Business Plan 2011/12

Transcription

1 2011/12 Delivering the Best SSPC (4) (6)

2 NHS Wales Shared Services Partnership Mission Statement To enable the delivery of World Class Public Services in Wales through customer focus, collaboration and innovation 2011/12 2

3 Contents 1) Introduction to the 4 Director s Introduction 4 2) Context of Shared Services for NHS Wales 5 a) Purpose 5 b) NHS Wales Shared Services Partnership 5 c) Developing the Shared Service 6 3) Vision and Values 8 4) Corporate Objectives for 2011/12 9 5) Key Issues 11 6) Supporting the 12 a) Managing Performance 12 b) Benchmarking 12 c) Customer Relationship Management 13 d) Communication 13 e) Risk Management 14 f) Sustainability 15 g) Estates 15 h) Information Governance 15 7) The Financial Plan 17 a) Financial Baseline 17 b) Savings 21 c) Funding Flows 22 d) Budget Finalisation 23 8) Service Improvement Overview 24 a) Procurement Services 24 b) Employment Services 25 c) Welsh Risk Pool Services 29 d) Facilities Services 30 e) Legal and Risk Services 32 f) Contractor Services 35 g) Audit & Assurance Services 37 h) Prescribing Services 41 9) Conclusion 46 10) Appendices 47 1) Origin of Services Provided 48 2) The Structure of the Organisation 49 3) Funding Flow Analysis 50 4) s Register /12 - draft

4 1) Introduction to the Director s Introduction The challenging economic climate means that new and innovative approaches are required in all areas of public service. The NHS Wales Shared Services Partnership will allow health organisations to focus on health care whilst it focuses on innovation and efficiency within the support services. NHS Wales is facing huge challenges, not just in delivering the Annual Quality Framework within financial balance but also significant changes that will require services to be delivered differently. In the longer term the increase in the elderly population means that consumption of NHS services is set to double by 2030 and the lower proportion of the population in the younger wealth generating group means that there will be even more pressures on public finances. How we respond to the financial and demographic challenges now will determine whether NHS Wales will meet its commitment to the health of its nation. It is not possible to provide quality healthcare services by doing the same things the same way with significantly less money. Efficiency savings alone will not be enough and significant transformational change will be required. NHS Wales must: Tackle clinical sustainability issues; Maximise workforce contribution; Lift productivity whilst ensuring quality and safety; Work with partner organisations ( both public and third sector ) to maximise resources; Engage the population in managing wellness; Ensure individuals can care for themselves at, or closer to, home; Use technology to deliver services differently to meet cost and volume issues; Best organise resources - buildings, workforce and equipment; and Work across the public sector to maximise the best use of resources. NHS Wales will require high quality business and professional support functions to tackle this challenging agenda and NWSSP and other support organisations will have a key role to play. Neil Frow Director of NHS Wales Shared Services Partnership 28 th March /12 4

5 2) Context of Shared Services for NHS Wales a) Purpose The purpose of this paper is to present the inaugural NHS Wales Shared Services Partnership (NWSSP) for 2011/12. The plan seeks to build on the foundations laid down by the NHS Wales Shared Services Programme and sets out the initial proposals for NWSSP to deliver more effective and efficient business and services to NHS Wales. b) NHS Wales Shared Services Partnership Background The NHS Wales Shared Services Partnership is a new way to deliver support services to NHS Wales Organisations. It is believed that this approach will result in significant efficiency savings and qualitative benefits for health organisations. The journey to a national Shared Services was initially proposed in the 2008 consultation paper Proposals to Change the Structure of the NHS in Wales. In 2009 a research study was commissioned by WG from Bath University to review best practice models for Shared Services. In November 2009, the Health & Social Services Directorate (HSSD) Chief Executives Group agreed a Shared Services concept and the proposed programme approach for the development and implementation of shared services. The shared services business case was completed in September 2010 and the Minister for Health and Social Services announced that the Shared Services Programme would be implemented with the shadow running period starting on 1st November 2010 and becoming operational on 1 April Arrangements NWSSP is not a statutory body or a hosted organisation but a virtual organisation with over 1300 staff and an overall net budget of nearly 50m. NWSSP staff are employed by LHBs and Trusts but are ultimately accountable to the Director of Shared Service and his Senior Management Team (Appendix 2) The Shared Services Partnership Committee is responsible for the setting of NWSSP s policy and strategy and monitoring delivery. The Committee is a subcommittee of the Health & Social Services Directorate General s National Delivery Group and comprises representatives from LHBs, Trusts, WG and staff side. 2011/12 5

