Browse site A to Z

Search results

Go To Advanced Search

Press release: Leading doctor says kidney patients and families "let down" by poor mental health support and therapy

Description: A leading children's doctor has said patients across the UK with kidney disease and their families are being "let down" by
Url: /AboutTheTrust/Newsandpublications/Latestnews/2019/August/Press-release-Leading-doctor-says-kidney-patients-and-families-let-down-by-poor-mental-health-support-and-therapy.aspx

Mixed messages

Description: In August 2018 a judge decided that a colostomy should be performed on an incapacitated man, and in doing so overruled
Url: /HealthProfessionals/Clinical-law-updates/Mixed-messages.aspx

Candid over complications

Description: Auto Generated Title When something has gone wrong during clinical management, it is now commonplace to expect that the patient or th
Url: /HealthProfessionals/Clinical-law-updates/Candid-over-complications.aspx

University Hospital Southampton NHS Foundation Trust Constitution

Description: Read our constitution here.
Url: /Media/UHS-website-2019/Docs/About-the-Trust/Trust-governance-and-corporate-docs/University-Hospital-Southampton-NHS-Foundation-Trust-Constitution.pdf

Papers Council of Governors 20 July 2022

Description: Agenda attachments 1 CoG Agenda - 20.07.2022.docx Date Time Location Chair Agenda Council of Governors 20/07/2022 14
Url: /Media/UHS-website-2019/Docs/About-the-Trust/Trust-governance-and-corporate-docs/2022-Trust-documents/Papers-Council-of-Governors-20-July-2022.pdf

