Organisational Development Strategy 2016 2019 · Welcome to NHS Halton CCGs Organisational Development Strategy 2016 – 2019. ... development of the organisation in line with

Page | 1

Organisational Development Strategy

2016 – 2019

Approved by Governing Body – July 2016

Page | 2

NHS Halton CCG

OD Strategy 2016 – 2019

Contents

Section Heading Page No

Executive Summary 3

1. Introduction 4

2. Strategic objectives 5

3. Successes 5

4. Developing the OD Strategy 2016 – 2019 6

5. Health of the local population 7

6. Internal and external context 8

7. Links with other strategies 11

8. Governing Body engagement 12

9. Staff engagement 13

10. OD objectives for 2016 – 2019 15

11. Monitoring and review 17

Appendix 1 18

Appendix 2 19

Appendix 3 20

Appendix 4 21

Appendix 5 23

Appendix 6 25

Page | 3


Executive Summary

Welcome to NHS Halton CCG’s Organisational Development Strategy 2016 – 2019. We are proud of all we have achieved to date and this strategy builds on this success, ensuring it supports the continued development of the organisation in line with the current key priorities described in our Operational Plan.

Over the next five years the NHS face increasing challenges with the demand for health and social care services rising and the need for a health and social care system that delivers excellence and a positive experience for those requiring these services.

This OD Strategy seeks to support the CCG as it rises to the external challenges, ensuring the workforce is equipped with the necessary skills and behaviours to accelerate performance in order to ensure the strategic aims of the organisation are delivered in conjunction with key stakeholders and within the challenging financial framework.

The strategy includes an implementation plan for year 1 to start our journey in achieving the ambitious goals contained within the document.

We are grateful to the members of the Governing Body and the staff of NHS Halton CCG for their input into this revised strategy and their on-going commitment to the work of the CCG

Dr Cliff Richards Simon Banks Chair Chief Officer

Page | 4


1. Introduction

NHS Halton Clinical Commissioning Group (CCG) is now in its fourth year of operation following authorisation on 1st April 2013. Made up of representatives from each of the 17 practices across Runcorn and Widnes, the CCG is responsible for planning NHS services across the borough, working with other clinicians and healthcare providers to meet the needs of local people. This includes:

Elective hospital care

Rehabilitation care

Urgent and emergency care

Most community health services

Mental health and learning disability services

General Medical Services

The CCG is committed to working with patients and healthcare professionals, as well as in partnership with local communities and Halton Borough Council to make sure that health and social care is linked together for people whenever possible. In addition to GPs, the Governing Body membership includes a variety of specialists including secondary care.

The ethos of the CCG is encapsulated in its vision and values:

Vision

‘Involving everybody in improving the health and wellbeing of the people of Halton’

Values

Partnership: We will work collaboratively with our practices, local people, communities and with other organisations with whom we share a common purpose.

Openness: we will undertake to deliver all business within the public domain unless there is a legitimate reason for us not to do so.

Caring: we will place local people, patients, carers and their families at the heart of everything we do.

Honesty: we will be clear in what we are able to do and what we are not able to do as a commissioning organisation.

Leadership: we will be role models and champions for health in the local community.

Quality: we will commission the services we ourselves would want to access.

Transformation: we will work to deliver improvement and real change in care.

Page | 5

2. Strategic Objectives

The CCG’s strategic objectives where refreshed during 2015 and are:

Number Objective 1 To commission services which continually improve the health and wellbeing of

Halton residents

2 To engage with local people and communities about our work and plans

3 To develop plans which will deliver improvements in local health services whilst making efficiency savings

4 To deliver all of our statutory duties and commissioning responsibilities effectively, whilst ensuring there are robust constitutional, governance and financial control arrangements in place

5 To develop into a high-performing organisation, working with our partners to deliver a joined-up approach to commissioning wherever possible.

3. Successes

NHS Halton CCG has made significant progress in its development journey and is proud to have

won the Primary care Innovation Award at the HSJ Awards in 2015. Alongside this some key

achievements since the approval of the OD Strategy 2012 – 2015 include:

Governing Body The Governing Body has continued to recognise the need to continuously develop as a board and as such has engaged in activities to ensure a consistent evidence based approach to board development is underway to ensure the continued success of the organisation.

The Governing Body continues to invest time in planned development activities and remains committed to ensuring all development work undertaken is understood, shared and consistent with development activities across the organisation.

Workforce and Leadership

Quarterly team development sessions have been a key commitment for the CCG during 2014/15 and these continue with an extended membership to include relevant CCG & HBC staff.

Staff Survey Culture. This information has been a useful barometer check for the CCG providing baseline information to continually assess the culture and working environment for staff. Year 2 demonstrated improvements on year 1, and continued evidence of staff satisfaction with the role and working environment.

Health & Wellbeing Plan Developed Heads of Function Group established to provide peer support to

Managers and enable EMT to delegate operational matters Executive Management Team expanded its membership.

