Programme Delivery

Delivering a service reconfiguration programme requires the management of complex process of development and political management of clinical and non-clinical communities alike

Programme Complexity in Service Reconfiguration

Clinical Engagement

At the centre of any service reconfiguration is the need to meaningfully with the clinical community to develop, review and agree clinical models. Creating an early consensus on the direction of travel is a key input to managing the development of the clinical models

Non-Clinical Engagement

Whilst clinicians are central to the development of the proposals, finance, workforce and estates often play as significant a role within the programmes, and can but not always have different priorities to the clinicians

Stakeholder Engagement

Stakeholder engagement is often the most complex and politically challenging. Our experience is that early engagement which is meaningful provides the opportunity to bring stakeholders on a journey which will develop through the process. However, the NHS works within constraints which might be at odds with the perception of local communities or individual stakeholders.
Whilst local communications and engagement teams will have knowledge and understanding, we have experience of across all our engagements of working with these local stakeholders,

Programme Leadership

Clinical, Non-Clinical and Stakeholder engagement is complex and most likely driving in different directions. Leadership in these environments becomes a key factor of any service reconfiguration, to allow decisions and to move the proposals forwards. Our national experience allows

Programme Structures

Each programme structure needs to respond to both the clinical services involved and the local context. However, within this key structures have a roll regardless of the shape or nature of the proposals.

Assurance

In addition to NHS England’s responsible for service reconfiguration, a number of other bodies play an assurance role within the process of developing proposals.

Health & Well Being Board

Assures the wider health system of the alignment between the proposed changes and the needs of the population

Key structures

This group brings together the clinicians that would responsible for developing the proposals. Sub-groups might also be established for particular clinical services
This group is responsible for the financial assessment of the options and associated modelling. Task & Finish Groups might be established to over see estate proposals or activity modelling.
This group oversee the communication and engagement with the local population, as well as the set piece engagements such as the Case for Change launch and Public Consultation
This brings the key decision-makers that need to support the proposals, prior to individual decisions within the statutory organisations

(Joint) Overview and Scrutiny Committee

Enables the local authority to undertake its scrutiny functional of significant change. Joint Scrutiny Committee can also be established

Public, Patient and Carer Engagement

Whilst both the Case for Change and Public Consultation will require significant engagement, there is also a need for meaningful engagement within the development of any proposals. Stakeholder Reference Groups, Patient and Carer Panels, or domain specific Deliberative Events all provide programme structures for engagement.

Clinical Senate

Undertakes the scrutiny of the clinical proposals on behalf of NHS England

Delivery Challenges

Time | Often changes are being made to clinical service because they have to be made. This might be the risks associated with estates, lack of appropriate workforce, or changes in clinical guidance, however there is a need to deliver a decision by NHS Commissioners against this backdrop
Interdependencies | As with any multi-dimension programme developing robust proposals requires a complex set of inputs and outputs, to be delivered against complex set of internal and external stakeholders. Managing
Decision-Making | Whilst some proposals can be simpler, such as stroke or some community services, often changes within an acute setting will require a wider clinical, financial and engagement footprint, creating mutliple levels within the programme structure. This in itself, unless tightly managed can create delay and misalignment in delivery planning.