SOUTH TYNESIDE NHS FOUNDATION TRUST

Notes of the Annual Members Meeting

held on Monday 5th December 2016 at 4pm in the

Education Centre, South Tyneside District Hospital,

Harton Lane, South Shields, NE34 0PL

PRESENT:
EXECUTIVE AND NON EXECUTIVE COLLEAGUES
Neil Mundy / Chairman
Ken Bremner / Chief Executive
Gordon Booth / Non Executive Director
Bob Brown / Director of Quality and Transformation
Melanie Johnson / Director of Nursing and Patient Experience
Iain Malcolm / Non Executive Director
Ian Martin / Medical Director – CHS
Julia Pattison / Director of Finance
Peter Sutton / Director of Planning and Business Development
Keith Tallintire / Chair of Audit, Non Executive Director
Dr Shaz Wahid / Medical Director - STFT
Steve Williamson / Deputy Chief Executive
GOVERNORS:
Mo Abuzahra / Public South Tyneside
Tom Defty / Public South Tyneside
James Hughes / Staff Non Clinical
Graeme Howe / Public Governor Sunderland
Graeme Hunt / Public South Tyneside
Marion Langley / Staff Non Clinical
Tom Scott / Public Gateshead
Allyson Stewart / Appointed
Nigel Thomas / Public South Tyneside
ALSO PRESENT:
Caroline Latta / North of England Commissioning Support
Sylvia Rees / Acting Private Office Manager (note taker)
Paul Thompson / Deloitte
Helen Taylor / Deloitte
33 Members from public and staff constituencies
Welcome and Opening remarks
Neil Mundy, Chairman welcomed members to the 2016 Annual Members Meeting and introduced members of the Board and colleagues who would be presenting during the meeting. He referred to the displays highlighting ‘Care Through Life’ services provided by the Trust, which had been available prior to the meeting and expressed his gratitude to everyone who had been involved.
Mr Mundy provided an update on the recovery of Mr Terry Haram, Public Governor for South Tyneside who had been involved in a serious road accident in November. He had conveyed the best wishes of the Trust and Membership for his continued recovery.
Mr Mundy informed the meeting that the Trust had recently won the Clinical Research Impact Award at the prestigious HSJ Awards Ceremony, which celebrated the outstanding work carried out by Professor Colin Rees and the Gastroenterology Team.
He outlined the topics which would be covered during the meeting, including reports for the 2015/16 financial position, an update following the CQC inspection and the Group approach.
He emphasized that whilst progress had been made this year in reducing the deficit through cost improvements, the task ahead was even more difficult. He noted that whilst the NHS was facing a period of change he was able to give assurance to Members that the future of South Tyneside District Hospital was secure with steps being taken to ensure safety, quality and sustainability.
Mr Mundy informed members that the Trust had made steady improvements in reducing the level of staff sickness and absence to address the previous poor record which had been highlighted recently in the media.
He offered thanks to Steve Williamson, Deputy Chief Executive, for his contribution to the Trust. Mr Williamson would be leaving at the end of December to start a new life in Australia. He offered best wishes to Mr Williamson and his family for the future.
Board of Directors Report
Review of the Year
The Chief Executive, Ken Bremner, addressed the members. He presented a review of the key performance against targets, including A&E 4 hour standard, Cancer treatment and 18 week referral to treatment (RTT). He also gave detail around the patient safety priorities for 2015/16 and the progress made against them.
Mr Bremner provided information regarding the CQC inspection in May 2015 and the work undertaken to address the areas identified during the assessment. The Trust received a re-inspection in July 2016 on safeguarding and further actions identified. Mr Bremner assured members that the Trust would be working closely with the regulators going forward.
Annual Report and Accounts 2015/16
Julia Pattison, Director of Finance presented an overview of the Annual Report and Financial Performance for 2015/16 and invited Paul Thompson, Partner, Deloitte who provided the independent external audit of the Annual Report for the organisation.
Auditors Report 2015/16
Mr Thompson provided an overview of the audit report carried out for 2015/16. He informed members that overall the NHS was showing a £1.5billion deficit and that nationally auditors faced quite challenging findings.
Mr Thompson thanked Mrs Patterson and her team for their input into what had been a positive process, which had been delivered on time and in a good quality format. The audit team had received full cooperation throughout the year allowing for open dialogue to take place when further detail was required.
