hw governance event 28th jan slides

Too Flexible or Too Formal?

Exploring community governance in the age of Localism & the Health & Social Care Act

28th January 2012, Action Stations, Historic Dockyard, Portsmouth,

10.00am to 1pm

Welcome

Zoe Gray (Chair) (CEO Learning Links ) James Sandy (Community Engagement PCC) Steve Taylor(Project Officer) (PCC) Amy Drahota, Aging Network Facilitator, UoP Julie Perry, Learning Links Tony Horne ,Strategic Healthcare Projects,UoP

Too flexible or too formalLocal Healthwatch Development Partnership: who are we?

Aims/format of the morning :

To begin to build the governance arrangements for the new local Healthwatch Portsmouth……

Two part event : initially hearing from other organisations to get

us thinking about some of the issues and

Asking you to help us with the design.

Too flexible or too formal?

NHS Organisational landscape post Health and Social Care Act 2012:

Its complicated !

Too flexible or too formal

Context: The big society Agenda aims:

To unleash entrepreneurial spirit Give communities more power Encourage communities to take an active role

in their communities Transfer powers from central to local

government/open government Support cooperatives, mutuals’ charities and

social enterprise.

Too flexible or two formal?

Healthwatch: the new local consumer champion for health and social care

Comes into being from 1/4/13 Seeking to involve patients /users/carers and the wider

public as stakeholders in in health and social care Working on a firm evidence base –gathering local views

on health and social care Engaging with the community and individuals Working with the NHS /LA and all interested others –to

improve care pathways. Inspection powers/rights to visit services to monitor

service delivery


Local Healthwatch (continued)

Individual NHS complaints advocacy

Signposting and advice to help make choices in health and social care


Local Healthwatch is still emergent and lots of unanswered questions e.g.:

It’s a membership body ..but what does this mean?

How does it work with other organisations How does it prioritize a potentially huge agenda How does it really engage and involve the local

community


How will we establish and appoint to the permanent Board i.e. Chair /membership /constitution etc.?

What do we assume are members mandates/roles responsibilities?

Who /should we co opt to the Board ?(eg open invites to relevant stakeholders/partners

Should we establish sub committees /focus groups etc?..etc?etc..?


PDF Who are we?

PDF is a local User Led non political lobbying and campaigning group recognised by Portsmouth City Council and the Primary Care Trust amongst many others as a Consultative Disability Group.

PDF Membership consists of individual

members, members nominated by voluntary organisations, statutory organisations (who have no voting rights) and interested individuals.

What is our legal status PDF is a legally constituted registered

Charity, with a Memorandum and Articles of Association, including a set of standing orders.

PDF is also a Company Limited by Guarantee.

PDF also have a non-legal status as a User Led Organisation.

What are the benefits of a Legal Structure Clarity of purpose and structure Commitment of individuals as

Trustees/Company Directors Recognition by others specifically in terms

of accessing funding The requirement to operate as a business,

professionally and appropriately.

What are the disadvantages of a Legal Structure Reporting responsibilities to the Charity

Commission and Companies House Requirement to operate under all

employment, health and safety laws etc. The impact of government regulations

changes to working hours, holiday requirements, pensions and redundancy.

The Red Tape environment

PDF simple Organisational Structure

PDF TRUSTEE BOARD

PDF CORE STAFF

PDF PROJECTS

FRANK SORRELL CENTRE

PDF PRINCIPLE OFFICER

What is a User Led Organisation (ULO)

There are two fundamental premises for ULOs’ modelled on Centres for Independent Living:

• that their work is underpinned by a social model of disability perspective

• that the organisation’s constituents constitute the majority of the governing and other decision making bodies.

ULO organisational characteristics provides support to enable people to exercise choice

and control is a legally constituted organisation has a minimum of 75 per cent of the voting members on

the management board drawn from the organisation’s constituency

is able to demonstrate that the organisation’s constituents are effectively supported to play a full and active role in key decision-making

has a clear management structure

ULO organisational characteristics (2)

has robust and rigorous systems for running a sustainable organisation (e.g. financial management/contingency planning)

is financially sustainable as there will be no ongoing central government funding

has paid employees, many of whom must reflect the organisation’s constituency

identifies the diverse needs of the local population and contributes to meeting those needs

is accountable to the organisation’s constituents and represents their views at a local level

ULO organisational characteristics (3)

supports the participation of its constituents in designing, delivering and monitoring of the organisation’s services

works with commissioners to improve commissioning and procurement.

What do we do ?

Our Aim is to promote the care, welfare, interest, education and advancement of disabled people their families and personal assistants and their independence and inclusion within the community of Portsmouth and the surrounding areas.

We work with service providers and other disability organisations to ensure that disabled people get the same rights and facilities as everyone else.

How do we do it?

We facilitate consultation with our members

We work in partnership with Portsmouth City Council and other Service Providers

We provide and promote conferences on disability

We inform service providers of preferred delivery of services

We identify the lack of or gaps in services We advise on disability access issues

How do we do it?

