MINUTES OF THE TRUST BOARD MEETING HELD ON
FRIDAY 30TH JANUARY 2004
Present
Veronica Worrall Chairman
Jan Bloomfield Director of Personnel & Communications
Pam Chrispin Clinical Director
John Cullum Non Executive Director
Nichole Day Director of Nursing & Community Relations
Mary Jones Non Executive Director
Judith Lancaster Non Executive Director
Linda Potter Director of Finance
Jessica Watts Director of Strategy
In Attendance
Mark Balaam Head of Planning & Performance
Simon How General Manager, Medical Services
Colin Muge Chairman, Suffolk West PCT
Jean Le Fleming Administrative Assistant
04/1 APOLOGIES
Apologies were received from Roy Bannon, Jane Harper-Smith, Colin Hilder,
Michelle Judd, Steve Moore, Ann Nicolson, Dermot O’Riordan, John Parkes,
Peter Richards, Liz Wright and Tony Ranzetta.
04/2 MESSAGE FROM THE CHAIRMAN
The Chairman took the opportunity at the beginning of the meeting to express her sincere appreciation to all staff for the considerable effort they were making to cope with increased activity. She believed that staff were responding magnificently to the challenge of increased attendance at A & E; and high patient demand as well as the weather conditions
Staff’s recent creative problem solving skills showed great initiative e.g. setting up a school room for children (when the schools were closed during the recent inclement weather) which allowed as many staff as possible to continue with their hospital duties. The Ambulance Trust had also been extremely helpful during this recent disruption to services.
This crisis had also highlighted the need for Public Authorities to liaise closely so that adequate contingency plans can be put into action. In the meantime, a Big Thank You was extended to all staff for their co-operation and commitment.
04/3 CHAIRMAN’S ANNOUNCEMENTS
The Chairman drew members attention to the following:
A joint meeting with representatives from the PCT and Professional Executive Committee (PEC) had been held on 14th January 2004 when the Local Delivery Plan had been discussed. Colin Muge was thanked for chairing this very useful meeting.
A workshop on Foundation Trust status had been facilitated by Mark Fletcher of the Department of Health on 23rd January 2004. This had been a useful aid to the Trust’s Project Team to progress with meaningful documentation and thanks were extended to Jessica Watts, Jacqui Grimwood and Peter Richardson for this work that will be on-going.
Joanna Spicer had been appointed Deputy Lieutenant of Suffolk and congratulations were extended to her.
Veronica Worrall had been invited to 10 Downing Street to meet the Prime Minister and his wife on Monday evening, 9th February 2004.
Veronica Worrall had also been invited to sit on a Regional Sub-Committee of the Advisory Committee for Clinical Excellence Awards (for the East of England).
The Strategic Health Authority had advised of a change in its Board Management arrangements but noted that David Burton would continue as the Non-Executive Director with responsibility for West Suffolk. It was planned to hold future Strategic Health Authority meetings on Trust premises and noted they would be visiting West Suffolk in May 2005.
The Chairman and non-Executive Directors were invited to tour the new Treatment Centre at lunchtime.
04/4 MINUTES OF THE MEETING HELD ON 19TH DECEMBER 2003
The minutes of the meeting held on 19th December 2003 were accepted subject to the following amendments:
Pam Chrispin is Clinical Director (not Medical Director)
Stella Jackaman was representing the Volunteers; not Chairman of CHC
2003/153 - The Board Workshop was held on 23rd January 2004 (not February)
156.1 - outliers (not outliners)
157.1 - The Ward Staffing Paper was presented (not tabled)
2003/159 - Mary Jones confirmed that this survey was in fact completed
04/5 MATTER ARISING FROM THE MINUTES
5.1 Clinical Governance Committee (158.1 refers)
NOTED that Mr. John Rapley would attend the February meeting as patient representative.
