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Commissioning Support Services: The Design of Checkpoint 2

DRAFT – RESTRICTED – NOT FOR CIRCULATION. Commissioning Support Services: The Design of Checkpoint 2. 15 February 2012. Content. DRAFT – RESTRICTED – NOT FOR CIRCULATION. Executive Summary 3 Objective and Purpose of Checkpoint 2 4 Outputs from Checkpoint 2 7

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Commissioning Support Services: The Design of Checkpoint 2

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  1. DRAFT – RESTRICTED – NOT FOR CIRCULATION Commissioning Support Services:The Design of Checkpoint 2 15 February 2012

  2. Content DRAFT – RESTRICTED – NOT FOR CIRCULATION • Executive Summary 3 • Objective and Purpose of Checkpoint 2 4 • Outputs from Checkpoint 2 7 • Checkpoint 2 Evidence Base 10 • Checkpoint 2 Assessment Tests 20 • Checkpoint 2 Implementation 29 • Next Steps 40 Text in italics is drawn from CSS guidance in ‘Towards Service Excellence’ and related guidance to SHAs Design of Checkpoint 2

  3. Executive summary DRAFT – RESTRICTED – NOT FOR CIRCULATION As Towards Service Excellence makes clear, Checkpoint 2is one of the most critical parts of the business planning and assurance process for Commissioning Support Services (CSS) and it aligns with the progressive evolution of Clinical Commissioning Groups as they evolve through shadow running and prepare for authorisation. The Business Development Unit (BDU) of the NHS Commissioning Board (NHS CB) has co-developed with SHAs and CSSs, a design for Checkpoint 2 that provides confident assessment of their development and is underpinned by principles of transparency, objectivity, proportionality and accountability. The Checkpoint 2 assessment process provides the foundation for secure development to full viability. It will use a range of evidence from the CSS as well as perspectives from both CCGs as customers and the SHA and PCT clusters in line with their responsibilities for CSS development. Although Checkpoint 2 has been designed to assess the development and improvement trajectory for each CSS to reach Checkpoint 3 across all four development domains: Leadership, Customer, Business and Delivery, the decision about whether the development path for a particular CSS is viable will be made on the basis of fundamental tests of leadership strength, relationships with potential customers and the commercial awareness and confidence of the developing business. The output from Checkpoint 2 will be a decision about the viability of the progression to Checkpoint 2 as well as a jointly agreed and binding development path between the BDU and the CSS leader. Failure to meet the subsequent development milestones will also trigger subsequent decisions about progression to Checkpoint 3. From Checkpoint 2, the lead responsibility for CSS assurance will pass from SHAs to the BDU although SHAs will remain responsible for development support. The Checkpoint 2 process will formally open on 30 March with the submission of the OBP and latest prospectus by CSS. Design of Checkpoint 2

  4. Objective and Purpose of Checkpoint 2 DRAFT – RESTRICTED – NOT FOR CIRCULATION Design of Checkpoint 2

  5. Objective and Purpose of Checkpoint 2 DRAFT – RESTRICTED – NOT FOR CIRCULATION “Checkpoint 2 is the most important part of the business planning and assurance process. It will take place alongside prospective CCGs going through their shadow running as part of their preparation for authorisation. CSSs should be supporting prospective CCGs as they prepare for authorisation and should be using this time to refine and hone the CS offers ensuring that they reflect their customers requirements and needs, at the same time as they also develop their business models and commercial capability. “ The Objective of Checkpoint 2 is to assess that the emerging CSS arrangements are on viable and secure trajectory for development to Full Business Plan (FBP) by August 2012, as a pre-requisite to hosting by NHS CB at April 2013 so that they can deliver high quality support services to the new commissioning system in the NHS. The Purpose of Checkpoint 2 is therefore to assess both the plans and the potential for CSS to develop and improve to the point where they are delivering high quality, commercially viable commissioning services that are valued and affordable for customers. Checkpoint 2 will identify CSS which do not have a viable development plan to achieve the FBP required at Checkpoint 3 and therefore cannot be assured to become a sustainable organisation hosted by the NHS CB. For each CSS at Checkpoint 2 who are assured to proceed to Checkpoint 3, a binding development and improvement plan will be agreed with the CSS and the BDU that will support their accelerated progress, enriches their offer and improves the quality of commissioning support. Failure to meet milestones in this plan will cause the BDU to reconsider support for the CSS. Design of Checkpoint 2

