Session recording
Q: is there a way for comms emails to be shorter? there is too much to read, can we just have comms which gets straight to the point?
Response: I’m hoping this update will help as the comms emails are often long is because there’s that much that keep moving and changing. So, I suspect now that we’ve got into a more stable position and know exactly what’s happening, we’ll be able to move forward with less complexity in it.
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Q: Has the viability of LHC remaining in the group been re-assessed as I think if the staff were asked their viewpoint they would want to stay standalone?
Response: LHCH are in the Group which their Board agreed and voted to do. We’re all in the Group and are now working on the priorities for LHCH. They will remain a statutory organisation in the sense that they’ll have their own staff survey, financial account, CQC rating and everything else. Those things will stay separate but the benefits will hopefully be streamlined corporate services and digital infrastructure, and the benefits of a larger organisation’s economy of scale because the financial challenge is here for everybody and this gives us as a Group the chance to take some of the easier to get to financial savings and keep that away from frontline services as much as possible.
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Q: Will we still be able to achieve our aim for Liverpool with only having 3 of the Adult Trusts on board?
Response: Yes, a lot of it we will be able to. Some of the biggest issues, as you know, were around Women’s services and Cardiology in particular, and the need to look at that across the city. So yes, we will be able to achieve that aim with three Trust’s on board. We’re still going to work very closely with the Walton Centre on Stroke and Neuro as we’ve been doing anyway and they’re keen to continue that. We’re doing a lot of restructuring around research and innovation across the city at the moment with the Liverpool Health Partners and all five organisations are still going to be part of that. We still aim to take the same electronic patient record as well so that’s an important thing.
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Q: Now that the LAASP has basically fallen through what will now happen to all those staff that have had toupee opportunities or worst case looked for employment elsewhere due to fear of losing their jobs?
Response: The three organisations where any TUPE has been discussed and enacted is still happening across the UHL Group as we are today. There is no change in that.
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Q: Seems crazy that you have been asked to do a business case for something that had national level direction to do - LAASP and then they advise not to proceed. How much money and staff time has been wasted on this?
Response: Well, there’s been a collective effort on this for 18 months or more, and it’s taken a huge amount of everybody’s time no doubt about it. We’ve still got to a position where we’ve got three or five organisations and a lot of benefits identified. I think if we hadn’t done this, we wouldn’t have got to a collective vision for a single unified EPR across the city. So, a lot of the work has been really helpful and has taken us to a new place. I think it’s improved and strengthened relationships across the five organisations and not a lot of that will be wasted. I’m just pleased that we’re not going to be asked to do further iterations of cases because obviously the focus needs to be on the three now.
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Q: Does this mean that Digital services will now just be LUHFT, LHCH and LWH or is this separate?
Response: So digital services will be LUHFT, LHCH, LWH and The Walton Centre. That will be a shared service across the four, Walton have decided they would like to stay in that. And CCC are going to continue with the EPR but retain separate digital help desk services and other things. Once we’ve got our single shared services in place around digital, other organisations may wish in future to invest in that themselves and become to be part of that. That’s one of the things that our shared corporate service models are really important for because we believe if we get those working effectively across our three organisations in future, other organisations may want to buy into those making the overall cost cheaper for everybody which keeps financial savings away from frontline services.
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Q: Why did Clatterbridge decide not to be involved?
Response: There was a lot of challenges around that and I think one of the key issues was that within the Business case, there was a lot of focus on specialities that weren’t necessarily cancer and I know that was a big part of their Board’s decision. We’ve had lots of meetings with CCC since around the wish to still partner on a number of things from research to commercial and various other things. We will continue to work together.
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Q: With the merger being the most desired outcome, does this mean that LWH, LHCH and LUHFT are now merging?
Response: We were asked to do the business case as you know, and this was the formality process. If it had been approved as a Group, we would stay as we are, but we might have been a group of five. If it had come out as a merger, then it would have been a merger of three, four or five. The scoring for a merger was much higher, largely for the governance reasons of not having to replicate structures. So, we’ve been asked as part of the case to say if it’s not now five, would we want to consider as the UHL Board the merger of the three and we have said no. We think it’s important now to not have any more change or any more business case distraction. We’re already in a group of three and are working through the structures described earlier. We can still see a lot of the benefits and opportunities, and we want to carry on doing that. We don’t think it would be beneficial to us to try and do a merger of the three now and incur more time, effort and cost over another year to do that.
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Q: Will TUPE still proceed for corporate services as planned?
Response: Yes it will.
