We are currently in negotiations with NHS Leadership Academy and HEE in the East Midlands about activity and funding for the next financial year.

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1 INTRODUCTION This paper provides the six-monthly update of the activities of the East Midlands Leadership Academy ( EMLA ) to the Board of Nottinghamshire Healthcare NHS Foundation Trust who host EMLA. It briefly summarises activity from April 2015 to the end of December 2015 and highlights up and coming activity and issues for the next six months. Its purpose is primarily to provide assurance to the Board that EMLA is a good organisation to be associated with, that there is no financial or reputational liability and indeed that there is mutual advantage in the current hosting arrangements which warrant continued support. THE NATIONAL PICTURE OF LEADERSHIP DEVELOPMENT Following publication of the Smith and Rose reviews which considered alignment of the improvement architecture with the Five Year Forward View and leadership in the NHS respectively, the NHS Leadership Academy has transferred from NHS England to Health Education England in shadow form from 1 st December 2015 and substantively from 1 st April The Arm s Length Bodies Care Quality Commission, Trust Development Authority and Monitor (NHS Improvement), Public Health England, NHS England and Health Education England along with the Department of Health are now in the process of devising a national strategy for leadership across the NHS which will be owned by all of them as representing the system but held/hosted by HEE. Plans are being made to ensure key agencies, including providers and commissioners at a sub-national level are involved in drawing up that strategy. Undoubtedly this will have implications for leadership development agencies such as EMLA in the next few months and we are engaging as best we can with the process to influence the strategy. The implications of the NHS Leadership Academy moving to HEE on its Local Delivery Partners, of which EMLA is one of 10 across the country, is not yet understood or known. It is possible that HEE will wish to host all of the LDPs (they currently host 7 out of the 10) or are content with leaving the arrangements as they are but develop a closer working relationship with a service level agreement. At a local level we are working increasingly closely with HEE in the East Midlands and this relationship is proving to be increasingly positive and mutually beneficial. We are currently in negotiations with NHS Leadership Academy and HEE in the East Midlands about activity and funding for the next financial year. ACTIVITY In our last report to the Trust Board we described our Systems Leadership offer and associated consultancy service. This has now been refined and developed into a dedicated publication a link to which can be found here (please use Google Chrome for a quicker access to the publication): %20web%20final.pdf A hard copy of this publication will be provided at the Trust Board meeting. Page 1 of 7

2 The model and associated offer outlined in the booklet has been well received and we are working with all Units of Planning, LETCs and counties to varying degrees to provide bespoke interventions as required. We see this work continuing well into the future. In terms of our traditional offer of programmes and events in the year to date (April to December 2015) we have provided 139 separate development sessions accessed by 1,230 delegates, creating 2,471 face-to-face contacts across 17 different types of programmes/interventions. This is around 38% less than the equivalent activity last year and is explained by a number of factors: The move to the bespoke systems leadership interventions, the activity for which is not quantified in the same way. 12% reduction in funding overall from 2014/15 levels. Delay in funding approval (some not until Q3) has shifted the highest level of activity to Q4. The projection for year end is that the outturn of the year for this type of activity (programmes and events) will be 20% less than last year s outturn with the move into consultancy/bespoke activity accounting for the majority of the difference. Nottinghamshire Healthcare remains a very active user of EMLA. They employ around 10% of the East Midlands NHS workforce and account for around 12% of the take-up of EMLA s offers. The Programmes and Events offered so far this year include: Action Learning Sets Aspiring Chairs Board Effectiveness Masterclasses Coaching and Mentoring Supervision Coaching Skills for Leaders Continuous Professional Development for Coaches and Mentors Emerging Leaders Financial Skills Development Health Care Leadership Model Integrated Commissioning For Health and Social Care Integrated Health and Social Care Conference Leading Across Boundaries Masterclasses Operational Leadership Organisational Development Essentials Foundation Programme Organisational Development Health and Social Care Network Supporting Transformation Page 2 of 7

