Upload
nhs-kirklees
View
216
Download
0
Tags:
Embed Size (px)
DESCRIPTION
http://www.kirklees.nhs.uk/fileadmin/documents/publications/policies_procedures/corporategov/PDF_Organisational_Development_Plan_March_2008.pdf
Citation preview
Ambitions for aHealthy Kirklees
Organisational Development Plan
2009/10
Contents
Chief Executive’s Introduction
Background Information
1.1 Introduction to NHS Kirklees and our approach to organisationaldevelopment
1.2 Strategic challenges1.3 Organisational vision and values1.4 Goals 1.5 Delivering our vision1.6 Equality and diversity
How the PCT is Organised
2.1 Organisation structure2.2 PCT Board2.3 Governance structures 2.4 PCT Directorate structure
Organisational Development
3.1 PCT current position 3.2 Current Organisational Development Needs3.3 Organisational Development Self Assessment Initiatives3.4 Partnership working3.5 Employer of choice3.6 Leadership development3.7 National programme for IT (NPfIT)
Organisational Development Overview
4.1 Objectives for the current year4.2 Achieving our objectives4.3 Risk4.4 Finance
Conclusion
Appendices
1 McKinsey’s 7-S Model 2 Vision and values chart3 Kirklees PCT directorate structures 5 PCT Organisational Development – WCC Competency
Plan Trajectory4 WCC outcome of first assessment6 Kirklees organisational development action plan
Section 1
Section 2
Section 3
Section 4
Section 5
3
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
5
6
6
67889
9
9101010
13
13131515151717
18
18202021
21
22
22232434
3545
4
Chief Executive’s Introduction
NHS Kirklees has made much progress overthe past eighteen months and is in a strongposition to meet future challenges. Duringthis time we have focused on strengtheningour commissioning capability to ensure thatwe spend public money in the mostefficient way to achieve the best possiblehealth for all the people of Kirklees.
We have continued to strengthen workingrelationships with our key partners acrossthe health economy. This has beenparticularly so with Kirklees Council wherewe have work jointly across a number ofagenda’s and have a number of joint posts,including the Director of Public Health. Aspart of our working with the council wehave completed a Joint Strategic NeedsAssessment (JSNA). This has provided uswith a wealth of information on the needsof the people in the seven localities thatmake up the borough of Kirklees. The NHSKirklees Strategic Plan reflects these needsin the outcomes we have identified as apriority, and also how we will measureprogress over the years.
We recognise the need to continue toengage and build stronger partnershipswith both our local clinicians and the peopleof Kirklees as they play a central role ininfluencing the way we commissionservices.
We engaged very positively with the WorldClass Commissioning (WCC) assessmentprocess in the period October to December2008, seizing this as a supportiveopportunity to identify requireddevelopment of our commissioning role.Careful consideration was given to our selfassessment of the current position against WCC competencies, and we were pleased
that the panel only felt it appropriate toalter two of our scores which resulted in theYear 1 WCC scoring process achieving 3scores at 3, 23 scores at 2, and 4 at 1, with2 greens and 1 amber for our StrategicPlans, placing us in a good place incomparison with the best PCT’s in thecountry.
Feedback from the panel was felt to be fairand good ’the panel developed an overallimpression of the organisation which is thatthe PCT has good foundations in place(systems, processes, resources, partnerships)the PCT has identified its significantchallenges and now is the time to deliverthe vision’.
Looking forward to 2009/10, we will drivetowards the outcomes we have identifiedand in this continue to tackle the issuesaffecting our local community, includingobesity, tobacco control, mental health andsexual health. We will continue to improveaccess and choice for service users thatreflect our diverse communities and deliverservices closer to people’s homes where it issafe to do so.
These key priorities are outlined in the PCT’sStrategic Plan. This clearly sets out how weintend to achieve our goals by workingproactively with partner organisations andengaging with clinicians, the public andservice users within Kirklees.
Mike PottsChief Executive
5
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Section 1
Background Information
1.1 Introduction to NHS Kirklees andour Approach to OrganisationalDevelopment (OD)
The NHS Kirklees OrganisationalDevelopment Plan builds on our existingwork and is designed to ensure the deliveryof both world class commissioningstandards and the PCT’s Strategic Plan. Theplan has been developed as a result ofseveral multi-disciplinary workshopsattended by the PCT Board, PEC, PCT seniormanagers, local authority representatives,local clinicians and Public and PatientInvolvement (PPI) representatives.
Diagnosis of our development to date andour future needs has been identified usingMcKinsey’s 7-S Model (Appendix 1). Thismodel has been shared amongst the seniormanagement team and will be adopted asour approach for future development. It hasallowed the PCT as a whole to look at themulti-dimensional areas that need to beconsidered to ensure the organisationaldevelopment plan is realised.
In November 2008 the PCT commissionedKPMG to work with the Board to identifyfuture needs and deliver an ongoingdevelopment programme to meet the needsidentified. This work, including BoardDevelopment, review of Governance,development of Provider Services hascontributed to the priorities identified in thisplan. A key part of developing providerservices is ensuring that Kirklees CommunityHealthcare Services (KCHS), the PCTprovider arm, is fit for purpose as outlinedin Transforming Community Services.
A Strategic Organisational DevelopmentGroup has been established to oversee thedelivery of the Organisational DevelopmentPlan for the forthcoming year. It is chairedby the Director of Human Resources andOrganisational Development with membersfrom the Director Group, and output fromthe group will report to the Chief Executiveand Senior Management Team andultimately the Board. The OD plan is a livedocument and will be further refined andupdated as the PCT continues itsdevelopment towards achieving world classcommissioning status.
1.2 Strategic ChallengesTo date, a number of key external strategicchallenges have been identified that willimpact on the PCT’s ability to meet its goals.These have been identified as part of ourwork with Kirklees Council and our partnersthrough the Kirklees Partnership.
The Kirklees Partnership has identifiednational and international trends that willhave a local impact and to which Kirkleesneeds to respond:
• Climate change – tackling ourcontribution to and planning to adaptto the impact of climate change.
• Ageing population – a growing ageingpopulation with long term conditions,many with co-morbidities
• Changing economic context
In addition, factors specific to Kirklees mustalso be addressed. To create a moresustainable Kirklees and achieve our 2020vision we must narrow the gaps inherent in:
• Infant mortality and other healthinequalities, including a lifeexpectancy below the nationalaverage
6
• Educational attainment• A low skill, low wage economy• Lack of confidence in some of our
towns (particularly in North Kirklees –Dewsbury, Batley)
• Community relations
These challenges are identified within theJoint Strategic Needs Assessment developedin partnership with Kirklees Council. ThePCT Strategic Plan identifies the actionsrequired to address them, the expectedoutput from these actions and how this willbe measured. The Strategic Plan wasdeveloped with our key partners enabling acomprehensive, joint approach to tacklingthese issues. The organisationaldevelopment plan is designed to ensurethat the PCT has the culture, capabilitiesand capacity to deliver this.
1.3 Organisational Vision and ValuesVisionThe PCT vision and values were originallydeveloped in collaboration with staff andour partners through a series of workshopsand communication events and were signedoff by the Board in 2007. In 2008, wereviewed our vision, values and goals inlight of world class commissioning, HealthyAmbitions and our strategic priorities.
Our vision is:
Working together to achievethe best health and well-being for all the people ofKirklees
This means that NHS Kirklees workstogether - with ourselves and with ourpartners - to achieve the best health andwell-being for all the people of Kirklees.
Some services are provided by our own staffand we commission services from others,including GPs, dentists, pharmacists,optometrists, voluntary organisations andhospitals. Our ambition is to further developour partnership working with these groupsfor the benefit of people in Kirklees.
ValuesOur vision is underpinned by our values.These are to:
• recognise that people are at the heartof everything we do;
• support people in taking responsibilityfor their own health and well-being;
• encourage innovation and continuousimprovement and celebrate thecontribution made by our staff;
• encourage open, clear and honestcommunication;
• value diversity and challengediscrimination;
• show understanding, dignity andrespect for all our clients, partners andstaff; and
• be accountable for the decisions wemake, the work we do, the resourceswe use and our impact on theenvironment.
7
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
1.4 GoalsTo achieve our vision, we are driven byclearly defined goals. These goals havebeen reviewed in the light of HealthyAmbitions and reflect both the key nationaldrivers and our local priorities. For thesereasons, our goals will form a ‘goldenthread’ running through our plans, and willunderpin our approach to our priorityhealth programmes.
Our goals are to:
• To place the person at the centre ofeverything we do.
• To improve health and reduce healthinequalities.
• To improve quality and promote safety.• To promote choice and accessibility.• To work well in partnership with
communities, individuals and theirfamilies, staff and organisations.
• To promote local sensitivity througheffective commissioning.
• To promote strong clinical leadership• To drive service redesign and
innovation.• To be a visibly credible organisation,
operating to the highest standards.
1.5 Delivering our visionWe have been working with local partners,stakeholders and our own staff to put inplace a range of programmes designed toalign the local NHS and related system todeliver the goals described above. Theseprogrammes form the key strategicpriorities within the PCT and have beenrigorously assessed to ensure deliveryagainst both the PCT’s goals and ourunderpinning vision and values.
An example of a successful programmeincludes the Population Centric WorkforcePlanning Programme undertaken
(Organisational Development Services) inthe field of obesity. This programme has ledto the development of a obesity servicespecification, which has in turn influencedthe work of Yorkshire and Humber on theDARZI obesity workforce development.Results of this work include, informing thecommissioning of the Public Health (PH)Continuing Professional Development (CPD)programme for teaching public healthnetwork. We have developed and increasedcapacity and capability within Kirklees. Todate we have run 26 specific PH Courseswith 211 people trained in motivationinterviewing and brief interventions up toDecember 2008
A number of enablers have been identifiedwhich will underpin delivery against theseprogrammes and these are identified withinthe Strategic Plan and will further beclarified by the Programme DeliveryStrategy. This organisational developmentplan includes key enablers, but also focusesmore broadly on world class commissioningand delivery of the PCT’s Strategic Plan.
Our organisational development goals havebeen developed to ensure that the PCT’svalues are integral to the way we conductour business, from our practice basedcommissioning process and associatedbusiness planning through to the way weengage with our community and cliniciansand lead our staff.
The organisational development plan is oneof the strategies identified as being integralto the delivery of the PCT’s goals. Forexample, we have invested in acomprehensive personal developmentreview (appraisal) process to ensure that allstaff are well trained, understand ourpriorities and are motivated to deliver them. We will measure this through our newperformance management framework; the
8
NHS Staff Survey; and achievement of theInvestors in People standard, towards whichwe are currently working.
Appendix 2 shows our vision and valuechart, which has been communicated tostaff and stakeholders alike.
1.6 Equality and diversity We are committed, to equality and diversityunderpinning everything we do, and this isreflected in both our vision and values andin our goals and Strategic Plan. It is anintegral part of the programme approach.Our JSNA clearly identifies the needs of ourdiverse communities and our commissioningstrategies are designed to ensure that notonly the programmes but resources aredirected where most needed.
Internally a multi directorate steering groupis leading the implementation of theequality duties across the commissioningside of the organisation. A substantiveappointment to a diversity manager posthas been agreed which replaces the fixedterm contract previously in place. An initialstock take of our organisational position onequality and diversity has been led by thesteering group and an action plan prepared.
The PCT also strives to ensure that itsworkforce reflects our diverse communityand its employment policies and proceduresfollow best practice. All policies, includingthose of human resources, are required toundertake an equality impact assessment aspart of their review, development andfollowed through in their implementation.In addition, basic awareness of equality anddiversity is featured in everyone’sKnowledge and Skills Framework (KSF) andis provided as part of our statutory trainingsupport.
Section 2
How the PCT is Organised
2.1 Organisation StructureKirklees PCT was established in October2006 from the three former PCTs inHuddersfield and North Kirklees. We havethe same boundaries as Kirklees Council(KC) and organise our work across the sameseven localities. We serve a population ofsome 400,000 people which is expected togrow by a further 33,000 by 20181.
In common with other PCTs, we have threemain functions:
• engaging with our local population toimprove health and well-being;
• commissioning a comprehensive andequitable range of high quality,responsive and efficient services withinallocated resources, across all servicesectors; and
• directly providing high quality,responsive and efficient services wherethis gives best value.