Page | 6

A culture of one team working together was highlighted as a development need for the organisation in 2014/15.

The CCG has taken on new teams supporting additional responsibilities from April 2015 and has in-housed some activity previously provided by the Commissioning Support Unit (CSU).

Further integration with HBC has provided alignment with a range of work areas and joint working with a wider team of staff.

Member Practice Engagement

The CCG has a signed constitution in place which outlines the relationship between the CCG and member practices.

Over the past 12 months significant work has been undertaken to ensure member practices are fully involved in the decision making processes of the CCG.

This is reflected in the feedback through the recent NHS England 360o review. Fewer practices contributed to the 360o in 2015.

The CCG has developed a Primary Care Strategy in 2014/15 that will require transformational change for practices.

The CCG has been awarded £1.6m from the Prime Ministers Challenge Fund that will be used to initiate transformation in primary care.

4. Developing the OD Strategy 2016 – 2017

Model for Organisational Development

There are many definitions of Organisational Development (OD) which may vary in emphasis, but there are some common features:

1. OD applies to changes in the strategy, structure, and / or processes of an entire system, such as an organisation, a single or multiple part of an organisation, a department or work group, or individual role or job.

2. OD is based on the application and transfer of behavioural science knowledge and practice (such as leadership, group dynamics and work design), and is distinguished by its ability to transfer such knowledge and skill so that the system is capable of carrying out more planned change in the future.

3. OD is concerned with managing planned change, in a flexible manner that can be revised as new information is gathered.

4. OD is orientated to improving organisational effectiveness.

OD is best defined as a planned system of change concerned with an organisation’s:

Health and its ability to create a high quality of working life for its employees

Effectiveness and its capacity to solve problems and ability to adapt and change

Page | 7

The CCG is committed to taking a whole systems approach for the OD programme to ensure the interrelationships between people, structures and systems to deliver organisational goals are taken into account.

This OD strategy has been developed using the McKinsey 7s model1 (Appendix 1) and is based upon the theory that, for an organisation to perform well, the seven elements within the model need to be aligned and mutually reinforcing.

5. Health of the local population

Over the last 10 years Halton’s population has increased by 7,600 residents, the significant areas being in the 0-4, 45-64 and 75+ age groups whilst the 5-14 age group has decreased2. The health of people in Halton is generally worse than the England average. Life expectancy for both men and women is lower than the England average3 with vast differences in life expectancy between the most deprived areas of Halton and the least deprived areas4.

Appendix 2 gives an overall summary of the health profile: some key things to note being:

Decrease in the overall death rates from heart disease and cancers

Decrease in the number of adults who smoke

Improvement in the diagnosis and management of common health conditions such as diabetes and cancers

Improved percentage of children and older people having their vaccinations and immunisations

Above the national average for the number of children participating in at least three hours of sport/ physical activity per week

Higher proportion of women who die from cancer than anywhere else in the country. A lot of this is due to lung cancer caused by smoking

Rise is obesity with links to incidence of diabetes

Alcohol and substance misuse continue to create challenges for both the health service and wider society, in particular crime and community safety

Increase in admissions to hospital due to alcohol related conditions with those under the age of 18 being amongst the highest in the country (2007-2010 figures)

Highest incidence in admissions due to substance misuse (age 15-24 years) in England (2008-2011 figures)5

These health and social challenges impact upon services requirements and hence how the

CCG commissions in response to this.

1 From In Search of Excellence, TJ Peters and RH Waterman Jnr 1982 Harper and Row

2 Halton Health and Wellbeing Strategy 2013-2016, p. 6

3 Public Health England Health Profile 2014 – Halton – 14

th August 2014

4 Public Health England Health Profile 2014 – Halton – 12

th August 2014

5 Halton Health and Wellbeing Strategy 2013-2016, p. 7-8

Page | 8

6. Internal and External Context

National Context

There have been many national changes to health and social care policy in recent years. One significant vision that underpins this is for the closer working of health and social care services. National policy has been designed to remove barriers between these two areas moving from partnerships, to formal joint working and, in some instances, fully integrated services with pooled funding.

Legislative changes with the NHS Act 2006 has given more scope to progress joint working, foster partnerships between health and social care agencies and to bring down the barriers between health and social care.

The Health and Social Care Act 2012 further supports the integration agenda with the introduction of the Better Care Fund: a catalyst to ensure that the integration agenda was progressed, services improved and value for money ensured.

Over the next five years the NHS face increasing challenges with the demand for health and social care services rising and the need for a health and social care system that delivers excellence and a positive experience for those requiring these services.

The NHS Five Year Forward View6, published on 23 October 2014 sets out a new shared vision for the future of the NHS based around the new models of care. In delivering this vision, the guidance introduces a Triple Aim framework that describes an approach to optimising health system performance through the simultaneous pursuit of three dimensions:

1. Improving the quality of healthcare 2. Improving the health of the population, and 3. Achieving value and financial sustainability

Furthermore, the outcomes from the Carter Review7 recommend that hospitals standardise procedures, be more transparent and work more closely with neighbouring NHS Trusts. The review outlines 9 must dos which are given in Appendix 3.

