Primary Care & Mental Health Transformation Programme (PCMHTP) Programme Initiation Document

Transcription

1 Primary Care & Mental Health Transformation Programme (PCMHTP) Programme Initiation Document Version: 0.7 July 2017

2 Contents s 1. INTRODUCTION National Context National Strategies Lanarkshire Position Adopting a Programme Approach to Transforming Primary Care 7 2. PROGRAMME DESIGN Programme Aim & Objectives Programme Approach Programme Scope Programme Deliverables Programme Exclusions Programme Constraints Programme Interfaces/Interdependencies Programme Assumptions PROGRAMME ORGANISATION Overall Governance Programme Board Programme Steering Group Programme Team Programme Workstream Quality Improvement PROGRAMME PLAN FINANCIAL FRAMEWORK RISK AND ISSUE MANAGEMENT COMMUNICATION & ENGAGEMENT STRATEGY PROJECT EVALUATION 17 2

3 APPENDICES PAGES Appendix 1 Programme Board Draft Terms of Reference 19 Appendix 2 Programme Steering Group Terms of Reference 22 Appendix 3 Programme Plan 24 Appendix 4 Programme Financial Framework 25 Appendix 5 Finance Flow Chart 26 Appendix 6 Programme Risk Register/Log 27 Appendix 7 Programme Communication and Engagement Plan 28 Appendix 8 Achievement Framework Example 29 Please note due to size and/or design of some of the above documents they have been included as links that should be opened and printed separately. 3

4 Version Control and Document Management The issue of this document requires the approval of the signatories below on behalf of the Programme Board. Name Title Programme Role Signature Date Val de Souza Dr Chris Mackintosh Kate Bell Marjorie McGinty Director of Health and Social Care, South H&SCP Medical Director, South H&SCP Head of Service Change and Transformation Senior Improvement Manager Executive Sponsor Chair, Programme Board Programme Director Improvement Lead & programme Management Version No. 0.1 Date Distribution /11/12 Programme Director, Chair and Senior Improvement Manager 0.3 Programme Director and Senior Improvement Manager /01/17 Programme Director and Senior Improvement Manager /01/17 Programme Director and Senior Improvement Manager /02/17 Programme Board /07/17 Programme Director 4

5 1. Introduction This first section of the Project Initiation Document (PID) provides information relating to the national and local background and context to the Primary Care & Mental Health Transformation Programme. 1.1 National Context It is widely recognised that the NHS is facing an unprecedented challenge in the need to improve the quality of services provided, and outcomes and experiences for patients and the public. In context this is at a time whilst managing the most severe and protracted period of resource constraint in workforce availability and increases in demand within limited resources in its history. Leaders of health and social care delivery systems are under pressure to achieve better outcomes. In response to these challenges the Scottish Government, in August 2015, announced plans for primary care developments, and new funding through the primary care transformation fund and other primary care investments which would represent the first steps in transforming our approach to primary care services while supporting the primary care workforce, including GPs, and improving patient access to primary care services. In addition the National Health & Social Care Plan (2016) also describes how reforming primary and community care is required to meet future demands. Community and hospital-based care needs to be integrated and rebalanced to ensure that local health services are more responsive and supportive to the needs of individuals; not least those with chronic conditions who would be better supported in primary and community care. That requires reforming the latter to deliver a stronger, better resourced and more flexible service for people. We are also working to address the current workload pressures and recruitment challenges facing many GP practices and cannot simply result in a crude redistribution of pressures between different parts of the health service. To do this, we must: support individuals, families and carers to understand fully and manage their health and wellbeing, with a sharper focus on prevention, rehabilitation and independence; expand the multi-disciplinary community care team with extended roles for a range of professionals and a clearer leadership role for GPs; develop and roll out new models of care that are person and relationship centred and not focused on conditions alone; enable those waiting for routine check-up or test results to be seen closer to home by a team of community health care professionals, in line with the work of the Modern Outpatient Programme 6 in hospitals (as detailed later); ensure the problems of multiple longer-term conditions are addressed by social rather than medical responses, where that support is more appropriate; and Reduce the risk of admission to hospital through evidence-based interventions, particularly for older people and those with longer-term conditions. 5

