2014/15 ANNUAL PLAN
Guidelines
(Including Planning Priorities)
WITH STATEMENT OF INTENT and STATEMENT OF PERFORMANCE EXPECTATIONS
Amendments
Date / Page / Description31 Jan 2014
28 Feb 2014 / 37
36-37 / Stroke: In response to feedback from DHBs we have made the following changes to RSP priorities:
· definition of ‘eligible’ added to measures
· removal of requirement ‘within 3 hours from onset’ from key actions
Cardiac:
· Further guidance is provided on the implementation of Accelerated Chest Pain Pathways (ACPPs) in Emergency Departments
· Recognising the need to gain national consensus, the deadline for definition of ‘high risk’ within Acute Coronary Syndrome (ACS) measures has been removed
28 February 2014
The District Health Board Annual Plan with Statement of Intent
Each District Health Board (DHB) has a statutory responsibility to prepare:
• an Annual Plan for approval by the Minister of Health (Section 38 of the New Zealand Public Health and Disability Act 2000) - providing accountability to the Minister of Health
• a Statement of Intent (Section 139 of the Crown Entities Act 2004, as amended by the Section 49 of the Crown Entities Amendment Act 2013) - providing accountability to Parliament and the public at least triennially[1]
• a Statement of Performance Expectations (New CE Act s149C) – providing financial accountability to Parliament and the public annually
In 2010 Cabinet determined that the above documents would be brought together into a single DHB Annual Plan with Statement of Intent, to be known as the ‘Annual Plan’ (AP). This will continue for 2014/15. The AP must incorporate national and regional (including sub regional) service planning, as well as balance the medium term accountability requirements inherent in a Statement of Intent (SOI) with annual requirements.
Annual Plan Structure
A modular approach has been adapted to the DHB Annual Plan, as in previous years, to achieve a single document that meets the requirements of both Acts, as well as Cabinet requirements and the needs of key stakeholders. The modules allow various sections of the document to be highlighted for different purposes and audiences. The modular structure also makes it possible to extract modules as appropriate and only table in Parliament those most relevant to the purposes of an SOI.
There is no major departure from the structure of previous guidance, and the modular approach of guidance for DHBs Annual Plans/SOIs is being retained for 2014/15. As for previous years this enables the relevant sections to be extracted for different purposes such as tabling the SOI in Parliament. (There may be some change for 2015/16). Please note that the order and shape of some modules has been adjusted to reflect the amended requirements of the New CE Act 2013. For example, what were modules One and Two have been combined into a single module, which is the guidance for the SOI. The Government priorities become module Two.
The slightly revised structure of the AP continues to allow the themes of the DHBs overall performance story through the whole document – helping cascade the conversation on each theme to a greater level of detail with each module – from high level strategic outcomes down to service delivery and financial detail. So while a theme may be repeated, it is expected the information will differ as the reader progresses further through the document to learn more about the topic with increasing detail.
The legislation that sets out the requirements for SOIs has been reviewed. Amendments to the Crown Entities Act 2004 can be found in CE Amendment Act 2013.
Key changes to SOI resulting from the CE Amendment Act 2013:
· extension of reporting timeframe of SOI to four years minimum (forthcoming year and at least the following three financial years) (New CE Act s139 (2) as amended/inserted by S49 CE Amendment Act 2013)
· an SOI to be produced at least once in every three-year period (New CE Act s139 (3))
· a Crown Entity’s responsible Minister may require the crown entity to provide a new SOI at any time (New CE Act s139A (1))
· SOIs to contain only high-level strategic information as relates to four year reporting timeframe, rather than as it relates to annual reporting requirements, which will be provided separately in a statement of performance expectations (New CE Act s141 & s149E).
· The Statement of Performance Expectations (SPE), (the old Statement of Forecast Service Performance), is separate from the SOI and is made up of the annual information that used to be in the SOI. It is produced and tabled each year and subject to the same process timeframe as the SOI (New CE Act s149B – s149M). The SPE includes the Financial Performance.
· During the year that the SOI is tabled the SPE can be consolidated with the SOI.
In 2011 DHBs were required to develop a Workforce Plan to support achievement of annual, regional and relevant national service plans. As with last year, the production of individual DHB Workforce Strategies is not a requirement for 2014/15 as DHBs will instead be required to develop their Workforce Strategies further in their 2014/15 Regional Services Plans (RSPs).
DHBs should find the State Services Commission’s - Preparing a Statement of Intent – Guidance and requirements for Crown Entities a useful resource while bearing in mind that the AP has considerations beyond solely an SOI[2].
