Be part of your local community health services

Our future as a NHS foundation trust

Public consultation Friday 3 February - Friday 27 April 2012 www.hrch.nhs.uk the only option available is a hospital. Whilst A bright future for this might be the right place some of the time, community health there is a growing recognition that most of us would like to be cared for at home or in the services in Hounslow community. We also know that we want our care to be joined up and that too often, and Richmond different parts of the health service do not communicate as well as they could do, and Hounslow and Richmond Community that there could be much closer links with Healthcare NHS Trust is a new, dynamic, colleagues in social care. forward thinking organisation. We were We want to be at the forefront of providing established as an NHS trust on 1 April 2011 services that help people stay safe and healthy with the unanimous support of our local at home, enabling people to stay out of stakeholders. Although our name might be hospital and to come home as soon as they new, our services are well established and are are ready. We will do this both through building a strong reputation for quality and developing and improving our own services excellence - thanks to the expertise and and by working in closer partnership with dedication of our staff. primary care (GPs), secondary care (hospitals) We have always looked upon gaining NHS and social care. trust status as a very important stepping stone At the same time, the NHS is changing - we towards achieving our ultimate goal of are facing a more competitive market and we becoming a foundation trust (FT). The need to be more productive and ensure we government wants all NHS trusts to become spend our money wisely and efficiently. foundation trusts (or be part of one) by 2014. We believe being a standalone foundation A great opportunity trust will offer us the scope and freedom to Becoming a foundation trust is a great develop our services in communities across opportunity to create a thriving community Hounslow and Richmond and beyond. services organisation that will improve the quality of care for the population, help reduce Be part of our future the over reliance on hospital beds and support As part of our foundation trust application we our commissioning colleagues in developing a are carrying out a 12-week consultation sustainable local health service. offering our staff, patients, the public, MPs, Foundation trusts also give their own staff, local councils, other NHS organisations and patients and local residents a real opportunity members of the voluntary sector a chance to to play their part in the future of their services have their say on our proposals. by becoming members or governors of the This booklet is our formal consultation trust. While we will have greater document and explains what a foundation independence we will still be part of the NHS trust is, how we believe it will help us develop and healthcare will be delivered according to and improve our services and describes how core NHS principles – free care, based on need you can become a member of the trust. and not the ability to pay. We are asking for your thoughts on a number Thank you for taking the time to read about of questions which are brought together at the our plans for becoming a NHS foundation questionnaire at the end of the booklet. trust. We look forward to receiving your comments and to welcoming many of you as An exciting time members of our new organisation. This is an exciting time for community health services. We want the best possible care for Richard Tyler Stephen Swords ourselves and our loved ones but all too often Chief Executive Chairman

2 About us We provide services 24 hours a day, seven days a week and operate from a number of different sites across Hounslow and Richmond Hounslow and Richmond Community including health centres, the therapies centre Healthcare NHS Trust provides community at West Middlesex Hospital, children’s centres health services for the 425,000 people living in and GP surgeries. Many of our staff such as the boroughs of Hounslow and Richmond health visitors and district nurses visit patients upon Thames. in their homes. We are a new NHS trust (1 April 2011), We also run Teddington Memorial Hospital created from the merger of the community health services previously provided by the local which has an NHS walk-in centre; diagnostics primary care trusts, NHS Hounslow and NHS department (including x-ray and ultrasound); Richmond. two inpatient rehabilitation wards and outpatient clinics. We have an annual turnover of £55m and employ just under 1,000 staff. We also have We are proud to have been chosen to pilot the 85 volunteers who devote their time to new Urgent Care Centre at West Middlesex helping our services. Hospital. This will open in early 2012. We provide services for both adults and Where possible, our staff work with primary children including community nursing; care (GPs), social services and the voluntary physiotherapy; podiatry; dietetics; health sector so that care can be more “joined up” visiting; speech and language therapy; sexual for patients. We would like to work more like health services and occupational therapy. We this in the future. You can read more about also run some specialist services jointly with our plans for the future on page 4. our borough councils. We are registered with the Care Quality Preventing people from becoming unwell in the first place is an important part of what we Commission without conditions which means do. Our stop smoking team in Hounslow that the care we provide across all our services helped nearly 2,000 people quit smoking last meets high standards of quality and safety. year. On the back of its success in running education and health promotion programmes across Hounslow, our health and wellbeing team were recently chosen to run a new In the last year Healthy Lifestyles Programme in one of our neighbouring boroughs, Ealing. ● 562,000 appointments were made with our services ● 158,000 home visits were made by our district nurses and community matrons ● 48,000 patients walked through the doors of our NHS walk-in centre at Teddington Memorial Hospital ● 6,630 babies were seen by our health visitors ● 69,000 people were seen by our physiotherapists at clinics across Hounslow and Richmond

3 Our mission and strategy

Our mission is simple – we aim to provide care and services that we and our families would want to use.