Engaging for increased research participation - full report

Description: Engaging for increased research participation Public and healthcare professionals' perceptions For further information contact: Chris Stock Head of R&D communications and strategy University Hospital Southampton NHS Foundation Trust T: 07795506319 / E: christopher.stock@uhs.nhs.uk Ben Hickman Research director Alterline Research T: 01616050862 / E: ben.hickman@alterline.co.uk This report presents independent research funded in part by the National Institute for Health Research (NIHR) Clinical Research Network: Wessex. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Contents 1. Executive summary 1.1. Headline findings and recommendations 1.1.1.People are positive about research and participation 1.1.2. The critical conversations are not happening 1.1.3 Healthcare professionals perceive major barriers to involvement 1.1.4 The public need information, of immediate relevance to their health 1.1.5 Time and fitting participation into life is a concern 2. Introduction and Methodology 2.1. Introduction 2.2. Key objectives 2.3. This report 2.4. Method 3. Review of the literature 3.1. General background 3.2. Why do people take part in clinical research? 3.3. What stops people from taking part in clinical research? 3.4. Why do people take part, or not take part, in related activities? 3.5. Summary 4. Likelihood to participate in clinical research 4.1. The public view clinical research as important 4.1.1. Demographic Differences 4.2. Few people have been asked to take part in clinical research 4.3. Likelihood to participate 4.3.1. Demographic differences 4.4. Likelihood to participate in various types of research 5. Motivations for taking part 5.1. Why do other people take part in clinical research? 5.2. What would motivate you to take part? 5.2.1. Demographic differences 5.3. Exploring motivations in more depth 6. Barriers to taking part 6.1. Why don't other people take part? 6.2. What stops you from taking part? 6.2.1. Demographic differences 6.3. Exploring barriers in more depth 6.4. What do people mean by the `risks' involved? 6.5. How are people forming opinions about risk? 6.6. What might reassure people? 7. The experience of taking part in clinical research 7.1.What motivated people to take part? 7.2. Would people recommend the experience? 7.3. Why would people recommend the experience? 7.4. Why would people not recommend the experience? 7.5. Knowing someone who has taken part 7.6. Why would people be more likely to take part, knowing someone who has? 7.7. Why would people be less likely to take part, having known someone who has? 4 4 4 4 4 4 5 6 6 6 7 7 8 8 9 9 10 11 12 12 12 14 15 15 16 18 18 18 19 19 22 22 22 24 24 26 27 28 29 29 29 29 31 31 31 32 Engaging for increased research participation ? key findings and recommendations 2 8. Knowledge and information 8.1. Level of understanding of clinical research 8.1.1. Demographic differences 8.2. Seeking information 8.3. What information would you need? 8.4. Media coverage 9. Healthcare professionals' perceptions of clinical research 9.1. What do healthcare professionals think of clinical research? 9.2. Who do they think are getting involved in research? 10. Motivations for getting involved in clinical research 10.1. What motivates healthcare professionals to get involved? 11. Barriers to getting involved in clinical research 11.1. What stops healthcare professionals from getting involved? 12. Research opportunities 12.1. Approaching healthcare professionals 12.2. Why are healthcare professionals approaching patients? 12.3. Why are healthcare professionals not approaching patients? 13. Availability of information 13.1. Awareness of clinical research 13.2. Finding information about clinical research 14. The future 14.1.What would make you more likely to get involved in research in the future? 14.2.What would make you more likely to get speak to patients the future? 15. Conclusions and recommendations 15.1. People are positive about research and participation 15.2. The critical conversations are not happening 15.2.1. Recommendation 1 15.3. Healthcare professionals perceive major barriers to involvement 15.3.1. Recommendation 2 15.4. The public need information, of immediate relevance to their health 15.4.1. Recommendation 3 15.5.Time and fitting participation into life is a concern 15.5.1. Recommendation 4 Appendix 1 ? Public survey demographics 33 33 33 34 34 35 37 37 38 39 39 41 41 43 43 44 44 45 45 46 47 47 48 49 49 49 49 49 49 50 50 50 51 52 Engaging for increased research participation ? key findings and recommendations 3 1. Executive summary See section 15 for summary findings and specific recommendations for increasing clinical research participation. 1.1.1 People are positive about research and participation The Wessex population views research in the NHS positively and a large proportion are open to participating: 90% of respondents think that it is important for the NHS to support research into new treatments, whilst 47% think it likely they would be willing to participate in clinical trials in the future. Those that have participated have positive perceptions, and they will likely have a significant influence on others' future participation: 80% of people who have taken part in clinical research would recommend taking part to a friend or family member, whilst around half (44%) of people who know someone who has taken part in clinical research said that they are more likely to participate now because of their experience. 1.1.2 The critical conversations are not happening Only 15% have had clinical research discussed with them by a healthcare professional in their lifetime, whilst only 5% of those who have seen healthcare professional in the last 12 months had clinical research discussed with them. Recommendation 1: Communications supporting participation in interventional trials should be focussed on enabling effective clinical conversations, with a reduced emphasis on broad public awareness approaches. 1.1.3 Healthcare professionals perceive major barriers to involvement The healthcare professionals interviewed were broadly positive about research; however they cite workload, time and lack of local trial information as constraints on discussion of research with patients. Better trial information was also identified as something that would increase the likelihood of discussing trial options with patients. Clinicians self-segregate themselves into `researchers' (an academically orientated minority) and `practitioners', with the latter positive about the benefits of clinical research and open to research referrals/facilitation but unlikely to have direct involvement in, or lead their own, research. Direct involvement in research by clinicians is limited by lack of programmed/sanctioned time within work plans, perceptions of excessive bureaucracy and lack of support. Recommendation 2: Local Clinical Research Networks, local research infrastructure and Trusts' senior leadership should support NHS clinicians' engagement with local clinical trials, and to explore management and education interventions to make communication with patients about trials a routine part of all NHS consultations. 1.1.4 The public need information, of immediate relevance to their health Public participation motivations centred on potential benefits to one's own health or that of close friends and family, whilst perceived risk of harm and receiving the `unknown' alongside concerns over time commitments and time off work were the biggest barriers to participation. Only 9% of respondents reported that they felt they understood clinical research very well, with this group the least likely to agree that risk was a significant barrier to participation. Generic online searches, condition-specific online sources of information and healthcare professionals were the primary sources of information, with a high degree of trust in the information provided by professionals. Recommendation 3: Public communications and engagement should have a greater emphasis on informing and empowering people at the point of care or enquiry, to enable discussion of trials with clinicians. Engaging for increased research participation ? key findings and recommendations 4 1.1.5 Time and fitting participation into life is a concern Concerns over time commitments needed to participate in studies, including taking time out of work and fitting such activity into daily/family life were significant barriers to participation. Recommendation 4: Changes to clinical research delivery to improve convenience and flexibility for participants, alongside interventions that lower the practical threshold to participation should be investigated and evaluated. Engaging for increased research participation ? key findings and recommendations 5 2. Introduction and Methodology 2.1 Introduction The partnership between University Hospital Southampton NHS Foundation Trust (UHS) and the University of Southampton enables clinical-academics to perform clinical research through quality assured support, facilities and resources embedded at the heart of a major teaching hospital trust. This partnership hosts, and participates in the National Institute for Health Research Clinical Research Network Wessex (NIHR CRN:Wessex), one of 15 regional CRNs that coordinate and support clinical trial activity across the UK on behalf of the NIHR. Participation in clinical research by the public, patients and clinicians is essential to advancing medicine and care, and access to such trials is a right conferred to patients under the NHS constitution1. Because of this, recruitment to trials is the primary measure by which NIHR manages performance of CRNs and their member organisations. Rapid, complete recruitment to open trials remains challenging for Trusts and CRNs nationwide, indicating a significant issue relating to public and patient engagement with trial treatment options and research participation. Against this background UHS, with match-funding from NIHR CRN:Wessex, commissioned Alterline Research Ltd. to conduct a programme of market research to better understand the perceptions, motivations and barriers to participation in clinical research across the region. This research is intended to inform more effective communication and engagement aimed at increasing participation, primarily focussed on interventional clinical research. 2.2 Key objectives The research was conducted with three audiences: ? The public (18 years and older across all demographics and geographies) ? Primary care professionals including GPs and community nurses across the region. ? Hospital clinical staff including consultants, nurses, midwives and allied health professionals across the region's trusts. The research outputs are intended to provide an evidence base to help: ? ? ? ? Shape and inform effective engagement strategies with these audiences Build an evaluation framework against which engagement can be assessed and developed for greater efficacy Ensure coherence and commonality in engagement approaches and messages across Wessex Provide a reference point and baseline data for long-term tracking and evaluation. 2.3 This report This report details findings of the research with the public and healthcare professionals, exploring their attitudes towards clinical research, their likelihood to participate and the drivers and barriers to increasing participation and recommending actions for increasing research participation. > > > 1 NHS Constitution, 2013 http://www.nhs.uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Documents/2013/the-nhs-constitution-forengland-2013.pdf Engaging for increased research participation ? key findings and recommendations 6 2.4 Method Review of literature and pilot A review of the existing literature was conducted to help inform the design of research materials including the quantitative and qualitative questionnaires. Quantitative questionnaire development A questionnaire comprising predominantly closed questions and a small number of open-ends was developed in partnership with the Trust. Quantitative public survey by telephone In total 1101 interviews were completed by telephone using specialist computer assisted telephone interviewing (CATI) software and an automated dialler system. The interview sample for the telephone survey was sourced from a specialist data provider using relevant postcodes. In order to ensure a representative survey sample of the Wessex population interview completions were monitored by key demographics such as gender, age and location. See appendix one for details of the demographic sample. Public depth survey Following the quantitative survey, key emerging themes were used develop a qualitative, in-depth survey which was administered by telephone. In total, 30 people took part in in-depth interviews including a mix of men and women, different ages and geographies. Clinician depth survey To explore perceptions, motivations and barriers of clinicians, an in-depth survey was designed and administered by telephone. In total, 25 healthcare professionals took part in the survey, including 6 GPs, 10 nurses, and 9 hospital consultants. Analysis The quantitative survey data was exported to SPSS (Statistical Packages for Social Sciences) where it was quality checked. Frequencies and cross-tabulations exploring differences between respondents were produced and key questions were charted and included in this report. Demographic differences have been included in this report following the application of tests of statistical significance. Open-ended data was themed, with key verbatim quotes pulled out and included in the report. The in-depth interviews were audio recorded and transcriptions were made. Key themes were identified from the focus group transcripts and representative verbatim quotes have been pulled out and included in the report. Engaging for increased research participation ? key findings and recommendations 7 3. Review of the literature 3.1 General background Clinical research is central to advancing medicine, developing and evaluating medications, treatments, and practices. The purpose of this review is to examine perceptions of clinical research, willingness to participate and motivations and barriers to taking part. As the research in the area is limited, it will also look at motivations and barriers to taking part in related, voluntary activities (i.e. giving blood and organ donation) in order to identify any commonalities. Generally, reports in the literature show support for clinical research to be high. The Wellcome Trust notes that 95% of adults and 93% of 13-18 year olds think that medical research should be supported2. Further 88% of those surveyed by the National Institutes of Health3 in the USA think that clinical trials are important for advancing knowledge about treating disease. A 2011 UK national survey of 990 adults by IPSOS-MORI, commissioned by the Association of Medical Research Charities, reported similarly strong public support for research with 97% believing the NHS should support research into new treatments, whilst 93% wanted their local NHS to be encouraged or required to support research. These figures are corroborated by a 2014 national survey of 3,000 adults commissioned by the National Institute for Health research, indicating that 95% of people said it was important to them that the NHS carries out clinical research4.5. Reported willingness to participate in research is also strong. In a monitor of people's views on science and research, 60% said they would be willing to take part in clinical trials6. 72% of those polled in the 2011 AMRC survey would want to be offered opportunities to be involved in trials of new medicines or treatments if they suffered from a health condition that affects their day-to-day life; 80% would consider allowing a researcher confidential access to their medical records, and 88% would be happy to be asked to talk to researchers about their family history or give a sample of their blood for laboratory testing. 