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Publications scheme
The publication scheme provides access to all the information the trust routinely publishes, across seven classes (categories). It is a useful place to start your search for information, before making a written FOI request.
Our commitment to publish information excludes any information which can legitimately be withheld under the exemptions set out in the NHS Openness Code or the Freedom of Information Act.
Where individual classes are subject to exemptions, the main reasons are the protection of commercial interests and personal information under the Data Protection Act 1998. This applies to most classes within the publication scheme.
Introduction
This publication scheme is a complete guide to the information routinely published by our trust. It describes the information about us that is publicly available.
We will review the scheme at regular intervals and monitor how it is operating. It is important to us that this scheme meets your needs; we have designed it to be a route map so that you can find information about us easily.
Under Section 19 of the Freedom of Information Act 2000, we have a legal duty to adopt and maintain a publication scheme for the publication of trust information. The purpose of the act is to promote greater openness by public authorities (of which Epsom and St Helier University Hospitals NHS Trust is one).
Patient confidentiality
The Freedom of Information Act does not change the right of patients to protection of their patient confidentiality in accordance with Article 8 of the Human Rights Convention, the Data Protection Act and common law.
Maintaining the legal right to patient confidentiality continues to be an important commitment on our part. To help with this, we have appointed a Caldicott Guardian, who is responsible for ensuring the protection of patient confidentiality throughout the trust in accordance with your legal rights.
Our Caldicott Guardian is:
Vipula Desilva
St Helier Hospital
Wrythe Lane
Carshalton
SM5 1AA
Email: v.desilva@nhs.net
Rights of access to information
In addition to accessing the information identified in this publication scheme, you are currently entitled to request information about Epsom and St Helier University Hospitals NHS Trust under the NHS Openness Code 1995.
A link to this is available in part three of the scheme and hard copies are available free of charge from:
Department of Health
Richmond House
79 Whitehall
London SW1A 2NS
Sometimes, some or all of the information cannot be provided and we will explain the reasons why not when this happens.
The Freedom of Information Act recognises that as a member of the public, you have the right to know how public services such as the NHS are organised and run, how much they cost and how you can make complaints if you need to.
You have the right to know which services are being provided, the targets that are being set, the standards of services that are expected and the results achieved.
Since 1 January 2005, we have been obliged to respond to requests for information that we hold and is recorded in any form, and to create a right of access to that information.
The rights to request and access this information are subject to some exemptions, which we must take into consideration before deciding what information can be released.
Under the Data Protection Act 1998, you are also entitled to access your clinical records or any other personal information held about you and you can contact the Health Records Manager to do this.
Health Records Deputy Manager
Dieter Pauls
Email - dieter.pauls@nhs.net
020 8296 2000 - ext. 6951
Information Management
Information falling into the classes will be retained in line with the trust's retention and disposal schedules, which comply with circular HSC1999/53 and Public Record Office Guidance.
Information not required for the business purposes of the trust is stored at the trust or at a place of deposit approved by the Lord Chancellor for the purpose of holding public records.
Key contacts
Any questions, comments or complaints about this scheme should be sent in writing to:
Head of Corporate Governance
70 East Street
Epsom
Surrey
KT17 1HF
Email: meg.stevens1@nhs.net
Who we are and what we do
How we fit into the NHS structure
- General information about the NHS and NHS organisations is available at www.nhs.uk (opens in a new window).
- Information on the Department of Health, its policies and initiatives can be found at www.dh.gov.uk (opens in a new window).
Format: electronic
Fee: free
Organisational structure
- Details of our organisational structure and committees are available on our website.
- Roles and responsibilities executive directors and non-executive directors can be found in the meet our board section of our website.
Format: electronic
Fee: free
Organisations we work in partnership with
- Please see the working in partnership and our charities and support groups section of our website.
Format: electronic
Fee: free
Senior staff and management board members
- Details of our organisational structure and committees are available on our website.
- Roles and responsibilities executive directors and non-executive directors can be found in the meet our board section of our website.
Format: electronic
Fee: free
Location and contact details for public-facing departments
Please see:
- Contact us section of the website for non-clinical departments.
- Our services for clinical departments.
- Consultant directory for our consultants.
- Ward directory for a list of our wards.
Format: electronic
Fee: free
What we spend and how we spend it
Annual statement of accounts
- Our annual report can be found in the corporate publications section of our website.
