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					                                                                    Agenda Number 3: TB(09) 19

                            EAST CHESHIRE NHS TRUST
                    MINUTES OF A MEETING OF THE TRUST BOARD
                       HELD ON THURSDAY 29th JANUARY 2009
                IN MEETING ROOMS 1 & 2, INGERSLEY BUILDING, MDGH

PRESENT:            Mrs K Cowell                   Chairman
                    Mr J Wilbraham                 Chief Executive Officer
                    Mrs L McGill                   Non-Executive Director
                    Mr S Fraser                    Non-Executive Director
                    Mr D Coorey                    Non-Executive Director
                    Mrs V Aherne                   Deputy CEO, Chief Operating Officer
                    Mr S North                     Director of Finance
                    Mrs B Salisbury                Director of Nursing and Patient Care Stds
                    Dr R Stead                     Medical Director
                    Ms S Campbell                  Director of Human Resources & Workforce

IN ATTENDANCE:      Mrs F Baker                    (Minutes)

     Members of the public were in attendance.

1.   APOLOGIES:
                    Mr A Dicken                    Deputy Chairman


2.   REGISTER OF INTERESTS

     None declared on this occasion. The Chairman requested members to complete a
     Register of Interests declaration form and return it to her office by the end of the following
     week.

3.   MINUTES OF THE MEETING HELD ON 27th NOVEMBER 09 – TB (09) 01

     The minutes were accepted as a correct record and duly signed by the Chairman. With the
     following amendment:

     Agenda Item 10 – HR Report – Half Yearly Update – TB (08) 97

     The second paragraph should read: The DHR confirmed that the Trust does not have an
     ‘e-training’ programme currently in place, however is looking to introduce some modules
     from April which will require improved infrastructure to run it effectively.

     The fourth paragraph should read: The DHR informed members that the Trust had
     continued to promote the ‘zero tolerance’ approach to harassment.....

4.   MATTERS ARISING

     Page 4 – Agenda Item 11 – Infection, Prevention & Control Report – TB (08) 98

     Mrs L McGill requested assurance that a meeting had been arranged with Winchester and
     Eastleigh NHS Trust, the Trust which has been MRSA free for a number of months. The
     Director of Nursing and Patient Care Standards (DoN) shared that she has still to make
     contact with them, but will be arranging a visit to meet with their Director of Nursing in the
     near future.




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                                                                 Agenda Number 3: TB(09) 19


     The Chairman sought assurance that the Trust’s No Smoking policy had been reinforced.
     The CEO shared that this was on-going and will be linked in with the forthcoming ‘no-
     smoking day’. Members recognised the difficulties that enforcement of the policy may bring
     and The Director of HR and Workforce (DoHR) shared that she will look to include this topic
     in the forthcoming ‘culture event’. Members reinforced their commitment to the Trust being
     a non-smoking environment for all staff and patients and recognised that conveying this
     message to our patients must be done sensitively.

5.   CHIEF EXECUTIVE’S REPORT – TB (09) 02

     A brief summary of the report was given by The Chief Executive (CEO).

     The CEO shared with members that the Trust had received the outputs of two reviews by
     the Healthcare Commission, compliance with the Hygiene Code and the Accident and
     Emergency national patient survey. The CEO shared that the Trust had demonstrated
     compliance in 12 out of the 16 sub duties that were assessed. The Trust was ranked as
     ‘red’ on one area and an action plan was put in place immediately to ensure that the Trust
     would be compliant with the code prior to the next inspection by the Commission.

     The Trust had also received feedback from a national survey recently carried out of
     Accident and Emergency (A&E) Departments where patients had been asked to rate the
     department. The CEO shared that the Trust’s overall position showed that 90% of patients
     rated their care here as good, very good or excellent. The CEO shared that he had written
     to colleagues within A&E to thank them for all of their efforts.

     The CEO reported that a major incident alert had been received on the 18th December
     where 30 casualties were expected in A&E. Although ultimately no casualties were
     received, the incident highlighted that the major incident systems that are in place worked
     well. Staff were commended for their efforts, many stayed longer than was expected and
     many arrived at the hospital for duty even though not rostered. The Board thanked staff for
     all of their efforts.

     The CEO shared with members that the Council’s Planning Committee was sitting on the
     9th February to discuss and decide on the planning applications submitted by the Trust and
     our partner Keyworker Homes Ltd for the Blue Zone. Councillors had visited the Trust on
     the 21st January to further acquaint themselves with the site and meetings have taken place
     between Trust Officers and our partners and Officers of the Council. Discussion took place
     as to the consequences to the Trust should the Planning Committee reject the applications.

     The CEO reminded members that the Trust together with Counter Fraud had brought a
     prosecution of a member of staff who we understood to have committed fraud against the
     Trust. The CEO shared with members that the case had been heard in court recently
     where the defendant had pleaded guilty and had offered to pay back the sum of £1,181.04
     plus costs and prosecution costs.

     RESOLVED: The Board noted the report of the Chief Executive.

6    MONTHLY PERFORMANCE REPORT TO 31ST DECEMBER 08 - TB (09) 03

     Papers presented by The Chief Operating Officer (COO) who wished to inform the Board
     on progress with regard to Performance Standards and for members to understand the
     risks and mitigating actions being taken by the Trust. The COO briefly summarised her
     paper.




