Item 10 Birmingham and Solihull Mental Health NHS Foundation Trust Minutes of Trust Board Public Session Wednesday 29 October 2014 2.00pm Plymouth room, Uffculme Centre, Moseley, Birmingham Present Sue Davis John Short Sandra Betney David Boden Brendan Hayes Sue Hartley Sukhbinder Singh Heer Waheed Saleem Joy Warmington Nerys Williams Barry Henley Also In attendance Gill Harrad Caroline Burgin Notes Dr Lisa Brownell Governors Maureen Johnson Hazel Kench Tony Brookes Steve Wordsworth Michelle Long Chair SD Chief Executive CEO Executive Director of Resources SB Non-Executive Director DB Executive Director of Operations/ Deputy CEO BGH Director of Nursing SH Non-Executive Director SSH Associate Non-Executive Director WS Non-Executive Director JW Non-Executive Director NW Non-Executive Director BSH Company Secretary & Head of Legal Services GH Board Support Officer CB Assistant Clinical Director LB (attending for Peter Lewis) Carer Governor MJ Public Governor HK Carer Governor elect AB Stakeholder Governor SW Carer Governor elect ML Patient Story Graham Bagnall, Bill Graham & Rob Halliwell attended to deliver their Fawlty Towers type skit to Board members. Following the presentation the Board were invited to ask questions on the performance. Questions from the Public No members of the public were in attendance. 1. Apologies Apologies received from Peter Lewis Medical Director; Dr Lisa Brownell is attending on his behalf. SD welcomed the newly elected Carer Governors, Tony Brookes & Michelle Long to their first Board meeting. 2. Review of Actions 2.2 The Chair reviewed the action log, all actions were noted as complete or not yet due.
3. Declarations of Interest SD asked for any Declarations of Interest, as required. No declarations were forthcoming. 4. Chair s Report 4.1 The Chair reported that the two Listening into Action (LiA) events, one for Service User & Carers and one event for Stakeholders had taken place and were very useful and helpful. The Service User event only expected 40-45 service users and over 90 turned up. SD confirmed it was very noisy in the main hall, but people did listen. There was a great deal of feedback received and this has been typed and will be published on the website shortly. The challenge to BSMHFT now is how we translate the feedback into how we work and change things for the better. The Chair also said she was challenged in the secure units by service users who wanted their own LiA event, as they were not able to attend outside of their secure units. The LiA team are looking to set up sessions soon. 4.2 The Chair reported that in addition, the two LiA events for staff who state they have suffered discrimination, or bullying and harassment or violence at work are coming up in November and early December and she hopes these events will be as positive and worthwhile. 5. Chief Executive s Report 5.1. The CEO reported it is Clinical Director Nicky Bradbury s last week in the Trust this week as Clinical Director and expressed thanks for her tireless work within the organisation and that will be greatly missed. 5.2 The CEO reported that BGH has been meeting with NHS England who have indicated that they do not intend to increase low secure women s service in the city for the next 1-2 years. Therefore subject to clinical sign off, the plans to move the Japonica service to Ardenleigh will be going ahead. 5.3 The CEO reported on the funding for Mental Health services that has been announced, stating that it is not yet clear what this sum will fund, but it is thought to include semipermanent funding for the Street Triage collaboration. 5.4 The CEO reported that last month the Birmingham Coroner issued the Trust with a schedule 5 PFD in relation to the death of Yohannes Kidane, who sadly died in the HMP Birmingham. The issues raised to us and the Governor of the Prison related to staffing in the prison. Sadly, the Coroner did not address the letter to the Commissioners as well, and as such the Commissioners say the issue is not their responsibility. The Trust has written again to the Coroner updating on progress with respect to staffing but also to request the letter be addressed to the Commissioners too. 5.5 SSH & DB asked on the fast tracking of service personnel through services as highlighted on Radio 4 today, BGH confirmed that there is concordat on this, which staff are aware of, however, the majority of service users are having access within a week, with all new referrals being seen within 6 weeks. The CEO added that for information, that unless service users identify they are service personnel, we are often not aware. 6. Quality of Clinical Services 6.1 Quality Report Page 2 of 8
