Consultation Working Draft

Consultation Working Draft

2017/18

Annual PlanGuidelines

WITH STATEMENT OF PERFORMANCE EXPECTATIONS

Table of Contents

Overview of the Annual Plan Structure

SECTION 1: OVERVIEW OF STRATEGIC PRIORITIES

1.1Strategic Intentions/Priorities

1.2Message from the Chair and Chief Executive

1.3Signature Page

SECTION 2: DELIVERING ON PRIORITIES

2.1Government Planning Priorities

2.2Financial Performance Summary

2.3Local and Regional Enablers

SECTION 3: SERVICE CONFIGURATION

3.1Service Coverage

3.2Service Change

SECTION 4: STEWARDSHIP

4.1Managing our Business

4.2Building Capability

SECTION 5: PERFORMANCE MEASURES

5.12017/18 Performance Measures

APPENDIX A: STATEMENT OF PERFORMANCE EXPECTATIONS including FINANCIAL PERFORMANCE (for tabling as SPE)

Statement of Performance Expectations (SPE)

Financial Performance

APPENDIX B: SYSTEM LEVEL MEASURES IMPROVEMENT PLAN

Additional Information

Glossary of Terms

Financial Checklist for 2017/18 Financial Statements (and supporting templates)

Output Class Recommendations

Overview of the Annual Plan Structure

SECTION 1:OVERVIEW OF STRATEGIC PRIORITIES (suggested three pages long)
1.1 Strategic Intentions/Priorities
1.2Message from the Chair and Chief Executive
1.3Signature Page
SECTION 2: DELIVERING ON PRIORITIES (suggested ten to twelve pages long)
2.1 Government Planning Priorities
SECTION 3 : SERVICE CONFIGURATION (suggested two pages long)
3.1 Service Coverage
3.2 Service Change
SECTION 4: STEWARDSHIP(suggested two pages long)
4.1 Managing our Business
4.2 Building Capability
SECTION 5: PERFORMANCE MEASURES (suggested two pages long)
5.1 2017/18 Performance Measures
APPENDIX A: STATEMENT OF PERFORMANCE EXPECTATIONS including FINANCIAL PERFORMANCE (for tablingas SPE)
Statement of Performance Expectations (SPE)
Output classes
Financial Performance
APPENDIX B: SYSTEM LEVEL MEASURES IMPROVEMENT PLAN
Guidance TBC.

Further guidance for the 2017/18 Annual Plans (APs) is outlined in the Planning Priorities Guidance.

For further information regarding the Annual Plan Guidelines please contact:

Stasha Mason

Service Commissioning

Ministry of Health

(04) 496 2265.

SECTION 1: OVERVIEW OF STRATEGIC PRIORITIES

This section should include a brief explanation of the DHB’s strategic intentions/priorities, key messages from the Chair and Chief Executive and the signature page, and therefore should be kept short (it is suggested that this section should be no longer than three pages).

1.1Strategic Intentions/Priorities

This must include a brief outline of the key strategic outcomes or objectives for the DHB to enable it to deliver on local, regional and national health needs.

1.2Message from the Chair and Chief Executive

1.3Signature Page

SECTION 2: DELIVERING ON PRIORITIES

This section should include DHB commitments to each of the Government priorities outlined in the Minister’s Letter of Expectations (once sent). Please note that it is suggested that this section should be no longer than ten to twelve pages.

DHBs need to engage with relevant stakeholders, including their primary care partners, when developing their 2017/18APs.

2.1Government Planning Priorities

Overarching Government priorities are presented in the Minister’s Letter of Expectations, which will be sent to DHB Chairs in December 2016. The planning priorities for DHB 2017/18 APs are:

Prime Minister’s Youth Mental Health Project

Reducing Unintended Teenage Pregnancy Better Public Service (contributory) Target

Supporting Vulnerable Children Better Public Service Target

Reducing Rheumatic Fever Better Public Service Target

Increased Immunisation Better Public Service and Health Target

Shorter Stays in Emergency Departments Health Target

Improved Access to Elective Surgery Health Target

Faster Cancer Treatment Health Target

Better Help for Smokers to Quit Health Target

Raising Healthy Kids Health Target

Bowel Screening

Mental Health

Healthy Ageing

Living Well with Diabetes

Childhood Obesity Plan

Child Health

Disability Support Services

Primary Care Integration

Pharmacy Action Plan

Improving Quality

Living Within our Means.

