Our Corporate Plan 2024-27 sets out our vision and mission for the organisation which are underpinned by our guiding HSC values. The plan also sets out our strategic priorities and the programmes of work we are prioritising for the year ahead so that we achieve the outcomes needed for our population.
Read the Western Trust Corporate Plan 2024-27
View the Standing Orders and Scheme of Reservation and Delegation
View the Standing Financial Instructions
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Foreword from the Chair and Chief Executive
We are pleased to present our Corporate Plan for 2024 to 2027, which sets out the Trust’s strategic direction and our ambitions for this organisation and the people we serve for the next three years.
We are committed to partnership working in our approach to delivering our strategic priorities. We want to ensure access to the best possible care in the right setting, while contributing to improved health outcomes and reduced inequalities for our population.
We aim to provide more opportunities for our communities to make their voices heard, while embracing diversity and inclusion.
The Western Health and Social Care Trust launched its new mission and vision in June 2023, following consultation and engagement throughout 2022 and 2023.
Since then, we have engaged with service users, staff and partners to identify what we need to do to achieve our agreed goals over the next three years. This Corporate Plan is the outcome of that work. It sets out our priorities, commitments and how we will work together to deliver the Plan.
We recognise that demand for our services is increasing across all areas and that it is challenging for services to keep pace. Recruitment challenges, which are also being experienced by other health and social care organisations, mean that patients and clients are waiting longer than we would want to access services.
We must continue to be innovative and flexible and work even more closely with our partners in health and social care and the wider community. This will help ensure that our resources are used as effectively and efficiently as possible to meet the needs of our local population.
Helping people to live well, independently and as part of a community that is at ease with itself is as important as treating immediate health and care needs. We therefore want to place greater emphasis on preventing illness and promoting wellbeing.
The challenging objectives in this Corporate Plan cannot be achieved without the professionalism, commitment and dedication of our staff.
For this reason, we have prioritised the development and stabilisation of our workforce and the creation of a caring, learning and empowering culture. We want to make our organisation an employer of choice and ensure that staff feel supported and valued.Dr Tom Frawley CBE
ChairMr Neil Guckian OBE
Chief Executive -
Introduction
Our Corporate Plan for 2024/25 to 2026/27 describes our mission, vision and values.
It sets out, at a high level, our strategic priorities and corporate objectives for the next three years, in line with regional policies, strategies and local priorities.
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Context
Who We Are
The Western Health and Social Care Trust is one of five Health and Social Care Trusts providing health and social care services across Northern Ireland.
Our services include:
- Acute and community care
- Mental health services
- Learning disability services
- Physical and sensory disability services
- Children’s services
- Social care services
We provide services to more than 300,000 people living in the West of Northern Ireland, covering:
- Limavady
- Derry
- Strabane
- Omagh
- Fermanagh
We also provide sub-regional services to the Northern Health and Social Care Trust in:
- Ophthalmology
- Trauma and orthopaedics
- Urology
- Oral surgery
These services increase the Trust’s catchment population to more than 410,000 people.
As a border region, the Western Trust has well-established cross-border collaborative arrangements with the Republic of Ireland for the delivery of several services, including the North West Cancer Centre.
The Trust’s geographical area covers 4,842 square kilometres and is coterminous with three council areas:
- Derry City and Strabane District Council
- Fermanagh and Omagh District Council
- Causeway Coast and Glens Borough Council, in relation to Limavady
The area includes a mix of densely populated urban areas and extensive rural communities.
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Our Values, Mission and Vision
Our Values
The Health and Social Care values should shape how we carry out our work every day and the behaviours expected of us.
They also send a clear message to patients, service users, families and carers about the care and support they should expect and how it should be delivered.
Our values are:
- Working Together
- Excellence
- Openness and Honesty
- Compassion
Our Mission and Vision
The Western Health and Social Care Trust launched its new mission and vision in June 2023.
Together, they set out:- Why the Trust exists
- What the Trust does
- Who the Trust serves
Our mission and vision are underpinned by the Health and Social Care values. Together, they represent the culture we will strive to achieve throughout the organisation.