For further information regarding these guidelines please contact:
Jacob White
National Health Board
Ministry of Health
Wellington 6145 , (04) 496 2000
MODULE 1: INTRODUCTION and STRATEGIC INTENTIONS (included in SOI extract)1.1 EXECUTIVE SUMMARY
· CEO foreword, executive summary and signatory page
1.2 CONTEXT
· Background and operating environment
· Nature and scope of functions / intended operations
1.3 STRATEGIC INTENTIONS – strategic objectives
· DHB vision
· Strategic outcomes in national, regional and local context
· Key risks and opportunities
MODULE 2: DELIVERING ON PRIORITIES & TARGETS (NOT included in SOI extract)
2.1 PRIORITIES & TARGETS – actions to achieve our outcomes
· Implementing Government priorities
· Better, Sooner, More Convenient system
· DHB regional, sub regional and local actions to deliver on RSPs
· DHB local priorities
MODULE 3: STATEMENT OF PERFORMANCE EXPECTATIONS (Can be consolidated with the SOI extract)
3.1 STATEMENT OF PERFORMANCE EXPECTATIONS – outputs from activities
· Statement of Performance Expectations (SPE)
· Output classes
· Measures of DHB performance by Output Class:
- Prevention Services
- Early Detection and Management
- Intensive Assessment and Treatment
- Rehabilitation and Support
MODULE 4: FINANCIAL PERFORMANCE (included with SPE)
4.1 FINANCIAL PERFORMANCE
· Statement of Performance Expectations (for current and three following financial years)
· Any other measures and standards necessary to assess DHB performance
· Any significant assumptions
· Any additional information to reflect the operations and position of the DHB
MODULE 5: STEWARDSHIP (included in SOI extract)
5.1 STEWARDSHIP – managing our business for efficient operation
· Managing our business
· Building capability
· Strengthening our workforce
· Organisational health
· Reporting and consultation
MODULE 6: SERVICE CONFIGURATION (NOT included in SOI extract)
6.1 SERVICE COVERAGE AND SERVICE CHANGE
· Service coverage
· Service change
· Service issues
MODULE 7: PERFORMANCE MEASURES (NOT included in SOI extract)
7.1 MONITORING FRAMEWORK PERFORMANCE MEASURES
· Dimensions of DHB Performance Measures (non-financial performance targets)
MODULE 8: APPENDICES (NOT to be included in final documents)
8.1 MODULE THREE CONTENT REQUIREMENT (NOT included in final – reference only)
8.2 GLOSSARY OF TERMS (DHB Option)
8.3 ANNUAL PLAN REVIEW: FINANCIAL STATEMENTS 2014/15 (and supporting templates)
8.4 OUTPUT CLASS RECOMMENDATIONS (NOT included in final – reference only)
· Prevention Services
· Early Detection and Management
· Intensive Assessment and Treatment
· Rehabilitation and Support
8.5 ANNUAL PLAN CONTENT REQUIREMENTS (NOT included in final – reference only)
· Crown Entities Act 2004 (CE ACT), as amended by CE Amendment Act 2013
· New Zealand Public Health and Disability Amendment Act 2010 (NZPHD Act)
· Recommendations from Cabinet Social Policy Committee (CSPC)
8.6 STRENGTHENING OUR WORKFORCE – DIMENSIONS OF THE WORKFORCE PLAN (NOT included in final – reference only)
8.7 LINE OF SIGHT GUIDANCE FRAMEWORK (NOT included in final – reference only)
MODULE 1: INTRODUCTION and STRATEGIC INTENTIONS
DHBs are strongly encouraged by the Minister of Health and the Ministry of Health to keep this section brief and to minimise use of diagrams, pictures and / or white space where possible. DHBs may wish to reference more detailed information contained on their websites if appropriate rather than replicate it here.
FOREWORD/EXECUTIVE SUMMARY
This section will contain: CE foreword, executive summary and signatory page.
1.2 CONTEXT
1.2.1 Background information and operating environment
Briefly comment on the background of your District Health Boards (DHB), and consider including:
· overarching system context that influences the DHB e.g. RSP objectives, the Ministry of Health’s Statement of Intent, and the Treaty of Waitangi
· health profile of the district linked to the key issues identified in the DHB’s Health Needs Assessment
· Government focus on Better Sooner More Convenient Services (BSMC) for all New Zealanders.
