Proposed GSTT and GSTS joint action plan

Proposed GSTT and GSTS joint action plan

Draft for discussion purposes

30 October 2013

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• This action plan is intended to allow GSTT and GSTS to monitor and evaluate progress towards agreed goals and resolution of issues in terms of the provision of pathology services to the Trust arising from the GSTT review performed during summer 2013 and presented to the GSTT Audit Committee

• Most workstreams are expected to be complete by the end of March 2014

• Each workstream has an executive lead from GSTS and a designated workstream lead from both GSTS and GSTT

• The workstreams are covered by four overarching themes

Introduction

Theme Workstreams Executive lead Page

Innovation and service improvement

1. Investment in R&D2. Clinical and scientific leadership3. A&E pathway4. Phlebotomy5. Contract management: TSA

Rab McEwan (David Wells from November 2013)

45678

Employee and clinicianengagement

6. One Organisation7. Employee experience and

engagement8. Training and development

Steve Bennett 910

11

Finance and Commercial 9. CCGs and specialist commissioning10. Price per test11. Information management12. 3rd party contract novation

David Brown and 12131415

Working together 13. Shareholder relations and alignment of business plans

14. Contract management process

Richard Jones 16

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2DRAFT FOR DISCUSSION PURPOSES ONLY

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• Obtain GSTT/GSTS JPC sign off on this plan at their next meeting [date] following revision of the terms of reference

• Each workstream will be monitored on a weekly basis by the GSTS and GSTT lead, with exception reporting to who will co-ordinate reporting of overall plan progress to the GSTS exec team

• and will meet with for a progress and issues update once per fortnight

• Monthly programme review at the JPC

• A full review of the programme will be undertaken and issues discussed by Richard Jones and Amanda Pritchard in December 2013 and March 2014

• The Audit Committee will be updated following these meetings in order for the committee to gauge progress against objectives

• Additional GSTT internal governance arrangements TBC

Programme governance

DRAFT FOR DISCUSSION PURPOSES ONLY 3

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GSTS exec lead: Jonathan Edgeworth GSTS workstream lead: GSTT lead: Ian Abbs Completion date: 31/3/2014

OBJECTIVES Increase visibility of R&D activity to our Users and staff through the Innovation Academy

Further develop metrics for measuring the impact of innovation and service developments driven by our senior Scientific and Medical staff - to include element of critical review from Users

Further develop collaborative partnerships between industry and our charity to support R&D delivery.

Be a full partner to GSTT/KCH as an academic health science centre, supporting teaching and research.

APPROACH Liaison between Clinical and Scientific leads to identify Service and R&D priorities within each speciality:

- Scientific and Medical Director to communicate 2014 R&D opportunities to the executive team.

- Resource allocated to support prioritised R&D activity (to include Innovation Fund awards)

- Scientific and Medical Director to measure and report quarterly progress against delivery of priorities to the executive team.

Rolling programme of symposium and workshop for 2014 driven by the Innovation Academy to highlight and support current and proposed R&D activity. .

DELIVERABLE DATE GSTS RESOURCING GSTT DEPENDENCIES

Appoint lead for GSTT 31/10/2013 n/a Sign off of all deliverables on behalf of GSTT by GSTT lead [TBC] Overview of 2014 R&D opportunities from GSTT services 30/11/2013 Scientific Lead,

R&D 2014 investment priorities identified and supported – part informed by BD and GSTT (including University requirements and NGS opportunities)

31/11/2013(spec al focus on relations with industry)

Complete list of R&D active senior Scientists by speciality. 15/12/2013

Full 2014 programme of events for Innovation Academy that is complimentary to R&D direction. Events to be part sponsored by Industrial partners

31/12/2013

Full suite of assessment tools (including mechanism for peer review) 31/3/2014

Support GSTT charity bid As required Leaders in Innovation group to liaise with charity


