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LEEDS TEACHING HOSPITALS NHS TRUST
2006/07 BUSINESS PLAN ACTION PLAN 30/06/06
RESULT AREA THREE
BECOMING A FINANCIALLY EFFECTIVE ORGANISATION WITH A SOUND FINANCIAL AND WORKFORCE STRATEGY THAT SUPPORTS THE SERVICE STRATEGY
OBJECTIVE REF NO TASKS/ACTIONS OUTCOMES/ OUTPUTS/ ACCOUNTABLE TIMESCALES
PRODUCTS OFFICER
/DIRECTORATE
STRATEGIC AIM: DEVELOPMENT OF A SOUND FINANCIAL STRATEGY THAT SUPPORTS THE SERVICE STRATEGY
Produce plan for achieving 3.5% 3.1
CIPs in 2006/07 and achieves Monthly financial reporting FD Monthly
financial balance by 31/03/07 Plans to be developed and risk assessed to achieve this Detailed plan which includes in- FD 15 May Trust
savings target year trajectories Board
Develop contingency plans to maintain income levels at DPPI
business plan levels including
clearing backlogs to achieve waiting time targets
equalising "other" waiting times
attracting activity from other commissioners
switching from non-elective to elective
Develop improved counting and coding strategy to DPPI (BD)
refute PCT plans to not pay coding errors.
Monitor delivery of tranche one savings through DOps
performance review process DPPI (GC)
Support taskforce leaders in delivery of change
management programme plans
Deliver 3.5% CIPs in 06/07 in corporate functions FD ( ) Q4 06/07
supported by operational plans
Establish Trust income plan Trust income plan FD Q1 06/07
Traditional incremental top-down plan developed as
part of FT Diagnostic
Bottom-up plan developed later based on 2006/07 PBR
arrangements and new local tariffs
Reconciliation top-down to bottom-up
Update LTFM for changes in national funding FD
assumptions, PCT de-commissioning plans and revised
national tariff
Assess recurrent impact of Change Management FD
Programme (CMP)
Updated LTFM assessed against 3.5% savings FD
"benchmark"
LTFM shared with SHA FD
Bid made against strategic reserve FD
Detailed plans to deliver CIPs to be identified through CMP; Task force delivery plan DPPI Q2 06/07
with identified timescales for delivery and quantification by
CMT
Compare planned spend in 06/07 with 05/06 actual to FD ( )
determine any material savings included in existing
CMT plans
Apportion 30% reduction on relevant items FD ( )
Share results with Directors/HoCMTs and agree FD ( )
performance management arrangements
Reduce budgets accordingly from 1st July FD ( )
Support taskforce leaders to develop robust plans DPPI (GC)
Agree savings trajectories
Support agreement with Heads of CMT for DOp (CB)
corresponding reduction in expenditure plans DOp (GB)
Monitor delivery of savings through performance review
process
Trauma and Orthopaedics CMP DOp
GI Surgery CMP DOp
Medical productivity CMP MD ( )
Procurement (general) CMP FD(CS)
A list of "target" areas have been agreed. Staff time
has been designated and new appointments are being
made.
The Head of Supplies to agree the savings
opportunities with CMTs and the CMTs expenditure
targets reduced accordingly
Procurement (drugs) CMP
The Head of Pharmacy to agree the savings FD (LK)
opportunities with CMTs and the CMTs expenditure
targets reduced accordingly
Absence management CMP HR ( )
Other clinical staff productivity CMP CN
Theatres & Anaesthetics CMP DOps
Discretionary non-pay CMP FD
Reduction in costs of management CMP CEO
Ensure that outcomes from task forces are integrated into An integrated service and DPPI Q1
CMT / corporate budgets as they emerge financial plan
Eliminate double-counting between savings and FD ( )
schemes
Identify trajectories and distribution by CMT FD ( )
CMP schemes signed off by HoCMT DOps
CMT/corporate budgets amended FD ( )
Assess realism of PCT decommissioning plans and reflect Documented service agreement DPPI (NP) Q1 06/07
in service plans with comissioners
1
OBJECTIVE REF NO TASKS/ACTIONS OUTCOMES/ OUTPUTS/ ACCOUNTABLE TIMESCALES
PRODUCTS OFFICER
/DIRECTORATE
Review and analyse PCT plans DPPI Q2
Review plans and clarify issues with PCTs DPPI Q2
share plans with CMTs and engage medical staff DPPI Q2
Design and establish framework for managing DPPI Q2
Develop CMT level business plans to be reviewed at Complementary operational DOps
BPAT and Ops Board delivery plans in CMTs / Corp
Services
CMTs to assess operational impact of reduced service DOp (CB)
provision reflecting commissioning plans DOp (GB)
Implementation of necessary reductions in capacity DOp (CB)
DOp (GB)
Monitor impact on delivery of key access targets, DOp (CB)
activity plans etc DOp (GB)
Overall medium term service strategy and national funding FD Q1 06/07
guidance assessed to inform approach to CMT allocations
Negotiate conditional strategic support with SHA FD Q4 06/07
CMTs develop financial plans with agreed resources DOps Q1 06/07
DOp (CB) DOp
Support CMTs to develop revised financial expenditure (GB)
targets to reflect the impact of the change management
programme and/or PCT decommissioning
Ensure no new service approvals resulting in cost pressure DOp (CB) DOp ongoing
drift (GB)
DOp (CB) DOp
Work with CMTs to manage in year service pressures (GB)
without recourse to unfunded service developments
Strengthen monitoring and supporting governance Improved performance FD ( ) ongoing
