OUTCOME REPORT June 2013

Foundation Trust Consultation

Executive Summary

St George‟s Healthcare NHS Trust consulted on proposals for becoming a Foundation Trust between 1 February and 26 April 2013.

We contacted more than 10,000 people by post, email, online, and face to face on trust premises and at 35 internal and external meetings.

More than 500 individuals and 23 organisations responded formally, either in writing or by completing our consultation questionnaire. The questionnaire contained seven questions on the specifics of our proposals, all of which received the support of more than two-thirds of respondents.

We are delighted with the overwhelming support for our proposals and the level of engagement with the consultation. We have received a number of important comments, all of which have been carefully considered.

As a result, we are making two substantial changes to our proposals:

We now propose to reallocate the number of Governors from each constituency roughly in proportion with trust income from each area.

This measure will increase the number of Wandsworth-based Governors from four to six and reduce the number elected from the regional or „rest of England‟ constituency from six to four which will keep the total number of public governors at 15. Merton and Lambeth will elect the same number as originally proposed, four and one respectively.

We also propose to increase the number of staff governors from four to five, adding a new constituency representing those working in community services.

We believe that the consultation process has been robust and successful, reaching all of our target audiences, including stakeholders, staff, patients, carers and the general public. This is reflected in the number of responses we have received from our three local boroughs and from further afield (the regional constituency), which is very closely proportionate to the number of members we have recruited from those four areas.

We now have three further steps to take:

Feed back to those who took part in the consultation and communicate the results to all interested parties. Submit our application to become a Foundation Trust to Monitor. Hold governor elections among staff and our members and discuss with the eight organisations who will appoint Governors, the exact process for this.

We hope for a successful outcome to our application and look forward to becoming a Foundation Trust early in 2014.

We are confident that the governance arrangements we will put in place will ensure that, as a Foundation Trust, we can build on our recent successes and continue to provide high quality healthcare to the communities which we serve.

Contents page

Introduction 4

1. Background a. Name of applicant Trust 5 b. Area served by the Trust 5 c. Contact details 5 d. About the public consultation 6

2. Communications a. The consultation documents 7 b. Public meetings 7 c. External consultation sessions 8 d. Meetings with key stakeholders 8 e. Staff engagement 9 f. Foundation Trust information stands 9 g. Letters to stakeholders 10 h. Other communications 10

3. Results a. Visitors to the website 11 b. Responses received 11 c. Formal responses 12 d. General tone of comments 13 e. Main topics attracting comment 13 f. Detailed questionnaire responses 15

4. Response a. Our proposals 17 b. Feeding back 19

Introduction

This report describes the process and outcome of the formal consultation process run by St George‟s Healthcare NHS Trust, on our proposed membership and governance arrangements for becoming a Foundation Trust.

Engagement with patients, staff and other stakeholders has been a key feature of the application process and this report demonstrates that:

Robust public consultation has been undertaken Staff and stakeholder involvement has been actively sought The consultation process and results have resulted in changes to proposed governance arrangements

Key issues: These are the key issues that lie at the heart of this public consultation.

Our mission, vision and priorities Membership of the trust Composition, constituencies and elections to the Council of Governors

1. Background a. Name of applicant Trust:

St George‟s Healthcare NHS Trust b. Area served by the Trust

Our main site, St George‟s Hospital in Tooting - one of the country‟s principal teaching hospitals - is shared with St George‟s, University of London, which trains medical students and carries out advanced medical research. St George‟s Hospital also hosts the St George‟s, University of London and Kingston University Faculty of Health and Social Care Sciences, which is responsible for training a wide range of healthcare professionals from across the region.

As well as acute hospital services, we provide a wide variety of specialist care and a full range of community services to patients of all ages. These services are provided from Queen Mary‟s Hospital, Roehampton, one of the largest community hospitals in the country and home to the world famous Douglas Bader amputee rehabilitation centre, and health centres across Wandsworth, GP surgeries and in patients‟ own homes. We are also responsible for providing and coordinating health services at Wandsworth Prison.

The trust is both a local provider of services (to about 500,000 residents in Wandsworth and Merton) and a regional and national provider of tertiary and specialist services, such as cardiothoracic medicine and surgery, neurosciences and renal transplantation, to south west London, Surrey and beyond (about 2 million people).

We also provide care for patients from a larger catchment area in south east England, for specialties such as complex pelvic trauma. Other services treat patients from all over the country, such as family HIV care and bone marrow transplantation for non-cancer diseases. We also provide a nationwide state-of-the-art endoscopy training centre.

A number of our services are members of established clinical networks which bring together doctors, nurses and other clinicians from a range of healthcare providers working to improve the quality of services for patients. These include the South London Cardiac and Stroke Network and the South West London and Surrey Trauma Network, for which St George‟s Hospital is the designated heart attack centre, hyper-acute stroke unit and major trauma centre.