5.2 Older Persons Panel (159 refers)
Mary Jones requested feedback from the survey report which Dr. Bannon had agreed to take to the Trust Management Team. Linda Potter agreed to ensure this feedback was available for the Panel’s meeting in February. ACTION: LP
04/6 FOUNDATION TRUST APPLICATION
Jessica Watts reported on the Trust’s action to progress its application for Foundation Trust status as a Wave 1A Trust by October 2004; and members noted the following:
· Documents being prepared to date included a Consultation Document; Proposals for Governance Arrangements; Service Development Strategy and Human Resources Strategy.
· Key to the Trust’s success would be its consultation with staff, members of the public and stakeholders. A communication plan had been developed to assist with this process. There will be a pre-launch week to ensure staff have access to the Trust’s proposals before going out to formal consultation.
· The formal consultation process would begin on 21st February 2004 and extend until 30th April 2004. The Trust will need to demonstrate that it has considered all comments and that these are reflected in the Foundation Trust application.
· It was important to note that the consultation was NOT about the principle of applying for Foundation Trust status; it was about what this status will offer the local population it serves and the proposed local governance arrangements.
· It is also important to run public consultation meetings at various locations to capture all of the people the Trust serves. Voluntary groups and stakeholders would also be encouraged to become involved and members of the public were invited to let the Trust know if they wished anyone to visit their local community.
· The formal Consultation Document will be submitted to the Board at its February 2004 meeting but a Draft was required by the Department of Health at the beginning of February.
· The Trust will be required to undergo two Financial Assessments, which will need to be robust and subject to external scrutiny.
· The staff working on this Application are liaising closely with Wave 1 and Wave 1A Trusts to learn from others whilst recognising that the application must have a specific local focus.
· A Foundation Trust web-site has been established on which regular updated information will be posted. Consideration was also being given to comments being submitted back to the Trust on “Freepost” cards.
John Cullum stated that a lengthy and meaningful consultation process underlines the Trust’s commitment to engage the local community and allow their views to influence the Trust’s decisions.
Jan Bloomfield added that the Human Resources Strategy has to include feedback from the consultation process to demonstrate how people’s views have been taken into account.
Veronica Worrall confirmed that the Trust Board endorsed the action being taken to encourage staff and the general public to take an interest and contribute more closely to the way the Trust’s services are provided. She hoped responses from the staff and local community would be plentiful and that there would be subsequent changes made to demonstrate the Trust had taken account of their views.
04/7 SUDBURY PROGRESS REPORT
Jessica Watts presented a Progress Report on the development of a Health and Social care campus in Sudbury, which demonstrated how the views of the local population had been received and adopted.
In addition to the key points set out in Ms. Watts report, Trust Board members were also asked to note:
· The majority of the 40 beds for rehabilitation, palliative, terminal and respite care would be provided on a single room basis. Flexibility of use was also necessary.
· A number of models were being considered for the minor injuries unit.
· The Trust was working with all its partners to provide a comprehensive Treatment Therapy Centre
· The Trust was also working with social care partners on sheltered accommodation, nursing home provision, etc.
· The Project Team is ensuring that the Gateway recommendations are being addressed.
· All effort was being made to meet the project timetable – advertising for private developer interest in the European Union in May 2004; beginning construction in 2005 and commissioning in 2006.
· The Trust Board will continue to be regularly updated on the scheme’s progress.
Veronica Worrall congratulated Jessica Watts, on behalf of the Board and the Sudbury population, for her endeavours with this project which was closely linked to the Primary Care sector.
She was also pleased to hear that a Newsletter was imminent and asked Jessica Watts to send a copy to Mr. Tim Yeo, MP. ACTION: JW
Veronica Worrall also asked that a “Friends of Sudbury Health Development Scheme” be established to work alongside the Trust and master-mind any fund-raising activities that may be required.
Noted that there was a Friends of Sudbury organisation already in existence which had been involved in the original discussions on the scheme.
Agreed that this Group should be approached with the aim of expanding their remit as necessary. ACTION: JW
Mary Jones added that she was pleased to see nursing home provision and believed this was an opportune time to consider innovative ideas. She proposed that the Developers look at a development in Osto, Norway.