arrangements, ensuring all emerging financial issues are management framework and
identified. Board report
Produce "budget books" for CMTs and the Board FD ( ) Q1
Establish process for reporting allocation changes in FD ( )
year and between years Q2
Review of reporting financial performance to the Trust FD ( )
Board taking into account KLOE/FT regime / published
best practice Q1
Review of financial reporting to CMTs FD ( ) ongoing
Review CMT performance management arrangements Improved performance FD ( )
in relation to the achievement of financial targets management framework and
Board report ongoing
Develop formal written reporting to DOF on financial FD ( )
performance of aggregated business units, eg, Patch 1,
Patch 2 etc Q2
Develop CMT trading accounts FD ( ) ongoing
Develop standard approaches to the production of FD ( )
business cases and financial analysis to support multi-
CMT projects Q3
Revise the process for CMT end of year forecasting. FD ( ) Q2
Produce plan for financial 3.2
balance between 2006/07 and
2009/10
Develop plan for financial balance between 2006/07 and Financial balance planned for FD November Board
2009/10 building on progress in the first half of 2006/07. next 3 years
Scope 3.5% savings for each of the next 5 years.
Future years task force areas to be scoped, taking into DPPI ( ) Q3
account evidence of excess cost compared with income
from specific services (ie impact of tariff on trading)
Overall medium term service strategy and national funding FD (ANC) Q4 each financial
guidance assessed to inform approach to CMT allocations year
Develop contingency plans for all 3.3
areas of financial risk
Refine assessment of risk relating to delivery of 2006/07 Monthly report to trust board FD From April 2006
plans and identify and monitor plans to manage risk. identifying risk assessment,
mitigating actions/milestones
and responsibilities
Refine assessment of risk relating to NOW/PCT Medium term risk assessed as ? Nov-06
commissioning/MLB/continued efficiency part of updating plan for future 3
improvements/tariff roll out/specialist services. Ensure all years and plans adjusted
plans incorporate delivery options which mitigate risk. accordingly
Identify any additional savings required to offset any risks
deemed unavoidable
Establish explicit process for recording and assessing Financial risk assessment FD Q2
financial risk in all business areas (consistent with overall framework
Trust approach) and make recommendations for any
further action required.
Review existing mechanisms at CMT and corporate
levels, amending and refining as appropriate
Develop reporting arrangements to the Board, HQMG
and Operations Board
Ensure plans incorporate delivery options which mitigate DPPI (NP) Q2
risk and identify additional savings to offset unavoidable
risks
Maintain income 3.4
Monitor SLA developments and plan to rebalance activity DOp (GB) ongoing
DOp (CB)
Monitor activity and income plans through regular DOp (GB)
performance review process with CMTs DOp (CB)
2
OBJECTIVE REF NO TASKS/ACTIONS OUTCOMES/ OUTPUTS/ ACCOUNTABLE TIMESCALES
PRODUCTS OFFICER
/DIRECTORATE
DOp (GB)
Agree remedial action with CMTs as appropriate DOp (CB)
3
OBJECTIVE REF NO TASKS/ACTIONS OUTCOMES/ OUTPUTS/ ACCOUNTABLE TIMESCALES
PRODUCTS OFFICER
/DIRECTORATE
Bring costs nearer to tariff 3.5 Document service agreement FD (PK) Q2
with commissioners
Trust Income Plan FD (ANC) Q2
Invest in clinical coding DPPI (BD) ongoing
Develop mechanisms for handling tariff FD Q2
exclusion/adjustment issues re service changes or
Principles & “Code of Practice” agreed up front with
PCTs and then applied
Joint work with CMTs, especially Pharmacy, to identify
and capture new data sources needed for SLA e.g high
cost drugs and devices
Reduce RCI - identify fit between RCI and tariff FD (ANC) ongoing
Performance manage services to tariff and RCI DOp (GB)
DOp (CB)
CMTs to implement actions agreed through change DOp (GB)
management programme DOp (CB)
Reduce expenditure plans to deliver current activity DOp (GB)
levels and support movement nearer to tariff DOp (CB)
Link with Change Management Programmes to extract FD (KG) ongoing
efficiencies
Provide advice on trading benefits / deficits associated with FD (PK) ongoing
specific services
Comparison of 2004-05 RCI with national average and
peer group
Re-present 2005-06 actual position in CMT trading
account format
Establish project to compare detailed input costs with
sub-set of provincial teaching hospitals
Establish and deliver capital 3.6 Capital programme framework Q2
programme
Assess and prioritise B&E capital infrastructure Improved capital programme F&E (DK) Q2
replacement needs, linked to estates strategy framework
All capital schemes are fully identified with realistic Improved capital programme FD (ANC) Q2
phasing within resources available framework
Agree priorities including patient environment and DPPI (SJC) Q3
expeerience against programmes
Establish Project Board to develop patient
experience pilot scheme
Produce integrated programme on single template DPPI (SJC)
showing total B&E capital spend
Agree prioritisation processes DPPI (SJC)
Manage impact of new capital regime FD (ANC) ongoing
Revitalise the Estates Capital Team to enable ongoing
delivery.
