Agenda and Papers

for the

meeting of the

Kent Community Health NHS Foundation

Trust

Council of Governors

in Public

to be held at 1 pm on

Wednesday 8 February 2017

at

Astor Pavillion Kent Event Centre

Kent County Showground Detling

Maidstone Kent

ME14 3JF

Meeting of the Kent Community Health NHS Foundation Trust Council of Governors

to be held in Public at 1:00pm on 8 February 2017 In the Astor Pavilion, Kent Event Centre, Kent Showground,

Maidstone, Kent ME14 3JF

AGENDA

1. STANDARD ITEMS

1.1

Introduction by Chairman

Chairman

1.2 Apologies for Absence

Chairman

1.3 Declarations of Interest

Chairman

1.4 Minutes of the Kent Community Health NHS Foundation Trust Council of Governors meeting held on 9 November 2016

Chairman Page 4

1.5 Matters Arising of the Kent Community Health NHS Foundation Trust Council of Governors meeting held on 9 November 2016

Chairman Page 17

1.6 1.7

Chairman’s Report

Trust’s Quarterly Report

Chairman Chief Executive

Verbal Page 19

2. REPORTS TO THE COUNCIL

2.1 Governor feedback from each of the

constituencies

Full Council Verbal

2.2 Quarterly Report on Patient Experience

Deputy Chief Nurse Page 22

2.3

Quarterly Report on Public Engagement

Director of Workforce, Organisational Development and Communications

Page 36

2.4

Report from the Governor Development Task Group

Public Governor, Canterbury

Page 41

Age

nda

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2.5

Feedback from Governor meeting with Director of Workforce, Organisational Development and Communications and Non-Executive Director

Director of Workforce, Organisational Development and Communications

Page 44

2.6 Update on Governor Elections, January/February 2017

Corporate Services Director

Page 51

2.7 Lead Governor Role Corporate Services Director

Page 54

3. ITEMS FOR CONSIDERATION OR REVIEW

3.1 Quality Account Update report

Priority setting for 2017/2018

Governor’s Quality Indicator for auditing in 2017

Deputy Chief Nurse Presentation

4. PAPERS AVAILABLE FOR GOVERNORS

4.1 The following papers are shared for

Governor information and are available on Flo, the staff intranet:

Workforce Report

Finance Report

Quality Committee Report

January Formal Board Agenda

November Board Confirmed Minutes

Chief Executives Report

Integrated Performance Report

For noting only

5. ANY OTHER BUSINESS

5.1

Any other items of business previously notified to the Chairman.

6. QUESTIONS FROM MEMBERS OF THE PUBLIC RELATING TO THE AGENDA

7. DATE AND VENUE OF NEXT MEETING

The next meeting of the Kent Community Health NHS Foundation Trust Council of Governors will take place in public at 1.00pm on 8 May 2017. Venue to be confirmed.

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Unconfirmed Minutes of the Kent Community Health NHS Foundation Trust Council of Governors Meeting

Held at 1.00pm on Wednesday 9 November 2016 In the Clive Emson Suite at the Kent Event Centre, Kent Showground, Detling,

Maidstone, Kent ME14 3JF

Meeting held in Public

Present: David Griffiths, Chairman (Chair)

Sonja Bigg, Staff Governor Adults Services Clare Buckingham, Staff Governor, Health and Well Being Services; Carole Coleman, Public Governor, Dover and Deal Garry Denman, Staff Governor, Adult Services Gary Frost, Public Governor, Dartford Anthony Moore, Public Governor, Out of Area Jo Naismith, Public Governor, Sevenoaks Dr Susan Plummer, Appointed Governor Universities David Price, Public Governor, Maidstone Jane Roberts, Appointed Governor Voluntary Organisations Ken Rogers, Public Governor, Swale and Lead Governor Andrew Scott-Clark, Appointed Governor Public Health Graham Shaw, Public Governor, Tunbridge Wells Kate Wortham, Public Governor Canterbury

In Attendance: Paul Bentley, Chief Executive Natalie Davies, Corporate Services Director Richard Field, Non-Executive Director Gordon Flack, Director of Finance Emily Hill, Engagement Lead, Grant Thornton UK LLP Steve Howe, Non-Executive Director Peter Maskell, Medical Director Chris Long, Engagement Manager, Grant Thornton UK LLP Louise Norris, Director of Workforce, Organisational Development and Communications David Robinson, Non-Executive Director Martine Saker, Compliance Officer (Note-taker) Lesley Strong, Director of Operations - Adults Ali Strowman, Chief Nurse

Absent: Peggy Lawlor, Public Governor, Gravesham Jack Wise, Public Governor, Tonbridge and Malling

Some items were taken out of order but the minutes correspond to the agenda.

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09/11/01 Welcome and introduction The Chairman welcomed everyone present to the Council of Governors (‘the Council’) meeting of the Kent Community Health NHS Foundation Trust (‘the Trust’). The Chairman advised that this was a Council of Governors meeting held in public, rather than a public meeting; and as such there would be an opportunity for public questions relating to the agenda at the end of the meeting.

09/11/02 Apologies for Absence

Apologies were received from Mark Johnstone, Staff Governor Children’s Services and Jane Hetherington, Public Governor, Thanet. The meeting was quorate.

09/11/03 Declarations of Interest

No declarations were made other than those formerly recorded.

09/11/04 Minutes of the Meeting of 11 May 2016

Item 11/05/31 - the date of the meeting should read 29 July 2016. However it was acknowledged that this date was subsequently cancelled The Council AGREED the minutes, subject to the amendment to the next meeting date.

09/11/05 Matters Arising The Council RECEIVED the Matters Arising.

09/11/06 Chairman’s Report

The Chairman presented a verbal report to the Council for assurance. The Chairman and the Chief Executive had both attended a number of local and national meetings where strong messages were conveyed about the significant financial pressures all NHS Trusts were experiencing together with the extensive work that was being undertaken to address those pressures. The Chairman reported that, as reported in May 2016, the Trust was undertaking a significant amount of cooperative working with other organisations across Kent and Medway, including social care, the acute

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Trusts and Kent County Council to ensure the system met its objectives. He stressed that it would not be possible for the Trust to meet its objectives without this cooperative work. The Chairman stated that he was pleased with the different focus of the reports presented at this meeting and was looking forward to working with the Governors to determine how best the Trust could support them in their role. He encouraged Governors to hold the Board to account and to seek assurance that the strategic objectives were being achieved. He also encouraged Governors to challenge the Non-Executive Directors on how they received assurances from the executive team. The aim was to develop a more constructive process and he welcomed feedback from the Governors. The Council RECEIVED the Chairman’s Report.

09/11/07 Any significant Governor feedback from each of the constituencies

Ms Wortham raised a question on behalf of the Canterbury constituency regarding the availability of a chaplaincy service at community hospitals. The Director of Operations for Adults advised that the Trust was aiming to adopt the current model available in West Kent and to provide a wider range of religious support. She had already met with the Bishop of Canterbury to explain her plan to create a formal memorandum of understanding and provide assurance to the chaplaincy that their support in the community hospitals was welcomed. Ms Naismith raised a question regarding funding for the chaplaincy service as she was concerned West Kent had lost its funding. The Director of Operations for Adults explained that expenses would be paid as well as training and support, however there would not be a formal contract and they would not be paid for their time. Ms Wortham explained that the community hospital websites were very focussed on inpatient services but did not provide other information such as parking availability on site. The Chairman asked for the Communications Team to take this forward. Action: Director of Workforce, Organisational Development and Communications Ms Coleman raised a concern on behalf of the junior staff on the Health and Wellbeing teams. The junior staff felt they would benefit from training on how to approach members of the public and lacked confidence in this area. She had asked the Communications Team if they would be able to arrange training for the junior staff. The Director of Workforce, Organisational Development and Communications agreed to take this request forward. Action: Director of Workforce, Organisational Development and Communications

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09/11/08 Governor Strategy Report

Strategy Group Report and Minutes The Lead Governor presented the reports and minutes and explained that a further update would be provided at the Strategy day due to take place in December 2016. The Council RECEIVED the Strategy Group report and minutes. Governors Next Stage Development Report The Corporate Services Director presented the report co-authored with the lead Governor and explained that the aim was to improve the overall effectiveness of the Council. Trust was committed to supporting the Council and the paper set out some recommendations for the way forward. Ms Wortham sought clarity regarding Governor attendance at Board Committee meetings. The Corporate Services Director explained that the Trust aimed to be open and transparent but attending Board Committee meetings was not necessarily the best use of Governor time. The Trust needed to find a way to ensure information from those meetings was fed back to Governors which was why the Governor information pack had been developed. In not attending these meetings, this allowed Governors the opportunity and time to allow for their other duties. In response to question regarding the new Public and Patient Experience Committee (PPEC), the Corporate Services Director explained that it was proposed that this committee be a Governor Committee with the aim of receiving patient and public experience and bringing those experiences and views to the attention of the Trust. In response to a request for clarification of the proposal to give Governors more access to Assistant Directors, the Corporate Services Director explained that the aim was to alleviate the pressure on the Executive Directors by raising the profile of the Governors with the Assistant Directors but it was acknowledged that access would need to be balanced to make the best use of everyone’s time. The Chairman acknowledged that improving the effectiveness of the Council was still a work in progress and welcomed the opportunity to identify ways to make the best use of Governors’ time and to provide clarity around what was expected of Governors in terms of time commitment. The Council RECEIVED the Governor Strategy Report and minutes of Governor Strategy Group meetings held on 27 June 2016 and 13 September 2016.

