business continuity response midlands region th april 2020 · rlt meetings organisation regional...

NHS England and NHS Improvement

Business Continuity Response Midlands Region

6th April 2020

2 |

Performance and Improvement slide 3-10

Finance slide 11- 15

Workforce and OD slide 16- 17

Medical slide 18- 23

Nursing slide 24- 28

Strategy and Transformation slide 29- 31

Commissioning slide 32-

Contents

3 |

Performance and Improvement

Service Area Work that is required to continue Work that can be postponed Who else is affected Other issues such as staffing compromisedbecause of recall

Regional Analytics NH has spoken with lead about how can support Covid however, tasks are being primarily co-ordinated by national team

Links to regionally managed analytical capacity in the PMO and RightCare

Regional Access Team Outpatients transformation - See next column - resource where available will be focused on supporting video consultations and patient initiated follow up - regional team speaking with Digital team.

(Miranda Carter draft letter 18/3);"we are reprioritising our outpatient transformation work to focus on video consultation and patient-initiated follow up"

Links to other teams including Digital, Op Prod, RightCare, GIRFT,

Asked all staff to go onto ICC rota

Support utilisation of independent sector capacity, tracking and assuring use - TBC

All other work not listed in previous column can be postponed

Asked staff to see if can support system ICCs

Managed choice - continue to develop approach, as will be key part of post Covid recovery approach, to support waitng times recovery. Not intense, but national team keen to not lose focus and want Midlands to continue to support development.

Cancer waiting times assurance - need to consider reasonable approach

Diagnostics - see Op Prod re capacity resilience. AA has drafted risk assessment paper, with recovery actions and internal oversight approach

52 weeks - AA has drafted risk assessment paper, with recovery actions and internal oversight approach

4 |



Regional UEC Team UEC - Daily Operations / Safety Support

UEC Transformation ECIST Staff with current or recent registration;

? SaTH improvement offer -Ambulance support

Ageing well programme (inc Frailty) Need to consider management/induction of new starters 1/4

David Ashford (ideally retain in UEC team to run ops)

Webinar Support and Practical guidance for flow

ECIST on-site activity Jenny Sears-Brown

? Worcester support offer - relatively limited but will require Ian S and ECIST input

Hands on service improvement Chris Morrow-Frost

Leicester programme - HHO delays -awaiting feedback from AO on how to proceed

Wendy Hoult

UEC Ops staff deployed to ICC (full numbers to be confirmed)

5 |



Regional PMO Team All current work can be suspended and support offered where required

Programme Governance oversight development

Programmes Staff can mobilise to whatever is required – overseeing what is left of bau, supporting the ICC (reporting or otherwise utilising the Analytics team as well), or anything else.

20/21 planning and monitoring oversight development

Regional Analytics In terms of preparedness we are closing down what we can, and the position on staff is as follows:

Business cycle proposal / Operating Model development

Programme and S&T Locality Teams x 1 Transformation Lead (Farhaj Pathan) – volunteered to support the Quality Cell

20/21 Operational Planning support -postponed nationally

Programme and S&T Locality Teams x 1 Programme Support Co-ordinator – wfh due to long term condition

WM Performance reporting (legacy to end of March 20)

Wm S&T Localty Team

6 |



RightCare Assumption is that zero normal R/C work is required to continue

From a national perspective RightCare is temporarily stood down

R/C work links to many of our directorates

No staff with clinical registration

R/C team members, especially Delivery Partners could support the following - taken from M Carter draft letter (18/3);"For a period of up to 6 months we will, rather than supporting general development work with systems, look to focus this work with systems on areas where collaborative working and integration enable more effective management of COVID-19"

One member of team is seconded out to a system, other team members could support system working potentially

Assuming the following will be stood down;Expert Advisory Groups (R/C supports number of these)

Links to Op Prod and GIRFT given plans to integrate the offer across the three teams

Meetings/ data packs on unwarranted variationSystem transformation meetings

Work on supporting planning round

Work of the analytical team in R/C

GIRFT Although not transferred to the region

Discharge co-ordination support -however this needs to be clarified as to what, where, how etc.

From Miranda Carter draft letter (18/3);"GIRFT visits to trusts have been stood down with resources concentrated on supporting hospital discharge coordination;"

Staff not yet transferred to region.

7 |

Performance and ImprovementNOTE – TEAM SUPPORTS MIDLANDS AND EAST OF ENGLAND


Operational Productivity

Assumption is that zero or very limited normal O/P work is required to continue in current form (see below)

Assumption is that zero or very limited normal O/P prductivity work is required to continue

O/P work links to many of our directorates

See column - "Work that is required to continue"

Theatre productivity lead could support / provide assurance re: providers converting theatres and recovery facilities (if she does not work clinically)

Use of Resources assessments are stood down

Links to R/C and GIRFT given plans to integrate the offer across the three teams

Diagnostics lead is already supporting Covid response - liaising with labs to try and get them up and running with the testing capacity we need. We have issues with lack of testing capacity. Also picking up specific liaison with set suppliers.Procurement lead is already supporting Covid response (note role is due to transfer to national team 01/04/20One of the clinical leads is already on site - in SaTH supporting the DoN, and could support Covid response and/ or clinical dutiesThe other Clinical Lead is a trained and registered children's intensive care nurse who could support the regional Covid response and/ or undertake clinical duties

8 |



Intensive Support Coordination of Regional intensive support offer with the national team.

Coordination / support of system recovery plans

Medical and Nursing Quality Teams. None

Input into national IS governance arrangements

System review events / Round table events

S&T teams in SM trust localities.

links withother directorates re monitoring of CQC action plan delivery

System diagnostics

Mental Health We await national guidance on what work needs to continue, this may be limted ot the oversight of Out of Area Placements.

We are already involving ourselves in new work around C19 preparedness with systems (planning support and convening clinicians on re-purposing teams).

Our monthly assurance work was suspended on 18/3.

All of our assurance visits and escalations have been either cancelled or turned into calls with a much smaller representation from systems.

All of our Clinical Network activities that involve conferences/convening groups/mass participation taining etc have been stood down or converted to TC/Teams where possible.

We have suspended recruitment into the remaining 5 roles in the team - as they are likely to come from Trusts.

We have 24 staff who will shortly have little to do, but they are a talented and flexible bunch.

9 |


Service Area Work that is required to continue Work that can be postponed Who else is affected

Other issues such as staffing compromisedbecause of recall

Comms Already supporting Covid Events

Other comms work will need to continue but with discretion based on need/ urgency

SEG support

Weekly staff newsletters - to continue but via Teams and Covid focused

Daily media summaries

Monthly staff briefings - to continue but via Teams and Covid focused

Notes from Friday national leaders calls

Chief of Staff team Estates - day to day business continuity issues Estates - have agreed with Property Services and national Estates team that we should suspend work on the estates strategy and potential site changes, subject to RLT approval

Clare Harrison (Corporate Governance Manager) and Helen Austin (appointed as Business Manager) are already working in the ICC

Smarter working - continue to support use of Teams and other SW opportunities to support home working and non f2f meetings

National Corporate Executive Committee - being done via correspondence, will need to communicate anythig urgent, but this should come via EPRR routes one assumes

Interim Chief of Staff (to start 01.04.20) can play a role in c-ordinating the activities on this sheet, plus more direct support to ICC if required

RLT meetings organisation Regional Business Plan - need to understand national expectations but assuming work can pause

Closing actions relating to transition, including continued transfer of staff into new roles

Risk management - assuming work can pause on risk register management and national returns - TBC

Tracking of mandatory training - in line with draft M Carter letter (18/3) one assumes only relevant MAST will need to be undertaken and oversight conducted - TBC

Monthly Business Development meetings - pause until further notice

Regional budget management - need to understand what the plans are for oversight of proposed 20/21 budgets, especially where programme allocations are lower than expected.

Six-monthly Leaders' event - postponed until 23.09.20

Complaints, PQs, FOIs - assuming we will need to continue to respond, albeit volume and type likely to be different to normal working practices

Regional OD plan - will need to determine, what if any actions are essential in Q1

10 |

Performance and Improvement – Risks IdentifiedService Area Risk No. Risk detail SRO

(Senior risk owner)

RAG Rating Any mitigating actions RAG Rating after mitigating actions

11 |

Finance

Service Area Current team resource

Subject area Work that is required to continue

Work that can be postponed

Required resource Who else is affected Other issues such as staffing compromisedbecause of recall

Actions

Intervention

4 x 8d

Planning

Finalise starting points and underlying positions to support 20/21 baseline.

Working through plans to identify areas for improvement and closing the gap to trajectory

1 x 8d

Need to communicate to organisations to set out expectations

Draft email to all organisations setting out our approach to finishing off planning. (GD) 19/3/20

Intervention Oversight

Month end process to monitor financial performance and delivery against breakeven plans.Query any under or over spends with organisations

RAFOTsEscalation slidesFinance report

What will the national team expect from us?

