Clevedon Community Hospital Clinical Services Project Project Initiation Document (PID) Aim To develop, sustain and improve the provision of high quality health care for the Clevedon Catchment area. Version no. 0.5 Status Draft Author ED Approver JG/CT Date for approval/ Date 01/06/13 approved Agreed circulation of Project Team, Board, CRG and SRG this version Version Date Reviewer Comment 0.1 30/04/13 Project Team Milestones/benefits 0.2 14/05/13 Project Board Titles/headers/added milestones 0.3 06/06/13 Jeanette George JG s comments included 0.4 07/06/13 Jeanette George JG s comments included 0.5 25/06/13 Jeanette George JG s comments included Contents 1. Introduction 1.1. Document Purpose 1.2. Background 2. Project Definition 2.1. Objectives 2.2. Approach 3. Project Scope 3.1. Inclusions 3.2. Exclusions 3.3. Constraints 3.4. Benefits 3.5. Project Success Criteria 3.6. Assumptions 3.7. Interfaces and Dependencies 4. Deliverables
5. Project Organisation 5.1. Project Budget 5.2. Project Governance 5.3. Roles and responsibilities 6. Accountability and Reporting 6.1. Key milestones 6.2. Workstreams 7. Project Closure 1 Introduction 1.1 Document purpose The purpose of this document is to describe; What the project is aiming to achieve Why it is important to achieve it Who is going to be involved How and when it will happen The Project Initiation Document (PID) also defines the scope of the project, the resources needed to complete the project and the project approach. It will outline how the project will be controlled to ensure it is delivered on time and to the agreed standards. The PID is a working document which will be updated throughout the project duration. During the project other templates will be used to manage risks, communications and the project plan. The content of these templates will then be summarised in Progress Reports to the Project Board. 1.2 Background Following the decision in July 2012 not to proceed with the development of a new Clevedon Community Hospital the Clinical Commissioning Group for North Somerset has established a new project in order to develop proposals for commissioning future clinical services at Clevedon Community Hospital and further to this a project mandate was agreed at the April meeting of the North Somerset CCG Governing Body. The proposals for commissioning future services will be co-produced through engagement with local people, patients and other stakeholders. Following the development of detailed options and review by the North Somerset Governing Body in September 2013 recommendations will be presented the North Somerset Health and Overview Scrutiny Panel for consideration. The drivers for change include: The announcement in July 2012 that the re-development of Clevedon Community Hospital at a new site would no longer be progressed.
The need to ensure that services at Clevedon Community Hospital help to meet the needs of the Clevedon catchment area 1 whilst delivering best value for commissioner investment. The commitment of the Clinical Commissioning Group to commission services outside of acute hospital settings and closer to home wherever clinically appropriate and cost effective to do so. The recent Clevedon Community Hospital conditions survey indicating that whilst services are being safely provided within the current building it is not possible to upgrade inpatient facilities in line with modern healthcare standards. The requirement to replace the current diagnostic imaging equipment in order to be able to expand the range of outpatient and diagnostic services available at Clevedon Community Hospital. 2 Project Definition 2.1 Objectives To engage with local patient, public and clinical stakeholders in the Clevedon catchment area 2 on the development of commissioning intentions based on the options identified for outpatient, diagnostics, therapy and inpatient services throughout the project. To define current activity and capacity for outpatient services including diagnostics and therapy services at Clevedon Community Hospital. To define the commissioning requirement for local outpatient, diagnostic and therapy services for the Clevedon catchment area 3. This will build on work undertaken previously on outpatients, diagnostics and therapy services with GPs and other partners as part of delivering the development of a new hospital. This will include defining activity requirement by specialty where possible. To identify options for diagnostic imaging including the replacement of equipment as appropriate. (This may include diagnostic support opportunities to the MIU) To identify the demand for inpatient services at Clevedon Community Hospital, taking into account current capacity and the balance between inpatient and community based 1 Whilst the Community Hospital is a resource for the population of North Somerset, the majority of services are delivered to the Clevedon catchment area which for the purposes of this project and in order to understand capacity and demand includes the following areas: Backwell, Clevedon, Congresbury, Long Ashton, Nailsea, Portishead, Yatton, Winscombe, Wrington and the Worle fringes. These populations are estimated to total approximately 100,000 people. 2, 3, 4 Whilst the Community Hospital is a resource for the population of North Somerset, the majority of services are delivered to the Clevedon catchment area which for the purposes of this project and in order to understand capacity and demand includes the following areas: Backwell, Clevedon, Congresbury, Long Ashton, Nailsea, Portishead, Yatton, Winscombe, Wrington and the Worle fringes. These populations are estimated to total approximately 100,000 people.
