Non-Executive Director, Camden and Islington NHS Foundation Trust

Candidate Brief, September 20161

Non-Executive Director, Camden and Islington NHS Foundation Trust

Candidate Brief

Brief for the position of

Non-Executive Director, Camden and Islington NHS Foundation Trust

September 2016

Contents

BackgroundPage 2

Job DescriptionPage 10

Person SpecificationPage 14

Application & Selection ProcessPage 16

Appendix I: Terms and ConditionsPage 18

Appendix II: The Nolan PrinciplesPage 30

Background

Camden and Islington NHS Foundation Trust is an outward looking ambitiousorganisation with a strong reputation for providing high quality, safe and innovative care to our service users and their families. In 2008, we became the first Care Trust to achieve Foundation Trust status.Our income for 2014/15 was £141million and we employ approximately 1,700 people, making the Trust the largest provider of mental health and substance misuse services to residents within the London Boroughs of Camden and Islington. We also provide substance misuse services in Westminster and substance misuse and psychological therapies service in Kingston. We have two inpatient facilities at Highgate Mental Health Centre and St Pancras Hospital, as well as community based services throughout the two boroughs of Camden and Islington. The Trust provides liaison psychiatry to the three acute hospitals across the area – The Whittington, Royal Free and University College.

Mental health need

In 2015, there were 462,000 people living in Camden and Islington. Each year the population is forecast to grow by 7,900 people (1.71%). This growth is driven by the difference between local births and deaths (3,600 people per year, 0.78%); net migration out to other parts of the UK (minus 4,050 people per year, -0.88%); and, net immigration from overseas (8,350 people per year, 1.81%). Over the ten year period from 2015 to 2025 the population is forecast to grow, in Camden from 237,000 to 264,000 (11% cumulative growth); and, in Islington from 225,000 to 254,000 (13% cumulative growth).

With three main rail terminals (Kings Cross, Euston, St Pancras International), there are a large number of new arrivals to London. As expected some people arriving from across the UK and abroad, have mental health and substance misuse problems and present to A&E or to the police, from where they are transferred to C&I for treatment and support.

According to the Index of Multiple Deprivation 2010, Islington is the 14th and Camden the 74th most deprived Local Authorities in England. The North-West part of Camden is more affluent and the remainder of Camden and the whole of Islington have low financial capability with small pockets of higher financial capability.

Islington has the highest and Camden the third highest prevalence of serious mental illness in London. Islington has the highest prevalence of depression in London and Camden the seventh. The relatively younger population explains the lower prevalence of dementia. There are very high levels of co morbid conditions particularly substance misuse.

International reputation for research and education

C&I ranks 3rd across mental health Trusts nationally in the league table for Research Capability Funding; an indicator of success in attracting grants; The Trust researchers published 155 papers in peer review journals in 2014/15. As of April 2015, there were 25 joint research projects underway which total almost £22 million in funding. This substantial amount of joint research funding is facilitated by the large number of joint posts held between the Trust and University College London (UCL), with 12 of 33 honorary appointments being at professorial level. C&I delivers the largest national training and education programme for medical and clinical staff in mental healthcare;

The Trust is part of the UCL Partners (UCLP) Academic Health Sciences Network and the Collaboration for Leadership in Applied Health Research and Care(CLAHRC) and has extensive experience working with research funding bodies within the NHS such as the National Institute of Health Research (NIHR). Its particular strength is applied research, i.e. the translation of research evidence into the development of new models of service delivery and the improvement of existing models.

The Trust is developing an Institute of Mental Health (IoMH) with UCL. The St Pancras Site, which is the proposed site for the IoMH, is very well-located in terms of accessibility through transport links and is located within the area where there is the highest need for mental health services (particularly complex mental health services) in the UK. Its location is within a prime ‘research corridor’ in Central London.

Our Vision

Our vision is

“people who use C&I services will have the best possible prospect of recovery”

Our Strategic Aims

Our vision is underpinned by four strategic aims that are categorised under the headings Excellence, Innovation and Growth.

Our Shared Values

In 2012 the Trust in consultation with over 500 members of staff, service users and carers developed a set of shared values which underpin everything we seek to do as an organisation.

Our shared Trust values:

How our services are organised

We have organised our services into five divisions. These are:

• Community Mental Health;
• Recovery and Rehabilitation;
• Services for ageing and Mental Health;
• Acute; and
• Substance Misuse Services.

You can find out more about our services here

Executive Management Structure

The current executive management roles and portfolios together with further information about our Board of Directors can be viewed here.

Our Performance

We are proud of our achievements, but as part of our drive for excellence we continuously seek to improve the quality and safety of services, treatment outcomes and the service user and carer experience. 2014/15 saw continued success in delivering excellent services to our service users and carers.