Veronica Worrall emphasised the need for the PCT to be actively involved and Jessica Watts confirmed that Mr. Jonathan Williams (Director of Clinical Services and Learning) had already visited various organisations with the Trust’s Advisers.
In response to John Cullum’s query about responsibility for any scheme changes and work of the User Groups, Jessica Watts explained:
1) As a review of the models of care had been necessary, the Outline Business Case would shortly be resubmitted to the Strategic Health Authority.
2) Daryl Murphy of Murphy Phillips was a member of the Implementation Group
and was actively involved with the work of the User Groups.
Linda Potter reassured members that the Business Case would be submitted to the Trust Board.
04/8 COMPLAINTS REPORT
Nichole Day presented the complaints report for the period July to December 2003. This identified the number of complaints received; gave a comparison with the previous year’s data; identified complaints by Directorate and showed examples of service changes.
Members were specifically asked to note:
· Although there was an increase in the number of complaints received, taking account of activity levels, the actual percentage of complaints received per patient treated had reduced.
· There was a disappointing percentage reduction in the target achievement of responding to patients within 20 days. This was due both to the complexity of the complaints being received but also due to revised arrangements for handling complaints. The administrative resources required to support this process should not be underestimated.
· It was a compliment to staff to note the reduction in “attitude” complaints.
Comments were received from members as follows:
As there was an increase in the number of “other” complaints, it would be helpful if these could be further scrutinised and classified as appropriate.
Despite the problems the Trust was having with car parking, it was pleasing to see the number of complaints for the Facilities Directorate had reduced.
It was pleasing to see examples of how the Trust was addressing some of the issues identified but Mary Jones queried whether or not the Trust should have picked up the problem in Dermatology earlier (example 1).
Mary Jones also asked if the work of PALS was being recorded and noted that reports were submitted to the Directorate Governance meetings.
In response to a query as to what the Trust was doing, in addition to national and local surveys, to actively encourage comments from patients, Nichole Day advised on a number of actions being taken to obtain users views. These included the compilation of patient diaries; specific specialty user groups seeking patients views on their experiences. Pam Chrispin also confirmed that a considerable amount of evidence was being collated in audits which would assist the Trust with the Foundation Trust consultation process.
Veronica Worrall suggested that the Trust map out what information was being collected. Members agreed it would be beneficial to co-ordinate the collation of all the various views in a more formal way to ensure the coherence of issues raised and how they are being addressed.
Veronica Worrall also asked that an action plan be prepared as to how the response times to complaints could be improved. She proposed that the Trust’s existing process be compared with other Trusts and that the new Complaints Manager, who was due to start on 2nd February 2004, should be asked to give this matter top priority.
She believed the Board, having invested in resources for the complaints process, should monitor the situation and receive a revised Strategy within three months. In response to Judith Lancaster’s advice not to consider complaints in isolation of incidents, it was agreed that a Feedback Strategy would be more appropriate.
John Cullum confirmed that this need for improvement had already been identified by the Clinical Governance and Organisational Risk Committees. He highlighted the fact that the deterioration, reflected in the data presented, had arisen after the introduction of a management change; such a decision should not have resulted in reduced management performance.
Nichole Day reiterated the importance of recognising the increased complexity of some of the complaints received and the timescale needed to engage all the relevant clinicians. It was therefore also important to support clinical colleagues in their endeavours to respond to complaints.
John Cullum added that the problems encountered in arranging Root Cause Analysis (RCA) meetings demonstrated the difficulty in adhering to tight timescales when a number of people were involved. It was therefore necessary to continually stress the importance of such investigations. The recently appointed Risk Manager had been tasked over the next month to benchmark our activity against otherTrusts.
Additional resources had been recruited into a Department that had, in the past, been under-resourced. One person alone would not be able to improve the situation but a smarter and more responsive process should gain results.
