Health and Social Care Sector

Dean Jones, Associate Programme Manager - Programme Leadership, Consulting

Transition Programme Manager

2012

2012

2013

2014

Client / Employer

embarked on an

exciting journey

to design, build,

commission and

operate new

care homes across

the UK

- Programme represented over

£250m of investment

- The Scale of growth demanded

repeatable systems

- Project management not a

core capability

- Private equity investor needed

more assurance

2014

2015

2015

2016

2017

Franchise Approach

- Programme Manage pipeline of New Builds

- Provide project management expertise

- Support Best Practice through the development

and implementation of various toolkits

- Blueprint - How to manage projects

- Launch Manual – How to launch new homes

- SOP - Standards expected when operational

- Implemented a cost effective project system to

improve collaboration, organisation and

transparency

“Scalability and

replication will become

the building blocks that

will enable REC providers

to sustain growth and

achieve high quality

standards “

Launch

Manual

Project Management

Blueprint

SOP

Project Lifecycle

Commissioning

Operational Readiness

Start Up

Operate New Home S

tan

da

rds

Ac

hie

ve

d

Programme Lifecycle

HR

Clinical Governance

Property

PR & Marketing

Sales

PROGRAMME MANAGEMENT

Commercial Team

Ma

turity

Handover to Core Business

Project Management Post Operational Reviews

Consult and engage with Operations regarding key decisions Transfer Accountability to Operations

Pre Day 1 Day 1 – X months X mths X mths

Project Management System

- Implemented a cost effective project system to

improve collaboration, organisation and

transparency

Past and Present Transition Programme Manager

2012

2012

2013

2014

Client / Employer

embarked on an

exciting journey

to design, build,

commission and

operate new

care homes across

the UK

- The Programme represented

over £250m of investment

- Scale of growth demanded

repeatable systems

- Project management not a

core capability

- Private equity investor needed

more assurance

Opened 7 new care homes

Opened 5 new care homes (60m Investment)

2014

Opened 7 new care homes

2015

Opened 6 new care homes (60m

Investment)

2015

2016

2017

- Increase clients total

number of homes by

circa 35%

REC Sector

#2

There is currently over

21,500 nursing,

residential and

care homes

in the UK.

Residential Elderly Care (REC) Uk Sector

The UK Elderly care sector includes

the following care categories:

Elderly

Physical disability

Dementia

The Cost of UK REC

Within the total REC sector:

• the private sector provides

over 381,000 beds (approx. 78%

of total provision)

• Generates over £11.2 billion

revenues

Public

The residential market is expected to

reach £44billion in 2040 with the

private setting contributing to

91% of revenues.

Residential Care £900

Avg. weekly bed rates

(Nursing)

Public

Private

Market Drivers

#4

REC Key Market Drivers

“REC remains an attractive sector for both lenders and investors alike. The

sector benefits from the strong demand drivers of an ageing population”

KE

Y T

RE

ND

S

- Ageing UK population

- Increase in dementia

- Increase in long term LA

transfers

- A trend towards consolidation

- Increased managed care homes

businesses

- Growing consumer expectations

for goods and services

- Growing need to replace or

upgrade outdated care homes

- Growing need for more affordable

care homes

- Immature Population Health

Management

- Escalating regulatory intervention

REC Past, Present and Future Key trends that will affect how REC is delivered

2010

2012

2014

2015

- Healthcare is projected to increase project management roles by 30 percent – the highest growth rate of any project-intensive industry between 2010 & 2020. PMI Industry Growth Forecase 2010

- Total REC bed capacity of 488,000 has increased over 5 years by 16,000 beds (+3%) driven by: Private sector growth of 34,000 beds (+10%) to 381,000 beds and LA and NHS reduction of 19,000 beds (-33%) to 39,000 beds

- People living longer, but not necessarily in good health. Men are now living to an average age of 78.8 years. Average female life expectancy is 82.8 years

- Around 430,000 elderly and disabled people live in long-term residential care in the UK

- Tougher Care Quality Commission (CQC) strategies

- Continuing issue long term residential care services are expensive, both for individuals and the government.

- Current number of nursing and residential care homes in the UK will have to almost double over the next 20 years to cope with the rising numbers of people aged 85 or more.

- Health care providers who fail to advance progressive management practices as well as information technology capabilities to effectively compete and collaborate in this new environment will be threatened for business survival. Capital Care Associates 2015

- Health and care a hot topic. General Election. - Cost of residential care hits £75,000 leaving the elderly

with a shortfall in pension pots many pensioners have to dip into savings to pay for their care and one in five is forced to sell their home.

- Industry data on providers is scarce for benchmarking and lenders / investors for underwriting and credit monitoring.

2016

- Rising National Minimum Wage (NMW) will adversely affect REC operators as wages are very closely linked to NMW and typically represent 49% (residential care) to 57% (nursing care) of revenues.

