COUNCIL OF GOVERNORS’ MEETING
WEDNESDAY, 27TH FEBRUARY 2013
AT 1.30 PM – 4.00 PM
Ground Floor Meeting Room, Nowgen Centre, MRI
NOTES OF MEETING
PRESENT:Peter Mount / Chair - Chairman
Governors – Public Constituency: -
Ivy Ashworth-Crees / Greater Manchester
Professor Malcolm Chiswick / Lead/Trafford
Lawrence Cotter / Rest of EnglandWales
Richard Jenkins / Rest of EnglandWales
Alexena Morrison / Manchester
Dr Keith Paver / Manchester
Bernice Reid / Manchester
Sue Rowlands / Manchester
Helen Scott / Manchester
Sue Webster / Manchester
Governors – Staff Constituency: -
Sharon Green / Nursing & Midwifery
Beverley Hopcutt / Other Clinical
Isobel Bridges / Non-Clinical & Support
Mary Marsden / Nursing & Midwifery
Mr John Vincent Smyth / Medical & Dental
Governors – Nominated Partner Organisations: -
Councillor Rabnawaz Akbar / Manchester City Council
Julie Cheetham / Central ManchesterClinical Commissioning Group
Professor Peter Clayton / University of Manchester
Angela Harrington / Manchester City Council
Professor Gillian Wallis / University of Manchester
IN ATTENDANCE:
Sue Allison / Director of Corporate Services/Trust Secretary
Darren Banks / Director of Strategic Development
Dr Ivan Bennett / Clinical Director (Central Manchester Clinical Commissioning Group)
Lady Rhona Bradley / Non-Executive Director
Mike Deegan / Chief Executive
Stephen Gardner / Project Director (Trafford Healthcare Trust Acquisition)
Cheryl Lenney / Director of Nursing (Adults)
Anthony Leon / Deputy Chairman/Non-Executive Director
Anthony Middleton / Director of Performance
Steve Mycio / Non-Executive Director
Dave Pearson / Director (Clinical & Scientific Services)
Mr Robert Pearson / Medical Director
Yvonne Rogers / Associate Director of Human Resources
Danielle Scapens / Communications Officer (Corporate Services)
Sam Simpson / Director of Operational Finance
Tony Ullman / Head of Commissioning & Quality (Central Manchester Clinical Commissioning Group)
Derek Welsh / Executive Director of Human & Corporate Resources
Public/Members: -
Mark Holden / Member of Public
David Rappin / Member of Public
Usamah Shafi / Staff Member
Sarah Dodgson / Staff Member
NOTES PREPARED BY:
Donna Beddows / Foundation Trust Membership Manager
APOLOGIES:
Governors: -
Dr Syed Nayyer Abidi / Public (Greater Manchester)
Councillor Dr Karen Barclay / Nominated (Trafford Borough Council)
Jayne Bessant / Public (Manchester)
Dave Brown / Public (Manchester)
Abu Chowdhury / Public (Manchester)
George Devlin / Public (Trafford)
Peter Dodd / Public (Manchester)
Matthew Finnegan / Public (Trafford)
Mariam Gaddah / Nominated (Volunteer Services)
Dr George Kissen / Nominated (TraffordClinical Commissioning Group)
Margaret Parkes / Public (Manchester)
Farhana Naseem / Nominated (Youth Forum)
Lynne Richmond / Public (Greater Manchester)
Jenny Scott / Nominated (Specialised Commissioning Group)
Board of Directors: -
Professor Rod Coombs / Non-Executive Director
Gill Heaton / Executive Director of Patient Services/Chief Nurse
Adrian Roberts / Executive Director of Finance
Brenda Smith / Senior Independent Director/Non-Executive Director
The Chairman opened the meeting by thanking all present for attending.
Agenda Item 2.1: To Approve the Minutes of the Council of Governors’ Meeting held on 17th October 2012The minutes of the Council of Governors’ Meeting held on 17th October 2012were approved as being an accurate record.
