Minutes of the Finance and Performance

MINUTES OF THE FINANCE AND PERFORMANCE

COMMITTEE MEETING

13.00 hours on 27 May 2015, Boardroom A, Farm Villa

Present: / Mark Bryant
Michael Sander
Richard Page
Ivan McConnell
Philip Cave
Malcolm McFrederick
Ada Foreman
John Carey
Lynda Day / Non Executive Director (Chairman)
Non Executive Director (Vice Chairman)
Non Executive Director
Director of Commercial Developments and Transformation
Executive Director of Finance
Interim Executive Director of Operations
Deputy Director of Finance
Director of Capital Planning & Estates
Secretary to the Committee
Apologies: / None
In attendance: / Les Manley
Vicky Boswell
Philip Lawrence
Justine Leonard / Director of ICT
Director of Performance
Deputy Director of Transformation
Director of OPMH
Minutes and
Papers sent to: / Mel Brown / Interim Trust Board Secretary

Chairman’s Welcome,IntroductionsandHealth and Safety Briefing

FPC/15/58APOLOGIES

None

FPC/15/59NOTIFICATION OF ITEMS FOR DISCUSSION NOT ON THE AGENDA

None

FPC/15/60DECLARATIONS OF INTERESTS

None

FPC/15/61MINUTES OF THE MEETING HELD 28 APRIL 2015

The minutes of the last meeting held on 28 April 2015 were ACCEPTED and signed as a correct record.

FPC/15/62MATTERS ARISING (ACTION LOG 28 APRIL 2015)

The Committee NOTED the outstanding items set out in the action log dated 28 April 2015.

FPC/15/63PERFORMANCE

(a)Integrated Quality and Performance Report Month 1

IM went through the month 1 IQPR and the Committee NOTED that the Trust:

Met five of the seven regulatory targets – (Delayed Transfers of Care target and CPA 12 month review target remained non-compliant)
met six of the seven workforce targets – (Vacancies remained non-compliant)
met eight of the twenty one RAG rated quality targets

The Committee discussed the report in detail and NOTED the following areas in particular:

Delayed Transfers of Care (DToCs)

The Trust’s performance reduced from 14.14% in March to 13.7% in April, against a 7.5% target. This equated to 39 patients. Actions were in place, monitored via Service Line Directors and the Director of Operations, but the target was not met in December or in each month of Quarter 4 2014/15. There were 946 bed days lost Trust-wide as a consequence of these delays (515 in the Acute Service Line, 1 in CRSL, 30 in Forensic and Specialist Services and 400 in OPMH). The overall cost to the Trust for the 946 bed days was £414k in April.

CPA 12 Month Review

The CPA 12 month review was not achieved in April. 94.9% of those on a CPA pathway for at least a year had a valid CPA review at the end of the month, as per the Monitor definition, with all Service Lines achieving target except CRSL. CRSL’s performance remained at 94.5% (equating to 136 out of 2456 patients without a valid review). This meant that a further 14 cases were required to be reviewed in order for the 95% target to be met. Action had now been taken to ensure daily reviews.

Vacancies

The Acute Service Line was holding a recruitment fair in June on the Littlebrook Hospital site and a generic advert had been placed in the Guardian for RMNs/RGN/RNLD. A new hire bonus of £1200 and a relocation package, where applicable, had also been agreed. Further meetings were taking place regarding skill mixing and what could be done to improve retention.

(b) CQUIN Progress Report

VB advised the Committee of the following CQUIN failure:

Cardiometabolic Assessment of Patients with Schizophrenia CQUIN 2014/15

Following the audit carried out in Quarter 3 2014/15 to demonstrate full implementation of the appropriate processes for assessing and documenting cardio-metabolic risk factors in patients with Schizophrenia; KMPT has been informally advised that we have achieved only 15% of patients audited with all 7 domains recorded. This is against the target of 90% proposed and outlined in the contract and as such KMPT has failed to achieve this CQUIN.

The results for all trusts have not been published yet by NHS England. We have been advised of this informally following our request for information and are satisfied that this is the position. We do not yet have benchmarked information showing the relative performance across MH Trusts.

This audit result was contrary to the assurance provided by the Service Lines and Nursing Directorate throughout the year based on their own internal audit work. It was reported that compliance was very high in the inpatient areas. As a result, the achievement of the CQUIN was expected and forecasted in the CQUIN reports provided to FPC in Quarter 4 2014/15.

The Trust has now set up a task and finish group to review the audit results once published and to determine recommendations on how we can improve the performance of the recording of the set parameters for this year’s Cardio-metabolic CQUIN, ensuring full compliance.

(c)Capacity/Demand and Bed Analysis

The Committee discussed and NOTED that there was continued pressure on out of area placements due to levels of demand and capacity, although the numbers of out of area beds reduced in April to 1036 following a total of 1464 in March across all bed types.

The Trust was negotiating a new arrangement with Kent and Medway CCGs and this was particularly sensitive for 2015/16 in terms of the Trust risk share contract.

