NHS South of England Options for the organisation of local ...

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5. This paper is organised as follows:5.1. It assesses options for the configuration of employer networks in South of England(Central) and presents the case for two local education and training networks andBoards;5.2. It considers the NHS organisations and geographical areas covered by each localeducation and training network and deals with several boundary issues;5.3. It deals with issues of Board governance and stakeholder engagement;5.4. It presents options for the organisation of executive and business teams for the twolocal education and training networks and the opportunity cost of different arrangements;5.5. It proposes principles and assesses different methodologies for apportioning fundsbetween the two local education and training networks;5.6. It assesses options for managing contracts for education across network boundaries;5.7. It summarises the recommendations about each of the issues addressed in this paper;6. This options paper is supported by a number of detailed working papers, available on request.7. In due course development plans, one each for the Thames Valley and Wessex LETBs, will beagreed and published. The development plans will reflect decisions by each of the Boardsconcerning the issues raised in this options paper.Executive summary of recommendations8. The following recommendations are made in this paper:8.1. concerning the South Central Ambulance Service NHS Foundation Trust in paragraph22:8.1.1. that the Trust determine one LETB of which it will be a full participating member;8.1.2. that the Trust should be allowed to participate in the business of the other LETB;8.1.3. that the LETB of which the South Central Ambulance Service NHS FoundationTrust is a full member should act as Lead Commissioner on behalf of both LETBswhen commissioning education services for this ambulance service;8.2. concerning the Southern Healthcare NHS Foundation Trust in paragraph 23, that theTrust become a full member of the Wessex LETB;8.3. concerning the South Western Ambulance Service (SWAS) NHS Foundation Trust inparagraph 25:8.3.1. assuming that SWAS will be a main member of one of the South West LETBs,the Trust should be invited to be a member of the Wessex LETB PartnershipCouncil. This ensures that SWAS has a formal role in engaging and influencingSWAS and vice versa.8.3.2. that the LETB of which the Trust is a full member act as a lead Commissioner inrelation to any education commissioning done for this ambulance service;8.4. concerning future members in paragraph 27: that the two LETBs should be open to thepossibility of admitting other partners into membership of their networks in future. Thedevelopment of Academic Health Science Networks may attract other healthcareOptions Appraisal Version 5 dated 08 June 2012 Page 2 of 15
providers towards Thames Valley or Wessex and they may wish to belong to an AHSNand the LETB that aligns with it.8.5. concerning the governance arrangements in paragraph 34, that each transitional Boardapproves these governance arrangements in principle and commissions further detailedwork to customise them for its own LETB. The final detailed arrangements for each LETBwill be published in its development plan;8.6 concerning the options for executive and business teams in paragraph 44, that thetransitional Boards at their meetings in June 2012:8.6.1 affirm their preference for the mixed option with separate executive teams(Managing Director, Director of Education and Quality and Director ofFinance/Business Manager) in the light of the opportunity costs and risksdescribed in this paper;8.6.2 confirm whether they would prefer to share a Finance Director8.6.3 consider the level of financial support required to sustain separate executivesfunctioning with an integrated/shared business team;8.7 concerning education commissioning across network boundaries, that the Boardsconsider the approaches described in paragraph 53 and agree, by the end of July 2012,lists of contracts that should be separated and contracts that should be managed by leadcommissioning.The case for two local education and training networks and Boards9. NHS healthcare providers have considered two options for configuring local education andtraining networks in South of England (Central):9.1. one network covering the South of England (Central) region, plus Dorset and Salisbury.This network would be one of the largest in England, depending upon the final nationalconfiguration.9.2. two networks configured as:9.2.1. the Thames Valley network, covering the counties of Berkshire, Buckinghamshire(including Milton Keynes) and Oxfordshire, and9.2.2. the Wessex network, covering the counties of Dorset, Hampshire, the Isle of Wightand Salisbury.This configuration could result in two of the smallest networks in the country.10. Deloitte were engaged to assess these options in March 2011 and, although the context in whichlocal education and training networks are to be organised has changed since that time, much inthe Deloitte analysis holds good. Deloitte considered the two options against three principlesagreed by the stakeholders: local ownership, quality enhancement and economies of scale. Thestakeholders, with Deloitte, found that:10.1. both options were capable of the quality enhancement they were seeking;10.2. the one network option (option 3a in the Deloitte paper) could deliver economies ofscale but the stakeholders doubted that it could deliver local ownership;10.3. the two network option (option 2 in the Deloitte paper) could deliver local ownership butnot the same level of economies of scale.Options Appraisal Version 5 dated 08 June 2012 Page 3 of 15
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