WHAT YOU TOLD US THIS YEAR The NHS Providers’ survey programme enables us to collect member views on key issues. We strive to ensure the data you provide is used to its full potential: utilising key messages to construct evidence-based consultation responses, raising awareness of the provider sector view in the media, supporting peer learning between members, and ensuring that our members’ voice is at the heart of all the conversations we are having. In 2014 over 200 trusts (over 90 per cent of our members) contributed to our survey programme. Below is a short review of how some of the information you provided made a difference.

OCTOBER 57 members responded to our annual remuneration survey, enabling us to provide all members with benchmarking data for executive and non-executive remuneration. Please contact us if you would like a copy.

NOVEMBER In advance of our annual conference and exhibition

we ran a series of polls in partnership with Sky News. The results were combined with a public survey carried out by

Ipsos Mori to underpin a keynote session and Sky News coverage of the event.

FEBRUARY Member data showed the costs of implementing the recommendations from Francis and Keogh far exceeded the additional funding given. Our analysis was used in the negotiations for a lower efficiency factor and widely quoted in the media.

JUNE NHS Providers supported the Dalton Review by evaluating the effectiveness of buddying arrangements in the NHS. Member interviews showed trusts are undertaking a wealth of mutually supportive activity. Our report was well received by the review team and is available to download from the Department for Health website. 6%

53%

41%

LIGHTc5 m0 y0 k40r157 g166 b171#9da6abPMS Cool Grey 6

PALEc5 m0 y0 k15r206 g216 b221#ced8ddPMS Cool Grey 2

MIDc15 m0 y0 k60r107 g123 b131#6c7b83PMS Cool Grey 8

DARKc25 m0 y0 k80r62 g80 b90#3e505aPMS Cool Grey 10

TABLEc5 m1 y2 k2r238 g243 b245#eef3f5PMS 7541

BLUEBERRYc100 m95 y0 k3r41 g57 b143#29398fPMS Blue 072

CHERRYc0 m100 y51 k22r192 g8 b72#c00848PMS 1945

SAFFRONc0 m52 y91 k0r247 g145 b49#f79131PMS 144

TOMATOc0 m83 y92 k0r240 g83 b45#f0532dPMS 1665

MAGENTAc12 m100 y0 k0r212 g14 b140#d40e8cPMS 233

MARINEc88 m53 y4 k0r44 g114 b179#1271b3PMS 660

MOSSc94 m13 y83 k44r0 g99 b63#00633fPMS 3425

JADEc79 m10 y46 k0r0 g168 b156#00a89cPMS 7473

Yes ■ No ■

Don’t know ■

Figure 16:Do you participate in any other improvement or benchmarking groups on a voluntary basis?(n=44)

0% 25% 50% 75% 100%

Patient experience(n=42)

Access(n=43)

[9pt regular] Safety(n=42)

Figure 13:If the e�ciency factor is greater than anticipated in your 2015/16 forward plan, please provide an indication of what impact this will have on patient care:

■ No impact■ Some impact■ Signi�cant impact

0%

25%

50%

75%

100%

(n=36)

Figure 3:What would be your projected 2015/16 year end position assuming:

■ Surplus■ Breakeven■ De�cit

E�ciency factor of 3%;

net de�ator of 0.5%

E�ciency factor of 4%;

net de�ator of 1.5%

E�ciency factor of 5%;

net de�ator of 2.5%

0%

[7pt bold axis numbers] 25%

50%

75%

100%

(n=36) [7pt regular - mid grey]

[9pt bold - mid grey] Figure A: [10pt bold] What would be your projected 2015/16 year end position assuming: [7pt regular - mid grey] (Data from 208 FTs and trusts)

■ Key [7pt regular]■ Key■ Key

[7pt regular]Column/item description

[7pt regular]Column/item description

[7pt regular]Column/item description

(n=36)

Figure 7:What would be your projected 2015/16 year end operating surplus/de�cit assuming:

-20

-30

-10

0

20

10

30■ E�ciency factor of 3%; net de�ator of 0.5%

■ E�ciency factor of 4%; net de�ator of 1.5%

■ E�ciency factor of 5%; net de�ator of 2.5%

£m

Role(n=48)

Chief Executive

[9pt regular] Other

Medical Director

13

18

15

Integrated

Ambulance

Community

Specialist

Mental Health

[9pt regular] Acute - DGH

Acute - large or teaching

13

1

3

4

1

14

11

Trust type(n=47)

0% 25% 50% 75% 100%

Monitor(n=43)

[9pt regular] TDA(n=23)

CQC(n=55)

Figure 11:How would you describe the overall approach of the regulators to scrutiny over the past two years? (5 = too much scrutiny, 1 = too little scrutiny)

■ 5■ 4■ 3■ 2■ 1

0% 25% 50% 75% 100%

Figure 12:In your view, to whom is your organisation most accountable?(5 = most accountable, 1 = least accountable)

■ 5■ 4■ 3■ 2■ 1

Regulators(n=48)

Parliament(n=44)

Commissioners(n=46)

Governors(n=37)

Wider public andlocal population

(n=46)

Figure 14:In your opinion, what impact have the regulators had on your organisation over the past 12 months? (Please choose up to 3 options)

Cost more in sta� and leadership time than expected, or in

previous years

Provided focus to strategic and operational planning

Caused a fear of punitive action among directors and sta�

Distracted the organisation from focusing

on agreed priorities

Provided insight to help the board ensure the

organisation is well led

Provided the board with robust information and insight to

drive quality improvement

No impact

Provided advice on competition issues

Provided the board with robust information and insight to

improve �nancial sustainability

Enabled the organisation to mitigate challenges across the

local health economy

E�ectively supported the organsiation

to recon�gure services

Don't know

Supported the organisation through a CMA

competition review

45%

36%

36%

29%

27%

15%

11%

7%

7%

7%

5%

2%

2%

(n=55)

Figure 15a:Has your organisation ever been sanctioned more than once for the same issue by di�erent regulators? ■ Yes■ No■ Don’t know

(n=55)13%

65%

22%

Figure 15b:Has your organisation ever been sanctioned more than once for the same issue by di�erent regulators? ■ Yes■ No■ Don’t know

(n=55)

13%

65%

22%

0

250

500

750

1000

(n=36)

Figure 6:Forecast turnover (£m)

2013/14 2014/15 2015/16

0

250

500

750

1000(n=36)

2013/14 2014/15 2015/16 2016/17 2017/18

Figure 5:Forecast turnover (£m)

Figure 4:Planned specialised commissioning income as % of turnover. (Data from 208 FTs and Trusts)

0%

25%

50%

75%

100%

Clatterbridge Cancer Centre

100%

LondonAmbulance Service

0.19%

Basildon and Thurrock

17.16%

0%

25%

50%

75%

100%

Figure 8:A&E patients seen within four hours:

■ 2013/14■ 2014/15

Week 521

(n=224)

Figure 1:The roles of the respective regulators are aligned?

2% 36% 9% 42% 11%

■ Strongly agree■ Tend to agree■ Neither agree nor disagree■ Tend to disagree■ Strongly disagree

(n=53)

Strongly agree

Tend to agree

Neither agree nor disagree

Tend to disagree

Strongly disagree

Figure 1:The roles of the respective regulators are aligned?

