DRAFT
WELSH AMBULANCE SERVICES NHS TRUST
MINUTES OF THE OPEN MEETING OF THE TRUST BOARD MEETING HELD ON 15 MAY 2014 AT VANTAGE POINT HOUSE, CWMBRAN
MEMBERS PRESENT:Mick Giannasi
Mike Collins
Mike Coupe
Emrys Davies
Pam Hall
Judith Hardisty
Sara Jones
John Morgan
James Mycroft
Elwyn Price-Morris
Patsy Roseblade
David Scott
Jonathan Whelan
Martin Woodford
/ Non Executive Director and Chairman of the Board
Director of Service Delivery
Director of Strategy, Planning and Performance
Non Executive Director
Non Executive Director
Director of Workforce and Organisational Development (OD)
Director of Quality and Nursing
Non Executive Director
Non Executive Director
Chief Executive
Director of Finance and ICT
Non Executive Director
Interim Director of Medical and Clinical Services
Non Executive Director
TRUST BOARD REPRESENTATIVES:
Sally Bruce
Nigel Heal
Nathan Holman
Roger John
Mick Jose
Steve Owen
Dawn Sharp / Corporate Communications Manager
Staff Side Representative (RCN)
Staff Side Representative (GMB)
Staff Side Representative (UNITE)
Staff Side Representative (UNISON)
Corporate Governance Officer
Corporate Secretary
APOLOGIES
Moawia Bin Sufyan
Bleddyn Roberts
Bernadine Rees
OBSERVERS
Jennie Allport
Leanne Hawker
Greta Sainsbury
Hugo van Woerden / Board Mentee
Staff Side Representative (UNITE)
Non Executive Director
Board Mentee
Partners in Healthcare Lead
Member of Public
Public Health Wales
25/14 / CHAIRMAN AND CHIEF EXECUTIVE’S WELCOME AND UPDATE The Chairman opened the meeting by welcoming all and added that this session of the meeting was being recorded. The Chairman further added that the current seating plan had been arranged in order to assist in the integration of the Board Members. Members were informed by the Chairman that the past few weeks had been fast moving and clarified that because of that some of the agenda items would be verbal updates.
With regard to the Integrated Business Plan (IBP), the Chairman informed Members that the Trust’s initial submission had been rejected and had not attained the required standard. In January 2015 the Trust would have a second opportunity to resubmit the plan for the three-year process. The Chairman added that this had been disappointing especially in terms of the work carried out by the Director of Finance and ICT and her team. The Minister, in his letter to the Trust indicated that there were certain elements within the plan missing in that without knowing the details of the budget it was difficult to formulate a comprehensive plan and that there was a temporary lack of capacity in terms of the planning function. The real gap in the plan was the absence of what the expectation of the Commissioners was.
The Director of Strategy, Planning and Performance stated that he expected that the Annual Delivery Plan would meet the end of month deadline and would be much more detailed in terms of how the Trust intended to achieve the 65% performance target.
The Chief Executive informed Members of the latest issues that surrounded the outcome of the ‘Andrews Report’ and indicated that the Trust must now take this on board not only in respect of how elderly people’s services were being delivered but to use it as an opportunity to provide fairness and equity for all who accessed the Trust’s services. He added that whilst the report had been written about a hospital failing it was important to adhere to the principles that had emerged from the report and apply these across the NHS.
The Chief Executive confirmed that the Director of Quality and Nursing had been commissioned to consider the ‘Andrews Report’ and provide assurance through the Quality Delivery Committee (QDC) to the next Board meeting with regard to the issues raised within the report.
The Director of Quality and Nursing provided Members with assurance that a response would be given in terms of the issues raised from the Andrews report with special regard to care of the elderly.
David Scott raised the issue with regard to the outstanding level of concerns and asked how the backlog was being addressed. Jonathan Whelan explained that there was a clear action plan in place to tackle the backlog.
