Minutes of the Twenty First Meeting of the Council of Governors of Portsmouth Hospitals

MINUTES OF THE TWENTY FIRST MEETING OF THE COUNCIL OF GOVERNORS OF PORTSMOUTH HOSPITALS NHS TRUST

Held on Tuesday 15 February 2011 – 10.00am to 1.00pm

Lecture Theatre, Education Centre, QueenAlexandraHospital, Cosham, Portsmouth, PO6 3LY

PRESENT:
David Rhind (Chair)
Public – Fareham & Gosport:
Richard Mackay
Mary Sheppard
David Gattrell
Public – Havant & East Hampshire:
Roland Howes
Jocelyn Booth
Kate Bowskill / Public –PortsmouthCity:
Ken Thompson
Syd Rapson
Sarah Edmonds
Isabel Pine
Staff:
Joc Wace
Nicholas Courtneidge
Patient/Carer:
Robin Marsh
Pepe Chisenga
Appointed Governors:
Cllr Gwen Blackett – Havant Borough Council / Stephen Arkle – University of Portsmouth
IN ATTENDANCE:
Peter Mellor – Company Secretary
Ursula Ward, Chief Executive / Robert Toole, Director of Finance
Simon Holmes, Medical Director
Susanna Kayley (Minutes)
APOLOGIES:
Cllr Peter Edgar – Hampshire County Council
Lucy Docherty – Fareham & Gosport
Norman Robson – West Sussex Primary Care Trust / Surgeon Commodore Noel Bevan – Ministry of Defence
Jackie Powell, NHS Portsmouth
DID NOT ATTEND:
Lisa Mundy – Portsmouth Carers
Les Jones – Staff Side / David Joel – Chamber of Commerce
01/11 / APOLOGIES
Peter Mellor announced those apologies received in advance of the meeting.
02/11 / DECLARATION OF ANY CONFLICT OF INTERESTS
No new conflicts of interests were noted.
03/11 / MINUTES OF THE PREVIOUS MEETING
55/10 – Remove ‘B&Q’. The minutes were approved as a true and accurate record of the meeting.
04/11 / MATTERS ARISING
David Rhind thanked the Governors for their input into the Independent Review Panel visit. Ursula Ward confirmed they had spent three days at the hospital and during their time had been shown the patient pathways; received formal presentations and talked to staff. They would be visiting for a further three days but would be based at Portsmouth City Council offices and would be meeting with critics of the change of the model of care. Their report is due back to the Secretary of State by 31 March 2011. Ursula advised that Portsmouth Hospitals NHS Trustwas the only Trust in the UK which ran the old model of care and was an indication of how outdated this model had become.
Mary Sheppard asked for clarification over the data received by the IRP, how many negative comments were received and what they were. Peter Mellor advised that this level of detail could not be provided.
Joc Wace asked if the Trust had any evidence to back up the score of 88% satisfaction and Peter Mellor agreed to look into this and clarify
Action: Peter Mellor
Jocelyn Booth asked if the ‘Employee of the Month’ could be put on the website.
Action: Rebecca Attwood
Post Meeting Note – this has now been actioned
Roland Howes again queried using ‘plain English’ within the Performance and Finance report. It was agreed that a glossary would be provided to assist when reading the report.
Robin Marsh queried the £13.1m loan article in The News. Ursula Ward advised that all hospitals had cash flow issues at certain times and that it was not uncommon for Trusts to receive temporary financial support from the Strategic Health Authority.
05/11 / CHAIRS REPORT
David Rhind asked the Chief Executive to update the meeting on progress towards Foundation Trust. Ursula briefed the Governors on her recent meeting with Ian Dalton from the Department of Health at the Strategic Health Authority on 20 January 2011. The meeting had been arranged to enable Ian Dalton to understand the problem facing NHS Trusts as they aspire to Foundation Trust status. All Chief Executives from non Foundation Trusts within the South Central Strategic Health Authority were asked a set of three questions; why were they not fit, what was preventing them and what needed to be done to ensure Foundation Trust status.
There was an expectation from Ian Dalton that by the end of March 2011 the Trust, our Commissioners and the Strategic Health Authority will have signed a formal contract with agreed timescales to reaching Foundation Trust.
Ursula emphasised that the PFI was not the sole financial issue facing the Trust. The climate is completely different than that previous with a policy shift from services currently provided within the Hospital being moved to out within the community. There are currently 130 hospitals which are not Foundation Trust’s and only 26/27 of these had PFI’s.
Ken Thompson queried the level of confidence the Trust had in reaching a ‘break even’ position and Ursula confirmed the Ian Dalton’s engagement would force all financial issues to be resolved one way or another.
Robin Marsh asked about the relationship between the Trust and GPs moving forward. Simon Holmes confirmed that new systems were already being put into place and lots of dialogue was taking place with GPs to ensure they were being kept informed. Simon advised that there were already regular meetings with the GP Consortium leads.
Syd Rapson suggested that some form of privatisation may need to be looked at. Gwen Blackett agreed that a private patient unit was a good way to bring in extra income and that she had experience of when this worked extremely well. Ursula confirmed that all options were being investigated and asked for Governors assistance when it came to communicating our future plans to the public.
Ursula updated on the intended ‘clustering’ of the Primary Care Trusts and confirmed that four Primary Care Trusts would be merged into one before their formal abolishing in 2013. There is a formal appointment process in place to recruit a Chief Executive and this should be complete by March 2011.
06/11 / BRIEFING ON PROPOSED CENTRALISATION OF SOME CLINICAL SERVICES
Ursula Ward advised that were three services which were being currently considered for centralisation; Vascular, Trauma and Stroke.
Stroke
