In Attendance: Mrs D Currie (Minutes) Mr K Walsh (representing Mr Throp) Mrs M Pointon, PPI Forum

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1 Southport & Ormskirk Hospital NHS Trust Minutes of the Trust Board Meeting held on Wednesday 13 th September 2006 at 2.00pm In the Boardroom, Southport & Formby District General Hospital Present: Mr A Johnson Mr J Parry Mr M Eastwood Dr G Boocock Mrs J Citarella Mr K Clarkson Mrs M Carberry Mrs L Yates Mr M Iskander In Attendance: Mrs D Currie (Minutes) Mr K Walsh (representing Mr Throp) Mrs M Pointon, PPI Forum Apologies: Miss C Aitken Mr C Throp Mr L Byrom Mr P Davies Presentation to Mr Stephenson, Executive Director, Planned Services Mr Johnson presented Mr Stephenson, Executive Director of Planned services with a farewell gift to show the Board s appreciation of his hard work and dedication to the Trust since he commenced employment with us in /137 Minutes of the Trust Board Meeting held on 19 th July 2006 The Minutes of the Trust Board meeting held on Wednesday 19 th July 2006 were formally agreed as a correct record. 06/138 Matters Arising (a) 06/0119 Finance Directors Report Cancer Targets At the last Board meeting Mr Throp had explained that the Trust had 7.5 breaches against the 62 day rule target. Mr Throp explained that 4.5 of the breaches were due to complex care pathways and that the remaining 3 breaches were caused by clinic cancellations. Members asked Mr Throp to provide them with more information at the September meeting of the Trust Board. In Mr Throp s absence, Mr Clarkson was disappointed to report that the 3 breaches were caused by an error in the implementation of the escalation plan. The person involved has been spoken to and Mr Clarkson is confident that this will not happen again. Members were pleased to hear that 100% performance against target was recorded for July and an anticipated 96% for August.

2 (b) 06/122 Closure of the Southport General Infirmary Mersey Care NHS Trust have issued a press release announcing proposals to replace the buildings on the Southport General Infirmary site with a 10M purpose built older people s facility. The Trust is on schedule to move all its services off the SGI site by 31 st March This will remain a standing item on the Trust Board Agenda. Action: Mrs Currie (c) 06/125 ISTC/CATS The Department of Health recently announced that the preferred bidders for the Cheshire and Merseyside ISTC is BUPA and for the Cumbria and Lancashire CATS, Netcare. Discussions with Netcare are progressing well, however the Trust is waiting to hear from the Department of Health if the Trusts association with BUPA is to continue. Members were reminded that this upholds the Trust s promise to continue to work to maximise capacity at Ormskirk hospital and to attract new revenue steams for the Trust. 06/139 Finance Directors Report to the Board Mr Walsh, Deputy Director of Finance, talked in detail to the Finance Directors Report, circulated with the Agenda, summarised thus:- Finance A revised four-year financial plan has been submitted to the North West Strategic Health Authority at the end of July. This demonstrated the need for a recovery plan of 14.4m over the two-year period and in order for the Trust to achieve a balanced monthly run rate. The plan recognised the opening deficit this year was too large to be addressed in one financial year, as such, after achieving a recovery plan of 5.2m this year, the plan forecasts an overspend of 5m at the end of March Discussions with the Strategic Health Authority in respect of this plan have commenced and once adopted, a formal budget will be brought to the Trust Board for approval. The Trust is therefore operating within a revised provisional budget of an in-year deficit of 5.0m. The financial performance at the end of July is an under-spend of 725k against the provisional budget deficit of 5m.. Recovery Plan Provisional plan of 5.2m. 3.7m current year effect implemented to date. 1.5m more to be actioned in 2006/07 as a minimum to achieve the plan although 384k identified as high risk. Cash Management The Strategic Health Authority debt management has been actioned and has had a positive impact on cashflow, 12m receipted in July. Capital Programme The Capital Programme was adopted at July s meeting of the Finance Committee. Expenditure of 630k to date. Activity and Targets Contracts Current activity performance is overachieving against the plan although the full financial gain will not be received until 2007/08. Realistic Payment by Results surplus of 204k for the first quarter. Admitted Patient Care all targets achieved.

