foi request number 93 2016 - Norfolk and Suffolk NHS Foundation

Transcription

Compliance Team – Health Records
Kestrel House
Hellesdon Hospital
Drayton High Road
Norwich
Norfolk
NR6 5BE
Tel: 01603 421687
Fax: 01603 421411
FOI REQUEST NUMBER 93 2016
Request and Response:
Please provide all emails sent or received by your Chief Executive on the subject of the new Junior
Doctors contract. This should be from 1/2/16 to date.
I enclose a copy of the emails sent or received by our Chief Executive on the subject on the new
Junior Doctors Contracts for the period 1st February 2016 to 1st April 2016.
The Trust provides a complaints procedure to deal with complaints about the Trust's handling of requests for
information. If you feel you need to make a complaint, in the first instance, you should contact a Non-Executive
Director via the Chair of the Trust. If you feel you have exhausted our internal complaints procedure, you also have
the right and may feel you wish to write to the Information Commissioner who can be contacted on telephone
number 01625 545740 or at www.ico.gov.uk.
Freedom of Information Request 93 2016
Page 1 of 50
Thorley Debbie (NSFT)
From:
Sent:
To:
Subject:
Scott Michael C (NSFT)
23 March 2016 08:29
Johnson June (NSFT); Solomka Bohdan (NSFT)
FW: Face-to-face engagement events on the junior doctors’ contract
For action please Best Wishes Michael Chief Executive NSFT From: Daniel Mortimer [mailto:danielmortimer@nhsemployers.org]
Sent: 22 March 2016 17:15
To: Scott Michael C (NSFT)
Subject: Face-to-face engagement events on the junior doctors’ contract
Dear Colleague
Yesterday in Newcastle my colleagues and I completed the last of the five face-to-face engagement
events to discuss the junior doctors’ contract implementation.
Across all the events I had the opportunity to speak to close to 400 HR professionals and medical
workforce leaders. I would encourage you to continue to support these colleagues to ensure that
the finalised junior doctors’ contract is implemented from August 2016.
To assist you, please find below a link to the Powerpoint slide deck that was used during the course
of the day (this includes the slides from both the morning and afternoon session). This pack was
adapted during the course of the events to take on board feedback from Trusts and FTs, and may
be slightly different to the version that was shared with you at the event.
You will note from the slides that the details of the contract are being finalised, and I hope to be able
to share the final contract with you shortly.
Powerpoint slide pack
You will be able to download the Powerpoint slide deck here. The link will open a Wetransfer page
in your web browser, and a download arrow and button will appear, click download to retrieve the
slide pack.
Please note: This download is only available for the next seven days. If you need to access
this document after the seven days please email the relevant contact from our national
engagement service.
North
Jane Raven
Jane.Raven@nhsemployers.org
Midlands & East
Amanda Rose
Amanda.Rose@nhsemployers.org
London
Bernadette ElHadidy
Bernadette.El-Hadidy@nhsemployers.org
South
Liz Gambrell
Liz.Gambrell@nhsemployers.org
1
Webinars
Page 2 of 50
Although the face-to-face engagement events have now come to an end, we are continuing to host
webinars for HR and medical directors. The next webinar will take place on Thursday 24 March,
you can book your place now.
We will also be scheduling webinars for your medical staffing leads once the details of the contact
are shared with you.
If you have any comments, or there are any additional resources that would support you, please
email me at danielmortimer@nhsemployers.org
Yours sincerely
Daniel Mortimer
Chief Executive, NHS Employers
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Page 3 of 50
Letter to all
NHS Chief Executives
2 Brewery Wharf
Kendell Street
Leeds LS10 1JR
Tel 0113 306 3000
Fax 0113 306 3001
enquiries@nhsemployers.org
www.nhsemployers.org
11 February 2016
Dear Colleague,
I want to explain and provide you with context to the position on the junior doctors’
contract. I have enclosed a copy of the letter I sent to Mark Porter and Johann
Malawana on 9 February. This outlines the much improved offer that was made at a
meeting at Tavistock House earlier in that day which was also attended by Clare
Panniker and Danny Mortimer. Before making this offer, Clare and I consulted with
the senior reference group who have been assisting us since early January and also
a wider group of senior leaders in the NHS in England: all of whom agree it needed
to be fair and reasonable for doctors in training and for the service.
The offer provided an improved position on the substantive issues that had not been
agreed when talks under the auspices of ACAS concluded on the evening of 29
January. These are summarised below.
Unsocial Hours
In my 16 January letter to Dr Malawana, I described revisions to the hours designated
as 'plain-time': Monday to Friday, 0700 to 2100 and Saturday 0700 to 1700. I
confirmed to the BMA that NHS Employers would move significantly further than the
current offer and that all junior doctors who work 1:4 weekends or more would receive
premium pay for all the Saturdays they work. This would mean, based upon our
assessment, of a representative sample of Trusts, that about half of trainees who work
Saturdays would get paid a premium rate. This was a substantial improvement on the
1:3 current offer where we assessed that c.15% would have received premium pay.
The final position means that if a trainee works one Saturday a month they will be
paid the premium rate and a trainee that works a less frequent ‘unsocial hours’ shift
pattern will not. I believe this is a fair final positon.
Non-Resident On Call
Our current offer proposed to pay a top-rate availability supplement to junior doctors
working non-resident on call of 10% for a 1:4 rota and 5% for those on less than a 1:4
rota. I confirmed to the BMA that our improved position would pay a higher rate to
ST1 and ST2 doctors based on applying these percentages to the ST3-ST7 nodal
point, and making these higher sums available to ST1 and ST2 doctors. We assessed
this would provide an increase, above the current offer, of over £1000 to ST1 and
ST2s, who work a 1:4 rota, and over £500 for those who work less than a 1:4 on call
rota. The final position means effectively introducing flat rate payments so that
trainees experiencing a higher frequency of on-call will get paid more and those
earning less will get proportionately higher payment. I believe this is a fair final
position.
Page 4 of 50
Fines and Pay for Work Done
Where a doctor breaches their hours protection under the EWTD (ie 48 hours) or
works greater than 72 hours in a week, our current offer would have provided a pay
rate of time and a half (150%). I confirmed to the BMA our willingness to make an
improved offer for the doctor to receive a double time excess hours’ payment.
Implementation
I also confirmed that the terms of the contract would be introduced by employers in a
phased manner over 12 months from August 2016, with the anticipation that
implementation would be completed in 12 months. The Guardian role would be
introduced in every employer in August 2016, and I proposed that the BMA and NHS
Employers would jointly monitor this implementation. This phasing satisfies the
concerns of the BMA that we would be ‘rushing’ into implementation and I believe this
is a fair and reasonable final position.
Review into Improving the Welfare and Morale of Doctors in Training
It is also very clear that no matter what the content of a final contract, no contract will
make a bad employer a good one, or a disinterested supervising consultant one who
takes a greater interest in the training support and welfare of a trainee. It has seemed
to me that much of the dispute is not solely, or even significantly, about the terms of
the contract, but are an expression of more profound issues which go far beyond any
contractual changes.
Throughout the discussions between NHS Employers and the BMA, both parties have
maintained that a settlement should protect the safety and welfare of doctors in
training and enable a safe and effective service for the NHS. Both parties have
acknowledged that there are underlying issues which, over a number of years, have
created the conditions for doctors in training to feel a high level of discontent. I have
reconfirmed my strong recommendation that an urgent review of these long standing
concerns should be established which can make meaningful recommendations to
improve the welfare and morale of trainees. The conduct of this independent review,
to be commissioned by the Academy of Medical Royal Colleges, Health Education
England and NHS Employers, must also ensure that the voices of junior doctors are
directly and personally heard.
A Safe and Fair Contract
Much has been said about how the proposed contract supports safe working
practices and safe patient care. I confirmed that the proposed contract would
provide further enhanced safeguards for protecting trainees from excessive hours
worked and consecutive long shift patterns, for example:
x
x
x
x
x
x
No doctor will ever be rostered consecutive weekends;
The maximum number of consecutive nights will be reduced from 7 to 4;
The maximum number of consecutive long days will be reduced from 7 to 5;
The maximum number of consecutive days will be reduced from 12 to 8;
There will be a 48 hour limit of 48 hours per week, worked on average over 26
weeks, and an absolute contractual limit of 56 hours where a trainee has opted
out of working time Directive; and
A new role of ‘Guardian’ within every Trust, who will provide safeguards against
excessive working hours in every workplace and the Guardian will have the
authority to impose fines on an employer for breaches to agreements in the
contract.
Page 5 of 50
These go further than the arrangements within the current contract and are in the
interests of safe working practices of trainees.
There have also been many statements in the media regarding the extent to which
the contract supports the NHS commitment to provide safe and reliable care across
the 7 days of the week. NHS Employers are committed to deliver the agreed Clinical
Standards which focus on the care to be provided (timely assessment, effective
clinical decision making and proper handover) for patients requiring emergency and
urgent care, and also those in-patients who require regular review. Doctors in training
already provide a significant level of service across all hours of the day and it is likely
that the additional service which will be required of them will be comparatively smaller
than that required from other staff. Nevertheless, as the workforce grows then
increased numbers will enable supplementary deployment. I can confirm that the
contract makes no requirement for existing trainees to work additional weekends and
it is not designed to dilute the numbers of staff working over Monday to Friday. The
contract is designed to future proof the NHS so that the costs of deploying additionally
employed staff are not prohibitive to achieving the agreed NHS Clinical Standards of
safe and reliable care every day of the week.
Conclusion
Intermittent negotiations have been ongoing since 2012. There has been substantial
progress since the end of last year and all significant issues associated with safety
and training had largely been addressed before Christmas. Despite the most recent
progress and substantial agreement on many elements of the contract, the BMA has
refused to compromise on its insistence that the whole of Saturday must be paid at a
premium rate. In contrast Employers position has moved several times, on each
occasion offering more hours attracting premium pay. Regardless of these changes
no agreement has been possible. It became clear that the only way to move forward
was to make a 'best and final' proposal in the hope that this would lead to settlement.
At the meeting on Tuesday I stressed that this significantly improved offer was the
best and final position on the substantive issues which remained outstanding. We
discussed the importance of ensuring that BMA members had the opportunity to
understand the final offer and I confirmed, at their invitation, that I would be happy to
present the offer to the Junior Doctors Committee (JDC) on 20 February 2016.
I asked the BMA to confirm to me in writing that they would publicly recommend the
best and final offer with respect to these substantive issues, to the JDC and
recommend that the committee endorse it as the proposition to be put to their
members. I further confirmed that I would need to know by 3pm yesterday at the very
latest, whether the BMA Council Chair and the Chair of the Junior Doctors' Committee
were both prepared to back the proposals and recommend their acceptance to the
JDC. I made it clear that if they could not provide this confirmation then I would be left
with no other conclusion than there being no realistic prospect of a negotiated
agreement.
Following consultation with Chief Executives and other leaders in the service, I am
clear that the NHS needs certainty on this contract and that a continuation of a
dispute, with a stalemate and without any clear ending, would be harmful to service
continuity, with adverse consequences to patients. I received confirmation that this
positon is supported by both the NHS Confederation and NHS Providers, together
with support from Chief Executives across the country.
of Information
93 hoped
2016for a resolution by
Both parties,Freedom
NHS Employers
and the BMA, Request
knew that I had
the end of January and had stated
that 6
weof
needed
Page
50 certainty by the middle of February
at the latest. The remaining substantive issues are not new, and I had hoped that my
last effort in making the improved offer would resolve these.
As I did not receive the confirmation which I requested from the BMA, I regrettably
concluded that we must now have reached the end of the road in relation to the
likelihood of achieving a negotiated settlement. I communicated this position in the
attached letter to the Secretary of State and let him know that the ball was in his court
to take the action which he deemed necessary to introduce a new contract which
reflected the best and final offer put to the BMA on 9 February.
This is a deeply disappointing position and I remain perplexed why the BMA
negotiators have not been able to see that agreement is always found between two
points of view. I have huge personal regret that my contribution has not been able to
secure the settlement so longed for by everyone. I very much hope that the service
can rapidly find ways to engage with and support the Review I have recommended,
in the hope we can build a new basis for improved morale and teamwork. Finally, I
would like to pay tribute to Danny Mortimer and his team from NHS Employers and
associated DH staff, for their outstanding support to me and Clare during the last 5
weeks.
Yours sincerely
Sir David Dalton
Chief Executive
Salford Royal NHS Foundation Trust
Page 7 of 50
Dr Mark Porter and Dr Johann Malawana
British Medical Association
BMA House
Tavistock Square
London WC1H 9JP
2 Brewery Wharf
Kendell Street
Leeds LS10 1JR
Tel 0113 306 3000
Fax 0113 306 3001
enquiries@nhsemployers.org
www.nhsemployers.org
9 February 2016
Dear Mark and Johann
I really appreciated the opportunity to meet today to consider whether we could make any further
progress on the substantive outstanding issues of the junior doctors' contract. As you know we
have reached substantial agreement on the issues of safety and training and have been
discussing these and the components of our best and final proposition on the contract, with
ACAS support, over recent weeks. Today was the opportunity to place an improved offer to you
on those substantive outstanding issues.
Thank you for your consideration of these issues which I outline below:
Unsocial Hours
In my letter of 16th January 2016 I described revisions to the hours designated as 'plain-time'
(Monday to Friday, 0700 to 2100 and Saturday 0700 to 1700). Following our discussions I can
now confirm that the NHS would move significantly further than the current offer and that we
would also pay premium rates to all junior doctors who worked 1 in 4 weekends or more for all
Saturdays they worked. This would mean, based upon our assessment, that the majority of
trainees who work Saturdays would get paid a premium rate for working Saturdays. This is a
substantial improvement on the current offer where we assessed that c. 15% would have
received premium pay.
Non-Resident On Call
Our current offer proposes to pay a top-rate availability supplement to junior doctors working
Non Resident On Call of 10% (for a one in four on call rota) and 5% for those on a less than one
in four. I can confirm today our improved position to pay a higher rate to ST 1 to 2 doctors
based on applying these percentages to the ST3 to 7 nodal point and making these sums
available to ST1 and ST2 doctors, we assess this would provide an increase of over £1000 to
ST1 and ST2's
Fines and Pay for Work Done
Where a doctor breaches their hours protection under the EWTD (ie 48 hours) or works greater
than 72 hours in a week, our current offer would provide a pay rate of 150%. I can confirm an
improved offer for the doctor to receive an excess hours payment of double (200%) of the
prevailing hourly rate, and the same amount would be levied as a fine held by the Guardian.
Implementation
As discussed the terms of the contract will be introduced by employers in a phased manner over
12 months from August 2016. It is expected that implementation would be completed in 12
months. The Guardian role would be introduced in every employer in August 2016, and we
agree that the BMA and NHS Employers would jointly monitor implementation.
Throughout our discussions we have both
agreed
that
a settlement should protect the safety and
Page
8 of
50
welfare of doctors in training and enable an effective service for the NHS. I am pleased that we
continue to share this position.
We have both acknowledged that there are underlying issues which have created the conditions
for doctors in training to feel a high level of discontent. I repeat my assurance that I will strongly
recommend that a Review of the long standing concerns should be established which can make
recommendations to improve the welfare and morale of trainees. The conduct of this review, in
addition to including the Academy of Medical Royal Colleges, Health Education England and
NHS Employers should also ensure that the voice of junior doctors is heard in partnership with
the BMA.
I must stress that this significantly improved offer is the best and final position on the substantive
issues which are outstanding. Since the start of my involvement I have always been clear that I
wanted to achieve a position which was 'fair and reasonable' and which would carry the support
of the Service. Following involvement of a senior reference group and a more wider involvement
of other senior leaders in the NHS, I can confirm that this improved offer is judged as having
achieved this objective.
We discussed the importance of ensuring that your members had the opportunity to understand
the final offer and I am happy to present, at your suggested invitation, to the JDC on 20
February 2016. Furthermore, I can confirm that NHS Employers are happy to work with you,
as suggested, to prepare the full package of offer materials to be presented to your membership
in any referendum. NHS Employers also confirm that they are happy, as requested, to share the
rota data with you.
As you will know from my previous letter, I have gone on record in saying that the service needs
certainty on the contract by the middle of February at the very latest. The issues under
discussion are not new, and it is absolutely vital that the service has resolution and clarity of
these issues as soon as possible. I therefore believe that it is crucial that I have a clearer
understanding of the endorsement you will give to this final offer if I am to be able to recommend
to government that it proceeds in the way that you have suggested.
I ask you to confirm to me in writing that you would publicly recommend this best and final offer
with respect to these substantive issues, to the JDC and recommend that they endorse it as the
proposition to be put to your members.
I therefore ask you to let me know, by 3pm tomorrow at the very latest, whether you are both
prepared to back the proposals and recommend their acceptance to your JDC. It is not possible
to offer an extension to this deadline.
If you are not able to give me the assurance, I ask for in this letter, I need to be absolutely clear
that I will assume that there is no realistic prospect of a negotiated agreement. In that
circumstance I will advise the Secretary of State that we would have reached the end of the road
in relation to the likelihood of reaching a negotiated agreement.
Yours sincerely
Sir David Dalton
Chief Executive
Salford Royal NHS Foundation Trust
cc: Danny Mortimer, CE, NHS Employers
Page 9 of 50
From:
Sent:
To:
Cc:
Subject:
Attachments:
11 February 2016 10:29
Ball Sarah (NSFT); Solomka Bohdan (NSFT)
Howlett Leigh (NSFT); Julie Cave (julie.cave@nsft.nhs.uk)
FW: Letter to chief executives on the junior doctors' contract
Letter to CEOs re JDs 11 Feb.pdf; J Malawana and M Porter BMA 09 02 16.pdf
Hi
Thought this may be of interest to you all
Carol
From: David Dalton [mailto:daviddalton@nhsemployers.org]
Sent: 11 February 2016 10:25
Subject: Letter to chief executives on the junior doctors' contract
Dear colleague
Please find attached a letter outlining the latest position on the junior doctors' contract and a letter
I sent to the BDM JDC on 09 February.
Kind regards
Sir David Dalton
The NHS Confederation
Registered Address:
Floor 4
50 Broadway
London
SW1H 0DB
Registered Company No: 05256894
Registered Charity No: 1090329
Confidentiality notice
This communication contains information which is confidential and may also be privileged. It is for the
exclusive use of the intended recipient(s). If you are not the intended recipient(s), please note that any
distribution, copying or use of this communication or the information in it is strictly prohibited. If you have
received this communication in error, please notify the sender immediately, delete the message from the
computer and destroy any copies of it.
1
Page 10 of 50
From:
Sent:
To:
Subject:
16 February 2016 17:13
Solomka Bohdan (NSFT); Ball Sarah (NSFT); Johnson June (NSFT)
FW: Next steps and support on junior doctors contract
Fyi Best Wishes Michael Chief Executive NSFT From: Rob Webster [mailto:RobWebster@nhsconfed.org]
Subject: Next steps and support on junior doctors contract
Dear Michael,
Following the Secretary of State’s announcement to the House last Thursday, I wanted to share
some insights into the current state of play and to let you know how we will be assisting our
members with the introduction of the new junior doctors contract.
The introduction of the contract is contentious. We fully supported constructive discussions
throughout the four years of negotiations and it is of real regret that, having made so much
progress on the contract in so many areas, full consensus could not be reached. We believe that
the offer rejected by the BMA, without due consideration or discussion, was fair and reasonable.
We also believe that the failure of the BMA to negotiate following a series of concessions by the
Government is a significant contributor to the Secretary of State’s decision to introduce the new
contract.
The NHS Confederation's priority now is to support our members through what we know will be a
difficult and contentious process of implementation. Our focus will be to improve relations with
doctors and to give you direct support. Junior doctors are a critical part of our workforce and the
issues that affect them go beyond the contract and into training, rota design, senior attitudes
and change. We welcome the work Dame Sue Bailey has been asked to do in reviewing
measures outside the contract that can be taken to improve the morale of junior doctors and will
provide support for this work in any way we can.
In terms of practical support, it is clear there is an expectation from National Bodies that CEOs
and their teams will be able to engage with junior doctors and their representatives to explain and
introduce the new arrangements. NHS Employers has produced a number of resources to help in
the immediate term, including:



