GRAMPIAN NHS BOARD

Revised Structure and Membership of the Service Strategy and Redesign Committee

Introduction

At an executive level, the management of NHS Grampian’s strategic and operational function has until recently been co-ordinated through the Operational Management Team (OMT), chaired by the Chief Executive. In order to better manage the strategic and operational functions,a decision was taken by OMT to split and to address these functions in two separate forums, OMT and the Strategic Management Team (SMT).

The Service Strategy and Redesign Committee (SSRC) was established as a sub-committee of the Grampian NHS Board in September 2003, in line with guidance provided in “Partnership for Care”. The SSRC reviewed its remit, membership and performance in 2008, to ensure consistency with current Scottish Government Policy and best practice requirements.

In light of the recent development of the SMT, the membership of the SSRC has been reviewed and refined. There are no plans to amend the remit of the SSRC.

Aim Of Paper

This paper recommends changes to the membership of SSRC in light of the recent establishment of the SMT.

Discussion

Background

The role and remit of the OMT was reviewed in order to improve manageability of the agenda and the efficiency of the meeting, resulting in agreement to split the executive workload into operational and strategic functions. It was agreed that OMT would continue to deliver the operational function and that SMT would be established to deliver the strategic function at executive level. The role and remit of SMT is attached as appendix 1.

The SSRC was established in 2003 as a formal sub-committee of the Grampian NHS Board. The purpose of the Committee is broadly to enable Non-Executive and Executive Directors, Senior Managers and Clinicians to influence and shape NHS Grampian’s strategic direction and redesign agenda, as well as being assured of effective strategic development.

The SSRC meets formally 4 times per year as a formal sub-committee of the NHS Board, and sponsors a range of seminars and workshops throughout the year involving a wide range of stakeholders. The Committee reviewed its role, function and effectiveness during 2008 and specifically reviewed the membership in August 2009, in light of the development of SMT. There are no plans to change the remit of SSRC.

Recommended Changes In SSRC Membership

In the interests of avoiding duplication and maximising capacity and efficiency, it is recommended that the membership of the SSRC is revised. Executive Directors, General Managers and Clinical Leads will routinely be involved in the SMT and it is proposed that they are no longer required to attend the formal committee meetings of the SSRC. It is proposed that the SSRC committee meetings principally involve Non-Executive Directors of the Board,with the support of a small number of Executives.

The suggested core membership of SSRC is as follows:

  • Non-Executive Director as Chairperson
  • CHP/Acute Sector Non-Executive Chairs
  • Chief Executive
  • Director of HR & Strategic Change
  • Director of Planning
  • Chair of the Advisory Clinical Forum

Members of the Board may attend SSRC committee meetings at anytime they wish, and will be included in the circulation of SSRC papers. Other Senior Managers and Clinicians would attend depending on the agenda. The revised SSRC role and remit is attached as appendix 2.

Linkage between SSRC and SMT is critical in the strengthening of the structure; this will be achieved through the membership of the Chief Executive, Director of Planning and Director of Human Resources and Strategic Change who are members of both groups. Minutes for the SMT and SSRC will be presented to the other forum to ensure connectivity and to support communication.

The Service Planning Lead for Public Health and Planning (Grampian Health Plan/MCNs) would be in attendance and will assist in preparing the agendas for both the SMT and the SSRC meetings.

SSRC’s role will continue to drive the strategic agenda and provide assurance to the Grampian NHS Board on the strategic direction. In order for this to occur, the annual schedule of the SSRC sponsored seminars and workshops will continue, andthese will reflect topics raised at both the SSRC and SMT meetings. An aligned annual work programme for SMT and SSRC will be developed and agreed by both forums.

Resource Implications

There are no resource implications associated with these developments, however, it is anticipated that these changes will support more effective and efficient use of executive staff capacity.

Key Risks

The key risks associated with not implementing the proposal outlined in this paper are that, there would be a failure to take the opportunity to reduce potential duplication and therefore, maximise membership and organisational capacity and efficiency in relation to SMT and SSRC.

Conclusion

In order to enhance the executive functions within NHS Grampian, a restructuring of executive meetings has occurred where business is now managed via two distinct forums, OMT and SMT. SSRC’s role will continue to drive the strategic agenda, in addition to providing assurance to the Grampian NHS Board on the strategic direction of the organisation.

This paper outlines the recommendation to refine SSRC membership to focus on Non-Executive Directors of the Board, with support from a small number of Executives. There are no plans to change the function of SSRC.

Recommendations

It is recommended that members of the Grampian NHS Board:

  1. note the changes to the executive level management of the operational and strategic agenda through OMT and SMT.
  2. approve the revised changes to the membership of the SSRC.

