1. The Single Oversight Framework
Catherine McDonald 13 September 2016
Title slide with embedded images

2. Purpose of the Single Oversight Framework
NHS Improvement will use the framework to
oversee the sector
identify potential support needs
help providers gain and maintain CQC good/outstanding ratings
intervene only where necessary
A single framework covering NHS trusts and foundation trusts
replaces Risk Assessment Framework and Accountability Framework
does not cover independent providers
Treats NHS trusts and foundation trusts in similar positions similarly, unless good reason not to
uses provider licence as basis for oversight
Linked to CQC key questions
we and CQC will align our approaches more fully

3. Single Oversight Framework areas of focus
Quality of care
CQC assessment: safe, effective, caring, responsive
Progress in implementing 7-day services
Finance and use of resources
Financial performance and efficiency, control totals
Reflects Carter Review recommendations
Operational performance
Includes A&E, 18 weeks, 62-day cancer waits
Performance vs Sustainability & Transformation Fund trajectories and absolute targets where relevant
Strategic change
How providers are supporting strategic change in their local health economy – 5YFV, Sustainability & Transformation Plans, new care models, devolution
Leadership and improvement capability
Build on existing tools (eg well led framework), working with CQC

4. How we will oversee providers
Identifying
potential support needs
Support
activity
Monitoring
Segmentation
Core set of data from all providers
Weekly /Monthly/ quarterly frequency depending on information source
Providers with critical issues may be monitored more frequently
Focus is on actual performance and, where possible, early warning
Support needs identified against each theme:
quality of care
finance/use of resources
operational performance
strategic change
leadership and improvement capability
Where may a provider need support?
Where providers are triggering concerns we will:
consider evidence (via existing knowledge and/or informal/formal investigation)
assess issues providers are facing
consider the level and intensity of support providers need
Place providers in the relevant segment
How serious and complex are the issues a provider faces?
Support will be driven by what we know:
background to issue
actions taken to date
plans prepared/ delivered
provider capability
Support is either via:
universal tools
targeted support offered to address specific areas, for providers to accept voluntarily
mandated by NHSI due to seriousness and complexity of the issue
(or a combination)
Support is tailored and proportionate to a provider’s circumstances

5. We will use a segmentation approach to identify where providers sit on each theme
Has a provider support need been identified in any of the five themes?
Yes, with major/complex concerns
Yes, with significant concerns
Yes, with some support needs No
Breach
Concern 4 3 2 1
Special
measures
Providers receiving mandated support
Providers offered targeted support
Providers with maximum autonomy
Mandated support required  
Targeted support offered   
Universal support offered    

6. Next steps Publication of SOF – Tuesday 13 September 2016
The Single Oversight Framework document published, along with a paper providing a summary of consultation responses
Go live of the Framework – October 2016
From this date, we will be overseeing provider performance against the criteria and metrics in the SOF.

7. Any questions? Please contact catherine.mcdonald8@nhs.net