def TRUST BOARD / JUNE 2013 PROPOSAL FOR UNIVERSITY STATUS Agenda Item: 9a PURPOSE Informally by the East and North Hertfordshire NHS Trust Chief Executive PREVIOUSLY CONSIDERED BY Objective(s) to which issue relates * 1. To continuously improve the quality of our services in order to provide the best care and optimise health outcomes for each and every individual accessing the Trust s services 2. To excel at customer service, achieving outstanding levels of communication and patient, carer and GP satisfaction 3. To provide and support the best standards of integrated care for the elderly and those with long term conditions by developing key partnerships and services 4. To consolidate services and enhance local access to specialist services in order to deliver high quality, safe, seamless, innovative and integrated services which are sustainable 5. To support the continued development of the Mount Vernon Cancer Centre and provision of leading local and tertiary cancer services 6. To improve our staff engagement and organisational culture to be amongst the best nationally Risk Issues (Quality, safety, financial, HR, legal issues, equality issues) Healthcare/ National Policy (includes CQC/Monitor) CRR/Board Assurance Framework * Corporate Risk Register BAF ACTION REQUIRED * For approval For discussion For decision For information DIRECTOR: PRESENTED BY: AUTHOR: Director of Nursing Medical Director Professor Ken Farrington & Head of Postgraduate Medicine, University of Hertfordshire DATE: June 2013 We put our patients first We work as a team We value everybody We are open and honest We strive for excellence and continuous improvement * tick applicable box
UNIVERSITY OF HERTFORDSHIRE AND EAST & NORTH HERTFORDSHIRE NHS TRUST PROPOSAL BY THE UNIVERSITY OF HERTFORDSHIRE (UH) FOR THE RECOGNITION OF EAST & NORTH HERTFORDSHIRE NHS TRUST (ENHT) AS A UNIVERSITY TRUST 1. EXECUTIVE SUMMARY This paper outlines the implications for ENHT becoming a University Trust recognised by the University of Hertfordshire. It outlines the benefits of collaborative working, proposes greater strategic alignment and summarises the legal actions required. 2. BACKGROUND 2.1 This proposal has arisen from the Vice-Chancellor of the University of Hertfordshire and is endorsed by the Chief Executive Officer of ENHT. The proposal is to create a strategic alignment that will facilitate both organisations; ENHT is in a strong position to propose a change of status to University Trust. 2.2 ENHT provides an extensive range of clinical care services, and as a learning organisation the aim is to develop its staff and reputation to achieve excellence for its clients through the provision of a well-trained and motivated workforce. ENHT already engages actively with the University, working closely with Strategic Business Units within a range of pre-qualification student, CPD and research activities. Selected members of ENHT staff have joint appointments, are Visiting Professors and Senior Lecturers contributing to the collaborative success in the areas of education including: medical, nursing, midwifery and allied health professions. 2.3 As two aspirational organisations, the institutions would be better able to support staff, students, patients, carers and the community as a whole. This would facilitate and support such initiatives as joint research and joint posts, as well as a strategic alignment. It is anticipated that in the future, following the ratification of University Trust status, both organisations will be better able to recruit high calibre staff and clinical practice development will evidence a culture that will ultimately improve the experience within the community. 2.4 Creation of a new relationship would consolidate the strong history of collaborative working, co-terminus boundaries and shared values. It is recognised that both have an organisational culture of being aspirational and this would provide a platform for consolidating the identification of future business opportunities. 2.5 The current partnership arrangements support training and education at all levels including: prequalification training, CPD, workforce development, allied health professions and medical education. Some innovative and exciting joint initiatives have begun in the areas of: simulation early recognition and medical emergency management development of a programme of Medical Education Supervisors which is attracting regional attention. 2
