NHS 24 Strategic Planning Resource Allocation (SPRA) and Financial Plan 2018/19 – 2022/23

1. NHS 24Strategic Planning Resource Allocation (SPRA) and Financial Plan2018/19 – 2022/23

2. Introduction • This presentation is a summary of the key outcomes from the 2018/19 SPRA Process • Follows the process as set out and agreed in Board Development Session in January 2018 • Process has also been presented and reviewed by the Audit and Risk Committee in March 2017 • Underpinned by the NHS 24 Strategic Objectives and Delivery Principles • 5-year summary of key activities • Financial plan and key assumptions • Supporting developments in relation to Governance and Performance arrangements • Risk considerations in relation to the plan • Equality and diversity considerations in relation to the plan

3. NHS 24 Key Principles In line with the delivery principles within our Strategy our resource allocation process is committed to: Adding value to the health and social care system across Scotland Delivering services as effectively and efficiently as possible Driving additional value to our partners through maximising our infrastructure, capacity and capability 24/7 Releasing cash savings, cost avoidance and productive opportunities across the national boards and to the regions through more effective and focussed collaboration

4. Vision 2018-2023 “To deliver a range of optimised health & social care services to the people of Scotland in an integrated seamless way, accessible through a range of channels, delivered by a highly skilled and valued workforce” 22/23 • An integrated multichannel range of unscheduled and scheduled care services for the Health & Social Care sector of Scotland in and out of hours. • Empowerment of patient and staff to contribute to the quality improvement agenda. • Continued extension of in hours services to support primary care and outpatients in line with strategic delivery plan. 21/22 • Continued extension of in hours services to support primary care and outpatients in line with strategic delivery plan. • Blended workforce and service delivery model embedded. • Continued growth of digital first within BAU. 20/21 5 Year Strategy – Summary of Key Activities • Strengthen access through digital channels, ensuring staff are skilled and workforce model is appropriate. • Continued development of GP triage, outpatient triage, advanced clinical support models. GPT Service model supporting a further +100,000 growth in service. • Implement and embed outputs from mental health services review. • Progress development of sexual health helpline to be in place 2022. • Flexible remote working opportunities established and in place. • Complete implementation of shift review outputs. • Embedded organisational approach to change. • Continuing growth in digital first provision of services and +10% channel shift. • Fully national MSK and PRS service in place. 19/20 • Continue to review the service management model to optimise blended workforce capacity, support strategic developments and introduction of new services. Lead the shift review process to better align capacity to demand. Draw out capacity, capability and skills especially around digital. Stabilise 111 service. • Support the delivery of national boards collaborative plan, working with regional and IJB partners to develop and implement appropriate new service models. Take forward Shared Services agenda. Look at Victim Support work. • Work with partners across OOHs, SAS, IJBs to improve patient journey and referral of patients. Take account of social care. Stakeholder engagement work to be taken forward. • Deliver the expansion of the GP triage service to include 100,000 population, including evaluation, development and delivery of technical system solution and patient pathway and protocols. • Deliver the expansion of the advanced clinical support, including effective design of operational model. • Support the development of outpatient triage services including evaluation, development and delivery of the technical solution and patient pathway and protocols. • Design and deliver review and redesign of NHS 24 Mental Health services. • Deliver implementation plan for growth and expansion to the channels by which the public can access our services. Digital alignment work required with a channel shift from 111 to online services. Deliver aspects which align with GPT, ACS, MH & MO. • Lead the development and delivery of eHealth and data strategies. • Lead the development and delivery of the workforce strategy and staff engagement process. • Consideration on whether flexible/remote working is achievable in 2018/19. • Consideration to be given to the development of a Quality Strategy or Performance Governance Obligation encapsulating people management, financial responsibilities, risk management and quality. • Lead the development of Corporate Performance Reporting. 18/ 19

