1

Minutes of the Board of Directors meeting held on

January 28th 2015

Seminar Room 1, Kingston Hospital Surgical Centre, Kingston Hospital NHS Trust

Present voting:

Sian Bates Chairman SB

Candace Imison Deputy Chairman CI

Michael Jennings Non-Executive Director (SID) MJ

Jacqueline Unsworth Non-Executive Director JU

Joan Mulcahy Non-Executive Director JMc

Martin Grazier Non-Executive Director MG

Chris Streather Non-Executive Director CS

Kate Grimes Chief Executive KG

Charles Bruce Interim Deputy Chief Executive CB

Nigel Baker Interim Director of Finance NB

Duncan Burton Director of Nursing and Patient Experience DB

Jane Wilson Medical Director from item 6 JKW

Present non-voting:

Terry Roberts Director of Workforce TR

Apologies:

Nicola Hunt Director of Productivity NH

Derek Macallan Associate Non-Executive Director DMc

In attendance:

Deborah Lawrenson Company Secretary & Head of Corporate Affairs DL

Lisa Ward Head of Communications LW

David Freeman Corporate Projects Director DF

Nicky Felix Operational Manager Surgery, Urology & Orthopedics

NF

Claire Wright

Senior Sister Isabella Ward CW

Governors:

Dennis Doe Public Governor – Kingston DD

Kate Fitzsimmons Public Governor – Kingston KF

Marilyn Frampton Public Governor – Merton MF

Frances Kitson Public Governor – Richmond and Lead Governor FK

Robert Markless Public Governor – Kingston RM

Ursula Kingsley Staff Governor – Administrative, Management and Support Staff (from item 5)

UK

Alison Tuck Staff Governor - AHP and Clinical Support Staff AT

Members of the public:

Erica Farmer EF

Bob Firman Patient Dementia Champion BF

2

Details Actions

1. Welcome and introductions

1.1 The chairman welcomed members of the public, staff and governors.

2. Apologies for absence

2.1 Apologies were received from Nicola Hunt and Derek Macallan

3. Declarations of interest

3.1 None

3. Minutes and Matters arising

4.1 4.1.1 4.2 4.2.1

Minutes The minutes of the previous meeting were approved. [note that later in the agenda Governor Dennis Doe asked for an amendment]. Matters arising Progress against actions was noted.

16.2 - It was confirmed the Director of Estates had contacted Governor Dennis Doe about his concerns regarding the status of pavements around the site and remedial action was being taken.

16.4 - It was noted that the glaucoma clinic was sub contracted to New Medica and transport provision should be no different to other patients in the hospital, provided they met the criteria. Any particular individual issues would be followed up if brought forward.

7.2.3 – The Chairman commended the improvements which had

been made to the complaints response times.

7.4.4 – CI asked for confirmation that detailed analysis on patient

length of stay was collated. CB confirmed that it was and that detailed analysis had been shared at FIC. Action analysis to be shared with full Board and further discussion would take place at QAC.

DL CB

4. Chairman's report

5.1

The Chairman noted the following:

Congratulations were given to staff for their considerable efforts in supporting patients through what had been a particularly challenging time over Christmas and New Year.

Collaboration underway with acute partners in South West London.

NED focus and scrutiny since the last board on budgets, planning process and quality.

Her attendance at the first two workforce committees and the induction session for new governors.

Recruitment of the new Director of Finance who will join the Trust at the end of March.

Recruitment, with the CEO and Lead Governor of a new Head of Corporate Affairs/Company Secretary who will join the Trust in April.

Appointment of Derek Macallan as an Associate NED for six months.

3

Attendance at the Trusts’ Memory Café and chair Zumba class with patients with dementia.

Participation with MJ in a tasting session of the new menu, with a range of stakeholders. Improvements made were commended.

5. Chief Executive's report

6.1

The Chief Executive drew attention to the following updates from her report with support from DB and RB:

Updates provided from Board walkabouts.

Progress with roll out of Service Line Management. An audit by KPMG had given positive assurance.

Introduction of nurse revalidation. A reference to this has been included in the draft corporate objectives for 2015/16.

Confirmation that the Trust will not be inspected by CQC in the next round but it was expected to take place before December 2015.

Results of the patient survey in A & E. It was confirmed the Trust would be commissioning external support to carry out a review and identify potential improvements.

