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SOUTH WARWICKSHIRE GENERAL HOSPITALS NHS TRUST SOUTH WARWICKSHIRE GENERAL HOSPITALS NHS TRUST Meeting Trust Board

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SOUTH WARWICKSHIRE GENERAL HOSPITALS NHS TRUST SOUTH WARWICKSHIRE GENERAL HOSPITALS NHS TRUST Meeting Trust Board Powered By Docstoc
					              SOUTH WARWICKSHIRE GENERAL HOSPITALS NHS TRUST


Meeting             Trust Board                                  Date          7 February 2008

Subject             Disbandment of Coventry and                  Enclosure     O
                    Warwickshire Provider Strategy Board
                    and Establishment of Successor
                    Arrangements


Nature of item      For information
                    For approval             
                    For decision

Decision            The Trust Board is asked to approve the disbandment of the Coventry
required (if any)   and Warwickshire Provider Strategy Board with effect from 1 March
                    2008, with full authority for strategic direction being returned to the Trust
                    Board.


General             Report Author            Glen Burley, Chief Executive
Information         Lead Director            Glen Burley, Chief Executive

Received or         Meeting
approved by         Date


Resource            Revenue
Implications        Capital
                    Workforce
                    Use of Estate
                    Funding Source


Freedom of          Confidential (Y/N)       No
Information         (if yes, give reasons)
                    Final/draft format       Final

                    Ownership                Trust

                    Intended for release     Yes
                    to the public


Decision Made
                    South Warwickshire General Hospitals NHS Trust

                         Report to Trust Board – 7 February 2008

         Disbandment of Coventry and Warwickshire Provider Strategy Board
                 and Establishment of Successor Arrangements


The Coventry and Warwickshire Provider Strategy Board (PSB) began its formal programme of
work in December 2006 having agreed Terms of reference in August 2006. The principal objective
was to “maximize local service availability within clinically and financially sustainable models
across the Coventry and Warwickshire acute sector by March 2008”. The context has changed
significantly since that time. The most significant change has been in the financial environment,
with both this Trust and George Eliot Hospitals NHS Trust having achieved financial balance in
2006/07 and balanced plans moving forwards.             The University Hospitals Coventry and
Warwickshire NHS Trust now has an agreed plan to maintain financial balance from 2008/09.

The collaborative working developed through the PSB has maintained its momentum with good
progress in establishing the shared services and formal clinical networks. The Pathology Shared
Service has commenced with its transition plan to establish the new service and will be formally
effective from 1 April 2008. Other shared service arrangements for clinical support services are in
development and the PSB is developing the corporate governance framework to support this
optimised model. The Emergency Care Network has been re-invigorated as has the Paediatric
and Maternity Network. The other recommendations from the Acute Service Review have been
actioned and largely completed.

Of important note are the continued positive relationships between the Trusts within the Health
Economy; with all agreeing that this provides an excellent opportunity for Coventry and
Warwickshire to contribute positively to the Strategy Health Authority’s position in demonstrating
effective pan trust strategic planning and provision of health care aligned to patient need.

The role of the PSB now needs to change to support a continued strategic overview of service
planning in the Health Economy. It is believed that the new forum (the Strategic Partnership
Board) could also take forward overseeing the implementation of any local plans resulting from the
“Our NHS, Our Future” review. The attached terms of reference have been agreed by PSB
members and the SHA and each Trust is now expected to formally resolve through their February
Trust Board meeting to disband the PSB and in doing so take back full strategic planning powers in
the context of an ongoing collaborative understanding between them.

In agreement with all of the Trust Chairs, the Chairman of the PSB, Ian Caulfield, has been asked
and has agreed to chair the Strategic Partnership Board for the period up to the end of March 2009
under existing terms and conditions. Support arrangements are currently being reviewed
alongside shared service management arrangements.

Recommendation

That the Coventry and Warwickshire Provider Strategy Board is disbanded with effect from 1
March 2008 and full authority for strategic direction returns to the Trust Board.

The Trust remains committed to ongoing strategic provider collaboration through active
membership of the Strategic Partnership Board.




                                                                                                 2
                                                                                             Coventry and Warwickshire
                                                                                            Strategic Partnership Board
                  Coventry & Warwickshire Provider Services Strategic Partnership Board

                                                       Terms of Reference

                                                            January 2008

Background
The Provider Strategy Board (PSB) was established in late August 2006; its main role was to develop
an overarching Turnaround plan as a result of the then poor financial position of the Trusts within the
Health Economy1. It was established by the NHS West Midlands (NHSWM) and was accountable for
timeous achievement to NHSWM.

The Acute Services Review (ASR) was published in January 2007 and the role of overseeing
implementation of the recommendations was incorporated into the PSB terms of reference.

