Programme for Health Service Improvement Clinical Services Planning Group Moving forward CARDIFF AND VALE NHS TRUST YMDDIRIEDOLAETH GIG CAERDYDD A’R FRO

Purpose  An opportunity to review progress and lessons learnt  Consider future work and scope of future public consultation  Consider potential way forward to drive clinical redesign

Where are we now….  SOP sets out direction of travel  Generally receiving positive responses from clinicians and stakeholders, but recognition that many issues still to be worked through  Gives commitment to undertake public consultation in the summer of 2007

High Level Project Plan

Next steps….preparing for consultation  What will be consulting on locally in the Summer of 2007? Primary and community services including “Resource centres…..”  Noting CRI consultation already done Specialist community inpatient rehabilitation provision….  including Westwing/Rookwood Unscheduled care Role and function of our two acute hospitals

Next steps … preparing for consultation (2) The consultation document will not :  include mental health services  repeat other consultations already undertaken e.g. CRI women and children’s services (although the emerging clinical model may require some reference to these. )  fully address the specialist and tertiary service issues (although clinical modelling will need to make a number of assumptions about these)

Next steps – preparing for consultation (3)  Need to consider framework for consultation – it will need to be accessible and clear about the changes proposed and the implications for local people. Use of scenarios to enable the impact and implications to be understood on locality basis (CSPG & Reference Group role?)

How? Next Phase of work needs to ensure :  improved co-ordination across the clinical themes  Stronger clinical leadership  Health community approach – greater ownership and accountability for programme  Stronger project management

Structure PHSI Programme Project Board Clinical Reference Group Programme Support Team Communications and Engagement Group Clinical Services Planning Group Clinical Planning Group – Primary & Community Stakeholder Forum Clinical Planning Group – Acute Hospital Services Clinical Planning Group – Unscheduled Care Clinical Planning Group – Specialist Rehabilitation

Clinical Services Planning Group  Acts as Project Board responsible for overseeing the work of the clinical workstreams.  Clinical Project Groups would be established for each clinical workstream.  Clinical Reference Group – provides advice, scrutiny and challenge “critical friend”. LMAC to be involved.

CSPG (1)  Project Board role Clinical leadership and sponsorship Signing off CPG project plans Performance managing CPG progress against key milestones Ensuring cross cutting issues, interfaces and links identified and addressed Maintaining overview of key risks Ensuring detailed and robust proposals prepared to support consultation by June 2007

CSPG (2)  Membership Sue Gregory (Chair) Trust & LHB Medical/Nurse Directors (or representatives) AHP Representative NPHS Representative CPG Lead X 4 PHSI Programme Director/Communications & Engagement Lead HR/OD Director Finance Director Estates Lead Trust Director of Operations or Representative LA Representatives (x2) Staff side representation

Clinical Planning Groups (1)  CPGs responsible for leading the work required to enable consultation on a preferred way forward, to include: the agreed service model options for delivery of the model implications for service users, including equality impact assessment implications for the workforce implications for estate financial implications implications in terms of capacity dependencies and risks Interfaces with other CPGs

Clinical Project Group Arrangements CPG Core Membership Primary Care Clinical Lead \ Trust Clinical Lead Project Leadership Senior Manager Lead / Senior HR/OD input \ Senior Finance input Project Manager Core Project support Information Analysis (incl RKW) Coms & Engagement input Project Administrator /

Clinical Project Group Arrangements (2) Additional input as appropriate  Additional clinical input?  Diagnostics and clinical support services (including facilities and medical records etc)  patient/carer ?  Public health?  Local Authority?  Voluntary Sector?  Health Commission Wales?  Staff side?

Suggested Lead Management Arrangements Primary & CommunityLHB Unscheduled CareLHB Specialist Rehabilitation Trust Acute hospitalTrust

PHSI Central Support Team  Project Management Skills  HR and OD skills  Finance skills – with financial accountability to DoFs  Information analyst (+ RKW)  Programme administration  Service and capital planning  Equality impact advice  PPI Advice

Key issues  Protected time for project leads to support the work, with backfilling as required? 1-2 days a week. Ask NLIAH for support with funding?  CSPG view that core project support should be provided through dedicated central team within PHSI

Other Issues  All work on care pathways needs to be completed by early February.  Links between the workstreams need to be much stronger – they will not be able to work in isolation  Each workstream to be provided with a set of scenarios which their model will be able to address.  Scenarios will be set by the CSPG and Clinical Reference Group

Other issues cont’d  Scenarios will need to cover issues such as: - surgical advice to physicians - medical responsibility outside hospitals  Service models need to reflect workforce, estate and finance – detailed costings of models to ensure they are affordable