The new Scottish Capital Investment Manual
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1 The new Scottish Capital Investment Manual Presented by: Paul Mortimer: Asset Management Policy Advisor for HFS Yvonne Summers: Performance Manager - Health Performance and Delivery Directorate
2 Today s Overview: Principles of good investment planning A journey through the business case process Plus, context from CIG members who receive your business cases 2
3 SCIM Refresh current status Draft guidance is now available for use Strategic Assessment Initial Agreement Outline Business Risk Management & Benefits Realisation Recommended for all live & future projects Seek guidance for existing business cases Real testing & feedback on guidance 3
4 IJB Strategic Commissioning Plan Service Planning Strategic & Investment Planning Process Where do we want to be? SAFR National perspective Local Delivery Plan How do we get there? (P)AMS Where are we now? Capital Planning System EAMS Business process Strategic Investment Prioritisation 4
5 Service Change process: Impact on Patient Care? Yes Impact Assessment & Engagement Plan No Stakeholder Option Appraisal Other Engagement Opportunities Consultation & Ministerial approval Yes Major Service Change? No Proceed to Business process 5
6 New SCIM framework Service Planning Develops the service change proposal Engages with stakeholders Identifies major service change Strategic Assessment Brief outline of proposal Indicates intentions to Scottish Government Used to assess strategic priority Initial Agreement Evidence base of need for change Confirms benefits of investment Identifies preferred strategic / service solution(s) 6
7 Service Planning Service Change process comes before Business process Well-established service change process already in place Requirement for capital investment should grow out of good service redesign SG is buying outcomes, not buildings Stronger collaboration and input from strategic planners / service planners required 7
8 Focus on Outcomes Greater emphasis needed on demonstrable benefits, right from the start Risk register must encompass organisational & service risks that may impact on outcomes not just construction risks Project evaluation must consider more than lessons learnt from the building project 8
9 Top tips: Project needs to be set in your broader strategic context what else is happening and how will this fit/contribute? Don t tell us what we all already know (presume I have read the 2020 vision!) Outcomes and benefits have to be credible so be realistic Be proportionate about level of detail & type/extent of engagement depends on size & complexity of project We re here to help as early as possible 9
10 How the new SCIM will help you to achieve this... 10
11 Strategic Assessment Brief outline of proposal Indicates intentions to Scottish Government Used to assess strategic priority 11
12 Strategic Assessment It describes your initial proposal It needs to be a shared view of proposal It provides the rationale for investment: That there is a need or opportunity for change That the benefits are significant It will be important for NHSScotland It should be included in Boards PAMS 12
13 PROJECT: A Care Village What are the Current Arrangements: Older People s Health & Care services in a location currently support 100 community beds, 75 care home beds in 4 locations, and 5 separate GP practices. They are all run at capacity. What is the need for change? More patients than necessary being discharged to care homes rather than home Patients are staying in hospital for longer than necessary Unable to afford projected increasing demand for service Existing facilities are functionally ineffective & unable to support proposed service model Identify Links What benefits will be gained from addressing these needs? Improves quality of life through care provided Improves support to allow people to live independently Increases proportion of people with intensive needs being cared for at home Ensures timely discharge from hospital Improves financial performance Improves functional suitability of the healthcare estate Reduces people waiting more than 14 days to be discharged from hospital into more appropriate care setting Identify Links How do these benefits link to NHSScotland s Strategic Investment Priorities? Person Centred Safe Effective Quality of Care Health of Population Value & Sustainability TOTAL SCORE Prioritisation Score What solution is being considered Service Scope/Size Full range of Older People s health & care services within a location Service Arrangement Integration of health & social care services & co-location of supporting services Service Providers Existing NHS, Council and GP health, community & social care service providers Impact on Assets Expansion of community hospital facility Value & Procurement Hub value circa 40m
14 Initial Agreement Evidence base of need for change Confirms benefits of investment Identifies preferred strategic / service solution(s) 14
15 Initial Agreement key steps Service planning & stakeholder engagement: Must engage with stakeholders for any service change You may have already agreed the outcome of an option appraisal exercise If so, then describe process and compare with Do Nothing If not, then test strategic plans here Adopt agreed stakeholder engagement recommendations 15
16 Initial Agreement key steps Describe current arrangements / do nothing This is an important step It becomes the benchmark for all investment decisions It covers services and buildings How might things get worse? Any interventions would become Do Minimum 16
17 Initial Agreement key steps The need for change The need for a new building isn t enough Problems with existing arrangements Any drivers for change Opportunities for improvement Any external drivers? Keep it concise and to the point 17
18 Initial Agreement key steps Demonstrable benefits IA likely to be returned if not done They are the rationale for any investment Ask yourself, how will I be able to demonstrate that they have been delivered? A benefits register is required 18
19 Initial Agreement key steps Strategic risks: Ask yourself, What risks might impact on the success of the project? What actions are you taking? Emphasis on client and service risks at this stage A risk register is required Examples are provided 19
20 Initial Agreement key steps Exploration of strategic / service solutions Again, not building solutions Only need to describe process and compare against Do Nothing if optional appraisal already done Otherwise, fully explore alternative service / strategic solutions Need to be real, step-change differences SWOT analysis of short list & test against investment objectives, vfm & affordability 20
21 Initial Agreement key steps Outcome: Single service / strategic solution identified Or more if appropriate Plus, Do Nothing / Do Minimum Strategic solution + implementation option = OBC Option 21
22 Initial Agreement key steps Readiness to proceed to OBC? What are programme & procurement plans Is this likely to be affordable? What resources are needed? Are appropriate governance arrangements in place? Should this proposal still be a priority for SG? 22
23 Outline Business Tests vfm of implementation options Identifies affordable preferred option Sets out arrangements for delivery 23
24 Strategic Management Outline Business : 5 Model Economic Financial Commercial 24
25 Strategic Has anything changed since IA May need more details of existing arrangements & need for change Update on design assessment process 25
26 Economic Options are combination of service & building solutions Consider best use of assets across public & possibly third sector Economic Appraisal: NPV or NPC? Discounted for presumed life of asset Use GEM, & CPS for life cycle costs Preferred option: best judgement of economic, benefit & risk appraisals 26
27 Commercial All procurements need to be set out (construction, advisors, equipment, pre-works, etc) Set out scope of works: Design information Included services Highlight interesting contractual arrangements 27
28 Financial Mainly as before Standard templates for capital & revenue financial projects Is the project affordable? Need confirmation of stakeholder and funding support 28
29 Management Are you ready & capable of taking this project forward? Are project resources available & capable? Is a full benefits realisation plan available? What community benefits will be delivered? Have all strategic & project risks been considered together? Are you already thinking about the commissioning stage? How will the project be monitored and evaluated? 29
30 Strategic Management Full Business : 5 Model Economic Financial Commercial 30
31 Full Business Has the strategic case for investment altered? Does the OBC s preferred option remain valid? What is the recommended v.f.m. commercial offer / service? Is the project financially viable? Is the organisation ready to proceed to contract award and implementation? 31
32 New SCIM: Looking ahead Continue with soft-launch of IA & OBC Evaluate feedback prior to formal launch Adopt Strategic Assessment & project prioritisation as part of PAMS process Complete FBC guidance Review training & support needs 32
33 Final words... 33
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