Format: electronic
Fee: free
Budgets and variance reports
- A finance report is produced regularly and can be downloaded from the board papers and agendas section of our website.
Format: electronic
Fee: free
Financial audit reports
- Our annual audit letter can be found in corporate publications.
Format: electronic
Fee: free
Standing financial instructions
- Standing financial instructions identify the financial responsibilities which apply to everyone working for the trust and its constituent organisations including trading units. The Standing Financial Instructions and Scheme of Delegation Policy ESH/POL/35016[pdf] 687KB can be downloaded from our website.
Format: electronic
Fee: free
Staff pay and grading structures
- Agenda for Change (AfC) pay circulars can be downloaded from the NHS Employers website (opens in a new window).
- Details of the pay scales for senior management can be found in our annual report in Corporate publications.
Format: electronic
Fee: free
Funding (including endowment funds)
The trust receives the majority of its income from NHS Surrey, Sutton CCG, Surrey Downs CCG and Merton CCG for the services it provides. These services are normally set out in service level agreements (SLAs) which can be priced at either national tariffs or with a local price depending on the service.
The trust also operates an umbrella charity called 'Epsom and St Helier NHS Trust Charitable Fund' which is registered with the Charity Commission under registration number 1049197. The charity's income comes primarily from voluntary donations, but it also receives a small amount of investment income. At present separate accounts are prepared and submitted annually to the Charity Commission. For further information visit their website (opens in a new window) and search using the registration number above.
Procurement and tendering procedures
Procurement activity follows the professional and ethical guidance provided by the Chartered Institute of Purchasing and Supply (CIPS), Public Procurement Regulations, our standing orders, standing financial instructions and Scheme of Delegation.
In many cases, we will use national contracts negotiated by NHS Supply Chain, the Purchasing and Supply Agency (PaSA) or the Office of Government Commerce (OGC).
If a suitable contract is not available, we will use best value for money through competition following one of the following procedures (based on the total value of the contract):
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Up to £1,000: one or more verbal quotations are informally secured
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£1,001 to £20,000: three written quotation offers are received and evaluated
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£20,001 to £90,318: three to five tenders are received and evaluated
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Above £90,319: European Union tender process is followed for all contracts except building works which have a higher threshold.
If you are a supplier, please visit our buying process page.
Our Procurement Guide ESH/POL/26915 [pdf] 598KB sets out the principles that ensure effective processes are followed and value for money is achieved.
Further information
Chartered Institute of Purchasing and Supply (opens in a new window) (CIPS)
The CIPS promotes and develop high standards of professional skills, ability and integrity among those engaged in purchasing and supply chain management.
Department of Health (opens in a new window) (DH)
Full and comprehensive information on the DH's national procurement policy, their purchasing frameworks, current tenders and calls for proposals is provided on the DoH website.
NHS Supply Chain (opens in a new window)
The NHS Supply Chain provides customer-focused healthcare products and supply chain services to the UK's National Health Service (NHS).
Official Journal of the European Union (OJEU) Contract Notices (opens in a new window)
OJEU contract notices can be accessed through 'Simap' which is the gateway to public procurements.
What are our priorities and how are we doing
Annual report
- Annual reports can be found in the corporate publications section of our website.
Format: electronic
Fee: free
Targets, aims and objectives
Format: electronic
Fee: free
Strategic initiatives
- The trust board reviews progress on all major strategic initiatives on a regular basis. Please see our five year strategy 2015 - 2020 and board papers and agendas for details.
Format: electronic
Fee: free
Performance against targets
Please see our performance section of the website.
Format: electronic
Fee: free
Clinical governance
The term 'clinical governance' is used to describe the systems and processes by which trusts lead, direct and control their functions whilst delivering high standards of patient care. Governance is the responsibility of all trust staff: to work to improve the safety, efficiency and effectiveness of the systems they operate and to report poor practice so that corrective action can be taken. More infomation can be found in the board papers and agendas on our website.
Format: electronic
Fee: free
Care Quality Commission registration
- See the Care Quality Commission section of our website
- See the Care Quality Commission website (opens in a new window)
Format: electronic
Fee: free
How we make decisions
Board papers
- Agenda, supporting papers and minutes of the meetings can be found in the board papers and agendas section of our website.
Format: electronic
Fee: free
Patient and public involvement strategy (PPI)
Section 11 of the Health and Social Care Act 2001 places a duty on NHS trusts to make arrangements to involve and consult patients and the public on planning services, on developing proposals for changes and in decisions that affect how services operate. We have embedded the involvement of patients, carers and public over a number of years and will continue to develop these activities to make sure that involvement is as thorough as possible.