2.6 The development of the Eastern Academic Health Science Network (EAHSN) will change the existing landscape and the University of Hertfordshire and ENHT will be well placed to influence future developments. Both have representation on the main EAHSN Board. The initiation of the Hertfordshire Node of the EAHSN was primarily driven by UH and ENHT and hence provides a platform for creating new synergies that will meet the strategic objectives of both organisations. These are closely interlinked with the EAHSN Strategic Goals which are detailed in Appendix 1. 3. CURRENT STAFFING AND APPOINTMENTS There are currently a number of joint, substantive, visiting and honorary posts held by ENHT staff including: 2 Visiting Professors 2 Joint Consultant appointments including the Associate Dean Medical Research Consultant Medical Researcher in Cardiovascular Medicine Honorary Senior Lecturers ( 7 ) Active Medical Researchers (3) 3.1 The EHNT has an excellent research and development track record in terms of the award of successful grants and recruitment to portfolio studies, rating highly within the region. Much of this work has been in collaboration with UH, specifically with Postgraduate Medicine, Psychology, Centre for Research in Primary and Community Care and Centre for Lifespan and Chronic Illness. There have been a number of successful grants awarded where applications and awards are mutually based Both organizations aspire to increase the number of successful applications specifically in NIHR funding streams With respect to health-related research, Trusts are now strongly encouraged to report, through Quality Accounts, their commitment to research and development as a driver for improving the quality of care and the patient experience. There is a major opportunity for collaboration to develop Trust R&D activity. With respect to Mount Vernon it is recognized that the proposed relationship will be complementary to the existing academic partnership. 3.2 Mapping of Activities The mapping illustrated in Figure 1 outlines current and future activities across the two organizations and aims to promote cross boundary partnership between the two organizations, enabling seamless collaboration. Key Principles are: To enhance health care provision locally, specifically in patient safety. To create an expanded network of health & academic resources. To build strategies of wealth creation. To align & integrate Trust & University education provision. 3
Figure 1 - Mapping Diagram of Current & Future Activities Paramedic Sciences Pharmacy Practice Nursing Clinical Service Development Develop Commercial opportunities Shared expertise and resources Research & Development Physiotherapy Occupational Therapy Pre- Qualified Training Midwifery Radiography Joint appointments Staff Opportunities Secondment of medical staff Access to joint research networks Joint grant applications Target organisational issues Designation & Recognition of E&NHT as an University Trust Joint support of PhD/ Doctorate programmes Alignment & integration of joint education provision Support and access to resources for clinical researchers Harness Creativity Technical Development Wealth Creation Influence Policy development PG Medical Education Responsiveness to health drivers Improve Environment & Service Delivery Networks Joint membership of AHSN Postgraduate Education Increase collaborative work Internal & External Networks 4 Implementation of R&D findings Simulation Provision Specialist clinical course development
3.3 Mapping of Activities Descriptors Pre-Qualified Training The Trust supports students in the following training programmes: Pre-Qualified Training Pharmacy Nursing Radiography Midwifery Occupational Therapy Physiotherapy Paramedical Sciences Staff Opportunities Developing a close working relationship would provide a spring board for our new posts and consolidate existing appointments: e.g. Increase number of Visiting Lecturer appointments. Further opportunity for joint appointments. Access to UH resources e.g. methodology, statistical analysis and support for clinical researchers. Research & Development Target organisational/ clinical issues within Trust. Opportunities through joint grant applications to access expertise, maximising income. Opportunities for Clinical Service Development. Link UH to external structure e.g. International Innovation Hubs Maximise utilisation of resources. Share expertise & resources in joint bids/ joint projects. Develop Commercial Opportunities. Provide access to joint research networks. 5
PG Medical Education Further alignment & integration of Trust & University education provision. Postgraduate Education including: Medical Education. Inter-professional Education. Leadership Development. Accreditation of Short Courses. Specialist Clinical Course Development. e.g. Diagnostic & Surgical Education development. Deanery approved medical programmes. e.g. Clinical Supervisors & Educational Supervisors. Simulation Provision for Team Development & Training: Significant investment by Uh in simulation facilities. New for 2013/14 will be a Diagnostic & Surgical Suite. Joint submission of Deanery approved medical programs. e.g.: FY1/2 Core Medical Training Medical Emergency for Teams Early Recognition for Teams Responsiveness to health drivers. e.g.: Francis Report Leadership Development Improvement Service Improvement Technical Development Exploit opportunities for practical projects; work with UH curriculae with respect to harnessing creativity & maximising resources to improve environment & service delivery. Multiple opportunities for collaborative work across Trust & University exist within most specialities: Development of solutions focussed service improvement e.g. environment design 6
