PMO Project Training

1. PMO Project Training October 2013

2. Aims & Outcome Today we’re aiming to give you an overview of : • What QIPP means to CCG • Strategies that define the on-going work • YHYC • HWB • CYPP • AOP • Use of Health Perform • Project Process • QIPP Assurance • Financial Limits • New Toolkit with key documents (PID, FBC, RAID) • Risks , Issues & Key Performance Indicators (KPIs)

3. What is QIPP? PCT • Savings Target • Meeting Financial Balance • Reduce Spend • Identify outliers CCG • Fundamentals of QIPP • Projects that involve savings and / or require investment • Driving forward change

4. The PMO • Ensure a structured programme and performance management framework is in place for priority CCG change programmes; with a focus on the QIPP plan, underpinned by a robust decision making framework. • Provide specialist guidance & assurance for organisational programmes of work. • Provide central comprehensive service in expertise for programme/project management, business case development & project performance management. • Lead development of the CCG Strategic Plan and Annual Operating Plan; working in collaboration with colleagues from across the organisation. • Lead the implementation of programmes and projects as required

5. CCG Strategies Health & Wellbeing Strategy (20yr plan) GCCG Plan (5yr Plan) Children & Young Peoples Plan Your Health Your Care Call to Action Annual Operating Plan

6. CCG Strategies Health and Wellbeing Strategy • Obligation as part of the Health & Social Care Act (2012) • 20 year strategy aimed to ensure Gloucestershire is ‘Fit for Future’ • Supports the same key principles linked to YHYC Your Health Your Care • Joint Strategy developed with all main providers and commissioners of Health & Social Care • Comprising Five-Year vision for Health & Social Care Children’s and Young Peoples Strategy • Three year strategy underpinning work that is already underway and work that needs to be done to help Gloucestershire residents excel. • 0-19 y/o or up to 25 with a Learning Disability • Focus on Vulnerable CYP • Aims to commission right the right care as early as possible Annual Operating Plan • One-year Strategy covering the core values of Gloucestershire CCG • Outlines CCG Vision – ‘Joined up care for the people of Gloucestershire • Linked to the Objectives key to CCG Authorisation • Based on the National Framework ‘Everyone Counts: Planning for Patients

7. QIPP Finance Schedule

8. Project and Programme Assurance

9. Project and Programme Assurance • A new framework for all projects (new and existing), built on PRINCE2 methodology • Internal (including locality initiated) and Provider schemes that impact our CCG • Designed to provide a more supportive approach from initiation to implementation for quicker, more robust, delivery of schemes

11. QIPP Assurance Group • Meet weekly on a Thursday morning • Reports to CCG Core Team • Core membership : • Associate Director Strategic Planning – Chair • Deputy Director of Nursing • Chief Financial Officer • Associate Director Business Intelligence • Head of Financial Planning • Deputy Director Commissioning Implementation • Head of Information and Performance • Additional attendees co-opted according to agenda items • Papers must be submitted to the PMO by the Friday preceding the weekly QIPP Assurance Group • Responsible for assessment, evaluation and sign-off of business cases (>£50k to Core Team), and for monitoring progress post implementation by scheme

12. Project – Stage 1 : Justify & Define • Project manager and/or GP Lead • Signed-off Project Initiation Document and self-assessment of priority using the Prioritisation Matrix • Submit to PMO with slide deck • Attend QIPP Assurance Group to give brief overview of initiative (10-15 mins) • QIPP Assurance Group • Initial assessment of scheme – including ability to deliver suggested outcomes to time and budget • Explore support required and opportunities to package with other initiatives • Specialist advice sought where required • Stage 1 decision outcome given Stage 1 pending Stage 1 approved Pause / Rework Stakeholder only Proceed to Prioritisation Stop Stage 1 withheld

13. Project – Stage 1 : QIPP Assurance Group (10-15 min) slot A brief overview of the scheme, the slide deck for stage 1 provides a high-level view supported by the PID and prioritisation self-assessment. Must include slides on: • Background and Rationale (What and how?) • Outline description of proposal • Funding required • Alignment with national and local priorities • Clinical Programme approved • Prioritisation self-assessment score • Potential Impacts (Why?) • Initial evidence review • Patient impact – outcomes / access / acceptability • Financial impact • Risk mitigation • Do-ability • Timing (When?) • Proposed dates for each ‘Stage’ • Plans for trial • Communications • Plans for launch (phased / full) • Urgency • Procurement indications • Engagement (Who?) • Which patients / citizens? – scale? • Which stakeholders need to be engaged and who already has been? • Who is the clinical lead? • Sponsor / accountable executive?

