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Agenda Item 11 Enclosure KPCT/11/40

NHS KIRKLEES Report To:

Trust Board

Title:

Four year Operating / Strategic Plan 2011 - 2015 Single Integrated Planning Process

FOI Exemption Category

Open

Lead Director:

Peter Flynn

Author:

Samantha Merridale

Key Points to Note:

The paper outlines the background to planning requirements as set by the Department of Health and the Y&H Strategic Health Authority, and gives a summary of the contents of the proposed 4 year plan. The plan triangulates activity, workforce, and finance information alongside the PCT’s QIPP programme. The plan is based on the PCT’s existing strategic plan

Budget Implications:

Is consistent with the budget approval being sought for 2011/12

Risk Assessment:

GP Commissioning Consortia are not yet able to fully sign up to this plan

Legal Implications:

No impact identified

Health Benefits:

Already documented in the Strategic Plan, based on the JSNA

Staffing Implications:

Increase to Health Visitor numbers is described, as required in the 11/12 Operating Framework

Equality Impact:

Attached

Environmental Impact:

No additional impact identified

Sub Group/Committee:

Discussed at F,P&S

Recommendation:

The Board is asked to approve this revised plan.

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NHS KIRKLEES Four year Operating / Strategic Plan 2011 - 2015 Single Integrated Planning Process March 2011 1. Purpose The purpose of this paper is to present the draft Four Year Operating / Strategic Plan 2011 – 2015 to the NHS Kirklees Board. The paper outlines the background to planning requirements as set by the Department of Health and the Y&H Strategic Health Authority, and gives a summary of the contents of the Plan. Finally, the Board is asked for formal sign off of the Plan and associated documentation. 2. Background In the Spring of 2010 NHS Kirklees presented a fully comprehensive five year Strategic Plan in response to the requirements of the World Class Commissioning Framework. This Plan was the output of extensive consultation with our Board, strategic partners, and clinical executive colleagues in primary care and was contributed to by all of our strategic programme leads and their teams. At the same time, the Strategic Goals for NHS Kirklees were also redrafted to more closely reflect our vision and objectives, and these were mapped against performance outcome measures to provide a means of measuring our progress. Following publication of the White Paper in the summer of 2010 and then the Operating and Outcomes Frameworks in December 2010, PCTs were asked, as part of the Single Integrated Planning Process to provide narrative strategic / operational plans for the period 2011 - 2015, firstly in draft format in January 2011 and then for final submission by 18th March 2011. In addition, detailed technical information was also required for activity, finance, workforce projects and QIPP plans for the same four year period. Initial feedback from the DH on draft plans described the main themes as being: The Integrated Plan must cover the 4 year period and not focus on the period 2011/12. Individual PCT plans (which they have now asked to see as appendices to overall SHA plans) must detail 4 year plans; Recovery of the position of A&E, waiting times and ambulance response times will need to be sustained through 2011/12 and onwards; QIPP narratives and plans need to be stronger and focus on the four year period to 2015. System plans also need strengthening. The overall QIPP challenge of £1.25bn (2011-15) appears low as a proportion of the recurrent baseline compared to other SHAs (15% compared to an average of 20-21%) and is not underpinned by any detailed milestones and projects to deliver this 4 year transformational goal; The plans need to demonstrate stronger links between the development of commissioning and delivery of today.