A Joint Commissioning Board2 (JCB) was established following the ASR and through attendance at
the PSB by the chair of the JCB opportunity for alignment of strategy has been achieved.

Through 2007, steady progress has been made on developing the Clinical Networks to support the
implementation of the ASR and also in establishing the Shared Service Business Unit; the governance
vehicle for managing the single managed Pathology service, and any future single managed services.

The strategic context in which the PSB is operating has changed; George Eliot Hospitals NHS Trust
(GEH), South Warwick General Hospital NHS Trust (SWGH) and University Hospitals Coventry &
Warwickshire NHS Trust have all delivered financial balance at the end of 2006/07. In 2007/08 the two
policy shifts (RAB and PBR cap flexibility) supported the opportunity for GEH and SWGH to deliver
financial balance with a significant level of cost Improvement (CIP) included within the financial plans.
In contrast UHCW has faced a much more significant level of CIP and liquidity issues.

As a result of a more stable recurrent financial position, both the GEH and SWGH have been advised
by the NHSWM that they may prepare applications for Foundation Trust (FT) status.

Warwickshire PCT have published for consultation their draft Commissioning strategy and Coventry
teaching PCT have published for consultation an update to the commissioning strategy published in
2007/08.

The NHS has embarked upon the next stage review; led by Lord Ara Darzi, “Our NHS, Our Future”.
An interim report published in October provides indication of the areas of focus and the process for
engagement across the service. Development of the NHS with greater focus on quality of experience
and better patient outcomes looking set to be the strategic emphasis. “Localise where possible and
centralise where necessary”.

Building upon the established collaborative achievements of GEH, SWGH and UHCW and the mature
organisation relationships across the Health Economy; the following Terms of Reference represent the
views of the participating organisations for the role and management of the PSB.




1
    Provider Strategy Board Terms of Reference published in the Acute Service Review Final Report, January 2007
2
    Joint Commissioning Board Terms of Reference published in the Acute Service Review Final Report, January 2007

                                                                                                                          3
1. Principles
        1.1. The three NHS Trusts across Coventry and Warwickshire are statutorily established and
              will remain so during this period. The three hospital Trusts are:
                   George Eliot Hospital NHS Trust
                   South Warwick General Hospital NHS Trust
                   University Hospitals Coventry & Warwickshire NHS Trust
        1.2. Nothing in the Strategic Partnership Board (SPB) proposal or operation takes away the
              individual responsibility of each Trust Board in respect of meeting the statutory duties of
              an NHS Trust or NHS Foundation Trust.
        1.3. The Principle purpose of the Strategic Partnership Board is to enable the environment for
              successful delivery of Change and Service Improvement within provider services and in
              doing so, support the aspirations of each Trust to become an Independent Foundation
              Trust.

2. Role of the Board
        2.1. Develop proposals to ensure sustainable services across Coventry and Warwickshire in
             partnership with the Commissioning organizations with particular regard to the
             Commissioning Strategy.
        2.2. Oversee the implementation of the key strategic recommendations resulting from the
             Coventry and Warwickshire Acute Services Review and underpinning financial analysis,
             in collaboration with the Commissioners of Services and Strategic Health Authority.
        2.3. Establish the Stakeholder Board for the Shared Services Business Unit and where
             disputes arise within the Stakeholder Board that can not be resolved within the
             framework of the accountability agreement; the SPB should provide resolution to such
             disputes.
        2.4. Support establishment of Clinical Networks
        2.5. Provide the forum for facilitating implementation of forthcoming recommendations from
             the Our NHS, Our Health next stage review and resulting PCT commissioning strategies.
        2.6. Maximise the utilisation of resources to ensure financial viability through sound financial
             and commercial leadership.

3. Chair and Executive Lead
        3.1. The SPB will be chaired by an Independent Chairman, appointed by the Trust Boards.
              The process for appointing the Chair and terms of office will be proposed by the three
              member Trust Chairs and agreed by each Trust Board.
        3.2. The SPB will appoint an Executive Officer to facilitate and lead on the work programme
              determined by the SPB. The term of office may be flexible to suit the work programme of
              the board and will be determined by the SPB.

4. Membership
      4.1. Membership of the SPB will consist of the following
             Independent Chairman
             Chair of George Eliot Hospital NHS Trust
             Chair of South Warwickshire General Hospitals NHS Trust
             Chair of University Hospitals Coventry and Warwickshire NHS Trust
             Chief Executive of George Eliot Hospital NHS Trust
             Chief Executive of South Warwickshire General Hospitals NHS Trust
             Chief Executive of University Hospitals Coventry and Warwickshire NHS Trust
      4.2. In attendance - SPB Executive Officer
      4.3. The Board will invite the Chair of the Joint Commissioning Board and/or PCT Executive
            Officers to attend.
      4.4. The Board may invite other relevant Trust Officers to attend where appropriate.

