Redevelopment Programme Board

Introduction

This paper provides a briefing about the strategic review events held between July and September across the Trust, and the ongoing associated work programmes.

Conclusions and recommendations

The Trust Board is asked to note the ambitious programme of strategic planning activity underway across the Trust to ensure successful review of the Integrated Business Plan by March 2009 and delivery of a robust Monitor Annual Plan by May 2009.

Prepared by: Ellen Rule, Head of Business Planning

Presented by: Robert Woolley, Director of Corporate Development

Trust Board

Report to update the Board on the latest position regarding the Strategic Review Programme for 2008/09

Purpose

This paper provides a briefing about the strategic review events held between July and September across the Trust, and the ongoing associated work programmes that are in hand to ensure successful review of the Integrated Business Plan by March 2009 and delivery of a robust Monitor Annual Plan by May 2009.

Background

The Trust undertakes an annual review of its strategic plans as part of the routine business planning process. The Clinical Services Strategy was last published in March 2006 and underpins the strategic direction presented in the Integrated Business Plan, submitted to Monitor last year. The 2007 strategic review included significant external stakeholder involvement as part of the Foundation Trust application. The intention of the 2008 strategic review is to validate or refine the basis on which Foundation Trust authorisation was achieved. Greater internal involvement has therefore been sought, particularly through arrangement of a series of Divisional strategy workshops. In addition, it is planned that the Membership Council will be engaged through establishment of a consultative group concerned with the strategic development of the Trust.

Objectives

The objectives of the Strategic Review were as follows:

1. Updated clinical service strategies, taking particular account of the vision for:
2. cancer services
3. diagnostic imaging
4. Review of the Integrated Business Plan leading to submission of the first Monitor Annual Plan in May 2009
5. Revised site development control plan
6. Revised capital investment programme
7. Priorities identified for the annual planning round for 2009/10
8. Evidence of Membership involvement.

Progress to Date

The progress on each of the preceding objectives will be noted in turn:

1. Updated clinical service strategies, taking particular account of the vision for:
2. cancer services
3. diagnostic imaging

The main period of Divisional engagement took place between May and early September. Divisions are currently working to update their clinical strategies and these will be available for review in November.

The updated Divisional Clinical strategies will:

• Take account of the latest definitions of national, SHA and PCT strategic goals when re-assessing the strategic issues
• Consider the operational issues identified as impediments to delivery of Divisional strategic objectives and set out action plans to mitigate these
• Ensure that specific Divisional objectives are reviewed in light of current actual or potential developments, including:
• selection of North Bristol Trust as preferred bidder for provision of Child and Adolescent Mental Health and Community Child Health services
• selection of the PCT provider arm (Bristol Community Health Services) as the “lead provider” for South Bristol Community Hospital
• Cancer Network / PCT review of and anticipated decisions about the future configuration of Head and Neck cancer services in Bristol
• Independent sector and commissioning developments, such as the potential development of home chemotherapy services in Bristol, North Somerset and South Gloucestershire.

The Divisional workshops culminated in a strategic review ‘plenary’ event held on the 9th September which was attended by around 135 people from across the organisation. The focus of the plenary event was to report back on the work from the Divisional workshops, seek input from the group on a further set of key questions and to provide an opportunity to develop Trust thinking on the important policy area of patient choice through a presentation given by Professor John Appleby of the Kings Fund.

Attendees were asked to consider the following questions:

• The most important considerations for the Trust Estate are?
• The Trust performance management framework should include?
• The top priority for investment next year should be?
• The Focus of next year’s strategic review should be?
• Please continue to engage with me by......

(The large number of responses to these questions were collated and are available on request from Ellen Rule, Head of Business Planning 0117 928 3626.)

1. Review of the Integrated Business Plan leading to submission of the first Monitor Annual Plan in May 2009

The revised clinical strategies and feedback from the plenary event will be used to inform the update of the Integrated Business Plan and the first Monitor Annual Plan. This process will also draw on recent comprehensive capacity planning and financial analysis that has been undertaken within the Trust. A forward work programme to ensure timely delivery of these planning documents is currently being agreed.

