Download - ORGANISATIONAL DEVELOPMENT PLAN
Organisational Development Plan Document 5 of 5 in the Integrated Strategic Operating Plan (ISOP)
Organisational Development Plan 2012-15
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Contents
1 Introduction 4
1.1 What is Organisational Development (OD)? 4
1.2 Our Organisational Development Goals 5
2 About NHS SES&SP CCG 6
2.1 A unique Organisation 6
2.2 Our Vision, Mission, Principles and Priorities 6
2.3 Our Structure 7
2.3.1 The Governing Body 7
2.4 Our Commissioning Support Arrangements (CSU) 9
2.5 Our Procurement Process 10
3 Our Organisational Development Journey 11
3.1 Our Organisational Development History 11
3.2 Responding to our 360 Feedback 15
3.3 Ensuring Delivery 16
3.4 Risks to Delivery 17
Appendix 1 NHS SES&SP CCG Organisational Development Plan 18
Appendix 2 Skills Audit Plan 33
Appendix 3 Diagnostic Detail 37
Appendix 4 Safeguarding Training 39
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What is the CCG Integrated Strategic Operating Plan?
The Integrated Strategic Operating Plan (ISOP) is a suite of documents which provides a clear picture of the
business and aspirations of NHS South East Staffordshire and Seisdon Peninsula CCG (NHS SES&SP CCG).
The documents are as follows:
Doc 1 – Strategic Plan 2012-2015 The Strategic Plan tells the story of the health issues for the CCG and the context within which the
organisation operates, clarifies the strategy to address the issues and sets out the delivery plan which will
be monitored to ensure implementation of the strategy.
Doc 2 - The Financial Plan 2012-2015 The Financial Plan outlines the CCG’s approach to managing its budget. It documents how healthcare
contracts will be managed and the finance aspects of the quality, innovation, productivity and prevention
(QIPP) challenge. The plan is aligned with the CCG’s challenges and ambitions as outlined in the Strategic
Plan.
Doc 3 - Operating Plan 2012-2013 The Operating Plan identifies all the work streams for the CCG over a single year. It is populated up until
April 2013 and will be updated on an annual basis (in February for the following financial year).
In addition to actions aligned with the CCG’s local ambitions, the plan includes responses to: Operating
Framework 2012/2013, Outcomes Framework 2012/2013, SHA ambitions 2012/2013 and CQUINs
2012/2013.
Doc 4 - Commissioning Intentions – 2013-2014 Commissioning Intentions are intentions set by the CCG for areas of focus for the following financial year
with their main providers.
The Commissioning Intentions for 2013/2014 are outlined by strategic area. These were shared with main
providers on 30 September 2012 and have been taken from requirements in the Strategic Plan.
Doc 5 – Organisational Development Plan – 2012-2015 The organisational development plan outlines how the organisation will support the development of a
culture of innovation, increase job satisfaction, develop positive relationships and foster greater
participation in creating plans and defining organisation goals. The plan focuses on 4 key areas to ensure
the establishment of a healthy, successful organisation: values, people, structures and systems.
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1. Introduction
This Organisational Development (OD) Plan describes the journey and the actions needed for NHS South East Staffordshire and Seisdon Peninsular (SES&SP) CCG as we strive to commission the best possible health and well being services for the people in our area. OD is crucial to ensure we are a fit organisation to take responsibility for spending considerable amounts of public money for the benefit of local citizens. Our CCG requires rapid development both in terms of the leadership ability of the governing body, the mechanisms to ensure we function effectively as a membership organisation, the technical skills covering the entirety of the commissioning cycle and the tools to engage effectively with public and partners. This document is owned by NHS SES&SP CCG and its member practices. We consider this an iterative working document which will develop as precise organisational and individual needs become clearer. We intend to review and refresh it with our partners both in the light of feedback and guidance received and in response to the rapidly changing public sector environment.
1.1 What is Organisational Development (OD)? Organisation Development is a planned and systemic change effort using organisation theory and behavioural science, knowledge and skills to help the organisation become more vital and sustainable. OD is not a technique or a group of tools but rather, something that can be applied at any time an organisation wants to make planned improvements. (McLean, 2005) The benefits of an OD approach supports the development of an culture, which underpins more innovation and creativity, increases job satisfaction, develops more positive interpersonal relationships and fosters greater participation in creating plans and defining organisational goals. The practice of OD is grounded in a distinctive set of core values and principles that guide behaviours and actions (interventions). These include:
Respect and inclusion—the perspectives and opinions of everyone are valued equally
Collaboration—building win-win relationships in the organisation
Authenticity—people within the organisation should behave congruent with their espoused values
Self-awareness—committed to developing self-awareness and inter-personal skills within the organization
Empowerment—focus on helping everyone in the organisation to increase their individual level of autonomy, and sense of personal power and courage, in order to enhance productivity and elevate employee morale
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Democracy and social justice—recognising that people will support those things for which they have had a hand in shaping; that human spirit is elevated by pursuing democratic principles
1.2 Our Organisational Development Goals
The organisation is at an early stage of its development which is why the OD strategy is in many ways one of the most important elements of the integrated suite of plans. Unlike CCGs which have kept the same form as previous PCTs, this is a genuinely new organisation with a leadership team that is yet to be finalised. That said, the shared culture, priorities and commitment of the member practices in both localities give an excellent and solid foundation on which to build. Appendix 1 gives a detailed delivery plan, however, the main organisational development priorities for the six months of operation are:-
Goal 1 – We will create an open and honest culture which supports people to be courageous in delivering better health outcomes One of the roles of the Governing Body is to create a positive culture. We will recruit skilled board members, have a clear board development plan and have engagement events with CCG staff and members to constantly reinforce our shared culture and priorities. We will do development work with staff and members about how we work together. There will be a clear drive through the quality strategy to encourage an open culture focussed on ensuring safety and good experience for patients. We will be clear about expectations, standards and support our staff to challenge.
Goal 2 – Every individual understands their role in the organisation and is working towards a common purpose We will develop a new appraisal system which ensures individual performance reviews discuss values and how each individual is contributing to the organisational objectives All staff will have a skills audit and will be supported to develop in order to support continuous improvement in their roles. We will develop a clear succession plan to grow future leaders in the organisation
Goal 3 – The organisational structure of the CCG is clear and meets the highest standards of governance and enables the organisation to achieve its strategic vision We will develop a clear governance framework, robust programme management and a good intelligence function to ensure the organisation is lean but fit for purpose
Goal 4 - We will cede control to really make collaboration work in the best way to maximize resources if that results in better outcomes for citizens As an organisation, our delivery will be mainly through partnerships. We will actively lead or engage in system wide transformation programmes and we will ensure clear arrangements around collaborative commissioning and partnership. Our CCG development will reinforce the need to focus on securing good outcomes for citizens not organisational boundaries.
