Our strategic priorities

Striving for excellence on behalf of our patients is core to what we do at Guy’s and St Thomas’.

We aim to provide the highest standards of care to our patients and communities across all aspects of healthcare quality and equity, from timely access to safe services, to positive health outcomes and good patient experience. These principles are set out in the NHS Constitution.

It also means that the Care Quality Commission’s (CQC) 5 key domains – ensuring our services are safe, effective, caring, responsive and well-led – are central to our operating model and to how we promote accountability across our clinical groups and services.

Guy’s and St Thomas’ has a strong track record for high-quality care and excellent patient outcomes. We consistently report one of the lowest mortality rates in the country across our services. Through national surveys, patients generally report positive experiences and our people feel confident to recommend the Trust as a place to work and receive care.

However, we recognise that waiting times are now too long for many services, both for diagnostic tests and treatment.

Fundamental to our strategy is continuing to deliver safe, high-quality care, while reducing waiting times and meeting all operational performance standards, and to do this efficiently, so that we live within our financial means. This will be challenging in the context of rising demand, a finite workforce and constrained resources.

Our strategic objectives to 2030

Delivering world-class quality and safety

Continuing to be amongst the safest organisations in the NHS – we will implement relevant findings and recommendations of major inquiries such as the Independent Blood Inquiry and use the national Patient Safety Incident Reporting Framework (PSIRF) to drive our safety culture. We will build on Martha’s Rule, giving patients and families the right to a second opinion, with the confidence that their concerns will be listened to and acted upon.

Quality improvement – we will use our comprehensive new quality management system to prioritise, deliver, measure and embed continuous improvement throughout the organisation, doing so across all domains of healthcare quality; from waiting times to patient outcomes and experience. This will be based on international best practice, accessible data and intelligence, supporting staff at every level to improve quality for our patients.

The opportunity of Epic – we will maximise the benefits of the Trust’s new electronic health record. For example, standardising clinical pathways where relevant, driving safety and enabling patients to receive the same high-quality care, every time they attend one of our hospitals or receive care from our community services. Epic will help us collect more and better data, meaning we can identify what works best and share improvements more easily and rapidly. Epic will enable us to pioneer new ways of working and delivering care.

Breadth of specialist care – our 5 main hospitals and community services work in partnership with others to offer a comprehensive range of specialist, lifelong, high-quality care. Our merger with Royal Brompton and Harefield hospitals has brought together a deep and broad concentration of specialist clinicians and services, capable of advancing the boundaries of healthcare.

Following public consultation, NHS England has announced that Evelina London Children’s Hospital should be the future location for specialist cancer services for children living in south London and much of south east England. Our depth of clinical and research specialisation for adults and children will support these services when they move from their current site.

Delivering improved access to diagnostics and treatment

Making it easier to access care – we will develop new ways for patients to receive information, receive care and communicate with clinical teams, including via the MyChart portal. We will improve ways for other clinical providers, such as GPs in primary care, to communicate with us.

Reducing waits for planned care – we will reduce our waiting times and improve equity of access. We will work innovatively and in collaboration with partners, including King’s College Hospital NHS Foundation Trust and Lewisham and Greenwich NHS Trust, to increase the number of appointments, scans and procedures, and to make best use of all local capacity.

Streamlined emergency pathways – our Emergency Department is one of the busiest and best performing in the country. The most unwell and vulnerable patients receive world-class emergency care. But we can do better. We will continue to develop Same Day Emergency Care, avoiding the need for inpatient admission where possible and by developing specialist support such as the Oncology Day Service.

Working with our regional partners, including South London and Maudsley NHS Foundation Trust, we will take every possible step to ensure that patients with mental health needs receive the care that they require, in the right setting for them. We will continue to advocate at every level of the NHS and government for investment in strong community mental health services, to reduce the need for admission, and to ensure adequate inpatient care, so that patients needing specialist mental health support are not left waiting in our Emergency Department for unacceptably long periods.

Ensuring our services are sustainable and we live within our means

Improving productivity – we will relentlessly pursue value for money, reducing unwarranted variation in how our services deliver optimal care, identifying opportunities using data and best practice and engaging staff and patients. The data from Epic, along with nationally collected data in the Model Health System and Getting It Right First Time (GIRFT), will help us identify further opportunities to improve consistency and efficiency in our services.