Set up call with national and regional finance teams to agree. (GD) w/c 23/3/20


Year end process to finalise 19/20 financial performance

any additional requirements particularly around CCGss?

Expectations around year end process to be confirmed by the national teamwill there be the usual 'Heads up'?

Set up call with national and regional finance teams to agree. (GD) w/c 23/3/20


Validation of COVID-19 costs - expected to be monthly

Regional process to be agreed To agree through SFT

Intervention Covid-19

Confirmation of business continuity arrangements for CCGs and trusts

To provide support where needed to cover gaps at organisations. Weekly call with CFOs/FDs to be set up

Weekly calls to be set up starting from w/c 23/3/20 (SB)

12 |

Finance





Actions

Reporting

2 x 8b2 x 7

Oversight Monthly reporting processGeneral queries we get from national team


Reporting Oversight

Additional reporting requirements around COVID-19


Reporting OversightContinued development of reporting capacity

use time to do developmental work if possible

Corporate

1 x 8d1 x 8b1 x 8a1 x 7

BAU Monthly reporting process

1 x 8d1 x 8b1 x 8a1 x 7


Corporate BAU Establishment control

Corporate BAU Procurement support

Corporate BAU


Expectations around year end process to be confirmed by the national team

Corporate BAU Budget finalisationWhat will the national team expect from us?

Mental health OversightMonitoring of compliance with MHIS

Awaiting guidance from national team

13 |

Finance





Actions

Commissioning BAU


Expectations around year end process to be confirmed by the national team

Commissioning BAU

Validation of national work on block payments

20/21 contract negotiations and planning

Commissioning PlanningNo further work to be done on planning

Commissioning BAU

Performance management and monitoring of contracts

Commissioning SpecialisedPayments to providers

Commissioning SpecialisedMonthly reporting process


Commissioning SpecialisedQIPP development and delivery

Commissioning SpecialisedProcurements and evaluation

Commissioning SpecialisedProvider collaboratives

exact details to be confirmed

Commissioning Specialised

Drugs and devices monitoring and payment

Commissioning SpecialisedLiving donor payments

14 |

Finance


Subject area Work that is required to continue Work that can be postponed

Required resource

Who else is affected Other issues such as staffing compromisedbecause of recall

Actions

CommissioningDirect commissioning GP Core Contract Payments

Provided by external company

CommissioningDirect commissioning

GP Additional contractual payments e.g. Premises reimbursements, locums etc..


GP Enhanced Services & QOF payments generated through CQRS (Public Health & Primary Care QOF & Enhanced Services)

To be wrapped up into core payments and so expected to be done by external company but needs to be confirmed


Primary Care Dental Contract Payments


CommissioningDirect commissioning Ophthalmic Contract Payments


CommissioningDirect commissioning Pharmacy Contract Payments


CommissioningDirect commissioning Pharmacy Local Services Payments tbc


Secondary Care & Community Dental Contract Payments (under the NHS Standard Contract)

To be wrapped up into block payments to providers


Public Health Contract Payments (under the NHS Standard Contract)


CommissioningDirect commissioning Health & Justice Contract Payments


CommissioningDirect commissioning GP Pension Payover

15 |

Finance – Risks IdentifiedService Area Risk No. Risk detail SRO

(Senior risk owner)


16 |

Workforce and OD


People Plan Awaiting confirmation. Most will be stood down but there is a proposal to maintain some developmental work

See (c) Staffing demand from central directorate to support this will be clarrified by end of the week

People Board

Vacancies

Talent Board

Best Place to work initiatives

Establishment of Systems People Boards

ICS assessment frameworks

New Ask - Regional Workforce Cell

The national workforce cell has asked that we establish a regional cell with Regional responsibilities to link with work of the national workforce cell HEE

A number of staff fall into the 'heightened at risk' group and should not travel but are fit to work from home

Vacancies

17 |

Workforce and OD – Risks IdentifiedService Area Risk No. Risk detail SRO

(Senior risk owner)


18 |

Medical


Professional Standards -Professional Regulation (Statutory function -patient safety impacts)

Case management of High and Moderate risk cases, triage of new concerns (low risk to be de-prioritised, but keep under watching brief)PAG/PLDP and Oral Hearings (all be be completed virtually)

Low risk cases out of triage will be refered directly to appraisal for reflection. They will not be retained in PAG or on ARC. There will be a system to cross check back to ensure this was done when apraisla is back online. The only exception to this will be regulator level concerns, which we will continue to monitor.

2 x Programme Managers and 1 x band 6 are Nurses and may be called to front line care

Professional Standards -Revalidation

MAJORITY TO BE STOPPED - some admin resource needed to keep 'ticking over' and support vulnerable Doctors, answer phones, inboxes etc.

National pause expected - duration unknown, how this will be enacted unknown - bulk deferrals may be required if GMC don't suspend at their end, which will then require more 'skeleton' resource to be retained in NHSE which can't be dedicated to Covid-19 work.

Practitioners - will be delayed being revalidated, this will create a 'bulge' later in year and possible capacity issues for our teams. Will release capacity for clinical staff (Leads, RO's, Senior Appraisers) and admin staff (B6)

Staff may be taken unwell, and may lead to delays to respond

Professional Standards -Appraisal

MAJORITY TO BE STOPPED - some admin resource needed tokeep 'ticking over' and support vulnerable Doctors, answer phones, inboxes etc.

National pause expected - duration unknown, how this will be enacted unknown - if abstaining from undertaking appraisals will be mandatory, more resource will be available. Some skeleton staff will need to be retained to man phone lines, inboxes and keep admin ticking over. If it is a voluntary pause, some GP's may wish to be appraised, and if so, admi and appraiser resource will need to be retained to cover the associated admin and requirements to make this possible.

A portion of admin staff will be diverted to other Covid-19 duties Senior/Lead Appraisers will be diverted to other Covid-19 duties Programme management resource will be diverted to other Covid-19 duties

Staff may be taken unwell, and may lead to delays to respond

19 |

Medical


Professional Standards -System Transformation -Establishing by 1 April the following Midlands wide systems/processes

Must continue - core processes approved and established by 1 April: 1) Triage of new concerns2) PAG3) PLDP4) Revalidation 5) Clarification of alignment of staff to tasks and line management responsibilities

All other non-essential process development (unless staff have capacity to progress)

There will exsist a level of variation of approach in process and delivery until late 2020. Although core systems will have changed by 1 April - this will affect staff and practitioners in terms of the service and experience they receive.

This will delay effective establishment of Midlands wide working until late 2020, prolonging staff uncertainty

Professional Standards -Performers List

Work will need to continue to support entry to the list for GP's, Dentists, Optometrists. The workforce must continue to receive new staff andtherefore this remains a priority. Also have GP registrars coming online in summer. This will require the exsisting admin team (and HEE input for registars) and access to clinical lead signs off on behalf of the MD.

Unclear at present time, need national steer on the other PL work (transfers etc) and if this will be paused as non-essential.

Portal continues to present a risk and need active management.Staff may be taken unwell, and may lead to delays to respond/case manage - in this instance may need to pull resource from other PS Team areas to support.

Professional Standards -HLRO Appraisals and Quality Assurance (national reporting etc.)

MAJORITY TO BE STOPPED - some admin resource needed to keep 'ticking over' and support vulnerable Doctors, answer phones, inboxes etc. AOA should be ceased

National pause expected - duration unknown, how this will be enacted unknown - if abstaining from undertaking appraisals will be mandatory, more resource will be available. Some skeleton staff will need to be retained to man phone lines, inboxes and keep admin ticking over. If it is a voluntary pause, some RO's may wish to be appraised, and if so, admi and appraiser resource will need to be retained to cover the associated admin and requirements to make this possible.

20 |

Medical


Maternity & PMH Clinical Network

pending decision from national team, due by end of the week. Agreed at regional maternity programme board yesterday that focus remains on safety. Will still continue with recruitment process (8a and 4) as these can be managed virtually/remotely. Handover continues between Laura Sadler (leaving team) and Ian Rothera (joining team) around PMH.

all external meetings & events have been cancelled/postponed/ rescheduled till post summer. Any meetings with clinical staff are kept to business critical discussions only and managed by Teams. Awaiting guidance from national team but likely to include post natal improvement, neonatal critical care plans, maternal medicine, maternal mental health clinics.

staff, families, clinical services

All staff now working remotely. All work to be saved on shared drive. 1 member of staff marginally impacted as school is closed from 16th to 20th March for deep clean. 1 member of staff self-isolating for 14 days from 17th March due to potentially symptomatic child (advised to complete tracker)

CDAO

Statutory Functions - LIN, occurrence report submission, CD incident management, alerts, Private Prescriber PIN management, CD destructions (depneding on risk), CD prescribing monitoring. Have requested further national confirmation on the statuory role and OR reporting

Quality Improvement work - GP audits, newsletters, delaying self-assessments for GPs and Dentists

To ask all pharmacy trained indivisuals to support the Regional Pharmacist on the COVID situation

Service Improvement urgent & emergency care priorities 7 day services

keeping systems safe & effectivesupporting cancer alliance with STP performance concerns

workforce demands & challengessupporting PHE with Leicester medical practice patient reviews

mortality / reg 28s

supporting trusts in special measures ( 3 Trusts in particular)

CQC outliers

supporting systems to deal with demands of Covid19

effective management of complaints

screening programmes

complete the derby clinical review

21 |

Medical


East Midlands Clinical Senate

A decision was made on 11.3.20 to defer all Senate activities until (at least) May and the situation will be reassessed again in early May. This includes the decision to delay the start of the Senate Leadership Fellows.

