MOORFIELDS EYE HOSPITAL NHS FOUNDATION TRUST
Minutes of the Public meeting of the Board of Directors
held on 24th July 2014
Board members present: / R. Markham (Chair)D. Flanagan
D. Harris
Sir P. Khaw
Sir R. Jackling
T. Luckett
C. Nall
A. Nebel
J. Pelly
M. Sherry
S. Sinha / Non-voting directors present: / S. Davies
R. Elek
S. Storey
I. Tombleson
In attendance: / O. Brady
K. Jeffreys
H. Wilcox
1 attendee from Novartis /
Apologies: / P. Luthert
S. Williams
14/1580 MINUTES OF LAST MEETING
The minutes of the meeting held on 26th June were agreed as an accurate record.
14/1581 REPORT FROM CHIEF EXECUTIVE
Received: Chief Executive’s report
John Pelly expanded on the following points:
· CQC style patient safety visits: A further visit took place recently within City Road outpatient clinics. Tracy Luckett reported that the visit went well and a full report would be produced in due course.
· Learning points from the John Lewis customer model: A date for this visit had now been set for September and a briefing will be given to the Board.
· AGM: This had taken place on 23rd July and was again noted to have been a successful event. The Chairman complimented all those who had helped in its organisation. One perception from comments made by patients on the day was that for the best treatment, patients should attend the main City Road site. It was therefore felt that we were not adequately getting the message across that we maintain exactly the same standards across all our sites and employ staff of the same quality wherever they are based. In addition, all our clinical governance arrangements and processes are identical across all satellites. It was agreed that Management Executive take this forward to explore the best way of communicating the message across. It was also felt that it would be helpful in future at the AGM if the Governors were given name badges to help patients identify them.
· Visit to China: John reported that he and Chris Canning would be visiting Beijing and Guangzhou next week to explore possible collaboration. A full report would be brought back via the Strategy & Investment Committee.
Ø ACTION
Kate Jeffreys to explore ways of further communicating the message that the same quality of care is provided across all our sites - KJ
14/1582 OPERATIONAL REPORT
Received: Monthly Operational Performance report for June 2014
· Mary Sherry updated the Board on the progress with improving the Trust’s RTT18 performance. Currently the team were in the process of changing the admission processes. Admission scheduling rights within OpenEyes would shortly be moved from doctors to admissions administrators in order to control bookings and run waiting lists effectively. There had been a significant increase in capacity over the last few months on a temporary basis in order to improve performance. Currently we were achieving approximately 82% for the admitted pathway and it was hoped that this would increase to 90% by October. Investigations were underway as to whether some work may need to be outsourced. Mary noted that there were still a significant number of patients potentially exceeding the 18 week target in October and efforts were being made to contact them to offer an earlier date.
With regard to the refurbishment of the airflow systems in City Road theatres, the nature of the work had been extensively reviewed and it had been concluded that this would need to be delayed until October to adequately allow for preparatory lead-in times and to give the best chance of reaching the RTT18 target. The infection control team were fully involved and agreed with this decision with any risks being closely monitored. The Chairman confirmed that the Board were supportive of the proposal but wanted to be quite sure that the organisation was fulfilling all its statutory responsibilities in this regard. Rob Elek agreed to follow up on this point.
· Rob Elek reported that A&E performance was still strong and activity was noted to be rising. The volume of work being done in relation to RTT18 was also noted to be rising. The slight dip in performance at the end of the quarter was predictable due to the fact that breaching patients were being brought forward and admitted earlier. Andrew Nebel asked if day to day data could be given regarding number of patients breaching the A&E target and Rob confirmed this would be contained within the next report. The Chairman enquired what the risk was of other hospitals closing their A&E departments and even more patients attending Moorfields. Rob noted that this was already happening “out of hours” and at present these volumes were manageable. Although the issue raised by the Chairman had not been specifically discussed, Rob explained that we were starting to think what our A&E and urgent care strategy should be across our network. Rob and Mary reported that a huge amount of work was being done in relation to improving data quality and the Chairman suggested that in the Autumn the Board reviews progress with this.
Ø ACTION
Rob Elek to confirm that all statutory/regulatory responsibilities were being fulfilled regarding the refurbishment of airflow systems in theatres.
14/1583 FINANCIAL REPORT
Received: Monthly financial report for June 2014
Charles Nall presented the report:
· Following discussions with the Audit Committee, the format of the report next month would reflect further changes to enhance understanding.
· A good NHS performance was recorded with a weaker commercial income giving an overall effect of income being down £1M. Across costs, pay was noted to be generally well controlled. NHS expenditure was recorded as £0.3M lower than anticipated and commercial income £0.5M below plan.