6.1.1 SH presented the Quality Report for thematic review of Serious Incidents (SI) advising Board that the Patient Safety Dashboard has been further developed this month, and that it is intended that this approach will be developed for Clinical Effectiveness and Service User experience sections of this report. 6.1.2 SH highlighted the LiA events taking place with regard to the staff who have suffered violence and aggression at work, and also confirmed that the meetings are underway on this issue to identify and recommend best practice. 6.1.3 SH acknowledged that the report on clinical vacancies is difficult to understand and she will obtain an actual position and circulate that. In addition, the monthly report on staffing, SH clarified that the areas rated outside of red, amber and green are predominately in the Solihull area and in relation to Bruce Burns unit. This may be due to an increase in staffing as a result acuity on the wards. 6.1.4 Regarding the national reporting system for serious incidents we have moved further into the top 25 of reporters, which is seen as positive, as we have a culture where staff/ service users feel able to tell us if they have concerns. 6.1.5 NW asked if we benchmark the support available to staff who suffer violence and aggression at work, BGH confirmed the team are looking at the national benchmark data and are looking at best practice elsewhere, to ensure we have robust processes in place. In addition the team are investigating the top 10 areas reporting violence and aggression so that focused work is undertaken. 6.1.6 SSH asked on the staffing levels, the report states that 36 posts are being recruited to, but there are only 18 vacancies. SH confirmed she does not have absolute clarity on the numbers and SB, BGH and herself are investigating this. SD added that we should have a total figure for each role, such as vacancies for nurses, consultants etc. ACTION Report on the final vacancy number to be provided (SH, Dec 14) SD added that last month Board requested the use of seclusion to be included in the report. SH confirmed that this will be reported next month. 6.2 Complaints Annual Report ACTION Quality report to include seclusion numbers (SH, Nov 14) 6.2.1 SH presented the Complaints Annual Report highlighting that over 2013/14 the Trust progressed 272 complaints through the formal process. Of those complaints, the highest (KO41) category of complaints related to all aspects of clinical care 6.2.2 The highest sub-categorisations of complaints related to the level of inpatient care provided, clinical judgement and the level of community care provided. All of these come under the KO41 category of all aspects of clinical care. Of the 272 complaints for the year, 64% (174) were closed within the initial agreed response date. Page 3 of 8
6.2.3 The average response time from date of registering a complaint, to the response being provided during 2013/14 was 40 days against a standard 35 day period. Of the 272 complaints, 42 complainants returned dissatisfied with the outcome of the complaint and further resolution was undertaken and over 2013/14 three complaints have been referred to the Ombudsman. Since this report, more robust intervention with the PALs team has been implemented to try and intervene in the process earlier to resolve matters and to try and avoid them becoming formal complaints. 6.3 Integrated Quality Committee report and draft October Minutes Circulated 6.3.1 JW reported that the Committee met on 22 October 2014 and received a report about the backlog of SI reviews and the implications with our commissioners. The Committee expressed concern that we need to have clarity about what we are doing and the consequences of failing to achieve both with respect to the reputational risk with commissioners, but also the failure to learn from serious incidents. 6.3.2 Committee also received reports on service user and carer experience, the review of homicide cases, an update on the Trust s financial position, performance report, a report on DNAs was received and update on the CQC action plan and a homicide review was interrogated. Finally the Committee heard about the Trust s response to the Department of Health Positive and Safe Programme. 6.3.3 SSH asked on the DNA rates, that Committee felt the model of care was not appropriate, Committee members discussed it was that the outpatients appointments, given the high rate of failure to attend, anecdotal feedback is that service users don t feel it is worth coming into see their consultant. SSH raised that the volume of what the Committee covers does need some review. 