Service Quality

The Care Quality Commission carried out a full inspection of the Trust in February this year assessing the Trust under the five domains of safe, effective, caring, responsive and well led. In the course of that inspection they observed core services, spoke to staff, service users and carers and looked in detail at patient record keeping. The full report of the inspection was issued on 21 June 2016 and gave the Trust an overall rating of “Requires Improvement”. You can read the full report here.

The CQC noted that Camden and Islington Foundation Trust was “good” for caring with staff “showing good understanding of the personal, cultural and religious needs of patients”. In addition Older Peoples community services were rated as “good” across all the domains as were services for those with Autism or Learning Disabilities.

Our Finances

The regulator of NHS Foundation Trusts, NHS Improvement, awards a Continuity of Service rating to Trusts. This is a measure based on the organisation’s liquidity, and its ability to cover its public dividend capital payments from its earnings. C&I delivered a rating of 3 for 2015/16. The financial climate continues to be challenging for mental health services. The Trust has worked hard to deliver its cost improvement programme. In 2015/16, the Trust delivered a normalised surplus of £0.7m. The five CCG’s have begun work that aims to achieve clinical and financial sustainability – the financial challenge for the sector as a whole is in the region of £1.2 billion over the next five years.

Camden and Islington Clinical Commissioning Groups (CCGs) remain in financial balance but they are very clear about the challenges ahead. The CCG’s in boroughs to the north of the Trust have been in significant financial difficulty, the analysis has shown they spend significantly more than comparator boroughs on acute care, with poor primary care and in two of the boroughs low spend on mental health. Both Camden and Islington Local Authorities, with whom the Trust is closely connected, are facing further budget reductions in 16/17.

Strategic Context and Transformation

The Trust is based in north central London whose five boroughs are now considered as a strategic planning group (SPG). Within the SPG there are three mental health and four acute Trusts. Community services are provided by four Trusts, two of whom are not based in north central London. Barnet, Enfield and Haringey MH Trust provides services to these boroughs and medium secure services for Camden and Islington. The Tavistock and Portman NHS Foundation Trust provides some specialist adult outpatient based mental health services and Child and Adolescent mental health services for Camden. The four acute Trusts are UCH, Royal Free (who now provide services from Royal Free, Barnet and Chase Farm Hospitals), North Middlesex and Whittington, which provides Child and Adolescent mental health services for Islington.

The Trust is fully engaged in work within the North Central London sector to develop a North Central London Sustainability and Transformation Plan (STP). Part of this work is a specific mental health workstream, led by Camden CCG.

Acknowledging that there are significant mental health needs in the five boroughs of North Central London, and that Camden, Islington and Haringey all have higher than average prevalence of mental health problems, the work on the STP for mental health sets out the following shared ambitions:

North Central London Sustainability and Transformation – shared ambitions

• To transform the nature, value and outcomes of local services close to home, through building partnerships that deliver around the needs of individuals and communities.

• Work with individuals and communities to support good mental health resilience.

• Build high quality specialist services for those with complex and intensive needs, that are as close to home as possible, and allow connection to local community services.

• Develop alternative responses for service users with Mental Health needs who do not respond, or prefer not to engage with current commissioned services.

• Develop systems of early interventions which ensure people with Mental Health crises receive a prompt and appropriate response.

• Breakdown barriers between mental health physical health in a way which delivers better outcomes for patients and better value to the system.

• Workforce training to better equip health and social care workers to support patients with Mental Health needs.

The Trust is part of the workstreams developing this approach, and has developed a revised Clinical Strategy for Camden and Islington. This sets out the Trust’s aims to promote recovery, resilience and independence, based around a service model that delivers services in practice-based services and specialist care pathways. There are ten overarching themes and principles on which this clinical model is based:

• We will co-produce with our service users and carers their treatment and support
• We will work in a recovery-orientated way;
• We will offer evidence-based interventions;
• We will choose outcomes that measure things that matter to service users and carers and use these to shape our services;
• We will integrate with other services so that service users have their mental, physical and social needs met in a coherent way;
• We will prevent mental illness deteriorating or relapsing in all our service users and we will contribute to initiatives that prevent mental health problems in children and young people;
• We will equip all our clinical staff to address drug and alcohol problems;
• We will improve access to our services for everyone, regardless of gender, race, ethnicity, disability, sexual orientation and other protected characteristics;
• We will choose a quality improvement methodology and implement it; and
• We will grow our already strong interest in research.

