Public Accounts CommitteeWritten evidence from Monitor


1.0 Introduction

1.1 This written memorandum is provided to assist the Committee by giving information on Monitor’s work to develop leadership in the Foundation Trust sector.

1.2 The Committee expressed interest in understanding work that has been undertaken to develop leadership in the aspirant foundation trust sector. This submission outlines the work that Monitor undertakes to support leadership development in NHS foundation trusts. Much of this work is also accessible to the leadership of aspirant foundation trusts.

1.3 Robust and effective leadership is essential in successful foundation trusts. As part of Monitor’s commitment to help NHS foundation trusts operate effectively and efficiently we invest time in supporting governors to understand their role and encouraging senior management teams undertake training and development.

2.0 Monitor’s Non-Executive Director Development Programme

2.1 As part of Monitor’s commitment to help NHS foundation trusts operate effectively and efficiently, we have designed a programme that helps Non-Executive Directors (NEDs) build upon their personal skills and develop a broad and comprehensive understanding of the NHS, including quality, finance, board dynamics and the strategic challenges facing the health sector.

2.2 The course is delivered by Cass Business School.

3.0 NHS Foundation Trusts Chairs’ Academy

3.1 The Foundation Trust Chairs’ Academy has three aims: to support Chairs in developing personal effectiveness; to help Chairs lead both the Trust Board and Council of Governors to higher levels of board performance; to help Chairs achieve even greater effectiveness for their Trusts and a stronger health economy as a whole.

3.2 The Academy is co-sponsored by the Foundation Trust Network and delivered by Cass Business School.

4.0 Strategic Financial Leadership Programme

4.1 Monitor, the Department of Health and the NHS Institute for Innovation and Improvement have collaborated to create the Strategic Financial Leadership Programme.

4.2 It has been created to help finance directors address the challenges they are facing in the modern NHS and helps develop their skills by focusing on leading-edge developments in the world of finance and management.

4.3 An alumni programme provides continuing support via a three day development programme.

5.0 Induction Seminars for Newly Appointed Chairs and Chief Executives

5.1 Monitor runs induction seminars for newly appointed Chairs and Chief Executives of NHS foundation trusts that have not had prior experience of Monitor’s authorisation process.

5.2 As part of Monitor’s reporting requirements, if a Chair or Chief Executive has not attended, or is not scheduled to attend, this programme within six months of their appointment, an explanation is required as to when they will attend or why attendance is not considered necessary.

6.0 Accelerated Service Line Management Programme (SLM)

6.1 Monitor first introduced SLM in 2006.

6.2 SLM sees clinical leaders managing service-lines and having the information, capability and decision rights to manage services with a large degree of autonomy.

6.3 2011–12 saw the development of our Accelerated SLM programme. It provides trusts with a framework assessment to fully understand their position in relation to SLM. It also aims to strengthen relationships between key board members and enable access to benchmarking information from around the UK and internationally where relevant.

6.4 A series of webinars about SLM have been held during 2012 to disseminate information. A conference was also jointly held with the Healthcare Financial Management Association.

7.0 Recent Publications to Develop Foundation Trusts and Share Best Practice

7.1 Current Practice in NHS Foundation Trust Member Recruitment and Engagement was produced in partnership with Electoral Reform research and Membership Engagement Services. It looks at trends in recruitment and engagement of members as well as offering best practice examples for current and aspirant foundation trusts to consider

7.2 Delivering Sustainable Cost Improvement Programmes was written jointly with the Audit Commission and identifies important lessons on delivering CIPs and provides examples of how CIPs can be delivered without compromising patient care, safety and satisfaction.

7.3 Director—governor interaction: a best practice guide in NHS foundation trusts was produced in partnership with PA Consulting. It looks at typical issues in working relationships between FT directors and governors and identifies best practice in the approach from several FTs where this works very effectively.

8.0 Conferences

8.1 Monitor runs and speaks at conferences and events aimed at developing leadership skills.

8.2 Conferences throughout the year include: Service-line Management, Sustainable Cost Improvement Programmes, leadership support for Non-Executive Directors and Robust Quality Governance. These are usually with third party organisations, such as the Health Finance Manager Association, the Kings Fund and the Foundation Trust Network.

8.3 Regular speaking slots at leadership events, hosted by third parties—eg Foundation Trust Network, Health Finance Managers Association and the Foundation Trust Governors Association covering a range of topics including the importance of clinical leadership and ensuring and maintaining a patient safety culture.

8.4 Seminars and webinars on various leadership challenges have been planned throughout 2012–13—topics include the board role in patient safety, the importance of clinical leadership in delivering sustainable efficiencies, the clinicians’ role in service delivery and CIPs.

28 September 2012

Prepared 31st October 2012