1. Investment in R&D

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GSTS exec lead: Jonathan Edgeworth GSTS workstream lead: Jonathan Edgeworth GSTT lead: Ian Abbs Completion date: 28/2/2014

OBJECTIVES Ensure that GSTS operating structure is reconfigured to bring Scientific and Clinical Leadership to the heart of the organisation (January 2014)

A Scientific Leader to join the executive team to inform service innovation and quality agenda (January 2014)

Scientists and Clinical staff to develop the innovation and service development strategy in collaboration with our Users, BD and external drivers (January 2014)

Development of our future leaders in Innovation and Quality through the provision of mentoring and formal programmes of professional learning

APPROACH Identify Scientific and Medical lead for each speciality.

For each speciality clarify accountabilities responsibilities and ways of working.

Scientific and Medical Director to work collaboratively to co-ordinate scientific and medical leaders respectively

Scientific and Medial leaders present innovation and service development direct to board – a thematic approach e.g. Quality; Development of our Staff; Development of our BioinformaticsCapabilities; Building a common approach to NGS and Separation Science (MS); Cancer Diagnostics; Primary Care; Forging more mature links with our academic partners.


Jonathan Edgeworth to attend monthly JPC meetings 20/11/2013

sign off

Board sign off

n/a

input and sign off

n/a

Ann Macintyre sign off

Reporting structure in place 31/12/2013

Increased scientific representation on exec Board TBC

Leaders in Innovation group to meet at 6 weekly intervals. Outputs to be communicated to Exec/board.

Group to meet from [date] Innovation group leaders

Agreement of remuneration and performance management framework for clinical leads 31/12/2013

Professional development offering to staff in place (see workstream 8) February 2014

New leadership structure in place for Scientific and Medical staff 31/1/2014


2. Scientific and clinical leadership


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GSTS exec lead: Rab McEwan (David Wells from November 2013)

GSTS Workstream lead: GSTT lead: Amanda Pritchard Completion date: 30/11/2013

OBJECTIVES Achieve agreed turnaround times (TAT) for ED

APPROACH Root Cause Analysis (RCA) in key areas of the process

Map specimen workflow from venepunture to result available

Observational time and motion studies to baseline times

Apply LEAN methodology to eliminate waste in the process

Assign Urgent Sample Co-ordinator to facilitate the above

DELIVERABLEDATE GSTS RESOURCING GSTT DEPENDENCIES

Root Cause Analysis covering RRL, CSR and Main Laboratories

31/10/2013 to sign off

Corrective action plans in response to RCA analysis worked up and submitted


Provide OPMS data on a weekly basis for TAT. Contract variation to reflect amended KPIs in place

1/11/2013 older

(contract variation)

to sign off contract variation

Implementation of the Urgent Sample Co-ordinator


New Biochemistry Roche c8000 systems are commissioned and operational


Vacancies are filled and adequate workforce in place for Blood Sciences



3. ED Pathway for Blood Sciences Specimens

6DRAFT FOR DISCUSSION PURPOSES ONLY

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GSTS exec lead: Rab McEwan (David Wells from November 2013)

GSTS workstream lead: supported by

GSTT lead: Amanda Pritchard Completion date: 31/1/2014

OBJECTIVES Ensure that OP phlebotomy services at STH move out of portacabin into purpose-built Trust Facilities by Nov 11th, as per project timelines

Maintain current contractual KPI performance with STH of 100% of inpatients bled by 10am.

Consider a variation to contract to extend the 10am bleed KPI to Guys Inpatients.

