Frequently Asked Questions ( FAQs )

These Frequently Asked Questions will be regularly refreshed as the project continues. If you would like a question answered about the proposed merger, please use the “Contact” section of this website to get in touch and we will add the question and answer to this document in response.

Timing

What happens now that the Outline Business Case has been approved?

  • A Full Business Case will now be developed with engagement and input from staff, governors, patients and the public, over the coming months. This Full Business Case will then be considered by both Trust boards later this year.

I thought a final decision was originally being made in July? Why the delay?

  • This is a really important decision and it’s vital we take sufficient time to consider all of the options and do the detailed work to evaluate the best way forward. On reflection, we decided that it was sensible to spend a little more time on the work for the Full Business Case. We also need to take into account any timeline that we may have to consider from a regulatory standpoint.

If the Trusts decide to go ahead with the proposed merger, when would this start?

  • If we reach that stage following a review of the Full Business Case later this year, then a full implementation plan and timeline will be developed and worked through.

The Proposed Merger

How will the proposed merger work?

If we decide to go ahead with the proposed merger, the actual route we will need to follow is an acquisition process due to regulatory requirements. If we want to preserve the Foundation Trust status (both Trusts have this) and Teaching Trust status (Derby has this) for any new organisation we may form together – which would bring considerable benefits – then the only route open to us is for one Trust to acquire the other. In all likelihood, this would mean Derby being the acquiring organisation due to its Teaching Trust status and a few other factors such as Care Quality Commission (CQC) status. However, the spirit of the collaboration would still and always be to merge as partners and both Boards are very clear that each organisation brings its own strengths to the collaboration.

Does a potential merger mean local services would be lost?

  • We are clear that this collaboration is based on the principle of improving and enhancing local services and this is what we will focus on as the work goes forward. For Queen’s Hospital in Burton, our fundamental principle is that we will retain a vibrant district general hospital in the town, keeping and improving the services we offer as part of that, including our A&E. There are one or two recognised services that are at risk in Burton due to low volumes of activity, for example, hyper-acute stroke. This has been known for several years. In this case, the proposed model would be for Derby to deliver this service to Burton patients, except for local rehabilitation and follow-up clinics which would still take place in Burton – we believe this is better for our patients in terms of their outcomes. Any significant clinical service change, like the example of hyper-acute stroke, will be subject to a public consultation.
  • In Lichfield and Tamworth, we think there is an opportunity for our community hospitals to offer some different services that recognise the changing needs of the two populations. These services would be heavily aligned with the local GPs and will offer more diagnostic work and specialist outpatients, as well as potentially more day case procedures (including specialist clinics such as spine, from Derby consultants) and more locally-focused end of life care. We are also looking at our local urgent care services, including the role of our MIUs and better alignment with local GPs, as part of the Staffordshire STP work across the county.

What are the benefits for Derby Hospitals?

  • The partnership will enable Derby Teaching Hospitals to deliver its specialist services, such as spinal services and cancer surgery, to a wider catchment population, thereby securing access to them for people in Staffordshire and Derbyshire. It will also improve the quality of the services offered by sharing learning and best practice, and offer increased job prospects and development opportunities for staff.
  • There will also be opportunities to better use our community hospital at London Road to become a focus for the new models of care centred on the place people live, which are being developed as part of the Sustainability and Transformation Plans in Derbyshire and Staffordshire.

What specialties are included in the scope of the collaboration?

  • All clinical specialties will be considered as part of the merger process, although at this stage, we have only been able to undertake a more detailed look at about 11 of them.
  • These are:
    • Orthopaedics
    • Endoscopy
    • Radiology
    • Stroke
    • Cardiology
    • Breast Screening
    • Breast Surgery
    • Oncology
    • A&E
    • Acute Medicine
    • Upper Gastrointestinal Cancer
  • If the Full Business Case is approved, then all specialties will be examined in depth over a period of about three to five years during implementation phase.

Couldn’t you get a lot of the benefits you describe by working together without a formal partnership?