Overall, we will seek to move beyond incremental improvements to transform how we deliver services to achieve a step change in productivity.

Growing non-NHS income to support NHS services – we will seek to develop diversified income streams and sources of funding, including through commercial activities, innovation and the treatment of private patients. We will expand access to high-quality care to self-paying and insured patients. We will make it easier for our expert clinicians to do their private work within the Trust. All such income will be reinvested to expand the amount of care we are able to provide, free at the point of delivery, to NHS patients.

In common with other developed countries, we must deliver sustainable healthcare for the populations we serve.

Rising demand, including from older patients who are frailer and those with multiple chronic diseases, is exceeding the capacity of the NHS in its current, largely reactive mode of delivery.

Within the communities we serve there are huge health variations between people of different socio- economic status, different ethnicities and those with learning disabilities. The difference in life expectancy between the richest and poorest in Lambeth and Southwark can be up to 12 years. The gap in years lived in good health is 17 years. Both Lambeth and Southwark have higher-than-average preventable mortality rates for major conditions, such as cancer and cardiovascular disease.

Our aim is to work with our partners and communities to support local people to live longer lives, with more years in good physical and mental health, and to narrow the gap between the least and most healthy.

For local communities, our focus will shift towards different ways of delivering care, working with our partners in primary care, mental health and local government to respond to their current health needs and to proactively support them to stay healthy.

Empowered by better data and new technologies we will reimagine services so that we can better predict and prevent disease, and help to keep people well.

As part of our commitment to tackle inequality and deliver inclusive healthcare, we will reach out to communities that are currently not well-served by the health system, and work with them to build more accessible and equitable services.

Our strategic objectives to 2030

Patients as partners in their care

Our MyChart patient portal – we will empower patients to take greater control of their own health and care, including via the MyChart app which is also used by other NHS partners who have deployed Epic, including King’s College Hospital, the Royal Marsden, Great Ormond Street Hospital and University College London Hospital.

Making Every Contact Count – we will use our contacts with patients to identify the ‘vital 5’ risk factors: obesity, high blood pressure, smoking, harmful alcohol use and poor mental health so these can be effectively monitored and treated. This will be part of our overall approach to improving population health and will also include adopting the national Core20PLUS5 NHS England approach – identifying the core 20% most deprived population, plus locally identified priority population groups and 5 clinical areas of focus.

Using technology and data to predict and prevent disease and to personalise care

Understanding healthcare needs and reducing inequity – the Trust’s new Population Health Hub, funded by Guy’s & St Thomas’ Charity, will help us understand how to make our services more responsive and preventative, and will help us to address local health inequalities, including the impact of digital exclusion.

Outside hospital care – we will dramatically increase use of remote technologies to care for more people outside our hospitals, keeping them stable and well at home for longer. We will continue to expand and develop our nationally recognised virtual wards

Working in partnership

With local partners – we will ensure the way we work with primary care is as smooth as possible for general practice teams and patients, and be bold in exploring the joint provision of services with local neighbourhood partners. We will organise care around the needs of patients and the communities we serve, including with more colleagues working together across primary, community and hospital services, located together where appropriate.

For primary care colleagues we will offer access to our professional development resources, interoperable IT systems, and also explore new technologies that help to keep people healthy and improve the way we support them out of hospital.

Building healthier communities as an anchor organisation – the Trust plays an important role locally as an anchor organisation and as such, we will support our communities in a number of ways, including: providing access to high-quality training and employment; buying goods and services locally where we can; and creating a healthier environment through our Clean Air Plan, which aims to reduce carbon emissions, including through the adoption of greener transport options.

Across all the hospital and community services in our organisation we have an exceptionally talented, committed and diverse team.

Our people habitually go above and beyond to deliver high-quality care for our patients and to support each other. They are undoubtedly our most precious asset.

To deliver our ambitious strategy, we must retain and recruit talented people in sufficient numbers, provide them with a fair, flexible, healthy and supportive environment, and ensure that they have opportunities to grow and develop fulfilling careers.

Our strategic objectives to 2030

Recruiting and retaining the very best people

New routes into work – we will continue to develop new opportunities, including more apprenticeships across a wider range of professions. We will expand our ‘widening participation’ programmes which aim to attract local people, including specific programmes for neuro-diverse people and for people with disabilities. Providing high-quality work to people living locally is one of the most important ways we can support healthier communities. We will ensure that our employer-offer is in line with expectations, and that our extensive benefits programme meets the needs of the people who work with us.

