North Central and East London Commissioning Support Service - proposed organisational structures 17 th May V0.6
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1 North Central and East London Support Service - proposed organisational structures 17 th May 2012
2 Proposed organisation structure consists of six directorate Not in 25/head of transition Short Term Post VSM / Band 9 MD VSM MD 1 Leadership Team Chief Operating Officer and of Customer Services VSM of Contracting and Quality VSM CON LT1 of Finance of Analytics of Improvement of HR & Corporate Services CUS LT1 VSM FIN LT1 VSM VSM VSM ANA LT1 DOI LT1 COS LT1 Senior Management Team development Band 9 CUS ST1 Support s Band 9 (x7) CUS ST2 Technical Contracting and Performance Management Band 9 CON ST1 Clinical and Quality Band 9 Contracting s Band 9 (x3) CON ST2 CON ST3 Financial Accounts and Governance Band 9 FIN ST1 POD Finance VSM (x3) Corporate Finance Band 9 FIN ST2 Project Support FIN ST3 Head of Data Warehouse and Solutions Management Band 8d ANA ST1 Central Intelligence Band 9 ANA ST2 Head of Intelligence Band 8d (x3) ANA ST3 Head of CSS Delivery Improvement Band 8d DOI ST1 Head of PMO Band 8c Planning and Best Practice Band 9 Major Change Programmes DOI ST2 DOI ST3 Company Secretary Band 8d Head of HR & People Development Band 8d COS ST2 1 Head of IT Band 8d Facilities Manager Band 8a COS ST1 COS ST3 Band 9 FIN ST4 COS 26 2 Communications and Engagement 1 IT arrangements TBC 2 Communications & Engagement arrangements TBC 2
3 MD s Office Managing Executive Assistant (EA) 6-1 MD 1 MDO 2 Managers 8b - 2 Transition Short Term Post VSM / Band 9 MDO 1 3 WTE total in the MD s office 3
4 Customer Services ate Chief Operating Officer and of Customer Services CUS LT1 VSM 1 coordinator and PA CUS G1 Development 9 1 PA 5 1 Support s PA / Snr Administrator 5 7 CUS ST1 CUS G2 CUS ST2 CUS G3 development team Development Team Manager CUS 1 Development Lead CUS 2 Development Officer 7 2 CUS 3 Support to Support s for CSP and other planning and delivery Report directly to and split across Support s Senior Support Manager 2 CUS 4 Support Manager 2 CUS 5 46 WTE total Customer Services ate 1 Some CCGs are sharing a Support 4
5 Contracting and Quality ate - Proposed division of area into Point Of Delivery pods Barnet, Enfield, Haringay, Camden, and Islington Covers UCLH, RNOH, North Midd, Barnet and Chase, Royal Free, Whittington, Mental Health Services and all other NHS and non-nhs providers in NC Plus lead responsibility for NCAs for these five CCGs, and for contracted activity for these CCGs with other providers outside NCL/NEL Barking, Havering and Redbridge Covers BHRUT, NELFT, Mental Health Providers and all other NHS and non-nhs providers in BHR Plus lead responsibility for NCAs for these three CCGs, and for contracted activity for these CCGs with Essex providers Tower Hamlets, City & Hackney, Newham and Waltham Forest Covers Barts Health, Homerton, Moorfields, GOSH, ELFT, Mental Health Services and all other NHS and non-nhs providers in ELC and Waltham Forest Plus lead responsibility for NCAs for these four CCGs, and for contracted activity for these CCGs with other providers outside NCL/NEL Plus lead responsibility for links to NHSCB on specialised services across all CCGs 5
