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Minutes of the Meeting of the Board of Directors
held on Friday, 3 February 2012
in the Fred and Ann Green Board Room, Montagu Hospital
Present: Mr C Scholey Chairman
Mrs N Atkin Non-Executive Director
Mr J Barnes Non-Executive Director
Dr R Bolton Medical Director
Mrs H Bond Director of Nursing & Quality
Mrs G Broderick Non-Executive Director
Mr R Calvert Chief Executive
Mr D Crowe Non-Executive Director
Mr J Parker Non-Executive Director
Mr D Pratt Director of Finance, Information & Procurement
In attendance: Mrs H Brand Communications Manager
Ms M Dixon Head of Corporate Affairs
Mr I Greenwood Director of Strategic and Service Development
Mrs S Michael Trust Minute Secretary
Mrs L Rothwell Director of Performance
Mrs H Selvidge Deputy Director of Human Resources
Governor Observers: Mr J Humphrey Patient Governor
Mr D Shaw Public Governor – Doncaster
Mr H Taylor Public Governor – Doncaster
Mr G Webb Public Governor – Doncaster
ACTION
Apologies for Absence
C/12/02/1 Mr J Brayford
Register of Directors’ Interests
C/12/02/2 No changes reported.
Minutes of the Meeting held on 3 January 2012
C/12/02/3 The minutes of the meeting held on 3 January 2012 were APPROVED as a true
and accurate record, and were accordingly signed by the Chairman, with the
following amendments:
C/12/02/4 (C/11/12/73) Mr Barnes noted for the record that the minutes bound in at the
December 2011 meeting were updated by the paragraph on charitable funds.
C/12/02/5 (C/12/01/06) Where it reads “Yorkshire and Bassetlaw”, this should read “South
Yorkshire and Bassetlaw sub-regional business case.
C/12/02/6 (C/12/01/59) This paragraph to be amended to read “Mr Barnes noted the good
work carried out to remove systemic overtime, and asked what action was being
taken to reduce the number of consultant PAs. He had noted that some
consultants were being paid on a block basis for 26 PAs in return for working a
maximum of 20 PAs. Mr Calvert replied that a working group had been set up to
investigate where PAs were allocated across the Trust, although he advised that
those with a higher number of PAs were few and far between and it was not
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possible for every consultant to be restricted to 10 PAs.”
C/12/02/7 (C/12/01/68 i) This paragraph should read “It was proposed to use the same
strategy in 2012/13 as was used in 2011/12. Mr Calvert would be leading a
refreshment of the strategy during the year.”
Matters Arising from the minutes of the meeting held on 3 January 2012
C/12/02/8 None
Chairman’s Correspondence
C/12/02/9 i) Several members of the public attended the Board of Governors meeting
held on 31 January 2012 and the meeting went well. Mr Crowe was re-
elected as a Non-Executive Director for a further term of office from 1 April
2012 to 31 March 2015.
C/12/02/10 ii) The next Board of Governors timeout would be held on 9 March 2012.
C/12/02/11 iii) Recruitment of Executive Directors had progressed and interviews would be
held on 28 February and 1 March 2012.
C/12/02/12 iv) A Monitor visit would take place on 30 April 2012.
C/12/02/13 v) Mr Scholey had attended a training event on Ward C2 where he noted the
increasing willingness to improve practice and performance.
C/12/02/14 vi) Mr Scholey had attended a recent meeting of Ward Sisters and was pleased
to see that they had received a presentation on mortality by Mr Cuschieri.
The Chairman’s Report was NOTED.
Chief Executive’s Report
Mr Calvert reported on the following:
C/12/02/15 i) College of Emergency Medicine (CEM) Visit – A review visit had been held
on 25 January 2012. Terms of Reference had previously been agreed and
the CEM had been provided in advance with relevant material concerning
patient numbers, performance, existing and previous service models and
staffing profile. The PCT’s Chief Operating Officer and a number of GPs had
attended the review.
