Non-executive Director

Transcription

1 ENC 1 MINUTES OF THE TRUST BOARD MEETING OF WALSALL HEALTHCARE NHS TRUST HELD ON THURSDAY AT 2:00PM IN THE MANOR LEARNING AND CONFERENCE CENTRE, MANOR HOSPITAL, WALSALL Present: Mr Ben Reid OBE Mr Nigel Summers CBE Mr G McEvoy Ms D Oum Mr R Cooke Mr A Burns Mr R Kirby Mr I Baines Mr A Khan Ms S Hartley Mrs J Tunstall Chair of the Trust Board Vice Chair of the Board Non-executive Director Non-executive Director Non-executive Director Non-executive Director Chief Executive Director of Finance and Performance Medical Director Director of Nursing Chief Operating Officer In Attendance: Mrs A Baines Director of Strategy Mrs D Clift Director of Governance and Trust Secretary Members of the Public Three Members of the Press One Members of Staff One Apologies: Nil 209/13 APOLOGIES FOR ABSENCE ACTION There were no apologies for absence. 210/13 PATIENT STORY Mr Andrew Mather attended the Board to share his experience of the outpatient department. He advised that following an inpatient stay he had been told that he would be seen in the outpatient department for a follow up appointment(may 2013). In August 2013, Mr Mather was admitted to the Trust once again. Mrs Mather stated that there was considerable confusion about who was making an outpatient appointment to discuss the results of diagnostic tests with her husband. After trying numerous areas, she managed to secure an appointment for 31 October 2013 (some 6 months after the tests had been completed). A complaint was then made to the patient relations team regarding the amount of time that Mr Mather had been waiting. 26 September 2013 For One and All 1

2 Following investigation of the complaint the appointment was brought forward to the end of August Mr Mather stated that the appointment itself was very satisfactory lasting 50 minutes. He advised that he had also kept the appointment for October, but that he had subsequently received a letter deferring this to December Then on the day of the Board meeting (ie 26 September 2013) he received further change pulling the appointment forward to October 2013 again. Mr Mather was keen to stress that he was not complaining about the quality of care he was receiving, but was very concerned about flaws in the outpatient appointment system. Mrs Mather was concerned that if she had not chased the appointment herself, one would never ever have materialised. Mrs Mather also referred to an admission that she had in May 2012 and received excellent care. She advised that the discharge letter said she would be seen in clinic 6 weeks later. She never received an appointment. She realised in September that an appointment had not arrived and made several phone calls to the hospital and on most occasions no one answered the telephone. She therefore left messages, but no one could give her an exact date for her appointment. Mrs Mather advised that she had repeated the process all of the way through October Eventually towards the end of October she received an appointment that she made herself over the phone (no paperwork sent to confirm arrangements). On arrival for the appointment a nurse sat next to Mrs Mather and asked her to explain why she was in clinic. Just before she went into room she was told her health records were not available for the clinic appointment. Mrs Mather also advised that she had been scheduled for hernia surgery which had been cancelled now on two occasions by the hospital. She had become so concerned about the time it was taking to receive her surgery that she opted to book privately as she was advised that the third scheduled date for surgery could also be cancelled in the event of emergencies presenting. Mr Kirby apologised to Mr and Mrs Mather for the difficulties and frustration that they had encountered. Mrs Tunstall advised that a full review of staffing and processes within the call centre and bookings centre had commenced. The review was scheduled to complete with a resolution to change in December Mr Burns asked Mrs Tunstall to review the systems of control in place to ensure that patients are not lost to follow up and also questioned what assurance was in place to ensure that patients whose waiting time exceeds 18 weeks is not excessively beyond this period. It was agreed that this matter would be included when concluding the above review. 26 September 2013 For One and All 2

