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					Ref                          WMSHA                                              Cluster Cross Ref.
                        Recommendation
1     Establish effective and consistent programme       Recommendation # 3 – Review structure of SHA and LHC/LHE
      management arrangements at LHC level               Programme Boards and their roles




2     Appoint senior level Programme Manager in each
      LHC



3     LHCs to take responsibility for consolidation,
      management and escalation of local project risks
4   LHCs to have overall responsibility for local plans




5   SHA to be proactive in further development of         Recommendation # 1 – Change focus of CPB, clarify role and review
    Cluster wide decision making framework                membership
                                                          Recommendation # 3 – Review structure of SHA and LHC/LHE
                                                          Programme Boards and their roles
                                                          Recommendation # 4 – Provide clarity over the extent to which
                                                          individual Trusts/PCTs can take decisions regarding NPfIT
                                                          implementation, and in particular the decision making authority of Chief
                                                          Executives as ‘accountable officers’
                                                          Recommendation # 10 – Cluster SRO to agree respective roles of
                                                          Cluster and NPfIT and accountability of Cluster team with National
                                                          Programme Board
6   SHA to provide senior level input to the proposed     Recommendation # 1 – Change focus of CPB, clarify role and review
    new Cluster Programme Board and sub-group             membership
    structure                                             Recommendation # 2 – Establish Sub-Groups to support the CPB




7   Strengthen SHA-level programme management             Recommendation # 3 – Review structure of SHA and LHC/LHE
    arrangements                                          Programme Boards and their roles
                                                          Recommendation # 12 – Establish joint Programme Support Office




8   Take steps to improve relationship with CSCA within
    WMS
9    Establish structured reporting and standardised   Recommendation # 14 – Establish structured reporting and
     Highlight Report template                         standardised Highlight Report template




10   Consider introduction of Balanced Scorecard for   Recommendation # 13 – Develop CPB Balanced Scorecard
     SHA




11   Implement improved Programme Board report packs Recommendation # 15 – Improved CPB Report Pack




12   Implement IT support for programme management     Recommendation # 17 – More automation of programme management
     and reporting




13   WMS to pro-actively support implementation of   Recommendation # 19 – Adopt national template across whole Cluster
     Cluster-wide recommendations on risk management Recommendation # 20 – Provide more feedback on escalated risks
                                                     Recommendation # 21 – Review risks on regular basis
                                                     Recommendation # 22 – Define risk management responsibilities
                                                     Recommendation # 23 – PSO to maintain risk register
                                                     Recommendation # 24 – Reinforce best practice risk management
                                                     principles
14   Implement a joint SHA and CSCA risk register       Recommendation # 19 – Adopt national template across whole Cluster
                                                        Recommendation # 23 – PSO to maintain risk register




15   Programme Boards to focus on management of ‘top Recommendation # 15 – Improved CPB Report Pack
     ten’ risks                                      Recommendation # 21 – Review risks on regular basis

16   SHA to work with Cluster and CSCA to improve local Recommendation # 27 – Develop better understanding of contract at
     understanding of contract                          local level




17   Improve overall planning across the SHA            Recommendation # 25 – Document process for signing off all plans
                                                        Recommendation # 26 – Start planning earlier and make it more
                                                        inclusive




18   SHA and LHCs to be responsible for impact analysis Recommendations # 30 – More impact analysis by CPB
     of local plans and changes to plans
19   Pro-active approach required to managing          Recommendation # 28 – Capture and manage interdependencies
     interdependencies between NPfIT and service
     development priorities




20   Implement SHA wide approach to benefits         Recommendation # 31 – Mandate new guidance on Benefits
     management and realisation Document process for Management and Realisation
     signing off all plans                           Recommendation # 32 – ‘Operationalise’ Benefits Management and
                                                     Realisation
                                                     Recommendation # 33 – Prioritise Benefits
                                                     Recommendation # 34 – Ensure all ‘enablers’ linked to benefits are
                                                     being managed


