MINUTES OF A MEETING OF THE TAMESIDE HOSPITAL NHS FOUNDATION TRUST BOARD 28 April 2011

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1 MINUTES OF A MEETING OF THE TAMESIDE HOSPITAL NHS FOUNDATION TRUST BOARD 28 April 2011 Present Mr T Presswood Mrs C Green Mr P Dylak Mr A Anderson Mr T Ward Miss K Brown Mrs D Bates Dr T Mahmood Mr A Griffiths Mr R Corless Ms T Kalloo Position Chairman Chief Executive Director of Nursing Director of Finance Medical Director Director of Clinical Services In Attendance Mr D Wilkinson Director of Human Resources 67/11 Apologies for absence There were no apologies for absence 68/11 Minutes of the meeting held on 31 March 2011 The minutes were approved as an accurate record of the meeting. 69/11 Matters Arising from previous meeting a) Single Gender Accommodation Compliance (minute 65/11 refers) Mr Dylak confirmed that he has written to the SHA confirming the compliance agreement previously approved by the SHA. 70/11 Chief Executive s Report Questions and comments were invited on Mrs Green s report, which included the following items: Q4 Monitor Submission National Productivity Metrics Q2 2010/11 HIT Update (April 2011) Annual Report 2010/11 Carbon Reduction Plan

2 Annual Plan Information Governance Toolkit Submission 2010/11 National Programme for IT in Greater Manchester Everyone Matters at Tameside The Board approved the position in response to the Q4 Monitor Governance Declaration, which will be a declaration 2. In respect of the national Productivity Metrics (also known as the Better Care, Better Value metrics), Mr Presswood noted the Trust s performance against the reducing length of stay metric and the associated savings potential. The Annual Plan had been discussed in detail at a Trust Board Seminar held on 26 April and the Annual Plan timescale was noted by the Board. The Board acknowledged the Information Toolkit Submission for 2010/11 and noted that the Trust met the key requirements for level 2 compliance required by Monitor. The Board discussed and noted the contents of the Chief Executive s Report. 71/11 Finance and Activity Report - March The finance position at the end of March 2011 was reported at a cumulative deficit of 1,388k against a revised planned deficit of 1,451k. The in month position had been a surplus of 162k giving an overall positive variance of 63k. The financial risk rating of 2 was noted. There was a detailed discussion of the underlying causes of the position including the impact of the 30% Non elective tariff which was noted at 1,136k. The position on CIP delivery was noted with regard to 2010/11, ie that it had been fully delivered. The pressure on the Trust s liquidity position was discussed as it had fallen to a 1 at 9.5 days. Although this was in line with the revised trajectory it was agreed that it would remain the subject of close scrutiny going forwards. The expected date of return to a Liquidity rating of 2 would be identified as part of the Recovery Plan process. The trends in activity were noted including the recovery in elective activity to 2009/10 levels following the finalisation of the negotiations on the rate of payment for additional sessions. As a result, the increase in activity was considered to be largely recurrent and would be enhanced by the planned work on theatre and outpatient productivity. The Board noted the Trust s financial position.

3 72/11 Statement of Position Report March The report was discussed and in particular, the Board agreed to monitor the payment of PCT debtors over the next two months. It was also noted that the format of cash flow forecasts would be reviewed to simplify them for the Board in 2011/12, as part of the wider review of financial reports that the new Director of Finance intended to undertake. 73/11 Performance Report - March The Board discussed the Trust s cumulative performance for the year 2010/11 and commented that performance was generally satisfactory. Waiting list performance and CDiff remain areas of concern. Mr Griffiths advised that the next performance report to come to the Board would reflect performance against the new targets which came into force this financial year. The Board discussed and noted the Performance Report. 74/11 Infection Prevention and Control Report The performance of 3 cases against the 2010/11 MRSA target of 4 was commended by the Board. The C.Diff performance however, was noted at 114 cases against a target of 90, with detailed discussion on the action plan. Whilst this indicated a 14% reduction on the previous year, it was a very disappointing result. Dr Mahmood reported that he was seeking an external expert physician willing to conduct a review of the application of the Trust s antibiotic prescribing policy. A clinical summit is also being organised which will focus on HCAI issues. The Board discussed and noted the Infection Prevention and Control Report. 75/11 NHS Annual Staff Survey 2010 Report The Chair commented that the results of the survey demonstrated a marked improvement on those of the previous year. Mr Wilkinson commented that over the last 6 months there has been very positive staff engagement as a result of the Everyone Matters campaign, which he felt was important to maintain, especially given the challenges ahead. The Board acknowledged the challenges relating to the Trust s financial situation and the implementation of the recovery plan, and that engagement with all staff categories will be a key factor in the Trust s success going forward. The Board discussed and noted the NHS Annual Staff Survey Report