Agree a contractual waiting time KPI at Guys outpatients (dependent on current volume of patients)

Agree timeline & funding arrangements for remodelling project of Guys OP phlebotomy services with GSTT following implementation of the STH changes (timeline to be advised)

APPROACH Build support with GSTT stakeholders via the JPC meeting forum to agree timelines and shared funding for the Guys OP refurbishment project

Continue engagement with GSTT Lead Nurse & Assistant Director of Clinical Development, Consultant Body and other Trust Stakeholders


Decant from STH phlebotomy portacabin November 2013

11/11/2013 n/a

11.28 min STH OP waiting time Contractual KPI –implementation date TBC

n/a

100% of (available) inpatients bled by 10am 1/10/2013 Patients available for bleeding

Service moves to ground floor of the South Wing 11/11/2013 Essentia

Ensure PPT model includes recurring costs for additional staff as agreed with JPC

31/12/2013 Sign off of PPT in December 2013

Phase out use of locums by January 2014 31/1/2014 n/a


4. Phlebotomy

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GSTS Exec lead: GSTS workstream lead: GSTT lead: Martin Shaw Completion date: 31/12/2013

OBJECTIVES Amend TSA to ensure that it is fit for purpose and allows both parties to be held to account using appropriate agreed contractual levers

APPROACH Resolve urgent priority areas such as flooding, chute and portering issues (Trust action) as these are impacting on GSTS’ ability to deliver services

GSTS to develop full service specifications with service levels and KPIs

GSTT to provide prices for new specifications

Both parties to negotiate and agree prices and SLAs for each service

Front end terms and conditions governing all services to be agreed

New TSA signed by 31 December 2013 (in line with Member MOU)


Obtain interim solution to flooding issue at Guy’s Hospital (GSTT DELIVERABLE)

31/10/2013 key contact and Essentia to provide details of solution

Detailed service specifications, service levels and KPIsfor each Trust service, including chute and porteringrequirements

31/10/2013 fortnightly meetings

Pricing negotiated and agreed 14/12/2013 to sign off

Final form contract for signature 31/12/2013 to sign off


5. Contract management: TSA


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GSTS Exec lead: Steve Bennett GSTS workstream lead: Steve Bennett GSTT lead: Ann Macintyre Completion date: ongoing

OBJECTIVES Our overarching objective is to create a unified culture and establish GSTS’ credentials as a market leader

Unify stakeholders around an agreed organisational vision, purpose & brand Create unity of purpose and ambition amongst all staff

Deliver, evidence and communicate on-going operational improvements

Communicate to external customers GSTS’ core purpose and role in the market

APPROACH This programme includes 9 interrelated workstreams:

1. Shareholders: Align the JV partners (GSTT, KCH & Serco) around a renewed vision and purpose for GSTS.

2. Rebranding: Develop, launch and gain full acceptance of a new brand for GSTS.

3. Clinical and Scientific Leadership: Develop, consult and implement a new model of clinical and scientific leadership within GSTS.

4. Operational Leadership and Delivery: Align operational leadership and service delivery to ensure tangible actions on the ground.

5. Laboratory Structure, Resourcing and Performance: develop optimal laboratory staffing and management structure and supporting framework

6. Customer Sales, Marketing and Contract Management: Implement an effective sales and marketing plan, an approach to account management and increase the capability of the Commercial function.

7. Employee Proposition: Implement an employee proposition that will ensure the attraction, development and retention of a unified, aligned and motivated workforce.

8. Web Site: Develop and launch a powerful new web site that communicates the new brand and supports sales and staff recruitment.

9. Communications Framework: Establish effective internal and external communications channels and key messages for engaging with stakeholders.

See detailed One Organisation plans and project timelines

Employee and clinician engagement

6. One organisation


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GSTS Exec lead: GSTS workstream lead: Steve Bennett GSTT lead: Ann Macintyre Completion date: Q1 2015

OBJECTIVES Build positive employment brand to strengthen loyalty with existing staff and attract future hires

Improve staff retention to levels better than NHS average

Create unity of purpose and ambition amongst all staff

Build better links between Operations and Corporate functions

APPROACH Establish strong and effective leadership capability throughout management cadre

Evaluate current performance and potential and implement appropriate development plans