We monitor services for good practice

We identify key topics of interest to and for our members in order to incorporate into existing working groups or new groups as required.

We signpost individuals and organisations to other relevant services/organisations

Where do we live ? At our fully accessible Frank Sorrell Centre, with a

conference room, two interview rooms, three accessible toilets, accessible kitchen and ample car park.

PDF has been gifted these premises from the Frank Sorrell Trust which in 1983 opened the building as a Disabled Living Centre.

PDF has had a very productive partnership with the Trust as the way we use the building is in total accord with their original aims, which is why the building has been given to us.

What else do we do? PDF manages the DIAL (Disability Information

Line), which is linked to the national DIAL network.

PDF manages the Shopmobility Scheme running from Arundel Street Portsmouth.

PDF manages the Portsmouth Parent Voice Coordinator, on behalf of a group of disability organisations, as part of the Aiming High for Disabled Children Agenda.

PDF supports the Get Together group which is a version of the Duke of Edinburgh award for people with LDD.

Governance Model at Portsmouth Hospitals NHS Trust

Peter Mellor, Company Secretary

January 2013

04/12/2023

Statutory Duties – 2006 & 2012 Legislation 2012 adds to existing duties

Duty to hold non-executive directors, individually and collectively, to account for the performance of the Board of Directors

Duty to represent the interests of the members of the Trust as a whole and the interests of the public

04/12/2023

Membership

Public, patient /carer, staff constituency 14yrs age minimum Public meetings Vote Public Benefit Corporation Greater say in how services are provided

04/12/2023

Additional Rights and Powers One or more Directors to attend, when required, Council meeting for the purpose of

providing information about the Trust’s performance of its functions or the director’s performance of their duties;

‘Significant transactions’ must be approved by Governors – description/definition of significant transaction can be included in constitution;

Council must approve intention to merge or acquire; Must decide whether the private patient work would significantly interfere with the

trust’s principal purpose; Governors must approve any proposed increase in private patient income of 5% or

more in any one financial year; Amendments to the constitution must be approved by the Council of Governors

Approval needed by at least 50%

04/12/2023

Additional responsibilities for the Trust A copy of the agenda of each meeting of the Trust

Board to be sent to the Council of Governors;

After each meeting of the Trust Board, a copy of the minutes must be sent to the Council of Governors.

04/12/2023

Further non-statutory Duties for Governors To act in the best interests of the trust and to

adhere to its values and code of conduct; To hold the board of directors collectively to

account for performance and ensure that the board of directors acts so that the trust does not breach the terms of its authorisation;

To regularly feed back information about the trust, its vision and performance to the constituencies or stakeholder organisations that either elected or appointed them.

04/12/2023

Board of Directors

At least half of the Board of Directors - Non -Executives

Non-Executive Directors to be member of public or patient constituency

Non-Executive Directors appoint/remove Chief Executive

Register of interests of directors

04/12/2023

Defining structures and processes that work best – decide how best to organise themselves to complete their statutory duties and to support the governance model through changes of Governors;

Council of Governor meetings Joint meetings between governors and directors Subgroups Meeting organisation

04/12/2023

Supporting the delivery of statutory duties – full understanding of what they are – not to seek operational management of the Trust – hold board of directors to account, via the non-executive directors;

Appointment of Chair and NEDs Approval of appointment of CEO Approval of appointment of auditor Setting remuneration of Chair and NEDs Holding Board of Directors to account Communicating with members

Governing the Students’ Union

The overview• Registered charity that is governed separately to the university

• Regulated by the University AND the charity commission

• Funded by the University of Portsmouth (c935,000), commercial trading (c100,000) and membership fees (c260,000)

• Managed by permanent staff and represented by student officers

• Governed by a Board of Trustees – 5 sabbaticals, 3 students, 3 externals, 1 university nominated

• Provides representation, sports, societies, student media, volunteering and a small amount of trading activity

• Turnover of about £1.7M

Some engagement statsActivity 2008/09 2010/11 2011/12

Athletic Union memberships 4,128 2,850 2,959

Athletic Union clubs 48 34 35

Societies memberships 3,178 3,767 3,503

Societies 68 90 90

Student media volunteers Not measured 1,121 (sign-ups) c250 contributors

Community volunteers Not measured 222 384

Community volunteer hours Not measured 4,056 4,991

RAG money raised Not known 26,031 73,000

Election turnout 2,657 4,122 5,027

Unique visits to UPSU.net during October Not known 28,798 44,447

Student satisfaction 64% N/A 76%

Our vision“A positive impact with

every Portsmouth student”

Our strategic themes 2011 - 14Innovation & growth

The local community

Stakeholders Finance & resources

Quality

Our valuesInclusivity Member

focusStudent leadership

Honesty CourageTransparency

Who runs the Union?• Student officers are the face and voice of the organisation

• Union services managed by permanent staff

• Political leadership = President

• Operational leadership = Chief Executive

• The Board of Trustees set strategy and provide the Chief Executive with work plan and budget

