Attachment 1
Minutes from the Council of Governors Meeting held in PUBLIC on
Friday 13 November 2015 at 12.30pm in the Lecture Theatre, Burrage Centre, James
Paget University Hospital
Present:
David Wright, Chairman
Appointed Governors:
Julie Brociek-Coulton
Sue Allen
Public Governors:
Lesley Bruin
Mick Castle
Penny Hutch
Sue Meecham
Lyn Gibbs
Stuart Brooks
Jean Goffin
Terry Rymer
Alison Mills
Peter Horton
Christina Horne
Angela Woodcock
Staff Governors:
Daryl Bourn
Ruth Davies
Justine Goodwin
General Public:
A Trust member
In attendance:
David Ellis, Non Executive Director
Peter Hargrave, Non Executive Director
Peter Franzen, Deputy Chairman
Christine Allen, Chief Executive
Ann Filby, Head of Communications & Corporate Affairs
Louise Ridge, Personal Assistant (minute-taker)
For briefings:
Andrew Palmer, Director of Performance & Planning
Apologies:
Keith Wilson, Staff Governor
Sharon Boothby, Staff Governor
Richard Holland, Appointed Governor
Andy Evans, Appointed Governor
Malcolm Bird, Appointed Governor
José Bamonde, Public Governor
Val Lattimer, Non Executive Director
Jane Harvey, Public Governor
Tony Goldson, Appointed Governor
Martin Arnold, Public Governor
Jean Macheath, Public Governor
Non Attendance:
Sara Barber, Public Governor (apologies received after the meeting)
General
1. Welcome and apologies for absence
The Chairman welcomed everyone to the meeting. Apologies were noted as
above.
Action
2. Declaration of Interests
Penny Hutch, Public Governor, declared her interest in Suffolk Health Watch. Mr
Wright, Chairman, advised that it was not necessary to declare this at each
meeting unless there is a related item for discussion within the meeting agenda.
There were no further declarations of interest.
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3. Minutes of previous meeting and matters arising
The Chairman approved the previous minutes as a true record of events and
agreed to sign off.
Action Points
14/03/15 – 9 – Chairman & NED performance review process 2014/15 – It was
agreed that this action is now complete and can be closed.
LR
Ms Filby, Head of Communications & Corporate Affairs, requested confirmation
from the Governors that all actions marked as green have been satisfactorily
closed and can be removed. This was agreed.
LR
Penny Hutch, Public Governor, advised that there is currently no emergency
mental health bed availability in Suffolk.
4. Chief Executive’s Overview
Mrs Allen, Chief Executive, highlighted the work going on with regards to the
integration of services. Mrs Allen advised that Mr Wright, Chairman, and Mrs
Libiszewski, Director of Nursing & Workforce, had recently attended an event
which had been organised by Norfolk County Council to start to explore how the
service providers can work more effectively across the county. A set of care
principles were agreed and these have been formally accepted by the Trust at the
October Board meeting. Mrs Allen advised that the next event is being held next
Wednesday which she will be attending. Mr Wright reported that all providers and
commissioners had been together at the event and had agreed that the principal
is focusing on the needs of the patients and beginning to take a step forward in
the integration of services. Mrs Allen felt it was a start but confirmed that the local
area is behind the pace of others throughout the UK.
Penny Hutch, Public Governor, asked whether Suffolk had been involved in any
way and also asked what the patient split was between Suffolk and Norfolk. Mr
Wright responded that from a commissioning perspective Suffolk was covered.
Mrs Allen stated that she believed that Suffolk providers had been invited. Mr
Palmer, Director of Performance & Planning, advised that he believed there are
currently more patients from Suffolk than Norfolk although exact figures were not
available at the meeting.
Mr Palmer discussed a meeting which had been held with the planning directors
of local providers including JPUH, NNUH, QEKL and NCH&H. He confirmed that
they had agreed to meet on a monthly basis to discuss how services can be
planned jointly. Each planning director had individually brought a list of possible
areas for integration including care of the elderly, estates and procurement. He
advised that the output of these meetings will feed into Chief Executives’
discussions. Mr Palmer advised that he had also arranged for the JPUH
transformation team to meet with the transformation teams from other Trusts and
felt the response from all concerned was really positive.
