Shetland Islands Council
Programme Initiation Document (PID)
Health and Social Care Integration
Transition Programme 2014/15
PROGRAMME INITIATION DOCUMENT
Author: Christine Ferguson,
Programme Executive
Date: 8 July 2014
1.
Health & Social Care Integration Project
Transition Programme
Stage:
Version Number: 2.0
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Programme Initiation Document Authorisation
This document requires approval from the Chief Executives of Shetland NHS
Board and Shetland Islands Council.
Signature
Ralph Roberts,
Chief Executive
NHS Shetland
Mark Boden,
Chief Executive
Shetland Islands
Council
Date
PROGRAMME INITIATION DOCUMENT
Author: Christine Ferguson,
Programme Executive
Date: 8 July 2014
Health & Social Care Integration Project
Transition Programme
Stage:
Version Number: 2.0
Page 3 of 12
Introduction and Background
Health & Social Care Integration is being taken forward nationally with the
introduction of new legislation. The Public Bodies (Joint Working) (Scotland) Act
2014 received Royal Assent in April 2014.
Progress in Shetland has been achieved through the establishment of a Health
and Social Care Integration Project Board in 2011, reporting to the SIC Social
Services Committee and the Community Health and Care Partnership (CHCP)
Committee.
The Board commissioned work through three main work streams:
 Governance – looking at joint committee arrangements
 Management and the single management model
 Developing integrated service delivery models in localities across Shetland
Joint working in health and social care is already well established through
Shetland’s Community Health Partnership.
Joint appointments exist in a number of key areas, including the post of Director of
Community Health and Social Care. This post is the joint accountable officer in
the terms of the Act.
This Programme Initiation Document establishes and co-ordinates a work
programme over the next 12 months that will develop the detailed governance
and operational management arrangements at all levels that are required to
implement a health and social care integration model for Shetland. This includes
the work to further develop the single management model and to develop
integrated service delivery models in localities.
The Board and the Council agreed at meetings on 1 July and 2 July 2014
respectively to implement a Body Corporate model of integration in Shetland.
Aim and Objectives
AIM: To implement a comprehensive, integrated governance framework for a
Shetland Health and Social Care Partnership as required by the Public Bodies
(Joint Working) (Scotland) Act 2014.
OBJECTIVES:
To develop and implement a Body Corporate health and social care integration
model meeting all national requirements and deadlines.
PROGRAMME INITIATION DOCUMENT
Author: Christine Ferguson,
Programme Executive
Date: 8 July 2014
2.
Health & Social Care Integration Project
Transition Programme
Stage:
Version Number: 2.0
Page 4 of 12
Project Brief
Background:
Shetland’s Community Health Partnership (CHP) has evolved
over the last 7 years. The vision, mission, aims, objectives,
service plans, development priorities, resources, financial
framework, budgets, governance and risks are set out in a
Partnership Agreement which is reviewed annually and
approved by the Shetland NHS Board (the Board) and
Shetland Islands Council (the Council).
CHP business is discussed at the CHP Committee, which is a
sub-committee of the Board and also at the Council’s Social
Services Committee. From July 2014, the two committees
meet concurrently as part of the shadow arrangements for
health and social care integration.
A single management structure was introduced in 2008/09.
This includes jointly appointed managers for:
 Mental Health
 Occupational Therapy and
 Adult Resources including all learning disability
services.
The single management structure reports through the Director
of Community Health and Care to the chief executives of both
the Board and the Council.
It was agreed at meetings of the CHP Committee (28 July
2011), the Council’s Social Services Committee (30 August
2011) and the Board (6 September 2011) that the CHP should
undertake a project to identify how the Council and the Board
could further the integration of health and social care services
in Shetland and develop the governance and management
arrangements.
The progress made to date across all the work streams is
reflected in the Project Action Plan which is available
separately.
Principles for
Change
Any change proposals should be assessed to see if they
deliver against the following principles:
 A focus on services delivered for customers that make
improvements to the customer’s experience of services
 Adherence to evidence based care pathways including
reablement
 Evolution, building on what has been achieved so far
 Improved efficiency and value for money; providing
efficiency savings for the public sector in Shetland
 Reduction in bureaucracy; eliminating duplication and
PROGRAMME INITIATION DOCUMENT
Author: Christine Ferguson,
Programme Executive
Date: 8 July 2014
Health & Social Care Integration Project
Transition Programme
Stage:
Version Number: 2.0
Page 5 of 12
improving the speed of decision making
Scope
Within Scope
 All governance arrangements for community health and
social care services in Shetland. Initially all adult services
and some services for all age groups.
 Corporate processes that support integrated health and
care service delivery, e.g. finance, capital programmes,
asset management, human resources, training, ICT,
performance management, risk management, health and
safety, committee services and administration.
 Clinical and professional governance in multi-disciplinary
health and social care work environments – this will be
informed by the H&SC localities project reporting to the
H&SCI project board, but will be represented through one of
the governance work streams.
Outwith Scope