4 76/11 Human Resources Report Quarter 4 Mr Wilkinson drew particular attention to the national Mutually Agreed Resignation Scheme (MARS) and stated that this will form part of the overall staff reduction strategy to support the Financial Recovery Plan. He went on to comment that the number of requests for bank and agency staff is starting to fall and that the number of long-standing vacancies, particularly in A & E, had also started to reduce. The Board discussed and noted the Human Resources Report for Quarter 4 and approved the Trust s adoption of the Mutually Agreed Resignation Scheme. 77/11 Sealed Documents Quarter 4 The Sealed Documents report was discussed and noted. 78/11 Corporate Objectives Review of 2010/11 Mr Presswood noted that there has been considerable progress in many areas and that the underachievement in relation to objective number 3 (financial issues) had been discussed in detail at the Board Seminar. A couple of points of clarification were discussed in respect of VTE and MRSA. The Board discussed and noted performance against the Trust s Corporate Objectives, and stressed the importance of the 2011/12 objectives. 79/11 Quarterly Nurse Dignity in Care Report The audit results were reviewed in some detail and a helpful discussion took place around the definition of zero tolerance. The Board agreed that zero tolerance mans that action will always be taken when a breach occurs. Whilst breaches may occasionally re-occur, repeat incidents demonstrating a lack of learning may result in formal disciplinary proceedings. The Board discussed and noted the Quarterly Nurse Dignity in Care Report, in particular the improvements made over time. 80/11 Statement on Internal Controls and Board Committee Annual Reports The Board noted and discussed the Statement on Internal Controls and Board Committee Annual Reports and acknowledged and agreed the intention to strengthen the SIC in line with the proposal in the report. 81/11 Board Assurance Framework 2011/12 and Corporate Risk Register Mr Dylak explained how the Board Assurance Framework (BAF) is developed, highlighting its links with the Corporate Objectives and Corporate Risk Register. He stated that he had recently attended the Audit Committee to present the BAF for 2011/12 and Corporate Risk Register. A small number of minor changes had been identified by the Audit Committee, and it was noted that the BAF has received

5 positive audit assurance, with one suggested action being made which was not material to the BAF overall. Mr Ward stated that in the near future the BAF will have to reflect the Bribery Act, the implementation of which has been delayed. The Board discussed and endorsed the Board Assurance Framework 2011/12 and Corporate Risk Register. 82/11 Committee Reports a) Quality and Clinical Governance Committee held on 4 March The report and minutes of the Quality and Clinical Governance Committee held on 4 March were discussed and noted. b) Risk Management and Corporate Governance Committee held on 29 March The report and minutes of the Risk Management and Corporate Governance Committee held on 29 March were discussed and noted. 83/11 Non Executive Directors Reports Mr Presswood reported that together with Mrs Green, Miss Brown, Mr Anderson, Mr Dylak and Dr Mahmood, he had attended a meeting with Monitor to discuss the Trust s financial position. Mr Corless stated that he had chaired a recent AAC for an Obstetrics and Gynaecology Consultant. He reported that there were 4 candidates and that the incumbent locum had been offered the position. 84/11 Any Other Business i. Notification of impending legal action. The Chair formally reported to the board that Consultant Surgeon Mr Pena was suing the Trust vicariously for liable for an amount between 50,000 and 100,000. The incident relates to an exchange that arose between Mr Pena and a consultant colleague. The consultant colleague is also being sued by Mr Pena. The Board agreed that the Trust should strongly defend the action. ii. Phase 2 - PWC Support Mrs Green informed the Board that she was entering into dialogue with PWC about the second phase of their work with the Trust, which would include a substantive element of support with regard to HR/employment issues, in addition to the technical support to some individual projects. There was an extensive discussion regarding the governance and accountability arrangements for the delivery of the Financial Recovery Plan. It was noted that

6 assurance or triangulation of data would be underpinned by clear metrics relating to the CIP delivery itself, compliance with the agreed annual plan monthly positions and cash balances against the planned positions. These metrics would support the Board s review and assurance of progress / delivery against the planned position. The Board noted the important distinction between re-assurance and assurance and agreed that strong governance arrangements were a critical element of the functioning of a unitary board. The CIP performance and accountability report, which is clearly a key element of the FRP, would be prepared by the Turnaround Director and the Project Management Office. It would form a substantial annex to the Financial Report and the figures contained within it would be signed off by both the Turnaround Director and the Finance Director. The appropriate Executive Director Sponsor would then be held to account at the Board for the delivery and performance of each scheme against plan. It was agreed that the governance arrangements for the CIP process would be reviewed after the first set of reports had been received to ensure that they addressed the Board s requirements. iii. CQC Feedback Mr Dylak tabled a report that described the outcome from the most recent visit of the CQC, following which a moderate concern is still registered. Whilst some of the points made by the Trust to the CQC had been accepted, the CQC concerns had not been changed. Accordingly, the CQC report had been very carefully considered by the full Executive team and Mr Dylak recommended that the Board accept the report and that an action plan is developed to address the concerns highlighted within the report. He added the Trust should position itself to have provided full evidence to the CQC by the end of July so that a further CQC review might occur between August and October. The Trust Board agreed to this approach and stressed the importance of regular evidence submission and an early review by the CQC once sufficient evidence had been collated. 85/11 Date and Time of Next Meeting The meeting will be held on Thursday 26 May 2011 at am in the Darnton Meeting Room.

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