Business Plan 2009 - Jersey and... · FAMILY NURSING & HOME CARE (JERSEY) INC 2009 Business Plan Section 1 Vision and Aim Vision 2009 - 2014 JEnabling life long well-being and care

Business Plan 2009

Family Nursing & Home Care (Jersey) Inc

Enabling life long wellbeing and carein the community

May 2009

Contents

Section 1 Vision & Aim Page 3

Section 2 Organisational Structure Page 4

Section 3 Key Areas of Development Page 5

Section 4 New Directions Page 5

Section 5 Current Performance Page 6

Section 6 2009/2014 Over-arching Strategic Aims Page 8

Section 7 2009/2010 Priority Objectives Page 10

Section 8 Statistical Information and Data Collection Page 13

Section 9 Budget Report 2009 Page 14

Appendix 1 Budget Plan 2009 Page 15

2

FAMILY NURSING & HOME CARE (JERSEY) INC

3


2009 Business Plan

Section 1 Vision and Aim

Vision 2009 - 2014

“Enabling life long well-being and care in the community”

Aim

To be the best at providing services for Family Health Improvements, Chronic Disease Management

and Long-term Care Provision in the Community that are cost effective, evidence based and within

a robust governance framework.

4


Ch

airm

an

Co

mm

itte

e T

rea

su

rer

Ch

ief E

xe

cu

tive

Offic

er

Div

isio

na

l M

an

ag

er

Clin

ica

l S

erv

ice

sF

ina

nce

Dire

cto

rD

ivis

ion

al M

an

ag

er

Go

ve

rna

nce

& P

erf

orm

an

ce

Div

isio

na

l M

an

ag

er

Bu

sin

ess S

up

po

rt

Op

era

tio

na

l L

ea

d

Dis

tric

t N

urs

ing

Op

era

tio

na

l L

ea

dH

om

e C

are

Su

pp

ort

Te

am

Op

era

tio

na

l L

ea

d

Ch

ild &

Fa

mily

Op

era

tio

na

l L

ea

d

Hu

ma

n R

eso

urc

es

Se

nio

r Te

am

Le

ad

er

Te

am

Le

ad

ers

De

pu

ty S

iste

rs

Sta

ff N

urs

es

Se

nio

r H

ea

lth

Ca

reA

ssis

tan

ts

Sp

ecia

list N

urs

es

Ph

ysio

OT

+ O

TA

SC

AT

Te

am

s

Ho

me

Ca

reL

oca

lity

Co

-ord

ina

tors

Se

nio

r H

ea

lth

Ca

re A

ssis

tan

ts

Ho

me

Ca

reA

ssis

tan

ts

Te

am

Le

ad

ers

He

alth

Vis

ito

rsH

ea

lth

Vis

ito

rA

ssis

tan

tsN

urs

ery

Nu

rse

s

Sch

oo

l N

urs

es

Sch

oo

l N

urs

es

Assis

tan

ts

Fa

mily

Pla

nn

ing

Nu

rse

sC

AP

Co

-ord

ina

tor

Pa

ed

iatr

ic S

iste

rS

taff N

urs

es

Nu

rse

ry N

urs

e(R

esp

ite

)

HR

Assis

tan

t

Sa

larie

s O

ffic

er

Occu

pa

tio

na

lH

ea

lth

Sp

ecia

list

Nu

rse

Ed

& D

ev

Co

-ord

ina

tor

Ed

& D

ev

Assis

tan

t

He

alth

& S

afe

tyO

ffic

er

Info

rma

tio

n

Go

ve

rna

nce

O

ffic

er

Arc

hiv

ing

Cle

rk

Clin

ica

l E

ffe

ctive

ne

ss

Fa

cili

tato

r

Sto

re S

uperv

isor

Head S

tore

man

Sto

re S

taff

Busin

ess

Support

Offic

er

Pro

ject O

ffic

er/

Fund R

ais

ing

Offic

er

Adm

inis

trativ

e/

Secre

tarial S

taff

Cle

rical S

upport

Fin

an

ce

Sta

ff

Ch

ild P

rote

ctio

n

Section 2 Organisational StructureMay 2009

5


Section 3 Key Areas of Development

Section 4 New Directions

4.2 Key Issues

HEALTH FOR LIFE

Family Health Improvement

INTERGATED PRIMARY

HEALTH CARE

Chronic Disease

Management

LONG TERM CARE

PROVISION

(in the community

Adding quality of

Life to Years

Population Age

Age 65 and over 13390 14458 15569 18225 + 4835 (36%)

Aged 80 and over 3482 3721 4015 4430 + 948 (27%)

2005 2010 2015 2020 Increase 2005 to 2020

In a world where people are able to survive with complex health conditions and live longer, the

demand for care will continue to increase. Significant changes in our society will challenge those

services that support carers and those that they care for. The next decade will see major and

substantial changes in the everyday lives of carers and the family members and friends they support.

