A G E N D A - Royal Bournemouth Hospital · Council of Governors Meeting Agenda - Part 1 April 2014...

Council of Governors Meeting Agenda - Part 1 April 2014 of 3

Meeting Name:

COUNCIL OF GOVERNORS

Chair:

JANE STICHBURY

Date: Tuesday 29 April 2014

Time: 10:00

Venue: Conference Room

A G E N D A

Item Item description Item presenter Appendix

1 Welcome Chair

2

Apologies for Absence

Carole Deas, Dean Feegrade, Doreen Holford, Keith Mitchell, Dexter Perry

Chair

3 QUALITY 10:00 – 10:15

3.1 CQC Monitoring Action Plan

Paula Shobbrook A

4 PERFORMANCE 10:15 – 10:45

4.1 Performance Report (Report to April Board of Directors)

Helen Lingham B

4.2 Financial Performance (Report to April Board of

Directors) Stuart Hunter C

5 QUALITY 10:45 – 11:00

5.1 Quality Performance Report (Report to April Board of Directors)

Ellen Bull D

5.2 Privacy and Dignity Update Ellen Bull Oral

6 PERFORMANCE 11:00 – 11:15

6.1 Staff Survey Results Vicky Douglas Presentation

BREAK 11:15 – 11:25

7 Declaration of Interests Chair E

8 Approval of the Minutes of the Meeting held on 20 January 2014 Chair

F



9 MATTERS ARISING

9.1 Actions Log from Minutes of the Meeting held on 20 January 2014

Chair G

10 FOR DECISION 11:35 – 12:15

10.1 Appointment of Deputy Chair/Lead Governor of Council of Governors – Eric Fisher

Karen Flaherty H

10.2 Appointment of Non-Executive Director – Alex Pike

Karen Flaherty I

10.3 Governor Vacancy – Derek Dundas

Karen Flaherty J

10.4 Governor Involvement with Patient and Public Engagement (GIPPE) Report since the change of Terms of Reference

Glenys Brown K

10.5 Governor Scrutiny Committee Revised Topic 2014/15

Sharon Carr-Brown L

10.6 Confirmation of Quality Indicator

Karen Flaherty M

10.7 Membership Engagement Strategy

Karen Flaherty N

10.8 Changes to the Constitution

Karen Flaherty O

10.9 Forward Plan and Private Patient Income

Karen Flaherty P

10.10 Guidance for Governors when in Clinical Areas

Karen Flaherty Q

11 FOR INFORMATION 12:15 – 12:45

11.1 Our New Values Bridie Moore Presentation

11.2 Hospital at Night Update Ellen Bull R to follow

11.3 Forward Planner Karen Flaherty S

11.4 End of Year Report of Governor Work Programme Karen Flaherty T

11.5 Governor Sub-Committee Meeting Reports Reporting Governors U

11.5.1 Membership Development Committee

(MDC) David Triplow

11.5.2 Governor Training Committee (GTC)

Sue Bungey

11.5.3 Governor Involvement with Patient and Public Engagement Committee (GIPPE)

Glenys Brown

11.5.4 Governor Scrutiny Committee

Sharon Carr-Brown

11.6 Trust Sub-Committee Reports Reporting Governors V



11.6.1 Carbon Management Committee

Mike Allen

11.6.2 Charitable Funds Committee

Graham Swetman

11.6.3 Constitution Joint Working Group

David Triplow/Sue Bungey/Emma Willett

11.6.4 Diversity Committee

Vacancy

11.6.5 Editorial Group Mike Allen/Judith Adda/Bob Gee/ David Bellamy/ Doreen Holford

11.6.6 End of Life Strategy

Glenys Brown

11.6.7 Governor Finance Briefing Group

Graham Swetman/ Vacancy/Eric Fisher

11.6.8 Healthcare Assurance Committee (HAC)

Sharon Carr-Brown/Emma Willett

11.6.9 Infection Prevention and Control Committee (IPCC)

Keith Mitchell

11.6.10 Organ Transplant Committee

Dexter Perry

11.6.11 Patient Experience and Communications Committee (PECC)

Sue Bungey / Eric Fisher / David Triplow / Glenys Brown

11.6.12 Patient Information Group (PIG)

Keith Mitchell

11.6.13 Valuing Staff and Wellbeing Group

Keith Mitchell / Sue Bungey

11.7 Reports from Governors 11.7.1 Activities since last Council of

Governors' Meeting

All Governors W

11.8 Report from the Trust Secretary’s Office

11.8.1 Actions Matrix

Karen Flaherty X

12 DATE OF THE NEXT COUNCIL OF GOVERNORS MEETING

Tuesday 22 July 2014 10:00 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.


Meeting Date and Part:

29 April 2014 – Part 1

Subject:

CQC Action Plan Monitoring

Section:

Quality

Author of Paper:

Joanne Sims, Associate Director Clinical Governance and Risk

Details of previous discussion and/or dissemination:

Healthcare Assurance Committee Board of Directors

Key Purpose: Patient Engagement

Governance Performance Strategy

X

Action Required by Council of Governors:

For information

Summary:

CQC Action Plan monitoring as at 14th April 2014 showing updates for those CQC actions still in progress

Strategic Goals & Objectives:

Links to CQC Registration: (Outcome reference)

Reg Action to meet regulation What the action intends to achieve

Who is

responsible?

Action Lead

How to ensure improvements have been

made & sustained? What measures to

check this?

Who is

responsible?

Monitoring Lead

Resources needed to

implement the changesDate actions will be completed Update 14th April

17

1.2 *Implement recruitment plan to

establish a substantive workforce

across all in patient wards and create

capacity to manage short term

sickness and expected levels of staff

turnover including:

*Targeted Journals

*Overseas recruitment plan

*Local recruitment fayre

Management of staff turnover and

short term sickness via over

recruitment and effective and timely

recruitment processes

HR Manager /

Deputy Director of

Nursing

*Review of milestones for recruitment

process *Vacancy template

report weekly and fill rates

HR Director Successful recruitment

campaign

*Interviews 30/1/14

*Advertise 30/01/14

*30/03/2014

Rolling recruitment programme for

directorates. Trust recruitment fayre 11th

June 2014. 9 Portuguese nurses starting

work 25/3/14 and 14/4/14. 14 Italian

nurses starting WC 24/3/14. 23 nurses

from Spain, Greece, Portugal and Italy

signing agreements. 12 more overseas

nurses interviewed 11/4/14. Advert for

newly qualified nurses placed 14/4/14

171.5 Recruitment of Senior Nurse

Elderly Care Directorate

Specialist nurse leadership for Elderly

Care

General Manager

Elderly Care

Monthly review of standards via CARE and

Safety Thermometer audits Director of Nursing

Availability and recruitment

of high calibre candidateAppoint by 31/3/14

Appointment to be included as part of

wider restructure. Interim post in place

17

1.9 Implementation of new Privacy

and Dignity Policy and education

programme to support embedding.

Focus on key standards to include:

response to call bells, provision of

suitable gowns , communication,

noise at night, use of curtains and

privacy of conversations

Cascade of corporate and directorate

actions at ward level. Greater staff

awareness of Trust action plans for

Privacy and Dignity. Consistency of

approach and compliance across the

Trust

Ward sisters

Trust overview by

Deputy Director of

Nursing

Repeat Privacy and Dignity Observational

Audit across all wards. Tool to be refined to

assess impact of previous actions

implemented. Audit to

include assessment of staff awareness of

actions implemented

Deputy Director of

nursing monthly

report to execs and

Board of Directors

Staff time to understand and

implement. Education and

communication with staff.

Re‐audit following policy

implementation via CARE

Audit.

Implement policy by 31/1/14

Complete re audit by 31/3/14

Daily dignity launched for embedding

practice. Re‐audit completed. Action can

be closed

17

1.11 New patient gowns to be used

across the Trust with improved

design

To improve patient dignity and

protect patients privacy

Deputy Director of

Nursing

Repeat Privacy and Dignity Audit across all

wards. Tool to be refined to assess impact

of previous actions implemented. Audit to

include assessment of staff awareness of

actions implemented

Senior Nurses.

Director of Nursing

to provide report to

Executive Team and

Board of Directors

Procurement and laundry

contract to ensure gowns

fully available

01/03/2014

Gowns delayed by supplier ‐

implementation and roll‐out from around

7th or 8th May

17

1.12 Implementation of standard

checklist for daily ward safety

briefing and handover by ward

sisters at start of each shift with all

available staff. To include discussion

on staffing levels, risk issues, patient

safety issues, staff questions and

concerns for shift

To improve clarity and consistency of

safety briefing and handover

information to support patient care

and patient safety. To ensure ward

teams receive consistent daily

information of ward safety and

staffing. To ensure wards consistently

communicate key actions to all staff

and staff are engaged and aware of

safety issues and responsibilities

Ward sisters /

Deputy Director of

Nursing

Audit of safety briefing implementation Director of NursingDesign of checklist and

support for roll out01/03/2014

Launched end of March ‐ implementation

demonstrates refinements required. New

safety briefing checklist agreed at ward

sisters meeting 16/4, to pilot will aim to

roll out by end of April 14

9

2.1 Generate 50% supervisory time

for ward sisters releasing time to

ensure all inpatients in their area

have their needs assessed, then met

in a safe and timely way

Enhanced leadership time to monitor

and ensure high and consistent

standards of nursing care are

delivered across the ward. To

improve risk assessment and audit

compliance. To support a learning

culture from additional review and

feedback of learning from adverse

events and complaint

Deputy Director of

Nursing Agreed plan with each ward sister Director of Nursing

£350k fund allowing

recruitment and backfill

*AMU and Stroke from 1/11/13

*Ward 3 and 26 from 31/1/14

*Plan for all wards by 31/3/14

Spreadsheet with requirements finalised.

Approval proposed and being re‐costed

against equitable distribution

9

2.5 Highlight all Nutrition and

Hydration Standard Operating

Procedures to ward staff

Further education around utilisation

of the nutrition risk assessment

scoring (MUST score)

Implement standard signs and

operating procedures for nil by

mouth on all wards

*To ensure practice is research based

and uniform throughout the Trust

*To improve awareness of methods to

calculate a MUST score and ensure

appropriate referrals, nutrition plans

and provision *To have a

corporate approach and standard

Dietetic Team

Nutrition team

MUST score reports Audit of

compliance, using patient and carers views:

CARE Audit.

Monitoring by

Nutrition Steering

Group

Director of Nursing

to provide monthly

report to Healthcare

Assurance

Committee and

Board of Directors

n/a31/01/2014 28/02/2014

28/02/2014

Permanent boards in progress of being

put up. Agreement of new standards for

risk assessment on admission to Trust and

ward agreed with Nutrition team.

Masterclass sessions on completion of

care plan documentation held with senior

nurses and ward sisters, additional

sessions planned. This action can be

CLOSED

9

2.6 Expand use of meal time

companions to encourage and

support relatives, carers and

volunteers to support patient’s

nutritional intake in elderly care

Mealtime companions can give

greater support for nutrition

Senior nurse

elderly care

Monitor implementation and views of

patients, carers and volunteers via CARE

Audit

Senior nurse elderly

careRecruitment of volunteers 31/03/2014

Training schedule in place ‐ this action can

be CLOSED

9

2.8 Implementation of bay based

nurse stations to all wards

Nursing staff to be based in bays to

provide increased visible presence

Basing staff within a bay to reduce

need for call bells use and ensure

more proactive and visible nursing

care.

To improve access to documentation

and nurses based in bays directly

inputting and reviewing risk

assessments and care plans. Ensuring

patients have sufficient care, nutrition

and communication

Ward Sisters /

Senior nurses

Monthly Board report on implementation

by wardDirector of Nursing

Mobile trolleys to be ordered

to support phased roll out.

*Ward 3 & 26 by 31/1/14 *All

medical wards by 31/3/14

*All wards by 30/6/14

Implementation of next wards to be

commenced. All trollies have arrived

9

2.9 Extend Speech and Language

Therapy (SALT) service

Phased approach to 6 and then 7 day

service

More rapid swallow assessment General Manager

Specialist ServicesAudit of response times

Chief Operating

OfficerExtra funding for SALT team

6 day service by 31/1/14

7 day service by 30/6/14

Existing staff going through consultation

to convert to 7 day service. The 7 day

service for SALT will commence from mid

May. This is on track.

10

3.5 Review of Directorate

management and nursing leadership

structure and accountabilities

To provide better governance and

responsiveness to patient and service

needs

Chief Operating

Officer Director of

Nursing

Staff consultation and reporting to Trust

Management Board and Board of DirectorsChief Executive n/a 30/06/2014

New directorate and nursing leadership

structure out to consultation 17th March

10

3.9 Governors Scrutiny Group audit

of patient and staff views on all

Elderly Care wards

To understand the important issues

for patients, relatives, carers and the

public. To involve stakeholders in

development of the Trust Strategy for

Elderly Care and quality priorities for

2014/15

Lead governor

Sharon Carr‐

Brown

Council of Governors Board of

DirectorsDirector of Nursing

Governor and volunteers

support

*Interim Apr 14 *Re‐

audit Jul 14 *Final

report Oct 14

Ongoing

10

3.12 *Improving incident reporting

levels. Implementation of Datix web

to improve incident reporting,

tracking, feedback and learning.

*Implement additional training and

awareness to support open culture

for reporting, investigation and

learning

Improve availability and ease of

reporting across the Trust Improve

feedback mechanisms to provide staff

with assurance that reports have been

received and appropriate actions

taken, as part of roll out

Associate Director

Clinical

Governance

AIRS reporting profiles, NRLS data set via

Healthcare Assurance CommitteeDirector of Nursing

Datix web installation

Later stage integration with

current IT systems (e.g. PAS,

ESR)

To start phased implementation

on 1/4/14

Datix web project launch date 29th April

2014. This action can be CLOSED

10

3.13 External peer review of

mortality with Frimley Park for

internal and external alerts

Reformed approach to internal

mortality reviews – deficiencies in

care, avoidable deaths (Nick Black

paper) and if death in acute hospital

was appropriate

Medical Director

E‐mortality, M&M actions logs and

completion. HSMR/SHMI via

Trust Mortality Group

Medical DirectorTime for external peer

review31/03/2014

AW response from Frimley following

review

Update 14th April

Total number of Actions completed 33

4

7

0

Actions likely to miss target date 3

43 Actions in total

Actions Completed these weeks

Actions on Track

Actions behind schedule


Meeting Date and Part: 29 April 2014 – Part 1

Subject: Performance Report

Section: Performance

Executive Director with overall responsibility

Helen Lingham, Chief Operating Officer

Author of Paper: David Mills/Donna Parker


PMG BoD

Key Purpose:

Patient Safety

Health & Safety

Performance Strategy

X

Action required by CoG: Information

Executive Summary:

This report accompanies the Performance Indicator Matrix and outlines the Trust’s performance exceptions against key access and performance targets for the month of February 2014, as set out in the Monitor Compliance Framework, ‘Everyone Counts’ planning guidance and contractual requirements. The report also incorporates the Trust’s Balanced Dashboard for Quality, Performance, Clinical Outcomes, Productivity and Efficiency, including the overarching Trust-wide dashboard.

Strategic Goals & Objectives: Performance


Section 2 – Outcome 4: Care and welfare of people who use services. Outcome - 6 Co-operating with others.

Links to Assurance Framework/Key Risks:

Performance

Type of Assurance: Internal External

X

Council of Governors – Part 1 29 April 2014

Performance Monitoring Page 1 of 4

Performance Exception Report 2013/14 - April

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 February 2014, as set out in Everyone counts: Planning for Patients 2013/14, the Monitor Risk Assessment Framework and in our contracts.

2 Cancer

Performance against Cancer Targets

The Trust’s Urology action plan, as outlined in the last report, is progressing. We are seeing a gradual reduction in the longer waiting patients and in those patients awaiting a confirmed diagnosis who are at 32+ days in their pathway. However, this ongoing work continues to mean a below threshold performance against the 62 Day Referral to Treatment target in January and through Q.4 as previously highlighted. The formal report from the national IMAS team has now been received with a number of recommendations which are under review and will be added to our action plan. These include:

Reviewing role, responsibilities and MDT working of Nurse Specialists and the Nurse Practitioners

Reviewing the potential for a consultant-led next day MDT follow up clinic Attaching timescales to mapped patient pathways Further demand and capacity modelling Broadening the use of the Somerset database system.