Our vision for the future reflects the impact we want to make on our communities:

We will be recognised as a high performing, integrated care organisation delivering quality services which enable people to live healthier and more independent lives.

The way we behave with each other and with our patients and partners is reflected in our values: We will be: ● Patient focused – Our patients and their carers are at the centre of our thoughts and actions and receive care tailored to their needs. ● Clinically led – Our clinicians are fully engaged in the design and development of our services. Our plans for the future ● Quality driven – We are constantly We are proud of the services we provide, but striving to be the best we can be as to continue to be successful we need to drive individuals and as an organisation. up quality and focus on improving patient ● Innovative – We encourage and outcomes and experience. It’s not enough for us just to provide good quality clinical care – implement new ideas that help it’s important that our patients have trust and transform the lives of our patients. confidence in our services, and that they are ● Productive – By working smarter on treated with dignity and respect each and the things that really matter we deliver every single time they have contact with our the best possible value for our services. patients. We are working closely with our partners to ● Responsive – We will work with our meet these expectations and to work with the partners to make care more joined money we have to spend. We would like to expand the range of community services we up and responsive for our patients offer in Hounslow and Richmond so that and their carers. patients can be cared for at home where possible, or in community settings. At the same time we are also looking to grow our business by providing services in other geographical areas.

4 We have agreed with our staff and stakeholders that we will focus on four areas of care which Integration and partnership encompass both our adults and children’s An important theme running through services. our plans for the future is integration 1. Preventing illness, improving health and working in partnership. This and wellbeing means providing services by teams This means providing services that support who work together in the community people to live healthier lives. Many of our services – including all the agencies that need such as health visiting, school nursing, and sexual to be involved. By working with GPs, health can play important roles in providing social care and our voluntary sector health education, influencing lifestyle choices and colleagues, we will build multi preventing long-term conditions. Our stop professional teams who identify those smoking services can take on a wider role in patients most at risk and develop care helping people make successful lifestyle changes. that’s tailored to their needs. We want to ensure that the people with 2. Maintaining independence, preventing the right skills provide the right deterioration in health support at the right time. This means helping those with long-term A good example of a service of this conditions to remain as healthy and independent kind is our new Integrated as possible, for as long as possible, in their home Community Response Team in or in a community setting. We see our services Hounslow – a team consisting of a playing a key role as a co-ordinator of care for GP, nurses, therapists, a mental health patients with complex needs, bringing together a nurse and social workers. Based at variety of agencies to provide a holistic approach. West Middlesex Hospital, they work 3. Preventing avoidable hospital together to prevent hospital admissions/extended stays in hospital admissions and help early discharges. We know that too many people are admitted to The breadth of professionals in the hospital in an emergency, when with the right team means that patients receive a care, they could be better supported in the comprehensive package of care that community. We will further extend our rapid looks at their health, social and response services and develop services for people mental health needs. with chronic obstructive pulmonary disease (COPD), congestive heart failure and cellulitis, which can usually be managed at home. By strengthening our falls services, we will identify early and manage those patients at highest risk of a fall, and support their recovery afterwards. 4. Providing high quality end of life care Our aim is that all people approaching the end of life have access to high quality care, wherever the person may be – at home, in a care home, in hospital, in a hospice or elsewhere. We will work to ensure that their needs are identified early, through open, honest conversations with a single care plan for each patient. We want to extend our community based services to support more patients to die at home and ensure that all relevant professionals receive end of life care training.

