3 rd July 2013 Enc No. 16 Birmingham South Central Governing Body Cover Sheet Date: 3 July 2013 Report title Presented by Prepared by Business Resilience Capability Scale David Morris David Morris For decision x For information Time required to present report: 15 minutes Please tick as appropriate PURPOSE & BACKGROUND Purpose of the report To assess BSC s ability to embed and operate business resilience methods and activities. Background papers Prior committee approval Finance & Performance Quality & Safety QIPP / Commissioning Date of committee: Not discussed What was agreed: Date of committee: Not discussed What was agreed: Date of committee: Not discussed What was agreed: Resources Quality & safety Patient experience Consultation & engagement Equality Delivery System (identify which goal it supports) Legal (including statutory equality duties) Staff to agree and create plan Aims to ensure services are available 1.1 Services are commissioned, designed and procured to meet the health needs of local communities, promote well-being, and reduce health inequalities 2.3 Patients and carers report positive experiences of their treatment and care outcomes and of being listened to and respected and of how their privacy and dignity is prioritised
BSC organizational goals to which this report relates Recommendations: Equality Analysis (indicate the key points the analysis has identified relevant to decision required) BSC CCG OBJECTIVES Prevention, Partnership The Governing Body is asked to support the plans to ensure business continuity 3 July, 2013 Business Resilience Capability Scale 1. Purpose of report To assess BSC s ability to embed and operate business resilience methods and activities. 2. Matters for consideration The report summarises the workshop held on 31 May, 2013. The purpose of the workshop was to explore the CCG s ability to design and implement business resilience methods and activities. Five domains were considered: goals and objectives, ownership, delivery, measurement, managing risk and supporting business critical functions. 3. Implications (inc. financial, consultation, equalities, HR & legal) All teams will participate in the creation of the plan. 4. RECOMMENDATIONS The Governing Body is asked to support the plans to ensure business continuity.
Business Resilience Capability Scale Birmingham South Central CCG Bartholomew House 31 st May 2013 Present: Birmingham South Central CCG: Fiona Allen, Deputy Designated Children s Safeguarding Nurse Cherry Dale, Chief Operating Officer Philomena Gales, Commissioning Manager Corrie Gardiner, Administrator John Guggenheim, Chief Finance Officer Jacquie Haden, Deputy Designated Children s Safeguarding Nurse Amos Mallard, Partnerships Facilitator Rhona Woosey, Commissioning Manager Central Midlands CSU: David Morris, Risk Manager Jasbinder Sandhu, Relationships Manager Introduction: This report summarises the BRCS workshop held on the 31 st May 2013 at Bartholomew House. The purpose of the workshop was to explore the CCG s ability to embed and operate business resilience methods and activities. Business Resilience encompasses Risk Management and Business Continuity and supports the achievement of organisational goals. Five domains are considered in the approach: goals and objectives, ownership, delivery, measurement, managing risk and supporting business critical functions. The session followed a semi structured question and discussion format to gather the information needed to produce the BRCS for the CCG. The BRCS uses a maturity model approach to scoring the organisation s capability. The BRCS outcomes are used to hold an improvement conversation with the CCG to discuss the level the CCG wants to achieve and how the CSU can support the CCG to attain this. The delegates were chosen by the CCG to represent its activities and the range of employee responsibilities. All delegates were encouraged to participate and express their views. Conversation was at the heart of the enquiry which was in a non -challenging, non-judgemental environment.