Author/s

Professor Neva Haites, Chair of SSRC

David Sullivan, Director of Corporate Planning, NHS Grampian

Lorraine Scott, Service Planning Lead for Public Health & Planning

Contact

David Sullivan, Director of Corporate Planning

Date

29th September 2009

Appendix 1

Strategic Management Team

Role and Remit

Date: May 2009

STRATEGIC MANAGEMENT TEAM

1. / purpose
The Strategic Management Team (SMT) will provide Executive Leadership of the Grampian Health Plan and associated strategies and plans. The SMT will be responsible for strategic development, change and redesign across NHS Grampian ensuring that complex interdependencies are managed and co-ordinated through a suite of priority programmes, which together form the Change and Innovation Programme and through Managed Clinical Networks. This will be done by following systematic and structured processes that make for effective and efficient planning and decision making. The SMT will form the basis of Executive input to the Service Strategy Redesign Committee, a sub committee of the Grampian NHS Board. The SMT will therefore, through the SSRC, enable the NHS Board to carry out it strategic functions.
2. / role and Remit
2.1 / To formulate NHS Grampian’s vision and strategic direction including clear statements of purpose, values and strategic objectives.
2.2 / To assess NHS Grampian’s external environment in order to identify and understand current and anticipated drivers for change and the needs and expectations of patients, public, partners and other key stakeholders.
2.3 / To develop an organisational profile that reflects NHS Grampian’s internal conditions and capabilities.
2.4 / To analyse the organisation’s options by matching its resources in context of the external environment.
2.5 / To identify the most desirable options for direction and development of NHSG and evaluating each in the light of NHS Grampian’s vision and values.
2.6 / To develop a set of long-term objectives and grand strategies that will achieve the most desirable options.
2.7 / To develop annual objectives and short term action plans that are compatible with the strategic objectives.
2.8 / To contribute towards implementation of strategic developments and annual objectives by means of budgeted resource allocations which emphasise the matching of tasks, people, structures and technologies.
2.9 / To evaluate the success of this strategic approach to influence future organisation and decision-making.
In practical terms the SMT will therefore
●Lead the development of the Grampian Health Plan.
●Provide overall leadership and direction for the development of associated plans including 5 year Financial Plan, Capital Plan, Workforce Plan etc. (Detailed work to be undertaken by sub groups e.g. AIG, Workforce Steering Group etc).
●Develop and agree the broad strategic themes which will underpin the Health Plan and set specific, measurable, time bound strategic objectives.
●Provide a clear strategic framework within which robust operational plans can be developed and implemented.
●Provide leadership and strategic direction for the Change and Innovation Programme, facilitating and supporting the work of a limited number of priority programmes through the Continuous Service Improvement Group.
●Informing and approving the prioritised work programme of the Continuous Improvement Group.
●Providing leadership and direction of MCN’s facilitating and supporting their work as well as monitoring the progress and performance.
●Identifying the key risks to achievement of NHSG’s Strategic Objectives and ensuing that these are effectively managed within the Corporate Risk Control Plan.
3. / STRATEGIC MANAGEMENT team - KEY RELATIONSHIPS
The SMT forms part of the broader leadership and managerial framework for NHS Grampian. The SMT will report directly to the SSRC and via this sub-committee to the Grampian NHS Board.
The SMT will also report to both the SSRC and the PGC in relation to performance against strategic objectives and in particular the progress of the priority programmes which make up the Change and Innovation Programme.
The SMT will have a critical relationship with both the OMT and the CSIG providing the strategic context and direction for operational activity/ implementation and service improvement effort, respectively.
4. / Membership
Chief Executive
Director of Finance/Deputy Chief Executive
Medical Director
* Director of Public Health
* Director of Planning
Director of Nursing
* Director of HR and Strategic Change
* Director of Performance Improvement/Board Secretary
~CHP/Acute General Managers + Clinical Leads
Employee Director
* Director of Corporate Communications
Chair of Area Clinical Forum
NB. ~ CHP/Acute General Managers and Clinical Leads provide the essential link between strategy development and operations
* An Executive Lead for each strategic theme has already been identified
5. / ATTENDANCE
Other staff may be invited to attend SMT meetings to inform and/or report on specific matters.
Other members of NHS staff in Grampian may also attend as observers by prior arrangement.
6. / QUORUM
A quorum is 50% of members plus one.
7. / Deputies
The Chair can appoint a Meeting Deputy (to cover unavoidable absence) from the members. Member deputies will be allowed.
8. / Meetings
It is expected that there will be 6 meetings per annum on last Wednesday of every second month running alternately with the Operational Management Team meetings.
9. / Minutes/Reports
The minutes of meetings will be circulated to SSRC, Executive Team members, Sector Management Teams and Grampian Area Partnership Forum. An Action Sheet summarising the key actions required to be taken by members will be issued within 24 hours of the meeting.
All minutes are publicly available online under the terms of the Freedom of Information (Scotland) Act 2002.
10. / STANDING ORDERS
The provisions of the NHS Grampian Standing Orders for Board meetings shall apply to this meeting as far as is practicable and appropriate.
Decisions reached by the SMT are by consensus with all members agreeing to abide by such decisions
11. / Sub-groups
There may be informal/formal sub groups dependent on programme of work of the SMT.