3 211/13 YEAR OF INTEGRATION SPOTLIGHT TOMS Caroline Whyte (Paediatric Matron) and Emma Hughes (Senior Sister in Paediatrics) attended the Board to present an update on the Paediatric Asthma Project PFCC Programme. It was noted that the Patient and Family Centred Care Programme (PFCC) is run as a partnership between the Kings Fund and the Health Foundation, with the main focus being to see and understand the paediatric patient journey through the patients eyes. Walsall Healthcare was proud to be one of only 11 trusts to have been chosen to participate in the programme across the Country. The methodology included shadowing patients, family interviews and feedback about the service, colleague engagement and feedback and faculty days. The programme had identified that patient journeys could be fragmented at times, coupled with inconsistencies in the quality and content of patient information. As a result, a new paediatric discharge bundle was developed for children with asthma. This included the development of new documentation and patient information which both patients, carers and staff deemed to be of help to patients. Matron Whyte confirmed that a range of quality indicators had been developed to assess satisfaction and experience with the new bundle. This demonstrated significant improvement and satisfaction from both patients and colleagues. Matron Whyte advised the Board that colleagues had very much enjoyed the empowerment that they had in leading and implementing the project and that motivation levels were very high, with a sense of achievement and pride. Next steps included roll out of the same methodology to paediatric day case surgery. The Board applauded the project and the leadership of Matron Whyte, Sister Hughes and the paediatric team. Mr Reid asked whether the project expanded into the community setting. Matron Whyte advised that community nurse led asthma clinics were in place and that they were seeking to launch the asthma plan outside the physical confines of the hospital so that the end to end journey was as positive and streamlined as possible. The Board noted the appointment of an Asthma Specialist Nurse who would also support the project. Ms Oum referred to an initiative for children with Asthma in Dudley and asked whether Matron Whyte was familiar with the initiative. Matron Whyte confirmed that the role of the specialist nurse was mirrored on the scheme in Dudley, which was noted to have made significant improvements to patient care and outcomes. The Board thanked the team for a positive and inspiring presentation. 212/13 DECLARATIONS OF INTEREST There were no declarations of interest. 26 September 2013 For One and All 3

4 213/13 MINUTES OF THE TRUST BOARD MEETING HELD ON 23 AUGUST 2013 The minutes of the meeting held on 23 August 2013 were agreed as a correct record. 214/13 MATTERS ARISING AND LIVE ACTION SHEET The live action sheet was reviewed and agreed. With regard to action 185/13, Mr Kirby confirmed that work to roll out the musculoskeletal pathway was ongoing. With regard to minute reference 190/13, Ms Oum asked for an update on the delivery of the advanced communications programme for Doctors. Mr Khan confirmed that this was ongoing with a prioritised list of individuals. 215/13 CHIEF EXECUTIVE S REPORT Mr Kirby presented the report and drew attention to the colleague nomination awards which were scheduled to be announced at the Trust Ball on Saturday 28 September Also of note was the positive news that the Trust had been shortlisted for three national awards namely:- Nursing Times Nursing in the Community Award Health Service Journal Staff Engagement Award Health Service Journal Efficiency Award Mr Kirby delivered an overview of key progress aligned to the six strategic objectives of the Trust. With regard to patient experience, it was noted that family and friends test scores had improved in all areas except A&E when compared to the previous month. Work continued to improve scores across all areas. Providing safe high quality services continued to be a core objective of the Trust and the majority of quality based outcomes remained stable across falls, pressure ulcers, HSMR and MRSA. It was however noted that cases of clostridium difficile had increased and the infection control committee were reviewing the root cause of these incidents to identify additional controls. Mr Kirby gave thanks to Sue Hartley and her team for the successful launch of new Clinical Documentation to support enhanced compliance with record keeping and improved compliance with CQC outcome 21 which had included the hospital reducing the range of clinical documentation from circa 1500 forms to 300 forms. The integration agenda continued to be progressed including the 26 September 2013 For One and All 4

