2017/18
Annual Plan Guidelines
WITH STATEMENT OF PERFORMANCE EXPECTATIONS
Amendments to the Annual Plan Guidelines (note that minor editorial amendments have not been recorded in the following table)
Page / Description9 / - PP7: Improving mental health services using wellness and transition (discharge) planning has been updated to more clearly show that there are two components associated with this measure.
Table of Contents
Overview of the Annual Plan Structure 3
SECTION 1: OVERVIEW OF STRATEGIC PRIORITIES 4
1.1 Strategic Intentions/Priorities 4
1.2 Message from the Chair and Chief Executive 4
1.3 Signature Page 4
SECTION 2: DELIVERING ON PRIORITIES 5
2.1 Government Planning Priorities 5
2.2 Financial Performance Summary 5
2.3 Local and Regional Enablers 6
SECTION 3: SERVICE CONFIGURATION 7
3.1 Service Coverage 7
3.2 Service Change 7
SECTION 4: STEWARDSHIP 8
4.1 Managing our Business 8
4.2 Building Capability 8
SECTION 5: PERFORMANCE MEASURES 9
5.1 2017/18 Performance Measures 9
APPENDIX A: STATEMENT OF PERFORMANCE EXPECTATIONS including FINANCIAL PERFORMANCE (for tabling as SPE) 13
Statement of Performance Expectations (SPE) 13
Output classes 13
Financial Performance 13
APPENDIX B: SYSTEM LEVEL MEASURES IMPROVEMENT PLAN 14
Additional Information 15
Glossary of Terms 15
Financial Checklist for 2017/18 Financial Statements (and supporting templates) 18
Output Class Recommendations 21
Overview of the Annual Plan Structure
SECTION 1: OVERVIEW OF STRATEGIC PRIORITIES (suggested three pages long)1.1 Strategic Intentions/Priorities
1.2 Message from the Chair and Chief Executive
1.3 Signature Page
SECTION 2: DELIVERING ON PRIORITIES (suggested ten to twelve pages long)
2.1 Government Planning Priorities
SECTION 3 : SERVICE CONFIGURATION (suggested two pages long)
3.1 Service Coverage
3.2 Service Change
SECTION 4: STEWARDSHIP (suggested two pages long)
4.1 Managing our Business
4.2 Building Capability
SECTION 5: PERFORMANCE MEASURES (suggested four pages long)
5.1 2017/18 Performance Measures
APPENDIX A: STATEMENT OF PERFORMANCE EXPECTATIONS including FINANCIAL PERFORMANCE (for tabling as SPE)
Statement of Performance Expectations (SPE)
Output classes
Financial Performance
APPENDIX B: SYSTEM LEVEL MEASURES IMPROVEMENT PLAN
Guidance TBC.
Further guidance for the 2017/18 Annual Plans (APs) is outlined in the Planning Priorities Guidance and in the mock streamlined plan that has been developed to assist DHBs.
For further information regarding the Annual Plan Guidelines please contact:
Stasha Mason
Service Commissioning
Ministry of Health
(04) 496 2265.
SECTION 1: OVERVIEW OF STRATEGIC PRIORITIES
This section should include a brief explanation of the DHB’s strategic intentions/priorities, key messages from the Chair and Chief Executive and the signature page, and therefore should be kept short (it is suggested that this section should be no longer than three pages).
1.1 Strategic Intentions/Priorities
This must include a brief outline of the key strategic outcomes or objectives for the DHB to enable it to deliver on local, regional and national health needs, and include brief commitment statements to:
· the Treaty of Waitangi
· the New Zealand Health Strategy
· the Healthy Ageing Strategy
· the UN convention on the Rights of Persons with Disabilities
· Ala Mo’ui: Pathways to Pacific Health and Wellbeing 2014-2018.
1.2 Message from the Chair and Chief Executive
1.3 Signature Page
SECTION 2: DELIVERING ON PRIORITIES
This section should include DHB commitments to each of the Government priorities outlined in the Minister’s Letter of Expectations. Please note that it is suggested that this section should be no longer than ten to twelve pages.
DHBs need to engage with relevant stakeholders, including their primary care partners, when developing their 2017/18 APs.
