VELINDRE NHS TRUST TRUST BOARD MEETING MINUTES OF A MEETING HELD THURSDAY 29 th SEPTEMBER 2011, 3PM 5PM CONFERENCE ROOM, WELSH BLOOD SERVICE, ELY VALLEY ROAD, TALBOT GREEN, PONTYCLUN Present: Dr Rosemary Kennedy - Chairman Mrs June Smail - Independent Member Mr Paul Griffiths - Independent Member Mr Harry Ludgate - Independent Member Prof Stephen Tomlinson - Independent Member Mr Simon Dean - Chief Executive Mr Steve Ham - Executive Director of Finance Mr Ian Sharp - Executive Director of Workforce & OD Prof Peter Barrett-Lee - Medical Director In attendance: Mrs Georgina Galletly - Board Secretary Mrs Jackie Charlton - External Member of Trust Committee Mrs Vivienne Cooper - Head of Nursing, Velindre Cancer Centre Dr Geoff Poole - Director, Welsh Blood Service Mr Stephen Pearce - Staff Representative Mrs Glynis Wilson - Staff Representative Mrs Lesley Radley - Patient Liaison Group Representative Mrs Sue Campbell - Aneurin Bevan CHC Representative Miss Jennifer Sinnott - Meeting Secretariat Apologies: Mrs Andrea Hague - Director, Velindre Cancer Centre Mrs Margaret Thomas - Staff Representative Mr Tony Millin - Staff Representative Mrs Sybil Arthur - Cardiff & Vale of Glamorgan CHC Representative Page 1 of 12
9/11/01 STANDARD BUSINESS 1.1 Apologies The aforementioned apologies were received. 1.2 Declarations of Interest No declarations of interest were reported. 9/11/02 CONSENT ITEMS The Chairman explained briefly the concept of the newly introduced consent agenda and members were provided with an opportunity to request items be removed from the consent agenda for clarification and/or discussion elsewhere on the agenda. As a result agenda item 2.3 Minutes from the meeting held 4 th August 2011 was removed from the Consent Agenda to become item 3.1.a. The Chairman moved to adopt /approve the Consent Agenda. This was ADOPTED by the Board as follows: For information/noting 2.1 Actions/Rolling Updates/Matters Arising This was RECEIVED by the Board 2.2 Infection Control Annual Report 2010/11 This was APPROVED by the Board. For approval 2.3 Minutes from meeting held 4 th August 2011 This was moved from the Consent Agenda to become 3.1.a. 2.4 Expected Urgent Decisions over 100,000 for the period 1 st October to 30 th November 2011 This was APPROVED by the Board. 2.5 Trust Top Up Payment Policy and Procedure This was APPROVED by the Board. Page 2 of 12
2.6 Trust Private Patients Policy This was APPROVED by the Board. 9/11/03 KEY REPORTS 3.1a 3.1.b Minutes from meeting held 4 th August 2011 This was moved from the Consent Agenda (to become 3.1a) to allow, prior to approval, comment on and clarification of the minutes under the Velindre Cancer Centre Report. To enable the minutes to remain on the Consent Agenda of future meetings the Chairman requested that circulation of the draft minutes be extended beyond members and to all Trust Board meeting attendees. This was APPROVED by the Board. Chair The Chairman reported on the following key issues: - The vacant Director of Nursing and Service Improvement post and the temporary allocation of the post s key responsibilities to other individuals across the organisation. The Board was assured that efforts continued to seek a suitable candidate for the post. - The recent interviews for two Independent Members. The requirement to schedule an additional interview prevented a recommendation being made to the Minister for an appointment, however it was anticipated the Board would have its full complement of Independent Members by December 2011. - The third Board Time Out session which completed the Board s deliberations on the concepts of quality, care and excellence. The Chairman thanked everyone for attending and confirmed a formal framework capturing the sessions outcomes was being developed by Mrs Heydon-Mann and would be shared with the Board later in the year. - Attendance, with the Chief Executive, at the official opening of the Velindre Cancer Centre Active Support Unit garden which offered a fantastic facility for use by patients, relatives and staff. JS Page 3 of 12
