NHS GRAMPIAN

BOARD ORGANISATIONAL DEVELOPMENT PLAN 2006-2008

  1. Introduction

NHS Grampian is responsible for leading the efforts to improve the health of the people of Grampian and for providing the NHS health care services which people need. We are the fourth largest Health Board in Scotland consisting of three Community Health Partnerships – Aberdeen City, Aberdeenshire and Moray and an acute sector, all supported by corporate services such as Finance, Human Resources, Facilities etc.

The purpose of NHS Grampian is to:

  • Improve the health of the people of Grampian (compared to the rest of Europe) and
  • Provide safe, high-quality treatment, based on clinical need in comfortable surroundings and within available resources

We will only achieve this by working with our partners – staff, patients, carers, communities, Community Planning Partners and organisations/groups – in Grampian, in the North of Scotland and nationally.

In order to ensure we maintain focus on our agreed priorities we have developed a corporate Balanced Performance Framework and related sector ‘scorecards’. We are clear there are five key perspectives on which we must consistently deliver results. These are:

  1. Improving Health – through maximising improvement in health status and outcomes
  2. Finance – in order to achieve strong and sustainable financial performance
  3. Service Delivery and Organisation – in order to deliver effective healthcare, promote innovation and improve quality
  4. People – through involving the public and partners to meet their needs
  5. Learning & Growth – in order to equip the organisation with the knowledge and skills to deliver the strategy

NHS Grampian’s priorities are set out in detail in the Grampian Health Plan. Service improvement/changes in priority areas are clearly laid out in the Change & Innovation Programme. This Board Organisational Development Plan focuses on the development initiatives and actions necessary to deliver the Health Plan which includes the local Delivery Plan. It is set out here in summary in support of the Balanced Performance Framework which includes the local Delivery Plan. A more detailed plan encompassing more specific actions is being developed alongside this document which will support prioritisation of resources and performance management in this area at local level.

This summary plan which follows, sets out our corporate objectives within each perspective and then goes on to describe at a high level the nature of the developmental focus. This is also clearly cross-referenced to the local Delivery Plan. The Chairman and Board of Directors were fully engaged in the development of this plan and will oversee progress and achievements through governance arrangements.

  1. Introduction (cont’d)

Inevitably there is a high degree of overlap in terms of development actions across all five of the perspectives. Our key focus in developmental terms is to ensure that connections are strengthened across the whole system and that we are able to link every developmental activity to a key element of the Health Plan/local Delivery Plan. We remain committed to ensuring delivery of the best possible value to the system with limited resource.

In order to avoid duplication within the body of the plan it is important that we set the leadership agenda in its widest context. It is clear that it is the central theme which underpins progress and delivery across all of our identified corporate objectives. Critical to our success is the development of key leadership groups across the organisation, in particular the Board itself and the Board Executive group. A personal development plan has been established with the NHSG Board members which is being managed and supported through Strategic Change and monitored through the Personal Performance and Development planning process. The Chairman is leading on this and has the full support of all Board members. In parallel the executive directors are committed to a process of personal and group development which has at its foundation the NHSS Leadership Framework and 360° feedback tool. Through these processes we will determine a clear description of the type of organisation to which we are aspiring and which supports the creation of a learning organisation in real terms. A significant component of the development activity will be to explore how best to determine both our targets and to address changes required to deliver the Change and Innovation programme and therefore ensure sustainability. These processes will identify the key areas of personal leadership development in order to lever the changes necessary across the whole system. Every key development action listed below will require clarity of the leadership role and style necessary to deliver our outcomes.

Leadership development in its widest sense continues to be a central theme as is the continuing integration of the system, delivering patient–centred care and the support necessary to the staff in order to provide such care as well as our commitment to achieving local and national targets. Key areas for change have been identified through our Health Planning process. The Change and Innovation Programme is key in maintaining a corporate overview of services and sectors delivering the redesign process. The projects (referred to within the detail of this summary plan) are principally focused on improving the patient experience. Our key outcomes include: the provision of a high tech tertiary care centre in the form of the Aberdeen Health Campus ; the provision of locally based services which will provide a range of diagnostic and treatment services; further development of Community based services; promotion and support for the concept of self care and the reduction in the health inequality gap which exists between our more affluent and less well off communities. NHS Grampian is clear that the continuing development of the CHPs is the major vehicle for the delivery of these.