6 Contracting and Quality ate of Contracting and Quality CON LT1 VSM 1 Co-ordinator and PA CON G1 Funded by the NCB, outside 25/head Technical contracting and performance Management IFR team 1 Clinical procurement and negotiation Claims management team Legislative / reg expert (PT) Provider performance monitoring team Market Development team Continuing care (not including continuing care assessments) Cancer commissioning team Other networks 9 1 PA 5 1 Clinical and quality director 9 1 Contracting (x 3) 9 1 (Member of the board) PA 5 1 CON ST1 CON G2 CON ST2 8a 4 8a a a c 2 8b 4 8a 4 8c TBD TBD CON 8 CON 9 CON 10 CON 11 CON 12 CON 13 CON 14 CON CON 16 CON 23 CON 24 CON 25 CON 26 CON 27 CON 28 CON 1 CON 5 CON 2 CON 6 CON 3 CON 7 CON 4 CON 17 CON 21 CON 18 CON 22 CON 19 CON 20 Pod 1 Clinical quality assurance deputy director Pod 2 Clinical quality assurance deputy director Pod 3 Clinical quality assurance deputy director Secondary care Medicines Mgmt (some locality-based) 1 Assuming supported by 3/4 WTE from PH and 3/4 WTE from medicines management PA 5 1 Pod 1 clinical quality assurance manager Specialist clinical expertise (maternity, children, safeguarding, CC, Cancer, general, IC MH) PA 5 1 Pod 2 clinical quality assurance manager Patient experience and effectiveness PA Pod 3 clinical quality assurance manager CON 39 Safety CON 40 CON 41 CON CON b CON 29 CON G3 CON 34 CON G4 8c 4 8a 2 CON 35 CON 38 CON G5 CON 44 CON 45 CON 46 CON 47 CON 30 CON 31 CON 32 CON 33 CON 36 CON 37 Commission-ing pod pod teams pod teams (see detail on teams following page) Contract mgrs CCG contract directors Non-CCG aligned contract managers 2 Contracting Contract officer pool (pod dedicated) Total across pods: 9-3 8d 11 8c- 14 8b- 16 CON ST3 CON G WTE total Contracting and Quality 8a
7 Contracting and Quality - Structure of Tower Hamlets, City & Hackney, Newham and Waltham Forest pod Housed in other function Contracting 9 1 PA 5 1 CON ST3 CON G8 Contract managers CCG contract directors CCG aligned contract managers 8d 4 1 8c 5 8b 8 8a 5 CON 62 CON 63 CON 64 CON 65 CON 66 Contract officer pool (pod dedicated) CON 67 CON 68 CON 69 Clinical and quality pool (pod dedicated. led by Clinical director) Finance analyst pool (pod dedicated. led by Finance pod lead) Informatics analyst pool (pod dedicated, led by Informatics pod lead) 40 WTE total in the pod 1 dedicated mental health contracting lead for City & Hackney, as reflected in their SLA 7
8 Contracting and Quality - Structure of Barnet, Enfield, Haringey, Camden, and Islington pod Housed in other function Contracting 9 1 PA 5 1 CON ST3 CON G7 Contract managers CCG contract directors CCG aligned contract managers 8d 5 CON 55 8c 5 8b 5 8a 5 CON 56 CON 57 CON 58 Contract officer pool (pod dedicated) CON 59 CON 60 CON 61 Clinical and quality pool (pod dedicated. led by Clinical director) Finance analyst pool (pod dedicated. led by Finance pod lead) Informatics analyst pool (pod dedicated, led by Informatics pod lead) 37 WTE total in the pod 8
9 Contracting and Quality - Structure of Barking, Havering and Redbridge pod CCG COO Central contracting resources Housed in other function CCG Relationship Managers Contracting CON ST3 9 1 PA 5 1 CON G6 Contract managers for ATs, Mental Health, Community Care, other providers Dedicated local team for contracting, finance, and analytics 8d 2 8c 3 8b 3 8a 2 Contract officer pool (pod dedicated) CON 48 CON CON 50 CON 51 CON 52 CON 53 CON 54 Clinical and quality pool (pod dedicated. led by Clinical director) Finance analyst pool (pod dedicated. led by Finance pod lead) Informatics analyst pool (pod dedicated, led by Informatics pod lead) 19 WTE total in the pod 9
10 Contracting and Quality ate - Principles for design of contracting organisation Centrally-based contracting resources Locality-based contracting resources (i.e. pods ) Centrally-based resources support economies of scale: Expert resources that can be deployed to situations in any CCG (e.g. experts) System-level intelligence Functions driven by core standard processes (e.g. provider performance monitoring) Central team includes: Technical contracting and performance management, including IFR and claims management Clinical quality, including core clinical experts, continuing care, complex case review, serious incidents investigation, and clinical quality review function Locality-based