PART II TRUST BOARD MEETING
IN PUBLIC
Held on Thursday 4 September at 2.30 pm
In the Conference Room, Dame Judith Professional Centre, Cosham
M I N U T E S
Present: / Ursula Ward, Chief Executive /Michael Waterland, Chairman
Neil Kemsley, Director of Finance / Maggie MacIsaac, Chief Operating Officer / Graeme Zaki, Medical DirectorDavid Eccles, Director of Human Resources and Workforce / Peter Mellor, Company Secretary / Mark Greenwood, Non-Executive Director
David Bailey, Non-Executive Director / Alan Cole, Non-Executive Director / Brett Gill, Non-Executive Director
In Attendance: / Lesley Kemp (Minutes)
Item No. / MINUTE /
ACTION
97/08 / ApologiesMark Nellthorp, Non-Executive Director
Declaration of interests
The Chairman asked whether any Board Member had any conflict of interest with any items on the agenda. There were none.
98/08 / Minutes of the meeting of the Trust Board held on 31 July 2008
The Minutes of the meeting held on 31 July 2008 were accepted as an accurate record of the meeting, with no amendments.
Matters arising:
- Healthcare Commission: the Chairman asked whether a report had yet been received and Ursula Ward replied that it had not. She did say, however, that if there had been anything significant she would have been briefed on the day of their visit.
None
99/08 / Chairman’s communications:
- Combined meeting of the Trust Board and Council of Governors: the Chairman reported that this joint meeting had gone very well. He explained that the Governors were a very mature group of peope, and there is an observable engagement with them. To date, he reported, seven meetings had taken place, all of which have provided an effective learning process.
100/08 / Chief Executive’s Report
Ursula Ward stated that she had nothing specific to report.
101/08 / Fire Officer’s Annual Report
David Eccles spoke to this report, and explained that it was the Board’s responsibility to receive this on an annual basis. He stated that Glen Hewlett and Bob Hookway were present to respond to any detailed questions. He reported positively that the Trust’s record in terms of unnecessary call outs was one of the smallest in the country. He also recorded that 4719 staff had been trained in fire safety, and that most importantly, there had been no fires.
David Eccles took the opportunity to publicly thank Bob Hookway, who had provided many years of dedicated and effective service. This view was endorsed by both the Board and byGlen Hewlett.
The Chairman asked Bob Hookway as Fire Officer, how well he feltthe Trust wasprepared to handle a serious fire? Bob Hookway replied that there was every chance everybody would get to the safetypoints. He stated that the most important issue was training staff in what they were required to do. He said that having an observant staff who report regularly on issues such as defective fire doors is very important. The Chairman then asked whether Bob Hookway felt comfortable that he was given adequate opportunities to raise any serious concerns at the appropriate level in order to be heard, and Bob Hookway confirmed that he was comfortable with this. Glen Hewlett endorsed this, stating that he had good access to the Chief Executive and that he was confident of the full support of the Board. The Chairman then asked whether the Board could assure itself that was being informed about all relevant issues, and Bob Hookway confirmed that they could feel confident in this regard.
102/08 / Performance Report
Maggie MacIsaac spoke to this report. She stated that, in overall summary, the Trust was performing very well and this was evidenced in comparison with other hospitals. She stated that in order to be sure the right targets were being hit, there needs to be a clear sense about areas which are at risk.
She drew attention to various sections of the report. She stated that there had been problems in achieving the target in terms of thrombolysis during the last year. The Trust was in detailed discussions with South Central Ambulance Service and she wished to reassure the Board that this matter was in hand. She stated that she would report back in greater detail at the next Board meeting
Maggie MacIsaac then went on to report on a number of other issues, as follows:
- MRSA figures stood at 7 against a target of 12
- There was still an issue with delayed transfer of care, although the number is reducing. A great deal of work is being undertaken with partners within the PCTs to reduce this number further.
- The performance within the Emergency Department is good, when compared both locally and nationally and is, in fact, consistently within the top ten in the country.
- 18 week target: performance in this regard is good, although there is concern with overheat. The number of referrals is up significantly, thus increasing the number of outpatients being treated. One reason for this increase in referrals is undoubtedly because waiting times are lower. David Bailey asked whether this was a situation which was reflected nationally, and Maggie MacIsaac said that the Trust was certainly not the only one experiencing overheat, but ours was quite noticeable in comparison with others.
