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BOD 41/2013
(Agenda Item: 5)
Report to the Meeting of the
Oxford Health NHS Foundation Trust
Board of Directors
24 April 2013
Chief Executive’s Report
For: Information
National Issues
1. Patients First and Foremost: the Initial Government Response to the
Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry
The Government published its initial response to the ‘Francis Report’ on 26 March
2013. A copy may be accessed here:https://www.gov.uk/government/publications/government-initial-response-tothe-mid-staffs-report
The response is thematic, rather than responding to each of the 290
recommendations, and is divided into five areas (each designed to improve the
care received through the NHS):1. Preventing problems – a culture of zero harm and compassionate care,
including new CQC inspection model; new Chief Inspector role; and single
aggregated ratings at trust and service level.
2. Detecting problems quickly – including organisational statutory duty of
candour; and Chief Inspector as ‘nation’s whistleblower in chief’.
3. Taking Action promptly – including a new failure regime where standards
are breached to include suspension of the Board.
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4. Ensuring robust accountability – including consideration of legal sanctions
for knowingly generating misleading information.
5. Ensuring staff are trained and motivated – including nurse revalidation (on
the doctor model); healthcare support worker code of conduct and
minimum training; every DH civil servant to do frontline work.
As part of the response, a revised NHS Constitution has also been published
which makes clear to everyone the importance of the fundamental value of
‘working together for everyone’. Further amendments to the NHS Constitution
are likely later in the year as part of the Governments full response to the
Inquiry’s recommendations.
The FTN produced a useful briefing on the Government’s response, which
includes the FTN view on many of the main proposals set out in the response. A
copy is attached to this report.
2. The Healthy NHS Board
The NHS Leadership Academy is commissioning a refresh of the ‘Healthy NHS
board: principles for good governance’, a guide for boards seeking to address the
challenges of improving quality for patients. The refresh has been commissioned
to take account of the significant changes in the governance landscape in the
three years since the guide was first published. The FTN is working with the
refresh team on the review and the Board will be informed when the new guide is
published.
3. Fair Playing Field Review
Monitor published its review into the operation of a ‘fair playing field’ for NHS
providers:http://www.monitor-nhsft.gov.uk/FPFR
Monitor considers the provision of NHS-funded care as a playing field on which
the players are the wide variety of health care providers offering or seeking to
offer services to NHS patients. If the playing field were fair, there would be
nothing to prevent providers with the best services from accessing patients,
regardless of the type of provider. Accordingly, Monitor has sought to
understand whether there are any systematic distortions in the playing field
preventing this from happening. In assessing the importance of any distortions,
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Monitor has focused on the ultimate impact they have on patients. This is
consistent with Monitor’s primary duty to protect and promote the interests of
patients.
Monitor has identified three types of material distortions:1. Participation distortions. Some providers are directly or indirectly
excluded from offering their services to NHS patients for reasons other
than quality or efficiency. Restrictions on participation disadvantage
providers seeking to expand into new services or new areas, regardless of
whether the providers are public, charitable or private. Participation
distortions disadvantage non-incumbent providers of every type.
2. Cost distortions. Some types of provider face externally imposed costs
that do not fall on other providers. On balance, cost distortions mostly
disadvantage charitable and private health care providers compared to
public providers.
3. Flexibility distortions. Some providers' ability to adapt their services to
the changing needs of patients and commissioners is constrained by
factors outside their control. These flexibility distortions mostly
disadvantage public sector providers compared to other types.
4. Department of Health Review and Response – Winterbourne View
Hospital
The Department of Health has published its final report into the events at
Winterbourne View hospital and has set out a programme of action to ensure
vulnerable people are cared for in line with best practice.
