Earned Autonomy Southport & Ormskirk Hospital NHS Trust Our Ambition for Clinical Business Units

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1 Earned Autonomy Southport & Ormskirk Hospital NHS Trust Our Ambition for An organisation that is capable and confident to run with autonomous, building on firm foundations of clinical quality and maximising operational effectiveness without risking the Trust s strong financial position.

2 Principles Devolution of autonomy Earned Autonomy Changing role of CEO, Board and Executive Directors Strengthening of CBU Emphasis to Safety & Quality, not just financial performance Service Line Reporting (SLR)

3 Value Proposition What are the Benefits.? Benefits 1) Shaping the future of services through local clinical and managerial ownership of the 3 year strategic agenda and service direction, utilising the framework of an annual planning process that is rooted in quality and patient care. 2) Earning the ability to plan service investments through: Payment by Results at a Clinical Business Unit level and, in the first instance, the potential to access financial over-performance against plan. The potential to retain cash generated from equipment depreciation to invest in future capital expenditure without recourse to the Trust s Capital Bidding Group. 3) Greater levels of autonomy and decision rights with the ability to more easily restructure and modernise to increase service capacity, efficiency and improve the patient journey without Executive Team input, and the opportunity to influence performance through clear internal trading arrangements. 4) An effective and robust performance management regime that recognises and rewards good performance, and that relies on exception reporting upwards rather than central control. In other words, the better the performance, the less involved the monitoring.

4 And the Constraints? Constraints 5) Post FT authorisation, the Trust will always be obliged to remain compliant with its terms of authorisation as an NHS Foundation Trust. 6) CBU actions must always be consistent with the wider objectives and obligations of the Trust as a whole. 7) CBUs will continue to perform against national and local targets and standards and in line with the Trust s overarching contractual requirements. 8) CBUs must continue to ensure Trust wide financial sustainability, and as such internal transfer pricing policy (i.e. between Trust services) cannot destabilise the Trust s core services. 9) Service developments must be consulted upon across all service lines and CBUs that are affected, with arbitration being undertaken by the Trust Executive Team.

5 The Challenge for CBU General Managers and Associate Medical Directors Service Understands drivers of financial performance Identifies and prioritises opportunities to improve operational excellence & implements initiatives Defines service strategy and delivers service-specific objectives to achieve it Recognises and deals with poor performance Leads change through people Collaborative Personal Acts within the overall interests of the Trust Effectively communicates and collaborates with other leaders Engages the Executive as appropriate providing early warning when appropriate Effectively engages external stakeholders, marketing the service at the L&D Self awareness Communication Integrity Self Belief Drive for Improvement Self Management This information will be used as the basis for 360 feedback and the production of a development plan. Critical to Clinical Director leadership is understanding how to tackle issues and use peer review to support development. Crucial to this is the relationship between consultants/medical workforce and the CD, and how some of the more difficult issues are managed.