Outcome of Foundation Trust Public Consultation...2 January 2014 Public meeting Harlequin Theatre Redhill 22 7 January 2014 Public meeting Drill Hall Horsham 23 10 January 2014 Public

Outcome of Foundation Trust Public Consultation

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 2 of 35

Background

1. Name of applicant Surrey and Sussex Healthcare NHS Trust

2. Area served by the Trust East Surrey

North West Sussex

South Croydon

3. Contact details of person responsible for the public consultation

Gillian Francis-Musanu Director of Corporate Affairs Surrey & Sussex Healthcare NHS Trust Canada Avenue Redhill RH1 5RH Tel: 01737 768511 Ext 2862 e-mail: [email protected]

About the public consultation

4. Dates of public consultation Started 21 November 2013

Finished 28 February 2014

5. Which media were used for the public consultation document?

Engagement planning Public events To advertise events we placed newspaper adverts, arranged for posters to be displayed locally and within the hospital on our notice boards and 24 digital information screens, advertised on our website and alerted our 5000 twitter followers, sent out press releases and offered regular interviews to print and broadcast. We walked around and gave out flyers to people visiting the hospital, sent posters to GP surgeries, placed articles in CCG and council newsletters, e-bulletins, intranet sites and websites. Many local groups, particularly the local business groups also placed articles and adverts in their newsletters and on their websites. We emailed and wrote to as many local organisations, voluntary sector, other health groups, and business partners that we could find and on the day we encouraged passers-by to join the FT discussion. The events were arranged to offer maximum flexibility for people, with some held in the morning, some in the afternoon and many in the evening.


Stakeholders The consultation booklet was sent to all GP surgeries and other stakeholders identified in the consultation plan, plus we have taken a very proactive approach to engaging with others – WI, nursing homes, sports/football clubs, libraries, local shops, schools – requesting they cover FT in citizenship lessons etc. In our mail-outs, we asked partner organisations ‘when’ we could attend their meeting and present. Uptake of this request was slow although Surrey County Council and Reigate and Banstead Council were very supportive. Reigate and Banstead, Mole Valley and Tandridge councils were also very supportive by publishing our consultation materials on their websites and staff intranets, helping us with venues for our events and offering us free editorial in their magazines. In our mail-outs we asked local groups if they would like us to come and present, and to GPs, we asked for all GPs and practice managers to send us their feedback and to display our materials in their waiting rooms. Staff Staff engagement activities took place throughout the consultation period with the aim of a member of the Executive Team to visit every staff team meeting, as well as holding specific FT events and having information stalls around the hospital, so that every member of staff has had the opportunity to raise questions or concerns. We have utilised our All Staff, Senior Leaders, All Consultants and Trade Union Stewards, JNCC Committee meetings to take the opportunity to give the latest FT updates. At the February All Staff meeting we invited a member of staff from Kingston Hospital who was previously at the Royal Surrey County Hospital, to talk to our staff about how it feels as a member of staff going through the FT process, and beyond. Managerial materials including a toolkit for managers and FAQs for staff were available on request and via the staff intranet. Regular ‘All staff’ (html) emails keep staff updated and notify them of FT engagement opportunities. We created a staff guide to becoming an FT leaflet and a schedule of activities was listed in the Consultation Plan. In their February payslips, every member of staff received a copy of the leaflet and a membership form so they can sign up a friend or patient. Our monthly internal staff newsletter carried FT stories throughout the consultation period, and it was one of the main campaigns running on our intranet.

