This plan sets out the foundational work we will do in the coming 12 months to get Sirona in the right shape to deliver our Strategy: Improved Outcomes for All.

Sirona is committed to the on-going provision of all community healthcare services across Bristol, North Somerset and South Gloucestershire (BNSSG) and, in this context, we are working with our commissioners to bring forward discussions around the long-term future of our contracts for both children and adults. We do not want the uncertainty of longevity or the distraction of a potential tendering process to inhibit the energy and innovation we can bring to this next phase of healthcare transformation.

As a not-for-profit Community Interest Company (CIC) Sirona exists for the purpose of adding social value to everything we do. We must use this social entrepreneurship, together with the skills and experience of our amazing workforce, to provide drive and leadership alongside our partners that ensures we have a strong foundation, and long future, for system-wide healthcare delivery.

We already have our vision of Improved Outcomes for All supported by our mission of One You, One Sirona, One System. During the past year, we have been working with our teams, our health and social care system partners and with voluntary, community and third sector organisations, to develop a shared vision, direction and ambition for the future. The result of this work is our new Sirona Strategy: Improved Outcomes for All, a framework for working together to make the shifts we all want to become a reality.

This collaborative approach has enhanced our thinking on how we can deliver high quality services at a time of increased demand and complexity; widening inequalities; significant financial constraints and the long-term underinvestment in capacity and technology, especially in the community.

We will continue this work over the coming months in the context of national NHS plans, BNSSG’s Healthier Together 2040 vision and emerging national Neighbourhood Health models.

For 2025-26 it is more important than ever that Sirona is in the best shape possible to support these changes and getting our foundations right will be our focus in the coming year.

If you have thoughts on any of our plans or ideas for how we might give even more back to our communities, please do get in touch.

Julie Sharma, Interim Chief Executive

Dr Barbara Brown, Chair

Across our area there is consensus about the need for a home/community first approach with people wanting less duplication; to tell their story only once; a greater emphasis on proactive care to help people stay healthier for longer; to understand their needs and support them in their ability to self-care; and to reduce health inequalities.

Our partners are ready and want to collaborate with us to deliver more joined up services so, together, we can provide seamless care for individuals. We will find shared ways to use our joint resources more effectively and efficiently to help us all meet the increasing demand and complexity of care outside hospital.

We know our staff are key to our successful delivery. We already have a dedicated, skilled and committed workforce who do not always have capacity to give their best because of the unrealistic demands asked of them.

We need to work at pace to address the fundamentals underpinning Sirona to ensure we are ready to undertake and support the coming NHS transformation. This means:

• Supporting the well-being of all our staff who are working to maximum capacity and beyond. Meeting the needs of our staff and increasing our capacity through our environment, facilities and culture. This means ensuring we have IT that works; estate that meets peoples’ needs and supports them to do their jobs more efficiently; and clear processes, structures and training that enable agile decision making at every level of Sirona
• Maintaining the safety and quality of the services we provide. Establish new, inclusive ways of providing and accessing services across whole pathways. Working in collaboration with partners including the VCSE sector to ensure the rights skills are in the right place at the right time.
• Understand peoples’ needs, listening to the voices of those closest to care delivery and our diverse communities to find solutions together.
• Allocating our resources differently to address areas of highest demand ensuring we have the right capacity and skills while supporting the well-being of all our staff and maintaining the safety and quality of the services we provide.
• Provide stability, confidence and optimism for the future. Staff are enabled to bring in change and improvements every day, showing how we can all make a difference to outcomes for our communities and our staff.

These factors have been at the forefront of our thinking as we developed our Business Plan for 2025-26.  While we will focus on these areas, we will also retain a clear focus on the longer term aims and ambitions both for Sirona and for the wider health system which align to our overall vision of Improved Outcomes for All.

