UHCW NHS Trust Foundation Trust Consultation Document

Foundation Trust

Consultation document

Your Health. Your Trust. Your Say. Be Involved – Be a Member

University Hospitals Coventry and Warwickshire

University Hospitals NHS Trust Coventry and Warwickshire NHS Trust

www.uhcw.nhs.uk/foundationtrust

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Introduction University Hospitals Coventry and Warwickshire NHS Trust (UHCW) is aiming to provide excellent patient care through learning and discovery to be the best choice for people in Coventry, Warwickshire and beyond.

We have started this journey by introducing a programme of improvements that will give our patients the very highest standards of care.

Our staff will benefit from the satisfaction of providing that care.

The Trust, which manages University Hospital in Coventry and the Hospital of St Cross in Rugby, is now proposing to become an NHS Foundation Trust. We believe that this is the best way for us to fulfil our exciting plans for the hospital, our patients and our staff. We also believe it is the best way for many people with an interest in health services to become involved in influencing them. Maybe that includes you?

Philip Townshend

Malcolm Stamp CBE

Chairman

Chief Executive

This brochure describes what a Foundation Trust is and why we think this is the right move for us all.

It also gives some information about how this would work at UHCW. From September 2009 to December 2009, we will be consulting patients, carers, staff, partners and members of the public about our plans and ideas.

We welcome your views and this publication (also available online at www.uhcw.nhs.uk/ foundationtrust) includes a questionnaire and membership form so you can let us know what you think of our plans and whether you are interested in becoming a member. We think this is a wonderful opportunity for local people and health services.

We hope you will agree.

Our services now UHCW provides general acute hospital services to a population of approximately half a million people living in Coventry and Rugby and a range of specialist services to a wider population of over one million people.

It operates over two sites: • University Hospital, Coventry • Hospital of St Cross, Rugby

Statistics for 2008–09 Number of people attending an outpatient appointment

483,212

Number of outpatient appointments

531,002

Number of people attending Accident & Emergency (A&E) including those in specialist children’s A&E

150,101

Number of inpatients and day cases

128,313 5,721

Babies delivered Pathology tests (including tests at the labs at UHCW, George Eliot Hospital and Warwick Hospital)

3,961,942

44,239

Patients operated on in our theatres Number of staff working in our hospitals

circa 6,400

UHCW NHS Trust had many notable achievements in 2008–09: • We are pleased to announce a 40% reduction in MRSA and a 50% reduction in Clostridium difficile infections in 2008/09. This was in addition to the significant reductions we achieved in 2007–08. We will remain focused on hospital cleanliness and we are currently on target for a further drop in 2009–10 with three cases of MRSA and 51 cases of Clostridium difficile to date (July 2009) • We recognise that an operation being cancelled is one of the most stressful things that can happen to a patient and so we are pleased to report that just 0.8% of operations were cancelled in 2008/09. We also met our target for treating affected patients within 28 days

• We have achieved and improved our performance against the three key targets for cancer patients for the second successive year • Our results from the national inpatient survey placed us in the top 20% of Trusts after patients once again rated their experience of care at UHCW as among the best in the country, achieving the highest-possible score for this target. The inpatient survey placed us in the top 20% of Trusts in a number of important areas: o Offering patients a choice of first hospital appointments o Not placing patients on mixed-sex wards or making them share mixed-sex facilities • We were rated in the top 25% of Trusts for maternity services in 2007 with a rating of “Best-Performing” The Healthcare Commission’s Annual Health Check assessment for 2007–08 rated UHCW’s quality of services as “Good’”, and its use of resources as being “Good”. This is an improvement on the previous year’s rating, and UHCW was acknowledged by the Healthcare Commission as one of the two Trusts within the West Midlands region that had made the most significant improvements in their use of resources.

University Hospitals Coventry and Warwickshire NHS Trust

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Foundation Trust Consultation document

www.uhcw.nhs.uk/foundationtrust

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What is a Foundation Trust and why do we want to be one?

Foundation Trusts are very much part of the NHS and provide free, quality healthcare based on need.