As a PCT, we are responsible for makingsure that NHS services are in place to meetthe needs of local people. The PCT isaccountable for ensuring that these servicesare accessible, high quality and safe. As thecustodian of NHS services in the local areawe are known as ‘NHS Kirklees’.
Kirklees’ seven localities are shown on themap below. Each locality has a locality plan,which specifically identifies needs anddevelopment within that area. The localityplans are overseen by a locality board.
9
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
1ONS 2006-based population forecasts (whereas the Kirklees Joint Strategic Needs Assessment,published in February 2008, uses ONS 2004-based forecasts).
NHS Kirklees Boundary
2.2 PCT BoardThe PCT Board is responsible for agreeingthe strategic direction, policy andperformance of the PCT. It is alsoresponsible for making sure the keyrequirements of governance are in place.The Board consists of:
• Chair, Rob Napier• Chief Executive Mike Potts• Six Non Executive Directors• Four Executive Directors
Board meetings are also attended by theProfessional Executive Committee (PEC)Chair and others, including PCT Directors, aPEC member, and a member of our LocalInvolvement Network (LINks) Forum.
2.3 Governance StructuresThere are nine Board committees whoprogress and oversee delivery of the PCTstrategy. These are:
• Remuneration and Terms of ServiceCommittee
• Audit Committee• Communications and Public Relations• Provider Board• Strategic Service Development• Specialist Commissioning Group• Governance Committee• Professional Executive Committee
(PEC)• Finance and Performance Committee
2.4 PCT Directorate StructureWhen the PCT was established in 2006,eight directorates were created: six in thecommissioning arm and two in the providerarm.
The PCT has been working closely with itsProvider Arm to oversee and support it inpreparation for delivery of TransformingCommunity Services. Several individual andjoint workshops have been held to discussthe implications of the split and the actionsnecessary to accomplish it.
The PCT Workforce Risk Assessment Planfor 2008 identified that a potential risk forboth the Commissioning and Provider armsof the PCT over the forthcoming year is thecapability and capacity issues arising from aformal split of the commissioning andprovider functions. A review of workforcecapability and capacity is currentlyunderway and output from this will informthe restructuring process required which isbeing planned.
10
Batley, Birstalland Birkenshaw
Spen
Dewsbury and Mirfield
HuddersfieldSouth
HuddersfieldNorth
The Valleys
Denby Daleand Kirkburton
Commissioning functions are carried outwithin six directorates and in April 2009 weare reviewing the effectiveness of thesearrangements and split across directorateportfolios in the light of the providerseparation and WCC feedback anddevelopment required.
• Commissioning and StrategicDevelopment (CSD)Reviews, plans and develops a widerange of high quality, responsive andefficient health care services. It alsosupports practice basedcommissioners and manages the localdelivery plan and Local AreaAgreement
• Public Health (PH)Delivers key public health goals,working in partnership with the localauthority. It influences thecommissioning of services to makesure they improve health locally andreduce health inequalities.
• Patient Care and Professions (PCP)Provides professional advice, leads onthe redesign of primary care servicesand oversees clinical governance ofthe PCT. It is also responsible forprofessional development andeducation.
• Performance and Information (PI)Manages performance systems andprocesses for the PCT so that it canmeasure its performance againstnational and local targets. It alsoevaluates the performance of ourprimary care services against nationaland local targets. This directorate alsoleads on the National Programme forInformation Technology
• FinanceEnsures robust financial controls are inplace so that the PCT can meet itsstatutory duties and achieve financialbalance. It also supports managers
and staff in ensuring that the servicescommissioned are value for money.
• Corporate Services (CS)Responsible for enabling andsupporting the PCT’s corporateagenda. It works across alldirectorates, contributes to thestrategic priorities and makes surestatutory duties and legislation arecomplied with. It leads oncommunications and engagement forthe PCT and risk management.
The provider arm of the PCT includes twodirectorates:
• Human Resources andOrganisational Development(HR/OD)Leads on human resources andorganisational development forKirklees and Calderdale PCTs, both onthe commissioning and provider arms.This directorate also provides supportfor workforce planning anddevelopment.
• Kirklees Community HealthcareServices (KCHS) Provides a range of primary care andcommunity services, including healthvisiting, school nursing, therapyservices and community dentalservices.
The Board and senior management teamare responsible for the delivery of the PCT’sgoals and priorities and these are sharedand delivered through the directoratestructure. Key commissioning activity isundertaken by the Commissioning andStrategic Development Directorate. Its workis informed and supported by the work ofthe other directorates across thecommissioning arm of the PCT, who all haveresponsibility for ensuring thecommissioning function of the PCT isdelivered.
11
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Cross-directorate working is carried outinformally, through organised developmentevents and Director, Deputy and AssistantDirector Meetings which are held monthly.There is potential for strengthening anddevelopment in cross-directorate workingand matrix working is currently beingexplored as an option for delivering this.
To maximise the opportunities forintegrated ways of working between healthand social care and other partnerorganisations, we have established anumber of Health Improvement Teams(HITs). These teams are made up ofmembers of our commissioning staff,clinical leads and representatives from ourpartners and stakeholders. Each HIT isresponsible for tackling a health priorityprogramme, identified within the StrategicPlan. Each HIT creates a clearcommissioning plan and performancemanages its implementation and ongoingactivity.
We have also appointed several people tothe new role of ‘clinical leads’. The purposeof the clinical lead is to act as a clinicalchampion for their area and facilitate jointworking between the Professional ExecutiveCommittee (PEC) (either as a direct memberor through their GP representative) andpractice based commissioners (PBC). ThePEC is responsible for clinical governance ofall business planning activities undertakenby HITs.
An innovation within the PCT is theestablishment of a Commissioning Collegewhich has been established to facilitatediscussion among all the key stakeholdersmentioned above. Meeting monthly beforethe PEC, this assembly allows stakeholdersto be informed and inform decisionsregarding the PCTs commissioning agenda.Feedback from the Commissioning Collegeinforms the clinical decisions taken by thePEC who retain their statutoryresponsibilities. The Director of CorporateServices has undertaken a review of theroles and statutory responsibilities of thePEC and the Commissioning College.Responsibilities have been clarified andcommunicated appropriately across relevantmembers. This model of working hasallowed us to develop more integratedworking with our strategic partners acrossboth health and social care.
A review of our governance structures iscurrently underway. The PCT hascommissioned KPMG to support the PCTwith this work. Our aim is to ensure theyare fit for the future and provide assuranceon the quality, safety and delivery of theservices we commission and provide.
Appendix 3 shows the Kirklees PCTdirectorate structures.
12
Chief Executive
Chief ExecutiveOffice
Public Health(PH)
HumanResources andOrganisationalDevelopment
(HR/OD)
KirkleesCommunityHealthcare
Services (KCHS)
Commissioningand StrategicDevelopment
(CSD)
CorporateServices (CS)
Care andProfessions (PCP)
Performance and Information
(PI)
Finance
Section 3
Organisational Development
3.1 Our Journey to DateAs a result of the Fitness for PurposeReview, NHS Kirklees developed acomprehensive development plan that was,in effect, an organisational developmentplan. The action plan was overseen by thePCT Board and delivery against keyoutcomes has been achieved. Wheredevelopment objectives are ongoing, somehave been streamlined into the PCT’sperformance framework and some areincorporated into our world classcommissioning development plans.
The key development areas addressedduring this period include:
• Public and service user engagement –an expansion of the PPI andcommunications team capacity.
• Business planning process andprioritisation – establishment of aprocess with HIT teams puttingforward business cases against thatprocess.
• Development of roles and capacity inthe PCT in commissioning, financeand information directorates with anemphasis on informingcommissioning, contracting andprocurement (for example engagingwith the advanced commissioningprogramme).
3.2 Current OrganisationalDevelopment Needs
During the past ten months the PCT hasbeen building on the development needsidentified from the Fitness for Purposeprocess. Throughout 2007 and 2008, wehave been working to develop and align ourstructures and systems to ensure delivery ofour goals, the development of our staff,organisational culture and ethos asidentified in our vision and values. This hasresulted in a clear performancedevelopment framework throughPerformance Accelerator that monitorsdevelopment and delivery of outcomes.Needs and gaps are swiftly identified andreported to the Board for further action asappropriate.
As part of our commitment to our ongoingorganisational development needs, the PCThas engaged in diagnostic work includingfitness for purpose, links with LocalAuthority Assessments, our Investors inPeople preparation and latterly WCCassessments, aimed at continuouslyimproving our performance in order toimprove our reputation as the ’local leaderof the NHS’.
A number of events have been held toexplain the WCC Strategy and its impact. Inaddition, the PCT utilised a number ofdiagnostic tools, including SWOT and PESTanalysis to identify needs in NHS Kirklees.This was followed through with a crossdirectorate analysis of the WCCCompetencies, using the strategic goals andpriorities as a baseline of activity required infuture.
13
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
WCC Assessment 2008 Feedback
Feedback from the WCC AssessmentProcess identified 5 major areas forconsideration by the PCT at this stage on itsjourney:
The panel acknowledges the journeythe PCT is on to improve clinicalengagementRecommendation: The PCT’s‘commissioning college’ is an innovativesolution to bring together PBC, PEC andHITS. However the panel recommends thatthe PCT be aware of the challenges andrisks that this presents. The PCT will needto be clear about the continuing statutoryrole of the PEC. The PCT should work toimprove the quality of information itprovides to support the management of theprimary care contract and variances inpractices
The panel observed the PCT’s strongpartnership workingRecommendation: The panel recommendthat the PCT should use this strongpartnership to drive delivery forward and asa means to keep a focus on the visionduring some challenging times ahead. ThePCT is well placed to tackle futurechallenges constructively and providemutual support to the LA
The panel observed there were somekey risks facing the PCTRecommendation: The panel recommendsthat the Board reflects on how it prioritisesthe efforts of the organisation and thefocus of the Board. This includes how thePCT prioritises its investments. The PCTshould not underestimate the challenges forstaff of programme management of abroad range of initiatives
The panel noted that the culture of thePCT is beginning to change fromturnaround to investmentRecommendation: The PCT shouldconsider how it readies its staff and teamsto think more about investing in work thatwill clearly provide value for money andbenefit more quickly, without losing thestrength of the turnaround disciplines.
The panel noted that PCT could benefitfrom more clearly articulating itsstrategyRecommendation: The panel recommendsthat the PCT considers how itcommunicates its strategy. The PCT shouldreflect on the flow, structure, order andclarity of the document with a view toamending the presentation of the StrategicPlan as part of the work to refresh thedocument over the coming weeks.
In order to deliver the necessary progresswe have grouped actions into the followingareas, in addition to those identified in theearlier Organisational Development Plan,which will continue to allow the PCT togrow and achieve the developmentobjectives identified to meet the trajectories(Appendix 4).
• improve the quality of information itprovides to support the managementof the primary care contract andvariances in practices – A review ofthe PCT internet and intranet isunderway. From March 2009 a linkwill be established for Primary Care, itwill communicate key information toprimary care contractors includingdiscussion and output from thecommissioning college.
• Culture Change – Supported by amove to a centralised Headquartersfor all Commissioning Staff where
14
consistent practices are achieved.Underpinning the culture change is acomprehensive leadership programmefor all those with leadershipresponsibility and shared objectivesthrough team development and PDRfor all staff
• System and Process Development –Systems and processes are beingreviewed to ensure a clear strategiccommissioning process from businesscase to implementation andmonitoring. In addition, clarity onwhat our goals will specifically achieveand how these will be measured,including, links to uality outcomesframework (QOF), programmebudgeting
• A refresh of the Strategic Plan is beingconducted for the end of March 09.
3.3 Organisational Development SelfAssessment Initiatives
In addition to the competency selfassessment, the PCT has conducted atraining needs analysis with representativesfrom our commissioning community toassess further details of the keydevelopment needs to deliver the WCCcompetencies. A Leadership Programmewill be procured in the next two months forthose involved in the commissioningprocess. This will not only address capabilityissues but will support the PCT to developthe culture and commitment necessary todelivery our Strategic Plan, including tofurther support relationship buildingbetween clinicians and managers.
In addition to the training needs analysis thePCT is working with the Peter Spurgeonfrom the NHS Institute as part of a pilotinto improving medical engagement. One
of three PCTs throughout the UK to becomeinvolved in the project, the feedback willenable us to put in place steps to continueto improve how we actively work with ourcolleagues in primary care.
