ydZKZ /EZzWµ o] } }( ] } P v of... · 2020-07-07 · Agenda Item Lead Paper Estimated Timings Page No Business Items A1 Apologies for Absence and Declarations of Interest Chairman

EXTRAORDINARY Public Board of Directors

07 May 2020, 15:30 to 15:55Starleaf Spotlight

Agenda

1. Public Board of Directors Agenda

A0 BoD Public Agenda ‐ EXTRAORD ‐ 7 May2020.pdf

(2 pages)

2. Business Items 25 minutes

2.1. Apologies for Absence and Declarations of InterestVerbal

Chair

2.2. Minutes of the meeting held on 26 March 2020 and Matters ArisingAttached

Chair

A2 NuTH Public BoD Minutes 26 Mar20 DRAFTCONFIRMED.pdf

(8 pages)

2.3. Chairman’s ReportVerbal

Chair

2.4. Chief Executive’s Report, including COVID UpdateVerbal

CEO

3. Pa ents

3.1. Nightingale Hospital North East UpdateAttached

COO

A5 Nightingale Hospital North East Update.pdf (5 pages)

4. Items to Receive

4.1. Next MeetingTuesday 26 May 2020 in the Boardroom, Freeman Hospital Verbal

Chair

EXTRAORDINARY PUBLIC TRUST BOARD OF DIRECTORS’ MEETING

Thursday 7 May 2020 via StarLeaf SpotlightStart time 3.30pm

Agenda

Item Lead Paper EstimatedTimings

Page No

Business Items

A1 Apologies for Absence and Declarations of Interest

Chairman Verbal

A2 Minutes of the ordinary meeting held on 26 March 2020 and Matters Arising

Chairman Attached

3.30pm – 3.32pm

A3 Chairman’s Report Chairman Verbal 3.32pm – 3.37pm

A4 Chief Executive’s Report, including COVID Update

CEO Verbal 3.37pm – 3.45pm

Patients

A5 Nightingale Hospital North East Update COO Attached 3.45pm – 3.50pm

Items to Receive

A6 Next Meeting: Tuesday 26 May 2020 in the Boardroom, Freeman Hospital

Chairman Verbal 3.50pm – 3.52pm

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THIS PAGE IS INTENTIONALLY BLANK

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Agenda item A2

________________________________________________________________________________________________Minutes of the Trust Public Board Meeting – 26 March 2020Trust Board – 7 May 2020 [Extraordinary]

DRAFT MINUTES OF THE BOARD OF DIRECTORS MEETING HELD ON26 MARCH 2020

Part A: Public Session

Present: Professor Sir J Burn ChairmanDame J Daniel Chief Executive OfficerMrs A Dragone Finance DirectorDr V McFarlane-Reid (via starleaf) Director for Enterprise & Business

DevelopmentMr D Stout (via starleaf) Non-Executive DirectorProfessor K McCourt (via starleaf) Non-Executive DirectorMr K Godfrey (via starleaf) Non-Executive DirectorMr S Morgan (via starleaf) Non-Executive DirectorMs J Baker (via starleaf) Non-Executive DirectorMrs P Ritchie (via starleaf) Associate Non-Executive Director

In Attendance:

Mrs A O’Brien, Director of Quality and EffectivenessMr G King, Chief Information OfficerMrs K Jupp, Trust Secretary [Minutes]

Note: The minutes of the meeting were written as per the order in which items were discussed.

20/13 BUSINESS ITEMS

i) Apologies for Absence and Declarations of Interest

Apologies were received from Mrs D Fawcett, Director of Human Resources, Mr M Wilson, Chief Operating Officer, Mr A Welch, Medical Director/Deputy Chief Executive, Ms M Cushlow, Executive Chief Nurse and Professor D Burn, Non-Executive Director.

The Chairman declared an interest in QuantumDX as Vice-Chair. It was noted that the company were in the process of developing COVID-19 response technologies. There were no additional declarations of interest noted at this time.