Flexibility – the way people work has changed significantly in recent years and flexibility will be key to attracting, recruiting and retaining a talented workforce in the future. We are committed to ensuring equitable opportunities to achieve a good work-life balance that will allow colleagues to thrive. Many of them already work flexibly and we will continue to empower them with greater control over their work schedules wherever possible, and by developing flexible and innovative working patterns.

Responding to new technology – artificial intelligence (AI) and new technology such as Epic will support the delivery of better, faster, fairer healthcare. Many ideas for better ways of working will come from our colleagues as they use these new systems. We will ensure that they are supported to take advantage of new opportunities, including through retraining where necessary so they are equipped to thrive in the new digital healthcare environment.

Creating a fairer and supportive workplace

Equality, diversity and inclusion – our commitment to equality, diversity and inclusion is embedded in our Trust values. We will work with our staff networks, trade unions and the wider workforce to make this the lived experience of all colleagues and patients, and the communities we serve.

We will build on the commitments made in our anti- racism statement with actions as well as words. We have launched our commitment to being a trans- inclusive organisation.

We will ensure the Trust is a supportive and inclusive place for people of all protected characteristics, recognising the importance of intersectionality.

We will embrace positive action programmes to facilitate progression of greater numbers of people from diverse backgrounds into middle and senior management roles. We will hold ourselves to account for measurable progress against the Workforce Race Equality Standard, the Workforce Disability Equality Standard and gender and ethnicity pay gap reports.

Staff health and wellbeing – we support our people through our ‘Showing we care about you’ programme, which is generously supported by Guy’s & St Thomas’ Charity. We will review and modernise this offer, making sure the support we provide from health and wellbeing opportunities, financial benefits and career development, to staff forums and networks ensures that everyone has a positive and personalised experience of working here.

Recognising the challenge of accessing affordable housing in central London, we will explore opportunities with our local authority partners and the wider housing sector to facilitate access to affordable housing for our people.

Providing opportunities to grow and develop

Education, learning and development – we are a centre of excellence for professional training and education, both for our students, trainees on educational placements and our colleagues. We want to cultivate an enriching, learning environment for everyone that supports them to make informed choices and realise their career ambitions. We will maximise the opportunities for colleagues to undertake apprenticeships both as part of their personal development and as a route into professional training.

Working in partnership with other employers and education providers across the south east London system, we will develop plans to improve our own programmes to maximise opportunity for rotations. Listening and responding to feedback from trainees and students, we will continuously improve educational placements and ensure that we are ready to meet the needs of the increased student numbers set out in the NHS Long Term Workforce Plan.

We will provide access to a broad range of development opportunities through our College of Healthcare Learning Hub, from education to research, leadership to quality improvement. We will focus on developing our future leaders to be compassionate, inclusive and able to work effectively with our systems partners to deliver excellent healthcare to our populations.

Working with our colleagues in King’s Health Partners, our strategy will focus on a number of areas.

Leadership development – we will develop a robust education leadership programme to cultivate future leaders in healthcare. This will include creating training pathways and opportunities for leadership at all career stages, fostering skills necessary for navigating the complexities of modern healthcare systems, and supporting teamwork across health and science professions to improve patient outcomes.

Health data sciences – recognising the growing importance of data in healthcare, we aim to train staff to effectively utilise big data, bioinformatics, machine learning, AI, and natural language processing. This initiative involves a joint effort with the South East London Integrated Care System to implement a comprehensive Health Data Sciences Blueprint.

Support for academic careers – we will continue to support the career progression of clinicians and researchers pursuing academic roles.

Developing online and hybrid educational programmes – we will create flexible and accessible learning opportunities leveraging technology and innovation.

Investing in simulation technology – we will enhance clinical training and education through advanced simulation technologies.

Expansion of the Learning Hub – over the last decade more than 9,000 people across 74 countries have benefitted from over 100 courses on the King’s Health Partners Learning Hub. We aim to grow the Learning Hub to support more high-quality, accessible postgraduate education.

Fulfilling and tailored careers – we want all our people to reach their full potential and be able to thrive and grow in the workplace irrespective of their role, profession or stage of life.

Creating a health system that is sustainable depends on high-impact clinical research and the widespread adoption of innovation.

