Public consultation response and evidence of staff engagement / involvement This document outlines the information required from aspirant NHS Foundation Trusts to satisfy key stakeholders that:

robust public consultation has been undertaken and a representative membership base has been developed

staff and stakeholder involvement in the development of the integrated business plan has been actively sought and impacted

the organisation can demonstrate a continued commitment to expand and progress the wider culture change and social responsibility required to operate as an NHS foundation trust.

Background

1. Name of applicant Staffordshire and Stoke on Trent Partnership NHS Trust

2. Area served by Trust

The Trust is located within the geographical boundaries of Staffordshire County Council and Stoke-on-Trent City Council. It serves a diverse population of 1.1 million people, covering a wide geographical area stretching from the Staffordshire Moorlands, which borders the Peak District in the North, to the conurbation of the Black Country in the South.

Although largely rural the Trust also provides services in urban centres such as Stoke-on-Trent, Leek, Burton upon Trent, Cannock, Lichfield, Stafford, Tamworth and Wombourne.

3. Contact details of person responsible for the public consultation

Kate MontgomeryEngagement & Membership Manager

Tel: 0845 602 6772 ext 1630Email: kate.montgomery@ssotp.nhs.uk

About the public consultation

4. Dates of public consultation

Started Finished

23/07/2012 20/10/2012

5. Which media were used for the public consultation document?

Full consultation document in hardcopy

Yes

Summary consultation document in hardcopy

No

Web-based consultation document Yes

Talking book/ audio tape/CD-ROM Yes

Large print versions Yes

Versions in ethnic languages (please specify which)

Yes

- Punjabi Pakistani- Punjabi Indian- Urdu- Polish- Hindi- Gujrati- Bengali

Presentation at public meetings (please specify where meetings were held and the number attending each)

The Trust facilitated 10 formal Foundation Trust public consultation meetings covering each of its proposed public member constituencies:

Town Hall, Burton upon Trent – 2-4pm / 15/08/12 / Attendance of 8

Wombourne Council, Wombourne – 3-5pm / 24/08/12 / Attendance of 0

Foxlowe Community Centre, Leek – 12-2pm / 29/08/12 / Attendance of 6

Stoke Potteries Museum, Stoke – 11am-1pm / 06/09/12 / Attendance of 1

Stafford Borough Council, Stafford – 11.30am-1.30pm / 20/09/12 / Attendance of 9

Lichfield Guildhall, Lichfield – 10am-12noon / 27/09/12 / Attendance of 5

Community Fire Station, Tamworth – 4.30-6.30pm / 03/10/12 / Attendance of 5

Leisure Centre, Cannock – 5-7pm / 08/10/12 / Attendance of 6 Community College, Newcastle under Lyme – 4-6pm / 10/10/12

/ Attendance of 16 South Cheshire College, Crewe – 5-7pm / 12/10/12 / Attendance

of 0

The Trust also attended and presented at a number of other public and partner meetings:

Leek & Biddulph Patient Participation GroupMoorlands Medical Centre (Leek) / 1pm / 11/09/12 / Attendance of 12

Staffordshire and Stoke on Trent Partnership NHS Trust AGMPenkridge Hall (Penkridge) / 5pm / 17/09/12 / Attendance of 60

Stoke on Trent LINk MeetingLondon House (Stoke-on-Trent) / 12.30pm / 13/09/12 / Attendance of 6

Staffordshire LINk Board MeetingBeacon International Centre (Stafford) / 10.40am / 14/09/12 / Attendance of 9

Age UK MeetingDudson Centre (Stoke on Trent) / 10.30am / 09/10/12 / Attendance

of 19

Staffordshire County Council Health Scrutiny CommitteeStaffordshire County Building (Stafford) / 10am / 01/10/12 / Attendance of 23

Youth Action Kouncil MeetingStaffordshire Place (Stafford) / 5pm / 17/10/12 / Attendance of 9

Stoke on Trent City Council Health Scrutiny CommitteeCivic Centre (Stoke on Trent) / 10am / 20/09/12 / Attendance of 20

Cannock CCG Board MeetingBeecroft Rd (Cannock) / 2.30pm / 04/10/12 / Attendance of 12

North Staffordshire CCG Board MeetingConference Centre (Newcastle Under Lyme) / 2.50pm / 12/09/12 / Attendance of 10

South East Staffordshire & Seisdon CCG Governing BodyMerlin House (Tamworth) / 2pm / 10/10/12 / Attendance of 9

Stafford & Surrounds CCG Board MeetingRising Brook Baptist Church (Stafford) / 1.30pm / 02/10/12 / Attendance of 20

Stoke on Trent CCG Board MeetingHerbert Minton Building (Stoke on Trent) / 2pm / 25/09/12 / Attendance of 10

East Staffordshire CCG Steering GroupEdwin House (Burton on Trent) / 1pm / 11/10/12 / Attendance of 12

Other (please specify)

The Trust undertook a variety of activities to ensure the widest possible distribution of information amongst its key stakeholders:

Internal Communication

Online: Basic information including the FT presentation, FAQs, a downloadable consultation brochure, events and an interactive consultation questionnaire were made available online.

All User Emails: Information on how to have a say and updates about the consultation were regularly circulated to all staff. These included regular reminders about upcoming events and meetings.

Team Meetings / Away Days: The Foundation Trust team encouraged requests from staff to speak about FT at their department away days / team meetings and attended a variety of these events. Senior staff were also urged to cascade information to teams and encourage their participation.

Team Brief: A monthly update was given on the Trust’s FT application and membership/consultation issues via ‘Team Brief’ sessions.

Staff Newsletter: Prior to its beginning, and during the consultation, updates on the Trust’s FT application and upcoming meetings / events

were communicated to staff via internal newsletter – ‘The Word’.

Fact Sheets: A flyer with key information on the FT process, membership and the Trust’s consultation was distributed to staff to increase their confidence in speaking to service users, carers and the general public about our plans.

