Why is it called a 'Group' and not a 'Trust'?
In the Group model, Liverpool University Hospitals NHS Foundation Trust (LUHFT) and Liverpool Women’s Hospital NHS Foundation Trust (LWH) remain two statutory entities. The Trusts still “exist” and have retained functions including separate Council of Governors, several committees (such as charitable funds), and our CQC ratings.
However, the Group means that the organisations can start to work as one, with a shared Board of Directors to provide unified strategic leadership across the whole Group. This means that we can set standardised systems, practices, and protocols – which result in benefits for both patients and colleagues. You can read more about what a Group model is here.
Do we all get a new email address again?
We are not going to change email addresses now. This will be reviewed as additional organisations integrate into the Group in the future.
How does the Executive Team plan to make themselves visible across so many sites?
The local leadership of each site is really important, and they are committed to increasing their visibility with staff. At each site, there is an Executive Managing Director and Hospital Leadership Team, and they have oversite of opportunities, risk and issues. Each site Executive Managing Director also hosts monthly briefing sessions to speak with colleagues and share the latest updates – with opportunities for you to ask questions. The Group Executive Team also carry out regular walk arounds of each site and will continue to do this, meeting colleagues in different areas.
Keen to understand why we wanted to move to a Group model in the first place. Do Groups get more funding for example? What are the pros and cons of being a Group?
Becoming a Group enables us to equalise what things look like across the local system. It isn’t necessarily about funding, but certain aspects of the system are funded better than others and there can then be disparity. One of the things we will be able to do as a Group is look at the totality of that financial position and review how the funding flows and make the right investments where they are most needed. You can read more about the benefits of Group model here.
As we have moved to a group model, why is the group board just the LUHFT Board plus a few extras from LWH? Shouldn’t there have been a recruitment process to make this fair? Having the group board as the previous LUHFT board makes it feel like a 'takeover'.
A fair recruitment process was held to form the Group Board. A number of people on the Board were already operating in joint roles across LUHFT and LWH, and other colleagues who are looking at retirement in this timeframe excluded themselves from this process. Non-Executive Directors are also 50% from LWH.
How would Alder Hey link in with the Women's? Would Alder Hey eventually be part of the Group?
LWH will continue to work closely with Alder Hey as we do now. Alder Hey will not become part of the Group, as the Group is only the adult acute specialist trusts in Liverpool. What we'll see happen in the future is a close partnership emerging with the three large providers in the city: Mersey Care, Alder Hey and UHLG.
What will this mean for relationships with other Trusts and services outside Liverpool e.g. Wirral and St Helens?
Where individual Trusts have a networked model with other Trusts and services, this will continue. Many of the services across the five Trusts serve a much wider population than just Liverpool with us all having a range of specialist regional services. These relationships will continue.
Are there any examples of how some of our services are already working together well across the Trusts who will be part of the Group?
Yes. To give one example, the Head and Neck Cancer Speech and Language Therapy Team have been working in an integrated model across The Clatterbridge Cancer Centre, Aintree University Hospital and community services for the last three years to great effect. This has significantly improved patient and staff experience. Other examples include stroke pathways, the trauma network, and neuro-oncology to name just a few.
How do you apply to become a NED - is it open to anybody?
NEDs tend to be recruited externally to be impartial from the organisation, but it's not completely excluded to apply from within. Colleagues would need experience in whatever the vacancy area is – for example, often we look for accountants to chair the audit committee, or people with different lived experience and backgrounds. If you are interested in becoming a NED, positions are also available in most other trusts as well. You can find out more about becoming a NED on the NHS England website.
Why does this all feel rather rushed and done very quickly in comparison to when Royal and Aintree merged?
Many Board colleagues, including the Chief Executive, have been working in a joint capacity at LUHFT and LWH for over a year. During this time, it became clear a Group model is the best way to improve services for patients. There have also been many clinical reviews over the years acknowledging that pathways for patients in Liverpool are really fragmented, which the Group model should address. The work of the LAASP joint committee and roadmap for additional organisations integrating into the Group will develop over the coming years.
We still haven't fixed all the issues from the merger. How will adding another Trust impact those issues? For instance, one domain across the Trust, being able to print across sites etc.
Becoming a Group should make it much clearer what direction we need to head in. Many digital issues we currently have, we were trying to fix awaiting a new EPR and what this could bring. Issues such as domains, printing across sites etc should get resolved as part of this same programme.
Do you see value in looking back at the LUHFT merger and identifying, with honesty and openness, things that haven’t or didn’t work so far?
