Seven Set Reviews 2009

1. Seven Set Reviews 2009

2. Background • NSS wants to be valued as a world class partner that enables & supports transformation in the health & well being of Scotland by 2012. • Corporate Strategy identifies 7 Strategic Enhancement Themes which we will need to progress to achieve our vision. • In 2008 we established a base level of understanding as to our capability and in 2009 reviewed our performance against the 2008 baseline.

3. Approach • Chief Executive spent ½ day with each division or service. • Agenda & Guidance sent to every management team well in advance. • This year we moved to Self Assessment • This was moderated by Chief Exec, Dof & DS&P using balanced judgement on the evidence provided to support development of each capability. • Evidence was normally written but verbal examples of activity accepted as support.

4. Agenda • Part 1 : Leadership • Director + Chief Exec + HR representative • Review service delivery drivers • Review Organisation Chart • Review Senior Team Bios & development • Review Succession planning • Review overall evaluation scores • Consider potential senior team movement • Review high potentials

5. Agenda • Part 2 : People • Senior team + Chief Exec +DoF + Dir S&PP • Review PDP completion rates & practices • Establishment numbers & vacancies • Review staff turnover rates & practices • Review Sickness absence rates & practices • Review number of Grievances • Review staff surveys & Action Plan follow up • Review exit interview stats • Review annual leave c/f • Consider all the above in the context of E&D • Review of equality & diversity impact assessments • Review of secondee management • Review & discussion of staff recognition practices

6. Agenda • Part 3 : Partnership working • Senior team + Chief Exec +DoF + Dir S&PP • Review Staff-side / Management partnership working • Review inter NSS partnership working • Review NHS partnership working • Discuss staff survey & subsequent improvements • Review best practice example

7. Agenda • Part 4 : Remaining Themes • Customer Focus • Survey results • Engagement work • Action Plans • Quality & Innovation • Quality KPI’s • Climate for innovation • Consistency in hitting targets • Plans to improve performance • Impact of change programs • Meeting regulatory requirements

8. Agenda • Part 4 : Remaining Themes • Modernising Working Practices • Review risk management processes • Review IM&T Enabled programs • Review Environmental initiatives • Best Practice example • Increased Efficiency • Review plan including CRES • Demonstrate savings • Benefits from process improvement • Review of Procurement savings to date • Best Practice example

9. Capability Assessment scale • Each of the 7 SET’s was scored using the following scale • 5: Exemplar, best practice already in continuous improvement mode • 4: Good Practice, built into plans & operationally effective • 3: Some good practice & evidence fo development work • 2: Few examples of good practice, significant improvement required • 1: Not acceptable

10. Seven Set Session Improvements • Improvements identified across all areas • All “1” areas from previous year were addressed & no area of the organisation reviewed was at 1 level • We recorded our first “exemplar” results • Leadership & efficiency remain our most challenging areas but are improving • Very little moderation of self assessment was required

11. Mixed understanding of service delivery drivers & their use • Most structures fit for purpose • Emergency backfill much improved • Succession planning still weak • Senior team development plans weak • PDP Evaluation showed significant improvement • Senior manager opportunity for advancement poor • High potentials support variable Leadership Good Practice Divisions : HFS, ISD, NSD, SHSC NSS Average : 3 – some examples of good practice, evidence of Development work

12. PDP completion good in all areas • Management of staff turnover was weak • Sickness absence practices much more consistent than previous year • Few grievances • Excellent staff survey follow up & comprehensive action plans • Exit interview process & practices weak • No statistical evidence of discrimination in the above • Most Equality & Diversity plans developing well • Consistency of E&D impact assessment was variable • Management of leave c/f was variable • Management of secondees was weak People Good Practice Divisions :CLO, HPS, ISD, NSD, PSD, SHSC, SPPM NSS Average : 3 – Some examples of good practice & evidence of development work