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2. About NHS SES&SP CCG
2.1 A unique organisation
NHS SES&SP CCG is the only CCG to be made up of localities that do not share boundaries but both
are localities within South Staffordshire PCT and so have a history of shared commissioning and
provider arrangements.
2.2 Our Vision, Mission, Principles and Priorities
The NHS SES&SP CCG Strategic Plan, as a key document within the CCG ISOP (Integrated Strategic
Operating Plan) and describes the work that was undertaken with all stakeholders to support the
organisation to develop clarity around how and what the CCG will focus on over the next few years.
This work identified the CCG’s vision, mission statement, values and priorities as follows:
CCG Vision
“Improve the health and wellbeing of our population by commissioning high quality services”
CCG Mission Statement
“Clinically led, quality driven needs focussed organisation. Working in partnership to reduce
inequalities to transform and improve local healthcare within the available resources”
CCG Organising Principles
The organisation will be driven by a continued commitment to quality improvement that embraces
all aspects of healthcare;
It is a membership organisation – the members being the GP constituent practices;
The organisation will use the experience of the membership to commission safe efficient, effective and sustainable care;
The organisation will be clinically led and supported by management;
The benefits of partnership working with all stakeholders, including the public and patients, as well as providers and other commissioners of healthcare, are recognised;
In making its decisions, the impact across the whole health and social care economy will be considered;
In making its decisions, the organisation will use evidence wherever possible and learn from others, sharing good practice;
In making its decisions, the organisation will be fair and equitable.
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CCG Priorities
The CCG will be responsible for delivering health outcomes across a range of areas. Through a
prioritisation process, we will focus our transformation effort in three key areas. This is where we
feel we can make most impact as an organisation.
1) Frail Older People 2) Long Term Conditions 3) Quality Improvements
Two additional enablers were identified as important in how we do our business. These are:
Partnership Working
Getting the Basics Right
The work to determine these has provided a clear steer on not just what the organisation will do but
how they will do it. They will shape the development of the CCG culture and, as a result, the
elements that will support the organisation to develop; the values, people, structures and systems.
Our quality strategy recognises quality as the organising principle of the NHS and as well as
transformational effort to improve outcomes, we take our responsibility around safety very seriously.
We have a clear approach to safeguarding both vulnerable adults and children. We host the South
Staffordshire Safeguarding team and are working with colleagues on an active programme of
awareness raising and training.
2.3 Our Structure
Detailed overview of our structure is provided in the Organisational Structure document. The
capacity and capability requirements of our proposed CCG are adequately demonstrated in this
document and through our working relationship with our CSU (see 3.2 below).
2.3.1 The Governing Body
The CCG has in place a Governing Body with an appropriately appointed Chair and Accountable
Officer. There are experienced lay members who have individual induction programmes. In addition,
there is a non-voting place on the Governing Body taken up by the CEO of one of the three local
authorities which are coterminous with the CCG. This role is formally agreed as representative of the
three local authority areas. We feel this is important in terms of recognising how much of our
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delivery will be through partnership and bringing an experienced senior leader into the governing
body team.
Appointment processes are in line with the Clinical Commissioning Group Governing Body Members:
Role outlines, attributes and skills’ framework. The Chair was appointed following a competency
interview and agreement from member practices. The Accountable Officer appointment process was
through open competition and the Lay Members were appointed through a formal competency
based process.
As well as the management structure, the CCG has built a strong infrastructure around clinical
leadership. The Clinical Directors have been specifically appointed to provide focus around quality,
our covered population and the priorities of the CCG (Long-term conditions, Frail Older People,
Unplanned Care, Planned Care, Public Health and Partnerships and Mental Health and Children’s
Services).
The CCG Accountable Officer is supported by our Chief Finance Officer who will assure CCG activities
run with our cost envelope, by a Chief Nurse responsible for quality and safeguarding, a Planning and
Governance Lead and the COO. Further details of the sub-committees in these areas are detailed in
our Constitution.
We also have structures in place to provide further support via the COO in the areas of service
development, medicines optimisation, engagement and partnership, operations and administration.
We have assessed the capacity of the organisation to fulfil its functions. Clearly this consideration has
taken account of our contracted activity with the Commissioning Support Unit (CSU).
Changes we have made as a direct result include:-
Boosting capacity around primary care engagement to ensure we have sufficient resource to
really actively engage with member practices
Recognising that where functions are delegated to the CSU, we still require internal capacity to
be ‘an intelligent customer’. This is primarily in quality, finance and information analysis.
Although strategic communications and engagement is commissioned through the CSU, we have
created a post to ensure some internal capacity around the public face of the organisation.
There is a clear split between that communication activity commissioned through the CSU and
the internal day to day resource e.g. around website management.
Of particular note (see also section 3.3) we have structures in place, as described in the
Organisational Structure document, which will focus on safeguarding and children’s services. These
include the necessary requirements for designated doctors, safeguarding leads and collaborative
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commissioning. Further capacity and capability requirements of the CCG will be met with in-house
training, as described for safeguarding in section 3.3. The Organisational Structure document outlines
the requirement for the Chief Nurse to take responsibility for ensuring that all appropriate staff
receives safeguarding training.
2.4 Our Commissioning Support Arrangements (CSU)
We have a working arrangement in place with Staffordshire CSU as outlined in the SLA document.
This relationship is maintained directly with the CSU Relationship Manager and Chief Financial Officer
through the CCG Finance and Performance Committee.
Conflict resolution processes are in place that can be escalated through the CSU customer forum, as
outlined in the SLA with the CSU.
Our confidence in the support capacity and capability of the CSU is demonstrated in our Financial
Plan section 2.8. It is known that the CSU provides service continuity with a team that has been in
place for 12 months with relevant experience. The Consultation Document for Staffordshire
Commissioning Support Unit that we have received satisfies our requirement that the CSU can
demonstrate a robust contract management structure and approach that has worked well for our
2012-13 contract sign-off delivery. The CSU has also delivered contract outturn positions and an
assessment of CQUIN’s achievements.