4.1 Demographic Drivers

6


Section 5 Current Performance

5.1 Performance Against 2008 Strategic Policy Objectives

5.1.1 Provide a comprehensive range of Health and Social Care services which support civil

society.

Changes in Social and Nursing Care delivery through the redesign of District Nursing Teams,

incorporating further skill mix, and the reallocation of geographical areas has taken place.

The introduction of a Social Care Assessment Team within District Nursing has enabled direct

referral to the Home Care Teams. The appointment of a new School Nurse has enabled an

increased immunisation programme and a targeted Health Assessment Programme to be

introduced.

5.1.2 Further develop community based services which are integrated and accessible.

The introduction of a Continence Clinic at De Fayes Pharmacy has provided easier access

for clients to obtain assessments, advice and support.

Working collaboratively with HSS to improve discharge and admissions to hospital.

The Association continues to progress work in relation to present and future needs of the

Association regarding premises.

5.1.3 Maintain, identify and develop the required resources and infrastructure to support

organisational development.

The Family Nursing and Home Care Strategy will be progressed this year setting out the

Association’s clear vision for the coming five years. Negotiations with Health and Social

Services continue and completion of a Service Level Agreement is anticipated shortly. This

will give clear guidelines on service delivery monitoring, clinical outcomes and availability

within set budgets.

The introduction of a new accounting system in 2008 will aid budget setting and allocation of

funds within the Association going forward.

5.1.4 Address the corporate governance agenda, involving clients, carers and other

stakeholders in the maintenance and development of service delivery.

Work is taking place with Health and Social Services and other key stakeholders to develop

an Island wide Continence Strategy and Nursing Strategy.

Patient involvement in the development of new Community Nursing Records has taken place

along with joint working with H & SS and other key stakeholders in the development of an

Integrated Care Record Project.

7


Section 5 Current Performance continued

An Association wide Infection Control Audit and Customer Satisfaction Surveys for the Health

Visitor “Pop in and Play” and “Baby Café” groups have been undertaken.

Close working with Social Security to ensure a smooth passage for clients in receipt of the

new Income Support has taken place.

Quality of Life measurement tools have been adapted within the Occupational Therapy and

Respiratory Care Services to elicit patient feedback regarding the effectiveness of their care.

5.1.5 Develop marketing and income generation strategies to support the Association’s

unique Third Sector status.

Opportunities for promoting the Association’s services and profile have been capitalised with

various features appearing in the media. A number of initiatives have taken place during 2008

to promote the Charity Shop since its launch in November 2007. Training in Fundraising has

taken place for Managers and those key staff involved in fundraising.

Clinical staff are entering a Nutritional Screening Tool into the Health and Social Services

Awards. The Association was a Flybe Hero award winner and the prize has given various

staff the opportunity to visit other areas in the UK and further a field to learn and exchange

information from other similar Organisations.

Numerous fundraising events took place throughout 2008 including a Summer Ball, Golf Day,

Sponsored Walk, Music in Action and Bingo Night.

Through the support of Islanders net funds from Fundraising activities in 2008 equalled

£36,464.

8


Section 6 2009/2014 Over-arching Strategic Aims

Following the completion of Family Nursing & Home Care’s 5 year strategy, the over-arching

strategic aims have been developed and agreed.

6.1 Key Aims

6.1.1 Key Aim 1

To deliver clinical services which will meet the demands of the community within Jersey.

Family Nursing and Home Care will support people from birth to death by planning and

implementing care aimed at;

• Family Health Improvements

• Chronic Disease Management

• Long-term Care Provision in the Community

• Developing a seamless ‘pathway’ to care that is multi-professional and locally based.

6.1.2 Key Aim 2

Develop strong communication and marketing strategies to promote joint working and the

charitable status of the Association to support income streams and the engagement of key

stakeholders and multi-agencies.

6.1.3 Key Aim 3

Develop and maintain a framework through which Family Nursing and Home Care can

ensure that the best quality of service is provided, to include benchmarking and patient and

public involvement. This will help demonstrate compliance with client, legal and

professional requirements, and which will stand scrutiny in any environment.

6.1.4 Key Aim 4

Develop the human resources function to ensure that the Association deals effectively with

everything concerning employment and the development of people, planning a workforce

that meets the needs of the Association.

9


Section 6 2009/2014 Over-arching Strategic Aims

6.1.5 Key Aim 5

Provide pro-active education and development for the entire workforce so they are fit for

purpose both today and in the future.