6 We will achieve this by building up capacity in primary and community care and supporting development of new models of care. The future of our health and social care services in Scotland is based on supporting people to live at home or in a homely setting. To support people in this way we need to transform our approach to primary care, supporting GPs and developing systems for multidisciplinary teams to work together and allowing the freedom to deliver high quality, safe and effective patient care. 1.2 National Strategies The objectives of the primary care transformational work within Lanarkshire will also support the implementation of various national and local strategies including: The National Clinical Strategy for Scotland (Scottish Government) Transforming Nursing Roles - Developing Advanced Practice in NHS Scotland (Scottish Government) Setting the strategy for Quality in Scotland s General Practices (RCGP) Developing a Quality Framework for Scottish General Practice, (Healthcare Improvement Scotland and RCGP Scotland) Quality Improvement for General Practice (RCGP) The Future of General Practice in Scotland: a Vision (RCGP). Driving Improvement in Healthcare: Our strategy (Healthcare Improvement Scotland). The National Delivery Plan for Allied Health Professionals in Scotland (Scottish Government) The Public Bodies (Joint Working) (Scotland) Act 2014 Integration of Health and Social Care (Scottish Government) Mental Health in Scotland a 10 year vision (Scottish Government) Lanarkshire Healthcare Strategy: Achieving Excellence,( NHS Lanarkshire 2016) Transforming Patient Safety and Quality of Care in NHS Lanarkshire Strategy (NHS Lanarkshire) In addition the Programme will also support the delivery of the 3 national quality ambitions, 6 national quality outcomes and 9 national outcomes for health and social care integration. Further details on this can be found in section 8 Programme Evaluation Plan. 1.3 Lanarkshire Position Within Lanarkshire there are numerous reasons why we cannot just continue to provide the same services in the same way, not least because of the need to close the gap between those with the best opportunity for good health and those with the greatest health inequalities. The growing complexity of primary care means that it is more important than ever to move from a sector-focussed perspective on health service reform to a whole system one. It is here that the biggest opportunities for transformation and improvement exist. Over the past 20 years there has been a growing awareness of the need to improve quality across health care and general practice, driven by a need to reduce inequalities in health care and the need to effectively translate evidence into practice and by the changing expectations of patients and carers. 6

7 Lanarkshire s Healthcare Strategy and the Health & Social Care Partnerships Strategic Commissioning Plans all clearly state that the status quo is no longer fit for purpose and more of the same will not have the capacity or the capability in the right place to meet future need and demand, Health & Social Care Partnerships have been asked to come together in a way they haven t before, integrating with a real sense of commitment and purpose, to create Strategic Plans to transform the health and care system. Everyone is clear that this is a real opportunity to do things differently, building a stable, sustainable, highquality, efficient health and care system that will deliver for the people of Lanarkshire. Lanarkshire is experiencing major and complex challenges to the delivery of services in the future. Stronger General Practice services in primary care are essential to managing the future demand. Within primary care there are both significant challenges and opportunities ahead: Challenges An immediate crisis of workload, morale and workforce pressures The challenge and requirements for efficiency savings A growing and ageing population with more complex health needs Growing expectation and strategic direction that sees more care transfer from secondary care settings to community care Managing patient & public expectations Opportunities Greater use of new technologies A recognition in General Practice that things need to change An imminent new GMS contract (2017) some of which will be trailed in 2016/17 Implementation of Pulling Together (2015) the Lewis Ritchie Report Changing patterns of care An increasing range of treatments available/new medical technologies Health and Social Care Integration Patients increasingly want a say in identifying their own care goals and, in turn, managing their own care Maximising use of NHS 24 Urgent Care access 24/7 (Source: Lanarkshire Healthcare Strategy: Achieving Excellence, NHS Lanarkshire 2016, Strategic Commissioning Plan, South Lanarkshire H& SCP, 2016, Strategic Commissioning Plan, North Lanarkshire H&SCP 2016) 1.4 Adopting a Programme Approach to Transforming Primary Care Over the last 18 months there have been various areas of national work aiming to support changes in general practice in view of workforce challenges, workload pressures and changing demographics. In Nov 2015, NHS Lanarkshire successfully proposed adopting a programme approach to supporting the primary care transformation required in general practice and community and across localities. This is known as the Primary Care & Mental Health Transformation Programme (PCMHTP) which is a Lanarkshire wide improvement programme. To avoid duplication of effort and achieve an integrated approach the programme will provide a structured, disciplined approach to the various investments. The Programme Board will manage and co-ordinate various primary care funded projects into one Programme of work over the next two years to 7

