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Tuesday, 22 December 2015

Latest Update from Southern Health to Request for Investigation

Well, the Government and Southern Health may have shut down for Christmas, but campaigners have not!

Before I do have a short break, I wanted to provide this update.

Below is the response from the Company Secretary (my emphasis added), following up my earlier request, and my follow-up that I would expect meetings to be called immediately given the gravity of the situation.

I also asked for the details of the Council of Governors meeting, and said that I want to ask questions of the governors and Trust Board. I also asked permission to record the Governors meeting - this request has been refused by the Chair. Our understanding is that the new regulations that apply to councils and other public bodies, do not apply to NHS foundation trusts.

So I have gone back to them with this:
"I wish for the same questions that I wish to put to the Council of Governors, to be put to the Trust Board.
Regarding recording of the meetings, I am disappointed to hear that the Chair will not allow recording. There are new regulations requiring local authorities plus many other public bodies to allow recording.
Even if this is down to the discretion of the Chair, I would have thought the Chair would want to encourage openness and transparency. But it appears not. To clarify, I only wish to take an audio recording."
Can I please encourage people to attend? Perhaps they are going to need a bigger venue than they are used to!

I understand that Michael Buchanan of the BBC has already indicated he will be attending the Trust Board. I will be inviting other media.

Let me know what you think of the below (either by email, Twitter or posting below).

And if you are having a break, enjoy it and come back refreshed for the campaign.

Best wishes,
Andrew

---

Dear Mr Pope,

Thank you for your further email.  With regards the timing of calling extraordinary Board and Council meetings; the report into Southern Health NHS Foundation Trust was released by NHS England on 17 December 2015.  Our governing documents routinely require that we provide five clear working days before each meeting.  As such, and recognising the important topic, it was agreed that it was pragmatic to wait until after the Christmas period to convene these meetings so as to ensure maximum attendance of Directors and Governors at their respective meetings.

Indeed, we are currently ascertaining availability of Governors to attend on 5 Januaryas it is essential that we are able to hold a quorate meeting (the Council is not able to convene to conduct business if this is not so).  We anticipate publishing the details of this meeting (time and venue) on our website by Thursday 24 December and would be happy to email you with this information once agreed.  I note from your email that you also wish to put questions to our Trust Board; there is an extraordinary meeting scheduled for the Trust Board on 11 January 2015 at 08:30.  Again, we are in the process of confirming final arrangements, but can send you this information as well in due course.

In terms of recording the meeting(s), I have discussed this matter with the Chair, who has not agreed to this request.  We will however be happy to send you the formal minutes of the meeting(s) once these have been approved.

If you wish to ask a question of either the Council of Governors, or the Trust Board, I would strongly encourage you to submit this in writing (via governors@southernhealth.nhs.uk or trustboard@southernhealth.nhs.uk).  For information, I have attached guidance from our website that relates to the rights of members of the public to ask questions of the Trust Board.  I have already noted down the previous question relating to the discussion relating to SIRIs that was recorded in the draft minutes of the meeting held on 27 October 2015 considered by the Board on 1 December 2015. 

If you have any further queries, please don’t hesitate to get in touch and I will look to respond to these.

Monday, 21 December 2015

My Research into "How Democratic Are NHS Foundation Trusts?"

Here is the "abstract" or summary of the research that I conducted in 2009-2010 as part of the Masters in Global Politics that I completed at the University of Southampton. I interviewed around sixty people.

National Health Service (NHS) Foundation Trusts (FTs) were brought in to allow a degree of autonomy from centralised Whitehall control, along with a degree of local governance, modelled on traditions of co-operatives and mutuals. 

This research assesses how democratic the arrangements for FT governance are. Interview and questionnaire responses, from individuals selected from politically engaged groups, were assessed against an analytical framework of democracy. 

Content analysis software was written specifically to aid the categorisation of the interview and questionnaire texts against this framework. 

Overall, comparing positive evidence against negative evidence, respondents felt that democracy was generally lacking in FTs. Also lacking were important aspects of democracy, including accountability, popular control, inclusion, legitimacy and considered judgement. There was insufficient evidence to be conclusive about transparency and efficiency. Assessment of local involvement was positive and generated significant support for FTs. Local autonomy also motivated significant support for FTs. 