- Attendance at a recent All Wales NHS Local Health Board/Trust Chairs meeting with the Minister for Health & Social Services, the key messages from which focused on (i) prevention of avoidable death; (ii) an outcomes based NHS; (iii) reduction of health inequalities with a 2020 target to raise life expectancy by 2.5%; (iv) delivery of NHS individual centred services; (iv) greater use of technology; and (v) more home delivered care. - Attendance at the Annual General Meetings of George Thomas Hospice (by the Chief Executive) and Aneurin Bevan Health Board (by the Chair). - Good news stories for the Trust including: recently awarded doctorate of philosophy to Mr Tony Millin, Head of Medical Physics Treatment Planning and Trust Board staff representative; shortlisting of Major Simon Lawrence, Senior Radiographer, for Reservist of the Year (Military and Civilian Health Partnerships Awards); and Regional Radiotherapy Team of the year awarded to Velindre Cancer Centre radiotherapy team who now progress to UK awards, winners of which will be announced at the House of Commons later in the year. 3.2 Chief Executive Mr Dean reported on the following key issues: - The key points of relevance for the Trust within the Programme for Healthcare recently announced by the Minister for Health & Social Services. The Board was commended to read the publication, a copy of which would be available on request. - The recent appointment of four new consultants at Velindre Cancer Centre, a very positive step in terms of consultant workload management. - The welcomed confirmation of funding of Intensity Modulated Radiation Therapy. Page 4 of 12
- The escalation of matters required to remedy defects delaying commissioning of Bunkers 7 & 8. The Trust was now engaged in a process with contractors to remedy the defect and Velindre Cancer Centre colleagues were developing a contingency plan to ensure continuation of radiotherapy services. Mr Dean acknowledged the lengthy delay and the steps being made towards resolution. - The Chief Executive s participation in the Cardiff half marathon, a significant fund raising event for the Velindre Cancer Centre, for which any sponsorship would be very gratefully received. 3.3 Directors Medical Director Professor Barrett-Lee reported on the following key issues: - The appointment of three new radiology consultants and an oncologist as earlier reported under the Chief Executive s report. - The morale boost amongst consultants on receipt of news confirming funding for Intensity Modulated Radiation Therapy. - The potential for future benefits deriving from ideas developed for addressing the junior doctor staff shortages, a full report on which would be received at December s Trust Board meeting; - The Medical Director s appearance on a recent Wales Today programme which reported significant improvements in Wales cancer survival statistics despite rising incidents. It was acknowledged the programme served as a reminder of Velindre Cancer Centre s larger role in health promotion, not just as a treatment centre but also as a leader in cancer prevention. The importance of engaging with Public Health Wales on the health promotion/prevention agenda was noted and Mr Dean confirmed he was engaged in regular meetings with Dr Robbe of Public Health Wales to take this forward. Page 5 of 12
Nursing & Quality Mrs Cooper reported on the following key issues: - The main agenda items at the recent All Wales Director of Nursing meeting which focused around issues of dignity and transforming care, areas within which the Velindre Cancer Centre was progressing well. - The completion of the Fundamentals of Care audit, a full report on which would be provided to the next Quality and Safety Committee. The audit demonstrated statistics remained on trend with scores of 90% compliance achieved in most areas. - The opportunities being provided within the Velindre Cancer Centre for developing nursing roles and the achievement by two healthcare assistants of the certificate in Healthcare Nursing a new qualification providing healthcare assistants with access to nursing qualifications. - The launch of the Dignity Code on October 7 th at the Velindre Cancer Centre. - The completion of the draft nursing structure for Velindre Cancer Centre, proposals for which would be shortly issued for consultation. Velindre Cancer Centre On behalf of Mrs Hague, Mrs Cooper reported on the following key issue: - The reassessment, under International Standards Organisation accreditation, of both the radiotherapy and medical physics department which found no nonconformance. Welsh Blood Service Dr Poole reported on the following key issues: - The very successful inspection by the regulating Human Tissue Authority at the end of August which was particularly complimentary of the Welsh Transplantation and Immunogenetics Laboratory, supporting the organ transplant service. Page 6 of 12
