5 Processes should be developed so that best practice in encouraging innovative ways to speed up project completion is disseminated effectively to local stakeholders. Delays and periods of "dead time" are common to all forms of procurement and need to be well managed. Some LIFT schemes for example, experienced delays in obtaining Strategic Health Authority approval for their business case. Local teams would benefit from meeting regularly with a representative from the Strategic Health Authority to discuss emerging issues. All parties should aim to synchronise finalisation of the business case with a Strategic Health Authority Board meeting to speed up the process.
6 To realise the full benefits of initiatives like LIFT, the local team responsible for implementation needs to be resourced adequately. We found for an average sized scheme that a core of three to four people was sufficient prior to financial close, although this needed to be increased at critical periods in the procurement. An experienced team leader, with excellent knowledge of at least one key aspect of LIFT (for example, the local health economy or experience in project finance) is important. Where local areas find it hard to employ a suitable individual to lead the process it is useful to consider alternative ways of recruiting somebody with the requisite skills and experience, for example through secondment or external project management support.
7 Buy-in from stakeholders is crucial. Guidance about the initiative aimed specifically at key groups of stakeholders (in the case of LIFT; clinicians, Local Authorities, Primary Care Trust senior management and secondary and acute care colleagues) should be developed and disseminated. Where there are specific issues arising which affect a particular class of stakeholder, there may be a case for national forums to help disseminate best practice. For example, the Department set up a network of local champions to help GPs understand LIFT. Local teams should seek to engage groups of key stakeholders early on and involve them in decision making, such as selection of the private sector partner. Appropriate channels, particularly more formalised local networking, need to be developed to disseminate lessons learned to participants in a timely manner.