Yes, there are elements that didn't work from the merger, and we acknowledge there are lessons learnt from this. We have also shared this learning with other organisations who have recently gone through a merger process.
There is inadequate real reward, recognition or career progression in LUHFT currently? How will this be improved in this Group?
There is an ongoing program of work on reward and recognition. This will come to fruition imminently and will be shared with colleagues. In the Group, career progressions should be improved as there will be more opportunities to rotate colleagues into different positions and a greater depth of roles at all levels.
If we need to move across all sites, including LWH, going forward will we have to pay for parking on site or will we move to one permit across all sites?
As there are no immediate changes, there will be no requirement for staff to travel between sites they don’t already operate from. In the future, we will review how to establish one permit across sites.
Will Community Service remain part of the Group or be transferred to a Community Trust such as Mersey Care?
Community services will continue to operate as they are. There have been no discussions around transferring any community services.
The Divisional structure charts seem to have disappeared off the Trust website, will they be uploaded so we know who people are?
These are currently being updated and will be shared with colleagues imminently.
Are there any staff Ts and Cs / HR changes needed to overcome and line up the new structures?
We will over time move to standardised policies, but recognising the scale of this we will work our way through this as policies come up for renewal. Any policy changes will go through the appropriate policy approval processes in each organisation. No changes to Terms & Conditions are envisaged at this point and any such changes would be subject to discussion and the normal consultation and approval processes.
Will this shorten/streamline recruitment processes for staff moving across Liverpool hospitals? e.g. staff moving from LWH to Royal.
LWH use LUHFT’s recruitment service already. We will of course continually take every opportunity to streamline our processes and ease movement between organisations in the interests of patients and staff.
LWH have NHSP but we have our own internal bank - will that change?
Over the next six months, we are planning to explore the opportunity to consider entering into a collaborative agreement with the specialist Trusts who currently utilise NHSP across Cheshire and Merseyside, identifying opportunities for more favourable cost savings for the system. This may mean moving away from an internal bank or may mean developing our own internal bank for the benefit of system partners.
What does this mean in terms of workforce education for those who deliver programmes? Will all staff be able to attend regardless of site - this could make content challenging due to differences in processes across sites.
Some of our training and education delivery will be very similar, and where that is the case and appropriate, we would look to standardise our offer, maximise our educational estate and our flexibility to ensure that staff can more easily access training and education opportunities at a site and time that suits them and their service. However, some elements of training and education will be very specific to roles or services provided by individual organisations, and we will respect and protect that as appropriate.
Does the lack of a clear plan here risk losing good people doing important work? How do you expect to keep talent? Clatterbridge may feel worried that by the time they join the group, it will be well established.
The LAASP joint committee are starting to discuss how the Group will look in the future. We are committed to ensuring that talent from all organisations are involved in the design of the future. We want to retain our great people and ensure they understand and are invested in the big picture and what this could do for patients in the future.
When will we hear more information about the roadmap?
There will be regular communications over the coming weeks and months which will explain in more detail about the priority programmes of work, who will be leading each one, what the work will consist of, and how staff will be involved.
A case for change will be finalised in January 2025. This is our ultimate end point for the Group – what we are all striving toward: to improve care for our patients. We look to share more information with colleagues in the new year.
This will include clarity over the programmes of work required to get there. There will be somethings that we as UHLG work on, and others that LAASP will oversee – but there will be crossover as we figure this out.
What is the LAASP Portfolio Board and who sits on it?
Board representatives from each of the five Trusts sit on the LAASP Portfolio Board which is leading the overall work programme, ensuring this is a genuine collective effort between all the organisations involved.
Currently, representatives from each organisation on the LAASP portfolio board consist of the following people who will be overseeing a number of priorities with the LAASP programme of work:
- Tim Gold – Group Chief Transformation Officer (UHLG)
- Dr Andy Nicolson – Medical Director and Deputy CEO (TWC)
- Ben Vinter – Director of Corporate Governance (LHCH)
- Tom Pharaoh – Director of Strategy (CCC and LHCH)
- Lynn Greenhalgh – Medical Director (LWH)
- Michelle Turner – Director of People (LWH)
- Matt Gardner – Chief Digital Officer (TWC)
- James Thomson – Director of Finance (CCC and LHCH)
- Rob Forster – Group Chief Finance Officer (UHLG).
I feel we are constantly undoing the planned, such as the merger, then the restructure, get B8s to all re-interview as not enough jobs, then recently seen an advert for 7x B8s, yet we have no money. This is the sole reason staff are losing respect for change.