The Trust had developed its understanding of patient flows and had identified further improvements that needed to be made, including:

Reducing avoidable admissions through the provision of a Mental Health Decision Unit.
Delivering a Crisis Personality Disorder pathway seven days a week.
Improving the management of Delayed Transfers of Care.
Improving crisis response through a single point of access.

The Committee AGREED that the ability of each CCG and Service Line to understand the supply and demand pressures was at the heart of this problem. East Kent should be prioritised for scrutiny.

(d)Variance – Analysis of Drivers of Demand-side and Supply-side Factors

The Committee NOTED that this report would now be sent to the JuneFPC meeting. ACTION: IM/PC/MM

FPC/15/64FINANCE

(a)Finance

(i)Finance Report Month 1

The Committee discussed the Finance Report for Month 1 and NOTED that the Trust had made a loss in month, after adjusting for technical items, of £587k in line with the plan submitted to the TDA on 14 May 2015. The plan was that the Trust would make losses in the first two quarters and then move towards a break-even position in the final two quarters of 2015/16. The current forecasted position was in line with plan at £2.4m loss (including technical adjustments). The delivery of this plan was subject to a challenging CRES target of £8.5m which was largely phased to deliver towards the end of 2015/16. It was imperative that, where original CRES schemes were not delivered, further schemes were found in year by Service Lines and Directorates.

(ii)CRES

The Committee NOTED that, in order to achieve the two year financial plan, the Trust must deliver CRES of £8.5m in 2015/16 and £10.3m in 2016/17. The Trust was strengthening its CRES management and identification processes to address this significant challenge and the FPC acknowledged the need for robust CRES plans that should now include a weighted view of achievability. New ideas were crucial for future CRES plans that could be worked up in 2015/16 for implementation in 2016/17.

(iii)Finance Plan 2015/16 and 2016/17

The Committee discussed and NOTED the overall numbers in this plan were still in line with the assumptions made during the April submission.

(iv)Review of Annual Accounts 2014/15

The Committee reviewed and NOTED the Annual Accounts 2014/15.

(v)NHS England – Outstanding Creditor Payments

The Committee NOTEDthat discussions with NHS England were ongoing.

(b)Risk

(i)Trust Financial Risks

The Committee NOTED the changes to the Trust Financial Risks and

requested that Risk 3753 (PCPTS) be updated for 2015/16.

ACTION: AF

(ii)Finance Department Risk Register

The Committee NOTED the Finance Department Risk Register.

The Committee NOTED the Capital Plan report.

(d)Reference Costs

The Committee NOTED the process in the completion and submission of both Reference Costs and the Education and Training Cost Collection return.

(e)Estates

(i)Estates Progress Report

Upnor (New Emerald) Ward

The Committee NOTED that an open day for staff, service users and carers was held on 23 April. The final account negotiations with the contractor would include discussion of consolidated damages if required (dependent on whether the contractor attempted to secure compensation for their over-run). The official opening date had yet to be agreed.

Modernising In-patients Programme

The Committee NOTED that work was progressing and a comprehensive Project Board arrangement had been established under the leadership of the Executive Director of Operations. This had now become a long term, multi-ward set of projects and the largest in the 5 year programme.

Cranmer Ward Relocation

The Committee NOTED that the FBC was scheduled to be presented to the September Board for approval. TDA approval was scheduled for December and start on site by Kier for January 2016. The Trust had commissioned a further review of procurement options, given the change in design and the passage of time. This would be available for the FPC June Meeting. ACTION: JC

Estates Transformation Programme (ETP)

The Committee discussed and NOTEDthe progressof the ETP team. JC advised that the results of the space utilisation review would be brought to the June meeting. ACTION: JC

Disposals Programme Progress

The Committee NOTEDthat a further meeting at the start of June between the Trust’s planning consultants, Lee Evans Partnership, and Canterbury City Council should allow the tabling of a final layout plan and submission of the planning application for St Martins West. The marketing agent, BNP Paribas, had been commissioned to provide a comprehensive valuation based on the final layout.

The TDA had requested a full business case for the disposal of the St Martins West site and work on this had begun.

Sustainable Development Management Plan (SDMP)

The Committee NOTED and ENDORSED the Trust’s SDMP (formerly Carbon Management Plan) on behalf of the Board which confirmed the Trust’s continued strong performance against its carbon reduction targets as required by the DH and Monitor.

Kent and Medway Facilities (KMF)

The Committee discussed and NOTEDthe risks identified by NHSPS’s decision to serve notice on their part of the Consortium which would remove more than 50% of KMF’s business. KMPT, as host, was contesting the basis of the decision and seeking to ensure NHSPS were held fully accountable for any financial impact. There was also a risk that inaction could result in the other consortium members serving notice.

(ii)Draft Estates Strategy 2015/20

The Committee RECOMMENDED that the Board approve the updated Estates Strategy 2015/20. JC to write a brief cover paper for the next Board meeting. ACTION: JC

FPC/15/65TRANSFORMATION

(a)Transformation

(i)Draft Transformation Board Minutes 27 April 2015

The Committee NOTED the draft Transformation Board minutes of 27 April 2015.

