TRUST BOARD MEETING

IN PUBLIC

Held on Thursday 5 February 2009 at 2.00pm

In Room 1, QUAD Centre, QueenAlexandraHospital

M I N U T E S

Present /
Ursula Ward
Chief Executive Officer /
David Rhind
Chairman / Peter Mellor
Company Secretary
David Eccles
Director of uman RHHumanResources & Workforce
/ Graeme Zaki
Medical Director
/ Neil Kemsley
Director of Finance
Maggie MacIsaac
Chief Operating Officer / Brett Gill
Non Executive-Director / Alan Cole
Non-Executive Director
Mark Nellthorp
Non-Executive Director
In Attendance: / Lesley Kemp (Minutes)
Item No. / MINUTE /

ACTION

12/09 / Apologies:
David Bailey, Deputy Chairman, Mark Greenwood, Non-Executive Director
Declaration of interests
The Chairman asked whether any Board Member had any conflict of interest with any item on the agenda. There were none.
13/09 / Minutes of the last meeting held on 8 January 2009
These were accepted as a true and accurate record of the meeting
Matters arising:
  • Minute 123/08: David Eccles stated that the vacancy report would be available for next month’s meeting.
  • Minute 05/09: Neil Kemsley will provide a report for a workshop on efficiency gains. Peter Mellor is to establish a date.
  • Minute 06/09:Maggie MacIsaac stated that further national comparative figures would be included as soon as possible.
  • Minute 10/09: Peter Mellor confirmed that the workshop to discuss risks surrounding the move into the new hospital had been arranged for March.
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PM
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14/09 / Notification of any other business
  • There was none.

15/09 / Chairman’s Communications
David Rhind announced that that Portsmouth Hospitals National Health Service Trust Board had decided to withdraw their Foundation Trust application. He explained the reasons behind this decision. The global financial situation has led to an atmosphere of uncertainty within our local health economy. The Trust will work with its commissioners to continue to plan the future provision of health care services locally in what is a volatile climate. David Rhind made it absolutely clear that the Trust will be pursuing the application at a later date. The reaction from staff and the Council of Governors was that this was the right decision for now – allowing us to focus on the new hospital opening in June.
16/09 / Chief Executive’s Report
Ursula Ward reported that the new Chief Nurse, Julie Dawes, has been in post since 1 January 2009.
She reported on the National Health Service Constitution, explainingthat it establishes the principles and values of the National Health Service in England. It sets out rights to which patients, public and staff are entitled to and pledges which the National Health Service is committed to achieve, together with responsibilities which the public, patients and staff owe to one another to ensure that the National Health Service operates fairly and effectively. Portsmouth Hospitals Trust will be required by law to take account of this Constitution in its decisions and actions.
There was a discussion concerning the various patient groups which exist, at which point Mr Cousins asked for clarification between the Public and Patient Involvement Forum and the Patient Experience Council and particularly whether the Public and Patient Information Forum was another Trust established group. Clarification was given.
17/09 / Performance Report
Maggie MacIsaac drew particular attention to how busy the hospital has been throughout the latest period of bad weather, and how well it had coped. She thanked staff for their hard work.
The report covered performance in December.
There were still concerns over the thrombylosis target, which had deteriorated slightly. Performance in the 18 week pathway was good and the targets were being met. There were no cases of Methicillin-resistent staphylococcus aureus (MRSA)in December and the cancer target remains strong. The numbers of delayed transfers of care was down to 33 from 44. Mr Cousins (member of the public) asked whether there were some delayed transfers of care which could never be eliminated, and Maggie MacIsaac replied that there would always be some because of the size of the hospital, but that the number is down and will continue to be focused upon. Mr Cousins (member of the public) then asked whether the reduction in numbers was as a result of internal or external measures, and was informed that there was improvement in both the hospital and in the Primary Care Trusts. Jock McLees (member of the public) stated that Southampton University Hospital Trust has social workers permanently on site, working in the wards, and asked whether this is something that Portsmouth Hospitals Trust would consider. Maggie MacIsaac replied that social workers are currently located at Queen Alexandra and St Mary’s Hospitals, andthat they will join together in the new hospital, forming a multi-disciplinary teamaiding the complex process of discharge.
18/09 / Finance report
Neil Kemsley drew the Board’s attention to appendix 1a which provided a summary of the up to date position. The Trust is reporting a break even position but he emphasised that this is against a £1.3m surplus. The underlying position remains very challenging. Considerable savings will need to be made with a particular focus on temporary workforce costs, whilst maintaining targets and upholding patient safety. Non-essential non-pay expenditure has been stopped until the end of the financial year.
David Rhind stated that future income may well not be as generous as in previous years, and that the challenge for the future was to become more cost efficient.
19/09 / Workforce & Human Resources Directorate Quarterly Report
David Eccles stated that the report covers the period up until the end of December. He reported that substantive workforce levels were within plan, sickness levels were below the 4% target and staff turnover and stability was good.
The temporary workforce rate was almost double the target and this was an area which remained under focus. The main reason for this was the excessive overheat in capacity.
There followed a discussion concerning staff turnover, and the need for balance between stability and the injection of fresh ideas and experience. Ursula Ward stated that there was a need to think creatively about how the workforce can remain refreshed.
20/09 / Assurance Framework
Peter Mellor reported that there were no increased risks but there were two decreases, and two new risks.
The two decreases were as follows:
  • The risk associated with the European Working Time Directive had been reduced from 15 to 12. David Eccles reminded the Board of the Directive and the impact that it would have on the hospital. He informed the Board that detailed was work in progress to ensure junior doctor’s rotas were compliant with the Directive.
  • The risk associated with the identification of potential leaders had been reduced from 9 to 6, as a talent management strategy had been established. Progress on this particular initiative would be provided to the Board in a separate report.
There were two new risks:
  • Failure to engage in the National Patient Safety Agenda
  • Quality and lack of availability of patient health records when they attend hospital for an appointment. Mr Cousins (member of the public)informed the Board that this was an area of real concern to the Patient Experience Council.
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21/09 / South Central Patient Safety Strategy and the formation of Portsmouth Hospital Trust’s Clinical Standards & Quality Board
Graeme Zaki explained that as the climate moves from the delivery of targets to greater emphasis on quality of care, safety needs to be brought into more focus. This paper attempts to lay out the strategy as outlined by the Strategic Health Authority, who is in fact leading in the country on this. Quality and patient safety will need to enjoy the same attention at the Board as currently given to Finance and Performance. A robust reporting mechanism will need to be in place to ensure regular feedback to the Strategic Health Authority.
22/09 / Committee Minutes
  • QueenAlexandraHospital Redevelopment Committee: Ursula Ward provided an update on the current status with the new hospital. Carillion have confirmed that 15 June is still the planned opening date and the retained estates programme is still on schedule. Communication about the new hospital was now being stepped up, hence the articles on local TV news channels recently. A mock up ward will soon be open for staff to begin to orientate themselves. The formal notice to the Ministry of Defence has been issued confirming the move from Haslar on 31 July. Ursula Ward informed the Board about the new Wellness Centre, which is being built in collaboration Chamber of Commerce. Opening in 2010, it will provide sport and fitness facilities to both staff and some local businesses.

Date, time and venue of next meeting
5 March 2009
Room 1, Quad, QAH

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