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Meeting Name:
Date:
COUNCIL OF GOVERNORS
Thursday 22
January 2015
Time:
08:30
Chair:
JANE STICHBURY
Venue:
Conference Room
AGENDA
Item
Item description
Item presenter
Appendix
1
Welcome
Chair
2
Apologies for Absence
Chair
3
Declaration of Interests
Chair
A
4
Approval of the Minutes of the Meeting held on
28 October 2014
Chair
B
5
MATTERS ARISING 08:35 - 08:45
Chair
C
5.1
6
Actions Log from Minutes of the Meeting held on
28 October 2014
STRATEGY 08:45 – 09:15
7
6.1
Developing the Trust’s Annual Plan 2015/16
6.2
Patient and Public Engagement Group (PPEG)
Sandy
Edington
Eric Fisher
Oral
D
PERFORMANCE 09:15 – 10:05
7.1
Workforce Report
Karen Allman
E
7.2
Quality Performance Report
Jo Sims
F
Richard
Renaut
Pete
Papworth
G
BREAK 10:05 – 10:15
PERFORMANCE continue 10:15 – 11:05
8
7.3
Performance Report
7.4
Financial Performance
H
FOR INFORMATION 11:05 – 11:30
8.1
Events for Membership
David Triplow
8.2
Website Task and Finish Group
Bob Gee
Council of Governors Meeting Agenda - Part 1
January 2015
Oral
I
Page 1 of 2
Item
Item description
Item presenter
Appendix
8.3
Forward Planner
Sarah
Anderson
J
8.4
Governor Sub-Committee Meeting Reports
Reporting
Governors
K
8.4.1
8.4.2
Membership Development Committee (MDC)
Governor Training Committee (GTC)
8.4.3
Governor Involvement with Patient and Public
Engagement Committee (GIPPE)
Governor Scrutiny Committee
David Triplow
David
Bellamy
(Interim)
Glenys
Brown
Part 2 item
8.4.4
8.5
Trust Sub-Committee Reports
8.5.1
8.5.2
Carbon Management Committee
Charitable Funds Committee
8.5.3
8.5.4
8.5.5
Diversity Committee
Editorial Group
End of Life Strategy
8.5.6
Governor Finance Briefing Group
8.5.7
8.5.8
Healthcare Assurance Committee (HAC)
Infection Prevention and Control Committee
(IPCC)
Organ Transplant Committee
Patient Experience and Communications
Committee (PECC)
8.5.8
8.5.10
Reporting
Governors
L
Mike Allen
Graham
Swetman
Vacancy
Various
Glenys
Brown
Graham
Swetman Eric
Fisher
Vacancies
Keith Mitchell
Dexter Perry
Glenys
Brown (GIPPE
Chair)
David Triplow
(MDC Chair)
8.6
9
8.5.11
Patient Information Group (PIG)
Eric Fisher
Keith Mitchell
8.5.12
Valuing Staff and Wellbeing Group
Keith Mitchell
Reports from Governors
8.6.1
Reports from Appointed Governors
8.6.2
Report from Staff Governors
8.6.3
Governor reports of activities outside the Trust
Appointed
Governors
Staff
Governors
All Governors
M
N
O
DATE OF THE NEXT COUNCIL OF GOVERNORS MEETING
Tuesday 28 April 2015
08:30
Conference Room, Education Centre
Royal Bournemouth Hospital
To resolve that under the provision of Section 1, Sub-Section 2, of the Public Bodies Admission to Meetings Act 1940,
representatives of the press, members of the public and others not invited to attend be excluded on the grounds that
publicity would prove prejudicial to the public interest by reason of the confidential nature of the business to be transacted.
Council of Governors Meeting Agenda - Part 1
January 2015
Page 2 of 2
Council of Governors Meeting
THE ROYAL BOURNEMOUTH AND CHRISTCHURCH HOSPITALS
NHS FOUNDATION TRUST
REGISTER OF GOVERNORS’ INTERESTS
as at 14 January 2015
The following Governors of The Royal Bournemouth and Christchurch Hospitals NHS
Foundation Trust have declared interests as listed below:
NAME/CONSTITUENCY
DECLARED INTEREST
ELECTED GOVERNORS
Public: Bournemouth and Poole
David Bellamy
 The Chairman of the Patient Panel of a local GP Group
Glenys Brown
None
Carole Deas
 Partner – Roger Parsons, Public Governor
Paul Higgs
None
Colin Pipe
None
Roger Parsons
 Partner – Carole Deas, Public Governor
Keith Mitchell
None
David Triplow
None
Monika Whitmarsh
None
Public: Christchurch and Dorset County
Chris Archibold
 Wife is a member of staff employed in the Orthopaedic
Department, based at the Royal Bournemouth Hospital
Paul McMillan
None
Derek Chaffey
 Member of the Stanpit and Mudeford Residents’
Association
Eric Fisher
 Member of East Dorset Locality Health Network Group (in a
personal capacity) which is arranged through the Dorset
CCG
 Member of the Patient and Public Engagement Group
(PPEG) with Dorset CCG as part of the Clinical Services
Review
Doreen Holford
None
Brian Young
 Consultant (salaried) for Immunotec
Public: New Forest, Hampshire and Salisbury
Mike Allen
None
Bob Gee
None
Graham Swetman
 Member of the Conservative Party
 Director, Family Property Investment Companies
Staff
Medical and Dental
Dean Feegrade
Administration, Clerical
and Management
Ian Knox
COG/Register of Governors Interests
Vacancy
None
None
Page 1 of 2
Council of Governors Meeting
Allied Healthcare
Professionals, Scientific
and Technicians
Nursing, Midwifery and
Healthcare Assistants
Richard Owen
Hotel Services and Estates
Vacancy
None
NOMINATED GOVERNORS
Local Authority Governors
John Adams
Bournemouth Borough
Council
Colin Jamieson
Dorset County Council











Phil Goodall
Poole Borough Council
Partnership Governors
The Royal Bournemouth
and Christchurch Hospitals
Volunteers
Dr Gail Thomas
Bournemouth University



Councillor Bournemouth Borough Council
Member of the Conservative Party
Chairman of the Dorset Police and Crime Panel
Elected member of Christchurch Borough Council
Elected member of Dorset County Council
Chairman of the Christchurch Planning Committee
Chairman of the Dorset Health Scrutiny Committee
Member of the Dorset Health and Wellbeing Board
Member of the Cabinet of Dorset County Council (Public
Health and Communities Portfolio)
Wife is a Constituency Agent for the Conservative Party
Member of the Cabinet of Dorset County Council, with the
Public Health and Communities portfolio, as such I will
have a seat on the Dorset Health and Wellbeing Board.
Councillor Poole Borough Council
Member of Dorset Police and Crime Panel
Director of Streetwise (West Howe)
Vacancy
None
Primary Care Trust Governors
Dr Tom Knight
General Practitioner
CCG Dorset
Board Member of Dorset Clinical Commissioning Group (CCG)
COG/Register of Governors Interests
Page 2 of 2
Name:
Date:
Present:
P
Ap
pologies:
Counciil of Goverrnors
Tuesday 28 Octtober
2014
Tiime:
10
0:00
Chair:
C
Jane Stichbury
S
Venue:
Confere
ence Room
m,
Education Centre
e
Jane Stichbury (JS
S), Chairm
man
Mike Allen (MA), Public
P
Govvernor (New
w Forest, Hampshire
H
e and Salisbury)
John Ad
dams (JA), Appointed
d Governor (Bournem
mouth Boroough Coun
ncil)
Chris Arrchibold (C
CA), Public Governor (Christchu
urch and D
Dorset County)
David Bellamy
B
(DB
B), Public G
Governor (Bournemo
(
outh and P
Poole)
Glenys Brown (GB
B), Public G
Governor (Bournemo
(
outh and Pooole)
C
(DC
C), Public G
Governor (Christchu
(
rch and Doorset Coun
nty)
Derek Chaffey
Dean Fe
eegrade (D
DF), Staff G
Governor (Administra
ative, Clericcal and Ma
anagement)
Eric Fish
her (EF), Public
P
Gov ernor (Chrristchurch and
a Dorsett County)
Bob Gee
e (BG), Pu
ublic Goverrnor (New Forest, Ha
ampshire aand Salisbu
ury)
Phil Goo
odall (PG),, Appointed
d Governo
or (Borough
h of Poole))
Paul Hig
ggs (PH), Public
P
Govvernor (Bou
urnemouth
h and Poolee)
Doreen Holford (D
DH), Publicc Governorr (Christchu
urch and D
Dorset Cou
unty)
Colin Ja
amieson (C
CJ), Appoin
nted Goverrnor (Dorse
et County C
Council)
Paul MccMillan (PM
M), Public G
Governor (Christchur
(
rch and Doorset Coun
nty)
Keith Mitchell (KM
M), Public G
Governor (B
Bournemouth and Pooole)
Tom Knight (TK), Appointed
A
Governor (NHS Dorrset Clinicaal Commiss
sioning Grroup)
Richard Owen (RO
O), Staff G
Governor (H
Hotel Services and Esstates)
Roger Parsons
P
(R
RP), Public Governor (Bournemouth and P
Poole)
Dexter Perry
P
(DP), Staff Govvernor (Me
edical and Dentistry)
Colin Pipe (CP), Public
P
Gove
ernor (Bou
urnemouth and Poolee)
Graham
m Swetman
n (GS), Pub
blic Govern
nor (New Forest,
F
Ham
mpshire an
nd Salisbury)
Gail Tho
omas (GT)), Appointe
ed Governo
or (Bournemouth Uniiversity)
David Triplow (DT
T), Public G
Governor (B
Bournemou
uth and Pooole)
Brian Yo
oung (BY),, Public Go
overnor (Christchurch
h and Dorsset County
y)
Carole Deas
D
(CD), Public Go
overnor (B
Bournemouth and Pooole)
Ian Knox (IK), Stafff Governo
or (Allied Health Profe
essionals, Scientific and
a Techn
nical)
Monika Whitmarsh
h, Public G
Governor (B
Bournemou
uth and Pooole)
Non
Atttendance::
Dily Rufffer (DR), Governor
G
C
Co-ordinato
or
In
egal Assista
ant to the Trust
T
Secreetary (minu
ute taker)
Atttendance:: Anneliesse Harrison (AH), Le
Richard Renaut, Chief
C
Opera
ating Officer
A
Dire
ector of Hu
uman Reso
ources
Karen Allman,
Pete Pa
apworth (PP
P), Deputyy Director of
o Finance
Ellen Bu
ull (EB), De
eputy Direcctor of Nurrsing
Octoberr 2014
Council off Governors Mee
eting Minutes – Part 1
1 Mike Richardson, Facilities Manager
Derek Dundas, Non- Executive Director
Ian Metcalfe, Non-Executive Director
Steven Peacock, Non- Executive Director
Paul Stanley-Watts, Councillor, Bournemouth Borough Council
Sue Bungey, Member of Public
Sharon Carr-Brown, Public Member
MINUTES
Action
The meeting commenced: 10:00
Welcome
JS welcomed everyone attending the meeting of the Council of
Governors.
Apologies for absence
As listed above.
Declarations of interest
None.
Approval of the minutes of the Meeting held 22 July 2014
The minutes were confirmed as an accurate record.
14/57
14/58
14/59
14/60
MATTERS ARISING
Actions Log from Minutes of the Meeting held on 22 July 2014
(14/49) Performance report- DB queried the readmission data that was DR
discussed by HL during the September Governor training and requested
this was re-circulated.
14/61
(14/49) Communication- KM noted the follow up regarding telephones on DP
wards and requested a response to his query about communicating with
relatives when patients are moved between wards on AMU.
QUALITY
CQC Visit Report- current position
JS confirmed that the Trust had received the CQC report and were
providing feedback to the CQC therefore the report was not available to
the public but would be circulated within the next few weeks. Further
details would be provided once publicised but there were no new issues
and no changes to the Trust’s position with the CQC. A more focused
inspection would be due by August 2015.
14/62
PERFORMANCE
Quality Performance Report
Harm free care- scoring had slightly decreased in month but the safety
thermometer tools were being used to focus on pressure damage and a
steering group were managing actions around this. It was emphasised
that the Trust was managing performance around key pressures and
safety thermometer performance.
14/63
Never events- one event was noted within minor surgery although the
patient was not harmed. A full investigation was completed and the team
presented follow up actions to the Board.
Friends and Family Test- performance was maintained and there had
October 2014
Council of Governors Meeting Minutes – Part 1
2 been an increase in compliance. The Emergency Department results
were improving from the token system and within outpatient areas. New
methodology and further guidance is to be introduced to obtain more
narrative and qualitative data.
Complaints- response times had improved and there is more focus on
the quality of complaints handling and taking greater acknowledgement
of what people are asking. Key areas of complaints were Medicine,
Elderly care, Orthopaedics and some Surgery. The Trust was managing
this and identifying any themes.
Patients Association- working with focus groups to support and try and
answer patient queries and concerns. Feedback from this is to be
provided to PECC and monitored through HAC.
DP queried why it had been defined as a never event if no harm had
been sustained. EB responded that following discussions with the
Governance Team, HAC, the CCG and Medical Director it agreed that DR/EB
the incident satisfied the definition. Further information to be provided on
Serious Incidents to Governors.
EF commended the use of the care campaign audit in driving actions
through. He queried whether the Trust had implemented the Francis
report requirement that the responsible clinician and lead nurse were
shown for each patient as he noted that the patient boards were not
always consistent. EB responded that there was still work to do as it was
a new process but that the Trust were looking to rationalise whiteboards
and the criteria to ensure the same structure is used throughout the
Trust.
CJ requested further information about patient opinions and complaints.
EB responded that the data collected from patient choice and NHS
England was reported into the Governance process although there is
often no detail to identify specific areas. The Trust is ensuring that a
response is provided and people are invited to contact the Trust/PALS to
discuss and resolve any issues. Emails and electronic communications
are also increasing to improve communication.
14/64
Performance Report
RR reported on the Trust’s performance against the national
requirements for August:




62 day wait (predominantly for urology cancers)- an improved
performance was sustained although this will remain at risk due to
impact from national campaigns, patient choice and potential
transfers from Dorchester;
Improvements had been made and there had been an increase in
slots for 2 week Cancer waits;
Due to potential risks it is likely that the Trust will not reach the 62
day target for this quarter although it is planned to be back on
track from January to March;
Robotic surgery operating has increased to aid with the volume of
patients waiting and discussions are taking place with
October 2014
Council of Governors Meeting Minutes – Part 1
3 


Commissioners about template biopsies as a more efficient and
less painful form of diagnostic test;
The Trust achieved 95% and narrowly missed compliance for the
4 hour target. Performance reflects the increased ambulance
conveyances and other organisations are also struggling with this
indicator;
Work is underway to alleviate some of the pressure within ED to
improve patient flow and best practice for rapid assessment on
arrival. There will be an increase in ambulatory clinics with some
being GP lead;
Building work will be taking place where the discharge areas are
situated to form an ED clinical area where patients will be fast
tracked. Emergency trolley admissions can be transferred to a
clinical setting earlier on with quicker access to pathways. There
will also be a close easy drop off and pick up area for the
discharge lounge.
BG queried the current numbers for robotic surgery. RR responded that
specific numbers could be provided but these would be increasing due to RR
additional patient transfers from Dorchester which will also increase year
on year.
EF queried the winter pressures plan and how it would be providing for
the increase in capacity of respiratory and thoracic issues and the
resources. Further he questioned whether the CCG rewarded the Trust
for working with the community to reduce admissions. RR responded
that the plan provided capacity for 12-15 additional beds and that over
the next week the additional numbers would be confirmed. He
emphasised that the Trust were conducting proactive work and
education outside of Trust for respiratory conditions. He confirmed that
the CCG do not reward the Trust for this work however it provides for a
better service.
CJ queried the cost associated with the Robot and the relationship with
the CCG. RR responded that the robot was donated by charity and the
cost paid by Commissioners was the same as traditional treatment
although it is more beneficial to patients. CJ further questioned the 4
hour target and the definition of admissions and attendances. RR
explained that an attendance concerned public arriving by foot and they
should then be seen within 4 hours of attending and a decision made as
to whether they are admitted. He added that by improving other services
it would allow for alternatives for the ambulance services to use.
JA queried the strategic alliance with Poole going forward due to patient
treatment commencing at Bournemouth and continuing at Poole. RR
confirmed that Radiotherapy treatments take place at Poole and
operations at the Trust. The cancer target culminates breaches from
both sites and is shared.
GS queried the figures for the 62 day cancer target and the profiles
behind the breakdown of the data. RR advised that the numbers were
small but that it was often those patients on pathways within the
diagnostic phase where breaches often occurred. RR added that he
would be able to provide specific examples of the pathways and stages
October 2014
Council of Governors Meeting Minutes – Part 1
4 in order to understand the targets. It was emphasised that a large
amount of patients require operations and the Trust aims to treat
patients as soon as possible but a system needed to be created for
speed of treatment taking into consideration the convenience of the
patient.


