Too Flexible or Too Formal?
Exploring community governance in the age of Localism & the Health & Social Care Act
28th January 2012, Action Stations, Historic Dockyard, Portsmouth,
10.00am to 1pm
Welcome
Zoe Gray (Chair) (CEO Learning Links ) James Sandy (Community Engagement PCC) Steve Taylor(Project Officer) (PCC) Amy Drahota, Aging Network Facilitator, UoP Julie Perry, Learning Links Tony Horne ,Strategic Healthcare Projects,UoP
Too flexible or too formalLocal Healthwatch Development Partnership: who are we?
Aims/format of the morning :
To begin to build the governance arrangements for the new local Healthwatch Portsmouth……
Two part event : initially hearing from other organisations to get
us thinking about some of the issues and
Asking you to help us with the design.
Too flexible or too formal?
NHS Organisational landscape post Health and Social Care Act 2012:
Its complicated !
Too flexible or too formal
Context: The big society Agenda aims:
To unleash entrepreneurial spirit Give communities more power Encourage communities to take an active role
in their communities Transfer powers from central to local
government/open government Support cooperatives, mutuals’ charities and
social enterprise.
Too flexible or two formal?
Healthwatch: the new local consumer champion for health and social care
Comes into being from 1/4/13 Seeking to involve patients /users/carers and the wider
public as stakeholders in in health and social care Working on a firm evidence base –gathering local views
on health and social care Engaging with the community and individuals Working with the NHS /LA and all interested others –to
improve care pathways. Inspection powers/rights to visit services to monitor
service delivery
Too flexible or too formal
Local Healthwatch (continued)
Individual NHS complaints advocacy
Signposting and advice to help make choices in health and social care
Too flexible or too formal
Local Healthwatch is still emergent and lots of unanswered questions e.g.:
It’s a membership body ..but what does this mean?
How does it work with other organisations How does it prioritize a potentially huge agenda How does it really engage and involve the local
community
Too flexible or too formal
How will we establish and appoint to the permanent Board i.e. Chair /membership /constitution etc.?
What do we assume are members mandates/roles responsibilities?
Who /should we co opt to the Board ?(eg open invites to relevant stakeholders/partners
Should we establish sub committees /focus groups etc?..etc?etc..?
Too flexible or too formal
PDF Who are we?
PDF is a local User Led non political lobbying and campaigning group recognised by Portsmouth City Council and the Primary Care Trust amongst many others as a Consultative Disability Group.
PDF Membership consists of individual
members, members nominated by voluntary organisations, statutory organisations (who have no voting rights) and interested individuals.
What is our legal status PDF is a legally constituted registered
Charity, with a Memorandum and Articles of Association, including a set of standing orders.
PDF is also a Company Limited by Guarantee.
PDF also have a non-legal status as a User Led Organisation.
What are the benefits of a Legal Structure Clarity of purpose and structure Commitment of individuals as
Trustees/Company Directors Recognition by others specifically in terms
of accessing funding The requirement to operate as a business,
professionally and appropriately.
What are the disadvantages of a Legal Structure Reporting responsibilities to the Charity
Commission and Companies House Requirement to operate under all
employment, health and safety laws etc. The impact of government regulations
changes to working hours, holiday requirements, pensions and redundancy.
The Red Tape environment
PDF simple Organisational Structure
PDF TRUSTEE BOARD
PDF CORE STAFF
PDF PROJECTS
FRANK SORRELL CENTRE
PDF PRINCIPLE OFFICER
What is a User Led Organisation (ULO)
There are two fundamental premises for ULOs’ modelled on Centres for Independent Living:
• that their work is underpinned by a social model of disability perspective
• that the organisation’s constituents constitute the majority of the governing and other decision making bodies.
ULO organisational characteristics provides support to enable people to exercise choice
and control is a legally constituted organisation has a minimum of 75 per cent of the voting members on
the management board drawn from the organisation’s constituency
is able to demonstrate that the organisation’s constituents are effectively supported to play a full and active role in key decision-making
has a clear management structure
ULO organisational characteristics (2)
has robust and rigorous systems for running a sustainable organisation (e.g. financial management/contingency planning)
is financially sustainable as there will be no ongoing central government funding
has paid employees, many of whom must reflect the organisation’s constituency
identifies the diverse needs of the local population and contributes to meeting those needs
is accountable to the organisation’s constituents and represents their views at a local level
ULO organisational characteristics (3)
supports the participation of its constituents in designing, delivering and monitoring of the organisation’s services
works with commissioners to improve commissioning and procurement.
What do we do ?
Our Aim is to promote the care, welfare, interest, education and advancement of disabled people their families and personal assistants and their independence and inclusion within the community of Portsmouth and the surrounding areas.
We work with service providers and other disability organisations to ensure that disabled people get the same rights and facilities as everyone else.
How do we do it?
We facilitate consultation with our members
We work in partnership with Portsmouth City Council and other Service Providers
We provide and promote conferences on disability
We inform service providers of preferred delivery of services
We identify the lack of or gaps in services We advise on disability access issues
How do we do it?