Les Manley joined the meeting

(b)ICT

(i)ICT Progress Report

The Committee discussed the report and NOTED:

LM was visiting service teams around the Trust and client issues were being discussed and corrected.
New computers were being rolled out on schedule and this exercise should be completed by the end of August 2015.
New disks, servers and server room network equipment had been purchased and installed.
Work had started to migrate systems onto the new infrastructure, i.e. cloud 2 to cloud 3 and the email system to the new servers.
Printers - a test group was currently trialling a reconfigured server and reported no printers going off-line.
The wireless issues would be resolved later in the year when the wireless network was refreshed.
ICT capital phasing was still not correct. ICT overspent by £90k against plan. This overspend was as a result of spend not being consistent with the phasing provided by the Director of ICT and £13k being incurred on a project that completed in 2014/15. LM to discuss with AF. ACTION: AF/LM

Les Manley left the meeting

The Committee was asked to recommend that the Board approve the final versions of the two PAS project contractswhich had been negotiated with Servelec Healthcare Ltd.

However, there was no PAS project business case or quality impact assessment for the Committee to review and the contracts could not be read by the Committee in the time scale given.

The Committee NOTED that the Trust had signed a Letter of Intent with Servelec which gave them contractual cover to begin purchasing items of equipment with long lead times. The Trust’s liability under this agreement was capped at £150k plus VAT.

The Committee also NOTED that this scheme could not be moved to capital and the Committee strongly recommended that the contracts include penalty clauses.

MM agreed to write an appendix report to the Board setting out how the original £2.1m approved by SIB for the PAS project was now £4.7m. MM also agreed to ensure the contracts included suitable penalty clauses. ACTION: MM

FPC/15/66SERVICE LINE REPORT - OPMH

Justine Leonard joined the meeting

The Committee discussed the report and NOTED:

The OPMH YTD financial position as at month 12 was £585k overspent.
KPIs: Care plans – 95%, Crisis Plans – 98.4%, Clusters assigned – 98%.
Dementia Home Treatment Services integrated to improve access and response to older people with more urgent need.
Admin and clerical now up to establishment and embedding processes and supporting patient flow.
Staff wanted to join the Single Point of Access.
Partnering with Darent Valley Hospital and the Beacon.

Justine Leonard left the meeting

FPC/15/67 POLICIES REVIEW

The FPC NOTED that the following financial policies would be reviewed against the updated SFIs and SOs by the end of July:

Business Case Production Procedures
Investment Policy
Budget Management and Control of Resources
Budget Virements and Changes to Funded Establishments

ACTION: AF

FPC/15/68 TERMS OF REFERENCE REVIEW

The FPC REVIEWED the amendments to the FPC’s Terms of Reference and RECOMMENDED them for Board approval.

FPC/15/69 STRENGTHS, WEAKNESSES, OPPORTUNITIES, THREATS

The Committee NOTED that the “Strengths, Weaknesses, Opportunities, Threats” (SWOT) would be incorporated into a strategy piece being taken to the Board later in the year.

FPC/15/70 FPC ANNUAL REPORT TO THE BOARD 2014/15/WORK PLAN 2015/16

The Committee REVIEWED and AGREED the FPC Annual Report to the Board 2014/15.

The Committee also REVIEWED and AGREED the FPC Work Plan 2015/16.

FPC/15/71 BOARD EFFECTIVENESS

The Committee discussed the feedback from the FPC’s effectiveness questionnaire exercise and AGREED the comments received.

FPC/15/72ANY OTHER BUSINESS

None

FPC/15/73FPC REPORTS TO THE BOARD/OTHER COMMITTEES

(a)Key Issues to Trust Board Meeting on 4 June 2015

IPQR Delayed Transfer of Care/Bed Modelling
IPQR Regulatory Targets
IPQR Vacancies/Agency Costs
CQUIN Progress Report
Cardiometabolic CQUIN 2014/15
Annual Accounts 2014/15
Finance Report Month 1
CRES Programme 2015/16
Finance Plan 2015/16 and 2016/17
BAF Financial Risks
Capital Plan
Annual Review of Reference Costs
Draft Estates Strategy 2015/20
Sustainability and Carbon Management Annual Report
Patient Administration Systems Replacement (PAS)
OPMH Service Line Report
FPC Terms of Reference
FPC Annual Report to the Board 2014/15
FPC Work Plan 2015/16
FPC Board Effectiveness Report

(b)Items to be referred to other Committees

None

FPC/15/74FPC MEETINGS 2015/16

25 June – 9 am to 1 pm – Meeting Rooms 1 & 2, Magnitude –

Change of Venue

24 July – 9 am to 1 pm – Boardroom A, Farm Villa

August – No Meeting

22 September – 1 pm to 5 pm - Boardroom B, Farm Villa

27 October – 1 pm to 5 pm – Boardroom B, Farm Villa

23 November – 9 am to 1 pm – Boardroom A, Farm Villa

December – No Meeting

25 January – 1 pm to 5 pm – Boardroom A, Farm Villa

25 February – 1 pm to 5 pm – Boardroom A, Farm Villa

25 March – 1 pm to 5 pm – Boardroom A, Farm Villa

Signed: ………………………………………………………….

(Chair of Finance and Performance Committee)

Dated:……………………………………………………………..