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ISI Plan template - ISIP template

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					Using this template
          Ano provides a suggested structure for your Integrated
This documentLHC Integrated Service Improvement Plan Service Improvement Plan. You can complete the
sections in stages as you progress through Integrated Service Improvement Planning, the first of four steps in the ISIP
roadmap.
You are advised to: (a) save a copy of the template for        External tools
future reference; (b) switch on the ¶ button on the main       You can create some of the content, especially the
menu while becoming familiar with the template.                summary diagrams and the outcomes links (D) in
The template uses a few basic paragraph styles: standard       separate PowerPoint and Excel files.
headings 1 – 2; body text; table text; table headings; body    In these cases you are recommended to:
and table bullets. There are variations in alignment and
colour for specific uses.                                        use the separate files to create the content
Guidance notation                                                copy the bits you want to include in the plan and
                                                                  paste special as a picture in the appropriate
These italics indicate underlying template usage
                                                                  locations (indicated by placeholder pictures)
‘instructions’ to be read and deleted.
Text in italics like this indicates content guidance, to         maintain the information in the separate file, re-
be replaced in normal font.                                       pasting when it changes.

Text like this is intended to suggest part of the              Headers and footers have different styles for portrait
content.                                                       and landscape pages.

This symbol cross-references the activities described 1.9      In general, rows in tables are set not to break across
                                                               pages. You will have to allow rows to break across
in the guidance available at nww.isip.nhs.uk/roadmap
                                                               pages if you lose text in a table at the bottom of a page.


         ANO

         Local Health Community


         Integrated Service Improvement Plan


                                                                                        Draft Version 0.01
                                                                                               dd Mmm yy




         553d3c08-f926-44c6-b7c4-25cf1902d3c6.doc                                                          1-Aug-10
         NHS Integrated Service Improvement Programme:
         Strategy and Benefits Template, Step 1
Ano LHC Integrated Service Improvement Plan



Document Control

Amend this page to comply with local documentation standards and practices.
 Title                  Ano Local Health Community
                        Integrated Service Improvement Plan

 Author/Editor

 Owner(s)

 File Ref



 Approver                                     Role




                                             Change History

 Version         Date      Author/Editor             Summary of Change




Contents

LHC Organisation, Governance and Participation                                1

Executive Summary 1 – Strategic Context                                       2

A: Drivers, Challenges and Enablers                                           4

B: Care Delivery System (vision and gap analysis)                             8

C: Priority Objectives and Outcomes                                           15

D: Outcomes and integrated change programmes                                  16

E: Integrated Change Programme Mandates                                       17

Executive Summary 2 - Timeline and Links                                      18




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NHS Integrated Service Improvement Programme:
Strategy and Benefits Template, Step 1
Ano LHC Integrated Service Improvement Plan
                                                                             Pre-
LHC Organisation, Governance and Participation                               req

The ISIP approach needs each participant in the LHC to commit to working together.
Success will also be dependent on joined-up governance for the LHC. This section
encourages you to describe who is in the LHC, who is impacted by it but is not
participating, and what governance arrangements are in place to manage the integrated
change planning and implementation process.

Participating NHS organisations



Other participating organisations



Other organisations impacted



Readiness




                     Ano LHC Integrated Service Improvement Board
                                       and Team

 Trust/org         Name              Position              Specific discipline/role

                                                    Chair and LHC ISI Executive Sponsor
                                                    LHC (ISI) Board Member
                                                    LHC (ISI) Board Member
                                                    LHC (ISI) Board Member
                                                    LHC (ISI) Board Member


                                                    LHC ISI Team Lead
                                                    LHC ISI Team Member


                                                    Xyz Contributor/Representative




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NHS Integrated Service Improvement Programme:
Strategy and Benefits Template, Step 1
                             Ano LHC Integrated Service Improvement Plan


                             Executive Summary 1 – Strategic Context
                             Either use the separate PowerPoint (see next page, delete contents on this page) or use the objects on this page and delete this line.   1.9

                                                                                                                                     1      Priority Objective
                             1                      2                        3




                                                                                                                                                                                   Objectives
                                                                                                                                     2      Priority Objective
  Care Delivery Principles




