VelindreNHSTrust BenchmarkingStrategy

Trust Strategy Lead:LHeydon-Mann

VELINDRENHSTRUST

BLACK: 127

TRUSTSTRATEGY

BENCHMARKINGSTRATEGY & FRAMEWORK

Lead:LHeydon-Mann,ClinicalGovernanceRiskManager.

ExecutiveSummary

EXECUTIVESUMMARY
TrustBenchmarkingStrategy & Framework
Overview: / TheTrustwillpro-activelybenchmarkitsServicesasanongoing,integralpartofanongoingimprovementprocess,withthegoalofcontinuousimprovement.TheBenchmarkingStrategy & Framework supportstheclinicaleffectivenessandperformancemanagementstructureoftheTrustandshouldbeimplementedinaccordancewithresponsibilitiesasperthatstructure.
Whoisthepolicyintendedfor: / AllTrustStaff
KeyMessagesincludedwithinthepolicy: / TheBenchmarkingStrategy & Frameworkrequiresthatbenchmarkingactivityiscapturedandresultsarerecordedandreported.ItisacknowledgedthatbenchmarkingisalreadyembeddedinthebusinessoftheTrust,however,suchperformanceactivityisnotalwaysidentifiedasbenchmarking.
Forthepurposeofthisstrategy,theapplicationofbenchmarkingisdefinedashavingfourkeystepswhicharedescribedintheStrategy.
ServiceDivisionshavearesponsibilitytoincludebenchmarkingaspartoftheiroverallperformanceimprovementframeworkandwillhavelocalplansinplacetoaddressthis.
TheBenchmarkingFramework supports the BenchmarkingStrategy.ThisFramework consistsofthemainStrategicbenchmarkingprioritiesfortheTrust
The Strategy also provides a template for reporting to the Modernisation Board
PLEASENOTETHISISONLYASUMMARYOFTHEPOLICYANDSHOULDBEREADINCONJUNCTIONWITHTHEFULLPOLICYDOCUMENT

TableofContents

Executive Summary

Introduction

Background

Policy

Scope

Responsibilities

The Benchmarking Process

When to Benchmark

Training

Monitoring

Contacts

Appendix 1

Appendix 2

Appendix 3……………………………………………………………………… 10

Appendix 4 Framework………………………….……………………………… 11

1.Introduction

BenchmarkingisincreasinglybecominganeverydaypartofworkwithintheTrustasameansofcontinuousimprovement.TheNHSmodernisationagendarecognisesbenchmarkingasakeytoolintheimprovementofhealthcareprovidersandtheirservices.

TheVelindreBenchmarking Strategy & Framework supportstheTrustAnnualOperationalFrameworkandimplementationoftheHealthcareStandardsforWalesandunderpinstheperformancemanagementofallotherTruststrategiesandpolicies.TheBenchmarkingStrategyalsotakesaccountoftheTrustContinuousImprovementCycle(Appendix1).

2.Background

BenchmarkinginVelindreisdescribedastheprocessofidentifying"bestpractice"inrelationtobothservicesandtheprocessesbywhichthoseservicesaredevelopedanddelivered.

Thesearchfor"bestpractice"cantakerplacebothinsidetheTrustandalsoinothercomparableorganisations(forexample-aretherelessonstobelearnedfromotherhealthcareproviders).

TheobjectiveofbenchmarkingwithinVelindreNHSTrustistounderstandandevaluatethecurrentpositionofourbusinessinrelationto"bestpractice"andtoidentifyareasandmeansofcontinuousimprovement.