2.1 Government Planning Priorities
Overarching Government priorities are presented in the Minister’s Letter of Expectations, which will be sent to DHB Chairs in December 2016. The planning priorities for DHB 2017/18 APs are:
Prime Minister’s Youth Mental Health Project
Reducing Unintended Teenage Pregnancy Better Public Service (contributory) Target
Supporting Vulnerable Children Better Public Service Target
Healthy Mums and Babies Better Public Service Target
Keeping Kids Healthy Better Public Service Target
Increased Immunisation Health Target
Shorter Stays in Emergency Departments Health Target
Improved Access to Elective Surgery Health Target
Faster Cancer Treatment Health Target
Better Help for Smokers to Quit Health Target
Raising Healthy Kids Health Target
Bowel Screening
Mental Health
Healthy Ageing
Living Well with Diabetes
Childhood Obesity Plan
Child Health
Disability Support Services
Primary Care Integration
Pharmacy Action Plan
Improving Quality
Living Within our Means.
In addition, DHBs should also identify any significant individual DHB actions to deliver on the Regional Service Plan priorities. These should be identified within the annual plan priority where the priorities overlap (such as ‘Mental Health’) or in the separate ‘Delivery of Regional Service Plan’ section of the planning priorities template within the Planning Priorities Guidance for those priorities that do not overlap.
The full detail of expectations within each priority is outlined in the Planning Priorities Guidance and inclusion of the templates within that guide are mandatory.
Detailed guidance on for the 2017/18 RSPs is available in the Regional Service Plan Guidelines.
2.2 Financial Performance Summary
This needs to include the consolidated statement of comprehensive income (previous year’s actual, current year’s forecast and three years plan), and the prospective summary of revenue and expenses by output class for the next three years.
2.3 Local and Regional Enablers
This component will outline the DHB specific actions to deliver on the following local and regional enablers:
Information Technology
Workforce.
More detail of expectations within each enabler is outlined in the Planning Priorities Guidance and inclusion of the templates within that guide are mandatory.
SECTION 3: SERVICE CONFIGURATION
Inclusion of the below service change template is mandatory within this section, if there are service changes to include. Please note that it is suggested that this section is no longer than two pages.
3.1 Service Coverage
In this section DHBs need to:
· describe all service coverage exceptions that have been approved for the 2017/18 year
· provide a high-level explanation setting out why the exceptions have been required and the process followed for approval.
*It is also suggested that DHBs include an express empowering provision for service agreements in the AP to avoid any doubt in relation to section 25(2) of the New Zealand Public Health and Disability Act 2000. DHBs are encouraged to seek independent legal advice on appropriate wording for this.
3.2 Service Change
DHBs are to describe all service changes that have been approved for implementation in the 2017/18 year. For each change, DHBs must explain how the changes will deliver benefits (see the below example).
Service coverage exceptions and service changes must be formally approved before they are included in APs. As in previous years DHBs are expected to provide early signals of proposed service changes to the Ministry. These are required by Friday 3 February 2017.
The template (with example) below must be included within this section, if there are service changes to include. The template should include a summary of the proposed service change information provided to the Ministry on Friday 3 February 2017.
Change / Description of Change / Benefits of Change / Change for local, regional or national reasonsRenal Services / We will explore how the DHB might better meet the renal needs of itscommunity with a specific focus on the southern part of the population. / Improved access, reduced cost, earlier intervention, improvement of long term outcomes. / Local
SECTION 4: STEWARDSHIP
This section will outline the DHB’s stewardship of its assets, workforce, IT/IS and other infrastructure needed to deliver planned services. Please note that it is suggested that this section only be up to two pages.
4.1 Managing our Business
Reflect the scale and scope of the DHB’s services and show the extent of resources required to provide these services. Consider briefly commenting on:
· organisational performance management
· funding and financial management (key high-level figures/assumptions)
· investment and asset management
· shared service arrangements and ownership interests
· risk management
· quality assurance and improvement.
4.2 Building Capability
Briefly outline the capabilities the DHB will need over the next three to five years and reference any sub-plans the DHB uses to support improvements in capability. Link to national or regional plans (including comment on the New Zealand Health Strategy) where relevant, and include high-level comments on:
· capital and infrastructure development
· information technology and communications systems
· workforce (including organisational culture, leadership and workforce development)
· co-operative developments (working with other organisations eg, education and training providers).
SECTION 5: PERFORMANCE MEASURES
Please note that it is suggested that this section is no longer than four pages.
5.1 2017/18 Performance Measures
Inclusion of a summary of the performance measures and performance expectations is required in this section. The below performance measures template is not mandatory but is an example of what could be included. Note: the full detail of the monitoring framework for 2017/18 forms a separate component part of the planning package.
Include the full set of performance measures in the template and ensure accuracy across any other use of this information in other parts of the document (eg, Health Target figures shown here match those used in Section 2 and Appendix A) and other plans.
