Public Board of Directors papers 27.01.22

Systems and Processes in theR&D Division’ f rom2012; theWendy Fisher report; the report of theNon- Executive Director into the ’Concerns in the R&I Division’ raised with the FTSUG; internal audit reports; ’Independent Assessment of theProgressionof Real-WorldEvidence/BigDataPartnershipOpportunities at The Christie 2018-2020’, (Prof essor Andrew Hughes) December 2020; Review of the Clinical Research Facility, Professor Jaclyn Smith, December 2020; and the responses to these to assure themselves that f ull attentionhas beenpaid to themand that learning has beenactedupon. • The Board should review its structures for theescalationof issues and scoringof risks. It would be helpf ul f or this to be facilitatedand overseenby theAudit Committee. • That the Board reviews its arrangements for communicatingwithand listening to theexperiences of the employees of TheChristie. 3.4.3 Important Note: The Chairman f elt that the Board of Directors should have had theopportunity to conduct an independent investigationand should havebeen advised of the allegations being made inorder to enable the Board to address the concerns being raisedwithout waiting f or theoutcomeof the review. The Chairman of theAudit Committee felt that, as a statutory body, theTrust shouldhavebeenpermitted to commissionan independent audit of theprocurement arrangementswithRoche. 4. ToR 6 In the context of these issues consider what learning theTrust should consider andmake recommendations in that respect. The review team’s observations and recommendations havebeenmadeunder the relevant sections of this report. The f ollowing general remarks areprovidedwitha viewto being helpf ul to theBoard of Directors and NHSEI. There is no doubt that The Christie NHS Trust is a highly regarded and successful healthcare provider and cancer research institution. It has an excellent reputation nationally and internationally and is rated as Outstanding by theCareQuality Commission. Thegreat majority of peoplewho asked tomeet the review team have worked at The Christie f or many years and are proud to be part of an organisation which plays such an important role in society, providing high quality care and contributing widely to the development of knowledge about the treatment of cancer. There is awell-established executive teamand anexperiencedboard of directors. It may theref ore be thought to be surprising that NHSEI f ound it necessary to commission an external rapid review to look into concerns whichhad been raised by colleagues within theResearchand InnovationDivision. The root causeof this seems to beanapparent f ailureby thosepeople in leadershippositionswho wereaware of the concerns that had been raised, in the circumstancescovered by the review, to listen to and takenoticeof a number of people who have some serious issues about the way they are treated and wish to contribute to an improvement in the culture. The leadership of TheChristiehad anumber of opportunities toavert this rapid reviewas colleagues in theR&I Divisionbegan to speak up about their concerns. Not only did they not seem to recognise this but therewere occasions when they appeared to bedefensiveand dismissive. The directors received a number of indications of a “perf ect storm” in the R&I Division. These included the contact with the FTSUG, the criticismof the research strategy f rom senior clinicians and representations from medical oncologists to themedicaldirectors regardinga rangeof issues. Decisionsweremade to pauseworkon the research strategy and to put discussionswithRocheonhold but the symptomswhich led to theseactions did not seem to beexamined and the connections werenot made. If therehad beengreater ref lectionabout this the directors couldhave intervened to provide the leadershipneeded to support colleagues, addressconcerns, and resolve complex management issues. (The review team are not able to assess whether matters would have been handled dif ferently if therehad not been the significant distractionof thepandemic.) It is disappointing that theunitary boardas awholewas not awareof the concerns that werebeing expressed as it is very likely that the collectiveexperienceof all directors wouldhaveensured that steps were taken to address the communication and governance issues which were causing much uneasiness among a number of very committed colleagues. The review team would recommend to the Board of Directors that they consider the evidence, observations and recommendations f rom this review, with a view to assuring themselves that colleagues throughout theTrust are conf ident that they will be supported to speak up through compassionatemanagement arrangements andan

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