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Business transformation
‘Local NHS’
Team/work areas
Reconfiguration• Transformation is work in progress• Learn• Disseminate• Improve• Repeat
• Managing relationships on ‘no disputes’ basis• Problem solving approach
• New contracted forms• Function before form• Understand what you need
• Build good governance into fabric of organisation• Train decision makers
• Prepare• Engage early• F.O.I• Public and patient involvement• Judicial review risk
Learn
Operate
Build
Test foundations
Alliance• Flexible• Remain separate• Risk remains with host• ‘No disputes’ relationship management
Joint ventureorganisation• New single organisation• Limited liability• Own registrations (CQC etc)• Asset/employee transfer• More integration
Prime provider• Lead provider organisation• Manages delivery by sub-contractors • Lead has ability to influence change• Lead responsible for service design• Separate organisations
Merger• Full integration of host organisations• Greater change is possible• Potential for standardisation• Expensive• Competition issues
• Consultation• Contracting• Commissioner/ provider• Decommissioning• Pooling funds• Local authority relationships
• Shared services• Back office• Contracting• Procurement• Legal• Estates• HR
Cost improvement programme (CIPS)
Sustainability and transformation plans
Cultural fit• TUPE impact• Flexibility to move staff• Staff engagement• Building new employer identity
Organisation fit• Contract reviews• Estates planning• Sharing/collaborating/ opportunities
Management fit• Governance processes• Board structure• Decision making requirements
Capability fit• Track record in collaboration• Experience in change management• Support functions and resources available
Business as usual• Governance• Procurement• Contracting• Consultation
Traditional split‘Commissioner’
Carter Savings
New models DaltonReview
Integrated primary and acute care system
Hospital/Chains/Groups
Multi-specialitycommunity providers
Traditional split‘Provider’
• Accountable care organisations• Accountable care system• Integrated care
Who it a�ectsWhat it is calledWhat we do
• Entity creation• Memorandum of understanding• Confidentiality agreements• Alliance contracting• Federations• Joint ventures• Governance• Vires• Merger/competition
Business as usual• Commissioning• Procurement• Consultation• Governance
Money
Managing public money
Joint funds
Who controls? Who pays?
Central funds
What do you want to achieve?
Delegated powers to directorsPossible loss of power to organisation
Essential to clarify terms of reference and Vires
Too slow?
Things to think about
Essential to clarify remit and reporting
New joint organisation board with powers
recommendations back to board
Morale
Communication
People
Ability to appoint joint posts
Check foundation trust constitution
TUPE
Confidentiality
ConflictOperatingmodel
Morale
Consistent with partners?
Keeping your eye on the ball
Build foundations
LeearnnWider regional service reconfiguration
Maintains individual organisationspower and clear discharge of functions
Teest founddationss
Buuildfounddationss
Buuild
Opperaate
Service transformation‘All great changes are preceded by chaos’At a time when the NHS is subject to an unprecedented level of transformation, our service transformation series highlights some of the key issues all NHS organisations should consider, whatever their transformation plans.
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About Hill DickinsonAs a long-standing provider of legal services to the health sector, Hill Dickinson understands the key issues and motivators facing healthcare organisations today. We act for more than 100 healthcare organisations, providing an unparalleled range of legal services with a distinctly commercial approach. With specialists in all areas of health-related law, we offer practical, timely advice and a proactive response to finding the best solution. With our experience, we see the bigger picture, providing advice that is focused yet sensitive to meeting our clients’ and their patients needs.
Key contactsFind out how we can make a difference to your organisation, please contact:
Sarah Brooke Partner +44 (0)20 7280 9347 [email protected]
Emma Stockwell Partner +44 (0)151 600 8173 [email protected]
Michael Wright Partner +44 (0)161 817 7266 [email protected]