5 What is a NHS foundation trust?

It is government policy that all NHS trusts must become foundation trusts (or be part of one) by 2014. More than half of NHS trusts in England are already foundation trusts. Foundation trusts are part of the NHS and provide care free of charge. They give patients, public and staff a much bigger influence on ● their local health services through their For patients and local people it means members and governors. having a real say in how services are run. ● As a foundation trust (FT), we will be different For our staff it means increasing the in the following ways: contribution that staff make to corporate decision making by having three staff ● FTs are accountable to the local governors. Staff will have more influence community they serve, staff, and local over how we run our services, helping us partner organisations rather than central become an employer of choice. government ● For our partners it means being more ● The local community, patients and staff can involved in our decision making and service become members of the foundation trusts plans, ensuring we take account of the needs of our local population in our future ● Members elect governors who work with plans. the board of directors, influencing decisions about how the organisation is What do we have to do to become a run and holding the board to account foundation trust? ● FTs have more freedom to manage their As part of our application to become a own affairs including how they spend any foundation trust, we are writing a long-term surplus money to invest in services plan which sets out how we are going to develop our services for our local community. ● FTs have extra flexibility to recruit and We have to demonstrate that: retain staff, so that their skills and expertise ● Our services are of a high quality and make improve care and treatment of patients a difference ● FTs are authorised by Monitor, the ● Our finances are in good order independent regulator of NHS foundation ● trusts. Monitor reports directly to Our risk of failure is low Parliament. ● We have the right numbers of staff with You can read more about foundation trusts at the right skills to deliver the services we the Department of Health’s website provide and want to provide in the future www.dh.gov.uk or the Monitor website at ● We can establish a strong membership and http://www.monitor-nhsft.gov.uk/ show how we plan to involve people that choose to become members Why do we want to become a We are also required to consult with patients, foundation trust? staff, partner organisations and our local We believe becoming a locally controlled community to give them the chance to foundation trust will be better for patients and comment on our plans. You can read more our local communities and better for staff. about the next steps on page 14.

6 How the trust will be 1. Members run and managed We are proposing two categories of membership – one for the public and one One of the major new benefits of becoming a for staff. foundation trust is the change of governance structure, which allows local people and local Public organisations to have more say in how the We provide services to people who live in both trust is run. Hounslow and Richmond and some further Currently NHS trusts have a board of directors afield. We are proposing that anyone who lives made up of executive and non-executive in one of these boroughs – and in our directors, whereas foundation trusts have neighbouring boroughs – can become a three main strands: member of our new foundation trust. We 1. Members want our membership to reflect the diversity of the communities we serve. 2. Governors 3. Board of directors Membership is free and you must be 16 years or over. If you become a member you can: Over the next few pages we will explain these ● in greater detail and how this new structure Elect representatives to serve as governors will work in practice. (see the governors’ section on page 10 for more information) and stand for election yourself Structure ● Have the opportunity to influence the trust’s strategic plans Chairman ● Attend meetings and events with governors, the board of directors and other senior managers ● Receive information about the trust and its Board of Governors Membership directors plans

7 ● Work with the trust by providing feedback Neighbouring areas through taking part in focus groups or We are proposing that members of the public completing surveys. from neighbouring areas can also become Membership can take as much or as little time members of the foundation trust. This is as you wish – you might want to receive a because a number of our services, for example newsletter or you might want to actively the walk-in centre at Teddington Memorial participate in meetings. Hospital and the Newborn Hearing Screening Programme, are used by residents in other To apply to become a member please boroughs. fill in the leaflet in the middle of this We propose that the boroughs that border document and freepost it back to us. Hounslow and Richmond, plus Merton (which does not have a direct boundary, but is only a few hundred metres away) also be included. These are: ● Royal Borough of Kingston upon Thames ● London Borough of Ealing ● London Borough of Hammersmith and Fulham ● London Borough of Hillingdon ● London Borough of Merton ● London Borough of Wandsworth ● The Borough of Elmbridge ● The Borough of Spelthorne This means we will have three public constituencies (Hounslow, Richmond and Neighbouring) as shown on the map on the next page.

Staff We hope all of our staff will want to be involved in governing the foundation trust and therefore we are proposing that staff will automatically become members of the new trust. There will be a process for staff to opt out if they do not wish to become members. Staff who opt out will not be able to vote in elections for staff governors but otherwise they will not be treated any differently.

Volunteers We recognise the invaluable role that our volunteers play. We currently have approximately 85 volunteers whom we will encourage to become public members.

8 We are intending to have three public constituencies. To be a member you must live in one of the areas indicated Hillingdon on the map.