Key Performance Indicators January 2014

2 weeks ‐ Maximum wait from GP 93.6%

2 week wait for symptomatic breast patients 100%

31 Day – 1st treatment 94.9%

31 Day – subsequent treatment ‐ Surgery 94.7%

31 Day – subsequent treatment ‐ Others 100%

62 Day – 1st treatment 80.9%

62 day – Consultant upgrade (local target) 100%

62 day – screening patients 86.4%



In January we also saw a reduction in performance against the 31 day standard. 6 of these patients were Urology patients and 3 were Skin. The latter were due to complex clinical pathways and a requirement for specialist surgery. Furthermore, two Colorectal patients were not treated within 62 days of screening due to a delayed radiotherapy appointment over Christmas and medical fitness. This resulted in a below threshold performance for January however, a compliant position is expected on these standards for the Quarter.

3 A&E 4 Hour Target

Maximum time from arrival to admission/transfer/discharge

An improved position has been seen in the A&E 4 hour performance to an above threshold position in February and we currently anticipate compliance with this Monitor quarterly target.

4 Stroke Indicators

Performance against Stroke Best Practice Tariff and Network indicators

Stroke Total

Patients (February)

Number of Patients

Failing Target (February)

February 2014

TIA High Risk Patients 38 17 60%

TIA Low Risk Patients 38 11 71%

Alteplase (Thrombolysis) 5 0 100%

90% Time Spent on Stroke Ward 34 8 78%

Direct Admission to Stroke Unit within 4 hours

32 9 72%

Brain Imaging – urgent within 1 hour 12 1 92%

Brain Imaging – other within 24 hours 34 3 91%



Following previous improvements a number of indicators remained above threshold in February except for three.

Direct Admission to the Stroke Unit within 4 hours Performance against direct admission to the Stroke unit within 4 hours was 72% with 9 patients failing. These 9 patients also failed direct admission overall, 3 had a delay in initiating stroke pathway, 5 had a delay in diagnosis, and 1 failed due to bed capacity. This is an improvement on the 66% (19 fails) reported in January. The below table shows the time taken to admit these patients to the Unit.

Time to Ward Grand Total

NOT ADMITTED 1

4‐6 HOURS 0

6‐10 HOURS 2

10‐24 HOURS 2

24+ HOURS 4

Grand Total 9

90% Time on Stroke Unit Performance against 90% time spent on the Stroke Unit was 78% in February with 8 patients out of 34 not spending 90% of their time on the Unit. 2 of the 8 patients were medically fit to be transferred to another ward, 2 patients were short length of stay, 2 failed due to delay in diagnosis, 1 failed due to bed capacity and 1 had a delay in initiating the stroke pathway.

Low Risk TIA 71% of low risk patients in February received their TIA assessment within 24 hours. Those not achieving assessment within 24 hours were due to GP late referral, patient choice and DNA.

5 Venous Thromboembolism

Risk assessment for hospital-related venous thromboembolism (95%)

Our performance against this CQUIN target improved in February to an above threshold performance of 95.32% from 93.48% in January.

6 Admitted RTT – Speciality Level

90% of patients on an admitted pathway treated within 18 weeks



The Trust continues to achieve the RTT targets at an aggregate level. However, admitted RTT performance continued to be below threshold in General Surgery and Ophthalmology, and for the second month Orthopaedics. This is largely due to the ongoing issues with demand and capacity, and action is ongoing to treat patients and stabilise the waiting lists. The Ophthalmology plan remains under review due to the inability to recruit recently to the locum post. The substantive post continues to be progressed. General Surgery continues with a recovery trajectory to April, though demand issues in individual sub specialities including Vascular and Colorectal continue to be reviewed. Orthopaedics are currently implementing additional Saturday lists and outsourcing a number of cases. Gynaecology has unfortunately seen an increase in sub speciality delays which has contributed to a below threshold performance this month. This is expected to continue in Q1 with the current trajectory projecting recovery in June or earlier.

7 Recommendation

HELEN LINGHAM CHIEF OPERATING OFFICER

The Council of Governors are requested to note the performance exceptions to the Trust’s compliance with the 2013/14 Monitor Framework

and ‘Everyone Counts’ planning guidance requirements.

Trust Balanced Dashboard Quality, Performance, Clinical Outcomes, Productivity and Efficiency

Reporting Month: Feb 2014

Trust Performance Dashboard: Feb 2014

2

Report produced: 02/04/2014 09:28:43

KPI Units Actual PlanLast

MonthLast Year

Rolling 12 Month Trend


MonthLast Year



MonthLast Year


HSMR - RBH (2) Ratio 75.6 100.0 77.4 89.9Medication administration incidents

No. 27 45 17 Average number of Outliers No. 9.7 26.5

HSMR - MAC (2) Ratio 204.5 100.0 164.9 153.8IP cardiac arrest calls / 1,000 bed days

Ratio TBC TBC TBC 0.75 Average length of Stay Days 4.7 5.4 4.0

% Harm Free Care (Patient Safety Thermometer)

% 87.0% 95.0% 88.0% 88.2%Acute Kidney Injuries / 1,000 bed days

Ratio 6.8 9.6 9.1 Theatre session utilisation % 86.0% 85.0% 87.8% 86.4%

Serious incidents No. 6 3 3 4Returns to theatre / 1,000 bed days

Ratio 3.3 3.5 1.4Average follow-ups per new attendance

Ratio 0.65 0.63

Emergency Department Friends & Family Test

Score 77 80 55Unplanned IP admissions to ITU or HDU / 1,000 bed days

Ratio TBC TBC TBC 1.8 Sickness absence % 4.0% 3.0% 4.5% 3.6%

Inpatient Friends & Family Test Score 71 69 76Dementia CQUIN (step 1 compliance)

% 78% 90% 71% Vacancy % 6.1% 15.0% 6.4% 7.0%

Delayed Transfers of Care No. 17 10 22 19% of CHC fasttrack patients that die on a ward

% 4% 30% 27% Appraisals % 78% 90% 76% 73%

30 day readmissions No. 465 451 535Mandatory training compliance

% 74% 75% 80%


MonthLast Year



MonthLast Year


MRSA Bacteraemias No. 0 0 0 0 ED Attendances No. 6,263 6,153 6,409 4,996

Clostridium difficile No. 1 2 0 3 Elective admissions No. 5,301 4,904 5,871 5,189

RTT metrics (below plan) No. 0 0 0 0 Non-elective admissions No. 2,327 2,115 2,492 2,726

Cancer metrics (below plan) (1) No. 3 0 4 2 GP OP Referrals No. 5,328 5,021 5,518 5,021

Stroke metrics (below plan) No. 3 0 2 3 Risk ratings Rating 4 4 4

A&E 4 hr maximum waiting time % 95.8% 95.0% 94.4% Surplus £000s 877-£ 931-£ 144£

Patients with a learning disability (Monitor compliance)

Y / N Y Y Y Y Transformational plans £000s 767£ 732£ 801£ 710£

TBC

68%

Time to antibiotics for patients with severe sepsis

hh:mm TBC TBC

Hospital at Night Average Response Time - Amber Calls

hh:mm 02:22 02:4104:00

TBC

02:20

Stroke mortality rate % 35% 15% 19%

Hospital at Night Average Response Time - Red Calls

hh:mm 00:48 00:48

% of Stroke patients discharged to usual residence

% 51% 71%

01:00 00:52

Quality Productivity & Workforce

Performance Activity & Finance

Clinical Indicators

(1) Metric reported 1 month in arrears in monthly views; quarterly values are unadjusted (2) Metric reported 2 months in arrears in monthly views; quarterly values are unadjusted

vrbhinfo / performance management / board tmb / 2013-2014 / Performance Indicator Matrix for April 14 Board Page 1 of 2

2013/14 PERFORMANCE INDICATOR MATRIX FOR BOARD OF DIRECTORS

Area Indicator Measure Target Monitor Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14

Monitor Governance Targets & Indicators

MRSA Bacteraemias Number of hospital acquired MRSA cases - Monitor de-minimis 6 1.0 0 0 > trajectory <= trajectory

Clostridium difficile Number of hospital acquired C. Difficile cases 29 1.0 0 1 > trajectory <= trajectory

RTT Admitted 18 weeks from GP referral to 1st treatment – specialty level 90% 1.0 90.1% 90.1% <90% >=90%

RTT Non Admitted 18 weeks from GP referral to 1st treatment – specialty level 95% 1.0 98.1% 98.0% <95% >=95%

RTT Incomplete pathway 18 weeks from GP referral to 1st treatment – specialty level 92% 1.0 95.1% 95.1% <92% >=92%

2 week wait From referral to to date first seen - all urgent referrals 93% 91.4% 94.5% 93.1% 93.6% <93% >=93%

2 week wait From referral to to date first seen - for symptomatic breast patients 93% 93.1% 100.0% 92.0% 100.0% <93% >=93%

31 day wait From diagnosis to first treatment 96% 0.5 97.1% 97.1% 97.0% 94.9% <96% >=96%

31 day wait For second or subsequent treatment - Surgery 94% 100.0% 100.0% 100.0% 94.7% <94% >=94%

31 day wait For second or subsequent treatment - anti cancer drug treatments 98% 100.0% 100.0% 100.0% 100.0% <98% >=98%

62 day wait For first treatment from urgent GP referral for suspected cancer 85% 85.6% 86.5% 89.2% 80.9% <85% >=85%

62 day wait For first treatment from NHS cancer screening service referral 90% 100.0% 100.0% 100.0% 86.4% <90% >=90%

A&E 4 hr maximum waiting time From arrival to admission / transfer / discharge 95% 1.0 94.4% 95.8% <95% >=95%

LD Patients with a learning disability Compliance with requirements regarding access to healthcare n/a 0.5 No Yes

Indicators within the Operating Framework / Key Contractual Priorities

TIA High Risk Patients High risk TIA cases investigated and treated within 24hrs 60% BPT 47% 61% 40% 61% 75% 71% 73% 74% 65% 74% 67% 76% 79% 60% < 50% 50% - 60% > 60%

TIA Low Risk Patients % of patients seen, assessed & treated by stroke specialist < 7 days 100% BPT 83% 77% 81% 86% 91% 97% 86% 84% 96% 85% 89% 86% 79% 71% < 80% 80% - 90% >90%

Brain Imaging – as per indicationsPatients with acute stroke meeting the indications receive brain imaging within 1 hr

95% BPT 82% 71% 95% 94% 80% 59% 100% 69% 67% 47% 81% 85% 91% 92% < 80% 80% - 90% >90%

Brain Imaging – other stroke Other stroke patients receive brain imaging within 24 hrs 100% BPT 95% 91% 92% 90% 92% 84% 95% 93% 90% 92% 88% 95% 98% 91% < 80% 80% - 90% >90%

Direct admission to stroke unitPercentage of patients with suspected stroke admitted to a specialist stroke unit within 4 hrs of arrival

90% BPT 54% 44% 44% 54% 52% 40% 61% 61% 74% 67% 66% 70% 66% 72% < 80% 80% - 90% >90%

Alteplase (Thrombolysis) Percentage of appropriate patients receiving thrombolysis 100% BPT 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% < 80% 80% - 90% >90%

90% time spent on stroke wardPercentage of patients spending 90% or more of their time on the stroke ward during their inpatient stay

80% BPT 65% 33% 57% 62% 62% 50% 74% 71% 83% 84% 77% 80% 85% 78% < 70% 70% - 80% >80%

MSA Mixed Sex Accommodation No of patients breaching the mixed sex accommodation requirement 0 0 0 > 0 0

IC MRSA Bacteraemias Number of hospital acquired MRSA cases - national stretch 0 0 0 >= 1 0

Cancer 62 day – Consultant upgrade Following a consultant’s decision to upgrade the patient priority * 95% 100.0% 100.0% 100.0% 100% < 95% >=95%

VTE Venous Thromboembolism Risk assessment of hospital-related venous thromboembolism 95% 93.7% 94.2% 94.2% 92.2% 93.3% 93.9% 94.2% 93.8% 94.1% 94.3% 94.1% 92.8% 93.5% 95.3% <95% >95%

Diagnostics Six week diagnostic tests Less than 1% of patients to wait longer than 6 wks for a diagnostic test <1% 0.3% 0.3% 0.5% 0.5% 0.3% 0.4% 0.3% 0.9% 0.7% 0.8% 0.2% 0.99% 3.7% 1.00% >= 1% 0.9%-0.99% <0.9

Patient Impact Indicator Achieve at least one of the Patient Impact Indicators No Yes

Timeliness Indicator Achieve at least one of the Timeliness Indicators No Yes

Ambulance Handovers No of breaches of the 30 minute handover standard tbc 3.1% 2.6% 3.3% 1.1% 0.4% 1.3% 0.6% 2.8% 1.1% 0.9% 1.4% 1.9% 1.7% 0.6%

Elective cancelled operations Cancelled Ops on day of admission as % of elective admissions < 0.8% 0.7% 0.6% 0.8% 0.4% 0.3% 0.2% 0.6% 0.5% 0.3% 0.5% 0.5% 0.6% 0.5% 0.79% >0.7% 0.65%-0.7% <0.65%

28 day standard Number of patients not offered a date within 28 days of cancellation 0 2.44% 2.41% 2.55% 2 0 >0 0

95.7%

94.2%

Y

Y

Y

75.6%

0

RAG Thresholds

Y

Y

96.2%

Yes

93.9%

97.6%

97.1%

100.0%

100.0%

100.0%

90.3%

0

100.0%

Stroke

E.D. Quality Indicators

Cancelled Operations

Referral to Treatment

Infection Control

Cancer

85.9%

100.0%

91.3%

96.4%

0

5

0.5

1.0

1.0

0

13

91.5%

96.8%

0

0 1

0

95.3%

0

3

98.6%

95.3% 96.8%

90.9%

98.6% 98.5%

3

1

91.1%

98.4%

96.6%

Y

Y

0

0

58.1%

5 6

95.1%

94.5%

97.6%

92.0%

97.8%

96.6%

98.3%

100.0%

78.7%

91.7%

4

Y

86.4%

vrbhinfo / performance management / board tmb / 2013-2014 / Performance Indicator Matrix for April 14 Board Page 2 of 2

Area Indicator Measure Target Monitor Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 RAG Thresholds

Sickness absence Percentage of monthly sickness 4%-3% 4.41% 3.58% 3.55% 3.58% 3.26% 3.43% 3.62% 3.50% 3.48% 4.09% 4.06% 4.21% 4.47% 3.96% > 4% 3% - <4% < 3%

Sickness absence Percentage of cumulative sickness (rolling 12 months) 4%-3% 3.76% 3.74% 3.72% 3.75% 3.74% 3.75% 3.73% 3.72% 3.71% 3.73% 3.75% 3.75% 3.76% 3.78% > 3.5% 3% - 3.5% < 3%

Appraisals Percentage compliance with annual appraisals 90% 74.71% 73.14% 70.58% 68.51% 72.46% 79.80% 81.48% 82.34% 80.97% 77.61% 76.79% 78.44% 76.38% 78.27% < 70% 70% - 89.9% >= 90%

RTT Admitted 100 - General Surgery 90% 92.9% 88.6% 90.5% 85.5% 82.7% 80.5% 82.4% 82.7% 77.4% 82.5% 88.7% 88.0% 85.1% 84.9% <90% >=90%

RTT Admitted 101 - Urology 90% 92.8% 90.0% 85.9% 82.7% 86.2% 85.3% 83.4% 87.2% 89.5% 92.0% 93.1% 95.4% 91.8% 90.0% <90% >=90%

RTT Admitted 110 - Orthopaedics 90% 91.5% 86.8% 83.6% 89.4% 91.0% 91.3% 90.3% 88.4% 88.6% 90.3% 90.1% 91.0% 89.6% 89.0% <90% >=90%

RTT Admitted 130 - Ophthalmology 90% 91.0% 91.3% 90.5% 92.3% 92.2% 93.6% 91.2% 90.3% 90.7% 86.7% 85.8% 87.3% 85.4% 86.3% <90% >=90%

RTT Admitted 140 - Oral surgery 90% 100.0% 92.3% 100.0% 97.2% 100% 95.7% <90% >=90%

RTT Admitted 300 - General medicine 90% 98.3% 99.7% 99.2% 97.9% 98.9% 98.0% 97.0% 99.2% 99.1% 98.1% 97.6% 98.1% 99.7% 99.7% <90% >=90%

RTT Admitted 320 - Cardiology 90% 92.9% 92.1% 95.1% 94.0% 93.6% 96.5% 95.3% 93.6% 91.7% 92.0% 94.2% 93.1% 93.8% 91.3% <90% >=90%