Taken together, this evidence indicates an encouraging appetite for local involvement and autonomy in FTs in theory, but the practical implementation of FTs has not met theoretical expectations. This evidence is backed up by the theoretical literature, and by predictions made by commentators when FTs were new. 

Lessons can be learnt from the literature, from the evidence presented herein, as well as lessons from before the NHS existed. Finally, suggestions for future policy and research are made.

If you would like to know more about the research, please get in touch.

Following the research, I made a number of recommendations, including on policy. I am campaigning on those recommendations, and on NHS governance.

Let me know your experiences of how foundation trusts are run. I would also be interested in hearing from other researchers, particularly in the light of failings of governance, such as at Mid-Staffs and Southern Health.

A Deeper Investigation into Southern Health Failures is Needed Now


Despite attempts to silence me as an opposition councillor by the Labour councillors running Southampton City Council, I have taken action to investigate the failings at Southern Health described by the Mazars report commissioned by NHS England.

I have joined the Justice for LB campaign, who have responded by supporting my actions to instigate changes at Southern Health NHS Foundation Trust, including requesting a deeper investigation to be instigated by the Council of Governors and Trust Board. This was last week, as follows:

Good Evening,

I request that the Council of Governors works with directors and the relevant Nominations and Appointments committees to conduct an investigation as to how and why the draft minutes of the 1st December 2015 Trust Board stated that the Performance Director responded that there were "no major concerns" when challenged by a Non-Executive Director on SIRIs, as quoted below.

I would also appreciate a statement from the Trust as to whether the Chief Executive, the Trust Board and Council of Governors supports the view minuted.

As this issue is now of national importance, and has drawn the attention of the Health Secretary and Parliament, I and the residents, patients, carers and families of Southampton would appreciate an urgent response, preferably by the end of this week.

Kind regards,
Andrew Pope

8.15. Jon Allen, Non-Executive Director, enquired as to whether there were any Serious Incidents Requiring Investigation (SIRIs) that should be brought to the Board’s attention. Chris Gordon confirmed that there were currently no major concerns but that the SIRIs reported still required to be fully investigated. Della Warren referred to paragraph 27.5 which indicated an increase in the number of falls and suggested that this be the subject of a ‘deep dive’ by the Quality & Safety Committee. Sandra Grant noted that the Service Performance & Transformation Committee had noted the increased number of falls and sought assurance as to whether this was linked to staffing levels. She assured members that this was regularly reviewed by the Director of Nursing & Allied Health Professionals and reported to the Quality & Safety Committee.
I also urge you to write to the Council of Governors with something similar. They can be emailed at governors@southernhealth.nhs.uk. Unlike other Foundation Trusts, you cannot email them directly (I have checked). I have also:

  • Sent a series of questions about Southern Health to the Chair of the Southampton Local Safeguarding Adults Board (at the time of writing I have had no response)
  • Studied a wide range of documents from Southern Health, in which some of the claims made are hard to believe
  • Written to my MP Alan Whitehead requesting support for the campaign (at the time of writing I have had no response)
  • Referred back to the research I conducted in 2009-10 on the governance of NHS foundation trusts. The weaknesses of these structures, and those working in them, do not seem to have improved. As many people have found, it can all come down to individuals. More details on the research are here.
  • Spoken with the BBC, who wished to interview me, but scheduling concerns changed their priorities
  • Read the appalling media releases sent out by Southern Health in response to both the leaked report and the final version of the Mazars report

Please note that I have NOT called for the resignation of anybody, although this is tempting considering the continual failures documented in the report, especially when the coroner complained to the Trust time and again over a protracted period.

We have heard a lot of claims of being "sorry" by the Trust.

We have heard a lot of claims of lessons being learned.

But we now need an investigation into how this happened, and who was individually and collectively responsible for acting, and not acting.

Then action can be taken against those who have failed the patients, carers and families of so many people in the care of Southern Health NHS Foundation Trust.