Derbyshire Community Health Services NHS Trust Board

Derbyshire Community Health Services NHS Trust Board
Document Title:
Integrated Business Plan 2012/17 (IBP)and supporting strategies
Simon Griffiths / Executive Management Team
As above with supporting teams
Contact details for
further information:
Executive Management Team
Date of Meeting:
27 October 2011
Item No: 151/11
Document is for: (indicate with an x)
No of pages
inc. this one: 5
Executive Summary
An Executive Summary of the draft IBP is being considered by the Board along with the
following supporting strategies:
Quality Strategy – previously discussed at September Board
Draft People and Organisational Effectiveness Strategy
Draft Estate Strategy
Draft Information Management & Technology Strategy
This documentation cannot be considered publicly at this stage as it is still at an early stage of
development (see section 3 on page 4 below) and is commercially sensitive.
Section 1 on page 4 below explains what the IBP is and why it is an important part of the
trust’s development as a community foundation trust.
Section 2 below describes how the IBP is assessed.
Section 3 outlines how the IBP has been developed and the overall timescale and process.
Section 4 indicates the further work which needs to be done between now and the final
approval of the IBP in March 2012.
Section 5 outlines the immediate next steps to be taken to develop the IBP.
Financial Impact
The financial impact of the draft IBP and supporting strategies is contained within section 5 of
the draft IBP being considered in confidential session.
Links to DCHS Strategy
The draft IBP reviews and sets out the DCHS Strategy in the light of analysis of the policy,
financial and demographic landscape and following extensive engagement with the Board,
DCHS staff, clinical commissioning groups and other stakeholders.
The Board is asked to:
Note the development of the IBP;
Note the commitment to develop a publicly accessible version of the plan in Spring 2012;
Ensure that the comments received during the foundation trust during July – September
2011 are appropriately included within the IBP’s development;
Commit to working with the PCT Cluster and clinical commissioning groups as part of their
consultation on any significant service changes brought about through the final agreement
of the IBP in March 2012.
It should be noted that full and final approval of this suite of documentation is not required until
the February 2012 DCHS Board meeting.
Monitoring Information
CQC Compliance
Monitor Compliance
NHSLA Compliance
Assurance Framework Ref:
Brief Summary
The IBP and supporting strategies focus on
ensuring DCHS exceeds the core standards
All documentation has been developed in line with
Monitor guidance and to achieve Monitor
The development of the IBP and supporting
strategies will support DCHS’ ambition to achieve
level 2/3.
The IBP and supporting strategies are aligned to
the assurance framework
(If no, why)
Are there Equality & Diversity
Are there Patient and Public
Involvement implications?
The equality and diversity impact will be identified
through the completion of an equality impact
assessment and mitigation plans will be prepared.
The responses to the foundation trust consultation
process are currently being analysed and will be fed
into the next version of the IBP. DCHS is committed
to working with the PCT Cluster and clinical
commissioning groups in their consultation around
any significant service changes resulting from the
final agreement of the IBP in March 2012.
Integrated Business Plan and Supporting Strategies
1. Aim of the IBP
The Monitor guidance states that
‘The integrated business plan is a document that sets out the organisation’s business
strategy for the next five years. It will be an evolving document that will assist the applicant
trust to plan for the risks and opportunities it will face as an independent, public benefit
Applicant NHS foundation trusts need to show that their proposed vision is based on local
consultation, sound financial modeling (taking into account all external factors e.g. Lord
Darzi’s Next Stage Review, payment by results, practice-based commissioning, and
choice), business knowledge, and the actions taken to mitigate risks, while adhering to
principles to ensure success for the organisation and the community it serves. The
business plan will need to demonstrate that effective staff involvement and commitment to
service development has been secured.’
2. IBP Assessment
To aid consideration of the IBP, the Board is reminded of the assessment questions set
out by Monitor in its guidance to applicant foundation trusts, summarised in the table
Is the level of activity
and mix of services
consistent with patient
needs and the
requirements of the
2006 Act?
Is the IBP internally
Is the IBP financially
viable and
Required services included?
Acceptable assumptions about property and asset disposals?
Private patient income consistent with cap?
Is it supported by key commissioners?
Fit with local and national service needs?
Are resources consistent with projected service activity and
• Are capital assumptions consistent with projected service
• Is the implementation plan clear and consistent?
1. What are the major changes proposed?
2. Are the key assumptions realistic?
3. Is there a realistic set of risk scenarios and clear contingency
3. Development process
Development if the IBP has been in line with the tripartite formal agreement (TFA) and
effectively started with the initial Board development session in March 2011. Since then, 4
further Board development sessions have been held in July, September and October,
where key planning assumptions and initial drafts have been shared and debated.
Updates have also been provided at the Community Foundation Trust (CFT) Project Board
and at the Quality Business Committee.
Set within a corporately derived planning framework and set of assumptions, the
development of the service models has been largely driven by the service divisions and
the resulting service concepts have been widely shared with nearly 1,000 staff through the
recent series of staff engagement events.
Similar discussions have been held with the local clinical commissioning groups, NHS
Trusts and Derbyshire County Council. Initial discussions have also been held with the
Improvement and Scrutiny Committee. Support for the early draft plan has been
It should also be noted that in line with national guidance, a detailed proposal around the
estate transfer has been developed with the PCT Cluster. This has led to some
assumptions around the future use of buildings which may require further refinement as
the IBP is further developed.
Thus a significant amount of progress has been made in developing the attached draft
plan and its supporting strategies. The Board is however reminded that, as indicated by
the timeline below, we are still at an early stage in the process with the final plan not being
approved by the SHA until March 2012.
While a robust draft has been developed, there is significantly more detailed work to be
done. Furthermore, the commissioners’ commissioning intentions are being developed and
the NHS Operating Framework for 2012/13 will be received later this year along with the
resulting financial settlement. While the plan has been developed with clear assumptions
and commissioner engagement, our planning assumptions may well need to be amended
in the light of further guidance.
4. Further work required
At this early stage, it is inevitably the case that there is still a significant amount to be done
to refine the IBP over the next 5 months. The major pieces of work are to:
Review our strategic objectives and service development plans in the light of our
planning work to get a clear linkage and ensure the core business of the trust can be
clearly stated;
Undertake further work on the long term financial model and downside scenarios to
address the financial and activity challenges raised from the work undertaken to date ;
Further develop the service development plans so there is a robust route map to the
future setting out a clear set of actions and timescales which also deliver the necessary
quality, finance and activity requirements, including private patient income and impact
of personal budgets;
Update the market analysis primarily around the comparative performance data given
the change in organisations and establish a more proactive approach to our
partnership development with non statutory sector organisations;
Include relevant components of the outcomes from the foundation trust consultation;
Further develop the evidence base for the changes outlined.
5. Next steps
In line with the TFA, the Board will need to sign off the final draft of the IBP at the Board
meeting in February.
It is therefore proposed that a further draft of the IBP and LTFM is brought to the Board in
December once further modelling work has been completed.