8 support the primary care workforce, including GPs, and improve patient access to these services. An Improvement Support Team is being established to lead and support improvements working with and alongside a range of key informants, subject matter experts and patient, carer and public representatives. A mixed quality improvement methodology will be taken to ensure a data and intelligence driven approach and ensure the right approaches, capacity and capability is released to develop, test, embed and sustain transformation. This approach and the consolidated infrastructure will optimize all aspects of the primary care transformation funding and other primary care investments from Scottish Government. The programme over the next two years will inform the design of primary care in the future. The Primary Care & Mental Health Transformation Programme (PC&MHTP) is a temporary infrastructure developed for the sole purpose of developing and delivering a programme of work within the cost, time and quality constraints in response to the growing challenges. It is not a business as usual function and will represent the view that an evidence based approach to improvement and change be followed. The Programme will support a review on how services are provided and how they could be developed to make them more effective and efficient within available resources. This Programme Initiation Document (PID) will set out the key elements of our approach and contain any validated data/information required to direct and manage a programme. The PID has two principle purposes: to ensure that the Senior Improvement Manager has a sound basis on which to ask the Programme Board to make a commitment to the project; and to act as a base document against which the Improvement Support Manager and Programme Board can assess progress, change management issues and ongoing viability questions. 8

9 2. Programme Design This second section of the PID provides information relating to the design of the Programme. 2.1 Programme Aims & Objectives The overall aim of the programme over the next two years is to test out different ways of transforming Primary Care and Mental Health to improve access to and quality of service of general practice for the people of Lanarkshire and to support the development and implementation of the 2020 GP contract. In order to achieve this aim the following objectives have been identified for the overall programme: 1. By March 2017 carry out in-depth work to establish the root cause of current service challenges and test out new ways of working to transform general practice and associated community services. 2. By July 2017 redesign primary care services to meet future needs with a particular focus on ensuring general practice is sustainable for the future demand. 3. By October 2017, complete a review of current service and begin to support GPs and multi-disciplinary teams to redesign services, pathways and processes based on the evaluation of tests of change to establish new ways of working that will shift the balance of care, ensuring people s conditions can be managed and treated in a community setting where clinically safe to do so with access to hospital based services when required. 4. By March 2018 establish plans to embed, spread and sustain new ways of working which evaluate positively. The Programme will follow the principles of: Putting patients and staff at the forefront of redesigning services Increasing the range of ways people can access their General Practice Providing access to the right person first time Reduce, delays by improving all inefficient work practices Improve the quality of care Re-vitalise the workforce Community services for urgent care will become the norm Hospital based services will only be accessed for planned treatments of acute presentations and emergencies, complex cases and some exacerbations of long term conditions where hospital treatment is necessary. 2.2 Programme Approach The evidence is clear that the most effective and successful programmes of this type of transformative work recognise the importance of a mixed improvement methodologies to deliver incremental and transformational change that results in sustainable improvements. We are entering a time for new ideas, re-thinking of old models, and the enthusiasm of new leadership to tackle old problems with fresh ideas and energy. We trust that the approach and resource described in this PID will inform the scope and scale of change needed at a system wide and local level. This will be achieved whilst we work toward transforming and integrating organisations and services for the future. 9

10 The programme will utilise standard project management approaches to plan, develop, implement, monitor and evaluate the overall programme and to identify the plans for sustainability of actions which demonstrate success. NHS Lanarkshire is committed to delivering world leading, high quality, innovative health and social care that is person-centred. Our ambition is to be a quality-driven organisation that cares about people (patients, their relatives and carers, and our staff) and is focused on achieving a healthier life for all. Through our commitment to a culture of quality we aim to deliver the highest quality health and care services for the people of Lanarkshire. The Lanarkshire Quality Approach is depicted in the following diagram: 2.3 Programme Scope Primary health care is all those health services provided outside hospital which include independent practitioners such as general practitioners, dental practitioners, community pharmacists and opticians. Crucially, it also involves other community health services, which include district nurses, health visitors and other allied health professionals such as physiotherapy, occupational therapy, podiatry, dietetics and speech and language therapy. Similarly, there are also community doctors, dentists, nurses, and midwives providing a level of care which is often similar to that more traditionally available in a hospital setting. The proposed transformation of General Practice and aspects of Primary Care is clearly not for the faint-hearted, and in the current transitional period, it is likely to be far more consuming than any strategic challenge that has come before. The programme scope will cover the areas identified as workstreams only. However interfaces and interdependencies will require joint working and overlap with other programmes of work within the organisation. 10