In answer to a question from the Chairman, Maggie MacIsaac stated that the target in terms of diagnostics was 100%. Ursula Ward commented that if the situation regarding diagnostics was right, then it was easier to get everything else right.
Martin Marks (member of the Council of Governors) drew attention to the anomaly within the table ‘Diagnostics – 15 Key Tests’. He pointed out that although the title mentions 15, only 13 were listed. Maggie MacIsaac said that she would investigate this anomaly. Post meeting note: the Department of Health have 15 key diagnostic tests, hence the title. The Trust, however, only performs 13 of them.
Jock McLees (member of the public) pointed out that there was still some infringement of the infection control rules and he was concerned that this might be the start of a trend. Graeme Zaki stated that 3 of the figures quoted were actually community acquired figures and were not from within the hospital. There was, he said, an almost 50/50 split between hospital and community acquired figures. He reported that the efforts in this regard within the hospital were immense and the targets are being pursued with vigour.
Jock McLees also drew attention to the need for an education drive, to make people aware that the PCTs are separate from the Trust. Ursula Ward commented that this was issue which had been raised at the Council of Governors meeting on 2 September. Martin Marks (member of the Council of Governors) stated that the Governors were in the process of preparing a leaflet explaining the roles of the PCTs, Hampshire PCT, the Trust etc., which would be available at the Council of Governors’ launch meetings.
Mark Greenwood stated that the new formatfor this report was a vast improvement. / Maggie MacIsaac
103/08 / Finance Report
Neil Kemsley spoke to this report. He stated that Appendix 1a was a summary of the position as at the end of July.
Neil Kemsley reported that there was a deficit of approximately £1m, against a planned surplus of £100k. He stated that it was the Trust’s view that approximately £6.6m was due in terms of payable overheat although only £4.8m had been factored into the reported position at the end of July. The pressures with regard to the overheat were specifically reflected in the medical and surgical divisions, with cardiology, orthopaedics and audiology being key areas of overspending on non pay budgets.
Neil Kemsley drew attention to the top right hand column of Appendix 1a which declared an overall risk rating of 3. He explained the system used by Monitor and that 3 was the minimum acceptable to be authorised as an NHS foundation trust. The score is primarily driven by the position with income and expenditure which in turn reflects the concern regarding payment for all activity.
Brett Gill stated that the situation within the NHS was very different to the one he was familiar with. In the commercial world, the more you did, the more you were paid. The Trust was doing more, but could not be sure of receiving payment, but was alsounable to ‘turn off the tap’.
104/08 / Assurance Framework Exception Report
Peter Mellor spoke to this report. One or two risk areas showed a reduced score, the reduction being as a result of works necessary to mitigate the risks having been carried out.
One significant area was MRSA, but although this now carries a reduced score, there was still recognition that it was a significant risk.
Peter Mellor also reported that there were two risks which had increased in rating. Firstly, CDiff has been upgraded from 16 to 20, and Graeme Zaki explained that this was as a result of a new strain of CDiff which was more virulent than previous strains. Secondly, the risks associated with the implementation of the electronic document management system had been increased.
The Chairman requested that the table format be amended with the addition of another column illustrating any new risk rating or new item. / Peter Mellor
105/08 / Committee Minutes
- QAH Redevelopment Committee (6/5/08): duly ratified. David Bailey stated that the Board had previously agreed that draft Minutes would be acceptable, to avoid any long delays in presenting them to the Board. He requested that Chairs of Committees be reminded that draft Minutes would be acceptable.
- Equity & Diversity Steering Group (28/5/08): duly ratified.
106/08 / Any other business
Mr Cousins apologised for not having recorded this item of any other business earlier. He drew attention to a recent article in the local paper, The News, which had reported that two theatres within the new hospital would be left empty because the Rocky Appeal had failed to raise the money necessary for new equipment. Peter Mellor explained that the article had been a little ‘tongue in cheek’ as it was trying to stimulate income into the Appeal. He reassured Mr Cousins that the theatres would not remain empty and that existing equipment would be used whilst the money was being raised for the specific new equipment.
107/08 / Resolution to Exclude the Press and Public
The Board considered and approved a resolution to exclude the press and public from the remainder of the meeting because publicity would be prejudicial to the public interest by reason of the confidential nature of the business to be transacted.
Date and venue of next meeting
2 October 2008, Conference Hall Dame Judith Professional Centre