04/9 PERFORMANCE AND FINANCE
9.1 Current performance
Jessica Watts presented the current year’s performance and actions required by the Trust for the remainder of the year. In addition to highlighting the key points set out in her report, Jessica Watts drew attention to the areas of highest risk identified on the NSC’s position for December 2003 (filed with the minutes). An action plan would be required for those with the highest risk of under-achievement.
A & E Target (patients being seen, treated, admitted or discharged within four hours)
Although the Trust had met the 90% target on some days, the overall result for December 2003 was 86.3%. As this was a key target that would affect the Trust’s star rating, it was essential to achieve a consistent performance above 90%, as it was not yet known which period would be used to assess the Trust’s performance.
Judith Lancaster queried the reason for the increased activity in A & E in January; whether the Trust was accurately predicting activity and whether this Trust was different to others. Nichole Day responded that there were a number of operational issues affecting the overall situation in the Trust. In addition to a significant increase in emergency admissions, the nature of patients’ illness was more critical resulting in longer lengths of stay. The numbers of outliers was also a factor and some patients were having to be moved three or four times to facilitate patient flow. This was a problem across the whole of the NSC.
Linda Potter cautioned the interpretation of the figures presented as it was important to note these would reflect activity above plan, not actual attendances.
Jessica Watts continued that, to take account of the bed availability and GP referrals, a temporary observation area was being set up on the EAU from Monday 2nd February 2004. This area, which will be open from 8.00 a.m. to 10.00 p.m. each day will enable medical patients to be appropriately assessed and treated and relieve the pressure on A & E.
Nichole Day added that this service should have a significant impact on A & E, particularly on Mondays when activity is increased. It will also improve the flow of patients and ensure they are treated appropriately in a suitable environment.
Veronica Worrall expressed her support to a change in practice that will assist the Trust in meeting its target of 90% patients being treated in A & E within four hours.
Jessica Watts also drew attention to other pro-active decisions that had been made to improve the current situation:
· the 24 hour discharge facility that was being established in the EAU which would move patients to chairs rather than having to wait in beds.
· Patient Flow Team working to ensure processes are as effective as possible eg. working in A & E to monitor the patient’s clinical route
· Appointment of locum Staff Grade
· Staff are working closely with the Primary Care Trust to improve communication with GPs and the community
· The Ambulance Trust is being co-operative in aiming to keep to a minimum the number of patients waiting in an ambulance outside the Hospital.
Members were also asked to note that staff were working closely with the Strategic Health Authority (SHA) to ensure they approved of the approaches being taken by the Trust and, at present, the SHA appears happy with the efforts being made by the Trust to process its action plans. The Trust had two more months to achieve its key performance targets and to provide appropriate care for its patients.
It was also noted that, by January 2005, the target for Trusts would be increased to 100% although a threshold of 98% would be accepted recognising that for clinical reasons it may be necessary to keep a patient in A&E for longer than 4 hours. A financial incentive was also to be introduced to achieve this target - £500,000 capital monies to be relocated on achievement of incremental targets moving towards 98% in January 2005..
Colin Muge made reference to the considerable disquiet amongst the population because of a misunderstanding over the “out of hours” service, which he believed could have an impact on the A & E Department. He stressed that the “out of hours” service would be seamlessly introduced and the patient should not notice any difference. It was therefore important to influence the public’s perception.
Veronica Worrall added it was important that the general public knew that the A & E Department should only be used in an emergency. The GP “out of hours” service should otherwise be used.
John Cullum believed that demand management was critical and attempts should be made to prevent a similar situation next year. He questioned the role of NHS Direct and the advice they may be giving to patients. Mary Jones was certain that NHS Direct were advising patients to use A & E when the GP is not available.
It was agreed that Colin Muge should ask the Director of Primary Care to ensure that the general public was receiving the correct message about the “out of hours” service. ACTION: CM
Jessica Watts also confirmed that a paper on Emergency Care would be presented to a future meeting of the Board. ACTION: JW
Nine Months In-patient Waiting Time
Following a review of capacity across all consultants’ lists, it was anticipated that this target would be met, subject to bed availability. There were four specialties (Orthopaedics, General Surgery, ENT and Dental) where particular attention was being focussed on how to distribute the work between the relevant consultants and/or the need to access services elsewhere.
