Case Study: System Wide Financial Recovery

Background

This assignment consisted of the recovery of three separate but linked Quality, Innovation, Productivity and Prevention (QIPP) recovery programmes.

We also identified that there was a significant cultural problem throughout the organisation in that there was little understanding of the concerning financial situation within the organisations we worked with, and little will to make the changes required to recover the position.

How We Helped

We approached each separate sub programmes in the same way.
• We reported to the Chief Officer/Finance Director
• We undertook a diagnostic review of the state of the QIPP plans at the point of our appointment.
• We reviewed the available PMO function including governance arrangements.
• We wrote a short report to show our findings and give recommendations for recovery.
• We commenced ‘1:1’ accountability/assurance meetings with the allocated SRO’s, Project managers and finance leads. Where there were issues to be resolved, these were held weekly, others two weekly.
• We used the meetings above to challenge, to offer support, advise and coach. The meetings were used to drive QIPP achievement through improving Drive and Pace.
• We set up governance arrangements, to oversee the achievement of the QIPPs.
• We set up and ran PMO’s and linked these to organisational structures so that sustainability would be maintained after we withdrew.
• We acted as experts in Programme/project management and also in the health care themes that the projects covered. These included, outpatient restructure, clinical pathways redesign in cardiology, respiratory, gynae and dermatology and mental health patient reviews.
• We ensured that our work was embedded within the organisations processes, so the programmes would be sustained.
• We undertook a supporting piece of work in working alongside key stakeholders to help address the cultural issues.

Results

• Significant financial improvements were achieved . Our total financial impact was 46.6 million of improvement over two financial years.
• By working with the management teams (including clinicians), we supported the identification of opportunities for QIPP and develop clear plans for implementation.
• Clear lines of accountability were defined and staff understood their roles and
responsibilities; this accountability was held through the weekly assurance meetings.
• We had success in leaving teams who were more aware of their roles and responsibilities in project management, and with a PMO, that understood the need to monitor achievement against plan. This included a greater integration between schemes across the 8 CCGs and the control of those through linked PMO’s. Governance was stronger in each case.
• We greatly increased the clinical engagement in the CCGs that we had worked with directly, and through developing a close working relationship with the senior management teams were able to influence them in focussing on the need for financial recovery.
• We were able to leave our assignment with a sustainable programme in process.