden of the last two years. In financial terms, the Trust achieved its forecast breakeven position in 2021/22 on a turnover of £1.15 billion. Our strong, long-term financial performance meant we could continue investing in the capacity and condition of our estate. During the last year we have welcomed patients into our new ophthalmology outpatients area, expanded the majors area of our emergency department, built Hamwic House for treating cancer patients and opened four new operating theatres. Our ambition remains to increase capacity and improve facilities so that we can meet rising demand for our services, treating more people in improved settings than ever before. The momentum we are building is informed and driven by our five-year strategic plan, which describes our collective ambitions on our journey to becoming a world-class organisation. Our successes over the last twelve months were set against a backdrop of exceptional pressure on our services, unlike anything we have seen before. Like most hospital trusts, the lifting of COVID-19 restrictions in the wider community saw significant increases in attendances at our emergency department and increased referrals for treatments including surgery and cancer care. Everyone at UHS is working hard to restore services and bring waiting times down, although there are headwinds impacting our elective recovery. As we write this report, we have more than 200 patients in the hospital who no longer need our care but are waiting for discharge, either to a care home or to their own home with domiciliary care packages. Like many sectors, our local authority partners are struggling to buy or directly provide the capacity that is needed due primarily to workforce shortages. On occasion, the number of patients stranded in our hospitals means we have had to cancel scheduled surgery patients due to a lack of beds. Despite this, we are making good progress on recovering our elective performance, for example the number of elective surgery procedures in May 2022 was over 8% higher than in May 2019, prior to the COVID-19 pandemic. 6 Looking back over the year, our achievements would not have been possible without every single one of our 13,000 staff, who have gone above and beyond to put patients first. As a Trust Board we recognise that our people are our greatest asset. The results of this year’s NHS annual staff survey are encouraging, with the percentage of staff recommending UHS as a place to work being the sixth highest across all NHS trusts in England. However, we know we can do even better and our new people strategy will help us achieve this by introducing programmes which enable our people to thrive, excel and belong in a diverse and inclusive environment. We ended the year by saying farewell to Peter Hollins, who completed his second and final term as chair on 31 March 2022. In the six years of his leadership, the Trust has undergone a huge transformation to the benefit of both patients and staff. Peter has been a trusted and respected colleague whose outstanding leadership has set UHS on course to be a world-class organisation with world-class people delivering worldclass care. We welcome the formation of the Hampshire and Isle of Wight integrated care system on 1 July 2022, which will facilitate increased integration and collaboration across health and social care partners. We look forward to continuing strong relationships with all our partners as we work to develop an NHS of which all the communities we serve can be proud. Jane Bailey Interim Chair June 2022 David French Chief Executive Officer June 2022 7 OVERVIEW AND PERFORMANCE Performance report Introduction from our chief executive 2021/22 is the second year that the ways in which the Trust has worked, and the performance it has achieved, have been strongly influenced the COVID-19 pandemic. Our circumstances varied significantly through the year, however, by March 2022: • COVID-19 related restrictions had been removed across the wider community, but remained necessary within healthcare settings; • a combination of partial immunity and improved treatments had reduced the numbers of patients experiencing the most severe symptoms of COVID-19, but the total numbers of people being infected remained very high; and • the numbers of patients attending, or being referred to, healthcare services for other conditions had returned to pre-pandemic levels or higher. Our challenges and priorities have varied through the year in a similar manner, and have included: • providing sufficient urgent care capacity for patients with COVID-19 alongside those with other illnesses or injuries; • running our services with significantly increased levels of COVID-19 related absence amongst our staff, as infection rates have increased in the wider community; and • increasing the numbers of elective treatments provided, back to pre-pandemic levels and higher, to start to reduce patient waiting times and reverse the increases in waiting list sizes caused by COVID-19. Our performance this year has often been impacted by the adversity of the circumstances. We have not always been able to achieve the targets established prior to the pandemic, nor to deliver the standard of service that we would aspire to for our patients. The Trust is proud to have performed well in comparison to other hospital trusts across many performance measures, however, I would like to thank our patients for their understanding and patience, and all our staff for their resilience, commitment and dedication to care for patients and their colleagues. As we begin to emerge from the pandemic, and consider the year ahead, we look forward to working with patients, hospital colleagues, and partners across health and social care to: • continue the recovery from the impacts of the COVID-19 pandemic; • improve our performance against key measures, continuing to perform well in comparison with other hospitals and moving closer to the national targets; and • continue to adapt and improve services such that the outcomes and results achieved for patients will be better than ever before. 9 Overview About the Trust Our services University Hospital Southampton NHS Foundation Trust is one of the largest acute teaching trusts in England with a turnover of more than £1 billion in 2021/22. It is based on the coast in south east England and provides services to over 1.9 million people living in Southampton and south Hampshire and specialist services, including neurosciences, respiratory medicine, cancer care, cardiovascular, obstetrics and specialist children’s services, to more than 3.7 million people in central southern England and the Channel Islands. The Trust is also a designated major trauma centre, one of only two places in the south of England to offer adults and children full major trauma care provision. As a leading centre for teaching and research, the Trust has close working relationships with the University of Southampton, the Medical Research Council, National Institute for Health and Care Research (NIHR), Wellcome Trust and Cancer Research UK. The Trust is consistently one of the UK’s highest recruiting trusts of patients to clinical trials and in the top ten nationally for research study volumes as ranked by the NIHR Clinical Research Network. 12,000 Every year over staff at UHS: treat around 160,000 inpatients and day patients, including about 75,000 emergency admissions see over 650,000 people at outpatient appointments deal with around 150,000 cases in our emergency department deliver more than 100 outpatient clinics across the south of England, keeping services local for patients The Trust provides most of its services from the following locations: • Southampton General Hospital – the Trust’s largest location, where a great number of specialist services are based alongside emergency and critical care and which includes Southampton Children’s Hospital. • Princess Anne Hospital – located across the road from Southampton General Hospital and providing maternity care and specialist care for women with medical problems during pregnancy and babies who need extra care around birth across the region. • Royal South Hants Hospital – although the Trust does not operate this site near the centre of Southampton it provides a smaller number of services from this location. • New Forest Birth Centre – located at Ashurst on the edge of the New Forest and run by experienced midwives and support staff it offers a safe, ‘home away from home’ environment for women having a healthy pregnancy and expecting a straightforward birth. The NHS patient services provided by the Trust are commissioned and paid for by local clinical commissioning groups (CCGs) and, in the case of more specialised services (such as treatments for rare conditions), by NHS England. Just under half of the Trust’s NHS patient services are paid for by CCGs and just over half are paid for by NHS England. We provide these under a standard NHS contract, which incorporates ongoing monitoring of the Trust and the quality of the services provided. 