2gether NHS Foundation Trust Council of Governors Meeting 13 July 2011 1 2 GETHER NHS FOUNDATION TRUST COUNCIL OF GOVERNORS MEETING BUSINESS CONTINUITY ROOM, RIKENEL, GLOUCESTER 13 OCTOBER 2011 PRESENT: Rennie Fritchie (Chair) Joan Tranter Julie Garnham David Maynard Gill Pyatt Mark Elliott Tim Stokes Ros Taylor Richard Butt-Evans Francesca Tolond John Gillett Rod Whiteley Duncan Smith Jan Furniaux Pat Ayres Amjad Uppal IN ATTENDANCE: Nick Baker, Deputy LD Governor Mike Brereton, 2gether (Supporter for LD Governors) Matthew Page, Director, Children & Young People’s Services (Item 4) Richard Szadziewski, Non Executive Director Shaun Clee, Chief Executive Frank Powell, Non Executive Director Thomas Dunleavy, Deputy LD Governor John McIlveen, Trust Secretary Roger Brimblecombe, Senior Independent Director Felicity Longshaw, Chair, Avon & Wiltshire Partnership Ted Quinn, Locality Director North 1. WELCOMES AND APOLOGIES 1.1 Apologies for the meeting were received from, Jo Smith, Nigel Hayward, Sam Tolley, Kristoff Fraszczak, Phil Hennessey, Marion Winship, Faye Henry and Peter Braidwood. Jill Crook did not attend the meeting. 1.2 Rennie Fritchie welcomed Rod Whiteley, Pat Ayres and Amjad Uppal to their first Council of Governors meeting following their election. 2. DECLARATION OF INTERESTS 2.1 Julie Garnham advised that she had taken up a role with the Shape charity, to help with their Help for Africa project. 3. NOTES OF THE MEETING HELD ON 13 JULY 2011 3.1 The following change to the minutes was agreed: 12.2 ‘Shaun Clee informed the Governors that 2gether had helped commissioners identify the needs of residents’. Subject to this change, the minutes of the last meeting held on 13 July were agreed as a correct record. 4. MATTERS ARISING AND ACTION POINTS 4.1 There were no matters arising from the last meeting. 2gether NHS Foundation Trust Council of Governors Meeting 13 October 2011 2 5. PRESENTATION – CHILDREN & YOUNG PEOPLE’S SERVICE 5.1 The Governors received a presentation from Matthew Page on the work of the Children and Young People’s Service. A copy of the presentation is attached to these minutes. 5.2 Matthew explained how the service was changing from the previous Child and Adolescent Mental Health Service (CAMHS) to its current model. Rod Whiteley asked about the risks involved in changing the service model. Shaun Clee explained that there would be some risks associated with every service change, but 2gether has a project management team in place to make sure that the change is properly managed. 5.3 Duncan Smith asked about the process for service users moving into adult care. Matthew Page explained that this was not a straightforward process, but 2gether has an organisational policy in place to manage it. Work had also been commissioned to find out service users’ experiences on moving into adult care, and on leaving children’s services altogether, without moving into adult services. Matthew agreed to update the Council of Governors about the results of this work in six months time. 5.4 Tim Stokes asked about out of hours care within the new service model. Matthew explained that this had improved, with 24 hour consultant cover being available via the usual referral routes, for young people in crisis. ACTION: Matthew Page to report back to the Council in the summer on the results of the review of the transition from children’s services to adult services 6. CHAIR’S REPORT 6.1 Rennie Fritchie had attended two Strategic Forum meetings with Chairs and Chief Executives of the PCT, Acute Trust and County Council. These meetings enabled organisations in the health economy to work together in order to save money and solve mutual problems. 6.2 Rennie Fritchie had attended 2 meetings with local government, concerning the new Health & Wellbeing Board which would plan and commission healthcare for Gloucestershire. The meeting was also attended by Mary Wilcox and Andrew Gravells. The meeting discussed the issue of mental health representation on the Health and Wellbeing Board, but did not agree that the Board should include a mental health representative. 6.3 Rennie Fritchie had attended two events for members of staff who were leaving the Trust. These were for Sheila Molesworth who was the Medical Director’s Secretary, and Mervyn Dawe, who was the Trade Union’s Staffside representative. Both had been with 2gether for many years. Rennie had also signed 104 long service certificates in the last 2 weeks. 