Loughborough University postgraduate programme in healthcare governance – next intake November 2012

February 7, 2011

This well established and popular part-time postgraduate programme in healthcare governance, run by Loughborough University School of Business and economics, will take its next intake in November 2012.

The programme accepts anyone interested in healthcare governance and with suitable qualifications and/or experience to undertake postgraduate level study. It is not always a necessity to have a first degree.

Students can study for a postgraduate certificate, postgraduate diploma or Master of Science (MSc) degree in healthcare governance. The full MSc degree takes a minimum of 2 years by part-time study and includes modules on corporate governance in healthcare, clinical governance (including patient safety) and managing healthcare risk, together with a dissertation on any healthcare governance related topic.

For further information, click here.

NHS accounts – revised guide for NHS non-executives and governors

April 30, 2010

The Audit Commission has updated its guides to NHS accounts for non-executive directors and foundation trust governors. There are separate guides for NHS trust/PCT/NHS foundation trust accounts for non-executives and a further guide to NHS foundation trust accounts for governors.

According to the Commission “Making sense of a set of accounts can be difficult in any sector, but in the NHS the challenge can be particularly demanding. [The new guides]…….make the task a little easier.”

The guides steer the reader step by step through the annual accounts. They help equip non-executives and, in the FT governors guide, FT governors to ask pertinent questions and challenge the various entries. They provide the reader with explanations of the primary statements and notes. They clearly explain the role of the non-executive and the external auditor. Each guide also includes an invaluable list of questions to help understand and gain assurance on the detail of the financial statements.

The new guides have been rewritten to reflect the requirements of the newly adopted International Financial Reporting Standards.

Download the 2010 revised guides here.

Charity Commission disputes Department of Health ruling on NHS charities’ accounts

October 31, 2009

According to an article in ThirdSector (27 October 2009), The Charity Commission appears to be heading for a showdown with the Department of Health (DH) over accounting procedures for NHS charities in England and Wales.

Senior Department of Health official Janet Perry has told health authorities that any NHS body that is the sole trustee of a charity must move that charity’s assets onto its own balance sheet.

Her position relies on a recently introduced international public accounting standard that says public sector bodies must consolidate the accounts of any organisations they control that have an income above a certain level. The DH estimates this to be about 30 of the 282 NHS charities that have NHS bodies as sole corporate trustees.

But the Commission is planning to write to the health authorities telling them they must not consolidate NHS charities’ accounts. Its official guidance says it is “wholly inappropriate” that charitable funds should ever appear on the balance sheets of public sector organisations, because it gives the impression that charitable assets are controlled by government.

Nick Brooks, head of not-for-profit at accountancy firm Kingston Smith, called the DH position “accounting dogma gone barking mad”. He said: “Consolidation should occur only if there is ownership. If you would not own the funds if the other organisation was wound up, you should not consolidate those funds into your own accounts.”

Jonathan Brinsden, a partner at specialist charity law company Bircham Dyson Bell, said he believed the commission was right to take a stand against the DH, but that corporate trustees would now be left in an invidious position.

“If I was in this situation, it would be impossible to know which authority to listen to,” he said. “Nor do I know how this conflict can be managed.”

A spokeswoman for the Commission said: “We don’t agree with the interpretation in the Department of Health’s letter. We will be following up with the Department of Health on this issue accordingly, and will also be writing to strategic health authority directors of finance to make our position clear.”

Source: ThirdSector – click here.

“Efficient use of resources and good quality services go hand in hand” – new finance guide for doctors

July 10, 2009

The Audit Commission and Academy of Medical Royal Colleges have published A guide to finance for hospital doctors.

In the publication, they state that “there are many examples where clinicians have led change and improved services, through taking greater responsibility for managing the money available to them. This is not about focusing on cost and cost alone, but how best money can be used to improve the quality of care, combining operational and clinical effectiveness. Efficient use of resources and good quality services go hand in hand.”

Healthcare Governance Review believes that the guide, whilst written for doctors, may be of interest to board members and managers.

Download A guide to finance for hospital doctors here.

Health Committee reckons ‘FTs have some proven strengths, but much is unknown’

October 19, 2008

The House of Commons Health Committee has published a short report on Foundation Trusts (FTs) and Monitor.