Ealing Hammersmith and Fulham

Hounslow

Wandsworth Richmond

Spelthorne Merton

Kingston upon Thames Elmbridge

Hounslow Richmond Neighbouring areas

9 ● Approve the appointment of the chief 2. Council of governors executive The council of governors is important because ● Represent the interest of members and it agrees the future direction and plans for the local stakeholders and be consulted on any trust and holds the trust’s board of directors to changes we propose for services account. The council works closely with the ● Hold meetings that are open to members organisation and reflects the needs and wishes ● Provide the perspective of the wider of staff, local people and partner organisations. community Governors will be elected from the public and ● Approve the remuneration and allowances staff constituencies and we will also have and other terms of office for the non- governors who are nominated from key executive directors stakeholder organisations in Richmond and ● Scrutinise the trust’s performance to ensure Hounslow. One of the main things we are that plans are carried out properly and asking your opinion about is the make-up and make sure the trust fulfils its terms of numbers of governors. authorisation with Monitor (the regulatory The governors will: body) ● Appoint (or remove if necessary) the ● Receive and consider documents such as chairman and non-executive directors the annual report and accounts and the ● Appoint the auditors quality account.

Proposed membership of the council of governors We are proposing that the council of governors has between 21-23 members. These will be made up of the following:

Twelve public governors, elected from the three constituencies: ● Six elected by members from Hounslow ● Five elected by members from Richmond ● One elected by members from neighbouring areas

Three staff governors: ● Three governors elected from our staff membership group

Up to eight partnership governors: We are proposing that each of the following organisations appoints one governor ● NHS Hounslow/Clinical Commissioning Group1 ● NHS Richmond/Clinical Commissioning Group ● London Borough of Hounslow ● London Borough of Richmond upon Thames ● Hounslow Local Involvement Network / HealthWatch2 ● 1 Primary care trusts are due to be abolished Richmond Local Involvement Network / HealthWatch with effect from April 2013. Their commissioning responsibilities will be taken As part of the consultation, we are inviting comments on over by Clinical Commissioning Groups whether any other organisations should be given the 2 Local Involvement Networks are due to be replaced by local HealthWatch groups from opportunity to be on the council of governors. October 2012

10 Questions and answers advertised, or under ‘any qualified provider3’ arrangements, and we should about our proposals for avoid the risk of conflicts of interest. governors How will you elect the council of Why are you proposing that Hounslow governors? members elect one more governor than We are proposing that elections to the council Richmond? of governors should be held using the single This is because of the difference in the size of transferrable vote system. We believe that this the population of the two boroughs. The latest system is most appropriate for the council of figures from the Office of National Statistics governors, as it will improve the chances of a show that Hounslow’s population is 236,760 broad spread of representation among elected and that the population of Richmond upon members. Thames is 190,920. What will governors’ terms of office be? How have you come to your proposal Governors will usually serve a three year term about the size and composition of the of office. To encourage some continuity we council of governors? will not hold elections for the entire set of We have reviewed the size of other foundation governors at the same time, except for the first trusts’ councils of governors and noted trends elections. in the size of the council of governors among recently authorised foundation trusts and Should any other organisations be given current applicants. We want to get a balance a position as a partnership governor? between being able to represent all types of Let us know by completing our members and being small enough for questionnaire at the end of this document. meetings to be run smoothly. We believe that a council of governors with about 22 members strikes the right balance for a trust of our size. The law requires that the public members of the council of governors must be in a majority. The law also states that there must be no less than three staff governors.

Why have you decided to limit the number of partnership governors? We have decided to limit the number of partnership governors for a number of reasons, including: ● If the council of governors is too large then it becomes more difficult for each governor to have their voice heard ● Voluntary organisations with an interest in health are involved through the LINk / HealthWatch structures ● Some voluntary organisations may want 3 Any Qualified Provider (AQP) allows patients to choose, where the freedom in future to compete against appropriate, from a range of qualified providers who are licensed to us when contracts for services are provide safe care and treatment, and select the one that best meets their needs.

11 3. Board of directors We will have a board of directors as we do currently. The board is legally accountable for the management of the foundation trust and sets the strategy and goals for the organisation. The board of directors has a chairman (who will also chair the council of governors), five other non-executive directors, a chief executive and five executive directors. The council of governors will appoint the chair and non-executive directors and approve the appointment of the chief executive. The chief executive and non-executive directors appoint the executive directors. Current directors will form the initial board of directors for the trust.

Our name We are proposing that the name of the new foundation trust should be: Hounslow and Richmond Community NHS Foundation Trust We believe that our name should refer to the communities that we serve. We would be interested in your views about this, or whether you would prefer Hounslow and Richmond Community Healthcare NHS Foundation Trust, so please answer the questions on the back of this booklet or on our website. By law, the precise term “NHS Foundation Trust” must be the final words of the name.

