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.