21   Implement structured approach to learning and     Recommendation # 35 – Structured approach to learning and evaluation
     evaluation across the SHA
                                    Issues & Actions
                                  Output from Workshop
Workshop consensus:
* WMS content with proposed LHC role in both the Secta reports, although the management
of interdependencies needs to be tightened.
* Cost implication for setting up a Programme Support Office (PSO) in each LHC could be
prohibitive - not sure there would be appetite for this

ACTIONS: Review Progamme Support requirements to see if some resources can be
pooled rather than creating dedicated PSO in each LHC




ACTIONS: Appoint a programme manager in each LHC




There is a need for greater local review of risks and issues. There is too much risk logging
and insufficient risk management. This would be a key role for the Programme Manager at
LHC level. Joint review with CSC would hasten decisions.

ACTIONS:
1. Role of Programme manager at LHC to incorporate risk management
2. CSC and WMSHA to discuss how joint management would be possible at LHC and SHA
levels.
ACTIONS: Ensure all LHCs have all interdependencies - within NPfIT and between
NPfIT and other initiatives - included in their local plans




Action with Cluster Team - workshop on 29th March 2005




No further action until Cluster receive feedback from all SHAs and finally confirm
membership of CPB. CSC idea of replicating sub-groups at SHA level not taken forward -
would introduce another unnecessary level of management.

There are, however, practical implications for implementation of CPB sub-groups:

1. Will senior execs have time to attend the Sub-Board meetings given the other meetings
they have to attend?
2. High risk that same person will need to attend more than one sub-group because of
overlaps
3. Need clear objectives and authority for sub-groups
4. Need right mix of people to ensure effective decisions are taken

Action with Cluster Team
Workshop consensus

* WMS content with proposed SHA role in both the Secta reports, although decisions for
SHA programme board need greater clarity. Furthermore, attendance at SHA progamme
boards an issue
* No requirement for a new dedicated Performance Management Team to support the SHA
programme board as this is already happening 'in principle'


ACTION: Martin Galloway to set up workshop with WMSHA to start to define the local
programme charter
Form of standardised report template rests with Cluster. However, greater standardisation of
reporting difficult to achieve unless:

* Reports are automated so that data presented to programme boards is very current (not
weeks in arrears) - see recommendation 12
* Programme managers are appointed in each LHC
* Mechanisms are put in place to ensure honest reporting yet avoid too much detailed
reporting
* Staff have received more programme/project management training

ACTIONS:

1. Progress reports are to be signed off locally by both CSC and NHS staff. This will
help to develop relationships. Few if any implementation issues, although SHA
should discuss implications of this with both Cluster and CSC
2. Appoint programme managers to all LHCs
3. Conduct programme/project management training needs analysis
Use of the Balanced Scorecard will need further consideration - not discussed in detail
during workshop due to time constraints. Best practice is to design the tool top down, and
therefore the SHA programme board scorecard should be designed first. SHA will need to
take account of Cluster scorecard, but SHA should still proceed even if Cluster scorecard is
delayed or not implemented. Worcestershire LHC already using the Balanced Scorecard
concept and conducting a 'dashboard' trial with Microsoft

Post-Workshop ACTION suggested by Secta: John Thornbury to report back to SHA
programme board once his 'dashboard' trial is complete
Worcestershire LHC have already adopted a report pack structure not too dissimilar to the
one recommended by Secta

ACTIONS:
1. All LHCs to adopt report pack structure recommended by Secta. There is also a
link to the new IT system that will be procured by the SHA to assist programme
management.
2. Ensure key decisions for each SHA programme board meeting are made explicit in
the meeting agenda
ACTIONS:
1. WMSHA to procure IT to support programme management including report
production. Alerting mechanism is another key requirement
2. Charles Goody to report back at the next SHA programme board with IT options
3. SHA to discuss with Cluster implications of procuring local IT system

Part of the problem lies in a lack of criteria for where decisions can be taken and clearly
defined roles at LHC level and for Implementation managers at Cluster. Implementation
managers from Cluster might improve current situation but open access would allow owners
to be chased. Current poor feedback due to lack of visibility to register and insufficient
proactive management of risks. There is also a training issue.

