EAST AND NORTH HERTFORDSHIRE NHS TRUST

CHIEF EXECUTIVE’S REPORT

30th March 2011

Chief Executive’s Overview The Executives attention this month has very largely been focused upon the need to ensure delivery of the Trust’s major strategic change programme “Our Changing Hospitals”. At the time of writing the Trust is still awaiting approval from the Department of Health and the Treasury for the Outline Business Case for Phase 4 of this programme. This phase enables the Trust to complete the reconfiguration of acute services on to the Lister site and achieve the substantial quality improvement and financial benefits associated with the programme. In order to mitigate the risk of delay to the programme and its associated benefits the Trust Board has, with the support of NHS East of England, been running a number of project management activities at risk. If the Trust Board had not taken this action the Trust would now be facing a delay in the completion of its reconfiguration and a consequent loss in revenue savings of approximately £600k per month from September 2013. In the absence of confirmation of OBC approval the Trust Board will need to consider for how much longer it is able to mitigate the risk of delay. This matter has been discussed at the Finance and Performance Committee on 23rd March and will be discussed further in Part 2 of this meeting. I am disappointed to report that following recent review meetings held between the Department of Health, NHS Hertfordshire and Clinicenta, at which the Trust has also been present, a decision has been reached that the Lister Surgicentre is not ready to provide services to patients from 18th April 2011, as planned. The decision means that the planned changes to the surgical services remaining with the Trust will also be delayed as these can only happen after the Surgicentre begins to treat patients. This is a particular concern as there are a number of quality benefits that will result from these changes. In the meantime, the Trust is continuing its work with Clinicenta and NHS Hertfordshire to progress plans towards delivering fully this new service as soon as possible. The Trust will continue, of course, to do everything it can to make a positive contribution to these discussions as and when it is asked to do so. Through our project team, we will also work to keep all staff affected by these changes informed as to what is happening as and when further information becomes available. Progress towards mobilisation of the Surgicentre has been discussed at the Finance and Performance Sub-committee and will be discussed further in Part 2.

NHS Hertfordshire has produced its Stage I Outline Business Case for the new QE2 hospital. It is crucial to the Trust that the new QE2 opens on schedule at the end of 2013 if the service and financial benefits of the Our Changing Hospital programme are to be achieved. I have written a letter of support for the OBC to Jane Halpin, Chief Executive of NHS Hertfordshire and have stressed the Trust’s desire to work collaboratively with NHS Hertfordshire to ensure that the new facility provides all of the appropriate services and constitutes the best possible value for money. This issue was discussed in some detail at the Finance and Performance Committee held on 23rd March and a more detailed paper is to be discussed in Part 2 of this meeting. The Our Changing Hospitals programme has to be about more than major capital investment if the Trust is to achieve its objective of “being amongst the best”. The Our Changing Organisation programme has been established to focus the Trust upon the need for a changed organisational culture which emphasises the central importance of an engaged workforce focused upon ensuring the satisfaction of our stakeholders. The work of the Our Changing Organisation Steering Group will be discussed in Part I of this Board meeting. Today’s Trust Board meeting will consider the Trust’s Annual Plan for 2011/12 which captures the Trust’s strategic objectives and finance and service plans for the forthcoming year. The annual Plan has already been discussed at Executive Committee, a Board “awayday”, the Finance and Performance Sub-committee and the Risk and Quality Committee. The Trust’s Foundation Trust application has been supported by NHS East of England and sent to the Department of Health Technical Committee and formal feedback is awaited. As part of the technical review process the DH will be considering the strategic changes outlined earlier in this report. In Part 2 of this Board meeting the Trust Board will be appraised of a tripartite agreement signed by Ian Dalton, Director of Provider Development at DH, Sir Neil McKay, Chief Executive of EoE NHS and myself. This confirms the Trust’s commitment and timescales for achieving Foundation Trust status by 2014. The Trust is making very good progress with NHS Hertfordshire in negotiating the 2011/12 contract. Many of the planning assumptions have already been agreed either through the Trust’s Long Term Financial Model (LTFM) as part of our FT application or through the agreement of the county-wide QIPP programme. There are however a small number of outstanding issues which are detailed in the Financial Plan 2011/12 paper in Part I of this agenda. Sue Greenslade, the Trust’s Director of Nursing is leaving the Trust to take up an opportunity with the Royal College of Nursing with effect from 28th March 2011. Sue has been with the Trust for 2½ years and her achievements have been important in enabling us to prepare for the next stage of our NHS Foundation Trust application, as well as the completion of the Trust’s Our Changing Hospitals programme. Sue’s contributions, therefore, have been of great value and I am sure that Board members will wish to join me in wishing her every success in her new role at the RCN.

