A short briefing on Corporate
Strategy & Transformation at HEFT
(Following recent discussion at Trust Board and EDs this paper is
intended to clarify the position on “transformation” at HEFT)
Beccy Fenton
Deputy CEO & Director of Strategy &
Transformation
April 2010
Strategy Alignment
Corporate
Strategy
Transformation
Strategy
Enabling
Strategies
Annual
Corporate
Business Plan
Corporate Strategy
Sets out the vision and blue print for the organisation by 2015.
The DH have recently published the NHS Strategy and Vision
for 2015 in “Good to Great”. This describes a) the standard of
care that the public will experience, b) the workplace and
benefits to staff and c) what the system will look like to
support the vision (e.g. integrated care). This is a good
example of the sort of document we need to produce for
HEFT.
Transformation Strategy
This sets out the road map and journey that the organisation
needs to take over a 5 year period to transform from its
current state to achieve its future vision. Currently HEFT has
adopted the “Transformation Diamond Diagram” as its
framework for transformation stating that it will need to focus
its transformation on; culture, access and flow, safety,
collaboration, environment and clinical outcomes. In the
absence of a Corporate Strategy/Blue print for 2015 HEFT’s
Transformation Strategy can only look forward about a year in
terms of setting out specific improvement activities. Once the
new Corporate Strategy has been produced then the
Transformation road map can be updated to extend across the
same time frame.
Enabling Strategies
HEFT’s enabling strategies such as Service Strategies, Site
Strategy, OD, ICT, Financial etc will need to be reviewed to
ensure they support the new Corporate Strategy and
Transformation Road Map for the same time period.
Annual Corporate Business Plan
Each year the Trust will set out specific activities that will be
the focus for the coming 12 months with detailed project
plans and measurable outcomes to ensure progress is made in
the short term to deliver the longer term plans.
A History of the Trust’s investment and support for the delivery
of continuous improvement and the Transformation Strategy
In 2007/08 the Trust agreed to invest in a small Transformation Team to support the Organisation in its delivery of the
Transformation Strategy to improve quality and productivity. The Team was similar to previous NHS improvement teams often
referred to as “Service Improvement” or “Modernisation” Teams. The HEFT team consisted of the following posts:
•Service Transformation Support – Cheryl Hudson
•Business Transformation Support – Kate Barber (replaced 0.5 wte by Paul Chew in 2008)
•Service Improvement Manager Medicine Business Unit – Helen Slater
•Service Improvement Manager Surgery Business Unit – Jo Hodgkiss
The team worked on a variety of projects during this early stage including OP Booking, Emergency Flow, SLRs, relocation of back
office functions. During this period the Trust recognised that the “burning platform” for change was not “hot enough” due to a
stable world wide economic position, high levels of NHS funding growth and 5 year financial forecasts at HEFT which would enable
a £290 million pound estate investment strategy and good performance against the external rating system. Against this back drop
transformation was slow and it was difficult to engage operations in continuous improvement activities.
During 2008 many parts of NHS began to get interested in how the application of Lean in healthcare could enable the seemingly
impossible task of improving the quality of patient care, staff morale and value for money. Under the remit of the then Medical
Director for Surgery, a Head of Lean was appointed to grow an internal resource for training staff and applying Lean techniques to
our continuous improvement agenda.
Lean was introduced to the Trust as a series of small local improvement projects which quickly demonstrated that significant
improvements could be made in reducing LOS, waiting times and mortality by applying techniques such as process mapping and
rapid improvement events to redesign systems and processes that put the patient at the centre. The success of these local projects
all relied on engagement and buy in from front line staff and therefore also succeed in improving front line engagement and
morale.
It is fair to say that fairly quickly the Lean team’s credentials and expertise over took the transformation team’s traditional NHS
improvement skills and there became some confusion over the roles and differences. So it was agreed that as part of the
organisational re-structure plans, the role of transformation/service improvement would be integrated into the new groups
structures and the Transformation team was disbanded on 1st April 2009. The Lean Team continues to support continuous
improvement through training and facilitation of improvement events as per its 2009/10 Business Plan approved by the EDs earlier
in the year. Many other organisations have spent several hundreds of thousands of pounds and in some cases millions by buying in
external Lean expertise. We continue to grow our own internal capacity to ensure sustainability and learning within HEFT. The
2010/11 Lean Business Plan will be presented to EDs Committee in May.
Department of Strategy & Transformation Budget
– Head of Department, Beccy Fenton
Budgets 2010/11
Strategy Development &
Support (old
Transformation Team
Budget)
£
Non Pay
Usual non pay items
36,000
Pay
1.0 WTE Beccy Fenton’s PA (Angela Hudson)
0.5 wte Paul Chew (Business transformation support, replaced Kate
Barber half time)
Plus remaining vacant budget left over from old “Transformation Team”
which ceased to exist on 1st April 2009, less CIPs.
144,329
Old team included Cheryl Hudson (now GHH), Jo Hodgkiss (now full time
HEFT Cons, Helen Slater (left) and Kate Barber (left). In 2009/10 some of
this vacant budget had been used to cover the internal costs of support to
the Trust on projects such as ADTs, 4 hour access programme set up, T&O
Review, Business Planning Support, Directorate Best Practice Reviews. The
external cost of this support would have been far greater.
TOTAL
Lean Team
180,329
Non pay
Usual non pay items
36,877
Pay
1.0 WTE Head of Lean
3.0 WTE Site Lean Academy Leads
3.0 WTE Analysts
0.75 WTE PA
0.4 WTE Clinical Lead
1.0 WTE Vacant (part of Productive theatre pilot)
632,366
TOTAL
TOTAL BUDGET FOR DEPARTMENT OF STRATEGY & TRANSFORMATION
669,243
849,572
Next Steps
•
•
Begin process for updating the Trust’s Corporate Strategy and blue print for 2015.
Update Transformation Strategy to clearly set out the road map for transforming the Trust
from its current state to its new blue print for 2015 setting out annual milestones for each
element of the Diamond Diagram.
• Update Enabling Strategies to ensure all align and support the delivery of the revised
Corporate Strategy.
• Deliver 2010/11 Corporate Business Plan and continue to produce robust annual corporate
plans that are integrated across the whole organisation.
• Ensure full integration of the transformation agenda as set out in the 2010/11 Corporate
Business Plan into the Group Business Plans and performance management frameworks.
• Produce Lean Business Plan 2010/11 for EDs Committee May.
Decision
• Following discussion at April’s Trust Board, the EDs are asked to consider whether an
External Review is required of “transformation” and if so what the scope of this is and what
value it will bring. Scope is currently unclear and could include the following:
– Transformation Strategy Framework (Diamond Diagram ratified by EDs Away Day Dec 09)?
– Progress and pace of the Trust in transforming culture, access and flow, safety, collaboration, environment,
clinical outcomes to improve Patient Quality, Staff Morale and Productivity?
– Methodologies used e.g. Lean, OD, SBAR?
– Methodology and ability to effectively deliver complex trust wide programmes of change?
– Assessment of our culture and whether it is one of “continuous improvement” with empowered and
engagement front line staff?
– Other?