6 NWSSP provides a range of business and professional services as follows; Procurement Services Employment Services Contractor Services Prescribing Service Facilities Services Legal and Risk Services Risk Pool Services Internal Audit Phased Development of Shared Services It is proposed that shared services will develop in 3 main phases: Phase 1 establishment and consolidation of services; Phase 2 transformation and modernisation; and Phase 3 Growth and development. Inevitably 2011/12 will very much focus on Phase 1 however NWSSP will also aim to make some progress on phases 2 and 3. There is a real need to develop and improve certain services by investing in technology and adopting a professional approach whilst also continuing to develop a customer service approach and an excellent reputation for quality and delivery. The required level of service will only be possible by developing a highly motivated and appropriately skilled workforce. Mechanisms will need to be developed to consider the individual cases and benefits to be gained from transferring new services to NWSSP. All proposals will need to be signed off and agreed by the Shared Services Partnership Committee c) Developing the Shared Services This business plan sets out how the NWSSP will strive to achieve a high degree of consistency and standardisation across all its services in NHS Wales whilst recognising the need to tailor services on a local basis where appropriate. The plan also provides details of the main functions of NWSSP and summarises the strategic objectives, main initiatives and focus that it will take during the forthcoming financial year. The has been developed in a number of stages. The Visions and Values have been produced by the Chair and Senior Management team Section 3; Functional area work streams were set up by the Shared Service Programme Board and they developed detailed Service Improvement plans during the shadow running phase; 2011/12 6

7 The Senior Management team of NWSSP have reviewed these plans and have developed Service Improvement Plan Summaries that are highlighted in Section 8; and These have now been underpinned by the Corporate Objectives (See Section 4) that have been developed based on an assessment of organisational needs. It is recognised that the business planning process will need to be refined, developed and become more sophisticated during 2011/12 and work is already ongoing to address this. 2011/12 7

8 3) Vision and Values NWSSP developed its Vision and values during the Senior Management development day in April Our corporate mission is: To enable the delivery of world class Public Services in Wales through customer-focus, collaboration and innovation Our corporate vision is: By 2015 we shall be recognised as a world class Shared Services through the excellence of our people, our services and our processes The implication is that to be the best at what we do we need to be consistently DELIVERING THE BEST. Core Values The Chair and Senior Management Team have identified the following Core Values that will form the basis of NWSSP conduct. Further work is ongoing with stakeholders, staff and customers to embed and develop our values. LISTENING AND LEARNING (to constantly improve the quality, effectiveness and efficiency of all we do) To include Patience, Tolerance, Understanding, Responsiveness, Respect. WORKING TOGETHER (with colleagues, customers and suppliers) To include Trust, Teamwork, Honesty, Loyalty, Openness, Humour, Co-operation, Embracing Diversity, Empowerment, Valuing Others. TAKING RESPONSIBILITY (for decisions and making things happen) To include Commitment, Focus, Dependability, Professionalism, Integrity, Delivery, Quality, Fairness, Leadership. INNOVATING (to encourage continuous improvement) To include Courage, Freedom, Support, Creativity, Risk Awareness, Vision and Challenge. 2011/12 8

9 4) Corporate Objectives for 2011/12 The business plan has been developed around a set of initial key overall objectives that provide the basis for NWSSP as a whole. These objectives will be refined and developed as NWSSP moves from phase 1 into phases 2 and 3. Key Objective 1 To set up and create a new effective shared services organisation that is fit for purpose, ensures business continuity and delivers significant benefits to NHS Wales from year 1 As a new organisation NWSSP will need to develop an identity, establish an effective partnership with its service users and implement robust governance arrangements in a virtual environment. Key objectives include: Achieving financial and performance targets and operating within budget Developing and implementing a sophisticated corporate performance management system; Ensuring business continuity and a seamless transfer of services to NWSSP; Appointing and creating a highly motivated senior management team; Introducing robust controls and procedures and operating within sound principles of governance; Developing and embedding integrated and effective Risk Management processes and systems; Delivering the financial and qualitative benefits identified in the benefits register; Assessing current Quality and Customer Service accreditations and rolling out throughout NWSSP as appropriate; and Developing and implementing an Estates strategy to maximise the efficiency and effectiveness of the NWSSP estate. Key Objective 2 To develop a highly efficient and effective corporate, customer focused approach that adheres to the principles of continuous service improvement and provides high standards of service provision and performance Improving the customer experience and providing a consistent high quality service is a key requirement for NWSSP. This will require close working with customers and the development of a culture of continuous service improvement that delivers efficiencies and improved quality. Key objectives include: Developing and implementing a Customer Service Strategy and client relationship management arrangements; 2011/12 9

