Merger Blueprint Workshop

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					The Merger Blueprint
Creating the South East London Healthcare NHS Trust

February 2009
Version 3.0

Private & Confidential




                                                 NHSL Feb 09 A7
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Document control

 Version   Date                  Drafted by       Input

                                                  Lorraine Knight, Jennie Hall, Ruth Russell, Louise
 1.0       30th   January 2009   Grant Thornton   McKenzie, Elisa Steele, David Wragg, Lynn
                                                  Saunders, David Sulch


 2.0       06th February 2009    Grant Thornton   Chris Streather, Molly Baack, Anna Klonowski.



 3.0       10th February 2009    Grant Thornton   Chris Streather




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Contents

Purpose of the Document              4
Summary                              5
Overview of the Merger               7
Organisational Structure           18
The Merger Programme               22
Day 1 Planning                     27
Communications for Day 1           32




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The purpose of this document

»   Set out the strategic rationale for the merger
»   Provide an overview of key merger objectives and a broad merger timeline
»   Provide an overview of the synergies to be realised as a result of the merger
»   Establish the key deliverables for the merger
»   Establish the key principles for the merger
»   Detail the objectives, scope and governance of the programme to control the merger
»   We will use this document to retain focus on the tasks ahead and to answer questions on
    the merger




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Summary




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Creating the South East London Healthcare NHS Trust

Bromley Hospitals NHS Trust, Queen Elizabeth Hospital NHS Trust and Queen Mary‟s Sidcup
NHS Trust will merge on 1st April 2009 to form the South East London Healthcare NHS Trust
This Merger is the first step in delivering improved patient care for South East London


On 1st April 2009 it will continue to be business as usual for all the hospitals within the
combined Trust, Our Patients and Our workforce:
   There will be no change to how, where and when patients receive acute care
   There will be no change to the level of patient care - patient safety will not be compromised



Over time we will face challenges and overcome them in partnership to build a Trust that will
be clinically, operationally, and financially stable


This will enable us to create a sustainable, quality organisation for local people that will be the
first choice for patients receiving clinical care throughout South East London




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Overview of the Merger




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Rationale for merger

To react to the changing future of Acute health care provision
»   Requirements are changing - more patients are treated locally or at home
»   It is envisaged the current structure would not provide a viable future for the three current Trusts
»   Anticipated changes will be easier to plan and deliver through a larger more stable organisation
To respond to the many drivers for change in South East London
»   Need to return to run rate balance and resolve historic debts
»   Provide more efficient and effective back office functions
»   Attract and retain talented staff for key posts
To enable the effective implementation of wider change within the NHS such as:
»   Service provision programmes such as A Picture of Health (APoH)
»   Regional strategies as are articulated in the Dazi Review (e.g. Stroke and major Trauma)
»   An ability to work with PCTs who are charged with delivering “world class commissioning”
»   Collaboration with AHSC provides opportunities for acute Trusts
To build a Trust that will be able to achieve foundation status 2011-2014



»

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The new Trust vision......

There are currently two statements relating to the vision for the merger:
»     The newly formed Trust will work to a shared vision to underpin the process of merging BHT, QEH and
      QMS to create a new organisation and the process of onward development to the achievement of
      Foundation Trust status.
      source: “Proposal for organisational merger of Bromley, Queen Elizabeth and Queen Mary’s NHS Trusts”



»     We want the new Trust to be “best in class” in all it does. It will be looking to recruit the best and the
      brightest people. It will be defining standards of care, levels of staffing and clinical cover, governance
      structures and financial and operational targets which will place the new Trust at the forefront of patient
      care and clinical excellence.
      source: www.safeandsound-selondon.nhs.uk
                                                                                                       onward
                              clear                    clinical             best in class
    become a                                                                                         development
                           governance                excellence
    foundation                                                   optimal levels of   defining
       Trust                   top quality patient                   staffing      standards of
                 shared vision       care          new organisation
                                                                                                     patient care
                          achieving developing, recruiting and retaining the
                           targets
                                                          best and brightest
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Objectives of the merger