10 Our structure UHS gained foundation trust status on 1 October 2011. A foundation trust is a public benefit corporation providing NHS services in line with the core NHS principles: that care should be universal, comprehensive and free at the point of need. The Trust is licensed as a foundation trust to provide these services by Monitor (the independent regulator, now part of NHS England and NHS Improvement) and the healthcare services we provide are regulated by the Care Quality Commission. Being a foundation trust has enabled greater local accountability and greater financial freedom and has supported the delivery of the Trust’s mission and strategy over a number of years. The Trust has been a university teaching hospital since 1971. The diagram below provides an overview of the overall organisational structure of the Trust. Division A Surgery Critical Care Opthalmology Theatres and Anaesthetics Public and foundation trust members Council of Governors Board of Directors Executive Directors Division B Division C Division D Cancer Care Emergency Medicine Helicopter Emergency Medical Services Medicine and Medicine for Older People Pathology Specialist Medicine Women and Newborn Maternity Child Health Clinical Support Cardiovascular and Thoracic Neurosciences Trauma and Orthopaedics Radiology 11 Trust Headquarters Division Always Improving Central Operations Clinical Outcomes Commercial Development Communications Contracting Corporate Affairs Data and Analytics Education and Workforce Estates, Facilities and Capital Development Finance Health and Safety Human Resources Informatics Medical Examinerss Service Occupational Health Organisational Development Quality Patient Safety Planning and Productivity Procurement and Supply Research and Development Safeguarding Strategy and Partnerships The Trust is also part of an integrated care system in Hampshire and the Isle of Wight, which is a partnership of NHS and local government organisations working together to improve the health and wellbeing of the population across Hampshire and the Isle of Wight. Our values Our values describe how we do things at UHS and act as a guide to all staff working with colleagues to deliver high quality patient care and a great patient experience every day. Our values are: Patients, their families and carers are at the heart of what we do. Their experience of our services will be our measure of success. Partnership between clinicians, patients and carers is critical to achieving our vision, both within hospital teams and extending across organisational boundaries in the NHS, social care and the third sector. We will ensure we are always improving services for patients through research, education, clinical effectiveness and quality improvement. We will continue to incorporate new ideas, technologies and create greater efficiencies in the services we provide. 12 Our strategy 2021-25 The Trust’s strategy was updated during 2020/21 to take account of everything our staff had experienced during the COVID-19 pandemic and what we had learnt from this. The vision for UHS is to continue on its journey to become an organisation of world class people delivering world class care. Our strategy is organised around five themes and for each of these it describes a number of ambitions we aim to achieve by 2025. Theme Ambitions Outstanding patient outcomes, • We will monitor clinical outcomes, safety and experience of our experience and safety patients regularly to ensure they are amongst the best in the UK By 2025 we will strengthen our and the world. national reputation for outstanding • We will reduce harm, learning from all incidents through our patient outcomes, experience and proactive patient safety culture. safety, providing high quality care • We will ensure all patients and relatives have a positive experience and treatment across an extensive of our care, as a result of the environment created by our people range of services from foetal and our facilities. medicine, through all life stages and conditions, to end-of-life care Pioneering research • We will recruit and enable people to deliver pioneering research in and innovation Southampton. We will continue to be a leading teaching hospital with a growing, reputable and innovative research and development portfolio • We will optimise access to clinical research studies for our patients. • We will enable innovation in everything we do, and ensure that ‘cutting edge’ investigations and treatments are delivered in Southampton. that attracts the best staff and efficiently delivers the best possible treatments and care for our patients. World class people • We will recruit and develop enough people with the right Supporting and nurturing our knowledge and skills to meet the needs of our patients. people through a culture that values • We will provide satisfying and fulfilling roles, growing our talent diversity and builds knowledge and through development and opportunity for progression. skills to ensure everyone reaches • We will empower our people, embracing diversity and embedding their full potential. We must provide compassion, inclusion and equity of opportunity. rewarding career paths within empowered, compassionate, and motivated teams. Integrated networks and collaboration We will deliver our services with partners through clinical networks, collaboration and integration across geographical and organisational boundaries. • We will work in partnership with key stakeholders across the Hampshire and Isle of Wight integrated care system. • We will strengthen our acute clinical networks across the region, centralising when necessary and supporting local care when appropriate. • We will foster local integration with primary and community care as well as mental health and social care services for seamless delivery across boundaries. • We will build on our successful partnership with University of Southampton (UoS), growing our reputation as a national leading university teaching hospital. 13 Theme Foundations for the future Making our enabling infrastructure (finance, digital, estate) fit for the future to support a leading university teaching hospital in the 21st century and recognising our responsibility as a major employer in the community of Southampton and our role in broader environmental sustainability. Ambitions • We will deliver best value to the tax payer as a financially efficient and sustainable organisation. • We will support patient self-management and seamless care across organisational boundaries through our ambitious digital programme, including real time data reporting, to inform our care. • We will expand and improve our estate, increasing capacity where needed and providing modern facilities for our patients and our people. • We will strengthen our role in the community as an employer of choice, a partner in delivery of services to our population and by leading the Greener NHS agenda locally. During each year of the strategy the Trust sets out a more detailed series of objectives to achieve and progress towards the delivery of its ambitions. In 2021/22 these objectives included: • Recovery restoration and improvement of clinical services • Introducing a robust and proactive safety culture • Empowering and developing staff to improve services for patients • Implementing the ‘Always Improving’ strategy • Delivering the first year of the research and investment plan • Restoring a full research portfolio and preparing for future growth • Delivering joint research and innovation infrastructure with UoS and Wessex partners • Increasing our people capacity (recruitment, retention, education) • Great place to work including focus on wellbeing • Building an inclusive and compassionate culture • Working in partnership with the integrated care system and primary care networks • Integrated networks and collaboration • Creating a sustainable financial infrastructure • Making our corporate infrastructure (digital, estate) fit for the future to support a leading university teaching hospital in the 21st century • Recognising our responsibility as a major employer in the community of Southampton and our role in delivering a greener NHS. Performance against these objectives will be monitored and reported to the Trust’s board of directors on a quarterly basis. Principal risks to our strategy and objectives The board of directors has identified and manages the principal risks to the delivery of its strategy and objectives through its board assurance framework. The principal risks to the delivery of its strategy and objectives identified by the Trust during 2021/22 were that: • It would have insufficient capacity to respond to emergency demand, reduce waiting lists for planned activity and provide diagnostics results in avoidable harm to patients • It would not be able to provide service users with a safe, high quality experience of care and positive patient outcomes • It would not effectively plan for and implement infection prevention and control measures that reduce the number of hospital-acquired infections and limit the number of nosocomial outbreaks of infection • It would not secure the required ongoing investment to support our pioneering research and innovation, driving clinical services of the future 14 • It would not realise the full benefits of being a University teaching hospital through working with regional partners to accelerate research, innovation and adoption; increasing the number of studies initiated and the patients recruited to participate in these studies and the delivery of new treatments and treatments that would not otherwise be available to patients • It would not be able to increase the UHS workforce to meet current and planned service requirements through recruitment to vacancies and maintaining annual staff turnover below 12% and develop a longerterm workforce plan linked to the delivery of the Trust’s corporate strategy • It would not develop a diverse, compassionate and inclusive workforce, providing a more positive staff