AGENDA ITEM 2i

Minutes of the Annual Members Meeting

Thursday 19 September 2013

Castle Green Hotel, Kendal

PRESENT:John CowdallChairman

Dr Enid Acheson Public Governor, South Lakeland and North Cumbria

Mrs Shahnaz Asghar Public Governor, Barrow and West Cumbria

Steve Cvijanovic Staff Governor

Mr Glyn DaviesStaff Governor, Estates and Ancillary

Mrs Sharon GranvilleStaff Governor, Management and Admin

Professor Philip HodgePublic Governor, Lancashire and North Yorkshire

Mrs Janet HamidPublic Governor, Lancashire and North Yorkshire

Canon J.G. HunterPublic Governor, Lancashire and North Yorkshire

Mr John KayePublic Governor,South Lakeland and North Cumbria

Mrs Kathleen KnipePublic Governor, Lancashire and North Yorkshire

Cllr Newman Thompson Partner Governors, Lancashire County Council

Mr Graeme NicholsonStaff Governor, Nurses, Midwives and ODP’s

Mrs Val RichardsPublic Governor, Lancashire and North Yorkshire

Mr Ian SoanePartner Governor, Voluntary Sector, Cumbria

Mr Roger TitcombePublic Governor, South Lakeland and North Cumbria

Mr Jim WoodPublic Governor, Lancashire and North Yorkshire

Jackie DanielChief Executive Officer

David HoldenInterim Director of Governance

Mary MooreActing Executive Chief Nurse

George NasmythMedical Director

Juliet WaltersChief Operating Officer

David WilkinsonDirector of Workforce & OD

Tim Bennett Director of Finance

IN ATTENDANCE:Paul JonesTrust Board Secretary

Olivia HegartyTrust HQ PA

Members and staff of the Trust and Members of the Public

1WELCOME AND INTRODUCTIONS

John Cowdall welcomed everyone to the Annual Member Meeting (AMM) and apologised for the delay.

2MINUTES OF THE MEETING HELD ON 28 SEPTEMBER 2012

The minutes were agreed as an accurate record.

3REVIEW OF THE YEAR

The Chairmancommented on how impressed he had been by the dedication and enthusiasm of staff to make real improvements for patients. In the early part of his term of office he had taken the opportunity to meet frontline staff members; including Consultants, Nurses and Administration staff etc. and sent his warmest personal thanks for their commitment.

John thanked Tim Bennett, Director of Finance who would be leaving the Trust at the end of November and wished him well for the future.

John also thanked all of the newly elected Governors who were due to join the Council of Governors in October for a 3 year term, as well as extending his congratulations to the newly elected Governors. John added that Michael Burke, previous Lead Governor had decided to step down and resign from the council not long after being elected, which was a loss of an individual who was very highly valued. Ian Soane, Deputy Lead Governor agreed to step in as Acting Lead Governor until a replacement was elected. He thanked Ian for all of his help.

Jackie Daniel reflected on the past year and commended staff for the progress has been made. Jackie stated that there has been a 6% increase in inpatient activity, and outpatient activity was also increasing. In terms of performance, there has been significant improvement since 12/13 and the Trust was beginning to achieve national standards.

80% of stroke patients now spent all of their time on dedicated stroke units which resulted in patients receiving the right treatment in the right location and meant that they can be discharged home or to a care home sooner. This was the seventh month in succession that the Trust has met the Stroke targets. Jackie stated that the Trust had also met the A & E waiting time standards for four consecutive months.

Jackiereported that the system for outpatient follow-up appointments had been reviewed and the Trust would continue to work with service users and partners. The Board made the decision last year to invest £1m in to record management. There would now be a central storage system in Lancaster and all records would be barcoded so that they can be transferred and located more easily.

In the last year the new inpatient unit at Royal Lancaster Infirmary had been opened and the Emergency Department has been extended which has made a significant difference. There is now a Minor Injuries Unit which means that those able to walk in to the department are not using the same entrance as those who arrive in an emergency.

Jackie Daniel reported that progress was being made in maternity services and good feedback is being received. Jackie noted that the clinical leaders were addressing issues around culture and how Teams were working together. Jackie noted that she was delighted to see that the Supervisor of Midwives had won an award.

Jackiecommented that many improvements have been made at Furness General Hospital, including the new Breast Screening Unit which had equipment upgrades etc. This has made a massive difference as there was now a one-stop clinic where a range of treatments and advice could be given. The Special Care baby Unit had also been upgraded and created an environment where babies can be close to their mothers. Jackie stated that there has been a lot of controversy around changes to the Oncology Unit at Furness General Hospitalbut the Trust had made a commitment to invest £400k to modernise the facilities and it was hoped that patients and Governors would be able to see the differences that this made to patients having treatments.

Jackie informed the members of the Projects Kendal, Barrow and Lancaster. Under this project the Trust has committed to spend £1m over the years to make experiences better for patients. At present the Trust is looking at making Wi-Fi available to patients and work was about to commence in the reception area at Westmorland General Hospital.

4ANNUAL REPORT AND ACCOUNTS 2012/13 AND RELATED AUDIT COMMISSION REPORTS

Tim Bennettpresented the Annual Report and Accounts.

Tim explained that the Trust had a number of quality and governance concerns in 2012/13 and in order to make significant improvement a large scale of intervention and support was underway. The Trust had not yet reached a point where all improvements had been made but significant progress was being made. There had been some financial consequences as some improvements have had to be done at considerable cost. The focus of the Trust in 2012/13 has been to address the quality and governance issues. As a consequence the delivery of cost improvements had been challenging and this had contributed to the deficit.