Payslips: Information regarding the Trust’s FT application and membership/consultation was distributed via payslips for three consecutive months to ensure full coverage of the workforce.

Corporate Induction: Consultation / membership information and upcoming event information was given out to new staff at three consecutive staff induction sessions during the consultation period.

Joint Staff Partnership: Staff Side have been briefed and engaged via the Joint Staff Partnership, with a number of discussions regarding staff membership and the configuration of the council of governors.

External Communication

Online: Basic information including the FT presentation, Frequently Asked Questions, a downloadable consultation brochure and an interactive consultation questionnaire / membership form were made available online.

Hard Copy: Consultation brochures, membership forms and upcoming events flyers were sent to Trust sites across Staffordshire for display in public areas.

Consultation brochures and membership forms were distributed at all public meetings and meeting venues, including Trust consultation meetings covering all membership constituencies.

Consultation brochures and membership forms and flyers on upcoming meetings were distributed at all community fetes and other events (AGMs of partner trusts for example).

Consultation information was distributed in response to contacts received by the Trust’s PALS team

The Trust sent its consultation document and information about upcoming meetings and events to its 1,500 strong membership. With many staff based out in the community, they were asked where possible to distribute consultation materials and information to service users/carers in the course of their day-to-day activities.

The Trust’s comprehensive database has been developed to ensure the inclusion of groups representing more vulnerable people and those with protected characteristics e.g. British Muslim Welfare Association, Disability Solutions and Reach (a group for people with learning disabilities). In a bid to consult with minority groups contact letters seeking views and offering meetings were sent to a wide range of diverse organisations. These included hard copy consultation brochures which were available in a number of languages and formats.

Emails: Regular updates and consultation materials were distributed via email to the Trust’s key stakeholders:

Chief Executive Officers of partner organisations – All CCGs in the Staffordshire region, Staffordshire County Council, Stoke on Trent City Council, Burton Hospitals NHS Foundation Trust, Mid Staffordshire NHS Foundation Trust, University Hospitals North Staffordshire NHS Trust, South Staffordshire & Shropshire NHS Foundation Trust, North Staffordshire Combined Healthcare NHS Trust, West Midlands Ambulance Service NHS Trust, Staffordshire Fire & Rescue Service, Staffordshire Police Service & VAST (a Local Development & Support Organisation)

MPs from each borough/district

All councillors from each borough/district

GP practices throughout Staffordshire and Stoke on Trent

Communication Departments of partnership organisations – for distribution to staff/public via newsletters and promotion online

An extensive list of voluntary organisations based in Staffordshire and Stoke on Trent

The North and South Staffordshire Chambers of Commerce for distribution amongst local private sector companies

Extensive database of service users and carers (usually also representing voluntary groups)

The Trust has consulted with a significant proportion of the population by having information circulated to all councillors and area committee members in Staffordshire and Stoke on Trent

The Trust’s comprehensive database has been developed to ensure the inclusion of groups representing more vulnerable people and those with protected characteristics e.g. Savana (a group supporting victims of sexual assault & violence), the LGBT Network, the North Staffordshire African Caribbean Association. In a bid to consult with minority groups contact letters seeking views and offering meetings were circulated to a wide range of diverse organisations. These emails included the consultation document which was available in a number of languages and formats.

Events / Displays: With the help of staff the membership office undertook consultation activity at a full calendar of events including local fetes, carnivals and shows. It consulted face-to-face with the wider community at events such as ‘Midsummer Mayhem’ and the ‘Leek & District Agricultural Show’ which attracted an audience of approximately 40,000.

Representatives also attended health related fairs, AGMs of partner organisations and conferences for health professionals to inform those with a vested interest in the NHS.

To ensure interaction with a variety of age groups the Trust had a presence at a number of fresher events at local colleges and universities, linking in with its sexual health team to ensure relevant messages for the audience.

The Partnership Trust is committed to engaging with its diverse communities and its consultation programme included attendance at events such as an Eid Health Festival in Stoke. The Trust has plans to

follow up the consultation with a presence at other key upcoming festivals such as Diwali. The organisation will also continue to gather input through its bi-monthly Community Health Equalities Network (CHEN), made up of representatives from the community and partner organisations who are supporting the organisation in embedding its Equality and Inclusion agenda.

In addition to meetings, the Trust attended just under 20 different community events across Staffordshire and Stoke on Trent during the three month consultation. This figure would have been even higher but for a number of cancellations due to inclement weather and reduced funding for events as result of the current economic climate.

However, the events attended by the Trust attracted over 50,000 other people, ensuring it was able to reach a wide and diverse audience within the West Midlands.

At all events, consultation brochures and membership forms were distributed alongside branded promotional items carrying the Trust’s website and contact details.

Meetings: The Trust held ten of its own public consultation meetings to discuss its Foundation Trust proposals. These covered the localities of each of its membership constituencies and attendance was fair given improved awareness about FT status amongst the general public and the length of time for which applications have been being undertaken – eight years. Consultation brochures, membership forms and copies of the Trust’s FT presentation were distributed at all 10 meetings and attendees had the opportunity to question executive leads about the Trust’s FT plans. The Trust also attended a number of other key meetings held by commissioners, voluntary sector groups and other local providers. The Trust consulted with over 280 people using this method of engagement.

The Trust’s Chief Executive and Chairman have held one-to-one meetings with the CEOs or relevant senior directors of key partnership organisations including Staffordshire Fire & Rescue Service, Staffordshire Police Service, Staffordshire County Council, Stoke on Trent City Council and VAST (a Local Development & Support Organisation). These meetings included discussions on the Trust’s FT proposals and potential upcoming opportunities for organisations to nominate an appointed governor to the Trust’s council of governors.

