Agenda item

10.55

The Oxford University Hospitals NHS Trust is currently consulting with the public about its application to become a Foundation Trust.

Dame Fiona Caldicott, Chairman, Sir Jonathan Michael, Chief Executive and Andrew Stevens, Director of Planning and Information, Oxford University Hospitals NHS Trust will present a report on the Trust’s application for Foundation Trust status and key issues facing the trust (JHO7).

Dame Fiona Caldicott, Chairman, Sir Jonathan Michael, Chief Executive and Andrew Stevens, Director of Planning and Information, Oxford University Hospitals NHS Trust presented the paper to the committee highlighting in particular the following changes in the past 12 to 18 months,

• The clinical management structure has been in place for over a year
• Integration with the Nuffield Orthopaedic Centre
• Improved links with the University of Oxford
• Implementation of the electronic patient record
• Biomedical research unit and integrated spinal pathways

The OUHT representatives went on to discuss their foundation trust (FT) application and noted that the trust has refreshed its values to put compassionate excellence at the core.  The trust’s priorities are to improve local accountability and be responsive to needs. Seventeen public meetings have been held during the consultation period along with engagement with the voluntary and community sector and media interest. It was noted that foundation status gives greater local accountability and ownership. As a FT any surplus generated will go back for reinvestment.

Other issues noted were,

• The Trust’s focus on transforming local services and the ambition to put more services in community settings.
• The new Health Science Network which is expected to bring benefits for local people. This is partnership between the hospital, university, GPs and local authority focusing on dementia with benefits for the Thames valley.
• The trust is trying to engage with local communities more having learnt lessons in the past.
• In terms of performance the trust is performing well though with the following issues noted – A&E four hour wait has been experiencing some difficulties but the target is expected to be met; issues with the 18 week referral are being overcome and the intensive work is underway including with partners to address the poor performance of delayed transfers of care.

The session was then opened up to questions from the committee. In response to questions from members the Trust provided the following responses,

• The trust is committed to high quality general acute services as well as providing specialist services to Oxfordshire and beyond. The committee were concerned that the trust is focusing too much on providing high profile specialist services at the expense of general acute services. The trust gave their strong commitment to general services for the local community.
• The trust’s viable financial position must be demonstrated to Monitor to achieve foundation trust status. The financial position is widely known and last year was 98% on target. This year the saving required is approximately £48M.
• The quality of the PFI buildings is excellent and the annual charge as a percentage of annual turnover is relatively small and can be managed. The aim is to move out of older buildings and reduce the footprint. There are no plans for new PFI projects.
• There is an action plan in place for delayed transfers however along with increased A&E admissions there is a resulting impact on planned work cancellations.
• The trust was not happy with it’s performance against the Care Quality Commission’s dignity and nutrition quality standards 18 months ago but has recently reviewed them and is now compliant.
• All efficiency proposals are reviewed at a senior level and to ensure that they do not have an impact on quality/safety go to a quality committee for approval.
• The trust agrees with the commissioner the likely levels of activity that will be delivered. The number of planned referrals was expected to go down and has done but the number of emergency admissions has not. This ‘overperformance’ is funded but not at full cost.
• The sustainability of maternity services if training posts cannot be filled was noted and that the trust is looking to see what the options are. The trust is working with the community partnership network in Banbury on this. Recruitment issues were noted and the age profile of staff making it hard to recruit new staff to an affluent area like Oxfordshire.
• There is a need to reconfigure services to be more integrated rather than institutional based ones. Experience in Banbury has shown how they need to engage only with patients, GPs and the public on proposals.
• It was welcomed that the trust is reversing the trend of the last decade by engaging more with the whole health economy in Oxfordshire rather than being isolationist.

The committee AGREED that it was happy to support the OUHT’s foundation trust application but with reservations on the financial position and the prioritisation of general acute services for people in Oxfordshire.