Proposals for Management Arrangements for NoSPG

Transcription

1 Meeting: NoS Chairs and Chief Executives Date: 7 th March 2012 Item: 07/12 (i) NORTH OF SCOTLAND PLANNING GROUP Proposals for Management Arrangements for NoSPG This paper considers options for the continued management of the NoSPG team following the resignation of the Director of Regional Planning & Workforce Development from 31 st March Background The National Health Service Reform (Scotland) Act, 2004 (s5) requires NHS Boards: "In exercising their functions in relation to the planning and provision of services which it is their function to provide, or secure the provision of, under or by virtue of this Act, Health Boards shall co-operate with one another, and with Special Health Boards and the Agency, with a view to securing and advancing the health of the people of Scotland." This was promulgated to NHS Scotland through a number of circulars and Health Department Letters (HDLs), the most recent of which was HDL (2004) 48 "Regional Planning" which outlines the statutory duties for Boards in relation to regional planning and can be summarised as: "Regional Planning will include both service planning and workforce planning and provides an opportunity to align work on service redesign and reconfiguration with workforce development... "NHS Boards must consider, not only the resource implications of working regionally but also the resources required to make the process work. Regional Planning will only work well if appropriate leadership, management, planning, clinical and financial time are dedicated to the process." Current Arrangements in the NoS Dr Annie Ingram was appointed as the Director of Regional Planning in January 2003 and soon after her initial appointment, in response to the requirement in Partnership for Care 1 for Boards to appoint a Regional Workforce Director, Chief Executives agreed that this should be a combined Regional Planning & Workforce role. In the other regions, two separate appointments were made to the Regional Planning Director and Regional Workforce Director posts. The Regional Director is supported by a small team, including one substantive Programme Manager (Child Health & CAMHS) and one Programme Manager (Acute Services & Workforce), funded through slippage, who both have a formal deputising role, a regional Project Manager, who has been assigned to support acute services and workforce, an Executive Assistant and administrative support. The Network Manager for NoSCAN also reports to the Regional Director, although he also undertakes a management role within NHS Grampian. Within the Regional role, the Director has personal responsibility for ensuring that NoSPG and all of the various sub groups have a workplan and drives the delivery of the workplan objectives. The current workplan has 19 high level objectives. Her responsibilities include supporting NoS Chairs and Chief Executives Group, the NoSPG Executive, the NoS Medical Directors Group, the Emergency Care 1 (2003) Partnership for Care: Scotland s Health White Paper February 2003, p 41, Scottish Executive, Edinburgh. ISBN:

2 Network Group. In addition, the Director chairs the Integrated Planning Group, the NoS Reshaping Medical Workforce group, the NoS ehealth Group and ensures regular dialogue between the North CJA and regional partners. The Director is the designated Project owner for the CAMHS project and is a member of the CAMHS Project Board. The Director is also a member but not regular attendee at the Child Health Clinical Planning Group, the Cardiac Services Group, the Oral health & Dentistry Board and the Regional Workforce Planning and Development Group, as these are led by the NoS Clinical Leads and Programme Managers. Within the region, the Director represents the North partners on the Secure Care Executive Project Board, the NHS Tayside Mental Health Delivery Board, the Eating Disorders MCN and Eden Unit Operational Board. The Director also represents the North Boards within SABRE, the link group between employers of reservists and the MoD. On a national basis, the Director represents the North partners on the National Reshaping Medical Workforce group; the Reshaping Medical Workforce Working Group; the Restructuring Medical Training Steering Group and the Regional Workforce Directors Group with SGHD. She also represents North partners on the National Planning Forum and the Directors of Planning Group; the Regional Planning Chief Executives Group and supporting Regional Directors Group; the PET Funding Review; the Child and Young People s Health Support Group and the Neonatal Expert Advisory Group. She represents the Regional Workforce Director perspective on the three Specialty Training Boards: Surgery, Paediatrics, Obstetrics & Gynaecology and has recently taken over the Mental Health STB from the departing Workforce Director in the West; and on the Supplementary Medical Staff Implementation Group. In addition, she represents the Regional Planning Director perspective on the Scottish Child and Young Peoples Palliative Care Executive (SCYPPEx). In addition to the regional role, the Regional Director has a number of national commitments. Since 2003, Dr Ingram has performance managed the Scottish Neonatal Transport Service on behalf of the Chief Executives of all of the territorial NHS Boards. Other commitments which have resulted from this role is membership of the Air Reprocurement Board for SAS, including membership of the Clinical User Group; membership of SCOTSTAR, the Review of Specialist Transport Services. Given her experience in Transport, Dr Ingram was asked by NHS Tayside, in October 2011, to chair the Tayside Helicopter Emergency Medical Service Group, involving a charitable company who wish to donate a significant asset to the NHS in Scotland, Scottish Ambulance Service, NHS Tayside and Tayside Police. In 2009, she was asked by Child & Maternal Health Division of SGHD to provide strategic leadership to establish the National Managed Service Network for Children and Young People with Cancer, in response to the commitments made by the Cabinet Secretary and promulgated in the National Delivery Plan. In addition to establishing the MSN Board and sub groups, this role includes membership of the MSN Board, MSN Executive Team, the MSN Operational Delivery Group. In 2011, following the publication of the final Report of the Remote and Rural Implementation Group, Dr Ingram was appointed by Scottish Government as the National programme Director for achieving Sustainable Quality in Scotland s Remote and Rural Healthcare. This commitment includes membership of the Remote and Rural subgroup of TAGRA, representing SGHD on the international dot.rural Board. The Regional Director is chair of a number of national or pan Scotland initiatives, including the Paediatric Unscheduled Care Project, which aims to establish decision support for RGHs and is linked to the regional work to establish an ECN; the National VC Infrastructure Project to establish a pan Scotland video-conferencing service. As a result of these roles, Dr Ingram was invited to join the Scottish Centre for Telehealth and Telecare Advisor Board established by SGHD. She is also leading the 2011 Review of Interventional Neuroradiology for Subarachnoid haemorrhage. This is a pan-scotland service, established in two centres between Glasgow and Edinburgh for the whole of Scotland. Dr Ingram was involved in the original work to establish the service in 2004 and 2

