M I N U T E S Part 1

Transcription

1 tem 0. Meetng of the Board of Drectors Held on 26 March 2015 at 9.00am n the Upper Lecture Theatre, Papworth Hosptal M I N U T E S Part 1 Present Prof J Wallwork (JW) Charman Mr S Brdge (SJB) Chef Executve Mrs K Caddck (KC) Non-executve Drector Dr R Hall (RMOH) Interm Medcal Drector Mss E Horne (EH) Drector of Human Resources Mr D Hughes (DEH) Non-executve Drector Dr S E Lntott (SEL) Non-executve Drector Mr M Mllar (MM) Non-executve Drector Prof N Morrell (NM) Non-executve Drector Ms J Paylng (JP) Drector of Fnance Mrs C Trpp (CT) Drector of Operatons Dr R Zmmern (RZ) Non-executve Drector In Attendance Mrs M MacDonald (MMac) Trust Secretary Mrs R Hawkns (RH) SIP Project Drector Observer Mr G Jagger Lead Governor (Publc Governor) Mr K Jackson Publc Governor Apologes Mrs J Rudman (JR) Drector of Nursng Agenda WELCOME, APOLOGIES AND OPENING REMARKS The Charman welcomed everyone to the meetng. Apologes were noted and accepted as above. DECLARATIONS OF INTEREST There s a requrement that Board members rase any specfc declaratons f these arse durng dscussons. The followng standng Declaratons of Interest were noted: 1. John Wallwork, Stephen Brdge and Nck Morrell as Drectors of Cambrdge Unversty Health Partners (CUHP). 2. Susan Lntott n regard to postons held wthn the Unversty of Cambrdge, partcularly n relaton to fundrasng. 3. Ron Zmmern as Charman for the Foundaton of Genomcs and Board of Drectors Meetng Part 1-26 March 2015: Mnutes Page 1 of 8

2 Populaton Health, an assocate organsaton of CUHP. 4. Dave Hughes as an employee of BT. The Charman remnded all Board members to complete the Declaraton of Interests form as part of the annual return, and return ths to the Trust Secretary. ALL MINUTES OF THE PREVIOUS MEETING 3 February 2015 Approved: The Board of Drectors approved the Mnutes of the Part 1 meetng held on 3 February 2015 and authorsed these for sgnature the Charman as a true record. Charman v UPDATE ON ACTIONS AND MATTERS ARISING Noted: The Board noted the acton checklst and no further matters were rased. 1 COMBINED QUALITY REPORT Patent Safety, Effectveness of Care, Patent Experence the Drector of Nursng and Interm Medcal Drector. The report covered: Care Qualty Commsson (CQC); Safety Excepton Report (Serous Incdents, Safety Thermometer); Rsk (Board Assurance Framework); Effectveness (Inquests, New Consultant appontments); Frends & Famly Net Promoter Score; CQUIN Related Patent Experence Data. Appendces to ths report were as follows: 1. Integrated Qualty Dashboard Results 2014/15; 2. CQC Qualty Report Plan; 3. Summary Board Assurance Framework (BAF) to be presented to the Qualty & Rsk Commttee 31 March RMOH spoke to the paper and durng dscusson the followng ponts were consdered/noted: CQC report should be on CQC web ste ths week; Papworth had receved an overall ratng of good wth two sectons of outstandng practce and three of good; All the factual accuracy challenges from Papworth had been accepted the CQC; The CQC team had been complementary and stated they would recommend Papworth to ther famly and frends for treatment; The report ncluded some areas for acton and these were summarsed n the paper; A detaled acton plan would be sent to Montor wthn 30 days; Montor had requested Papworth commssoned an external qualty revew and ths would take place n Q1 of 2015/16; Board of Drectors Meetng Part 1-26 March 2015: Mnutes Page 2 of 8

3 The safer staffng fgures were noted and these reman a challenge at Papworth as s the poston natonally; The frends and famly net promoter score was noted; The CQUIN related patent experence data was noted. Noted: The Board of Drectors noted the contents of the Combned Qualty Report. Drector of Infecton Preventon and Control [DIPC] Report the Drector of Nursng. The report covered: Health Care Assocated Infectons (HCAIs); Bed closures. Noted: The Board of Drectors noted the contents of ths report. v Qualty & Rsk Commttee 3 February 2015 Receved and noted: The Board of Drectors receved and noted the draft Mnutes of the Qualty & Rsk meetng held on 3 February WORKING DIFFERENTLY Servce Improvement Programme (SIP) the Chef Executve/SIP Drector on Month 11. RH spoke to the paper and durng dscusson the followng ponts were consdered/noted: Poston year to date was dsappontng wth an n-month shortfall of 226k; It was requested that future papers should nclude a short paragraph explctly statng the reasons for any shortfall and ths was agreed; More formalsed escalaton processes would be ntroduced. Ths would be confrmed for the next meetng as part of the budget settng proposals; Procurement changes needed to be speeded up. SJB and RMOH would be dscussng ths wth clncal colleagues; SJB stated that tghter central control of expendture would be requred n the short term; As prevously dscussed, the need to ntegrate SIP and fnancal reportng was hghlghted as SIP was only one of a number of devces to meet targets. As prevously agreed Servce Lne Reportng would be used to ad ths from 2015/16. Performance Commttee 24 February 2015 RH SJB/RH JP Aprl 15 Aprl /16 DH, as Char of the Commttee nformed the Board that the Commttee had consdered the deteroratng fnancal poston and the need for Board of Drectors Meetng Part 1-26 March 2015: Mnutes Page 3 of 8