C/12/02/16 A formal report was awaited and a follow up visit would be undertaken at
Easter. The Trust had already carried out a number of actions which the
CEM would have recommended and they were pleased to see how well the
rest of the Trust had responded. They advised that consultants should be
more frontline and recommended an increase of 6 consultants, bringing the
total to 12, with increased support for registrars.
C/12/02/17 The CEM had recommended that the Trust should concentrate on achieving
improvements at DRI in the first instance, and agreed with the proposal that
one pool of consultants should be on-call for both Bassetlaw and DRI. It was
noted that A&E Consultants had an overwhelming workload and one of the
top priorities while building the workforce and implementing changes, would
be to provide them with more support.
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C/12/02/18 Increasing support for Specialist Registrars was a Trust-wide issue. Mr
Scholey advised that he was proposing to include training as a specific issue
in the Chief Executive’s objectives for 2012/13. It was necessary to improve
training facilities to attract trainees to the Trust.
C/12/02/19 In response to a query from Mr Parker, Mr Calvert replied that the response
from consultants regarding the review had been positive. A number of
events, to be attended by members of the Executive Team, Clinical Directors
and General Managers, had been scheduled to discuss business planning
objectives which would include the requirement to increase the consultant
workforce. Actions would also be built in to ensure that registrars received
more support. The Board of Directors would be adopting a refreshed
strategy in the Autumn and a Management Board timeout was to be
arranged to discuss this and other topics of importance.
C/12/02/20 Mr Crowe asked if CEM had confirmed that the steps the Trust had taken
were the right ones or were there other things which the Trust could be
doing. Mr Calvert replied that they had said that a lot of good work had
already been undertaken. It was noted that following Mrs Rothwell’s input
into the A&E service in November, significant improvements had been made,
although it was felt that primary care should be doing more. It was unlikely
that the PCTs would be able to reduce attendance at A&E and therefore the
Trust’s systems should be geared up accordingly. Mrs Bond added that the
new 111 telephone service which was in place in other parts of the country
should deflect some people from A&E.
C/12/02/21 Mrs Broderick requested that the induction programme be reviewed as there
appeared to be no sense of welcome at the Trust. Mr Scholey replied that
this had started to happen and he and Mr Calvert had arranged some
informal lunch sessions to meet with consultants who had joined the Trust BB
28.05.12
from January 2010 onwards. It was agreed to discuss the induction process
in more detail at a Board Briefing session.
C/12/02/22 ii) Breast implants – No women had been given the PIP implants directly by this
Trust, although patients did receive the implants at Park Hill Hospital, which
is operated by Ramsay Health Care who lease the site from the Trust.
Ramsay would be offering all patients affected, with appropriate support and
assistance, including a free consultation and screening scan with a specialist
breast surgeon. Following discussion with a surgeon, if women wished to
have their PIP implants removed and replaced then Ramsay would
undertake the surgery at no cost to the patient or the taxpayer.
C/12/02/23 iii) Academic Health Science Networks – A recent paper, launched by the
Department of Health entitled “Innovation, Health and Wealth – accelerating
adoption and diffusion in the NHS” would attempt to drive reconfiguration as
part of the agreement to shift care and move away from small provider units.
This was believed to be a significant threat to the Trust. At a recent meeting
on 9 January 2012, it was proposed to establish a Sheffield/South Yorkshire
AHSN which would encompass all acute and mental health trusts in South
Yorkshire, the Universities and a GP provider representative. Sheffield
Teaching Hospitals would be developing a paper to be shared with
colleagues in February, with a view to deciding whether a collective bid could
be developed.
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The Chief Executive’s Report was NOTED.