The recent 360 feedback highlighted that the CSU reports a very good relationship with NHS SES&SP
CCG and has full confidence in the CCG’s ability to fulfil its part of the SLA or contract. This
stakeholder also says the SLA or contract is fit for purpose for the longer term.
There are particular challenges for us working with the CSU in that our geography means more than
half of our patient flow is out of the area. We will particularly need to ensure that the Staffordshire
CSU works closely with neighbouring CSUs and CCGs to ensure a joined up approach.
Our CSU support will enable us to deliver required capacity and capability as we have been directly
involved with comment on the structure of the CSU needed to deliver support required for our CCG.
This involvement took the form of direct feedback from our Governing Body members and senior
management of the CCG, discussed at our management team meeting in advance.
The cost of the CSU support has been clearly defined and is mapped out in the Financial Plan section
2.7.2. Within that document, we have built this cost into our understanding and need to deliver
financial balance within our cost envelope for 2012-13 and beyond to 2016.
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2.5 Our Procurement Process
Whilst we have a signed SLA and the Staffordshire CSU has passed Checkpoint 2 with limited issues,
the CCG has taken the decision in October 2012 at Finance & Performance Committee that it will
retender the services by 31 March 2014. We do have options as we are on the border and we are
actively beginning to have conversations with alternative support services. There is also work going
on with the King’s Fund in Staffordshire to develop integrated commissioning which may impact on
our CSU requirements. Our plan is to develop a detailed implementation plan by June 2013 for
retendering of support services.
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3 Our Organisational Development Journey
Tamworth and Lichfield enjoy a shared organisational history both as a PCT and as a practice based
commissioning (PBC) locality. Practices in the Seisdon Peninsula worked together under Practice
Based Commissioning as early as 2006. Both are localities within the former South Staffordshire PCT
and so have a history of shared commissioning and provider arrangements. The two localities chose
to merge to form a single CCG for a number of reasons. There is a shared, genuine focus on quality
and cultural synergy, both in terms of priority and approach. Both localities are in the position that
the majority of services are delivered through contracts where the CCG is not a lead commissioner,
requiring specific relationships with the host CCGs and Providers.
There are a number of reasons why the 2 localities have chosen to merge as a single CCG:
A true focus on Quality Improvement – the CCG seeks to embrace the opportunities of clinical decision making set out in the 2012 Health and Social Care Act, and truly place quality improvement at the heart of everything it does.
Similarities with Associate Commissioner contracting relationships – unlike most other CCGs the majority of services are delivered through contracts where the CCG is not a host commissioner, requiring specific relationships with the host CCGs and Providers.
Similarities in demographics and health data – whilst the districts have an individual identity, there are some consistencies within specific patient groups and demographics, with similar demographic profiles, for example between Seisdon and the Lichfield district
Cultural similarities in values, approaches to delivery and governance, coupled with a genuine wish to be a member led organisation.
3.1 Our Organisational Development History
Key Milestones
2011/12
NHS SES&SP CCG was delegated £243.1m of the PCT’s budget for 2011/12. Whilst the CCG is
predominantly an associate commissioner for acute services it was actively involved in the managing
of the performance of its three key acute providers Burton, Wolverhampton and Heart of England
Foundation Trust. The contract management was also undertaken on behalf of the other 3 CCGs
within South Staffordshire. The contract management for Mental Health and the community
provider has been managed through a collaboration arrangement with the other South Staffordshire
CCGs.
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2012/13
In terms of organisational form, the Governing Body is relatively new with key appointments
happening over the summer and early autumn of 2012. The Chief Finance Officer post is currently
filled by an interim and final recruitment will be in November 2012. This means we are relatively
under-developed as a team but we have a strong legacy, significant clinical commitment and have
taken the time to build the right team.
The following summary gives key points in our development over the last 6 months.
April - CCG was officially formed
May - Full diagnostic against authorisation domains with KPMG Partnership
June - Planning and Priorities Workshop attended by each of the 33 member practices
July - Mock Board to Board Site Visit with KPMG Partnership
July - Chair Appointed
September - Quality Workshop attended by key representatives from partner organisations
- Frail Older People and Long Term Condition workshop attended by 37 peoplE
from 17 different organisations including local authorities, provider trusts,
voluntary sector, the fire service and neighbouring CCGs
- Accountable Officer appointed
- Patients and the Public Workshop
- Board Development Planning Session with KPMG Partnership
October - Document Review and issue development by KPMG Partnership
As well as specific events and workshops, we have continued to develop our Board Development
Plan and engagement strategy. There is active engagement with practices and one of our key
priorities over the coming months is to build the organisational infrastructure across SES and
Seisdon. We remain confident we can overcome the geographical distance and build a strong
organisation across the two former organisations. The new structures and clinical leadership will
work across both geographical locations and our OD strategy will include targeted support to
expedite the creation of a single organisation, with clear devolved decision making where
appropriate.
Diagnostic Journey
To date 2012/13 the organisational development interventions that have been delivered to support
Authorisation have focused upon developing an awareness of the changing landscape and devolved
responsibilities, and supporting the Governing Body in readiness for Authorisation assessment. The
CCG commissioned the services of KPMG to support them in this work and establish a baseline for
moving forward.
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In May 2012, the KPMG Partnership reviewed the CCG against readiness for establishment using the
6 domains identified for Authorisation. The findings identified were prioritised into 4 key areas for
development:
Values and Culture
People
Structure
Systems
These are shown in the table below:
Theme Priority Organisational Development Actions
Completed by October 2012
Values and Culture
Practice Engagement Strategy o Practice event to determine vision, mission
and values o Confirm how practices feed into
governance
Patient and Public Engagement strategy o Map stakeholders and develop strategy
Produce a suite of clear and credible 2013/14 plans:
o Obtain existing plans to use as a guide o Describe the strategic context o Priority setting of objectives o Include activity / performance / QIPP and
Finance plan
Completed. Member Practices were instrumental in the development of CCG Vision, Values and Priorities
Constitution Completed which confirms practice responsibilities and gives clarity around devolved decision making to localities
A CCG Practice Development Programme has been developed and supports this requirement to produce routine practice information to support them to develop both personally and within team environments
Completed. (ref: Communication and Engagement Strategy p45)
Completed. The ISOP suite of documents including a strategic plan, operating plan, finance plan and commissioning intentions
People Development of a constitution o Develop a constitution steering group o Share and secure sign off with practice
members
Develop Board Development plan to support positive culture
Constitution has been developed and signed off by Member Practices. Conflict of Interest declarations signed by all Practice Members (see Appendix 1, 1.1)
Appendix 2, Organisational Culture Workshop to held in new year, a
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Develop succession plan to grow future leaders
Development of an appraisal system and skills audit
o Develop an appraisal system that uses individual performance reviews to discuss values and the individual’s contribution to organisational objectives
o Support continuous development with a skills audit
product of which will be a plan
Formal Succession Planning process to begin in new year, see Appendix 2
Formal appraisal system to be initiated for all staff members Appendix 2 for Skills audit for individual development plans
Structures Appoint Governing Body o Define roles and responsibilities of
Governing Body members and Locality members including elected or appointed and levels of leadership
Integrated governance: o Appointing a governing body (assign
Chair, assign Nurse, assign Consultant to the Board, identify clinical leads)
o Agree an approach for Quality and implementation of Quality
o Develop federation agreement
o Systemic approach to information gathering and use
o Identify collaborative services
The Accountable Officer has been recruited to externally. The lay members are in place. Recruitment is currently underway for the CFO and secondary care clinician.
