30th Meeting of the Council of Governors

6th September 2013

11.15am-1pm Holiday Inn, Bexley

Chair: Dave Mellish

Trust Secretary and Head of Governance: Ann Rozier

Public Governors / Service user/ carer Governors / Appointed Governors
Stephen Brooks / Julian Baker / Alan Downing
Richard Diment / Richard Comaish / John Fahy
Amanda Finlay / Rob Hayles / Maureen Falloon
Jennifer Grant / Jenny Kay / Eleanor Jones
Eimear Mallen / Chris Purnell / Carl Krauhaus
Steven Turner / Steve Seabrooke / Raymond Sheehy
Ken Thomas / Malcolm Wood
Anne Voce
Staff Governors
Marcos Da Silva / Kaye Jones

In attendance:

Non Executive Directors / Executive Directors /

Guests and Presenters

Archie Herron / Helen Smith / Anna Blackman PWC
Anne Taylor / WilfBardsley
Steve James / Simon Hart
Ben Travis
Item /

Action

1. / Apologies
Alan Cork, Steve Davies, Judith Ellis, Maggie Grainger, Scott Hunt, Raymond Pope, Judy Wolfram,John Woolgrove,Stephen Firn, James Kellock, Michael Witney, Estelle Frost, Iain Dimond. / Noted
2. / Minutes of the last meeting of the Council of Governors
Page 2, item 5 – line 9 service users can have access. / Agreed
3. / Matters arising
Page 2 Item 5 – Care coordinators are expected to support service users with accessing local facilities for advice on welfare benefits.
AF – The Low Commission consultation recommends that all CCGs and NHS Trusts look at the leading examples of where services for advice have been commissioned and this has led to better health outcomes. Many vulnerable people still don’t have access. Rather than provide services in house these services could be commissioned e.g. Sheffield NHS mental health. / Noted
4. / Nominations Committee - Reappointment of Archie Herron
The Nominations Committee met on 3rd September 2013 to review the process followed by the Chairman for the reappointment of Archie Herron as Non-Executive Director for a final three year term of office. Having reviewed the submitted documentation (attached) the Nominations Committee were satisfied that the appropriate process had been followed.
Governors were in favour of the reappointment. / Approved
5. / External Audit Report to the Council of Governors
Anna Blackman from PWC gave an overview of the Annual Auditors Report to Governors (ISA 260). Audit opinions were issued in regard to the Directors Remuneration Report, Annual Governance Statement and Quality Report. Work was conducted in areas of judgement e.g. valuations and liabilities and accounting standards. No concerns were identified.
SS – The three unadjusted items seem to all be examples of being over-prudent. / Noted
6. / Lessons learned from incidents and DM action plan
DM introduced the item stating that this was an opportunity to discuss concerns raised by governors in regard to repeated recommendations in serious inquiry reports and organisational learning.
JE presented the action plan arising from the inquiry report presented to governors at the last meeting. The actions following the recommendations from the Board Level Inquiry are detailed below. Progress will be monitored at the Trust Patient Safety Embedding Learning Meeting.
  1. Protocol to be put in place within acute inpatient areas to cover arrangements for unescorted leave including expected time of return, communication process and actions to be taken in the event of non-return.
An at a glance board in the ward office has been updated to include expected time of return for all patients on leave and there is a weekly audit of observation sheets. The protocol is in place and the Trust PAN London AWOL meeting was scheduled for 27 August 2013.
  1. There should be an early involvement of specialist services in discussion of treatment choices including suitability of referral to the SlaM MBU for anyone admitted with post-partum or perinatal mental health needs.
The contracts for services to access the SLaM Mother and Baby Unit (MBU) have been operationalised and guidance on access to specialist services have been disseminated via the Clinical Effectiveness Group (CEG). There have also been two well attended joint ‘Embedding the Learning Events’ with SLaM MBU.
  1. When a safeguarding referral is agreed by a ward team or in a ward round then a named member of staff to be allocated to complete the referral within 24 hours and a progress note made recording this fact and the destination to which the referral has been sent.
The revised pre ward round nursing summary includes safeguarding referral information and referrals are monitored by the safeguarding children quarterly monitoring report.
  1. A laminated sheet with a list of clinical details required by the LAS and the unit’s address and postcode to be placed by the main ward phone in all wards and the presence of this sheet becomes the responsibility of a named member of staff.
This information has been circulated to all inpatient services and is also provided to all staff attending the Basic Life Support Training programme.
  1. Staff should be reminded that, (where possible), LAS send two crews to an incident when cardiac arrest is suspected, so that staff must be ready to allow a second crew into the unit.
This has been included in the “What to do when calling 999” poster and reinforced in the resuscitation training programme.
  1. Following a resuscitation event, if requested by the ambulance service, a member of staff should accompany the patient to A&E, to ensure relevant information is provided.
This has been included in the “What to do when calling 999” poster and reinforced in the resuscitation training programme.
  1. Nursing staff supervision should place emphasis on shift coordinators being informed when any significant event occurs in the care of a nurse’s allocated patient, so it can form part of handover information.
The handover template has been revised to include this information.
WB gave a presentation on common themes from national and local serious incident inquiries:
•Assessment and formulation of risk
•Management of substance misuse
•Sharing information
•Listening to concerns from others
