South Tyneside and Sunderland Healthcare Group

The South Tyneside and Sunderland Healthcare Group (STSHG) is an alliance between City Hospitals Sunderland NHS Foundation Trust (CHSFT) and South Tyneside NHS Foundation Trust (STFT).


The two organisations have formally committed to collaborating to transform services to ensure that the local communities they both serve will continue to receive high quality, safe and sustainable hospital and community health services in the future.

MEMORANDUM OF UNDERSTANDING


Vision, aims and values

Vision

To deliver nationally recognised high quality, cost effective, sustainable healthcare for the people we serve with staff who are proud to recommend our services.

The path to excellence


Aims

  • To provide a wide range of high quality, safe and accessible healthcare services;
  • To ensure financial performance provides value for money;
  • To recruit, retain and motivate skilled and compassionate staff who are proud to act as ambassadors of the services they provide;
  • To be the employer of choice in the North East of England; and
  • To listen, learn and innovate.

Values

  • Compassionate and dignified, high quality, safe patient care always the first priority.
  • Working together for the benefit of our patients and their families or carers.
  • Openness and honesty in everything we do.
  • Respect and encouragement for our staff.
  • Continuous improvement through research and innovation.

Structure

Although CHSFT and STFT remain individual statutory organisations, the Path to Excellence work being undertaken by STSHG is overseen by a Group Board which is Chaired by Neil Mundy, Chair of STFT. For further information relating to Group Board membership, see below.

Board membership

Neil Mundy - Chair, South Tyneside NHS Foundation Trust (and Chair, South Tyneside and Sunderland Healthcare Group) - Neil Mundy became Chairman of South Tyneside NHS Foundation Trust in January, 2016. He is a chartered public finance accountant with many years’ experience in healthcare and economic regeneration, He has held both Executive and Non-Executive roles in public, private and third sector organisations in the North East and London. He is Vice Chair of the Joint Audit Committee for the Police and Crime Commissioner and Chief Constable of Northumbria Police and is Senior Independent Trustee of Age UK Northumberland.

John Anderson - Chair, City Hospitals Sunderland NHS Foundation Trust (and Deputy Chair, South Tyneside and Sunderland Healthcare Group) - Mr Anderson has been Chairman of City Hospitals Sunderland since 2008. Mr Anderson sold his main business (Mill Garage Group) in 1993 and has since devoted his time to public/private partnerships. He is Regional Chairman of Coutts & Co (Private Banking), RBS Group, Sun FM and Durham FM Radio. He is Executive Chairman of Milltech Training Ltd, a company that assists young people into work through apprenticeships. He is Chairman of the North East Business and Innovation Centre. In 1996 Mr Anderson was honoured with the CBE for his services to education and training and in 2006 was awarded the Queens Award for Enterprise Promotion. He has been a member of the NHS Provider Board since 2013.

Ken Bremner - Chief Executive, City Hospitals Sunderland NHS Foundation Trust and South Tyneside NHS Foundation Trust - Ken Bremner has been Chief Executive of City Hospitals Sunderland since 2004. He is a qualified accountant and joined the Trust in 1988 becoming the Finance Director in 1994 and then Deputy Chief Executive in 1998. Mr Bremner is a member of the SAFC Foundation of Light Development Board and chairs the Sunderland Partnership Executive. He is also a Non-Executive Director of the Academic Health Science Network for the North East and North Cumbria.

Allison Thompson - Non Executive Director, South Tyneside NHS Foundation Trust

Allison joined the Trust in November 2012, she is a positive, agile and results driven Executive Director with a highly successful background. She has built her career on solid, business, commercial and marketing foundations over a 24 year period and latterly held Executive positions as Chief Operating Officer and HR Director. Allison has a track record of significant commercial and restructuring success throughout her career.

Stewart Hindmarsh - Non Executive Director, City Hospitals Sunderland NHS Foundation Trust


Clinical Services Review Programme

A Clinical Services Review programme is now underway the purpose of which is to look at clinical services and make recommendations to STSHG on the future configuration of services to ensure we are able to continue to provide high quality and sustainable services in the future for the communities both Trusts serve. To support and manage this process a Clinical Service Review Group has been set up which is Co-Chaired by:

  • Dr Shahid Wahid - Medical Director (STFT) and
  • Peter Sutton - Director of Planning and Business Development (CHSFT & STFT)

Patrick Garner, Programme Manager, will be leading this review process with clinical leaders from the specialties being reviewed. Terms of reference for this group, along with the timescales for these reviews can be found below:

Clinical Services Review Group Terms of Reference - updated September 2016

South Tyneside NHS Foundation Trust and City Hospitals Sunderland NHS Foundation Trust with South Tyneside and Sunderland Clinical Commissioning Groups are working together as South Tyneside and Sunderland NHS Partnership

This partnership is supporting the programme of Clinical Service Reviews.

