31St Meeting of the Council of Governors

31st Meeting of the Council of Governors

12 December 2013

3pm – 5pm Applegarth Suite,

Marriot Hotel, Bexleyheath

Chair: Dave Mellish

Trust Secretary and Head of Governance: Ann Rozier

Public Governors / Service user/ carer Governors / Appointed Governors
Stephen Brooks / Julian Baker / Alan Downing
Richard Diment / Alan Cork / Carl Krauhaus
Amanda Finlay / Jenny Kay / Raymond Sheehy
Jennifer Grant / Chris Purnell / Malcolm Wood
Eimear Mallen / Steve Seabrooke / Steve Davies
Dalla Jenny / Ken Thomas
Judy Wolfram / FolaBologan
John Woolgrave / Katherine Copley
BaetiMathobi
Staff Governors
Marcos Da Silva / Kaye Jones / Barbara Cawdron
Maggie Grainger / Mary Titchener

In attendance:

Non Executive Directors / Executive Directors /

Guests and Presenters

Anne Taylor / Stephen Firn
James Kellock / Michael Witney
Dr Ify Okocha
Iain Dimond
Item /

Action

1. / Apologies
Judith Ellis, John Fahy, Maureen Falloon, Steve Francis, MartynGaylard, Eleanor Jones, Hugh Morgan, Jason Morgan, Raymond Pope, Lesley Smith, Anne Voce, Helen Smith, Archie Herron, Estelle Frost, Steve James. / Noted
2. / Minutes of the last meeting of the Council of Governors
John Woolgrove had sent apologies for the meeting. Subject to this amendment, the minutes were agreed as an accurate record. / Agreed
3. / Matters arising
AF asked if the Council of Governors were to receive feedback on developments in Greenwich and Bexley.
SF – All initiatives will be highlighted in the Annual Plan main agenda item. This will cover all services and the acquisition of property. / Noted
4. / Patient Experience
Michael Witney, Director of Therapies gave a presentation on the Trust’s approach to improving patient experience. He covered:

The NHS Outcomes Framework (Domain 4 – Ensuring that people have a positive experience of care)
How governance of and approach to Patient Experience is organised within Oxleas
Approaches to collecting feedback (trackers, surveys, ResearchNET and OPEQ)
The Friends and Family test and our results so far in adult mental health and community health

In the Friends and Family Test, 6 questions are always asked:

Have you been provided with enough information?
Have you been involved as much as you want about your care and treatment?
Treated with dignity and respect?
Family/ carer supported?
Improvement in quality of life?
and the Friends and Family test itself

RD – How are the targets set?
MW – All scores are to be over 80% as this is what is used in other areas.
EM – Is there any way to compare this with previous and current patient experience initiatives e.g. OPEQ
MW – They are different approaches. The OPEQ is very detailed; the tracker does not pick up this level of detail. If the tracker showed a possible problem we would drill down further.
BC – How many trackers are there?
MW – 31 but we can obtain more.
CP – Are we still allowing suggestions to come through?
MW – Yes, even with the Friends and Family Test there is a free text section. It is good to get feedback but it is more important to fix issues raised – improve experience.
DM – The actions taken are published on the Trust’s website.
JB – Are the numbers shown the numbers discharged or numbers competing the questionnaire?
MW – These show the completed questionnaires from the number of discharges e.g. Avery 11 questionnaires from 29 discharges.
SB – I am still unsure about what local Patient Experience Groups are.
MW – Our local PEGs need more input from service users and carers. Governors are very welcome to attend these groups.
RD – The results look fine. Are the targets robust enough?
SF – We have looked at these results at the Executive Team meeting and have started to take action on the results.
EM – Has anyone thought to apply these questions to staff?
SF – We tend to go with the CQC National Staff Survey. Where we think there are problems we have focus groups with staff.
DM – This is a key area of interest for Governors. If any Governors would like to get involved in OPEQ please inform AR. Each service directorate has a PEG and there is an open invitation to Governors to attend.
5. / Membership Committee update
Due to the election there has only been one Membership Committee since the last Council of Governors meeting. The Committee is looking for new members. BM and JK have joined and KT has put himself forward today.
The Membership Report shows that we are broadly on target with the exception of young people. An event is being planned to promote membership for young people.
There was a brilliant day on 5thOctober at the Valley. Charlton Athletic and the Trust signed a pledge to help with mental health awareness. Jo Mant and the team are planning visits to Queen Mary’s to encourage membership. There are now 75 associate members.
CK – We will repeat the event at the Valley every year. It was very positive. It woke the fans up regarding mental health. It was in the match day programme and there was a live radio phone in triggered by this event. / Noted
6. / Election update
As reported in September a by-election was held for the remaining vacant seats. The results were as follows:

Services User/Carer: Carer vacancy – elected unopposed (Steve Seabrooke)
Staff: Older Adult Mental Health – elected unopposed (Steve Francis)

We had no nominations for Bexley Community Health Services Staff Governor and CAMHS Staff Governor. / Noted
7. / Annual Plan
SF, IO, and ID gave an Annual Plan update. The 4 key priority areas being taken forward for 2013/14 are:

Improve quality
Promote innovation
Increase productivity
Implement TSA Plans (Queen Mary’s)

Helen Smith has offered to provide a dedicated session for Governors to go through the detail of the Annual Plan before the Borough Focus Groups. The dates for the Borough Focus Groups are:
Tuesday 4 February – Bexleyheath Marriott 3-5pm
Tuesday 11 February – Woolwich Town Hall 6-8pm
Thursday 20 February – Bromley Community House 3-5pm
IO expanded on the 4 Must Do priorities as these continue to be important:

Support for families and carers
Better information
Involvement in care planning
Improved relationships

In the National Patient Survey we were in the lowest performing trusts for 5 questions relating to Health and Social workers:
Q4. Did this person listen carefully to you?
Q5. Did this person take your views into account?
Q6. Did you have trust and confidence in this person?
Q8. Were you given enough time to discuss your condition and treatment?
Around 200 patients took part in the survey and the last question asked of them was around the overall quality of care received which we scored in the top 20% of trusts. SF asked for Governors’ views on these results as we need to understand the reasons for this response. Significant progress has been made on information on medication and the care planning process but people’s experience of what they encounter has gotten worse.
BC – There is an emphasis in services about completing paperwork which can get in the way of patient interaction.
SF – Perhaps ResearchNET should produce a video of what a good consultation looks like.
SS – The use of role play in training is effective. If filling in boxes is your measured output that’s what will take priority.
RD – Can we use professional networks to find out what higher performing trusts are doing differently?
RS – It’s not ‘what’ but ‘how’ you change things. Francis talked about culture and leadership.
It was agreed to arrange a further session for Governors with Helen Smith before the Borough Focus Groups. / Noted
AR
8. / Chief Executive Update
Our top ten achievements this year have been:

Best staff survey results in London and South of England
Monitor ratings Green for Governance and 5 for Finance
Acquisition of Queen Mary’s associated services and Bexley Specialist Children’s Services
Outstanding Ofsted rating for Bluebell Unit
Nursing Times Respiratory Award of the Year
Selected as National Pioneer Site for Integration (Greenwich)
8 CQC inspection reports – 6 with no concerns
NHS Innovation Challenge Prize for Dementia shortlist
HSJ Provider of the Year shortlist (didn’t win)
HSJ Staff Engagement Award shortlist (didn’t win)