Ursula confirmed the Stroke centralisation process was underway and that Portsmouth Hospitals NHS Trust was hopeful that it would be designated as a Hyperacute Stroke Unit as it treated circa. 1200 patients a year, compared to 800 at Oxford and 500 at Southampton. The Trust was able to evidence a high quality service and itsearly discharge rate was recognised as one of the best in the UK.
Trauma
Ursula briefed on the rationale for the Trauma centralisation. It had been decided that Oxford and Southampton would become Trauma Centres. A process had then been undertaken to select the Trauma Units to support the Centres. Ursula confirmed that the Trust would be designated as a Trauma Unit with caveats and these still had to be agreed as they had implications for the Trust. Ursula also advised that the Trust was the only Trauma Unit with Military personnel and had a specialist Orthoplastic unit. There was discussion regarding the triaging of patients and where this would take place, this was yet to be agreed.
Vascular
Ursula stated that this centralisation was being driven by the Vascular Committee and all Trusts had been required to go through a process and submit bids. Southampton had been successful in their application and Portsmouth had not. Ursula had grave concerns over the impact to the Trust in this decision and said that Southampton had to confirm how they would, and if they could, serve the population of Southampton, Portsmouth, Winchester and the Isle of Wight. The Trust’s preference had been to submit a joint bid with Southampton but they had rejected our proposal. There were significant implications for the Trust; as Stroke, Vascular and Renal were all very closely linked. If all Vascular work were to be undertaken at Southampton then this would have a massive negative effect upon the Trust.
Simon Holmes fully supported centralisation if it produced better clinical outcomes; however there were significant clinical arguments which did not support centralisation of Vascular services. Many patients would be affected should they have to travel to Southampton if this centralisation were to go ahead. The final decision had been expected in March 2011; however it had now been postponed until September 2011.
Both Ursula and Simon stressed the importance of the Governors helping with any public consultation and to support the Trust in keeping this service. There was some discussion over the Health Overview and Scrutiny Committee’s role in the review of the suggested major change in the provision of this service.
David Gattrell asked if Southampton University Hospitals Trust would need to shed other services in order to be able to cope with the demand and Simon agreed this was an area where the Trust had concerns, Southampton could end up cherry picking the services that they wanted (the high income generating ones) and leave the rest to Portsmouth Hospitals NHS Trust.
It was agreed that a paper would be prepared setting out all the facts, along with the evidence, for the Governors. This paper could also be submitted to the Health Overview and Scrutiny Committee to assist in its review.
Action: Ursula Ward / Simon Holmes
Pepe Chisenga asked if the Trust could request detail from Southampton University Hospitals Trust regarding their bid and Ursula confirmed that this had already been asked for.
07/11 / FEEDBACK FROM THE TRUST ADVISORY GROUPS
BestHospital
Mary Sheppard briefed on the groups recent meeting and advised of their concerns surrounding wheelchairs. Whilst there are 100 on site there was often none readily available. Several ideas has been suggested for Tesco like Trolley shelters to be erected. There is also a new 'Don't Walk By' scheme for all staff which might encourage anyone who sees a trolley to return it to its correct location.
Mary asked for interested Governors to remain behind after the Council meeting to discuss the 2011 public meetings and Open Day.
Best People
Kate Bowskill briefed on their recent meeting and advised that discussions had taken place as to whether this TAG should merge with another TAG. No final decision had yet been reached.
Kate asked if the Governors could be invited to future Chief Executive Forums as some had expressed an interest in attending.
Action: Susanna Kayley
Best Care
Robin Marsh briefed on their recent meeting and summarised the presentation that Fiona McNeight, Head of Governance, had given.
Business Planning & Performance
Ken Thompson updated on the groups recent meeting. He confirmed a separate meeting would be taking place on 17 February 2011 to identify and agree some SMART objectives.
08/11 / PERFORMANCE AND FINANCE REPORT
Peter Mellor handed out the previously submitted questions and their answers for perusal. Robert Toole was in attendance to answer any further questions that might be raised by the Governors regarding the Performance and Finance Report.
Syd Rapson asked about the recent £6.7m compensation award to a patient and asked if the Trust were covered for such eventualities. It was confirmed that the Trust contributed to a national scheme which dealt with such matters.
Ken Thompson queried the answer for question 10 and asked that a more in depth / updated answer be provided.
Action: Robert Toole / Peter Mellor
The staff sickness levels in MOPRS was discussed, it was agreed that these roles were the hardest to appoint to and that most of the junior nurses started out in these wards before transferring to other departments which is why there was always a higher level temporary staff needed.
09/11 / PROPOSED AGENDA ITEMS FOR NEXT MEETING
It was agreed that the results from the staff survey should be a future agenda item. It was also agreed that the annual Business Plan for 2011/12 would be a future agenda item.
10/11 / ANY OTHER BUSINESS
Jocelyn Booth advised that the Dr Foster Intelligence report showed that only 36% of all Non Executive Directors throughout the UK said they were well informed on patient safety. Peter Mellor advised that the Trust had a programme of Patient Safety Walkabouts and the Non Executive Directors took part in these.
There being no further business the meeting closed at 1.00pm