The programme of action includes:
 setting out proposals to strengthen accountability of boards of directors
and senior managers for the safety and quality of care which their
organisations provide
 reviewing all current placements
 each area to have a joint plan to ensure high quality care and support
services for all people with learning disabilities or autism and mental
health conditions or behaviour described as challenging, in line with best
practice
 reducing hospital placements for this group of people
 a new NHS and local government-led joint improvement team will be
created to lead and support this transformation
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A copy of the report may be accessed here:https://www.gov.uk/government/publications/winterbourne-view-hospitaldepartment-of-health-review-and-response
Local / Trust Issues
5. CEO Stakeholder Meetings & Visits
Since the last meeting, key stakeholders that I have met have included: Dr John Stedman, Chief Executive, NHS Innovations South East
 Mr Andrew Carter, Friends of the Warneford Meadow
 Dr Denis O’Leary, Head of School, School of Psychiatry – Oxford Deanery
 Professor Derrick Crook, Professor of Microbiology
 Sir Jonathan Michael, CEO, OUH
 Dr Catherine O’Sullivan, Chief Executive, Thames Valley HIEC
 Professor Andrew Hamilton, Vice Chancellor, University of Oxford
Key visits I have undertaken and meetings that I have attended have included: FTN Mental Health Group
 Visit to Vodafone Customer Experience Centre, Newbury – to learn about
their approach to working and share ideas
 Oxford Mindfulness Centre
 Highfield Unit, Oxford
 Marlborough House, Swindon
6. Visit to NIHR-supported Clinical Neuroscience Research Facilities, Oxford
On 21 March 3013, Professor Dame Sally Davies, Chief Medical Officer and Chief
Scientific Advisor, Department of Health, visited a number of NIHR funded
facilities in Oxford. This included a visit and tour of the Clinical Research Unit at
the Warneford Hospital, which Dame Sally officially opened.
Dame Sally also toured the Oxford Centre for Human Brain Activity providing her
with an opportunity to see the MEG scanner on the Warneford Hospital site and
learn of the proposed joint initiative between Oxford Health NHS FT and the
University of Oxford for a 3T MRI scanner.
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7. Oxford Academic Health Science Network (OAHSN)
Following the OAHSN application formal interview in February 2013 (partners are
still to be informed of the outcome), work continues on developing the Network.
On 26 March 2013, I and other partners attended the Milton Keynes and Bedford
Locality Meeting at the Business School, The Open University. The Locality
Meeting provided us with an opportunity to provide an update on our proposals,
with a particular focus on developing the clinical and research networks across
Thames Valley. It also provided an opportunity to seek feedback on the
proposals and hear about local issues which will help ensure that OAHSN covers
the region.
8. Consultant AAC
An Advisory Appointment Committee, attended by Cedric Scroggs and chaired
by Dr Clive Meux, convened on 8 April 2013 and offered the post of Consultant
Psychiatrist in Child & Adolescent Psychiatry (Banbury) (Full Time) to Dr Dorothy
Ann Rowlands and the post of Consultant Psychiatrist in Child & Adolescent
Psychiatry (Aylesbury) (Full Time) to Dr Vinod Singaravelu, subject to Board
agreement and relevant pre-employment checks.
Dr Dorothy Ann Rowlands gained her medical degree in Sheffield and trained in
psychiatry in Yorkshire. She is an experienced Consultant Psychiatrist in Child &
Adolescent Psychiatry with a wealth of clinical experience, who initially worked as
a consultant in Mid & South Powys and then most recently in Shropshire
Community Health NHS Trust. She is keen to be involved in service development.
Dr Vinod Singaravelu gained his medical degree in India and trained in psychiatry
in Sussex, Manchester and London, with his higher specialty training in Child &
Adolescent Psychiatry being in Oxford, where he has most recently been Acting
Consultant Psychiatrist in Child & Adolescent Psychiatry in Swindon &
Marlborough. He already has well developed teaching skills and is a keen,
energetic and well thought of young doctor.
The Board is asked to approve these appointments.
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Recommendation
The Board is asked to note the report and approve the Consultant AAC
recommendation.
Lead Executive Director: Stuart Bell, Chief Executive