1 Minutes Board of Directors Wednesday 30 March 2016 at 9.30 am Boardroom, Trust Headquarters PART I Present: John Schofield Michael McCourt Martin Roe Keith Walker Ian Trodden Henry Ticehurst Judith Crosby Julie Taylor Robert Ainsworth Joan Beresford Tony Berry Keith Bradley Michael Livingstone Paula Ormandy Sandra Jowett Chairman Chief Executive Executive Director of Finance / Deputy Chief Executive Executive Director of Operations Executive Director of Nursing and Healthcare Professionals Medical Director Director of Service Development and Sustainability Director of Business Development In attendance: Louise Bishop Helen Taylor Trust Secretary Communications Officer Patient Story: Dil Jauffur Lindsey Baucutt RHSD Directorate Manager Unit Manager, Specialist Services Governor representative: Dr My Staff Governor, Medical and Dental 1. Apologies for absence No apologies were received. 2. Declarations of interest There were no declarations of interest.
2 3. Previous meeting of the Board of Directors 3.1 Minutes from a meeting of the Board of Directors The Chairman presented the minutes from a meeting of the Board of Directors (PI) held on 24 February 2016 to the Board for approval. The minutes were approved as an accurate record. 4. Matters arising and action plan 4.1 Action plan arising from meetings of the Board of Directors The Chairman presented the action plan arising from meetings of the Board of Directors to the Board for approval. The Board approved the action plan. With regards to item five on the action plan, community teaching, Mr Trodden advised that he would provide an update at the next meeting on discussions with the University of Manchester, Manchester Metropolitan University, and University of Salford. 5. Strategy 5.1 Chief Executive s update: March 2016 Michael McCourt provided a verbal Chief Executive s update for March 2016 to the Board for assurance. Mr McCourt reported on the series of communications to engage the organisation on its mental health strategy, integrated business plan (IBP), and Manchester Mental Health and Social Care NHS Trust (MMH&SCT). The Trust recognised the importance of engaging and involving staff in what was happening across the organisation. Arrangements were also being made for Mr McCourt and Dr Ticehurst to meet with the consultant psychiatrics regarding the mental health strategy and Manchester bid. The process to recruit to a substantive HR Director was underway and at the shortlisting stage. Interviews were scheduled for 18 April Further to Professor Jowett s enquiry regarding the number of applications received, Mr Walker agreed to check and circulate this information outside the meeting. Mr McCourt added that this post would report to the Chief Executive but be line managed by the Executive Director of Operations. Mr McCourt noted that a letter from Jim Mackey (Chief Executive, NHS Improvement) had been circulated to Board members on 29 March The letter was a note of thanks to the organisation for its continued focus on financial performance, and maintaining a surplus. The letter would be shared with service, clinical, and professional leads across the organisation it was important their hard work and the pressures they faced were recognised. Professor Ormandy suggested this could be developed into a positive news story for all staff. Mr McCourt agreed, adding that he would speak with the Communications department to process this proposal.
