Agenda item

The committee is asked  to respond to Central London Community Healthcare NHS Trust consultation on its Foundation Trust plans.

Mr James Reilly and Ms Anne Barnard presented the application by Central London Community Healthcare NHS Trust (CLCH) to achieve NHS Foundation Trust status in September 2013.

NHS trusts either had to achieve Foundation Trust status by April 2014 or merge with another trust which had already achieved Foundation Trust status. CLCH considered that it was of benefit to the local community to remain focused as a community organisation working in partnership with other organisations to provide integrated social and health care, rather than becoming part of a larger organisation.

Foundations trusts have a membership, comprising local people, patients and employees which elects a Council of Governors. This means that foundation trusts are more accountable to the people who use its services, its staff and local communities. They are able to be more innovative in developing their services and responding to the changing healthcare needs of their local communities. They have greater autonomy and freedoms, and specifically greater financial flexibility to invest any surpluses in existing services or to develop new services, rather than returning surpluses to the NHS.

Foundation trusts are regulated by Monitor, the independent regulator, and are responsible to the Secretary of State. There is a rigorous authorisation process, which takes over a year, in which trusts have to demonstrate governance and financial capabilities as well as the capability to deliver clinical effectiveness.

In response to members’ questions Mr Reilly confirmed that CLCH was on schedule with its application, with only a five/six week delay in respect of the consultation because of the mayoral elections. The trust had considered the alternative of merging with another trust, but  this would mean merging with an organisation providing hospital or mental health services, and losing the ability to focus purely on community healthcare. There had also been the option of forming a social enterprise structure. However, staff had indicated a clear preference for remaining within the NHS.

CLCH’s application had been discussed with the North West London cluster and a formal agreement reached with the Strategic Health Authority and the Department of Health, which had to be satisfied that the programme was realistic and to sign off key milestones.

In  addition to the statutory consultation with overview and scrutiny committees, there had been a  series of public events, but these had not been well attended. Six people had attended the Hammersmith & Fulham event and attendances were similar for other events. There had been a number of outreach events, where patients had been interviewed at centres, where they were using the services. There had been a substantial mail out of the consultation document and 130 responses had been received to date. The benchmark figure for consultations of a similar size was 150.

In response to questions in respect of finance, Mr Reilly stated that CLCH had a £190million turnover, compared with an NHS average of £300 million. Some £36 million was in respect of provision of services to Hammersmith & Fulham residents. CLCH was required to achieve savings of 5%. A cost improvement programme was on target to deliver 5.6% (£10 million). In the previous year, CLCH had achieved a small surplus and had achieved its budget every year since becoming  a trust, with a surplus of £8 million over this period.

Savings had been achieved primarily from overheads. There had been a management restructure, with the elimination of 70 management posts across the organisation. CLCH  was looking to make further savings without impacting on direct patient care through information technology to increase productivity and reviews of administration and clerical support and the estate Mr Reilly stated that CLCH was working towards an integrated seamless approach to patient care and offered to attend a future meeting to discuss.

RESOLVED THAT:

The committee noted the application.

The committee then voted on supporting the application.

In favour: 5

Abstain: 2

RESOLVED THAT:

The committee supported the application.