Minutes of the Board of Directors Meeting held in the Boardroom of Our Lady s Children s Hospital, Crumlin, on Wednesday, 28 th October, 2015, at 4.30pm Some items have been redacted in line with the Freedom of Information Acts 1997 & 2003 Present Archbishop Diarmuid Martin (Chairperson), Mr. Frank Magee (Deputy Chairperson), Ms. Helen Shortt (Chief Executive), Mr. John Byrne, Mr. Con Cronin, Mr. David Devlin, Mr. John Healy, Ms. Geraldine Hickey, Ms. Mary Kelly, Ms. Rachel Kenna, Sr. Anna Kennedy, Councillor Ruairi McGinley, Mr. Martin O Rourke, Dr. Maurice Smyth and Dr. Sean Walsh. In Attendance Ms. Suzanne Allen, Dr. Colm Costigan, Mr. John Cotter, Ms. Sharon Hayden, Ms. Pamela McDonald & Ms. Noreen Johnson. Apologies Councillor Ray McHugh & Mr. Turlough O Sullivan Conflict of Interest No declarations of conflict. The Chairman welcomed the newly-appointed Chief Executive, Ms. Helen Shortt, to the meeting. His Grace spoke of the great dedication of the Board to the mission of the hospital and alluded to the challenges ahead as the hospital moves towards the new children s hospital. The Chairman and the Board also expressed their thanks to the outgoing Interim Chief Executive, Dr. Sean Walsh. 15.9.1 DRAFT MINUTES Draft minutes of meeting held on 30th September, 2015, having been circulated, were APPROVED and signed by the Chairperson. 15.9.2 MATTERS ARISING No matters for discussion. Action: Approved 15.9.3 CHIEF EXECUTIVE S REPORT Dr. S. Walsh spoke to: 15.9.3.1 Clinical Director Dr. Walsh expressed his appreciation to Dr. Colm Costigan, who terminates as Clinical Director of the three paediatric hospitals on 31 st October, 2015. Dr. Costigan held this position for three years and his dedication & tireless service to the paediatric population of the three hospitals in pursuit of excellence of care for children was recognised. As advised previously, Dr. Walsh will commence as OLCHC Clinical Director on 1 st November, 2015. Following discussion, IT WAS AGREED that the holder of the position of OLCHC Clinical Director replace that of Chair of the Medical Board as an ex-officio Director of the Company. This proposal will require ratification by the members at an EGM to change the Articles of Association. IT WAS RESOLVED that
an EGM will take place immediately prior to the next Board meeting. It was noted that the Chairperson of the Medical Board should be in attendance at Board meetings. Action: Company Secretary 15.9.3.2 HIQA Antimicrobial Stewardship Dr. Walsh advised the Board of an announced HIQA visit regarding antimicrobial stewardship which will take place on Friday, 30 th October, 2015. He confirmed that a self-assessment tool was submitted to HIQA as part of the first phase of HIQA s National Quality Assurance Review of the provision around antimicrobial stewardship in public acute hospitals. Discussion took place surrounding the self-assessment tool. 15.9.3.3 Children s Hospital Group New Paediatric Hospital Dr. Walsh spoke to the onerous time commitment by hospital staff in attending the numerous meetings currently being scheduled. OLCHC is committed to the entire process and is progressing the integration of cross-hospital groupings. 15.9.3.4 Hybrid Cardiac Catheterisation Laboratory (HCCL)/Orthopaedic Operating Theatre Dr. Walsh advised that building work has recommenced with a planned completion date of February, 2016. Letter was received from the HSE dated 8 th October, 2015, approving an uplift of the capital budget to 8.05m to incorporate funding for the paediatric orthopaedic theatre. Redacted 15.9.3.5 St Joseph s Ward / GI Unit The area continues to experience challenges with environmental screening, however, it is anticipated that the Unit will open in November, 2015. 15.9.3.6 Cardiac Day Unit (6 bed) The Board was informed that the anticipated opening day for the new unit will be 1 st November, 2015. This will allow the hospital to increase the number of cardiac catheterisations being carried out. Redacted 15.9.3.7 Redacted 15.9.3.8 All Island Cardiac Initiative Dr. Walsh spoke to capacity challenges being experienced due to recruitment challenges and bed availability. Service Level Agreement remains in place and meetings are taking place to streamline the entire network process. Mr. Devlin sought assurance that, given the current pressures, no patient from the Republic of Ireland is being disadvantaged. The Board was assured on this point.