Mr Thompson advised that the auditors had given an unqualified opinion on the Accounts and also Value for Money which reflected the actions taken by the Trust to address the deficit. He advised that the quality report had received a modified opinion in relation to the A&E 4 hour waits and 18 weeks RTT indicators, where some issues had been found with data quality. However he noted that overall the Trust should be pleased with the audit results.
Mr Mundy thanked Mr Thompson and his colleagues and opened the meeting to questions from members.
Q. In relation to the CQC slide, it mentions community services, what is the position for acute services?
A. Dr Shaz Wahid, Medical Director advised that some acute services had been rated as ‘outstanding’ and some as ‘good’ but that although very close, the overall rating for acute services had been ‘requires improvement’. Following a review of the draft report where some inaccuracies had been corrected, an action plan had been developed to address the issues which had been identified in some services. One specific domain identified as ‘inadequate’ (red) had been ‘well led in surgery’, had been progressed to green in the 18 months since the report was published.
Q. What does it mean by areas requiring improvement, including safety? Does this mean that patients are not safe?
A. Dr Wahid advised that during the inspection, it had been felt that the date of portable appliance testing (PAT) for some of the medical equipment was an area for improvement. He assured members that there were no areas which had been rated as ‘inadequate’ for safety. Dr Bob Brown, Director Quality and Transformation, added that the five areas identified on the slide were used to reflect the range of the inspection carried out by the CQC. He added that the Trust was continually monitoring performance against the five key areas.
Q. Is the 18 week RTT from GP to hospital?
A. Mr Bremner advised that this was the date of referral received by the hospital to definitive treatment regardless of the source of the referral.
A member expressed concern at the lack of public engagement with members in regard to the alliance with City Hospitals Sunderland NHSFT. Mr Mundy thanked the member for his comments and assured members that the appropriate processes had been followed. Mr Bremner added that engagement and consultation would be covered later in the meeting.
Q Is there PAT processes in place?
A. Mr Mundy assured members that appropriate processes were now in place and embedded with the organisation.
Chief Executives Update
Mr Bremner gave an overview on the Single Oversight Framework. From October, NHS Improvement, the main financial regulator, would move to a different way of rating the performance of foundation trusts. He advised that the rating took into account 5 elements, money, performance, CQC rating for well led, CQC general rating and engagement in the STP process. For 2016/17, the Trust had been rated as 2 which meant not requiring formal regulatory action.
Mr Bremner advised of a number of successes over the year both organisational and individual. These included the new surgical centre, the urgent care hub within A&E and Haven Court at South Tyneside District Hospital. Other successes included the transformation of community health with the Vanguard programme and the self care pioneer project.
Mr Bremner advised that in March 2016, the South Tyneside NHS Foundation Trust and City Hospitals Sunderland NHS Foundation Trust created an alliance between the two organisations recognising the many pressures faced by both trusts. Key areas in the process included clinical service reviews, which had commenced, and noted that as members were aware, Stroke Services was one of the first services which had been considered. The future delivery of this service would be subject to a public consultation process beginning on 1st March 2017. Other services would then follow as necessary. This process was reflected nationally in order to address some of the challenges facing the NHS going forward.
Mr Bremner noted that on 21st November a single Executive Management Team was created which contained the skills and experience to manage the challenges facing both organisations in the coming years.
Sustainability and Transformation Plan (STP)
Mr Bremner advised that the NHS had requested the service as part of the 5 year forward plan to produce local 5 year forward plans within specific footprints. The Trust was within the Northumberland, Tyne and Wear and North Durham (NTWND) STP. The STPs were to address three key gaps to ensure quality health outcomes.
Mr Bremner advised that locally the South Tyneside and Sunderland STP was consistent with the Path to Excellence programme of clinical service reviews, which showed that the joint working between South Tyneside and Sunderland would demonstrate the pathways to sustainability for all the services provided across both organisations.
