THE 69th MEETING OF THE BOARD OF DIRECTORS OF THE ROYAL DEVON AND EXETER NHS FOUNDATION TRUST MINUTE

Transcription

1 THE 69th MEETING OF THE BOARD OF DIRECTORS OF THE ROYAL DEVON AND EXETER NHS FOUNDATION TRUST Held on Wednesday, 28 July 2010 In the Boardroom, Noy Scott House, RD&E MINUTES PRESENT: Mr B Aird Vice Chairman Ms A Ballatti Chairman Mr D Bishop Senior Independent Non-Executive Director Mr M Cooper Joint Medical Director Mr J Gaisford Non-Executive Director Miss E Hobson Chief Operating Officer Mrs L Lane Director of Human Resources Dr V Pearce Joint Medical Director Mrs A Pedder Chief Executive Mr G Sturtridge Non-Executive Director Mrs S Tracey Director of Finance & Business Development Mrs Em Wilkinson-Brice Director of Nursing & Patient Care Mr D Wright Non-Executive Director APOLOGIES: Mr J Rackstraw Non-Executive Director IN ATTENDANCE: Mr J Chinnock Divisional Manager, Corporate Affairs & Comms Mr R Schofield Corporate Affairs Manager Mr M Spivey Specialist Registrar (Anaesthetics) Prof S Thornton Dean of PMS AGENDA ITEM MINUTE ACTION APOLOGIES Apologies were received from Mr Rackstraw DECLARATION OF INTERESTS Mr Chinnock reported the following interests declared by Mr Gaisford: Governor of Exeter School Chairman of the Eight Men of Broadclyst (Almshouse charity) Director & Shareholder - Bartons Prior Limited (Property Company) Shareholder - Brunel House (Properties) Limited (Property Company) Livery member of the Weavers, Fullers & Shearers CHAIRMAN S REMARKS Board Minutes, Part 1, 28 July 2010 Page 1 of 7

2 Ms Ballatti welcomed Professor Thornton and Mr Spivey as observers and Mrs Wilkinson-Brice to her first meeting as a member of the Board. Ms Ballatti congratulated Richard May on his election as the new Deputy Chair of Governors. Ms Ballatti reported the following meetings she had attended during the month: With Mrs Pedder attended the Monitor Chair/CEO annual event. However, the event was held before the publication of the White Paper so was of limited use for picking up policy intelligence. Cynthia Bower from the CQC spoke about the new regulatory regime. With D Radford Chairman NHS Devon where a possible Board to Board meeting was discussed. With Mr Aird and Mr Bishop visited the Critical Care Directorate. They heard details of very promising service re-design plans, including around surgical pre-assessment. They had also been shown a very powerful patient safety video which they recommended to the rest of the Board. Mr Bishop had been very impressed by the briefing and de-briefing that was occurring at either end of the day. Ms Ballatti thanked the Critical Care team on behalf of the Board CHIEF EXECUTIVE S VERBAL REPORT Mrs Pedder reported that: The CQC will not be undertaking a periodic review this year and are still considering how they will publish their data. Monitor had confirmed that they will not be doing an additional review on the Annual Plan MINUTES OF THE LAST MEETING The following amendments were agreed to the minutes of the meeting held on Wednesday 30 June: add an expression of thanks from the Board to staff in the Neonatal unit replace the word consultation with developments Subject to these amendments Ms Ballatti signed the minutes as a true, official record of the meeting MATTERS ARISING AND BOARD ACTION SUMMARY CHECK Mr Chinnock reported that he had contacted Monitor and they had confirmed they were happy with the approach taken to resolve the issue of differing Statements of Internal Control between the Quality Account and the Annual Report and Accounts As agreed at the last meeting Mrs Tracey had approached the Trust s bankers who had confirmed they would be prepared to increase the overdraft facility to 26m, with this option remaining open for three months. Mrs Tracey confirmed that she would come back to the Board Board Minutes, Part 1, 28 July 2010 Page 2 of 7

3 with specific proposals in September. ST EQUITY AND EXCELLENCE. LIBERATING THE NHS. DEPARTMENT OF HEALTH WHITE PAPER. Mrs Pedder summarised the headline points from the White Paper and emphasised the following points: The lead on commissioning will move from PCTs (which will be abolished) to GP Consortia with oversight from the new NHS Commissioning Board (which will have regional arms). Top tier local authorities will be given far more responsibility for health issues including taking control over public health. Monitor will become an economic regulator from 2012 with greater freedom for FTs, easier processes to facilitate mergers and acquisitions and transactions. A new Healthwatch organisation will be created within the CQC. Patient choice will be expanded to include: o Choice of consultant from April 2011 o Performance data published by clinical team o Choice of diagnostic provider NICE will develop 150 outcomes-based quality standards Mrs Pedder reported that the DH will be consulting in several strands on aspects of the White Paper and the Executive Team will produce Board briefings as a basis for future discussions about the impact of the White Paper on Trust strategy. The Board noted the Report STRATEGY REVIEW VISION AND VALUES Mrs Tracey introduced the report and emphasised that the new draft of the Vision and Values and Priorities reflected the outcomes from the Members Say consultation and the work of the group of NEDs and Governors agreed suggested at the Board in May. The objective in the drafting of the new version was to make the language crisper and more accessible. The Board agreed that the new version was an improvement and there was consensus that the priorities identified by members should be amalgamated into the final version. There was also a feeling within the Board that at times the language was too passive and that this could be reviewed. Ideas on specific points included: - Should be there some reference to integrity? - There is now no reference to a research culture in the Values. ST/E Board Minutes, Part 1, 28 July 2010 Page 3 of 7