Quality Report
Mrs Bond reported on the following:
C/12/02/24 i) The following were within trajectory:
HCAI: MRSA and C.Difficile – from an unconfirmed report it was noted
that there had been 6 cases of C.Difficile in January 2012 and no cases
of MRSA
Patient Falls
Complaints regarding attitude of staff
VTE Risk Assessments
C/12/02/25 ii) There was concern regarding the following:
Healthcare Acquired Pressure Ulcers within a hospital setting – The
number of ungradable pressure ulcers acquired whilst an inpatient
continued to rise. One Grade 3 pressure ulcer and two Grade 4
pressure ulcers were reported which had resulted in the loss of part of
the CQUIN payment. Root cause analysis was being undertaken and
learning would be identified from this.
Cardiac Arrests – 25 cardiac arrests occurred during December 2011
and a brief analysis was provided. Case note reviews were undertaken
on 12 patients and no concerns were raised regarding care.
C/12/02/26 In response to a query from Mr Parker regarding the delay in reporting, Mrs
Bond explained that it was a process issue relating to Critical Care not
alerting the risk office of the occurrence of a Category 4 pressure ulcer in a
timely manner, although it was noted that this was completion of a weekly
return over the Christmas/New Year period.
C/12/02/27 Mrs Broderick enquired how much impact the reduction in the specialist
Tissue Viability team had had. Mrs Bond replied that there was currently one
specialist nurse in post. The two “task force” roles had terminated, therefore
only serious and complex issues could be addressed and direct support to
CSUs could no longer be undertaken. A business case to increase capacity
in the Tissue Viability service was progressing through BSG. Although many
specialties agreed that the service was necessary, some CSUs were
overspent and were unable to support the proposal; therefore this
requirement would go through the 2012/13 budget setting process.
C/12/02/28 Mr Pratt was proposing, within the budget setting process, to identify a
centrally held sum for financing smaller projects such as this.
C/12/02/29 In response to a query from Mr Crowe, Mrs Bond agreed that the Trust had
been too optimistic with regard to the trajectory, as it had hoped to achieve a
significant improvement. The increase in pressure ulcers in November and
December was cyclical and it was noted that staff were much more aware
and were identifying more occurrences. Criteria definitions were being
investigated and it was noted that commissioners recognised the amount of
work being undertaken by the Trust.
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C/12/02/30 Mr Barnes requested information regarding the root cause analyses in next HB
month’s Quality report.
C/12/02/31 iii) Complaints – There had been shared learning with regard to the good results
shown by Women’s and Maternity Services and Orthopaedics. Mrs Bond
advised that on page 12 of the report, line 4 of the text relating to clinical
care complaints should read that Nursing and Medical staff were the ‘main
groups’ who deliver clinical care, rather than the only group as stated.
C/12/02/32 Mr Calvert reported that the process regarding complaints had changed and
CSUs were taking direct responsibility for writing and co-ordinating
responses before sending a draft to the central office which was an incentive
to try to avoid complaints. Mr Calvert continued to sign every complaint and
there had been a slight improvement in numbers. Increased focus would be
put into areas which were outliers.
C/12/02/33 With regard to the accountability meetings, Mrs Atkin reported that a letter of
apology had been received from the General Manager of A&E who had not
yet attended an accountability meeting. Some CSU action plans had been
received, although it was thought they contained too much dialogue and not
enough target setting to ensure that outcomes could be seen.
C/12/02/34 iv) VTE – The final position recorded for December 2011 was 96.5% against the
national trajectory of 90%. It was noted that the local CQUIN target was
100% which the Trust had missed by one set of records in quarter and would
therefore lose part of the CQUIN income.
C/12/02/35 v) Out-Patient Survey – A number of downward trends were noted.
C/12/02/36 vi) In-Patient Survey - Mr Parker commented that the Trust had reported that it
had not breached the Eliminating Mixed Sex Accommodation guidance, yet
15% of patients had reported that they had shared patient accommodation
with people of the opposite sex. Mr Barnes queried why there was a sudden
increase in numbers in December. Mrs Bond explained that this was likely to
be patient perception as there had been no areas which had experienced
unjustified mixing of sexes. Mrs Atkin suggested that there might be
communication issues with some patients. Mrs Bond would investigate HB
whether patients were being correctly advised of the guidelines.