14/65
RR
18 week RTT target- working to clear the back log of patients
already waiting and the Trust is making progress but concerns
have been highlighted between January and March for in patients
while dealing with emergency patients. There was a planned miss
for this quarter as nationally all Trusts are working to clear
inherent backlogs;
Non admitted outpatients were under considerable pressure with
follow ups and there was a risk of missing the target from
December to March and there are due to be monthly updates to
the Board.
Financial Performance
PP outlined the report to 31 August 2014 highlighting that the increased
pressures had impacted upon the financial position. The planned deficit
for month five was £600,000 which formed part of the full year deficit of
£1.9 million. This was the first year that the Trust had set a deficit plan
and was in line with many other Foundation Trusts. For the five month
position the Trust delivered £2.3 million which was significantly away
from the plan however has resulted from the increase in activity and
reflects the national shortage for medical and nursing staff.
The Trust did not deliver the cost improvement programme and as such
a financial recovery plan has been put in place with weekly meetings to
ensure directorates have support in delivering the improvement
programme. The forecast will not be achieved in full but it will be a
greatly improved position in light of the increased pressures and activity.
Work is currently underway to explore why staff are leaving to aid with
further recruitment. The junior doctor rotation has improved the position
in elderly care. It was noted that not all plans were backed by the CCG
and the new winter ward would therefore add to the Trust’s deficit
position but will ensure the hospital is safe. The CCG have highlighted
that national funding may be available although confirmation is yet to be
received.
There is also a draft tariff package which will be received soon but the
Trust will need to save 4% per year. National variances will continue and
there is a possibility that organisations will be penalised for emergency
readmissions. Subject to the final package there is an open door for
moving away from nationally funded packages and this will be
considered over the next few weeks.
The Council discussed the sharing of risk between commissioners and
providers and raised concerns that this will de -incentivise Trusts. It was
also noted that moving away from Tariffs for elderly patients would be
beneficial.
RP commented on the Tariff system and penalisation for readmissions.
October 2014
Council of Governors Meeting Minutes – Part 1
5 He raised concerns that the CCG give undue favouritism to Trusts in
deficit rather than those in surplus. PP advised that there was no
additional funding and Trusts were bound by the national tariff and that it
was not in the Trusts’ favour and this highlighted concerns.
DB queried the use of locums and the impact upon the deficit and
whether now that the Trust had employed more staff it had improved the
position. PP responded that agency reliance continues but winter
pressures would require more staff which would be at a premium. The
Junior doctor rotation had reduced reliance on locums and was
encouraged that the trend would move in the right direction once the
winter pressures had been dealt with.
TK suggested that Dorset needed to have a better healthcare position
and wanted Governors to be aware of the Clinical Service Review and
the impact this would have upon the Trust. PP advised that in terms of
the overall approach of the review that the implications would be
significant. It was proposed that a briefing was held for Governors on the
purpose and impact of the Clinical Service Review.
14/66
RR
Workforce Report
KA advised the Council of Governors that the position remained
challenging although the Trust had recruited a large number of staff
particular within overseas nursing. The Trust are looking at other
campaigns to further increase recruitment such as overseas Consultants
who are NHS trained and returning to the United Kingdom.
The figures reflected the position for August and the data for the next
few months was being processed and would include starters and
leavers. The Trust is currently following up with staff who are leaving
with EXIT questionnaires and a piece of work will be brought to the
Board in order to understand the reasons.
Mandatory training and the assessment of competency levels are to
become an individual electronic process. The new education and training
structure is hoped to be more positive and increase clinical education
amongst staff. The use of the simulation suite has increased with more
staff engagement and within ward areas.
The Trust is working to improve the development of staff, their
progression and introducing new leaders through the ‘Time to lead’
programme, which has received good feedback. There has also been an
increase in the ways in which the Trust recognises staff and their hard
work as it is important to engage, listen and communicate. The recent
tea party for staff and for volunteers was highlighted and the staff awards
that took place in November.
It was emphasised that different ways to recruit are being identified to
fulfil the vacant roles and those that will be required for the future. It was
noted that it will be important to redesign the strategy in light of the
impact upon finances.
GB queried the recruitment from Bournemouth University. KA advised
October 2014
Council of Governors Meeting Minutes – Part 1
6 that applications were being made across the country and that the Trust
may not have been the preferred choice. The Trust is ensuring that they
are providing good support and giving the best experience while
students were training at the Trust. KA commented on upcoming
recruitment events and stands at careers events across the country.
There is also work underway to develop a role for apprentices by joining
up locally with other organisations and to structure a training.
EF welcomed the report and was encouraged by the development in
encouraging people to stay and work at the Trust by developing roles.
He queried the comparison of turnover with other trusts. KA responded
that it was lower but that the template change had masked turnover.
DT advised that the Trust was developing plans to encourage younger
people in careers with the NHS and queried why the Trust had not
attended the recent Poole Careers event. KA added that she would look
into this as an option in the future and emphasised that work experience
was occurring although it had not been coordinated at present.
JA commented on Ward 26 and queried the previous issue with staffing.
KA advised that the figures for the elderly care wards were challenging
and remained difficult to retain staff in this area. The Trust is considering
incentives and training with a rotation to improve retention. JS confirmed
mitigation was completed to ensure all wards were up to template.
CA commented on appraisal compliance being below target and queried
whether there were regular meetings with managers to pick up on
themes. KA advised that a recent audit had been completed and a
system was being developed to ensure appraisals are more meaningful
and this to be implemented in April. It was acknowledged that feedback
was fundamental and that performance is discussed with staff. The
Annual staff survey reflected that the value of appraisals were low and
this is what the Trust is also focused on improving. JS added that this
was an issue that has featured amongst staff governor’s feedback and
will be discussed at Board.
CJ commended queried the ramifications for mandatory training non
compliance. KA responded that there are a variety of areas of
compliance and the new approach would feature core skills with a new
platform which will be implemented in March and it is hoped the new
programme will have a positive impact on compliance. DP added
highlighted the importance of a balance between training and
compliance. KA outlined that under the new programme competency
would be assessed and would require less time and training would be
flagged accordingly.
JS suggested that a seminar session was held for Governors regarding
staff training, the appraisal process and the Trusts’ workforce strategy
going forward.
14/67
DR/KA
PLACE Report
MR advised that the report reflected an audit that focused on the hospital
and the environment and the data was collected during February and
October 2014
Council of Governors Meeting Minutes – Part 1
7 March 2014. In general the results were better compared to last year
and every area audited had improved with the exception of the condition
of Christchurch hospital and the food at Bournemouth.
The report highlighted some issues within Medicine for the elderly and
dusting which reflected difficulties with resourcing and accessing wards
for deep cleaning. This was reported to BCC and a bid was placed this
month for frequent public toilet cleaning which has been recognised as
an area to improve upon. The food results at Bournemouth had not
been positive and were low compared to the national average. It was
noted that the Hostess on the particular ward was new and had not been
provided with adequate support.
KM queried whether water coolers would be more feasible for elderly
wards. MR added that this was dependent upon individual ward budgets
and maybe something the Board should discuss. JS encouraged that
this should be actioned and prioritised.
MR
EF questioned whether there were any themes identified from the walkarounds and audits as a form of independent evidence supporting the
targets going forward. MR confirmed that this occurs and that the Trust
constantly audit information which is also fed back to the IPCC. It was
acknowledged that external consultants were looking at cost and quality
and where savings could be made to redirect funds into clinical areas.
JS added that Executives and management had been very responsive
on this point as it is representative of the Trust.
PG commented that disabled toilets needed to be made bigger for
scooter access and MR noted this for future reference.
GB commented on a particular ward that scored low for appearance,
maintenance and privacy and dignity. She requested assurance whether
this had been dealt with. MR advised that this concerned flooring and
RR added that the difficult areas to reach have been a priority and the
next areas for refurbishment would be ward 4 and 5 next year.
MR added that the data was old but that the actions had been
completed. A final report would be provided highlighting any outstanding
actions and it was noted that the information is reviewed through the
committees.
FOR DECISION
Council of Governors Meetings and Training dates of 2015
JS requested the Council response to support for the proposed dates.
14/68
The Council agreed the dates.
14/69
Council of Governor 2015 meetings time of day
EF outlined the paper highlighting that meetings were interactive and
constructive however were too long. He requested the Councils thoughts
as to adapting the times in light of Governors’ commitments.
DB highlighted that many Governors were able to attend Board meetings
October 2014
Council of Governors Meeting Minutes – Part 1
8 at 8:30am and suggested meetings should encompass two short breaks
in the morning terminating at lunch time.
Governors discussed that Poole meetings were often held in the
evenings and would be an option for one meeting although it was noted
that Executive attendance may be difficult. In contrast it was highlighted
that this may attract more public and younger members. The Council of
Governors confirmed that it was not favourable for the meetings to begin
at 4pm.
It was agreed by consensus of a mandate to change the meeting times
to 8:30am.
14/70
Governor Involvement with Patient and Public Engagement (GIPPE)
Terms of Reference
GB commented that the terms of reference had been changed 12
months ago when the group was altered to encompass public
engagement. One of the changes included the frequency of meetings to
quarterly under the rationale that this would enable the group to
complete surveys. The reports would then be fed to the Patient
Engagement and Communications Committee whereas previously they
took place before PECC verbally and this reporting will give opportunity
to present a paper.
GB added that additional paper discussed progress made in the last
year and it was discussed that a review would be provided. There has
been a lot of engagement from the public through many of the methods
and the paper highlights the triangulation of these surveys.
JS requested the Councils agreement of the changes to the terms of
reference and the Council agreed.
14/71
Governor Scrutiny Committee update from previous reports
including:
 Discharge Letters
 Hospital at Night
 Food and Nutrition
EB summarised the update noting that the scrutiny outcomes were not
available but progress was being made.





Food and nutrition: out of 8 points raised these have all been
achieved;
Education and support for the MUST score is being managed and
is reported through the Healthcare assurance committee. The
Trust has significantly improved upon compliance in the
completion of risk assessment and food ordered on same day/ hot
food with a changeover to tray delivery system also;
Patients who require help are assessed and are monitored
through a steering group. Audits had been conducted and the
Trust achieved 100% but this must remain consistent;
Meal times- dedicated members of staff with ward hostesses and
ward sisters work together to ensure meals are delivered;
Hand cleaning- wipes are available before and after meals and
work is underway to ensure that these are offered and monitored
October 2014
Council of Governors Meeting Minutes – Part 1
9 


through observational audits and patient engagement;
Urine bottles and commodes to be cleaned more regularly- bottle
holders have been ordered to fit on the side of beds and
distributed accordingly. Commodes now have a clear structure
for cleaning;
Better communication around food nutrition and abbreviations
have now been rationalised and are available on patient television
with hostess support with choices;
Nutrition and patient meals- reported through nutrition steering
group. Actions have been achieved and some have been closed
and some will continue to be monitored.
SE presented to the Council on the topic of discharges:
 The Trust had reviewed the content of letters and are sending
more electronically to GP practices within 24 hours of discharge.
This will then be followed up with paper copies but the Trust is
pushing towards a 100% electronic process;
 Issue with acronyms by junior medical staff and the Trust is
working to educate upon induction and will continue to work with
Juniors on this point;
 Acronyms between specialities are not understood and a glossary
is being considered to be published on the website;
 Patient notification of death- a structure is being put in place
electronically to be followed up with GPs by telephone to speed
up the process. The Trust is also developing a system to notify
GPs of cancellations so that another appointment can be made;
 Best practice and content of acronyms- tests are often undertaken
and commenced in hospital with results being received after
discharge and the Trust is working to ensure that these are
managed internally with GPs being notified of results;
 Letters have been more defined with better content and receiving
feedback from GPs about fit notes to be issued as part of the
discharge summary;
 Electronic discharge summaries are to also include pharmacy
information with a list of drugs and whether the GP should
continue to prescribe particular drugs/the rationale for changing
any medication;
 More changes are to be made and the process is under continual
development such as DNRs and elevating communications to
GPS which will be available in April.
DB commented that it was reassuring that the scrutiny recommendations
were impacting upon changes within the Trust. Further he added that
subsequent surveys about food after surgery remained difficult and
helping patients to order food on screen needed to be considered. DB
queried the hospital at night survey and that staff weren’t able to access
food at night and result. EB added that night shifts begin at 7pm and
catering have engaged arrangements for restaurant to stay open until
8pm and orders could be made to access food but it will not be open
through the night.
TK commented that electronic summaries and paper information did not
coincide with electronic information and this was not completely reliable.
He was encouraged by further GP involvement and emphasised that
October 2014
Council of Governors Meeting Minutes – Part 1
10 senior clinicians should be more involved if there are difficulties
engaging junior doctors. He suggested that the prescribing of drugs
could be improved by ambulatory care plans. SE commented that this
was an IT issue and had been noted.
KM added proposed extending ward hostesses in the evenings to help
with meal times. He questioned whether enough was done to encourage
people to eat and whether this was being monitored. EB advised that
ward hostesses and the staffing review on the acuity wards was being
reviewed. In terms of monitoring the food that patients eat and this is
monitored through intervention and prescribed charts are completed with
clear guidance on process. Relatives ordering food is something that is
being implemented within the culture of the Trust and work with ward
sisters and hostesses is being supported to ensure needs are met. A
drinks availability list has been issued with times for up to 7 drink rounds
a day along with the availability of water. An audit is due to be completed
on this area.
PH questioned the discharge of patients and whether anything could be
done to expedite discharge and when patients are aware of this. EB
advised a project was underway concerning the structure of the day and
the completion of paperwork.
DC questioned whether there was a facility for a GP to advise about
transport and if it is required within discharge letters. EB responded that
these issues are picked up on separately.
JS added that the items outstanding should be identified and that a
paper had not been provided for decision. The slides from the
presentation were to be attached to outstanding points and identified
from the update.
EB
RR added that the water coolers had been offered to every ward 2 years
ago and will write to every ward to request whether each sister required
these on their wards.
The Council of Governors received the update.
FOR INFORMATION
Clinical Service Review and Better Together
RR outlined the Clinical Services Review and its aim to consider the
healthcare across Dorset making in sustainable for the future. The
company Mckinseys had been appointed by the CCG to implement the
review and it was confirmed that there was widespread patient
engagement and the Trust will encourage the team to engage with
Governors and voluntary groups. Initial reviews will be due by next
summer following the election for a blueprint model for healthcare
services.
14/72
TK added that the review was looking to the future and highlighted the
website ‘Dorset Vision’. It was highlighted that the CCG budget was
being used for the review in order to consider how the remaining budget
should be used. DT proposed that this should be a training item for DR
October 2014
Council of Governors Meeting Minutes – Part 1
11 Governors.
14/73
Trust Secretary Appointment
The item was noted for information.
Forward Planner
The item was noted for information.
Governor Sub- Committee Meeting Reports
 Membership Development Committee (MDC)
14/74
14/75

Governor Training Committee (GTC)

Governor Involvement with Patient and Public Engagement
Committee (GIPPE)