committee structure in place.
A Quality workshop was held in September 2012 which was attended by key representatives from partner organisations including NHS Trusts, member practices and local authorities (ref: Strategic Plan). Quality strategy complete
Constitution outlines agreement
IGF and SOP Manual outlines information gathering approach and use
Clear legal agreement around collaborative services. Agreed protocols in place re delegated decision making.
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Systems Commissioning Support Unit (CSU) approach
o Agree service specification with CSU, particularly how and when performance, quality and finance activity will be provided
o CSU driven engagement o Agree service level agreement SLA o Retest CSU SLA gaps
CSU approach, specification and SLA agreed and assessed. Ongoing monitoring of CMT output by Finance and Performance Committee
The diagnostic (Appendix 3) was considered with Governing Body to determine our key future OD
priorities.
Our Organisational Development Plan (Appendix 1) is a direct product of these outcome priorities
(Values and Culture, People, Structures and Systems). For each OD theme there are detailed plans
that include relevant required supporting materials, a clear vision of what a successful outcome will
look like, a status tracker and appropriate timescales to complete. Future work will build on the
actions in the OD Plan and these will be monitored by the Governing body.
Where there are any delays to actions as proposed in the Organisational Development Tracker, the
CCG will follow the guidelines in the ‘Strategic Plan’ document section 4.4.4 that addresses recovery
plans
3.2 Responding to our 360 feedback
In October 2012 we received 360 stakeholder feedback. There are a number of positive results
which reflect the emphasis we have placed in involving our stakeholders throughout our
development, for example:-
Stakeholders are very positive about the engagement that has taken place so far, with more
than four in five saying they are very or fairly satisfied, outperforming the average across
aspiring Wave 4 CCGs.
Working relationships are also rated positively, with more than four in five saying they have a
very or fairly good working relationship with the CCG, slightly higher than the Wave 4 average.
Stakeholders are also positive about the leadership of the CCG, with, for example, around two
in three saying the leadership is clear and visible and reporting confidence in the leadership to
deliver its plans and priorities.
However there were a number of highlighted areas for improvement, for example
Two of the six NHS stakeholders reported that they were not very/not at all confident in the
QIPP plans. Similarly , three of the seven state that the CCG is committed to helping them to
deliver their own QIPP plans
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While two stakeholders from the upper tier local authority say that arrangements are in place
for safeguarding children, opinion is divided between the two regarding the appropriateness of
these arrangements. In addition, only one stakeholder says arrangements are in place for
safeguarding adults, although that individual thinks they are appropriate
Stakeholders are not all aware of the accountability arrangements within the CCG for
safeguarding children or adults
Consequently a number of areas such as QIPP and Safeguarding will be revisited as a matter of
urgency and this Organisational Development Plan updated accordingly. Our plan is to complete a
revised OD strategy by January 2013, which addresses these issues and includes more detailed board
assessment and development plan.
3.3 Ensuring Delivery
The OD Action Plan outlined in the Appendix will be monitored by the Delivery Board of the CCG.
There will be exception reports to the Governing Board on a quarterly basis. We will test culture with
members and partners through annual 360 degree assessments.
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3.4 Risks to Delivery
The key OD risks have been identified:-
Description of Risk Mitigating Action Update (Oct ‘12)
We fail to develop the right organisational structure and culture to deliver our objectives
Clear Management of Change process in place Skills audit Succession Plan Programme of staff ‘away days’ and development sessions Leadership development Board development programme
Management of change process underway. Appointment of clinical directors with clear role definitions Staff sessions diarised Board development plan being refreshed following further appointments
We are not focussed on the priority areas and fail to achieve Delivery Plan
Appraisal system links personal objectives to organisational objectives Delivery Group monitors deliver and moves resource if required
The Appraisal system is being revised Programme management is being established to ensure clear governance processes around decision making Enhanced suite of metrics have been agreed with the CSU
Collaborative arrangements fail to deliver
Clear governance process in place with other CCGs and with partners Clear delegated authority for staff attending partnership meetings Collaborative Commissioning Board to provide high level leadership overview
Clear Memorandum of Understanding in place outlining responsibilities. Further work has begun on operating standards e.g. expectations around communication and engagement
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Appendix 1
April 2012-April 2015 This plan is divided into the 4 goals described on page 8
Values and Culture
People
Structure
Collaborative working
Staff Groups OD Action Supporting documentation What success will look like
Status Timescale
Goal 1 – Values and Culture ‘We will create an open and honest culture which supports people to be courageous in delivering better health outcomes’
1.1 CCG FAIRNESS AND EQUITY In making its decisions, the organisation will ensure it is fair and equitable
Nolan Principles Equality and Diversity Strategy
Patients are placed at the heart of decision making and all factors are considered objectively in order to achieve the right outcome All staff members are treated in a fair and equitable way
Decisions are made with the best available data. Processes to be put in place to improve the quality of data and comply with Equality Assessments (EAs)
Jan 13
CCG
In making its decisions, the impact across the whole health and social care economy will be considered
Strategic Plan
Relevant partners will be identified and consulted with, prior to the making of final decisions that will impact upon the local population
Member Practices, Providers, and Patients and the Public have attended stakeholder events. The outcomes of which have shaped the CCG Strategic Plan. Engagement will continue with these
Sept 12 and on-going
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Staff Groups OD Action Supporting documentation What success will look like
Status Timescale
Goal 1 – Values and Culture ‘We will create an open and honest culture which supports people to be courageous in delivering better health outcomes’
Practice Members
Those involved in decision making within the CCG will act with impartiality
Constitution Conflict of Interest Policy
All Practice Members have signed and abide by the Conflict of Interest document
groups of partners Conflict of Interest declarations signed by all Practice Members
Sept 12
1.2 CCG
ORGANISATIONAL OBJECTIVES: Development of an annual set of objectives that reflect the vision, mission, values and priorities of the CCG
Annual Operating Plan
Set of objectives produced and published on the CCG website
Board Development sessions organised to support this work. Website under production
Jan 2013 Dec 2012
Member Practices and CCG staff
CCG objectives to be used to support the development of team and individual objectives
Appraisal Documentation Personal Development Plan Practice Development Plan
All teams and staff to have personal objectives linked to the strategy with supporting teams and individual development plans.
