Trust strategy 2025-2030: Towards Excellence

We are an acute and community services provider delivering a comprehensive range of acute hospital and specialist healthcare services for more than 500,000 people living in York, North Yorkshire, East Yorkshire and Ryedale - an area covering 3,400 square miles.

Our sites include:

• York Hospital
• Scarborough Hospital
• Bridlington Hospital
• Malton Hospital
• The New Selby War Memorial Hospital
• St Monica’s Hospital Easingwold
• White Cross Rehabilitation Hospital
• Nelsons Court Inpatients Unit
• Several community team bases in the Vale of York

We provide a comprehensive range of district general hospital services, in addition to regional and sub-regional services including renal and cystic fibrosis services.

The Trust manages community-based services in Selby and District, and the City of York.  This includes community nursing and specialist services for both adults and children.

We value being the provider of the community services.  This enhances our ability to provide continuity of care, streamlined patient pathways, and improves outcomes by offering us the ability to deliver seamless coordination between hospital and community-based services.  This means we can work to reduce unnecessary hospital admissions, facilitate early intervention, and support holistic, patient-centred care for both adults and children.

The benefits of being an integrated acute and community provider means we can promote efficient use of resources, better communication, and collaboration across teams, while addressing public health needs through prevention and population health initiatives.

We have an annual turnover in excess of 800m and a workforce of over 10,000 people, making us one of the largest employers in the locality.

We created York Teaching Hospital Facilities Management Limited Liability Partnership (YTHFM) as a subsidiary of our Trust.  It has a workforce of over 1,000 people, providing a range of estates and support services, such as catering, cleaning, portering and security.

In 2023-24, we saw the following activity:

• 115,414 A&E attendances
• 100,613 attendances in Urgent Care Centres on our sites
• 160,808 inpatients (adults, including maternity)
• 779,908 outpatient attendances (including telephone and video appointments)
• 9,921 inpatients (children)
• 121,700 operations or procedures as an inpatient
• 3,916 babies delivered

The Trust is located in a region of rich and diverse geography, encompassing scenic coastal areas, rural countryside, bustling market towns, and vibrant urban communities.

This varied landscape, combined with the area's appeal as a tourist destination, presents both challenges and opportunities.  Serving these dispersed communities requires innovative approaches to healthcare delivery, ensuring accessibility across different locations while meeting the diverse and unique needs of residents and visitors alike.

This diversity also presents challenges in ensuring equitable access to services, particularly for our ageing and transient populations, and in addressing health inequalities in our more deprived communities.

A stark example of this disparity is the life expectancy gap, with residents in the most affluent areas living up to 13 years longer than those in the most deprived areas.  

Scarborough is the most deprived district within North Yorkshire and this community includes three-quarters of the county’s most deprived areas.  There are ten electoral wards in which, currently, more than one-third of children live in poverty.

We know that providing a comprehensive, local service is important to our communities, especially given the distance between local health services, and we believe in the principle of local services for local people.

Our Trust is part of the Humber and North Yorkshire Health and Care Partnership.

The partnership is led by the statutory health body, the NHS Humber and North Yorkshire Integrated Care Board (ICB), which is accountable for spend and strategic commissioning across Humber and North Yorkshire. The partnership includes NHS providers and local councils together with voluntary, community and social enterprise (VCSE) organisations.

By working collaboratively, we aim to ensure the priorities of our organisation are consistent and contribute to the broader local Places and Integrated Care System (ICS), especially the ICS ambition of ‘ensuring that everyone in our community lives longer, healthier lives’. This includes narrowing the gap in healthy life expectancy between the most and least advantaged communities by 2030 and increasing overall healthy life expectancy by five years by 2035.

Partnerships within the ICS include:

Place-based partnerships

Between the NHS, local councils and voluntary organisations, residents, people who access services, carers and families - these lead the design and delivery of integrated services in their local area.
In our catchment area there are three Places: York, North Yorkshire and East Riding.

Furthermore, there is an ambition to develop Integrated Neighbourhood Teams, of which the Trust will be part within the Places.

Provider collaboratives

Bringing NHS providers together across one or more ICSs, working with clinical networks, alliances, and others, to benefit from working at scale.

We are a member of the Collaboration of Acute Providers (CAP), working with Harrogate District NHS Foundation Trust, Hull University Teaching Hospitals NHS Trust, and Northern Lincolnshire and Goole Hospitals NHS Foundation Trust.

Recent years have been very challenging for our Trust, other health and care partners and our communities, as we navigate a post-pandemic world.