Our Vision
Working together to provide the best health and social care so that:
- People who need us feel cared for
- People who work with us feel proud
- People who live in our communities trust us
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The Context We Work In
The health and social care system is facing considerable demand and financial pressures. It continues to operate within an ongoing cycle of contingency and recovery plans.
The Western Trust area has some of the highest poverty and deprivation rates in Northern Ireland. This results in high levels of need and demand for care in areas across the West.
In line with national and regional trends, the Trust serves a growing and ageing population. This creates an increased need for health and social care services.
Backlogs in planned care that developed during the COVID-19 pandemic have also contributed to a substantial imbalance between demand and capacity across many acute and community services.This has resulted in:
- Long waiting lists
- Significant unmet need
- An impact on health outcomes for the population
Access to quality healthcare services has traditionally been viewed as the most important factor in achieving better population health outcomes.
However, evidence and research indicate that access to high-quality healthcare influences approximately 20% of health outcomes at a population level.
The remaining 80% relates to:
- Individual behaviours
- Socioeconomic conditions
- Other factors that can be difficult to address through healthcare provision alone
We are therefore increasingly focused on working in partnership across the entire system. This includes working with all sectors, partners and citizens to meet the needs of our population.
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Our Services
The Trust spends approximately £970 million each year delivering a wide range of health and social care services.
Approximately 12,000 staff work across more than 90 sites.
Services are delivered from:
- Hospitals
- Community facilities
- People’s homes
Community Services at a Glance
The Trust provides approximately:
- 1,800 residential and nursing home placements
- Domiciliary care services to 3,700 people in their homes
- £4.5 million of community equipment each year
- 218,000 community allied health professional contacts, including physiotherapy and occupational therapy
- 17,000 social work contacts
- 96,000 mental health outpatient contacts
- 218,000 district nursing contacts
- Four GP practices
- 390,000 community nursing and health visitor contacts
Trust Facilities
The Trust delivers services from:
- Seven hospitals
- 11 health centres and clinics
- Eight children’s homes
- 30 day centres
- Eight residential homes
- One hostel
- Six training centres
- 12 administration hubs
Hospital and specialist facilities referenced in the Plan include:
- Altnagelvin Area Hospital
- South West Acute Hospital
- Tyrone and Fermanagh Hospital
- Omagh Hospital and Primary Care Complex
- Lakeview Hospital
- Grangewood
- North West Cancer Centre
- Waterside Hospital
Hospital Activity
Each year, the Trust’s hospitals handle approximately:
- 55,000 hospital admissions
- 32,500 day cases
- 345,000 outpatient appointments
- 126,000 Emergency Department attendances
- 314,000 imaging tests
- 23,000 regular day attenders
- 3,300 births
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Our Population
Population Projections
The overall population is projected to remain broadly static between 2023 and 2030.
The projected population by 2030 is 305,216 people, comprising:
- 153,444 females
- 151,772 males
There is projected to be marked growth in the population aged 65 and over, with an overall increase of 18.5% by 2030.
This includes:
- A 17.3% increase in people aged 65 to 84
- An increase of almost 28% in people aged 85 and over
This trend is projected to continue, with further marked growth in the older population up to 2043.
In contrast, the population aged 16 and under is projected to decrease by 7.5% by 2030, with a further reduction projected by 2043.
Source: NISRA Population Projections.
Ethnic Diversity
The diversity of the population in the West is changing.
The 2021 Census identified that 3.4% of Northern Ireland’s population, or approximately 65,600 people, belonged to other ethnic groups.
This was:
Approximately double the 2011 figure of 1.8%, or 32,400 people
Four times the 2001 figure of 0.8%, or 14,300 people
All council areas within the Western Trust have recorded an increase in their ethnically diverse populations during the previous 20 years.
Based on the 2021 Census, minority ethnic groups account for:
1.5% of the Causeway Coast and Glens Borough Council population
2.3% of the Derry City and Strabane District Council population
1.7% of the Fermanagh and Omagh District Council population
Source: NISRA Census 2021.