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Q: What does this mean for the single EPR plans? Will Walton and CCC still be included in that - huge opportunity lost if not.
Response: Yes, Walton and Clatterbridge still want to do that absolutely. So, as you know the procurement is concluded. Other Trusts will follow and yes, they all absolutely want to be in the same EPR. So that’s really beneficial and a huge opportunity.
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Q: Does the fall through of LAASP extend the non-clinical vacancy freeze?
Response: No, we’re doing the VR at the moment, then we’ve got the corporate services work that we’re doing over the next few months. That’s the thing that we think could stop that non-clinical vacancy freeze. LAASP was never really going to be the solution to that and largely even though we were doing LAASP still it was the three UHL Trust’s that were doing the transfer of corporate services and other things, so that will continue.
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Q: Will this change impact VR and can you clarify if VR is available to all staffing groups?
Response: This change doesn’t impact VR at all, and it was available for everybody to apply for. It doesn’t necessarily mean everybody will be granted it because we would have to prove that we wouldn’t need to replace the post.
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Q: How will this affect the TOMs? Specifically for site-based working
Response: It won’t because the TOM’s were all designed around the three organisations and UHL. Because we were concerned back in Autumn that if anything changed in the business case it could all get unpicked for staff again. But we also could have ended up having to do it twice. So, the TOM’s will continue as they are for the three that they were always designed for. The exception is digital as I’ve said which is moving ahead with a solution because Walton are involved in that.
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Q: There are key staff from the now nongroup partners who have been embedded in UHLG HMB’s and high-ranking posts clearly with a view to get the integration benefits. Will they now go back to their original roles?
Response: So where there’s been appointments made, in the past, those appointments were always made with LAASP as the first pool if you like. Because at that point in time there was a national and strategic direction to move the five organisations together in some way. So that’s why that was done. So those appointment processes, if people have been permanently appointed into jobs they would stay as they are. We have got a few people who are in acting roles or seconded roles. I will discuss this with the Walton Centre and take a view with those individuals about what happens now. However, there are very few that that applies to.
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Q: There would be significant savings in merging - is this completely off the table or just for now?
Response: What we have been told is to stop for now, focus on the financial challenges and embed the Group. The partners could all come back to this at a point in time if they feel that’s beneficial. I think in all reality, it’s off the table for a good while because it’s going to take us a while to get through the next few years of NHS funding gaps. So, there’s no immediate plans to bring anything like that back right now. So the savings of a merger wouldn’t be back on the table and there’s also significant savings we can make as a group of three and we’re doing that anyway.
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Q: How will this affect teams from WCFT and CCC providing support to other Trusts within UHLG?
Response: It would be really helpful to receive some examples of what this is as I am not entirely sure who they would be. I am assuming we have people supporting still on digital from CCC over at LHCH so further clarification on that would be great.
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Q: With the 3 hospitals staying as 3 separate organisations, will LHCH and BGH have separate operational teams or will they be coming together
Response: So, we always intended as a group of three this model, and are still moving to these new models of the HLT’s. The reasons for this was never about the names of the organizations, they were about the logic of things like shared estate and also size and scale and having a similar size and scale to divisions and other things as well. So those things will carry on exactly as they were.
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Q: Staff are still unsure of structures, we are losing great people as the uncertainty is unsettling LHCH
Response: The work on structures is continuing as fast as we can possibility do it and we’ll keep updating through the staff brief on that.
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Q: Where can we see the UHL 3 Strategy please?
Response: Well, it’s the UHL 2030 strategy and was always that. We planned a strategy for UHL whether it was three, four or five because we knew what needed to be done.
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Q: If we are currently working with Clatterbridge and TWC to standardise working processes and working practice, does this mean that we now no longer do this and just concentrate on LWH and LHCH?
Response: It would be useful to know what that specifically refers to. Where it’s clinically helpful it would be a good idea to carry on doing that. We have spoken about aligning policies previously and we’ll certainly just do that within the group of three now. So we will see.
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Q: Will LHCH not be a foundation trust as of 1st April
Response: No, it still will be as will LUHFT and LWH.
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Q: Has the financial implications of the smaller UHLG been assessed in terms of our recovery plan
Response: Interestingly, the benefits of the five weren’t landing in the plan till years 4 and 5 anyway in terms of the work we were going to do. So for the next three years it won’t really make a huge amount of difference. There is a small corporate services number but it’s not really significant. So, there’s no massive financial issue as a result of it being the three and we have always planned on it being the three because it was the only certainty we had.