3 Outpatients all targets achieved. Booking 100% achieved A&E 99.5 performance against 98% target Diagnostics all waits continue to fall over all categories Cancer as reported earlier, the end of July performance against target was 100% and the predicted position at the end of August is 96%. Mr Johnson asked Mr Walsh to incorporate dashboard style information into next month s Finance Directors Report. Action: Mr K Walsh/Mr C Throp 06/140 Financial Business Plan and Turnaround Mr Parry submitted the Trust s Corporate Financial Turnaround Strategy to Mr Ogden, the NHS North West s Finance Director on the 31 st July In August, Mr Throp met with the Assistant Director of the NHS North West to discuss this document in detail, who in turn will feedback a summary of their meeting to the NHS North West s Finance Director. The Trust is waiting for a meeting to be called with Mr Ogden, Mr Parry and Mr Throp to sign off the financial business plan. The Trust has been advised that we will need to appoint to an interim post of Turnaround Director to work alongside Mr Throp for eighteen months to deliver the Recovery Plan. 06/141 Staff Reductions Update Members noted the latest position regarding recovery savings from the staff reductions within the Trust summarised as follows:- 2006/2007 CYE 2007/2008 FYE Compulsory Redundancies 15, ,196 Voluntary Redund ancies -225, ,227 Vacancy Freeze 775,543 1,002,375 TOTAL 565,537 2,320,798 At the July meeting of the Trust Board, Mrs Partington reported that following a consultation period with the staff side, 33 members of staff have been made compulsory redundant and a further 50 posts would need to be identified. These figures have been updated and Mr Parry reported that the actual figures, due to the strict implementation of a vacancy freeze have reduced. 20 members of staff have been made compulsory redundant (not 33) and the Trust is now looking for less than 20 posts (not 50) to be identified. Members were pleased to note the reductions, but still disappointed that the Trust is having to make 40 of its staff compulsory redundant. 06/142 Future Management Structure Manpower reduction discussed earlier in the meeting will affect all staff across the Trust and the Chief Executive has looked at the Directors posts within the Trust with a view to reducing the number of senior managers and making a contribution towards the Recovery Plan.

4 The Remuneration Committee met in July and authorised the offer of voluntary early retirement with support for the Director of Agenda for Change and the Executive Director of Planned Services posts. Mr Lloyd-Jones and Mr Stephenson, the respective post holders have accepted the offer and will leave the Trust s employ in November and September As a consequence of Mr Stephenson s retirement, the opportunity exists to restructure the senior management team in order to produce further manpower savings. There will be internal competition for the new posts to be established at senior management level and this process is now underway. The Directorate level has been restructured and is represented diagrammatically and explained in the paper circulated with the Agenda. Members noted and gave their AGREEMENT to the proposed new management structure. 06/143 Reports from the Director of Nursing:- (a) Nursing Directors Report Mrs Yates spoke to the report circulated with the Agenda which informs the Trust Board of developments taking place in the nursing organisation and provision in order to ensure optimal care for patients within the resources available. The impact of the patient s experience of care is vital both to patients and to the reputation of the Trust. In recognising this nurses, are making a valuable contribution to achievement of the Trusts objectives by working at all levels to bring about improvements in the care of patients and thereby reinforce Southport & Ormskirk Hospital NHS Trust as the facility of choice for Healthcare provision. Members noted the contents of the report circulated with the Agenda. (b) Nurse Staffing The paper circulated with the Agenda details the results of the Trust s Nurse Staffing Review which was undertaken between January and June The review consisted of several components designed to achieve the following objectives:- Provision of high quality nursing service within the resources available. Complete review as recommended by Acute Hospital Portfolio Ward Staffing Audit. Assurance regarding the use and deployment of Specialist Nurses Development of clear information regarding the average number of vacant nursing posts Containment of overall nurse staffing expenditure within budget limits. Members accepted the results of the Specialist Nurse Review and debated and agreed the redirection of identified savings to the Trust Recovery Plan Mr Johnson wanted the Director of Nursing to be assured that once the Trust is in a better financial position, nurse staffing will be the first priority for increased budget. (c) Improving the Use of Temporary Nursing Staff in Acute and Foundation Trusts In response to the National Audit Office document Improving the Use of Temporary Nursing Staff in NHS and Acute and Foundation Trusts published in July 2006