  6. Checkpoint 2 Design Principles DRAFT – RESTRICTED – NOT FOR CIRCULATION The following principles have been used to shape the design of Checkpoint 2: Design of Checkpoint 2

  7. Outputs from Checkpoint 2 DRAFT – RESTRICTED – NOT FOR CIRCULATION Design of Checkpoint 2

  8. Outputs from Checkpoint 2 DRAFT – RESTRICTED – NOT FOR CIRCULATION There will be two core outputs from Checkpoint 2: • The first output will be the result of a formal assessment of the CSS position at Checkpoint2 against a set of fundamental tests in the domains of Leadership, Customer and Business. It will set out the rationale as to why the CSS either has or has not been assured to proceed to Checkpoint 3. The result of the formal assessment will be communicated to the CSS leader by the Chair of the assessment plan within 24 hours of the panel discussion and interviews. • Where the CSS has been assured to proceed to Checkpoint 3, will also be a detailed and binding development plan, which will be prepared by the BDU within 7 days of the panel discussion, and agreed between the BDU and CSS. This plan will set out in in detail: • The development required to Checkpoint 3 • The evidence that will be required to demonstrate achievement • The owner of each development objective • The milestone for achievement. The development plan will be signed by the CSS leader and the BDU. Failure to meet development plan milestones will prompt further assessment of viability to progress to Checkpoint 3. Design of Checkpoint 2

  9. Outputs of Checkpoint 2 – 3 Scenarios DRAFT – RESTRICTED – NOT FOR CIRCULATION Checkpoint 2 Outputs: Three Scenarios Post Checkpoint 2, BDU has responsibility for CSS assurance. SHAs continue to be responsible for CSS development Scenario 1 – CSS application process stops because a failure against fundament tests of leadership, customer focus and business awareness Scenario 2 – Proceed to Checkpoint 3 with a significant requirement for development and improvement (Development plan for FBP) CSS Development Scenario 3 – Proceed to Checkpoint 3 with medium to low requirement for development and improvement (Development plan for FBP) Pre Checkpoint 2, SHAs responsible for CSS assurance and development All CSS will notify BDU if ‘notifiable’ events occur e.g. change of leadership Time Checkpoint 1 Service prospectus December 2011 Checkpoint 2 Outline Business Plan March 2012 Checkpoint 3 Full Business Plan August 2012 Design of Checkpoint 2

  10. Checkpoint 2 Evidence Base DRAFT – RESTRICTED – NOT FOR CIRCULATION Design of Checkpoint 2

  11. Checkpoint 2 Evidence Base - Introduction DRAFT – RESTRICTED – NOT FOR CIRCULATION In order to allow a rigorous and objective assessment for each CSS at Checkpoint 2, the BDU will draw on evidence submitted by the CSS and face to face dialogue with the CSS. In addition, the BDU will draw on perspectives and insight from the SHA and potential customers. The evidence base will be designed to form a consistent and coherent perspective on the development of the CSS. The OBP will frame a dialogue with each CSS, consisting of a panel interview during April and May will to test ownership and self-awareness of the development of the OBP and consistency of the CSS development with the views of the CSS leadership team. Alongside the CSS panel discussion, an interview with the lead CCG customer will also take place to understand the alignment of proposed CSS services with CCG needs and whether a constructive and mutually reinforcing dialogue is being used to refine and improve the CSS offer. A 360o survey will be used to supplement the interview with the lead customer. The panel and customer interviews will form the most important element of the Checkpoint 2 process. Design of Checkpoint 2

  12. DRAFT – RESTRICTED – NOT FOR CIRCULATION Summary of Evidence base for Checkpoint 2 Assessment: • The Checkpoint 1 summary from SHA clusters. • Post Checkpoint 1, Pre Checkpoint 2 assessments from SHA clusters. • The Outline Business Plan • The latest version of the CSS Prospectus at 30th March 2012. • Perspectives and input from SHA and PCT clusters. • Customer perspectives from CCGs identified as CSS potential customers in the OBP. • Dialogue with the CSS in the form of an interview with the CCG leader, a panel assessment of the CSS leadership team and an interview with a leading potential CCG customer. To establish a continuous loop of feedback, SHA clusters should look to seek sight of early drafts of some of the sections during the period from January, February and March before the submission deadline in March. In summary, therefore, the inputs to the evidence base to be submitted to the BDU on 30 March for the Checkpoint 2 Assessment are: Inputs to the evidence base From CSS OBP Prospectus Dialogue Dialogue From SHAs C1 Summary Post C1 Pre Checkpoint 2 assessments Perspectives and input From PCT Clusters Perspectives and input From CCGs Customer perspectives Dialogue Design of Checkpoint 2 Dialogue