»   To use our combined skill and experience to build an organisation that is in a position to
    respond adequately to external and internal changes
»   Deliver cost effective, best in class patient care without compromising patient safety
»   Re-organise our operational around our services/divisions rather than our hospitals in line
    with APoH
»   Become the Trust of choice for patients and to develop a critical mass which enables the
    us to achieve of Foundation Trust status by 2011/14
There are three key pillars that will enable the Trust to Deliver this objective:
              Clinical and
              Operational




                                               Workforce




                                                                               Financial
               Stability




                                                Stability




                                                                               Stability
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Clinical and Operational Stability


                                           To achieve our objective of delivering a Trust which demonstrates
                                           operational stability we must:
      Clinical and Operational Stability




                                           »   Deliver uncompromised patient safety
                                           »   Meet our national, clinical care and clinical risk management targets
  Financial                                »   Deliver 8 week planned care targets and 4 hour A&E targets
  Stability                                »   Ensure that all our regulatory and statutory obligations are met
                                           »   Implement a standardised governance approach to managing the new Trust
                                           »   Work together to develop best of breed operational practices
                                           »   Work together to resolve capacity management and service availability issues
                                           »   Develop a stronger relationship with our external stakeholders
                                           »   Improve patient care
                                           »   Become the provider of choice
                                           »   Address and resolve, as one team, outstanding operational and service issues.
                                           »   Implement better capacity management strategies
                                           »   Maintain levels of local delivery




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Workforce Stability


                            To achieve our objective of delivering a Trust which has workforce
                            stability at all levels we must:
                            » Make permanent appointments to the Board and wider Management Team
                            » Leverage our workforce‟s combined skills and experience to deliver improved
  Financial                   service provision to our patients
      Workforce Stability




  Stability                 » Provide greater certainty and opportunities for career progression to all our
                              medical and non medial staff
                            » Develop our key talent whilst attracting experienced and skilled individuals to
                              complement our existing talent pool
                            » Increase workforce retention
                            » Nurture strong and effective leaders who are empowered to lead
                            » Operate in a clear and uncomplicated governance structure with an agreed
                              decision making and conflict resolution process
                            » Motivate our workforce to promote one Trust and one culture
                            » Build a flexible workforce
                            » Achieved working-time directive compliance




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Financial Stability


                            To achieve our objective of delivering a financially stable Trust we
                            must:
                            » Deliver £2.5 m saving in senior management overheads by May 09
                            » Achieve run rate balance within 23 months
  Financial
                            » Deliver quantifiable back office cost savings
      Financial Stability




  Stability
                            » Reduce our reliance on interim staff and management
                            » Centralise procurement and leverage buying power
                            » Consider outsourcing where possible and practical
                            » Improved financial reporting ultimately through a single system




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Long term objectives

Once we have achieved stability in the new Trust we will be in a position to deliver
other benefits, for example:
» Greater flexibility in workforce planning with staff working across hospital sites and into community
  settings
» Enable on the delivery of other projects such as Pathology
» The efficient implementation of APoH (see additional slide)
» Collaboration with AHSC provides opportunities for us as an Acute Trust
» The ability to work with PCTs in the delivery of “world class commissioning”
» The ability to rapidly react to changes in legislation and other compliance regimes
» Develop specialised service for local patients (cancer and stroke units)


Ultimately by achieving these long term objective we will have become the hospital of
choice for patients and staff in South East London and will have achieved foundation
status between 2011-2014




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 The relationship between the Merger and APoH

 A Picture of Health (APOH), which is due to report on 30th March 2009 concerns the delivery of patient-centric
 services closer to home in the community and at primary care centres. This out-of-hospital care policy will involve
 significant clinical service re-configuration. Only patients that require care in acute setting will be referred to hospital
 for treatment
 The formation of the South East London Healthcare NHS Trust is seen as a key enabler of the implementation of
 APoH
 Once the merger has successfully achieved its objectives of financial, workforce and operational stability, it will be
 in a strong position to implement the finding of APoH
 If APoH is not implemented there is still a requirement for a programme within the South East London Healthcare
 NHS Trust to deliver better patient care and reduce operating costs.