Our plans for 2025-26 fall under five key areas:

1. Maintaining our collective focus to deliver on our contract requirements: This means we will pay particular attention to areas where we know our performance is not optimum. To support this, we will need to match our current demand with our capacity through demand modelling; undertake productivity reviews that can help us change how we work; stop doing some things that are not effective for our patients, so we can focus on where we can achieve most impact and the improved outcomes we seek.
2. Ensuring safe care: We will address specific areas where we know services are under significant pressure due to high demand, which is potentially leading to less optimal care and provision
3. Improving our infrastructure to support delivery: This includes ensuring we have the right skills and staff numbers in the right place at the right time; improving our IT and estates; managing our financial resources effectively; implementing strong governance and accountability for delivery; and instilling confidence in what we are delivering to secure our long-term contracts
4. Enhancing the experiences of those who use our services: We will increase the level and quality of feedback to ensure we are paying attention to the experiences of our service users and those who care for them so we can learn from this, supporting our aim of continuous improvement
5. Developing our inclusive culture where staff have a voice and are focused on improving services: We want our staff to feel valued, enabled to perform to their maximum potential and to develop the skills and leadership capability we need; to ensure we understand the impact our work is having; and to adapt and respond accordingly.

1.1 Reduce our waiting lists

• No adults wait more than 52 weeks
• 85% of all adults wait less than 18 weeks
• All highest priority patients in Community Paediatrics to be offered a first appointment within the 18-week Referral to Treatment Time (RTT).

1.2. Ensure our capacity is optimised to meet demand

• Maximise efficiency through effective rostering; skill mix; care planning and caseload management
• Undertake demand and capacity planning to match resources accordingly
• Undertake a review of referral routes and professional points of contact with all Sirona services with a view to simplifying and supporting better demand management.

1.3. Achieve our statutory targets for Children’s Services

• Undertake over 90% of all mandated  visits in Public Health Nursing (PHN)
• 95% of Initial Health Assessments (IHAs) completed within 15 days internally
• 95% of Education Health Care Needs Assessment achieved within the statutory timeframe.

1.4.  Actively support a Home First approach to healthcare through optimising flow through all pathways

• Increase our admission avoidance activity through working with System partners
• 80% occupancy of our 165 NHS@Home Virtual Ward
• Reduce average Length of Stay (LoS) within our rehabilitation beds
• Reduce average LoS in our stroke beds.

1.5. Close collaboration with our Voluntary Community and Social Enterprise (VCSE) sector and System partners to develop new models for care delivery

• To develop our leadership role in the development and implementation of a neighbourhood health model
• Develop the foundations of how we work with volunteers to enhance the experience of people using our services
• Embed our Health Inclusion services with focus on better understanding the needs of communities

2.1. Reduction of harm and improved safety

• Implement Children’s Development Improvement Plan (CDIP)
• Redesign and deliver improved Podiatry Pathway
• Redesign and deliver improved Heart Failure Pathway
• Clarify pathway for Forensic Learning Disability provision in the community
• Revise pathways to improve how our Integrated Network Teams (INTs), bedded units and Specialist and Support Services (SaSS) work together
• Deliver the INT Improvement Programme, including improvements in planning and prioritisation processes and introducing the new prioritisation framework to improve monitoring and oversight of harm-free care.

2.2. Ensure the right capacity in the right place to meet the demand for services

• All services to have a recognised service specification and delivery model that has been signed off through appropriate governance
• 95% of all agreed establishments to be filled substantively
• 5% reduction in use of agency and temporary staffing
• 3% reduction in staff sickness levels across Sirona with a particular focus on areas of highest concern.

3.1. Continued financial sustainability that allows us to invest in our services and communities

• Ensure a strong financial foundation by operating within our means
• Maximise the investment we make in our services to ensure we receive value for money
• Deliver on-going efficiencies by achieving our agreed savings plans
• Develop a sustainable financial plan through to 2030.

3.2. Ensure Sirona is the community provider of choice in BNSSG through robust contract management and retention which provides value for money 

• Review all aspects of our current contracts to identify efficiency, effectiveness and risk
• Clear process for securing on-going provision of children’s services contract post 2027
• Clarity around proposals for re-procurement of adult services contract from 2030
• Identify appetite and potential for future growth and business development to add value to our current portfolio.

