Annual Plan Presentation to Board of Directors, 22 nd May 2007 Zoë Reed, Executive Director

Annual Plan: content 1.Past year performance 2.Future business plans 3.Risk analysis 4.Declarations and self certification 5.Membership 6.Financial projections 7.Supporting information

Annual Plan: past year performance Past year performance CONTINUES… Our clinical focus Early intervention Both for people in the course of an illness such as psychosis or dementia, and supporting people with mental health problems at an earlier stage in their lives, especially younger people Promoting recovery and rehabilitation And helping people to move from mental health services back to independence Managing the process of care Offering the most effective interventions - consistently and reliably - and helping people move through the system of care without delay

Clinical developments Medium Secure Unit [MSU] provision 23-bed.£10.4m MSU opened at Lambeth Hospital in July 2006 [on time and within budget]. Construction of 89-bed MSU at Bethlem due for completion in early 2008 Crisis care in Lambeth and Southwark Clinical Decision Unit Beds at the Maudsley Hospital Investment in recovery With support from Guy’s and St Thomas’ Charity Addictions and low secure forensic services Capital investment Annual Plan: past year performance Past year performance CONTINUES…

R&D Biomedical Research Centre, Technology Platform for imaging, six programme bids [amounts to up to £11m] But changes in funding arrangements may lead to a significant loss of R&D income over next 3 years Standards for Better Health Compliance across all standards [including C21 as of 1 April 2007] C21 achieved following extensive review of the environment, considerable improvements to estate and internal assessment Annual Plan: past year performance...CONTINUED CONTINUES…

Finance £3.6m surplus - £170k ahead of plan £7.5m efficiency savings [8% variance from plan, mostly due to slippage on schemes] Disinvestment in services by Lambeth and Southwark PCTs [£6m in 2006/07, rising to £8m in 2007/08] Agreed non recurring reduction of £900k from Lewisham PCT £1m deficit in Southwark due to nursing and residential placements Annual Plan: past year performance...CONTINUED

Annual Plan: content 1.Past year performance 2.Future business plans 3.Risk analysis 4.Declarations and self certification 5.Membership 6.Financial projections 7.Supporting information

Future business plans Annual Plan: future business plans Strategic context Healthy strategy for London Growing differentiation between types of provider Growth of the Polyclinic Competition and choice in primary care and urgent care Based on 3 strategic objectives Effectively treating mental illness Working in partnership to promote mental well-being Supporting others by sharing our clinical knowledge and expertise CONTINUES…

Future business plans Annual Plan: future business plans External drivers include Financial situation in London and wider NHS Changes to R&D funding streams Payment by Results / Activity Based Contracts Legislation e.g. Mental Health Act Drug costs and new technologies Internal drivers include Development of staff and their expertise Service user and care involvement Developing business processes Driving down costs and increasing productivity CONTINUES…

…CONTINUED Annual Plan: future business plans Service development plans No plans for significant change to mandatory services [apart from existing MSU development plans] All services to undertake redesign / change to deliver improvement Infrastructure investment, where this delivers future benefit e.g ICT, estate, clinical effectiveness, financial planning to support clinical services CONTINUES…

Annual Plan: future business plans …CONTINUED CONTINUES… Estates strategy Consolidation on to 4 main inpatient sites Guy’s & St Thomas’ have asked when we will withdraw from their sites Capital schemes identified as part of directorate cost improvement plans Commitment to infrastructure renewal / improvement / compliance Site development plans being developed for 4 main sites Schemes identified to strengthen the Trust’s strategic position / improve service quality / offer opportunities for future improvements in efficiency Major development proposal at Maudsley Hospital

Annual Plan: content 1.Past year performance 2.Future business plans 3.Risk analysis 4.Declarations and self certification 5.Membership 6.Financial projections 7.Supporting information

Risk analysis Annual Plan: risk analysis 1. Governance Breach of Terms of Authorisation - we are operating in a new regulatory framework Performance management - our ability to manage statutory, regulatory and other external target requirements Partnership arrangements - includes the development of activity based contracts CONTINUES…

Annual Plan: risk analysis 2. Mandatory services Managing the estate and maintaining acceptable service standards [and remaining compliant with C21] Service user / carer perceptions of care - ensuring that internal perceptions of service quality match those of the people who use our services, and their carers Knowing the competition for our services - the risk that we will lose income if we fail to compete …CONTINUED CONTINUES…

Annual Plan: risk analysis 3. Finance Changes in funding arrangements - may lead to loss of R&D income or shift of current funding to new areas Position in the wider NHS - includes the risk of further loss of income because of wider instability with the NHS Responding to Service Line reporting Agenda - development of activity based contracts and 3 year planning process Financial control – preventing overspends, delivering cost improvements, continuing to generate a surplus …CONTINUED

Annual Plan: content 1.Past year performance 2.Future business plans 3.Risk analysis 4.Declarations and self certification 5.Membership 6.Financial projections 7.Supporting information

Declarations and self certification Annual Plan: declarations and self certification Clinical quality Service performance Risk management Compliance with terms of authorisation Board roles, structure and capacity

Annual Plan: content 1.Past year performance 2.Future business plans 3.Risk analysis 4.Declarations and self certification 5.Membership 6.Financial projections 7.Supporting information

Membership Annual Plan: membership [see separate detailed extract] Membership numbers Currently just over 3000 – against original target of 4400, offset by high retention rate [only 9 leavers] Recruitment strategy Based on using our ‘opt in’ approach, using our networks, face-to- face recruitment, direct mailing Priorities for 2007/08 Recruit additional 600 members, target recruitment at areas of under representation

Annual Plan: content 1.Past year performance 2.Future business plans 3.Risk analysis 4.Declarations and self certification 5.Membership 6.Financial projections 7.Supporting information

Financial projections Annual Plan: financial projects Income and expenditure Balance sheet statement Cash flow

Annual Plan: content 1.Past year performance 2.Future business plans 3.Risk analysis 4.Declarations and self certification 5.Membership 6.Financial projections 7.Supporting information

Supporting information Annual Plan: supporting information Activity projections and contract analysis Financial assumptions Education and training contracts Glossary