MINUTES OF THE TRUST BOARD MEETING
HELD IN PUBLIC
On Wednesday 24th August 2011, at 1pm,
at the Boardroom, Trust Headquarters, St Bernard’s site, Uxbridge Road, Southall UB1 3EU
Present:
Mr Nigel McCorkell
Mr Peter Cubbon
Mrs Barbara Byrne
Mrs Ann Chapman
Mrs Barbara Kerin
Ms Christine Higgins
Dame Sally Powell
Mr Neville Manuel
Miss Leeanne McGee
Professor Lefkos Middleton
Mr Steve Trenchard
Chairman
Chief Executive
Executive Director of Finance & Information
Non-Executive Director
Non-Executive Director
Non-Executive Director
Non-Executive Director
Non-Executive Director
Executive Director of High Secure Services
Non-Executive Director
Executive Director of Nursing & Patient Experience
In attendance:
Ms Jean George
Mr Nigel Leonard
Mr Andy Weir
Ms Georgia Denegri
Mr Arthur Muwonge
Interim Director of Local Services
Director of Planning & Corporate Affairs
Director of Specialist and Forensic Services
Interim Assistant Company Secretary (minutes)
Staff Side Chair
Minute
2350/11
2351/11
Action
APOLOGIES FOR ABSENCE
Apologies had been received from Mr Geoff Rose, Non-Executive Director, Dr
Nick Broughton, Medical Director, and Mrs Ruth Lewis, Executive Director of
Organisation Development & Workforce.
DECLARATION OF INTERESTS
No interests on the agenda items were declared by Board Members.
2352/11
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MINUTES OF PREVIOUS MEETING HELD ON 27th JULY 2011
a The Board considered the minutes of the meeting held on 27th July 2011.
Subject to the following amendments, the minutes were agreed as a true and
accurate record and were duly signed:
b Minute 2327/11 d, second sentence: replace “Connoly ward” with “Conolly
Wing”.
c Minute 2329/11 b, third sentence: replace word “people” with “clinicians”.
d Minute 2329/11 e and f, replace with following three paragraphs:
“e: It was suggested that Non-Executive Directors who were not
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already involved in the work of the committee should receive
training in order to participate in hearings.
They could then attend proceedings as observers in preparation
for sitting on panel hearings. Mr Towers would email the date of
the scheduled training events and if these were not suitable, he
would consider alternative arrangements for training the NonExecutive Directors. The chairman also requested dates for the
next two managers’ committee meetings so that he could attend.
f: Dr Broughton proposed that a psychiatrist could assist in the
work of the committee by providing advice. It was acknowledged
that only MHA managers were members of the committee, but it
would only be helpful if a psychiatrist could be identified to attend
the committee. Action: Dr Broughton”
e Minute 2330/11 a: delete the word “limited”.
f Minute 2330/11 m: fourth line, amend it to read “significant financial deficit
requiring a subsidy from other funds of the Trust, it felt …”
2353/11
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BOARD ACTION SCHEDULE AND MATTERS ARISING
Action Schedule
a The Board noted that the two actions due in August had been completed.
Matters Arising
b Minute 2326/11 f: The feedback reports from CQC’s announced visits to The
Limes and The Cassel had now been received. The report regarding The Limes
stated that the Trust had met all the outcomes.
2354/11
CHAIRMAN’S REPORT
a No Board visits to Services had taken place since the end of July.
Service User and Carer Trust-wide Forum:
b The first meeting of the Service User and Carer Trust-wide Forum had taken
place on 17th August 2011. It was well attended although there was
predominance of carers and professionals rather than service users present.
The meetings were open to all service users and carers and it was anticipated
that as the Trust’s arrangements with regard to involvement became more
established, the meetings would attract greater participation from service users.
c The Chairman of the Board was chairing all these meetings which were
scheduled quarterly. Dame Sally had attended the meeting on behalf of the
Board. It would be helpful if a different Non-Executive Director attended in
rotation each meeting. Mr Leonard would liaise with the Non-Executive Directors
to make the necessary arrangements.
d The Chairman asked that a report to the Board was produced after each
quarterly meeting summarising the discussion that took place, the actions
agreed and the outcomes. This way the Board would be able to demonstrate
that it was monitoring the delivery of actions.
Appointment of Non-Executive Director
e The interview panel had concluded the interviews for a new Non-Executive
Director to replace Mrs Chapman whose appointment was ending at the end of
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Mr Leonard
Mr
Trenchard
November 2011. The panel had made a recommendation to the Appointments
Commission who in turn were due to approve it on the 14th September with the
appointment effective from 1st October 2011.
The Board noted the Chairman’s report.
2355/11
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CHIEF EXECUTIVE’S REPORT
The Chief Executive highlighted the following issues from his report:

The consultation with staff at The Cassel had commenced following the
Board’s decision in July 2011 to close the Families service. The consultation
would conclude at the end of August and set out the proposed restructuring
of the remaining services, including how a financial balance could be
achieved.