5 Appendix 1 of the paper circulated with the Agenda contains the Trust s position against the recommendations contained in the Audit document. Appendix 2 is the Trust s Action Plan which will highlight the Trust s position against the Good Practice Guidelines. Progress against each of the actions will be monitored and presented at the Finance and Performance Committee. Action: Mrs Yates/Mr Throp Members noted the contents of the paper circulated with the Agenda. 06/144 National Patient Survey Inpatient Survey 2006 The National In Patient Survey commenced on the 4 th September As in previous years the Survey will canvass the views of 850 inpatients who were discharged in June, July and August Members noted the contents of the paper, including a timetable incorporating key dates of the national timescales, circulated with the Agenda. 06/145 Proposal to join the Greater Manchester Collaborative Procurement Hub The Trust has for a number of months been actively involved with partners from Cheshire and Merseyside Strategic Health Authority in reviewing the merit of joining a collaborative procurement hub. The options of either joining the Manchester based hub or setting up a more locally based alternative have been fully explored. A group of 10 to 12 organisations within Cheshire and Merseyside have determined that the optimal and most timely proposal, which will maximise the savings for the Trust, is to join the current set up in Manchester. The paper, circulated with the Agenda, outlines an interim agreement for the next 18 months to facilitate this as part of one of the on-going recovery plan proposals. The Chairman, Non-Executive Directors and the Medical Directors expressed the need for the Trust to be absolutely certain, before entering into a contract, that there is proper and adequate choice in supplies for clinicians and nursing staff. The Chairman asked Mr Throp to reassure the Medical Directors and Director of Nursing of any concerns they have. The Chairman of the Finance Committee was disappointed with the annualised savings targets identified and felt that the savings for the Trust should be far greater than those predicted. Mr Johnson asked Mr Walsh to relay the Board s concerns to the Greater Manchester Collaborative Procurement Hub and the Board gave their AGREEMENT, subject to the caveats described above, to join the Greater Manchester Collaborative Procurement Hub on an interim tailored service, before committing to joining as a full service stakeholder in April /146 Biphasic Outbreak of Clostridium Difficule in Stoke Manderville Hospital A summary of the Report into the biphasic outbreak of clostridium difficule in Stoke Manderville Hospital was sent to members of the Trust Board in August. Members were pleased to hear that the Infection Control Team have assured the Medical Directors that the Trust has measures in place to avoid a similar outbreak happing at this Trust.

6 06/147 Recent Paediatric Reports in the Press Members noted the events surrounding recent articles which appeared in local newspapers over the last few weeks. 06/148 Commercial Group Progress Report Members of the Board, noted and SUPPORTED the Commercial Group s progress report circulated with the Agenda. Members stated the need for measurable objectives to be set against the Commercial Plan, which should be brought to the Trust Board on a quarterly basis for review. Action: Mrs S Finnegan 06/149 Best Care Practice Members noted the contents of the Report circulated with the Agenda. 06/150 Integrated Governance Members noted the contents of the Integrated Governance Report, circulated with the Agenda. Mr Clarkson will be bringing a Patient Experience Report to the October meeting of the Trust Board. Action: Mr K Clarkson Members APPROVED the Integrated Governance Action Plan which requires a number of actions to be completed for the October meeting of the Trust Board. Action: Mr K Clarkson 06/151 Trust Board Meetings Draft Dates for 2007 Following short debate, it was agreed that Mr Throp, Mrs Carberry and Mr Clarkson would meet outside the meeting to look at the timing and production of the financial accounts and information, the timing of the performance information and agree a more suitable time in the month for the Trust Board to meet in /152 Minutes of the Finance & Performance Committees held on 31 st July and 29 th August Members had discussed in detail the Finance Directors Report earlier in the meeting. Members noted the Minutes of the Finance & Performance Committee held on 31 st July 2006 and 29 th August /153 Minutes of the Audit Committee held on 5 th July 2006 The Minutes of the Audit Committee held on 5 th July 2006 were noted. raised. No issues were Mrs Citarella gave her apologies to the Audit Committee scheduled for the 28 th September and requested Mr Throp ensure the meeting is quorate and arrange for another Non- Executive Director to chair the meeting. Mrs Carberry volunteered to chair if Miss Aitken could not attend.

7 06/154 Minutes of the Human Resources Strategy Sub Committee held on 22 nd June 2006 The Minutes of the Human Resources Strategy Sub Committee held on 22nd June 2006 were noted. No issues were raised. 06/155 Minutes of the Remuneration Committee held on 19 th July 2006 The Minutes of the Remuneration Committee held on 19 th July 2006 were noted. No issues were raised. 06/156 Minutes of the Risk Management Committee held on 20 th July 2006 The Minutes of the Risk Management Committee held on 20 th July 2006 were noted. issues were raised. No 06/157 Any Other Business (a) Mrs Pointon raised the inappropriate use of designated disabled spaces within the Trust, particular in the parking area at the back of the Boardroom. Mr Parry will ask Mr Taylor to speak with Mrs Pointon direct. Action: Mr J Parry 06/158 Date, Time and Venue of Next Meeting Wednesday 18 th October pm Boardroom, Southport & Formby DGH