RESOLVED:
That the Director of Quality and Nursing prepare a report as outlined above for QDC and subsequently the Board following publication of the ‘Andrews Report’
26/14 / PROCEDURAL MATTERS
The Chairman reiterated Non Executive Director Emrys Davies’ declaration of interest as a retired member of UNITE. Members were asked to consider the Minute from the last Trust Board meeting and the following issues were raised.
The Director of Finance and ICT referred to page six of the open session minutes in terms of the outline budget and emphasised that it was important to note that displaced staff had not been dealt with. Furthermore, the wording which surrounded the board development day should be amended to read that the day was to be used as a discussion in terms of the potential for future savings and not the in year budget. The venue recorded for the closed session of the Minutes was to be amended to read Coleg Powys, Newtown.
The Chairman referred to the membership of the Board and it was agreed that this be ratified. He then asked Members that they consider the Statement of Principles and Behaviours for the Board’s future operation which had been circulated for comment and asked members, should they wish to, acknowledge and sign the master copy.
The Director of Workforce and OD, informed Members that a Board Development day had been scheduled for 19 June 2014 which would include a presentation from Academi Wales.
The Corporate Secretary referred Members to the timeline which required to be adhered to in terms of signing off the Annual Governance Statement (AGS). Members were further informed that the Annual Quality Statement (AQS) and AGS featured as part of the Annual Report. The intention was to bring the draft AQS and draft Annual Report to the June meetings of QDC and Audit and have them presented at the July board for sign off prior to the release to KPMG as part of the auditing arrangements. The documents would then be translated in preparation for their formal presentation at the Annual meeting in September.
RESOLVED: That
(1) the declarations of Mr Emrys Davies as detailed above be noted;
(2) the minutes of the meeting (open and closed sessions) of the Board held on 20 March 2014 be confirmed as a correct record subject to the comments made as detailed above;
(3) the appointments to Chairmanships and Memberships of Committees including the appointment of Vice Chairman of the Board, and Champion roles as set out in Annexes 2 and 3 to the report be endorsed;
(4) the Statement of Principles and Behaviours regarding for future operation of the Board be endorsed;
(5) the urgent business (Ref: 7, 8 and 9/2014) approved by the Chairman and Chief Executive under the procedures contained in Standing Order No 2.1 relating to the Procurement of Automated External Defibrillators and Mangar Camel Lifting Device, Employee Tribunal Settlement and Employee Settlement Agreement be endorsed;
(6) the position regarding the draft Annual Governance Statement be noted;
(7) the ongoing work in terms of producing the Annual Report / Annual Quality Statement for 2013/14 be noted; and
(8) the register of documents sealed as listed in Annex 5 to the report be noted.
27/14 / PATIENT EXPERIENCE
The Partners in Healthcare Lead provided Members with a story which related to a patient who had been admitted to hospital following urinary problems. The patient, following his treatment raised the following concerns through a survey he had completed: -
· could a catheter have been inserted to avoid the need to be transported to hospital;
· why couldn’t the hospital have used the paramedic’s blood test results; and
· could the same ECG equipment for the Trust and hospitals be introduced.
The Board noted that catheter insertion was not a core paramedic skill, however if the crew had felt that urinary retention was the issue, guidance could have been sought from an Advanced Paramedic Practitioner.
With regard to the blood test results, there was an issue with the labelling of the samples in terms of the standard accepted by hospitals. Leanne Hawker advised Members that the governance arrangements for this process were being considered.
The ECG pads used by the Trust and hospitals were not compatible. Discussions had taken place with the provider of the equipment and it was hoped a solution would be available within the next couple of months in terms of uniformity of supply.
Members held further discussions which considered the core level of skills requirements of paramedics in terms of their development.
The Chief Executive explained that the Trust needed to prepare for the eventualities which had come out of this story and added that the Trust had moved clinical practice forward and was committed to providing the Board with practical examples throughout the transformation process.
The Director of Quality and Nursing added that it was important to make the connections with patient stories of this type and the issues arising from the ‘Andrews Report’.
