Lunch & Learn – Session 2

PMO Development

19th February 2014

Lunch & Learn – Session 2

Aim: To develop the PMO processes with you.

Previously….on Lunch & Learn #1:

• Keep it Simple• Keep it Proportionate• Remove the Bureaucracy

Feedback

• “I really value the introduction of the PMO, I think it will help Programme Leads manage and prioritise their work and help us to know what is expected and when”

Head Of Planned Care

Lunch & Learn – Session 2

By 2.00PM

Part 1

• overview of PMO• The story so far• What is a PMO• Ideas to Projects – a high level process

Part 2 - flexible• What do you need from a PMO?• What does a PMO need from you?

Lunch & Learn – Session 2

What do you want from this Lunch & Learn?

(apart from cake)

PMO – was it good for you?

PMO – The Story so Far

1) NHS England – 2 Year Operational & 5 Year Strategic Plan from each CCG

• Programme Leads presented first draft Dec 2013

• Draft 5 Year plan Jan 2014

• Draft 2 Operational Plan Feb 2014

• Final Operational plan Apr 2014

• Final Strategic Plan Jun 2014

2) CCG recognise the need for structured planning, prioritising, monitoring and reporting

5 Year Strategic Plan – NDCCG Plan on a Page

Measured using the following success criteria:

The health and wellbeing of the North Derbyshire population will be maximised

Inequalities and unwarranted clinical variation will be reduced People will increasingly be enabled to retain their independence

with the support of their local community and through integrated care teams provided in the community

Services, when required, will be responsive, safe, caring and provide a good experience of care

All organisations within the health economy will meet their financial targets year on year.

No provider will be under enhanced regulatory scrutiny due to performance concerns

Achievement of the improving outcomes ambitions will be used as the key set of measures to determine whether the above criteria have been met.

Strategic Aim One Transform Primary Care

Strategic Aim Two Develop integrated models of care (with a focus on frail and elderly, children’s and young

people and mental health pathways)

Strategic Aim Three

Redesign urgent and emergency care

Strategic Aim Four Improve the management of

long term conditions

Strategic Aim Five Focus on prevention/

self management

Strategic Aim Six Review the productivity of

elective care

1. Develop a GP Federation 2. Address clinical variation through RMMT visits and the wider medicines management programme 3. Ensure seamless 24/7 access to primary care 4. Introduce a shared clinical record across all primary care medical care providers 5. Implement Flo telehealth system

Overseen through the following governance arrangements:

Existing system wide structures: o Adult Care Board o Health and Well Being Board o Joint Commissioning Co-ordinating Group o 21st Century Transformation Programme Board

Internal governance structure support by Programme Management Office

2

3

5

System values and principles

All services will be commissioned in accordance with the publically consulted on system wide guiding principles for service change and the CCG’s values: Patient Focus Integrity Courage Responsiveness

6

Delivered through the following improvement interventions:

Description of the improvement intervention required to deliver the desired state outlined in the vision section above

4

1. Develop integrated community services for the frail elderly 2. Develop an integrated behaviour pathway for children and young people 3. Introduce new commissioning arrangements for children’s continuing care 4. Review of children’s services mapping, cost and value to enable outcomes based commissioning 5. Develop primary care based dementia services 6. Implement RAID psychiatric liaison service 7. Transform the care pathway for patients with learning disabilities moving to a more integrated,

community based service

1. Offer assessment, treatment and care in the community as an alternative to travel to hospital 2. Optimise emergency patient pathway flow through CRH – ED, CDU, EMU and wards 3. Improve discharge planning and post acute pathway

1. Review and recommission new integrated diabetes pathways for type 1 and 2 patients 2. Review the current model provision/services for patients with COPD 3. Develop the Hospice at Home model supporting patients to die at home.

1. Continue to work with Public Health on a range of measures related to prevention and early diagnosis 2. Review and adopt the recommendations (as appropriate) of the prevention review commissioned

from Public Health

1. Commission a deep dive analysis on a number of elective care pathways commencing with Neurological conditions and MSK

2. Analyse and benchmark CCG performance on a range of elective care metrics such as conversion rates, day surgery rates and new to follow up ratios

3. Work with the Clinical Strategic Networks to identify specialised services which necessitate concentration in centres of excellence

DERBYSHIRE SYSTEM VISION

Derbyshire health and social care economy is a system comprised of partners from Erewash, Hardwick, North and Southern CCGs, Derbyshire County Council and all Provider Trusts within the Derbyshire borders. Our common vision focuses on achieving a seamless health and social care service; at an individual level we have adopted the vision from National Voices: ‘I can plan my care with people who work together to understand

me and my carer (s), allowing me control and bringing together services to achieve the outcomes important to me’.