Budget setting and planning process work underway for 2015/16. It was noted that 50% of savings had been identified but that in some areas it was unclear how further savings could be found given that the Trust had the lowest reference costs in England. It was confirmed discussions would be taking place with commissioners on this issue in February.

It was noted that Monitor would be expecting a one year plan to be submitted in February with the final plan due on April 10th.

It was noted that it was likely a deficit plan would be submitted in February but that the Trust would continue to work with partners to reduce this before the final submission was made. It was confirmed this would be discussed with the Council of Governors, predominantly through its strategy sub-committee.

6.2

CI commended the strength of the process which had been used to introduce service line management but asked what the Executive’s level of confidence was that the remaining service lines would become accredited. KG confirmed that some would not be accredited until leadership issues had been resolved but that the majority would have been accredited by the end of March 2015 and progress was being kept under weekly review. It was agreed a further update on progress with SLM accreditation to be given to the Board early in the new financial year. Note for forward plan

6. Quality and Performance

7.1 Patient Story for discussion

7.1.1

DB reminded the Board of the purpose of hearing patient stories:

To connect with patients, relatives, frontline staff and volunteers on an emotional level.

To understand the impact of the experience on the patient and their perspectives on why it happened and how it could be avoided in the future.

4

To appreciate the human aspects of harm and errors and develop an open culture to learn from errors.

To make the experience of the patient staff member or volunteer personal to the Trust at all levels, recognising that ‘this experience happened here’.

7.1.2 DB read out two patient letters, one a complaint and one complimentary. He then posed the following three questions to the Board:

7.1.3 How have hearing the stories made you feel? The following observations were made: Board members felt proud of the staff who had been commended, the need to give more publicity to the good care provided, but concerned about the waiting room environment. It was noted that there was considerable value in listening to both complimentary and complaints letters as a rich source of information. It was also recognised that it was always more powerful when the patient stories were delivered directly to the Board.

7.1.4 Looking at the board agenda how might we use the stories to reflect on the issues we have to discuss? The following observations were made: Board members suggested the issues raised would be beneficial in the discussions planned around A & E, the Admin review and spending on the Estate.

7.1.5 Are there issues that have been raised we might want to focus on in next month’s board walkabouts? The following observations were made: It was agreed the area complained about would be visited in the next round of Board walkabouts and staff would be asked for their views on how environmental improvements might be made to waiting areas.Action add to walkabout plan.

DL

7.1.6 The Chief Executive was asked how compliment letters were shared. It was confirmed they are given to the manager of the area concerned to share with their teams, and were often referenced in team brief or the weekly CEO message to staff.

7.2

Clinical Quality Report

7.2.1

JKW drew attention to the following issues from her report:

Very good performance on mortality ratios, VTE responses had continued to improve but was still being monitored and presuure ulcer numbers remained stable.

Cdifficile cases had increased slightly but were below the level to be expected, and only one case, year to date, had been noted as due to a ‘lapse in care’.

Falls had gone down however there had been a noticeable reduction in incident reporting recently which may have had an impact on numbers.

Complaints times had improved.

The FFT response rate was low but there had been some

5

technical issues with data collection, which had been resolved.

There had been a number of quality improvement projects reaping rewards in improving patient care and experience such as the work around the support provided to tongue tied babies and their families, which is to enable babies to feed more effectively.

The Trust had scored an ‘A’ in the national stroke adult which had been an improvement from ‘C – A’ over an eighteen month period which was commended.

7.2.2

CI noted that on a recent walkabout a junior doctor had suggested to her that although VTE risk assessments were taking place, they were not necessarily being acted upon. She asked how this was being remedied and asked for more detail on re-admission rates as this had been an issue raised at the last Council of Governors meeting. JKW explained that the thrombosis committee reports into the Clinical Effectiveness Committee, which was chaired by herself, and efforts had gone into improving the process and reviewing issues raised through the junior doctors audit. She confirmed re-admissions were being tracked and that there was a potential increase following emergency admissions. She explained there had been a change in the recording process nationally, six months previously, which was having an impact and that whilst there had been a rise the numbers were very low. Nevertheless further investigations were taking place into the areas concerned and action being taken where required. CI asked if the VTE audit would be repeated. JKW confirmed consideration would be given to how best to do so taking into account the broader picture and it was agreed feedback on this would be given in a future quality report. JKW to note. CI stressed that there did still appear to be a winter trend and it was agreed that more information on trend data around re-admissions would be provided. JKW to reflect in the next report.