The partnership has a dedicated website which has been set up to provide more information for the general public and news on how you can be involved. The website can be found here


Frequently Asked Questions

We do understand that many of you will have questions relating to the function of STSHG and the clinical service reviews. Please read our FAQs and if you have a question which is not covered, please email pathtoexcellence@chsft.nhs.uk. This section will be updated regularly to reflect questions asked by our patients, our staff and the public.

Why are you introducing a single executive and management structure?

When the South Tyneside and Sunderland Healthcare Group was formed in February, we indicated then that we would be managing the transition towards one common management team and, indeed, this is cited within the Memorandum of Understanding signed by both organisations in May and available to view on the public websites of both Trusts.

What will be the benefits of this change?

For staff: a single management team will significantly improve the focus and leadership capacity to both Trusts.

The new management structure will help us deliver improvements required in some clinical services identified by CQC, which will improve the quality, experience and safety for our patients.

It is anticipated that creating a single executive and management structure across the two NHS Foundation Trusts will generate initial savings in excess of £500,000 per annum, with additional savings being achieved as a result of the way in which services (both clinical and non-clinical) are delivered across both organisations.

As well as significant financial savings there will be greater efficiencies in the way health services are managed, other advantages include:

  • More focused leadership which will ensure a consistently high quality and safe service for patients
  • Shared experience and learning across the two organisations
  • Greater flexibility in managing pressures across the system, with improved resilience services for local residents by sharing clinical expertise
  • Support for the transformation of local services and empowering local people to stay well and be looked after outside of hospital

Will this mean closure of some hospital services?

Both hospital and community healthcare services will be transformed across South Tyneside and Sunderland through the South Tyneside and Sunderland Healthcare Group approach. We know concern has been expressed about South Tyneside District Hospital and we can say with great confidence that its future is assured, however, as is the case throughout the NHS, we cannot guarantee that in every case services will be run exactly as they are currently. With regard to the Accident and Emergency Department, this will form part of a service review in 2017 but we wish to make it absolutely clear that our vision is for patients and residents of South Tyneside to continue to receive urgent and emergency care at South Tyneside District Hospital. Currently, many emergency and elective hospital services are duplicated at both Sunderland Royal Hospital and South Tyneside District Hospital. However, in a number of these hospital services recruitment of key staff is challenging and it is becoming increasingly difficult to ensure the delivery of high quality 24/7 services across both hospital sites in some of these services. There are many quality standards being developed nationally and an increasing pressure to further establish 7-day services in all areas. Addressing these challenges as two completely independent Foundation Trusts is increasingly difficult so, subject to the outcome of service reviews, some hospital services may need to change and aspects of them may be delivered at only one hospital - either in South Tyneside or Sunderland.

Will Sunderland/South Tyneside residents have to travel to South Tyneside/ Sunderland to receive their care?

We understand transport and travel is a concern and whilst it is possible that the outcome of a service review may result in some patients from South Tyneside travelling to Sunderland (and likewise patients in Sunderland travelling to South Tyneside), we envisage that residents will continue to receive their general, straightforward care at their local hospital or clinic. However, where there are complexities or a specialist team is required, it may be necessary, as is often the case now, for patients to travel. Whilst the distance between the two areas is relatively short, with good public transport links, we are working closely with partners in the local authorities and transport providers to address ways of meeting the needs of patients. Where such a situation is deemed appropriate, it will only be after clinicians have been involved in service transformation discussions and agree that to travel to another community is in the best interests of patient safety and patient experience.

Is this a takeover or a merger by stealth?

No. Both South Tyneside NHS Foundation Trust and City Hospitals Sunderland NHS Foundation Trust had already agreed to work together as part of a group structure. Both Foundation Trusts are, and will continue to be, separate statutory bodies with respective Councils of Governors and Boards of Directors.

However, both Trusts have also recognised that, in light of the huge financial challenges in the NHS and social care and in light of projected demographic and demand changes, the current model of healthcare delivery is not sustainable.

Both Trusts believe that a single executive management team supporting both Foundation Trust Boards is required now to better manage that challenge and improve efficiency.

Does the regulator/NHS Improvement support this?

Yes, we have fully engaged with NHS Improvement, as well as NHS England, and they are aware of the background to our intention to form a joint management team and strongly support this move, which they believe is essential.

Do the CCGs support this?

Yes. We have been working closely with our CCG partners from both South Tyneside and Sunderland and they are supportive of this single management team.

Why hasn't there been consultation / engagement about this?

