Blackpool Teaching Hospitals NHS Foundation Trust: Governance
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The Minister for Health (Stephen Barclay)
May I begin by thanking the hon. Member for Blackpool South (Gordon Marsden) for securing the debate? I am pleased to see my hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard) in his place, and I know that both my hon. Friend the Member for Fylde (Mark Menzies) and the hon. Member for Lancaster and Fleetwood (Cat Smith) have expressed an interest in the issue.
The issues raised by the hon. Member for Blackpool South are clearly a cause for concern. While the CQC has not identified any governance issues in the trust, it is clear that the recruitment process for the new chair had a number of irregularities. One of the defining features of our approach to the NHS since the Francis report has been a willingness to face up to difficult issues. I therefore welcome the opportunity to focus on these irregularities and will address each in turn.
The previous chair of the trust resigned in January 2018 to take up the role of chair in another, nearby foundation trust, University Hospitals of Morecambe Bay. That caused a recruitment process for the chair of Blackpool Teaching Hospitals NHS Foundation Trust to commence in February this year. Autonomy in appointing executives is an important NHS foundation trust freedom. As a foundation trust, Blackpool Teaching Hospitals NHS Foundation Trust has the freedom to determine many of its own policies and procedures, including those relating to the appointment of a new chair.
The process followed by Blackpool is explained in the trust’s own constitution, which sets out the make-up of the nominations committee responsible for senior appointments. That committee is made up of six individuals, including the chair, or another senior role if the chair is the position being recruited for, as well as three governors and the chief executive. The sixth member is an independent assessor—in this case, the chair from another foundation trust, Salford Royal.
This is where the first irregularity arises. NHS Improvement guidance states that a foundation trust’s chief executive should not be permitted to vote on the appointment of the chair to whom he or she will be accountable. However, in this case, the chief executive was on the nominations committee for this role. While she did not breach the guidance, it is clear to me that if a chief executive should not vote on the appointment of the chair, it follows that a chief executive should also not be involved earlier in the appointments process, given the relationship of accountability that exists between chief executives and chairs of NHS trusts and foundation trusts.
However, I recognise that that instruction was deep within guidance dating from 2012, and there have been other pieces of NHSI guidance for foundation trusts regarding their governance arrangements that did not contain similar advice. There is an expectation that advice and guidance given to NHS trusts is clear and understandable. I have been informed that guidance on this topic is being refreshed by NHSI as part of the review of NHSI’s role in board appointments following Dr Kirkup’s findings in relation to Liverpool Community Health NHS Trust, to which the hon. Member for Blackpool South referred, and I have asked for the lessons learned to be fed into that refresh.
The chief executive did voluntarily stand back from the process after concerns were raised by the hon. Gentleman regarding her involvement. That was before the final interview was held for any of the candidates. Though it might be fair to ask whether involving the chief executive in the recruitment of the chair was the wisest course of action, it was within the trust’s constitution.
The second irregularity is the response from NHSI to the hon. Gentleman’s letter of 3 May, which fails to refer to its own guidance regarding the need to ensure that the chief executive is not permitted to vote on the appointment of a chair to whom he or she will be accountable. That is regrettable, and I understand that NHSI will write again to him to apologise for that error.
The third irregularity highlighted is the speed of the process. The nominations committee engaged recruitment consultants GatenbySanderson to provide professional services during the recruitment process. Part of that process involved emailing local MPs to inform them that the recruitment process was taking place. However, as the hon. Gentleman has highlighted, there was little time between that email being sent and the closing date for applications—10 working days over the Easter holiday period. The email did not include the closing date for applications, further hampering MPs’ ability to contribute effectively to the process.
I understand that the recruitment process began in February and concluded in May, with the new chair in post from 1 June. The recruitment company has confirmed that this process was run to a standard timeframe. That raises the question of why the local engagement, an important part of the overall appointments process, appears to have been rushed in this instance. There are clearly lessons to be learned, and I will be working with NHSI to ensure that its guidance is refreshed, and that it is clear in its advice to foundation trusts and trusts about the importance of local engagement.
The hon. Gentleman’s letter to the trust of 17 May referenced the trust’s council manual, pointing out that it did not include any reference to the chief executive sitting on the nominations panel. This document sits under the constitution of the trust, and I am satisfied that the explicit rules addressing this matter in the constitution have been followed. I have today received a personal assurance from the trust chief executive, Wendy Swift, that the trust will review its constitution to remove any ambiguity in respect of the appointment of the chair and non-executive directors.
Just to reassure the hon. Gentleman, I will read directly from that letter to me:
“I would like to reassure you that we had already taken a decision to review our Constitution to remove any ambiguity in respect of the appointment of the Chair and Non-Executive Directors.”
I will happily share that letter with the hon. Gentleman.
The independent assessor on the panel was the chair of Salford Royal NHS Foundation Trust. He agreed as to the candidate recommended by the nominations committee’s interview panel to the council of governors, and has not raised objections about how the process to recruit the new chair was run. I have had a personal assurance from the chief executive that there has been no contact between her and the chair of Salford Royal NHS Foundation Trust, and that she has not in any way tried to influence the decision-making process leading to the chair’s appointment.
The chief executive’s letter to me, dated 27 June—it might be helpful to the House if I quote it—goes on:
“I did know the new Chair on a professional basis prior to his appointment. We have worked within the same Health Economy for a number of years and attended the same strategic meetings and events. For clarity, the Chair was the Chief Executive of the Strategic Health Authority (2002-2006) whilst I was the Chief Executive of Blackpool PCT. After 2006, there were no personal or professional links until the Chair was appointed as the Chair of the University Hospitals of Morecambe Bay NHS FT (2014-2018).”
It is clearly difficult to reconcile the involvement of chief executives in the process of selecting chairs with principles of good governance. This appointment took place under the system of foundation trust autonomy put in place under successive Governments, and is a matter for the foundation trusts themselves. However, NHSI recognises that the role it plays in board appointments, both executive and non-executive, is not sufficiently clear and that there would be benefit in reviewing and codifying its oversight and support arrangements.
While any such changes should pay due regard to the fact that autonomy in appointing executives is an important NHS foundation trust freedom, I assure the House that I will be working with NHSI to ensure that the irregularities regarding this appointment do not occur in the future.
The hon. Gentleman has done the House a service in highlighting the clear irregularities in respect of this appointment. I hope that my response goes some way to reassuring him that NHSI will work with the Department to ensure that further irregularities do not occur.
Question put and agreed to.