3.4 Partnership WorkingA key priority for the PCT is theestablishment and further development ofpartnership relationships, for example, withKirklees Council and practice basedcommissioners. Over the past twelvemonths, we have implemented structuresand systems to improve our relationshipwith our partners and have held a numberof development events to support this.
Our key organisational developmentchallenges for partnership include:
• Enhancing clinical engagement andcollaboration through thedevelopment and establishment of theCommissioning College (see 2.4)
• Building a leadership community withKirklees Council though joint learningevents both at Directorate and seniormanager levels.
• Developing joint approaches tobusiness planning through clinicalleads, HITs, and the CommissioningCollege
3.5 Employer of ChoiceTo meet our commitment to our staff,achieve our values and goals, and continueto work towards achieving employer ofchoice status, we have formally committedto working towards Investors in Peopleaccreditation. This work is being led by arange of employees from each directorateand is chaired by a Non Executive Director.
15
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
A review against the standard wasundertaken in 2007. The results have beenincluded in an organisational action planbeing implemented by the IIP Group. Thisgroup has also worked with directors toaddress the needs identified in the 2007staff survey. Some of the staff supportinitiatives developed include:
• Chief Executive Talk Time• Celebration events to recognise and
reward staff• Information events to support the
transfer to the PCTs new Headquarters• Refocus and support to the PCT’s
Personal Development Review process• Improved communication networks, to
include improvements to the PCTwebsite.
• Implementation of stress at workguidance and developmentprogramme for managers
• Review of information anddevelopment for new starters,including the Induction process andEmployee Handbook
• Employee development initiative toencourage all staff to achieve a NVQLevel 2 as a minimum
As well as using the information receivedfrom our staff survey, we have held anumber of focus groups to establishprogress against the development actionsarising out of the previous year’s survey andto identify future development. The focusgroups highlighted that much progress hasbeen made. However, further developmentis needed in the following areas:
• Communication and establishing aclearer feedback loop
• Job satisfaction and how this isaffected by change in the PCT
• To ensure the quality of personaldevelopment reviews (PDR) are
improved.• Improved access to mentoring and job
shadowing for all staff• Improved cross-directorate and inter-
team communication
Initial feedback from the 2008 surveyindicates a positive improvement across allthe areas identified above and action plansare currently being developed to improvethis further and address development areasidentified in the current survey. The PCT isconsidering assessment against theInvestors in People Standard in 2009.
NHS Kirklees’ workforce planning activity isclosely linked with its intention to be anemployer of choice, and is underpinned bythe organisation’s new workforce scorecard.This allows the organisation to moreeffectively monitor and improve keyelements related to the workforce, includingsickness, agency spend and staff well-being.
The PCT has increased its capacity foranalysing workforce data and recruitmentactivity through the appointment of aworkforce analyst who will enable the PCTto review how well we are achieving ourdesire to be an employer of choice.
Our key organisational developmentchallenges for our role as an employerinclude:
• Ensuring appraisal/personaldevelopment review (PDR) isconducted consistently and to a highquality
• Creating a learning environmentthroughout the PCT effectively – theLearning and Development Strategyhas formally been presented to theGovernance Committee
• Managing change and risk arisingfrom formal split of commissioning
16
and provider functions• To support recruitment of new staff
from those communities who are lessrepresented within NHS Kirklees, anexample would be the slivers of timeproject being rolled out across thePCT.
3.6 Leadership DevelopmentThe Board has committed to an ongoingdevelopment programme commissionedfrom KPMG that builds on the previouswork with both Finnamore ManagementConsultants and the Audit Commission.The diagnosis reports from thesedevelopment activities identify that theBoard is a well performing team, that has aclear understanding of priorities and howthese will be achieved. Relationships arewell formed and appropriate levels ofchallenge are achieved. This was furtherconfirmed in feedback from our recentWCC Board observation event.
Our most recent Board diagnosticundertaken by KPMG includes Boardobservation, one to one interviews, reviewof personal development reviews and areview of governance information. A BoardDevelopment Programme is currently beingplanned for delivery over the forthcoming18 months.
The PCT signed off its Leadership Strategyin November 2007 and funding for deliverywas secured in early 2008.
During June and July, the Board undertookan assessment using the PCT world classcommissioning self assessment tool(Appendix 5).
We will continue to assess our progressagainst this and continue to adapt our ODplan as our needs develop.
Our key organisational developmentchallenges for leadership include:
• To embed a consistent approach tousing our vision and values in how wework
• To consider issues of talentmanagement and succession planningin future leadership investment
• To further develop business planningand project management skills
Plans are currently underway to deliver arange of development programmes insupport of our clinical and commissioningleaders; including
• Leadership programme for PCTmanagers and stakeholders withresponsibility for commissioning
• Development programme forCommissioning College
• Development of the DDAD (Director,Deputy Director and AssistantDirector) Network
• Talent management and selection ofstaff to regional leadershipprogrammes, including AspiringDirectors, National MiddleManagement DevelopmentProgramme and AdvancedCommissioner Programme
3.7 National Programme for IT(NpfIT)
NHS Kirklees will support its programmeunder the National Programme for IT (NpfIT)through:
• its existing capacity/capability • the procurement of additional capacity
from its main IT services provider, TheHealth Informatics Service (THIS) andfrom external agencies, such as ThePhoenix Partnership (TPP)
17
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Our key organisational developmentchallenges for IT include:
• achieving good project managementskills;
• employing sufficient high qualityinformation specialists; and
• planning for the ongoing support ofan increasingly IT-dependentworkforce.
Sufficient specific funds have beenidentified in the forward resource plan toenable these issues to be addressed. As partof this work, we will ensure:
• that basic IT training is included in allmandatory training for staff; and
• we have enough specialist IT staff tosupport the sustainable use of IT andInformation systems.
In designing the existing PCT structure wehave already expanded capacity to lead thisthrough the Performance & Informationdirectorate, which was created as the PCTcame into being in late 2006.
Section 4
Organisational DevelopmentOverview
4.1 Objectives for the Current YearIn developing our Strategic Plan, we haveidentified a range of enablers, which willsupport the PCT to deliver its goals andpriorities. These enablers are integral withinthe PCT and reviews show that there arestrengths in both capacity and capabilitywithin these enablers.
We have also undergone a rigorous selfassessment process against the WCCcompetencies, engaging with stakeholdersincluding PBC and Kirklees Council to givebalance in this self assessment
Arising from this process we have identifiedthe following specific weaknesses (wherewe scored ourselves at 1) in our currentcapability:
• dissemination of information tosupport clinical decision making
• knowledge of current and futureprovider capacity
• creation of effective choices for serviceusers
• creation of robust contracts based onoutcomes
In addition, to the above, the PCT hasconsidered through its strategicdevelopment a number of key strategicdocuments, including NHS Quality Care forAll, Health Ambitions, NHS Next StageReview, as well as local strategies anddocuments such as the Joint StrategicNeeds Assessment.
Some of the PCT’s organisationaldevelopment objectives will have a direct
18
impact on the working of the PCT’s corerole on an ongoing basis, while others aremore externally focused and will have alonger time frame for delivery.
Our strategic organisational developmentobjectives have been updated to:
• Ensure that NHS Kirklees as a brand isrecognised as a leader of the NHSwithin Kirklees. As set out in thecommunications strategy, this meansenhancing our profile withstakeholders and the public. We willalso continue to work with ourpartners for the specific benefit of thepeople of Kirklees.
• Provide the local lead for the NHS inKirklees, ensuring that all leaderswithin the PCT understand their roleand can deliver our strategic goals.We have developed our shared valuesand improved internal communicationto ensure clarity for all staff and this isdelivered though regular PDR and useby all of the Knowledge and SkillsFramework (KSF).
• Develop our clinical leadership andImprove our clinical engagement incollaboration with our clinicians tocommission and prioritise with greaterfocus on outcomes.
• Develop greater knowledge ofprovider capacity and consequencesfor service user choice.
• Continually improve the quality ofservices that we commission, ensuringthat these are evidence based, costeffective, and where possible deliveredcloser to people’s homes. A number ofstrategies are currently beingformalised and signed off or are indevelopment. For example,the Value
for Money Strategy was agreed at theFebruary 2009 PCT Board and iscurrently being implemented This isinfluenced by our need to build ourinformation skills.
• Increase and improve our service userand public involvement so that theymay be actively engaged in anongoing basis in the development anddelivery of our services. The PCT candemonstrate engagement andinvolvement activity in thedevelopment and commissioning/procurement of care pathways andservices.
• Create a learning environmentthroughout the PCT, where innovationis valued and recognised and staffcapacity and capability are key to thedelivery of our services. We have settargets through the workforcescorecard and will demonstrateongoing commitment throughshowcasing work in celebratingsuccess and annual staff awards
• Ensure that our governancearrangements are fit for purpose andwill support the delivery of ourstrategic goals. We need to embedstronger governance, performancemanagement and following use of theexternal Audit Commission boarddiagnostic tool have initiated a furtherreview
These overarching PCT organisationaldevelopment objectives will becommunicated to staff and partners as partof our communication strategy for worldclass commissioning and our Strategic Plan.
19
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
20
4.2 Achieving Our Objectives NHS Kirklees has a strong foundation onwhich to continue to develop the PCT.The PCT has a strong Board andrelationships between the Board and PECare good with clear lines of accountabilityand understanding of roles. In our recentanalysis against the WCC competencies weidentified additional strengths as follows:
• Our people • Leadership/Chief Executive• Our partnerships and the way we
develop relationships• Joint working to influence
commissioning decisions acrossorganisations to maximise benefits forthe people of Kirklees.
• Our culture (open and reflective)• Understanding the health needs of the
population (JSNA)• Our systems and how the PCT works• Ever improving use of information to
support commissioning decisions.
We wish to consolidate our position on thecompetencies and steadily progress tobecoming world class. Our detailed PCTdraft trajectories are incorporated into thisOD plan as Appendix 4, which is subject toBoard discussion in March 2009.
4.3 RisksIn order to achieve our ambitions we willneed to address the following capacity andcapability gaps. These include the followingrisks, which have an action plan to addressthem:
• The organisation must be able torecruit and retain high quality staff inthe face of competition fromsignificantly larger local andneighbouring organisations
• Small teams are vulnerable to capacity
problems if individuals leave or areincapacitated for any reason
• There is a limited labour pool foremployees with high quality specialistskills
• There are skill/capacity gaps withinvarious teams that need to beaddressed
• In driving forward our investment inproject management this may increasethe marketability and retention issueswith our own staff
• The potential of our newly formedcommissioning college may not berealised.
There is further work to be done beforeworkforce planning is fully integrated withthe organisation’s standard businessprocesses, though there are plans toaddress this; and the workforce planningrelationship between commissioner andprovider is still evolving. However, NHSKirklees is pleased with its progress to dateand continues to make positive steps in theright direction.
A further area for development is how thePCT addresses the issues of healthinequalities and the capability of staff withinthe PCT to address this agenda. There aretwo levels of action required to achieveimprovements in health inequalities andwell-being for all the people of Kirklees:
• a systematic cultural change across thewhole public sector system whichincludes real partnership working; and
• specific targeted programmes, whichwould include recruitment selectionand development of future andcurrent staff
The PCT is in a fortunate position in that ithas already invested resources in developinginternal organisational developmentcapacity. Therefore, our programme ofdevelopment is comprehensive and co-ordinated in its approach, accessing externalcapacity only as appropriate. The organisational development action planshown in appendix 6 identifies the range ofhigh level actions that have been identifiedto ensure that the PCT achieves world classcommissioning status.
4.4 FinanceIn the year 2007/2008 significantinvestment has been made in increasing ourPCT capacity within a number ofdirectorates; the further diagnostic workwill assist us in assessing whether additionalresources are being appropriately utilised orneed to be redirected internally. We havealso made non recurrent investment intraining needs analysis and leadership whichin forthcoming years will be mainlysustained using internal OD capacity.
The strategic and financial plans recognisethe need for limited further investment incapacity and capability. Workforce changesas a result of changes in service delivery willbe accommodated within workforce plansin the HITs. Workforce planning is identifiedas a critical component in our developmentand initial workforce risk assessments havebeen completed.
