Clinical Board PID Version 1November meeting agenda item 2

Transcription

1 CENTRAL MANCHESTER CLINICAL BOARD AGENDA NO: 2 DATE OF MEETING: 10 th November Report of: Signed Off By: Sara Radcliffe Programme Lead Mike Eeckelaers - Chair of the Clinical Board Date of Paper: 3 rd November Subject: Project Initiation Document for the Clinical Board Purpose of Paper: To describe the PID which will: Specify the strategic direction Six month programme of change Governance arrangements Communication In case of query, please contact: Action required: Link to: Other Design and Delivery Teams etc If acronyms or abbreviations appear in the attached paper, please list them in the adjacent box. Sara Radcliffe sara.radcliffe@cmft.nhs.uk Discussion/Decision/Information To agree the PID Six design and delivery team areas plus the winter transformational management team PID Project Initiation Document MCH Manchester Community Health MCC Manchester City Council CMFT - Central Manchester Foundation Trust - Practice Based Commissioning SoSF Securing Our Shared Futures 1

2 CENTRAL MANCHESTER CLINICAL BOARD TRANSFORMING SERVICES CHANGE PROGRAMME PROJECT INITIATION DOCUMENT 1 Executive Summary To provide a PID for the Clinical Board which outlines a change programme which will run for six months, from October 2010 until April 2011, and prioritising six design and delivery areas plus the winter transformational management team. 2 Introduction 2.1 The health and social system in Central Manchester is in a process of immense change. TCS is an enormous opportunity to combine the redesign of services and the integration of community services in CMFT. The forming of GP consortia to commission services in the future, and the changing role of the council services as it responds to the Comprehensive Spending Review creates a challenging landscape. 2.2 It is clear that in the midst of all this change we need to focus on designing and delivering services that will be improved for patients and carers across our system. We believe that services can be transformed, integrated and managed in ways that: Drive up quality and contribute significantly to the productivity challenge; Enable an increased shift of care of provision into community settings; Enable accelerated integration between community, hospital and other NHS services, and between NHS and social care services. 2.3 The PID sets out the 6 month programme of change that will be led by the Central Manchester Clinical Board, to address transformational change across the Central Manchester health and social system. 3 Strategic Direction 3.1 This change is not only about clinical services, it is about the health and social system that all sectors work within. Therefore, there are key players within the system that have to be involved in any transformation of services these being MCH staff, primary care particularly Central Manchester working with NHS Manchester, MCC and secondary care staff that will link to, and work with, community staff in developing future teams in CMFT. All these organisations have a place on the Central Manchester Clinical Board. (Membership in appendix 1) 3.2 There is a need for the services to look at whole system thinking together, to understand the joint vision and direction of an integrated system and the pressures and constraints on each part of the system. This needs to be done across primary, community, social and secondary care and not only with key players but also with wider teams to enable the buy in for the future. 3.3 SoSF has set an ambitious goal of developing plans to achieve 200m of efficiency gains by The Clinical Board will be working within the context of sustained economic constraints and the financial challenge to ensure that what we do is using resources effectively and efficiently. There will be many additional demands on our 2

3 resources over the next few years which we will need to meet from within the resources we have now, in real terms. Making sure that all of what we do across our health system is effective and makes a tangible positive impact for our patients is also a transforming part of the system we work within. 3.4 The Central Manchester Clinical Board wants to work across the health and social care system, working across boundaries, sharing the care management of a patient so that it limits gaps, waits and duplication. We want to focus on personalised care, building teams around people and their needs rather than organisations and structures. In doing so we aim to share skills and expertise in a creative and coordinated way which enables innovation, develops joint working and achieves quality patient outcomes. 3.5 The integration of community services with CMFT is an opportunity for innovation and development, which will take teams and individuals beyond their present roles and into an arena of development that could be whole system in approach and aspiration. By concentrating on teams and pathways, skills and behaviours, there is an opportunity to change the way the system works, so it is responsive to the needs of its community, whilst also enabling teams and individuals to have the aspiration and inspiration to innovate and develop for the future. 3.6 The Clinical Board will operate to a vision which has four foundations (Vision document appendix 2) 3.7 In summary our vision in Central Manchester is: We believe in joined up care: We will design services to a shared care model We will communicate, inform and educate We will redesign our health and social care system 4 Programme of Change - Transforming Services 4.1 The Central Manchester Clinical Board believes it needs to start transforming services by addressing the pathways that we will make the most difference. Community, primary and secondary and social care staff need to work together on ways to make the pathways easier and more effective for the patient. 4.2 In this programme of change this does not mean redesigning whole pathways. It means designing and delivering steps within a pathway to a short timescale to deliver positive change for patients and staff. The clinical board believes this will build staff ownership in the system and also start to create a firm foundation in terms of change management for integrated working in the future. 4.3 The overall direction of this transformational change must be towards care closer to home, integrated teams across pathways and enabling the patient to be able to receive care in the most appropriate place, at the most appropriate time. The clinical board wishes to move through a system change cycle, and work to a model of change at scale (national QUIPP model). The diagram below demonstrates this model which has been adapted locally to demonstrate change through 8 steps. 3

