Meeting of the Council of Governors
5.30 p.m., Thursday 14th July 2016
Education Centre, Homerton Hospital
Present:
Tim Melville-Ross
John Bootes
Stuart Maxwell
Christopher Sills
Julia Bennett
Paul Ashton
Ayse Ahmet
Patricia Bennett
Helena Charles
Shuja Shaikh
Wayne Head
Hilda Walsh
Marion Rabinowitz
Charlotte Adeniregun
Suzanne Levy
Dr Mark Rickets
Ben Hayhurst
Peter Bentley
Susan Osborne
Sir John Gieve
Martin Smith
Polly Wietzman
Jude Williams
Sheila Adam
Daniel Waldron
In Attendance:
Sam Armstrong
Simon Bell
Chairman
Lead 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
Staff Governor
Appointed Governor
Appointed Governor
Appointed Governor
Non-Executive Director
Non-Executive Director
Non-Executive Director
Non-Executive Director
Non-Executive Director
Chief Nurse and Director of Governance
Director of Organisation Transformation
Head of Corporate Governance (minutes)
Head of Business Development (item 7)
Two members of the public were in attendance.
1.0
Welcome and Introduction
The chairman opened the meeting and welcomed all present. He noted that the timing of
the meeting would require further consideration for next year, as there were many
apologies for this meeting. It was also requested that future meeting dates be
coordinated to avoid a clash with a meeting of the Hackney Health and Wellbeing Board.
2.0
Apologies for Absence
Apologies were received from:
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Danny Turton
Siva Anandaciva
Suri Freedman
Hazel McKenzie
Helen Cugnoni
Caroline Bowring
Emma Price
Vanni Treves
Tracey Fletcher
Martin Kuper
John Yarnold
Dylan Jones
3.0
Public Governor
Public Governor
Public Governor
Public Governor
Staff Governor
Staff Governor
Appointed Governor
Non-Executive Director
Chief Executive
Medical Director
Interim Director of Finance
Chief Operating Officer
Declaration of interests regarding items on the agenda
The following was declared:

Stuart Maxwell had been appointed as a lay member, representing the public, to
the Hackney Devolution Pilot Board

Christopher Sills would be standing for a vacant seat on the Hackney local
authority.
After a brief discussion, it was agreed that the non-executive directors would not need to
absent themselves for item 10.
4.0
Minutes of the previous meeting and matters arising
The minutes of the previous Council of Governors meeting were agreed as a correct
record of the meeting.
The following matters arising were considered:

minute 5.0 – it was requested that longitudinal data be added to the friends and
family test results presented in the chief executive’s report. It was pointed out
that longitudinal data was difficult to provide from the annual in-patient surveys,
however it was subsequently agreed that data would be presented, for
consideration, in the next report;
Action: add longitudinal data to friends and family test (SA, Oct 2016)

minute 5.0 – in relation to a personal matter raised at the previous meeting, it
was noted that the governor who raised the matter wanted her concern regarding
the complaints process recorded;

minute 9.0 – arrangements and items for the annual members meeting were
confirmed. It was noted that the annual report and accounts would be published
after it was confirmed they had been laid before parliament and it was agreed the
report would be circulated to governors at this point. After a discussion it was
agreed not to have 100 copies of annual report and accounts professionally
printed, as in previously years, and instead, in addition to posting online, print inhouse copies only for people who requested them;