10 Producing robust service Improvement Plans for each service and managing performance on a regular basis; Process mapping and evaluating existing transaction based services to identify efficiencies and to standardise and modernise systems and provide common consistent patterns of service; Continually seeking to improve services through standardisation and/ or rationalisation; Developing VFM services and evidencing this through the effective use of benchmarking; Developing a programme to provide staff with skills in service improvement techniques; and Utilising IT solutions to automate manual systems and procedures e.g. intelligent scanning and E expenses. Key Objective 3 To have an appropriately skilled, healthy, productive and engaged workforce Our 1300 staff represents our major asset and their continued development will be key to the success of NWSSP. Key objectives include: Developing and implementing an organisational development plan; Ensuring that all staff are subject to performance and development reviews; Implementing effective, regular and innovative methods of communication with staff; Developing a local partnership forum; Promoting and participating within the Corporate Health Standard; and Developing systems to measure and improve staff satisfaction and morale. Key Objective 4 To develop the medium and longer term strategy for shared services NWSSP will work with WG and NHS Wales to identify the most appropriate way forward in terms of the strategic development of shared services across Wales. Key objectives are: Securing benefits from the synergies to be gained from existing services within NWSSP; Transforming, modernising and rationalising existing NWSSP services; and Identifying potential further services to be included in NWSSP 2011/12 10

11 5) Key issues The key issues impacting on the NWSSP are: Business continuity of some transactional services in particular the payroll services transferred from two LHBs are significantly under resourced and have required immediate support from the wider payroll resource to deliver the core service; Shortfalls in senior managerial resources - LHBs have transferred direct staff to NWSSP however certain senior management within LHBs and Trusts (with NWSSP services as part of their previous responsibilities) have not transferred; Financial resources transferred from LHBs and trusts in a number of cases the budgets transferred from LHBs do not fully reflect the current costs of running the service, as a result some services will be starting off in a deficit position. The underlying deficit is being finalised and falls within a range of 0.4m to 1m. Further work is necessary to determine the baseline and sign off budgets with Directors of Finance; Baseline staffing information data quality issues with the information held in ESR has had a significant impact on the time taken to draw accurate information for development of the business plan; Insufficient designated finance and corporate resources Whilst there are potential synergies to be gained from shared services, there is a gap in the resources available to cover corporate areas. Whilst significant support is currently being provided by NLIAH, this area needs to be formalised; Communication - effective communication will be key to successful staff engagement but requires innovate solutions in a virtual organisation; Staffing the recruitment and retention of staff will be a vital part of NWSSP s ability to deliver the services required by LHBs and other clients, especially as we enter a period of financial constraint and significant change. As a key service principle it is essential that NWSSP is in a position to provide sufficient training to its staff, so as to enable them to be fully competent and qualified to carry out tasks in an effective and efficient manner. Failure to do this may result in delays in driving forward service and savings plans. Managing the introduction of new / enhanced systems the changes envisaged over the next few years represent a considerable challenge to NWSSP and NHS Wales. Proposals when developed will need to be based on realistic and robust assumptions progressed within a tight project management framework to ensure business goals are delivered on time and within approved budgets. 2011/12 11

12 6) Supporting the Introduction The business plan will need to be supported by a range of activities across NWSSP addressing issues of efficiency, governance and infrastructure. A major challenge for 2011/12 will be to establish the NWSSP arrangements and develop the culture and behaviours to support partnership working with service recipients. The arrangements for implementing the plan will need to be developed, including project planning, timetabling, key milestones and monitoring. The main initiatives that will be undertaken are outlined in the remainder of this section a) Managing Performance We will develop a comprehensive performance dashboard which assists in driving the NWSSP s performance. The dashboard will be interrogated at various levels and provides performance data on the following: Financial performance; Specific service level operating performance; Project performance; Key performance indicators (KPIs); Customer satisfaction; Benchmarking of operational processes and industry standard services; and Employ engagement and satisfaction. During the year, the system will evolve to include client satisfaction measurements. The KPIs used by NWSSP will measure performance of our services at the highest level and at local level. Many of the KPIs are already in place however other KPIs will need to be developed over time. b) Benchmarking We will undertake a benchmarking exercise of our services and use the resulting data to highlight areas where driving performance towards the market s highest performers will bring customer, operation and financial benefits. 2011/12 12

13 c) Customer Relationship management NWSSP understands the importance of Customer Service in the delivery of services to individuals and groups. A draft strategy has been developed to help create and develop a positive approach to Customer Service in which we strive to consistently exceed the expectations of our customers. We aim to create an environment within which 'Customer Service' is seen as essential to the management and delivery of services. The aim of this strategy is to ensure that all users of NWSSP services including our staff are treated as valued customers. The strategy focuses on creating the overall conditions under which excellent service delivery can be achieved. In particular: The Shared Services Committee will have representatives from each health organisation in Wales; Each health organisation will have a nominated Management Contact who will ensure regular review meetings are held with that organisation to cover key developments and issues; Service User Groups will be established for functional areas e.g. Payroll, Recruitment and Accounts Payable to ensure engagement in service development; and An issue and complaints process will be developed to ensure that problems are resolved and lessons learnt. We will regularly conduct structured customer satisfaction surveys. These will provide valuable feedback to enable action plans to be created to improve our customer s experiences. The areas surveyed will mirror our KPIs but also include an overall customer satisfaction result based on customers being asked to consider all aspects of the service they currently receive. d) Communication NWSSP recognises the importance of effective communication in a brand new virtual organisation with over 1300 staff and a wide range of stakeholders. NWSSP is committed to producing a communication strategy which will cover both internal and external communication. An initial communication plan was developed by the Shared Service Programme Board. This now needs to be refined and developed to cover internal and external communication and will build on existing best practices within the NWSSP services organisation and from a review of other approaches. 2011/12 13

