PROTECT-COMMERCIAL
Project Initiation Document
The provision of healthcare within the custody environment through the NHS Commissioners
Police in Partnership
Within NHS Bury
Version 1.1.2
Project Initiation Document
Project Title / The provision of healthcare within the custody environment using NHS Bury to commission the processDocument Reference / Healthcare contract PID
Version / 1.1.2
Dated: / 29th March 2011
Author: / Adrian Emberton
Distribution:
Mr Tim Ewen
Ms Louisa Sharples
Mr Ian Cosh
ACC Andrew Cooke
Mr Peter Alton
Project Team: NHS Bury
Nicola Ellis
Tracy Ann Wilson
Project Team: Police
Adrian Emberton
John Clucas
Peter Higson
VERSION CONTROL
Amendment / Status / Authorisation /
1.0.0 / 05 April / A Emberton / DRAFT
1.1.0 / 14 April / A Emberton / Edited by Partnership Board / DRAFT / Tim Ewen
1.1.1 / 5 May / A Emberton / Updated with financial details for feasibility study / DRAFT / Tim Ewen
1.1.2 / 12th Dec / A Emberton / Updated following national information / DRAFT / Tim Ewen
1.1.3 / 14.1.12 / A Emberton / Updated following consultation / FINAL / Tim Ewen
PROJECT BUSINESS CASE
Purpose
The purpose of this Project Initiation Document (PID) is to assist in the changes created by being an early adopter within the national scheme in the provision of healthcare within the custody environment.
The provision of healthcare has been outsourced for the past 5-years and the current provider is MEDACS. A number of different companies were tendering for the contract and in the event that a new company is successful then the transition between companies will have needed to be managed.
However national guidance from ACPO and the DH has recently recommended that healthcare should be commissioned with the assistance of an NHS Commissioner. The ‘Goodwin’ paper on police deliverables recommended that the provision of healthcare should be handed to the NHS National Commissioning Board, who would be responsible for the commissioning of healthcare. This document deals exclusively under the precept that the NHS commissioners, in this instance appoint NHS Bury Regional Offender Health Team (ROHT) will act as the commissioners’.
This PID outlines the methodology for this implementation rather than a business case, as the business case to outsource healthcare provision has already been made, although this document will highlight the risks and issues with the transfer
All external and internal stakeholders have been identified as well as the project products that will be produced as part of the project remit.
The document identifies any risks, issues, constraints’, as well as the organisational structures, implementation teams, and implementation plans for the delivery of such a change
Background
Since 2007, healthcare within Lancashire custody suites has been outsourced, and as mentioned previously MEDACS currently holds the tender.
The current value of the annual contract is £1,200,000
Supporting National Strategy
The aim of outsourcing healthcare must always be to provide a standard of care, which is compliant with the “safer detention & handling of persons in police custody 2006”, updated April 2010, which lays out the minimum standards to which all forces must adhere to.
In addition, the outsourcing of healthcare supports the ACPO strategy of ‘police deliverables of the health and criminal justice board’. Throughout any such process there must we must be an overarching consideration to providing ‘value for money’, the current financial restrictions being faced, and probity for the public purse
The National Early Adopters’ Scheme greatly assists the Constabulary in the area of healthcare addressing areas outside of its normal remit, areas such as healthcare needs assessments, workforce analysis, leading to the eventual increase of standards in the service we provide
The assistance of the NHS in commissioning of this provision brings custody environments into line with other offender areas such as prisons; offering equitable provision to patients regardless of the environment they reside (Department of Health 2001)
Project Aim
Objective
To plan, review and implement a process for the transfer of the budgetary and commissioning responsibility for healthcare in police custody suites to the ROHT.
Lancashire Constabulary is committed to delivering a high quality policing service to those who are detained within the custody environment as part of an offence.
The aim being to transfer budgetary and commissioning responsibility for the provision of healthcare to NHS Bury, and to be in a state of readiness by April 2013/2015.