6.4 Rennie Fritchie had also visited Gloucester Prison, where 2gether had recently taken on responsibility for prison healthcare, to meet with the Governor, Mike Bolton. Rennie explained that the head of the Prison healthcare service, 2gether NHS Foundation Trust Council of Governors Meeting 13 October 2011 3 Marieanne Bubb-McGhee was due to give a presentation to the October Board about the work of the Prison healthcare service. Marieanne is one of only 2 Queen’s Nurses in prison healthcare, both of whom work for 2gether. 6.5 Rennie had also attended a meeting of the Role of the Governors working group, and papers from that meeting were on the agenda for the Council of Governors this evening. Rennie had also attended the Trust’s Annual General Meeting on 21 September. There had been good attendance both from Gloucestershire and Herefordshire. 6.6 Rennie Fritchie pointed out that this would be Frank Powell’s last Council of Governors meeting, as Frank’s term of office as a Non-executive Director ended on 31 December 2011. The Council of Governors thanked Frank for his hard work during his time with 2gether. 7. NON-EXECUTIVE DIRECTOR RE-APPOINTMENT 7.1 John McIlveen presented a report to Governors which confirmed that Martin Davis had been reappointed as a Non-executive Director for a period of 2 years. 7.2 John reminded Governors that earlier in the year, the Nomination and Remuneration Committee had recommended that Martin be reappointed. Because there was no Council of Governors meeting due, Governors were asked to vote by post or email. Everyone who voted had agreed that Martin Davis should be reappointed, and Rennie Fritchie had sent Martin a letter to congratulate him on his reappointment. 8. UPDATE ON GOVERNOR ELECTIONS 8.1 John McIlveen gave Governors an update on the results of recent elections for Governor positions. 8.2 An election had been held for two vacant Public Governor positions in the Cotswolds. Three candidates had put their names forward. Rod Whiteley and Pat Ayres were elected. 8.3 An election was held for the vacant Medical Staff Governor. Amjad Uppal was elected unopposed. 8.4 An election was held to replace Tim Coupland, who was stepping down as Nursing Staff Governor. Phil Hennessey was elected unopposed. Rennie Fritchie had written to Tim Coupland to thank him for his hard work as a Governor. 8.5 Governors asked whether elections for a Herefordshire Governor would take place. John McIlveen explained that there were still some vacant Governor positions. There was no separate Herefordshire constituency, but members living in Herefordshire would be free to stand for election in the Greater England constituency. John agreed to report back to the next meeting about membership in the Greater England constituency, and also to tell Governors whether there was a minimum number of members that the Trust needed to recruit before elections could be held for that constituency. 2gether NHS Foundation Trust Council of Governors Meeting 13 October 2011 4 ACTION: John McIlveen to report back on the minimum number of members needed to hold an election for Governor in the Greater England constituency 9. LEAD GOVERNOR’S ROLE DESCRIPTION 9.1 The Governors received a report from the Role of the Governor Working Group which set out a role description for the Lead Governor. 9.2 John McIlveen explained that the Lead Governor had a formal role in enabling the Council of Governors to communicate with Monitor, or with the Chief Executive, if the Council felt that communication via the Chair would be inappropriate. 9.3 The Role of the Governor Working Group had therefore approved a role description for the Lead Governor which set out the statutory and other responsibilities of the Lead Governor role, and also set out some of the abilities which a good Lead Governor would need to have. The report which Julie Garnham had written for the July Council of Governors meeting had been very helpful in putting this role description together. 9.4 Ros Taylor noted that the role description would be very useful for future Lead Governors, as they would now have a clearer understanding of what the role involved. 9.5 Frank Powell asked whether the Lead Governor was also the Chair of the Nomination & Remuneration Committee. Rennie Fritchie explained that although Julie Garnham had held both positions last year, they were not linked. Julie would continue to chair the Nomination & Remuneration Committee, with Ros Taylor as Lead Governor 9.5 The Council of Governors approved the Lead Governor role description. 10. GOVERNOR ATTENDANCE AT BOARD COMMITTEES 10.1 John McIlveen presented the Council with a report from the Role of the Governor Working Group concerning Governor attendance at key Board committees. 