rehabilitation services and GP led/safe haven beds required for North Somerset patients and specifically for the Clevedon catchment area 4 To establish the capacity and capability of existing providers and of providers in the wider market to meet commissioning requirements. To determine the appropriate commissioning or procurement routes for the options considered and recommend subsequent commissioning or procurement actions for the next stage. To identify detailed and evidenced based options with recommendations for the future provision of outpatient, diagnostic and inpatient services for the Clevedon catchment area 5 for approval at the September Project Board to go to the October North Somerset Governing Body. 2.2 Approach The project will follow a co-production approach to ensure stakeholders are involved from the earliest possible point in the process and given a voice in the decision making process. The project will be delivered using the South West Commissioning Support (SWCS) NHS project management framework based on PRINCE2 methodology and utilising the NHS change model as shown below. It will be led by the Project Board, supported by the Project Team. The formal project management approach will increase visibility of the work that needs to be undertaken and the decision making process. This means the project will be managed against a clear documented project plan; there will be a communications and engagement plan to ensure all stakeholders are kept up to date and a risk and issues log. The Project Board will meet and agree to review and sign off key deliverables and approve progression to the next stage of the project. 5 Whilst the Community Hospital is a resource for the population of North Somerset, the majority of services are delivered to the Clevedon catchment area which for the purposes of this project and in order to understand capacity and demand includes the following areas: Backwell, Clevedon, Congresbury, Long Ashton, Nailsea, Portishead, Yatton, Winscombe, Wrington and the Worle fringes. These populations are estimated to total approximately 100,000 people.
(NHS Institute for Innovation and Improvement (2012) The NHS Change model. Available from: http://www.changemodel.nhs.uk/pg/dashboard (Accessed 11.01.13)) 3 Project Scope 3.1 Inclusions 3.2 Exclusions The project scope includes all outpatient clinics (consultant led and therapy led), diagnostic facilities and inpatient services at Clevedon Community Hospital. It is also anticipated that in discussion with NHS Property Services, the commissioner proposals - once agreed - will inform decisions about the future of the Millcross site. The Minor Injury Unit which has recently been subject to detailed review and improvement. The only element of the Minor Injuries Unit that is in scope is as a user of diagnostic services. The resolution of outstanding commercial matters relating to the previous new build project.
3.3 Constraints Service provision outside the Clevedon Hospital site, except where the services are proposed to be transferred in or out of the site. The selection and implementation of a commissioning option will not be carried out as part of this project although a phase two of the project may be developed and agreed to include this work. Proposals for improving local services for the Clevedon catchment area 6 must be clinically and financially sustainable in the context of the wider CCG position Access to capital for investment in buildings or equipment will be a matter for NHS Property Services and service providers respectively. It is anticipated that the project team will work with NHS Property Services and with service providers to identify any building modifications or equipment issues associated with service proposals. Further to this the requirement for capital investment and any revenue consequences arising from this will be assessed by the project team and presented to the project board for consideration. 3.4 Benefits Below is a summary of the key benefits from developing options for the future commissioning of clinical services at Clevedon Community Hospital. As part of the development of the options, the benefits of each possible option will be explored and detailed in the options appraisal itself. Beneficiary Benefit Overall benefits 1. Recommend a sustainable model for delivering high quality health services to patients in the Clevedon catchment area. 2. Effective engagement with local patients, public and stakeholders through the work of the project 3. Develop a clear commissioning plan (and subsequent commissioning and procurement actions) for services based at Clevedon Community Hospital 6 Whilst the Community Hospital is a resource for the population of North Somerset, the majority of services are delivered to the Clevedon catchment area which for the purposes of this project and in order to understand capacity and demand includes the following areas: Backwell, Clevedon, Congresbury, Long Ashton, Nailsea, Portishead, Yatton, Winscombe, Wrington and the Worle fringes. These populations are estimated to total approximately 100,000 people.