experience for all staff • It would not create a sustainable and innovative education and development response to meet the current and future workforce needs • It would not implement effective models to deliver integrated and networked care, resulting in suboptimal patient experience and outcomes, increased numbers of admissions and increases in patients’ length of stay. • It would be unable to deliver a financial breakeven position and support prioritised investment as identified in the Trust’s capital plan within locally available limits (CDEL). • It would not adequately maintain, improve and develop our estate to deliver our clinical services and increase capacity. • It would fail to introduce and implement new technology and expand the use of existing technology to transform our delivery of care through the funding and delivery of the digital strategy. • It would fail to prioritise green initiatives to deliver a trajectory that will reduce our direct and indirect carbon footprint and reach net zero direct carbon emissions by 2040 and net zero indirect carbon emissions by 2045 While the COVID-19 pandemic presented the Trust with new risks as it introduced more stringent infection control processes, stopped certain types of activity and responded quickly to care for large numbers of seriously ill patients who had tested positive for COVID-19, it also prompted innovation across a wide range of areas. However the ongoing impact of the pandemic on both our staff, patients who have had COVID-19 and patients who have waited longer than expected for treatment as a result, have added to the risks facing the Trust. This risk has continued into 2021/22 and has been coupled with increases in referrals for cancer and increased attendances to our emergency department and non-elective activity. National targets for performance have not been amended as a result of the pandemic, although the national plan has focussed on the recovery of activity levels as the first stage in a restoration of elective services. Capacity – The initial and subsequent waves of the COVID-19 pandemic have led to increases in the waiting times for patients and the number of patients waiting more than 52, 78 and 104 weeks has increased significantly. While there was a significant reduction in the number of patients waiting over 104 weeks in 2021/22, with the Trust expecting that no patients will be waiting more than 104 weeks by July 2022, its ability to reduce the overall waiting list and the length of time patients are waiting for treatment remains one of the key risks for the Trust. This may be compounded by future waves of the COVID-19, a continuation of the sustained demand for urgent non-elective activity and an ongoing number of referrals, often requiring more complex treatment due to delays in people visiting their GPs for the first time and presenting with more advanced disease. The Trust utilised the support available from the independent sector to continue cancer treatment and surgery for those patients at highest risk and continues to make use of independent capacity for cardiac surgery. It also increased the number of outpatient attendances which took place by telephone or video call. The Trust developed a clinical assurance framework during the year to better assess the risk of harm to patients as a result of delays in treatment and this has been utilised in decision-making around the allocation of resources to those areas where there is the greatest risk of potential harm to patients. In addition to opening additional capacity during 2021/22 (described in the Estates section below), the Trust also committed expenditure in 2021/22 to open further wards and operating theatres during 2022/23 and 2023/24. These initiatives will contribute to further improvements in elective waiting times in coming years. 15 Quality and compliance – The Trust continued to monitor the quality of care delivered throughout 2021/22. During the COVID-19 pandemic the primary focus became infection prevention and control, with the launch of an award-winning COVID ZERO campaign that saw the Trust reduce the transmission of the virus in hospital (nosocomial transmission). While the Trust continued to perform well overall, the Trust exceeded its annual threshold for Clostridium difficile infections and there was one MRSA bacteraemia during March 2022, the only such event in 2021/22. The Trust continued to develop its proactive patient safety culture during 2021/22 with changes to the way in which patient safety incidents are investigated and the launch of its Always Improving strategy and transformation initiatives in theatre efficiency, patient flow and outpatients. Reporting and investigation of incidents continued during 2021/22. The Trust continues to prepare for the implementation of the new patient safety incident response framework in June 2022/23. Partnerships – During 2021/22, the Trust and its partners continued to work together to discharge patients safely, to ensure patients requiring urgent cancer treatment and surgery were able to continue their treatment in the independent sector and to develop the regional COVID-19 saliva testing programme for local schools, hospitals and other employers. The new arrangements for integrated care systems will be implemented in July 2022. This is expected to reinvigorate work with partners at a system, place and provider level in Hampshire and Isle of Wight. The Trust is already part of an acute provider collaborative with other acute trusts in Hampshire and the Isle of Wight and is progressing a number of projects including the development of an elective hub at Winchester Hospital, diagnostics, pathology, endoscopy and imaging networks. The Trust also continued to progress research activity and opportunities with the University of Southampton and Wessex health partners. Workforce – The Trust continued to recruit nurses from overseas and through targeted recruitment campaigns during 2021/22 meaning that the number of nursing vacancies has remained relatively stable. Vacancies in other areas have increased reflecting a more competitive job market, particularly for lower band roles. The Trust also continued to work with its staff networks and specific focus groups to increase diversity in leadership roles. Staff turnover remained above the 12% target during 2021/22 and retention is a key element of the people strategy. While workforce capacity continues to be one of the biggest challenges faced by the Trust, during 2021/22 we have also focused on supporting our staff to respond to the COVID-19 pandemic and operational pressures by providing both the tools and time to help staff recovery. We are incredibly proud of the way that staff responded to the pandemic and continue to recognise this in whatever ways we can, however, we also want to ensure that staff continue to be able to contribute to patient care at their best and want to stay and develop with the Trust. Technology was also used at levels not previously achieved to continue to deliver training to staff and enable staff to work from home where possible, ensuring a safer environment for patients and staff in the hospitals. Estate – The Trust continued to invest in and develop its estate during 2021/22 including opening a new ophthalmology outpatient area, expansion of the majors area of the emergency department and four new operating theatres. These were part of £65 million of capital expenditure in 2021/22 that also included equipment, digital and the backlog maintenance programme. Innovation and technology – There have been exceptional levels of achievement in relation to COVID-19 related research activity, including in partnership with the universities. You can read more about these in part three of the quality account. The board of directors has also supported the funding of an expansion of research and innovation activity to allow the continued delivery of the Trust’s ambitions to innovate and improve and transform its services. 16 The Trust and its partners also been successful in securing external funding including one of only four successful NHSX awards to test the concept of federated trusted research environments with its Wessex health partners and core funding of £10.5 million for the National Institute for Health and Care Research (NIHR) Southampton Clinical Research Facility (CRF) for the period between September 2022 and August 2027. Sustainable financial model –The Trust achieved its forecast breakeven position in 2021/22. Income was more predictable in 2021/22 as block contract arrangements remained in place in response to the COVID-19 pandemic and ensured that costs were covered, however, funding from the elective recovery fund, particularly, in the first half of 2021/22 introduced a degree of income volatility as did changes to the framework for the elective recovery fund half way through the year. The Trust continues to maintain a strong cash position and to implement improvements and efficiency savings, allowing it to continue to invest in its services. The financial outlook across the NHS looks extremely challenging going into 2022/23 due to the reductions in non-recurrent funding and efficiency targets. The Trust currently has an underlying deficit, with pressures on energy prices and drugs cost growth within block contract arrangements, which had been supported with non-recurrent funding in previous years. While specific funding has been provided to address inflationary pressures there is a risk that inflation could exceed this funding and raw material and supply shortages could also impact on costs. Performance overview The Trust monitors a very wide range of key performance indicators within its departments, divisions, directorates and executive committee. Assurance for our board of directors and executive committee includes an integrated performance report which is reviewed monthly and contains a variety of indicators intended to provide assurance regarding implementation of our strategy and that the care we provide is safe, caring, effective, responsive and wellled. The integrated performance report also includes a monthly ‘spotlight’ section, to enable more detailed consideration of any topics that are of particular interest or concern. The selection of topics is informed by a rolling schedule, any performance concerns and requests from the board of directors. Assurance for our council of governors includes a quarterly Chief executive’s performance report, which includes a range of non-financial and financial performance information. 