Walsall Healthcare NHS Trust

Maternity Services Business Case

Sedgwick Igoe & Associates Ltd provided business case development services to Walsall Healthcare NHS Trust for the redevelopment of Maternity services at Walsall Manor Hospital.

Over recent years the Trust had experienced a rise in demand for maternity services that has placed significant pressures on its existing service arrangements and infrastructure. In September 2015 the Care Quality Commission issued a warning notice and the Trust worked with Commissioners and other providers to introduce a cap of 4,200 births while improvements in services could be made.

The Trust's strategy of lifting the cap and increasing the number of births to just below 5,000 per annum requires a redevelopment of maternity facilities. The Trust commissioned Sedgwick Igoe & Associates Ltd to produce a business case for NHS England to support the redevelopment of the maternity facilities, including a second, dedicated, co-located obstetrics theatre.

Sedgwick Igoe & Associates' work:

SIA partnered with the Trust in the development of a comprehensive Full Business Case to make the case for change. SIA worked with staff right across the Trust to ensure clinical, estates and strategic engagement in the development of the business case and acted as a critical friend of the Trust in order to ensure the best possible case for investment was put forward. SIA also coordinated the inclusion of feedback from NHS Improvement and collated all supporting documents, providing the Trust with a comprehensive pack for submission to NHS England.

Royal Wolverhampton NHS Trust

Vertical Integration - New Models

The NHS Five Year Forward view centres on the importance of New Care Models in order to tackle the challenges facing the NHS. Aligned to that work The Royal Wolverhampton NHS Trust launched its Vertical Integration project and Sedgwick Igoe provided the project support to deliver this innovative new model of service delivery.

The Trust believed that by bringing Primary Care and Secondary Care closer together it could better align services, reduce duplication and ensure that patients are healthier for longer.

The Trust did this through conversations with GP Practices interested in developing new ways of working and on the 1st June 2016 three GP Practices, across five sites, in Wolverhampton sub contracted their GMS contract to the Trust. Staff, including GPs, all became salaried staff of the Trust, contracts were novated over and workstreams bringing Primary and Secondary care clinicians were set up to facilitate the development of new ways of working. Other quick wins including the relocation of physiotherapy services into Practices and support from the Trust to recruit extra GPs and other staff to manage demand.
On the 1st January 2017 another Practice joined and SIA manage the acquisition of one more Practice on the 1st April 2017 - bringing the total number of patients over 30,000.

In amongst this new governance arrangements in the Trust were developed, including a Steering Group and Directorate Management team, and external assurance was provided to NHS England, Care Quality Commission and Clinical Commissioning Group.

Sedgwick Igoe & Associates' work:

SIA provided the project management from initial planning through business as usual for the first five practices. Specific outputs from SIA include:

  • Design of new care model, including internal and external assurance structures.
  • Project management of the acquisition of five GP Practices into the Trust including managing the due diligence process; Trust Board and Non-Executive Directors report writing; NHS England and CQC external assurance and legal, financial, HR and contractual acquisition.
  • Development and recruitment of a Directorate Team in order to manage the project long term.
  • Bid writing for new investment from NHS England for the relocation of one practice, for clinical pharmacists and acceptance for the Productive Primary Care Programme.

NHS West London Clinical Commissioning Group

Development of a business case for the relocation of Primary Care.

Sedgwick Igoe & Associates Ltd provided business case development services to NHS West London Clinical Commissioning Group (NHS WLCCG) for the location and merger of two primary care practices to a new build provision funded by Section 106 monies.
The two practices had a combined list size of 18,000 patients, and were delivering care from accommodation which was acknowledged as too small and both had very poor compliance in terms of DDA and environmental standards. Neither surgery could be reconfigured or refurbished to address these issues
Having undertaken an assessment of available properties in the area an approach was made to the CCG by the developer seeking to provide a landmark replacement for a rundown building plot above Notting Hill Tube Station, to explore the opportunity to provide a GP Surgery in that proposal.

The project entailed working closely with the practices, developer and CCG to establish an appropriate footprint, layouts and negotiation of the terms of occupation.
On completion of these steps the necessary business case was prepared for consideration and approval by the CCG.

Following CCG approval further support was required by the practices to assist in the successful application by the developer for planning permission. The proposal was not fully supported by the local community and the application was subject to appeal and referral to Secretary of State.
However, having achieved the approval assistance has continued with the progress of the detailed design and planning for relocation which is expected to be in 2023.

Sedgwick Igoe & Associates' work:

SIA partnered with the practices and CCG to establish the detailed requirements of the practices and to negotiate the terms of occupation and subsequent agreement for lease. SIA also prepared the comprehensive Business Case to make the case for change and approve the relocation. SIA worked with the GP partners, the developers, design teams and legal advisors to broker the Section 106 proposal and complete the business case and acted as a critical friend of the CCG in order to ensure the best possible case for investment was put forward.