Appendix 1

SMTSub Groups Appendix 2

Group / Chair / Frequency
Continuous Service Improvement Group / Mark Sinclair / Minimum of 6 times per year
Asset Investment Group / David Sullivan / Monthly
Workforce Steering Group / Mark Sinclair / 4 x per annum
Inequalities Steering Group / Lesley Wilkie / 4 x per annum

Appendix 2

Service Strategy & Redesign Committee

Constitution

(September 2009)
NHS GRAMPIAN

SERVICE STRATEGY AND REDESIGN COMMITTEE

1.BACKGROUND

The Service Redesign and Redesign Committee (SSRC) was established asa sub-committee of the Grampian NHS Board in September 2003 in line with guidance provided in “Partnership for Care” and HDL 2003 (ii). The SSRC reviewed its remit, membership and performance in January 2008 to ensure consistency with Current Scottish Government Policy and Guidance and bestpractice requirements.

2.KEY FUNCTIONS AND RESPONSIBILITIES OF THE SSRC

The SSRC is charged with developing the overarching strategy for the Grampian NHS Board and for overseeing ongoing system and service redesign. The Committee is responsible for steering the development of the Grampian Health Plan, NHS Grampian’s key strategic document which sets out the Board’s vision, long term strategic direction and objectives. The Committee also ensures that this is consistent with national policy, best practice and the main drivers for change.

The SSRC is also responsible for initiating, steering and influencing the development of a range of programmes and projects which reflect NHS Grampian’s strategic priorities and which together form the Change & Innovation Programme.

The key functions and responsibilities of the SSRC can be summarised asfollows.

  • To develop a clear understanding of the needs of the population of Grampian (and where appropriate the North of Scotland) and the current and long term drivers for change, as a foundation for strategic planning – Director of Public Health Report.
  • To develop, shape and oversee the long term strategy for health and healthcare services in Grampian on an ongoing basis – Healthfit.
  • To reflect this strategy, the long term and annual objectives in the Grampian Health Plan.
  • To develop, steer and oversee a comprehensive multi-functional programme of change and redesign in order to achieve NHS Grampian’s strategic objectives – Change & Innovation Programme.
  • To ensure that the internal conditions and capabilities of NHS Grampian are developed and aligned to achievement of the strategy and objectives – OD Plan.
  • To match resources (people, facilities, money) to strategic choices and priorities – Financial Plan, Workforce Plan, Capital Plan.
  • Evaluation of the impact of NHS Grampian’s Strategy.

3.METHOD OF OPERATION

In carrying out its responsibilities the SSRC must:

(a)Demonstrate active participation by patients and leadership by clinicians.

(b)Challenge traditional boundaries of service delivery.

(c)Develop sustainable services.

(d)Ensure information systems support changing patterns of care.

In addition, the SSRC should promote and actively demonstrate a commitment to continuous improvement with an emphasis on:

(i)Developing community health services through Community HealthPartnerships (CHP’s).

(ii)Increasing integration of primary, community and specialist care through the development of system-wide patient pathways and managed clinical networks.

Given its key functions and responsibilities and the need to involve a wide range of stakeholders, the SSRC should sponsor and facilitate an annual programme of workshops and seminars to explore and develop strategies and significant redesign themes and topics.

In order to meet its responsibilities as a sub-committee of the Grampian NHS Board there should be a minimum of four minuted meetings of the Committee each year. Minutes to be presented to the Grampian NHS Board.

The outcome of workshops and seminars should be presented and recommended to the Grampian NHS Board for information and/or approval.

The relationship between the SSRC (strategic planning and development and assurance function), the SMT (executive strategic development, implementation and performance), OMT (implementation and performance management) and the PGC(governance and assurance) will be critical.

Membership of the SSRC committee meetings principally involves Non-Executive Directors of the Board with the support of a small number of Executives. The Committee should be chaired by a Non-Executive Director of the Grampian NHS Board, supported by an Executive Director.

The core membership of SSRC is as follows:

  • Non-Executive Director as Chairperson
  • CHP/Acute Sector Non-Executive Chairs
  • Chief Executive
  • Director of HR & Strategic Change
  • Director of Planning
  • Chair of the Advisory Clinical Forum

The Chairman of NHS Grampian and other Non-Executive’s will be included in the circulation of SSRC papers. All members of the Board may attend SSRC committee meetings if theyso wish. Other Senior Managers and Clinicians will attend depending on the agenda.

Executive members of the SSRC are also members of SMT, they have a key role in ensuring appropriate reportingof decisions made at either SMT or SSRC are communicated to the other forum. Supporting this will be the circulation of minutes to the other forum.

Executive Directors, General Managers and Clinical Leads will routinely be involved in the SMT but will with other key stakeholders, be critical inthe SSRC sponsored workshops and seminars.

David Sullivan

Director of Corporate Planning

September 2009