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MINUTES OF THE THIRTY FIFTH MEETING OF THE BOARD OF DIRECTORS OF

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MINUTES OF THE THIRTY FIFTH MEETING OF THE BOARD OF DIRECTORS OF Powered By Docstoc
					 MINUTES OF THE THIRTY FIFTH MEETING OF THE BOARD OF DIRECTORS OF THE
          SOUTH LONDON AND MAUDSLEY NHS FOUNDATION TRUST
                          HELD ON 25TH MAY 2010

PRESENT          Madeliene Long                   Chair
                 Dr Martin Baggaley               Medical Director
                 Stuart Bell                      Chief Executive
                 Charles Bland                    Non Executive Director
                 Prof Chris Clare                 Non Executive Director
                 Dr Patricia Connell-Julien       Non Executive Director
                 Robert Coomber                   Non Executive Director
                 Harriet Hall                     Non Executive Director
                 Gus Heafield                     Director of Finance and Corporate Governance
                 Kumar Jacob                      Non Executive Director
                 Prof Hilary McCallion            Director of Nursing and Education
                 Zoë Reed                         Director of Strategy & Business Development

IN ATTENDANCE Alison Baker                        PA to Chair & Non Executive Directors
              Clive Baker                         Head of Capital Planning
              Cliff Bean                          Deputy Director Patient Safety & Clinical Governance
              Dan Charlton                        Head of Communications
              Steve Davidson                      Service Director, Lewisham and Croydon
              Patrick Gillespie                   Service Director, Lambeth
              Kay Harwood                         Trust Programmes Co-ordinator
              Michael Kelly                       Deputy Director of Human Resources
              Jill Lockett                        Service Director National Division & Neurodevelopment
              Shubhra Mace                        Principal Pharmacist Clinical Services
              Paul Mitchell                       Trust Board Secretary
              David Norman                        Service Director, Older Adults
              Tracey Power                        Programme Director, CAG Development
              Jane Sayer                          Programme Director Nursing
              David Taylor                        Chief Pharmacist
              Graham Thornicroft                  Director of R&D
              Noel Urwin                          Members’ Council

APOLOGIES        Mark Allen                       Director of Specialist Services
                 Paul Calaminus                   Service Director, Southwark
                 Louise Norris                    Director of Human Resources
                 Prof Eric Taylor                 Non Executive Director (from item 13)

DECLARATIONS OF INTEREST
Routine declarations were made:
   • Madeliene Long declared an interest as a Lewisham Councillor.
   • Hilary McCallion declared an interest as Visiting Professor to South Bank
       University and Kings College London.
   • Stuart Bell declared an interest as a Board member of the Picker Institute
       (Europe) and as an Honorary Fellow of King's College London.
   • Charles Bland declared that his wife is employed as a Consultant
       Psychotherapist by the Trust.
   • Patricia Connell-Julien declared an interest as an employee of Kings College
       London.



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MINUTES
The minutes of the meeting held on the 27th April 2010 were agreed as an accurate
record of the meeting.

The draft minutes of the R&D Strategy Team March meeting were noted.

BOD 62/10 MATTERS ARISING
    There were no matters arising from the previous minutes.

BOD 63/10 RATIFCATION OF CONSULTANT APPOINTMENT
    The Board of Directors ratified the following Consultant Appointment:

     Dr Alaa Al-Sheikh – Consultant Psychiatrist, York Clinic, Learning Disabilities.

     The Board of Directors ratified the appointment.

BOD 64/10 PRESENTATION – MEDICINES MANAGEMENT REPORT
    David Taylor explained that the presentation and report informed the Board of
    Directors of the Medicines Management activity within the Trust for the period of
    May 2009 to May 2010.

     A number of NHS documents highlight the importance of medicines management.
     The Trust medicines management policy outlined procedures for the use of
     medicines within the Trust. Compliance with the policy was governed and
     overseen by the Trust Medicines Management and Drug and Therapeutic
     Committees.

     The Trust assessed itself as fully compliant with the relevant criteria in the
     Standards for Better Health declaration in November 2009. Details of the Care
     Quality Commission inspection for 2010 were still awaited.

     The Trust had made some important progress against national and local targets
     within the year which included:

         •   an approved medicines management policy
         •   approved procedures for controlled drugs
         •   reporting of medication errors to NPSA
         •   progress with the action plan on the corporate risk log
         •   appointment of the Director of the Pharmaceutical Sciences CAG

     Medicines Reconciliation remained a pressure for the Trust, however the DB2 pilot
     suggested that cost effective reliable implementation was possible and that several
     professional groups could contribute. Recruitment and retention of experienced
     staff remained a challenge. Job descriptions, roles and responsibilities of
     specialist staff were being revised to ensure that the skills of specialist staff were
     being utilised in the most effective way. The Trust pharmacy continued to supply
     medication to over 2,500 patients within the CMHTs across the Trust. Trust
     services and the PCTs were being consulted around moving community
     prescribing to FP10HPs. There was also a pilot due to commence in Lambeth



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     where the pharmacy would provide prescribing support for GPs to assist the
     transfer of prescribing to primary care. A live pilot for Electronic Prescribing had
     been provisionally scheduled for implementation in July 2010.

