Planning


The Planning Process

Integral to health planning is ensuring a professional agreed approach to conducting a planning process together with a standard format for presenting plans.

1. Develop the Planning Scope

The planning process scope should ideally provide a written outline of the major tasks and key timeframes for the planning process. The process should be agreed by the responsible service provider/manager/General Manager/Chief Executive. A planning scope would typically include:

  • The membership of the Steering Committee/Service Development Group that will oversee the process.  Key meeting dates of this group
  • The Terms of Reference of the Steering Committee
  • The meetings and consultations required with key stakeholders, including community, clinicians and providers
  • The data and evidence required for the Plan.
  • The community consultations, focus groups, surveys etc required to provide additional data for the plan
  • An outline of the table of contents for the Plan
  • Timeframes for all key processes including notional dates for first, second and final drafts, dates for presentations to community groups, service providers, senior executives, board committees

All senior staff and key stakeholders should be advised in writing or by e-mail of the service planning process and the rationale for the plan. Contact details for the planner/manager should be clearly provided.

2. Establish the Steering Committee

Ensure appropriate representation from clinicians, academics, different locations/divisions/units, community health/hospital staff, nursing/allied health/medical/support staff, community members/groups/consumers, community groups or, if relevant, Board members. Dependent on the plan, it may not be necessary to include all these groups.

Issue terms of reference and membership lists, estimate numbers of meetings and establish draft meeting dates.
Advise the Ministry of Health of the process if appropriate.

3. Review any Previous Plans

Review major previous plan and the recommendations and implementation status.

Ensure recommendations from evaluations are incorporated into the new planning process.

Determine if an evaluation is required as a part of the current service planning process.

4. Collect and Review Relevant Policy, Literature and Evidence

Collect relevant national, state, area and local plans and reports. For some planning exercises, international plans/reports may be useful.

Check major websites to see if new policies have been developed. Speak to relevant policy advisers and service providers.

Ask key service providers for relevant evidence, best practice guidelines etc

Seek out planning or clinical guidelines which may be relevant e.g. Guide to Role Delineation, Guidelines for the Hospitalisation of Children, Guidelines for Patient Management, Planning Principles for Rural Health Services

Undertake a literature search on the subject area to ensure an evidence base to the plan.

5. Consult Key Stakeholders and Visit Services

Interview a broad range of key stakeholders to determine their views of current services/models/strategies and their views on the issues raised by the terms of reference. This consultation process may be undertaken by the planner alone or in conjunction with service providers dependent on the aims of the planning process. The latter collaborative approach is usually preferable as it actively engages the key stakeholders in the process. A broad range of stakeholders may be consulted e.g. service providers, District, hospital and community managers, community groups and organisations, academics, referral groups, Medicare Locals, GPs etc

Visit service sites and meet service providers.

Outline the issues arising from the consultations in an Issues Paper. Present and discuss issues or the Issues Paper and their implications at the Steering Committee Meeting(s).

6. Collect and Analyse Quantitative Data

Select and access data relevant to the service plan - geographic, demographic, epidemiological and utilisation data. Where a great deal of data is available, it is important to establish which data provides the most strategic information.

Discuss data and its implications, shortfalls and usefulness with service providers.

Analyse the data in collaboration with service providers.

Assess the best way to present the data (e.g. tables, graphs, written text).

Present and discuss the data and its implications at the Steering Committee Meeting(s).

7. Collect and Analyse Qualitative Data

Undertake and analyse community/other agency or staff surveys. Consider an on-line survey.
Undertake focus groups/community meetings and forums as required.

Feedback outcomes to the group being consulted to ensure that you have an accurate record of the needs, issues and views raised.

Present and discuss the findings and implications at the Steering Committee Meeting(s).

8. Describe and Analyse the Current Model of Care or Issue/Service

Describe the current service or model of care. If you are uncertain about the current service you can distribute a service pro-forma/survey to key providers and from Area/local sources. Collect information on staffing numbers and types, budgets and allocation of resources and assets (facilities and equipment). Evaluate the current and future model of care, service approach and adequacy of resources.

  • Gather and analyse service utilisation information
  • Assess the interrelationship with other services
  • Gather information on similar services for the purpose of benchmarking
  • Assess the model of care and adequacy of the service against any best practice guidelines/planning standards
  • Check the agreed Model of Care with the Agency of Clinical Innovation (ACI)

Discuss gaps, overlaps and deficiencies at Steering Committee Meeting(s).

9. Forecast Changes

Use quantitative data, qualitative data and evidence to assess future changes in demand.

For major service planning exercises, liaise with the Ministry of Health to ensure that the methodology is robust.

Planning staff use future projections tool such as Aim, SIaM to project future demand and to trial supply scenarios.
Expert opinion may also inform forecasted changes.

Present and discuss findings and implications at the Steering Committee.

10. Outline the Major Issues to be Addressed

This paper would consolidate the major issues arising in the planning process.

11. Develop Strategies

Discuss issues and strategies at the Steering Committee.

12. Set Priorities

Cost all strategies.

For many plans, additional resources are not available, and thus, a plan must be achieved within existing resources or with internal reallocation of resources. Efficiencies related to overall decreased costs or increased throughput should be identified.
Capital costs can usually be broadly estimated within a service plan or alternatively the plan may recommend that a capital planning process be undertaken.
Establish a process for prioritising strategies. Such a process could include community participation. Alternatively it may be undertaken by the Steering Committee. The process may simply establish whether strategies are high, medium or low priority. (For many plans any strategy that is not a high priority would not be included in the plan).
Alternatively the process might include a Kepner Tregoe analysis which would seek to establish, weight and score strategies against agreed criteria. A modified nominal group technique can also be used (each participant records their preferred strategy(ies), after discussion each person has (say) 5 votes to allocate to strategies. The strategies with the most votes are adopted).

13. Develop a Draft Plan for Comment

Develop a draft plan. A draft should be a professional and well written document. For example: spelling and grammar should be correct; formatting should be consistent; data should be consistent and well organised (e.g. the same years); all tables, graphs and figures should be  sequentially and clearly numbered; all pages should be numbered; the document should be stamped as a draft with the relevant date.
Distribute to Steering Committee for initial discussion and comment.

14. Print and Issue the Plan for Implementation and Evaluation