ANNUAL GENERAL MEETING
Minutes of the fourth Annual General Meeting of County Durham and Darlington NHS Foundation Trust (CDDFT) held on Wednesday 20 July 2011 at 5.30 pm in the Auger Suite, Radisson BLU Hotel, Durham City.
PRESENT
Mr Tony Waites Chairman
Rt Hon Baroness Hilary Armstrong Non-Executive Director
Ms Kathryn Larkin-Bramley Non-Executive Director
Dr Ian Robson Non-Executive Director
Mr Andrew Young Non-Executive Director
Mr Stephen Eames Chief Executive
Ms Sue Jacques Chief Operating Officer & Executive Director of Finance
Mr Tom Hunt Executive Commercial Director
Dr Robin Mitchell Executive Medical Director
Ms Laura Robson Executive Director of Nursing
Mr Roy Beckwith Public Governor (Derwentside)
Mrs Brenda Bell Public Governor (Derwentside)
Mrs Janet Brown Public Governor (City of Durham)
Mrs Jean Brown Public Governor (Sedgefield)
Mrs Adele Bone Public Governor (Chester le Street)
Mr Colin Burnett Appointed Governor (North East Chamber of Commerce)
Cllr Veronica Copeland Appointed Governor (Darlington Borough Council)
Mrs Marjorie Dunn Public Governor (Darlington)
Mrs Barbara Dyer Public Governor (City of Durham)
Mr Robert Erskine Public Governor (City of Durham)
Mr James Heap Public Governor (Tees Valley, Hambleton, Richmondshire)
Mrs Betty Hoy Public Governor (Darlington)
Mr Kevin Hull Staff Governor (Ancillary)
Mr Ian Jennings Public Governor (Wear Valley & Teesdale)
Prof Paul Keane OBE Appointed Governor (Local Universities)
Mr Laurie McLeman Public Governor (Darlington)
Mr Alex Murray Public Governor (Easington)
Mr John Short MBE Public Governor (Wear Valley &Teesdale)
Dr Oliver Schulte Public Governor (Gateshead, S Tyneside, Sunderland)
Ms Dorothy Teasdale Appointed Governor (North East Ambulance Service)
Mr Laurence Welsh Public Governor (Derwentside)
IN ATTENDANCE
Mr Bill Headley Director of Estates & Facilities
Ms Chris Lisle Director of HR and Organisational Development
Ms Donna Swan Trust Secretary
Ms Gaye Ferguson-Boyes Trust Secretariat Co-ordinator
Ms Joanna Tyrrell Freedom of Information Officer
Ms Rachel Cassidy Trust Secretariat Admin Assistant
Ms Barbara Crozier PA to the Chief Operating Officer
Ms Gillian Parsons Communications Manager
Ms Suzanne Jarvis Minute Taker
There were also in attendance 57members of the Trust and 9 members of the public whose names were recorded separately.
Trust Board Members introduced themselves to members of the public.
1 / WELCOME & APOLOGIES FOR ABSENCEApologies for absence were received from:
Dr Mike Waterston Non-Executive Director
Mr Bill Davies Public Governor (Sedgefield)
2 / DECLARATIONS OF INTEREST
Anyone who was aware of a conflict of interest relating to any item on the agenda was required to disclose it at this stage or when the conflict arose during consideration of a particular item.
Ms Larkin-Bramley declared an interest in respect of her membership of the Durham Police Authority
No other declarations of interest were made.
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(b) / MINUTES & MATTERS ARISING FROM THE ANNUAL GENERAL MEETING HELD ON 21 JULY 2010
Accuracy
The Minutes of the last meeting were approved as a true record.
Matters Arising from the Minutes of the Last Meeting
There were no matters arising from the Minutes of the last Annual General Meeting.
4 / CHAIRMAN’S OPENING REMARKS
The Trust Chairman advised that, despite there having been a number of objections to this location in 2010, the AGM was being held at this same venue for the third year running due to the fact that it had proved extremely difficult to find a room which could accommodate 100+ people and which was also convenient in terms of public transport. Although it appeared that the number of people in attendance was slightly reduced in comparison to previous years, probably due to the adverse weather conditions, the Chairman was pleased to welcome so many people to the meeting.