Philippa Davies will be acting up as the Trust’s Director of Nursing whilst an external recruitment process is undertaken. The Board may be aware of recent recruitment activities within the operational team.The team have been successfully covering significant shortfalls in recent months. I am pleased to confirm that successful appointments have been made to six of our senior leadership positions, including development for three internal candidates. Further Information Trust's End-of-Life Care Campaign Launched 10 March 2011 Sometimes the experience of people with a life-limiting condition and who are in the final stages of their illness, is that they are admitted to, and end up dying in, hospital. With the right documentation in place, they could instead have died at home with their loved ones. Now a new multi-agency Message in a Bottle campaign, which is being led by the Trust, aims to help such people realise this wish. The Trust’s Message in a Bottle campaign was launched on 10 March 2011. This enables patients to keep a summary sheet in a special plastic container, explaining about the documentation and where it is kept. These containers, which are normally found in a person’s fridge, are already very familiar to healthcare professionals as they have been in use for some years to support people with a wide range of medical conditions. While a more active approach to supporting people coming to the end of their life – called Advance Care Planning – is becoming increasingly common within the NHS, the Trust is the first regionally to use the containers for this purpose. The Trust’s palliative care team, which covers east and north Hertfordshire, as well as parts of Bedfordshire, will see an average of 210 new patients every month. Public Member Engagement The Trust has greatly exceeded its 2010/11 target of gaining the support of 8,000 residents of the community as public members, with almost 10,000 local people now public members. Members are invited to participate in the development and improvement of Trust services by taking part in events such as the successful 'Delivering Maternity Services for the Future' afternoon held in WGC on Wednesday 23 March. The event was held by the Trust to showcase the developments in maternity services underway; highlighting to our public members and other invited stakeholders the changes taking place in Maternity services. A programme of events offering members the chance to hear about and contribute to the delivery of hospital services is run throughout the year through the Trust's Membership Team. More information can be obtained by emailing ftmembership.enh-tr or calling 01438 781846.

Final meeting of the Trust's Patients' Panel The Chairman attended the final meeting of the Trust's Patients' Panel on 14 March. The Panel has contributed to a range of consultations and initiatives and has been a valuable source of feedback and challenge for the Trust. The work undertaken by the Panel is to be integrated into the Trust's membership engagement activities and the

majority of panel members have already become public members. I would like to publicly acknowledge the role of Lizzie Conder who has chaired and led the Panel since its inception. Her commitment and wise contribution has been immensely valuable and I am grateful to both Lizzie and her fellow panel members for the support and commitment that they have shown over the last seven years. Elections for East & North Hertfordshire GP Pathfinder Consortium Board The elections of 5 locality leaders making up the East and North Hertfordshire GP Pathfinder Consortium Board have taken place Dr Tony Kostick has been selected as interim chair. Dr Kostick has significant previous experience as clinical executive committee Chair of NHS Hertfordshire and we look forward to working with him in his new role. Please refer below for the full list of GP Locality Leaders.

North Herts: Dr. Martin Hoffman, Chair Dr Rob Graham, Vice Chair South Dr Mohammed Hossain ,Chair Dr Alison Jackson,Co Vice Chair Dr Vivienne Emmett, Co Vice Chair

Stevenage: Dr. Tony Kostick, Chair Dr Prag Moodley, Vice Chair WelHat – Dr. Hari Pathmanathan, Chair Dr Peter Shilliday, Co Vice Chair Dr John Constable, Co Vice Chair West & Central Dr Nicky Williams, Co Chair Dr Mark Andrews, Co Chair

Nick Carver 30th March 2011