Foreword. Thank you. Phil. Philomena Corrigan, Chief Executive NHS Leeds West CCG

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2 Foreword Normally when organisational development (OD) plans are put together they involve a small number of people so I'm really pleased to present our OD plan as I know this has involved all our staff as much as possible. Although this a personal foreword from me I want to thank all of you for helping to establish the organisation and helping to lay the foundations which will allow us to deliver on our ambitious strategy. The development plan is intended to help the CCG and its members deliver our strategy over the next two years. The delivery plan sets out how we can work with our members, clinical leads, partners and our staff within the CCG to ensure we successfully deliver what we have set out to do. To be a successful caring organisation we have to continually learn and continually seek to improve what we do. Our aim is to develop an environment where: staff feel valued; have the support they need to think differently to deliver innovative approaches to tackling the key issues affecting our local communities; and continue to get involved in setting our future direction. I, and our Governing Body, are committed to developing all our staff by ensuring we identify your training and development needs, supporting you to undertake your roles and valuing the contribution you make. I hope that you agree that we have created an open and transparent organisation where we all support each other and have the confidence to raise any concerns. With that in mind I would like you to let me know of anything that you feel could be added to our OD plan or any other general comments. I look forward to seeing us work together to make a real difference for our local communities while also continuing to enjoy our time working for the CCG. Thank you. Phil Philomena Corrigan, Chief Executive NHS Leeds West CCG 2

3 Contents Introduction 4 National strategic context 5 Strategic context for our CCG 6 Our vision and values 7 Our strategy - drivers for change 8 Our strategy objectives 9 Our organisational development goals and principles 11 Organisational development goals

4 Introduction The purpose of this second edition of our organisational development plan (ODP) is to set out how we will meet the development needs of the CCG and our workforce so that we are better equipped to deliver the reforms set out in the Health and Social Care Act 2012 and our Clinical Commissioning Strategy and related objectives. The ODP supports the delivery of our Strategy and Workforce Strategy and should also be read in conjunction with other key documents: NHS Leeds West CCG s Constitution; NHS Equality Delivery System; NHS citywide equality objectives; Leeds Health and Wellbeing Strategy and the Joint Strategic Needs Assessment. The definition underpinning our approach to Organisation Development is: The practice of planned intervention to bring about significant improvements in organisational effectiveness. In order to deliver the level of transformation reflected in our vision, strategy and goals we will need to develop leaders, our wider workforce and an organisational culture that supports high performance. Our structure, systems and management practices will also need to be aligned to deliver results. The plan takes into account this range of inter-related factors and identifies goals that will enable us to improve CCG performance in order to meet the changing needs of our population. It encapsulates our approach to the development of our CCG by setting out: 1 Strategic national and local context for our CCG and our goals 2 Our vision, values and how CCG staff will show they are putting those values into action 3 The principles underpinning the ODP and our CCG s organisation development goals and action plan 4 Our commitment to the NHS Leadership Academy s Leadership Model and approach to leadership development, together with that of the Faculty for Medical Leadership and Management. 4

5 National strategic context We know that there are many challenges facing the NHS. Some of these can be addressed by making continuous quality improvements, by raising performance across the board, providing more care outside hospitals and ensuring we always deliver a safe, high quality, value-for-money service. But improving the current system will not be enough. Future trends threaten the sustainability of our health and care system: an ageing population, an epidemic of long term conditions, lifestyle risk factors in the young and greater public expectations. Combined with rising costs and constrained financial resources, these trends pose the greatest challenge in the NHS s 66 year history. Significant and transformational change is needed, including refocusing on prevention, putting people in charge of their own health and healthcare, and matching services more closely to individuals risks and specific characteristics. 5

6 Strategic context for our CCG NHS Leeds West Clinical Commissioning Group (CCG) is an organisation established in April 2013 which serves a diverse population of approximately 350,000 people living in West Leeds. Its purpose is to work with its 38 member practices to improve the health of our populations through effective commissioning, collaboration and primary care development. The Strategic Plan sets out in detail what the challenges and opportunities are and how we will address them. The largest of three CCGs in the city, and one of ten CCGs in West Yorkshire, we are a membership-led organisation committed to commissioning the best health and care possible within available resources. Working with our members and patients, we have set out a vision which captures our ambition to involve local stakeholders in the commissioning decisions we take. Collaborative relationships across the three Leeds CCGs are now well established and gaining momentum in leading and delivering transformational change for the health economy. Several key staff work collaboratively across the three Leeds CCGs and this reflects the lead provider management arrangements agreed. We are committed to working with other CCGs in Leeds and the wider region, sharing resources effectively to commission coherent clinical pathways and services for the city and region. We work closely with staff from the Commissioning Support Unit, who provide a range of managerial support. We have developed key relationships with other stakeholders, in particular the local authority through the Leeds Health and Wellbeing Board and the Integrated Commissioning Executive, with NHS England and the Local Area Team. 6

