25th Meeting of the Council of Governors
21st June 2012
3pm – 5pm Applegarth Suite, Marriott Hotel, Bexleyheath
Chair: Dave Mellish
Trust Secretary and Head of Governance: Ann Rozier
Public Governors / Service user/ carer Governors / Appointed GovernorsStephen Brooks / Bob Bedwell / John Fahy
Ann Lucas / Richard Comaish / Dennis Crapnell
Raymond Pope / Alan Cork / Raymond Sheehy
Judy Wolfram / Jenny Kay / Malcolm Wood
John Woolgrove / Chris Purnell
Stephen Seabrooke
Mary Stirling
Anne Voce
Staff Governors
Scott Hunt / Kaye Jones
In attendance:
Non Executive Directors / Executive Directors & Directors /Guests and Presenters
Archie Herron / Stephen Firn – Chief Executive / Michael Asbury, Greenwich LINkSally Jacobson / Helen Smith – Executive Director / John Bell, Bexley LINk
James Kellock / Ben Travis - Executive Director
Anne Taylor / Trevor Eldridge - Director
Stephen Whitmore – Director
Item /
Action
1. / ApologiesJulian Baker, Amanda Finlay, Maggie Grainger, Rebecca Linton, Eimear Mallen, Shelley Ratcliffe, Ken Thomas, Julian Thornington, Steven Turner. / Noted
2. / Minutes of the last meeting of the Council of Governors
Item 4 – EM asked how many incidents led to disciplinary action being taken against staff. WB informed Governors that the NE case had led to disciplinary action for two members of staff.
Subject to the amendment the minutes were agreed as an accurate record. / Agreed
3. / Matters arising
Item 4 – Serious Incident. The plea hearing is scheduled for Friday 22nd June and it is expected that the trial will be held in early July. TE assured Governors that the issue of access to RiO for staff at QueenElizabethHospital has been resolved.
Item 6 - Crayford Centre. SF met with service users and staff to confirm 12 months notice last September. There is a concern about a letter sent from Bexley Business Support Unit stating that the reason for the closure was that there was no alternative accommodation. As previously reported to the Council of Governors, this is not the case. Park Crescent is available if Crayford Centre closes. The closure will be postponed until after the review has been completed. SF has written to Commissioners and will be speaking to staff tomorrow.
Item 11 – National Staff Survey. CP asked if there had been any further information about the question of physical violence from staff on staff.
SF – These were very small numbers and we have spoken to Staff-side and looked through reported incidents without finding any evidence. If there had been any assaults on staff by staff we would act but this has not been reported. / Noted
4. / Nominations Committee
DM left the meeting room and AH took the Chair for this item.
The Nominations Committee of the Council of Governors met on the 10th May
2012 to consider the reappointment of the Chairman for a further three year termof office. The Committee was comprised as follows:
· Raymond Sheehy Appointed Governor (Lead Governor and Chair)
· Chris Purnell Elected Governor (Service User & Carer)
· Judy Wolfram Elected Governor (Public Greenwich)
· John Woolgrove Elected Governor (Public Bromley)
· Eimear Mallen Elected Governor (Public Greenwich)
· Maggie Grainger Elected Governor (Staff - Corporate and Partner)
Simon Hart, Director of HR & OD and Anne Taylor, Senior Independent Non ExecutiveDirector were in attendance. The Committee considered the assessment process of the performance of theChairman as carried out by Anne Taylor. A questionnaire was submitted to allvoting executive and non executive directors who were able to provideconfidential responses. A further questionnaire wassubmitted to the Deputy Chair of Governors who consulted as widely as possible togive a view of the Chair’s performance from the point of view of the governors ofthe trust. The Committee was satisfied with the assessment process followed butrecommended that future assessments be enhanced by asking all governorstheir opinion via a short questionnaire. The Chair’s strengths and areas for improvement were noted in the enclosed report.
The Committee was unanimous in its wholehearted support of thereappointment of the Chair. The Council of Governors agreed the recommendation of the reappointment of the Chair for a further three years.
DM returned to the meeting and thanked governors for their continued support and said that he would work on the suggested improvements to the meetings with AR. / Agreed
5. / Feedback from Governors Away Day – Health and Social Care Act
RS gave a summary of the day. John Coutts from the Foundation Trust Network gave a presentation on the 2012 Act: Governor roles and responsibilities. ResearchNet led a session in the afternoon to identify skills and contributions of Governors. Once the write up of the day has been completed by Researchnet, this will be distributed to governors.
DM – Capsticks solicitors gave a similar presentation to the Board covering the changes and implications of the Act. It was the unanimous wish of the Board of Directors to have a representative body comprising of Directors and Governors to discuss the implications. A meeting is planned for July(Please Note: Due to delays in regard to constitutional issues, the proposed joint meeting in July will now take place in early September). The outcome of the meeting will be fedback at the September meeting with an action plan developed for December.
CP – The point of ‘Approve/not approve proposed increases of non-NHS income of more than 5% of income’ – will governors receive a report?
DM – Yes, but currently there are none to report.
SB – In regard to Chair/NED remuneration, is there any external guidance on this?