6 Five Year Forward View: NHS England, October 2014

7 Operational productivity and performance in English NHS acute hospitals: Unwarranted variations An

independent report for the Department of Health by Lord Carter of Coles, February 2016

Page | 9

NHS Halton CCG

The OD Strategy seeks to support the CCG as it rises to the external challenges described, ensuring the workforce is equipped with the necessary skills and behaviours to accelerate performance in order to ensure the strategic aims of the organisation are delivered in conjunction with key stakeholders and within the challenging financial framework.

Therefore the actions contained within the strategy underpin the successful delivery of strategic priorities as outlined below. Supporting this is the need to ensure the CCG is able to measure the maturity of the CCG in regards to risk management and business continuity in order to ensure business critical functions are available and able to maintain acceptable levels of service and consistency.

One Halton

NHS Halton CCG is committed to pursuing integration with Halton Borough Council, believing that through real partnership working with the local authority and other organisations across all areas of their work every opportunity can be maximised to make a real difference to improve health and wellbeing in the Borough. The NHS Five Year Forward View makes this case strongly and compels NHS Halton CCG, its partner organisation and the local community to embark upon radical transformation of all aspects of the care commissioned and delivered. In response, NHS Halton CCG and its partners refreshed and aligned its previously published five year strategy 2014 – 2019, clearly setting out its vision for the future, progress made to date and commissioning intentions for 2015/16.

During 2014/15, with its member practices and local partners, the CCG developed and produced a Strategy for General Practice Services in Halton. Implementation commenced during 2015/16 the vision of which is to deliver sustainable general practice services that are at the heart of out of hospital care in the Borough. From this Strategy and other work on new models of urgent care and community services provision, a future service model has emerged: One Halton.

One Halton is a philosophy, a way of working that involves joining up all the services that deliver care and wellbeing to the people of Halton. The vision is for multi-specialty community provision, harnessing the talents and skills of all health and care organisations to ensure the right care and support is provided, at the right time, in the right place to provide the best possible outcomes for everyone. The core objectives of One Halton is to

To work better together regardless of discipline

To find or identify those 'hidden' people who don't access care

To treat and care for people at the right time, in the right place by the right people

To help people stay healthy and keep generally well

To provide the very best in care, now and in the future

Provide a programme of ill-health preventative strategies

Page | 10

Operational Plan 2016 – 2017

The CCG’s operational plan for 2016/17 sets the framework for the place based commissioning of health and wellbeing services in Halton with a particular emphasis on prevention and early intervention.

The CCG is committed to embedding a Cultural Commissioning Manifesto which sets the cultural way of being for the CCGs vision of commissioning. Integration is key to the strategic approach with all partners working together to deliver joint commissioning, culture change through community development, training for all staff in how to deliver health messages to every contact counts, development of multi-disciplinary teams and joint advocacy and policy work.

Sustainability and Transformation Plan

Cheshire and Merseyside CCGs, Local Authorities and Provider Trusts agreed in January 2016 that the geographical footprint for the local Sustainability and Transformational Plan (STP) would encompass the whole of Cheshire and Merseyside. Therefore, the STP will work to deliver the high level strategic transformational change areas, rationalising wider service provision and driving the major network programmes

NHS Halton CCG is also a member of the Alliance Local Delivery System, together with Warrington. St Helens, Knowsley, West Lancashire and Southport and Formby CCGs. This LDS is the single largest LDS within the STP with a population of approximately one million people. The LDS incorporates the acute trusts of Warrington and Halton, St Helens and Knowsley and Southport and Ormskirk, plus 5 Boroughs Partnership NHS Foundation Trust and Bridgewater Community Healthcare NHS Foundation Trust.

Furthermore, the CCG will produce its own Sustainability and Transformational Plan setting of the key priorities and actions for the five years to 2021. It will be a fully integrated Health and Wellbeing Strategic Plan focussing solely on the delivery of services to the local population and the financial sustainability of the borough

Devolution

Liverpool City Region made a formal submission to the 2015 Comprehensive Spending Review (CSR) outlining proposals for a devolution framework which will enable them to draw down powers, control and resources from central to the Liverpool City Region Combined Authority.

This will enable the City Region to have greater control and influence over funding and to ensure there is greater value from existing investment that is clearly focused to raise productivity, transform lives and the economy.

Page | 11

Through this the vision is to deliver a ‘place-based’ approach to:

Accelerate economic growth: growing jobs and increasing productivity;

Public service reform: local re-design and co-ordination of services to reduce costs and improve outcomes across the whole of the public sector

Improved social outcomes and better health and wellbeing of local residents.

