COMMERCIAL IN
CONFIDENCE
Peterborough
Transition Plan
To establish
Peterborough
Final Draft
May 2009
1
Supporting Documents:
CONTENTS
A.
B.
C.
D.
Foreword
Executive Summary
Our Transition Plan
Our Plans for Commissioning
Community Services
E. Our Journey so far
F. Our Integrated Business Plan
1. Executive Summary
2. Profile
3. Strategy
4. Market Assessment
5. Service Development Plans
6. Financial Plans
7. Risks
8. Leadership and Workforce
9. Governance
G. Conclusion
Available on request
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Peterborough Community
Services Transition Project
Initiation Document (PID)
PCS Transition Action Plan
NHS Peterborough “Living
longer, living well” 5 Year
Strategic Plan 2009-2014
NHS Peterborough
Operational Plan 2009/10
Next Steps Project PID
Moving Forward Project PID
Diagnostic and audit reports
E&Y Reports on Service
Reviews
 Core Service Review
 Time to Care
 Priority Based Service
Reviews
Reports on District Nursing &
Health Visiting Reviews
Service Line Management
Project PID
Next Steps Consultation
Document
NHS Peterborough Business
Case recommending the future
organisational model for
Peterborough community
services, ,November 2008
Capacity for Change Project
proposal
PCS Annual Plan 2009/2010
PCS Financial Plan 2009/2010
Draft Care Strategy
Section 75 Partnership
Agreement
2
FOREWORD
We are both pleased to introduce this joint Transition Plan.
NHS Peterborough and Peterborough Community Services (PCS) are committed to ensuring there is a strong community provider
that ensures that the ‘unique’ integration of health and social care is sustained. There is a shared belief that full separation
and ultimate Community Foundation Trust (CFT) status will benefit the people served by NHS Peterborough and PCS by
providing a solid platform from which to maintain a balanced portfolio of the highest quality and most cost effective health
and social care community services delivering maximum public value
.
The assessment process for CFT status, including strict scrutiny of the governance and financial systems, will provide NHS
Peterborough with assurance that PCS has the qualities to remain a major provider of community services in Peterborough.
Contestability of community services will be an ‘ongoing’ process. The Transition Plan outlines a plan for ensuring that
contestability and choice is at the heart of community services provision, ensuring continuous improvement in both the
quality of services and a continued emphasis on supporting personalisation, choice and control to meet local peoples needs.
It is critical to ensure that we can best meet the aspirations of our population with viable providers that can deliver high
quality care closer to home and where appropriate in peoples homes.
To conclude, NHSP is committed to supporting PCS achieve CFT status in the full belief that this is the best model for the future
delivery of our integrated health and adult social care community services. A great deal of progress has already been made
to transform the PCS into a World Class Provider and the PCT into a World Class Commissioner. This Transition Plan
outlines the next steps in that journey. We are jointly committed to ensuring this is successfully delivered for the people of
Peterborough by achieving strong, vibrant and viable community services for the future.
Angela Bailey
Chief Executive
NHS Peterborough
Robert Ferris
Managing Director
Peterborough Community Services
3
‘Our Organisation is unique.
EXECUTIVE
SUMMARY
We commission and provide both health
and adult social care services
to the people of Peterborough.’
Our
Peterborough Transition Plan describes the journey we are taking to establish our directly managed primary and community
services as a separate, viable, independent organisation, offering high quality services to meet the needs of our local community. It is
the joint plan of NHS Peterborough and Peterborough Community Services and forms part of the PCT’s World Class Commissioning
Development Plan.
Our journey to separation started in 2006, when Peterborough PCT was established following the publication
of ‘Commissioning a Patient Led NHS’ (CPLNHS) in August 2005. CPLNHS proposed that, to allow PCTs to
focus on their commissioning role, they should consider divesting themselves of their directly managed
provider services. Our journey is likely to continue to 2012 and beyond.
We have acted on CPLNHS recommendations by assessing all of the options open to our community services,
identifying our preferred model and separating our provider services into an Arms Length Trading Organisation
(ALTO).
We have determined that the best future organisational model for Peterborough Community
Services is that of a community foundation trust (CFT). This is the only model that appears to be acceptable to
Our key stakeholders mainly because, as a CFT and a statutory organisation, we could continue to provide the integrated health and
adult social care services which are so important to us in Peterborough. We also believe that the process of preparing to become a
CFT will ensure that our community services are delivered in the most effective and efficient way possible.
Our Transition Plan describes our journey so far and the journey we still have to make to reach our desired destination. We have
already made significant progress and are aware that we still have a great deal to do to transform PCS into an organisation fit to be a
CFT. The time line shown below sets out this journey. We have estimated the time we will need based on the experience of
foundation trusts and the pilot community foundation trust who have advised us that the process is long and the time line is likely to
change frequently.
2006
NHSP established
Separate Provider
Directorate
2007
2008
Next Steps/Moving PCS established
Forward Projects
as an ALTO
CFT Model confirmed
2009
2010
2011
2012
PCS on FT pipeline Service transformation Apply to
Peterborough
and established
& business readiness SoS & Monitor
established
as an APO
for CFT status
as a CFT? 4
EXECUTIVE SUMMARY
NHS East of England have asked that our Transition plan responds to the following questions:
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How our plans for provider unit separation will lead to contestability and competition for community services;
How we will strengthen our commissioning of these services to ensure commissioner-led redesign of services
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Staff and stakeholder engagement plan and communications strategy
Provider separation arrangements
Identification of organisational models and their appraisal leading to preferred selection
Development of robust business plans for preferred model(s) and their evaluation for appropriateness, viability and
sustainability
Business continuity plans for the period of development
Development and training plan for skills and competencies to assist providers make successful transition to new forms
Risk assessment, mitigation and management plan
A timeline with key milestones identified
Transitional costs
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We have set out our plan in four main chapters to cover these questions. These are:
Our Transition Plan
This chapter introduces the transition plan and describes the context, principles and approach to our plan. It also covers the
timeline and estimated transition costs.
Our Plans for
Commissioning Community
Services
This chapter sets out our vision for commissioning community services and describes how we will assess the market,
strengthen our commissioning and support PCS through our contestability and procurement plans. It outlines our strategic and
operational plans and identifies our key developments together with our commissioning timeline.
Our Journey so far
Our journey so far describes the process we used to separate PCS into an ALTO and the transformation work we have
already undertaken to change and develop our services. It also explains the process we used and the reasons for deciding on
our preferred organisational model for PCS of a Community Foundation Trust.
Our Integrated Business
Plan
This section includes PCS’s first draft Integrated Business Plan (IBP). It is set out in the format recommended by Monitor and
covers a profile of our services, our vision and strategy. It outlines market assessment, our rationale for becoming a CFT, our
service development plans and our financial projections and risks. It also includes our stakeholder engagement plans,
development and training plan, continuity plan and governance arrangements. The IBP contains commercially sensitive
information and is at a very early stage of development. It will continue to be developed over the next months and years.
5
OUR
TRANSITION
PLAN
NHS
‘Peterborough Community Services is aspiring to
perform as a World Class provider and
operate as a Community Foundation Trust’
Peterborough (NHSP) has decided to separate the
services it directly provides, known as Peterborough Community
Services (PCS), into an autonomous organisation and ideally
establish it as a Community Foundation Trust (CFT) for
Peterborough.
Our Transition Plan describes our journey from the beginning
when we were established as Peterborough PCT in 2006 (we
are now called NHS Peterborough) and separated our provider
services into one directorate.
It covers the progress we have made by separating our provider
It includes work we have already started to become an
Autonomous Provider Organisation (APO) and transform
our services by understanding our services better and
identifying areas where we can improve.
Our transition plan then moves on to set out a challenging
programme to change our services and business
infrastructure to ensure that PCS can operate as an
independent viable organisation delivering high quality
services which respond to our commissioners' requirements
and meet the needs of our local community. We have
described our future plans in the section on our Integrated
services into an Arms Length Trading Organisation (ALTO),
agreeing our preferred long term organisational models for our
Business Plan.
different service groups and confirming our commissioning plans
for community services which include how we will develop the
Our plan forms part of our World Class Commissioning
market for community services and ensure contestability.
2006
NHSP established
Separate Provider
Directorate
2007
2008
Next Steps/Moving PCS established
Forward Projects
as an ALTO
CFT Model confirmed
Development Plan and is a joint plan between NHSP and
PCS.
2009
2010
2011
2012
PCS on FT pipeline Service transformation Apply to
Peterborough
and established
& business readiness SoS & Monitor
established
as an APO
for CFT status
as a CFT? 6
OUR TRANSITION PLAN: Guiding Principles
Context
Principles
The Transition Plan has been
prepared in the context of the
following National, regional and local
policy, guidance and requirements:
‘Transforming Community Services’
sets out a number of guiding
principles which have been used to
underpin our transition plan and
associated programmes and projects.
 Commissioning a Patient Led NHS’,
August 2005,
 Our Health; Our Care; Our Say, 2006,
 Every Child Matters, 2003
Putting People First, October 2007
 High Quality Care for All, June 2008,
 The NHS Operating Framework,
2009/20010
 Transforming Community Services:
Enabling new patterns of provision’ 2009
 Improving Lives; Saving Lives, NHS East
of England, 2007
Towards the Best, Together, NHS East
of England
 Peterborough PCT Strategic Service
Development Plan, 2007- 2012
 Joint Strategic Needs Assessment
for Peterborough, 2007
Section 75 Partnership Agreement for
adult social care services with
Peterborough City Council
 NHS Peterborough 5 year Strategy
‘Living Longer, Living Well’ 2009
 Annual Accountability
Agreement 2009-2010 with
Peterborough City Council
They are summarised as follows:
 Interests of patients and carers are
paramount
 Quality is the organising principle
 There is a clear commissioning strategy
 Proposals must deliver value for money
 Decisions about services should be made
locally and include consultation
 Services should be designed to meet local
need
 Staff, unions and stakeholders must be
involved in decisions
 High standards of human resource
management
 Processes must be clear, robust and
transparent
 Proposals must enable integrated care,
with Local Authorities, World Class
Commissioning and patient choice
 Proposals must fit DH principles and
rules for cooperation and competition