17 Performance analysis COVID-19 Impacts In 2021/22, the most prominent impacts of COVID-19 have been in relation to occupancy of inpatient beds by patients with a COVID-19 diagnosis and increased levels of staff sickness absence associated with COVID-19, in addition to normal levels of absence due to other causes. The impact of COVID-19 has varied significantly through the year, linked primarily to the prevalence of the disease within the wider community. In comparison to 2020/21: • bed occupancy (all types) did not reach the same exceptional peaks, however, it exceeded 50 patients between August 2021 and March 2022 and reached an average of 83 in March 2022; • the number of patients requiring treatment in intensive care and high care were much reduced, though still significant; • fewer patients were admitted requiring hospital treatment for COVID-19 alone, and greater numbers were admitted requiring treatment for other medical conditions who were also infected with COVID-19 at the same time; • staff sickness absence levels were typically higher, particularly in the second half of the year when national restrictions had been removed and COVID-19 infections in the community increased – the sickness absence rate (from all causes) peaked at 6% in March 2022 All bed types Intensive care/higher care beds 18 Staff sickness absence Emergency access through our emergency department Following a reduction during the first year of the pandemic, the numbers of patients who presented to receive care at our emergency department increased exponentially in 2021/22. Attendance levels exceeded the higher levels seen prior to the pandemic by approximately 10%. All patients presenting to the emergency department This exceptional increase in the clinical demand upon our department has had a significant adverse impact upon the timeliness of care, particularly for those patients who have a less urgent condition. The department has also continued to deliver services separately for those patients who have respiratory symptoms and those who do not, and to implement additional infection control measures. Emergency access performance is measured as the percentage of patients discharged from emergency department care or admitted to a hospital bed within four hours of arrival to the department. The national target of 95% was not achieved and the Trust experienced a large deterioration in our own performance to 64% (main ED/Type 1 attendances) by March 2022. Our performance compared favourably with other acute trusts in England despite this, however. 19 Emergency access four hour performance The number and duration of any ambulance handover delays are another important performance indicator. Ensuring that ambulance staff can ‘hand over’ the patients they convey to our emergency department without delay is important because this releases the staff and their vehicle to meet the needs of other medical emergencies in the community. We are very proud to have an exceptionally good record in this regard, working with colleagues in ambulance services to transfer arriving patients into our emergency department and the care of our staff even when the hospital is already fully occupied. 20 Elective Waiting times Demand 2021/22 has seen a continuation of the trend of increasing elective referrals, following a major reduction which occurred at the start of the COVID-19 pandemic. Referral rates to our services are now typically at, or above, the levels seen before the pandemic. Feedback from clinicians is that they are also seeing more patients with advanced disease than they would normally, because of delays in referral to the service/diagnosis. Accepted referrals The number of patients referred to hospital with suspected cancer increased exceptionally during 2021/22; the number of patients seen for a first consultant-led appointment was 27% higher than in 2020/21 and 18% higher than in 2019/20. Performance remained below the national target of 93% throughout the year, with a deterioration to 74% in December 2021 prior to a recovery to 90% in March 2022. Our performance also declined in comparison with other acute trusts in England. Most of the patients who waited longer than two weeks for their first appointment were within our breast service, which sees a very large number of referrals for suspected cancer and experienced a 22% increase in the number of patients seen compared to 2019/20. Additional consultants who specialise in breast cancer have now been recruited and performance in this service returned to target in April 2022. 21 Performance following ‘Two week wait’ urgent referral for suspected cancer 22 Activity The number of UHS hospital appointments, diagnostic tests and elective admissions all increased significantly during 2021/22. The number of appointments undertaken, and diagnostic tests performed, exceeded activity levels in both 2019/20 and 2020/21. The number of elective and day case admissions increased significantly compared to 2020/21 (the first year of the pandemic) yet remained approximately 10% below the levels achieved between April 2019 and February 2020 (prior to COVID-19). There were a wide range of factors influencing these activity levels, and the lower levels of admitted activity specifically, including: • the availability of beds for the admission of elective patients after emergency patients with COVID-19 and other conditions had been accommodated; • the availability of staff to deliver elective care, during periods of increased COVID-19 bed occupancy, and during periods of increased staff absence related to COVID-19; • additional infection prevention measures which were maintained, particularly within inpatient treatment settings where risks of COVID-19 transmission are otherwise increased. Most of the activity has been delivered within NHS hospitals in 2021/22 (local independent sector hospitals were used to replace NHS elective capacity in 2020/21), and we have recruited additional staff and invested in an additional ward, theatres and outpatient rooms in order to be able increase our treatment activity. The graphs below show 2021/22 activity levels as a percentage of those achieved prior to the COVID-19 pandemic. Elective admissions (including day case) 23 Outpatient attendances Diagnostics Our performance measures for diagnostics report on a total of 15 different frequently used tests. At the end of March 2022, 20% of patients were waiting more than six weeks to receive their investigation. This is a significant improvement compared to 28% of patients waiting more than six weeks at the end of March 2021, yet still significantly worse than the national target (1%) and UHS performance prior to pandemic. At the end of March 2022, the total waiting list size (including patients waiting less than six weeks) had increased by 14% compared to March 2021 and was 34% larger than before the pandemic. These trends reflect a combination of large reductions in diagnostic activity in the first year of the pandemic, followed by record levels of diagnostic tests being performed during 2021/22 (7% higher than before the pandemic) combined with very high levels of referrals for diagnostic testing over the same period. 