Review/investigate services to increase efficiency
and performance with respect to programme
management
The impact of 2005/06 undershoot is incorporated in FD ( )
the programme
The capital programme is reviewed to assess FD ( )
deliverability of spend
Concerns are raised with SHA and „special FD ( )
arrangements‟ sought as necessary
Briefing on the implications is provided to all FD ( )
concerned with managing the capital programme
Progress monitored through quarterly reviews FD (ANC)
Continue estate refurbishment programme F&E (DK) ongoing
STRATEGIC AIM: DEVELOPMENT OF A WORKFORCE PLAN TO SUPPORT THE SERVICE STRATEGY
Develop integrated and costed 3.7
workforce plan Trust workforce plan HR (RA) Q2
Improve integration through business Plans are fully integrated with HR (RA) May-06
planning/performance management service and financial plans DOps
brought together in business
plan. Each CMT has an agreed
workforce number for 2006/07
Training and development strategy to be developed to Workforce needs mapped to HR (RA) Sep-06
reflect this plan. service and financial strategies
Each CMT to have an agreed workforce target for 2006/07 HR (RA) Q1
Identify a clear workforce baseline within CMT areas HR (RA)
which integrates with the financial view of workforce
numbers
Remove from the establishment, posts which were HR (RA)
held vacant in 2005/06
Plans should account for developments and savings HR (RA)
with CMT areas
Plans should also account for taskforce and other HR (RA)
change management programme savings
CMT plans collated Trust wide to produce workforce HR (RA)
trajectories
Ensure CMTs understand workforce targets DOps Q1
Remove from budgets all posts which have been held FD (ANC) Q2
vacant during 2005/06
Ensure workforce outcomes from Change Management DOps ongoing
Programme are integrated
Plan for workforce cost savings 3.8
so that the workforce strategy
and financial plans inter relate
Taskforce leads to develop plans for savings which Q1
include workforce implications
Taskforce plans to be reviewed and workforce HR (RA) Q2
implications identified
4
OBJECTIVE REF NO TASKS/ACTIONS OUTCOMES/ OUTPUTS/ ACCOUNTABLE TIMESCALES
PRODUCTS OFFICER
/DIRECTORATE
Workforce reductions quantified and implications of HR (RA) Q2
managing these changes considered and planned
Workforce implications of taskforce outcomes HR (RA) Q2
documented within workforce plans and implemented
Develop training plans with Development Confederation HR (RA) Q3
Plan developed for staff consultation, redeployment,
training and development requirements
Develop workforce plan for 2007/08 based on view of core HR (RA) Q3
business
Clarity on workforce baseline for 2007/08 revisited HR (RA)
which should include a shared organisation
understanding of workforce numbers
Service strategy with full account taken of financial HR (RA)
constraints clarified from the outset for 2007/08
Include known development such as NOW, MLB, ASR HR (RA)
etc.
Workforce implications of service strategy including any HR (RA)
reduction or expansions in workforce numbers identified
and documented
Workforce plan developed with consideration awarded HR (RA)
to staff consultation, training and development,
redeployment, labour market constraints and retention
issues
Deliver workforce plans in CMTs 3.9
/ corporate functions
Develop plan for staff consultation, redeployment, training Implementation plan with phases HR (RA) Jul-06
and development requirements and recruitment of staff in of activity
shortage groups Trust wide picture of workforce HR (RA) Jul-06
implications of service strategy
and financial plans
CMTs to develop detailed workforce plans together with complementary OP delvier DOp (GB) + DPPI Q2
implementation plans (business plan) DOp (CB)
CMTs to identify revised workforce plans to reflect the DOp (GB)
impact of change management programme/PCT DOp (CB)
decommissioning
Workforce plans agreed with DOP DOp (GB)
DOp (CB)
DOp (GB)
Implementation
DOp (CB)
DOp (GB)
Monitoring through performance review process
Corporate functions to develop detailed workforce plans DOp (CB)
HR (RA) Q1
together with implementation plans
5
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