Tuesday 18 April 2023

The Foundation Trust Experiment and UCLH

Presentation to Civitas

22nd October 2007

Tuesday 18 April 2023

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 = £300m

– Attendances 600k p.a.– Turnover c£600m:

Tuesday 18 April 2023

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

Tuesday 18 April 2023

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?

Tuesday 18 April 2023

Foundation Trusts

Political Context

Tuesday 18 April 2023

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)

Tuesday 18 April 2023

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)

Tuesday 18 April 2023

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

Tuesday 18 April 2023

Foundation Trusts

Are they delivering benefits?

Tuesday 18 April 2023

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)

Tuesday 18 April 2023

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 transformed our drive towards financial efficiency.”

Dr Mary Archer,

Chair, Cambridge Hospitals FT

“We have championed the need for the Trust to listen to and learn from patients.”

Veronica Beechey,

Governor, UCLH FT

“It’s a different world. It’s about developing services to our own prescription.”

Chris Burke,

CEO, Stockport FT

Tuesday 18 April 2023

Foundation Trusts

How do they compare?

Tuesday 18 April 2023

Foundation TrustsDelivering improved efficiency

EBITDA margin

Percent

AP FY 07/08

Quarters 2-4

06/07

Quarter 1

07/08

•6.8 7.6

6.76.56.5

3

2006/07

2007/08

Achieved CIP

PbR efficiency assumption

Planned CIP

PbR efficiency assumption

2.9%

2.5%

% COST BASE

3.0%

2.5%

1 2 3

Tuesday 18 April 2023

I&E Surplus - 2007/08 Plan

Tuesday 18 April 2023

NHS Trusts and Foundation Trusts Use of Resources 2006/7

1%

34%

32%

33%

ExcellentGood Fair Weak

NHS Trusts

Tuesday 18 April 2023

NHS Trusts and Foundation Trusts Use of Resources 2006/7

1%

34%

32%

33%

ExcellentGood Fair Weak

Foundation TrustsNHS Trusts

87%

10% 3% 0%

Tuesday 18 April 2023

Foundation Trusts Only Use of Resources 20005/6 – 2006/7

53%34%

13% 0%

Excellent

Good

Fair

Weak

FT’s 2005/06

Tuesday 18 April 2023

Foundation Trusts Only Use of Resources 20005/6 – 2006/7

87%

10% 3% 0%

FT’s 2006/07

53%34%

13% 0%

Excellent

Good

Fair

Weak

FT’s 2005/06

Tuesday 18 April 2023

NHS Trusts and Foundation Trusts HCC Quality Standards - 2006/7

NHS Trusts 2006/7

25%

36%

35%

7%

Excellent

Good

Fair

Weak

Tuesday 18 April 2023

NHS Trusts and Foundation Trusts HCC Quality Standards - 2006/7

Foundation Trusts 2006/7NHS Trusts 2006/7

25%

36%

35%

7%

Excellent

Good

Fair

Weak

37%

37%

2%

24%

Tuesday 18 April 2023

Foundation Trusts Only HCC Quality Standards

Foundation Trusts 2005/6

13%

59%

25%

3%

Excellent

Good

Fair

Weak

Tuesday 18 April 2023

Foundation Trusts Only HCC Quality Standards

Foundation Trusts 2006/7Foundation Trusts 2005/6

37%

37%

2%

24%

13%

59%

25%

3%

Excellent

Good

Fair

Weak

Tuesday 18 April 2023

“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 17th October 2007

Tuesday 18 April 2023

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???

Tuesday 18 April 2023

Ambulatory cancer centre

• New patient focused cancer care

• Designed for each cancer specialty

• Building planned to start next year

Tuesday 18 April 2023

The UCLH campus of the future