Central and North West London
NHS Foundation Trust
Annual General Meeting / Council of Members Meeting
23 September 2008
Minutes of a meeting of the Council of Members, combined with the Trust’s Annual General
Meeting, held at 5pm in public on 23 September 2008 at Congress House, Great Russell Street,
London WC1B 3LS.
The Chair welcomed Governors to the meeting, and paid tribute to them for their work during
the year gone by.
Dame Ruth Runciman (Chair) Mr. Sean Bell-Briggs
Dr. Mike Crawford Mr. Paul Byrne
Ms. Jo Andrews Ms. Jenny Trite
Ms. Charlotte Green Mr. Roger Warren
Mr. Marek Stepniak Ms. Janet Seale
Ms. Monique Klang-Voves Cllr Barry Macleod-Cullinane
Dr. Alicia Etchegoyen Dr. Kostas Agath
Ms. Andrea Rayner Mr. Robin Walker
Ms. Shalinie Tewarie Ms. Zrinka Bralo
Mr. Timothy Seale Mr. Christopher Keeffe
Mr. Chris Bumstead Head of Patient & Public Involvement
Mr David Brettle Director of Human Resources
Mr. Ian Holder Non-Executive Director
Ms Bhavana Desai Non-Executive Director
Prof. Dorothy Griffiths Non-Executive Director
Dr. Alex Lewis Director of Clinical Governance and Medical Director
Ms. Claire Murdoch Chief Executive
Ms Christine Baldwinson Trust Secretary
Mr Nick Bell Deputy Trust Secretary
Mr. John Vaughan Director of Partnerships
Mr. Richard Vergez Associate Director, Corporate Governance
Ms Robyn Doran Director of Operations
Mr Trevor Shipman Director of Finance
Mr. Ian McIntyre Director of Business and Estates
a Apologies for absence were received from Cllr John Detre, Jill Patel, Russell Healy, Andy
Lale, Rami Jumnoodoo, Edward Matt, Cllr Alexander Nicholl, Hiroo Chothia, Cllr Robert
Freeman, and Tony Ogofere.
2. Governor Election, Appointments, Resignations and Terminations Update
a The Chairman welcomed new User Governor Timothy Seale to his first Council of
3. Minutes of the Last Meeting- 23 July 2008
a The Council received and noted the minutes of the last meeting, COM 19/2008, which
were confirmed as a true and accurate record.
4. Matters Arising
a Item 5b, Governor Workshops: the Chair noted that there had been two workshops held
since the last Council of Members meeting, on the NHS Constitution, and CPA.
b Item 5c, Mental Health Day: the Chair confirmed that the date is the 10th October 2008,
and flyers were available to take away.
c Item 6c, Harrow Vocational Strategy: the Chair advised that there would be an item on
social inclusion on the agenda for the next Council of Members meeting in January.
d Item 8c, Appointments Committee: the Chair advised that the Committee had met on the
16th September 2008 and considered the process for appointing Non-Executive
Directors, and following presentations from the applicants it had been unanimously
agreed to use the Appointments Commission.
e Item 10d, Board to Board meeting: the Chair asked that all Governors respond to the
Trust Secretary’s email requesting availability on a selection of dates, as not all
responses had yet been received.
f Item 11, Review of Council of Members’ Performance: the Chair asked that appraisal
forms be returned as soon as possible, as they would be used as a basis for discussion
during the away day.
5. Annual Report and accounts for the 1 month period 1 April 2007 to 30 April 2007
6. Annual Report and accounts for the 11 month period 1 May 2007 to 31 March 2008
a The Director of Finance explained that two sets of accounts had been produced because
CNWL was authorised as a Foundation Trust part way through the year 2007/8, and
statute required that two separate sets of accounts be produced to govern the periods
pre- and post-authorisation.
b The Director of Finance advised that in both sets of accounts the Trust had finished in
surplus and had made a £5.2m surplus over the whole year 2007/8. The Director of
Finance noted that he further anticipated a surplus in the region of £7.8m for the year
2008/9. He then invited questions from the public. The Trust’s External Auditor, Mr.