4 Should this be reviewed? W-B - The document needs to be reviewed to ensure commitments are achievable. It was agreed that Mrs Tracey and Mrs Wilkinson-Brice would bring a further version of the document to the Board in September for final decision INTEGRATED PERFORMANCE REPORT Miss Hobson introduced the Report and emphasised the following points around key performance areas. Performance Targets The following Monitor targets were not achieved for quarter one: All Cancers: 62 day wait for first treatment from urgent GP referral Performance for Quarter 1 was at 83.7% against a target of 85%. MON07 All Cancers: 31 day wait from diagnosis to first treatment. Performance for Quarter 1 was at 95.4% against a target of 96%. The following CQC targets were likely to be underachieving based on previous year s thresholds: CQC18.I - Cancelled Operations - Performance currently at 0.89% against an expected target of 0.8%. CQC19 Delayed Transfers of Care - Performance currently at 5.3% against an expected target of 3.5%. Finance At month 3 a surplus of 1.1m had been generated and a forecast year end surplus of 3.6m which is in line with plan. Achievement of Monitor Risk Rating of 3 (as per plan) Clinical income was over recovered year to date by 753k with the forecasted position to be an over recovery by 1.5m at year end. Pay continued to under-spend year to date, the year end forecast reflected that this is expected to reduce. Non pay spend was overspent both year to date and at year-end. However a significant element of this overspend related to expenditure that was rechargeable to PCTs for instance drugs, patient transport services and community estates. CIP plans were underachieved year to date by 152k and forecast to be achieved at year end. Plans at Directorate levels were on track however some Trustwide schemes have slipped. Plans are in place to manage this and the profile of savings achievement in these areas may alter as a result. Quality The number of reported incidents continued to reflect an increasing trend as targeting training and general awareness-raising enhanced the Trust s patient safety culture. Human Resources PDRs - following the validation exercise undertaken by directorates with support from Human Resources and Learning and Development, the Board Minutes, Part 1, 28 July 2010 Page 4 of 7

5 compliance rate had improved to 75.8%. Three directorates have compliance rates in excess of 93% and support continues to be offered to the remaining directorates. During discussion the following points were raised: Is there any cause for concern because cash balances are down? (Mr Sturtridge). Mrs Tracey responded that there wasn t as a process for recovery had been agreed with the PCT and this would be reflected in the next report. What was the likelihood that the year end cash position would be below plan? (Mr Aird). Mrs Tracey that any uncertainty related to whether or not the Heavitree sale completed. If completion does not occur by year end then the cash position at year end will be below plan. The inclusion of transferred community midwifery and theatre staff in the headcount makes it difficult to identify the underlying trend. Is it possible to separate out the newly included community staff? (Mr Wright) Mrs Lane responded that headcount was being controlled much better and that this was a priority. What are the main factors affecting turnover of staff as high turnover brings high costs? (Mr Bishop). Mrs Lane responded that it was important to be clear at first advert what a particular role entailed to avoid creating false expectations. It was also clear that commuting and car parking were still important recruitment and retention issues and that this needed to be looked at again. How can we be sure that the increase in reported incidents is due to improved training rather than a worrying increase in incidents? (Ms Ballatti). Mrs Pedder responded that national benchmarking suggested the RD&E was in the mid range for reported incidents. Mrs Wilkinson- Brice added that improved Ward to Board reporting would also provide greater assurance. The Board noted the report OVERDRAFT TERMS CONFIRMATION The Board noted the issue of a certificate confirming that it has complied with the terms of the overdraft facility with the National Westminster Bank plc OPERATIONAL PLAN Mrs Tracey explained that although the Board had seen the vast majority of the Plan before it had not been possible to produce a final version until contract negotiations had been finalised. The final changes to the Plan had been circulated with the papers and a copy of the full Plan had been tabled. The Board approved the Plan DATE OF NEXT MEETING Board Minutes, Part 1, 28 July 2010 Page 5 of 7

6 The next meeting of the Board of Directors will take place on Wednesday, 29 September 2010 at 09.00hrs in the Boardroom. Ms A M Ballatti Chairman 29 September 2010 Board Minutes, Part 1, 28 July 2010 Page 6 of 7

7 THE 70th MEETING OF THE BOARD OF DIRECTORS Wednesday 29 September, Boardroom, Noy Scott House, RD&E ACTIONS SUMMARY This checklist provides a status of those actions placed on Board members in the Board minutes, and will be updated and attached to the minutes each month. Completed actions will remain on the Summary until the Board meeting following completion. ACTIONS SUMMARY OPEN AGENDA Minute No. Month raised Description Action By Target date April 2010 Update on implementation of Carbon Reduction Strategy ST Oct July 2010 Strategy Review Vision and Values ST/ EW-B Sept July 2010 Overdraft facility proposal ST Sept 2010 Remarks Board Minutes Actions Summary Board date: 29 September 2010