    Some
                           Development of service
Elements                  capacity, infrastructure of      Clinical Pathways re-design         Rationalisation of A&E Units
                                                                                                                                   Re-configuration of Medical
 of APOH                                                                                                                             Assessment Services
                         community and primary care
      Potential Impact




                         • Understanding of supply &       • Building a divisional             • Decommissioning services        • Understanding of supply &
                           demand in SE London.              structure that is best in class     in acute care                     demand in SE London.
                         • Streamlining acute care         • Developing best of breed          • Re-locating acute care in the   • Developing best of breed Medical
                         • Attracting specialist acute       Clinical Models                     community,                        Models
                           care to SE London.              • Developing key talent in our      • Requirement to balance any      • Patient care and outcomes are
                         • Building a flexible workforce     divisions                           potential financial losses        not to be compromised through
                           under a divisional structure.   • Attracting the best clinicians      with fixed cost overheads         inadequate capacity and facilities
                                                                                                 (e.g. facilities)




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To deliver our objectives we need to apply some key principles

Externally
»   We must continue to deliver a quality service to our patients
»   We must engage all stakeholders in the merger
»   We must use clear and consistent messages
»   We must demonstrate and communicate how the new Trust will
    benefit our stakeholders
»   We must provide clarity and assurance to our stakeholders in terms
    of our objectives and implementation plans




                                                                                             Internally
                                                              »     We must focus on business as usual
                                                              »     We must work together to develop the best possible Trust for the
                                                                    future

    The reality is it’s                                       »     We must not change anything unless we have fully understood the
                                                                    consequences of the change.


    Business as Usual
                                                              »     We must make sure our patient safety is not compromised
                                                              »     We must ensure clear governance arrangements are in place
                                                              »     We must value and retain our people
                                                              »     We must ensure there are clear accountabilities for delivering each
                                                                    element of the merger
                                                              »     We mush communicate with our people openly, honestly and on a
                                                                    timely basis
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The benefits for the merger

»      Merger will yield immediate savings through reduction in management costs (~£2.5m) and
       within the context of a £400m organisation, it will provide more scope for future savings
       beyond those currently projected by the individual Trusts
»      Ultimately it is the goal of the South East London Healthcare NHS Trust to demonstrate
       and achieve Foundation Trust status.

                                                                        Potential Annualised
                                      Benefit                                                  Cost to Deliver   Delivery Timeframe
                                                                          Financial Benefit

    Length of Stay Reduction                                                   £11m            Not quantified          2011

    Estate and site utilisation optimisation                                    £6m            Not quantified      Not quantified

    Reduction in QMS Overheads                                                  £6m            Not quantified      Not quantified

    Reduction in Board numbers                                                  £2.5           Not quantified        March 09

    Reduction (halt) in the cost of interim managers                       Not quantified      Not quantified      Not quantified

    Reduction in the number of senior managers                             Not quantified      Not quantified      Not quantified

    Leverage procurement benefits achieved by greater size                 Not quantified      Not quantified      Not quantified

    Improved asset utilisation                                             Not quantified      Not quantified      Not quantified

    Operational efficiency programmes across a much greater cost base      Not quantified      Not quantified      Not quantified

    Standardisation of PFI commitments                                     Not quantified      Not quantified      Not quantified



                                 Further quantification, planning and costing to be done in order to submit a
                                 business case to the Trust Challenge Board
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Organisational Structure




                           NHSL Feb 09 A7
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Organisational Structure - Overview


                 Current                                          Day 1                                              Oct 09

  The three NHS Trusts current          Appointments are made to 5 key                           Appointments are made to the
  operate autonomously in their         posts, the remainder continue as                         remaining 7 senior positions
  delivery of medical and some back     transitional roles.                                      There is a transition to the
  office functions.                     These posts are removed from the                         divisional organisational structure
                                        current hospital structures.                             at each of the hospitals
                                        Hospital COOs report directly in to                      South East London Healthcare
                                        the SELH NHS Trust CPP with                              NHS Trust, operates through one
                                        other relationship continuing                            clear organisational structure in
                                        through dotted reporting lines as                        line with the proposed divisional
                                        required                                                 structure.



