Meeting documents

            Meeting: Health Scrutiny Sub-Committee (County Hall, Durham - Committee Room 2 - 03/04/2006 10:00:00 AM)

                  Item: A4 (a) County Durham and Darlington Acute Trust - Foundation Status

         

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Health Scrutiny Sub-Committee 3rd April 2006 County Durham and Darlington Acute Hospitals Trust - Consultation about Foundation Trust Status.
Report of Head of Overview and Scrutiny

Purpose of Report

1. To explain the attached report from the Acute Hospitals Trust about its application to become an NHS Foundation Trust.


Background

2. The attached report explains that the County Durham and Darlington Acute Hospitals NHS Trust is consulting about its proposal to apply to become a Foundation Trust. A copy of the formal consultation document is also attached. THE CONSULTATION DOCUMENT IS NOT AVAILABLE ELECTRONICALLY THEREFORE TO VIEW PLEASE REFER TO HARD COPIES HELD IN CORPORATE SERVICES OR THE COUNTY RECORD OFFICE

3. The consultation process continues until the 26th May 2006. As the role of Health Scrutiny is to look at this type of issue from the point of view of patients and the public, it would be very helpful if the Trust could report back to the Health Scrutiny Sub-Committee when the consultation process is coming to an end so that public views can be taken into account.

4. The guidance from the National Health Service indicates that, over time, the Government wants all NHS Trusts to be in a position to achieve Foundation Status.

5. A summary of the aims of becoming a Foundation Trust as set out in the local consultation document are set out below:-

· Giving local people and staff a say in the future of the Trust.
· Understanding what local people want.
· Sharpening the way decisions are made.
· Financial flexibility to meet future challenges.
· Meeting changing demands in the NHS.

6. The governance arrangements of Foundation Trusts involve much more representation by local people in the Trusts’ Constitution.


Some issues for the Health Scrutiny Sub-Committee

7. The different constitutional arrangements for a Foundation Trust will change the relationship with the Health Scrutiny Sub-Committee. Foundation Trusts are “scrutinised” by an independent regulator known as “Monitor”. Also, there is a proposal for the establishment of a large membership as part of the Foundation Trust’s governance. This is intended to produce more direct accountability. Accordingly, we will need to clarify the role of Health Scrutiny if this application to the Secretary of State for Health is approved.

8. There will also need to be some clarification about the role of the Patient and Public Involvement Forum.

9. The consultation document indicates that the current Trust has achieved financial balance in 2003/4 and 2004/5. It is understood that the financial situation this year may not be as favourable. The implications of the financial position of the Trust will be an issue to consider.

10. Also, the indication on the 23rd March 2006 that significant staff reductions are expected over the next three years will need to be borne in mind.

11. Following the investigation into stroke services the need for compliance with the National Service Framework for Older People in relation to a specialist stroke service is another issue which may need to be raised.

12. Overall, there will be a need to explain how the application for Foundation status will, in practical terms, improve services for people in County Durham.

Recommendation

13. At this stage the Sub-Committee may wish to receive the presentation from the Acute Trust about this application and seek further information and assurances. This will provide the opportunity for further consideration at the end of the consultation process.

Contact: Ian Mackenzie Tel: 0191 383 3506

Overview and Scrutiny Committee -
Foundation Trust consultation


County Durham and Darlington Acute Hospitals NHS Trust is applying to become an NHS Foundation Trust.

An NHS Foundation Trust is still part of the NHS, but is accountable to its local community through its membership and Board of Governors.

What is an NHS Foundation Trust?

§ An NHS organisation - foundation trusts still provide healthcare free to NHS patients
§ Based on the “co-operative” tradition - Local people are involved in how it is run
§ Less bureaucracy; more local control - foundation trusts are free from Department of Health control and are more accountable to their local community

Our vision

As a Foundation Trust our plan is to be:

§ First class - provide services which hold the full confidence of local people, earning us a reputation for excellence across the North East.
§ First choice - patients can now decide where they receive NHS treatment. We are committed to a standard of care which local people will value and want to choose.
§ Your local hospital - provide fast, convenient and local access to as wide a range of services as possible, working closely in partnership with primary care trusts and local authorities.

Why become a Foundation Trust?

As a Foundation Trust we will:

§ Be directly accountable to the communities we serve
§ Give local people a real say in the decisions we take
§ Have more control over our money, and how we spend it on better healthcare

Foundation Trust members

Patient and public involvement is “hardwired” into an FT through its membership and Board of Governors.

Any local resident - or service user can apply to be a “member” of the FT. As part of our consultation we aim to attract an initial membership of 2,000, which we will build on over the next few years.

Our members will:

§ Receive our members’ newsletter - read about what’s happening in our hospitals
§ Give views on our future plans - we carry out around 70 “patient and public involvement” projects each year
§ Get involved in issues that interest them - patient services like heart disease or maternity, or other matters like no smoking, or hospital food
§ Vote in elections to the Board of Governors
§ Represent their local community as a public governor - the Board of Governors puts local people at the heart of a Foundation Trust and gives them a real say in how the hospitals are run.

Members can do as many, or as few, of these things as they wish.

Board of Governors

FT members will elect a total of 19 local governors from across County Durham and Darlington, and other areas that our patients come from.

To ensure representation from across the patch, the following electoral “constituencies” are proposed, based on individual and combinations of local authority areas:

§ Durham City
§ Chester-le-Street, Easington, Gateshead, Sunderland, South Tyneside and beyond
§ Derwentside
§ Darlington, Tees Valley Hambleton, Richmondshire and beyond
§ Sedgefield
§ Wear Valley and Teesdale

Staff will elect seven governors. There will also be 9 governors appointed directly by our local partner organisations. These include:

§ Other NHS organisations
§ Local authorities
§ Voluntary sector
§ Universities

An FT must include among its stakeholder governors a representative of local authorities which provide social services. Our plans include governors appointed by Durham County Council and Darlington Borough Council.

The Board of Governors has real power and influence. For example, it will, in the future, be responsible for appointing the Chairman and Non-Executives to the Board of Directors.

Consultation process

It is Government policy for NHS Trusts to apply for Foundation status.

We are consulting are our vision for the future, and our arrangements for the Board of Governors and membership.

We are consulting with:

§ NHS partner organisations
§ District and Parish Councils
§ Our PPI forum, and those of PCTs
§ Voluntary sector organisations
§ Patient groups
§ Hospital societies of friends and volunteers
§ Individual patients and members of the public

Six public meetings have been held, but we are also seeking meetings with organisations listed above.

The consultation began on 27 February, and continues until 26 May 2006.

Edmund Lovell
13 March 2006


Attachments

 Consultation about Foundation Trust Status - 3rd April.pdf;
 FT OSC paper.pdf