We aim to be the provider of choice for all of our patients, whether they are local people or from outside south west London receiving our specialist services. c. Contact details of person responsible for the consultation

Peter Jenkinson Director of Corporate Affairs St George's Healthcare NHS Trust Blackshaw Road Tooting London SW17 0QT Tel: 020 8725 3897 Email: [email protected]

d. About the public consultation

Dates of public consultation

Started Finished Friday 1 February 2013 Friday 26 April 2013

2. Communications a. The consultation documents

7,000 copies of the full consultation document in hard copy, distributed to members, community groups, staff, stakeholders and to the general public o This document included a hard copy of the questionnaire in postcard form to be filled in and returned to the Freepost address pre-printed on the reverse of the form 15,000 Foundation Trust summary leaflets with basic information on the consultation and information on how to get more information and take part Online full consultation document and further information Online feedback / reply form Powerpoint presentation used at all events Reminder letters and emails to all public members of the Trust

The consultation document was distributed to partner and stakeholder organisations, as well as to public members of the trust, and to staff.

Documents were sent out as hard copy to our key stakeholders, with a covering letter. Other local partners and groups were also targeted by email. Our staff were informed by email, through online content and through staff communication channels including a newsletter and email newsletters.

More than 250 external organisations were contacted to invite them to respond formally to the consultation (see Appendix 2). b. Public meetings We organised a series of Foundation Trust consultation public meetings at the following locations. At each of these events our presentation was delivered by either the Chief Executive or our Director of Corporate Affairs and was attended by a communications team member.

Venue Number of attendees Monday 11 February, 1-2pm Michael Heron Lecture Theatre, 1st floor, Hunter Wing. 35 St George‟s Hospital, Tooting. Tuesday 19 February, 6-7pm Barnes and Richmond Rooms 13 Queen Mary‟s Hospital, Roehampton. Thursday 7 March, 1-2pm Michael Heron Lecture Theatre, 1st floor, Hunter Wing 32 St George‟s Hospital, Tooting. Tuesday 2 April, 1-2pm Barnes and Richmond Rooms 26 Queen Mary‟s Hospital, Roehampton Wednesday 3 April, 6-7pm Michael Heron Lecture Theatre, 1st floor, Hunter Wing 42 St George‟s Hospital, Tooting.

We publicised these public meetings in the consultation document and with posters and leaflets across the trust estate. Display adverts were published in local authority newsletters and in the local press, to ensure that we reached as wide an audience as possible.

We also targeted specific groups of members with emails. Through our membership database we were able to email or write to all those members living in the postcodes close to Queen Mary‟s Hospital in Roehampton inviting them to attend. For the second meeting at St George‟s, we contacted all those members who had attended a members‟ event at St George‟s but had not attended the first meeting on becoming a Foundation Trust. These efforts were successful in attracting people to the events and, at these formal consultation events we spoke to 148 people, patients, public, carers, staff and the general public.

The meetings took the form of a 30-45 minute presentation followed by a question and answer session. The question and answer sessions were lively and a large proportion of the attendees raised issues on all aspects of the proposals and these are reflected in section 3.e below. c. External consultation sessions

The following meetings were held with community groups and others:

Group Date Colliers Wood Residents Association 5 March Wimbledon Labour Party 25 April Roehampton Limb Users Group 17 April The Roehampton Forum 8 March Merton Seniors Forum 10 April d. Meetings with Key stakeholders

The following meetings were held with key stakeholders

Group Date Wandsworth Council, Health Overview and Scrutiny 22 April Committee Patient Reference Group 14 February Merton Health and Wellbeing Board and Merton Healthier 17 April Communities and Older People Overview and Scrutiny Panel Lambeth CCG 15 April Merton Council open forum 17 April Croydon CCG 4 February Kingston CCG Governing body 5 February Wandsworth CCG Management team 6 February Merton CCG 7 February Merton CCG 26 February Richmond CCG membership group 20 March Merton CCG Governing Body 21 March Surrey Downs CCG 12 April Wandsworth LINk executive 26 April

e. Staff engagement

Group Date IT department meeting 25 March Trust new staff induction 23 April Trust new staff induction 9 April SGUL Academic Forum 26 March Diagnostics Directorate meeting 15 March Trust new staff induction 18 March Trust new staff induction 6 March Staff Side AGM 28 February Radiology department meeting 13 February Trust volunteers meeting 5 March Matron‟s Forum 7 February Nursing Board 7 February f. Foundation Trust information stands

We held information stands in the main reception areas of our three major sites throughout the consultation. The stands included posters and banners promoting the consultation and were staffed by Trust staff and volunteers who handed out the consultation leaflets and documents, approaching passers by (staff, patients and visitors) to explain the consultation and encourage people to take part. During these events we also signed up a number of new members.

The information stands were held late morning and early afternoon, during the busy lunch time period at the hospitals in order to maximise the number of people we were able to talk to.

Across these 15 events we distributed an estimated 1,100 leaflets. We estimate that we spoke in some detail and handed full consultation documents to more than 500 individuals and recruited more than 100 new members.