ACTIONS:
1. WMSHA to raise risk management at decision controls workshop.
2. WMSHA to ensure Implementation manager plays a risk management role for the
SHA with the Cluster.
3. Risk management training needs to be reviewed.
Projects currently use different system from SHA. Should be a single visible system kept on-
line. Clearer documented process for escalation. Should have shared views with CSC
though not necessarily a single joint system. A shared risk tool between CSC and WMSHA
would be best maintained by a joint PSO. All risks are not equal. Financial impact is one
criterion for ranking but there are others. It was felt that joint management of the Risk
register would allow top priorities to be agreed for reporting to Board.

ACTIONS:
1. Colin Bexley and Martin Galloway to review way forward looking at CSC's risk
tool/process. List of alternative tools given by Secta.
2. CSC and WMSHA to discuss possibility of shared PSO for NPfIT.
Included under recommendations 11 and 13 above


Action with Cluster Team to re-submit 'idiot's guide' to the contract

ACTION FOR WMS: In accordance with Secta report produced for SHA, need specific
agreement on local interpretation of the contract for local plans. SHA and LHCs
should work with the Cluster and CSC Alliance to ensure absolute clarity for future
planning



Workshop consensus was that sign off process is not a key issue. However, the actual
agreement of plans needs to be formalised.

ACTIONS:
1. CSC/Cluster to advise SHA earlier when planning support tools will be available
2. CSC/SHA/LHCs to reinforce/remember that this programme is about transformation
and not just IT
3. All interdependencies to be included in local plans



ACTIONS:
1. Impact analysis to be part of regular SHA and LHC planning and monitoring
function, not a one off exercise.
2. As per Seta report to SHA, LHCs and the SHA to carry out impact analysis of any
changes for their local communities and for the SHA as a whole, and for reporting to
Cluster level. This should be done once a full plan capturing all interdependencies
has been created
As per Secta report to SHA, SHA has a key role in consolidating its five LHC plans and in
helping manage their interdependencies. This should be a regular function not an annual
process.

Although interdependency management needed, the implication of undertaking is: does the
SHA/LHCs have the staff with both the time and knowledge to this 'joined up' planning?

ACTIONS:
1. Create SHA holistic view of the programme - a route map
2. To save time and avoid reinventing the wheel a) confirm what work David
Nicholson has been doing in this area and b) Charles Goody to present the
Transformation Mapping work (conducted 12-18 months ago) at the next SHA
programme board meeting

Post-Workshop ACTION suggested by Secta: Tony Lunt to share work in progress
linking interdependencies relating to benefits realisation

Not discussed during workshop due to time constraints.

Benefits realisation to be a feature of report pack. (Note by Secta: benefits realisation can
be monitored through the balanced scorecard. This is also consistent with new NPfIT
guidance on benefits realisation.) No further action required.




Not discussed during workshop due to time constraints
                        Worcs LHC                                             Worcs LHC
                       Actions Taken                                     Further Actions Rqd.
1. Review of ToR complete - felt to be appropriate,         1. Sign off of new ToR (July)
however, for consistency have adjusted (draft) to reflect   2. Complete TNA for Programme & Project
high level elements of SECTA recommendation #3.             Management (June)
2. Membership felt to be appropriate - in addition, a       3. Complete training packs for pm roles (Sep)
number of support groups exist - Clinical Advisory Group,
Technical Advisory Group, Primary Care Working Group
(in conjunction with SHA), Information Governance
Group, Project Managers Forum.
3. A full time ICT Programme Manager is supported by 5
full time and 1, 3/5 wte ICT Project Managers. Each has
a TNA under development to cover Prince2 Practitioner
and Management of Risk (Foundation). We are seeking
an appropriate Configuration Management specialist
course for the PSO Officer. We are working with Social
Care to develop an appropriate set of short courses for
those involved in projects - e.g. Board Roles, 1 day
Executive insight into PM, Lunchtime Bytes - What's in a
Project etc..