C/12/02/37 vii) Picker Outpatient Survey 2011 – Results of the findings from the National
Outpatient Survey 2011, presented, which compared data against other
Trusts and also the Trust’s performance in 2009. It was anticipated that the
Picker data would be fed into the CQC report, which was to be published on
14 February 2012.
C/12/02/38 It was recognised that there were a number of areas where more work
should be carried out. Mrs Bond agreed to circulate a detailed report by
specialty where available. Two Matrons would be attending a national HB
workshop to learn from other organisations.
C/12/02/39 With regard to sending letters to patients (copies of letters sent between
hospital doctors and GPs), it was believed that the Trust was disadvantaged
by the question asked, as an ‘opt in’ process was operated by the Trust.
Page 5
C/12/02/40 vi) Mortality – Dr Bolton explained the new process which had been developed
with regard to analysis of weekend deaths. Data on each death was
circulated to the Review of Mortality Group, Mr Cuschieri, individual
consultants and Clinical Directors for analysis. Information was provided
regularly to the Patient Safety Review Group and the Clinical Governance
Standards Committee to see what lessons could be learned.
C/12/02/41 Dr Bolton advised Mr Scholey that availability of consultants at weekends
had not been identified as a factor impacting on deaths at weekends. Dr
Bolton added that junior doctor training, perception and attitude was
changing, EWTD rotas were causing difficulties with continuity of care and
significant work was being carried out to promote better team working
between consultants and trainees. It was noted that the working
environment at the Trust was highly intensive, with some consultants feeling
pressured and unable to take enough time with their juniors.
C/12/02/42 Following publication of the Dr Foster data, two audits had been carried out
and results from these showed that there were no different problems at
weekends than during the week. Work to try to improve practices where
patients were deteriorating continued.
C/12/02/43 Mrs Rothwell advised that the issue about senior decision maker availability
at weekends had been recognised and considerable work had been carried
out. Dr Noble, Clinical Director for General and Acute Medicine had moved
a number of sessions into weekends and had ensured that senior doctors
were available 7 days a week.
C/12/02/44 vii) Fractured Neck of Femur – In response to a query from Mrs Broderick, Dr
Bolton advised that the best practice tariff figures were not nationally
published, although information was available relating to the Yorkshire and
Humber region. It was noted that significant work had been put in at both
Bassetlaw Hospital, which had shown a 10% improvement, and DRI and
both sites were working hard to improve performance.
C/12/02/45 viii) CQUINS – Quarter 2 update – With regard to encouraging staff to stop
smoking, it was noted that the Staff Health and Wellbeing Group were
addressing this issue at their quarterly meetings. With regard to the CQUINs
target of 33% of smokers receiving advice which was based on a survey of
smoking patients, Mr Barnes asked if this target should be revised to 100%. HB
Mrs Bond to contact Mr Barnes following the meeting with clarification.
The Quality Report was APPROVED.
Financial Performance Report as at 31 December 2011 (Month 9)
Mr Pratt reported on the following:
Corporate Trading Position
C/12/02/46 The Trust recorded a trading surplus of £1.731m, which was in-line with the
original and re-phased plans for the year to date.
C/12/02/47 The reported £317k surplus in month was artificially inflated by the impact of a
nationally required change in accounting treatment showing an actual gain in the
December position of £231k, giving a surplus in-month of £86k. Monitor would
Page 6
make adjustment for any technical gains/losses when calculating the Trust’s risk
assessment, therefore a surplus of £3.4m would be required to demonstrate
delivery of the original plan.
Income
C/12/02/48 Income receivable to date of £247.715m was £5.660m above plan, although only
£91k related to the afore-mentioned technical change. On a like-for-like basis,
income performance was down by £563k on the monthly average for the year,
against an expectation of £300k.
Expenditure
C/12/02/49 Pay costs remained broadly in line with previous months, although there was a
rise from £18.141m to £18.212m in December. There was an increase in agency
spend of £62k relating principally to A&E and Paediatrics.
