Document Version Control
Version / Changes / Status / Author / DateV.01 / Original Gateway / Final Draft / Dr Ian Pattison / 12/12
V.14 / Gateway (Internal version) / Draft / D.Jones / 27/07/2013
V.15 / General Formatting, reference to programme boards / Draft / Lynsey Caizley / 23/08/2013
V.16 / Approved by Executive / Final / Lynsey Caizley / 03/09/2013
Contents
Section 1 - Introduction 10
Section 2 - The Gateway Process 11
Stage One – The Project Brief 11
Stage Two – The Project Business Case 12
Locality Innovation Funding for Primary Care Projects 13
Approval Criteria for Submitted Applications 13
Decision and Feedback to the Bidder 17
Appealing a Decision 17
Flowchart Diagram of the Process 18
Templates & Appendix 18
Section 1 - Introduction
NHS Sunderland Clinical Commissioning Group is clinically led and managerially supported working with and through our Localities. Our vision is to achieve ‘Better Health for Sunderland’. To achieve this our membership is committed to improving the health and well-being of all local people and to integrate services better across health and social care, while making effective clinical decisions for the benefit of all people across Sunderland.
The Sunderland Health and Care System Strategic Plan, developed with our partners, sets out our 5 year strategy to achieve this vision including the changes that we need to make to deliver our defined ‘future state’.
Our Plan on a Page provides an overview of our annual plan and priorities for 2014/15, outlining:
§ Our challenges
§ SCCG Vision
§ Outcome aspirations
§ Transformational cha
§ nges
§ Cross cutting programmes
The Executive Committee and CCG Governing Body wishes to encourage its own staff, member practices and wider partners in the development of ideas to help us improve and redesign services to achieve our vision.
This Gateway Guidance for Service re-design contains information and templates to enable those developing ideas for improvement to gain approval, and if required, secure funding to take forward the idea from inception to implementation. In addition, use of the Gateway tools will increase the likelihood of the success of any idea in practice particularly through the early identification and management of key issues. Those using the framework are advised to familiarise themselves with the process and information contained in the Gateway before attempting to complete any of the documents and submit an idea.
It should be noted that preference will be given to ideas/projects/cases considered as contributing to the CCG Commissioning Plan and in particular achievement of our strategic objectives and annual outcome aspirations for the health of the people of Sunderland.
Section 2 - The Gateway Process
There are two stages to the Gateway process. The aim is to ensure that ideas move from inception to implementation with the minimum of delay and maximum efficiency by ensuring they fulfill the following requirements:
§ Support the delivery of the CCG commissioning strategic objectives and annual outcome aspirations
§ Improves clinical quality and outcomes / experience for patients
§ Engages patients, carers and the public in the design and delivery of the idea
§ Is achievable and has a realistic opportunity to be implemented on the scale of change envisaged
§ Demonstrates and evidences delivery for the lifetime of the project
§ Demonstrate value for money and the benefits and costs for realising them in the right balance
§ Is the appropriate, or optimum, way of achieving the desired outcome(s)
The two stages are:
Stage 1 - The Project Brief (The proposal /Idea)
Stage 2 - The Project Business Case (The Justification)
Stage One – The Project Brief
Stage one involves submitting the project idea to the CCG Executive for consideration using a Project Brief document. The Project Brief provides the proposal for your project and gives an overview of the need and context around the idea, with enough outline information for the Executive to make a decision as to whether the project will contribute to achievement of Sunderland CCG selected outcome aspirations and can progress to stage two – the Project Business Case.
The Project Brief when completed should be submitted to the Programme Management Office who will allocate the brief to the relevant Programme Board for initial review. The brief will then be taken to the Executive meeting together with comments from the Programme Board to assist the Executive in making a decision. Further information can be obtained via the Programme Management Office, email The Executive Committee meets monthly and will endeavour to give you timely feedback on whether your project / idea was supported and whether you should proceed to the next stage.
Stage Two – The Project Business Case
Stage two involves submission of a Business Case to the CCG Executive. The Business case provides further in depth information to that initially provided in the Project Brief to enable the Executive to evaluate your project proposal and make a decision as to whether the project is desirable, viable and achievable.
Key information contained in the Business Case includes information to justify the project, including the relevant evidence, and details of the impact on quality, patient benefits / outcomes, stakeholder implications and a detailed financial breakdown.
The Business Case when completed should be submitted to the Programme Management Office who will allocate the brief to the relevant Programme Board for initial review. In preparation for the Programme Board meeting, key individuals ie: finance, risk, quality & safety etc will undertake an initial assessment of the business case which will inform the discussion within the Programme Board.
