BENEFITS OF BEING A FOUNDATION TRUST
PETER HERRING
CHIEF EXECUTIVE
COUNTESS OF CHESTER HOSPITAL NHS FOUNDATION TRUST
COUNTESS OF CHESTER HOSPITAL NHS
FOUNDATION TRUST
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580 bed single-site general hospital
£150m revenue – 2.5 size of Amstrad
3000 Staff
400,000 patients a year
One of first 10 FTs established in 2004
GOVERNANCE ARRANGEMENTS
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Public-benefit Corporation
Independent of government
Board of Directors
Board of Governors
 Public Governors
 Staff Governors
 Appointed Governors
Regulated by Monitor – risk metrics
NATIONAL POLICY FRAMEWORK
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Independence of service provision
Foundation Trust policy
Private sector providers
PCT provider services
Payment by results
Competitive market economy?
FINANCIAL REGIME
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Mirrors private sector
Freedom to make surpluses / deficit
Investment income
Capital generated from revenue surpluses,
depreciation, access to public dividend
capital, borrowing
Tariff variation
Regular surpluses generated
Highest risk rating
A CATALYST FOR BUSINESS APPROACH
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Profitability
Understanding costs
Productivity, operational & cost efficiency
Viability of services
Financial planning
Risk-based decision-making
Justification of investments
Customer care focus
Incentive mechanisms
Innovative business models
Board skills
POLITICAL ISSUES
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High level political support
Department of Health uncomfortable
SHAs variable
Uncertainty of independence
Monitor/DOH spat
Cash surpluses
Surplus v quality
CONSTRAINTS ON FREEDOMS
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National targets and standards
Healthcare Commission/NPSA
Directives through PCTs
New standard contract
PCT/SHA approach
Freedom vs accountability
CHALLENGES OF BECOMING A FOUNDATION
TRUST
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Responsibilities of independence
Engaging the membership and governors ensuring local governance adds value
Exploiting the benefits of financial regime whilst
maintaining viability
Adapting to dynamic change and shifting tariff
Contracting regime
Achieving cultural change
Delivering real and rapid progress
BENEFITS OF FOUNDATION TRUST
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Freedom of decision-making
Freedom from DOH/SHA bureaucracy
Engagement of local members and governors
Financial freedoms
Development of new business models
Catalyst to business approach