Organisational Clinical Commissioning Group Clinicians and staff Patients The North Somerset Governing body will have comprehensive options and recommendations set out for the future commissioning of healthcare services at Clevedon Community Hospital that they are happy to approve. The Health Overview and Scrutiny Panel will have comprehensive options and recommendations set out for the future commissioning of healthcare services at Clevedon Community Hospital options to advise the Project Board on the next steps for implementation of a future commissioning plan. The involvement of key stakeholders and use of co-production as well as a comprehensive communication and engagement plan will pave the way for local ownership of future commissioning decisions and help expedite any changes to services agreed to improve services. Allowing sufficient time for the development of the options and full involvement of stakeholders will mean that all options are fully investigated including details around the next steps for commissioning and procurement in order that there is a clear action plan to implement the chosen option. Clinicians and staff will have contributed to the development of options via co-production. Clinicians and staff will feel assured that any recommended changes to the commissioning or delivery of services will make best use of the facilities and building at Clevedon Community hospital, in the context of other health services provided elsewhere to the population of North Somerset. Patient groups will have contributed to the development of options via co-production. Patients will feel well informed about any recommendations for the commissioning of healthcare services at Clevedon Community Hospital. Patients will feel assured that any changes to the commissioning or delivery of services will make best use of the facilities and building at Clevedon Community hospital, in the context of other health services provided elsewhere to the population of North Somerset.
3.5 Project success criteria The project will be a success if:- 1. Fully developed proposals approved by the project board and CCG Governing Body to be co-produced with the public and other stakeholders leading to agreement of a future commissioning plan for Clevedon Community Hospital. 2. Residents of the Clevedon catchment area will have access to high quality and sustainable services in a location close to home, wherever clinically appropriate and cost effective to do so. 3. All stakeholders feel they have been effectively engaged and have contributed to the development of options and agreement of commissioning plans for Clevedon Community Hospital. 3.6 Assumptions That the commissioning proposals will be informed by patient, public and stakeholder involvement and sufficient time will be allowed in the project timetable to do this effectively. That following advice from HOSP on further engagement an option will ultimately be selected for implementation. 3.7 Interfaces and dependencies A number of potential interdependencies with other projects have been identified and are summarised below. The project team will undertake further work to map these interdependencies in order to assess their relevance to the development of commissioning plans for Clevedon. Bristol North Somerset and South Gloucestershire (BNSSG) rehabilitation review BNSSG demand & capacity modelling North Somerset Integrated Care project Review of North Somerset safe-haven beds Bristol North Somerset and South Gloucestershire stroke pathway review CCG medium term financial plan and commissioning intentions. NHS Property Services maintenance programme Service strategy and operating models of potential providers, including North Bristol Trust and North Somerset Community Partnership. Weston Area Health Trust procurement.
Acute services review being undertaken by University Hospitals Bristol and North Bristol Trust. Existing Healthy Future project to develop models of care and business case for ambulatory hot clinics. 4 Deliverable A deliverable is anything that comes into existence as a direct result of the project during its life cycle. Deliverable Purpose By Due date Status Project Mandate Project Initiation Document to include; Engagement and communications plan Project plan Risk register Report on outcomes of rehab review and the impact for Clevedon Hospital Report on inpatient demand at Clevedon Hospital Report on diagnostic imaging at Clevedon Hospital First cut options appraisal report Materials on first cut options for SRG and CRG Defines scope of project Defines, what, why, how and who. Incorporate wider work on rehab beds into options To understand future capacity requirements To understand capacity and equipment needs To share viable options for comment To share viable options for comment within co-production BB/ED April Approved ED May Draft EW/DC ED ED ED ED/MA July Communications To inform MA/BB Ongoing Ongoing July
materials Materials and papers for stakeholder meetings Report on the outcome of engagement on options for HOSP and CCLG Report on capacity and capability of existing providers to meet commissioning requirements for options A report on appropriate commissioning or procurement routes for the options considered and recommendations on subsequent commissioning or procurement actions for the next stage. stakeholders correctly about project development To inform stakeholders correctly about project development for input To ensure coproduction To inform stakeholders correctly about project development To inform stakeholders correctly about project development ED/MA July Drafts produced ED/MA ED/BB ED/BB August/ Septem ber August August Options with recommendations for Commissioning to Governing Body Key project deliverable Project Team Septem ber
5 Project organisation North Somerset Governing Body Clinical Reference Group Project Board Stakeholder Reference Group Project Team Work stream 1 (Outpatients and Diagnostics) Work stream (Inpatients) 5.1 Project budget The expected resource required for this project is human resource as follows; Project Manager 3 days a week (split between 1 day commissioning manager and 2 days project manager) (CSU) Project Director - 1-2 days a week (CSU) Project Support 1 day a week (CCG) CCG Project Management input 1 day a week (CCG) SRO 0.2 days a week (CCG) Project team, project board and reference groups time allocated to meetings There is no financial budget for this project although the options the project will deliver may include the anticipated cost of changes to the commissioning of healthcare services and initial business case outlines.