Work in place to build upon existing structures in primary care to support staff engagement
Feb 2013
1.3 Member Practices and CCG staff
VISION, MISSION, VALUES & PRIORITES Continue to engage with staff and member practices to work towards implementing the CCG vision, mission, values and priorities
Strategic Plan Communication and Engagement Strategy
All staff and members are clear about the CCG, how and why it functions and the aims of the organisation
Vision, mission, values and priorities in every key CCG document. Documents to be disseminated and shared with staff
Jan 13
1.4 CCG staff MANAGEMENT CULTURE Develop a customer focussed professional organisation
Education Strategy Quality Strategy Communications and Engagement Strategy
The CCG functioning within a business model built on individual accountability and with quality as the goal
NHS model of working that needs re-modelling and enhancing
Mar 13
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Staff Groups OD Action Supporting documentation What success will look like
Status Timescale
Goal 2 – People ‘ Every individual understands their role in the organisation and is working towards a common purpose’
2.1 CCG
PATIENTS AND THE PUBLIC Continue to put the patients and the public at the heart of the CCG work through implementation of a PPI structure
Communications and Engagement Strategy Patient Engagement Strategy
Patients will feel valued and seek to become involved in PPI interventions that support the commissioning of services
Membership scheme launched Strategy in development
Jan 13
Member practices
Review and implementation of an effective Patient and Public Involvement (PPI) structure
Patient Engagement Strategy Services that are commissioned and monitored using patient knowledge and experience
PPI structure under review and under development
Jan 13
2.2 CCG Member Practices
LEADERSHIP Implement a CCG Leadership programme that supports succession planning A SES Leadership programme for Clinical Leads will be extended to all clinicians
Education Strategy Education Strategy
Supply of confident, informed individuals who know the business of the CCG A set of competent Clinical Directors to lead the CCG
Appropriate Leadership opportunities to be sourced and commissioned following approval by the Governing Body
Mar 2013 Jan 13
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Staff Groups OD Action Supporting documentation What success will look like
Status Timescale
Goal 2 – People ‘ Every individual understands their role in the organisation and is working towards a common purpose’
Practice Members and CCG Staff
Identify CCG Leadership requirements and commission appropriate CPD and a rolling cycle of Leadership development
Education Strategy CCG and practice member staff display leadership skills at all levels of the organisation support succession planning
A number of Leadership programmes are in place. These are to be reviewed and appropriate development identified from team and individual PDPs
Mar 2013
2.3 CCG staff
LEARNING AND DEVELOPMENT Development of a CCG Induction programme for new employees
Education Strategy
Employees will feel confident and well informed
Programme to be produced as part of the Education Strategy
Mar 2013
Practice Members and Board
Development of a clear succession plan
Board development plan Succession plan
Governing body with clear development plan and future leaders identified
Early stage of development
Mar 13
CCG Staff Production of a PDP for all CCG staff that maps individual requirements against the CCG objectives
Practice Development Plans
Staff accessing appropriate personal development identified on their PDP
Work to commence in the New Year
Mar 13
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Staff Groups OD Action Supporting documentation What success will look like
Status Timescale
Goal 2 – People ‘ Every individual understands their role in the organisation and is working towards a common purpose’
CCG Staff
Production of a framework to support organisational and staff development, e.g. KSF, LQF, EDS Competency Framework
Education Strategy
Staff undertaking learning and development relevant to their role against an appropriate competency framework
Competency Frameworks to be reviewed
Mar 13
CCG Board, Practice Members and CCG staff
Ensure all staff are compliant with mandatory training as a minimum, particularly with Safeguarding
Education Strategy
Workforce that is safe and competent, take responsibility when appropriate, and who know where with whom to raise concerns.
Compliance of staff with mandatory training to be identified in PDPs
Jan 13
Practices to be supported to produce a Practice Development Plan outlining the training requirements of the Practice and individual staff
Practice Development Plans The production of a CCG PDPs that incorporates the needs of each Practice and the CCG.