Scoring and Comment Goals and Objectives Level 3: Evidence of defined organisational goals and objectives being recognised across organisation The CCG s goals are widely published and discussed regularly. The CCG is still forming but there is an intention to revisit the goals annually. Staff are engaged through a standard induction pack and ongoing stand-up sessions. Evidence was not presented to support the necessary link between goals and the infrastructure intended to deliver them. Ownership Level 3: Clear evidence of golden thread linking personal, team and organisational goals and objectives The CCG feels that everyone can contribute to the CCG s success and that it is creating the ability to recognise value. There is evidence to suggest that the CCG is willing to adopt new ideas and accept the risk that accompanies initiatives that have not been tried before. The CCG clearly wants its goals to be identifiable externally through the actions of its people. There is some concern about the strength of the golden thread linking personal and organisational goals but there is evidence that the thread exists. Whilst there is an opportunity to discuss issues at stand up, there was no evidence to suggest day to day interactions between teams to review the goals and ensure that activity supports their achievement. Delivery Level 2: Determination of critical path to delivery of objectives evident There was clear evidence of the understanding of the importance of milestones. Arrangements are in place to report progress but there was no evidence to support the existence of a plan that describes the critical events necessary for the goal to be achieved on time, on budget and to scale. Similarly there was evidence of the understanding of the role of Key Performance Indicators but no evidence to demonstrate their current use. Measurement Level 2: Evidence of measurement of progress in the delivery of goals and objectives There was a good discussion demonstrating the realisation of the importance of measurement and some useful sources of information were identified. The CCG relies on other partners to provide the
data it needs. It may encounter difficulty in obtaining the data it needs as a consequence and may not be able to translate the data into the intelligence that drives continuous improvement. Measurement of progress is made but there was no evidence of the use of Key Performance Indicators. Managing Risk Level 4: Evidence of record of risks likely to impact on the achievement of objectives The risks the CCG encounters are discussed at each stand-up meeting. Each CCG team owns a section of the risk register. Every member of staff can access the register and is encouraged to write up any new risk identified. The CCG understands the need to make the management of risk part of its employees daily activities rather than one carried out once a month. A risk register is produced and updated regularly but is not yet linked to the achievement of goals and objectives. Supporting Business Critical Functions Level 2: Ad hoc approach to recovery when something goes wrong Some people had experienced difficulties in the past; particularly as a consequence of bad weather. There was a clear understanding that certain events could leave the CCG unable to achieve its objectives. There seemed to be an overreliance on the ingenuity of a junior member of staff to resolve minor business continuity issues. The Chief Operating Officer is the designated person responsible for business resilience. The understanding of the need to respond was evident but a preplanned response is unlikely at present. There was no evidence of an assessment of what to do if things go wrong. Business Resilience Capability Scale 2.8 Goals and Objectives: 3.0 Operations: 2.3 Resilience: 3.0 Business Resilience Capability Scale: 2.8
Further Actions and Plans The initial conversation was reviewed on 20 th June 2013 leading to the actions below being developed and discussed. Goals and Objectives: Current Score: 3 Aspirational Score: 4 Ongoing activity to embed staff understanding and ownership of goals and objectives Introduction of multi-function project teams tasked with achieving goals and milestones Formalise project teams and enable reporting by project team Introduction of goal driven risk management process Ownership: Current Score: 3 Aspirational Score: 4 CCG to pursue its desire for staff to be recognised as BSC staff through their attitude and action Strengthen golden thread through introduction of project teams Ensure that knowledge gained in project teams is transferred to colleagues in the common skills pool/team Delivery Current Score: 2 Aspirational Score: 3 Determine and record the critical path to success for each goal i.e. the milestones to be achieved to demonstrate that plans are on target for achievement Consider and document where we are, where we want/need to be and how we are going to get to where we want/need to be Describe and introduce a set of Key Performance Indicators for each milestone on the critical path and demonstrate their use in underpinning the achievement of the CCG s goals Measurement Current Score: 2 Aspirational Score: 3 Be able to translate data into a measurement (key performance indicator) that can be used to evidence the achievement of milestones Secure the data needed to support the measurement required Demonstrate the application of data to continuous improvement and a corresponding uplift in performance required to achieve the goals Managing Risk Current Score: 4 Aspirational Score: 5 Switch from team focus to goal focus Pursue implementation of a goal driven risk management methodology Supporting Business Critical Functions Current Score: 2 Aspirational Score: 4 Agree, implement and support proposal to deliver a CCG Business Continuity Plan
