1. Operational Planning & Contracting 2019-20
Council of Governors – 4th July 2019
Sue Barnett, Strategy & Planning Consultant
Richard Eley, Interim Director of Finance

2. Operational Plan 2019/20 1. Operational Plan outline
Activity Planning Assumptions & Growth
Waiting List Position
Transformation
Quality Priorities
Workforce
Finances & Contracting
Capital
Risks and Mitigation

3. Operational Plan 2019/20 - Outline
The purpose of this Operational Plan is:
To outline the Trust’s challenges and objectives for the coming year
To refresh of activity, quality, workforce and financial plans for 2019/20
Consistent with the Trust Strategic Objectives
Alignment to the 10 year NHS Long Term Plan
Through a system-wide approach, working in collaboration to align key assumptions on income, expenditure, activity and workforce between commissioners and providers.

4. Operational Plan 2019/20 – Activity Planning & Growth
Activity System Alignment, Planning Assumptions & Growth
Three main partners, NLAG, NELCCG and NLCCG have agreed the submitted aligned activity plans
Trust and CCGs have used a forecast outturn based on month 7 with overall growth rates applied based on a 3 year rolling average with the exception of:
A&E 6.36%
Ambulatory zero length of stay 15.31%
Non-Elective 1+ length of stay -1.5%

5. Operational Plan 2019/20 – Waiting List Position
Year End Position
Total RTT Waiting List Size
RTT Performance
Overdue follow ups
March 2018
29396
66.23%
31569
March 2019
75.70% %
March 2020
81.20% %
There will no patients waiting over 52 weeks
Intention is to achieve no patients waiting over 40 weeks by March 2020
Greater validation on waiting lists including RTT clock stops
Continue to tail gun activity
Pooling of procedures
Further roll out of virtual clinics /Full implementation of Advice & Guidance
eRS to full year application
Follow Up Outpatient Waiting List to reduce by (for 7 specialities targeted) by March 2020

6. Operational Plan 2019/20 - Transformation
Humber Coast and Vale Sustainability and Transformation Partnership
The Partnership has been working together to deliver the collective vision of: supporting our local communities to start well, live well and age well.
 Humber Acute Service Review (HASR)
We recognise that we cannot deliver sustainable services on our own and continue to work with our key partners through place based provision, the Humber Acute Services Review and the Humber, Coast and Vale STP.
Service Development Improvement Plans
Outpatient Transformation
Urgent Treatment Centres / integrated Assessment
Day Case to Outpatient Procedures
Medicine optimisation
Pathway redesign between primary and secondary care, e.g. Implementation of the RightCare programmes and Getting it Right First Time (GIRFT) best practice

7. Operational Plan 2019/20 - Quality
 Quality Priorities for 2019/20
Mortality reduction and the management of the deteriorating patient
Medication Safety
Patient flow
Cancer pathways
Other Improvement Plans for 2019/20 Impacting on Quality:
Gram-negative blood stream infections (GNBI)
Staffing numbers and engagement
Priority standards for seven-day hospital services
Special Measures for Finance and Quality
National intelligence: Learning from relevant national investigations

8. 6. Operational Plan 2019/20 - Workforce
Workforce – key points for 19/20
Decrease agency by wte
Expected higher fill rate for junior doctors
20 nurses from the Phillipines in pipeline by end Qtr2
Anticipate intake of 65 newly qualified nurses by end Qtr2
Introduction of Physician Associates on a 2 year rotational preceptorship programme
Plan to introduce 6 Band 3 Physician Assistants
Advanced Clinical Practitioners – 4 year training programme
Further utilisation of Apprenticeship Levy
Succession Planning (CAESER / overseas recruitment)
Staff engagement/Pride and Respect

9. Operational Plan 2019/20: Finance/Contracting
Contracts signed on 21st March 2019
The Trust has been able to negotiate contracts with all the CCGs, and NHSE, except an aspect of East Lincolnshire
Activity levels and key statistics such as waiting times have been fully agreed with system CCGs.
The dispute with East Lincs has been resolved through agreeing an SDIP to review the position at the end of the first quarter.
The contract process was concluded successfully on the due date but did not yield sufficient cash to materially assist the Trust to achieve it`s original Control Total. However the Control Total was adjusted by NHSI.
The National basis for the calculation of the NEL contract, still does not give full funding for NEL work.

10. 8. Operational Plan 2019/20: Finances/Control Total (2/4)
The Trusts 18/19 out-turn position needed to be moved several times during the year
The Trust has reported a year end deficit of (£58.9m) to NHSI for 18/19
This compares to the original control total deficit of (£39m), a movement of (£20m)
This outturn position was the basis for the Trust’s financial planning for 2018/19
In future the basis will move to being based on budgets with the forecasts being taken into account when setting budgets
Out-turn has been the basis on which CIPs were set

11. Operational Plan 2019/20: Finances/Control Total

12. Operational Plan 2019/20: Finances/CIP
Cost Improvement Programme (CIP)
The CIP target set for the budget units was originally £32m but this proved to be impossible
Following discussions with NHSI the Control Total was revised from (£15.4m) deficit
The Final CIP following an adjustment to the Control Total deficit is £20m within NLAG and a £2m system CIP ie £20m plus £2m
The Control Total is a deficit of (£25.4m)

13. Operational Plan 2019/20 – Capital Planning
19/20 Capital allocation £7.4 m to cover:
Major Schemes: SGH ward (25 beds)
Backlog Maintenance (statutory requirements)
IM&T / IT (Cyber risks)
Equipment Replacement (high risks)
STP Capital funding allocation £29.26 m
Urgent & emergency Care (creation of Multi-disciplinary assessment units both main sites)
SGH MRI (additional scanner)
DPoW Critical Care collocated unit
Lengthy process for HM Treasury approval of the funding prior to release (18-24 months)
Emergency Funding £8.1m
DPoW MRI (new build – additional scanner)
DPoW CT (additional scanner)
Risks:
Critical maintenance backlog requirements (tune of £22.5 m)
IM&T infrastructure to support service developments
Theatre upgrades (including SGH Theatre E laminar)
Wards requiring refurbishment