It is acknowledged that we have yet toidentify costs and return from the specificinitiatives identified in the OD action plan,such as key finance and performancemetrics (for example uptake of mandatorytraining, employee days per head ondevelopment etc). This detail will enhancethe content of our workforce scorecard indue course.
Section 5
Conclusion
We are confident that our plans will help usachieve the growth and developmentrequired to ensure we become a WorldClass Commissioning organisation and alsodeliver better healthcare for the people ofKirklees as outlined in our Vision, Valuesand Goals.
21
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
22
The
orga
nisa
tion
char
t an
dac
com
pany
ing
info
rmat
ion
that
show
s w
ho r
epor
ts t
o w
hom
and
how
tas
ks a
re b
oth
divi
ded
up a
nd in
tegr
ated
A p
lan
to a
lloca
tere
sour
ces
over
tim
e to
achi
eve
iden
tifie
d go
als
–se
ts d
irect
ion Th
e w
ay m
anag
ers
colle
ctiv
ely
beha
ve w
ithre
spec
t to
use
of
time,
atte
ntio
n an
d sy
mbo
licac
tions
The
proc
esse
s an
dpr
oced
ures
thr
ough
whi
ch t
hing
s ge
t do
nefr
om d
ay t
o da
y
The
peop
le in
the
org
anis
atio
n –
thei
r de
mog
raph
ics,
soc
ialis
atio
nin
to o
rgan
isat
ion
(for
mal
&in
form
al),
rew
ards
, tra
inin
g,pr
omot
ion,
pee
r pr
essu
re, r
ewar
ds,
folk
lore
. All
thes
e ar
e po
wer
ful
leve
rs f
or c
hang
e
Cap
abili
ties
poss
esse
d by
the
orga
nisa
tion
as a
who
le a
s di
stin
ctfr
om t
hose
of
indi
vidu
als
Har
dEl
emen
ts
Stra
tegy
Stru
ctur
eSy
stem
s
Soft
Elem
ents
Shar
ed V
alue
sSk
ills
Styl
eSt
aff
The
over
arch
ing
purp
ose
and
belie
f of
the
orga
nisa
tion
– th
ey im
ply
a tr
ust
abou
tco
mm
on g
oals
and
bel
iefs
whi
ch is
oft
en t
hegl
ue h
oldi
ng t
he o
rgan
isat
ion
toge
ther
Str
uctu
reS
trat
egy
Sys
tem
sS
tyle
Ski
llsS
taff
Sha
red
Val
ues
Ap
pen
dix
1
7 -
S M
odel
(McK
inse
y)
23
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Ap
pen
dix
2
NH
S K
irkle
es V
isio
n an
d Va
lues
24
Ap
pen
dix
3
Kirk
lees
PC
T D
irect
orat
e St
ruct
ures
as
at O
ctob
er 2
008
NH
S K
irkl
ees
Dir
ecto
rate
of
Pati
ent
Car
e an
d P
rofe
ssio
ns
25
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
NH
S K
irkl
ees
Hu
man
Res
ou
rces
/Org
anis
atio
nal
Dev
elo
pm
ent
Shar
ed S
ervi
ce S
tru
ctu
re
26
NH
S K
irkl
ees
Perf
orm
ance
an
d In
form
atio
n D
irec
tora
te
27
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
NH
S K
irkl
ees
Fin
ance
& E
stat
es D
irec
tora
te
28
NH
S K
irkl
ees
Co
rpo
rate
Ser
vice
s D
irec
tora
te
29
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
NH
S K
irkl
ees
Co
mm
issi
on
ing
& S
trat
egic
Dev
elo
pm
ent
Dir
ecto
rate
30
NH
S K
irkl
ees
Pub
lic H
ealt
h D
irec
tora
te
31
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Pharmacy Strategy
Committee
Exceptions Committee
PCT - LOC Interface
PCT - LPC Interface
PBC Forum
PEC
PCT - PDC Interface
PCT - LMCInterface
ProfessionalAdvisory Group
Information Governance
Group
Operational Clinical
Governance Group
Pharmacy PanelPrimary Care panel Medicines
Management Committee(Area Prescribing
Committee)
Records Management
Group
Governance Committee
Commissioning /Provider Split
OperationalRisk Management
Group
Strategic Emergency
Planning Group(Operational Emergency
Planning Group)
32
Audit CommitteeFinance &
PerformanceCommittee
Provider Board
Strategic Development
Group
Communications & Public Relations
Committee
PEC
TRUSTBOARD
Finance andPerformanceCommittee
Productivity and Efficiency
Group
GovernanceCommittee
Remuneration &Terms of Service
Committee
Specialist Commissioning
Group
33
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Any section 11 consultation
group
Equality and Diversity Group
Communications and Public Relations
Committee
Internal Communications
Group
34
Appendix 4
PCT Organisational Development - WCC Competency PlanTrajectory
CurrentScore
Expected Score Yr 2
1
2
3
4
5
6
7
8
9
10
Reputation as local leader of the NHS
Reputation as change leader of local organisations
Position as the local healthcare employer of choice
Creation of Local Area Agreement based on joint needs
Ability to conduct effective partnerships
Reputation as an active and effective partner
Influence on local health opinions and aspirations
Public and patient engagement
Improvement of patient experience
Clinical engagement
Dissemination of information to support clinical decision making
Reputation as leader of clinical engagement
Analytical skills & insights
Understanding of health needs trends
Use of health needs benchmarks
Predictive modelling skills and insights
Prioritisation of investment to improve population’s health
Incorporation of priorities into strategic investment plan
Knowledge of current and future provider capacity and capability
Alignment of provider capacity with health needs projections
Creation of effective choices for patients
Identification of improvement opportunities
Implementation of improvement initiatives
Collection of quality and outcome information
Understanding of providers economics
Negotiation of contracts around defined variables
Creation of robust contracts based on outcomes
Use of real time performance information
Implementation of regular provider performance discussions
Resolution of ongoing contractual issues
2
2
2
3
3
2
2
2
2
3
1
2
2
2
2
2
2
2
1
2
1
2
2
2
2
2
1
2
2
2
3
3
3
3
3
3
3
3
3
3
2
3
3
3
3
3
3
3
2
3
2
3
3
3
3
3
2
3
3
3
Competency
35
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Appendix 5
WCC outcome of first assessment
Competency 1: Self assessment
Are recognised as thelocal leader of the NHS
NHS Kirklees leads the health agenda inKirklees. We are core members of the LocalStrategic Partnership. We have strongworking relationships with Kirklees Council(KC), working on the health elements of theLocal Area Agreement (LAA).
We have strong & effective relationships &partnerships with other providers in primarycare, secondary care, mental health & aredeveloping this with the voluntary sector.This has enabled the PCT to drive forwardhealth issues & strategy acrossorganisational boundaries for the benefit ofour public & patients.
We developed our relationships with thepublic through such forums as the LiNKs &partnership forums & listening events. ThePCT uses Social Marketing techniques, forexample in commissioning urgent careservices, to allow us to get to the core ofwhat people need. In conjunction with theJSNA this gives the PCT a clear awareness &direction for developing & improving itsrelationship with the public we serve.
The PCT has led on a number of events withpartners that cut across a variety oforganisations & allows strategy to be setthat influences health care. An example ofthis is joint events with KMC ‘A Picture ofKirklees’. In addition the PCT has led onhealth economy events focusing on 18week delivery with secondary & primarycare clinicians to enable cross organisationpathway development.
The PCT has a strong focus on developingits staff with a variety of opportunities tomaximise individual potential, for exampleparticipation in the AdvancedCommissioning Programme.
The PCT is proud of its staff & as suchinvests in celebrating its success. Severalindividuals & groups have been recognisedregionally & nationally. In addition the PCTholds its own award events to congratulatestaff for the work they do.
Competency MeasureLevel
1Level
2Level
3Level
4
• Reputation as the ‘local leader ofthe NHS’
• Reputation as a change leaderfor local organisations
• Position as the local healthcareemployer of choice
36
Competency 2: Self assessment
Work collaborativelywith communitypartners tocommission servicesthat optimise healthgains & reduce healthinequalities
The JSNA was developed with the PCTpartners, principally KC. The PCT worksclosely with Local Strategic Partnership (LSP)to develop & agree the LAA. The LAAreflects the JSNA & clearly demonstrateswhat is to be delivered either in partnershipor by specific organisations with keymilestones, for which the PCT has a historyof delivering. The PCT plays a key role inensuring that the LAA priorities reflect theJSNA & the needs of localities. For examplethe Children’s & Young people’s plan hasbeen informed by the JSNA & monitoredthrough the LAA. The PCT has an active rolein shaping & influencing locality workingwith KC. The PCT has a clear approach tothe delivery of its element of the LAA,working closely with partners in health &social care & also statutory services, such asthe Police & the voluntary sector.
NHS Kirklees & KC share posts include thejoint DPH & commissioning managers forChildren, Older People & Physical & SensoryImpairment. This has allowed greaterintegration with the functions & cultures ofthe PCT & KC. The partnership posts have
allowed for the development of pathwaysof care, for example in older people, tosupport health & social care delivery. Inaddition there are clear & effectivegovernance arrangements for these posts.There are clear structures in both the PCT &KC where the partnership posts influence &deliver on commissioning intensions jointlyto enable delivery of the LAA, optimisehealth gains & reduce health inequalities.
The JSNA & LAA, together with PBC localknowledge, allow PBC consortiacommissioning plans to be set. The PCTworks closely with PBC & encourages theproduction of practice plans that outlinespecific actions to address local need to beimplemented.
Competency MeasureLevel
1Level
2Level
3Level
4
• Creation of Local AreaAgreement based on joint needs
• Ability to conduct constructivepartnerships
• Reputation as an active &effective partner
37
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Competency 3: Self assessment
Proactively buildcontinuous &meaningfulengagement with thepublic & patients toshape services &improve health
NHS Kirklees communication & patient &public involvement (PPI) strategies focus onensuring a meaningful & rich relationshipwith the public & the PCT. We haveconsistently sought to offer different waysof addressing improved communicationeither through literature or public events,such as ‘A Picture of Kirklees’ & formalconsultation sessions on service strategyhave enabled the public to work inpartnership with us & to influencecommissioning decisions. We activelyinvolve patients in developing services thatpromote independence, health, wellbeing &personalisation. The ‘Year of Care’ work indiabetes, the Co-creating healthprogramme for Musculoskeletal as well asself care for Long Term Conditions followthe principles of care of Long TermCondition management & actively involvepatients in the design & development ofthese services. The expert patientprogramme has been recognised nationally& encourages people to maximise theirpotential. Our approach to patient & publicinvolvement has ensured that there is atangible influence on how services are
commissioned. Social Marketing techniqueshave been used to influence how UrgentCare Services are designed & commissioned,& is being used in a wide range of issues,for example in safeguarding children &asking about their attitudes to alcohol,obesity, infection control. The PCT, with KC,has partnership forums; the Working InPartnership team that hold consultationsessions with the public. These areopportunities to share information & havetwo way dialogue with people who useservices & allow commissioning intension tobe influenced. Involving Young Citizensequally with children & parent involvementfurther demonstrates our approach as doesthe redesign of speech & languagetherapies involving parents. PALs are anintegral link between us & the public,receiving issues & complaints that areanalysed & reported to the Board, as well asinfluencing commissioning decisions.
Competency MeasureLevel
1Level
2Level
3Level
4
• Influence on local healthopinions & aspirations
• Public & patient engagement
• Delivery of patient satisfaction
38
Competency 4: Self assessment
Lead continuous &meaningfulengagement of allclinicians to informstrategy & drivequality, service design& resource utilisation
The PCT’s structure & PBC arrangementsstrengths are that it generates strong clinicalengagement. The PEC & PBC participate ina joint commissioning forum with the PCTwhich strengthens integration & clinicalengagement in our commissioningfunctions. All clinicians, GPs & others, areactively involved in the PCT planningforums, such as Health Improvement Teams(HITs), the Long Term Conditions Board &redesign groups with regular PECattendance. We are actively engaged withPBC consortia to ensure joint developmentof commissioning plans based on the needsof patients, using the JSNA & broaderplanning documents such as HealthyAmbitions, whilst maintaining a local focus.PBC consortia have the delegatedresponsibility to drive improvement in health& wellbeing through their commissioningplans. To support PBC, resource utilisationpacks have been developed & regularlydiscussed with practices. The intention isthat these give an accurate picture of howservices & resources are being used.Clinicians are encouraged to submitcommissioning plans & business cases to
improve health gains. Clinical engagementin redesign is seen as paramount in thesuccessful development & implementationof pathways. Primary and 2º care clinicianswork with the PCT on pathway redesign ofwhich the PCT actively facilitates & leadsjoint working. Our success in our approachto clinical engagement for 18 weeks wasrecognised nationally as excellent. Clinicalengagement is embedded in other areas ofdevelopment, Urgent care, Health visiting,Intermediate Care, all using pathways ofcare as the basis of improving services forpatients. The PCT is currently establishing acommissioning development programmewith clinicians supported by a trainingneeds analysis, that will further enhanceclinical & management partnerships inKirklees.