However, they have some major advantages over the way NHS Trusts are run at the moment, and more than half of all Provider Trusts in England are now Foundation Trusts.

Currently we are accountable to the Secretary of State for Health. If we become a Foundation Trust, that accountability will move away from the central offices in London and be based here in Coventry and Warwickshire, at the very heart of the communities we care for.

The most exciting aspect of becoming a Foundation Trust is that people from local communities, members of staff, patients and partners can have a much bigger say in influencing health services. In a similar way to the co-operative movement, Foundation Trusts are accountable to their members. More information on how this would work is to be found later in the consultation document.

We believe that as a Foundation Trust, we will be able to work more closely with members of the public as a truly public service, ensuring that health care is timely, effective and making contributions to the wellbeing of people in our community. We will have more freedom to look at better ways of meeting our patients’ particular needs but we will still be closely inspected to make sure we meet performance and other NHS standards. We will also

strive to deliver the principles, values, rights and responsibilities that underpin the NHS, as outlined in the NHS Constitution. An independent regulator called Monitor has been created and, along with the Care Quality Commission, it makes sure that Foundation Trusts meet the required standards. We will have the powers to enter into legal and financial agreements that will strengthen relationships with existing partners, help us to forge new partnerships and enable us to develop services more effectively.

We will have more freedom to borrow and to invest in order to do this.

Another advantage of becoming a Foundation Trust is that we can give a greater say to our staff, as we intend to automatically offer them the opportunity to become members. Our staff are vital to the Trust’s success – they are each experts in their own field. As members of a Foundation Trust, they will not only continue to provide services but will also have a greater input into service development. We aim to build on our existing partnerships with staff.

Foundation Trusts have the freedom to develop new rewards and incentives for staff who contribute to a successful organisation and services.

Finally, we need to be realistic. The government expects all Trusts to have the opportunity to become Foundation Trusts by 2010. If UHCW does not apply for Foundation Trust status, it will not be in a strong position to maintain and develop its services. That would not benefit our patients, staff or partners.

Our vision for the future UHCW’s vision is to provide excellent patient care through learning and discovery.

The organisational values that support the achievement of our vision are: • Patient focus: putting patients, their safety, experiences and confidence in us, at the heart of what we do • Compassion: listening to and caring for our patients and staff, always showing respect and dignity • Commitment: to safe, effective, high-quality care through delivery, development, learning and research • Accountability: for the actions that we take and the decisions we make

In 2009–10, the Trust will review and update the corporate objectives and identify a range of supporting initiatives and success measures to support delivery of the five-year Integrated Business Plan, ensuring patients receive a high quality of care.

Achieving Foundation Trust status will allow the Trust to seek greater local involvement and support in providing healthcare for the people of Coventry and Warwickshire. It will provide the opportunity to strengthen and deepen the relationship with our community and enhance our local responsibility and accountability. Our constituency and stakeholder organisations are supportive of our application and interested in membership.

• Innovation: always seeking to discover best practice and new ways of delivering safer, high-quality care • Collaboration: working together in teams in the best interests of patients and our community • Connectivity: with and across organisations, to deliver high performance in healthcare and in our use of resources

Our name If we become a Foundation Trust our name will simply change to University Hospitals Coventry and Warwickshire NHS Foundation Trust.

We will adopt the identity:

University Hospitals Coventry and Warwickshire NHS Foundation Trust

University Hospitals Coventry and Warwickshire NHS Trust

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How the Foundation Trust would be run As a Foundation Trust, we would be run in a similar way to organisations belonging to the co-operative movement. The population served by the Trust, along with its staff and partners, will therefore be directly involved in monitoring what the Trust does. Full details of this, including information about roles and responsibilities, is being put into a new constitution.

This will be available online at www.uhcw.nhs. uk/foundationtrust or you can contact us via the address at the back of this document. The following information, however, gives an outline of the main points.

We are aiming to develop a membership of local people, patients who use our services and our staff.

Our members will reflect our diverse community and offer advice and views on service development.

