Portfolio Overview as at 13.01.11 page 1 of 3Portfolio Headlines

Clinical pathway work is progressing, with all three clinical pathway programmes being reviewed to take forward the next stage of planning related to supporting implementation, against IBP dates.

Stakeholder engagement has progressed with three borough LA, PCT and GP involvement and a shared risk and issue log being drafted.

The St. Bernard’s Redevelopment programme will impact significantly on the care pathways, financial, workforce and estate plans.

The Cassel Business Case is temporarily on hold due to legal and process issues

Top 3 Portfolio Risks/Issues Benefits Realisation

1. Advice re: legal issues in Cassel Hospital Business Case has put temporary hold on progression of Business Case

2. New PCT and LA Clustering exerts another “pull” and increases stakeholder engagement risks to cross borough pathway work – mitigation in process through engagement and risk & issues log

3. Three key programmes to support IBP for FT application have implementation and financial issues and risks

•Pathways will increase consistency of service and improve patient experience across three boroughs•Stakeholder engagement events will build relationships to strengthen FT process•Pathways will support service line reporting and PbR for mental health•Clarity in expectation of efficiency targets should improve focus on service redesign delivery and workforce requirements•Estate rationalisation should support efficiencies

Summary of individual Work Stream RAG Assessments

Programme Previous Current Comments/Detail

Meeting Statutory and Regulatory Requirements

Executive Sponsor: Nigel Leonard Governance structure refined – meeting in January with key senior staff to approve document for internal consultation

Improving the efficiency of Central Services

Executive Sponsor: Barbara Byrne Inventures review implementation still in progress

Other work BAU

Developing and Motivating our people

Executive Sponsor: Peter Cubbon OD and workforce issues mapped as Business as Usual

SpR Leadership Programme with PMO has commenced

Enhancing High Secure Services

Executive Sponsor: Leeanne McGee As previous months – work stream is amber, still awaiting DH approval of OBC

Improving Service Delivery (London)

Executive Sponsor: Peter Cubbon Stakeholder engagement progressing well.

St Bernard’s Redevelopment programme – OBC deadline Nov 2011 – impact on care pathways implementation

Cassel Business Case on hold due to legal advice

Improving Patient Experience & Safety

Executive Sponsor: Steve Trenchard Time to Care still behind schedule however plans to mitigate are in place. Exit strategy from the programme identifies future risks re: sustainability

Portfolio Overview as at 13.01.11 Page 2 of 3Work Stream Headlines Key Issues and Delivery Risks

Meeting statutory and Regulatory Requirements

Nigel Leonard

This Programme is amber as the programme objectives are subject to a number of organisational risks and issues.

New Governance Structure being refined to consult to internal senior team

•Overall Trustwide responsibility for Compliance and Assurance still not identified, separated across a number of individuals and functions.•Organisational re-structure will be aligned to governance structure•Clear compliance and reporting structure and process vital to FT application and IBP

Improving the Efficiency of Central Services

Barbara Byrne

Electronic job planning progressed to implementation stage, however future funding a risk

Inventures review recommendations have been processed by EDs, and form part of the next stage of the Trust re-structuring consultation

•Trust-wide consultation 2nd stage to be implemented – Jan-March ‘11•Other reviews of central services form part of this•Organisational consultation will impact on how central services are delivered•Outsourcing project now undergoing feasibility study for the business case

Developing and Motivating our People

Peter Cubbon

Business as Usual

Consultation on move to three CSUs will impact on workforce

SpR leadership and management programme commenced

•Anxiety continues to be high and needs to be managed with the amount of internal and external change and ‘unkowns’•Financial efficiencies, consultation and external change will impact on staff morale •SpR leadership programme increases medical engagement in business perspective

Enhancing High Secure Services (Broadmoor)

Leeanne McGee

OBC approval still with DH

Mall/Clinical model work continues

•OBC is not approved by the Department of Health – interim risks documented through Redevelopment Programme Board and assurance programme board•Financial interdependencies with St Bernard’s Redevelopment Programme a risk

Portfolio Overview as at 13.01.11 Page 3 of 3Work Stream Headlines Key Issues and Delivery Risks

Improving Service Delivery (London)

Peter Cubbon

•Care pathways based on NICE Guidance, Map of Medicine and best practice completed•Associated finance/workforce/estate detail of preferred models continues to support IBP•Stakeholder Engagement Strategy complete, engagement activity progressing well•Pathways oversight group now operational to manage communication, risks and issues•Relationship management with external GPs, PCT Clusters and LA prioritised and progressing•Specific SDU projects to reduce caseload•Cassel Business Case – legal advice to go to public consultation has put Business Case on hold temporarily

•Some proposed pathway redesign may not be financially viable•Stakeholder engagement progressing well, with shared three borough risks and issues log being drafted.•Key risks around differing stakeholder drivers and priorities still high - for all clinical pathways, complex commissioning arrangements and changes in organisational clusters and affiliation may impact on tight delivery timescales and pathway implementation•Clinical pathway programmes need to be reviewed and longer term “ageless” service progressed, in order to manage key interdependencies such as transitions (ages 14-25 year olds), and vulnerable older adults with functional illness•Forensic pathway programme board dates need to be set for 2011•St Bernard’s redevelopment programme interdependencies being mapped, and “masterplanning” group has been proposed•Cassel Business Case – business case temporarily on hold as, due to high media and political interest, legal advice is to progress and Equality Impact Assessment and go to public consultation. •Still awaiting national funding decision re: Cassel Family Service•Workforce and financial action plan to bring family service “in budget” requested by 31 Jan 2011 to be implemented 1 April 2011.

Improving Patient Experience and Safety

Steve Trenchard

•Time to Care Programme has financial and implementation risks

•Will not be able to deliver a fully embedded and effective programme by March 2011 under baseline programme timeframe, and sustainability on exit from programme a risk•Exit strategy from programme in plan