Activity profiles indicated there would be sufficient beds available in February and March 2004 to deal with both elective and emergency admissions. With the opening of the transitional care beds, the delayed transfers of care (DTOC) had decreased. Provided patients continued to move through this area as planned, the number of DTOCs should continue to decrease.
Nichole Day confirmed that the effectiveness of the transitional care beds was being monitored closely and staff were working closely with Social Services and the Liaison Team to ensure the throughput remains good.
It was acknowledged that this service, together with the EAU observation area and discharge facility, will assist the Trust in meeting its targets.
John Cullum queried why it was not daily practice to distribute patients to the different consultants. Noted that, although this varied within specialties, it was primarily due to historic referral practices.
Although Jan Bloomfield confirmed that profiles of all newly appointed Consultants were distributed to GPs, it was agreed that the Trust should endeavour to promote the range of skills of all consultants to the PCT and its GP practices.
Colin Muge stated that GPs would need such information to facilitate patient choice and agreed that he would liaise with Jessica Watts to see how generic referrals could be encouraged to address demand management. ACTION: CM/JW
17-week Wait for Out-patient appointment
Noted that Rheumatology and Endoscopy were two areas of risk and plans were being developed to address this and ensure the 17 week outpatient target is achieved.
Additional capacity was also being sought to deal with specialist areas such as ENT and Vascular. Mary Jones referred to the additional Staff Grade appointed who would assist with this situation in due course.
Jessica Watts also drew attention to the following:
· Once again, cancer targets were being achieved.
· The Trust was committed to undertaking 160 inpatient and day case procedures for the Norfolk and Norwich Hospital, in the new Treatment Centre
In summary, she asked Board members to note:
· The biggest challenge to the Trust was the A & E target
· The nine-month in-patient target should be met subject to no further increase in demand
· 17 week out-patient wait should be met if the high risk areas were addressed
· The Trust should learn from others in the NSC and aim to achieve “green” on the targets crucial to the star rating assessment
· The waiting list staff and General Managers should be acknowledged for their exceptional hard work in endeavouring to achieve these targets and deal with the increased activity.
Veronica Worrall endorsed this last statement and reinforced her thanks to staff expressed at the beginning of the meeting.
Pam Chrispin queried the NSC data on urgent cancellations which did not correlate with West Suffolk’s evidence. Mark Balaam agreed to check this. ACTION: MB
Post meeting minute: The six urgent cancellations in December were recorded against WSH in error. There were no urgent cancellations in December.
Judith Lancaster asked what contingency plan the Trust had for an unforeseen eventuality. Jessica Watts reiterated that current profiling showed sufficient capacity in February and March 2004 which would allow more flexibility than was possible in January. The Trust has also been mindful of looking at capacity outside the organisation and such discussions are on-going but these do have financial consequences.
Linda Potter added that, as Trust managers were having daily discussions on the activity position, immediate action can be taken to deal with any crisis that may arise.
Veronica Worrall concluded that it was imperative that the Trust was meeting its targets by the end of March 2004 and the next two months were therefore critical.
9.2 Performance Report Layout
Jessica Watts drew attention to the Trust’s development of a balanced scorecard methodology to assist in reflecting the needs of the organisation (preparing for Foundation Trust status) and the current thinking of the Department of Health.
The paper was for information at present but also to demonstrate that progress was being made in this area, with the aim of implementation by April 2004. Particular attention was drawn to objective setting being divided into four quadrants and the need to involve all areas within the organisation.
Mark Balaam added that this was a fairly new philosophy for the NHS but was supported by the Department of Health. It was important that this approach linked closely with the Trust’s application for Foundation Trust status; and the Chairman and Board should have a clear vision of the key objectives to pass on to other Managers within the organisation.
