EXECUTIVE SUMMARY by QjDFZhPh

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									EXECUTIVE SUMMARY
This Your Healthcare Integrated Business Plan (IBP) for 2009/10 – 2013/14 brings together all the
information a reader will need to make an informed decision about our potential to succeed as a
Social Enterprise in a very competitive market place. The main thrust of the plan is to describe our
services, to show you how we are performing to date, and to share with you our service development
plans for the future.

It is written with many audiences in mind. A Social Enterprise is a ‘not for profit’ organisation that exists to
benefit its members; its roots are firmly planted in the mutual and cooperative society movement. The
members of Your Healthcare are our patients and service users, their carers and our staff. To this end,
everything in this plan will matter to you if you fall into one of these member categories. The contents of
this plan will matter to you if you commission services on behalf of local people; delivered by our staff.
The plan will also matter to you if you are one of our partners in the delivery of our services.

This IBP is the vehicle by which any further assessments are made of our capability, capacity,
commitment and preparedness to be a stand-alone business. It is clearly a document that needs to
‘sell our wares’ but it is also a plan that we measure ourselves against.

Provider Services (NHS Kingston), soon to be known as Your Healthcare, currently delivers a full range of
NHS services to the general practice population of Kingston and for people with Learning Disabilities in
the borough of Richmond. In addition, we provide a broad range of infrastructure and business
support services to NHS Kingston. There are 23 services in all and these are described in more detail in
the body of the IBP. We have an operational budget of £24.7m. We currently employ 542 staff and we
work in a number of different settings in the community.

In line with National Policy, notably Transforming Community Services (TCS): Enabling new patterns of
care’ (DH, January 2009), and local intent (PCT Board decisions to separate the provision of services
from commissioning - March 2007 and July 2008) we have exercised our ‘Right to Request’ (DH,
November 2008) to become a social enterprise and take the opportunity to run our business without a
market test being applied. In essence, this Social Enterprise is being formed in order to satisfy the
commissioners desire to see an independent local community healthcare provider in the area and our
desire to be that local provider of choice.

This social enterprise aims to provide and invest in a wide range of community based health and social
care services for local people, when and where they need them. Social enterprises are able to retain
any surplus that are made to reinvest in services; such an obvious bonus.

We aim to deliver these services in partnership with others, particularly where services would benefit
from being joined up for the sake of our service users. Our future model of service is described in our
strategy chapter. This is a model that promotes a strong patient focus, community partnership and a
desire to be a local employer of choice. This business model is the vehicle that will help us deliver the
benefits to our members – ultimately this is a member based organisation of service users and staff –
and it is our members who will guide the developments signposted in this IBP.

To further draw out some of the key elements of the plan an extract from the pivotal Transforming
Community Services policy is provided here. It reads:

‘…to secure modern, high quality community services we also need to ensure that the organisations
providing them are fit for purpose. We need modern organisations, which enable and empower front-
line staff to innovate and free up their time to care for patients. Organisations which empower all
clinicians to shape the future of community services, and provide them with the support and resources
they need to be world class practitioners. Organisations which have a robust business infrastructure,




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capable of contracting with commissioners and effective business planning. Such organisations also
need to be sustainable and flexible – capable of evolving to meet an increasingly challenging
environment of rising patient expectations, more demanding PCT and practice based commissioners
(wanting higher service quality, more effective targeting of resources to need, and better value), and
increasing patient choice.’

This quote forms the perfect context for this Executive Summary. What is interesting about the TCS
guidance is that it came some time after NHS Kingston and its Provider Services had commenced the
journey to establish a local Social Enterprise called Your Healthcare. This in itself will tell you something
about the organisation we are separating from and the organisation that is being established. Clarity
of vision, sticking to agreed plans, strength of leadership and commitment of staff to play their role as
positive change agents – are just some of the attributes that have helped see this new venture grow
from something conceptual to a reality. And a pure and dogged determination to see benefits for
service users and all our staff helps too.

Taking each of the elements from the opening quote this Executive Summary will offer pointers to the
detail to be found in this IBP.