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Working to a very clear set of requirements we have therefore produced our Supplementary Four year Strategic / Operating Plan to give assurance that we have a robust planning process in place through transition to the new Commissioning arrangements. This Plan should be read in conjunction with our Five Year Strategic Plan, published in the Spring of 2010 and it should be noted that at this early stage in Transition any medium/long term planning and vision has been taken directly from the 2010 plan, since Shadow Boards of newly emerging GP Consortia are only newly confirmed at the time of publication, and will wish to formulate their own Plans once their structures are established. 3. Plan content The Supplementary Narrative Plan 2011-2015 supports the various submissions by NHS Kirklees of finance, demand / activity and workforce plans, and our QIPP programme, and fully triangulates those “Four Pillars of Information”. It describes the engagement with strategic partners – particularly GP Commissioning Consortia – at this early stage in the transition process. We have encapsulated the key messages from the 2011 Operating and Outcomes Frameworks into the Plans, and have a prioritised programme approach to delivering our plan which sits alongside an integrated approach to QIPP delivery. We describe our proposed Clustering arrangements with partner PCTs in Calderdale and Wakefield, the opportunities around working as a Cluster specifically on our QIPP programme and synergies to be gained by working together, and outline our shared ongoing working relationship with our two main acute Trust providers – Calderdale and Huddersfield NHS Foundation Trust and the Mid Yorkshire Hospitals NHS Trust, particularly as Mid Yorkshire work towards Foundation Trust status. Our emerging GP consortia are positioned strategically well in terms of forging new relationships with the acute sector, given their geographical footprints in North Kirklees and Greater Huddersfield. At the time of finalising this plan, the moves relating to opening the new Pinderfields Hospital have been successfully completed. This means that the two new PFI hospitals operating in both Pontefract and Wakefield are now open and the full opportunity afforded by these superb new facilities should enable the Mid Yorkshire Hospitals NHS Trust to become more efficient, speed patient journeys through the system; provide better working conditions for the staff and above all a much superior patient experience. Nevertheless, it has to be recognised that the size of the two hospitals when taken together are markedly smaller than the previous hospitals. The new hospitals were planned on assumed population growth at the time the hospitals were designed together with key assumptions relating to improved efficiency at Mid Yorkshire Hospitals NHS Trust. We have thus factored critical risks in terms of matching capacity with demand and the knock on impact on financial plans moving forwards into our calculations and these are described in detail within the Plan. The PCT has a track record of delivery of its financial targets and we expect to once again achieve our control total for 2010/11 whilst playing a major part in managing the risks within our health economy. Our financial plans, as described in Section 5 of this supplementary plan, anticipate the additional risk associated with the level of current and future change at MYHT. A number of the now confirmed financial planning assumptions are more favourable to the PCT than had previously been anticipated. However, a number of additional financial commitments are also contained within the Operating Framework. For 2011/12, we are 3


planning to deliver the agreed control total of £8.3m. Within this we have a QIPP requirement of £13.3m in order to deliver the control total. We have triangulated the Finance, Activity and Workforce plans to assure ourselves that an increase in activity is supported by appropriate funding and is deliverable through the known workforce plans (See section 7.5 in the Plan on Health Economy Workforce). For those areas where we have identified a potential risk to delivery this is described in full with mitigating actions where relevant. Supplementary to the Plan narrative, the QIPP Dashboard summary is provided as Annex 1, which gives a breakdown of our progression with QIPP plans. Annex 2 gives the full summary list of our prioritised programme plans which are provided to give additional clarity to our QIPP programme, and gives a start and end date to each project and anticipated benefits to be realised. Annex 3 describes the Public Health Transition programme, and Annex 4 presents our project plan for recruitment of additional Health Visitors in line with the national priorities described in the Operating Framework. Other supporting Appendices requested as part of the planning process are also attached, which give further detail around our QIPP programme as Appendices 2 and 3, our Risks Plan as Appendix 4, our PCT migration Plan as Appendix 5 and GP Consortia Development Resource Plan as Appendix 6. This supplementary Plan for 2011 will evolve over the forthcoming months as transitional arrangements with shadow GP Commissioning Consortia progress, and contractual arrangements are agreed and finalised. We are committed to providing assurance around delivery of our targets, and delivery of our QIPP programme in line with our financial planning. This Plan should therefore provide the necessary assurance to our Board, our strategic partners in partnering PCTs, GP Consortia and the Strategic Health Authority that our planning and governance processes are sufficiently robust to allow us to deal with forthcoming challenges in 2011 and beyond. 4. Recommendation The Board of NHS Kirklees is asked to: (a) Note the contents of this Paper which describes the planning process, and summarises the contents of the Strategic Plan 2011-2015; (b) Formally sign off the Strategic Plan Appendix 1: Link to the NHS Kirklees Four Year Operating / Strategic Plan 2011-2015 NHS Kirklees 4 year plan (N.B. this is currently only accessible from within the PCT’s intranet) Samantha J Merridale Head of Portfolio Office 21st March 2011 4


Equality Impact Assessment 1

What is being Equality Impact Assessed?