It was resolved: to note the apologies listed and the Chairman’s declaration.

ii) Minutes of the Meeting held on 30 January 2020 and Matters Arising

The minutes of the meeting were agreed to be an accurate reflection, with a small amendment required as suggested by Professor McCourt to section 20/02 (iii) Executive Chief Nurse Report. The amendment being to specifically reference that the Nursing and Midwifery Council visit was to look at Nurse Education models and further, that Nurses from the Trust were presenting at the Commonwealth Nurses and Midwives Federation Conference in London.

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It was resolved: to (i) receive the minutes and (ii) note the required amendment.

iii) Meeting Action Log

It was agreed that all actions on the log were now complete.

It was resolved: to note the action log position.

iv) Chairman’s Report

The Chairman presented the report, with the following salient points noted: The COVID-19 pandemic would be a test to both organisational resilience and that of

the wider health and social care system. The Trust would continue to operate within the existing governance framework,

noting some flexibility may be required in response to the evolving position. A visit was undertaken to the High Consequence Infectious Diseases (HCID) unit at the

start of the COVID-19 outbreak and highlighted the important role of the staff in the unit who brought significant onsite expertise to Newcastle Hospitals.

It was resolved: to receive the report.

v) Chief Executive’s Report

The Chief Executive presented the report and outlined the following key points to note: In response to COVID-19, the Trust enacted its Pandemic Influenza Plan on 11 March,

following the publication of the Government’s plan on 3 March and the World Health Organisation pandemic declaration.

Due to organisational focus on the response to COVID-19, routine requests for the information have been suspended as well as non-essential meetings such as Directorate performance reviews.

Structures to support the operational command and control of the Trust’s response to COVID-19 have been enacted.

While the pandemic has had, and will continue to have, a significant impact on the organisation, the Executive Team was cognisant of the need for some elements of the organisation to operate as ‘business as usual’ where possible.

Teams within the Trust continue to establish recovery and transformation plans, which will enable the organisation to progress in the future, having learnt lessons from revised working models during its response to COVID-19.


20/14 PATIENTS

i) Patient Story

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Agenda item A2


The Director of Quality and Effectiveness presented the report, noting that the patient representatives had been stood down from attending on this occasion following the release of Government guidelines around social distancing.

It was noted that the Board would receive a presentation on the work of the Perspectives Research Partnership Group at a future meeting.


ii) Medical Director’s Report

The Director of Quality and Effectiveness presented the report on the Medical Director/Deputy Chief Executive’s behalf, noting his absence, along with the absence of the Executive Chief Nurse, was due to their central role in the organisation’s COVID-19 response.

The Medical Director Report was received for information.

a. Guardian of Safe Working Report

The Guardian of Safe Working (GoSW) Report was included in the Board Reference Pack (BRP) for information.

b. Learning from Deaths Report

The Learning from Deaths Report was received. The Director of Quality and Effectiveness advised that the three investigations outlined on page 39 regarding serious incidents had been completed, with lessons learned recorded. The full Learning from Deaths report would be presented to the meeting of the Trust Board scheduled for 26 May 2020.

c. Consultant & Honorary Consultant Appointments

The Consultant and Honorary Consultant Appointments were included in the Board Reference Pack (BRP) for information.

Professor McCourt extended the gratitude of the Non-Executive Directors to all Trust staff involved in providing quality care to patients in response to COVID-19. It was resolved: to (i) receive the reports and (ii) to note the inclusion of the GoSW report in the BRP for information.

iii) Executive Chief Nurse Report

The Director of Quality and Effectiveness presented the report, noting the following points: The success of the ‘Big Room Event’ at St James Park was noted, which attracted over

400 staff from Nursing, Midwifery and Allied Health Professionals backgrounds. As a result of the event, feedback was collated which has been organised into

workstreams to be progressed going forward.

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Agenda item A2


Staff who attended commented positively that the event represented a valued investment in time to listen and engage on future strategies.

The results of the Patient-Led Assessments of the Care Environment (PLACE) were received which advised that although the Trust generally performed well, work to improve the environment for patients with dementia and patients with disabilities were required. Feedback from the assessments have been incorporated into the programme for ward refurbishment and include for example improved signage and changing facilities.