24 The tests with largest numbers of longer waiting patients are non-obstetric ultrasound, peripheral neurophysiology, MRI and CT. Initiatives to improve performance include the recruitment of additional staff in the relevant professions and investment in additional equipment, in the context of NHS forecasts that diagnostic demand will continue to increase over the longer term. Patients waiting for a diagnostic test to be performed (sum of 15 different frequently used tests) Percentage of patients waiting over 6 weeks for a diagnostic test to be performed 25 Referral to Treatment Our waiting list from referral to treatment increased in size by 27% (9,768 patients) during 2021/22 and is now 36% larger than before the pandemic. Both referrals and hospital activity declined steeply at the start of the pandemic, but referral levels increased more quickly than hospital activity following this. The rate at which the waiting list is increasing has however reduced in the most recent six months. Number of patients waiting between referral and commencement of a treatment for their condition The national target is that at least 92% of patients should be waiting for treatment no more than 18 weeks from their referral to hospital. Our performance has deteriorated from 80% immediately before the pandemic, to 68% at the end of March 2022. Our performance continues to be typical of the major teaching hospital trusts that we benchmark with, and the trend has been similar to that experienced across trusts in England. Percentage of patients waiting up to 18 weeks between referral and treatment 26 The fact that some patients wait significantly longer than the 18 week target is a particular concern. In 2020/21 NHS England targeted the stabilisation of the numbers of patients waiting more than 52 weeks and the elimination of waiting times more than 104 weeks (except when patients choose to wait longer). The percentage of patients waiting more than 52 weeks at UHS reduced from 9% to 4%. The number of patients waiting more than 104 weeks reduced, from a maximum of 171, to 59 at the end of March 2022 (of whom only five were wishing to proceed with treatment at that time). The patients who typically wait longest for treatment continue to be those who require admission for surgical procedures in specialities such as ear nose and throat, orthopaedics and oral surgery. The Trust opened four additional operating theatres during 2020/21 and is working in collaboration with partners in the Hampshire and Isle of Wight integrated care system to implement further elective recovery plans. Percentage of patients waiting more than 52 weeks, between referral and commencement of a treatment for their condition 27 Cancer Waiting Times The timeliness of urgent services for patients with suspected cancer has unfortunately declined during 2021/22. The Trust continues to perform well in comparison with the teaching hospitals that we benchmark with and deliver a similar range of services, however. We have faced a range of challenges including: • a large increase in the number of new patients referred for investigation; • delays in the onward referral (for specialist investigation or treatment) of patients from other trusts which have also experienced increases in referrals; • the need to provide capacity to investigate and treat the full range of other conditions, alongside those patients with suspected cancer; and • an increase in the complexity of treatment required by new and existing patients, potentially because of delays in referral or treatment during the first year of the pandemic The national target is to provide the first definitive treatment to at least 85% of patients with cancer with 62 days of referral to hospital. UHS exceeded this level of performance in April 2021 but has not done so since then, performance deteriorated to 66% in January 2022 before recovering somewhat to 72% by March 2022. Treatment for Cancer within 62 days of an urgent GP referral to hospital The national target is to provide the first definitive treatment to at least 96% of patients within 31 days of a decision to treat being made and agreed with the patients. Trust performance has been very variable in 2021/22, ranging from 89% to 98% in individual months. Likewise, performance has ranged from below average in some months, to amongst the best in the group of teaching hospitals that we benchmark with. 28 First definitive treatment for cancer within 31 days of a decision to treat A range of initiatives are being pursued to maintain and improve the timeliness of our cancer services including: • changes to some of the processes for the referral and initial assessment of patients with suspected cancer, for example the inclusion of high quality photographs within referrals for suspected skin cancer; • projects to refine processes and procedures for the investigation of suspected gynaecological and urological cancers; • an operating services improvement programme designed to improve the flow of patients, and the numbers of patients treated, through our existing theatre facilities; and • staffing level increases and recruitment to clinical roles in specialities where the increases in demand require this. Quality priorities The Trust set four quality priorities in 2021/22, which were aimed at ensuring we continued to deliver the highest quality of care. The quality priorities were shaped by a range of national and regional factors as well as local and Trust‐wide considerations. We recognised the overriding issues of significant operational pressures being felt right across the health and social care system, including those associated with the second year of the COVID-19 pandemic, by limiting the number of priorities to four. We also acknowledged the risk that the delivery of our priorities could be disrupted by the ongoing pandemic and that we needed to be flexible in adapting the priorities to changing circumstances. The Trust set the following four priorities: 1. Introduction of midwifery continuity of carer for women at risk of complications in pregnancy. 2. To support staff wellbeing and recovery. 3. Managing risks to patients delayed for treatment and restoring elective programmes. 4. Reducing healthcare associated infection (HCAI) 29 The Trust achieved three of the quality priorities and partially achieved one priority. In relation to midwifery continuity of carer, the Trust’s performance exceeded the ambition that had been set by NHS England in 2020/21 following its national review of maternity services in 2015 as shown below. NHS England ambition set in 2020/21 35% of women will be booked to receive care in a continuity of carer team 35% of black and minority ethnic women booked to receive care in a continuity of carer team 35% of women living in an IMD-1 area (most deprived areas measured using indices of deprivation) Percentage achieved 41.7% 75% 80% The Trust continued to introduce programmes, interventions and wider support offerings to promote staff wellbeing and recovery in 2021/22. Our 2021/22 annual NHS staff survey results are positive with our scores relating to wellbeing above the benchmark average. Contributing factors to wellbeing such as staff engagement, morale, staff experience in areas such as kindness and respect, feeling valued and trusted to do their job were all above the benchmark average. More information about staff health and wellbeing is included in the staff report below. The Trust only partially achieved the priority relating to managing the risks to patients delayed for treatment and restoring elective programmes. The Trust’s performance against elective waiting time standards are described in more detail above. While the Trust focused on prioritising all patients waiting for surgery to ensure we continued to treat people based on need and urgency, we continue to recognise the impact of delays on people’s quality of life and, at times, outcomes. COVID-19 remained a key area of focus for the Trust in 2021/22 in terms of infection prevention. The Trust implemented a number of awareness campaigns, including its award-winning COVID ZERO campaign, and strategies to reduce in-hospital transmission of COVID-19 and kept these under review throughout the year. The chart below shows the trend of hospital-onset cases of COVID-19, which has broadly followed local and national prevalence of the virus, and the Trust’s performance compared very favourably with its local and national peers. 30 The table below provides an overview of the Trust’s performance against national and other infection prevention standards and limits to minimise infections, the majority of which have been achieved by the Trust. Category National Objectives: MRSA bacteraemia Clostridium difficile infection E coli Bacteraemia End of year RAG Action /Comment R One MRSA bloodstream infection attributable to UHS 2021/22 in March 2022. R 74 cases against a threshold of 64 for the year. G 138 cases in 2021/22 against a threshold of 151. Klebsiella Bacteraemia A 64 cases in 2021/22 against a threshold of 64. Pseudomonas Bacteraemia MSSA G 30 cases in 2021/22 against a threshold of 34. 43 cases in 2021/22 after 48 hours in hospital. Other: Hospital onset, healthcare associated COVID-19 103 hospital-onset probable healthcareassociated cases in 2021/22. 125 hospital onset definite healthcare associated cases in 2021/22. Prudent antibiotic Antimicrobial prescribing Stewardship G The standard contract requirement for reduction in antibiotic usage for 2021/22 was waived, as in 2020/21. Had it been applied as anticipated, the Trust would very likely have met this. Provide Assurance of Infection G The annual infection prevention audit assurance of Prevention Practice programme was reinstated in April 2021 for basic infection Standards the monitoring and assurance of infection prevention prevention and control practices but practice: subsequently suspended in September 2021. You can find more information about how the Trust delivered and measured its quality priorities, including feedback from patients and staff and improvement aims and quality priorities for 2022/23, in the Trust’s quality account for 2021/22, incorporated in the Trust’s annual report and accounts. 31 Financial performance The Trust delivered a surplus of £0.048 million from a revenue position of over £1.2 billion, once items deemed as “below the line” by NHS England and NHS Improvement, su
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Workforce Race Equality Standard Annual Report 2022