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Q: Does this decision present greater financial challenge for UHLG now. For example, do the financial savings as part of Corporate Services Review need to be greater now as there will no longer be Walton Centre and Clatterbridge joining later down line which may have helped with extra resource and economies of scale etc? Will this have any impact on staffing budgets, and following on from that security of jobs
Response: I think as I say if you take a look at the total size and scale of the challenge, the difference is a very small number and again it was only going to be realised in later years four and five. No this will have no impact on staffing budgets other than what we were already doing that everyone’s aware of.
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Q: If we're staying as three separate orgs, how does that effect LHCH and BGH?
Response: It doesn’t affect them. We were always three separate organisations in terms of statutory bodies but the way we run, manage and operate them will be exactly as we’ve planned to do.
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Q: Now LHCH isn’t merging, will it remain financially independent?
Response: LHCH, in the model of three in a group, has always had its own budget, cash in the bank and charitable funds etc. That’s won’t change. It is the same as it always has been. If we’d have ended up in a merger, all of those things would have been combined. That was always a worry for us in terms of how you make sure if you, for example, merge organisations that you don’t lose the legacy benefit of it. For example, suddenly LHCH charities or cash getting swallowed up into a larger thing and we always considered how we can protect that if we did end up in a merger system. Now that we’re not, that’s much simpler. It just remains as it is.
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Q: How would CQC now inspect, would this be based by site or as a whole for the three legacy trusts?
Response: The CQC now inspect exactly the same as they always would. We’ve always been three separate Trusts; we’ve just got a single Board and a single management structure overseeing it. So, it would be exactly the same. The CQC would come and inspect LHCH or LWH.
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Q: In the last two years, the general working atmosphere has been very demotivating and does not embrace the vision for individual services. There is no real engagement with the individual services and no vision to develop good services. SMT also does not engage with services which need attention or important conversations.
Response: I think now we have real clarity, for the first time in a while, as to exactly what we’re working with and working to. We know which organisations and strategy. So as we are now looking to push out the corporate objectives for the three. That will all get down to individual service level, and we start to get back to what individual services want to do, improve on and engage on.
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Q: Given the outcome of this decision, in hindsight is there anything yourself - or the group executives - would have done differently?
Response: In hindsight, there probably is. We’ve gone through in the last 18 months, a very strong national policy of “this needs to happen” to where we are now with it’s not the right time. So there’s always things you could do differently. There are things I think we could have got wrong. I think back in April 2025 we took too long to go ahead and make the decision to just go ahead as three operational structures and the corporate services. In the end I’m glad we did make the decision to move ahead as three because we would have been sat waiting another number of months until we got this decision. There are also a number of decisions we have made that have ended up being the right ones and safeguarded the three organisations in a way that perhaps wouldn’t have happened if we just kept following that process.
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Q: Was NHS England consulted prior to starting the LAASP process?
Response: Yes. It began with NHSE telling us to go ahead with it. That was like all things in the NHS over the years with a different set of people at a different time with different leadership in place. Then it has gone through a whole iteration of changes over that time.
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Q: What is the risk that this will this impact the Corporate Services Programme - will it still go ahead?
Response: Yes, 100%.
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Q: If you are currently employed by TWC or CCC but have been supporting within the group, will you be returning to substantive post at the end of March? Thanks
Response: Someone else within my Team will be able to advise with this further and provide you with an answer. If you could please email me directly or email the Comms Team for me so I can make sure we are not missing anything.
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Q: What will this mean for services that are trying to integrate with CCC services will it be more collaboration than integration for future services?
Response: There’s always collaboration across organisations. We’ve got great services that work across organisations that aren’t together. There’s no doubt about that. So yes, I believe it will be more collaboration than integration I would think.
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Q: If we are remaining as separate statutory bodies, how will having corporate services aligned with another trust work? We have separate financial responsibility, but the finance team could be employed by another trust? How does sitewide leadership work across three separate trusts with differing financial, regulatory etc targets.
Response: The TOM for corporate services will take that into account. We never really designed corporate service models for a merged organisation because we weren’t necessarily going to have one and definitely not from March or April next year. So, all of that needs to be considered, there’s a paper going to Board next week regarding statutory responsibilities. Don’t forget we’ve done this now for a period of years with LWH and more recently LHCH. So, I’m very clear of my responsibilities as the accountable officer and accounting officer for all three statutory organisations. I am the CEO for all three statutory organisations, and our Board is a Board of three separate statutory organisations, but we do business through a single Board structure. And that’s what we’ll continue to do.