5. Five Year Financial Plan 2018/19 to 2022/23 • Key Objectives • Statutory responsibility to confirm financial balance over the period of the plan • Deliver best value and efficiency in resource utilisation • Evidence value add to the Health and Social Care Services in Scotland • Key Risks & Issues • Overall challenges in demand for and access to key services • Overall financial position for Health and Social Care Services in Scotland • Delivery of Strategic Development Programme • Effective delivery of the National Board Collaboration • Workforce Planning assumptions. Proposal to increase workforce plan for USC above the total resource agreed in the 2017/18 RAM • Significant brokerage repayment profile from 2018/19 • Challenge for Non Clinical departments to achieve Efficiency Savings

6. 5-Year Key Financial Planning Assumptions • Annual uplift on income of 1% included in each year. • 3% uplift for salaries less than £36k, 2% uplift for salaries above £36k in each year. • Additional funding to be provided to cover salary uplift for A4C staff. This is not guaranteed to be funded in full. • A non recurring saving of 5% applied to non clinical areas. • Income reduces in line with repayment of brokerage from 2018/19. Brokerage fully repaid in 2022/23, thereafter there is a recurring surplus. • Frontline budget has been increased by £1.9m to take staffing levels to optimal requirement agreed at February 2017 RAM meeting. This represents £3.8m increase over 2 years. • Approval to increase this further in 2018/19 by £0.75m. • Corporate Reserve £0.5m in each year. • SG European monies of £1m no longer received. • National Transformation Fund monies assumed in line with 2017 business case. Now to be considered as part of the National Board Collaborative Proposals.

7. Strategic Planning Resource Allocation –Priority Funding to Support: Additional frontline staffing request. Cost is a minimum of £0.75 million. Head of Clinical Service post at Cardonald created, cost of £73k. 2 Planning posts created within Governance & Performance directorate at a cost of £117k. Facilities Manager post added at a cost of £52k. Allowance of £200k included with Technology budget for system enhancements including clinical content. £33k added to HR budget to run a Leadership Programme.

8. Summary Financial Position Statement – based on 5% savings target for non clinical areas

9. Efficiency Savings Challenge – based on 5% savings target for non clinical areas

10. We will review the strategic planning team requirements and associated investment in people and skills to enable delivery of future strategic and tactical planning needs. This will aim to better equip the organisation to: Develop its policy and planning response to SG and wider system strategic developments Improve the internal planning support provided to key groups and programmes Contribute more fully to the national, regional and local planning arrangements of our partners. Support Board Administration and Development We will continue to contribute to the National Boards Collaborative Plan and in particular work closely with SAS to support our national, regional and local partners to plan, test and implement new service models which are aligned to SGs Health & Social Care Delivery Plan. We will lead work to continue to improve the organisational culture to risk management in terms of training, implementation of effective risk management practice and supporting a review of the role of risk groups. We will facilitate and drive an improvement plan regarding our emergency response arrangements - business impact assessment, business continuity framework, disaster recovery plans. Governance & Performance - Key Messages

11. *We will facilitate, educate and drive implementation of our Records Management Plan and review all information security policies. *We will facilitate improvements and organisational compliance in:- Information Governance arrangements with specific training on information security policies, FOI requests and business classification. readiness for the introduction of General Data Protection Regulation in 2018 We will support the development of a measurement framework in relation to our Service Transformation Programme. We will lead relevant areas in support of the development of a corporate measurement framework and associated visualisation of data and information. We will, through the provision of high quality data & analytics, support the continuous improvement of NHS 24 service delivery. *Leadership for these development areas will be transitioned to the Chief Information Officer Governance & Performance - Key Messages

12. Key Strategic Risk Considerations • Business • Stabilise, develop and maintain the core 111 service • Ability to deliver multi channel & digital solutions • Broad scope of service development proposed • Cash efficiency savings • Staff • Develop appropriate workforce model that will include the appropriate capacity and capability • Empower and develop staff • Clinical • Ensuring Clinical Governance arrangements are in place internally and across our partners to support new service development • Consistently delivering safe, effective, person centred care • Reputation & Stakeholder Engagement • Working effectively with partners to co-design and deliver models of care

13. Equality and Diversity Considerations • General equality duty • Eliminate discrimination • Advance equality of opportunity • Foster good relations • The Fairer Scotland (Socio-economic) Duty • Actively consider reducing inequalities • In strategic decision making • Policy development • Human rights • Inclusive • Joined up and responsive • Focussed on outcomes