To secure modern, high quality community services we also need to ensure that the organisations
providing them are fit for purpose.

We believe that we are ‘fit for purpose’. An external review of our business potential was undertaken by
Newchurch Ltd at the beginning of 2008 and concluded that Provider Services was clinically viable,
managerially viable and financially viable. Subsequently Provider Services have undergone a series of
challenge and peer review assessments conducted by NHS London, our Strategic Health Authority, and
undertaken rigorous due diligence exercises, again carried out by NHS London supported by external
agencies such as Deloitte. These assessments have enabled us to hold the designation ‘Autonomous
Provider Organisation’ (March 2009) and latterly a ‘Business Ready’ (October 2009) organisation.

We need modern organisations, which enable and empower front-line staff to innovate and free up
their time to care for patients.

The IBP offers many examples of where we have or are planning to release more time to care, for
example face to face contact in District Nursing has improved by nearly 3%. This doesn’t sound much
but this increase amounts to many extra hours of patient time per week and a 15% reduction in cost per
contact. The narrative on performance, both last years and this year’s can be found in the section
entitled Your Healthcare Profile and here you will read about how we are collecting information to
enable us to share data like this that is meaningful, for us in terms of quality of care delivery but for our
commissioners also who wish to measure improved performance over time. We are busy working with a
partner organisation to develop a ‘health, wealth and happiness tracker’ to aid the monitoring of our
performance. In many ways it speaks for itself but you will find more on this in this section of the plan.

There is a whole chapter on our future service development plans which we first shared with a wide
audience in March this year following the PCT Board meeting. Remarkably, some of the plans have
been achieved already but they remain in this IBP for continuity as they form, in part, the basis of our
contract with our commissioners for this year. They also aid and enable the telling of a rich story of
service developments over time and in this respect they form an important element of the IBP.
Alongside these plans for the future you will find a prepared list of staff academy projects that still need
to be firmed up. These have been wholly generated from our front line staff; ever keen to innovate.
The projects reflect both local and national priorities which, when delivered, will realise much benefit to
our service users. We have just been nominated as a Department of Health’s ‘Right to Request’ first
wave pilot. This award comes with ‘transformational’ funding of £30,000 and we would like to use this
money to provide project management support to our local leaders so that these projects become
real and service improvements are delivered.

Organisations which empower all clinicians to shape the future of community services, and provide
them with the support and resources they need to be world class practitioners.




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Staff engagement in the continued development of the social enterprise, ‘our’ social enterprise, is
critical to its continued success. To maximize staff involvement we have developed a staff involvement
model called ‘Potential’ which has been shaped after much discussion and research into what works
well elsewhere. The principle function of the group is to inform and influence the Board of Your
Healthcare. They will keep the Board briefed on the key issues from our staff’s perspective; what’s going
well; what’s not going so well and what changes would make a difference to service users and staff
members alike. It is a non-hierarchical group and membership and representation could be drawn from
anywhere in the organisation. There is more on this unique group in the IBP. Staff involvement can take
many forms and we are, and have always been, committed to see staff side union affiliated
representation at Board level.

Resources have been identified to support our staff involvement at all levels in the organisation and this
includes investment in their professional and personal development too. We take our responsibilities for
work based learning and development very seriously and to this end have a well articulated learning
and development strategy and organisational development plan.

Clinicians and others have had to get used to constant change – some change is welcomed; some is
not. Managing change well amid a backdrop of uncertainty is something we claim to do well. The test
we ask you to take is to ask our staff how they feel and what they think about the future. Much of the
content of this IBP is focused on the workforce, sensibly, given that without a skilled workforce it would
be impossible to achieve many of the objectives referenced here. Just as organisations evolve so do
the systems for communication evolve. We have many ways of communicating and engaging with
our staff and these methods will continue for as long as they remain effective. We do share our staff
communication with our GP colleagues and other partners in care delivery to keep everyone abreast
of developments.

Organisations which have a robust business infrastructure, capable of contracting with commissioners
and effective business planning.