Mr Palmer also discussed ‘Most Capable Provider’ which is a different approach
to commissioning services which involves looking at different bundles of care
which overlap different providers i.e. therapy and managing beds. He advised
that the CCG is looking to award contracts for these services for a period of five
years with two x one year extensions. As well as the JPUH the other providers
involved were ECCH, Norfolk Social Care, Suffolk Social Care, Mental Health and
All Hallows Hospital. The Chief Executives for these providers have all signed a
Memorandum of Understanding.
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Mr Palmer advised that at the end of October each provider had attended an
event organised by the CCG to make a presentation following which the CCG is
now satisfied that everyone can work together. He confirmed that the first
meeting will be held in the next two-three weeks.
Mr Palmer discussed other areas of work including Mrs Allen visiting local GPs to
establish what they think the Trust should be doing differently. He advised that he
had also been involved in the Shape of the System Consultations and had taken
part in planning workshops at the end of October with other local services
including GPs, Police, Social Care and Ambulance Service.
Mr Wright discussed the question which had been raised by the Review &
Planning (R&P) Committee with regards to the efficiency of the Trust. Mr Palmer
advised that in a recent Board meeting it had been recognised that the Board
would like to see more information. His team would be looking at productivity and
efficiency figures and would present this data in a dashboard. He confirmed that
there is a lot of work going on but the information is not fed back at present. Mr
Franzen, Deputy Chair, asked whether the new SLR project would help provide
this information. Mr Palmer discussed the SLR (Service Line Reporting) project
and advised that the new system can take an individual service and break down
all the costs associated with it which would allow the Trust to see any
discrepancies. Mr Palmer advised that one of the aims of this work is to reduce
variability in practice.
Angela Woodcock, Lead Governor, advised that there seemed to be a lot of
variance within the Endoscopy Service and asked how in depth the system was
capable of reporting. Mr Palmer advised that it is possible to break the
information down to individual patient level.
Mr Palmer left the meeting and was applauded by the Governors.
Governance
5. Audit Committee Annual Report
Mr Hargrave, Non Executive Director (Chair of the Audit Committee), discussed
the report which covers the 2014/15. He highlighted that the Audit Committee is
not specifically about money. He confirmed that also in attendance at the Audit
Committee are representatives from Grant Thornton, who are the Trust’s external
auditors, Pricewaterhouse Coopers, the Trust’s internal auditors, and also the
counter fraud specialists.
Mr Hargrave highlighted item six on the report entitled ‘The Future’ and provided
an update position as follows:
-
The internal audit programme has been changed to reflect the Trust’s
deficit position
Peer Review – This is when the Audit Chair from another Trust shadows
here at the Trust and vice versa. Mr Hargrave confirmed that the Audit
Committee meeting scheduled to be held in December will be attended by
the Frimley Park Audit Chair and in January Mr Hargrave will be attending
their meeting.
6. Board of Directors
Mr Wright, Chairman, advised that the approved July and September minutes
were included in the papers.
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Ms Filby, Head of Communications and Corporate Affairs, advised that the July
minutes included a discussion on clinical audit which is an area that the R&P
Committee wanted to escalate. She also advised that the September minutes
included staff stories from nurses at various stages of training as well as items
discussing C-Diff., mortality and the current financial position.
7. Review and Planning Committee Report
Jean Goffin, Deputy Lead Governor, discussed the issues raised at the R&P
Committee and escalated to Council.
She advised that there had been concern at the level of participation of Governors
for patient experience visits and that a form was being distributed at the meeting
today, and would also be sent to absent Governors, to ascertain whether
Governors are interested in being involved in patient experience visits in future.
Lesley Bruin, Public Governor, felt that this is part of being a Governor. Lyn
Gibbs, Public Governor, advised that these visits are always held on a Thursday
and asked if it would be possible to vary the day. Ms Filby, Head of
Communications and Corporate Affairs, to investigate and advise.
AMF
Jean advised that there had also been a lot of concern with regards to the lack of
a membership figures report, however, assurance has been received that this will
be provided at the next Patient Experience & Public Engagement (PE&PE)
meeting in December.