Queen Marys
Queen Mary’s is a very busy hospital site: over 40k treated in Urgent Care Centre; 170k outpatients’ attendances; 12k day cases; 2k inpatient procedures and 9k patients receiving rehabilitation or intermediate care.
The site transferred to Oxleas on the 1st October along with 215 staff. Staff induction has been very positive and there have been no serious incidents since the transfer. We have already made some improvements to lighting, the car park, 2 clinical areas, signage and waste bins.
The clinical service providers at Queen Mary’s are: Oxleas (with 24% of the site footprint), Dartford and Gravesham, Kings, Guys and St Thomas’ and Lewisham and Greenwich. Bexley CCG have committed to commissioning services from Queen Mary’s for the next 10 years. We have committed to invest £30 million in the site and develop it into a modern hospital and centre for integrated care. Significant redevelopment plans include:

Refurbished and modernised wards and day case areas
New area for main outpatients
New theatre suite
New kidney treatment unit
New cancer treatment centre (Board to approve business case)

AD – Are we signed up for providers?
SF – Providers and Commissioners have agreed. All we need to do is have the business case and draw down from NHS England.
DM – This highlights the importance of the public meetings in order to stop rumours and reassure the public.
KT – When will A Block be demolished?
SF – Lewisham and Greenwich need to transfer inpatient surgical to Queen Elizabeth and this will not happen for 12 months.
RD – Some people are still confused about what treatment the Urgent Care Centre provides. Could something simple be produced?
SF – Most UCCs are next to A&E departments but this isn’t the case at Queen Marys. It has been a struggle to describe this for people. If people are suffering serious symptoms such as chest pain, they should go directly to A&E. We have teamed with Grab a Doc to bid for the Urgent Care contract, we have passed the pre-qualifying questionnaire stage and we are being interviewed next Friday.
NE Independent Inquiry Report
The NE Draft Independent Inquiry Report has been sent to NHS England and we expect this to be published in the New Year.
Inspections in the last quarter
Ofsted inspected Bluebell House and gave a rating of ‘Outstanding’.
The CQC inspected:

Ivy Willis House – no concerns
Bracton Centre – no concerns
Hazelwood and Greenwood – no concerns
Atlas House (ALD) – no concerns
Blantyre House (female prison) – no concerns
Oxleas House - 2 minor concerns
Oaktree Lodge - 2 minor concerns and 1 moderate concern

Estelle Frost, Director of Older Persons Services and/ or Dr Adrian Treloar to be invited to the next meeting to talk about this and give an update on the Dementia Strategy. / Noted
AR
9. / Advance Question
Stephen Brooks: I noticed recently that Oxleas has accepted liability for the DM case. This case was discussed at the Governors meeting. Can the Trust explain why liability was accepted?
The NHS Litigation Authority (NHSLA) received two independent opinions which were based on clinical notes. The NHSLA felt that they would have difficulty defending the claim as this patient was not receiving continuous 1:1 observations (she was receiving observation at 15 minute intervals). Based on this, the NHSLA decided to settle out of Court and they sent a letter accepting liability on our behalf. This outcome was shared with the press. Communication between the NHSLA and the Trust should have been better.
JW – If we have an internal Inquiry Panel that arrives at a different view to that of the NHSLA or the Courts, can this risk be mitigated?
SS- The NHSLA are our insurers and work on our behalf, how can this be correct? How can we improve processes in the future?
CP – Dissonance is inevitable as an Inquiry will be concerned with learning and a claim/litigation is about finding where blame lies.
EM – I heard the Radio 4 interview. The commentator commented on the language used by the Trust. I had raised this at the time.
BC – How have staff been supported?
ID – In light of the publicity around this case, the Clinical Director and Associate Director have met with staff to reassure them. / Noted
Time and Date of the next meeting
3pm- 5pm 20thMarch2014
Applegarth Suite, Marriott Hotel
Bexleyheath
3.00 – 5.00pm

I confirm that the minutes of the Council of Governors meeting of 12thDecember 2013 are a true record

SignedDate:

Dave Mellish Chairman

H:\ROZIERA\COUNCIL OF GOVERNORS\Council Meetings\2014\a) 20th March 2014\Enc 1 Minutes of the 31st Meeting of the Council of Governors.docx