All work could potentially be postponed. The NHS Rehab Centre clinical review (additional) is currently scheduled for 6.5.20. The implications for both the Senate and the commissioners has been raised with NS today and this will be taken to RLT for a decision.

Senate members work in a voluntary capacity and the Senate Council supported a leadership decision to reduce the risk to the workforce, and to free up people’s time to deal with the added demands of the Covid-19 situation.

This is a very real possibility in relation to the upcoming Clinical Review Panel.

West Midlands Clinical Senate

? DudleyHead of West already pulled to support COVID by system

IGPR

Supporting current cohorts in their new jobs, OH and GMC ID checks, NPL checks, Interviews, RO interveiws, consulation skills teaching, classroom teaching on campus, practice engagement events,

We are looking at doing Skype. GMC have indicated that they keep the window for 6 months open for providing document sfor registration. We are using Teams and doing a lot of this now virtually.

GP Candidates, supplier, educators, project leads in the localities

Impact on RO interveiws and sign off for GMC license to practice

CVD -R Clinical Network

Establishment of Stroke ISDNs, stroke rehab pilot in Northampton, establishment of east mids FH Service, National Diabetes Transformation of care. Continuation of shortened EAGs and CAGs via Teams to maintain regional leadership in vulnerable services, i.e Stroke, Respiratory, Cardiac, Renal, Diabetes. Management of national funding and bids for pilots in respiratory, stroke, Heart Failure, cardiac rehab, obesity.All of this work to support early discharge

longer term improvement programmes; primary prevention of CVD such as AF/HT, out of hospital heart attacks. Stroke ambulance pre-alert programme, cardiac rehabiliation. Pulmonary rehab programme. National Diabetes Prevention programme (national approval required to postpone this work). Renal transplant and CKD work programme. End and life and palliative care work programme. Diabetes footcare improvement programme.

EAG and CAG's. Clinical Directors CVD-R network has 1 registered nurse within the team. CD's unable to support networks

22 |

Medical


Cancer Alliances

Which cancer treatments to be prioritised, confirm and clarify which LTP issues should be delayed /slowed; operational performance (reduced),; stratified follow up

Team to be deployed within the systems to support cancer

Pharmacy -medicines Fully consumed in COVID and needs support

DigitalInfastructure support to connect systems and work virtually; Cyber security

LTP for system support paused; EPMA paused

23 |

Medical – Risks IdentifiedService Area Risk No. Risk detail SRO

(Senior risk owner)


24 |

Nursing


Specialised Commissioning

Quality oversight of Specialised Services Attendance at Trust/Provider Contract and Quality meetings

Specialised Commissioning Teams Reduced oversight of quality of Specialised Services due to staff supporting the Covid-19 ICC, localities, and maternity leave.

Supporting challenged providers e.g. St Andrew's HC Attendance at national quality meetings

Regional Quality Surveillance Teams (QST)

Serious Incident Management Routine face to face meetings

Provider collaborative Quality Support Attendance at non-essential events e.g. conferences

Independent Sector MH providers - support business preparedness and IPC requirements

Interviews to fill vacant posts (exploring VC/Skype options)

Patient Safety and Quality

Complaints handling conferences/away days

recuritment to vacancies YONM events

expert advice re quality and patient safety Routine face to face meetings

risk identification and management rollout of revised QSG operating model

Implementation of new patient saferty incident response framework

25 |

Nursing


Localities Supporting our challenged Trusts - ULHT via teleconference, continue to monitor quality and safety in ED

Visiting Providers and senior clinical staff

Complaint targets will deteriorate due to CCC now supporting NHS 111 and capacity of clinical reviewers.

Supporting ICC for Nursing and Quality, UEC ICC and oncall from senior nursing

Routine face to face meetings Slippage on programmed targets such as TC, maternity etc due to lack of capacity to support and challenge

Quality monitor and surveillance through intelligence including STEIS, CQC , local QSG

Conferences Loss of clinical staff due to the need to support local providers and increase sickness levels (Cally has the number of clinical staff in nursing). Weekend working

Prioritising programme work including TC tracking of patients and supporting discharge via teams/teleconference

Staff meetings Unable to fill vacancies due to challanges in recruiting

Responding to complaints and QA complaints

Health & Justice prisoners to be seen as vulnerbale patients; consider access for appointments on risk based approach - to add more

26 |

NursingService Area Work that is required to continue Work that can be postponed Who else is affected Other issues such as staffing compromised

because of recall

Safeguarding Working with national NHS Safeguarding team on safeguarding impact of isolation, risks, system support across region and regions.

Postponed our regional safeguarding conference (was arranged for 19.6.20 now we’ll plan for Nov time).

Region, all system wide; nationally too as a national - regional hybrid. National team aware we've postponed (as have other regions)

1. Numbers of vulnerable citizens being isolated/ social distanced who may be more at risk at home – forced to be with perpetrator of abuse/ potential abuse – thinking children subject to a protection plan, children in need status. Need to be aware of these cases and if they are known to be affected/ isolated and plans for picking up. 2. As above re domestic abuse victims 3. As above for adult safeguarding plans 4. Need to consider Looked after Children and system support to foster carers re health and isolating etc. 5. need to work with partners LGA, PHE etc re vulnerable groups - homeless, those in temp accomodation re health advice

Set up an internal log of activities on hold etc so we can reprioritise when we are the other side of this

Put on hold the safeguarding training regional scope. Region wide; commissioning of

training potentially at level 3

ICS safeguarding development work (but I recommend we switch this to safeguarding system Covid support work and use date planned and subsequent dates to support system on this)

I’d suggest put on hold the regional safeguarding commissioning assurance work - we can pick up later in summer. I’ll need to get national agreement -but do you support this Manjit? As above for other safeguarding assurance development work (spec comm, DOP).

? national return so am asking if this can be agreed on call on pm 17.3.20. We could potentially defer till Autumn 2020

SEND system support for urgent/ priority care only. Any priority meetings to be virtual

SEND - new inspection work with inspection teams/ DFE to put on hold and reschedule inspections. Will discuss with inspectors.

DFE colleagues; national SEND lead -will seel Lorraine Mulroney's steer too; CCG colleagues; providers; system wide across region

Support to our challenged systems re a safeguarding focus to continue STAH, SATH, Huntercombe etc

potentially pause/ exception report to national NHS Safeguarding the regional quarterly return - seeking position nationally

Safeguarding shout out weekly email will continue

pause the regional safeguarding newsletter until Autumn 2020

Region wide; but key message still pout via te weekly safeguarding shout out

27 |

Nursing


Infection control Communication of key messages Stopped IP review visits.

Stopped IP sustainability visits.

Stopped regional IP visits.

Stopped general contact with trusts as IP teams busy.

Stopped oversight of HCAI lapse/avoidable.

Maternity Delivering the national programme Stopped face to face meetings CCG’s, Providers

GPN end of year fnancial allocations and new allocation for 20/21

change to remote working and programme largely requirements stop.

seconded staff realeased back to clinical practice

Longer term impact of reduced focus on gpn recruitment, retention and return.