7 Our vision and values Our vision is: Working together locally to achieve the best health and care in all our communities. Values We are committed to upholding the core values set out in the NHS Constitution and have identified the following local values to underpin the work of our organisation. Our values are at the heart of the decisions we make. They will guide us when we develop our plans for health services, what we think we need to do first, any changes we may need to make and how we tackle the challenges we face. Respect and dignity Commitment to quality of care Compassion Improving lives Working together for patients Everyone counts We will aim to: Ensure that local people are at the centre of our commissioning decisions; Commission services based on what we would want for our own families and friends; Commission services which are the best possible value for money; Work in collaboration with our partners to make sure we achieve the best possible health and care for all our communities; and Be an organisation where our staff are valued and where everyone counts. 7

8 Our strategy drivers for change In developing a strategy the organisation recognises the need to respond to a range of internal and external drivers for change including: The priorities identified by patients and members The Joint Strategic Needs Assessment (JSNA) 2012 The Leeds Joint Health and Wellbeing Strategy 2013 The NHS England Operating Framework: Everyone Counts The NHS Constitution The NHS Mandate The Need for Change Our Population The health of our population of approximately 350,000 in west Leeds is characterised by a scattered pattern of need with some highly affluent areas and some of the most deprived in the country. Areas of high deprivation have amongst the lowest average life expectancy in the city, whilst variation in average life expectancy across the CCG population (the life gap ) equates to 10.9 years (based on Middle Super Output Area data from ). The population we cover also includes diverse communities with specific need including offenders, gypsies and travellers and a high student population. The Need for Change Our Services We, along with commissioner and provider partners, must continue to ensure the safety, effectiveness and good quality of services provided in the local health economy. This is a particular priority in the current financial climate of limited resources, and in context of the need to transform services to sustain a response to growing demand for health and social care. Performance in relation to key national pledges, including Referral to Treatment Times (RTT) and the Emergency Care Standard needs to improve and this strategy will address the organisational actions to support this. In delivering change, the organisation will also take account of standardised access rates which indicate that, although there is a relatively good choice of providers for elective surgical care in particular, elective access to hospital services is at a lower rate than could be expected for the population, whilst emergency access is higher. Our strategy is focused on the key priorities identified for our population but is interdependent with and supportive of a range of strategies across the wider partnership agenda. 8

9 Our strategy objectives Towards delivering the organisational vision, and in response to the drivers set out below, we have identified four strategic objectives in order to build a highly effective organisation and tackle the health and care needs of our communities. Strategic objective 1 Priority Health Goals To tackle the biggest health challenges in West Leeds, reducing health inequalities. Strategic objective 2 Quality and Safety To transform care and drive continuous improvement in quality and safety. Strategic objective 3 Best Use of Resources To use commissioning resources effectively. Strategic objective 4 Organisational Development To work with members to meet their obligations as clinical commissioners at practice level and to have the best developed workforce we possibly can. Priority Health Goals Underpinning delivery of this strategy and aligned to the objectives above, we will focus on eight priority health goals as follows: A. Promoting healthy living to tackle the wider determinants of health. B. Improving the sexual health of the population. C. Proactive management for people with long term conditions. D. Improving the mental health of the population E. Improving outcomes for those diagnosed with cancer. F. Improving access to elective care services. G. Commissioning an effective response to urgent care needs. H. Improving end of life care. In addition to the specific priority health goals above NHS LWCCG has also committed to the following priorities: Children and families Improving the quality of Primary Care 9

10 Quality and safety Effective use of resources Patient feedback and public involvement Best developed clinical commissioners and workforce Priority Health Goals Effective partnerships Outcomes In delivering the strategic objectives over the next three years, the organsiation aspires to achieve the following strategic population health outcomes in line with the Joint Health and Wellbeing Strategy for the city: Improved life expectancy at birth Reduced differences in life expectancy (at birth) between communities (through greater improvements in more disadvantaged communities) In delivering this strategy, impact to the health economy is expected to be defined in terms of: More care delivered in primary and community care settings. More proactive care, co-created with patients on an individual basis. More integrated care pathways, regardless of organisational boundaries. A reduction in hospital based care, particularly in relation to emergencies. 10