                                                                  Tran.
                                                                                                                      CEO
                                                                  CEO



      Existing    Existing   Existing
                                                       Transitional Management Team                              Management Team
       Trust       Trust      Trust



                                            Existing             Existing             Existing
                                                                                                      Division       Division      Division
                                             Trust                Trust                Trust




                     The phased transition to divisional management in the South London
                     Healthcare NHS Trust
                                                                                                                                              NHSL Feb 09 A7
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Organisational Structure (Day 1)

Key Changes:
•    Appointment of 5 key posts as highlighted in
     green on day 1                                             CEO
•    Remaining roles are transitional
•    Hospitals continue to function with dotted
     reporting lines to in post and transitional
     leaders as required



                                           Director of HR and
            Director of Finance                                 COO                    Director of Nursing           Medical Director
                                                   OD



                                                                                                                                      Director of
                                               Director of                                                                             Infection
                                                                        Director of Estates             Director of IMT
                                               Business                                                                             Prevention and
                                                                           and Facilities
                                              Development                                                                               Control


                                                                                         Director or Service           Director of
                                                                                            Improvement              Communications
Additional dotted
reporting lines to
 transitional and
appointed leaders
will exist at Day 1               Bromley Hospitals NHS Trust         Queen Elizabeth Hospital                            Queen Mary‟s Sidcup

                              Revised Management Structure       Revised Management Structure                         Revised Management Structure




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Organisational Structure (Oct 09)

Key Changes:
•   Appointment of the remaining 7 senior                                   CEO
    positions
•   Transition to divisional organisational
    structure at the lower levels




                                           Director of HR and
           Director of Finance                                              COO                        Director of Nursing                    Medical Director
                                                   OD




                                                                                                                                                            Director of Infection
                                           Director of Business                       Director of Estates                   Director of IMT                   Prevention and
                                              Development                                and Facilities                                                           Control



                                                                                                        Director or Service                     Director of
                                                                                                           Improvement                        Communications




                                                                                 Unplanned Care and Specialist                           Women and Children's, and clinical
                                      Planned Care Division
                                                                                       Medicine Division                                        Support Division
                                        Divisional Director
                                                                                        Divisional Director                                        Divisional Director




                           Divisional Director       Divisional Director   Divisional Director        Divisional Director           Divisional Director          Divisional Director
                             of Operations               of Nursing          of Operations                of Nursing                  of Operations                  of Nursing


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The Merger Programme




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Merger Programme Objectives

»   Minimise any disruption from merger activities to the day to day business
»   Deliver merger benefits on time and to budget
»   Manage the merger, on time and to budget
»   Build strong working relationships between our teams
»   Maximise the sharing of knowledge, experience and best practice
»   Quickly resolve key issues through the merger Programme Governance structure
»   Communicate Project Board decisions and direction consistently and on a timely basis




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Merger Programme Governance
                                                       Organisational Reconfiguration
                          Joint Committee                                                DP, CS, MD, DW, LMc, LS, ES, DS, JH, JU, RH, RS
                                                               Project Board

                                                       Organisational Reconfiguration
                                                                                         Chris Streather
                                                             Project Executive

                Integration Programme Office
                                                            Integration Director         To be Appointed
                Anna Klonowski



 Medical                                    Bromley                            Queen                            Queen Mary’s
 David Sulch
                                       Hospitals NHS                         Elizabeth                           Sidcup NHS
 Non-Medical                                   Trust                      Hospital NHS                               Trust
 Jennie Hall
                                                                               Trust
 Finance
 David Wragg

 HR
 Louise McKenzie

 ICT
 Elisa Steele

 Communications
 Molly Baack

 Planning and SLA
 Lynn Saunders

 Estates and Facilities
 John Mills

 Operations
 Louise Knight / Ruth Russell




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Major risks to the integration programme

                                                   Risk Description                                                    Probability   Impact

Key resources continue to leave during the merger causing knowledge loss, lack of business continuity and extending
                                                                                                                          High        High
the merger timetable

Cash consumption in the new Trust is higher than expected                                                                 High        High

Decisions are not made on a timely basis which impacts BAU performance as well as merger timeframes                       High       Medium

The organisational structure is not properly communicated to those impacted by the changes , resulting in confusion
                                                                                                                         Medium       High
and breakdown in governance.
Regulatory requirements for Day 1 are not delivered. The New Trust is not able to operate the hospitals on Day 1
                                                                                                                         Medium       High
leading to a breakdown in service.

