How the Strategy and Business Plan fit together

The structure of the PPA Strategy is set out in terms of the five key challenges. These can be directly related to the broad activity groupings of Delivery, Development and Foundation. (Figure 1)

Key Challenge	Arrow	Activity
KC1 - Improving Service Delivery		Delivery
KC2 - Service Development KC3 - Business Transformation		Development
KC4 - Organisational Development KC5 - Partnership Working		Foundation

Delivery - Delivering efficient and effective products and services

Key Challenge 1. Delivery objectives - Targets set against our KPIs for Output, Efficiency and Quality of service

Striving for new and improved products and services, which meet the needs of our customers.

These objectives cover the performance of the authority's five groups of products and services. They specify minimum performance standards agreed with the DH. They assume that annual efficiency improvements will be made against the global expectations of the Department of Health and in order that we can identify the means to reinvest in the improvement of our services. They are linked to any input from the users of the services canvassed under the Foundation heading.

Development - Meeting the development needs of new products and services

Key Challenges 2 and 3 the Development Objectives

These objectives cover the wide range of service improvements, reengineering and new service developments that are underway. Where the development parameters are within the authority's control, the Delivery, Cost and Quality targets for each development are set out. Where control of the development lies elsewhere, then the emphasis of the targets set is scaled back accordingly. These cover:

• Pharmacy in the future - changes which affect the volume and complexity of the work we undertake and new information flows in and out of the PPA.
  
  
• Development of the National IT Programme covering the National Prescriptions Service and the Electronic Transmission of Prescriptions - this is the impetus for our planned programme of reengineering, which will be necessary to fully achieve the opportunities afforded by electronic message transfer. We are setting out to underpin the transformation of our core business processes to simplify and automate processes and hence reduce the unit costs and cycle times associated with processing, compliance, information production and services supporting the front-line of patient care.
  
  
• Reengineering and performance improvements designed to deliver better, more cost effective services based on projections of growth in our workflow and the needs of our stakeholders.

Foundation - Maintaining sound foundations and developing the capacity to grow and achieve continuous improvement in those products and services.

Key Challenges 4 and 5 - the Foundation Objectives

Our 'organisational development' is the collective term for our ability to learn and to grow as an employer and as a service provider. This is where we decide how to deploy and develop our resources to improve the efficiency and effectiveness of our services. It is also how we respond to the demands placed upon us as a responsible and publicly accountable NHS body.

Our present relevance and our future utility are dictated by the relationships we nurture with our stakeholders. We must consider how we communicate with them, building their requirements and ideas into the development of our products and services.

These objectives cover the management and the development of the PPA as an organisation. These reflect our strategic capacity to deliver products, services and developments and to respond to the evolving governance and employment agenda of a publicly funded body.

A Three-year Plan

Relationship to the strategy
Our Strategy sets out the complex interrelationship between the underlying growth in our established workload, the modernisation of the NHS, and the changes that will bring to our stakeholders, and our own plans to redesign the delivery of our products and services to achieve improved efficiency and service quality.

This Business Plan reflects the three immediate development priorities, which we face as an NHS body. In the short term, the range of services and our user base are shifting to reflect the changes brought about by 'Shifting the Balance of Power' to the front-line providers of primary care.

Alongside these changes, the pharmacy environment is developing in the direction set out in Pharmacy in the Future. These developments will result in new products and services and in adaptations in existing services, bringing with them increased volume and complexity.

To adapt flexibly to these volume and complexity changes and to improve our own service efficiency, we will continue to redesign and reengineer our business processes to reflect the skills of the people who work for the PPA and to harness technical advances in electronic messaging and process automation.

Priority in the Business Plan

The Authority gives priority to activities that promote the implementation of the NHS Plan. This priority is:

1. To meet or exceed current business targets, improving the efficiency and effectiveness of our services wherever possible.
2. To expand our existing products and services to new users and to meet the developing needs of existing stakeholders in support of cost-effective patient care in the NHS.
3. To diversify into new products and services, developing new services and products for new and existing stakeholders and building on our existing specialisms and expertise.

The rules governing us as an effective public body and the requirements of the Department of Health span these broad priority bands and can result in the promotion of a particular objective within the overall structure. This is the foundation on which we can deliver our services.

Overall Relationship
The priority bands A-C are broadly applicable across all five key challenges as illustrated. (Figure 3)

		A. Meet existing service levels	B. Expand products, services and users	C. Diversify into new products & services
Delivery	KC1 - Improving Service Delivery
Development	KC2 - Service Development
	KC3 - Business Transformation
Foundation	KC4 - Organisational Development
	KC5 - Partnership Working

Its principal use is to monitor our activity and performance.

It is geared to the achievement of our aims against the Vision and five key challenges set out in our Strategy covering the period up to 2008. This plan covers the next three years in the scope of the objectives we have set. The majority of activity and of the detailed targets is relevant to the next financial year and is directly linked to the budget allocation, which funds the PPA. These budget figures will be applied to the objectives in this plan once finalised.

Management timetable
This plan, which covers the next three years, contains a number of objectives that will interact to impact upon the volume and complexity of the core work we do. We can rationalise these interactions through the Capacity Model, which has been developed to prototype the organisation's operational processing capacity under a range of scenarios. We use the outputs of the model to inform the decisions underlying our reengineering programme and the response we provide to initiatives and opportunities which arise within our operating environment.

Issues, which affect the pace with which objectives within this plan are pursued, are linked by the Capacity Model. On the input side, this models the impact of prescription volume growth and incremental changes in workflow caused by prescribing and dispensing initiatives. These are matched against expected productivity improvements. In addition, assumptions based upon the rollout and adoption of technological changes to both the processing environment and to the basic forms of data input (e.g. ETP) are considered.

Current planning assumptions underpinning this plan are:

• Annual prescription growth of 6% in each financial year to the end of 2005-06
• A step-change in volume attributable to repeat dispensing of 14.5%, phased at 1.67% by Q1 of 2003-04, 5.72% by Q3 of 2003-04 and 14.5% by Q1 of 2004-05. The implications of this phasing and the benchmark for monitoring its implementation are discussed in the objective on repeat dispensing (18).
• Underlying performance improvement across processing is assumed to follow the profile:
• Cumulative improvement at year end:
  2003-04 6%
  2004-05 8%
  2005-06 11%

Based upon current organisational capacity, this would require the opening of a new processing division in August 2005. The need for this is obviated by the performance improvements expected of improved data capture, which is itself a precursor of the reengineering programme due to be implemented from July 2006.

Our concept for reengineering is based upon a blueprint where by data enters the PPA through a variety of routes and processes. Manual data capture is one of these routes. At first it will predominate, but over time we will work through ETP and otherwise to reduce the paper flows and increase the inflow of electronic information in a consistent format. To prepare our core processes to deal with this diversity of input, we will reengineer our data capture with the goal of creating a structured message that can then be handled electronically and is analogous to an electronic message received under ETP.

These consistent messages, dealing with prescribing and dispensing events, will then be directed to a 'rules engine' which will be software designed to apply the correct rule set to enable prompt and accurate reimbursement and remuneration based upon the received data. To enable this part of the process, we will work to identify and apply simply those rules, which determine the reimbursement and remuneration of prescribed products.

We envisage that in its first iteration, such a rules engine will require significant exception processing to be carried out through manual intervention using expert staff. Thus our staff profile entering this period of reengineering will combine numbers of staff using the new data capture process complemented by expert staff interpreting data which by exception can not be processed via the rules engine.

The Capacity Model is reproduced in Appendix (B)

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