Delivering the Operational Plans

Delivering the Operational Plans

12/01/2016
by Rob Findlay

Just before Christmas, NHS England lobbed out its guidance for this year’s annual planning round. As usual, the immediate requirements are to balance the books and meet the targets, but the expectation of co-operation between organisations is much greater, and the deadlines are breathtakingly short.

In particular, the guidance requires “First submission of full draft 16/17 Operational Plans” by the 8th of February, which is a mere 31 working days after the guidance was published. This deadline is euphemistically described as “an early task”. So the immediate question is: how can you meet it?

For most “local system leaders” there are two ways of doing demand and capacity planning in a hurry.

You could ask operational managers to come up with plans. On the plus side, every one of those plans will be based on a thorough operational understanding of each service, and the main clinical pathways – things like outpatient activity converting to inpatient demand – will be represented correctly. On the downside, you will get back a great variety of spreadsheet models, each one using a different method, most of them prone to error (even in areas as fundamental as the calculation of demand), and the input numbers may be hard to reconcile with other sources of data such as those held by commissioners.

Alternatively you could ask the information or planning department to come up with the plans, which means you’ll get a consistent and better methodology based on the same data sources that other people recognise. However the numbers, the structure around clinical pathways, and the conclusions may (how can I put this?) not be recognised by operational managers or acted upon.

So neither answer is particularly satisfactory. Perhaps the question is wrong?

After all, the main purpose of operational planning is not to satisfy NHS England or the finance department. It is to help operational managers to manage the delivery of healthcare.

Real operational planning would plan every week, not every year. It would model every important clinical pathway in every subspecialty; not be tied to national classifications. It would paint a rich picture of operational life that managers instinctively recognised and were willing to act upon; not be a work of fiction that balanced the books but sat on the shelf.

Which is all very well, but how does that help with your 8th of February deadline? It might not. If you are fortunate enough to have good operational planning already, then you can adapt it quickly for NHS England. Otherwise you’ll have to cobble something together for submission in the usual way.

Does it matter? We all know this won’t be the last time you’ll be asked to submit plans. And your need for good operational planning will be just as great after the 8th of February as it is today.

So you need an approach that uses the best of both worlds. Use the immediacy of this deadline to get real operational planning started, using the skills of your information and planning colleagues. With that task out of the way, you can engage operational managers to continuously refine the planning, and get it in synch with your regular operational management cycle.

Then you’ll always have a plan, and you’ll be ready to meet every planning deadline. And when the regulators come looking for evidence that you have “the skills to plan effectively” you will absolutely blow their socks off.

(The above post was first published at the Health Service Journal)

Doing it with Gooroo

You can do this very quickly using Gooroo Planner:

Day 1: We’ll sit down first thing with your top information analyst, and by mid afternoon your first-cut plans should be ready. These initial demand and capacity plans cover every main specialty, across both electives and emergencies for a choice of scenarios, and include outpatient to inpatient conversions, week-by-week profiling, and patient-by-patient waiting times simulation.

Week 1: We can help take your operational managers through these plans for the first time, feed back to your information analyst, and build the skills of your staff who will lead on this for the future. This initial work will identify the main areas where clinical pathways are not yet modelled correctly, and where the data needs refining. Once those changes have been taken in, you should have plans that can be used for this year’s planning round.

After that: repeat the cycle of taking operational managers through the modelling, and feeding back their comments to information. After a few iterations it should be good enough to use in regular operational management meetings. Then you can automate the modelling (via the Gooroo Planner API) so that plans are refreshed every week with no human effort, and can be integrated into regular management reports.

Then you can carry on improving the modelling; unlike a spreadsheet you don’t have to periodically start again from scratch. You will probably want to extend your modelling into areas like follow-up waiting times, diagnostics, and finance, and we’ll be there to support you every step of the way.

PS: You may have seen Annex 1 of the technical guidance, which introduces the IHAM/IMAS models and then says “Local health and care communities should utilise the outputs from these modelling tools as part of the planning process, to inform their activity planning submissions.” (pp.4-5 of Annex 1)

Does that mean the IHAM/IMAS models are mandatory? It turns out that no, it doesn’t, and you are absolutely free to use Gooroo if you prefer.

A Trust that began developing its Gooroo Planner modelling fairly recently has asked NHS England’s Demand and Capacity Project team:

I am trying to determine if the use of the demand and capacity tools developed by IMAS are compulsory for the 16/17 Operating Plan where alternative tools have already been developed locally? We are of course interested in the tools and will take any learning we can from them but do not necessarily want to start again on this when we have some reasonably well developed tools already in use.

The NHS England response was:

Thanks for your email. Use of the demand and capacity tools is advised, but not compulsory. Where you have developed local models these can be used instead.

If you want to confirm this for yourselves, you can always email the NHS England Demand and Capacity Project and ask them directly. But I think that response from them is commendably clear.

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