This move represents only changes to the management structure and not a change to the provision of clinical services for which consultation would normally be required. There is therefore no requirement to undertake public consultation. This is an agreement to work in a different way which does not alter the statutory responsibilities or the FT licence arrangements of both organisations. We will, however, be consulting, where appropriate, regarding any changes to clinical services and more information will be available in the autumn regarding this. Any individual service changes will be considered on a case-by-case basis and, in discussion with our CCG colleagues, we will examine if those changes are such that public consultation is required. It is our intention, however, to communicate regularly and openly with our patients, staff and the general public to ensure they are all kept up-to-date with our plans and progress.

Why does it have to happen so quickly?

Our Trusts have been working well together as part of a Group structure since February. We feel it is now essential, as does our regulator NHS Improvement, that if we are to protect the future sustainability of health services for both our populations, we now move to a joint executive and management team as quickly as possible to secure efficiencies and to use the combined strength of that team.

You're just selling South Tyneside out, aren't you?

No, this is certainly not the case. We do appreciate the concerns that some South Tyneside patients and staff may have about the pace of these necessary changes. The work that is being undertaken is an essential process to secure the future delivery of health services in both Sunderland and South Tyneside. To do nothing would certainly put our services at risk. The programme of clinical service reviews will be looking to ensure sustainable and improved services fit for the future.

Will jobs be under threat as a result of this / will people be made redundant?

It is not possible to guarantee that there will be no job losses in these challenging times but it will be the strong preference of both Trusts to achieve such economies through natural wastage wherever possible. We cannot rule out, however, the possibility of redundancy as a last resort, if absolutely necessary.

What jobs will go?

It is not possible to say at this time.

Will this lead to outsourcing or job losses?

It is not possible to say at this time.

How will you select the management team?

A thorough appointment process based on selection by skills and experience, together with emphasis on a succession planning will be adopted by the two Foundation Trusts and will be independently scrutinised by the Non Executive Directors of both Boards.

Is this just a cost-cutting measure?

Whilst financial benefits will be realised, the main driver for change is that a single executive team will mean it is easier to lead on the transformational change required quickly to protect the future of services to the communities served by both organisations.

Is it just the executive team structure that will be affected or will other levels of the organisations be affected?

It is probable that other levels of the organisations will be affected but further change will only be undertaken where absolutely necessary. Directors will be asked to review their structures in the autumn.

How does this latest change affect the recent management restructure in South Tyneside?

When the earlier restructure was planned it was not anticipated that we would be moving to a single management structure so quickly, however, a significant number of the changes resulting from the restructure will support the single executive team and any further change will only be undertaken where absolutely necessary and in full consultation with staff.

Which services will be affected?

As part of the programme of transformation, all services will be looked at over time. However, in the first instance the services to be looked at will be stroke, trauma, emergency surgery and maternity.

Will radiology services be looked at as part of the Clinical Services Review programme?

We can confirm that a specific review of diagnostics (including radiology) will be taking place twice during the review programme due to the critical nature that diagnostics play in both emergency and elective services. It is anticipated these

reviews will be undertaken between September and December 2016 and again between September and December 2017. How the two radiology teams can work more collaboratively and efficiently across the two organisations will be explored during this process.

Will staff have to move off site/rotate?

This could be an option in some services but it is too early to say what the implications may be for staff working arrangements.

How are you going to ensure you communicate effectively with staff?

We are committed to openness and to doing everything we possibly can to get the communication and engagement right. We aim to do this in a timely manner, and whenever and wherever possible, over the coming weeks and months through a variety of methods e.g. face-to-face briefings, email messaging, intranet information. If you have a preference for a particular form of communication then please let us know by emailing pathtoexcellence@stft.nhs.uk or pathtoexcellence@chsft.nhs.uk

Will there be consultation regarding any back office and support staff changes?

The Trust is committed to ensuring the impact of change and reconfiguration on staff is handled fairly, effectively and in line with agreed processes. We are committed to supporting staff throughout the process of organisational change by consulting

and communicating appropriately with staff involved and listening carefully to the views of staff affected. We will seek to manage all change programmes in a planned, open and honest way in order to maximise the potential benefits and minimise any adverse implications for staff.

What is the vision for Maternity and Paediatric services?

These service reviews are currently underway and the vision for the future is not yet known however they will be included in the first phase of listening and engagement activities where you will be able to learn more about the potential solutions being proposed and have the opportunity to give your views. In addition they will also be subject to formal consultation early next year.

There's a Clinical Services review but what about a Primary Care Community Services review?

We don’t have a timetable yet for the out-of-hospital services review. This has to be decided with our colleagues in the CCGs and the Local Authorities but we are conscious of the need to ensure that current service reviews are not looked at in isolation and do take account of community services We hope by doing this we are able to provide more joined up services which will benefit our patients.