7. Links with other strategies

The OD strategy will be aligned with other CCG strategies so the actions support the key

objectives contained within these strategies. These include:

Strategy Key Themes / Objectives

5 Year Strategic Plan

Aligned with the Better Care Fund, this integrated approach has 8 priority areas:

Maintain and improve quality standards

Fully Integrated commissioning and delivery of services across Health & Social care

Proactive prevention, health promotion and identifying people at risk early

Harnessing transformational technologies

Reducing health inequalities

Acute and specialist services will only be utilised by those with acute and specialist needs.

Enhancing practice based services around Specialisms

Providers working together across interdependencies to achieve real improvements in the health and wellbeing of our population.

Financial Strategy

To give an overview how the financial allocations received from NHS England are used to commission healthcare services

To detail how the CCG will manage the costs of management, administration and commissioning functions carried out by the organisation.

Quality Strategy

Five key strategic areas for driving quality improvement:

Patients

People

Partnerships

Performance

Procurement

Page | 12

Sustainability Plan 2016 – 2021

Transformation of service provision to ensure the sustainability of services and financial position within the health system by 2021. For NHS Halton CCG the size of the anticipated deficit is anticipated to be beyond the CCG’s ability to deliver a balance position within the current financial year. This therefore links to and requires a robust financial recovery strategy with a realistic set of milestones and completion dates to bring the position back into balance

Communication & Marketing Strategy

To build on the CCG’s national reputation for being progressive and innovative.

Continue enhancing the organisation’s reputation at a leader of the local NHS system

Consultation and Engagement Strategy

To continue to build meaningful engagement with our public, patients and carers to influence the development of services and improve the health and wellbeing of people in Halton

To ensure that the CCG is clearly visible as the leader of the local NHS and to instil confidence, with patients, public, provider and partner organisations in the CCG as an effective commissioning organisation

Develop a culture within the CCG that promotes and facilitates open consultation and engagement, with all stakeholders

Continue to develop effective consultation channels to ensure that local people have the information they need to enable them to access the right care at the right time, helping them to look after themselves and improve their health and wellbeing

Equality and Diversity

To make fair and transparent commissioning decisions;

To improve access and outcomes for patients and communities who experience disadvantage

To improve the equality performance of our providers through robust procurement and monitoring practice

To empower and engage our workforce

Ensuring robust processes for commissioning and decommissioning of services

Page | 13

8. Governing Body Engagement

Engagement with the Governing Body has been key to ensuring the development of the OD programme supports the overall aims of the organisation. Equally ownership and championing of the OD Strategy by the Governing Body is fundamental to its success. As part of the engagement exercise the Governing Body members were asked to consider:

If the CCG was being the best that it could be: what would be happening and how would the organisation be working

What are the big ambitious goals that should inform the OD Strategy

What support is needed to achieve these goals

Who are the key partners and how can the CCG work best with them

The feedback from the engagement session are given in Appendix 4, however the critical areas which the OD objectives are given below. The actions contained within the implementation plan need to be aligned to these to support their delivery.

Being the best that we can be

Healthy, productive and active CCG workforce

Great public engagement and communication: listening as well as talking

Better clinical care

Knowing our Unique Selling Point: what sets us apart

Clear understanding of our goals and being focused

Our big ambitious goals

Creating and maintaining organisational resilience

Technology that enables not inhibits

Saving £8M and meeting our sustainability agenda

Meeting the Triple Aims

Facilitating social action

Support to achieving

Ensuring resources: time and money

Taking time to think and reflect

Working from a better evidence base

Fully engaged and working ‘One Halton’

Successful partnerships

Effective membership engagement o Identifying what prevents this happening o Sharing the workload o Knowing where we are and where we need to

be

Effective partnership working with the public: living our values

Page | 14

Effective partnership working with other statutory organisations (Fire, Police, NHSE, Housing etc)

9. Staff Engagement

Staff involvement is also an essential building block in the development of the OD Strategy: the CCG is committed to ensuring staff who work for the CCG feel involvement and engaged.

This commenced with the staff cultural survey, the questions of which are given in Appendix 5. Following completion of the survey, staff will be invited to be further involved in the development of actions for priority areas identified:

Engagement with the population regarding the decisions the organisation has to take on the provision of healthcare for the population of Halton

Lines of communication within the CCG provide staff with a sense of direction

Line managers take a positive interest in the health and wellbeing of staff

Everyone feels they are an important part of the CCG

Belief that the CCG provides equal opportunities for career progression and promotion

Staff feel supported by the clinical leaders

During the CCG away day in May 2016, staff were involved in the development of the Standards of Behaviours. Following approval work will continue to ensure these behaviours are embedded.

