KIRKLEES COMMUNITY HEALTHCARE SERVICES Report to NHS Kirklees Board DECEMBER 2008 DIRECTORS REPORT 2008 1.0
People 1.1
Over the last 2 months we have taken on approximately 20 additional district nurses, together with new health visiting and therapy staff. We also now have a full compliment of community matrons, though most of those remain in period of development.
1.2
We have appointed Helen Frain as Head of Long Term Conditions. This post will report directly to Tina Quinn, and have responsibility for all specialist nurses, community matrons and GP practices. Michael Crowther has now been appointed as Head of Performance and Business Development. Michael previously worked with NHS professionals and Wakefield PCT in senior contract management roles. Michael will report directly to Julie Lawrenuik.
1.3
Following a selection process based on Kirklees PCT’s organizational change policy Julie Lawrenuik has been appointed as Deputy Director and Finance Lead, and Tina Quinn has been appointed as Assistant Director and operations lead. We are shortly to advertise for a Medical lead which will be interviewed by David Anderson, Sheila Dilks, Vanessa Stirrum and myself.
1.4
2.0
Since the last report to PCT Board Denise Boyd has moved on to become the Director of Provider Services at Bury PCT. We wish Denise all the best in this post.
Workstreams 2.1
Review of the Provider/Commissioner split Kirklees PCT has now appointed KPMG as the consultancy responsible for overseeing the delivery of an option appraisal for the future model of KCHS, and for a governance review – related to both
the provider/commissioning split, and World Class Commissioning. Initial discussions have already taken place between KPMG and myself and Helena Corder on the exact detail of the project. Both the KCHS Board and the PCT main Board will be closely involved in this piece of work. 2.2
National policy on the future direction of PCT provider arms On November 20th the DH released the ‘right to request’ for staff to request commissioners to become social enterprises. The aim of this policy is to allow groups of clinical staff to set up social enterprises with an independent contract with the commissioners. The policy allows for some specifics including: 1. A guaranteed contract for 3 yrs 2. Remaining within the NHS pension scheme 3. some funding assistance to help with set up costs A further piece of work is due to be shortly released. This includes a business readiness checklist which will clearly detail the expectations of the provider/commissioner split by April 2009. We have now received the outline copy of the NHS community services contract. This is the contract all community providers will need to sign for 2009/10. This document has a significant impact on delivery of key areas of work by splitting into 6 key service specifications which are: 1. 2. 3. 4. 5. 6.
Families and children Long term conditions Public health improvement Acute services in a primary setting Rehabilitation services Palliative care
We anticipate sharing our approach to this with the board in more detail through our work with KPMG. 2.3
Performance Reporting One of the key areas in which we needed to improve in KCHS, was our performance reporting. Over the last few months we have now made significant strides in this area. A monthly performance report is now produced and presented to the KCHS Finance and Performance Group, for detailed review prior to submission to the Board.
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This shift in our performance reporting has been made by a concerted effort from all our staff – concentrating on information required by the commissioner and information that helps them deliver in their teams. A copy of October’s performance report is included at Appendix 2. 3.0
Improving business processes 3.1
Committee Structure We have now put in place a new committee structure underneath the KCHS board. This is in early stages of development and not all committees are yet formed. The structure is designed to be tweaked to allow KCHS to react to new opportunities and improve its assurance process. Please see the structure at appendix 1.
3.2
Contract Management Board We now meet on a monthly basis with the commissioners to look in more detail at the main issues surrounding the community services contract and existing performance. This meeting is attended by Bryan Machin, Carol McKenna, Peter Flynn and Rachel Carter from the commissioner and Julie Lawrenuik, Michael Crowther and myself from KCHS.
4.0
Name change 4.1
The name change has now successfully taken place. This means all staff have now got a new email address and headed paper etc is now in circulation. A more detailed branding exercise will begin shortly. This will help us to work with staff on the future of Kirklees Community Healthcare Services.
5.0
Finance 5.1
Financial Forecast We are now forecasting a year end surplus of £250k, this is in the main due to slippages in recruiting to vacancies.
5.2
Financial Risk
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In forecasting the financial position there are a number of risks that need to be considered where expenditure may change from that currently forecast, these include: •
Slippage on the non recurrent agreed expenditure plan
•
Further slippage in recruiting to vacancies
If these risks materialize they are likely to result in an increased under spend of around ÂŁ300k. 6.0
Transforming Community Services 6.1
Background The Transforming Community Services (TCS) Programme is the DH strategic programme to oversee the development of a new approach to community services. It is based on the realization that for too long community services has been seen as secondary to hospital care and has not had the focus of either commissioners or strategic health authorities until the prsent TCS has been a major central piece of work. This section is designed to provide a very brief overview of the programme; and try and then place our existing position against it.
6.2
Strategic Overview The 4 key strategic drivers are: 1. Giving people more control over the care they receive and making them more responsible for their health behaviours 2. Promoting health and tackling health inequalties 3. Continuous improvement of clinical services through clinical leadership 4. Allow clinical professionals to lead local change and join up local services where appropriate. The ways in which these will be delivered are: 1. Clinical services improvement based on 6 key areas which are: Children and families Health improvement and health inequalities Long Term condition management Acute care in a primary setting Rehabilitation services Acute care in a primary setting. 2. National community services contract with development to KCHS report to PCT Board Page 4
come on pricing options 3. A quality framework to be made an official part of the contract on 10/11 – but with encouragement to do this as soon as possible. 4. A world class commissioning toolkit to improve the skills and knowledge of commissioners in this area 5. The introduction of a information set which allows the commissioner and the patient to gauge the quality of the community provider. 6. A full range of organizational forms to be available to the community provider – but a review of these forms to be led by the commissioner 7. The option of a ‘right to request’ to be available to all staff allowing them to set themselves up as a social enterprise as required.
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Appendix 1
Sub committees of KCHS Board KPCT Board
KCHS Board
Audit committee Chair - NED F&P Chair – DD & ADOF
Governance Chair – medical lead NB – committees report to
HR & workforce Chair – HR lead
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