Requirements
The objective is to explore review and implement healthcare within police custody and support the transition between providers, deliverables will include, but are not exhaustive
§ The formation of a healthcare Partnership Board in order to provide clinical governance
§ To sign and agree both a MoU and Terms of Reference
§ To instigate and complete a Healthcare Needs Assessment
§ A baseline review of current services
§ A baseline cost collections; a study to identify whether such a transfer is financially feasible
§ A Healthcare needs Assessment for Lancashire
§ A work force analysis
§ To complete a statement of readiness/shadow transfer which will be completed by April 2013
§ If necessary, the management of a transitional change between the old and new provider
§ Ensure that adequate monitoring systems and quality measures are in place, and agreed to manage its introduction
Outcomes
The primary outcomes of the project are:
o To provide additional governance to custody healthcare
o An improved standard of healthcare to individuals within the custody environment
o To be in a state of readiness in order to transfer commisioning responsibility to NHS Bury ROHT
o The development of improved care pathways into and from community health providers and criminal justice partners for detainees
o The transfer of clinical and financial liabilities to NHS Bury when legislation allows
o The development of a clinical governance framework, plans and clinical protocols
o Improved engagement with healthcare professionals
o The setting up of performance monitoring to collect and measure health outcomes
Delivery principles
These principles are outlined within the following headings
o Organisation & Governance
o Communication strategy
o Project Management
o Partnership
o Resources
Organisation and governance
o Guidance from ACPO and the Department of Health have expressed a preference for police forces to commission their healthcare provision through the NHS National Commissioning structure
o A Partnership Board to be created in order to agree and implement terms of references and for the setting up of a partnership agreements.
o An MoU is to be ratified between both parties and the DH
o Working relationships between the police and health commissioners to be formalised prior to any transfer
o A clear and defined protocol to be agreed that ensure efficient and effective feedback on behalf of all parties concerned
Communication strategy
o A comprehensive communications strategy will be developed in order to inform and provide updates both internally and externally for partner agencies/stakeholders’
Project Management
o The Constabulary will manage this project within its existing structure jointly with members of the provider and NHS Bury.
o Agreed evaluation outcomes will ensure the provision of healthcare as stipulated under the tender agreement; PACE and SHDP, but with an NHS clinical governance structure
Partnership
o A Partnership Board will be created in order to agree and implement terms of references and the setting up of a partnership agreements, and to liaise with the appointed commissioning board
o A Memorandum of Understanding wil be signed between the Constabulary, Department of Health and NHS Bury
o Direction and support will be provided by the Department of Heath which includes ACPO representation
Resources
o The project team will identify any areas of concern surrounding the medical establishments, staffing structures etc. These will be members of NHS Bury and Lancashire Police
o Funding will be provided by the DH for the commissioning process for 2011-2012 and 2012-2013. this will be apportioned as per the MoU
Roles:
Police
The police will be the partner within the project; however it will provide resources within the following areas
o Will provide a Project Management role for the Partnership Board
o Lancashire Police Procurement Department will carry out the procurement exercise in consultation and partnership with NHS Commissioners Bury
o Will provide assistance to, and work in partnership with members of NHS Bury in order to achieve their targets
o To manage and implement recommendations in of the Partnership Board
NHS Bury
o Assess the needs, through a systematic process, understanding of the health and health care needs of the offenders in the system. (Healthcare needs assessment)
o Review services and gap analysis: reviewing the services currently provided and based on the needs, defining the gaps (or over provision)
o Risk management: understanding the key health and healthcare risks facing the police and deciding on a strategy to manage it and implementation of the strategy
o Decide upon priorities, using available evidence of cost effectiveness and based on a robust and defensible ethical frame
o Strategic options: bring together all the available information into a single strategic commissioning plan that includes how the Police will deliver its core objectives in relation to healthcare in line with PACE Guidance.
o Provider development (including care pathway redesign and demand management); support provider improvements or introduce new providers to deliver the services (including setting up demand management systems and designing new care pathways). The development of pathways and interventions will assist the police in meeting their objectives by reducing reoffending and crime. This includes supporting the decommissioning of services as appropriate.
o In partnership manage provider performance: monitor and manage the performance of providers against their contracts, especially Key Performance Indicators (KPIs).