With regard to the CQC visit to the Ealing site, there may still be some
issues with the Mary Seacole Ward and the Board should be following these
up.

The police had written to the Chief Executive to thank staff for their
cooperation during the recent riots in Ealing. Also, the Chief Executive
commended staff in the local and forensic services who worked in
partnership to implement emergency plans and maintain continuity of
service following intelligence by the police that further episodes were
expected in Southall. The significant cooperation from both staff and service
users allowed the Trust to successfully maintain ‘business as usual’ with
virtually no disruption to service delivery during this period.

The Chairman asked that in addition to the Chief Executive’s message to all
staff thanking them for their cooperation and readiness to deliver services
without disruption, the Board also wished to note their thanks to both staff
and service users for their cooperation.

The National Women’s Enhanced Medium Secure Services (WEMSS) pilot
evaluation report had been submitted to the Department of Health. The
report was embargoed. The Board discussed the implications of any
potential loss of pilot status. The Board noted that if WEMSS were to be
removed, a high number of women would need to return to high security
even though they did not actually need that level of security. There had been
two meetings between commissioners and senior staff of the Trust to
discuss implications of funding and the Trust was asked to make
recommendations that would be considered by Ministers in September
2011. The Board recognised that the confirmation of the future strategy
would not be ready before the end of the financial year when the Trust’s
current funding of women’s services ended, and this presented a risk to the
Trust.
The Board noted the Chief Executive’s report.
2356/11
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RESEARCH AND DEVELOPMENT 5 YEAR STRATEGY PROGRESS- STAGE
1 PROJECTS
a The report sought the Board’s approval of the proposed approach to the funding
and review of the Research and Learning Centre’s (R&LC) Stage 1 projects,
which supported the delivery of the Research and Development 5 years
strategy, following scrutiny of the required funding by the Trust Management
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Team (TMT). In accordance with the Board’s Standing Orders and Scheme of
Delegations, it was presented to the Board due to the total value of the Stage 1
projects exceeding £1m over five years, the requirement for agreement to the
modification of the R&LC staffing structure, and the requirement for the Board to
delegate authority to TMT to monitor the implementation of the strategy.
b The R&LC programme was reliant on attracting income. The total cost for the
stage 1 projects was estimated to be £1.433m and it was anticipated that this
would generate an income of £6.843m over a 5 year period, providing a surplus
of £452k which could be reinvested in the R&LC. The TMT at their meeting on
13 July 2011 agreed in principle to support the business case for the Stage 1
projects from the Invest to Save budget but the requested funding would be
curtailed if the estimated income was not achieved. The TMT supported the
investment of £116k for the Modernisation of the Corsellis Collection; £257k for
the Development of the Research Registers Project; and 2 years’ initial costs of
£313k to March 2013 for the Workforce and Development project. The TMT
would continue monitoring progress of the programme and the Research and
Development Director would provide an update on income and expenditure
progress in January 2013 and July 2013. This approach would provide an
opportunity to the Trust to review the viability of the programme’s financial
outcomes after 2 years, thereby reducing exposure to the financial risk
associated with the additional expenditure of £747k for years 3 to 5.
c In discussion the key points made were as follows:

In response to a question on whether a period of 2 years was sufficient to
show the viability of the programme, the Chief Executive responded that it
was expected that this would give a good indication on whether the
programme would start to bring money in. TMT had taken a cautious
approach to avoid the risk of investing in non viable projects as had been
the case in the past.

In response to detailed queries about the assumptions made and the figures
included in the business case, it was confirmed that these had been
scrutinised by Finance and the Trust Management Team. The risk for the
Board would be that if the programme were to stop at the end of 2012-13,
the Trust may make a loss at that point.

A risk relating to having the dual affiliation of the University (Imperial
College) and the Trust was that the University placed pressure on University
staff to achieve research income for the University. It would be helpful to
develop in future a Trust strategy identifying the clinical research income
activity.

The recruitment of staff to the programme should be fixed term.

The income projected from the Comprehensive Local Research Network
(CLRN) for the stage 1 projects was realistic. The Trust had an impressive
and increasing high profile in clinical research and Dr Ritchie was the CoDirector of the London (North West) CLRN.

The Business Development Manager’s post identified would solely be
focussing on driving the income in relation to the R&D strategy and was not
related to the business development work in relation to the Trust’s Marketing
strategy. However, the two post-holders would work in partnership.