Full consultation document in hard copy Yes

Summary consultation document in hard copy Yes for staff

Web-based consultation document Yes

Talking Book / audio tape / CD Rom Available on request

Large print versions Available on request

Versions in ethnic languages (specify which) Available on request

Other


5.1 Presentation at public meetings (specify where meetings were held and the number attending)

Date Meeting type Venue Attendance

6 November 2013 Hot topic – care of the elderly and FT

ESH 12

25 November 2013 Public meeting Dorking Halls Dorking

11

29 November 2013 Public meeting Oxted community Centre

18

3 December 2013 Public meeting Meridian Hall East Grinstead

0

9 December 2013 Public meeting ESH 15

13 December 2013 Public meeting Crawley Hospital 3

17 December 2013 Public meeting Reigate Community Centre

5

2 January 2014 Public meeting Harlequin Theatre Redhill

22

7 January 2014 Public meeting Drill Hall Horsham 23

10 January 2014 Public meeting Crawley Civic Centre 16

26 February 2014 Public meeting United Reformed Church Purley

17

27 February 2014 Hot topic – care of the elderly / dementia and FT

ESH 45

5.2 Presentation at other meetings (specify where meetings were held and the number attending)

Date Meeting Venue Attendance

11 September East Surrey League of Friends AGM

ESH 75+

21 November West Sussex Health and Wellbeing Board

County Hall Chichester

22

28 November Board to Board with East Surrey CCG

ESH 30

2 December Reigate and Banstead Local Committee

Reigate Town Hall 20

2 December Patient Experience Forum ESH 14

12 December Surrey Health and Wellbeing Board

County Hall Kingston upon Thames

16 December Surrey Traveller Community Forum Health and Wellbeing Group

Burpham, Guildford 9

9 January Surrey CC Health Overview & Scrutiny Committee

County Hall Kingston upon Thames

16


13 January Horsham League of Friends Horsham Hospital 13

14 January East Surrey College Redhill 33

15 January

Surrey Information Summit

20 January

West Sussex Health and Wellbeing Board


22

20 January East Surrey Empowerment Board

Tandridge 16

22 January West Sussex CC – Health and Adult Social Care Committee


17

24 January East Surrey Hospital Volunteers

ESH 25

30 January West Sussex Health and Wellbeing Board

County Hall Horsham

20

February East Surrey CCG Patient Reference Group

Nutfield 30

13 February Reigate and Banstead Council – member briefing


13 February West Sussex HASC liaison members (Peter Griffiths, Dr David Skipp)


2

6 March Reigate and Banstead Voluntary Services


5.3 Presentation at staff meetings (specify where meetings were held and the number attending)

Date Meeting Venue Attendance

15 November All staff meeting ESH 75 - 100

21 November Senior leaders ESH 50 - 75

13 December All staff meeting Crawley Hospital 25 - 50

13 January 2014 Junior doctors ESH 25 - 35

15 January Medicine senior managers / Clinical Leads

PGEC ESH <25

16 January Medicine and Surgery Matrons, Surgery Senior Sisters

ESH <25

16 January All staff meeting ESH 75 - 100

17 January Staff road show at main entrances

ESH 75 - 100

19 January Surgical Division senior ESH <25


managers and clinical leads

23 January Anaesthetists ESH 25 - 50

23 January Theatre staff ESH 25 - 50

23 January Staff Road show ESH 50 - 75

23 January Senior leaders ESH 50 - 75

23 January Microbiology staff Crawley 25 - 50

23 January All Staff Crawley – Comet Ward <25

24 January Volunteers ESH 25 - 50

29 January All Staff Health & Wellbeing event

ESH 600 - 700

31 January All Staff Horsham <25

3 February Medical Division ESH <25

20 March WACH Division ESH <25

7 February All consultants ESH 25 - 50

10 February All consultants ESH 25 - 50

12 February Unions - TUSC ESH <25

13 February Surgical Division ESH <25

14 February All Staff inc presentation from staff member of another FT

ESH 50 - 75

4 March Clinical Support Services Division

ESH <25

24 February Lead Clinicians ESH <25

25 – 28th February Senior Sisters ESH 6

Finance and procurement ESH 10

Porters ESH 25

Housekeeping ESH 25

12 March Transport and post room staff

ESH <25

21 March PALS and complaints ESH 5

12 February Night shift staff ESH 15

5.4 Consultation information sent / e-mailed to

Local Authorities West Sussex County Council (Chair, CEO, HASC, Director Adult Services, Director Children’s Services, Health & Well Being Board) Surrey County Council (Chair, CEO, HSC, Director Adult Services, Director Children’s Services, Health & Well Being Board, Local Committee) Mid Sussex District Council (Leader and CEO) Horsham District Council (Leader and CEO) Crawley Borough Council (Leader and CEO)


Reigate and Banstead Borough Council (Leader and CEO) Tandridge Borough Council (Leader and CEO) Mole Valley Borough Council (Leader and CEO) East Grinstead Borough Council (Leader and CEO) Ash Parish Council Capel Parish Council Charlwood Parish Council Godstone Parish Council Tandridge Parish Council Wotton Parish Council Abinger Parish Council Buckland Parish Council Chaldon Village Council East Horsley Parish Council Limpsfield Parish Council Salford and Sidlow Parish Council Tatsfield Parish Council Brockham Parish Council Betchworth Parish Council Leigh Parish Council Ockley Parish Council Headley Parish Council Holmwood Parish Council Mickelham Parish Council Health Overview & Scrutiny Committees West Sussex County Council HASC Surrey County Council Surrey HSC HealthWatch Health Watch Surrey Health Watch Sussex MPs Crispin Blunt Sam Gyimah Henry Smith Chris Grayling Fancis Maude Nicholas Soames CCGs Surrey Downs CCG East Surrey CCG


Crawley CCG Horsham and Mid Sussex CCG Croydon CCG CCG Patient Reference Groups (via host CCGs) Surrey Downs CCG Patient Reference Group East Surrey CCG Patient Reference Group Crawley CCG Patient Reference Group Mid Sussex CCG Patient Reference Group NHS organisations Ashford St Peters NHS Foundation Trust Brighton and Sussex University Hospitals NHS Trust East Sussex NHS Trust Frimley Park NHS Foundation Trust Queen Victoria NHS Foundation Trust Royal Surrey County NHS Foundation Trust Surrey & Borders NHS Trust South East Coast Ambulance NHS Foundation Trust Sussex Partnership Trust Local Training and Education Board Kent Surrey Sussex Deanery Brighton and Sussex University Medical School Other healthcare providers Sussex Community Trust First Community Health and Care Central Surrey Healthcare GPs All GP surgeries in the proposed public constituencies (full lists in Appendix 1) Libraries Materials for display throughout libraries in Surrey and Sussex Hospital League of Friends East Surrey Hospital League of Friends Crawley League of Friends Horsham League of Friends Surrey and Sussex Healthcare NHS Trust Patients Council Voluntary organisations


Carers Support Crawley Community Relations Forum Crawley Council for Voluntary Services Oxted Council for Voluntary Services Horsham Area Council for Voluntary Services Reigate and Banstead Council for Voluntary Services Surrey Compact Surrey Empowerment Board Tandridge Council for Voluntary Services Tandridge Health and Social Care Forum Action for Life – the East Surrey Walking for Health Scheme Horsham Voluntary Action Mid Sussex Council for Voluntary Services Family Line St Peter’s House Project, Redhill Voluntary action in Elmbridge Crawley community and Voluntary Services Carers support (East Surrey) Community Groups Men’s Health Forum Surrey Youth Support Service Gender Identify Research and Education Society National Childcare Trust Schools and Colleges Royal Alexandra and Albert School, Reigate East Surrey College, Redhill Reigate School, Reigate Reigate 6th Form College, Reigate Dunnotar School, Reigate Oakwood School, Horley Oriel High School, Crawley St Bedes Secondary School, Redhill Reigate Grammer School Woodfield School, Surrey Thomas Bennet Community College, Crawley St Wilfred’s Catholic School, Crawley Hazelwick School, Crawley Ifield Community College, Crawley Holy Trinity C of E Secondary School Residential Care Homes Coppice Lea Care Home, Merstham


Chaldon Rise Nursing Home, Merstham The Reigate Beaumont The Elms Nursing Home, Redhill Wray Common Nursing Home, Reigate Kings Lodge Centre for Complex Needs, Nutfield, Redhill Acorn Court Care Home, Redhill, Nuffield Care Centre, Redhill The Barn House, Merstham Rutland Care Home, Reigate Wykeham House, Horley Chaldon Rise Nursing Care Home, Merstham Oakhurst Court Nursing Home, South Godstone The Brambles Care Centre, Horley Old Wall Cottage in Reigate, Betchworth Rosewood, Horley The Woodhatch Centre, Reigate Other Regent House Community Centre, Horley Oxfam, Redhill Oxfam, Reigate Shopmobility, Redhill British Heart Foundation, Redhill British Heart Foundation, Crawley Redhill Evening Townswomen Guild, Redhill Marie Curie Cancer Care, Redhill St Catherine’s Hospice Charity Shop, Redhill Cancer Research UK, Reigate Age Concern, Merstham, Redhill and Reigate Age Concern, Banstead Age UK, Horley Age UK, Surrey The Children’s Trust, Crawley Donyngs Recreation Centre, Redhill The Children’s Trust, Tadworth Young Epilepsy

