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Betsi Cadwaladr University Health Board

Betsi Cadwaladr University Health Board Pharmacy & Medicines Management Clinical Programme Groups (CPG) Partnership Working Initiative

Download the partnership case study

Project rationale

Each University Health Board in Wales has a statutory duty to develop a three year strategic plan.

Betsi Cadwaladr University Health Board is the largest health organisation in Wales, providing healthcare services to a population of around 676,000 people across the six counties of North Wales, as well as some parts of mid Wales, Cheshire and Shropshire. It employs around 16,100 staff and has a budget of around £1.2 billion.1

The financial and operational challenges of 2013/14, together with the introduction of more robust planning required new ways of working and new ways of thinking.

In order to ensure that the University Health Board’s strategic plan was robustly developed and successfully delivered, there was an additional need for the development of operational plans at a Clinical Programme Group (CPG) level.

To support the University Health Board’s three year strategic plan, the Pharmacy & Medicines Management CPG along with other CPGs within the organisation were charged for the first time with the development of their own strategies and plans.

The aim of this externally facilitated project was to support the CPG in the process of developing their one year operational plan and to begin to consider what was required to develop three year rolling strategic plans.

Desired Outcomes

  • Development of a one year operational plan for 2014/15
  • Begin to consider the CPG strategic priorities for the next three years

Agreed objectives

The objectives of the project were aligned to:

  • Achieving the priorities defined within the University Health Boards three year strategic plan
  • Prudent healthcare principles
  • Redesign and improvement of patient pathways
  • Financial and service sustainability
  • Achievement of some of the CPG’s £8 million efficiency targets

Facilitation methodology

The facilitators led four dedicated sessions over the 13 months of the project

  • three one day events
  • one intense two day solution focused thinking event

The CPG team were set a task of developing their plans based on; MUST DO IMPERATIVES ONLY
This challenged historical ways of working at both an individual and team level

The facilitators supported the team in:

  • Agreeing four priority areas for 2014/15 – condensing their original list of over 30
  • Developing robust enabling plans to support implementation
  • Working at pace and at scale

The facilitators encouraged the CPG team to:

  • Challenge historical ways of thinking
  • Develop integrated plans that spanned the entire system supported by the CPG not just discreet areas of it i.e. community and acute teams, manufacturing and acute teams worked together for the first time
  • Work on fewer more achievable priorities
  • Develop plans that were truly patient centered
  • Develop plans that delivered sustained long term improvements

The facilitators consistently:

  • Challenged the achievability and delivery of the CPG plans
  • Encouraged the CPG team to look beyond the obvious whilst always concentrating on the imperatives

Outcomes achieved

The project delivered more outcomes than were initially planned


  • Development of a one year operational plan for 2014/15
  • Delivery of 60% of the targets set out in the plan for 2014/15
  • Development of a three year rolling strategic plan for the CPG
  • Development of an outline operational plan for 2015/16


  • Realignment of operational and strategic priorities
  • Introduction of a new way of working
  • Establishment of an ‘imperative led’ decision making framework
  • Establishment of a peer review approach to all of the CPG plans has led to the delivery of leaner, achievable integrated plans

Innovative ways of working moving forward

The approach;

  • Was applied to all operational activities of the CPG
  • Supports the CPG to think, plan and implement rapidly
  • Can be applied to other CPGs within the University Health Board


For the Betsi Cadwaladr University Health Board:

  • Delivery of a realistic and achievable operational plan for the CPG
  • Establishment of a new way of working that encourages a bottom up led, top down supported approach
  • Allows for better informed planning

For the Pharmacy and Medicines Management Clinical Programme Group

  • Development of robust and achievable operational and strategic plans
  • Delivery of CPG efficiency targets
  • Delivery of CPG key performance indicators
  • Ahead of plan development of 2015/16 operational plan
  • Ahead of plan development of 3 year rolling strategic plan
  • Development of integrated plans that span the entire system
  • Ownership of the CPG plans and delivery schedules

For the wider NHS, this approach

  • Is totally transferable to other NHS organisations
  • Encourages long term service improvement
  • Ensures achievable priority setting
  • Supports higher success of achievement
  • Encourages the sharing of best practice

Teva UK

  • Delivery of a successful partnership working initiative with the NHS in Wales
  • Adopting an innovative approach to provide solutions to address local challenges for the NHS
  • Engaging external facilitators to encourage a creative way of thinking and doing


1. http://www.wales.nhs.uk/sitesplus/861/page/40836, website last accessed 9/10/15