Staffing issues at some hospitals may result in wards not being able to be staffed unless staff are able to move
                                                                                                                         Medium       High
between each hospitals

Current projects and support will be affected by the merger and will cause problems with BAU                             Medium      Medium

Cultural implications of the merger are neglected and the organisation fails to integrate / does not feel like one
                                                                                                                         Medium      Medium
organisation

An integration Director is not appointed to take responsibility for the delivery of the Day to Day merger programme.      Low         High

Patient Service Quality and safety are compromised due to staff and patients moving between sties in an uncontrolled
                                                                                                                          Low         High
way.

Immediate cost savings are not realised further increasing the financial instability of the Trust                         Low         High

Sign off for communications process is unclear, resulting in mixed messages                                               Low         High

APoH is not taken forward and reducing the impact of the merger in the long term.                                         Low         High




                                                                                                                                     NHSL Feb 09 A7
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    Performance against the Blueprint



                                                                                                                             2011
                                                                                                                             » APoH Implemented
                                                                                               2010                          » Run rate balance
                                                                                                                               achieved
                                                                                               » Enhanced patient
                                                                                                                             » Foundation Trust
                                                                October 2009                     experience embedded
                                                                                                                               Application initiated
                                                                                               » Combined financial
                                                                » New board fully appointed                                  » T&Cs harmonisation
                                                                                                 reporting capability
                                                                » Divisional structure                                         commenced
                                                                                                 rolled-out
                               Day 1                              implemented                                                » Single financial reporting
                                                                                               » Joint Management
                                                                » APoH implementation plan                                     suite
                                                                                                 Conference held
                               » Transaction completed            developed                                                  » Single set of systems
Pre Day 1                                                                                      » Single brand in place
                               » New Trust governance is        » Plan for common finance                                      and process across
                                                                                                 across the Trust
                                 launched                                                                                      business
» Chairman and                                                    systems development and      » Year 1 ICT strategic plan
                               » All staff transferred to new     being implemented                                          » Culture change
    transitional Management                                                                      implemented
                                 Trust under TUPE               » Detailed capital plan                                        programme completed
    board in place                                                                             » Implementation of APoH
                               » Plans in pace to deliver
»   All regulatory                                                delivered                      underway
                                 DOH targets in 09/10           » One IT support network
    permissions obtained for
                               » Emergency plan for New           implemented
    new Trust
                                 Trust implemented
»   SLA planning for new                                        » OD and Talent
                               » All phase 2 Directors put at     Management programme
    Trust completed and
                                 risk of redundancy               initiated
    submitted
                               » Leadership development
»   Proactive comms plan                                        » Integrated HR and Payroll
                                 programme launched               Systems implemented
    developed and
                               » Go-live for rebranded          » One remuneration policy in
    implemented with
                                 website and intranet sited       place
    patients and staff
                               » Day 1 rebranding complete
»   New telephone number                                        » Medium term plan agreed
                               » New bank accounts in             with Trust Challenge Board
    and IVR launched
                                 place and operational,         » Implementation of medium
                                 finance team                     term plan underway.
                               » Submission to Trust
                                 Challenge Board in draft


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Day 1 Planning




                 NHSL Feb 09 A7
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Key assumptions for Day 1 – 1st April 2009

»   On 1st April 2009 the three Trusts will merge into one Trust and the Trust will be branded "South
    London Healthcare NHS Trust“ – Day 1

»   Patient safety must not be compromised

»   Our Directors will be visible to the workforce and our stakeholders

»   Operationally very little will change, all the hospitals will continue to operate as they do today

»   Business as usual is the priority - the patients will not experience any change in the quality of
    care received

»   There will be no sharing of services or movements of staff and patients on Day 1

»   The legal employing entity will change for all employees to the „South London Healthcare NHS
    Trust‟

»   All contracts with or for services provided by the current 3 Trusts will be transferred or novated
    to „South London Healthcare NHS Trust‟

»   The Compulsory Statutory Relationship with oversight bodies will be maintained




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What do we need to do on Day 1 (excluding Comms)