  13. Inputs from CSS: The OBP Document DRAFT – RESTRICTED – NOT FOR CIRCULATION Each CSS will submit to the BDU, by 30 March the Outline Business Plan. A template for this plan has been included in previous guidance and we expect the plan to follow these headings. As part of Checkpoint 2, the BDU will develop a consistent synthesis of each OBP to draw out and highlight key facets in a summary of leading indicators of future success. The OBP will be reviewed and assessed by the BDU against both the fundamental assessment tests and these leading indicators across each of the four domains. This will focus the panel discussion in terms of specific discussion points and the interview with the CCG customer. In addition, the review will look for consistency between the written document, dialogue with the leadership team and CCG customer and the perspectives of SHA and PCT Clusters. The OBP should be presented as a ‘living’ document with evidence that it is being used to plan a commissioning support business that will be commercially viable. It should outline the ‘as now’ position of the CSS development story and the development ‘journey’ to Checkpoint 2 including the current status of development. The OBP should clearly identify the author and sponsor and their status. The review of the OBP will also seek to assess confidence that the CSS will support delivery of high quality clinical commissioning operations that build upon and improve those offered through existing support arrangements. There will be some business development issues that CSS do not wish to publish in the OBP at this point. Checkpoint 2 will respect issues concerning content/confidentiality/innovation. Design of Checkpoint 2

  14. Inputs from CSS: The Prospectus DRAFT – RESTRICTED – NOT FOR CIRCULATION The Checkpoint 2 assessment will look for evidence that the CSS ‘offer’ has been developed further on the basis of customer dialogue and whether Is their a clear and direct alignment between the offers to customers outlined in the prospectus and the other core elements of the business plan. Each CSS can submit an updated (from Checkpoint 1) version of their Prospectus to the BDU by 30 March. Some CSS will present this as a standalone document and some as part of the OBP itself. Design of Checkpoint 2

  15. Inputs from SHAs into Checkpoint 2: DRAFT – RESTRICTED – NOT FOR CIRCULATION • SHAs were responsible for Checkpoint 1 assessments and signing off Checkpoint 1. • The responsibility for CSS assurance moved to BDU following Checkpoint 1. • At Checkpoint 2, SHAs will share: • The assessment of local progress of Checkpoint 1 development plans • Any other local post-Checkpoint 1, pre-Checkpoint 2 assessments that have been made by the SHA on CSS development • Any issues regarding the resolution of high risk CSS configuration consequences from Checkpoint 1 and assimilations of Checkpoint 1 feedback • Perspectives of the strength of CSS leadership and the ability of the leadership to drive development to Checkpoint 3. • While the BDU is responsible for overseeing Checkpoint 2, the decision about whether a CSS should progress to Checkpoint 3 will be a joint one. • SHAs continue to provide development support to CSS through to Checkpoint 3. Design of Checkpoint 2

  16. Inputs from CCGs: Customer perspectives DRAFT – RESTRICTED – NOT FOR CIRCULATION Checkpoint 2 will also capture customer perspectives through: • A 360o survey on the issues surrounding the CSS/CCG dialogue and how this is improving the development of both customers and providers of commissioning services • The review of the OBP document that will set out the progress made on customer relationships • Any new Prospectus provided by the CSS (within or outside the OBP) • The panel dialogue which will include a representative from a ‘distant’ CCG. The perspectives obtained will provide evidence of the customer-focus of the aspiring CSS, the extent to which they understand the issues facing CCGs, the stated requirements of CCGs and their thoughts on future CCG support requirements. Design of Checkpoint 2

  17. DRAFT – RESTRICTED – NOT FOR CIRCULATION Inputs from CSS and CCG: Dialogue at Checkpoint 2 (1/2) The Checkpoint 2 assessment couples the document review of the OBP and other inputs from SHAs, PCT clusters and CCGs with face-to-face dialogue. The face-to-face dialogue is more critical to the key development decisions and stop/proceed considerations at Checkpoint 2 than the assessment of the OBP document itself: Checkpoint 1 Summary and pre-Checkpoint 2 Assessments from SHAs OBP and Prospectus from CSS Perspectives and input on CSS development from SHAs and PCT Clusters Customer perspectives Dialogue process Panel interview with CSS Leader and Leadership team (3-4 members) Interview with Lead Customer Outputs: Assessment decision and feedback to CSS Agreed development plan Design of Checkpoint 2

