Trust Operating Model Roadshow March 2019 Patient centred . - PowerPoint PPT Presentation

Trust Operating Model Roadshow March 2019 Patient centred . Excellence . Respect . Compassion . Safety

Aim: Provide your with an overview of the background to developing our new Trust Operating Model and how this will be supported through new ways of working. Patient centred . Excellence . Respect . Compassion . Safety

Background We have been reviewing our delivery model since 2017, and working on the TOM throughout 2018 to ensure we have an operating model that will facilitate us to deliver our 2021 Strategy. Key benefits The aim is to reduce the tension that pulls service areas into meeting day- to-day activity, at the expense of delivering and driving transformational change to meet our 2021 vision by: • Smaller number of directorates, focused on groups of services, not sites • Integrated approach to quality, performance, financial management and improvement • Strong and clear clinical leadership • Increased ability to resolve issues through clear governance, meeting structures and decision making • Clarity of performance, planning, and earned autonomy through devolution Patient centred . Excellence . Respect . Compassion . Safety

Trust Operating Model CEO • Move from 15 Directorates to 4 Divisions COO • Triumvirate approach throughout – 2 clinicians and 1 manager X4 Divisions • Reduce variation through consistent structures with strengthened roles X13 Clinical • Business Units Clearer decision making closer to service delivery X36 Specialities • Move to a “one team” approach Patient centred . Excellence . Respect . Compassion . Safety

Division Clinical Business Clinical Service Unit Women’s and   Breast Obstetrics Women’s Health  Children Gynaecology   Children’s and Younger Paediatrics Neonatology Person   Clinical Support Radiology Pathology Services   Diagnostics Radiotherapy Audiology  Medical Physics   Rehabilitation Speech and Therapies and Medicine Language Therapies   Rehabilitation Occupational Dietetics  Therapy Physiotherapy  Pharmacy  Outpatients   Haematology Palliative Care Cancer  Oncology   Surgery General Head and Neck Surgery Surgery  Vascular  Urology   T+O and Orthopaedics Ophthalmology  Ophthalmology Orthoptics   TACC & Pain Theatres Critical Care   Medicine Urgent and Emergency A&E Acute Medicine Care   Cardiology (incl Diabetes  Cardiac Renal Cardiovascular Physiology)  Stroke  Endocrinology   Dermatology Gastroenterology   Rheumatology Respiratory Specialty Medicine   Neurology Health Care of the Older Person Patient centred . Excellence . Respect . Compassion . Safety

Chief Operating Officer Divisional Clinical Director 4 Divisional ‘Triumvirate’ Divisional Divisional Nurse / Managing Midwife Director 13 Clinical General Deputy Divisional Nurse Associate Business Manager * /Lead Nurse/ Midwife / Clinical Unit (Clinical Professional Director Business Unit) Professional leadership 40 Specialty/ Clinical leads Clinical Service Operational/ * Professional lead in (Clinical Matrons clinical services groups CSS services/Specia manager lty) Ward/OP managers Admin and Nursing / Clinical staff business Patient centred . Excellence . Respect . Compassion . Safety Midwife/Therapy and (excl nursing) support ward staff

New Ways of Working 1. Governance outlined in: The organisational structure for the • Governance Guide Divisions is part of a bigger picture of • Meeting structures change to enable us to meet our ambitions • The Executive Devolution policy to deliver our 2021 Strategy. We need to support new ways of working, 2. People Capability strengthened by: where we are all clear about how things • New roles developed work in the Trust, where decisions are made • Person specifications revised to and devolving decision-making closer to match where the issues are, building more • Rigorous assessment and selection freedoms and flexibilities to make changes. processes We want everyone to have a clear sense of 3. Enabled by: direction and how what they do makes a • Organisational Development Plan real and important difference to how we • Agile Working Policy deliver our services to our patients. • Corporate Offer Patient centred . Excellence . Respect . Compassion . Safety

