1. Portfolio Overview as at 13.01.11 page 1 of 3 Portfolio Headlines Clinical pathway work is progressing, with all three clinical pathway programmes being reviewed to take forward the next stage of planning related to supporting implementation, against IBP dates. Stakeholder engagement has progressed with three borough LA, PCT and GP involvement and a shared risk and issue log being drafted. The St. Bernard’s Redevelopment programme will impact significantly on the care pathways, financial, workforce and estate plans. The Cassel Business Case is temporarily on hold due to legal and process issues Top 3 Portfolio Risks/IssuesBenefits Realisation 1. Advice re: legal issues in Cassel Hospital Business Case has put temporary hold on progression of Business Case 2. New PCT and LA Clustering exerts another “pull” and increases stakeholder engagement risks to cross borough pathway work – mitigation in process through engagement and risk & issues log 3. Three key programmes to support IBP for FT application have implementation and financial issues and risks Pathways will increase consistency of service and improve patient experience across three boroughs Stakeholder engagement events will build relationships to strengthen FT process Pathways will support service line reporting and PbR for mental health Clarity in expectation of efficiency targets should improve focus on service redesign delivery and workforce requirements Estate rationalisation should support efficiencies Summary of individual Work Stream RAG Assessments ProgrammePreviousCurrentComments/Detail Meeting Statutory and Regulatory Requirements Executive Sponsor: Nigel Leonard  Governance structure refined – meeting in January with key senior staff to approve document for internal consultation Improving the efficiency of Central Services Executive Sponsor: Barbara Byrne  Inventures review implementation still in progress Other work BAU Developing and Motivating our people Executive Sponsor: Peter Cubbon  OD and workforce issues mapped as Business as Usual SpR Leadership Programme with PMO has commenced Enhancing High Secure Services Executive Sponsor: Leeanne McGee  As previous months – work stream is amber, still awaiting DH approval of OBC Improving Service Delivery (London) Executive Sponsor: Peter Cubbon  Stakeholder engagement progressing well. St Bernard’s Redevelopment programme – OBC deadline Nov 2011 – impact on care pathways implementation Cassel Business Case on hold due to legal advice Improving Patient Experience & Safety Executive Sponsor: Steve Trenchard  Time to Care still behind schedule however plans to mitigate are in place. Exit strategy from the programme identifies future risks re: sustainability

2. Portfolio Overview as at 13.01.11 Page 2 of 3 Work StreamHeadlinesKey Issues and Delivery Risks Meeting statutory and Regulatory Requirements Nigel Leonard This Programme is amber as the programme objectives are subject to a number of organisational risks and issues. New Governance Structure being refined to consult to internal senior team Overall Trustwide responsibility for Compliance and Assurance still not identified, separated across a number of individuals and functions. Organisational re-structure will be aligned to governance structure Clear compliance and reporting structure and process vital to FT application and IBP Improving the Efficiency of Central Services Barbara Byrne Electronic job planning progressed to implementation stage, however future funding a risk Inventures review recommendations have been processed by EDs, and form part of the next stage of the Trust re-structuring consultation Trust-wide consultation 2 nd stage to be implemented – Jan-March ‘11 Other reviews of central services form part of this Organisational consultation will impact on how central services are delivered Outsourcing project now undergoing feasibility study for the business case Developing and Motivating our People Peter Cubbon Business as Usual Consultation on move to three CSUs will impact on workforce SpR leadership and management programme commenced Anxiety continues to be high and needs to be managed with the amount of internal and external change and ‘unkowns’ Financial efficiencies, consultation and external change will impact on staff morale SpR leadership programme increases medical engagement in business perspective Enhancing High Secure Services (Broadmoor) Leeanne McGee OBC approval still with DH Mall/Clinical model work continues OBC is not approved by the Department of Health – interim risks documented through Redevelopment Programme Board and assurance programme board Financial interdependencies with St Bernard’s Redevelopment Programme a risk

3. Portfolio Overview as at 13.01.11 Page 3 of 3 Work StreamHeadlinesKey Issues and Delivery Risks Improving Service Delivery (London) Peter Cubbon Care pathways based on NICE Guidance, Map of Medicine and best practice completed Associated finance/workforce/estate detail of preferred models continues to support IBP Stakeholder Engagement Strategy complete, engagement activity progressing well Pathways oversight group now operational to manage communication, risks and issues Relationship management with external GPs, PCT Clusters and LA prioritised and progressing Specific SDU projects to reduce caseload Cassel Business Case – legal advice to go to public consultation has put Business Case on hold temporarily Some proposed pathway redesign may not be financially viable Stakeholder engagement progressing well, with shared three borough risks and issues log being drafted. Key risks around differing stakeholder drivers and priorities still high - for all clinical pathways, complex commissioning arrangements and changes in organisational clusters and affiliation may impact on tight delivery timescales and pathway implementation Clinical pathway programmes need to be reviewed and longer term “ageless” service progressed, in order to manage key interdependencies such as transitions (ages 14-25 year olds), and vulnerable older adults with functional illness Forensic pathway programme board dates need to be set for 2011 St Bernard’s redevelopment programme interdependencies being mapped, and “masterplanning” group has been proposed Cassel Business Case – business case temporarily on hold as, due to high media and political interest, legal advice is to progress and Equality Impact Assessment and go to public consultation. Still awaiting national funding decision re: Cassel Family Service Workforce and financial action plan to bring family service “in budget” requested by 31 Jan 2011 to be implemented 1 April 2011. Improving Patient Experience and Safety Steve Trenchard Time to Care Programme has financial and implementation risks Will not be able to deliver a fully embedded and effective programme by March 2011 under baseline programme timeframe, and sustainability on exit from programme a risk Exit strategy from programme in plan