 Options are equality impact assessed
 Service continuity, assets and staff
pensions must be safeguarded
Objectives
The Next Stage Review, High
Quality Care for All, identified a
number of objectives to achieve the
vision for community services. These
have been taken into account in our
transition plan.
They are:
 Make quality our organising principle
 Empower staff to improve patient care
and focus on quality
 Enable World Class Commissioning
 Provide direction and strengthen
leadership
 Promote patient choice
 Foster appropriate competition to
drive better service quality and value for
money
 Protect assets and the interests of
taxpayers and ensure flexibility
 Ensure the provision of safe, fit for
purpose buildings
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OUR TRANSITION PLAN:
Our Approach
“In order to facilitate Monitor’s review of the Integrated Business Plan,
PCS should maintain the robust project management disciplines,
including the availability of clear and balanced supporting documentary
evidence, that have been in place to date in the Moving Forward project.”
NHSP: Provider Services – Audit Commissioned ‘red risk review’,
December 2008, PriceWaterhouseCooper
From the start, we have managed the separation
using formal project management to ensure that
the agreed aims and objectives are delivered.
Programme Structure
Our Transition Plan is complex and will require
many projects and activities to achieve the
desired outcomes.
Our approach for this next stage of the transition
is to use a programme management approach to
ensure that all the projects and related activities
are integrated and coordinated to achieve
maximum benefits.
The Transforming Peterborough Community
Services
Programme
incorporates
two
programmes: the Transition Programme and the
Transformation Programme. An overall Project
Initiation Document and Programme Structure
sets out the objectives, scope, approach, key
issues,
organisational
arrangements,
assumptions and constraints in more detail and is
supported by an action plan and risk log.
Five
strategic
workstreams
have
been
established to ensure that all the objectives are
achieved and the resulting changes are
embedded throughout the organisation. They
are: Governance, Finance, People,
Commercial and Operations.
PCS Board
PCT Board
PCS Committees
Audit
Integrated
Governance
Finance &
performanc
e
Transformation
Programme Board
Chair RF
Transition
Programme Board
Chair AB
Programme Management Team
PCS Directors Group
Strategic Workstreams
Programme
management
Governance
Finance
People
Commercial
Key
Operations
Joint PCT/PCS
Reports to
Programme
Management Office
Transition Projects
Transformation
Projects
Supports
SRO: RF
PM: AR
PC: ABr
BRM: Tbc
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OUR TRANSITION PLAN: Costs and Assurance
Our Transition Costs
Using a recognised formula applied to organisational changes we have estimated a total transition cost equivalent to approximately 2%
of turnover spent over a three year period.
Assuming an amended recurring income of £69m our transition costs will be £1.3m. We
can expect to spend approximately 50% of this in the first year with reducing amounts in the subsequent two years. An additional 2%
efficiency each year for three years would generate the equivalent of 6% or £4.1m. In addition, it has been estimated that approximately
£0.6m will be required for non-recurring transitional costs.
NHSP has agreed in principle that there is a need to recognise the cost of
transition and will address this as part of its overall financial plan for 2009/10 and beyond. The Business Case agreed by the PCT
Board estimated additional recurrent revenue costs of £1.3m to operate PCS as a CFT. Transition costs cover three areas: Additional
Capacity associated with being a fit for purpose organisation, Transformational Costs associated with building a sustainable future,
Additional Costs associated with being a separate organisation e.g. external audit.
OUR ASSURANCE
The SHA have asked six questions to provide assurance that the Transition Plan will lead to the required standards for provider separation.
We believe that our plan, together with other supporting evidence, demonstrates that we have fully achieved all the requirements and,
in many cases, exceed them. Under the RAG rating, we have scored ourselves ‘green’
Will delivery of the plan lead to the formal transition
to ALTO being completed by April 2009
Yes: ALTO status achieved in April 2008. ALTO checklist completed with evidence available. Full “business
readiness for PCT provision check list (by DH) completed and all tasks due to be completed or have been
achieved. All others are in progress and on time. Our Annual Plan has been submitted to EoE PDB
How the Provider will identify the core services that
it will be responsible for providing?
Yes: We have carried out a core service review and clarified our core services. We carried out a Time to Care
exercise and have a clear view on current productivity and competitiveness levels of our services following a
market analysis, a costing exercise and improved data collection and analysis.
Does the plan indicate how the PCT will develop a
clear view on which organisational form to adopt?
Yes: Our Transition Plan describes the consultation, option appraisal and business case produced to confirm our
preferred organisational model. Risks, costs, timescales and draft Integrated Business Plan are covered.
Does the plan outline how the PCT will establish
robust governance arrangements for the transition?
Yes: Our Integrated Business Plans includes both the governance arrangements specific to the Transition
Programme and the arrangements in place or being established to ensure the organisation is well governed.
These include our Board appointments and development programme, BAF and use of Performance Accelerator
Does the plan ensure that the Provider has the
capability and capacity to operate as an ALTO?
Yes: the Plan demonstrates that not only can we operate as an ALTO, we are making fast progress towards APO
status. Where we have identified shortfalls in capacity an capability, we have engaged external support, such as
Deloitte to carry out the market analysis and E&Y to support some of our Transformation Programmes. We have
proposed a new Executive structure and are implementing Service Line Management and service redesign to
maximise capacity
Is the Provider engaging all relevant stakeholders in
developing the transition plan?
Yes: all relevant stakeholders have been and will be engaged throughout the transition process, including recent
involvement in developing our Care Strategy. We have a Communication Plan, and are in the process of 9
producing our Transition Engagement and Communication Plan. Out transition plan builds on a number of plans
and projects which have been developed with our stakeholders. Our Board includes lay members and the LA.
OUR TRANSITION PLAN: Timeline
10
Our Plans for Commissioning
Community Services: Vision for
community services
‘The future focus will be on
moving care into the community, the
home, and other primary care settings ‘
The challenge of enabling 21st century health and adult social care services in Peterborough is both ambitious and formidable. With
the new City Care Centre opening in 2009, a new hospital, new mental health facilities, and with more accessible services planned in
its neighbourhoods, the ambition to ensure 21st century care has started well.
However, some of Peterborough’s population still have poorer health outcomes, shorter life expectancy and a higher burden of
disease than their neighbours. Consequently as the local leaders of the National Health Service, we are determined to see that
picture change. NHS Peterborough takes very seriously the responsibility of working with organisational partners and listening and
working with local people to change the patterns of the past to deliver a better future for the health and well being of the people of
Peterborough.
With the current economic outlook the underlying theme is that service change and improvement must be undertaken through
redesign, modernisation and improved efficiency of existing services. A key focus will be to use hospital services for the more
complex and specialist care, whilst continuing a comprehensive programme to increasingly support care delivery within the home and
other community and primary care based settings; this will be achieved through creating financial flexibility by disinvestment in
outmoded or outdated services and detailed robust service specification leading to (re) investment in new 21st century services that
meet the needs of individual patients and service users in Peterborough.
Our Strategic Plan “Living longer, Living Well” and the directly related 2009/10 Operational Plan are the outcomes of key planning
processes within NHS Peterborough which are derived from extensive engagement with partners via the Sustainable Community
Strategy and Local Area Agreement and most importantly, are underpinned by listening carefully to the views of local people.
The ongoing strategy of shifting care (outpatient, minor and routine surgery, some invasive procedures) away from hospitals into a
community setting has and will continue, to present opportunities for community providers including Peterborough Community
Services, to grow their businesses.
Our planning processes and commissioning intentions have informed the parallel business planning and related processes of PCS
contained within this Transition plan. We are confident that our strategic aims have been communicated effectively and are at the
centre of PCS’s mission to provide cost effective, high quality services which meet specified outcomes.
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Our Plans for Commissioning
Community Services: Vision
for community services
(Continued)
‘PCS’ vision is to provide competitive,
integrated health and social care services
which contribute to individual well-being.’
Driven by the action plans emanating from the current Organisation Development Plan process, NHS Peterborough’s enhanced
world class commissioning (WCC) approach (throughout the whole of the commissioning cycle) will, over the next two to three years
or so, undertake a market segmentation analysis in relation to community services. Where appropriate and possible this will lead to
market stimulation and lead to enhanced choice for service users and patients and value for money.
Concurrent with the segmentation of the community services health and social care markets, reviews of PCS services within those
market segments will be undertaken. Each service or set of related services along a current or proposed future pathway or pathway
redesign will then be robustly examined and analysed as to their current and future fitness for purpose. It is envisaged that all
services provided by PCS will be reviewed in the next three years.
Where redesign or re-specification is sought the NHS Peterborough Principles of Contestability will be used to determine whether
PCS services will be subject to full contestability within the market place or that the qualifying conditions for ‘non contestability’ apply
and a collaborative commissioner led redesign approach will be undertaken with Peterborough Community Services and other
providers if applicable. (i.e. GPs and Peterborough and Stamford Hospitals Foundation Trust)
NHS Peterborough is committed to ensuring that over the next two to three years, through the series of robust reviews outlined that
PCS will be perfectly placed as a strong provider with a portfolio of high quality, outcome based, value for money community
services.
This will be coupled with a drive to ensure that the market for services is stimulated, developed and managed so that, where
appropriate and right, services that may currently be provided by PCS are provided by other organisations in order to best serve the
individual preferences and needs of the population of Peterborough. The corollary of this is that PCS will also be able as a strong
provider to grow its business in ‘core areas’ where it is strongest and that best fit its own strategic direction as a provider in a timed
and managed way.
Thus there will be a strong and sustainable platform to move from being an Arms Length Trading Organisation (ALTO) to an
independent Community Foundation Trust (CFT) .
12
Our Plans for Commissioning
Community Services:
Market Development
As part of our Organisation Development