Discrete children’s services
Single management model for health and Social Care
Directorate – this is a separate project reporting to the
H&SCI project board
H&SCI localities project
Business Case
Benefits to the business of the Council and NHS Shetland
include:
 Improved outcomes for customers through quicker decision
making and reduction in bureaucracy leading to more time
to care
 Efficiency savings
 Clear lines of accountability for delivery supporting
integrated partnership working.
Constraints:


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
Customers:



Tight timescale – by April 2015
Budget constraints across the Council and the Board
Limited project resources e.g. management time
Demographic profile of Shetland population and remote
islands localities; increasing demands/pressure on services
People using health and care services in Shetland
Unpaid/family carers
Present and future users of health and care services in
Shetland
 NHS Shetland
 Shetland Islands Council
 Other Community Planning Partners
PROGRAMME INITIATION DOCUMENT
Author: Christine Ferguson,
Programme Executive
Date: 8 July 2014
Health & Social Care Integration Project
Transition Programme
Stage:
Version Number: 2.0
Page 6 of 12
Deliverables:
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Method of
delivery
The programme will be delivered through a number of projects
and work streams specifically in the following areas:
 Governance and the integration model
 Finance
 Workforce planning and development
 Capital resources
 ICT infrastructure and systems
 Information Management and Data Sharing
 Safety and Risk
 Performance management
 Care and clinical governance
Integrated governance model by April 2015
Integrated budget setting process by July 2014
Integrated budgets agreed by December 2014
Integrated management arrangements at all levels by April
2015 including in localities
PROGRAMME INITIATION DOCUMENT
Author: Christine Ferguson,
Programme Executive
Date: 8 July 2014
Health & Social Care Integration Project
Transition Programme
Stage:
Version Number: 2.0
Page 7 of 12
Risks:
 Timescales
 Failure to reach agreement on proposals for change
 Lack of support for the project across the two statutory
agencies
 Changes in financial resources available e.g. from external
organisations or through a change in priorities for
expenditure within the Board or the Council.
Assumptions
 Staff will ensure “business as usual” as the programme
goes forward so there will be no adverse impact on services
 Staff including senior managers will be able to dedicate time
and energy to this project.
 There will be additional resources available to support the
programme; specifically with regard to OD and support for
the work force through the transition to an integrated model
Resources:
 Director of Corporate Services as Programme Executive
 Dedicated project officer reporting to the Programme
Executive
 An implementation team drawn from the Council and the
Board
 Dedicated time from the support services of the Council and
the Board e.g. HR, finance, ICT, governance and law,
safety and risk, performance and improvement, capital
programme and buildings maintenance
 Input from elected members of the Council, members of
Shetland NHS Board and representatives of third sector
organisations, service users and carers.
Budget:
 Initially, £66,140 has been made available by the Scottish
Government to support the organisational change
requirements and work programme. There will be a further
allocation through a Change Fund
 All other costs will be met from within existing resources
across the Council and NHS Shetland
3.
Organisation and Reporting Structure
ROLES
NHS Shetland and
Shetland Islands
Council


To be responsible for the agreed outcomes from the
programme
To implement the decisions of NHS Board and the
Council with regard to the outcomes of the programme
PROGRAMME INITIATION DOCUMENT
Author: Christine Ferguson,
Programme Executive
Date: 8 July 2014
Community Health
Partnership
Meeting concurrently
with SIC Social
Services Committee
during 2014/15

SIC Social Services
Committee
Meeting concurrently
with CHP Committee
during 2014/15

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
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
Senior Stakeholder
Group

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
Health & Social Care Integration Project
Transition Programme
Stage:
Version Number: 2.0
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To receive reports on the progress made against the
objectives of the programme
To advise Shetland NHS Board regarding the work of
the programme and make recommendations for
approval by the Board
To ensure that services continue to be provided to meet
the assessed needs of customers and support
family/unpaid carers as the transition programme goes
forward
To receive reports on the progress made against the
objectives of the programme
To advise the Council regarding the work of the
programme and make recommendations for approval
by the Council
To ensure that services continue to be provided to meet
the assessed needs of customers and support
family/unpaid carers as the transition programme goes
forward
To maintain an overview of the Programme on behalf of
the Council and the Board
To receive reports on the progress made against the
objectives of the programme
To support and advise the Programme Executive.
Name
Title
Cecil Smith (Chair)
Chair CHP Committee /
Chair SIC Social Services Committee
Chief Executive NHS Shetland
Chief Executive Shetland Islands Council
Director of Public Health
Director of Community Health and Social Care
SIC Convenor
NHS Board Chairman
NHS Board non-executive member
Additional member(s) of Social Services Committee and
non-executive Board members of CHP Committee
Ralph Roberts
Mark Boden
Sarah Taylor
Simon Bokor-Ingram
Malcolm Bell
Ian Kinniburgh
Keith Massey
To be advised
Christine Ferguson
SIC Director of Corporate Service
Programme Executive in attendance
Transition Programme Board
PROGRAMME INITIATION DOCUMENT
Author: Christine Ferguson,
Programme Executive
Date: 8 July 2014
Transition
Programme Board
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