5 launch of a new way of working in the community nursing teams to provide stronger coordination and working with GPs to ensure patients can be kept as fit and well at home as possible. A high level review of the top risks on the Corporate Risk Register took place and it was agreed that scoring be reviewed in readiness for the next update to reflect the increasing risks relating to the financial agenda. The Board resolved to note the content of the report. 216/13 FOR ONE AND ALL PROGRAMME PROGRESS REPORT Mr Kirby presented the report which included a summary of the results of the replica inpatient survey undertaken in July patients were asked to complete the survey with a 45% response rate. The high level results of the national inpatient survey were also included which demonstrated three key messages Overall some slight improvement in scores Some areas are showing encouraging progress such as food and communication between Drs and patients Demonstrates weaknesses in the patient experience in relation to discharge planning. (Now focussing energy in this area) With regard to colleague engagement, Mr Kirby delivered an update on the delivery of the action plan approved by the Board earlier in the year. It was noted that one action was rated as red. This related to reduction in the use of bank and agency staff. It was hoped that the impact of the Boards investment in substantive staffing levels (as demonstrated at the August 2013 Board meeting) would help to address reductions in temporary staffing levels. Ms Oum asked how assured the Board could be that staff are comfortable to speak up to management if they have any concerns. Mr Kirby referred to the recent colleague connect sessions where colleagues had been very vocal about areas we could improve. Questions relating to raising concerns were also included in the staff PULSE survey. In addition, the In your shoes exercise for management and colleagues was to be repeated in the near future. The Board resolved to note the content of the report. 217/13 QUALITY AND SAFETY STRATEGY REFRESH September 2013 For One and All 5

6 Mr Kirby presented the report which drew together key intelligence and themes arising from a range of national publications including the Berwick Review, Keogh Review and Francis Report. It was noted that whilst a number of improvements had been made in the organisation relating to quality and safety outomes, there remained to be a need to transform the culture of the organisation to ensure that quality and safety was embedded at all levels. The Trust Board had previously considered the findings of the Francis report and agreed a range of actions in response to the report. Mr Kirby delivered an overview of the progress that had been made in implementing these actions. Action 6 related to the production of the single A&E improvement plan. Whilst it was recognised that this plan had been developed and approved by the Quality and Safety Committee and Trust Board, it was considered that the action could not be classified as complete until all actions within the plan had been implemented. Quarterly reports on progress were being presented to the Quality and Safety Committee. A discussion relating to recruitment to vacant posts within the A&E department took place and it was noted that recruitment was ongoing to nursing posts in particular. Concern was expressed that there may be insufficient qualified applicants available and that failure to fill these posts could impact significantly on our ability to deliver over the Winter period. Mr McEvoy asked that Board members be appraised of what % of the establishment the Trust was running at currently (both as a whole and by staff group). Mr Reid asked whether consideration should be given to the appointment of qualified staff from overseas and requested that a contingency plan be developed with immediate effect in the event that we fail to recruit from within the UK. Ms Oum stated that this should be restricted to a short term strategy rather than a longer term strategic approach to recruitment. Mr Reid reinforced the need for the Board to ensure that staff ratios were at a nationally acceptable level. Mr Burns requested an update on the recruitment of A&E consultants and expressed the need for the Trust to lock down its resources in this area due to a national shortage of qualified A&E consultants. In conclusion, Mr Kirby agreed to develop a paper detailing staffing ratios (as a whole and by staff group) together with target levels and a contingency plan for overseas recruitment. Consideration was given to Patients First and Foremost which sets out a five point plan for the NHS, together with the Keogh Report on Mortality within 14 NHS Trusts in England and the associated 8 ambitions. The recommendations from the Don Berwick report on patient safety were also considered and in particular the cultural needs of a safe, high quality NHS. Changes to the CQC regime were also considered. The culmination of these reports identified five core areas of focus:- Culture Staffing levels 26 September 2013 For One and All 6