14 e) Risk Management The effective Management of Risk is vital to the success of NWSSP. It will inherit a number of risks from the project phase and these will need to be effectively managed during the early phases of operation. A corporate risk register will be developed as part of the overall risk management framework, structured around the sources of risk and the following themes: External Strategic risks Significant operating risks Significant directorate risks Corporate Risk Register Significant contractual risks Significant project risks Business plan risks This structure will provide clarity of risks across the organisation; it will highlight all significant sources of risk and allows action plans to be tailored to the classification of risk. The corporate risk register will be supported by risk management arrangements through the organisation and a corporate risk management group that ensures the Shared Services Committee is aware of risks emerging in the business. The corporate risk register will be reviewed regularly by the Senior Management team. 2011/12 14

15 f) Sustainability NWSSP is fully committed to long term sustainable development and will strive to promote awareness of, and engagement in, sustainable development across all business activities. We will: Implement a sustainable development action plan Promote continuous improvement in sustainable development practices Continuously review best practice in sustainability issues Engage with key stakeholders and business partners on relevant aspects of sustainable development Maintain an environmental management system to measure, manage and report performance Incorporate sustainability into strategic plans, business plans and business cases Embed sustainability into operational activities Provide appropriate training and guidance materials for our people, contractors and other stakeholders in sustainability and environmental issues. To retain the focus on sustainability and ensure sustainable development remains high on our agenda, a sustainable development action plan will be developed. This will be reviewed on an annual basis and highlight the key actions that will be undertaken to minimise our impact on the environment. g) Estates An estates strategy will be developed to support the business by ensuring our property portfolio is fit for purpose and suitable buildings are available in the most appropriate location to help us achieve services excellence and value for money. The Strategy will focus on continuously reviewing our property needs to actively manage the property portfolio when business events, and to lesser extent, market conditions, dictate. h) Information Governance Information governance is concerned with the way in which we handle all organisation information including sensitive and personal data. Each LHB and Trust will have arrangements for managing information governance in accordance with the requirements set up in NHS Wales. NWSSP will introduce similar arrangements which will dovetail into existing policies. Effective and responsible management of such information will be a very high priority for NWSSP. 2011/12 15

16 Currently NHS Wales LHBs and Trusts internal policies and procedures will be used to provide the framework for handling data. During the first year NWSSP will focus on the following areas; Information Governance Management; The Confidentiality NHS Code of Practice; Data Protection Act; Information Security; Information Quality; Records Management; and Freedom of Information Act 2011/12 16

17 7) The Financial Plan a) Financial Baseline once figureceived 2011/12 Financial Baseline Budgets for services transferred to NWSSP Pay 37,513 Non Pay 9,655 Budget available to NWSSP 47,168 Funding to be transferred re budget deficit 577 NWSSP running Costs: Pay 355 NWSSP Running Costs: Non Pay /12 Recurrent Baseline before cost pressures 48,275 Cost pressures Pay Pay Award / National Insurance impact 625 Incremental Drift 325 Assistant Director - Internal audit appointment 100 Non Pay: Inflation general 409 General Contingency reserve 250 1, /12 Recurrent baseline prior to savings 49,984 Additional budget requirement 2,816 Funded by Shared Services Business case savings 1,622 Additional cost savings / income 737 Money to be confirmed 577 2,936 Direct savings for distribution to WG, LHBs and Trusts 120 The budget can be analysed over services as follows: 2011/12 17

18 Financial Plan There are 2 distinct elements to the NWSSP budget: 1. Services undertaken on an All Wales basis Facilities, Legal and Risk Services, Risk Pool Services, Contractor Services and the former element of Welsh Health Supplies Procurement Services and Prescribing Services; and 2. Services previously undertaken within LHBs and Trusts - Accounts payable, Procurement, Employment Services and Internal Audit. Services undertaken on an All Wales Basis Approximately 60% of the budget is associated with services that have traditionally been provided on an All Wales basis. The respective budgets are relatively self contained and the funding in respect of the All Wales services have all been agreed on a timely basis. Services previously undertaken within LHBs and Trusts The identification of the budgets associated with services previously undertaken within LHBs and Trusts has been challenging. A significant amount of work was undertaken by the Shared Services Finance Work stream and subsequently by NWSSP in conjunction with LHBs and Trusts to identify the baseline budgets for 2011/12. During June and July NWSSP has been provided with detailed budget reports and staffing information from LHBs and Trusts which have been reviewed and analysed in detail. This work has identified differences in the way that budgets have been determined in individual LHBs and key differences in some of the principles applied eg local cost improvement targets have been set in some LHBs. As a result of the inconsistencies the following principles were discussed and agreed at the All Wales Director of Finance meeting on 15th July Key principles Shared Services is a ministerial priority supported by a business case and was established to improve service levels and quality within Wales and to bring about financial benefits through maximising the opportunities of scale. In order to achieve this it is essential that it is established with a solid financial baseline that is clearly understood. The overriding principle agreed is Shared Services should not be set up to fail and it is imperative that NWSSP is set up with a balanced budget. The overriding principle is supported by the following underpinning principles: 1. The resources should be consistent and based upon the financial declarations produced by the Shared Services Finance Workstream in March/April /12 18