Deprivation
The Western Trust area has the highest poverty rates in Northern Ireland:
- Derry City and Strabane: 22%
- Fermanagh and Omagh: 21%
- Causeway Coast and Glens: 21%
Source: Households Below Average Income Northern Ireland 2019/20, NISRA.
Additional indicators include:
- Five of Northern Ireland’s ten most deprived areas are in Derry City and Strabane.
- Ten of the 20 areas with the poorest access to services are in Fermanagh and Omagh.
- The Trust has the highest rate of children on the Child Protection Register.
- The Trust has the second-highest rate of looked-after children and children in need.
- Thirty-five per cent of mental health hospital admissions across Northern Ireland in 2022/23 were in the Western Trust area.
Health Inequalities
The Health Inequalities Annual Report 2023 compares sub-regional health outcomes with the regional average.
For the Western Trust, the report identifies:
- Nine measures that are better than the regional average
- 22 measures that are similar to the regional average
- 24 measures that are worse than the regional average
Life Expectancy at Birth in the Western Trust Area
Males
- Average life expectancy: 78.1 years
- Life expectancy in the most deprived areas: 73.3 years
- Difference: 4.8 years
Females
- Average life expectancy: 81.7 years
- Life expectancy in the most deprived areas: 79.0 years
- Difference: 2.7 years
Healthy Life Expectancy
These figures relate to Northern Ireland overall.
Males
- Average healthy life expectancy: 59.1 years
- Healthy life expectancy in the most deprived areas: 50.6 years
- Difference: 8.5 years
Females
- Average healthy life expectancy: 60.9 years
- Healthy life expectancy in the most deprived areas: 52.7 years
- Difference: 8.2 years
Source: Health Inequalities Annual Report 2023.
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Regional Context
During the latter half of 2023/24, the Trust engaged with:
- The Trust Board
- The Corporate Management Team
- Staff
- Stakeholders
- Service users
This engagement informed the development of the Corporate Plan and the review and agreement of the Trust’s strategic priorities and corporate objectives for the following three years.
The Trust also considered national, regional and local priorities to ensure that the Corporate Plan aligned with relevant policies and strategies, including:
- Systems, Not Structures: Changing Health and Social Care
- Health and Wellbeing 2026: Delivering Together
- Making Life Better 2012 to 2023
- Local council community plans
- Future Planning Model Integrated Care System Northern Ireland Framework
In developing the Corporate Plan, the Trust was conscious that the new Programme for Government from the Northern Ireland Executive was awaiting publication.
However, the Trust was confident that its strategic priorities continued to align with those of the Health Minister and that the Plan had sufficient flexibility to adapt to new priorities.
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Our Strategic Priorities and Corporate Objectives
Following targeted engagement with staff and stakeholder groups in 2023/24, the Trust reaffirmed five strategic priorities.
These priorities provide the framework for the Trust’s corporate objectives and key areas of focus over the following three years.
Staff and stakeholder groups identified the following key areas:
- Workforce stabilisation
- Addressing medical workforce challenges
- Ensuring the efficient use of resources
- Maintaining financial sustainability
- Reforming and rebuilding services
The corporate objectives are high-level aims. They will form the basis of more detailed plans and programmes within individual Directorate Plans, which will be updated annually.
The five strategic priorities are:
- Quality and Safety
- Our People
- Performance and Access
- Delivering Value
- Our Culture
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Strategic Priority 1: Quality and Safety
Our Commitment
We put patients and service users at the heart of everything we do and provide care to the highest standard, with a focus on quality and safety.
People are often at their most vulnerable when accessing our services. They need to know that they will receive safe and effective care focused on their individual needs.We want everyone using our services to:
- Have a positive experience
- Feel involved in their care
- Be involved in decisions supporting their wellbeing and recovery
We want to improve our services by using evidence and data to identify where improvement is needed.
We will:
- Share excellent practice
- Support learning and development
- Involve staff, patients, carers and partners in making and achieving change
We Will
- Provide the best possible care and support for people who use our services.
- Increase our focus on prevention, early intervention and population health.
- Work to reduce health inequalities.
- Support people to manage their health and wellbeing.
- Continually review care pathways, taking account of patient experience and available data, to ensure they remain safe and appropriate.