minute 12.1 – it was pointed out that a question was raised at the recent
Hackney Health Scrutiny Commission meeting about whether there would be a
public consultation on plans for a future pathology service for the Trust. The Trust
was to still to decide on this matter. It was suggested that a consultation be held
by the Trust before the Board chose an option;
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
minute 11.0 – it was noted that information on nurse ward roundings had been
circulated to governors. The governors expressed an interest in an ‘adopt a ward’
programme. In response the chief nurse agreed to circulate a list of wards and
appropriate community services for governors to suggest what they would like to
be paired with. She pointed out that such a scheme would require coordination
by the Trust.
Action: circulate list of wards and community services, and develop a coordinated
process, for governor engagement (SA, Oct 2016).
5.0
Chief Executive’s Report
In absence of the chief executive the report was taken as read.
It was noted that a presentation on the sustainability and transition plan (STP) was on
the agenda. The Trust had recently received a draft report from the latest visit by the
CQC to Mary Seacole. The latest PLACE results indicated that the Trust had improved
compared to its performance last year and it remained to be seen how this compared to
other trusts.
In response to a question, the director of organisation transformation clarified that the
devolution pilot was looking at the use of the health and care estate in Hackney as well
and the strategic planning needed to get the most from this resource. In response to a
question, the chairman stated that so far, the financial position was on track with plan,
however there were more QIPP schemes to be identified, which the Trust was working
on. The Trust had engaged EY to assist it in improving its financial performance,
however it remained mindful of quality and long-term sustainability in its decisions
regarding finance.
It was agreed to include a brief update on finances in the chief executive report for future
meetings.
Action: add finance updates to regular chief executive reports (TF, Oct 2016)
6.0
Quality Account External Audit Report
The meeting received the report, which was taken as read.
The chairman stated that the Trust was not concerned about the two qualifications made
in the report, as they appeared to be similar to other Trusts and Deloitte had assured
him that they were not of great concern. Jonathan Gooding, from Deloitte, had offered,
through the chairman, to attend a future meeting, if required. In response to another
question, the chief nurse explained that the recording of patient progress through A&E
for the four-hour wait standard was paper based and that this was destroyed once the
Trust had verified the figures; this meant it could not be audited by Deloitte, which is why
they raised a qualification. It was pointed out that the Audit Committee monitors data
validity and while it cannot gain complete assurance on its own from this, it added to the
overall assurance for the Trust.
It was pointed out that the report had been scrutinised by the Audit Committee.
It was agreed to have a report from the director of organisation transformation on patient
experience feedback and including a breakdown of results by ethnicity.
Action: report on patient experience feedback, including a breakdown of results
by ethnicity, to be presented to a future Council of Governors meeting (DW, Oct
2106).
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It was suggested from anecdotal evidence that Turkish people had experienced some
difficulty with accessibility, language and cultural difference across the NHS. It was also
suggested that some had concerns about care at the Trust.
7.0
Trust Business Development
The meeting received a presentation on the Trust’s business development programme.
It was noted that the Trust’s business development team been in place for almost two
years and that its work was aligned to the Trust’s strategy. Competition to supply
services for commissioners was expected to remain and grow over time. It was thought
that changes such as devolution would not alter the requirement for competition.
Tenders were becoming more common for community services in North East London.
Among other competitors, we are aware that Virgin Healthcare was actively seeking
contracts in London, particularly in children services.
The Trust ensured that quality remained at the core of its strategic decisions and bids.
The Trust provided more than hospital services, including community services, teaching,
and regional-based services such as bariatric surgery and research, beyond Hackney.
The customer-oriented approach of the business development team was noted. The
meeting was informed of the overall structure of healthcare commissioning and the
impact of the changes after the PCTs were decommissioned.
It was noted that before the establishment of the business development team, the Trust
had lost two school nursing contracts. Since then, the Trust’s bidding process had been
developed and was very successful and had won its last five bidding projects, including
recently being awarded the contract for the diabetes eye screening programme across
the whole of NEL. The Trust was also better at making careful no-bid decisions for
contracts that would ultimately not be suitable for it.
A series of questions were asked, which elicited the following responses for noting:
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8.0
tenders are mainly for community services which account for approximately 10%
of the Trust’s NHS income;
research funding was acquired by the Trust under a different process to that of
business development and mostly came from funds outside the CCGs and
NHSE;
the Trust learned from not being awarded the two school nursing contracts
mentioned in the presentation, and made consequent improvements to its
bidding process;
at this stage, it was not expected that Brexit would alter the procurement