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09/11/09 Membership Committee Report and Minutes

Mr Shaw presented his report and highlighted progress developing the Governor Engagement Strategy. He also explained that the Membership Engagement Strategy had been revised and welcomed comments on both documents but it was stressed that the documents were still a work in progress. Ms Roberts suggested moving the benefits of membership nearer the beginning of the membership engagement strategy in order to highlight sooner the values the Trust placed on its members. She also suggested that some of the practical steps were missing from the action plan with regard to raising the profile of the Governors. For example she suggested a feature on the Trust’s website that took people directly to information on how they could contact their Governors. She also suggested raising the profile of Governors amongst staff to ensure Governors were invited to any events planned by the various services. The Director of Workforce, Organisational Development and Communications confirmed that the Communications Team did invite Governors to events it knew were taking place and work was underway to encourage services to inform the Communications Team of any events being planned. Ms Coleman asked whether any funding would be available to Governors to help them fulfil their engagement objectives and the Chairman confirmed that an appropriate budget was available. Ms Wortham expressed the importance of providing opportunities for Governors to canvas the views of the public and the Chairman provided assurance that the Trust would support Governors in their engagement with local communities. Mr Shaw presented the results of the last staff survey, highlighting the action plan that had been developed to address the bottom five scores. Concern was raised around the percentage of staff who did not feel confident about raising concerns about unsafe clinical practice. Assurance was provided that the Trust was committed to improving this score and had already appointed a Speak Up Guardian to help support staff. The improvement in the percentage of staff appraised compared to the results from the previous year was commended. The Director of Workforce, Organisational Development and Communications advised that this year’s survey was currently underway, with results due to be available in March 2017. She agreed to present the results to the Governors as soon as they are available. Action: Director of Workforce, Organisational Development and

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Communications The Council RECEIVED the Membership Committee Report and acknowledged the work in progress.

09/11/10 Patient Experience and Equality Committee (PEEC) Report

Mr Shaw presented the report to the Council which highlighted the topics discussed at the Committee’s last meeting held in June 2016. He highlighted in particular a recent carers’ event around loneliness which had been very positive and thought provoking. He explained that the Committee was a very useful opportunity for understanding engagement. In response to a suggestion that the Committee developed an action plan Mr Shaw explained that essentially the Governors Engagement Strategy presented under the previous agenda item would fulfil that requirement. The Council RECEIVED the Patient Experience and Equality Committee (PEEC) Report and the unconfirmed minutes of the Patient Experience and Equality Committee meeting of 27 June 2016.

09/11/11 Governors’ Development Group Report

Ms Wortham presented the report to the Council which provided an update on the Group’s work and highlighted that Ms Roberts was also a member of the Group. Ms Wortham requested feedback from the Council in relation to the new bi-monthly information pack and the new format for meeting papers. Ms Naismith requested that the agenda for the meeting included the pack page number of the accompanying papers for each item. Action: Corporate Services Director The Council raised concern around the late availability of the meeting papers. The Council expressed concern that they had not been given sufficient time to read and digest the information and requested that papers be distributed earlier in future with hard copies also available earlier. The Corporate Services Director apologised for the delay in distributing the papers and confirmed documents should be available on the secure governor only area of the Trust’s website. The Chairman also apologised for the delay requested that papers for the Council of Governors meetings be available in the secure area of the website at the latest by the Thursday on the week prior to the meeting and that Governors requesting hard copies be sent their papers at the same time. Action: Corporate Services Director

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The Council agreed that the bi-monthly Governor information packs were good. Ms Wortham provided feedback from the NHS Providers Regional Governor Workshop held in London on 31 October 2016 which she attended. The event highlighted that there was no single way of operation but KCHFT’s approach seemed to be in line with many other Foundation Trusts. Key observations from the day were:

There was a split of Foundation Trusts who did and didn’t invite their Governors to see Committee minutes and minutes of private Board meetings.

There were various levels of Non-Executive engagement across the sector.

Some Trusts asked Governors to interview Non-Executive Directors seeking re-appointment.

The importance of Governor involvement in the Trusts’ annual plans and sustainability plans, with a focus on quality was acknowledged.

A presentation on the constitution by the Chair of Guys and St. Thomas’ Hospitals NHS FT highlighted the process for consulting with Governors when appointing the Senior Independent Director; an opinion that Non-Executive Directors should only be allowed to sit on one Foundation Trust Board; a debate on what a significant transactions was; and that there was no fixed rule as to whether the Trust Board or the Council of Governors had to approve constitutions first.

Overall Ms Wortham found the event a positive experience and refreshing to learn that KCHFT was performing in line with other Trusts. She recommended the Development Task Group explored developing the interaction between Governors, Non-Executive Directors and the Trust Board, developing the constitution and Governor development. The Council noted the presentation given by Ms Wortham at the event was well received. The Council RECEIVED the Council of Governors’ Development Task Group Report.

09/11/12 Constitution Review Group Report

Summary of constitution changes The Corporate Services Director tabled a revised report outlining the recommended changes to the constitution:

change of the term ‘Monitor’ to ‘NHS Improvement’;

removal of the word ‘applicant’ to reflect change in Trusts

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status;

removing terms regarding holding positions on two Board concurrently where there is no significant conflict of interest; and

A small number of grammatical changes. The Corporate Services Director explained that allowing Non-Executive Directors to hold positions on two Boards would provide experience and knowledge could prove beneficial to the Trust. Each applicant would be assessed before appointment to determine any conflicts of interest. Ms Naismith suggested it would be helpful to see a version of the constitution showing the tracked changes as well as a final version of the document when being asked to approve changes. Action: Corporate Services Director. Mr Price queried a phrase in the constitution ‘no significant transactions’. The Corporate Services Director explained that this had been debated at length and it had been previously determined that the constitution detailed several specific examples for items which would come to the Council and that the constitution of the Council was an agreed principle throughout the document. The Chairman asked for the amendment to remove the word ‘applicant’ be postponed as sentences containing that word required further amendment to ensure they still made sense. The Council RECEIVED the Constitution Review Group Report, and APPROVED the following changes to the constitution:

change of the term ‘Monitor’ to ‘NHS Improvement’;

removing terms regarding holding positions on two Board concurrently where there is no significant conflict of interest; and

A small number of grammatical changes. Governor Vacancy/upcoming Governor Elections January 2017 During a discussion around Council vacancies Ms Coleman suggested that the Trust needed to establish clarity regarding what it expected from Governors before it filled vacancies. Ms Roberts also raised concern that the appointed Governor role was much more involved than the partner organisations understood. The Trust needed to be able to clarify the role and the benefits for organisations to be represented on the Council as well as the role and benefits for public Governors. The Corporate Services Director agreed with this observation and advised that with regard to appointed Governors, the Trust was reviewing whether there was a better way to involve some of the organisations rather than as Governors.

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The Council of Governors NOTED that further detail on the Governor election process would follow in January 2017.

09/11/13 Performance Report

The Chief Executive presented his report and summarised the key activities and performance of the Trust. He highlighted the Trust’s overall strong performance against the Key Performance Indicators and explained that the Trust would be focussing on improving performance against the six red indicators. The Council noted that the increased lengths of stay and the delayed transfers of care were challenged across the whole of Kent and Medway and the Trust was working collaboratively with other organisations to address the challenges. There had been an increase in the number of pressure ulcers and an action plan had been presented to the Quality Committee together with assurance that robust action was being taken. The Chief Nurse explained that the aim was to address the issue and reduce the number of pressure ulcers urgently. A new Pressure Ulcer Task Force had been formed and would be meeting fortnightly from Thursday 10 November 2016. The Task Force included Team Leaders, nurses and hospital representatives. The aim would be to identify avoidable pressure ulcers and whether there had been any lapses in nursing care. The Chief Executive reported that at the end of October the Trust had been awarded the highest rating within the Single Oversight Framework for NHS Providers and was the only NHS provider in Kent and Medway to achieve this. The Council noted that the Trust had been successful in applying for a bid to pilot the Büurtzorg model of nursing care within West Kent. West Kent Clinical Commissioning Group asked the Trust to work with Edenbridge Medical Practice look at bringing GP and community health services together and some proposals for this model were likely to go out to consultation at the end of 2016 or early 2017. The Chief Executive explained that work was underway across Kent and Medway to develop the Sustainability and Transformation Plan. Examples of work streams within the plan were to improve performance against the four hour Accident and Emergency Department wait target and to reduce the use of temporary staffing. The aim was for the plan to be published before Christmas at which point a detailed briefing for Governors would be provided. The Council noted that the new Sexual Health contract in Medway had now been fully taken over by Kent Community Health NHS Foundation Trust.

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During the subsequent discussion around the performance report the following points were raised:

There was potential to roll out the Edenbridge model to other areas.

There had been no recent planned CQC inspections at the Trust but it was noted that ad-hoc inspections could take place at any time at any location.

The poor performance against the new birth home visits had been investigated as the national standard was for visits to take place within the first 14 days. It had been determined that most visits were taking place between 14 and 16 days and therefore the Trust was confident that while no significant delays were taking place, work was already underway to improve procedures ensuring visits took place earlier to improve compliance.

Clarity was provided around why the Trust had applied to pilot the Büurzorg model: The Integrated Pioneer Steering Group had been looking at this model which had strongly evidenced success in the Netherlands. The Trust has been successful in obtaining funding for this pilot which was also being run by a London Trust. Outcome of the London pilot would be reviewed and lessons learned taken forward for the Trust’s pilot of this model. A briefing on the model would be provided to the Council at a future meeting but the Trust acknowledged that implement the model would be a challenge. A Coach would work with the Trust to help identify any blocks in work practices and improve the work flow. A new supernumerary team would be developed to pilot the new work flows alongside current practices.

Ms Plummer asked for an update regarding mandatory training compliance in relation to fire training and moving and handling. The Director of Operations for Adults advised that the shortfall in fire training was largely among Adult Services and non-compliant staff had been contacted and booked onto courses. Extra manual handling training courses had been put in place and the Council should soon see an improvement in compliance for both these mandatory training requirements.

The Council RECEIVED the performance report.