A new at-a-glance factsheet setting out the key points of the contract which senior teams
can share in discussions with junior doctors and consultants.
A board presentation pack, summary booklet and FAQs available on the website.
An online enquiry form that allows you to submit questions on behalf of your junior doctors.
NHS Employers will use these questions to update the existing FAQs.
1


Freedom
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Request
93more
2016
Regular webinars
for HR and
staffing teams
covering
detailed technical
11 of 50 Joining details will be available on the
questions about the contract and Page
its implementation.
NHS Employers events web page shortly.
A series of regional face-to-face briefings for your HR and medical staffing teams. These
will also be on the events section of the NHS Employers website shortly.
Further resources will include an updated online pay system demonstrator and more guidance on
the details of the contract.
We know implementation of this new contract will be a test for everyone. We must get this right for
benefit of the people we all serve - patients, their families and carers, NHS staff and the wider
public.
We will do everything we can to support you.
Rob
Rob Webster
Chief Executive
NHS Confederation
2
Page 12 of 50
From:
Sent:
To:
Subject:
15 February 2016 12:34
Armstrong Alison (NSFT); Cave Julie (NSFT); Howlett Leigh (NSFT); Nesbitt Robert
(NSFT); Sayer Jane (NSFT); Solomka Bohdan (NSFT); White Deborah (NSFT)
FW: NHS Confederation Friday note
Best Wishes Michael Chief Executive NSFT From: David Hare [mailto:DavidHare@nhsconfed.org]
Subject: NHS Confederation Friday note
Dear Michael,
Welcome to the Friday note,
I’m standing in for Rob today, bringing you a summary of what the Confed group has been up to
during another eventful week for health and care.
Following industrial action earlier in the week, the junior doctors’ contract negotiations came to an
impasse on Thursday with Jeremy Hunt taking the decision to implement a contract without
agreement from the BMA. There has been some confusion over David Dalton’s letter to Jeremy
Hunt. As Sir David Dalton made clear, the statement that chief executives, NHS Confederation
and NHS Providers agreed to was confirming that the best and final position was considered fair
and reasonable, and that they believed the NHS needed certainty and not continuation of the
stalemate. Our priority now is for NHS Employers to work with trusts to ensure that they have the
support they need to help introduce the new contract.
A number of barometers showing how the NHS is performing under considerable pressure and
increased demand were published this week. The Nuffield Trust and Health Foundation published
a report on winter pressures reinforcing what you are already telling us, that it’s winter all year
round. Equally the latest performance figures show the increasing pressure on elective
treatments, with the 18 week target being breached for the first time in seven years. We continue
to strongly highlight that these ongoing pressures are symptomatic of wider demands across
health and social care and that all parts of the service must work together in the best interests of
patients to turn the position around. I believe that the independent sector has a crucial yet
currently under-utilised role to play here across elective care, diagnostics, clinical home
healthcare and primary and community services and expect the fledgling public/private
partnerships already observed across the service to develop considerably in the months and
years ahead.
Today the OECD have published a report on quality in healthcare in the United Kingdom. The
report confirms the findings of previous research that have sought to compare performance
between the four health systems, concluding that no consistent picture emerges of one performing
better than another. What it does show is that there is significant scope for more collaboration
between the four nations to learn from one another. This is where the Confed can really help with
Welsh and Northern Ireland members as part of the Confed group.
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Freedom
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93 2016
The NHS Confederation
is all aboutofpartnership
working
and this week
we were delighted to have
Page 13 Chief
of 50Executives Ambulance Leadership
a strong presence at the Association of Ambulance
Forum. Ambulance services have an important role to play in helping deliver the new models of
care and this was a great opportunity to learn more about the innovative work already being
done.
Two important documents were published this week. Monitor have published the tariff consultation
for 2016/17. There is nothing unexpected in this. Our focus is to help improve engagement and
ensure the whole sector has the opportunity to shape how prices are set and to voice concerns
where necessary. We need to learn from the mistakes of the past where the sector wasn’t
properly engaged in the process and are working closely with all partners to improve engagement
ahead of 2017/18.
NHS Improvement’s implementing the Forward View: Supporting providers was also launched at a
conference in London. The document sheds more light on NHS Improvement’s strategy for
working with providers to develop an effective improvement offer alongside their legal duties as
the economic regulator of the service. The report makes a number of welcome commitments
including supporting ongoing and important work which is emerging between public and
independent sector organisations and stressing the need to strengthen national and local
collective system leadership to succeed.
The NHS Confederation is busy working with Jim and his new team to further strengthen our
relationship and our Director of Policy, Johnny Marshall, is hosting a roundtable with senior
colleagues from NHS Improvement and members from across the group on Tuesday 23 February.
The roundtable will explore how NHS Improvement’s role will be different from that of its
predecessor organisations, and what it can do, working together with NHS England, to enable
local organisations from the statutory and non-statutory sectors to work together more closely.
Places are still available so please do get in touch by emailing Hannah.ChristieCastronari@nhsconfed.org if you would like to join the discussion.
We continue to work with all the national bodies to make sure you are well represented. We met
with many of you and the CQC on Tuesday to discuss the key proposals in the regulator's 201621 strategy and help inform our formal consultation to the response. Thank you to everyone who
attended and if you would like to feed in any further comments please email
sam.hunt@nhsconfed.org
On Tuesday NHSCC Chief Executive Julie Wood gave evidence at the Health Select Committee’s
inquiry into public health. The Committee were interested in a wide range of topics including
devolution, funding, data and health and wellbeing boards. Also on Tuesday an Independent
Commission led by Nigel Crisp published its report on adult acute mental health care. As David
Dalton highlighted in his response to the report, this is not just about beds but is about
understanding why people are admitted and why it can be difficult to discharge some people. The
report rightly recognises this. The real answer is to ensure people can get care when and where
they need it most. You can also read NHSCCs response to the report on their website.
Finally some weekend reading with two great blogs on NHS Voices on the themes of supporting
an older population. Lord Filkin writes on the importance of fostering healthy ageing while
Elisabetta provides insights from Italy on managing the chronic conditions of an aging population.
Have a great weekend
David
David Hare
Chief Executive
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From:
Sent:
To:
Subject:
02 February 2016 12:23
Best Wishes Michael Chief Executive NSFT From: Rob Webster [mailto:RobWebster@nhsconfed.org]
Sent: 29 January 2016 14:50
Dear Michael,
In this fragmented and conflicted system we now work in, who do you trust and where do
you find out what is really going on? Mixed messages from ALBs, political spin and media
leaks of draft documents parading as official guidance mean it has never been harder to discern
the important from the inconsequential and the meaning from the mire. One of the key roles we
fulfil is to help to do this as a trusted voice on the issues that matter.
We can do this because we do the hard yards behind the scenes with politicians, ALB
chiefs and the most influential in health and care – as well as spending time with each of
you. This week has been no different with productive time spent with people like Ben Gummer,
Simon Stevens, Jim Mackay, Sarah Wollaston and Ian Cumming representing your views and
influencing their actions; and a great visit to Weston Hospital and a regional chair and chief
executive dinner in the South West exposing the brilliant work that goes on in the midst of the
pressures we face each day.
And we lead on issue that make the biggest difference, building movement to drive
momentum for change. Published on Thursday The Commission on Improving Urgent care
report really demonstrates how the NHS Confederation can bring all parts of the system together
to find solutions to problems, showcase some the excellent work already happening and
disseminate best practice across the service. With the help of Dr Mark Newbold as chair, the
commission didn’t look at the issue of older people’s care as an ‘acute problem’ or a ‘social care
problem’ or a ‘primary care problem’, instead it brought key players together to understand what
we could all do differently and learn from organisations who have got this right. We’ve had a
fantastic response to the report and it received widespread media coverage as well as a mention
in a Commons debate by Sarah Wollaston.
One of my aims is for the Confed to go beyond the papers and into practice, and the next
phase of the commission is to focus on implementation. Over the coming months we will be
working to embed the principles of the report and make positive improvements to how we deliver
care for older people. Because the best practice examples save lives and money. They are
backed by the Royal Colleges, patient groups and the managerial representative organisations.
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We are working with the ALBs to speed up the planning guidance. Drafts are in circulation
and we are making sure they are fit for purpose. We will continue to press for more frequent
communication and better engagement. Because you need to know and they need to understand
the fantastic work that goes on in the service.
Three great examples:

Monday saw the launch of Care City, an innovative health ageing centre in North East
London. This ground-breaking collaboration between North East London NHS Foundation
Trust (NELFT) and the London Borough of Barking and Dagenham aims to improve the
health of the local community and also act as a catalyst for regeneration in the area. You
can read more about the project from two of the collaborators, John Brouder, CEO of
NELFT and Anne Bristow from London Borough of Barking and Dagenham who have
blogged for us on NHS Voices.

On Wednesday NHSCC shared further best practice in clinical commissioning with a
series of case studies on diagnosis and prevention. The case studies demonstrate how
CCGs are taking the lead in preventing illness and the causes of ill health – and working to
keep people out of hospital.