processes for the Trust;
the Trust has undertaken market research to further understand commissioner
and referrer needs and priorities;
it was clarified that nurse training occurred through universities and the Trust was
not able to engage in this work, however it was expected that it would bid for any
upcoming school nursing contracts;
sexual health arrangements were more complex as an open access policy was in
place in London, and some boroughs had different tariffs; the Trust was hoping
that Hackney residents would be attracted to the Hackney service.
Sustainability and Transformation Plan (STP)
The meeting received an update on the (STP).
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It was noted that the five-year draft STP had been submitted, as required, on 30th June
2016 and that it was not yet a public document; the final version was due for submission
in October and would include a public consultation. The currently identified financial gap
in north east London was £850m, assuming nothing specific was done to achieve
efficiencies.
Transformation and productivity work was being planned to improve the sector finances;
this included the Hackney devolution pilot, which was included in the STP draft. In
response to a question the director of organisation transformation stated that NHS
England wanted financial deficits within the sector to be solved within the STP, at sector
level. In response to a question it was clarified that collaboration aspects of the STP
were the activities the Trust agreed to work with others on, however there was still some
changes the Trust would need to make on its own. In response to a question, the
director of organisation transformation stated that future STF funding allocations were
still being considered and the related governance process was being developed. It was
added that the Trust needed to sign up to the plan to receive the related funding and it
was thought that the Trust would not want to isolate itself, as this would be
unsustainable in the future. It was suggested that the plan required radical options to
achieve long-term savings and the Trust would need to consider making short term
investments to achieve this.
The STP version for submission in October would require details of the short term
activities. In response to a question, the director of organisation transformation
suggested that the financial challenges to the sector were more than the current PFI
issues. In response to a question the director of organisation transformation advised the
governors that north east London did not perform as well as others regions at early
cancer diagnosis, however actions were in place to improve this. To a follow up question
it was reported that the Hackney devolution pilot was being pursued as it was believed
the Trust could apply local solutions to good effect.
9.0
Complaints Process
A verbal update on the Trust’s complaints process was received.
It was noted that the Trust had worked to improve the process and considered a variety
of possible option including extending the response times, increasing resources and
developing a new rating system. In response to a question the chief nurse advised that
complaints had a variety of themes that made it difficult to isolate single reasons that
could be proactively managed by staff to avoid the circumstances that may cause a
complaint. In response to a follow up question it was pointed out that the PALS contact
was an informal way for the Trust to respond to patient concerns, and that they received
100 – 250 contacts per month.
10.0
Non-Executive Director Terms
The meeting received a paper outlining the possibility of extending the total number of
terms a non-executive director could serve at the Trust. After a brief discussion, and as
per the recommendations, it was agreed to leave the current constitutional conditions as
they were.
11.0
Electronic Voting
The meeting received a paper recommending the allowance of the option of electronic
voting for members of the public and staff for the current election as well as a
recommendation to change the constitution to have future elections for staff governors
conducted wholly by electronic voting. After a brief discussion it was agreed to allow
members the option to vote electronically from the current election and to put an
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amendment to the constitution to allow the Trust to conduct the voting for staff governors
wholly by electronic voting.
12.0
Open Forum

in response to a question, the director of organisation transformation clarified that
while the Trust already had in place an apprentice scheme to attract local
residents, nurses required a qualification before they commenced work at the
Trust;

it was suggested that the membership application form be used when
undertaking promotions, rather than a document that invites people to request a
membership application form;

it was agreed that the Trust invite HRH Princess Anne to
anniversary of the opening of the hospital;

in response to a question regarding district nurse training and pressure ulcers,
the chief nurse advised that the Trust was running further training sessions for
district nurses;

in response to a question, the director of organisation transformation stated that
the Trust had decreased its spend on locum and temporary staff from £1.3m per
month to approximately £950k, and it was intended to get it down to £850k per
month.
13.0
attend the 30th
Questions from members of the Public
In response to a question from a member of the public, it was noted that the Trust
recognised the seriousness of sepsis and had in place management and governance
plans for it. Further aspects of the question were taken outside of the meeting.
14.0
External Auditor Contract (Governors Only)
The governors noted the arrangements in place for the procurement of a new external
audit contract.
15.0
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Date of Next Meeting
Council of Governors meeting on 13th October 2016
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