The Chairman put on record that the purpose of this public AGM was to allow the Board of Directors to formally submit the Trust’s Annual Report to the Governing Council. The Chairman was concerned to remind all of those present that, in the interest of transparency, all of those meetings which take place between the Trust Board and its Governing Council, as well as those of the Governing Council, are open to public attendance. However, unfortunately, public attendance at such meetings had been very sparse indeed.
Various Trust colleagues were to speak to the Annual Report. However, the Trust Chairman was concerned to highlight those remarks made by himself and the Chief Executive in the introduction to the Report and, in particular, the fact that the organisation has gone through a number of nationally driven changes within the NHS and will continue to go through considerable periods of change. Those changes had placed enormous strains upon Trust staff who already had very stressful jobs – dealing as they do with the health of the community. The Chairman emphasised that the Executive Team were genuinely grateful to the Trust’s staff for the way in which they had persevered in carrying out extremely difficult work and in coming through all of those changes.
Although the Trust Chairman was actually appointed by the Governors, he put on record his view that the staff of the Trust were his personal priority. He acknowledged, however, that the Governing Council had been of great support to the Trust Board – whilst also posing some quite tough questions to the Board on behalf of their constituents. The Chairman formally thanked all Governors collectively - and especially those present on this occasion.
The Chairman then invited the Chief Executive to comment.
5 / CHIEF EXECUTIVE’S REVIEW 2010-11
The Chief Executive then gave an overview of highlights of the year 2010-11, the views of patients and staff, Trust performance and the challenges which lay ahead.
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(b) / PRESENTATION OF THE ANNUAL REPORT AND ACOUNTS 2010-11
Quality Accounts
Ms Laura Robson, Director of Nursing, delivered a presentation on the Quality Account. It was noted that, although these appear within the Trust Annual Report, a smaller, more user friendly version, was to be made available for distribution across the various CDDFT hospital sites.
Essentially, the Quality Account focused on the safety of care and the effectiveness of care provision. Quality was the number one priority for the Trust Board and was on the agenda of every Trust Board meeting. The purpose of the Quality Account was to drive for improvement in the patient experience throughout the year and to measure quality across the entire range of Trust services – and to continue to improve. Quality Accounts were for the benefit of patients and that was why it was intended to provide a shorter version to facilitate understanding on the part of patients and to promote communication between themselves and the organisation. It was also strongly emphasised that Governors have a significant input into the production of the Quality Account by using, and commenting upon, information provided throughout the year.
Financial Accounts
Ms Sue Jacques, Chief operating Officer & Director of Finance, then gave a presentation on the Trust’s financial performance throughout 2010-11. Governors and members of the public were advised that full sets of Financial Accounts were available upon request.
7 / GOVERNING COUNCIL AND MEMBERSHIP
Ms Donna Swan, Trust Secretary, spoke to a presentation which set out the new governance arrangements in respect of 2011-12. Ms Swan was keen to thank all members of the Trust Governing Council’s Membership & Engagement Committee who had worked so hard to increase Trust membership from 6,047 at the end of 2009-10 to 7,340 at the end of March 2011. As the staff membership now included community staff, and currently stood at a total of 8,000, it was now Ms Swan’s objective to correspondingly increase public membership to circa 7,600.
8 / OPEN QUESTION AND ANSWER SESSION
Ø Ms Mo Ryland stated that she had been a patient in December 2010 at UHND A&E Department when staff had been extremely busy. Given the increasing demands of patients, Ms Ryland questioned the capacity of the Trust and, specifically, whether it was the Trust’s intention to enlarge its buildings or if patients were to be encouraged to use GPs, Out of Hours services and community care in preference to CDDFT. Ms Ryland was also concerned to know how the organisation was to cope in the face of winter pressures and how much funding the Trust received, and utilised, in relation to those winter pressures.