89% of people surveyed in the 2014 NIHR national survey would be willing to take part in clinical research if they were diagnosed with a medical condition or disease, with only 3% saying they would not consider it at all5. Comis et al7 report that, in relation to cancer trials, 32% of adults would be willing to take part and 38% would potentially be interested, but would hold some reservations. Further, willingness to participate is not static and much depends on the nature of the trial. For example, 74% of people would be willing to allow access to their medical records, whereas only 30% would be willing to test a new drug2. These figures showing positive perception and willingness to participate are however in stark contrast to reported and actual participation rates. In two monitors by the Wellcome Trust, lifetime participation varied from 10%6 to 23%2, whilst a further 10% of people have a family member who has taken part6. These findings support National Institute for Health Research official figures indicating that annual recruitment to clinical trials in the English NHS stands at 0.94% of the English population (2013-14 figures)8, with CRN Wessex reporting recruitment of 1.15% of the regional population in the same period9. > > > Butt, S., Clery, E., Abeywardana, V., Phillips, M. (National Centre for Social Research). Wellcome Trust Monitor 1. London: Wellcome Trust; 2010 National Institutes of Health, National Cancer Institute. (1997). Results from Quarterly Omnibus Survey: Clinical Trials Questions-April 22, 1997. Bethesda: National Cancer Institute. 4 IPSOS-MORI / Association of Medical research Cahrities J11-02572 Public support for research in the NHS, http://www.ipsos-mori.com/ researchpublications/researcharchive/2811/Public-support-for-research-in-the-NHS.aspx 5 National Institute for Health Research, 2014, http://www.crn.nihr.ac.uk/blog/news/nine-out-of-ten-people-would-be-willing-to-take-part-inclinical-research/ 6 Clemence, M., Gilby, N., Shah, J., Swiecicka, J., Warren, D. (2013). Wellcome Trust Monitor Wave 2: Tracking public views on science, biomedical research and science education. London: Wellcome Trust. 7 Comis, R.L., Miller, J.D., Aldige, C.R., Krebs, L. and Stoval, E. (2003). Attitudes toward participation in cancer clinical trials. Journal of Clinical Oncology. 21: 830-835. 2 3 Engaging for increased research participation ? key findings and recommendations 8 3.2 Why do people take part in clinical research? By far, the most reported reason for taking part in clinical research in the literature was a sense of altruism and helping others. Mattson et al10, found that 65% of participants took part for altruistic reasons. Rosenbaum et al11 noted that 46% of people who participated in clinical research reported altruism as the reasons for doing so. Of those people, just under half (45%) provided an altruistic reason as their only motivation. Those who gave altruistic reasons were more likely to have higher levels of social support, have a college education, and were less likely to say they had a disability. Specifically in cancer trials, altruism is often reported as a reason for taking part12. Jenkins et al13 report that 23% of those who consented to take part in clinical research did so because others would benefit from their participation. Many people also said that they took part because of healthcare professionals. Some report that this was because of a recommendation from their doctor3 and others report that it was through the doctor's influence that they decided to take part14. Jenkins et al13 looked solely at people who had decided to take part after being asked by their doctor. Of those who were asked, 72% decided to take part, of which 21% said it was because they trust their doctor. Further, it is apparent that some people also take part in clinical research because of the benefit that it will have to them. Such motivations include a hoping that there will be a therapeutic benefit or because there is no other treatment available12. Further, in Mattson et al10 74% of participants for aspirin and beta-blocker trials said they were motivated by non-altruistic motivations. These motivations included better medical monitoring and reassurance, physical improvement and preventions of further illness. 3.3 What stops people from taking part in clinical research? A concern about side effects and risks present a significant barrier to participation in the literature. Looking into cancer trials, a fear of making the cancer worse presented a significant barrier when being asked to participate15. Further, when testing a new drug, 93% of those with concerns in the Wellcome Trust study said they were worried about the possible risk to their own health from participating2. As with many factors, concerns about the side effects and risks of a trial are not stable across all groups. Basche et al16 spoke to seniors who were asked to participate in cancer trials. They found that those ages 65?75 were more likely to participate in the trial when the side effects were likely, than those aged over 75. Further, many studies report that issues related to the time commitment of clinical research and logistical difficulties also present a significant constraint on participation. A quarter of people asked about their attitudes to participation in clinical research said that they did not have the time to participate17. Further, a third of people in Basche et al16 said that they were concerned about the time commitment and other issues, such as getting to the trial facility. Many other barriers have been reported in the literature. These include: a dislike of randomisation13 and the potential to be in a placebo group; lack of knowledge of both the processes involved in clinical research19 and the trials that are available18, and a lack of trust in medical research19. > > > NIHR Clinical Research Network Annual Report 2013/14 http://www.crn.nihr.ac.uk/wp-content/uploads/About%20the%20CRN/13_14%20Annual%20Performance%20Report_PUBLIC_FV.pdf 9 CRN Wessex Performance Report May2014, www.odp.nihr.ac.uk/default.htm 10 Mattson, M.E., Curb, J.D., and McArdle, R. (1985). Participation in a clinical trial: The patients' point of view. Controlled Clinical Trials. 6: 156-167 11 Rosenbaum, J.R., Wells, C.K., Viscoli, C.M., Brass, L.M., Kernan, W.N., and Horwitz, R.I. (2005). Altruism as a reason for participation in clinical trials was independently associated with adherence. Journal of Clinical Epidemiology. 58: 1109-1114. 12 National Institutes of Health, National Cancer Institute, Working Group on Enhancing Recruitment to Early Phase Cancer Clinical Trials. (2004). Enhancing Recruitment to Early Phase Cancer Clinical Trials: Literature Review. Bethesda: National Cancer Institute. 13 Jenkins, V. and Fallowfield, L. (2000). Reasons for accepting or declining to participate in randomised clinical trials for cancer therapy. British Journal of Cancer. 82(11): 1783-1788. 14 Chu, S.H., Jeong, S.H., Kim, E.J., Park, M.S., Park, K., Nam, M., Shim, J.Y., and Yoon, Y. (2012). The views of patients and healthy volunteers on participation in clinical trials: An exploratory survey study. Contemporary Clinical Trial. 33: 611-619 15 Solomon, M.J., Pager, C.K., Young, J.M., Roberts, R., and Butow, P. (2003). Patient entry into randomized controlled trials of colorectal cancer treatment: Factors influencing participation. Surgery. 133(6): 608-613. 16 Basche, M., Baron, A.E., Eckhardt, S.G., Balducci, L., Persky, M., Levin, A., Jackson, N., Zeng, C., Brna, P., and Steiner, J.F. (2008). Barriers to enrollement of elderly adults in early-phase cancer clinical trials. American Society of Clinical Oncology. 4(4): 162-168 8 Engaging for increased research participation ? key findings and recommendations 9 Although little literature looks into healthcare professionals' motivations regarding clinical research, several have looked at the barriers to getting involved. The research suggests that concerns for patients represent significant barriers to participation. In in-depth interviews with clinicians in South-west England, clinicians suggested that concerns for individual patients and respect for patients' preferences for different treatments prevented them from approaching patients and getting involved20. Further, concern for patients and a worry about the impact on the doctor-patient relationship was shown to be a significant barrier in Ross et al's meta-analysis21. 3.4 Why do people take part, or not take part, in related activities? Many reasons, both similar and dissimilar to those expressed above, are noted in the literature that motivate blood and organ donation. Coad et al22 found that those who knew someone who had donated or received an organ were more likely to agree with donating an organ to a family member or friend. Further, Wildman and Hollingsworth23 note that those who have donated blood before are more likely to donate again. Further, Cohen and Hoffner24 note that self-interest explains motivations to become an organ donor. 40% said they would be willing to sign a blood donor card. Self-interest motivations were the most important predictor of willingness to sign the card, including pride and satisfaction with the decision, otherwise known as the `warm glow' feeling. A questionnaire of university students in Japan showed that being in good health, having time to donate, being given opportunity to donate and helping others were the most important motivations for those who both had given blood before and those who had not25. The same study also looked at barriers to taking part. These were very much the opposite of the motivators, and included having time to donate, not knowing when and where to donate and not being given the opportunity to donate were considered barriers to taking part25. Lack of knowing where to go and it not being in a convenient place was corroborated by a further study of American adults, as well as a fear of needles and pain26. 3.5 Summary In summary, although many people believe that clinical research is important and are willing to take part, this is not reflected in rates of participation. Reasons why people take part in clinical research include altruism, the influence of a healthcare professional and a benefit to themselves. Major barriers to participation include the risk to themselves and time commitments. Clinician barriers generally revolve around a concern for their patients. Significantly different motivators and barriers to taking part in related activities include knowing someone who has taken part, taking part before and knowing what opportunities were available. > > > Bevan, E.G., Chee, L.C., McGhee, S.M. and McInnes, G.T. (1993). Patients' attitudes to participation in clinical trails. British Journal of Clinical Pharmacology. 35(2): 204-207 18 Mills, E.J., Seely, D., Rachlis, B., Griffith, L., Wu, P., Wilson, K., Ellis, P., and Wright, J.R. (2006). Barriers to participation in clinical trials of cancer: a meta-analysis and systematic review of patient-reported factors. Lancet Oncol. 7: 141-148 19 Lovato, L.C. and Kristin, H. (1997). Recruitment for controlled clinical trials: Literature summary and annotate bibliography. Controlled Clinical Trials. 18: 328-357 20 Langley, C., Gray, S., Selley, S., Bowie, C., and Price, C. (2000). Clinicians' attitudes to recruitment to randomised trials in cancer care: A qualitative study. Journal of Health Services Research and Policy. 5(3): 164-169 21 Ross, S., Grant, A., Counsell, C., Gillespie, W., Russell, I., and Prescott, R. (1999). Barriers to participation in randomised controlled trials: A systematic review. J Clin Epidemiol. 52(12): 1143-1156 22 Coad, L., Carter, N., and Ling, J. (2013). Attitudes of young adults from the UK towards organ donation and transplantation. Transplantation Research. 2: 9-14 23 Wildman, J., and Hollingsworth, B. (2009). Blood donation and the nature of altruism. Journal of Health Economics. 28: 492-503 24 Cohen, E.L. and Hoffner, C. (2012). Gifts of giving: The role of empathy and perceived benefits to others and self in young adults' decisions to become organ donors. Journal of Health Psychology. 18(1): 128-138 25 Ngoma, A.M., Goto, A., Yamazaki, S., Machida, M., Kanno, T., Nollet, K.E., Ohto, H. and Yasumura, S. (2013) Barriers and motivators to blood donation among university students in Japan: Development of a measurement tool. Vox Sanguinis 105(3): 219-224 26 Adelbert, J.B., Schreiber, G.B., Hillyer, C.D., and Shaz, B.H. (2013). Blood donations motivators and barriers: A descriptive study of African American and white voters. Transfusion and Aphresis Science. 48(1): 87-93 17 Engaging for increased research participation ? key findings and recommendations 10 4. Likelihood to participate in clinical research 4.1 The public view clinical research as important To provide a background to people's perceptions of clinical research, we asked respondents to tell us how important they thought it was for the NHS to support research into new treatments. As figure 1 below shows, the overwhelming majority of people (90%) think that it is either important or very important. However, of those who responded to the survey, only 10% have actually taken part in clinical research. There is a clear gap between how important the area is seen to be, and how many people are taking part. Figure 1 g1 How important do you think it is, if at all, for the NHS to support research into new treatments for patients? Base: 1101 3% 6% 13% 77% Very unimportant g3 unimportant Neither important nor unimportant Important Very important 4.1.1 Demographic Differences Age Belief that supporting research is important is lowest in 18-24 year olds (73%). As people get older, they are more likely to believe that it is important, peaking at 96% for 75-84 year olds. Gender Females (95%) a more likely to say supporting research is important than males (85%). Educational attainment Those who have qualifications other than a degree are the most likely to view research as important (97%). Those who have no educational qualifications are least likely (80%). Employment status Students (90%), retired people (83%) and those who are employed (76%) are more likely to see clinical research as important, compared to those who are self-employed (69%), home-makers (67%), or gout of work and not looking for work (55%). 7 Dependents Those with dependents (96%) are more likely to view clinical research as important than those without dependents (90%). Health Those with good (80%) or very good health (80%) are more likely than those with fair (70%) or very bad (54%) to view research as very important. Previous participation Those who have participated in clinical research (99%) are more likely to say supporting research is important than those who have not (89%). g8 Knowing someone who has taken part Those who know someone who has taken part in clinical research (97%) are more likely to see supporting research as important, compared to those who don't (89%). > > > Engaging for increased research participation ? key findings and recommendations 11 g7 g7 4.2 Few people have been asked to take part in clinical research g8 g8 Importantly, of those surveyed, only 15% recalled a time when a healthcare professional had discussed involvement in clinical research with them. Further, of the 43% who had seen a healthcare professional in the last month, only 5% had clinical research discussed with them (Figure 2, below). Figure 2 Did the healthcare professional you saw discuss involvement in clinical research with you? Base: 367 5% Do you recall a time at any point in your life when a healthcare professional has discussed clinical research with you? 15% Base: 799 Yes No 95% Yes No 85% Increasing the number of conversations taking place between clinicians and their patients about clinical research is likely to increase the number of people who take part. In the in-depth interviews, people often said they reason they had not taken part before was because no-one had ever asked. "I just haven't been asked." "No-one's ever asked me." Further, previous research has shown that trust in healthcare professionals is high, with 72% of adults saying that they trust a medical professional to provide them with information about clinical research27. This was also seen in the in-depth interviews, where many respondents expressed a great deal of trust for their doctor. "So if they said `blardy blardy blah', would you take part? Then I probably would have done, because we gained that much trust." g1 "Yes I would trust them if they talked about clinical research because the consultant I've been under for four years now, my GP I've known for over 20 years now so they're people that I've known long enough to trust." 