19 The 2010/11 budget should be used as the financial baseline for 2011/12 subject to consideration being made for any overspend that arose in 2010/ The 2011/12 in year cost pressures will be met through efficiencies and savings made by NWSSP. Local CIP programmes will not be applied to NWSSP related budgets, however the overall level of direct savings required from NWSSP will be determined and set by the NHS Wales Shared Services Partnership Committee. 3. The liability for any inherited deficits will remain with the relevant LHB or Trust. 4. The agreed financial baseline for each LHB and Trust should be formally signed off. The accountability and therefore the liability for any inherited deficits remains with the LHB or Trust. However there is a shared responsibility to deliver the business case benefits. In order to discharge the above principles and objectives the following key operating principles have been agreed: 1. Existing SLA agreements between NWSSP and LHBs and Trusts for hosting arrangements eg Procurement Services, Risk Pool will remain at 2010/11 levels. Similarly charges levied on LHBs and Trusts for All Wales Services provided by NWSSP eg Materials Management SLA will remain at 2010/11 levels. 2. The overall control of the budget for Shared Services has been delegated to the Director of NWSSP through NHS directions and amendments to standing orders and financial instructions that have been agreed by each Board. Further delegation where appropriate for the management of Service budgets being made to members of the NWSSP Senior Management Team. 3. Budgets for NWSSP services will remain in the financial ledgers of NHS Wales Organisations and will be reported as part of the overall financial position of individual LHBs and Trusts. 4. LHBs and Trusts will provide NWSSP with relevant staffing and financial information by the 7th working day of each month. 5. There are differences in the manner which non staff budgets are reflected within LHBs. In some LHBs such budget and expenditure is allocated to individual cost centres, in others elements are maintained centrally. Where historically expenditure has not been separately identified NWSSP staff will continue to have the same level of access to central budgets as in prior years eg training. 2011/12 19

20 Agreement on financial baselines Good progress has been made and overall agreement in principle has been reached in all meetings held. The detailed analysis of budget reports has identified a large number of relatively small issues in some organisations that could cumulatively prove significant. These matters are being resolved with LHBs and Trusts. In addition, staff in post and vacancy information has now been received to enable the costing exercise to be completed for comparison to baseline pay budgets. The findings are broadly consistent with the Month 4 information. Overall agreement in principle has been reached in the meetings to date and subject to the satisfactory completion of the staff reconciliation the budgets will be signed off in September The main outstanding matters are: Hywel Dda the LHB is forecasting an outturn deficit of approx 200,000 on employment and procurement services. This represents an improvement on the declaration outturn position where an overspend of 257,000 was identified. There are also pressures on the Capital and PFI audit budget. NWSSP are working with the Hywel Dda Finance Director to resolve the issues. Betsi Cadwaladr at month 4 there is a large YTD overspend identified which equates to a forecast outturn deficit of 300, ,000. The declaration position for 2010/11 identified a deficit of 317,000. NWSSP will work with Hywel Dda and BCU to reduce the deficits during 2011/12 however any remaining deficit will remain in the respective LHB accounts and will need to be funded in the event of NWSSP becoming a hosted organisation. Summary of Budgetary Pressures The Budget Pressures outlined in the table above includes a general contingency reserve to cover unexpected cost pressures that may arise eg VERs. In the event that this is not required it will be distributed to organisations. There are also a number of significant financial risks including: Business continuity of some transactional services in particular the payroll services transferred from tow LHBs are significantly under resourced and have required immediate support from the wider payroll resource to deliver the core service. Additional short term support from Aneurin Bevan has also been obtained to cover the ongoing absence of the Head of Employment Services. The ability to generate financial savings in the short term is challenging and action is being taken to stabilise the situation ; Shortfalls in senior managerial resources - LHBs have transferred direct staff to NWSSP however certain senior management within LHBs and Trusts (with NWSSP services as part of their previous responsibilities) have not transferred; and 2011/12 20