4 Diagram 1 System Change Model Hold to Account Step 7 Join Up Plans and Actions Step 6 Build Capacity and Capability Step 5 Make Progress Visible Step 8 Delivery at Scale Develop Mind Set for Change Step 4 Frame The Story Step 1 Evidence and Analysis Step 2 Design and Delivery at Scale Step 3 Sara Radcliffe 5 Programme of Change - Objectives and Outcomes 5.1 The Central Manchester Clinical Board has agreed six priority areas for the six months: Urgent Care Adults - to develop a whole systems approach to urgent care for adults. This would include redesign which fully integrated primary care services into AE as well as developing a vehicle by which we can transfer care from an acute setting to primary and community care. Long Term Conditions Cardiology - to develop an integrated approach to long term conditions including appropriate alternative community provision. End of Life - to develop an integrated shared, whole system EoL model across the secondary, primary and independent sectors. Planned Care Musculoskeletal and Ophthalmology - to develop appropriate primary and community services and gateways in priority areas to reduce demand on planned care services. Children and Families Urgent Care Children - Development of an emergency and urgent care pathway for children and young people. This is to provide a platform for clinically effective and cost effective services that are provided in an 4

5 appropriate setting and contributing to avoiding inappropriate admissions to secondary care. 5.2 Central Manchester has completed the scanning process which has framed the story for the six areas and is supported with evidence and analysis (steps 1 and 2) of the cycle. These steps have culminated in agreed commissioning briefs which have distilled the transformational change expected, the impacts, the outcomes, the evidence and analysis. 5.3 The Clinical Board has identified a small group of people from across the organisations to form design and delivery teams in the six areas working to agreed commissioning briefs and a six month design and delivery plan.. To do this we believe the teams need to be focussed and the membership is outlined (appendix 1). 5.4 A member of the design and delivery team will act in a leadership role and will ensure that the team undertakes the innovation timetable and achieves the agreed objectives. This team will be responsible for steps 1-6 the change model, being accountable to the Clinical Board at regular meetings. 5.5 The design and delivery teams aim to improve the services identified in the commissioning brief so that it can demonstrate an improvement in the pathway in terms of quality for the patient, effectiveness of care outcome and value for money. 5.6 In order to do this the team must specify the particular area of the pathway they need to change, that will have the most effect and be delivered within the 6 months. 5.7 The teams will work to a PDSA cycle, using process mapping and identifying value added steps in the patient s journey. 5.8 We recognise that many individuals, within the system, will have already undertaken important pieces of work which will feed into this process and enable the work to be completed as effectively as possible. A document outlining the team leadership, team member role is in appendix The Clinical Board has also agreed to the establishment of a winter transformational management team. The team s aim will be to ensure the effective and efficient flow of patients through the Central Manchester health and social care system in winter 2010/11. The team will try and mirror and pilot different ways of working which will be a foundation for integrated working in the future. 6 Programme of Change Management and Governance 6.1 The Clinical Board has agreed a six month programme of change. The Clinical Board s role is to oversee the programme of change and enable the system to respond to and deliver the changes it needs. 6.2 The membership of the clinical board reflects the senior decision making levels of the organisations, to ensure that change is implemented, and is held to account through monitoring and evaluation. It has a direct link to the SoSF Programme Board to ensure that the transformational change is part of the wider city changes that are taking place. Therefore, the Clinical Board has senior level membership from CMFT, 5

6 , MCH and MCC and is chaired by the Chair of Central Manchester Hub who is a member of the SoSF Programme Board. 6.3 Design and delivery teams will be accountable to the clinical board working to agreed plans that will be submitted in November 2010, to be implemented in December 2010 and measured in February This will enable the Clinical Board to take decisions on future action in March It is important that transformational change is seen as a priority for organisations to enable the system to modernise and move forward. Therefore, there needs to be clear accountability and governance arrangements. The diagram below shows how Central Manchester design and delivery teams will feed into governance structures that incorporate the Central Manchester organisations, as well as the overall city arrangements for SoSF. Such arrangements would provide a clear accountability structure for steps 7 and 8 of the system change model. Central Manchester -Transformation Redesign, Accountability, Implementation Implementation and development Clinical Board Design &Delivery Teams SOSF Programme Board SOSF Thematic Group Sara Radcliffe 6.5 A risk log will be initiated for the programme overall and updated through the monthly programme plan, which will be agreed each month at the Clinical Board. 7 Communication and Engagement 7.1 This programme of change will need to be communicated across organisations. It will be the role of Clinical Board members to make sure that their own organisations are aware and involved in the programme of work. 7.2 There will also be a web page available which will be able to be accessed by anyone and will hold all the Clinical Board papers and documents. 7.3 It is also hoped that the wider stakeholder group, including staff, patients and carers is built upon over the six months and communication channels are opened up and used to engage people in how the programme of change is developing. 7.4 An engagement and communication log will be part of the monthly programme plan. Sara Radcliffe November