LDA Delivering the national programme Stopped face to face meetingsReduced meetings

Spec comm team, CCG’s, Providers Impact on undertaking CTR reviews -resulting inpatients not being reviewed for suitability for discharge

28 |

Nursing – Risks IdentifiedService Area Risk No. Risk detail SRO

(Senior risk owner)


29 |

Strategy and Transformation


OperationalPerformance Management

Needs to continue. Will be refocussed to look at covidimpact. Routine - UEC performance mgmtEscalated UEC performance Routine Elective performance mgmtEscalated Elective performance mgmtCancer performance - need a discussion re transformation and underpinning 62d improvement work

P&I

Finance Financial performance – largely led by financeCapital Cases Support on priority cases as identified by systems. Deprioritise otherwise BCF (limited action on this agenda currently ) Productivity improvement

Finance

Programmes UEC transformation –Elective transformation Cancer transformation -Other Programmes - routine Other Programmes - escalated

P&I, Medical, Programme SRO

LD&A and MH support from S&T to continue as is

Quality

Quality oversight To discuss given potential redeployment of nursing teams

Planning (operational and LTP)

Strategy and Operational Planning

Agreed a curtailed, prioritised process. Consider whether could deploy resource from S&T into systems to support planning Advice provided by HoSP (S&P, S&T Directorate)

Locality emergency planning (LHRPs) CCGs have been asked to take on NHSEI role

30 |

Strategy and Transformation


Governance and Oversight

Appointments - Statutory role. Limited draw on S&T time CCG constitution and boundary changesSRMs - Continue with modified agenda/format/attendees list Service Reconfigurations -Agree with systems whether this continues to be a priority and that they have the capacity . If it is we need to supportTransactions - Don’t support new transactions into the pipeline. Not yet at the level to step down CCG 20/21 mergers.ICS Development - can we defer routemaps? Needs pragmatic system by system consideration. Recognise that for some systems we’ll have to modify our approach. Consider whether we could step up our input through deploying S&T resource released from deprioritised activities

Heath and Wellbeing board – will no longer attend

Regulation - Complete CCG IAF process. Other regulatory activity by exception, but expect very limited activity

Organisational governance - Well led reviews etc - deprioritise as CQC have stopped inspections

Advice provided by Strategic Change Lead (S&P team, S&T Directorate)DoSP, S&T Directorate

Advice provided by ICS Development Manager (S&P, S&T Directorate)

Special measures (systems and organisations) QSM Trusts Medical ,P&I

FSM Trusts Finance

Special Measures systems

Parliamentary Requests, Media and FOI

ParliamentaryMediaFOIWhistle Blowing/protected disclosures

S&T CommissioningPrivate/Corporate office

x

31 |

Strategy and Transformation – Risks IdentifiedService Area Risk No. Risk detail SRO

(Senior risk owner)


Key Activity /

Programme of Work

E / S ? Impact RAG Resilience with

remote working

Resilience to

withstand sickness

level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?

Further Comments Lead Contact Details

Commissioning

Development: Comms

E G yes yes N 1 N Ensure resilience with the wider

comms team and key messages

and robust

Jo melling

Commissioning

Development:

Engagement

S G yes yes N 1 N Utilise teleconference facilities to

hold engagement meetings

where possible. Develop on line

resource and repository

Jo melling

Commissioning

Development: Integration

Programme

A yes yes N 1 N potential slower start over the

first 3 months. Utilise on line

facilities to sustain momentum

and

Jo melling

Commissioning

Development: System

capability and capacity

building & business

development

yes yes N 1 N Develop on line resourcing and

information library, evidence

base nationally and

internationally spring board

action learning in the autmn

Jo melling

Commissioning

Development: OD

planning

E yes yes N 1 N Support staff through the next 5

months. Develop a short term

staff support plan

Jo melling

Commissioning

Development: Planning

and intelligence

yes yes n 1 n Develop a robust approach to

business intelligence and

planning

Jo melling

Commissioning Development

Key Activity / Programme

of Work

E / S

?

Impact RAG Resilience with

remote working

Resilience to

withstand sickness

level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?


Contract Administration

(GMS/PMS/APMS/Contract

Variations, etc)

S M A No issues – can

be undertaken

remotely

Able to with stand

NHEI 10-20% staff

sickness

Not appropriate Nil No This service is provided to

CCGs under the GP Hub

Offer

Variations need to be

processed within 28 days

as per Contract

Regulations

Anna Nicholls

[email protected]

07770315685

Bal Dhami

[email protected]

07770314703

Gary Lucking

[email protected]

07736 484542

Directed Enhanced

Services to GP practices for

NHS England (Vaccination

and Immunisations)


be undertaken

remotely

Able to with stand

NHEI 10-20% staff

sickness

Not appropriate Nil No Anna Nicholls

[email protected]

07770315685

Bal Dhami

[email protected]

07770314703

Gary Lucking

[email protected]

07736 484542

Processing and payment of

Enhanced Services - these

can be monthly, quarterly

and annually


be undertaken

remotely

Able to with stand

NHEI 10-20% staff

sickness

Not appropriate Nil No Payments are made using

a combination of manual

and web based systems

including CQRS

Anna Nicholls

[email protected]

07770315685

Bal Dhami

[email protected]

07770314703

Gary Lucking

[email protected]

07736 484542

Primary Care Transformation - GMAST

mailto:[email protected]











of Work

E / S

?


remote working

Resilience to

withstand sickness

level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?


GP Locum Claims S M A No issues – can

be undertaken

remotely

Able to with stand

NHEI 10-20% staff

sickness

Not appropriate Nil No This service is provided on

behalf of CCGs under the

GP Hub offer - processed

and paid as per the SFE

Anna Nicholls

[email protected]

07770315685

Bal Dhami

[email protected]

07770314703

Gary Lucking

[email protected]

07736 484542

Management of Rent

Review Process for GP

Practices


be undertaken

remotely

Able to with stand

NHEI 10-20% staff

sickness




and paid as per the

Premises Costs Directions

and SFE

Anna Nicholls

[email protected]

07770315685

Bal Dhami

[email protected]

07770314703

Gary Lucking

[email protected]

07736 484542

QOF including Payment of

year end Quality and

Outcomes Framework


be undertaken

remotely

Able to with stand

NHEI 10-20% staff

sickness




and paid as per the SFE

Anna Nicholls

[email protected]

07770315685

Bal Dhami

[email protected]

07770314703

Gary Lucking

[email protected]

07736 484542

Primary Care Transformation - GMAST










Key Activity / Programme of Work Scaled back or

suspended?

% decrease or

numbers

How many staff

available to support

other areas?

Long term impact Further Comments Lead Contact Details

Processing of contract variations Scaled back 20% 2 Long terms impact may

introduce legal challenges for

CCGs

Can be delayed for 28 days

otherwise potential contractual risks

Anna Nicholls

[email protected]

07770315685

Bal Dhami

[email protected]

07770314703

Gary Lucking

[email protected]

07736 484542

Management of Rent Review Process for

GP Practices

Scaled back 30%-50% 4 Long terms impact may

introduce legal challenges for

CCGs plus back dated rent

for practices

Anna Nicholls

[email protected]

07770315685

Bal Dhami

[email protected]

07770314703

Gary Lucking

[email protected]

07736 484542

Processing of financial activity by GP Hub

(QoF/Enhanced Services) but would need

to have some sort of national agreement in

place to continue to pay practices (eg.

based upon previous year’s activity subject

to reconciliation).

Staff hours taken

to process

transactional

activity could be

potentially scaled

back or

suspended

6 Will cause financial hardship

to practices and risk of

challenges if practices are

not paid

Will require reconciliations by finance

teams and would require approval

by Commissioner

Anna Nicholls

[email protected]

07770315685

Bal Dhami

[email protected]

07770314703

Gary Lucking

[email protected]

07736 484542

Reduced activity - Primary Care Transformation GMAST













Key Activity /

Programme of Work

E /

S ?


remote working

Resilience to

withstand sickness

level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?


Delivery of the ETTF

Programme 19/20

E Low G Team already works

remotely, this should

not impact on delivery

There is capacity in the

rest of the team to

cover for a short period

of time

n/a n/a n/a Programme year coming to a

close. No impact in 19/20

John Harness, Kerry

Wathen, Amanda

Anderson and Rachael

Preston

Processing of ETTF and

BAU payment claims

E Low G Claims are made

electronically and

approvals gained

electronically so no

impact with remote

working.


rest of the team to


of time

n/a n/a n/a Generic mail boxes to be set up

and communicated with users so

working staff can action.

Potential for delays in next step

of approvals if other depts staff

are not available.

John Harness, Kerry

Wathen, Amanda


Preston

Delivery of the ETTF

Programme 20/21

E Low G A number of schemes

are either advanced in

planning or already in

delivery and should

continue to progress


rest of the team to


of time

n/a n/a n/a Potential for delays in approving

schemes if approval routes

(internal and external) are not

functioning. Also there may be

issues with the supply chain.

John Harness, Kerry

Wathen, Amanda


Preston

Primary Care Transformation - ETTF


suspended?

% decrease or

numbers

How many staff


other areas?


The ETTF Programme for 19/20 is coming

to a close and delivery of the 20/21

programme is underway.

The work needs

to continue to

ensure the

Programme is

delivered as we

are working to a

non-negotiable

deadline

There should be

no decrease in

numbers.

All staff could be

available to support other

areas should the need

arise in the short term

If projects are substantially

delayed due to a reduction in

availability of supplies,

labour, or inability of GP

practices, STPs to drive the

projects, they may not be

able to proceed or access the

funding agreed in 20/21.

Work with the national team to

assess the national response to this

and potential mitigation. The National

team is in discussions with the

Treasury to see what can be done to

mitigate this risk.

John Harness, Kerry

Wathen, Amanda Anderson

and Rachael Preston

Reduced activity - Primary Care Transformation ETTF

Key Activity /

Programme of

Work

E / S ? Impact RAG Resilience

with remote

working

Resilience to withstand

sickness level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?