21 Staffing the recent appointment of the Assistant Director Audit & Assurance from outside the existing internal audit staff has resulted in an additional cost pressure. b) Savings The Business Case highlighted a range of potential savings both qualitative and quantitative. Direct savings achieved from Shared Service operations will be shared in accordance with the benefit distribution methodology agreed with DoFs in May It should however be noted that direct savings on WG funded services will be redistributed to WG. The Shared Services Business case identified the need to generate direct savings of 1,622k in 2011/12 and this is supported by a detailed benefits register. Further work is ongoing within NWSSP to finalise plans to secure the additional savings of 737k required above. The total direct savings equate to 5% of the budget in 2011/12. Service Savings Employment Services 684 Procurement Services 160 Internal Audit Services 0 Legal and Risk Services 154 Risk Pool Services 0 Facilities Services 203 Contractor Services 241 Prescribing Services 180 Total 1,622 As well as direct savings arising in Shared Services there are also significant financial savings that will arise within Local Health Boards and Trusts as a result of the professional influence of Shared Services e.g. Procurement over 30 million see appendix 4 for further details. Distribution of Savings Application of the key principles should result in the types of savings and benefits distribution as follows: Types of Savings* Transactional Savings Local Initiative Approach to Distribution Local Saving retained net of any recharges e.g. Source of Savings Payroll & Recruitment Services and P2P Services (e.g. transfer of work between sites due to standardisation and streamlining of processes) 2011/12 21

22 Types of Savings* Transactional Savings National Initiative Regional Collaboration Approach to Distribution Shared pro rata to 2010/11 costs Share agreed in advance Shared between those organisations affected on a pro-rata basis e.g. Source of Savings Payroll & Recruitment Services and P2P Services (e.g. New IT systems reducing manual workload). Sharing 1 post between 2 organisations when a vacancy occurs Intelligent Client Role Reduced running costs of an existing all Wales service Local saving Shared pro rata to 2010/11 costs/ contributions Legal Services; Internal Audit Services; Capital Project Management (e.g. in-house and not contracted-in work) Contractor Services (e.g. restructuring of management arrangements) Payroll & Recruitment Services (e.g. reduced costs of ESR fees) Economies of Scale Shared pro rata to 2010/11 costs *Available savings after the funding of any I2S requirements or additional marginal running costs. **s will only be distributed to individual LHBs once any underlying deficit has been eliminated C) Funding Flows The principles for funding flows are as follows: The process must be simple and transparent; Administration must be kept to a minimum and transactions minimised; The way in which the benefits are distributed must act as a positive lever for change; The process should ensure that the NHS Wales Shared Service Committee (and Management Team) has clarity of existing relevant spend and its associated activity; The opportunity to re invest savings to produce enhanced savings must exist if Shared Services are to deliver its full potential savings; and The proposed approach should ensure and develop organisational commitment to NWSSP. Whilst the Funds Flow for many areas remains unchanged a number of specific changes are proposed for the reasons outlined below (detailed analysis is shown in Appendix 3): 2011/12 22

23 Internal Audit - The budget will still be held in the ledger of each Health Organisation but will be managed by and be the responsibility of NHS Wales Shared Services. The savings made through the shared service changes will be reflected in the ledger of each organisation; Contractor Services - It is proposed to amend the funding to reduce the level of recharges and therefore the associated administration of this process. This meets with the legal advice received and is also in line with the principles of the project in terms of reduced administration. This will leave the head of service time to focus on key activities linked to gaining best value for NHS Wales; Accounts Payable and Procurement - The budget will still be held in the ledger of each Health Organisation but will be managed by and be the responsibility of NHS Wales Shared Services. The savings made through the shared service changes will be reflected in the ledger of each organisation; Payroll and Recruitment - The budget will still be held in the ledger of each Health Organisation but will be managed by and be the responsibility of NHS Wales Shared Services. The savings made through the shared service changes will be reflected in the ledger of each organisation; and ESR Payroll Fee to minimise recharging and recirculation of funds this fee will be paid to one organisation and expenditure due will be settled directly with WG. Any savings achieved from Shared Service operations will be shared in accordance with the benefit distribution methodology. d) Budget Finalisation A considerable amount of work has been undertaken by the Shared Services Finance Workstream to identify the resources to be transferred to NWSSP. The work is substantially complete however: SLAs with WG for All-Wales service budgets are still in the process of being finalised; and Resources for services previously provided by LHBs and Trusts require final sign off with Directors of Finance. The budget will be updated to reflect the outcome of the above. 2011/12 23