4 mprovement n forecastng, wth the settng of challengng but achevable budgets and then careful montorng and holdng to account n year. Receved and noted: The Board of Drectors receved and noted the Mnutes of the Performance Commttee dated 24 February WORKFORCE Values and Standards of Behavour the Drector of Human Resources whch updated the Board of Drectors on how the organsaton s, and proposes to, ensure that every member of staff s aware of and s expected to demonstrate n practce our core values of Care, Innovaton, Valued and Excellence. Appendx A detaled the Draft Papworth Hosptal Consultants Standards and Appendx B detaled the Draft Consultant Competency Framework. Durng dscusson the followng ponts were consdered/noted: The ntroducton of trust wde standards of behavour for consultant staff amed to algn all consultants as part of the Papworth team; The proposals had the support of the Papworth Medcal Advsory Commttee (PMAC) and had been developed from shared good practce examples at other hosptals; Followng a queston from a Non-executve Drector (NED), the Board was nformed that these standards were supplemental to General Medcal Councl (GMC) and other natonal professonal standards; The standards helped to re-enforce postve behavours and move the measurement of behavour from a subjectve to objectvty bass. Noted and Dscussed: The Board of Drectors noted the actons taken to date regardng values based recrutment and dscussed the proposed standards of behavour for Consultant staff and competency framework. Freedom to Speak Up An Independent Revew Sr Robert Francs QC the Drector of Human Resources whch brefed the Board on the recent report Sr Robert Francs Freedom to Speak Up and to revew recommendatons and agree the actons to be taken. Recommendatons, prncples and actons ncluded n the Report s Executve Summary were reproduced at Appendx A to ths report. Durng dscusson the followng ponts were consdered/noted: Board of Drectors Meetng Part 1-26 March 2015: Mnutes Page 4 of 8

5 SL would dscuss wth the other Non-executve Drectors (NEDs) who would undertake the local guardan and NED to whom staff can rase concerns role; The Trust s Whstleblower Procedure (Rasng Issues of Concern) s scheduled for formal revew n July Ths wll enable ssues arsng from the Report to be addressed n consultaton wth Staff-Sde; Extensve publcty to rase awareness of the revsed procedure, together wth an approprate tranng package, wll then follow. EH EH July 2015 Summer 2015 Noted, agreed and appont: The Board of Drectors noted the contents of ths report and agreed the course of acton proposed to respond to the report, and appont the local guardan and NED to whom staff can rase concerns. [Trust Secretary post meetng note: The current Whstleblowers Procedure (Rasng ssues of concern) DN259 lsts Karen Caddck and Nck Morrell as NED contacts]. 4 GOVERNANCE Performance Report The Board of Drectors receved a verbal update from the Drector of Fnance. JP nformed the Board that the Trust was currently on track to acheve the natonal cancer targets, ths would be confrmed when the natonal data collecton system closed after the month end. Noted: The Board of Drectors noted the verbal update on Performance. Fnance Report Month 11 (February 2015) The Board of Drectors receved ts regular report on fnance for month 11 (February 2015). The net surplus of 208k at month 11 s sgnfcantly below plan (95%); Income from NHS patent servces was 207k above plan n the month due manly due to hgh ECMO and Transplant actvty; prvate patent ncome was below plan; Expendture over all categores was overspent n month ( 1,091k) wth agency staff costs contnung to be a sgnfcant cause of the overspend ( 276k); Cash balances of 36.7m were below plan due to the reduced surplus beng generated. Durng dscusson the followng ponts were consdered/noted: JP explaned that the report was n the standard format for the Board, but that on reflecton ths dd not provde suffcent emphass on the deteroraton on the fnancal poston; JP drew to the Board s attenton the key pont whch was an n month loss of 500k; There was no one cause of the n month movement and a number Board of Drectors Meetng Part 1-26 March 2015: Mnutes Page 5 of 8