11 2.4 Programme Deliverables The programme will deliver a range of tests of change and new models of working to support the achievement of the programme aims and objectives. These will include: ANPs working in GP Practices as part of the general practice team in a new model for general practice. Advanced Physiotherapists providing assessment and management of some musculoskeletal conditions in GP Practices instead of GPs. Mental Health and Paediatric trained staff working in Out of Hours Hub to see patients instead of GPs for certain conditions. ANPs working in Out of Hours Hub to see patients instead of GPs for certain conditions and also to undertake home visits instead of GPs. Improved use of IT such as to support efficient working within general practice. Surgery Pods in GP Practices to release GPs time for more complex patients. Provide an integrated approach that will encourage and support people with long-term conditions to play an active part in managing their health and determining their own care and support needs by engaging in a collaborative care planning process through use of House of Care framework. Pharmacists working in GP Practices as part of the general practice team in a new model for general practice. Develop the contribution community pharmacists can make to support the very large number of patients with mental health illness who use community pharmacies including the Clozapine dispensing services within NHS Lanarkshire. Review the impact of the link worker programme currently operational in North Lanarkshire and explore the possibility of using this model across Lanarkshire Review the use of self-management and social prescribing programmes by GP referred patients to address the wider individual, social and economic determents of mental health and well-being. Improve primary care mental health input by creating two lead Primary Mental Health Care GPs to provide GP influence and leadership in Primary Care Mental Health. Each of the eight programme workstreams will develop detailed action plans which will describe the actions they will undertake to support delivery of the programme aims. Each of the workstream Action Plans can be viewed on the Primary Care & Mental Health Transformation Programme webpage on NHS Lanarkshire s website at The programme will deliver a cross cutting agenda to enable economies of scale in relation to the limited capacity which is a daily feature for the operating divisions and Health & Social Care Partnerships (H&SCP) in this time of transition to new and emergent infastructure. 11

12 2.5 Exclusions This Programme aims to develop, implement and evaluate tests of change to improve access to and quality of general practice in Lanarkshire. While it will inform and support the current challenges within GP Practices and GP sustainability issues this programme is not directly or solely responsible for resolution of these challenges. This Programme does not have responsibility for day to day business as usual operations within primary care. 2.6 Constraints The following constraints for the Programme are noted: The programme is time limited and funding is restricted to two years with funding only being released in July The funding period is due to end in March The limited capacity from the operating division of health & social care partnerships to undertake project work on top of daily work presents issues for scoping out areas of work with operational staff and planning well to respond to the challenges that exist. The recruitment process in Lanarkshire with a default process to redeployment has built in delays to appointing the Improvement Support Team. These issues represent both a constraint and a risk to success. 2.7 Interfaces/Interdependencies The Programme is integral to both the Healthcare Strategy for NHS Lanarkshire and the respective Strategic Commissioning Plans for both North and South Health and Social Care Partnerships. This Programme is therefore supported through the NHS Board and both Integrated Joint Boards (IJBs) to take forward this work whilst feeding into the respective performance arrangements for each of the constituent bodies. Excellence-March-2017.pdf missioning%20plans/slhscp-commission-plan pdf missioning%20plans/hscnl-strategic-plan.pdf 2.8 Assumptions The critical assumptions for the Programme are: The current source of funding committed from Scottish Government until March 2018 will be replaced with other sources of investment to maintain and sustain improvement and transformational plans. 12

13 3. Programme Organisation This third section of the PID describes the organisational arrangements for the Programme. 3.1 Overall Governance The overall governance structure for the programme is described in the diagrams below: IJB North H&SCP NHSL Board IJB South H&SCP Primary Care Strategy Board Scottish Government PCMHTP Board Val De Souza, Director of Health & Social Care, South Lanarkshire H&SCP is the Executive Sponsor for the Programme on behalf of Lanarkshire and is the link between the Programme Board, Primary Care Strategy Board, NHSL Board and both IJBs. 3.2 Programme Board The Programme Board (PB) is accountable to the Scottish Government for the success of the programme and reports directly to the Primary Care Strategy Board and through them to the IJBs and NHS Lanarkshire Health Board. The PB has the authority to direct the Programme within the remit agreed in the programme brief set out in January 2016 and in the Programme Board Terms of Reference. (Appendix 1) The Programme Board will sign off the PID to delegate the day-to-day authority to the Senior Improvement Manager for the Improvement Support Team, on behalf of the Programme Board to be responsible for the day to day decision making, ongoing planning and communications between the project management teams and stakeholders external to that team. The Programme Board, chaired by Dr Chris Mackintosh, was established in July 2016 and met monthly in 2016 during the Programme set up stage and will meet quarterly in 2017 as the Programme moves into implementation and evaluation stage. The Programme Board is represented by key stakeholders from across Lanarkshire and includes representatives from General Practice, Nursing, AHPs, 13

