Date of Board meeting:28th September 2010

Title of report:Integrated Business Plan

Title of director presenting:Director of Planning & Corporate Affairs

Paper number:WL1907

For decision For discussion For information tick as appropriate

Purpose of the report:

The purpose of this report is to present an outline of the Integrated Business Plan to the Trust Board for discussion. The Trust Board is asked to delegate authority to the chief Executive to complete the submission of an outline Integrated Business Plan to NHS London on Monday 18th October 2010.

Action required:

The Trust is asked to note the Foundation Trust application process and the early indicator assessment plans for NHS London.The Trust Board is asked to delegate authority to the Chief Executive to complete the initial Integrated Business plan for submission to NHS London on 18th October 2010.

Summary of key issues

  • NHS London has produced an early indicator assessment for Trust’s applying for Foundation Trust status. This involves a requirement to receive an outline of the Integrated Business Plan and long term financial model by 18th October 2010 and will potentially be followed by Board interviews and observation in November 2010. The early assessment interview process will also include the views of commissioners.
  • The Trust aims to complete the Integrated Business Plan and long term financial model and other Foundation Trust supporting documentation for presentation to the January 2011 Board.
  • Despite uncertainty within the local health economy the Trust has developed a broad range of medium term plans to reshape services, introduce new infrastructure and improve patient and staff experience.

Relationship with the Assurance Framework (Risks, Controls, and Assurance):

The Integrated Business Plan covers the Trust’s five corporate objectives and the risk assurance framework is a key document for a successful Foundation Trust application

Care Quality Commission Registration Regulations:

Regulation 10: Assessing and monitoring the quality of service provision

Summary of Financial and Legal Implications:

The Integrated Business Plan and long term financial plan will provide information on the future financial projections for West London Mental Health NHS Trust. There will be legal implications in terms of potential consultation and the development of a new constitution.

Equality & Diversity and Public & Patient Involvement Implications:

As the Integrated Business Plan develops there will be wide consultation on all aspects of the Foundation Trust application.

ENCLOSURE I

Paper WL1907

WEST LONDON MENTAL HEALTH NHS TRUST

INTEGRATED BUSINESS PLAN

A REPORT FROM The DIRECTOR OF PLANNING AND CORPORATE AFFAIRS

1.0INTRODUCTION

1.1The purpose of this report is to present an outline of the Integrated Business Plan to the Trust Board for discussion. The Trust Board is asked to delegate authority to the Chief Executive to complete the submission of an outline Integrated Business Plan to NHS London on Monday 18th October 2010.

2.0FOUNDATION TRUST APPLICATION PROCESS

2.1Members of the Trust Board will recall that a report outlining the process for the development of an FT application was considered at the Board meeting in May 2010.

2.2The new white paper “liberating the NHS” has confirmed that all NHS provider organisations must be Foundation Trusts by 2014. Special arrangements will be made for the three organisations licensed to provide high secure services.

2.3Following the white paper NHS London have issued further details of their assessment process. NHS London now plan to undertake an early indicator assessment of all London Trust’s applying to become Foundation Trusts. This process will enable the health authority to complete an assessment of each organisations viability as a Foundation Trust and will occur early in the Foundation Trust application cycle.

2.4In August 2010 the Trust was invited to a meeting with representatives of the health authority to discuss the Foundation Trust trajectory and to assess the key risks and challenges facing the organisation.

2.5Members of the Trust Board will recall that there are three stages to securing a Foundation Trust licence. The first stage is a detailed assessment by the health authority and following approval the Trust’s submission would be considered by the Secretary of State for Health. Once approval from the Secretary for Health is secured the Trust would then be subject to a detailed review by the independent regular for Foundation Trust’s, Monitor. In discussion with colleagues from NHS London the Trust agreed a planned trajectory for obtaining a Foundation Trust licence and this included completing the health authority stage before 1st October 2011 and securing the Foundation licence date by 1st April 2012.

2.6To enable NHS London to form a view on the capability of West London Mental Health NHS Trust to achieve Foundation Trust status they have asked for an outline of the Integrated Business Plan to be submitted on Monday 18th October 2010. The NHS London Trust assessment team will then review the Integrated Business Plan and long term financial model and provide feedback to the Trust. NHS London are considering meeting with Board members and observing the Board during November 2010. The review team will also meet with the Trust’s commissioners before providing feedback to the Trust Board.