Decision: Noted / Action by: N/A / Date: N/A
Agenda Item 2.2: Actions and Matters Arising from Previous Minutes
Actions from Previous Minutes: -
Trust’s Equality & Diversity Work Programme Update to be provided to Governors.
The Chair informed Governors that the above update would be provided at the next Council of Governors’ Meeting scheduled for 3rd July 2013.
Decision:
Trust’s Equality & Diversity Work Programme Update to be provided to Governors / Action by:
Derek Welsh / Date:
3rd July 2013
Agenda Item 3: Chairman’s Report
The Chairman provided a verbal report with the following points being highlighted: -
- Governors were invited to review the summary Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry paper (tabled at the meeting). The report was prepared by the Clinical Effectiveness Team following the findings of the inquiry led by Robert Francis with the Trust currently reviewing the290 recommendations made (Francis Report). From these a subset of recommendations will be developed from which the Trust will establish an action plan which will be presented to Governors. Attention was drawn to the problems experienced at Mid Staffordshire which were felt to be compounded by a lack of medical professionals escalating and/or reporting incidents coupled with Senior Management not listening to patients/carers who were voicing their concerns (complaints).
- Governors’ Annual Planning Workshop – thanks and appreciation were forwarded to Governors who recently attended the workshop (20th February 2013). The workshop, facilitated by Adrian Roberts (Executive Director of Finance), provided a very real opportunity for Governors to put forward their comments and suggestions in relation to the Trust’s Annual Plan (2013/14) with Governors actively contributing and adding valuable comments towards its development. At the workshop, a presentation was also provided to Governors on the new Health & Wellbeing Boards (Ged Devereux, Project Lead, North West Transition Alliance Health and Wellbeing Board).
- Governor Effectiveness Annual Report (2012) – in order to assess the effectiveness of Governors, an annual report has been produced outlining the actions driven by Governors (during meeting attendance) over the course of 2012. From these actions (over 200 in total) the corresponding benefits and outcomes have been assessed to reveal that the Council of Governors is effectivelydriving actions to improve both patient and staff experiences in addition to raising issues on behalf of members. In addition, the report also reveals that the Trust is committed to providing Governors with the knowledge and skills to fulfil their role and provides regular updates, presentations, information, training and actively encourages Governor development.
- Attention was drawn to a document recently circulated to Governors from a public member (Martyn Lewis) which describeshis patient journey through the Manchester Royal Infirmary and highlights problems in relation to a lack of “joined up services”. The points raised are being reviewed by Cheryl Lenney (Director of Nursing – Adults) and will be taken forward by the Governors’ Patient Experience Group. Professor Malcolm Chiswick (Lead & Public Governor) will also be responding directly to the member.
Decision: Noted / Action by: N/A / Date: N/A
Agenda Item 4: Chief Executive’s Report
4.1) Assurance and Risk Report
Mike Deegan, Chief Executive undertook the risk report section of the presentation.
The following areas were discussed in detail: -
- Current High Level RisksIncluding Actions to Mitigate Risks:
- Risk – Failure to achieve Infection Control Targets 2012/13
- Risk - Failure to attain level 3 accreditation of NHSLA General and Maternity risk management standards
- Trafford Hospitals HSMR and SHMI
- Quality of Patient Record
- Trafford Service Redesign
- Risk – Failure to achieve improved response to staff survey and staff engagement rates
- Risk – Transition to the new commissioning landscape.
Clarification was sought in relation to the staff survey return rate specifically those areas of the Trust that have a higher return rate than others. In response, previous surveys have historically revealed a low return rate from Sodexo staff however this year’s survey has seen an overall increase to 23% (was previously 10%) with most areas having had a return rate of around 40% on average. Of note, the Research and Innovation Division achieved the highest return rate of around 60%.