Henry Arthurs from Baker Tilly, was also available at the meeting to respond to any
c In response to a question regarding the Trust’s improved financial position, the Director
of Finance explained that this was due to its authorisation as a Foundation Trust, which
gave CNWL scope to negotiate its own contracts and manage its own resources. As an
NHS mental health trust in previous years, the NHS took any surplus to offset deficits of
d Following a question about the projected surplus for 2009/10, the Director of Finance
advised that that it was hard to be specific, as there were a number of factors which
could affect targets, but he was anticipating steady growth. It was queried whether a
large surplus could have any detrimental effect. In response, the Director of Finance
advised that PCTs would want to see they are getting value for money on their contracts,
and that the Trust was using its surplus both to secure its position and to invest back into
the services it provides. An excessive surplus could therefore lead to PCTs questioning
the cost of the service provided.
e The Council of Members received the accounts.
7. Activity and Innovation in Child and Adolescent Mental Health Services – A CNWL
a The Chairman introduced a series of presentations by CNWL CAMHS staff, noting that
there was an increasing national emphasis on helping children, families and the
community, and that this item was to celebrate some of the work currently being carried
out by the CNWL CAMHS directorate.
b Marie Crofts, Deputy Service Director of the CAMHS directorate, provided an overview of
the service, and explained that the presentations would focus on the work of two teams,
Collingham Gardens and the Marlborough Family Service.
c Paul Byrne, Manager of Collingham Gardens and also a Staff Governor on the Council of
Members, presented a description of the service Collingham Gardens provides, the work
ethos of the team and the range of initiatives it had implemented in London and the
awards the team and these initiatives had received.
d Dr. Eia Asen and Jane Dutton, Consultant Psychiatrist and Head of Social Work
respectively at the Marlborough Family Service, presented an overview of the
Marlborough Family Service and the specialist projects it currently provides, and the
take-up of some of their initiatives within the country and across Europe.
e Following a question about preventative work done in schools. Dr. Asen explained that
there was a devolved service within schools to identify problem children early.
Furthermore a series of training sessions are provided to the Headmaster, and then to
Year Heads and other identified personnel. These sessions coach how to identify
children with more complex needs early, and are free of charge.
f A question was raised about the service’s response if the child’s problems stem from the
parents, for example abuse. Mr. Byrne responded that Risk Assessments are always
carried out to gauge the suitability of the child staying at home, but noted that most cases
involve a range of complex factors and cannot be pinned down to simple bad parenting.
The projects run within the CAMHS service are aimed at helping parents manage the
problems a child presents with.
g A question was asked about the development of further specialist services in Asperger
Syndrome. Mr. Byrne advised that there was a gap nationwide for children with learning
disabilities, and that there was a need to address this. He added that, in comparison to
other parts of the UK, London was well served in these areas.
h Following a question about whether treatment was ever enforced, Mr. Byrne responded
that they look to the parent to make the decision for pre-adolescents. In the case of
adolescents, there can be the possible use of the Mental Health Act, but again largely it
is a decision-making process on the part of the family. There were also semi-voluntary
cases whereby a family has been referred by court order to the service.
i Following a question about the referral process, Mr. Byrne explained that all referrals
come from outpatient CAMHS services. As the service has to operate on a low volume
basis, cases are ‘filtered’ through the other CAMHS services so only the most needy are
j Following a question about the recording of information, Mr. Byrne acknowledged that it
was a difficulty faced by the team, to balance the need to document the relevant
information against the desire not to label the child for life.
k Ms. Crofts, Mr. Byrne, Dr. Asen and Ms. Dutton were thanked for their informative and
enlightening presentations and answers.
