Transferring community services to a foundation trust allows one PCT to focus on choice, say Jamie Foster and Jane Gateley

The transfer of the community services of NHS Barking and Dagenham to North East London Foundation Trust in July last year for 21 months - until March 2011 - is an innovative response to the Department of Health’s Transforming Community Services programme.

Our ambition is for the people of Barking and Dagenham to be healthier and happier, with access to world class health services in local communities

It was the first time in London, and only the second time nationally, that a community healthcare provider has joined up with a foundation trust through a process involving the primary care trust, strategic health authority and Monitor.

The transfer was also the first case to be reviewed by the NHS cooperation and competition panel, which highlighted the positive steps taken by the PCT to facilitate patient choice and competition.

The move is a milestone in the PCT’s progress towards becoming a world class commissioner, allowing it to focus on commissioning the best quality services for the local population in line with the change in the role of PCTs envisaged in the world class commissioning and Transforming Community Services programmes.

The PCT will now concentrate on developing its strategic planning capabilities and introducing greater patient choice and competition into community services, while the foundation trust focuses on providing world class community health services.

At the end of the foundation trust’s period of hosting the services there will be a competitive process to commission the best possible services for patients. At that time the trust may bid to run some or all of the services longer term.

NHS Barking and Dagenham chief executive Stephen Langford says: “Our ambition is for the people of Barking and Dagenham to be healthier and happier, with access to world class health services in local communities.

“Externalising our provider services to a foundation trust will have two key benefits: it will stimulate the market by bringing another local provider in, ensuring greater competition locally; and it will enable NHS Barking and Dagenham to strengthen local procurement processes and deliver Transforming Community Services”.

Effective framework

Community services are a major part of the NHS and have a fundamental role to play in responsive care based on patients’ needs closer to home.

Monitor’s risk based system of regulation coupled with the Care Quality Commission’s checks and controls means that foundation trusts need to show an effective framework to continuously improve the quality of their services and safeguard high standards of care.

North East London Foundation Trust aims to provide an environment in which excellence in clinical care will thrive within an organisational culture that fosters communication and teamwork and engages patients and staff in order to achieve world class provision.

Continual assessment

Having divested itself of its provider functions the PCT will be able to focus on continually assessing the needs of patients and the local health economy to address more effectively the local population’s concerns, issues and demands and provide a more targeted response to their particular needs.

As the PCT’s ability as a world class commissioner grows, so will its expectations of providers

As part of the switch, the PCT’s staff transferred to the foundation trust under the Transfer of Undertakings (Protection of Employment) Regulations 2006. For staff this means continuity in their existing terms and conditions of employment, being able to access NHS professional development opportunities and, as they have transferred to an NHS body, the right to remain in the NHS pension scheme.

The transferring staff are reassured they are working for a sustainable organisation within the “NHS family” which will provide them with support and resources to become world class practitioners and will empower and motivate them on the understanding that they are central to high quality community services.

The PCT ensured the workforce was involved throughout the development and implementation of the transfer plans.

“For patients it is business as usual. However, the team are aware of the changes,” said team leader of community coronary heart disease service Dawn Gough. “We have strong leadership which will support us to develop community health services within North East London FT and clinicians who are dedicated at all levels.

“The challenges ahead are exciting and daunting as we enter a new phase for healthcare. But I do believe that as a team we can overcome them, move forward and be the best.”

Staff will play a major role in the transformation of the community services both during and at the end of the 21 month contract period. This will include participating in market reviews and giving feedback on levels and types of services and patients’ needs.

The PCT’s transfer of services and staff to the FT is the starting point for staff to unlock their potential and drive future service improvements.

Benefits

For staff

  • Continuity of terms and conditions of employment
  • Retention of NHS pension scheme rights
  • Professional development opportunities
  • Assurance to work for a sustainable employer within the “NHS family”
  • Service and business continuity minimises disruption to the workforce

For patients

  • Service continuity
  • Helps the move towards integrated, flexible and seamless care
  • Efficiency, innovation and development
  • High quality care and responsive services
  • Provision of care closer to the community
  • Public accountability and engagement

Community services reform

  • More effective commissioning is crucial to the transformation of community care into a poly-system
  • Community services are critical to delivery of improved services for patients and local communities
  • Staff are critical to driving change to improve quality outcomes and access to care
  • Investment in staff and infrastructure is a requirement to develop and deliver top class out of hospital care
  • The transfer of the PCT’s community services to North East London FT was driven by all of these principles