2.7NHS London acknowledges the current position of West London Mental Health NHS Trust and the embryonic stage of our Foundation Trust application.

3.0DEVELOPMENT OF INTEGRATED BUSINESS PLAN

3.1A series of discussions and reports are being scheduled for the Executive Directors and senior managers of the Board over the coming months. The Trust has already completed an analysis of strengths, weaknesses, opportunities and threats which will form the basis for the objectives within the Integrated Business Plan. The position across London is unclear following delays with the key policy document Healthcare for London. The future commissioning arrangements during the transitional period are also subject to a degree of uncertainty as NHS commissioning structures are subject to changes resulting from the move towards a reduction from 8 Primary Care Trusts in North West London to a new arrangement of three clusters within a single North West London commissioning sector. The planned cluster arrangements are as follows:

Cluster 1 will cover Hammersmith & Fulham, Kensington & Chelsea and Westminster.

Cluster 2 will cover Ealing, Hillingdon and Hounslow

Cluster 3 will cover Brent and Harrow

3.2Each cluster will be supported by a merged management team which is yet to be appointed. The proposals for restructuring PCT’s in North West London is subject to the approval by NHS London and individual PCT Boards. The proposed changes will not mean the abolition of PCT’s any earlier than set out in the recent government white paper which had a date of April 2013.

3.3The North West Sector is also preparing a medium term financial plan and it is anticipated that this plan will be completed in December 2010. It is expected that the new structures, operating model and governance arrangements for the merged management teams or clusters will be in place by April 2011.

3.4Although the position with commissioning and NHS structures is unclear there are a range of initiatives being undertaken by West London Mental Health NHS Trust that will help to populate the Integrated Business Plan.

3.5 The key service changes that have already received support from the Trust Board relate to the following service objectives:

  1. The Broadmoor Hospital Redevelopment programme: The Trust is awaiting Outline Business Case approval for the redevelopment of BroadmoorHighSecureHospital.
  1. The development of a forensic campus on the St Bernard’s Hospital site.
  1. The development of six change management workstreams:
  • Meeting regulatory and statutory requirements (review of assurance processes)
  • Improving the efficiency of central services
  • Developing and motivating our people
  • Enhancing High Secure services
  • Improving service deliver for London
  • Improving patient experience and safety

3.6The Trust has also recently completed a wide ranging project to develop a new vision for the Trust supported by four core values. The Trust is also seeking to realign director portfolios and management structures to reflect the new white paper and likely changes in commissioning arrangements. As detailed above a range of initiatives are underway to redesign patient pathways, review infrastructure requirements and improve patient engagement and experience. The pathway work will be subject to wide consultation with colleagues from primary care, secondary care and once proposals are developed these plans will be subject to wide public consultation.

3.7All of these initiatives will be included within the Integrated Business Plan and will need to be adjusted to reflect the future position of the health economy and the emerging commissioning intentions.

3.8The Trust has also developed new risk management processes and assurance framework and aims to link these processes with future planning cycles.

4.0OUTLINE OF THE INTGRATED BUSINESS PLAN

4.1An outline of the content of an Integrated Business Plan is attached in Appendix 1. The Trust will be asked to submit a brief outline of the intended Integrated Business Plan in mid October. The Trust Board is asked to delegate authority to the Chief Executive to complete the initial outline of the Integrated Business Plan which will include more detail on the developments outlined above.

4.2A further update on the outline Integrated Business Plan will be presented to the Trust Board meeting in October 2010.

5.0CONCLUSION

5.1The Foundation Trust application processes challenge and test applicant organisations in their ability to respond to requests for information. Although the Trust has only recently commenced the development of a timetable for the completion of a Foundation Trust application there are a number of initiatives and development plans already underway that will shape the organisation and the services provided over the next 7 years. The Integrated Business Plan is a development tool which will be updated and adjusted as more information becomes available over the coming months.

6.0RECOMMENDATION

6.1The Trust Board is asked to note the Foundation Trust application process and the early indicator assessment plans for NHS London.

6.2The Trust Board is asked to delegate authority to the Chief Executive to complete the initial outline Integrated Business Plan for submission to NHS London on 16th October 2010.

Nigel Leonard

Director of Planning & Capital Affairs

September 2010

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