SUMMARY OF MINUTES OF A MEETING OF THE WRIGHTINGTON WIGAN AND LEIGH NHS FOUNDATION TRUST BOARD HELD IN PRIVATE ON WEDNESDAY 23rd SEPTEMBER 2009 AT THE DW STADIUM, WIGAN Present Mr L Higgins Mr R Armstrong Mr G Bean Mr S Ball Mrs L Barnes Mr A Foster Mr R Collinson Mrs P McCann Mr T Chambers Mr C Chandler Mrs G Harris Mr K Griffiths Mr B Livingstone In attendance Mr E Kerr Mrs H Hand Mrs J Berry Mr G Tinline Mr D Evans Apologies No apologies were received. PRESENTATION ON BOARD DEVELOPMENT Gordon Tinline from Robertson Cooper Limited had been invited to give a presentation to the Trust Board which gave an overview of the board development tool. The Trust Board would also be observed at its meeting in October. There would be initial feedback to LH and AF with full feedback being brought to the Trust Board in November. Head of Comms.& Marketing EK Trust Board Secretary HH Corporate Services Administrator JB Robertson Cooper Ltd (opening presentation only) GT Ass. Director, Estates & Facilities (for item 11 ) DE Chair NED NED NED Deputy Chair/NED Chief Executive NED NED Director of Operations Medical Director Director of Nursing & PS Director of Finance & IT Director of HR LH RA GB SB LB AF RC PMc TC CC GH KG BL
CHAIRMAN’S OPENING REMARKS LH reported on the Away Day held on 21st September. The Board Assessment programme would examine the working of our Board and identify ways of ensuring that we continue to improve as a high performing team. He suggested that the Board should consider the use of a facilitator and other ways of organising away days. FT149/09 DECLARATION OF INTEREST
None declared. FT150/09 MINUTES OF THE LAST MEETING
The minutes of the meeting held on 29th July 2009 were approved as a correct record subject to minor amendments. • • • FT130/09 - Third paragraph FT138/09 - Last paragraph FT138/09 - Action to be amended
FT127/09 – Decontamination Option Appraisal – Costs and Risks Option 1 It was confirmed that the contract between WWL and its partner would be legally binding for both parties and this should provide the necessary assurance required. FT151/09 MATTERS ARISING
A Action List 29.7.09 Resolved: • All completed actions be noted. Those actions not recorded as “completed” to be marked as complete. (HH)
FT138/09 – Board Assurance Framework Action: The amendment to the minute also to be reflected in the action list. (HH)
FT141/09 – Trust Residential Accommodation It was noted that a few of the properties had been advertised in order to test the market. FT147/09 – Any Other Business – Hospital at Home
A meeting had taken place with the CEO and Chair of ALW CH on this topic. There had been an improvement in partnership working on this project. B Decontamination Update The document circulated had been requested at the July Trust Board and gave an update as well as clear timescales regarding the joint decontamination project. A full business case would be brought to the November Trust Board. The capital costs associated with delivering a joint facility would be split 50/50. LH thanked TC for producing an excellent informative document. FT152/09 CEO’S REPORT
AF reported that the contract had not yet been signed. Following the recent CQC Infection Control Visit a verbal and written report had now been received. The Trust had moved from medium to low risk. A number of staff had been thanked personally, as well as being included in the Team Brief. It was agreed that a press statement should be made to highlight this positive message. Action: EK to ensure a press statement was given regarding the CQC Visit. (EK)
TC was to resign from his post and would be leaving the Trust in December. GH would become the Director of Operations and Nursing but would shed some of her other responsibilities to other Directors. CC’s term of appointment came to an end in March 2010 and he had decided that he would leave the Trust at that time. The advertisement for a replacement for CC’s post was to be expedited. This post would be taking over responsibility regarding the quality and clinical governance agenda more formally from GH’s post . FT153/09 Resolved: • Trust Board note actions and progress to date and continue to support the executive in driving forward the transformational programme including the LEAN strategy. LEAN REPORT
There had been a general discussion at a recent NED meeting on the LEAN work and an update had been requested for Trust Board. He drew the Trust Board’s attention to the fact that the commencement of NVQ level 2 at Leigh Infirmary was a direct result of work carried out by the LEAN team. The work of the team was largely taken up in supporting the BIG agenda. It was difficult to put a figure on some of the schemes eg the scheme on discharge planning had resulted in a reduction in the length of stay. He compared the work that the LEAN team were doing to the productive ward project and said they followed the same process.