4.3 Likelihood to participate Although only 10% of people have taken part in clinical research, the results would show appetite for participation is higher than this. When respondents were asked if they would consider taking part in clinical research, just under half (47%) agreed that they would be likely or very likely to (Figure 3, below). Figure 3 How likely is it that you would be willing to participate in clinical research in the future? g3 Base: 1101 15% 16% 22% 31% 16% Very unlikely 27 unlikely Neither likely nor unlikely likely Very likely Butt, S., Clery, E., Abeywardana, V., Phillips, M. (National Centre for Social Research). Wellcome Trust Monitor 1. London: Wellcome Trust; 2010 g7 > > > 12 Engaging for increased research participation ? key findings and recommendations 4.3.1 Demographic differences The demographic differences below explore whether some people are more likely than others to participate. Characteristics of people who are more likely to participate include: ? ? ? ? ? ? ? ? ? Having previously participated (64%) or knowing someone who has (63%) Having a good understanding of clinical research (63%) Students (58%) and those unable to work (63%) Having a degree or equivalent level of education (58%) Registered organ donors (58%) People in very good health (57%) People who do regular volunteer work (55%) People who have given blood (54%) People aged 35-64 (52%). Age People aged 35-64 (52%) are most likely to agree that they would be willing to take part in clinical research, this decreases amongst 25-34s (48%), 16-24s (46%), 65-74s (49%) and in particular 75-84s (32%) and 85+ (12%). Understanding of clinical research Those who have a very good understanding of clinical research (63%) are the most likely to say they would take part in clinical research, followed by those that have some (54%), little (40%) or none (39%). Previous participation Those who have participated before (68%) are more likely to say they would be willing to take part than those who have not (45%). Knowing someone who has taken part People who know someone who has participated in clinical research (63%) are more likely to say that they are willing to take part than those who don't (44%). Educational attainment Those with a degree or a degree equivalent (58%) and those who have other qualifications (52%) are more likely than those with no qualifications (35%) to say they would take part. Employment status Students (66%), those who are unable to work (62%), and those who are employed for wages (52%) are more likely to say they are willing to take part than those who are those who are retired (37%) and out of work and looking (26%). Volunteers Those who give help as a volunteer to clubs or organisations weekly (55%), monthly (53%) or occasionally (54%) are more likely to say they are willing take part than those have volunteered in the last year (46%) and those who give unpaid help on an individual basis (36%). Giving blood People who have previously given blood (54%) are more likely to say they would participate than those who have not given blood (45%). Organ donors Those who are registered as organ donors (58%) are more likely to say they would participate than those who are not (42%). Health Those who have very good (57%), good (49%) and bad health (47%) are more likely to say they are would take part than those who have very fair (35%) or bad health (32%). > > > Engaging for increased research participation ? key findings and recommendations 13 4.4 Likelihood to participate in various types of research To expand on people's likelihood to take part, we asked people about different scenarios they would be willing to take part in. As shown in Figure 4 (below), the scenarios that might improve their own health or care are those in which people were most willing to participate . Likelihood to participate extends to 61% in the scenario where it may help prolong a respondents' own life, or where it is looking at new forms of care and exercise to regain movement after a knee injury. In contrast, the scenarios which people were least willing to take part reflected those which were at earlier stages of the research process. This may be because research into new medications or treatments is seen as riskier. Figure 4 How likely is it you would be willing to take part in clinical research if...? Base: 1101 The study might help prolong or improve your life because you have a condition, significant illness or injury The study is looking at a new form of care and exercises to regain movement after knee injury The study is observing how your condition, illness or injury develops or responds to current treatments, over time The study is looking at how the way care is given affects you and your health (e.g. care at home versus staying in hospital) The study is looking at a new medical device 9% 6% 9% 9% 9% 10% 8% 11% 12% 11% 11% 9% 9% 11% 12% 15% 17% 18% 24% 19% 22% 23% 21% 23% 24% 22% 22% 40% 42% 43% 44% 44% 39% 39% 40% 39% 21% 19% 17% 15% 14% 17% 12% 9% 10% The study is looking at a treatment at a very advanced stage of development The study is looking for healthy volunteers The study is looking at a new vaccination The study is looking at a new drug The study is looking at a treatment in the very early stages of development 11% 19% 25% 35% 10% Very unlikely Unlikely Neither likely nor unlikely Likely Very likely Engaging for increased research participation ? key findings and recommendations 14 5. Motivations for taking part 5.1 Why do other people take part in clinical research? In order to understand what motivates people to take part in clinical research, we asked respondents to tell us what they thought motivated other people to take part. The most commonly cited reasons were: ? Helping others/altruism ? A positive impact on their own health ? A personal interest in a particular disease/condition. 5.2 What would motivate you to take part? To look into motivations further, we asked people what would motivate them (rather than others) to take part in clinical research. When people are speaking about their own motivations, they tend to agree more with statements which are related to personal motivations, i.e. helping to improve their own, or a close relative's, health. However, altruistic motivations are still important, with 72% agreeing that they would be motivated by helping others. Respondents also indicated that other things would motivate them, beyond those factors seen earlier. Knowing that aftercare would be available (67%) and an interest in a particular disease (67%) are both seen as important to respondents. Just 32% of respondents said that money would motivate them to take part. Figure 5 To what extent do you agree or disagree that the following would motivate you to take part in a clinical trial? Base: 1101 g5 Supporting research into a condition a close family member suffers from A positive impact on my own health Getting access to the latest treatments for a condition I have Helping others by helping to find new treatments Knowing that there would be continued aftercare and follow-up A personal interest in a particular disease / condition I would find the process of being involved interesting Money / financial gain 6% 5% 12% 6% 5% 6% 5% 6% 7% 7% 6% 7% 8% 8% 10% 13% 15% 15% 19% 17% 22% 36% 42% 48% 44% 51% 45% 44% 47% 15% 35% 28% 30% 21% 22% 23% 14% 25% 7% 17% Strongly disagree Disagree g6 Neither agree nor disagree Agree Strongly agree > > > Engaging for increased research participation ? key findings and recommendations 15 5.2.1 Demographic differences Understanding of clinical research Those who have no understanding of clinical research (58%) are the least likely to agree that they would be motivated by getting the latest access to treatment for a condition they have. Age 35-44 year olds (76%) are more likely to agree that they would be motivated by helping others by finding new treatments than 16-24 (70%) and 25-34 (64%) year olds. 34-44 (86%), 44-54 (85%) and 55-64 (84%) years olds are more likely to agree that they would be motivated by a positive impact on their own health than 16-24 (64%), 25-34 (70%) and 75-84 (64%) year olds. 35-44 (77%), 45-54 (80%) and 55-64 (78%) year olds are more likely to agree that they would be motivated by getting access to the latest treatment for a condition they have than 16-24 (64%), 25-34 (67%), 75-84 (70%) and 85+ (53%) year olds. Gender Women (80%) are more likely than men (75%) to agree that supporting research into a condition a close family member suffers from would motivate them to take part. Educational attainment Those with a degree of degree equivalent and those with other qualifications are more likely than those who have no qualifications to say they are motivated by helping others by helping to find new treatments, a positive impact on their own health, getting access to the latest treatment for a condition they have and supporting research into a condition a close family member suffers from. Employment status Students (90%) are more likely to agree that they are motivated by helping others by helping to find new treatments than those who are employed (76%), self-employed (70%), retired (66%) and out of work and looking (50%). Employed persons (77%) are more likely to be motived by getting access to the latest treatment for a condition they have than those who are retired (71%). Students (96%) are more likely than any other group to strongly agree that they are motivated by supporting research into a condition a close family member suffers from. 5.3 Exploring motivations in more depth When exploring what would motivate people to take part some clear themes emerged from both the open survey questions and the in-depth interviews,. The key motivations are summarised below. It would have a positive impact on my own health Many felt that they would be motivated to participate because it may have a positive impact on their own health. "I've got a few health problems so I would like to take part to see if there any treatments or information in regards to arthritis that would help me" "I have arthritis - anything new to improve life or find a cure." "Finding a drug that helps me." "If anybody could help me with my lifestyle and my health, I'm in a lot of pain, I'm overweight, so that would help." Although some people who responded did not currently suffer from a condition, they suggested they would be motivated to take part if they did and it would help that condition. "I still think the key motivation for me to do it would be if there was something detrimental to my health or something for my health and well-being to improve my lifestyle." "Of course I would, if I had a condition that required treatment and was offered something that would alleviate that." > > > Engaging for increased research participation ? key findings and recommendations 16 Further, some suggested that they would take part as a last resort if nothing else would help their condition. "If I had something that was as of yet untreatable I'd give it a go, but otherwise no." "If I was in an unfortunate situation of having a life threatening illness then I tend to think you grasp at anything." Altruistic motivations and helping the people around me A willingness to help with clinical research relating to a condition that those close to them suffer from was evident in people's responses. "Because my mother has dementia." "In recent years a lot of people I know have suffered from cancer and arthritis." "I suppose its family history, we have had a run in with cancer so I suppose we would be interested in getting involved." "My son's diabetic, anything that would help." Respondents also suggested that they were motivated by a more general altruistic sense of helping others. "Because I want to help people." "If it helps give people a better life." "It's being out there trying to help somebody that is unable to help themselves." It will help advance medical science Some respondents expressed that they would be likely to take part because it may help improve medicine and medical science. "Because it is interesting and it helps the process of medical science." "I feel if people don't participate then science will not advance, for everyone's benefit." "It is important to help the development of medicine and if people aren't helping then there would be no progress and it wouldn't get anywhere." I would find it interesting Respondents said that they would be motivated to take part in various types of trials because they found it interesting. "I find that really quite interesting, I quite like a bit of psychology myself, I'd like to see what goes on in their heads to make it go one way or the other." "Yeah that's a fascinating thing, it's just so clever!" "I'm quite interested in exercise and diet." "Because it would be interesting to see how your health can be affected by those types of things." > > > Engaging for increased research participation ? key findings and recommendations 17 Because I've taken part before Those who had already taken part in clinical research suggested they would again because of their previous experience. "Previous experience in a clinical trial." "Already have been part of a clinical trial for cancer. So far it is a beneficial experience." "I have already taken part and thought it helped." "I have previously been part of a clinical trial and had a good experience." Money Earning money through participating was a clear motivation for a minority of people. "Depending on what the cash incentive was. I wouldn't participate in it if there was no financial gain because of the dangers behind it." "It would depend what it was in aid of and if it was for money." "If there was a large pay out I would take part." Engaging for increased research participation ? key findings and recommendations 18 6. Barriers to taking part 6.1 Why don't other people take part? We also looked into the barriers to taking part in clinical research. When asked what may stop other people from taking part, respondents mentioned: ? Being worried about the risks ? Lack of knowledge/information ? Lack of time to be involved. 6.2 What stops you from taking part? In order to explore this further, respondents were asked what would stop them personally (rather than others) from taking part. Respondents' answers reflected concerns about the risks involved in clinical research, a lack of knowledge and information, and practical issues with time and having to take time off work. When prompted, it was clear that there were other issues which concerned respondents. For some, the involvement of private drug companies (33%) and stories they have seen in the media (31%) would stop them from taking part in clinical research. Figure 6 To what extent do you agree or disagree that the following would stop you from taking part in a clinical trial? Base: 1101 g6 I'm worried about the risks g5 4% 11% 8% 7% 10% 12% 10% 20% 24% 28% 27% 32% 19% 19% 19% 28% 25% 42% 32% 35% 32% 25% 25% 19% 16% 32% 46% 14% 15% 14% 10% 6% 8% 6% 6% 5% 5% I might need to take time off work I don't have time to participate I don't know enough about clinical trials The involvement of a private drug company Stories I have seen in the media I wouldn't pass the medical screening test 37% 32% 44% 34% 20% 34% My family and friends would disapprove I'm not the type of person the NHS want to participate in clinical trials My religious or moral beliefs 18% 12% 25% 17% 16% 11% 5% Strongly disagree Disagree g9 Neither agree nor disagree Agree Strongly agree > > > Engaging for increased research participation ? key findings and recommendations 19 6.2.1 Demographic differences Understanding of clinical research Those who have a very good understanding (41%) are the least likely to agree they are worried about the risks, rising with some understanding (55%), little understanding (60%) and no understanding (62%). Those who have no (50%) or little understanding (48%) are more likely to agree that they don't have the time to take part than those with some (40%) or very good understanding (37%). Age Those aged 85+ (70%) are the most likely to say that not knowing enough about clinical research stops them from taking part. Those ages 75-84 (43%) and 85+ (59%) are the most likely to think that they are not the type of people the NHS want to take part. Gender Women (62%) are more likely to say that a worry about the risks would stop them from participating than men (52%). Women (48%) are also more likely to worry about needing time of work than men (43%). Educational attainment Those with no qualifications are least likely to agree that they are worried about the risks of participating (50%), that they don't have the time to participate (39%), and that they may need to take time off work (33%). However, this group are the most likely to agree (27%) that they are not the type of person the NHS wants to participate. Employment status Those who are unable to work are least likely to agre
Url: /Media/Southampton-Clinical-Research/Marketresearch/Engaging-for-increased-research-participation-full-report-v2.pdf