Clarification was sought as to whether the Trust’s A & E waiting timesshould be considered as a risk. In response, hospitals have ongoing challenges in achieving the A & E waiting times target i.e. 95% of patients to be seen (admitted, treated or discharged) within 4 hours with the Trust achieving compliance for Q1, Q2 and Q3(2012/13). Of note, difficulties have also been experienced in surrounding hospitals as a result of the significant number of patient attendances, however recent attendance rates havestabilised. Issues in relation to the broader healthcare footprint (community setting)are ongoing with the Trust progressing plans in order to equalise performance.
Clarification was sought as to whether the risk management process currently being undertaken is appropriate for the future as a consequence of the findings from the recent Francis Report i.e. “Trust managing the right risks”. In response, the Clinical Effectiveness Team which leads the risk management process has reviewed the Francis Report and its recommendations. From this review, it isanticipated that no resultant body of work will beunexpectedand will undoubtedly focus upon patients with the Trust already firmly putting patients at the heart of what it does. The report also focuses upon the culture of the organisation and its leadership rather than specific work streams. In addition, the report places huge emphasis on nursing and its practices.
Of note, the Government’s response in relation to the recommendations to be taken forward is awaited and Gill Heaton (Executive Director of Patient Services/Chief Nurse) is attending aconference regarding the report findings. Further updates will be provided to Governors on a regular basis.
4.2) Central Manchester Clinical Commissioning Group – Quality Care
Clinically Led
Dr Ivan Bennett - Clinical Director, Julie Cheetham - Board Nurse and Tony Ullman - Head of Commissioning & Quality for Central Manchester Clinical Commissioning Group undertook the assurance section of the presentation and invited Governors to review Central Manchester Clinical Commissioning Group’s strategic plans.
The following areas were discussed in detail: -
- Central Manchester Clinical Commissioning Group (CCG) – Who We Are
- Health Needs in Central Manchester
- How We Work – Collaboration and Integration
- Our Priorities – Improving Health Outcomes.
Clarification was sought as to where monies were held for GP services. In response, monies for GP services are taken from the NHS budget and in the future will be held by the National Commissioning Board. Of note, these monies are not the same as those allocated to secondary and tertiary healthcare providers. As a result of working together it was felt that monies could be managed more creatively so to reduce waste (estimated around 30% of budget wasted) and reinvest these monies so to improve health and services.
Clarification was sought as to Central Manchester CCG’s mental health priorities. In response, secondary care mental health services are currently being re-evaluated by a Joint Committee (includes North, Central and South CCGs), however the outcome is awaited. Of note, primary care mental health services will remain unchanged.
Clarification was sought as to when the Integrated Care Model would be implemented. In response, the Integrated Care model is currently being progressed by Sara Radcliffe(Programme Director for Integrated Care) with the model already being in place for people at the highest risk of admission to hospital (plans being developed to roll out to wider patient groups).
Attention was drawn to the importance of Central Manchester CCG and the Trust working together in order to ensure the successful delivery of the model with the need of a similar model being developed in relation to Trafford. The Trust welcomes the opportunity to progress joint working with Trafford and at the recent Governors’ Annual Planning Workshop, Trafford Governors were encouraged to raise this issue with the Trafford CCG.
The suggestion was made that the phrasing in relation to “care being provided closer to home” may need to be adapted as in some cases care may be provided further afield requiring individuals to travel further distances than anticipated.
Clarification was sought as to whether Central Manchester CCG would also be commissioning healthcare services outside of Central Manchester. In response, it was felt that Central Manchester patients wouldwishto receive secondary and tertiary care from the Trust with the exception of those services that would be more appropriately delivered closer to home. Emphasis was made that Central Manchester CCG is actively engaging with the Trust to provide an integrated healthcare system and would only go outside if the quality of care proved to be better elsewhere (challenge quality of services).
