What does this mean? We want to be recognised by our patients, commissioners, peers and staff as being amongst the best for patient safety, quality, patient engagement and clinical outcomes. Just meeting the minimum standards is no longer acceptable and our patients, rightly expect the best care possible. Our quality ambition is to be up there with the highest performing hospitals in the NHS.

In some areas, our performance is comparable to these hospitals but there are others where we can improve and we want to ensure a consistently high quality standard across everything we do. We are aware of our responsibility to ensure that every penny of public money invested into our services is spent wisely and efficiently. We accept that investing in Quality and Patient Experience will mean eliminating wasteful practices.

What does this mean? If we are to be the leader in integrated and specialist care we need to retain and attract the best possible workforce. We can only do this by becoming one of the best places to work. It is well evidenced that staff who are engaged, empowered to carry out their role, well trained, well led and supported are more likely to deliver outstanding care, leading to a positive impact on patient outcomes and an improvement in financial efficiency.

We want Leeds Teaching Hospitals to be the best place to work: where our colleagues work within supportive and positive teams and where we are viewed as a fair employer by our employees; where activities and tasks are simpler and easier to complete because there is a common approach across the Trust.

We will promote opportunities for local people to build a career with us at every level of the organisation. We will manage and encourage our talent, creating clear employment paths and be an organisation that has a succession plan.

Using our talent in full will mean embracing the diversity of our workforce and using that rich experience to improve patient care. We have good representation in the senior medical workforce from a diversity of backgrounds but we want all our senior teams to better reflect the diverse community we serve.

Many of our staff already contribute to the city in other ways. As a socially responsible employer we will encourage volunteering. Together with Leeds City Council we will organise for senior hospital staff to mentor young people from deprived communities around Leeds.

We must ensure we develop strong clinical leadership, removing any ‘them and us’ between management and clinicians and focus on working as one team in the interests of patients.

Across the Trust we have more than 16,000 people working for us in a wide variety of roles. We have already started to engage them to get their views for our vision and values, known as ‘The Leeds Way’, more than 2,500 of our colleagues have offered views and opinions on our values and vision. This positive response we have had, shows just how keen they are to be involved in shaping the future of the organisation.

What does this mean? There are ground-breaking innovations happening in research and education and it is essential that we remain at the forefront of this work if we are become the leader in specialist and integrated care. Our strong reputation is evident in the numerous examples of leading edge research programmes, international innovation partnerships, UK- first operations, the use of cutting edge technology and our strong teaching hospital status. All of this work not only benefits patients in our own hospitals, but those further afield too, and is a valuable opportunity for us to encourage new investment into the Trust from external partners.

We want Leeds to impact directly on National and International discovery that will in turn be translated and implemented into enhanced patient care. We will build on our world leading Musculoskeletal Biomedical Research Unit, Cardiovascular Sciences, Cancer & Pathology and Health Engineering/surgical technologies, Imaging as well as our predominance in Medical Informatics.

Our links with the University sector are going from strength to strength and there is a shared ambition for us to work together to build a strong partnership and really drive research, education and innovation across the city.

We will be innovative and resourceful. We will build our commercial activities with the aim of re-investing surpluses directly to support patient services. We will champion and deploy digital communications and we will continue to work towards becoming a paper- light hospital service.

We are enthused by the prospects offered to improve healthcare through the appropriate use of “Big Data”. Leeds is perfectly positioned in the race to integrate and use these systems for the public benefit. Ultimately we want to create a single personal patient record that contains all your images, scans, data and your genome so that information is ready for any medic you choose to treat you with all the facts at their finger-tips.

We will be nimble with flexibility embedded in all R&D/ education processes so that we can rapidly respond to Regional, National and International research and education priorities.

This creates the perfect platform which will allow us to build our portfolio of specialist work and establish ourselves as one of the centres of excellence for specialist services across the UK which are currently being proposed by NHS England. NHS England is reorganising services nationally to provide specialist care in a smaller number of centres of excellence because the evidence suggests that for many conditions you will get a better outcome if patients are seen by a specialist in a place with the best equipment and staff available. We are already designated as a specialist centre for many health problems such as major trauma, uncommon cancers and liver transplants. Our goal is to further strengthen and develop our specialist status.