7 Appendix 1 Clinical Board Membership Central Manchester Clinical Board and Design and Delivery Team Membership Clinical Board Urgent Care Adults Urgent Care Children EoL Cardiology MSK Ophthalmology Winter Mike Helen Helen Selina Ivan Benett Selina Martin Whiting Eeckelaers Hosker Hosker Dunn Dunn Helen Ruth Ruth Janette Chantal Chantal Chantal Franco Hosker Cammish Cammish Hogan Franco Franco Selina Dunn Stefanie Cain Tony Ullman CMFT Gill Heaton Ian Lurcock* Bob Nicola Pearson Marsden Ian Lurcock Jimmy Stuart MCC MCH NHSM Programme Lead Jon Simpson Pauline Newman Liz Bruce John Harrop Ian Williamson Sara Radcliffe Peter Selby Diane Eaton Chris Lamb Through Stefanie Cain Anna Addison Rachel Whittingham Jill Scotsman Shirley Woods- Gallagher Heather Johns Denise Ditchfield Eleanor Roaf Sam Bradbury Sara Fletcher Sara Fletcher Jon Simpson Cliff Garratt Karen England Bethan Weston* Ian Lurcock Rob Davis Sue Lunt Jon Simpson K Salmon Jamieson Dawn Pike Suzanne Reid Pip N/A N/A N/A Diane Cotterill Eaton Sue Ware Natalie Neild Through Through Yvonne Casson Peter Linsley Through Through * Please send all design and delivery team information to the stated Divisional Directors who may name other members of their directorates as members of the teams for future meetings. Design and Delivery Team Leaders Appendix 2 Central Manchester Clinical Board Vision for Central Manchester Health and Social System Chris Lamb Joanne Royle In Central Manchester, we believe in joined up care: - Working to create a self-reliant, resilient and healthy population - Listening to patients & designing services based on real experience - Working to create an integrated health and social models of care - Working to educate and shift mindsets of patients/service users/public - Developing leaders at all levels because we are all leaders - Shifting the balance of where care occurs o Our care focus is the home o Our care aim is self-management in the community o Our care objective is that nothing happens in a hospital that doesn t have to happen there 7

8 We will design services to a shared care model Care Planning - Better understanding/knowledge in the system around patient groups - More care is planned with input from all - Individualised plans/packages of care that are continuously reviewed and updated Care Delivery - Care delivery is easily accessible to those who need it - Care services are effective, efficient, lean - Teams and access points exist for types of patients that are effective, and efficient - Using all episodes of care as an opportunity to educate patients/carers about where best to access care in future - Flexible Plans of care easily, and quickly implemented We will communicate, inform and educate - About the content of care and how to best access it - Patients and carers about their conditions and what is in their plan of care - Our plans are widely, effectively communicated throughout the care system - Easily accessible information about where to best access services - Involve community stakeholders in patient/carer education We will redesign our health and social care system - We will raise & address issues/barriers/enablers in e.g. commissioning, legislation and professional practice - We will use incentives for change/ and penalties poor care - We have structures and processes to explicitly work and manage as a multi agency whole system - We will measure what we do Appendix Design and Delivery Teams Central Manchester Clinical Board 1.1 Central Manchester Clinical Board has agreed service redesign areas that will be led by task focused design and delivery teams. Listed below are what we believe are the roles of the team leader, team members and the team method of working. The teams, through the team leader, will be accountable to the clinical board, but each team member will be accountable to their own organisations for delivering the change that has been signed up to. 2.0 Team Leader 1. Create a team which is creative, cohesive, action orientated and can communicate the changes needed Ensure that the way the team works is effective and efficient either through meetings, s, conference calls, workshops etc. 8

9 2. Communicate the vision of the clinical board and the design and delivery team s objectives to the team but also the wider stakeholder groups. 3. Lead by example with behaviour consistent with words, be able to motivate and inspire team members, resolving problems through facilitation and collaboration. 4. Be results orientated, focus on action, encourage creativity, risk-taking, and constant improvement. Strive for win-win agreements, ensuring discussions and decisions lead to positive action. 5. Be clear on the ways we work, lead the team to focus on improvement and reaching the design and delivery objectives specifically following the PDSA cycle over the 6 months. 6. Report to the board, document the team s work and provide necessary information to the clinical board about progress, ensuring that the design and delivery team achieves its objectives. 3.0 Team Members 1. Be a part of a multi agency team delivering on their part of the design and delivery brief. 2. Communicate the vision of the design brief to others to influence and enable them to support the change programme. 3. Strive to use their influence and skills to deliver the objectives both internally to their organisation and across the system to deliver the team objectives. 4. Work with the team leader and other members to make the decisions needed and obtain necessary resources to support the design and delivery of the brief. 4.0 Ways of Working 4.1 The design and delivery team aims to improve the services identified in the commissioning brief so that it can demonstrate an improvement in the pathway in terms of quality for the patient, effectiveness of care outcome and value for money. 4.2 In order to do this the team must specify the particular area of the pathway they need to change, that will have the most effect and be delivered within the 6 months. 4.3 The team should work to a PDSA cycle, using process mapping and identifying value added steps in the patient s journey. The team needs to be able to report on the planning stage by November, the doing stage by December and the study by the end of February - so that any action can be taken into the new financial year 2011/12. 9