We will have an Assembly of Governors, the majority of whom will be elected by members and some of whom will be appointed. The Assembly of Governors will be available for consultation and to provide views to the Board of Directors, representing the interests of members. The Trust Chairman will also chair the Assembly of Governors.

Members

What will members do?

We are proposing to have two groups of people who can be members and there are no limits on the number of people who can register.

Members will help the Trust by:

Members of the public – you are eligible to be a member if you are over 16 years of age (there will be no upper age limit).

• Being consulted on plans for service developments

Members of staff – you are eligible if you are on a permanent contract or a contract of at least 12 months or have worked for the Trust for 12 months.

We are proposing an opt-out scheme so that all such staff become members automatically unless they specify they do not wish to be.

Members will receive regular communications from the Trust keeping them in touch with what is happening and seeking their views.

We will include staff who are employed by the Trust but work at other sites. We will also include you if you work for companies providing contracted-out services or are a registered volunteer and have worked at the Trust for at least 12 months.

As being a member of an NHS Foundation Trust is a responsible position, we propose that certain people should not be allowed to be members. For instance: • Anyone who abuses the complaints system or uses it inappropriately • Anyone known to have threatened, harassed, harmed or abused staff, patients or visitors in any way • Members of staff who have submitted their notice (though if eligible, such people could apply to be public members)

• Advising on the needs and views of the local community

• Electing representatives to be on the Assembly of Governors

Being a member is a voluntary role and there are no financial benefits or costs. There is, however, much satisfaction in holding a position that can help local people and health services.

How do you become a member?

Complete a copy of the membership application form online at: www.uhcw.nhs.uk/foundationtrust Alternatively, complete the pull-out membership application form attached to this document and return it to the address at the back of the brochure (no stamp needed).

You can also: • Call us on 02476 964747 • Fax the completed form to 02476 965224 • Email us at foundation@uhcw.nhs.uk Eligible staff do not need to return an application form as they will be contacted directly.

The Board of Directors will be responsible for the day-to-day management of the Trust, monitor its performance and plan its strategic direction. There will be some changes to the way appointments to the Board are made.

University Hospitals Coventry and Warwickshire NHS Trust

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Governors

Assembly of Governors

We are proposing to have 23 governors. Of these, 16 would be elected by members, consisting of 12 elected public governors and four elected staff governors. The remaining seven governors would be appointed from partner or stakeholder organisations.

The Assembly of Governors will be made up as follows:

Public Constituency Coventry NE

Coventry NW

Coventry South

Rugby

North Warwickshire

Warwick & Stratford

Nuneaton & Bedworth

Stakeholders

Rest of England

PCTs

Chairman

• Coventry PCT • Warwickshire PCT

Non-Executive Directors

Trust Board

Chairman

Executive Directors

Local Authorities

Assembly of Governors

• Coventry City Council • Warwickshire County Council

University

Board Secretary

• Chief Executive • Chief Operating Officer • Chief Medical Officer • Chief Nurse • Chief Finance Officer • Communications & Commercial Director

• Coventry University • C&W Local Medical Committee

Registered Nurses & Midwives

Other Healthcare Professionals

Map of public constituencies The map below shows the public constituencies from which the public governors will be elected.

