CHIEF EXECUTIVE’S BRIEFING

Tom TaylorChief Executive

1st August 2006

PATIENT FOCUS

• Consultation document on public involvement.

• “Obligation” on PCTs to respond to community views.

• How do we get patient issues and clinical achievements more prominent?

• First County-wide volunteers forum.

APPOINTMENTS

• David Nicholson – CEO NHS• Andrew Cash – Director of Provider Development• Cynthia Bower - NHS West Midlands CEO (Acting)• Peter Spilsbury – Director of Strategy• Jo Lenaghan – Director of Communications• Various – PCT Chairs / CEOs

PERFORMANCE & FINANCE

• Performance ahead of contract.

• Performance ahead of 2005/06 target achievement.

• Costs are reducing month on month.

• Need to plan now for Practice Based Commissioning and Our Health, Our Care, Our Say.

TURNAROUND

• SaTH public consultation commences 4th September (officially!!).

• Increased clinical engagement.

• Delivery teams in place.

• Clinical structure progressing.

• Turnaround is the day job not just finance!

NEW RISK ASSESSMENT AND MONITORING FRAMEWORK

• Principles– Board accountability– Making action proportionate– Transparency– Rules basis to assessment– Preparation for external regulatory regime– Helps SHA to focus our resource

• Rating formally revised monthly and formally notified to organisations

• Need to learn from experience in operating this system

OUTLINE OF RISK ASSESSMENT SYSTEMRisk Area Elements Description

Financial Demand Management Quantified assessment of demand management risk based on LDP Plans and updated by monthly performance data

Legacy Current National Turnaround status, receipt of NHS Bank Loans

Cost Improvement Programmes Quantified risk scoring of CIP plans, updated by performance

Workforce Scale and quality of workforce plans updated by performance

  PCT Fitness for Purpose and FT Diagnostic Reviews

Significant issues will shift rating

Governance

Statement of Requirements Board self-certifying compliance with requirements

Performance on key targets Monthly monitoring to assess compliance

Exceptional reports eg. Reports of Healthcare Commission or other third-party reports

PCT and Trust Board reports Quality and content of board reports

  PCT Fitness for Purpose and FT Diagnostic Reviews

Significant issues arising will shift rating

Risk Score

1 - 4

Updated Monthly

Risk Score

1 -4

Updated Monthly

CONSEQUENCES OF RISK RATING

Rating Summary Financial Governance

4 Low Light-touch Routine returns Routine returns

3 Moderate Performance Management Challenge

Above plus

- issue based exception reporting where needed

Above plus

- issue-based exception reporting where needed

2 High Board-level Challenge and intensive monitoring

Above plus - quarterly joint reporting - monthly review with health economy/ individual organisations- 3rd part review - access to peer review and support

Above plus -Significant degree of investigation and intervention. - Requirement for rectification plans signed off by Board. - Regular monitoring reports on issues of concern

1 Very High Turnaround-style monitoring and intervention

As above plus -"Local turnaround regime" for those not in national turnaround, including- Fortnightly reporting - SHA turnaround team - External support mandatory

Above plus

- high-degree of SHA and 3rd-party intervention as organisation appears to be failing on fundamental aspects of Statement of Requirements

NEXT STEPS

• Issue Statement of Requirements and Risk Assessment and Monitoring Framework next week

• Issue Performance to Date comparative data next week

• Review with every health economy in August– low-risk: confirmation/assurance and scope

for surpluses– high-risk: placing discussions which are now

taking place with many on a formal footing