Healthcare Provider
Once appointed. To review service provision; to benchmark against requirements of the NHS and to cost relevant service areas, as identified by the project team.
To continuous develop the service that is provided in line with the tender contract
Benefits
Benefits identified as part of the project are as follows, and benefit a wider audience than just the judicial system:
o Improve health and well-being for detainees
o Better access to care and continuity of care through the offender journey
o Integrated delivery of services (long-term aim)
o Reduced reoffending and unnecessary use of police time (long-term aim)
o Improve the use of conditional cautioning and alternatives to fixed penalty notices with health, including drugs and alcohol, conditions
o Help courts to make the most appropriate disposal of offenders
o Corporate management of organisational risk for the Constabulary through the NHS Commissioners
o Corporate management of clinical and financial liabilities
o The setting up of a clinical governance framework, plans and clinical protocols
o Improved engagement with healthcare professionals
o The utilisation of existing NHS commissioned services (long-term aim)
o Saving in respect of the procurement of consumables
o Tighter governance on existing medical contracts and the supply of pharmaceutical supplies
o The setting up of performance monitoring to collect and to measure health outcomes
Proposed schedule
To formally agreed a schedule which will only take place once approval to continue has been granted by the Chief Constable
Constraints
The constraints to the Project can be identified under the following headings:
o Implementation timescales. To enter into a partnership in April 2011 with a tender award before 01/01/2012
o Funding criteria
o Partnership resourcing
o Legislation
o Training timescales
Refer to the Constraints register
Quality Control
Prior to outsourcing to any provider a baseline for quality will need to be agreed, this will be based upon
o The financial/feasibility study
o A scoping exercise to identify both set-up and on-going costs/facilities/governance issues
o A defined programme of implementation
o A due diligence exercise to establish a service which is fit-for purpose
In line with project management, quality criteria will be defined and agreed against each of the planning phases to ensure compliance to the baseline is achieved, thus allowing costs and resources to be managed effectively. This will be by using the following criteria;
Pre-commencement; identification and agreement of quality criteria to be followed
During; on-going review of work being carried out
Post; final checkpoint to ensure that standard and criteria has been achieved
All quality criteria prior to the commencement of any stage will require approval from the Project Director, Mr Tim Ewen and Ms Louisa Sharples
Resource Management
All necessary resources will be identified as part of the planning schedule, as resources for both staff and costs will be required. Areas from parties, police and NHS may require resources within the following areas
Procurement
Finance
Estates
ICT/Networks
Human Resources
Training
A training schedule for any new staff will be subject to an additional review
Resource schedule
Funding has been provided by the DoH for the commissioning arrangements of tender process. Project management will be provided by Headquarters CJ. This will become part of the Governance remit
Resource tracking
All expended resources will be managed by the Partnership Board
Stakeholders
A number of stakeholders both within and outside the Constabulary will be affected by the outsourcing to the NHS Commissioners
National
o Department of Health
o ACPO
o NPIA
o Within Lancashire:
o Police Authority
o NHS Commissioners & Providers
o Lancashire Care NHS Foundation Trust
o HMCS
o CPS
o Lancashire Coroners
o NOMS, including probation and prisons
o Youth Offending Team
o Voluntary Organisations
Within the Constabulary:
o Chief Officers
o Divisional Commanders & SMTs
o Heads of departments
o Operational police officers
o Custody Staff
o Staff Associations (Police Federation/Unison/T&GWU/LBPA/GPA
Interdependencies
o Sustaining Excellence