The UK has a pioneering history of biomedical and technological discoveries, and life sciences are a crucially important sector for future economic growth. We are committed to making a leading contribution to biomedical and health-tech research, and to trialling and adopting healthcare innovations that can support our vision. We will build on our position as one of the most research-active trusts in the NHS.

We will continue to work closely with our academic, charitable and industry partners to discover and apply new medicines, therapies and technologies that either prevent diseases, or treat them earlier and more accurately.

Using increasingly sophisticated digital technologies, we will be able to automate many repetitive tasks, both simple and complex, so that our talented people can focus their time, skill and experience on the many inherently human aspects of healthcare.

We do not underestimate the ethical and technical challenges that may be involved, for example in the application of emergent artificial intelligence (AI) or gene and cell therapies. We will work closely with patients and staff, as well as ethicists, regulators and other partners to address these issues and ensure that our research and innovation is responsible and safe.

Our strategic objectives to 2030

Translational research, advanced therapies and academic partnerships

Translational research – we are a leading centre for translational research. Our Centre for Translational Medicine, a strategic partnership with King’s College London, King’s College Hospital and Guy’s & St Thomas’ Charity, will further enhance our leadership position in taking scientific research and discoveries into frontline clinical practice.

Multi-professional research – we are committed to supporting all professions to engage in research through ACORN (A Centre of Research for Nurses and Midwives) and expanding it to include allied health professionals and healthcare scientists.

Academic and industry partnerships – we will deepen and strengthen our academic partnerships. The establishment of a Joint Research Office with our principal academic partner King’s College London, and the appointment of a joint Chief Academic Officer with King’s College Hospital, King’s College London and King’s Health Partners, will enable us to increase further the breadth and depth of our clinical academic research.

We will also continue to work closely with other key academic partners, such as London South Bank University, as well as Imperial College London and Brunel University, which have productive and longstanding links to Royal Brompton and Harefield hospitals.

We will continue to develop our industrial partnerships with biotech and pharma companies to help our patients access the latest diagnostic tests and treatments.

Academic Health Science Centres – we are founding members of King’s Health Partners Academic Health Sciences Centre and, through Royal Brompton and Harefield, we are associate members of Imperial College Academic Health Science Centre. Both are critical to our research efforts, supporting clinical, academic and educational integration. Many of our clinical research and innovation priorities align with those of our academic partners, including advanced therapies, data and population health.

Advanced therapies – we are at the forefront of the development of advanced therapies, including cutting-edge cellular and gene therapies and will utilise our outstanding genomic capabilities to ensure more patients have access to personalised and precision medicine.

Using data for research – we will responsibly use valuable clinical data to drive research that will improve the health of the populations we serve locally, nationally and further afield. We will play a leading role in the national health data research agenda through links with Health Data Research UK and, over time, we will develop research that utilises the new opportunities provided by Epic.

Healthcare innovation, digital technologies and industry partnerships

A leading innovator – we will be amongst the most innovation-friendly NHS trusts in the country, driven by our Centre for Innovation, Transformation and Improvement (CITI). We will seek to attract, accelerate and fund healthcare innovators and health-tech start-ups. We will do this by making portfolio careers more accessible to entrepreneurs, reforming our approach to Intellectual Property, and by expanding the scale and reach of our unique health-tech investment fund, KHP Ventures.

Future technologies – we will support the Royal Brompton and Harefield Charity’s ‘Think Beyond’ initiative that aims to actively encourage promising research and innovation in the fields of heart, lung and critical care medicine and surgery.

With King’s College London, we are also leading a new health-tech research centre, funded by the National Institute for Health Research (NIHR), to promote new technologies to address cardiovascular disease.

Automation and artificial intelligence (AI) - we will develop the London AI Centre for Value Based Healthcare to support the safe and ethical use of automation and AI in healthcare. We will also contribute to national policy through the UK Research and Innovation sponsored Responsible AI group.

We are committed to maintaining and modernising our estate, both in our hospitals and the community, ensuring our infrastructure is resilient and that we continue to be at the leading edge of healthcare.

Over the coming years, capital investment in the NHS is expected to remain tightly constrained. We therefore need to invest wisely and sustainably to deliver capital projects efficiently, reduce our infrastructure risks and use our estates and IT differently to transform the way we provide care.