14 Pharmacy, Mental Health, Primary Care, Finance, Planning and Development, Organisational Development, ehealth/im&t, NHS24, Third sector organisation, patient and public reps and Lanarkshire Medical Committee. PCMHTP Board Programme Steering Group WS 1 WS 2 WS 3 WS 4 WS 5 WS 6 WS 7 WS Programme Steering Group A small Programme Steering Group chaired by Craig Cunningham has been established and its first meeting was held on 8 th Dec This group will meet monthly to monitor progress of the workstream action plans. The PSG will have delegated authority from the Exec Sponsor. Terms of Reference for the Programme Steering Group are included as (Appendix 2) 3.4 Programme Team The programme team consists of the following: Programme Executive Sponsor Val De Souza Programme Director Kate Bell Programme Board Chair Dr Chris Mackintosh Programme Clinical Lead Dr Iain Hathorn Senior Improvement Manager Marjorie McGinty Evaluation Lead Dr Helen Alexander Improvement Support Team staff Programme Workstream Leads 3.5 Programme Workstreams The Programme is made up of 8 workstreams with a 9 th virtual workstream. The workstreams and their chairs are noted below: WS 1 - General Practice & Community Redesign (Dr Chris Mackintosh) WS 2 Urgent Care 24/7 (Tom Bryce) WS 3 - House of Care (Dr Sue Arnott) WS 4 - Leadership Programme (Dr Iain Hathorn) WS 5 - Recruitment & Retention (Alistair MacKintosh) WS 6 - Digital Programme (Donald Wilson) WS 7 Pharmacy Independent Prescribers (Christine Gilmour) WS 8 - Mental Health (Dr Linda Findlay) NHS24 Virtual Workstream (Lynne Huckerby) 14

15 Each of these workstreams is developing detailed Action Plans which include all of the actions to be delivered, the lead officers responsible, timescales and financial requirements. These action plans are available on the Primary Care & Mental Health Transformation Programme page of the NHS Lanarkshire website Quality Improvement This large scale transformation programme will use recognised Quality Improvement and change management methodologies to design, test, embed, spread and sustain the changes required to achieve the programme aims. A dedicated Improvement Support Team will provide the expertise and support to clinical and managerial teams to make the shift from the current to the future model of primary care and mental health required to provide a sustainable general practice fit for the future. 4. Programme Plan A Programme Plan has been developed which describes the detail of the overall programme (Appendix 3). This plan will be updated and monitored by the Senior Improvement Manager and be available to the Programme Board and Steering Group as required. Any unplanned deviations from the plan will be reported to the Programme Board by way of an Exception Report. 5. Financial Framework In 2015 Scottish Government, from a variety of their internal departments requested proposals are submitted from NHS Boards for funding to support improvements and transformational change within primary care. Within NHS Lanarkshire these proposals were developed and submitted as requested. Following notification of approval of these proposals NHS Lanarkshire sought agreement from Scottish Government that it would adopt a programme approach to these various streams of funding. Financial arrangements have been put in place under the direction and guidance of Fiona Porter, Assistant Head of Finance, Primary Care, NHS Lanarkshire, to ensure effective and efficient management of these funds. The financial framework for the overall Programme is summarised below and in (Appendix 4). The table includes the original amount of funding requested in each proposal submitted to Scottish Government, the actual value of the funding allocated to NHS Lanarkshire for each proposal and the allocation received as at Jan