Strengthen through new hires where necessary

Maximise value to staff of overall compensation package – introduce flexible benefits, address key areas of non-competitiveness

Establish best possible information sharing and consultative mechanisms – create genuine employee involvement

Establish an intranet

Establish local, site and group wide employee recognition systems

Create all employee participation through ‘John Lewis Partnership’ style profit share arrangement


Launch intranet 3/1/2014 n/a

Objective assessment of current management capability and development needs

31/1/2014 n/a

Tailored leadership development programme that is compatible with and supports improved service delivery through employee engagement

1/3/2014 n/a

Identify a range of employee recognition systems

31/3/2014 n/a

Employee consultation and involvement ‘charter’ with structure and methodology

Q3 2014 Ann Macintyre sign off

Communication plan re: alternative compensation structure / flexible benefits

Q4 2014 Ann Macintyre sign off

John Lewis Partnership style employee participation proposal

Q1 2015 n/a


7. Employee experience and engagement


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GSTS exec lead: Steve Bennett GSTS workstream lead: Steve Bennett GSTT lead: Ann Macintyre Completion date: 30/6/2014

OBJECTIVES Establish GSTS capability to deliver statutory, mandatory and regulatory compliance induction training and periodic refresher and re-accreditation requirements.

Develop and deliver operational and change leadership training programmes to support delivery of strategic objectives.

Respond to collective and individual development needs identified through annual PPR and PDP processes.

Create training paths and ring-fence funding to support the establishment of scientific career paths for entry level, graduate and post-graduate staff across GSTS.

APPROACH Evaluate options of 3rd party statutory and mandatory induction and refresher training provision and internal or blended solution.

Utilise outputs of management performance & potential review. Identify specific requirements (e.g. Kotter change leadership model) and select suitable external provider.

Ensure 100% adoption of PPR and PDP processes and monitor training & development outputs – prioritise requirements in context ofaffordability on annual basis.

Adopt Modernising Scientific Careers (MSC) framework to establish GSTS structure for scientific career pathways. Recruit expertise to oversee the programme.

Create communications to establish internal awareness of. and competition for scientific development opportunities and build external ‘brand’ to attract new staff.


Comprehensive list of statutory, mandatory and regulatory compliance accreditation requirements at speciality lab level.

31/12/2013 n/a

Appropriate leadership development programme(s) that address identified needs.

1/3/2014 Ann Macintyre input

Full integration within OPMS 31/3/2014 n/a

2013 PPR and PDP outputs 31/1/2014 n/a

MSC framework-based career pathway structure for scientists

31/12/2013 n/a

Structured training programmes for scientific staff 28/2/2014 n/a

Internal and external comms programmes to market scientific training and career opportunities

31/3/2014 n/a

Formal /contractual arrangements with relevant academic institutions

30/6/2014 n/a


8. Training & Development


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GSTS exec lead: GSTS workstream lead: Tony Sackville (specialist commissioning), Chris Granville (CCGs)

GSTT lead: Martin Shaw Completion date: 31/3/2014

OBJECTIVES To develop and implement a sales and marketing plan that will help mitigate the financial risks to GSTS from the novation of contracts, particularly CCG contracts for direct access pathology

To develop and implement a sales and marketing plan that addresses the markets for specialist tests, nationally commissioned services and the international market

APPROACH The existing sales and marketing plan needs to be updated to reflect the latest thinking about:

the priorities for marketing specialist tests (based on the ‘Crown Jewels’ review by GSTS)

the opportunity to take on work from the PRUH

International opportunities (especially in the Middle East), by building on GSTS and GSTT relationships

the changing landscape for national specialist commissioning (e.g. genomics, new born screening)

approaches to increasing demand from GPs in South London through better account management and a stronger GP service offering

This will build on the new account management approach that is being used (territory sales allocation and management of strategic accounts)


Meet with and continue dialogue with CCGs First meeting 10/10/2013

to attend initial meeting (complete)