- Possible cap on the UK’s immigrant workforce community

- Fee growth rising despite on-going economic climate with LAs seeking to avoid Judicial Review (JR) challenges by acceding to reasonable annual base fee rate increases

2018

- It is expected that 2.9m people in England will have three or more long term conditions with a additional care cost of £5b. Source Kings Fund

- LA/NHS beds reducing to just 18,000 with private sector beds increasing to c.400,000 beds

- Adult social care workforce will need to grow by 1m

- 1m people in England expected to have dementia with estimated care costs of nearly 35b. Source Alzheimer’s Society, 2012

2020

2025

2026

Opportunities

Business Transformation

Programme Leadership

Programme and Project Controls

Risk Advisory

Programme Planning Advisory

Procurement & Commercial Advisory

#8

Programme Management Opportunities

- Lead/Support New

Investment Growth

Programmes

- Support new and existing care homes businesses with Best Practice through

implementation of

- New Home Home Manager Launch Manual

- New Home BluePrint

- New Home Standard Operating Procedures (SOP)

- Lead implementation of cost effective project systems to improve collaboration,

organisation and transparency

- Support Major Healthcare Programmes & Projects Across AECOM

- Establish a recognised and respected portfolio, programme and project

management profession in health and social care organisations

Programme Management &

Mega Projects

Programme

Advisory

Portfolio, Programme &

Project Office

Programme

Leadership

Service Service Lines

Business Transformation Opportunities

Programme

Leadership

Opportunitie

s

Programme

and Project

Managemen

t of REC

Investment

Growth

Programmes

REC

Portfolio,

Programme

and Project

Office Setup

REC Project

Managemen

t BluePrint

Design &

Implementati

on

Provide best

practice on

programme

managemen

t and

benefits

realisation

Support

Best

Practice

through

implementati

on of REC

Standard

Operating

Procedures

(SOP)

REC Home

Manager

Lunch

Manual

Design &

Implementati

on

- Climate/Maturity

Assessment for existing

and expanding REC

businesses

- Culture Strategy for REC

mergers

- Change Readiness

Assessment for REC

investment growth

programmes

- Organisational Design for

mergers

- Change management for

mergers

- People process review and

alignment for mergers

- Operational Readiness for

new REC businesses

- Performance Management

to reduce High usage of

agency staff to improve

profitability

Culture Effectiveness and

Transformation

Performance

Management

Service Service Lines

Programme & Project

Controls

Programme & Project Controls Opportunities

Deployment and

implementation of low

value and high adaptation

online collaboration

software solution for REC

programmes and projects

- Training and support

for document & data

management

- Maturing REC providers

data management

capability

Create high level Exec

programme reports and

dashboards using online

collaboration software

solution for REC

programmes and projects.

as no REC provider excels

in all categories - –Data

analytics – Data

Aggregation; – Population

Insight – Care

Management – Workflow

and Action

Conduct a comprehensive

situational analysis and

develop strategic

business plan for REC

businesses

Document & Data

Management

Performance

Management &

Reporting

Systems

Strategy

Service Service Lines

Risk Advisory Opportunities

- Support high level in-flight operational

projects

- Support REC Investors and property

developers

- Support REC operators under the media

spotlight

- Support failing residential elderly care

businesses

- Provide risk advisory for in-flight REC

investment growth programme and

projects

Risk Advisory Programme & Project Risk Management

Service Service Lines

Programme Planning Opportunities

- REC Programme Planning development

- REC Operational Planning Management

Programme Planning Advisory

Service

Procurement & Commercial Advisory Opportunities

- Procurement advice strategy for REC

operators to alleviate waste

Procurement & Commercial Advisory

Service

#15

Proposals

Business Prognosis Reviews 4 areas of a

care home business including Estate

Management , Commercial, Quality, and

Business Growth and provides a high level

report with unbiased recommendations in

actions and a prognosis grade.

Benefits:

Make better decisions

Overcome weaknesses

Support business reviews

Minimize threats & expose opportunities

Our approach We conduct a three-to-five

day assessment service, that engages with

a wide range of internal and external

stakeholders.

Business Prognosisa-f

Acquisitions If an assessment is for a recently

acquired care home, the business prognosis will

focus on:

- Regulatory record

- Background, business style and culture

- Estate condition

Not Included

- Assessments on quality of care

- Health and safety assessments*

- Income assessments

Prognosis Grades:

A. Best possible grade,

excellent (around 70% -

100%)

B. Above average grade,

very good (around 60% -

70%)

C. Minimum pass,

improvement needed

(around 50% - 60%)

D. Close fail, (between 45%

and 49%)

E. Fail, (0% - 45%)

A

B

C D

E

F

Prognosis Grade

Business

Growth (BG)

A

B C

D

E

F

Commerical (CM)

Quality (QOS)

A

B

C D

E

F

Estate Management

(EM)

A

B C

D

E

F

Prognosis

Grade

C

Aecom’s (DBFO) Programme Management Lifecycle Model

PROJECT MANAGEMENT

Design Fund Build Operate

Any questions?

Dean Jones, Associate - Programme Leadership, Consulting

TOGETHER WE HELP HEALTH AND SOCIAL CARE CLIENTS TO SEE FURTHER, GO FURTHER THANK YOU

dean.jones@aecom.com