     The Board of Directors noted the presentation.

BOD 65/10 KHP PARTNERSHIP AGREEMENT
    Madeliene Long explained that the draft Partnership Agreement was being
    considered at the meetings of the three NHS Partner Boards in May 2010. It had
    already been approved by KCL. Further financial and legal advice had been
    obtained since the Partnership Agreement had been considered by the Board in
    February 2010 with amendments being made accordingly. The Articles of
    Association of Kings Health Partners Limited was tabled.

     Gus Heafield confirmed that the document had been reviewed at the request of the
     Trust by legal advisers and internal audit. There were no outstanding areas of
     concern. A log pulling together all the advice received was being compiled.

     Stuart Bell explained that the Partnership Agreement set out how the four partners
     would work together. Mechanisms were already in place for reporting back to the
     SLaM board. The Partnership Agreement also created an executive structure for
     KHP, arrangements for planning by all the partners and the establishment of a
     company for KHP so as to manage liability with external partners. The Partnership
     Agreement set out the approach to the employment of staff which would involve
     staff continuing to be employed by the individual partner organisation and
     seconded to other partners and KHP if required.

     The Board of Directors agreed the Partnership Agreement, and confirmed
     the role and indemnification of the Chair and Chief Executive as members of
     the KHP Board on behalf of the Foundation Trust Board.

BOD 66/10 INFECTION CONTROL SURVEILLANCE REPORT
    Martin Baggaley explained that this report informed the Board of Directors of
    Infection Control data with particular reference to MRSA, C.Difficile and outbreaks.

     During the month of April there had been 2 cases of colonised MRSA. Three
     patients were affected in the Ladywell inpatient Adult ward, the unit was closed
     from 5th – 10th May 2010, following investigations food was not implicated and the
     pattern suggested that the outbreak was of viral origin.

     The Board of Directors noted the report.

BOD 67/10 NURSING ANNUAL REPORT & STRATEGY 2009-2014
    Jane Sayer explained that this report informed the Board of Directors of the
    progress made within Nursing in the Trust during 2009.

     The Nursing Strategy had been ratified by the Board of Directors in March 2009
     and was based on the Magnet Recognition Programme. This was a system of
     accreditation of nurses and nursing practice which focused on setting and
     maintaining consistently high standards of care delivery.



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     The Modern Matron roles continued to have a positive impact on clinical areas,
     which had been demonstrated in a number of services. MHOA had seen
     improvements against the nursing assurance visit standards. A new edition of The
     Maze (MHA manual) had been published which had been selling well and had
     already made £4,000.

     Jane Sayer reported that there had been an improvement in sustaining rates of
     mandatory training, however it was still difficult for people to be released, although
     there had been a rise in nurses applying for longer courses. When the move to
     service line management was introduced eRostering would provide more
     information around training and give a clearer picture on the use of current
     resources.

     The Board of Directors noted the report.

BOD 68/10 ANNUAL QUALITY REPORT 2009/2010
    Cliff Bean explained that this report was required under the Health Act 2009. The
    report would develop in line with the Trust’s strategy to improve quality of all
    services within the next five years, and develop comprehensive measure of quality
    across the whole range of service provision. A full assessment process would take
    place next year, this year the report would be sent to Monitor by the end of June
    2010. The report had also been discussed at a Members’ Council Quality Sub
    group meeting and with Internal Audit.

     The Trust was developing initiatives to improve quality. Measurement of service
     user satisfaction and the improvement of the collection and analysis of clinical
     outcome measures had all taken place. In order for the quality report to evolve
     priorities will need to increasingly align with those of service users and
     commissioners.

     The Board of Directors noted the report.

BOD 69/10 SINGLE EQUALITY & HUMAN RIGHTS SCHEME
    Kay Harwood explained that the report brought together the Trust’s previous Race,
    Gender and Disability Equality Schemes, and also incorporated sexual orientation,
    religion and belief and age. The report contained an action plan with objectives,
    progress would be monitored against the plan and where necessary take steps to
    address any areas of underperformance. Agreed levels of targets were still to be
    agreed. A summary of the report would be produced for wider distribution.

     As the Trust did not have a Human Rights Policy a statement had been prepared
     for approval by the Board of Directors which would be added to the recruitment
     pack.