Page | 15

10. OD Objectives 2016 – 2019

The OD objectives of the three year strategy are given below alongside the 2016/17 actions detailed in the implementation plan (Appendix 6)

OD Theme 3 Year OD Strategy Objective 2016/2017 action

Shared values Embed behaviours to accelerate performance and deliver 5 year forward view

1. Build on organisational vision and values and develop standards for behaviours 2. Arrange a sharing event for all staff, governing body members and clinical leads

to promote a one team philosophy with integrated activities that promote team building and the development of trust

Strategy

Embed the CCG culture commissioning manifesto: our way of being and the way we are going

3. Enhance the Health and Wellbeing Group to enable staff to identify champions and take ownership of implementation of the staff survey action plan

4. In light of STP develop a programme to ensure staff have the skills required to lead their area of work

Ensure effective public engagement and communication: listening as well as talking to facilitate social action

5. Ensure public engagement and communication is central to the transformational change programme and takes into account the public sector duty contained within the Single Equality Act 2010

Structure Facilitate effective partnership working: realising the vision for One Halton

6. Executive Management Team to create space to future plan for changes to Governing Body to ensure the development of capacity and capability for delegated commissioning responsibilities

7. Ensure joint working arrangement with key stakeholders are understood and are effective

8. Review outcomes from stakeholder survey 2016 and identify actions required 9. Executive Management Team to develop opportunity for joint horizon scanning

opportunities with local authority

Page | 16


Systems Monitor performance: having the confidence to challenge

10. Embed PMO methodology to support the delivery of the 5 Year Plan for Halton CCG (including One Halton) to enable greater analysis of data, consistency in approach and methodology, clarity for wider membership and a bottom up approach to delivery

11. Further develop the Primary Care Commissioning Committee and embed standards for behaviours within the agreed terms of engagement

12. Develop a measure of the maturity of the CCG in regards to risk management and business continuity

Staff Support a resilient workforce: ensuring staff and organisational wellbeing and resilience

13. Review the IQ programme and ascertain if the NHS Change model has been adopted as the methodological approach to change management within the CCG

14. Work with practice nurses using an appraisal process to ensure 6cs are prevalent in their work, and support revalidation process

15. Use the themes from the staff survey, collate team personal development needs into CCG TNA and source relevant learning solutions in terms of decision making, accountability, culture of one team working together and being creative in our approach to work

Skills

Ensure strong plans are in place to support transformation: ensuring staff have the skills to lead transformation

16. Ensure alignment of the organisational development activities with 5 Year Forward View to ensure staff have the required skills to future forecast, generate scenarios, understand economic modelling in their commissioning responsibilities, and work towards commissioning for outcomes

17. Continue to look to the quarterly team development sessions to ensure staff are equipped with the appropriate skills and development opportunities they need to complete their roles

Page | 17


Style

Develop Systems Leaders and embedding a system leadership approach

18. Continue to plan and ensure participation of Governing Body development. Sessions to encompass strategy, governance and values. The priority area for 2016/17 includes

One Halton

Delegated commissioning of primary care

Primary care strategy implementation

Sustainability 19. Support the on-going development needs of the clinical leads. Continue to

support succession planning for the role of Chair and Clinical Leadership posts across the CCG

20. Develop a talent management and succession planning approach and complete the NHS Leadership self-assessment tool

Maintain effective membership engagement: supporting clinical leadership to deliver key objectives

21. Ensure member practice engagement and communication through Service Development Committee

22. Develop a planned programme of activities to support transformational leadership development centred around

Assessment coaching conversations for potential candidates

Clinical leadership self-assessment framework tool & assessment centres

Clinical leadership development plan with actions and activities for the individual

23. Review clinical leadership model & further strategic clinical lead role to enhance the contribution of clinical leads to the commissioning plan and the 5 year forward view

24. Provide greater clinical input to the EMT and support a joined-up approach linking individual clinical lead work areas

Page | 18

11. Monitoring and Review

Following approval by the Executive Management Committee and the HR / OD Committee, the strategy will be presented to Governing Body for final endorsement.

On-going monitoring of the action plan will be the responsibility of the HR / OD Committee who will report on progress as required. Success will be evaluated through a number of mechanisms including:

Staff survey feedback

Stakeholder survey feedback

Achievement of actions and acknowledging the contributions of the overall objectives of the CCG

Page | 19

Appendix 1

McKinsey 7s Model

Plans for the allocation of

an organisation’s scarce

resources, over time, to

reach identified goals:

environment, competition

and customers

The procedures, processes

and routines that

characterise how important

work is to be done: financial

systems, hiring, promotion

and performance and

appraisal systems,

information systems.