‘Understanding the developing market
is a key focus for NHSP and PCS'
we will manage and develop the market to give a clear approach to addressing the
market development issues of a) segmenting the market through client groups, care pathways and geographical areas b)
identification of gaps in the market and attraction of new providers and c) a greater understanding of provider economics and
quality will emerge.
Following on from the regionally led Health Market Analysis Project 2008 which NHS Peterborough Commissioner’s took part in,
the methodology undertaken will form a basis for the type of approach that NHS Peterborough will take for Health and Adult Social
Care market development.
The Methodology of the 7 step approach to Market Development is broadly as follows:
1.
Segmentation - an initial approach to common segmentation informing data collection to support economic analysis
2.
Demand Forecasts – demand modelling focusing on utilisation by disease category
3.
Service Analysis – aspects of service quality analysed using common metrics across the EoE region, similar PCT
comparators and the national average.
4.
Economic Attributes – economic structure of services in EoE analysed using data on expenditure, providers and contracting
5.
Priorities – prioritised services for further review following demand, service and economic analysis
6.
Options – market development options pursued for the prioritised services
7.
Road Map – showing the way forward to the creation of a more diverse and vibrant market for community services.
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Our Plans for Commissioning Community Services:
NHS Peterborough Strategic and Operational Planning
NHS Peterborough’s “Living longer, living well” 5 year Strategic Plan 2009-2014 in line with national and regional priorities and policy
development, has four overarching sustained NHS Peterborough strategic priorities:
♦ Promoting Healthy Lifestyles ♦ Reducing Health Inequalities ♦ Supporting Vulnerable People ♦ Improving Access
Within each of these strategic priorities the strategic plan and the yearly Operational Plan 09/10 states specific and targeted goals
and explains how focused activity, with clear timelines underpinned by a financial plan will meet national, regional and local health
and social care expectations.
The 5 year Strategic Plan and this year’s Operational Plan categorise within 17 Goals the specific areas for action and achievement.
They are as follows
Promoting Healthy Lifestyles
Goal 1: We will reduce the number
of smokers in Peterborough
Goal 2: We will halt the rise in
obesity in all age groups and
reduce childhood obesity
Goal 3: We will reduce under 18
conceptions and improve the
sexual health of our population
Goal 4: We will reduce the harm
caused by drug and alcohol
substance misuse.
Reducing Health Inequalities
Goal 1: We will reduce the morbidity
and mortality for coronary heart
disease and stroke with a focus
on our most deprived communities
Goal 2: We will reduce the morbidity
and mortality from cancer
Goal 3: We will reduce the morbidity
and mortality from chronic
obstructive pulmonary disease,
with a focus on our most deprived
communities
Goal 4: We will reduce infant mortality
in our most deprived communities
Supporting Vulnerable People
Goal 1: We will ensure services
safeguard the vulnerable
Goal 2: We will improve and maintain
the health and independence
of older people
Goal 3: We will enable inclusion
for those with mental illness
and learning disability
Goal 4: We will support carers
Goal 5: We will ensure modern
and responsive services are
provided for people with disabilities
Improving Access
Goal 1: We will increase
personalisation, choice
and control
Goal 2: We will commission
more care to be delivered
closer to home
Goal 3: We will drive up quality
and access to both general
practice and dentistry
Goal 4: We will commission
first class maternity care
Over the next 5 years PCS has a key role to play either directly or indirectly in enabling the achievement of almost all of the
strategic goals of NHS Peterborough.
14
Our Plans for Commissioning
Community Services: The evolution of
Peterborough Community Services via
strengthened commissioning and contestability
‘Contestability will be
the key to
competitive,
high quality,
best value services'
Both commissioners within NHS Peterborough and providers within PCS hold a shared vision of what full separation and
ultimate Community Foundation Trust (CFT) status would mean for patients and social care service users.
CFT status would provide a solid platform from which to maintain and where prudent enhance a balanced portfolio of the
highest quality and most cost effective health and social care community services.
Peterborough is a pioneer in the integration of health and social care services. A pooled budget and annual accountability
agreement with Peterborough City Council, through a Section 75 Partnership Agreement for adult social care services with
Peterborough City Council, enables NHS Peterborough to commission via Peterborough Community Services a full range of
integrated health and social care services for adults and older people in a variety of settings (e.g. A Healthy Living Centre
and imminently a new City Care Centre). The integrated nature of health and social care services within PCS provides a high
degree of assurance to the PCT as commissioner that service delivery will be maintained throughout the process of
transformation.
Through the careful and robust implementation of key principles of contestability outlined below a balanced and planned
approach to testing contestability is already well underway in relation to the services provided by Peterborough Community
Services. Over the next two to three years all of the services provided by PCS will be part of a robust and comprehensive set
of service reviews and mutually sequenced and coordinated Programme Budget Reviews.
15
Our Plans for Commissioning
Community Services:
Principles of Contestability
‘Through a managed market process,
we will ensure our community receives
the best service available,
with minimal disruption to their care’
NHS Peterborough recognises that it has a leadership role in the development, stewardship and management of the local health
and social care provider market. In doing this NHS Peterborough recognises the contribution and expertise of the local authority,
the third sector, the independent sector and other NHS partners in developing a successful world class contestability and robust
market management approach.
The probability of risk of service disruption through ‘rushed’ procurement is mitigated if not eliminated by NHS Peterborough
systematically and robustly undergoing a cycle of commissioning/contestability and the specific implementation of the principles
of contestability.
Contestability is best achieved through a managed market process where the risks and rewards to patients and service users,
providers and NHS Peterborough are thoroughly and consistently appraised and acted upon. This sometimes subtle balance
between risks and rewards needs to be under-pinned by a commissioning/procurement implementation plan which provides
insight, research and full comprehension of supply sectors and providers, their motivations and behaviours and economic/cost
environment.
Over the next three years all of PCS’s services will be reviewed. Following the review of each service three principles of
contestation (which are logically derived from the strategic context and theoretical framework outlined above.) will be applied to
determine whether or not formal ‘contestation’ will be carried out or not.
16
Our Plans for Commissioning
Community Services:
‘Maintaining a balanced health
economy for Peterborough
is a key objective’
Principle 1: When to contest a service
The events or qualifying conditions that may trigger the contestation of the provision of a service are as follows:
♦ Substantive concerns about less than optimum quality, effectiveness, strategic fit or cost effectiveness of an existing service
♦ New National and/or Regional policy guidance and interpretation ♦ The end of previously awarded contract terms
♦ Commissioning of a new service for which there is no existing provider ♦ The commissioning of an existing service when
it involves a substantive change in its delivery model (e.g. different setting, different skill mix, reconfigured care pathway)
♦ Or as a consequence of new technology and its application.
Principle 2: When not to contest a service
Any decision not to contest a service will be determined by the scrutiny of demonstrable clear and transparent evidence as to which of the
“qualifying conditions” have been met in a individual case.
The non contestation qualifying conditions are as follows:
♦ Timescale genuinely precludes the ability to provide a safe continuity of service provision or the timely delivery of a new required service.
♦ Specialist source. Only one provider or provider designation has already taken place at National or regional level .
♦ Service must be provided by a particular provider to protect essential public services; this may include consideration of the potential
destabilisation of other services but must not be used to protect providers that are not best placed to deliver the needs of their patients and
service users and the relevant population.
♦ Where failure to award a contract to a preferred provider would place other core services at a significant risk of destabilisation
♦ Any willing providers arrangements are in place
♦ There is a clear and demonstrable benefit to be gained from maintaining or establishing integration with an existing service due to very
strong service alliances. However in such cases the benefits of such integration must exceed any potential quality or financial advantage to be
gained by competitive tendering.
♦ Where through probing market analysis there is not a reasonable expectation of competition with no more than one provider coming forward
Principle 3: Identification of Risk
Mitigation of risk for NHS Peterborough is paramount in its central role as commissioner.
Additional risks to NHS Peterborough in relation to market testing and introduction of new services and providers may include:
♦ Decreases in service quality ♦ Continuity problems ♦ Lack of initial or ongoing capacity with concomitant effects on
performance targets ♦ Allied market stability problems ♦ Deleterious financial effects ♦ Adverse reputation management
In evaluating whether to formally ‘contest’ or ‘not contest’ a service (via the application of the components of principles
(1 and 2) above, the risk mitigation issues in principle 3 will be thoroughly researched and addressed in the decision
making process and if applicable the subsequent procurement route chosen.
17
Our Plans for Commissioning
Community Services:
Strengthening of Commissioning
The
‘NHSP and PCS were part of the national
testing process for the new NHS
Community Contract, giving us a shared
insight into the benefits of the new contract’
commissioning of community services is being strengthened through formal monitoring of the new NHS Contract for
Community Services by a Contract and Performance Group and the management at a strategic level of in year developments
by a Strategic Development Group coupled with an ongoing review of services within an overall Programme Budget approach.
The NHS Contract for Community Services
NHS Peterborough has utilised the National NHS Contract for Community Services as a SLA so as to be able to facilitate the
use of the format in its full legal sense at the point that Peterborough Community Services becomes an Autonomous Provider
Organisation. The NHS Peterborough / PCS Community NHS contract was successfully agreed on schedule for 2009/2010.
A formal set of two interlocking PCS/PCT commissioner forums each with their own specific focus has been established. The
Contract and Performance Group (CPG) was established in April 2009 with membership from the PCT, PCS and associate
commissioners from neighbouring PCT areas. Its remit is to review progress against existing SLAs between PCS, NHSP and
other associate PCTs. NHS Peterborough PCT will be the lead Commissioner for those neighbouring PCTs who wish to be
involved, so forming a multilateral contract with PCS at the point it becomes an Autonomous Provider Organisation (APO).
The Strategic Development Group (SDG) has been established between PCS and the PCT, in the first instance, with a joint