In relation to patient involvement two discharge workshops had been held where the whole health economy were involved. The benefits of the LEAN project were tracked by the BIG programme. 3 out of 5 best practice awards, including the Chairman’s Award, were LEAN projects. Future projects would need to be adequately resourced to result in efficiency savings. FT154/09 EMERGENCY PLANNING REPORT AND H1N1 STATEMENT OF READINESS REQUEST
Resolved: • The approval of the statement of readiness report as circulated and that this is communicated to the DOH.
The Trust was required to provide assurance to the DOH that it is preparing appropriately to meet the swine flu outbreak. An audit report had needed to be prepared and WWL were one of the few Trusts with nothing new to add. Some work had been carried out with the PCT Commissioners and Providers looking at surgical capacity that would be required. Discussions had also taken place with the Critical Care Network as there could be up to 25% of patients requiring critical care. Pressures would also be high on Maternity and Paediatrics. Work had also been undertaken with HR to ensure staff are prepared. HR had also had an emergency planning session to test its preparedness and this had been found to be very useful. It was noted that there was a gap in assurance from Community Services/Adult Services. There would need to be an increase in Hospital at Home activity to avoid delayed discharges. This would be raised at a future joint meeting. Action: GH to inform the DOH that the Trust’s statement of readiness report has been approved. (GH) PERFORMANCE REPORT AND ADVANCING QUALITY APPENDIX MONTH 5
Resolved: • The Performance Report and Advancing Quality Appendix Month 5 noted for information.
The Performance Report and Advancing Quality Appendix were discussed in detail at the Trust Board Away Day held on 21st September 2009 so it was not discussed in depth. However, LB commented that she had found the Operations Dashboard very helpful. The ward to board maternity figures were to be split in the same way as MSK had been to give more clarity. The number of medically discharged patients in medical beds was raised in relation to recouping of the costs. This process
was in place but that there was still a cohort of patients awaiting discharge in WWL. Dr Sundar is looking at patient flow as a special interest and has just started visiting weekly any patients who are still awaiting discharge after two weeks. FT156/09 Resolved: • The Trust’s current financial position at Month 5 was noted. FINANCE REPORT MONTH 5
The Finance Report had been discussed in detail at the Trust Board Away Day on 21st September 2009 so this was not deliberated further. FT157/09 CIP/BIG REPORT MONTH 5 AND CAR PARKING SCHEMES PROPOSAL
Resolved: • The BIG Update August Month 5 was noted.
CIP/BIG Report Month 5 As indicated in the report circulated, the year to date position showed a position of £4.3m, £1.5m ahead of target. The in month position showed a £177k shortfall against target of £1.1m. KG reported a demonstrable level of engagement amongst staff as CIP targets were devolved at divisional level. Stress amongst staff was raised. This could be measured in the amount of sickness absence being recorded. Action: BL to ensure sickness absence was monitored closely in the light of the CIP. (BL)
Car Parking Schemes Proposal Resolved: • The Trust Board approved in principle the implementation of the review of car parking charges.
In order to deliver a significant BIG/CIP target, a review of car parking charges for visitors, staff and disabled parkers was undertaken. A Staff Car Parking:
A verbal summary of the document was provided and comments sought from Board members. The last review of visitors car parking had been undertaken in 2008, staff in 2007. NED’s commented that the car parking was currently inexpensive and in need of review but believed that the new payments should be in stages.