Papers Trust Board - 30 January 2024

Description: Date Time Location Chair Apologies Agenda Trust Board – Open Session 30/01/2024 9:00 - 13:00 Conference Room, Heartbeat/Microsoft
Url: /Media/UHS-website-2019/Docs/About-the-Trust/Trust-governance-and-corporate-docs/2024-Trust-documents/Papers-Trust-Board-30-January-2024.pdf

Papers Trust Board - 27 July 2023

Description: Date Time Location Chair Agenda Trust Board – Open Session 27/07/2023 9:00 - 13:15 Conference Room, Heartbeat/Microsoft Teams Jenni Douglas-Todd 1 Chair’s Welcome, Apologies and Declarations of Interest 9:00 Note apologies for absence, and to hear any declarations of interest relating to any item on the Agenda. 2 Patient Story The patient or staff story provides an opportunity for the Board to reflect on the experiences of patients and staff within the Trust and understand what the Trust could do better. 3 Minutes of Previous Meeting held on 25 May 2023 9:15 Approve the minutes of the previous meeting held on 25 May 2023 4 Matters Arising and Summary of Agreed Actions To discuss any matters arising from the minutes, and to agree on the status of any actions assigned at the previous meeting. 5 QUALITY, PERFORMANCE and FINANCE Quality includes: clinical effectiveness, patient safety, and patient experience 5.1 Briefing from the Chair of the Audit and Risk Committee (Oral) 9:20 Keith Evans, Chair 5.2 Briefing from the Chair of the Charitable Funds Committee (Oral) 9:25 Dave Bennett, Chair 5.3 Briefing from the Chair of the Finance and Investment Committee (Oral) 9:30 Jane Bailey, Chair 5.4 Briefing from the Chair of the People and Organisational Development 9:35 Committee (Oral) Jane Harwood, Chair 5.5 Briefing from the Chair of the Quality Committee (Oral) 9:40 Tim Peachey, Chair 5.6 Chief Executive Officer's Report 9:45 Receive and note the report Sponsor: David French, Chief Executive Officer 5.7 10:10 5.8 10:20 5.9 10:50 5.10 11:05 5.11 11:20 5.12 11:35 5.13 11:40 5.14 11:45 5.15 11:55 5.16 12:05 6 6.1 12:15 Hampshire and Isle of Wight (HIOW) Recovery Support Programme Review and agree to the undertakings Sponsor: David French, Chief Executive Officer Performance KPI Report for Month 3 Review and discuss the report Sponsor: David French, Chief Executive Officer Break Finance Report for Month 3 Review and discuss the report Sponsor: Ian Howard, Chief Financial Officer People Report for Month 3 Review and discuss the report Sponsor: Steve Harris, Chief People Officer Maternity Dashboard/Perinatal Quality Surveillance Report Receive and note Sponsor: Gail Byrne, Chief Nursing Officer PMRT (Perinatal Mortality Review Summary) Report Receive and note Sponsor: Gail Byrne, Chief Nursing Officer Guardian of Safe Working Hours Quarterly Report Receive and discuss the report Sponsor: Paul Grundy, Chief Medical Officer Attendee: Diana Hulbert, Guardian of Safe Working Hours and Emergency Department Consultant Medical Appraisal and Revalidation Annual Report including Board Statement of Compliance Receive and discuss the Annual Report. Approve the Statement of Compliance. Sponsor: Paul Grundy, Chief Medical Officer Annual Complaints Report 2022-23 Receive and discuss Sponsor: Gail Byrne, Chief Nursing Officer Attendee: Ellis Banfield, Associate Director of Patient Experience STRATEGY and BUSINESS PLANNING Corporate Objectives 2023-24 Quarter 1 Review Review and feedback on the corporate objectives Sponsor: David French, Chief Executive Officer Page 2 6.2 Board Assurance Framework (BAF) Update 12:25 Review and discuss the update Sponsor: Gail Byrne, Chief Nursing Officer Attendee: Craig Machell, Associate Director of Corporate Affairs and Company Secretary 7 CORPORATE GOVERNANCE, RISK and INTERNAL CONTROL 7.1 Feedback from the Council of Governors' (CoG) meeting 26 July 2023 12:35 (Oral) Sponsor: Jenni Douglas-Todd, Trust Chair 7.2 Register of Seals and Chair's Actions Report 12:40 Receive and ratify In compliance with the Trust Standing Orders, Financial Instructions, and the Scheme of Reservation and Delegation. Sponsor: Jenni Douglas-Todd, Trust Chair 7.3 Trust Executive Committee Terms of Reference 12:45 Approve the proposed amendments to the Terms of Reference Sponsor: David French, Chief Executive Officer Attendee: Craig Machell, Associate Director of Corporate Affairs and Company Secretary 8 Any other business 12:50 Raise any relevant or urgent matters that are not on the agenda 9 Note the date of the next meeting: 28 September 2023 10 Resolution regarding the Press, Public and Others Sponsor: Jenni Douglas-Todd, Trust Chair To agree, as permitted by the National Health Service Act 2006 (as amended), the Trust's Constitution and the Standing Orders of the Board of Directors, that representatives of the press, members of the public and others not invited to attend to the next part of the meeting be excluded due to the confidential nature of the business to be transacted. 11 Follow-up discussion with governors 13:00 Page 3 Minutes Trust Board – Open Session Date 25/05/2023 Time 9:00 – 13:00 Location Heartbeat Education Centre/Microsoft Teams Chair Jenni Douglas-Todd (JD-T) Present Jane Bailey, Non-Executive Director (NED) (JB) Dave Bennett, NED (DB) Gail Byrne, Chief Nursing Officer (GB) Diana Eccles, NED (DE) Keith Evans, Deputy Chair and NED (KE) David French, Chief Executive Officer (DAF) Paul Grundy, Chief Medical Officer (PG) Steve Harris, Chief People Officer (SH) Jane Harwood, NED/Senior Independent Director (JH) Ian Howard, Chief Financial Officer (IH) Tim Peachey, NED (TP) Joe Teape, Chief Operating Officer (JT) In attendance Femi Macaulay, Associate NED (FM) Craig Machell, Associate Director of Corporate Affairs and Company Secretary (CM) Ellis Banfield, Associate Director of Patient Experience (EB) (item 5.8) Julie Brooks, Head of Infection Prevention Unit (JBr) (item 5.7) Sarah Herbert, Deputy Chief Nursing Officer (SHe) (item 5.10) Kelly Kent, Head of Strategy and Partnerships (KK) (item 6.1) Christopher Kipps, Clinical Director of R&D (CK) (item 6.3) Kyle Lacoste, Trust Documents Manager (KL) (item 6.4) Christine Mbabazi, Equality & Inclusion Adviser/Freedom to Speak Up Guardian (CMb) (item 5.9) Clare Rook, Chief Operating Officer, CRN Wessex (CR) (6.2) Julian Sutton, Interim Lead Infection Control Director (JS) (item 5.7) Sarah Williamson, Director of Research and Improvement, Solent NHS Trust (SW) (item 2) 1 member of the public (item 2) 5 governors (observing) 5 members of staff (observing) 1 member of the public (observing) Apologies Martin De Sousa, Director of Strategy and Partnerships (MDeS) Note: items 5.7 and 5.9 were addressed prior to item 5.6. 1. Chair’s Welcome, Apologies and Declarations of Interest The Chair welcomed attendees to the meeting. It was noted that there were no interests to declare in the business to be transacted at the meeting. The Chair provided an overview of her activities since April 2023, including visits to hospital departments, meetings with peers and other key stakeholders. Page 1 2. Patient Story Dr Sarah Williamson, Director of Research and Improvement at Solent NHS Trust was invited to relate the experience of her sister, who has a learning disability, when she received a course of radiotherapy at the Trust in late 2022. 3. Minutes of the Previous Meeting held on 30 March 2023 The Board requested an amendment to item 4.10 in the minutes from 30 March 2023 to reflect that the Trust was rated seventh in terms of recommendation as a place to work, rather than overall. 4. Matters Arising and Summary of Agreed Actions It was noted that all actions due had been completed or would be addressed through the business of the meeting. 5. QUALITY, PERFORMANCE and FINANCE 5.1 Briefing from the Chair of the Charitable Funds Committee The chair of the Charitable Funds Committee was invited to provide an overview of the meeting held on 9 May 2023. It was noted that: • In terms of the Charity’s financial position, it had received £2.9m against a target of £4m for 2022/23. In addition, the Charity’s costs remained high. The current structure of the Charity and its funds continued to cause difficulties in spending its money effectively and efficiently. • The Charity intended to launch a capital fundraising plan in order to raise funds for general refurbishment activities. • The Charity was supporting the ‘Wild in Art’ programme in Southampton, by which it was intended to strengthen its relationships with corporate entities for the future. • It was intended that proposals to reform the Charity would be presented to the Board in July 2023. 5.2 Briefing from the Chair of the Audit and Risk Committee The chair of the Audit and Risk Committee was invited to provide an overview of the meeting held on 22 May 2023. It was noted that: • The committee reviewed waivers of tendering requirements granted and considered that there were valid reasons for these waivers and that the approval process had been followed. • A report on the cause and impact of a supplier payment error, which occurred on 13 March 2023 was reviewed and the committee received assurance in respect of the controls now in place to prevent a re-occurrence. • The committee reviewed a draft of the annual report and accounts for 2022/23. • The committee reviewed the progress by the external auditors in respect of the accounts for 2022/23. • As part of its review of the proposed internal audit plan for 2023/24, the committee agreed that the plan should include an audit of recruitment controls. 5.3 Briefing from the Chair of the Finance and Investment Committee The chair of the Finance and Investment Committee was invited to provide an overview of the meeting held on 22 May 2023. It was noted that: • The committee reviewed the Trust’s latest financial position and operating plan and noted that 2023/24 would be a challenging year. Page 2 • The committee received an update in respect of Wessex NHS Procurement Limited’s performance. • The committee reviewed ‘Getting It Right First Time’ in cardiology and noted the use of data and efficiencies achieved as well as the support provided by the Always Improving team. 5.4 Briefing from the Chair of the People and Organisational Development Committee The chair of the People and Organisational Development Committee was invited to provide an overview of the meeting held on 17 May 2023. It was noted that: • The committee reviewed the People Report and noted that sickness absence rates had improved and that appraisal completion rates required improvement. In addition, the committee noted the controls in place to control staff numbers. • The committee reviewed the 2023/24 People objectives, which included broadening of system working and steps to address bullying and harassment. • It was agreed that Phil Bunting, Director of Operational Finance, would attend meetings of the committee in order to ensure closer links between People and Finance. 5.5 Briefing from the Chair of the Quality Committee The chair of the Quality Committee was invited to provide an overview of the meeting held on 22 May 2023. It was noted that: • The committee reviewed the Trust’s key quality indicators and noted that performance was not as good as three years ago, which indicated a system under pressure. • The committee received reports on recent never events. • The Trust’s complaints closure time was only one day above the target at 36 days. • The committee reviewed the Infection Prevention Control Annual Report (item 5.7) and a draft of the Trust’s Quality Account for 2022/23. • The committee received an update from the Learning Disability team and noted that whereas four years ago the Trust received approximately 200 referrals per annum, of which 70% were inappropriate, the Trust now received approximately 1,600 referrals per annum, of which only 7% were inappropriate. The committee further noted that training was to be rolled out during 2023/24 in respect of mental health and autism. 5.6 Chief Executive Officer’s Report David French was invited to present the Chief Executive Officer’s Report, the content of which was noted. It was further noted that: • Several of the Agenda for Change trade unions had accepted the Government’s offer and, as a result, the pay deal had been implemented despite it having been rejected by some of the unions. • The Royal College of Nursing was balloting members for a further mandate for industrial action. • Junior doctors were expected to go on strike for 72 hours from 14 June 2023 and consultants were being balloted for industrial action. • The ongoing industrial action was having a significant impact on the Trust’s staff and its performance. • A recent inspection by the Care Quality Commission had identified some concerns in respect of security measures at the Princess Anne Hospital, which were acted on immediately by the Trust. • The expected deficit for the Integrated Care System for 2023/24 had reduced to £118m and the Integrated Care Board was implementing five workstreams, Page 3 each headed by a provider chief executive. David French would be leading on the elective recovery workstream. • The Trust had recently completed its 1,000th Transcatheter Aortic Valve Implantation. • ‘Diabasics’, a scheme to raise awareness of diabetes across the Trust was being launched. 