PAYMENT BY RESULTS

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ITS MY HOSPITAL! DEMOCRACY IN ACTION THROUGH
NHS FOUNDATION TRUSTS

SUSAN SELLERS PETER HERRING CHAIRMAN CHIEF
EXECUTIVE
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What is a NHS Foundation Trust

• Integral part of NHS system
• Greater freedom to run own affairs
• Truly self-governing - controlled locally not
  nationally
• Public Benefit Corporation (Not-for-profit)

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Why do we believe it of benefit to become a NHS
Foundation Trust ?

• Freedom to make decisions more rapidly
• Accountability to local people
• Involvement of local people in service change
• Faster progress to equality in funding
• Greater freedom to borrow and start capital
  schemes more quickly

Much faster progress towards improving services
for NHS patients in our health community
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Local governance arrangements
Membership Comprising public, staff and patients
Council of Members (referred to in the
legislation as the Board of Governors) Elected
from public, patient and staff membership, with
others appointed by partner organisations
Board of Directors Executive and Non-Executive
Directors
Independent Regulator
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Membership

• Residents of
• Ellesmere Port Neston
• Chester City surrounding rural areas
• Flintshire
• Surrounding districts
• Staff
• Voluntary

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Council of Members
Chairman
19 Public / Patient Foundation Trust Council
Members
12 Partnership Organisation Foundation Trust
Council Members Appointed 3 Primary Care and
Local Health Board representatives 4 Local
Authority representatives 2 Voluntary Services
representatives 1 representative from University
College Chester 1 representative from the
Chamber of Commerce 1 representative from
Flintshire CHC
Elected from Chester, Ellesmere Port and Neston,
parts of Crewe and Nantwich, parts of Vale Royal
and parts of Flintshire.
6 Staff Foundation Trust Council Members
Elected by staff members of the NHS Foundation
Trust
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Council of Members

• Powers duties
• Approve annual reports accounts
• Approve appointment of Auditor
• Appoint/remove Chair and NEDS
• Ensures FT operates within Terms of Authorisation
• Consultation on forward plans

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CONSULTATION

• 3 AUDIENCES
• PUBLIC AND PATIENTS
• STAFF
• STAKEHOLDERS
• APPROACH TAILORED TO EACH CONSULTATION

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CONSULTATION

• PRESS
• STAFF MAGAZINE
• PUBLIC MEETING
• DISPLAYS
• HOSPITAL
• SUPERMARKETS
• LEISURE CENTRES
• HEALTH PARTNERS
• MAIL SHOT
• WEBSITE

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CONSULTATION

• STAKEHOLDER MEETINGS
• MPs
• HEALTH PARTNERS
• VOLUNTEER GROUPS
• STAFF PARTNERSHIP BODIES
• LOCAL AUTHORITIES
• OVERVIEW SCRUTINY
• COMMUNITY HEALTH COUNCIL

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CONSULTATION - RESULTS

• FORMAL RESPONSES RECEIVED 1,922
• VAST MAJORITY EITHER IN FAVOUR OR BROADLY NEUTRAL
• SMALL MINORITY OPPOSED

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CONSULTATION DID IT MAKE A DIFFERENCE?

• MANY PROPOSALS WERE SUPPORTED
• e.g.
• SUPPORT FOR DESIGNATED YOUTH MEMBER ON COUNCIL OF
  MEMBERS
• but
• RAISE LOWER AGE LIMIT FROM 14 TO 16
• STAFF CHOSE TO BREAK THEIR CONSTITUENCY DOWN
  ACCORDING TO STAFF GROUPS

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CONSULTATION CONCERNS

• LOCAL ACCOUNTABILITY WELCOMED
• (BUT NOT IF IT INCREASES COSTS)
• COUNCIL OF MEMBERS TOO BIG
• PRIVATISATION
• TWO TIER SERVICE

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MEMBERS RECRUITMENT

• PUBLIC
• LOCAL MEDIA INCLUDING ADVERTS
• POSTERS SIGNS IN HOSPITAL GROUNDS
• EXTERNAL DISPLAYS (MANNED AND UNMANNED)
• SUPERMARKETS, LARGE LOCAL EMPLOYERS
• MEMBERSHIP DESK ROVING MEMBERSHIP ADVISERS
• LETTERS TO RECENT PATIENTS (OUT OF AREA)
• WEBSITE/FREEPHONE
• PROMOTION THROUGH EXISTING NETWORKS
• SPECIAL TARGETING OF HARD TO REACH GROUPS