I’ve been out and about seeing some best practice in action at Weston Area Health
NHS Trust, which is definitely open for business under the leadership of James
Rimmer. Weston is a brilliant example of how award winning services – like the excellent
EdibleEddie programme on tissue viability – sit alongside new innovations driven by staff in
an organisation that has faced structural uncertainty and financial stress. James’ team
showed how backing staff and building an engaged model of leadership can start to
change culture and care.
Sometimes we must go further afield – and the Confed took 27 representatives from some
of the vanguard and pioneer sites to Almelo in Holland this week to see first-hand the
innovative way care is being delivered to people in their own homes. The Buurtzorg concept is
very simple – the patient is at the centre of their care, they choose and help co-design the care
they receive and it is all carried out by a team of self-managed nurses who have complete
autonomy over the decisions they make. This has resulted in better outcomes for patients,
economic savings and a better overall experience for patients, their families and importantly also
for staff. Thank you to the European Office for organising this trip.
And when the rhetoric is damaging, or plans are flawed, we say so. The Welsh NHS
Confederation have worked with Health and social care organisations to outline ten actions they
would like the political parties to commit to in order to improve health, social care and wellbeing in
Wales. The political rhetoric in Wales is set to “stun” and on Thursday there was the usual
wrangling over whether England has a better health system than Wales. This tit for tat squabbling
is unhelpful when we know the incredible pressure the health service across the UK is under and
that the focus needs to be on transforming care for patients.
The CQC have now published their draft strategy consultation which supports a shift in
focus, moving away from solely regulating individual organisations and towards health and
care services in local areas and for local populations. We believe this would better reflect the
impact that healthcare providers can have on each other and support them to work together to
offer more joined-up care for patients. We will be canvassing your views on the strategy at a
roundtable in February and you can also send your views to sam.hunt@nhsconfed.org
So who can you trust when the noise becomes a cacophony? This is a massive question
when it comes to the Junior Doctors contract. NHS Employers, with the support of Sir David
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Dalton, are continuingFreedom
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find
a resolution toRequest
the junior doctors’
contract. You will have
Page via
17TDA/Monitor
of 50
now received a special Chair and CEO briefing
on progress to date and are
encouraged to read this and share with your boards. We will continue to keep you informed, with
significant detail from NHS Employers going regularly to your HRDs.
That’s what I think but am I right? Thank you to everyone who has completed our membership
survey. If you’ve not done so already there is still time to have your say. Look out for an email
reminder in your inbox. For those who read our regular publication The Insider we are also keen to
get your thoughts on how we can improve it. Take our quick survey and be in with a chance to win
a free place at our annual conference in June.
Rob
Rob Webster
Chief Executive
NHS Confederation
3
Page 18 of 50
From:
Sent:
To:
Subject:
21 March 2016 16:52
Sent: 18 March 2016 17:50
Dear Michael,
Welcome to the Friday note
The language we use can connect us, it can divide us and it can define us. In the NHS we have our own
array of acronyms and terms that often feel like another language. The popularity of our Acronym Buster
shows how opaque our language can be and the #Hellomynameis campaign was born out of a desire for
patients to be treated with respect as equals rather than be labelled as “the tumour in bed 7”.
As a senior civil servant, I became quite skilled at “finding ever more elegant ways of not saying what
I really meant”. This came in handy with certain ministers and in difficult public situations where
neutrality had to be maintained. Fortunately I am no longer a civil servant and can be clearer about what I
mean – which was apparent at our event with the Nuffield Trust on #Daringtoask about whether the NHS
was on the brink of disaster or serious transformation. My summary was that we cannot collude with anyone
who states we have a clear plan on how to deliver the 5YFV.
The PAC published a scathing report on acute hospital finances on Tuesday that seemed to agree –
they certainly have no qualms about saying what they mean either. The report suggested there was no
credible plan for turning around the NHS finances and that national bodies were acting too late. What is
clear is that there is an urgent and pressing need to reform the financial system of reward and risk in the
NHS. Too often the incentives work against whole person care. We also need support from politicians and
regulators to change services, change finances, and change a culture looking at performance based on
individual hospitals, into one that measures and supports the whole system.
Prevention and social care are both contributing factors to a successful future. It was disappointing that
underfunding of social care was not addressed in the Budget – especially as a 32% increase in people stuck
in hospitals due to the unavailability of social care contributed to January showing the worst NHS
performance results in recent history. The proposed sugar tax is expected to raise £500m which is a drop in
the ocean compared to the funding gap in public health spending. Business rates are also due to be cut
which again will not help local government raise vital funds for social care.
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We must hope that theFreedom
STP process of
is given
the space and
the support
succeed. The 44 geographic
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19 ofto50
areas that will bring together local health and
care systems
transform care, as mandated by the NHS
planning guidance, were revealed on Tuesday, alongside a small number of the senior leaders who will
coordinate them. Old thinking suggests that these “leaders” are now “in charge”. This isn’t the case
statutorily, legitimately or practically.
My take on this is that these networks of organisations now have lead CEOs who should be supported
to deliver changes to their local services, with good relationships and respect at their core. This means
a robust package for all 44 patches. You’ve told us that in order to transform services, you need a joined-up
approach from the national bodies. This must improve as 86 per cent of you feel the national bodies work in
a contradictory way, and the majority feel that their policies do not support local transformation. We must
avoid excessive control from the centre, which is in danger of stifling local ambitions to transform local
services.
All parts of the service have a role to play, including the independent sector. Our NHS Partners
Network have produced a guide on how this support could be realised in three specific areas, capital,
capacity and capability – each of which are essential ingredients. You will note the language here and the
fact we have used alliteration but avoided the usual word associated with this sector :
“Competition”. “Collaboration” is more appropriate now. You can download the guide on our website and
if you’d like to find out more please contact sejal.patel@nhsconfed.org.
More guidance, support and evidence is being made available on a regular basis. We have also
produced an interactive timeline for transformation with all the key dates and useful links. We will continue
to support the development of new arrangements and our director of policy, Johnny Marshall wrote to you
all this week, sharing the work we are doing with NHS England and NHS Improvement on your experiences
so far. NHSCC has also written in similar terms.
Place based regulation is part of the future and we have submitted our response to the CQC strategy
consultation on how this might happen. Thank you to all of you who provided feedback. Our submission
shows support for the proposed direction of travel. We have however raised a number of significant
challenges and concerns. A summary and the full consultation response is available on our website. We are
also expecting a decision on the CQC fees consultation imminently.
Our people continue to be front and centre of the NHS story. Also announced in the Budget were
changes to pensions which will impact on the NHS in 2020. There are no accurate figures on what the
impact will be at present because pensions figures will need to be updated with 2018 data and mined by the
actuaries. Our own estimate, based on current pro-rata division of public sector liabilities, is around £600m.
For full details on all the issues in the budget relevant to employers and the NHS workforce see the NHS
Employers website.
Danny Mortimer and his team have been touring the country explaining how introduction of the new
junior doctors contract will be delivered. These have been very well attended. The contract was subject to
a great deal of conversation and some interesting language at the Presidents’ Dinner for Royal Colleges and
Partners at the BMA. We continue to work hard behind the scenes to understand and act in any way we can
in these febrile times.
I spent time with graduate trainees today, talking about leadership and their future. Variability,
uncertainty, complexity and ambiguity will be a big part of their lives – as will a need for clarity of purpose
and clarity of values. Other staff new to careers in the NHS include apprentices and NHS Employers has
produced a briefing to provide an overview of key policy changes around apprenticeships, including the
apprenticeship levy and public sector apprenticeship targets. The briefing suggests key actions that boards
may wish to take to obtain the maximum benefit from these policy changes, and a set of key questions to
consider. We will be following up with chief executives next month to build a picture of confidence levels
in these areas and to shape our national offer of support for employers.
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It’s been a big week politically
in Wales
and on TuesdayRequest
the Welsh Confederation
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hustings. The event saw around 80 people from
across
Wales, independent, third and voluntary
sectors, pose questions around the pledges and priorities of five political parties ahead of the National
Assembly Elections in May. With health a key issue in the elections, the themes that emerged during the
debate included the recruitment and retention of the workforce, integration, finance and addressing public
health challenges.
Finally a few leadership changes here: welcome to Louise Scull and Julia Hickey, Chairs of Nottingham
University Hospitals NHS Trust and Gateshead Health NHS FT who have joined as trustees.
Congratulations to Jim Easton who has been appointed as chair of the NHS Partners Network, Bev
Humphrey who has been elected Chair of the Mental Health Network and Graham Jackson who has been
elected co-chair of NHSCC.
Rob
Rob Webster
Chief Executive
NHS Confederation
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From:
Sent:
To:
Subject:
01 April 2016 17:18
Sent: 01 April 2016 13:16
Dear Michael,
It’s April Fool’s Day and HSJ came up with a reasonable effort this year. In the current
political world of #Brexit it is often difficult to separate reality from the risible so it must have been
tougher this year.
What’s no joke is the number of changes that come into force on 1 April. Our indispensable
guide to all of the changes is available here and covers everything across all sectors. One for all
company secretaries and Chairs to enjoy cross checking against local governance and delivery
mechanisms.
This week saw the publication of NHS England’s Business Plan and the creation of NHS
Improvement. These changes signal another move towards a different approach to delivery of
the 5YFV. This is often a place based focus and one where organisations are expected to
collaborate to be sustainable. We look forward to these behaviours being modelled by the national
bodies.
This won’t be easy for them or us. This week we received the news that CQC will be pressing
on with a substantial increase in fees, aiming to cover all costs from inspected organisations within
two years. This will leave a sour taste in the mouths of many for two reasons. Firstly,
consultations must be genuine and this one feels like a four year recovery was a distant
possibility. Secondly, the CQC must demonstrate better value for money if it is to maintain the
respect and goodwill of an NHS and care sector on the efficiency rack. I mentioned last week our
member survey results which reflect little confidence in the regulator’s ability to support
transformation or provide value for money. The senior leadership of CQC have seen the detail.
We will continue to press on this.
Notably, this week we saw a group of leaders step forward as NHS England announced the
full list of STP area leaders. We’ve been clear about the support, freedom and flexibility these
leaders will need from the national bodies and will be working to ensure that this is the case.
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2016CEOs and Council
As one of these leaders
in West of
Yorkshire,
I will beRequest
working with
of 50
leaders, building on partnerships andPage
strong22
relationships
across the system. STPs should
be ours not a bureaucratic exercise to appease HMT or anyone else. I am looking forward to the
challenge, and I am determined to show that the best way to enable transformation is to resist the
pressure from the centre to revert to the old style of leadership. Any FT leader will tell you that
their freedoms have already been eroded. CCGs are too often prescribed courses of action by
NHS England - you may have seen the story in the Guardian about the £600m hospital fines
being levied on providers over patient targets. What the story could perhaps have made clearer is
that commissioners are now mandated to impose fines and are prohibited from reinvesting this
money in the local system. NHSCC issued a response and rightly say this policy hampers local
efforts for organisations to work in partnership and drive improvements to care.
The only answer to the issues that face us is to embrace the laws of subsidiarity and plan