5.5 Other consultation activity

Hospital wards and departments Our Membership Officer regularly visited wards and departments around East Surrey, Crawley and Horsham hospitals. This face to face activity proved to be extremely effective at explaining the FT proposals and recruiting members. Posters and leaflets were displayed prominently throughout all facilities from which the Trust


provides services. Media / Social media We regularly engaged with our 5000 plus followers on Twitter about FT and had radio coverage from Heart and Radio Redhill. Letters to community groups We met with other local groups as opportunities arise and in particular we have been keen to attend meetings with groups of people that are often more difficult to reach, such as the Gypsy and Traveller group. With our Chief Nurse a consultation and engagement Afternoon Tea event was held at East Surrey hospital with some of our patients with learning disabilities.

Website / intranet Both the website and intranet have dedicated FT pages targeted at patients and members of the public as well as staff.

Posters and leaflets Posters and leaflets are located in all main entrances and available on all digital display screens at East Surrey Hospital and Crawley Hospital.

Communication with staff In addition to the meetings with staff, [Corporate Governance Officer, and members of the Communications and Corporate Affairs Team) were available to hand out information and receive feedback:

in the main entrance on 17 January between 7am and 9am to catch staff on their way in to work

in the main entrance on 22 January between 12 and 1pm

In the restaurant between 12 and 1pm on 22 January

Display stands These were set up in key locations in the hospitals:

East Surrey hospital – main and east entrances; outside the restaurant, X-ray, OPD & ED restaurant

Crawley – main entrance

Horsham – outpatients department

Pop up stall We have been out and about with a pop-up stalls. The Trust Executive Team accompanied our Membership Officer talking to shoppers in local shopping centres, and this engagement activity will continue beyond the consultation period.

Belfry, Redhill

Whitgift Shopping Centre, Croydon,

Mid Sussex shopping centre,


We also took the stall to engage with the students at East Surrey College and will continue to engage with students at other nearby colleges as and when we are granted permission. We have written to all local schools asking how best to engage their students in our membership.

6 Number and type of formal responses received

Type of response Number received

Hard copy using proforma provided 23

Hard copy – others eg letter 5

On website 5

By e-mail 1

By telephone 0

By fax 0

By text 0

Verbally at public meetings 71

Verbally at community forums etc 38

Other – specify Comments were received at staff meetings, meetings with stakeholders including Trade Union Stewards Committee; Traveller Forum, local college, MPs, HWBBs etc

Reigate Borough Council Members meeting 9 comments / questions

An e-mail reminder was sent to all partner organisations in the middle of January requesting feedback on the consultation proposals.

7 Was the pattern of responses to the public consultation in line with the demography and geography of the area? Were there any areas or groups that were not adequately represented in the responses received? Provide explanations where necessary. And details of Trust action plan to target under-represented areas

Different approaches were used to engage with different sectors of society and ensure the consultation engaged with a representative population. Public engagement Public meetings were held in each of the proposed public constituencies and all except the meeting in East Grinstead (Mid Sussex constituency) attracted some attendance from local residents and other interested people. Although the numbers attending were often relatively low, the level of engagement and interest was high with the majority of people being very supportive of the Trust and the aspiration to become a foundation trust. The majority of people attending these meetings were in older age groups The pop up stand in shopping centres provided excellent opportunities to meet with younger people including mothers with children and people of working age.


The meetings at East Surrey College [any other colleges] were well attended by students who were interested not only in the plans for FT status but also in the work of the Trust and potential future employment opportunities. More than 30 students also signed up to being members of the Trust. Meetings were held with several user and other interest groups including Travellers in Surrey and Reigate voluntary services forum, Surrey Empowerment Forum & Disability group. Patient and Carer engagement Throughout the consultation period our Membership Officer regularly visited wards and departments around East Surrey, Crawley and Horsham hospitals. This face to face activity proved to be extremely effective at explaining the FT proposals and recruiting members. Presentations were also given to the Trust’s Patient Experience Forum and each of the League of Friends for East Surrey, Crawley and Horsham hospitals. Membership information is included in all new appointment letters and is resulting in a number of new members being recruited each week. The Trust has entered into a contract for membership support services with Membership Engagement Services who will provide regular analysis of the demographics of the membership and will also undertake targeted membership recruitment in any underrepresented public or patient constituencies. Staff living in underrepresented areas are being asked to identify opportunities for engagement with local groups. Staff engagement A comprehensive programme of presentations and discussions at staff meetings included ward and departmental meetings, staff group specific discussions (junior doctors, Clinical Leads, Matrons etc) as well as the monthly All Staff meeting. It is estimated that approximately one third of all staff attended one or more meetings and some also attended the public meetings with relatives. A toolkit and communications pack was also provided for managers to support discussion within teams and all members of staff received a summary leaflet with payslips in February. Regular updates were also provided to the Trades Union Staff Consultative Committee. Partner organisations The Trust FT Project Board includes members from both County Councils and the four Surrey and Sussex CCGs. Key elements of the FT application, including strategic intent; consultation plan and consultation document, were discussed by the FT Project Board prior to the start of consultation. Following the consultation the outcome of the consultation and the draft consultation response report were considered by the FT Project Board which made consequent recommendations to the Trust Board for changes to the proposed composition of the Council of Governors.


Engagement with the County Councils was positive throughout the consultation with presentations given to members of the HOSC / HASC committees and the Health & Wellbeing Boards. The Reigate and Banstead Council also accepted the offer of a presentation which was provided to members. Perhaps reflective of the newness of their organisations and the breadth of issues they are managing, access to and comment back from CCGs was minimal. [No CCGs were willing to receive a presentation on the proposals, although a joint Board to Board was held with East Surrey CCG during the consultation period, and only two submitted a formal response to the consultation]. A meeting with the Reigate and Banstead Voluntary services was well attended.