C/12/02/50 Overtime (£79k) and additional sessions (£96k) were at new lows for the year.
Savings
C/12/02/51 Savings of £1.674m achieved was a small increase on previous months and this
level was required for the final 3 months of the year. However reduced
achievement of £1.455m was reported due to the loss of CQUIN income relating
to failure against the pressure ulcer target.
C/12/02/52 A number of schemes would be online in January, significant savings were
anticipated from the implementation of social care redesign.
C/12/02/53 The first two weeks of trading by the outsourced Co-op outpatient pharmacy had
been successful, resulting in higher gain share returns to the Trust than outlined
in the business case.
C/12/02/54 Mr Pratt advised that he believed that the Trust was in a positive position to
achieve savings of £1.7m over the next 3 months, providing that strong cost
control was maintained throughout the Trust.
C/12/02/55 The final income position with Doncaster PCT would be signed off in the next few
weeks. The PCT would be making a £2m payment with regard to outstanding
over-performance work. The Trust would be receiving £800k from Doncaster
PCT and £200k from Bassetlaw PCT with regard to reducing waiting times across
a range of surgical specialties from now to the end of the year.
C/12/02/56 Mr Crowe asked if the e-rostering scheme had been rolled out to all wards and
what general savings were expected. Mr Pratt responded that a review had taken
place with regard to base establishments and a paper had been presented to
Management Board in November 2011.
C/12/02/57 Mr Crowe had been informed that there were significant grievances regarding the
impact which e-rostering had had on staff and work patterns. Mrs Selvidge was
unaware of this and reported that the e-rostering project had a great deal of
support from the workforce for implementing limits and rules regarding core
working hours and standardisation of working patterns. From feedback she had
received, there were no formal grievances from either staff or staff side
organisations.
Page 7
The Financial Performance Report was APPROVED.
Service Performance Report as at 31 December 2011 (Month 9)
Mrs Rothwell reported on the following:
C/12/02/58 Monitor/Headline Targets – The Trust had achieved the targets with regard to
C.Difficile, MRSA and Cancer targets.
C/12/02/59 IND109a: Referral to Treatment Waits (Median Wait Measures) – Admitted 18
week target - all Trust targets had been achieved, although there were issues
within GI and Ophthalmology, and also a capacity and demand issue in General
Surgery.
C/12/02/60 IND112b(ii): A&E total time in A&E 95th Percentile - The high incidence of
Norovirus had impacted on performance, due to a large proportion of beds at DRI
being unavailable.
C/12/02/61 IND115 and IND115a: Emergency Re-admissions within 30 days (Prior Elective
and Prior Emergency) - A detailed project was well underway and an
improvement was starting to be shown. A comprehensive report on re- LR
admissions by specialty would be developed by the end of the financial year.
Integrated Performance Measures for National Oversight
C/12/02/62 IND118: Cancelled Operations – An area of concern as significant cancellations
had occurred due to bed constraints caused by the Norovirus outbreak.
Supporting Measures – Quality (Safety, Effectiveness and Patient Experience)
C/12/02/63 IND111: Implementation of Stroke Strategy – TIA Patients Assessed and Treated
within 24 hours – This target was of significant concern and although a number of
additional sessions had been carried out, it was likely that the PCT would issue
the Trust with a Performance Notice. Capacity had been underestimated and the
Trust was now carrying out 3 sessions per week instead of the one session
previously carried out. The issue was being dealt with by an Executive Director
and the position would be improved upon.
C/12/02/64 IND153: Infant Health & Inequalities Breastfeeding Initiation – An improvement
was starting to be seen.
Supporting Measures - Resources
C/12/02/65 IND141: GP Referrals – The cumulative year to date position had increased
slightly.
C/12/02/66 CSU Dashboard – The CSU dashboard for General Surgery was noted.
C/12/02/67 CQC Quality Risk Profile – Mrs Rothwell reported that information regarding the
high red risk relating to Outcome 11 had now been submitted to CQC.