4 February St George‟s Hospital, Main Reception – 10am to 2pm 11 February St George‟s Hospital, Main Reception – 10am to 2pm 18 February St George‟s Hospital, Main Reception – 10am to 2pm 25 February St George‟s Hospital, Main Reception – 10am to 2pm 27 February Queen Mary‟s Hospital, Lobby area – 11am to 1pm

04 March St George‟s Hospital, Main Reception – 10am to 2pm 06 March St John‟s Hospital, Main Reception – 11am to 1pm 11 March St George‟s Hospital, Main Reception – 10am to 2pm 18 March St George‟s Hospital, Main Reception – 10am to 2pm 20 March Queen Mary‟s Hospital, Lobby area – 11am to 1pm 25 March St George‟s Hospital, Main Reception – 10am to 2pm

08 April St George‟s Hospital, Main Reception – 10am to 2pm 10 April Queen Mary‟s Hospital, Lobby area – 11am to 1pm 15 April St George‟s Hospital, Main Reception – 10am to 2pm 22 April St George‟s Hospital, Main Reception – 10am to 2pm

g. Letters sent to additional stakeholder groups

At the opening of the consultation we wrote to all stakeholders and other interested parties inviting them to take part in the consultation and enclosing a copy of the consultation document. 1,600 copies of the document were distributed in this way. A full list of the individuals and organisations we contacted is included in Appendix 2. h. Other communications

Paid-for adverts promoting the consultation appeared in a range of newspapers and other publications (see Appendix 1) The public consultation was promoted throughout on the trust‟s Twitter and Facebook accounts Articles in staff and public publications and e-newsletters produced by various partner organisations Our trust magazine Gazette was also used to publicise the consultation. This is sent to all public members of the trust, as well as local GPs, and many hundreds of copies are distributed throughout the Trust estate for staff and general public to see, and at events eG is our weekly all staff email newsletter and included an article on becoming a Foundation Trust in each of the twelve weeks of the consultation.

3. Results a. Visitors to the website

Our main Foundation Trust consultation page received more than 8,000 visits during the period of the consultation averaging roughly 100 visits per day. There was an initial peak of activity in the first few weeks during which time we were regularly receiving 200 visits per day. Activity then settled down to near the daily average for the rest of the consultation period until the last couple of weeks when the number of visits rose again to around 150 visits per day.

The full consultation document in pdf form on the website was viewed more than 5,000 times. b. Responses received

The number of responses to the consultation received by the closing date of Friday 26th April is detailed as follows:

Responses received Number Online 354 Hard copies of questionnaire returned in person or by post. 155 Total questionnaire responses 509 Other responses 11 Overall total 520

The questionnaire response form did not ask for any demographic data from respondents other than name and address, however there was a tick box for respondents to indicate if they are a member of the trust. Therefore, in many cases we were able to identify respondents on our membership database for both staff and public members of the trust.

Of the 509 questionnaire responses, 136 (roughly one third) could be identified from our membership database as public members of the trust. For these respondents, using the membership database we can identify which of the four public constituencies (Wandsworth, Merton, Lambeth and the regional constituency) they reside in.

This showed that, assuming these 136 respondents are representative of all of those who took part, we gained responses roughly in proportion to the numbers of members we have in each constituency although, by small margins, Merton is over-represented and Wandsworth and the regional constituency under-represented.

Constituency % of membership % of respondents difference Wandsworth 33.91 31.85 -2.06 Merton 27.20 31.85 +4.65 Lambeth 03.79 04.44 +0.65 Regional 34.65 31.11 -3.54 Constituency

c. Formal responses

A list of the formal written responses received from, or on behalf of stakeholders.

Organisation Type General tenor of response Merton CCG Commissioner Supportive. London Borough of Local Authority Supportive except for the proposed representation of Wandsworth, Health public members in Wandsworth on the Council of Overview and Scrutiny Governors. Committee London Borough of Local Authority Mixed, concerned at representation of Sutton residents Sutton within the regional constituency. London Borough of Local Authority Positive other than a call for more staff governors and Merton, Health and the age for becoming a governor is raised to 18. Wellbeing Board London Borough of Local Authority Positive other than lack of direct representation for Richmond upon residents of Richmond other than through the regional Thames constituency. St George‟s Healthcare Staff The staff side response is, in principle, opposed to NHS Trust, Staff Side Foundation Trusts as a matter of national policy. On our specific proposals, they suggest a larger number of staff governors. St George‟s University Partner Positive. of London organisation Wandsworth Healthwatch Positive other than feeling that Wandsworth is under Healthwatch represented on the proposed council of governors. Kings Health Partners Partner Positive. organisation Headway South West Patient Group Supportive and would like to be involved in planning London care for people with brain injury. Roehampton Limb Patient Group Generally supportive but concern over number of staff Users Group governors and possible threats to the amputee service at Queen Mary‟s Hospital St George‟s Maternity Patient Group Supportive other than maternity input to the council of Forum governors as “LINk does not cover maternity services.” St George‟s Kidney Patient Group Supportive. Patients‟ Association Federation of Disabled Patient Group Supportive, though they would like more detail on the People younger persons‟ forum. St George‟s Patient Group Supportive other than minimum age of governors. Continence Group Cardiac Exercise Club Patient Group Supportive. Macmillan Cancer Patient Group Supportive. Support Merton Residents Community Supportive with some reservations and disagreement Health Forum Organisation on age for membership and governorship. Caribbean Hindu Community They were supportive of our application and added that Association Organisation they would like a Hindu chaplain at the hospital. Wandsworth Older Community Supportive other than representation of Wandsworth Peoples‟ Forum Organisation and community services on council of governors. Yew Tree Lodge Community Supportive with some reservations. Residents‟ Association Organisation Keep the NHS public Campaigning Supportive other than disagreement on age for Organisation membership and governorship and worries about future private provision.

d. The general tone of comments and responses received

The general tone of comments received was extremely positive, with a range of constructive suggestions that were supportive of our intentions. On a number of issues there were negative comments, or questions asked. These are detailed below. e. Main topics attracting comment

The issues raised in comments on the questionnaire and in our public and other meetings can be broadly categorised as follows:

1. How to include the views of young people (366* comments).

In the questionnaire there were three questions on involving young people in the Foundation Trust. These were our proposals for the age at which people are eligible to become members (14) and to become a governor (16), and our proposal for a younger persons‟ forum.