3 despite a request that the MSN for Neurosurgery take responsibility for this service, they have been reluctant to do so and Dr Ingram was asked to lead this new review. The Director has also been part of the tailored support team, established by SGHD to support NHS Orkney and there is ongoing work to review the strategic clinical relationship between NHS Grampian and NHS Orkney. Need for Regional Approaches In September 2011, NoSPG hosted a regional planning event aimed at determining how the regional partners should best concentrate their efforts, working collaboratively for the benefit of the people of the North. The conclusion of that event was summarised in paper 75/11 (iii) NoSPG Annual Event 2011 Implications for Regional Working 2 : the approach that regional partners take in the future and how NoSPG concentrates regional efforts may need to change the future will include closer integration both horizontally with other local public and third sector partners, regionally with other Boards and vertically to do things differently across the region. Collaboration and commitment to see these new approaches through to delivery was strongly identified in the feedback from delegates as key. The paper also recognised that where NoSPG has established regional approaches, these should all continue, although may need to be prioritised and that there are new things that regional partners should take forward together. When the paper was discussed and approved at NoSPG on 30 th November 2011, members recognised that regional working is an essential issue for the future sustainability and high quality of care in the NoS and it was suggested that the Event Report should be submitted along with the NoSPG Annual Report to the individual Boards to seek a restatement of commitment to regional working. The nature of the NoS configuration is such that patients and clinicians move constantly between Boards to receive or provide clinical care. Sustainability of many services is challenging and the regional approach and constantly seeking new solutions ought to be considered core business. Additionally, there are also strong national agendas around key workstream areas with increasing requirements and expectations at SGHD level that regional structures and approaches are adopted to support these. Options for the Future Management of NoSPG In the North, the need to work across boundaries has always been recognised and been a fact of service delivery before there was any statutory requirement to do so. Given this desire for recommitment and changing the approach to regional working, the vacancy created by the promotion of the Director of Regional Planning & Workforce Development might provide an opportunity to consider how things might be different in the future. Whilst we might want and indeed need to change the approach for the future, we should reflect upon the lessons learnt over the last nine years that the current approach has been in place. Key to delivery is and has been strong leadership, without which the complexities of regional working might struggle to keep pace. NoSPG recognised in 2004 that Executive and senior staff within Boards across the region should have regional responsibilities within their individual objectives. This has had variable success and with only a very few exceptions, in Public Health and in weight management, delivered against the regional workplan. 2 (2011) Paper 75/11 (iii) NoSPG Annual Event 2011 Implications for Regional Working NoSPG meeting 30 th November

4 As the Chair of the NoS Chairs and Chief Executives Group, states in his foreword to the Annual Report for 2011/12: [Regional working] requires commitment at all levels of our individual organisations and we must get better and smarter in the way we identify opportunities for collaboration and overcome the challenges and barriers that can prevent regional working fulfilling its potential. There are four potential options for the future: Option 1: Immediate Replacement of Director of Regional Planning & Workforce Development. This approach would ensure that there is continued leadership across the region to deliver against an expansive regional workplan. This may incur a temporary delay in leadership until the position is filled but might be considered a straightforward option. Option 2: Interim Appointment to allow wider debate on the future arrangements. This option would allow partners time to debate how the regional agenda should be structured in the future, in line with the outcome of the September 11 Annual Event. There are currently two designated Deputies and the Network Manager for NOSCAN, each of whom are familiar with the workplan and could be considered as appointable for acting up. There will be a significant loss of capacity in the regional team and potentially within NHS Grampian, if this approach is supported. Either the workplan would need to be reduced or the arrangement should be considered to be timelimited. It would however generate an opportunity for a member of the current senior team and test out exist skill and capability for any of the appointable individuals. Option 3: Interim Appointment and wider discussion across Scotland on the strategic planning requirements at national and regional level. Similar to option 2, this would suggest that Chief Executives might want to broker a pan-scotland discussion on the future for collaborative planning. The Deputy Director, responsible for national planning at SGHD is due to leave his post at the end of February. The West Regional Workforce Director has moved to a Board post with effect from 1 st February 2012 and has not been replaced, with roles shared amongst Board level colleagues. There has recently been a review of the planning arrangements for NSAG and there are currently proposal to review the role and function of the National Planning Forum. The Regional Directors, particularly in the North and West have each carried a significant national workload in the past and this reduction in capacity will be apparent beyond the North boundaries. Perhaps the time is right for a wider debate. Option 4: No replacement and adopt portfolio approach for regional initiatives. NoSPG has a strong regional identity and has a reputation nationally of delivering. This option may seem attractive and to offer savings to Boards but may have a reputational risk and will have a cost in terms of time for Board based staff who might be expected to take responsibility for individual projects on a regional basis. It will require a greater level of commitment than has previously been evident. 4

5 It will also require the identification of someone to ensure that the core regional groups continue to function in support of the region. There are potentially higher risks associated with this option. Members are invited to consider how they would wish to proceed. Dr Annie Ingram Director of Regional Planning and Workforce Development North of Scotland Planning Group 14 February 2012 G:\NOSPG\Dundee\NoSPG Mtgs\290212\09_12_i_Future_Management_NoSPG PGs response_final.doc 5