In developing this strategy, we heard clearly and consistently from our people that the priorities for capital investment should be maintaining and modernising the existing estates, updating ageing medical equipment, ensuring our IT is fast and reliable and providing a safe and comfortable environment for patients and colleagues.

We are also ambitious for a better future. We have already made a major multi-year investment into our technological estate through the introduction of Epic in 2023. To be at the forefront of healthcare innovation we will also invest in the technologies that support healthcare automation and AI, gene and cell diagnostics and therapies, advanced clinical imaging and robotic surgery.

In addition, we have a number of significant building schemes that we will progress during the lifetime of this strategy, and which will require new approaches to capital investment.

Our strategic objectives to 2030

A strategic approach to our estates

Estates master plan – we will progressively re-engineer our estate and how it is used over time. We will develop a campus plan for each hospital site, and a community services plan, using the following principles:

prioritise our acute hospital sites for high acuity and specialised care that needs to be delivered in high specification buildings, which typically include operating theatres, high dependency and critical care, advanced imaging and inpatient care – taking account of climate change to ensure resilience

change where we deliver outpatient and day care, moving services from hospital settings to community sites or patients’ own homes where appropriate

maximise efficient use of clinical and non-clinical space in our hospitals and community sites, particularly for outpatient clinics, where we will make it easier for services to share capacity

make best possible use of our existing estates and equipment, through longer working days, weekend working and initiatives such as high intensity theatre lists

ensure that new facilities are designed flexibly, so they can be repurposed quickly and efficiently, thereby reducing capital costs to convert space to alternative use in future

Addressing and responding to climate change – we will upgrade existing facilities to adapt to climate change, especially through appropriate use of air conditioning and chilling equipment. We will make our infrastructure more environmentally sustainable, as part of our drive towards net zero. We will also seek to take advantage of available government funding to drive the energy transition.

Quality spaces – we will ensure that clinical spaces are suitable for the delivery of high-quality patient care. Where possible, we will use best practice from organisations such as the Design Council, to ensure our spaces are designed for recovery, ease of wayfinding, and are inclusive.

We will invest in spaces for our people, including changing facilities and rest spaces. Where possible, patients, visitors and colleagues will also have access to green and outdoor spaces on our sites.

Developing our facilities

Expanding Evelina London Children’s Hospital – we have planning permission for a world-class new facility to expand the existing Evelina London Children’s Hospital on Lambeth Palace Road. Investment in this scheme will benefit from the support of Evelina London Children’s Charity. It will also require specific financial approval from NHS England and will sit outside the Trust’s routine annual capital allocations.

Increasing operating theatre capacity – we will launch a rolling programme of operating theatre and catheter laboratory upgrades to improve the quality, efficiency and resilience of these vital facilities across all of our hospitals.

We will prioritise an expansion in the number of operating theatres at Guy’s Hospital, as a centre of surgical excellence.

Developing Royal Brompton Hospital and surrounding sites – we have planning permission for an expansion of Royal Brompton Hospital on Britten Street and we will consider options for the development of the Chelsea Farmer’s Market site for healthcare use, subject to appropriate funding, engagement with a wide range of partners and any required consultation and planning approvals.

In developing a masterplan for the site, we will work closely with our partners at the Royal Marsden NHS Foundation Trust, Imperial College London and the Royal Borough of Kensington and Chelsea.

We will also update and renew the infrastructure of Harefield Hospital to maintain and improve its highly specialist and renowned services.

Infrastructure to support innovation

Research and innovation – we will ensure that our leading researchers have access to state-of-the-art infrastructure through our Centre for Translational Medicine, our clinical research facilities, our core research platform technologies (such as genomics and cytometry), and advanced therapies manufacturing capabilities.

We are also committed to supporting health-tech innovation, including joint projects with King’s College London such as the Artificial Intelligence (AI) Centre, Health Tech Research Centre and projects hosted at the London Institute for Healthcare Engineering.

Advanced Therapies – we will invest in aseptic pharmacy services and apheresis capacity to support the clinical delivery of cell therapies at scale, as well as research focused on these new treatments.

We will also extend capacity for the manufacture of viral vectors and cell and gene therapies at Guy’s Hospital, in partnership with King’s College London.

Computing power and data storage – as part of our commitment to be at the forefront of health technology innovation and to underpin our data and analytical capabilities, we will ensure that we have sufficient computing power and data storage, with a carefully balanced blend of on-premises and cloud hosting for resilience.