3.Policy

TheTrustwillpro-activelybenchmarkitsServicesasanongoing,integralpartofanongoingimprovementprocess,withthegoalofcontinuousimprovement.Inachievingthis,theTrustwill;

  • Seektocompareitselfwithhighperformingorganisationsandwherepossible,thisshouldbebestinclass
  • Usecomparativedatafromotherlikeorganisationstoassessthequalityoftheservicesweprovideandtoidentifybestinclassorganisations
  • Focusonroles,processes,andstrategicissues
  • Conductingandparticipatinginauditsandparticipateinnationalaudits
  • Eachservicedivisiontoidentifywhoandwhatareasoftheirservicetobenchmark
  • TheTrustCorporatedepartmenttoensurevalueandquality–toconsiderbenchmarkingaspartoftheirownmodernisationagenda
  • ConsidertheeffectiveuseofIT
  • TheTrustwilltakeallreasonablestepstoassistotherswithbenchmarkingrequests–particularlywherewehavebestinclassperformanceandprocesses

ThisstrategyallowsflexibilityacrosstheTrustsothatindividualServiceDivisionsmaybenchmarkoutsideofthisprotocolifconsideredappropriatebytheServiceDirector.

EachServiceDivisionwillhavelocalperformanceindicatorsandwilldeterminewhichoftheseindicatorstobenchmarkandwhichmethodshouldbeused.WhilstflexibilityremainswiththeServicedivision,itwouldbeunwisetoproceedwithanypartofthebenchmarkingprocesswithoutgivingfullconsiderationtowhatresultsareexpectedandwhatinformationisneeded.

With regards to strategic benchmarking, it should be noted that performance measures may need to be quite general, however, the important point is that benchmarking is integral to the work of the Trust and is deployed wherever possible in order to deliver a quality service.

TheBenchmarkingStrategyrequiresthatbenchmarkingactivityiscapturedandresultsarerecordedandreported.ItisacknowledgedthatbenchmarkingisalreadyembeddedinthebusinessoftheTrust,however,suchperformanceactivityisnotalwaysidentifiedasbenchmarking.Greateremphasisisthereforerequiredforidentifyingbenchmarkingactivityandreportingresultstotheappropriategroup/committee.

4.Scope

ThisStrategyappliestoallServiceDivisionsoftheTrustandtotheCorporatestructureandworksinharmonywithotherperformancemanagementtoolsandtechniquesalreadyinuse.

5.Responsibilities

TheBenchmarkingStrategysupportstheclinicaleffectivenessandperformancemanagementstructureoftheTrustandshouldbeimplementedinaccordancewithresponsibilitiesasperthatstructure.

6.TheBenchmarkingProcess

ForthebenefitofVelindreNHSTrust,benchmarkinginvolveslookingoutward(outsideofthedepartment/Division/Trust,regionorcountry)toexaminehowothersachievetheirperformancelevelsandwhereperformancelevelsarehigher,tounderstandtheprocessestheyuse.Whenthelessonslearntfromabenchmarkingexerciseareappliedappropriately,theycanfacilitateimprovedperformanceinkeyareasofservicedeliveryandwillinturnleadtocontinuousimprovement.

Forthepurposeofthisstrategy,theapplicationofbenchmarkingisdefinedashavingfourkeysteps:

(1)Understandindetailexistingbusinessprocesses

(2)Analysethebusinessprocessesofothers

(3)Compareownbusinessperformancewiththatofothersanalysed

(4)Implementthestepsnecessarytoclosetheperformancegap

ThereareanumberofdifferenttypesofbenchmarkingwhichtheTrustwillusewhicharesummarisedinappendix2.

7.WhentoBenchmark

TheTrustwillconsiderandincludebenchmarkingactivityinallareasofprojectdeliveryandserviceimprovementactivity.Inaddition,theServiceDivisionshavearesponsibilitytoincludebenchmarkingaspartoftheiroverallperformanceimprovementframeworkandwillhavelocalplansinplacetoaddressthis.Asaminimum,theTrustwillconsiderbenchmarkinginthefollowingsituations:

  • Qualityprogramsaudit
  • Costreduction/budgetprocess
  • Serviceimprovementdirectives
  • Managementchange
  • Newoperations/newventures
  • Reviewingexistingstrategies

Benchmarkingcanbeusedtoestablishthefunctionormissionofanorganisation.Itcanalsobeusedtoexamineexistingpracticeswhilelookingattheorganisationasawholetoidentifypracticesthatsupportmajorprocessesorcriticalobjectives.Whenfocusingonspecificprocessesoractivities,thedepthoftheanalysisisakeyissue.