JKW to note

7.2.3 MG asked if the fall in FFT collation was an issue around collection of data. JKW explained it was due to technical issues with the tablets which had been resolved. MJ noted that with regards to the FFT scoring approach, DB had indicated at the last Board that the data would be rebased to better reflect the national approach and asked if this had happened. DB confirmed it had and this was shown in the clinical quality report.

7.2.4 KG asked for monitoring of data around failed discharge to take place. It was agreed this would be taken to the Quality Assurance Committee. Action JKW

JKW

7.3

Corporate Performance Report

7.3.1

CB provided an overview of the corporate performance including achievements and areas of development [See slides for detail]. He drew attention to the following:

Impact of delayed discharges of care (DTOC) – with up to 38 beds occupied by patients fit to move into the community, at any

6

one time over the Christmas and New Year Period which had a significant impact on A & E performance and the wider flow in the hospital. It was noted this had been outlined at the Council of Governors meeting. It was confirmed the Trust was working with partners to address the issues and figures were currently around 17 patients delayed.

RTT – good progress was continuing to be made on meeting requirements.

Activity levels were up for emergency, slightly below plan for elective with recovery plans in place and slightly up for outpatients against plan.

Cancer performance controls were working well in general and steady progress was being made and regularly reviewed at EMC. However one of the Cancer targets had been breached and was referenced in the Q3 report to Monitor.

A & E targets were breached at the end of the Quarter and with January expected to under-perform it was expected it would fail in Q4 overall which would be two quarters in succession.

DB confirmed staffing levels were generally stable and meeting safer staffing reporting requirements.

TR confirmed that vacancy levels were slightly higher than hoped, turnover remained high at 18.4% and sickness levels remained good. With regard to turnover he explained that action plans were in place to tackle turnover issues in specific areas.

The I & E performance at Month 9 was noted.

7.3.2

The Chairman asked if the Q3 cancer breach would result in a red rating overall for cancer and CB confirmed that it would, but that the numbers were extremely small and would be outlined to Monitor.

7.3.3

JMC noted that some patients were treated elsewhere but this was impacting on attainment of the targets, and asked how the Trust controlled this. CB explained the Trust was working closely with St Georges and the Royal Marsden to improve pathways. JMc asked if service line agreements were in place with them. KG explained that the relationship was governed by the London cancer alliance and that Monitor would, in her view, be more concerned with those higher numbers of patients being managed directly by the Trust than this particular indicator but that discussions would take place with them.

7.4 Finance report

7.4.1

NB provided an update on the financial position noting that this was cumulatively £29 k favourable overall and just above break-even which was a strong position when compared with other Trusts nationally. However, the Trust was £800 k off its end of year plan. He confirmed he was relatively confident it would be achieved but that there were some risks around payments which were being worked through with commissioners. He explained the cash position would go down in Quarter 4 but he did not anticipate this would cause any issues.

7.4.2

MJ noted income was only just favorable and that the area which was most difficult was around non-pay spend. He confirmed some of this was as a result of increased activity and the Executive team were working hard with service lines to try to bring the spend back in line and he

7

remained hopeful the end of year plan would be achieved.

7.4.3

MG added that the majority of the overspend against non-pay (which was a total of £1.9 m adverse) was not related to increased activity and asked if there was learning which could be taken forward to ensure better planning going forward.

7.4.4

NB explained that a lot of issues related to one off monies in income and the need for better matching across to the non-pay budget lines. This was being addressed by looking at last year’s spend against this year to see if budgets had been set incorrectly. He stressed that in planning for the next financial year the Executive would be ensuring the right budgets were agreed.

7.4.5

The Chairman noted that both service lines and the Executive team were working hard to ensure as strong a position as possible for the end of the year.

7.4.6

JU noted with regard to A & E attendances being down and yet the target being breached, that it highlighted risks in the system given that had attendances been higher the situation would have been potentially even worse.

7.4.7

KG explained that there had been a reduction in attendances related to minor attendances but that the total numbers of acutely unwell patients coming through and being admitted had risen. [Anna Carratt (People First programme manager) and Nicky Felix (Service Line Manager) joined the meeting]

7.4.8

CI asked if there was learning for the emergency service division as whole in terms of budget setting and planning.