6.1.6 Key Aim 6

Maximise income streams to adequately meet the operating needs of the Association and

the safeguarding of its assets, and to continually strive to improve operational efficiency and

to evidence the same.

6.1.7 Key Aim 7

Ensure that the Association’s premises are fit for purpose and meet both short and long

term needs.

10


Section 7 Priority Objectives for 2009/2010

Each division within FNHC will agree time framed action plans to meet the 2009 objectives which

fall into the Strategic Aims agreed within the FNHC Strategy Document.

Priorities for 2009/2010 are:-

To Develop District Nursing Teams to meet the demands of Chronic Disease management within

Palliative Care, Respiratory Care, Tissue Viability and Diabetes.

7.1 Key Aim 1 – Objectives

Action Timeframe

Develop Clinical team with skill knowledge and skill mix to meet Ongoing

the demands of service delivery.

Develop a framework to enable clear guidance of roles and March 2010

responsibilities of Clinical staff.

Develop Nurse led clinics and specialist nursing. March 2009

Develop and implement a falls prevention framework. February 2009

Research and work collaboratively with HSS at services that support December 2009

early discharge and prevent admission.

Develop breast feeding advice and support and collect accurate data. March 2009

Development and implementation of referral criteria January 2010

Address gaps in service by project leading Rapid Response Ongoing

Unit or Agency


Action Timeframe

Staff to attend communications work shop January 2009

To foster collaborative working with Key stakeholder Ongoing

To agree Service Level Agreement with HSS for 2009 March 2009

To agree Service Level Agreement with HSS for 2010 June 2009

11




Action Timeframe

Engage Service Users – Process Implemented April 2009

Improve the clients experience of the services delivered, February 2009

promoting a culture of dignity and respect

Develop Patient & Public Involvement initiatives April 2009

Undertake various Clinical and Organisational Audits to monitor Ongoing

adherence to national & local standards

Introduce Association Core Values December 2010

Develop a data collection system to assist in collecting statistical November 2009

data to enable future benchmarking for clinical services


Action Timeframe

Change staff titles that reflect the work each grade covers. Develop April 2009

Clear roles and responsibilities for each grade

Utilise Development Frameworks to support staff through changes January 2009

Progress Succession Planning to ensure the association has a August 2009

workforce fit for purpose and able to meet the Associations Strategic

agenda and future challenges – Commencing with senior posts


Action Timeframe

Risk Assessment Ongoing

Redefine roles and responsibilities in order to extend the September 2008

existing roles and utilise skill mix

Continue to provide essential education & development Ongoing

for the employees of FNHC

12




Action Timeframe

Review and implement agreed new charging process for Home Care June 2009

A full review of stores department within FNHC in collaboration with June 2009

key stakeholders

Provide equal access of care to all FNHC members with an June 2009

equitable system of charges


Action Timeframe

To drive forward proposals for new short term premises to June 2009

meet today’s needs of FNHC

To drive forward proposals for new long term premises to December 2009

meet the future needs of FNHC

13


Section 8 Statistical Information and Data Collection

8.1 Clinical Outcomes

Measuring performance in healthcare is challenging. Whilst it is relatively easy to show

performance in a quantitative way, demonstrating the quality of care delivered is more

difficult, and this problem is further compounded by the Association’s lack of IT resources.

The clinical outcomes, or performance, should be detailed to reflect both the quantity and

quality of some of the services delivered by Family Nursing and Home Care. Where

possible validated performance measures should be used and during 2009 we will be

working towards bench marking and agreeing audit tools to ensure Clinical outcomes are

measured.

By 2009 the Association will be able to demonstrate a broader range of clinical outcomes

across more of the clinical services which it provides.

8.2 Data Collection

All statistical information and data collection processes are being reviewed to meet the

demands of being timely, staff and client friendly, cost effective, meaningful and support

HSS Service Level Agreement. This will clearly demonstrate clinical care that is being

delivered. Implementation of new processes and presentations of data will be a priority

for the first quarter of 2009.

8.3 Monitoring and Evaluation

The Senior Management Team will drive forward action plans and will monitor the progress

being made and this will include priority areas and cost implications. Any joint initiatives will

agree a monitoring and funding process in order to proceed through usual organisational

processes.

Progress in relation to the strategy, and action plans will be given to the CEO at one-to-one

meetings by Senior Managers. Detailed six monthly/annual reports will be submitted to the

Committee so that progress can be measured against the strategic aims.

