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BOD 140/2014
(Agenda item: 4)
Report to the Meeting of the
Oxford Health NHS Foundation Trust
Board of Directors
26 November 2014
Chief Executive’s Report
For Information
National Issues
1. NHS Five Year Forward View
On 23 October 2014, NHS England, Public Health England, Monitor, the NHS
Trust Development Authority, Care Quality Commission and Health Education
England published the ‘NHS Five Year Forward View’ which sets out a vision for
the future of the NHS. A copy of the document is attached to this report. The
Five Year Forward View sets out why change is needed and outlines potential
solutions to the challenges we face. Importantly, the document defines the
framework on how NHS planning decisions will be taken over the next five years.
In presenting the report, Simon Stevens, NHS England’s Chief Executive, stated
that action was required on four fronts: Do more to tackle the root causes of ill health.
 Commit to giving patients more control of their own care, including the
option of combining health and social care, and new support for carers
and volunteers.
 Invest in new models of care built around the needs of patients rather
than historical or professional divides to ensure the NHS meets the needs
of a population that lives longer, for the millions of people with long-term
conditions, and for all patients who want person centred care.
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Action needed to develop and deliver the new models of care, local
flexibility and more investment in workforce, technology and innovation.
I encourage all Board members to read the Five Year Forward View as this will set
the tone for many of our strategic and planning discussions over the coming
years. It is worth noting that the approach we have been taking in terms of
integrating care and developing service models based on the needs of patients is
in line with the vision set out in the Five Year Forward View.
2. National Data Guardian
The Secretary of State for Health appointed Dame Fiona Caldicott to a new role
as National Data Guardian for health and care; this role is designed to be the
patients’ champion on security of personal medical information. The National
Data Guardian will be able to intervene when there are concerns about how an
organisation is sharing data; the Guardian may refer concerns directly to the
Information Commissioner’s Office and the Care Quality Commission to
investigation and sanction where necessary. Organisations that fail to act on
recommendations made by the Guardian will face sanctions including fines and
the removal of the right to share personal data. Furthermore, no data will be
extracted from GP practices as part of the care data programme until the
Guardian has informed the Secretary of State that they are satisfied with the
proposals and safeguards.
This appointment is connected to the plans to improve health outcomes and
quality of care through digital technology. The Secretary of State announced that
by 2020 the care record will be available across the whole health and care system.
The vision commits to giving everybody online access to their GP records, viewed
through approved apps and digital platforms, by 2015 and access to health
records held by hospitals, community, mental health and social care services by
2018.
3. NHS Litigation Authority (NHS LA) Review
The Department of Health invited organisations to submit evidence to the NHS
LA Triennial Review. The Trust submitted evidence based on our experience
working with the NHS LA including suggesting greater transparency on how
membership costs / premiums were calculated. The Board will recall that we have
discussed in the past our concerns with the costs levied on the Trust which did
not seem to take account of our claims history or risk profile.
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4. Publication of Fundamental Standards
The Government has now published the fundamental standards regulations and
confirmed that the fit and proper person requirements for directors and the duty
of candour will take effect from 27 November 2014; the remaining fundamental
standards will come into force from April 2015. Replacing the 16 ‘essential
standards’, the fundamental standards are: Care and treatment must be appropriate and reflect service users' needs
and preferences.
 Service users must be treated with dignity and respect.
 Care and treatment must only be provided with consent.
 Care and treatment must be provided in a safe way.
 Service users must be protected from abuse and improper treatment.
 Service users' nutritional and hydration needs must be met.
 All premises and equipment used must be clean, secure, suitable and used
properly.
 Complaints must be appropriately investigated and appropriate action
taken in response.
 Systems and processes must be established to ensure compliance with the
fundamental standards.
 Sufficient numbers of suitably qualified, competent, skilled and
experienced staff must be deployed.
 Persons employed must be of good character, have the necessary
qualifications, skills and experience, and be able to perform the work for
which they are employed (fit and proper persons requirement).
 Registered persons must be open and transparent with service users about
their care and treatment (the duty of candour).
We are advised that both the CQC and the FTN will shortly publish guidance on
how we can meet the duty of candour and fit and proper persons test. Board
members will recall that we discussed these requirements at a Board seminar in
September 2014. The Medical Director / Director of Nursing and Clinical
Standards on the duty of candour, and the Director of Finance on the fit and
proper persons test will provide assurances to the Board on how the Trust was
meeting these requirements at the appropriate juncture.
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Local / Trust Issues
5. CEO Stakeholder Meetings & Visits
Since the last meeting, key stakeholders that I have met, visits I have undertaken
and meetings that I have attended have included:
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Ministry of Defence: clinicians seminar
2014 Education Quality Visit to the Trust by Oxford Deanary
Health Bucks Leaders
Next Generation Electronic Health Records Programme
Vice-Pro Chancellor, Professor Nick Rawlins
Rt. Hon. Dominic Grieves QC MP
6. Manor House / Tindal Centre Planning Application Decision
In early November the planning application and related conditions for the
development of surplus land in Aylesbury, resulting from the completion of the
construction of the Whiteleaf Centre, were considered at the Aylesbury District
Council Planning Committee meeting. Despite having had numerous discussions
around the scope for flexibility in the Section 106 agreement conditions, the final
proposal put to the Committee by the Planning Officer did not support our
request for a lower proportion of affordable housing and surprisingly remained
unchanged from the standard policy of the Council. The impact to Oxford Health
FT of not being able to reduce the proportion of affordable housing is to reduce
the expected land sale receipt by up to £2m which puts further pressure on the
future years’ cash flow. Advice is being taken as to the site configuration and
marketing to maximise the realisable value.
7. Bicester Community Hospital
The partners involved with the new Bicester Community Hospital (Oxfordshire
Clinical Commissioning Group, NHS Property Services, Oxford Health NHS
Foundation Trust, Oxford University Hospitals NHS Trust, South Central
Ambulance Service, Bicester Community Hospital League of Friends and Kajima)
recently agreed to work towards services moving from the current hospital to the
new one on 4 December 2014.
Regular on-site meetings are continuing to take place to ensure the final works
are completed and I am advised that we do not anticipate any delays of more
than a week. If there is any delay beyond one week then we will not be able to
complete the move until January 2015 (so as to avoid difficulties associated with
moving over the Christmas / New Year period). A deep clean of the new hospital
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will be carried out prior to services transferring over and staff training for the new
hospital has commenced.
Once transfer has taken place, the old site will be cleared ready for development.
The official opening of the new hospital will take place in the first few months of
2015.
8. Letter to Staff
Following the discussion at the Board meeting in October 2014 where we noted
the pressures staff faced and the need to acknowledge these set out our support
for staff, the Chairman and I jointly signed a letter addressed to all staff. A copy
of the letter is attached to this report.
Recommendation
The Board is asked to note the report.
Lead Executive Director: Stuart Bell, Chief Executive