SUMMARY BUSINESS PLAN
2015/16
ANGLIAN COMMUNITY ENTERPRISE (ACE) COMMUNITY INTEREST COMPANY
IMPROVING HEALTH AND WELL-BEING
Introduction and profile
4
ACE’s services
6
Delivering quality of care
8
Social impact
9
Community and stakeholder involvement
10
Staff ownership and influence
11
Service delivery and development
11
Finance and performance
12
Commissioners and income
12
Improved efficiency and productivity
13
Business and financial risks
13
Governance and leadership
14
Governance framework
14
Key performance indicators
15
Current and future workforce profile
15
Organisational development
15
Contents
Lynne Woodcock
Managing Director
Introduction
ACE is a multi-award winning social enterprise providing a comprehensive range of community health and well-being services across Essex and increasingly in Suffolk. ACE has a history of safe, efficient service delivery. Each year we generate an income approaching £56 million.
A Community Interest Company employing over 1,140 staff, ACE is limited by shares and employee owned. We maintain a NHS ethos and abide by the NHS Constitution. We continue to embed the National Nursing Strategy – ‘The 6C’s of Care and Compassion’
– Care, Compassion, Competence, Communication, Courage and Commitment – across ACE.
Achievements
Over the past year, ACE has continued to develop as a social enterprise and a trusted provider of high quality health care services. Examples of some key successes are:
An average of 99.03% compliance against target-based Key Performance Indicators; Maintenance of regulatory standards, e.g. Care Quality Commission Essential
Standards of Quality and Safety (ESQS); registration as a Community Interest Company;
Level 2 compliance in the national Information Governance Toolkit;
The introduction of the Rapid Assessment Service (RAS), an innovative new model of health care designed to provide care closer to home and avoid unnecessary
admissions to Colchester Hospital is going from strength to strength; Expansion of Services outside of North East Essex, for example the Weight
Management Programme for Mid Essex;
UK shortlisted finalist for Social Enterprise of the Year in the National Social Enterprise Awards 2014. ACE was the only ‘spin-out’ organisation to be shortlisted and this has been acknowledged nationally as a tremendous achievement.
Challenges
2015/16 continues to be a pivotal year for ACE, with the organisation’s principal
commissioner’s procurement – ‘Care Closer to Home’, having significant implications for ACE’s future. We responded to this risk through the implementation of a structured
programme of preparation to respond to these commissioning intentions. As a result in July 2015, ACE was awarded the seven year contract that will see patients having access to greater person-centred, co-ordinated care and support in the future.
We hope you find this summary document both informative and easy to read.
We would welcome any feedback via [email protected]
Richard Kearton
Chairman
Vision and missions
To maximise our role as a service provider, employer, purchaser, community member, partner and investor to improve the health and well-being of the communities in which we work.
‘To be the leader in the communities that we serve, providing innovation, quality, and value for money as we deliver healthcare services that are accessible to all’
The vision is achieved through the application of the complementary social and commercial missions which define ACE’s key purpose. These are:
Social mission
Commercial mission
To provide effective, profitable, value for money services which meet the needs of our customers and support organisational growth.
Organisational values
1team
Action-oriented Community-focused Excellence, in all we do
……and by our organisational values:
Strategic Objectives
ACE’s vision, mission and values are delivered through 5 Strategic Objectives:
Survive and thrive:
With you, not to you:
Keep lean, keep keen:
One enterprise, one purpose, one voice:
Make and measure social impact:
Managing the business to ensure continual and on-going viability.
Delivering safe, high quality care.
Continual development of efficient services that meet customer needs.
Developing a culture of one team with a common purpose.
6 Year on year, we make improvements in services and work
closely with local communities and partners to bring about the most effective outcomes, enhance quality of care and improve the health and well-being of the local population.