2%

36%

9%

42%

11%

(n=53)

0

125

250

375

500 Minutes(n=36)

Figure 2:What would be your projected 2015/16 year end position assuming:

Trusts with UCC/PCA ■Trusts without UCC/PCA ■

Minor patients treated in UCC

Minor patients treated in A&E area

Minor patients treated in

A&E majors area

187 236 237290

440

[8pt bold] Axis descriptor

[Axes - light grey

2pt line0.25pt divisions] [Arrows - light grey, 0.5pt line

Arrowhead - simple solid triangle]

[black, 0.5pt line]

[black, 2pt line]

[white, 1pt line]

[2pt lines]

[where too many items to use a range of colours,or all the same colour,you may apply a verysubtle gradient acrossall the colour segments]

95%

[Arrowed lines use perpendiculars and 90º angles]

[1pt white divisions]

0

10

20

30

40

50

0

10

20

30

40

50

0 10 20 30 40 50

WHAT ARE THE ROLES OF THE MAIN BODIES REGULATING NHS PROVIDERS?

providersNHS

NHS providers operate within a complex regulatory framework. There are three main regulators of NHS foundation trusts and trusts, but many other bodies exercise regulatory or monitoring functions that also affect NHS providers.

IN HEALTHCARE, REGULATION IS FUNDAMENTAL IN...● Assuring patients and the public that

agreed quality standards are met

● Giving NHS provider boards information to drive improvement

● Building confidence in the health and care system

IN HEALTHCARE, REGULATION IS FUNDAMENTAL IN...● Assuring patients and the public that

agreed quality standards are met

● Giving NHS provider boards information to drive improvement

● Building confidence in the health and care system

NHS PROVIDER BOARDS HAVE A KEY ROLE TO PLAY

● Showing strong local leadership and accountability, working with local partners and driving continuous improvement

● Encouraging learning cultures and empowering their staff

● Learning from each other through benchmarking and peer review

HOW MUCH DOES REGULATION COST?

● The combined budget of Monitor, CQC and TDA (2014/15) is £232.8m – roughly equivalent to running the South Western Ambulance Service for one year (£225m)

● NHS providers and other regulated bodies also dedicate considerable resources to ensuring compliance with agreed standards

HOW SHOULD REGULATION DEVELOP? 1 Recognise that NHS providers must be responsible for their own improvement

2 Insist on independent, proportionate and risk based regulation

3 Develop regulatory assurance that takes local context into account

4 Facilitate tailor-made solutions in distressed local health systems

5 Hold the regulators to account for providing value for money

at a glanceREGULATION OF NHS PROVIDERS

Regulators

Providers

Monitor is the sector regulator for

health and also licenses and regulates foundation trusts,

focusing on risk, governance and financial viability

The NHS Trust Development

Authority is not a statutory regulator,

but monitors the performance of

NHS trusts

The Care Quality Commission

is the independent quality regulator for health and

social care. It regulates and inspects the quality of

services

Professional regulators

(e.g. GMC and NMC)

Royal Colleges (e.g. RCP, RCS, RCGP)

Competition and Markets Authority

NHS Litigation Authority

Are organisations able to deliver essential services on a

sustainablebasis? Is the organisation

well led and accountable?

Are services caring, safe, responsive and well led and do they

produce good outcomes?

GOVERNANCE

QUALITYFINANCE

Commissioners

Sources: HSJ May 2014, SWASFT annual report 2013/14

■ Yes■ No■ Don’t know

(n=35)9%

74%

17%

■ Yes■ No■ Don’t know

(n=46)

48%

2%

50%

Yes ■No ■

Don’t know ■

(n=35)

Yes ■No ■

Don’t know ■

(n=46)

2%

48%

50%

LIGHTc5 m0 y0 k40r157 g166 b171#9da6abPMS Cool Grey 6

PALEc5 m0 y0 k15r206 g216 b221#ced8ddPMS Cool Grey 2

MIDc15 m0 y0 k60r107 g123 b131#6c7b83PMS Cool Grey 8

DARKc25 m0 y0 k80r62 g80 b90#3e505aPMS Cool Grey 10

Do you have a voluntary or informal buddying

arrangement with another trust

in place?

6%

53%

41%

LIGHTc5 m0 y0 k40r157 g166 b171#9da6abPMS Cool Grey 6

PALEc5 m0 y0 k15r206 g216 b221#ced8ddPMS Cool Grey 2

MIDc15 m0 y0 k60r107 g123 b131#6c7b83PMS Cool Grey 8

DARKc25 m0 y0 k80r62 g80 b90#3e505aPMS Cool Grey 10

TABLEc5 m1 y2 k2r238 g243 b245#eef3f5PMS 7541

BLUEBERRYc100 m95 y0 k3r41 g57 b143#29398fPMS Blue 072

CHERRYc0 m100 y51 k22r192 g8 b72#c00848PMS 1945

SAFFRONc0 m52 y91 k0r247 g145 b49#f79131PMS 144

TOMATOc0 m83 y92 k0r240 g83 b45#f0532dPMS 1665

MAGENTAc12 m100 y0 k0r212 g14 b140#d40e8cPMS 233

MARINEc88 m53 y4 k0r44 g114 b179#1271b3PMS 660

MOSSc94 m13 y83 k44r0 g99 b63#00633fPMS 3425

JADEc79 m10 y46 k0r0 g168 b156#00a89cPMS 7473

Yes ■ No ■

Don’t know ■

Figure 16:Do you participate in any other improvement or benchmarking groups on a voluntary basis?(n=44)

0% 25% 50% 75% 100%

Patient experience(n=42)

Access(n=43)

[9pt regular] Safety(n=42)

Figure 13:If the e�ciency factor is greater than anticipated in your 2015/16 forward plan, please provide an indication of what impact this will have on patient care:

■ No impact■ Some impact■ Signi�cant impact

0%

25%

50%

75%

100%

(n=36)

Figure 3:What would be your projected 2015/16 year end position assuming:

■ Surplus■ Breakeven■ De�cit

E�ciency factor of 3%;

net de�ator of 0.5%

E�ciency factor of 4%;

net de�ator of 1.5%

E�ciency factor of 5%;

net de�ator of 2.5%

0%

[7pt bold axis numbers] 25%

50%

75%

100%

(n=36) [7pt regular - mid grey]

[9pt bold - mid grey] Figure A: [10pt bold] What would be your projected 2015/16 year end position assuming: [7pt regular - mid grey] (Data from 208 FTs and trusts)

■ Key [7pt regular]■ Key■ Key

[7pt regular]Column/item description

[7pt regular]Column/item description

[7pt regular]Column/item description

(n=36)

Figure 7:What would be your projected 2015/16 year end operating surplus/de�cit assuming:

-20

-30

-10

0

20

10

30■ E�ciency factor of 3%; net de�ator of 0.5%

■ E�ciency factor of 4%; net de�ator of 1.5%

■ E�ciency factor of 5%; net de�ator of 2.5%

£m

Role(n=48)

Chief Executive

[9pt regular] Other

Medical Director

13

18

15

Integrated

Ambulance

Community

Specialist

Mental Health

[9pt regular] Acute - DGH

Acute - large or teaching

13

1

3

4

1

14

11

Trust type(n=47)

0% 25% 50% 75% 100%

Monitor(n=43)