Networks Academic Health Service Network. Joint Membership provides joined-up approaches to innovation & solutions focused on health inequalities Rapid implementation of research & design findings into clinical practice. Create Wealth Increased clinical efficiency Income generation Exploiting innovation in collaboration with industry e.g. SBRI bid for funding for Patient Safety innovation. Alliance to obtain value added in influencing policy development: more than the total of our sum parts. e.g. Influencing Policy development Local & National Research Networks: Shared approaches to LCRN Research design service (UH) Benefits include opportunity to exploit research funding streams jointly Internal & External Networks Improve platform for collaboration across two organisations e.g. CLiCR Develop a collaborative external facing entity. 4. LEGAL IMPLICATIONS To bring into effect an appropriate Trust, possibly entitled East and North Hospitals University NHS Trust, the following actions would be required: ENHT would need to apply to the Department for Business, Innovation and Skills for permission to use the word University ; this would require the University s support in the form of a letter of support to indicate how closely it would work and continue to work with ENHT; The relationship between the University and ENHT would need to be underpinned by a Memorandum of Agreement which would set out the responsibilities and liabilities of the two institutions; 7
The University would need to approve ENHT as a collaborating partner which should be conducted by the University s Academic Development Committee. 5. SUMMARY OF KEY ISSUES In summary, the key benefits to establishing a formal University affiliation for the Trust are: Consolidate existing collaborative work in health and medical education Consolidate existing collaborative work in workforce development Consolidate existing collaborative work in research and development, specifically to develop capacity of the two organisations to drive forward health-related and health services research Provide a learning environment which is an exemplar within the sector High quality learning tailored to meet the specific needs of healthcare organisations Embrace technological developments to enhance our learning provision Develop excellent relations with organization responsible for the quality of education & training Work with business, industry and the professions to optimise training opportunities Foster entrepreneurship and the associated wealth creation 6. RECOMMENDATION The RAQC is asked to approve the recommendation that the Trust formalise the collaboration with the University of Hertfordshire and adopt the status of East and North Hertfordshire Hospitals University NHS Trust. 8
Appendix 1: The EAHSN strategic goals 6. Create a regional framework for the implementation of Innovation, Health & Wealth and the Strategy for UK Life Sciences that connects researchers in our academic institutions with partners in primary, secondary and tertiary care, public health, social care, and industry. 7. Work in partnership with industry, and support both industry and NIHR research, by providing easy access to academic and clinical collaborators, research infrastructure and research subjects. To make the Eastern Region the go to place in Europe to set up substantial new knowledge-based healthcare businesses, building jobs, increasing exports and creating wealth for the region and the UK. 8. Lead the effective identification of innovation, best practice and evidence based approaches for improving health that are cost-effective, and can be rapidly adopted and implemented across the Eastern Region. This will include nationally designated innovations and those arising from the EAHSN programme of work. 9. Address health inequalities by identifying and addressing variations in health outcomes and in the delivery of healthcare in the Eastern Region through the analysis of robust data; and to develop a trusted centre for data analysis and data sharing within the EAHSN, that will link primary, secondary and tertiary care data, improving the quality and availability of information. 10. Use proven improvement science methods and professional networks to deliver measurable improvement in outcomes for the major chronic diseases that have the greatest scope for improvements. This will be achieved both through better prevention of disease, better management of ill health and improved healthcare systems. 11. Develop capacity and capability by creating a culture of learning within the EAHSN workforce, educated to be literate in research and research translation, using an inter-disciplinary approach to professional and clinical leadership development. 9