RTT Admitted 330 - Dermatology 90% 94.5% 95.8% 93.3% 96.2% 95.6% 94.7% 96.4% 97.4% 94.7% 94.2% 95.0% 95.2% 90.2% 91.2% <90% >=90%

RTT Admitted 410 - Rheumatology 90% 98.1% 94.6% 100.0% 95.8% 96.9% 95.2% 90.5% 97.6% 100.0% 90.1% 94.2% 97.3% 96.9% 100.0% <90% >=90%

RTT Admitted 502 - Gynaecology 90% 94.8% 90.2% 85.8% 81.9% 92.5% 90.6% 93.5% 92.3% 90.4% 91.1% 90.3% 90.9% 91.3% 88.7% <90% >=90%

RTT Admitted Other 90% 96.9% 98.1% 96.9% 98.3% 97.6% 98.5% 99.2% 100% 99% 99.4% 99.3% 97.4% 97.3% 98.6% <90% >=90%

RTT Non admitted 100 - General Surgery 95% 98.7% 98.3% 96.6% 97.6% 99.0% 97.5% 98.5% 98.1% 97.1% 95.7% 96.0% 97.2% 95.3% 95.0% <95% >=95%

RTT Non admitted 101 - Urology 95% 99.0% 99.1% 98.9% 98.8% 98.8% 96.1% 98.4% 97.6% 97.4% 98.8% 98.8% 97.3% 99.2% 99.1% <95% >=95%

RTT Non admitted 110 - Orthopaedics 95% 98.1% 98.5% 100.0% 100.0% 97.1% 100% 100% 100% 99% 97.0% 98.8% 98.3% 98.8% 97.6% <95% >=95%

RTT Non admitted 120 - ENT 95% 99.1% 98.9% 95.3% 99.0% 100% 100% 99% 96% 97% 96.4% 95.5% 95.2% 95.2% 95.4% <95% >=95%

RTT Non admitted 130 - Ophthalmology 95% 100.0% 100.0% 99.8% 100.0% 100% 99.8% 100% 99.8% 100.0% 100% 100% 98.9% 100% 99.4% <95% >=95%

RTT Non admitted 140 - Oral surgery 95% 95.0% 98.3% 95.1% 95.0% 95.1% 95.1% 97.1% 97.0% 95.7% 97.0% 97.9% 96.1% 96.2% 97.4% <95% >=95%

RTT Non admitted 300 - General medicine 95% 97.9% 95.9% 96.2% 96.3% 97.6% 96.3% 98.4% 98.1% 95.2% 98.8% 97.8% 98.0% 95.3% 95.2% <95% >=95%

RTT Non admitted 320 - Cardiology 95% 98.1% 98.3% 97.8% 97.6% 96.4% 98.8% 98.9% 98.3% 97.8% 99.6% 98.1% 98.9% 98.2% 97.8% <95% >=95%

RTT Non admitted 330 - Dermatology 95% 99.7% 99.6% 100.0% 99.2% 99.6% 100% 98.2% 99.7% 99.2% 99.2% 99.0% 99.5% 100% 99.6% <95% >=95%

RTT Non admitted 340 - Thoracic medicine 95% 100.0% 100.0% 98.8% 99.1% 100% 98.9% 99.5% 98.0% 99.5% 100% 99% 99.0% 100% 100% <95% >=95%

RTT Non admitted 400 - Neurology 95% 97.1% 100.0% 98.5% 98.9% 100% 100% 95.0% 97.4% 95.0% 98.7% 95.3% 97.2% 100% 100% <95% >=95%

RTT Non admitted 410 - Rheumatology 95% 97.1% 97.0% 96.9% 98.0% 97.5% 97.2% 96.5% 97.6% 99.3% 99.0% 95.7% 98.8% 99.0% 98.4% <95% >=95%

RTT Non admitted 502 - Gynaecology 95% 99.1% 99.1% 98.9% 99.0% 99.1% 98.0% 99.4% 98.1% 97.0% 99.2% 98.7% 100% 99.0% 98.9% <95% >=95%

RTT Non admitted Other 95% 99.6% 99.7% 99.3% 100.0% 99.1% 99.7% 99.7% 99.5% 98.4% 100% 99% 100% 98.0% 97.1% <95% >=95%

RTT Specialty

Workforce


Meeting Date and Part: 29 April 2014 – Part 1

Subject: Financial Performance

Section: Performance

Executive Director with overall responsibility

Stuart Hunter, Director of Finance

Author of Paper: Pete Papworth, Deputy Director of Finance


Finance Committee, Trust Management Board and Board of Directors

Key Purpose:

Patient Safety

Health & Safety


X

Action required by CoG: For Information

Executive Summary: Review of the financial performance for Month 11 2013

Strategic Goals & Objectives: Goal 7 – Financial Stability


Outcome 26 – Financial Position

Links to Assurance Framework/Key Risks:


X

Council of Governors April 2014

Financial Performance Page 1 of 3 For information

Financial Performance

1. Introduction

This report summarises the Trust’s financial performance for the period to 28 February 2014. A financial overview is attached.

2. Overview

Being a shorter month, February sees fewer clinical operating days and thus reduced income; whilst not seeing the same reduction in expenditure, particularly in relation to salary costs. This together with seasonal pressures faced by all acute trusts resulted in a budget deficit of £0.9 million. The trust remained broadly on plan during February, with a small favourable variance of £54,000 against this deficit plan.

The financial pressures as a result of continued reliance upon a flexible workforce together with an under delivery against the Transformation Programme have been significant, and as a result the Trust is likely to under achieve against it’s full year surplus target of £1.25 million.

3. Key Financials

Net Surplus

The Trust reported a net deficit during February of £877,000, being a favourable variance of £54,000. The year to date surplus now stands at £100,000 being £457,000 behind plan.

Earnings Before Interest, Taxation, Depreciation and Amortisation (EBITDA)

The EBITDA ratio is a key performance indicator for the Foundation Trust. As at 28 February the Trust returned 4.9%, against a plan of 5.2%. The full year EBITDA margin is forecast to be broadly consistent with the planned return of 5.5%, with the increase in operating costs being mirrored by an increase in operating income.

Transformation Programme

Savings recorded to date total £8 million against a target of £8.3 million, meaning that the Trust is currently under delivering by £0.3 million. The Trust continues to forecast an under delivery against the full year target. In addition to supporting those directorates who are forecasting an under delivery, the Improvement Team are working closely with directorate management teams to confirm and embed future years programmes. This will include detailed Quality Impact Assessments which must be signed off by the Medical Director prior to approval and implementation.



Capital expenditure

Capital expenditure currently stands at £8.8 million against a plan of £8.3 million. This position sees the correction of the year to date slippage in relation to the IT strategy, together with additional capital spend approved since the initial plan was set. The current forecast is for capital expenditure to total £9.4 million by the end of the financial year.

4. Financial Risk Rating

As at the end of February, the Trust reports a rating of 4 against the new Continuity of Service Risk Rating, being the best possible (lowest risk) rating. Under the previous metrics, the Trust would have reported a Financial Risk Rating of 3, consistent with the annual plan.

5. Activity

To date, activity has exceeded budgeted levels by an aggregate 2%. This is reflective of the pressures faced across the acute sector and recognised at a national level. Elective activity was above plan during February, and remains 7% above budget. However due to changes in case mix, this is not resulting in additional income to the Trust, with elective income remaining below budget. The significant pressures facing the Emergency Department appear to have slowed in recent months. Activity to date is now 3% above plan, having reduced every month from a peak at the end of August when activity was 9% above plan. Even following significant investment at the start of the financial year, this increased demand continues to place pressure on expenditure budgets; particularly due to the increased costs associated with using a flexible workforce, which is essential to ensure that appropriate medical and nursing cover is maintained.

6. Income and Expenditure

As at 28 February the Trust has earned income of £235.4 million against a budget of £233.5 million, being a favourable variance of £1.9 million. Expenditure during the same period totalled £235.3 million against a budget of £232.9 million, being an adverse variance of £2.4 million. The favourable income position and adverse expenditure variance is mainly attributable to additional cost and volume drugs, for which the cost is directly passed through to the Clinical Commissioning Groups. The remaining expenditure variance is due to the premium cost of utilising a flexible workforce, together with additional clinical supply costs.



7. Workforce

Recorded sickness improved during February, with an absence rate of 3.96% against the recorded rate of 4.47% during January. The rolling twelve month cumulative sickness level remained consistent however, at 3.78%. Whilst this is above the Trust’s internal stretch target, it remains a strong position when benchmarked nationally; particularly given the current demand pressures faced by the Trust.

8. Conclusion

The Trust continues to forecast the achievement of all financial duties, however is likely to underachieve against its initial surplus plan due to continued financial pressures. Members are asked to note the Trust’s financial performance for the period to 28 February 2014.

Pete Papworth Deputy Director of Finance March 2014

ANNEX A

2012/13YTD ACTUAL PLAN ACTUAL VARIANCE VARIANCE PLAN FORECAST VARIANCE VARIANCE

£'000 £'000 £'000 £'000 % £'000 £'000 £'000 %

NET SURPLUS/ (DEFICIT) 3,322 557 101 (456) (82%) 1,250 850 (400) (32%)EBITDA 15,785 12,053 11,419 (634) (5%) 13,745 13,745 0 0% TRANSFORMATION PROGRAMME 7,777 8,260 7,963 (297) (4%) 10,379 8,880 (1,499) (14%)CAPITAL EXPENDITURE 3,640 9,153 8,787 (366) (4%) 9,475 9,417 (58) (1%)

2012/13YTD ACTUAL PLAN ACTUAL RISK WEIGHTED PLAN FORECAST RISK WEIGHTED

METRIC METRIC METRIC RATING RATING METRIC METRIC RATING RATING

EBITDA Margin % 7.0% 5.2% 4.9% 2 0.4 5.5% 5.5% 3 0.8 EBITDA Achievement of Plan % 118.6% 100.0% 94.7% 4 0.4 94.3% 94.3% 4 0.4 Net Return after Financing % 1.6% 0.1% (0.1%) 3 0.6 0.5% 0.5% 3 0.6 I&E Surplus Margin % 1.2% 0.2% (0.1%) 2 0.4 0.5% 0.5% 2 0.4 Liquidity Days 62.0 54.0 51.7 4 1.0 56.4 56.4 4 1.0 FINANCIAL RISK RATING 3.7 2.8 3.2

2012/13YTD ACTUAL PLAN ACTUAL RISK WEIGHTED PLAN FORECAST RISK WEIGHTED

METRIC METRIC METRIC RATING RATING METRIC METRIC RATING RATING

Debt Service Cover 3.15X 2.78X 2.60X 4 2 2.79x 2.99x 4 2 Liquidity 62.0 54.0 51.7 4 2 56.4 56.3 4 2 CONTINUITY OF SERVICE RISK RATING 4 4 4


NUMBER NUMBER NUMBER NUMBER % NUMBER NUMBER NUMBER %

Elective 57,846 57,120 61,287 4,167 7% 62,275 66,330 4,055 7% Outpatients 287,090 255,492 258,286 2,794 1% 278,524 281,550 3,026 1% Non Elective 31,928 25,212 25,887 675 3% 27,575 28,146 571 2% Emergency Department Attendances 61,770 73,393 75,859 2,466 3% 80,204 82,724 2,520 3% TOTAL PbR ACTIVITY 438,634 411,217 421,319 10,102 2% 448,578 458,750 10,172 2%


£'000 £'000 £'000 £'000 % £'000 £'000 £'000 %

Elective 65,053 66,848 66,608 (240) (0%) 72,873 72,372 (501) (1%)Outpatients 34,734 28,616 28,686 70 0% 31,195 31,246 51 0% Non Elective 49,585 46,846 46,949 103 0% 51,194 51,425 231 0% Emergency Department Attendances 5,788 6,948 7,085 137 2% 7,593 7,724 131 2% Non PbR 50,556 60,049 62,411 2,362 4% 65,466 68,030 2,564 4% Non Contracted 17,325 22,330 21,794 (536) (2%) 24,677 24,090 (587) (2%)Research 1,662 1,681 1,761 80 5% 1,834 1,920 86 5% Interest 369 138 137 (1) (0%) 150 148 (2) (1%)TOTAL INCOME 225,072 233,456 235,431 1,975 1% 254,982 256,955 1,973 1%


£'000 £'000 £'000 £'000 % £'000 £'000 £'000 %

Pay 129,440 139,648 140,943 (1,295) (1%) 152,000 153,412 (1,412) (1%)Clinical Supplies 31,340 31,330 32,622 (1,292) (4%) 34,135 35,499 (1,364) (4%)Drugs 21,799 21,854 23,412 (1,558) (7%) 23,817 25,458 (1,641) (7%)Other Non Pay Expenditure 24,023 26,233 24,847 1,386 5% 28,688 26,797 1,891 7% Research 1,662 1,681 1,761 (80) (5%) 1,834 1,920 (86) (5%)Depreciation 8,810 7,894 7,676 218 3% 8,611 8,604 8 0% PDC Dividends Payable 4,676 4,259 4,068 191 4% 4,646 4,414 232 5% TOTAL EXPENDITURE 221,750 232,899 235,330 (2,431) (1%) 253,732 256,105 (2,373) (1%)


£'000 £'000 £'000 £'000 % £'000 £'000 £'000 %

Non Current Assets 144,370 146,079 146,439 360 0% 146,266 146,266 0 0% Current Assets 70,028 67,048 68,281 1,233 2% 67,593 68,804 1,211 2% Current Liabilities (26,555) (26,611) (28,648) (2,037) 8% (26,691) (28,281) (1,590) 6% Non Current Liabilities (2,799) (2,396) (2,414) (18) 1% (2,357) (2,378) (21) 1% TOTAL ASSETS EMPLOYED 185,044 184,120 183,658 (462) (0%) 184,811 184,411 (400) (0%)

Public Dividend Capital 78,674 78,674 78,674 0 0% 78,674 78,674 0 0% Revaluation Reserve 68,500 64,488 64,485 (3) (0%) 64,488 64,488 0 0% Income and Expenditure Reserve 37,870 40,958 40,499 (459) (1%) 41,649 41,249 (400) (1%)TOTAL TAXPAYERS EQUITY 185,044 184,120 183,658 (462) (0%) 184,811 184,411 (400) (0%)


% %

Staff (Whole Time Equivalents) 3,613 3,824 3,816 8 0.2% 3,773 3,824 51 1.4% Sickness (Rolling Twelve Months) 3.74% 3.0% 3.8% (0.78%) (25.9%) 3.0% 3.8% 0.80% 26.7%

FINANCIAL RISK RATING2013/14 YEAR TO DATE 2013/14 FULL YEAR

STATEMENT OF FINANCIAL POSITION2013/14 YEAR TO DATE 2013/14 FULL YEAR

2013/14 FULL YEAR

CONTINUITY OF SERVICE RISK RATING2013/14 YEAR TO DATE 2013/14 FULL YEAR

ACTIVITY2013/14 YEAR TO DATE 2013/14 FULL YEAR

INCOME2013/14 YEAR TO DATE 2013/14 FULL YEAR

WORKFORCE2013/14 YEAR TO DATE 2013/14 FULL YEAR

EXPENDITURE2013/14 YEAR TO DATE

THE ROYAL BOURNEMOUTH AND CHRISTCHURCH HOSPITALS NHS FOUNDATION TRUST

FINANCIAL PERFORMANCE FOR THE PERIOD TO 28 FEBRUARY 2014

2013/14 YEAR TO DATE 2013/14 FULL YEARKEY FINANCIALS

9966


Date and Part of Meeting: 29 April 2014 – Part 1

Subject: Patient Safety Indicators – Performance and Quality Dashboard

Section: Quality

Executive Director with overall responsibility:

Paula Shobbrook, Director of Nursing and Midwifery

Author of Paper: Joanne Sims, Associate Director Clinical Governance Ellen Bull, Deputy Director of Nursing

Details of previous discussion and / or dissemination:

HAC – 27th March 2014 TMB – 4th April 2014 BOD – 11th April 2014

Key Purpose:

Patient Safety

Health & Safety


X

X

Action required by CoG: For information

Executive Summary:

This report provides a summary of information and analysis on new key performance and quality (P&Q) indicators agreed by the Board for 2013/14. The Trust level dashboard provides information on patient safety and patient experience indicators for February 2014 including: Patient safety incidents

6 serious incidents were reported on STEIS and were 6 RCA/ SI Panels in February 2014

Safety thermometer The ST data is 87.04% harm free care – a

further reduction on the previous month. Pressure ulcers and CAUTI benchmark worse than the national average. Falls and VTE and CAUTI are better than the national average

Never events There were no never events

Patient experience performance The in-patient compliance has seen a 7%

increase since January although the FFT score has remained virtually static at 73.