Description: Workforce Race Equality Standard - Annual Report 2022 Table of Contents Executive Summary 3 Introduction 5 WRES Data Submission 2022 6 Indicator 1: Percentage of staff in each AfC Band 1-9 and VSM compared to overall workforce 6 Indicator 2: Relative likelihood of BME staff being appointed from shortlisting 8 Indicator 3: Relative likelihood of staff entering a formal disciplinary process 8 Indicator 4: Relative likelihood of staff accessing non-mandatory training and CPD 9 Indicator 5: Percentage of staff experiencing harassment, bullying or abuse from patients, relatives, or the public 9 Indicator 6: Percentage of staff experiencing harassment, bullying or abuse from staff 9 Indicator 7: Percentage of staff believing that the Trust provides equal opportunities for career progression or promotion 10 Indicator 8: Percentage of staff personally experiencing discrimination at work by a manager/team leader or other colleagues 10 Indicator 9: % difference between the organisations’ Board voting membership and its overall workforce 10 Conclusion and Next Steps 11 Appendix 1: Infographic to visualise WRES data 12 Appendix 2: WRES Action Plan 2022 13 Executive Summary The Trust has submitted WRES data since 2015 and has a quarterly programme of reviewing progress against the nine indicators contained within the WRES dashboard. This report shows the latest dataset from 2022 and explores whether there have been any significant improvements or deterioration compared with the results from 2021. An updated WRES action plan is also within this report (Appendix 2), which shows the areas of focus for the Trust in the coming year. In addition to the analysis within the report an infographic offering a visual representation of the data is also found in Appendix 1. The key findings from the 2022 submission show: 1. BME staff represent 23.5% of the workforce, which is a 2.5% increase from the 2021 data submission. There continues to be an overall improvement in proportionate representation in most of the bands since 2021and especially so amongst the clinical workforce. 2. There is no more or less likelihood that BME applicants will be appointed from shortlisting than white applicants. (Data from Trac automatic download into ESR). 3. BME staff continue to be less likely than White staff to be entered into a formal disciplinary process. 4. BME staff are less likely than White staff to access non-mandatory training and continued professional development opportunities. 5. BME staff experience more harassment, bullying or abuse from patients, relatives or the public than white staff, with the gap of inequality continuing to widen. 6. BME staff report a higher level of experiencing harassment, bullying or abuse from other staff compared with White staff. 7. The perception around the equal opportunities for career progression or promotion within the Trust is lower amongst BME staff than it is for White staff. 8. BME staff are more than twice as likely as White staff to report personally experiencing discrimination at work by a Manager/Team leader or other colleagues. 9. The representation of BME staff on the Trust Board has increased to 14%. It is reassuring that all nine indicators have seen an improvement from 2021, however viewing the context of the improvements in line with the disparity gap shows that there is still a large gap between the experiences of people from black and minority ethnic backgrounds and white backgrounds. This is where we must focus our efforts in order to make sustained improvements. The action plan sets out in detail the priorities and programmes of work as part of the Trust’s Equality, Diversity and Inclusion Strategy which will drive improvements against these indicators. The action plan will continue to be reviewed by the One Voice Staff Network and reviewed by the regional NHSi EDI Lead. The outcomes of the WRES does not alter the themes contained in our strategy, and the action plan is aligned to these themes: 1. Inclusive recruitment practices and equal opportunities: Large scale review of current recruitment practices to eliminate bias from the systems and promote inclusivity. The Inclusive Recruitment Programme will ensure that recruiting managers are trained in inclusive recruitment techniques and criterion based methods will ensure bias is removed. We will align with the national programme for overhauling recruitment and promotion and contribute to this work wherever possible. The implementation and embedding of processes that ensure inclusive recruitment and equal opportunities for all. This will be in line with the National 6 high impact actions. Our talent management programme will provide further opportunities for people from BME backgrounds to access development and the review of processes for data collection in terms of training, development, recording as part of the data dashboard workstream will ensure the intelligence is available to correctly measure whether we are improving access or if there is more action required. 2. Workforce reflecting our wider communities: In line with the Inclusive Recruitment programme, we will be increasing efforts to make recruitment processes inclusive and therefore not post any barriers to the community in terms of applying for roles at UHS. We will be implementing a specific project with Black History Month South which focuses on outreach to the black communities in Southampton to promote roles and careers within UHS. Our recruitment outreach will also work more with local communities to attract people from the city from diverse backgrounds. We will be implementing positive action talent programmes that will enable people from black and ethnic backgrounds to access development, networking, and coaching to confidently apply and be successful at roles when they become available. We will provide career toolkits for all people who are unsuccessful at interviews to help them to succeed next time. We will continue to strive to meet the national target of 19% representation in band 7s and above. 3. Safe and healthy working environments: Our Equality, Diversity and Inclusion strategy states a clear intent for UHS to become an anti-racist and anti-discriminatory organisation. We aim to decrease disparity of experience by 5% across all indicators in the WRES which will either reduce by half or eliminate disparity altogether. We will be working closer with colleagues who lead on hate crime, violence and aggression to ensure robust mechanisms for reporting of incidence and the data is used to steer accountability and meaningful action. We will identify mechanisms and root causes of the disproportionality of BME staff experiencing discrimination, harassment, bullying and/or abuse and in turn whether there are trends within the trust that need targeted action. The link to the leadership and management work programme is a critical enabler of creating safe and healthy work environments. 4. Inclusive leadership and management: Ensure leaders and managers are clear on their accountabilities with regards to EDI and the responsibilities they hold to deliver the actions within the EDI strategy. To have development opportunities in supporting BME staff and those who may identify with a protected characteristic. That all leaders and managers understand their own bias and can access learning in terms of how they lead and make decisions. To support leaders and managers to understand their role as allies and role models, and how to challenge behaviours or actions that are not in line with Trust policy or values. To support leader and managers to develop greater awareness of the legal aspects of their roles in relation to equality, and how diversity and difference can enhance their team delivery and performance. Introduction Research and evidence strongly suggest that less favourable treatment of black and minority ethnic (BME) staff in the NHS, through poorer experience or opportunities, has significant impact on the efficient and effective running of the NHS and adversely impacts the quality of care received by all patients. The NHS Workforce Race Equality Standard (WRES), introduced in 2015, seeks to prompt inquiry to better understand why it is that BME staff receive poorer treatment than White staff in the workplace and to facilitate the closing of these gaps. This is the 2022 annual WRES Data report. Data has been directly compared to 2021 data providing a clear picture on the indicators where the Trust is performing well and those that require our focus in the year ahead. Despite an improvement in the overall representation of BME staff in the workforce, the data highlights that the experiences and opportunities for BME staff are not the same as for White staff, and more action and focus is needed to close the gap in experience between these two staff groups. The focus of this report is to present the Trust’s performance against the WRES indicators for the past 12 months and provide recommendations and an action plan by which to better our performance and ultimately improve the experience and opportunities for our BME staff in the coming years. WRES Data Submission 2022 The WRES submission is comprised of 9 indicators which compare the experience of White and BME staff in an employment context. The submission for 2022 is broken down below and compared with data from the 2021 submission, with a summary of whether there has been an improvement or deterioration in the data. It is important at this point to note that indicators 5 to 8 are measurements taken from the 2021 staff survey and therefore are percentages of individuals who took part and not of the total workforce which is the case for indicators 1 to 4 and indicator 9, which are taken directly from the trusts electronic staff records system (ESR). Indicator 1: Percentage of staff in each AfC Band 1-9 and VSM compared