Mr Bremner advised members that the Trust had received a number of potential resolutions put forward by members. One was a statement of dissatisfaction regarding the development of the alliance and the other was a statement of concern regarding the development of the Sustainability and Transformation Plan (STP). Mr Bremner officially acknowledged those concerns.
Mr Bremner went on to note that with regard to involvement, the review of clinical services was key and a series of engagement events had taken place with service users and that the consultation process would begin in March 2017, led by the Clinical Commissioning Groups (CCGs). He noted that lessons had been learned from comments and concerns raised and gave assurance that there would be appropriate opportunities for involvement and engagement going forward.
Caroline Latta, North of England Commissioning Support outlined the engagement and involvement activities which had taken place and were planned for the future as the clinical service reviews progressed. She noted the importance of listening and engagement with governors, staff, service users and community involvement. Mr Bremner assured members that the clinical service reviews would include appropriate public consultation.
Mr Bremner noted that the STP was still in draft and was available on the CCG website. He noted that the Trust, nor the rest of the NHS in the North East, had not received any feedback to date.
On a personal note, Mr Bremner expressed his delight in the opportunity he had been given to lead South Tyneside NHS Foundation Trust. He assured members that the hospital had a secure future and had fantastic staff and services.
Mr Mundy thanked Mr Bremner and invited questions.
A member thanked Mr Bremner for mentioning the resolutions raised and expressed concern as to the direction the Trust would be taken in terms of the acute services. He also expressed concern at the unrealistic financial gaps of the STPs and noted his objection to this approach which he felt would result in a reduction of key services. The member also expressed concern at the lack of opportunity for foundation trust members to raise concerns and asked what powers members had to influence decisions.
Mr Mundy assured members that the Trust had followed legal advice and the proposed resolutions had not been valid. He advised that the Governing Body was the direct link with members and followed a robust process and duty of governance.
Q. Regarding STPs, if no agreement on STP is given, what would the next steps be? Worried that no accountable challenge from outside the NHS being considered. As a non clinical governor and staff side representative, she would like to have more participation into the clinical service reviews.
A. Mr Mundy gave assurance that the most important objective was to provide high quality sustainable services to residents and the process of transformation to achieve this would be followed. Mr Bremner advised that ways would be developed to encourage staff side participation.
Ms Latta added that learning from previous comments, the CCGs were committed to engaging with all sectors during the consultation process.
Q. No consultation in CAF meeting, audience not involved, simply told.
A. Ms Latta advised that formal consultation was not likely to commence until 1st March 2017. The engagement process had commenced working directly with service users and carers. The presentation to the Community Area Forums (CAFs) had been at their request to give an update on the process. She stressed that this was not the public consultation phase.
Q. Regarding the STPs, when will the stress tests be carried out and by whom?
A. Mr Bremner advised that no response had been received from NHS England and that he was not aware of any stress test being undertaken.
Mr Mundy thanked Mr Bremner and colleagues for their presentations.
Council of Governors Report
Re-appointment of Non Executive Director
Mr Mundy presented the Council of Governors reports and was pleased to inform members that Mrs Pat Harle, Non Executive Director had been re-appointed for a further three year term.
Membership Report
The current membership figures were presented. Mr Mundy noted that the aim was to increase these figures in the coming year to provide a more engaged membership with the Governing Body.
Council of Governors Election Results
The election results were presented to the meeting. Mr Mundy congratulated all the new governors and expressed his thanks to the outgoing Governors.
Mr Mundy thanked everyone for attending the Annual Members Meeting 2016 and closed the meeting.

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