3 Mr McCourt reported that he, Ms Taylor and Mr Berry had met regarding Corporate Social Responsibility (CSR) and were developing a proposal to adopt the GM taking charge theme, promoting good health and self care amongst staff and their families. This would be discussed in more detail at the next meeting of the CSR Group as it would need resources to support it. Colin McKinless had completed his final report on the review of business planning / performance management, and would be presented to the next meeting. Mr Walker and his team would now take this project forward. The IPDRs for the Executive team were underway and due to be completed in the next two to three weeks. Mr McCourt met with Colin Scales (CEO, Bridgewater Community Healthcare NHS FT) on 26 February 2016 to discuss the development of local care organisations. Within Devolution GM, the Provider Federation Board had recognised the need for a more robust infrastructure to take its work forward and influence the DGM strategy. This was expected to need dedicated resources working on behalf of providers with shared investment to support this. Further meetings were planned to discuss. Mr McCourt met with Simon Wootton (new Chief Officer, HMR CCG) on 8 March 2016, which recognised past challenges but there was a positive approach to working together in the future. Mr McCourt, on behalf of the Provider Federation Board, spoke at a GM-wide health and social care event on 11 March 2016, and reaffirmed the positive progress made over the last year. Mr McCourt met with Mike Farrar (Independent Management Consultant) on 21 March 2016, who had been appointed as the independent chair of the review of the North East Sector, including the sustainability of Pennine Acute Hospitals NHS Trust. Referring to engagement with universities, Mr McCourt reported that the University of Manchester, Manchester Metropolitan University, University of Salford, and University of Bolton had signed a Memorandum of Understanding to work collaboratively on the provision of graduate and undergraduate training. It was acknowledged these institutions would still develop their own unique selling points and compete for business but, along with Mr McCourt as chair of the GM Local Workforce and Education Group, plus Health Education England; they would come together as a task and finish group to ensure that nursing and healthcare professional training remained attractive in the city region. As an employer, the Trust would also need to consider it arrangements for students, for example income / reward schemes, in order to attract people to future opportunities. The Trust held a positive discussion with Greater Manchester West NHS FT (GMW) and the Trust Development Agency (TDA) on 14 March 2016 regarding the Manchester Mental Health and Social Care NHS Trust (MMH&SCT) bid. Whilst the two organisations would submit competing bids for this opportunity, they agreed to devise a collaborative narrative regarding mental health services across the city region that would be overseen by an independently chaired strategic board. Lord Bradley enquired as to how this strategic board would relate to the DGM mental health strategic board. Mr McCourt responded that he envisaged they would come together as the structures developed.
4 The Board noted the update. 5.2 Technology Steering Group highlight report: March 2016 Martin Roe presented the Technology Steering Group (TSG) highlight report for March 2016 to the Board for assurance. Mr Roe reported that the like-for-like roll-out of Paris had been completed in Bury, Oldham, and Specialist Services. HMR and Mental Health were on track for completion by July TSG discussed the strategy and timeline for the Electronic Patient Record (EPR), which was covered in more detail under item 5.3 of the Board agenda. Dr Ticehurst provided an update on the child health system. The Trust had been informed that NHS Wales was no longer able to support the provision of this system, and organisations would have to find an alternative. Paris did have a child health system but the work involved in the migration of data was significant and, because this work needed to be prioritised, it was impacting on the timescales for the like-forlike roll-out and the implementation of the 'choose and book' system. With regards to the latter, implementation had now been pushed back by a further three months to December 2016 and left the Trust with financial risk exposure amounting to 120k. Mr Roe added that NHS England had advised affected organisations to keep this issue on the risk register. Professor Ormandy enquired if there were any opportunities to utilise the 120k to support work now. Dr Ticehurst advised that this was being explored and could involve, for example, engaging additional staff to support data migration. Drawing attention to the section on Wi-Fi funding, Mr Roe noted that TSG discussed patient internet access to aid recovery, complement treatment, and satisfy a number of external requirements. TSG approved a request for funding to progress this programme. Mr Roe highlighted that Barbara Hoyle (ICT Director) had now retired. An Interim ICT Director, Iain Marsland, was in place under an initial six month contract. Mr Marsland would be assisting the Trust to develop its five-year IT Strategy, part of which would be to identify the type of Director needed to take the strategy forward. This strategy was expected to be ready for Board sign off in summer Dr Ticehurst added that the development of the strategy would also include consideration about the role and function of Performance and Information, and how all these support services might be brought together as part of an overall strategy. 5.3 Electronic Patient Record Strategy Henry Ticehurst presented the Electronic Patient Record (EPR) Strategy for to the Board for approval. Dr Ticehurst reported that the EPR Strategy had been reviewed by the Technology Steering Group, where it was acknowledged that the strategy would require regular review as the organisation flexed and responded to local and national priorities, and the changing landscape of GM devolution. The EPR timeframe in the strategy set out a phased programme for the delivery of a fully functioning integrated clinical system by March Dr Ticehurst highlighted that the definition of EPR would