North Derbyshire CCG supports this with their vision:

‘Work together across health, social care, housing, voluntary sector and with the public itself to enable people to retain independence supported by their local community. When publicly funded services are required they will be responsive, safe, caring and provide a good experience of care still within the local community in the majority of cases. Where exceptionally people need to access more specialised services outside of their

community this will happen easily and they will be supported to return to their local community as quickly as possible’.

1

Why do we need a PMO?

• Where do I get a decision on this project?• What information do I need to get this proposal considered?• Which meeting does my proposal need to go to?• Who should I report progress to? When? How? Why?• Who do I speak to, to change the scope of my project?• Is there any funding available for a new change project?• How does my project relate to other projects/programmes?

• The PMO will help to put in place the process to answer these questions

Why do we need a PMO?

• Operational: To ensure the CCG delivers its plan and fundamentally improves services for

patients.

• Strategic/Transformational: – the CCG will need to transform health services in North Derbyshire. This will only be

delivered if we have a clear roadmap of how to get there and ensure we deliver against this.

– The CCG will also need to ensure sustainability of its providers or if sustainability is not desirable drive the commissioning of alternative models.

Why do we need a PMO?

• Financial: – Comprehensive Spending Review – funding increases will not cover demand and inflation

in future years and the CCG will need to make some difficult decisions about where to invest (and disinvest).

– QIPP is not delivering year to date – will be critical in future years to deliver financial balance and maintain authorisation.

2013/14 2014/15 2015/16355,000

360,000

365,000

370,000

375,000

380,000

385,000

390,000

Forecast SpendResources Available

Year 2 Gap: £14.1m

Year 1 Gap: £9m

PMO - People

• Jo Ross, Brian Nevin, Jo Gregory

• Amy Miles, Evelyn Koon

• Shofiq Rahman, Aaron Gillott

• GEM - Ian Rosser, Helen Short, Obrad Sudar

One to One / Meeting - Any time, by request

What is a PMO?

The PMO provides

Programme support• Programme/project development;• sufficiently robust to provide best chance of

success during implementation;• rigorously detailed to allow measurement and

to track progress;• ensure appropriate tools, templates and

processes are used and followed;• implemented within the planned time limit and

with the intended outcomes (i.e. milestones and KPI’s are met);

• provide project managers with support, advice and signposting to additional expertise for their projects

Monitoring and Measurement function

Co-ordination, Review and Scrutiny of key projects

Ch

alleng

ing

P

rog

ress

Detailed Plans

Risk Management

Contingency

Planning

Stakeholder

Reporting R

igorous

Reporting

Process

Benefit Tracking

ProgrammeManagement

Office

New

Pla

n

Dev

elop

men

t

What isn’t a PMO?

A PMO is NOT a function that takes control over the projects from Programme Leads

It oversees and monitors delivery, it doesn’t do or deliver the projects themselves!

Ch

alleng

ing

P

rog

ress

Detailed Plans

Risk Management

Contingency

Planning

Stakeholder

Reporting R

igorous

Reporting

Process

Benefit Tracking

ProgrammeManagement

Office

New

Pla

n

Dev

elop

men

t

What are the benefits of our PMO?

The PMO will help you to:

• Demonstrate that we are delivering tangible improvements in service/patient care and shout about our successes!

• Provide assurance to the Governing Body that implementation of our plans is progressing and delivering the intended benefits.

• Identify what work/projects are priority and focus resource accordingly• Enable any barriers to progress/issues to be resolved quickly• Facilitate more effective and quicker decision making.• Develop excellent project management capabilities that will ensure we are an effective and

slick organisation.

DRAFT PMO Governance Structure

Governing Body

Gov. Body Assurance Committee

Planning Delivery Group

Purpose: Oversees/monitors and ensures delivery of the

CCG Plan

Clinically led Programme Groups, i.e.:

• Urgent Care Working Group• Integrated Care project group• Primary care• Children, maternity and young

people• Long Term Conditions/Planned

Care groups• Mental Health and LD• Medicines Management

PMO SUPPORT:

Provides assurance in the form of a monthly highlight report including exceptional progress and exceptions they can assist to progress

• Identifies key decisions to be made• Highlights issues that the Group can assist in

resolving• Coordinates the agenda and produces highlight

report (by exception).

• Assist in expediting/unblocking barriers to progress

• Project resource is deployed where required to bring projects back on track

• Works with programme leads to ensure all project documentation is in place

• Status reports are provided monthly

PMO Structure

Notes: • Clinically led programmes will continue to

report via their existing governance processes. Links into PMO therefore shown as a dotted line here.