Organisation Structure                                                   COO
» CEO and Chairman appointed                                             » Combined performance and target reporting in place
» Key Directors appointed to key roles, reporting lines in place         ICT
» No other roles & responsibilities will change                          » New domain names secured and websites launched
» Employees effected by organisational change supported and              » Branding changes to website launched
   coached appropriately so that they understand the changes to          » Changes to Switchboard and IVR implements
   reporting lines
                                                                         » All e-mail addressed changed to “@nhs.net”
HR                                                                       » Ensure that changes to Trust registrations are reflected appropriately
» Top level organisation structure implemented
                                                                         Medical and Non Medical
» Residual TUPE issues resolved
                                                                         » Repeat message to all medical and non medical staff that there will
» No changes to T&Cs, policies, and pensions at Day 1 confirmed to all
                                                                            be no movement of patients or staff between departments
   staff
                                                                         Planning and SLA
Finance
                                                                         » All required registrations are obtained to enable the hospitals to
» Ability to report as one Trust in place
                                                                            operate
» FY09/10 budgets communicated to budget holders
                                                                         » All procedural requirement are complete to enable the hospitals to
» Changes to authorisation mechanisms communicated                          operate
                                                                         Estates
                                                                         » All leaseholds novated to new Trust name
                                                                         » New name badges issues to management
                                                                         » Signage and Letter head to be updated / replaced at all locations.




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 Draft High Level Milestone Plan for Day 1
               19 Jan 09                  02 Feb 09                       16 Feb 09                   02 Mar 09                    16 Mar 09                     30 Mar 09                  13 Apr 09
                                                                                                               Agreed overarching emergency plan for new Trust (71)
                                             Determine transitional structure for safeguarding vulnerable groups (74) re-iterate message re not transfers
Medical                                                                                                                                                             Clinical Governance in Place (76)
                                                                                                                      of staff or patients
                                                              Divisional Director Job Description (466)                                                   NHSLA standards section 1 in place (483)
                                                                                        Develop command and control functions for implementation (440)
Non-medical                    Ensure ability to implement major
                                                                                      Develop action cards for key functions to integrate (443)

                                              incident plans (436)
                           Review of PCT commissioning                    Publication of business              Open new bank accounts (235)                                   combined reporting launched
Finance                          intentions complete (199)                  plans schedules (209)
                                                                                                                                         FY09/10 budgets communicated
                Costing of Trust Management                   Due and Careful enquiry completed (216)
                                                                                                                                    Launch finance staff consultation (225)
                            etc complete (204)         Inform Audit Commission of Merger (232)
                                                                                                                  Existing NHS employees transferred under TUPE (137)            Support for impacted staff
                         Gain Joint Committee approval to proposed board structure (25)
                                                                                                                                                                              One Occupational Health
HR                                                        Chairman Appointed (107)                                                     New OD strategy in place (168)
                                                                                                                                                                              programme in place (184)
                                                                   Transitional Directors in place (111)             Leadership development programme initiated (169)         JDs developed for all posts (100)
                  Start Development           ICT Inventory Completed (387)                                             Complete Development activities (245)                 Go-live all sites (249)
                  activities (245)
ICT             Order new phone
                                             Establish list of systems affected by Trust names (251)                     Launch single phone number (375)                     Roll-out .nhs e-mail addresses (360)
                number and IVR (370)                                        Agree methodologies for single management reporting (353)        Sign off manual reporting mechanism (356)

                  Develop Vision, Mission and Objectives for the New Trust            Chairman's introductory letter to all staff             CEO          e-mail communicating TUPE process outcomes
                                                                                                                                              Road
Comms                                       Communication re Secretary of State Approval
                                                                                                   Rational communicated to                   shows
                                                                                                                                                                               Day 1 Comms activities completed
                                   Public announcements following Trust board meetings                  external stakeholders                 start        External Stakeholder focus groups held
                 Prepare and share merged assumption (273)                Negotiate details of SLA (275)              Finalise Capital Development Plans (322)
Planning and
SLA              Submission of APoH business                         Contracts agreed to NHS London                         Confirmation that all registrations have
                    plans to NHS London (330)                                          time table (282)                    been obtained to allow Day1 to happen
Estates and                                                                                                                                     all leaseholds novated        All signage updated to
Facilities         No detailed Day 1 planning completed                                                                                             to new Trust Name         new Trust Names
                                                                                                                                                      Launch combined         Launch combined
Operations         No detailed Day 1 planning completed (re Operational plans for                                       FY09/10)                         target reporting     performance reporting
                                                                                                    SHA Approve Merger (16)         Governance frameworks in place (42)
Programme         Establish Statutory Requirements for April First (48)                                Secretary of State Approves Merger (20)
                                                                                                                               Confirmation of registration with CQC (57)