14. Project – Stage 3 : Design • Project manager and GP lead • Signed-off Full Business Case with project plan, KPIs and Risk & Issues • Submit to PMO with slide deck • Attend QIPP Assurance Group to provide more in-depth details of project deliverables, patient outcomes and the service specification (25-30 mins) • QIPP Assurance Group • Assess robustness of business case, service specification, project plan and KPIs • Stage 3 decision outcome given : Business cases for less than £50k investment approved; greater than £50k to Core Team • Confirm if further attendance required at Stage 4 (Develop) or Stage 5 (Implementation) Stage 3 pending Stage 3 approved Pause / Rework Proceed to Develop / Core Team (>£50k) Stakeholder only Stop Stage 3 withheld

15. Project – Stage 3 : QIPP Assurance Group (25-30 min) slot A more detailed assessment of the scheme, the slide deck for stage 2 is supported by the full business case, project plan and evidence review. Must include slides on: • Study outcome • Finalised scope • Options appraisal • Investment required • Procurement advice • Anticipated benefits • Evidence • Clinical evidence review • Financial and Informatics appraisal • Risks and Issues • Key assumptions • Contribution to QIPP agenda • Timing • Implementation plan with milestones, with explicit agreement from task owners to the proposed dates • Procurement timetable • Planned Stage 3 and Stage 4 timetable • Engagement • Public engagement • Stakeholder engagement • Equality Impact Assessment • Impact analysis across health and social care, including workforce, buildings, IT and equipment • Access

16. Project – Stages 4 & 5 : Develop, Deliver & Implement • Following sign-off of Full Business Case, the Project Manager and lead GP work with the Project Team to develop the service specification, procure (as required), set-up monitoring against agreed KPIs, communicate and launch. • Reporting commences on HealthPerform following approval at Stage 3. • If requested at Stage 3, the Project Manager and lead GP may be required to attend either the QIPP Assurance Group and / or the CCG Core Team prior to implementation for a Go / No Go decision • At any point of a project, the QIPP Assurance Group will be available for supplying technical expertise as required to ensure the smoothest, quickest implementation.

17. HealthPerform GCCG’s chosen system to monitor all change projects. This has been used since 2009; previously known as Performance Accelerator (PA)

18. HealthPerform: Helpful Hints Don’t post questions in HealthPerform Status Update Fortnightly Ask Kirsty! Used for a range of reports i.e. Core Team KPIs & Risks

19. Project Toolkit • To support this new framework, the PMO have re-developed the project toolkit, available on CCG Live. • This streamlined version aims to match-up the expectations of our CCG Governing Body and our patients with each stage of a project • Aim - To help you do the right things, at the right time, to the right quality, first time and to understand why you’re doing it • Get this right, and projects will progress quickly and effectively; ultimately for the benefits of our patients

20. PMO ‘Project Lab’

21. The Project Toolkit – Starting Out • Five important questions: • Why are we doing it? • When will I know I’ve finished? • How will it be measured? • What do I need to deliver? • What are the benefits, outcomes, costs and risks? • So, first document to complete is the Project Mandate where you can capture these answers and get sign-off from your Sponsor

22. Project Toolkit : Project Mandate • A simple one page document to complete at the very start of the project • Can be used to refer back to later to help prevent ‘scope creep’ • Can be shared with others to secure engagement or share project aims.

23. Project Toolkit : PID • Next document to complete : the Project Initiation Document (PID) • New, shorter, easier to complete designed for ‘Stage 1’ sign-off; • Suitable for all projects • To complete activity and finance sections, work with Finance and Information colleagues – the PMO will help put you in contact with the right people if unsure • Finance & Information leads, Sponsor and, where relevant, Clinical Programme Group to sign-off prior to QIPP Assurance Group

24. Project Toolkit : Business Case • Following sign-off of the PID, you’ll start developing your business case. • The new toolkit has a re-designed full business case with more auto-population. • May not always be required • Work with colleagues across Project Team especially procurement, patient and public engagement, finance and activity, communications • Must be signed off by Sponsor, Financeand Clinical Programme Group (where relevant) prior to Stage 3 attendance at QIPP Assurance Group

25. Why do some projects fail? Others say: • Inadequately trained and/or inexperienced • Failure to set and manage expectations • Poor leadership at any and all levels • Failure to adequately identify, document and track requirements • Poor plans and planning processes • Poor effort estimation • Inadequate or misused methods • Inadequate communications, progress, tracking and reporting

26. Why do some projects succeed? • Factors present in successful projects: • Everyone knowing what the project is meant to achieve • People are asked to demonstrate how it’s going • There’s active resolution of challenges • The right stakeholders are engaged and mobilised • Work is planned and scheduled • People on the project

27. ‘Project Lab’ – Key Performance Indicators (KPIs) • ‘Key Performance Indicators’ = measurable outcomes, agreed to beforehand with Finance, Information and your sponsor, that reflect the objective(s) of the project – THINK QIPP • Why have KPIs when we know what our aim and objectives are? See this example for Referral Peer Review: • Put simply, KPIs are what you use to measure success

28. ‘Project Lab’ – Benefits • The new business case helps you define your benefits with drop-downs • A definition of a benefit? • Something that adds value • Benefits can be:

29. ‘Project Lab’ – Risks and Issues • Likelihood Score (1 - 5) • Consequence Score (1 - 5) • L x C = Risk Score • Most commonly written risks – who has ever seen these?? • There might not be enough resource • The pilot might not identify all the issues • The scope might change • While these could happen, they are common to nearly all projects, so mitigations should already be in place through good project management • So make a start by identifying your specific risks, rather than generic ones

30. ‘Project Lab’ – Risks and Issues • Once identified and scored with your stakeholders, you now need to decide what action to take: • Risk management should be ongoing at all times

31. Summary You should now have an understanding of: • What QIPP means to CCG • Strategies that define the on-going work • YHYC • HWB • CYPP • AOP • Use of Health Perform • Project Process • QIPP Assurance • Financial Limits • New Toolkit, key docs (PID, FBC, RAID) • Risks , Issues & KPIs

32. Any Questions? Please contact a member of the PMO Team for any further details