Numbers, types and skill mix

of personnel within the

organisation; any resourcing

issues, performance and the

workforce

What the organisation

stands for and what it

believes in, its central

beliefs and attitudes

Distinctive

capabilities of

personnel or of the

organisation as a

whole

Objectives and

performance

Roles and

responsibilities Governance and

business processes

Leadership and

management

development

Learning,

development

and talent Workforce

capacity and

capability

Purpose and

belief

The way the

organisation’s functions

and services units relate

to each other: corporate

directorates; divisional

operational business units

Cultural style of the

organisation and how

key managers behave in

achieving the

organisation’s goals

Page | 20

Appendix 2 Halton Health Profile: changes 2014 to 2015

2014 2015

Trend Indicator Number

Indicator Halton Value

Signif to Eng

Halton Value

2014 Signif to

Eng

1 Deprivation 48.8 48.8 No update

2 Children in poverty (under 16s) 26.7 25.6

3 Statutory homelessness 0.3 0.9

4 GCSE achieved (5A*-C) 62.5 57.2

5 Violent crime (violence offences) 12.8 13.2 =

6 Long term unemployment 13.7 9.6

7 Smoking status at time of delivery 18.9 19.0 =

8 Breastfeeding initiation 52.3 51.6

9 Obese children (Year 6) 23.9 21.1

10 Alcohol-specific hospital stays ( 18) 73.5 60.5

11 Under 18 conceptions 40.4 33.3

12 Smoking prevalence 22.6 18.4

13 % of physically active adults 49.8 51.5

14 Obese adults 35.2 35.2 No update

15 Excess weight in adults 70.2 70.2 No update

16 Incidence of malignant melanoma 17.4 20.7

17 Hospital stays: self-harm 325.9 361.0

18 Hospital stays: alcohol related harm 814.4 814.0 =

19 Drug misuse 8.4 8.4 No update

20 Recorded diabetes 7.2 7.3 =

21 Incidence of TB 0.0 0.5 =

22 Acute sexually transmitted infections

Not comparable 677.0

Not comparable

23 Hip fractures: people 65yrs and over 553.1 838.0

24 Excess winter deaths (three year) 9.5 15.2

25 Life expectancy at birth (male) 77.1 77.3 =

26 Life expectancy at birth (female) 80.6 80.4 =

27 Infant mortality 3.9 2.9

28 Smoking related deaths 415.5 416.0 =

29 Suicide rate 7.8 9.6

30 75yr mortality rate: cardiovascular 112.2 101.1

31 75yr mortality rate: cancer 190.2 188.0

32 Killed and seriously injured on roads 32.1 31.8 =

not significantly different to England average

significantly better than England average

significantly worse than England average

Source: Public Health England

Page | 21

Appendix 3

Carter Review 2016: 9 must dos for the NHS

1. Develop a high quality and agreed ‘sustainability and transformation plan’ that will

dictate the most locally critical milestone that must already be achieved in 2016-17.

2. Providers must return to aggregate financial balance, including secondary care

providers delivering efficiency savings and complying with the maximum total

agency spend and hourly rates.

3. All organisations to develop and implement a local plan that addresses the

sustainability and quality of general practice, including existing workforce and

workload issues.

4. Get back on track with access standards for A&E and ambulance waiting times to

make sure at least 95% of patients do not wait more than four hours to be seen, and

that all ambulance trusts respond to at least 75% ‘Category A’ calls within eight

minutes. This will require making progress in implementing the urgent and

emergency care review and associated ambulance standard pilots.

5. Delivery improvements against standards that dictate more than 92% of patients or

non-emergency pathways must wait no more than 18 weeks from referral to

treatment, as well as offering patient choice.

6. Meet the 62-day cancer waiting standard, including by safeguarding better

diagnostic capacity, and continue to improve the two-week and 31-day cancer

standards. Providers are also asked to make progress in ensuring one-year survival

rates are kept by delivering a year-on-year improvement in the proportion of cancers

diagnosed at an earlier stage.

7. Achieving and maintaining two new mental health access standards: more than 50%

of people experiencing a first episode of psychosis will start treatment with a NICE-

approved care package within two weeks of referral, and 75% of those with

“common mental health conditions” will be referred to the Improved Access to

Psychological Therapies (IAPT) programme, treated within six weeks of referral (but

95% treated within 18 weeks). At least two-thirds of the estimated number of people

with dementia must be diagnosed.

8. Local pans must seek to transform care for those with learning disabilities, including

by implementing better community provision, reducing inpatient capacity and rolling

out treatment reviews aligned with published policy.

9. All NHS organisations must develop and introduce an affordable plan to improve

quality, particularly for those currently in special measures and publish avoidable

mortality rates annually.

Page | 22

Appendix 4

Governing Body Engagement Session: 21st April 2016

If we were being the best that we can be: what would be happening &

how would we be working

Understanding public & patient views / ideas / concerns / expectations

Listening to population, statutory organisations, voluntary sector etc.