7 Patient Voice Colleague Voice Governance and Inspection Staffing Levels Mr Reid expressed the need to identify and understand the skills of staff and numbers of staff required to deliver a high quality service at Walsall. Ms Hartley advised that this piece of work had commenced and would be concluded by December This would enable the Board to make an informed decision regarding investment levels in staffing for 2014/15 as part of the Annual Planning process. Mr Kirby advised that nationally it was suggested that on average a staffing level of 1 qualified nurse to 8 patients was safe, however this needed to be refreshed dependent on acuity and at shift by shift level. Ms Hartley also reminded the Board of the need to ensure that Ward Sisters are supernumery in the final model. Mr Reid asked whether the Trust had appropriate software in place to enable a formulaic approach to be given to the development of a baseline position which could then be manipulated to reflect acuity. Ms Hartley stated that she was comfortable in principle with this approach and felt that the tool referred to above was credible. The Board therefore agreed that the calculation of need would be determined from:- What people tell us (patients and staff) Use of the formal assessment tool Acuity and patient need by ward Mr Reid stressed the need for the Board to receive a recommendation from the Director of Nursing in relation to nurse staffing levels underpinned by a strong assurance that the solution would meet the needs of the organisation and demonstrate safe staffing levels. It was agreed that this would be presented to the Board in December A second phase of work related to the establishment of safe staffing levels for Doctors (qualified and in training). Mr Khan advised that the numbers of Doctors in training was reducing nationally which would have an impact on the District General Hospital model. Mr Khan advised the Board that the Clinical Service Strategy was therefore being developed to reflect this national strategic change in workforce planning. This could see an increased level of consultant led services. It was noted that the Medical Workforce staffing levels would be confirmed by March Mr Reid challenged whether this was sufficient pace. Mr Kirby agreed that it would be advantageous to pull this date forward so that any impact could be considered within the annual planning round for 2014/15. Mr Kirby advised that the longer term strategic model for the workforce would need to then be developed. Mr Summers expressed a view that this was very acute focussed and suggested that an alternative approach through investment and well resourced community based care could equally respond to the forthcoming strategic challenges. Ms Oum supported 26 September 2013 For One and All 7

8 this view and encouraged colleagues to think more strategically around the integration agenda. Mr Cooke reinforced the need for integration of care and community investment as an enabler to responding to acute demand. Mr Burns stressed the need for any cultural change to address the need to ensure that staff work within a supportive culture and understand the behaviours expected of them. The Board agreed that colleagues should be held to account for the delivery of the Trust s promises and where behaviours did not demonstrate delivery of the promises, individuals would equally be held to account. The Board resolved to:- Approve the actions contained in report with quarterly updates on delivery to be presented to the Quality and Safety Committee Receive a report on staffing levels from the Director of Nursing in December 2013 SH 13 Dec 218/13 WINTER PLAN 2013 Mrs Tunstall presented a verbal update on the development of the Winter Plan for 2013/14. Discussions continued with Social Care partners and the Walsall Clinical Commissioning Group to align the health and social care system for integration. The full written plan would be presented to the Board in October The Board resolved to note the continuing discussions and to receive the written plan at the October 2013 Board meeting. JT Oct /13 A&E INTERIM CAPITAL REFURBISHMENT SCHEME AND ASSOCIATED REVENUE IMPLICATIONS Mr Kirby presented a business case which had been considered by the Performance Finance and Investment Committee the previous week. The business case described the interim refurbishment plans for the A&E department with the provision of:- Three new majors cubicles A triage room Relocation of office accommodation Relocation of the plaster room Relocation of dirty utility A glazed lobby to the main blue light entrance Improvements to the staff base 26 September 2013 For One and All 8