There were 23 FFT returns with ‘extremely unlikely to recommend’ from 12 areas.

Complaints and PALs There were 31 formal complaints in February,

a reduction from 45 in January. The detail is provided in the dashboard front screen and ‘drill down’ pages. The reporting timetable for patient safety indicators is in line with standard performance and financial reporting.

Strategic Goals & Objectives

All

Links to CQC Registration Outcome 1, 4, 9, 10, 16

Links to Assurance Framework/Key Risks

All


X

Quality & Patient Safety Performance Exception Report – February 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 February 2014 The report includes the 2012/13 baseline for each indicator and the improvement trajectories and targets for 2013/14

2. Patient Safety Performance against Patient Safety Indicators 2.1 New Serious Incidents Reported February 2014

6 Serious Incidents were confirmed and reported on STEIS in February 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 April – February 14 data collection are as follows:

NHS SAFETY THERMOMETER

April May June July Aug Sept Oct Nov Dec Jan Feb

Safety Thermometer %Harm Free Care

88.4 88.5 90.7% 87.50%

88.4%90.54%90.36%90.21%89.94 87.98%87.04%

Safety Thermometer % Harm Free Care (New Harms only)

98.1% 96.8% 97.8% 97.5%

96.35% 96.1 96.9% 95%

Monthly survey using Safety Thermometer (Number of patients with Harm Free Care)

522 512 524 420 463 488 478 470 456 483 470

Number of eligible patients to be surveyed

626 619 624 624 561 590 580 577 556 605 575

Number of patients actually surveyed

590 578 578 480 524 539 529 521 507 549 540

% of patients submitted in the organisation

94 93 92% 76% 93% 91% 91% 90% 91% 90.7% 93.9%

This month risk assessment compliance has been recorded as part of the Safety Thermometer data collection. Results are as follows:

July 13

Aug 13

Sept 13

Oct 13

Nov 13

Dec 13

Jan 14

Feb 14

Number of patients surveyed

480 524 539 529 521 507 549 470

Number of old pressure ulcers

48 47 35 34 30 36 45 41

Number of new pressure ulcers

6 6 6 9 16 16 14 19

New falls by severity

No harm 4 7 6 7 6 6 3 5 Low harm 2 2 1 1 3 1 1 2 Moderate harm 0 3 0 0 0 0 1 1 Severe harm 0 0 0 0 0 0 0 0 Death 0 0 0 0 0 0 0 0

New VTE 1 3 4 1 0 1 0 1 New Catheter UTI 1 3 1 2 1 2 1 5 Risk assessment compliance

Falls 85.6% 90% 93% 95% 89% 89% 88% 88% Waterlow 90.6% 84% 88% 90% 87% 94% 93% 91% MUST 74.7% 69% 73% 70% 59% 71% 69% 74% Mobility 82.9% 84% 82% 88% 85% 89% 89% 88% Bedrails 89% 90% 95% 95% 92% 91% 91% 92%

MUST Screening in 24 hours. February Performance Areas where performance was low are; Ward 3 - 36%, Ward 7 -23%, Ward 9 39%, Ward 12 21%, Ward 23 - 38%, Ward 26 -39%, Eye Unit – 46%, ICU - 44% AMU - 0%, which impacts on the results of other wards on transfer

Five wards were 95% - 100% compliant. Direct training has been targeted throughout mid February to mid March 2014 at areas of low compliance with a total of 250 staff (including staff nurses, deputy sisters, sisters, charge nurses, and health care assistants). An IT’ app’ is being piloted in AMU to work out the MUST score electronically on an ipad. Review of the recent results indicate improvement. Comparison with National Data – February 14 RBCH (%)

Feb 14 National Average

All Organisations

(Feb 14)

National Average All Acute Hospital Wards

(Feb 14) Harm Free Care 87.04% 93.34% 93.52% Pressure Ulcers – All 11.11% 4.73% 4.28% Pressure Ulcers – New 3.52% 1.11% 0.97% Falls with Harm 0.56% 0.81% 0.58% Catheters and new UTis 0.93% 0.42% 0.55% New VTEs 0.19% 0.48% 0.67% All Harms 12.96% 6.66% 6.48% New Harms 5.00% 2.76% 2.70% 4. Patient Experience February 2014 4.1 FFT netpromoter scores summary Internal data reports indicate FFT Score February (January) Compliance Rate Trust wide 73 (73) 19% (17%) In- patient 71 (69) 44% (37%) ED 77 (80) 11% (10%) Maternity 88 (92) 1% (4%) Trustwide, amalgamated compliance with the national target of 15% is maintained; however both Maternity and ED separately are below the data compliance rate. The in-patient compliance has seen a 7% increase since January although the FFT score has remained virtually static. Comparisons with national data is not currently possible as the February data has not been uploaded onto NHS England website, however the January results show that the Trust inpatient FFT score of 69 (compliance rate 36.8) for in-patients placed performed joint 30th (with 5) other Trusts out of 170 participants. The ED results for January place our FFT score of 80 (compliance rate 10.2%) as joint 4th with 4 other Trusts from a sample of 144 Trusts. This is a significant improvement and all areas have been made aware of the improvement in the results

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In an effort to increase the numbers of FFT compliance, additional token boxes have been purchased for AMU, whose data is integrated into ED. The token boxes are bespoke and smaller than other areas so as not to decrease the width of the corridors to enable safe transport of patients on beds. 4.2 Extremely Unlikely Trust wide and including areas not included in NHS England submission we have 30 “Extremely Unlikely”. This table identifies the FFT submission areas with 23 Extremely Unlikely to recommend defined by area:

Area No. of returns

Ward 3 1 Ward 5 1

Ward 22 1

Stroke Unit 3

Derwent Ward 2 Ward 15 2 Ward 16 1 Ward 17 1

Short Stay Unit (Ward 12) 1 ED 5

AMU 2 Eye Unit A&E 3

Each area receives a template for a bespoke action plan that is populated with their triangulated data from FFT / PALs and complaints. These are reviewed and completed by the Ward Sister and Senior Nurse. They are to be reviewed at PEPC and PECC.

4.3 Maternity In accordance with NHS England guidelines elements of the maternity data is estimated. This is a recognised national issue due to the data base systems being held separately in many Trusts. RBCH Trust system is linked with Poole General Hospital using the Medway system. There is work in progress to identify development in this process. The compliance rates are significantly below set standards. Maternity Jan-14 Feb-14Q1 Total number eligible to respond 250 250Q1 Total responses 4 0Response Rate 1.60% 0.00%Q2 Total number eligible to respond 26 29Q2 Total responses 9 5Response Rate 34.62% 17.24%Q3 Total number eligible to respond 22 25Q3 Total responses 9 3Response Rate 40.91% 12.00%Q4 Total number eligible to respond 250 250Q4 Total responses 2 0Response Rate 0.80% 0.00%Overall response rate 4.38% 1.44% 4.4 Data by Ward The table below provides the January data by ward:

Medical Directorate FFT Score (Jan FFT)

Compliance % for FFT question

Extremely Unlikely

Ward 1 62 (78) 33% 0 Ward 2 60 (70) 52% 0 TOTAL 61 (73) 43% 0

Elderly Care Directorate FFT Score (Jan FFT)


Extremely Unlikely

Ward 3 11 (53) 27% 1 Ward 4 86 (25) 18% 0 Ward 5 13 (63) 60% 1 Ward 22 50 (57) 60% 1 Ward 25 43 (89) 48% 0 Ward 26 59 (56) 48% 0 Stroke Unit 73 (100) 51% 3 TOTAL 49 (61) 49% 6

Cardiology Directorate FFT Score (Jan FFT)


Extremely Unlikely

Ward 21 88 (76) 62% 0 Ward 23 87 (60) 26% 0 Ward 24 88 (78) 33% 0 CCU 91 (90) 73% 0 TOTAL 87 (87) 39% 0

Orthopaedic Directorate FFT Score Compliance % for FFT question

Extremely Unlikely

Ward 7 100 3% 0 Ward 9 61 (44) 37% 0 Derwent Ward 78 (75) 69% 2 TOTAL 79 (72) 49% 2

Pathology Directorate FFT Score (Jan FFT)


Extremely Unlikely

Ward 11 91 (70) 32% 0

TOTAL 91 (70) 32% 0

Surgical Directorate FFT Score (Jan FFT)


Extremely Unlikely

Ward 14 60 (67) 15% 0

Ward 15 76 (62) 49% 2 Ward 16 68 (66) 36% 1 Ward 17 68 (69) 40% 1 SAU 60 (57) 35% 0 TOTAL 70 (64) 38% 4

Ophthalmology Directorate FFT Score (Jan FFT)


Extremely Unlikely

Eye Unit Ward 85 (71) 51% 0

TOTAL 85 (71) 51% 0

Anaesthetics Directorate FFT Score (Jan FFT)


Extremely Unlikely

Short Stay Unit (Ward 12) 84 (72) 47% 1 ITU 67 (93) 240% 0 TOTAL 82 (75) 53% 1

ED FFT Score (Jan FFT)


Extremely Unlikely

ED 72 (80) 8% 5 AMU 60 (69) 6% 2 Eye Unit A&E 85 (81) 18% 3 TOTAL 77 (80) 11% 10

Corporate FFT Score (Jan FFT)


Trustwide (Inpatients, ED & Maternity)

(73) 19%

*When reviewing the FFT scores please note that the number of respondents varies by area from 3 – 239, having a significant impact on the FFT score 4.5 Quintiles Report The table below identifies the top 5 FFT scores and the 5 lowest FFT scores. It is possible to get a score of minus -100

Ward Extremely

likely Likely

Neither likely nor unlikely

UnlikelyExtremely unlikely

Don't know

FFT Score

Birth 5 0 0 0 0 0 100

Ward 7 2 0 0 0 0 0 100

Ward 11 10 1 0 0 0 0 91

CCU 20 2 0 0 0 0 91

Ward 24 29 4 0 0 0 0 88

Ward 21 37 1 2 0 0 0 88

Ward 23 33 5 0 0 0 0 87

Ward 4 6 1 0 0 0 0 86

Ward 26 16 11 0 0 0 0 59

Ward 22 47 23 2 5 1 0 50

Ward 25 7 6 1 0 0 0 43

Ward 5 11 5 6 1 1 1 13

Ward 3 4 2 2 0 1 0 11

Top Quintile For those in the top quintile, ward 7 attained an FFT score of 100 based on only 2 respondents and only achieving 3% compliance rate well below National requirements. The Birth unit also had an FFT score of 100 based on only 5 respondents with a compliance rate of 17%. Whilst ward 11 and CCU achieved a 91 FFT score based on 32% and 73% compliance respectively. Ward 4 have increased their FFT score to take them from the lowest quintile to the top although they have completed only 7 cards.

Bottom Quintile The “extremely unlikely” responses have a significant bearing on these areas being in the bottom quintile, for example ward 26 has this month again is in the bottom quintile. However, all respondents have noted they are extremely likely or likely to recommend. This is similar to ward 25. However, wards 3, 5 and 22 have one “extremely unlikely to recommend” each. Ward 3’s comment related quality of care, the comment for ward 5 related to Noise at Night, staffing levels and inability to self-medicate, ward 22 had no comments to support the response. . 4.6 Care Campaign Audit The Care Campaign audit is now implemented across elderly care, the majority of medical wards, AMU and ED. The challenge to ensure each area receives 20 completed audits per month is supported by Governors and Volunteers. Wards are contacted on a daily basis if any of the identified anchor questions receive a negative response. This results in a call to the ward on the day. In addition the results are used to support their monthly patient experience action plans for improvement and the ward patient experience templates. Action plans are received from the areas participating in these audits, The identified “Anchor Questions” by section are: 1.6 Do you have access to a nurse call bell or buzzer at all times? 1.9 Were your dressings checked and replaced in a timely way? 2.2 Do you always receive assistance to prevent ‘an accident’ i.e. wet the bed? 3.1 Do staff regularly make you comfortable and help to relieve any pain you may have? 4.5 Can you reach your meals and drinks from where they are left for you? These questions in consultation with the patients association have been identified as key indicators for patients’ satisfaction with quality standards of care which were specifically identified as needing improvement in the CQC 2013 report. The aggregated scores by question section for each participating ward is presented at TMB. Each section has a number of questions relevant to the heading and staff can identify results by specific question. The data is refreshed daily. 4.7 Patients Opinion and NHS Choices Patients Opinion and NHS Choices are monitored daily from Monday – Friday and responses are provided with a 24-hour working day timescale, using the criteria set and monitored by Patients Opinion. During February, 11 comments were posted of which 5 were a positive reinforcement of high quality care, professionalism, treatment and teamwork. 6 comments were negative highlighting poor treatment, staff attitude and noise at night. All comments are passed to the respective areas and those who display

dissatisfaction are responded to in cooperation with the appropriate manner and also invited in for further consultation with the PALS team. 4.8 Focus groups A focus group was held in February for Trust Complainants who have experienced the formal process, however due to the low attendance numbers some patients have booked and attended to have 1-1 interviews. A report will be generated now that a second focus group has taken place and the completion of the one to one interviews. The report will contain recommendations from the complainants. 4.9 Schedule of planned engagements A schedule of planned patient and partnership engagements events is being developed in coordination with the Patient Experience Team, the communications team and the GIPPE. This identifies on an annual basis, events planned and how these will be prioritised dependant on their links with organisational imperatives. This plan will enable Governors to support events and ensure a coordinated strategic approach. 4.10 Review of annual patient engagement strategy In close association with the GIPPE a review date has been proposed for 22nd May for key stakeholders and partners to attend a work shop to identify progress to date and areas for improvement or focus to be included in the annual strategy. This workshop is in the process of design in collaboration with GIPPE members who will also facilitate elements of the workshop. 4.11 Patient Audits The patient experience team continues to provide support to those undertaking patient audits within their speciality. This varies from support to design and is approved by this team as due process. This month, assistance has been provided for the following across the Trust;

Patient Feedback Survey for Stroke ESD Service Evaluation of a Therapy Stroke Outreach Pilot Hepatology Service Patient Satisfaction What is the Patient Satisfaction with the Orthopaedic Therapy Service - Does

a ward transfer during admission influence satisfaction? 4.12 Conclusion The Board is requested to note that the Trust has achieved 4th place nationally for the ED FFT score. This is data published by NHS England for the January period. It must also be noted that Eye ED was also in the top quintile last month and played a significant role in the Trust achievement. In addition in January and through scrutiny of the NHS England data the Trust wide FFT score was amongst the top 30 scores when compared with the 170 participating organisations. The Care audit continues to drive improvement at frontline nursing care level, and the individual areas have

submitted action plans. The Patients Association representative has agreed to provide improvement support specifically for the Care audit. 5. Recommendation The Council of Governors are invited to note the report

Friends and Family Test Compliance (Matermity)

Did hospital staff tell you who to contact if you were...

Friends and Family Test Compliance (ED)

% Harm Free Care (Safety Thermometer)

Are you given enough privacy when discussing your...

Did a member of staff tell you about medication side...

Are you involved as much as you want to be in...

Did you find someone on the hospital staff to talk to...

Number of Formal Complaints

Number of Informal Complaints

No of Patients having Harm Free Care (Safety...

Patient safety incidents (all events) / 100 ...