16 Workstream Allocation Received To Date WS 6 Digital Services Fund 162,539 WS 3 Hoc Alliance 60,000 WS 8 Mental Health Investment 434,855 WS 1 General Practice & Community Redesign *998,668 WS 7 Pharmacy Investment 628,470 WS 5 Recruitment Retention Fund 100,000 WS 2 Urgent Care 150,000 WS 4 Leadership Programme (NES Funded) 0 Programme Budget 2,534,532 *The Improvement Support Team (including evaluation) costs of approx. 255,000 and an allocation to the House of Care workstream of 123,000 have been funded from the PC Transformation Fund total of 998,668. The remaining funding of 620,668 is the funding assigned to deliver the action Plan of the General Practice & Community Redesign. Each workstream lead has been advised of their allocated budget for 2016/17 and their respective cost codes to charge expenditure to. The finance team led by Fiona Porter will provide the Steering Group and Programme Board with detailed financial reports on the expenditure of each workstream to ensure that spend is management in line with agreed financial arrangements. Should any of the workstreams wish to amend the use of their allocated funding a process has been established to ensure robust financial arrangements are in place to manage the overall Programme budget. A flow chart describing this process is included as appendix Risk and Issue Management A risk is defined as any uncertain event that affects the outcomes of a project, programme or organisation. In any improvement programme it is important to identify and manage any known or anticipated risks and a Risk Register and Risk Log can be used to do this. The purpose of the Risk Register is to ensure risks are recorded in a standard format, including all mitigating actions and to provide a basis for analysis of the operational, project, programme or strategic risk(s). As part of the assessment of identified risks the 5 x 5 matrix used by NHS Lanarkshire will be used. This method is based on the AUS/NZ Standard, and adapted for use by NHS Lanarkshire for assessment of risk levels. The Programme Risk Register/Risk Log is included as (Appendix 6). 16

17 7. Communication and Engagement Strategy Key to the Programme s success is people knowing about and understanding what we are trying to achieve and why. Communication is imperative to achieving these aims. Emphasis will be placed on external communications, conveying information and messages to the wider public, primarily via the media. Also, information and key messages have to be conveyed to all internal stakeholders including staff/members of all the partner organisations and other key stakeholders, including MPs, MSPs and Councillors, via internal communications channels, like newsletters, e-bulletins and leaflets. It is crucial that staff and others throughout Lanarkshire fully understand, engage with and are committed to all elements of the Programme so they can proactively contribute to improving individual outcomes for people. This includes supporting, informing and advising their own service users/patients of the Programme and what it means for them. In order to ensure efficient, effective and coordinated communications regarding the Programme a Programme Communication & Engagement Strategy and a Communications Action Plan has been developed (appendix 7). 8. Programme Evaluation The Programme will use a contribution analysis approach to evaluation. Contribution Analysis (CA) is a method that can incorporate both project complexity and changes over time (Mayne, 2012). It begins by making explicit the link between project activity and desired outcomes then gathers evidence of various different contributions to those outcomes. It was successfully applied to Lanarkshire s Reshaping Care for Older People programme (Alexander & Allison, 2015). The Programme will use Contribution Analysis (CA) to evaluate all of the initiatives within the workstream action plans, which will enable very disparate work to be judged together. Key stakeholders agree what they wish to achieve and the evaluation demonstrates achievement of these outcomes. Each of the workstream groups will develop an Achievement Framework (example for House of Care at Appendix 8) which will describe the inputs, outputs and outcomes expected of its action plan over the short, medium and long term. Based on the outcomes contained within each Achievement Framework a set of metrics and measures will be agreed with the evaluation team to demonstrate the impact of the activities implemented. Data gathering will mainly be carried out by the staff involved, although evaluation support is available if required. The evaluation team will rate the quality of the evidence submitted and write a contribution story using robust evidence of outcome achievement. An initial story will present the early evidence, which will then be refined to strengthen the contributions as the workstreams evolve. 17

18 The Programme evaluation will describe how each of the workstream Action Plans supports delivery of the 3 national NHS Scotland quality ambitions of safe, effective and person-centred care and the 6 national quality outcomes noted below: Everyone has the best start in life and is able to live longer healthier lives; (Effective) People are able to live well at home or in the community; (Person Centred) Everyone has a positive experience of healthcare; (Person Centred) Staff feel supported and engaged; (Effective) Healthcare is safe for every person, every time; (Safe) Best use is made of available resources. (Effective) The Programme evaluation will also show clear impact on the achievement of the 9 national outcomes for health and social care integration: 1. People are able to look after and improve their own health and wellbeing and live in good health for longer 2. People, including those with disabilities or long term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community 3. People who use health and social care services have positive experiences of those services, and have their dignity respected 4. Health and social care services are centred on helping to maintain or improve the quality of life of people who use those services 5 Health and social care services contribute to reducing health inequalities 6. People who provide unpaid care are supported to look after their own health and wellbeing, including to reduce any negative impact of their caring role on their own health and wellbeing 7. People who use health and social care services are safe from harm. 8. People who work in health and social care services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide. 9. Resources are used effectively and efficiently in the provision of health and social care services. 18