5 need to be explicit in the IT Strategy to reflect the fact that EPR was about data flows, algorithms of care, and care pathways. In terms of roles and responsibilities, Ian Marsland, the new Interim ICT Director was developing a paper on programme management methodology to ensure the skills required to take this work forward were clearly identified. Mr Marsland was also supporting the development of methodologies that would measure benefits realisation, and in turn this would form part of the EPR Strategy. Mr Roe cautioned against putting names against the roles and responsibilities until the department review was completed. Mr Ainsworth enquired as to what considerations had been given to the compatibility of the Trust s EPR with the future direction of travel across GM. Dr Ticehurst replied that Mr Marsland had made contact with GMW, which also used Paris, to ensure systems were aligned as much as possible. MMH&SCT had a different system and so, irrespective of who was selected as preferred provider, it would migrate to Paris. The Chairman enquired whether the Trust had a clear picture from across its services of who was on like-for-like Paris, full Paris, and who was using mobile technology. In response, Ms Beresford suggested that it would be helpful for any future EPR updates to develop a dashboard for each DBU so progress against the EPR project could be seen at a glance. Dr Ticehurst advised that this suggestion would be fed back to Mr Marsland as part of the development of the strategy going forward. Professor Ormandy queried whether this project would be led by an experienced IT manager. Dr Ticehurst agreed that the project manager would need to be experienced in EPR, and these considerations would be picked up as part of the development of the strategy and departmental review. The Board approved the Electronic Patient Record Strategy Trafford Section 75 Partnership agreement Keith Walker presented the Trafford Section 75 Partnership agreement to the Board for approval. Mr Walker reminded colleagues that the Trafford Section 75 Partnership agreement had been subject to a detailed Board development presentation by Richard Spearing (Interim Integrated Network Director, Trafford) on 16 March The Board papers contained a copy of the Section 75 agreement that would come into force on 1 April 2016 until 31 March This was an exciting development for the borough of Trafford through the bringing together of community health and social care services into one all-age integrated model. Pennine Care retained its statutory obligations (as did the local authority), but the Trust would now be responsible for the day-to-day operational management of services under the leadership of a director employed by Pennine Care (post currently occupied by the Interim Integrated Network Director). This director had a duel reporting line to Mr Walker and Jill Colbert (Corporate Director, Trafford Council). Management processes were overseen by the Trafford Integrated Provider Board; whilst the Trust s quarterly assurance process would change in that the Trafford panel would be jointed chaired between Pennine Care and Trafford Council, and would look at the totality of provision. This would mean the Board would have line of sight of the total outputs of the integrated service. Professor Jowett requested an update on the status of the Integrated Network Director role, as this was not clear from the Section 75 agreement or the presentation at Board development. Mr Walker responded that the post had been appointed to in
6 2015 on an interim basis this was the most appropriate arrangement at the time because of the expediency required in developing the agreement. Mr McCourt added that the process to recruit substantively to this position would need to be developed, but it would be open, transparent, and competitive. Professor Jowett expressed concern that the status of the post was not referred to in the Section 75 agreement, and this might be misleading for people. Mr McCourt clarified that the Section 75 agreement was a stand-alone legal agreement between Pennine Care and Trafford Council; whereas the operational management structure, including arrangements for the lead post, would need to be clearly developed once the agreement took effect. Mr McCourt stressed that this was a significant achievement for the organisation and Trafford Council in that it was the first GM strategic partnership agreement for all-age community health and social care services. The Board approved the Section 75 partnership agreement between Pennine Care NHS FT and Trafford Council. Mr McCourt would sign the agreement on behalf of the Trust on 1 April 2016, and joint communications would follow thereafter. 6. Quality Governance 6.1 Performance and Quality Assurance Committee Terms of Reference Henry Ticehurst presented the Performance and Quality Assurance Committee (PQAC) Terms of Reference (ToR) to the Board for approval. The ToR were discussed at PQAC on 23 February The Chairman advised that discussion had taken place in the NEDs pre-meeting regarding the quorum for the Committee (currently set at five), and that it did not include the requirement for a NED. Ms Bishop agreed to revisit this point, to ensure there was consistency across the ToR for other Board committees. Subject to the above amendment, the Board approved the ToR for the Performance and Quality Assurance Committee. The updated ToR would be circulated to Board outside the meeting. 6.2 Monthly performance highlight report Michael McCourt presented the monthly performance highlight report to the Board for assurance. The report was circulated to Board members on 29 March Mr McCourt reminded colleagues of the progress made in improving the overall performance and assurance system. One of the areas that had needed to be strengthened was oversight by the Executive team this was being addressed via the enhanced scrutiny of performance at the formal EDs business meeting every month. In terms of the issues highlighted in the report, Ms Crosby drew attention to information governance (IG) training compliance, which attracted a 95% target. Previously there had been a degree of latitude, with compliance expected over a reasonable period, which the Trust took to be three years. The requirements had now changed and the Trust was expected to be compliant with the IG training target by 31 March This meant that a large number of staff had to be trained in a very tight timeframe.