Underpinning all these activities is the support, expertise and influence provided by the NHS Grampian Strategic Change team, NHS Grampian’s Learning & Development team and the Professional and Practice Development team. In addition it is critical that we maintain and continue to develop quality dialogue and partnership working with the Area Clinical Forum and the Grampian Area Partnership Forum.

  1. Key Development Priorities

PERSPECTIVES/
CORPORATE OBJECTIVES / KEY DEVELOPMENT ACTIONS / LDP CROSS-REFERENCE / LEAD / WHEN BY / BOARD INVESTMENT / MEASURES OF ACHIEVEMENT
  1. Improving Health Perspective

  • Implement agreed Health Improvement priorities
/ Key areas of focus are the leadership of a devolved Public Health function and effective performance management / H.02T – H.07T / Director of Public Health / March 2008 / Within existing Health Improvement resources / Identifiable shifts in resources from illness to health and self care
Plans with CHPs & the Acute Sector complement and are consistent with the Health Plan
  • To develop all parts of NHS Grampian and its partners as Public Health Organisations
/ Creating an explicit understanding of what a Public Health Organisation is for Grampian
Ensure there is full understanding among managers/leaders of their responsibilities in relation to improving health / Director of Public Health
Chief Executive / March 2008 / Within existing Public Health resources / Board can articulate a clear and consistent description of what a PHO is. An objective and owned plan exists.
The community forum recognises their influence on the Board.
Health Improvement responsibilities are included in personal objectives
  • Reduce Health Inequalities in priority areas
/ Review Health Inequalities Framework and agree priorities and development plan / H.01T / Director of Public Health and General Managers / June 2007 / Within existing resources / Action Plan agreed that is achievable and has ownership and is resourced and prioritised appropriately
Action Plan is reflected in personal objectives

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NHS GRAMPIAN

BOARD ORGANISATIONAL DEVELOPMENT PLAN 2006-2008

PERSPECTIVES/
CORPORATE OBJECTIVES / KEY DEVELOPMENT ACTIONS / LDP CROSS-REFERENCE / LEAD / WHEN BY / BOARD INVESTMENT / MEASURES OF ACHIEVEMENT
  • Protect the population from hazards which damage their health
/ Developing/expanding communication methods to reach the wider Public and explaining/expanding networks. Key to this is the development of appropriate skills
Improved understanding of health protection function in Grampian
Ensure there is understanding among managers/leads of their responsibilities in protecting health / Director of Public Health
Director of Corporate Communications / On-going / Within existing resources / Through feedback from forums, e.g., PFPI committee, community forum, voluntary organisations etc.
Major health protection issues, e.g., communicable diseases and immunisation are communicated and understood
Board can describe health promotion function and recognise importance of multi-agency response, e.g., preparing for emergencies
Health protection responsibilities are included in persona objectives. E.g., planning for pandemic immunisation
  1. Financial Perspective

  • Meet financial targets
/ Performance management processes owned by budget holders and fully implemented / E.01T / Director of Finance
Director of Performance / On-going – March 2007 and March 2008 / N/A / Performance management processes fully operational and effective with clear evidence that financial targets are met and performance is being accounted for
The financial plan is achieved
  • Meet revenue efficiency targets
/ As above / Sector GMs / On-going – March 2007 and March 2008 / Efficiency targets of circa £20m required to balance expected levels of spend with available recurring resources / As above

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NHS GRAMPIAN

BOARD ORGANISATIONAL DEVELOPMENT PLAN 2006-2008

PERSPECTIVES/
CORPORATE OBJECTIVES / KEY DEVELOPMENT ACTIONS / LDP CROSS-REFERENCE / LEAD / WHEN BY / BOARD INVESTMENT / MEASURES OF ACHIEVEMENT
  • Redistribute resource in line with Health Plan
/ Develop agreed plan with all stakeholders on redistribution and timescales gaining ownership and commitment
Shared understanding and agreement on the extent and meaning of key aspects of the Health Plan
Achieve full engagement of the wider clinical community with the Health Plan to ensure realistic and achievable implementation plans / E.03T / Chief Executive, Medical Director, Nurse Director, Lead AHP / March 2007 / Within existing resources after meeting £20m of savings targets / Plan agreed and owned by all stakeholders
Aspects of the plan are included in personal objectives at all levels
Speciality plans fully reflect the Health Plan
  1. Service Delivery and Organisation Perspective