A summary of the services that ACE provides is shown in the table below. For further information on all these services, please visit the ACE website at www.acecic.co.uk
Children’s Services
Paediatric Rehabilitation (Occupational Therapy and Physiotherapy) Paediatric Speech & Language Therapy
Specialist Health Visitor and Specialist Continence Nurse
Children’s Community Services (Health Visiting and School Nursing) Looked After Children
Learning Disabilities
Occupational Therapy
Speech and Language Therapy Physiotherapy
Football for Life Dietetics
Sexual Health
Primary Care Dental Services
Health and Well-being
Stop Smoking Service Sexual Health
Tier 2 Weight Management Health Trainers
NHS Health Checks GP Care Advisers
End of Life End of Life Care Team
A N G L I A N C O M M U N I T Y E N T E R P R I S E ( A C E ) C O M M U N I T Y I N T E R E S T C O M P A N Y
Rehabilitation Occupational Therapy Physiotherapy Podiatry Tier 2 Musculoskeletal Intermediate Care Falls Prevention
Speech and Language Therapy (Adult) Early Supported Discharge Service for Stroke Clinical Assessment Service
Care Closer to Home
Community Matrons Community Nursing 2 Community Hospitals
Rapid Assessment Service (RAS) Minor Injuries Unit
Lymphoedema Service
Long Term Conditions
Cardiac Rehab
Chronic Obstructive Pulmonary Disorder (COPD) Heart Failure
Home Oxygen Assessment and Support Service Pulmonary Rehabilitation
Tissue Viability
Urology and Continence Services
Alternative Provider
Medical Services (APMS) 4 GP Practices
Other Services
Primary Care Support England Safeguarding Children and Adults Infection Prevention and Control Community Dental Service
ACE’s services
8 ACE is proud of the high quality services that it provides. We have robust quality assurance and governance systems that ensure:
ACE staff at all levels are engaged in the quality and assurance agenda; Evidence of compliance with registration and legislative standards and
requirements;
Outcomes and effectiveness of service delivery is monitored;
Service user opinion and feedback is collected, analysed and lessons learnt on their experience of services and care provided;
Assurance for commissioners, the public and all stakeholders that resources are well deployed;
Assurance for service users and carers that safety is not put at unnecessary risk and that safety incidents are reviewed and lessons learnt result in practice development and service improvement; and
The right structures and effective reporting with appropriate controls and risk management at all levels.
Each year we produce an annual Quality Account, giving us the opportunity to look back and reflect on the quality of our services during the previous year and set out priorities for quality improvements. It is written and provided to the populations we serve and is influenced by the outcomes of patient experience surveys, discussions with staff, and a review of the many indicators of quality we measure as a matter of routine. The Quality Account can found on the ACE website www.acecic.co.uk
Delivering quality care
The guiding principle for ACE is our Social Mission. ACE’s Social Impact Plan supports the achievement of the mission, with resources within it combining expertise, time and money. Decisions on the implementation of each element of the plan are agreed with the full input of ACE shareholders and stakeholders.
2014/15 has seen the continuing implementation of the plan, with achievements including:
Element 1 -
Investment Through the Social Impact Fund (SIF)
ACE provides a percentage of any profit each year to Anglian Community Trust (ACT), to be used in line with the charity’s objects: to promote and protect the social, mental and physical health, welfare and wellbeing of people in the communities in which ACE provides services. During 2014/15, ACT funded £129k to 38 projects/schemes.
For 2015/16, we will develop a social return on investment mechanism.
Element 2
-Corporate and Personal Volunteering
In 2014/15, the Corporate and Personal Volunteering Strategy commenced
implementation, with a directory of volunteering opportunities available which was jointly developed with ACE and the local Volunteer Centres. An example of corporate volunteering is three staff who took part in the “Big Beach Clean Up‟ with Marks & Spencer and the Marine Conservation Society. They spent a day, not only keeping the coastline clean and looking it’s best, but to help preserve sea life at risk of ingesting plastic rubbish.
For 2015/16, we will increase the number of staff shareholders who have undertaken corporate volunteering to 15.
Element 3 -
Career opportunities for both new entrants and those returning to employment
ACE is working to support young people through apprenticeships and during 2014/5 has worked with Health Education East of England to develop a formal Apprenticeship Scheme and has recruited 5 apprentices.
For 2015/16, we will support a further 10 (internal/external) apprenticeships.