Jean felt that there was a lot of confusion with regards to whether HCAs are paid,
or not, for attending their five day induction with the Trust. Ms Filby, Head of
Communications & Corporate Affairs, confirmed that as HCAs are employed as
bank staff they are not paid to attend and further clarification had been provided.
Long term sickness – It has been agreed that this will be presented, by either the
Executive Lead or Associate Director of Workforce, at a future Council meeting.
Lesley Bruin, queried whether the booklet, as discussed on page six, has been
produced. Ms Filby confirmed this had been implemented and is still in use.
Ms Filby requested clarification from the Governors that the answers were
sufficient or whether they required further escalation. The Governors agreed they
were satisfied with the responses provided and no further action was required.
The Patient Experience
8. CQC update
Mrs Allen, Chief Executive, stood to make a CQC presentation and was
applauded by the Governors.
Mrs Allen advised that the overall outcome is ‘Good’. Dr Ellis, Non Executive
Director, emphasised that the areas which were highlighted as ‘requiring
improvement’ are within a ‘safe’ rating and therefore wanted to reassure the
Governors that does not mean the Trust is an unsafe trust.
Mrs Allen highlighted the urgent and emergency services which received an
‘Outstanding’ in the ‘well led’ category. She continued to provide brief details of
what the inspection team had found including the opportunities to improve. Mrs
Allen advised that the Trust had received the following:-
Two ‘Requirement Notices’ where an improvement plan must be submitted
to the CQC
Five ‘Must Do’s’
Numerous ‘Should Do’s’
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Mrs Allen went on to discuss the Trust’s response and confirmed that there are
only two ‘Outstanding’ hospitals in England, namely, Salford and Frimley Park,
both of which had areas which required improvement within their inspection. She
advised that the Chair of the Inspection Team had told the Quality Summit that
they had seen something that money can’t buy, which was the pride shown by all
staff.
Penny Hutch, Public Governor, asked how long a DNACPR was in place for. Mrs
Allen advised that this is a complex area and confirmed that some patients have a
DNACPR already in place when they are in the community and brought into the
Trust and some are only relevant for one episode of care. In addition some are in
place for ongoing medical condition. Mrs Allen confirmed it isn’t a straight forward
process and it is a challenging area for the Trust.
Stuart Brooks, Public Governor, felt that the openness and honesty of staff was
noticeable when reading the report and advised that three weeks ago he had
been a patient in the Trust and concurred with the report findings.
Sue Allen, Appointed Governor, asked if a brief communication/presentation could
be sent to Councillors and Town Clerks for distribution. Ms Filby, Head of
Communications and Corporate Affairs, to action.
AMF
Sue Meecham, Public Governor, confirmed that DNACPR is very complicated.
Mr Wright, Chairman, felt that the risk of receiving a good report is that it inflames
people who are less than happy with the service they have received from the
Trust. He wanted to acknowledge that we do make mistakes but we have an
environment of learning from them.
Ruth Davies, Staff Governor, left the meeting at 1.30pm.
Daryl Bourn, Staff Governor, felt it would be a challenge to maintain the level of
service. Mrs Allen agreed but felt that staff were continuing to maintain this level
and had pride in their workplace/service/environment.
Terry Rymer, Public Governor, felt a good CQC report would attract new staff.
Mrs Allen confirmed the Trust would take every opportunity to use the information
to promote the Trust.
Other Issues
9. Lead and Deputy Lead Governor re-appointments
Angela Woodcock, Lead Governor and Jean Goffin, Deputy Lead Governor, left
the room for this item.
Ms Filby, Head of Communications and Corporate Affairs, advised that the current
agreement, as approved at Council last year, is that the Lead and Deputy Lead
appointments are on a one year basis. She confirmed that further to discussions
at the Review and Planning Committee a proposal has been set out in the paper
for Angela and Jean to continue in their roles for the remainder of their term and
in 12 months look at an election to identify a shadow lead and deputy lead.
Stuart Brooks, Public Governor, proposed to accept the proposal and this was
seconded by a number of other Governors.
Angela Woodcock and Jean Goffin re-joined the meeting.