                             Health equality        support individual       Care provided in
                             across populations     wellbeing                the right setting
                                                                                                                                     3      Priority Objective

                                                    5                                                                                4      Priority Objective
                             4                                               6
                                                    Timely, convenient
                             Appropriate access                              High quality
                                                    and responsive                                                                   5      Priority Objective
                             and choice for all                              clinical outcomes
                                                    services

                                                    8                        9                                                   1       Change Programme




                                                                                                                                                                                   Programmes
                             7 Optimise
                                                    Efficient and            Financial balance                                   2       Change Programme
                             workforce capacity
                             and capability         effective delivery of    across the local
                                                                                                                                 3       Change Programme
                                                    services                 health economy
                                                                                                                                 4       Change Programme
                                                                                                                                 5       Change Programme
Drivers & Challenges




                                                                                                                                                                                   Enablers
                                                                       Challenge
                                                                       Challenge
                                                                       Challenge
                                                                       Challenge
                                                                       Challenge
                                                                       Challenge




                                                                                                                                 Enabler
                                                                                                                                 Enabler
                                                                                                                                 Enabler
                                                                                                                                 Enabler
                                                                                                                                 Enabler
                                                                                                                                 Enabler
                                                          Challenges
                                        Driver
                                        Driver
                                        Driver
                                        Driver

                                        Driver
                                        Driver
                                        Driver
                              Drivers
                                        
                                        
                                        
                                        
                                        
                                        
                                        


                                                                       
                                                                       
                                                                       
                                                                       
                                                                       
                                                                       




                                                                                                                                 
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                                                                                                                                 
                                                                                                                                 
                                                                                                                                 
                                                                                                                                 
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                             NHS Integrated Service Improvement Programme:
                             Strategy and Benefits Template, Step 1
Ano LHC Integrated Service Improvement Plan


Delete the placeholder picture below, create the executive summary using the PowerPoint template, and paste here, then delete this text,

                                       Care Delivery System                                                                                                                            Priority Objectives
                                                                                                                                                                     1. priority objective
            Principle 1                                            Principle 2                                        Principle 3

               Health equality                                 Support individual              Care provided in the                                                  2. priority objective
             across populations                                   wellbeing                        right setting

                                                                                                                                                                     3. priority objective
            Principle 4                                            Principle 5                                        Principle 6
                                                                                                                                                                     4. priority objective
             Appropriate access                                Timely, convenient              High quality clinical
              and choice for all                              and responsive care                  outcomes
                                                                                                                                                                     5. priority objective

            Principle 7                                       Principle 8                      Principle 9

             Optimise workforce                                   Efficient and                        Financial balance                                             1. change programme
                capacity and                                  effective delivery of                     across the local
                 capability                                          services                           health economy                                               2. change programme




                                                                                                                                                       Programmes
                                                                                                                                                        Integrated
                                                                                                                                                                     3. change programme




                                                                                                                                                         Change
                                                                                                                                                                     4. change programme
                                       Drivers / Challenges




                                                                        Drivers / Challenges




                                                                                                                                Drivers / Challenges
                Drivers / Challenges




                                                                                               Drivers / Challenges




                                                                                                                                                                     5. change programme

                                                                                                                                                                     6. change programme




                                                                                                                                                                          Enabler(s)



                                                                                                                                                                                         Enabler(s)



                                                                                                                                                                                                      Enabler(s)



                                                                                                                                                                                                                   Enabler(s)



                                                                                                                                                                                                                                Enabler(s)



                                                                                                                                                                                                                                             Enabler(s)
                                       Drivers / Challenges
                                                                                                                                                                                                      Enablers

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NHS Integrated Service Improvement Programme:
Strategy and Benefits Template, Step 1
Ano LHC Integrated Service Improvement Plan


A: Drivers, Challenges and Enablers
The following tables have been pre-populated with suggested elements. Review and
                                                                                                   1.1
modify these, as well as adding the LHC’s own perspective on national and local drivers,
challenges and enablers.