The best clinical leaders and researchers will attract the best medical staff. This, in turn will improve our outcomes. We will continue to strengthen the consultant body and place greater emphasis on their research capabilities in candidate selection.

The best, seamless integrated care across organisational boundaries.

What does this mean? If we are to be truly patient-centred we must organise our care around our patients in an integrated way. Good integrated care sees all health and care providers working together seamlessly for the benefit of the patient to make sure that they receive their care in a timely, convenient, co-ordinated and consistent manner and have a bigger say over their own care and how we work with them to deliver that.

Leeds Teaching Hospitals NHS Trust and the other health and social care providers across Leeds are all committed to this and as part of the national Integrated Care Pioneer Programme, will be pushing for this to happen quickly across the City.

We are a specialist centre where you will receive the latest trial drugs, therapies and treatments; but we care equally as passionately about making sure that “everyday” conditions and minor surgical procedures are given the same time and attention as brain or heart surgery.

Keeping the public well (and out of hospital) is a task that stretches beyond the NHS and Social Care services; housing, transport, environmental services and many other sectors play a vital part in this. The Leeds Joint Health and Well-being Strategy sets out actions and outcomes that will support us by keeping demand for hospital based services down. We will work with our partner to achieve the outcomes contained in the Strategy.

Many patients do not need to be in hospital and can be better supported in the community or even in their home. We will work with our NHS, Leeds City Council Social Care and voluntary sector partners to reduce admissions to hospital for frail elderly patients and those with long-term conditions by providing better alternatives closer to or at a patient’s home.

For example our maternity services will work with other care providers to ensure that babies have the best start in life with joined up services for families before their babies are born. We will work with families and GPs to ensure the best care and we will make sure that everyone can access their own care record.

If you need to go into hospital your experience will be planned and managed effectively with good links to your GP and other services. We will make sure that you are able to go home as soon as possible and that you are provided with the right aftercare to make sure you can stay at home.

On leaving our hospital, you will go back to services as close to home as possible with effective support for rehabilitation. We will work closely with NHS partners, the local authority, charities and voluntary groups to bring about the best possible outcome for you.

Releasing the pressure for beds and theatres by improving our efficiency and standard length of stay for minor and non-complex conditions will allow us to expand our specialist portfolio. There is a compelling case for being the best for specialist AND integrated care.

What does this mean? Each day, 365 days a year we spend nearly £3m delivering our services. So the context for sustainability is to focus on what we have and having confidence that it is put to the best use.

Like the rest of the NHS we face major financial constraint for the foreseeable future. We need to be able to make annual efficiency savings of between four and six per cent per year for the next three years and expectation while demand for health care is increasing.

There are limits to the level of savings we can make through salami slicing annual budgets without compromising the delivery of the safe and high quality care that our patients expect and deserve. We need to think differently, take a more long term approach and look at new and innovative ways of delivering services differently in order to be sustainable and more effective.

Our ambition will not be realised unless we are financially viable. We can no longer expect to be allocated money ear-marked for other parts of the NHS to subsidise practices that continue in our hospital but have been transformed in other Trusts. The entire health system in Leeds will not succeed unless we become a truly integrated health and social care service and that means fundamental changes need to be made without traditional organisational boundaries getting in the way of better care.

Leeds Teaching Hospitals is not currently financially sustainable and we will need to achieve this by: ensuring we are paid correctly for the work we do; treating patients differently who do not necessarily need to come to a hospital and by being amongst the best in the UK for efficiency, length of stay, purchasing and the use of Information Technology, so every taxpayer pound counts.

We are clear that unless we invest immediately in more nursing staff, improved processes, the best researchers, managers and infrastructure, we will not bring about the step change we need in the quality of patient care we offer.

We believe that investment will allow us to work more efficiently. For example, an investment in staffing levels will see more staff on our wards enabling nurses to spend more time with patients and running ward more efficiently. This will lead to our length of stay and infection rates reducing and will release us from our reliance on expensive agency staff. This greater productivity and a focus on better integrated care in the most appropriate setting could reduce the number of wards and even sites we need to deliver care from and reduce our overheads and costs in the longer term.