NHS

^{EXECUTIVE SUMMARY}

^{THE STIMULUS AND THE CHALLENGE}

^{HPC Ltd & Associates were stimulated into action when the Senedd Committee Chair raised concerns on September 8 2020, about how the Glan Clwyd Hospital Refurbishment went alarmingly over budget.}

^{In 2012, the Welsh Government agreed on £110.4 million to remove asbestos and refurbish the hospital.}

^{However, the process eventually cost £170.8 million, 55% more than the original approved budget. Basic financial project disciplines had broken down, and as a consequence, the Glan Clwyd Hospital Refurbishment went £60m over budget.}

^{This extremely poor outcome was all the more disappointing because, overall, the NHS is one of the industrialised world's most efficient health care systems and operates at a substantially lower cost than other advanced European countries such as France, Germany, Sweden or Switzerland.}

^{Had proper controls been in place for Glan Clwyd, it is unlikely that the overspend would have happened. However, growing pressure on the UK Government's fiscal budgets creates the strategic imperative to increase the transparency of the NHS's mission-critical investments and improve their realised benefits and efficiencies.}

^{HPC Ltd and Associates believe that the established Earned Value Management Systems (EVMS) approach would have provided the appropriate methodology and controls to secure a better outcome for all parties, including the taxpayer.}

^{A COHERENT SOLUTION TO BENEFIT ALL STAKEHOLDERS}

^{HPC Ltd and Associates believes that Earned Value Management Systems would be a strategic enabler in the process of finding efficiencies and economies for the NHS.}

^{As EVMS is a discipline in which we have considerable experience, we have put together a proposal to assist the BCUHB and the NHS more widely in finding sustainable savings in the long term by focusing explicitly on Project and Performance Management.}

^{Earned Value Management Systems enable industries of all descriptions to meet their objectives by having adequate control over project schedules and budgets. It is based mainly on the principle of "earned time" popularised by Frank and Lillian Gilbreth in the early 20th century and applied extensively to industrial manufacturing. The concept took root in the United States Department of Defense in the 1960s and is now one of the essential techniques used today in Project & Performance Management. In addition, EVMS acts as an early warning system for projects behind cost & or schedule; it helps correct course and progress, thereby reducing or mitigating losses and delays.}

^{IMPLEMENTATION}

^{To implement effective EVMS, we create a framework within which all activities - procurement of materials, resources etc.  - and assets are logically organised, thus enabling systematic and structured feedback.  There are two key strands of information that we analyse to make relevant and purposeful recommendations. These are;} 

^{1.         Budgeted Cost of Work Performed (also called Earned Value) and} -

^{2.         Actual Cost of Work Performed (also called Actual Cost ).}

^{You can find a more detailed explanation about EVMS on our website, which is at;https://harveyplanningconsultancy.co.uk/earned-value-analysis-management/}

^{We looked at how we could help increase efficiencies within BCUHB specifically and in the NHS more generally. We recognise the significant efforts made by the NHS in managing critical capital framework investments and the running of hospitals, healthcare centres and other services. However, we also believe there are improvements to be made and efficiencies to be gained.  To this end, we envisage a developing programme as set out below.}

^{Stage One: FRAMEWORK PROGRAMME CREATION}

^{1.1  Create a project Framework Programme, which will require information gathering from BCUHB.}

^{1.2  HPC creates the framework programme, and then we route it back to BCUHB for approval.}

^{1.3  Subject to changes made by BCUHB, HPC revises & resubmits for stage one approval.}

^{Stage Two: APPLYING EARNED VALUE MANAGEMENT SYSTEMS}

^{2.1  Agreement by all parties on stage one will lead to an entire framework hierarchy forming the basis for measuring operational performance.}

^{2.2 Next, add resources, materials and budgeted costs to the framework programme.}

^{2.3 Once HPC receives final approval for the framework programme, and this becomes the basis for measuring performance and completing stage two.}