[9pt regular] TDA(n=23)

CQC(n=55)

Figure 11:How would you describe the overall approach of the regulators to scrutiny over the past two years? (5 = too much scrutiny, 1 = too little scrutiny)

■ 5■ 4■ 3■ 2■ 1

0% 25% 50% 75% 100%

Figure 12:In your view, to whom is your organisation most accountable?(5 = most accountable, 1 = least accountable)

■ 5■ 4■ 3■ 2■ 1

Regulators(n=48)

Parliament(n=44)

Commissioners(n=46)

Governors(n=37)

Wider public andlocal population

(n=46)

Figure 14:In your opinion, what impact have the regulators had on your organisation over the past 12 months? (Please choose up to 3 options)

Cost more in sta� and leadership time than expected, or in

previous years

Provided focus to strategic and operational planning

Caused a fear of punitive action among directors and sta�

Distracted the organisation from focusing

on agreed priorities

Provided insight to help the board ensure the

organisation is well led

Provided the board with robust information and insight to

drive quality improvement

No impact

Provided advice on competition issues

Provided the board with robust information and insight to

improve �nancial sustainability

Enabled the organisation to mitigate challenges across the

local health economy

E�ectively supported the organsiation

to recon�gure services

Don't know

Supported the organisation through a CMA

competition review

45%

36%

36%

29%

27%

15%

11%

7%

7%

7%

5%

2%

2%

(n=55)

Figure 15a:Has your organisation ever been sanctioned more than once for the same issue by di�erent regulators? ■ Yes■ No■ Don’t know

(n=55)13%

65%

22%

Figure 15b:Has your organisation ever been sanctioned more than once for the same issue by di�erent regulators? ■ Yes■ No■ Don’t know

(n=55)

13%

65%

22%

0

250

500

750

1000

(n=36)

Figure 6:Forecast turnover (£m)

2013/14 2014/15 2015/16

0

250

500

750

1000(n=36)

2013/14 2014/15 2015/16 2016/17 2017/18

Figure 5:Forecast turnover (£m)

Figure 4:Planned specialised commissioning income as % of turnover. (Data from 208 FTs and Trusts)

0%

25%

50%

75%

100%

Clatterbridge Cancer Centre

100%

LondonAmbulance Service

0.19%

Basildon and Thurrock

17.16%

0%

25%

50%

75%

100%

Figure 8:A&E patients seen within four hours:

■ 2013/14■ 2014/15

Week 521

(n=224)

Figure 1:The roles of the respective regulators are aligned?

2% 36% 9% 42% 11%

■ Strongly agree■ Tend to agree■ Neither agree nor disagree■ Tend to disagree■ Strongly disagree

(n=53)

Strongly agree

Tend to agree

Neither agree nor disagree

Tend to disagree

Strongly disagree

Figure 1:The roles of the respective regulators are aligned?

2%

36%

9%

42%

11%

(n=53)

0

125

250

375

500 Minutes(n=36)

Figure 2:What would be your projected 2015/16 year end position assuming:

Trusts with UCC/PCA ■Trusts without UCC/PCA ■

Minor patients treated in UCC

Minor patients treated in A&E area

Minor patients treated in

A&E majors area

187 236 237290

440

[8pt bold] Axis descriptor

[Axes - light grey

2pt line0.25pt divisions] [Arrows - light grey, 0.5pt line

Arrowhead - simple solid triangle]

[black, 0.5pt line]

[black, 2pt line]

[white, 1pt line]

[2pt lines]

[where too many items to use a range of colours,or all the same colour,you may apply a verysubtle gradient acrossall the colour segments]

95%

[Arrowed lines use perpendiculars and 90º angles]

[1pt white divisions]

0

10

20

30

40

50

0

10

20

30

40

50

0 10 20 30 40 50

WHAT ARE THE ROLES OF THE MAIN BODIES REGULATING NHS PROVIDERS?

providersNHS

NHS providers operate within a complex regulatory framework. There are three main regulators of NHS foundation trusts and trusts, but many other bodies exercise regulatory or monitoring functions that also affect NHS providers.

IN HEALTHCARE, REGULATION IS FUNDAMENTAL IN...● Assuring patients and the public that

agreed quality standards are met

● Giving NHS provider boards information to drive improvement

● Building confidence in the health and care system

IN HEALTHCARE, REGULATION IS FUNDAMENTAL IN...● Assuring patients and the public that

agreed quality standards are met

● Giving NHS provider boards information to drive improvement

● Building confidence in the health and care system

NHS PROVIDER BOARDS HAVE A KEY ROLE TO PLAY

● Showing strong local leadership and accountability, working with local partners and driving continuous improvement

● Encouraging learning cultures and empowering their staff

● Learning from each other through benchmarking and peer review

HOW MUCH DOES REGULATION COST?

● The combined budget of Monitor, CQC and TDA (2014/15) is £232.8m – roughly equivalent to running the South Western Ambulance Service for one year (£225m)

● NHS providers and other regulated bodies also dedicate considerable resources to ensuring compliance with agreed standards

HOW SHOULD REGULATION DEVELOP? 1 Recognise that NHS providers must be responsible for their own improvement

2 Insist on independent, proportionate and risk based regulation

3 Develop regulatory assurance that takes local context into account

4 Facilitate tailor-made solutions in distressed local health systems

5 Hold the regulators to account for providing value for money

at a glanceREGULATION OF NHS PROVIDERS

Regulators

Providers

Monitor is the sector regulator for

health and also licenses and regulates foundation trusts,

focusing on risk, governance and financial viability

The NHS Trust Development

Authority is not a statutory regulator,

but monitors the performance of

NHS trusts

The Care Quality Commission

is the independent quality regulator for health and

social care. It regulates and inspects the quality of

services

Professional regulators

(e.g. GMC and NMC)

Royal Colleges (e.g. RCP, RCS, RCGP)

Competition and Markets Authority

NHS Litigation Authority

Are organisations able to deliver essential services on a

sustainablebasis? Is the organisation

well led and accountable?

Are services caring, safe, responsive and well led and do they

produce good outcomes?

GOVERNANCE

QUALITYFINANCE

Commissioners

Sources: HSJ May 2014, SWASFT annual report 2013/14

■ Yes■ No■ Don’t know

(n=35)9%

74%

17%

■ Yes■ No■ Don’t know

(n=46)

48%

2%

50%

Yes ■No ■

Don’t know ■

(n=35)

Yes ■No ■

Don’t know ■

(n=46)

2%

48%

50%

LIGHTc5 m0 y0 k40r157 g166 b171#9da6abPMS Cool Grey 6

PALEc5 m0 y0 k15r206 g216 b221#ced8ddPMS Cool Grey 2

MIDc15 m0 y0 k60r107 g123 b131#6c7b83PMS Cool Grey 8

DARKc25 m0 y0 k80r62 g80 b90#3e505aPMS Cool Grey 10

SEPTEMBER Members told us that while regulation was felt to facilitate improvement within some areas the burden of data requests is an increasing distraction from other key areas of work. Our report launched in January and received over 5,000 Twitter impressions.

