Response to Trust criticisms

With regard to Mr Pearman’s letter to the Rotherham Advertiser about Rotherham Doncaster and South Humber NHS Foundation Trust (RDaSH), I’d like to respond to a number of points raised.

Mr Pearman’s letter refers to ‘private patients’ and the use of the facilities and potential limits on income derived from this source.

The Private Patient Income Cap has been in place since foundations trusts were created. With a few exceptions, it is set at the proportion of total income derived from private patient charges in 2002/03 and more recently it was set at 1.5 per cent for mental health trusts (from 2009/10).

RDaSH was authorised in August 2007. The PPI Cap set on authorisation was zero, as no income was derived from this source in 2002/03. Hence from 2007 the Trust was not permitted to earn private patient income.

This explains why no mention was made of it as we sought foundation trust status. The cap was subsequently increased to 1.5 per cent of our income from 2009/10.

Contrary to Mr Pearman’s statement, this was reported to the Council of Governors at the November 2009 meeting in my Chief Executive’s Report.

In our Annual Plan for 2010/11 (which was discussed with the Council of Governors and a full version shared with them in August 2010) reference was made to the potential opportunity for the Trust to establish income streams from private patients, but I can confirm that the total private income in 2009/10, 2010/11 and 2011/12 was zero.

I can also confirm that the plans currently being finalised for 2012/13 do not include any private patient income.

The Health and Social Care Bill has now removed the PPI Cap. However recent amendments by the Lords resulted in the inclusion of two related points:

• Where a proposal is included in a forward plan for non-NHS funded services the Council of Governors must consider whether it is satisfied that it will not, to any significant extent, interfere with the fulfilment of the foundation trust’s primary purpose.

• Where a foundation trust proposes to increase income from non-NHS funded sources by more than 5 per cent of its total income it may implement the proposal only if more than half of the Council of Governors voting approve the proposal.

So, if we propose to start with private income we need to ask the Governors to consider the proposal; and if we were to increase the amount generated from that source by more than 5 per cent of the total income (which currently equates to £850,000) then we need the backing of the Council of Governors as described above.

I believe that the Trust has always kept the Council of Governors up to date with our intentions. Our draft Annual Plan will be presented to them in May 2012 before it is submitted to Monitor.

Mr Pearman also refers to a number of other issues: 1. The Trust began managing the early intervention service in Manchester in April 2008. Initially, the Trust was awarded a three-year contract which was extended and now runs until March 2013. The contract pays for all of the management costs associated with the service and does not have a detrimental effect on the Trust’s other services.

2. The Trust ‘accumulated a number of other services that were not initially within its remit as a mental health trust’ when in April 2011 we took over the community health services in Doncaster. This successful bid, in partnership with Doncaster Metropolitan Borough Council, was in line with our Annual Plan 2010/11 that set out the opportunities that were available at the time.

This document was shared with the Council of Governors in August 2010, prior to which in May 2010, we had shared our strategic direction with Governors which included the opportunity to: “Diversify into services that fit with the Trust vision, objectives and values eg Transforming Community Services.”

3. From April 2011, the Trust removed the term ‘mental health’ from its name. This was to reflect the wider range of services provided with around 40 per cent of income now relating to non-mental health services.

Contrary to Mr Pearman’s claim, the change in name was the subject of a consultation process in February/March 2011 which was publicised on the website, in staff communications, in letters to local stakeholders and Governors, with the majority of respondents supporting the change.

Mr Pearman also refers to the Trust’s facilities in Rotherham. The modernisation process for the development of The Woodlands and the re-development at Swallownest Court has resulted in a significantly improved estate, which benefits staff, carers and service users.

As with any re-development there was a period of transition, with temporary arrangements put in place while construction work was undertaken. This work was completed last year and it was very pleasing to showcase the facilities in October 2011 when they were officially opened by Lynda Bellingham.

Christine Boswell, Chief Executive Rotherham Doncaster and South Humber NHS Foundation Trust.

Alan Pearman's original letter.