Engaged membership

Shared services acute providers

Better pathways: primary and secondary care

Clinical leads working together not alone

Single clinical system

Prioritise and do must dos

Healthy, productive & active workforce. Attitude of can do and avoid burn out

Focus

Hitting targets, be fully responsible for budgets, financially sound

Using mode technology to communicate

Planning, partnership and integration

Innovative: live by our values

Our big ambitious goals that inform our OD Strategy

Facilitate social action

System integration / technology

Hospital when hospital is needed

Raising expectations of good health / ownership of health

PN best friend

Communications improved

Resilient organisation and workforce

Succession planning: preparing for the future

Do not duplicate and reduce waste

Triple Aim

Improving health and wellbeing: reducing inequalities

Save £8M and be sustainable

Strong relationships with public health

One Halton working better together

What support do we need to help us get there

7 day working: GP engagement

Explore skills gap

Better evidence: know our business, data and future

Shared agreed vision

IT infrastructure

Use the media more

Time and capacity to do important work

Engagement and buy in from all

Positive messages

One Halton fully engaged scenario

Who are our partners and how can we work best together

Member practices, clear understanding on roles etc

Providers: clinical engagement

NHSE

Local authority: are we where we are / change we go further

Other CCG’s: getting to know and sharing the load

Public health

Police, fire, NWAS, Housing

Politicians: council / leaders

Page | 23

Partners engaged

Space to think and reflect

resources

Voluntary sector: build on relationships

Public – information – high DNA etc

Community pharmacists

Public: live our values

Optometrists, dentists

GPs, members

External providers / social values

Page | 24

Appendix 5

Staff Cultural Survey 2016

Answer either Strongly Agree, Agree, Disagree, Strongly Disagree

Objectives and Vision

1. I understand how my role supports NHS Halton CCG in achieving its objectives and overall vision

2. I work well with others to accomplish the objectives and vision of our CCG 3. I believe we engage with and listen to our population in the decisions we have to

take on the provision of healthcare for Halton

Working Culture

1. I believe I am part of a clinically led organisation 2. I am supported in my role by the clinicians working in the CCG 3. I understand what I am responsible for and when I need to seek approval from my

line manager 4. We have clear lines of communication within the CCG which provides me with a

sense of direction 5. I believe we have a strong culture of teamwork and collaboration at Halton CCG 6. I believe we have the freedom we need to get the job done 7. Our values are visible to me in the way we conduct our work at the CCG

Health and Wellbeing

1. Work does not adversely affect my health 2. My immediate manager takes a positive interest in my health and wellbeing 3. My organisation takes positive action on health and wellbeing 4. I am encouraged to take personal responsibility for my H&W

Personal Value

1. I am made to feel that I am an important part of the CCG 2. My opinions are listened to and really count in the running and development of the

organisation 3. My role is enjoyable and challenging 4. I have had opportunity to use my skills effectively within the CCG 5. I am encouraged to find new and better ways to get work done

Page | 25

Working Environment

1. I have experienced harassment, bullying or abuse from patients, relatives or the public in the last 12 months

2. I have experienced harassment, bullying or abuse from staff engaged within NHS Halton CCG in the last 12 months

3. I believe the CCG provides equal opportunities for career progression or promotion

4. In the last 12 months I have personally experienced discrimination at work from any of the following: Management/team leader or other colleagues

Job Satisfaction

Using a score ration of 1-5 with one being strongly dissatisfied, and 5 being completely satisfied:

1. Overall, how satisfied are you with your role at NHS Halton CCG?

Page | 26

Appendix 6

NHS Halton CCG

OD Strategy Implementation Plan

July 2016 / December 2017

Organisational Development Objective

Agree Action / Development Need Timescales Responsible Person / Methodology

Shared Values: Purpose and belief

Embed behaviours to accelerate performance and deliver 5 year forward view

Build on the organisation vision and values and develop standards for behaviours

July - Dec 2016 Head of Corporate Services / CSU OD Team

Arrange a sharing event for all staff, Governing Body Members and Clinical Leads to promote a one team philosophy with integrated activities that promote team building and the development of trust

Mar 2017

Chair / Chief Officer / CSU OD Team

Quarterly team development days

Establish annual sharing event

Strategy: Objectives and performance

Embed the CCG cultural commissioning manifesto: our way of being and the way we are going

Enable staff to understand and embed the cultural manifesto to underpin the work of the CCG

Mar 2017

Chair / Director of Transformation

In light of STP develop a programme to ensure staff have the skills required to lead their area of work

April 2017

Chief Officer / Head of Corporate Services / CSU

Ensure great public engagement and communication: listening as

Ensure public engagement and communication is central to the transformational change programme and takes into account the public sector duty

On-going Chief Nurse / Engagement Lead / Communications Lead

Page | 27



well as talking to facilitate social action

contained within the Single Equality Act 2010

Structure: Roles and responsibilities

Facilitate effective partnership working: realising the vision for One Halton

Executive Management Team to create space to future plan for changes to Governing Body to ensure the development of capacity and capability for delegated commissioning responsibilities

Nov 2016


Away day programme for EMT every 6 months

Ensure joint working arrangements with key stakeholders are understood and are effective

On-going Director of Transformation

Review outcomes from stakeholder survey 2016 and identify actions required

Sept 2016 Chief Officer / Head of Corporate Services

Executive Management Team to develop opportunity for joint horizon scanning opportunities with local authority

