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New approaches within the Health Sector

This document, created by business advisor Andrew Nicholson in May 2007, offers insights into Trust Foundation status and the application process's impact on the Mobility Service of the NTW, encompassing significant details on restructuring governance, service line analysis, and the planning framework, emphasizing the importance of financial freedoms and strategic management within the healthcare sector.

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New approaches within the Health Sector

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  1. New approaches within the Health Sector Andrew Nicholson Business Advisor May 2007

  2. Aims • To provide an overview of the Trust Foundation Trust status • To describe the application process and impact for the Mobility Service

  3. NTW Overview • Formed through merger of three Trusts in April 2006 • Covers population of 1.4 million; wider for specialist services • Financial budget of circa £280m • Five clinical Directorates; Mobility part of Children, Young People and Specialist Services • Aim to be FT in April 2008

  4. Foundation Trust Freedoms • Financial Freedoms • Freedom to retain surpluses • Freedom to borrow (but very limited use) • Freedom from over-regulation (not the experience yet) • Freedom to set own strategy and manage implications (but within a requirement to fully meet NHS targets) • Freedoms very much dependent on overall risk rating • Restructured Governance • Greater public involvement • Greater staff involvement

  5. Planning Framework

  6. Defining Service Lines • Service Lines should be: • The building blocks of the business model • Providing a distinct service offering • Governed by common standards/outputs • Of sufficient size to enable effective service/ business modelling-manageable no. overall • Governed by specific policy • Proposal to use distinct parts of pathway • Single service units serving multiple markets

  7. Service Lines

  8. Service Line Analysis • Need a plan and risk/market assessment for each service line. • For Mobility these included: • Satellite service in Cumbria • Closure of national tertiary service • Replacement and renewal of car fleet • Waiting times • etc

  9. What is Monitor looking? • Realism – not optimism nor pessimism • Forward understanding of tariff (market awareness) • Detailed understanding of service line profitability • Bottom up planned CIPs not balancing figure! • Reflects strategy (joined up story) • Thought through balance sheet – not flat lined!

  10. Example of using Service Line Analysis

  11. Summary • Financial targets can be met by expansion not just cost cutting • FT status includes terms like ‘market analysis’ and ‘profit’ • FT application leads to more detailed planning at an individual service level • FT rewards profitable services achieving targets with freedom to develop

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