About the consultation responses / comments received

8 Responses received from major stakeholders (individuals and organisations) and their general view – including local MPs, local authorities, local NHS organisations, professional and staff representative bodies, local commercial organisations, national and local voluntary organisations

Name Broadly in favour / neutral opposed

Main issue raised

Surrey County Council Not stated Keen to work in partnership with the Trust and to have representation on the Council of Governors

Surrey Health Scrutiny Committee

In favour Notes improvements in performance by the Trust in recent years Recommend emphasising quality of Trust leadership and encouraging participation of younger people (14+) for mutual benefit of public services

Family Line (charity)

Not stated Keen to work in partnership with the Trust and would like to be a member

West Sussex County Council Health and Adult Social Care Select Committee

In favour We have no objections to your proposals as set out in the consultation document and support your application to become an FT. We welcome the fact that your proposed governance arrangements will give West Sussex County Council a seat on your Council of Governors through an appointed governor. This is particularly important, given the interface and increasing integration


between health and social care. We also welcome your vision and values.

Crawley CCG

In favour (with financial caveats)

Recognise demonstrable improvements in service delivery and overall performance. Concerns relate to:

impact of wider economic environment and Better Care Fund

little growth in CCG allocations

SaSH proposals for increasing range of services provided at ESH

Payment by Results not seen as sustainable and placing financial risk with CCGs

Horsham and Mid Sussex CCG

Brighton and Sussex Medical School

In favour No comments provided other than support for all of the consultation questions

Reigate Borough Council (Members meeting)

In favour Based on population size should Reigate have 3 Governors Is the Trust as passionate about having good managers as it is about good clinicians? Will having a membership help the community to be involved and aware? Has been a step change , good improvements demonstrated by number of good consultants How can the Estates Strategy be improved? Need to look at how to do more fundraising Asked about relationships with CCGs and how commissioning decisions are made.

HealthWatch Surrey

In favour Healthwatch Surrey responded in support of the application to become an NHS Foundation Trust and the appointment of a Health Watch representative to the Council of Governors to represent Surrey and Sussex

Trade Union Staff In favour Requested assurance that if it became authorised as


Consultative Committee (TUSC)

an FT that the Trust would not go ahead without meaningful consultation with staff and the TUSC of any plans they may have to change any terms and conditions (i.e. to Agenda for change). Asked whether the Trust had received any indication from any members of staff who were objecting to the “Auto-enrol” for staff.

Sussex Health & Wellbeing Board

In favour Responded that responses to the consultation should really come from the constituent members of the Board (i.e. the CCGs, NHS England, Healthwatch etc.) – and that it isn’t really the HWB’s role, as a commissioning body, to respond to such consultations. The response noted that this shouldn’t be interpreted as lack of interest in SaSH - but rather that it’s not within the Board’s remit.

9 Apart from those listed in Q8 above, how many other responses were received in total?

28 formal 109 informal – i.e at meetings – excluding feedback from meetings with staff

9a. Was there a HOSC review process?

Surrey Health Scrutiny Committee Alan McCarthy, Chairman, and Michael Wilson, CEO, attended the January meeting of the Health Scrutiny Committee at Surrey County Council and presented the plans for the Trust’s FT application. Writing to the Trust after the meeting the Chairman of the Health Scrutiny Committee made the following comments: The Committee would like to offer its support for the (FT) application based on these plans and the discussion had with the Chairman and Chief Executive at the meeting. The Committee would also like to note the improvements made by SASH in recent years which have allowed it to make quick progress to the application for FT status. As a result of the discussion on 9 January, the Committee recommended that:


a) The Trust should emphasise the quality of its leadership when publicising their FT application;

and b) Encourage the participation of the younger cohort (14yrs+) for the mutual benefit of public

services. Additionally, the Committee offers its support while continuing to note the financial situation at SASH, which though much improved was in technical breach of the statutory breakeven duty of the NHS Act 2006 in 2013. The Committee hopes to continue its positive working relationship with SASH in the future and will continue to monitor its progress. West Sussex Health and Adult Social Care Select Committee (HASC)

The consultation documentation was sent to HASC along with a request to meet with members to present the proposals. Although it wasn’t possible for the whole committee to meet with the Trust two of its members did meet with the Trust CEO to discuss the proposals. The Chairman of the Committee subsequently wrote to the Trust with the following response to the consultation: Thank you for sending me a copy of the consultation document on Surrey and Sussex Healthcare NHS Trust’s proposal to become an NHS foundation trust. I am sorry that it was not possible to arrange for you to attend a meeting of the West Sussex Health and Adult Social Care Select Committee (HASC) to present your proposal, but we did forward the consultation document to all members of the HASC for comment. I was pleased to hear that HASC liaison members Peter Griffiths and Dr David Skipp had the opportunity to discuss this with you on 13 February. Their comments are included in this response. HASC is aware that Foundation Trusts (FT) have more financial and operational freedom, but remain within the NHS, and that all NHS acute, mental health, ambulance and community service trusts are expected to become Foundation Trusts. As such, HASC understands that Surrey and Sussex Healthcare NHS Trust has no option but to apply for FT status. We have no objections to your proposals as set out in the consultation document and support your application to become an FT. We welcome the fact that your proposed governance arrangements will give West Sussex County Council a seat on your Council of Governors through an appointed governor. This is particularly important, given the interface and increasing integration between health and social care. We also welcome your vision and values and hope to be updated on your plans for the future, either through our liaison members or through briefings for the Committee (as appropriate).


10 Excluding those recorded at Q8 above how many responses were:

Broadly in favour Broadly neutral Broadly opposed

25

2

1

In addition to these formal responses, feedback was received from people attending the public meetings, meetings with special interest groups, conversations with the public in shopping centres and staff meetings with the vast majority being in favour. Responses received to the specific questions raised Only one formal response was received from a member of staff. However the tenor of all staff meetings, which were attended by approx. one third of all staff, and meetings with the Trade Union Staff Consultative Committee, was that staff were in favour of the proposals. Q1 Do you agree with the Trust’s objectives and plans for the future?