resources provide responsiveness to CCGs and flexibility to address changing needs: Dedicated CCG contracting leads to ensure commissioning intentions are effectively implemented These leads are double-hatted, leading contracting with specific providers in addition to representing CCG needs Pool of provider-facing contract management and analytics roles to effectively develop, negotiate, and execute contracts Leads for major providers are pulled from this pool, and are not double-hatted with CCG contracting leads Locality-based clinical quality teams are colocated with contracting but report to central director of clinical quality 10
11 Contracting and Quality ate - CCG view of how CSS contracting structure will work Organisational view Contract spend view (illustrative figures) CSS Provider CCG Board 100% CCG s total contracts Support s 1 CCG Leadership Dedicated CCG contracting lead Dedicated CCG Contracting Lead CCG Finance Lead CCG Dedicated Analytics Lead Other contract managers in CCG s pod Contract managers in other pods Contracting manager pool Finance analyst pool Central support team for data management, clinical expertise, and other functions BI analyst pool 40% 40% 20% CCG lead collaborates with other contract managers in local pod Directly contracted by contracting lead, on behalf of all CCGs in pod CCG lead collaborates with contract managers in other pods 1 Exact structure (e.g. one-to-one, 1 to 2 or 3) will be detailed in each SLA 11
12 Contracting and Quality ate - Provider view of how CSS contracting structure will work Day-to-day Escalation CCG CSS Provider Large Acute Trust, Mental Health, and Specialty Medium-sized and smaller providers, including CHS Provider Chief Executive and contract team Provider Chief Executive and contract team Contracting Contracting CCG Clinical Lead (CCG staff) CCG contracting lead OR pod contract manager CCG Clinical Lead (CCG staff) Band 9 Band 8a 8d CCG contracting lead CCG contracting lead CCG contracting lead CCG contracting lead CCG contracting lead CCG contracting lead CCG contracting lead CCG contracting lead 12
13 ate of Finance of Finance VSM 1 coordinator and PA PA 5 3 FIN LT1 FIN G1 FIN G2 Financial accounts and governance Financial Services Financial Control & Accounts 9 1 FIN ST b Pod team NCl Acute + Non acute + Planning & Control Pod team ELC+WF Acute + Non acute + Planning & Control VSM 1 8d 2 8b 2 8a VSM 1 8d 2 8b 2 8a FIN ST2 FIN ST2 Project support 9 1 Sr. business support accountants 8c 6 FIN ST4 FIN 34 Corporate Finance Corporate management accounts 9 1 FIN ST3 FIN FIN 35 FIN 36 FIN 37 Detail on next pages Pod team ONEL Acute + Non acute + Planning & Control VSM 1 8c 3 8a FIN ST2 Detail on next pages 112 WTE total Finance 13
14 Finance pod 1 team: covering Barnet, Enfield, Haringey, Camden, and Islington Pod team lead VSM 1 FIN ST2 Acute lead Non-acute lead Planning and control lead FIN 1 FIN 5 FIN 11 Acute support FIN 2 FIN 3 FIN 4 Mental health and continuing care 6 2 FIN 6 FIN 7 FIN 8 FIMS, reporting and planning 8a 5 FIN 12 Community health service and other FIN 9 FIN 10 14
15 Finance pod 2 team: covering City & Hackney, Newham, Tower Hamlets and Waltham Forest Pod team lead VSM 1 FIN ST2 Acute lead Non-acute lead Planning and control lead FIN 13 FIN 17 FIN 22 Acute support 6 2 FIN 14 FIN 15 FIN 16 Mental health and continuing care Community health service and other 6 2 FIN 18 FIN 19 FIN 20 FIN 21 FIMS, reporting and planning 8a 4 FIN 23 15
16 Finance pod 3 team: covering Barking, Havering and Redbridge Pod team lead VSM 1 FIN ST2 Acute lead Non-acute lead Planning and control lead FIN 24 FIN 27 FIN 32 Acute support FIN 25 FIN 26 Mental health and continuing care 6 2 FIN 28 FIN 29 FIMS, reporting and planning 8a 3 FIN 33 Community health service and other FIN 30 FIN 31 16
