Council of Governors Meeting
2 December 2015
MINUTES
COG 2015
Minutes of the meeting of the Council of Governors held on 2nd December 2015 at 17:00 in Bevan 1 & 2, Stephenson House
Members Present:
Prof. Dorothy Griffiths Chair Ms Myrna Hayter
Mr. Paul Byrne Mr. Mike Crawford
Cllr. Angela Mason Mr Mike Norton
Mr John Parkinson
Mr. John Clark
Ms. Elvira De Souza
Mr Bob Walker
Mrs Janet Seale
Ms Geraldine Vacher
Mr. Henry Arthurs
Ms. Ann Sheridan
Cllr. Charles Williams
Dr. Karim Dar
Mr Howard McFarlane,
In Attendance:
Ms. Claire Murdoch Chief Executive
Ms. Robyn Doran Chief Operating Officer
Ms. Jane McVey Director of People
Mr. John Vaughan Director of Strategic Development
Ms. Christine Baldwinson Trust Secretary
Ms. Caroline Leveaux Associate Director Strategic Planning
Mr David Walker Non Executive Director
Ms Helen Edwards Non Executive Director
Mr Andy Mattin Director of Nursing and Quality
Mr Trevor Shipman Director of Finance
1. Welcome
a The Chair welcomed Governors, colleagues from the Board of Directors, staff colleagues, and members of the public, to the meeting.
2. Apologies for Absence
a Apologies for absence were received from Ketan Sheth, Irene Leeman, Lina Christopoulou, Peter Bradley, Michael O’Dwyer, Stephen Chamberlain
3. Governor Election
a. The Trust Secretary advised that Sarah Somerville had stood down since the last meeting. The Chair will write offering her best wishes.
4. Minutes of the meetings held on 7th September
a The minutes of the meeting held on 7th September 2015 were considered for matters of accuracy and were confirmed as an accurate record.
5. Matters Arising
a. There were no matters arising
6. Board updates
a The Chair advised that, as the terms of office of Ian Holder (Deputy Chair) and Bhavana Desai (Senior Independent Director) have now come to an end that the Council of Governors is required to make appointments to these two important roles.
b The Chair nominated David Walker as the new Deputy Chair and Helen Edwards as the new SID and the Council of Governors unanimously approved these appointments.
c The Chief Executive advised of changes at Executive Director level. Ian McIntyre was retiring in December from his post as Executive Director Commercial Development. He would not be replaced on the Board although a very experienced Director of Estates has been appointed who will report to the Director of Finance.
d Jane Mcvey has been appointed, through a full external process, as the Director of People and Organisational development
e Dr Con Kelly has been appointed as job share with Dr Alex Lewis to the post of Medical Director as Dr Lewis has taken up a half time appointment with Monitor
f Trevor Shipman will be retiring as Director of Finance at the end of March. The post has been advertised nationally and interviews are set for next week. All shortlisted candidates are experienced Directors of Finance. CM also reassured Governors that the Trust also has a very able Deputy Director of Finance and each division has a senior finance lead.
7. Physical healthcare
a Dr Pramod Prabhakaran introduced the report which set out progress that has been made to improve the physical healthcare of patients presenting with mental health conditions and which set out the future plans to continue to drive improvement in this area.
b Governors discussed the paper and raised a number of comments. It was noted that the Trust must maximize the benefits of having both mental health and physical health services and it was noted that the clinical networks will operate across the Trust to ensure the spread of best practice. It was noted that health promotion is already a key issue for our Occupational Therapists who make every contact count by discussing physical health issues and signposting patients to relevant services. It was agreed that the trust needs to ensure that System One is configured in such a way as to make it easy to record physical health assessments. The meeting noted the importance of regular screening particularly when anti psychotic drugs known to cause side effects have been prescribed.
c It was agreed to have a report back on progress in six months time
8. CQC Update
a. The Chief Operating Officer advised that the Trust is still on track to be fully compliant with all CQC issues by the end of December 2015 and it was noted that the most recent MHA visit raised no concerns at all
b. RD advised that the Trust had recently carried out its own quality inspection with 170 inspectors, mostly staff but with 40 stakeholders, visiting 89 teams and it had proved to be a very positive learning experience. The teams identified many areas of good practice which will be shared across the Trust. Hover there was some inconsistency and overall the four key areas for further work were; staffing ( recruitment and retention); leadership( multi disciplinary leadership down to team level); care plans( ensuing they all involve the patient) and physical environment( both good housekeeping and some more major capital projects).