chairing arrangement between NHS Peterborough Commissioners and PCS to project manage an in-year Work Development
Programme for 2009/10.
Both the Contract and Performance Group (CPG) and Strategic Development Group (SDG) will meet monthly.
18
Our Plans for Commissioning
Community Services:
Strengthening of Commissioning
‘
The information collected and reported by PCS
is continually improving to provide accurate,
timely and useful performance reports to both
the PCS and PCT Executive and Boards’
The CPG will use key available metrics to monitor performance against agreed specifications, the overall financial quantum of
the contract and to review the performance of the contract to ensure that all national targets and milestones, together with any
locally agreed targets, are met within the agreed plans, and that effective steps are taken to resolve issues which may
adversely impact on the delivery of these targets. In addition consideration will be made of any capacity issues that may arise
during the course of the contract period initiating the appropriate review to support the effective delivery of services.
As part of the NHS Contract for Community Services a CQUIN incentive scheme payment of 0.5% of the NHS contract value
has been agreed. This provides an incentive for PCS to provide specified quality data in a timely manner in the following areas:
Maximum 18 Week Referral to Treatment Targets for non consultant led targets with key quality markers to aid responsive
delivery
Minimum Data sets across all services within the year for ten key items of data (e.g. postcode, date of birth)
Financial information
Pilot CQUIN (prior to national implementation) in terms of Safety, Effectiveness and service users across 4 services.
Establishing, maintaining and regularly reporting on the clear links between the 5 year Strategic Plan, the yearly Operational
Plan, the NHS Standard Community Contract and the in year Work Development Plan will ensure progress across the
commissioning cycle within a demonstrably robust WCC framework. Relevant and appropriate performance software will be
utilised to enable this process.
NHS Peterborough is confident that the appropriate level of capability and capacity that is required by the commissioners to
complete fully the key tasks of managing and monitoring the contract with PCS and therefore providing support and assurance
to the transition process will be in place.
19
Our Plans for Commissioning Community
Services: Strengthening of Commissioning
‘Balancing investment and
disinvestment in specific
Service areas will be crucial’
Programme Budget Reviews
Delivery of the Strategic Plan is based upon recognition of the need to change the way services are delivered if financial
balance is to be achieved. This will involve investing in some areas and disinvesting in other areas. A programme of service
reviews, managed by a board convened by NHS Peterborough, will be implemented. It will use Programme Budget and
Health Outcome data to review 100% of the expenditure and identify areas where outcome is poor and/or expenditure is high.
This will instigate service redesign to meet the strategic objectives, generate financial efficiencies and release resources for
reinvestment.
The comparative work has highlighted a number of areas that may require changes in services and service models currently
provided by PCS including:
 Learning Disability
 Respiratory
 Musculoskeletal System problems
 Adult Social Care
20
Our Plans for Commissioning Community
Services: 2009/10 key developments
Outlined
NHSP and PCS will work
together to review, redesign
and develop services
below are some of the key planned and ongoing developments within 2009/10 which will have major direct or
indirect impacts on PCS activity.
Chronic Obstructive Pulmonary Disease
Currently in conjunction with the East of England SHA a COPD
Care Pathway is being redesigned to the Gold standard (2008).
This includes aspects of prevention and public awareness
through to clinical intervention and spans primary care,
secondary care and rehabilitation. A community based
pulmonary rehabilitation service which will lead to positive
outcomes for service users is planned to be established within
the Healthy Living Centre by December 2010. There is a
potential impact on PCS as it currently provides part of the
current arrangements through respiratory nurse staff and the
reconfiguration of the COPD rehabilitation pathway will provide
for a shift of activity within it through a contestable procurement
process.
Musculoskeletal Assessment and Treatment Service
(MATS)
The existing musculoskeletal system in NHS Peterborough has
used a Musculoskeletal Assessment and Treatment Service
(MATS) since October 2007 to assess and triage the majority of
GP referrals into the local system. The main purpose of that
system is to improve the quality of referrals reaching its main
provider of secondary care, Peterborough and Stamford
Hospitals Foundation Trust (PSHFT). The service is currently
being reviewed and proposals for redesign and re-specification
will be developed by May 2009 with the scope to consider wider
integration with Pain Management Services.
Chronic Heart Disease
By December 2010 NHS Peterborough will re-commission
comprehensive cardiac rehabilitation services with a clear methodology
for identifying, treating and following up those patients post myocardial
infarction (MI) with extension of this to all those manifesting with CHD
symptoms by 2011. A regional Cardiac Rehabilitation service
specification is currently being used as a template to inform the design
of a local template. There is expected to be a move away from the
‘sequential phases’ of the current ‘heart manual’ approach to a menu
driven approach. There is a potential impact on PCS as it currently
provides part of the current cardiac rehabilitation approach and the
reconfiguration of the CHD rehabilitation pathway will provide for a shift
of activity within it through a contestable procurement process.
Learning Disability
A Priority Based Review of Learning Disability services is currently
being undertaken. This review will include all learning disability
services commissioned by NHS Peterborough.
The current level/model of service will be defined as a baseline
against which alternative levels of service can be developed. The
service and financial impact taking into account risks, quality and
benefit will then be developed for a variety of option levels –
minimum, intermediate, current and enhanced. Service users will take
part throughout the process assisted where appropriate by their
advocates.
When a preferred option is selected then it is envisaged elements of
the learning disability service will be redesigned and potentially
21
tendered for.
Our Plans for Commissioning Community
Services: 2009/2010 Key Developments continued
Self Directed Support
Self directed support (SDS) incorporating individual budgets (IB) in social care commissioning are a key to developing choice for service
users. The development of an Independent Living Support Services Access and Information Centre (ILSS AIC) is central to the success
of ensuring contestability within the Self Directed Service program. An Independent organisation, providing advice and guidance to
service users, carers, or their representatives and general members of the public will promote the development of the service user driven
market, and allow real choice in service provision.
The AIC is currently in the procurement phase and is anticipated to commence operation on the 1st October 2009. The operator of the
AIC will not be allowed to provide services. Once fully operational it is anticipated that the AIC will become the information centre for all
of the population of Peterborough who require Adult Social Care Services, care and housing support, advice or assessment.
The ability of individuals to direct their own individual social care budgets to their preferred provider and the move away from block or
‘purchasing intention’ contracts to “any willing provider” status will ensure over time a far more competitive market place.
Older Peoples Accommodation Strategy
Six Peterborough City Council Older Peoples Homes are managed and staffed by Peterborough Community Services. In June 2009
PCC Cabinet members will finalise agreement for a substantive redesign programme for this provision to include potentially extra care
housing, respite facilities, health and well being and dementia resources. Procurement of these services will be undertaken in line with
key principles of contestability over the next two years.
There are additional developments already at the implementation stage which are offering new ongoing developments for PCS in
2009/10 for instance:
A Stroke Coordinator with specific DH Social Care funding for two years is to be recruited and employed by PCS to support patients,
carers and organisations across Peterborough to enable more effective and efficient working along the stroke pathway.
An Integrated Diabetes service within the Healthy Living Centre facilitated by PCS has been in operation from April 2009.
22
Our Plans for Commissioning Community Services:
Timeline
23
Our Plans for Commissioning Community Services:
Services to be reviewed
24
Our Plans for Commissioning
Community Services: Conclusion
‘We have a clear strategy and
timeline to achieve the successful
development of PCS as a CFT'
The strategy outlined above will be further formalised and supported by a NHS Peterborough Procurement Plan in line with the
October 2009 timetable set out in Transforming Community Services: Enabling new Patterns of provision.
This procurement plan with its time-line informed at a summary level by the “Review of Community Services 2009-2012
Timeline” will be organised in four thematic areas:
The assessment of relevant markets (including the need for services, market structure, competition, capacity and innovation)
The evaluation of existing contracts (measured by their performance, efficiency, demand and fitness for purpose)
The evaluation of procurement options (by outcomes, attractiveness and whether in lots or a whole and/or from a single or multi
source)
The evaluation of procurement routes (e.g. EU part A or B options)
NHS Peterborough commissioners and PCS are confident that with a clear strategy and timeline of commissioning
developments and reviews, a well defined and increasingly robust contract relationship and a transparent, objective, relevant
and fair view of contestability, that the road from ALTO to CFT will be achievable within the timescale outlined.
Reports used:
NHS Peterborough “Living longer, living well” 5 Year Strategic Plan 2009-2014
NHS Peterborough Operational Plan 2009/10
Transforming Community Services
PPCT working paper entitled “Programme Based Budgeting for Health – Summary of
2006/7 data.
Programme Budgeting Report Peterborough PCT – Eastern Region Public Health
Observatory
Community Services – Separation – Tool 1 – Implementation Planning – Deloittes – East
of England – January 2009 – V1.0
25
Our Journey so far: Identifying our
preferred organisational model –
Public consultation
‘PCS has a track record for genuine
and inclusive public consultation’
Our Journey began in 2006, when Peterborough PCT was established and brought together all the provider services into a single
directorate. The provider arm started to look at its future options should in be separated from the PCT and commissioned a
feasibility study of all potential models and in 2007, the PCT and provider arm set up the Next Steps project.
The project was tasked with recommending the future direction and best organisational model (s)
for the provider services to the PCT Board. Work groups were established to consider the legal,
commercial and workforce implications of the options, to engage with staff and the public and
carry out a formal public consultation. Five possible organisational forms were identified and
matched against the seven service groups.
Arms Length
Trading
Organisation
Community
Foundation Trust
Integration (vertical
or horizontal) with
other organisations
Social Enterprise
Independent
sector
General services for
adults and older people
Possible but least
preferred
Possible option
Possible option
Preferred
option
Possible option
Specialist services for
adults and older people
Possible but least
preferred
Possible option
Possible option
Preferred
option
Possible option
Services for adults with
learning disabilities
Possible but least
preferred