When staff make a mistake we need to drill them in their practice. When systems fail patients and staff, organisational learning becomes paramount. In Oxleas there is a governance structure around safety. The Patient Safety Group meets regularly to review incidents and there is a very well attended Embedding Learning event looking at serious incidents every 2/3 months. This is led by Dr Peter Jarrett, consultant psychiatrist who is the Trust’s dedicated clinical lead for patient safety. His remit is to support investigations and ensure learning.
SS – We also need intelligence gathering from outside the Trust.
WB – Dr Jarrett and the Head of Patient Safety, Bryony Robertson, are members of various patient safety networks.
HS – We could invite Dr Okocha, Medical Director to a future meeting to speak about how the Trust is alerted to good practice.
EM – Are commissioners prejudiced against voluntary organisations making bids for lower levels of need, generally?
WB – All CCGs will have their own priorities. All sectors are working hard to build relationships with the voluntary/ third sector. Specialist commissioners will look at specialist services e.g. mother and baby units. We need to continue to work with commissioners.
RS – Pleased to see a trend toward better information but point 7 (action plan - handover) was a surprise.
WB – Significant work has been done around handovers and governors can be assured that we continue to work to make this effective.
AF – Recommendations 4,5 and 6 – the need for these recommendations is worrying as it should be expected that staff remain calm and professional in these circumstances.
WB – Resuscitation situations are very rare in our services but nurses do need to be ready. We need to ‘drill’ staff regularly using a ‘dummy’ to enact this situation.
BR – The aide memoire was not around resuscitation as this was carried out well. The problem arose because of the postcode not being known.
ST – It is astounding that the London Ambulance Service could not find a building on an acute hospital site without a postcode.
KT – Some reports show that drugs and alcohol are taken by patients when they are unescorted leave. What can we do about this?
WB – We aim to ensure that staff have a conversation with the service user about support and what is acceptable behaviour. Teams need also to deal with the risks that may arise from this e.g. suicidal behaviour. / Noted
7. / Election results
We have the election results for:
  • Public: Bexley – Mai Wells
  • Public: Greenwich – Dalla Jenny and EimerMallen
  • The Public: Bromley vacancy was elected unopposed – Martin Gaylard
  • Service User/Carer: Working Age Adults–Lesley Smith
  • Service User/Carer: Learning Disabilities – Hugh Morgan
  • Service User/Carer: Children and Young Peoples Services – FolaBalogan
  • Service User/Carer: Adult Community Health – Katherine Copley and Tim Humphrays
  • Service User/Carer: Older Adults Mental HealthJenny Kay and BaetiMothobi
  • Staff: Greenwich Community Health Services – Mary Titchener
  • Staff: Working Age Mental Health - Barbara Cawdron
Richard Comaish and Steve Turner were not re-elected. Thanks go to them both for all their hard work. Steve Seabrooke has stood in the Service User carer: Carers section and the results of this will be known in October.
We had no nominations for:
  • Staff: Bexley Community Health Services
  • Staff: CAMHS
  • Staff: Older Adult Mental Health.
These vacancies, and the new Service User/Carer: Carers vacancy, are currently going to election and will be reported at the December meeting.
The Nominations Committee are considering the term of office for governors and if each term is sufficiently long enough to take full advantage of the experience gained over 3 years. To come back to the meeting. / Noted
AR
DM
8. / Annual Plan Progress Report
The Trust Board and Council of Governors approved the Trust’s three-year service development strategy (2013/14 – 2015/16) at their meetings in March 2013.Three overall priorities were identified in the strategy. The tables describe some of the work programmes that are underway to deliver the priorities. A number of the work programmes meet more than one priority (eg., the nursing strategy), although are only shown against one priority in the table.
The three priorities in the SDS are:
  • Enhance quality: offer a guarantee of excellence for every patient
  • Promote innovation: redesign services with patients, families and commissioners
  • Increase productivity: be resilient and resourceful to thrive in difficult times
Every quarter each service director meets with SF, HS and Corporate Directors to go through their plans for delivering on these strategic priorities. The progress document shows the sorts of work programmes underway.
There are many more programmes of work in addition to these, for example, our Quality and Safety Improvement Plan, CQUIN, compliance and performance programmes. / Noted
9. / Chief Executive Update
We have been shortlisted for 2 prestigious awards:
  • National Pioneer Awards: An initiative to promote integration across the health economy. We put in a bid in Greenwich and it seems we are the only ones in London. Bidding ‘Pioneers’ will need to demonstrate that they have truly integrated services across all agencies. We have been shortlisted to the final ten from a pool of 111 applicants. Interviews will take place on 11 September and we should know the outcome by 19 November.
  • In the Health Service Journals annual awards we have been shortlisted for Provider of the Year and Staff Engagement. We will know the outcome in November.
/ Noted
DM reminded Governors that the Annual Members Meeting is being held at the O2 on the 11th September 2013
Time and Date of the next meeting
3pm- 5pm 12th December 2014
Applegarth Suite, Marriott Hotel
Bexleyheath
3.00 – 5.00pm

I confirm that the minutes of the Council of Governors meeting of 6th September 2013 are a true record

SignedDate:

Dave Mellish Chairman

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H:\ROZIERA\COUNCIL OF GOVERNORS\Council Meetings\2013\12th December 2013\PART 2 - Minutes of the 30th Meeting of the Council of Governors.docx