1. Revised site development control plan

A short-life Site Strategy Review Group was established, chaired by the Chief Executive, to co-ordinate a review of the site development control plan.

This group generated a number of explicit principles to guide the future development of the Trust’s estate, which were refined at the Clinical Strategy Group and approved at the Trust Executive Group in July.

An independent, high-level review of the site development strategy has also been commissioned, which should report by the beginning of November. It is also planned to hold an interactive workshop for Board members to explore scenarios for development of the Trust estate in November (subject to availability).

1. Revised capital investment programme

The process for agreeing capital investment is currently under review. A number of changes have been implemented to date including ensuring that all capital proposals are subject to a single process of evaluation. The investment criteria for capital investment (as previously approved by the Board) are being applied to all proposals and the Trust Operational Group are taking a direct role in the prioritisation and scoring of proposals against these criteria to make recommendations for funding to the Trust Executive Group and the Finance Committee.

1. Priorities identified for the annual planning round for 2009/10

The annual planning round for 2009/10 was launched at the strategic review plenary event. A work programme has been set for the coming six months to ensure timely agreement of the investment priorities for next year. The process has been developed from last year to ensure increased opportunities for Divisional engagement in decision making.

1. Evidence of Membership involvement

Governors have been involved in all of the strategic event workshops, with plans in place to build on this engagement through the establishment of a Governors’ strategy group, subject to the agreement of the Membership Council.

NHS Next Stage Review

In addition to the work programmes set out above, existing service strategies need to be tested against the vision laid down in the final report of Lord Darzi’s NHS Next Stage Review, and enshrined in the NHS South West draft strategic framework, which sets out a number of objectives of significance to the Trust, including:

• creation of specialist centres for major trauma, heart attack and stroke
• more devolution of planned care closer to people’s homes
• greater choice in maternity and newborn services
• greater design of services for children around the needs of the child and family.

An internal programme of service design has been established to support the strategic planning process.

Vision and Values

The Trust Executive Group has agreed that a branding exercise should be undertaken across the Trust. As part of this exercise, the Trust's vision and values will be tested with stakeholders. At present, a baseline audit is in progress to determine what action is required to complete the introduction of the new name for the Foundation Trust.

Recommendations

This briefing note has described the context, objectives and progress to date for the 2008 strategic review. It has also highlighted a number of the key strategic issues to be addressed.

The Trust Board are asked to note progress with the 2008/09 Strategic Review.
Annex 1: Outline Programme for 2008/09 Strategic Review

• Consultation over Divisional requirements
• Identification of cross-cutting themes
• Collection of strategic review evidence base by Division

• Revised capital investment policy and decision structure

• Divisions review local clinical service strategies
• Agreement of evidence base inputs to workshops
• Divisional SWOT (Strengths / Weaknesses / Opportunities / Threats) analyses
• Consideration of cross-cutting themes
• Consideration of risk profile / investment and divestment opportunities

• Service strategy:
• NHS Next Stage Review outcomes
• PCT service design agenda
• Cancer services strategy
• Patient experience
• Site strategy
• Development control plan
• Future role and development of BHOC
• Future role and development of St Michaels
• Extent of BRI redevelopment
• Technology strategy:
• Diagnostic imaging
• Other
• Operational policy:
• Accessibility and parking
• Records management
• Supplies distribution
• Organisational development

• Revised Research & Development Strategy
• Revised Teaching and Learning Strategy

• Feedback from workshops
• Speaker(s) on policy direction (tbc)

• Revised Clinical Services Strategy
• Revised Research & Development Strategy
• Revised Teaching and Learning Strategy
• Annual Plan and Resources Book

• Integrated planning guidance issued
• Local Delivery Plan and budget-setting
• Capital investment programme
• Trust Annual Plan

• Foundation Trust annual plan submission to Monitor

Table 1. Strategic Review programme 2008/09

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