Benchmarkingusesdifferentsourcesofinformation,includingpublishedmaterial,networking,meetings,partnershipworking,knowledgefromspecialistsinfield,serviceusersandstakeholders,statisticalanalysisandresearch.Thereareseveralkeystosuccessfulbenchmarkingofwhichmanagementcommitmentisthecrucialcomponent.TheExecutiveTeamarethereforecommittedtotheprinciplesofbenchmarkingandactivelypromoteitsbenefitsacrosstheTrust.

8.Training

Inordertoimplementbenchmarkingatallstages,theremustbeawell-trainedteamofpeoplefortheprocesstoworkaccuratelyandefficiently.Basedontheinformationgatheredbyawell-trainedteam,theremustalsobeanefforttowardcontinuousimprovement.Otherkeysincludeabenchmarkingprocessthathashistoricalsuccess,sufficienttimeandstaff,andcompleteunderstandingoftheprocessestobebenchmarked.

TheTrustsupportstheabovebydemonstratingacommitmenttothedevelopmentofitsstaffinallareas.TheKSFandobjectivesettingprocesswillidentifythosestaffwitharesponsibilityforperformancemanagementandmonitoring/implementingserviceimprovement,andwillprovidetraining/developmentasnecessarytofacilitatethisprocess.

9.Monitoring

AnannualBenchmarkingFrameworkwillsupporttheBenchmarkingStrategy.ThisFrameworkwillconsistofthemainbenchmarkingprioritiesfortheTrustandperformanceagainstthisframeworkwillbereportedtotheTrustClinicalGovernanceRiskManagementCommittee,theTrustPlanningandPerformanceGroup and the Trust Modernisation Board.

The Healthcare Standards for Wales promote benchmarking in order to achieve continuous improvement. In line with the Trust’s Governance arrangements, and in order to provide sufficient evidence for the Healthcare Standards a template has been produced at appendix 3 which should be used to report modernisation, benchmarking, continuous improvement and service user involvement.

10.Contacts

ForfurtherinformationonthisstrategypleasecontacttheTrustClinicalGovernanceRiskManagerortheTrustHeadofPlanningPerformance

Appendix1

CurrentTrustContinuousImprovementFramework(agreedMay2007)

Implementationduringtransitionalyear(2007/08)