09/11/14 Financial Plan 2017-19 Update

The Director of Finance advised that a summary of the operational financial plan had to be submitted in November 2016 with the plans being finalised before Christmas 2016. He explained that budget setting would start in December 2016 and be signed off in March 2017. The Council would have an opportunity to review the plans at a later stage in 2017. It was noted that the Clinical Commissioning Groups would be negotiating contracts with a 2% efficiency savings target for each NHS Trust. The

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Director of Finance explained that KCHFT would be working with a stretched target of 2.5% and would expect the Clinical Commissioning Groups to fund 2.1% inflation. The Director of Finance highlighted that nationally a £1.8 billion Sustainability and Transformation Fund (STF) had been allocated to Trusts in both 2017/18 and 2018/19. If KCHFT could secure a contribution of £1.8m, from the STF it would be able to plan for a £2.7m surplus. The Council noted that the Trust Board had received and agreed the financial plan recommendation and the risks and detail behind how to achieve the plan would be discussed over the next few months. In response to a question regarding the how the £1.8b contribution from the STF would be allocated over the three year period, it was explained that for the first two years the focus would be on sustainability, with the expectation that the focus would move to transformation during the third year. In response to a question regarding whether the financial controls would have an impact on the Cost Improvement Plan, The Director of Finance confirmed that there would be a 2% Cost Improvement Plan so there would be a component of financial control for this. The Council RECEIVED the Financial Plan 2017-19 update.

09/11/15 External Auditor’s Report on the Quality Report and Governors’ Indicator for 2016/17

Chris Long, Engagement Manager at Grant Thornton UK LLP introduced his colleague Emily Hill and presented the External Auditor’s report on KCHFT’s Quality Report. He explained that the report set out the external auditor’s testing of two mandatory indicators and one governor selected indicator. He confirmed that the auditors did not identify any issues with regard to the two mandatory indicators: compliance with regulations; and data quality of reported performance indicator. He also confirmed that the auditors did not identify any issues with regard to the governor selected indicator: number of attributable safe medicine errors. This allowed the auditors to issue an unqualified conclusion. Mr Long advised that the Council needed to set an indicator to be subjected to audit review for 2016/17. He explained that the indicator must be reportable and have comparable data. He gave suggestions such as: the number of patient falls; number of acquired pressure ulcers; number clostridium difficile cases; or one of the other targets from within the performance report. In response to concern raised regarding delayed reporting of medicine errors, the Medical Director advised that the Trust had a new contract with Boots for the financial year 2015/16 and the reporting of medicine errors

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should now become quicker. In response to a question regarding whether the national quality indicators for 2017/18 had been set yet, Mr Long advised that these were usually available by February each year. He advised that there had been no change to the national indicators in the last two years. He also highlighted that so far there had been no indicators specific for Community Trusts but this was expected to change in the future. The Council RECEIVED the External Auditor’s report on the 2015/16 Quality Report.

09/11/16 External Auditor’s Report on the Audit of Accounts 2015/16

Mr Long presented the external auditor’s report on the audit of the Accounts 2015/16. He confirmed the audit was completed successfully with minor revisions made to the report. The external auditor issued an unqualified opinion. Mr Long thanked the Trust for its cooperating during the audit process. The Council RECEIVED the external auditor’s report on the audit of accounts 2015/16. Ms Hill and Mr Long left the meeting.

09/11/17 Feedback from the Audit and Risk Committee on performance of the External Auditors

The Director of Finance presented the report from the Audit and Risk Committee and advised that the Finance Team had developed a professional relationship with the external auditors. He explained that the report set out the views of the Non-Executive members of the Audit and Risk Committee and recommended the Council retained the external auditors for a further year to provide a three year period of audit as a Foundation Trust before testing the market for a further three year period 2018/19 to 2020/21. The Director of Finance supported this recommendation. In response to a question regarding Grant Thornton’s fee for 2017/18, the Director of Finance explained that he understood the fee would not be increasing and a report confirming this was expected to be presented at the next Audit and Risk Committee meeting due to take place on Friday 11 November 2016. The Director of Finance explained that a tendering and appointment process would begin to be developed with the Governors later in the year.

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The Council APPROVED the recommendations to retain Grant Thornton as the external auditors for a further year and to begin a process to test the market for a three year period covering 2018/19 and 2020/21.

11/07/18 Governor annual review of External Auditors’ appointment

This item was discussed together with the previous agenda item 11/07/17 ‘Feedback from the Audit and Risk Committee on performance of the External Auditors’

09/11/19 Papers shared for Governor Information The Council NOTED the papers shared for Governor information.

09/11/20 09/11/21

Any Other Business No other business was discussed. Questions from Members of the Public Relating To The Agenda In response to a question regarding what the Trust was changing to avoid patients being readmitted to hospital after discharge, the Director of Operations for Adults acknowledged that there were whole system issues across Kent and Medway. She advised that the Trust had been involved in a meeting across Kent to discuss social care funding and the shortfall of available carers. She explained that the aim was to create a whole system approach where the Trust worked more closely with other organisations to help people remain more independent when they first came out of hospital. Mr Scott-Clark confirmed that developing a sustainable service was also key target for Kent County Council who had recognised the issues and were committed to improving social care service provided. The Chairman thanked everyone for attending.

09/11/22 Date and Time of Next Meeting

Wednesday 8 February 2017, 1.00pm Astor Pavilion at the Kent Event Centre, Kent Showground, Maidstone, Kent ME14 3JF

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1. Executive Summary

This report provides an update for Governors on the work of the Trust since the last Council meeting. I can report a strong position overall in Finance and Quality with areas for attention highlighted and discussed. The Sustainability and Transformation Plan is also explained..

2. Performance – Quality and Operational

The full Integrated Performance Report (IPR) has been circulated to the Council. Overall the targets on the IPR are showing a strong performance with 60% either green (meeting the target) or blue (meeting the aspirational or stretch target). All NHS Constitutional targets are being achieved. The recording of Long Term Condition activity (for example wound care home visits) is still proving problematic but is improving steadily. The Board also focused on the new birth visits target which was low; while the target is a visit within 14 days performance averages 16 days, and in some cases up to 21 days. Interventions here have proved successful and the Trust is on trajectory to hit this level of performance in the month nine figures. As the council will be aware, the pressures on the health and social care system have been significant over the last months. The whole system is stretched with capacity to meet the needs of all patients who require health care. This presents itself in high levels of attendances in primary care and hospital emergency departments. The period has also seen increased pressure on social care. The Trust has felt this pressure and I want to take the opportunity to thank all of our teams for the way they have gone beyond the normal for such a protracted period of time. The levels of collaboration between the parts of the system have been strong with Kent Community Health NHS Foundation Trust playing its full part. The use of the Trust’s Minor Injuries Units has increased by 7% with a slight dip in the 4 hour wait performance, but still well above target. Delayed transfers of care, when a patient could be discharged from our Community Hospitals but is not, are still far too high; as is the consequential length of stay in hospitals. While there is internal work on-going with regards to tackling these indicators, the Trust believes that the solutions will require whole system working and coordination, particularly with social care and acute trusts. The Sustainability and Transformation Plan designed to develop and implement a whole system response is discussed below. The Trust has regrettably had its first ‘Never Event’. A patients tooth was taken out in error. It has been reported to all the relevant regulatory bodies, immediate

Kent Community Health NHS Foundation Trust

Formal Council of Governors Meeting

Date of Meeting: Wednesday 8 February 2017

Agenda Item: 1.7 Trust’s Quarterly Report

Presenting Officer: Paul Bentley, Chief Executive

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measures have been put in place to prevent this happening again and a full in depth investigation with independent oversight s under way.

3. Financial

The Trust is maintaining financial performance with high confidence that it will meet its end of year target. Recent assessments estimate that the Trust will not just meet but surpass this target finishing the year with a £3 Million surplus. This is good news which means that the Trust is able to reinvest in services and measures to support the local health economy. The Trust has signed contracts for two years commencing 1 April 2017 with its main commissioners, which is a positive development. It has been achieved three months ahead of previous years and provides more time for the Trust and commissioners to concentrate on the ambitious plans for the local health and social care economy as outlined in the Sustainability and Transformation Plan.

4. Oversight and Regulation The Trust Executive has met with both its major regulators in the last few weeks. NHS Improvement and CQC both noted the Trust’s strong and stable position with no areas of concern raised by the regulators regarding the Trust. The CQC are supporting the Trust with the Never Event investigation.

5. Strategy

The Sustainability and Transformation Plan is the whole system plan to address Health and Social care needs. It incorporates all major healthcare providers in Kent, commissioners, and both Medway Unitary Authority and Kent County Council. The first iteration of the plan has previously been shared with the council and overarching aims are now being discussed with staff and the public to develop the proposals further. As the Council is aware the STP focuses on four priorities: Prevention of ill-health

Local care - better access to care and support in people’s own communities

Mental health – just as important as physical health

Hospital care – in a community, mental health or acute (main) hospital.

These priorities have been well received and endorsed by staff through a series of road shows and workshops. The Trust is pursuing an approach to integrate services with partners to enable coordination. Agreements are in place with both East Kent Hospitals and Maidstone and Tunbridge Wells Hospitals in relevant areas to coordinate care with developing partnerships with different primary care led groups around the county. Public consultation to any specific post changes is likely to begin later in 2017.

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In West Kent, the Clinical Commissioning Group (CCG) met with NHS England on 5 January 2017 to seek approval to proceed to a public consultation on options to bring together GP services and community services, including those provided by Edenbridge War Memorial Hospital into a single site. Approval was agreed in principle; with the proviso that the consultation reflected what the preferred option is, the workforce implications and the financial viability of the options. This work is now being carried by West Kent CCG, Kent Community Health NHS Foundation Trust and Edenbridge Medical Practice. The public consultation, which will be led by the CCG supported by Kent Community Health NHS Foundation Trust, will, subject to NHS England approval of the consultation document and West Kent CCG Board approval on 31 January 2017, commence on 1 February 2017 and run to 26 April 2017. A public launch event will take place on 7 February 2017. Kent Community Health NHS Foundation Trust will also be holding dedicated sessions for staff.