7.4.9

CB explained that it would be vital to profile activity well and to put good plans in place, which was not the case in some service lines but was being addressed. This included planning months rather than weeks ahead, and ensuring planning for holiday cover was factored in. He added that activity was already being tracked more closely.

7.4.10 MJ noted that one patient staying a very long time would affect the data dramatically due to percentages and suggested the Trust should keep a close eye on modes, which in his view provided better data in terms of the overall experience for patients. This was noted. Action CB

CB

7.5 Workforce Report

7.5.1

TR informed the Board that turnover remained high with the average at around 32 members of staff leaving each month. He confirmed detailed monthly reviews were taking place with action plans in place locally to address issues. He outlined issues around management of vacancies and actions being taken particularly to address vacancies in nursing, administration and estates. It was confirmed that work was in place to:

Understand the root cause and to develop a formal action plan.

Improve the recruitment processes with SLAs and KPIs

8

developed.

Look at further overseas recruitment.

Monitor the administration service model in the weekly PRM meetings.

7.5.2

The Chairman commended the progress made.

7.5.3

JU added that it was helpful that root cause analysis was taking place by service line, and that this was being monitored through the performance management review processes to ensure local ownership.

7.5.4

MG asked for detail on retention of overseas recruits. TR confirmed that retention surveys had taken place and to date none of the recruits had indicated they would be leaving in the near future. He stressed there was a need to ensure 1:1s were taking place and it was disappointing that it was taking longer for the recruits from the Philippines to start than had been expected due to new immigration processes. It was noted that they would begin to arrive at the end of February 2015.

7.5.5

CI commended progress made but asked that a close eye be kept on the granularity of data and asked for benchmarking data to be provided. She noted that London had a more competitive market than any other in England with regard to nursing and given the Trusts location and the fact it did not pay inner London weighting this was a potential issue. She added that in terms of use of agency and bank staff she was disappointed not to see an aspiration to reduce this in the objectives for 2015/16 as it had been in the current financial year. It was agreed this would be picked up in the discussion about objectives later in the agenda.

7.5.6

The Chairman noted that if the Trust could reduce monthly leavers to 26 this appeared a manageable target but would require considerable efforts.

7.5.7

JMC asked if contract staff were skewing the figures and if they could be isolated. TR confirmed only substantive staff had been included in the analysis provided.

7.5.8

DB noted with regard to benchmarking, that the Trust was working with Kingston University, on behalf of HESL, to look at turnover for all London Trusts and this was due to complete in April and when the report is available it would be brought back to the Board. Note for forward plan – potentially for the July meeting.

7. Quality Governance Framework

8.1

DB outlined the findings following the Board review in November, which overall demonstrated that the Trust Board could continue to declare compliance with the requirements of the QG framework with areas of additional focus identified. It was noted that further discussion would take place on the narrative against the ten questions in terms of evidence of compliance at the February 2015 Board Development meeting.

8.2

CI commended the process the Board had used, she asked what the time frames were for completing key actions. DB explained these were captured in separate action plans for delivering corporate objectives in

9

2015/16.

8.3

The Chairman noted that the Board was increasingly hard on itself in the self-assessment process which demonstrated the rigour being shown.

8.4 The update against the framework was noted and the recommendation with regard to compliance was endorsed.

8. Quality Account priorities and process

9.1

DB reminded the Board that detailed discussions had taken place on the Quality Account priorities at QAC and the COG Quality Scrutiny Committee and that a long list of potential objectives had been shared with staff and members for views.

9.2

DB noted that the COG had asked for end of life care to be added as an area of focus and he proposed adding an item under safety around ‘reduction in catheter associated infections’ which the Trust had signed up to a project with the Health Innovation Network (HIN).

9.3

MJ noted that two of the areas under patient experience around food and parking would have been addressed by the end of the current financial year and asked if they should therefore still be included. DB explained this would be referenced in the narrative, when the items are sent for voting.

9.4

SB asked if the Trust was only obliged to consult with its lead commissioners who in turn were expected to feed in the views of the other commissioners. DB confirmed this was the case but that it would be copied into the other CCGs at the same time, and their views were being requested via CQRG. Action DB

DB

9.5 The Board supported the proposals and the changes outlined and congratulated DB and his team for preparing the Quality Account ahead of schedule.

