The Merger Blueprint Creating the South East London Healthcare NHS Trust

1. The Merger BlueprintCreating the South East London Healthcare NHS Trust

2. Document control

3. Contents Purpose of the Document 4 Summary 5 Overview of the Merger 7 Organisational Structure 18 The Merger Programme 22 Day 1 Planning 27 Communications for Day 1 32

4. The purpose of this document Set out the strategic rationale for the merger Provide an overview of key merger objectives and a broad merger timeline Provide an overview of the synergies to be realised as a result of the merger Establish the key deliverables for the merger Establish the key principles for the merger Detail the objectives, scope and governance of the programme to control the merger We will use this document to retain focus on the tasks ahead and to answer questions on the merger

5. Summary

6. Creating the South East London Healthcare NHS Trust Bromley Hospitals NHS Trust, Queen Elizabeth Hospital NHS Trust and Queen Mary’s Sidcup NHS Trust will merge on 1st April 2009 to form the South East London Healthcare NHS Trust This Merger is the first step in delivering improved patient care for South East London On 1st April 2009 it will continue to be business as usual for all the hospitals within the combined Trust, Our Patients and Our workforce: There will be no change to how, where and when patients receive acute care There will be no change to the level of patient care - patient safety will not be compromised Over time we will face challenges and overcome them in partnership to build a Trust that will be clinically, operationally, and financially stable This will enable us to create a sustainable, quality organisation for local people that will be the first choice for patients receiving clinical care throughout South East London

7. Overview of the Merger

8. Rationale for merger To react to the changing future of Acute health care provision Requirements are changing - more patients are treated locally or at home It is envisaged the current structure would not provide a viable future for the three current Trusts Anticipated changes will be easier to plan and deliver through a larger more stable organisation To respond to the many drivers for change in South East London Need to return to run rate balance and resolve historic debts Provide more efficient and effective back office functions Attract and retain talented staff for key posts To enable the effective implementation of wider change within the NHS such as: Service provision programmes such as A Picture of Health (APoH) Regional strategies as are articulated in the Dazi Review (e.g. Stroke and major Trauma) An ability to work with PCTs who are charged with delivering “world class commissioning” Collaboration with AHSC provides opportunities for acute Trusts To build a Trust that will be able to achieve foundation status 2011-2014

9. The new Trust vision...... There are currently two statements relating to the vision for the merger: The newly formed Trust will work to a shared vision to underpin the process of merging BHT, QEH and QMS to create a new organisation and the process of onward development to the achievement of Foundation Trust status. source: “Proposal for organisational merger of Bromley, Queen Elizabeth and Queen Mary’s NHS Trusts” We want the new Trust to be “best in class” in all it does.  It will be looking to recruit the best and the brightest people.  It will be defining standards of care, levels of staffing and clinical cover, governance structures and financial and operational targets which will place the new Trust at the forefront of patient care and clinical excellence. source: www.safeandsound-selondon.nhs.uk

10. To use our combined skill and experience to build an organisation that is in a position to respond adequately to external and internal changes Deliver cost effective, best in class patient care without compromising patient safety Re-organise our operational around our services/divisions rather than our hospitals in line with APoH Become the Trust of choice for patients and to develop a critical mass which enables the us to achieve of Foundation Trust status by 2011/14 There are three key pillars that will enable the Trust to Deliver this objective: Objectives of the merger

11. Clinical and Operational Stability

12. Workforce Stability

13. Financial Stability

14. Long term objectives Once we have achieved stability in the new Trust we will be in a position to deliver other benefits, for example: Greater flexibility in workforce planning with staff working across hospital sites and into community settings Enable on the delivery of other projects such as Pathology The efficient implementation of APoH (see additional slide) Collaboration with AHSC provides opportunities for us as an Acute Trust The ability to work with PCTs in the delivery of “world class commissioning” The ability to rapidly react to changes in legislation and other compliance regimes Develop specialised service for local patients (cancer and stroke units) Ultimately by achieving these long term objective we will have become the hospital of choice for patients and staff in South East London and will have achieved foundation status between 2011-2014

15. The relationship between the Merger and APoH A Picture of Health (APOH), which is due to report on 30th March 2009 concerns the delivery of patient-centric services closer to home in the community and at primary care centres. This out-of-hospital care policy will involve significant clinical service re-configuration. Only patients that require care in acute setting will be referred to hospital for treatment The formation of the South East London Healthcare NHS Trust is seen as a key enabler of the implementation of APoH Once the merger has successfully achieved its objectives of financial, workforce and operational stability, it will be in a strong position to implement the finding of APoH If APoH is not implemented there is still a requirement for a programme within the South East London Healthcare NHS Trust to deliver better patient care and reduce operating costs.