1. Full time Programme Manager in post for 5 years.




1. Management of Risk directed through Project Boards, 1. Complete piloting of Project Summary tool.
then to Programme Manager and Worcs ICT Programme (July)
Board. Managemnt by exception in place with clear
escalation process.
2. Interim tool under construction to ensure consistent
approach to scoring risk with weighting according to
degree of risk evident in project, allowing for semi
automated escalation to Project Board, Programme
Board and SHA.
1. Local LHC plans reflect LDPs. Workshops held to
ensure priorities are reflected in ICT plans, recognising
the NPfIT / CfH timetables and existing ICT national
targets.
2. Clinical Informatics Dept is ensuring that the link with
service leads is strengthened.


1. No. LHC reps already sit on Cluster level bodies -
Primary care, Ambulance.
2. John Thornbury acting as SHA rep. for Primary Care
(General Practice) development.




Linked to above




SHA action - Worcs provides monthly performance report
and interim reports as requested.




Cluster action - Worcs contributes to debates as
requested.
1. Worcs provides monthly performance report and        1. Meet with Bernard Considine to create
interim reports as requested following standardised     project brief (July)
templates wherever possible.
2. Interim tool under construction to ensure consistent
approach to scoring risk with weighting according to
degree of risk evident in project, allowing for semi
automated escalation to Project Board, programme
Board and SHA.
3. Worcs ICT Programme Manager to work with Bernard
Considine to consider options for standardising toolset




1. As above                                             1. As above




1. As above                                             1. As above




1. As above                                             1. As above




1. SHA / Cluster Action                                 1. Complete piloting of Project Summary tool.
1. Management of Risk directed through Project Boards, (July)
then to Programme Manager and Worcs ICT Programme
Board. Managemnt by exception in place with clear
escalation process.
2. Interim tool under construction to ensure consistent
approach to scoring risk.
3. Support SHA review of appropriate tools.
4. Local project implementing MoR service tool.
1. As above                                            1. PSO training to be found. MoR training to be
2. PSO to be formally training in configuration        confirmed (July)
management, incl MoR




1. As above                                            1. As above


1. Plans under regular review.                         1. Ensure plan articulated and circulated
                                                       appropriately :-
                                                         a. Review plan structure
                                                         b. Ensure Comms & Engagment Plan at
                                                       Programme level up to date (July)
                                                         c. Review consistency of messages with SHA
                                                       / Cluster (July)


1. Sign off process via Worcs ICT Programme Board led 1. Ensure planning cycles understood at an
by PCT CEO and attended by service leads, provides    early stage. Commence 2005/6 (for 2006/7)
clear link to LDP process.                            review in August.
                                                      2. ICT / LDP event to be planned for Oct(?)




1. Sign off process via Worcs ICT Programme Board led 1. Formal policy to be developed and
by PCT CEO and attended by service leads, provides       distributed. (Aug)
clear link to LDP process.
2. Clinical Informatics Dept ensures more proactive link
to service leads on a regular basis.
1. As above




1. SHA Actions                                             1. Cotinue developing local tool for Benefits
2. Benefts managed incrporated into ealy planning cycle Realisation - ensuring consistency with SHA /
to ensure clear link between national and local service    Cluster.
priorities, balancing the ability to support these through
national and local ICT initiatives.
3. Support of processes through Clinica Informatics
Dept.


1. Countywde ICT ETD lead in post.                        1. Refine ICT TNA to reflect growing
2. Specialist ICT TNA and budget available for 4 years.   programme / project / management of risk
                                                          training requirements.

				
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