10.2 The Working Group had been looking at ways to improve the way that Governors could hold the Board to account. A number of systems had been tried in recent years, such as having all business going to the Council of Governors. This had proved unwieldy, and the current system of Governor Committees had been set up. However, this system did not provide Governors with the opportunity to see Board members in action, and also incurred extra administration costs. 10.3 The Working Group had therefore recommended that a trial be set up which would enable Governors to attend key Board Committees. At the end of the trial period, there would be a review and a report to the Council of Governors. If the trial was felt to be successful, the Council of Governors could agree to retain the new system and formally disband some Governor Committees. 2gether NHS Foundation Trust Council of Governors Meeting 13 October 2011 5 10.4 The Working Group proposed that the trial should cover three meetings each of the Governance and Delivery Committees, and that two Governors should be in attendance at each Committee. Ideally, the same two Governors should attend all three meetings of the Committee. A maximum of four Governors would therefore be needed for this trial. 10.5 Mark Elliott said that this was a good option, and that having a review of the trial at a Council of Governors meeting would be useful. Francesca Tolond supported the trial, as it demonstrated open governance. Duncan Smith also supported the trial, but expressed some concern that Governors may find it difficult to attend Board Committees as these were held during office hours. David Maynard agreed with this point, and suggested that an alternative might be to have the Committee Chairs report to Governor Committees. 10.6 Shaun Clee said that the timing of meetings was a difficult issue. It would be difficult to change the timings of Board Committees, but many employers do give employees time off to attend such meetings. 10.7 Shaun Clee said that any Governor wishing to take part in the trial would need to work with John McIlveen to understand the role and purpose of the Board Committee, and what Governors would need to look for when attending those Committees. Governors would also need to think about their own skills and interests and whether these would equip Governors to attend a Board Committee. 10.8 Governors would be asked to nominate themselves if they wished to take part in the trial. John McIlveen agreed to circulate to all Governors some information about the Committees in order to help Governors make a decision about taking part. 10.9 The Council of Governors agreed to a trial of the proposal, with a formal review at a future Council of Governors meeting. ACTION: John McIlveen to circulate information about Committee timings and purpose, and skills/interests required by Governors in attendance at these Committees. ACTION: Governors to nominate themselves to John McIlveen if they wish to take part in the trial. 11. CHIEF EXECUTIVE’S REPORT 11.1 Shaun Clee gave the Governors a useful verbal update on the national and local context of the NHS. 11.2 This was a busy and confusing time for the public sector. The Health Bill was going through the House of Lords, and although some amendments had been made, the infrastructure continues to be implemented, with appointments being made to Public Health England. The final picture was still unclear, so it was important that any actions we take are sensible ones. However, the biggest challenge for the NHS would be the £25 billion savings requirement. 2gether NHS Foundation Trust Council of Governors Meeting 13 October 2011 6 11.3 Public sector unions were currently balloting for strike action in defence of pensions. Shaun pointed out that at 2gether, both sides were in agreement about the right of employees to strike, and the importance of maintaining patient safety and service continuity. The Board has put in place a group chaired by the Chief Executive to put contingency measures in place in the event of a vote for strike action. This will ensure that patient safety and service continuity are not compromised. 11.4 The Mental Health Strategy had been published in February this year. The Mental Health Network will be writing to the Minister to ask what has been achieved so far. 11.5 There had been an unannounced inspection yesterday at Westridge by the Care Quality Commission. This had come about following the revelations about Winterbourne View, after which the CQC had announced that inspections of all Learning Disability facilities would take place. 