6%

53%

41%

LIGHTc5 m0 y0 k40r157 g166 b171#9da6abPMS Cool Grey 6

PALEc5 m0 y0 k15r206 g216 b221#ced8ddPMS Cool Grey 2

MIDc15 m0 y0 k60r107 g123 b131#6c7b83PMS Cool Grey 8

DARKc25 m0 y0 k80r62 g80 b90#3e505aPMS Cool Grey 10

TABLEc5 m1 y2 k2r238 g243 b245#eef3f5PMS 7541

BLUEBERRYc100 m95 y0 k3r41 g57 b143#29398fPMS Blue 072

CHERRYc0 m100 y51 k22r192 g8 b72#c00848PMS 1945

SAFFRONc0 m52 y91 k0r247 g145 b49#f79131PMS 144

TOMATOc0 m83 y92 k0r240 g83 b45#f0532dPMS 1665

MAGENTAc12 m100 y0 k0r212 g14 b140#d40e8cPMS 233

MARINEc88 m53 y4 k0r44 g114 b179#1271b3PMS 660

MOSSc94 m13 y83 k44r0 g99 b63#00633fPMS 3425

JADEc79 m10 y46 k0r0 g168 b156#00a89cPMS 7473

Yes ■ No ■

Don’t know ■

Figure 16:Do you participate in any other improvement or benchmarking groups on a voluntary basis?(n=44)

0% 25% 50% 75% 100%

Patient experience(n=42)

Access(n=43)

[9pt regular] Safety(n=42)

Figure 13:If the e�ciency factor is greater than anticipated in your 2015/16 forward plan, please provide an indication of what impact this will have on patient care:

■ No impact■ Some impact■ Signi�cant impact

0%

25%

50%

75%

100%

(n=36)

Figure 3:What would be your projected 2015/16 year end position assuming:

■ Surplus■ Breakeven■ De�cit

E�ciency factor of 3%;

net de�ator of 0.5%

E�ciency factor of 4%;

net de�ator of 1.5%

E�ciency factor of 5%;

net de�ator of 2.5%

0%

[7pt bold axis numbers] 25%

50%

75%

100%

(n=36) [7pt regular - mid grey]

[9pt bold - mid grey] Figure A: [10pt bold] What would be your projected 2015/16 year end position assuming: [7pt regular - mid grey] (Data from 208 FTs and trusts)

■ Key [7pt regular]■ Key■ Key

[7pt regular]Column/item description

[7pt regular]Column/item description

[7pt regular]Column/item description

(n=36)

Figure 7:What would be your projected 2015/16 year end operating surplus/de�cit assuming:

-20

-30

-10

0

20

10

30■ E�ciency factor of 3%; net de�ator of 0.5%

■ E�ciency factor of 4%; net de�ator of 1.5%

■ E�ciency factor of 5%; net de�ator of 2.5%

£m

Role(n=48)

Chief Executive

[9pt regular] Other

Medical Director

13

18

15

Integrated

Ambulance

Community

Specialist

Mental Health

[9pt regular] Acute - DGH

Acute - large or teaching

13

1

3

4

1

14

11

Trust type(n=47)

0% 25% 50% 75% 100%

Monitor(n=43)

[9pt regular] TDA(n=23)

CQC(n=55)

Figure 11:How would you describe the overall approach of the regulators to scrutiny over the past two years? (5 = too much scrutiny, 1 = too little scrutiny)

■ 5■ 4■ 3■ 2■ 1

0% 25% 50% 75% 100%

Figure 12:In your view, to whom is your organisation most accountable?(5 = most accountable, 1 = least accountable)

■ 5■ 4■ 3■ 2■ 1

Regulators(n=48)

Parliament(n=44)

Commissioners(n=46)

Governors(n=37)

Wider public andlocal population

(n=46)

Figure 14:In your opinion, what impact have the regulators had on your organisation over the past 12 months? (Please choose up to 3 options)

Cost more in sta� and leadership time than expected, or in

previous years

Provided focus to strategic and operational planning

Caused a fear of punitive action among directors and sta�

Distracted the organisation from focusing

on agreed priorities

Provided insight to help the board ensure the

organisation is well led

Provided the board with robust information and insight to

drive quality improvement

No impact

Provided advice on competition issues

Provided the board with robust information and insight to

improve �nancial sustainability

Enabled the organisation to mitigate challenges across the

local health economy

E�ectively supported the organsiation

to recon�gure services

Don't know

Supported the organisation through a CMA

competition review

45%

36%

36%

29%

27%

15%

11%

7%

7%

7%

5%

2%

2%

(n=55)

Figure 15a:Has your organisation ever been sanctioned more than once for the same issue by di�erent regulators? ■ Yes■ No■ Don’t know

(n=55)13%

65%

22%

Figure 15b:Has your organisation ever been sanctioned more than once for the same issue by di�erent regulators? ■ Yes■ No■ Don’t know

(n=55)

13%

65%

22%

0

250

500

750

1000

(n=36)

Figure 6:Forecast turnover (£m)

2013/14 2014/15 2015/16

0

250

500

750

1000(n=36)

2013/14 2014/15 2015/16 2016/17 2017/18

Figure 5:Forecast turnover (£m)

Figure 4:Planned specialised commissioning income as % of turnover. (Data from 208 FTs and Trusts)

0%

25%

50%

75%

100%

Clatterbridge Cancer Centre

100%

LondonAmbulance Service

0.19%

Basildon and Thurrock

17.16%

0%

25%

50%

75%

100%

Figure 8:A&E patients seen within four hours:

■ 2013/14■ 2014/15

Week 521

(n=224)

Figure 1:The roles of the respective regulators are aligned?

2% 36% 9% 42% 11%

■ Strongly agree■ Tend to agree■ Neither agree nor disagree■ Tend to disagree■ Strongly disagree

(n=53)

Strongly agree

Tend to agree

Neither agree nor disagree

Tend to disagree

Strongly disagree

Figure 1:The roles of the respective regulators are aligned?

2%

36%

9%

42%

11%

(n=53)

0

125

250

375

500 Minutes(n=36)

Figure 2:What would be your projected 2015/16 year end position assuming:

Trusts with UCC/PCA ■Trusts without UCC/PCA ■

Minor patients treated in UCC

Minor patients treated in A&E area

Minor patients treated in

A&E majors area

187 236 237290

440

[8pt bold] Axis descriptor

[Axes - light grey

2pt line0.25pt divisions] [Arrows - light grey, 0.5pt line

Arrowhead - simple solid triangle]

[black, 0.5pt line]

[black, 2pt line]

[white, 1pt line]

[2pt lines]

[where too many items to use a range of colours,or all the same colour,you may apply a verysubtle gradient acrossall the colour segments]

95%

[Arrowed lines use perpendiculars and 90º angles]

[1pt white divisions]

0

10

20

30

40

50

0

10

20

30

40

50

0 10 20 30 40 50

■ Yes■ No■ Don’t know

(n=35)9%

74%

17%

■ Yes■ No■ Don’t know

(n=46)

48%

2%

50%

Yes ■No ■

Don’t know ■

(n=35)

Yes ■No ■

Don’t know ■

(n=46)

2%

48%

50%

Figure 1:The roles of the respective regulators are aligned?

■ Strongly agree■ Tend to agree■ Neither agree nor disagree■ Tend to disagree■ Strongly disagree

(n=54)

Strongly agree

Tend to agree

Neither agree nor disagree

Tend to disagree

Strongly disagree

0%

28%19%

44%

9%

0-10%

11-20%

21-30%

More than30%

Figure 1:The roles of the respective regulators are aligned?