7 Ms Crosby, Mr Walker, and members of the IG team had met to discuss and agree a process to achieve compliance across the Trust by the end of March 2016, which included paper-based training exercises because of the issues of access to computers for some people in wards and community teams. As of 24 March 2016, the compliance level was 88%; and by 30 March 2016 it was 94.3%. Work continued to improve the figures further. Mr McCourt added that the immediate issue was to address the required compliance levels but following on from this there would be a review of systems in order to learn from this experience, and ensure there was an appropriately phased approach to training going forward. Professor Jowett enquired as to the extent the issue was about access to equipment. Ms Crosby replied that the high volume of people requiring training in March did put pressure on the electronic system and, for example in ward environments, it was difficult for people to do individual e-learning. Some areas had therefore found it beneficial to undertake training in a team meeting, and so the Trust would look to adopt this as one of its methodologies for training in the future. 6.3 Mental Health and Community Health governance report: February 2016 Henry Ticehurst presented the Mental Health and Community Health Governance dashboard for February 2016 to the Board for assurance. Referring to the mental health dashboard, Dr Ticehurst noted that there had been one homicide case in the reporting period. This case related to an incident in Bury whereby a mother and adult daughter were assaulted, which resulted in one death and one serious injury. The alleged assailant had been referred to Trust services. An internal investigation was currently underway. Mr Trodden reported on a Regulation 28 letter, received from the Coroner on 29 February The case related to SG, who had informal stays on the ward in October and November SG had a history of anxiety, obsessive compulsive disorders, depressive traits, and suicide ideation. Upon discharge from the ward, SG took her own life and was found the following day. The Coroner s R28 letter set out a number of concerns about the care and treatment of the patient, including the response to the ward team in terms of SG s risk profile, and concerns about communication between the ward and family. Mr Trodden and Dr Ticehurst had met with SG s brother to offer the Trust s condolences; apologise on behalf of the organisation; and discuss his concerns, particularly in relation to engagement with the family and how this could have been improved, and the family s concerns about the conduct issues of two nurses and their perceptions about the behaviour of the Consultant Psychiatrist in the court environment. Two nurses involved in this case had been referred to the NMC by the Coroner. During the inquest fresh evidence came to light from a transcript between the police and a nurse, of which the Trust was unaware. This nurse was subsequently suspended pending a full investigation. A second nurse was alleged to have made unprofessional comments and, although this could not be proved, the Coroner had referred the individual to the NMC. Mr Trodden added that neither of these nurses had previously been subject to fitness to practice concerns or complaints. In addition to the formal processes referred to above, Mr Walker was commissioning a piece of psychologically-based organisational development work / cultural support
8 for the locality it was hoped this model would also be appropriate for replication in other boroughs. Mr Livingstone queried the Trust s assessment of its own review process in light of the Coroner s findings. Dr Ticehurst replied that the alleged unprofessional comments by a nurse had been investigated as part of the internal review; however the recording by the police was not known about until it was submitted as evidence in court. Referring to safeguarding, Dr Ticehurst noted that there were two cases involving young people one in Trafford and one in Rochdale that were subject to investigations. The Specialist Services DBU was working in partnership with Papyrus, a national charity for the prevention of young suicide; and a programme had been initiated in Tameside and Glossop, and Stockport, whereby young people would undertake suicide prevention training and raise awareness in their communities. With reference to the community services dashboard, Dr Ticehurst commented on slips, trips, and falls, plus pressure ulcer reporting; adding that the majority of cases were low graded and the reporting culture remained healthy. 