Drivers                                       LHC status                            Timing
What local and National policy changes are                                          Deadline?
significantly impacting the LHC’s planning    What is the current LHC status with   By when does the
horizon?                                      respect to each driver?               LHC plan to comply?

Standards for Better Health (including NICE
guidance)
Commissioning a Patient-led NHS
Payment by Results
Practice Based Commissioning
Workforce policies, legal requirements and
regulations, including:
 Modernising Medical Careers
 Improving Working Lives
 National Mental Health Workforce
  Strategy
 Redesign of the Role of Nursing in
  Mental Health
 European Working Time Directive
 Equality and Diversity
 Junior Doctor Training
 Pensions Review
Mental Health White Paper/Bill/Act


Local Drivers                                 LHC Status                            Timing




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NHS Integrated Service Improvement Programme:
Strategy and Benefits Template, Step 1
Ano LHC Integrated Service Improvement Plan


Challenges                                     LHC status                            Timing

What local demographic, social and/or health                                         Are there any timing
service changes are significantly impacting    What is the current LHC status with   constraints or
the LHC’s planning horizon?                    respect to each challenge?            expectations?




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NHS Integrated Service Improvement Programme:
Strategy and Benefits Template, Step 1
Ano LHC Integrated Service Improvement Plan


Enablers                                        LHC status                            Timing

                                                                                      When is the enabler
What enabling initiatives will be utilised to   What is the current LHC status with   planned or expected
assist the LHC over the planning horizon?       respect to each enabler?              to happen?

10 High Impact Changes (and 10 High Impact
changes For Mental health) ie
  Change No1: Treat day surgery as the
   norm for elective surgery
  Change No2: Improve access to key
   diagnostic tests
  Change No3: Manage variation in
   patient discharge
  Change No4: Manage variation in
   patient admission
  Change No5: Avoid unnecessary follow-
   ups
  Change No6: Increase the reliability of
   performing therapeutic interventions
   through a Care Bundle approach
  Change No7: Apply a systematic
   approach to care for people with long-
   term conditions
  Change No8: Improve patient access by
   reducing the number of queues
  Change No9: Optimise patient flow
   using process templates
  Change No10: Redesign and extend
   roles
NHS Connecting for Health
  Choose and Book
  CRS
  PACS
  ETP
  N3
Workforce development
  Agenda for Change
  Improving Working Lives
  Workforce Redesign
  Implementation of Modernising Medical
   Careers
  Consultant contracts
National Service Frameworks
National Procurement Projects
Single Assessment Process



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NHS Integrated Service Improvement Programme:
Strategy and Benefits Template, Step 1
Ano LHC Integrated Service Improvement Plan


Enablers                                        LHC status                            Timing

                                                                                      When is the enabler
What enabling initiatives will be utilised to   What is the current LHC status with   planned or expected
assist the LHC over the planning horizon?       respect to each enabler?              to happen?


Local Enablers                                  LHC Status                            Timing




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NHS Integrated Service Improvement Programme:
Strategy and Benefits Template, Step 1
 Ano LHC Integrated Service Improvement Plan


 B: Care Delivery System (vision and gap analysis)                                                                                              1.4
                                                             1.2
Care Delivery                                                                                                                                 Rank or
Principle       ISIP CDS Explanation          LHC Vision & Future State            LHC Current State                       Gap                Priority

1. Health       Inequality is societally      Use the ISIP CDS Explanation to      Describe the LHC’s current   Describe the gaps that need    1–9
equality        unfair – good health          create a local description of each   performance & capability     to be closed for each Care
                                                                                                                                              and/or
across          remains the primary           Care Delivery Principle that         with respect to each Care    Delivery Principle to move
populations     purpose of NHS.               articulates the LHC’s vision for a   Delivery Principle.          the LHC from its current
                                                                                                                                              H/M/L
                                              patient-led NHS. These                                            state to its desired future
                Ensuring fairer access for
                                              descriptions should take account                                  state.
                all by sharing health                                                                                                         and/or
                                              of the drivers, challenges and
                insight across agencies to
                                              enablers outlined earlier in the
                identify populations                                                                                                           RAG
                                              template. They may also make
                experiencing health
                                              use of the characteristics of a
                inequalities and inequities
                                              high performing Care Delivery
                in accessing health and
                                              System available on the ISIP
                social care services.
                                              website.
                Redesigning and
                                              Where the LHC’s vision relates to
                integrating services around
                                              a timeframe that is longer than
                the needs of disadvantaged
                                              the current planning period, use              1.3
                communities, actively to
                                              this column or insert another
                address health inequalities
                                              column to identify or highlight
                experienced by
                                              the part(s) of the vision that can
                disadvantaged
                                              be achieved within the planning
                communities and groups.
                                              period. ISIP refers to this subset
                                              of the vision as the LHC’s desired
                                              future state.