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Q: Was this more CCC decision or NHSE not to join? Will this be revisited in the future?
Response: It’s clear that this was always a very tricky thing to pull off in the time frame. Board’s make decisions for their own organisations. We try and adapt to those but at the end of the day we are now where we are but at least we have clarity.
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Q: Is there still the possibility for CCC to join later?
Response: With our group of three, there is always the possibility for someone else to join at a later point in time. But what’s really clear is we’d have to go through that business case process which takes a year and there’s a huge amount of time, effort and distraction. So, we’d have to be really certain that if everybody wanted to do that and that it was a really demonstrable, clear wish to do it and that the conditions were right.
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Q: The direction of travel is almost like a larger DGH, the way things are moving forward
Response: I don’t think that it is. We still have a very different model in that we’ve got our HMB’s and all of our committee structures sitting in the three parts of the organisation.
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Q: The loss of LAASP will come with financial implications. Will this mean pushing towards reducing numbers of staff for cost savings, leading to redundancies?
Response: It doesn’t really. Certainly not for the next three years. The benefits of the other two organisations were always going to be down the line, years four and five. So that’s not a huge issue for us. It will not make a big difference to the cost savings or recovery financial plans for the next three years at all. They were always predicated on the three who were already in the group.
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Q: You have just answered 'Yes' to the TUPE process still going ahead. Can you elaborate on why this is the case?
Response: Yes, because we are still a group of three who had already planned to TUPE to a host to run shared service because that’s the best way of doing it. That’s the case with digital across four and with all the others across the three. That was always the intention.
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Q: Will LWH remain statutory separate or one with royal?
Response: It’s always going to be and always was going to be statutorily sperate. But it will be managed by the Royal because we’ve got to put in now joint business cases and services that support across sites. So, you can have two statutory organisations under one management team. We’re already doing it and have been doing it over the last two years.
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Q: Some of the benefits of closer working within corporate services would only be realised with a merger. The administrative burden has increased and specialty elements (and staff) lost. Personally, it seems that this further reinforces the feeling across LWH/LHCH of everything being rushed through without complete assessment. Would it not be worth delaying and fully appraising all change options before pushing through changes (including unfreezing recruitment). If mergers are the best options then shouldn't we proceed geared towards that rather than a halfway option?
Response: I take your point however we have fully worked up a Group model. The merger asks only came in November. So, the worst thing we could do now is delay again. If people feel that delay is what they would like, further delay in corporate services and management structures, I think that would be catastrophic to be honest for the organisation. People have waited for such a long time to know what’s happening with that. We need to get that done and get on ground level where everyone is clear about what their roles and what our objectives are.
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Q: I work in a corporate team where we have been asked to provide support to a Trust which now sits outside the LASSP model. Is the expectation that this work is to continue although it does not specifically support the aims of the collaborative work all Trusts will be contributing to.
Response: We are working through now, myself, Walton and Clatterbridge, to close down issues that might lead to this. So, we will come to that, just bear with us. I don’t think there are a huge number of these examples but there are some.
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Q: In relation to digital and TWC, how does that come together as surely can’t report to people or manage people not in this trust. Are TWC digital staff tupe to LUHFT - how will SLAs with TWC work etc?
Response: You absolutely can. So corporate and shared services can be done. Lancashire and Cumbria have done it across all of their hospitals and they’re all separate Trust’s. We will just have a service provision that we deliver to Walton but the staff will be part of UHL effectively, TUPE’d to UHL but provide a service to Walton. That is what Walton have chosen to be part of.
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Q: You mentioned R&D, what are the planned changes?
Response: So Research & Innovation is one of the corporate services going through its TOM at the moment. So that is across three and was always going to be up to this stage.
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Q: We have had a lack of leadership since our previous leadership team was shipped over to COCH. This only seems to be getting worse, and we are losing our individual identity bit by bit. Why can our BoD not refuse to join too?
Response: The LHCH BoD agreed to join a year ago. The BoD did agree as they could see the benefits to that. I was talking to a clinician this morning who was applying for a job at LHCH, and they asked me about what it was all about and I explained that simplistically the economies of the scale of a large organisation where you can afford to do fantastic digital implementations/ new EPR etc. across the piece. Shared corporate service that are more cost efficient and therefore not asking for CIP’s from the front line are some of the big opportunities. But as for everything else, LHCH will continue as it is - but don’t forget the financial situation in the NHS, LHCH is not immune from it. As the accounting officer, I believe it is the best thing for LHCH to be able to access the benefits of scale but still remain the sovereignty of a statutory body.