The DHB, to explain its operating environment, is encouraged to provide a very brief description of the structure and funding of wider health structures including the hospital and primary/community organisations. The DHB may note any:
· key internal/external operating environment factors that affect performance
· key areas of risk and opportunity
· coverage or location.
1.2.2 Nature and scope of functions / intended operations (New CE s141(2)(a)):
Explain the nature and scope of the entity’s functions and intended operations, performed by the DHB in the following roles:
· Planner (in partnership with appropriate stakeholders)
· Provider
· Funder (including managing budget within funding allocation/specific financial constraints)
· Owner of Crown assets.
1.3 STRATEGIC INTENTIONS – strategic objectives (New CE Act s141(1))
WHAT outcomes we want to achieve through a whole of system approach
Keep this section high level and be sure to demonstrate how the DHB is giving effect to the New Zealand Public Health and Disability Act (NZPHD Act s38(2)(a&b)). The AP must reflect the overall direction of the New Zealand Health Strategy and New Zealand Disability Strategy (NZPHD Act s38(2)(d)).
High level strategic objectives that the entity intends to achieve or contribute to (strategic intentions must be identified here (New CE Act s141(1)(a)). Links between high level strategic intentions and DHB performance on an annual basis will be outlined in the SPE (New CE Act s149(b-g)).
System integration
While taking a whole of system approach is not new to the health sector it is expected that a growing commitment will be applied to achieving more effective system integration in partnership with primary care and other appropriate stakeholders; and this will be demonstrated in the strategic direction and planned activities of DHBs. This includes the DHB’s work to provide Better Public Services (including Social Sector Trials) in:
Prime Minister’s Youth Mental Health Project
Children’s Action Plan
Increased Immunisation Health Target
Reducing Rates of Rheumatic Fever
DHBs are expected to demonstrate how they will use clinical leadership to drive system integration and Better Public Services.
DHBs are expected to use their Alliance Leadership Team and any Service Level Alliance Teams to jointly develop 2014/15 DHB Annual Plans for:
Primary Care (including Rural Health)
Prime Minister’s Youth Mental Health Services – Youth Health
While in 2014/15 there is no requirement that NGOs are formal members of your ALT, the principle of partnership must underpin any service development including:
· the Shorter Stays in Emergency Departments Health Target – Primary Care
· the Improved Access to Elective Surgery Health Target
· Shorter Waits for Cancer Treatment
· Faster Cancer Treatment
· Increased Immunisation Health Target
· the Better Help for Smokers to Quit Health Target – Primary Care
· More Heart and Diabetes Checks Health Target
· Reducing Rheumatic Fever
· Prime Minister’s Youth Mental Health Project
· Children’s Action Plan
· Whānau Ora
· Long Term Conditions
· Diabetes Care
· Stroke
· Acute Coronary Syndrome
· Improved Access to Diagnostics
· Cardiac Services – Network Agreed
· Health of Older People
· the Mental Health Service Development Plan
· Maternal and Child Health
Intervention logic flow
Intervention logic is central to this module as the links between outcomes in this section and subsequent sections of the AP illustrate the performance story (CSPC 8A rec: 21.3):
· specific actions/activities the DHB will undertake to deliver on these outcomes should be described in Module 2
· how the outcomes identified here flow into detailed impacts and outputs in the SPE in Module 3 should be clear
· how DHB activity to build organisational capability in Module 5 will enable delivery on these outcomes should also be clear
Consider some form of reference to link sections, e.g., numbering outcomes and referencing numbers in Statement of Performance Expectations where relevant.
This section must be consistent with and reflect the RSP and any national plans. (CSPC 8A rec: 16).
DHB vision
Outline the vision for the DHB population and service provision.
Strategic outcomes in national, regional and local context (New CE Act s141, NZPHD Act s38 (2)(a))
Outline the specific strategic outcomes or objectives for the DHB. These should be considered in the context of developing service planning to ensure the AP addresses:
i. local, regional, and national needs for health services, including Better Public Services; and
ii. how health services driven by clinical leadership can be properly integrated to meet those needs; and
iii. the optimum arrangement for the most effective and efficient delivery of health services.
The DHB’s vision should include an outline of how the DHB will support clinically led service planning in partnership with primary care and other appropriate stakeholders to achieve its high level objectives and Better, Sooner, More Convenient (BSMC) service. It should focus on service sustainability, service quality and safety, integrated models of care where appropriate, and best use of resources. It could also describe key DHB issues that will be addressed by the intended focus areas of service planning for each stakeholder.