Council of Governors Meeting 9 June 2016 MINUTES COG 2016 Minutes of the meeting of the Council of Governors held on 9 June 2016 at 17:00 in Bevan 1 & 2, Stephenson House. Members Present: Prof Dorothy Griffiths, Chair Mr Henry Arthurs Cllr Iain Bott Ms Lorraine Calcott Mr John Clark Mr Stephen Chamberlain Ms Lina Christopoulou Mr Karim Dar Ms Elvira De Souza Mr Richard Drummond In Attendance: Ms Claire Murdoch Ms Robyn Doran Mr Con Kelly Mr Andy Mattin Ms Jane McVey Mr John Vaughan Mr Hardev Virdee Mr Ian Peters Mr David Walker Ms Christine Baldwinson Ms Alison Butler Ms Belinda Iringe-Koko Ms Vimbai Lyons Ms Ela Pathak-Sen Mr Grant Macdonald Mr Mike Waddington Ms Irene Leeman Ms Angela Hook Mr Colin Hurst Mr Howard McFarlane Mr Emmanuel Musendeki Mr Mike Norton Ms Cheryl Prax Mr Chandu Shah Mr Ketan Sheth Cllr Charles Williams Chief Executive Chief Operating Officer Medical Director Director of Nursing and Quality Director of People and Organisational Development Director of Strategy and Performance Chief Financial Officer Non Executive Director Non Executive Director Trust Secretary Associate Director of Programme Management Quality Assurance Analyst Deputy Trust Secretary Associate Director- Quality and Service Improvement Director of Improvement Communications Director 1. Welcome a. The Chair welcomed Governors, colleagues from the Board of Directors, staff colleagues, and members of the public, to the meeting. 2. Apologies for Absence a. Apologies for absence were received from Carina Sheridan, Ann Sheridan, Ponniah Rasanesan, Gloria Goldring, Ushma Soneji, Valdete Kapendani Margaret Davine, John Parkinson and Angela Mason.
3. Governor Election, Appointment, Resignation and Termination Updates since last meeting a. The Trust Secretary advised that elections had ended and the following governors had been re- elected:- Lina Christopoulou, Service User Governor Irene Leeman, London Borough of Harrow Howard McFarlane, London Borough of Ealing, Hounslow, Hammersmith & Fulham The following had been appointed governors:- Lorraine Calcott, Borough of Milton Keynes Richard Drummond, Service User Governor Gloria Goldring, Service User Governor Angela Hook, Service User Governor Colin Hurst, Service User Governor Valdete Kapendani, Borough of Camden Ushma Soneji, Service User Governor Chandu Shah, Carer governor Ponniah Rasanesan, Carer governor Carina Sheridan, Staff governor Emmanuel Musendeki, Staff governor Scott Robinson, Staff governor b. The newly appointed governors were welcomed to the meeting. 4. Minutes of the meetings held on 22 nd March a. The minutes of the meeting held on 22 March 2016 were considered for matters of accuracy. It was noted that the minutes were an accurate reflection subject to it being noted that the last Council of Governors meeting had occurred on 2 nd December 2015. b. It was noted that the minutes of the 2 December 2015 regarding the physical healthcare presentation would be amended to reflect Cheryl Prax s comments to read as: c. Governors discussed the paper and raised a number of comments. Cheryl Prax questioned why, given that psychotic drugs are affecting the physical health of patients, more effort is not being given to withdrawing this medication rather than dealing with its effects. It was noted that the Trust must maximize the benefits of having both mental health and physical health services and it was noted that the clinical networks will operate across the Trust to ensure the spread of best practice. It was noted that health promotion is already a key issue for our Occupational Therapists who make every contact count by discussing physical health issues and signposting patients to relevant services. It was agreed that the trust needs to ensure that System One is configured in such a way as to make it easy to record physical health assessments. The meeting noted the importance of regular screening particularly when anti-psychotic drugs known to cause side effects have been prescribed. 5. Matters Arising a. There were no matters arising.
