Meeting of the Council of Governors
5.30 p.m., Thursday 10th December 2015
Education Centre, Homerton Hospital
Present:
Tim Melville-Ross
John Bootes
Stuart Maxwell
Christopher Sills
Julia Bennett
Paul Ashton
Wayne Head
Ayse Ahmet
Shuja Shaikh
Danny Turton
Patricia Bennett
Siva Anandaciva
Charlotte Adeniregun
Suzanne Levy
Hilda Walsh
Emma Price
Dr Mark Rickets
Chairman
Lead Governor
Public Governor
Public Governor
Public Governor
Public Governor
Public Governor
Public Governor
Public Governor
Public Governor
Public Governor
Public Governor
Staff Governor
Staff Governor
Staff Governor
Appointed Governor
Appointed Governor
In Attendance:
Tracey Fletcher
Martin Kuper
Matthew Metcalfe
Daniel Waldron
Dylan Jones
Vanni Trteves
Martin Smith
Sir John Gieve
Susan Osborne
Sam Armstrong
Chief Executive
Medical Director
Interim Director of Finance
Director of Organisation Transformation
Chief Operating Officer
Non-Executive Director
Non-Executive Director
Non-Executive Director
Non-Executive Director
Head of Corporate Governance (minutes)
One member of the public observed the meeting.
1.0
Welcome and Introduction
The Chairman opened the meeting and welcomed all present.
2.0
Apologies for Absence
Apologies were received from:
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Suri Freedman
Helena Charles
Hazel McKenzie
Caroline Bowring
Helen Cugnoni
Marion Rabinowitz
Ben Hayhurst
Dr Lisa Reynolds
3.0
Public Governor
Public Governor
Public Governor
Staff Governor
Staff Governor
Staff Governor
Appointed Governor
Appointed Governor
Declaration of interests regarding items on the agenda
There were no declarations of interests.
4.0
Minutes of the previous meeting held on 10/12/2015 and matters arising
The minutes of the previous Council of Governors meeting were agreed as a correct
record of the meeting.
Previous actions were noted:

redecoration of Mary Seacole action – it was noted that the Trust had put
together a bid for refurbishment. The Trust has also requested the owners of the
building to make some improvements, which were expected to occur next year.

League of Friends Action – it was noted that re-establishing a league of friends at
the Trust would be challenging, as it would cost a considerable amount of money
to manage and possibly risk losing commercial income. It was pointed out that
the Trust volunteers provided free tea and coffee onsite.

PLACE actions – it was noted that benchmarking data was difficult to obtain,
however work was underway to prepare for the next PLACE assessment. It was
confirmed that the governors would receive an update on PLACE outcomes, in
due course.

Pathology action – it was confirmed that the Trust did not have insurance against
the contractor going into liquidation, however it did have an assurance of 10%
against non-delivery of the project. The company was not apart of P21, whose
bids were significantly more expensive. In response to a question, the chief
executive advised that the Board was investigating options to provide the
pathology service in the future. In response to another question, it was noted that
the Trust would, like last time, need to work within the NHS tendering rules.
In a matter arising it was pointed out that not all volunteers involved in the last PLACE
assessment were given the opportunity to decide which areas were visited.
5.0
Trust Complaints Process
The governors received a presentation on the Trust’s complaints process. It was noted
that the NHS had received 174k written complaints in 2013/14; and the Trust had
received 324 in that time. The general trend was an increase in complaints and that in
the last month, the Trust had received 45 complaints, the highest in one month that it
had experienced. All trusts were allowed up to six months to resolve written complaints,
however the Trust had set itself the challenging target of 25 working-days. On occasion,
and due to circumstances or the complexity, a different timescale was negotiated with
the complainant.
The Trust worked to ensure it was not defensive with complaints and continuously
attempted to learn from the issues raised. The process of receiving and responding to
complaints was presented in detail and it was pointed out that the chief executive signs
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all response letters. The timescales the Trust employed for acknowledging, investigating
and responding were noted. The importance of the NHS constitution and the Trust’s
process for complying with the NHS duty of candour was noted. Services, departments
and themes of complaints were presented and discussed and benchmarking data was
noted. The Trust receives a higher number of complaints related to A&E and maternity
than other services, however it was pointed out that this observation was normal across
the NHS. Complaints related to elderly care were a concern.
In 2013/14 and quarter 1 of 2014/15, the Trust had 49 resolved complaints referred, by
the complainant, to the Parliamentary Health Services Ombudsman, who decided that
only eight needed to be investigated further with ultimately none of them being upheld.
The governors were requested to advise members of the Trust, and public, to follow the
complaints procedure, if they wished to raise any issues.
Governors asked a series of questions, which elicited that following responses for
noting:

complaints data included only formal complaints;

staff were able to respond immediately to a non-formal complaint;

a complaint needs to be formal and this would include any that were received by
telephone;

complaints data was regularly reported to the Board

the Trust challenged the divisions’ responses to complaints and they can be
initiated into an SI, where appropriate; the patient, or their family, received a copy
of the final SI report

