Wednesday, 5 December 12 Sir Peter Carr Chair NHS Trust ...

Sterling WayLondon N18 1QXDirect Line 020 8887 2390Direct Fax 020 8887 4219E-mail David.Hooper@nmh.nhs.ukWednesday, 5 December 12Sir Peter CarrChairNHS Trust Development AuthoritySouthside9th Floor105 Victoria StreetLondon, SW1E 6QTDear Sir Peter,Re:My future role as Chair of North Middlesex University Hospital NHS TrustThis letter is neither of the style nor of the length that you would normally expect for its purpose. ButI hope you will bear with me and persevere to read what I have to say in its entirety.I was appointed to take up the role as Chair of Basildon and Thurrock University Hospitals NHS Trustin December 1997. This was my first involvement in the NHS, except as a patient, and was at a timewhen NHS Trust chairs were expected to do little more than chair board meetings efficiently, and tomeet bodies such as the League of Friends or WRVS on appropriate festive or celebratory occasions.It was only after the set of reforms introduced during the late 1990s that the NHS trust chairs’ rolebegan to develop meaningfully. I was very fortunate to have been part of that development process.After listening to Alan Milburn, the then Secretary of State for Health, introduce the notion offoundation trusts at a national meeting of trust chairs in the Queen Elizabeth’s Hall, I was able,against their better judgment, to persuade the then chief executive and deputy chief executive thatwe should make every effort to become an early foundation trust.Nearly three years later Basildon and Thurrock NHS Trust became an FT in April 2004, as one of theten first to be authorised. I counted it as a personal accomplishment that I had been part of the lead ofa team to achieve this.Shortly after this I was elected as vice‐chair of the nascent Foundation Trust Network, and alongsideGill Morgan, Andrew Cash and Janet Trotter we appointed Sue Slipman as the FTN’s first Director. Iwas shortly after thanked for writing the FTN constitution almost single handed, and for three years IChairman David Hooper Acting Chief Executive Lance McCarthy 1

egularly participated in top team meetings with the DH at Richmond House, with the leadership ofthe then Healthcare Commission, and also, of course with Monitor.After ten years as Chair at Basildon and Thurrock I had to relinquish the position. I was bothfortunate and proud to be offered the post of Chair at North Middlesex University Hospital, thehospital in which I was born, and I took up post there on March 1st 2007.When I arrived at NMUH the Trust was in a fairly parlous state, in the previous years it hadaccumulated a significant historic debt, had run consecutive deficits, and was achieving poorly onquality ratings. The fairly newly appointed Chief Executive, Clare Panniker, was coming towards theend of a period of maternity leave, and the Board had been designated weak by the health authority.Over a period of five years Clare and I completely turned the trust round. We made financialsurpluses for five years in a row, and repaid wholly our historic debt. Our quality ratings improveddramatically, particularly with regard to mortality rates, and from high incidences of MRSA and C.Diffwe have moved to a situation where there has not been an MRSA case for well over 500 days, andC.Diff is well below target.Soon after I arrived we signed major PFI agreement to replace about 60% of the old hospital, much ofwhich was over 100 years old. This PFI is affordable within our revenue stream, and was delivered ontime and on budget and opened in June 2010. It is a building that is admired by almost all who enterit.Alongside this we have coped with the continuing problem of the Barnet, Enfield and Haringey (BEH)Clinical Strategy. This was agreed by the trusts and the PCTs in December 2007. Since then therehave been numerous delays caused by local and political opposition, and also by the moratoriumplaced on such schemes by the Secretary of State following the change of government in 2010.These delays introduced a major uncertainty into our planning, and halted the progress that we weremaking towards achieving foundation trust status. This uncertainty was only finally removed aroundEaster time this year, and we have just commenced another development (£80m) to construct newwomen’s and children’s services on the site as part of the implementation of the BEH strategy. This isdue to open in late 2013.The performance of NMUH through all this has been exemplary. Plans and business cases have beenproduced on time and within budgetary forecasts, and at no time have we been responsible for anydelay.Clare Panniker left us in September this year, and we have continued, performing well with herdeputy now taking on the Acting CE role. Last week I was able with my NEDs to offer the permanentCE role to Julie Lowe, currently at Ealing. She intends to start with us in early February.Chairman David Hooper Acting Chief Executive Lance McCarthy 2