6. The Council of Governors The review of the Governor role within the Trust, incorporating the effectiveness of the Council, its support and the relationship with the Board has now been completed. This is presented as a separate agenda item in more detail. It has been a useful review and I believe this will ensure the continued development and on-going effectiveness of the Council of Governors. Paul Bentley Chief Executive 31 January 2017

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1. Introduction

This report provides the Council of Governors with assurance that the Trust is

gathering patient feedback, responding to complaints and acting on this

feedback to improve services.

Kent Community Health NHS Foundation Trust is committed to improving

patient experience. Our key values are to ensure good care that meets our

organisational values: compassion, aspirational, responsive and excellence.

All our staff hold responsibility to deliver care that is safe, effective and

provide patients and their families with a positive experience. This report

details the feedback for Quarter 3, 1 October to 31 December 2016.

2. Background

The Care Quality Commission, as the independent regulator in England, registers and inspects services to ensure they meet fundamental standards of care, including how caring and responsive organisations are to those in their care. Having a good experience of care, treatment and support has increasingly been seen as an essential part of an excellent health and social care service, alongside clinical effectiveness and safety. There are poorer outcomes, and health resources are wasted when people do not feel involved or do not understand the treatment they are offered (Doyle et al 2013). Data is taken from the Meridian surveys and is reported by team/locality. Complaints are recorded following the Trust’s complaints process.

3. Assessment

Complaints

The graph below shows complaints per 10,000 contacts, based on average

monthly contacts, showing a decrease in the number of complaints per month.

Kent Community Health NHS Foundation Trust

Formal Council of Governors Meeting

Date of Meeting: 8 February 2017

Agenda Item: 2.2 Quarterly Report on Patient Experience

Presenting Officer: Ruth Herron, Deputy Chief Nurse

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3.2 Benchmarking against other providers

The benchmarking club of community trusts shows the following (KCHFT orange bar). This is complaints per 1000 WTE budgeted staff.

4. Complaints Received

• There were 77 complaints for quarter 3.The graph below shows

complaints by subject. (Note: some complaints may cover more than 1

area).

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5. Key themes

Clinical Treatment Complaints that fall into this category may involve aspects of clinical care provided by health professionals, medical nursing or allied health professionals. They involve complaints about the patient’s diagnosis and treatment, complications that may arise either during or after treatment, patient falls, nutrition and hydration, infection control measures, hygiene, and pressure area care. During the quarter there were 26 complaints that fell into this category, which included:

• Querying the level of care a patient receives

• Unhappy with the treatment provided

• Staff did not recognise deteriorations/slow development

• Unhappy with diagnosis and that missed diagnosis

• That treatment was stopped

• Unhappy with outcome of surgery

• Delay in contacting ambulance service

• Lack of nursing input following discharge from acute hospital

Admissions, discharges and transfers During the quarter there were 4 complaints that fell into this category.

• Unhappy with tone of letter

• Unhappy that discharged from service after did not attend appointment

• Unhappy that discharged from community hospital too soon

0

5

10

15

20

25

30

Complaints by Subject (primary) and Opened

Dec 2016

Nov 2016

Oct 2016

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Access to treatment and medication During the quarter there were 24 complaints that fell into this category. The majority of these concerns were in relation to:

• Unhappy with new booking system

• Unhappy with delay in receiving HIV medication

• Unhappy regarding closure of clinic

• Unhappy with the waiting time for treatment, equipment or onto correct

pathway

• That patients with disabilities wait too long for urgent dental treatment

• Not receiving a home visit

• Appointment being cancelled

• Unhappy that flu vaccinations not received

Values and behaviours This category may include complaints about staff attitude, professional behaviour, failure of staff to introduce themselves and breaches of confidentiality. During the quarter there were 8 complaints that fell into this category. These concerns included:

• Feeling comments made by staff member were rude

• Unhappy with verbal statement staff member made

• Attitude of staff

Communication During the quarter there were 25 complaints that fell into this category. The concerns were in relation to:

• Letter for appointment sent to patient for ante-natal review following a

miscarriage

• Lack of contact and unhappy about booking system

• Difficulty in making telephone contact

• Information on external internet searches incorrect

• Family unhappy for patient to be told that they were dying

• Communication issues between professionals and with family

6. Ombudsman Cases

There are currently 2 complaint cases with the Ombudsman, these are being

formally investigated. These are in relation to:

• Patient transfer

• Inpatient treatment and hydration

During the quarter we have received 2 Ombudsman rulings and the 2 cases

were not upheld. These cases related to the care of an end of life patient and

to a transfer of care issue.

7. Response Times

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The timescale for responding to each complaint is dependent upon the nature

of the issues raised and the level of investigation required. For the majority of

complaints the Trust aims to respond within 25 working days. For more

complex complaints, for example those involving a number of different

specialties, organisations or a serious incident that require a root cause

analysis, a longer timescale for the response is agreed with the complainant

allowing time to undertake a thorough and fair investigation – this may take up

to 60 working days to complete. The Trust now works to a response of 60

working days for multi-agency complaints that it is leading on. During the year

the Trust responded to 90% of all complaints within the timescale initially

agreed. Where delays occurred regular contact was made with the

patient/family to keep them updated.

In the last 3 months there were 4 complaint responses not meeting the set 25 day (internal) timeline. In 1 case this was due to operational manager delay in response. The further 3 were due to delays in approval at senior management level as the Trust has commenced a more rigorous approval process at executive level, in order to improve the quality of the complaint response. All multi-agency complaints (53) met the 60 day multi-agency response target.

8. Complaint Feedback

The Trust surveys complainants after the complaint is closed in order to get

feedback on the way the complaint was handled. In Quarter 3 there was only

1 response to the Trust’s survey sent to complainants. Feedback from this

survey was 100% satisfactory.

9. The Customer Care Team (PALS)

Customer Care enquiries are contacts from patients or family members that

can be easily remedied by the service concerned. The Customer Care Team

contacts the service to ask them to resolve the issue and make contact with

the caller. This enables services to resolve issues as they arise, and reduce

the number that go on to become complaints.

93%

7%

Met

Not Met

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Key themes from PALS feedback: • Child Immunisation Service. The calls were mainly concerning the on-

line consent form and the process to receive the vaccination

• The transfer from Medway Community Healthcare to KCHFT for

podiatry services in regards access and contact information

• The Customer Care Team has received several emails/calls from

parents who are unhappy with the National Child Measurement

Programme letters they have received, the wording of which suggests

that their child is overweight

10. Compliments

Services are encouraged to log compliments. The table below shows the

compliments logged in quarter 3. It is estimated that there is substantially more feedback that is not shared centrally and therefore this is a snapshot of the compliments across KCHFT.

Directorate Written Compliments

Verbal Compliments

Total

Adults

103 46 149

Adults – Health

Improvement & Self-Management

52 43 95

Children and Young People

37 38 75

CYP- Dental

4 3 7

CYP – Sexual Health

11 23 34

Other Directorate

1 - 1

TOTAL 208 153 361

11. Friends and Family Test data

The Trust’s overall patient experience score for quarter 3 is 96.76 % based on

15,522 surveys. This is a slight decrease in score (96.88%) and a decrease in

survey returns (18,365) when compared with quarter 2. This can be

explained by the loss of services provided in the Dartford, Gravesham,

Swanley and Swale areas since the end of September 2016.

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The Trust’s NHS Friends and Family Test (FFT) score for quarter 3 is 97.71%

to recommend, which is an improvement on the last quarter of 97.64%.

14,891 people answered the FFT question, with only 68 patients being

unlikely or extremely unlikely to recommend.

Quarter 3

Recommend Not

Recommend Total

Responses Extremely

Likely Likely

Neither Likely or Unlikely

Unlikely Extremely Unlikely

Don't Know

Trust 97.71% 0.46% 14891 12183 2367 154 36 32 119

Quarter 2

Recommend Not

Recommend Total

Responses Extremely

Likely Likely

Neither Likely or Unlikely

Unlikely Extremely Unlikely

Don't Know

Trust 97.64% 0.49% 17491 14267 2812 218 48 37 109

The table below shows the FFT score across all services per CCG:

Clinical Commissioning Group

Recommend Not

Recommend Total

Responses Extremely

Likely Likely

Neither Likely or Unlikely

Unlikely Extremely Unlikely

Don't Know

Ashford 97.71% 1.00% 698 570 112 5 5 2 4

Canterbury and Coastal

97.77% 0.56% 1797 1409 348 14 6 4 16

Dartford, Gravesham and Swanley

96.90% 0.19% 1063 838 192 17 1 1 14

Dover, Deal and Shepway

98.34% 0.36% 2771 2310 415 16 8 2 20

East Sussex 95.29% 1.18% 170 122 40 5 1 1 1

Maidstone, Malling, West Kent and Weald

96.95% 0.50% 3177 2541 539 46 10 6 35

Medway 97.54% 1.40% 285 232 46 2 1 3 1

Other 96.29% 0.71% 566 393 152 8 2 2 9

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Clinical Commissioning Group

Recommend Not

Recommend Total

Responses Extremely

Likely Likely

Neither Likely or Unlikely

Unlikely Extremely Unlikely

Don't Know

Swale 99.51% 0.15% 3256 2977 263 8 1 4 3

Thanet 94.86% 0.72% 1108 791 260 33 1 7 16

Summary 97.71% 0.46% 14891 12183 2367 154 36 32 119

Services that fall into ‘Other’ category above

Recommend Not

Recommend Total

Responses Extremely

Likely Likely

Neither Likely or Unlikely

Unlikely Extremely Unlikely

Don't Know

CHATS (Child and Adult Therapy Service) - London

100.00% 0.00% 1 1 0 0 0 0 0

Community Chronic Pain - Hillingdon

60.00% 0.00% 5 0 3 2 0 0 0

Dental (Adult): Colnbrook Immigration Removal Centre

88.89% 0.00% 9 4 4 1 0 0 0

Dental (Adult): Dover Immigration Removal Centre - Dover

100.00% 0.00% 1 0 1 0 0 0 0

Dental (Adult): Harmondsworth Immigration Removal Centre

72.73% 0.00% 22 9 7 2 0 0 4

Dental (Adult): HMP Maidstone - Maidstone

85.71% 0.00% 7 5 1 0 0 0 1

Dental (Adult): HMP Standford Hill - Swale (Isle of Sheppey)