Governance Guide: • A quality and safety culture is everybody’s business and every member of clinical and non -clinical staff has an important role in making governance and assurance work across all of the organisation. • The Guide sets out for staff how ULHT governs and assures itself in respect of the development and delivery of its vision, strategy and core priorities. What is Governance Decision making • • Sets out the arrangements for direction and Sets out the roles and responsibilities for control, decision making processes and governance for the Board, CEO, Executive authority, covering: Team, Clinical Divisions, CBUs, Speciality/Clinical Teams and Wards and – Clinical Governance Departments. – Corporate Governance – Standing Orders – Assurance – Scheme of Delegation How we set Strategy – Standing Financial Instructions • Looking forward – Executive Devolution Policy • Aligning to the STP Assurance • Aligning to our vision and ambitions • Board Assurance Framework Turning ambitions into reality • Board Committees • Operational Plans • Clinical governance • Shaping our plans each year Performance Management Patient centred . Excellence . Respect . Compassion . Safety

Meeting Matrix: • Sets out the proposed meetings to support the future governance. Tier 1 Tier 3 Board Level Divisional Cabinets x4 • • Statutory Committees Divisional management • Assurance Committees / quarterly Audit Engagement Committee • • Regular Forums, Committees, Meetings ULHT Charity Trustees • Team Brief – to be disseminated by Tier 2 Divisional and CBU leads Corporate/Trust Wide Management • Business as Usual • Improvement • Performance Management • Strategy, Policy and Transformation Patient centred . Excellence . Respect . Compassion . Safety

Executive Devolution Policy: • Sets out ULHTs policy direction for the delegation of authority and decision-making power to Divisions, including devolution of control through the system of ‘Earned Autonomy’ . Purpose Benefits • • Outlines how the Chief Executive and Clarify roles and responsibilities Director of Finance devolves permission • Shape our future services though to act. clinical and managerial ownership • Aims to empower each Division to run • Earn autonomy to plan service its own business through earned investments autonomy. • Greater levels of autonomy and • Build on firm foundations of clinical decision-making rights with the ability to quality and maximising operational more easily restructure and reshape effectiveness through strong local services performance and financial management. • Effective and robust performance management regime that recognises and rewards good performance • Promotes a culture of transparency and openness Patient centred . Excellence . Respect . Compassion . Safety

People capability strengthened: • Defines the organisational structure, skills, capabilities and competencies required to support operational processes and activities. People skills and capabilities Strengthened structure • • Outlining who and where activities are Over 100 roles performed • Revised JD’s and person specifications • Building capacity for the future • Internal and external adverts • Supported by an OD plan which focuses • Assessment centres based on values on building individual capability, and a • Appointed candidates involved in later strong sense of teamwork. This will recruitment support the Divisions to implement TOM • Likely outcome - existing and new Ways of Working. external staff appointed Patient centred . Excellence . Respect . Compassion . Safety

The new ways of working will be supported by: Organisational Development Plan Agile Working Policy • OD plan sits within the over-arching framework of the People Strategy, which • Develop modern working practices will support the Divisions to implement which enable the Trust to operate its TOM Ways of Working. buildings more efficiently and cost • Create open and transparent effectively whilst enabling employees to engagement with every member of our maximise their performance. staff in changing our ways of working. • Facilitate new ways of working • The Plan works through facilitated by technology and digital – solutions. Our vision and narrative – Linking our People Strategy Corporate Offer – System and processes – Hearts and minds • Developing the corporate offer for – Measuring impact Divisions – how they will support – Communication and Divisions to be successful. engagement Patient centred . Excellence . Respect . Compassion . Safety

We want your views? • In groups, please discuss the following : • How will our new TOM structure improve patient care? • How will the new ways of working improve how we deliver our services? • How will this way new way of working improve how you can do your day-to-day work? Patient centred . Excellence . Respect . Compassion . Safety