The governance of the organisation is clearly set out in the document and assessments of our
governance capability to date have been very favourable. Our senior management team has also
been through a number of personal and team assessments and again, the high level results are
contained within; team and personal effectiveness scores are very high.

This IBP offers much illustration of our robust infrastructure; we offer strategic action plans for all these
services as well as our clinical services because there is interdependence between them. The strategies
that we have developed for the support services are available in the suite of documents that
supplement the IBP. To aid our business planning capability we are in the process of further developing
a range of project management services which will be made available to implement and deliver IT
strategies and organisation wide individual projects. We have known many successes in our
infrastructure services, including the implementation of a new electronic patient record system that
connects to the national ‘spine’ for efficient and safe patient care tracking and management; we
were the first community provider to achieve this.

We know, like many others, that we need to continue to improve our contracting with our
commissioners but our commissioners would say that we will grow and develop alongside them as they
too develop their world class commissioning competencies and skills in commissioning from a social
enterprise. We haven’t done too badly though. We don’t think that there are many organisations with
a five year contract in place.

Such organisations also need to be sustainable and flexible – capable of evolving to meet an
increasingly challenging environment of rising patient expectations, more demanding PCT and
practice based commissioners (wanting higher service quality, more effective targeting of resources to
need, and better value), and increasing patient choice.’

We believe that we will continue to be sustainable and flexible. We have made a series of assumptions
in our IBP to enable us assess and plan for the growth of our business moving forward. We have also
modelled no growth scenarios as well, and we note with some confidence, that we remain viable. We
will not know if our assumptions are right until much later on in the life of our plan. We can be confident



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about whatever the future holds because at best, we can look to our past achievements in uncertain
and challenging times and be assured that we performed well; at worst we will be in a similar position
to others but we have a history of partnering well and this is a strategy that we wish to firm up some
more.

We will be able to better judge what our service users are looking for because they will be part of our
organisation, helping to shape its development. Imperatively, as a back-up if you like, we will continue
to commission external and independent patient satisfaction surveys. The findings from our first surveys
afford us much satisfaction but we will never be complacent in this regard.

Our financial position is strong; we are currently projecting a surplus for 2009/10 and have plans to invest
this. These plans are contained herein. We have a bid on the table with the Social Enterprise
Investment Fund and this is at an advanced stage of assessment. We know that we have the support of
our commissioners, who are keen to see us established to succeed.

We know that we offer professional, high quality services. These services are priced fairly. We have
researched our market and we know that there is room for us to be successful and grow in this market.
We are a reliable, innovative, flexible provider of services. We want to work in partnership with others to
realise the best outcomes for the communities we serve.

We hope to see Your Healthcare grow into the sort of organisation that people cherish because they
are involved in it and they understand how it works and it delivers what it says it will. We will be
accountable to our community in this respect and this plan is a method of continually monitoring our
performance. This is a plan that will see many reviews and updates; it is a living document.

We wouldn’t have got this far if it hadn’t been for the many people that have advised us and
supported us along the way. There are too many to mention in this Executive Summary but they are
referenced in the body of the plan. Our thanks are afforded to them for understanding where we are
coming from and where we want to get to and for helping us to translate that passion in the story that
is represented here.

We aim to be a high quality, high performance, and high trust business. This plan reflects that ambition.




Your Healthcare is the registered name of our business and will be the successor organisation to NHS
Kingston’s Provider Services.

This document can be adapted further for any reader on request. Please contact Siobhan Clarke at
siobhan.clarke@kpct.nhs.uk or telephone 020 83398044 if you would like help with this.

There is reference throughout the document to NHS Kingston and the PCT as if they were
interchangeable. The PCT is the statutory body that currently discharges the functions of commissioning
and service provision. The commissioning element of the PCT has been rebranded as NHS Kingston and
the provider element of the PCT is being rebranded as Your Healthcare. Your Healthcare is clearly the
subject of this IBP and any reference to NHS Kingston or the PCT is in respect of holding the
commissioning responsibility or a statutory accountability and duty.




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