We monitor services for good practice
We identify key topics of interest to and for our members in order to incorporate into existing working groups or new groups as required.
We signpost individuals and organisations to other relevant services/organisations
Where do we live ? At our fully accessible Frank Sorrell Centre, with a
conference room, two interview rooms, three accessible toilets, accessible kitchen and ample car park.
PDF has been gifted these premises from the Frank Sorrell Trust which in 1983 opened the building as a Disabled Living Centre.
PDF has had a very productive partnership with the Trust as the way we use the building is in total accord with their original aims, which is why the building has been given to us.
What else do we do? PDF manages the DIAL (Disability Information
Line), which is linked to the national DIAL network.
PDF manages the Shopmobility Scheme running from Arundel Street Portsmouth.
PDF manages the Portsmouth Parent Voice Coordinator, on behalf of a group of disability organisations, as part of the Aiming High for Disabled Children Agenda.
PDF supports the Get Together group which is a version of the Duke of Edinburgh award for people with LDD.
Governance Model at Portsmouth Hospitals NHS Trust
Peter Mellor, Company Secretary
January 2013
Page 3104/12/2023
Statutory Duties – 2006 & 2012 Legislation 2012 adds to existing duties
Duty to hold non-executive directors, individually and collectively, to account for the performance of the Board of Directors
Duty to represent the interests of the members of the Trust as a whole and the interests of the public
Page 3204/12/2023
Membership
Public, patient /carer, staff constituency 14yrs age minimum Public meetings Vote Public Benefit Corporation Greater say in how services are provided
Page 3304/12/2023
Additional Rights and Powers One or more Directors to attend, when required, Council meeting for the purpose of
providing information about the Trust’s performance of its functions or the director’s performance of their duties;
‘Significant transactions’ must be approved by Governors – description/definition of significant transaction can be included in constitution;
Council must approve intention to merge or acquire; Must decide whether the private patient work would significantly interfere with the
trust’s principal purpose; Governors must approve any proposed increase in private patient income of 5% or
more in any one financial year; Amendments to the constitution must be approved by the Council of Governors
Approval needed by at least 50%
Page 3404/12/2023
Additional responsibilities for the Trust A copy of the agenda of each meeting of the Trust
Board to be sent to the Council of Governors;
After each meeting of the Trust Board, a copy of the minutes must be sent to the Council of Governors.
Page 3504/12/2023
Further non-statutory Duties for Governors To act in the best interests of the trust and to
adhere to its values and code of conduct; To hold the board of directors collectively to
account for performance and ensure that the board of directors acts so that the trust does not breach the terms of its authorisation;
To regularly feed back information about the trust, its vision and performance to the constituencies or stakeholder organisations that either elected or appointed them.
Page 3604/12/2023
Board of Directors
At least half of the Board of Directors - Non -Executives
Non-Executive Directors to be member of public or patient constituency
Non-Executive Directors appoint/remove Chief Executive
Register of interests of directors
Page 3704/12/2023
Defining structures and processes that work best – decide how best to organise themselves to complete their statutory duties and to support the governance model through changes of Governors;
Council of Governor meetings Joint meetings between governors and directors Subgroups Meeting organisation
Page 3804/12/2023
Supporting the delivery of statutory duties – full understanding of what they are – not to seek operational management of the Trust – hold board of directors to account, via the non-executive directors;
Appointment of Chair and NEDs Approval of appointment of CEO Approval of appointment of auditor Setting remuneration of Chair and NEDs Holding Board of Directors to account Communicating with members
Governing the Students’ Union
The overview• Registered charity that is governed separately to the university
• Regulated by the University AND the charity commission
• Funded by the University of Portsmouth (c935,000), commercial trading (c100,000) and membership fees (c260,000)
• Managed by permanent staff and represented by student officers
• Governed by a Board of Trustees – 5 sabbaticals, 3 students, 3 externals, 1 university nominated
• Provides representation, sports, societies, student media, volunteering and a small amount of trading activity
• Turnover of about £1.7M
Some engagement statsActivity 2008/09 2010/11 2011/12
Athletic Union memberships 4,128 2,850 2,959
Athletic Union clubs 48 34 35
Societies memberships 3,178 3,767 3,503
Societies 68 90 90
Student media volunteers Not measured 1,121 (sign-ups) c250 contributors
Community volunteers Not measured 222 384
Community volunteer hours Not measured 4,056 4,991
RAG money raised Not known 26,031 73,000
Election turnout 2,657 4,122 5,027
Unique visits to UPSU.net during October Not known 28,798 44,447
Student satisfaction 64% N/A 76%
Our vision“A positive impact with
every Portsmouth student”
Our strategic themes 2011 - 14Innovation & growth
The local community
Stakeholders Finance & resources
Quality
Our valuesInclusivity Member
focusStudent leadership
Honesty CourageTransparency
Who runs the Union?• Student officers are the face and voice of the organisation
• Union services managed by permanent staff
• Political leadership = President
• Operational leadership = Chief Executive
• The Board of Trustees set strategy and provide the Chief Executive with work plan and budget
• Students set policy via general meetings and student council
• The Board of Trustees is the most senior authority
Organisational model
Uni
on D
emoc
racy
Stud
ents
/
mem
bers
Refe
rend
a /
Elec
tions
Gen
eral
Mee
tings
Stud
ent C
ounc
il
Sabb
atic
al O
ffice
rs
Pres
iden
t
Union G
overnance
Board of Trustees
Sub Comm
ittees / PSUT
Board
Deputy Chair of the
Board
Chair of the Board
Union Operations
Chief ExecutiveSenior Management Team
ManagersCoordinators / Front line
staff
The Trustees hold management to account, performance
manage the Chief Executive, scrutinise the operational work of the Union and act as guardians
of the Union’s vision and values
The democratic structures inform and guide the operational work of
the Union, elect the sabbatical officers and the Chair of the Board. The democratic structures pass
policy that provides the boundaries within which the Union’s work is
carried out.