16. To deliver our objectives we need to apply some key principles Externally We must continue to deliver a quality service to our patients We must engage all stakeholders in the merger We must use clear and consistent messages We must demonstrate and communicate how the new Trust will benefit our stakeholders We must provide clarity and assurance to our stakeholders in terms of our objectives and implementation plans

17. Merger will yield immediate savings through reduction in management costs (~£2.5m) and within the context of a £400m organisation, it will provide more scope for future savings beyond those currently projected by the individual Trusts Ultimately it is the goal of the South East London Healthcare NHS Trust to demonstrate and achieve Foundation Trust status. The benefits for the merger

18. Organisational Structure

19. Organisational Structure - Overview

20. Organisational Structure (Day 1)

21. Organisational Structure (Oct 09)

22. The Merger Programme

23. Merger Programme Objectives Minimise any disruption from merger activities to the day to day business Deliver merger benefits on time and to budget Manage the merger, on time and to budget Build strong working relationships between our teams Maximise the sharing of knowledge, experience and best practice Quickly resolve key issues through the merger Programme Governance structure Communicate Project Board decisions and direction consistently and on a timely basis

24. Merger Programme Governance

25. Major risks to the integration programme

26. Performance against the Blueprint

27. Day 1 Planning

28. Key assumptions for Day 1 – 1st April 2009 On 1st April 2009 the three Trusts will merge into one Trust and the Trust will be branded "South London Healthcare NHS Trust“ – Day 1 Patient safety must not be compromised Our Directors will be visible to the workforce and our stakeholders Operationally very little will change, all the hospitals will continue to operate as they do today Business as usual is the priority - the patients will not experience any change in the quality of care received There will be no sharing of services or movements of staff and patients on Day 1 The legal employing entity will change for all employees to the ‘South London Healthcare NHS Trust’ All contracts with or for services provided by the current 3 Trusts will be transferred or novated to ‘South London Healthcare NHS Trust’ The Compulsory Statutory Relationship with oversight bodies will be maintained

29. What do we need to do on Day 1 (excluding Comms) Organisation Structure CEO and Chairman appointed Key Directors appointed to key roles, reporting lines in place No other roles & responsibilities will change Employees effected by organisational change supported and coached appropriately so that they understand the changes to reporting lines HR Top level organisation structure implemented Residual TUPE issues resolved No changes to T&Cs, policies, and pensions at Day 1 confirmed to all staff Finance Ability to report as one Trust in place FY09/10 budgets communicated to budget holders Changes to authorisation mechanisms communicated COO Combined performance and target reporting in place ICT New domain names secured and websites launched Branding changes to website launched Changes to Switchboard and IVR implements All e-mail addressed changed to “@nhs.net” Ensure that changes to Trust registrations are reflected appropriately Medical and Non Medical Repeat message to all medical and non medical staff that there will be no movement of patients or staff between departments Planning and SLA All required registrations are obtained to enable the hospitals to operate All procedural requirement are complete to enable the hospitals to operate Estates All leaseholds novated to new Trust name New name badges issues to management Signage and Letter head to be updated / replaced at all locations.

30. Draft High Level Milestone Plan for Day 1

31. Rebranding on Day 1 It is fundamental that we only concentrate on the things that we absolutely must do to maintain our legal and regulatory compliance, the following will need to be re-branded by Day 1: Letterheads Invoices Payslips Websites (re-branded with a "top-level" website www.****.nhs.net to be which direct patients and 3rd parties to South East London NHS Trust) Intranet Sites Switchboards and IVR Email addresses (all email address to become nhs.net) Official signage (e.g. Queen Elizabeth Hospital: part of the South London Healthcare NHS Trust) Senior Executive Business Cards On Day 1 the following will not be re-branded: Staff Uniforms Choose & Book

32. Communications for Day 1

33. Charter for Communication and Change A critical requirement for the successful merger is the delivery of an effective communication and change management programme. This reflects the need to gain “buy in” from the staff of all three Trusts who are effectively key stakeholders The attached communications plan maps out an agenda for delivering key messages to all stakeholders and supports the integration programme management. In doing so it will enable the programme to demonstrate clear leadership, deliver consistent and clear messages, promote staff engagement and facilitate the wider acceptance and support for the merger process Communication will be delivered through a variety of mediums, including face to face sessions, project meetings, departmental meetings, regular e-mails, and external communications. A central aspect of the communication plan is to encourage and capture stakeholder feedback through regular engagement and incorporate such into future communication Effective communication will support the required organisational change management, ensuring staff understand the benefits and opportunities of the merger and feel empowered to continuously deliver quality work in the successfully merged Trust

34. Core Messages

35. Internal Stakeholder and key messages

36. External stakeholder and key messages…….

37. Internal Communication prior April 1st

38. External Communication prior April 1st

39. Day 1 and beyond communication

40. How are we going to communicate with them? The following communication channels have been identified as the most suitable methods through with to communicate and facilitate feedback with all stakeholders Stakeholder engagement will be encouraged by providing easy to use feedback mechanisms

41. Communication Architecture