In addition, the Trust has distributed information to its own bi-monthly Service User & Patient Experience Forum with 10 people in attendance which included service user/carer representatives from both Staffordshire and Stoke on Trent. Media: Staffordshire and Stoke on Trent attempted to raise further awareness of the Trust’s public consultation and upcoming public meetings through the local press. Following press releases on the Trust’s plans coverage appeared in a number of publications covering a significant number of the Trust’s membership constituencies, including ‘out of area’:

The Sentinel (Staffordshire Moorlands, Stoke on Trent, Newcastle, Stafford, Cheshire) – Daily Circ. 50,792

Tamworth Herald (South Staffordshire, North Warwickshire) – Weekly Circ. 30,000

Burton Mail (East Staffordshire, South Derbyshire, North West Leicestershire) – Daily Circ. 12,198

Leek Post & Times (Staffordshire Moorlands) – Weekly Circ.

10,815

6. Number of formal responses received

No. of responses

Hardcopy, using proforma provided as part of the consultation exercise

16

Others in hardcopy – letters, etc 12

On website 8

By email 10

By telephone 1

By fax 0

By text 0

Verbally at all public meetings 223

Others (please specify) 7: Comments received through attending team meetings and Team Brief

7. Was the pattern of responses to the public consultation in line with the demography and geography of the area? Were there any areas or groups that were not adequately represented in the responses received? Please provide explanations where necessary, and details of trust action plans to target under-represented areas. Geographically, response to the Trust’s consultation was fairly evenly distributed. The Trust held 10 formal FT public consultation meetings, with one located in each of the proposed membership constituencies. The meetings were held at various times during the day and evening to maximise potential participation and were well publicised in local media, at events, via email distribution and on the Trust’s website. Emails were distributed to over 15 partner organisations, 12 MPs, 211 council representatives (council members, select committee members and district leads and their local health committees), 185 GP Practices and a database of third sector groups and organisations across the Staffordshire and Stoke on Trent region, many of which include service users and carers as members. Some of these were:

Community Health Voice VAST CVS Organisations (All districts) Staffordshire LINk Stoke on Trent LINk Staffordshire Buddies (a group promoting sexual health) Age UK Deaf Vibe Homestart ELITE Enabling Living Independently Patient Participation Groups Newcastle 50+ Forum North Staffs Users Group North Staffs Carers Association

The majority of public meetings were fairly well attended, ensuring audiences from a mixture of postcodes. The Trust also noted that audiences at number of its meetings included local councillors.

The Trust recognises however, that holding formal, single issue public meetings is not always the most appropriate method of consultation. As a result, the Trust’s senior team attended a significant number of both formal and informal meetings during the consultation period to discuss FT plans (as listed in section 5). The Trust has tried to ensure an equal and consistent approach to engagement across all its boroughs and districts. A range of consultation materials were distributed across the localities, including any formal meetings where FT plans were part of their agenda.

Throughout the consultation exercise and FT membership drive, it has been important to the Trust to engage with seldom listened to communities. The membership office worked closely with the Trust’s Equality & Diversity Lead to ensure information about the consultation was distributed as widely as possible amongst diverse groups. This included information being sent out to the Trust’s Community Health Equalities Network (CHEN) representatives, who in turn were asked to cascade this to their wider communities. Printed copies of the consultation document were also forwarded to Islamic, Bengali & Pakistani community leaders, Hindu and Islamic Cultural Centres and local Mosques. Other groups contacted include the British Muslim Welfare Association, Disability Solutions and Reach (a group for people with learning disabilities). In addition to sending out information, the Trust’s Equality & Diversity Lead discussed the consultation with community representatives during face to face meetings on a variety of topics.

Finally, the Trust noted a good mix of ages, gender and ethnic groups etc at public meetings and community events. One meeting in particular attracted attendance from a number of people with hearing and visual impairments. Many were encouraged to attend by local third sector group, DeafVibe, who favourably advertised the meetings to its members upon learning that an interpreter would be present.

About the comments

8. Please list responses received from major stakeholders (individuals and orgs) and their general view – include local MPs, local authorities, local NHS organisations, professional and staff representative bodies, local commercial organisations, national and local voluntary organisations, etc.

Name Broadly in favour

Broadly neutral

Broadly opposed

Main issue raised

East Staffs CCG

Yes – ‘ES CGG supports the transformation regarding an integrated and proactive approach to supporting people with long term conditions’.

ES CCG supports a genuine shift in power to the patient/user, making shared decision making a reality.

Stoke on Trent CCG

Yes – ‘Encouraged with the clear vision and working in collaboration with a commitment to work with communities and socially deprived people’.

SOT CGG asserted the need to include ‘Stoke on Trent’ in the name. SSOTP must recognise health inequalities in the region and give the people of SOT a sense of ownership.

North Staffs CCG

Yes – ‘We welcome

Appointed governors

Trust’s commitment to personal health inequalities. SSOTP shows strong leadership in sexual health services’.

could include representation for the ambulance service.

Cannock CCG

Yes – ‘ We are supportive of your plans to increase the amount of time front line staff have with patients, a more proactive approach is also pleasing to see’.

Broadly supportive of governance arrangements but Trust could consider an appointed governor for both SW Staffordshire and SE Staffordshire rather than one governor for all of South Staffordshire.

Stafford & Surrounds CCG

Yes – ‘The use of technology and a standardised approach to assessment is welcomed’.

Will be key to deliver changes at a pace and scale which creates changes we need to see to support QIPP and allow for better use of taxpayers resources.

Michael Fabricant (MP)

Yes – ‘The application has my full support’.

The standardised assessment process and single point of access / care will be helpful to constituents that write to me re: length of time taken for care plans to be put in place.

Staffordshire Fire & Rescue Service (Glynn Luznyj – Head of Risk Reduction)

Yes – ‘It is pleasing to be identified as a key stakeholder and we look forward to supporting the Trusts’ plans

The consultation document also details a very robust approach to governance arrangements involving key

and priorities through inclusion on the council of governors’.

partner agencies and the development of a diverse membership which is crucial to the successful delivery of services.

Staffordshire Police Service (Mike Cunningham – Chief Constable)

Yes – ‘I agree with the proposed name for the new Foundation Trust’.