Healthwatch
We work with our three local Healthwatch organisations, Healthwatch Merton (opens in a new window), Healthwatch Surrey (opens in a new window) and Healthwatch Sutton (opens in a new window), to improve our servcies for local people.
Public consultations
We consult with patients on potential changes to services. Where plans are more considerable in size, consultations will be more wide-ranging with local press publicising meetings, options appraisals and forums.
For information about our plans, see our five year strategy 2015 - 2020.
Format: electronic
Fee: free
Internal communications guidance and criteria used for decision making
We have a number of committees who provide assurance to the our board that decisions have been through the appropriate level of scrutiny before being recommended to the board for approval.
The roles and responsibilities of the committees are clearly defined by a formal set of terms of reference which are reviewed annually.
Format: electronic
Fee: free
Our policies and procedures
Standing orders
- Download our Standing Orders Policy ESH/POL/16114 [pdf] 109KB
Format: electronic
Fee: free
Human resources (including race, disability, age, gender and equal opportunities)
The equality and diversity section of our website includes our annual equalities analysis report.
Format: electronic
Fee: free
Recruitment and employment
Please see the work for us section of our website for current vacancies and information about the recruitment and application process.
Format: electronic
Fee: free
Complaints and other customer service policies and procedures
Format: electronic
Fee: free
Data protection
We have a Data Protection Policy ESH/POL/53919[pdf] 1MB and Trust Information Security Policy ESH/POL/53419[pdf] 228KB in place.
Information governance
We have an Information Governance Policy ESH/POL/58720[pdf] 973KB in place.
Caldicott Guardian
A Caldicott Guardian is a senior person responsible for protecting the confidentiality of patient and service user information and enabling appropriate information-sharing. The Guardian plays a key role in ensuring that the NHS responsibilities and partner organisations satisfy the highest practicable standards for patient-identifiable information.
The Caldicott Guardian for the Trust is:
Vipula Desilva
St Helier Hospital
Wrythe Lane
Carshalton
SM5 1AA
Email: v.desilva@nhs.net
Estate management and environmental
Please see the estates strategy in the board papers and agendas of our website.
Format: electronic
Fee: free
Charging regimes and policies
See the services we offer section of the publication scheme below.
Format: electronic
Fee: free
Lists and registers
List of main contractors/suppliers
See the procurement section in the what we spend and how we spend it section of the publication scheme.
Asset registers and information asset register
Similar to other NHS trusts, we are required to maintain a detailed asset register of our land, buildings and equipment. A summary of the assets held can be found in the statement of financial position in our annual accounts. These figures are broken down into standard NHS groupings in the supporting notes. Our annual accounts also contain our accounting policies in relation to assets.
The full set of annual accounts and the funds held can be obtained free of charge from:
PA to Director of Finance
St Helier Hospital
Wrythe Lane
Carshalton
Surrey SM5 1AA
The balance sheet can also be found in the summarised financial statement in our annual report, which can be found in corporate publications.
Format: electronic
Fee: free
Any register of interests kept in the authority
Please see board disclosures section for our website.
Format: electronic
Fee: free
Register of gifts and hospitality provided to board members and senior personnel
Please request a copy of the register from esth.corpgov@nhs.net free of charge.
Format: electronic
Fee: free
The services we offer
Clinical services provided and/or commissioned
Please see the our services section of the website for all clinical services.
Format: electronic
Fee: free
Non-clinical services
Please see useful services and facilities for each of our hospitals and information, advice and support services sections of our website.
Format: electronic
Fee: free
Services for which the authority is entitled to recover a fee
We are entitled to charge a fee for the following services:
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Car parking
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Pharmacy prescriptions
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Treatment of overseas and private patients
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Copies of medical records and other medical documents
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Certain FoI requests
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Use of the Hospedia bedside television, radio and phone system
Patient information leaflets and other booklets and newsletters
We are currently in the process of developing an electronic central library of the available literature for the trust. In the meantime, please browse our services for available material.
Format: electronic
Fee: free
PALS
Please see Patient Advice and Liaison Service (PALS)
Format: electronic
Fee: free
Advice and guidance
For advice and guidance, please see information, advice and support services
Format: electronic
Fee: free
Corporate communications and media releases
Please see the news and events of our website, including:
Format: electronic
Fee: free
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