Possible option
Possible option
Preferred
option
Possible option
Services for children
Possible but least
preferred
Possible option
Preferred option
Possible option
Possible but
least preferred
General practice services
Possible but least
preferred
Not an option
Possible option
Possible option
Preferred
option
Dental services
Possible but least
preferred
Possible option
Possible option
Possible option
Possible option
Unplanned Care services
Possible but least
preferred
Possible option
Possible option
Possible option
Possible option
The outcome of the public
Consultation was:
All services transferred to an ALTO
The directly managed GP
Practices transferred to
independent providers
 A business case was produced
and agreed recommending that the
remaining services should apply
for community foundation trust
status was agreed.
The Moving Forward project was
set up to establish the ALTO and
26
produce the Business Case
Our Journey so far:
Our Business case
Our Moving Forward Project took the three organisational
models shortlisted for further analysis and carried out an
option appraisal to assess which model deliver the most
non financial benefits and would best support the delivery of
our services, meet the key national, regional and local
targets and be most acceptable to our stakeholders.
Ten benefits criteria were agreed, based on researched
criteria for community services. These were weighted and
each model was scored against them. The rationale for the
scores were discussed and a sensitivity test was carried
Arms
Length
Trading
Organisation
An NHS organisation, which remains part of the PCT but with
governance arrangements so that the provider is treated like
any other provider. Staff remain PCT employees & public
procurement laws do not apply. There is limited freedom.
Community
Foundation
Trust
An NHS organisation, established as a Public Benefit
Corporation, consisting of members who may be in constituencies
of the public, patients and staff. There is a Board of Governors and
a Board of Directors.
Social
Enterprise
A business which has defined social or environmental objectives. A
Community Interest Company limited by guarantee or shares,
designed for SEs that want to use profits and assets for the public
good
out.
The highest scoring option by a significant amount was the
Community Foundation Trust model.
The social enterprise model was not acceptable mainly
because, as a non statutory organisation, it could not
provide social care assessments or case management and
as such, integrated health and social care services could
not be provided. In addition, the lack of access to the NHS
pension was not acceptable to staff and could have limited
the organisation’s ability to recruit staff.
Separate financial, economic and commercial cases also
ranked the CFT model as highest. Due diligence was
carried out by KPMG and supported the findings.
27
Our Journey so far: Separating our
provider and commissioning functions –
becoming an ALTO
The
first stage of our journey was achieved on April 1st 2008, when we were established as an Arms Length Trading
Organisation (ALTO). While legally remaining part of the PCT, the provider has operated since then as a separate
organisation through a Scheme of Delegation and Terms of Engagement, with its own PCS Board and sub committees.
The Moving Forward Project was set up to ensure that
arrangements were in place to run the provider services as
a separate organisation. This was demonstrated through
the completion of the SHA’s ALTO template. Evidence was
collected to confirm that all the requirements had been
achieved. These included:
 ALTO ‘Board’ & management structure
 Financial separation.
 Separate governance arrangements
 Finance and Performance Committee
 Business Strategy and Business Plan.
 Services reviews: Services Specifications and plans
 Performance Dashboard with improved data collection.
 Market analysis.
 Communications Plan and Strategy.
 Identification & separation of PCT and Provider assets.
Separation by transfer or SLAs of internal support teams
 Workforce and Organisation Development Plan
28
Our Journey so far: Separating our
provider and commissioning functions
– from ALTO TO APO
PCS has a track record
for laying good foundations
for future development
Since becoming an ALTO, we have continued to review, improve and develop our services and infrastructure in preparation for
becoming and Autonomous Provider Organisation (APO).
During 2008, a number of audits and diagnostics were
carried out to confirm our ALTO status.
All the audits confirmed that we were working well as an
ALTO, had set up the appropriate arrangements and were
progressing to APO.
We have improved our Business infrastructure with:
The development of a commercial team including a contracts
and bidding team and an Information Management team
The implementation of a bespoke IT system to ensure we
collect robust activity data from all our services while STPP, the
The audits and diagnostics confirmed that we understand the
journey we still need to undertake to become a CFT. We
have started on that journey but know we have a long way to
go.
national community system, is being rolled out.
Financial recovery plan resulting in 6% efficiency savings
Tactical cost reduction programme identifying over £400k to
improve the 2008/09 financial position.
The audits and diagnostics were carried out by:
PriceWaterhouseCoopers for the Audit Commission
Ernst & Young audit of Finance & Governance
The East of England Health Authority diagnostic
We have also carried out self diagnostics using the
Department of Health Business Readiness template and
have completed 98% of the requirements.
We have produced an action plan which brings all the
recommendations from the audits and diagnostics together
with other business readiness tools and CFT requirements.
Performance Accelerator has been implemented to support risk
and performance management.
Increased and strengthened our Finance Team
Agreed to increase the establishment of our communications
team
We commissioned Deloittes to carry out a detailed market
analysis
We have established our Transformation Programme: ‘Building
a Sustainable Future’ and through it carried out a number of
reviews to inform future service development
29
Our Journey so far:
Separating our provider and
commissioning functions
‘’Really
understanding our services
will enable us to maximise our
Patient focus’
PROGRESS TOWARDS APPLYING TO BECOME A COMMUNITY FOUNDATION TRUST
Transforming Community Services – Building a Sustainable Future
Our transformation programme has progressed in a number of stages.
We have started by carrying out a number of service reviews, which
together with the market analysis, will inform the transformation work that
is required to before we can apply to become a CFT.
Ernst & Young have supported the following projects:
A Core Business Review covering all the services provided by PCS.
The review included the production of a Directory of Services and
identified over 150 service redesign opportunities and areas for cost
Directory of Services Access Database
reduction.
The Time to Care tool was used to analyse the working practices of the
nursing profession across PCS and will be used to improve workforce
productivity and identify opportunities for improvement and efficiency. For
example, the time spent on administration and travel varies widely
between teams. We will identify best practice and extend to all teams.
Example of Time to Care findings
A Priority Based Service Review has been carried out of all Home Care
Services, covering Hospital at Home, Intermediate Care and Home Care.
Alternative service models have been developed and assessed using
quality scores.
Tactical Cost reduction programme identified over £400k to improve the
financial position of 2008/2009.
We had commissioned two external reviews on our health visiting and
district nursing services. The findings and recommendations have been
included in the Priority based service reviews described in our service
30
‘Our Integrated Business Plan will
deliver our vision and our
Business and Care Strategies’
OUR INTEGRATED BUSINESS
PLAN: Executive Summary
Our Integrated Business Plan (IBP) will be our main submission in our application to be a Community Foundation Trust. The IBP
in this section of our Transition Plan is the first, high level draft of our IBP. Over the next few months, we will continue to populate
the plan in more detail with information we have already collected and further information as it is agreed. We will engage and
consult with our staff and other key stakeholders in the production of the plan. We anticipate that over the next two years, our
plan will be redrafted many times to reflect our progress towards our long term destination, using all the feedback from our
service development plans, business units and updated market analysis.
As our IBP
evolves,
this
chapter
will
provide a highlevel overview
of PCS, our
vision,
our
performance,
the market in
which
we
operate, why
we wish to
become a CFT
and
the
benefits it will
bring to our
local
community.
STRENGTHS
Excellent Services
Safe
effective
and
efficient
Our vision is
to provide competitive,
integrated health and
social care services
Which contribute
to individual
well-being.
Modern
sustainable
business
•Integrated health and
social care provision
•Strong clinical skill base
•Gold Star services
•Strong partnerships
•Good reputation
•Dedicated and committed
workforce
• Diverse group of services
OPPORTUNITIES
•Repatriate out of area
placements
•Build on successes i.e.
grow dental access centre
Improved Customer Satisfaction
WEAKNESSES
•Disparate IT systems
•Poor perceived reputation
with some GPs
•Poor access to quality
management information
•Limited commercial
experience/expertise
•Separate silos and
associated behaviour
THREATS
•Large number of
independent and voluntary
sector players
•Other NHS providers
•Develop service to provide
24 hour support
•Difficult recruitment market
•Develop services to accept
self referrals into prevention
and enablement care group
•Economic climate
•Individual budgets
31
OUR INTEGRATED BUSINESS PLAN: Profile
‘We are a strong, vibrant, viable
provider of community services’
Peterborough Community Services is the Arms Length Trading Organisation of NHS Peterborough. We provide integrated community
health and adult social care services across Peterborough. We also provide specialist community health services to parts of
Cambridgeshire, Lincolnshire and Northamptonshire. Adult social care services are provided through a Section 75 Partnership
Agreement between NHS Peterborough and Peterborough City Council. As a provider of integrated services, we are in a unique
position to develop and support individualised self directed health and social care.
Our population base is around 250,000 people of which about 163,000
people live in the Peterborough City Council boundary.
We employ around 1400 staff (1036 w.t.e)
We provide approximately fifty different, high quality services.
Services are delivered in a wide range of settings including community
clinics and health centres, GP practices, people’s homes, schools and
nurseries as well as into the Peterborough and Stamford hospitals.
Our annual turnover is in the region of £82million
A significant number of our services have received national and regional
recognition.
We have mapped all our services to produce a service directory
including a description of the service, where it is provided and who it is
provided by, for use of our commissioners, referrers and ourselves
The geographic area currently receiving PCS
services
Functional
Department
Service
Name
Service
Description
Locality
Setting
Staff
Involved
Darzi
Pathway
NHS East of
England Pledges
LAA Social
Indicators
32
OUR INTEGRATED BUSINESS
PLAN: Strategy
‘Our vision will inform our
Strategic direction’
During 2008, we agreed our vision, values and strategic priorities. In 2009, we revisited these and validated them when we started to
formulate our Care Strategy. The four strategic priorities are underpinned by high level objectives which are delivered by activities
agreed each year in our Annual Plan.
Our Vision is to provide competitive, high quality, integrated health and social care services which contribute to individual well-being.
Our values are that we will respect our services users, protect vulnerable people, value and support our staff, provide excellent, safe and effective services, be
innovative and responsive
Excellent Services