Governor Scrutiny Committee
The reports were taken as read.
Trust Sub- Committee Reports
GT suggested an update at the next meeting from Bournemouth GT
University and graduate recruitment.
CJ added that that appointed governors as DCC had provided a public
health paper for Governors information.
Reports from Governors
Reports from Appointed Governors
The reports were noted.
Report from Staff Governors
The reports were noted.
Governor reports of activities outside the Trust
The reports were noted.
Date of the next Council of Governors Meeting
Next meeting to be held on 22 January 2015 at 08:30am
Conference Room, Education Centre
Royal Bournemouth Hospital
14/76
14/77
14/78
14/79
Concluded at 13:17
To resolve that under the provision of Section 1, Sub-Section 2, of the Public Bodies Admission to
Meetings Act 1940, representatives of the press, members of the public and others not invited to
attend be excluded on the grounds that publicity would prove prejudicial to the public interest by
reason of the confidential nature of the business to be transacted.
October 2014
Council of Governors Meeting Minutes – Part 1
12 Council of Governors Meeting – Part 1
22 January 2015
THE ROYAL BOURNEMOUTH AND CHRISTCHURCH HOSPITALS
NHS FOUNDATION TRUST
Actions carried forward from a meeting of the Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust Council of
Governors Part 1 held on 28 October 2014.
14/61
Actions Log from Minutes of the Meeting held on 28 October 2014
(14/49) Performance report- DB queried the data that was presented by
HL during the September Governor training and requested this was
circulated.
DP
Completed
(14/49) Communication- KM noted the follow up regarding telephones
on wards and requested a response to his query about communicating
with relatives when patients are moved between wards on AMU.
DP
Completed
EB/DR
Training given to Governors on 4
December 2014
PERFORMANCE
14/63
Quality Performance Report
Further information would be provided on Serious Incidents to
Governors.
14/64
Performance Report
BG queried the current numbers for the robotic surgery. RR added that RR
he would provide specific numbers but would be increasing numbers
and patients from Dorchester will have impact and year on year will
increase and trajectory.
14/65
110 in last 12 months.
Predicted to be more than 150 in
next 12 months, which would
comply with minimum numbers
Financial Performance
It was proposed that a briefing was held for Governors on the purpose RR
and impact of the Clinical Service Review.
Tony Spotswood has provided the
briefing and this will be on-going
__________________________________________________________________________________________________________________
PAGE 1 OF 2
Council of Governors Meeting – Part 1
22 January 2015
14/66
Workforce Report
JS suggested that a seminar session was held for Governors regarding
staff training, the appraisal process and the Trusts’ workforce strategy
going forward.
14/67
KA
Been added to the Governor training
schedule
PS/JS
Completed
PLACE Report
DH added that the results had been disappointing concerning food on
Ward 17 and everything else was of a good standard. She highlighted
one member of staff who was not given sufficient support or training. JS
confirmed that comments would be obtained from the Director of
Nursing and reassurance provided that this had been addressed.
14/71 Governor Scrutiny Committee update from previous reports
including: Discharge Letters, Hospital at Night, Food and Nutrition
JS added that the items outstanding should be identified and that a
paper had not been provided for decision. The slides from the
presentation were to be attached to outstanding points and identified
from the update.
Slides were circulated to Governors
following the meeting
14/72 Clinical Services Review
DT proposed that the CSR should be a training item for Governors.
DR
See 14/65 comment
GT
Completed - see Appendix N
14/73 Trust Sub- Committee Reports
GT suggested an update at the next meeting from Bournemouth
University and graduate recruitment.
__________________________________________________________________________________________________________________
PAGE 2 OF 2
COUNCIL OF GOVERNORS
Meeting Date and Part:
22 January 2015 – Part 1
Subject:
Clinical Services Review (CSR) Public Engagement Process
Section:
Strategy
Author of Paper:
Eric Fisher
Details of previous discussion
and/or dissemination:
Dorset Clinical Commissioning Group
Key Purpose:
Patient
Engagement
Governance Performance Strategy
X
Action Required by Council of
Governors:
For information
Summary:
Key Decisions/Discussions/Actions
Strategic Goals & Objectives:
Links to CQC Registration:
(Outcome reference)
N/A
X
Council of Governors Meeting – Part 1
22 January 2015
CLINICAL SERVICES REVIEW (CSR) - PUBLIC ENGAGEMENT PROCESS
Governor: Eric Fisher
(and member of the CCG CSR Patient & Public Engagement Group - PPEG)
Meeting Dates: December and January 2015
Key Decisions/Discussions/Actions
1. The Dorset Clinical Commissioning Group (CCG), which is the organisation
responsible for commissioning most NHS services in Dorset, is undertaking a
review of health care in Dorset with the aim to ensure that everybody in the
county has access to safe, high-quality, effective and affordable health
services now and into the long-term.
2. The evidence shows that most patients currently receive good care in Dorset,
but there is too much variation, both against national (and international)
standards and within Dorset itself. In addition, our population is changing and
getting older, bringing new health demands which need to be met. And the
money to secure healthcare for local people isn’t increasing at the same rate
as rising costs and demand.
3. Over 120 people attended public engagement events in December 2014 and
three have been planned in January 2015 in Sherborne, Weymouth and
Poole.
4. Those taking place in January 2015 are to consider the Need for Change – a
document which can be accessed on the www.dorsetsvision.nhs.uk. This
summarises the current picture of healthcare in Dorset based on the evidence
gathered as part of the Clinical Services Review (CSR). The evidence has
been reviewed by over 100 doctors, nurses, other clinicians and health
leaders. This material has been drawn from published sources, and insight
from provider organisations (including the Royal Bournemouth & Christchurch
Hospitals NHS Foundation Trust), other key stakeholders and patients and
the public.
5. The first stage of the review was to look at all the evidence about NHS health
care in Dorset giving a detailed picture of what is working well and where
performance needs to be improved. Now the clinicians have started the task
of coming up with models of good clinical care. What does good care look
like? What would need to happen to ensure that it is delivered consistently
across Dorset? They are basing their discussions on the evidence gathered,
including UK and international comparisons, and a wealth of patient and
public insight and feedback. They will work on developing a set of options to
be tested out with local people in a public consultation next summer.
6. The Dorset CCG has stressed their keenness for the Need for Change
document to be seen by as many people as possible so please share it widely
through your organisation or network. The views of patients, carers and the
public are vital to the success of the review. At each stage of the CSR
process clinicians, patients, the public and key stakeholders are being given
Council of Governors Meeting – Part 1
22 January 2015
the opportunity to review and comment on the evidence which has been
gathered and the developing thinking.
7. More public events are planned each month to provide the basis for options
on differing models of care to be developed and further consulted upon before
decisions can be made in Autumn2015.
8. Governors are encouraged to play their part in engaging in the CSR process
and to use it as an opportunity to meet with public and organisations in our
catchment area. It would be useful to share any feedback with Eric Fisher as
a member of PPEG.
COUNCIL OF GOVERNORS
Meeting Date and
Part:
22 January 2015 – Part 1
Subject:
Workforce Report
Section:
Performance
Author of Paper:
Karen Allman
Details of
previous
discussion and/or
dissemination:
Board of Directors and Workforce Committee
Key Purpose:
Patient
Engagement
Governance
Performance
Strategy
X
Action Required
by Council of
Governors:
Summary:
For Noting.
This report is a slight variation on that tabled at Board and shows
Trust-wide figures for a range of workforce metrics. The report
includes updates on recruitment, the staff retention project, together
with detail around mandatory training compliance rates within the
Trust.
Strategic Goals &
Objectives:
To listen to, support, motivate and develop our staff
Links to CQC
Registration:
(Outcome
reference)
Outcomes 12, 13 & 14 - Staffing
WORKFORCE REPORT
This report contains information concerning the progress with recruitment and gives
some more context and detail around compliance regarding mandatory training in
particular and the steps being taken to improve these areas.
1. Workforce Data as at 31 October 2014
The monthly workforce data is shown below, both by care group and category of
staff. Trust targets of 90% appraisal compliance and 3% sickness absence have
been set and performance has been RAG rated against these targets.
Care Group Appraisal Compliance Mandatory Training Compliance Sickness Absence At 31 Oct Joining Rate Turnover Rolling 12 months to 31 Oct Vacancy Rate (from ESR) At 31 Oct Surgical 68.5% 77.2% 4.23% 12.0% 10.8% 4.3% Medical 73.0% 78.7% 3.41% 18.8% 11.5% 3.4% Specialities 72.1% 77.4% 3.80% 10.3% 10.1% 2.1% Corporate 76.3% 83.5% 4.08% 13.5% 13.1% 5.2% Trustwide 72.4% 78.9% 3.83% 14.1% 11.3% 3.7% Appraisal Compliance Mandatory Training Compliance Sickness Absence Joining Rate Turnover Vacancy Rate (from ESR) Staff Group At 31 Oct Add Prof Scientific and Technical Additional Clinical Services Administrative and Clerical Allied Health Professionals Rolling 12 months to 31 Oct At 31 Oct 70.1% 83.8% 4.18% 8.8% 14.7% 5.4% 73.2% 79.5% 5.73% 21.4% 10.8% 6.4% 74.5% 81.9% 3.42% 15.0% 12.6% 4.3% 69.3% 84.6% 1.72% 13.9% 12.8% 1.3% Estates and Ancillary 80.1% 85.0% 6.20% 10.1% 14.6% 4.3% Healthcare Scientists 62.9% 87.5% 3.71% 9.7% 12.9% 5.9% Medical and Dental Nursing and Midwifery Registered 66.9% 51.6% 1.05% 8.1% 7.2% 0.1% 71.5% 83.0% 3.85% 12.6% 9.7% 3.1% Trustwide 72.4% 78.9% 3.83% 14.1% 11.3% 3.7% Council of Governors: 22nd January 2015 – Workforce Report
Page 1
The charts show that Trust-wide appraisal compliance, mandatory training and
sickness absence have been fairly static since last month. Reports to directorates
and care groups highlighting areas of poor compliance have already been sent. The
vacancy rate fell again during October from 4.4% in September to 3.7%. The joining
rate continues to exceeds or match the turnover percentage across the Care
Groups and corporate areas demonstrating the considerable work undertaken to
recruit staff.
2. Medical Staff Recruitment
The overseas recruitment of consultants continues; two doctors from Singapore who
had previously been interviewed via video link for posts in E.D. and Orthopaedics
visited the hospital on 3 & 4 November. They met some of the Executive team,
spent time in the respective departments and visited in and around Bournemouth to
look at housing and schools. Unfortunately they have now decided that the time is
not right for them to relocate their family at this time.
A candidate from Australia was also interviewed via video link and visited the Trust
on 19 December. This applicant was also planning to move to Bournemouth;
however for family reasons they have also decided to stay where they are. Another
doctor from Australia, who is interested in Emergency Medicine, visited the hospital
on 29/30 December and again it is hoped this candidate will take up a consultant
post in 2015. Whilst it is disappointing that we have yet to formally recruit consultant
staff from overseas we continue with our programme to secure appropriate medical
staff for the Trust.
We have been successful in appointing a consultant in Acute Medicine and a further
AAC (Consultant Appointment process) is scheduled for the 5th February with a
strong field of applicants for an additional post.
3. Recruitment and Retention
The campaigns for recruiting qualified nursing staff and Health Care Assistants
(HCAs) continue.
A schedule of HCA recruitment events has been drawn up and these will be
continuing in 2015. Due to the success of such events Nurse Recruitment days are
also being considered.
There are plans for the Trust to be represented at a number of recruitment events
during 2015 which includes University and Healthcare fares, conferences etc. This
will involve attending events around the country and supporting information
marketing opportunities at the Trust and providing comprehensive information.
There is a recruitment fair at the Westfield Shopping centre in London on 6th / 7th
February which the Trust will attend and has wide representation, and hopes to
recruit qualified nurses, therapy staff and other staff groups.
Council of Governors: 22nd January 2015 – Workforce Report
Page 2
Accommodation and car parking is being reviewed as part of the strategy to attract
and retain staff.
An incentive payment is to be trialled to the nursing staff who work on older people’s
wards. This incentive aims to attract and retain staff on the wards where there are
the highest numbers of vacancies. A “refer a friend” incentive scheme is also being
considered and relocation expenses are being reviewed as well.
An overseas task and finish group has been set up to make proposals for any future
overseas recruitment campaigns. A collaborative working group with local
recruitment leads from other Trusts has been set up to discuss joint overseas
recruitment initiatives and other careers and recruitment events. Additional task and
finish groups on retention, work experience and car parking have also been
established.
Staff Retention Project
A specific project to identify reasons for staff leaving the Trust between August and
October was established.
98 staff were identified as potential interviewees and were contacted initially by
telephone. 32 leavers were interviewed in the end and they came from a mixture of
clinical and non-clinical backgrounds. Of these 9 people left to move to further education and they gave mainly positive comments
about the Trust:
“My team encouraged me to complete further education” and
“I was supported and grew in confidence whilst working at RBH”
In addition there were some concerns expressed about staff car parking and poor
staffing levels.
4 people moved for promotion and these all said that they has experienced a positive
working environment although one Occupational Therapist said that beds were an “ongoing challenge”. A radiographer left citing lack of career progression, and a Personal
Assistant left for a higher salary and a less pressurised role from this group.
7 people left citing personal reasons and all 7 gave positive feedback
10 people gave negative reasons for leaving the Trust. These include:



Poor communication and teamwork
Inflexibility regarding hours of work
Lack of training and development opportunities
3 members of staff have since returned to the Trust and all unsurprisingly speak
positively about the organisation.
Council of Governors: 22nd January 2015 – Workforce Report
Page 3
The workforce committee will be reviewing the detailed outputs from the project at the
meeting on the 8th December. Information will also be shared as appropriate ensuring
confidentiality with care groups and individual directorates and a similar independent
review will take place again in the spring.
Data from all available sources of information regarding staff views and concerns will
also be triangulated and inform our future work plans.
4. Update on staff survey
The staff survey closed on the 1 December 2014 and the Trust final response rate
was 48.5%.The national range as at 25 November was 24.3% to 60% and two
reminders were sent by the Picker Institute directly to employees who received the
questionnaire. Regular e-mails were also been sent to senior managers, detailing
response rates for their area and requesting that they remind staff to complete
questionnaires. A number of reminders to staff also appeared in the weekly
communications round-up and a “have your say” screensaver was produced and
displayed. Nationally there is a trend for lower response rates and this has been
suggested that this is because of the number of other staff surveys that have taken
place this year including the Friends and Family Test for staff. The national staff
survey results will not be available until February/ March 2015.
5. Safe Staffing
The final Safe Staffing Unify return for October 2014 showed a total Trust
aggregate fill rate of registered nurses in the day of 93.8% and at night a 101.1%.
The aggregate fill rate of healthcare assistants is 94.8% in the day and 112.9% at
night.
RN Actual
HCA Actual
Day
93.8%
94.8%
Night
101.1%
112.9%

Areas which were below 90% for registered nurse fill rate on day duty were;
AMU, Stroke ward, Surgical Admissions Unit, ward 1, ward 21 and ward 24.
These areas were only just below 90% and were all mitigated at a local level.

Ward 9 (Orthopaedics): the template requires refinement. The position is much
more favourable than reported from e-roster as the actual number of patients is
lower than the number of patients the staffing template is set for.

No areas were below 90% for the registered nurse fill rate on night duty.

There were 5 wards across care groups where the HCA fill rate was lower than
90% in the day. These ward areas had RN fill rate higher than 90% with the
exception of SAU.
Council of Governors: 22nd January 2015 – Workforce Report
Page 4

There are 7 ward areas across surgery and the older people’s wards where over
100% usage of HCAs existed during the night shifts. This is due to clinical acuity,
falls prevention and specials. This is being reviewed within the Care Group and
has elevated the overall aggregate to 112.9%.