In response to the level of training that is required and will be offered, Mark Balaam confirmed that he had attended a number of workshops but these had been more focussed on the mental health sector.
In response to Judith Lancaster’s comment that there was no comparative data over time, Mark Balaam confirmed that trends and benchmarking would follow and be weighted against targets.
Jessica Watts added that the Trust’s success will be measured against how far it can move towards “live” reporting and using current rather than retrospective data.
Jan Bloomfield cautioned the need to increase resources to capture such data and stated it was imperative the Trust was entirely clear about what it required to manage the organisation. Jessica Watts hoped that depending on the External Performance Management environment there may be capacity that could be utilised post-Foundation Trust status.
John Cullum pointed out the importance of the Trust establishing its own realistic and meaningful targets
Veronica Worrall proposed it would be helpful for Trust Board members to have a workshop dedicated to this process with an external facilitator. She saw the advantage of this methodology in managing the Trust’s business as a Foundation Trust. Jessica Watts believed it may also be helpful to have a contribution from another Trust that had already implemented this methodology.
Mary Jones supported the Chairman’s proposal and suggested one amendment to the Vision for Patients: “to ensure patients receive courteous, timely and appropriate care at all times”.
Agreed that a workshop on Balanced Scorecard methodology should be arranged. ACTION: JW
9.3 Finance Report
Linda Potter presented the Trust’s financial position as at December 2003 and Members were asked to note:
· With the current overspend of approximately £2 million, the end of year forecast was anticipated to be £3.5 million; and the most significant increase in deficit was linked to reduced income from the Treatment Centre.
· Additional income was expected from; the PCT for increased activity; technical adjustment funding by the Strategic Health Authority which will need to be repaid; and an anticipated HSDU stock adjustment of approximately £half-million.
· The Trust will continue to have an underlying deficit but the impact of January activity was not yet known.
Judith Lancaster asked for reassurance that the increased costs related to increased activity; and there was evidence that the Trust had costs under control, including the drugs budget. She also queried what patients would be cared for in the Treatment Centre.
Linda Potter responded that:
· The Trust was controlling costs as well as it could. Some expenditure related to activity carried out earlier in the year and the recruitment of staff for which the income had not yet been received.
· The Trust has taken steps to monitor expenditure where possible i.e. the Expenditure Panel that reviews all vacancies; and centralisation of the IT budget.
· The introduction of a specific drug recommended by the National Institute for Clinical Excellence (NICE) had been introduced in a planned way, in conjunction with the PCT.
· It was evident that non-clinical areas could be monitored more closely than clinical but expenditure over £5,000 could only be authorised by the Director of Finance.
· Discussions were on-going concerning the Treatment Centre case mix and, although 100 hip operations had been planned, the Trust relied on the PCT and Norfolk and Norwich Hospital to refer these patients. They would only refer out of their catchment area if the care could not be provided locally.
Discussion took place on the implications of Patient Choice and it was noted that, although a transfer to West Suffolk may speed up treatment, patients would also take into account the distance to travel and inconvenience for family. Pam Chrispin pointed out that the Trust was currently working with GPS on the periphery and may need to extend their discussions further.
John Cullum referred to the slippage in achieving CRES targets and stated he believed the Trust should aim to achieve these, even if it proved difficult, to avoid similar criticism from the Suffolk Review as eighteen months ago. He also wished to know what the underlying issues were and what assurance the Trust could give that money earmarked for nursing development had not been spent.
Linda Potter explained the Trust’s budgeting arrangements and stressed the impact the Treatment Centre and transitional care beds in G8 were having across the whole organisation. She accepted that, due to the pressures currently being experienced by all staff, CRES targets did not always have priority.
The Trust had a number of options which included a major decision to review the level of activity; and/or rely on payment by results as a Foundation Trust. With current reference costs, the Trust was providing services cheaper than other hospitals. This situation would be rectified if the Trust was successful in its Foundation Trust application.