Whilst we are already working together in some areas, and can see further areas for development, it is clear that the closer the partnership, the greater the proportion of potential benefits. For example, improved clinical sustainability and quality, reductions in duplication and the benefits to patients of the accreditation of certain specialist services, improved career opportunities for staff and the realisation of financial savings could not be realised simply by working together informally.

Why have you not considered a merger with University Hospitals of North Midlands?

  • The partnership between Burton Hospitals and Derby Teaching Hospitals is a long-standing one, due to the meaningful proximity of Derby to the core population in Burton and it should be noted that there are already existing joint services in place which benefit the Staffordshire population, such as Breast Surgery, Oncology and Maxillo-Facial Surgery. We are committed to extending these patient benefits as part of the proposed merger, yet at the same time, this does not stop us continuing to work with partner organisation across the county, for example University Hospitals of North Midlands; Staffordshire and Stoke-on-Trent Partnership NHS Trust and South Staffordshire and Shropshire Healthcare NHS Foundation Trust.

Why does Derby have to acquire Burton?

  • If we decide to go ahead with the proposed merger, the actual route we will need to follow is an acquisition process due to regulatory requirements. If we want to preserve the Foundation Trust status (both Trusts have this) and Teaching Trust status (Derby has this) for any new organisation we may form together – which would bring considerable benefits – then the only route open to us is for one Trust to acquire the other. In all likelihood, this would mean Derby being the acquiring organisation due to its Teaching Trust status and a few other factors such as Care Quality Commission (CQC) status. However, the spirit of the collaboration would still and always be to merge as equal partners and both Boards are very clear that each organisation brings its own strengths to the potential collaboration.

Will Burton end up as the poor relation in the proposed merger?

  • We intend to form a new organisation as true equals and hope to bring the best of the two Trusts to a wider population across East and South Staffordshire and Southern Derbyshire and Derby. Only one service, hyper acute stroke, is currently planned to move from Burton, where the best treatment for such patients is to go to a specialist centre in Derby. In terms of Queen’s Hospital in Burton, our fundamental principle is that we will retain a vibrant district general hospital in the town, keeping and improving the core services we offer as part of that, including our A&E.

How will breast services at Burton be affected by the proposed merger?

  • We can confirm that there are no plans to move Breast services at Burton. We will be using Derby consultants to help deliver the service which will be delivered equally across the areas.

What assurances can you give around mental health services in Burton?

  • Mental health is pivotal and a central focus of the Sustainability Transformation Plans.

How important are the community hospitals in Lichfield and Tamworth in the proposed merger?

  • The community hospitals in Lichfield and Tamworth are very important to us and to the local populations. A key benefit of the proposed merger will be to ensure the appropriate and relevant use of our community hospitals facilities.
  • In Lichfield and Tamworth, there will be an opportunity for our community hospitals facilities to offer some different services that are more relevant locally. These services will result in us working more closely than ever with our local GPs. We want to offer more diagnostic work and specialist outpatients, as well as more day case procedures. We are also looking at our local urgent care services, including the role of our Minor Injuries Units and better alignment with local GPs, as part of the Staffordshire STP work across the county.

Will there be an opportunity to have a Burns unit if a proposed merger goes ahead?

  • This is a highly specialised area of care which we would not be able to deliver at Burton or Derby. Birmingham Children’s Hospital (for children) and West Midlands Regional Burns Centre (for adults) would always be the best option for this kind of specialist care.

Will a merger increase levels of privatisation?

  • Patients and the public can be assured that the proposed merger is not about privatisation at all and we have no plans to privatise services. Both Trusts are NHS organisations and rather than privatising services a merger would in fact strengthen, sustain and improve NHS services that are all free at the point of delivery.

What will be the name of the new Trust?

  • All of our patients can be assured that the names of the hospitals will not be changed. We are committed to involving staff, members, patients and the public in creation of the name for the newly merged organisation.  Any proposal for a new name has to comply with the NHS Brand Guidelines.

Will there be a new Council of Governors for the newly merged organisation and how will this be organised?

  • Yes, there will be a new Council of Governors. A Joint Working Group is currently working through the options to create a Council of Governors which is fully representative of the new public and staff constituencies and includes appointed governors from key organisations.