All areas were appropriately risk mitigated. Staffing is reviewed daily by the
Matron workforce with localised assessment and decisions on use of temporary
workforce, skill sets required and staff
Staffing for the additional bed capacity
A structured procurement process has succeeded in the Trust proceeding with a
block booking contract and the block booked agency nurses received induction with
the Trust on 1st December 2014. They have been allocated to the workplace and
have had a tour and introduction with the Matron or Sister of the area. Some of the
individuals have worked in the Trust before, and all commented on how welcome
they have felt at the induction session on the 2nd December.
6. Mandatory Training – Essential Core Skills and Appraisal Compliance
The current Trust target for Mandatory Training is 95%. This is historic and was set
based on NHSLA (NHS Litigation Authority) recommendations. A recent study by
Skills for Health, reports that the best performing Trusts consistently achieve above
80% compliance rates and are working towards 90% compliance.
Our overall Trust compliance rate was 78.6% in November 2014. This compliance
is split into two categories - Trust and National Core skills . The subjects listed
under National Core Skills are all part of the UK Core Skills Training Framework
(UKCSTF).
Competency x Month Apr‐
14 May‐
14 Jun‐14 Jul‐14 Aug‐
14 Sep‐
14 National Core Skills 76.4% 48.0% 48.2% 83.8% 84.6% 83.5% 72.7% 81.1% 70.8% 86.4% 85.5% 76.3% 48.3% 49.5% 83.9% 84.6% 83.3% 70.5% 80.5% 70.5% 86.1% 85.9% 76.4% 49.9% 51.4% 84.7% 84.2% 82.9% 67.6% 81.1% 71.1% 86.2% 85.8% 76.8% 51.2% 55.1% 84.9% 84.6% 83.2% 66.2% 81.8% 72.1% 86.2% 85.4% 77.1% 53.7% 54.2% 85.6% 85.5% 84.2% 64.8% 83.4% 70.8% 87.2% 84.9% 76.6% 57.0% 53.3% 84.9% 84.9% 83.7% 62.0% 83.3% 71.0% 87.1% 83.9% Conflict Resolution Diversity Fire Safety Health and Safety Infection Control Information Governance Manual Handling Resus (BLS/ILS) Safeguarding Adults Safeguarding Children Council of Governors: 22nd January 2015 – Workforce Report
Oct‐14 Nov‐14 76.1% 57.1% 54.8% 84.5% 84.3% 84.9% 58.5% 83.6% 71.9% 86.3% 82.1% 75.7% 58.7% 54.4% 84.3% 83.7% 85.5% 55.6% 82.6% 71.6% 86.3% 82.4% Page 5
Trrust Mandattory Trainin
ng Blood TTransfusion Bullyingg & Harassment Falls Aw
wareness Medicin
ne Managemeent Securityy & Counter Fraud Sharps Viability Tissue V
Venous Thromboemb
bolism on Violence & Aggressio
Overall Co
ompliance 82. 0% 60. 8% 87. 0% 72. 0% 80. 7% 83. 0% 84. 2% 79. 2% 81. 4% 88. 9% 82.1%
62.0%
87.0%
74.8%
80.5%
83.1%
84.1%
79.1%
81.4%
88.2%
82.4% 62.6% 86.8% 77.3% 80.4% 84.0% 83.8% 79.0% 81.6% 88.4% 83..2% 66
6.4% 86
6.4% 84
4.0% 81
1.7% 85
5.1% 83
3.3% 78
8.6% 81
1.2% 88
8.3% 78. 6% 78.6% 78.7% 79.1% 79.7%
% 79.3% 78.9% 78.6%
Council of Governorrs: 22nd Janua
ary 2015 – W
Workforce Re
eport
82.6% 62.8% 87.0% 81.2% 80.0% 84.3% 84.0% 78.8% 80.5% 88.4% 83.6%
% 60.4%
% 87.9%
% 83.6%
% 81.9%
% 85.6%
% 84.8%
% 78.6%
% 82.2%
% 89.7%
% 83.6% 62.5% 87.1% 84.1% 82.8% 85.6% 84.2% 77.9% 82.3% 89.7% 83.2% 64.6% 86.6% 84.3% 82.0% 85.1% 83.6% 77.6% 81.2% 89.0% Page 6
National Core Skills
Conflict Resolution
Diversity
Fire Safety
Health and Safety
Infection Control
Information Governance
Manual Handling
Resus (BLS/ILS)
Safeguarding Adults
Safeguarding Children
Trust Mandatory Training
Blood Transfusion
Bullying & Harassment
Falls Awareness
Medicine Management
Security & Counter Fraud
Sharps
Tissue Viability
Venous Thromboembolism
Violence & Aggression
Overall Compliance
78%
28%
61%
94%
90%
90%
46%
87%
84%
90%
86%
88%
58%
93%
n/a
100%
90%
90%
100%
81%
93%
82%
78%
52%
53%
89%
87%
89%
58%
83%
85%
86%
86%
85%
64%
91%
85%
n/a
86%
87%
87%
83%
89%
80%
78%
68%
58%
84%
85%
84%
59%
83%
0%
84%
86%
87%
n/a
90%
n/a
n/a
85%
84%
n/a
n/a
87%
81%
85%
76%
67%
94%
91%
94%
62%
86%
87%
92%
93%
83%
50%
90%
77%
n/a
84%
85%
80%
59%
91%
84%
Council of Governors: 22nd January 2015 – Workforce Report
81%
68%
63%
90%
90%
90%
55%
91%
100%
90%
90%
92%
76%
94%
n/a
n/a
92%
90%
n/a
n/a
94%
85%
82%
n/a
66%
84%
88%
89%
68%
81%
n/a
88%
89%
90%
n/a
92%
n/a
n/a
89%
89%
n/a
n/a
89%
84%
47%
n/a
49%
44%
43%
55%
25%
64%
25%
68%
46%
55%
61%
44%
n/a
67%
58%
43%
34%
62%
68%
50%
Nursing and Midwifery Registered
Medical and Dental
Healthcare Scientists
Estates and Ancillary
Allied Health Professionals
Administrative and Clerical
Additional Clinical Services
for the period: Nov ‐14
Add Prof Scientific and Technic
Competency by Staff Group
79%
58%
48%
92%
92%
92%
62%
85%
76%
91%
89%
89%
70%
93%
85%
87%
91%
92%
91%
90%
94%
83%
Page 7
Current Overall Competency by Staff Group
100%
90%
80%
84%
80%
82%
85%
85%
87%
83%
70%
60%
50%
52%
40%
30%
20%
10%
0%
Medical and Dental staff compliance remain low and have a detrimental effect on
overall staff compliance. The Board will be aware that the a new Virtual Learning
Environment is currently being developed and is due to go live in March and this will
support the delivery of essential core skills training and assessment at a time that suits
the individual. This training can be accessed off site through a tablet, PC or other
mobile device and should have a significant impact on the levels of compliance. Doctor
revalidation and appraisal also support the need to be up to date with mandatory
training. The revised process will also ensure that competency and knowledge is
assessed rather than an individual receiving a credit for attending a training session.
Council of Governors: 22nd January 2015 – Workforce Report
Page 8
COUNCIL OF GOVERNORS
Meeting Date and Part:
22 January 2015 Part 1
Subject:
Quality Report – October 14
Section:
Performance
Executive Director with
overall responsibility
Paula Shobbrook, Director of Nursing and Midwifery
Author(s):
Ellen Bull, Deputy Director of Nursing and Midwifery
Joanne Sims, Associate Director Quality & Risk
Action required:
The CoG is asked to note the report which is provided for information.
Summary:
This report provides a summary of information on patient safety and patient experience
indicators for October 2014 including:
Patient safety incidents
 4 Serious incidents were reported on STEIS in October 2014,
Safety thermometer
The ST data is 89.05% harm free care. This represents a slight decrease from last month.
Patient experience
Trust wide FFT remains consistent. The Trust FFT is 76 and the response rate is 18.7%, a
reduction on last month. This is due to the implementation of the new system in the
emergency department and AMU.
Related Strategic Goals/
All
Objectives:
All
Relevant CQC Outcome:
Risk Profile:
i. Have any risks been reduced?
No
ii. Have any risks been created?
No
Reason paper is in Part 2
Not applicable
Quality & Patient Safety Performance Exception Report
October 2014
1. Purpose of the Report
This report accompanies the Quality/Patient Performance Dashboard and outlines the Trust’s
performance exceptions against key quality indicators for patient safety and patient experience for
the month of October 2014. This was presented to the Trust Board in December
2. Serious Incidents
Four Serious Incidents were confirmed and reported on STEIS in October 2014.
3. Safety Thermometer
All inpatient wards collect the monthly Safety Thermometer “Harm Free Care” data. The survey,
undertaken for all inpatients the first Wednesday of the month, records whether patients have had
an inpatient fall within the last 72 hours, a hospital acquired category 2-4 pressure ulcer, a
catheter related urinary tract infection and/or, a hospital acquired VTE. If a patient has not had
any of these events they are determined to have had “harm free care”.
The results for the October 2014 data collection are as follows:
NHS SAFETY
13/14
14/15 May June July Aug Sept Oct 14
THERMOMETER
Average Target 2014 2014 2014 2014
14
Safety Thermometer
89.0%
95% 90.95%91.11%90.02%89.76% 92.15%89.05%
%Harm Free Care
Safety Thermometer %
97.84%97.58% 97.6% 97.19% 96.9% 95.79%
Harm Free Care (New
Harms only)
Monthly survey using Safety
480
NA
421
451
450
445
444
420
Thermometer (Number of
patients with Harm Free
Care)
Results are as follows:
RBCH (%)
Sept 14
RBCH (%)
Oct 14
National Average
All Acute Hospital Wards
( Oct14)
Harm Free Care
92.15%
89.05%
93.87%
Pressure Ulcers – All
6.82%
9.47%
4.44%
Pressure Ulcers – New
2.27%
2.74%
1.03%
Falls with Harm
0.62%
0.42%
0.63%
Catheters and new UTIs
0.21%
0.84%
0.36%
0%
0.42%
0.44%
New VTEs
April
2014
490
May
2014
464
June
2014
495
July
2014
501
Aug
2014
498
Sep
2014
484
Oct 14
2
0
3
4
0
3
2
New Pressure
Ulcers
11
8
4
6
9
11
13
New VTE
1
1
2
0
1
0
2
New Catheter UTI
2
1
3
2
4
1
3
Number
of
patients surveyed
Falls with Harm
475
4. Risk Assessment Compliance
Compliance continues to be reviewed by ward sisters and matrons and formally audited monthly.
Risk assessment compliance
 Falls
 Waterlow
 MUST
 Mobility
 Bedrails
May
2014
June
2014
July
2014
Aug 14
Sep 14
Oct 2014
92%
96%
88%
91%
95%
91%
95%
88%
91%
93%
91%
96%
89%
93%
94%
88%
94%
90%
87%
90%
91%
96%
91%
90%
93%
91%
96%
87%
93%
95%
5. Patient Experience
FFT scores
FFT Score October (Sept)
Compliance Rate October (Sept)
Trust wide (Inc. OPD)
76 (75)
NA
All FFT Areas
75 (77)
19% (23%)
In- patient
81 (75)
43% (47%)
ED
66 (80)
8% (14%)
Maternity
68 (82)
17% (13%)
Having complied with the original NHS England directive and a CCG requirement, the refined
methodology was implemented. Discussions with NHS England have confirmed that the directive
to remove the tokens will not be withdrawn. The methodology replaces tokens with paper
‘bookmarks’. The ED areas that have struggled with the new methodology are now taking forward
actions led by the Matrons (Claire Liggins and Alison Pressage) which also include additional
volunteer support.
Staff have initiated action plans to improve the FFT compliance rates which in AMU has evidenced
an increase in compliance from 23% (September) to 40% (October). Main ED reported challenges
with staffing, number of patients admitted and the environmental changes taking place.
FFT themes
A total of 3,277 Patient Experience Cards have been returned this month, with total of 1797 (55%)
having also completed written comments. Overall, comments are much improved and more
positive about the hospital experience. Main themes for negative comments are poor
communication especially with medics, waiting (for appointments, TTA`s, discharge) and
perceived staff attitudes and availability. Ward moves at night resulting in disruption and lost
property continue to feature.
The table below evidences the breakdown of comments themes.
Positive Negative
Mixed
NA
1491
120
161
29
83%
7%
9%
2%
Extremely Unlikely results from FFT – October data
There have been 18 “extremely unlikely” to recommend from areas which are included in the FFT
national submission. We collate all ‘extremely unlikely’ responses so that we can review the trend
across the entire Trust.
Extremely Unlikely
Total Extremely
Unlikely to recommend
No of returns
% Extremely Unlikely
to recommend
Apr-14
May-14
Jun-14
Jul-14
Aug-14
Sep-14
Oct-14
40
19
30
40
44
32
25
2547
2441
2299
2527
3278
3188
3277
1.57%
0.78%
1.30%
1.58%
1.34%
1.00%
0.76%
The table provides a comparison using NHS England’s reporting system which has changed to
using percentage of patients who would not recommend the Trust. The result is in line with our
CQUIN target of 1.5% and evidences that there is consistent improvement.
6. Recommendation
The Council of Governors is requested to receive the report which is provided for information.
COUNCIL OF GOVERNORS
Meeting Date and Part:
22 January 2015 - Part 1
Subject:
Performance Report
Section:
Performance
Executive Director with overall
responsibility
Richard Renaut
Author(s):
Donna Parker/David Mills
Previous discussion and/or
dissemination:
PMG & Board of Directors in December 2014
Action required:
The Council of Governors is asked to consider the information provided and support any actions
highlighted in relation to non-compliant or ‘at risk’ indicators.
Summary:
The attached Performance Indicator Matrix and Exception Report outline the Trust’s performance
exceptions against key access and performance targets for the month of October 2014.
It also incorporates an indicative RAG rating for expected performance in the following month based
on internal monitoring to date, as well as an indication of Trust level risk in relation to the metrics over
the quarter.
Key non compliances in October were:
 Cancer 2 week wait for September performance including for breast symptomatic patients
 62 and 31 day cancer targets in September, however, these are compliant for the full Q2
 A&E 4 hour target, but in line with our trajectory agreed with the CCG
 Admitted RTT at aggregate level and in General Surgery, Orthopaedics, Ophthalmology,
Cardiology and Gynaecology – in line with planned breach to remove longer waiters
 Non admitted RTT speciality level in ENT, Oral Surgery, General Surgery and General Medicine,
though aggregate was maintained.
 52 week waits (x1) on incomplete (unadjusted) pathways – patient treated in November and will
unfortunately be reported as a 52 week waiter in November.
 VTE slightly under threshold at 94.2%
Performance risks for the forthcoming month are:
 C Difficile, we are within our Monitor trajectory year to date, but below our stretch target
 Cancer 2ww (October reporting), however, our weekly run rate is on track for compliance
 A&E 4 hour target
 RTT admitted, non-admitted and incomplete pathways targets as per national RTT recovery plan
 52 week waits due to increased RTT pathway pressures and patient choice
 6 week wait to diagnostics due to endoscopy capacity
For Quarter 3 the key risks to the Trust remain:
 Cancer 2ww including breast symptomatic, predominantly due to patient choice and capacity
issues in specific specialities.
 Cancer 31 and 62 day due to Urology treatments being carried out
 A&E 4 hour wait - the higher level of ambulance conveyances has continued
 RTT admitted, non admitted and incomplete pathway targets as per national RTT recovery plan of
reducing long waiters and potential impact on 52 week waiters
These remain under close review and management.
Related Strategic Goals/ Objectives:
Performance
Relevant CQC Outcome:
Section 2 – Outcome 4: Care and welfare of people who use
services.
Outcome - 6 Co-operating with others.
Risk Profile:
i.
ii.
iii.
iv.
v.
vi.
Risk assessments for the cancer 62 day wait non-compliance and potential risk to the trust’s
authorisation remains on the risk register despite Q1 and Q2 compliance, due to ongoing risks.
Risk assessment against the 4 hour target has been reviewed to reflect the increase in
ambulance conveyances and attendances and our continued non-compliance.
RTT speciality performance continues on the risk register with aggregate performance noncompliance also now added, though this position is expected as part of the national RTT recovery
plans.
The urgent care impact risk assessment remains on the Trust Risk Register given the increased
activity pressures, 4 hour non-compliance and other indicators such as the increase in outliers.