10
Element 4 -
Doing business with local firms so we maximise the sustainability of the local economy.
In 2014/15, 25% of ACE’s spend on services/products/supply in its supply chain was with local businesses.
For 2015/16, we will increase the number of local businesses that ACE has in the supply chain.
We continue to be a Cabinet Office Mutuals Pathfinder organisation and ACE’s Managing Director, a Mutuals Ambassador. This has enabled us to support aspirant mutual
organisations and promote social enterprise.
Community and stakeholder involvement
Engagement and involvement of the public and stakeholders is a key principle in the
continued success of ACE and crucial for maintaining incorporation as a Community Interest Company.
A coherent and prioritised action plan has been developed and implementation is taking place to ensure that ACE is maximising the opportunities for wider community involvement and influence over the next 5 years. The action plan is broken down into Information Exchange between ACE and its communities; Access and Engagement to enable the community to be substantively engaged with ACE; and Exercise of Power to enable the community to be part of service development and in the longer term, the governance of the organisation.
If you would be interested to receive regular updates about what ACE is doing, with a view to becoming involved, please go to our website at www.acecic.co.uk to subscribe.
Staff ownership and influence
In accordance with ACE’s Articles of Association, all permanent and fixed term contract members of staff are eligible to hold a £1 share in the organisation. This share has no financial benefit, with no dividends payable, but it does enable shareholders to have an influence on key organisational decisions. Approximately 50% of eligible staff are
shareholders, with numbers continually increasing. ACE aspires to have 90% of eligible staff members as shareholders in the future, with an objective during 2015/16 of increasing the current percentage.
Shareholders have the ability to influence the decision making of the organisation through the elected Staff Council, for example:
Joint work between the Community Forum and Staff Council on consideration of applications for social impact funding.
Consideration of re-appointment to second term of office for Non-Executive Directors.
Service delivery and development
ACE’s services are provided across communities, health pathways and in partnership with many other local service providers with a principle of providing services as close to home as possible.
Patients want to receive and we want to deliver, high quality and integrated services, where teams within a discrete locality really know and understand the local community they serve. Alongside this, the NHS continues to face challenging times, with demand for services
increasing, whilst efficiency savings need to be realised. Commissioners and patients want to see innovative solutions to this challenge.
Through service transformation, ACE has been responding to delivery of care closer to home, outside of traditional hospital settings and in local community settings or in the home over the last few years by extending the range of services offered, the places from which they are delivered and developing a community-based workforce ready to work in new and different ways.
This model of service delivery aligns to the commissioning intentions for 2015/16 of the North East Essex Clinical Commissioning Group, NHS England and Essex County Council, together with key strategy documents such as North East Essex Clinical Commissioning Group’s 5 Year Strategy; Essex joint Health and Well-being Strategy and NHS England’s Everyone Counts: Planning for Patients 2014/15 – 2018/19.
As we develop services for the next 5 years, we are:
Retaining focus on our key purpose of maintaining and improving the health and well-being of our population;
Continuing to play our role in increasing the quality, capacity and productivity across the full healthcare system in North East Essex;
Supporting people to help themselves and keep themselves well;
Building on our community involvement to enable the community to be involved in service development and delivery.
Finance and performance
ACE has continued to thrive in 2014/15 and has had a successful year in both service and financial growth.
ACE has an expectation of delivering a profit in 2015/16 and based on current projections, the detail of this is shown below:
Commissioners and income
We are contracted to provide NHS services, the vast majority of which are free at the point of access. In 2014/15, ACE’s services were commissioned by the following commissioners:
North East Essex Clinical Commissioning Group – majority of community health care services.
West Essex Clinical and Mid Essex Commissioning Groups – Learning Disabilities Services Essex County Council - Public Health Services and School Nursing.
NHS England – GP Practices Contract, Community Dental Contract, Health Visiting and School Nursing Immunisations.
Public Health England – Immunisations.