Discussions are ongoing in relation to funding from Northern Ireland to address the hospital s cardiac waiting list. Dr. Walsh advised that Ernst & Young has carried out 3 workshops to assist in the creation of a model for the All Island Cardiac Service. Redacted 15.9.3.9 National Model of Care Paediatrics Dr. Walsh confirmed that Prof. A. Nicholson & Dr. J. Murphy will make a presentation to the Board at the December meeting. 15.9.3.10 HSE Black Escalation Dr. Walsh spoke to a positive meeting with the HSE on 13 th October, 2015. The Interim Chief Executive Dr. Walsh and Corporate Management Team were in attendance together with the management team of the Children s Hospital Group. Four metrics, being head count, patient experience time, access targets and finance were presented to the HSE Management Team. 15.9.3.11 European Examination in Surgery Dr. Walsh informed the Board that the hospital recently hosted the first European Examination in Surgery, the first time this examination has been held in an Irish hospital. Ms. S. Allen spoke to: 15.9.3.12 Employment Controls and Absenteeism Ms. Allen noted a slight increase in employment numbers and a current absenteeism rate of 4.14%. 15.9.3.13 Recruitment & Retention Ms. Allen spoke to recruitment & retention challenges currently in the hospital and advised that the situation is being managed on a weekly basis. Ms. Kenna spoke specifically to nursing recruitment and retention challenges, and advised that 68 WTE s have left OLCHC and 62 WTE s have been recruited. 10 new paediatric trained nurses from Belfast will commence in November. Of note, there were no resignations from Theatre in October, however, 2 further PICU nurses are resigning this month. Ms. Kenna noted the significant work being undertaken in this area including attendance at Expo in London and an open day under the Children s Hospital Group planned for November. As previously advised, Ms. Kenna also referred to the further challenge regarding NMBI (Nursing and Midwifery Board of Ireland) whereby processing of nursing registration is taking upwards of 6 months. Ms. Kenna has written to NMBI seeking assistance. Mr. Devlin requested an analysis of the reasons for resignation. The Board may be able to assist in addressing identified issues. Ms. Kenna advised that the top three reasons for resignation, as provided at exit interviews, were: promotion posts, relocation for family life/reasons and other opportunities with which the hospital cannot compete in terms of salary. Councillor McGinley requested that the Board be provided with a report on a monthly basis. Action: S. Allen
15.9.3.14 NCHD Recruitment Ms. Allen referred to significant challenges in NCHD recruitment, specifically for the specialty of Cardio-Thoracic Surgery, where difficulties with visas etc. is impacting recruitment. This situation is also being experienced in other hospitals. The hospital continues to work with the Cardio-Thoracic Surgeons in terms of on-call. Ms. Allen advised that the NCHD January 2016 intake has been completed, with two vacancies remaining in Orthopaedics. Of note, there is also a significant reduction in the availability of SPR s within the colleges. OLCHC has advertised in the British Medical Journal and on international websites in an effort to source staff. Councillor McGinley suggested that advertisings for NCHDs be extended to North America/Africa. M. S. Hayden spoke to: 15.9.3.15 Key Targets Year to date figures, previously circulated, were noted. Action: S. Allen 15.9.3.16 Theatre Ms. Hayden confirmed that one theatre remains closed due to nursing recruitment challenges. 15.9.3.17 Special Delivery Unit Scheduled Care Ms. Hayden noted that funding has been received from the HSE to outsource treatment and contact is being made with families to ascertain where surgery will take place. Stanmore Orthopaedic Hospital will attend OLCHC to review 28 patients for possible surgery in the UK and Ms. Hayden confirmed that families are delighted with this opportunity. 101 non-spinal cases have been transferred to the private sector. Additional funding has also been received from the HSE to send an additional 28 patients to Blackrock, and Children s University Hospital Temple Street has agreed to treat 4 patients. Ms. Hayden advised that taking these measures into account, together with the hospital s own internal clearance plan, it is expected that the waiting list will reduce to 15 months. 15.9.3.18 Special Delivery Unit Outpatients Ms. Hayden spoke to opportunities under review for Rheumatology patients and confirmed that costings have been submitted to reduce the waiting list for Genetics. The Genetics waiting list is currently made up of 74% children and 26% adults. Dr. Costigan advised of an upcoming national report on genetics, authored by Prof. Owen Smith. 15.9.3.19 Redacted