The business case will then be taken to the Executive meeting together with comments from the Programme Board to assist the Executive in making a decision. The Executive Committee meets monthly and will endeavour to give you timely feedback on whether your Business Case has been supported and advise you regarding next steps.
Further information can be obtained via the Programme Management Office, email .
Locality Innovation Funding for Primary Care Projects
Applications from Member Practices for access to the Locality innovation funding monies (100k per Locality) will be decided within each locality and should follow the Locality Group Innovation Projects Guidance which can be obtained via the Programme Management Office. This does not prevent a Practice/Locality from using the Gateway for significant ideas requiring funding of over 100k.
Approval Criteria for Submitted Business Cases
All project applications will be scored against the strength of the evidence provided in each section and category within the application form. The rubric scoring criteria table below outlines each scoring category along with an outline of the depth of evidence required for approving funds.
As a general guide, business cases must score at the mid scale (3) or above in each category to gain approval by the Executive Committee.
Scoring Table CriteriaCategory / Very Low
1 / Low
2 / Mid-scale
3 / High
4 / Top
5
Contribution to achievement of CCG selected outcome aspirations
(Evidence should be outlined in Business Case Strategic Fit Section 1) / Project does not demonstrate link to achievement of CCG outcome aspirations / Project indicates a loose link to contribution to achievement of CCG outcome aspirations / Project demonstrates contribution to achievement of one CCG outcome aspiration / Project demonstrates a clear contribution to achievement of one or more CCG outcome aspirations / Project strongly demonstrates a significant contribution to achievement of more than one CCG outcome aspiration
Quality & Safety
(Overall evidence outlined throughout the document) / Does not provide enough quality evidence. / Weak, but includes some quality evidence. / Reasonable amount of quality evidence. / Adequate amount of quality evidence. / Strong quality evidence base.
Finance & Performance
(Evidence should be outlined in Business Case Section 5) / Project costing does not appear to be within budget and has not been scoped out correctly. / Project calculations and estimated expenditure are weak and does not detail a breakdown and or forecast of the project expenditure. / Project outline project is viable, achievable and affordable. Includes a breakdown and projected spend forecast. / Project calculations detailed with breakdown of quarterly expenditure, affordable, viable and achievable, with indication of projected savings. / Project is cost effective and within budget detailed savings expected over project delivery and beyond as a result of expected impact -spreadsheet costing, detailed project expenditure and projected forecast provided attached as appendix.
Risk Management
(Evidence should be outlined in Business Case Section4- Risk) / Project shows no consideration of risk, nor how risk would be managed in the event a risk should arise. / Project indicates consideration of risk and management reduction/
minimizing risk / Project includes risks to the project and includes a strategy, contingency plans for future risk. / Project Includes detailed risk register and interdependencies, including the issues that ,may arise as a result of delivery / Project clearly identifies the potential or real risk and proposes mitigating actions (including risks to the health economy)
Contracting & Procurement
(Evidence should be outlined in Business Case Section 3 ) / Project does not clearly identify the implications for contracting, procurement or the implications for existing contractors or decommissioning strategy, nor timelines for procurement process as part of the application and delivery. / Project indicates how services will be impacted, what the current timeline and impact and what services and support would be required as part of the process for delivery. / Project indicates the implication for timelines and how this will be incorporated into the process for delivery. / Project clearly indicates the approach to and options considered as part of the delivery process. / Project clearly identifies the implications for contracting, procurement and the implications for existing contractors and decommissioning strategy, outlining how the contract will achieve real objectives in the appropriate contractual schedules.
Decision and Feedback to the Bidder
Feedback to the bidder will be provided within 5 working days of the decision being made at the Executive Committee meeting.
Monitoring and Tracking
Once approved, your project will be logged by the CCG Programme Management Office (PMO). Your project will monitored against delivery of its key milestones and planned benefits as outlined in the Business case. Upon approval of your business case you will receive a PMO project guide outlining the specifics of the project which has been approved, including reporting requirements, and a toolkit including key templates to support you in managing your project. Progress should be reported on in any regular meetings held between the project lead/manager and CCG lead as outlined in the project details section of the Project Brief/Business Case or through the appropriate channels determined by the delegated level of authority. Please note: Project documentation should be available for CCG audit throughout the lifecycle of the project.
NHS Protect Item
Flowchart Diagram of the Process
Templates & Appendix
The templates, supporting information and guidance can be found in the supporting guidance document, The Gateway Process – Templates & Supporting Guidance.
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