6.4 Whistleblowing Report 6.4.1 BGH delivered the Whistleblowing Report updating Board on the current cases, this is now including submissions from different sources such as Dear John. BGH confirmed that all investigations are on track to deliver. The reports are also reviewed robustly on a weekly basis. 6.5 SUCE (Service User and Carer Experience) Recovery & Inclusion Report 6.5.1 SH presented the SUCE (Service User and Carer Experience) Recovery & Inclusion Report. The SUCE team report the following milestones for the month as follows: Patient experience metrics Complaints and PALS data: month 6 Position statement: complaints and PALS data, 6 months summary Position statement: real time feedback data, 6 month summary Current position against delivery of Triangle of Care Mainstreaming Recovery: progress update, and priorities Friends and Family Test (FFT): delivery against plan Page 4 of 8
6.5.2 SH reported on the month 6 position seems to demonstrate an improvement (reduction) in the numbers of complaints and the corresponding in rise in PALs intervention. 6.5.3 SSH queried the process changes taking place, and suggests that seeing how other organisations deal with complaints or benchmarking will be very useful. SH agreed and confirmed the teams are suggesting some of these changes themselves to improve processes. 6.5.4. WS commented that some of the measures don t have targets and it would be useful to know the target on each measurement. 7. Use of Resources 7.1 Finance Report Month 6 7.1.1 Trust Board were presented with the Month 6 Finance Report by SB. The Trust year to date position is a surplus of 0.7m, which is 0.4m ahead of plan. SSL has a deficit of 0.1m as planned. The consolidated position is a surplus of 0.6m. The revised Monitor forecast is a surplus of 1.96m. 7.1.2 SSH noted that Board intend to look at the liquidity position going forward. 7.2 Performance Report Month 6 7.2.1 SB presented the Performance Report to Trust Board highlighting that in relation to the 2014/15 definitions, performance for September 2014 shows 7 of the 7 Monitor indicators assessed on a monthly basis being met for month 6. Following Trust Board decision last month to introduce 3 day follow up, monitoring arrangements have been established to enable operational teams to track and action as required. 7.2.2 In addition, it should be noted that quarter 2 compliance for CPA 7 day follow up was 96.92% above the national 95% threshold. This will be submitted to Monitor as part of the quarter 2 declaration. 7.2.3 SD asked in relation to the CPA compliance, is it a letter from commissioners, or a contract query. SB clarified it is called a contract query notice. 7.2.4 DB asked in relation to the outcome measures, SB clarified that the ethnicity recording has reduced, which means there are a number of people who have not been asked a specific question. 8. Items for Organisational Sign Off 8.1 Constitutional Amendments 8.1.1 GH presented the Board report on Constitutional Amendments reminding Board members that following the consideration of the Birmingham 0-25 years tender, a discussion took place at the August meeting as to how the Trust may respond to the wider provision of care to younger people. This further led to a discussion as to how currently our membership is available to those aged 14 years and over, which is the group to which we currently provide services. It was decided to ask the Council of Governors to consider whether Page 5 of 8
membership should be open to those aged 12 years and over recognising that there are young people who have parents or relatives in our services who may be interested in membership of the Trust. The Council of Governors considered and recommended this change at their September 2014 meeting. 8.1.2 In addition, whilst the Constitution is being amended it is recommended that the model rules of election be updated, to include the possibility of conducting elections by both e- voting and the current postal process, which will hopefully improve participation as well as reducing the costs of ballots. 8.1.3 Finally, amendments to the Constitution are recommended to include reference to the Bribery Act and make explicit that obligations extend wider than just employees, specifically including governors and non-executive directors. 8.1.4 SD asked Board members to consider the amendments as detailed within the report, and approve them. Board members voted and unanimously approved. 8.2 Board skills and experience ACTION BSMHFT Constitutional Amendments approved. 