The Chairman concluded that a letter would be sent to the patient to thank him for raising these issues and asked that an update be brought forward to the next Trust Board meeting.
RESOLVED: That
(1) that the lessons learnt from this story be taken forward; and
(2) the Partners in Healthcare Lead provide an update report on this story at the next Trust Board meeting.
28/14 / RECRUITMENT PLAN
The Director of Workforce and OD provided Members with an overview of the recruitment plan and highlighted that the programme involved a great deal of staff and changed almost on a daily basis in terms of the vacancies for paramedics. With regard to speeding up the training process this was reliant on the finances.
The Director explained that the recruitment process consisted of assessments in driving, fitness and theory which followed into a value based interview. Members were further updated on the status of the newly qualified paramedics in addition to the recruitment of Urgent Care Staff.
Emrys Davies, Non Executive Director, asked if within the report a timeline could be incorporated to reflect whether the plan was ahead or behind schedule. The Director agreed to reflect this within future reports.
The Director of Finance and ICT, in response to the query raised by David Scott regarding the risks associated with Fleet capacity and accommodating the extra staff, informed Members that there were ongoing workstreams involved in addressing this issue.
The Chairman emphasised the need for an appropriate communication plan for staff to advise them of the recruitment plan and acknowledging that this would lead to a reduction in overtime in due course. It was acknowledged that the recruitment plan offered significant opportunities.
Nathan Holman, Staff side representative asked whether the appropriate feedback had been given to those not selected, and whether appropriate backfilling arrangements were in place for those for example from PCS who were appointed to HCS positions. The Director of Workforce and OD explained that one to one discussions had taken place and in terms of successful PCS applicants and any resulting vacancies would be recruited to.
RESOLVED: That
(1) the actions being taken to recruit to both new posts and funded vacancies be supported;
(2) the monitoring of the work through the Strategic Transformation Board as part of the Workforce, OD and Improvement work stream of the Strategic Transformation Programme be supported; and
(3) the ongoing work to include this information in the integrated performance report and balanced scorecard be noted.
29/14 / TRANSFORMATION
Review and Approval of Strategic Transformation Programme (STP) Initiation Documents
The Director of Strategy, Planning and Performance informed Members that the documents had been reviewed in considerable depth at the Strategic Transformation Board (STB) last week. The discussion had looked at governance and the Director was very keen that assurance was provided to the Board that the Trust was moving in the right direction.
Members were informed that the Scottish Ambulance Service had agreed to act as a critical friend and it was intended to invite two other ambulance Trusts from England (consisting of one rural and one urban) to assist in a gateway review process every six months.
The Chairman asked that the Non Executive Directors who had been involved in the process to provide their opinion and comments.
James Mycroft confirmed that the priorities contained within the plan were correct and added that more information with regard to ICT should be incorporated within the plan. He added that he had a sense that along with the operational visits he had undertaken, the aims that were articulated within the plan were absolutely the right things that the Trust should be concentrating on.
Martin Woodford mentioned that there were a number of risks outside the issue of resourcing and project managing the programme itself. These risks must be flagged and tracked and the Trust must do all it could to mitigate against them.
David Scott asked whether there had been any feedback from KPMG in terms of them looking at the effect on the organisation of the reform programme and the Trust’s ability to perform.
The Chief Executive confirmed that there had been an initial response and that the report was yet to be finalised. He added that the important point was how the Trust went about protecting day to day operations whilst also carrying out the transformation and not diminishing or diluting resources. The Executive Team needed to consider the capacity issue as it had been indicated that there were a number of lines the Trust was perusing internally and externally to identify people within the organisation who had the right skills. In conclusion he added that the Trust still needed to map out the risks emanating from the transformation process and the day to day operational management in more detail.
Pam Hall indicated that ICT was not mentioned in the PID and having read ‘Working Together for Success’ and some of the case studies outlined the Trust could not deliver modernisation at that level without significant investment in ICT.
The Chief Executive accepted that it was helpful to have this opportunity to expose the areas that needed to be further developed.