5.2 Project Governance The project governance arrangements are summarised below. The project board will agree the detailed project governance arrangements including relevant terms of reference. 5.3 Roles and Responsibilities The Senior Responsible Officer (lead executive) chairs the Project Board and is the single individual with ultimate responsibility for ensuring that a project meets its objectives and delivers the projected benefits. The Project Director is responsible for ensuring that the project meets its objectives and delivers the projected benefits The Project Manager will manage the day to day project activities and coordinate the workstreams. The lead commissioner is responsible for the specification of the needs of all those who will use the services, commit any required resources and ensure access to clinical expertise. The Healthy Futures Project Management Office (PMO) will provide the Project Director with project support. Access to expertise in service redesign, finance, workforce planning, IM&T and data analysis will be made available through the CSU, as part of its Service Level Agreement with the CCG 6. Accountability and Reporting The Project Team will report to each of three Project Boards The Project Team will report into the Clinical Reference Group and the Stakeholder Reference Group The Clinical Reference Group and the Stakeholder Reference Group will advise the Project Team and the Project Board and take on an advisory role for the communications and engagement plan for the whole process. The stakeholder group will also carry out work such as equality impact assessments. The Project Board will present the options developed by the project for the future commissioning of services at Clevedon Hospital to the North Somerset Governing Body for approval.
6.1 Key milestones Process Responsibility Timeline Project Mandate approved by April Jeanette George 16 th April 2013 CCG Governing Body meeting Establish project team, project board, Ellie Devine 26 th April 2013 stakeholder group and clinical reference group, and set dates. Information gathering exercise to Ellie Devine April collect existing data and inform project plan and workstream planning to include mapping of interdependencies Draft Project Initiation document Ellie Devine End of April produced Engagement and Communication Mary Adams End of May Plan finalised Commence public, patient and Mary Adams May stakeholder engagement and communication Commence project team and Ellie Devine May workstream meetings First Project Board Jeanette George 21 st May Monthly progress report to board Ellie Devine ongoing Produce detailed Project plan and risk/issues log for approval by Project Board Ellie Devine BNSSG Rehabilitation report outcomes reviewed (provide report) Diagnostics Activity and Equipment Review (provide report) Develop first cut assessment for future provision of outpatient and diagnostic services Develop first cut options for future provision of inpatient services Debbie Clark/Elizabeth Williams Ellie Devine/Jackie Green Project Team Project Team End of May
Process Responsibility Timeline Communications statement/position to coincide with initial sharing of draft options Ben Bennett Pre-meets with members of stakeholder and clinical reference groups Write to all stakeholder groups with update about plan to develop options and offer to attend group meeting to present 1 st cut of options 2nd Project Board review first cut of options Hold one-off separate stakeholder and clinical reference group meetings share and discuss first cut of options (provide papers) Update to HOSP and CCLG that options will be presented for review in early autumn Produce project board report including Draft options for future clinical services at Clevedon hospital (to include input from CRG and SRG) Updated engagement and communications plan for next phase Stakeholder workshop (to include CRG) to discuss 2 nd cut of options Report on outcome of engagement to HOSP and CCLG Report on the capacity and capability of existing providers and of providers A report on appropriate commissioning or procurement routes Project Board Mary Adams/Jan Blews Ben Bennett/Ellie Devine Jeanette George Miriam Ainsworth/Mary Adams/Kathy Headdon Mary Adams Project Team Mary Adams Mary Adams/Ellie Devine Ellie Devine Ellie Devine Jeanette George Early July Mid- July July July/August August August August August 12 th September
Process Responsibility Timeline Finalise governing body paper Ben Bennett September Report to CCG leadership group and Project Board October governing body Present preferred option to HOSC and agree requirement for further engagement if indicated Ben Bennett October 6.2 Workstreams There are currently two workstreams identified; Workstream 1 will focus on outpatients and diagnostics Workstream 2 will focus on inpatients The workstream actions will form the basis of the project plan but these workstreams are interdependent as the findings of one will impact the possibilities for the other. 7. Project closure Further phases of the project for example, the selection of a preferred option for future commissioning of services and the subsequent implementation of that option post October 2013 need to be agreed between the SRO and Project Director. Available as separate documents as part of PID: Terms of Reference for Project Team. Project Board, Stakeholder Reference Group and Clinical Reference Group. Communications and engagement plan (to include stakeholder analysis) Project Plan Risk and Issues Log