A risk assessment for the cancer two week wait target is being completed.
A risk assessment has been completed in relation to the RTT non admitted target compliance.
Council of Governors – Part 1
22 January 2015
Performance Exception Report
2014/15 - December
1
Purpose of the Report
This report accompanies the Performance Indicator Matrix and outlines the Trust’s
performance exceptions against key access and performance targets for the month of
October 2014, as set out in Everyone counts: Planning for Patients 2014/15, the Monitor
Risk Assessment Framework and in our contracts.
2
Infection Control
Number of Hospital acquired C. Difficile and MRSA cases
For October, three cases of C. Difficile were reported on the Wards, bringing the financial
year total to 10. Whilst this total is over the local cumulative target, we are still below the
Monitor cumulative target (15). There have been no reported cases of MRSA.
3
Cancer
Performance against Cancer Targets
Key Performance Indicators Current indicative performance (unvalidated) Threshold Q2 14‐15 Sep‐14 Oct‐14 Nov‐14 2 weeks ‐ Maximum wait from GP 93% 78.2% 73.7% 80.6% 87.0% 2 week wait for symptomatic breast patients 93% 68.8% 61.5% 86.7% 88.5% 31 Day – 1st treatment 96% 96.1% 94.7% 96.5% 87.8% 31 Day – subsequent treatment ‐ Surgery 94% 95.5% 100.0% ‐ ‐ 31 Day – subsequent treatment ‐ Others 98% 100.0% 100.0% 96.6% 95.0% 62 Day – 1st treatment 85% 87.1% 84.1% 83.9% 77.2% 62 day – Consultant upgrade (local target) 90% 50% 100% 100% 50% 62 day – screening patients 90% 96.4% 100.0% 92.3% 91.7% Performance Monitoring
For Information
Page 1 of 4
Council of Governors – Part 1
22 January 2015
As expected we continued to remain below the threshold against the overall and breast
symptomatic Two Week Wait target for September and for Q2, predominantly as a result
of patient choice.
Previously reported capacity related breaches especially in
Dermatology have now improved however, Quarter 3 performance remains challenging.
Compliance was maintained against the 62 and 31 Day targets for Q2, although
September performance was below threshold due to a number of Urology treatments
being carried out.
Current projections for Q3 do show a risk against the 62 Day and 31 Day targets due to
Urology treatments. The 62 Day Screening to Treatment target continues to be monitored
as there is a potential risk due to a late referral from another provider, patient choice and
complex pathways.
4
A&E Performance
4 hour maximum waiting time – 95%
Whilst a very slight improvement was seen against the 4 hour target in October to 92.9%
we remained below the 95% threshold. The on-going significant increase in ambulance
conveyances continued: up 9% compared to the same period last year (August to
October), with a 16.8% increase in non-elective admissions.
Monthly performance for November is currently also at risk, as there has been a 10.1%
increase in ED attendances for November (1st - 23rd) compared to the same period last
year. Performance month to date is 93.78% and is in line with the trajectory indicated to
commissioners.
Task and Finish groups to review implementation of best practice have been established.
Specific focus is on initial assessment (‘pit stop’ protocols) targeted to start in January,
‘see and treat’ for minors (start December), improved Resus capacity and flow, and faster
diagnostics. We are currently in the process of recruiting middle grade doctors and
consultants; it is hoped that these may be in post in January. We have trained a number of
Majors Assisting Practitioners in ED to support the implementation of rapid assessment
and further practitioners are commencing training. In addition, an ambulatory area is also
being established within the department to improve patient flow.
5
VTE
Risk assessment of hospital-related venous thromboembolism
For October, the VTE return was 94.2%, narrowly missing the target of 95%.
Unfortunately staff absence did result in a slight reduction in monitoring of data inputting
and outcomes in October and early November, however this has now been addressed
Performance Monitoring
For Information
Page 2 of 4
Council of Governors – Part 1
22 January 2015
with medical staff, Matrons and Ward Leaders. An IT issue has been raised with regard to
VTE input on Ward 1 which is also being addressed.
6
Cancelled Operations
Number of patients not offered a binding date within 28 days of cancellation
Unfortunately one patient was not given an operation date within 28 days during October.
This patients’ procedure was originally cancelled on the 1st September as there was no
bed available, and rebooked on the 4th September for an appointment on 3rd October.
7
52 Week Waiter (Incomplete Pathways)
Zero tolerance of over 52 week waiters (Incomplete Pathways)
Unfortunately the General Surgery patient reported in September continued to be
reportable in October as their treatment was carried out in November.
8
Admitted RTT – Aggregate and Specialty Level
90% of patients on an admitted pathway treated within 18 weeks
In line with the national requirement to work towards the reduction of waiting lists and long
waiters, we were non-compliant on a planned basis with the Referral to Treatment
Admitted aggregate target in October. In line with Monitors’ expectations for implementing
the national plan, we reported a non-compliant position against the target for Quarter 2.
Increased capacity both internally and outsourced has been funded nationally allowing us
to work towards bringing down both our outpatient and surgical treatment times. The
particular specialities which were below threshold in October were: General Surgery,
Orthopaedics, Ophthalmology, Cardiology and Gynaecology. A focus on continuing to
reduce long waiters continues in November in line with national guidance.
We plan to return to aggregate compliance for Jan-Mar 2015.
9
Non-Admitted RTT - Specialty Level
95% of patients on a non-admitted pathway treated within 18 weeks
Performance Monitoring
For Information
Page 3 of 4
Council of Governors – Part 1
22 January 2015
For October, whilst aggregate performance was compliant, a number of specialities were
non-compliant and further work is underway to reduce outpatient waiting times. Oral
Surgery improved to 91.0% though remained below threshold along with ENT, General
Medicine and General Surgery.
Work to move to the new recording system (PPW) is progressing. Pressure upon first
outpatient appointment waiting times is being responded to by targeted extra clinics.
10
Recommendation
The Council of Governors is requested to note the performance exceptions to the
Trust’s compliance with the 2014/15 Monitor Framework and ‘Everyone Counts’
planning guidance requirements.
Performance Monitoring
For Information
Page 4 of 4
2014/15 PERFORMANCE INDICATOR MATRIX FOR BOARD OF DIRECTORS
Area
Indicator
Measure
Target
Monitor
Jan-14
Feb-14
Mar-14
Apr-14
May-14
Jun-14
Jul-14
Aug-14
Sep-14
Oct-14
Forecast Next Month
Forecast Quarter
RAG Thresholds
Monitor Governance Targets & Indicators
Infection Control
Referral to Treatment
Cancer
A&E
LD
Clostridium difficile
Number of hospital acquired C. Difficile cases
(25 2.1
pcm)
2.1
0
1
2
1
2
3
1
3
> trajectory
<= trajectory
RTT Admitted
90%
1.0
90.1%
90.1%
90.2%
90.1%
88.7%
86.8%
86.2%
89.3%
<90%
>90%
RTT Non Admitted
18 weeks from GP referral to 1st treatment – aggregate
18 weeks from GP referral to 1st treatment – aggregate
95%
1.0
98.1%
98.0%
98.7%
98.5%
98.2%
97.4%
97.1%
96.4%
<95%
>95%
RTT Incomplete pathway
Patients on an 18 week pathway awaiting treatment – aggregate
92%
1.0
95.1%
95.1%
94.9%
95.0%
93.9%
94.1%
94.9%
95.1%
<92%
>92%
2 week wait
From referral to to date first seen - all urgent referrals
93%
1.0
93.6%
95.7%
95.9%
90.4%
88.7%
70.1%
73.7%
<93%
>93%
2 week wait
From referral to to date first seen - for symptomatic breast patients
93%
1.0
100.0%
100.0%
100.0%
100.0%
92.9%
20.0%
61.5%
<93%
>93%
31 day wait
From diagnosis to first treatment
96%
1.0
95.4%
94.5%
91.6%
97.6%
97.0%
96.7%
94.7%
<96%
>96%
31 day wait
For second or subsequent treatment - Surgery
94%
1.0
100.0%
100.0%
<94%
>94%
98%
1.0
93.8%
100.0%
84.4%
For second or subsequent treatment - anti cancer drug treatments
100.0%
100.0%
96.3%
31 day wait
94.4%
100.0%
100.0%
100.0%
100.0%
100.0%
<98%
>98%
62 day wait
For first treatment from urgent GP referral for suspected cancer
85%
1.0
80.7%
91.7%
84.6%
84.1%
<85%
>85%
For first treatment from NHS cancer screening service referral
90%
1.0
86.4%
81.7%
94.4%
82.4%
62 day wait
76.6%
100.0%
90.5%
100.0%
90.5%
100.0%
<90%
>90%
4 hr maximum waiting time
From arrival to admission / transfer / discharge (Type 1 & 2)
95%
1.0
94.4%
95.8%
95.8%
94.5%
93.1%
95.9%
92.6%
<95%
>95%
Patients with a learning disability
Compliance with requirements regarding access to healthcare
n/a
1.0
No
Yes
0
92.9%
Indicators within the Everyone Counts: Planning Guidance/ Key Contractual Priorities
MSA
Infection Control
Cancer
VTE
Diagnostics
A&E
Cancelled Operations
Referral to Treatment
RTT Specialty
SUS Submissions
n/a
0
0
0
0
0
0
0
0
0
>0
0
0
0
0
0
0
0
0
1
0
0
>1
0
Following a consultant’s decision to upgrade the patient priority *
90%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
50.0%
0.0%
100.0%
< 90%
>90%
Risk assessment of hospital-related venous thromboembolism
95%
93.5%
95.3%
95.0%
95.3%
95.3%
95.0%
95.8%
95.0%
95.1%
94.2%
<95%
>95%
Six week diagnostic tests
More than 99% of patients to wait less than 6 wks for a diagnostic test
>99%
96.30%
99.00%
96.50%
99.4%
97.0%
99.30%
99.8%
99.8%
99.8%
99.8%
<99%
>99%
Admission via A&E
No. of waits from decision to admit to admission over 12 hours
0
0
0
0
0
0
0
0
0
0
0
>1
0
Ambulance Handovers
No. of breaches of the 30 minute handover standard
tbc
19
17
24
15
46
25
52
37
33
75
tbc
Ambulance Handovers
No. of breaches of the 60 minute handover standard
tbc
13
4
11
13
14
9
4
9
9
13
tbc
28 day standard
No. of patients not offered a binding date within 28 days of cancellation
0
2
0
1
0
0
0
1
0
0
1
>1
0
Urgent ops Cancelled for 2nd time
No. of urgent operations cancelled for a second time
0
1
0
0
0
0
0
0
0
0
0
>1
0
0
3
1
1
0
0
0
1
3
3
1
>1
0
Mixed Sex Accommodation
Minimise no. of patients breaching the mixed sex accommodation requirement
MRSA Bacteraemias
Number of hospital acquired MRSA cases
62 day – Consultant upgrade
Venous Thromboembolism
0
52 week waiters
Zero tolerance of over 52 week waiters (Incomplete Pathways)
RTT Admitted
100 - General Surgery
90%
85.1%
84.9%
85.8%
89.3%
86.9%
88.5%
80.7%
81.7%
81.8%
84.7%
<90%
>90%
RTT Admitted
101 - Urology
90%
91.8%
90.0%
91.8%
94.8%
92.0%
90.3%
87.0%
86.0%
91.4%
92.5%
<90%
>90%
RTT Admitted
110 - Orthopaedics
90%
89.6%
89.0%
90.3%
89.5%
89.9%
89.1%
89.8%
80.0%
76.9%
84.0%
<90%
>90%
RTT Admitted
130 - Ophthalmology
90%
85.4%
86.3%
83.9%
81.4%
84.2%
86.0%
84.7%
82.9%
84.6%
83.2%
<90%
>90%
RTT Admitted
300 - General medicine
90%
99.7%
99.7%
99.7%
99.7%
98.7%
99.1%
98.7%
98.3%
99.7%
99.4%
<90%
>90%
RTT Admitted
320 - Cardiology
90%
93.8%
91.3%
92.0%
91.0%
92.1%
91.4%
93.3%
92.3%
91.0%
89.3%
<90%
>90%
RTT Admitted
330 - Dermatology
90%
90.2%
91.2%
93.4%
95.9%
91.5%
91.9%
95.6%
94.9%
87.7%
91.7%
<90%
>90%
RTT Admitted
410 - Rheumatology
90%
96.9%
100.0%
100.0%
97.4%
95.1%
97.7%
97.1%
90.9%
88.9%
98.1%
<90%
>90%
RTT Admitted
502 - Gynaecology
90%
91.3%
88.7%
88.4%
89.9%
84.9%
79.5%
85.7%
<90%
>90%
Other
90%
97.3%
98.6%
99.3%
93.0%
98.1%
86.7%
RTT Admitted
80.7%
98.1%
97.4%
100.0%
98.8%
98.7%
99.4%
<90%
>90%
RTT Non admitted
100 - General Surgery
95%
95.3%
95.0%
99.3%
96.5%
98.5%
96.6%
96.4%
95.2%
95.7%
90.9%
<95%
>95%
RTT Non admitted
101 - Urology
95%
99.2%
99.1%
99.6%
98.1%
99.1%
98.7%
99.1%
99.5%
97.4%
99.5%
<95%
>95%
RTT Non admitted
110 - Orthopaedics
95%
98.8%
97.6%
98.7%
99.4%
99.2%
97.8%
100.0%
97.8%
97.8%
96.7%
<95%
>95%
RTT Non admitted
120 - ENT
95%
95.2%
95.4%
95.1%
95.2%
95.8%
95.0%
95.2%
91.9%
93.0%
92.6%
<95%
>95%
RTT Non admitted
130 - Ophthalmology
95%
100.0%
99.4%
99.6%
99.5%
100.0%
100.0%
99.7%
99.7%
99.7%
100.0%
<95%
>95%
RTT Non admitted
140 - Oral surgery
95%
96.2%
97.4%
97.3%
97.4%
95.6%
96.8%
92.1%
86.4%
86.6%
91.0%
<95%
>95%
RTT Non admitted
300 - General medicine
95%
95.3%
95.2%
97.6%
97.6%
98.6%
95.9%
96.9%
96.3%
95.1%
93.3%
<95%
>95%
RTT Non admitted
320 - Cardiology
95%
98.2%
97.8%
97.0%
98.3%
97.8%
100.0%
99.5%
97.3%
97.8%
95.8%
<95%
>95%
RTT Non admitted
330 - Dermatology
95%
100.0%
99.6%
99.7%
100.0%
100.0%
97.9%
99.4%
100.0%
100.0%
100.0%
<95%
>95%
RTT Non admitted
340 - Thoracic medicine
95%
100.0%
100.0%
100.0%
100.0%
100.0%
99.0%
100.0%
100.0%
98.7%
97.5%
<95%
>95%
RTT Non admitted
400 - Neurology
95%
100.0%
100.0%
100.0%
98.5%
100.0%
96.5%
100.0%
97.9%
98.5%
97.4%
<95%
>95%
RTT Non admitted
410 - Rheumatology
95%
99.0%
98.4%
97.2%
97.7%
98.3%
99.0%
97.7%
96.6%
97.5%
95.9%
<95%
>95%
RTT Non admitted
502 - Gynaecology
95%
99.0%
98.9%
98.5%
99.4%
99.4%
98.6%
99.1%
100.0%
97.7%
98.3%
<95%
>95%
RTT Non admitted
Other
95%
98.0%
97.1%
100.0%
99.6%
99.3%
98.0%
98.9%
97.8%
98.5%
98.8%
<95%
>95%
NHS Number Compliance
Completion of NHS Numbers in SUS Submission (IPS/OPS)
99%
N/A
N/A
N/A
100%
100%
100%
100%
99.8%
tbc
<99%
>99%
NHS Number Compliance
Completion of NHS Numbers in SUS A&E Submissions
95%
N/A
N/A
N/A
98%
98%
97%
97%
96.8%
tbc
<95%
>95%
* Local standard of 90% with a de minimis of 2 breaches per month or 6 per quarter
COUNCIL OF GOVERNORS
Meeting Date and Part:
22 January 2015 – Part 1
Subject:
Financial Performance
Section:
Executive Director with
overall responsibility
Author(s):
Performance
Previous discussion and/or
dissemination:
Stuart Hunter, Director of Finance
Pete Papworth, Deputy Director of Finance
Finance Committee, Trust Management Board and Board
of Directors
Members are asked to note the report for information.
Summary:
The activity and demand pressures faced by the trust continued during October, with nonelective activity 16% above planned levels and emergency department attendances 5%
above planned levels.
This continues the pressures seen in previous years and this year to date, and brings the
year to date activity increases to 13% for non-elective activity and 7% for emergency
department attendances. This level of additional demand continues to have a significant
impact on the financial performance of the Trust.
At 31 October, the year to date budget was for a net surplus of £0.4 million, against which the
Trust has reported an actual deficit of £1.9 million. This represents an adverse variance of
£2.4 million.
Income has overachieved by £1.1 million year to date, driven by additional cost and volume
drugs, aseptic drug issues recharged to Poole Hospital, and additional CCG income in
recognition of the premium agency pressures the Trust is facing due to the national shortage
of trained medical and nursing professionals.
Expenditure reported an over spend of £727,000 during October, bringing the year to date
over spend to £3.5 million. This has been driven by:




Activity pressures, particularly in relation to emergency activity for which the Trust only
receives 30% of the national tariff price;
Significant additional pay costs as a result of continued reliance upon locum and
agency staff;
Additional cost and volume drugs, most notably within oncology and which are
recharged directly to Commissioners;
Drug issues in relation to the Aseptic unit, which have been recharged to Poole
Hospital.
The Trusts’ variance to budget is illustrated at Care Group level below, which highlights the
impact of the demand and recruitment pressures within the Medical Care Group particularly.
TOTAL TRUST WIDE
Surgical Care Group
Medical Care Group
Specialties Care Group
Corporate Services
(3,000)(2,500)(2,000)(1,500)(1,000) (500)
0 500 1,000 1,500 The adverse expenditure position has reduced the Trust Continuity of Services Risk Rating to
a rating of 3.
Given the considerable adverse variance reported to date; a financial recovery plan has been
developed and approved by the Board. In addition to targeting further Improvement
Programme Savings; this focuses on reducing the Trusts expenditure on expensive medical
and nursing agency staff.
A re-forecast position has been requested by Monitor, given the predicted £5.2 million deficit,
which exceeds the planned deficit for the year originally of £1.9 million. The Trust is currently
working towards securing 2015-16 Improvement programme savings and identifying further
sustainable delivery plans.
Related Strategic Goals/
Objectives:
Relevant CQC Outcome:
Risk Profile:
Goal 7 – Financial Stability
Outcome 26 – Financial Position
No new risks have been added to the Trust risk register, and none have been removed or
reduced.
ANNEX A
THE ROYAL BOURNEMOUTH AND CHRISTCHURCH HOSPITALS NHS FOUNDATION TRUST
FINANCIAL PERFORMANCE FOR THE PERIOD TO 31 OCTOBER 2014
CURRENT YEAR TO DATE
ACTUAL VARIANCE
£'000
£'000
2013/14
YTD ACTUAL
£'000
PLAN
£'000
NET SURPLUS/ (DEFICIT)
2,136
424
(1,934)
EBITDA
9,326
8,392
TRANSFORMATION PROGRAMME
4,784
4,055
CAPITAL EXPENDITURE
4,027
8,545
2013/14
YTD ACTUAL
NUMBER
PLAN
NUMBER
39,122
166,282
16,393
50,333
272,130
39,388
198,907
17,012
49,299
304,606
2013/14
YTD ACTUAL
£'000
PLAN
£'000
42,553
18,461
30,119
4,584
39,628
14,054
1,131
87
150,617
40,869
18,871
31,829
4,979
40,815
14,464
1,070
88
152,985
2013/14
YTD ACTUAL
£'000
PLAN
£'000
88,344
19,981
14,965
16,734
970
4,849
2,639
148,481
92,760
20,331
16,266
13,596
1,074
5,513
3,022
152,562
2013/14
YTD ACTUAL
£'000
PLAN
£'000
Non Current Assets
Current Assets
Current Liabilities
Non Current Liabilities
TOTAL ASSETS EMPLOYED
144,431
70,345
(26,519)
(2,563)
185,694
163,430
70,437
(27,679)
(11,710)
194,478
163,241
70,227
(27,952)
(11,888)
193,628
(189)
(210)
(273)
(178)
(850)
(0%)
(0%)
1%
2%
(0%)
Public Dividend Capital
Revaluation Reserve
Income and Expenditure Reserve
TOTAL TAXPAYERS EQUITY
78,674
64,485
42,535
185,694
78,674
72,999
42,805
194,478
79,063
72,999
41,566
193,628
389
0
(1,239)
(850)
0%
0%
(3%)
(0%)
CONTINUITY OF SERVICE RISK RATING
2013/14
YTD ACTUAL
METRIC
PLAN
METRIC
Debt Service Cover
Liquidity
CONTINUITY OF SERVICE RISK RATING
3.30x
58.5
4
KEY FINANCIALS
ACTIVITY
Elective
Outpatients
Non Elective
Emergency Department Attendances
TOTAL PbR ACTIVITY
INCOME
Elective
Outpatients
Non Elective
Emergency Department Attendances
Non PbR
Non Contracted
Research
Interest
TOTAL INCOME
EXPENDITURE
Pay
Clinical Supplies
Drugs
Other Non Pay Expenditure
Research
Depreciation
PDC Dividends Payable
TOTAL EXPENDITURE
STATEMENT OF FINANCIAL POSITION
2.72x
52.2
IN MONTH
ACTUAL VARIANCE
£'000
£'000
VARIANCE
%
PLAN
£'000
(2,358)
(556%)
997
564
(434)
(43%)
6,185
(2,207)
(26%)
2,069
1,677
(392)
(19%)
3,370
(685)
(17%)
461
461
0
0%
9,004
459
5%
1,048
1,507
459
44%
CURRENT YEAR TO DATE
ACTUAL VARIANCE
NUMBER
NUMBER
40,048
196,227
19,238
52,932
308,445
660
(2,680)
2,226
3,633
3,839
CURRENT YEAR TO DATE
ACTUAL VARIANCE
£'000
£'000
41,357
18,842
32,173
5,058
39,844
15,599
1,131
87
154,091
488
(29)
344
79
(970)
1,135
61
(2)
1,105
CURRENT YEAR TO DATE
ACTUAL VARIANCE
£'000
£'000
94,552
20,742
16,743
14,306
1,134
5,497
3,051
156,025
(1,792)
(411)
(476)
(710)
(61)
16
(29)
(3,463)
CURRENT YEAR TO DATE
ACTUAL VARIANCE
£'000
£'000
VARIANCE
%
PLAN
NUMBER
2%
(1%)
13%
7%
1%
6,082
30,703
2,442
7,061
46,288
VARIANCE
%
PLAN
£'000
1%
(0%)
1%
2%
(2%)
8%
6%
(2%)
1%
6,309
2,913
4,611
713
6,249
2,138
153
14
23,100
VARIANCE
%
PLAN
£'000
(2%)
(2%)
(3%)
(5%)
(6%)
0%
(1%)
(2%)
13,205
3,035
2,468
2,058
156
788
393
22,102
VARIANCE
%
CURRENT YEAR TO DATE
ACTUAL
RISK WEIGHTED
METRIC
RATING
RATING
1.91x
52.3
3
4
1
2
3
IN MONTH
ACTUAL VARIANCE
NUMBER
NUMBER
6,105
29,945
2,832
7,415
46,297
VARIANCE
%
VARIANCE
%
23
(758)
390
354
9
0%
(2%)
16%
5%
0%
IN MONTH
ACTUAL VARIANCE
£'000
£'000
VARIANCE
%
6,415
2,907
4,621
726
6,128
2,422
162
12
23,393
106
(7)
11
13
(121)
283
9
(2)
293
2%
(0%)
0%
2%
(2%)
13%
6%
(12%)
1%
IN MONTH
ACTUAL VARIANCE
£'000
£'000
VARIANCE
%
13,586
3,082
2,394
2,429
165
772
403
22,829
(381)
(46)
74
(371)
(9)
16
(10)
(727)
(3%)
(2%)
3%
(18%)
(6%)
2%
(3%)
(3%)
COUNCIL OF GOVERNORS
Meeting Date and Part:
22 January 2015 – Part 1
Subject:
Web Development
Section:
For Information
Author of Paper:
Bob Gee and Eric Fisher
Details of previous discussion
and/or dissemination:
Web Development Task and Finish Group
Key Purpose:
Patient
Engagement
X
Governance Performance Strategy
X
Action Required by Council of
Governors:
Note for information
Summary:
Key Decisions/Discussions/Actions
X
X
Council of Governors – Part 1
22 January 2015
WEB DEVELOPMENT TASK & FINISH GOUP
Meeting Date: 8 January 2015
Governors: Bob Gee & Eric Fisher
Key Decisions/Discussions/Actions
1. Set up by the Trust last Summer to revamp the RBCH web site with two
governors included via Membership development committee
2. The new homepage is now quicker and visual with FAQs, videos, links, thank
you options and updating of Departments information with gaps filled in as
part of a Trust wide programme. A slides presentation which goes into this in
more detail will be sent to Governors separately.
3. This has been achieved in house by an innovative, enthusiastic and expert
ICT group – well overseen by a proactive Communications and input from
governors providing the means for easier updating for the future.
4. We have seen increased hits on the web site and improved
5. This was the last meeting of the Task & Finish Group but plans are in place to
continue the improvements to the site and especially to a Patient & Visitors
Section
6. Bob Gee will continue to act as the Governor link if anyone spots any area
needing correction/updating and he will then pass this on to enable an
updates in a joined up way rather a more disruptive piecemeal approach
7. A short video is to be prepared for the web site on the importance of
membership to the Foundation Trust with an interview with a couple of
Governors building upon a “storyboard” which is being developed by Bob
Gee. Another on the role of governors will then be produced.
8. Governors are encouraged to ensure that their profile statements are
complete and kept up to date and to let BG know of any suggested changes
to the web site.
COUNCIL OF GOVERNORS
Meeting Date and Part:
22 January 2015 – Part 1
Subject:
Forward Planner
Section:
For Information
Author of Paper:
Sarah Anderson
Details of previous discussion
and/or dissemination:
None
Key Purpose:
Patient
Engagement
Governance Performance Strategy
X
X
Action Required by Council of
Governors:
Note for information
Summary:
Copy of the Council of Governors Forward Programme
Strategic Goals & Objectives:
Links to CQC Registration:
(Outcome reference)
N/A
Council of Governors Forward Programme 2015
What
Annual Plan
Annual Plan - Draft for Public Consultation
Annual Plan - Feedback from Consultation to COG
Who
Where Before
Jan
Apr
May
Jul
Sept
Where After
RR
RR
TMB
TMB
Annual Report & Accounts
Annual Report & Accounts First Draft
Annual Report & Accounts - Final draft presented
SH
SH
BoD
BoD & Audit Cttee
Quality
Inpatient Survey Results
Outpatient Survey Results
Quality Performance Report
Significant Risk Report
PLACE Inspection
Quality Accounts - First Draft
Quality Accounts - Final Draft presented
PS
PS
PS
PS
PS
PS
PS
BoD
BoD
BoD
BoD
HAC
Clinical Governance
Clinical Governance
DR
DR
N/A
N/A
N/A
AMM
PS
BoD
N/A
Monitor
Monitor
BoD
N/A
BoD
Election Results
Deputy Chair Election
Public Governor Election
Infection Control
Infection Control - Annual Report
Constitutional Documents
Constitution
Standing Orders
Membership Development Strategy
Policy on Composition of COG
Policy on NED Composition
Trust Sec
Trust Sec
DT
Trust Sec
Trust Sec
Constitution Grp/BoD
Constitution Grp/BoD
MDC
N/A
NED RemCo
Governance
Register of Interests
Meeting Dates for Next Year
Forward Programme
Actions Matrix
Annual Members' Meeting
Governor Attendance
Governor Budget
Trust Sec
Trust Sec
Trust Sec
Trust Sec
Trust Sec
Trust Sec
Trust Sec
Trust Secretary
Trust Secretary
Trust Secretary
Trust Secretary
MDC
NED RemCom
Trust Secretary
Reports from COG Committees/Groups
Constitution Joint Working Group
Governor Induction and Training Committee
Governor Involvement with Patient and Public Engagement Committee
Membership Development Committee
Nomination Committee
Non-Executive Director Remuneration Committee
Governor Scrutiny Committee
Trust Sec
SB
GB
DT
JS
DD
SCB
N/A
N/A
N/A
N/A
N/A
N/A
N/A
MAll
GS
Vacancy
Various
GB
GS/EF/Vac
Vacancy
KM
DP
EF/GB/DT
KM
KM
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Reports from Trust-led Committees/Groups
Carbon Management Committee
Charitable Funds Committee
Diversity Committee
Editorial Group
End of Life Strategy Group
Finance Briefing Group
Healthcare Assurance Committee
Infection Control
Organ Transplant Committee
Patient Engagement and Communications Committee
Patient Information Group (PIG)
Valuing Staff and Wellbeing
Performance Reporting
Financial Reporting
Performance Reporting
Governors' Work Programme
Non-Executive Director Role
Review Performance & Terms of Reference of Subordinate Committees
and Groups
Constitution Joint Working Group
Governor Training Committee
Governor Involvement and Patient and Public Engagement Committee
Membership Development Committee
Nomination Committee
Non-Executive Director Remuneration Committee
Governor Scrutiny Committee
SH
RR
Chairs
NEDs
BoD
BoD
Relevant Committees
N/A
Part 2
Nov
Part 2
BoD
BoD
Part 2
BoD
Monitor/Parliament
Part 2
N/A
N/A
Part 2 Part 2
Part 2
Part 2 N/A
N/A
N/A
Publication
Part 2
Part 2
23
Part 2 Part 2
Part 2 Part 2
Part 2 Part 2
Part 2
Part 2
Part 2
File
N/A
N/A
N/A
N/A
Part 2 N/A
Part 2 N/A
N/A
N/A
N/A
N/A
N/A
Part 2 N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Part 2 Part 2
Part 2
N/A
N/A
BoD
Part 2 N/A
Trust Sec
Vacancy
GB
DT
JS
Vacancy
Vacancy
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
General Reports
SWGEN
Outside the Trust engagements
All
All
N/A
N/A
N/A
N/A
Staff
Staff Survey
KA
BoD
N/A
COUNCIL OF GOVERNORS
Meeting Date and Part:
22 January 2015 – Part 1
Subject:
Governor Sub-Committee Meetings Report
Section:
For Information
Author of Paper:
Representatives of the Trust Committees/Groups
Details of previous
discussion and/or
dissemination:
Key Purpose:
None
Patient
Engagement
X
Patient
Engagement
X
Patient
Engagement
X
Patient
Engagement
X
Action Required by
Council of Governors:
To note
Summary:
Key Decisions/Discussions/Actions from committee meetings
held during the past quarter
Strategic Goals &
Objectives:
Links to CQC
Registration: (Outcome
reference)
N/A
N/A
Council of Governors Meeting Part 1
22 January 2015
GOVERNOR SUB-COMMITTEE MEETINGS REPORTS
October 2014 – January 2015
MEMBERSHIP DEVELOPMENT COMMITTEE (MDC)
Chair: David Triplow
Meeting Dates: 5 November 2014 and 7 January 2015
Key Committee Decisions/Discussions
1.
Various talks have been organised in constituencies for 2015. Full details later.
2.
We need to gain more21to 60 year olds, Dave to talk to all governors about getting us to local events.
3.
An e mail about careers to be sent to under21 year olds on a monthly basis. We need to update governors video on
recruitment
4.
We updated terms of reference, had feedback from Web development group and Equality and Diversity meting
Activities and Events in Previous Quarter
Description
Date
Many careers conventions ,
October/November
Including
Avonbourne,
Harewood,
Bournemouth Boys and Girls, Talbot
Heath, Ringwood and Purbeck
Careers in schools day
10th November
Talk in West Hants Club
Future Activities and Events
Description
Parkstone Careers Convention
22 October
Attendance and Outcome
Encouraging young people to aim for a career in the
NHS and also gaining new members.
Thanks for the help of governors
Nearly 100 students and many representatives from
parts of the hospital. Brilliantly organised by Dily and
thanks for help from governors.
Over 50 people attended
Location
Opportunities for Governors to be Involved*
Parkstone
Yes
Grammar School
*Please contact Governor Co-ordinator if you are interested in getting involved in a particular event
Governor Sub-Committee Meeting Reports
Date
4 March 2015
Page 1 of 4
Council of Governors Meeting Part 1
22 January 2015
GOVERNOR TRAINING COMMITTEE (GTC)
Interim Chair: David Bellamy
Meeting Date[s]: [DATE]
Key Committee Decisions/Discussions
1.
Arrange programmes for future Governor training and education. Teaching sessions will take place two monthly.
Departmental tours are also to be arranged.
2.
Discuss the format for the next Board / Governor Away day
3.
4.
Assess feedback from Governors of previous educational sessions and consider suggestions made by them for future
topics of learning.
The committee agreed to meet every two months. The election of a new chair will take place at the next committee
meeting once new Governors have been appointed with the current elections.
Activities and Events in Previous Quarter
Description
Date
Training
October 22nd 2013
Training
December 4th 2013
Away Day
November 20th
Governor Sub-Committee Meeting Reports
Attendance and Outcome
Alison Ashmore gave a very good overview of the out patient
department. Dr Krishnan provided a stimulating presentation of
aspects of the gastroenterology department which received the
high acclaim of 100% excellent in Governor assessments.
Finally Richard Ford gave us an update of what was happening
to car parking.
Overall the meeting was very well received.
Kelly Spaven Matron for acute medicine, gave an inspirational
talk about AMU and ambulatory care in the ED. .Joanne Sims
gave us a clear presentation on what serious incidents are and
Vanessa Mason talked about the Working Together
programme.
The day was centred on Strategy both from the CCG – the
Clinical Services Review- and the forward plan from the Trust.
Future plans are far reaching and likely to incur major changes
to the local Health service. Small group sessions allowed
everyone to express some viewpoints.
Page 2 of 4
Council of Governors Meeting Part 1
22 January 2015
Future Activities and Events
Description
Opportunities for Governors to be
Involved*
Building Professional Relations
January 14th and 15th Post Grad Centre
This is a very interactive course to help
Governors with communication with
the public, patients and staff.
*Please contact Governor Co-ordinator if you are interested in getting involved in a particular event
Governor Sub-Committee Meeting Reports
Date
Location
Page 3 of 4
Council of Governors Meeting Part 1
22 January 2015
GOVERNOR INVOLVEMENT with PATIENT and PUBLIC ENGAGEMENT (GIPPE)
Chair: Glenys Brown
Meeting Date: 7 November 2014
Key Committee Decisions/Discussions
1.
Key messages from the patients surveys taken to PECC
2.
Forward Plan of the Committee
Activities and Events in Previous Quarter
Description
Date
Stakeholder event
November 2014
Future Activities and Events
Description
Opportunities for Governors to be
Involved*
Relative and Carers Audit
TBC
Christchurch Hospital
Yes
*Please contact Governor Co-ordinator if you are interested in getting involved in a particular event
Governor Sub-Committee Meeting Reports
Date
Attendance and Outcome
See separate report
Location
Page 4 of 4
COUNCIL OF GOVERNORS
Meeting Date and Part:
22 January 2015 – Part 1
Subject:
Trust Committee / Group reports
Section:
For Information
Author of Paper:
Representatives of the Trust Committees/Groups
Details of previous
discussion and/or
dissemination:
Key Purpose:
Trust Committee / Group reports
Patient
Engagement
X
Patient
Engagement
X
Patient
Engagement
X
Action Required by
Council of Governors:
To note
Summary:
Key Decisions/Discussions/Actions points
meetings held during the past quarter
Strategic Goals &
Objectives:
Links to CQC
Registration: (Outcome
reference)
N/A
N/A
Patient
Engagement
X
from
committee
Council of Governors Meeting Part 1
22 January 2015
TRUST COMMITTEE MEETING REPORTS
October 2014 – January 2015
CARBON MANAGEMENT COMMITTEE
Governor Representatives: Mike Allen
Meeting Dates: 25 November 2014
Key Decisions/Discussions/Actions
1.
2.
3.
4.
Consideration of updating Terms of Reference
Future activities that could be included
Green Impact progressing 1 Silver, 4 Bronze and more departments
Degree days to be considered
CHARITABLE FUNDS COMMITTEE
Governor Representatives: Graham Swetman
Meeting Dates: 21 November 2014
Key Decisions/Discussions/Actions
1. The draft Charity Strategy was discussed prior to presentation to the
December Board of Directors
2. Of the total funds of £5.1million, it was noted that about £2.4 million had
already been committed for Jigsaw Building running costs.
3. Approvals were given for the Alter G treadmill machine, and the use of
£290K of Christchurch charitable funds for equipment for the
development.
4. Plans to rationalise the various charitable funds were discussed, largely
to bring the funds into line with organisation changes.
DIVERSITY COMMITTEE
Governor Representative: Vacancy
Meeting Dates: No Governor attended, therefore no report this quarter
Trust Committee Meeting Reports
Page 1 of 5
Council of Governors Meeting Part 1
22 January 2015
EDITORIAL GROUP
Governor Representative: Mike Allen, Dean Feegrade, Bob Gee, David
Bellamy, Doreen Holford and Vacancy
Meeting Dates: 7 January 2015
Key Decisions/Discussions/Actions
1. Theme – Life in the Hospital
2. JS introduction
Dates for your diary
News stories and news in brief
You said, We did
Focus on feature – Pain management
A day in the life – Bob Gee, Governor
Day in the life – Career path
Governor page
END OF LIFE STRATEGY GROUP
Governor Representatives: Glenys Brown
Meeting Dates: 14 November, 27 November, 12 December 2014
Key Decisions/Discussions/Actions
1. A review of the Bereavement Service at Christchurch Hospital has taken
place. Report with recommendations is included with the COG papers
2. Discharging of End of Life patients to a setting outside an acute hospital
continues to be a problem given the shortage of appropriate beds in the
community.
3. The implementation of an electronic palliative care co-ordination system
continues to be an IT challenge, meanwhile this poses a risk for effective
service delivery.
4. All consultants are expected to take part in the advanced
communication programme as part of compassionate care training. All
remaining staff will have this aspect of care delivery as part of mandatory
training. Funding of this remains an issue.
Trust Committee Meeting Reports
Page 2 of 5
Council of Governors Meeting Part 1
22 January 2015
GOVERNOR FINANCE BRIEFING GROUP
Governors: Graham Swetman; Eric Fisher, Vacancy
Paul McMillan (as observer)
Meeting Date: 25 November 2014
Key Decisions/Discussions/Actions
1. The underlying financial performance against the revised forecast deficit
of £5.2m was discussed. The month on month position continues to
stabilise.
2. The two main drivers of the adverse variances continue to be the
additional emergency activity and the continued requirement to cover
vacant shifts through the use of expensive agency staff and locums.
3. Progress was being made to address the slippage on the approved cost
improvement programme and to commence plans to meet the continuing
4% requirement (equivalent to £8.5m) in improvements per annum into
2015/16 and 2016/17.
4. The Trust’s Continuity of Services Risk Rating is now a robust 3 and this
is likely to remain for the remainder of 2014/15 due to the strong liquidity