3 The plans for programmes and events for next year are well advanced and projections for activity are that overall capacity will be 12% more than this year and 90% of the capacity planned in our highest ever year in 2014/15, before the systems leadership/consultancy approach was developed. The importance of the shift to a different model of delivery, that of bespoke development work across organisations was expected to mean less programme and event activity this year. This type of activity is more difficult to produce quantifiable measures for, or at least not measures which are simply numbers of attendances. Examples of this type of project work are as follows: Developing clinical teaming skill across pathways in Northamptonshire. Developing innovation and improvement skills for neighbourhood teams in Lincolnshire. Providing coaching and Action Learning Sets for community pharmacists in Nottinghamshire. Working with paediatric clinicians across clinical pathways to develop well led services in Derbyshire. Planned interventions in Leicestershire for team coaching, Action Learning Sets, innovation and improvement skills and facilitated discussions. The move towards a consultancy approach was based on feedback from members as to their needs and has been developed and regularly reported to the EMLA Board. There is national interest in the model and approach we have developed, and the model has been recommended by all LETB directors to HEE to be adopted and funded across the country next year. KPIs/PERFORMANCE A performance report is included at the Board s request at. Some of the issues contained within are already discussed in the activity section above. Other key points to note are that the overall rating as Very Good or Excellent on the day remain high at an average of 93% and Recommend to a Colleague rate of 95%, attendance rate averages at 87%. Trusts in Nottinghamshire and CCGs in Derbyshire are the most engaged organisations when looked at by county. Mental health and community Trusts use us proportionately more than the acute hospital Trusts when compared to their headcount. RISK REGISTER Following a previous request to include our risk register, please see attached as Appendix 2. Page 3 of 7

4 FINANCIAL SPEND TO DATE The table below summarises our income and expenditure to date. The Academy is currently 152k underspent against planned expenditure and we are currently operating under the assumption that there will be a slight underspend against forecast at year end. Additionally, the current forecast is showing 30k of un-allocated expenditure which if not committed will translate into an underspend by the end of the Financial Year which will be within the range of the acceptable level agreed with Nottinghamshire Healthcare s Director of Finance. However, plans are in place to allocate further spend. Annual Planned Out Turn YTD Plan YTD Actual YTD Variance Forecast Forecast Variance 000s 000s 000s 000s 000s 000s INCOME NHS Leadership Academy funding Membership Income FSD Core & Programme Income LETB Funding Other Operating Income Funding Brought Forwards TOTAL INCOME 2,148 1,442 1, , EXPENDITURE Level One Leadership Level Two Mid Career Leadership Development Level Three Senior Leadership Career Development Leadership At All Levels Core & Central Budgets 1, Unallocated Funds TOTAL EXPENDITURE 2,148 1,443 1, , Surplus/(Deficit) Page 4 of 7

5 000s 000s /16 EMLA Financial Performance Plan Actuals Forecast Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 15/16 EMLA Cumulative Financial Performance Plan Actuals Forecast 0 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Page 5 of 7

6 LOOKING AHEAD Over the coming months the following issues and plans will demand our attention and efforts. Finance our funding from the NHS Leadership Academy as part of HEE and any support we may also get locally from the LETB is currently being discussed and negotiated. We are about to write to our members to ascertain whether they plan to renew their membership for next year. The membership fees will stay at the same level as they have for the last 3 years and in addition, organisations will also have access to our systems leadership offer where they are working with other organisations on projects which align to the implementation of the Five Year Forward View and an optional extra to purchase additional consultancy days to support their own internal OD plans. Our planning assumption is that our total income for next year will be around 2m. Programmes and Events a wide range of programmes and events are planned for next year including some regular features including, Emerging Leaders, Aspiring Chairs, Operational Leadership and Coaching and Mentoring. We plan to provide more of this activity next year than this. Talent Centres we have worked with the Nottinghamshire Nursing Cabinet and the Notts. LETC to develop a series of interventions to support the development of Aspiring Nurse Directors. This will include coaching, mentoring, masterclasses and gaining experience in different fields where this is necessary. We have been asked to widen this approach for other professions including DoFs and HR directors and these plans are now in place. Development networks EMLA has hosted the Financial Skills Development network for a number of years, it provides development activities for finance professionals, both technical finance skills and softer leadership and management skills. We have now been asked to host a similar network for Procurement professionals which we are keen to do. We are also in discussion with other profession specific development networks. HEE and Medical Education we have been approached by the Medical Education section (the old Deanery) at HEE to help plan, design and deliver the Leadership and Management modules for trainee medical staff. This will be significant additional offer if these negotiations conclude successfully. We are optimistic about our involvement in this. Page 6 of 7