80.00% 0.00% 5 3 1 1 0 0 0

Dental (Adult): HMP Swaleside - Swale (Isle of Sheppey)

92.31% 0.00% 13 7 5 1 0 0 0

Dental (Adults and Children) - Appleby Centre

98.44% 0.93% 321 234 82 0 2 1 2

Dental (Adults and Children) - Shrewsbury Centre

98.86% 0.57% 176 129 45 0 0 1 1

Looked After Children Nursing Service - KOLA

100.00% 0.00% 2 1 1 0 0 0 0

Looked After 33.33% 0.00% 3 0 1 1 0 0 1

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Services that fall into ‘Other’ category above

Recommend Not

Recommend Total

Responses Extremely

Likely Likely

Neither Likely or Unlikely

Unlikely Extremely Unlikely

Don't Know

Children Nursing Service - OLA

Specialist Nurse Practitioner for Looked After Young People

100.00% 0.00% 1 1 0 0 0 0 0

Summary 96.29% 0.71% 566 394 151 8 2 2 9

The table below shows the FFT scores for Minor Injury Units (MIUs) in the last

quarter. The highest area for negative feedback was at the Royal Victoria

Hospital, Folkestone MIU (6 unlikely and 1 extremely unlikely responses).The

recommendations have improved in comparison to the previous quarter

(99.04%).

MIUs Recommend Not

Recommend Total

Responses Extremely

Likely Likely

Neither Likely or Unlikely

Unlikely Extremely Unlikely

Don't Know

Minor Injury Unit (Community Hospital at Deal)

99.43% 0.14% 699 629 66 1 1 0 2

Minor Injury Unit (Community Hospital in Edenbridge)

98.60% 0.60% 501 436 58 3 2 1 1

Minor Injury Unit (Community Hospital in Sevenoaks)

98.58% 0.43% 704 625 69 5 1 2 2

Minor Injury Unit (Gravesham Community Hospital)

98.44% 0.00% 192 161 28 3 0 0 0

Minor Injury Unit (Royal Victoria Hospital, Folkestone)

98.23% 0.56% 1073 876 178 7 5 1 6

Minor Injury Unit (Sheppey)

99.52% 0.00% 1042 941 96 4 0 0 1

Minor Injury Unit (Sittingbourne)

99.83% 0.06% 1776 1678 95 2 0 1 0

Summary 99.15% 0.23% 5987 5346 590 25 9 5 12

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The table below shows the FFT scores for community hospital in-patients in

the last quarter. These are showing high levels of satisfaction within the

services.

Community Hospitals

Recommend Not

Recommend Total

Responses Extremely

Likely Likely

Neither Likely or Unlikely

Unlikely Extremely Unlikely

Don't Know

Community Hospital (Deal) - Elizabeth Ward

95.74% 0.00% 47 38 7 1 0 0 1

Community Hospital (Edenbridge)

100.00% 0.00% 17 16 1 0 0 0 0

Community Hospital (Faversham)

100.00% 0.00% 21 14 7 0 0 0 0

Community Hospital (Hawkhurst)

100.00% 0.00% 29 22 7 0 0 0 0

Community Hospital (Herne Bay) - Heron Ward

95.92% 2.04% 49 33 14 1 1 0 0

Community Hospital (Sevenoaks)

100.00% 0.00% 25 14 11 0 0 0 0

Community Hospital (Tonbridge) - Goldsmid Ward

100.00% 0.00% 15 11 4 0 0 0 0

Community Hospital (Whitstable and Tankerton) - Friends Ward

100.00% 0.00% 14 8 6 0 0 0 0

Summary 98.16% 0.46% 217 156 57 2 1 0 1

All surveys which receive an unlikely or extremely unlikely response to the

FFT question are recorded and also included in Quality Group reports and

teams are asked to note and take action where there is negative feedback.

Examples of negative feedback and actions include:

• Extremely unlikely to recommend however positive responses to all

survey questions (Child and Adult Therapy Service – Gravesham).

• Extremely unlikely “Every time I had a question the health visitor did

not know the answer! Google was more informative. Weigh on

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sessions were of little use.” The Locality Clinical Manager has advised

Team Coordinators to make staff aware of this feedback.(Health

Visiting – Thanet)

• Unlikely “I was seen on time well after waiting ten minutes to be seen

at reception and I have changed it to unlikely.” Clinical area manager

highlighted this was due to staff sickness and a notice has now been

displayed informing patients when there is currently no receptionist that

the dental nurses are covering the reception area as well as surgery.

Dental (Adults and Children) - Appleby Centre

• Extremely unlikely “Because they would need a hospital referral.”

Physiotherapy (MSK) - Sevenoaks Hospital

• Unlikely “Unable to treat my injury or health problem. No x-ray was

taken of my probably broken toe”. Service advised that this was a

primary care issue and the service does not treat this conditions

anymore. Service feedback states “Patients have been very angry over

Christmas as they are unable to see a GP and because the service

used to treat Primary care patients get very cross when they are told

they have to ring 111”.(Minor Injury Unit Royal Victoria Hospital,

Folkestone).

• Unlikely “Walked up to hospital and note on door saying service

moved. Poor communication. Disorganised - waited 2.5 hours after

being told an hour wait. Medway hospital much more organised.” The

service has advised that waiting times are regularly updated hourly or

sooner if needed. This has been communicated to the reception staff

and has also been suggested that they make patients aware of the

waiting time upon arrival at the reception. This is being monitored by

the reception team and they will flag up any concerns with the clinic

managers. (Sexual Health Service – Chatham).

The Trust measures patient experience against seven key areas. The table

below shows the overall scores per locality based on a combined score

across children’s and adult services.

Locality Returns Communi-

cation

Co-ordinated

Care

Equality and

Diversity

Given necessary

info

Involved in

decisions about care

and treatment

Listened to and worries taken

seriously

Staff Attitude

Ashford (Locality)

664 98.61% 92.50% 99.20% 98.72% 99.10% 98.85% 99.20%

Canterbury and Coastal

1763 98.51% 92.37% 99.83% 97.09% 96.04% 98.54% 99.57%

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Locality Returns Communi-

cation

Co-ordinated

Care

Equality and

Diversity

Given necessary

info

Involved in

decisions about care

and treatment

Listened to and worries taken

seriously

Staff Attitude

(Locality)

Dartford, Gravesham and Swanley

1007 97.21% - 99.69% 99.01% 98.99% 99.19% 100.00%

Dover, Deal and Shepway

972 98.07% 92.09% 99.57% 97.52% 98.54% 98.62% 98.92%

East Sussex (Locality)

213 99.01% - 100.00% 98.92% 98.21% 99.37% 99.31%

Maidstone, Malling, West Kent and Weald

1875 97.14% 94.82% 99.16% 96.72% 97.91% 98.77% 99.17%

Medway (Locality)

288 97.11% 90.00% 99.64% 96.42% 98.10% 99.65% 100.00%

Other 571 97.54% - 95.30% 98.98% 97.47% 97.81% 99.65%

Swale (Locality)

440 97.63% - 99.54% 98.39% 98.38% 99.07% 99.78%

Thanet (Locality)

1018 98.32% 91.10% 99.44% 96.77% 97.70% 99.00% 99.61%

Trust Total 8704 97.87% 92.84% 99.26% 97.56% 97.79% 98.80% 99.46%

• Key Words (from Meridian data)

Words are coloured green/red depending on the score (above/below average)

of the surveys they appear in. They are also sized to show how often they

appear (the larger the more frequent).

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12. Actions from closed complaints and Patient Experience feedback:

A new leaflet giving clear information on assessment and expectations was devised following feedback that a patient was unhappy that she was 'forced' to do more than she was capable of and not allowed to take breaks within the assessment. (South East DriveAbility)

Individual training and support has been provided on fundamental and advanced communication skills in end of life care to a community nurse. A further workshop was delivered to the whole team around involving patients and their families in difficult conversations at the end of life by our end of life care facilitator. This action was undertaken following feedback from a patient’s family on care at end of life (community nursing).

Pain assessment tool being utilised following patient complaint regarding pain not being treated (community hospital)

Spot audits being undertaken to review dressings and treatment following complaint that home visits for replacement of dressings were missed (community nursing)

Information, process and guidance updated for immunisations

‘Taking a swab’ information and guidance for patients revised (Sexual Health services)

13. NHS Choices / Patient Opinion comments

There were 31 comments on NHS Choices and Patient Opinion during the

quarter. A selection of these is listed below:

• I recently visited this hospital for a blood test. The staff were so

friendly. I didn't feel well and the team really looked after me. Even

after I left their area they came and checked I was ok. The nurse who

did my test even went out of their way to get some Lucozade and also

put a fan on me! Great service (Gravesend Phlebotomy).

• I'm appalled at the level of service my daughter and I received at

Sevenoaks MIU today. We attended three days ago with my daughter's

swollen and sore toe, to be told it was "probably" a soft tissue injury

and given the usual advice to rest, elevate the foot, apply ice packs

and take ibuprofen and it should improve after a couple of days. An X-

ray couldn't be done as it was after that dept had closed for the day.

When it hadn't improved after three days, and in fact was worse, we

visited Sevenoaks MIU again. we were then taken to see a nurse who

quite abruptly and rudely told us that they wouldn't be looking at my

daughter's toe again as she had already been seen three days ago by

their colleague. We saw our GP who gave it a thorough examination

and referred us to Darenth Valley Hospital for an X-ray to rule out a

fracture something that could quite easily have been done at

Sevenoaks MIU. Thankfully, I have the diagnosis that it is not in fact

broken. What a complete and utter waste of ours and everyone else's

time.