The DHB monitoring framework aims to provide a rounded view of performance using a range of performance markers. Four dimensions are identified reflecting DHB functions as owners, funders and providers of health and disability services. The four identified dimensions of DHB performance cover:
· achieving Government’s priority goals/objectives and targets or ‘Policy priorities’
· meeting service coverage requirements and supporting sector inter-connectedness or ‘System Integration’
· providing quality services efficiently or ‘Ownership’
· purchasing the right mix and level of services within acceptable financial performance or ‘Outputs’.
Each performance measure has a nomenclature to assist with classification as follows:
Code Dimension
HS Health Strategy
PP Policy Priorities
SI System Integration
OP Outputs
OS Ownership
DV Developmental – Establishment of baseline (no target/performance expectation is set)
Inclusion of ‘SLM‘ in the measure title indicates a measure that is part of the ‘System Level Measures’ identified for 2017/18.
Performance measure / Performance expectationHS: Supporting delivery of the New Zealand Health Strategy / Quarterly highlight report against the Strategy themes.
PP6: Improving the health status of people with severe mental illness through improved access / Age 0-19
Age 20-64
Age 65+
PP7: Improving mental health services using wellness and transition (discharge) planning / 95% of clients discharged will have a quality transition or wellness plan.
95% of audited files meet accepted good practice.
PP8: Shorter waits for non-urgent mental health and addiction services for 0-19 year olds / 80% of people seen within 3 weeks.
95% of people seen within 8 weeks.
PP10: Oral Health- Mean DMFT score at Year 8 / Year 1
Year 2
PP11: Children caries-free at five years of age / Year 1
Year 2
PP12: Utilisation of DHB-funded dental services by adolescents (School Year 9 up to and including age 17 years) / Year 1
Year 2
PP13: Improving the number of children enrolled in DHB funded dental services / Year 1
Year 2
PP20: Improved management for long term conditions (CVD, Acute heart health, Diabetes, and Stroke)
Focus Area 1: Long term conditions / Report on activities in the Annual Plan.
Focus Area 2: Diabetes services / Implement actions from Living Well with Diabetes.
Improve or, where high, maintain the proportion of patients with good or acceptable glycaemic control (HbA1C indicator).
Focus Area 3: Cardiovascular health / 90% of the eligible population will have had their cardiovascular risk assessed in the last 5 years.
Percentage of ‘eligible Māori men in the PHO aged 35-44 years’ who have had their cardiovascular risk assessed in the past 5 years.
Focus Area 4: Acute heart service / 70% of high-risk patients receive an angiogram within 3 days of admission.
Over 95% of patients presenting with ACS who undergo coronary angiography who have completion of ANZACS QI ACS and Cath/PCI registry data collection within 30 days.
Over 95% of patients undergoing cardiac surgery at the regional cardiac centres will have completion of Cardiac Surgery registry data collection within 30 days of discharge.
Focus Area 5: Stroke services / 8% or more of potentially eligible stroke patients thrombolysed 24/7.
80% of stroke patients admitted to a stroke unit or organised stroke service with demonstrated stroke pathway.
80% of patients admitted with acute stroke who are transferred to inpatient rehabilitation services are transferred within 7 days of acute admission.
PP21: Immunisation coverage / 95% of two year olds fully immunised
95% of four year olds fully immunised
75% of girls fully immunised – HPV vaccine
75% of 65+ year olds immunised – flu vaccine
PP22: Delivery of actions to improve system integration including SLMs / Report on activities in the Annual Plan.
PP23: Implementing the Healthy Ageing Strategy / Report on activities in the Annual Plan.
Percentage of older people who have received long-term home and community support services in the last three months who have had an interRAI Home Care or a Contact assessment and completed care plan. / 95%
PP25: Prime Minister’s youth mental health project / Initiative 1: Report on implementation of school based health services (SBHS) in decile one to three secondary schools, teen parent units and alternative education facilities and actions undertaken to implement Youth Health Care in Secondary Schools: A framework for continuous quality improvement in each school (or group of schools) with SBHS.
Initiative 3: Youth Primary Mental Health. As reported through PP26 (see below).
Initiative 5: Improve the responsiveness of primary care to youth. Report on actions to ensure high performance of the youth service level alliance team (SLAT) (or equivalent) and actions of the SLAT to improve health of the DHB’s youth population.
PP26: The Mental Health & Addiction Service Development Plan / Provide reports as specified for the focus areas of Primary Mental Health, District Suicide Prevention and Postvention, Improving Crisis Response services, improving outcomes for children, and improving employment and physical health needs of people with low prevalence conditions.