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10. Any Other Business
Terry Rymer, Public Governor
-
Asked for information on possible strike action being taken by junior
doctors’. Mrs Allen, Chief Executive, felt that the junior doctors’ are a very
valuable part of the Trust team. She advised that the Medical Director,
Director of Medical Education and Associate Director of Workforce are
meeting with the doctors on an informal basis to understand where their
concerns are, however, this is a national negotiation and guidance and
process have been distributed by the BMA on how to cover services. Mrs
Allen confirmed the priority is patient safety.
-
Asked if any decision had been reached with regards to whether it was
appropriate for a representative of the CCG to remain as a Governor. Ms
Filby, Head of Communications and Corporate Affairs, advised that it had
been agreed to review this as part of the current constitution review.
Angela Woodcock, Lead Governor
-
Asked if a decision had been made on the previous agenda item. Mr
Wright, Chairman, confirmed that the Committee had unanimously agreed
with the proposal to confirm the appointment of the Lead and Deputy Lead
Governor.
-
Discussed an article she had read in the NHS Executive Newsletter with
regards to contracts being set by CCG’s with companies which have a
conflict of interest by having GPs involved and asked if the Governors
could receive some assurance that the local CCG are behaving
appropriately. Mrs Allen felt that the Governors could write to the CCG
and ask the question. Mr Wright advised he would write to John
Stammers, Chairman of the CCG.
-
Felt that different support is given to mothers who deliver a still birth as
opposed to losing a baby shortly afterwards. Daryl Bourn, Staff
Governor, felt there are lots of voluntary organisations in place to provide
support and care. Mrs Allen advised that an investigation into an
individual case would need to take place outside of the meeting.
-
Asked whether the Trust has received the result of Expert Determination.
Mrs Allen advised that Mr Palmer, Director of Performance & Planning,
and Mr Flynn, Director of Finance, are currently working through the report
but the initial review is that it would appear to be a 50/50 split. Mr Palmer
and Mr Flynn are now investigating the impact on the Trust’s financial
position.
-
Asked if the nominees had won the Nursing Times Award. Mr Wright,
Chairman, advised they had not.
DW
Mr Wright, Chairman
-
Advised that Alan Howard, Non Executive Director (NED), had resigned
on the basis that he is getting involved in new business opportunities and
doesn’t feel he can fulfil his role as a NED going forward.
Lesley Bruin, Public Governor
-
Felt confidence in Mr Palmer and the team to see the Trust through this
and wanted to wish him every success.
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Penny Hutch, Public Governor
-
Asked for a copy of the Chief Executive’s blog in future. Ms Filby to
action.
AMF
11. Questions from the Public
A Trust member asked whether the closure of community hospitals will cause
problems with bed blocking within the hospital. Mrs Allen, Chief Executive,
advised that the Trust had responded to the public consultation and that she felt
the timing is awkward and it would be a challenge for the Trust.
He continued and asked how much the Trust spends on locum staff. Mrs Allen
confirmed that the government is currently consulting on changes to the way
agency/locum posts are managed and provided assurance that the Trust would
not employ locums if there was any other alternative. She advised that, hopefully,
the outcome of the CQC inspection will raise the profile of the hospital and allow
recruitment of more permanent members of staff.
Terry Rymer, Public Governor, wanted to express his thanks to everyone involved
in the Remarkable People Awards. Mr Wright, Chairman, agreed.
12. Reflection: Has the meeting been conducted in accordance with the
Trust values?
Yes.
13. Date, time and venue of next meeting
Friday 15 January 2016 at 9.30am in the Lecture Theatre.
With no further business the meeting closed at 1.55pm.
14. To resolve that representatives of the press and other members of the
public be excluded from the remainder of the meeting having regard to the
confidential nature of the business to be transacted
Signature:
____________________________
Name:
Date:
Position:
Distribution :
Council of Governors; Board of Directors; Public papers available on website the Monday prior to the meeting
Contact Details
Ann Filby, Head of Communications & Corporate Affairs, James Paget University Hospitals NHS Foundation Trust,
Lowestoft Road, Gorleston, Great Yarmouth, Norfolk NR31 6LA
Tel : 01493 452162; Fax : 01493 452078
[email protected]
www.jpaget.nhs.uk
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