to overall workforce Non-Clinical Non Clinical Workforce 2021 2022 Change from 2021/22 in BE White BME Total White BME Total # % # % # # % # % # Band 1 43 87.76% 6 12.24% 49 32 86.48% 5 13.51% 37 +1.27% Band 2 749 85.50% 127 14.50% 876 660 87.18% 97 12.81% 757 -1.69% Band 3 609 90.22% 66 9.78% 675 590 87.79% 82 12.20% 672 +2.42% Band 4 337 90.84% 34 9.16% 371 371 91.60% 34 8.39% 405 -0.77% Band 5 224 84.21% 42 15.79% 266 255 84.15% 48 15.84% 303 +0.05% Band 6 177 90.31% 19 9.69% 196 215 89.21% 26 10.78% 241 +1.09% Band 7 156 90.17% 17 9.83% 173 163 88.10% 22 11.89% 185 +2.06% Band 8A 108 95.58% 5 4.42% 113 124 94.65% 7 5.34% 131 +0.92% Band 8B 62 92.54% 5 7.46% 67 61 92.42% 5 7.57% 66 +0.11% Band 8C 41 95.35% 2 4.65% 43 42 95.45% 2 4.54% 44 -0.11% Band 8D 17 94.44% 1 5.56% 18 23 100% 0 0% 23 -5.56% Band 9 13 86.67% 2 13.33% 15 13 81.25% 3 18.75% 16 +5.52% Total 2,536 88.61% 326 11.39% 2,862 2,549 88.5% 331 11.49% 2,880 +0.10% Clinical Clinical 2021 2022 Change from 2021/22 in BE Workforce White BME Total White BME Total # % # % # # % # % # % Band 1 0 0.00% 0 0.00% 0 0 0 0 0 0 0 Band 2 1089 82.00% 239 18.00% 1328 984 78.97% 262 21.02% 1246 +3.02% Band 3 388 87.78% 54 12.22% 442 416 87.94% 57 12.05% 473 -0.17% Band 4 448 70.55% 187 29.45% 635 452 71.97% 176 28.02% 628 -1.43% Band 5 1389 63.48% 799 36.52% 2188 1277 56.78% 972 43.21% 2249 +6.69% Band 6 1498 84.25% 280 15.75% 1778 1545 81.48% 351 18.51% 1896 +2.76% Band 7 857 87.63% 121 12.37% 978 876 87.33% 127 12.66% 1003 +0.29% Band 8A 240 90.57% 25 9.43% 265 272 90.96% 27 9.03% 299 -0.40% Band 8B 73 94.81% 4 5.19% 77 76 92.68% 6 7.31% 82 +2.12% Band 8C 19 95.00% 1 5.00% 20 20 95.23% 1 4.76% 21 -0.24% Band 8D 14 100.00% 0 0.00% 14 13 100% 0 0.00% 13 0% Band 9 2 100.00% 0 0.00% 2 2 100% 0 0.00% 2 0% Consultants 594 76.94% 178 23.06% 772 647 76.38% 200 23.61% 847 +0.55% Non-Consultant Career Grades 287 72.84% 107 27.16% 394 283 71.46% 113 28.53% 396 +1.37% Trainee Grades 545 56.48% 420 43.52% 965 548 55.57% 438 48.88% 986 5.36% Total 7443 75.50% 2415 24.50% 9858 7,411 73.27% 2,703 26.72% 10,114 +2.22% The 2022 data submission indicates that 23.5% of the workforce are people from black and minority ethnic backgrounds, which is a 2.5% increase from the 2021 data submission. The disparity between the organisational average for BME clinical (26.72%) and non-clinical (11.49%) at various grades has widened further as more BME staff joined clinical posts and likely to be directly attributed to the international recruitment programme. The local population is represented with approximately 14% of people from black and ethnic backgrounds. The most notable increases for the non-clinical workforce were at Band 7 (increase of 2.06%), Band 9 (increase of 5.52%) and Band 3 (increase of 2.42%). In the clinical workforce, there were increases across a number of pay bands, with significant increases within band 5 of 6.69% and band 8b of 2.12%. The trust continues to strive towards 19% of positions Band 7 and above being occupied by BME staff. Indicator 2: Relative likelihood of BME staff being appointed from shortlisting Relative likelihood of staff being appointed from shortlisting across all posts 2021 2022 White BME White BME # # # # Number of shortlisted applicants 7968 5105 6273 1845 Number appointed from shortlisting 407 222 1957 605 Relative likelihood of White staff being appointed from shortlisting compared to BME staff 1.17 0.94 The 2022 data collection identifies the relative likelihood of white applicants being appointed from shortlisting in comparison to BME applicants. The data now suggests a broadly equal likelihood of BME and White applicants will be appointed from shortlisting, with a relative likelihood of 0.94 in favour of BME applicants, now below a measurement of 1. This is a positive improvement in comparison to the 2021 data collection of a relative likelihood of 1.17. Indicator 3: Relative likelihood of staff entering a formal disciplinary process Relative likelihood of staff entering the formal disciplinary process, as measured by entry into a formal process 2021 2022 White BME White BME # # # # Number of staff entering the formal disciplinary process 46 12 76 15 Relative likelihood of BME staff entering the formal disciplinary process compared to White staff 0.95 0.65 People from black and minority ethnic backgrounds are less likely to enter a formal disciplinary process compared with White staff. This is below a relative likelihood of 1 and has seen a significant improvement from 0.95 in 2021 to 0.65 in 2022. Indicator 4: Relative likelihood of staff accessing non-mandatory training and CPD Relative likelihood of staff accessing non-mandatory training and CPD 2021 2022 White BME White BME # # # # Number of staff accessing non-mandatory training and CPD 286 43 791 172 Relative likelihood of White staff accessing non-mandatory training and CPD compared to BME staff 1.82 1.33 BME staff are less likely to access non-mandatory training and CPD as compared with White staff, although this likelihood score has improved since 2021 from 1.82 to 1.33 there is still improvements that need to be made in reducing the disparity and achieve a relative likelihood score that is closer to or equal to 1. As a result of this there will be a focus on improving the likelihood of BME staff accessing non-mandatory training and CPD through engagement with individuals to understand the barriers of access. Also improvements to the scope of the data collection and improvements to the way we bring sources of data together in relation to CPD. There are currently various different places where information on CPD is held, this needs to be brought onto one consistent platform (our virtual learning environment VLE) to enable us to get a better representation of the real picture in order to determine the action required. Indicator 5: Percentage of staff experiencing harassment, bullying or abuse from patients, relatives, or the public In contrast to last year, the percentage of white staff experiencing harassment, bullying or abuse from patients, relatives or the public is reported at 21.8% and has decreased by 3.4%. The percentage for BME staff is reported as 25.1% and has decreased by 5.4%. although improvements have been noticed, there remains a disparity of 3.3%. Indicator 6: Percentage of staff experiencing harassment, bullying or abuse from staff This year’s data indicates that BME staff experience more harassment, bullying or abuse by staff than White staff. The experience for BME staff is reported at 22.8% in comparison to white staff which is reported at 18.2%. This year the experience for white staff dropped by 3.1% and experience for BME staff dropped by 5.8%. although there is a disparity in experience, this year’s data indicates the disparity is improving now with a difference of 4.5% compared to 7.2%. With this in mind and although improvements have been recognised within this indicator, planned action will continue in efforts to eradicate the occurrence of this experience and in turn the disparity between BME and white staff. Indicator 7: Percentage of staff believing that the Trust provides equal opportunities for career progression or promotion This year’s data indicates the perception of white staff and the opportunities for career progression is now 64.6% and has decreased by 1.4%, however the view of BME staff has increased by 3% to 53.7%. The disparity between people from White backgrounds and those from BME backgrounds relating to opportunities for progression is 10.7% compared to the 2021 data submission of 12.7%. Although there are marked improvements, the Trust will continue with its efforts to reduce this gap by implementing training and career progression opportunities as set out in the action plan as part of our talent development and positive action programmes. Indicator 8: Percentage of staff personally experiencing discrimination at work by a manager/team leader or other colleagues This year’s data submission shows that 14.7% of BME staff experienced discrimination at work by a Manager/team leader compared to their White counterparts. Although there has been an improvement of 1.3%, the experience of white staff remains lower at 5.9% and therefore the percentage for BME staff is more than double. It is also important to note that the experience of white staff within this data collection period increased by 0.04%. It is not acceptable for any member of staff to experience discrimination at work by a manager or team leader. The work programme which will deliver the priorities of the EDI strategy will aim to tackle this issue and reduce the disparity. Indicator 9: % difference between the organisations’ Board voting membership and its overall workforce There has been an improvement in the 2022 submission of the number of people from black and ethnic backgrounds on our Trust Board, from 8.3% to 14%. The Trust remains committed to adopting recruitment methods when recruiting for future Board positions that will continue to improve BME representation at Board level. Conclusion and Next Steps Based on the 2021 data we have seen improvements in all indicators, however the disparity gap is still large across a number of indicators, the following indicators have been identified as those that must be prioritised: * Indicator 1: Percentage of staff in each AFC band * Indicator 4: Number of staff accessing non-mandatory training and CPD. * Indicator 5: Percentage of staff experiencing harassment, bullying or abuse from patients, relatives, or the public * Indicator 