Ms. R. Kenna spoke to: 15.9.3.20 PCHCAI Ms. Kenna advised that PCHCAI data will form a significant part of the HIQA announced visit on 30 th October, 2015. Ms. Kenna assured the Board that fully documented processes are in place. 15.9.3.21 OLCHC Quality Plan 2015 Ms. Kenna confirmed that the OLCHC Quality Plan 2015 remains on target. PEWS is now implemented in nine areas and remains on target for full implementation in all clinical areas by year end. 15.9.3.22 Environmental Contamination Ms. Kenna informed the Board of an environmental contamination (VRE) identified on routine screening. A process and action plan were put into immediate effect with the ward closed to admissions and those beds reallocated. Environmental swabs are now testing negative, and it is expected that the situation will be stood down tomorrow, 29 th October, 2015. 15.9.3.23 Redacted 15.9.3.24 Nursing Awards Ms. Kenna informed the Board that a Cardiac Clinical Nurse Specialist has been nominated by a parent for the Infant & Child Nurse Award. The Maternity and Infant Awards Ceremony is taking place on Friday, 30 th October, 2015. Ms. Kenna also advised that the PICU Nursing Team were awarded 3 rd place in the National Pedometer Challenge, and a PICU Nurse was awarded the top prize of a place on the Irish Heart Foundation s Overseas Walk on 2016. These awards are run by the National Transport Authority of Ireland
Mr. J. Cotter spoke to: 15.9.3.25 Budget 2015 Mr. Cotter advised of the latest budget allocation for 2015 which is 118.1m. An additional allocation of 165k was received in September related to funding for cost increases among Sickle Cell patients. Funding has been transferred, on a once-off basis, in advance of the transition of patients over the age of 18 to St. James s Hospital. 15.9.3.26 Monthly Financial Performance Mr. Cotter noted the net expenditure reported for the month of September of 10.5m, and referred to a significant impact on private health insurance income following the introduction of medical cards for paediatric oncology patients. Redacted Of note, there was also an overspend of 288k in September relating to medical and nursing pay, primarily as a result of increased medical basic pay following the introduction of new consultant salary scales, and also the payment of increments to staff. The Board were also advised of a further expenditure of 100k on psychiatric nurse specialing for patients awaiting discharge to an appropriate service. Both issues have also been raised with the HSE in the hope of a resolution by year end. Action: J. Cotter 15.9.3.27 Patient Income Mr. Cotter advised of a significant drop in patient income in September arising from an overall drop in private inpatients, from an average of 28% for the first 7 months of this year to 22%. This issue arose mainly from policy decisions at a national level, which has been highlighted to the HSE. 15.9.3.28 Redacted 15.9.4 Redacted Action: J. Cotter
15.9.5 AUDIT & NON-CLINICAL RISK COMMITTEE Mr. Devlin advised the Board that the Audit & Non Clinical Risk Committee has issued a Request For Quotation for co-sourcing of Internal Audit resources. 15.9.6 GOVERNANCE, NOMINATIONS & REMUNERATION COMMITTEE 15.9.6.1 Update to Hospital Boards Mr. Magee spoke to paper previously circulated and advised that the Chairpersons of the three paediatric hospital boards continue to meet regularly. Redacted 15.9.6.2 Ethics Medical Research Committee As a result of four resignations from the Ethics Medical Research Committee, Ms. Kelly sought the approval of the Board to the following nominations: Ms. Carol Hilliard, Assistant Director of Nursing/Nurse Practice Development Co-Ordinator due to the retirement of Ms. Dinah Roche, Clinical Cardiac Nurse Specialist; Ms. Bridget Conway, CNM3 in the Emergency Department replacing Ms. Mary Rose Carroll who resigned her post as Assistant Director of Nursing; Professor Eleanor Molloy, nominated by the Medical Board of the Hospital to replace Professor Maureen O'Sullivan who has resigned from the Committee due to work commitments. All nominations were AGREED by the Board. Ms. Kelly further noted a replacement for Ms. Josephine Bartley, who represented the Board on the Committee, will be considered by the Governance, Nominations and Remuneration Committee. Action: Turlough O Sullivan The Board noted the Summary Minute Report of the Ethics Medical Research Committee for the period 1 st January to 30 th June, 2015. 15.9.7 ANY OTHER BUSINESS Dr. Smyth referred to recent media reports concerning lead pipes in healthcare institutions and asked the Chief Executive to investigate if any lead piping is in existence in OLCHC. There being no further business, the meeting then concluded. Date of next meeting: Wednesday, 25 th November, 2015, commencing at 4.30 p.m.