We have worked hard to reduce the long waits for planned care and diagnostics for our patients, and we have seen positive progress despite pressure on resources, a growth in demand, and the impact of a period of industrial action - the likes of which the NHS has never experienced.

We have made improvements with our performance against the key operational standards, exceeding our planned trajectories on both referral-to-treatment times and the 62-day cancer standard, and whilst we still have further to go, we are making good progress on the new faster diagnostic standard for cancer.

Waiting times for outpatients, surgery and diagnostics continue to reduce, as well as the total number of people waiting.  A testament to the commitment of our workforce to the people we serve.

Meeting standards for urgent and emergency care remains particularly challenging, highlighting broader issues such as patient flow, timely discharges, delays with ambulance handovers and waiting times for patients being admitted by our two emergency departments.

The NHS has faced significant financial pressure in recent years.  An ageing population and increasing demand means health and care services continue to evolve and innovate to meet the needs of our communities.  This is a challenge faced by all our partners in the wider health and care system, and one that we will need to work together to address.

The safety and quality of our services remain our core priority.  We recognise we have further work to do to ensure we are achieving the highest standards, and this was reflected in our most recent inspection reports from our regulator the Care Quality Commission (CQC).

Top of our agenda is to create a workplace where staff feel valued, their voice is heard and supported to give their best and enjoy their work.  We know that this is not the case for all our staff, as evidenced successive annual staff surveys.

Through our culture and leadership programme Our Voice, Our Future, and our new Leadership Framework, as well as other initiatives, we have committed to fostering a culture where all staff feel listened to, treated fairly, valued, respected and enjoy coming to work.

Our largest hospitals, York and Scarborough, are ageing.  All aspects of the estate, infrastructure and equipment need to be continually reviewed to ensure it is fit for purpose and safe to enable care to be delivered in the most effective and efficient way.

In response, we have delivered the largest capital programme the Trust has ever seen, including the completion of the £19 million emergency department extension in York.
2025 will see the opening of the new £50 million Urgent and Emergency Care Centre in Scarborough, transforming the delivery of care for our most critically ill patients on the East Coast.

We are also seeing developments in the delivery of research.  We have been awarded £3m by the National Institute for Health and Care Research (NIHR) to lead national research into a new bowel imaging technology for patients - known as colon capsule endoscopy.

The launch of the Scarborough Coastal Health and Care Research Collaborative (SHARC) will help to understand and reduce health inequalities affecting the population of Scarborough and the East Coast.  This will inform future initiatives to improve health for future generations.

We receive patient experience feedback from a range of sources including Friends and Family Test (FFT), surveys, complaints, and Patient Advice and Liaison contacts (PALS).

Whilst the majority of our patients have a positive experience of our services, with numerous examples of staff demonstrating kindness and support for patients and carers, we can see that the pressure we are facing is having a negative impact on our ability to consistently provide the high standard of care that we want, and that our patients expect.

The Trust is receiving the highest number of complaints in its history, indicating there is much to do to provide ‘an excellent patient experience every time’.  The main reasons for our patients and their families complaining are waiting times and poor communication.

Our strategy is informed by what our patients, staff and stakeholders, including our regulators, tell us about the services that we currently provide.

We are clear about our purpose, ambition, strategic objectives and our values and behaviours.  They are the cornerstone of this new five year strategy ‘Towards Excellence’.

Our Purpose (why we exist) is:

• To deliver excellent healthcare every day

Our Ambition (where we aspire to get to - our True North) is:

• To provide an excellent patient experience every time

Our Strategic Objectives (what we will do to achieve our ambition) are:

• To provide timely, responsive, safe, accessible and effective services at all times
• To create a great place for our people to work, learn and thrive
• To work together with partners to improve the health and wellbeing of the communities we serve
• To challenge the ways of today to develop a better tomorrow through research, innovation and transformation
• To use resources to deliver healthcare today without compromising the health of future generations
• To be well-led with effective governance and sound finance

To be successful, our workforce will have a clear understanding of the strategic objectives of the organisation and their role in contributing to their attainment.  Our actions and choices, no matter one’s role, should be aligned with the Trust’s purpose, ambition, and strategic objectives. We believe that every colleague has an important contribution to make and are committed to ensuring they are enabled to provide the services our communities deserve.

The way we do things is just as important and what we do.  Our Values (how we behave and make decisions at work), developed with our staff are: Kindness, Openness and Excellence.

To support staff to live our values every day, we have a behavioural framework, defining the standards we should all expect of ourselves and each other.