It may be helpful to add “Constructive Challenge” to the Governor’s general duties and responsibilities.

Burton Hospitals NHS Foundation Trust (Jackie Jones – Director of Strategy)

Yes – ‘I can confirm that we are happy to support your application forFoundation Trust status’.

We recognise and support the Trust’s plans and priorities for the future. We have no issues regarding the proposed name and would support your proposals regarding membership, and your constitution around the Council of Governors.

Mid Staffordshire NHS Foundation Trust (Lyn Hill-Tout - CEO)

Yes – ‘We support your vision to integrate health and social care services around the needs of service users, especially those with long term conditions. This will lead to a more patient focussed approach and improve quality of service to

Your planned number of governors does seem on the high side, although it is appreciated that for a provider of community services it may be beneficial given the number of organisations from whom you would wish to have an appointed governor and the diverse range of public

patients in terms of overall health outcomes’.

you serve.

South Staffordshire & Shropshire NHS Foundation Trust (Neil Carr - CEO)

Yes – ‘Following the consultation pleasefacilitate continued discussions with otherpartners in the economy’.

It would be better if the name better reflected the primary care nature of the business.

Staffordshire University (Michael Gunn – CEO)

Yes – ‘The university welcomes the scope of the community based health and social care services that the Trust will deliver. It also recognises the opportunities that Foundation Trust status will provide, such as effective engagement with the community’.

We would be pleased to become a member of the Trust and to nominate a representative to fill the proposed seat for an appointed governor from the University.

Keele University (Nick Foskett – Vice Chancellor)

Yes – ‘Keele University looks forward to making a positive contributionto the Trust’s future plans and priorities in relation to education and training and in research and adoption of evidence -based best practice’.

Keele University welcomes an opportunity to contribute to the new organisation via its appointed governor category on the council of governors.

Community Health Voice

Yes – ‘Both “Our Vision” and “Our Goals” recognise that the aspiration

Members felt it was unnecessary to have 3 ‘Public Governors’ for Stoke-on-Trent.

should be to provide best possible outcomes. This is positive’.

A reduction to one governor would free up two positions on the council, which should be added to the service user/carer category.

Stoke on Trent LINk

Yes – ‘Stoke-on-Trent LINk wishes SSOTP every success in its bid to gain Trust status and it looks forward to working with the Trust into the future’.

The only major area of disagreement concerns the suggested renaming of the organisation and the drop of ‘Stoke-on-Trent’ from its title. We feel this should be retained as Stoke is a key geographical area.

Staffordshire LINk

Yes – ‘We agree with the future plans and priorities and are comfortable with the proposed name. However, we acknowledge that Stoke-on-Trent service users and politicians may feel differently’.

Whilst it is recognised that the Council of Governors must be fully representative, it also needs to consider the size of the council of governors and ensure it remains manageable. Regarding the recruitment of a representative from the voluntary sector, we feel this could be via the Staffordshire and Stoke on Trent Healthwatch, with a governor from each board.

9. Apart from those listed in 8 (above), how many other responses were received in total?

An additional 256 responses were received.

9 (a). Was there an OSC review process?

Yes.

Stoke on Trent City Council – Adult & Neighbourhoods Scrutiny Committee

Stoke on Trent City Council’s Adult & Neighbourhoods (including Health) Scrutiny Committee met to consider the Trust’s FT consultation proposals on 20th September 2012. The meeting was attended by members of the committee and a number of other senior staff to allow the opportunity for a full and open debate regarding the Trust’s plans. The main points that were raised and debated as part of the discussions of the Overview & Scrutiny Committee were as follows:

There was no major disagreement with the service transformation plans laid out, although it was pointed out that these must be delivered in a transparent and accountable way to the citizens of Stoke on Trent.

The committee was keen to understand and see how the health inequalities and needs of the citizens of the city will be reflected in the planning, prioritisation and governance of the trust.

Given the levels of health inequalities and distinct needs of the population of Stoke on Trent, the committee felt it was important both politically and symbolically that Stoke on Trent was retained in the Trust’s title

The committee broadly agreed with the proposals regarding members of the trust, plans being consistent with other schemes required by Monitor.

The committee broadly supported the proposal of a council of governors but outlined some areas of concern:

o 5 staff governors for a Trust with 6,000 employees did not strike the committee as representational or reflective of a multi-professional organisation

o Regarding third sector representation, the committee was unclear as to how one individual will represent the voice of such a large geographical area

o The committee expressed concern over how Stoke on Trent CCG would be represented in the governance arrangements, being a key commissioner and investor in the Partnership Trust

Following these discussions, the overall view of the Adult and Neighbourhoods Scrutiny committee was that it was in broad support of the Trust’s application and proposals. It was deemed important for there to be stronger democratic accountability in the NHS and that the proposed governance and member approach should assist in delivering some aspect of this. It was also acknowledged that a well governed, efficient, effective and economic NHS organisation would be important in delivering high quality care.

Staffordshire County Council – Health Select committee

The Trust’s consultation was also considered by Staffordshire County Council’s Health Select committee on 1st October 2012. Again, this meeting was attended by members of the select committee and a number of other senior staff to allow the opportunity for a full and open debate regarding the Trust’s plans. The main points that were raised and debated as part of the discussions of the Health Select Committee were as follows:

There was concern about the higher number of public governor representatives in Stoke on Trent.

After expressing concern about the negative history of some Foundation Trusts in the region, the committee was reassured of the learning process that had been undergone by both Trusts and Monitor and that quality was the Partnership Trust’s first priority

A number of comments and questions were raised regarding the Trust’s service transformation plans. Committee members asked for further detail around how paperwork would be reduced and timescales for new projects to be implemented.

There was a clear appetite for Stoke on Trent City Council to follow the county council’s lead in integrating social care services into the Partnership Trust. The Trust was asked how it would be progressing in this area.