A financial recovery plan had been developed and this had been shared with the Monitor the Trust’s regulator. Tim explained that the recovery plan would take 3 years as the Trust needed to ensure that no risks were taken and any decisions made on changes that would impact on the quality of care. John Cowdall thanked Tim Bennett.

Jackie Ballard, External Audit thanked the Trust for inviting herself and colleague, Gareth Kelly to attend the meeting. Jackie explained that Grant Thornton were appointment by Governors to give assurance.

She noted that accounts were prepared to a high standard and there were no errors noticed and they were all supported by good working papers. The Trust had provided responses were required for any issues which were raised.

Gareth Kelly stated that the Quality Report which was included in the Annual Report requires an audit of the content and performance indicators stated. There were some areas for improvement on performance indicators but overall Grant Thornton was able to give assurance and a clear opinion on the account

John Cowdall thanked Jackie and Gareth for attending the meeting.

5REPORT OF THE COUNCIL OF GOVERNORS

Ian Soane introduced himself to the members stating that he was currently the Acting Lead Governor until a replacement for Michael Burke was elected. Ian mentioned Gilbert Ozuzu, previous Lead Governor and the high standard which he set whilst fulfilling the role at such a critical time for the Trust.

Ian Soane noted that Governors need to be in a position where they fully understand all that is happening within the Trust to allow them to ask the correct questions. Ian noted that the Trust was beginning to work with Governors more closely and hoped that this would continue

.

He thanked all Governors who have been working hard in subgroups, as well as thanking Directors and members of staff who are working closely with Governors.

The Governors would continue to represent the views of members and seek assurances that the Board would continue to deliver improvements.

John Cowdall thanked Ian Soane for his report.

6REPORT ON THE WORK ON NON-EXECUTIVE DIRECTORS

Denis Lidstone, Non-Executive Director and Senior Independent Director gave a presentation on the work and role of Non- Executive Directors.

Their role was to scrutinise the performance of management and ensure service quality was being delivered. Denis added that all of the main subcommittees of the Board are chaired by a Non- Executive Directors which includes, Audit Committee, Risk Committee, Finance & Performance Committee, Clinical Governance & Quality Committee and Serious Incident Requiring Investigation Panel.

Denis stated that the current Non-Executive Directors were very proactive and challenging of Executive Directors and this would continue.

John Cowdall thanked Denis Lidstone for his report.

7ELECTION OF GOVERNORS

Paul Jones presented a report setting out the results of the recent elections of the Council of Governors. A vacancy occurred after the election process had begun and the Council of Governors had made the decision to invite the next highest polling candidate to fill the vacancy.

8AMENDMENTS TO CONSTITUTION

The Chairman invited the meeting to formally approve the constitution which had been considered in detail by a Task and Finish Group of governors and subsequently approved by the Council of Governors who had recommended it to the Annual Member Meeting for approval. Shahnaz Ashgar proposed that the Constitution be approved as amended and this was seconded by Val Richards.

Mr Robert McKittrick was invited to address the meeting and raised concerns about the proposed changes to the Constitution and sought assurances that his long standing issues would be resolved.

Other members raised the following comments and or concerns were expressed by members:

  • Why should it automatically follow that a person deemed to be vexatious and persistent should be excluded from membership of the Trust
  • Concerns were expressed that members have not received a copy of the Constitution prior to the meeting. The Trust Secretary explained that a copy of the constitution was on the website and if hard copies were requested they would have been made available

The proposal that the Constitution be approved was put to the meeting and the voting showed that 13 members were in favour of approving the document and 14 members were against it.

Accordingly the constitution and amendments were not approved.

Arrangements would be made for a further meetingof the Membership and further consultation would be undertaken on the changes to Constitution.

The Chairman agreed to invite Ian Soane and other Governors to provide assistance in helping to resolve Mr McKittricks issues

9QUESTIONS FROM THE MEMBERS

John Cowdall asked if members had any questions they wished to ask the Board.

Helen Kaye, FT member noted that it was reassuring to hear what Jackie Daniel said about meeting targets and sustaining targets. Helen asked if there have been any decisions made yet with regards to centralising the Trust in one area, possibly Westmorland General Hospital. Jackie Daniel stated that the Trust needs to wait for the outcome of Better Care Together. The Trust was working with commissioners on plans for an integrated health economy but any views from members would be gladly received.

Ian Tomlinson, FT member noted that the Annual Report stated that the consultation for the Clinical Strategy was expected to start in September and be completed by next year and queried why this timescale had now been extended. Jackie Daniel informed members that an ambitious timescale was initially set but as things began to move forward it was quickly realised that the Trust and Commissioners needed more detailed information and data about community care and primary care in order to develop proposals that would meet local needs

Malcolm Taylor, FT member stated that he had submitted to the Trust Board Secretary a number of questions which were scheduled to be submitted at the meeting. Malcolm noted that as the meeting had been underway now for sometime it would be helpful for members to have more time for questions and discussions. John Cowdall that he had received Mr Taylor’s questions and agreed to respond in writing.

It was noted that there had been a number of issues with medical record management in the past and queried what measured are being put in place to improve this. Juliet Walters stated that there were new teams in place who were undertaking a review and implementing news systems.

John Cowdall closed the meeting thanking everybody for their attendance together with an undertaking to convene a further meeting in the near future to deal with the question of the proposed amendments of the Constitution and to put in place arrangements to respond to the issues of concern raised by Mr McKittrick.

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Minutes of the Annual Members Meeting – 19 September 2013

University Hospitals of Morecambe Bay Hospitals NHS Foundation Trust