  • Co-ordinate approach to 24 hour unscheduled care
/ Development of a co-ordinated and integrated emergency care service in a purpose build facility / A.05T / Medical Director
Director of Primary Care / March 2008
March 2007 / Within existing resources / An integrated system where patients progress through the system seamlessly giving consistently positive feedback through regular surveys/comments processes and Community Forum
Agreed clinical protocols/pathways for service re-design
Integrated management arrangements of A&E and AMAU within Acute Services
  • Improve access to healthcare
/ Development of a whole system approach to waiting times and whole system redesign of services / A.03T / Waiting Times Director, Service Managers & CHP GMs / Plan to invest circa £7m in achievement of Waiting Times targets in 2006/07 / Objective evidence that redesign has impacted positively on length of waits
Waiting times and targets achieved and maintained

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NHS GRAMPIAN

BOARD ORGANISATIONAL DEVELOPMENT PLAN 2006-2008

PERSPECTIVES/
CORPORATE OBJECTIVES / KEY DEVELOPMENT ACTIONS / LDP CROSS-REFERENCE / LEAD / WHEN BY / BOARD INVESTMENT / MEASURES OF ACHIEVEMENT
  • Develop a range of intermediate care services to deliver treatment for patients who do not require the specialist services of acute hospitals
/ Development focus on the relocation & redesign of geriatric assessment and the consequential shift in activity
Redesign of Primary Care services in order to facilitate the development of D. & T.S.
Development of co-ordinated and integrated Primary Care based Dental Services / T.02.T
A.04T
A.06T
A.02T / Director of Planning & Head of Service
CHP Clinical Leads & GMs
Associate Medical Director / March 2008 / Planned to achieve a saving. No additional net investment
Within existing resource
Within existing resource / Positive feedback from patients being treated appropriately
Improved outcome of repeat intermediate care audit
Audit of bed usage in community hospitals reflects the intermediate care agenda and provides baseline for future measurement
Reducing numbers of patients being referred into specialist services
Dental services which reach a wider population
  • Develop integrated health and social care to shift balance from hospital to community
/ Focus on delayed discharges
Continuing development of the CHP model and working with LA partners
Development of community based Rehabilitation Services & Children’s Services / T.01.T / Director of Nursing
CHP Chairs & GMs
Heads of Service / Ongoing
Ongoing
March 2008 / Within existing resources / Positive impact on delayed discharge figures (142 target by April 2006)
CHPs which balance the needs of their local community with the wider needs of Grampian
Patient experience of a more integrated service
  • Meet appropriate clinical standards and ensure patient safety
/ Integration of Clinical Governance/Risk Management Services
Developmental focus on the cultural aspects of creating a climate which gets rid of blame actively promotes learning & supports occurrence reporting / T.04.T / Director of Nursing
All Directors and Chief Executive / June 2006
Ongoing / Within existing resources / Clarity of interdependencies and accountabilities within the organisation
Level of reporting reflects actual number of incidents and there is a visible response to addressing learning issues

