Progressing a Potential Application for Foundation Trust Status – Wave 2 A whistle stop tour! Louise Adams (16/11/04)

Public Service Context in which FTs sit Public service principles; –Choice and diversity of provision –Devolution of responsibility –More flexibility for front line workers –High national standards/clear accountability Foundation status gets us there through; –Liberating talents of frontline staff –Stronger public ownership and accountability –More empowered partnership

What is an NHS Foundation Trust? fully part of the NHS controlled locally not nationally with greater freedom to run their own affairs

Fully part of the NHS core NHS values public benefit corporation services for NHS patients national standards & inspection legal duty of partnership legal duty to continue to provide education and training for NHS staff

Controlled locally not nationally NHSFT constitution –broad parameters in legislation –detail defined locally –modelled on mutuals and co-ops –patient, public and staff members - opportunity to engage with local communities and staff

Controlled locally not nationally Board of Governors Board of Directors Chair advice on the business (ie the how) Must have Non- executives Chief Executive Finance director medical/dental nurse/midwife Approve (second) chief executive must have due regard to views on forward planning

Board of Governors (Members Council) NHSFT decides with partners Elected by staff members 3 staff Public PCT Local Authority University Other Patient Elected by public and patient members If sub-divided must have at least 3 categories one must be carers

Governance Constitution Board of Governors (Members Council) with formal powers; –Appoint/remove Chairman and NEDs –Decide remuneration of Chairman and NEDs –Appoint/remove financial and other auditors –Receive annual report and accounts, including auditors report –Provide views to Directors on forward planning

With greater freedom regulation not direction operational freedoms financial freedoms –access to capital based on ability to service debt, not policy judgements PFI route also available –retention of surpluses / proceeds from asset disposal

Why and why now? Now is the time to influence the new regime All Trusts to be FT by 2008 SoS is keen to invite applications from the 10 MH Trusts who have 3 Stars We decide how to make it worth it

Preliminary Application – Key dates September 2004 – Wave2 Applicants event October 2004 – Executive consideration/ Senior Leadership Group November 2004 – Staff side Meeting/ Team Leaders Meeting/Trust Board decision on progressing with application or not 26 th November 2004 – potential preliminary application submitted to DoH

Preliminary Application Content –Short Submission providing evidence of fitness to proceed including; Patient Survey Results CHI Review Clinical Governance Annual Report and Plan Performance against ratings targets National and local staff surveys Information on CNST Annual report and accounts for 3 years

Preparatory Application – Prospective Key Dates December 2004/ January 2005 – DoH gives authority to proceed with application (or not) January 2005 to August 2005 – preparatory application work Autumn 2005 – submission to DoH Autumn 2005 – DoH supports submission to the Regulator/ Monitor (or not) Winter 2005/6 and on –Regulator/Monitor assessing Earliest Wave 2 authorisation – December 2005 (Regulator determines “batching”) Mental Health – more likely to be a later batch

Preparatory Application Content 3 submissions for the Regulator; –A service development strategy developed in discussion with local NHS partners and complementary to the local health community’s strategic vision –A document describing the proposed governance arrangements including membership community (constitution) –An HR strategy discussed with staff

What the Regulator looks for Criteria for assessment –Retain 3 stars (and throughout) –Evidence of PPI in the application –Evidence of robust CG, risk management etc –Evidence of “high quality leadership”, strategic vision –IWL accredited and continuing evidence –Evidence - effective partnership, working with health community, stakeholder support –Financial balance (without undue £support)

Regulator assessment Financially stable Competently run Legally constituted Lessons from Wave 1 = robustness of 5 year financial projections

Staff in all organisations that directly provide services to our patients/service users  In SLaM  In ISS (catering domestic contracts  In social firms  Local statutory partners  LAS x 4  Police x 4  SHA x 2  PCT x 4  Universities  Outsourcing public services to social enterprises  Housing (HPU + residential)  Care in the community services eg ISIS  Facilities management  Building community capacity through mutuality & reciprocity  Time Banks  Service User groups  Faith groups  Encouraging the growth of social firms (to provide employment for service users)  Scotch Bonnett  Abbevilles  Carpet cleaners  Non profit- distributing organisations Building the membership by building a network of mutually dependent organisations NHS SlaM FT

What does this mean for staff? No major changes to structure, services or terms and conditions Staff engagement strategy Consultation on key parts of the process Involvement – through membership, B.o.G representation

Implications for the current SLaM Board Decision to proceed in wave 2 or not Ownership of the application Building the membership base Representation in the Board to Board discussions with Monitor New regime will require; –Assessment of Board skills/competencies –Robust Board business conduct –Assessment of management team capacity and capability

Issues for discussion This is a means not an end in itself We need to be clear about getting a better deal for our patients To achieve FT status we will need a robust strategy for SLaM Importance of data, financial systems, forecasting and capacity planning Governance and Membership issues