• Students set policy via general meetings and student council

• The Board of Trustees is the most senior authority

Organisational model

Uni

on D

emoc

racy

Stud

ents

/

mem

bers

Refe

rend

a /

Elec

tions

Gen

eral

Mee

tings

Stud

ent C

ounc

il

Sabb

atic

al O

ffice

rs

Pres

iden

t

Union G

overnance

Board of Trustees

Sub Comm

ittees / PSUT

Board

Deputy Chair of the

Board

Chair of the Board

Union Operations

Chief ExecutiveSenior Management Team

ManagersCoordinators / Front line

staff

The Trustees hold management to account, performance

manage the Chief Executive, scrutinise the operational work of the Union and act as guardians

of the Union’s vision and values

The democratic structures inform and guide the operational work of

the Union, elect the sabbatical officers and the Chair of the Board. The democratic structures pass

policy that provides the boundaries within which the Union’s work is

carried out.

The Trustees are ultimately accountable for everything that happens in the Union; they are responsible for upholding the law and overseeing management. The democratic structures are responsible for

setting the policy framework within which the Union operates.

A balance between Governance and Information

The Board satisfy themselves that they have the right tools to govern effectively. These include:

• A defined scope of delegation for operational activities• An annual agenda cycle for Trustees business• A range of sub-committees to scrutinise and oversee high risk areas

The Board also receive information that provides context to decision-making and a better idea of the impact they have. This includes:

• An annual cycle of presentations from Union departments / activities• Annual satisfaction survey reports from beneficiaries, funders and staff

How do beneficiaries influence the organisation?

• Students influence the Union both formally and informally, to ensure that we remain student led

Formal

• 8/12 of our Board are students• Over 5,000 students vote in our elections to choose our 5 sabbatical officers• Student Council• General Meetings• Annual Members Meeting• Referenda• Student Committees

Informal

• Regular satisfaction surveys• Feedback through our services• Participation rates in our activities and services• Talking to us!

Examples of ‘bottom-up’ change

• Creation of the ‘DCC’, gender neutral toilets, using locally sourced fish within the whole University,

Satisfying funders vs. satisfying beneficiaries

We have sometimes found that a tension can exist between these stakeholders

Can funders and beneficiaries objectives be aligned?

Can you satisfy both?

Are they mutually exclusive or not?

‘Like a partnership between a cat and a mouse’?

Questions?

From April 2013

AdvocacySignpostingAdvice

Health & Wellbeing BoardRight of entry

RepresentEmpowerInform

Healthwatch

A responsibility for NHS health care

and social servicesFacilitate and

influence consultation

Specific Enter & View Powers

Abolished April 2013

Local Involvement Networks (LINk)

“a new system of patient and public

involvement in health for England

involving traditionally hard to

reach groups"

CPPIH recruited members to the

Forums

Abolished in 2008

Public & Patient Involvement Forums

Local Authority representatives, nominees from local Third Sector bodies and members appointed by the Minister in response to advertCo-opt non-voting members to the Council.Abolished in 2003 (in England)

Community Health Councils

Evidence & Research

Governance & Membership

Outreach & Intelligenc

e

Healthwatch

Portsmouth (HWP)

HWP Governance Model (A)

Signposting

3 Deliver

y Partner

s

Health & Wellbeing

Board

Healthwatch Network Members

Healthwatch Community Researchers

Healthwatch Governors

HWP Board•Corporate body•Oversees “Enter & View” powers•Commissions ad-hoc research groups•Represents HW

Advocacy

Public involveme

nt

3 Service

User Groups

4 Elected Govern

ors

1 Rep

Healthwatch

Portsmouth (HWP)

HWP Governance Model (B)

Signposting 3

Delivery

PartnerAdvisor

s

Health & Wellbeing

Board





Advocacy

Public involveme

ntMembership

Elects

7 Govern

ors

1 Rep

Healthwatch

Portsmouth (HWP)

HWP Governance Model (C)

Signposting

3 Deliver

y Partner

Health & Wellbeing

Board





Advocacy

Public involveme

nt

Membership “Senate” of 10

Governors

5 Membe

rs

1 Rep

2 Reps

Local Healthwatc

h

Community Intelligence

Strategic Direction

Public Scrutiny

HW Engla

nd

CQC

Health & Wellbeing

Board

Health Overview &

Scrutiny Panel

NHS NCB

Signposting

Advocacy & Complaints

Public & User Involvement

Strategic Commissioning Board

PCC/Public Health/CCG

City wide organisations

Democratic Challenge

Policy development

Task group investigation

Enter & View Powers

Information & Attendance Powers

Cross Referral

Sec. Stat

e

One Seat

hw governance event 28th jan slides

Health & Medicine

local user

local level

organisations services

pdf membership

byvoluntary organisations

new local consumer champion

toimprove care pathways

primary care trust amongstmany