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• I have had two knee replacement operations since February this year

and have both times been referred to Herne bay for Physio. Both times

I have found that the staff including the person at reception through to

the Physiotherapists are all without exception, understanding, helpful,

caring and very professional. It has been a pleasure to deal with them.

(MSK Herne Bay).

14. Recommendation

The Council of Governors is asked to note this report.

Mary Kirk Head of Practice Excellence and Quality January 2017

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1. Introduction

This report provides the Council of Governors with assurance that the Trust is

engaging with patients and the public including those we find harder to reach

and ensuring they are involved in on-going service improvement.

The Trust has a statutory duty to consult patients and the public on all

significant changes to services. Consultation may range from informing

people and seeking comments and concerns to full public consultation. Best

practice is for services to be co-designed with patients / service users and

staff as partners.

In the last quarter the Trust engaged with patients, public and other

stakeholders in a variety of ways including getting new patient / public

representatives for several committees, listening to young people about the

ways they want to be involved and working in partnership with KCC and our

services on supporting migrant communities to better engage with health

services. We recruited 460 new foundation trust members in the quarter,

bringing the total to 12,483.

The Trust received its Engagement health check from Healthwatch Kent and

this was very positive about the Trust’s work on engagement, in particular our

efforts to involve those who are often harder to reach.

The Engagement Team is increasingly involved in staff engagement.

Highlights in the quarter included supporting the three staff networks to hold

an event focussed on ‘Recruiting and retaining a diverse workforce’. The

event was very successful with the ideas from staff shaping an action plan

that will be taken forward by the Trust’s Workforce Equality Group.

Kent Community Health NHS Foundation Trust

Formal Council of Governors Meeting

Date of Meeting: 8 February 2017

Agenda Item: 2.3 Quarterly Report on Public Engagement

Presenting Governor: Louise Norris, Director of Workforce, Organisational Development and Communications

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Implementing the Accessible Information Standard has been a big focus in

terms of patient communications, with work streams for communication,

feedback, IT and training for staff.

2. Patient and Public Engagement and Membership

The Public and Patient Engagement Manager and Membership and

Engagement Officer work with services to promote and support patient and

public involvement.

During the quarter the team has:

• Continued to engage with young people and youth organisations to

develop our engagement plan with young people’s direct involvement.

This has included attending Swale Youth Forum, Millmead Young

Person’s Group, sending out a survey to younger FT members and

voluntary organisations, meeting with ‘Young Kent’, and presenting a

briefing to the Children and Young People’s Quality Group and

Specialist Services group on engaging with young people

• Attended Faversham, Deal and Tonbridge Community Hospital Patient

Experience Groups (PEGs) and reviewed how they are working. Also

recruited new members for Faversham and Sevenoaks PEGs

• Set up the Kent Migrant Communities network for professionals, which

builds on the model we developed with KCC for the Roma Community

Network

• Worked with colleagues at KCC and from Health Visiting to develop a

project proposal to improve awareness among migrant communities of

the way the NHS works in order that people use services appropriately

and understand the role of services such as health visiting. It will also

provide cultural awareness training for our staff to assist them to work

more effectively with migrant communities. This proposal will result in a

bid to the government’s Controlling Migration Fund, aimed at ensuring

that resident communities are not adversely affected by migrants

settling in their area

• Presented a NHS overview to the Syrian resettlement programme ‘train

the trainers’ in conjunction with Ashford borough council and the Home

Office

• Worked with our Sexual Health Services in Medway to set up a sexual

health public advisory group. This included recruiting patient / public

representatives and engaging with Strood Academy

• Recruited voluntary sector representatives from Porchlight to join the

Kent Sexual Health Public Advisory Group

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• Recruited three new members for Thanet Adult Speech and Language

Therapy forum

• Recruited representatives from Medway gender sexual diversity centre

and a carers organisation for the Patient Experience and Equality

Committee

• Recruited a new patient/public representative for the Research and

Development Committee

• Arranged an information session for Patient Engagement Network

(PEN) members on complaints

• Worked with the KCHFT research team for them to present at

Healthwatch Kent’s volunteer awareness day

• Held well attended thank you event for Patient / Public reps, which

included workshops on ‘Patient Leadership’. This involved a speaker

from the Point of Care Foundation talking about the concept of patient

leadership. Some KCHFT staff who work with patient / public reps

attended too and found the event very useful

• Supported the volunteer thank you events in Gravesend and Sheppey

• Supported our three staff networks to hold their first joint event in

October and facilitated the subsequent meeting to pull together

feedback from the event into an action plan

• Attended the LGBTQ staff network meetings and the Red Ribbon

Route walk on World Aids Day

• Attended the BME Staff Networks Black History Month event

• Made links with Maidstone and Tunbridge Wells NHS Trust to help us

develop work on transgender issues. They have allowed us to attend

one of their staff awareness sessions and shared their Transitioning at

Work policy with us.

During the quarter the team recruited 460 new members, bringing the total

public membership to 12,483. Of the total membership, 860 are from Black

and Minority Ethnic communities, 352 are aged 19 or under, and 501 are

aged over 80. The team has continued targeting recruitment in areas

where membership is lower, including: Dartford, Gravesham and

Tunbridge Wells and amongst working age men.

3. Patient Information

The Accessible Information Standard (AIS) launched by NHS England

became mandatory as of 31 July 2016. The standard tells organisations how

to make information accessible to patients, service users and their carers or

parents whose needs relate to a disability, impairment or sensory loss. The

AIS will be monitored as part of the Care Quality Commission’s inspection

process.

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During the last quarter, the Patient Information Manager, jointly with the

Standard Assurance Team, have been the key contacts for the AIS and

working with the Trust’s steering group to oversee implementation. The

Patient Information Manager is responsible for the communication work

stream. During the quarter this has included:

• Drafting materials to help to raise staff awareness: Staff poster, prompt

cards, pens, bookmarks, Staff handbook and Managers’ presentation

pack. Managers’ pack will be expected to be shared at team meetings

and cascaded down to staff. The planned launch date is early March,

with roadshows across the patch to help staff understand the

requirements.

• The public website and flo is being updated as and when required, with

dedicated pages about AIS

• The Trust’s electronic patient record software - CIS - is currently being

updated, and we are working with services to set up a generic form that

can be used to meet the AIS requirements

• Information Governance is producing a new leaflet on the subject of

consent when communicating information by email and text. Once this

has been ratified an Easy Read and large print version will be

produced.

• An AIS survey for people is available on the public site or on request

from staff when they use our services. This will enable people to give

feedback on whether their communication needs are being met.

Interpreting services continue to prove to be a challenge and so a new service

provider is being used by services to work alongside Capita interpreting

services for foreign languages, due to shortage of interpreters for face-to-face

interpreting. A new contract is in place with the Kent Association for the Blind

(KAB) to provide the Trust an audio and braille transcription service.

4. Community Involvement and Equality

During the quarter we have worked with School Nursing to continue to engage

with young people and seek their views on both the current service and how it

should be delivered in future. This included a session at Abbey School,

Faversham in December.

We continue to work with Kent carers organisations to implement our Carer

Action Plan and they have provided several carer awareness sessions for

KCHFT teams, including community nursing in Whitstable and in Thanet.

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We assisted a number of colleagues with doing an Equality Analysis on

policies, including Ecommerce, Resuscitation, Procurement, IT disposal and

the Purchase card policy.

We continue to deliver Equality and Diversity training at corporate induction

every two weeks and to deal with queries from colleagues concerning equality

issues.

5. Conclusion The Council of Governors is asked to note the report. Karen Edmunds Head of Engagement 25 January 2017

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1

1. Executive Summary

This report updates the Council of Governors on the Governor Development Task Group’s membership, on progress made to date and current position. It recommends a review of this task and finish group’s remit and membership. The report notes topics included in Governors’ Development Day held on 7 December 2017.

2. Introduction

The Governors’ Development Task Group is a task and finish group set up to oversee the development programme for Governors. The Group held its first meeting on 21 April 2016. The Council of Governors approved the group’s membership and objectives at the Council meeting on 11 May 2016. There have been two meetings of the Group since the last Council meeting on 9 November 2016. The January meeting was cancelled.

Three members of the Group have resigned from the Council: Ken Rogers, Graham Shaw and Jane Roberts. They with current members are thanked for their contribution to the success of the Group. The remaining members are:

Sonja Bigg Carol Coleman

David Price Kate Wortham (Chair)

The Group is supported by the Trust.

3. Development Task Group

The Development Task Group set three main goals:

1. To develop and maintain more effective communication with the Trust and across the Council.

2. To have developed and implemented a Governors’ Engagement Programme with the support of the Trust

3. To build and develop effective processes to support Governors in executing their duty of holding NEDs individually and collectively to account for the performance of the Board

Progress to date

A considerable amount of work has been undertaken to achieve more effective communications including setting up of a Flo intranet workspace and a shared

Kent Community Health NHS Foundation Trust

Formal Council of Governors Meeting

Date of Meeting: 8 February 2017

Agenda Item: 2.4 Governor Development Task Group Report

Presenting Governor: Kate Wortham, Public Governor Canterbury

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calendar for Governors; bimonthly information packs for Governors which started in October 2016; a simplified format for papers for Council meeting; pre-meeting workshop to look at meeting papers to improve effectiveness of Council meetings.

In addition, guidance was provided on Board members’ roles and responsibilities; a Governor skills audit was undertaken; a forward plan has been developed for Council meetings and Development Session; and the Development Group had input into the content of Development Days in 2016.

The Group recognised attending Board Committee meetings was not a routine part of the Governor’s role, but could be useful for understanding aspects of the Trust and the work of Non-Executive Directors. The Group recommended that any Governor wishing to attend a Board Committee meeting should seek prior approval from the Committee Chair explaining why they wished to attend.

Outstanding actions.