The full detail of expectations within each priority is outlined in the Planning Priorities Guidance and inclusion of the templates within that guide are mandatory.

2.2Financial Performance Summary

This needs to include the consolidated statement of comprehensive income (previous year’s actual, current year’s forecast and three years plan), and the prospective summary of revenue and expenses by output class for the next three years.

2.3Local and Regional Enablers

This component will outline the DHB specific actions to deliver on the following local and regional enablers:

Information Technology

Workforce.

For Information Technology DHBs must demonstrate how they are regionally aligned and where they are leveraging digital hospital investments.

In addition, DHBs should also identify any significant individual DHB actions to deliver on the Regional Service Plan priorities. These should be identified within the annual plan priority where the priorities overlap (such as ‘Mental Health’) or in the separate ‘Delivery of Regional Service Plan’ section of the planning priorities template within the Planning Priorities Guidancefor those priorities that do not overlap.

More detail of expectations within each enabler is outlined in the Planning Priorities Guidance and inclusion of the templates within that guide are mandatory.

SECTION 3: SERVICE CONFIGURATION

Inclusion of the below service change template is mandatory within this section, if there are service changes to include. Please note that it is suggested that this section is no longer than two pages.

3.1Service Coverage

In this section DHBs need to:

• describe all service coverage exceptions that have been approved for the 2017/18 year
• provide a high-level explanation setting out why the exceptions have been required and the process followed for approval.

3.2Service Change

DHBs are to describe all service changes that have been approved for implementation in the 2017/18 year. For each change, DHBs must explain how the changes will deliver benefits (see the below example).

Service coverage exceptions and service changes must be formally approved before they are included in APs. As in previous years DHBs are expected to provide early signals of proposed service changes to the Ministry. These are required by Friday 3 February 2017.

The template (with example) below must be included within this section, if there are service changes to include. The template should include a summary of the proposed service change information provided to the Ministry on Friday 3 February 2017.

Change / Description of Change / Benefits of Change / Change for local, regional or national reasons
Renal Services / We will explore how the DHB might better meet the renal needs of itscommunity with a specific focus on the southern part of the population. / Improved access, reduced cost, earlier intervention, improvement of long term outcomes. / Local

SECTION 4: STEWARDSHIP

This sectionwill outline the DHB’s stewardship of its assets, workforce, IT/IS and other infrastructure needed to deliver planned services. Please note that it is suggested that this section only be up to two pages.

4.1Managing our Business

Reflect the scale and scope of the DHB’s services and show the extent of resources required to provide these services. Consider briefly commenting on:

• organisational performance management
• funding and financial management (key high-level figures/assumptions)
• investment and asset management
• shared service arrangements and ownership interests
• risk management
• quality assurance and improvement.

4.2Building Capability

Briefly outline the capabilities the DHB will need over the next three to five years and reference any sub-plans the DHB uses to support improvements in capability. Link to national or regional plans (including comment on the New Zealand Health Strategy) where relevant, and include high-level comments on:

• capital and infrastructure development
• information technology and communications systems
• workforce (including organisational culture, leadership and workforce development)
• co-operative developments (working with other organisations eg, education and training providers).

*It is also suggested that DHBs include an express empowering provision for service agreements in the AP to avoid any doubt in relation to section 25(2) of the New Zealand Public Health and Disability Act 2000. DHBs are encouraged to seek independent legal advice on appropriate wording for this.

SECTION 5: PERFORMANCE MEASURES

Please note that it is suggested that this section is no longer than two pages.

5.12017/18 Performance Measures

Inclusion of the below performance measures template is mandatory within this section. Note: the full detail of the monitoring framework for 2017/18 forms a separate component part of the planning package and is still under development. This document will be released for consultation shortly.

Include the full set of performance measures in the template and ensure accuracy across any other use of this information in other parts of the document (eg, Health Target figures shown here match those used in section 2 and Appendix A) and other plans.

