System savings

Delivering the financial strategy

The proposed approach shifts the traditional approach to efficiency and transformation within the context of the overall financial strategy roadmap. Traditionally, we have defined our efficiency and transformation schemes and assessed the impact they have on our individual financial positions.

The new approach sets financial envelopes for all partners in the system, and then tasks individuals in the system to identify and work up the strategies to deliver this (i.e. transformation as an enabler to live within our means).

The system has developed both system-wide and localised schemes which are focused over the next three years to deliver the financial ambition, with year one being focused on schemes to deliver flat activity.

Most importantly, these are entirely consistent with the priorities from the Long Term Plan (i.e. urgent and emergency care, planned care, enhanced primary and community care, mental health and back office and estates).

Delivering system savings

The original set of system savings Project Implementation Plans (PIPs) were approved by the System Finance and Performance Committee on 28 July 2021 and have been implemented, delivering benefits as assessed by the system metrics that were agreed by the Health and Care Senate. Of the original 19 PIPs:

• 4 are in closure because the key milestones have been completed
• 15 are being refreshed for 22/23, with new critical milestones and metrics for monitoring success.

10 new PIPs are currently being scoped and we continue to deliver projects across the 5 key programme areas.

However, we are also exploring 2 additional programmes across LD&A and Pharmacy. Each scheme has both activity and productivity metrics against which delivery is assessed.

Assessing financial delivery

System-level understanding of the financial delivery of the savings programme is key as a system:

• Aggregate individual organisational savings at the system level through the ICS finance lead to ensure full transparency on the areas where savings are being delivered within each of the partners
• Each organisation also has its own internal efficiency programmes (CIPs)
• Savings which require two or more partners working in collaboration are identified as the system savings
• Financial delivery are captured in three dimensions:

1. Cost growth avoided (a PbR-based proxy to assure the impact of flat activity)
2. Cash releasing savings
3. Productivity gains.

• Cost growth avoided will be assessed at system level, but each of the programmes will be responsible for capturing and reporting cash releasing savings and productivity gains