Finances

Is this just about saving money?

The proposed merger would mean that both Trusts would be able to make some savings through sharing good practice, removing duplication and reorganising and developing certain services. However, this is only part of the story. Our key aims are to improve the quality of the care we offer patients and to improve the health of our local populations by dealing effectively with the challenges we face on a daily basis.

Workforce

Do staff at both trusts benefit from the same pension?

  • Yes, staff benefit from the same NHS pension fund.

Would people lose their jobs as a result of the proposed merger?

  • Our partnership is based on the principle of sustaining local services across Staffordshire and Derbyshire, and our workforce is absolutely key to delivering these. Indeed, one of the key challenges that both Trusts face at the moment lies in not being able to recruit enough clinical staff at varying levels, which means there are lots of opportunities now, and in the future, for people to grow their careers with us and to also come and work for us. We are also in the early stages of developing our plans to bring together certain “shared services”, such as Finance and Human Resources, among others, as our ambition is to create an outstanding support service across South Derbyshire and Staffordshire for our clinical teams.We will be working through these plans in the coming months and talking with staff as they develop. We may look at some roles as part of this to ensure we are not duplicating skills and services, but we will do all we can to retain talented staff and where changes are necessary, we aim to achieve the majority of this through natural turnover (for example, if someone chooses to retire) and redeployment.We will be talking with our staff to ensure they are kept fully informed about any changes, as well as the opportunities on to ensure they are kept fully informed about any changes, as well as the opportunities on offer, and there will be a timeline set out once we are further along the path to the Full Business Case.

How to Get Involved

Why has there been no progress since the patient workshops in March?

  • We are keen to maintain a close dialogue with everyone who attended the workshops and will continue to listen to their views. Now that the Outline Business Case has been approved, people will then be selected to join the Patient Reference Group for the various specialties. If you’d like to contribute to this process please make contact here

How can I get more involved in these discussions?

  • We are continuing to look at ways of ensuring that staff, governors, patients, their families and carers have a direct say in helping us to shape the future. Based on the feedback received from people who attended the two patient involvement workshop sessions in March 2017, we are currently exploring the most effective ways of how patients and clinicians can work together to shape future services.
  • Now that the Outline Business Case has been approved, the next steps will be to select people to join the Patient Reference Groups for the various specialities.

Staffordshire and Stoke-on-Trent Sustainability and Transformation Plan (STP)

Does the Staffordshire and Stoke-on-Trent Sustainability and Transformation Plan (STP) approve of the proposed merger

  • Burton Hospitals is a full partner in the Staffordshire and Stoke-on-Trent STP (encompassing our acute hospital in Burton and our community hospitals in Lichfield and Tamworth). We believe the merger to be in the best interests of the Staffordshire population we serve, and that in pursuing this course of action, we are working to secure a sustainable future for the provision of local services in Burton, Lichfield and Tamworth that reflect the core goals and aims of the Staffordshire and Stoke-on-Trent STP.

How are the Staffordshire County Council and other STP partners being engaged with?

  • Burton Hospitals is a full member of the Staffordshire and Stoke-on-Trent STP and as such, the Chief Executive Helen Scott-South sits on the Health and Wellbeing Transformation Board that oversees the STP from a strategic perspective. We consider Burton Hospitals to be fully embedded within the leadership of the STP and with strong links to partners across the county footprint.
  • The matter of the proposed merger with Derby Teaching Hospitals is one that has been discussed many times within the STP executive forum and with a clear articulation to partners of the benefits for Staffordshire of a) acting to secure sustainable clinical services at Burton and b) providing opportunities for residents for Lichfield and Tamworth to benefit from specialist outpatient and day case services by merging formally with Derby (and therefore helping to also repatriate work to Staffordshire from outside of county i.e. from Birmingham).
  • We believe that the goals of the proposed merger are consistent with the aims of the STP and we share a common vision of reducing acute sector activity and supporting people with place-based care.

What work is taking place to ensure GPs in Lichfield and Tamworth are aware of the potential new services or change in services?