10. Admin review

10.1

David Freeman provided a presentation outlining progress made with the Administration Review work. See slides for detail [Jane Wilson joined the meeting]

10.2

The Chairman commended the holistic approach which had been taken to identifying and addressing issues but asked what would be done to reduce the number of letters sent out by the Trust. DF explained that there may be a need for investment in new technology to best support a reduction.

10.3

JMC asked if, as a result of the review, there would be individuals who may not be in suitable roles currently. DF confirmed that refresher training was underway and there may be some staff who choose to move into different roles.

10.4 MG asked what was meant by the term ‘managing beyond April 2015’ in the narrative. DF explained this related to the fact that the service lines would all be at different stages of development and there was a need to ensure traction was not lost.

10.5 MG asked what the cost savings would be if the planned reduction in

10

postage took place. DF confirmed it would be around £130 k per annum saved on consumables and postage but some of this would be offset by the need to invest in technology.

10.6

MJ asked how the impact of activities would be evaluated. DF explained that there was a KPI scorecard in place which gave indications of where there may be issues.

10.7

CS asked, with regard to the potential for using automated check in at the beginning of the patient process, if this would free up staff to focus on other critical areas of work where human interaction added value. DF confirmed that there was a desire to increase the use of kiosks but this was at the tail end of the planned improvements.

10.8

KG added that the Trust had increasing numbers of volunteers helping patients to use kiosks. Her anxiety was that the Trust would not be able to go entirely paper free given that most patients were likely to want to receive paper copies of letters and therefore the postage savings were likely to be less than outlined. She noted that only 50% of GP practices were currently using the electronic system and the Trust was working with GPs to try and encourage more take up.

10.9

RB asked how confident DF was of delivering the target outlined. DF stressed that it was possible there would be issues given the number of initiatives staff were engaged with at the same time however once staff were trained correctly and numbers of letters had been reduced, the target would be manageable.

10.10

The Chairman asked what was being done to ensure clinical engagement particularly through transition. DF confirmed he was working closely with Service Line Manager, Nicky Felix, to meet with the trios in service lines, to begin the conversations. He stressed that the level of engagement to date had been positive though potential issues that were being raised.

10.11

JMC asked if improvement to documentation was included in the review. DF confirmed it was built into the pathway coordinator model.

10.12

The Chairman asked when a progress report would be given to the Board. It was agreed this would happen in June or July. Note for forward plan.

10.13

The Chairman thanked DF,NF and all those involved with the admin review for their efforts.

Strategy, Policy and Implementation

11. Corporate objectives

11.1

KG reminded the Board that the draft Corporate Objectives for 2015/16 had been discussed with the Board, EMC and Governors and changes had been made to reflect issues raised. She noted that Governors had particularly asked for more clarity on measures.

11.2

CI asked why use of agency staff had not been included as she felt it was an ongoing important aspiration. She asked if it was possible to track agency use and whether it was solely linked to turnover. KG confirmed it

TR

11

could be tracked and shared and that whilst there remained an ambition to reduce agency use the prime issue was around addressing vacancies on the wards. It was agreed the ambition to reduce agency usage would be added within the metrics. Action TR

11.3

JU noted with regard to the objectives around strengthening service line management that reference to work around performance management be added to the narrative. RB asked if this was around strengthening performance management processes. The Chairman suggested it was about identifying what has been achieved. KG noted that balanced scorecards were in place for service lines and these were reviewed at the monthly Performance Review meetings. It was agreed KG would consider including a meaningful measure.

11.4

MJ suggested the wording, in relation to development to plan, be changed to ‘monthly reports to Board or FIC’ which was agreed.

11.5

The Chairman asked with regard to the reference to the estates strategy if the wording needed to change given the financial challenge and potential implications on the estates plans. KG suggested it did not as the Trust would implement what it could, and there may be changes to the programme.