Practice Development Plans initiative to be shaped with the support of Practice Members
Mar 13
2.4 CCG Board, Practice Members and CCG staff
COMMISSIONING SKILLS Developing commissioning skills: - The business of the
CCG - The accountability
associated with clinical decision making
Constitution Education Strategy
Individuals will have appropriate skills to commission effectively and hold relevant others to account
The focus initially is upon developing the Board and will extend to CCG and Practice staff
Mar 2013
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Staff Groups OD Action Supporting documentation What success will look like
Status Timescale
Goal 2 – People ‘ Every individual understands their role in the organisation and is working towards a common purpose’
Practice Members
Involvement of the membership to commission safe, efficient, effective and sustainable care
Strategic Plan Member Practice staff that are well informed and confident in their decision making
CCG are engaging Practice staff through formal activities such as the stakeholder event, and informally through one-to-one working
On-going
2.5 CCG staff STAFF AWARENESS - DOCUMENTS Ensure that all relevant CCG documents are shared and owned by CCG staff (ISOP)
Communications and Engagement Strategy
Documents remain live, i.e. are referenced, discussed at relevant committee meetings, and up-dated as appropriate
Documents under development with relevant staff in readiness for Authorisation. To share with all staff once complete
Dec 2012
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Staff Groups OD Action Supporting documentation What success will look like
Status Timescale
Goal 3 – Structure ‘The organisational structure of the CCG is clear and meets the highest standards of governance and enables the organisation to achieve its strategic vision’
3.1 CCG
STRUCTURE REVIEW Fully implement the Committee Structure for the CCG
Constitution Integrated Governance Framework
Effective structure in place TORs all agreed
Most committees have met
Nov 13
CCG Staff Member practices and CCG staff
Regular review of the CCG structure to ensure that the organisation can respond and perform appropriately Implementation of a Clinical Leadership model to support the work of the CCG
Constitution Clinical Leadership Paper
CCG that has the capacity and capability to fulfil requirements An organisation that is driven by clinicians
The CCG structure is currently under review as part of a management of change process Service Redesign staff re-positioned within the CCG. Clinicians to be appointed to Lead positions
Jan 13 and on-going Oct 12
3.2 CCG
CLINICAL DECISION MAKING Development of a clinically led organisation
Strategic Plan
Clinicians are conversant with all relevant aspects of the CCG
Clinicians hold prominent roles within the CCG and the clinical structure continues to be strengthened
Sept 12 and on-going
Practice Members and CCG staff
The structure will support the production of commissioning intentions based upon clinical decision making
Strategic Plan
Commissioning Intentions that are produced driven by clinical input and the experiences with of patients
Clinicians involved in the process to determine 2013/14 Commissioning Intentions through identifying priorities
Sept 12
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Staff Groups OD Action Supporting documentation What success will look like
Status Timescale
Goal 3 – Structure ‘The organisational structure of the CCG is clear and meets the highest standards of governance and enables the organisation to achieve its strategic vision’
3.3 CCG Board
GOVERNING BODY: Continue to develop the Governing Body roles and responsibilities, competency and capability, taking note of ‘’, and responding to the identified building blocks:
The Healthy NHS Board, Principles for Good Governance Constitution
Governing Body members are confident, competent and effective members on their respective committees
Development opportunities maximised through Board Development sessions and appreciation of committee roles
Sept 12 on-going
CCG Board
i) Context - Board development will incorporate national and regional requirements, including the findings from the Francis Inquiry
Operating Framework NHS Outcomes Framework Francis Inquiry MkII CCG Operating Plan
The Board is assured that the organisation is incorporating recommendations into the work of the CCG
Responses to the Operating Plan and NHS Outcomes Framework are contained within the Delivery Plan
Jan 13
iii) Engagement – The Governing Body will actively engage with relevant stakeholders
Strategic plan Operating Plan
Plans that incorporate the priorities of all our partners and show ways of working that fit with partner organisations ways of working also
Stakeholder events have identified shared priorities and engagement with partners. To continue to focus on engagement in order to achieve the deliverable within CCG plans
3.4 CCG HUMAN RESOURCES CCG to have access to expert HR advice and support
CSU SLA HR support is accessible, reliable and current
HR currently provided SLA with CSU. To review needs and identify HR resources
Dec 12
3.5
CCG INFORMATION TECHNOLOGY CCG to have access to IT expertise and resources
CSU SLA IT support that is readily available and provides appropriate IT solutions
IT currently offered by HIS. To transfer to North IT system imminently
Nov 12
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Staff Groups OD Action Supporting documentation What success will look like
Status Timescale
Goal 4 – Systems ‘We will cede control to really make collaboration work in the best way to maximize resources if that results in better outcomes for citizens’
4.1 CCG PARTNERSHIP WORKING
Further develop relationships with Provider organisations in order to secure QIPP support at all levels within the organisation
Communication and Engagement Strategy
Strategic Plan
The CCG will have a full appreciation of all the QIPP schemes and where the schemes are not delivering
Meetings arranged with CEOs and AOs to initiate cross working
Nov 2012
CCG
Partner Providers and the CCG working together to identify actions that will result in improved quality of care
Quality Strategy Production of a set of quality markers that promote good quality care
CCG Quality event in Sept 12, where Providers and the CCG identified a desire to work together on this.
Follow up event to be organised to produce the indicators
Nov 12
CCG Continued close working with JCU to commission appropriate services
Provider Contracts
JCU SLA
Services commissioned with the appropriate support and expertise
Continued support and close working
On-going
CCG
Partners
East Side Strategic Forum developed
TORs transformation programme A clear cross organisational transformation plan in place for the East economy
Initial sign up achieved
On-going
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Staff Groups OD Action Supporting documentation What success will look like
Status Timescale
Goal 4 – Systems ‘We will cede control to really make collaboration work in the best way to maximize resources if that results in better outcomes for citizens’
CCG
Partner Provider
Continued close working with non- health partners, e.g. LINks and Healthwatch
Joint Strategic Needs Assessment
Joint Health and Wellbeing Strategy
Partnership working to achieve and share priorities and support the development of a seamless service for patients
CCG working closely with partners; stakeholder events and the development of the Health and Wellbeing Board
Sept 12 and on-going
4.2 CCG NHSCB LAT
Continued close working with the NHSCB with regard to legacy information and forward direction of travel
Delivery of the Primary Care services from the NHSCB LAT
Legacy Documents
Operating Framework
NHS Outcomes Framework
NHSCB LAT Functions
National and regional directives will be adopted and incorporated into commissioning arrangements taking into account historical learning
Delivery of effective, integrated primary care services to support the work of the CCG
Legacy documents, and national and regional documents used to inform CCG documentation.