                                                                                                        4
5. Quorum and SPB Voting
       5.1. For the SPB to be Quorate, at least one of the voting members of the stakeholder Trust
             Boards must be present.
       5.2. The SPB will be a non-voting forum and will strive to achieve consensus on matters that
             arise.

6. Resources
       6.1. The SPB will be supported by the SPB Executive Officer and a small team that may
             include secretarial, administrative, financial and project management skills. It may also
             draw upon, ad-hoc or in project mode, from the skills and resources of the three Trusts.
             Appointment of such resources will be agreed by the SPB.
       6.2. The staff of the SPB will be employed by one of the Trusts acting in a host capacity; but
             such arrangement does not carry alternative accountability except in employment-
             related or contractual matters.
       6.3. The SPB will meet the costs of the enterprise through an agreed budget, reviewed
             annually, to which each of the acute trusts will contribute in proportion to their turnover.

7. Frequency of meeting
       7.1. The SPB will meet a minimum of 6 times per year and will agree an annual meeting
             schedule at its December meeting each year or prior to the end of any existing schedule.

8. Governance
       8.1. Conduct of Business
         8.1.1. The agenda for each meeting will be circulated in advance, together with any
                supporting papers, and will be distributed by the Secretary to the SPB.
         8.1.2. Normally the key papers will be supplied by the Executive Officer, together with
                supporting analysis which commands the agreement of the relevant executives
                from the individual trusts.
         8.1.3. The SPB shall have access to any member of staff within the Trusts, and shall have
                the right to seek independent professional advice as necessary in order to fulfil its
                duties and obligations.
       8.2. SPB Process
         8.2.1. The SPB will direct and oversee the work of the Executive Officer and the team,
                actively shaping both the plan of work and the emerging strategic proposals. A
                clearly defined programme of work will be developed and approved by the SPB.
         8.2.2. The SPB will undertake the fact-finding, analysis, consultation with stakeholders
                and evaluation of options leading to the production of reasoned proposals.
         8.2.3. The SPB will prepare recommendations for approval by each Trust Board. At this
                point a proposal becomes a project.
         8.2.4. The SPB will create an implementation plan for each project, with responsibilities for
                component tasks assigned to appropriate executives.
         8.2.5. For each project the SPB will designate a Project Leader (either from the small
                team or one of the Trusts) who will be accountable to the Executive Officer for
                effective co-ordination and monitoring of the implementation.
         8.2.6. Trust executive teams will be accountable to their respective CEs for effective
                execution of their assigned roles in the implementation plans.
                Sub-Boards




                                                                                                            5
9. Communication with Other Boards
      9.1. The SPB recognises the need for effective communication between the following
           existing Boards. Communication may include formal approvals, information and advice,
           progress updates.
             Coventry & Warwickshire Joint Commissioning Board
             George Eliot Hospital NHS Trust Board
             South Warwick General Hospital NHS Trust Board
             University Hospitals Coventry & Warwickshire NHS Trust Board
             Clinical Network Boards, including:
                o Emergency Care Network
                o Arden Cancer Network
                o Paediatric & Maternity Network
             Stakeholder Board – Shared Services

10. Review of Terms of Reference
         10.1. These terms of reference will be formally reviewed by the SPB in December 2008, and
               annually thereafter and may be amended at any time to reflect changes in
               circumstances which may arise, especially concerning the fuller involvement of
               commissioning interests.
         10.2. These Terms of Reference require approval from each Trust Board and amendments to
               them will require the approval of the Trust Boards.

         Coventry and Warwickshire Provider Strategy Board Meeting Schedule 2008

           Month                   Date                   Time                  Venue
                                                                         Seminar Room 1,
                                                                         George Eliot Training
    February 2008          Tuesday 5th            2.00pm – 4.00pm        and Education
                                                                         Centre, George Eliot
                                                                         Hospital
                                                                         Boardroom,
    April 2008             Tuesday 1st            2.00pm – 4.00pm        Executive Suite,
                                                                         University Hospital

                           Tuesday 3rd                                   Brooke Suite,
    June 2008                                     2.00pm – 4.00pm
                                                                         Warwick Hospital

                                                                         Seminar Room 1,
                                                                         George Eliot Training
    August 2008            Tuesday 5th            2.00pm – 4.00pm        and Education
                                                                         Centre, George Eliot
                                                                         Hospital
                                                                         Boardroom,
    October 2008           Tuesday 7th            2.00pm – 4.00pm        Executive Suite,
                                                                         University Hospital

                                                                         Brooke Suite,
    December 2008          Tuesday 2nd            2.00pm – 4.00pm
                                                                         Warwick Hospital




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