■ Strongly agree■ Tend to agree■ Neither agree nor disagree■ Tend to disagree■ Strongly disagree

(n=54)

Strongly agree

Tend to agree

Neither agree nor disagree

Tend to disagree

Strongly disagree

0%

28%19%

44%

9%

50%

41%

7%

2%(n=44)

The regulators coordinate their activity effectively(n=54)

NOVEMBER 74 per cent of HR directors told us seven-day services would not be cost neutral within the existing Agenda for Change framework. This formed part of the key arguments in our response to the Pay Review Body and Doctors’ and Dentists’ Review Body.

6%

53%

41%

LIGHTc5 m0 y0 k40r157 g166 b171#9da6abPMS Cool Grey 6

PALEc5 m0 y0 k15r206 g216 b221#ced8ddPMS Cool Grey 2

MIDc15 m0 y0 k60r107 g123 b131#6c7b83PMS Cool Grey 8

DARKc25 m0 y0 k80r62 g80 b90#3e505aPMS Cool Grey 10

TABLEc5 m1 y2 k2r238 g243 b245#eef3f5PMS 7541

BLUEBERRYc100 m95 y0 k3r41 g57 b143#29398fPMS Blue 072

CHERRYc0 m100 y51 k22r192 g8 b72#c00848PMS 1945

SAFFRONc0 m52 y91 k0r247 g145 b49#f79131PMS 144

TOMATOc0 m83 y92 k0r240 g83 b45#f0532dPMS 1665

MAGENTAc12 m100 y0 k0r212 g14 b140#d40e8cPMS 233

MARINEc88 m53 y4 k0r44 g114 b179#1271b3PMS 660

MOSSc94 m13 y83 k44r0 g99 b63#00633fPMS 3425

JADEc79 m10 y46 k0r0 g168 b156#00a89cPMS 7473

Yes ■ No ■

Don’t know ■

Figure 16:Do you participate in any other improvement or benchmarking groups on a voluntary basis?(n=44)

0% 25% 50% 75% 100%

Patient experience(n=42)

Access(n=43)

[9pt regular] Safety(n=42)

Figure 13:If the e�ciency factor is greater than anticipated in your 2015/16 forward plan, please provide an indication of what impact this will have on patient care:

■ No impact■ Some impact■ Signi�cant impact

0%

25%

50%

75%

100%

(n=36)

Figure 3:What would be your projected 2015/16 year end position assuming:

■ Surplus■ Breakeven■ De�cit

E�ciency factor of 3%;

net de�ator of 0.5%

E�ciency factor of 4%;

net de�ator of 1.5%

E�ciency factor of 5%;

net de�ator of 2.5%

0%

[7pt bold axis numbers] 25%

50%

75%

100%

(n=36) [7pt regular - mid grey]

[9pt bold - mid grey] Figure A: [10pt bold] What would be your projected 2015/16 year end position assuming: [7pt regular - mid grey] (Data from 208 FTs and trusts)

■ Key [7pt regular]■ Key■ Key

[7pt regular]Column/item description

[7pt regular]Column/item description

[7pt regular]Column/item description

(n=36)

Figure 7:What would be your projected 2015/16 year end operating surplus/de�cit assuming:

-20

-30

-10

0

20

10

30■ E�ciency factor of 3%; net de�ator of 0.5%

■ E�ciency factor of 4%; net de�ator of 1.5%

■ E�ciency factor of 5%; net de�ator of 2.5%

£m

Role(n=48)

Chief Executive

[9pt regular] Other

Medical Director

13

18

15

Integrated

Ambulance

Community

Specialist

Mental Health

[9pt regular] Acute - DGH

Acute - large or teaching

13

1

3

4

1

14

11

Trust type(n=47)

0% 25% 50% 75% 100%

Monitor(n=43)

[9pt regular] TDA(n=23)

CQC(n=55)

Figure 11:How would you describe the overall approach of the regulators to scrutiny over the past two years? (5 = too much scrutiny, 1 = too little scrutiny)

■ 5■ 4■ 3■ 2■ 1

0% 25% 50% 75% 100%

Figure 12:In your view, to whom is your organisation most accountable?(5 = most accountable, 1 = least accountable)

■ 5■ 4■ 3■ 2■ 1

Regulators(n=48)

Parliament(n=44)

Commissioners(n=46)

Governors(n=37)

Wider public andlocal population

(n=46)

Figure 14:In your opinion, what impact have the regulators had on your organisation over the past 12 months? (Please choose up to 3 options)

Cost more in sta� and leadership time than expected, or in

previous years

Provided focus to strategic and operational planning

Caused a fear of punitive action among directors and sta�

Distracted the organisation from focusing

on agreed priorities

Provided insight to help the board ensure the

organisation is well led

Provided the board with robust information and insight to

drive quality improvement

No impact

Provided advice on competition issues

Provided the board with robust information and insight to

improve �nancial sustainability

Enabled the organisation to mitigate challenges across the

local health economy

E�ectively supported the organsiation

to recon�gure services

Don't know

Supported the organisation through a CMA

competition review

45%

36%

36%

29%

27%

15%

11%

7%

7%

7%

5%

2%

2%

(n=55)

Figure 15a:Has your organisation ever been sanctioned more than once for the same issue by di�erent regulators? ■ Yes■ No■ Don’t know

(n=55)13%

65%

22%

Figure 15b:Has your organisation ever been sanctioned more than once for the same issue by di�erent regulators? ■ Yes■ No■ Don’t know

(n=55)

13%

65%

22%

0

250

500

750

1000

(n=36)

Figure 6:Forecast turnover (£m)

2013/14 2014/15 2015/16

0

250

500

750

1000(n=36)

2013/14 2014/15 2015/16 2016/17 2017/18

Figure 5:Forecast turnover (£m)

Figure 4:Planned specialised commissioning income as % of turnover. (Data from 208 FTs and Trusts)

0%

25%

50%

75%

100%

Clatterbridge Cancer Centre

100%

LondonAmbulance Service

0.19%

Basildon and Thurrock

17.16%

0%

25%

50%

75%

100%

Figure 8:A&E patients seen within four hours:

■ 2013/14■ 2014/15

Week 521

(n=224)

Figure 1:The roles of the respective regulators are aligned?

2% 36% 9% 42% 11%

■ Strongly agree■ Tend to agree■ Neither agree nor disagree■ Tend to disagree■ Strongly disagree

(n=53)

Strongly agree

Tend to agree

Neither agree nor disagree

Tend to disagree

Strongly disagree

Figure 1:The roles of the respective regulators are aligned?

