EVIDENCE FROM INDEPENDENT ADVISER
To hear evidence from Joy Tweed.
Minutes:
Joy Tweed was asked to collect comparative case study data from three other Foundation Trusts. This would help the committee to compare models of governance and financial operation which would help to inform decisions concerning the Whittington Hospitals proposals. A summary of the main points arising from panel discussions of this data is presented below.
· Foundation Trusts had only been operating since 2004 therefore there is a general paucity of evaluative data relating to these institutions.
· An outline of case study data was presented to members of the panel which related to the size of the membership, the number of governors and the relationship between the Board of Governors and the Board of Directors. This is summarised in the Table 1 below:
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Table 1 - Summary of case study Foundation Trusts |
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Case Study 1 |
Case Study 2 |
Case Study 3 |
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Membership |
14,800
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12,300 |
100,000 |
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Members Council (Board of Governors) |
37 (7 staff, 10 public, 10 patients, 10 stakeholders) |
33 (5 staff, 3 public, 14 patient, 11 stakeholders)
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33 (5 staff, 17 public, 2 patient, 9 stakeholder) |
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Relationship between Board of Directors and Members Council |
§ Board meetings attended by Council Members: report on progress & activities. § Board Members invited to all Council Meetings: report on progress & activities. § All Member Council sub committees attended by an Exec and Non Exec. |
§ Board has 4 general meetings a year. § There is one joint Board and Council meeting per year. |
§ Governors do not attend Board of Directors meetings. § Members Council meeting attended by at least 2 Execs, Non Execs are always invited.
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· Obtaining specific financial data from Foundation Trusts proved problematic, particularly those costs relating to recruitment and maintenance of trust Membership (as such data was not detailed in annual accounts). However, data was presented from a Foundation Trust which was not one of the three case studies. This Foundation Trust had a budget of £150,000 set aside for costs associated with the Membership of which £25,000 was used to fund the election of governors. Approximate spend per Member at this Trust equated to £30 per annum.
· The Members Council was noted to have different functions in each of the case study Foundation Trusts, with some having more progressive roles than others. Thus, whilst one Member Council was involved in strategic planning, the work of another appeared to focus on the “patient experience”. In one case study, the members Council had played a significant role in the takeover of a failing NHS Trust.
· The relationship between the members Council and the Board of Directors would also appear to vary across the case studies. In one case study, the Council and the Board met regularly and the relationship would outwardly appear to be transparent. In other Foundation Trusts, the Council and the Board only met once per year.
· The ultimate sanction that the Board of Governors may have with the Board of Directors is the dismissal of the Chair and Directors. Evidence suggests that Governors are reluctant to use this ... view the full minutes text for item 16