as close to the problem as possible. That will require working on most issues at a local level and
some issues on bigger footprints - and this must be a local choice. Speaking to many of you and
senior figures in the system, I know this will be no easy task.
After some detailed work, NHS Employers published the full terms and conditions of
service for junior doctors, now available on NHS Employers website. Along with the contract
there are a number of supporting resources including a model contract, a communications toolkit,
an A-Z reference guide for the terms and conditions and details on the new guardian role. The
resources are aimed at supporting employers through the implementation phase. Danny wrote to
all of you this week and NHS Employers continues to work hard to ensure you have as much
material as possible to help the transition to the 2016 junior doctors’ contract. If you have any
questions regarding the new junior doctor contract our team are available to help. Please contact:
juniordoctors@nhsemployers.org
The contract includes the equality impact assessment which will be the focus of a judicial
review by the BMA of the DH and their decision to introduce the contract. This is part of the
ongoing opposition by the BMA to the contract, which also includes industrial action with more
details and support here.
In these tough times, the resilience of our collective and individual leadership will continue
to be tested. Congratulations to Sue Sjuve & Paula Head at Sussex Community NHS Foundation
Trust and Tom Storrow & Tracy Taylor at Birmingham Community Healthcare NHS Foundation
Trust for getting over the very high bar that is now set for FTs. Your leadership and resilience is a
credit to you, your teams and the NHS.
The NHS Confederation will only succeed if we are driven by what our members, leaders in
the NHS, tell us they need. Our board of trustees is vital to this and we were delighted to see two
new NHS leaders joining the team - Julia Hickey, Chair, Gateshead Health NHS Foundation Trust
and Louise Scull, Chair Nottingham University Hospitals NHS Trust. Both bring a wealth of talent
and experience with them and will no doubt help to ensure the Confederation continues to be led
by its members.
Throughout my career I have always believed that having the protection and support of the
NHS Confederation is essential. In these times where the system and individual sector voice is
so important, the role of the NHS Confederation and its Networks has never been more vital.
When I leave here on 6 May to join South West Yorkshire Partnership NHS Foundation Trust, I
will be glad that we are members of the Mental Health Network and the NHS Confederation.
Finally, I wanted to take the opportunity to again thank you for your support. You should
have received our member renewal pack by now and I wanted to highlight the impact report we
have produced which outlines our activity over the last year. There are some real achievements
and none of this would be possible without your continued backing. Value for money is also a key
issue for us and we have worked hard to ensure we can keep our fees flat for the ninth year
running (plus a decrease of 4% in 2012/13) and - unlike CQC - our fees are not increasing!
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Have a great weekend,
Rob
Page 23 of 50
Rob Webster
Chief Executive
NHS Confederation
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Page 24 of 50
From:
Sent:
To:
Subject:
24 March 2016 17:03
FW: NHS Confederation Thursday note
Good focus on community capital here Best Wishes Michael Chief Executive NSFT From: Rob Webster [mailto:RobWebster@nhsconfed.org]
Sent: 24 March 2016 16:51
Subject: NHS Confederation Thursday note
Dear Michael,
Welcome to the Thursday note,
Easter is a time of extra pressure in parts of the service and sometimes a chance to take a
break and reflect. We will spend time at work and with our families and relatives in the
communities we live or serve.
The idea of seeing communities as assets has long been a passion of mine and is an
agenda which is gaining in pace across the service. This week I chaired a dinner sponsored
by the Social Action team in the Cabinet office with a group of members to explore the role of
social action in health and care services. This is part of a broader programme of work being led by
our associate director, Joan Saddler, and is always a source of great stories. Cliff Richards from
Halton CCG spoke eloquently about the power of Halton Community Wellbeing practices that sit
alongside GP practices. A couple – let’s call them Harry and Rita - experiencing mental health
problems approached Dr Cliff for medication and were sent to the Wellbeing practice. It became
apparent that Harry was suffering from early dementia and was no longer able to cycle as he
became confused and lost. This affected his mental health and Rita was stressed and isolated.
The Wellbeing practice arranged for the local cycling club to pick Harry up and drop him off as part
of their regular rides and put him in the peloton. He regained his self-worth, Rita got respite and
the club carried on giving back to the community.
There are many stories like this and this approach needs hard wiring into the way we do
business. It’s clear there is much good work going on in the service around how we use of
volunteers and people in our communities to lead innovative developments in the NHS. Equally
there is much more we can do. It is clear that the Cabinet Office are prioritising health in their
£40m social action programme and we will work with them to share this work across the system.
We are organising an event next month in Sheffield looking at patients as partners. You can find
out more here.
Social action is part of the 5YFV transformation and in our recent member survey nearly
70% of you said you were part of a pilot scheme for new models of care. The vanguards are
1
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important, although ofFreedom
course not the
picture. Along
with NHS
Page
25 of 50involvement and ownership of the
NHSCC, we are working to create greater
understanding,
vanguard vision, showcasing new ways health and care economies can help establish a
sustainable health service. We're running a series of site visits to localities involved in the
vanguard programme which aim to help share the learning of developing new models of care
across localities. If you are interested in attending one of these visits, you can find more
information here. I’d also encourage you to listen to the latest podcast about the vanguards. This
one is an interview with the ever engaging Sir Sam Everington, from Tower Hamlets CCG – who
knows about social action very well.
In recent months we’ve seen a welcome focus on “places” rather than individual
institutions, with devo deals and combined authorities as one manifestation of this. This
week we published a slide deck aiming to make sense of devolution following an event we ran
with the LGA and NHSCC earlier this month. A key part of this agenda is the huge potential for
the NHS to contribute to efforts to foster greater local growth in many places. This is why we
appointed Michael Wood as our local growth advisor earlier this year. This agenda will lead to
opportunities for new sources of funding for the NHS and we are running a series of workshops to
help NHS organisations take advantage of this.
CQC will regulate places in future. We expect an announcement at time of writing about the
CQC fee increase for next year. This will not be good news and piles further pressure on finances.
It’s something I reiterated when I met with David Behan earlier today. Our member survey was
crystal clear on the need for the CQC to make progress in a number of areas before the service
can be confident CQC’s regulation will support transformation and offer trusts genuine value for
money. David was receptive to these messages and keen to work with us in future to get this
right.
Sadly, service and financial pressure remain a theme in the modern health and care
system. There was some good news with the publication of Monitor and NHS England’s 2016/17
National Tariff Payment System. This confirmed a 2% efficiency factor which will help strained
budgets, and follows continued lobbying from the NHS Confederation. We have helped in
ensuring there is genuine engagement with the sector around the tariff so we avoid last year’s
debacle. It’s only a sticking plaster solution – what we need is long term redesign of the payment
system. We’ll continue to press on this.
Workforce issues remain front and centre. Following sustained lobbying, we have seen more
good news with the MAC continue to put nurses on the shortage profession list for overseas
recruitment. NHS Employers have responded.
The dispute around junior doctors’ contracts rumbles on, with news this week that the BMA
has voted to intensify industrial action, planning to withdraw emergency cover during
upcoming the strikes. NHS Employers continues to provide support for trusts in meeting this
challenge. NHS Employers has developed a helpful slide deck on this subject, based on 5 recent
events which I’d encourage you to share with your team. You will be able to download the
Powerpoint slide deck here. We are continuing to host webinars for HR and medical directors. The
next webinar will take place on Thursday 24 March, you can book your place now.
There is a saying that “you never saw your hometown until you went around the world”. I
hosted a Dutch delegation this week and gave them an outline of where we are as a service.
Providing a view to outsiders focuses the mind. There are a number of serious challenges faced
and some degree of hope too. This will require good leadership, a genuine local vision and
ambition for the places we serve and new ways of working.
I have been clear on this in debates about the STPs. We know there is a lot of positive intent
and hope linked to these – and a lot of unhappiness. I know as the putative lead for the STP in
West Yorkshire that there is a lot to do to if we are to develop a network approach to STPs that
engages all parties and includes everyone. I made these points to Simon Stevens and Jim
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2016
Mackey this week, as Freedom
well as developing
a shared approach
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that we will take
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of 50
forward nationally. Meeting with LGA CEO,
Mark26
Lloyd
this week, it is clear that the Confed and
LGA share much common cause.
Leadership will be needed at all levels to drive this agenda. This will be a theme at our annual
conference, which is always a unique opportunity to take stock of the big issues we face every
day. Conference this year will focus on transforming care for patients. Our trustees, including Sir
Andrew Cash, have been speaking about the many benefits of conference and why it is important
to bring all the different parts of the system together. See what they said in our latest conference
video. To book your place visit www.nhsconfed.org/conference
Speaking of leadership, we are out for a new CEO of the Confed. I expect a very strong field
for a great job. There will be a gap between me leaving on 6 May and my successor. I have
asked the excellent MHN CEO Stephen Dalton to act as CEO during the interregnum. As an
experienced front line CEO and a national figure he is ideally suited to take temporary charge for a
while after 6 May.
Have a fantastic long weekend,
Rob
Rob Webster
Chief Executive
NHS Confederation
3
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From:
Sent:
To:
Subject:
15 March 2016 15:17
FW: Update on the junior doctors’ contract position
To note Best Wishes Michael Chief Executive NSFT From: Daniel Mortimer [mailto:danielmortimer@nhsemployers.org]
Sent: 15 March 2016 14:45
Subject: Update on the junior doctors’ contract position
Subject: Update on the junior doctors’ contract position
Dear Colleague
Last week saw the first in the latest series of planned industrial action by junior doctors. During
this 48-hour period, although no major incidents were reported, there was considerable pressure
on services on the second day and it is hugely regrettable that so many patients were
inconvenienced.
It is frustrating that the NHS is in this position, as I believe we made significant progress in
addressing the concerns regarding the new junior doctors' contract, especially around safe
working. As David Dalton has previously stressed, the contract we are offering junior doctors from
August 2016 is both safe and fair.
The next planned industrial action is due to take place from 8am on Wednesday 6 April until 8am
on Friday 8 April. Once again, we will do everything we can to support you and will be updating
our industrial action web page with latest information. I know there are additional concerns during
this period due to the changeover of doctors on many rotations, and we will update our advice
accordingly. If there are any additional resources you would find useful during this period, please
contact me at danielmortimer@nhsemployers.org.
Engagement events
I had the opportunity to speak to a number of you recently at our face-to-face engagement events
in London, Manchester and Birmingham, and look forward to meeting colleagues at the upcoming
events in Exeter and Newcastle. I greatly valued the opportunity to speak candidly with colleagues
and listen to the questions you have regarding the implementation of the contract. The full contract
is being finalised and will be published by the end of the month. I have been struck by the
commitment of those who have attended to ensuring that the new contract is properly
implemented. We will of course all need to work closely together to ensure that is the case.
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To support you with any
local engagement,
I have included
the powerpoint
slide pack that I’ve
28any
of additional
50
been using at the engagement events. IfPage
there are
resources that would support
you, please email me at danielmortimer@nhsemployers.org
Understanding the facts
On 4 March, Dr Johann Malawana, chair of the BMA junior doctors committee, wrote to all NHS
trust chief executives in England expressing his concerns over the introduction of the new
contract. Much of what he wrote to you surprised me, as it appeared to minimise all that had been
achieved between the end of November 2015 and mid-February 2016. I wanted to take this
opportunity to give you some information that may help in responding to the points raised in his
letter both directly if you so choose, or in discussion with your doctors. The slide pack attached will
also be useful with such a response.