5.7 Infection Prevention and Control Annual Report 2022-23 Julian Sutton and Julie Brooks were invited to present the Infection Prevention and Control Annual Report 2022-23, the content of which was noted. It was further noted that: • The Trust had not met the targets in respect of methicillin-resistant staphylococcus aureus (MRSA), clostridioides difficile (C-Diff), e-coli and antibiotic prescribing. • The Trust had transitioned to managing COVID-19 differently towards a ‘Living with COVID-19’ approach. The Trust had experienced benefits due to its cautious approach to Covid-19. • There had been a five-fold increase in cases of norovirus nationally, which caused significant issues elsewhere in April 2022. However, due to its management of infection risk, the Trust had not experienced this. • The Trust was moving toward administering antibiotics orally rather than intravenously in order to minimise infection risks. 5.8 Learning from Deaths 2022-23 Quarter 4 Report Ellis Banfield was invited to present the Learning from Deaths report for the fourth quarter of 2022/23, the content of which was noted. It was further noted that: • Work was ongoing in order to improve the interface between external and internal investigations. • Digital reporting was being used to improve the process of investigating deaths. • A review was ongoing in respect of the use and consistency of Morbidity and Mortality meetings. 5.9 Freedom to Speak Up Report Christine Mbabazi was invited to present the Freedom to Speak Up Report, the content of which was noted. It was further noted that: • The main themes of matters reported using the Freedom to Speak Up process continued to be bullying and harassment, violence and aggression and team dynamics. • Further work was to be carried out in order to promote the aims of Freedom to Speak Up across the Trust. • Diana Eccles had agreed to act as the Freedom to Speak Up champion on the Board. The Board challenged how confident the Trust could be that staff felt able to speak up, as there was a gap between the number of speak up cases and the staff survey results. It was noted that the Freedom to Speak Up champions were a very important network. It was further noted that Paul Grundy speaks to all new consultants about speaking up and gives them information about a number of options to raise concerns. Action: Craig Machell and Christine Mbabazi agreed to include Freedom to Speak Up on a future Trust Board Study Session agenda. Page 4 5.10 Violence and Aggression against Staff Progress Report Sarah Herbert was invited to present the progress report in respect of Violence and Aggression against Staff, the content of which was noted. It was further noted that: • The staff survey indicated that 9% of staff had experienced violence and aggression from patients and/or families of patients. The responses appeared to be largely reflective of the national picture. • The Trust had recently signed up to a new service level agreement with Hampshire Police. • The Trust continued to work on its exclusions policy and had issued its first ‘yellow cards’ under the policy, although it had yet to exclude any individual. The Trust was also making use of ‘behavioural contracts’. • The Trust had noted that it was necessary to improve collaboration across the system to ensure that other providers are informed when patients were excluded from an organisation. • The deployment of body-worn cameras had been received positively. • The deal agreed between the Government and the unions in respect of Agenda for Change staff also included an agreement to take steps to improve the situation with respect to violence and aggression against staff. • There was possible correlation between the increased number of incidents of violence and aggression and the increasing number of patients presenting with mental health/alcohol abuse issues. It was necessary for the Integrated Care Board to play a greater role in managing the relationship with the police and the support provided to providers in handling these patients. 5.11 Break 5.12 Performance KPI Report for Month 1 Joe Teape was invited to present the Performance KPI Report for Month 1, the content of which was noted. It was further noted that: • The report had been amended to remove the People-related metrics and to amend or add metrics in agreement with the various committee chairs. • The industrial action between 11-15 April 2023 had resulted in a loss of elective recovery programme income and impacted patients. • The Trust was aiming to be in the top quartile of ~20 equivalent trusts in the UK, although its current performance was varied and cancer targets in particular were proving to be challenging. • The Trust had written to the Integrated Care Board regarding the inclusion of patients requiring organ transplants in the waiting list measures. • There was a system-wide target to reduce the number of patients not qualified to reside by the end of the year, but there was no credible plan currently in the system to achieve this. It was noted that the Trust monitored deterioration of patients in this category and reported falls and pressure ulcer data to the Quality Committee on a regular basis. The Board noted the spotlight on cancer performance, including the Trust’s twoweek wait, 28 days diagnosis and 31- and 62-day standards performance. Page 5 Action: Joe Teape agreed to come back to the Board with further details about the plans to reduce the number of patients with no criteria to reside and how the Trust would manage and monitor their stay in hospital. 5.13 Finance Report for Month 1 Ian Howard was invited to present the Finance Report for Month 1, the content of which was noted. It was further noted that: • The Trust had anticipated a deficit of £4m during the month whereas the deficit had been £5.4m. However, there were a number of factors, particularly the additional staffing costs due to industrial action and the resultant lost elective recovery programme income. • The Trust was targeting a £1m per quarter improvement in its deficit in order to reach break-even. The Trust had committed to a challenging cost improvement programme and was working on strengthening its recruitment and resourcing controls. • The Trust had significantly reduced its use of Thornbury for temporary resourcing. 5.14 People Report for Month 1 Steve Harris was invited to present the People Report for Month 1, the content of which was noted. It was further noted that: • The Trust was 191 whole-time equivalents above its plan for 2023/24, although April 2023 had seen a spike in bank staff use due to industrial action. • Expenditure on temporary staff appeared to be reducing. • The sickness absence rate was the lowest for some time with a rolling average of 4.1%. The People and Organisational Development Committee would be reviewing the Trust’s plan for sickness absence and the internal auditors would be examining the controls in this area. • It was intended to open the roof garden at Princess Anne Hospital and the wellbeing hub as part of the NHS 75th anniversary celebrations. The Board questioned what the impact had been of the reduced sickness absence rate and noted that whilst reduced use of bank and agency staff would generally be expected, the staff member type absent was a core determinant as to whether or not temporary resource was required or not. The Board enquired about the impact of ‘long COVID’ and noted that this impacted approximately 20 whole-time equivalents, although this was likely not the full picture. 6. STRATEGY and BUSINESS PLANNING 6.1 Corporate Objectives 2023-24 David French was invited to present the proposed Corporate Objectives for 2023/24. It was noted that there would be fewer, more focused objectives aligned with the Trust’s strategic themes. Page 6 The Board discussed the proposed objectives and noted that: • The shared decision-making target should be amended to 500. • The research and development objectives were vulnerable due to the reliance on investment. • The Board Assurance Framework would need to be updated to reflect the objectives for 2023/24. Actions: Joe Teape agreed to consider a balanced scorecard for the Corporate Objectives. Paul Grundy and Gail Byrne agreed to discuss which areas were good, bad or indifferent to transformation and/or change. Decision: Subject to the amendment referred to above, the Board approved the Corporate Objectives for 2023/24. 6.2 CRN Wessex Annual Report 2022-23 and Annual Plan 2023-24 Clare Rook was invited to present the CRN Wessex Annual Report 2022-23, the content of which was noted. It was further noted that: • The plan for 2023/24 would be a transitional plan toward the new regional research network for south/central. It was expected that the current organisational format would continue for six months due to delays in the transition. • The Wessex Clinical Research Network had met seven out of eight of its objectives during 2022/23 and has been historically successful in obtaining National Institute for Health Research funding. Noting that Jenni Douglas-Todd was chair of the Dorset Integrated Care System, the Board discussed the need to collaborate with Dorset and other neighbouring networks, including Wessex Health Partners and Thames Valley. 6.3 Research and Development Plan 2023-24 The paper ‘Research and Development Plan 2023-24’ was presented to the meeting, the content of which was noted. It was further noted that the proposal outlined in the paper had been reviewed by the Trust Executive Committee on 17 May 2023. The Trust Executive Committee had not approved the proposals on the basis that further work was required. Whilst it was agreed that research and development was a fundamental part of a teaching hospital, it was necessary to consider the Trust’s financial position and as such the proposals for research and development in 2023/24 required further scrutiny. 6.4 Board Assurance Framework (BAF) Update Craig Machell was invited to present the Board Assurance Framework, the content of which was noted. It was further noted that: Page 7 • The BAF was to be updated in line with the corporate objectives reviewed as part of item 6.1. • It was intended to change the approach to presentation of risk at Board meetings to include focused ‘deep-dives’, a risk appetite workshop and an annual review. 7. CORPORATE GOVERNANCE, RISK and INTERNAL CONTROL 7.1 Feedback from the Council of Governors’ (CoG) meeting on 26 April 2023 The Chair provided an overview of the meeting of the Council of Governors held on 26 April 2023. It was noted that the Council of Governors had considered the following matters: • Annual Report and Quality Account timetable • CEO’s Performance Report • Operational Plan 2023/24 • Non-NHS Activity • Appointment of Deputy Lead Governor (Sandra Gidley) • Review of terms of reference • Elections 2023 • Update on appointed governor for Hampshire County Council • Agreed to fill the Rest of England and Wales vacancy with the next-highest polling candidate (Brian Lovell) • Membership engagement update • Reports from the working groups 7.2 Register of Seals and Chair’s Actions Report The paper ‘Register of Seals and Chair’s Actions Report’ was presented to the meeting, the content of which was noted. Decision: The Board agreed to ratify the application of the Trust Seal to the documents listed in the ‘Register of Seals and Chair’s Actions Report’. 7.3 Charitable Funds Committee Terms of Reference Amended terms of reference for the Charitable Funds Committee were tabled to the meeting for approval. It was noted that the amendments were in order to align the terms of reference with the Trust’s Standing Financial Instructions. Decision: Having reviewed the amended terms of reference for the Charitable Funds Committee, the Board approved the terms of reference tabled to the meeting. 8. Any other business There was no other business. 