11 Our organisational development goals and principles In support of the priority health goals, and to ensure fitness for purpose in delivering the strategy, we will also continue to focus on three key organisational development goals: A. Build commissioning capacity and capability at member practice level. B. Develop the workforce, embedding clinical leadership in commissioning. C. Continue to collaborate with partners, ensuring system efficiency. Diagnostic work The organisational development plan (ODP) goals and action plan are informed by a range of diagnostic work in 2013 including: Staff attitude survey and related action plan Practice visits: Chair and Chief Officer visits to all member practices Membership survey: sent to all member practices and shared at a membership event in March 2013 Governing body assessment: video of a public governing body meeting in January 2014, followed by one-to-one coaching and feedback for all members. Review of the CCG against the six domains in NHS England s Draft Framework of Excellence in Clinical Commissioning for CCGs. Six OD focus groups were set up with a cross-section of staff and led by a member of our senior management team (SMT). Staff reviewed what is working, what more we need to do and suggested three priorities for inclusion in the ODP. We will also take into account feedback about training and development needs once all appraisals are complete. 11

12 The guiding principles for the OD plan are Supporting excellence in clinical commissioning Whole organisation and system Ownership Practical and clear Inclusive CCGs are responsible for safely discharging a number of legal duties as set out in the Health and Social Care Act NHS England s Draft Framework of Excellence in Clinical Commissioning for CCGs builds upon these statutory duties by setting out the qualities, practices and behaviours of a healthy CCG in a strong position to succeed in delivering transformational change. The OD plan will support the delivery excellence as s described in the Draft Framework. The OD plan covers all aspects of the organisation that we are engaged in that are directed toward building and maintaining the health of the organisation as a total system. The plan has been developed with and is owned by CCG leaders. Despite the challenge and complexity of the CCG s agenda, the OD plan aims to describe a practical, coherent approach to the organisation s development priorities in a clear and straightforward way. The plan should reflect the needs of a diverse workforce and population. NHS leadership model and approach to leadership development Our approach to leadership development is underpinned by the NHS Leadership Framework. This provides a consistent approach to leadership development for all staff in health and care irrespective of discipline, role, function or seniority and represents the standard for leadership behaviours that all staff should aspire to. Based on research and created through extensive consultation, the Leadership Framework has been tailored to the specific needs and environment of health and care, and is applicable to all staff at any stage of their career. It sets out the expectations of leadership at every level of the system and provides guidance to those who commission leadership development. 12

13 Organisational Development Goals Organisational development goal A. Build commissioning and cocommissioning capacity and capability: i) at member practice level ii) citywide iii) in specialist commissioning & primary care Work programmes Milestones Measure/evidence Delivery deadline CMC will be fully April 2015 Locality representative of all infrastructure member practices. Continue developing a forum with Clinical Leads and member practices as part of the Clinical Management Committee (CMC) in order to make commissioning decisions. All member practices will feel enabled to make commissioning decisions on behalf of the population of NHS Leeds West CCG. The clinical leadership within the organisation will be fully functioning and have developed a range of options that support listening to members and facilitating membership engagement. A diverse, well-trained and motivated clinical leadership workforce will be in place; a growing Board lead / delivery lead Sue Robins/Pete Belfield/ Kirsty Turner 13

14 Commissioning Information Member Practice Engagement Continue to develop peer review data interpretation support available to practices through a Practice MOT. Development of project management and analytical expertise. Support members to develop their programme of locality development sessions aligned to strategy. pipeline of new clinical leadership talent will be identified. Number of changes implemented in practices as a result of peer reviews. Training and development needs identified; training and development complete. Clinical and Management leads draw on & involve those with expertise in modelling and forecasting pathway changes at beginning of projects. A programme of development delegated to and shaped by members that will support the delivery of the CCG s priorities; The programme is multiprofessional; is population, quality and outcomes focused; and encourages neighbouring practices to collaborate to December 2014 October 2015 October 2014 Simon Stockill /Sue Robins / Kirsty Turner Sue Robins/Kirsty Turner 14

15 achieve results. Patient and Public Involvement Develop a primary care development group The Patient Insight Group (PIG) to strengthen CCG s you said we did approach to collecting and using patient insight. The PIG to identify all planned service improvement work/ redesign and embed patient representatives in project or task and finish groups to achieve improved process. Membership survey feedback about engagement & satisfaction levels and related action plans delivered. Delivery of the Patient Engagement Strategy/ work plan. Patient insights are used systematically to inform contract monitoring /service development. Patient insight/ information is reflected in the work of the CMC Continue to develop the Patient Insight dashboard and share this information with commissioners. October 2014 November 2014 Diane Hampshire/ Kirsty Turner The PIG to work with Primary Care Improvement Group to consider how to implement shared November

