SCIM Refresh Presented by Paul Mortimer Asset Management Policy - - PowerPoint PPT Presentation

SCIM Refresh

Presented by Paul Mortimer Asset Management Policy Advisor paulmortimer@nhs.net

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Why a Refresh?

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What Boards say:

• The guidance isn’t always easy to follow
• Expectations of information requirements and

format is unclear

• Following the business case guides is resource

intensive

• The guidance needs to be written in plainer

language

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What Scottish Government say:

• The quality & consistency of business cases is

variable

• Too much focus is given to solutions before

understanding the real benefits of change

• More service challenge is needed at Initial

Agreement stage

• Funding allocations will need to be prioritised in

the future

• Current guidance is out of date with current

thinking and new initiatives

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What we are trying to achieve:

• Guidance that supports service change through

the effective delivery of infrastructure programmes and projects

• Better informed investment decisions linked to

measurable benefits & outcomes

• Future investments focussed on NHSScotland’s

key priorities

• More challenge of service change proposals
• Improved quality of business case submissions
• A more standardised approach to business case

submissions

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Current proposals for SCIM Refresh

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Current proposals for SCIM Refresh

1. A new Strategic Assessment stage prior to Initial Agreement 2. A refresh of the Initial Agreement guide to focus on the strategic brief of a proposal 3. To focus on benefits to be achieved from an investment at earliest planning stage 4. To provide clearer guidance on risk management and mitigation 5. To update option appraisal guidance in line with Greenbook changes 6. A refresh of Financial & Commercial Cases to suit each main procurement route 7. Make design assessment process integral to the overall business case process

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• 1. Strategic Assessment:
• A single page proposal outlining the main

need for change & benefits to be gained from investment

• It will be used to confirm national priority for

the proposal

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• 2. Initial Agreement Refresh
• To provide clarity on its purpose and intended
• utcome
• To provide the evidence base for change &

benefits from investment

• To ensure appropriate challenge on service

redesign opportunities

• To test and confirm the strategic brief for the

project

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• 3. Benefits Realisation
• Main benefits agreed at Strategic Assessment

stage

• Benefits realisation plan set out at Initial

Agreement stage

• The evidence base for investment decision and

national prioritisation

• Benefits linked to economic appraisal in OBC
• Benefits realisation plan used to inform post-

project evaluation

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• 4. Risk Management
• Mitigation of risks to begin at Initial

Agreement stage

• Separate guidance on risk management
• Looking into alternatives to optimism bias

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• 5. Option Appraisal guidance
• Fundamentally the same approach as before
• Needs updating to align with changes

proposed to Greenbook

• Need to simplify and align:

– Option appraisal guidance – GEM guidance – OBC guidance on economic appraisal

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• 6. Financial & Commercial Cases
• Updating guidance to reflect new

procurement routes:

– hub, NPD & Frameworks Scotland2

• Standard template approach for each

procurement route (?)

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• 7. Design Assessment process
• Making this guidance more integral to business

case guidance

• AEDET style questionnaire will be used to

compare existing arrangements with new proposals

• Developing flow diagrams showing links with:

– Business case process – AEDET reviews – RIBA stages – BIM information expectations

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Introducing the Strategic Assessment stage

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Where it fits in:

Clinical Strategy LDP PAMS Initial Concept Initial Agreement Outline Business Case Full Business Case Workshop to develop proposal

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Strategic Assessment SG Investment Prioritisation Strategic Assessment

Strategic Assessment stage

• Based on the following 5 questions:
• 1. What are the current arrangements?
• 2. What is the need for change?
• 3. What benefits will be gained from addressing

these needs?

• 4. How do these benefits link to NHSScotland’s

strategic priorities?

• 5. What solution is being considered to deliver

these benefits?

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Q1: What are the current arrangements?

• Required at Strategic Assessment stage:

– Brief description of current arrangements that are in need of change

• Detailed analysis of existing arrangements

causing and/or affected by the need for change will be required at Initial Agreement stage

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Q2: What is the need for change?

• Required at Strategic Assessment stage:

– Main reasons / drivers / opportunities for change – This should be based on a summary of discussions formed in a stakeholder workshop

• Detailed evidence of the cause and effect of

this need for change will be required at Initial Agreement stage

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Q3: What benefits will be gained from addressing these needs?

• Required at Strategic Assessment stage

– Indication of main benefits to be gained from proposed investment – Indication of expected value of those benefits – Demonstration of links between need for change and benefits to be gained

• Detailed benefits realisation plan required at

Initial Agreement stage

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Q.4: How do these benefits link to NHSScotland’s strategic priorities?

• Required at Strategic Assessment stage:

– Demonstration of links between the expected benefits and NHSScotland’s strategic priorities – Use benefits to validate investment prioritisation score – Link to Capital Planning System

• Investment objectives are developed at Initial

Agreement stage

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• Required at Strategic Assessment stage:

– Indication of early thoughts on proposed solution :

• What is scope / coverage of solution?
• How will service be delivered?
• Who will deliver the solution?
• How & when will solution be implemented?
• What is indicative value of investment needed and how will

it be procured?

– The Initial Agreement will be used to confirm the strategic brief for the proposal

Q.5: What solution is being considered to deliver these benefits?

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Prioritisation Score (early thoughts)

• The process:

– A scored Strategic Assessment template is sent to Scottish Government for prioritisation & approval – Scores also recorded onto Capital Planning System – Initial Agreement will provide further evidence base to justify score – Scores are re-evaluated and confirmed at each business case stage

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Prioritisation Score (early thoughts)

• Scores are made against NHSScotland’s five

strategic priorities; currently confirmed as:

– Person Centred – Safe – Effective Quality of Care – Health of Population – Value & Sustainability

• Further guidance being developed on their

intended scope / definition

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Prioritisation Score (early thoughts)

• Each strategic priority is to be linked to:

– Appropriate Quality Outcome Indicators – HEAT targets – SAFR performance framework KPI’s – Local benefit measures

• Calibration of scoring is being developed:

– Single 1-10 criteria – Or, three point criteria: importance, impact & likelihood

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Next Steps

• Intend to begin consultation process for

business case manuals from early next year

• Followed by other supporting SCIM manuals
• n project organisation etc
• Any comments / contributions e-mail to:

paulmortimer@nhs.net

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