3.3. Improve our efficiency and effectiveness in our digital offering

• Digital Strategy. Support the transformation and improvement of service delivery through the development of an aligned digital strategy that outlines our approach to: technology & platforms, data & analytics, people & culture, cybersecurity & risk management, supplier management and investment.
• Digital Infrastructure. Improve our Digital Maturity Assessment score by year end. Complete a review of the use of our Electronic Patient Record, including safe storage and audit. Establish minimum standards for equipment and connectivity. Enhance security with Cyber Essentials accreditation.
• Digital Intelligence. Deliver the Data Quality Action Plan and Integrated Dashboard. Support data sharing (Intelligence Centre and protected characteristics sharing) including implementing Data Sharing Agreements with key partners as part of a BNSSG-wide approach.
• Digital Workforce. Establish a Clinical Informatics function to bridge the gap between clinical, service design and digital services. Ensuring digital projects and strategy are clinically led and focused on delivering operational change and clinical benefit.

3.4. Provide equitable access and positive experiences for patients and staff while reducing our carbon footprint through our estates management and green agenda

• Set out a clear plan and priorities for improvement of our current estate
• Develop proposals for the relocation of staff and services currently in Castlewood
• Implementation of initiatives to reduce our carbon footprint in line with our environmental strategy.

4.1. Improve outcomes for people by addressing areas of known inequalities

• Deliver our implementation plan to improve compliance with Accessible Information Standard (AIS) and reasonable adjustment recording
• Review our current referrals, waiting lists and caseloads from an equalities lens to identify gaps and areas for priority attention
• Identify and target known underserved populations through collaboration with VCSE partners to understand and address barriers to access

4.2.      Ask, listen and learn from our communities and people who use our services

• Design and deliver processes to ensure a wide range of service users are engaged in consultation, review and planning of service delivery through codesign particularly those from seldom heard groups and communities
• Improve our feedback rates from people who have used our services in line with national averages
• Develop and deliver an Experience and Engagement dashboard to support services use of data and feedback to monitor and improve service delivery.

4.3. Continue to improve our understanding of the peoples’ needs

• Deliver training in personalised care planning, using a ‘What matters to me’ approach, to core staff in prioritised areas (children and adults)
• Implement ‘This is Me’/Personalised Care plan for patients in prioritised areas
• Deliver clinical skills development to key staff in comprehensive assessment and use of Rockwood Score for Frailty (see below)
• Delivery of our year one Frailty Implementation Plan to embed the identification and support of people living with the impact of frailty.

5.1. Improved staff Engagement and Experience

• Achieve a 10% increase in number of staff who respond to annual staff survey
• 70% of staff who respond to the staff survey will recommend Sirona as a good place to work
• 90% of staff will have an annual appraisal and personal development plan within first quarter of the new financial year
• Undertake the Freedom To Speak Up (FTSU) reflection tool to identify key actions for development and priority.
• Implement new Internal Communications Platform to replace WorkPlace.

5.2. Improve diversity in our workforce and ensure equality of opportunity

• 95% of job applicants to complete an Equality and Diversity profile
• Increase the number of people appointed with protected characteristics
• Increase the number of people at grade 8a and above who have a protected characteristic
• Continue to drive and embed our Equality, Diversity and Inclusion (EDI) strategy.

5.3. Improved retention of staff

• Quarterly Executive review and understanding of key themes for staff leaving the organisation and have an active Action Plan in place to reduce the rate.
• By 31^s March 2026, 50 per cent reduction in the number of staff leaving Sirona within first year of appointment
• Month–on-month staff turnover reduced.

5.4. Be well-led

• Agree a framework for compassionate and inclusive leadership values and behaviours that we want to see in the organisation
• Develop and implement a programme for strategic leadership development for the organisation to include all Board Members and all members of our Senior Leadership Group (SLG)
• Underpin the values and behaviours of all of our service managers with a clear development programme of how to manage well
• Embed behaviours of continuous improvement using the NHS Impact Framework and moving within the framework from “Starting” to “Developing” in line with our self-assessment maturity scoring
• Develop improvement skills from within our service delivery areas together with the identifying a change/improvement team at corporate level
• Finalise and implement the redesign of our Governance Framework in line with agreed recommendations from recent external assessments and the developmental governance review, ensuring compliance is maintained through accountability and sound decision-making

Our Finances

The budget approved by the Board has been built up taking into account the following factors:

• Contract funding and National NHS Efficiency Targets
• Agreed investments.
• Cost pressures that cannot be managed within existing funding
• Savings needed to deliver a balanced overall financial plan.

The planned budget for the organisation for 2025/26 is £225m.