Following these discussions, the overall view of the Health Select Committee was that it was in broad support of the Trust’s application and proposals.

10. Excluding those recorded at 8 (above), how many responses were:

Broadly in favour Broadly neutral Broadly opposed

34

Most people who answered the consultation questionnaire were in favour of the Trust becoming a Foundation Trust, and mostly in favour of the individual proposals put forward by the Trust. There were also positive comments at meetings in addition to numerous emails from partner organisations.

213

The Trust was encouraged by the large number of people who proactively engaged with the organisation in order to find out more about its FT plans and proposals. The broadly neutral responses were recorded at public and staff meetings where attendees requested extra information.

General questions allowed the Trust to raise its profile amongst the local community and reiterate its vision to provide personalised care of the highest quality, with the best possible outcomes for users and carers, empowering them to remain independent. No objections were raised to our becoming a Foundation Trust.

9

The majority of these responses did not outline an explicit rejection of Foundation Trust status in itself, but outlined problems with some of the individual proposals. There was some reticence for example around whether the membership / council of governors would achieve a genuine improvement in shared decision making. There were also some comments about past experiences of care that were unsatisfactory.

There were only two responses showing blanket opposition to the Trust becoming an FT – this related largely to historic failures in the region of Staffordshire and a concern that financial issues would be put ahead of quality.

Trust Response

11. Does the Trust have any comments about the general tone of responses received? For example, were those opposing the proposals expressing fundamental objections or picking up minor (possibly technical) issues? The general tone of responses to the Trust’s Foundation Trust consultation was in broad support of the proposals described in the consultation process. Stakeholders seemed to be fully aware that the requirement to become a Foundation Trust is national policy and overall, commented positively on the Trust’s proposals for membership and governance arrangements. Of all the responses received, only two outlined a fundamental disagreement with the Foundation Trust process in itself. In the main however, responses were either positive or neutral.

Common themes that emerged from the responses related to:

the configuration of the Council of Governors, particularly regarding Appointed Governor seats and increased representation for the voluntary sector and CCGs

the name of the Trust and whether Stoke on Trent should be included in the title the Trust’s service transformation plans with requests for extra detail on projects and how the

organisation will achieve its required efficiencies the FT application process and what this would mean in terms of how quality and finance

would be prioritised

The Trust will be amending its draft Constitution accordingly to address these views.

Many responses included requests for more information about the Foundation Trust model, the implications of standing for election as a Governor or other general queries about the Trust and its services. These more general issues were all responded to accordingly during the consultation.

12. What were the main topics that attracted critical comment and what was the trust’s response? Issue (please include in brackets the name of the main person(s)/ bodies raising it)

Trust’s response

Configuration of the council of governors

Raised by: Local Authorities / Commissioners / Partner Organisations / Staff / Service Users & Carers / Voluntary Sector / General Public

Number of times raised: 40

A common theme from the responses pertained to the configuration of the Council of Governors, particularly regarding Appointed Governor seats. The consultation proposes that seats in this category are divided up as follows:

Commissioners x 2 Staffordshire County Council x 2 Stoke on Trent City Council x 1 Staffordshire Police Service x 1 Staffordshire Fire & Rescue Service x 1 Staffordshire University x 1 Keele University x 1 Voluntary Sector x 1

Representation for the voluntary sector and commissioners was considered lacking. It was also suggested on some occasions that an ambulance trust representative may be beneficial.

The most common concern about elected representatives related to the higher number of seats allotted to Stoke on Trent in the Public Governor category. It was also suggested, although to a lesser extent, that the Service User/Carer Governor category should be bigger.

The Trust has taken this feedback into account and on reflection has decided to increase the number of appointed voluntary sector representatives from one to two. To maintain a majority of one for the public and service user/carer governor categories, the number of seats for service users/carers will be increased from four to five. The Trust’s constitution has been amended accordingly.

Trust Name

Raised by: Local Authorities / Commissioners / Partner Organisations / Staff / Service Users & Carers / Voluntary Sector / General Public

Number of times raised: 46

The Trust received 46 separate pieces of feedback on its proposed new name:

Staffordshire Partnership NHS Foundation Trust

This topic sparked an unexpectedly fierce debate, centred chiefly around the proposed exclusion of ‘Stoke on Trent’ from the title.

Many were in favour of the proposal and of dropping ‘Stoke on Trent’, feeling the current name was too long and unwieldy, but others strongly opposed its exclusion, feeling it should remain to keep focus on the health inequalities in that area.

There were also calls for the name to include words such as ‘healthcare’ or ‘community’, with many respondents commenting that it was unclear what the Trust did, regardless of the geographical issue. The word ‘partnership’ was considered unnecessary by some who felt it was too ambiguous. After taking all feedback into account, the Trust has decided not to omit ‘Stoke on Trent’ from its title. This means that should the Trust achieve FT status, its name will be as follows:

‘Staffordshire and Stoke on Trent Partnership NHS Foundation Trust’.

This change is now reflected in the Trust’s Constitution.

Future Plans

Raised by: Local Authorities / Commissioners / Partner Organisations / Staff / Service Users & Carers / Voluntary Sector / General Public

Number of times raised: 82

The Trust’s plans for service transformation play an intrinsic part in its Foundation Trust application and were brought up 82 times during the consultation. While this topic attracted a lot of interest it is important to note that the majority of this was positive and not critical. One NHS partner commented that the Trust’s service transformation plans would ‘lead to a more patient focused approach and improve quality of service, especially in terms of overall health outcomes’.

Some respondents merely wanted more detail on Service Transformation projects and how they would work. Others raised questions about the ambitious timescales set out by the Trust for both achieving FT status and implementing service transformation projects.

Some respondents however, were concerned that service transformation and efficiencies would inevitably lead to a reduction in care provision and local knowledge. The need for increased focus on children’s services and public health

issues was also raised intermittently. Even where concerns were raised it was still generally conceded that extra efficiency was ‘needed’ and that the general ideas were ‘good’. There was regular comment however on the amount of information given about the projects, with many people saying they would like more detail and a better understanding of how it would affect individual teams.