11.6 Action KG to update the Corporate Objectives with changes as outlined, with input from relevant directors.

KG with input from Execs

12. Dementia Strategy update

12.1

DB informed the Board that overall good progress was being made against the Dementia Strategy in a number of areas including development of new governance structures. It was noted that a CHKS assurance standards assessment would be taking place in March 2015. The Trusts success in the HSJ safety awards, its receipt of Alzheimer’s accreditation (the second NHS Trust to receive this for volunteering training) and through presentations at various conferences was helping to raise the Trusts profile externally. It was further noted that the fundraising project had begun and the Trust had been successful in securing volunteering monies through its bid to NESTA and that the Trust would be hosting a simulation training event for London Trusts in February 2015. It was noted that although a lot had been done with regard to training and education there was more to do.

12.2

Work on improving the environments of care were noted which included progress made to establish the activities room, memory café and therapeutic activities programme. To further progress, this funding from the Charity appeal would be required.

12.3

The Chairman commended progress made and CI congratulated the team for their efforts. She noted a connection with the patient story that day and links to charitable work around improving the patient environment. She informed the Board she had recently seen a presentation where Trusts had implemented a range of improvements such as painting around doors and clear signposting and felt that more could be done to progress these improvements more quickly as they made a considerable difference to the patient experience. The Chairman noted that she and a member of the Charitable Funds Committee would

12

be meeting with the environment of care group to see plans presented and agreed that some improvements may be progressed at a quicker pace. DB added that whilst some things could be done immediately, changes to layout in ward environment etc needed to be done in a planned way taking all elements into consideration.

12.4

It was agreed that work around fundraising would be shared with the Board including photos and architectural drawings. Action DB

DB

12.5

The Chairman welcomed Clare Wright to her appointment supporting the dementia programme and her leadership around development of the memory café which had been a tremendous success and thanked Bob Firman, Patient Dementia Champion for his work in bringing in the Alzheimer’s Society to the Trust and his work with the Chairman and the Director of Nursing in reviewing progress against the strategy.

12.6

CS noted that the Trusts work around the Dementia agenda was important for its local population nationally and suggested more could be made of the achievements to date in communications. Action LW/DB

LW/DB

13. Risk Management Strategy

13.1

DL reminded the Board that the Risk Management Strategy had been updated and discussed in detail at the QAC and Audit Committee who had recommended its approval by the Board. Noted and approved.

14. Communications Strategy update

14.1

LW provided an update on progress against the Communications Strategy noting in particular:

Internal communications - team brief, the weekly CEO email to staff and daily updates were continuing but that over the next twelve months there would be a re-focus on boosting the staff engagement score and to support this, an internal communications audit would take place.

Significant communications planning was required to prepare for the CQC inspection.

Successful launch of the new website – which required constant updating and the team were continuing to work with teams across the Trust to support them in making best use of the website to promote services.

The increase in Twitter followers to 6 k. It was noted a number of board members and senior staff were regularly tweeting and a number of governors were taking the opportunity to re-tweet which had been very helpful.

Going forward there was a need to try to get more press coverage in Richmond and Merton and the Dementia appeal provided a good opportunity for doing so.

Dementia fundraising event – Richmond Park 24th of July.

13

The success of the Trusts first annual open day in 2014 with about 700 attendees and staff very keen to get involved again for the Open Day planned for June 13th.

Membership communications is ongoing and 6600 members have been recruited – reinvigorated approach to showcasing services through tours.

Plans to redevelop the intranet, funding permitting.

14.2 DB commended progress made with developing a strong Twitter following. He noted that more work could be done around pushing external messages on health communications, work which has a national profile including volunteering and work around clinical electronic documentation and systems.

14.3

The Chairman encouraged Board members to attend the Volunteering Conference being arranged by the Trust. Action LW to share programme wih the Board.

LW

14.4

CI encouraged other NEDs to join Twitter noting it provided an opportunity to join policy debates as well as sharing news about the Trust.

14.5

KG noted that Twitter provided quicker access to breaking news and a link with staff and patients. It was agreed the Twitter handles of key individuals would be shared with the Board. Action LW

LW

14.6

The Chairman asked what was being done to ensure Volunteers are kept up to date with corporate developments. It was agreed that this would be reflected in the monthly Volunteers Bulletin. Action LW

LW

14.7

MJ welcomed the increasing use of plasma screens but felt more could be done to make the best of them which was noted.

14.8

The Chairman commended the progress made by the Head of Communications and her team.

15. Board Assurance Framework

15.1

DL confirmed that the BAF had been updated with the latest position by Exec leads and that the draft BAF for 2015/16 would be brought to the March 2015 Board.