13. Partnership Working • Significant improvement in management & staff side joint working • Partnership working around the staff survey has been excellent • Within NSS is much improved • With other organisations is evolving • Definite NSS area of strength Best Practice Division: NSD Good Practice Divisions : SNBTS, NP, PSD, SPPM, HPS, CLO, ISD, CA, SHSC, HFS, NISG, Fac Man NSS Average : 4 – Good Practices, built into plans, operationally effective

14. Customer Focus • NSS customer survey of limited value • Divisional surveys significantly improved • Better evidence of customer satisfaction from multiple sources • Customer engagement practices variable • Action plans improving Best Practice Division: CLO Good Practice Divisions : SNBTS, CFS, PSD, ISD, NSD, SHSC, Fac Man NSS Average : 3 – Some examples of good practice & evidence of development work

15. Quality & Innovation • Improving climate for innovation • More consistency in setting & hitting targets • Broad establishment of KPI’s • Plans to improve performance in place for all operations • Impact of change programs often compromised by weak process • Meeting regulatory requirements despite increasing pressures Best Practice Division: PSD Good Practice Divisions : SNBTS, NP, CLO, ISD, NSD, CA, SHSC, HFS NSS Average : 4 – Good practices, built into plans, operationally effective

16. Modernising Working Practices • All divisions operating risk management processes • Broad range of initiatives • Most operations can evidence plans for improvement • Good examples of environmental initiatives Good Practice Divisions : SNBTS, NP, PSD, ISD, SHSC, HFS NSS Average : 3 – Some examples of good practice & evidence of development work

17. Increased Efficiency • Most plans include clear efficiency savings • Most operations could share plans to improve efficiency • Little evidence of benefits from process improvement • More consistency in approach • More plans for improving productivity Good Practice Divisions: SNBTS, SHSC NSS Average : 3 – some examples of good practice, and evidence of development work

18. In Summary • Our strongest capability area is partnership working, • Our weakest areas are enhancing our leadership capability & increasing our efficiency • ISD remains our strongest 7 SET operation • NISG has demonstrated the biggest improvement in performance (+1.15) • All operations are expected to be able to demonstrate further progress at the next 7SET reviews in 2010 • Divisions are encouraged to share best practices • A strong priority in 2010 will be narrowing the gap between the best & worst performers. • The 7 SET process itself needs to continue to develop & evolve

19. 7 SET Process Improvements • In 2010 we will continue to use self assessment & a moderating panel • Plan 7 SET reviews for June 2010 • 2010 Format will be evolved by specialist areas & reviewed by Chief Executive (as process owner) prior to issue • Leadership Capability – HR & Workforce / Nurse Director • People - HR & Workforce / Nurse Director • Partnership Working - Strategy & Support / Nurse Director • Customer Focus - Strategy & Support / Nurse Director • Quality & Innovation - Clinical Support • Modernising Working Practices - Finance • Increased Efficiency - Finance • Better connectivity to other areas / initiatives • Leadership capability –joined up processes & review leadership development process progress • People – develop & integrate with staff action plan. Review workforce planning progress • Partnership working – link to partnership forum work & PFPI agenda • Customer Focus – link to account relationship management • Quality & innovation to become more clinically focused, link to QIS approach & quality strategy • Modernising working practices to include risk management. Review outcomes matrix progress • Link efficiency to formal productivity / efficiency program. Review financial planning progress

20. NHS QIS Clinical Governance & Risk Management Review 2009

21. Reviewing Monitoring Implementation CG&RM Standard Development

22. Strengths & Recommendations Strengths • Hosted a series of risk management workshops to ensure that all staff groups are appropriately involved in organisational risk management • Engaged staff in the development of seven strategic enhancement themes (7-SET) which have been defined by the NHS board in order to achieve it’s vision through specific annual targets • Demonstrated long term commitment to equality and diversity.

23. Strengths & Recommendations Recommendations • Develop an accountable framework for business continuity planning which ensures that it is embedded throughout the organisation, and is assessed and evaluated systematically • Embed the principles of clinical effectiveness across all areas of the organisation • Begin to formally review long term arrangements in a planned and systematic manner.