SHREWSBURY _ TELFORD HOSPITAL NHS TRUST by dfsiopmhy6

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									                                                                                  Enclosure 2
         THE SHREWSBURY AND TELFORD HOSPITAL NHS TRUST
                 TRUST BOARD – 26 SEPTEMBER 2006

          Statement of Requirement for 2006/7 and Board Etiquette




BOARD MEMBER                Margaret Bamford
RESPONSIBLE                 Chairman

AUTHOR (if different from   Julia Buckley
above)

CORPORATE OBJECTIVE         1 – To achieve Foundation Trust status by April 2008
NUMBER(S)                   (including recurrent financial balance and sound governance
                            arrangements)

BUSINESS PLAN
OBJECTIVE NUMBER(S)
                            The NHS West Midlands requires the Chair and Chief
EXECUTIVE SUMMARY           Executive of all NHS organisations to have signed a
                            Statement of Requirements by the end of August 2006, to be
                            subsequently endorsed by the Board at the next meeting.

                            There will be new reporting requirements that include a
                            monthly sign-off form in respect of financial risk and a
                            requirement to submit a quarterly self-certification in relation
                            to governance risk.

                            This requirement mirrors recommendations accepted by the
                            Board from the Integrated Governance Handbook in relation
                            to recognition of obligations and responsibility of Trust
                            Boards. There is also a requirement for the Board to properly
                            exercise its duties, with directors taking care to act
                            reasonably. The Board should recognise the importance of
                            constructive challenge and a suggested guide to board
                            etiquette has been published to facilitate this.

KEY FACTS                   The intention of the NHS West Midlands is that Boards
                            accept the obligations placed upon them by the NHS
                            Operating Framework

                            There will be additional reporting requirements for higher-risk
                            organisations that are being finalised.


RECOMMENDATIONS             The Board is asked to approve
                            the Statement of Requirements
                            • the proposed Board etiquette
                            .
           SHREWSBURY & TELFORD HOSPITAL NHS TRUST
          STATEMENT OF REQUIREMENTS/BOARD ETIQUETTE


1.     INTRODUCTION
The NHS West Midlands requires the Chair and Chief Executive of all NHS
organisations to have signed a Statement of Requirements by the end of
August 2006, to be subsequently endorsed by the Board at the next meeting.
This is considered an important aspect of Local Delivery Plans, making clear
the responsibility of boards for the plans of their organisations and the
management of risk, and making clear that Boards accept the obligations
placed upon them by the NHS Operating Framework.

The Trust has been assigned a risk score of 1, so from September 2006 will
be required to submit a declaration of compliance with the Statement of
Requirements on a monthly basis for financial risk and a quarterly basis for
governance risk, as minimum. This compliance will be on the basis of self-
certification.

The four areas in the Statement of Requirements (See Attachment 1) are;
• financial outturn
• activity management
• workforce profile; and
• commitment to the Governance Framework

2.     FINANCIAL RISK SCORE
The methodology for deriving the financial risk score is based on the
following;
• Financial legacy score – as SaTH has formal ‘turnaround’ status it is
    automatically scored as 1 (very high risk).
• Cost improvement plan risk derived as a percentage of operating income
• Workforce risk from the percentage reduction in FTE workforce from April
    2006 to March 2007 as set out in the FIMs returns.

The categorisation of SaTH as very high risk will result in Turnaround-style
monitoring and intervention. The form and frequency has not yet been
described by the SHA and will be agreed with individual organisations.

3.    GOVERNANCE RISK
The SHA will assess and rate performance against existing national targets
as part of the preparation for the Healthcare Commission’s ‘Annual Health
Check and new commitments made in the LDP planning round –these new
commitments are;
• Implementing relevant NICE Improving Outcomes Guidelines
• Maximum 11 week outpatient wait by March 2007
• Maximum 13 week wait for MRI, CT or other diagnostic test by March
   2007
• Maximum 20 week wait for inpatient admission by March 2007
•   Increase the percentage of patients admitted into treatment, in the
    financial year, who were retained in treatment for 12 weeks or more.

Self-certification returns will be required on a quarterly basis and exception
reports will be required where
• existing standards are not being met
• new commitments look unlikely to be met by March 2007
• performance problems in the six priority areas (health inequalities, cancer
   waiting times, progress towards 18 weeks maximum waiting times, MRSA,
   sexual health and access to GUM, Choice & Booking)
• serious breaches of acceptable clinical quality, patient safety or other
   service performance standards


The self-certification declarations are shown at Attachment B


4.      BOARD ETIQUETTE
The SHA recognises that the approach to the assessment of governance risk
will only work if there is a degree of openness between Boards and the SHA
and early notification of potential problems – the principle of ‘no surprises’
should apply.

To facilitate this and to ensure there is an equal degree of openness and
transparency between Board members, the Board is asked to consider the
attached protocol (Attachment C). This sets out the key principles between
Board members and allows for the Chair to lead the Board to review its
performance against these standards. This is based on the guidance in the
Integrated Governance Handbook and an established protocol and comments
received from Board members at development days.

5.    RECOMMENDATIONS
The Board is asked to
(i)   Endorse the Statement of Requirements
(ii)  Note future reporting requirements
(iii) Approve the Board protocol and ensure regular review against its
      standards
                                                                 Attachment A

                          NHS West Midlands
                    Statement of requirements 2006/07

      NHS Trust: Royal Shrewsbury & Telford Hospitals NHS Trust

Section 1
The Board of Royal Shrewsbury & Telford Hospitals NHS Trust confirms that
its Local Delivery Plans for 2006/07 are as set out in returns submitted to the
SHA at the end of April 2006 and subsequently revised in resubmitted data at
the end of May.