The Trust has already undertaken a significant amount of public, patient and staff engagement around its new service model, some of which has coincided with the Trust’s FT consultation. For example, three events in October (held in partnership with North Staffordshire CCG) served to engage service users with long-term conditions, gathering their input on the new ‘integrated local working’ model. The Trust will be looking to maintain engagement during the implementation of its service transformation programme.

The Trust is not looking at altering its service transformation plans as a result of feedback received, believing they will result in an improved and more efficient service for users and carers.

Staff Issues

Raised by: Local Authorities / Service Users & Carers / General Public / Voluntary Sector

Number of times raised: 13

Topics relating to staff were raised 13 times during the consultation. The Trust received favourable comments from external stakeholders regarding its attempt to encourage staff to sign up proactively rather than adopting an ‘opt out’ approach, with a feeling that this would foster a culture of more genuine engagement with the workforce. It was commented on however, that the Trust had a big job to do in terms of bringing its workforce along with planned changes and keeping morale up. In agreement with Staffside, an opt-out approach to staff membership has been implemented given the scale of change currently being undertaken across the organisation.

On the issue of not sub-dividing the staff constituency however, Staffside raised concerns saying this could result in uneven representation either on the basis of professional group, grade, service area or geographical location. Having listened carefully to this feedback, the Trust made the decision to split its staff membership into five separate constituencies based on profession. The Trust’s constitution has been amended to reflect this.

There were some concerns that staff did not fully understand the FT process or the direction of the organisation. Information on the different channels through which staff could access updates was given out in response and this has

now been further addressed through a road-show of sizable staff events.

The question of whether there would be redundancies as a result of the Trust’s service transformation plans came up a number of times. The Trust explained that it wished to avoid this course of action and would instead be looking at natural turnover. As well as considering every vacancy very carefully, the Trust may also look at employing staff on fixed term contracts. It was made clear however, that if there was room for working more efficiently less staff would ultimately be needed.

Membership age restrictions

Raised by: Youth Action Kouncil

Number of times raised: 10

Generally, there was widespread agreement with the Trust’s plans for membership. However, a number of younger respondents felt the age limit to join as a member should be lowered to 14 years old to ensure better engagement of children.

This idea has now been actioned and the Trust’s constitution updated accordingly.

Further integration required with Stoke on Trent City Council’s Adult Social Care Services

Raised by: Local Authorities / Service Users & Carers / General Public / Voluntary Sector

Number of times raised: 10

Following the Trust’s recent integration with Staffordshire County Council, a number of responses were received regarding the possibility of further integration work involving Stoke on Trent City Council’s adult social care services. There was also a suggestion that children’s social care services should be brought into the organisation as well. This was on the basis that there would be a better transition for service users between child and adult services.

13. What were the main areas attracting support locally? (please indicate in brackets the main source(s) of this support, e.g. patients, staff, general public) Foundation Trust Application (Service Users / Carers / General Public / Staff / Partner Organisations / Local Authorities / MPs / Commissioners)

All key stakeholders with whom the Trust has engaged about the FT application have been broadly supportive of the proposals, commenting that it will allow further improvement of care and services for local people. Some people did seek reassurance about the Trust’s commitment to quality over finance, given the history of other NHS Foundation Trusts based in Staffordshire. This was given by senior members of staff who could set out the ways in which the Trust would be held accountable during and after the FT application process. On those occasions, stakeholders appeared happy with the response.

Membership and the Configuration of the Council of Governors (Service Users / Carers / General Public / Staff / Partner Organisations / Commissioners / Local Authorities / MPs) There was overall and general broad support for the plans. Stakeholders have commented positively on the Trust’s plans for improved engagement and accountability – in particular the inclusion of standalone membership and governor categories for service users/carers, ensuring the proper representation of this group. There have been a number of responses regarding the proposed configuration of Appointed Governors (see section 12 above), which the Trust will take into consideration when amending its Constitution.

Future plans (Service Users / Carers / General Public / Staff / Partner Organisations / Local Authorities / Commissioners / MPs) The Trust is undertaking a significant programme of service transformation which was referred to and commented upon throughout the FT consultation process. Overall, there has been wide-ranging support for these plans but also recognition of the vast amount of work to be done and the challenges involved in achieving planned improvements while delivering significant savings. There also seemed to be an appetite for further detail on the transformation projects and how they would affect individual services.

14. Specifically, what was the general tenor of responses with regard to: Membership Responses to the Trust’s proposals for its

membership were generally positive. A number of individuals have joined as members as a direct result of the consultation process.

Board of Governors A common theme within the responses pertained to the configuration of the council of governors, particularly regarding the following areas:

a suggested increase in the number of appointed governors representing the voluntary sector

a suggested increase in the number of appointed governors representing CCGs

the suggested inclusion of an ambulance trust representative in the appointed governor section

a suggested increase in the number of seats allocated to service users/carers

queries regarding the higher number of public governors allotted to the Stoke on Trent constituency

The Trust will take this feedback into account for future developments of its draft constitution.

Board of Directors There were no objections to proposals over the configuration of the Board of Directors. On a couple of occasions the issue of the salaries of senior staff was raised. The Trust reassured the people in questions that all information pertaining to senior staff salaries was publically available in the annual report.

Elections There was a great deal of interest in the Governor elections. During the consultation process, a number of individuals and stakeholders expressed interest in standing for election or in nominating themselves from partner organisations as appointed governors. In terms of appointed governors, the Trust received interest from a number of organisation leaders such as the Chief Constable for the Staffordshire Police Service.

Constituencies Respondents were in general agreement with the constituencies for the Trust’s membership.

Boundaries There were no objections to the proposed geographical boundaries.

Constitution There was general support for the main elements of the Trust’s constitution, which were set out in the consultation document.