Ms Baker requested that the invitation to attend events such as the ‘Big Room Event’ be extended to the Non-Executive Directors in future to which the Director of Quality and Effectiveness agreed to feedback to the Executive Chief Nurse.

Mr Godfrey commended the Executive Chief Nurse’s team for their ongoing work, particularly in relation to plans to implement a revised ward dashboard to incorporate quality indicators later in the year.


iv) Healthcare Associated Infections (HCAI) Director of Infection Prevention and Control Report

The Director of Quality and Effectiveness presented the report on behalf of the Director of Infection Prevention and Control, noting that it had previously been considered by the Trust’s Quality Committee.


20/15 PERFORMANCE

i) Integrated Board Report – Quality, Performance, People and Finance

The Director of Quality and Effectiveness presented the report, with the following salient points noted: At the end of January 2020, the Trust had one instance of MRSA Bacteraemia in 16

months. Lessons learnt have been shared across the Trust. To the end of February 2020, C.difficile infections were marginally above the Trust

trajectory with a total of 105 cases against the year-end ambition of 113. The Trust continued to observe an overall reduction in MSSA bacteraemia cases. Regarding Performance, the Trust achieved the 95% A&E 4 hour standard at 95.9%

during the month of February. The Trust was highlighted as the third best performer in the country in relation to A&E performance during February where the national average was 82.8%

The Trust failed to achieve the 92% 18-week standard in February 2020 at 87.0%, however performed favourably when compared to its peers.

The Trust’s waiting list position was currently above its year-end trajectory position however, a reduction had been observed since January 2020.

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Agenda item A2


The Trust was unable to meet the 99% 6-week diagnostic standard at 96.0%, having last been compliant in November 2018. Significant pressures remain within Endoscopy, Audiology and Sleep Studies.

The Trust met one of the eight Cancer waiting time standards in January 2020 being the 31-day subsequent treatment (radiotherapy) target. The Northern Cancer Alliance met two of the eight standards during the same period being 31-day treatment (radiotherapy) and 31-day first treatment.

Regarding patient care, it was noted that a downward trend in instances of pressure damage had been observed. In addition, the Trust anticipated closing the year with five Never Events, which demonstrated an improved position on the previous year and compared favourably with peers. Of these five Never Events, one related to a delayed diagnosis, two related to falls that resulted in harm and two related to pressure ulcers.

In relation to complaints management, it was noted that the Trust received 555 formal complaints in the year to the end of January 2020, with 65 of these received during the month of January.

Regarding the Trust’s current financial position, it was noted that: The Trust had an Income and Expenditure deficit, excluding Provider Sustainability

Funding (PSF), of £74k at Month 10 (£12.8m surplus including PSF). This was consistent with the Trust’s Plan for 2019/20.

To date, the Trust delivered £24.8m in savings relating to its efficiency requirements. The cash balance at this stage was £120m, being above Plan.

The Finance Director added that at Month 11, the Trust was on course to deliver all of its year-end financial targets and obligations and currently had a risk rating of 1.


ii) Update from Committee Chairs

The Update from Committee Chairs report was received.

Mr Godfrey added that the extraordinary meeting of the Charitable Funds Committee on 30 January 2020 considered two high value bids pertaining to the creation of a Quality Improvement Faculty and events to celebrate the Year of the Nurse and Midwife.


iii) Corporate Governance Update

The Trust Secretary presented the report.

It was noted that in response to the COVID-19 pandemic, a number of changes to regulatory deadlines have been implemented, including those relating to the Data Security and Protection Toolkit and the National Data Opt-Out as outlined in the report.

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Agenda item A2


It was anticipated that there would also be changes to the deadlines for the production of the Annual Report and Accounts and the subsequent submission to Parliament. Further guidance was awaited with updates to be made to the Board in due course.

The appended Quarterly NHS Improvement (NHSI) Declarations were approved.

It was resolved: to (i) receive the report and (ii) note the approval of the NHSI Quarterly Declarations.

20/16 PEOPLE

i) People Update

The People update was received for information.