The Board hereby confirms that it will manage its affairs in 2006/07 as
follows:
            a. The financial outturn will be at or better than the agreed
               control total for 2006/07 of balance.
            b. The Trust will manage activity in 2006/07 in line with activity
               assumptions for those items which are within its control
               recognising that outpatient and emergency reforms can only
               be by joint management with PCT colleagues.
            c. The Trust changes in the workforce profile (spend and
               headcount) will be in line with Local Delivery Plans.
            d. The Trust will maintain existing and new commitments as set
               out in the Governance Framework (Attachment C).


                  Signed

                  Chair

                  Chief Executive
Section 2


The SHA has reviewed the plans of Royal Shrewsbury & Telford Hospitals
NHS Trust and has assigned the Trust plans a risk score of 1.


This score will determine the performance management relationship between
the SHA and Primary Care Trust as set out in Attachment D. The SHA will
formally review risk scores monthly and will notify the Primary Care Trust
formally of any change.


The Board of Royal Shrewsbury & Telford Hospitals NHS Trust hereby
agrees to provide to the SHA all monitoring requirements appropriate to its
risk rating as set out in Attachment D.


                  Signed

                  Chair

                  Chief Executive

Section 3


Starting in September 2006, the Board of Royal Shrewsbury & Telford
Hospitals NHS Trust will make to NHS West Midlands a formal declaration of
compliance with the Statement of Requirements using the format set of in
Attachment E. The declaration will be on a monthly basis for financial risk
and on a quarterly basis for governance risk.


                  Signed

                  Chair

                  Chief Executive
                                                                 Attachment B


In Year Governance Declarations
Boards must confirm compliance with the Statement of Requirements. No
supporting detail (in addition to monitoring requirements determined by the
organisation’s risk rating) is required unless compliance cannot be confirmed.
Please sign one of the two declarations below. If you sign declaration 2,
provide supporting details using the form below.


Declaration 1a – Finance (Monthly)
The Board confirms that its commitments under the Statement of
Requirements have been met over the period and that plans are in place to
ensure that they will be met going forwards.


                  Signed

                  Chair

                  Chief Executive



Declaration 1a – Governance Framework (Quarterly)
The Board confirms that its commitments under the Statement of
Requirements have been met over the period and that plans are in place to
ensure that they will be met going forwards.


                  Signed

                  Chair

                  Chief Executive
Declaration 2

For one or more elements of the Statement of Requirements, the Board
cannot make Declaration 1 and has provided relevant details below.
The Board confirms that all other aspects of the Statement of Requirements
have been met over the period and that plans are in place to ensure that they
will be met going


                   Signed

                   Chair

                   Chief Executive



Please identify which elements of the Statement of Requirements have led to
the Board being unable to sign declaration 1. For each please state the
reason for being unable to sign the declaration, and explain briefly what steps
are being taken to resolve the issue by when:



Target/standard:




Reason for being unable to sign the declaration:




Steps being taken to resolve the issue:

_____________________________________________________________




Repeat this format on additional pages as required
                                                                                                                               Attachment C
                                               Shrewsbury & Telford Hospital NHS Trust
                                          WE WILL                                                             WE WILL NOT
1. Respect one another as possessing individual and corporate skills, knowledge and
    responsibilities                                                                         1. Refer to past systems or mistakes as being
2. Show determination, tolerance and sensitivity                                             responsible for today’s situation.
    -       rigorous and challenging questioning, tempered by respect                        2. Act as ‘stoppers’ or ‘blockers’
3. Show group support and loyalty towards                                                    3. Regard any arrangements as unchangeable
    -       The Trust                                                                           or unchallengeable
    -       each other                                                                       4. Adopt territorial attitudes – any members of
    -       the Hospital Executive Group/ Management Executive                                  the team has the right to challenge/question
4. Listen carefully to all ideas and comments and be tolerant to other points of view – be      another
    sensitive to colleagues’ needs for support when challenging or being challenged          5. Avoid giving offence – be ready to apologise
5. Be honest, open and constructive                                                          6. Avoid taking offence – stay open to discussion
6. Be courteous and respect freedom to speak, disagree or remain silent                      7. Regard papers presented as being ‘rubber-
7. Regard challenge as a test of the robustness of arguments – ensure no one becomes            stamped’ without discussion and agreement
    isolated in expressing their view. Treat all ideas with respect.                         8. Act in an attacking, crushing or dismissive
8. Read all papers before the meeting and clarify any points of detail with the relevant        manner
    author before the meeting, arrive on time and participate wholeheartedly                 9. Become obsessed by detail and lose the
9. Focus discussion on material issues and on the resolution of issues, allow differences       strategic picture
    to be forgotten                                                                          10. Breach confidentiality – will be candid not
10. Make the most of time – support the Chair, colleagues and guests in maximising               secret.
    scope and variety of viewpoints heard. Individual points are relevant and short.
                        At the end of each meeting will review performance against the above standards
                                                Did we use our resources well?
                                              Who else should have been here?
                                              What helped it go as well as it did?
                                               What could we have done better?

								
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