Age limits There were no fundamental objections to the age limits proposed for membership. However, younger age groups consulted suggested that it was lowered slightly to be 14 years and over. Given the Trust’s delivery of children’s services it was commented that this would allow a better opportunity for everyone using Trust services to have a say.

Youth representation There were no objections to the way in which the Trust proposed representing younger members i.e. a youth council or sub-committee feeding into one of the governors on the main council with a special interest in children’s services. It was suggested by Youth Action Kouncil – one of the groups consulted with by the Trust – that their existing group should act as a readymade sub-committee to prevent duplication of work.

Staff representation There were no responses from staff which objected to the Trust’s proposals to become an FT. The Trust also received favourable comments from external stakeholders regarding its attempt to encourage staff to sign up proactively rather than adopting an ‘opt out’ approach, with a feeling that this would foster a culture of more genuine engagement with the workforce. Staffside raised concerns regarding the plan to not sub-divide the staff constituency, saying this could result in uneven representation either on the basis of professional group, grade, service area or geographical location. The Trust explained however, that it did not want staff to be restricted in their involvement based on these parameters. Using an open and democratic process, this approach would allow the most committed employees to put themselves forward for election. On balance, a single staff constituency has been supported.

There were some concerns that staff did not fully understand the FT process or the direction of the organisation. Information on the different channels through which staff could access updates was given out in response and this has now been further addressed through a roadshow of sizable staff events. Executive directors were present at these meetings to give an overview of the organisation one year on from its formation, as well as information on its strategy and future plans.

Vision There were no objections to the Trust’s vision of being ‘Better Together’ and a Trust that delivered personalised care of the highest quality, with the best possible outcomes for users and carers, empowering them to remain independent.

Transitional arrangements Given the planned pace of the Trust’s FT application, the only transitional arrangement which the Trust will be implementing is a Shadow Council of Governors. The elections for this are planned for Spring 2013.

HR Strategy There were no objections to the Trust’s HR strategy but the question of whether planned efficiencies would result in redundancies was raised on a few occasions. The Trust explained that it wished to avoid this course of action and would instead be looking at natural turnover. As well as considering every vacancy very carefully, the Trust may also look at employing staff on fixed term contracts. It was made clear however, that if there was room for working more efficiently less staff would ultimately be needed.

Communications The Trust produced a wide range of communication materials to support the FT consultation, available in a variety of languages and formats. These were positively received by most of its stakeholders. There were a couple of concerns raised about the amount such materials would cost at a time when services were being cut back. It was explained that the Trust had worked hard to balance presenting a professional image and making the necessary materials available with keeping costs reasonable. The Trust also reassured people that printed materials would only be sent to those who had specifically requested them. Where possible, people would be communicated with via phone, text or email.

Any novel suggestions received as result of consultation

Due to conflicting views over which geographic elements should be included in the Trust’s title and a perceived lack of clarity around what the Trust delivers, alternative suggestions were made such as ‘Staffordshire Knot Community NHS Foundation Trust’.

It was also suggested that service users and carers should be represented as appointed governors rather than in a separate elected governor category.

Other issues (please specify) Not applicable

15. Is there anything else about the public consultation exercise and outcome that you would like to let the Secretary of State or regulator know?

The Trust has consulted extensively about its FT plans and has made every effort to ensure that all partners and stakeholders have had ample opportunities to express their views. The consultation process has represented an excellent opportunity to engage in a general way with local communities, as well as discussing specific FT-related proposals.

The Trust wishes to draw attention to the high levels of responses that that have been received from key stakeholders and partners, including Stoke on Trent City Council’s Adult & Neighbourhood Scrutiny Committee, Staffordshire County Council’s Health Select Committee, MPs, Local Authority leaders, NHS Commissioners, local NHS provider trusts and some key voluntary sector groups including service user/carer representatives.

16. Please provide the contact details for the person who will be available to answer detailed queries on the public consultation and provide copies of any responses required for further scrutiny? Name: Kate Montgomery

Address: Staffordshire and Stoke on Trent Partnership NHS Trust

Telephone number: 0845 602 6772 ext 1630

Email: Kate.Montgomery@ssotp.nhs.uk

Staff engagement, involvement and wider culture change

17. How have staff been given ample opportunity to play an active part in the dialogue and deliberations around the NHS foundation trust application? Where have staff dialogue and views influenced the broad HR ‘strategy’, which in turn supports the service development plans and organisational goals for the Trust? The Trust ensured staff were given every opportunity to voice their opinions about the Trust’s Foundation Trust application by facilitating the following engagement activities:

Online: Basic information including the FT presentation, FAQs, a downloadable consultation brochure, events and an interactive consultation questionnaire were made available online.

All User Emails: Information on how to have a say and updates about the consultation were regularly circulated to all staff. These included regular reminders about upcoming events and meetings.

Team Meetings / Away Days: The Foundation Trust team encouraged requests from staff to speak about FT at their department away days / team meetings and attended a variety of these events. Senior staff were also urged to cascade information to teams and encourage their participation.

Team Brief: A monthly update was given on the Trust’s FT application and membership/consultation issues via ‘Team Brief’ sessions.

Staff Newsletter: Prior to its beginning, and during the consultation, updates on the Trust’s FT application and upcoming meetings / events were communicated to staff via internal newsletter – ‘The Word’.

Fact Sheets: A flyer with key information on the FT process, membership and the Trust’s consultation was distributed to staff to increase their confidence in speaking to service users, carers and the general public about our plans.

Payslips: Information regarding the Trust’s FT application and membership/consultation was distributed via payslips for three consecutive months to ensure full coverage of the workforce.

Corporate Induction: Consultation / membership information and upcoming event information was given out to new staff at three consecutive staff induction sessions during the consultation period.

In addition:

A set of ten CEO/Director of Operations led staff sessions were recently undertaken to inform and update staff on the strategic direction of the Trust, including its journey to Foundation Trust status.

Staff Side via the Joint Staff Partnership have been briefed and engaged in a number of discussions regarding staff membership and the configuration of the council of governors.