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 NHS Integrated Service Improvement Programme:
 Strategy and Benefits Template, Step 1
 Ano LHC Integrated Service Improvement Plan


Care Delivery                                                                                            Rank or
Principle       ISIP CDS Explanation           LHC Vision & Future State       LHC Current State   Gap   Priority

2. Support      Enabling individuals to
individual      keep well – fulfilling their
wellbeing       potential for well being
                and a long and healthy life
                - by education,
                encouraging self
                management and proactive
                identification and
                management of risk.
                Supporting and engaging
                individuals in achieving
                their potential for
                empowerment, self help
                and the maintenance of
                personal independence and
                wellbeing.

3. Care         Providing a range of
provided in     integrated services and
the right       packages of care, tailored
setting         to individual need and
                preference: maximising
                independence and avoiding
                unnecessary use of hospital
                based services by
                proactively managing
                people with long term ill
                health or disabling
                conditions, through
                improving early and local
                access to specialist
                diagnosis and developing
                care support outside of
                hospital to avoid

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 NHS Integrated Service Improvement Programme:
 Strategy and Benefits Template, Step 1
 Ano LHC Integrated Service Improvement Plan


Care Delivery                                                                                            Rank or
Principle       ISIP CDS Explanation          LHC Vision & Future State        LHC Current State   Gap   Priority
                unnecessary
                admissions/readmissions;
                avoiding needless
                admission to hospital,
                ensuring hospital stays are
                only for clinical reasons;
                supporting patients at
                home with rehabilitation
                and care; ensuring dignity
                at end of life.
                Developing services which
                deliver freedom from:
                avoidable death and
                disease; needless pain and
                suffering, mental and
                physical; erosion of
                independence or feelings
                of helplessness; loss of
                dignity and respect;
                unwanted delay; waste of
                resources, whether time,
                money or human spirit.




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 NHS Integrated Service Improvement Programme:
 Strategy and Benefits Template, Step 1
  Ano LHC Integrated Service Improvement Plan


Care Delivery                                                                                            Rank or
Principle        ISIP CDS Explanation         LHC Vision & Future State        LHC Current State   Gap   Priority

4.               Maximising independence
Appropriate      by empowering patients to
access and       make informed choices of
choice for all   which pathway of care
                 meets their individual
                 needs best.
                 Improving access for
                 communities or individuals
                 who currently experience
                 inequity, discrimination
                 and stigma, by
                 implementing transparent
                 and fair rules with
                 decisions devolved closer
                 to patients.




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  NHS Integrated Service Improvement Programme:
  Strategy and Benefits Template, Step 1
 Ano LHC Integrated Service Improvement Plan


Care Delivery                                                                                             Rank or
Principle       ISIP CDS Explanation           LHC Vision & Future State        LHC Current State   Gap   Priority

5. Timely,      Building confidence and
convenient      removing needless fear and
and             uncertainty by redesigning
responsive      the journeys to and from
services        clinical care, including
                preventative interventions
                and diagnostics.
                Improving responsiveness
                to, and shaping care
                around, the diversity of
                needs and circumstances
                among service users,
                patients and carers,
                respecting individual
                differences and
                preferences and offering
                real choice, wherever
                practicable.
                A more personalised
                pathway through services,
                based on needs at
                different stages of life and
                a health maintenance
                philosophy.