C/12/02/68 Mr Scholey and Mr Calvert thanked Mrs Rothwell for her work in A&E to improve
performance in 8 of the 9 indicators.
C/12/02/69 Mr Calvert noted that he remained concerned about 4 areas of performance:
Total time in A&E – Throughout the year the Trust had not achieved the
Page 8
4-hour wait for admitted patients – he felt that CSUs had significant
work to do to support A&E and achieve this target.
Emergency Re-admissions – The Trust was an outlier and increased
pace would be vital to enable to achieve the associated income. Mrs
Rothwell responded that in comparison with data from Dr Foster the
Trust was performing significantly better than reported.
Stroke Strategy – This was a high profile indicator and Mr Calvert felt
that there had been poor capacity planning which should be addressed.
Day Case Procedure rate – Mr Calvert felt that 70% was too low and
should not have been impacted upon by the outbreaks of norovirus.
C/12/02/70 Mr Calvert felt that poor performance was a symptom of poorly organised
services and there was a significant issue with the planned and operational
delivery of those services. Mrs Rothwell was asked to prioritise these areas for
next year and Mr Greenwood was asked to ensure that there was adequate
emphasis on the need to capacity plan and to revise the associated underpinning
of systems and processes.
The Service Performance Report was APPROVED.
Capital Performance Monitoring Report as at 31 December 2011
Mr Pratt reported on the following:
C/12/02/71 i) Capital expenditure for the first three quarters of the 2011/12 financial year
was £7.966m.
C/12/02/72 ii) Total funds available as at 31 December 2011 were £17,897, predicated on
£1m receipts of which £672,000 had been reserved. £300k was held in
reserve to offset potential undershoot.
C/12/02/73 iii) The main areas of undershoot were: IT/computers, pharmacy automation,
Bassetlaw Breast care, the education centre and the day surgery facility.
The first three areas were projected to return to the budgeted level of
expenditure for the year in the last quarter. There would be a smaller
undershoot on the education centre at the end of March than in December.
C/12/02/74 iv) The schemes which were behind profile were partially offset by the Estates
Strategy work which was ahead due to the expedition of the first phase of the
Bassetlaw A&E development and the refurbishment work on Ward 18 at DRI.
C/12/02/75 The forecast year-end outturn predicted a £1.285m undershoot, of which three
schemes should return to the budgeted level of expenditure in the last quarter
and the other two being:
An undershoot of £200k on the education centre as reported at the end
of the second quarter;
An undershoot was yet to be identified with regard to the development
of the Theatre/Day Surgery scheme. The Trust was working through
and finalising a revised scheme to ensure that single sex compliance
was addressed and achieved.
C/12/02/76 Mr Pratt advised that the principle of developing the day surgery facility was
acceptable as the incentive to carry out day cases would increase. The scheme
would be reviewed and carried forward to next year. The undershoot was well
Page 9
within the Monitor tolerance levels.
C/12/02/77 Mr Barnes asked if the Trust was spending enough money on replacement of
medical equipment. Dr Bolton replied that the Medical Equipment Group held a
register of all medical equipment in the Trust which was monitored and
equipment was replaced as necessary. It was estimated that the Trust would
need to spend around £25m to bring all medical equipment up to date. There
was no automatic replacement plan for when equipment reached a certain age
and maintenance was carried out via service agreements or internally by Trust
maintenance staff.
C/12/02/78 In response to a query from Mr Parker, Dr Bolton replied that he was not
concerned about the age of equipment per se, as long as it was fit for purpose.
The Medical Equipment Group was regularly briefed with regard to equipment
which required replacement.
C/12/02/79 In response to a query from Mr Crowe, Dr Bolton suggested that an additional
£5m would make a significant difference, and £10m would revolutionise the BB
equipment stock. It was agreed to discuss this further at a Board Briefing. Mrs 23.04.12
Bond advised that the Capital Equipment Budget related to items over £5k and
there was a large amount of equipment which cost less than this which required
replacing. Mr Calvert suggested that the business planning process would take a
strategic view of capital requirements and would feed into the business plans
accordingly.