The Chief Executive acknowledged that the pattern of UHND admissions was increasing. As a result, more capacity had been built into hospitals to reflect that trend. A major challenge lay ahead in shifting the focus of demand away from hospitals. A huge investment had been made by the Primary Care Trust (PCT) and, for the future, it was hoped to see some changes in avoiding hospital admissions and in the provision of care closer to home by enabling community staff, supported by specialists, to carry out more specialist work.
Ms Jacques added that, although no extra funding had been provided in the last year in respect of winter pressures, the Trust was paid for that level of activity put through its various hospital sites. Nationally, however, the Department of Health, was attempting to incentivise care closer to home. As a consequence of that initiative, foundation trusts (FTs) were paid only 30% of the actual cost of any extra activity undertaken. It was emphasised that these funding arrangements were very difficult to manage and must be monitored extremely tightly. Any monies received were allocated to those clinical areas carrying out extra activity and over the last winter extra investment had been made in levels of nurse staffing, medical staff and pharmacists. Throughout the winter of 2010-11, despite the fact that very difficult weather conditions had been experienced, the Trust had performed relatively well in comparison to other organisations. Planning was already under way for the winter of 2011-12 with lessons having been learned from the previous winter period.
Ø Ms Patricia Francis referred to the attendance record of Public Governors as set out in the Annual Report and suggested that the attendance record of Governors representing the City of Durham had not been as good as that of other Governors. Ms Francis also questioned whether Trust Governors received any allowances or reimbursement for their work.
The Chairman expressed his own view that the work of Trust Governors on behalf of their constituents within the City of Durham had been extremely influential. He formally put on record that Governors were not paid but did receive travelling expenses. It was, however, acknowledged that one Governor had not attended throughout the year. With that exception, all Governors worked extremely hard and made a very valuable contribution to the work of the Trust Board.
Ø Ms Lillian Taylor, who had previously worked for Social Services and was now a volunteer in A&E, asked how UHND would cope when the Hartlepool Hospital A&E closed. Ms Taylor highlighted that the A&E services at UHND had been under extreme pressure in the last two weeks, with patients waiting on trolleys for five to six hours. She also had concerns about security, and particularly the environment for children in A&E, when sometimes three or four police officers accompanied prisoners.
Mr Headley advised that security was run by the organisation’s PFI operator. Although he was not aware of any specific issues, Mr Headley undertook to pursue the point about security in some detail outwith this formal meeting.
Mr Eames advised Ms Taylor that the Trust had factored into its planning the closure of A&E at Hartlepool - with a forecast of up to 2,000 additional A&E attendances. Mr Eames was extremely concerned to hear that patients had recently been waiting on trolleys. Those circumstances should have been escalated to him. It would appear that the rules and protocols around these pressures had not been followed. He conceded that, sometimes, there was a huge raft of patients presenting at A&E at any one time – the trend being that this occurred towards the end of the day.
Ø Mr Bakerson, of Wear Valley, declared that he had used the services of every hospital within the Trust at various times. He was very positive about all of the services he had received, stating that he had been treated with great dignity and had been looked after very well. All staff were very pleasant and jovial and had been extremely reassuring. As a recipient of the Trust’s services he could not have been better satisfied. The Trust had the highest standard of any hospital trust in the region and worked well within its financial constraints. Mr Bakerson believed that congratulations were in order.
There was then a round of applause.
The Chairman thanked Mr Bakerson for his comments.
Ø A question was then raised around working with elderly patients who required assistance at mealtimes.
Ms Robson confirmed that it was very important to the Trust that its inpatients receive proper food and drink. A huge amount of work had been done with Age Concern to obtain the services of voluntary helpers and to train those volunteers to help patients at mealtimes – not only with eating but also to have some interaction with patients while they are in an unusual environment. Work had also been carried out with the Dementia Collaborative as, at any one time, it was known that 400 of the organisation’s beds are occupied by people with mental health problems. The Trust also worked in collaboration with the local mental health trust and the local Primary Care Trust (PCT) to improve the experience of those people.