Unfortunately, our financial challenges have often been an underlying cause for some of issues we have faced. One of the ambitions of the Group is that if we can execute our strategy, we can resolve the underlying financial problems across the city and avoid financial cuts year after year. The ultimate bigger picture is, if we can balance the books in a way that is far better for everybody, we will stop cost cutting. We acknowledge there have been difficult periods since merger and are working hard to get ourselves to a sustainable footing and improve things at the same time.
There is a huge amount of change fatigue, and this feels like more. Good to hear the plans regarding reward and recognition. I'm hearing more than ever colleagues talking about retirement, how will you reach out to these staff and persuade them to stay, this feels like a huge amount of change coming?
In the near future, we look to share the broader picture with colleagues of some of the tangible benefits that this Group is going to create. We hope that if colleagues can see the reality their efforts are going to have on improving things for our patients, and us resolving some of the long-standing issues - such as pathways and systems – colleagues will feel proud to be a part of this change. The Group is a significant step forward in how Liverpool can deliver its services and we want to be the best NHS organisation we can be.
The support for research is not as great as it should be. What I have managed to do is very much through my own initiative and spending extra time to achieve this.
Through the Group, the power of five research and innovation departments coming together to think about research and how we support research collectively will be huge. Improvements should be made as a result of this.
Are Corporate Services a part of the sites or is this still considered a separate site under UHLG?
Corporate Services have always been separate to the sites, but we've been working on what those should look like at a site level. There's been lots of work going over the last year with several teams, regarding what site structures are and what sits corporately, and this work will continue.
What are the timescales for reviewing corporate services and is this being done across all the Trusts, or just the Women's and LUHFT?
The LAASP joint committee will decide what are the first things to review, and this will be based on strategic intent. For example, one area we may look to start in is digital as there are plans to implement a single Electronic Patient Record (EPR) – so it makes sense to begin thinking now about how this could look in the future. Once the committee has reviewed these elements, timescales will be shared with colleagues of what future plans will look like.
Will services like FOI / SAR now pick up all sites, including the Women's?
For now, all services will continue to operate as they are. For statutory functions, such as FOI, we will start to work through how these operate and if they will move to a single way of doing things. Updates will be provided to colleagues as these reviews progress.
Will finance pots and estate be shared across the group or kept separate?
This is not happening from Day 1, but we have been asked by the ICB to move to a point where next year we look at the financial pot as ‘one’. There will also be an estates plan of how we can look to share buildings going forward – which may open opportunities for improvements.
A lot of focus on non-clinical corporate services, what about clinical corporate services e.g. IPC / tissue viability or safeguarding. These are trust wide across LUHFT, is the plan for the LWH services to be merged or remain site based?
Where it makes good sense from both a quality of service and efficiency perspective to bring services together, we will work with leaders and teams to develop and implement the optimal shape of the service. Any proposed changes will be well signalled, and subject to engagement and normal consultative processes. The teams who know best what good practice looks like, are most often those who are delivering those services on a day to day basis.
Will we be using the hashtag #TeamUHLG as we did with #TeamLUHFT on our social channels?
As we develop how we work in these new arrangements, we will continue to share with staff our new brand identity as it develops – including any hashtags for social media.
How are we pronouncing the UHLG abbreviation?
Colleagues can pronounce the acronym as U-H-L. The ‘G’ only needs to be included when writing the Group name in full, or the acronym, UHLG.
We’ve just spent a lot of money on patient information and letterhead with LUHFT branding - are we not allowed to use this now?
There is no expectation to immediately replace all documents. We are mapping out a process in which branded items may change, and this will be communicated in advance with teams.
The new branding is a little simple - are we still able to use the existing LUHFT branding/pretzel etc, alongside the UHLG logo?
This is an interim brand whilst we work through the new arrangements, and future plans of other organisations integrating into the Group. The LUHFT branding will be phased out. Where possible, particularly when representing the organisation externally, new UHLG templates should be used, which feature our new Group logo.
Will outpatients at Women's fall under DSS, therefore report to Aintree?
Nothing is changing right now and clinical services will continue to operate as they are. As more organisations integrate into the Group, we will be reviewing how the Group can operate in the long term and gradually move forward. We don’t want to put staff through multiple periods of change.
Will we have to provide specialist services across sites like we did when AUH and RLH merged?
There are no plans to do this now. Any changes would come out of a clinically led review, to see what areas need to be focused on first. Reviewing what future clinical structures should look like would be driven by two things: commissioning specifications (e.g. what services need to be alongside others when they're performed) and a clinical view on what would provide the best outcome for patients.