The Capital Quarterly Report as at 31 December 2011 was APPROVED.
Human Resources Quarterly Report as at 31 December 2011
Mrs Selvidge reported on the following:
C/12/02/80 i) Sickness absence for quarter 3 of 2011/12 was 3.89%, which was slightly
above the 3.5% target. The cumulative rate for the year was currently
3.74%. Areas which had exceeded the target continued to be reviewed.
47 staff had been recorded as being off sick for 90 days or more, although of
these 10 had since resigned, been dismissed on the grounds of ill health, or
had returned to work in the first 3 weeks of January 2012.
From benchmarking data accessed via the Strategic Health Authority,
overall, the Trust compared favourably to other Foundation Trusts.
C/12/02/81 ii) 141 staff left post in Quarter 3, with the majority of staff leaving as a result of
retirement or cessation of fixed term contracts. In addition, 11 staff had been
dismissed from employment by reason of either capability or conduct. In
total 3 staff were made redundant during the quarter.
C/12/02/82 iii) The table of individual and collective grievances submitted was noted, as
was the table relating to appeals.
C/12/02/83 In response to a query from Mr Crowe, Mrs Selvidge anticipated that the sickness
rate at 31 March 2012 would be approximately 3.8%.
C/12/02/84 The number of employee tribunal claims had increased over the last two years,
although not all had progressed to a full hearing. This was thought to be a
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significant risk to the Trust in the future.
The Human Resources Quarterly Report as at 31 December 2011 was
APPROVED.
Transformation Report – Changes to Social Service provision
C/12/02/85 Mrs Rothwell reported that relationships with social care provision were much
improved and following some process changes, there had been significant
improvement with regard to length of stay.
C/12/02/86 Patients now followed two pathways and since implementation of these
pathways, there had been a considerable increase in the number of patients who
had been discharged home, saving an average of 150 bed days in just over one
month, which equated to a reduction of 40-50 beds over a six-month period.
C/12/02/87 It was agreed to cascade and publish this information as a ‘good news’ story. LR
The Transformation Report – Changes to Social Service Provision was
APPROVED.
Budget Setting 2012/2013
C/12/02/88 Mr Pratt explained the external context and National Tariff 2012/13 requirements
and outlined the internal priorities and framework, and the proposed approach to
contract negotiations and arrangements with commissioners.
C/12/02/89 The aim was to set budgets which promoted ownership, accountability and
responsibility for delivery.
C/12/02/90 Development of a robust savings programme continued and CSUs had been
asked to produce 6% efficiency plans. Existing and new cost-cutting and
transformation schemes would also continue to be implemented.
C/12/02/91 The risks to delivering the budget for 2012/13 were noted.
C/12/02/92 Mr Greenwood welcomed the idea of a £1.2m general investment reserve to
support future ‘invest to save’ pump priming and in year pressures, subject to
business cases.
C/12/02/93 Mr Crowe requested that implementation of savings schemes should start at the
beginning of the financial year. Mrs Broderick was concerned about future
changes in the Trust’s income level and suggested that more work should be
done at CSU level, on the impact on the Trust of care being provided closer to
home and asked for financial modelling to be carried out. Mr Greenwood advised
that in terms of outpatient pathways and care closer to home, a significant IG
amount of work had already been carried out with commissioners, which had BoD
been costed. It was agreed that Mr Greenwood would present a report on this to 06.03.12
the Board.
Budget Setting 2012/2013 was APPROVED.
Governance and Financial Declaration to Monitor – Q3
C/12/02/94 The Quarter 2 bottom line income and expenditure position of £1.731m surplus
was in line with the original Monitor plan phasing for the year to date, resulting in
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a financial risk rating of 3. The Governance declaration for Quarter 2 remained
Green.