9 A new psychiatric treatment room Additional nursing staff to safely manage the increased environment The Board noted that this was an interim refurbishment scheme and that a major scheme was scheduled as part of the ongoing Estates Strategy. The interim scheme was agreed to be a priority in terms of quality and safety of care and would respond positively to increased demand for emergency care. Mr Baines confirmed that the capital costs had been approved as part of the capital programme and funding was in place in this regard. With regard to the additional revenue implications associated with extra cubicles (staffing), Mr Baines confirmed that this was committed to be managed financially within the existing financial forecasting. The Board resolved to approve the business case. 220/13 COMMUNITY NURSING REDESIGN AND INVESTMENT PLAN 13/14 AND 14/15 Mrs Baines presented a paper which outlined existing investment in the Community in response to the 14% growth in referrals experienced in the last 12 months, and outlined the workforce plan for the future which would require immediate investment. Mrs Baines confirmed that the Walsall Clinical Commissioning Group have confirmed that 1.5M investment over 2 years is in place. The plan was aimed at supporting a range of whole health economy objectives including:- Reduction in hospital admissions Reduction in admission to nursing and residential home placements Reduced lengths of stay Reduced hospital readmissions Full development of the patient virtual ward Integration of care around local population needs The Board welcomed the investment in strengthening rapid response teams across community based nursing and therapies and commended the development of community nursing wrap around locality teams, noting that both initiatives would improve patients flow, service alignment and step/down facilities for patients. Mr Burns questioned how the Board would know if each initiative for assessment had been successful and whether the above Key Performance Indicators (KPIs) had been quantified and aligned to specific developments. Mrs Baines advised that the KPIs would be 26 September 2013 For One and All 9

10 developed over the forthcoming weeks. Mr Kirby gave thanks to the CCG for their support in this investment. This was endorsed by the Trust Board. Ms Oum applauded this development and highlighted the need to ensure that GPs are fully engaged in the deployment of this model to ensure success. Board The Board resolved to:- Endorse the plan, requesting immediate implementation to achieve maximum impact over the Winter period Approve the revenue spend of 940K in 2013/14 and 588K in 2014/15 221/13 DELIVERING OUR YEAR OF INTEGRATION Mrs Tunstall presented a paper updating the Board on progress with existing integration workstreams, together with a proposal to relaunch this work with an updated programme approach for integrated care. Mrs Tunstall confirmed that stakeholders have agreed the vision to ensure that By 2018, the people of Walsall and their carers will experience a jointly planned, largely home-based model of care, centred around the specific needs of individuals. An overview of achievements to date was delivered, including the development of pioneer pathways and examples of patient stories (before and after integration) which showed dramatic improvement in patient experience, independence and outcomes. Mrs Tunstall then highlighted the specific actions that had been assigned to Executive Directors over the forthcoming months covering 6 focus areas. These would continue to evolve over time and would be the core of a relaunch of the integration programme. Mrs Tunstall confirmed that she would be the Executive Lead for the integration programme. Programme support to assist in delivering the agenda was detailed, together with underpinning programme support. In addition, service improvement officers would be assigned to Divisions with the aim of developing integration, with responsibilities also aligned to an Associate Medical Director to demonstrate medical ownership and drive. Key performance indicators of success included readmissions, A&E reattenders, average length of stay, active community case management numbers and the number of people care for in the virtual ward. The voice of the user would also be included as a key performance indicator. Reports on delivery and progress would be made to the Performance Finance and Investment Committee on a monthly basis, and the Trust Board on a quarterly basis. Mr Reid commended the report but felt that the objectives within the 26 September 2013 For One and All 10

11 domain of maximising technology were not as strong as they could be and asked that these be reviewed to strengthen this area and objectives. Ms Oum felt that a financial measure should also be included in the KPIs/measures of success to demonstrate value for money. Mr Summers stated that he was now gathering a sense of pace in implementing integration. He asked for clarity of the size of the challenge projected over the next 5 years, followed by a scoping exercise of the cost of this challenge and quality and safety outcomes for patients. He encouraged engagement with the voluntary sector and other stakeholders to then support integration and gave the example that some of the technological developments may mean exploring partnerships with the private sector. Mrs Baines stated that the vision and modelling element of the plan was aimed at ensuring that all data available to the organisation be analysed to develop a model of care which could be costed and visualised in terms of scale. Mr Baines would be working closely to undertake the costing analysis and to determine the return on the cost of investment. Mr McEvoy stated that the 6 workstreams referred to earlier have been approved for some 2 years and appealed that integration of hospital and community aspects now be put to bed with a renewed focus on the agency integration aspects. This was agreed. The Board resolved to approve the content of the paper and the action plan subject to the above comments. 222/13 CHILDRENS PARTNERSHIP Mrs Baines presented the bi-annual report to the Board which updated Board members on the delivery of the Children and Young People s Partnership Plan which was approved by the Board in January Mrs Baines delivered an overview of some of the key developments in driving forward childrens partnership working in the Borough including improvements in the Looked after children s service, prevention of teenage pregnancy and models of care for young parents. The Board considered the priorities of the Children and Young People s Board for 2013 which would aim to ensure that all children in the borough. Ms Oum asked whether the work detailed in the paper was deliverable within approved expenditure. Mrs Baines stated that additional funding was not required to deliver these improvements and it was more a case of redesign and use of existing resources. The Board resolved to:- 26 September 2013 For One and All 11