These three issues taken together received 366 comments. The comments received on our proposed age limits were 80% in favour of higher age limits, typically 16 to become a member and 18 to become a governor though roughly half suggested ages higher than this or did not specify with comments such as “Too young”.

The remaining 20% of comments on age limits were positive and in favour of our proposals.

Our proposals for a younger persons‟ forum provoked 78 comments split roughly half and half between those who welcomed the idea and those who were sceptical that young people would want to be involved, questioned why younger people in particular should be given this extra opportunity for involvement or were dubious as to the value such a forum would add to the running of the trust.

2. The composition of the Council of Governors (141 Comments).

The questionnaire asked if respondents agreed with our plans for public constituencies and our proposals for the Council of Governors. The smaller number of these (13) concerned the proposed stakeholder governors, some questioning the inclusion of the proposed stakeholder governors, some suggesting additional stakeholders and there were questions about the process of appointing these Governors.

61 comments were received regarding the number of staff governors with well over 90% of these calling for the proposed four staff Governors to be increased. There were a few questions on the allocation of governors between the different proposed staff constituencies.

The largest number of comments (67) concerned our plans for public Governors and the constituencies from which they will be elected.

A number of comments were made calling for specific representation from local boroughs which are proposed to form part of the regional constituency. These were Richmond (2 comments), Croydon (2), Sutton (5) and Kingston (1).

On the boroughs which are part of the proposals six comments were received calling for greater representation for Wandsworth. Three comments were received calling for more representatives from Merton, and one calling for fewer. For Lambeth there were four comments saying that the proposed number of governors for that borough is too low, and four saying it is too high.

The largest number of comments (15) concerned the regional constituency and all of these stated the view that we are proposing too many Governors to be elected from this constituency.

3. Governance structures.

65 comments were received on the role of Governors and the Council of Governors, not including those listed above commenting on its composition and election. These comments ranged across a number of themes, chief of which were comments on the size of the Council of Governors, proposed to be 27. 13 respondents commented that they saw this is potentially unwieldy, costly and slow in making decisions.

The skills and experience of Governors and the support they will need (particularly public governors) to fulfil their role fully was questioned through 8 comments.

The proposed length of a term of office as a governor and the number of terms which can be served was raised by 10 respondents and there were 10 comments on the Council‟s relationship with the Board of Directors.

There were also small but significant numbers of people who expressed worries that: -

These are all very good ideas but implementation will be the real challenge (48). Our membership may not be representative of the communities we serve (34). Foundation Trust status will lead to privatisation (20) Community Services have been overlooked in the proposals (18) They are not convinced of the merits of Foundation Trusts (12)

* the number of comments listed throughout the section above is not necessarily the number of individuals who commented, many people commented on the same issue, or range of issues more than once in their questionnaire response.

f. Detail of questionnaire responses

Question 1. Question 1 Do you agree with the priorities we have 8.1% set to help us achieve our vision?

496 of the 509 individual respondents answered with 456 saying “yes” and 40 saying “no”. 91.9% Yes No

Question 2. Question 2 Do you agree with our plans for public 5.9% membership?

472 of the 509 individual respondents answered with 444 saying “yes” and 28 saying “no”.

94.1% Yes No

Question 3. Question 3 Do you agree with our plans for public 15.5% constituencies?

453 of the 509 individual respondents answered with 383 saying “yes” and 70 saying “no”. 84.5% Yes No

Question 4. Question 4 Do you agree with our proposals for the 30.9% minimum age of members?

453 of the 509 individual respondents answered with 313 saying “yes” and 140 saying “no”. 69.1%

Yes No

Question 5. Question 5 Do you agree with our proposals for the minimum age of governors? 31.0%

449 of the 509 individual respondents answered with 310 saying “yes” and 139 saying “no”. 69.0%

Yes No

Question 6. Question 6 5.7% Do you agree with our proposals for a younger persons’ forum?

439 of the 509 individual respondents answered with 414 saying “yes” and 25 saying “no”. 94.3% Yes

Question 7. Question 7 Do you agree with our proposals for the 13.3% Council of Governors?