c. In response to a question from Councillor Williams, RD advised that bed management was greatly improved. Commissioners are now funding a number of ECRs but within that envelope there have been no cases of patients having to sleep on chairs or to be escorted by taxi between units in order to find a bed
9. Finance Report
a. The Director of Finance introduced the finance update and advised that the trust is on track to deliver to plan. However he noted that without property sales in year the Trust would be in deficit. He also noted that there will be a lot of pressure to deliver CIPs in the final part of the year.
b. He advised that planning for the next year had already started with the Trust estimating that it will need a 6% saving just to break even.
c. One the pressures will be pay as the changes to pension costs and National Insurance will add 4.3% to our pay costs. TS explained that over recent years cash costs have risen by 4% and income only risen by 2% which has had a cumulative pressure on the Trust’s finances.
d. Governors thanked TS for the clarity of his explanation and noted that while the Trust is currently on plan that the future continues to look extremely difficult.
10. Performance Report
a. The Director of Strategy and Performance advised that the Trust was currently non-
compliant with one Monitor indicator, that of referral to treatment times. This is applicable to only two very small teams within the Trust and one service in Milton Keynes has underperformed. Actions are in place to bring the trust back to full compliance.
11. Accountable Care Organisations
a. JV introduced the paper which provided a simple explanation of likely future organisational forms within the health economy. He advised that the Trust was currently engaged in discussion in Hillingdon, Milton Keynes and Camden with Hillingdon being the most advanced with a shadow board in place.
b. Governors asked what effect these new arrangements would ultimately have on the governance of the Trust and in particular the role and responsibility of Governors. The current proposals will not affect the role of governors and the Trust will ensure that lines of accountability and responsibility remain clear.
c. Governors also asked that specific attention be given to the maintenance of quality standards.
12 Workforce
a JM introduced the item reminding the Governors of how important quality staff are and how competitive the recruitment market is. She outlined the plan to develop the Trust recruitment and retention package. Governors then discussed the issues in detail and suggested the following areas for closer scrutiny.
· Providing as much support as possible to leaders throughout the organisation
· Considering whether there are any opportunities to provide affordable accommodation
· Linking incentives to the development of competencies which could spread the financial impact over time and encourage staff to focus on the areas where we need skills eg physical healthcare
· To be mindful during reorganisations of the need to support staff so that that we don’t lose people
· Make sure that we feedback to staff as people stay if they feel they can make a difference
· Don’t devalue benefits by constraining them eg let people carry over leave,
12. Board meeting update
a. The Chair advised that the key items considered by the Board at its last meeting had been quality and finance. They had considered many of the issues considered by the Governors this evening including the CQC and performance. There had been a specific focus on the , changes to the financing of children’s services and how the Trust is managing the upgrade of its ICT infrastructure and clinical system.
13. Trust Update from Chief Executive
a The Chief Executive advised that the SPA (single point of access) had now been operating for 4 weeks and was receiving between 80 and 100 calls a day. Cases are being triaged and where necessary someone could be sent out to a patient within an hour. It was not however an urgent care service and should not be used as an alternative to 999
b It was noted that the Trust had not been advised in advance of the proposed closure of Holloway prison and staff had found out about the closure through the media. The Trust is now working with staff to manage the transition.
c CM advised that sexual health services are to be re-commissioned by 29 Local Authorities. The service needs to redesign to reduce its current cost base and this may involve changes to the Margaret Pike centre but as yet there is no firm proposal and a range of options are being considered which are based on the ability to treat the largest number of patients to the highest standards within the commissioning budget. This is likely to mean operating from fewer building as to make savings in any other way would mean fewer staff. Decisions on changes are likely to be difficult but need to be based on accurate information.
d It was noted that the proposed strike for junior doctors had been postponed but CM gave assurance that the Trust had planned for the eventuality and been impressed by the willingness of doctors and other staff to work with the trust to ensure the safety of patients.
e CM drew attention to the recent report by Quality Health, the company responsible for the national patient survey, who had commended the improvements in the quality of service provision in Milton Keynes since they were acquired by the Trust.
14. Question and Answers session
a In response to a question from a member of the public the Chief Executive confirmed that the Trust was in close liaison with CLCH to ensure continuity of the physical and mental health care of patients in West London.
15. AOB
a. There was no further business.
b The Chair thanked Governors for their hard work throughout the year.
End of the meeting 19.00
Prof. Dorothy Griffiths
CNWL Chair
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