PCN Development

programme

E M A No Issue –

can be done

remotely

Able to with stand NHEI staff

sickness as CCGs leading

operational delivery

Not appropriate 1 No Key activity may be

considered non-

essential by CCGs

Soyuz Shrestha

[email protected]

0773-037-5292

Rollout of PCN DES E H A No Issue –

can be done

remotely


sickness as CCGs/PCNs

leading operational delivery


considered non-

essential by CCGs

Soyuz Shrestha

[email protected]

0773-037-5292

Recruitment into

ARRS by PCNs

S L G No Issue –

can be done

remotely


sickness as CCGs/PCNs



considered non-

essential by CCGs

Soyuz Shrestha

[email protected]

0773-037-5292

GP Contracting -

Midlands region

event

E M G No Issue –

can be done

remotely

10% Not appropriate 5 No WebEx planned Soyuz Shrestha

[email protected]

0773-037-5292 or Sarah McCormack

[email protected] 07730

379326

Delivery of GPFV

Extended Access

Programme

E H A No Issue –

can be done

remotely


sickness as CCGs/access

hubs leading operational

delivery


considered non-

essential by CCGs

Soyuz Shrestha

[email protected]

0773-037-5292

Delivery of GPFV

Workforce

programme with

recruitment of GPs

and Nurses

E H R No Issue –

can be done

remotely


sickness as local systems



considered non-

essential by CCGs

Kerrie Woods

[email protected] 07918 336070

International dental

recruitment

E M A No issues –

can be done

remotely

Small key workforce leading

on this so very little

resilience.

Not appropriate Yes Very new workstream

to the transformation

team.

Amanda Alamanos

[email protected]

07900715127

Dental

Transformation

Programme

E L A Work would

need to stop

Small key workforce leading

on this so very little

resilience.

Not appropriate Yes Very new workstream

to the transformation

team.

Amanda Alamanos

[email protected]

07900715127

Primary Care Transformation – Transformation











suspended?

% decrease or

numbers

How many staff


other areas?


Dental Transformation Programme Suspended 2/3 with expertise in

primary care

Very new workstream so no

long term impact should it be

delayed.

Amanda Alamanos

[email protected]

t

07900715127

Reduced activity - Primary Care Transformation


Key Activity /

Programme of Work

E / S

?

Impact RAG Resilience

with remote

working

Resilience to

withstand

sickness level of

10-20%

Redeployment

required?

How many

staff are

required?

Clinical Staff

required?


Payment of Invoices E Yes Yes No N/A No Chris Kerry -07730374786

Liz Gundel – 07918 336071

Ruth Bolderston

07918 336017

Finance tbc ? Mark Cartwright

Monitoring of CPCS

service/linking with 111

E Yes Yes No N/A Only for

clinical

queries

Several staff already aware

of the service requirements

Chris Kerry -07730374786

Liz Gundel – 07918 336071

Ruth Bolderston - 07918 336017

Out of Hours and bank

holiday Provision

E Yes Yes No N/A No Several staff already aware

of the service requirements


Liz Gundel – 07918 336071


Enhanced Services -

Pharmacy First (minor

ailments service),

Palliative Care,

Emergency Supply etc

E Yes Yes No N/A Only for

clinical

queries

Several staff already aware

of the service

requirements. Service in

Nottinghamshire only


Liz Gundel – 07918 336071


Fitness to Practice E Yes Yes No N/A Yes Could be done by other

pharmacists nationally, if

no local clinical advisor


Liz Gundel – 07918 336071


Complaints E Yes Yes No N/A Only for

clinical

queries

Could be done by other

pharmacists nationally, if

no local clinical advisor


Liz Gundel – 07918 336071



Issuing of Pharmacy

Alerts

E Yes Yes Yes – Need to

retain admin

temporarily and

delay transfer to

Section 7a

No Anyone with access to

distribution lists can do this


Liz Gundel – 07918 336071



Pre reg claim processing E Yes Yes No No Could maybe undertaken

by NHSBSA


Liz Gundel – 07918 336071



Pharmacy

Key Activity /

Programme of Work


remote working

Resilience to

withstand

sickness level

of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?


Payment of enhanced

services

E Yes Yes No No Chris Kerry -07730374786

Liz Gundel – 07918 336071

Ruth Bolderston

07918 336017


DoS Updates E Yes Yes No No Chris Kerry -07730374786

Liz Gundel – 07918 336071

Ruth Bolderston

07918 336017


Communications to

Providers

E Yes Yes No No Chris Kerry -07730374786

Liz Gundel – 07918 336071

Ruth Bolderston

07918 336017


Pharmacy

Key Activity /

Programme of Work


remote working

Resilience to

withstand sickness

level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?

Further

Comments

Lead Contact Details

Contractual Changes

including

Applications/Variations/

Terminations

E A Yes Yes No No Chris Kerry -07730374786

Liz Gundel – 07918 336071

Terry Chikurunhe

07770 314914

Jennie Fitzgerald

07736 484543

Contract Monitoring

Risk assess and deal with

urgent issues only

S 2 A Yes Yes No No Chris Kerry -07730374786

Liz Gundel – 07918 336071

Terry Chikurunhe

07770 314914

Jennie Fitzgerald

07736 484543

GOS Voucher Queries E A Yes Yes – adopt pragmatic

approach to pay and

reconcile later

No No Chris Kerry -07730374786

Liz Gundel – 07918 336071

Terry Chikurunhe

07770 314914

Jennie Fitzgerald

07736 484543

QIPP programmes S 1 G Yes Yes No n/a No Chris Kerry -07730374786

Liz Gundel – 07918 336071

Terry Chikurunhe

07770 314914

Jennie Fitzgerald

07736 484543

Optometry

Key Activity /

Programme of Work


remote working

Resilience to

withstand sickness

level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?


Routine Contractual

Changes

S 2 A Yes Yes – if relax

timeframes for

responding

No No Tom Bailey – 07876852202

Andrew Morrall

07900 715207

Compass Performer

Changes – urgent vs non

urgent

E R Yes Yes - need to prioritise

to ensure ongoing

urgent services

No No

IMOS Payments E R Yes Yes – suggest interim

payments and later

reconciliation if needed

No No Ruth Bolderston

07918 336017

Jane Green

Secondary Care

Payments – Purchase

Order

E 4 R Yes ? Finance ? ? No Carole Pitcher – 07918368403

Finance???

Secondary Care

Payments – NCA

E 3 A Yes No – relies on two

trained staff with

limited access to cover

- priories large value

invoices

Yes 2 No Currently recruiting and

being covered by

someone moving to

another role

John Dell

Debbie Graham

Monitor and manage

contractual risks

E 3 A Yes Yes No Yes Implement risk based

approach

Tom Bailey – 07876852202

Darrell Jackson

07900 715241

Terry Chikurunhe

07770 314914

Tracy Harvey

07568 431795

Dental

Key Activity /

Programme of Work


remote working

Resilience to

withstand sickness

level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?


Urgent Communications

to Providers – CAS and

COVID updates

E 4 R Yes Yes No Maybe PHE staff already on business

continuity and limited access to

DPA

Sue Nabbs

QIPP Programmes S 1 G Yes Suggest suspend No No N/A

Response to queries

from outside agencies –

GDC CQC etc

E 2 A Yes Yes No No Nuala Woodman

Liz Gundel

FOI and MP requests E 3 A Yes Yes No – may have

to slip

timescales

Occasional PHE staff already on business

continuity and limited access to

DPA

Nuala Woodman

Liz Gundel

Compass Online

Payments

E 5 R Yes Not Known ? finance No Lack of clarity about finance

arrangements at present

tbc

Contract Round –

Secondary and

Community

E 4 A Yes Yes – take a pragmatic

approach to getting

contracts signed with

resource available.

No No Regional co-ordination Local

engagement

Howard Thompson

Dental

Key Activity /

Programme of Work


remote working

Resilience to

withstand sickness

level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?


Routine Communications S 2 G Yes Yes No No Sue Nabbs

Routine Contract

Meetings – primary care

S 2 G Yes Yes No Suggest

suspend

No Andrew Morrall

Amanda Borland?

Routine Contract

Meetings – primary care

S 2 G Yes Yes No Suggest

suspend

No Howard Thompson

Ruth Bolderstone

Jane Green

Out of Hours provision E 5 R Yes Yes No No tbc

Year end and mid year

processes

E 3 A Yes Yes No No Largely managed by BSA –

some local work needed

Andrew Morrall

Amanda Borland?

Review of Serious

Incidents

E 3 A Yes Yes Yes ? Medical role in new world

anyway

tbc

Dental


suspended?

% decrease or

numbers

How many staff


other areas?


