FHS Project Group

Lyngford House, Taunton27th June 2011


Jeff James-NHS Wiltshire and B&NES (Chair)

Paul Vater-NHS Dorset

Simon ?-NHS CIOS

Bridget Sampson-NHS CIOS

James Short-NHS Devon

Jo Cullen-NHS Wiltshire

Julia McClean-NHS Gloucestershire

Mike Vaughan -NHS Gloucestershire & Swindon

David Slack-NHS Somerset

Jill Shepperd-NHS Bristol & South Gloucestershire &North Somerset

Original FHS Project Steering Group

There were concerns that the outcomes of this PSG did not adequately reflect the concerns raised by PCTs about FHS services as discussed at CEO meeting 2 months ago. At CEO meeting, it was agreed to:

  • reset project group
  • review the membership
  • take stock of where the project was re the SBS SW regional proposal
  • review any alternative proposal received
  • and agree the process/timetable from here on in

The purpose of the meeting today is to fulfil that discussion.

"Do nothing" is not an option because:

  • no home the FHS from 2013
  • need organisational destination for all services
  • backdrop against 40% reduction in management savings/cost reduction – non front line costs need to be lowered even more as infrastructure and board CCG cost even morethan current PCTs.
  • consensus with regional proposal as otherwise every PCT will have a residual problem with FHS.

2 propositions in SW

  • SBS
  • FHS in South West

Proposed Timescale:

July 2011 – PCT Boards to make a decision in the SBS project timescale to meet a May go live operational date.

Risk if not meet this deadline is that the SBS team will move to another area (? West Midlands)

DS (NHS Somerset)

Raised concerns re: commissioning support functions as a 3rd option for NHS Somerset – the FHS services form part of the commissioning support functions (and other residual services/functions).

Any option/proposal for the services needs to be able to be described and cover all services to all areas. Is it acceptable to have a single PCT (NHSS) only answer.

National context:

DH – producing a national specific for FHS Services from April 2013

Ongoing project work at NHSCB/DH – involving local SW reps – plan to commission FHS Services (? from 10 organisations).

National specification presented to DH in October 2011.

Further guidance and direction expected on National Performers lists

View of Richard Armstrong at DH that the NHSCB will expect some local payments systems and processes to remain post 2013.

Agreement that we need information/clarity from DH/NHSCBon the national work/specification.

Agreement that PCTs need to be able to vary what is in either SBS or SW NHS offer and PCTs need to be clear that the two offers are flexible or not too expensive to vary in order to mitigate the risk of a national specification.

If the timescale for decision is delayed then this would increase the risk for transition/legacy – agreed that ideally we would like a year of the new arrangements in operation before end of PCTs to ensure that there are staff still around who know the FHS services and staff.

Key dates:

12 July – CEO and Chairs convergence meeting at DH.

23 July – PC Leads at London/DH and NHSCB with SW reps


1. SBS Offer:

-Agreed deadline re: offer by 30 June 2011

-Updated offer available produced for meeting 27 June

Differences to earlier versions:

As a response to the challenge of the 4 centre model as not viable with lower staff and managementresources than existing services, and not viable post 2013 so possible further changes - SBS response is that the 4 centres will be extended to be the base for whole of South of England. The Exeterbase has been confirmed as a proposed national base for records. This is not seen by SBS as a transitional model but permanent solution.

More detail with information Governance – covering the IT concerns raised.

  • Need to check with SBS about terms and conditions for contract variation – and the commercial terms of contract.
  • To check with East Midlandstheir client legal advice to see what issues were.
  • To check Essex/Kent/Cheshireas areas who decided not go with SBS
  • The SBS service catelogue includes everything in the offer – if PCTs have services outside of the core then this is not included (page 40).

View that PCTs reach view on evaluation of the proposals and have a governance framework for Board assurance so can score proposals and make objective decision and have regional sign off form expert leads e.g. QA, IMT, KPIs.

Concerns about reaching agreement / sign off.

Could do it collectively in a co-ordinated approach as a joint committee of all PCTs

Original timeline would have set up a project group with experts/leads for HR, IT, Finance, FHS etc

Concern about why SBS and clarification of what process we are following – competitive tendering or single action decision for SBS – what is SHA position? What is DH view?

2. FHS South West – Julia Maclean:

-Proposed and developed by individuals within FHS services retaining characteristics of current provision

-opportunity for NHS staff to develop and produce counter proposals and of process turning into business case

-match SBS proposal in terms of productivity and price and savings

-Jan Stubbings as Sponsor and Executive support function

PCT view expressed that Boards are keen to have a comparator when making a decision.

FHS model has taken FHS staffing 09/10 as baseline (from PCT SBS submissions)

Difference between the 7 PCTs and the FHS staff/agencies - could be counted differently as PCT staff or FHS – not all run as separate agencies and some functions incorporated in other functions / staff.


  • Proposal is a description of what is possible and needs working through concepts of having management Board up until transition in 2013.
  • Who would hold accountability?
  • How would agreement be reached that existing PCTs made changes to service delivery or lower staff costs etc
  • If commitment to doing it jointly – have to agree parties have to change not maintain status quo
  • What would be the organisational vehicle - Social Enterprise or CIC or commercial partner
  • The proposal has to be able to answer question about what is the solution for 2013
  • PCTs have to decide whether to live with uncertainty and decide to take a “wait and see” strategy about national solution for FHS services.
  • Boards need assurance on savings and future running costs
  • With proposed 6 bases – have included accommodation costs for less than 23% of current costs
  • Some PCTs FHS staff review and reductions already counted towards achieving management savings/QIPP plans

Key points:

  • SBS proposal - there are clear financial savings and where the risk will sitbut questions from PCTs around delivery and quality
  • FHS proposal –PCTs will be confident about the delivery but unsure about the financial model and delivery of savings.

Summary / Actions:

  1. Need check national policy framework

-Do we have to make these decisions?

-Do we have to do it now?

-Is this the wrong time to be doing this?JJ

  1. Do we need two documents/propositions to consider rather than just SBS?
  2. Should we be testing the viability of the local staff based answer?

Yes to both – then require a period of further work to bring the second FHS proposal up to speed for Boards to consider which would then be unlikely to meet deadline for papers for July Board.

- Need to flesh out the operational vision – Julia McClellan + Paul Ham + Julie Cooper (in July)

- Be clear the governance arrangements for future proposal post 2013– Jan

  1. Ask Cluster CEO as Accountable officer about decision-making process to follow

-joint committee to take decision?

-Devolved to CEO/Chairs for all areas?

  • If outside of Board timetables then needs a validated decision-making process to be agreed so not lose the potential benefits of the project.
  • If SBS not heard from South West by 1st September go to West Midlands

5. Notes from meeting and notes to CEO/PCTsJJ and JC