6.4 CQC preparation: Board update Ian Trodden provided a verbal update on CQC preparation to the Board for assurance. Mr Trodden reported that the Trust had made two information submissions to the CQC thus far, and third evidence request was expected in due course. A Board development session was planned for 13 April 2016 regarding the CQC assessment process. A number of mock inspections had taken place in services across the organisation, the findings of which will be collated into themes / hotspots. The communications plan for the inspection was currently being reviewed to ensure there was an appropriate balance of information for, and engagement with, services. In terms of logistics, the inspection start date was 13 June 2016 however some activities, such as focus groups, were expected to take place before this date. The logistical plan was in the process of drawn up, and would be shared with Board at a Board development CQC update session. The Board noted the update. 6.5 Finance and Performance dashboard: February 2016 Martin Roe presented the Finance and Performance dashboard for February 2016 to the Board for assurance. Mr Roe reported that, as at month 11, the Trust had a year-to-date underspend of 2,234k against a budget of underspend of 1,515k. The end-year forecast was a surplus of 679k, which equated to 0.24% of Trust income. The combined CIP target for 2015/16 was 7,604k, all of which had now been achieved recurrently. A Board development session on 23 March 2016 provided a detailed review of next year s plans, including the CIP requirement of 9m of which 3.3m related to the loss of contribution to overheads.
9 With regards to performance, CPA (adults) having a formal review within 12 months was currently at 92% against a target of 95%; however the target was expected to be achieved by year-end. Work continued in relation to the achievement of the new IAPT targets. Professor Jowett enquired as the actual numbers involved in the CPA target. Mr Walker agreed to clarify this outside the meeting. Further to Ms Beresford s enquiry about the new CPA policy, Mr Walker advised that this was now in place but it was too soon to see an impact; adding however that work had been undertaken to improve the process elements around CPA recording, although the fluctuations experienced with this target were most likely due to work flow and the prioritisation of work within the quarter. Referring to the new IAPT targets, Mr Walker clarified that although these were Q4 targets, not all commissioners had invested in 2015/16 to achieve these targets some funding would not be available until 1 April Monitor confirmation of Q3 2015/16 feedback Michael McCourt presented Monitor s confirmation of Q3 2015/16 feedback to the Board for assurance. Feedback confirmed that the Trust had a financial sustainability risk rating of four and a governance rating of green in the reporting period. 6.7 Agency: TDA and Monitor requirements Keith Walker presented a report on the Trust Development Agency (TDA) and Monitor requirements regarding agency usage to the Board for assurance. Mr Walker reminded colleagues that Monitor and the TDA issued guidance in autumn 2015 regarding controls on agency expenditure. Technically, the guidance applied to those trusts receiving support or in breach of their licence for financial reasons; however Pennine Care decided to work in the spirit of the guidance. There were three areas of control in place: mandatory use of frameworks, price caps, and an expenditure ceiling. With regards to the mandatory use of frameworks, action had been taken to significantly reduce the use of off-framework agencies. In the last three months, only nine shifts within nursing had been worked off-framework (compared to 270 shifts between September and November 2015). In terms of price caps, there were on-framework agencies that did not comply with the price caps this was a national issue recognised by Monitor / TDA whereby some agencies were refusing to support the agency rules. The Trust applied a tiered system tier one framework agencies were the preferred providers because they complied with the price caps; tier two framework agencies did not comply with the price caps however they could not be removed from the booking system because the tier one agencies alone could not meet the Trust s demand. Tier two agencies currently accounted for approximately 25% of agency usage. Monitor was taking
10 further action from 1 April 2016 in relation to the price caps, and agencies that did not comply with the price caps would be subject to a formal process at the end of this process the agencies would either be off-framework or comply with the price caps. The final area of control was expenditure a target of 4% (as a percentage of total nursing staff expenditure) for 2015/16 was set. Performance was currently at 3.9%. Referring to the data in the report, the Chairman commented on agency usage for Allied Health Professionals (AHPs) and enquired if this meant that there were not enough of these posts on the bank. Mr Walker acknowledged that the majority of developmental work with the bank in recent times had been for nursing posts; however the work patterns of AHPs reduced the ability of substantive staff to undertake extra hours (as opposed to the 24/7 nature of ward environments), and so the number