17 Financial Accounting Financial Accounts and Governance 9 1 FIN ST1 Financial Services Financial Control & Accounts FIN 38 FIN 48 Non Clinical Procurement Financial controls, Ledger and Cash 8b FIN 49 FIN 50 Accounts Payable FIN 39 FIN 40 FIN 41 FIN 42 FIN 43 FIN 44 FIN 45 Systems Support FIN 51 FIN 52 Accounts Receivable 5 4 FIN 46 FIN 47 17
18 ate of Analytics of Analytics VSM 1 Coordinator and PA ANA LT1 ANA G1 66 WTE total Informatics Detail on next pages Head of Intelligence (NCL) ANA ST3 Head of Intelligence (ELC+WF) ANA ST3 Head of Intelligence (ONEL) ANA ST3 Central Intelligence 9 1 Head of Data warehouse & solutions mgmt ANA ST1 CCG Analyst 8a 5 ANA 1 CCG Analyst 8a 4 CCG Analyst Strategy and health economics analytics 8c 3 8b 2 8a 2 Data architect ANA 6 ANA 10 ANA 30 Performance and quality analysts 8a ANA 2 ANA 3 ANA 4 ANA 5 Performance and quality analysts ANA 7 ANA 8 ANA 9 Performance and quality analysts ANA 11 ANA 12 ANA 13 Claims & central performance mgmt analytics 8a Database admin and data quality SQL programmers ANA 31 ANA 32 8a ANA 33 ANA 34 18
19 Substructures for Central Intelligence Team Central Intelligence 9 1 ANA ST2 Head Of Claims and Performance Management ANA 22 Head Of Strategic Intelligence 8d 1 ANA 14 Snr Analyst Performance, Quality and Claims ANA 23 Health Economist Statistician Development Manager ANA 15 ANA 16 ANA 17 Snr Analyst Performance and Quality Snr Analyst Claims Senior Benefits Realisation Manager Benchmarking Analyst Intelligence Projects Manager ANA 25 ANA 24 ANA 18 ANA 21 ANA 19 Performance and Quality Analyst Claims Analyst Benefits Realisation Analyst ANA 27 ANA 26 ANA 20 Performance and Quality Officers 6 2 Claims Officer ANA 29 ANA 28 19
20 ate of Analytics - overview of responsibilities on analysis CCG analysts Performance and quality analysts Strategy/health analytics Claims management analytics Responsibilities Support to CCGs in interpreting and interrogating the data Analytical support in CSP development CCG-specific analyses Statutory returns Work with contracting on performance management, quality and contract negotiation Also looks at activity data for mental health & community services, CQUIIN analytics, vital signs Work with finance and financial activity reporting Productivity performance metrics Support to CSS strategy team on complex and cross CCG pathway redesign Support and advice to CCG analysts in analyses for CSP development Drives innovation through data mining and other complex analyses Health economic/clinical support to IFR processing Benchmarking Responsible for creating challenges on claims and working with contracting on claims management process Works across CCGs to constantly improve challenges, in cooperation with pod informatics teams 20
21 ate of Improvement Improvement directorate contains PMO resources, drawing on other directors for other capabilities as needed of Improvement VSM 1 Coordinator and PA DOI LT1 DOI G1 Head of CSS delivery improvement CSS delivery improvement analysts 8b 3 Head of PMO PMO support 8b 2 Planning and best practice 9 1 DOI ST1 DOI ST2 DOI ST3 DOI 1 DOI 2 Pathway and service best practice knowledge DOI 3 DOI 4 DOI 5 1 Major Change Programs 13 WTE total Improvement 1 Funding arrangements TBC 21
22 HR & Corporate Services ate of HR & Corporate Services VSM 1 Co-ordinator and PA COS LT1 COS G1 PA 5 1 COS G2 Head of HR and People Development COS ST2 Company Secretary COS ST1 1 Head of IT COS ST3 2 Communications and Engagement Facilities Manager partners and workforce management 8a 3 In House Solicitor COS 26 People development Head of Internal Performance Recruitment and resources Information governance Board support 7 2 HR, and Company Secretary sub directorates on next pages Risk 26 WTE total Corporate Services (pending decision on IT and Communications/Engagement 1 IT arrangements TBC 2 Communications & Engagement arrangements TBC 22