the Trust promotes the complaints process through leaflets on wards, in the
welcome pack and it was pointed out that PALs is situated by the front entrance
of the Trust.
6.0
Local Devolution Pilot
The governors received a presentation on the proposed devolution pilot for Hackney.
It was noted that the proposal would bring together service providers, the local authority
and the commissioners in Hackney with devolved responsibility to the local level for
providing healthcare to people in Hackney. It was hoped this system would transform
outcomes and achieve sustainability by shifting the focus to prevention and early
intervention.
Three levels were understood to exist in the wider context of devolution: regional, subregional and local. The process for bidding, and related benefits, of a devolution pilot
were noted. Hackney was thought well placed with alignment of commissioning, local
authority and service providers along with a positive history of working well together. A
public announcement was expected soon and it was hoped that Hackney would be
announced as one of the pilots.
Governors asked a series of questions, which elicited that following responses for
noting:

the Trust would require resources to develop and implement the pilot, if granted,
and would bid to central government for these; it was hoped that the central
government may allow the CCG to release some of its surplus for the pilot;

the Trust would also need to contribute, however most of its contribution would
be in time;
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7.0

devolution should reduce the current transaction costs between commissioning
and provision, as well as through better preventative medicine;

the goal is for local organisations to come together to solve problems in the
context of less funding being available, the details of how the groups would work
together is currently being developed;

it was not yet known how the recent release of funding would be divided up in the
NHS;

the CCG had a £35m surplus, however it did not have the authority to allocate it.
Chief Executive Report
The governors received an update on the Trust performance and other matters from the
chief executive.
The CQC report on the Mary Seacole Nursing Home was noted. Governors were
advised of the visit at their last meeting and the outcomes from the recently published
report were discussed. The CQC verbal feedback had been positive, however the written
report criticised aspects of the management of care at the home. The Trust was very
disappointed with the conclusion and that its feedback to the draft report had not been
upheld by the CQC. The Trust held a meeting with residents’ relatives and carers, who
supported the Trust and did not appear to recognise the criticisms. There were no
notices and an action plan was being developed to address the issues raised by the
CQC. In response to a question it was confirmed that the ownership of the building was
not relevant to the report outcome.
The governors received an update on the CQC follow up visit to the Trust’s maternity
services. The report had not yet been completed, however, the verbal feedback from the
CQC did not raise any immediate concerns, which the Trust had specifically checked for.
It was not known when the report would be published, however it was expected in
December 2015. In response to a question, it was pointed out that the unhappy
midwives were not directly related to the Trust and it was not known who they were as
they prefered to remain anonymous. In response to another question, the chief nurse
and director of governance advised that still births data was published nationally,
however she was not aware of a government requirement to report. In response to follow
up question the medical director indicated that the Trust usually benchmarked well on
this issue.
The CQC was undertaking a system wide review of diabetes care across Hackney. It
would involve the Trust, however it was not a direct review of the Trust’s services.
The governors discussed the planned junior doctors’ strike, which had been suspended
the night before, after talks. The governors expressed sympathy for the junior doctors’
concerns, however they also expressed concern over the potential impact of a strike on
patient care: they noted that the Trust had been well-prepared for the strike. Mr. Stuart
Maxwell, public governor, wished his personal support for the junior doctors be recorded
and pointed out the significant turnout and vote for action by the junior doctors. The
Trust cancelled approximately 20 operations and eight clinics as a result of the planned
strike; consultant appointments were unaffected.
The governors praised Dr. Matt Smith, a member of Trust staff, who bravely saved a
critically injured victim after a knife attack at Leytonstone Tube station and it was noted
that the chairman had written to him on behalf of the Trust. It was reported that the Trust
had paused reporting for RTT data while it reviews the data processes. The CCG was
aware and supportive of the situation.
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The governors noted the report.
8.0
Senior nurse Ward Roundings
The paper was taken as read.
It was noted that the governors welcomed the process.
The Council of Governors noted the report.
9.0
Confidentiality Guidelines
The paper was taken as read.
The Council of Governors noted the report.
10.0
Quality Account Indicators
The governors discussed the indicators for external audit for the Trust’s quality account
2015/16. The governors chose emergency re-admissions within 28 days of discharge
from hospital and incidence (not point prevalence) of pressure ulcers to add to the
mandatory indictor of percentage of incomplete pathways within 18 weeks for patients
on incomplete pathways at the end of the reporting period (RTT).
11.0
Board Evaluation
The governors received the evaluation report of the performance of the Board. It was
noted that the evaluation was positive.
Concern by some governors was expressed over having the Board meeting in private
before the meeting in public. The chairman assured the governors that the private and
public agendas would not change as a result and that only matters that needed to be
taken in private, were. The Board had deliberated on the issue and was keen to try it.
12.0
Open Forum
No matters were brought up that had not already been covered on the agenda.
13.0
Questions from members of the Public
There were no questions from the public.
14.0
Trust Finances (item taken in private)
The governors received a briefing on the Trust’s finances under reserved business.
15.0
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Date of Next Meeting
Council of Governors meeting on 18th February 2016
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