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 NHS Integrated Service Improvement Programme:
 Strategy and Benefits Template, Step 1
 Ano LHC Integrated Service Improvement Plan


Care Delivery                                                                                             Rank or
Principle       ISIP CDS Explanation           LHC Vision & Future State        LHC Current State   Gap   Priority

6. High         Ensuring patients receive
quality         appropriate, high quality,
clinical        safe care, which is also
outcomes        free at the point of access,
                by rigorous systems of
                standard setting,
                education, governance and
                inspection.
                Ensuring clinical services
                are consistently evidence-
                based, protocol-driven,
                safe and of a high
                standard.

7. Optimise     Ensuring that staff have
workforce       the knowledge, skills and
capacity and    competences that will
capability      empower them to provide
                high quality, responsive,
                patient-centred care.
                Maximise employee
                engagement by ensuring
                that staff know what is
                expected of them, have
                the resources (equipment
                and skills) to work
                effectively and
                opportunities to learn and
                grow within the health and
                social care system.
                Individual staff are
                supported, engaged and
                rewarded.

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 NHS Integrated Service Improvement Programme:
 Strategy and Benefits Template, Step 1
 Ano LHC Integrated Service Improvement Plan


Care Delivery                                                                                            Rank or
Principle       ISIP CDS Explanation          LHC Vision & Future State        LHC Current State   Gap   Priority

8. Efficient    Streamlining care pathways
and effective   and administrative
delivery of     processes to: manage
services        input costs by making
                optimum use of resources,
                assets and facilities
                available to the NHS;
                provide maximum value for
                money for the taxpayer;
                deliver high quality
                evidence-based care;
                ensure that waste is
                continuously decreased.
                Optimising the
                procurement and use of
                resources to minimise the
                costs of delivering
                effective and streamlined
                care and administration.

9. Financial    Ensuring that the local
balance         health community also
across the      lives within the available
local health    financial resources.
economy         Given the interconnections
                between care in different
                settings, NHS organisations
                within a health community
                will need to collaborate to
                ensure that the whole
                health economy remains in
                financial balance.



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 Strategy and Benefits Template, Step 1
Ano LHC Integrated Service Improvement Plan


C: Priority Objectives and Outcomes

   CDS                                          Priority                                                         Target Success
Principles                Gaps              Objective ‘label’               Priority Objective                     Measure(s)            Measurable Outcomes

To which     Which specific gaps,           Devise a short      Describe the objective. Ensure that it is   In what terms/units,        What outcomes need to
of the       identified in ‘B’ above, are   name for the        as SMART (Specific, Measurable,             and/or against which        be in place in order for
highly       addressed by this priority     priority            Achievable, Relevant and Time bound) as     targets, will success be    the Priority Objective
ranked       objective?                     objective, for      possible at this stage in the planning      measured?                   to be achieved?
CDS                                         use in diagrams     process. High level capabilities from the
                                                                                                                                        Express each outcome
principles                                  and elsewhere       CDS Planning Framework may be of help       If the objective is truly
                                                                                                                                        as a future, changed
does the                                    throughout the      here.                                       SMART, these will be
                                                                                                                                        state, viewed from the
priority                                    document.                                                       immediately apparent
                                                                A suggested structure for SMART                                         perspective of a patient
objective                                                                                                   (see left).
                                                                objectives is:                                                          or other individual
relate?
                                                                                                                                        stakeholder.
                                                                verb … metric … population/scope …
                                                                object … from baseline value to target
                                                                value … timeframe.

                                                                eg: Increase the percentage of adult
                                                                patients with non-resistant TB who
                                                                completed therapy within 12 months
                                                                from 80% to 90% by 2006.
                                                                                                        1.4                                      1.5




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Ano LHC Integrated Service Improvement Plan


D: Outcomes and integrated change programmes
Delete the placeholder pictures below.
Either: Develop ‘D’ using the ISIP D spreadsheet template (this includes analysis tools such as filtering and sorting) and paste below, then delete this line.
        (Use this spreadsheet approach if there are many outcomes, or if there are many complex links between Integrated Change Programmes, Outcomes and
        Objectives.)
Or: Develop D using the PowerPoint template (if there are relatively few outcomes and relatively simple relationship links).
 Change Programme                                                                                                            Objective                    Timing