Seven-day working – We want a new junior doctors’ contract that is safe and fair, and
supports effective working across the week. Under the proposals, plain time has been
extended as part of moving from highly variable pay to more predictable earnings, while still
ensuring that those working the most unsocial hours (nights, Saturday evenings and
Sundays) will continue to receive premium pay for those hours. The contract does not in
itself compel doctors to work more frequently at weekends, and you will of course be aware
of whatever priority actions you have identified locally to deliver the clinical standards
expected by NHS England. These may be worth sharing with your junior doctor workforce.

Concerns over training and supervision – the current new deal contract makes no
reference to training and there are no mechanisms to rapidly address circumstances where
training opportunities are missed because of service pressures. There is too much reliance
on fixed leave and insufficient notice of training placements, so as part of determining the
final contract position we agreed with the BMA a number of new measures to tackle the
issues of training, including:
o
o
o
o
ensuring proper notice of forthcoming rotational placements
a review of access to flexible training
developing national procurement of essential clinical courses
implementing tax-efficient ways of paying professional and examination fees.
These actions will be supplemented by any that might be recommended by Dame Sue
Bailey in her review.

Non-resident, on-call availability proposals - The on-call arrangements set out in the
proposals are similar to those that are currently used for speciality doctors and consultants,
though the availability supplement for juniors is more generous at 10 per cent and 5 per
cent. Employers are therefore already skilled in planning anticipated workloads during oncall periods and most already do for this for junior doctors to roster on-call and rest periods
under the current contract. We were not able to accept the BMA position that being
available for on call should be paid at 20 per cent of contract earnings, when weekend shift
duties receive 30 per cent pay uplift.

Plain time and unsocial hours – We agree that it is important that the junior doctors have
a work/life balance, and the new contract reflects this by paying doctors who work the most
Saturdays. In addition, junior doctors cannot be rostered for consecutive Saturdays without
agreement. Junior doctors will be paid for actual work done, with an increase in basic
pensionable pay; additional pay for additional rostered hours; enhanced rates for unsocial
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93 2016
hours; on-call availability
supplements,
and (where
appropriate)
flexible pay premia.
Page 29 of 50

Locum restrictions - The proposed contract sets a clear limit on weekly average hours of
work in any setting at 56 hours, where a doctor has opted out of the Working Time
Regulations. Doctors have a responsibility to ensure that when working any additional
hours outside their work schedule, those hours are safe and in line with the contractual
limits that are binding for both the employer and the doctor. I accept that some doctors may
find unwelcome the requirement that they offer 'first refusal' on any time they intend to work
as locums compared to at present, particularly as there will be a set national rate. These
new requirements will however be balanced against a set of rules that require the first
refusal to be deployed within a reasonable timeframe, and which ensure a similarly
reasonable approach in terms of 'acting down' to cover shifts of more junior colleagues.

Pay and pay protection - The Secretary of State made a commitment to doctors in
training that during the transition to the new contract, there will be 'no doctor earning less
that she or he does today.' This will apply to all doctors in training, save those who receive
Band 3 payments. Those doctors at the later stages of their training will continue to receive
pay and banding, as if they were still working on the present contract.

The guardian role – Trusts will be supported in setting up the guardian role, and we had
always expected that you should seek to involve junior doctors within your organisation in
its appointment and functioning. Johann was concerned in our negotiations to ensure the
role of the regional and national BMA apparatus in oversight of the role, whilst we
emphasised the local accountability to your board and junior doctors. We will shortly be
producing a package of materials for employers on the role, including a job description and
a role specification.