7 RELATIONSHIP WITH NOTTINGHAMSHIRE HEALTHCARE NHS FOUNDATION TRUST Our current hosting arrangement with the Trust remains beneficial and one we would wish to continue. This may need to change if there is a move to ensure all LDPs must be hosted by HEE, however we do not believe this is particularly likely at the moment. We will continue to offer the best possible value and quality for money to our members and will always endeavour to proactively consider future need and continue to mould and adapt the business model to meet the needs of our regional and national stakeholders. Paul O Neill Director East Midlands Leadership Academy January 2016 Page 7 of 7

8 East Midlands Leadership Academy Activity Reports April - December 2015

9 than EMLA Planned Programmatic Activity by Organisation (Trusts) Nottinghamshire Healthcare NHS Foundation Trust % LYR % Nottingham University Hospitals NHS Trust % % Nottingham CityCare Partnership CIC Sherwood Forest Hospitals NHS Foundation Trust Lincolnshire Community Health Services NHS Trust United Lincolnshire Hospitals NHS Trust Lincolnshire Partnership NHS Foundation Trust Derbyshire Community Health Services NHS Trust 55 3% 86 5% 125 7% % 121 7% 8% 278 8% 90 3% 138 4% 153 4% 226 7% 186 5% 249 7% Derby Teaching Hospitals NHS Foundation Trust Chesterfield Royal Hospital NHS Foundation Trust Derbyshire Healthcare NHS Foundation Trust % 4% 93 5% 283 8% 65 2% University Hospitals of Leicester NHS Trust 164 9% 157 5% Leicestershire Partnership NHS Trust Northamptonshire Healthcare NHS Foundation Trust Northampton General Hospital NHS Trust Kettering General Hospital NHS Foundation Trust % 62 2% 3% 142 8% % 212 6% 143 4% 119 3% 83 2% East Midlands Ambulance Service NHS Trust 68 4% 132 4% Trust Area Nottinghamshire Lincolnshire Derbyshire Leicestershire Northamptonshire Other Activities Current Year Area % Current Year 35% 19% 18% 17% 8% 4% Activities Previous Year 1, Area % Previous Year 30% 16% 22% 18% 10% 4% Activity Growth vs Previous Year -39% -38% -56% -51% -59% -48% Area Growth % VAR vs Previous Year 5% 3% -4% -1% -2% 0% Total 1,825 3,450-47%

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11 EMLA Planned Programmatic Activity by Organisation (CCGs and Others) NHS Southern Derbyshire CCG NHS North Derbyshire CCG NHS Hardwick CCG NHS Erewash CCG NHS Nottingham City CCG NHS Mansfield & Ashfield CCG NHS Nottingham West CCG NHS Nottingham North & East CCG NHS Rushcliffe CCG NHS Newark & Sherwood CCG NHS Lincolnshire West CCG NHS South West Lincolnshire CCG NHS Lincolnshire East CCG NHS South Lincolnshire CCG NHS West Leicestershire CCG NHS Leicester City CCG NHS East Leicestershire & Rutland CCG NHS Nene CCG NHS Milton Keynes CCG NHS Corby CCG Other - non membership organisations CSU NHS England - Central Midlands HEEM PCDC - Derbys and Notts East Midlands Leadership Academy Framework Housing Association Academic Health Science Network Public Health England NHS Leadership Academy % % 17 2% 12 1% 6 1% 39 4% 18 2% 15 2% 14 1% % 30 3% 2% 44 5% 4% 4% 19 2% 16 2% 13 1% % 32 3% 32 3% 14 1% 11 1% 7 1% 5 1% 4 0% 6% 71 8% % Area Derbyshire Nottinghamshire Lincolnshire Leicestershire Northamptonshire Activities % 22% 17% 9% 7% 5% Other %

12 EMLA Planned Programmatic Activity by Activity FSD % Emerging Leaders % Leading Across Boundaries % Supporting Transformation 244 9% Operational Leadership 206 7% Chimp Management Masterclass Coaching Skills for Leaders % 6% Integrated Health and Social Care Conference 133 5% Aspiring Chairs Continuous Professional Development for Coaches and Mentors Integrated Commissioning For Health and Social Care % 2% 3% Organisational Development Essentials Foundation Programme Organisational Development Health and Social Care Network Board Effectiveness Masterclasses % 2% 1% Action Learning Sets Coaching and Mentoring Supervision 8 Healthcare Leadership Model % 0% 1%