· Charles noted some concern around CIP relating to costs but thanked Declan for his assistance in this area and in raising this issue at TMB and amongst the consultants.
· In summary, the opening of the financial year generally showed some deterioration in the cash position but this was expected to recover somewhat by the end of August once further settlement was achieved with commissioners.
· All PCT legacy items were noted to have been settled.
· Charles informed the Board of the intention to draw down £31M with 25 year borrowing at interest rates around 3-4%.
· Steve Davies reported that there had been discussion during the recent Audit Committee around cost efficiencies and the need to get back on track by the end of the summer in delivering these.
· Roger Jackling enquired what assumptions were being made around timing of costs associated with additional RTT18 activity. Steve indicated that plans were currently being formulated.
The Chairman noted the financial position which was not quite as strong as previous recent years and provided full support to the operational management in dealing with the challenge of a number of conflicting priorities.
14/1584 WORKFORCE REPORT
Received: HR & Workforce Report Q1 2014-2015
Sally highlighted work that had started on the education strategy. This had begun with the implementation of the new learning and development system, including the development of standard administrative processes that would transform the experience of all our learners, and the commissioning of an e-learning platform and capability to create e-learning material, across all staff groups, that was worthy of the excellence we aspire to. A specification for a Director of Education was in draft form.
Work on “The Moorfields Way” was noted to be progressing and listening events had been attended by large numbers of staff and patients. A key theme emerging was the need for Moorfields to develop greater consistency across all services, so that all patients experienced the excellent service that so many, but not all, our patients enjoy. The plan was to consult widely on a new set of values and behaviours and launch them formally at the clinical governance half day in November. The Chairman asked for Governors to be involved and Sally agreed to arrange this.
The work to transform our recruitment service, creating a dedicated and expanded team that would improve the service to managers, had progressed well, and appointments to the new team had been made. The new team would be operational by the end of September.
Deborah commented on the need to ensure that all strands of HR activity were clearly linked with the cultural change needed across the trust, and Sally agreed to look at ways of making this more explicit.
The Chairman commented on the growing importance of the pension tax arrangements, and the potential for this to create significant problems in the attraction and retention of senior staff. The issue would be explored within the Remuneration Committee.
14/1585 MONITOR SUBMISSION
Ian Tombleson noted that the Monitor template was not yet available, but was expected to look similar to previous quarters. Mary, Steve and Ian continued to update Monitor with progress against RTT18. Authority was delegated to the Chairman and Chief Executive to sign off the submission once it had been completed.
14/1586 QUALITY & SAFETY COMMITTEE
Received: Quality & Safety Committee Annual Report 2013/14
In view of Phil Luthert’s absence, this item was deferred until the next meeting.
Deborah Harris asked that Board be informed regarding the changes made to the way in which the Friends and Family test was recorded and reported. Tracy Luckett said that this would be included in her next Patient Experience report.
Ø ACTION
Tracy Luckett to report on changes to Friends & Family test in next Patient Experience report.
14/1587 AUDIT COMMITTEE
Deborh Harris provided an oral report following the meeting held on 23rd July. She highlighted two areas which had been discussed:
· A summary of the briefing for Governors to support their formal receipt of the Trust's Annual Report.
· The systems and controls to address a theme of accountability and matching authority of operational managers. This would underpin delivery for projects such as CIPs or the transformational service redesign.
14/1588 SUMMARY STRATEGIC PLAN
Received: Strategic Plan for 2014-19
Rob Elek reported that this document was the published version of the Strategic Plan and would be put on the website and also issued formally to Monitor.
The Chairman raised a question, for consideration at a later date, concerning “eye care provision”. He wondered to what extent Moorfields had a clear view of the future model for eye care provision. He noted the organisation has a clear model that we think is fine today and which is being articulated better each year, but increasingly it was important that we described very clearly why the role of the specialist eye hospital remains essential for the future of eye care. He felt that as our strategic clarity continued to evolve and crystallise, there was an opportunity for stating what our model is and to use this as part of getting a wider group of people supporting and contributing to that development
The Board agreed that the Strategic Plan document should be put on the website.
14/1589 BOARD CALENDAR
Noted.
14/1590 AOB
· Deborah Harris asked the Board to note that Parul Desai was the first woman appointed to role of Master of the Oxford Congress.
· Declan Flanagan reported that Dr Millicent Stone had just been appointed to a joint adult rheumatology consultant post between Guys and St. Thomas’ Hospital and Moorfields.
14/1591 NEXT MEETING
The next meeting of the Board will be held at 9am on Thursday 4th September 2014
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24.7.14 Board of Directors PUBLIC Meeting