                                                  <-- Key (Change Programme & Enabler links)
                                                  1 = primary / major outcome of change programme / enabler




                                                                                                                                                                           2008 / 9 / 10
                                    Outcome Ref




                                                  2 = there is a minor dependency on this change programme / enabler
                                                                                       Key (Objectives links) -->




                                                                                                                                                     2006 / 7
                                                                                                                                                                2007 / 8
                                                                                        1 = primary / major impact
                                                                                       2 = secondary / some impact
xxx
      xxx
            xxx
                  xxx
                        xxx
                              xxx




                                                                                                                       xxx
                                                                                                                             xxx
                                                                                                                                   xxx
                                                                                                                                         xxx
                                                                                                                                               xxx
 1    2     3     4     5     6                   Outcome                                                              1     2     3     4     5
                                     1
                                     2
                                     3
                                                                                                                                                                                               Integrated
                                     4                                                                                                                                                                                            Priority
                                     5
                                     6
                                                                                1.5                                                                                                             Change
                                                                                                                                                                                              Programmes
                                                                                                                                                                                                                   Outcomes
                                                                                                                                                                                                                                 Objectives
                                     7                                                                                                                                                                      1. Outcome

             1.6                     8
                                     9
                                                                                                                             1.6                                                           1. Programme
                                    10                                                                                                                                                                                         1. priority objective
                                                                                                                                                                                                            2. Outcome
                                    11
                                    12
                                    13
                                    14
                                                                                                                                                     1.7                                   2. Programme
                                                                                                                                                                                                            3. Outcome         2. priority objective
                                    15
                                    16                                                                                                                                                                                   1.5
                                                                                                                                                                                                   1.6
                                                                                                                                                                                           3. Programme
                                                                                                                                                                                                            4. Outcome
                                                                                                                                                                                                                                      1.6
                                                                                                                                                                                                                               3. priority objective


                                                                                                                                                                                                            5. Outcome
                                                                                                                                                                                           4. Programme                        4. priority objective


                                                                                                                                                                                                            6. Outcome

                                                                                                                                                                                                                               5. priority objective
                                                                                                                                                                                           5. Programme
                                                                                                                                                                                                            7. Outcome




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Strategy and Benefits Template, Step 1
Ano LHC Integrated Service Improvement Plan


E: Integrated Change Programme Mandates
                                                                          1.8
Change Programme                                          Date commenced
Progress status          %                                Date reviewed
Description Outline      Describe the integrated change programme including a reference the
                         priority objectives it helps to achieve.

Organisations affected
Enablers
Outcomes                 Full text if few.
                         Reference numbers if many, eg:
                         Programme makes a major contribution to: 1, 3, 5, 7, 8, 9
                         Programme makes a minor contribution to: 2, 4, 6


Key assumptions and      Any major assumptions, dependencies on the LHC’s other change
dependencies             programmes, and external dependencies / pre-requisites.
SRO
Programme Manager



Change Programme                                          Date commenced
Progress status          %                                Date reviewed
Description Outline


Organisations affected
Enablers
Outcomes




Key assumptions and
dependencies
SRO
Programme Manager




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Strategy and Benefits Template, Step 1
Ano LHC Integrated Service Improvement Plan


Executive Summary 2 - Timeline and Links
This picture presents a pictorial view of the information given in D above, Delete the placeholder picture below. Develop Executive Summary 2 using the
PowerPoint template and paste below, then delete this line.

         1. priority objective

         2. priority objective

         3. priority objective

         4. priority objective
                                                                                                1.9
         5. priority objective



        1. Change
           programme                                                                                                          1


        2. Change
                                                                                                                                  4 7   8
           programme


        3. Change
                                                                                                                                                      3
           programme


        4. Change
                                                                                                                                  4     8 17 18 19
           programme


        5. Change
           programme


        6. Change                                                                                                                 4           18 19
           programme

         Change
         Programmes              2006 - 7                              2007 - 8                                 2008 - 9                2009 - 10


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Strategy and Benefits Template, Step 1

				
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