                                                            Today

                          Milestones
                                On schedule / on target, no issues
                                Minor issues or slippage, will not impact overall delivery
                                Major issues or slippage, may delay or reduce delivery                                                      n.b. number in brackets correspond to line items on the
                                                                                                                                            PMO Day 1 Planning Gantt Chart.
                                Milestone achieved or Completed
                                                                                                                                                                                              NHSL Feb 09 A7
                                                                                                                                                                                                page 30 of 41
Rebranding on Day 1

It is fundamental that we only concentrate on the things that we absolutely must do to maintain
our legal and regulatory compliance, the following will need to be re-branded by Day 1:
        Letterheads
        Invoices
        Payslips
        Websites (re-branded with a "top-level" website www.****.nhs.net to be which direct patients and
         3rd parties to South East London NHS Trust)
        Intranet Sites
        Switchboards and IVR
        Email addresses (all email address to become nhs.net)
        Official signage (e.g. Queen Elizabeth Hospital: part of the South London Healthcare NHS Trust)
        Senior Executive Business Cards


On Day 1 the following will not be re-branded:
        Staff Uniforms
        Choose & Book




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Communications for Day 1




                           NHSL Feb 09 A7
                              page 32 of 41
Charter for Communication and Change

»   A critical requirement for the successful merger is the delivery of an effective
    communication and change management programme. This reflects the need to gain “buy
    in” from the staff of all three Trusts who are effectively key stakeholders
»   The attached communications plan maps out an agenda for delivering key messages to all
    stakeholders and supports the integration programme management. In doing so it will
    enable the programme to demonstrate clear leadership, deliver consistent and clear
    messages, promote staff engagement and facilitate the wider acceptance and support for
    the merger process
»   Communication will be delivered through a variety of mediums, including face to face
    sessions, project meetings, departmental meetings, regular e-mails, and external
    communications. A central aspect of the communication plan is to encourage and capture
    stakeholder feedback through regular engagement and incorporate such into future
    communication
»   Effective communication will support the required organisational change management,
    ensuring staff understand the benefits and opportunities of the merger and feel
    empowered to continuously deliver quality work in the successfully merged Trust




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Core Messages




                                      We are creating a
                                     sustainable quality
                                    organisation for local
                                     people . We want to
                                    be the first choice for
                                       clinical care for
                                     patients throughout
                                     South East London




                Aiming for excellence in all what we do - A world class hospital
                 providing excellent patient care and is the employer of choice

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Internal Stakeholder and key messages


               Staff
                                   The merger will relieve current recruitment problems by
                                   providing greater certainty for all staff and patients. It is a
                                   management change not a service change and frontline staff
           Clinical staff          are not affected. There will be no perceived changes on Day 1


            Consultants
                                   The merger will create critical mass and the Trust will be able
                                   to define itself as a significant health provider, there by
                                   becoming a powerful ally for the emerging South East London
        Current Executives
                                   Academic Health Science centre


        Management teams           The merger will provide opportunity to create a new platform
                                   for delivering top quality services, primarily through the
                                   implementation of APoH
    Picture of Health Executives

                                   The merger will focus on organisational change to improve
           NHS Partners            services and guarantee quality of care to our patients




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External stakeholder and key messages…….


             Patients              Nothing will to change for you on Day 1.
                                    The merged Trust will provide the critical mass that enables
                                   the NHS to develop sustainable and resilient clinical services
                                   into the future. It will help ensure financial resilience and
   Patient Representative Groups
                                   stability. It will also mean that the NHS in South East London
                                   will be able to develop, recruit and retain the leadership it
                                   needs to provide world class quality health services to the
               PCT                 local community


           Local People            The merger is restricted solely to organisational change. No
                                   changes will be made to clinical care. The focus is on
                                   improving management and organisational arrangements to
         Local Authorities         ensure we have a resilient organisation going forwards to
                                   implement other initiatives such as APoH

               MP's
                                   It will provide the opportunity to create a new platform for
                                   delivering top quality health services to the local community in
              Media                the future




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Internal Communication prior April 1st