430 of the 509 individual respondents answered with 373 saying “yes” and 57 saying “no”. 86.7% Yes No

4. Trust response a. Our proposals

1. Public Governors. Our initial proposal, based on patient numbers was for the 15 public Governors to be made up of: 4 from Wandsworth 4 from Merton 1 from Lambeth 6 from the regional constituency

This proposal attracted a lot of comment with many stating that they thought the regional constituency has too many representatives. Many also stressed the role of St George‟s as a local trust, based in Wandsworth and suggested that more public governors should be elected from the Wandsworth constituency. A formal response was received from the London Borough of Wandsworth adult care and health overview and scrutiny committee stating that:

“There is disappointment that compared with the previous application, the Trust appears to have made a decision to strengthen the position of Merton within the governance structure at the expense of Wandsworth, despite Wandsworth’s position as the host borough and having a large proportion of the Trust’s catchment population living in the Borough.”

Therefore we propose to amend the numbers of public Governors by increasing the number elected from the Wandsworth constituency by two, and reducing the number elected from the regional constituency by two also. This will give the following make up of the public governors:

6 from Wandsworth 4 from Merton 1 from Lambeth 4 from the regional constituency

The original proposals allocated governors roughly in line with the number of patients treated by the trust from each of the constituencies. This new proposal allocates governors roughly in line with the percentage of trust income from each of the constituencies as detailed in the table below.

Constituency Electoral Wards Population % of Trust Number of income governors

Wandsworth Whole Borough 300,000 40% (including 6 community services) Merton Whole Borough 200,000 25% 4

Lambeth Clapham Town, 50,000 6% 1 Clapham Common, Thornton, St Leonard‟s Regional By region 2.5 m 30% 4

2. Age of membership and to stand as a governor

The two questions we asked on the minimum ages for becoming a member (14) and for becoming a governor (16) of the trust received the most comments of all of our questions. And the responses of those who did comment were strongly in favour of increasing these ages, the most popular suggestions were 16 and 18 for membership and governorship respectively.

In numbers:

Of all respondents, those saying „yes‟ to question 4 (age of membership) and question 5 (age of governorship) were 69.1% and 69.0% respectively. These two questions produced by far the least enthusiastic response. The next „worse‟ question received 84.5% approval.

Looking at the 196 respondents who commented on one or both of these questions, the percentages in favour are 39.3% for question 4 and 41.8% for question 5.

So we have a significant and vocal minority, roughly 30% of all respondents who are against our current proposals in this area and 110 out of 140 of these respondents (79%) commented on their disagreement with the proposals.

This does of course mean that we have a 70% majority, albeit a less vocal one, in favour of our plans. Of the 313 and 310 respondents who agreed with our proposals for membership and governorship respectively, 40 (13%) commented on their view in favour of the proposals.

After considering the responses to the consultation, we have decided to go with the majority view and retain our original proposals in this area. However, in response to many of the comments in the survey, well will ensure that all members, and all governors and candidates for governor of whatever age - but especially young people - are given all the support needed for them to fulfil these roles to the best of their ability. This support and our decision on this issue will be communicated to members and others in our public response to the consultation.

3. Staff Governors

Whilst we did not directly ask a question on the number of Governors to come from our staff, one of the questions addressed this issue. Question 7 asked for agreement on our proposals for the Council of Governors as a whole. The overall response to this question was positive with 86.7% saying that they agree. This number was slightly lower among the 134 respondents who identified themselves as members of staff at 82%. 32 members of staff directly asked for more staff representation on the council of governors within the comments sections of the questionnaire and a further 29 respondents who did not identify themselves as staff made similar comments. We also received a formal Staff Side response to the consultation which stated that:

“We do not believe that four staff governor posts is adequate or representative of the circa 8,000 staff who work at SGH. Given the size of the Trust, particularly after the integration with Wandsworth Community Services, we believe there should be 6 staff governor posts with appropriate representation from the community and nursing.”

We also received comments in favour of greater staff representation from the London Borough of Merton Health and Wellbeing Board and the Roehampton Limb Users Group.

The consultation document proposed that four staff governors should be elected: One from among medical and dental staff One from among nursing and midwifery staff One from among allied health professionals and other clinical and technical staff One from among non-clinical staff

Taking into account the responses received in favour of more staff representation, we have decided to add a fifth staff constituency to those listed above:

One from among Community Services staff

All those members of staff who work in our Community Services division will be a part of and vote in this constituency. This is notwithstanding the fact that they may, for instance, be nurses who under our original proposals would have been in the nursing and midwifery constituency. These members of staff will not get a vote in or be a member of two constituencies.

In addition to increasing the number of staff governors on the Council of Governors we will continue with our mechanisms for staff consultation. b. Feeding back

This document is available online. We will communicate this to the groups we initially aimed to consult with, whether they took part in the consultation or not. These are staff, patients, our members, stakeholders and the communities which we serve. Hard copies will also be available on request.

There will also be publicity through our usual channels, website, Gazette, eG, intranet and internet, twitter and facebook.

Every individual who took part in the consultation and for whom we hold an email address, will receive this document in electronic form attached to an email thanking them for taking part.

The organisations which took part will also receive the document, and a letter which will address the particular issues which they raised.

