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Strategic Update

Strategic Update. 2017/18 and 2018/19. What we will cover today in our session on strategy. An opportunity for Governors to inform Board thinking A reminder of our agreed organisational strategy (2015 – 2020) An update on national context and its relevance to our organisational strategy

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Strategic Update

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  1. Strategic Update 2017/18 and 2018/19

  2. What we will cover today in our session on strategy • An opportunity for Governors to inform Board thinking • A reminder of our agreed organisational strategy (2015 – 2020) • An update on national context and its relevance to our organisational strategy • Progress during 2017/18 • Priorities for Q3 and Q4

  3. Roles and responsibilities of Boards and Council of Governors

  4. Roles of the Board According to the NHS Leadership Academy, the PURPOSE of NHSFT Board “is to govern effectively and in doing so, build public and stakeholder confidence that their health and healthcare is in safe hands"

  5. NHS Leadership Academy goes on to detail the role and state that effective NHS Boards are responsible for: • Formulating strategy • Ensuring accountability (for delivery of the strategy) • Shaping a healthy culture for the Board and organisation.

  6. In discharging these responsibilities, Boards "must have regard to the views of the council of governors in preparing its forward plans"

  7. Our agreed Organisational Strategy

  8. Strategy timeline December 2016 Strategic Plan Refresh October 2016 Strategy discussion April 2017 Board Strategic Review September2017 CoG update November2016 CoG Strategy Stocktake discussion Aug 2017 Board receives progress and rec's April 2015 Org Strategy Agreed January 2017 Strategic Plan Presented to CoG May 2017 Strategy Stocktake discussion to CoG

  9. Our Vision Our vision has four main elements: • To be the provider of choice • To be an employer of choice • To provide high quality, cost-effective services that are attractive to commissioners and individuals • to ensure the long-term stability and viability of our services Key Strategic Priorities In 2016/17 our strategic and operational plan for NHSi highlighted three key priorities: quality engagement sustainability

  10. Questions we asked ourselves in December 2016 • Can we deliver our strategic intention? • What would be the impact on our strategic intentions from withdrawing from any services? • What if any benefits are there from different organisational forms? • Is there commonality in our ambitions with partners? • Seek sustainability through merger or acquisition?

  11. External context

  12. The challenge • Most challenging year in NHS history • Changing landscape – locally and nationally • Trusts in special measures • Some CCGs nationally in financial deficit “CCG’s Deficit Forecast Rockets by £180m” “Health Service Performance Hits Record Low” “Mental Health Budgets Still Being Cut” (National headlines)

  13. Last year (2016/17)…… • underlying £250,000 deficit left over from 2015/16. • £1.8 million of £4.3 million savings delivered last year were non-recurrent • no "rainy day" moneyleft We met our ‘control total’ – the end of year position we agreed with NHS Improvement. Result = we enter 2017/18 £2 million (approx) worse off than we hoped to be.

  14. The outlook for 2017/18…. *We also need to make 2% efficiency savings

  15. 2017/18 continued

  16. 2017/18….

  17. Our plan

  18. Our priorities

  19. Assurance that the Board is fulfilling its responsibilities

  20. In line with NHSi framework guidance we agreed to: Review existing strategy and determine level of refresh/revision needed Seek appropriate and sufficient professional views identify longlist of potential options Informal discussion with CoG, JNCC, LMC • Assess impact on service viability • Impact on regulatory assessment • Support from system • Agree strategy and short list options • Pursue discussions with partners and progress evaluation/deliverability of options Agree proposal Discussions with local partners: GCS, GCCG, HCCG etc Discussions with NHSI, NHSE, Political leaders

  21. Progress in 2017/18 so far • Significant energy into building a sustainable workforce • Peripatetic teams • Agency medical cover – trust locums and permanent staff • Rapid improvement projects on agency reduction • Strengthening bank arrangements in Herefordshire • Continues Quality focus • Investment in QI capability • Change in focus of PM office • "Good to Outstanding" • Significant engagement • Huge effort into STP work • Strengthening partnerships

  22. Significant progress in Partnership working • Following strategic review with Board and CoG • Clarity on next quantum step in improvement requires more effective working with physical health care services • Relationships with Primary Care critical within "Place Based Plans" • Aspiration to be a provider of integrated mental health and physical health care services

  23. Formation of an FT Chain. • National strategy for integration around place based plans • Greater emphasis on collaboration • Engagement with NHSI and negotiation with GCS • Proposition to CoG to form an FT Mental Health and Physical Health Care Services Chain. • Decision by Board on 19 September • Announcement on 20 September

  24. What does this mean • That 2gether NHSFT and Gloucestershire Care Services NHS Trust will enter a formal partnership covered by • A jointly produced "Our Strategic Intent" • Heads of Terms • A Memorandum of Understanding • Commence a formal transaction with NHSI to integrate our organisations – technically an acquisition however a clear commitment to this to be a blending of strengths and feel like a merger

  25. How and when • Both Boards have committed to "working at pace" • Appoint a Joint Chair followed by • Appoint a Joint Chief Executive • Establish a Joint Working Group to develop and deliver • Strategic Outline Case • Full Business Case

  26. Timeline • Board approved proposed actions to COG - Aug Board • CoG asked to support and endorse enactment of agreed strategy – 19 September • Public announcement – 20 September • Appointment of Joint Chair – October • Appointment of Joint CEO – November • Commence in post January 2018 • Strategic Outline Case (Spring 2018) • FBC – late summer 2018

  27. Strategy timeline December 2016 Strategic Plan Refresh October 2016 Strategy discussion April 2017 Board Strategic Review Oct 2017 Chair Appt September2017 CoG update Nov 2017 CEO Appt November2016 CoG Strategy Stocktake discussion Aug 2017 Board receives progress and rec's April 2015 Org Strategy Agreed January 2017 Strategic Plan Presented to CoG May 2017 Strategy Stocktake discussion to CoG

  28. What does it mean for CoG • The Remuneration Committee will need to commence the process of recruiting our new CHAIR – this will also be the Joint Chair of the FT chain and as such will include NHSI assurance. • Your continued engagement, support and challenge is critical and will be particularly so during the Strategic Outline Case and FullBusiness Case stages • Support in acting as an ambassador in planned engagement events with members and public

  29. What does it mean for CoG • Ongoing assurance and holding to account of the Board via NED's to ensure focus on in-year delivery and timely and appropriate engagement and consultations • Support in acting as an ambassador in planned engagement with members and public • Approval or otherwise at final FBC in relation to "significant transaction"

  30. Priorities for Q3 and Q4 • Deliver the 17/18 plan • Ensure continuity and improvement in performance • Implement Team Accounts and performance meetings • Stabilise LD provision in Herefordshire • Final preparations for CQC inspection – "Good to Outstanding" • Preparation for 2018/19 • Develop sustainable propositions to deliver MH5YF objectives • Develop CIP plans

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