Atherstone NORTH WARWICKSHIRE

Bablake

Radford

Bedworth

Whoberley

Earlsdon

RUGBY

Foleshill Upper Stoke

Sherbourne

Westwood

Nuneaton

NORTH O EAST E COVENTRY O T Henley

NORTH WEST COVENTRY

Woodlands

Coleshill

Longford

St. Michael’s

Cheylesmore

SOUTH TH COVENT COVENTRY Wainbody

Kenilworth

Wyken

Lower Stoke

Binley and Willenhall

Number

Public

Coventry NE

2

Public

Coventry NW

2

Public

Coventry South

2

Public

Rugby

2

Public

North Warwickshire

1

Public

Warwick & Stratford

1

Public

Nuneaton & Bedworth

1

Public

Rest of England

1

Staff

Registered Medical & Dental Practitioners

1

Staff

Registered Nurses & Midwives

1

Staff

Other Healthcare Professionals

1

Staff

Other Staff

1

Stakeholder/Partner Organisations

Coventry PCT

1

Stakeholder/Partner Organisations

Warwickshire PCT

1

Stakeholder/Partner Organisations

Coventry City Council

1

Stakeholder/Partner Organisations

Warwickshire County Council

1

Stakeholder/Partner Organisations

University of Warwick

1

Stakeholder/Partner Organisations

Coventry University

1

Stakeholder/Partner Organisations

C&W Local Medical Committee

1

Other Staff

Staff Constituency

Holbrook

Group or Ward

• University of Warwick

Partners

Registered Medical & Dental Practitioners

Constituency

Leamington WARWICK AND STRATFORD

Alcester

Southam Stratford upon Avon Stratford on Stour

What do governors do?

• Governors’ duties and responsibilities include representing the views of members to the Board of Directors • They will bring expertise from our partner organisations

How do you become a governor?

Further information on the role of governors and how they will be appointed or elected will be included in the new constitution.

• They will receive reports on how the Trust has carried out its plans, including financial accounts • They are available for consultation and to provide views to the Board of Directors • They will also be involved in the appointment of non-executive directors including the chairman Governors will hold meetings in public and will be expected to attend some other meetings at the Trust.

There will be restrictions on who can be a governor – for instance, if you are a partner or a spouse of a Trust Board Director, or a member of the local Council Overview and Scrutiny Committee, you are ineligible.

University Hospitals Coventry and Warwickshire NHS Trust

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The Board of Directors The Board of Directors will be responsible for the day-to-day management of the Foundation Trust.

We propose it should consist of: • Six non-executive directors, plus the chairman • Six executive directors including the chief executive The chairman and the non-executive directors will be appointed by an Assembly of Governors.

The chief executive will be appointed by the non-executive directors, and the appointment approved by the Assembly of Governors. The chief executive and non-executive directors will appoint the executive directors. Further details of this will be available in the new constitution.

Transitional arrangements So that any disruption to the running of the Trust is kept to a minimum, we are proposing to put in place a set of transitional arrangements. These include: • The current non-executive directors, including the chairman, remaining in position for a minimum of 12 months following the establishment of the Foundation Trust, or until the end of their current tenure, whichever is the longer • All the existing executive directors, including the chief executive, being appointed to the Foundation Trust Board of Directors • The chief executive approving membership applications, consulting and agreeing arrangements with our partner organisations for the selection of appointed governors, and giving a final ruling on any matter that arises in relation to membership

Your views Your views, your involvement During the consultation period (September to December 2009), we will be holding a series of meetings with staff, key stakeholders and partner organisations to explain the Trust’s plans and hear their views. The staff meetings will be publicised across the organisation in team briefings and on the intranet.

We will also be holding a series of meetings for the public which will be publicised beforehand at www.uhcw.nhs.uk/foundationtrust. These are open to any member of the public and no invitation is needed to attend.

We want your views If, when you have attended one of these meetings or have looked at our proposals at www.uhcw.nhs.uk/ foundationtrust, you want to send us your views, you can: Write to us at the address at the back of this document Email us at foundation@uhcw.nhs.uk Call us on 024 7696 4747 We look forward to hearing from you.

Whilst we hope you would view this as an opportunity to apply to become a member of the Foundation Trust, you do not have to have done so to attend these meetings, although people who have already applied to become Foundation Trust members will be sent advance notice and invitations.

We will use the views and suggestions we receive at these meetings and afterwards to help us further develop the plans for our services.

Next steps and provisional timetable for becoming a Foundation Trust End of consultation

December 2009

Request to Secretary of State

January 2010

Decision of Secretary of State

End of February 2010

Monitor authorisation process

March 2010 to June 2010

Earliest date of authorisation

July 2010

University Hospitals Coventry and Warwickshire NHS Trust

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Write to this address to give us your feedback:

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Foundation Trust Consultation document

Foundation Trust Office University Hospitals Coventry and Warwickshire NHS Trust Clifford Bridge Road Coventry CV2 2DX