14


Section 9 Budget Report 2009

Appendix 1 sets out the Actual, Forecast and Budget for 2007, 2008 and 2009 respectively. Following

a difficult financial year in 2007, 2008 provided only marginal improvement. Whilst operating income

rose by £405k to £6.7m, net Operating Expenditure also rose by £371k to £7.6m causing an

Operating Deficit of £956k. An improvement of just £34k on 2007. The increase in Operating

Expenditure was driven by an increase in salaries and pensions of £568k netted off by a decrease in

Other Expenditure of £196k. The Legacies received in 2008 have been particularly generous and

the overall Deficit for the year is forecast to be £146k.

Looking forward to 2009 we can expect that income will be hard to achieve whilst costs will always

be inclined to rise. In this light the budget for 2009 has sought to recognise where a negative change

in income is inevitable, for example Bank Interest, and to anticipate the change and to take a pro-

active approach to those areas where income might reasonably be improved, for example Home

Care charges.

Operating expenditure predominantly consists of salaries. There will always be a natural pressure

for salaries to rise as new posts are incurred and pay rises seek to keep up with the cost of living.

The situation has been exacerbated as a number of Grants relating to specific posts ended in 2008

whilst employment costs continue. Senior management recognise that costs in excess of income can

not continue forever and shall exercise full consideration during the year to deliver a more effective

and efficient result from its most valuable Human Resources. Whilst the engagement of new staff

will be heavily scrutinised before commitment, we are fully committed to the continuation and

development of existing teams.

From 1st January 2008 the cost of repaying the pre 1987 PECRS liability will be fully absorbed by

the States of Jersey with a corresponding reduction in their Grant to us. Other cost reductions are

anticipated in professional fees and motor expenses. Increased funds will be targeted at Learning

and Development.

The target of higher Operating Income against stable Operating Expenditure will cause our Operating

Deficit for 2009 to reduce to a loss of £652k. A significant step forward from recent years. Net

Charitable Income of £315k will mitigate the overall deficit to £337k. As a matter of principle, Legacies

are not included in budgets although any received during the year will reduce the deficit further.

Senior management recognise the need to improve overall financial performance for both the medium

and long term. Actions taken during 2009 will form the basis of continued future improvements. All of

the Management team are fully committed to the long term stability of FN&HC.

15


Appendix 1 2009 Budget

Family Nursing & Home Care Actual Forecast Budget

Appendix 1 2007 2008 2009

OPERATING INCOME £ £ £

States of Jersey 5,588,840 5,965,835 6,027,487

Other grants 24,420 58,604 25,800

Subscriptions 290,777 287,346 309,778

Home Care fees 349,415 338,303 598,356

Sale of Services 0 13,643 7,880

Rental income 14,841 9,723 3,600

Operating Income 6,268,293 6,673,454 6,972,901

OPERATING EXPENSES

Nursing and Home Care salaries 5,242,048 5,759,687 5,871,382

Central Support Services 939,096 989,107 1,080,117

Salaries & Pensions 6,181,144 6,748,794 6,951,499

Other Expenditure

Training & Library 25,796 33,505 41,863

Uniforms & clothing/laundry allowances 17,329 20,156 16,056

Motor expenses & allowances 258,272 261,166 266,425

Recruitment costs 21,843 15,484 12,000

Medical supplies & equipment - Net of Income 134,813 174,180 62,000

Accountancy 3,500 4,500 4,500

Professional fees 4,100 2,550 4,800

Investigation costs 0 67,513 36,000

Organisational expenses 91,789 44,778 29,786

Furniture, office & IT equipment 5,839 9,160 6,000

Property expenses 43,385 62,527 34,271

Insurance 41,556 44,580 45,800

Stationery, postage & telephone 75,331 102,621 98,094

Rental for Clinics/Buildings - Net of Income 25,144 37,755 16,300

PECRS 328,002 0 0

Other Expenditure 1,076,699 880,475 673,895

Operating Expenditure 7,257,843 7,629,269 7,625,394

OPERATING (DEFICIT) (989,550) (955,815) (652,493)

CHARITY INCOME

Donations - general 136,307 103,822 80,000

Donations -restricted 50,450 35,472 60,000

Fund Raising - Net of expenses 25,480 36,464 66,500

Bank deposit interest 44,392 59,989 8,500

Other investment income 50,597 100,111 100,000

Legacy Income 125,250 474,161 0

Income 432,476 810,019 315,000

TOTAL FN&HC SURPLUS/(DEFICIT) (557,074) (145,796) (337,493)

Documents

Business Plan 2009 - Jersey and... · FAMILY NURSING & HOME CARE (JERSEY) INC 2009 Business Plan Section 1 Vision and Aim Vision 2009 - 2014 JEnabling life long well-being and care