Solihull Review of Urgent Care Programme Approach And Governance 2013

Contents Summary of Recommended Approach 1. Programme Principles 2. Programme Governance 3. Programme Lifecycle

The route uses the tried and tested Stage/Gate approach To support the Urgent Care Review and to maximise success probability a structured approach will be implemented. The benefits of using a programme and project management approach are that it provides a framework for implementing strategies and initiatives through the co-ordinated management of a portfolio of projects, to achieve benefits of strategic importance. The recommended model is based upon the Managing Successful Programme (MSP) principles which are well established norms as follows:- 1 2 3 Programme Principles  These are derived from positive and negative lessons learned from programme experiences. They are the common factors that underpin the success of any major change which we need to ensure are in existence within this programme Programme Governance  These define an approach to the management of the programme and constituent projects. They will support putting in place the right leadership, delivery team, organisation structures and controls, maximising the chances for success Programme Life Cycle  This provides a consistent route through the lifecycle of the programme from conception through to the delivery of new models, outcomes and benefits. The route uses the tried and tested Stage/Gate approach

Contents Summary of Recommended Approach 1. Programme Principles 2. Programme Governance 3. Programme Lifecycle

The reasons programmes fail or do not delivery all that was anticipated can generally be boiled down to a few key reasons. In order to maximise success in the programme all of the following will need to be worked through: Programme Failure Strategy Ownership Benefits Engagement Capacity & Capability There are not clear links between the projects /programme and the organisations strategic priorities There is not clear senior management ownership, support and leadership There is not the capacity & capability within the organisation to implement the programme There is insufficient and effective engagement and communication with stakeholders. Realisation of the benefits is not the number 1 priority of the programme

Contents Summary of Recommended Approach 1. Programme Principles 2. Programme Governance 3. Programme Lifecycle

Health and Wellbeing Board The Programme Board will oversee the Programme Management Office & Overall Progress Health and Wellbeing Board Health and Wellbeing Board – Key Roles Act as the Sponsoring Group for the Programme Provide External Scrutiny Has oversight of options developed CCG Governing Body CCG Governing Body Key Role: To make commissioning decisions on preferred option Programme Board – Key Roles: Hold the Programme Team to account Approve programme plans and ensure risks are mitigated Escalate issues as appropriate Provide assurance on delivery to the Health and Wellbeing Board and others Approve programme gateways Ensure the programme is following due process Make recommendations of preferred option Programme Board Programme Team– Key Roles: Develop programme delivery, monitoring and reporting mechanisms Co-ordinate establishment of plans that are required e.g. Communication and Engagement Plan Maintain the programme milestone map and risk register Co-ordinate reporting progress to the Programme Board Ensuring delivery of all actions within the plan Escalating issues where necessary Programme Team

Key players in the delivery of this programme are illustrated below: Health and Wellbeing Board Solihull CCG Governing Body Solihull CCG Programme Board SRO (Chief Officer) Clinical Lead for Urgent Care Lay advisor (PPI) Senior Officers Provider Group To test data and information and ensure ongoing communication Local and external clinicians to provide advice on best practice Clinical Reference Group Patient and Carer representatives to provide patient experience feedback Patient Reference Group Project Team Members of the CCG, CSU and some external support National Department of Health Emergency Care Intensive Support Team Vista Consulting Facilitation Support Project Support Birmingham & Solihull Reference Group Head of Strategic Transformation (CSU) Birmingham CrossCity Urgent Care Lead Birmingham CrossCity Service Redesign Programme Manager Head of Urgent Care Key players in the delivery of this programme are illustrated below:

Mitigation and management of risks will maximise the probability of the delivery of the programme benefits Strategy Tactics Identification Risks are clearly identified Strategic risk register to be drafted by the Programme Team using the CCG format and the Aspyre documentation system Strategic risk register to be presented to the Programme Board Risk are understood across the Programme Risks and delivery progress to be a key element of communications cycle Management Clear plan to manage risk Risk management responsibility of the Programme Team Risks assigned an owner, timeframe, score and mitigations Risks are actively managed Risk management recognised as a key priority of programme Regular reporting of key risks to Programme Board (score of 8 or more) Monitoring Ref Description Owner Probability Severity Rating Mitigations 1 Strong public opinion to ‘do nothing’ Jo Blogs Likely (4) Major (4) Catastrophic (16) Support from Programme Board Strong Comms & Engagement

Contents Summary of Recommended Approach 1. Programme Principles 2. Programme Governance 3. Programme Lifecycle

A “Stage/Gate” process has been developed to provide a structured approach to managing individual phases of this programme Stage 1: Planning Gate 1 Gates are approval processes, designed to challenge, ensure that programmes are robust and to show who can be held to account for what Agreement sought from Programme Board of the proposed approach Stage 2: Information Gate 2 Events arranged with Stakeholders and Providers to garner views Stage 3: Analysis Gate 3 Draft Clinical Case for Change Drafted Stages are working phases, designed to produce key outputs Stage 4: Creative Gate 4 Clinical Case for Change agreed High level options produced Patient Ref group feedback sought Programme Board agreement of next steps

Depending on the outputs of the clinical reference group, a full review with Consultation would need to go through the following stages: Stage 4: Creative Stage Gate 4 Clinical Case for Change agreed High level options produced Patient Ref group feedback sought Programme Board agreement of next steps Gates are approval processes, designed to challenge, ensure that programmes are robust and to show who can be held to account for what Stage 5:Evaluation Stage Gate 5 NCAT Health Gateway Reviews Modelling and Financial analysis Programme Management Resource identified Options appraisal Draft service specification Stage 6:Pre-Consultation Gate 6 Draft Strategic Outline Case HW Board agree Draft Strategic Outline Case OSC to make decision on full public consultation Pre consultation/engagement activities Stage 7: Consultation/ Engagement Gate 7 ? Engagement ? Consultation ?Procurement Implementation plan to be drafted Implementation Stages are working phases, designed to produce key outputs