APPENDICES

1. Paid for adverts in local media. Newspapers and magazines in which we placed adverts: The Guardian series of newspapers in: o Croydon o Elmbridge o Epsom o Kingston o Sutton and Epsom o Wandsworth o Wimbledon and Morden Richmond and Twickenham Times Surrey Comet

Local Authority publications: o Wandsworth Brightside o Lambeth Talk o My Merton

2. Organisations and individuals directly invited to take part.

GP practices across Wandsworth and Merton (84) NHS Organisations Croydon CCG Acute Commissioning Unit Kingston CCG NHS South West London Lambeth CCG NHS London Merton CCG NHS Wandsworth Richmond CCG Epsom & St Helier University Hospitals Sutton CCG NHS Trust Wandsworth CCG Kingston Hospital NHS Trust London Specialised Commissioning Kingston Cluster Group Wandsworth Cluster South London Commissioning Support Unit

Local Authorities London Borough of Croydon London Borough of Richmond London Borough of Kingston London Borough of Sutton London Borough of Lambeth London Borough of Wandsworth London Borough of Merton

Members of Parliament and political parties Jane Ellison MP for Battersea Tom Brake MP for Carshalton and Wallington Siobhan McDonagh MP for Mitcham and Morden Justine Greening MP for Putney and Roehampton Chuka Umanna MP for Streatham Paul Burstow MP for Sutton and Cheam Sadiq Khan MP for Tooting Kate Hoey MP for Vauxhall Stephen Hammond MP for Wimbledon

Conservative, Labour and Liberal Democrat parties in the following parliamentary constituencies: Battersea Sutton and Cheam Carshalton and Wallington Tooting Mitcham and Morden Vauxhall Putney and Roehampton Wimbledon Streatham

Members Number of members who received a letter via post or email at the beginning of the consultation: 5,352 Number of new members recruited during the consultation who subsequently received an email about the consultation: 997 Number of new members recruited during the consultation period who received a copy of the summary document in their welcome packs: 3,356

Local Involvement Networks (LINks, now Healthwatch) Croydon LINk Richmond LINk Kingston LINk Surrey LINk Lambeth LINk Sutton LINk Merton LINk Wandsworth LINk

Community groups Africa Community Involvement Association SHARE Community Ltd (ACIA) Age Concern Signhealth Age UK Wandsworth Sivayogam Alton Activity Centre Somali Community Advancement Organisation Asha Project South London African Womens Organisation (SLAWO) Asian Elders Support Scheme South London Chinese Community Association Asian Young Womens group - Youth Services South London Refugee Association - Wandsworth Asylum Welcome Association of Somali Women and children South London Tamil Welfare Group Aurora Health Foundation Storm Empowerment Balham Community Centre Sunni Muslim Association South London Battersea Islamic Cultural and Educational The Federation (Sutton) Centre Battersea Law Centre The Redeemed Christian Church of God Battersea Pastoral Cente Thinking Partners Group Battersea Pensioners Retired Persons Together at Triangle Resource Association Battersea Society Tooting Islamic Society Bluebird Care Tooting Neighbourhood Centre BrahmBhandi UK (BBUK) Transition Town Tooting Connect - Service for people with aphasia Turning Point Prospects Contact a Family - Wandsworth United African Family Association Disability and Social Care Advice Victim Support - Wandsworth Safety Net Doddington & Rollo Centre Voiceability Elays Network Voicing Views FACET Volunteering Wandsworth Family Action - Recovery Star Mental Health Waeberi Community Association (Somali Service Community Association) French African Welfare Association (FAWA) Wandsworth Access Association Furzedown Project Wandsworth Asian Women's Association GDC Wandsworth Bengali Welfare Association Generate - Opportunities for people with Wandsworth Care Alliance learning disabilities

Haideri Islamic Centre Wandsworth Carers Centre Heathside Resource & Education Centre Wandsworth Community Empowerment Network Hestia Age Activity Centre Wandsworth Community Transport Home Instead Senior Care Wandsworth Crossroads Katherine Lowe Resource Centre - Young Wandsworth Floating Support Service Carers Project Lifetimes Wandsworth Health Trainers Linking Bridges - Women's Community Group Wandsworth Interpreting Service Mushkil Aasaan (Community Care for Asian Wandsworth LGBT Forum Families in Crisis) New Testament Assembly-Tooting Wandsworth Parental Partnership Service Newpin Roehampton Wandsworth Somali Society Putney Society Wandsworth Victim Support Randall Close Day Centre Wandsworth Visual Impairment Service Regenerate - The Juice Bar Wandsworth Voluntary Sector Development Agency Right At Home(Wimbledon and Putney) Wandsworth Women's Aid Servol Community Trust Outreach Project Welcare in Wandsworth Shanti Refuge (Servite Housing) Your Way

Patient groups Alzheimer's Society SW London Branch League of Friends of Sutton and St Helier Hospitals Balham Park Surgery Patient Liaison M.S. Society Group Maternity Services Liaison Committee Battersea Fields Patient Group Mencap Bedford Hill Family Practice Patient Merton MIND Group Older Peoples Forum CSW patient panel Paul D'Auria Cancer Resource Centre Disability and Social Care Advice Service Roehampton Limb User Group Edward Wilson House Mental Health St George's patient reference group Resource Centre - FWA St Helier and Surrey Kidney Patients Association Expert Patients Sutton Mencap Franciscan Surgery patient group Wandsworth Continence Group Gwyneth Morgan Day Centre - Leonard Wandsworth MDF Chesire Disability The BiPolar Organisation Heathbridge Practice - patient group Wandsworth MENCAP HIV+ patient group Wandsworth Mental Health Resource Centre Lavender Hill Practice Patient Group Wandsworth MIND

Residents’ Associations in Merton (37) Residents’ Associations in Wandsworth (72) Contacted through Wandsworth‟s four Resident Participation Officers.

