1. Staff Meetings October 2012 V3

2. Agenda 1.Progress on FT Project 2.An update on BEH

3. All NHS Trusts have to become Foundation Trusts by 2014. To become an FT requires passing financial and governance criteria. A detailed independent review of Barnet & Chase Farm hospitals financial outlook led the Board to conclude in July that the Trust could not meet Monitor criteria for FT authorisation as a stand alone organisation by the 2014 deadline This principally because of the level of savings required over the next five years is beyond what an individual Trust could sustain The Trust Board therefore agreed to start the search for an NHS organisation to partner with Barnet and Chase Farm Hospitals Our aim was to select a preferred partner by October 2012 and to prepare a joint case to form a new organisation for authorisation in late 2013 This will ensure we can implement the BEH clinical strategy and construction and refurbishment works on both sites are on track to begin in January 2013 Background to the Trust Board’s decision 3 Savings required to achieve FT status 2012/132013/142014/152015/162016/17 6.5%6.2%5.3%

4. What are the implications of partnership? If we are acquired by an FT the FT Board continues and it adapts its structures to an expanded organisation We aim to create an expanded organisation that can offer patient, staff and financial benefits that would not be possible for either organisation on its own BEH implementation remains the priority: the aim of the partnership is to facilitate this The aim is to create a new organisation with sufficient scale to be clinically excellent and financially sustainable to operate in the best interests of patients 4

5. Time-table and main activities July Project Board meeting monthly Request for informal expressions of interest from potential partners [17 th ] Draft evaluation criteria shared with key stakeholders [27 th ] AugustDeadline for expressions of interest [3 rd ] Deadline for comments on evaluation criteria [16 th ] “Prospectus” issued [17 th ] Partners confirmation intention to submit a proposal [31 st ] SeptemberTrust-to-trust meetings to identify clinical benefits and opportunities Deadline for partnership submissions [27 th ] Commence preparation of strategic outline case OctoberEvaluation of proposals and recommendation of preferred option Complete drafting of strategic outline case Trust Board approves strategic outline case NovemberCommissioners and NHS London review proposal NHS London approves launch of transaction preparation [22 nd ] End 2013Complete preparation for the integration of Barnet & Chase Farm Hospitals into a new organisation 5

6. London TrustsFTNHS Acute89 Acute Specialist31 Community Services1 Mental Health63 Total1714 All acute, specialist, mental health and community Trusts within 25km were invited to take part BH CFH 25km Herts & EssexFTNHS Acute3 Community Services1 Mental Health2 Total24 6

7. We devised evaluation criteria which we shared with the local NHS, staff, patient representatives and wider stakeholders Patient benefits deliver better outcomes and benefits for patients facilitate implementation of the BEH clinical strategy secure the future of Chase Farm Hospital improve the way local health services work together build on the best in each organisation Patient benefits deliver better outcomes and benefits for patients facilitate implementation of the BEH clinical strategy secure the future of Chase Farm Hospital improve the way local health services work together build on the best in each organisation Staff benefits improve opportunities for staff to develop their skills improve workplace satisfaction Staff benefits improve opportunities for staff to develop their skills improve workplace satisfaction Financial and organisational benefits complete the transaction at pace to minimise uncertainty for both patients and staff bring additional opportunities to reduce costs and increase efficiency Financial and organisational benefits complete the transaction at pace to minimise uncertainty for both patients and staff bring additional opportunities to reduce costs and increase efficiency 7

8. The Response 8 Three organisations responded by the deadline of 30 July. On 17 August these three organisations were invited to apply to submit partnership proposals using a structured Questionnaire. Subsequently, only the Royal Free chose to proceed with the process. During September, a number of workshops took place between senior leaders from BCF and the Royal Free to discuss the potential partnership. The Royal Free submitted its response to the Questionnaire and a non-binding offer letter on the 21 September deadline, which: confirmed their Trust Board’s commitment to develop a joint SOC with BCF for approval by the NHS London Capital Investment Committee on 22 November 2012; and provided an indicative date for the completion of the transaction of 1 October 2013 (subject to approvals by the relevant regulators).

9. The Evaluation An evaluation panel was convened to assess the submission and make a recommendation to the Trust Board. The panel comprised of: Clinicians and managers from Barnet & Chase Farm CCG Chairs from Enfield, Barnet and Hertfordshire SHA Observers were invited from: Enfield, Barnet and Hertfordshire LINks BCF Staff Side The panel looked at patient, staff and financial benefits 9

10. Evaluation Results The Royal Free was judged to be a suitable partner for BCF to proceed to the next stage of a transaction, namely the preparation of a joint outline business case (OBC). The response was also confirmed to be fully compliant. The overall assessment was that the proposal demonstrated the potential for patient benefits, although more could be done to reflect opportunities identified in the bilateral clinical benefits workshops. The overall assessment was that the proposal demonstrated significant potential for staff benefits and workforce-related synergies Synergy savings were identified that significantly exceeded the anticipated costs of the transaction, based on conservative estimates. However, at this stage it was not possible to fully test the sensitivity of the long-term financial projections for the combined organisation. Conclusion: to recommend that the Trust should proceed to prepare a joint Strategic Outline Case for submission to NHS London, seeking authorisation to develop a detailed business case for the creation of a partnership with the Royal Free subject to the SOC reflecting the potential clinical and financial benefits identified to date, the expected levels of implementation costs and transitional funding requirements, 10

11. Next Steps The BCF Board confirmed the decision to proceed to SOC at its meeting on 12 October If approved the SOC will be submitted to NHS London for its November meeting The next stage will be an Outline Business Case for submission in Spring 2013 Final authorisation will depend on the agreement of the two Boards, commissioner support, SHA support, and passing the regulatory requirements of Monitor and the Co-operation and Competition panel. 11

12. An Update on the BEH Strategy The Full Business Case for BEH implementation has been submitted to NHS London and was agreed by BCF Board on 12 October It confirms the investment and changes to our two hospitals The North Middlesex FBC has now been approved by NHS London The planned date of service transfer is November 2013 Barnet hospital has received planning permission for its expansion, including the new 200 space car park A leaflet explaining the Urgent Care Service at Chase Farm hospital is about to be published and distributed to local residents The reconvened transport group had its first meeting 11 October and will be updating the travel work. 12

13. Questions