Agenda item

Angela McNab (Chief Executive, Kent and Medway NHS and Social Care Partnership Trust), and Pippa Barber (Executive Director of Nursing and Governance, Kent and Medway NHS and Social Care Partnership Trust) were in attendance for this item.

(1)       The Chairman introduced the item and welcomed the Committee’s guests. Angela McNab was asked to provide an overview of the Foundation trust (FT) application. Referring to the copy of the presentation Members had before them included in their Agenda pack, attention was drawn to the overarching vision of the Trust and how achieving FT status would enable the Trust to realise this fully.

(2)       It was explained that the Trust’s clinical strategy underpinned all that Kent and Medway NHS and Social Care Partnership Trust (KMPT) undertook and this in turn has been clinician led with heavy user involvement. Four key strands could be identified in the vision. Firstly, stronger community services would enable a more localised service. Secondly, the services would be oriented to recovery. Thirdly, services should deliver quality patient experience. Fourthly, there was the goal to develop flagship specialist services. Forensic services run by the Trust were in the top 3 or 4 in the country. Expanding and enhancing specialist services would enable patients who would have needed to be travel outside of Kent for treatment to be treated at facilities within Kent in the future. Along with this repatriation repatriated to Kent, length of stay would be reduced.

(3)       In terms of the point of the FT process, a number of comments from Members were made about whether it made any difference to the quality of services and whether it was a distraction. It was explained that being granted FT status was a form of accreditation that the Trust was able to achieve high standards in governance and quality of service so that the connection between the two was close. The three key risks to achieving FT status were currently being examined by external assessors. Firstly, there was the need to achieve financial balance and demonstrate financial sustainability. Secondly, the safety of patients was essential. Thirdly, the need to engage staff and develop the organisation was necessary. When asked about the alternative, it was explained that the Trust could not remain as a NHS Trust in the way it was currently. If the FT application was not successful, it was possible that organisations based outside of Kent would take over the running of the services.

(4)       Another difference between FT status and KMPT’s current status as an NHS Trust was highlighted following a question on the Trust’s estate. It was conceded that the Trust had a large number of older properties which were not fit for purpose. These properties could currently only be sold if no other NHS organisation wished to use them. KMPT would be freer to sell properties and reinvest the proceeds with FT status. 

(5)       In addition, being an FT meant it was a Membership organisation. This meant that staff, service users, the public, local authorities and others would be able to directly influence the work of the Trust. There would be 20 public governors, including 4 selected by staff and 2 appointed by Kent County Council. There would also be 2 carer representatives.

(6)       On the subject of carers, there were carers’ fora in East and West Kent and these fed into the patient experience groups. The needs of carers were an important part of the work of the Trust on a day-to-day basis and the assessment of carers needs was carried out in conjunction with social services.

(7)       Mr Peter Lake asked to make a comment to the debate. He explained that he chaired a joint meeting between Kent County Council and KMPT on a regular basis and looked forward to continuing successful partnership working and supported the FT application.

(8)       Members asked a number of questions about the capacity of the organisation to improve. It was explained that on the key indicator for measuring patient satisfaction, the Trust had improved 8% over a year. However, the representatives of KMPT did not have to hand a record of what this was an increase from, though they would be able to provide it. External assessors had recently given a low score on quality and this was a good thing as the lower the score the better. The threshold for achieving FT status had been met on this but the Trust was looking to achieve a 0, which was the highest. On a range of issues raised by Monitor and the Care Quality Commission most had been dealt with and the general direction was improving, though the Trust explained that they were not complacent.

(9)       Clarification was sought over some figures in the presentation and it was clarified that all 8 emerging Clinical Commissioning Groups (CCGs) in Kent and Medway supported the Trust, formal letters having been received from most of them already. There was consensus with the CCGs on the strategic goals, and the local variations sought by them as they commissioned services in the future would become clear. A number of specialist services would be commissioned directly by the NHS Commissioning Board. The Trust did also provide some services beyond Kent, and it was explained that this was additional capacity and was not provided at the expense of any Kent resident. The comment was made that it was unclear who would have the final say over issues and services in the future.

(10)     It was explained that the next step was a board to board meeting with the Strategic Health Authority in early November.

(11)     The Chairman proposed the following recommendation:

·        That this Committee supports the FT bid and looks forward to a further update in 12 months time.

(12)     In response to a question, the Trust undertook to return earlier if there were any issues with the application to discuss.

(13)     RESOLVED that this Committee supports the FT bid and looks forward to a further update in 12 months time.