SERVICE TRANSFORMATION COMMITTEE

TERMS OF REFERENCE

DRAFT FOR APPROVAL

Trust Board decision to set up the STCJanuary 2010

Date of this versionFebruary 2010

This version prepared by Rob Hurd

Chief Executive

Terms of Reference Approval

by Trust BoardExpected February 2010

Proposed date of first meetingApril 2010

Terms of Reference

1. Purpose

The purpose of the Service Transformation Committee is to support the Trust’s Assurance Framework through monitoring the establishment of detailed plans and delivery of the service transformation plan and cost improvement programme. This relates to assurance both that initiatives that have been implemented are being achieved in line with plan and that initiatives proposedto be implemented have robust and deliverable plans in place. This is of particular significance during the procurement phase of the proposed redevelopment project as the sustainability of the Trust’s redevelopment plans are dependent on the delivery of the service transformation plan and cost improvement programme.

2. Establishment of the Service Transformation Committee

The Committee is a non-executive committee of the Board and has no executive powers, other than those specifically delegated in these Terms of Reference. The Committee is established in accordance with the Trust’s Standing Orders, Standing Financial Instructions and Scheme of Delegation.

3. Authority & Accountability

The Committee reports to the RNOH Performance Committee and Trust Board through reporting the work of the committee from each meeting for information and approval.

4. Duties

The duties of the Committee are as follows:

  1. Monitor the service transformation plan and CIP key performance indicators and agree the detailed reporting arrangements that will be needed to gain assurance on delivery. Summary milestones and associated key performance indicators are attached.
  2. Seek assurance that that the work of the individual cost improvement and service transformation projects are fully integrated into the RNOH’s Assurance Framework and supporting risk registers and that the process integrates with developing the Trust’s existing key strategies and annual plans e.g. Workforce Strategy, Procurement Strategy, Estates Strategy, IM&T Strategy, Integrated Business Plan, Redevelopment Outline Business Case and Annual Business Plans.
  3. Seek assurance that the interdependencies of individual cost improvement and service transformation projects (and related Trust strategies and plans listed above) are monitored and that due consideration is made in project plans as to elements within the direct control of the Trust and those elements which require input from external stakeholders.

5.Membership

Non-Executive Director (Chair)

Chief Executive

Joint Medical Director

Chief Nurse

Finance Director

Director of Service Transformation (to be appointed)

Director of Operations

Clinical Director for Clinical Governance

Clinical Director

RNOH Head of Therapies

Invited external stakeholders

North Central London Commissioning Agency

NHS London representative

In attendance:

Service transformation project manager (including meeting administration support)

6.Frequency of meetings

Meetings shall be held once every two months.

7. Quorum

A quorum shall be four members comprising as a minimum:-

Non-Executive Director or Chief Executive

Joint Medical Directoror representation by Clinical Director

Finance Director or senior representation (minimum deputy level)

Director of Service Transformation or Director of Operations or senior representation (minimum General Manager level)

8. Reporting Arrangements

RNOH Trust Board Committee Structure

(See Annex 2 for links between Clinical Governance Committee and Service Transformation Committee)

The Committee reports to the Trust Board through the Performance Committee. After each meeting the Chairman of the Committee, Chief Executive and Finance Director will jointly report the progress of the work of the Committee to the Trust Board. The monitoring reports received by the committee will also be shared with external stakeholders e.g. North Central London Commissioning Agency and NHS London.

The Committee will receive reports from the Trust’s Clinical Governance Committee to provide assurance that cost improvement and service transformation projects are maintaining and enhancing the RNOH patient experience including quality of care. The Chair of the Clinical Governance Committee will be a member of the Service Transformation Committee. The work of the Committee will also interface closely with the Trust’s patient experience group, staff partnership forum and aspirant Foundation Trust membership. Please find attached a diagram (Annex 2) indicating the reporting mechanisms and linkages with the Clinical Governance Committee.

9. Required Frequency of Attendance by Members

It is highly important that members attend the Service Transformation Committee on a regular basis. No more than two meetings should be missed in any one year unless due to extenuating circumstances agreed with the chair of the committee. A delegated deputy should attend the meeting in the absence of a Joint Academic Committee member.

If in exceptional circumstances a committee member is unable to attend the meeting or send a deputy then, in addition to standard reporting arrangements, a formal summary report of progress made against their areas of responsibility should be provided in a minimum of 5 working days in advance of the meeting for inclusion with the papers .

10. Process for monitoring the effectiveness of all of the above

In its reports to the Trust Board, the Committee will review its effectiveness against its objectives, including reviewingand updating membership as necessary.

11. Administration

The Committee shall be supported administratively by the service transformation project manager, in consultation with the Chair of the Committee, Chief Executive and Finance Director.The duties of the project manager, in this respect will include:

  • Agreement of agenda with the Chairman and attendees and collation of papers
  • Agenda and papers to be circulated minimum of 5 working days in advance of meeting
  • Reminding members of forthcoming meetings to ensure the best possible attendance
  • Taking the minutes and recording of matters arising and updates.
  • Monitoring the actions decided upon are followed up.

9. Review

The terms of reference will be reviewed every year or sooner if necessary

Annex 1

Overview of key indicators that will be monitored by the RNOH Trust Board and Service Transformation Committee

Performance

Deliver existing targets and national priorities consistent with 2010/11 operating framework and agreement with NHS London and Commissioners (through North Central London Commissioning Agency).