YTD Total / Avg

12/13 Baseline

13/14 Trajectory

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

Total Number of reported Serious Incidents

Number of NPSA NEVER events

Medication AIRs (all) / 100 admissions

Inpatient falls (harm events) / 1000 bed days

Inpatient falls (all) / 1000 bed days

Patient Safety

Patient Safety Indicators - P & Q Dashboard

Patient Experience

Friends and Family Test Score

Friends and Family Test Compliance (Inpatients)

1%4%5%11%15%6%

7% 11%7%16%15%11%8%7%5%8%8%9%

86%

74% 90% 67% 80% 82% 57% 64% 61% 62% 59% 66% 72% 65%

85% 90% 76% 89% 87% 79% 71% 63% 74% 76% 72% 83% 84%

95% 90% 94% 94% 96% 93% 93% 93% 94% 94% 93% 92% 93%

94% 90% 93% 93% 96% 91% 93% 95% 93% 93% 92% 93% 91%

85% 90% 80% 87% 81% 77% 75% 78% 82% 76% 88% 79%

307 290 338 32 32 21 25 33 36 27 34 22 45 31

941 - 1155 115 87 80 95 84 106 142 107 107 119 113

95% 89.057505187... 88.47% 88.58% 90.66% 87.5% 88.4% 90.5% 90.36% 90.21% 89.94% 87.98% 87.04%88%

4704834564704784885244205245125225347-5714

8.1510.37

0.54

0

0.59

2.38

5.86 6.3 5.28

8.388.5411.5

3.49 2.08 2.79

0 0 0

2 5 3 4

5.61 7.3 6.97

8.73 8.87

2.73 2.35 3.12 2.66

0.64 0.59 0.69 0.75

0 1 1 0

7 5 6 5

7.51 6.65 5.92

9.45 9.04 8.49

2.9 2.61 2.12

0.82 0.9 0.47

0 0 0

7 3 6

6.25.4 5.4 6.32

8.79 9 8.68

3.43 3.1 2.66

0.61 0.55 0.65

- 0 2

43 32 53

5.9

7.41

0.6 0.51

72 71 75 72 68 71 68 77 73 72 73

38% 32% 39% 30% 36% 43% 40% 40% 39% 34% 37% 44%

74

Council of Governors Meeting - Part 1

COG/Register of Governors Interests Page 1 of 2


REGISTER OF GOVERNORS’ INTERESTS

as at 29 April 2014 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 Judith Adda None Jayne Baker None David Bellamy The Chairman of the Patient Panel of a local GP Group Glenys Brown Co-Director of Shakeaway Poole Ltd Carole Deas None Sharon Carr-Brown Member - Labour Party

Less than 2% share-holding in Cicero (political lobbying firm)

Husband works for the Department of Health Director, QGi, a training company for FT Governors and

NEDs Derek Dundas None Keith Mitchell None David Triplow None Public: Christchurch and Dorset County Chris Archibold Dispensing Doctor Account Manager for Leo Pharma

Partner is a member of staff employed in the Orthopaedic Department, based at the Royal Bournemouth Hospital

Sue Bungey Trustee of the Women’s Breast Care Fund raising funds for the Breast Care Unit at Royal Bournemouth Hospital

Derek Chaffey Member of the Christchurch Historic Society 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 PCT

Alf Hall None Doreen Holford None Public: New Forest, Hampshire and Salisbury Mike Allen None Bob Gee None Graham Swetman Member of the Conservative Party

Director, Family Property Investment Companies

Council of Governors Meeting - Part 1

COG/Register of Governors Interests Page 2 of 2

Staff Dexter Perry Medical and Dentistry

To be notified

Dean Feegrade Administration, Clerical and Management

None

Ian Knox Allied Healthcare Professionals, Scientific and Technicians

To be notified

Emma Willett Nursing and Midwifery

None

Richard Owen Hotel Services and Estates

None

NOMINATED GOVERNORS Local Authority Governors John Adams Bournemouth Borough Council

Councillor Bournemouth Borough Council Vice Chairman of the Dorset Police and Crime Panel Member of the Conservative Party Appointed Governor for Poole Hospital NHS Foundation

Trust Chairman of the Dorset Police and Crime Panel

Colin Jamieson Dorset County Council

Elected member of Christchurch Borough Council Elected member of Dorset County Council Wife is a Constituency Agent for the Conservative Party Chairman of the Christchurch Planning Committee Chairman of the Dorset Health Scrutiny Committee

Phil Goodall Poole Borough Council

Councillor Poole Borough Council Member of Dorset Police and Crime Panel Director of Streetwise (West Howe)

Partnership Governors Lee Foord The Royal Bournemouth and Christchurch Hospitals Volunteers

None

Dr Gail Thomas Bournemouth University

None

Primary Care Trust Governors Dr Tom Knight CCG Dorset

To be notified

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January 2014 Council of Governors Meeting Minutes – Part 1

2

Tony Spotswood (TS), Chief Executive Edward Gardner, Locum Consultant, Orthopaedics Douglas Smith, Member of Public

MINUTES The meeting commenced: 10:00 14/01 Welcome JS welcomed everyone and particularly TK who was attending his first

meeting of the Council of Governors.

14/02 Apologies for absence As listed above.

14/03 Declaration of Interest (Appendix A) The declarations of interest were noted and there were no additions or

amendments to these.

14/04 Minutes of the last meeting (Appendix B) The minutes of the meeting held on 24 October 2013 were taken as read

and approved as an accurate record of the meeting subject to a change in 13/89 to reflect that CJ had highlighted that there needed to be a sufficient number of beds available to ensure that patients were treated in the appropriate location. In relation to item 13/86, SB highlighted that an audit had been agreed to check whether patients from the Women’s Health Unit who had been placed in other wards were satisfied with their treatment. KF believed that this had been addressed in the paper presented to the meeting and agreed to contact Richard Renaut for an update on this work.

KF

MATTERS ARISING 14/05 Action Log (Appendix C)

13/83(i) 13/64 GIPPE The deferral of this item to April 2014 as agreed at the last meeting of the Council of Governors was noted.

PERFORMANCE 14/06 Performance Report (Appendix F) This agenda item was bought forward due to TS and PS being delayed.

DPa delivered a presentation which provide an overview and update on the report, highlighting the following. Urgent Activity Trends Activity trends for non-elective admissions had remained relatively consistent although above plan since December 2012, although there had been a slight reduction in September 2013. Activity Update The new ambulatory care pathway had started on 6 January 2014 providing a range of alternatives to admission for patients including:

– introduction of a matron role to take calls from GPs;


3

– signposting to the appropriate ambulatory care option; and – better signposting of the Stroke pathway.

During the first two days of the project there were 42 calls from GPs and 16 admissions were avoided or the patients were treated in an ambulatory setting instead of being admitted. Delayed Transfers of Care A snapshot of delayed transfers of care on 6 January 2014 showed there were eight formal delays with continued issues with access to community hospitals with some of the intermediate beds at Broadwaters closed due to flooding, beds in St Leonards Community Hospital closed due to norovirus, Alderney community hospital had a leaking roof and there were also increased delays for Hampshire patients being discharged to Lymington New Forest Hospital. Cancer Standards The unvalidated data for the third quarter indicates that the Trust will not meet the 62-day standard for referral to first treatment and there is a continued risk of non-compliance in the fourth quarter. A locum consultant had been appointed and the surgical robot as part of the action plan to improve performance against the 62-day cancer target in Urology. Patient pathways were also being reviewed as the Urology department were continuing to receive a high number of referrals due to the national media campaign which continued to present challenges. Stroke Performance Performance has improved in all areas other than the standard relating to low risk TIA and there were still issues with urgent brain imaging and delays in direct admission to the Stroke Unit. More recent changes to the Emergency Department (ED) pathway which allowed appropriately trained nurses to assess patients who were suspected of having suffered a stroke had led to a further improvement on the percentage of patients directly admitted to the Stroke Unit within four hours. Infection Control There were no hospital acquired MRSA cases during December, with only one case year to date. There was only 1 case of Clostridium Difficile during December and the Trust was well below the trajectory set by Monitor for 2013/14. Urgent Care Board Projects An update on the outcomes of the various projects funding through the Urgent Care Board in Dorset was provided including:

the increase in the out of hours primary care service in the past 3 months and the reduction in referral times from the ED to primary care services;

the reduction in the patients staying in the Hospital for over 30 days;

the reduction in patients’ length of stay as a result of the use of community hospital beds and the Trust’s Surgical Assessment Unit (SAU).

Bed Configuration


4

The changes in the bed configuration throughout the Trust was described:

• Ward 7 has now opened (Orthopaedics); • Ward 9 is now the seasonal ward (General

Medicine/Respiratory/Elderly Care); • Additional 6 beds in Ward 21; • Additional bay opened on Ward 16; • Additional bay in Surgical Assessment Unit for triage and

assessment; • Internally there are 25 additional beds available for Medical

patients; • Externally 12 additional beds St Leonards Community Hospital

and 25 interim care beds. The Governors asked questions on a number of topics including: DB enquired about fast track referrals and whether consultants could make fast-track referrals as well as GPs. DPa responded that GPs referred patients directly on to the fast track pathway and consultants only refer a small number of patients. DB asked a further question about patient access to the SAU and DPa confirmed that GPs can send patients directly to the SAU for further assessment although some patients were not admitted and were sent home following triage. DD enquired about patients receiving thrombolysis as the performance indicator always showed 100% compliance but he noted that the Care Quality Commission (CQC) in its report had said that the Trust was below expectations for the treatment rate for thrombolysis DPa confirmed that the case notes for patients were reviewed to validate these numbers but the Stroke Sentinel National Audit Programme data to which the CQC were referring in its report was based on the proportion of all patients who are thrombolysed; whereas the data currently used by the Trust reports the proportion of eligible patients She noted that the change in Stroke data reported by the Trust was due to be considered at the Board of Directors. DPa agreed to follow up on the national benchmarking. DP reported that the daily bed occupancy levels were not reflected in the performance reporting and therefore this would not identify the pressures on the wards in terms of activity. TS noted that the bed occupancy levels in the Trust had been “green” for eight days. SCB asked if the number of beds available could be presented. DPa agreed to review this request. DC questioned the information in the CQC report regarding escalation beds. TS confirmed that all escalation beds in the Trust had now been removed. RO confirmed that all fixtures and fittings for these had been removed. SCB questioned if £120,000 would adequately fund GPs to provide primary care in the acute hospital setting. DPa replied that these funds were for two years and investment had been made to increase the hours. SCB also highlighted that staff sickness had increased but DPa confirmed that this was mainly due to short term/seasonal illnesses and

DPa DPa


5

that there was no increase in long-term sickness. KM identified there was a great deal of information provided for the ED but not for the Acute Medical Unit (AMU). DPa confirmed that AMU data was reviewed and could be shared with the Governors. BG highlighted that there had been a significant increase in the number of referrals to the ophthalmology department since summer 2013. DPa confirmed that this was across Dorset and Hampshire and the clinical commissioning groups were investigating the reasons for the increase. TS also noted that the Trust was having difficulties recruiting new staff. DB repeated his request for information on the length of time between GP referral and outpatient appointments. DPa confirmed she would include this in the next presentation to the Council of Governors.

DPa DPa

QUALITY 14/07 CQC Report and Action Plan (Appendix D) TS explained that:

the CQC Report had been received in December and a copy had been provided to the Governors;

an action plan to meet the compliance actions in the CQC report had been agreed at the meeting of Board of Directors and submitted to the CQC for their agreement and there was a further action plan, which had been tabled at the Board meeting, covering the areas of improvement highlighted in the report and other comments made elsewhere in the text of the report which indicated a need for improvement; and

a further inspection was expected within three months following agreement of the action plan will be expected within three months.

The Governors asked many questions to which PS and TS responded as follows:

Further information on the time that patients waited on trollies in the ED would be obtained i.e. how many patients waited 4 hours and 12 hours and whether these waits ran concurrently or consecutively. TS confirmed that patients rarely waited in the ED for more than 12 hours but recognised the risks in relation to patient comfort and pressure areas.

PS explained that is was likely that the CQC follow-up inspection would be later than expected due to the delay in receiving the CQC’s response to the action plan. PS confirmed that some actions had already been completed and NHS Dorset Clinical Commissioning Group (CCG) and Monitor were also monitoring delivery of the plan.

The Trust-wide action plan was tabled and was being reviewed weekly by the Executive Directors and it was agreed that an update on progress against the action plan would be sent to Council of Governors each month as well as to the Board of Directors.

The precise cost to implement all the actions had not been calculated but it was expected to cost approximately £1-1.25 but

KF TS


6

could rise to £2 million depending on the recruitment of permanent staff to the full nursing establishment; although some of the costs may be absorbed into current budgets.

It was highlighted that the action regarding the Governors’ Scrutiny Committee had not been updated as requested at the Board meeting but PS confirmed that the action plan submitted to the CQC in relation to its compliance actions had been amended.

Concern regarding the low numbers of paediatric trained staff in the ED was discussed although the system relating to child safeguarding had been shown to be exemplary. PS reported that the Trust was recruiting paediatric specialists but this was difficult as there was no paediatrics department.

PS reported that the Care Audit was being piloted and the methodology would be shared with the Council of Governors and the number of patients to be surveyed on each ward each month would be clarified i.e. 10 or 20.

Patient and public input had been incorporated in the action plan which had well received and the use of public listening events as part of this was discussed. A public listening event in February had been discussed but Healthwatch Dorset had suggested a different format which was now been considered before confirming a date for a listening event.

The Trust’s complaints procedure was being revised to ensure a more proactive approach by staff in responding to and resolving complaints.

PS

14/08 Quality and Patient Safety Report (Appendix E) PS delivered a short presentation highlighting the key areas in the

report: the collection process for the harm-free care data which was

being collected using iPads which were also used to collect data on the completion of various risk assessments;

nurses from the Trust and in the community were working closely with nursing and rest homes covered by the CCG to reduce the numbers of patients with pressure ulcers which was working well;

five serious incidents were reported in November and in all cases formal Serious Incident Panels have been arranged to review action plans and identify learning points;

both the compliance and results for the Friends and Family Test (FFT) in ED had improved significantly since the introduction of token boxes;

the FFT was now being rolled out for Maternity services which included ante-natal, care within the hospital environment, post-natal care in the community and discharge and therefore data was being collected over a long period of time resulting in low numbers;

the Quintiles reports which showed how all areas of the Trust were receiving positive scores as the scores could range from +100 to -100 and the review of qualitative comments to focus any improvement actions; and

a more detailed overview of FFT scores in the wards within the Elderly Care Services Directorates which demonstrated the majority of patients were extremely likely or likely to recommend


7

the hospital but a scoring of likely was discounted in the calculation of the overall net promoter score.

There were a number of questions from Governors:

It was difficult to assess if the quality of care was improving. PS responded that the national average for harm-free care for acute trusts was 92% last year but was now at 90%. PS confirmed that she would present a breakdown of harm-free care performance against each harm at the next meeting.

Concerns were expressed as to the way patients interpreted the FFT question about recommending the hospital to friends and family based on their own experiences of asking this question. PS confirmed that this question followed the national requirements.

clarification was sought of the reasons for the low number of risk assessments for MUST (Malnutrition Universal Screening Tool) being conducted and whether the reasons were the same identified in the report from the Governors’ Scrutiny Committee in its report on patient nutrition. PS confirmed that a higher emphasis was being placed on completing the assessments.

As a result of the CQC report it has been identified that staff do not know the correct staffing template for their wards or understand how the staffing template was calculated and this was being addressed by displaying the information outside each ward and making the information readily available to staff;

An explanation of the current plans for nurse recruitment was provided which was focussing on nurses leaving the military, nurses from Ireland and mainland Europe and increasing the numbers of nurses recruited from Bournemouth University;

A question was also raised about recruitment of doctors and PS confirmed that a workforce review of doctors was taking place led by Helen Lingham and BJ Waltho; and

PS clarified that the six monthly review of nursing templates incorporated the number of patients, reasons for admission and treatment required, bed occupancy levels, FFT scores and the budget for nursing staff and the process emphasised that safety and quality was paramount for all patients.

PS

The meeting was adjourned for a short break. PERFORMANCE (continued) 14/09 Financial Performance Report (Appendix G) PP presented the financial performance report as at the end of

November 2013. The key points highlighted were: activity remains ahead of budgeted levels by an aggregate of 3%,

with increases in both elective activity and ED attendances; the current net surplus was £1.5 million which was £68,000

behind plan which was due to: o slippage on transformation savings o flexible staffing requirements;

the Trust’s Continuity of Services Risk Rating was four (it would have achieved a Financial Risk Rating of three using Monitor’s old metrics);

further pressures were expected in the period prior to the end of the financial year; and


8

current capital expenditure was slightly behind plan at £5.2 million.

PP provided some further detail on the Trust’s transformation programme which had delivered savings of £5.6 million year to date against full year forecasted savings of £9.1 million. He noted that although this was a strong performance, it would be very challenging to deliver the future savings required without merger as the Trust was already very efficient with a Reference Cost Index of 91, would need to include £0.5 million of non-recurrent savings from the current financial year in next year’s programme and the need to ensure that any cost improvement schemes focussed on maintaining or improving the quality of care provided. He also highlighted the financial challenges in 2015/16 which included:

a tariff deflator of 1.5% which was attributable to all services; non-payment for emergency readmissions; and payment of a 30% marginal rate for increases in emergency

activity, resulting in a 4% efficiency requirement for the Trust before taking into account any under-delivery of savings in 2013/14. PP responded as follows to questions from the Governors:

Although there was a “best practice” tariff that was paid in addition to the national tariff, the Trust would receive less overall in the next financial year as it would receive 1.5% less per patient.