- An investigation into the Medicines and Healthcare Products Regulatory Agency s concerns that the service had made the potentially serious error of supplying product out of specification. The investigation s results conclusively provided this not to be the case and the incident was promptly closed. Workforce and Organisational Development Mr Sharp reported the following key issue: - Potential industrial action in the NHS relating to pension reform, the first date for potential action identified as November 30 th. The Board was reassured service divisions were in the process of developing contingency plans and meeting with staff side colleagues to ensure appropriate levels of service would be maintained. Finance Mr Ham reported that there were no key issues in addition to those already included on the agenda. Local Partnership Forum Mr Pearce reported on the following key issues: - The staff side discussions taking place with management in order to ensure appropriate levels of service would be maintained in the event of any industrial action. - The outstanding resolution to the All Wales on-call issue. All the above reports were RECEIVED by the Board. 9/11/04 INTEGRATED GOVERNANCE 4.1 4.1.1 Quality & Safety Older People s Commissioner for Wales Dignified Care? Mr Dean presented for noting the Older People s Commissioner for Wales request for further work to be undertaken on the Trust s response to recommendations from the Dignified Care Hospital Review. Mr Dean confirmed that the further evidence requested would be submitted by the deadline of 30 th September. It was anticipated that this response would fully address the concerns raised. Page 7 of 12
Mrs Smail requested a copy of the response JS 4.2 4.2.1 Performance Month 5 (August) Finance Report Mr Ham presented for noting and discussion the report on the financial position/performance for the Trust for the period ended 31 st August 2011. Mr Ham highlighted (i) the positive variance of 56,000; (ii) the differing positions for Velindre Cancer Centre and WBS being discussed at regular meetings with each division; (iii) the very high cash balance almost entirely related to the NHS Wales Informatics Service; and (iv) the very positive position with respect to agency expenditure. 4.2.2 Workforce and OD Report August 2011 Mr Sharp presented the above report identifying the (i) strategic and operational context and work being undertaken within the function; (ii) integration with the Workforce and Organisational Development Action Plan, the Annual Quality Framework and the Service, Workforce and Financial Framework Action Plan; and (iii) Key Workforce Metrics. Mr Sharp highlighted the following key issues: - The boost to the HR function provided by the NHS Staff Management and Health Service Quality publication which acknowledged how good management of staff leads to higher quality of care, patient satisfaction, lower mortality. The publication s findings linked with work being forward from the staff survey responses. - The Trust s intention to apply for Investors in People reaccreditation, a formal re-appraisal for which would take place in February 2012. - The imminent circulation of Health Support Workers guidance, demonstrating the importance of this staff group s role in service delivery and the value attached to them by the Trust. Page 8 of 12
- The organisational risks associated with, and contingencies developed for, the proposed revised on-call arrangements and potential national industrial action relating to proposed changes to the NHS pension scheme. - The improvement of 0.5% for 2011 s May, June and July sickness absence rates compared the same period in 2010, which, notwithstanding the work still required, demonstrated progress in the right direction. In response to concerns expressed around long term sickness absence levels, Mr Dean assured the Board of the very active process in place for supporting individuals through periods of sickness and of the good practice and lessons learned being shared across the Trust s divisions. 9/11/05 STRATEGY AND PLANNING 5.1 Delivering Quality, Care and Excellence Service Workforce and Financial Framework 2011/12 2015/16 Mr Dean presented for approval the above document setting out the strategic framework within which the Trust would plan and deliver high quality services to patients and donors during the next five years. Mr Dean confirmed no significant changes had been made from the version last presented to the Board. Notwithstanding the work already underway, Mr Dean acknowledged that the next challenge lay in delivery/implementation and further developing performance frameworks within which to demonstrate and report to the Board progress against the agenda identified. The Chairman confirmed that the document would be taken forward as a Board by a further series of Time Out Board sessions. This was APPROVED by the Board. 5.2 WBS Strategy: Blood Donation Dr Poole presented for information a report on the Welsh Blood Service s blood donation strategy reporting on issues related to donor panel size, motivation and loyalty. This was RECEIVED by the Board. Page 9 of 12