position of the Trust. The liquidity measure (EBITDA) of 4% represented
a better position than most acute Trusts.
5. Next Meeting 2 February 2015
INFECTION PREVENTION AND CONTROL COMMITTEE
Governor Representative: Keith Mitchell
Meeting Dates: 23 October 2014
Key Decisions/Discussions/Actions
1. Hand washing at meal times - patients are being offered the ability to
wash hands but in addition hand-wash wipes to be purchased and
circulated to cover any gaps from patients who are unable to use the
current methods
2. No hospital acquired MRSA Infections in the reporting period.
CDiff below trajectory.
3. The Trust has produce plans and procedures to manage the unlikely
event of an Ebola case within the Trust. Numerous meetings had taken
place with working document now available.
4. PLACE Report -All areas improved and above national average other
than condition and appearance at Christchurch.
Food and hydration at Bournemouth not scoring well but this was
due to one ward where there was a Ward Hostess on her first day,
scoring 36%. Scores would still have been marginally under
national average.
Trust Committee Meeting Reports
Page 3 of 5
Council of Governors Meeting Part 1
22 January 2015
HEALTHCARE ASSURANCE COMMITTEE
Governor Representatives: Vacancies x 2 – David Bellamy in attendance
Meeting Dates: 30 October 2014, 27 November, 16 December 2014
No report received
ORGAN TRANSPLANT COMMITTEE
Governor Representative: Dexter Perry
Meeting Dates: No meeting held
PATIENT ENGAGEMENT AND COMMUNICATIONS COMMITTEE
Governor Representatives: Eric Fisher / David Triplow / Glenys Brown
Meeting Dates: 7 November 2014
Key Decisions/Discussions/Actions
1.
2.
3.
4.
Discussion on using e mails to connect patients.
Discussion on models for the future in the local Health service
Decisions on format for new patient experience cards.
Glenys briefly fed back from GIPPE. No time for Dave T item.
PATIENT INFORMATION GROUP (PIG)
Governor Representative: Keith Mitchell
Meeting Dates: Monthly
Key Decisions/Discussions/Actions
1. See approved information leaflets following this report
Trust Committee Meeting Reports
Page 4 of 5
Council of Governors Meeting Part 1
22 January 2015
VALUING STAFF AND WELLBEING
Governor Representative: Keith Mitchell and vacancy
Meeting Dates: 14 November 2014
Key Decisions/Discussions/Actions
1. LH (Active Dorset) and TH (Bournemouth Borough Council) outlined a
project proposal for partnership, namely Living Well Active Workplaces
(LWAW). The project aims to promote active travel and physical activity
at the workplace in order to improve sustainable travel choices and
employee health in the long term.
2. Employer Assistance Programme quarterly report for the period 1st June
2014 to 31tst August 2014. During this time a total of 110 staff members
made a contact of which 60 have been to the telephone counsellors, 37
have received face to face counselling, 12 were advised by information
specialists and 1 through the online counselling service.
This is one of the highest usage since the contract commenced, marking
a 34% increase from the same quarter last year.
3. Flu vaccination - It was the stage of submitting the interim data to the DH
– and over 2500 people were vaccinated, among which approximately
50% of all patient facing staff
4. Staff Physiotherapy was briefly reviewed: the number of referrals is
currently 49 per month with the average waiting times increased to 7
(from 3) days for urgent referrals and 26 days for routine appointments
(up from 9 days) due to staff shortages over the last few months.
Trust Committee Meeting Reports
Page 5 of 5
Department of Clinical Nutrition & Dietetics
Re-introduction of higher fibre
foods after a low residue diet
Your Dietitian is:
The Royal Bournemouth Hospital: 01202 704732
Your doctor or dietitian has advised you to start re-introducing fibre in your diet. You should build up
the amount of fibre gradually. Use the guidelines below:
These re-introductions give a gradual build up of fibre in your diet. The aim is to determine the level
of fibre that you can tolerate before provoking symptoms again. Once you find the level of fibre that
suits you, try to stick to it. Use the guidelines below.
Week one
Introduce one extra portion of fruit or vegetables per day up to a maximum of five portions per day:
Remember that some fruits and vegetables can be very hard to digest and you should continue
to avoid these eg sweetcorn, nuts, dried fruits, peas, string beans, broad beans, oranges and
tomatoes.
An example of one portion is one medium piece of fruit e.g. banana/apple/pear (fits into the palm of your hand)
two plums/kiwi fruit/other small fruit
one cupful of grapes/cherries
three tbsp vegetables
small glass of fruit juice
Week two
Try replacing your normal portion of white bread with wholemeal bread.
Remember that granary bread should still be avoided.
Week three
Try a higher fibre breakfast cereal e.g. Weetabix, Shredded Wheat, Bran Flakes.
Week four
If you are still symptom free, you may like to introduce further portions of fruits and vegetables.
You may find that you can eat high fibre vegetables on days when you do not have wholemeal
bread and high fibre breakfast cereals. If this is the case, try varying the sources of your fibre
intake on a daily basis to achieve a balanced diet.
Vitamin and mineral supplements
Five portions of fruit and vegetables per day (not including potatoes) are recommended long-term
for a healthy diet.
If you are unable to tolerate the recommended five portions of fruits and vegetables per day you may
require a multivitamin supplement to ensure an adequate intake of vitamin C and folic acid. Please
consult your dietitian for advice.
Fluid
Fibre adds bulk to your diet by absorbing fluid and making stools easier to pass. It is, therefore,
important to increase your fluid intake. Aim to drink at least eight cups (approximately 200ml) every
day this can include water, squash, decaffeinated tea/coffee or fruit teas.
Our Vision
Putting patients first while striving to deliver the best quality healthcare.
The Royal Bournemouth Hospital
Castle Lane East, Bournemouth, Dorset, BH7 7DW
Please contact the author if you would like details of the evidence in the production of this leaflet.
We can supply this information in other formats, in larger print, on audiotape, or have it translated for you.
Please call the Patient Advice and Liaison Service (PALS) on 01202 704886,
text or email [email protected] for further advice.
Author: Dael Hartley
Date: October 2014 Version: Two Review date: October 2017 Ref: 021/14
Website: www.rbch.nhs.uk n Tel: 01202 303626
cs/ljs/sharedfile/dietsheets/low residuereintro of higher fibre foods/Feb2014
We are committed to providing excellent care for every patient, every day, everywhere and our dedicated
staff are here to care for you and then support you to leave hospital to recover. It is essential that we
discharge patients when they are medically fit to ensure we have enough beds for those requiring
operations and those who come to us through our Emergency Department to prevent them from having
long, uncomfortable waits.
Choice process - Factsheet 1
Planning your discharge from hospital
This factsheet is to explain the social assessment and discharge process for all patients.
The ward will be requesting a social care and/or therapy assessment for you, to find out which services you
might require to support your safe discharge from hospital. A therapist, social care professional or member of
the community mental health team will discuss your needs with you and any family/friends/carers you would like
involved. The aim is to find out whether, with the right help and support, you can return to home after your
assessment and treatment or whether care elsewhere might be needed.
The team looking after you at the hospital, will do all that they can to help you and give you the information you
need to make a decision.
If it is agreed you need carers at home or to move to a care home, you will be offered help to arrange this via our
learning hospital support service (BCHA), or Social Services. If there is little availability in the community, or your
preferred choice has no current vacancies/availability, you will need to accept a temporary option, sometimes
called ‘interim care’ while you wait or search for your first choice.
It is not possible for you to remain in this hospital when you are ready for discharge or transfer, as this puts you
at increased risk of hospital acquired illnesses or infections. This will also help us ensure we have beds available
for those who are critically ill. The hospital team will help you to make arrangements for discharge within the next
few days.
If patients/their carers do not accept the options offered to support discharge, the Trust may charge £100 per
day for any days spent in hospital longer than is deemed appropriate by the hospital team.
If you would like a copy of this factsheet to be given to someone else please speak to one of the nurses on your
ward. Please ask a member of the multidisciplinary team if you have any questions.
Our Vision
Excellent care for every patient, every day, everywhere.
The Discharge Coordination Team, The Royal Bournemouth Hospital
Castle Lane East, Bournemouth, Dorset, BH7 7DW
Please contact the author if you would like details of the evidence in the production of this leaflet.
We can supply this information in other formats, in larger print, on audiotape, or have it translated for you.
Please call the Patient Advice and Liaison Service (PALS) on 01202 704886,
text or email [email protected] for further advice.
Author: Kt Whiteside
Date: October 2014 Version: Two Review date: October 2017 Ref: 130/14
Website: www.rbch.nhs.uk n Tel: 01202 303626
Endoscopic Clips
What do others say about the group?
There is a lot of positive feedback from recent participants in the group,
such as:
l “Staff very kind, helpful and professional”
l “A leisurely atmosphere giving you confidence to join in with all
the equipment and enjoy with everyone”
l “I was really encouraged as it gave me motivation to come out and
join in”
l “[I gained] Control - belief that I can do more without pain.”
l
“[I gained] Confidence and hope that exercise will improve my condition.”
Statistics from questionnaires also demonstrate that many participants
experience increased ability to manage their condition and perform daily
activities after the programme.
Move to improve
exercise class
How can I get involved?
To find out more information and how to get involved, it is a good idea
to ask your therapist (if you are already visiting a physiotherapist or
occupational therapist at Christchurch Hospital) or your rheumatology
practitioner. They will be able to discuss with you whether the class may
be suitable, and then refer you into the group.
Our Vision
Putting patients first while striving to deliver
the best quality healthcare.
The Royal Bournemouth Hospital,
Castle Lane East, Bournemouth, Dorset, BH7 7DW
Please contact the author if you would like details
of the evidence in the production of this leaflet.
We can supply this information in other formats,
in larger print, on audiotape, or have it translated for you.
Please call the Patient Advice and Liaison Service (PALS)
on 01202 704886, text or email [email protected] for further advice.
Author: Lucy Chaldecott Date: May 2014
Version: Four Review date: May 2017 Ref: 169/14
08
Website: www.rbch.nhs.uk n Tel: 01202 303626
Do you find it hard to maintain activity
due to a condition such as
Rheumatoid Arthritis, Lupus or Fibromyalgia?
Would you like to safely increase your activity
in a supportive environment?
Website: www.rbch.nhs.uk n Tel: 01202 303626
It is a gentle movement class which meets at Christchurch Hospital once
a week for people who have conditions such as Rheumatoid Arthritis,
Lupus or Fibromyalgia. It aims to illustrate the benefits of regular physical
activity by introducing safe and appropriate activities for people with
long-term conditions who currently find exercise painful, difficult or
frightening.
How may I benefit from attending?
There are several benefits from attending this group, such as:
l Improving your overall fitness and activity levels
l Finding new, suitable ways to exercise
l Developing your confidence to exercise
l Meeting like-minded people
l Discovering further support available to you, such as schemes
to maintain exercise and support networks
So why not come and try it out for yourself?
Why should I attend?
There are numerous benefits of regular physical activity.
For example, it can:
l Increase the strength of your muscles and bones
l Improve your function in day to day living
Reduce your risk of developing conditions such as type II diabetes
and osteoporosis
l
You may find your condition limits what you can do due to pain or fatigue,
or you may feel scared to exercise. However, research demonstrates
that exercise for people with conditions like RA not only has these normal
benefits but may also:
l Ease your pain
l Reduce fatigue
l Improve your quality of life
l Reduce the progression of your disease
l Reduce your need for so much medication
Not only is exercise safe for you, it is extremely beneficial. This group
can help to introduce, or re-introduce, suitable activities to start producing
these positive effects.
What are the practicalities of the group?
The group meets once a week in the therapy gym at Christchurch
Hospital and lasts approximately an hour.
l It is a 6-week programme which 5-10 participants attend
l It is led by 2 or 3 therapists who can tailor the exercises to your
needs and talk to you about any concerns or goals you may have.
l Therapists will also discuss what support networks are available to
you and the opportunities to continue activities and exercise after
the programme.
l
What does a typical session look like?
Each week the group involves a gentle warm-up, graded circuit
exercises, a group activity and then a cool-down. This is tailored to the
group as a whole and also to you individually depending on your own
needs and wishes.
1Warm-up - simple movements to gently move your muscles and
joints and gradually increase your heart rate and breathing rate.
2 Graded circuit exercises - aerobic and strengthening exercise
stations to do individually. These include:
- gym equipment, like the static bike
- gym balls
- therapeutic hand equipment, like hand putty
- shoulder pulleys and resistance bands
3 Group activity - a short activity led by the therapists for the group
to do together. This may include:
- tai chi
- gym balls
- pilates
- short tennis or badminton
- relaxation methods
4 Cool down - simple movements to gently stretch and cool down
your muscles and reduce your heart rate and breathing rate.
Endoscopic Clips
Endoscopic Clips
What is the Move to Improve Exercise Group?
Food and drink
Additional Notes
Food and drink
Our Vision
Putting patients first while striving to deliver
the best quality healthcare.
The Royal Bournemouth Hospital,
Castle Lane East, Bournemouth, Dorset, BH7 7DW
Please contact the author if you would like details
of the evidence in the production of this leaflet.
We can supply this information in other formats,
in larger print, on audiotape, or have it translated for you.
Please call the Patient Advice and Liaison Service (PALS)
on 01202 704886, text or email [email protected] for further advice.
Author: Dieticians Department
Date: July 2014 Version: One
Review date: July 2017 Ref: 178/14
Website: www.rbch.nhs.uk n Tel: 01202 303626
Nutrition and Dietetics
Website: www.rbch.nhs.uk n Tel: 01202 303626
If you do not eat or drink enough your recovery from illness
and length of stay in hospital may be prolonged. You could
also be at risk of complications. It is important that you know
what the problems are if you do not eat or drink enough and
to report any concerns to your nursing and medical team
looking after you. If you are hungry or thirsty at anytime,
please inform a member of staff.
Lack of food - malnutrition can cause:
l
l
l
l
l
l
l
l
increased risk of illness and infection
References
British Association of UK Dietitians Malnutrition May 2012 Overcoming the Problem Food Fact Sheet
National Collaboration Center for Acute care,
NICE CG 32 February 2006. Nutrition Support in Adults.
Oral nutrition support, enteral tube feeding and parenteral
nutrition. Methods evidence and guidance 2006/2012
Food and drink
Food and drink
This leaflet aims to tell you why food
and drink are important
Nutrition and Hydration Council. Hydration in Hospital.
June 2011. Fact Sheet
Water UK (2011) Hydration Toolkit for Hospitals and Healthcare.
slower wound healing
increased risk of falls
difficulty keeping warm
low mood
reduced energy levels
reduced muscle strength
weight loss
How will my food and fluid needs be
assessed?
Both nurses and doctors will assess your needs and ask
about your preferences during your hospital stay. You may be
referred to a specialist team or dietitian.
02
07
You can check the colour
of your urine using the
chart below; if you are
unsure please check
with a member of staff
“Healthy pee is 1-3,
4-8 you must hydrate!”
1
2
3
4
5
6
7
Aim to drink 8-10 cups
of fluid a day unless
instructed otherwise by
your doctor. We have
modified drinking cups /
mugs which you may find
more comforta
Eat well, get better
You should aim to eat three meals a day and two snacks
l
l
If you do not manage all your meal, additional snacks
are available.
Food can be brought in from home, please check with
ward staff to ensure its suitability.
Please note there are no facilities on the ward to heat
food.
l
Foods can be fortified at ward level e.g. made richer
in calories
l
We protect our mealtimes from interruption
l
l
Family and visitors are welcome to help you at mealtimes.
The League
of Friends at The Royal Bournemouth Hospital
Food
and drink
Food and drink
How do I keep hydrated?
8
04
05
We use a red crockery system for people who need
assistance or feeding. Modified eating/drinking aids are
available.
We have specials menus available. These include
Halal, kosher, vegan, gluten free, fork mashable, puree,
finger foods and vegetarian.
Our gluten free products include:
Bread, cereals, cake, biscuits and all hospital made soups.
If you have any concerns ask the nurses to call the Catering
Department.
How do I order my meals?
We use an electronic system to order food / meals, through
using a bedside TV. You will be shown how to use this and
assisted throughout your stay.
There are seven hot drink rounds every day and fresh water
is available throughout the day. Please ask if you would like a
hot drink at other times.
Lack of fluid/drinks - dehydration can
cause:
l
l
l
l
l
l
l
l
l
l
l
l
06
Food and drink
Food and drink
Snack boxes are available if you miss a meal / or you are
admitted late e.g. between 8pm and 8am when the kitchens
are closed and a hot meal cannot be given.
weight loss
thirst/ Extreme thirst
feeling dizzy/light headedness
risk of falls
sleepiness/tiredness
sunken eyes
dry, sticky mouth and skin
headache
rapid heartbeat
passing small amounts of dark, concentrated urine
urine infections
kidney damage
03
COUNCIL OF GOVERNORS
Meeting Date and Part:
22 January 2015 – Part 1
Subject:
Appointed Governor Reports
Section:
For Information
Author of Paper:
Appointed Governors
Details of previous
discussion and/or
dissemination:
Key Purpose:
None
Action Required by
Council of Governors:
Patient
Engagement
X
Patient
Engagement
X
Patient
Engagement
X
To note
Summary:
Reports of activity from Appointed Governors:
 Bournemouth University
 Clinical Commissioning Group
 Dorset County Council
Strategic Goals &
Objectives:
Links to CQC
Registration: (Outcome
reference)
N/A
N/A
Patient
Engagement
X
Council of Governors – Part 1
22 January 2015
Update from Bournemouth University
and the Faculty of Health & Social Sciences
January 2015
Bournemouth University (BU)
BU is in the middle of its 6 year strategic plan, BU 2018. Significant progress has
been achieved since the inception of the plan which is based on the concept of
fusion- the integration of research and professional practice into an excellent student
experience. There has recently been a restructure from the pre-existing 6 schools
into 4 faculties:




Health & Social Sciences
Science & Technology
Media & Communications
Management
Student recruitment at undergraduate levels is buoyant, there is considerable
building taking place (International College in Holdenhurst Road, Student Centre and
new teaching block at Talbot Campus) with plans for a new building for Health &
Social Sciences at the Lansdowne moving forward. The Research Excellence
Framework recently reported that the proportion of world recognised and world
leading research at BU is increasing very positively and generally our student
evaluations are very good. The last audit undertaken by the Quality Assurance
Agency for Higher Education commended BU for the quality of its student learning
opportunities. In summation, BU is developing in strength and reputation.
Faculty of Health & Social Sciences (FHSS)
The mission of FHSS is to ‘help to make peoples’ lives better’ through academic
endeavour. All of our work aims to touch people’s lives, directly or indirectly. This
includes preparing students to have the theoretical knowledge, the skills and the
compassion to support individuals in challenging life situations; offering opportunities
for continued learning beyond graduation/ registration to ensure practice is well
informed, up-to-date and of the highest quality; engaging in practice development
work that leads to improved service delivery; and by conducting and publishing high
quality research in areas of health and social sciences, that provides insights,
understanding and sound evidence to increase knowledge and enhance practice.
Academic areas include nursing, midwifery, health professions, social work,
sociology, public health and health sciences.
Our undergraduate courses are approved by professional bodies, feature
placements / fieldwork opportunities, and are geared to ensuring graduates are well
equipped for their chosen careers. Post-registration and postgraduate students
Council of Governors – Part 1
22 January 2015
benefit from opportunities that allow them to focus their studies on specialist areas of
knowledge and / or advanced practice, providing pathways for lifelong learning and
growth. Our student numbers total 4300 (mix of full and part time), supported by
approximately 160 academic (as well as some lecturer practitioners from local NHS
Trusts) and 60 administrative staff.
Our contracts with the NHS are with Health Education Wessex and we work with
acute and community Trusts in Dorset, Somerset, Hampshire and south Wiltshire
(acute Trusts include Yeovil, Dorset County, Poole, RBCH, Salisbury, Portsmouth,
Basingstoke, Winchester, Isle of Wight). We have a University Centre in Yeovil
where we deliver adult nursing and a sub campus in Portsmouth where we deliver
midwifery. The number of commissioned places in adult nursing is increasing in
order to meet the workforce demands of the Trusts, other numbers are remaining
fairly static.
In addition to pre-registration education, we have a highly regarded Masters course
for nurse practitioners which recruits well as well as post graduate degrees in public
health, leadership and management and other areas of advanced practice. We have
approximately 100 doctoral level students, mainly from health and social care
backgrounds, undertaking research projects that will make a positive impact on the
quality of care. Areas of current growth include the BU Dementia Institute (BUDI)
which was established two years ago and has become known as an important centre
for research and development work to support people with dementia and their
carers. The University is planning to invest significantly with the support of the
Wessex AHSN to create an Orthopaedic Research Institute, working with colleagues
from RBCH to establish a centre of excellence. In addition we are launching a Centre
for Leadership, Impact and Management in Bournemouth (CLIMB) to work with
health and social service colleagues to build leadership capacity and effectiveness in
services. One unique aspect of the work in CLIMB stems from earlier programmes in
social care where evaluating the impact of educational interventions is a key feature.
These research centres complement our existing expertise in humanisation,
maternal health, social work and social science research.
Next Steps
This note is the first of planned updates for the Governors at RBCH to provide
information on BU that may be of interest and useful for considering potential
collaborations. As it is the first, it provides some general background as well as a few
current developments; feedback is welcome on its helpfulness and any other
particular aspect Governors would find useful.
Professor B. Gail Thomas
Dean of Health & Social Sciences
RBCH Appointed Governor – Bournemouth University
Council of Governors – Part 1
22 January 2015
Dorset
Clinical Commissioning Group
Report from the Dorset Clinical Commissioning Group
January 2015
The CCG is currently allocating most of its time and resource to the CSR.
I would like to thank all RBH members of staff who have been involved and
encourage them to continue their involvement. The highlight has been getting lots of
different primary and secondary care clinicians in the same room. We all have the
same ideas of what the problems are and what needs to change.
Tom Knight
Appointed Governor – Clinical Commissioning Group
Council of Governors – Part 1
22 January 2015
Report from Dorset County Council
January 2015
Health Improvement Hub procurement
The Joint Public Health Board in July approved plans to develop a pan-Dorset health
improvement hub. This will bring access to all existing health improvement services
such as smoke stop and weight loss services into a single hub. This means that we
will be able to offer a holistic approach to health improvement, as people often have
multiple lifestyle factors that could contribute to ill health. This will also mean that
there is a clear offer to support those who are identified as being at risk of
cardiovascular disease through Health Checks.
The service will offer signposting to locality based options such as sports and leisure
activities, as well as motivational interviewing and referral to specific health
improvement services as appropriate.
A provider has been identified through the procurement process and will be
announced week commencing 19th January, with the service due to commence April
2015.
Sexual health
Currently sexual health services in Dorset are based in a range of settings, over the
last two years commissioners and providers of current services have been working
together to coordinate development of some initial improvement plans.
The vision for sexual health service is to procure a comprehensive, integrated
service that enables transformation to a single managed system providing the right
intervention, by the most appropriate professional, at the right time and place to meet
population needs.
The focus of the commissioning intentions will be to focus on open access provision
of most contraceptive services, specialist services including young peoples sexual
health. Outreach, HIV prevention, Sexual health promotion, STI testing and HIV
testing. The scope of this commissioning exercise currently excludes GP and
Pharmacy contracts; there will be future opportunities for further integration with
primary care as services evolve.
A procurement process has commenced for the development of an integrated open
access sexual health service for our local population and will continue during 2015.
Supplier engagement events and online e-procurement tools, to support the process,
have successfully engaged providers in this vision for a more effective way of
working.
Teenage pregnancy pilot in Weymouth and Portland
Smoking during pregnancy causes significant harms to both mothers and the babies
and reducing the incidence of smoking during this time is critical if we are to improve
maternal and longer-term public health outcomes. There is a growing evidence base
nationally to show that the additional use of incentives during pregnancy can improve
Council of Governors – Part 1
22 January 2015
outcomes, and this has been acknowledged in NICE guidance and through
subsequent national guidance.
The pilot project which will last for a 12 month period and will be evaluated to test a)
the viability of the approach b) the effectiveness and cost effectiveness of the use of
incentives in this context should be going live in early February 2015.
Cllr. Colin Jamieson
Dorset County Council
COUNCIL OF GOVERNORS
Meeting Date and Part:
22 January 2015 – Part 1
Subject:
Staff Governor Reports
Section:
For Information
Author of Paper:
Staff Governors
Details of previous
discussion and/or
dissemination:
Key Purpose:
None
Patient
Engagement
X
Patient
Engagement
X
Patient
Engagement
X
Action Required by
Council of Governors:
To note
Summary:
Reports of activity from Staff Governors
Strategic Goals &
Objectives:
Links to CQC
Registration: (Outcome
reference)
N/A
N/A
Patient
Engagement
X
Council of Governors – Part 1
22 January 2015
Overview of AHPST Staff Governors Activities 2014 – 2015
No.
1.
Overview
AHPST Forum
Agreed to formulate and set up a Strategic AHPST Forum to initially meet 6 weekly with
AHPST Staff representatives and the Trusts Directors (Terms of reference available).
Work with the Director of Nursing and Lead for AHPST Staff ref: AHPST Issues.
2.
3.
Trust Theatres
Visited Theatres with Helen Lingham and agreed to highlight 5 key points of concern in mini
report with AHPST team.
Cost Savings
Met with Stuart Hunter following COG Meeting ref: cost savings:
Items discussed:
1. Lease/ Rental Contracts
2. Out- sourcing services
3. Current ordering process
4. Manager to be provided with Debit Cards
5. Income generation
6. Electronic ordering of Drugs
7. Electronic booking of next appointment for & with Patients
8. Reduce Agency expenditure
4.
Ward Three
Concern raised reference Ward Three to IK by Senior staff in the Trust. Followed this up with
PS and agreed to meet Ward Three team and report on findings to management team and
directors/JS.
This visit took place:
Report compiled and delivered: good management and patient care noted and
discussed improvements to consider.
5.
Pathology Department
Visited Pathology AHPST Staff
6.
7.
8.
Issues highlighted:
 Staffing and workforce planning
 Increased demand for their services year on year
 Trust training being appropriate for AHPST staff needs
 An urgent need to improve their rest facilities (improvements in progress post meeting
and assistance with JS/TS)
Information Technology in the Trust
IK raised concern ref: Information Technology services with JS & TP at monthly meeting (TS
suggested to meet with PG):
Many concerns discussed with PG and further meeting to explore solutions:
 IT Help Line & frustration with IT equipment clinical teams
 Many systems labour intensive
 Frustrations with systems:- eCamis, eIDF etc.
 Benefits of other options explored, do systems meet end-users needs and an
evaluation process for the future. IK & PG
 AHPST staff to be invited and attend IT Meetings
 Work on-going
Trusts modernisation event
IK & RO attended and supported the Modernisation event run by Debora Matthews
HR Workforce planning
Mini report produced highlighting: HR Strategy, workforce development, training concerns and
workforce planning - major concerns from AHPST Forum also mentioning nursing workforce
Council of Governors – Part 1
22 January 2015
planning issues.
9.
Attend: Trusts Workforce planning session for the Trust.
FFT London Visit
Attended FFT Forum and followed up with briefing from meeting.
10.
Cardiac Physiology visit
Met the Cardiac Physiology AHPST team and their unit;
Mini report delivered ref: concerns and highlighted good care.
11.
Attend: Governor Training events
GOG Meetings
Ian Knox Staff AHPST Staff Governor
COUNCIL OF GOVERNORS
Meeting Date and Part:
22 January 2015 – Part 1
Subject:
Governor Additional Activity Report
Section:
For Information
Author of Paper:
Written by Governors
Compiled by Dily Ruffer
Details of previous
discussion and/or
dissemination:
Key Purpose:
None
Patient
Engagement
X
Patient
Engagement
X
Patient
Engagement
X
Patient
Engagement
X
Action Required by
Council of Governors:
To note
Summary:
Additional activities undertaken by Governors since the last
Council of Governors meeting held in October 2014 over and
above their general commitments on meetings and training
Strategic Goals &
Objectives:
Links to CQC
Registration: (Outcome
reference)
N/A
N/A
Bereavement service provision at Christchurch Hospital
Background
The only in -patient facility at Christchurch Hospital is the Macmillan Unit.
Approximately 5 years ago the Macmillan Init was accredited by Bournemouth
University as a Practice Development Unit . As part of this review a decision was
made that the death certificate would be collected from the Macmillan Unit rather
than the General Office.
Current practice
Following a death relatives are advised to contact the Macmillan Unit by phone on
the next working day and are given an appointment time to come in to collect the
death certificate. Three appointment times per day are identified for this purpose. At
the same time any property is returned to the relatives. Plastic carrier bags are still
being used for the return of property and valuables are in a wooden box.
On average the mortality rate is one per day.
Advantages
There is a dedicated quiet room to receive relatives which is pleasant and
reasonably quiet.
Where possible one of the nurses who has cared for the deceased will be the person
meeting with the relatives. This means that if there are any areas which they wish to
address this can be facilitated.
There is normally a doctor available if any further explanation of the death certificate
is required.
Advice is given about the process for registering the death.
It gives closure to staff who have often been caring for the patient and family for an
extended period of time.
Disadvantages
The nurse is part of the ward team and if relatives require more time this can be to
the detriment of patients on the ward.
Relatives are coming back to the ward area where their loved one was dying.
Recommendations
A sign could be placed on the quiet room door so that those in the corridor are aware
and can respect the need to lower their voices.
Consideration could be given to whether there needs to be some adjustment to
staffing levels or rotas to accommodate time spent with relatives of the deceased.
The same property bags which have been introduced at Bournemouth Hospital
should be made available to the Macmillan Unit.
Consideration could be given to the suitability of the box used for valuables.
Viewing area
Current situation
The viewing area is immediately adjacent to the mortuary and very close to the
Macmillan Unit.
Viewings are rare, on average about one a month. This may be because provision is
made to allow relatives to say goodbye to their loved one in the Macmillan Unit for up
to several hours if required.
There are no capacity issues in the mortuary.
The viewing room is rather tired looking and not a welcoming area.
There is recognition that the future provision of a mortuary at Christchurch is under
discussion however in the short term some minor changes could be made which
would have a minimal cost impact yet improve the service.
Recommendations
The metal cabinet in the corner of the room could be removed and shelves set into
the recess with doors to match the rest of the facia.
The walls could be repainted with a warmer colour.
The carpet could be given a deep clean
Dried flower arrangement could be replaced (This action has been completed by
Duncan)
Glenys Brown
Public Governor
Patient and Public Stakeholder Event
28 November 2014
This was held on 28 November and was attended by around 45 people which
included representatives from the voluntary sector, public sector, governors, patients
and staff from the Trust.
110 invitations had been sent out.
Glenys Brown had been invited to give the key note address and presented the
progress made since the CQC report of 2013 and the revisit in 2014. Consideration
was given to themes which had emerged from Governor survey work and where this
chimed with other audit work carried out by the Trust. Areas where improvement
was required were identified.
Sue Mellor, Head of Patient Engagement, gave a brief update on the outcomes from
the previous stakeholder event and explained that the breakaway groups for the
afternoon would each have one of the problem areas to consider and to identify
ways for improvement.
There was considerable energy in the room with participants fully engaged with the
process. The feedback session which followed demonstrated that there were many
positive suggestions for improvement and these were captured on flipcharts.
Sue Mellor will be working with the ward sisters and department leaders to take
these suggestions for improvement forward.
Glenys Brown
Public Governor
Additional Activity Conducted by Keith Mitchell
October 2014 – January 2015
Date
Activity/Event/Meeting
28/10/14
Flu champion
30/10/14
AMU visit
5/11/14
Matrons talk – elderly care
20/11/14
PRIDE Awards
1/12/14
Understanding Health
1/12/14
Hospital charity tea
1/12/14
Trust values
2/13/14
Ward 3 workshop
4/12/14
Housekeeping thank you
7/12/14
Housekeeping thank you
10/12/14
Housekeeping thank you
10/12/14
Volunteer coffee morning
11/12/14
Housekeeping thank you
11/12/14
Christchurch Hospital Tea Dance
17/12/14
Stroke Unit Fair
18/12/14
Hospital Christmas Lights
21/12/14
Hospital Carol Service
23/12/14
Housekeeping thank you
25/12/14
Elderly wards
6/1/15
Mealtime training
8/1/15
iPad training
9/1/15
Focus group
12/1/15
Governor Talk – St Barnabas
15/1/15
CCG Consultation
21/1/15
Sisters talk – elderly care