The estimated surplus and potential losses would be reviewed in the next
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version of the Long Term Financial Model (LTFM) and Integrated Business
Plan (IBP) as the decision on the R&LC programme – stage 1 projects had
been taken after the work on the draft IBP and LTFM had been completed
for submission to the Strategic Health Authority.

A desktop review at the end of March 2012 should be undertaken as part of
the annual budget. Following the update report on progress and income
generated in January 2013, an annual report to the Board should be
scheduled from then on.
DECISION MADE:
Subject to a desktop review at the end of March 2012, followed by an
update report on progress and income generated in January 2013, the
Board approved the two step investment approach, including the
modification of the R&LC structure, to support the implementation of the
Research and Learning Centre Programme – Stage 1 projects which had a
total value of £1.433m over 5 years.
2357/11
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INTEGRATED PERFORMANCE REPORT – MONTH 4 (JULY 2011)
a The Director of Finance and Information introduced the report and highlighted
the key issues for discussion identified at the cover summary of the report and
drew attention to the change in the DH performance framework percentage of
adults on CPA and receiving Secondary Mental Health Services in employment.
This was previously a target to record employment status and was now a target
to be in employment. The target set by the Department of Health was 10% and
the target for underperformance was set at 5%. The Trust was currently at 6%.
b In discussion the following key points were raised:

There was differential performance among the 3 CSUs. There was
deterioration of performance in Hammersmith & Fulham and Hounslow with
an increase in readmissions, underperformance regarding the 95% target for
patients who did not have a physical healthcare check within 72 hours of
admission, and CPA reviews not being completed. These were being
investigated and were likely due to both data quality issues and clinical
leadership issues. Once fully developed, the clinical dashboards would
assist in focussing services.

The KPI relating to incidents of violence reported to police was queried by
Mr Weir, given those reported to the police were a subset of the total
number of incidents of violence in the CSU. Mrs Byrne agreed to review
with Dr Broughton the rationale for indicators.

In response to a query regarding the actions being taken to deal with the
£344k cumulative variance of the 3 Local Services CSU’s net operational
income and expenditure budget , the Interim Director of Local Services
noted that run rate had improved on the previous year but recognised the
need to take action. Work being undertaken included reviewing the inpatient budget, the number of observations and transfer of budgets following
the establishment of the CSU.
The Board noted the Integrated Performance Report for July 2011.
2358/11
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PMO PORTFOLIO UPDATE
a The Chief Executive introduced the report and highlighted the ongoing work with
Page 5 of 7
Mrs Byrne/
Dr
Broughton
regard to the interface of the London Services Transformation Programme and
the St Bernard’s Redevelopment programme. The Integrated Business Plan and
the Long Term Financial Model had been submitted to NHS London on time and
feedback was expected shortly. The staff consultation following the Board’s
decision to close the Cassel Hospital Families Services was underway.
b With regard to the London Services Transformation Programme, the preferred
option associated with reconfiguration of local services would come to the Board
for sign off in the autumn 2011.
The Board noted the PMO Portfolio update report as at 24th August 2011.
2359/11
MINUTES OF MEETINGS
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Trust Management Team Meeting – 13 July 2011
a The Board received and noted the minutes of the TMT Meeting held on 13 July
2011. The Board asked that all TMT sub-groups submit their minutes to TMT
regularly.
WL2133
Finance and Investment Committee – 21 July 2011
b The Board received and noted the minutes of the Finance and Investment
Committee Meeting held on 21 July 2011.
c It was noted that all Board members were invited to hourly sessions on the
LTFM scheduled to take place at the end of the committee’s meetings. All
members were also invited to email any questions they had relating to the LTFM
to Mrs Byrne. Frequently Asked Questions would be compiled and circulated to
all members.
d The Board noted that Mrs Barbara Kerin had been nominated as the vice-chair
of the Committee.
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Trust Management Team Meeting – 10 August 2011
e The Board received and noted the draft minutes of the TMT meeting held on 10
August 2011.
2360/11
ANY OTHER BUSINESS
None reported.
The next Board Meeting was scheduled to take place on 28th September 2011,
at Broadmoor Hospital. A programme for the day and special security
arrangements would be circulated to members in advance of the meeting.
Members who wished to visit the wards inside the hospital before 9.30am were
asked to email Miss McGee.
2361/11
INVITATION TO COMMENT
Mr McCorkell invited those attending the meeting to comment or ask questions
on the issues that had been discussed. No questions relating to the agenda
were raised.
Page 6 of 7
RESOLUTION
The Chairman proposed that the Trust Board resolve to hold the rest of its
meeting in private, as publicity would be prejudicial to the public interest by
reason of the confidential nature of the business transacted.
The meeting ended at 2.07pm
Signed:___________________________________
Chairman
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Date:___________________________