- Listen to and involve service users, their families and carers.
- Ensure continuous improvement.
- Maintain a focus on openness, transparency and learning when things go wrong.
- Integrate Quality Improvement methodology into processes for delivering improved outcomes.
- Promote an open and just culture.
- Improve our ability to identify and implement effective improvements in quality and safety.
- Promote research and innovation to improve diagnostics, treatment and care.
- Embed effective systems for identifying, assessing and managing risks to Quality and Safety objectives.
- Maximise the benefits of technology to support safer and more informed decision-making.
- Use technology to improve patient experience and patient and service-user engagement.
- Prioritise capital funding to maintain standards across hospital and community facilities.
- Support the delivery of safe, high-quality care.
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Strategic Priority 2: Our People
Our Commitment
We strive to be a place where we attract, retain and develop compassionate and talented people, creating an environment in which they can thrive.
People are central to everything we do.
Our workforce, including volunteers and students, is our greatest asset.
Workforce stabilisation has been identified as one of the biggest challenges facing the organisation.
Staff are working in increasingly complex and challenging environments, with many clinical and support areas experiencing staffing shortages.
To deliver our vision, we need to:
- Recruit and develop high-calibre staff
- Meet current and future service needs
- Support the health and wellbeing of staff
We Will
- Increase the number of people who want to work with us.
- Respond to local workforce needs and vacancies through local, regional, national and international attraction initiatives.
- Retain staff for longer.
- Improve work-life balance.
- Increase staff engagement.
- Regularly acknowledge and reward excellent work.
- Increase opportunities for staff at all levels to learn, develop and succeed.
- Use appraisal as the starting point for supporting development in current and future roles.
- Actively care for the health and wellbeing of staff.
- Continue expanding holistic support at individual, team and Trust-wide levels.
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Strategic Priority 3: Performance and Access
Our Commitment
We strive to achieve and maintain high levels of performance.
We will use our resources as effectively and efficiently as possible to improve access to services.
We operate in an increasingly challenging environment that has created significant pressure across the system.
Demand for services is rising faster than the resources available. This is happening alongside significant workforce challenges across a range of service areas.
Despite these pressures, we want to:
- Achieve and maintain high levels of organisational performance
- Grow and develop our services
- Provide a high standard of healthcare
- Maintain operational, clinical and financial sustainability
- Better understand how to use resources and systems to improve access
We Will
- Maintain strong operational performance.
- Strive to meet service-delivery targets.
- Build and deliver sustainable services.
- Deliver service developments commissioned regionally and locally.
- Change and improve our range of services.
- Implement Encompass, the new single Health and Care Record for Northern Ireland.
- Use Encompass to improve care for the population and introduce new ways of working for staff.
- Progress reform and modernisation programmes focused on productivity and efficiency.
- Reduce waiting times.
- Reduce the number of people waiting to access services.
- Maximise community capacity through effective management of Trust services and contracts.
- Work in partnership and engage with providers.
- Develop and strengthen strategic partnerships across the entire system.
- Help create an integrated care system that improves service delivery.
- Make the best use of available resources across the system.
- Embed analysis, data and business-intelligence tools to improve decision-making.
- Develop digital expertise.
- Ensure staff have confidence and competence in using technology.
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Strategic Priority 4: Delivering Value
Our Commitment
We aim to achieve financial stability through sound financial governance and the effective use of resources to deliver greater value and efficiency.
Achieving and maintaining financial sustainability is a long-standing challenge for the Trust and the wider health and social care system.
The Trust continues to operate in an increasingly financially constrained environment and must take steps to live within its funding allocations.
We aspire to ensure the sustainability of the Trust so that we can:
- Continuously improve the quality of care
- Make a positive contribution to local communities
- Contribute positively to the local economy
We need to continue developing a culture of improvement and transformation, identify opportunities to improve productivity and understand where value for money can be increased.
We Will
- Deliver effective financial planning through a financial-management framework.
- Support financial sustainability.
- Balance budgets.
- Provide value for money.
- Minimise waste.
- Progress initiatives that deliver cost improvements, cash savings and efficiencies.