Appendix2

Type / Description / MostAppropriatefortheFollowingPurposes
StrategicBenchmarking / WheretheTrustorDivisionneedtoimproveoverallperformancebyexaminingthelong-termstrategiesandgeneralapproachesthathaveenabledhigh-performerstosucceed.Itinvolvesconsideringhighlevelaspectssuchascorecompetencies,developingnewproductsandservicesandimprovingcapabilitiesfordealingwithchangesintheexternalenvironment.Changesresultingfromthistypeofbenchmarkingmaybedifficulttoimplementandtakealongtimetomaterialise / Re-aligningbusinessstrategiesthathavebecomeinappropriate.
PerformanceorCompetitiveBenchmarking / TheTrust/Divisionconsiderstheirpositioninrelationtoperformancecharacteristicsofkeyservices.Benchmarkingpartnersaredrawnfromthesamesector.Thistypeofanalysisisoftenundertakenthroughthirdparties(suchasinternalauditdepartmentsandexternalauditorssuchasHIW)toprotectconfidentiality. / Assessingrelativelevelofperformanceinkeyareasoractivitiesincomparisonwithothersinthesamesectorandfindingwaysofclosinggapsinperformance
ProcessBenchmarking / TheTrust/Divisionfocusesonimprovingspecificcriticalprocessesandoperations.Benchmarkingpartnersaresoughtfrombestpracticeorganisationsthatperformsimilarworkordeliversimilarservices.Processbenchmarkinginvariablyinvolvesproducingprocessmapstofacilitatecomparisonandanalysis.Thistypeofbenchmarkingoftenresultsinshorttermbenefits. / Achievingimprovementsinkeyprocessestoobtainquickbenefits
FunctionalBenchmarking / TheTrust/Divisionlookstobenchmarkwithpartnersdrawnfromdifferenthealthsectorsorareasofactivitytofindwaysofimprovingsimilarfunctionsorworkprocesses.Thissortofbenchmarkingcanleadtoinnovationanddramaticimprovements. / Improvingactivitiesorservicesforwhichcounterpartsdonotexist.
InternalBenchmarking / InvolvestheTrustbenchmarkingprocessesoroperationsacrosstheTrust(e.g.corporatefunctionsintheDivisions).Themainadvantagesofinternalbenchmarkingarethataccesstosensitivedataandinformationiseasier;standardiseddataisoftenreadilyavailable;and,usuallylesstimeandresourcesareneeded.TheremaybefewerbarrierstoimplementationaspracticesmayberelativelyeasytotransferacrosstheDivisions.However,realinnovationmaybelackingandbestinclassperformanceismorelikelytobefoundthroughexternalbenchmarking. / SeveralcorporatefunctionswithintheTrustexemplifygoodpracticeandmanagementwanttospreadthisexpertisequickly,throughouttheTrust
ExternalBenchmarking / InvolvestheTrustanalysingoutsideorganisationsthatareknowntobebestinclass.Externalbenchmarkingprovidesopportunitiesoflearningfromthosewhoareatthe"leadingedge".Thistypeofbenchmarkingcantakeupsignificanttimeandresourcetoensurethecomparabilityofdataandinformation,thecredibilityofthefindingsandthedevelopmentofsoundrecommendations. / Whereexamplesofgoodpracticescanbefoundinotherorganisationsandthereisalackofgoodpracticesinternally
InternationalBenchmarking / Bestpractitionersareidentifiedandanalysedelsewhereintheworld,perhapsbecausetherearetoofewbenchmarkingpartnerswithinthesamecountrytoproducevalidresults.Globalisationandadvancesininformationtechnologyareincreasingopportunitiesforinternationalprojects.However,thesecantakemoretimeandresourcestosetupandimplementandtheresultsmayneedcarefulanalysisduetonationaldifferences / Wheretheaimistoachieveworldclassstatusorsimplybecausethereareinsufficient"national"businessesagainstwhichtobenchmark

Appendix 3

Service Modernisation Report
Service Division: / Period:
Activity 1 (description of activity/initiative/project)
Link to Healthcare Standards (provide reference to relevant HCS)
Benchmarking activity undertaken (provide details of internal and external benchmarking)
Improvements in service delivery identified (state the outcomes and improvements)
Service User Involvement (provide details of user involvement or stakeholder involvement)

Appendix 4

AnnualBenchmarking

Framework2009/2010

Contents

Strategic Objectives 2009 – 201014

Designed to Work Framework14

Informing Healthcare14

Corporate Services15

Corporate Health Standard15

HSE Stress Management Standards15

Velindre Cancer Centre16

Welsh Blood Service17

Screening Services17

StrategicObjectives2009–20010

NB: As part of the Delivering the New NHS for Wales Consultation Paper ii, the Velindre NHS Trust will be undergoing considerable re-organisation during 2009. The following framework does not take account of any benchmarking activity undertaken as part of the project management of the re-organisation but concentrates on the services which support the delivery of the Annual Operational Framework and the Healthcare Standards

TheVelindreNHSTrustAnnualOperationalFrameworkhasbeendevelopedtocontainallapplicabletargetswithintheNHSWalesAnnualOperatingFramework(AOF)for2009/2010.TheFrameworkcontainsspecificactionswhichdetailhowperformanceandqualitywillbedeliveredinlinewithnationaltargets. BenchmarkingactivitywillalreadybebuiltintotheperformancedeliveryofthosetargetsandwillbeaseamlessprocessindeliveringagainsttheAOF.InadditiontotheTrustAOF,theServiceDivisionsarerequiredtohavelocalservicemodernisationplans,whicharereportedtotheTrustPlanningandPerformanceCommitteeand Modernisation Board and are measuredthroughtheBalancedScorecardandtheTrustassessmentagainsttheHealthcareStandardsforWales.