  18. DRAFT – RESTRICTED – NOT FOR CIRCULATION Inputs: Dialogue at Checkpoint 2 (2/2) The dialogue process at Checkpoint 2 will consist of : • A panel interview with the CSS Leader and with the CSS leadership team (3-4 people) • An interview by the panel with the lead customer (defined as the CCG comprising the proposed largest percentage of CSS income) of the CSS. The purpose of the dialogue is to connect both the OBP analysis, soft intelligence and customer perspectives received into a common discussion on CSS development potential. The dialogue will cover the fundamental assessment tests and provide the opportunity for the CSS to describe their development journey from the trajectory at Checkpoint 1and their perspective on the further development and improvement that will be required for Checkpoint 3. It will also provide the panel the opportunity to test the consistency and coherence of the CSS and their self awareness of their development plan and the expected development curve including the challenges and specific support required to maximise the CSS’s potential. The dialogue will also provide the CSS with the opportunity to describe their Unique Selling Points (USPs) and innovation in potential services which the CSS did not wish to describe in their OBP submitted to the BDU. It is NOT the purpose of the dialogue to assess the leader or interview the leader(s) for their post but it will assess whether the leader and the leadership team can drive the development plan required to Checkpoint 3. Design of Checkpoint 2

  19. Inputs: Dialogue at Checkpoint 2 - Composition of the Panel DRAFT – RESTRICTED – NOT FOR CIRCULATION A four person panel is proposed, chaired by a BDU representative. The panel will consist of: • A NHS CB BDU representative who will Chair the panel • An SHA representative which will be one of either the Director of Commissioning Development; or an Immediate deputy considered by the DCD as most appropriate person for the panel • A CCG representative from a different and distant CCG from those proposed as customers in the OBP • An Independent expert who has experience in leading or investing in successful business start ups A person from the BDU assurance support team will be in attendance to ensure that the process facilitates a smooth transition into the creation of an agreed and binding development plan. Design of Checkpoint 2

  20. DRAFT – RESTRICTED – NOT FOR CIRCULATION Checkpoint 2 Assessment Tests Design of Checkpoint 2

  21. DRAFT – RESTRICTED – NOT FOR CIRCULATION Checkpoint 2 Assessment Tests – Introduction Checkpoint 2 will have two assessment components. The first is three fundamental tests to ensure progression beyond Checkpoint 2 which are: • Whether there is the required strength of leadership to support progression to Checkpoint 3 • Whether the CSS has a focus on potential customers and whether they are supporting a constructive and mutually beneficial dialogue with customers about requirements and value propositions that allows a compelling ‘offer’ to be made by a customer-focussed CSS from April 2013 • Whether the CSS has the core business awareness, mindset and commercial drivers at the heart of its plan for future success. The second is an assessment against a set of leading indicators across each of the four domains where the assessment will focus on the extent of further development/improvement that will be required for Checkpoint 3 and the FBP. Design of Checkpoint 2

  22. DRAFT – RESTRICTED – NOT FOR CIRCULATION Summary of Fundamental Assessment Considerations Checkpoint 2 is positioned to ensure that CSSs that progress past this point are able to achieve the required commercial strength to be able to deliver high quality commissioning services to their customers. There are three fundamental tests to ensure progression beyond Checkpoint 2: • CSS will need to demonstrate that there is the strength of leadership to support progression to Checkpoint 3 and agree a binding development plan with the BDU • CSS will need to demonstrate that they have formed a constructive and mutually beneficial dialogue with potential customers about requirements and value propositions. This dialogue will allow a compelling ‘offer’ to be made by a customer-focussed CSS from April 2013 • CSS will need to demonstrate that they have the core commercial mindset at the heart of their business planning, a solid awareness of the business drivers for future success and evidence that this awareness has been translated into business planning activities. Fundamental Assessments Strength of Leadership Customer Focus Business Development Proceed to Checkpoint 3 Stop Leading Indicators Scenario 1 – CSS application process stops Scenario 2 – Proceed to Checkpoint 3 with a significant requirement for development Scenario 3 – Proceed to Checkpoint 3 with medium to low requirement for development Design of Checkpoint 2