of AHPs able to work on the bank was not sufficient to meet the Trust s needs. Ms Crosby added that there were also wider national and regional issues of skills shortages and reduced numbers in training within AHP disciplines. Mr Roe noted that the Trust s plans for 2016/17 included a CIP requirement relating to agency spend of 1m, which was borne out of national guidance and the Trust s more effective use of the bank. The latest development on this issue was for Monitor to write to trusts with a proposal that included all agency staff, including locums, into a ceiling for 2016/17. For Pennine Care, the allocated ceiling was 7.8m; however given that forecast total agency expenditure for 2015/16 was 13.4m, the organisation considered the ceiling unrealistic. The Trust was trying to clarify the status of this target, given that the original targets in 2015 were mandated for organisations in deficit or subject to special measures and only advisory for trusts such as Pennine Care. An appeal against this target, which it was in the process of pulled together, would be submitted by 31 March The Board agreed to this approach, adding that whilst the organisation was committed to reducing agency expenditure, any target had to be realistic in the context of how it managed and maintained quality and safety as part of its workforce strategy. Professor Jowett noted the useful information in the report regarding the breakdown of nursing agency spend by DBU, and requested that this kind of information be provided across all other disciplines. Mr Walker agreed to circulate this information outside the meeting. 6.8 Board self-assessment of collective performance: March 2016 Louise Bishop presented the Board s self-assessment of collective performance as at March 2016 to the Board for approval. Ms Bishop reminded colleagues that foundation trust boards were expected to assess their performance annually, in line with the Monitor Code of Governance. Pennine Care had chosen to assess its performance against the provisions in the Code of Governance, and the report set out the requirements, the evidence against them, actions to address gaps, and the applicable red / amber / green rating. When the exercise was carried out in 2015, the overall compliance score was 94% against 107 indicators. There were two red rated areas. The first related to a statement of the responsibilities between Chairman and Chief Executive. This had since been developed and approved; hence this area was now green. The second red provision concerned Governor and member engagement. The Trust had a
11 Patient Experience Strategy however there was a risk that the focus on Governors and members might be lost if it was subsumed into this strategy. The matter had been discussed by the Executive team, where it was agreed that the Chief Executive would be the lead for all engagement. Ms Bishop, Zoe Molyneux (Associate Director of Quality Governance) and Kathleen Dixon (Communications and Marketing Manager) were to meet in April 2016 to ensure Governor and member engagement was highlighted as it should be going forward. This provision had now changed to an amber rating. The self-assessment exercise had been revisited, and the performance rating was now 98%. The Board approved the contents of the report. 7. Audit Committee 7.1 Feedback from a meeting of the Audit Committee held on 16 March 2016 Tony Berry provided verbal feedback from a meeting of the Audit Committee held on 16 March 2016 to the Board for assurance. Mr Berry reported that the Committee received the results from a meeting feedback exercise conducted following the December 2015 meeting. This exercise would be conducted twice a year. The Committee received two detailed presentations regarding controls, systems and process one for safeguarding, and the other for contracts. External audit provided an update on their workplan, and the Committee discussed the criteria for the value for money conclusion. The timetable for the annual accounts was noted, as was progress in relation to quality account indicator testing. KPMG presented progress updates in relation to the internal audit plan and counter fraud. The Committee approved the Internal Audit Charter plus the Counter Fraud Strategic and Operational Plan for 2016/17. The next meeting of Audit Committee would take place on 20 May The Board noted the update. 8. Council of Governors 8.1 Draft minutes from a meeting of the Council of Governors held on 2 February 2016 The Chairman presented the draft minutes from a meeting of the Council of Governors held on 2 February 2016 to the Board for information. The Chairman noted the Council s enquiries regarding the provision of autism services by the Trust, advising that a development session was scheduled on 10 May 2016 for the Governors on the topic, which would be facilitated by Clair Carson (Assistant Director of Operations, Mental Health) and Jeremy Bentham (Clinical Manager). The Board noted the contents.