Teddington Memorial Hospital Heart of Hounslow Centre for Health

12 The consultation process ● Come to a public meeting between Consultation is used by the government and February and April. You can find the details public sector organisations to involve people in of the public meetings below. We are also important decisions. They give members of the publicising these meetings on our website. public the opportunity to comment on proposals being made and suggest alternatives. Date: Tuesday 7 February Time: 7pm - 8pm We want to hear from you and would be Venue: York House grateful if you could send your feedback by Address: Richmond Road, 27 April 2012. You can respond in a number Twickenham, TW1 3AA of ways: Date: Tuesday 21 February ● Fill in the response form at the back of Time: 7pm - 8pm this document Venue: Montague Public Hall Address: Montague Road, ● Write to us at Hounslow, Middlesex, TW3 1LD Foundation Trust Communications Office, Hounslow and Richmond Community Date: Thursday 29 March Healthcare NHS Trust, Time: 7pm - 8pm Thames House, Venue: Cole Court Centre 180 High Street, Teddington, TW11 8HU. Address: 150 London Road, Twickenham, TW1 1HD ● Email us at [email protected] We would also be happy to attend any group ● Visit our website and fill in our meetings to provide more information on the response form online at consultation. If you would like for this to be www.hrch.nhs.uk/foundation-trust arranged, please contact us.

What happens next? The timetable for our foundation trust programme is outlined below: The public consultation finishes on ● 3 February 2012 Consultation launched 27 April 2012. We will carefully review all the comments we receive and reflect these as ● 27 April 2012 Consultation ends much as possible in our formal application to ● become a foundation trust to the Department May 2012 Consultation feedback of Health. This application will be submitted by published 1 October 2012. Around the same time, we ● October 2012 Application submitted to will publish a summary of responses to the Department of Health consultation and explain how we have taken ● them into account in our application. Early 2013 Monitor assessment ● After that the Department of Health and Early 2013 Council of Governors Monitor (the independent regulator of elections foundation trusts) will review our application ● Spring 2013 Foundation trust is and make a decision on our application. This established means we could become an NHS foundation Please note, these timescales may be trust by April 2013. subject to change.

13 Any questions? We welcome your views For more copies of the consultation document, This is a consultation document about membership leaflet or if you have any Hounslow and Richmond Community questions please get in touch by emailing Healthcare NHS Trust’s application to [email protected] or calling become a NHS foundation trust. 020 8973 3143 or go to our website www.hrch.nhs.uk where you will find more If you have any questions please information about us and our plans. contact us.

If you would like a summary of this document in your own language, please call 0208 973 3143 and state clearly in English the language you need and we will arrange an interpreter to speak to you.

Farsi

Arabic

Somali

Polish

Panjabi

14 PLEASE FOLD AND STICK EDGES Be part of the conversation We welcome your comments on anything in this consultation document and would especially like your views on the following questions. You can complete the questionnaire online by visiting www.hrch.nhs.uk

Please tick the relevant box and add any comments at the end of the form. 1. Do you support our plans for NHS community healthcare in Hounslow and Richmond, with a local foundation trust, dedicated to community healthcare, with strong democratic membership involvement? Yes No

2. Do you support our plans to improve integration across health and social care? Yes No

3. Do you agree with our plans for staff membership? Yes No

4. Do you agree with the proposed public constituencies? Yes No

5. Do you agree with our plans for the number of governors and the make up of the council of governors? Yes No a) Should any other organisations be given an opportunity to be on the council of governors? If so, please state the name of that organisation:

______

6. Do you agree with our proposed name for our new organisation? Hounslow and Richmond Community NHS Foundation Trust Hounslow and Richmond Community Healthcare NHS Foundation Trust

New suggestion: ______

7. Do you feel that the way that we have consulted has given the opportunity for everyone to make their views known? If not, what would your suggestion be? ______

8. Do you have any other comments to make about the questions above or our proposals? ______

Your details (optional): Name: Job title: Organisation: Email or contact details:

Thank you for taking the time to tell us your views. The closing date for feedback is Friday 27 April 2012.

PLEASE FOLD AND STICK EDGES Hounslow and Richmond Community Healthcare NHS Trust Foundation Trust consultation FREEPOST SEA11027 TEDDINGTON TW11 8BR