The relationship between our Purpose, Ambition, Strategic Objectives, and Values is shown below; this also incorporates the enabling strategies.

To provide timely, responsive, safe, accessible and effective services at all times

Quality of care is of paramount importance to us.  We are committed to keeping our patients safe at all times.

We will:

• Provide high quality, effective care.
• Ensure timely and accessible services for all and meet NHS constitutional standards.
• Involve patients and carers in decisions about their care to achieve their most appropriate outcome.
• Ensure equity of access to our services.
• Provide efficient pathways that support patients to return to their usual or new place of residence, minimising delays and patient harm.

To create a great place for our people to work, learn and thrive

We value our people and aspire to be an excellent employer; which people choose to join, want to stay and where they can develop their careers.

We will:

• Nurture professional growth and development through education and training of our workforce.
• Recruit and retain people who live our values and behaviours.
• Foster a safe, inclusive, diverse and supportive workplace.
• Nurture a culture of feedback, appreciation and recognition.
• Improve staff wellbeing.

To work together with partners to improve the health and wellbeing of the communities we serve

We work collaboratively with other providers including primary care, local authority, voluntary organisations and social care providers to best meet the needs of the people we serve.

We will:

• Work with our system partners to have innovative care pathways that treat people in the best place possible without delay.
• Develop new pathways of care by working across organisational boundaries at a place-based or locality-based level.
• Work with partners in our role as an Anchor Institution to maximise local economic growth and improve our community’s health and wellbeing.
• Work with Primary Care Networks and other neighbourhood partners to reduce health inequalities and increase positive health and wellbeing.
• Develop joint initiatives with educational institutions to grow the workforce of the future and providing employment routes for local people.

To challenge the ways of today to develop a better tomorrow through research, innovation and transformation

As a learning organisation, with two acute hospitals and vibrant community services, we are perfectly positioned to be actively involved in research, improvement and innovation opportunities.  Enhancing our involvement in these areas will strengthen our offering to our patients and staff.

We will:

• Establish and embed a systemic approach to continuous improvement which will empower our staff and engage our patients to improve the quality and value of what and how we do things.
• Embrace digital technologies to innovate and transform, improving our patient and staff experience and increasing productivity.
• Work with academic and commercial institutions to explore appropriate research partnerships.
• Aim to increase the amount of funded research and encourage and support innovative ideas and proposals.

To use resources to deliver healthcare today without compromising the health of future generations

Our long-term sustainability is tied to the wellbeing of the population we serve and as an Anchor Institution we strive to ensure our actions and decisions do not compromise our future.

We will:

• Make effective and efficient use of our current and future estate.
• Work with our partners to promote healthy lifestyle choices and ill health prevention.
• Integrate sustainable practices into everything we do and reduce our carbon footprint.
• Consider the environmental impact of all the decisions we make.
• Invest in environmentally friendly technologies.

To be well-led with effective governance and sound finance

We are a public sector NHS organisation with responsibility for providing best value for the use of the public’s money and to conduct ourselves in accordance with public sector values and principles, including openness and accountability.

Good governance is essential; whilst it alone does not guarantee a Trust's success, no Trust can succeed without it.

We will:

• Create a culture of compassionate leadership and accountability.
• Routinely use data and intelligence to inform decisions to provide best value and quality of service.
• Ensure clear lines of communication and engagement.
• Foster a culture of openness where staff feel safe to speak up.
• Ensure sound financial governance providing services within the resources available.
• Have effective governance arrangements that meet or exceed ‘best practice’ guidelines.
• Comply with standards outlined by our regulators.

The Trust has six crucial enabling strategies, which are in place to underpin and support the delivery of this strategy:

• Quality
• People
• Digital
• Estates
• Research and Innovation
• Green Plan

The Trust will produce an Annual Plan, describing the key objectives and work plan for the next year.

In effect, this is the tactical plan to take the Trust ever closer to realising its ambition of ‘providing an excellent patient experience every time’ through its strategic objectives.  The Annual Plan will be updated every 12 months.
This strategy will be continually assessed against its progress, as measured through the delivery of the Annual Plan and the Strategy Scorecard.

Quarterly progress reports on the attainment of the Annual Plan will be considered by the Trust Board, with a progress report every 12 months on the key metrics on the Strategic Scorecard.

Our Towards Excellence Strategy for 2025-30 is built upon a clear understanding of the needs, challenges, and priorities of the people we serve and is based upon sound organisational knowledge, not least, feedback from our workforce.  

The development of specific strategic objectives means there is clear line of sight on how we intend to achieve our ambition: To achieve an excellent patient experience every time.