DGH and Conquest hospital trust should review its board, says review


A Sussex hospital trust has been told it should consider refreshing its non-executive board due to concerns around the scrutiny of its finances.

The recommendation came as part of a governance report into East Sussex Healthcare NHS Trust by consultants Deloitte, which was set to be discussed at a meeting of the trust’s board on Tuesday (December 4).

Conquest Hospital, Hastings. SUS-181008-112146001

Conquest Hospital, Hastings. SUS-181008-112146001

According to the report, consultants considered there to be ‘relatively low levels of scrutiny and challenge’ from board members, particularly around the trust’s troubled financial position.

The report said: “The trust has a number of executive directors who have high levels of functional capability as well as experienced non-executive directors who have demonstrated good levels of insight.

“However, in our view, delivery of financial sustainability alongside current quality, cultural and performance improvements, will require a comprehensive focus on strategy, as well as improvements to the effectiveness of financial scrutiny.

“We have concerns over the current depth of strategic skills amongst the non-executive group to lead the delivery of this significant piece of strategic work.

Dr Adrian Bull SUS-161025-123735001

Dr Adrian Bull SUS-161025-123735001

“We therefore believe that the board would benefit from developing a plan for a refresh in membership to ensure there is sufficient strategic and financial capability for the future.”

Consultants also recommended the trust begin to develop its five-year financial plan into a comprehensive corporate strategy and called for a new accountability framework within the trust.

They also recommended that chief executive Adrian Bull – who was praised in the report for delivering quality and operational improvements – attempt to reinforce a message among staff ‘that the financial situation is critical.’

In response to the report, an East Sussex Healthcare NHS Trust spokesman said: “We are pleased that the report recognises the impressive progress the trust has made to improve quality, culture and performance under a well-respected leadership team.

“It notes the trust’s comprehensive financial governance structure and the developments we have made in respect of our financial agenda.

“We welcome the recommendations made in the report. The implementation of these recommendations will build on existing improvements to strengthen governance and accountability across the trust.”

This week also saw the publication of another Deloitte review into the ‘capacity and capability’ of the Hastings and Rother CCG and the Eastbourne, Hailsham and Seaford CCG.

The review was carried out in August and published ahead of a public meeting held on  Wednesday, November 28.

In the review, consultants criticised the CCGs’ financial controls, citing their combined deficit of £37m for 2017/18.

The review called on the CCGs to review their executive teams, in an effort to strengthen financial recovery and improve its strategic commissioning experience.

Responding to the report, a CCG spokesman said: “The CCGs welcome the recommendations this independent governance report brings and recognise many of the areas that have been highlighted for improvement.

“We have already taken clear and early action to address many of the issues raised, most notably with new leadership.

“This has brought renewed rigour, focus and strategic oversight to help drive improvement within our organisations and set a clear path to financial sustainability in the future.

“We have also begun to develop reporting that ensures our committees and Governing Bodies have very clear oversight of our financial position and progress towards finalising an integrated system Financial Recovery Plan.

“To support this we have rapidly implemented changes to ensure CCG grip, governance and decision making is underpinned by an effective programme delivery framework.

“We have more work to do and will be focusing on ensuring we address all recommendations.”

The CCGs and ESHT also provided a joint statement on the reports.

A spokesman for the CCGs and ESHT said: “Through our local transformation plan – East Sussex Better Together – we have in recent years worked in partnership to make significant progress to improve health and care inequalities and the quality, safety and access to services for local people.

“We are committed to building on this work and are developing joint plans that address the areas where improvements need to be made and support continued progress in an affordable and sustainable way.

“The developing shared approach that has been taken across East Sussex, with the support of NHS England, NHS Improvement and our local STP, has provided the opportunity for partners to work closer together to ensure all our communities have access to the highest standards of NHS care.

“We are working together to respond to the challenges we face, taking action in a more joined-up way, and ensuring we are making better use of the resources available.

“We recognise that the size of our financial commitment, the increasing demand on health and care services, our aging population and the ability to recruit permanent specialist staff means that clinical and financial sustainability will only be achieved by working in partnership across the whole system.

“With the continued commitment and joined-up support of all partners we are confident  we can continue the progress we have already made to improve the care for our local population.”

Huw Oxburgh, Local Democracy Reporting Service