13 EMLA Planned Programmatic Activity by Organisation (Trusts, CCGs and Others) 2013/14 2,989 Activities Booked 2014/15 3,088 Activities Booked 2015/16 2,088 Activites Booked 8,000 7,000 6,000 5,000 4,000 3,000 2,000 1, April May June July August September October November December January February March April May June July August September October November December ,351 1,865 1,911 2,357 2,989 3,986 4,526 January 4,765 February 5,316 March 6, / / / ,179 1,487 1,550 2,437 3,088 4,078 4,484 5,018 5,827 6, ,120 1,218 1,694 2,089 2,563 2,761

14 35 Number of Programmes and Events Cumulative in April May June July August September October November December January February March Projected

15 1200 Face to Face Contacts (not including DNAs and Cancellations) 1068 Cumulative 2,471 3,860 in April May June July August September October November December January February March Projected

16 Monthly % of VG/Excellent Ratings 100% Evaluations - Rating Very Good or Excellent 97% 98% 100% 95% 94% 94% 92% 90% 90% 90% 90% Average - VG or Excellent 85% Target 85% 93% 80% 75% 70% April May June July August September October November December January February March

17 Monthly % of Recommendations 100% Evaluation - Recommendations 98% 98% 100% 95% 94% 96% 96% 94% 93% 91% 90% 85% Target 85% Average - VG or Excellent 80% 95% 75% 70% April May June July August September October November December January February March

18 Average Monthly % Attendance Rate 100% Target 85% 95% 90% 89% 92% 89% 92% 91% Average - Attendance 85% 85% 83% 85% Target 85% 81% 87% 80% 75% 70% April May June July August September October November December January February March

19 Average Monthyl % 100% 100% Marketing Days > 84 days 90% 89% Target 85% 80% 70% 60% 78% 71% 63% 68% 73% Average - Marketing Days 50% 48% 40% 40% 70% 30% 20% 10% 0% April May June July August September October November December January February March

20 Risk owner ID number Total score Likelihoo d Severity Next review Total score Likelihoo d Severity Paul O Neill /12/ /12/2015 Lyndsay Short 1053 Appendix 2 Risk Register Report Risk description Key controls Gaps in controls Assurances Gaps in Assurances Residual level of risk Current Review Monitoring Residual level of risk actions group Secure funding position for 2015/16. Risk of funding streams not being available as a result of changes in funding decisions at DOH, Health Education England. Diverse income streams None Change of funding by the Department of Health at national level. Agreed Service Level Agreement & LDP status with National Leadership Academy Established partnership and increased collaboration with LETB ROI measures /03/2015 No change to current risk. Agreed at Board /02/2015 Risk reviewed following 11 Feb 2015 ELT and grading reduced from 20 to 12 (4 likelihood, 3 impact) /12/2014 Risk rating increase whilst we await the outcome of the NHS LA funding bids and establishment of new SLA. Agreed at Board Current National Leadership programmes do not demonstrate outcomes and return on investment including sustained changes in the workplace. - Robust and regular information gathering on qualitative experience. - Focus on the alumni from programmes to ensure sustained impact. - Model developed with pilots under way nationally. Data is more robust at the 'experienced' compared to 'learned and applied' stage. Current feedback anecdotal rather than hard data. Not all systems designed and/or effectively deployed to gather data. - Use appropriate anecdotal rather than hard Qualitative methods of evaluation throughout the programme and after; Track career progression of candidates post completion through regular contact. Leadership Academy will track candidates post completion. - Pilot of the new LeaDER evaluation framework /03/2015 No change to current risk. Agreed at Board /12/2015 Risk rating increased as new evaluation processes being implemented and development of new evaluation and ROI framework nationally. Agreed at Board /09/2014 No change to risk. Agreed at Board /06/2014 No change to current risk level. Agreed at Board /03/2014 No change to risk. Agreed at Board meeting /12/2013 No change to risk. Agreed at Board meeting /09/2013 No change to current risk level. Agreed at Board /05/2013 No change to current risk level. Agreed at Board /02/2013 No change to current risk level. Agreed at Board /11/2012 Update to risk actions completed. Agreed at Board /09/2012 No change to current risk level. Agreed at Board Directorate Governance Group Date Printed: 04/12/2015 Page: 1 of 3

