1. Management Development Programme
7 January 2016
The NHS in Context
Management Development Programme
Importance of MDP from the Boards perspective
Key role of line Managers
Is part of the HR Strategy to equip managers with the tools and skills to do their jobs
Context of the NHS
Challenging roles
Purpose of the presentation is to give an overview of contracting arrangements and how that impacts on the trust.
Cohort 16

2. Management Development Programme
7 January 2016
The History of the NHS
Founded on 5th July 1948
Park Hospital Trafford (now Trafford General)
First hospital in the world to offer free healthcare to all
Cohort 16

3. Management Development Programme
7 January 2016
The History of the NHS
NHS based on 3 core principles
That it meets the needs of everyone
That it be free at the point of delivery
That it be based on clinical need, not ability to pay
NHS has undergone significant change since 1948
1990 Community Care Act – Introduced NHS Trusts
2000 NHS Plan – Significant additional funding & introduced NHS Foundation Trusts
2012 Health and Social Care Act – NHS England & CCGs
Cradle to Grave
Free at the point of delivery – recognition that there is a cost ie we pay through our taxes, pay for prescriptions
Cohort 16

4. Management Development Programme
7 January 2016
The NHS Today
NHS Budget 2016/17 £120bn (£437m in 1948)
Total Employees 1.7m
5th largest employer in the world
US Department of Defense 1st: 3.2m
McDonalds 4th: 1.9m
2012 Health and Social Care Act
Introduced new commissioning system to the NHS
Primary Care Trusts and Strategic Health Authorities Abolished
Focus on most recent change Change is a constant in the NHS. Will cover in more detail later in the presentation
Cohort 16

5. Management Development Programme
7 January 2016
The current NHS System
Slightly out of date but principles remain. No of CCG’s and LAT’s have changed. HEE downsized significantly. Level and pace of change continuous
Cohort 16

6. Since then… £71.9bn funding in 16/17 to Clinical Commissioning Groups
Five Year Forward View (Oct 14)/Vanguards
£3.9m Better Care Fund – pooled NHS funding
13 LATs integrated into 4 regional teams
6 Commissioning Support Units from 19
15 Academic Health Science Networks created
NHSI joined together Monitor and the NHS TDA
Devolution – Greater Manchester…Liverpool?
Sustainability and Transformation Plans

7. Wirral Community NHS Foundation Trust
Management Development Programme
7 January 2016
Wirral Community NHS Foundation Trust
Formed 1st April 2011, previously provider arm of NHS Wirral
Expenditure plan
£70m in 2016/17 (£192,000 per day)
70% is on pay (£49m)
30% is on non-pay (£21m)
Employs 1,426 staff inc. temporary staffing (1105 permanent WTE)
Provide services to 4 main commissioners
NHS Wirral CCG
Wirral Council
Cheshire East Council
NHS England
CCG – Block Contracts – most of our services are on block contracts
Wirral Council – Livewell Services . Most people will be aware of the loss of those services and decision to transfer to Wellbeing Services
NHSE – Primary Care – All Day Health Centre and Dental (ADHC contract ceasing 30th September)
Cohort 16

8. Wirral Community NHS Foundation Trust
Management Development Programme
7 January 2016
Wirral Community NHS Foundation Trust
Achieved Foundation Trust status 6th May What does this mean?
free from central government control and able to decide how to improve services for patients
able to retain any surpluses to invest in new services, and borrow money to support these investments
accountable to the local community, with local people able to become members and governors
Cohort 16

9. Strategic Context The Five Year Forward View Sustainability & Transformation Plans Cheshire and Merseyside STP STP Priorities: 1. Demand management and prevention at scale 2. Reducing variation & improving quality through hospital reconfiguration 3. Reducing cost through ‘back & middle office’ collaborative productivity 4. Changing how we work together to deliver the transformation
This brief slide pack describes a pragmatic approach to the high level scope, design and decisions for the next stage of planning the C&M STP. Detailed plans to support and underpin the 30 Jun 16 submission are to be delivered to NHS England by 31 Oct 16.

10. Management Development Programme
7 January 2016
Commissioner Intentions
(to which WCT plans are aligned)
Healthy Wirral
Strategic Service Developments:
Integration of Health & Social Care
Urgent Care system change
Long Term Conditions pathway transformation
Important that we align our plans with those within the Health Economy
Cohort 16

11. Contracts for services
Management Development Programme
7 January 2016
Contracts for services
Contracts agreed annually with Commissioners
Set out service specifications
Set expectations in form of KPIs
Agree financial value
Set type of payment
Block
Cost per case
CQUIN
Quality Improvement/patient experience. Gathering data. Worth about 1 million pounds to the trust.
Are delegates aware of the arrangements within their own service?
Have they had sight of the Service Spec, have an understanding of the KPI’s?
How the payments work. Discussions at Team Meetings
Block v cost per case – pro’s and con’s . Impact of increase in activity in a block contract.
Cohort 16

12. Financial Sustainability Risk Rating (FSRR)
Management Development Programme
7 January 2016
Financial Sustainability Risk Rating (FSRR)
The way Monitor assesses the financial strength of a Foundation Trust. Based on:
Liquidity: days of operating costs held in cash or cash-equivalent forms
Capital servicing capacity: the degree to which income covers the Trust’s financing obligations
Income and expenditure (I&E) margin: the degree to which the organisation is operating at a surplus/deficit
Variance from plan in relation to I&E margin
Now we have achieved FT status have the ability to go to the bank for a loan for a new build etc. No intention of doing this but could if we wanted to.
We were 1 of only 3 Trust’s in the NW who delivered financial balance last year. Received a letter from Jim Mackey from NHSI acknowledging and thanking us.
Cohort 16

13. Financial Sustainability Risk Rating (FSRR)
Description
Regulatory Activity 4
No evident concerns
None 3
Emerging or minor concern potentially requiring scrutiny
Potential enhanced monitoring 2*
Level of risk is material but stable 2
Material risk
Potential investigation 1
Significant risk
Likely investigation and potential appointment of contingency planning team

14. Management Development Programme
7 January 2016
Our financial challenge
Yearly focus on CIP
Opening balance in April k surplus
Each year there is a tariff reduction which makes it harder for us to get back to a surplus position.
Redundancy provision – haven’t needed to use in the past but that’s now changing.
Reference to Transformation Programme
Cohort 16

15. Management Development Programme
7 January 2016
Any questions?
Cohort 16