Southport & Ormskirk Hospital NHS Trust Minutes of the Trust Board Meeting held on Wednesday 18 th October 2006 at 2.00pm In the Boardroom, Southport & Formby District General Hospital Present: Mr A Johnson Mr J Parry Mr M Eastwood Dr G Boocock Mrs J Citarella Mr K Clarkson Mrs M Carberry Mrs L Yates Mr L Byrom Mr M Iskander Miss C Aitken Mr C Throp In Attendance: Mrs D Currie (Minutes) Mrs M Lloyd Mrs P Roberts, PPI Forum Mr G McGarrity Apologies: All present 06/158 Introduction of Mr G McGarrity, Turnaround Director Mr Johnson introduced Mr Gerry McGarrity who commenced his post of Turnaround Director on the 5 th October 2006. Mr McGarrity has worked in Liverpool and Arrowe Park and is a welcome addition to the team who will lead on the Recovery Plan. 06/159 Minutes of the Trust Board Meeting held on 13 th September 2006 The Minutes of the Trust Board meeting held on Wednesday 13 th September 2006 were formally agreed as a correct record. 06/160 Matters Arising (a) Trust Board Dates 2007 Members NOTED the Trust Board dates for 2007 tabled at the meeting. The meetings have moved to the first Wednesday of the month to ensure the most up to date finance and performance information is provided to Members each month. (b) ISTC and ICATS The Department of Health has confirmed that the Trust will not continue its association with BUPA, the preferred bidder for the Independent Sector Treatment Centre (ISTC). However the Department of Health has asked the Trust to take on an additional 200 cases of activity each year for the next four years. ICATS the Trust continues to hold discussions with Netcare, the preferred bidder for the Cumbria and Lancashire ICAT scheme.
(c) Integrated Governance Action Plan Mr Clarkson and Mr Throp have looked in detail at each of the Strategic Objectives and requested that the recommendations on how future Board agendas will be structured be brought to the November meeting of the Trust Board which was supported by the Board. Action: Mr Clarkson/Mr Throp 06/161 Finance Directors Report to the Board Mr Throp talked in detail to the Finance Directors Report, circulated with the Agenda, summarised thus:- Finance The Director of Finance and Turnaround Director from the NHS North West have arranged to meet Mr Parry, Mr Throp and Mr McGarrity on 10 th November to discuss the revised four year financial plan submitted to the North West SHA at the end of July. The plan recognised the opening deficit of 10.2m was too large to be addressed in one financial year and as such, after achieving a recovery plan of 5.2m this year, the plan forecasts an overspend of 5m at the end of March 2007. When the Trust s original draft plan was drawn up it was envisaged that the cumulative debt of 14.2m would be written off. This has now been actioned but in two stages. 12.2m has been written off in 2006/07. The remaining 2m will not be written off until 2007/08. We have now received written confirmation from the NHS North West that this will be funded from the newly created Sefton PCT in 2007-08. For reporting purposes in this financial year the Trust will have to show the 2m debt as a 2006/07 overspend. The Trust is therefore still operating within a revised provisional budget of an in-year deficit of 5m. The financial performance at the end of August is an overspend of 1m. This performance is encouraging when considered against the operational planned deficit and is mainly due to underspend on pay costs. Recovery Plan Provisional plan of 5.2m. The Trust continues to make good progress against this target with 4.7m current year effect implemented to date. 0.5m more to be actioned in 2006/07 as a minimum to achieve the plan. Cash Management The Trust continues to run with high cash balances until the Public Dividend Capital is repaid later in the financial year. Capital Programme Expenditure of 926k to date. Final formal approval for the vacation of the SGI site from NHS North West is imminent. Once received, then plans are in place to deliver within the agreed timeframe. If all schemes perform to plan the Trust will be able to offer up brokerage of 1m at the end of the year. Activity and Targets Contracts. Current activity performance over-achieving against plan with the full financial gain not received until 2007/08. In-year over performance against baseline contract subject to discussions with the Primary Care Trusts. Admitted Patient Care All targets achieved. Outpatients All targets achieved. Booking 100% achieved.