16 decision making and promoting responsibility for own health and wellbeing. B. Developing the workforce, embedding clinical leadership in commissioning HR systems, processes and procedures Implementation of Workforce Strategy objectives & action plan: 1. Being a wellgoverned organisation 2. Being a collaborative organisation 3. Supporting a healthy, happy and motivated workforce 4. Being an employer of choice Bench-marked levels of sickness absence. Review of intelligence from exit interviews to understand reasons for leaving and pick up concerns. Staff survey feedback about engagement and satisfaction levels and related action plans delivered. Staff have had meaningful appraisal and mid-year review; CSU will have developed IT system which supports the 360 degree process; staff have had 360-degree feedback based on CCG Behaviours Framework and linked to pay Quarterly workforce report August 2014 October 2014 November 2014 Diane Hampshire/Hanna h Morris & Holly Tetley 16

17 progression; actions built into PDP. 100% of staff working to PDPs with individual objectives aligned to the CCG s strategic objectives. March 2015 CSU identify training needs for all staff arising from appraisal and identify suitable development options to meet these; relevant development delivered. Clinical leadership strategy Continue to implement clinical leadership strategy to embed clinical leadership in delivery of strategic objectives Recognition award(s) that recognise and value staff for their contribution and are aligned to CCG Values and Behaviours. All clinical leaders have clear objectives and a PDP aligned to CCG strategy. A continuing programme of clinical leadership development based on national best practice and emerging standards for October 2014 Ongoing Simon Stockill 17

18 leadership from the Faculty of Medical Leadership and Management (FMLM). Ongoing Ongoing programme of development for Clinical Fellows. Development within the CCG of the concept of improvement teams focused on the delivery of demonstrable impact in priority health goals in CCG strategy through tackling unwarranted clinical variation. Collaboration with the Education sector e.g., Universities and training establishments needs agreeing. Specifically around workforce development and training requirements for the future. Clinical and Managerial Leads have clear understanding about March 2015 August 2014 Phil Corrigan Sue Robins 18

19 decision-making process and what is required by CMC. Robust, evidenced-based, fit for purpose business cases agreed at CMC. Clinical leadership strategy continued Staff engagement and decisionmaking Invest in the leadership and development of primary care nursing at practice level See also B above (Workforce Strategy action plan) Consultation with staff about how we make commissioning decisions. Clinical and Managerial Leads able to work effectively as part of CMC to secure resources aligned to CCG strategy. Needs-based programme of continuing development agreed with and for nurse leaders. Support and develop the nursing contribution within locality meetings and active promotion of this to practices. Staff understand how they can put forward ideas for innovation and improvement and the process for decisionmaking in the CCG. Number of staff ideas put forward and accepted for October 2014 August 2014 April 2015 Diane Hampshire/Gil Ramsden Sue Robins 19

20 Personal, team and organisational development aligned to organisational strategic objectives innovation and improvement. Staff will have completed statutory and mandatory training in a timely manner and taken any related follow-up action. CSU identify training needs for all staff arising from appraisal and PDP and identify suitable development options to meet these; relevant development delivered. October 2014 See B i) Diane Hampshire Leadership development: workshop programme for Governing Body including three development sessions focused on critical review and development of key elements of the strategy. Quarterly ongoing Carol Pickering, Sue Robinson and Gordon Sinclair Training and Develop outcomesbased Feedback and developmental event for members of Clinical Commissioning Executive. Members understand key aspects of OBA and how March 2015 July 2015 Carol Pickering, Sue Robinson and Gordon Sinclair Sue Robins/ Kirsty Turner 20

21 development to support member practices accountability (OBA) to enable us to focus on key aspects of strategy, maximise delivery (e.g. CVD, MH, Cancer). to apply it. Members are engaging service users and communities to collaborate and share responsibility for making a difference and achieving better outcomes. December 2014 Feedback that shows how service users are better off and that services are well-delivered. C. Continue to collaborate with partners, ensuring system efficiency Building relationships with our range of partners Continue to demonstrate commitment to: working with our partners to deliver city-wide priorities; e.g., safeguarding making sustainable our local health economy using the Leeds Pound in an effective way with our partners. Develop a communication plan and process for creating a shared narrative on the meaning of the Leeds Pound across all organisations. Work with our Communications Team to enable us to articulate to the public, our staff and partners our plans, visions and strategy as a statutory body serving our own population. Work with the citywide August 2014 Phil Corrigan/Carolyn Walker 21

22 Continue to: work with and as a member of the Leeds Health and Wellbeing Board to ensure that health needs of the city are addressed and outcomes improved; Review and clarify the purpose and role of the Patient Assurance Group /Patient Insight Group re patient and public involvement so that we change patient consultation into collaborative working. Communications Team to enable us to articulate to the public, our staff and partners: Health economy wide plans, visions and strategy for Leeds as a City; NHS wide and West Yorkshire plans, visions and strategy as a Core City and significant provider of tertiary care. Develop a strategy for working with voluntary and community sector April