12 9. Other reports 9.1 Briefing from a meeting of the Board Appointment and Remuneration Committee held on 24 February 2016 The Chairman presented a briefing from a meeting of the Board Appointment and Remuneration Committee held on 24 February 2016 to the Board for assurance. 9.2 Fit and Proper Persons guidelines Louise Bishop presented the Fit and Proper Persons (FPP) guidelines to the Board for ratification. Ms Bishop reported that the FPP guidelines had been reviewed and discussed at the Board Appointment and Remuneration Committee (ARC). The guidelines set out how the Trust would demonstrate FPP requirements; there was a code of conduct and declarations that Board members were expected to sign. There had only been one minor change to the guidelines submitted through ARC, which was to clarify that any offence did not include driving offences. The Board ratified the FPP guidelines. 9.3 Information circulated to Board since last meeting The Chairman presented a schedule of information circulated to the Board since the last meeting. 10. Any other business 10.1 Quality Strategy Mr Trodden noted that the Trust was currently reviewing its Quality Strategy. It was continuing to support the sign up for safety campaign; lead on suicide prevention work; and progressing with collaborative care planning and carer engagement in mental health and community services. The strategy would be reviewed by the Quality Group, and was expected to be presented to Board by summer Patient Story Dil Jauffur and Lindsey Baucutt were in attendance to present a patient story. Mr Jauffur explained that the patient story had come about due considerations about how to respond to the Friends and Family Test. The Rehabilitation and High Support Directorate (RHSD) held a series of focus groups with patients to gather information about their experiences, and this had helped to inform a new model for capturing patient experience. Ms Baucutt provided background to the Tatton Unit, situated on the Tameside General Hospital site. The unit opened in 2013 for males of adult age requiring a long-term low secure service. The cohort of patients comprised of people that had spent long periods of time in secure services and required long-term pathways. They
13 could not be discharged due their risk profiles but could be cared for in a low secure environment. The aim of the unit was to deliver patient-centred rehabilitation by working closely with patients and their families. The multi-disciplinary team on the unit proactively supported service users with reintegration into local communities, with the goal of stepping them out of secure services. Ms Baucutt described the story of patient R. R was asked three simple questions about his time on the unit, and his responses provided a wealth of information about patient experience such as the benefits of psychological therapies, group and individual therapeutic activities, plus medication. R had been able to make friends, improve the relationship with his mother, and take leave away from the ward. His care and treatment had enabled him to better understand his feelings and symptoms, change his way of thinking and the way he used his time, utilise skills and techniques to manage difficulties, and make plans for the future. Overall R was very positive about his experiences on the ward and the help he had received. Mr Jauffur noted that the next step for R would be a plan for discharge. Of the 16 patients that were admitted to the unit when it opened, five had been discharged in less than two years this was a significant achievement for secure services, and the NHS England were interested in learning from the unit about stepping patients down though the pathway. Mr Ainsworth enquired whether the levels of therapeutic interventions described were typical for RHSD. Mr Jauffur replied that all services in RHSD had access to psychological and occupational therapies, providing a range of activities. The minimum was 25 hours of activity per patient per week this was difficult to record so at least once a year the directorate held a quality event to share narratives and patient stories. Professor Ormandy commented that the Trust-wide Patient Experience Steering Group was scoping out the range of ways services captured patient experience, adding that it was important the RHSD approach was described along with the impact it had made. Mr Jauffur added that the Specialist Services DBU were due to meet with Zoe Molyneux (Associate Director of Quality Governance) to discuss how patient narratives could be shared with other areas. The Board thanked Mr Jauffur and Ms Baucutt for sharing this patient story. 12. Questions No further business was discussed. 13. Date and time of next meeting The next meeting of the Board of Directors will take place on Wednesday 27 April 2016 in the Boardroom, Ground Floor, Pennine Care NHS Foundation Trust Headquarters, 225 Old Street, Ashton-under-Lyne, commencing at 9.30 am.