Derbyshire Community Health Services NHS Trust Board Document Title: Integrated Business Plan 2012/17 (IBP)and supporting strategies Presenter: Simon Griffiths / Executive Management Team Author: As above with supporting teams Contact details for further information: Executive Management Team Date of Meeting: 27 October 2011 Agenda Item No: 151/11 Document is for: (indicate with an x) Assurance Information X No of pages inc. this one: 5 Decision Executive Summary An Executive Summary of the draft IBP is being considered by the Board along with the following supporting strategies: • Quality Strategy – previously discussed at September Board • Draft People and Organisational Effectiveness Strategy • Draft Estate Strategy • Draft Information Management & Technology Strategy This documentation cannot be considered publicly at this stage as it is still at an early stage of development (see section 3 on page 4 below) and is commercially sensitive. Section 1 on page 4 below explains what the IBP is and why it is an important part of the trust’s development as a community foundation trust. Section 2 below describes how the IBP is assessed. Section 3 outlines how the IBP has been developed and the overall timescale and process. Section 4 indicates the further work which needs to be done between now and the final approval of the IBP in March 2012. Section 5 outlines the immediate next steps to be taken to develop the IBP. Financial Impact The financial impact of the draft IBP and supporting strategies is contained within section 5 of the draft IBP being considered in confidential session. Links to DCHS Strategy The draft IBP reviews and sets out the DCHS Strategy in the light of analysis of the policy, financial and demographic landscape and following extensive engagement with the Board, DCHS staff, clinical commissioning groups and other stakeholders. Recommendations The Board is asked to: • Note the development of the IBP; • Note the commitment to develop a publicly accessible version of the plan in Spring 2012; • Ensure that the comments received during the foundation trust during July – September 2011 are appropriately included within the IBP’s development; • Commit to working with the PCT Cluster and clinical commissioning groups as part of their consultation on any significant service changes brought about through the final agreement of the IBP in March 2012. It should be noted that full and final approval of this suite of documentation is not required until the February 2012 DCHS Board meeting. Monitoring Information 9 CQC Compliance 9 Monitor Compliance 9 NHSLA Compliance 9 Assurance Framework Ref: 9 Brief Summary The IBP and supporting strategies focus on ensuring DCHS exceeds the core standards All documentation has been developed in line with Monitor guidance and to achieve Monitor compliance. The development of the IBP and supporting strategies will support DCHS’ ambition to achieve level 2/3. The IBP and supporting strategies are aligned to the assurance framework Other (If no, why) Are there Equality & Diversity implications? 9 Are there Patient and Public Involvement implications? 9 The equality and diversity impact will be identified through the completion of an equality impact assessment and mitigation plans will be prepared. The responses to the foundation trust consultation process are currently being analysed and will be fed into the next version of the IBP. DCHS is committed to working with the PCT Cluster and clinical commissioning groups in their consultation around any significant service changes resulting from the final agreement of the IBP in March 2012. 2 Integrated Business Plan and Supporting Strategies 1. Aim of the IBP The Monitor guidance states that ‘The integrated business plan is a document that sets out the organisation’s business strategy for the next five years. It will be an evolving document that will assist the applicant trust to plan for the risks and opportunities it will face as an independent, public benefit corporation. Applicant NHS foundation trusts need to show that their proposed vision is based on local consultation, sound financial modeling (taking into account all external factors e.g. Lord Darzi’s Next Stage Review, payment by results, practice-based commissioning, and patient choice), business knowledge, and the actions taken to mitigate risks, while adhering to NHS principles to ensure success for the organisation and the community it serves. The integrated business plan will need to demonstrate that effective staff involvement and commitment to service development has been secured.’ 2. IBP Assessment To aid consideration of the IBP, the Board is reminded of the assessment questions set out by Monitor in its guidance to applicant foundation trusts, summarised in the table below: Is the level of activity and mix of services consistent with patient needs and the requirements of the 2006 Act? Is the IBP internally consistent? Is the IBP financially viable and sustainable? • • • • • Required services included? Acceptable assumptions about property and asset disposals? Private patient income consistent with cap? Is it supported by key commissioners? Fit with local and national service needs? Are resources consistent with projected service activity and funding? • Are capital assumptions consistent with projected service activity? • Is the implementation plan clear and consistent? 1. What are the major changes proposed? 2. Are the key assumptions realistic? 3. Is there a realistic set of risk scenarios and clear contingency plans? • 3. Development process Development if the IBP has been in line with the tripartite formal agreement (TFA) and effectively started with the initial Board development session in March 2011. Since then, 4 further Board development sessions have been held in July, September and October, where key planning assumptions and initial drafts have been shared and debated. Updates have also been provided at the Community Foundation Trust (CFT) Project Board and at the Quality Business Committee. Set within a corporately derived planning framework and set of assumptions, the development of the service models has been largely driven by the service divisions and the resulting service concepts have been widely shared with nearly 1,000 staff through the recent series of staff engagement events. Similar discussions have been held with the local clinical commissioning groups, NHS Trusts and Derbyshire County Council. Initial discussions have also been held with the Improvement and Scrutiny Committee. Support for the early draft plan has been significant. It should also be noted that in line with national guidance, a detailed proposal around the estate transfer has been developed with the PCT Cluster. This has led to some assumptions around the future use of buildings which may require further refinement as the IBP is further developed. Thus a significant amount of progress has been made in developing the attached draft plan and its supporting strategies. The Board is however reminded that, as indicated by the timeline below, we are still at an early stage in the process with the final plan not being approved by the SHA until March 2012. While a robust draft has been developed, there is significantly more detailed work to be done. Furthermore, the commissioners’ commissioning intentions are being developed and the NHS Operating Framework for 2012/13 will be received later this year along with the resulting financial settlement. While the plan has been developed with clear assumptions and commissioner engagement, our planning assumptions may well need to be amended in the light of further guidance. 4. Further work required 4 At this early stage, it is inevitably the case that there is still a significant amount to be done to refine the IBP over the next 5 months. The major pieces of work are to: • Review our strategic objectives and service development plans in the light of our planning work to get a clear linkage and ensure the core business of the trust can be clearly stated; • Undertake further work on the long term financial model and downside scenarios to address the financial and activity challenges raised from the work undertaken to date ; • Further develop the service development plans so there is a robust route map to the future setting out a clear set of actions and timescales which also deliver the necessary quality, finance and activity requirements, including private patient income and impact of personal budgets; • Update the market analysis primarily around the comparative performance data given the change in organisations and establish a more proactive approach to our partnership development with non statutory sector organisations; • Include relevant components of the outcomes from the foundation trust consultation; • Further develop the evidence base for the changes outlined. 5. Next steps In line with the TFA, the Board will need to sign off the final draft of the IBP at the Board meeting in February. It is therefore proposed that a further draft of the IBP and LTFM is brought to the Board in December once further modelling work has been completed. 5
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