CPAF Visits (Routine) Suspend Routine We could possibly

release 1 band 6 and 1

band 7

Assurance would be through

CPAF declaration to

NHSBSA

Undertake visits where they is

deemed to be a clinical risk only


Liz Gundel – 07918 336071

Ruth Bolderston

07918 336017

DSQS visits Suspend Usually

undertaken

between Oct-Feb

Validation would be through

self assessment alone


Liz Gundel – 07918 336071

Ruth Bolderston

07918 336017

Monitoring of Unplanned Closures Suspend On average 20 a

month for DENO

– other areas

don’t monitor to

same degree

Pharmacies wouldn’t be

issued with breach notices


Liz Gundel – 07918 336071

Ruth Bolderston

07918 336017

Monitoring of out of pocket expenses Suspend Recovery of monies not

undertaken


Liz Gundel – 07918 336071

Ruth Bolderston

07918 336017

Market entry (pharmacy applications) Scale back for

areas where the

PNA has

determined there

is sufficient

provision

Potentially restricting new

providers to the market

Would need national guidance on

whether we could do this


Liz Gundel – 07918 336071

Ruth Bolderston

07918 336017

NMS/MUR data – failure to submit Suspend Pharmacies wouldn’t be

issued with breach notices

Would expect national direction on

whether this data continues to be

collected


Liz Gundel – 07918 336071

Ruth Bolderston

07918 336017

Reduced activity - Pharmacy


suspended?

% decrease or

numbers

How many staff


other areas?


Controlled Localities determination Suspend Only 1 received

in the past 12

months for

DENO

May need national guidance to

support suspension


Liz Gundel – 07918 336071

Ruth Bolderston

07918 336017

Scoping of Enhanced Services across the

region

Scale back Status Quo would remain in

place for longer

Could prioritise what we scoped Chris Kerry -07730374786

Liz Gundel – 07918 336071

Ruth Bolderston

07918 336017

Reduced activity - Pharmacy


suspended?

% decrease or

numbers

How many staff


other areas?


Processing of new optometry applications Suspend where

sufficient

provision already

within an area –

Triage needed

On average 2

applications a

month

As per pharmacy

comment as joint

pharmacy/optom team

Potentially restricting new

providers to the market

potential for complaints

Would need national guidance on



Liz Gundel – 07918 336071

Terry Chikurunhe

07770 314914

Jennie Fitzgerald

07736 484543

Optometry Assurance Process Suspend Delay the assurance cycle Would need national guidance on



Liz Gundel – 07918 336071

Terry Chikurunhe

07770 314914

Jennie Fitzgerald

07736 484543

Routine Contract Monitoring Scale Back –

triage and deal

with urgent issues

only

Less assurance around

quality of services although

these are likely to be

curtailed in any case


Liz Gundel – 07918 336071

Terry Chikurunhe

07770 314914

Jennie Fitzgerald

07736 484543

Reduced activity - Optometry


suspended?

% decrease or

numbers

How many staff


other areas?


MCN meetings Scale Back Loss of engagement with

clinicians

Important forum to gain input from

clinicians to help with current crisis

and disseminate guidance

Liz Gundel

Nuala Woodman

Suspend monitoring of RTT Suspend Further delays to treatment

for patients

Unlikely that secondary care will be

undertaking elective care

Howard Thompson

Contract monitoring Scale back Less assurance around

service delivery

Risk based approach Suspend

routine meetings

Tom Bailey – 07876852202

Darrell Jackson

07900 715241

Terry Chikurunhe

07770 314914

Tracy Harvey

07568 431795

Contract Variations Scale back Potential complaints from

providers

Extend timeframes for processing Andrew Morrall

Amanda Borland

Practice Visits Suspend Less assurance around

quality

Triage for urgent concerns and refer

to CQC?

Andrew Morrall

Amanda Borland

Reduced activity - Dental


of Work

E / S

?


remote working

Resilience to

withstand sickness

level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?


Contract management –

including performance

monitoring and service

discussions

E 3 G Most elements can

be managed via

remote working

Work can be covered

by other staff members

This will depend

on level of work

and input

required

1 contract

manager & 1

business

support per

STP

Sometimes,

depending

on nature of

issue

Level of input will be determined

by ongoing continuation of

programmes

Stephanie Cook

Richard Yeabsley

Administrative and business

support, including

finance/payments and

activity reconciliation


be managed via

remote working

Work can be covered


This will depend

on level of work

and input

required

1 business

support

assistant and

1 contract

manager per

STP

No Level of input will be determined


programmes. Support is also

provided to PHE SIT colleagues

Stephanie Cook

Richard Yeabsley

Supporting and inputting

into national programmes

via meetings / WebEx’s and

national/regional returns


be managed via

remote working

Work can be covered


to a degree, although

there are fewer people

covering this element

This will depend

on level of work

and input

required

2 / 3

individuals

per East /

West of the

region

No Level of input will be determined


programmes

Stephanie Cook

Richard Yeabsley

Everyday management of

staff


be managed via

remote working

Work can be covered


This will depend

on level of work

and input

required

As per team

structure

No Level of input required will be

determine by issues and

challenges as they arise

Stephanie Cook

Richard Yeabsley

Support offered to PHE SIT

embedded team


be managed via

remote working

Work can be covered


This will depend

on level of work

and input

required

This will

depend on

the level of

support that

is required

No Level of input required will be


challenges as they arise. PHE

team are already supporting

Covid-19 activities

Stephanie Cook

Richard Yeabsley

Advice to programmes and

dealing with any queries

arising from specific

situations, including

management of serious

incidents/ outbreaks in

different settings

E 4 A Most elements can

be managed via

remote working

Work can be covered


This will depend

on level of work

and input

required

This will

depend on

the level of

support that

is required

Yes,

depending

on nature of

issue

Level of input required will be


challenges as they arise

Stephanie Cook

Richard Yeabsley

Business Continuity Planning


of Work

Scaled back

or

suspended?

%

decrease

or

numbers

How many

staff available

to support

other areas?

Long term impact Further Comments Lead Contact

Details


including performance

monitoring and service

discussions

Scaled back 3/4 Low-medium impact, depending on length of disruption. Clearly,

some provider services may be scaled back following national

updates which will have a knock-on effect on the work of the

team.

Rolling contracts not problematic whereas new contracts e.g.

SAIS will need to be in place for new service to commence

Currently in contracting round. Delays already

expected due to transition etc.

Submissions to CEG for extensions could be

impacted

Stephanie Cook

Richard Yeabsley

Administrative and business

support, including

finance/payments and

activity reconciliation

Scaled back 3/4 Low impact from business support perspective, subject to length

of disruption.

Medium to high risk re finance activity/payments.

Immediate priority is rota for generic inboxes

(nb performance data/returns from providers)

and decision on what tasks are to be scaled

back suspended.

Short-medium term priority to train new

contract managers in use of and ensure access

to Oracle/payments systems. First payments to

trusts from May 2020 onwards.

Stephanie Cook

Richard Yeabsley

Supporting and inputting into

national programmes via

meetings / WebEx’s and

national/regional returns

Scaled back

Potential to

suspend

some in line

with national

BCP

3/4 Low-medium, given ability to work remotely.

National programme changes will be affected – national BCP e.g.

DESP interval extension, Cervical interval extension

Stephanie Cook

Richard Yeabsley

Everyday management of

staff

Scaled back 5/6 Regular briefings, good diary management and ICT/Mobile phone

access in place. Low impact

Through remote working need to ensure regular

team contact through Teams

Stephanie Cook

Richard Yeabsley

Support offered to PHE SIT

embedded team

Scaled back

Potential to

suspend

3/4 Low-medium impact.

Complete cancellation of all programme boards/conversion to

virtual meetings

Number of PHE SIT colleagues currently

redeployed due to COVID 19 and therefore

some review of activity and prioritisation has

taken place.

Stephanie Cook

Richard Yeabsley

Advice to programmes and

dealing with any queries

arising from specific

situations, including

management of serious

incidents/ outbreaks in

different settings

Scaled back

but essential

input for SI’s

Difficult to

qualtify

Management of serious incidents cannot be suspended

Depending on nature and scale of the serious incident will

determine degree of impact to business

Will also look to SQAS for support Stephanie Cook

Richard Yeabsley

Reduced activity

Key Activity / Programme of

Work


remote working



Redeployment

required?

How many staff

are required?

Clinical Staff

required?


Contract management S 3 G Can be completed

remotely

Can be cross covered

within the team

No 2 x secure, 2 x

L&D, 2 x SARC, 1

x CYP

No Relies on AGEM CSU reporting Sarah Forrest/Anthony

Nichols

Internal reporting and

assurance

E 3 G Can be completed

remotely


within the team

No 2 x secure, 2 x

L&D, 2 x SARC, 1

x CYP

No Sarah Forrest/Anthony

Nichols

Responding to information

requests (FOI, IMB, HMIP,

Ministerial, PPO, regulators)

E 3 R Can be completed

remotely


within the team.

No 2 managers (E

and W) and 1

admin (plus

Director sign off)

No Rota and SPOC to be established

for COVID 19 specific requests

Sarah Forrest/Anthony

Nichols

Clinical reviews (instructing,

assuring, submitting)

S 3 A Can be completed

remotely


within the team.

No 1 Yes Includes death in custody reviews,

serious incident reviews. SOP in

place


Nichols/Cheryl Sherratt

Procurement S 3 A Can be completed

remotely

Limited. No – staff are

unlikely to have

the required

subject matter

expertise

3 (SRO,

procurement lead

and

commissioning

lead)

Yes Relies on AGEM CSU

procurement support and a pool of

subject matter experts inc

clinicians. Can some procurement

be deferred/contracts extended for

6 months – CEG decision?