  23. DRAFT – RESTRICTED – NOT FOR CIRCULATION Summary of Development/Improvement Considerations Where the CSS has passed the fundamental assessment tests, there will a second assessment against a set of leading indicators across each of the four domains: Leadership, Customer, Business and Delivery. The assessment will focus on the extent of further development an improvement that will be required for Checkpoint 3 and the FBP The output of the assessment will result in two probable scenarios: • CSS’s which will require from SHAs, ongoing significant levels of development support; • CSS’s who have made the most substantial progress with medium to low levels of development support required for Checkpoint 3. The output of the second assessment will be a jointly agreed and binding development path between the BDU and the CSS leader. Failure to meet the subsequent development milestones in the development plan will also trigger subsequent decisions about progression to Checkpoint 3. Fundamental assessments - passed Leading Indicators Leadership Leading Indicators Customer Leading Indicators Business Leading Indicators Delivery Scenario 2 – Proceed to Checkpoint 3 with a significant requirement for development Binding agreed development plan between CSS & BDU Scenario 3 – Proceed to Checkpoint 3 with medium to low requirement for development Binding agreed development plan between CSS & BDU May 2012 – August 2012 Monitoring by BDU Breach of binding agreement Decision to Stop Design of Checkpoint 2

  24. DRAFT – RESTRICTED – NOT FOR CIRCULATION • Fundamental Assessment of the Strength of Leadership There are eleven elements within the tests of CSS leadership. At Checkpoint 2, the CSS will need to demonstrate that: • A leader has been appointed and is in place to lead the development of the CSS to Checkpoint 3 • The leader has been instrumental in sponsoring and shaping the key decisions within the OBP • The views of the leader are consistent with the vision, values, ethos and beliefs encapsulated in the OBP • The leader and the leadership team are spending more than 75% on developing the CSS (not more than 25% on other roles) • The personal objectives, goals and motives of the CSS leader are consistent with the requirements of CSS development to Checkpoint 3 • The customers have confidence in the leader of the CSS • There is a core leadership team in place with distinct roles to support the CSS leader • There a scheme of delegation that enables the leader to make rapid decisions about CSS development including deployment of staff, investment in the supply chain, commissioning tools and techniques and the use of delivery partners • There is evidence of passionate and inspirational leadership ‘setting the tone’ and driving the communication of vision, values, ethos and mission to customers and within the developing CSS • There is evidence of leadership underpinning the business development dialogue with customers • There evidence of leadership making commercial decisions about the financial plan and business KPIs The assessment IS NOT A TEST OF CAPABILITY OF LEADER BEYOND CHECKPOINT 3 DELIVERY. It is testing the ability to lead sufficiently to take the CSS to the next stage of development and to commit to a binding development plan between the CSS and the BDU. Design of Checkpoint 2

  25. Fundamental Assessment of ‘Customer’ Focus DRAFT – RESTRICTED – NOT FOR CIRCULATION There are five elements within the tests of customer focus. At Checkpoint 2, the CSS will need to demonstrate that: • The CSS has a deep understanding of the issues and challenges facing potential customers • The CSS understands the interplay between likely customer needs and stated customer requirements • There is evidence that this understanding is continuing to shape the service propositions that will be offered by the CSS • There is evidence of a continuing, constructive and mutually beneficial dialogue between the CSS and potential customers from Checkpoint 1 • The CSS is communicating value propositions and differentiating its offer to customers from likely competitors. Demonstratesunderstanding CSS CCG Proposes services of value A mutually beneficial dialogue between the CSS and potential customers Aids understanding Describes value of different offers Design of Checkpoint 2

  26. Fundamental Assessment of Business Development DRAFT – RESTRICTED – NOT FOR CIRCULATION At Checkpoint 2, CSS will need to demonstrate that: • There is evidence of the CSS planning for sustainable commercial success through the provision of high quality commissioning services to customers • There is evidence of credible financial planning underpinned by an understanding of the key parameters of financial success: • Turnover • Margin (both cost base and income drivers) • Pricing and pricing strategies • Costing and delivery management • The CSS leadership has identified the key risks to commercial success and they have the strategies and tactics to manage and mitigate against these risks • The CSS has undertaken sensitivity analysis on customer/business scenarios and behaviours and has used this analysis to shape business development activities and the financial strategy of the CSS • There are clear connections between customer expectations, the service offer and the financial strategy within the OBP. Design of Checkpoint 2