                                                                  Initiator/Sign
        Who           To Whom      Frequency       Channels                                         What
                                                                  off, Start date
                                                                                    • Core brief to communication leads
Project executive   Executive                                                         and executive teams to be used for
                                  Fortnightly   e- mail           ongoing
Team                Team                                                              internal communication and to
                                                                                      update intranet
                                                face to face,
                                                                  One week
Chief Execs         Staff         Once          newsletters- e-                     • TUPE process outcome
                                                                  before Day1
                                                mail
                                                                                    • Reassure staff and reinforce agreed
                    all four                    road show         one week before
CEO & SRO                         Once                                                messages about future of the
                    hospitals                   meetings          Day1
                                                                                      merged Trust
                                                                                    • Public announcement following
                                  After Board                     23/24/25
Board               All sites                   usual channels                        Board meetings on each site, to
                                  meeting                         February
                                                                                      announce decision on the merger
                                                e- mail, letter
Trust Chair         All sites     Cone                            24/2              • Introduction after appointment
                                                Press release
                                                                                    • Immediate information after
DH                  All & Media   Once          Press release     26/3                Secretary of State decision in early
                                                                                      March
CEO and                                                           One month         • Walkabout during March once a
                    all sites     once a week   face to face
Transitional Team                                                 before Day1         week at all hospitals




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External Communication prior April 1st

                                                                                   Initiator/Sign
        Who                 To Whom              Frequency          Channels                                         What
                                                                                   off, Start date
                                                                                                     • Core brief to media rational of the
Project executive                                                                 2 weeks before
                         Media                  to be decided   written                                merger, reinforce agreed messages
Team                                                                              Day 1
                                                                                                       about future of the Trusts
                                                                face to face,                        • Emphasize quality and safety for
Project executive                                                                 1 week before
                         Patient Groups         focus groups    newsletters- e-                        patients and reinforce messages
Team                                                                              Day 1
                                                                mail                                   about future of the Trusts
                                                                                                     • Highlight quality and safety and
Project executive        MPs                                    group meetings    1 week before
                                                focus groups                                           reinforce messages about future of
Team                     (not Cross Party)                      face to face      Day1
                                                                                                       the Trusts


Communication Lead to prepare in advance

• Prepare material for merger announcement during Week 1
• Coordinate Farewell events for Boards
• Posters / leaflets available in all clinics
• Draft articles for Trust magazine
• Update signage - corporate NHS logo and issue letterhead
• Develop new website




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Day 1 and beyond communication

Date / Time            Event                     Site                             Lead                          Invitees

                                                          April 1

9am – 11am         Board meeting          Queen Mary's Sidcup       All transitional Exec and NED team            Board

                                                                    Chair, CE, QMS management team
  11.30am        Staff open meeting              QMS                                                             All staff
                                                                            (Med Dir, Dir Ops)

  12.15pm         Walking the floor              QMS                            Chair, CE                        All Staff

                                                                     All Exec and NED team, Bromley      All staff invited to meet
   1pm          Lunch in dining room              QE
                                                                            management team                      the team

  1.30pm          Walking the floor               QE                 Chair, CE, other available Execs            All Staff

                                                          April 2

   2pm            Walking the floor            Bromley               Chair, CE, other available Execs            All Staff

                                                                       All Exec and NED team, QE
  3.30pm      Meet the team over coffee        Bromley                                                           All Staff
                                                                            management team




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How are we going to communicate with them?

»   The following communication channels have been identified as the most suitable methods
    through with to communicate and facilitate feedback with all stakeholders
»   Stakeholder engagement will be encouraged by providing easy to use feedback
    mechanisms

                    Cascade Channels                                Feedback Channels
      » Launch Events – alternating between all three   » Central email address
        Trusts                                          » Phone line support
      » Presentations                                   » Drop-in sessions
      » Targeted audience emails
      » Website (Internet & Intranet)
      » Information for patients
      » Structured meetings
      » Kick off Meetings Day 1
      » Posters / Leaflets




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                                                                                          page 40 of 41
Communication Architecture

                                                                                   Cascade


                                                                                   Feedback
                                    CEO
   Internal
Communication


   Bromley

                                                           Project Exec Team
    QMS                          Comms Lead                         +             PMO
                                                          Integration Director



    QEH




                         External Communication

             Patients   Locals            Government   Media




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