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					                                                 NHS Dudley Board meeting – 27 May 2010
                                                      Report from TCS Programme Board
                                                                    Agenda item No: 4.3



TITLE OF REPORT:                      Report from TCS Programme Board

PURPOSE OF REPORT:                    To update the PCT Board on the progress of the
                                      Transfer of Community Services

REPORT PRESENTED BY:                  Kimara Sharpe
                                      Director of Community Engagement and Primary
                                      Care

BOARD LEAD:                           Jude Deakin, Non-Executive Director

KEY POINTS:                                     Seven projects set up
                                                Project initiation document has been
                                                 approved
                                                Risk register in place and being monitored

RECOMMENDATION TO THE                 The PCT Board is requested to note this report
BOARD:                                and approve the following in relation to the
                                      Community ENT service:

                                                To endorse the clinical advice that if
                                                 discussions relating to the transfer of
                                                 services to DGOH as part of the trading
                                                 arm prove fruitful that the tendering will
                                                 cease.
                                                To delegate this decision to the
                                                 programme board.

                                      The PCT Board is also requested to approve the
                                      terms of reference.


BOARD ACTION REQUIRED:                □ Decision
                                      x Approval
                                      x Assurance



27 May 2010 NHS Dudley Board – Public Item                              Page 1 of 12
TCS Programme Board
NHS Dudley strategic direction                     □ To help and encourage people be as
                                                     healthy as possible
                                                   □ To make sure health services meet the
                                                     needs of the local people
                                                   x To raise the quality of services

NHS Dudley goals                                   □ Tackling Obesity
                                                   □ Reducing Alcohol Misuse
                                                   □ Improving Mental Health and Wellbeing
                                                   □ Providing Systematic and Targeted
                                                     Prevention
                                                   □ Care at the Appropriate Setting
                                                   □ Improving our Urgent Care Services
                                                   □ Managing Long Term Conditions
                                                   □ Improving Patient Safety and Outcomes
                                                   □ Improving Patient Experience
                                                   □ Championing Innovation and Excellence
                                                   x Enabling

NHS Dudley WCC outcomes                            Enabling

View of the Professional Executive Committee       There is clinical engagement at each of the
or clinical lead(s)                                project teams

View of patients, carers or the public and the     Further discussion at the Healthcare Forum
extent of their involvement                        on 11 May

Implications on resources                          There are workstreams dealing with these
                                                   issues.

Legal implications                                 The PCT needs to be mindful of the CCP
                                                   guidance

Implications on quality and safety                 Major risks identified regarding the TCS
Assurance framework number                         programme
Risk register number

Implications on health inequalities                Care needs to be exerted so that health
                                                   inequalities are not widened as a result of
                                                   the transfer

Equality impact assessment                         Each project team needs to undertake an
Indicate how the outcome of the EIA has            EIA.
influenced the development of the content and
recommended outcomes in this report

Publication Required                               No
If the report is accepted by the board does this
require the report/strategy to be published as a
separate document from the Board Papers on the
Trust website and Publications scheme?




27 May 2010 NHS Dudley Board – Public Item                                  Page 2 of 12
TCS Programme Board
Executive summary

1      Introduction
       Work has commenced on the overall programme to divest ourselves of our
       community services.

2      Programme Board terms of reference
       The programme board terms of reference are attached for approval.

3      Project Initiation Document
       This has been approved by the Programme Board and is attached for
       information.

4      Project updates
       Seven projects have been set up.

4.1    Dental
       We are looking to transfer all services on 1 November 2010 to South
       Birmingham Community.

4.2    Learning disabilities
       The SHA has requested a lot of further information relating to the transfer of
       these services and the project team is currently working its way through them.
       We are still on track for transferring the LD services to Sandwell.

4.3    Sexual health
       The team has been set up to market test the service. Concern has been
       raised about the ability to undertake the market testing within the timeframe
       given.