20/17 ITEMS TO APPROVE

i) NIHR CRN NENC Annual Business Plan and Annual Financial Plan 2020-21

The Trust Secretary presented the National Institute of Health Research Clinical Research Network North East and North Cumbria (NIHR CRN NENC) annual business plan and annual financial plan. It was noted that Board approval was required for both documents due to the Trust’s role as network host prior to sign off and submission by the Department of Health and Social Care.

Mr Godfrey extended the gratitude of the Board to Professor Stephen Robson, Clinical Director for the network, for his work in this area. The Board of Directors approved the Annual Business Plan and Annual Financial Plan for 2020/21.

It was resolved: to i) receive the plans and ii) note the approval of the Board of Directors.

20/18 ITEMS TO RECEIVE

i) Date and Time of Next Meeting:

The next meeting of the Board of Directors was scheduled to take place on Tuesday 26 May 2020 in the Board Room of the Freeman Hospital [Subject to Government guidance regarding social distancing and non-essential travel].

ii) Members of the press and public were excluded from the meeting in accordance with the Health Services Act 2006 (Schedule 7 Section 18(E)) (as amended by the

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Agenda item A2


Health and Social Care Act 2012) and in view of publicity being prejudicial to the public interest

Due to the ongoing impact of COVID-19 and restrictions around social distancing, no members of the public were permitted to attend the meeting of the Board of Directors on this occasion.

The meeting closed at 11.22pm

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Agenda item A5

TRUST BOARD

Date of meeting 7 May 2020

Title NHS Nightingale Hospital North East

Report of Martin Wilson, Chief Operating Officer (and chief executive, NHS Nightingale Hospital North East)

Prepared by Martin Wilson, Chief Operating Officer (and chief executive, NHS Nightingale Hospital North East)

Public Private InternalStatus of Report

☒ ☐ ☐For Decision For Assurance For Information

Purpose of Report☐ ☐ ☒

Summary

This paper provides an update to the Board on the NHS Nightingale Hospital North East (NHNE), which is hosted by The Newcastle upon Tyne Hospitals NHS Foundation Trust, and due to be officially opened on Tuesday 5 May 2020.

The hospital will remain in a standby state without any staff or patients, until such time as its capacity is required to support the NHS’ COVID-19 response across the North East and North Cumbria. At that point it would become an operational hospital.

Recommendation The Board is asked to note this report.

Links to Strategic Objectives

We deliver the best possible health outcomes for our patients.We focus on prevention and population health.We lead the way in delivering world class, cutting-edge diagnostics, treatment and care. Research, education, innovation and management.

Quality Legal Finance Human Resources

Equality & Diversity Reputation Sustainability Impact

(please mark as appropriate) ☒ ☒ ☒ ☒ ☐ ☒ ☐

Impact detail The NHS Nightingale Hospital North East is being established and hosted by Newcastle Hospitals on behalf of NHS England as part of the regional response to the COVID 19 pandemic.

Reports previously considered by New Public Board report.

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Agenda item A5

____________________________________________________________________________________________________Nightingale Hospital North East UpdateTrust Board – 7 May 2020 [Extraordinary]

THE NHS NIGHTINGALE HOSPITAL NORTH EAST

1. BACKGROUND

The coronavirus pandemic is an unprecedented challenge to the NHS requiring urgent, new and innovative solutions. Social distancing has reduced transmission rates however the ongoing scale and duration of the pandemic will likely be very large.

On 23rd March 2020, NHS England and NHS Improvement (NHSE/I) assessed that there may be insufficient hospital and intensive care bed capacity in the North East and North Cumbria, along with other parts of the country, to meet projected demand. They determined that a Nightingale Hospital was required in the area, and asked The Newcastle upon Tyne Hospitals NHS Foundation Trust to establish such a facility on behalf of the wider NHS.

The Newcastle Hospitals Trust Board agreed at an extraordinary meeting on 1st April 2020 to commence preparations for the establishment of the NHNE.

The NHNE is now built and partly equipped. Formal commissioning assurance processes with NHSE/I and the Care Quality Commission (CQC) are underway, with a view to the hospital being placed in standby on 1st May 2020 ready to be operationalised with 7-10 days’ notice if the need arises later in the COVID pandemic.