8. Chief Executive’s Report – Perspective on the year and a view to the future
a The Council received and noted a verbal presentation from the Chief Executive that
provided a look back at the highlights of the previous year and a summary of
expectations for the forthcoming year.
b The Chief Executive started by congratulating the CAMHS directorate on their work and
noting that this was one example of the range of services that CNWL provided to its
c The Chief Executive noted that two booklets had been provided to the Council of
Members that they could review at their leisure – a green booklet which provided the
annual review for 2007/8, and a blue booklet which provided a summary of the annual
plan for 2008/9, which Governors had helped develop.
d The Chief Executive thanked the Trust’s many partners – the Local Authorities, the
PCTs, the private and voluntary sector bodies, and also the Governors, service users,
carers, and staff – for their contribution in the delivery of the high quality services CNWL
e The Chief Executive went on to identify some key highlights of the year gone by for the
Trust: Quentin Blake-led arts projects at various hospitals within the Trust; the
development of a bespoke Onset of Young Dementia service in Kensington, Chelsea and
Westminster; the reinvigoration of the Learning Disabilities services at Kingsbury since
the Trust’s takeover; the success of the bid to provide SMS services in Feltham prison;
the expansion of the Court Diversion work, including working with the Old Bailey; the
medication helpline; the sale of Collingham Gardens and deployment of a new
Collingham Gardens service at another site, the profits from which had also helped fund
developments at Northwick Park Inpatient Services and the Horton Haven; and the move
of Westminster SMS services to Latimer House.
f Looking to the year ahead, the Chief Executive acknowledged that it would be another
hard year’s work for CNWL, and that the Trust needed to be innovative and develop new
services, but also to improve on the core functions it already provided. To this end, the
Trust would continue to review its service provision and ensure that it responded to
changes in the health service, including the probable introduction of poly-clinics. The
Trust would also be looking to develop proposals for an autism and aspergers service,
and would be opening the UK’s first gambling addiction clinic. The Chief Executive also
noted that the new Mental Health Act and CPA frameworks would need to be integrated
into the Trust’s service provision.
g Following a query about the Northwick Park redevelopment, the Director of Business and
Estates advised that, as there was currently a spare ward on the site, service users
would be accommodated by rotating them into the spare ward whilst work was
undertaken on their wards. It was further noted that work needed to be carried out on
Park Royal to bring it up to the same standard, and in the meantime the Trust was
examining ways to improve the overcrowding situation there, such as looking for
alternatives to admission and ensuring there are no delayed discharges.
h Following a query about minority communities within the Trust catchment area, it was
noted that a range of innovations had been introduced to provide a better service,
captured within the Delivering Race Equality scheme and carried out largely through the
Focussed Implementation Site Project. A report on the work of the FIS project over the
last three years would be forthcoming and will be presented to the Council at a future
9. Council of Members’ Review of the Year
a The Council received the paper entitled ‘Council of Members Review of the Year
2007/08’, presented by the Director of Partnerships.
b The Director of Partnerships advised that it had been informed by the contribution of the
Governors that had been provided to the Trust Secretary, and summarised the roles and
responsibilities of the Council, and what they had done over the last year. The Director of
Partnerships advised that their responses would inform a larger debate at the Board-to-
Board Away Day.
10. Questions from Members of the Public
a The Chairman invited questions from the floor.
b Following a query about providing mental health services to the Armed Services, the
Chief Executive advised that the Ministry of Defence had advertised for provision of
services, however the Trust had decided not to bid for it because it required an inpatient
facility for the service, which the Trust did not have available.
c The Director of Partnerships undertook to look into why a member of the Trust had not
received information back from the Trust as to possible projects he could become
d The Director of Clinical Governance and Medical Director undertook to meet with a
member of the public to discuss her individual concerns about a gap in information
provided around medication, and more generally the provision of services she had
e Following a further concern raised that not enough information is provided at medication
meetings, the Chief Executive noted that in the last two user surveys over 90% of
patients had indicated that they felt they were treated with dignity and respect. Evidence
was there that the Trust’s approach did work, but the Chief Executive fully acknowledged
that further work needed to be done to improve contact for those who responded
negatively in this respect.
11. Any Other Business
a There was no further business.
12. Date of Next Meeting
a The Chairman thanked the attendees for coming and advised that the next meeting
would be held at 5pm on 20th January 2009 at Westminster Council House.
The meeting was declared closed at 7.10 p.m.