Staff Side were being consulted on this issue and were conscious of the charges made in neighbouring organisations. It was agreed that once the principle had been agreed by Trust Board and the details agreed following consultation with staff side representatives through the Green Travel Group, there should also be an agreement to an annual review so that the whole process could take less time to implement in future years. B Visitor Rates:
It was noted the comparisons contained within the document related to a price increase shown for a 6 hour period, yet in other organisations there were other tariffs. It was believed that few people would want to park for 6 hours and that it would be fairer to introduce new tariffs for shorter term parking. Attention was drawn to the problems at TLC where visitors often parked their cars there and visited the town centre for shopping, even though this was discouraged. The fact that patients had a choice of hospital for their treatment was highlighted and that if the car parking prices were raised patients could choose to go to other hospitals. It was reported that one piece of press coverage on car parking had been about the flat rate, requesting that staged payments be available. It was agreed to investigate whether the machines could be re-programmed to introduce staged payments. C Disabled Car Parking:
The need to ensure suitable access to machines if a charge for disabled car parking was to be implemented was highlighted. Reference was made to the work being undertaken by DisabledGo who could look at accessibility to car parking machines as part of their ongoing work within the Trust. Attention was also drawn to the assistance available with travel and car parking costs via HC11 – Help with Health Costs – for disabled people and those who were not disabled but on low income. It was noted that a car parking specialist had looked in detail at Leigh, Wrightington and TLC and developed proposals around that review. Action: To issue a press statement to reflect the change in the policy on car parking. (EK) Trust Board delegated full responsibility to DE for the following actions: DE to hold urgent discussion with Staff Side through the Green travel Group. DE to proceed with the revision of staff car parking charges subject to the consultation as outlined. DE to investigate the feasibility of re-programming the car parking meters to accommodate the introduction of staged payments.
DE to establish and implement a new system of visitor charging using staged hourly rates. DE to introduce car parking charges for disabled visitors on a staged hourly basis providing access to machines is made suitable for disabled. FT158/09 Resolved: • Board Assurance Framework Update was noted. BOARD ASSURANCE FRAMEWORK
Mandy Leyland had attended Meeting Point and will continue to attend on a six-weekly basis to remind Executive Directors of their responsibilities to update the BAF. At the next Governance and Risk Committee one area has been identified to be under close scrutiny. The document now produced has been found to be much easier to manage in its current format. LB added that the first hour of the Governance and Risk Committee has been ring fenced for discussion on the BAF. She had invited GB to attend, as Audit Chair, and extended an invitation to any other NED who wished to attend. LB reiterated the need for each Executive Director to take responsibility for their areas within the BAF and also reminded them that she had instructed HH not to accept any late documents for the agenda of the next meeting. When the BAF was updated, opinions were subjective, a risk is identified and mitigated against. For example, the swine flu is a risk where controls can be in place but some things occur outside the Trust’s control. The links between the Governance and Risk Committee and the Audit Committee were explained in that if assurance was not gained at Governance and Risk Committee then LB could escalate the matter to Audit Committee. If, alternatively, the Audit Committee wanted to check a process of how assurance had been gained then this would be devolved to the Governance and Risk Committee. LB will be invited to attend the Audit Committee twice a year and LB and GB would support GH in presenting the BAF. The SIC needed to be pushed back to the Divisions and Clinical Audit needed to be aligned to the strategic objectives. FT159/09 Resolved: • • • • • • • ITEMS FOR INFORMATION To receive the following reports for information:
Use of Company Seal Minutes of the Finance Committee 22.7.09 and 19.8.09 – unapproved. Unapproved Minutes of the Audit Committee 5.8.09 Unapproved Minutes of the Governance and Risk Committee Unapproved Minutes of the Investment Committee 29.6.09 Emergency Care Review Report Research & Development Annual Report 7
ANY OTHER BUSINESS
LH informed the meeting that the Green Committee had met in September and a report would come to a future Trust Board meeting. Action: HH to note that a report from the Green Committee would come to a future Trust Board meeting. (HH) DATE OF NEXT MEETING
It was noted that the next meeting would be held on 28th October 2009 at 9.45 am.