Royal National Orthopaedic Hospital NHS Trust
Foundation Trust Application Project Plan
Updated June 2008
1
CONTENTS
Page
Foundation Trust Application Milestones
3
Integrated Business Plan & Financial
Governance
(Including management of key performance
risks & developing Service Line Reporting)
4
Governance Plan
8
FT Project Plan
2
Overall Timetable Key Milestones
1
2
3
4
5
6
7
8
9
10
11
12
13
Milestone
Updated First draft Integrated Business Plan (IBP) and Long Term
Financial Model (LTFM) submitted to SHA
SHA/DH/Trust Exec meeting to review IBP and LTFM
Trust informal due diligence (check to avoid issues identified in formal
due diligence)
Final IBP/LTFM
SHA/DH/Trust Exec final review
Board to Board with SHA
Provider Agency Board - support for due diligence
Formal historic due diligence
Final support by SHA (post due diligence)
Date
July 2008
August 2008
Sept 2008
12th Sept 2008
September 2008
Mid-October 2008
13th October 2008
November 2008
End of November
2008
30th
Applications Committee
Secretary of State Gateway
Monitor Assessment
February to April
Or March to May
April - June
FT Authorisation date
Supporting Project Plans
o Integrated Business Plan and Financial Governance Plan (including service line reporting)
o Governance, Communications & Consultation Plan
3
RNOH Foundation Trust Application
Integrated Business Plan & Financial Governance
(Including developing Service Line Reporting)
Overall Timescale



July –September 2008 : Updating Draft Integrated Business Plan, Working Capital Model and Long Term Financial Model
12th September 2008: Submission of Final IBP & Financial Models to support application to DoH
October 2008 – April 2009: IBP & Financial models updated to final version during monitor assessment.
Staffing Resources
Overall Lead: Rob Hurd – Deputy CEO & FD
Lead Modeller: Cai Morgan – Deputy FD
Financial Modelling Support: Being recruited
Business Planning lead: Lesley Macleod, Head of Commissioning & Performance
Project Management: To be agreed
4
Ref
No.
1.0
1.1
Task
Produce Integrated Business
Plan
IBP Financial Modelling &
Summary Tables – Version 1
Action
Responsibility
Timescale
Outcome
Update Financial Models supporting Provider
Sustainability Plan and NHS London Provider Agency
Plan and Redevelopment OBC to format required for FT
IBP.
Update Provider Sustainability Plan and NHS London
Provider Agency Plan and Redevelopment OBC to format
required for FT IBP.
Cai Morgan
18th July 2008
FT Financial Model
Version 1
Lesley Macleod
18th July 2008
IBD in format &
headings required
for FT Application –
Version 1
FT Financial Model
Version 2
IBD in format &
headings required
for FT Application –
Version 2
FT Financial Model
Version 3
IBD in format &
headings required
for FT Application –
Version 3
FT Financial Model
DoH Submission
IBD in format &
headings required
for FT Application –
DoH Submission
1.2
IBP Narrative – Version 1
1.3
IBP LTFM Financial Model
Version 2
IBP Narrative – Version 2
Update IBP Financial Model
Cai Morgan
August 2008
Update IBP Narrative
Lesley Macleod
August 2008
IBP LTFM Financial Model
Version 3 submission
IBP Narrative – Version 3
submission
Update IBP Financial Model
Cai Morgan
Update IBP Narrative
Lesley Macleod
12th September
2008
12th September
2008
IBP Financial Model Final
Submission drafts updated
IBP Narrative – Final
Submission drafts updated
Update IBP Financial Model
Cai Morgan
Update IBP Narrative
Lesley Macleod
RNOH + SOA Trusts to model estimated impact of DoH
notified 2008/9 tariff “fixes”
Rob Hurd
July 2008
Robust 2009/10
income assumption
included in financial
modelling
RNOH + SOA Trusts to model updated local estimated
Rob Hurd
July 2008
Robust 2009/10
1.4
1.5
1.6
1.7
1.8
2.0
2.1
Demonstrate tariff and income
risks can be managed
Estimate 2009/10 impact of
HRGv4 and “fixes” agreed with
DoH
2.2
Initial HRGv4 income
5
October 2008 –
January 2009
October 2008 –
January 2009
Ref
No.
Task
Action
assessment based on Trust’s
local assumptions
impact of HRGv4
2.3
DoH confirmation of validity
Trust tariff assumptions
DoH to indicate to RNOH/SOA a view on the validity of v4
tariff assumptions built into model
Andrew
Woodhead
September 2008
2.4
Test Trust HRGv4 assumptions
based on 2007/8 Reference
Cost weightings
Demonstrate Private Patient
income cap risks can be
managed
Agree base case assumptions
required to meet PP income cap
and reflect this within the LTFM
Options appraisal of risks
associated with delivery of base
case assumptions and
alternative options available to
the Trust
RNOH + SOA Trusts to model updated local estimated
impact of HRGv4
Rob Hurd
December 2008
Incorporate PP income model into LTFM and IBP
Rob Hurd
July 2008
PP income cap base case assumptions built into the
financial model with risk assessment and options
appraisal incorporated into IBP.