^{Stage Three: FRAMEWORK PROGRAMME MAINTENANCE}

^{3.1 HPC receive regular detailed monthly updates from BCUHB.}

^{3.2 HPC applies actual costs from monitored records to the framework programme.}

^{3.3 HPC Attend monthly meetings}

^{3.4 HPC reports budgeted costs vs actual costs against a detailed report to BCUHB.}

^{As part of the above, HPC Ltd will create a private customer portal for BCUHB to access updated information 24/7.}

^{We believe in continuous improvement. We can assist BCUHB by introducing}

^{active control methods, namely in the better procurement of products and services, the processes used to design and produce them, and how the workforce within the BCUHB operate more efficiently.}

^{Continuous improvement is a philosophy, and adopting changes may require a cultural shift that will require consistent effort to embrace to realise the benefits.}

^{A PILOT PROGRAMME}

^{BCUHB may view HPC's suggestions with caution, and that is a natural and prudent response. However, we believe that integrating Earned Value Management Systems (EVMS ) into the current BCUHB practices will bring considerable value and benefits to operations within the health board.}

^{Consequently, we are happy to offer a free one-month pilot programme to demonstrate that using information from EVMS will carry significant weight at the monthly progress meetings and add long term value.}

^{Earned Value Management Systems data can be an integral part of a test exercise for a chosen hospital business study before aligning other healthcare facilities with the same principle, which is imperative for establishing a strategy-driven healthcare facilities portfolio.}

^{EVMS data and methods can link project performance to strategy. For example, the performance data that EVMS provides can aid portfolio managers in determining whether their projects are meeting current performance targets – from this can be predicted whether they may meet their intended strategic outcomes.}

^{The pilot programme is offered for one month at no cost to BCUHB and is without obligation.}

^{HPC's ultimate goal is that you cease to see us as a cost at all – in the fullness of time, we have done our job if your budgeted forecasts remain intact and the day-to-day running operations become structured in such a way that project planning and attention to detail will save you from incurring extra cost, extra time, and extra worry.}

^{THE KEY BENEFITS OF USING HPC'S PLANNING SUPPORT SERVICE}

^{1.         Increased planning and financial efficiency}

^{2.         Reduced risk of programme/schedule overruns}

^{3.         Visibility to identify bottlenecks and delays.}

^{4.         Early-stage corrective action.}

^{5.         Insight to current and future resource usage for accurate forecasts and decisions.}

^{6.         Resolve overallocation through levelling or changing resource assignments!}

^{7.         Earned Value Analysis and Management – EVMS.}

^{8.         BIM & Visualisation Services to track Capital Projects.}

^{Leading to;}

1. ^{Surplus budgets to invest in more technology and resources.}
2. ^{Investment in the refurbishment of existing facilities.}
3. ^{Investment in new hospitals and healthcare centres.}
4. ^{Increase in patient satisfaction.}
5. ^{Reduction in waiting times, utilising methodical planning.}
6. ^{Decrease in waste and save on Water and Electricity.}
7. ^{Improvements for basic financial disciplines. ('capital projects') – As Planned vs As-Built monitoring.}

^{Next Steps}

^{We hope you will want to find out more about what we propose.}

^{If you want to see our analysis of information already publicly available and learn more about how we can support efficiencies and improvements within BCUHB, please get in touch with Michael Harvey at Harvey Planning Consultancy Ltd.}

^{Email:   hpc@harveypc.co.uk}

^Telephone: 0794 088 5667

Earned Value Management Systems would be a strategic enabler in the process. We possess the skills and experience to work with the BCUHB in finding efficiencies and economies.

Should you wish to receive a full report, please furnish us with your particulars to; hpc@harveypc.co.uk

Go to https://harveyplanningconsultancy.co.uk/earned-value-analysis-management/ for fuller information on Earned Value Management Systems

THINK OF HPC'S 'PLANNING CONSULTING SUPPORT SERVICE' AS A PROACTIVE FINANCIAL BUSINESS PLAN TO DELIVER BETTER VALUE FOR THE USE OF THE PUBLIC MONEY THE NHS SPENDS.