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

Organisational Development Plan

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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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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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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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Status Timescale


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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Status Timescale


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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Status Timescale


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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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


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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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

https://www.appointments.org.uk/resources/res.aspx?p=/Publication/fileFilename/49/The%20Healthy%20NHS%20Board.pdf

https://www.appointments.org.uk/resources/res.aspx?p=/Publication/fileFilename/49/The%20Healthy%20NHS%20Board.pdf


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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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Status Timescale


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


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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Status Timescale


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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Status Timescale


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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Status Timescale


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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Status Timescale


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


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


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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Status Timescale


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.

ORGANISATIONAL DEVELOPMENT PLAN

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