2. THE HOSPITAL FACILITY

During the early scoping phase a number of locations and buildings were identified as potential options, with the most appropriate venue determined to be Sunderland City Council’s newly built Innovation Centre, just off the A19 Testos roundabout in Washington.

Between 28th March and 22nd April, the Innovation Centre has been transformed into a 460 bed hospital facility, comprising 20 wards, with the flexibility to provide ward based (level 0/1), high dependency (level 2) or ventilated critical care (level 3) capacity, dependent on regional health care needs.

A number of site based Rehearsals of Concept (ROCs) for the NHNE have been undertaken from 22nd to 30th April. These rehearsals have included clinical staff and senior leaders drawn from all Trusts in the North East and North Cumbria.

3. CLINICAL MODEL

The clinical model is that the hospital will only become operational if and when NHSE, together with local NHS Chief Executives from across the region, determine that its capacity will be required.

The hospital has been designed to care for COVID-19 positive patients who have already been stabilised for at least 24 hours in an existing acute hospital and then transferred for step down care. Patients are expected to be discharged direct from the NHNE to their own home or community facilities.

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There is a phased plan for opening beds within the NHNE which starts with the hospital accepting a small number of ward level care patients. A minimal critical care presence would be available in this initial phase to support transfers. Ward and critical care bed numbers would then be scaled upwards, in varying ratios, as demand dictates.

This flexible model has widespread support from senior clinical and operational staff as being the most appropriate for the local situation.

4. GOVERNANCE AND LEADERSHIP

Newcastle Hospitals has taken on responsibility for the Nightingale under ‘directions’ issued by NHS England, in recognition that it is the largest acute provider in the North East and North Cumbria and has an established organisational model which could embrace a new hospital. Dame Jackie Daniel is the Accountable Officer. An Executive Team for the hospital has been established, led by Martin Wilson, who is the Trust’s Chief Operating Officer. Separate Heads of Terms and Particulars of Contract with NHSE have been put in place for the NHNE.

The NHNE is however very much a collaborative effort of all the NHS provider organisations across the North East and North Cumbria. A team of ‘Trust Link Nightingale Directors’ of Executives from every Trust in the region has been established and who meet three times per week to support and ensure the effective mobilisation of the hospital. This is particularly important because in the event that the hospital needs to become operational it will be staffed by staff drawn on a ‘fair-shares’ bases from existing NHS Trusts in the region. A memorandum of understanding to enable NHS staff to work in other local NHS organisations has recently been put in place to support this.

It is recognised that in releasing sufficient staff to open an additional 460 bed hospital, staffing ratios will be altered in all parts of the region. The number of nursing and other staff per patient may have to be reduced to reflect the increased need for a finite staff resource. Such changes are within national frameworks for use in the COVID pandemic and are safety assured by relevant local and national arrangements overseen by medical and nursing directors.

5. IMPLICATIONS FOR THIS TRUST

It is encouraging that current modelling indicates that there is sufficient capacity within existing local hospitals to accommodate COVID-19 demand; however, it is prudent to have the NHNE readily available to provide flexible ward and critical care bed capacity in the event that it is required.

In the event that there are indications the additional Nightingale capacity will be required, NHSE will, in consultation with local NHS Chief Executives, instruct that the NHNE moves into the pre-operational phase. At this point, this Trust will be required to release our pre-agreed phased numbers of staff, within 7 days to enable them to complete the appropriate induction and familiarisation training and for the hospital to be operational by day 10.

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Agenda item A5


6. RECOMMENDATION

The Board is asked to note this report.

Report of Martin WilsonChief Operating Officer, The Newcastle upon Tyne Hospitals NHS Foundation Trust & Chief Executive, NHS Nightingale Hospital North East

27th April 2020

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Documents

ydZKZ /EZzWµ o] } }( ] } P v of... · 2020-07-07 · Agenda Item Lead Paper Estimated Timings Page No Business Items A1 Apologies for Absence and Declarations of Interest Chairman