The number of Orthopaedic referrals had reduced and some further information on the number of Orthopaedic patients and operations was requested including revisions.

Contracts with commissioners should be agreed and signed by 28 March 2014 and good discussions were taking place with the CCG on a flat cash contract which was likely to be for the same amount as in 2013/14 but with the Trust needing to deliver higher levels of activity as a result of the tariff changes.

The Trust was underperforming in terms of private patient activity but there was no intention to significantly increase beyond the current levels.

JS thanked PP for presenting the report in such an understandable way.

PP

FOR DECISION 14/10 Appointment of Non-Executive Directors (Appendix H (tabled)) DD left the meeting whilst this item was discussed.

KF presented the paper which was tabled at the meeting. She noted that:

Odgers Berndtson had been appointed to assist the Trust with the recruitment process including both the long and short listing of candidates;

a carousal of nine candidates was held on 7 January 2014 which included three stakeholder sessions including one made up of four Governors;

psychometric assessments were also held which were organised


9

by Rachel Frost Associates and each candidate was given individual feedback;

following the carousal, one candidate withdrew; and the interviews of the shortlisted candidates conducted by the

Nomination Committee took place on 16 and 17 January 2014 to fill three positions, each with a separate focus on Operations, Finance or Clinical.

Following this process, the following candidates were now being recommended to the Council of Governors for appointment with effect from 1 April 2014:

William (Bill) Yardley (Operations); Ian Metcalfe (Finance); and Derek Dundas (Clinical).

GT noted her concern that all the recommended candidates were men. The members of the Nomination Committee responded that the best candidates had been selected using a rigorous process. The appointment was proposed by SCB and seconded by JB. The Council of Governors unanimously approved the appointment of the individuals as Non-Executive Directors as recommended by the Nomination Committee. DD re-joined the meeting. JS informed DD of the approval of the recommendation and the Council of Governors congratulated him on his appointment.

14/11 Non-Executive Directors (NED) Letter of Appointment (Appendix I) KF presented the letter of appointment which had been reviewed in

detail by the Non-Executive Director Remuneration Committee and the proposed changes had been highlighted in the paper. The following points were discussed:

the initial term of office which was three years, having previously been four years, with the option for reappointment for a further three year term;

there were payments for extra responsibilities; the expected time commitment was three days per month; and the attendance of Non-Executive Directors at meetings of the

Council of Governors committees of which they were members was not a requirement in the same way as for committees of the Board of Directors.

KF was asked to consider whether to include a requirement for Non-Executive Directors to attend meetings of the committee of the Council of Governors although she stressed that this needed to be balanced with the expected time commitment and the requirement for Non-Executive Directors to attend meetings of the Board of Directors and Board committees. Governors voiced their support for Non-Executive Directors attending meetings of the committees of the Council of Governors and that attendance by telephone conference could be arranged to make

KF


10

attendance easier. The numbers of Non-Executive Directors attending the meeting of the Council of Governors that day was also highlighted. The proposed changes to the letter of appointment were unanimously approved.

14/12 Community Care Provision in East Dorset (Appendix J) SB presented the paper regarding community care provision in East

Dorset. She noted that the recommendation was to write to the CCG regarding the lack of community healthcare provision for patients living in the east of Dorset. TK confirmed that the CCG supported the treatment of patients closer to or at home and supported sending the letter but suggested that the Council of Governors should consider sending the letter to the local authorities given their responsibility for the provision of community care. He added that this was being considered as part of the Dorset-wide Better Together imitative. The Council of Governors agreed to send a letter to the CCG as proposed from the Deputy Chairman of the Council of Governors on behalf of the Council of Governors which should be copied to:

Dorset Healthcare University NHS Foundation Trust Bournemouth and Poole Health and Wellbeing Board Dorset Health and Wellbeing Board NHS West Hampshire Clinical Commissioning Group Healthwatch Dorset

KF and DD agreed to draft a letter which will be circulated to the Governors by email for approval. It was noted that the letter should refer to patients being treated at facilities to which relatives and carers were able to travel to visit.

KF/DD

14/13 Governor Scrutiny Committee Revised Topic 2013/14 SCB explained the rationale for revising the 2013/14 topic from The

Patient and Staff experience of weekend emergency pathway to The culture of care in Medicine for the Elderly at the Royal Bournemouth Hospital in the wake of the CQC report to look at the care of the elderly on all the wards in that Directorate. SCB confirmed that the choice of the new topic for the review was supported by the Trust. The resolution was proposed by Sue Bungey and seconded by Doreen Holford. The new topic was unanimously approved.

14/14 Communication with Members (Appendix K) DD presented this paper in DT’s absence. He noted that:

there was concern amongst some of the Governors at the lack of communication with members especially since the CQC report had been published;

the previous Monday, an email was sent by email to members with an information leaflet about the CQC report attached;


11

a special FT Focus devoted the CQC report would be sent to members in early February having brought the normal publication date forward which would include a letter from the Council of Governors on the first page;

it had always been the policy to communicate with all members simultaneously whether by post or email but communication methods had changed and it was felt that the Trust should be sending more messages to members by email;

there was a need for a clearer communication strategy for communicating with members and not just around a single issue like the CQC report;

the Council of Governors now had a named link in the Communications Department;

at present the Trust had email addresses for just under 2,500 members and other members should be encouraged to provide their email address in order to receive timely communications from the Trust;

the Head of Informatics, Peter Gill, had been invited to the next meeting of the Membership Development Committee (MDC) to discuss the use of the website as it was not easy to find the information relating to the Council of Governors on the website and it could be used more effectively; and

the link on the homepage of the website to be reinstated as it had been removed in error.

It was recommended that the Deputy Chairman of the Council of Governors and the Chairman of the MDC would agree the content of regular messages to be sent to members. Due to concern about annoying members if they were contacted too frequently, it was agreed that sending an email once a month would be appropriate. The use of social media could be explored to communicate in other ways. Tracey Hall, Head of Communications and Fundraising, would be asked to provide information/training on this. DB explained that the timescale for the production of FT Focus was lengthy from collating the information for publication, design and then printing and posting and meant that the news contained in it was not always the most recent so an alternative was required. He added that the next issue of FT Focus would include a new campaign to obtain email addresses from more members. It was agreed that the use of the website by members to keep up to date with news from the Trust should be promoted which had also been discussed at the Patient Experience and Communication Committee. The personal profiles of the Governors needed to be refreshed as some were out of date and in some cases Governors had never submitted a profile. All Governors were encouraged to provide a profile for website and to ensure the links to contact them on the website worked.

MDC Deputy Chair/MDC Chairman DR All Governors/DR

14/15 Terms of Reference – Governor Scrutiny Committee (Appendix L) KF presented the paper noting that the terms of reference for the

Governors’ Scrutiny Committee had been revised to update the report


12

process and remove duplication. She added that the changes had been discussed with SCB and reflected her comments and had also been reviewed by the Governors’ Scrutiny Committee. The changes to the terms of reference were approved.

14/16 Terms of Reference – Governor Induction and Training Committee (GIT) (Appendix M)

The terms of reference for the Governor Induction and Training Committee were presented with changes proposed to the name of the committee to avoid the unflattering acronym. It was proposed to change the name of the committee to the Governor Training Committee. KF also highlighted a correction of the date until which David Bellamy would be a member of the committee. The changes were briefly discussed and then approved.

FOR DISCUSSION 14/17 Guidance for Governors in Clinical Areas and the “Governor Link”

role (Appendix N)

KF presented the paper highlighting that the document had been first approved by the Council of Governors in January 2011. The changes were discussed and the following changes were agreed that:

the use of hand gel on entering and leaving clinical areas needed to be clarified in line with the five moments of hand hygiene; and

the document needed to reflect engagement with patients and relatives as well as staff on the wards.

KF agreed to revise the document and email this to Governors for agreement as soon as possible with the document to be ratified at the meeting of the Council of Governors in April. KF would also email suggestions regarding the “Governor Link” role and ask that Governors return their comments to KF by email. This will also be included as an agenda item at the April meeting.

April CoG Agenda item April CoG Agenda item

FOR INFORMATION 14/18 Forward Planner (Appendix O) The report was noted for information and no questions were asked.

14/19 Progress Report of Governor Work Programme (Appendix P) The report was noted for information and no questions were asked.

14/20 Governor Sub-Committee Meeting Reports (Appendix Q) The report was noted for information and no questions were asked.

14/21 Trust Sub-Committee Reports (Appendix R) The report was noted for information and no questions were asked.

14/22 Reports from Governors (Appendix S) The report was noted for information and no questions were asked.

14/23 Action Matrix (Appendix T)


13

The report was noted for information and no questions were asked.

14/24 Date of the next Council of Governor Meeting Tuesday 29 April 2014 at 10:00

Conference Room, Education Centre

Jane Stichbury left the meeting and Derek Dundas, Deputy Chairman of the Council of Governors, assumed the role of chairman of the meeting for the remainder of the meeting

14/25 Reappointment of Chairman (Appendix U) The reappointment of the Chairman had been discussed at the

Nomination Committee meeting held in December 2013, chaired by Alex Pike, Vice-Chairman of the Board of Directors. The process was outlined in the paper. DD noted that the recommendation was to reappoint Jane Stichbury for a further term of three years. It had been highlighted that the profile of the Chairman of the Trust had changed since JS had been appointed: she was highly visible throughout the Trust, had elevated the profile and involvement of the Governors and encouraged the Governors to provide good challenge to the Board of Directors. SB emphasised that the recommendation to reappoint JS had been thoroughly considered by the Nomination Committee and that the recommendation to reappoint had been unanimously supported by the Committee. SCB proposed the recommendation for approval and DB seconded the proposal. The reappointment of Jane Stichbury was unanimously approved. It was agreed that a letter would be sent to the Chairman confirming her reappointment and that the appropriate statements as to the compliance with the Code of Governance would be included in the Annual Report and Accounts for 2013/14.

The meeting closed at 13:40

Council of Governors Meeting – Part 1 29 April 2014

__________________________________________________________________________________________________________________ PAGE 1 OF 5


Actions carried forward from a meeting of the Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust Council of Governors Part 1 held on 20 January 2014.

13/83i 13/64 GIPPE

Glenys Brown (GB) requested that the report to be presented to the Council of Governors in April 2014 due to the first meeting in the trial period did not commence until the end of September 2013. This was agreed.

GB Completed

14/04 13/86 Women’s Health Unit

In relation to item 13/86, SB highlighted that an audit had been agreed to check whether patients from the Women’s Health Unit who had been placed in other wards were satisfied with their treatment. KF believed that this had been addressed in the paper presented to the meeting and agreed to contact Richard Renaut for an update on this work.

KF Eiri Abdulgani has contacted Sue Bungey and Sharon Carr-Brown to assist her with the audit

14/06 Performance Report

DD enquired about patients receiving thrombolysis as the performance indicator always showed 100% compliance but he noted that the Care Quality Commission (CQC) in its report had said that the Trust was below expectations for the treatment rate for thrombolysis DPa confirmed that the case notes for patients were reviewed to validate these numbers but the Stroke Sentinel National Audit Programme data to which the CQC were referring in its report was based on the proportion of all patients who are thrombolysed; whereas the data currently used by the Trust reports the proportion of eligible patients. She noted that the change in Stroke data reported by the Trust was due to be considered at the Board of Directors. DPa agreed to follow up on the national benchmarking.

DPa Board of Directors agreed to move to Stroke Sentinel National Audit Programme (SSNAP) from 1 April 2014


__________________________________________________________________________________________________________________ PAGE 2 OF 5


DP reported that the daily bed occupancy levels were not reflected in the performance reporting and therefore this would not identify the pressures on the wards in terms of activity. TS noted that the bed occupancy levels in the Trust had been “green” for eight days. SCB asked if the number of beds available could be presented. DPa agreed to review this request.

DPa To be included in the presentation at the Council of Governors meeting on 29 April 2014.


KM identified there was a great deal of information provided for the ED but not for the Acute Medical Unit (AMU). DPa confirmed that AMU data was reviewed and could be shared with the Governors.

DPa This was shared with the Governor who attended the recent walkround on AMU.


DB repeated his request for information on the length of time between GP referral and outpatient appointments. DPa confirmed she would include this in the next presentation to the Council of Governors.

DPa Covered in the Governor training given in February under “Performance Metrics”.

14/07 CQC Report and Action Plan

Further information on the time that patients waited on trollies in the ED would be obtained i.e. how many patients waited 4 hours and 12 hours and whether these waits ran concurrently or consecutively. TS confirmed that patients rarely waited in the ED for more than 12 hours but recognised the risks in relation to patient comfort and pressure areas.

KF

This has been confirmed as 12 hours from the decision to admit.


The Trust-wide action plan was tabled and was being reviewed weekly by the Executive Directors and it was agreed that an update on progress against the action plan would be sent to Council of Governors each month as well as to the Board of Directors.

TS Included in the Board of Directors agenda papers sent monthly to Council of Governors.


__________________________________________________________________________________________________________________ PAGE 3 OF 5


PS reported that the Care Audit was being piloted and the methodology would be shared with the Council of Governors and the number of patients to be surveyed on each ward each month would be clarified i.e. 10 or 20.

PS Completed.

Confirmed as 20 per month.

14/08 Quality and Patient Safety Report

It was difficult to assess if the quality of care was improving. PS responded that the national average for harm-free care for acute trusts was 92% last year but was now at 90%. PS confirmed that she would present a breakdown of harm-free care performance against each harm at the next meeting.

PS To be included in the presentation at the Council of Governors meeting on 29 April 2014.

14/09 Financial Performance Report

The number of Orthopaedic referrals had reduced and some further information on the number of Orthopaedic patients and operations was requested including revisions.

PP Completed. An email was sent to Council of Governors following the January meeting with a link to the NHS Choices data.

14/11 Non-Executive Directors (NED) Letter of Appointment

KF was asked to consider whether to include a requirement for Non-Executive Directors to attend meetings of the committee of the Council of Governors although she stressed that this needed to be balanced with the expected time commitment and the requirement for Non-Executive Directors to attend meetings of the Board of Directors and Board committees.

KF Completed.

Not included as membership of Board committee meetings is required to meet quorum requirement.

14/12 Community Care Provision in East Dorset

KF and DD agreed to draft a letter which will be circulated to the Governors by email for approval. It was noted that the letter should refer to patients being treated at facilities to which relatives and carers were able to travel to visit.

KF/DD Completed.

A response has been received and an update will be provided at the


__________________________________________________________________________________________________________________ PAGE 4 OF 5

Council of Governors meeting on 29 April 2014.

14/14 Communication with Members

There was a need for a clearer communication strategy for communicating with members and not just around a single issue like the CQC report

MDC Committee

Communication Strategy is now included in the Membership Engagement Strategy


It was recommended that the Deputy Chairman of the Council of Governors and the Chairman of the MDC would agree the content of regular messages to be sent to members. Due to concern about annoying members if they were contacted too frequently, it was agreed that sending an email once a month would be appropriate.

Deputy Chair/MDC Chairman

Monthly emails are being sent to Members who have provided email addresses.


The use of social media could be explored to communicate in other ways. Tracey Hall, Head of Communications and Fundraising, would be asked to provide information/training on this.

DR Training deferred by the request of Governors. Task and Finish Group has been set up who are meeting for the first time in May 2014.


The personal profiles of the Governors needed to be refreshed as some were out of date and in some cases Governors had never submitted a profile. All Governors were encouraged to provide a profile for website and to ensure the links to contact them on the website worked.

All Governors / DR

A radical change has taken place on the website and most Governors have submitted a revised statement to fit in with the new format.

14/17 Guidance for Governors in Clinical Areas and the “Governor Link” role (Appendix N)

KF agreed to revise the document and email this to Governors for agreement as soon as possible with the document to be ratified at the meeting of the Council of Governors in April.

April CoG Agenda item

Agenda item 9.1


__________________________________________________________________________________________________________________ PAGE 5 OF 5

14/17 Guidance for Governors in Clinical Areas and the “Governor Link” role

KF would also email suggestions regarding the “Governor Link” role and ask that Governors return their comments to KF by email. This will also be included as an agenda item at the April meeting.