There has been limited progress in the following areas:

The Governors’ Engagement Programme is part of the Trust’s Membership Engagement Strategy which is under review. This work is being undertaken through the Council of Governors Membership Committee. Meanwhile, Governors are still involved in engagement events with Members and the public, including Patient Engagement Groups at community hospitals and joining Trust staff in health promotion events. An event with East Kent Hospitals University NHS Foundation Trust focussing on Diabetes is planned in Canterbury on Saturday 18 March 2017.

A discussion paper has been drafted looking at ways Governors can effectively hold Non-Executive Directors to account for the performance of the Board. The paper draws on examples of how other Councils of Governors are carrying out this duty.

Systems to improve communications, such as Flo intranet workspace and shared calendar, are in place but need active maintenance and updating which has not been possible due to changes and temporary shortages of Trust support for Governors. The forward plan for Council meetings and Board Committee papers have not been upload onto Flo; bimonthly information packs for Governors have yet to become routine.

Discussions on the composition of the Council of Governors including public and staff Governors constituency areas and appointed Governors. This work is being led by the Constitution Group which meets on an ad hoc basis.

A visit to another well established Foundation Trust Council of Governors has been put on hold until the election of a new Lead Governor and new Governors are appointed.

Review of the Development Task and Finish Group

The Group has made considerable progress. The outstanding actions are currently outside the control of the Group. It is currently depleted in the number of Governors. The Group was set up as an ad hoc time limited group to be reviewed in March 2017.

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3

Council is asked to note the work undertaken by the Development Group to date. It is asked to agree a review of the ongoing need for a Development Group. The review to include the format of the Group, its composition and remit if it is decided the Development Group should continue. The review to take place when Governors are appointed following the current elections.

4. Development Day

Governors had a Development Day on 7 December covering:

Sustainability and Transformation Plan – Paul Bentley Chief Executive

New Models of Care – Cathy Bellman from Encompass Vanguard

Governor Engagement – Julia Rogers, Assistant Director Communications

Governor Elections update – Natalie Davies, Corporate Services Director

5. Conclusion

The Council is asked to

Note the work undertaken by the Development Group to date

Approve the recommendation that any Governor wishing to attend a Board Committee meeting should seek prior approval from the Committee Chair explaining why they wished to attend.

Approve a review of the ongoing need for a Development Group. The review:

o To include the format of the Development Group, its composition and remit, if it is decided the Group should continue.

o To take place when Governors are appointed following the current elections.

Kate Wortham Public Governor Canterbury Chair Governors Development Task Group 27 January 2017

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1. Executive Summary

The CEO had been listening to some recent requests for information and enhanced clarity and thought that the Trust could provide greater support to the Governors to enable them to fulfill their responsibilities as Governors. With this in mind the CEO suggested a short review to better understand:

How Governors understand what the Trust is striving to achieve

What support the Trust needs to give to enable Governors to do their job

How Governors define their success

What administrative resources would make the Governors feel supported

What information the Governors need to understand the business and enable The Trust to deliver the correct care to our Patients

What ideas the Governors have to ensure the support required is achieved The objective of this work is to provide better Governor support, take the Governor contribution to an even higher level and make the role more interesting and rewarding. 15 Governors included in review - Gary Frost, Sue Plummer, Carol Coleman, Jo Naismith, David Price, Andrew Scott Clark, Ken Rogers, Kate Wortham, Antony Moore, Mark Johnson, Claire Buckingham, Sonja Bigg, Gary Denmark, Jane Hetherington, and Jane Roberts.

2. Findings

Suggested recommendations which have been distilled from conversations with Governors during the review

Clarity of Role

General Administration

Information Support requested by the Governors

Development Days

Induction of Governors

Kent Community Health NHS Foundation Trust

Formal Council of Governors Meeting

Date of Meeting: 8 February 2017

Agenda Item: 2.5 Feedback from Governor meeting with Director of Workforce, Organisational Development and Communications and Non-Executive Director

Presenting Officer:

Bridget Skelton, Non-Executive Director

Louise Norris, Director of Workforce, Organisational Development and Communications

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Engaging constituents.

Holding NEDs to account

3. Clarity of Role

Most Governors were clear that their role involved three distinct roles:

Listening to and engaging their constituents - be the voice of the constituent

Adhering to statutory duties of appraisal, recruitment and reappointment

Holding the NEDs to account There was some useful discussion about elements of each role with clarity sort on what it meant to for example ‘input’, and ‘represent’. Many felt that various parties could benefit from having the role of a Governor restated – staff, Governors, NEDs, executive and constituents. Useful expressions describing the role were shared including 'being the voice', having a 'temperature gauge', collecting 'soft intelligence', sense of 'what is happening on the ground', 'representing the public' and 'ambassador of the Trust'. Most Governors wish to find the role interesting, wish to make a difference and feel valued. They were in the main unsure how much value they added but were keen to do more especially with their constituents, whether they be staff, members or the public. The Governors wish to be engaged in such a way they believe they are valued, and not just a piece of Governance to be tolerated. Suggested recommendations:

Draft a short paper that sets out the role of a Governor and the types of Governors including a clear articulation of benefits to an organisation or body for sponsoring an ‘appointed’ as opposed to an elected Governor

Share the paper with Governors, NEDs, Executive, and Staff as well as constituents if appropriate

Introduce the workings of a Governor at Staff induction as part of explaining the governance of a ‘Foundation Trust’

4. General Administration Governors felt they would be able to do a better job if they had ‘dedicated support’ that understood their role, what they needed and could tailor material to their needs. Over the last few months they have had meetings organized and cancelled, materials arriving late and have felt the Trust does not really care or is trying to over control them. The Governors wished to be supported not controlled, there is a general feeling that they are being managed as opposed to supported. Suggested recommendations:

A dedicated member of staff is appointed who has a clearly defined role with the necessary skills to provide dedicated and continuity of support to the Governors

Meetings are set up in advance with an annual calendar setting out a forward plan that has been agreed

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A schedule of Trust meetings is shared with the Governors with clear suggestions of which they could attend with an explanation of why they are relevant and useful to be part of - for learning, for information, or for contribution

5. Information Support requested by the Governors Nearly all Governors said the volume of papers received made reading and understanding them prohibitive and requested shorter, executive summaries describing key issues with links to appendices, minutes or papers for further reading if interested or required. Suggested recommendations:

Executive summaries produced for papers exceeding four sides of A4 sent to Governors

6. Development Sessions Development sessions were felt to be important to work more closely together as Governors, discuss issues in a more informal manner than is possible than at a formal Council Session and learn from each other. It was felt there could be a little more tailoring of Development sessions to ensure all the different types of Governors can benefit and find them relevant. It was felt the emphasis on most presentations was on Public Governors. Many presentations are currently made to the Governors as information describing what the Trust is doing. Governors felt many topics could be better tailored to help them either understand how they could support the trust or discuss the relevance to their constituents be invited to consider how they should be talking about the issue with them as well as gathering views to feedback to the Trust. Many of the Governors appreciated that their role was to hear the voice of their constituent but was not sure how to bring that voice back to the Trust. Many Governors wished to spend more time discussing and agreeing the best way to engage and consult with their constituents. Governors welcomed briefings from the Chairman and CEO on the Trusts vision, CQC status, Finances, Long term issues, the National picture and issues around Staff and Patients, complaints, serious incidents, safety, commercial contracts, strategic ideas, performance as well as the STP, performance and benchmark data. The Governors would welcome working with KCHFT Communications team to identify and develop communications together that would work for KCHFT, and not be told what KCHFT are doing for engagement, with no mention of Governors involvement.

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7. Induction of Governors There were a number of items that it was felt useful to have included at Induction and then updated at the Development days. Content to include could include:

Services provided by the Trust and those delivered in each area.

Explain how the NHS works and how it relates to Local Authorities, CCG and CQC

The business and its model of operation.

Stakeholders and the Trusts relationship with GPs and Acute Hospitals specific to each area

Committees and what they do

Explain what is expected of a Governor and how to carry out the role with clarification of the level of support provided

How the Trust works, fits together, makes a difference

How performance in measured and issues are handled Suggested recommendations:

Executive summaries are prepared for Governors with references or links to further detail

Development sessions always include a briefing from the Chairman or CEO on National status of NHS, key Trust strategic issues and performance matters. Skill development is included to support the enhancement of aligning the Governors to support the strategic direction of the Trust

The Agenda of Development sessions is tailored to all those present and material is not presented at them but discussed in such a way that they can understand and feel equipped to talk about key points with their constituents if appropriate

Induction is revisited to ensure it includes all items suggested as useful. Induction involves attending a Board and a Committee once in the first year of office to observe and listen to the working of the Trust

To respect the time Governors give and to ‘real time’ specific needs of the Governors i.e. to support the greater strategic understanding or craft messages to engage members

The Council is asked to

Note the work undertaken by the Development Group to date

Approve the recommendation that any Governor wishing to attend a Board Committee meeting should seek prior approval from the Committee Chair explaining why they wished to attend.

Approve a review of the ongoing need for a Development Group. The review:

o To include the format of the Development Group, its composition and remit, if it is decided the Group should continue.

o To take place when Governors are appointed following the current elections.

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8. Engaging Constituents The Governors all stated as a key part of their role the importance of engaging with either the Public, or staff or their particular constituent. Currently some feel more able to do this than others. The reasons getting in the way include lack of information of who the members are in various areas, where and when meetings are taking place, where the Governor might meet them, an absence of material to hand out and in a couple of individual cases the confidence or skill to engage the public. Each Governor has a unique set of skills and experience and it was felt that these could both be appreciated and utilised better. Many of the Governors thought that their role and work could be better publicised. Suggested recommendations:

Equip Governors with details about their constituents, members and tailored details of events and meetings in their areas, together with materials to share with constituent members staff or public and provide any key messages that the trust would like delivered

A quarterly news page from Governors promoting the activities that they have undertaken in the preceding 3 months

Identify how each Governor can contribute more to the other Governors and promote better working together

9. Holding NEDs to Account Many Governors start with the overall business performance as the base line to judge NED performance. They felt the performance reports provided a certain level of assurance. To better hold NEDs to account the Governors felt they would benefit from some additional information in order to know what the NEDs are doing, but more importantly whether those interventions are having any impact. They were generally aware that activity levels were limited as a measure of contribution and that every NED did not have expertise in every area of the business. Much discussion was had as to where and how they could get a better view of how each NED worked and what their contribution was to the Trust. Several Governors commented on the value of meeting and talking with NEDs at Patient Safety walk abouts. Suggested recommendation:

Governors continue to receive Trust performance data to gain overall assurance of a positive NED contribution

Governors where possible attend a couple of Patient Safety Walk abouts each year as a means of getting a closer appreciation of the Trust services and observe a NED in action

That NEDs attend Council of Governor meetings to enable Governors to seek assurance on how NEDs have held Executive Directors to account on issues

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At the end of each year when the NED lists their activities of the year they highlight the key areas where they have contributed with a couple of examples where they feel they have added value or made a strategic/safety/financial difference to the business.