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                                                                   Agenda Number 3: TB(09) 19
     The COO shared that she will be changing the way in which the reporting of thrombolyasis
     to needle is recorded to encourage a stronger quality control. Members supported the
     change in reporting.

     The Trust reported a drop in our 4 hour target through December, The COO shared that
     this was due to particularly high attendance, pressure from lack of discharges and sickness
     and absence of medical and nursing staff. A review has been done on the weekend which
     was particularly challenging. Recent feedback from the SHA had shown that the North
     West region is struggling to achieve this target with four other Trust’s declaring that they are
     unable to achieve the annual target.

     The Chairman questioned the average length of stay recorded for patients as this had
     increased, the COO to provide an explanation.

     Assurance was sought with regard to the Trust achieving the statutory and mandatory
     training target and Mr S Fraser requested more details of the action plans put in place in
     order for the Trust to succeed. The Director of HR and Workforce (DHR) shared that a
     range of communications and actions were on going and that a risk report was to be taken
     to the February Performance Committee for discussion.

     Assurance was sought with regard to plans being in place in order for the Trust to achieve
     its 18-week target. The COO confirmed that plans were in place and these were
     continually being reviewed to ensure the Trust remains on track.


     RESOLVED: The Board noted the monthly performance report and actions being taken by
     the Trust.

7.   FINANCIAL REPORT AS AT 31ST DECEMBER 08 – TB (09) 04

     Papers presented by The Director of Finance (DoF) who wished to appraise the Board of
     the key financial risks the Trust faces in achieving its financial objectives in 2008/09
     together with informing members of progress made to date. The DoF summarised his
     papers.

     The DoF shared that there was a surplus of £107K with an improvement in month of £258K
     however, the emphasis remains that improvement is required. The Trusts cash position
     remains challenging; with measures and agreements in place with the PCT the Trust aims
     to meet its requirements this financial year.

     The Chairman shared the DoF concerns regarding the Trusts challenging financial position;
     nonetheless there had been improvements delivered for patients and staff, for example two
     new wards and a pathology laboratory being built.


     RESOLVED: The Board noted the Trusts January Finance Report.



8.   HEALTHCARE ASSOCIATED INFECTIONS – PROGRAMME OF INSPECTIONS TB (09)
     05

     Paper presented by The Director of Nursing & Patient Care Standards (DoN) who wished to
     share with members the outcome of the recent Healthcare Commission report on the
     Inspection Visit.




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                                                                   Agenda Number 3: TB(09) 19



      The DoN shared that the Trust had been commended by the Commission for our immediate
      response and for initiating a robust action plan so promptly. The DoN however shared her
      disappointment that the Trust had failed initially in this area; however lessons learned were
      now embedded within the organisation. Wider lessons had been learned around
      developing policies with staff at the forefront rather than putting policies into the
      organisation and not achieving full compliance. The DoN shared that the Trusts Dress
      Code policy had been reissued. The Chairman reiterated that it is unacceptable for
      colleagues not to comply with the Trusts Dress Code policy and was pleased that this was
      being managed robustly.

      Members discussed the impact of the above on the Trusts Annual Health Check
      Declaration as the Trust will not be able to declare full compliance with C4a and C4c.
      Members will need to decide what level of compliance should be declared, the options
      being declaring compliance, not met or insufficient assurance. Further discussion was
      required and this topic will be taken to a forthcoming Executive Management Team meeting
      for debate.

      RESOLVED: Members noted the report and the actions taken.

9.    SUB-COMMITTEE TERMS OF REFERNECE

      Members discussed the Terms of Reference for the following sub-committees of the Board:

      Performance Committee TB (09) 06
      - minor changes were needed to these with section 5.5 in need of confirmation
      (committees that report into the Performance Committee) and 5.6 to include receiving
      reports form the IT SLA performance group

      Clinical Management Board TB (09) 07

      Finance Committee TB (09) 08


      RESOLVED: Members noted the revised sub-committee Terms of Reference and they
      were ratified.


10.   ITEMS FOR INFORMATION

      The following Minutes were presented for information:

      TB (09) 09 - Clinical Management Board – November 08
      TB (09) 10 and TB (08) 11- Finance Committee – November 08, December 08
      TB (09) 12 and TB (09) 13 - Performance Committee, November 08, December 08
      TB (09) 14 and TB (09) 15 - Executive Risk Committee – November 08, December 08
      TB (09) 16 and TB (09) 17 - SQS Committee – October 08, November 08
      TB (09) 18 - Audit Committee – November 08



      DATE OF NEXT MEETING

      1400 on Thursday 26th March 2009 at Wilmslow Library, South Drive, Wilmslow SK9 1NW.



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                                                                         Agenda Number 3: TB(09) 19



It was then RESOLVED that in accordance with Section 1(2) Public Bodies (Admission to Meetings) Act
1960 and paragraph 3.1 of the Standing Orders of the East Cheshire NHS Trust, representatives of the
press and other members of the public be excluded from the remainder of this meeting, having regard to the
confidential nature of the business to be transacted, publicity on which would be prejudicial to the public
interest.




                                       Signed ……………………………………Chairman

                                       Date ………………………………………




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