Nichols

Partnership Engagement

(co/collaborative

commissioning)

E 3 G Can be completed

remotely


within the team

No 2 x secure, 2 x

L&D, 2 x SARC, 1

x CYP

No Standard boards may be stepped

down/ deferred however

engagement to plan / tackle

incidents will be required


Nichols

SARC Premises (West Mids) E 4 R Can be completed

remotely

Only 2 members of staff

with this knowledge

No but an SOP is

required

Min 1 No Relates to premises issues and

closures. May happen but is

infrequent. Reliant on public health

and lead commissioning /have

local detail

Sarah Forrest/Stephanie

Beaumont/Anthony Nichols

Financial Management

(payment of providers)

S 4 A Can be completed

remotely


within the team

No 2 x secure, 2 x

L&D, 2 x SARC, 1

x CYP

plus finance

No Payment of contracts and

authorisation and transacting of

emerging / urgent support

requests. Reliant on finance and

directors (approval limits)


Nichols/ Lydia Greenwood

Health and Justice Business Continuity Plan – covering West Midlands Team and East Midlands Team


suspended? **

% decrease or

numbers

How many staff


other areas?


Contract management Could be reduced Possibly 2 Reduced information and

assurance of delivery of

routine healthcare services

which could increase health

vulnerabilities risks

Possible that standard reporting and

assurance is replaced with COVID

19 activities


Nichols

Responding to information requests Could be

suspended but

requires national

stance

Possibly 2 (same 2 as

above)

Backlog of requests, failure

to support ministerial

requests

Possible that standard requests are

replaced with COVID 19 activities


Nichols

Procurements Suspend tenders

– needs CEG

support

Difficult to quantify Will create a backlog of

procurement activities and

convergence of tenders

which saturates the market,

commissioning teams and

subject matter expertise and

capacity

Contract negotiations will be needed

to extend existing contracts and CEG

approval will be required


Nichols

Internal reporting and assurance Scaled back Difficult to quantify Less frequent sharing of

information and assurance of

delivery of routine healthcare

services

Move to high level reporting could

free up capacity. Decision needed by

MCG


Nichols

** should activities be suspended / deferred

the increased workload to catch up could

require additional resource /capacity.

Reduced Activity – Health & Justice

Key Activity /

Programme of Work


remote working

Resilience to

withstand sickness

level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?


Payment to providers

(Mandated 1/12th of

Contract)

S 5 R Yes Remote working. Pay

1/12th of contract value

without amendment

No 4 No This should be routine payment

so automated on system

Dave Boehmer/

C Louis

Chris Pursooth

Support for management

of HPN Supply Issue

E 1 G Yes Identify deputy within

the pharmacy team

No 0.1 WTE No Can be managed by

commissioning team if

necessary

[email protected]

S Taylor

Development of recovery

action plans (access)

E 3 A Yes Access to partners to

develop and maintain

relationships will be

helpful but not

essential

No 8 No Unlikely to be a required action

until incident intensity is

diminishing

[email protected]

[email protected]

FOI Responses S 4 A Yes Teams/emails support

reponse provision

No 5 Yes

Seek view

of PH or

CRG

May require longer turn-around

time to respond

[email protected]

[email protected]

R Lindridge

Business Continuity Planning (Specialised Acute – WM/EM)







suspended?

% decrease or

numbers

How many staff


other areas?


Case Management – Neuro Rehab Suspended 100% (1) 1 Minimal Opportunity for current employee

(Speech and Language therapist) to

be deployed onto a rehab unit to

provide clinical input

[email protected]

Contractual Management of Quality

Concerns

Scaled back 50% 3 (WM)

Subject to Nursing Team

plan (EM)

Minimal Staff are administrative so could be

redeployed. Note this assumption

relates to Commissioning Team

transactional approach to managing

quality concerns. Assumed nursing

team will be able to offer more.

[email protected]

Mel McFeeters

Management of contractual financial

performance (non drugs)

Performance related payments/ IFR & CPC

treatments

Scaled back 2

3

2

3

Could result in providers

under or over-recovering

income which results in

cashflow/budgetary issues

Confirm additional payment

or approval of specific

funding requests (PGD,

HBOT)

Could enable contract management

staff to develop contracts with

Independent Sector providers to

develop additional acute capacity.

Similarly could enable contract

management of additional PTS if

required.

[email protected]

[email protected]

Contract Negotiation/ CQUIN Review Scaled back 6 4 Agree financial values only

as per deadline and develop

formal contracts over period

Remote working feasible but there

will be times when contrat

documentation will require f/f

[email protected]

C Louis

Procurements Suspended 1 0.1 WTE Delay in transport for PICU

patients in line with service

spec.

Probably would defer for at least 6

months therefore extend existing

arrangements where notice given

Dom Tolley

Transformation Programmes/QIPP Scaled back 3 1 Delay development of

schemes to support QIPP

&/or service changes

Potential impact on financial budgets R Williams

K Cauldwell

S Eaton

J Gulliver

Reduced activity







suspended?

% decrease or

numbers

How many staff


other areas?


ODN Oversight Suspended 1 0 Delay in governance process

& potential impact on

transformation programme

[email protected]

FOI / Media Enquiries Scaled back 0.1 WTE 0 Delayed response times National /regional message may be

required to confirm delays in these

unprecedented times

Roy Williams

K Cauldwell

R Lindridge

Comms Team

NHSE Performance Reporting Suspended 0.2 WTE 0 Delay in delivering reports

other than Unify outputs

COVID reporting may overwhelm

normal working procesess

[email protected]

Reduced activity



Key Activity /

Programme of Work


remote working

Resilience to

withstand sickness

level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?


Contract negotiations

2020 with all Midlands

specialised providers

S 2- Low Amber Yes Near end of process.

Most key elements

agreed. Achievable.

No No

additional

staff.

Current

resources

are 6 across

East and

West

Midlands

((2x(8c, 8b &

8a))

No West Midlands

[email protected]

East Midlands

[email protected]

Contract review

meetings for Q4 and

invoice payments

E 2 - Low Amber Yes Process can be

undertaken remotely

No As above Yes (Case

Managers

but can be

remote)

Liaise with finance regarding

payment on account

arrangements and

national guidance around Qtr 1

payment approach

West Midlands

[email protected]

East Midlands

[email protected]

Case Management E 3-4

Medium

/High

Green Partially Will have reduced

oversight of patients

and providers

No 16 (current

CM team).

No

additional.

There are

current

vacancies

Yes Some activities of role can be

done remotely but dependent

upon digital solutions of

individual provider. Actual

activity may cease completely as

virus spreads and hospitals

close to all visitors. Needs N3 or

better connection.

West Midlands

[email protected]

East Midlands

[email protected]

CETR/CTR review panel E 3 – 4

Medium

/High

Amber Partially if only

carry out paper

review but risk if

full review not

undertaken

Organising and panel

membership will have

some impact.

No Many across

several

areas but no

additional

staff.

Yes Exploring remote/shorter

CETR/CTR’s. Closure of

hospitals to visitors may result in

suspension of process.

Only possible if N3 connection

Delay in undertaking full

CETR/CTR re community

discharge packages/ impact to

national KPI will not be met.

Midlands

[email protected]

Relevant case

managers

Specialised Commissioning MH,LD&A








Key Activity /

Programme of Work


remote working

Resilience to

withstand sickness

level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?


West Midlands Tier 4

bed management

referral process

E 3

Medium

Red Yes Nominated duty case

manager cover interim

but long term would

have a significant

impact.

No 1 No If nominated staff not available –

duty case manager pick up

requests for tier 4 CAMHS

West Midlands

[email protected] –

Generic email inbox

camhs.wmsc@net

Provider Collaborative

Developments

E 2 – Low Green Currently working to

vacancy

West Midlands

[email protected]

East Midlands

[email protected]

EPC (Exceptional

Package of Care)

Requests

E 3 -

Medium

Red Yes No At least

2x8b in

Midlands

No for

admin

process but

could

involve

clinical staff

West Midlands

[email protected]

East Midlands

[email protected]

Quality and incident/

clinical reviews

E 4 - High Red/A

mber

Partial Depending on the

issue e.g. if significant

patient safety concern

No At least 3

e.g. nursing

& quality,

case

manager

and a senior

manager

Yes West Midlands

[email protected]

East Midlands

[email protected]

Lisa March/ Manjit Darby

Quality and Nursing

National data

submissions/returns e.g.

weekly Toto reports, tier

4 CAMHS bed

numbers/SMH/ NCDM

data uploads

E 2-3 (low

–

medium

)

Green Yes Process can be done

remotely

No At least 2

people

depending

on nature of

return

Partial

depending

on nature of

submission

e.g. rely on

case

managers to

update

SMH/NCDM

system

N3 connection if confidential PID West Midlands

[email protected]

East Midlands

[email protected]



mailto:camhs.wmsc@net










Key Activity /

Programme of Work

E / S ? Impact RAG Resilience

with remote

working

Resilience to

withstand sickness

level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?