Night shifts - The current contract introduced in 2000 does not provide all the safeguards
we would want for trainee doctors. For example, it does not allow for short rest periods after
night work or late ('twilight') shifts. Working with the BMA, we reached agreement on a
package of measures to protect doctors in training against working unsafe hours, including
night work. These go beyond the European Working Time Directive and the current new
deal contract. Further, we have in the 2016 contract prioritised payment of work at nights
over other periods, whereas the BMA’s view was that work during the weekend daytime
hours was equivalent in pay terms to work at night.
I would again stress that whatever feeling there is about the implementation of the contract without
agreement, the contract itself is a fair one that has benefited from the discussions between the
BMA and the NHS from late November until mid-February. Naturally, we all share the sentiment
that Dr Malawana expresses regarding agreement to a way forward being a clear preference. In
my experience, such agreements involve a degree of compromise and I am very aware that the
employers side agreed to steps in the negotiations - the new guardian role and the application of
financial penalties - about which many trusts and FTs have real concerns, but which were
supported to ensure a deal could be agreed. I had very much hoped that a similar compromise
could be reached by Dr Malawana's committee regarding payment for Saturdays.
Implementing the contract
I wanted to clarify the issue regarding the implementation of the new contract by foundation trusts,
as questions have been raised at some of the recent face-to-face events. Ian Cumming, chief
3
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of Information
93 2016
executive of Health Education
England,
wrote to trust Request
chief executives
on 15 February stressing
Page
30 new
of 50
the importance of consistent implementation
of the
junior doctor contract across the service.
In his letter he said: “A single national approach is essential to safeguard the organisation and
delivery of postgraduate medical training to ensure all doctors can secure the professional
development they require to complete their training programmes. They are not prepared to see a
system where a competition based on a local employer’s ability to offer different terms is part of
the recruitment process. The recruitment process should be based on patient and service need
and quality of training, as it always has been.”
We have raised, on your behalf, the need for HEE and NHS Improvement to ensure the proper
tracking of the differential impact of the new contract, in terms of costs and savings in different
organisations, during 2016/17.
I hope that you have found this update useful and if you have any queries or comments then
please do not hesitate to drop me a line at danielmortimer@nhsemployers.org
Yours sincerely
Daniel Mortimer
4
Page 31 of 50
From:
Sent:
To:
Subject:
05 February 2016 19:21
Cave Julie (NSFT); Nesbitt Robert (NSFT); Sayer Jane (NSFT); Solomka Bohdan
(NSFT); Howlett Leigh (NSFT); Armstrong Alison (NSFT); White Deborah (NSFT)
Fwd: NHS Confederation Friday note
Sent from my iPhone
Begin forwarded message:
From: Rob Webster <RobWebster@nhsconfed.org>
Date: 5 February 2016 17:02:04 GMT
To: Michael Scott <m.c.scott@nsft.nhs.uk>
Dear Michael,
“Everything we see is perspective not the truth” said Marcus Aurelius around
2,000 years ago. “We must have a single version of the truth” said Lord Carter
today. Both in a way are right. The Carter Review was published today, an
important document in both the way it was produced – with the service, with good
engagement, using evidence and analysis - and for what it says. You can read a
summary on our website and understand what the 15 recommendations mean for
your organisation.
The review has strong messages for the Government and the ALBs. It is good
to see that the work we have done to contribute to the review is reflected in the
requirements for a people strategy; a single framework for reporting that
reduces the burden on the service; and a single approach to support for
improvement. This clearly is about sharing perspectives in pursuit of a single
agreement on the truth and what needs to be done.
Carter also suggests a move to system based solutions to patient flow. This
captured a lot of media interest and, as I said on BBC News, when you cut social
care, the NHS bleeds. Carter claims £900m could be saved by improving support in
communities – when social care DTOCs are up 31% in a year, he has a point. Our
Independent Commission on Improving Urgent and Emergency Care for Older
People covered this too.
Clearly this requires leadership within and across systems, which is our focus
as the collective voice of all parts of the NHS. This is an area we're keen to
explore further as we support the implementation of the Carter programme with a
project of our own that brings leaders together to share learning on delivering better
value. If you would like to be involved in this work, please contact
Emma.Paveley@nhsconfed.org.
A good example of system working is through the Streamlining Programme, a
collaboration between NHS Employers, HR for London and Skills for Health
looking at reducing excessive time and bureaucracy involved in transfers between
1
Information
93 2016
trusts. WorkingFreedom
with staff to of
engage
in efficiencyRequest
savings needs
to be seen in the
32 not
of 50
light of the whole health and carePage
sector and
just in hospitals so that rostering,
and management of staff are based on the care needs of local people, and
determined by an integrated health and care system.
Government could do with role modelling here, seeking to learn lessons from
different parts of the UK, instead of bitter politicking over the differences
between us.
Clearly by investing in social care and integration, the Welsh position on
DTOC and demand is improving in a way not seen in England. This was clear at
the Welsh NHS Confederation annual conference which championed values,
leadership, resilience and ambition. It was a very well attended event with high
profile speakers including the First Minister for Wales, Rt Hon Carwyn Jones AM.
New research by the Welsh NHS Confederation launched at the conference shows
that the public do understand the breadth and scale of the challenges faced by the
NHS. The survey reinforces the messages in The 2016 Challenge: A Vision for NHS
Wales.
It is not always about flow, we also need to do what is in our gift within our
organisations, as evidenced by the brilliant work on “crowding” coming out of
the Bristol Royal Infirmary. The excellent Dr Emma Redfern shared work on
National Early Warning Scores and the development of an ED checklist that is
saving lives and improving services. The work is spreading across the South West,
under the Patient Safety Collaborative supported by the West of England AHSN.
The AHSNs are currently collating their top three innovations for a
compendium – after half a day at the brilliant WEAHSN, they will struggle to
get it down to only three each. There are some days when you feel you are
stealing a living and this was one of them. From the PreCePT work on preventing
Cereberal Palsy in preterm babies to risk factors in Atrial Fibrillation in general
practice, the work is clinically led, evidence based and having impact. Lives are
being saved, clinicians enthused and the public informed. Check out things like
dontwaittoanticoagulate.com and www.openprescribing.net for examples of what
they do. Thanks to Deborah Evans and her team at West of England AHSN for
reinforcing the power of AHSNs. It was timely as Sir Hugh Taylor and I met this
week to discuss how AHSNs play into the final recommendations of the Accelerated
Access Review.
Speaking of local collaboration, the Communities and Local Government
Committee have published their report on devolution this week. I gave
evidence to this committee back in November. It was good to see the committee’s
final report reflecting our view that devolution is not the silver bullet to the funding
problems facing social care. Equally the committee recognises that devolution might
not be right for all areas and that we need a locally driven approach to designing
services.
Devolved areas need community focused solutions and on Thursday our
community health services forum held an event to talk about the future of the
community workforce. Delegates discussed the barriers and enablers to ensuring
a sustainable community-based workforce. New models of care usher in more
flexible ways of delivering services based around local population needs and not
organisational structures.
NHS Partners Network produced an important report this week on the sharp
rise in the use of block contracts for elective care. The increase in the use of
block contracts gives a clear indication of how much of a priority CCGs are putting
2
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of Information
93 2016
on support for the
balance sheets
of trusts. ThisRequest
balance between
block contracts
Pagepatients
33 of should
50 be allowed choice is one of
being financially tempting, and whether
the daily challenge for NHS leaders. I despair that the HSJ continue the joke
comparison with the PM’s salary and won’t validate it by claiming we are worthy of
being paid more than the Prime Minister! Until you all get two houses on expenses,
clothing allowance, your own personal staff, a plane and a pension after 10 years, it
is a ludicrous claim.
Thanks to Rod Barnes at Yorkshire Ambulance Service for our meeting today
on ambulance services, innovation and place based planning. The innovation in
YAS is noteworthy – from the 111 predictive planning, to new specialist paramedic
roles and shared developments with the Fire Service. It was a mouth-watering
precursor to the AACE conference next week, which I am looking forward to. These
meetings are so important to me and my team in being able to understand the
challenges you face and find out more about the work you are doing. Check out our
interactive map of recent and up and coming visits and do get in touch if you’d like
us to come and see you. YAS is also dealing with industrial relations. Something
that continues to be an issue across the NHS.
The BMA have refused to negotiate on plain time for Saturdays and patients
will suffer. It is extremely disappointing that more industrial action will take place
next week when progress has already been made and significant offers have been
made to the BMA to address the concerns raised by junior doctors. Daniel Mortimer
wrote to you earlier this week outlining progress to date and sharing David Dalton’s
letter to junior doctors. I would encourage you to work with your medical directors to
ensure all your junior doctors are aware of and understand the details of this letter.
I have seen perspectives on the NHS from London, Cardiff, Bristol, Leeds and
Wakefield this week. What is true is that you remain an inspiration and an asset to
the country in these tough times.
Rob
Rob Webster
Chief Executive
NHS Confederation
3
Page 34 of 50
From:
Sent:
To:
Subject:
19 February 2016 16:35
Cave Julie (NSFT); Nesbitt Robert (NSFT); Sayer Jane (NSFT); Solomka Bohdan
(NSFT); Howlett Leigh (NSFT); Armstrong Alison (NSFT); White Deborah (NSFT)
Fwd: NHS Confederation Friday note
Sent from my iPhone
From: Rob Webster <RobWebster@nhsconfed.org>
Dear Michael,
When numbers get really big, they become difficult to grasp. The much
anticipated Mental Health Task Force report, published on Monday contains some
very big numbers. It suggests 600,000 people need to be assessed for depression &
anxiety and 350,000 should complete treatment. Around 30,000 women should get
access to MH support in the perinatal period. At least 70,000 children need access
to high quality care when they need it. Around 280,000 people with severe MH
problems should get access to services that improve their physical health. I could go
on.
Big numbers are made up of units of one – each a collection of single adult
patients, new mums and children. Think of it that way and the suffering we are
overseeing in our system becomes an urgent issue in need of a collective fix. Read
a summary of the report that MHN have produced and read NHSCCs response on
their website.
The report meets one of the tasks we set the new Government when it came in
– to set out plans to make Mental Health as accessible as physical health. It’s a
good report founded on input from over 20,000 people. It sets out a vision for
