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NHS Trust Assurance Review Summary

Review of XXXX Trust's trajectory against DH assurance process, highlighting outstanding issues affecting timeline. Financial viability, governance, and service performance assessments outlined.

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NHS Trust Assurance Review Summary

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  1. Dave Stocks FOUNDATION TRUST UNIT

  2. SHA DD Review of FT trajectory against assurance process XXXX NHS trust Date (adapted from the South East Coast SHA ‘diagnostic’)

  3. Overview • The Trusts FT trajectory has been reviewed and evidenced against 6 of the DH assurance domains. • A summary of outstanding issues for the Trust, SHA and DH that impact on the timeline have been set out • The trusts resulting timeline reflects the earliest date to Monitor application in the absence of issues being resolved. XXX Trust

  4. Summary of issues – overall trust has a number of areas to work XXXX Issues Timeline Area • XX • XX • XX Isthe applicant financially viable? Good business strategy Mmm-yy • XX • XX • XX • XX • XX Is the applicant financially viable? Financially viable Mmm-yy Is the applicant well governed? Well governed Mmm-yy • XX • XX Is the applicant well governed? Capable board to deliver Mmm-yy • XX Is the applicant well governed? Good serviceperformance Mmm-yy • XX • XX Is the applicant well governed? • XX • XX • XX LHE issues/External relations Mmm-yy MMM-yy Overall timeline to Monitor XXX Trust Note:* XXXX

  5. DH Assurance – Financial Viability - Good business strategy Issue and evidence Timeline Area • Strategic fit with SHA direction of travel • Commissioner support to strategy • Takes account of local/national issues • Good market, PEST/SWOT analyses • XX • XX • XX • XX • XX • XX • XX • XX • xx • XX • XX • XX • XX • XX • XX • XX • XX • XX • XX • XX • XX Mmm-yy Note where each issue results in clearly different timelines they should be shown separately XXX Trust Sources: XXX

  6. DH Assurance – financial viability - Financially viable Issue and evidence Timeline Area • Issue 1 • XX • XX • XX • Issue 2 • XX • XX • XX • Issue 3 • XX • XX • XX • Assumptions revision • XX • XX • XX • Commissioner issue 1 • XX • XX • XX • XX • Financial Risk Rating of at least 3 under a downside scenario • Surplus by year 3 under a downside scenario • Above underpinned by a set of reasonable assumptions eg CIPs, PFI capex plans etc • Commissioner support for activity/ service development assumptions Mmm-yy Note where each issue results in clearly different timelines they should be shown separately XXX Trust Sources: XX

  7. DH Assurance – Governance - Well governed Issue and evidence Timeline Area • ALE score • XX • XX • Breakeven duty • XX • SIC issues • XX • XX • XX • HCC core standards declaration • XX unmet, YY insufficient assurance • Additional work on risk management systems • BAF issues • XX • XX • XX • XX • Evidence of meeting statutory targets • Declaring full compliance or robust action plan in place • Robust, comprehensive and effective Risk Mgmt & Performance Mgmt systems in place which are proven to effect decision making Mmm-yy Note where each issue results in clearly different timelines they should be shown separately XXX Trust Sources: xx

  8. DH Assurance – Governance - Capable Board to deliver Issue and evidence Timeline Area • Issue 1 • XX • XX • XX • XX • Issue 2 • XX • XX • XX • XX • XX • XX • SLR in place? • SLR in place? • Board reporting changed? • Anything from board papers? • ZZZZ • Evidence of reconciliation of skills/exp to requirements of the strategy • Evidence of independent analysis of board capability/capacity • Evidence of learning appetite via FT processes • Evidence of effective, evidence based decision making processes Mmm-yy Note where each issue results in clearly different timelines they should be shown separately XXX Trust Sources: XX

  9. DH Assurance – Governance - Good service performance Issue and evidence Timeline Area • SHA performance reports • 18 weeks • HCAIs – MRSA and Cdiff – • A&E – • HCC rating 06/07 • Use of resources - XX • Quality/service - XX • Data quality ?? • Internal audit ?? • HSE?? • Complaints? • Continued poor performance on patient survey. • Maternity review? • Staff survey? • Benchmarking? • XXX • Evidence of meeting all statutory and national/local targets • Evidence of no issues/concerns/reports from 3rd parties e.g. HCC • Evidence that delivery is meeting/exceeding plans Mmm-yy Note where each issue results in clearly different timelines they should be shown separately XXX Trust Sources: XX

  10. DH Assurance – Governance - LHE issues/external relations Issue and evidence Timeline Area • XX • XX • XX • XX • XX • XX • XX • XX • XX • XX • XX • XX • XX • XX • XX • XX • XX • XX • XX • XX • If LHE FRPs in place does the application adequately reflect this • Any commissioner disinvestment/contestability not reflected • Effective and appropriate contractual relations in place • Other key stakeholders such as LAs,SHAs, other trusts etc Mmm-yy Note where each issue results in clearly different timelines they should be shown separately XXX Trust Sources: XX

  11. Trust name: XXXXXXX NHS Trust Turnover: £xxxm beds XXX xx hospitals xxsites SHA: XXXX Apps Cttee Dec S NS Legally Constituted Compliant constitution Due consultation G Members Representative Numbers (ex staff) Business Strategy Strategic fit with SHA direction of travel Market assessment G G G G G xxxx G G Financially Viable 08/09 09/10 10/11 11/12 12/13 13/14 08/09 09/10 10/11 11/12 12/13 13/14 G Base Case Normalised I&E Downside Case Normalised I&E Robustness of assumptions: Linkage with IBP (£0.9m) £4.9m £4.6m £3.3m £5.4m £5.7m G FRR Base FRR D/Side 2 3 3 3 4 4 £ £ £ £ £ £ - - - G 3 3 2 3 3 A Statutory BE duty G PPI duty G G PBC duty Base D/Side G Well Governed HDD Robust risk & perf mngmnt systems HCC Rating 06/07 UoR G Capable Board Board capacity/capability Effective evidence based decision making G G LHE issues Commissioner Support Effective contractual relations G G G G G G G G Other information - Audit Commission / Public interest / S19 / independent reports - G Service Performance Current Performance HCC Rating 06/07 QoS - Core Standards QoS - Existing national targets New national targets G G G G G

  12. ACCELERATING THE FLOW OF NHS FOUNDATION TRUSTS • December 2008 - Final SHA trajectories submitted to DH including those who will not apply by deadline • December 2009 - Agreed clear plans for any trust considered unable to achieve FT status within the timescale • December 2010 - SofS sign-off for final FT applicants

  13. ACCELERATING THE FLOW OF NHS FOUNDATION TRUSTS

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