4.4    Community ENT
       The tendering for this service continues. The Programme Board has agreed
       that in parallel to this exploratory talks and work is commenced to investigate
       whether the service can be transferred to DGOH as part of project 4.5. The
       Board is requested to endorse the clinical advice that if these discussions
       prove fruitful that the tendering will cease. If this decision is made then the
       programme board, on advice from the lead clinicians, will make it. The PCT
       Board is requested to delegate this power to the programme board.

4.5    Adult services
       A project plan is being drawn up regarding the transfer of these services.




27 May 2010 NHS Dudley Board – Public Item                         Page 3 of 12
TCS Programme Board
4.6    Children, Young People and Families
       This project has been split into 4 phases culminating in a report to the Board
       at the September meeting as per the PCT Board’s resolution on 31 March.

4.7    Social Enterprise
       The staff who have expressed interest in going for a social enterprise are
       being supported where appropriate. Business plans will go to the PCT Board
       in November.

4.8    Child health screening
       The final area of work is to transfer the child health screening service to FHS
       services. The SHA has not given us permission to do this so further
       information is being sought urgently as the transfer is nearly complete. There
       is no project team for this work.

4      Timeline
       The project is on track to deliver transfer of services by 31 March 2011.

5      Risks
       The programme board approved the risk register as below:

            Risk                                 Mitigation                        Colour
                                                                                   (score)
       1    Inability to execute the public      Contracts to be amended to        Red
            health agenda once staff have        reflect the need to deploy        (20)
            transferred                          staff at short notice.
       2    Capacity of staff to undertake the   Directors aware of work           Red
            work                                 required                          (16)
       3    Format of community contract –       Service specifications being      Red
            ability to robustly commission       written that are robust.          (16)
                                                 Finance and information
                                                 working closely to ensure
                                                 adequate data.
       4    Unknown impact of general            Communication channels            Red
            election                             are open to ensure that as        (15)
                                                 soon as further guidance is
                                                 issued the PCT will be
                                                 aware.
       5    Changes in commissioning             Service specifications being      Red
            arrangements for services – risk     written that are robust           (15)
            of discontinuity of care
       6    Risk of loss of staff due to         Robust two-way                    Amber
            uncertainty                          communication strategy            (12)
                                                 being developed
       7    Risk of loss of stability in         Robust analysis of residual       Amber
            corporate functions                  staff being undertaken            (12)
       8    Risk of instability of leadership    Mging director working            Amber
27 May 2010 NHS Dudley Board – Public Item                          Page 4 of 12
TCS Programme Board
               Risk                                Mitigation                          Colour
                                                                                       (score)
                                                   closely with mgt team               (10)
       9       Risk of detrimental impact on the   Transformation is integral to       Amber
               transformation agenda               the process and service             (9)
                                                   specifications will reflect this
       10 Risk of the configuration being          Assurance that decisions            Amber
          contested                                are being made in the               (9)
                                                   proper manner following
                                                   national guidance
       11 SHA does not approve the                 Work is currently being             Amber
          transfer configuration                   undertaken with the SHA on          (9)
                                                   the reasons why the
                                                   configuration was chosen
       12 Disruption for receiving                 Work is ongoing with                Amber
          organisations                            receiving organisations to          (9)
                                                   ensure that the transfer
                                                   takes place smoothly and in
                                                   liaison with other PCTs
       13 Risk of new configuration being          Work is currently being             Amber
          unstable financially                     undertaken to understand            (8)
                                                   the financial risk
       14 Risk of loss of programme staff          There is always a risk that         Amber
                                                   staff move for career               (8)
                                                   purposes
       15 Reduction in quality and patient         Work streams are in place           Amber
          safety                                   which will mitigate this risk       (8)
       16 Risk of inadequate resources to          A project manager has been          Amber
          execute the programme                    recruited. Admin support is         (8)
                                                   in place.
       17 Risk of stakeholder                      OSC planned for mid-July.           Green
          disagreement                             Healthcare forum discussed          (6)
                                                   May 10

6      Action required
       The PCT Board is requested to note this report and approve the following in
       relation to the Community ENT service:

                To endorse the clinical advice that if discussions relating to the transfer
                 of services to DGOH prove fruitful that the tendering will cease.
                To delegate this decision to the programme board.