  27. DRAFT – RESTRICTED – NOT FOR CIRCULATION Individual Vs Collective Assessment Fundamental assessment – Leadership Strength The three fundamental assessment tests are inter-related and inter-dependent. Strong, passionate and visionary leadership is the fundamental foundation of successful business planning, a failure to pass the leadership assessment would also result in failure in the other two assessments. A customer-focussed enterprise ensures that commercial success is gained through a deep insight into the business issues facing customers and the propositions they will value. A failure of the customer focus assessment would lead to failure of the business development test since the commercial analysis is not grounded on the foundation of valued service propositions. Not ‘passing’ Strength of Leadership assessment would mean an overall failure to pass remaining tests Fundamental assessment – Customer focus Not ‘passing’ Customer focus assessment would mean a ‘pass’ could not be achieved on ‘Business Awareness’ Fundamental assessment – Business development Design of Checkpoint 2

  28. DRAFT – RESTRICTED – NOT FOR CIRCULATION Checkpoint 2: Implementation Design of Checkpoint 2

  29. DRAFT – RESTRICTED – NOT FOR CIRCULATION Checkpoint 2: Implementation - Introduction The Checkpoint 2 process will formally open on 30 March with the submission of the OBP and the updated perspective by CSS to the BDU. Responsibility for CSS assurance is handed to BDU at Checkpoint 2 which begins directly after Checkpoint 1 has concluded. CCGs will be invited to submit any customer perspectives also by 30 March and both SHAs and PCT clusters will submit their perspectives and soft intelligence on CSS development to the BDU on the same date. Panel assessments and customer interviews will take place over a 3 to 4 week period from Mid-April with the process concluding by Mid-May. Design of Checkpoint 2

  30. DRAFT – RESTRICTED – NOT FOR CIRCULATION Checkpoint 2: Implementation – Roles of the BDU and SHA clusters Role of the BDU The BDU will manage and oversee the Checkpoint 2 assurance process. The BDU will assess OBP documents following their submission on 30th March against fundamental assessment criteria and leading indicators and will request and review perspectives from SHA Clusters, PCT Clusters and CCGs. BDU will chair all assessment panels and will be responsible for communicating the outcome of the fundamental assessment tests within 24 hours of the panel discussion assessment and agreeing development plans with CSS for Checkpoint 3 within 7 days of the panel discussion. The BDU will be solely responsible for the assurance process at Checkpoint 3 which will be an assessment of commercial viability through strong leadership, customer focus, sound delivery capability and robust business models. Role of the SHA SHAs will continue to support CSS development following Checkpoint 1 and assist the resolution of issues that threaten successful assessment at Checkpoint 2 SHAs will provide ongoing support to the development of CSS OBPs up to submission to the BDU on 30 March SHAs will provide soft intelligence as an input to the Checkpoint 2 evidence base and attend assessment panels Where CSS fail to demonstrate that they have passed the fundamental assessment tests, SHA clusters will be responsible for completing the impact assessment and support CCGs and PCT Clusters to resolve the implications on CCG authorisation. Development plans agreed by the BDU with CSS will be shared with SHAs and they will continue to provide development support to CSS up to Checkpoint 3. Design of Checkpoint 2

  31. DRAFT – RESTRICTED – NOT FOR CIRCULATION The Role of BDU and SHA clusters at Checkpoint 2 “The BDU will oversee the process [Checkpoint 2] nationally. SHA cluster Directors of Commissioning Development and their staff will play a critical role in the business planning and assurance process. SHA Clusters should work with emerging commissioning support to oversee the development of sustainable operations, ensuring that the necessary service expertise, culture change and planning takes place and that CSS meet the timescales set out in the business review”. Assurance process for the CSS overseen by the BDU from Checkpoint 1 and managed from Checkpoint 2 onwards Management of Assurance CSS Development Joint decisions on CSS by SHAs and BDU made at Checkpoint 2 Leading Development support Ongoing development of the CSS managed by the SHA Clusters in parallel with support for CCG authorisation Time Checkpoint 1 Service prospectus December 2011 Checkpoint 2 Outline Business Plan March 2012 Checkpoint 3 Full Business Plan August 2012 Design of Checkpoint 2