6: Percentage of staff experiencing harassment, bullying or abuse from staff * Indicator 7: Percentage of staff believing that the Trust provides equal opportunities for career progression or promotion * Indicator 8: Percentage of staff experiencing discrimination at work by a manager/team leader or other colleagues These indicators are inextricably linked so it makes sense that they should be tackled alongside each other. The action plan (Appendix 2) sets out in detail the actions the Trust will take to achieve improvements against these indicators. Appendices Appendix 1: Infographic to visualise WRES data 2 Appendix 2: WRES Action Plan 2022 WRES Themes / Areas Proposed actions Responsible for Actions Deadline / review date 1: Workforce reflecting our communities, at all roles, at all levels; ensuring those who are underrepresented groups can access support to thrive, excel and belong within their roles. a) Achieve 19% BME representation through all levels in both the clinical and non-clinical workforce. This is aligned to National target set and we will remain focused on increasing representation within senior leadership roles within the organisation which currently remain lower in representation of BME staff members. Chief People Officer / Director of OD & Inclusion September 2023 b) To develop and initiate positive Action Programmes both UHS and HIOW system wide; for BME staff and/or other protected characteristics. Acknowledging individuals experience of barriers to promotion, development and career progression. Workforce Inclusion & Belonging Consultant / Head of EDI / Head of OD July 2023 c) UHS partnership with maaha people in developing and running a positive action leadership programme which will enrol 24 individuals who identify with a protected characteristic and will be designed to support individuals looking to move into, or those who are moving through senior leadership roles within the organisation, building on individuals personal identity, power and influence within the organisation. Workforce Inclusion & Belonging Consultant January 2023 d) Partnership with the Florence Nightingale Foundation; Nurse leadership programme aimed at aspiring nurses from backgrounds that are under-represented in our nursing workforce and ensuring that opportunity for individuals is equal and representative of wider society. Deputy Director of Nursing & Head of OD April 2023 e) Talent development programme for individuals supporting the career development, pathways, training and development of individual’s, ensuring talent workstreams and pipelines that encourage opportunity at earlier stages than current and will include long-term career planning. Develop a talent pipeline/talent management plan to include stretch activities, secondments, shadowing, specialist training, qualifications, coaching and mentoring. This will look at strengthening as well as unearthing our current talent within UHS and ensuring that individuals continue to thrive, excel and belong and we support them to do this. Head of Talent Management / Head of EDI / Workforce Inclusion & Belonging Consultant July 2023 f) Continue to build on newly found working relationship with Southampton job centre. Continue to liaise, attend and promote UHS as an employer of choice, the support that is offered and the career opportunities that are available including volunteering roles. Workforce Inclusion & Belonging Consultant / HR Recruitment team April 2023 g) Partnership with Black History Month South to outreach into schools with high BME pupil populations, aiming to positively influence young people from BME backgrounds into NHS careers. Head of EDI / Workforce Inclusion & Belonging Consultant June 2023 2: Safe and healthy working environments, free from aggression, hate and discrimination a) Creation of a behaviour framework to bring to live our Trust Values and more clearly describe the expected behaviours relating to equality, diversity and inclusion that impact BME staff and/or those with a protected characteristic. Director of OD & Inclusion / Head of EDI / Workforce Inclusion & Belonging Consultant August 2023 b) Fully establish divisional EDI Steering Groups to drive actions and improvements derived from race specific metrics throughout all teams, care groups and divisions. Director of OD & Inclusion / Head of EDI April 2023 c) Creation of EDI data and information dashboard to evidence improvements and scrutinise themes that impact individuals and determine actions required. Director of OD & Inclusion / Head of EDI April 2023 d) Developing a culture of Allyship: All staff to participate in Actionable Allyship training by 2024. The actionable allyship – stop.Start.continue programme will continue on the statutory and mandatory matrix for all staff to complete. This will provide individuals with the insight, knowledge and skill and to be active allies within a moment of challenging non inclusive behaviours and supporting our statement in becoming an anti-racist and anti-discriminatory organisation. in turn decreasing the disparity of experience between BME and white staff within the organisation. Workforce Inclusion & Belonging Consultant August 2023 e) Continue conversations on race, sharing of lived experience, building on fostering a culture of inclusion where allyship is exampled and individuals feel welcomed, respected, valued and heard to bring their whole and authentic selves to work. Head of EDI / Workforce Inclusion & Belonging Consultant August 2023 3: Recruitment processes which are free from bias and are inclusive a) Implement a work programme to review and improve the equity of recruitment processes and practices that impact all individuals. Working group to include partnership with the chairs of the staff network and representation from our diverse workforce. The working group will look at each stage and deliver on recommendations from engagement within the process. Aligning to the NHS People Plan England/Improvement High Impact Actions and Inclusive Recruitment Programme. Workforce Inclusion & Belonging Consultant December 2022 b) Inclusive training, learning and development for all people involved in recruitment and attraction. Head of Talent attraction / HR Recruitment Team September 2023 c) Deliver a truly inclusive process with equitable practices as standard. This will include processes from pre-employment to recruitment, through to employment and the onboarding process. Head of HR / Head of EDI / Workforce Inclusion & Belonging Consultant September 2023 4: Inclusive leadership and management a) Inclusive Leadership content in all UHS leadership & management programmes to include personal learning, person action and accountability. This will move us to a place where equality, diversity and inclusion is the golden thread that runs through all our processes at UHS. Head of OD / Head of Leadership & Development / Head of EDI / Workforce Inclusion & Belonging Consultant April 2023 b) Board and Senior leadership programmes to include the element for all leaders plus strategic and cultural responsibilities for equality, diversity and inclusion. Head of OD / Head of EDI July 2023 c) Inclusive leadership and management as part of the UHS Managers Induction Programme. Head of Leadership & Development / Head of EDI / Workforce Inclusion & Belonging Consultant April 2023 d) Implementation of ongoing learning and development opportunities to enable leaders and managers to role model inclusive behaviours every day. For example: * Inclusive meetings * Agile working * Equality impact assessment * Adjustments required to enable people to thrive and be at their best at work. * Creating environments for people to succeed * Support the development of reciprocal mentoring * Inclusive leadership behaviours aligned to our values Head of EDI / Workforce Inclusion & Belonging Consultant September 2023 5: Networks and partnerships that thrive and support creation of an inclusive and safe place to work. a) Development programmes for Networks and Network Chairs clearly identifying roles to enable leadership of highly active networks, clarity of purpose and future plans. Head of EDI / Workforce Inclusion & Belonging Consultant May 2023 b) Heightened focus to re-engage active membership of the one voice network and to support the interim chair in securing a permanent position. Development opportunities will include; coaching, mentoring, influential leadership skills and recognising their contributions as career development opportunities. Head of EDI / Workforce Inclusion & Belonging Consultant April 2023 c) Implement and establish the Equality, Diversity and Inclusion Council; A place for network leads and members alongside the equality, diversity and inclusion team to dialogue with one another, bring forward ideas or concerns from the networks and a place for the voices of all individuals within the organisation to be recognised and heard. This will also offer a place for future projects and funding to be discussed and where a decision on what risks and/or assurances need to be raised within committee meetings. Director of OD & Inclusion / Head of EDI / Workforce Inclusion & Belonging Consultant November 2022 d) Network chairs to remain a standing member and integral voice for diverse individuals at all people committees and board meetings Chief People Officer / Director of OD & Inclusion September 2023 2
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WRES report and action plan 2023

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