A paper to the NHS Kirklees Board on 30th March 2011 which presents the Four Year Operating/ Strategic Plan 2011-2015 Prompt: (Service plan, policy, strategy (new or revised), process, decisions or other public functions)

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Description of the function being Equality Impact Assessed: The purpose of this paper is to present the draft Four Year Operating / Strategic Plan 2011 – 2015 to the NHS Kirklees Board. The paper will outline the background to planning requirements as set by the Department of Health and the Y&H Strategic Health Authority, and give a summary of the contents of the Plan. Finally, the Board are asked for formal sign off of the Plan and associated documentation.

Prompt: What is the aim of this function and who are the recipients of this proposal?

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Lead contact person for the Equality Impact Assessment:

Samantha Jane Merridale, Head of Portfolio Office, NHS Kirklees

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Who else is involved in undertaking this Equality Impact Assessment:

No one 5

Sources of information used to identify barriers etc

Existing strategic plan, existing EqIA within the Strategic Plan, local demographics (Prompts: service delivery equality data, satisfaction surveys, complaints, local demographics, national or local research & statistics, anecdotal.)

What does your research tell you about the impact your proposal will have on the following equality groups? BME Groups: This paper has no adverse impact upon this particular equality group (Prompt: Black African and Caribbean, Mixed Heritage, South Asian, Chinese, Irish, new Migrant, Asylum & Refugee, Gypsy & Travelling communities)

Disability Groups: This paper has no adverse impact upon this particular equality group 5


(Prompt: Learning Disabilities or Difficulties, Physical, Visual, Hearing disabilities and people with long term conditions such Diabetes, Cancer, Stroke, Heart Disease etc.

Gender: This paper has no adverse impact upon this particular equality group (Prompt: Female, Male &Transgender issues should be considered)

Age: This paper has no adverse impact upon this particular equality group (Prompt: Older people & Young People issues should be considered)

Sexual Orientation: This paper has no adverse impact upon this particular equality group (Prompt: Heterosexual, Bisexual, Gay, Lesbian groups are included in this category)

Religion & Belief: This paper has no adverse impact upon this particular equality group (Prompt: Main faith groups and people with no belief or philosophical belief issues should be considered)

6 Consultation: New or Previous: This paper and accompanying Plan is prompted by new planning guidance issued by the Department of Health, via the Y&H Strategic Health Authority. It has been suggested by the Y&HSHA that public consultation of the newly published Four Year Plan is undertaken, but given that full consultation was carried out in 2010 when our Five year Strategic Plan was published, and that this supplementary narrative largely contains our vision and strategic objectives from that Plan, further consultation is felt unnecessary at this stage.

7 Assessment and Actions needed Prompt: Your EIA should promote the General Equality Duty; Eliminating Discrimination, Promote Equality of Opportunity, Promote Good Relations & Demonstrating Equity

Location of Organisational Barriers Geographical location

Assumption of normality / description of barrier

Action needed

Situation normal

None

Built environment

Situation normal

None

Information and communication

For information purposes None only

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Responsibility

Deadline


Location of Organisational Barriers Timing

Assumption of normality / description of barrier

Action needed

Involvement in Planning

Subject to Board discussion and approval

Sign off by Board

Costs of the service

Situation normal

None

Customer Care and Situation normal Staff training

None

Stereotypes and Assumptions

Situation normal

None

Involvement in Planning

Situation normal

None

Specific Issues/ Barriers

None identified

None

Responsibility

Deadline

Chair

30/3/11

Within planned timetable None of regular Board meetings

8 Methods of Monitoring progress on Actions The Board are asked to sign off the Four Year Operating / Strategic Plan. This will be minuted.

9 Publishing the Equality Impact Assessment

As part of the Board Paper.

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10 Signing off Equality Impact Assessment:

Samantha Jane Merridale Service Manager, Head of Service or your Corporate Equality Team

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