     The Board of Directors noted the report and approved the Human Rights
     Statement.

BOD 70/10 FINANCE REPORT – MONTH 1
    Gus Heafield explained that the Trust was reporting a net deficit of £0.3m which
    was a £0.77m adverse variance from Plan. EBITDA was £0.87m worse than Plan.
    Without immediate action to begin to claw back this deficit there was a risk that the


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     Trust would not achieve the planned EBITDA target which would result in a
     Monitor Financial Risk Rating of 2 and potential intervention by the Regulator.

     The three main drivers were high nursing costs with an overspend by £0.6m;
     unmet CIPs which accounted for over £400k and overspill to the private sector
     which continued to be an issue in Lambeth and Croydon Adults.

     Charles Bland suggested that that the approach to managing the CIP be reviewed
     as current performance on delivery needed to be improved.

     Stuart Bell confirmed that immediate action had been taken to control expenditure
     through better control of bank and agency staff, halting of any avoidable
     expenditure and freezing of any appointments of temporary staffing within
     corporate departments.

     The Trust was rolling out the eRostering system and had targeted the highest
     spending wards which included Psychosis and Forensic in the first wave of 23
     wards.

     As from 4th June ward teams with the highest overspends would be meeting
     weekly with Executive Directors so as to understand the reasons for the overspend
     and to agree measures for correction.

     Robert Coomber acknowledged that the quality of the data provided was
     continuously improving but asked that a workforce strategy be brought to the
     Board for consideration.

     The Board of Directors noted the report.

BOD 71/10 REPORT FROM THE CHIEF EXECUTIVE
    Stuart Bell introduced his report which informed the Board of significant issues
    arising from Trust Executive Meetings, Performance Management Meetings, and
    the local health economy and nationally in the NHS and Social Care.

     Stuart Bell explained that he had received the resignation of Prof. Graham
     Thornicroft, R&D Director, who had been invited to direct the new Health Service
     Policy and Evaluation Institute at KCL/KHP. Prof. Graham Thornicroft had seen
     through many significant achievements in his role as R&D Director. The Board of
     Directors thanked Prof. Thornicroft for his considerable achievements and wished
     him well in his new role. Arrangements would be set in train for the appointment of
     a new R&D Director.

     The Board of Directors noted the report.

BOD 72/10 UPDATE FROM THE MEMBERS COUNCIL
     Noel Urwin explained that a meeting had been arranged for Thursday, 17th June
    2010 at Prospero House to review the Members’ Council bids scheme. Invitations
    were being sent out soon.

     The first meeting of the Quality group had taken place on 17th May 2010 where the
     Quality Report was discussed. It was agreed that the group would meet three or


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     four times during the year. Steve Hill agreed to be the MC Lead and will now meet
     with Cliff Bean to draw up an action plan.

     The by-election process commenced on 24th May to fill the 8 vacancies on the
     Members’ Council.

     The Board of Directors noted the report.

BOD 73/10 UPDATE ON KINGS HEALTH PARTNERS
    Zoe Reed informed the Board of Directors on the progress made on the
    developments across King’s Health Partners.

     Frances O’Callaghan had been appointed Director of Performance and Delivery.
     Interviews for Wave 3 and Wave 4 of Acute CAGs were scheduled for 28th April
     and 4th June.

     Work had been undertaken to integrate the KHP Business Plan with Trust Annual
     Plans and would be completed by the end of May 2010.

     The Board of Directors noted the report.

BOD 74/10 ASSURANCE FRAMEWORK
    Gus Heafield explained that this updated the version of the Assurance Framework
    for 2010/11. It was based on the risks which were discussed at the Board Seminar
    held in March and which were listed in the Trust’s Annual Plan. A discussion had
    also been held at the Patient Safety & Service Improvement Committee meeting
    earlier in the day.

     The framework would continue to be monitored by the Patient Safety and Service
     Improvement Committee for the service quality issues, and by the Audit Committee
     for the financial position.

     The Board of Directors noted the report.

BOD 75/10 DIRECTOR’S REPORTS
   There were no Directors reports noted.

BOD 76/10 FORWARD PLANNERS

     The Board of Directors noted the report.

BOD 77/10 ANY OTHER BUSINESS
    No other business was considered.

BOD 78/10 MOTION TO EXCLUDE THE PRESS AND PUBLIC
    The Board of Directors agreed that representatives of the press and other
    members of the public be excluded from the remainder of the meeting having
    regard to the confidential nature of the business to be transacted, publicity on
    which would be prejudicial to the public interest (Section 1(2) Public bodies
    (Admission to Meetings) Act 1960.



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The date of the next meeting will be: Tuesday 29th June 2010 3:00pm – Board Room,
Maudsley Hospital, Denmark Hill, London, SE5 8AZ.


Chair




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