The must-read stories and debate in health policy and leadership.

Rocky relationship

Foundation trust boards have many key relationships, but one of the most important ones is likely to be with their governors.

In an ideal world, relations should be mutually supportive, giving both sides valuable insights and often a different perspective.

But not all trusts benefit from such perfectly harmonious relationships, with a review carried out for Surrey and Borders Partnership Foundation Trust laying out the problems which likely lurk in many trusts but are rarely voiced in public.

The review talked of a “breakdown of trust” and a “them and us” environment. Governors felt the board was defensive, while the board felt that the council misunderstood its motivation.

But do governors influence the board in the way they are meant to? The review – carried out by experienced mental health trust chair Marie Gabriel – suggested board members could provide only limited examples of how governor input impacted strategic thinking. The governors at SABP sometimes got too involved in operational matters rather than the broader picture, the board also claimed. 

To its credit, the trust has acted quickly in making changes to improve relationships and benefit from the insight that governors can offer – perhaps particularly important in mental health trusts.

But how many governors at other trusts will read the report and feel a pang of recognition? Not least in the complaint about papers for their meetings being “too lengthy, too full of graphs”.

NHS trusts outside London must look on in envy at the income generated by private patients in the capital.

The Royal Marsden FT made £121m through its private patient units in 2018-19, representing more than a quarter of its total income.

The figure was up from £104m the previous year, representing a 16 per cent rise.

The trust now accounts for 18 per cent of all private healthcare carried out by NHS organisations, a market which is dominated by London providers offering specialised services.

Great Ormond Street Hospital for Children FT, Imperial College Healthcare Trust, Royal Brompton and Harefield FT, and Moorfield Eye Hospital FT are the next biggest beneficiaries.

In comparison, the likes of Alder Hey Children’s FT and The Clatterbridge Cancer Centre FT made peanuts from private patients last year, with income of £200k and £2.4m respectively.

The two Merseyside trusts also have excellent reputations, and will see huge potential to try and market their services to overseas patients.