2%

36%

9%

42%

11%

(n=53)

0

125

250

375

500 Minutes(n=36)

Figure 2:What would be your projected 2015/16 year end position assuming:

Trusts with UCC/PCA ■Trusts without UCC/PCA ■

Minor patients treated in UCC

Minor patients treated in A&E area

Minor patients treated in

A&E majors area

187 236 237290

440

[8pt bold] Axis descriptor

[Axes - light grey

2pt line0.25pt divisions] [Arrows - light grey, 0.5pt line

Arrowhead - simple solid triangle]

[black, 0.5pt line]

[black, 2pt line]

[white, 1pt line]

[2pt lines]

[where too many items to use a range of colours,or all the same colour,you may apply a verysubtle gradient acrossall the colour segments]

95%

[Arrowed lines use perpendiculars and 90º angles]

[1pt white divisions]

0

10

20

30

40

50

0

10

20

30

40

50

0 10 20 30 40 50

WHAT ARE THE ROLES OF THE MAIN BODIES REGULATING NHS PROVIDERS?

providersNHS

NHS providers operate within a complex regulatory framework. There are three main regulators of NHS foundation trusts and trusts, but many other bodies exercise regulatory or monitoring functions that also affect NHS providers.

IN HEALTHCARE, REGULATION IS FUNDAMENTAL IN...● Assuring patients and the public that

agreed quality standards are met

● Giving NHS provider boards information to drive improvement

● Building confidence in the health and care system

IN HEALTHCARE, REGULATION IS FUNDAMENTAL IN...● Assuring patients and the public that

agreed quality standards are met

● Giving NHS provider boards information to drive improvement

● Building confidence in the health and care system

NHS PROVIDER BOARDS HAVE A KEY ROLE TO PLAY

● Showing strong local leadership and accountability, working with local partners and driving continuous improvement

● Encouraging learning cultures and empowering their staff

● Learning from each other through benchmarking and peer review

HOW MUCH DOES REGULATION COST?

● The combined budget of Monitor, CQC and TDA (2014/15) is £232.8m – roughly equivalent to running the South Western Ambulance Service for one year (£225m)

● NHS providers and other regulated bodies also dedicate considerable resources to ensuring compliance with agreed standards

HOW SHOULD REGULATION DEVELOP? 1 Recognise that NHS providers must be responsible for their own improvement

2 Insist on independent, proportionate and risk based regulation

3 Develop regulatory assurance that takes local context into account

4 Facilitate tailor-made solutions in distressed local health systems

5 Hold the regulators to account for providing value for money

at a glanceREGULATION OF NHS PROVIDERS

Regulators

Providers

Monitor is the sector regulator for

health and also licenses and regulates foundation trusts,

focusing on risk, governance and financial viability

The NHS Trust Development

Authority is not a statutory regulator,

but monitors the performance of

NHS trusts

The Care Quality Commission

is the independent quality regulator for health and

social care. It regulates and inspects the quality of

services

Professional regulators

(e.g. GMC and NMC)

Royal Colleges (e.g. RCP, RCS, RCGP)

Competition and Markets Authority

NHS Litigation Authority

Are organisations able to deliver essential services on a

sustainablebasis? Is the organisation

well led and accountable?

Are services caring, safe, responsive and well led and do they

produce good outcomes?

GOVERNANCE

QUALITYFINANCE

Commissioners

Sources: HSJ May 2014, SWASFT annual report 2013/14

■ Yes■ No■ Don’t know

(n=35)9%

74%

17%

■ Yes■ No■ Don’t know

(n=46)

48%

2%

50%

Yes ■No ■

Don’t know ■

(n=35)

Yes ■No ■

Don’t know ■

(n=46)

2%

48%

50%

LIGHTc5 m0 y0 k40r157 g166 b171#9da6abPMS Cool Grey 6

PALEc5 m0 y0 k15r206 g216 b221#ced8ddPMS Cool Grey 2

MIDc15 m0 y0 k60r107 g123 b131#6c7b83PMS Cool Grey 8

DARKc25 m0 y0 k80r62 g80 b90#3e505aPMS Cool Grey 10

6%

53%

41%

LIGHTc5 m0 y0 k40r157 g166 b171#9da6abPMS Cool Grey 6

PALEc5 m0 y0 k15r206 g216 b221#ced8ddPMS Cool Grey 2

MIDc15 m0 y0 k60r107 g123 b131#6c7b83PMS Cool Grey 8

DARKc25 m0 y0 k80r62 g80 b90#3e505aPMS Cool Grey 10

TABLEc5 m1 y2 k2r238 g243 b245#eef3f5PMS 7541

BLUEBERRYc100 m95 y0 k3r41 g57 b143#29398fPMS Blue 072

CHERRYc0 m100 y51 k22r192 g8 b72#c00848PMS 1945

SAFFRONc0 m52 y91 k0r247 g145 b49#f79131PMS 144

TOMATOc0 m83 y92 k0r240 g83 b45#f0532dPMS 1665

MAGENTAc12 m100 y0 k0r212 g14 b140#d40e8cPMS 233

MARINEc88 m53 y4 k0r44 g114 b179#1271b3PMS 660

MOSSc94 m13 y83 k44r0 g99 b63#00633fPMS 3425

JADEc79 m10 y46 k0r0 g168 b156#00a89cPMS 7473

Yes ■ No ■

Don’t know ■

Figure 16:Do you participate in any other improvement or benchmarking groups on a voluntary basis?(n=44)

0% 25% 50% 75% 100%

Patient experience(n=42)

Access(n=43)

[9pt regular] Safety(n=42)

Figure 13:If the e�ciency factor is greater than anticipated in your 2015/16 forward plan, please provide an indication of what impact this will have on patient care:

■ No impact■ Some impact■ Signi�cant impact

0%

25%

50%

75%

100%

(n=36)

Figure 3:What would be your projected 2015/16 year end position assuming:

■ Surplus■ Breakeven■ De�cit

E�ciency factor of 3%;

net de�ator of 0.5%

E�ciency factor of 4%;

net de�ator of 1.5%

E�ciency factor of 5%;

net de�ator of 2.5%

0%

[7pt bold axis numbers] 25%

50%

75%

100%

(n=36) [7pt regular - mid grey]

[9pt bold - mid grey] Figure A: [10pt bold] What would be your projected 2015/16 year end position assuming: [7pt regular - mid grey] (Data from 208 FTs and trusts)

■ Key [7pt regular]■ Key■ Key

[7pt regular]Column/item description

[7pt regular]Column/item description

[7pt regular]Column/item description

(n=36)

Figure 7:What would be your projected 2015/16 year end operating surplus/de�cit assuming:

-20

-30

-10

0

20

10

30■ E�ciency factor of 3%; net de�ator of 0.5%

■ E�ciency factor of 4%; net de�ator of 1.5%

■ E�ciency factor of 5%; net de�ator of 2.5%

£m

Role(n=48)

Chief Executive

[9pt regular] Other

Medical Director

13

18

15

Integrated

Ambulance

Community

Specialist

Mental Health

[9pt regular] Acute - DGH

Acute - large or teaching

13

1

3

4

1

14

11

Trust type(n=47)

0% 25% 50% 75% 100%

Monitor(n=43)

[9pt regular] TDA(n=23)

CQC(n=55)

Figure 11:How would you describe the overall approach of the regulators to scrutiny over the past two years? (5 = too much scrutiny, 1 = too little scrutiny)

■ 5■ 4■ 3■ 2■ 1

0% 25% 50% 75% 100%

Figure 12:In your view, to whom is your organisation most accountable?(5 = most accountable, 1 = least accountable)

■ 5■ 4■ 3■ 2■ 1

Regulators(n=48)

Parliament(n=44)

Commissioners(n=46)

Governors(n=37)

Wider public andlocal population

(n=46)