Other groups Battersea Citizen Advice Bureau Careers Development Group Ingeus (work directions) Wandsworth Police Community Safety Unit

Appendix 3 Our revised proposals for becoming a Foundation Trust

Our mission, vision and priorities

Our mission (our purpose) is to provide excellent clinical care, education and research to improve the health of the populations we serve.

Our vision (what we want to be) is to become an excellent integrated care provider and a comprehensive specialist centre for south west London, Surrey and beyond with thriving programmes of education and research.

Our priorities

Redesign care pathways to keep more people out of hospital We will play a key role in keeping people healthy and well at home by working with our partners in primary and social care and the charity and voluntary sector. This ranges from keeping people healthy for as long as possible to enabling those with a health condition to live as independently as possible.

Redesign and reconfigure our local hospital services to provide higher quality care We need to improve the way in which we provide our local hospital services from planned surgery through to discharge planning. We will work with other NHS trusts in south west London to ensure the highest quality, sustainable configuration of clinical services.

Consolidate and expand our key specialist services We will work to ensure that south west London continues to have access to a comprehensive range of specialist services available locally at St George‟s Hospital.

Provide excellent and innovative education to improve patient safety, experience and outcomes We will build on our strong history as a teaching institute and our partnerships with St George‟s, University of London, and Kingston University to provide excellent education and develop the healthcare professionals of the future.

Drive research and innovation through our clinical services We will strengthen our approach to research programmes, making research a part of the trust‟s core business so that we can advance our understanding of healthcare provision and apply this knowledge to improve patient care.

Improve productivity, the environment and systems to enable excellent care There are some changes that we need to make to our systems and processes, such as investment in our IT system, to ensure we are able to continue to provide the highest quality care. We will also look to make major improvements to our buildings and facilities.

Develop a highly skilled and motivated workforce championing our values Services cannot be delivered without our staff and we will continue to invest in our staff to ensure that they have the right skills, and are engaged and motivated to provide consistently excellent services.

Our values

Our four organisational values represent the way we approach our healthcare provision and we aim to always keep these at the heart of what we do.

• Anticipate and respond to patients‟ and • Look after our patients as we would carers‟ concerns and worries like to be looked after ourselves • Support each other under pressure and • Set ourselves high standards and be consider the impact of our actions on others open to new ideas • Help people find their way if they look unsure • Be professional in our approach and or lost in our appearance • Smile, listen and be friendly • Promote and share best practice

• Have patient safety as our prime • Keep patients, families and carers involved consideration and informed. • Be responsible for ensuring good • Protect patients‟ dignity and confidentiality patient experience • Wear our name badges, introduce ourselves • Use resources wisely and address people in a professional manner • Challenge poor behaviour in others • Respect colleagues‟ roles in patient care and • Learn from experience including our experience mistakes • Value and understand the diversity of those • Say sorry when things go wrong around us

Membership proposals

Foundation trusts are membership organisations. We are offering all those who have an interest in or connection to the trust the opportunity to become a member of St George‟s.

Becoming a member is free and demonstrates that you: • Support us • Believe in our values (Kind, Excellent, Responsible, Respectful) • Care about the services we provide • Want to hear more from us and celebrate our success

Members will: • Receive regular news and information from the trust • Receive invitations to exclusive events and seminars • Be entitled to vote for and elect the Council of Governors • Be able to stand for election to the Council of Governors

We expect to attract a membership which is both representative of our diverse local community and which can reflect the needs of our specialist patients from outside our immediate catchment area. Our membership will include patients, local residents and other members of the public, as well as our staff.

We already have around 16,000 members. More than 9,000 of these are members of the public, with the rest being members of staff.

As we become an FT we will establish a Council of Governors, who will engage with the membership and represent members‟ views as they advise our Board of Directors. The Council of Governors will be made up of a majority of public Governors elected by the membership, as well as elected staff Governors and appointed Governors from among our stakeholders (read more about Governors on page 19`).

Membership constituencies

We are proposing to establish membership constituencies for the following:

Public – any patient or member of the public Staff – people who work for or on behalf of St George‟s Healthcare NHS Trust

Public

As an FT, we will be required to have at least one public constituency. We propose to create four public constituencies:

A Wandsworth constituency – for public members from the London Borough of Wandsworth A Lambeth constituency – for public members from the London Borough of Lambeth A Merton constituency – for public members from the London Borough of Merton A Regional constituency – for all other public members

Our public constituencies will include patients, volunteers, members of our local community and people from outside of south west London.

We provide local services to around 500,000 residents in Wandsworth and Merton and tertiary and specialist services to south west London, Surrey and beyond (about 2 million people).

Our ambition is to recruit a membership which is as inclusive as possible and representative both of our diverse local population and those receiving our specialist services.