Jan Bloomfield pointed out that Green and Kessab, when agreeing the CRES targets, had recognised that the organisation was already working very efficiently and would have difficulties in achieving the savings. A considerable amount of management time was being spent on achieving Department of Health targets as well as focusing on how to increase income.
Judith Lancaster believed the Trust should focus on increasing income rather than decreasing expenditure and stated she could not understand why patients would not want to travel if it meant they received quicker care. Veronica Worrall responded that the Trust would need to analyse patients’ requirements and have an open debate with the neighbouring PCT’s.
Jan Bloomfield drew attention to the opening of the new Ophthalmic Clinic in the Treatment Centre the following week. Promotional literature had been prepared and GPs would be invited to visit and hear more about the team and services to be provided.
Nichole Day stressed the importance of marketing the Trust’s services as neighbouring hospitals were also considering developing treatment centres. This would be a key component of the application for Foundation Trust status.
9.4 Local Delivery Plan Progress Report
Linda Potter confirmed that discussions had commenced with PCT colleagues to achieve an acceptable Local Delivery Plan (LDP). It was important for the Trust to show financial recovery; and meet its key targets. Service Level Agreements and local contracts will need to be developed and it will be necessary to follow a strict timetable in order to gain approval from both Trust Boards, before submitting to the Strategic Health Authority.
Colin Muge responded that there was considerable advantage in the close proximity of the two organisations which were working well together to achieve an acceptable LDP. It was anticipated that a joint Briefing would be held on 24th March 2004.
It was agreed that the LDP should be an agenda item for more detailed debate at
the closed Board meeting in February 2004.
ACTION: LP
Linda Potter added that there was still a considerable amount of work to do and a
generic list of cost pressures had been submitted to the PCT and Strategic Health
Authority.
If Foundation Trust status is achieved, the consequences of locally binding
Agreements could not be overlooked.
There were a number of commissioning complications in the coming year but Linda Potter was discussing these with her colleagues.
Veronica Worrall concluded that there was a lot of work in a short timescale which
was crucial to the future of the Trust. Good negotiations and debate necessary with
commissioners. The Trust must be paid for the services it provides.
04/10 STAFF
Consultant Contract Update and Clinical Excellence Awards
Jan Bloomfield reported:
that further work was required with NSC colleagues on the structure of the Clinical Excellence Awards Committee.
Work was on-going with the BMA on the interpretation of the Consultants national contract terms and conditions. Realistic job plans cannot be developed until these are finalised.
All Consultants are completing diaries to be incorporated into the job plans.
When final agreement is reached with BMA there will be a review of programmed activities.
A key debate centres around how the local activity plan can be translated into the Consultants’ job plans
It was anticipated that the end of March 2004 target for all Consultants to have a signed contract would be achieved.
Pam Chrispin congratulated Jan Bloomfield on the sensitive and productive way in
which this process had been handled in the Trust.
10.2 Register of Directors’ Interests
Members received and noted the register of Directors’ Interests prepared in
accordance with the Codes of Conduct and Accountability for NHS Trusts.
10.3 Consultant Appointments
Members received and noted details of two additional Appointments:
Consultant Histopathologist/Cytopathologist to commence 1st May 2004.
Thanks were extended to Mr. Barry Cotterell for his efforts in achieving a full
establishment in this department.
Consultant in Palliative Medicine – start date to be confirmed.
04/11 GOVERNANCE
11.1 Report of the Clinical Governance Committee
Members received a report from the Clinical Governance Committee (CGC) held on
4th December 2004. Judith Lancaster highlighted the following:
Syringe Labelling Risk Assessment - lessons learnt from the introduction of new syringe labelling demonstrated the importance of team briefing to ensure all staff
were made aware of critical issues.
NICE - A procedure was to be implemented to enable the Board to be notified of
NICE recommendations and implications of implementing.
Suspension of Clinical Staff - It was encouraging to know that the Department of
Health had no concerns about the Trust’s process.
Jan Bloomfield added that the Trust’s policy and procedure would be revised in the
light of new guidelines, which would be discussed with the BMA in the first instance.