High quality services
with Improved
outcomes for service
users within available
resources
Prevention and early
intervention as well as
treatment
Integrated services
planned and delivered
around care pathways
Staff empowered to
transform services
Service users
empowered to selfmanage their own care
Improved Customer Satisfaction






New and improved
customer services
developed with the
people who use our
services
Services delivered in
the right place, at the
right time
Increased choice
Patient / service user
centred care
Access to services
clarified and
streamlined
Improved
communication and
information
Safe, Effective and Efficient





Integrated care to avoid
duplication and improve
productivity, efficiency
and acceptability
Safeguarding measures
to identify and protect
the most vulnerable of
our society
Use of evidence based
practice and
professional guidelines
Well prepared for
emergencies
Appropriately trained
and supported
workforce
Modern, Sustainable Business




Development of a
competitive,
commercial business
Understand our market
to provide services that
meet local needs and
priorities
Deliver year on year
CIP savings to ensure
our business is
sustainable
Work with our
commissioners and
stakeholders to design
and deliver services
that meet their needs
33
OUR INTEGRATED
BUSINESS PLAN: Strategy
Our Vision means
services and care
that are:
Built from a strong
core—getting our
care services right
clinically and
professionally
viable and locally
accountable
‘Through careful planning and
a systematic, supportive approach
we will change our culture, develop and
empower our staff and restructure our
organisation to achieve our vision’
Our Business Strategy is to maintain and expand our portfolio of services designed to meet
local health and social care needs by guarantee value for money and increasing our market
share, through geographic and demographic expansion, diversification and extending our
contribution to the pathways of care delivered to our service users.
We are in the process of developing our Care Strategy to support business strategy and
deliver coordinated, responsive care which is personalised and designed around the needs
of our service users.
Effective transformation of community services will require
strong leadership to drive delivery of any change.
A clear vision is needed before
effective implementation can be made.
well governed
delivering high
levels of quality and
performance
developing as a
business
delivered by
highly skilled staff
exceeding
customer
expectations
financially viable
1. Leadership
2. Vision
A change will be necessary
to ensure that the culture
and behaviours are aligned
to PCS’ core values and are
consistent throughout the
organisation.
6. Culture
change
Becoming a
World Class
Provider
5. Organisation
design
The organisation needs to be fit for
purpose with the right structures,
resources and roles to deliver its
vision and strategy for care.
4. People
3. Strategy
A clear and concise
strategy needs to be
developed to articulate
how PCS will deliver
care. This will be
followed by individual
Business Units
developing strategies
aligned to this vision
and the development of
supporting strategies
by corporate services,
for example, finance,
IT, workforce
development.
PCS will need to ensure it has
the right people, with the right
skills who are empowered to
deliver the necessary changes.
34
OUR INTEGRATED BUSINESS
PLAN: Strategy
‘Only the CFT model will support
us fully in our aspiration to be a
world class provider of community
services
The Rationale for Community Foundation Status
We believe that the Community Foundation Model is the best organisational form for PCS because as a CFT we would :
 Be able to continue to provide integrated adult health and social care services Statutory Social Care assessment and care
management functions can only be delegated to a statutory organisation.
 Through a governance framework which is robust and demonstrates clear public involvement, be able,, to fully engage with
and involve our local community and membership in the development and delivery of services.
 Have a solid framework from which to maintain and enhance a balanced portfolio of the highest quality and most cost
effective health and social care community services.
 Have freedoms to access capital on the basis of affordability instead of the current system of centrally controlled allocations
 Have freedom to invest surpluses in developing new services for local people
 Have freedom of local flexibility to tailor new governance arrangements to the individual circumstances of their community
 Retain the NHS identity and brand, which is trusted by staff and the people who use our services.
 Have continued access to the NHS pension for both existing and new staff
 Be in a better position to respond to market forces than other organisational forms
In addition, an independent review carried out by the Healthcare Commission has shown that NHS Foundation Trusts are
making good progress in developing new innovative approaches to providing better quality healthcare services for the benefit of
NHS patients, and improving accountability to their local populations. While there are currently no CFT to review, our experience
so far, of preparing to be a CFT, leads us to believe that the freedoms available as a CFT combined with the rigorous
requirements of Monitor, will encourage and enable us to become a world class provider of community services.
35
‘
OUR INTEGRATED BUSINESS
PLAN: Market Assessment
In 2008, we commissioned Deloittes to carry out an independent
analysis of the local health care market. The purpose of the analysis was
to assist us in understanding our local health economy, increase our
knowledge of our competitors and the threats they may pose, to
understand our position in the market and our opportunity to increase
We are operating in an increasingly competitive
market. Understanding our market will help
us to ensure that we are the preferred provider
of community services
Our Local Health Economy
Our Local Health Economy (LHE) consists of all the
organisations who commission or provide health and
social care services across East Anglia. This includes
organisations which form part of NHS East of England,
The outcome of the analysis has helped us to develop our strategy for
service delivery and business development over the next 5 years. It has
helped us to identify the main risks to our future and the service
development plans we need to put in place to ensure that we are
preferred provider of community health and social care services.
the local authority, voluntary and private sector. PCS
covers Peterborough, parts of Cambridgeshire,
Northamptonshire and Lincolnshire.
The city of Peterborough is a heavily urban area but the
surrounding areas are largely rural with some suburban
areas.
There are four PCTs which border the PCS area, these
are Cambridgeshire PCT, Lincolnshire TPCT,
Leicestershire County and Rutland PCT and
Northamptonshire TPCT. All these PCTs except
Cambridgeshire PCT sit in the East Midlands SHA.
Peterborough PCT, Peterborough & Stamford
Hospitals NHS Foundation
Trust, Cambridgeshire PCT,
Key issues from our market assessment are summarised in this draft of
our IBP and will be covered in more detail in the next draft. We intend to
repeat the analysis on a regular basis to ensure that our information
remains up-to-date and that we adjust our plans accordingly.
Cambridgeshire & Peterborough
NHS Foundation Trust .
can be considered key
parts of the Local Health
and Social Care Economy.
our current market share and future market growth. We used eight care
groups selected to capture the key services areas of PCS and to broadly
follow the Transforming Community Services framework. The care
groups we used were:
Integrated Health and Social Care; Treatment and
Procedures Out of Hospital; Unplanned Care; Children’s
Services; Long Term Conditions; Prevention and
Enablement; Learning Disabilities and End of Life Care.
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OUR INTEGRATED
BUSINESS PLAN
‘We have the right portfolio of services
but need to review and redesign
some of them to be more competitive’
Our market opportunity and competitive position is summarised by each care group in the chart below. The analysis suggests that
there are opportunities to grow all our services and increase our market share. However, some service groups are are potentially
at risk because other providers could be more competitive.
For example, learning disabilities is a
small service and the majority of its
budget
is
used
for
secondary
commissioning. There could be strong
competition from the neighbouring Mental
Health Trust and the voluntary sector
organisations in Peterborough.
The market analysis highlighted a number
of opportunities for the learning disability
service including:
Repatriation of a portion of out of area
specialist learning disability placements,
Expansion of current provision of
specialist learning disability speech and
language therapy and occupational
therapy services to neighbouring PCTs
Capture community service provision
from neighbouring Mental Health Trusts
Provide specialist primary care services
e.g., CAMHS, ADHD, Aspergers, Autism
Provide day services.
NHS P and PCS have prioritised learning
disability services and are carrying out a
priority based service review.
37
OUR INTEGRATED BUSINESS
PLAN: Market Assessment
‘Detailed knowledge of our
services will support our
service redesign’
A detailed SWOT
analysis was carried
out on all the service
groups.
An example of one of
the summary report is
shown opposite.
The findings have
been discussed and
have informed our
care strategy.
Plans to address the
issues are being taken
forward in the service
development plans.
Key issue from the
SWOTs
include
demographic changes
and the drive to move
services
out
of
hospital.
38
OUR INTEGRATED BUSINESS PLAN: Market Analysis
A PEST analysis was also carried out and provides a summary of the external environment in which we operate and confirms
if future initiatives and service development plans are in line with issues, trends and developments at both the local and
national level
39
OUR INTEGRATED BUSINESS PLAN
Service Development Plans
Our service development plans are designed to transform our services so that they deliver our vision, strategic priorities and
Business and Care Strategies. They are designed to respond to our commissioners requirements identified through Practice
Based Commissioning and NHSP’s Strategic Plan. They are also designed to maximise our strengths, reduce our weaknesses
and respond to our opportunities and threats.
Our transformation programme includes a number of projects which will have a significant impact on our future success. Four of
these service development projects are described below. As these are successfully completed and embedded across the
organisation, others will be introduced.
Case management and Care Planning
The majority of our resources are currently focused on providing care to a small group of people with complex health and
social needs. We need to ensure that our services are designed around their needs and wants. We will achieve this by:
Risk stratification and management: understanding the different groups within our population and how our response and
input into these different groups needs to vary.
Case management and care planning: we see case management as the thread that will run through the services we provide.
Providing our users with individualised, live care plans will become the tenet of how we deliver services.
Supporting independent living: empowering individuals to take control of their care and conditions through education,
support and other mechanisms such as telehealth.
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OUR INTEGRATED
BUSINESS PLAN
‘Service Development Plans,
using techniques designed to
improve effectiveness and efficiency’
To redesign our services we are using the Ernst & Young Priority Based Service Review (PBSR) approach. The technique is
illustrated below.
41
OUR INTEGRATED
BUSINESS PLAN
Service Development Plans
Care in the Home
We are redesigning our home based service having carried out a PBSR , a Time to Care exercise and market assessment
into the model of care we currently provide and the model that our commissioners wish to purchase.
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OUR INTEGRATED
BUSINESS PLAN
Service Development Plans
Early intervention Services For Children
We are reviewing our current model of care for our universal children’s services (school nursing and health visiting) to redesign
a service which will stream line care and remove duplication.
Our project will build on the health visiting review and Time to Care information and involve detailed process mapping and
significant redesign of service delivery.
Priority Based Services Review of Learning Disability Services
PCS and NHS Peterborough are reviewing Learning Disability Services using PBSR to ensure more personalised services
which deliver more choice and control including individual budgets, while focusing attention on current service provision and
future requirements to ensure that our Learning Disability services are professionally and financially viable for patients and
services users in the future.
Nationally there is pressure within Learning Disability Services for a number of different reasons including a significant
increase in the number of people, with learning disabilities, surviving into adulthood with major disabilities and complex needs,
adults with learning disabilities are living longer and surviving into older age, limited capacity of family carers to care for the
extent and diversity of needs and significant increases in costs of specialised services for people with high dependency,
complex needs and challenging behaviours.
43
OUR INTEGRATED BUSINESS PLAN: Financial Plan - Overview
This summary plan has been developed using the MONITOR 5 year EBITDA
pro formas and has been completed as best as we can at this time.
Financial Planning and reporting will continue to be developed and refined as
supporting systems (e.g. performance management) and skill sets are
developed and a full IBP is produced.
The Summary plan shows the following:

The actual position for 2008/2009 (subject to audit). Although shown as a
rounded break even in the summary, there was actually a small under
spend of £36k with a £2k closing cash balance.

The original plan for 2009/2010 as approved by the PCS Board. Details
of the movements between 2008/2009 and 2009/2010 and assumptions
are given below.

Projection for 2010/2011 based upon an net uplift of 1.5% and estimated
cost increases for infrastructure costs.

Projection for 2011/2012 based upon a net uplift of 1% and including an
increased efficiency requirement to address anticipated reductions in
health spending increases and full year impacts of infrastructure costs.
The plan does not include service developments/changes that may occur in
future years nor funding streams that may be associated with them. We
accept that there will be changes and are planning on the basis of no overall
change to income levels though sources may change. Excess costs will be
shed as appropriate.
We are currently engaged, with Ernst & Young and staff in service reviews
leading to changes in how services are delivered in order to ensure we provide
cost effective services, competitive quality value for money services.
EBITDA
Earnings before Interest, Depreciation, Tax and Amortisation is a
measure used to highlight surpluses generated by business
actives and is a measure of viability and success.
Whilst PCS needs to plan to generate a surplus each year for
investment in its services the reality is that whilst we are funded
under block contracts the surplus is dependant upon entirely new
business from non NHS sources or achieving efficiencies and
relies upon Commissioner agreement to retain such savings as
opposed to reinvesting in additional services activity at no cost
to the Commissioner. In the light of current efficiency savings we
have not set a surplus target.
The measure, as currently used by MONITOR uses expenditure
categories that are not currently relevant to ALTO.
The first is Depreciation which presumes a fixed asset base.
initial agreement was reached with NHS Peterborough over which
assets would transfer to PCS.
Following the Transforming Community Services guidance this is
to be reviewed before any physical transfer takes place.
For most, if not all, of the premises PCS operates in they will be
owned by either NHS Peterborough or the City Council with PCS
as effective tenants.
NHS Peterborough will also own the IT networks and records
system that PCS would use. PCS may own some small pieces of
equipment .
As an ALTO within a PCT, PCS remains bound by various rules
and regulations that apply to PCTs. For example we cannot invest
surplus funds to generate interest and we are not subject to
taxation on "profits/losses". Similarly we do not pay a PDC
dividend.
As we don't own the assets we can't profit from sales.
The result of this is that the EBITDA as defined by MONITOR
only really revolves around generating a surplus or a deficit and
the model would therefore generate a low score. The SHA has
44
been considering this.
OUR INTEGRATED
BUSINESS PLAN
Financial Plan:
Overview
In 2009/2010 our main commissioner is funding a level of recurrent
and non recurrent costs associated with our move to APO status and
discussions are ongoing regarding longer term funding. This plan
assumes a need to achieve an additional level of efficiency to order to
cover recurrent costs. We have already achieved some efficiency
which are funding part of the infrastructure changes.
Peterborough City Council and NHS Peterborough are seeking to
action a number of savings initiatives, which it has already ‘top sliced
from the contract with us’. There is acceptance by the Commissioner
that achievement of the savings requires a commonly agreed
implementation plan which is currently being developed in conjunction
with them. This is over and above the baseline efficiency requirements
and represents a significant risk to PCS achieving financial balance in
2009/2010. In partial recognition of this, NHS Peterborough has
deferred part of the saving requirement to 2010/2011 if it is not
There are two underlying issues to be resolved in
2009/2010 that are currently shown as an efficiency
requirement.
Full year effect of 2008/2009 client placements
Learning Disability Services where a full service review is
underway led by NHS Peterborough
achieved.
The plan recognises the current economic climate and that there will be
a requirement for more cost effective services and future projection
rates reflect this.
NHS Peterborough is currently publishing its strategic plan and we will
work with them, and other commissioners, to develop responsive
services for the future. The projections therefore do not include overall
future growth at this time.
Pending final agreement with NHS Peterborough, the
plan does not include a PCS share of the PCT's central
corporate costs. These are currently estimated at £2.8m
and include such things as accommodation costs, and
support services.
PCS currently receives the vast
majority of its income under block contract arrangements.
Work to develop currencies, costs and prices will be
developed with NHS Peterborough during 2009/2010 and
as the performance management infrastructure comes on
line.
45
OUR INTEGRATED BUSINESS PLAN: Financial Plan - Summary
46
Our Integrated Business Plan: Financial Plan
47
Our Integrated Business Plan: Financial Plan
Service Line Management and Reporting
Our services are currently managed in three directorates in professional groups or specialist services. The services are supported
by corporate services managed in three specialist directorates. Care delivery is structured around the professional groups rather
than our service users which often results in duplication and multiple touch points for service users, particularly those with
complex needs. There can be lack of coordination and clarity for service users and for PCS, inefficiency in ways of working.
We have agreed that to improve service integration and customer experience, we need to redesign the way our services are
structured around care groups and care pathways. The most appropriate model for us appears to be Service Line Management
(SLM), supported by Service Line Reporting.
SLM is a robust approach that combines trusted management techniques and effective business planning in an NHS setting. By
identifying specialist areas and managing them as distinct operational units, it enables NHS Foundation Trusts to understand their
performance and organise their services in a way which benefits patients and delivers efficiencies for the Trust. It also provides a
structure within which clinicians can take the lead on service development, resulting in better patient care.
A project plan has been agreed that will see the development of SLM across PCS over the next year or so. This will help
business management and assist in our preparation for Community Foundation Trust status. Children’s Service has been agreed
as a Pathfinder to develop SLM. It will be one of a few key Strategic Business Units in PCS and its preparation for SLM will be
managed and monitored during 2009 to assist in rolling out SLM to the other business units. This will change the we manage our
services by professional service groups to managing them by service pathway / service lines. We will improve our costing,
information and management and clinical leadership of these service and as a result, will develop more patient focused efficient
and effective services that respond better to our customer needs.
48
OUR INTEGRATED BUSINESS
PLAN
Risks
In 2008, PCS produced its own Board Assurance Framework (BAF). The BAF reports against the four PCS key priorities and the
objectives. We have recently purchased Performance Accelerator as the software tool to support risk management across PCS.
This is currently being populated with the BAF risks, the key performance Indicators and national and local targets. It will also be
used to monitor the risks associated with the transition and transformation programmes and the Annual and Integrated Business
Plans.
We have identified five key risks for transition and plans for mitigating these risks. These and other risks are include in the
programme’s risk log and will be managed by the Directors responsible for each workstreams area. A detailed risk and mitigation
plan is included in our 2009/2010 Annual and Financial Plans.
Risk
Mitigation
Affordability: Failure to achieve financial balance through
We will plan for better and worse financial positions as well as
loss of income or inability to achieve Planned savings in
the current economic climate.
status quo,
Skills and capacity: ensuring we have sufficient skills and
capacity to transform our culture and our services.
We have established a Capacity for Change programme
Stakeholder engagement: Stakeholders may not be
We are developing a comprehensive Stakeholder engagement
and communication plan covering both internal and external
stakeholders.
interested in or willing to engage in discussions on
service changes and may loose interest if the Transition
takes too long.
Demographic Growth: The population of Peterborough is
predicted to grow to over 200,000 people by 2021, an
increase of over 20% on the 2006 figure.
We are working closely with all our commissioners to plan for
this increase in population
49
OUR INTEGRATED
BUSINESS PLAN: Risks
It is crucial to effectively manage the transition period activities and maintain
the continuity of our core business activities. The service business continuity
plans will ensure that essential services are maintained whatever the
disruption and other services are restored according to their assessed priority
Business Continuity
Business Continuity is a major risk during transition. Business Continuity Management (BCM) is a statutory requirement for both
NHS Peterborough and Peterborough Community Services. The Civil Contingencies Act 2004 and the NHS Emergency Planning
Guidance 2005 require both organisations to have a Business Continuity Management Policy (BCMP) with robust procedures and
plans in place to ensure that, in the event of a significant service interruption, critical day-to-day functions can be maintained.
Timely recovery and restoration of key services, systems and processes must also be achieved.
The Business Continuity Management Policy and Procedure for both NHS P and PCS has been drafted and is being circulated for
discussion. The organisations’ approach to determining its Business Continuity Management arrangements is to:
 Implement appropriate measures to reduce the likelihood and impact from identified risks
 Provide continuity for key or critical activities during and following an incident
 Review Recovery Time Objective following a period of disruption
 Understand the costs of implementing strategy and plans
 Understand the costs and consequences of inaction
PCS is updating the business continuity plans for all its services using Shadow planner software. Services are carrying out
business impact analyses to identify and prioritise critical services which have to be maintained, the likelihood of disruption to the
services and the impact, the point at which the situation becomes critical, the time in which they have to be restored and the
basic resources needed to maintain and restore the services.
Business continuity is about safeguarding critical work. If an incident occurs it is important to know which critical work priorities
need to be urgently continued, and the likely impact if they are affected the order of priority to restore all services to normality.
The transition programme is not a critical service which needs to be maintained. However, there are risks associated with the
transition which could impact on services and in extreme cases, could disrupt services. These risks have been identified in the
section on risk and will be included in the risk register and inform business continuity planning.
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OUR INTEGRATED
BUSINESS PLAN
Leadership and Workforce
To become a world class provider, change the way services are delivered and managed and achieve CFT status, we need to
ensure that new way of working are embedded through strategic organisational design, change management and culture
change. Staff need to be equipped with the appropriate skills and support to perform well in the new environment. The change
needs to be led from top-down. Training and development needs to be provided to the whole organisation.
Our training and development will be co-ordinated through a comprehensive organisational development programme, led by the
PCS workforce development team with support from Ernst Young and other external consultants.
The skills which need to be developed are being identified through the Service Line Management project, other projects, Board
assessments, the diagnostics and services and staff reviews.
For example, our Leadership Development Programme will include:
One to one leadership development coaching
Board development workshops
Change management competency framework against which existing skills can be assessed
Leadership of change survey undertaken with key senior individuals
Development sessions to address gaps in change management capability
Buddy system instigated to create a community of individuals to sustain development and change
Change management toolkit developed to provide ongoing support and training for staff
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OUR INTEGRATED
BUSINESS PLAN
Leadership and Workforce
Development and Training is an ongoing
process with Individual Development Plans in
place for all staff.
As part of the Transformation programme, the
PCS has been undergoing a Board
Development
Frontline.
programme
supported
by
Managers have the opportunity of undertaking a
number of in-house and external management
courses.
To start the specific Development and Training
programme
being
designed
for
our
transformation
programme,
we
have
commissioned Ernst & Young to carry out a
Capacity for Change project. This involves
training Change agents and change champions
to manage the changes resulting from the
transformation and transition projects.
52
OUR INTEGRATED BUSINESS PLAN
Governance
Governance for the CFT
We are building on the governance arrangement we put in place
as an ALTO and developing them in line with Monitor's
requirements for foundation trusts.
This will include:
 A Governance Strategy and framework
 A membership Strategy
 The establishment of a membership and Board of
Directors
 Appointment of a Board of Directors through the Appointments
Commission.
The PCT has agreed the appointment of a Chair and up
to five Consultant Advisors to the Board, to act as lay
members on the PCS Board. Formal appointments as
Non Executive Directors will be made when we are
established as a CF
The Executive team is being restructured and a
proposal to create five Directors posts will go to the PCS
Board and internal consultation shortly. Appointments to
these posts will be made by the Chair and Managing
Director when the Chair has been appointed.
 A constitution will be produced in line with the model
constitution for FTs.
 The subcommittees to the Board will be reviewed to ensure
that they cover all the areas necessary to provide the Board with
assurance that the organisation is well governed.
Governance for the Transition
We are putting in place comprehensive governance
arrangements for managing the separation process and
the transition from ALTO to APO and on to CFT.
The Governance Framework will help to:
Clarify leadership roles and responsibilities
Support the decision making process including sign off
arrangements
Provide assurance to the PCS and PCT Boards and the
SHA
Enable monitoring of progress
Ensure staff and stakeholder engagement
Ensure the changes are fully embedded in the
organisation
Ensure co-ordination and cohesion
Make best use of resources avoiding duplication of time
Align organisational agendas and priorities
Identify and mange risk
Identify and manage benefits
Create a culture of mutual respect and trust
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OUR INTEGRATED
BUSINESS PLAN
Governance:
Stakeholder Engagement and Communication
THE TRANSITION ENGAGEMENT PLAN AND COMMUNICATION STRATEGY
We are committed to engaging with all the staff and other key stakeholders throughout the transition process. To date, a
significant amount of communication, consultation and engagement has been carried out by both the PCT and PCS around the
separation to ALTO status and the decision to apply to become a CFT.
In 2007, a Communications and Consultation Workgroup was set up as part of the Next Steps Project. The workgroup carried
out a stakeholder mapping exercise and produced and implemented a Communications and Involvement Strategy. The group
ensured that all key stakeholders were engaged in the debate on the future direction and organisational model for the provider
services through a series of events, workshops, communication material and a formal public consultation.
Following the establishment of PCS as an ALTO in April 2007, PCS has established direct links with many of the stakeholders
and an Internal Communication Strategy was agreed.
The PCT and PCS are now developing an engagement plan and a communication strategy focused specifically on the transition
to a CFT and the transformation of PCS and the services it provides to support the transition and the Transforming Community
Services agenda.
The PCT and PCS, supported by the National Centre for Involvement are reviewing the existing PCT Public and Patient
Involvement (PPI) arrangements and establishing separate arrangements for PCS.
Producing a membership Strategy and recruiting the membership for the aspiring CFT is also an essential part of the
engagement plan and Transition arrangements for the aspiring CFT.
Until April 2009, our communication support was provided by the PCT Communication Team. From April 1st 2009, we have our
own Communications Manager who will take forward the Internal Engagement and Communication Plans. The Internal
Communication Strategy previously agreed has been updated and will be reviewed further as part of the Transition and
Transformation Programmes.
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OUR INTEGRATED
BUSINESS PLAN
Governance:
Stakeholder Engagement and Communication
The communication and engagement activities will include the following:
Two Public Consultations
The Next Steps Communications &
One will be carried out by NHS to seek public opinion on the
Consultation group conducted a stakeholder
establishment of PCS as an NHS Trust. This is a legal requirement
mapping exercise using the following chart
before PCS can apply to become a CFT. The other consultation
developed by Johnson, G, Scholes, and K
will be led by PCS to seek public opinion on its proposal to apply to
Whittington (2005). The exercise will be
become a CFT and the benefits of doing so. At present, the
repeated as part of the Transition Plan.
Department of Health has not said if these consultations will be run
consecutively or concurrently.
An identity for PCS
Level of interest
As part of the consultation, PCS will ask for public opinion on the name
Low
High
for the new CFT. PCS will follow the national NHS guidelines for
branding NHS services while at the same time aim to create an
Consult
Partner
High
identity which is meaningful and recognisable.
Board meetings in public
We will listen to you
We need to work
and respond
together to deliver
During 2009, the PCS plans to start holding its meetings in public to
mutually beneficial
increase both public and staff engagement
outcomes
Celebrate staff success and innovation
Inform
Involve
PCS has created a staff reward and incentive scheme which will be
launched following further discussion and agreement with the
We will keep you
We can work
unions.
informed
together where
Engagement in developing Strategies, plans and services
common ground
We wish to engage with our staff and stakeholders on the way we
exists
transform our services
Low
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OUR INTEGRATED
BUSINESS PLAN
Governance:
Stakeholder Engagement and Communication
Our Stakeholder Engagement and Communication Plans are designed to ensure that:

key stakeholders, partners, and staff are kept fully up-to-date and have the opportunity to be involved in informing the future
direction of the community health and adult social care services directly provided by Peterborough PCT,

Maintain staff morale through regular communications and ensure staff have the opportunity to influence decisions taken
through consultation, as well as undertaking a formal staff consultation.

To manage, through engagement, expectations of stakeholders, partners and staff in the relation to future health and social
care services.

To reduce the risk of misinformation.
Formal responsibility for external relationships has previously been with NHS P. During 2008, PCS developed its own
relationship with its commissioners, partners and other key stakeholders, establishing itself as full partner in the local economy.
The Managing Director now has a place on or attends a number of Local Health Economy forums. Regular meetings are held
with commissioners and relationships with other key stakeholders are being developed.
Examples of the evolving external relationships are:
The Managing Director and the Chairman of PCS are full members of the CEO and Chairman meeting for the Peterborough
Health System.
The Managing Director represents PCS on the Children’s Trust Board and the Greater Peterborough Partnership.
The Managing Director attends the Health Overview and Scrutiny Committee on a regular basis.
PCS Chair and Managing Director meet regularly with the Chair and Chief Executive of the PCT.
PCS has actively started to develop relationships with the Practice Based Commissioning Consortium and to meet with the
PEC Chair.
56
PCS now links directly with the portfolio holder for Adult Social Care.
CONCLUSION

'NHSP is committed to ensuring that PCS emerges
as a strong provider and has our support in its ambition
to become a CFT.
PCS is committed to transforming itself to achieve the
high standards required to become a CFT as it
believes this is the best organisational form
from which to deliver the community services
its community needs and deserves.‘
PCS has achieved the business readiness requirements for ALTO status and is continuing to transform and develop its services and
infrastructure to achieve the level of business readiness required to become a community foundation trust.

PCS has developed a detailed plan for transforming community services, which prioritises services for improvement and development
which will enhance individual choice, control and personalisation and continue to drive up service quality and value for money

PCS has carried out a core service review and a market analysis and is working to wards a position when it can demonstrate
contestability and be able to respond proactively to the commissioners’ 5-year Strategic Commissioning Plan.

NHS P and PCS have reviewed the options for most appropriate organisational forms that best suit local need and circumstances and
declared an interest in establishing a Community Foundation Trust to deliver Peterborough Community Services

NHS P and PCS have moved into a contractual relationship, using the new NHS Community Contract.

PCS has a plan in place supported by formal programme management for moving towards the preferred end state of becoming a
community foundation trust. This plan will be updated following a formal diagnostic by the SHA and on an ongoing basis to take account
of changes in the local and national environment.

NHSP has agreed the principles for the future ownership of the assets used by PCS and will agree with their SHAs a robust strategy for
the future of the community estate.
57