improving the mental health of children, young people, working-age adults and older
people. The Confed had good representation on the taskforce with Stephen Dalton
from the Mental Health Network and Dr Phil Moore from NHSCC’s mental health
commissioners network.
The report will be widely supported - by mental health service providers and
commissioners but the finances are questionable. Mental health trusts have
been straining to provide care with shrinking resources in complex environments.
The promise of a billion pounds of extra investment by 2020 is welcome – on top of
previous announcements for CAMHs. The issue is leverage, and whether this can
be found by a system under pressure and when it is a sum included in the growth
announced in the SR settlement.
1
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oftoInformation
93 2016
As the financial
year draws
a close, thereRequest
has been much
pessimistic
Pageof35
oftrusts
50 with the King’s Fund
rhetoric about the financial position
NHS
describing the NHS as nearing ‘make or break’. As our senior policy advisor Paul
Healy said in the Guardian on Thursday we know the status quo isn’t sustainable
and are working hard to join up across the health and care system, so as to be more
efficient, deliver better value and offer a more individual service for the public. This
takes time and we need the space to be able to do this.
Supporting local leaders to deliver sustainable health and care is another of
our asks of Government – and sustainability and transformation plans (STPs)
have featured heavily this week. After weeks of drafting, a letter from the ALBs
arrived providing more detail on process and content. We have tried hard to
influence this communication, being involved in multiple drafts, while stressing the
requirement for the pace and scale of engagement to pick up. I would also urge you
to keep at the forefront of your mind that the STP footprint is not an organisation or
an administrative boundary for all occasions. It is not the new structure of the NHS –
it is simply a footprint within which a network of organisations can operate services
that make sense.
This is very apparent in Cumbria, West Yorkshire and North West Surrey
where I have had the pleasure of spending time with members in the last week.
Each was different. Cumbria Partnership NHS Foundation Trust is an organisation
that has a vanguard in the South and a success regime in the North with a need to
meet the requirements of both. West Yorkshire encompasses a mental health led
urgent care vanguard, integration pioneers and one of the biggest tertiary hospitals
in Europe. North West Surrey is delivering a whole system programme of
transformation that includes a potential acute trust merger, one of the longest
standing private sector community and radical reform of community services and
social care. Through effective partnerships, driven by excellent leaders,
organisations are developing credible plans for the future of services. Thanks to
Mike Taylor, Suzanne Rankin and Linda Pollard for the invitations to spend time in
their systems. Thanks also to Ann Taylor, taking time out from her 15th anniversary
at Penrith hospitals, to show me around and talk through the issues she faces as a
clinical manager in services today. They each now need support from a set of ALBs
that will help deliver not cut across some excellent work.
This is writ large in our member survey which is a humdinger for the ALBs,
including CQC. The survey paints a picture of conflicting, duplicative and
burdensome arrangements that must change. Thanks to all of you who completed
the survey. Look out for news on this next week and rest assured we will be having
private conversations with ALB CEOs using the data to get extra leverage over their
impact on you. Judging from the conversations at our NW regional dinner on
Tuesday, it is long overdue.
NW leaders also debated the junior doctors situation and risks – and NHS
Employers have been cutting through the noise and providing as much factual
information as possible for junior doctors on the new contract. There is a
summary guide, factsheet and pay calculator to help explain what the new contract
offers. NHS Employers will also be running a series of roadshows to provide further
information and enable junior doctors to raise any questions they have. The Junior
Doctors Committee meet on Saturday to decide whether to ballot for further
industrial action. It is time for them to take positive action towards reconciliation.
Given their approach to date, I am not convinced that this will happen.
In other news, the GP Committee of the BMA and NHS Employers have
reached agreement on changes to the GP Contract. Effective, collective
2
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of Information
Request
93 2016
bargaining done
between committed
and professional
negotiators
out of the public
36 ofon50the NHS Employers website.
spotlight has worked well. DetailsPage
are available
We need to rebuild the social contract with doctors – and other staff – and Sue
Bailey’s work on this will help in time. In the meantime, a consistent approach to
contract implementation is helpful and multiple approaches to building momentum
on the NHS as a good employer are required. NHS Employers through #Thinkfuture
have launched a series of toolkits to support HR professionals, managers and
comms managers in helping to bring more young people into the NHS workforce.
Please do share these with your teams.
David Cameron is in Brussels today hammering out a deal, as are senior
colleagues from Confed members, NHS Blood and Transplant. In parallel
negotiations, they will meet with EU decision-makers to discuss EU legislation and
policy on blood, tissues, cells and organs. The visit aims to strategically position
NHS Blood and Transplant to pro-actively influence EU policy which has a direct
impact on their work.
Space prevents me from reflecting on other system issues like how the
independent sector have a role to play in helping to manage demand and reduce
waiting times. As David Hare wrote to Jeremy Hunt last week, covered in the FT on
Monday, less than one percent of the extra capacity offered by the independent
sector is being used.
Finally, it’s all change at the Confed. Firstly congratulations to Dr Graham
Jackson who has been appointed as the new co-chair of NHSCC. Secondly thank
you for all your kind messages of congratulations following my announcement that I
am leaving the Confederation to take up a new role at CEO at South West Yorkshire
Partnership FT. My start date is likely to be in May and there will be plenty of time for
us to catch up before then. There is always annual conference, the place for
networking with peers. Bookings for the event in Manchester in June have now
opened and I have already booked my place and hope to see many you there.
Have a good weekend
Rob
Rob Webster
Chief Executive
NHS Confederation
3
Page 37 of 50
From:
Sent:
To:
Subject:
03 February 2016 20:00
Collins Dawn M (NSFT); Howlett Leigh (NSFT); Hills Ryan (NSFT); Cave Julie (NSFT);
White Deborah (NSFT); Bakshi Kapil (NSFT); Johnson June (NSFT); Solomka Bohdan
(NSFT); Sayer Jane (NSFT); Ball Sarah (NSFT); Armstrong Alison (NSFT)
Fwd: Sir David Dalton’s letter to junior doctors
Game on
Sent from my iPhone
From: Daniel Mortimer <danielmortimer@nhsemployers.org>
Subject: Sir David Dalton’s letter to junior doctors
Dear colleague
I just wanted to let you know that Sir David Dalton has today written to all doctors in
training across England to provide them with a clear outline on the current position of
the negotiations and to highlight the ongoing areas of disagreement with the BMA.
A copy of this letter can be found on our junior doctors web page and it has also been
shared with your chief executives and medical directors. I would encourage you to
work with your medical directors to ensure all your junior doctors are aware of and
understand the details of this letter.
As ever, I will continue to keep you updated on progress.
Industrial action planning for 10 February
I also wanted to let you know that NHS England has confirmed that they will be issuing
two sit-reps during the course of the industrial action next week. These will be at 9am
with a return by 10:30am and second one at 8pm for a return by 9:30pm. If you have
any queries about these then please contact your local NHS England office.
Yesterday’s email provided you with useful contact details to support you during this
period of industrial action, but should you require any additional support and resources
do not hesitate to contact me danielmortimer@nhsemployers.org
Yours sincerely
Daniel Mortimer
1
Page 38 of 50
From:
Sent:
To:
Subject:
23 March 2016 08:55
Johnson June (NSFT)
RE: Face-to-face engagement events on the junior doctors’ contract
I should have guessed – thanks June ! Best Wishes Michael Chief Executive NSFT From: Johnson June (NSFT)
Sent: 23 March 2016 08:40
To: Scott Michael C (NSFT); Solomka Bohdan (NSFT)
Subject: RE: Face-to-face engagement events on the junior doctors’ contract
All in hand, I attended the face to face session and also doing all the webinars. Regards June Johnson
Medical staffing Manager Norfolk and Suffolk Foundation NHS Trust telephone: 01473 266379 email: june.johnson@nsft.nhs.uk Human Resources Department, Purple floor 2, Endeavour House, Russell Road, Ipswich IP1 2BX From: Scott Michael C (NSFT)
Sent: 23 March 2016 08:29
To: Johnson June (NSFT); Solomka Bohdan (NSFT)
Subject: FW: Face-to-face engagement events on the junior doctors’ contract
For action please Best Wishes Michael Chief Executive NSFT 1
From: Daniel Mortimer [mailto:danielmortimer@nhsemployers.org]
Page 39 of 50
Sent: 22 March 2016 17:15
Subject: Face-to-face engagement events on the junior doctors’ contract
Dear Colleague
Yesterday in Newcastle my colleagues and I completed the last of the five face-to-face engagement
events to discuss the junior doctors’ contract implementation.
Across all the events I had the opportunity to speak to close to 400 HR professionals and medical
workforce leaders. I would encourage you to continue to support these colleagues to ensure that
the finalised junior doctors’ contract is implemented from August 2016.
To assist you, please find below a link to the Powerpoint slide deck that was used during the course
of the day (this includes the slides from both the morning and afternoon session). This pack was
adapted during the course of the events to take on board feedback from Trusts and FTs, and may
be slightly different to the version that was shared with you at the event.
You will note from the slides that the details of the contract are being finalised, and I hope to be able
to share the final contract with you shortly.
Powerpoint slide pack
You will be able to download the Powerpoint slide deck here. The link will open a Wetransfer page
in your web browser, and a download arrow and button will appear, click download to retrieve the
slide pack.
Please note: This download is only available for the next seven days. If you need to access
this document after the seven days please email the relevant contact from our national
engagement service.
North
Jane Raven
Jane.Raven@nhsemployers.org
Midlands &
East
Amanda
Rose
Amanda.Rose@nhsemployers.org
London
Bernadette
El-Hadidy
Bernadette.ElHadidy@nhsemployers.org
South
Liz Gambrell
Liz.Gambrell@nhsemployers.org
Webinars
Although the face-to-face engagement events have now come to an end, we are continuing to host
webinars for HR and medical directors. The next webinar will take place on Thursday 24 March,
you can book your place now.
We will also be scheduling webinars for your medical staffing leads once the details of the contact
are shared with you.
If you have any comments, or there are any additional resources that would support you, please
email me at danielmortimer@nhsemployers.org
Yours sincerely
Daniel Mortimer
2
Chief Executive, NHSFreedom
Employers
Page 40 of 50
3
Page 41 of 50
From:
Sent:
To:
Cc:
Subject:
15 February 2016 13:20
Mckay Fraser (NSFT); Solomka Bohdan (NSFT)
Ball Sarah (NSFT); Mungham-Gray Lisa (NSFT); Armstrong Alison (NSFT)
RE: MEDIA ENQUIRY: Junior Doctors contract enquiry - draft statement
Looks good to me Best Wishes Michael Chief Executive NSFT From: Mckay Fraser (NSFT)
To: Solomka Bohdan (NSFT)
Cc: Ball Sarah (NSFT); Mungham-Gray Lisa (NSFT); Armstrong Alison (NSFT); Scott Michael C (NSFT)
Subject: RE: MEDIA ENQUIRY: Junior Doctors contract enquiry - draft statement
Importance: High
Hello, please find below suggested statement with regards to any change to the junior doctors’ contracts. Please feel free to amend or add anything – the deadline is today. Bohdan Solomka, Medical Director at Norfolk and Suffolk NHS Foundation Trust, said: “We would