C/12/02/95 Mrs Bond commented that the indicator relating to ‘Compliance with requirements
regarding access to healthcare for people with a learning disability’ should not be
reported as N/A as it was relevant and the Trust was compliant with this indicator.
This was noted.
The Governance and Financial Declaration to Monitor – Quarter 3 was NOTED
Equality Act 2010 – Publishing Requirements
C/12/02/96 Mrs Selvidge advised that the Trust had published information on the Trust
website with regard to the Equality Act 2010 and had met its statutory duty. The
general duties of the Act, and the way in which the Trust was addressing these
duties were noted.
The Equality Act 2010 – Publishing Requirements was NOTED.
Reconfiguring the Montagu and Tickhill Road Hospitals
C/12/02/97 Mr Greenwood presented an update on the reconfiguration of Montagu and
Tickhill Road Hospitals. The final decision by commissioners to progress the
changes to some services was not expected until 20 February 2012.
C/12/02/98 A start date had yet to be agreed and it was noted that the build would take
around 15 months to complete. Mr Tyson was currently working on the business
plan, and when the cost of the development was known, an ad-hoc meeting
would be organised of the Fred and Ann Green Charitable Fund Committee.
Reconfiguring the Montagu and Tickhill Road Hospitals was NOTED
Minutes of the Audit and Non-Clinical Risk Sub-Committee meeting held on
16 December 2011
C/12/02/99 The minutes of the Audit and Non-Clinical Risk Sub-Committee meeting held on
16 December 2011 were NOTED.
Minutes of the Clinical Governance Standards Committee Accountability
meetings held on 16 December 2011
C/12/02/100 This was the third quarterly accountability meeting held with the following CSUs:
i) General and Acute Medicine
ii) Children’s Services
iii) Ophthalmology
iv) Genito-urinary Medicine
C/12/02/101 In response to a query from Mr Barnes, Mr Pratt reported that a business case
had been developed with regard to the difficulties experienced with
Ophthalmology accommodation. It had been flagged as a risk on the CSU risk
register and the corporate risk register and had been included in the business
plan for 2012/13 and capital bids 2012/13.
C/12/02/102 Mrs Atkin was advised that Mr Cuschieri and Mrs Humphries had developed a
schedule of indicators to assess the degree of progress.
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The minutes of the Clinical Governance Standards Committee Accountability
meetings held on 16 December 2011 were NOTED.
Actions from the Previous Minutes
C/12/02/103 Actions from the Board of Directors meeting held on 3 January 2012 were
reviewed and updated.
Any Other Business
C/12/02/104 In response to a query from Mr Crowe with regard to car parking at Bassetlaw, Mr
Scholey advised that there had been an update at the Board of Governors
meeting on 31 January 2011. One of the issues which arose was a requirement
to address the cost of parking for part-time staff.
C/12/02/105 REDACTED – COMMERCIAL SENSITIVITY
Date and Time of next Meeting
C/12/02/106 It was confirmed that the next meeting of the Board of Directors would be held at
9am on Tuesday 6 March 2012 in the Fred & Ann Green Boardroom, Montagu
Hospital.
Governor comment and questions
C/12/02/107 Mr Shaw was pleased to note that the Trust was investigating how to improve the
out-patient facility at DRI.
C/12/02/108 Mr Webb noted the number of attendees at the public meetings with regard to the
reconfiguration of Montagu and Tickhill Road Hospitals and requested an update
on the respite care which had been provided at Tickhill Road Hospital.
Mr Greenwood advised that 60 people had gone through an assessment process
by RDaSH, who had managed the process well.
C/12/02/109 Mr Scholey reported that Mr Brayford would retire on 24 February 2012. A
presentation would be held in the Boardroom at 12.30pm on that date.
C/12/02/110 Mrs Selvidge would be leaving the Trust shortly and Mr Scholey thanked her for
her work and wished her well in her new job.
C/12/02/111
………………………………………………… ……………………………………………………..
Mr C Scholey Date
Chairman
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