The Foundation Trust Experiment and UCLH Presentation to

The Foundation Trust Experiment and UCLH Presentation to Civitas 22 nd October 2007 Saturday, March 17, 2018

UCLH context – 7 central London hospitals – Acute local services – Five major tertiary services • • • Neurosciences Cardiac Cancer Women's Health Gastrointestinal – Biomedical Research Centre • 1, 200 R&D projects • R&D budget = £ 300 m – Attendances 600 k p. a. – Turnover c£ 600 m: Saturday, March 17, 2018

UCLH Hospitals University College Hospital, Eastman Dental Hospital, The Heart Hospital, Hospital for Tropical Diseases, Elizabeth Garrett Anderson & Obstetric Hospital, National Hospital for Neurology and Neurosurgery, Royal London Homoeopathic Hospital Saturday, March 17, 2018

Our vision “UCLH is committed to delivering: • top quality patient care • excellent education • world class research Can this vision be better delivered as a Foundation Trust? Saturday, March 17, 2018

Foundation Trusts Political Context Saturday, March 17, 2018

Political comment - Milburn • “The challenge over this next decade is to move power irrevocably outwards and downwards to those using public services…” Alan Milburn Secretary of State for Health (1997 -2002) Saturday, March 17, 2018

What are Foundation Trusts? • NHS plan ‘earned autonomy’ & ‘funding for reform’ • Public benefit corporations, but part of the NHS • A membership of local people and staff • A Board of Governors of patients, staff, and local people (elected by members) + local stakeholders • Freedom to borrow & use surplus cash to reinvest in new services and innovation • Not centrally managed, but regulated by Monitor Source: Foundation Trust Network – The story so far (2007) Saturday, March 17, 2018

Progress Towards FT Status • • April 2004 – 20 First wave FT’s April 2007 – 70 FT’s – 200, 000 staff – 600, 00 members – 1, 000 Governors • April 2008 – 100+ FT’s - 100 non-FT’s Saturday, March 17, 2018

Foundation Trusts Are they delivering benefits? Saturday, March 17, 2018

Delivering Benefits • Better governance, enhanced accountability to patients and the public • Greater focus on patients’ (customers) needs • Strong financial management, improved efficiency and productivity • Freedom to innovate in health care • Higher staff and patient satisfaction Source: Foundation Trust Network – The story so far (2007) Saturday, March 17, 2018

Insider Views “We have to stand or fall by our own decisions. The buck really does stop here. ” Alan Whittle, CEO, Basildon Hospitals FT “We have championed the need for the Trust to listen to and learn from patients. ” Veronica Beechey, Governor, UCLH FT Saturday, March 17, 2018 “We have transformed our drive towards financial efficiency. ” Dr Mary Archer, Chair, Cambridge Hospitals FT “It’s a different world. It’s about developing services to our own prescription. ” Chris Burke, CEO, Stockport FT

Foundation Trusts How do they compare? Saturday, March 17, 2018

Foundation Trusts Delivering improved efficiency % COST BASE EBITDA margin Percent 2006/07 Achieved CIP 3. 0% Pb. R efficiency assumption • 6. 8 2. 5% 2007/08 Planned CIP 2. 9% Pb. R efficiency assumption 2. 5% 1 Saturday, March 17, 2018 2 3 3 AP FY 07/08 Quarters 2 -4 06/07 Quarter 1 07/08

I&E Surplus - 2007/08 Plan Saturday, March 17, 2018

NHS Trusts and Foundation Trusts Use of Resources 2006/7 NHS Trusts Saturday, March 17, 2018

NHS Trusts and Foundation Trusts Use of Resources 2006/7 NHS Trusts Saturday, March 17, 2018 Foundation Trusts

Foundation Trusts Only Use of Resources 20005/6 – 2006/7 FT’s 2005/06 Saturday, March 17, 2018

Foundation Trusts Only Use of Resources 20005/6 – 2006/7 FT’s 2005/06 Saturday, March 17, 2018 FT’s 2006/07

NHS Trusts and Foundation Trusts HCC Quality Standards - 2006/7 NHS Trusts 2006/7 Saturday, March 17, 2018

NHS Trusts and Foundation Trusts HCC Quality Standards - 2006/7 NHS Trusts 2006/7 Saturday, March 17, 2018 Foundation Trusts 2006/7

Foundation Trusts Only HCC Quality Standards Foundation Trusts 2005/6 Saturday, March 17, 2018

Foundation Trusts Only HCC Quality Standards Foundation Trusts 2005/6 Saturday, March 17, 2018 Foundation Trusts 2006/7

“These results endorse our view that with strong leadership and the right freedoms, NHS foundation trusts will deliver improvements for their patients. ” Bill Moyes, Monitor 17 th October 2007 Saturday, March 17, 2018

Foundation Trusts – Should we go further? • FT’s now ‘model of choice’ • Mergers and acquisitions - will FT’s acquire failing NHS Trusts? - who represents customers & shareholders? • Extension of public/private partnerships? • Commerciality and franchising • Will FT’s become a “holding company” with internal/external contracts and JV’s • What can UCLH do? ? ? Saturday, March 17, 2018

Ambulatory cancer centre • New patient focused cancer care • Designed for each cancer specialty • Building planned to start next year Saturday, March 17, 2018

The UCLH campus of the future Saturday, March 17, 2018