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Great Ormond Street proposes to manage international patient division through new charity

1 October 2007

Great Ormond Street Hospital for Children NHS Trust today announced proposals to manage its international and private patient division (IPP) through a separate charity.

The proposals were agreed at the Board meeting Sept 26th, but are subject to a 12 week period of public consultation, starting today. (October 1st)

All those interested in receiving a copy of the consultation document should email foundation@gosh.nhs.uk or call 020 7239 3123.  More information is on the website www.gosh.nhs.uk/world

Chief Executive Dr Jane Collins said

“We need to find a legal, open, fair, and sound solution to our international patient issue.   We want to become a Foundation Trust, independent within the NHS.  However, the ‘private patient cap’ would require us to limit our international income, from an estimated £25 m this year to only £17 m, an £8m shortfall.  At a time of financial pressure, this would have a significant effect on our financial stability, particularly in future years.”

“Most of our international work involves working with foreign governments, to pay for children who cannot get the treatment they need at home.”

“The international income we receive allows us to treat more NHS patients than would otherwise be the case.  Limiting international income actually reduces our capacity to treat sick children on the NHS.”

“In fact we believe we can expand our international work, further benefiting the NHS work.  But the cap would prevent this.”

“The solution we propose is, we believe, fair to staff and guarantees that international patients can be treated to our standard of excellence; it also ensures we can grow our international work, benefiting the NHS service.”

“We want to hear people’s views.”

Key elements of the proposals are:

A legally independent charity will manage the International and Private Patient division

We propose around 30 staff – admin, finance and business support staff and a small number of senior management – will transfer to employment by the new charity.

These staff will be protected by TUPE (the transfer of undertakings regulations).

The charity will buy its clinical services from the NHS Trust.  Therefore, the clinical staff on the wards will remain employees of the NHS Trust, with NHS terms and conditions.

A series of agreements will cover use of the buildings, the services supplied from cleaning to operating theatres and so forth.  These agreements will need to satisfy the broad regulatory and legal requirements for fair terms.

The charity will make a surplus which it will donate to the work of the NHS Trust

The new body can seek funding (bank loans, etc) without competing for resources within the NHS Trust, it will be free to operate in the market for international services, and it should be able to grow.

This allows more business freedom , potentially generating more income to support the NHS services in the Trust. The new body will also continue to support  broader social obligations such as staff training and clinical research.

The Trust is seeking the views of staff and its stakeholders through a 12 week consultation.

Key elements of the IPP service

IPP is 10 per cent of our patient admissions but 16 per cent of our income

The main business is helping children judged by foreign governments to require care at a world centre of excellence.  77 per cent of these patients are sponsored by foreign governments and healthcare systems to receive care not available at home.  15 per cent are overseas patients paying for themselves or through private insurance and 9 per cent UK patients choosing to pay.

For 06/07 we identified 19 separate countries of origin, based on the location of the agencies paying for treatment.  In 06/07, we had 2018 in-patient and day case admissions, and 12,499 out-patient attendances.   The Middle East and the Greek speaking world are key customers.

Key arguments for becoming a Foundation Trust

The Trust wishes to remain independent in order to keep its focus on the needs of children.  The Trust contends that children’s services have a lower priority in mixed Trusts.

Foundation Trust status keeps us within the NHS but allows for quicker decision making and a measure of greater financial freedom.  The Trust welcomes the user involvement aspects of Foundation Trust status and has recruited nearly 3000 members, 70 per cent of whom are patients over ten, or parents.

The Trust needs to demonstrate a viable business plan.  The requirement to cut and then hold low our international income has a significant effect on our financial planning.

We face financial pressures through changes to the regime for research funding and the payment by results system, which covers many of the patients we treat.  We are working closely with the Strategic Health Authority and the Department of Health on these issues.  A sound solution on IPP income removes a further area of pressure.

Key facts about Great Ormond Street Hospital for Children

Great Ormond Street Hospital for Children is (with its partners)

-the largest centre for research into childhood illness outside the United States (1)

-the largest trainer of paediatric staff in the UK (2)

-the hospital with the widest range of children’s specialists in the UK

-the largest UK centre for children with cardiac, renal, or neurological problems; and with UCLH, the largest centre for children with cancer in Europe.

1 – with UCL Institute of Child Health

2 - with UCL Institute of Child Health and London South Bank University among others

Contact information:

GOSH-ICH Press Office: 020 7239 3130
Email: Coxs@gosh.nhs.uk
For genuine and urgent out of hours call speak to switchboard on 020 7405 9200

Notes to editors

Great Ormond Street Hospital for Children NHS Trust is the country’s leading centre for treating sick children, with the widest range of specialists under one roof.

With the UCL Institute of Child Health, we are the largest centre for paediatric research outside the US and play a key role in training children’s health specialists for the future.

Our charity needs to raise £50 million every year to help rebuild and refurbish Great Ormond Street Hospital, buy vital equipment and fund pioneering research. With your help we provide world class care to our very ill children and their families.