A&E 4 hour wait maintained with continued good performance by the CDU. Diagnostics All waits continue to fall over all categories. Cancer All targets achieved. Future reporting of performance against activity and targets will be presented to the Board in a separate report, produced by Mr Clarkson. Action: Mr K Clarkson 06/162 Financial Business Plan and Turnaround Mr McGarrity has met with the Trust s Executive Directors and has arranged to meet with each budget holder to go through each of their budgets in detail. An Interim Turnaround Director Report for the December meeting of the Trust Board will be produced. Action: Mr G McGarrity 06/163 Healthcare Commission Annual Performance Report for 2005/06 Members were delighted to hear that in the first Annual Healthcheck the Healthcare Commission have rated the quality of services by the Trust as good. The Annual Healthcheck replaces the star ratings for NHS organisations and are a much more stringent assessment of a whole range of categories. Hospitals are scored either as weak, fair, good or excellent and only 11 Acute hospitals have an excellent score for quality of service. This puts the Trust in the top 34 per cent nationally with over half of all Trusts being scored fair or weak. The Trust just missed an excellent rating and will strive to retain or improve its quality rating for 2006/07. Although the use of resources score was weak, this was due to our overspend, not our financial governance. The Trust Board wished to formally record its sincere thanks and appreciation to every member of staff who made this possible. 06/164 Staff Reductions Members noted the paper circulated with the Agenda which shows the latest position regarding recovery savings from staff reductions within the Trust as 586,870k for 2006/2007 CYE and 2,382,175m for 2007/08 FYE. The Trust has announced a second tranche of compulsory redundancies which due to the strict implementation of a vacancy freeze, has resulted in a further 10 posts being made compulsory redundant instead of the anticipated 50 posts. Nineteen members of staff from the first tranche have been made compulsory redundant out of the reported thirty-three due to suitable alternative employment being found within the Trust. The Trust will continue to apply the vacancy freeze, voluntary early retirement and voluntary redundancy schemes to continue to reduce staffing costs. 06/165 Southport General Infirmary Update Members noted the paper tabled at the meeting. Plans for the transfer of Ophthalmology, Audiology and ENT services onto the Southport District General Hospital site and Ophthalmic and ENT day case procedures onto the Ormskirk District General Hospital are on target. Much of the pre-enabling schemes associated with these moves are now complete. The Trust awaits formal business case approval from the Strategic Health Authority, which is imminent.
Sefton Primary Care Trust now intend to accommodate its headquarters on Curzon Road. This may require a minor net book value transfer of additional land to provide additional car parking and enable an acceptable site disposal plan. Following negotiations with Sefton Metropolitan Council it has been agreed that the remaining portion of the SGI site will be made available for housing development. Consequently, two planning applications will be submitted in November. To aid this process public consultation meetings were held to enable the public to make informed comment on the proposals. The Trust continues to have difficulties resolving the restrictive covenant associated with the use of the SGI site. To date an agreement to pay a consideration of 250k with 25k expenses has been agreed by representatives of the beneficiaries of the covenant, to release the covenant, with all but one member of the family who does not accept the terms of the arrangement. Subject to the outcome of the covenant issue and the replacement of the Nurses Home it is proposed that the remainder of the site will be offered for sale during 2007/08. 06/166 Direction of Travel for Urgent Care The Department of Health has issued a document entitled Direction of Travel for Urgent Care: a Discussion Document, October 2007 a copy of which was circulated to Members with the Agenda. Mr Parry is arranging to meet with Mrs Yates and Miss Brookes to discuss what implications this Report has on our Accident and Emergency and Minor Injuries Unit. 06/167 Energy Price Rises and Sustainable Food Purchasing by the Trust s Catering Services Energy Management Members noted the paper, circulated to Members prior to the meeting. The Trust currently spends 2.89m on energy and utilities such as gas, electricity and water, this expenditure is forecast to increase significantly. Consequently, the control of energy is of particular importance for the Trust to both minimise expenditure and also reduce the impact on the environment. A Sustainability Forum, chaired by Mr Eastwood was established two years ago to monitor and minimise the impact of trust activities on the global environment. The Forum receives and analyses reports on waste management and