consider very carefully, in close consultation with our junior doctors, any proposed changes to their existing
contracts.”
Thank you Fraser Fraser McKay | Communications Officer Norfolk and Suffolk NHS Foundation Trust Hellesdon Hospital | Drayton High Road | Norwich | Norfolk | NR6 5BE Tel: 01603 421484 | Switchboard: 01603 421421 | Mobile: 07771 877983 www.nsft.nhs.uk | @NSFTtweets | www.facebook.com/NSFTrust From: Scott Michael C (NSFT)
To: NSFT Communications; Solomka Bohdan (NSFT)
1
FreedomLisa
of(NSFT);
Information
Request
Cc: Ball Sarah (NSFT); Mungham-Gray
Armstrong Alison
(NSFT)
Subject: RE: MEDIA ENQUIRY: Junior Doctors Page
contract enquiry
42 of 50
93 2016
Given the deadline we might want to say we are still considering the position – un less anyone’s made a decision in my absence Best Wishes Michael Chief Executive NSFT From: NSFT Communications
Cc: Ball Sarah (NSFT); Mungham-Gray Lisa (NSFT); Scott Michael C (NSFT); Armstrong Alison (NSFT)
Subject: MEDIA ENQUIRY: Junior Doctors contract enquiry
Importance: High
Hello, could you please confirm whether our Trust would be implementing the new government‐suggested contract on junior doctors? The EDP would like a response explaining the reasons either way? Thank you Fraser Fraser McKay | Communications Officer Norfolk and Suffolk NHS Foundation Trust Hellesdon Hospital | Drayton High Road | Norwich | Norfolk | NR6 5BE Tel: 01603 421484 | Switchboard: 01603 421421 | Mobile: 07771 877983 www.nsft.nhs.uk | @NSFTtweets | www.facebook.com/NSFTrust From: Lodge, Will [mailto:Will.Lodge@archant.co.uk]
Subject: Junior Doctors contract enquiry
Hello,
Following on from an article in the national press at the weekend suggesting foundation trusts do not have to impose
the new contract on junior doctors – and that many would not, with concerns over losing and alienating staff, I would
like to ask if your trust plans to implement the new government-suggested contract on junior doctors.
Could I also please get a statement explaining the reasons either way?
I would need a response today, preferably by 2pm.
For reference: http://www.theguardian.com/society/2016/feb/12/hospitals-jeremy-hunt-junior-doctors-contract
Many thanks
2
Will
Page 43 of 50
Will Lodge
Essex Chief Reporter
East Anglian Daily Times
--M: 07785 616283
E: will.lodge@archant.co.uk
Twitter: @essexwill
www.eadt.co.uk
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3
Page 44 of 50
From:
Sent:
To:
Cc:
Subject:
15 February 2016 12:58
NSFT Communications; Solomka Bohdan (NSFT)
Ball Sarah (NSFT); Mungham-Gray Lisa (NSFT); Armstrong Alison (NSFT)
RE: MEDIA ENQUIRY: Junior Doctors contract enquiry
Given the deadline we might want to say we are still considering the position – un less anyone’s made a decision in my absence Best Wishes Michael Chief Executive NSFT From: NSFT Communications
Cc: Ball Sarah (NSFT); Mungham-Gray Lisa (NSFT); Scott Michael C (NSFT); Armstrong Alison (NSFT)
Subject: MEDIA ENQUIRY: Junior Doctors contract enquiry
Importance: High
Hello, could you please confirm whether our Trust would be implementing the new government‐suggested contract on junior doctors? The EDP would like a response explaining the reasons either way? Thank you Fraser Fraser McKay | Communications Officer Norfolk and Suffolk NHS Foundation Trust Hellesdon Hospital | Drayton High Road | Norwich | Norfolk | NR6 5BE Tel: 01603 421484 | Switchboard: 01603 421421 | Mobile: 07771 877983 www.nsft.nhs.uk | @NSFTtweets | www.facebook.com/NSFTrust From: Lodge, Will [mailto:Will.Lodge@archant.co.uk]
Subject: Junior Doctors contract enquiry
Hello,
Following on from an article in the national press at the weekend suggesting foundation trusts do not have to impose
the new contract on junior doctors – and that many would not, with concerns over losing and alienating staff, I would
like to ask if your trust plans to implement the new government-suggested contract on junior doctors.
1
Freedom
of Information
Could I also please get a statement
explaining
the reasons eitherRequest
way?
Page 45 of 50
93 2016
I would need a response today, preferably by 2pm.
For reference: http://www.theguardian.com/society/2016/feb/12/hospitals-jeremy-hunt-junior-doctors-contract
Many thanks
Will
Will Lodge
Essex Chief Reporter
East Anglian Daily Times
--M: 07785 616283
E: will.lodge@archant.co.uk
Twitter: @essexwill
www.eadt.co.uk
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2
Page 46 of 50
From:
Sent:
To:
Subject:
Attachments:
15 February 2016 17:06
Barlow Lesley (NSFT)
RE: MMM
MMM_15 02 16.doc
Thanks Lesley – have amended slightly so good to go please Best Wishes Michael Chief Executive NSFT From: Barlow Lesley (NSFT)
Subject: MMM
Hi Michael
Attached is the starter for 10 for your comment.
Lesley Barlow Deputy Head of Communications Norfolk and Suffolk NHS FT Hellesdon Hospital | Drayton High Road | Norwich | Norfolk | NR6 5BE Tel: 01603 421563 E: lesley.barlow@nsft.nhs.uk www.nsft.nhs.uk | @NSFTtweets | www.facebook.com 1
Page 47 of 50
15.02.16
Michael’s Monday Message
Today I announced that we have appointed Verita, a specialist agency, to lead an
independent review into unexpected deaths. The review will include examining how our
Trust investigates deaths and learns lessons.
The review will also examine how the numbers of unexpected deaths compare with national
rates, and will help to establish whether we are an outlier in terms of numbers or trends.
Most importantly, we can take any learning and implement it, if this prevents even one death
it will be worth while
You may remember that I announced that we would commission the review at the January
Board meeting and I can confirm that this work will begin later this month, with a clear and
detailed scope.
It has been agreed that for the review to be as thorough as possible, it will be held in two
parts with a report on phase one ready by the end of May, and the second phase ready in
the summer.
Any urgent concerns or emerging issues would, of course, be immediately fed back to the
Board and operational leads, and actions put in place immediately.
We don’t take this matter lightly and that is why we are looking into all of the facts. We want
people to be assured that we have commissioned this independent review to be as in-depth
as possible.
The safety of our service users is paramount. One single avoidable death is one too many –
which is why we have commissioned this investigation, to ensure we are fully confident that
our services are as safe as they can be.
Verita is a leading independent consultancy. Its work ranges from specialist support and
advice on challenging operational and strategic matters, to reviews and investigations of
complex, sensitive issues. The company will be supported by Colin Vose, an independent
clinical reviewer who has worked on suicide investigation, and who has a long career in the
NHS.
During the first phase of the review Verita will look at several key areas, including:
•
•
•
Comparing NSFT’s rates of unexpected deaths with national trends
Reviewing the Trust’s internal investigation process to examine if it sufficiently
rigorous for lessons to be learned, that there is consistency, sound challenge and
families and carers offered opportunity to contribute to the process of investigation
Identifying potential themes, priorities for action and effective systems for monitoring
and sharing learning
This will be followed by phase two, to also incorporate:
•
An appraising of NSFT’s suicide prevention strategy
Page 48 of 50
•
•
An examining of how NSFT has progressed with the national requirements for
mortality review
A review of Trust governance around investigating deaths set against guidance in the
new NHS Serious Incidents Framework
We look forward to receiving its report so that we can understand whether there are any
issues which we need to address to further improve the safety of our services for the benefit
of everyone in Norfolk and Suffolk. I believe that the data show that this is an area where
nationally there has been insufficient focus and that our work will become a national
exemplar of how to deal with this vital topic.
Junior doctors’ contract
If you had the chance to read the national papers at the weekend you may have seen that
one of broadsheets is suggesting that foundation trusts do not have to impose the new
contract on junior doctors proposed by the health secretary, Jeremy Hunt from August. We
will consider this very carefully and work in close consultation with our junior doctors on any
proposed changes to their existing contracts.
Putting People First Awards
The shortlisting for the Putting People First Awards is well underway in the lead up to the
staff vote and the judging panel taking place next week. The Shortlisting process will whittle
down over 150 entries to six to eight nominees in each of the categories and I understand
that this is proving to be a really difficult task as the standard is so high. I am really looking
forward to reading the entries as I’m sure you are too. Look out for more information about
how to cast your vote next week.
The Five Year Forward View for Mental Health
The Chief Executive of Mind and independent Chairman of the Mental Health Taskforce
launched its final report today – The Five Year Forward View for Mental Health.
It sets out what needs to happen to make sure people get access to the treatment and
support they need, when they need it. It makes recommendations for the NHS to achieve the
ambition of ‘parity of esteem’ between mental and physical health for children and young
people, adults and older people. This includes prevention, early intervention, access to crisis
care and better integration of mental and physical health care.
The report also includes an important set of recommendations to tackle inequalities at both a
local and a national level –and the need for more resources . The Board of our trust has
been campaigning for just these issues so it is good to see them being recognized in this
report
Page 49 of 50
From:
Sent:
To:
Subject:
04 February 2016 08:53
Ball Sarah (NSFT)
RE: Sir David Dalton’s letter to junior doctors
Agreed but at least they now have the high moral ground … Best Wishes Michael Chief Executive NSFT From: Ball Sarah (NSFT)
To: Scott Michael C (NSFT); Howlett Leigh (NSFT)
Subject: RE: Sir David Dalton’s letter to junior doctors
I think it’s a real shame that they’ve lost their nerve and conceded on making unsocial hours payments. There was a real opportunity here to lead the way for change that could then be followed for other medical staff and those on Agenda for Change if we want to change the culture to proper 7 day services. The ‘Guardian’ role is interesting….! From: Scott Michael C (NSFT)
To: Collins Dawn M (NSFT); Howlett Leigh (NSFT); Hills Ryan (NSFT); Cave Julie (NSFT); White Deborah (NSFT);
Bakshi Kapil (NSFT); Johnson June (NSFT); Solomka Bohdan (NSFT); Sayer Jane (NSFT); Ball Sarah (NSFT);
Armstrong Alison (NSFT)
Subject: Fwd: Sir David Dalton’s letter to junior doctors
Game on
Sent from my iPhone
From: Daniel Mortimer <danielmortimer@nhsemployers.org>
Subject: Sir David Dalton’s letter to junior doctors
Dear colleague
I just wanted to let you know that Sir David Dalton has today written to all doctors in
training across England to provide them with a clear outline on the current position of
the negotiations and to highlight the ongoing areas of disagreement with the BMA.
A copy of this letter can be found on our junior doctors web page and it has also been
shared with your chief executives and medical directors. I would encourage you to
work with your medical directors to ensure all your junior doctors are aware of and
understand the details of this letter.
As ever, I will continue to keep you updated on progress.
1
Industrial action planning for 10
February
Page
50 of 50
I also wanted to let you know that NHS England has confirmed that they will be issuing
two sit-reps during the course of the industrial action next week. These will be at 9am
with a return by 10:30am and second one at 8pm for a return by 9:30pm. If you have
any queries about these then please contact your local NHS England office.
Yesterday’s email provided you with useful contact details to support you during this
period of industrial action, but should you require any additional support and resources
do not hesitate to contact me danielmortimer@nhsemployers.org
Yours sincerely
Daniel Mortimer
2

foi request number 93 2016 - Norfolk and Suffolk NHS Foundation

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