Rob Hurd
Dependent on
outcome of
Monitor
consultation
expected
September 2008
Procure new PLC and SLR costing solution system
Rob Hurd
October 2007
Develop information systems to support improved PLC &
SLR, In particular integrate patient level information for
areas highlighted in 2006 costing review – prosthesis and
drugs
Service Line Reporting steering group set up with support
from Clinical Champions to improve data quality
Rob Hurd/Cai
Morgan
October 2007 –
September 2008
Rob Hurd
August 2008 –
September 2009
3.0
3.1
3.2
4.0
4.1
Demonstrate improved
business decision making
processes through
implementing Service Line
Reporting
Develop improved Patient Level
Costing and service line
reporting
Responsibility
6
Timescale
Outcome
income assumption
included in financial
modelling
Validation & update
of income
assumptions
Validation & update
of income
assumptions
PPI cap not planned
to be breached in
financial model
Options for
mitigating PP
income cap risks
incorporated into
IBP/LTFM
New PLC & SLR
systems
implemented
PLC & SLR systems
implemented based
on improved
information systems
PLC & SLR systems
implemented based
on improved
information systems
Ref
No.
5.0
5.1
Task
Action
Responsibility
Timescale
Outcome
Agree Working Capital Facility based on working capital
model risk assessment
Rob Hurd
February 2009
Working Capital
facility in place
6.0
Demonstrate Estates
Redevelopment Risks can be
managed
6.1
Agree treatment of Estate
Redevelopment strategy to be
included in FT plan – including
modelling “Plan A, B & C”
sensitivities
Feedback from SHA on outcome of review of April 2008
OBC
Rob Hurd
July 2008
6.2
Initiate Redevelopment sources
of finance strategy including
Agree fundraising target and strategy and land sales
strategy
Rob Hurd/Mark
Masters
July 2008
6.3
Agree Redevelopment FBC
timetable
Trust Board to agree site redevelopment plan and
alternative estates redevelopment options within this
Mark Masters
August 2008
Clear agreement of
“Plan A” and
demonstrate how
risks can be
mitigated with
potential alternative
plans
Agreed fundraising
and land sales
strategy
incorporated into
IBP
Agreed
Redevelopment
FBC action plan and
timetable
7.0
Demonstrate that all other key
performance and financial
risks impacting FT application
can be managed
Delivery of 2008/09 Business
Plan
Implement Joint Academic R&D
Strategy to mitigate income risks
in financial plan
Deliver 18 week access
- Deliver Cost Improvement Target
- Deliver Turnaround plan
Deliver increased grant income and R&D savings included
in financial plan.
Executive Team
March 2009
R&D Director
March 2009
Implement and deliver 18 week access agreed trajectory
through 18 week backlog capacity plan
Incorporate Clinical Unit Service Development Strategies
consistent with free patient choice and associated longer
term capacity plans into IBP and
Sheila Puckett
December 2008
Rob Hurd/Sheila
Puckett
September 2008
7.1
7.2
7.3
7.4
Working Capital Review
Set up Working Capital facility
Agree Clinical Unit Service
Development Strategies
consistent with free patient
choice and associated longer
term capacity plans
7
Delivery of Financial
Plan
Joint Academic
Strategy financial
plan being delivered
18 week access
delivered
Clinical Unit Service
Development
Strategies
incorporated into
IBP
Ref
No.
7.5
Task
Action
Responsibility
Timescale
Outcome
Repayment of all remaining
loans currently £2.1m repayable
2008/09
Repay £1m loan in September 2008 and £1m in March
2009
Rob Hurd
March 2009
FT balance sheet
metrics 4/5 by
March 2009.
8
Governance Plan for Foundation Trust status
Staffing Resources
Overall Lead: Andrew Woodhead, Chief Executive
Project Director: Rob Hurd – Deputy CEO & FD
Governance Lead & “Company Secretary” role: Mark Vaughan, Director of Human Resources and Corporate Affairs
Lead Manager on Governance & Communications: Jackie Stephen
Project Management: To be agreed
Work stream/event
Timescale
RNOH Lead
Project Steering Group set up
Project structure agreed incl. Governance project structure
Identify stakeholders and launch consultation
Identify levels of skills, knowledge and expertise required
on Board (incl. Board secretary responsibilities)
Develop plan for addressing skill/knowledge gaps on Board
Identify number of Board Directors NED/EDs
Implications for current non-voting Board members agreed
and communicated i.e. attendance/status
Proposed membership eligibility and constituencies
Consultation plan agreed by Board
Membership & communication strategy 1st draft completed
Public consultation agreed by Project Steering Group
Public Consultation Document agreed by Board
Public Consultation begins
Public Consultation ends
Maximising Membership recruitment
Completed January 2007
Completed January 2007
Completed February 2007
Completed February 2007
Project Director (RH)
Project Group
Director of HR & Corporate Affairs
Project Group
Completed February 2007
Completed February 2007
Completed February 2007
Director of HR & Corporate Affairs
Chief Executive
Chief Executive
Completed April 2007
Completed April 2007
Completed October 2007
Completed May 2007
Completed June 2007
Completed July 2007
Completed September 2007
Ongoing from September
2007
Ongoing from September
2007
July 2008
Director of HR & Corporate Affairs
Director of HR & Corporate Affairs
Director of HR & Corporate Affairs
Director of HR & Corporate Affairs
Director of HR & Corporate Affairs
Director of HR & Corporate Affairs
Director of HR & Corporate Affairs
Director of HR & Corporate Affairs
April 2009
Director of HR & Corporate Affairs
Updating members on progress with Redevelopment & FT
application
Review outcome of consultation & requirements to update
stakeholders on latest Trust plans and governance
proposals
Target 3000 members (excluding staff)
9
Director of HR & Corporate Affairs
Director of HR & Corporate Affairs
Work stream/event
Timescale
RNOH Lead
Board Development & preparation for Board to Board
meetings
Council of Governors elections launched
August & September 2008
Director of HR & Corporate Affairs
February 2009
Director of HR & Corporate Affairs
10