April CoG Agenda item

An email will be circulated regarding the Governor link. The “NED link” is still under development.




Subject:

Appointment of the Deputy Chairman and Lead Governor of the Council of Governors

Section:

Decision

Author of Paper:

Karen Flaherty


Nomination and voting forms were distributed to all Governors by the Governor Co-ordinator.



X X


To approve the appointment of the Deputy Chairman and Lead Governor of the Council of Governors following the results of the recent election. The Trust Secretary will notify Monitor of the appointment once confirmed. (Please note that there is no further document with this paper)

Summary:

Eric Fisher has been elected as Deputy Chairman and Lead Governor of the Council of Governors, unopposed, for a term of one year.


N/A


N/A




Subject:

Reappointment of Non-Executive Director

Section:

For Decision

Author of Paper:

Karen Flaherty, Trust Secretary


Nomination Committee – 22 April 2014



X


Approval

Summary:

The current term of appointment of Alex Pike as a Non-Executive Director is due to expire on 21 June 2014. At that date she will have served for an overall term of eight years and it is proposed that she is appointed for a further term of one year.


N/A


N/A

Reappointment of Non-Executive Director Background The current term of appointment of the Non-Executive Director (NED), Alex Pike, will terminate on 21 June 2014 having been reappointed as a NED for a term of one year commencing on 22 June 2013 by the Council of Governors. By 21 June 2014 Alex Pike will have served a total term of 8 years, having first been appointed as a NED on 22 June 2006. The NHS Foundation Trust Code of Governance (Code of Governance) published by Monitor specifies that:

any term of appointment which would take a NED beyond a total term of six years should be subject to rigorous review and should take account of the need for progressive refreshing of the Board;

NEDs may in exceptional circumstances serve longer than six years but must be subject to annual re-appointment; and

serving more than six years could be relevant to the determination of a NED’s independence.

The key issues for consideration on reappointment of a NED are:

continuing commitment to the role including any changes to their other commitments and the time available;

the need for progressive refreshing of the Board; and the NED’s independence.

The dates of appointment of the other Board members (Executive and Non-Executive) are listed below to assist in determining how membership of the Board has been progressively refreshed: Director Date Appointed Karen Allman June 2007 Basil Fozard September 2013 David Bennett October 2009 Derek Dundas April 2014 Stuart Hunter February 2007 Helen Lingham April 2008 Ian Metcalfe May 2013 Steven Peacock October 2009 Richard Renaut April 2006 Paula Shobbrook September 2011 Tony Spotswood January 2000 Jane Stichbury April 2010 Bill Yardley April 2014 Alex Pike is currently appointed as the Vice-Chairman of the Board of Directors and Senior Independent Director but this appointment will be subject to review later in 2014 when the Board of Directors will be asked to elect a

Vice-Chairman and Senior Independent Director in consultation with the Council of Governors. Recommendation The Trust Secretary has spoken to Alex Pike who would be happy to be reappointed as a NED for a further term of office of up to one year to 21 June 2015. Given recent changes in the composition of the Board of Directors, particularly the NEDs, illustrated by the table above, it may be also useful to maintain some continuity in the NED membership at this time. The principal concern in reappointing NEDs for more than six years is to ensure that they remain independent. There are no concerns as to the independence of this individual and an assessment of the independence of the NEDs will be reported on in the Annual Report and Accounts as will the explanation regarding compliance with the Code of Governance in relation to the appointment of NEDs for two three-year terms as in previous years. All NEDs take part in a formal annual appraisal process undertaken by the Chairman. This includes reviewing attendance at Board and Board Committee meetings and meetings of the Council of Governors and attendance at any Council of Governor Committees of which the NED is a member. The appraisal also reviews whether the NED provides effective challenge to the Executive Directors. The process for evaluating the NEDs is agreed by the Non-Executive Director Remuneration Committee. (NED RemCo) The most recent appraisal took place in 2013 and the outcome of the evaluation was considered by the NED RemCo on 8 July 2013. The NED RemCo subsequently confirmed to the Council of Governors that the appraisals of all the NEDs had been completed to the full satisfaction of that Committee. The process for the appraisals in 2014 has recently been agreed by the NED RemCo and will be completed by June. The Chairman can confirm that, following formal performance evaluation in 2013 Alex Pike's performance continues to be effective and to demonstrate commitment to the role. This confirmation has also been provided by the Chairman to the Council of Governors as required by the Code of Governance. The Nomination Committee considered Alex Pike's reappointment at a meeting on 22 April 2014. The Nomination Committee agreed that it was satisfied that Alex Pike continued to provide effective challenge to the Executive Directors and her contributions at meetings were very incisive, and that the membership of the Board of Directors had been progressively refreshed during her period of appointment through the appointment of new Executive and Non-Executive

Directors, including the appointment of three new NEDs with effect from 1 April 2014. The Nomination Committee also discussed the rationale for not complying with the Code of Governance, and recognised that the most important thing when appointing NEDs was ensuring that the organisation had the right individuals for the role with relevant and recent experience and recognising the difficulty in recruiting suitable individuals to these roles. Alex Pike's contribution and focus in relation to the patient experience and care was noted. The Nomination Committee also recognised the benefits of continuity amongst the NEDs with two very experienced NEDs having recently left the Board. The Nomination Committee recommended the reappointment of Alex Pike as a Non-Executive Director to the Council of Governors for a further term of one year. Next Steps If reappointed a letter will be sent to Alex Pike confirming her reappointment. The appropriate statements as to the independence of the NEDs and compliance with the NHS Foundation Code of Governance will be included in the Annual Report and Accounts 2015/16.




Subject:

Governor Vacancy

Section:

Decision

Author of Paper:



None



X


To approve (Please note that there is no further document with this paper)

Summary:

A vacancy has arisen on the Council of Governors following Derek Dundas's appointment as a Non-Executive Director with effect from 1 April 2014. The Trust's Constitution provides that where a vacancy arises among Elected Governors, the Council of Governors may:

call an election within three months to fill the seat for the remainder of that term of office; or

invite the next highest polling candidate for that seat at the most recent election, who is willing to take office to fill the seat until the next annual election, at which time the seat will fall vacant

and subject to election for any unexpired period of the term of office.

It is recommended that this vacancy be included in the elections for Public Governors which will be called within the next three months. However, as the term of office will have almost expired by this time, it is recommended that the term of office will be for the normal three year term.


N/A


N/A




Subject:

Governor Involvement with Patient and Public Engagement (GIPPE)

Section:

For Decision

Author of Paper:

Glenys Brown / Eric Fisher


Governor Involvement with Patient and Public Engagement (GIPPE) Committee



X


For Approval

Summary:

Review of the new terms of reference of the Governor Involvement with Patient and Public Engagement (GIPPE) Committee’s


• Contribute to optimising the patient experience • Be the conduit between the delivery of the patient

experience agenda and the wider group of the Council of Governors

• Provide support for specific engagement initiatives • Act as a conduit to escalate issues to Patient

Experience and Communication (PEC) Committee • GIPPE Chair (or nominated representative) to

attend and report to PEC Committee • Key issues identified by Governors and Governor

Sub-Committees will be supported by this committee for escalation, as appropriate.



Governor Involvement on Patient and Public Engagement (GIPPE)

GIPPE was reconstituted following agreement at the July 2013 Council of Governors meeting in order to become more inclusive involving not only patients but the wider context of relatives, carers and our constituents. Public engagement and the recognition of the key role to be played by Governors is an essential part of Governors’ expanded responsibility under the Health & Social Care Act 2012. This is particularly pertinent following the CQC Inspection and the priority for the Trust to improve its listening. There is a greater need for cohesion across the Trust between the various engagement activities and for key messages and for common themes to be identified and acted upon. As part of this, the Patient Engagement & Voluntary Services Manager is working with Governors in conjunction with key stakeholders and partners to establish a Patient and Public Involvement Strategy/Framework. It has also been recognised that a model needs to be developed to ensure the Trust has a cohesive programme of engagement and this is now in progress. At this stage, given that there has been only three meetings since the change in remit it is difficult to measure outcomes, however a series of actions and an embryonic work programme for the 2014/15 year has been developed and is attached. Our aim is to ensure that key messages/themes which are identified via the listening/engagement programme are reported to the Trust’s Public Engagement and Communication Committee (PECC) for action and that a feedback loop is ensured. Recommendation To note the progress and the challenging agenda set; To endorse the proposed work programme for 2014/15; and To extend for a further six months the review period for the revised committee

Governor Involvement in Patient and Public Engagement (GIPPE) Work Programme 2014-15

Objective Task Timing Lead of

Project Task completion

Commentary

Developing Model to ensure Trust has a cohesive programme of engagement

Engagement with stakeholders and partners on Quality strategy & Patient and Public Involvement Strategy/Framework

July 2014

SM with input from GB/DH/EF

Planning conference call 25 April 2014 and workshop 18 May 2014;

To feed into PECC and Board for July 2014

Preparation of Annual programme for engagement with patients and public

Developing model to ensure the Trust captures everything

Commenced EB/SM Work in progress Challenges- to

Raise profile and identify themes from individual engagement streams for RBCH PECC

Involvement of Governors in Trust led Focus Groups

Outpatient Departmental Visits by Governors

On going

Completed for 2013

SM GB/EB

Programme of focus groups with hard to reach and vulnerable groups under way, with Governors now involved as appropriate; GB attended focus group with Parkinson & Lupus Groups.

The collated responses to the Outpatients survey conducted by governors in November 2013 will be sent to the relevant managers by

Monkey Survey of FT members and public

Care Audit Campaign

Patient Engagement cards

Complaints Feedback Staff governors input

Planned for July/August 2014

Each meeting

Each meeting

Each meeting

Each meeting

GB/GIPPE

SM

SM

SM Staff governor

Ellen Bull with a request for an action plan to be returned to PECC. This is to be continued every six months with the support of clinical audit and for it to be registered.

FT members are to be surveyed via survey monkey in order to determine public perception of the trust. GIPPE members are in the process of designing the questionnaire.

Initial review of pilot January 2014 results reported

Look closely at Friends and Family Test and complaints data from EB, specifically the Extremely Unlikely category and get involved in action planning for improvements, particularly on consistently underperforming wards and departments

Attention particularly on consistently underperforming wards and departments

MDC developing membership events to include a listening event Developing a collaboratively working relationship with Healthwatch in order to expand our opportunities for patient engagement

Quarterly

MDC

GB

Working collaboratively with the MDC A representative from Healthwatch attending GIPPE on 2 May 2014

Establish joined up programme across the Trust for engagement

Diary for engagement events to be recorded

EB/SM 1st draft diary completed with all departments asked to advise of their programmes for engagement; Governor action/involvement is to be added by Dily Ruffer to the annual programme of events to ensure that there is better use of resources and to minimise overlap

GB= Glenys Brown (Chair GIPPE) EB = Ellen Bull, Deputy Director of Nursing & Midwifery SM = Sue Mellor, Patient Engagement & Voluntary Services Manager DH = Doreen Holford, Governor & member of GIPPE EF = Eric Fisher, Governor & member of GIPPE RO = Richard Owen, Staff Governor MDC = Membership Development Committee PECC = Public Engagement and Communication Committee




Subject:

Governor Scrutiny Committee 2013/14 Report Topic

Section:

For Decision

Author of Paper:

Sharon Carr-Brown


Governor Scrutiny Committee



X X X X


For Approval

Summary:

The Governor Scrutiny Committee’s remit is to select a topic relevant to patient care or patient services for scrutiny each year. The Committee consulted the Director of Nursing and Midwifery and decided on two projects.


To listen to, support, motivate and develop our staff

To offer patient centred services by providing high quality, responsive, accessible, safe, effective and timely care

To promote and improve the quality oif life of our patients

To strive towards excellence in the services and care we provide


Outcome 4 – Care and welfare of people who use services

Outcome 14 – Supporting workers


Scrutiny Report and Proposed new Scrutiny Topic For approval

Scrutiny report and proposed new scrutiny topic for 2014 The beginning of the year was spent finalising the questionnaires and arrangements for the ‘culture of elderly care’ topic that was agreed at the January CoG. A great deal of work was put into this, however, it became clear that it was not going to be possible to go ahead with it at this time. Elderly care was under a great deal of pressure and our surveys were extensive and time consuming. We agreed to delay our elderly care project until the autumn when other work would be finished and it would serve better as a scrutiny topic. The scrutiny committee had also been discussing the degree of focus on elderly care and the possible side effect of this on the rest of the Trust – are there any other departments that would benefit more from scrutiny oversight at this time? On referring back to the CQC report, two areas were considered worth looking at more closely. We discussed this with Paula Shobbrook, Director of Nursing, who agreed that surgery and outpatients might appreciate some scrutiny work. The scrutiny committee discussed these two areas at a meeting on April 8th and we would like to propose a change of topic to the Council for a short project to be completed by the end of the summer. The working title for this is: How is care delivered in the surgical directorate? Can the experience for patients and staff be improved? The main focus of our work will be a short questionnaire for 10 staff (nurses and doctors) and 10 patients. Other key data such as clinical outcomes and quality data will be gleaned from other sources. Assuming agreement from the CoG, we have already composed the questions. We also decided not to go ahead with our review of the effectiveness of scrutiny reports so far for the time being. However, work towards the elderly care topic will be proceeding over the summer. Sharon Carr-Brown Chair, Governors’ Scrutiny Committee




Subject:

Confirmation of Quality Indicator

Section:

Decision

Author of Paper:



By email to Council of Governors on 26 March 2014



X


To ratify the selation of press (Please note that there is no further document with this paper)

Summary:

In its guidance relating to the external auditors' assurance on the Quality Report for 2013/14 Monitor requested that trusts select two of the following indicators for review by the external auditors who will then produce a limited assurance report for the Board of Directors and the Council of Governors:

C. Difficile maximum waiting time of 62 days from urgent

GP referral to first treatment for all cancers emergency readmissions within 28 days of

discharge.

The external auditors' report will focus on the accuracy and reliability of the data and the processes used to collect it. The guidance also requested that one local indicator included in the Quality Report was selected by the Council of Governors. This will not be included in the limited assurance report from the external auditors but the external auditors will carry out sample testing to provide additional assurance on the data. Following circulation of an email by the Governor Co-ordinator, the quality indicator selected by the majority of the Governors who responded was pressure ulcers.


To offer patient centred services by providing high quality, responsive, accessible, safe, effective and timely care.


Various




Subject:

Membership Engagement Strategy

Section:

For Decision

Author of Paper:

Karen Flaherty


Membership Development Committee Governor Training – February and April 2014



X


For approval

Summary:

The Membership Engagement Strategy has been revised to reflect current initiatives identified and/or supported by the Council of Governors. The objectives and tasks relating to membership from the Governors' Work Programme have been included as an appendix to the Membership Engagement Strategy. A target of 350 new public members has been set for 2014/15.


To offer patient centred services by providing high quality, responsive, accessible, safe, effective and timely care


N/A

Membership Engagement Strategy 2014 Page 1 of 13

Membership Engagement Strategy

Approval Committee

Version Issue Date Review Date Document Author(s)

Council of Governors 2014 Draft April 2014 April 2015 Membership Development Committee


CONTENTS 1.0 AIMS AND OBJECTIVES ........................................................................................... 2 2.0 MEMBERSHIP REQUIREMENT ................................................................................ 3 3.0 BECOMING A MEMBER ............................................................................................ 3 4.0 BUILDING AND MAINTAINING THE MEMBERSHIP BASE ...................................... 4 5.0 MANAGING MEMBERSHIP ....................................................................................... 6 6.0 MEMBERSHIP COMMUNICATION ............................................................................ 6 7.0 DEVELOPING MEMBERSHIP BENEFITS ................................................................. 8 8.0 PLAYING A KEY COMMUNITY ROLE ....................................................................... 8 9.0 WORKING WITH OTHER MEMBERSHIP ORGANISATIONS ................................... 8 10.0 EVALUATING SUCCESS ........................................................................................... 9 11.0 MEMBERSHIP RECRUITMENT – EQUALITY AND DIVERSITY ............................... 9 12.0 APPROVAL, REVIEW AND REVISION ...................................................................... 9 APPENDIX A ....................................................................................................................... 10 APPENDIX B ....................................................................................................................... 11 APPENDIX C ....................................................................................................................... 12 1.0 AIMS AND OBJECTIVES 1.1 A foundation trust is accountable to the local community through its members and the

Council of Governors. The Membership Engagement Strategy sets out the way in which The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust (RBCH or the Trust) will recruit, maintain, develop and engage with its members. The Membership Engagement Strategy will ensure that the Trust adopts a planned structured and co-ordinated approach to membership.