9. Note the date of the next meeting: 27 July 2023 10. Resolution regarding the Press, Public and Others Page 8 Decision: The Board resolved that, as permitted by the National Health Service Act 2006 (as amended), the Trust’s Constitution and the Standing Orders of the board of directors, that representatives of the press, members of the public and others not invited to attend to the next part of the meeting be excluded due to the confidential nature of the business to be transacted. The meeting was adjourned. Page 9 List of action items Agenda item Assigned to Deadline Status Trust Board – Open Session 25/05/2023 5.9 Freedom to Speak Up Report 987. Future TBSS Machell, Craig Mbabazi, Christine 09/11/2023 Pending Explanation action item Craig Machell and Christine Mbabazi agreed to include Freedom to Speak Up on a future Trust Board Study Session agenda. Update: Scheduled for TBSS on 9 November 2023. Trust Board – Open Session 25/05/2023 5.12 Performance KPI Report for Month 1 988. Patients with no criteria to reside Teape, Joe 27/07/2023 Completed Explanation action item Joe Teape agreed to come back to the Board with further details about the plans to reduce the number of patients with no criteria to reside and how the Trust would manage and monitor their stay in hospital. Update: An emergency and urgent care action plan is in place overseen by our Urgent and Emergency Care Board. The system are still working through plans to reduce nCTR patients and we continue to try and influence this through the various ICB wide transformation programmes of which we are members. A Board update can be scheduled when required. Page 1 of 2 Agenda item Assigned to Deadline Status Trust Board – Open Session 25/05/2023 6.1 Corporate Objectives 2023-24 989. Scorecard Teape, Joe Explanation action item Joe Teape agreed to consider a balanced scorecard for the Corporate Objectives. 27/07/2023 Completed Update: Having discussed with Jane Harwood and the Strategy team, a decision was made to look at RAG rating the Corporate Objectives as a way of creating a scorecard. After the Q1 Corporate Objectives were populated, we had the following observations: 1) The content and structure of the corporate objectives lend themselves to quarterly review rather than monthly review and rating. 2) Some of the objectives are not specific enough to readily lend themselves to effective RAG rating. Therefore, if we were to create a “balanced scorecard” it would require an additional and new report to be built, rather than utilising the Corporate Objectives. At this stage we are unclear whether this report would be a valuable addition to the existing reports which we have in place. Trust Board – Open Session 25/05/2023 6.1 Corporate Objectives 2023-24 990. Transformation Byrne, Gail Grundy, Paul 27/07/2023 Pending Explanation action item Paul Grundy and Gail Byrne agreed to discuss which areas were good, bad or indifferent to transformation and/or change. Page 2 of 2 Report to the Trust Board of Directors Title: Agenda item: Sponsor: Date: Purpose: Issue to be addressed: Response to the issue: Chief Executive Officer’s Report 5.6 David French, Chief Executive Officer 27 July 2023 Assurance Approval or reassurance Ratification Information X My report this month covers updates on the following items: • Operational Update • Impact of Industrial Action • Stretched to the Limit: Tackling the NHS Productivity Challenge • National Long-Term Workforce Plan • New Hospital Programme • Project Fusion • UK Covid-19 Inquiry • Additional Funding The response to each of these issues is covered in the report. Implications: Any implications of these issues are covered in the report. (Clinical, Organisational, Governance, Legal?) Summary: Conclusion The Board is asked to note the report. and/or recommendation Page 1 of 6 Operational Update At the time of writing this update and since the last open Board meeting held on 25 May 2023, there has been further industrial action with the doctors in training having taken action between 14 – 16 June 2023 and further action on 13 – 18 July 2023, including across a weekend. The Trust is also currently planning for industrial action by consultants on 20 – 22 July 2023 and by the society of radiographers between 25 – 27 July 2023. Whilst the Trust continues to acknowledge, support and respect that its staff have the right to take industrial action, it is becoming increasingly more challenging to provide cover during the periods of strike action and there continues to be a significant impact on the services that can be safely operated, with each day seeing further outpatients, diagnostics and elective procedures having to be rescheduled. As well as the impact this will have on those patients rescheduled, there is also a significant administrative burden of rescheduling patients, an impact on the Trust’s finances and performance, and the knock-on impact on other patients who may also have future appointments rescheduled as the Trust continues to see those that need care most urgently first. In addition, staff are being asked to cover more activity and this is undoubtedly affecting morale as well as the downstream impact on capacity for those staff that understandably wish to take back the time due in lieu of pay. The Board will note from the above that this is a challenging period, but I wanted to place on record my sincere appreciation and thanks for every one of our staff who has supported covering the industrial action and who have worked differently to help us navigate these periods saf ely. I hope that these disputes can now be resolved with a mutually agreeable outcome. Impact of Industrial Action Moving to the national situation, on 17 July 2023, NHS Providers published a summary of the impact of industrial action on patients, staff and performance. The summary describes impacts very consistent with the UHS experience. Whilst NHS trusts have performed admirably in managing strike action, the eight consecutive months of action has meant that management and leadership time and capacity is being diverted from the critical work needed to improve patient outcomes, cut waiting lists and meet financial targets. In terms of the impact of the industrial action on patients: • More than 651,000 routine procedures and appointments have been rescheduled across acute, mental health and community health services, with thousands more likely to be impacted as trusts seek to recover services. • The need to maintain emergency and elective care led to the de-prioritisation of community services, including some mental health services. • There is an increased risk to quality of care due to further constrained resources. The number of vacancies in the NHS and mounting workloads have a detrimental impact on staff morale and the 2022 NHS staff survey shows that all measures relating to burnout remain high. Industrial action is also impacting the relationship between staff and trust leaders with trusts finding themselves in the difficult position of having to manage industrial action without access to any of the levers to resolve it. Page 2 of 6 The financial impact is also significant due to loss of elective income for acute trusts, additional reliance on agency spending and increasing use of BMA rate card payments for strike cover. Some large NHS trusts have reported that a three-day strike can cost them £2.5-3m in direct costs. Stretched to the Limit: Tackling the NHS Productivity Challenge On 13 July 2023, the NHS published its new report, ‘Stretched to the Limit: Tackling the NHS Productivity Challenge’. The report explores the main barriers facing trusts as they seek to recover performance and improve productivity as well as the financial impact of current pressures and the scale of the efficiencies required. The report also examines what trusts are already doing and what is needed from government and national bodies. The report notes that the NHS is facing a significant challenge in that it must contain costs and use existing resources to increase activity within a context of significant operational and financial pressure. In terms of improving productivity, the following are highlighted: • Improving patient flow and discharge processes • Different delivery models of care (including virtual wards) • Focusing on staff wellbeing • Provider collaboratives to inform joint working across pathways • Use of analytics to inform clinical and operational decision-making. National data indicates good early progress in terms of achieving interim recovery targets for urgent and emergency care and reduction of the number of long waits. However, there are substantial backlogs in mental health, community and children and young people’s services. The report states that it will be ‘very difficult’ for the NHS to deliver the government’s overall performance ask, protect quality of care and deliver unprecedented efficiencies. Significant issues facing the NHS include: • Capacity to meet demand and staff morale • Prolonged industrial action • Risks across trusts’ estates – 73% of trusts surveyed strongly disagreed or disagreed that they had access to sufficient capital funding for 2023/24 • Increased patient acuity, higher average lengths of stay and need for investment in community and social care services. The report states that 89% of trust leaders surveyed believed that the efficiency ask for 2023/24 was more challenging than 2022/23 and they are concerned about the deliverability of the efficiency targets and the impact of these financial pressures on quality and scale of service provision. In terms of short- and medium-term government support required: • Expansion of capacity in community settings • Delivery of the long-term workforce plan • Resolution of industrial action • Enabling fully digitally connected estates • Improving coverage and quality of production data. Over the longer term: • Enabling a step change in operational and strategic capital investment • Enabling the NHS to invest in management capacity alongside the clinical workforce • Providing a sustainable solution to social care capacity. The full report is available at: https://nhsproviders.org/stretched-to-the-limit Page 3 of 6 National Long-Term Workforce Plan Coinciding with the 75th birthday of the NHS, the Long-Term Workforce Plan has been published by NHS England. This plan sets out how the NHS will address existing and future workforce challenges by recruiting and retaining thousands more staff and working in new ways to improve the experience of staff and patients. Commissioned and accepted by the government, the plan provides a costed 15-year approach to developing the current NHS workforce to meet current and future demand and challenges and to support the health and wellbeing of the population. Over £2.4 billion has been committed on top of existing funding commitments to fund additional education and training places over the next five years. The three areas that NHS England have focused on in the plan are: • Train: Substantially growing the number of doctors, nurses, allied health professionals and support staff in both secondary and primary care settings. This is underpinned by a £2.4 billion funding commitment. • Retain: A renewed focus and major drive on retention, with better opportunities for career development and improved flexible working options. This comes alongside reforms to the pension scheme, with an aim to retain 130,000 staff working in the NHS for longer. • Reform: Working differently and delivering training in new ways. Advances in technology and treatments will be explored and implemented to help the NHS modernise and meet future requirements. The plan aims to reform training and education opportunities, including making greater use of apprenticeships as a route to qualified staffing for nursing and other professional roles. In addition to significantly expanding medical placements, a new route for training will be opened in 2024 supporting students to train in medicine through an apprenticeship. The plan also complements the Trust’s existing People Strategy (the Thrive, Excel and Belong pillars) and builds on work from the NHS National People Plan in 2020, with a particular focus on retaining and developing the existing workforce. The plan has been broadly welcomed by NHS leaders, although concerns have arisen about the long-term financial sustainability of the proposals. The £2.4bn funding commitment is only understood to be for the first five years, with no clarity on how the proposal will be funded beyond this. The People team is reviewing the specific detail within the Workforce Plan and assessing what this will mean locally for UHS. This will be reviewed through the People and Organisational Development Committee. New Hospital Programme The National Audit Office (NAO) published its report into the progress with the New Hospital Programme on 17 July 2023. Under this programme, in 2020, the Government had committed to build 40 new hospitals by 2030. The National Audit Office examined whether the programme: • was designed and set up to manage the programme effectively; • is making progress against its baselines for time, cost and quality; and • is effectively identifying and managing the main risks to successful delivery. Page 4 of 6 Whilst the NAO considered that the programme has innovative plans to standardise hospital construction, which could deliver efficiencies, the building programme was announced in October 2020 