Competency MeasureLevel
1Level
2Level
3Level
4
• Clinical engagement
• Dissemination of information tosupport clinical decision making
• Reputation as an active &effective partner
39
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Competency 5: Self assessment
Manage knowledge &undertake robust ®ular needsassessments thatestablish a fullunderstanding ofcurrent & future localhealth needs &requirements
The JSNA is comprehensive & refreshed onan annual basis & takes into accountinformation from public involvement &clinical opinion. PBC annual plans are basedon the JSNA & allow commissioning ofservices at a local level through consortia &practice plans. Other data is used &analysed to support commissioningdecisions; secondary care activity referralrates for example. This information is usedas part of predictive modelling. Inconjunction with the JSNA gaps in serviceprovision are recognised & addressed. TheStrategic Development Plan provides aframework for commissioning that gives apriority to the major health needs ofKirklees.
The JSNA identifies clear priorities for localpopulation by locality, children, youngpeople & adults. The JSNA identifies riskfactors for disease, current & future, &focuses on these allowing subsequentcommissioning decisions to be made. Thereis also trend data for mortality of majorhealth issues. The CLIK & YPHS majorsurveys have contributed significantly to theJSNA.
Part of the JSNA focuses on benchmarkingKirklees nationally & further work onbenchmarking against local PCTs is beingdeveloped. The PCT benchmarks itselfagainst other PCTs in a number of otherareas, e.g. delivery of the 18 week standard& the PCT’s position against this regionally ismeasured & used as a tool to driveperformance & influence commissioningdecisions. Health Care Commission reportsbenchmark the PCT performance against allPCTs & from these come action planssupported by commissioning plans toimprove performance.
PBC use resource utilisations packs thatdemonstrate patterns of activity at practicelevel across the PCT where it is usedthrough peer development, to drive forwardimprovements through focused redesignwork & changed commissioning plans.Further needs assessments are undertakenas appropriate; for example children withdisabilities, cardiovascular disease, obesity,health behaviours of women of childbearing age.
Competency MeasureLevel
1Level
2Level
3Level
4
• Analytical skills & insights
• Understanding of health needstrends
• Use of health needs benchmarks
40
Competency 6: Self assessment
Prioritise investmentaccording to localneeds, servicerequirements & thevalues of the NHS
NHS Kirklees uses predictive modellingacross a range of its functions. Notably theService Strategy with Mid Yorkshire HospitalTrust as part of forecasting commissioningintention for service provision in the newhospitals. This long term model, at specialtylevel, has been developed across primary &secondary care incorporating demographic& health needs based data. Redesign ofservices at Calderdale & HuddersfieldFoundation Trust has used predictivemodelling to inform commissioningintensions at specialty level.
Specialty level modelling is used annually forcapacity & demand planning with acutetrusts. As part of this process wherechanges in service delivery are made, fromsecondary to primary care for example, thisis incorporated. An example of this is inLong term Conditions where disinvestmentin secondary care & investment in primarycare is planned.
These changes are progressed through thebusiness planning & commissioning cycle.The business planning process is an
outcome from HITs. There are HITs for all ofthe PCTs key strategic areas & fit withdelivery of policy, for example ‘healthyambitions’. Business plans have definedcriteria & fit with the vision & values as wellas the goals of the PCT & highlight whereimprovements will be made. In addition, thecomposition of the HITs incorporatesclinicians as well as managers & otherstakeholders ensuring the commissioningcycle & business planning process isreceptive to local need, clinicians &stakeholders.
Through locality working & the use of theJSNA the PCT has been able to focusinvestment & develop services where theneed is greatest. The equitable access centrewill be in Dewsbury, this is an area with alower patient to GP ratio. The sameapproach has been used to invest indentistry. These being agreed inconsultation with key stakeholders includingGPs & other clinicians.
Competency MeasureLevel
1Level
2Level
3Level
4
• Predictive modelling skills &insights
• Prioritisation of investment toimprove population’s health
• Incorporation of priorities intostrategic investment plan
41
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Competency 7: Self assessment
Effectively stimulatethe market to meetdem& & securerequired clinical &health & wellbeingoutcomes
NHS Kirklees understands the local marketfor health services & jointly commissionedservices with social care. We have usedcompetitive processes to procure services.The equitable access procurement sourced anumber of providers to enable delivery ofthis initiative. Urgent care procurement forOut of Hours care & the development ofurgent care services has stimulated themarket & attracted a variety of potentialproviders for this service. As part of theurgent care procurement publicconsultation & social marketing techniqueshave been used to ensure that patients’views & opinions are included in thespecification. In addition the inclusion ofpatients & clinicians in the procurementprocess has been vital. There has beenanalysis of the providers ability to deliver theservice at a defined minimum level ofquality & within a specific budgetaryenvelope. This is representative of the PCTapproach to procurement & sourcingproviders.
To further develop our approach toincreasing the supply market we havedeveloped a procurement policy ensuringfuture procurement is robust in itsassessment of a wide range of providersusing competitive approaches.
The PCT uses demand & capacity analysistools in conjunction with secondary careproviders to plan specialty based activityforecasts incorporating local needdetermined by the JSNA. Review is on amonthly basis, any gaps in service provisionare commissioned accordingly. An exampleof this is Audiology where capacity in localservices was not available in order to reducewaiting times. An independent sectorprovider, sourced through a procurementprocess, was secured to deliver the activity& reduce waits to acceptable levels.
Patients will be offered Choice by their GP.Where it becomes apparent that there is alack of services & Choice then the PCTensures GPs are aware alternative providers.
Competency MeasureLevel
1Level
2Level
3Level
4
• Knowledge of current & futureprovider capacity
• Alignment of provider capacitywith health needs projections
• Creation of effective choices forpatients
42
Competency 8: Self assessment
Promote & specifycontinuousimprovements inquality & outcomesthrough clinical &provider innovation &configuration
The PCT incorporates benchmarking intoservice improvement. This is demonstratedboth in our performance managementprocesses where current performance insome areas is benchmarked against national& local levels. In addition GP performance isbenchmarked locally, for example in referralrates, so that there can be an analysis ofextreme high & low referrers & any changesmade accordingly.
Developing commissioned services throughjoint working and innovation is essential &the PCT has a track record of this. Clinicalpathway improvement has been seen in anumber of areas, Musculoskeletal Care,Gynaecology, Cardiology, Diabetes amongstothers. Within pathway development thewhole patient journey is consideredhighlighting key areas where improvement& changes can be made. For example LongTerm Conditions pathway focuses on selfcare & all 3 levels of prevention includinghow patients can be cared for in a primarycare setting as the norm, not admission tosecondary care, a specific example being,the ‘Year of Care’ programme, involving
patients & clinicians, considers how patientscan improve self care & with cliniciansimprove outcomes.
PBC are core to pathway development. ThePCT has a ‘planned care’ HIT with PBCinvolvement. PBC are also involved withsecondary care to develop integrated carepathways. As part of 18 weeks, clinicians &patients reviewed pathways underdevelopment. This formed a strong basis ofensuring pathway implementation fits withpatients need & is clinically driven. Pathways are developed against a seriesexpected outcomes which are thenmeasured. Quality boards have beenestablished with MYHT, CHFT & SWYMT.The PCT is improving its process ofincorporating quality metric & benefitrealisation techniques into it improvementwork.
The PCT holds regular monitoring sessionswith providers, in areas where there isongoing improvement, for example urgentcare, this is weekly, for other areas this ismonthly.
Competency MeasureLevel
1Level
2Level
3Level
4
• Identification of improvementopportunities
• Implementation of improvementinitiatives
• Collection of real time quality &outcome information
43
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Competency 9: Self assessment
Secure procurementskills that ensurerobust & viablecontracts
Through the PCT relationship with itsproviders & broader intelligence the PCT hasgood understanding of provider economics& market dynamics. NHS Kirklees has anrobust and mutually respectful relationshipwith its major acute providers & mentalhealth providers. The contract unit meetwith providers to discuss capacityconstraints, activity & financial positionsagainst plan on a monthly basis & includesfeedback on patient experience. All of thisinformation is documented & reported onat weekly internal contracts meetings. Thesemeetings also ensure that the strategicdirection of providers is in line withcommissioning intentions. Finance &Commissioning Directors lead contractnegotiation in line with the PCTsprocurement strategy supported by thecontract team where variables such as cost& quality are identified.
A more systematic approach to quality isbeing developed with quality metricsintegrated into contracts & new QualityBoards being integrated into contractmanagement structures. However there is a
requirement for further improvement inincorporating patients experience into thecontracting & reporting process. Wherethere are variables for example, referralrates or variance of activity against plan,these are discussed & solutions agreed atregular, at least monthly, contract teammeetings.
Contracts are based on outcomes. Recentlydeveloped contracts for Equitable Access &Urgent care for example, are outcomebased & include quality metrics that aremonitored through key performanceindicators. Contracts with major acuteprovides are standard & legally bindingincluding details of arbitration & breakclauses.
The PCT has risk sharing arrangements forspecialist commissioning & chairs theSpecialist Commissioning Group (SCG).Through the SCG a number of specialties &provided services have been improvedthrough clear common performanceindicators & robust specifications.
Competency MeasureLevel
1Level
2Level
3Level
4
• Understanding of providerseconomics
• Negotiation of contracts arounddefined variables
• Creation of robust contractsbased on outcomes
44
Competency 10: Self assessment
Effectively managesystems & work inpartnership withproviders to ensurecontract compliance &continuousimprovement inquality & outcomes &value for money
The PCT has a dedicated information teamthat analyses & validates data & presents inusable formats to ensure that information isprovided in a such a way that is easilyunderstood by commissioning staff &stakeholders as appropriate. Where there isa need for validation or to challengeinformation provided this is done. Theinformation is then used to supportcontracting meetings, provide evidence forpathway development & supportperformance management. This isparticularly important where there arevariances against plan & actions required tobe taken. The performance data & minutesfrom contract & performance discussionwith main providers is used internally by thecontract team to assimilate all providerperformance & take coordinated actionsaccordingly.
In addition where there are specific areas ofmonitoring required on a weekly basis theinformation is provided in a format to allowdecisions to be made to influences keyprogramme areas, for example 18 weeks &A&E performance.
Performance is shared with PBC consortiawho have opportunities throughcommissioning forums to reflect onperformance & play an active role incommissioning decisions.
The PCT also produces & disseminates dailyreal time information relating to access tocommunity based services & any providedservice issues through SITREP reports.
A corporate performance report is producedmonthly & reported to the board & is publicinformation. The board takes a keen interestin performance & have influence over keydecisions relating interventions requiredwith providers particularly if performancevaries significantly or consistently from theplan. Further interrogation is through theFinance & Performance committee,reporting to the board. There are monthlybespoke performance reports for key areasto support specific development workincluding 18 weeks, cancer waits & A&Efour hour target. Reports are shared withproviders on a regular basis.