12 Note the content of the report Endorse the key priorities for delivery within the Children and Young People s Plan objectives 223/13 NHS FOUNDATION TRUST APPLICATION PROGRESS REPORT Mrs Clift presented a report updating the Board on the potential implications of the national pause to the Foundation Trust pipeline resulting from the new CQC inspection regime. Mrs Clift advised the Board that work would continue internally to periodically refresh the Integrated Business Plan and Long Term Financial Model, with the next iteration being completed in December It was likely that the Trust would not attain FT status under the new regime until An update on membership development, engagement and communication was delivered including positive feedback from the recent Medicine for Members event focussing on Dementia. Membership numbers were noted to have increased to 13,797. The Board resolved to note the content of the report and the external changes to the NHS Foundation Trust pipeline. 224/13 MID STAFFORDSHIRE NHS FOUNDATION TRUST SPECIAL ADMINISTRATOR CONSULTATION FORMAL TRUST RESPONSE Mrs Baines presented the Trust s formal response to the proposals on which the Trust Special Administrators had consulted. Mrs Baines stated that the response from the Trust included a requirement for capital investment to increase physical capacity in key areas such as maternity services at the Manor Hospital due to changes in patient flow. Mr Burns highlighted that the Trust requires 14M capital to ensure that there is sufficient physical capacity to continue to ensure safe, high quality services to the people of Walsall and Staffordshire. Mr Khan reinforced that he was concerned about the delivery of inpatient hospital services at Cannock at night as they were considered not to be safe. This was noted by the Trust Board. The Board resolved to approve the formal response to the consultation document. 26 September 2013 For One and All 12

13 225/13 PERFORMANCE AND QUALITY REPORT Mr Baines presented the Performance and Quality Report as at the end of August It was noted that a line by line analysis of the report had taken place the previous week at the Performance Finance and Investment Committee and the Quality and Safety Committee. Mr Summers highlighted the particular challenges pertaining to the A&E 4 hour wait and ambulance handover. Mr McEvoy stated that whilst improvement had been seen in some quality indicators, infection control continued to be a concern particularly levels of Clostridium Difficle. Mr McEvoy confirmed that the Quality and Safety Committee had received a presentation from the Infection Control Team the previous week and were assured that the Infection Control Committee were reviewing all root cause analysis to identify improvement actions. Positive performance was noted in relation to HSMR, Cancer and 18 weeks referral to treatment time standards, resulting in a provisional status of Green against the Monitor Framework. The Board resolved to note the content of the report. 226/13 MORTALITY REPORT FOR AUGUST 2013 Mr Khan presented the Mortality Report which had been discussed in detail at the Mortality Review Group and the Quality and Safety Committee. It was noted that 72 deaths in hospital had occurred in August 2013 which was a lower figure than July The Rebased HSMR for the period April 2013 June 2013 was against an average of 100, with a final rebased HSMR for the period 2012/13 of This level of improved performance was echoed in the Standardised Hospital Mortality Index (SHMI) and overall crude mortality rates. Mr Khan appraised the Board of the exercise to analyse any link between mortality levels and day of admission. So far the exercise had proved inconclusive. He advised that mortality reviews continue to be presented by independent medical experts to ensure that we maximise lessons to be learnt. Mr McEvoy reminded the Board that achieving current HSMR has been a consistent drive and needs to continue relentlessly. The Board resolved to note the content of the report. 26 September 2013 For One and All 13