• Multi-stakeholder/disciplinary groups will be supported by an Executive Sponsor, Clinical and Programme Manager. They provide the top-level vision and support to the Programme Manager to drive the change by:

• advocating the case for change to strategic stakeholders,

• enabling delivery of the programme plan,

• assisting resolution of major issues, • encouraging progress, and • ultimately ensuring delivery of

benefits.

Authorization of Projects - 1

ACTION RESPONSIBILITIES TIMELINE

Identify Need Locality / Programme Week 1

Generate & prioritize ideas Locality / Programme Week 2

Draft project Proposal and identify priority level

Locality / Programme / PMO Week 2

Submit To Authorising Group* Locality / Programme / PMO Week 2

Prioiritization Reviewed and Agreed

Authorising Group* Week 3

Decision to proceed Authorising Group* Week 3

Process for Development & Implementation of Change Projects

YES

NO

Authorization of Projects - 2

ACTION RESPONSIBILITIES TIMELINE

Refine project Proposal into Project Planning Document

Locality / Programme / PMO Week 4-7

Submit to Authorising Group* Locality / Programme / PMO Week 8

Decision to Proceed Authorising Group* Week 8

Implementation Locality / Programme / PMO

project performance and outcome monitoring

PMO

Process for Development & Implementation of Change Projects - page 2

YES

NO

Project Proposal

• Purpose: justify the release of resources to work up this proposal into a project

Project Planning Document

• Purpose: set out how and when the project’s aims and objectives are to be achieved. It will define the approach to be used by the Project team and provides details of the execution, management and control of the project to include costs, milestones, activities and resources

End of Part One

What does it mean for your role/team?

What sort of work underway/planned in your team will be affected by the PMO process?

1. What issue is my project addressing?

2. What is the project setting out to do?

3. What is the plan to get there - 5/6 milestones?

4. How will I measure success – quality/activity?

5. What resources will I need – people / finance?

minimum information 1

6. How will I manage and govern the project?

7. What issues am I aware of?

8. What are the most significant 5-10 risks to the project?

9. Is our success dependant on anything else (and if so, what)?

minimum information 2

Lunch & Learn – Session 2

Next Steps:

Programme Leads - Answer the 9 questions by Feb 28th

Produce a Project Planning Document by March 31st

Lunch & Learn – Session 2

Next Lunch & LearnsTuesday 4th March Back to Basics:

For staff looking to refresh your project management skills

Wednesday 12th March Crunchy Numbers:Measuring the success of your project is critical in ‘knowing how you are doing’. This session will help you in developing outcomes and how to measure impact

Wednesday 19th March The Future Understanding the PMO reporting cycle

Wednesday 26th March Last Chance Saloon:Open space for questions, specific project support and development

TBC A Basic Introduction to PMO – for anyone to attend

Lunch & Learn – Session 2

Thank you

Please Evaluate now

Alternative options

North Derbyshire CCG - Project Proposal Prioritisation Tool

Notes 1. Use Atlas of Variation or equivalent

1. Does the Proposal contribute to the CCG’s vision and aims OR is it nationally mandated ?2. Is there good evidence supporting the reason for the change?1

3. Can the impact of the change be measured? NO DO NOT PROCEED

Will it deliver savings?

YES

Is the proposal cost neutral? Will the proposal cost money?

Rate of Returnnow

Rate of return

< 2 years

Rate of return

< 2 years

Rate of returnnow

Rate ofReturn

> 2 years

Cost < 100k

Cost 100k >< 500k

Cost > 500k

High priority

High priority

Low priority

Medium priority

Low priority

Low priorityProcurement route via F&R

Consider the following questions and answer yes or no

1. Does the proposal have an impact on health inequalities2. Will the proposal improve health outcomes

Increase priority level by one Maintain original priority level

Reduce priority level by one

Rate of return

> 2 years

Medium priority

High priority

Medium priority

ONE YESBOTH YES N0 YES

PMO Reporting Cycle

Day 3 Programme Leads submit Highlight report – summarising project and programme progress to the end of the calendar month

Day 5 CCG Programme Pack collated Day 10 Month End Finance & Activity available - TBC

Day 11 Finance & Activity information added to Highlight Report

2nd Tuesday?

Pack submitted to Planning Delivery Group (2nd SMT of the month) for confirmation

PDG Progress report createdNB – if PDG meeting is before the Finance/Activity info is available, then the info is added after the PDG

3rd Monday?

PDG Progress report submitted to ?FRC equivalent - TBC? (3rd week of the month) NB – papers for this may need to be submitted 1 week before