1. Solihull Review of Urgent Care Programme Approach And Governance 2013

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

3. 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

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

5. 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

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

7. 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

8. 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:

9. 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

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

11. 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

12. 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