An overview of performance
During the last year we have continued to deliver care to thousands of people, despite increasing demand, complexity and pressures the NHS remains under.
After analysing the data and reviewing our progress over the past year, we can confidently state that our Trust continued to deliver high-quality healthcare services to the people of Lincolnshire. We remain committed to further enhancing the quality and accessibility of our services, in close collaboration with service users, carers, staff and partners.
- 367,353 patient contacts
- 175,240 patient contacts face to face
- 93,539 patient referrals
- 14,297 people accessed talking therapies
- 5,980 children and young people accessed support
- 28,048 crisis referrals
Financial position
To support the delivery of our vision it is important that we continue striving to ensure the Trust is financially sustainable in the future.
Continuing to build on our strong financial management processes is an important part of our best use of resources strategic delivery plan and will help us to make the most of every £1 invested in services. Maximising efficiency and productivity across all areas of the Trust will enable the us to continue to deliver the best services possible for our patients.
Recent years of investment in services alongside recruitment challenges has resulted in one off financial surpluses for the Trust whilst recruitment and retention processes have been developed in order to maximise recruitment to funded posts.
The 2023/24 financial year has been a really successful year for recruitment to funded posts which does reduce the likelihood of financial surpluses in future years supporting us to maximise investment in services to support our patients.
Investment in our estate continues to be an important focus for the Trust supporting us to continue to improve how we design, use, and build our estate to create the best environments to work and receive care in.
The Trust has reported a surplus of £8.9m in 2023/24. This has been driven by higher than planned income levels alongside other one off financial adjustments reported in line with national guidance issued by NHS England.
Cash balances are reported as £50.5m which is £2.1m higher than was planned reflecting the receipt of income not planned for.
During 2023/24 over £13.9m has been invested in our estate supporting us to continue to eradicate our remaining dormitory based accommodation in Lincoln and commence the new build replacement scheme in Boston.
Our workforce
Our workforce remains one of our biggest challenges as an organisation, like all NHS Trusts nationally, we have particularly felt challenged in some specific areas during 2023/24 and in some services have required to enact business continuity plans, whilst proactive recruitment could take place to stabilise our workforce.
This has been particularly felt in our inpatient services, early intervention in psychosis team, children and young people and medical workforce.
We have however made great progress with our recruitment across the board and our workforce is now stabilising in many of these areas. It was particularly pleasing to see over 800 new starters in 2023/24, which was a significant improvement on the total for 2022/23, where there were 460 new starters. Despite the usual turnover of staff and the expansion of services the Trust now has over 300 more whole time equivalent staff working in the organisation than previous years.
We were also extremely pleased to have once again been rated amongst the best mental health and learning disability trusts in the national staff survey for staff recommending us as a place to work. You can read more about this in our Staff Report.
Recognition
2023/24 saw the Trust recognised with a number of awards and accreditations, including winning Best Service User Engagement Award at the 2023 Design in Mental Health Awards and shortlisted for project of the year – New Build, for our work on the two new mental health wards at Peter Hodgkinson Centre in Lincoln which officially opened in June 2023.
Some of our colleagues also won student nurse of the year: mental health at the Student Nursing Times Awards and were shortlisted in the Lincolnshire Apprenticeship Champion Awards.
Several of our services also renewed or achieved national accreditation schemes through the Royal College of Psychiatrists demonstrating our commitment to meeting the very best standards of care for our service users and their families. We were particularly proud to have retained our two-star Triangle of Care status for the fourth year in a row through the nationally recognised Carers Trust programme.
Equality, diversity and inclusion (EDI)
We were delighted to continue our progress with EDI this past year – though we know that we have so much more to do.
We ranked just outside the Stonewall Workplace Equality Index Top 100, ranking at 105th. This is an assessment and benchmarking of workplaces who have dedicated themselves to supporting LGBTQ+ inclusion inside and outside the organisation and something we continue to be proudly working towards.
We also ranked in the top 10% of trusts nationally in the Workforce Disability Equality Standard (WDES) in eight areas, but most notably ranked fourth for our disabled staff representation within our clinical workforce.
The system developed Allyship Toolkit also won the Capsticks Award for Innovation at the Healthcare People Management Association (HPMA) Awards of which LPFT were a significant contributor in the development of the toolkit.
Regulatory performance
Our NHS Oversight Framework rating was scored 1, in recognition of our high performance across a number of areas. However, we are also part of the wider Lincolnshire system rating which during the 2023- 24 was 4 and required additional support. We were pleased however that during this year as a system the progress we have made to improve was acknowledged and our rating as a system improved to 3.
There remains existing and emerging challenges however in terms of waiting lists in some areas. Our focus remains on robustly and swiftly tackling these waits, ensuring we are seeing those people with greatest needs, most urgently and ensuring we are in regular contact with those waiting, to ensure their needs have not changed and provide signposting and resources where this is appropriate.
Further transformation of services should further help us tackle our waiting lists and reduce these in line with nationally mandated targets.
Financial challenges across the system also continue to be tackled and LPFT will continue to endeavour to deliver on cost improvement targets and deliver a breakeven position in our financial planning.
Quality performance
We measure the quality of our care against the five questions (called Key Lines of Enquiry or KLOE) that the Care Quality Commission (CQC) asks of NHS organisations. These make sure we focus on what matters when providing care:
- Are services safe? People are protected from abuse and avoidable harm.
- Are they effective? Care, treatment and support achieves good outcomes, helps people to maintain quality of life and is based on the best available evidence.
- Are they caring? Staff and services involve and treat those who use the services with compassion, kindness, dignity and respect.
- Are they responsive? Services are organised to meet people’s needs.
- Are they well-led? The leadership, management and governance make sure the Trust is providing high-quality care that’s based around individuals’ needs, that it encourages learning and innovation, and that it promotes an open and fair culture.
Our Trust was rated as ‘Good’ overall and ‘Outstanding’ for well-led by the CQC in 2017 and remained so following its last inspection of the Trust’s long stay rehabilitation wards for people of working age in March 2020.
We continue to receive regular mental health act inspections each year to ensure our compliance with this national legislation and are in regular contact with the CQC to provide additional data and reassurance as required.
We also measure our patient care, safety and experience closely by reviewing:
• Performance data
• Internal and external quality benchmarking
• How we respond to incidents, complaints and Patient Advice and Liaison Service (PALS)
• Feedback from patients and carers
• Information from key stakeholders (our commissioners, partners, volunteers, and governors)
• Patient involvement and experience groups
Each year the Trust agrees key quality improvement priorities which in 2023/24 were:
• Improving physical healthcare, including falls
• Safer management of self-injury and suicide
• Improving carer involvement
• Safe and appropriate restrictive practice
• Improving patient experience of care
These priorities are selected each year to take into account several sources including CQC inspections feedback, Commissioner’s requirements and feedback and serious incidents, complaints, coroner and serious case review feedback (local and national).
Good progress has been made in all of these areas and we recommend you read our Quality Report 2023/24 by visiting our website at www.lpft.nhs.uk for more on our performance analysis, progress against our quality priorities, and the learnings we are applying in the priorities we have set for the year ahead.
Whilst new quality priorities have been developed for the coming year, work will continue on these areas to ensure they are embedded as business-as-usual in our services.
Whilst a busy and challenging year, it has been great to see us maintain a positive overall performance across all areas of our services and continue to deliver the very best care to our service users, their families and our colleagues.
Sarah Connery, Chief Executive