5.3 5.3.1 5.3.2 5.3.3 Designed to Donate Designed to Donate Service Modernisation Programme Designed to Donate Consultation document Business Justification Case for the Modernisation of the Blood Collection Fleet Agenda items 5.3.1, 5.3.2 and 5.3.3 were received and discussed by the Board simultaneously. Dr Poole provided the Board with an outline of proposals associated with the modernisation of the Blood Collection function to future proof the service, ensuring it remained fit for purpose, placing quality and the donor at the forefront of service delivery. Dr Poole gave a historical context to the proposals and provided reassurance in response to queries from members concerning staff inclusion in the proposals development; the ability to absorb associated training costs; and opportunities taken to work collaboratively and cooperatively with other services and benefit from experiences and lessons learned. Following discussion Dr Poole requested the Board: - Note the contents of the report/associated documents and the case for change; - Approve the D2D consultation document to enable the WBS to proceed to formal consultation; and - Approve the Business Justification Case for the Modernisation of the Blood Collection Fleet for submission to the Welsh Government for approval and funding from the All Wales Capital budget. This was NOTED and APPROVED by the Board. 5.4 Capital Programme 2011/12 and 2012/13 Mr Ham presented updated 2011/12 and 2012/13 capital programmes detailing the capital requirements identified and prioritised by the Velindre Cancer Centre and the Welsh Blood Service for the next two years. Page 10 of 12
Mr Ham requested the Board: - Note the current status of the 2011/12 and 2012/13 capital programme; - Note the capital bids received from the Velindre Cancer Centre and the Welsh Blood Service; and - Approve the capital schemes recommended for approval. Mr Ham provided assurance around the detailed, rigorous risk assessment and risk mitigation comprising the process for prioritisation of urgent schemes. Mr Dean informed the Board that significant work had been undertaken to ensure the Welsh Government were fully aware of the associated risks and pressures. This was NOTED and APPROVED by the Board. 8/11/06 COMMITTEE HIGHLIGHT REPORTS 6.1 Audit Committee Mr Griffiths presented for noting details of the key issues considered by the Committee at its most recent meeting (unconfirmed minutes of which were not yet available). Mr Griffiths reported nothing further to report or highlight in addition to the contents of the report. 6.2 Charitable Funds Committee Mr Dean presented for noting the key issues considered by the Committee at its most recent meeting (unconfirmed minutes of which were not yet available). Mr Dean highlighted funding approved for the chemotherapy Hafan ward development which represented a key strategic development in not only improving chemotherapy services but also in providing an opportunity for unlocking potential around the site. 6.3 Quality & Safety Committee Professor Barrett-Lee presented for noting an update on discussions and outcomes from the Committee s most recent meeting held 11 th August 2011. It was noted a review of the committee s function and operations would be commenced. Page 11 of 12
6.4 R&D Committee Professor Tomlinson presented for noting a summary of the outcomes of issues considered by the R&D Committee (unconfirmed minutes of which were not yet available). Professor Tomlinson highlighted (i) the forthcoming Medicines and Healthcare Products Regulatory Agency s Good Clinical Practice Inspection; and (ii) the Phase 1 business case and the identified need for support in framing proposals (assistance with which would be picked up outside of the meeting). 6.5 Remuneration Committee Mr Sharp presented for noting details of the key issues considered by the Committee at the two meetings held since the last Trust Board meeting. Mr Sharp reported that following the Committee meeting held earlier in the day the way forward on a Trust care lease scheme had been identified and the scheme would be issued shortly for consultation. 8/11/07 ANY OTHER BUSINESS (prior approval required) 7.1 Trust Board Agenda Evaluation Mrs Galletly presented the above report for discussion noting the areas of good practice and improvement identified in the recent evaluation of the Trust Board agenda. The Board confirmed its satisfaction with the actions identified and the Chairman agreed to revisit the inclusion of patient stories on the agenda. RK This was RECEIVED by the Board. 8/11/08 DATE AND TIME OF NEXT MEETING The next meeting of the Trust Board will be at 10am on Thursday December 8 th 2011. Page 12 of 12