Figure 14:In your opinion, what impact have the regulators had on your organisation over the past 12 months? (Please choose up to 3 options)

Cost more in sta� and leadership time than expected, or in

previous years

Provided focus to strategic and operational planning

Caused a fear of punitive action among directors and sta�

Distracted the organisation from focusing

on agreed priorities

Provided insight to help the board ensure the

organisation is well led

Provided the board with robust information and insight to

drive quality improvement

No impact

Provided advice on competition issues

Provided the board with robust information and insight to

improve �nancial sustainability

Enabled the organisation to mitigate challenges across the

local health economy

E�ectively supported the organsiation

to recon�gure services

Don't know

Supported the organisation through a CMA

competition review

45%

36%

36%

29%

27%

15%

11%

7%

7%

7%

5%

2%

2%

(n=55)

Figure 15a:Has your organisation ever been sanctioned more than once for the same issue by di�erent regulators? ■ Yes■ No■ Don’t know

(n=55)13%

65%

22%

Figure 15b:Has your organisation ever been sanctioned more than once for the same issue by di�erent regulators? ■ Yes■ No■ Don’t know

(n=55)

13%

65%

22%

0

250

500

750

1000

(n=36)

Figure 6:Forecast turnover (£m)

2013/14 2014/15 2015/16

0

250

500

750

1000(n=36)

2013/14 2014/15 2015/16 2016/17 2017/18

Figure 5:Forecast turnover (£m)

Figure 4:Planned specialised commissioning income as % of turnover. (Data from 208 FTs and Trusts)

0%

25%

50%

75%

100%

Clatterbridge Cancer Centre

100%

LondonAmbulance Service

0.19%

Basildon and Thurrock

17.16%

0%

25%

50%

75%

100%

Figure 8:A&E patients seen within four hours:

■ 2013/14■ 2014/15

Week 521

(n=224)

Figure 1:The roles of the respective regulators are aligned?

2% 36% 9% 42% 11%

■ Strongly agree■ Tend to agree■ Neither agree nor disagree■ Tend to disagree■ Strongly disagree

(n=53)

Strongly agree

Tend to agree

Neither agree nor disagree

Tend to disagree

Strongly disagree

Figure 1:The roles of the respective regulators are aligned?

2%

36%

9%

42%

11%

(n=53)

0

125

250

375

500 Minutes(n=36)

Figure 2:What would be your projected 2015/16 year end position assuming:

Trusts with UCC/PCA ■Trusts without UCC/PCA ■

Minor patients treated in UCC

Minor patients treated in A&E area

Minor patients treated in

A&E majors area

187 236 237290

440

[8pt bold] Axis descriptor

[Axes - light grey

2pt line0.25pt divisions] [Arrows - light grey, 0.5pt line

Arrowhead - simple solid triangle]

[black, 0.5pt line]

[black, 2pt line]

[white, 1pt line]

[2pt lines]

[where too many items to use a range of colours,or all the same colour,you may apply a verysubtle gradient acrossall the colour segments]

95%

[Arrowed lines use perpendiculars and 90º angles]

[1pt white divisions]

0

10

20

30

40

50

0

10

20

30

40

50

0 10 20 30 40 50

WHAT ARE THE ROLES OF THE MAIN BODIES REGULATING NHS PROVIDERS?

providersNHS

NHS providers operate within a complex regulatory framework. There are three main regulators of NHS foundation trusts and trusts, but many other bodies exercise regulatory or monitoring functions that also affect NHS providers.

IN HEALTHCARE, REGULATION IS FUNDAMENTAL IN...● Assuring patients and the public that

agreed quality standards are met

● Giving NHS provider boards information to drive improvement

● Building confidence in the health and care system

IN HEALTHCARE, REGULATION IS FUNDAMENTAL IN...● Assuring patients and the public that

agreed quality standards are met

● Giving NHS provider boards information to drive improvement

● Building confidence in the health and care system

NHS PROVIDER BOARDS HAVE A KEY ROLE TO PLAY

● Showing strong local leadership and accountability, working with local partners and driving continuous improvement

● Encouraging learning cultures and empowering their staff

● Learning from each other through benchmarking and peer review

HOW MUCH DOES REGULATION COST?

● The combined budget of Monitor, CQC and TDA (2014/15) is £232.8m – roughly equivalent to running the South Western Ambulance Service for one year (£225m)

● NHS providers and other regulated bodies also dedicate considerable resources to ensuring compliance with agreed standards

HOW SHOULD REGULATION DEVELOP? 1 Recognise that NHS providers must be responsible for their own improvement

2 Insist on independent, proportionate and risk based regulation

3 Develop regulatory assurance that takes local context into account

4 Facilitate tailor-made solutions in distressed local health systems

5 Hold the regulators to account for providing value for money

at a glanceREGULATION OF NHS PROVIDERS

Regulators

Providers

Monitor is the sector regulator for

health and also licenses and regulates foundation trusts,

focusing on risk, governance and financial viability

The NHS Trust Development

Authority is not a statutory regulator,

but monitors the performance of

NHS trusts

The Care Quality Commission

is the independent quality regulator for health and

social care. It regulates and inspects the quality of

services

Professional regulators

(e.g. GMC and NMC)

Royal Colleges (e.g. RCP, RCS, RCGP)

Competition and Markets Authority

NHS Litigation Authority

Are organisations able to deliver essential services on a

sustainablebasis? Is the organisation

well led and accountable?

Are services caring, safe, responsive and well led and do they

produce good outcomes?

GOVERNANCE

QUALITYFINANCE

Commissioners

Sources: HSJ May 2014, SWASFT annual report 2013/14

■ Yes■ No■ Don’t know

(n=35)9%

74%

17%

■ Yes■ No■ Don’t know

(n=46)

48%

2%

50%

Yes ■No ■

Don’t know ■

(n=35)

Yes ■No ■

Don’t know ■

(n=46)

2%

48%

50%

LIGHTc5 m0 y0 k40r157 g166 b171#9da6abPMS Cool Grey 6

PALEc5 m0 y0 k15r206 g216 b221#ced8ddPMS Cool Grey 2

MIDc15 m0 y0 k60r107 g123 b131#6c7b83PMS Cool Grey 8

DARKc25 m0 y0 k80r62 g80 b90#3e505aPMS Cool Grey 10

DECEMBER 50 per cent of

respondents to a snap survey said over

10 per cent of beds were occupied by delayed

discharges at any one time. The results received

national coverage in a Guardian article.