14 227/13 FINANCIAL REPORT FOR AUGUST 2013 Mr Baines presented the financial position as at 31 August He advised the Board that the Trust had a negative variance to plan of 968,000. The negative variance was mainly driven by high usage of temporary staffing, slippage on Cost Improvement Programme schemes and restrictions on the income envelope to the Trust. The Board noted the mitigating actions being put in place to reduce temporary staffing spend and the development of contingency cost improvement schemes to close any gaps resulting from slippage. Mr Summers advised that the report had been scrutinised at the Performance, Finance and Investment Committee the previous week and assured colleagues that the Committee continued to monitor the level of risk associated with the delivery of the financial plan, together with the impact of financial recovery initiatives. Ms Oum asked about medical negligence and employer liability variance. Mr Baines advised that this could represent a higher level of claims than anticipated. The Board resolved to note the content of the report. 228/13 PROVIDER MANAGEMENT REGIME (PMR) Mr Baines presented the Trust s performance against the provider management regime as at the end of August An amber/green governance rating was noted due to failure to achieve the A&E 4 hour target. A year to date normalised financial risk rating of 3 was approved for submission to the NTDA. The Board resolved to arrive the document for submission to the NTDA. 229/13 MINUTES OF THE QUALITY & SAFETY COMMITTEE HELD ON 22 AUGUST 2013 Mr McEvoy presented the minutes of the meeting held on 22 August 2013, together with a verbal update on issues discussed at the September 2013 meeting. The Board resolved to note and receive the minutes of the meeting 26 September 2013 For One and All 14

15 held on 22 August /13 MINUTES OF THE PERFORMANCE, FINANCE & INVESTMENT COMMITTEE HELD ON 22 AUGUST 2013 Mr Summers presented the minutes of the meeting, together with a verbal update on key issues debated at the September 2013 meeting. He advised the Board that A&E continues to be the biggest risk in terms of performance and advised of the scrutiny given to all aspects of A&E performance by the Committee. The Board resolved to note and receive the minutes of the meeting held on 22 August /13 ESCALATION REPORT FROM THE AUDIT COMMITTEE MEETING HELD ON 25 SEPTEMBER 2013 Mr Cooke delivered a verbal report on key issues debated by the Audit Committee at its meeting on 25 September He advised the Board of a gap in assurance relating to the data quality aligned to VTE which could result in a qualification being applied to the Quality Account 2013/14. Mr Cooke requested that the Executive Team give this significant attention in order to mitigate any risk. Mr Cooke raised the importance of making patients and the populace aware of VTE by leaflets, posters in relevant parts of the hospital (applicable wards etc) and seeking the support of the local press in publicisng the matter. This was agreed by the Board. Mr Cooke also confirmed that the Committee had received a verbal report on the organisations commitment and policy for Whistleblowing and had requested that additional controls be established such as an independent telephone helpline or address and Non-executive Director training in supporting Whistleblowers. The Board resolved to note the verbal report from the Audit Committee. 232/13 ANY OTHER BUSINESS There was no other business. 233/13 QUESTIONS FROM THE PUBLIC Mr Pagett commended the work relating to membership recruitment and as a member of the recruitment team advised of a successful 26 September 2013 For One and All 15

16 event at the Freshers Fair earlier in the week which had attracted circa 100 new younger members. Mr Pagett referred to a previous request made by a member of the public for age analysis to be included in the Mortality report. Mr Khan agreed to ensure this was included in future reports. 234/13 DATE & TIME OF NEXT MEETING Thursday 31 October 2013 at 2:00pm in the Manor Learning & Conference Centre, Walsall Manor Hospital 26 September 2013 For One and All 16