The Rotherham NHS FT,
Community Services
Board approved strategic direction
1. Diversification – to spread and reduce the risk of operating within a single market which is in decline (Acute Hospital
2. Harnessing the benefits of scale
a. Economies of scale e.g. shared services/back office functions, reduced corporate overheads, lower supplies costs, etc.
b. Increased borrowing capacity
c. Ability to recruit the highest calibre of managers
d. Influencing National Policy
e. Greater influence when working with the Private Sector
3. Innovation
a. Building flexibility in our capacity to respond to the way future services will be delivered;
b. Developing multi-functional expertise across our portfolio of services that can be deployed wherever there is a need;
c. Identifying, developing capability and meeting emerging gaps in the market for new forms of service;
4. Altruism
a. We are passionate about the NHS and believe we have much to contribute to its successful transformation into a world
class health system
b. We believe that the strategy of supporting patients in managing themselves is correct, but requires a different approach
and new models of service; we want to influence that new approach and provide those new models
c. We are concerned that Community Services will taken over by Hospitals eager to asset strip them to resolve their own
financial challenges/deficiencies, which we fundamentally oppose
d. We believe that we can beat the Private Sector at what they do, and do not want to see tax payers money going to
private sector shareholders without effective NHS competition
Our 10 areas of business interest
Operating Acute Hospitals – acquisitions and takeovers
Operating Community Provider Services
Developing and operating “Alternate Levels of Care” (reinventing the Community
Running and operating Nursing Homes and potential Residential Homes/hybrids*
Providing Managed Services*
Consultancy services, including turnaround*
Provision of shared services*
Professional services to the NHS and Business Sectors in a range of areas, e.g.
Service Improvement (Lean), Occupational Health, IT, etc.*
Franchising and selling Intellectual Property*
10. Creating and building Joint Ventures with the Private Sector working at the leading
edge of health care, e.g. McKesson, Microsoft, Strata Pathways, Surgicube, BAMM
Construction, etc.
We are building our capacity and capability in all of these areas incrementally
Who we are
• First Wave Foundation Trust established in 2005
• Now structured to operate as a Health Care Provider, not an Acute
Hospital (Group Structure)
• Trust ethos of delivering excellence in Health Care and committed to
the NHS
• Successful and verifiable track record in delivering quality,
productivity, innovation and prevention
• Ground breaking business models and strategies which empower and
engage staff in the delivery of services
• Partnering with class-leading businesses to develop and deliver
innovation in service delivery and to stimulate growth in the local
• Fully understand and support the need to manage care in the
community, and committed to that principle
Track record on Quality & Performance
Double-Excellent rated by the CQC (07/08 and 08/09)
Double-Green/4 rated by Monitor
HSMR reduced from 107 to 92 in 3 years
Amongst the Lowest MRSA and C.Diff infection rates in UK
Amongst the shortest waiting times in the UK for access to
9 days from GP referral to OP appointment and
16 days from DTA to elective admission
All diagnostics <1 week; MRI same day
Voted #1 for shortest waiting times - National Inpatient Survey
• CHKS 40 Top Hospitals Award Winner 2009
• Health Investor Magazine’s “Foundation Trust of the Year”
Track record on efficiency and productivity
6% CRES delivered 4 years in a row
30% more throughput than 4 years ago
150%+ increase in referrals from outside Rotherham
Maximum 9 week wait achieved for over 90% of patients
Reduction in sickness absence of 1.2% in past year
Increased staff satisfaction ratings from 3.38 to 3.43 in past year
(statistically relevant)
• Increased Consultants by 33% in 4 years
• Generated a £4m surplus in 2008/9
• Since becoming a Foundation Trust, we have never compromised or
pressurised NHS Rotherham’s financial position, which is now the
strongest in the Y&H Region
Track record on leading edge innovation
• £30m investment in Digital Patient Records (outside the
National Programme) – Plan to be paperless by 2012
• £50m investment in our Hospital of Tomorrow project
• Brought InterQual Level of Care assessment tool to the UK
and developing new “Alternate Level of Care” services
• From £25k to £1m R&D programme in 3 years
• National lead on Ultra Efficient Lighting & carbon reduction
• Introducing community based Ophthalmology Services and
theatre-less ophthalmic surgery to the UK
• For 2009/10, our Governors set our objectives
Options for the way forward
Do nothing
Retain as ALMO
Social Enterprise?
Community Foundation Trust?
Merge with other Community Provider(s)
Vertically Integrate with local Acute Hospital
Outsource to a Managed Service (e.g. Careplus)
Join The Rotherham NHS FT Group
Joining TRFT
Community Services would become a Division of TRFT, and operate
independently of the Acute Hospital arm of the business.
Contributes to management overheads but does not carry a major management
overhead of its own
Accesses all the benefits of being part of the TRFT Group:
– Unlimited borrowing (subject to adequate Business Plan)
– Immediate cost reduction opportunities through shared services
– Taps into full range of expert TRFT services (Clinical Effectiveness; Patient Experience;
Patient Safety; Contracting and Marketing; Service Improvement; Service
Transformation; R&D & Technology Adoption; IT; OD; HR; etc.)
– Access to, and opportunity to provide services for, strategic business partners
– Access to Marketing Division with existing business structure to allow services to
extend beyond existing boundaries should they wish to grow/expand (Careplus)
– Access to leading edge business models - Internal trading; surplus retention; carry
forward of under-spends for investment in services; clinically led and managed
services; etc.
One of the highest performing FTs in the Country, with a solid track record of
progress and improvement, highly rated by Regulators.