Staff Public

Yes 1 24

No 2

Not stated 1

Total 1 27

Q2 Do you agree with the proposed geographical areas for our membership?

Staff Public

Yes 1 (but not for Croydon) 20

No 6

Not stated 1

Total 1 27

Q3 Do you think they are representative of the communities we serve?

Staff Public

Yes 1 20

No 6

Not stated 1


Total 1 27

Q4 Do you agree that people aged 14 should be able to become a member?

Staff Public

Yes 1 16

No 10

Not stated 1

Total 1 27

Q5 Do you agree with our proposals for the Council of Governors?

Staff Public

Yes 24

No 1 (think there should be an additional nurse / midwife)

1

Not stated 1

Total 1 27

Q6 Do you agree with the proposed new name: Surrey & Sussex NHS Foundation Trust?

Staff Public

Yes 1 21

No 5

Not stated 1

Total 1 27

Trust response

11 Does the Trust have any comments about the general tone of the responses received? For example were those opposing the proposals expressing fundamental objections or picking up minor (possibly technical) issues?

Many of the responses received, and questions posed at meetings, related to issues broader than the Trust’s FT application, including

Concerns about the removal of services from Crawley hospital

How SaSH services relate to services provided at Crawley and Horsham hospitals and why


more services aren’t provided at these locations

Wanting to see additional primary care / community base services e.g. new GP surgeries in Crawley and Oxted, audiology (hearing aids) in Surrey, services to support frail older people

How services are funded e.g. if activity increases through Choice how will the Trust be funded to ensure quality doesn’t deteriorate

Concerns about transport system and difficulty for non-drivers to access services Many respondents, and especially at the public meetings, raised understandable concerns about maintaining quality as an FT citing the failures at Mid Staffordshire and Morecambe Bay. Responses relating to the FT proposals included

Wanting to more / understand better the differences between NHS trusts and NHSFTs; role of members and governors

Seeking assurance that the patient voice will be heard and that the emphasis on public governors doesn’t dilute this

Seeking assurance that the quality of services will be maintained

Questions about the minimum age for membership, membership constituencies, Council of Governors and name of the Trust

For the two CCGs that responded, the challenges facing the health economy were prominent in their joint response:

Financial – managing demand with limited income; transfer of funding from the NHS to the Better Care Fund

Integrated Care – delivering integrated care pathways in the community and patient’s homes rather than in an acute hospital

Within this context the CCGs recognised the demonstrable improvements in service delivery and supported the aim of providing excellent DGH services for the catchment population. The response acknowledged that it is in the interests of all parties for SaSH to achieve FT status with the CCG wanting to play an active part in ensuring this success. Responses from local councils noted the step change in quality and performance at the Trust in recent years. Surrey Health Scrutiny Committee positively encouraged the participation of younger people for the mutual benefit of public services. Staff meetings were overwhelmingly in support of the FT proposals which were also supported by the Trust Trade Union Staff Consultative Committee. There were no objections from staff to the proposal to auto-enrol eligible staff as members. Only one response was firmly against the proposal to become an FT. A member of the public felt that the Trust was not yet ready to become an FT and gave two reasons for this – firstly their experience of being a member of other FTs and secondly their experience as a patient at ESH.


12 What were the main topics that attracted critical response and what was the trust’s response?

Issue (include in brackets the name of the main person(s) / bodies raising it)

Trust’s response

Trust objectives and plans for the future

Several people asked to see the IBP or to have more information about services currently provided and those planned for the future (patient, public)

The consultation document, by its nature, provided summarised information. The presentation given at meetings [and in information on the trust website] provided more detail of range of services currently provided and the areas for future development. A short version of the IBP will be published later in the FT application process - once the Trust makes its final submission to the Trust Development Authority for their approval to apply to Monitor for consideration for FT status

In both formal responses and at meetings people questioned whether to the aspirations of the Trust can be sustained. In particular they were concerned that the quality of services has deteriorated at other trusts after they have become foundation trusts. One respondent expressed concerns about the quality of care they had experienced both as an inpatient at ESH and also when accompanying a mental health patient to A&E. These concerns were given as reasons for not supporting the Trust’s plans for FT as they didn’t think the Trust is yet ready. (patient, public)

All NHS trusts, including Surrey & Sussex Healthcare NHS Trust are very mindful of the appalling levels of care exposed in some NHS hospitals. The provision of high quality of services is a key objective of SaSH along with implementing our plans to continue to improve the experience of patients. The Care Quality Commission has recently introduced a rating for all trusts in which the Trust was placed in Group 6 which is the group considered least at risk of poor quality of care. Also, nationally the Care Quality Commission has introduced a risk rating and inspection by the Chief Inspector of Hospitals. Without a good or / excellent] rating from this the Trust will not be able to apply to Monitor for FT status.

The two GGCs that responded were concerned about the Trust’s plans for the future which they considered to be ambitious plans for growth that are at odds with wider NHS policy / planning guidance and especially the Better Care Fund (CCGs)

The Trust is working with all its CCGs to ensure all our plans and priorities align with each other and deliver the maximum benefit for the local community. The plans to develop the ESH site to provide a broader range of specialist and tertiary services in partnership with others have two main aims:

Firstly to provide services more locally for


patients so that they do not have to travel out of the area for treatment

To support CCG plans to repatriate activity from London teaching hospitals

At a meeting with local councillors the Trust was asked about the Estates Strategy for ESH (LA Councillor)

The Trust has an estates strategy and works in conjunction with the LA both for planning applications and in developing, for example, its travel plans.

Membership

Several responses questioned the rationale for including part of South Croydon in the public membership constituencies:

Catchment too large and Croydon should be excluded

The catchment population is too large given the poor quality of public transport

Croydon is part of Greater London and there is no benefit in including it

Don’t want Mayday Hospital to be included (patient, public, staff)

The number of people who live in South Croydon and choose to receive panned treatment at ESH is increasing year on year. The public constituencies comprise those electoral wards from which around 10% or more of the resident population has received treatment at the Trust. The consultation isn’t about Mayday (Croydon University) Hospital which is a separate NHS trust.