Report on priority specialist tests & services 15/11/2013 n/a

Obtain agreement on priority specialist tests and services from clinical and scientific leads and key GSTT contact

30/11/2013

Sales & marketing plan (update) with budget for 2014 30/11/2013 n/a

Marketing collateral for priority specialist tests 31/12/2013 Support from GSTT commercial team on international marketing

Novation implementation plan (& successful novation) 31/3/2014 (see workstream 12) sign off

Finance and commercial

9. CCGs and specialist commissioning


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GSTS exec lead: David Brown GSTS workstream lead: GSTT lead: Martin Shaw Completion date: 31/1/2014

OBJECTIVES Agree price per test with GSTT to replace existing DU arrangements in line with Contractual agreement with GSTT

Identify how activity will be counted in PPT pricing contract variation

Identify what is chargeable activity

Documented taxonomies are agreed with GSTS and underpin the price per test exercise – so that it is clear exactly what is being paid for and when an activity is (or is not) chargeable.

APPROACH Perform full costing exercise in order to calculate a price per test to replace existing DU rates

Agree price per test thought engagement with key clinical and scientific leads

Send out list of top 110 tests to Lab Managers which represent 70% of PPT income per year

Use tabular format to complete a taxonomy document which will be appended to the Contract variation

Work over the next 6 months to increase the coverage of test definitions to get to 90% complete by 1 April 2014


Agreed price per tests signed off 5/11/2012

Datawarehouse goes live 22/11/2013 n/a

Agree taxonomy definitions for the top 110 tests, including chargeable and non chargeable definitions

10/12/2014 sign off

Go live of PPT 1/1/2014 sign off

Taxonomy Document as appendix to PPT Contract variation. To be signed off by GSTS and GSTT

10/12/2013o sign off

Agree taxonomy definitions for all tests 31/3/2014 o sign off

Finance and Commercial

10. Price Per Test


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GSTS Exec lead: Marc O’Brien GSTS Workstream lead: GSTT lead: Steve McGuire Completion December 2015

OBJECTIVES Select & Implement a new LIMS for the GSTT laboratories by 31st December 2015

Ensure implementation facilitates growth and minimises risk for the service

APPROACH Select new LIMS

Validate fit for Blood Transfusion

Implement Integration Layer that supports growth and take on of new labs

Implement electronic order comms for GSTS

Implement new LIMS

Projects will be service led and each stream will have a clinical, operational and scientific lead


Fund approval for LIMS project 16/10/2013 (complete) n/a

New MHRA BT LIMS implementation 31/1/2014 GSTT programme board member input as required

Product selection 31/1/2014 GSTT programme board member input as required

New LIMS for all other specialties 31/12/2015 GSTT programme board member input as required

Integration layer to address needs of new Labs joining our networks, labs taking on new test business from 3rd parties

Ongoing GSTT programme board member input as required

CSR functionality to facilitate CSR users in processing samples

31/12/2015 GSTT programme board member input as required


11. Information Management – LIMS Upgrade


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GSTS exec lead: GSTS workstream lead: GSTT lead: Martin Shaw Completion date: 1/4/2014

OBJECTIVES Novate all third party contracts as per the signed MOU (dated 17 July 2013) by 1 April 2014

Ensure GSTS processes and policies are amended as appropriate to enable smooth take on of these contracts with minimal impact to customers

Novation value per customer agreed and the baseline activity and monthly invoice amended accordingly

APPROACH For each contract, the following must be agreed between GSTT and GSTS

Is the contract in scope

Is the contract profitable under agreed PPT

What is the bad debt risk

What is the risk that the customer will not wish to novate and/or that the contract will be lost as a result of novation (triggers for retender of services)

Customer communication to be led by GSTS BD team – customer visit, phone call, written communications

