Joint Council of Governors and Board of Directors Meeting
Thursday 17th July 2014
Present: Tim Melville-Ross Chairman
Stuart Maxwell Public Governor
Jess Brand Public Governor
Patricia Bennett Public Governor
John Bootes Public Governor
Wayne Head Public Governor
Christopher Sills Public Governor
Eli Kernkraut Public Governor
Talaat Qureshi Public Governor
Hilda Walsh Staff Governor
Marion Rabinowitz Staff Governor
Claudine Matthews Staff Governor
Tracey Fletcher Chief Executive
Sheila Adam Chief Nurse & Director of Governance
Dr Martin Kuper Medical Director
Jude Williams Non-Executive Director
Polly Weitzman Non-Executive Director
Gary Wong Baker Tilly
David Bridger Head of Governance (minutes)
Tim Melville-Ross welcomed the Governors to the meeting. He welcomed Claudine Matthews, Polly Weitzman and Martin Kuper to their first meeting.
He explained that he had received resignations from Governors Prof Stan Newman and Eric Sorensen. They were thanked for their contribution to the work of the Trust.
Apologies: Suri Freedman Public Governor
Julia Bennett Public Governor
Paul Ashton Public Governor
Jonathon McShane Partner Governor
Prof Stan Newman Partner Governor
Dr Gary Marlowe Partner Governor
Jo Farrar Director of Finance
Dylan Jones Chief Operating Officer
John Gieve Non-Executive Director
Vanni Treves Non-Executive Director
Susan Osborne Non-Executive Director
Minutes of the Council of Governors meeting 15 May 2014
The minutes from the previous Council of Governors’ meeting were agreed. It was noted that despite being listed Jess Brand was not at the meeting in May.
Independent Auditors Assurance Report on the Quality account.
Gary Wong from Deloitte LLP presented the independent auditors external assurance report on the Trusts Quality Account for 2013/14. He provided an explanation of the limited scope review, stating that this aimed to check consistency and content of the report in relation to Monitor guidance. It also reviewed a number of the performance indicators in the report including C. Diff data, Cancer 62 day waits and Breast Feeding 6-8 weeks.
Based upon the results he reported that nothing had come to their attention to indicate that the report was not produced in line with the reporting requirements. One issue was highlighted regarding the lack of glossary in the report but this was not considered significant. He reported that information contained within the Quality Account was reliable with only minor data issues associated with the breast feeding indicator. This related to the audit trail of cases where GP letters are sent. Recommendations from last year’s testing had been reviewed and no new recommendations had been identified.
The report had been presented to the Trust Audit Committee in May 2014.
He thanked the relevant members of Trust staff for their assistance with the production of the report.
Those present discussed a number of aspects of the report including diagnostic delays associated with the 62 day target and wider issues associated with the C diff target.
The Council of Governors noted the report
Annual Report and Strategic Plan
Tracey Fletcher confirmed that the Trust had met all publication deadlines in respect of the Annual Report and Accounts.
She went on to provide the Governors with an update on the annual planning process. She confirmed that the Trust had met the deadline for submission of the 5 Year Strategic Plan to Monitor. This had been reviewed by a small group of Governors and any comments received incorporated.
Reablement and Intermediate Care Service (RICS) - presentation
The Governors were given a presentation on the reablement and intermediate care service by Dr Natasha Arnold, Consultant Physician. She provided an overview of the service which aims to provide planned, short term, intensive assistance to adults. She summarised how the service is structured, the composition of teams, and their roles. She went on to provide national context to the service and proposed future developments.
The Governors thanked her for the presentation and asked a number of questions about the service including:
When will the Trust start seeing results – Funding for the service was confirmed two weeks ago and we are planning to implement the change by October 2014. It is anticipated that there will be an integrated team by the end of 2104/early 2015. It is likely to take a year to embed and will be evaluated by audit after 18 months.
How will data sharing be managed – All teams currently use slightly different data collection systems and whilst a solution to this has not yet been identified there is a plan to have a single care plan to determine the management of ongoing care needs.
Where does the psychogeriatrician fit into the team – In parallel there is a mental health team working with the Trust on the model.
How will it be determined when the patient is back to normal – This decision will be made as part of the multidisciplinary team review.
What can be done about the lack of communication leading to current situation of patients waiting for a team to review – The current issues are in some part a reflection of what the local authority can deliver. As we move towards the model of care there will be improvements leading to care being delivered more efficiently and effectively.
Patient Experience Strategy
Daniel Waldron presented the draft Patient Experience Strategy. He provided an overview of the strategy and the objectives set out to meet the overall strategic aim to ‘Ensure all patients have an excellent experience of our services through providing person-centred care that takes into account each patient’s or service user’s needs concerns and preferences’. He set out the Trust approach to delivery against the context of the NHS Patient Experience Framework including the measurement approach and improvement cycle.
Those present discussed the strategy and provided feedback including consideration of the concept of every contact counts and the relationship between the strategy and the Trust values
Council of Governors Evaluation
Tim Melville-Ross presented a paper summarising the results of the Council of Governors evaluation. He explained that the response rate had been quite low which was disappointing. Most responses rated the overall performance of the Council as satisfactory. He provided a summary of the key comments provided by Governors and the actions planned to address these. The Governors discussed the report and potential training opportunities available to them to aid their development. This area will remain a key priority for Governors.
It was agreed that the evaluation will be repeated annually.
Lead Governor Appointment
The Governors present voted for a new lead Governor. Two nominations had been received. The Governors present voted by secret ballot and John Bootes Public Governor for the City was voted to be the new Lead Governor.
John Bootes thanked the Governors for their support and explained that he would continue to build upon the work started by Jude Williams to ensure that the Governors work better together as a team.
Wayne Head raised two items. He enquired regarding the level of building activity and requested sight of the Trust wide development plan. It was agreed that he would be put in touch with the Director of Estates, Facilities and Capital Projects. He also offered to arrange a meeting between the Trust and the Design Council regarding the work they have done to reduce bad behaviour in A&E. Daniel Waldron agreed to meet with him to discuss this opportunity.
Question from the public
Mr Andrew Ezsias, Public Member, congratulated John Bootes on his election to Lead Governor.
He went on to raise two questions previously circulated to the Governors. These were:
Would you please confirm that all governors currently in post have obtained individually verifiable inside and outside training and attended appropriate outside courses so they are fully aware of their rights, duties and obligations, including legal ones, in connection with their position as governors so if complex issues may come up in forthcoming months with regard to holding to account the chair and non-executive directors effectively, including questioning and seeking explanations for their actions or lack of it, they will know what to do to discharge their obligations and what rights they have to do so?
Please confirm that all non-executive directors too have had verifiable inside and outside training and attended outside verifiable courses so they are fully aware of their rights, obligations and duties to account the board effectively and what to do in case of concerns might be raised on executive directors?
Tim Melville-Ross responded that training is made available to governors through a number of ways including presentations at meetings and courses run by outside agencies such as the FTGA. There remains issues associated with the fact that Governors give their time voluntarily and with other outside commitments access to training can be difficult for them. The Trust is able to fund some training for Governors.