       To approve the programme board terms of reference.

Kimara Sharpe
Director of Community Engagement and Primary Care


27 May 2010 NHS Dudley Board – Public Item                              Page 5 of 12
TCS Programme Board
May 2010




                                   Terms of Reference


         TRANSFER OF COMMUNITY SERVICES PROGRAMME BOARD




Version: 1.0

Terms of Reference approved by: PCT Board

Date approved:

Author: Programme Director

Responsible directorate: Chief Executive

Review date: August 2010




27 May 2010 NHS Dudley Board – Public Item              Page 6 of 12
TCS Programme Board
                                      NHS DUDLEY

         TRANSFER OF COMMUNITY SERVICES PROGRAMME BOARD

                                  Terms of Reference

1      Introduction
       The board will ensure that NHS Dudley divests itself of its provider services by
       31 March 2011 according to the requirements of NHS Dudley Board. During
       the transfer process, the board will be mindful of the requirement to maximise
       the opportunities for concurrent transformation.

       Constitution
       This committee, known as the Transfer of Community Services (TCS)
       Programme Board is established as a time limited sub committee of the NHS
       Dudley Board.

2      Membership
       Non Executive Director
       Lay member, DCS
       Staff Partnership Officer
       Chief Executive
       Director of Community Engagement and Primary Care
       Managing Director, DCS
       Director of Human Resources
       Director of Adult Social Care
       Clinical lead for DCS
       LINks chairman

       In attendance
       Project Manager

       Where a member cannot attend a nominated deputy should attend on behalf
       of that member with delegated authority.

       A list of the named members can be found in appendix 1.

2.1    Chair
       The Chair of the committee will be the non-executive director.

3      Arrangements for the conduct of business
       The programme board will meet monthly to oversee the implementation of the
       TCS programme.

27 May 2010 NHS Dudley Board – Public Item                         Page 7 of 12
TCS Programme Board
3.1    Chairing the meetings
       The Chair of the Transfer of Community Services programme board is Non –
       Executive Director. In the absence of the Chair, the chief executive will be
       chair.

3.2    Quorum
       Five members including one from DCS and one lay.

3.3    Frequency of meetings
       The programme board will meet monthly in the first instance, to be reviewed
       after three meetings.

3.4    Frequency of attendance by members
       Members are expected to attend meetings wherever possible and to send a
       deputy if necessary. If a member does not attend these meetings then the
       chair will discuss the issue with them.

3.5    Declaration of interests
       If any member has an interest, pecuniary or otherwise, in any matter and is
       present at the meeting at which the matter is under discussion, he/she will
       declare that interest as early as possible and shall not participate in the
       discussions. The Chair will have the power to request that member to
       withdraw until the TCS programme board consideration has been completed.

       All declarations of interest will be minuted.

3.6    Urgent matters arising between meetings
       It is expected that urgent matters will arise between meetings and where it is
       not possible for the programme team to resolve these, they will be resolved
       through discussion with the executive director lead and / or NED Chair of the
       programme board as appropriate and then discussed at the next meeting.

3.7    Secretariat support
       Secretariat support for the TCS programme board will be provided by a
       member of the Strategy & Innovation directorate.

4      Authority
       The programme board is authorised by the PCT Board to implement the
       programme of work agreed and submitted to the SHA on 31st March 2010.

5      Purpose and functions

5.1    Purpose

27 May 2010 NHS Dudley Board – Public Item                       Page 8 of 12
TCS Programme Board
       The purpose of the board is to ensure that the plans for the transfer of
       community services are progressed in line with agreed milestones and
       timescales.

5.2    Duties
       In discharging the purpose above, the specific duties of the Transfer
       Community Services Board are as follows:

          Overseeing the safe transfer of community services
          Provide an assurance role to the overarching process of integration
          Approve the Programme Implementation Document for the programme,
           including the project plans and budget
          Receive regular progress reports from the Programme Director, including
           progress against the plan and expenditure against budget
          Be responsible for the programme risk register
          To ensure that all opportunities for transformation of community services
           are exploited
          Consider any recommendations made by the Programme Director
          Approve and sign off the outputs from each stage of the programme
          Identify opportunities and projects for members of the Board and the wider
           community to get involved with and be heard
          Act as advocates and champions for the programme.