2gether had done its own mock inspection in preparation for the visit. The CQC report would be sent to the Trust within 28 days. Westridge had also been the subject of an unannounced visit by the Mental Health Act Commissioner. The results of this visit had been very good. 11.6 The Trust had submitted a tender to acquire Oxford learning Disability Trust. The tender document and a presentation had been submitted, and we were waiting to hear whether we have been selected to go forward as one of the final three bidders. While the tender process was going on, the Board was undertaking its own due diligence to decide whether we would want to proceed with the acquisition if we were successful in the tender process. If we were successful, Monitor would deem this a ‘significant transaction’ and a Board-to-Board with Monitor would be required. Following this, Monitor would express a view as to whether it would be appropriate to proceed, although the final decision would be for 2gether’s Board. 12. GOVERNANCE AND PERFORMANCE COMMITTEE REPORT 12.1 Richard Butt-Evans, Chair of the Governance and Performance Committee presented the Council with the Committee summary from the meeting held on 17th August 2011. 12.2 The Committee received three key reports at the meeting; Sickness Absence, Serious Incidents, and the Performance Dashboard. 12.3 The sickness absence report showed that while the Trust was currently missing its target of 4%, the current level of 4.8% was better than the average performance of other mental health trusts. 21gether was the only mental health trust in the South West region to have achieved sickness absence levels below 5% between April 2008 and March 2011. 12.4 The Committee received a report that provided assurance on the way serious incidents were managed. There was a clear process for reporting, investigating and learning from serious incidents. Serious incidents were reported monthly to the Board. The numbers of serious incidents reported had risen of late due to new business being taken on in Herefordshire and the Prison. 2gether NHS Foundation Trust Council of Governors Meeting 13 October 2011 7 12.5 The next meeting of the Governance and Performance Committee would take place on 16th November 2011. 13. QUALITY REVIEW COMMITTEE REPORT 13.1 Ros Taylor presented the summary report from the Quality Review Committee held on 6th September 2011. 13.2 The Committee had received the results of the National Patient Survey for community patients in Herefordshire and Gloucestershire. For both areas, results were at or above the national average, although Gloucestershire’s results had declined slightly since last year. The Committee noted that action plans were in place for both areas, and that next year a single survey would cover both counties. 13.3 The Committee received the Quarter 1 Service Experience report. Complaints had increased during the period, but this could be attributed to new business in Herefordshire and the Prison. The increase in complaints was consistent with the larger population which the Trust now serves. The Committee noted that the Trust now offers complainants a face to face meeting to discuss their complaint. While this has meant that some complaints aren’t dealt with as quickly as before, satisfaction levels with the way complaints are dealt with have gone up. 13.4 The Committee received a report updating them on progress with the Quality Account. Good progress had been made in the five major Quality Account categories. We had not met our target for accurately recording ethnic origin, and violent assaults on staff had increased. Work was underway to understand and address both these issues. 13.5 The Committee received an update on the patient safety works at Wotton Lawn. These would address some safety concerns raised by the clinical team, and would result in a reconfiguration of bed numbers across the hospital, to bring those numbers into line with best practice. Work would be done on a rolling basis, beginning with the reception area, where work had already commenced. 13.6 The Committee also received a presentation on AIMS accreditation for inpatient wards. This accreditation is given to individual wards, following an application process led by the ward staff. The accreditation covers several quality standards, and several wards already hold the accreditation. 13.7 Paul Winterbottom, Medical Director had also attended the meeting to give the Committee a presentation on the work being carried out within the Trust to develop services for people with a personality disorder. 13.8 The next Quality Review Committee would take place on Tuesday 6th December. 14. MEMBERSHIP COMMITTEE UPDATE 14.1 Ros Taylor presented the summary report from the Membership Committee held on 22th September 2011, and gave the Council an update on the latest membership statistics. . 