without having made key decisions in terms of the programme’s funding and approach to construction. Until 2023, the Department for Health and Social Care (DHSC) was unable to secure agreement from the Major Projects Review Group about the programme’s approach to building future hospitals and capital funding required. When decisions were finally made, major changes to the programme’s scope were required, resulting in some schemes facing substantial delays and will not be completed by 2030. DHSC had spent about £1.1bn on the programme by March 2023 and deliv ery has been slower than expected. The NAO has highlighted the development of Hospital 2.0 as not having achieved good value for money so far. The full report can be found at: https://www.nao.org.uk/reports/progress-with-the-new-hospitalprogramme/ Project Fusion The Trust was informed on 18 July 2023 about the appointment of Ron Shields as the chief executive officer for the new trust to be formed following the conclusion of the merger between Solent NHS Trust, Southern Health NHS Foundation Trust and certain elements of other neighbouring trusts. Ron Shields is currently chief executive officer of Southern Health NHS Foundation Trust and has over 23 years of experience in leadership roles in community, mental health and acute hospital organisations. The new organisation has appointed a chair, non-executive directors and chief executive officer and will now make appointments to the other executive roles. These individuals will take up their appointments when the new organisation is formed in April 2024. UK Covid-19 Inquiry The Government established the UK Covid-19 Inquiry on 21 July 2022 in order to examine the UK’s preparedness for and response to the pandemic and to learn lessons for the future. The chair, Baroness Heather Hallett DBE has adopted a modular approach to the Inquiry. The public hearings for the first module commenced on 13 June 2023 and concluded on 19 July 2023. This module examined the period between June 2009 (when the World Health Organisation (WHO) announced that the scientific criteria for an influenza pandemic had been met) and 21 January 2020 (when the WHO issued the first situation report on what would become the Covid-19 pandemic). The Inquiry heard evidence in respect of: • A pandemic being a known possibility • The adverse impact of Brexit on resilience planning and preparedness • Underinvestment in the healthcare system • Consideration of health inequalities • The particular circumstances of the devolved nations The witnesses appearing before the Inquiry included representatives of national and devolved government departments, former and current national and devolved government ministers, experts in public health and representatives of bereaved families. Page 5 of 6 Additional Funding On 22 June 2023, the Trust was notified that £1.7m in funds were awarded to organisations in Wessex as part of the capital investment call for National Institute for Health and Care Research (NIHR) infrastructure award holders. However, it should be noted that the Trust was asked to reprofile its funding such that the majority of the expenditure (80%+) would be incurred during 2024/25. The Trust intends to use its share of the funding to purchase approximately £900,000 of equipment, including the Agilent Seahorse CF Analyser. In addition, the Trust was notified on 17 July 2023 that it was successful in obtaining £1,105,000 of funding from NHS England for additional bi-plane angiography equipment as part of the national thrombectomy expansion programme. Thrombectomies are ideally performed using a bi-plane angiography machine and there is a move, nationally, toward using bi-plane equipment for all such procedures. In 2021/22, the Trust only carried out 73.7% of thrombectomies using this method, compared to 94.8% nationally. The Trust intends to use the funding from NHS England to procure a second bi-plane, which would be enabled for neuro use, in order to both supplement its current equipment and also to provide cover when the existing bi-plane machine is replaced in 2024/25. Page 6 of 6 Trust Board – Open Session Title of paper Agenda item Lead Author Oversight Framework 4 and Recovery Support Programme 5.7 Date of meeting 27 July 2023 David French, Chief Executive Officer Clinical Sponsor N/A Tara-Lee Baohm, Deputy Director of Assurance, Hampshire and Isle of Wight Integrated Care Board Craig Machell, Associate Director of Corporate Affairs - NHS organisations across Hampshire and Isle of Wight have a combined financial deficit that is challenging and as a result are implementing a joint recovery plan to transform health and care services. Purpose - To support this work all NHS partners made a request to enter the NHS England Recovery Support programme. - Following NHS England Regional and National decision making, all NHS organisations in Hampshire and Isle of Wight have been moved into Oversight Framework 4/Recovery Support Programme. Formal notification of this move was received 1 June 2023. - This paper outlines the key next steps following this notification. Executive Summary NHS organisations across Hampshire and Isle of Wight have a challenging combined deficit for 2023/2024. We have begun the journey of significant transformational change working closely with partners across the Integrated Care System (ICS) to ensure greater efficiency and long-term sustainability of services. Working together to bring the system back into balance and living within the allocations provided is a collective priority. We are in a good place to do this as our partnerships are already well established and we are already working with our people and our communities on this journey of transformation. Given the scale of the challenge the ICB along with NHS provider Chief Executives sought help from NHS England by proactively seeking to enter the national recovery support programme. This has enabled the system to secure support from NHS England to support the system in delivering the scale and pace of transformation needed whilst delivering other key commitments to improve access, reduce waiting times and reduce health inequalities as set out in the ICB response to the 2023/2024 national planning guidance. This paper sets out the financial context and recovery approach that the ICS is taking, provides more information about the recovery support programme and what this means, and sets out the governance framework for the system. Page 1 of 6 Recommendations Please provide details of the risks associated with the subject of this paper - To note that following NHS England Regional and National decision making (27 April and 16 May respectively), all NHS organisations (including the Integrated Care Board and all of the NHS Trusts within the Integrated Care System, including University Hospital Southampton NHS Foundation Trust), have been moved into Oversight Framework 4/Recovery Support Programme. Formal notification of this move was received 1 June 2023. - To note that all NHS Boards in Hampshire and Isle of Wight will be asked to agree regulatory undertakings with NHS England. These will be discussed in Private Boards and a collective representation made back to NHS England on behalf of the system. - To note the proposed assurance and oversight structures for the system recovery plan via Integrated Care System architecture. The scale and pace required to return the Integrated Care System to financial balance will be challenging. To support, the system will be provided with improvement support from NHS England. In addition, a new system wide assurance and oversight infrastructure is proposed to maintain grip and control. Regulatory and legal implications (e.g. NHS England/Improvement ratings, Care Quality Commission essential standards, competition law etc) Following NHS England Regional and National decision making (27 April and 16 May respectively) all NHS organisations in Hampshire and Isle of Wight have been moved into Oversight Framework 4/Recovery Support Programme. Regulatory undertakings will be agreed between NHS England and all NHS Boards. Financial implications / impact (e.g. cost improvement programmes, revenue/capital, year-end forecast) A system wide financial recovery plan is being implemented. Trust Chief Executives, Chief Finance Officers, and clinical leaders will take key leadership roles across the six key programmes of work which will support delivery of financial recovery and balance. Delivery of the system recovery plan will be overseen by the Integrated Care System Recovery and Transformation Board Specific communications and stakeholder/staff engagement implications A joint communications and engagement plan is in place. The Integrated Care Board communications team will lead on behalf of the Integrated Care System. Patient / staff implications (e.g. linked to NHS Constitution, equality and diversity) Entry into Oversight Framework 4/Recovery Support Programme is being driven primarily on the basis of the combined financial deficit. There are no specific concerns regarding the quality of care for our patient population, that have driven the move into the Recovery Support Programme. Equality and quality impact assessment Page 2 of 6 Quality/equality impact assessment processes have been built into the system recovery assurance and oversight architecture. Data protection impact assessment N/A Impact on/implications for health inequalities Quality/equality/health inequality impact assessment processes have been built into the system recovery assurance and oversight architecture. Previous considerations by the Board N/A Background papers / supporting information Appendix 1: Recovery Support Programme Page 3 of 6 Appendix 1: Recovery Support Programme Introduction NHS organisations across Hampshire and Isle of Wight have a challenging combined deficit for 2023/2024. We have begun the journey of significant transformational change, working closely with our partners across the Integrated Care System (ICS) to ensure greater efficiency and long-term sustainability of services. Working together to bring the system back into financial balance and living within the allocations provided is a collective priority. We are in a good place to do this as our partnerships are already well established and we are already working with our staff and our communities on this journey of transformation. Given the scale of the challenge, the Integrated Care Board (ICB) - along with Chief Executives from our NHS Trust providers - sought help from NHS England by proactively seeking to enter the national Recovery Support Programme (RSP). This has enabled the system to secure support from NHS England to help us deliver the scale and pace of transformation needed whilst also delivering other key commitments to improve access, reduce waiting times and reduce health inequalities. These additional commitments are set out in some detail in our response to the 2023/2024 national planning guidance. This paper sets out the financial context and the approach to recovery that the ICS is taking. It also provides more information about the recovery support programme and what this means the system governance and sets out the governance framework for the system. Financial Context and Recovery Approach NHS organisations across Hampshire and Isle of Wight have a combined financial deficit that is significant and challenging. In order to tackle this we have developed a joint recovery plan to transform health and care services and we are now impl
Url: /Media/UHS-website-2019/Docs/About-the-Trust/Trust-governance-and-corporate-docs/2023-Trust-documents/Papers-Trust-Board-27-July-2023.pdf

UHS adult major trauma guidelines

Description: Adult Major Trauma Guidelines University Hospital Southampton NHS Foundation Trust Dr Mark Baxter Director of Major Trauma, Consultant in Older Persons
Url: /Media/SUHTExtranet/WessexTraumaNetwork/UHS-adult-major-trauma-guidelines.pdf

Papers Trust Board - 9 September 2025

Description: Date Time Location Chair Apologies Agenda Trust Board – Open Session 09/09/2025 9:00 - 13:00 Conference Room, Heartbeat Education
Url: /Media/UHS-website-2019/Docs/About-the-Trust/Trust-governance-and-corporate-docs/2025-Trust-documents/Papers-Trust-Board-9-September-2025.pdf

1 to 10 of 12

Previous 1 2 Next

Browse site A to Z

Search results

Press release: Leading doctor says kidney patients and families "let down" by poor mental health support and therapy

Mixed messages

Candid over complications

University Hospital Southampton NHS Foundation Trust Constitution

Papers Council of Governors 20 July 2022

Engaging for increased research participation - full report

Papers Trust Board - 30 January 2024

Papers Trust Board - 27 July 2023

UHS adult major trauma guidelines

Papers Trust Board - 9 September 2025

Site policies

Contact details

Useful links