Domain Measures: Goals and Objectives Current Score: 3.0 Aspirational Score: 4.0 Operations Current Score: 2.3 Aspirational Score: 3.3 Resilience Current Score: 3.0 Aspirational Score: 4.5 Business Resilience capability Scale Current Score: 2.8 Aspirational Score: 4.0 It is possible to achieve the aspirational score by the year end (December 2013) although the CCG will want to determine how it can implement the improvements in year (2013/14) whilst continuing to work towards the achievement of its in year goals. An inability to achieve improvements in the Operations domain will diminish the ability to deliver effective resilience programmes and ensure these become part of how the CCG seeks to ensure the achievement of its goals on time, on budget and at scale. Evidence gathered during the initial session Goals and Objectives: Published on website, in integrated plan, business plan, through social media Couldn t find them on the net [they are there but not identified as the goals] Know where they are but didn t have time to read them Publish goals on: Web/business plan/integrated plan/social networks/prospectus CCG still forming Plan to revisit on an annual basis Engage staff through stand up sessions and standard induction pack CCG doesn t departmentalise Governance structure/commissioning Programme Board aligned to goals Ownership: Everyone contributes to the successes Strong culture for recognising value delivered through a flat structure No such thing as failure just feedback and appreciative enquiry - want to be able to try something new without worrying from the outset that it might not work Goals set after development events with all stakeholders Headline goals summarised in 5 words (Prevention, Partnership, Localism, Education and Access) - identifies BSC CCG and its culture Early days for a champion of the goals- only just started running Try and live what we say Thinking about how we present ourselves to people outside Want to reach point where people know where you come from i.e. BSC CCG Want everyone to take on the achievement of the goals Teams interact through conversation get up and talk, no internal emails, stand ups, vibrant, noisy
Value is something that makes a difference, going the extra mile, borne out of the culture Teams focused on delivering value through stand up sessions, briefs and continuous dialogue between SMT and teams, no hierarchy where staff able to raise concerns No dark corners in BSC, no quiet conversations Delivery: Success means meeting a deadline, a job well done, feeling motivated, feeling satisfied and having achieved something, feeling supported, held up as an example of good practice, feedback on results, patient care and active engagement at all levels Important to determine key sequence of milestones allows you to see if you are making progress all the way through, is it still working?, are we going in the right direction Arrangements in place to determine progress include determination of progress through action plans and progress made and reported to committees, monthly or quarterly, progress reports to Governing Body, all reports to Governing Body published, production of balanced scorecard linked to goals and priorities Outcomes focused framework used which has been linked to Area Team assessment framework, CCGs providing hosted services report quarterly All papers are available to staff and public via internet Staff encouraged to attend meetings where progress discussed Measurement: Measure how engaged patients and partners are through social media, achievement of goals, quantitative and qualitative patient experience, Quality reports, number of people through the system, yellow card scheme. Secure effective data from the teams Data owned by acute providers, service users, CSU business intelligence team and public health Verify accuracy through audit and case review, cross reference back to practice, agreed timetable of internal audit Progress in delivering goals reported bimonthly to SMT and staff by a ratings system for the business plan Create value by monitoring progress against the business plan, using the measures in joint meetings with other agencies, using measures to influence future planning, holding improvement conversations and benchmarking Managing Risk: Management of risk is a standing agenda item at stand-up Each team has its own section of a collective risk register Board session identified key risks Updated monthly and reviewed at governing body and 1:1s Risks reviewed by individuals and groups Every member of staff can see the risk register and write up a new risk Seeking to make risk management part of what you do rather than an activity carried out once a month Facilitated session - these are our goals, what are the risks that fall out of them? Support culture of effective risk management through: 1:1s, Stand up, briefings, open access to register, no fear culture Accountable Officer promotes the use of conversation as a route to learning and progressing Supporting Business Critical Functions: People had experienced crisis. Responses varied from ground to a halt and lack of formal arrangements to redefine work programme and working from home in adverse weather
BC important to organisation because an adverse event could leave organisation stranded, key work could be lost, vulnerable adults endangered, compromise ability to achieve goals Chief Operating Officer is named person responsible for business resilience. Accountable officer is the emergency planning lead Would call Corrie if something went wrong BC in contracts with acute trusts Practice BC delivered via Area Team primary care commissioning team No strategy No knowledge of MPTD No system for prioritising demand other than the safeguarding function No BC plan