The DHB monitoring framework aims to provide a rounded view of performance using a range of performance markers. Four dimensions are identified reflecting DHB functions as owners, funders and providers of health and disability services. The four identified dimensions of DHB performance cover:

• achieving Government’s priority goals/objectives and targets or ‘Policy priorities’
• meeting service coverage requirements and Supporting sector inter-connectedness or ‘System Integration’
• providing quality services efficiently or ‘Ownership’
• purchasing the right mix and level of services within acceptable financial performance or ‘Outputs’.

Each performance measure has a nomenclature to assist with classification as follows:

CodeDimension

PPPolicy Priorities

SISystem Integration

OPOutputs

OSOwnership

DVDevelopmental – Establishment of baseline (no target/performance expectation is set)

Inclusion of ‘SLM‘in the measure title indicates a measure that is part of the ‘System Level Measures’ identified for 2017/18.

Performance measure / Performance expectation
PP6: Improving the health status of people with severe mental illness through improved access
PP7:Improving mental health services using transition (discharge) planning
PP8: Shorter waits for non-urgent mental health and addiction services for 0-19 year olds
PP10: Oral Health- Mean DMFT score at Year 8
PP11: Children caries-free at five years of age
PP12: Utilisation of DHB-funded dental services by adolescents (School Year 9 up to and including age 17 years)
PP13: Improving the number of children enrolled in DHB funded dental services
PP20: Improved management for long term conditions (CVD, Acute heart health, Diabetes, and Stroke)
PP21: Immunisation coverage
PP22: Delivery of actions to improve system integration including SLMs
PP23: Improving Wrap Around Services for Older People
PP25: Prime Minister’s youth mental health initiative
PP26: The Mental Health & Addiction Service Development Plan
PP27: Supporting vulnerable children
PP28: Reducing Rheumatic fever
PP29: Improving waiting times for diagnostic services
PP30: Faster cancer treatment
PP31: Better help for smokers to quit in public hospitals
PP32:Improving the accuracy of ethnicity reporting in PHO registers
PP33: Improving Māori enrolment in PHOs
PP34: Improving the percentage of women who are smoke free at two weeks postnatal
PP35: Reducing SUDI infant deaths
PP36: Reduce the rate of Māori on the mental health Act: section 29 community treatment orders relative to other ethnicities.
SI1: Ambulatory sensitive hospitalisations
SI2: Delivery of Regional Service Plans
SI3: Ensuring delivery of Service Coverage
SI4: Standardised Intervention Rates (SIRs)
SI5: Delivery of Whānau Ora
SI6:Improving cervical screening rates
SI7:Improving breast screening rates
OS3: Inpatient Length of Stay
OS8: Reducing Acute Readmissions to Hospital
OS10: Improving the quality of identity data within the National Health Index (NHI) and data submitted to National Collections
Output 1: Mental health output Delivery Against Plan
Developmental measure DV4: Improving patient experience

APPENDIX A: STATEMENT OF PERFORMANCE EXPECTATIONSincluding FINANCIAL PERFORMANCE(for tabling as SPE)

This section must be tabled in Parliament. All components of this section are mandatory (section 149C of the Crown Entities Act 2004[1]) and relate to a reporting timeframe of five years minimum (prior year audited actual, current year forecast and three years’ plan) (section 149G(2)(b) of the CE Act).

Statement of Performance Expectations (SPE)

(section 149B-G of the CE Act)

To ensure that the SPE meaningfully supports the key strategic outcomes and priorities of the DHB’s planned activities (as outlined in the precious Sections) and performance, clear intervention logic is expected to explain the link between the selected outputs and how they will contribute to impacts, and outcomes.*Refer to definitions provided in the glossary to ensure consistency of terms.

The SPE is to provide specific measures/targets for the coming year, with comparative prior year and current year forecast (at a minimum). The Ministryencourages DHBs to provide both historic and future trends in theirSPEs so far as it is meaningful and practical to do so.

Output classes

(section 149E of the CE Act)

Four Output Classes are to be used by all DHBs to reflect the nature of services provided. There is a close correlation between these descriptions and the logic applied when mapping Purchase Unit Codes (PUCs) to each output class. *Refer to theoutput class definitions included. The Output Class categories are:

• Prevention
• Early Detection and Management
• Intensive Assessment and Treatment
• Rehabilitation and Support.