8.2.1 GH presented a report on the skills and experience of Board members following the discussion undertaken during the August Trust Board meeting on possible governance changes that may need to be considered if the Trust is successful with the Birmingham 0 25 years tender. The discussion highlighted that there was a number of areas to which consideration was required such as Trust Board, Council of Governors and operational matters. The report considers that the Board members as they are currently hold sufficient skills and experience to appropriately lead and direct the additional services that would be delivered by the Trust if successful in the Birmingham 0 25 years tender and recommends Board members to consider and approve this recommendation. 8.2.2 BGH added Board already provide services to 16-25 year olds and both himself and SH have served on the Safeguarding Board. JW added her organisation also holds a role on the Safeguarding Board which either she or her deputy attend.. 8.2.3 SD asked Board members to consider the proposal as detailed within the report, and approve the recommendation. Board members unanimously approved. 9. Items for Information 9.1 Mental Health Legislation Committee Report ACTION Board Skills & Experience recommendations approved. 9.1.1 BSH presented the Mental Health Legislation Committee report enclosing the minutes of the last meeting. Committee also reviewed the work plan for 2014 and no changes were made. Summary reports were received from Legal, Complaints, Incidents and Lay Managers and the annual report was received for complaints. An audit on consent to treatment was discussed and the policy was reviewed and agreed with no amendments. The MHA dashboard, MHA compliance summary and risk log were received and the risk log was reviewed. Finally the legislative update was received on the MHA Code of Practice consultation. Page 6 of 8
The minutes of the meeting have been circulated to Board members. 9.2 Charitable Funds Committee report 9.2.1 NW presented the Charitable Funds Committee report confirming the Committee met on 22/10/14 to review the charity future strategy future aims of fundraising. The Committee felt that the principle of sustainable fundraising should continue, financial targets be set with the fundraising post holder about future fundraising with expectations on internal and external sources. Further the Committee had discussed whether the principle of a capital project such as family accommodation or a service user venue would be a worthy cause. The minutes of the meeting have been circulated to Board members. 9.2.2 SB asked on the strategy for the charity, is this in line with our charitable aims? NW confirmed that the discussion was around what aims the charity has, and what outcomes does the charity seek to achieve. GH added it may not be written in a single document, but the discussions do take place in the meetings. Committee members discussed the aims of the charity. BSH asked about the current fundraiser, NW confirmed the current post holder is part time and inwardly facing on a fixed term contract which is due to expire in January, the proposal discussed and approved was for more hours, and the development of a job description with a more outward focus. 9.2.3 JW commented that that no single document exists identifying the aims of the charity is a valid comment, NW added that she will draw up a document for circulation. ACTION NW to draw and circulate a strategy document for consideration (NW, Jan 15) 9.2.4 The CEO discussed that the scope and aims of the charity. 9.4 Use of Trust Seal 9.4.1 GH reported on the use of the Trust Seal this month which was affixed to a contract for sale of the former Grounds & Gardens Department of Reaside to Bellway Homes Limited. The variation related to a small land swap with the developer in order to straighten a boundary. 10. Minutes of the last Public Board meeting 24 September 2014 10.1 The minutes of the Public Trust Board meeting held on 24 September 2014 were reviewed for accuracy. Amendments as follows: Page 3 Item 5.7 ACTION Wolverhampton service report to IQC & Board report October 14. Page 9 Item 7.1.2 the removal of the paragraph. Page 7 of 8
With 2 amendments, as shown above, the minutes of the Public Board meeting held on 24 September 2014 was considered a fair and accurate reflection of the meeting held. 11. Matters Arising (not on the agenda) 11.1 The Chair asked for any Matters Arising. No matters arising were raised. 12. Any Other Business No any other business raised. Next meeting: Wednesday 26 November 2014 at 2.00pm, Uffculme Centre, 52 Queensbridge Road, Moseley, Birmingham. Page 8 of 8