24 8) Service Improvement Overview Introduction Over the last few months several Shared Service Programme workstream meetings have been held in conjunction with LHB, Trust and WG colleagues to start to develop Service Development Plans (SDPs). Further work will be carried out during the early part of 2011/2012 to further refine SDPs, through more meaningful engagement with customers and stakeholders including the development of robust Key Performance Indicators (KPIs) which will aid the measurement of the continued improvement of services provided across the Health Communities in Wales. As part of this process the NWSSP aims to achieve a higher degree of consistency and standardisation across all services in Wales. That said it is recognised that one size does not always fit all and it is important that the local focus is not lost. a) Procurement Services Challenges Faced Procurement Services as a function has been established out of the wider reorganisation of services within NHS Wales and more specifically the Shared Services project. Procurement Services is an NHS Procurement organisation providing a Sourcing, Purchasing, Materials Management, Payments and Equipping service to NHS Trusts and Boards in Wales. The next few years will undoubtedly be characterised by large scale, complex change. Key Improvements / Changes Change Deliver 20 million plus figure of cash realising savings. Deliver an end to end Supply Chain solution with full electronic ordering & reporting. Develop a Sourcing function that manages the entire Sourcing Strategy for NHS Wales, including Capital Equipping. Supports the delivery of individual Boards/Trusts overall CIP target. This helps deliver more benefit to frontline services as efficiencies are made. Will help deliver a more efficient and effective service. It will reduce overall cost, eliminate unnecessary waste and reduce non added value activity. It will provide a consistent level of system and service across Wales. Standardise on recognised Procurement Best Practice for all processes, and contracting once for Wales. This will help deliver a common way of working which will reflect current Best Practice. This allows more of a flexible approach 2011/12 24

25 Change Develop an integrated Purchase to Pay function for Wales which is utilising the best available technology Develop staff to deliver to their full potential. Building staff capabilities to deliver benefits and realise new opportunities. to moving work around and consistent approaches. It should reduce errors and the need for re-work. Helps in developing and training of staff. Deliver transaction savings from all processes particularly invoice payments. Deliver a more efficient and effective system and reduce cost. It will provide a modern way of working and offer benefits for suppliers. We need a skilled, focused and inspired workforce. They need to have the skills to do the job and to rise to the challenges of change that we will work through. Support Needed The availability of IT and systems is critical and this is particularly key in the Delivery of the Accounts Payable process savings; Board and Trust support on the delivery of savings is key particularly with clinical reference Most importantly will be the support of the staff going forward; Stakeholder buy in and support for the principles; and The support of our partners Success Criteria The overall plan details a number of KPIs that will be important at a number of levels. b) Employment Services Challenges Faced Challenge Obtaining buy in from staff to support the required changes. Solution Involve staff in developing proposed solutions to change working practices. Train and develop staff including the acquisition of new skills such as service improvement techniques. Openness, honesty and transparency throughout. Work in partnership with staff from the outset. 2011/12 25

26 Challenge Obtaining support from staff side representatives for the required changes. Ensuring service recipients are engaged with the service and support the change management process. Development of relevant and appropriate technological solutions. Ensuring the service is up to date and future proof. Current services are inconsistent in relation to scope, quality, size and resource. Solution Work in partnership with staff side from the outset. Openness, honesty and transparency. Enable representatives to participate in the change. Ensure representatives have a thorough understanding of what a shared service means. Effective customer service links are developed. Develop the customer/provider relationship to ensure a common understanding. Engage key individuals in developing new ways of working. Ensure key Business and Systems support staff are involved in all stages of the procurement process. Learn from others who have experienced the process and the consequent changes. Network with relevant colleagues in shared services. Strong networking and benchmarking. Robust development plans are in place. Learn from others. Scope the services and quantify resources required. Engage with staff and service recipients in developing plans to standardise services. Key Improvements / Changes Change Safe transfer and stabilisation of existing services a) Transfer recruitment teams as per the agreed phased implementation plan and financial framework. b) Assess the service provision against resources transferred. a) Reduced risk of service failure. b) identify any shortfalls in service provision against individual legacy statements. 2011/12 26

27 Change c) Implement agreed governance arrangements for the services. d) Review business continuity plans and develop standardised plan for the services. Procedures & protocols Internal i) Standardisation of internal procedures & protocols. c) Reduce risk and ensures compliance. d) Reduce risk of service failure a) Reduced costs and increased efficiency through standardisation of processes and use of best practice. b) Improved ESR data quality through correct and timely data being entered onto the system. c) Reduced overpayments due to improved working practices. Management information Standardised internal management information systems (i.e. Recruitment management database; Errors and overpayments reporting database; risks, issues & complaints logs). Production of relevant KPIs. Standardised method for calculating cost per payslip. Evidence based information. Improved customer service. Electronic solutions a) Implementing year 1 e-expenses project plan. b) Prepare strategy for implementing Web ADI. c) Implement project plan for the new NHS Jobs system. Improved efficiency and reduced costs. Service model and supporting management structure a) Review interim structure put in place for 1 April 2011 and implement appropriate changes as required until implementation of the final service model and management structure. b) Develop and agree future service model based upon the strategic vision for shared services. Improved governance. Clarity of vision and strategic direction. Effective management arrangements in place. 2011/12 27