Competency MeasureLevel
1Level
2Level
3Level
4
• Use of real time performanceinformation
• Implementation of regularprovider performance discussions
• Resolution of ongoingcontractual issues
45
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Ap
pen
dix
6
Org
anis
atio
nal D
evel
opm
ent
Act
ion
Plan
200
8/9
Stra
teg
y
Wo
rld
Cla
ssC
om
mis
sio
nin
gC
om
pet
ency
Org
anis
atio
nal
Dev
elo
pm
ent
Ob
ject
ive
Act
ion
s R
equ
ired
Ou
tco
mes
Mea
sure
sTi
mes
cale
Exec
uti
veLe
ad
Loca
lly L
ead
th
eN
HS
T o e
nsu
re t
hat
NH
SK
irkl
ees
as a
bra
nd
is r
eco
gn
ised
as
ale
ader
of
the
NH
Sw
ith
in K
irkl
ees
To a
lign
our
stra
tegi
es,
as a
ppro
pria
te, w
ithth
ose
of K
irkle
esC
ounc
il on
an
ongo
ing
basi
s
Usi
ng s
tron
gpa
rtne
rshi
p w
ith t
heLA
, dr
ive
deliv
ery
and
deve
lopm
ent
forw
ard
and
as a
mea
ns t
oke
ep a
foc
us o
n th
evi
sion
dur
ing
som
ech
alle
ngin
g tim
esah
ead
Path
way
red
esig
nev
ents
pla
nned
invo
lvin
g a
rang
e of
part
ners
Impr
oved
hea
lthou
tcom
esFi
ve y
ear
revi
sed
stra
tegy
to in
clud
e W
CC
, LA
A a
ndvi
tal s
igns
Part
nerin
g an
d jo
int
com
mis
sion
ing
stra
tegy
isde
fined
Prog
ram
me
Del
iver
ySt
rate
gy w
ill b
e de
velo
ped
that
will
iden
tify
how
prog
ram
mes
will
be
deliv
ered
bot
h by
NH
SK
irkle
es a
nd jo
intly
with
the
LA.
A p
lan
is d
evel
oped
whi
chid
entif
ies
how
to
build
on
exis
ting
rela
tions
hips
with
the
LA a
nd t
o en
sure
tha
tst
rate
gies
and
act
iviti
esar
e al
igne
d in
ord
er t
odr
ive
forw
ards
impr
ovem
ents
in h
ealth
outc
omes
WC
C p
artn
er f
eedb
ack
asse
ssm
ent
Benc
hmar
k pa
rtne
rshi
pw
orki
ng e
g. H
AD
/LG
AG
uida
nce
Stra
tegy
and
Pla
nsde
liver
ed a
ndm
onito
red
by t
heFi
nanc
e an
dPe
rfor
man
ceC
omm
ittee
Path
way
red
esig
npr
oces
s ac
hiev
ed in
part
ners
hip
Cle
ar p
rogr
amm
em
anag
emen
t an
dac
tion
plan
s fo
r LA
Apr
ogra
mm
es
Ong
oing
Ong
oing
All
Dire
ctor
s
Chi
efEx
ecut
ive
46
Loca
lly L
ead
th
eN
HS
To e
nsu
re t
hat
NH
SK
irkl
ees
as a
bra
nd
is r
eco
gn
ised
as
ale
ader
of
the
NH
Sw
ith
in K
irkl
ees
To e
mbe
d th
e N
HS
Kirk
lees
vis
ion,
bra
ndva
lues
and
iden
tity
with
in t
he P
CT
and
Kirk
lees
as
a w
hole
To e
nsur
e th
at t
hele
ader
ship
com
mun
ityw
ithin
the
PC
Tun
ders
tand
key
stra
tegi
c go
als
and
prio
ritie
s an
d w
ork
tode
liver
the
se w
ithin
the
PCT
and
with
out
part
ners
To e
mbe
d th
e N
HS
Kirk
lees
vis
ion,
bra
ndva
lues
and
iden
tity
with
in t
he P
CT
and
Kirk
lees
as
a w
hole
A m
etho
dolo
gy f
ortr
acki
ng o
utco
mes
and
ineq
ualit
y im
prov
emen
tsag
ains
t th
e 12
ele
men
tsof
the
LA
A is
dev
elop
ed
That
the
peo
ple
ofK
irkle
es a
s w
ell a
s ou
rpa
rtne
rs u
nder
stan
d th
ele
ader
ship
rol
e of
the
PC
T
Wor
ld c
lass
com
mis
sion
ing
deve
lopm
ent
prog
ram
me
deve
lope
d
Enga
gem
ent
thro
ugh
the
Com
mis
sion
ing
Col
lege
Ong
oing
join
tde
velo
pmen
t pr
ogra
mm
esor
gani
sed
with
key
part
ners
eg
Med
ical
Enga
gem
ent
Proj
ect
Dev
elop
men
t pr
ogra
mm
eto
sup
port
who
le s
cale
chan
ge a
cros
s K
irkle
esth
at is
mul
ti-di
scip
linar
y
That
the
peo
ple
ofK
irkle
es, a
s w
ell a
s ou
rpa
rtne
rs, u
nder
stan
d th
ele
ader
ship
rol
e of
the
PC
T
Staf
f su
rvey
, WC
Cpa
rtne
r fe
edba
ckas
sess
men
tsW
CC
ass
essm
ents
Staf
f su
rvey
sIm
prov
ed h
ealth
outc
omes
Med
ical
Eng
agem
ent
Proj
ect
Stak
ehol
der
surv
ey a
ndfe
edba
ck, W
CC
par
tner
feed
back
ass
essm
ents
,Pu
blic
per
cept
ion
polls
Mar
ch20
09
2008
/200
9
Mar
ch20
09
Dire
ctor
of
Cor
pora
teSe
rvic
es
Dire
ctor
of
HR/
OD
Dire
ctor
of
Cor
pora
teSe
rvic
es
47
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Co
llab
ora
te w
ith
Clin
icia
ns
Prio
riti
seIn
vest
men
t
To im
pro
ve o
ur
clin
ical
eng
agem
ent
and
colla
bo
rati
on
wit
ho
ur
clin
icia
ns
To im
pro
ve t
he
pri
ori
tiza
tio
n o
fre
sou
rces
To d
evel
op c
linic
alle
ader
ship
and
enga
gem
ent
acro
ssK
irkle
es
To im
prov
e cl
inic
alen
gage
men
t th
roug
hco
llabo
ratio
n w
ith o
urcl
inic
ians
The
Boar
d re
flect
s on
how
it p
riorit
ises
the
effo
rts
of t
heor
gani
satio
n an
d th
eBo
ard
Trai
ning
Nee
ds A
naly
sis
unde
rtak
en w
hich
iden
tifie
s ke
y en
gage
men
tis
sues
To e
nsur
e th
at t
heC
omm
issi
onin
g C
olle
ge is
an in
tegr
al p
art
of N
HSK
,in
form
ing
clin
ical
deci
sion
s an
d PE
C a
ctio
n
Dev
elop
a d
ives
tmen
tst
rate
gy
Dev
elop
a b
ench
mar
king
stra
tegy
Dev
elop
men
tpr
ogra
mm
e to
mee
tne
eds
iden
tifie
d in
TN
A
Feed
back
thr
ough
the
PBC
Exe
cutiv
e on
leve
lsof
clin
ical
eng
agem
ent
Out
put
from
the
clin
ical
enga
gem
ent
tool
Stra
tegi
es p
rodu
ced,
shar
ed a
nd e
mbe
dded
with
in t
he o
rgan
isat
ion
usin
g th
eC
omm
issi
onin
g C
olle
gean
d Le
ader
ship
Prog
ram
me
Nov
embe
r20
08
June
200
9
PEC
Cha
ir
Dire
ctor
of
Fina
nce
Syst
ems
and
infr
astr
uct
ure
Wo
rld
Cla
ssC
om
mis
sio
nin
gC
om
pet
ency
Org
anis
atio
nal
Dev
elo
pm
ent
Ob
ject
ive
Act
ion
s R
equ
ired
Ou
tco
mes
Mea
sure
sTi
mes
cale
Exec
uti
veLe
ad
Co
llab
ora
te w
ith
Clin
icia
ns
To im
pro
ve t
he
qu
alit
y o
fin
form
atio
n it
pro
vid
es t
osu
pp
ort
th
em
anag
emen
t o
fth
e p
rim
ary
care
con
trac
t an
dva
rian
ces
inp
ract
ice
Iden
tify
and
ratio
naliz
e th
e hi
ghqu
ality
info
rmat
ion
we
have
/nee
d in
ord
erto
man
age
the
prim
ary
care
con
trac
t?
Redu
ce t
he v
aria
tions
in p
rimar
y ca
re h
ealth
ineq
ualit
ies
byde
velo
ping
asy
stem
atic
and
tran
spar
ent
appr
oach
Robu
st c
ontr
act
man
agem
ent
of t
hePr
imar
y C
are
cont
ract
isem
bedd
ed in
to o
urC
omm
issi
onin
g C
ycle
Hea
t m
ap e
stab
lishe
d
A r
educ
tion
in v
aria
tion
ofPr
imar
y C
are
perf
orm
ance
base
d on
the
act
ions
initi
ated
fro
m t
heex
amin
atio
n of
thi
s ov
eral
lin
form
atio
n
Feed
back
fro
m t
heM
edic
al E
ngag
emen
tSu
rvey
and
ong
oing
proc
ess
Intr
anet
link
est
ablis
hed
Feed
back
fro
m
Com
mis
sion
ing
Col
lege
Feed
back
Revi
ew o
f co
ntra
cts
tode
term
ine
impa
ct
June
200
9D
irect
or o
fPe
rfor
man
cean
dIn
form
atio
n
48
Eng
age
wit
hPu
blic
an
dPa
tien
ts
Dev
elo
p a
ro
bu
stst
rate
gy
for
pu
blic
eng
agem
ent
and
un
der
stan
d t
he
key
loca
l iss
ues
that
will
en
sure
that
NH
SK t
aps
into
th
e h
ard
to
reac
h p
art
of
its
po
pu
lati
on
to P
rimar
y C
are
usin
ga
heat
map
of
unde
rper
form
ance
To d
evel
op t
heco
ntra
ctua
lfr
amew
ork
to t
rigge
rpe
rfor
man
cem
onito
ring
and
“Eve
nt”
mile
ston
es
Use
the
Com
mis
sion
ing
Col
lege
to
solic
it an
ddi
ssem
inat
e qu
ality
impr
ovem
ent
idea
sfr
om c
linic
ians
Und
erst
andi
ng k
eyth
emes
sur
roun
ding
succ
essf
ul p
ublic
enga
gem
ent
Dev
elop
a t
oolk
it fo
rsu
stai
ned
publ
icen
gage
men
t
Expl
ore
the
conc
ept
ofa
mem
bers
hip
coun
cil
type
of
mod
el t
osu
ppor
t th
e pa
tient
and
publ
icin
volv
emen
t ag
enda
Tool
kit
embe
dded
thro
ugho
ut N
HSK
Cro
ss d
irect
orat
e w
orki
ngen
able
sha
ring
ofin
form
atio
n on
pat
ient
expe
rienc
e, c
ompl
aint
san
d PA
LS t
o sh
ow h
owth
is h
as im
prov
ed q
ualit
y
Dem
onst
rabl
een
gage
men
t an
din
volv
emen
t ac
tivity
inth
e de
velo
pmen
t an
dpr
ocur
emen
t of
car
epa
thw
ays
and
serv
ices
All
busi
ness
cas
esid
entif
y th
e ra
nge
ofpu
blic
eng
agem
ent
and
invo
lvem
ent
unde
rtak
en
July
200
9D
irect
or o
fC
orpo
rate
Se
rvic
es
49
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Man
age
kno
wle
dg
e an
das
sess
nee
d
To c
on
tin
ual
lyim
pro
ve t
he
qu
alit
y o
f se
rvic
esth
at w
e d
eliv
er,
ensu
rin
g t
hat
thes
e ar
e ev
iden
ceb
ased
, co
stef
fect
ive,
an
dw
her
e p
oss
ible
del
iver
ed c
lose
r to
peo
ple
’s h
om
es
To e
nsu
re t
hat
ou
rg
ove
rnan
cear
ran
gem
ents
are
fit
for
pu
rpo
se a
nd
will
su
pp
ort
th
ed
eliv
ery
of
ou
rst
rate
gic
go
als
Impl
emen
t an
dem
bed
the
PCT
Qua
lity
and
Clin
ical
Gov
erna
nce
Stra
tegi
cFr
amew
ork
Impl
emen
t th
e H
ealth
Dia
logu
e ris
kst
ratif
icat
ion
syst
em.