We will invite any member of the public to become a member. Each member will be allocated to the constituency that corresponds with the address they use when they register as a member. We believe that these proposals will achieve a proportional membership of both local people and those from further afield.

Public members will be eligible to stand for election to represent their constituency on the Council of Governors.

We propose to have 15 Governors elected from our public constituencies, as follows,

Six Governors from the Wandsworth constituency Four Governors from the Merton constituency One Governor from the Lambeth constituency Four Governors from the Regional constituency

These Governors will all be elected by our public members. Public members will all be eligible to vote for candidates standing for election to the Council of Governors from their constituency.

Staff constituency

Our staff are our greatest asset and should play a strong role as part of our membership and on our Council of Governors. We are absolutely committed to enabling staff to become active members as easily as possible.

Members from this category will be able to stand as Governors.

All staff members on permanent contracts, or on fixed term contracts of 12 months or more, will automatically become members unless they formally tell us that they do not wish to.

A proportion of staff at St George‟s work on our behalf through our service partners. Although not directly employed by the trust, these staff provide integral services to our patients, such as transport, catering and cleaning. We propose to invite these staff to opt in to our staff membership.

We propose that five Governors will be elected from our staff constituency, as follows:

• One Governor from community services staff • One Governor from among medical and dental staff • One Governor from among nursing and midwifery staff • One Governor from among allied health professionals and other clinical and technical staff • One Governor from among non-clinical staff (including the staff of our service partners)

Membership age We provide high quality specialist children‟s and young people‟s services. We are committed to encouraging as many young people as possible to become members and ensuring that their views are fully represented at the Council of Governors.

We propose that the minimum age for membership will 14 years of age. All members will have the right to vote during elections.

In line with current practice in other FTs (and particularly those who are major providers of children‟s services), we propose that the minimum age to stand for election as a Governor will be 16 years of age.

A younger persons‟ forum will be established under the ownership of the Council of Governors, through which their views will be represented to the Council via a nominated Governor.

Our proposals take account of the difficulties which are inherent in having younger members taking on the role of governors, such as youth mobility, the demands of full-time education, and the maturity required to take on the role of the governor and represent members‟ interests.

Governance proposals As an NHS trust, we currently have a Board of Directors. The Board of Directors is legally accountable for the management of the trust and is responsible for the day-to-day running of the organisation. The Board is currently made up of five non-executive directors, four executive directors and four non-voting executive directors.

The chairman and the non-executive directors come from a range of professional backgrounds with a wide range of skills and experience that reflect the needs of the trust. Although members of the Board, non- executive directors are not part of the St George's Healthcare executive management team, and are effectively independent experts in their field employed to challenge the trust and provide expert leadership and guidance.

Executive directors are appointed members of staff and are responsible for managing the operational aspects of the organisation. The non executive directors scrutinise the performance of the executive and constructively challenge the way the trust is performing.

When we become a Foundation Trust, the Board of Directors will: • Be responsible for the day-to-day management and strategic development of the Foundation Trust • Be collectively responsible for the exercise and performance of the Foundation Trust • Be held accountable for the performance of the organisation by the Council of Governors • Have a voting majority of non-executive directors

Our members will elect the majority of our Council of Governors, who will represent the views of the membership and advise the Board of Directors. The Chair of the Board of Directors will also Chair the Council of Governors and will serve as an important link between both bodies.

The Council of Governors will:

• Engage with the board of directors on their performance, compliance with the terms of authorisation and other matters related to the general well being of the Foundation Trust. • Engage with the membership and represent their views to the Board of Directors • Advise the Board of Directors on strategic plans and service developments

• Appoint the chair and non-executive directors • Appoint the trust‟s external auditors

Council structure

The Council of Governors is the body through which the membership maintains dialogue with the Board of Directors.

Legislation dictates the basic composition of the Council of Governors. It must include staff representatives, as well as representatives from the public, Local Authorities and partner organisations. It is a requirement that over half of the Council of Governors is comprised of public Governors.

We propose that our Council of Governors comprises 28 Governors in total.

We propose to allocate 15 seats to elected public Governors.

We propose to allocate five seats to elected staff Governors. We propose that eight further Governors will be appointed by some of our key stakeholders, such as local commissioners, academic partners, patient representative groups and local authorities, as follows:

• One Governor from primary care services in Wandsworth • One Governor from primary care services in Merton • One Governor from the London Borough of Wandsworth • One Governor from the London Borough of Merton • One Governor from St George‟s, University of London • One Governor from Kingston University • One Governor from Wandsworth Local Involvement Network (or successor body) • One Governor from Merton Local Involvement Network (or successor body)

The Council of Governors will be accountable, through its membership, for ensuring that the views of the public, staff and partner organisations are represented when decisions are made about future trust strategy. The Council of Governors will work closely with the Board of Directors to ensure that the trust delivers services that reflect the needs of the local community and specialist patients.

Election process

Governors will be elected by their respective constituencies. We propose that each Governor will hold office for a period of three years after which they will be eligible for re-election or re-appointment. Governors can serve for a maximum of nine years.

Bodies with the right to nominate Governors will be asked to review their nominations every three years.

The initial terms of office for the elected members of the Council of Governors will be of differing lengths to prevent all of their terms of office ending at the same time.