19 Appendix 1 Programme Board Terms of Reference Primary Care & Mental Health (PC&MH) Transformation Programme Board TERMS OF REFERENCE 1. NAME OF GROUP The name of the group shall be the Primary Care & Mental Health (PC&MH) Transformation Programme Board. 2. CHAIR Dr Chris Mackintosh shall act as Chair with the authority to nominate a deputy in his absence. 3. REPORTING The Chair will be responsible for the production of meeting action notes and the production of any reports to be submitted to the Transformation Programme Board. 4. FUNCTION / REMIT OF THE PROGRAMEM BOARD The Programme Board has the following duties: To be accountable for the success or failure of the programme. To provide unified direction to the projects within the scope of the programme Manager. To provide the resources and authorize the funds for the programme. To provide visible and sustained support for the Project Management approach. To ensure effective communication within the programme team and with external stakeholders. Appointing a programme manager (and programme director if applicable) - if these roles are combined, agreeing remit and delegated authority Approving programme identification and definition, signing off relevant documentation, for example programme brief or programme definition Agreeing/approving all major plans Confirming and communicating the programme vision Communicating information about the programme or projects to organisations and stakeholder groups Ensuring the required resources are available Resolving any conflicts escalated by the programme or project teams, client, supplier or delivery agent Providing overall strategic direction for the programme Managing and mitigating risks associated with the programme including those escalated from project level Quality assurance for the programme and its associated projects Resolving deviations from plans or escalating as necessary 19

20 5. MEMBERSHIP Membership shall comprise of: Name Remit Role Val de Souza Director of SL HSC Executive Lead for PC&MH Programme Chris Mackintosh Medical Director SL HSC Chairperson and Medical Director HSCP (South) Alastair Cook Medical Director NL HSC Senior Responsible Officer HSC North Craig Head of Performance and Senior Responsible Officer HSC Cunningham Commissioning SL HSC South Maria Docherty Nurse Director SL HSC Nursing Lead for programme Lynn Duff GP Lanarkshire Medical Committee Alistair Mackintosh Primary Care Manager Recruitment & Retention Project Lead Dr Sue Arnott GP Clinical Lead House of Care Lynne Huckerby NHS 24 NHS24 Representative Yvonne Cannon Organisational Development Leadership in Integration project Manager SLHSCP Louise McKeever Analyst, Scottish Government SG Mental health Programme (as req.) Kate Bell Head of Service Change and Programme Director Transformation Marjorie McGinty Senior Improvement Manager Programme Manager, PCTF (PC&MH Programme) Peter McCrossan Director of Allied Health Professions Professional Advisor Tom Bryce General Manager South West Unit Urgent Care Out of Hours project lead Gary Tanner Director Psychological Services Judith Milligan Strategy & Service Delivery Manager (Deputising for D Wilson) Digital Project Lead Ross McGuffie Head of Performance and Links to Strategic Commissioning Commissioning NL HSCP Plans Fiona Porter Deputy Director of Finance Primary Care Finance Lead for Programme Jennifer Wilson Improvement Advisor Scottish Government Liaison Person Christine Gilmour Chief Pharmacist Pharmacist in Practice project lead Iain Hathorn Lead Clinician South West Unit Clinical Lead for PC&MH Transformation Lesley Ann Smith Associate Director of Quality Quality Improvement and Assurance and Improvement Assurance Lead Linda Findlay Associate Medical Director SL Mental Health Project lead HSCP Donald Wilson IM&T Manager Digital Project lead Calvin Brown Communications Manager, NHSL Communications Lead 6. LINKS TO PRIMARY CARE & MENTAL HEALTH TRANSFORMATION PROGRAMME 7. QUORUM A quorum shall consist of 50% of the members of the Programme Board, excluding the Chair. 20

21 8. MEETINGS OF THE STEERING GROUP Meetings will take place monthly and will last approximately 90 minutes. The meeting will cover business and development agenda with themes for the development session planned in advance. The venue will be rotated. 9. AGENDA Agenda items shall be given to Marjorie McGinty one week in advance of the meeting. 10. MINUTES Detailed minutes will be produced of the meeting with action points and timescales will be circulated at a reasonable time following the meeting (within one week). 11. CHANGES TO THE TERMS OF REFERENCE (TOR) Changes to the TOR and functions of the Board may be proposed at any meeting of the group with due notice of the proposed change having been given on the Agenda of the meeting. Any such change shall only become operative after approval of the Chair of the Programme Board and the executive Sponsor on behalf of the organisation. 21