Decision: Further update to be provided to Governors re; Francis Report recommendations / Action by:
Medical Director / Date:
3rd July 2013
Agenda Item 5: Trafford Consultation Update
Stephen Gardner, Project Director – Trafford Healthcare Trust Acquisition undertook the above presentation. The following areas were discussed in detail: -
- Consultation Process
- Decision-Making Process
- Referral to Secretary of State
Decision: Further update to be provided to Governors re; Trafford Health Deal proposals outcome / Action by:
Stephen Gardner / Date:
Ongoing
Agenda Item 6: Update on the New Critical Care Facility
Dave Pearson, Director – Clinical & Scientific Services undertook the above presentation. The following areas were discussed in detail: -
- History of Critical Care at Manchester Royal Infirmary
- Background to new Critical Care Unit Business Case
- Scheme Design
- Progress to Date
- Next Steps.
Decision: Noted / Action by: N/A / Date: N/A
Agenda Item 7: Governors
7.1) Governors’ Declaration of Interest Register - 2013
Sue Allison, Director of Corporate Services/Trust Secretary invited Governors to review the above document stating that all Governor interests (2012/13) have now been received and recorded.
7.2) Governor Development/Actions from Working Group Reviews and Questionnaire Update (2012/13)
Sue Allison, Director of Corporate Services/Trust Secretaryinvited Governors to review the above document stating that following last year’s scoping exercise i.e. Governor Questionnaire,Working Group Reviews and Skill Mix Matrix, the Governor Development Plan (2012/13) was produced and implemented. The revised plan has been updated to outline the key actions that have been progressed over the course of the year in order to support the developing and evolving role of Governor.
7.3) To receive the Governor Questionnaire as part of the agreed Performance Review Process for the Chairman and Non-Executive Directors (2013/14)
Sue Allison, Director of Corporate Services/Trust Secretary invited Governors to review the above document stating that as in previous years, the Governor Questionnaire has been produced in order to inform the Performance Review Process of the Chairman and Non-Executive Directors in addition to the findings being utilised to produce the Annual Governor Development Plan.
Encouragement was given to Governors to complete the questionnaire by the required deadline in order to draw representative conclusions and actions to be progressed in order to further support Governors in their role.
7.4) Lead Governor feedback following the FTGA Experienced Governor Network Event (13th February 2013)
Professor Malcolm Chiswick, Lead & Public Governor (Trafford) informed Governors thathe and Keith Paver (Public Governor – Manchester) recently attended the above event. The following points were highlighted: -
- Two Key Note Speakers presented to over 100 delegates (representing Foundation Trusts nationwide)– presentations included the new powers and duties of Governors following the recent Health & Social Care Act (2012) with attention being drawn to:
Governors will hold the Board to account for the performance of the Trust via
the Non-Executive Directors (collectively and individually).
Governors will represent the interests of the Members, as a whole, and the interests of the public.
Significant transactions must be defined in the Trust’s Constitution and approved by more than half of the members of the Council of Governors voting.
Applications by the Trust to enter into a merger, acquisition, separation or dissolution must also be approved by more than half of the members of the Council of Governors voting.
Where an amendment is proposed to the Constitution in relation to the powers or duties of the Council of Governors, these proposals must be presented by the Governors at the next Annual Members’ Meeting and,
The Trust must also give its members a chance to vote on such
amendments to the Constitution.
The Trust must ensure that Governors are equipped with the skills and
knowledge they require to undertake their role.
Of note an overview of the Health & Social Care Act (2012) was presented to Governors by Cliff Mills (Cobbetts Solicitor) at a previous Governors’ Development Session (30th May 2012) which included a review of the Trust’s Constitution to highlight areas of significant, little or no change. The Trust’s Constitution was therefore later revised to incorporate the required amendments following the Act with the proposed revisions being sent to all Governors for review/approval. In addition, the Governors’ Membership Working Group was also presented with the proposed changes for approval following which a Special Members’ Meeting was held in order to seek members’ approval.
Attention was drawn to the subtle changes in the wording relating to holding Non-Executive Directors to account “both collectively and individually”.
Concerns were raised in relation to the ability of Governors to “represent Members, as a whole, and the interests of the public” as itwas not felt possible for Governors to represent views as a whole. Of note, the consensus from the event was that all Foundation TrustGovernors encounter problems when attempting to engage with members.