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NHS GRAMPIAN

BOARD ORGANISATIONAL DEVELOPMENT PLAN 2006-2008

PERSPECTIVES/
CORPORATE OBJECTIVES / KEY DEVELOPMENT ACTIONS / LDP CROSS-REFERENCE / LEAD / WHEN BY / BOARD INVESTMENT / MEASURES OF ACHIEVEMENT
  • Provide modern infrastructure to support clinical services
/ Ongoing review and redesign of facilities services
Integration of Health Intelligence & Health infomatics to develop capacity
Develop a strategic OD approach to the development and implementation of the EPR / Heads of Service & Strategic Change Manager / On-going
Oct 2006 / Planned investment of £29.3m capital programme in buildings, IT and equipment / More efficient provision of service and improved feedback from users in relation to facilities
Higher quality information which is integrated and contextualised
Decisions at all levels informed by appropriate use of information
  • Support and influence development of national and regional approaches to service planning and delivery
/ Development support to the NoSPG to ensure greater focus and delivery
Developmental support to the N of S Maternity Services Framework
Development support to the Dental Services Network / Chief Executive, NoSPG Lead & Strategic Change
Director of Nursing
Medical Director / On-going
June 2006 / Within existing resources
Within existing resources / Greater influence and impact on the wider agenda in North of Scotland
Service change/development is taken forward on a national regional and local basis as appropriate.
Agreed implementation plan for the North of Scotland
  1. People Perspective

  • Ensure that the public is involved/engaged and consulted in service planning and delivery
/ Build on the successes of major consultation exercises undertaken such as Health Plan, Maternity Services, OOHs
Proactively develop the impact on decisions of the Community Forum and other CHP communication methods / Director of Communication & Director of Planning / On-going
March 2007 + on-going / Within existing resources. / Higher number of responses when consulting with the public
Greater understanding of the complexity of the NHSG issues by the public
PERSPECTIVES/
CORPORATE OBJECTIVES / KEY DEVELOPMENT ACTIONS / LDP CROSS-REFERENCE / LEAD / WHEN BY / BOARD INVESTMENT / MEASURES OF ACHIEVEMENT
  • Develop effective joint working with partners
/ Continuing development of the CHP model and working with LA partners / CHP Chairs, GMs & Clinical Leads / On-going / Within existing resources / CHP teams where it is almost impossible to know who is employed by which partner agency
  • Promote and encourage self-care
/ Development of Self Care as a defined project within the Change & Innovation programme / Deputy Director of Public Health / March 2007 / Within existing resources / Agreed % of people with structured programme of self care for chronic diseases
PID in place which clearly details the OD actions and outcomes
  • Improve customer satisfaction
/ Existence of a clear emphasis throughout the organisation on ensuring satisfaction among users and patients both internally & externally
Development of a strong and healthy relationship with the community forum focussed on understanding needs and improving services
Development & Implementation of an agreed Complaints Strategy / Learning & Development Team
Clinical Governance Support Unit
Director of Nursing and Corporate Communications / Oct 2006 / Within existing resources / Improved feedback both formal & informal
Meet agreed SEHD targets
Consistently higher levels of satisfaction reported with people reporting more frequently in a positive manner

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NHS GRAMPIAN

BOARD ORGANISATIONAL DEVELOPMENT PLAN 2006-2008

PERSPECTIVES/
CORPORATE OBJECTIVES / KEY DEVELOPMENT ACTIONS / LDP CROSS-REFERENCE / LEAD / WHEN BY / BOARD INVESTMENT / MEASURES OF ACHIEVEMENT
  1. Learning and Growth Perspective

  • Ensure effective staff involvement to achieve a healthy and positive work experience
/ Through consistent and accountable leadership at all levels create a work environment that supports individuals to reach their potential within an appraisal and development framework and participate in planning for service redesign / E.02T / Chief Executive & HR Director / On-going. March 2007 / Within existing resources, subject to any specific funding received from the SEHD for these areas / Implement revised appraisal and development process, staff governance action plan and support cultural changes around managing absences
Increase in positive statements in the staff survey
  • Ensure right numbers of staff willing and skills in right place
/ Support redesign and creativity to realise the benefits to service from pay redesign, recognising the critical nature that effective and consistent leadership throughout the system plays
Development of a comprehensive workforce plan to underpin the Health Plan / E.03T / Director of HR / On-going. March 2007 / £200K plus additional staff time / Implementation of the Pay Modernisation Action plan and Agenda for Change
Implementation Plan to redesign workforce and development of new roles to support Change and Innovation programme
  • Promote the development of a flexible, creative learning organisation
/ Engagement of the Board and Board Executive in describing the type of organisation of the future and its associated values, principles and behaviours / Chief Executive, Chairman and Board / March 2007 / Within existing resources / Learning Organisation NHS Grampian is aiming for, described to staff and action plan developed to support this cultural change

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