Health & Social Care Integration Project
Transition Programme
Stage:
Version Number: 2.0
Page 9 of 12
Responsible for the co-ordination of the projects and
work streams to deliver against the programme
objectives on time
Overall responsibility to ensure that the programme is
completed on time; reporting to the CHP Committee
and Social Services Committee
Responsible for the development of the integrated
governance arrangements

Membership and attendance at Programme Board meetings would comprise one
or more representative(s) from each work stream as required to support the
agenda. These would include:
Name
Title
Christine Ferguson (Chair)
Director of Corporate Services and Transition
Programme Executive
Director Community Health & Social Care
Director Public Health
CHP Projects Manager
Executive Manager Governance and Law, SIC
Executive Manager Finance, SIC
Director Finance, SIC
Executive Manager HR, SIC
Director HR and Support Services, NHS
Chair Shetland Data Sharing Partnership
Executive Manager ICT, SIC
ICT Manager, NHS Shetland
Executive Manager Capital Programme, SIC
Buildings Manager, NHS Shetland
Simon Bokor-Ingram
Sarah Taylor
Laura Saunders
Jan Riise
James Gray
Colin Marsland
Denise Bell
Lorraine Hall
Shona Thompson
Susan Msalila
Craig Chapman
Robert Sinclair
Lawson Bissett
Project Teams
The Project Teams comprise a number of subgroups and
other substantive partnership teams who will be responsible
for the different work streams reporting through members of
the Programme Board to the Programme Executive.
Health & Social Care Integration Transition Programme Work Streams
PROGRAMME INITIATION DOCUMENT
Author: Christine Ferguson,
Programme Executive
Date: 8 July 2014
Transitions Programme Work Stream
Corporate Governance:
Body Corporate model
 Standing Orders
 Schemes of Delegation
 Risk management
Health & Social Care Integration Project
Transition Programme
Stage:
Version Number: 2.0
Project Team/
Working Group
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Named
Representative(s)
Lead officer in bold
Governance
subgroup
Christine Ferguson
Simon Bokor-Ingram
Sarah Taylor
Jan Riise
Local Partnership
Finance Team
Christine Ferguson
James Gray
Colin Marsland
ICT
 Shared systems and infrastructure
 Integrated support arrangements
ICT subgroup
Christine Ferguson
Lorraine Hall
Information Governance:
Data Sharing
 With You For You
 GIRFEC
Data Sharing
Partnership
Shona Thompson
Jane Cluness
Joint working
group comprising
members from
APF and HRPG
Christine Ferguson
Denise Bell
Lorraine Hall
Care & Clinical Governance
Care & Clinical
Governance
working group
Kathleen Carolan
Roger Diggle
Hughina Leslie
Communications Strategy
Communications
working group
Carol Anderson
Carolyn Hand
Senior
management
teams of the
Board and the
Council
Simon Bokor-Ingram
Finance
 Integrated budget setting process
for 2015/16 and 3 year projections
 Integrated budgets
 Integrated programme budgeting
and cost analysis
 Savings calculations
Staff Governance / HR
 Integrated HR framework
agreement
 Integrated workforce development
and training
 Support for staff consultation
 Support for implementation of
structural changes
Single Management Structure Adult
Services
 Review single management
structure and capacity taking into
account issues of corporate and
care/clinical governance
PROGRAMME INITIATION DOCUMENT
Author: Christine Ferguson,
Programme Executive
Date: 8 July 2014
Localities
 Develop a locality model for
Shetland to support frontline
service delivery
Health & Social Care Integration Project
Transition Programme
Stage:
Version Number: 2.0
CHCP
Management
Team
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Simon Bokor-Ingram
Edna Mary Watson
PROGRAMME INITIATION DOCUMENT
Author: Christine Ferguson,
Programme Executive
Date: 8 July 2014
4.
Health & Social Care Integration Project
Transition Programme
Stage:
Version Number: 2.0
Project Authority
Schedule
Transition
Programme
presented to CHP
Committee and
Social Services
Committee
Update reports to:
 senior
Stakeholder
Group,
 CHP Committee
and
 Social Services
Committee
Reports for Council
and NHS Shetland:
Approval of the
Integration Scheme
including:
 The functions to
be delegated to
the Body
Corporate
 Budgets for
2015/16 and the
budget allocations
for the Body
Corporate
 The governance
arrangements
 The locality model
Planned
(Y/N)
Y
Comments
31 July 2014
Y
In each cycle of the committees
Y
December 2014
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