  32. DRAFT – RESTRICTED – NOT FOR CIRCULATION From end of Checkpoint 1 to Pre Checkpoint 2: Timeline January 2012 February 2012 March 2012 SHAs complete CSS summary report from Checkpoint 1 Identifying, agreeing and resolving high risk CSS configuration consequences from Checkpoint 1 BDU plan the logistics for the Checkpoint 2assurance process i.e. Panels SHA/CSS confirm availability and dates for Panel assessment BDU conduct a Checkpoint 2 design workshop with SHA and CSS Lead    BDU circulates the templates for capturing soft intelligence to SHA, PCT Clusters, CCGs CSS submit Prospectus, OBP and supporting documents for Checkpoint 2 assessment to BDU BDU designs and implements a communication plan for Checkpoint 2 Assimilating Checkpoint1 feedback and development plans  Soft intelligence SHA communicate the details of Checkpoint 2 design to CSS applicants & CCGs SHAs share soft intelligence to guide decisions pre-Checkpoint 2 Checkpoint 2 process Customer intelligence  CSS prepare the inputs for Checkpoint 2 assessments SHA and CSS agree joint actions on CSS reconfiguration.  Prospectus OBP/ Delivery Assurance document Design of Checkpoint 2

  33. DRAFT – RESTRICTED – NOT FOR CIRCULATION • From end of Checkpoint 1 to Pre Checkpoint 2: Timeline - Summary Role of the BDU • BDU shares the communication details of Checkpoint 2 with SHA for their respective CSS and CCGs. • BDU will work with SHAs on the handover of responsibilities for CSS assurance including support for bi-lateral meetings with CSS where required • BDU will plan the logistics and dates for Checkpoint 2 i.e. panel assessments and customer interviews. • BDU will circulate templates for capturing perspectives on CSS development to SHAs, PCT Clusters and CCGs. Role of the SHA Clusters • SHAs will continue to support prioritisation of CSS development following Checkpoint 1and provide ongoing support to the development of CSS OBPs up to submission to the BDU on 30th March • SHAs will provide the BDU with a baseline assessment of the development and improvement trajectories for each CSS and implications of any agreed CSS reconfiguration following Checkpoint 1 with updates on a weekly basis. • SHA Clusters confirm availability and dates for Panel assessments. • SHA submits CSS perspectives to the BDU by 30th March. Key Milestones • SHAs provide a baseline assessment to the BDU by Monday 20th February. • SHAs provide weekly updates to the BDU ongoing up to Friday 30th March. • SHA Clusters communicate details of Checkpoint 2 with SHA for their respective CSS applicants and CCGs by Tuesday 21st February. • BDU plans the logistics and dates for Checkpoint 2 Panel assessments by Friday 24th February (tbc). • BDU circulates templates for capturing soft intelligence to SHA, PCT Clusters and CCGs by Friday 17th February (tbc). • SHA Clusters confirm the availability and dates for Panel assessments by Wednesday 29th February (tbc). Design of Checkpoint 2

  34. DRAFT – RESTRICTED – NOT FOR CIRCULATION Checkpoint 2: Timeline May 2012 March 2012 April 2012 Pre Checkpoint 2 BDU reviews the OBP, Prospectus submitted by the CSS and draft a create CSS summary on a Page BDU obtains soft intelligence from SHA, Clusters, customers Interview with CSS Leader and with the leadership team (3-4 people) BDU discuss and agrees the development plan with the CSS Leadership team Soft intelligence Customer perspectives Dialogue DEVELOPMENT PLAN Interviews/discussion with the lead customer of the CSS Final OBP and CSS one page review by BDU and SHA CSS summary sent to the CSS for confirmation on details BDU finalises the Development plan for the CSS PASS / FAIL? BDU consolidates perspectives, agenda for panel visit and pre-panel briefing PASS Are the details correct? Yes BDU issues the outcome of the CSS Assurance process to all CSS applicants Pre panel briefing FAIL No Agenda BDU communicates the outcome of the Panel assessment to the SHA and CSS C3 Process CSS provides feedback to BDU on missing elements and leading indicators CSS on a page STOP Design of Checkpoint 2

  35. DRAFT – RESTRICTED – NOT FOR CIRCULATION • Checkpoint 2: Timeline - Summary Role of the BDU • The BDU will manage and oversee the Checkpoint 2 process. • BDU representatives will assess OBP documents, obtain and review perspectives from SHA Clusters, PCT Clusters and CCGs as customers. • BDU will chair all assessment panels and will be responsible for communicating the outcome of the fundamental assessment tests within 24 hours of the panel discussion and agreeing development plans with the CSS for Checkpoint 3 within 7 days of the panel discussion. Role of the SHA Clusters • SHAs will provide perspectives on CSS development as an input to the Checkpoint 2 evidence base and • An SHA representative will form part of all assessment panels. • Development plans agreed by the BDU with CSS will be shared with SHAs and they will continue to provide development support to CSS up to Checkpoint 3. Key Milestones • CSS submit their OBP and Prospectus to the BDU by 5pm on Friday 30th March. • SHA Clusters provide CSS perspectives to the BDU by Friday 30th March (tbc). • CCGs provide feedback on CSS customer perspectives to the BDU by Friday 30th March (tbc). • CSS’s confirm ‘CSS on a page’ summary by Friday 13th April (tbc). • Panel interviews and assessment take place in three triaged waves between w/c 16th April and w/c 7th May (tbc). • Feedback on panel assessment are provided to CSS’s by Friday, 11th May (tbc). • Development and Improvement plans are agreed with CSS’s by Friday 18 May (tbc). Design of Checkpoint 2