  • We are committed to working very closely with our GPs and we have a full engagement plan in place to ensure that they are aware of the latest developments and all the benefits that our partnership will bring to them and their patients. We view the proposed merger as a sensible option for ensuring the sustainability of services at Burton, and which would enable the STP to execute its vision for transformation of local health care into a place-based approach which would see us working closely in partnership with GPs in Lichfield and Tamworth.

Surely the proposed merger will reduce competition in Staffordshire with patients potentially having less choice?

  • On the contrary, patients will have more choice. In Lichfield and Tamworth, there will be an opportunity for our community hospitals facilities to offer some different services that are more relevant locally. These services will result in us working more closely than ever with our local GPs.
  • We want to offer more diagnostic work and specialist outpatients, as well as more day case procedures. We are also looking at our local urgent care services, including the role of our Minor Injuries Units and better alignment with local GPs, as part of the Staffordshire STP work across the county.

Governance

Why have key prospective appointments been made before the Full Business Case has been approved by the two Trust Boards?

  • As part of the approval process needed to create a new organisation, we are required to identify a prospective board which would be responsible for the running of the newly created organisation if both Trust Boards approve the Full Business Case.

What was the process for the appointments of the prospective Chair and Chief Executive?

  • Both Burton and Derby Council of Governors’ approved the appointment of John Rivers as Prospective Chairman of the new organisation.
  • The appointment of Gavin Boyle as the Prospective Chief Executive of the new organisation was made jointly by the Nominations and Remuneration Committees of both Trusts who met together to make this important decision. Their decision has also been approved by both Burton and Derby Councils of Governors.
  • Helen Scott-South chose not to put herself forward for this role and she has decided, after a lengthy and distinguished NHS career, that she will be retiring when a new organisation comes into being, in the spring of 2018.

Does the appointment of Gavin Boyle indicate that this is a takeover by Derby?

  • Patients and the public can be assured that our proposed merger is about bringing the best of both organisations together in terms of how each can contribute to our future success. Both Boards are very clear that each organisation brings its own strengths to the proposed merger.
  • If we decide to go ahead with the proposed merger, the actual route we will need to follow is an acquisition process due to regulatory requirements, rather than the traditional method of merging. Specifically, if we want to preserve our Foundation Trust status (both Trusts have this) and Teaching Trust status (Derby has this) for any new organisation we may form together – which would bring considerable benefits for both staff and patients – then the only route open to us is for one Trust to acquire the other. This is because dissolving the two Trusts in order to merge (which is the traditional way) would mean we could lose these important characteristics, which help shape how we run and how we can attract high quality staff to our new organisation.
  • This would mean Derby being the acquiring organisation due to its Teaching Trust status and a few other factors such as Care Quality Commission (CQC) status. However, the spirit of the collaboration would still and always be to merge as partners bringing the best that both Trusts have to offer for the benefit of our patients.

Transport

What transport plans are in place to support the elderly who may have to travel from Lichfield, Burton and Tamworth?

  • The planned merger with Derby is something we feel strongly will benefit local people in Lichfield, Burton and Tamworth, as it will enable us to sustain and improve the quality of core NHS services at Queen’s Hospital, including A&E. There may be one or two exceptions where we feel that patients will be better served by a move to Derby, such as hyper-acute stroke. However, the over-riding principle is to sustain and improve services at Queen’s and make better use of our community hospitals in Lichfield and Tamworth.

Is a shuttle service being provided from Burton to Derby?

  • With just one or two exceptions, our plans do not involve services moving. So, a shuttle service would not be necessary.

What is being done about the car parking problem at Royal Derby which will impact on Staffordshire patients?

  • While there will be some occasions where patients will need to travel to Derby, this collaboration is all about retaining core services at Burton, and continuing to offer the right kind of community care from our sites at Lichfield and Tamworth. Our main hospital will remain in Burton serving our local community.

As Derby Teaching Hospitals are responsible for operating their own car parking will this now be the case at hospitals in Burton, Lichfield and Tamworth?

  • At this early stage this is an area we have not yet considered.
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