Also during the time I have been Chair I have completely changed the NED membership, and theposition of the Board now is that only myself and the Medical Director, Stanley Okolo were here formy first Board meeting in March 2007. All other personnel have changed.We have now signed our TFA, and we are due, all being well, to achieve FT status in the summer of2014. Even with the expanded activity resulting from the BEH strategy we will still be a relativelysmall trust, and as tariffs and modes of delivering healthcare move away from hospitals, it can by nomeans be taken for granted that foundation trust status will be achieved. Alongside the FT pathwaywe also need to significantly develop new ways of working, and also look to attract activity that is atpresent located elsewhere. Without this it will be very difficult to demonstrate the requiredcontinuing financial viability to Monitor.For a long time it had been my ambition (foolishly perhaps) to have been the chair that led one of thefirst group of trusts through to become an FT, and also one of the last so to do. Four years ago I wasinvited by the then Appointments Commission to work with Andrea Sutcliffe and Janice Scanlon,amongst others on the group that was reviewing the non‐executive appointments and appraisalprocesses for NHS Trusts. It was during one of these meetings that the above ambition was formed.Without doubt I am able to look back in pride at the contribution I have been able to make to the NHSin these various roles, and am pleased that I have never had less than a “B” appraisal during the past15 years. I have certainly done my very best, and I think I have been able to make a difference in therather limited arenas in which I have been able to operate. I have always done this, I hope withhumility and without pomp or false vanity.When, last week I spoke to the Trust Board, indicating to them that it could be the time for me to stepaside, and allow someone younger than myself to take over I was amazed by the reaction of several ofthe executives.• We all respect you and admire you .. we need you• You're an absolute champion and an outstanding chairman (by no means only my view) thathas taken NMUH from the brink of disaster to the heady heights of where it stands today• I was quite taken aback by your announcement. I think you have been a first class chairman• You have first class achievements here. Do not let anyone take that away from you.These are direct quotes from senior Board members, which have made me think very seriously aboutcarrying on to achieve my ambition. However, I think I should follow my instinct rather than bedriven by hubris.I reminded the Board that two years ago I held an event in the hospital at which I invited all staff whowere able to join me in a celebratory drink (soft) and a piece of cake. This event ran from about 11Chairman David Hooper Acting Chief Executive Lance McCarthy 3

am through to 3.30 pm. A few hundred staff attended and I was able to speak with almost all of them.The feed back I was given indicated that this had been a morale booster for them. I said that I wouldwish to repeat this event to celebrate my 72nd birthday in the New Year. This is for two reasons ‐ onethat as each year above the age of 70 is reached so the chances of reaching the next birthdaydiminish. But more seriously I have decided that this should be my last birthday as Chair of NorthMiddlesex University Hospital Trust.The route to achieving FT status, particularly from this summer onwards will be very demanding, andin many respects arduous. I also am aware that the person who is chair of an NHS Trust when itattains FT status should remain chair of the new foundation trust for at least one year. If I was to stickthrough this whole process then I would be well into my 75th year before I relinquished the role.I have been very fortunate to be blessed with a genetic make up that most people judge me to be inmy mid 60s rather than the age that I am. Alongside this I still have an energy and enthusiasm thatbelies my age. However, I cannot but escape the realisation that I am likely to increasingly feel myage, and perhaps put the Trust at risk on its path to becoming a foundation trust. Therefore I thinkthat it is better that I regard my term of office as ending during 2013 rather than 2015, as itotherwise might.Taking all things into account I am proposing that a good time for me to step aside step from my roleas Chair of North Middlesex University Hospital Trust is from April 30th 2013. I have thought verycarefully about this date, and would justify it on reasons both in the interests of the Trust and also forpersonal reasons• Julie Lowe, the newly appointed Chief Executive is due to start with us near the beginning ofFebruary and to maintain stability in the Trust leadership for me to remain till April would appearapposite.• Alongside this two very senior members of staff have just been offered promotions at other trustsand will need to be replaced.• This will give Julie, working alongside Lance McCarthy, our Acting CE a chance to consider and putin place a management structure for the future. I hope my experience and knowledge can be veryhelpful here. Whatever else, I know the strengths and weaknesses of the Board and seniormanagers.• I have today approved a job description for the appointment of a Board Secretary. From my workwith Basildon and Thurrock I am aware of the significance of this role, more perhaps than someother senior executives.• I have been very much involved in the development of the Trust’s strategy, and will be well versedwith the IBP prior to the first test of the Board in mid‐April.Chairman David Hooper Acting Chief Executive Lance McCarthy 4

• My replacement would then have time to fully take on board the remainder of the FT process. It isalso the case that the achievement of FT status can by no means be taken for granted.• This would give sufficient time for a strong replacement for me to be appointed, and someone whoat the same time qualifies to be a member of the foundation trust by virtue of residentialqualifications according to the proposed constitution. Also, those who aspire to the role should beaware that chairing meetings is only one part of a very much larger role.For the reasons I give above I wish to formally give notice that I wish my term of office as Chair ofNorth Middlesex University to end on April 30th 2013.This would fit in very well with plans that my wife has for her own retirement, and also plans thatarise because we have a daughter and grand‐daughter living in Australia whom we see far tooseldom.Therefore, I ask, in light of my long and successful record as an NHS Trust (and NHS FT) chair that myrequest to leave on 30th April is accepted.Sincerely yours,David HooperChaircc:Professor Mike Spyer, Chair NHS LondonNMUH Board MembersAll staff of NMUHChairman David Hooper Acting Chief Executive Lance McCarthy 5