The Trustees are ultimately accountable for everything that happens in the Union; they are responsible for upholding the law and overseeing management. The democratic structures are responsible for
setting the policy framework within which the Union operates.
A balance between Governance and Information
The Board satisfy themselves that they have the right tools to govern effectively. These include:
• A defined scope of delegation for operational activities• An annual agenda cycle for Trustees business• A range of sub-committees to scrutinise and oversee high risk areas
The Board also receive information that provides context to decision-making and a better idea of the impact they have. This includes:
• An annual cycle of presentations from Union departments / activities• Annual satisfaction survey reports from beneficiaries, funders and staff
How do beneficiaries influence the organisation?
• Students influence the Union both formally and informally, to ensure that we remain student led
Formal
• 8/12 of our Board are students• Over 5,000 students vote in our elections to choose our 5 sabbatical officers• Student Council• General Meetings• Annual Members Meeting• Referenda• Student Committees
Informal
• Regular satisfaction surveys• Feedback through our services• Participation rates in our activities and services• Talking to us!
Examples of ‘bottom-up’ change
• Creation of the ‘DCC’, gender neutral toilets, using locally sourced fish within the whole University,
Satisfying funders vs. satisfying beneficiaries
We have sometimes found that a tension can exist between these stakeholders
Can funders and beneficiaries objectives be aligned?
Can you satisfy both?
Are they mutually exclusive or not?
‘Like a partnership between a cat and a mouse’?
Questions?
From April 2013
AdvocacySignpostingAdvice
Health & Wellbeing BoardRight of entry
RepresentEmpowerInform
Healthwatch
A responsibility for NHS health care
and social servicesFacilitate and
influence consultation
Specific Enter & View Powers
Abolished April 2013
Local Involvement Networks (LINk)
“a new system of patient and public
involvement in health for England
involving traditionally hard to
reach groups"
CPPIH recruited members to the
Forums
Abolished in 2008
Public & Patient Involvement Forums
Local Authority representatives, nominees from local Third Sector bodies and members appointed by the Minister in response to advertCo-opt non-voting members to the Council.Abolished in 2003 (in England)
Community Health Councils
Evidence & Research
Governance & Membership
Outreach & Intelligenc
e
Healthwatch
Portsmouth (HWP)
HWP Governance Model (A)
Signposting
3 Deliver
y Partner
s
Health & Wellbeing
Board
Healthwatch Network Members
Healthwatch Community Researchers
Healthwatch Governors
HWP Board•Corporate body•Oversees “Enter & View” powers•Commissions ad-hoc research groups•Represents HW
Advocacy
Public involveme
nt
3 Service
User Groups
4 Elected Govern
ors
1 Rep
Healthwatch
Portsmouth (HWP)
HWP Governance Model (B)
Signposting 3
Delivery
PartnerAdvisor
s
Health & Wellbeing
Board
Healthwatch Network Members
Healthwatch Community Researchers
Healthwatch Governors
HWP Board•Corporate body•Oversees “Enter & View” powers•Commissions ad-hoc research groups•Represents HW
Advocacy
Public involveme
ntMembership
Elects
7 Govern
ors
1 Rep
Healthwatch
Portsmouth (HWP)
HWP Governance Model (C)
Signposting
3 Deliver
y Partner
Health & Wellbeing
Board
Healthwatch Network Members
Healthwatch Community Researchers
Healthwatch Governors
HWP Board•Corporate body•Oversees “Enter & View” powers•Commissions ad-hoc research groups•Represents HW
Advocacy
Public involveme
nt
Membership “Senate” of 10
Governors
5 Membe
rs
1 Rep
2 Reps
Local Healthwatc
h
Community Intelligence
Strategic Direction
Public Scrutiny
HW Engla
nd
CQC
Health & Wellbeing
Board
Health Overview &
Scrutiny Panel
NHS NCB
Signposting
Advocacy & Complaints
Public & User Involvement
Strategic Commissioning Board
PCC/Public Health/CCG
City wide organisations
Democratic Challenge
Policy development
Task group investigation
Enter & View Powers
Information & Attendance Powers
Cross Referral
Sec. Stat
e
One Seat