Will the NHS number become THE unique identifier for all patients in each hospital?
When we move to a new EPR and single digital systems, this should mean there is one unique identifier.
Will jobs be at risk in the new Group model?
There are no plans at present relating to workforce and are looking at a three-to-four-year process of starting to bring things together over time. A lot of the costs are held in Board and the replication of things occurring across the organisations within LAASP, where we are spending similar amounts of money to do things five times. However, this doesn’t mean that jobs are at risk. Everything is being worked through in a staged process and will be communicated with colleagues.
Will we have to switch sites?
There are no immediate plans for colleagues to switch sites. Colleagues will continue to work as they currently are. Until we understand what the long-term future looks like, and the creation of the strategy of the Group, we don’t know if there will be changes. If there were to be any changes to clinical services, there would be public consultations held and colleagues would know well in advance.
Am I now employed by the Group, rather than my old Trust?
No, all colleagues are still employed by their statutory organisation. We are planning to work with Staffside and unions to try and align all the things that we do across these organisations, so whether you're employed by LUHFT or LWH, or any of the future organisations, your future terms, conditions and benefits start to look the same.
What does all this actually mean for us in our day-to-day roles?
Nothing is really changing at this point. For many colleagues, you may not notice any immediate changes within your area – especially as clinical services and how our patients access services will remain the same. In this regard, we ask colleagues across all sites to continue the fantastic work you are delivering to support our patients.
Flex your Life at LUHFT was a great idea but doesn't seem to be working with a lot of colleagues burning out due to inflexibility by management. How can we address this?
We’re working to try and make flexible working a possibility for all colleagues who request it. If colleagues have made a flexible working request, and it hasn’t been accepted by their manager, managers should work with colleagues to explore alternatives or seek further advice from the Organisational Development team or a Business HR representative. There is a suite of supportive resources you can access for further guidance, including:
- Flexible Working Policy
- Training and upskill for managers: Flex Launch Briefing covering the basics for managers on ESR homepage
- Employee flex guide: to help colleagues make flexible working requests
- Manager flex guide: to help managers effectively manage flexible working and have confident conversations.
For any further queries, please contact: organisational.
Nurses are leaving all the time, then their posts are being de-banded from (for example) from a 7 to a 5 to save money. But then you have office-based staff who are receiving promotions - how is this fair?
Nursing levels are currently as high as they’ve been for a long time, with turnover around 10-12% which is a normal turnover for this staff group. A review of bandings needed for the service may be undertaken where there is a review of skill mix within a particular area as people leave post, or as a result of workforce change. All admin and clerical vacancies / internal appointments are subject to robust scrutiny prior to appointment.
Management costs seem to be on the rise with multiple appointments to 8b + and VSM posts but many clinical and admin are frozen? This impact on morale and culture has been significant.
All admin and clerical posts, including management posts, are risk assessed prior to approval. Those posts with direct access to patient care are prioritised. Recent managerial appointments at 8b are a result of workforce change which has left significant vacancy gaps impacting on service delivery.
Why don't we appoint to the Board from internal members staff so that diversity can be addressed within. They have lived experiences working here.
Board appointments can come within and outside of the organisation. In terms of diversity, schemes such as the Elevate programme is supporting colleagues from ethnic minority backgrounds to develop into senior management positions, so they can be future board members. From a Non-Executive Director perspective, these appointments tend to be external to be impartial from the organisation. We acknowledge we did have a much more diverse board in our NEDs, but unfortunately colleagues have recently left, or terms have finished. With these vacancies we intend to resolve that.
Will the EDI focus be expanded further? It feels that there's a cohort of staff who are from multiple ethnicity backgrounds are missed from these great programmes because they don't fit into a nice bracket.
We are sorry to hear that you feel you have missed out on opportunities. The ED&I team would welcome any colleagues to contacting them directly via inclusion
Will there be one IT system across LAASP by 2028 then?
There is no current timeframe, but the ambition is to have a single EPR solution. Where we need to retain other corporate or specialist systems, these will be fully integrated into the EPR. Through LAASP, we will work to rationalise the many different systems we have, especially where we have different supplier products that provide the same functionality.
We are still not a single active directory to support email from the merger in 2019 - will it take another 4 years to get a single network?
We will be implementing a single active directory domain across the five Trusts, which means that staff will be able to log onto computers from any LAASP site using their one network account. This project is being initiated now and we expect the project to conclude within three years.