Knowledge transfer from Trust to GSTS BD and finance team as appropriate

DELIVERBLE DATE GSTS RESOURCING GSTT DEPENDENCIES

Full list of all contracts showing those to be novated, those out of scope (with reasons) and novation value signed off by David Brown and Chris Bowler

30/11/2013 – finance and overall signoff, fortnightly meetings and involvement as required. GSTT finance staff to provide data as required

– Contracting lead, fortnightly meetings, involvement as required

Full suite of process documentation completed by GSTS and available for inspection by GSTT

31/1/2014 n/a

Communications plan and communications documentation for customers and staff

31/12/2013 (customers)

(staff)

n/a

SLAs signed by customers where this has been agreed / general business terms sent to other customers

31/3/2014 n/a

Novation value signed off at GSTS board level, customers billed and GSTT invoice adjusted accordingly

15/2/2014 Sign off by


12. Novation of 3rd party contracts


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GSTS exec lead: Richard Jones GSTT lead: Amanda Pritchard Completion date: 31/12 2013,

Ongoing monitoring and review

OBJECTIVES This is an overarching scheme underpinning all the individual workstreams

In response to known issues and those highlighted by the Trust review there are a number of processes which should be clarified or amended in order to enable better communication between the two organisations and align their respective goals

APPROACH We recognise the need to work differently to improve our working relationship and this should be addressed through a number of new processes,

Shareholder relations:

Agree key issues with the shareholder group and ensure ongoing effective communication, egVAT, Contract novation principles

Alignment of business plans

Engage with Trust business planning and ensure GSTS plans are aligned with key objectives

KEY MILESTONES DATE RESOURCING

Review JPC terms of reference and amend as appropriate.

GSTS GM to attend Trust GM meetings

Continually work to identify areas appropriate for transformation across GSTT and KCH

Trust to identify a senior GSTT representative to be key point of contact between the two organisations and confirm appointment to GSTS

Joint project to provide root cause analysis regarding why specialty codes are not being captured by current systems and agree a joint action plan in order to resolve this

Jointly develop revised appropriate KPIs to be used in TSA end PSA contracts (see workstream 5 and 14

Trust to confirm GSTT internal governance and key leads for each workstream

GSTS to attend Trust Directorate annual planning meetings to enable alignment of business plans

Ongoing review and monitoring by Richard Jones and Amanda Pritchard

30/10/2013

30/11/2013

Monthly meeting commencing December 2013 – TBC

31/10/2013

31/3/2014

31/3/2014

30/10/2013

22/10/2013

Ongoing

, with sign off by Richard Jones, Amanda Pritchard and

to attend

(GSTS), (GSTS), GSTS executive team , KCH leads

(clinical and operationsal), (finance and commercial)

[TBC]

See workstreams 5 and 14

Richard Jones and Amanda Pritchard

13. Working together


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GSTS exec lead: Richard Jones GSTS workstream lead: GSTT lead: Martin Shaw Completion date: ongoing

OBJECTIVES Ensure that PSA is fit for purpose in respect of obligations on GSTS

Monitor service delivery and KPIs in PSA and TSA

Ensure contractual compliance

Address any issues and/or complaints which may arise

Amend contracts with CCNs or contract variations as required

APPROACH Clearly define operating brief for GSTS Contract Manager and Trust Authorised Officer

Develop proactive approach to ensure quality of service

Maintain a log of any issues arising

Hold regular meetings to monitor progress and arrange further ad hoc meetings are required to address specific issues

Define a clear escalation process

DELIVERABLE DATE GSTT RESOURCE GSTT DEPENDENCIES

Appointment of GSTS Contract Manager (completed)

1/10/2013 n/a

Agree updated KPIs to be monitored in the contract

31/12/2013 to design KPIs to sign off on KPIs

Monitor TSA when this has been agreed

31/12/2013

Ongoing issues log Ongoing

Compliance audit 30/6/2014 External party External party

Working together

14. Contract management process


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Proposed GSTT and GSTS joint action plan

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