Senior Staff Side Officers have agreed to work in partnership with the Trust on some joint events to inform employees about membership.

Staff side were consulted about the wider HR strategy for the trust and the CEO and executive directors meet with them on a monthly basis.  In addition there are three staff side members on the Workforce Matters Sub Committee – feeding into the Quality Governance Committee – which is responsible for monitoring progress against the workforce strategy. The workforce strategy is also aligned to the organisational goals.

18. How did (and for the future ‘how will’) the organisation ensure effective staff involvement and participation in shaping cultural change and service development and delivery, and in embracing social partnership in its broadest sense? The Trust is extremely committed to the involvement of staff in the development and cultural and service change within the organisation. There are a whole range of internal communication and engagement opportunities, as well as a number of key elements of staff engagement which are fundamentally embedded within the Trust’s strategic development e.g. monthly Team Briefing sessions and the annual staff survey.

The Trust has also developed an extremely positive and robust relationship with Staff Side via its Joint Staff Partnership and is committed to continuing to operate in a spirit of partnership with employees. To this end a representative of Staff Side is invited to Trust Board meetings. Further examples of involvement and participation by staff include:

One vision events were led by the Trust’s CEO and Chairman, which helped to shape the current vision and values for the organisation.

The Trust’s values also form part of the new annual appraisal system, which must be carried out with all staff between April and June each year. This follows the annual process of the Trust Board agreeing the organisation’s goals and objectives for the forthcoming year, which are then cascaded to all staff so that they understand where they fit into the overall programme of work. 

Nearly 1,000 staff have been involved in service transformation workshops and nearly 180 have agreed to be champions for particular transformation projects in order to help progress the change needed.

The Trust has an excellent relationship with its Trade Unions and Staff Side, and they are keen to be involved in helping shape the future of the Trust.

The Trust has a Professional Forum, made up of clinicians and professionals who have a keen interest in wanting to make a difference to high quality patient care. They are used as a sounding board for particular issues and are asked to propose ways in which the organisation can improve.

The Trust has a formalised structure of Professional Leadership – these leaders are responsible for shaping the quality agenda and culture for their particular profession. This includes effective staff engagement in any changes proposed for that area.  They are also a

resource of expertise for operational managers to call on when they are considering changes which include their profession.

19. How has the organisation engaged with (and how will it continue to engage with) clinicians in determining the future direction of service provision, and how have the outcomes of such discussions been analysed from a cost/benefit perspective and integrated into the service development plans outlined in the business plan? Clinical engagement is at the very heart of decision-making and strategic planning within the Trust. There are a number of senior clinicians working on the implementation of the Trust’s service transformation plans.

The Trust’s workforce has been involved with the development of its Quality Framework via a large consultation exercise. All the documentation regarding this is available and has been presented to the Trust’s Quality Governance Committee. The work around service transformation has played a significant part in informing the Trust’s quality agenda, as have the Professional Leadership and Professional Forum structures.

The Trust has already and continues to facilitate a range of opportunities for clinicians to be closely involved with development and implementation of service developments.

20. How is the Trust developing/managing new (and existing) relationships with local health organisations and other local networks, social care, good citizenship and social responsibility, and playing a role in the wider community? One of the Trust’s five strategic goals is to: ‘work with partners, users and carers to deliver integrated services simply and effectively’.

The Trust is a central and influential partner within the local health economy. It has good and developing relationships with its commissioners and its plans are aligned to that of the wider Staffordshire Local Health Economy in providing high quality, innovative services in the community and out of acute settings. The Partnership Trust also has extremely positive relationships with both Staffordshire County Council and Stoke on Trent City Council. Other local partners include voluntary and community organisations, service users and carers, the police service, fire service and universities in the region.

This commitment to partnership working is reflected in the configuration of the Trust’s council of governors, which will include representatives from all of the groups mentioned above.

It is envisaged that the Trust will be a key member of the local Health & Wellbeing Boards, once established.

21. What is the degree of ‘integration’ of first-rate HR practice in all the main functions of the organisation (operational, strategic and clinical) – with a view to demonstrating that good HR practice and thinking is present in the wider organisation and not only in the specialist HR function itself.

The HR Director is a member of the Trust Board and the Executive Management Team The Senior HR Business Partners sit as functional members of the Senior Management

Teams in both North and South Divisions of the Trust The HR Team work to a Business Partner model, meaning they work alongside operational

management and support them to enhance their HR skills – the HR team aims to support and facilitate HR practices rather than being solely responsible for them.

Managers have a set of HR KPI’s which help them to identify how they are doing in terms of managing sickness, turnover, appraisal compliance, statutory/mandatory training compliance

The HR team are working with staff side to harmonise all HR policies, process and procedures where possible. There are some restrictions due to TUPE regulations but progress is good. 

The Trust runs a four-day people management programme for those managers who have been recently promoted into a team leader/management role.

The Workforce Matters Sub-Committee is made up of representatives from the HR function and operational management, who discuss all issues relevant to HR/workforce development practice for the Trust.

22. How has the organisation demonstrated its commitment to unlocking the potential of all staff and enabling all staff to progress their skills and careers through lifelong learning and development? The Trust supports particular initiatives concerning lifelong learning and development:

The Workforce Matters Sub-Committee is currently in the process of making a recommendation to the Trust board on its Talent Management Strategy and process for developing Trust Leaderships.

The new appraisal system (see qu.18) allows a structured discussion between staff and managers to identify any potential skills gaps and desires of an individual to set their career direction.

The Trust Board has just committed to a Workforce Development Strategy which clearly outlines how staff will be developed to meet the organisational goals and objectives.

The Trust has a dedicated budget for workforce development and seeks external funding at every opportunity to enhance staff development and learning.

The Trust has a Learning & Development Committee that is chaired by a Chief Operating Officer and which monitors all aspects of learning and development across the trust.

The Trust is an active member of the new Learning & Education Training Committee (LETB/LETC structure)