2gether NHS Foundation Trust Council of Governors Meeting 13 October 2011 8 14.2 The Committee had discussed a draft Membership Strategy, which covered a three year period and which aimed to recruit and retain members, communicate effectively with members, and encourage meaningful membership. 14.3 The Committee agreed that given the current resources available to the Trust, it would not be possible to achieve everything in the draft strategy, and some prioritisation would therefore be required. 14.4 The Committee asked that further work be done on the strategy, and agreed to consider an amended version at the next meeting of the Committee. 14.5 The next meeting of the Membership Committee is 15th December 2011. 15. NOMINATION AND REMUNERATION COMMITTEE UPDATE 15.1 Julie Garnham gave the Council an update on the Nomination and Remuneration Committee meeting of 22 September 2011. 15.2 The Committee had met to discuss the process for appointing a replacement for Frank Powell. The Committee had agreed to use an executive search agency, and had agreed the role and person specification for the position. 15.3 The recruitment process would comprise discussion groups involving Board members and members of the Committee, with a separate discussion group involving service users. A formal interview panel would then be convened, comprising the Trust Chair, members of the Committee, and a Non-Executive Director. 15.4 The Committee intended to make a recommendation to the Council of Governors in January. 16. GOVERNOR UPDATE 16.1 John Gillett had taken part in a protest against the proposed move to a Social Enterprise Trust for Gloucestershire community health services. 16.2 Thomas Dunleavy had taken on a new role as a Quality Checker for Gloucestershire Voices. 16.3 Nick Baker informed the Governors that he was on the Board of Gloucestershire Voices. 16.4 Rod Whiteley had attended a meeting of the South West Governors Exchange Network in Taunton. This had been a useful opportunity to meet with other Governors and exchange information. Together with Pat Ayres, Rod had also attended a very good conference organised by 2gether and SOBS (Survivors of Bereavement by Suicide). 2gether NHS Foundation Trust Council of Governors Meeting 13 October 2011 9 17. GOVERNOR QUESTIONS 17.1 David Maynard had submitted a question asking about the reasons for the recent shortage of inpatient beds in Gloucestershire, and the actions the Board was taking to address this. 17.2 Shaun Clee replied that the problem had applied to the whole of the South West region, and not just Gloucestershire, for the past ten days. Historically there has been a rise in admissions each year around late September/early October. The reasons were unclear, but all South West inpatient units, including those in the private sector, had been full. 17.3 The Trust had agreed with Commissioners to put additional beds into our inpatient units, to provide 69 beds instead of the usual 66. Clinicians and colleagues in Crisis Home Treatment Teams had worked closely with the new Countywide Clinical Director to treat patients in the community where possible, and to manage inpatient admissions. 17.4 Governors expressed their thanks to the staff involved in managing this challenging situation. 18. FTGA UPDATE 18.1 Julie Garnham informed Governors that she had attended a meeting of the FTGA in Taunton. This had been a good opportunity to meet and exchange ideas with other Governors. 19. ANY OTHER BUSINESS 19.1 There was no other business. 20. DATE OF NEXT MEETING 20.1 The next meeting would take place on Thursday 19th January 2012 at 5.00pm in the Business Continuity Room, Rikenel 2gether NHS Foundation Trust Council of Governors Meeting 13 July 2011 10 Council of Governors 13 October 2011 Action Points Item Action Lead Progress Ref 5.4 Report back to the Council in the summer on the Matthew Page Scheduled for results of the review of the transition from children’s July 2012 meeting services to adult services 8.5 Report back on the minimum number of members John McIlveen A minimum of 50 needed to hold an election for Governor in the members are required. Greater England constituency Membership in this constituency exceeds this number 10.9 Circulate information about Committee timings and John McIlveen Complete purpose, and skills/interests required by Governors interested in attendance at these Committees. 10.9 Governors to nominate themselves to John Governors Complete McIlveen if they wish to take part in the trial of attendance at Board Committees.
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