The report finds that FTs have some proven strengths. They have performed well financially and generated surpluses. They have been high performers in routine NHS process quality measures. However, much is unknown. With a lack of objective evidence, it is not clear whether their high-performance is the result of their changed status, or simply a continuation of long term trends, since the best trusts have become FTs.

Key aims of FTs were the promotion of innovation and greater public involvement. While the Committee was provided with examples of good practice in both of these areas, again there was a lack of
objective evidence. 

In relation to public involvement, while the Committee saw some examples of good practice in FTs’ new governance arrangements, in general they seem to be slow to deliver benefits and despite numerous small studies, there remains a lack of robust evidence of their effectiveness. The governance process currently costs circa £200,000 per trust, giving a total of around £20 million per annum. We recommend that the Department of Health make it a priority to evaluate rigorously the FT governance system and to give guidance on best practice so that public money as well as members’ and governors’ time can be used as effectively as possible to improve services.

The Committee also found that while FTs do not appear to have yet exploited the full potential of their autonomy, witnesses from FTs told them that the ability of boards to make decisions more quickly was important and made a ‘tangible’ difference to the dynamic of their organisations. Unfortunately, concerns persist about what level of Government intervention in FTs’ affairs is legitimate, and the Government must clarify what the appropriate levels of intervention are.

Finally, the Committee found that Monitor’s application process and regulatory regime seems to be well regarded. However, a complex regulatory environment of other organisations also surrounds FTs, and in particular there is potential duplication between the Healthcare Commission and Monitor both of which evaluate the quality of FTs’ services.

Download the Health Committee report Foundation trusts and Monitor here.

‘Credit crunch’ could see government ‘raiding’ foundation trust surpluses

October 12, 2008

The Guardian newspaper last week ran a short article looking at How the financial crisis will affect the health service.

The ‘credit crunch’ is biting and is likely to squeeze public expenditure. Consequently, according to Professor Robert Harris at Monitor, “Foundation trusts need to budget for lower income streams.” He says that “Many are in a good position because they have made efficiency savings. They should try to insulate themselves by investing in a service they are good at to attract more custom in the future.”

Chris Ham, professor of health policy and management at Birmingham University, is concerned that the government may attempt to claw back surpluses that the government has encouraged them to build up for future investment in patient care. He advises boards to take “every possible step” to protect their surpluses, including spending them to avoid them being raided by Treasury.

Bromley Hospitals NHS trust publishes independent financial management and governance review report

October 1, 2008

According to Bromley Hospitals NHS trust’s latest annual report, “2007/08 has been a difficult and challenging year for the Trust.”

The year ended with a deficit of £17.9million. This, together with an £87M accrued cash debt, resulted in Bromley becoming one of the 17 most financially challenged Trusts in the country.

The current trust board, in an attempt to “demonstrate public accountability” for historically poor financial performance, commissioned an independent review of financial management and governance. The review report states “The Trust Board was ineffective, until 2007, in scrutinising the financial information provided. This led to a series of failings in the financial management and high-level governance of the Trust.”

As a result, until 2007/8 the review finds that “the Trust Board did not meet its conjoint responsibilities for effective clinical care and effective financial management, favouring the former at the expense of the latter. Insufficient attention was paid to the many early warnings received by the Trust Board about its worsening financial position.”

The extent to which the report attempts to leave no stone unturned is summed up by its author, Michael Taylor, thus: “This Review has revealed various and serious failings. I recognise that many of the findings will be unpalatable to some recipients of this Report. I fully expect that attempts will be made by certain parties to distance themselves from the findings, find faults with my interpretation of the evidence, or the methodology for the progression of the Review.”

The report is extensive at 156 pages plus a total of 30 appendices. There is undoubtedly much than can be learned from Michael Taylor’s review that can be translated into lessons for other trust boards. The report and its appendices can be downloaded here.

It is interesting to note that former CEO at Bromley, John Watkinson, whilst being applauded for his concerns for patient care, is nevertheless accused of having breached certain provisions within the NHS Code of Conduct and Accountability. Mr Watkinson left Bromley at the end of 2006 to become CEO at the troubled Royal Cornwall Hospitals Trust (RCHT). He is apparently now on extended leave from RCHT pending an investigation into its governance and financial management. For further information, click here.

UPDATE 22 MARCH 2009 – Readers might like to download a document presented to the board of the Royal United Bath NHS Trust in January 2009 that demonstrates how that particular trust has addressed the issue of learning from the Bromley report. Click here.