16. Q3 monitor return

16.1 The Q3 submission to Monitor was received. It was noted it had been discussed in detail at FIC and was approved for submission.

17. Board Forward Plan

17.1 The Board forward plan was noted.

14

18. Charitable Funds annual report and account

18.1

MJ noted the progress which had been made over the past year and commended the report and accounts for formal approval following detailed discussion at the Audit Committee.

18.2

KG commended MJ for his work in strengthening management and grip in Charitable funds.

18.3 The Charitable Funds Annual Report and Accounts were approved

19. CFC Committee update

19.1

MJ provided an update on recent progress. He noted that £2 m in funds were available in the account; plans were in hand for the dementia strategy launch and the business planning and investment policy had been strengthened. He thanked the Charitable Funds Manager, Julian Roberts for his work in supporting the Charity and wished him well in the future as he would be leaving the Trust. He welcomed Michelle Bartsch who would be joining the Trust.

19.2

It was noted that at the next meeting of the Charitable Fund a discussion would take place on whether or not charities should be entirely separate.

19.3 The report was noted and actions endorsed.

19.4

The Chairman encouraged NEDs to attend fundraising events where possible.

20. Questions from the public

20.1

Governor Dennis Doe asked for an amendment to be made to the minutes of the last meeting in respect of the question he had raised under 16.3. He asked that it be amended to read ‘exploring opportunities initially with the UK Ambassador of the Korean Republic’. Action DL

DL

20.2

DD asked for an update with regard to development of a brand for the charity. LW explained that a logo had been developed and was being used which was distinct from the branding of the Trust and communications was being built around that branding. It was agreed this would be shared with the Board and Governors for information. Action LW

LW

20.3

Lead Governor, Frances Kitson asked for the Twitter ‘handles’ referred to in the meeting, to be shared also with Governors. Action LW

LW

20.4

FK asked TR with regard to exit interviews for staff, if he did not feel this was too late to make a difference given that the person had already decided to go. She asked if issues could be picked up and addressed through the 1:1 process and appraisals. TR explained that this was happening and that a retention questionnaire for new staff had been introduced and there had been a 38 % response rate to date. The Trust was working to ensure 1:1s were taking place and exploring potential issues from the surveys. KG added that all managers do 360 processes with their staff which were fedback to HR to help identify areas for improvement for individuals, professions or service lines and stressed that analysis showed that staff who regularly received 1:1s felt more

15

engaged. [MF left the meeting]

20.5

Governor Robert Markless, asked with regard to the dementia strategy, if the Trust had considered adopting ‘Johns Campaign’ which was calling for families and carers to have the same rights as the carers and parents of children. DB noted that the Trust had already extended visiting hours and was buying reclining chairs to support those visiting their family member but it was important this was balanced with supporting them to get respite as well and signposting them to what was available.

20.6

RM asked when Governors would be joining walkabouts. KG confirmed that the Board had agreed a governor could join an Exec and NED on each of their joint walkabouts and this would be built into the programme. Action DL

DL

20.7

Governor CJ Kim, who had recently been appointed, noted that he had met with many members of the Board since joining as a Governor and would be providing support to engage with the Korean community through his work on the Membership Engagement Committee. He added that he had met with staff of the Trust who were Korean and with patients and was aware of the role he had to play to support the Trust in developing its understanding around customs such as addressing elderly people by their full name.

20.8 The Chairman thanked him for joining the committee and the significant role he had to play in helping the Trust to reach out to the Korean community. [DD left the meeting]

21. Finance Investment Committee (FIC) report

21.1

MJ noted that the committee had looked at flow, length of stay and discharge processes as well as energy costs. The report was noted.

22. Quality Assurance Committee (QAC) report

22.1 CS noted that the committee had discussed the Trusts decision to join ‘Sign up to Safety’ and was a trailblazer in this campaign, and had received a deep dive on End of Life Care and would be looking at Sepsis at the next meeting. The report was noted.

23. Audit Committee Report

23.1 JMC noted that the committee had reviewed the audit plan which was on track, had received positive assurance from the Service Line Management audit and had received assurance around work underway on developing the Annual Report and Accounts and the Quality Account.

24. Any other business

24.1 As this was her last formal Board meeting before leaving the Trust at the end of February, the Chairman thanked Deborah Lawrenson for her support to the Board and wished her well in her new role.

16