  36. DRAFT – RESTRICTED – NOT FOR CIRCULATION CSS on a page Following an assessment of the OBP and Prospectus documents submitted to the BDU on 30 March, a ‘CSS on a page’ summary will be prepared based on the leading indicators across all four domains of Customer, Leadership, Business and Delivery. The completed CSS on a page template will then be sent to the CSS to confirm and agree the accuracy of the information on the template and then return the template back to the BDU. The CSS on a Page will form part of, along with soft intelligence and customer perspectives, of the briefing pack for assessment panels and help focus the agenda of panel discussions and customer interviews. Design of Checkpoint 2

  37. CSS One-page summary Name of Commissioning Support Service: Mission/Objectives/Purpose/Values: Leadership: Name of CSS Leader: Status of Leader: CV of leader available?: Leadership team: Structure: Customer: Expected customers and size: Status of customer/CSS dialogue: Customer Matrix Business: Financial plan: 1 yr ?(Y/N): Pricing strategy? (Y/N) Financial plan: 3 yr+?(Y/N) Expected turnover in 2013/14: Expected margin in 2013/14: Fixed/variable cost proportion: Sensitivity analysis? (Y/N) Risk assessment?: (Y/N) Organisational development/recruitment plan? (Y/N) IM&T implementation dependencies identified? (Y/N) Other enablers/infrastructure: Delivery: CSS Structure chart: (Y/N) Delivery model (Y/N): Expected launch date: Pre-launch trading details: Delivery partners and role: Supply chain partners and role: Status of partnership agreements:

  38. Summary of the Assurance process CCGs evolve mission, ethos, vision, operating model and begin to discuss do/buy/share options and define commissioning support requirements As part of preparations for authorisation, CCGs establish firmer agreements with CSS and demonstrate management costs are within envelope CCGs work with CSS to establish Service Level Agreements. While ‘shadow’ CSS and Cluster Teams are supporting CCGs to this point, CCGs from Oct 2012 are receiving CSS consistent with management cost CCG acting as customer of CSS. Period of time provides track record of delivery required for authorisation Reminder of the CSS assurance process and timescales Early plan and development Sept – Dec 2011 Stage 1 Initial implementation Jan – Jun 2012 Stage 2 Mobilisation Jun Oct 2012 Final approval and NHSCB hosting Oct – Apr 2013 • Forming ethos, values, mission, and early customer engagement • Key functions identified for potential inclusion in CSS offer • At scale activities defined • High level review of the potential market players • Governance arrangements confirmed to enable design process • Commissioning Support value proposition confirmed • Decision on arrangements for April 2013 – host or outsource • CSS leadership and business development team in place • Organisational architecture confirmed • Planning completed and design principles agreed • Value proposition completed • HR and OD plan in place • Staff consultation commences • Assets, estates & supporting infrastructure confirmed • Finance, costing and pricing structure emergent and visible; consistent with (RCA) • Model CS contract established • CSS commence in shadow forms • Risk assessment and mitigation plans in place • PCT clusters implementing TUPE consultation and staff transfers as appropriate • Customer relationships and marketing and approach agreed • Evidence of CSS contract pipeline with MOA/SLA for contract 2013/14 • Due diligence undertaken on plans • Notation or assignment of existing contracts confirmed • Partnership arrangements identified • Commercial plans produced • NHSCB decision of support to be hosted • Compliance with assurance criteria • Contracts and SLAs agreed • 360 assessment of business models undertaken • Risk assessment and mitigation plans in place • Performance monitoring systems established • Formal transfer to hosting arrangement • CSS trading under NHSCB hosting arrangements Checkpoint 1 Service Prospectus December 2011 Checkpoint 2 Outline Business Plan March 2012 Checkpoint 3 Full Business Plan August 2012

  39. DRAFT – RESTRICTED – NOT FOR CIRCULATION Commissioning Support Services:The Design of Checkpoint 2 15 February 2012

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