DHBs must describe services they plan, fund, provide, and promote within each Output Class. Include at least total expected revenue and proposed expenses for each Output Class that in total agree to your financial statements (section 149E of the CE Act).

Financial Performance

(section 149B-G of the CE Act)

Please note that financial templates submitted to the Ministry in support of financial statements must be completed in accordance with the ‘Requirement and Guidelines for using Financial Templates’, which are issued to DHBs in conjunction with the blank templates. *Refer to the checklist for financial templates included.

Each SPE must, in relation to a Crown entity and a financial year, contain forecast financial statements that comply with section 149G (section 149E(1)(d) of the CE Act), be prepared in accordance with generally accepted accounting practice, and for each reportable class of outputs identify the expected revenue and proposed expenses (section 149(E)(2)(b) of the CE Act). The forecast financial statements must include:

• a statement of all significant assumptions underlying the forecast financial statements (section 149G(2)(a) of the CE Act)
• any additional information and explanations to fairly reflect the forecast financial operations and financial position of the DHB (section 149G(2)(b) of the CE Act).
  

APPENDIX B: SYSTEM LEVEL MEASURES IMPROVEMENT PLAN

Guidance for the 2017/18 System Level Measures Improvement Plans is TBC. Further information will be provided when it is available.

Additional Information

(NOT to be included in final plans – for reference in developing documents only)

Glossary of Terms

Term / Meaning
Activity / What an agency does to convert inputs to Outputs.
Capability / What an organisation needs (in terms of access to people, resources, systems, structures, culture and relationships), to efficiently deliver the outputs required to achieve the Government's goals.
Crown agent / A Crown entity that must give effect to government policy when directed by the responsible Minister. One of the three types of statutory entities (see also Crown entity; autonomous Crown entity and independent Crown entity)
Crown entity / A generic term for a diverse range of entities within one of the five categories referred to insection 7 of theCE Act, namely: statutory entities, Crown entity companies, Crown entity subsidiaries, school boards of trustees, and tertiary education institutions.
Crown entity subsidiary / Companies incorporated under the Companies Act 1993that are controlled by Crown entities, and that are: (a) a subsidiary of another Crown entity undersections 5–8 of the Companies Act; or (b) a multi-parent subsidiary of two or more Crown entities(section 7(1)(c) of theCE Act).
Cost containment / Reducing costs or cost growth in general, whether through improved efficiency, or other means, such as contract negotiation/consolidation, changes to budget management, changes in structure etc.
Efficiency / Reducing the cost of inputs relative to the value of outputs.
Effectiveness / The extent to which objectives are being achieved. Effectiveness is determined by the relationship between an organisation and its external environment. Effectiveness indicators relate outputs to impacts and to outcomes. They can measure the steps along the way to achieving an overall objective or an outcome, and test whether outputs have the characteristics required for achieving a desired objective or government outcome.
Financial Statements / AP financial statements are forecast financial statements required to cover five years: prior year audited actual, current year forecast and three years’ plan.
Impact / Means the contribution made to an outcome by a specified set of goods and services (outputs), or actions, or both.It normally describes results that are directly attributable to the activity of an agency. For example, the change in the life expectancy of infants at birth and age one as a direct result of the increased uptake of immunisations.
Impact measures / Impact measures are attributed to agency (DHB) outputs in a credible way. Impact measures represent near-term results expected from the goods and services you deliver; can often be measured soon after delivery, promoting timely decisions; and may reveal specific ways in which managers can remedy performance shortfalls (refer to State Services Commission Performance Measurement – Advice and examples on how to develop effective frameworkspage 13).
Input / The resources such as labour, materials, money, people, and information technology used by departments to produce outputs, that will achieve the Government's stated outcomes.
Intervention / An action or activity intended to enhance outcomes or otherwise benefit an agency or group.
Intervention logic model / A framework for describing the relationships between resources, activities and results. It provides a common approach for integrating planning, implementation, evaluation and reporting. Intervention logic also focuses on being accountable for what matters – impacts and outcomes (refer to State Services Commission Performance Measurement – Advice and examples on how to develop effective frameworks).
Intermediate outcome / See Outcome
‘Living within our means’ / Providing the expected level of outputs within a break-even budget or Ministry agreed deficit step toward break even by a specific time.