Memorandum by the Chesterfield Royal Hospital
NHS Foundation Trust (FTM 05)
PROGRESS AND IMPACT OF NHS FOUNDATION TRUSTS
1. BACKGROUND
Profile
Serving North Derbyshire's population of around
375,000, Chesterfield Royal Hospital NHS Foundation Trust provides
a full range of acute services—plus 24-hour accident and
emergency care and specialist children's services based in the
community (including family therapy services, child and adolescent
mental health, children's physiotherapy and school nursing). The
Trust also manages a small maternity centre in Darley, near Matlock.
1.1 Organisational facts and figures 2008-09
— Employs approximately 3,400 staff.
— Around 560 beds and 8 beds at Darley
Birth Centre.
— More than 115,000 x-rays and 26,000
physiotherapy appointments.
— 250,000 out-patients in 10 out-patient
suites.
— 25,000 patients admitted in an emergency.
— 30,000 patients cared for on our
wards.
— 58,000 A&E attendances expected.
— 12,000 community members, 3,200 staff
members.
— Council of governors—17 public
(elected governors), 4 staff (elected governors) and 8 partner
(appointed governors).
1.2 Achievements 2007-08
— Rated a double excellent by the Healthcare
Commission (use of resources and quality of services). Only organisation
in East Midlands to achieve this.
— Rated a "best performer"
by Healthcare Commission for maternity services (one of only 38
hospitals in the country).
— Rated "excellent" by mothers
surveyed by the Healthcare Commission in 2007.
— Achieved 18-week referral to treatment
target by December 31 2007 (a year early)—one of only six
hospitals to do so.
2. BENEFITS
Foundation trust status has allowed Chesterfield
Royal Hospital NHS Foundation trust to achieve:
— An enhanced board of directors—bringing
in vital skills and experience and higher quality.
— Speedier decision making.
— "Surplus with a purpose"—developing
long-term investment strategies.
— Greater investment in facilities
and services (three-fold increase in capital expenditure).
— Improved governance systems—setting
strategy, targets and long-term plans.
— Engaged governors representing the
community.
— Engaged members—involved with
the trust.
— Wider and leading role in the community—supporting
business and partnerships.
— The opportunity to lead change.
— An "all terrain vehicle"
model—goes everywhere, does everything, unrestricted by
the usual boundaries.
— Democracy within its systems and
processes.
— Improved risk management across the
organisation—from the clinical and environmental perspectives.
3. PROGRESS
Working with governors, members and the local
community:
Seeks views, opinions and ideas on key plans
and developments from the Council of Governors before the Board
of Directors (to influence, inform and shape strategy and decision
making).
Creates meaningful roles for governors, for
example:
— developing the patient and public
involvement agenda—being involved in all aspects of patient
care, cleanliness, food etc and "mystery shopping" checks;
— supporting membership engagement
through an outreach committee;
— advising the trust on site strategy
and capital developments;
— appraising the chairman and non-executive
directors; and
— representing the community on a joint
board and council corporate sustainability committee—working
to reduce the trust's carbon footprint and exploring opportunities
for local sustainability.
Consults with governors and members on issues
that will affect the local community—visiting hours, capital
schemes and health issues.
Informs and educates members through literature,
open evenings, events.
Backs local business through a discount scheme
for members.
Creates local business opportunities through
contracts for services.
Offers opportunities for wider public engagement
with its members—for example, working with Derbyshire County
Primary Care Trust to consult governors and members on their proposals
through Darzi.
4. STATEMENTS
Bernard Everett, public governor:
"Foundation trusts are a movement in the
opposite direction that governments have been going in for generations;
they are returning power back to the community, rather than aggregating
it all to Whitehall, and that really interested me. The NHS is
something we all care about—being a governor means local
people can influence decisions on matters that affect their healthcare".
Sheila Smith, public governor:
"Those who have been governors for longer
are more confident in the role, they are able to foresee problems
and articulate how things can be resolved. When we started, I
think most of us saw it as a rubber stamping exercise, but now
as we're growing into the role and developing committees and systems
we realise we're making a genuine contribution.
"I'm starting to find that my trust is a
lot more experienced at this than most other foundation trusts,
the event hosted by Monitor really highlighted that. It was the
first time since I became a governor that I felt more experienced
than others. We were one of the first foundation trusts and we
weren't sure how we'd fit into this new role. But now, if governors
go to events, such as those hosted by Monitor, there is likely
to be somebody who can pass on experience that might help. It's
certainly something we would have liked at the beginning when
there were so few of us. As new foundation trusts are being authorised
on a monthly basis there are a lot of comparatively new governors
about".
Richard Gregory OBE
Chairman
June 2008
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