July 2016 - Dec 2017

Chief Officer / Head of Corporate Services

Establish quarterly joint EMT / SMT with HBC

Systems: Governance and business processes

Monitor performance: having the confidence to challenge

Embed PMO methodology to support the delivery of the 5 Year Plan for Halton CCG (including One Halton) to enable greater analysis of data, consistency in approach and methodology, clarity for wider membership and a bottom up approach to delivery

Sep 2016 – Mar 2017

Head of Planning / CSU OD / Transformation Team

Integrating PMO methodology into commissioning hub

Develop Primary Care Commissioning Committee and embed standards for behaviours within the agreed terms of engagement

July – Dec 16 Director of Commissioning/Head of Primary Care

Page | 28



Develop a measure of the maturity of the CCG in regards to risk management and business continuity

March 2017 CSU

Staff: Workforce capacity and capability

Support a resilient workforce: ensuring staff and organisational wellbeing and resilience

Review the IQ programme and ascertain if the NHS Change model has been adopted as the methodological approach to change management within the CCG

Mar 2017 Chief Officer / Head of Corporate Services / CSU

Work with Practice Nurses using an appraisal process to ensure 6cs are prevalent in their work, and support revalidation process

Mar 2017 Deputy Chief Nurse

Practice Nurse Forum

Use the themes from the staff survey, collate team personal development needs into CCG TNA and source relevant learning solutions in terms of

Decision making

Accountability

Culture of one team working together

Being creative in our approach to work

Oct 2016 Head of Corporate Services / CSU

Develop the Health and Wellbeing Group to enable staff to identify champions and take ownership of implementation of the action plan

Sept 2016 – Mar 2017

Chair / HR Business Partner

Skills: Learning, development and talent Ensure strong plans are in place to support transformation: ensuring staff have the skills to lead transformation

Ensure alignment of the organisational development activities with 5 Year Forward View to ensure staff have the required sills to future forecast, generate scenarios, understand economic modelling in their commissioning responsibilities, and work towards

On-going Chief Officer / Head of Corporate Services / CSU

Page | 29



commissioning for outcomes

Continue to look to the quarterly team development sessions to ensure staff are equipped with the appropriate skills and development opportunities they need to complete their roles

On-going


Heads of Function Group to inform development of away days

Style: Leadership and management development

Develop systems leaders and embedding a systems leadership approach

Continue to plan and ensure participation of Governing Body development. Sessions to encompass strategy, governance and values. The priority area for 2016/17 includes

One Halton

Delegated commissioning of primary care

Primary care strategy implementation

Sustainability

July 2016 – April 2017

CCG Clinical Chair / Chief Officer / Head of Corporate Services

Create capacity and develop capacity for One Halton and delegated commissioning

Coaching support via NW Leadership Academy grant and access to approved executive coaches

Support the senior management team to further develop opportunities to broaden their system leadership roles across the health economy

On-going Chief Officer / Chair

Support the on-going development needs of the clinical leads. Continue to support succession planning for the role of Chair and Clinical Leadership posts across the CCG

On-going CCG Clinical Chair / Chief Officer / Head of Corporate Services

Page | 30



Develop talent management and succession planning approach. Complete the NHS Leadership self-assessment tool

Mar 2017 Chief Officer / Head of Corporate Services / HR Business Partner

Maintain effective membership engagement: supporting clinical leadership to deliver key objectives

Ensure member practice engagement and communication through Service Development Committee and Members Forum

On-going Chair / Director of Transformation / Strategic Clinical Leads

Review how we engage with our members and consider different methods

Sep – April 2017

EMT / Communications Team

Develop a planned programme of activities to support transformational leadership development centred around

Access to national assessment centre

Assessment coaching conversations for potential candidates

Clinical leadership self-assessment framework tool

Clinical leadership development plan with actions and activities for the individual

Access to appropriate clinical leadership

CCG Clinical Chair / Chief Officer / Head of Corporate Services

Access to NW Leadership Academy Aspiring Leaders programme

Shadowing opportunities Board to Board CCG / HBC

GB protected time for GB personal development during 2016/17

Re-align strategic clinical lead role to enhance the contribution of clinical leads to the commissioning plan and the 5 year forward view

July – Dec 2016

CCG Clinical Chair / Chief Nurse

Define role descriptor, recruit to post

Integrate into Executive Management Team

Provide greater clinical input to the EMT and support a joined-up approach linking individual clinical lead work areas

On-going

Ensure effective engagement of clinical membership Clinical Chair / EMT / Chief Nurse

Page | 31



through the role of the practice clinical lead On-going Practice Visits

Members Forum

Service Development Committee

Build and facilitate productive relationships across the Governing Body, CCG staff groups and lead clinicians. Measure the effectiveness of relationships

On-going

Documents

Organisational Development Strategy 2016 2019 · Welcome to NHS Halton CCGs Organisational Development Strategy 2016 – 2019. ... development of the organisation in line with