6. Finance Update and Briefing a. The Chief Finance Officer informed that the auditors had reviewed the Trust s financial position as part of the annual accounts. The Trust had ended 2015/16 with a positive position. This was a good achievement because approximately 85% of providers were in deficit. b. Meeting the 2016/17 targets would be challenging due to financial constraints on healthcare. This included making a 25% reduction in agency use whilst workforce was a challenge. Efficiencies would be needed to meet savings targets and though this would be challenging, the Trust had previously met targets and had robust plans in place. c. In response to a question from Howard McFarlane, the Director of People and Organisational Development responded that agency savings would be challenging whilst also trying to introduce new services however there would be an increase in recruitment events and more frequent monitoring of recruitment and retention by the Board. d. In response to a question from Iain Bott, the Director of People and Organisational Development informed that it was not just sickness absence which necessitated agency use. Sickness absence is relatively low and is reducing. Other factors are shortages in specialist services and geographical hot spots particularly in areas where demand is higher than supply. The Trust was considering alternative workforce models as a solution to high demand for staff. e. The Governors were informed that staff wellbeing was a focus and that carer s support had been introduced for staff in order to better support them. 7. Physical Healthcare Update a. The Council of Governors was informed that the Trust had not performed as well as it would have liked in the physical healthcare audit. It was noted that this was in part due to the fact that in our mental health services a patient s mental health is seen as the key priority. The Trust was keen to improve this to provide better care to patients by assessing both their physical and mental health. b. In response to a question from Emmanuel Musendeki, the Director of Nursing and Quality responded that not all staff were dual trained, however the curriculum for new nurses was being revised to ensure nurses are better skilled to provide for both physical and mental health checks. This would take some time to be seen in practice. In the meantime focused training was being provided. Further work is being undertaken to ensure that there is better access to equipment to carry out physical healthcare checks and for access to results. We are also focusing on wellbeing including offering smoking cessation, encouraging patients to engage with the Recovery College and; partnership initiatives with sports clubs and leisure centres to utilise exercise and sports for better wellbeing. The Trust has adopted a programme managed approach focusing initially on adult, older adult and learning disability services and will be measuring progress against key outcomes. c. It was noted that there is concern about the effect of some medication on patient s physical heath and it was confirmed that other potential treatments are considered. d. The benefits of improving handover between acute and mental and community health was noted. 8. CQC update a. The CQC had inspected the Trust s services in February 2015. The Trust was working through the actions the CQC had set it and now anticipated that the CQC would do a follow up inspection in the autumn of 2016. The CQC had recently inspected IRC Colnbrook and advised the Trust that improvements were needed specifically with staffing, the complaint process and patients involvement in their care plans. An action plan had been created to tackle all the areas that required improvement. b. It was noted that the Improvement Group set up by the Chair in the wake of the CQC inspection, which had included Governors and other stakeholders, had now concluded.
c. The Governors noted that bed availability remained a focus for the Trust. Improvements were being seen on bed availability as there had been no sleep outs and few breaches but there was still immense pressure on beds which is being managed on a daily basis.. 9. Performance Report a. The Director of Strategy and Performance presented the performance report. It was noted that the Trust was performing well against the NHS Improvement key performance indicators. It was noted the majority of these indicators focussed on mental health. The Trust reviews internal key performance indicators to monitor all service areas including community services. b. The Council of Governors was informed that the CAMHS 18 week referral to treatment time indicator was improving, the waiting list for patients was being prioritised and advice was being given to patients ahead of their appointment to assist with care. 10. Quality Priorities a. The Director of Quality & Nursing introduced the item. The consultation for the quality priorities was now closed. Feedback had been good with stakeholders and patients advising that they wanted more involvement. In particular the Trust was commended for its local approach to service provision. Respect and dignity had been identified as being very important and the roll out of the hello my name is campaign would help drive this. There is evidence that outcomes are better if people are more engaged in their care and that the better engaged staff are then the better the care provided. These two core requirements will be the Quality Priorities for the coming year b. The Council discussed practical ways of delivering these priorities and ideas included widening the role of peer support workers, recognising that many staff are hidden carers, encouraging co production, looking at better ways to get key messages to staff including using social media, sharing patient/carer stories. It was also noted that there could be greater engagement with the voluntary sector. c. It was highlighted that it was Carer s week and the Trust had held a number of activities for all carers be it patient or staff carers. Thanks were given to Karen Doherty, Head of Patient and Carer Involvement and Chandu Shah, Carer governor for their work during carers week. 11. Board meeting update a. The Chair advised that the key items considered by the Board at its last meeting had been performance, the Trust s financial position and the sexual health consultation. The Chair expanded that the Margaret Pyke service would continue to be provided although the sexual health service would be consolidated and would operate from 2 rather than 3 sites. 12. Trust Update from Chief Executive a. The Chief Executive advised that notice had been given on all sexual health service contracts whilst Local Authorities, which had responsibility for the provision of sexual health services, reviewed them. The Trust anticipated that the contract value may reduce by between 20 and 50% due to the financial pressures on local authorities and was considering how it could be more innovative particularly by utilising technology so that it able to make a competitive bid. b. The Board had agreed to extend the Milton Keynes contract by a further 2 years. c. The Council of Governors was informed that the Trust sat under 3 Sustainability and Transformation Plan (STP) footprints. These include 2 in London and the Milton Keynes Luton and Bedfordshire STP where the Trust is actively engaged. A dedicated session on STPs would be organised to update governors.
d. The Trust had successfully bid for several new services which included: dentistry in Bedfordshire which was a specialist service; the provision of community learning disability services in Hillingdon and; the Community Independence Services, which was a service that aimed to keep people well to avoid hospital admission through close work with GPs in primary care. e. The Chief Executive informed governors of the Trust s disappointment in receiving such a low position on the national transparency and openness league. It was noted that the metrics used to calculate the scores had included one relating to the recording of incidents on a national data base. Unfortunately a system issue had prevented the Trust from uploading its normal data feed for the month in question which significantly affected the trust rating. On all other metrics the Trust had scored highly. f. The Council of Governors was informed that the Chief Executive had been appointed NHS National Mental Health Director by Simon Stevens, Chief Executive of NHS England (NHSE). She explained that NHSE s areas of focus were urgent care, mental health and cancer and that she would assist in expanding Improving Access to Psychological Therapies (IAPT) services and raising the profile of mental health nationally. The new role is part time and it was clarified that Claire Murdoch would remain the Chief Executive of CNWL, but some of her responsibilities would be shared amongst the Executive Directors. 13. Question and Answers session a. Questions had been raised during the meeting and there were no further questions. 14. Any Other Business a. There was no any other business. End of the meeting 19.02pm Prof. Dorothy Griffiths CNWL Chair