DM – Remuneration was last considered by governors in 2006.
SJ – There is national information on NEDs remuneration.
SS – Private Patient Income – At the moment NHS work is covered by the NHSLA scheme. Non NHS work will need to be considered in terms of risk. / Noted
6. / Community Interest Company
BT gave a presentation on the new Community Interest Company, ‘SEEC’, set up by the Trust. SEEC is 100% owned by Oxleas. Its primary aim is to support ‘job ready’ Oxleas service users and carers into paid employment. It will act as a recruitment agency to place users with local employers in either a permanent or temporary paid capacity. It is committed to improving the quality of life, confidence and self esteem of service users by facilitating them to re-engage in paid employment. The Trust’s social inclusion team will manage the links between SEEC and Oxleas services.
A feasibility study identified 32 local companies interested in engaging SEEC’s services. The selection process to identify a partner organisation to provide the recruitment services has been completed. Twining Enterprise, a third sector charity with experience of achieving and maintaining service user employment has been selected as preferred partner. Oxleas Board approved £150k interest free start up funding in the form of a loan to SEEC. The next steps for the project are to register as a Community Interest Company, finalise the provider contract and recruit to key management roles. The recruitment of “job ready” service users and carers will take place over summer 2012. The official launch will be in October 2012.
MA LINKs – Will there be a charge and how does this relate to the Volunteer to Work (V2W) scheme?
BT – Yes, employers will be charged just as any other recruitment agency. The Social Inclusion team are managing this so it will relate to V2W.
JK – Will this cover all types of employment; not just filling shelves?
BT – Yes, it will deal with all types of jobs and it will be available to patients across all our services.
AC – Who will support service users to be ‘job ready’?
SJ – We are hoping that SEEC will make enough money to buy in training.
AC – If SEEC is a separate entity, will it have its own base/ Head Quarters?
BT – We are looking at this currently. We need to make this as accessible as possible. Discussions are taking place on how we may hold sessions in each borough.
RP – There needs to be a focus on the successful application of terms and conditions of employment. Is it Twining’s role to ensure compliance? Who will be responsible for salaries and NI contributions?
SJ –Employers will be recognised employers. The terms and conditions for our service users need to be the same as other employees. It will be the manager’s job to ensure good practice. We will keep in contact with the service user for the first 6 months of employment and any problems encountered will be reported.
MW – Bromley MENCAP expressed an interest in this. We would like to bring our expertise to the table. We hope that this is not a missed opportunity.
DM – This is a generous offer. We would welcome your support.
JK – Was interest spread equally across all boroughs?
BT – I do not have the details to hand but there was a good response.
SS – What rules do Community Interest Companies work to?
BT – I will share the advice we have received in regard to this.
DM - The potential of this project is good. It would be useful to receive updates at future Council of Governors meetings under the Social Inclusion agenda item. / Noted
BT
7. / Social Inclusion Update
Apologies have been received from Julia Vater, Events Coordinator who was to give a presentation on the Health Festival. MS is no longer part of the Social Inclusion group. SB gave a brief update. The group has been kept up to date with the progress on the Community Interest Company. The Health Festival had 400+ attendees and there were various stalls. The demand for ResearchNet’s services is increasing. A scheme for peer support for Oxleas’ clients is being developed.
SF – Ian Dimond, Director of Complex Needs and Recovery gave a presentation on peer support to Executive Directors and would be glad to present at a future Council of Governors. DM to invite.
SB – Ian Dimond has shown great interest and attends most meetings in support of social inclusion. / Noted
DM
8. / Patient Experience Update
AL gave the update for Patient Experience. Volunteers are needed to attend the Directorate Patient Experience Groups to talk about the outcomes of the visits. Service Users and Carers need to know what has been done. 3-4 visits have been organised plus 2 in Older People’s Services in Bromley. Podiatry is being revisited to establish what has been changed since the first visit. Many questionnaires have been completed and we now need to analyse these to identify themes/ trends. More volunteers are needed to carry out the questionnaires. Governors interested to contact AR.
TE thanked governors for their hard work on the OPEQ initiative. This work enables managers to think more critically about how services are delivered.
TE presented the actions taken following the questionnaires in Betts Ward, Bromley SIT, Millbrook Ward and Shrewsbury Ward.
The issue of Nurses should spend more time with clients and less time in the officeis a common theme. At least 25% of staff time was being spent on essential administrative tasks. We found that unqualified support staff were doing the relationship work and we wanted to change the balance of this. Discussions were had with the ward manager and staff to conduct a pilot on Shrewsbury ward where the unqualified staff spent more time in the office and nurses spent more time with patients. The result was a much calmer ward with fewer incidents, less restraint used and improvement in the recording of conversations. The higher quality interactions are leading to better quality care plans.
Following the comment, ‘I think reception staff need better communication and confidentiality skills’, the Estates and Facilities department are looking to redesign and improve access to the reception area at Stepping Stones and are contacting other service directors to ensure that reception areas are accessible and meet the needs of our service users/ carers. A number of customer care training courses are also being considered.
