As part of the Phase 4 National QIPP Support Programme, Midlands and Lancashire Commissioning Support Unit (CSU) and North of England CSU were commissioned by NHS England (NHSE) to provide QIPP support to North Cumbria Clinical Commissioning Group (CCG).
The CSUs worked collaboratively to develop a system-wide QIPP implementation plan and to consider, scope and recommend opportunities to stretch existing schemes or identify new opportunities to optimise in-year delivery.
Action The CSUs started by reviewing the CCG’s Efficiency and QIPP Plan and associated documentation to establish a working knowledge of the specific plans and schemes and to highlight any issues, gaps or concerns to the CCG.
The review highlighted gaps in the governance process and the level of alignment of the system-wide PMO with the QIPP PMO, raising the level of risk against delivery and potentially increasing the existing financial gap of circa £940k to meet the £14m QIPP target.
Through a joint approach, the CSUs and the CCG agreed these areas of focus:
* all plans and business cases to be completed and taken through a single gateway process for scrutiny and formal sign-off
* all scheme implementation and delivery plans to be completed with clear measures and a phasing across the financial year
* a consistent set of RAG rating principles and risk adjustment percentages to be developed and agreed with a single reporting tool that captures the entire plan and delivery
* a ‘pipeline’ of scheme ideas to be developed as a rolling programme and a range of solutions to be provided to support in-year mitigation against identified slippage.
Impact
Through joint working the two teams from the CSUs were able to undertake an efficient review utilising skills and knowledge aligned to different elements of the project, to build rapport with the CCG’s senior management team providing confidence in the recommendations. These were supported by evidence and practical solutions that the CCG was able to adopt and implement in a timely manner to gain optimum benefit in-year.
The outputs from the project supported:
* improvements in project management and organisational governance
* robust reporting
* the system integration programme
* development of a wider programme of referral management and triage that supports the system-wide outpatient reduction model
* management of demand
* primary care development of best practice in demand management, peer support and clinical variation reduction
* progress in delivery of the CCG control total and mitigation to meet the identified gap of £940k.