Progressing a Potential Application for Foundation Trust Status Wave 2

1

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

2
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

3
What is an NHS Foundation Trust?

• fully part of the NHS
• controlled locally not nationally
• with greater freedom to run their own affairs

4
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

5
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

6
Controlled locally not nationally
Must have Non- executives Chief
Executive Finance director medical/dental nurse/mi
dwife
Approve (second) chief executive
advice on the business (ie the how)
must have due regard to views on forward planning
7
Board of Governors (Members Council)
If sub-divided must have at least 3
categories one must be carers
8
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

9
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

10
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

11
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
• 26th November 2004 potential preliminary
  application submitted to DoH

12
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

13
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

14
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 communitys
  strategic vision
• A document describing the proposed governance
  arrangements including membership community
  (constitution)
• An HR strategy discussed with staff

15
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)

16
Regulator assessment

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

17
Building the membership by building a network of
mutually dependent organisations
Non profit- distributing organisations

• 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

• Encouraging the
• growth of social
• firms (to provide
• employment for
• service users)
• Scotch Bonnett
• Abbevilles
• Carpet cleaners

• Building community
• capacity through
• mutuality reciprocity
• Time Banks
• Service User groups
• Faith groups

NHS SlaM FT
18
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

19
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

20
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