28 Change c) Develop future management Improved operational performance. structure based on agreed service model. d) Develop critical areas such as Business Management and Project Support, Service improvement, customer services. e) Develop HR systems team to support service delivery and the provision of critical management information. Support Needed Assessment of the expectations of service recipients to establish the future direction of travel. Service recipients must be engaged with the service and support the change management processes; Flexible use of financial resources and significant business systems and IT support; Capital investment through Invest to Save and other relevant schemes. Staff side buy-in and shared services staff support; Freedom to develop services within agreed parameters; and Investment in project management, service improvement, staff training and development and customer services. Success Criteria Safe transfer and stabilisation of existing services a. Transfer plan implemented successfully; b. All shortfalls identified and either level of service adjusted or additional resources secured; c. Governance arrangements operating effectively; and d. Business continuity plans in place and understood. Procedures & protocols e. Standard internal procedures rolled out across Wales; f. ESR data quality input by the service meets agreed minimum criteria; g. Overpayments protocol fully implemented in all NHS organisations; and h. Staff understand procedures and protocols and have been provided with the relevant training. 2011/12 28

29 Management information i. A consistent and comparable set of performance indicators for payroll and recruitment services is provided to relevant individuals within service recipient organisations; and j. Targets are agreed and progress towards them is identified. Electronic solutions k. Target levels of implementation plans achieved; l. Savings targets delivered; and m. Customer satisfaction increased. Service model and supporting management structure n. Future service model delivered; o. Effective management structure in place; p. Staff understand agreed reporting arrangements; and q. Shared services customer services framework implemented. c) Welsh Risk Pool Challenges Faced Lack of clarity regarding assessment role in 2011/2012; Need to agree to broaden assessments to include higher level governance issues around the Emergency Dept, Maternity and Surgical front line areas; and; Finance support for Welsh Risk Pool and Legal & Risk Key Improvements / Changes Change Re-introduction of financial incentivisation scheme for improved practice. Work with Internal Audit. Make more use of joint L&Rs/WRP database to inform and educate NHS Wales. Expansion of current training and education role in risk management eg MSc, tailored training. Broader ownership of risk management issues and their implications. Reduce opportunity for duplication in gaining assurance for non-financial issues. Increase awareness/broaden lessons learned. Improvement in practical knowledge of how to evaluate and control risk and improve practice. 2011/12 29

30 Change Themed initiatives around high risk areas. Lead development and adoption of national initiatives in identified risk areas. Success Criteria Agreement and roll out of incentivisation system; Working arrangement with Internal Audit; Continue with current networking arrangements; use of data as part of education and training provision; Successful completion/qualification by students; and Identification of national risk issues and solutions. d) Facilities Services Challenges Faced The NHS Estate is a critical component in the delivery of safe, effective and efficient healthcare services and patient surveys consistently demonstrate that the standard of healthcare buildings and facilities management services have a huge impact on the patient experience. NHS Wales has an interest in over 500 properties, occupying 1.8 million m 2 and incurring revenue costs of 330 million per annum. In 2010/11 over 400 million was invested in capital procurement, of which the majority was in respect of building projects. Property generally is an expensive asset but healthcare property is particularly costly and the more we can rationalise the NHS Estate, the more resource can be redirected to front line services. Good work has been done by NHS Wales in recent years in this regard but further progress is now needed as the financial pressure of reduced funding starts to take effect. Key Improvements / Changes Change Implement a national property management service utilising the e- PIMS database. This initiative will require NWSSP-FS to provide all professional services in respect of NHS Wales property management needs Will assist Health Boards/Trusts in the more efficient and effective management of property and better utilisation of the NHS Estate. 2011/12 30

31 Change Develop a more robust approach to the management of capital projects. This initiative has 3 aspects; a) Streamlining the business case process; b) Improving the Designed for Life Building for Wales Framework; and c) Introducing in-house construction project management services. Develop estate management solutions for those NHS organisations currently lacking the critical mass to fulfil this function. Will contribute to a more efficient and effective management of capital delivering better value for money. Better use of existing estate management resources and the control of estate risks. It is proposed that work is undertaken to explore the possibility of the smaller NHS organisations being managed as a single entity from an estates management perspective with NWSSP-FS overseeing and supporting the arrangement or alternatively for one of the Health Bodies to fulfil this function. Support Needed NWSSP - Facilities Services is fully funded by the Welsh Government to provide advice and support to the Welsh Government s Health Department on all matters of asset management and to provide specialist services to NHS Wales. To implement any changes requires the support of both the Welsh Government and NHS Wales and NWSSP-FS always engages its key stakeholders in all of its change programmes. This applies to all aspects of the Service Improvement Plan. Property Management NWSSP-FS are currently working on the premise that the delivery of a national property management service can be absorbed within its existing establishment. This is based on the assumption that approximately new leases will be identified by Health Boards/Trusts. Whilst NWSSP-FS will provide all professional services in respect of the NHS Wales property management requirements, a local contact liaison officer will be required at each Health Board/Trust. Capital Projects Good progress has already been made with improving the business case process and NWSSP-FS is currently procuring a new Regional 2011/12 31