Around a third of responses disagreed with the proposal for children 14 years and older to be eligible to be members. The reasons included:

14 seen as possibly too young

Members need to have a broad and balanced view of the issues involved - sceptical of the input from people of this age group other than specifically for children’s’ services

Minimum age should be the same as the legal voting age

Minimum age should be the same as for consent to treatment

18 considered more appropriate (patient, public)

Two thirds of respondents supported the proposed lower age limit of 14 years. In deciding to retain this age limit the Trust is keen to engage with younger people many of who either have been, or may be patients or who are carers for a relative who is a patient. Their experiences and insights in to the way services are provided will therefore be especially valuable in developing patient and carer awareness and focus for service developments.

Several responses suggested 9000 members is low given 3500-7000 are potentially staff and their partners and so will have a better informed,

The target public membership at authorisation as a FT is planned to be c5500 based on 1% of the population in each catchment area becoming a


or perhaps biased, view of services (patient, public)

member. As noted above, the catchment area is all those electoral wards from which around 10% or more of the resident population has received treatment at the Trust. A further 546 patient members are also planned to be recruited. This target was determined on the basis of it being 10% of the total public members which is a little above the current 7% of patients who live outside the Trust’s catchment area. These membership targets are the minimum membership numbers that the Trust hopes to achieve. Membership recruitment will be on-going and so over time these numbers will be expected to increase until such time as the number of new members balances the number of members who leave. The public and patient Governors elected to the Council of Governors will have an important role to play in representing the views of their constituencies not just their own personal views.

Suggestion that patients and carers living in a public constituency should be able to choose whether to be a patient or public member and hence to be able to stand for election as a Governor in either category (patient, public)

This was considered by the Trust but was considered administratively complicated in comparison to the proposed approach. This will be kept under review by the Council of Governors with review informed by appropriate analysis of the membership.

Request for information regarding whether any members of staff had indicated their objection to auto-enrolment of staff. (TUSC)

No concerns or objections have been raised by staff during the consultation process.

Council of Governors

The composition of the Council of Governors attracted a broad range of comments regarding appointed Governors:

There should be additional representation

To be effective the Council of Governors has to be of a manageable size and the proposed representation for partner organisations provides a broad spectrum of interest and relevance to the work of the Trust.


from ‘special interest’ / user groups e.g. third sector, long term mentally ill, disabled, elderly, carers

It will be difficult to have just one umbrella organisation for voluntary sector covering two counties and similarly for Healthwatch

Reigate and Banstead should have an additional governor

Not having an appointed Governor for Croydon could make the Croydon public governor feel quite isolated

(public, patient, staff, voluntary sector, LA Councillor)

The number of governors for each of the public constituencies is proportional to the resident population for the constituency. This mirrors the statutory requirement for the membership to be representative of the population served. In considering the overall size of the Council of Governors the Trust has decided to retain the overall number on the Council of Governors but to reduce the number of Patient Governors (out of area) but increase the number of Public Governors. The Trust will provide development support for elected governors and a key role for the Chair of the Council of Governors is to ensure that all Governors have equal opportunity to participate in discussion and to influence the decisions of the Council. The Trust believes that the overall size of the Council of Governors is sufficient to enable the appropriate transaction of decisions and the constitution of the FT has clear guidelines and procedures for managing conflicts of interest for all governors.

There were also several comments and suggestions regarding elected Governors:

A 5th staff Governor to represent patient interests was suggested, as was

An additional nurse / midwife governor

Elected Governors need to be representative of the socio-economic, ethnic, religious and age profile of the patient population (which itself will be different from the population as a whole)

Concern that if patient membership is restricted to only those patients / carers living outside the public constituencies then having 4 Patient Governors for a potentially small membership constituency would seem to be too many

(patient, public, staff)

Several responses related to the overall size of the Council of Governors:

Will it be too large to be an effective decision making body?

The number of appointed governors may be too high and also some may have conflicts of interest


(patient, public, voluntary sector forum )

One respondent suggested that Governors should not be employed by / or be beneficiaries of private healthcare providers (patient, public)

The constitution of the FT has clear guidelines and procedures for managing conflicts of interest. However, a blanket exclusion of anyone employed by or a beneficial of private healthcare providers would not be beneficial as a key benefit of the Council of Governors is to consider new and different ways of providing services to better meet the needs of the local population.

Elections should be every 5 years (patient, public)

The requirement of the DH Model Election Rules is for elections to be held every three years

Name of Trust

20% of respondents disagreed with the proposed name of the Trust:

The name doesn’t describe what the Trust does just where it is

The name isn’t geographically correct as doesn’t cover all of Surrey and Sussex

The name should include the word hospital

The name implies the intention to take over other NHS Trusts in Surrey & Sussex

The name should better describe the services provided

Several alternative suggestions were offered:

ESNEWS – East Surrey and North East West Sussex

REACH – Royal Earlswood and Community Health

East Surrey

East Surrey and Mid Sussex (patient, public)

The majority of respondents supported the proposed name.

Other

Several respondents asked about the cost of the FT application process and being an FT:

of the reorganisation (FT application) and the time it will take;

There some additional costs associated with the FT application and of being a FT. Wherever possible additional activity, and hence cost, is being managed through existing teams


of recruiting and maintaining a membership

CRB checks for governors (patient, public, voluntary sector forum)

and budgets. Where additional resource is required this is / will be procured in accordance with Standing Financial Instructions to ensure value for money.

Several respondents said they would have liked to have had more information on the non-FT options – merger, acquisition, franchising – and why they were discounted (member of the public who works for a CCG)

Achieving FT status the NHS policy preferred approach. The Trust Development Authority only considers other options where FT status is not considered achievable.

Request for assurance that if the Trust becomes authorised as an FT that it would not go ahead without meaningful consultation with staff and the TUSC of any plans they may have to change any terms and conditions (i.e. to Agenda for change). (TUSC)

The Trust does not have any plans to make changes to staff terms and conditions. If this changes in the future then the normal consultation processes would be followed.