6      Relationships and Reporting (see appendix 2)

6.1    Reporting arrangements from the sub committees/groups
       The TCS programme team reports directly to the TCS programme board
       through the Director of Community Engagement and Primary Care.

6.2    Reporting arrangements
       The TCS Programme Board will report to every board during the transition
       period (to March 2011).

7      Review of Terms of Reference
       These terms of reference will be reviewed after three months.


Insert date: May 2010

Insert reference:     g:\gov\tcs\tcs_programme board tor




27 May 2010 NHS Dudley Board – Public Item                        Page 9 of 12
TCS Programme Board
                                                                                                                Appendix 1

                                                              NHS DUDLEY

                                                           TCS Programme Board

           Member                                                               Deputy
         Insert job title             Add member’s name                      Insert job title   Add member’s name
   Non Executive Director                Jude Deakin                        Chief Executive        Sarah Dugan
        Lay chair DCS                    Danielle Oum                      Lay member DCS          Tony Cooke
  Staff Partnership Officer             Jackie Garland
  Managing Director, DCS                 Tessa Norris                      Associate director   Sally Anne Osborne
       Chief Executive                   Sarah Dugan                      Programme Director      Kimara Sharpe
          HR Director                  Mandy Shanahan
   Director of Community                Kimara Sharpe                      Associate director   Sally Anne Osborne
 Engagement and Primary
             Care
   Clinical representative             Mary Akufo-Tetteh
Director of Adult Social Care           Linda Sanders                      Associate director    Brendan Clifford
       LINk chairman                     David Orme
        In attendance
      Project Manager                        Sam Dhillon

                                                           TCS Programme Team

      Member                                                                    Deputy
    Programme                       Kimara Sharpe                         Sally Anne Osborne
      Director
    Information                       Fran Gillett                            Jane Hanson
27 May 2010 NHS Dudley Board – Public Item                          Page 10 of 12
TCS Programme Board
DCS representative               Sally-Anne Osborne               Tessa Norris
 Communications                     Laura Broster                 Steve Corton
  and Community
    Engagement
   Market testing                Stephanie Cartwright           Michael Sullivan
       Dental                        Sue Cooper                  Hazel Smith
      Finance                       Matt Hartland
     Learning                        Neill Bucktin           Carol Richardson/Lisa
Disabilities/Sexual                                                 Johnson
       health
   Adult Services                  Caroline Salmon                Tessa Norris
 Children Families                  Valerie Little                 Anna Dodd
and Young People
    Contracting                      Julie Argenteri            Caroline Salmon
  Estates IT and                     Kevin Gaffney               Jim Dempster
      facilities
    Governance                      Paul Couldrey               Rachel McCarty
         HR                        Mandy Shanahan               Jackie Freeman
 Project Manager                     Sam Dhillon




27 May 2010 NHS Dudley Board – Public Item              Page 11 of 12
TCS Programme Board
                                                                                                                                                  Appendix 2
                                                                  NHS DUDLEY

                           Accountability of the TCS Programme Board

                                                                       Dudley PCT Board




                                                                      Transfer of Community
                                                                       Services programme
                                                                              Board



                                                                           Programme
                                                                             Director




                                                                        Programme Team




                                    Project 2
                                                                                                                Project 6
               Project 1            Learning            Project 3          Project 4            Project 5                        Project 7
                                                                                                               Children and
             Dental Services       Disabilities       Sexual Health     Community ENT         Adult Services                  Social Enterprise
                                                                                                                Families




            Comissioning and   Estates, Facilities,                                            Engagement/
                                                        Finance            Information                         Governance     HR and Workforce
              Contracting              IT                                                     communications




27 May 2010 NHS Dudley Board – Public Item                                                                                     Page 12 of 12
TCS Programme Board

				
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