6%

53%

41%

LIGHTc5 m0 y0 k40r157 g166 b171#9da6abPMS Cool Grey 6

PALEc5 m0 y0 k15r206 g216 b221#ced8ddPMS Cool Grey 2

MIDc15 m0 y0 k60r107 g123 b131#6c7b83PMS Cool Grey 8

DARKc25 m0 y0 k80r62 g80 b90#3e505aPMS Cool Grey 10

TABLEc5 m1 y2 k2r238 g243 b245#eef3f5PMS 7541

BLUEBERRYc100 m95 y0 k3r41 g57 b143#29398fPMS Blue 072

CHERRYc0 m100 y51 k22r192 g8 b72#c00848PMS 1945

SAFFRONc0 m52 y91 k0r247 g145 b49#f79131PMS 144

TOMATOc0 m83 y92 k0r240 g83 b45#f0532dPMS 1665

MAGENTAc12 m100 y0 k0r212 g14 b140#d40e8cPMS 233

MARINEc88 m53 y4 k0r44 g114 b179#1271b3PMS 660

MOSSc94 m13 y83 k44r0 g99 b63#00633fPMS 3425

JADEc79 m10 y46 k0r0 g168 b156#00a89cPMS 7473

Yes ■ No ■

Don’t know ■

Figure 16:Do you participate in any other improvement or benchmarking groups on a voluntary basis?(n=44)

0% 25% 50% 75% 100%

Patient experience(n=42)

Access(n=43)

[9pt regular] Safety(n=42)

Figure 13:If the e�ciency factor is greater than anticipated in your 2015/16 forward plan, please provide an indication of what impact this will have on patient care:

■ No impact■ Some impact■ Signi�cant impact

0%

25%

50%

75%

100%

(n=36)

Figure 3:What would be your projected 2015/16 year end position assuming:

■ Surplus■ Breakeven■ De�cit

E�ciency factor of 3%;

net de�ator of 0.5%

E�ciency factor of 4%;

net de�ator of 1.5%

E�ciency factor of 5%;

net de�ator of 2.5%

0%

[7pt bold axis numbers] 25%

50%

75%

100%

(n=36) [7pt regular - mid grey]

[9pt bold - mid grey] Figure A: [10pt bold] What would be your projected 2015/16 year end position assuming: [7pt regular - mid grey] (Data from 208 FTs and trusts)

■ Key [7pt regular]■ Key■ Key

[7pt regular]Column/item description

[7pt regular]Column/item description

[7pt regular]Column/item description

(n=36)

Figure 7:What would be your projected 2015/16 year end operating surplus/de�cit assuming:

-20

-30

-10

0

20

10

30■ E�ciency factor of 3%; net de�ator of 0.5%

■ E�ciency factor of 4%; net de�ator of 1.5%

■ E�ciency factor of 5%; net de�ator of 2.5%

£m

Role(n=48)

Chief Executive

[9pt regular] Other

Medical Director

13

18

15

Integrated

Ambulance

Community

Specialist

Mental Health

[9pt regular] Acute - DGH

Acute - large or teaching

13

1

3

4

1

14

11

Trust type(n=47)

0% 25% 50% 75% 100%

Monitor(n=43)

[9pt regular] TDA(n=23)

CQC(n=55)

Figure 11:How would you describe the overall approach of the regulators to scrutiny over the past two years? (5 = too much scrutiny, 1 = too little scrutiny)

■ 5■ 4■ 3■ 2■ 1

0% 25% 50% 75% 100%

Figure 12:In your view, to whom is your organisation most accountable?(5 = most accountable, 1 = least accountable)

■ 5■ 4■ 3■ 2■ 1

Regulators(n=48)

Parliament(n=44)

Commissioners(n=46)

Governors(n=37)

Wider public andlocal population

(n=46)

Figure 14:In your opinion, what impact have the regulators had on your organisation over the past 12 months? (Please choose up to 3 options)

Cost more in sta� and leadership time than expected, or in

previous years

Provided focus to strategic and operational planning

Caused a fear of punitive action among directors and sta�

Distracted the organisation from focusing

on agreed priorities

Provided insight to help the board ensure the

organisation is well led

Provided the board with robust information and insight to

drive quality improvement

No impact

Provided advice on competition issues

Provided the board with robust information and insight to

improve �nancial sustainability

Enabled the organisation to mitigate challenges across the

local health economy

E�ectively supported the organsiation

to recon�gure services

Don't know

Supported the organisation through a CMA

competition review

45%

36%

36%

29%

27%

15%

11%

7%

7%

7%

5%

2%

2%

(n=55)

Figure 15a:Has your organisation ever been sanctioned more than once for the same issue by di�erent regulators? ■ Yes■ No■ Don’t know

(n=55)13%

65%

22%

Figure 15b:Has your organisation ever been sanctioned more than once for the same issue by di�erent regulators? ■ Yes■ No■ Don’t know

(n=55)

13%

65%

22%

0

250

500

750

1000

(n=36)

Figure 6:Forecast turnover (£m)

2013/14 2014/15 2015/16

0

250

500

750

1000(n=36)

2013/14 2014/15 2015/16 2016/17 2017/18

Figure 5:Forecast turnover (£m)

Figure 4:Planned specialised commissioning income as % of turnover. (Data from 208 FTs and Trusts)

0%

25%

50%

75%

100%

Clatterbridge Cancer Centre

100%

LondonAmbulance Service

0.19%

Basildon and Thurrock

17.16%

0%

25%

50%

75%

100%

Figure 8:A&E patients seen within four hours:

■ 2013/14■ 2014/15

Week 521

(n=224)

Figure 1:The roles of the respective regulators are aligned?

2% 36% 9% 42% 11%

■ Strongly agree■ Tend to agree■ Neither agree nor disagree■ Tend to disagree■ Strongly disagree

(n=53)

Strongly agree

Tend to agree

Neither agree nor disagree

Tend to disagree

Strongly disagree

Figure 1:The roles of the respective regulators are aligned?

2%

36%

9%

42%

11%

(n=53)

0

125

250

375

500 Minutes(n=36)

Figure 2:What would be your projected 2015/16 year end position assuming:

Trusts with UCC/PCA ■Trusts without UCC/PCA ■

Minor patients treated in UCC

Minor patients treated in A&E area

Minor patients treated in

A&E majors area

187 236 237290

440

[8pt bold] Axis descriptor

[Axes - light grey

2pt line0.25pt divisions] [Arrows - light grey, 0.5pt line

Arrowhead - simple solid triangle]

[black, 0.5pt line]

[black, 2pt line]

[white, 1pt line]

[2pt lines]

[where too many items to use a range of colours,or all the same colour,you may apply a verysubtle gradient acrossall the colour segments]

95%

[Arrowed lines use perpendiculars and 90º angles]

[1pt white divisions]

0

10

20

30

40

50

0

10

20

30

40

50

0 10 20 30 40 50

■ Yes■ No■ Don’t know

(n=35)9%

74%

17%

■ Yes■ No■ Don’t know

(n=46)

48%

2%

50%

Yes ■No ■

Don’t know ■

(n=35)

Yes ■No ■

Don’t know ■

(n=46)

2%

48%

50%

Figure 1:The roles of the respective regulators are aligned?

■ Strongly agree■ Tend to agree■ Neither agree nor disagree■ Tend to disagree■ Strongly disagree

(n=54)

Strongly agree

Tend to agree

Neither agree nor disagree

Tend to disagree

Strongly disagree

0%

28%19%

44%

9%

0-10%

11-20%

21-30%

More than30%

Figure 1:The roles of the respective regulators are aligned?

■ Strongly agree■ Tend to agree■ Neither agree nor disagree■ Tend to disagree■ Strongly disagree

(n=54)

Strongly agree

Tend to agree

Neither agree nor disagree

Tend to disagree

Strongly disagree

0%

28%19%

44%

9%

50%

41%

7%

2%(n=44)

(n=44)

IF YOU HAVE ANY COMMENTS ABOUT THE NHS PROVIDERS SURVEY PROGRAMME please contact: Deborah Gulliver