13 What were the main topics that attracted support locally? (indicate in brackets the main sources of support e.g. patients, staff, general public)

Topic Comments received

Trust objectives and plans for the future

Stakeholder responses noted the improvement in quality of the Trust’s leadership and the services provided. (County Council)

Membership

Almost two thirds of those who responded agreed with children aged 14 yrs and above being eligible to be members:

Definitely need insights from teenagers’ who are often uncluttered with adult style expectations

They are the adults of the future

They should have a say in children’s’ services

(patient, public)


Participation of younger people (14yrs +) will be for the mutual benefit of public services (County Council)

Council of Governors

The majority of those responding agreed with the proposals for the Council of Governors and did not provide any further comment

Name of Trust

The majority of those responding agreed with the proposed name of the Trust and did not provide any further comment


14. Specifically, what was the general tenor of the responses with regard to:

Membership At public meetings there was general interest in becoming a member with the majority of those attending also completing a membership application form. One respondent specifically raised a concern about the balance between the number of members who are either staff or related to staff and everyone else and felt this might introduce bias No objections were received from staff regarding the auto-enrolment / opt out approach being proposed.

Council of Governors The proposals were generally supported. Comments related to the size of the Council, and the number and type of Governors Several comments asked about the level of help and support that will be provided to people wishing to stand for election as a governor.

Board of Directors No comments were received

Elections Although not a specific consultation question one respondent suggested that Governor elections should be held every 5 years

Constituencies Seven respondents thought the overall catchment area was too large. Of these four respondents specifically questioned the rationale for including a public constituency for the five Croydon electoral wards. Respondents were against the proposal for two reasons:

The larger the geographic area covered the more people to be treated which would impact negatively on those living in areas closer to the Trust

Transport links are not good enough to enable people to travel from south Croydon to the Trust

Boundaries The only comments received related to the proposal for a public constituency for Croydon (described above)


Constitution No comments were received

Age limits Approx 2/3 of respondents were in favour of children aged 14yrs+ being able to be members with 1/3 against There were no comments on the proposed minimum age for Governors

Youth representation Those in favour of membership from 14years described benefits in terms of the general perspective that younger people would bring as well as the ability to comment on children’s services

Staff representation Staff were in favour of the proposals to become a Foundation Trust and were also in favour of the representation of staff on the Council of Governors. The Trade Union Staff Consultative Committee was in favour of the FT proposals

Vision The public and key stakeholders, other than the two CCGs that responded, liked the proposals to develop the ESH site to provide a wider range of specialist and tertiary services. The two CCGs that responded were concerned that the proposals were expansionist and would put the CCGs at risk financially.

Transitional arrangements Not part of the consultation

HR Strategy Not part of the consultation

Communications Comments emphasised the need for effective communication

Any novel suggestions received as a result of the consultation?

One respondent suggested that Governors should not be employed by / or be beneficiaries of private healthcare providers

Name of Trust The majority of respondents were in favour of the proposed name for the Trust. A few respondents felt that the name could be improved and made suggestions for how this could be achieved e.g.:

Including the word hospital in the name

Having a name that describes what the Trust does rather than where it is

Being more accurate geographically


Other issues - specify No other material issues were raised

15. Is there anything else about the public consultation exercise and outcome that the Trust would like the Secretary of State or regulator know?

The overwhelming majority of the formal responses and comments received at public staff and other meetings were supportive of the Trust’s aspiration to become a FT, its strategic plans and most of the proposed governance arrangements. However, the consultation process did raise a pertinent concern about the proposed governance arrangements:

That the proposed number of patient governors was too high given the number of patient members from outside of the catchment area

Following consideration by both the FT Project Board (which has Council, CCG and patient representation) and the Trust Board the following changes will be made to the composition of the Council of Governors:

To retain the overall number of governors at 28 and to revise the composition by: o Reducing the number of patient governors to 1 (from 4) o Increasing the public governors from the following constituencies:

Reigate and Banstead to 3 (from 2) Crawley to 3 (from 2) Horsham to 3 (from 2)

o Retain the number of CCG governors at 4: with each CCG governor representing 1 CCG Crawley CCG - 1 Horsham & Mid Sussex CCG – 1 East Surrey CCG – 1 Surrey Downs CCG -1

These changes address the issues identified in the consultation whilst also ensuring the Council remains legally constituted with a majority of patient / public governors.

16. Contact details for the person who will be available to answer detailed question on the public consultation and provide copies of any responses required for scrutiny?

Gillian Francis- Musanu Director of Corporate Affairs Surrey & Sussex Healthcare NHS Trust Canada Drive Redhill RH1 5RH Tel: 01737 768511 Ext 2862 e-mail: [email protected]


Staff engagement, involvement and wider cultural change

17. How have staff been given ample opportunity to play an active part in the dialogue and deliberations around the NHS Foundation Trust application? Where have staff dialogue and views influenced the broad HR strategy, which in turn supports the service development plans and organisational goals of the Trust?

As an organisation we have used a number of ways of engaging staff in our vision and values, and on ways to improve performance for the benefit of our patients. At the heart of our Workforce Strategy is staff engagement which we see as more than just good communication. We have therefore concentrated on developing leadership at all levels of the organisation which has enabled the views of staff to be taken into account in our development and performance improvement plans. Our new partnership agreement negotiated with union representatives has further strengthened our work with staff representatives.

18. How did (and for the future, ‘how will’) the organisation ensure effective staff involvement and participation in shaping cultural change and service development and delivery, and embracing social partnership in its broadest sense?

Our strategy has been to ensure our workforce is representative of the communities we serve; we have and will continue to recruit locally recognising the positive impact that employment has on individuals. As a major employer in the area we are well placed to further engage with our communities. We have and will continue to develop our links with local schools and colleges and offer a wide range of work experience opportunities.

19. How has the organisation engaged with (and how will it continue to engage with) clinicians in determining the future direction of service provision, and how have the outcomes of such discussions been analysed from a cost / benefit perspective and integrated in to the service development plans outlines in the business plan (IBP)?