disposal, general procurement, construction and energy management. Attached to the paper is a summary report and trend analysis of energy consumption for the period 2006/07 compared to 2005/06. Sustainable Food Purchasing by the Trust s Catering Services During the last two years catering services have been reviewing purchasing arrangements and suppliers to the Trust, with the aim of more sustainable practices and a local focus for suppliers wherever possible. Working within the Trust s financial and supplies procedures, which make full use of the PASA purchasing frameworks, the Catering department has made substantial efforts to source food products from within a 25 mile radius of the Trust. Efforts have been particularly directed at the fresh foods, examples of which are provided in the paper. Members noted the paper tabled at the meeting The Catering Department will continue to pursue and develop strategies which reflect a more sustainable practice and reduce the environmental impact of catering services. New initiatives will be in line with the
Trust s finance and supplies procedures and take into account any national guidance that there may be in the future. 06/168 Chrysalis Project Update Members noted the Report circulated with the Agenda which provided Members with an update on the progress of the Chrysalis Project to date. In order to move to the next phase of the project the Trust Board was asked to consider the appointment of a Project Lead which will be funded by Partnership Contributions for the next 12 months. Members considered and APPROVED the fixed term appointment of a Project Lead which will be funded as described above. 06/169 Non-Executive Director Visit to HSDU and Medical Day Unit Members noted the Report summarising the Non Executive Directors visit to HSDU and the Medical Day Unit 06/170 Best Care Practice Members noted the content of the Report circulated with the agenda. The Report demonstrates some significant achievements and improvements but it also identifies key delivery area s where further improvement is necessary, namely:- Improving the overall percentage of new outpatient activity. Reducing the numbers waiting over 20 weeks for elective surgery. Reducing the numbers waiting over 11 weeks for routine new outpatient appointments. Reducing diagnostic waiting times towards 13 weeks 06/171 Integrated Governance Members noted the Integrated Governance Report circulated with the Agenda, a summary of which is given below. NICE Guidance Compliance Report as at 30 th September 2006. Shown in the report is the Trust s compliance with all NICE guidance published since April 199 to January 2006. The tables within the report summarise the total number of guidance issued during the period and the Trust s level of compliance Consultant Appraisal Progress Report as at 30 th September 2006. Currently 60% of appraisals have been completed; the Medical Directors are following up on those which are outstanding. Confidential Enquiries Monitoring Report as at 30 th September 2006. Progress noted. CHKS Clinical Benchmarking Progress Report as at 30 th September 2006. The report attached to the paper identifies a number of key achievements actioned within the Trust throughout 2005/06 using CHKS clinical benchmarking data. The Action Plan for 2006/07 is also included in summary form. Any items of concern that may arise from each of the listed reviews will be reported to the Trust Board along with an appropriate action plan to address any issues which are identified.
06/172 Patient Experience Report Members noted the Patient Experience Report tabled at the meeting, but felt that this was an important report which needed to be read fully before being discussed. It was therefore agreed to defer this agenda item to the November meeting of the Trust Board. Action: Mrs L Yates/Miss D Currie 06/173 Minutes of the Finance & Performance Committees held on 25 th September 2006 Members had discussed in detail the Finance Directors Report earlier in the meeting. Members noted the Minutes of the Finance & Performance Committee held on 25 th September 2006. 06/174 Minutes of the Charitable Funds Committee held on 26 th June 2006 The Minutes of the Charitable Funds Committee held on 25 th June 2006 were noted. issues were raised. No 06/175 Minutes of the Human Resources Strategy Sub Committee held on 24 th August 2006 The Minutes of the Human Resources Strategy Sub Committee held on 24 th August 2006 were noted. No issues were raised. 06/176 Any Other Business (a) Mr Johnson felt that it was a decision for the soon to be appointed Chairman to agree who would Chair the Infection Control Committee when Mr Eastwood retires in December. Dr Boocock to raise this with the Chairman following his/her appointment in November. Action: Dr G Boocock 06/177 Presentation and Thanks to the Chairman upon his Retirement Mr Parry presented the Chairman with a farewell gift to show the Board s appreciation for his dedication to the Trust during his seven years as Chairman of Southport & Ormskirk Hospital NHS Trust and wished him every success in the future