10. Conclusion The interviews with the Governors provided some rich and positive contributions as to how the Trust could provide greater support to the Governors to enable them to fulfill their responsibilities as Governors. To this end this paper provides a number of recommendations to address this. However it is important to emphasis that success is not just a simple case of implementing the recommendations. The tone and manner in which the recommendations are implemented is of equal importance if the objective of providing better Governor support, take the Governor contribution to an even higher level and make the role more interesting and rewarding is to achieved.

11. Background to the Role of Governors in NHS Foundation Trusts Foundation trusts (FTs) are part of the NHS but are independently run and directly accountable to their local communities for the performance and strategic direction of the trust. This is achieved through the trust governance structure, in which a unitary board of directors is scrutinised by, and answers directly to, the Governors of the trust. Governors are the direct representatives of local community interests in FTs. The governing council, or council of Governors as it is referred to by the majority of FTs, consists of public Governors (and optionally patient, service user and carer Governors), who are elected by the public members of the trust (people from the local community who have an interest in the strategic development of the organisation), as well as staff Governors and appointed Governors. Staff Governors represent the interests of the staff members at the FT and appointed Governors are representatives of key stakeholders such as commissioners, local councils, universities, local voluntary groups and charities. The existing statutory duties of FT Governors, under the National Health Service Act 2006, are to:

appoint and, if appropriate, remove the chair and non-executive directors (NEDs);

decide the remuneration and other allowances of the chair and NEDs;

approve the appointment of the chief executive officer (CEO);

appoint and, if appropriate, remove the trust's auditor; and

receive the annual accounts, auditor report and annual report

hold the non-executive directors, individually and collectively, to account for the performance of the board of directors

represent the interests of the members of the trust as a whole and the interests of the public

The council of Governors may require one or more of the directors to attend a Governors‟ meeting for the purpose of obtaining information about the trust’s

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performance of its functions or the directors‟ performance of their duties

Significant transactions‟ must be approved by the Governors. Approval means that at least half of the Governors voting agree with the transaction

The council of Governors must approve an application by the trust to enter into a merger, acquisition, separation or dissolution. In this case, approval means at least half of all Governors agree with the application

Governors must decide whether the trust’s private patient work would significantly interfere with the trust’s principal purpose, i.e. the provision of goods and services for the health service in England or the performance of its other functions

The council of Governors must approve any proposed increases in private patient income of 5% or more in any financial year

Amendments to the trust’s constitution must be approved by the council of Governors Additional responsibilities for the Trust

Before each Board meeting, the Board of Directors must send a copy of the agenda to the Council of Governors

After the meeting, the Board of Directors must send a copy of the minutes to the Council of Governors

The Trust must take steps to ensure that Governors have the skills and knowledge they require to undertake their role

The Trust must hold Annual Members’ meetings. At least one of the directors must present the Trust’s annual report and accounts to the members at this meeting

The Trust may combine the Annual Members’ meeting with the Governors‟ meeting which is held for the purpose of considering the Trust’s annual accounts and reports

Where there has been an amendment to the constitution which relates to the powers, duties or roles of the Council of Governors, at least one governor must attend the next Annual Members’ meeting and present the amendment to the members

To act in the best interests of the Trust and adhere to its values and code of conduct

To hold the Board of Directors collectively to account for the performance of the trust, including ensuring the Board of Directors acts so that the Trust does not breach the terms of its authorisation; and

To regularly feedback information about the Trust, its vision and its performance to the constituencies and stakeholder organisations that either elected or appointed them.

For further details of the existing statutory duties, please see Monitor’s publication ‘Your statutory duties: A reference guide for NHS foundation trust Governors’.

Louse Norris Director or Workforce, Organisational Development and Communications 31 January 2017

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1. Executive Summary This paper is to update Governors on the position to date of the current Governor elections.

2. Introduction Governor elections in seven areas have been triggered by recent resignations for a variety of reasons. There are vacancies in six Public Constituencies and one Staff Constituency. We are required to use an independent election company to conduct the elections and Electoral Reform Services (ERS) have been selected.

3. Election update

The publicity sent out to members to attract candidates for the forthcoming elections was very effective, resulting in a large number of members declaring an interest across the area, and eleven candidates actually standing for election. Uncontested results Three candidates were uncontested in their constituencies and were therefore declared duly elected, by Michelle Barber, the Returning Officer at ERS, Please see attached report. These three new Governors are:- John Fletcher – Pubic Governor, Ashford Mike Mackenzie – Public Governor. Tunbridge Wells Lisa Sherratt – Staff Governor, Corporate Services Elections Elections are to be held in four Constituencies:- Gravesham – Ian Douglas Armitage & Pete Sutton Shepway – Jo Clifford & Michael David Townsend

Kent Community Health NHS Foundation Trust

Formal Council of Governors Meeting

Date of Meeting: 8 February 2017

Agenda Item: 2.6 Update on Governor Elections

Presenting Officer: Natalie Davies, Corporate Services Director

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Swale – Amanda Green & Penny Nicholls Tonbridge and Malling – Gabrielle Piazza and Sue Stephens Notice of elections has been published on our website and all members have been sent the ballot papers and election materials on 3rd February and voting will be closed on 23rd February, with results declared on 24th February. Voting can be done by post or electronically. All elected candidates will be elected for a three year term. Induction Induction training has already been arranged for 8th March and all candidates have been notified in order that they can keep the date in case of being successfully elected. All Governors have been invited to attend this day to meet the new Governors at lunchtime, at the Aylesford Community Centre at 12.30 p.m.

4. Conclusion

Governors are asked to note this update and are invited to comment on the progress to date.

Isabel Woodroffe Head of Governor Liaison 31 January 2017

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20 January 2017

KENT COMMUNITY HEALTH NHS FOUNDATION TRUST

ELECTION TO THE COUNCIL OF GOVERNORS

Further to the deadline for nominations for the above election at 5pm on Monday 16 January 2017, the following

constituencies are uncontested:

Public: Ashford

1 to elect

The following candidate is elected unopposed:

John Fletcher

Public: Tunbridge Wells

1 to elect

The following candidate is elected unopposed:

Mike Mackenzie

Staff: Corporate Services

1 to elect

The following candidate is elected unopposed:

Lisa Sherratt

Elections are to be held in the following constituencies

Public: Gravesham

Public: Shepway

Public: Swale

Public: Tonbridge and Malling

These will conclude in February 2017

Michelle Barber

Returning Officer

On behalf of Kent Community Health NHS Foundation Trust

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1. Introduction

The election of a Lead Governor for the Council of Governors is a statutory requirement for all Foundation Trusts. It is for Trusts to determine any extension to the role of Lead Governor above the role set by NHS Improvement. In Kent Community Health NHS Foundation Trust, the role of the Lead Governor is elected annually and it was agreed that the scope of the role would also be reviewed annually. The election for lead governor is scheduled for March 2017.

2. Report Guidelines

The essential elements of the role of the Lead Governor are set by NHS Improvement (NHSI) in the Code of Governance. The role in this context only has one function and that is, to be a direct point of contact between NHSI and the Council. This would be used in rare circumstances when the usual channels of communication are not appropriate; for example if the Trust breached its terms of authorisation.

KCHFT Lead Governor role The Council agreed to an extended role of the Governor whereby the Lead Governor would take on other duties in addition to that established by NHSI, to assist in the smooth running of the Council and includes the following aspects:-

• Ensuring and supporting an effective and constructive relationship between

the Board of Directors and the Council of Governors • Gathering and summarising Governor views

• Arranging other meetings at the request of the Council • Chairing Governor only meetings The Lead Governor does not have any additional powers or accountability in their role; the Council as a whole retain these. The role should not require significant additional time to undertake in comparison to any other governor.

Kent Community Health NHS Foundation Trust

Formal Council of Governors Meeting

Date of Meeting: 8 February 2017

Agenda Item: 2.7 Lead Governor Role

Presenting Officer: Natalie Davies, Corporate Services Director

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Deputy Lead Governor/s

KCHFT currently has two Deputy Lead Governors who were elected for one year term, which will come to an end on 1 March. Members of the Council might want to review this role in terms of its remit or even the existence of Deputy Lead Governor(s).

Process for Appointment

The Trust Constitution states that the Lead Governor can be a Public, Staff or Appointed Governor. All nominations for Lead Governor and Deputy Lead Governor will be submitted to the Trust Secretary. A nomination should be accompanied by a short statement, no more than 500 words, which explains what skills and abilities the candidate will bring to the role. These statements will then be circulated to the Council members prior to the election being held. If either post is uncontested, the appointment will be confirmed immediately. If the post is contested, the election will be held in accordance with the Trust’s Constitution. The successful candidate will be appointed for a term of office of one year. After the election for lead governor is completed, the deputy lead governor election will follow the same process.

3. Conclusion The Council is asked to: • Review the current lead governor role and determine whether any changes

to the role are required • Confirm the outline process for appointment as detailed in paragraph 5 • Review the current role of deputy lead governor and approve a continuation

of the current role or any changes as required.

Isabel Woodroffe Head of Governor Liaison February 2017

Page 54 of 56

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