23 HR & Corporate Services ate - HR and People Development Head of HR and People Development 8d 1 COS ST2 Deputy Head of HR COS 9 Deputy Head of People Development COS 12 HR Partners 8a 3 Workforce Management Lead COS 10 COS 11 People and Development Manager COS 13 Recruitment and Resource pod 5 2* 4 1 COS 14 COS 15 *COS G3 COS 16 1 Predicated on the introduction of self service and electronic systems and processes * 1 of the band 5 s is a dual PA/ admin support role 12 WTE 1 total HR 23
24 HR & Corporate Services ate - Company Secretary and Legal Company Secretary COS ST1 1 PA COS G2 Head of Internal Performance In House Solicitor Information Governance Manager COS 2 COS 1 COS 3 Board Secretary COS 6 Risk Manager COS 8 Information Governance Data Compliance Officer 7 2 Board support COS 4 COS 5 COS 7 9 WTE total Gov and legal 1 Shared resource IT and Company Secretary and Legal 24
25 Customer Services ate - Relationship managers, part of the Customer Services ate, are the critical link between CSS and CCG Chief Operating Officer and of Customer Services Potential way of working development CCG COO Accountable officer Sets strategy with CCG clinical leads Sets commissioning support priorities with the CSO s CCG Lead On day-to-day basis, may work with CCG lead and other CSS team members as required Support Support Support Dedicated senior -level manager Is accountable to the CCG for overall relationship with the CSS Advises CCG COO on strategy, service redesign, and serves as a sounding board on all matters Single point of contact for all CSS matters Support Support Support Support Support Named contracting lead Named Informatics lead Named finance lead Part of pod covering 3-5 CCGs, reporting into central functions, evaluated based on feedback from relationship manager and pod team Responsible for all contract management and monitoring Locally based (either in CCG or local multi-ccg pod ) In daily contact with the provider-facing CSS contracting teams Responsible for all analytics queries and requests from the CCG Locally based (either in CCG or local multi-ccg pod ) In daily contact with the more skilled analytics and data management experts The business partner for the CCG finance director and the CCG COO Locally based (either in CCG or local multi-ccg pod ) Responsible for all financial analysis and management accounting queries In daily contact with financial analysis teams that focus on provider economics, special projects, whole system analysis, PBR pricing and coding challenges 25
26 Proposed local delivery model Formal reporting line Direct point of contact Locally placed CCG resources Deputy Chief Executive Regionally placed pod resources Contracting and Quality 2 CCG COO Support Contracting pod lead Named Finance lead CCG informatics team CCG Contract lead Non-CCG aligned contract managers Pod Informatics lead Pod Finance team, including CCG and provider finance CCG contract lead sits within CCGs, dealing with the majority of contracts of all different sizes Also have pod responsibilities Accountable to Pod contracting manager CCG informatics lead sits within CCGs, dealing with any informatics questions the CCG might have on a day-to-day basis Consists of one 8a reporting directly to an 8d Accountable to Informatics ate Acts independently from the informatics pod team Named finance lead sits within the pod, but is a direct point of contact for CCGs, and the main point of access to CSS finance services Accountable to Finance ate Contract analysts Pod Informatics team Pod Finance team, including CCG and provider finance 1 Clinical quality and medicines management staff also located in pod, though reporting through those functions 26
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