The Trust is engaged in a number of integrated care initiatives’ across Camden and Islington boroughs. The Trust was part of a Haringey and Islington Vanguard bid, which although not successful, reached the final stages of the selection process. The work has continued to develop since then. The SPG has adopted and is developing value-based approaches to commissioning. The Trust is leading or very involved in a number of initiatives including an Integrated Practice Pathway for the whole population of people with Psychosis in Islington and Camden, a population based Dementia pathway in Islington, Frailty pathways in both boroughs and ‘RAID’ style service in three acute hospitals. The Trust has piloted primary care mental health services in Barnet, Camden and Islington and is also developing a service in Kingston.

We are strongly committed to working with others and to developing new processes and organisational forms which will produce better mental health outcomes for the populations we serve.

Board of Directors

Ms Leisha FullickChair

Mr Richard BroomanNon-Executive Director / Deputy Chair

Mr Paul CalaminusChief Operating Officer / Deputy Chief Executive

Ms Pippa AitkenNon-Executive Director

Dr Sue Goss Non-Executive Director

Ms Angela Harvey Non-Executive Director / Senior Independent Director

Ms Claire Johnston Director of Nursing and People

Dr Vincent KirchnerMedical Director

Ms Angela McNabChief Executive

Mr Patrick Vernon OBENon-Executive Director

Mr David Wragg Director of Finance

Mr Darren SummersDirector of Strategy and Business Development

Professor Tom Burns CBENon-Executive Director

Further Information

For more information on the Trust please visit our website at:

The role of the Board of Directors

The Board of Directors’ role is to provide active leadership of the NHS Foundation Trust within a framework of prudent and effective controls which enables risk to be assessed and managed

The Board of Directors is responsible for ensuring compliance by the NHS Foundation Trust with its license, its constitution, mandatory guidance issued by NHS Improvement, relevant statutory requirements and contractual obligations

The Board of Directors should set the NHS Foundation Trust’s strategic aims, taking into consideration the views of the Council of Governors, ensuring that the necessary financial and human resources are in place for the NHS Foundation Trust to meet its objectives and review management performance

The Board of Directors as a whole is responsible for ensuring the quality and safety of healthcare services, education, training and research delivered by the NHS Foundation Trust and applying the principles and standards of clinical governance set out by the Department of Health, the Care Quality Commission, and other relevant NHS bodies. The Board of Directors should also ensure that the NHS Foundation Trust exercises its functions effectively, efficiently and economically

The Board of Directors should set the NHS Foundation Trust’s values and standards of conduct and ensure that its obligations to its members, patients and other stakeholders are understood and met

All Directors must take decisions objectively in the interests of the NHS Foundation Trust

All Directors have joint responsibility for every decision of the Board of Directors regardless of their individual skills or status. This does not impact upon the particular responsibilities of the Chief Executive as the Accounting Officer. The Chief Executive should refer to guidance from Monitor on the responsibilities and obligations of the accounting officer (NHS Foundation Trust Accounting Officer Memorandum, April 2005)

The concept of the unitary Board refers to the fact that within the Board of Directors the Non-Executive Directors and the Executive Directors share the same liability. All Directors, Executive and Non-Executive, have responsibility to constructively challenge the decisions of the Board and help develop proposals on strategy

As part of their role as members of a unitary board, Non-Executive Directors have a particular duty to ensure such challenge is made. Non-Executive Directors should scrutinise the performance of the management in meeting agreed goals and objectives and monitor the reporting of performance. They should satisfy themselves as to the integrity of financial, clinical and other information, and that financial and clinical quality controls and systems of risk management are robust and defensible. They are responsible for determining appropriate levels of remuneration of Executive Directors and have a prime role in appointing, and where necessary removing, Executive Directors, and in succession planning

The Board of Directors will function as a corporate decision-making body, Executive and Non-Executive directors will be full and equal members. Their role as members of the Board of Directors will be to consider the key strategic and managerial issues facing the Trust in carrying out its statutory and other functions.

The Trust has developed a number of corporate governance documents on its website including a guide to its corporate governance framework and a handbook detailing all the standing committees of the Board of Directors. These can be found at the following link:

The Role of Governors

Foundation Trusts have Members and Governors. The Members elect the Governors. The role of the Governors will make sure that the views of local people and service users are heard by the management of the Trust. They will also inform Members about important decisions made by the Trust.

The Governors have a number of important powers; they appoint or remove the Trust Chair and Non-Executive directors, and decide on their pay. They also approve the appointment of the Chief Executive, advise the Trust on its strategic direction, advise the independent regulator about poor performance and appoint or remove the Trust's auditors. The Governors are not responsible for the day to day running of the Trust.

The Trust has developed a Governor’s Handbook which sets out more information on the Council of Governors committee and working group structure. This can be found at the following link:

council of governors Sub-Committee and Working Group Handbook.pdf