To e
mbe
d sy
stem
s an
dpr
oces
s w
hich
unde
rpin
our
clin
ical
enga
gem
ent
and
allo
w u
s to
iden
tify
best
pra
ctic
e an
dan
alys
e im
pact
and
outc
omes
To e
nsur
e th
at t
hePC
T re
view
s sy
stem
san
d pr
oces
s to
ens
ure
that
the
y ar
e fit
for
purp
ose
and
mee
tre
quire
men
ts o
f W
CC
To d
evel
op a
ran
ge o
fqu
ality
indi
cato
rs in
colla
bora
tion
with
colle
ague
s in
Yor
kshi
rean
d H
umbe
r
Info
rmat
ion
at lo
calit
yle
vel
Build
in h
ealth
ineq
ualit
ies
to p
lann
ing
– vi
a H
IT le
ads
but
part
of
the
HW
BIn
equa
litie
s St
rate
gy
Impr
oved
alig
nmen
t,op
erat
ion
and
com
mun
icat
ion
amon
gPB
C, P
EC, B
oard
and
HIT
s
Gre
ater
und
erst
andi
ng o
fth
e bu
sine
ss p
lann
ing
appr
oach
Gov
erna
nce
revi
ewpl
anne
d fo
r 20
08.
To a
lign
the
plan
ning
proc
ess
betw
een
prac
tice
base
d co
mm
issi
oner
s an
dhe
alth
impr
ovem
ent
team
s, e
nsur
ing
ther
e is
aco
nsis
tent
pro
cess
for
all
new
ser
vice
dev
elop
men
t
Qua
lity
indi
cato
rsde
velo
ped
and
embe
dded
with
in t
hePC
T pe
rfor
man
cede
velo
pmen
tfr
amew
ork
and
revi
ewof
pro
gram
me
man
agem
ent
cond
ucte
d
PCT
plan
s ha
ve b
een
shar
ed w
ith o
urC
omm
issi
oner
s th
roug
hth
e C
omm
issi
onin
gC
olle
ge
Info
rmat
ion
Stra
tegy
embe
dded
Impr
oved
Hea
lth
Out
com
es
Com
mis
sion
ing
proc
ess
is a
ligne
d m
ore
clos
ely
to b
usin
ess
plan
ning
proc
ess
Fina
ncia
l spe
nd r
evie
w
WC
C a
sses
smen
tIn
tern
al r
evie
w o
f su
bco
mm
ittee
pro
cess
Mar
ch20
09
Nov
embe
r20
09
Janu
ary
2009
Dire
ctor
of
Patie
nt C
are
and
Prof
essi
ons
Dire
ctor
of
Com
mis
sion
-in
g an
dSt
rate
gic
Dev
elop
men
t
PEC
Cha
ir
Dire
ctor
of
Cor
pora
teSe
rvic
es
Dire
ctor
of
Perf
orm
ance
& In
form
atio
n
50
Shar
ed V
isio
n a
nd
Val
ues
Wo
rld
Cla
ssC
om
mis
sio
nin
gC
om
pet
ency
Org
anis
atio
nal
Dev
elo
pm
ent
Ob
ject
ive
Act
ion
s R
equ
ired
Ou
tco
mes
Mea
sure
sTi
mes
cale
Exec
uti
veLe
ad
Wo
rk w
ith
Co
mm
un
ity
Part
ner
s
To c
on
tin
ue
tow
ork
wit
h o
ur
par
tner
s to
use
ben
efic
ial i
mp
act
of
imp
rove
dre
lati
on
ship
s fo
rth
e p
eop
le o
fK
irkl
ees
To e
nhan
ce o
ur w
ork
with
our
par
tner
s in
deliv
erin
g ou
rin
divi
dual
and
join
tst
rate
gies
To r
evie
w t
he o
utco
mes
of
the
CA
A p
ilot
and
impl
emen
t ch
ange
s
To a
lign
syst
ems
and
proc
esse
s w
ith o
urpa
rtne
rs s
o th
atst
ream
lined
ser
vice
s ca
nbe
del
iver
ed
To s
tren
gthe
n ou
rre
latio
nshi
p w
ith o
ur k
eypr
ovid
ers
and
iden
tify
addi
tiona
l pot
entia
lpr
ovid
ers
of s
ervi
ces
To e
xten
d pa
rtne
rshi
pw
orki
ng a
t al
l lev
els
of t
hePC
T. T
his
will
incl
ude
part
ners
hip
with
pub
lic,
priv
ate
and
volu
ntar
yse
ctor
org
anis
atio
ns b
yim
plem
entin
g th
e ac
tions
iden
tifie
d in
the
Com
mun
icat
ions
Str
ateg
y
WC
C p
artn
eras
sess
men
tIm
prov
ed h
ealth
outc
omes
As
abov
eFe
edba
ck t
hrou
gh o
urfo
rmal
and
info
rmat
ion
com
mun
icat
ion
links
Ong
oing
Ong
oing
PCT
Boar
d
All
Dire
ctor
s
51
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Wo
rk w
ith
Co
mm
un
ity
Part
ner
s
To in
crea
se a
nd
imp
rove
ou
rse
rvic
e u
ser
and
pu
blic
invo
lvem
ent
so t
hat
th
ey m
ayb
e ac
tive
lyen
gag
ed in
an
on
go
ing
bas
is w
ith
the
dev
elo
pm
ent
and
del
iver
y o
f o
ur
serv
ices
To e
nsu
re t
hat
PMO
bec
om
es a
core
way
of
wo
rkin
gth
rou
gh
ou
t N
HSK
To e
nhan
ce o
ur w
ork
with
our
ser
vice
use
rsan
d th
e pu
blic
inK
irkle
es
Dev
elop
a r
obus
tst
rate
gy f
or p
ublic
enga
gem
ent
Dev
elop
a s
trat
egy
and
reso
urce
ban
k fo
rso
cial
mar
ketin
gin
itiat
ives
and
eng
age
with
soc
ial m
arke
ters
Und
erst
andi
ng k
eyth
emes
sur
roun
ding
succ
essf
ul p
rogr
amm
em
anag
emen
t w
hat
aPM
O f
unct
ion
can
dofo
r N
HSK
Dev
elop
men
t of
am
etho
dolo
gy t
hat
can
be u
sed
and
adop
ted
thro
ugho
ut N
HSK
on
a co
nsis
tent
bas
is
To in
crea
se o
ur le
vels
of
part
ners
hip
with
our
serv
ice
user
s an
d pu
blic
inK
irkle
es
Und
erst
andi
ng b
y st
aff
ofke
y th
emes
sur
roun
ding
succ
essf
ul p
ublic
enga
gem
ent
A t
oolk
it fo
r su
stai
ned
publ
ic e
ngag
emen
t is
deve
lope
d
Del
iver
mea
sura
ble
impr
ovem
ents
for
our
inve
stm
ents
and
how
thes
e ca
n be
mon
itore
dan
d tr
acke
d
Und
erst
and
whe
n to
use
Expl
ore
the
conc
ept
of a
mem
bers
hip
coun
cil
A n
umbe
r of
key
sta
ff h
asal
read
y un
dert
aken
PM
trai
ning
and
pla
ns a
reun
derw
ay t
o ex
tend
thi
str
aini
ng.
Usi
ng t
he k
now
ledg
ew
ithin
NH
SK t
o sh
are
know
ledg
e an
d de
velo
ppr
otoc
ol a
nd n
ew s
yste
ms
and
proc
esse
s us
ing
PMO
Com
mun
icat
ions
Stra
tegy
Impl
emen
ted
Impr
oved
sat
isfa
ctio
n in
serv
ice
user
and
pub
licop
inio
n su
rvey
sIm
prov
ed q
ualit
yin
dica
tor
perf
orm
ance
as a
sses
sed
thro
ugh
our
cont
ract
s w
ith o
ur k
eypr
ovid
ers
PMO
bec
omes
an
embe
dded
way
of
wor
king
thr
ough
out
NH
SK
Dec
embe
r20
09
June
200
9
Dire
ctor
of
Cor
pora
teSe
rvic
es
Dire
ctor
of
Publ
ic H
ealth
52
Staf
f an
d S
kills
Wo
rld
Cla
ssC
om
mis
sio
nin
gC
om
pet
ency
Org
anis
atio
nal
Dev
elo
pm
ent
Ob
ject
ive
Act
ion
s R
equ
ired
Ou
tco
mes
Mea
sure
sTi
mes
cale
Exec
uti
veLe
ad
Effe
ctiv
ely
Stim
ula
te t
he
Mar
ket
Secu
rePr
ocu
rem
ent
Skill
s
To e
nsu
re t
hat
PC
Th
as t
he
rig
ht
cap
acit
y an
dca
pab
ility
to
mee
td
eman
d a
nd
secu
re r
equ
ired
clin
ical
an
d h
ealt
han
d w
ell b
ein
go
utc
om
es
To d
evel
op
key
asp
ects
of
pro
cure
men
t,co
ntr
act
man
agem
ent,
bu
sin
ess
risk
s an
dfi
nan
ce
To e
nhan
ce a
naly
tical
skill
s an
d ab
ility
to
unde
rtak
e co
st/b
enef
itan
alys
is.
To r
evie
w c
apac
ity a
ndre
sour
ce c
apab
ility
acro
ss t
he P
CT
and
brin
g in
exp
ertis
e as
requ
ired
Und
erst
and
wha
tsu
cces
sful
str
ateg
icso
urci
ng lo
oks
like
Dev
elop
unde
rsta
ndin
g ar
ound
cont
ract
man
agem
ent,
nego
tiatio
n an
d le
gal
issu
esD
evel
opm
ent
of k
eybu
sine
ss r
isks
unde
rsta
ndin
g of
how
thes
e ca
n be
man
aged
Broa
d un
ders
tand
ing
of f
inan
cial
ris
km
anag
emen
t,tr
ajec
torie
s, b
alan
cesh
eet
and
P&L
issu
es
Cho
ice
prin
cipl
es a
reem
bedd
ed a
cros
s th
e PC
TA
nnua
l rev
iew
of
dem
and
and
supp
ly t
hat
prod
uces
clea
r ga
p an
alys
is a
ndpr
opos
ed a
ctio
ns.
HIT
s in
crea
se f
ocus
on
mea
surin
g de
man
d an
dca
paci
ty, w
ith p
roce
ss f
orid
entif
ying
gap
sem
bedd
ed
NH
SK h
as a
goo
dun
ders
tand
ing
and
appl
icat
ion
ofpr
ocur
emen
t co
ntra
ctm
anag
emen
t an
dbu
sine
ss r
isks
at
appr
opria
te le
vels
fro
mth
e Bo
ard
thro
ugho
ut.
A r
isk
regi
ster
/pla
n is
impl
emen
ted
at N
HSK
Boar
d to
Boa
rd le
arni
ngw
ith h
igh
perf
orm
ing
(cor
pora
te) b
oard
s
Syst
ems
in p
lace
to
mea
sure
and
cou
ntno
n-m
anda
ted
activ
ity.
