1. Swindon Local Involvement Network Open Meeting 18 th May 2011 Lyn Hill-Tout Chief Executive Email: lyn.hill-tout@gwh.nhs.uklyn.hill-tout@gwh.nhs.uk Telephone: 01793 604174

2. Some Facts About The Trust 3,300 staff Serving 340,000 people across Swindon, Wiltshire, parts of Oxfordshire, Gloucestershire and West Berkshire 9,200 members (Over 5,000 are members of the public) Annual income of £200 million Authorised by Monitor (the Foundation Trust Regulator) as a Foundation Trust in December 2008 Licensed by the Care Quality Commission (April 2010) Provide services at Great Western Hospital, Brunel Treatment Centre, Fairford Hospital, Savernake Hospital and various GP practices in Wiltshire Wiltshire Community Health Services integration (income £80m per annum and 1,906 staff will transfer)

3. GWH Income 2010/11 = £200.2m

4. Context Less care in hospital, more care provided in the community Choice – where and how care is provided by GPs, hospital, any willing provider (private or voluntary sector) Greater regulation by the Care Quality Commission Safety, quality and growing patient satisfaction (and expectations) Although the NHS is receiving the same level of funding, nationally savings of £20bn are required These savings are needed to deal with increasing health needs and medical advances White Paper published – radical reforms Concerns about changes and effect on NHS

5. How The NHS Operates … Currently Parliament Department of Health Strategic Health Authorities Primary Care Primary Care Trusts (PCTs) General Practitioners (GPs) Dentists Opticians Pharmacists Walk in Centres Secondary & Tertiary Care Acute Hospitals Ambulance Trusts Mental Health Trusts Care Trusts Foundation Trusts Monitor (Regulator of Foundation Trusts) Contract

6. How The NHS Will Operate Parliament NHS Commissioning Board ? Regional Commissioning Boards Foundation Trusts Any Willing Provider Monitor (Economic regulator of Foundation Trusts) GP Consortia Contract Regulated for quality by Care Quality Commission Contract Department of Health Public Health England Director of Public Health (based in Local Authorities)

7. What The Changes Mean For GWH Competition – any qualified provider Reduction in income to the Trust (because of competition and national £20bn savings) Commissioning via General Practitioners (smaller commissioning groups) More care provided out of hospitals Use of GWH and Treatment Centre Length of stay in hospital = less beds No longer provide treatments of low or not proven clinical benefit Use of technology to improve care and reduce cost