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MEMBERS RECRUITMENT

• STAFF
• STAFF MAGAZINE
• TEAM BRIEF
• LETTER WITH PAYSLIPS
• MEMBERSHIP DESK
• PRESENTATIONS AT TEAM MEETINGS
• E MAILS INTRANET

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MEMBERS RECRUITMENT

• OPT IN NOT OPT OUT
• PUBLIC
• 4 GEOGRAPHICAL CONSTITUENCIES
• CHESTER RURAL CHESHIRE
• ELLESMERE PORT NESTON
• FLINTSHIRE
• OUT OF AREA
• PATIENT MEMBERS NO

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MEMBERS RECRUITMENT

• STAFF
• 1 STAFF CONSTITUENCY BROKEN INTO 5 CLASSES
• NURSES/MIDWIVES QUALIFIED
• NURSES/MIDWIVES UNQUALIFIED
• DOCTORS
• ALLIED HEALTH PROFESSIONALS/TECHNICAL/SCIENTIFIC
• ALL OTHER STAFF GROUPS

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MEMBERS RESULTS (AT TIME OF APPLICATION)
PUBLIC 2,983 MALE 1273 FEMALE 1710 STAFF
434 MALE 122 FEMALE 312 FTs HAVE TO TRY
TO ENSURE THAT MEMBERSHIP IS REPRESENTATIVE OF
COMMUNITY e.g. GENDER/AGE/CONSTITUENCY/ETHNIC
ORIGIN
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ELECTIONS

• RAISING AWARENESS
• PRESS/RADIO
• LETTER TO ALL MEMBERS UPON
• RECEIPT OF APPLICATION
• PRESENTATIONS

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ELECTIONS
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ELECTIONS

• PUBLIC
• (ALL CONTESTED BAR ONE)
• CHESTER RURAL CHESHIRE 18 FOR 9 SEATS
• ELLESEMERE PORT NESTON 9 FOR 5 SEATS
• FLINTSHIRE 7 FOR 4 SEATS
• OUT OF AREA 1 FOR 1 SEAT

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ELECTIONS

• STAFF
• (ALL CONTESTED BAR ONE)
• NURSES/MIDWIVES (QUALIFIED) 6 FOR 2 SEATS
• NURSES/MIDWIVES (UNQUALIFIED) 1 FOR 1 SEAT
• DOCTORS 4 FOR 1 SEAT
• AHP/TECHNICAL/SCIENTIFIC 2 FOR 1 SEAT
• ALL OTHER STAFF GROUPS 5 FOR 1 SEAT

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DO MEMBERS MAKE A DIFFERENCE?

• ENGAGEMENT WITH HOSPITAL
• ASKED TO IDENTIFY AREAS OF INTEREST ON
  APPLICATION FORM
• DETAILS HELD ON DATABASE
• MEMBERS CONTACTED AND ASKED TO PARTICIPATE AS
  OPPORTUNITIES ARISE
• COMMUNICATION ABOUT HOSPITAL VIA ANNUAL
  REPORT/NEWSLETTER/LETTER

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HOW HAVE MEMBERS PARTICIPATED?

• TRUST OPEN DAY
• MODEL PATIENTS
• NURSING PATIENTS STRATEGY
• CARE PROJECT
• ANNUAL MEMBERS MEETING
• FEEDBACK ON ANNUAL REPORT
• VOLUNTEERS/FUNDRAISING
• LINKAGE TO PPI AGENDA

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CONCLUSIONS

• DOES THE PUBLIC WANT TO BE INVOLVED?
• DO THE BENEFITS OUTWEIGH THE COSTS?
• DOES THIS MAKE A DIFFERENCE?
• ONE SIZE FITS ALL?

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What difference have local governance
arrangements made

• Greater freedom to make decisions
• National direction still strong
• Culture approach of Board of Directors
• Increased community awareness
• Increased community engagement