Feed
back
fro
m B
oard
Dev
elop
men
t Pr
oces
sSu
cces
sful
impl
emen
tatio
n of
Lead
ersh
ip P
rogr
amm
ePa
tient
exp
erie
nce
data
regu
larly
rev
iew
ed in
cont
ract
mee
tings
Benc
hmar
ked
info
rmat
ion
in S
LApe
rfor
man
ce r
epor
ts(b
e pr
oduc
ed o
nqu
arte
rly b
asis
)
May
200
9
May
200
9
Dire
ctor
of
Com
mis
sion
-in
g an
dSt
rate
gic
Dev
elop
men
t
Dire
ctor
of
Com
mis
sion
-in
g an
dSt
rate
gic
Dev
elop
men
t
53
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Pro
mo
teIn
no
vati
on
an
dC
han
ge
To c
reat
e a
lear
nin
gen
viro
nm
ent
thro
ug
ho
ut
the
PCT,
wh
ere
inn
ova
tio
n is
valu
ed a
nd
reco
gn
ised
an
dst
aff
cap
acit
y an
dca
pab
ility
are
key
to t
he
del
iver
y o
fo
ur
serv
ices
To c
on
sid
er is
sues
of
tale
nt
man
agem
ent
and
succ
essi
on
pla
nn
ing
inta
rget
ing
fu
ture
lead
ersh
ipin
vest
men
t
To c
ontin
ue t
o em
bed
the
PCT
Pers
onal
Dev
elop
men
t Re
view
Proc
ess
(PD
R)To
ens
ure
that
PPI
‘insi
ghts
’ to
be b
uilt
into
prio
ritis
atio
n
To b
uild
inte
grat
ion
ofJS
NA
into
com
mis
s’in
g de
cisi
ons
& p
riorit
isat
ion
To d
eliv
ery
the
PCT
Lear
ning
and
Dev
elop
men
t St
rate
gy
Iden
tify
area
s w
here
turn
over
or
addi
tiona
lca
paci
ty is
an
issu
e
The
KSF
pro
ject
lead
to c
ontin
ue t
o w
ork
with
KSF
cha
mpi
ons
to e
nsur
e ad
optio
n of
the
KSF
pro
cess
Gre
ater
und
erst
andi
ng o
fth
e PC
T st
rate
gic
obje
ctiv
es a
nd p
riorit
ies
byal
l sta
ff a
nd h
ow t
hey
supp
ort
thei
r de
liver
y.To
em
bed
a va
lue
for
mon
ey m
inds
et a
ndcu
lture
thr
ough
out
NH
SK
Link
ing
pers
onal
deve
lopm
ent
to t
hebu
sine
ss o
f th
e PC
T as
wel
l as
care
erde
velo
pmen
tEn
surin
g th
at a
ll st
aff
have
the
appr
opria
tekn
owle
dge,
ski
lls a
ndbe
havi
ours
to
deliv
er t
heir
role
s
A t
alen
t an
d su
cces
sion
plan
ens
ures
the
PC
T is
equi
pped
to
deliv
er it
sob
ject
ives
100%
ach
ieve
men
t of
PDRs
acr
oss
the
PCT
asou
tline
d in
the
PC
Tw
orkf
orce
sco
reca
rdIm
prov
ed s
taff
sur
vey
resu
lts o
n th
e qu
ality
of
appr
aisa
lsA
ll st
aff
with
in t
he P
CT
havi
ng a
KSF
out
line
To e
nsur
e th
at t
he e
-K
SF is
ado
pted
PC
Tw
ide
Ach
ieve
men
t of
Inve
stor
s in
Peo
ple
stan
dard
Targ
ets
on w
orkf
orce
scor
ecar
d.W
orkf
orce
and
mar
ket
anal
ysis
100%
of
staf
f ha
vecu
rren
t K
SF o
utlin
e10
0% o
f st
aff
reco
rdin
g de
velo
pmen
tpl
ans
on e
-KSF
Ann
ual t
rain
ing
plan
deriv
ed f
rom
e-K
SF
July
200
9
2009
/10
Mar
ch20
09
Dire
ctor
of
HR&
OD
Dire
ctor
of
HR/
OD
Dire
ctor
of
HR&
OD
54
To e
nsur
e fu
ture
capa
bilit
y ne
eds
are
iden
tifie
d ac
ross
the
PCT
in a
tim
ely
man
ner
To e
nsur
e th
at t
hePC
T Tr
aini
ng a
ndD
evel
opm
ent
Stra
tegy
is a
ligne
d to
the
PC
TSt
rate
gic
Fram
ewor
k
To e
nsur
e th
at t
hebu
sine
ss p
lann
ing
proc
ess
iden
tifie
spo
tent
ial d
evel
opm
ent
need
s ne
cess
ary
tode
liver
the
pla
n
To e
nsur
e th
e ou
tput
from
the
WC
Ctr
aini
ng n
eeds
ana
lysi
sis
iden
tifie
d as
par
t of
the
PCT
annu
altr
aini
ng p
lan
Revi
ew o
f PC
T tr
aini
ngan
d de
velo
pmen
t st
rate
gyto
ens
ure
fitne
ss f
orpu
rpos
e
To u
pdat
e bu
sine
sspl
anni
ng p
roce
ss s
o th
atde
velo
pmen
t ne
eds
are
requ
ired
to b
e id
entif
ied
as p
art
of t
he p
roce
ss
To e
nsur
e th
ere
is a
clo
sed
loop
bet
wee
n bu
sine
sspl
anni
ng a
nd t
rain
ing
and
deve
lopm
ent
requ
irem
ents
A c
ompl
eted
WC
Ctr
aini
ng n
eeds
ana
lysi
sre
port
A p
rogr
amm
e of
act
ivity
will
be
deve
lope
d fo
r al
lth
ose
invo
lved
inde
liver
ing
wor
ld c
lass
com
mis
sion
ing
aris
ing
from
the
out
com
es o
f th
etr
aini
ng n
eeds
ana
lysi
s
NH
S st
aff
surv
eyA
chie
vem
ent
of t
he II
Pst
anda
rdPD
R pr
oces
sU
pdat
ed t
rain
ing
and
deve
lopm
ent
stra
tegy
Revi
sed
busi
ness
proc
ess
Wor
ld c
lass
com
mis
sion
ing
trai
ning
prog
ram
me
deliv
ered
Mar
ch20
09
Dec
embe
r20
09
Dire
ctor
of
Patie
nt C
are
and
Prof
essi
on
Dire
ctor
of
Perf
orm
ance
& Info
rmat
ion
Dire
ctor
of
Perf
orm
ance
& In
form
atio
n
Prio
riti
seIn
vest
men
t
Secu
rePr
ocu
rem
ent
Skill
s/M
anag
eLo
cal H
ealt
hSy
stem
To im
pro
ve t
he
pri
ori
tiza
tio
n o
fre
sou
rces
To f
urt
her
dev
elo
pth
e B
oar
d t
op
erfo
rman
cem
anag
e ke
y ar
eas
and
ou
tco
mes
Dev
elo
p c
on
sist
ent
met
ho
do
log
yar
ou
nd
pro
gra
mm
em
anag
emen
t u
sin
gin
du
stry
bes
tp
ract
ice
Staf
f un
ders
tand
too
lssu
ch a
s pr
ogra
mm
ebu
dget
ing
and
pred
ictiv
e m
odel
ling
and
how
the
se c
anin
form
dec
isio
nm
akin
g
Und
erst
and
how
we
enab
le s
yste
mat
icpr
iorit
izat
ion
ofco
mm
issi
onin
g ac
tivity
To e
mbe
d a
VFM
cultu
re u
sing
a r
ange
of t
ools
Key
del
iver
able
as
part
of t
he B
oard
Dev
elop
men
tPr
ogra
mm
e pl
anne
dw
ith K
PMG
To e
nsur
e th
atpr
ogra
mm
em
anag
emen
tpr
ogra
mm
es a
repr
ovid
ed t
o ac
ross
Dire
ctor
ates
usi
ngPD
R as
a m
echa
nism
All
prog
ram
mes
man
aged
eff
ectiv
ely
and
mile
ston
esre
view
ed t
hrou
ghpe
rfor
man
ceac
cele
rato
r
Staf
f un
ders
tand
at
appr
opria
te le
vels
how
VFM
Str
ateg
y (s
igne
d of
fby
the
Boa
rd in
Feb
ruar
y)an
d et
hos
fits
with
the
com
mis
sion
ing
cycl
e,m
arke
t m
anag
emen
t, u
seof
res
ourc
es a
ndpa
rtne
ring
stra
tegy
.U
nder
stan
ding
of
key
stra
tegi
es, i
nclu
ding
the
Prog
ram
me
Del
iver
ySt
rate
gy
The
Boar
d (N
on E
xecu
tives
and
Exec
utiv
es h
old
the
orga
nisa
tion
and
each
othe
r to
acc
ount
bas
ed o
nth
e in
itiat
ives
Th
e Bo
ard
trac
k an
dpe
rfor
man
ce m
anag
e ke
yar
eas
and
outc
omes
Und
erst
and
how
mea
sure
men
t an
dbe
nefit
s tr
acki
ng t
oget
her
with
rob
ust
mile
ston
esan
d de
liver
y tim
elin
es c
anle
ad t
o su
cces
sful
impl
emen
tatio
nsSt
aff
have
the
com
pete
ncie
s ne
eded
to
impl
emen
t ch
ange
and
lead
on
sign
ifica
ntpr
ogra
mm
es o
f se
rvic
ede
sign
.
The
WC
C L
eade
rshi
pPr
ogra
mm
e in
tegr
ates
fit w
ith t
heco
mm
issi
onin
g cy
cle,
mar
ket
man
agem
ent,
use
of r
esou
rces
and
part
nerin
g st
rate
gy.
Und
erst
andi
ng h
owm
easu
rem
ent
and
bene
fits
trac
king
toge
ther
with
rob
ust
mile
ston
es a
nd d
eliv
ery
timel
ines
can
lead
to
succ
essf
ulim
plem
enta
tions
Boar
d D
evel
opm
ent
Prog
ram
me
Del
iver
edan
d D
evel
opm
ent
Plan
sre
view
ed a
s pa
rt o
f th
ePD
R pr
oces
s
Roll
out
of P
rogr
amm
eM
anag
emen
tPr
ogra
mm
e C
larit
y am
ong
staf
f re
the
role
of
the
Prog
ram
me
Man
agem
ent
Off
ice
and
how
the
ir ro
leco
ntrib
utes
to
this
May
200
9
June
200
9
May
200
9
Dire
ctor
of
Fina
nce
PCT
Boar
d
Dire
ctor
of
Patie
nt C
are
and
Prof
essi
ons
55
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
56
Stru
ctu
re
Wo
rld
Cla
ssC
om
mis
sio
nin
gC
om
pet
ency
Org
anis
atio
nal
Dev
elo
pm
ent
Ob
ject
ive
Act
ion
s R
equ
ired
Ou
tco
mes
Mea
sure
sTi
mes
cale
Exec
uti
veLe
ad
To e
nsur
e th
at t
hePC
T ha
s su
ffic
ient
capa
city
and
cap
abili
tyin
the
long
er t
erm
To im
prov
e cr
oss-
dire
ctor
ate
wor
king
,le
arni
ng a
ndun
ders
tand
ing
of r
oles
and
resp
onsi
bilit
ies
Cur
rent
wor
kfor
cean
alys
is c
urre
ntly
unde
rtak
en, h
ighl
ight
ing
pote
ntia
l gap
s ac
ross
PC
T
Plan
s cu
rren
tly b
eing
deve
lope
d to
iden
tify
whe
re s
taff
will
be
base
d,an
d on
wha
t tim
epr
opor
tion
once
the
com
mis
sion
er a
ndpr
ovid
er a
rms
sepa
rate
.
Act
ion
plan
req
uire
d to
addr
ess
any
gaps
,id
entif
ying
whe
re a
ndw
hat
skill
s, k
now
ledg
ew
ill b
e re
quire
d in
fut
ure
To id
entif
y ho
w w
e ca
nad
dres
s ou
r go
als
and
impa
ct o
n th
e w
ell-b
eing
of t
he p
eopl
e of
Kirk
lees
thro
ugh
proa
ctiv
ere
crui
tmen
t pr
actic
es
Com
preh
ensi
ve a
ndco
nsis
tent
pla
ns a
ndst
rate
gies
tha
t ar
eun
ders
tood
and
bui
lt in
toal
l rel
evan
t di
rect
orat
e,te
am a
nd in
divi
dual
pla
ns
Cle
ar p
lan
will
be
prod
uced
re
the
wor
kfor
ce g
aps
inte
rms
of c
apac
ity a
ndca
pabi
lity,
to
incl
ude
for
exam
ple,
bas
ic IT
trai
ning
as
a m
anda
tory
prog
ram
me
for
all s
taff
Regi
onal
wor
kfor
cede
velo
pmen
tco
nfer
ence
wor
k pl
acem
ents
,sl
iver
s of
tim
eca
reer
fai
rs
NH
S st
aff
surv
eyRe
view
of
the
busi
ness
plan
ning
app
roac
hO
utco
mes
of
the
Stra
tegi
c Pl
an
Mar
ch20
09
Mar
ch20
09
Dire
ctor
of
Fina
nce
Dire
ctor
of
HR
& O
D
All
Dire
ctor
s
57
Ambitions for a Healthy Kirklees Organisational Development Plan 2009/10
Further information about the PCT can be found on the PCT’s website
(www.kirklees-pct.nhs.uk) or by contacting the PCT at:
Kirklees Primary Care TrustSt Luke’s House
Blackmoorfoot RoadCrosland Moor
HuddersfieldHD4 5RH
Tel: 01484 466000