ThefollowingobjectiveshavebeentakenfromtheAOFandtheTrustwillensurethatStrategicbenchmarkingisactivelyincludedineachobjective.Performancereportsforeachofthefollowingobjectivesmustincludeinformationon benchmarkingactivityandtheoutcome/effectivenessofsuchactivity.

InadditiontotheStrategicBenchmarkingactivitiesbelow,theTrustwillhaveanumberofotherinitiativesbeingtakenforwardatadepartmentorteambasis.

ThesuccessofthisframeworkwillbetheoverallachievementoftheAnnualOperatingFramework,thePerformanceImprovementFrameworkandtheHealthcareStandardsSelfAssessment.Therefore,Thisframeworkshouldbereadinconjunctionwiththethosedocuments:

1)DesignedtoWorkFramework–tobetakenforwardinlinewith

  • WorkinginPartnershipatTrustBoards.
  • BringingRespecttoWork–ADignityatWorkPolicyforNHSWales.

AsanallWalesframeworktheTrustwillhaveopportunitytobenchmarkagainstotherNHSorganisationsandcompareownbusinessperformancewiththatofotherTrusts.Thiswillinturnidentifyfurtheropportunitieswherefunctionalandprocessbenchmarkingcanbeapplied. TheExecutiveDirectorofHRhasaleadroleforensuringtheimplementationofDesignedtoWorkandwillberesponsibleforidentifybenchmarkingopportunitiesandreportingoutcomestotherelevantcommitteesandTrustBoard.

2)InformingHealthcare

TheVelindreTrustI.TStrategy2008–10isconsistentwiththeemergingthemesofInformingHealthcare. Additionally,projectmanagementsfortakingforwardtheStrategywillincludeensuringcloseworkingwiththeInformingHealthcareProgrammeandanybenchmarkingactivityaspartofthatprocess.TheExecutiveDirectorFinanceisresponsiblefortheimplementationoftheTrustI.TstrategyandforidentifyingbenchmarkingopportunitiesappropriatetotheTrustforthevariousstagesoftheInformingHealthcareprogramme.

3)CorporateServices

TheTrustisworkingaspartoftheSouthEastWalesRegionalGrouptodevelopSharedServiceswithinareasoffinance,procurement,humanresources. Scopingworkisongoingwhichwillhaveaheavyfocusonbenchmarkingprocesses,functionsandperformance.RecommendationsfromthisprojectandanyimplementationwilltakeplaceafterApril2009. ProgresswillbereportedviatheSharedServicesProjectManager.

InternalbenchmarkingwillalsotakeplacetoconsiderHRfunctionsprovidedacrosstheServicesoftheTrust.ThiswillhelptoinformlocalinitiativeswithintheTrustinrelationtoRecruitmentModernisationandthedevelopmentofaHRhelpdeskande-procurement.

4)CorporateHealthStandard

TheStandardisthenationalmarkofqualityforhealthintheworkplace,identifyinghoworganisationspromotethehealthandwell-beingoftheiremployees. TheTrustisworkingtowardsassessmentforaGoldAwardfor 2009,withsupportfromspecialistsinNPHS.TheTrustwilladoptanumberofbenchmarkingapproachesinordertoidentifyandlearnfromotherGoldandPlatinumholdersoftheawardandbylookinginternallyacrosstheTrusttoidentifybestpracticewithinandsharegoodpractice.TheExecutiveDirectorofHRisresponsiblefortheTrustsubmissionandforthecaptureandreportingofbenchmarkingactivity.TheTrustintranethasbeendevelopedtocaptureinformationontheCorporateHealthStandardandshouldbeutilisedtoincludetheresultsofbenchmarkingactivity–thismaybeintheformofsharingdivisionalhealthimprovementactivity.