21 14/12/2015 Paul O Neill /12/2015 Paul O Neill /12/2015 Paul O Neill CORP /12/2015 Paul O Neill 1306 Ability to manage current and future capacity and demand for all EMLA programmes with existing resource. - Workforce capacity aligned to meet demand. - Contingencies to deliver more popular programmes on a regular basis to satisfy need. - Consultation with members to agreed future approach - Membership Collaborative. - KPI reporting to measure capacity. - Account management model N/A N/A - New weekly reporting process to measure capacity versus demand to enable quick responses to address any issues. - Actions being considered following member suggestions - Membership Collaborative. - Regular reviews at operational meetings and KPI measures. - On-going dialogue at membership collaborative - Meeting 85% of expressed demand /03/2015 No change to current risk. Agreed at Board /12/2014 Risk rating increased as need to consider new models of working following 5 year forward view and potential impact of not adapting business model to meet system transformation requirements. Agreed at Board /06/2014 No change to current risk level. Agreed at Board Appendix 2 24/03/2014 Risk rating decrease due to mitigating actions agreed at Board. 13/12/2013 Amendment to risk description and additions to controls agreed at Board meeting /09/2013 Risk level increased to 9 in board meeting on /05/2013 No change to current risk level. Agreed at Board Failure for members to understand the rationale for introducing the new approach to system transformation. Potential reduction in core programme activity to support new work stream. Failure to communicate rationale could result in member dissatisfaction around programme access. Directory, web site, membership letters all detailing the background to the introduction of the transformation work stream with rationale re its purpose in supporting the 5YFV. Development of the system leadership model and competency framework. Account management, HEE Strategy, National Strategy /03/2015 No change to current risk. Agreed at Board Member organisations choosing not to support the transformation work stream, and opting for alternative approaches to workforce development, as it may not support their current organisational/workforce strategy. Account management, system drivers, reports such as Francis, Keogh and Berwick driving system change. The need to respond to the Care Act 2014 (Social Care). Needs of 5YFV. LETC relationships. Voluntary participation unless mandated Voluntary participation unless mandated Organisational governance processes and performance will drive this agenda /03/2015 No change to current risk. Agreed at Board Potential reputational risk associated with LDP partnership arrangement. - Monitoring of current EMLA brand - Membership model - Account management model - Maintaining close working relationship with the national Leadership Academy National directives None - Membership uptake - Good feedback re EMLA in region - Quality of EMLA programmes - 96% good to excellent ratings on offers - Managing close membership relationships /03/2015 No change to current risk. Agreed at Board /12/2014 No change to risk. Agreed at Board /06/2014 No change to current risk level. Agreed at Board /03/2014 Risk reduced at Board meeting Date Printed: 04/12/2015 Page: 2 of 3

22 14/12/2015 Paul O Neill /12/2015 Paul O Neill Any dissatisfaction with membership/ subscription model leads to reluctance/refusal of members to pay. - Report utilisation and feedback to CEOs/HRDs. - Subscriptions calibrated to reflect staff numbers/size of organisation. - Good account management relationships - Membership collaborative to ensure offer remains relevant - Customer Survey Continued need to plan ahead for subsequent financial years funding. Detailed monitoring, follow up and dialogue required. - Membership models are constantly being developed to support the new NHS architecture with positive commitment to subscription evident. - Membership Collaborative - OD Network /03/2015 No change to current risk. Agreed at Board /12/2014 No change to risk. Agreed at Board /06/2014 No change to current risk level. Agreed at Board /03/2014 Amendment made to risk description, agreed at Board meeting. Directorate Governance Group Appendix 2 13/12/2013 Updates made to risk description, controls & assurances at Board Meeting /09/2013 We have 100% subscription this year, indicating member satisfaction. Membership collaborative survey indicated members are happy with current model. Risk reduced at Board /05/2013 Reviewed at Board meeting Risk increased due to changes in NHS architecture which require new models of membership to be developed. Models being confirmed in quarter 1. To be reviewed at next Board meeting ( ) 11/02/2013 No change to current risk level. Agreed at Board /11/2012 No change to current risk level. Agreed at Board /09/2012 No change to current risk level. Agreed at Board /05/2012 No change to current risk level. Agreed at Board Ability to maintain a full and healthy workforce to meet the business capacity and demand. - Health and wellbeing initiatives at monthly team meetings - Flexible working and reasonable adjustments to support individuals Date Printed: 04/12/2015 Page: 3 of 3