Financial Year Surplus (Before Taxation)
1 January 2012 - 31 March 2013 £2,111,103 1 April 2013 - 31 March 2014 £794,171 1 April 2014 - 31 March 2015 £844,463 Financial Year 2015/16 Income £57.1m Expenditure £57.1m
Profit Before Tax £0.1m
Improved efficiency and productivity
The need to deliver services more efficiently and the on-going drive for productivity
continues within both the NHS and Local Authority Commissioning sectors. The NHS target is to deliver 4% in year, although the CCG has a more ambitious target to achieve and this may further impact on ACE.
Business and financial risks
ACE’s Board Assurance Framework (BAF) provides the organisation with a comprehensive method of recording and managing its principle strategic risks against strategic objectives. The critical strategic risk for ACE in 2015/16 is the loss of current or future business due to the impact of commissioning intentions and the expiry of some current contracts. 2014/15 continued to be a pivotal year for ACE, with the commencement of the organisation’s principal commissioner’s procurement – ‘Care Closer to Home’, along with its re-design of Urgent Care and End of Life Care. These intentions had substantial implications on ACE’s future, with a potential significant loss of income and risk to the viability of the organisation, if the contract was not awarded to ACE.
ACE responded to this critical business risk through the implementation of a structured programme of preparation to respond to these commissioning intentions. As at result in July 2015, ACE was awarded England’s largest current healthcare Care Closer to Home contract—a seven year contract that will see patients having access to greater
person-centred, co-ordinated care and support in the future.
Governance and leadership
ACE’s governance arrangements aim to provide an effective overall framework which support ACE’s commercial and social missions. Staff and stakeholder involvement in the governance of ACE is an important aspect for both the development of the organisation and to remain as a Community Interest Company.
In the same way as a private limited company, ACE is controlled by the appointed Board Members and its shareholders. However, in addition, the Directors and Shareholders are responsible for ensuring that the company is run in such a way that it will continue to satisfy the Community Interest Test. Accountability for the success of ACE rests with the Board, however every member of staff also has a responsibility to own the actions and
achievements of the organisation which will require cultural change.
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Governance framework
The ACE Board comprises four Non-Executive Directors (including the Non-Executive Chair) and four Executive Directors who have a wide range of skills and backgrounds.
They are:
Richard Kearton, Chair (Non-Executive) Lynne Woodcock, Managing Director David Harrison, Non-Executive Director Lawrie Payne, Non-Executive Director Anne Thain, Non-Executive Director Nicola Carmichael, Director of Operations Sharon Charlton, Director of Resources
Jayne Hiley, Director of Clinical and Corporate Governance
Further information about the Board, including each member’s biography can be found on the ACE Website at www.acecic.co.uk
Key performance indicators have been identified to provide information and analysis and support decision making, monitoring and the development of key people related themes for the organisation. These are used to benchmark change and drive improvement within the organisation and also enable benchmarking with external organisations using recommended best practice indicators. The KPIs will change over time to ensure they are relevant for the organisation’s needs.
Analysing the indicators enables ACE to plan targeted actions or to drive or support change programmes. KPIs are reviewed at local management, Director and Board level.
Current and future workforce profile
The organisation currently operates with a workforce of 1140 staff (917WTE), with the largest workforce areas being nursing and allied health professionals. Due to the need to drive efficiencies and contribute to the local economy’s quality, innovation, productivity and prevention programme (QIPP), we recognise that the workforce will change over the coming years. In order to reduce the likelihood of redundancies we have maintained flexibility by holding vacancies, where possible, using temporary staff to fill some vacancies and have reviewed our age and length of service profiles. Therefore, we know we can redeploy staff and manage our resources effectively over forthcoming years.
Organisational development
ACE’s Workforce and Organisational Development Strategy, continued to be implemented in 2014/15. Incorporating organisational development, it includes areas such as leadership and succession planning; performance management and appraisal and the rationalisation of mandatory training.
ACE is continuing to work with the staff side on flexibility of the workforce. Multi-skilling is at the heart of the current discussions and by creating an interest in this and opportunities to join job swap banks etc, we intend to support and encourage movement around the organisation which will become accepted when flexibility due to service change etc takes place in the future.
Anglian Community Enterprise (ACE) Community Interest Company 659-662 The Crescent, Colchester Business Park, Colchester, Essex, CO4 9YQ