11.2 Organisational Risk Committee
Members received a report from the Organisational Risk Committee (ORC) held on
10th December 2003. John Cullum highlighted the following:
Missing Patients - Extension of this policy to Sudbury Hospital was delayed due
to staff’s involvement in the Foundation Trust application. Nichole Day agreed to progress this matter. ACTION: ND
Violence and Aggression - The Committee had noted the conflicting views within the organisation on how to deal with security issues and agreed that additional training was required in high risk areas. Appropriate guidance was also required as to when the police should be called and a report would be submitted to TMT in due course.
Jan Bloomfield added that a fully costed Training Plan had been considered by TMT which will be incorporated in the Trust’s overall business plan. The Director of Facilities would now take the lead on Zero Tolerance with support from the Director of Personnel. Although it was pleasing to note there were not many violent incidents at the hospital, such incidents would not be tolerated by the Trust.
11.3 Joint Modernisation Steering Group
Members received and noted the Notes of the Joint Modernisation Steering Group
held on 11th December 2003.
Clarification was requested on statements regarding an expectation that SMTs achieve 10% savings when the £1million quoted was also classed as an assumption. Linda Potter responded that some SMTs may achieve more than 10% and this was considered an average.
04/12 SEALING OF DOCUMENTS IN REGISTER
Members received and noted documents nos.52 – 61 sealed in the Trust, in the
presence of the Chairman, Chief Executive and former Acting Chief Executive.
04/013 ANY OTHER BUSINESS
13.1 Treatment Centre
Jan Bloomfield advised members that an official open evening was scheduled for
Tuesday 3rd February 2004 from 6.30 – 9.00 p.m. Invitations had been extended to
the general public and GPs to visit the new Centre.
In addition, a document called Advance had been produced to promote the skills of the staff working in this Centre; copies were being circulated to all GPs and the community generally. Colin Muge suggested that this circulation be extended beyond the immediate vicinity.
ACTION: JW
Jan Bloomfield also proposed discussing with the media a promotional feature for the Bury Free Press and/or East Anglian Daily Times.
13.2 Staff Survey
Jan Bloomfield advised that a 61% response had been achieved to a recent staff
survey. This response would contribute towards the Trust’s star rating
assessment and Improving Working Lives policy.
A full management report would be presented to the Trust Board in due course.
ACTION: JB
13.3 Arts Co-Ordinator
Jan Bloomfield advised that the Trust would be submitting a request to the Arts
Council for an Arts Co-ordinator. This national charity, which promotes paintings in
Hospitals, has selected West Suffolk Hospital as a suitable location for displaying
50 – 60 pieces of work. She was optimistic that the Trust’s application would be
successful for this Co-ordinator who, although based in West Suffolk, would have a
Regional remit.
13.4 Public Participation
The following issues were raised by Mr. Geoff Milton, general public representative:
Patient Forum - noted that there was no representative present.
Foundation Trust application - how could this be obtained if the Trust did not achieve financial balance?
Linda Potter reiterated the actions being taken by the Trust and stressed the importance of payment by results in accordance with a national tariff.
Agreed that Jessica Watts should discuss the application for Foundation Trust status process and star rating implications with Mr. Milton in more detail after the meeting. ACTION: JW
Mr. Milton also asked that Trust Board members and staff be mindful of terminology and the use of acronyms when preparing documentation for the general public’s understanding. Jessica Watts agreed to address this issue. ACTION: JW
Patient Choice – confirmed that this process would start with the GP and there was a lot more work needed. Veronica Worrall agreed it would be helpful for the Trust to have feedback from patients themselves.
Stella Jackaman added that she would be willing to assist with the dissemination of information from the Trust in a Newsletter circulated to over 300 people.
13.5 Media Reporting
The status and availability of the reports presented to the Trust Board was clarified
for the reporter from the Bury Free Press.
04/14 DATE OF NEXT MEETING
Friday 27th February in the Committee Room at 10.00 a.m.