6 of contrbutng factors were dscussed ncludng servce mx, expensve transplant actvty, reducton n overall actvty wth no equal reducton n costs and non-recurrent expendture; It s unlkely that the Trust would acheve a surplus n excess of the current poston and a forecast of a 0.4m surplus had been provded to Montor n lne wth monthly reportng requrements for all foundaton trusts; The Board dscussed the mplcatons of the current fnancal poston on budgetng for 2015/16 and the long term fnancal model (LTFM); JP remnded the Board that the Trust was commtted to pay approxmately 12m of captal contrbutons towards New Papworth n the next fnancal year; SJB stressed the mportance of brngng costs under control n a manner that was both legal and safe for patents. Noted and Dscussed: The Board of Drectors noted and dscussed the contents of the Month 11 Fnance Report. Montor s revsed annual plannng tmetable and tarff arrangements for 2015/16 the Drector of Fnance whch nformed of the changes to Montor s annual plannng revew (APR) tmetable for 2015/16 arsng from the delay n publshng the new natonal tarff for 2015/16. Montor had wthdrawn ts natonal tarff proposals for 2015/16 after suffcent objectons were receved from NHS Provders. On the 10 March Montor and NHS England reported that the majorty of NHS trusts and foundaton trusts had agreed to move to the Enhanced Tarff Opton (ETO) for 2015/16. Papworth had voted for the ETO. In dong so Papworth had noted ts support for the ssues rased the Assocaton for UK Unversty Hosptals (AUKUH).e. extreme dsappontment about two deeply unsatsfactory choces wth an ultmatum, no consultaton and a very short tmescale. As explaned n the paper to the Board ETO s advantageous over the alternatve default tarff rollover (DTR) opton n the followng ways: Provders on ETO wll contnue to have access of up to 2.5% of CQUIN fundng; Under ETO, provders wll beneft from prces that ncorporate addtonal fundng for Clncal Neglgence Scheme for Trusts (CNST) premum ncreases. AUKUH has snce rased a legal challenge. Fnal contract proposals have not been ssued. Papworth had only receved a draft offer of contract for 2015/16. Noted: The Board of Drectors noted the contents of ths report and the revsed submsson dates to Montor of 7 Aprl (draft) and 14 May (fnal). Board of Drectors Meetng Part 1-26 March 2015: Mnutes Page 6 of 8

7 v Draft Operatonal Plan 2015/16 the Drector of Fnance whch presented the Trust s draft operatonal plan (OP) 2015/16 n accordance wth Montor s revsed annual plannng revew (APR) tmetable. The Board had a lengthy dscusson on the mplcatons of the report. Agreed: The Board agreed that gven the turmol n the current plannng round and the absence of agreed budgets that Papworth should submt to Montor a draft plan n lne wth the LTFM, whch should nclude caveats ncorporatng ssues already dscussed under the fnance report. Work on refnng the OP nto a delverable plan for the May fnal plan submsson date could then be undertaken. Noted: The Board of Drectors noted ths report and that the fnal OP wll be presented for approval at the 30 Aprl Board meetng, gvng an opportunty to dscuss the ssues arsng at the meetng of the Performance Commttee on 23 Aprl. v Audt Commttee 24 March 2015 meetng MM nformed the Board of Drectors that the meetng had consdered routne tems ncludng Internal Audt reports, counter fraud reports, external audt reports and follow up on audt actons. A concern had been rased at the meetng on assurances for the Audt Commttee that the Board Assurance Framework (BAF) was beng revewed, partcularly followng CQC comments. In response RZ, as char of Qualty and Rsk, nformed the Board that JR was arrangng a meetng to dscuss the BAF. Receved and noted: The Board of Drectors receved and noted a verbal update from the Audt Commttee meetng held on 24 March JR/RZ TBC v Examnng new optons & opportuntes for provders of NHS care (The Dalton Revew) the Drector of Fnance whch nformed of the publcaton of the Dalton Revew. Ths report had been presented to the Forward Plannng Commttee at ts meetng on 17 March SJB nformed the Board that the Dalton Revew provded helpful context for Papworth dscussons wth Cambrdgeshre and Peterborough Clncal Commssonng Group on becomng the preferred provder for heart dsease n the East of England. Noted: The Board of Drectors noted the contents of ths report. Board of Drectors Meetng Part 1-26 March 2015: Mnutes Page 7 of 8

8 The meetng fnshed at 10.50am..Sgned. Papworth Hosptal NHS Foundaton Trust Board of Drectors Meetng held on 26 March 2015 GLOSSARY OF ABBREVIATIONS APR AUKUH BAF CNST CQC CQUIN CUHP DIPC DTR EBITDA ECMO ETO GMC HCAI LTFM NED OP PMAC Q&R SI SIP Annual Plannng Revew Assocaton for UK Unversty Hosptals Board Assurance Framework Clncal Neglgence Scheme for Trusts Care Qualty Commsson Commssonng for Qualty Innovaton Cambrdge Unversty Health Partners Drector of Infecton Preventon and Control Default Tarff Rollover Earnngs Before Interest, Tax, Deprecaton and Amortsaton Extracorporeal Membrane Oxygenaton Enhanced Tarff Opton General Medcal Councl Healthcare Assocated Infecton Long Term Fnancal Model Non-executve Drector Operatonal Plan Papworth Medcal Advsory Commttee Qualty and Rsk Commttee Serous Incdent Servce Improvement Programme Board of Drectors Meetng Part 1-26 March 2015: Mnutes Page 8 of 8