- Seek opportunities to address service pressures.
- Influence funding allocations.
- Mobilise investments that have already been agreed.
- Work collectively across the Health and Social Care system.
- Seek external support and expertise where appropriate.
- Identify and implement improvements in areas where there is variation.
- Secure efficiency improvements.
- Support the organisation to become financially expert.
- Provide training to staff with budgetary responsibilities.
- Enable staff to make the best decisions for patients and teams.
- Ensure staff understand the benefits of financial sustainability.
- Ensure staff understand their responsibilities in delivering financial sustainability for the Trust.
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Strategic Priority 5: Our Culture
Our Commitment
We are committed to a culture that is open, just and always learning.
We recognise the importance of creating a diverse and inclusive workplace that:
- Reinforces our values and behaviours
- Is based on a just and restorative culture
- Supports curiosity and continuous improvement
We want a culture in which everyone feels able to be themselves.
We want our people to have a voice that is listened to and acted upon.
We also want a positive culture in which concerns can be raised openly and confidently.
We Will
- Address inequalities experienced by staff.
- Take action to improve diversity, equality, inclusion and belonging.
- Demonstrate openness in everything we do.
- Empower staff to raise concerns.
- Enable staff to contribute ideas.
- Act fairly.
- Prioritise accountability, fairness and compassion when things do not go as planned.
- Build systems that support innovation, learning and quality improvement.
- Increase involvement and contributions from staff and communities.
- Continue building strong partnership working.
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Delivering Our Plan
The Trust has developed a performance framework that sets out structures for executive-led oversight of strategic reform programmes.
These structures support and enable delivery of the Trust’s strategic priorities. They also drive performance and continuous improvement across the organisation.
The governance arrangements referenced in the Plan include:- Trust Board
- Finance and Performance Committee
- Delivering Strategic Change Board
- Delivering Value Management Board
- Unscheduled Care Flow Board
- Elective Care Board
- Children’s Services Board
- Service Delivery Plan Performance Escalation Reporting
- Mental Health and Disability Board
- Trust Service Changes and Reform Oversight
- Encompass Implementation Board
- Digital Transformation Board
- Adult Integrated Services Board
The Trust’s strategic priorities and corporate objectives provide a framework for individual services to set their priorities and plans.
This supports alignment at every level of the organisation.
Planning Structure
The planning structure includes:
- Corporate Plan – Three-year strategic priorities.
- Directorate Plans – Annual business plans.
- Directors’ Objectives – Set annually.
- Individual and Team Objectives – Linked to annual appraisal.
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How Will We Know If We Are Making a Difference?
The Trust has developed a HealthCheck approach to organisational measurement.
This approach focuses on the five strategic priorities:
- Quality and Safety
- Performance and Access
- Our People
- Delivering Value
- Our Culture
The Trust is committed to achieving improvements across each area during the period of the Plan.
Key indicators will be used to monitor progress and determine:
- How much we do
- How well we do it
- What impact we have
Delivery of outcomes will be tracked and monitored through the Trust’s performance-framework arrangements.
Oversight will be provided through:
- Delivering Strategic Change Board
- Delivering Value Management Board
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Measures
Quality and Safety Measures
Measures will include:
- Timeliness of responses to complaints
- Serious Adverse Incidents
- Lookback reviews
- Incident trends and learning
- Morbidity and mortality data and trends
- Compliance with audits and standards
Performance and Access Measures
Measures will include:
- Achievement against Health and Social Care Service Delivery Plan targets
- Waiting times across services
- The number of people waiting
- Efficiency and productivity indicators for each service
Our Culture Measures
Measures will include:
- Staff engagement
- Psychological safety
- Delivery of the Equality, Diversity and Inclusion Plan
- Targeted growth in involvement and engagement activities
Our People Measures
Measures will include:
- Staff turnover rate
- Vacancy rate
- Absence rate
- Reliance on agency staff
- Mandatory training completion rate
- Job-planning completion rate
- Staff appraisal levels attained
Delivering Value Measures
Measures will include:
- Expenditure run-rate growth
- Budget overspends
- Achievement of recovery and contingency planned-savings targets for the year