Specific key performance indicators of risk areas to be monitored:-

  1. Sustainable delivery of 18 week access in all clinical units except spinal deformity by end of March 2010.
  2. Sustainable delivery of 18 week access in spinal deformity Quarterly trajectory by end of March 2011 – quarterly trajectory to be agreed for April 2010 – March 2011.
  3. Sustainable delivery of cancer waiting times

Cost Improvement and Service Transformation Plan

Key performance indicators:-

  1. Annual Business Plan and associated financial plan agreed with NHS London
  2. Financial monitoring demonstrating that in-year financial performance consistent with agreed financial plan as evidenced in monthly/quarterly FIMs returns.
  3. Documented detailed underlying project plans for all cost improvement & transformation projects detailing resources required to implement, ting and amount of financial benefit, actions required to deliver the financial benefit, lead responsibilities and accountabilities and timescales. Monitoring of project plans will include reporting against items delivered, assessment of actual impact against plan and risk rating of future actions. The Service Transformation Committee will receive these plans and monitoring reports as evidence that this process is in place.
  4. Documented detailed project plans will be supported by a monthly profile of planned savings against which actual savings will be monitored monthly in addition to standard financial reporting. The Service Transformation Committee will receive these plans and monitoring reports as evidence that this process is in place.
  5. Embedded service line reporting and patient level costing influencing service transformation as evidenced through monthly reporting from April 2010.
  6. The Trust considers that an overall bottom line deviation from monthly CIP trajectory of higher than 5% to be an indication of significant risk to overall delivery. In such circumstances it would be expected that the actions indicated in the downside mitigation plan that accompanies the OBC would need to be implemented to offset the shortfall. In such circumstances the Trust Board would formally minute whether it considers the agreed overall CIP and service transformation plan financial targets are still achievable.
  7. Additional and particular assurance will be required for projects involving significant service reconfiguration leading to significant savings in the later years of the plan (e.g. items 1-4 and 22). Additional assurance on these through the Service Transformation Committee will be evidenced by external /independent assurance (e.g. internal audit or appropriate alternative) to the Trust that the project plans produced in these areas remain deliverable.

Procurement Milestones and Summary Key Performance Indicators

The following table summarises the key performance indicators that the Board will sign off as remaining on target at each key procurement milestone. Where the key indicator has not been met the Board will indicate the scale of risk that this brings to the Trust’s plans detailed in the Outline Business Case and associated LTFM and formally confirm whether it considers that the overall plan remains achievable taking into consideration all indicators available at the time. A more detailed breakdown of key performance indicators against project milestones will be agreed and monitored through the service transformation committee.

Key Milestones / Target dates / Summary Key Performance Indicator
OBC Submission / November 2009
(Final February 2010) /
  1. Trust Board approval of OBC and associated CIP and service transformation plans.

SHA / DH OBC Approval / February 2010
Outline Planning Approval / March 2010 /
  1. RNOH Service Transformation Committee Terms of Reference agreed and Committee set up for first meeting April 2010
  2. 2010/11 Annual Plan agreed by Trust Board and NHS London, including 2010 CIP and Service Transformation project implementation resources
  3. 18 week access target March milestone met

Health Gateway Review (Gate 2) / May 2010 /
  1. 2009/10 financial outturn delivered on target (evidenced in draft accounts – May , audited accounts - June)

OJEU Advertisement / July 2010 /
  1. Detailed project plans for all CIP and service transformation signed off by service transformation committee.
  2. 2010/11 Quarter 1 performance and financial targets met (including 18 week spinal deformity trajectory)
  3. Monthly Service Line Reporting in place to inform CIP and service transformation plans.

Shortlist Bidders / October 2010 /
  1. Service Transformation Committee confirmation that project plans remain on target
  2. 2010/11 Quarter 2 performance and financial targets met (including 18 week spinal deformity trajectory)

Issue ITPD / November 2010
Issue ITSFB / Call for Final Tenders / September 2011 /
  1. 2010/11 performance and financial targets met (including 18 week spinal deformity trajectory)
  2. 2010/11 CIP monthly trajectory met
  3. 2011/12 Quarter 1 CIP monthly trajectory met
  4. 2011/12 Quarter 1 performance and financial targets met

Receive Final Tenders / October 2011
Trust Recommendation to Appoint Preferred Bidder / December 2011 /
  1. 2011/12 Quarter 1 & 2 performance and financial targets met
  2. 2011/12 Quarter 1 & 2 CIP monthly trajectory met

ABC Approval / April 2012 /
  1. 2011/12 Quarter 3 performance targets and financial targets
  2. 2011/12 Quarter 3 CIP monthly trajectory met
  3. Service Transformation Committee and Trust Board receive external/independent assurance that longer term high risk service reconfiguration projects on track

Health Gateway Review (Gate 3) / May 2012 /
  1. 2011/12 Financial targets met (audited accounts)

Treasury Approval of Full Business Case / September 2012 /
  1. 2012/13 Quarter 1 & 2 performance and financial targets met
  2. 2011/12 Quarter 1 & 2 CIP monthly trajectory met
  3. Service Transformation Committee and Trust Board receive external/independent assurance that longer term high risk service reconfiguration projects on track

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Service Transformation Committee Terms of Reference February 2010

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Service Transformation Committee Terms of Reference February 2010