Sunday, 11 January 2009

NHS Foundation Trust


I like to think that I take an interest in the machinations of the hospital and I try to have a broader idea of what’s going on, but I received a letter last week that has me puzzled.

You see, my hospital is trying to get “Foundation Trust Status” and I received a letter from the-powers-that-be asking if I wanted to “opt out of being a foundation trust member.” I assume that they have to ask all their staff this question as a legal requirement because everyone in the hospital has received the same letter.

The thing is, I have no idea what being a “Foundation Trust” means. I have no idea what difference it would make to what I or any of my colleagues do on a day-to-day basis. Funnily enough, nobody else seems to know either. Not my junior doctor colleagues, not the consultant, the nurses. To be fair to the management, they sent us all a nice leaflet which I think was meant to explain what foundation trust is. It had lots of pictures of smiling people and lots of nice phrases like “delivering first-class healthcare,” “communicating with staff,” and “engaging with the community” but isn’t this what we are doing anyway? Nowhere did it say how things are going to be different if we get Foundation Trust Status.

I thought I’d try and dig a bit deeper so I collared the theatre manager and asked his what difference Foundation Trust Status would make.

He breezily tells me that “it lets the hospital have more control over how we spend money.”

“So how would that change what I do in my job?”

He didn’t have an answer for me.

Some of the nurses are more cynical about the whole exercise and told me that “it basically means that they can re-band our jobs and pay us less,” but I don’t know if this is true either.

I’m still none the wiser about what Foundation Trust Status means and it doesn’t look like anyone’s going to tell me.

It seems strange to me that becoming a Foundation Trust is obviously a big priority for the people running the hospital, but none of the staff even know what it means. How can an organisation that employs hundreds of people be successful when the people who are working have no idea what they’re allegedly meant to achieve?

6 comments:

Dr Michael Anderson said...

A bit more poking around led me to this on the Department of Health Website, but it still seems a lot of waffle and I still have no idea what difference it would make to how I treat my patients

Dr Grumble said...

.......becoming a Foundation Trust is obviously a big priority for the people running the hospital......
**************************
That, Dr Anderson, is a key observation and you should think very carefully about why this might be.

angus said...

What it actually means is that the hospital is released from Government control, any money "left over" at the end of the year can in theory be used for capital projects, ie-new buildings or refurb, what it means in practice is the attitude of the management changes from patient led to financially led, the senior management will hike their salaries as far as they can. My trust was one of the first to be "converted", the standard of treatment took anose dive, the directors are earning-CEO £150, 000+ medical Director £175,000+ nursing director £100,000+ Personell director £10,000+ beware of management bearing gifts,they will screw you as far as they can.

angus said...

Personell Director should be £100,000+

Anonymous said...

It also means, with the whole membership bit, that the local community (staff included) should have more of a say in how the hospital is run. Members are consulted in planning for services and for the future. They can also take more active roles as governors.

There's more info here, http://www.dh.gov.uk/en/Healthcare/Secondarycare/NHSfoundationtrust/DH_4095717
but the reason they gave you an 'opt out' form is that they are starting with the assumption that you care about your hospital and know more about how it should work than any bureaucrat in an office.

You may not love the other ramifications of Foundation status, but this one I think has pretty good intentions.

Andrew Walton said...

It is often said that FT status will lead to hospitals being more accountable, more democratic, greater patient involvement, etc. What they don't say is that FT boards - don't have to meet in public; governors have little real input into the day-to-day running of the hospital; the hospital is independent, so there is actually less public accountability. Opt out!