SaSH prides itself on being clinically led and managerially enabled and is pro active in the engagement


and participation of clinicians in agreeing the vision and future direction of future service provision. This has been done at trust wide, divisional and specialty levels in the development of the Clinical Strategy. At a trust wide level the clinical strategic objectives were proposed and developed by the medical director and chief nurse. These were then shared with the divisional chiefs and lead clinicians who developed clinical priorities for their service developments which have been included in the clinical strategy. Each of the individual developments at specialty level were then linked backed to the clinical strategic objectives and the trust strategic objectives so that there was line of sight with how local developments enabled the Trust to meet its overarching strategy. As the strategy was being developed the updated versions were shared with all of the lead clinicians, chief of services and chief nurses so that everyone could see the priorities of others and how everything fitted together across a five year timescale. The priorities were then aligned to other core strategies i.e. estates, workforce which in turn link to the long term financial model. The clinical strategy will be reviewed on an annual basis as part of the annual business planning process. This will ensure that there is on-going engagement with clinicians and that clinically led service developments are reflected in the forward plans for the organisation.

20. How is the Trust developing / managing new (and existing) relationships with local health organisations and other local networks, social care, good citizenship and social responsibility, and playing a role in the wider community?

SaSH plays an active part in the local health economy working with CCGs, County and local authorities. This is evidenced in the part played in the Local Transformation Board, Urgent Care Board, Kent, Surrey & Sussex AHSN, along with a wide range of partnership and clinical and network events and meetings in both Surrey and Sussex along with other Provider and Commissioning organisations. The Trust will continue to engage and with our key stakeholders and with the wider community through the voluntary and community networks.

21. What is the degree of ‘integration’ of first rate HR practice in all the main functions of the organisation (operational, strategic and clinical) – with a view to demonstrating that good HR practice and thinking is present in the wider organisation and not only in the specialist HR function itself

The Trust recognises the importance of good people management skills in the delivery of excellent healthcare care to our patients and the key role that line managers play in supporting, developing and


motivating their teams. A small team of professionally qualified corporate HR staff led by the Director of HR support the Board develop a culture of staff engagement through our Workforce Strategy and ensure that the HR policy framework to support managers and staff is effective. Our Partnership Agreement recognises the importance we place on engaging with our trade union colleagues as we develop our organisation. At the heart of our strategy is the organisational development aspects of staff engagement which we describe in our ‘staff engagement star’. This provides a vehicle for delivering actions within the five themes of:-

Every role counts

Management and leadership

Promoting a health and safe working environment

Supporting personal development

Involvement in decision making Operationally managers are supported by professionally qualified Divisional HR Business Partners who, as part of the management team provide leadership and professional expertise to support their Divisions deliver excellent services to patients through good people management. The Business Partners have developed ‘management guides’ and training which ensures that managers are equipped with the technical skills to interpret and apply the Trusts people management policies and procedures. More importantly they ensure that managers understand fully their key role in motivating, developing and managing their staff. Development of people management skills is also provided as part of our Essentials of Management training for new and aspiring managers in the Trust. Transactional HR advice and support is provided to Managers by our HR Advisory Service through Capsticks HR via telephone and attendance at formal employee relations ‘cases’.

22. How has the organisation demonstrated its commitment to unlocking the potential of all staff and enabling all staff to progress their skills and careers through lifelong learning and development?

The process of learning and development begins before an employee commences with us with development into the role through induction and provision of job related training. Throughout their employment learning and development needs are identified through our performance management and appraisal process. We have developed new roles for assistant practitioners and physicians assistants and will continue to work with staff and managers to develop our workforce to deliver our service development plans.


Appendix 1: GP practices to which the Consultation document was sent NW Sussex

Bewbush Medical Centre, Crawley Bridge Medical Centre, Crawley Coachmans Medical Practice, Crawley Crawley Health Centre Furnace Green Surgery Crawley Gossops Green Medical Centre, Crawley Ifield Medical Practice, Crawley Langley Corner Surgery, Crawley Leacroft Medical Practice, Crawley Pound Hill Medical Group, Crawley Saxonbrook Medical Centre, Crawley Southgate Medical Group, Crawley Woodlands and Clerklands, Crawley Courtyard Surgery, Horsham Holbrook Surgery, Horsham Orchard Surgery, Horsham Park Surgery, Horsham Riverside Surgery, Horsham Rudgwick Medical Centre, Rudgwick The Village Surgery, Southwater The Brow Medical Centre, Burgess Hill The Surgery, Cowfold, Partridge Green Crawley Down Health Centre Cuckfield Medical Practice, Dolphins Practice, Haywards Heath Judges Close Surgery, East Grinstead Lindfield Medical Centre The Meadows Surgery, Burgess Hill Mid Sussex Health Centre, Hurstpierpoint Moatfield Surgery, East Grinstead Newtons Practice, Haywards Heath Northlands Wood Practice, Haywards Heath Ouse Valley Practice, Handcross Parkview Health Partnership, Burgess Hill Ship Street Surgery, East Grinstead Silverdale Practice, Burgess Hill


Surrey Whyteleaf Surgery, Whyteleaf Warlingham Green Surgery, Warlingham Caterham Valley Medical Practice, Caterham Pond Tail Surgery, Godstone Oxted Health Centre Wayside Surgery, Horley Greystone House Medical Practice, Redhill Elizabeth House Medical Practice, Warlingham Chaldon Road Surgery, Caterham Townhill Medical Practice, Caterham Lingfield Surgery Smallfield Surgery Birchwood Medical Practice Health Centre, Horley Moat House Surgery, Merstham South Park Surgery, Reigate Woodlands Road Surgery, Redhill Wall House Surgery, Reigate Rusper Road Surgery, Newdigate Leith Hill Practice, Dorking Hawthorns Surgery, Redhill Holmhurst Medical Centre, Redhill Brockham Surgery North Holmwood Surgery Dorking South Holmwood Surgery Dorking Westcott Street Surgery, Dorking Croydon (public constituency electoral wards) The Moorings Medical Practice, Kenley Mitchley Avenue Surgery, Sanderstead Purley Medical Centre, Purley Keston House Medical Centre, Purley Woodcote Medical Centre, Purley Bramley Avenue Surgery, Coulsdon Downlands Surgery, Old Coulsdon Chipstead Valley Road Surgery, Coulsdon Old Coulsdon Medical Practice The Coulsdon Medical Practice Dr Irfan, Old Coulsdon

Documents

Outcome of Foundation Trust Public Consultation...2 January 2014 Public meeting Harlequin Theatre Redhill 22 7 January 2014 Public meeting Drill Hall Horsham 23 10 January 2014 Public