The Foundation Trust Experiment and UCLH

1

• The Foundation Trust Experiment and UCLH
• Presentation to Civitas
• 22nd October 2007

2
UCLH context

• 7 central London hospitals
• Acute local services
• Five major tertiary services
• Neurosciences
• Cardiac
• Cancer
• Women's Health
• Gastrointestinal
• Biomedical Research Centre
• 1,200 RD projects
• RD budget 300m
• Attendances 600k p.a.
• Turnover c600m

3
UCLH Hospitals

• University College Hospital,
  Eastman Dental Hospital,
• The Heart Hospital,
  Hospital for Tropical Diseases, Elizabeth
  Garrett Anderson Obstetric Hospital,
• National Hospital for Neurology and
  Neurosurgery,
• Royal London Homoeopathic Hospital

4
Our vision

• UCLH is committed to delivering
• top quality patient care
• excellent education
• world class research

• Can this vision be better delivered
• as a Foundation Trust?

5
Foundation Trusts

• Political Context

6
Political comment - Milburn

• The challenge over this next decade is to move
  power irrevocably outwards and downwards to those
  using public services
• Alan Milburn
• Secretary of State for Health (1997-2002)

7
What are Foundation Trusts?

• NHS plan earned autonomy funding for
  reform
• Public benefit corporations, but part of the NHS
• A membership of local people and staff
• A Board of Governors of patients, staff, and
  local people (elected by members) local
  stakeholders
• Freedom to borrow use surplus cash to
  reinvest in new services and innovation
• Not centrally managed, but regulated by Monitor
• Source Foundation Trust Network The story so
  far (2007)

8
Progress Towards FT Status

• April 2004 20 First wave FTs
• April 2007 70 FTs
• 200,000 staff
• 600,00 members
• 1,000 Governors
• April 2008 100 FTs
• - 100 non-FTs

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Foundation Trusts

• Are they delivering benefits?

10
Delivering Benefits

• Better governance, enhanced accountability to
  patients and the public
• Greater focus on patients (customers) needs
• Strong financial management, improved efficiency
  and productivity
• Freedom to innovate in health care
• Higher staff and patient satisfaction
• Source Foundation Trust Network The story so
  far (2007)

11
Insider Views

• We have to stand or fall by
• our own decisions. The buck
• really does stop here.
• Alan Whittle,
• CEO, Basildon Hospitals FT

• We have transformed our drive towards financial
  efficiency.
• Dr Mary Archer,
• Chair, Cambridge Hospitals FT

• We have championed the need for the Trust to
  listen to and learn from patients.
• Veronica Beechey,
• Governor, UCLH FT

• Its a different world. Its about developing
  services to our own prescription.
• Chris Burke,
• CEO, Stockport FT

12
Foundation Trusts

• How do they compare?

13
Foundation TrustsDelivering improved efficiency
COST BASE
EBITDA margin
Percent
2006/07
Achieved CIP
3.0

• 6.8

PbR efficiency assumption
2.5
2007/08
Planned CIP
2.9
PbR efficiency assumption
2.5
Quarter 1 07/08
Quarters 2-4 06/07
AP FY 07/08
3
1 2
3
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IE Surplus - 2007/08 Plan
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NHS Trusts and Foundation Trusts Use of
Resources 2006/7
NHS Trusts
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NHS Trusts and Foundation Trusts Use of
Resources 2006/7
Foundation Trusts
NHS Trusts
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Foundation Trusts Only Use of Resources
20005/6 2006/7
FTs 2005/06
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Foundation Trusts Only Use of Resources
20005/6 2006/7
FTs 2006/07
FTs 2005/06
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NHS Trusts and Foundation Trusts HCC Quality
Standards - 2006/7
NHS Trusts 2006/7
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NHS Trusts and Foundation Trusts HCC Quality
Standards - 2006/7
Foundation Trusts 2006/7
NHS Trusts 2006/7
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Foundation Trusts Only HCC Quality Standards
Foundation Trusts 2005/6
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Foundation Trusts Only HCC Quality Standards
Foundation Trusts 2006/7
Foundation Trusts 2005/6
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• These results endorse our view that with
  strong leadership and the right freedoms, NHS
  foundation trusts will deliver improvements for
  their patients.
• Bill Moyes, Monitor 17th October 2007

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Foundation Trusts Should we go further?

• FTs now model of choice
• Mergers and acquisitions - will FTs acquire
  failing NHS Trusts?
• - who represents customers shareholders?
• Extension of public/private partnerships?
• Commerciality and franchising
• Will FTs become a holding company with
  internal/external contracts and JVs
• What can UCLH do???

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Ambulatory cancer centre

• New patient focused cancer care
• Designed for each cancer specialty
• Building planned to start next year

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The UCLH campus of the future