Primary care review as part of the NHSCB development work
Oct 12
Nov 12
Delivery of Specialist Commissioning Services from the NHSCB LAT
Delivery of effective integrated Specialised Commissioning services to support the work of the CCG
Identification of Specialist Commissioning services to be delivered by the NHSCB LAT. Further details to be released
Nov 12
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Staff Groups OD Action Supporting documentation What success will look like
Status Timescale
Goal 4 – Systems ‘We will cede control to really make collaboration work in the best way to maximize resources if that results in better outcomes for citizens’
4.3 CCG COLLABORATIVE COMMISSIONING
Monitoring of a collaborative commissioning agreement that ensures robust commissioning arrangements and reporting/monitoring processes but that does not relinquish individual CCG responsibility
Collaborative Commissioning Agreement
Collaborative Commissioning Agreement
CCGs conversant with their responsible functions with communication that supports all partner organisations to feel engaged and informed
Teams regularly reviewed to ensure that funding, processes and mechanisms remain fit for future, effective and collaborative
Collaborative Commissioning Agreement produced. To be developed to include communication and accountability of CCGs
Hosted teams housed within the CCG base. Teams incorporated into the CCG structure. Staff to benefit from team and personal PDP work. To liaise with partner CCGs to ensure adequately up-dated and informed
Sept 12
and on-going
Sept 12
To ensure that NHS SES&SP CCG hosted collaborative functions are supported and reviewed appropriately:
- Safeguarding - Medicines
Management - Individual Funding
Requests (IFR) - Children’s
Services
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Staff Groups OD Action Supporting documentation What success will look like
Status Timescale
Goal 4 – Systems ‘We will cede control to really make collaboration work in the best way to maximize resources if that results in better outcomes for citizens’
4.4 CCG staff
QUALITY IMPROVEMENT
Review the CQRM agenda to promote positive working
Quality Strategy Provider information that supports an improvement in the quality of care
Quality event with Providers that identified the need to review CQRMs
Jan 13
CCG Staff In making its decisions, the CCG will use evidence wherever possible and learn from others, sharing good practice
Quality Strategy
Research Strategy
Committee meeting agendas will reflect where good practice is shared and learning implemented
Quality Improvement mechanisms maturing and influencing the culture of the CCG to recognise and utilise learning and good practice
Feb 13
CCG Develop a significantly different approach to recording patient experience
Quality Strategy The collation of patient experience data to support the commissioning and monitoring of services
Patient experience data used currently to support the CQRM process. To explore methods of acquiring and utilising data more broadly
Jan 13
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Staff Groups OD Action Supporting documentation What success will look like
Status Timescale
Goal 4 – Systems ‘We will cede control to really make collaboration work in the best way to maximize resources if that results in better outcomes for citizens’
CCG
Members
Develop a more open and protected approach to registering the concerns of health service staff
Quality Strategy
An organisation where staff are accountable and a process that supports the concerns of staff and acts upon them
Current system managed via CSU where ‘soft intelligence’ collated.
New system, Datix, to be launched that collates data, identifies trends and produces reports
Partners registered their interest at a CCG Quality event. Dates and agenda to be established
Jan 13
Jan 13
GP practices
Quality Strategy
Elements of the Quality agenda will be shared and addressed across the health and social care economy
CCG
Develop a Quality Forum with partner Providers
4.5 CCG INNOVATION
Responding to the DoH ‘Innovation, Health and Wealth’ report and embedding innovation within the business of the CCG
Quality Strategy
Strategic Plan
A CCG culture where innovation is embedded in the business of the organisation and staff readily identify innovate opportunities
QIPP schemes identified that support service redesign initiatives. Innovation to be highlighted as a CCG priority
Jan 13
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Staff Groups OD Action Supporting documentation What success will look like
Status Timescale
Goal 4 – Systems ‘We will cede control to really make collaboration work in the best way to maximize resources if that results in better outcomes for citizens’
4.6 CCG QIPP
Continue to implement a QIPP process that supports regular review and refresh
Strategic Plan
Operational Plan
Financial Plan
QIPP schemes that support innovation and financial savings and improve the quality of care
CCG processes reviewed and developed to support monitoring and reporting to appropriate committees and Governing Body
Sept 12 and on-going
4.7 CCG staff CSU
Monitor and review the CSU SLA to ensure it supports the work of the CCG, responds to the changing landscape and supports a compliant procurement process
CSU SLA Procurement of a CSU SLA via a robust, complaint procurement process and the delivery of services as stated in the SLA CSU
CSU SLA completed and signed for an 18 month period. Forum to be established to monitor delivery
Sept 12 and on-going
4.8 CCG INFORMATION GOVERNANCE
Compliance with Information Governance requirements
Information Governance Strategy
Achievement of level 3 for the IG toolkit and an understanding of IG within the workforce
IG Level 2 currently. Working closely with the CSU.
Mar 13
4.9 CCG SUSTAINABILITY
Implementation of the CCG Sustainable Management Development Plan (SMDP) and reporting via the ERIC return
Sustainable Management Development Plan
The CCG will adopt priorities and actions that support the aim to reduce the CCG’s carbon footprint
The CCG has a SMDP which is to be shared with staff and implemented
Jan 13
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Staff Groups OD Action Supporting documentation What success will look like
Status Timescale
Goal 4 – Systems ‘We will cede control to really make collaboration work in the best way to maximize resources if that results in better outcomes for citizens’
4.10
CCG EXTERNAL SUPPORT
Continued relationship building with KPMG to achieve establishment and support development of the CCG
NHSCB Applicants’ Guide The establishment of NHS SES&SP CCG and the skills to function as a competent CCG
CCG working towards the Authorisation deadlines of 1st November for submission of documents, and the site visit on the 20th December.
Dec 2012
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Appendix 2
Skills Audit Plan
As part of our development, the CCG Governing Body has identified a key number of challenging areas where development is needed including individual
development of senior team members, development of personal development plans, cultural development of corporate behaviours and developing leadership
potential across the CCG and addressing succession planning.
We aim to tackle these challenges and broaden the required management skills through both individual and group based interventions. Below is a summary of our
approach which covers:
Skills Audit Individual Development
Review CCG Governing Body role descriptions. Ensure leadership potential and competency levels are part of the description and are appropriately detailed. Use these criteria for assessment of Governing Body skill level
Undertake a similar skills audit of CCG support staff to identify extent of in-house talent and areas needing development
Using the results of the skills audit and a 360° assessment, help individuals identify current strengths and weaknesses through coaching and PDP development
Board Development Succession planning
Group Dynamic assessment to gain a full understanding of the team’s effectiveness. Develop Governing Body team action development plan which complements the emerging PDPs
Organisational Culture Assessment to structure discussions around the behaviours and culture the Governing Body would like to foster.
Governing Body skills audit to thematically identify gaps and alter the organisational development plan accordingly
Conduct a survey to categorise GP active interest level
Establish GP Succession Scheme aimed at developing the leadership and commissioning skills of those identified as possible successors
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A. Skills Audit
Assess each Role Description - We will conduct a full review of the CCG Governing Body role descriptions, ensuring that leadership potential and competency levels are part of the description and are appropriately detailed in regards to role clarity and what is expected. Each role should matrix the skills/competencies required, including importance to the role and competence level required.
Self assessment of each Governing Body/Support Staff capabilities - Self assessment of each Governing Body and support staff against the skills/knowledge/experience identified in the role descriptions, to identify extent of in-house talent and areas needing development.
Skills Matrix - We will then construct a matrix which summarises the skills strengths and weaknesses for the Governing Body and support staff, compare to the skills required as specified in the role descriptions. We will use the completed skills audit as a launch pad for discussions with individuals which would then, in the coaching sessions create the starting point of a personal development plan.
B. Individual Development
360 feedback exercise – Those individual who have requested it will
undertake a 360 feedback exercise.