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Q: Shouldn't the TUPE of the UHLG 3 staff be paused. The combining of the departments can still take place without the unnecessary step of TUPE and TUPE makes no difference to how the combined departments are managed
Response: It shouldn’t. We know that it is far clearer to have everybody in the same structures in the same budgets in the same place. Shared services are always like that when they’re done properly. It would make no sense to have a single service where everybody’s employed in different parts of organisations.
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Q: What constitutes the DTC on the BGH site and why is it identified as a third entity with BGH and LHCH? Is it not just part of the site that houses a combination of LHCH and BGH services?
Response: No, the DTC houses a combination of services across the entire organisation. In particular the radiology and pathology across the entire group. So, it is bigger than that and we do that in some of our operating models where services are run across the whole group but out of one site and that helps make sure that we’ve got visibility of the quality performance financial aspects.
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Q: Why only digital including Walton centre, how will this work...and why no other services?
Response: Digital was the key issue that Walton had. We’re still talking about other things that Walton may want to do in the future. I think Walton are keen on seeing our corporate services established and then they can decide about which ones if any it would want to be part of. We obviously share quite a lot around estates and facilities for example. So, I suspect that that might be another one that they want to talk about in time.
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Q: Will our jobs/locations (below band 8) still be changing?
Response: If it’s related to existing management to change processes and existing corporate service integrations, then nothing is changing in that result other than what you’ve already been discussing.
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Q: When will we know what the finance structures will look like?
Response: We are nearly there with the finance TOM, we will update in the staff brief next week as to where some of the corporate services are.
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Q: How will this impact our ambition to become financially sustainable? I thought LAASP / integration of specialist and acute finances was intended to balance things out...will we now continue to be subject to massive CIPs each year?
Response: LAASP helps it as does corporate services. But it’s still on incumbent organisations to meet the financial challenge. Certainly, in LUHFT and LWH we’ve still got significant recovery plans. LWH is unsustainable as we know in its current form. So, we’ve got conversations about how that’s going to be supported and LUHFT’s still got a way to get to financial balance, but this year is starting to improve its underlying position which is great.
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Q: What was the preferred option in the business case? Merger?
Response: That was the option that scored the most in the draft business case, yes.
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Q: There is a general feeling that more could have been done to convince everyone to come together, it makes sense. The LAASP messaging and the Stronger Together strapline may be a reflection of the quality/richness of the talks. The feeling was purely about money, when shared workings should have featured more prominently. We like hearing about good patient and staff stories but it feels we only hear about governance.
Response: I understand staff concern and would encourage colleagues to please come here for the information, don’t listen to rumours. I would imagine that 1 in 100 rumours are probably true. There’s no compulsory redundancy programme or anything like that happening. We’ve got a voluntary redundancy programme because that was something that it seemed like there was a wish for, for those where it might be an option but entirely voluntarily.
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Q: Apologies if this is a daft question but is LAASP no longer from this moment forward, i.e. we are simply UHLG with the 3?
Response: Yes, so LAASP is something we’re going to close down in terms of the programme board and other things. We’re UHLG with three Trusts and obviously we’ve got some shared services like digital being put together with Walton and usual partnership arrangements with Walton and Clatterbridge. We’ve just got our own organisations, our own strategy for our three organisations with our own plans and activities.
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Q: LHCH were covered with execs from CCC... what will happen now?
Response: They haven’t been covered with Execs from CCC for quite a while. Digital is the exception where we’re just working through when the handover period of that will come in.
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Q: What assurance process has been in place for LHCH joining the group if this wasn't approved prior will LHCH remain a foundation trust?
Response: That was done a long time ago by the Board at the time. So that assurance process has been gone through.
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Q: If LWH and LHCH have their own finances, will we have our own finance teams rather than being absorbed?
Response: So again, that will come out of the TOM’s. Finance Teams will be aligned to the operational structures for running the organisation. We just need to be able to report separately statutorily upwards.
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Q: In terms of governance meetings will this still include all UHLG sites or go back to being specific site governance meetings? Currently we have directorate meetings including LUHFT and LWH which have started recently (would this impact DTC?)
Response: Everything will stay the same as what we’ve been doing and nothing’s changing. We’re doing exactly what we set out to do.
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Q: Structures are a little difficult to understand or know where to escalate, would there be a time when UHLG update all three organisations governance structures so we all know the escalation routes in all areas?
Response: Yes we are looking to update an organisation chart and this will be shared in comms when finalised.