22 Appendix 2 Programme Steering Group Terms of Reference Primary Care & Mental Health (PC&MH) Transformation Programme Steering Group TERMS OF REFERENCE 1. NAME OF GROUP The name of the group shall be the Primary Care & Mental Health (PC&MH) Transformation Programme Steering Group. 2. CHAIR Craig Cunningham shall act as Chair with the authority to nominate a deputy in his absence. 3. REPORTING The Chair will be responsible for the production of meeting action notes and the production of any reports to be submitted to the Transformation Programme Board. 4. FUNCTION / REMIT OF THE STEERING GROUP The role of the Group is to Have authority to validate decisions on behalf of the Programme Board Coordinate the development and implementation of the programme plan Progress actions to enable the overall programme to move forward within timescale Monitor current workstream action plan activities against programme aims. Encourage and strengthen links between the programme and other relevant strategic work Monitor financial arrangements of the Programme 5. MEMBERSHIP Membership shall comprise of: Membership Craig Cunningham, Head of Commissioning and Performance, South H&SC Partnership Dr Chris Mackintosh, Medical Director, South H&SC Partnership Fiona Porter, Assistant Director of Finance, Primary Care Kate Bell, Programme Director Maria Docherty, Director of Nursing, South H&SC Partnership Linda Findlay, Associate Medical Director, South H&SC Partnership Marjorie McGinty, Senior Improvement Manager North HSCP Operational Management Representative to be nominated by Owen Watters Role Chair of the Steering Group & South HSCP Lead Clinical Lead for the programme Programme Finance Overview and Direction of Improvement approach and resource Nursing Lead for the programme Mental Health lead for the programme. To provide mental advice in respect of mental health issues Management and Leadership of the Improvement support Team North HSC Lead 22

23 The Steering Group shall have the right to invite representatives from other Departments and expertise to any of its meetings when deemed appropriate. 6. LINKS TO PRIMARY CARE & MENTAL HEALTH TRANSFORMATION PROGRAMME The group will ultimately report to the Primary Care & Mental Health Transformation Programme Board. 7. QUORUM A quorum shall consist of 50% of the members of the Steering Group, excluding the Chair. 8. MEETINGS OF THE STEERING GROUP Meetings will take place monthly and will last approximately 90 minutes. The venue will be rotated. 9. AGENDA Agenda items shall be given to Marjorie McGinty one week in advance of the meeting. 10. MINUTES Detailed minutes will not be produced; rather a note of the meeting with action points and timescales will be circulated within one week on the meeting. 11. CHANGES TO THE TERMS OF REFERENCE (TOR) Changes to the TOR and functions of the group may be proposed at any meeting of the group with due notice of the proposed change having been given on the Agenda of the meeting. Any such change shall only become operative after approval of the Chair of the Steering Group. 23

24 Appendix 3 Draft Programme Plan as at January

25 Appendix 4 Programme Financial Framework The following table summarises the original amount of funding requested in each proposal submitted to Scottish Government, the actual value of the funding allocated to NHS Lanarkshire for each proposal and the allocation received as at Jan Propsal/Workstream Original NHSL Bid Value SG Notified Bid Value Allocation Received To Date Comments Digital Services Fund 629, , ,539 Hoc Alliance 60,000 60,000 60,000 Non SG funded. Mental Health Investment 434, ,855 Pc Transformation Fund 998, ,668 Pharmacy Investment 798, , ,470 Recruitment + Retention Fund 124, , ,000 Urgent Care 860, ,000 No figure in original bid. 1,612,262 3,946,254 2,534,532 25

26 Appendix 5 Finance Flow Chart Mechanism for amendments to workstream funding Proposal Prepared by Author Considered at Workstream Not approved Author Advised approved Considered at Steering Group Not approved Workstream Advised approved Approval requested from Programme Board Not approved Steering Group Advised approved Workstream Lead and Finance Lead advised of changes to workstream funding plan Workstream Lead Advised 26

27 Appendix 6 Risk Register/ Risk Log 27

28 Appendix 7 Communication and Engagement Plan 28

29 Appendix 8 Achievement Framework House of Care Workstream