Coaching - Following both these events we will commence 1:1 coaching for individuals who request it. These sessions will work on progressing
the issues identified in the Skills Audit Reflections and 360 feedback results. Together the coach and coachee will work on the individual’s Personal Development Plan (PDP)
C. Board Development
Group dynamic assessment - In January 2013 the KPMG Partnership will run a group dynamic assessment (using a structure such as Lencioni’s 5 Dysfunctions of a Team/Myers Briggs) to gain a full understanding of the team’s effectiveness and explore what steps may be required to further develop as a group. This session would allow the opportunity for individuals to understand how they contribute to the success of the CCG. It will also facilitate a discussion about any potential gaps that may exist in the current leadership skills. This will compliment any ongoing PDP discussion.
Organisational Culture assessment - We will conduct a cultural assessment of the Leadership Team which tackles the interdependencies between strategy, culture and leadership. This session will explore not only what our perception of the current culture is but also where we think we ought to be. Our alignment of our future state will be crucial to our success as a Board.
Governing Body Skills Audit - Using the skills audit as a base, we will thematically identify gaps and plan interventions accordingly. We will assess if the group has sufficient knowledge, skills and experience to fulfil core functions. Identify any gaps in regards to capacity (does the Governing Body have sufficient representation with particular skills to fulfil its role?) and capability (does the Governing Body have sufficient in-depth knowledge, skills and experience to fulfil its functions?). We will then develop an action plan accordingly.
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D. Succession Planning
GP Survey
As a membership organisation developing those with talent and leadership potential at Practice level will be imperative for business continuity and long-term viability. In order to assess the current interest level regarding involvement with CCG Governance, we will be surveying all CCG GPs asking them to categorise how active they wish to be in Governing Body conduct. This will be then used to develop GPs who are already interested in taking a more active role, as well as identify where more practice buy-in is required to attract more interest.
The appointment process for the Clinical Directors will also be used to identify future leaders.
GP Succession Scheme
For those GPs who have declared definite interest in developing their leadership and commissioning skills, we will pilot a GP Succession Scheme. Following a competitive application/interview process applicants will be offered mentoring, participation in development events, and access to leadership meetings. This will build on existing leadership development programmes currently running in SES which we plan to roll out across the area.
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E. Broad Timescale
Skills Audit Individual Development
Board Development
Succession Planning
Assess each role against description
Self assessment of capability
360 Feedback
Group Dynamic Assessment
Organisational Culture Workshop
121 Coaching
GP Survey
GP Succession identification
GP Succession Scheme begins
Dec
Jan
Feb
Mar
Apr
2013-14
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Appendix 3:
Diagnostic Detail In May 2012, the KPMG Partnership reviewed the CCG against readiness for establishment using the 6 domains identified for Authorisation.
Authorisation Domain Organisational needs (progress update as of October 2012)
1 - A strong clinical and multi-professional focus which brings real added value • Practice engagement
• Example case studies • Clarifying roles and responsibilities • Ownership of vision (Planning and Priorities Workshop attended by
each of the 33 member practices developed the vision) • Signed constitution • Identifying conflicts of interest • Nurse and consultant appointment • Public health offering • Clear & credible plan • Engagement with partners
2 - Meaningful engagement with patients, carers and their communities • Understanding links to partnership
• Priority setting
• Engaging with communities and patients
• Develop Data strategy
• Develop Local JSNA
• Resourcing strategy
• Stakeholder management strategy
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3 - Clear and credible plans which continue to deliver the QIPP challenge within
financial resources, in line with national requirements (including excellent
outcomes) and local joint health and wellbeing strategies
• Financial understanding
• Reporting standards
• Contracting relationships
• CSS relationship ownership
• Performance measurement techniques
4 - Proper constitutional and governance arrangements, with the capacity and
capability to deliver all their duties and responsibilities including financial
control, as well as effectively commissioning all the services for which they are
responsible
• Agreement on way forward for constitution
• Quality approach beyond framework
• Safeguarding strategy
• Definition of statutory responsibilities
• Legal status check
• Review by independent body
5 - Collaborative arrangements for commissioning with other CCGs, local
authorities and the NHSCB as well as the appropriate commissioning support
• Systematic look at collaboration
• Understanding of providers roles and link to quality
6 - Great leaders who individually and collectively can make a real difference • Development of less task-orientated OD plan
• Leaders role definition
These were later prioritised and synthesised into the four themes of Values and Culture, People, Structure and Systems see section 3.1
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Appendix 4:
SAFEGUARDING TRAINING The responsibility of Safeguarding is transferring to the CCG in 2013 and a programme of induction is planned to ensure the new process is understood and staff are aware of their individual responsibilities.
The lead for both adult and children’s safeguarding currently sits with the Cluster PCT. However, responsibility will transfer to the CCGs this year in time for establishment in April 2013. As a consequence, the adult and children’s safeguarding teams will transfer from the Commissioning Support Service (CSS) to the CCGs in 2012.
The Staffordshire wide team currently consists of four highly trained and experienced nurses:
Two lead nurses for adult safeguarding
Two designated nurses for safeguarding children
When transferring to CCGs, the team will be split on a North/South Staffordshire basis, with both an adult and children’s lead nurse for South Staffordshire hosted by SES&SP CCG on behalf of all CCGs in the South of the county.
The lead/designated nurses take the responsibility for safeguarding vulnerable adults and safeguarding children across Staffordshire on all aspects contributing to the safeguarding of these groups and the promotion of their welfare. The lead/designated nurses will provide strategic leadership and act as a source of expertise for clinical commissioners across the area, leading and delivering the corporate and strategic safeguarding agenda.
They will also provide basic training on Safeguarding emphasising the crucial part each staff member plays in identifying and helping those using the CCGs services who are suffering from abuse. The broad plan for Safeguarding training is below:
January – March 2013 all SES&SP CCG staff will be issued basic guidance on Safeguarding, emphasising each staff members responsibilities and how to access Safeguarding support and advice
March –December 2013 all staff will have attended a half day training session reviewing the Safeguarding arrangements, and process training including the use of scenarios. Completing this mandatory training will a requirements in all PDPs.
March –December 2013 a Practice Lead for Safeguarding to be identified within each Practice to tie in directly with Safeguarding nurse for policy advice and ongoing policy change cascade
More information on the roles and responsibilities of safeguarding nurses can be found in Schedule 1 of ‘Explanatory note to SLA for Shared Services’ document.