High Secure / Clinical

incident/ reviews

E 4 High Red No At least 2 Possible

subject to

nature of

issue

Karon Glynn

Andrew Horton

Offender Personality

Disorder

E 4-High Red Currently work

remotely due to

nature of

work. Adaptatio

ns have been

made for

business

continuity

Would be an issue as

small team (1.5wte

currently in team)

covering wide

geography across

multiple services.

No At least 2 Yes Midlands & East of

England

anne-

[email protected]




suspended?

% decrease or

numbers

How many staff


other areas?


Case Management Scaled back with

possible

suspension for

some but not all

Dependent upon

spread across

providers and

their

management of

visitors

16 case managers/senior

case managers all have

professional registration

Reduced oversight of quality

of providers. Potential

increase in LosS and delayed

discharges.

Some activities of role can be done

remotely but dependent upon digital

solutions of individual provider.

Actual activity may cease completely

as virus spreads and hospitals close

to all visitors.

West Midlands

[email protected]

East Midlands

[email protected]

CETR/CTR reviews Scaled back with

possible

suspension but

need to note risks

to community

discharge

planning

Dependent upon

spread across

providers and

their

management of

visitors

2 (admin staff) Increased LoS, compliance

with trajectory targets,

backlog of work may result in

requirement for additional

short term resources after

crisis.

Exploring remote/shorter

CETR/CTR’s. Closure of hospitals to

visitors may result in suspension of

process.

Midlands

[email protected]

Relevant LD/ASD Case

managers

Reduced activity – Midlands Specialised Mental Health, LD&A




Key Activity /

Programme of Work


remote working

Resilience to

withstand sickness

level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?


QIPP development and

monitoring

E Yes Possible 2 Y Require staff with a knowledge

of pharmacy, spec comm and

data analysis

Susanna Taylor

07876859935

CQUIN monitoring E Yes Possible 2 Y Require staff with a knowledge


data analysis


drugs AIV challenges,

contract meetings with

Trusts

E Yes Possible 2 Y Require staff with a knowledge


data analysis

Individual Funding

Requests

E Yes Possible 1 Y Pharmacists with training in IFR.

Part of national process.

Clinical advice/

engagement

E Yes Possible 1 Y Pharmacists with knowledge of

spec comm

Clinical prescribing

networks – SRIAP, HIV

E Yes Possible 1 Y Pharmacists with knowledge of

spec comm

Specialised Commissioning - Pharmacy


of Work

E / S

?

Impact R

A

G

Resilience

with remote

working



Redeployme

nt required?

How

many

staff are

required?

Clinical

Staff

required?


Team has a statutory requirement to make an entitlement decision within 20 working days.

S 5 R Yes (where

paperless)

Business critical tasks

would be prioritised. Some

activities may be postponed

until recovery phase

No Min 10 No • Continuity planning to allow the team

to work remotely are well advanced

and will cover statutory and essential

key tasks the team undertake.

• The team is aiming for paperless

working, but is not yet there.

• Applications received prior to

treatment would be prioritised as they

have an added health impact for the

applicant.

[email protected]

Managing complex applications – inc. DHSC discretionary cases, legal cases, high profile cases.

E 5 A Yes (where

paperless)

Undertaken by senior

manager, so could be

critically affected

No 2 No • Continuity planning to allow the team






[email protected]

Liaise with NHS commissioners to determine patient entitlements and Undue Delay requirement.

E 3 A Yes Business critical tasks








[email protected]

The team is responsible for

costing applications using

the National tariff / HRG

Grouper and financial

statements for EU Directive

reimbursements.

E 4 A Yes (where

paperless)

Business critical tasks










[email protected]

Manage process and for appeals, reviews, complaints, FOI requests, Health Ombudsman, legal challenges / requests

S 4 A Yes (where

paperless)

Undertaken by

management team so could

be affected

No 4 No • Continuity planning to allow the team






[email protected]

ECBH






Key Activity /

Programme of Work

E / S

?

Impact RAG Resilience

with remote

working

Resilience to

withstand sickness

level of 10-20%

Redeployment

required?

How many

staff are

required?

Clinical

Staff

required?


Inform current

Department of Health and

Social care (DHSC) and

NHS England discussions,

related to the need for

and potential form of

reciprocal cross border

arrangements post EU

Exit.

E 5 A/R Yes Can be delayed until

recovery phase if

DHSC / NHSE/I policy

delay their EU Exit

planning.

If not, operational input

is crucial.

No 2 No Continuity planning to allow the

team to work remotely are well

advanced and will cover statutory

and essential key tasks the team

undertake.

[email protected]

Internal reporting to NHS England on performance / risks / impact.

E 4 A/R Yes Continued reporting of

performance / risks /

impact is essential.





undertake.

[email protected]

Reporting to DHSC / EU Commission (annual returns).

E 2 G Yes Can be delayed until

recovery phase





undertake.

[email protected]

Provide advice to

patients and applicants,

via email and live phone

lines.

E 4 A Yes Business critical tasks

would be prioritised.

Some activities may be

postponed until

recovery phase.





undertake.

[email protected]

ECBH






suspended?

%

decrease

or

numbers

How many staff


other areas?


Team has a statutory requirement to

make an entitlement decision within

20 working days.

New applications

likely to fall, where

treatments have not

yet taken place.

WiP applications will

continue until

completion

Not known 0 Very high.

• Applications taking longer than 20 days to

decision will breach statutory obligations.

• Patients may not be able to make a timely

decision on their healthcare choices.

• New applications received, either

before or after treatment, will be

progressed.

• Applications received prior to

treatment, will be prioritised, as

they also have a health impact for

the patient.

• Advice also sought from legal,

DHSC, policy on team

responsibilities.

• All team members involved with

process from start to finish.

[email protected]

Managing complex applications –

inc. DHSC discretionary cases

These can be high

profile, media and

legal cases and need

to be dealt with as

they arise

Not known 12 (Managers and

below)

Very High.

• Consequences of not scaling back or

suspending will be legal and reputational.

Undertaken by HoS and Senior

Manager only.

[email protected]

Liaise with NHS commissioners to

determine patient entitlements and

Undue Delay requirement.

Relates to both new

and in-progess

applications.

Commissioner delays

can cause breaches

to the 20 days.

Not known 4 (Administrators) Medium - High.

• Applications taking longer than 20 days to

decision will breach statutory obligations

Undertaken by all team members,

Officer level and above.

[email protected]

The team is responsible for costing

applications using the National tariff

/ HRG Grouper and financial

statements for EU Directive

reimbursements.

Could be scaled back 50% 10 (not trained in

costings)

High.

• Patients not getting refunded for purchased care

on a timely basis. Possible financial hardship.

Activity undertaken by 4 of the team,

who are trained in this area.

[email protected]

Manage process and responses for

appeals, reviews, complaints, FOI

requests, Health Ombudsman, legal

challenges / requests

Statutory and

organisational

deadlines apply

Not known 10 (below

management level)

High.

• Statutory and organisational obligations will not

be met.

• May have health impact if patient not had

treatment and is awaiting an outcome.

Activity undertaken by management

team (4)

[email protected]

Reduced activity - ECBH






suspended?

% decrease or

numbers

How many staff


other areas?


Inform current Department of Health and Social care (DHSC) and NHS England discussions, related to the need for and potential form of reciprocal cross border arrangements post EU Exit.

Could be scaled

back but would

only be supported

if DHSC EU Exit

negotiations are

suspended.

0% 12 Very high.

• Decisions made without

the input of ECBH.

• Serious impact on future

of team and

operational/service

implications.

If DHSC EU Exit planning continues,

ECBH Senior Management are

required to input.

Completed by HoS and Senior

Manager.

[email protected]

Internal reporting to NHS England. Could be scaled

back in some

areas, but

reporting of risks,

impact and

performance

would still be

required.

25% 12 High.

• Continued reporting

needed to understand

volume, capacity, risk,

impact and performance

issues on the team /

service.

• If backlogs develop,

future planning needs.


Manager.

[email protected]

Reporting to DHSC / EU Commission (e.g. annual returns).

Could be scaled

back if led by

DHSC.

Not known. 12 Low

• Only if approach

supported by DHSC.


Manager.

[email protected]

Provide advice to patients and applicants, via email and live phone lines

Scaled back 50% 10 High

• Patients and applicants

will not have timely

communications

regarding their

applications and advice

needed. This may affect

their healthcare decisions.

• Reputation of NHSE/I and

ECBH damaged.

Currently undertaken by

administration staff. Lines can be

closed temporarily if necessary.

[email protected]

Reduced activity - ECBH


66 |

Commissioning – Risks IdentifiedService Area Risk No. Risk detail SRO

(Senior risk owner)


business continuity response midlands region th april 2020 · rlt meetings organisation regional...

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