Services users on Betts Ward said; “We need more activities to do on the ward”. There is a gap in the perception of staff and service users. To overcome this we have set up a co-design project which is being supported by Researchnet. A DVD of what patients say is being shown to staff so that both can work together on a solution.
All of the reports coming out of the interviews are discussed at the Patient Experience Group and feedback can be given to those involved in OPEQ.
MA LINKs – Some supporting work is being done by LINKs. We need to balance results with the nature of the wards.
KJ – Has feedback from Health Care Assistants (HCA support workers) on Shrewsbury Ward been received?
TE – HCAs now better appreciate the work that was being done by nurses in the nurses’ station.
AL – Natalie needs to get in touch with LINKs as we would want to coordinate with/ understand their programme of work.
DM – The presentation shows that Oxleas are getting better at effecting change as a result of the questionnaires and we need to increase the number being carried out. The new Care, Compassion and Engagement work will be presented in detail to the Council of Governors in September. / Noted
TE
9. / Psychological Therapies Board Update
RP gave the update for the Psychological Therapies Board. The Board is chaired by the Director of Therapies, Dr Michael Witney. 15 people attended the meeting and there was a comprehensive agenda for discussion and review. Highlights were:
Priorities for 2011 were:
- NICE guidelines compliance (Borderline Personality Disorder; Obsessive Compulsive Disorder; Bi–Polar Disorder; Anxiety; Post Traumatic Stress Disorder)
- Family Inclusive Practice training
- Increase number of patients by 10%
- Caseloads and waiting times monitoring
- Referrals to treatment reports now generated are: sensitive waiting time length; differentiate assessment or therapy; establish point of discharge; establish who cancels.
- Access to psychological therapies
- Mainstreaming psychological therapies
- Improving services for patients who present with personality disorder
- Developing health psychology in our integrated organisation
- High priority: group skills; family intervention for psychosis; mentalization based therapy (BPD), mindfulness CBT (depression)
- Medium priority: CBT group supervision; eye movement desensitisation; reprogramming therapy; non violent resistance (for families in CAMHS)
10. / Feedback from the Membership Committee
SS gave feedback from the Membership Committee. There have been 2 meetings since the last Council of Governors where the Strategy was approved. Targets and achievements were highlighted. The Committee also monitor ethnicity and gender as per Monitor’s requirements. Targets are slightly below trajectories but this has been hampered by the weather and some data cleansing. There is substantial over representation of female members.
The introduction of associate membership has been an overwhelming success. There are now 36 associate members which are mostly 3rd sector agencies. 5 associate members were recruited on one day at the Health and Wellbeing Festival. Also, supermarkets are turning out to be successful venues to sign up members. We will be attending the Danson Festival on the 7th and 8th July.
Work is being carried out on ‘branding’ items such as information on membership and links to social media. Engagement events are work in progress.
RC – One reason for the gender imbalance is that there is no family membership.
SF –BME members are not being attracted to standing for Governor. This needs to be promoted.
AL – There is no Irish category on the analysis.
SS – We are using Monitor’s categories for BME monitoring.
CP – Gypsy Travellers are also omitted
DM thanked SS and the Committee. Reports and presentations will be circulated.
11 / Chief Executive Update
New directorate structure
There will be a new directorate structure from the 1st October 2012. Adult community health services in Greenwich and Bexley will combine into one directorate and children’s specialist and universal services (including CAMHS) will also be brought together into one directorate across both boroughs. Adult Learning Disability services, previously joined with CAMHS will move to Complex Needs and Recovery. This is a management restructure and does not affect patients. The consultation with staff showed that people were overwhelmingly in support of the new structure. There will be a smooth transition between the 1st June and 1st October. The restructure enables better integration and substantial savings.
Tender update
We have been successful in our bids for Greenwich Specialist Children’s Service – starting1/7/12 and Kent CAMHS Tier 2 & 3 (sub-contract) with Sussex FT. Sussex is the main contractor with Oxleas providing some specialist services.
Tenders in progress are Supported Housing Greenwich MH (Oxleas currently provides) and Bexley Psychological Therapies. We are also bidding to be added to the list of ‘Any Qualified Provider’ (where patients choose who to receive treatment from) for Psychological Therapies –NHS Kent & Medway, musculo–skeletal service – Eastern & Coastal Kent and Continence Service around 12 London Boroughs and Greenwich, Lambeth,Southwark,Lewisham.
Monitor ratings
For Quarter 4 Oxleas was rated 5 for Finance and Amber-Green for Governance. The Trust did not meet the 23 week referral to treatment target in specialist foot surgery (16 patients) due to restricted access to theatre space at SLHT. From the 1st April this target has been changed to 18 weeks. Because of the backlog we have breached the 18 weeks in Quarter 1. There is also a new target around all people waiting for consultant led clinics including sexual health, dentistry and paediatrics). There are booking issues in Community Paediatrics and procedures needed to be more robust. Currently performance stands at 86% and we are confident that performance will be on track by the end of June.
Local commissioning update
The first stage of the Clinical Commissioning Group (CCG) authorisation process is to appoint an Accountable Officer.