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The Foundation Trust Experiment and UCLH Presentation to Civitas 22nd October 2007 Sunday, 17 July 2016 UCLH context – 7 central London hospitals – Acute local services – Five major tertiary services • • • • • Neurosciences Cardiac Cancer Women's Health Gastrointestinal – Biomedical Research Centre • 1,200 R&D projects • R&D budget = £300m – Attendances 600k p.a. – Turnover c£600m: Sunday, 17 July 2016 UCLH Hospitals University College Hospital, Eastman Dental Hospital, The Heart Hospital, Hospital for Tropical Diseases, Elizabeth Garrett Anderson & Obstetric Hospital, National Hospital for Neurology and Neurosurgery, Royal London Homoeopathic Hospital Sunday, 17 July 2016 Our vision “UCLH is committed to delivering: • top quality patient care • excellent education • world class research Can this vision be better delivered as a Foundation Trust? Sunday, 17 July 2016 Foundation Trusts Political Context Sunday, 17 July 2016 Political comment - Milburn • “The challenge over this next decade is to move power irrevocably outwards and downwards to those using public services…” Alan Milburn Secretary of State for Health (1997-2002) Sunday, 17 July 2016 What are Foundation Trusts? • NHS plan ‘earned autonomy’ & ‘funding for reform’ • Public benefit corporations, but part of the NHS • A membership of local people and staff • A Board of Governors of patients, staff, and local people (elected by members) + local stakeholders • Freedom to borrow & use surplus cash to reinvest in new services and innovation • Not centrally managed, but regulated by Monitor Source: Foundation Trust Network – The story so far (2007) Sunday, 17 July 2016 Progress Towards FT Status • • April 2004 – 20 First wave FT’s April 2007 – 70 FT’s – 200,000 staff – 600,00 members – 1,000 Governors • April 2008 – 100+ FT’s - 100 non-FT’s Sunday, 17 July 2016 Foundation Trusts Are they delivering benefits? Sunday, 17 July 2016 Delivering Benefits • Better governance, enhanced accountability to patients and the public • Greater focus on patients’ (customers) needs • Strong financial management, improved efficiency and productivity • Freedom to innovate in health care • Higher staff and patient satisfaction Source: Foundation Trust Network – The story so far (2007) Sunday, 17 July 2016 Insider Views “We have to stand or fall by our own decisions. The buck really does stop here.” Alan Whittle, CEO, Basildon Hospitals FT “We have championed the need for the Trust to listen to and learn from patients.” Veronica Beechey, Governor, UCLH FT Sunday, 17 July 2016 “We have transformed our drive towards financial efficiency.” Dr Mary Archer, Chair, Cambridge Hospitals FT “It’s a different world. It’s about developing services to our own prescription.” Chris Burke, CEO, Stockport FT Foundation Trusts How do they compare? Sunday, 17 July 2016 Foundation Trusts Delivering improved efficiency % COST BASE EBITDA margin Percent 2006/07 Achieved CIP 3.0% PbR efficiency assumption •6.8 7.6 2.5% 6.5 6.5 6.7 2007/08 Planned CIP 2.9% PbR efficiency assumption 2.5% 1 Sunday, 17 July 2016 2 33 AP FY 07/08 Quarters 2-4 06/07 Quarter 1 07/08 I&E Surplus - 2007/08 Plan Sunday, 17 July 2016 NHS Trusts and Foundation Trusts Use of Resources 2006/7 NHS Trusts 1% 33% 34% 32% Sunday, 17 July 2016 Excellent Good Fair Weak NHS Trusts and Foundation Trusts Use of Resources 2006/7 NHS Trusts Foundation Trusts 1% 0% 10% 3% 33% 34% 32% Sunday, 17 July 2016 Excellent Good Fair Weak 87% Foundation Trusts Only Use of Resources 20005/6 – 2006/7 FT’s 2005/06 13% 0% Excellent Good 53% 34% Sunday, 17 July 2016 Fair Weak Foundation Trusts Only Use of Resources 20005/6 – 2006/7 FT’s 2005/06 13% FT’s 2006/07 0% 10% 3% 0% Excellent Good 53% 34% Fair Weak 87% Sunday, 17 July 2016 NHS Trusts and Foundation Trusts HCC Quality Standards - 2006/7 NHS Trusts 2006/7 7% 25% Excellent Good Fair Weak 36% 35% Sunday, 17 July 2016 NHS Trusts and Foundation Trusts HCC Quality Standards - 2006/7 NHS Trusts 2006/7 Foundation Trusts 2006/7 7% 2% 25% 37% Excellent Good Fair Weak 36% 35% Sunday, 17 July 2016 24% 37% Foundation Trusts Only HCC Quality Standards Foundation Trusts 2005/6 3% 13% 25% Excellent Good Fair Weak 59% Sunday, 17 July 2016 Foundation Trusts Only HCC Quality Standards Foundation Trusts 2005/6 3% 2% 13% 24% 25% Excellent Good Fair Weak 59% Sunday, 17 July 2016 Foundation Trusts 2006/7 37% 37% “These results endorse our view that with strong leadership and the right freedoms, NHS foundation trusts will deliver improvements for their patients.” Bill Moyes, Monitor 17th October 2007 Sunday, 17 July 2016 Foundation Trusts – Should we go further? • FT’s now ‘model of choice’ • Mergers and acquisitions - will FT’s acquire failing NHS Trusts? - who represents customers & shareholders? • Extension of public/private partnerships? • Commerciality and franchising • Will FT’s become a “holding company” with internal/external contracts and JV’s • What can UCLH do??? Sunday, 17 July 2016 Ambulatory cancer centre • New patient focused cancer care • Designed for each cancer specialty • Building planned to start next year Sunday, 17 July 2016 The UCLH campus of the future Sunday, 17 July 2016