5)HSEStressManagementStandards

TheHSEhasintroducedthesestandardsasawayforemployerstobettermanagestresswithintheworkforce. NHSWalesiscommittedtoimplementingthesestandards. ProgresswithintheTrusthasbeendifferentialwithintheDivisions. Asaresult,theServiceDivisionshaveproducedactionsplansforthemeetingofthesestandards.ItwillbeessentialtoincludebenchmarkingasakeydrivertothedeliveryoftheactionplanswhichwillinturnassisttoimproveTrustwidecompliancewiththeStandards.TheExecutiveDirectorHRhasBoardresponsibilityfortheimplementationoftheStressManagementStandards.ATrustgrouphasbeensetuptoactasanetworkfortakingtheseStandardsforwardandwillbenchmarkinternallywitheachotherforimplementationofDivisionalactionplans.

6)VelindreCancerCentre

ByMarch2009allorganisationsinWaleswillneedtohaveimplementedtherequirementssetoutinyear1oftheDesignedtoTackleCancer2008-2011strategicframeworkandtohavedeliveredtheNationalCancerStandards.

Benchmarkingwithotheroncologyserviceswillbeanon-goingrequirementaspartoftheimplementationoftheStandardsandtheCancerServicesDivisionwillhavelocalplansforincludingthis.

ThereissignificantworkongoingatallWalesandregionallevelsinworkforceplanning. ItisonlyinrelationtoVelindreCancerCentrehoweverwheretheTrustcandirectlyutilisethiswork,whichisverymuchbasedonservicemodelsinvolvinghealthandsocialcarecommunities.

VelindreCancerCentreisinvolvedthroughtheproposeddevelopmentofimprovedradiotherapyprovisioninSouthEastWalesandthereisrobustintegrationoffinancial,workforceandserviceplanninginthisarea.

PerformancewillbecapturedviatheServiceModernisationreports,theBalancedScorecardanddeliveryagainsttheTrustAOf/PIF

7)WelshBloodService

TheWBS are currently undertakingamajorstrategicreviewofservicestoensurethatitisfitforpurposeforthefuture. Itisrecognisedthattheremaybesignificantchangemanagementandemployeerelationsissuesassociatedwiththereview. Aframeworkdocumenthasbeenproducedinrelationtothisreviewwhichwillincludethebenchmarkingofservicesandfunctions. Keyissuesare:

  • Theimpactofpossibleincreaseinbloodtesting.
  • Considerationofchangesinbloodcollection.
  • Technicaladvancesinbloodcollectionwhichwouldimpactoncurrentpractices.

8)ScreeningServices

TheAllWalesBowelScreeningProgramme commencedinOctober2008.TheService is implementinganAllWalesBowelScreeningProgrammeandwillcontinuetoworkincloseliaisonwithothernationalbowelscreeningprogrammeswhenimplementingtheprogramme.InternalbenchmarkingwillalsobeakeyactivityfortheServicesincetheywillbeutilisingtheexpertiseoftheotherscreeningprogrammeswithintheDivision.

TheimplementationoftheBowelScreeningProgrammeismanagedvia Screening Serrvices andaspartofthatprocess,regularperformanceandactivityreportsarealreadybeingcompletedandreported.Theprogrammeisbeingdevelopedwithqualityassurancebeingintegratedwithintheprogramme,whichincludesbenchmarkingagainsttheothernationalscreeningprogrammes.

TheDirectorofScreeningServicesisresponsibleforthedeliveryoftheBowelScreeningProgrammeandperformancewillbereportedtoBoardviatheBalancedScorecardandservicemodernisationreports.Benchmarkingperformancewillbereportedaspartofthisprocess.

AmajortaskforScreeningServicesduring2009/2010andbeyondisplanningforandtheimplementationofdigitalmammographyforBreastTestWales.AbusinesscaseseekingfundingfromWAGtomodernisemammographyservicesisbeingtakenforwardwithconsiderationbeinggiventoEuropeanandworldwidebenchmarkingofserviceprovisiontoensuretheprovisionofarobustbreastscreeningserviceinWalesforthemediumtolongterm.

Ref:Black 127 Issue Number: 1

Approvedby: Exec Board Page:Page1of17

ApprovalDate:Jan 2009 NextReviewDate: Jan 2012