1.2 Engaging with the membership is a central aspect of a foundation trust. As both a community employer and provider of vital services, there is an obligation continually to listen and react to the needs of staff, local people and stakeholders. Engagement with the membership is a measure of success as a foundation trust as the more local people are involved and help inform decisions, particularly on patient-centred services, the better the resulting management decisions. In turn this will inspire the local community to become more involved in a hospital they value and in which they have confidence.

1.3 The principal mechanisms for this will be:

Holding events in the public constituencies to meet members and share information about the Trust;

maintaining an active membership and ensuring it is as representative of the local population as possible;

engaging with the membership on an ongoing basis and at the earliest opportunity, and showing how their views are incorporated into decisions; and

reporting, via the Annual Report, Annual Members' Meeting and Annual Plan, the state of membership, how members have been engaged over the previous year and how they will be engaged in the coming year.


2.0 MEMBERSHIP REQUIREMENT What is the requirement for membership? 2.1 The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust is required

by law to have a membership from which a Council of Governors is elected. Members have the right (subject to the Trust's Constitution) to stand for election as a Governor and to vote for their representative(s) on the Council of Governors. One of the primary purposes of the Council of Governors is to represent the views of the local community to the Board of Directors.

Eligibility for membership and the Constitution 2.2 The Trust membership is to be drawn from the communities served by the hospitals

and their catchment areas and should reflect as closely as possible the demographic make-up of those communities. The membership should reflect the different age, socio-economic, gender and ethnicity percentages in the communities served.

2.3 There are two elected membership groups for RBCH:

public membership, representing patients, carers and members of the public living in the catchment area; and

staff membership, representing employees of the Trust.

2.4 Provisions on eligibility to become or remain a member are set out in the Trust’s Constitution. Any person over the age of 16 years may become a member and membership is open to the constituency area covering Bournemouth and Poole, New Forest, Hampshire and Salisbury and Christchurch and Dorset County.

2.5 There are four classes of staff membership: Medical and Dental, Nursing and Midwifery (including healthcare assistants), Estates and Ancillary Services, Allied Health Professions, Scientific and Technical and Administrative, Clerical and Management. Provisions on the eligibility for membership of the staff constituency are set out in the Trust's Constitution.

3.0 BECOMING A MEMBER How to apply to become a member 3.1 Interested individuals can join the Trust as a member by filling in the membership form

available on the Trust's website or by obtaining a printed membership application form from the Governor Co-ordinator.

3.2 Becoming a member is easy, free of charge and members can get involved as little or as much as they want, in accordance with the Trust's governance and constitutional arrangements.

3.3 All new staff who meet the eligibility criteria will automatically become members of the

Trust unless they choose to opt out. The benefits of being a member are explained to staff on induction. Staff who joined the Trust prior to 1 January 2010 must apply to become a member of the Trust by completing a membership application form.


3.4 Details of the composition of the membership at the time of the publication of this

Membership Engagement Strategy are included in Appendix A of this document. Benefits of being a member 3.5 Joining the Trust gives members a voice so that they can help shape the future of The

Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust. Members, where they have indicated that they wish to take part, will:

be sent a regular newsletter giving information about the Trust; receive invitations to events; receive invitations to an Annual Members' Meeting; be asked for their views on future developments at the hospitals; be able to vote in elections if over the age of 16; if eligible, have the opportunity to stand for election to the Council of Governors; and find out more about how to get involved in fundraising or voluntary work.

3.6 Members will be supporting their local hospitals and will have access to their local

Governors.

4.0 BUILDING AND MAINTAINING THE MEMBERSHIP BASE Building the membership base 4.1 The Council of Governors is responsible for the implementation of this Membership

Engagement Strategy which is approved and endorsed by both the Council of Governors and the Board of Directors of the Trust. The involvement of the Board of Directors ensures it has the necessary support and resources to be successful and to work alongside the Trust’s other aims and objectives.

Resources 4.2 Resources are necessary for the membership recruitment activities to continue and to

maintain communications with the Trust's current membership. The Trust has provided a Governor Co-ordinator to act as principal contact for members and Governors. The Governor Co-ordinator, alongside the Trust Secretary and the Head of Communications, will also support the activity of the Council of Governors, promote communication with members and work to engage with and develop the membership community.

4.3 Resourcing will cover: the continuation of the staffing of the membership function; non-pay costs associated with membership governance such as elections and

maintenance of the membership database; provision of consultants to continue the Council of Governors’ Constituency Health

Talks which have proven to be a successful way of showcasing the work of the Trust to members and raising the Trust’s profile with potential members; and

continuing support for members’ meetings.


Maintaining the membership register 4.4 This Membership Engagement Strategy requires the Trust to have a proactive

approach to membership recruitment. The Trust must seek to ensure that the communities it serves are aware of the opportunity to become a member of the Foundation Trust and what this means for them.

4.5 Details of planned events for members is available on request and will be made available on the Trust's website and advertised in member publications.

4.6 The Trust will need to continue its work to:

strive for a membership that reflects the diverse communities it serves; provide a simple and accessible process for becoming a member; encourage staff not to opt out and to empower them to take an active role in helping

to build the membership base; recognise and use members as a valuable resource who can assist in improving

services; maintain an accurate and informative membership database to meet regulatory

requirements and to be a tool for developing the membership; identify initiatives for raising the profile of membership with employees of the Trust to

encourage them to become active members; consult with patients, the public and other stakeholders so their views and ideas can

inform the process of recruitment and retention; produce explanatory materials; advertise membership; seek out best practice from other member-based organisations and adopt if

appropriate; and develop and use appropriate monitoring systems to evaluate whether membership is

open and representative. Revision of constituency boundaries 4.7 The Constituencies were revised in 2011 and now cover:

Bournemouth and Poole; Christchurch and Dorset County; and New Forest, Hampshire and Salisbury. Maps are included at Appendix B.

Membership target for 2014/15 4.8 The Trust aims to attract new members and has set a target of 350 new public

members for the financial year 2014/15.

4.9 The focus of recruitment for staff members will be on reducing the numbers of new staff who opt out of membership by providing more information on membership and the work of Staff Governors at induction and more generally and also to get more staff who joined the Trust prior to 1 January 2010 to become members. The viability of the introduction of automatic membership for these staff has been considered by the Constitution Joint Working Group and a proposal will be submitted to the Council of Governors and the Board of Directors in 2014.


4.10 An action plan for membership recruitment, management and engagement during the

financial year 2014/15 is provided at Appendix C.

5.0 MANAGING MEMBERSHIP 5.1 The Trust Secretary's Office is responsible for facilitating and managing the public

membership recruitment, engagement and development. A database provides efficient data for the annual reporting to Monitor and helps the Trust to improve its services to members. The database also ensures that the public register of the Trust is accurate and maintained in accordance with the Data Protection Act 1998. The register is regularly validated to ensure it is up to date.

5.2 The public membership database allows analysis of membership by constituency, age, ethnicity, gender, disability and socio-economic grouping which allows the Trust to monitor how representative the members are of the constituencies. It also records levels of individual member engagement through attendance at events and other participation.

5.3 The Human Resources Department database is used to update and maintain the staff

membership database together with a register of opted out staff managed and maintained by the Governor Co-ordinator.

5.4 The register of members must be available for public inspection and a copy or extract

must be provided on request. A reasonable charge will be made if the request for a copy or extract is not from a member. The information made available or provided will be the name of each member, the constituency to which he/she belongs and, where there are classes within that constituency, the class to which he/she belongs.

6.0 MEMBERSHIP COMMUNICATION 6.1 The Trust will support all members and their elected Governors to contribute as

effectively as possible to the development of the organisation and its services. Building on established good practice, clear and reliable methods of communication between the Trust and its members are required.

6.2 A range of methods have been identified for this including: Understanding Health talks in public constituencies Governor stands at the Trust’s Open Days, Understanding Health talks and Trust

charity events ‘Town Hall’ style meetings Governor stands at community events Governors presenting to local groups Governors delivering school talks Governors attending school and university careers events Annual ‘Careers in the NHS’ event Surveys of members Governor visits to meet patients in Outpatients and other areas of the Hospitals. Public meetings of the Council of Governors and the Board of Directors and the

Annual Members' Meeting.


6.3 Governors are encouraged to hold meetings within their constituencies, whether they are educational or for consultation. These will be important for gathering members’ views which can be used to develop the Trust’s future strategies and service delivery. They also serve to support Governors in their role and help build solid relationships between Governors and their constituency members.

6.4 The Trust will need to arrange and keep members informed of: events and meetings; meetings between members and their elected Governors; membership opportunities and contacts for queries or further information; and election processes and the outcome of elections.

6.5 The Trust will need to keep members informed of:

the services and organisation of the Trust; and Trust activities, plans and the processes used in developing those plans, and key

performance indicators. 6.6 The Trust will seek members’ feedback and engagement by:

encouraging members to vote in Governor elections; consultation on future strategies and plans; communication opportunities for members to share views amongst themselves, with

their elected Governors and with the Trust; surveys; and involvement in appropriate consultative and advisory groups.

6.7 Comments made by members demonstrate that the quarterly FT Focus newsletter is

valued as an important source of information on developments at the Trust and forthcoming events. However, as well as the regular newsletter sent to members, emails will be sent to members who have provided email addresses to provide more current news and promote the use of the Trust's website to keep up to date on news about the Trust.

6.8 Events will also be promoted in FT Focus and emails to members but also through the use of posters and flyers in relevant locations in the public constituencies identified by Governors and within the Hospitals (including the LCD screens), press releases to local media, including community publications, and stakeholder groups, Twitter and through notifying local media of events using the facilities provided on their websites. There is still progress to be made with regard to ongoing consultation with our members through workshops or focus groups and to use information sheets and information videos available on the Trust's website to address common issues which are raised by members. Governors have also been requested to provide details of community publications and groups to be included on the circulation list maintained by the Communications team.

6.9 Governors collect information from members regarding their interest area and preferred level of involvement using the initial membership forms and via questionnaires distributed at members’ meetings. This helps us identify the members who wish to have a more active role in the Trust.

6.10 It is the Council of Governors’ responsibility to engage with the membership on behalf of the Trust. That includes expanding the membership, communicating with it, ensuring that it is representative and that its voice is heard. Methods by which the


Governors and the Trust intend to communicate, recruit and engage with members are set out in Appendix C.

7.0 DEVELOPING MEMBERSHIP BENEFITS 7.1 An important aspect of Governor work is the development of a benefits package that

will make membership more meaningful. Governors are ideally suited to assisting the Trust in its patient feedback and quality assurance effort.

7.2 Governors will set up and manage focus groups looking at patients’ and relatives’

experiences and patient engagement across the hospital on a periodic basis. This method will also be used to help drive recruitment.

7.3 The work of the Governors with members and direct feedback will mean that members

have direct input into the day-to-day operation of the Trust. 7.4 Governors will take responsibility to feed back to the Board a summary of the key

issues raised and will communicate the resolution of any issues to the membership.

8.0 PLAYING A KEY COMMUNITY ROLE 8.1 NHS organisations are established to serve the needs of their local population. Being

an NHS foundation trust highlights the importance of accountability to local communities and of working in partnership with members and colleagues in other organisations to strengthen the community focus and engagement that the Trust seeks to achieve. Benefits from the activities of the Trust in the local community are already significant. The Trust employs around 4,000 people. Professional and vocational training contributes to the development of skills in the local workforce.

8.2 Through the Trust membership and partnerships with local government, Bournemouth

University, voluntary organisations and service user, carer and staff groups the Trust will develop its civic partnership role as an active and accessible participant in the life of the community. The Trust seeks to make positive contributions to local initiatives and partnership working that offer greater social inclusion for service users and improve awareness of and access to its services.

8.3 The Trust's aim is to develop a strong sense of shared purpose with other like-minded

organisations and we will work with other NHS foundation trusts to raise the profile of community activity. We will seek to share best practice with partner organisations on membership, co-operation and community relations.

9.0 WORKING WITH OTHER MEMBERSHIP ORGANISATIONS 9.1 The Trust is a member of the Foundation Trust Network and the Foundation Trust

Governors’ Association. These organisations offer training and best practice information to help develop Governors and the membership function; Governors regularly attend training days run by these two organisations and will be encouraged to provide reports to the Council of Governors and disseminate information from the training and other events to fellow Governors.


10.0 EVALUATING SUCCESS 10.1 The Council of Governors has a key role in monitoring the effectiveness of this

Membership Engagement Strategy and ensuring that it remains a meaningful and relevant document as the membership of the Trust grows and the organisation matures.

10.2 The Member Development Committee of the Council of Governors will meet as necessary and not less than quarterly to review progress against this Membership Engagement Strategy. This ensures that Governors are fully involved in membership development and engagement given their responsibility for the delivery of this Membership Engagement Strategy. A report will be provided to all members in the Annual Report of the Trust and future plans will be set out in the Trust’s Annual Plan.

10.3 The success criterion will be that members will become more engaged. This will be

supplemented by other measures such as a closer alignment of the membership base with the demographics of the catchment areas (as benchmarked using the Trust maintained membership database) and the number of active members, i.e. those attending events organised by the Trust, individual Governors and the Council of Governors.

10.4 Using the membership database, the effectiveness of recruitment processes will be

monitored and the profile of the membership recruited will be compared to the demographic characteristics of the local population at regular intervals through the Membership Development Committee of the Council of Governors. Consideration will be given to any gaps in the membership profile and what targeted recruitment activities should be introduced to address them. In executing this strategy the Membership Development Committee will ensure close liaison and cooperation with the Board of Directors' Patient Engagement and Communication Committee.

11.0 MEMBERSHIP RECRUITMENT – EQUALITY AND DIVERSITY 11.1 All activities connected with membership recruitment will comply with the Trust’s

Equality and Diversity Policy.

12.0 APPROVAL, REVIEW AND REVISION 12.1 The Membership Engagement Strategy will be approved by the Board of Directors

and the Council of Governors. 12.2 The Membership Engagement Strategy will be reviewed annually, or earlier if

recommended by the Member Development Committee of the Council of Governors. 12.3 Version control will be managed by the Trust Secretary's Office.


APPENDIX A MEMBERSHIP

i. Eligibility Criteria

Membership is open to individuals who: are over 16 years of age who live in one of the constituencies as stated in 3.2 complete a membership application form

Full details are given in the Foundation Trust’s constitution.

ii. Constituencies and Statistics

As at 31 March 2014 there are over 12,500 members in the following constituencies: Bournemouth and Poole 8804 Christchurch and Dorset County 1832 New Forest, Hampshire and Salisbury 658 Staff 1345

iii. Council of Governors

Members of the Council of Governors as at 31 March 2014 are set out below.

Public Governors Staff Governors Appointed Governors 18 5 6


APPENDIX B

Bournemouth and Poole - Yellow Christchurch and Dorset County - Red New Forest, Hampshire and Salisbury – Blue


APPENDIX C

ACTION PLAN

It is the Council of Governors’ responsibility to engage with the membership on behalf of the Trust. That includes expanding the membership, communicating with it, ensuring that it is representative and its voice is heard. This Membership Engagement Strategy has outlined how the Trust and the Governors intend to do this with a series of tasks and actions needed to fulfil those objectives:

OBJECTIVE TASK TIMING LEAD OF PROCESS 1. Membership Development:

Engage with members and within the constituencies

1.1 Establish an annual programme for meetings/events in constituencies and the communication strategy for these

April 2014

Constituency Governor Leads: David Bellamy Chris Archibold Bob Gee

1.2 Review target for new members 2014-15

January 2014

MDC > CoG

1.3 Work with Governor Co-ordinator / Communications Department to ensure Governors’ pages on the website are up-to-date, informative and include events over the next 12 months

Ongoing All Governors and Trust Secretary’s Office and Communications Department

1.4 Include a section in Trust’s Annual Plan on Governors’ future plans for membership development

April-May 2014

Trust Secretary’s Office > Director of Service Development

1.5 Include report in Annual Report on Governor membership activities during 2013/14

April 2014

Trust Secretary’s Office > Head of Communications

1.6 Staff Governors to promote the benefits of Ongoing Staff Governors


membership to staff and use different means of engagement with staff

1.7 Continue to develop strategies to reach identified hard to reach groups, including the Youth Strategy

Ongoing MDC with all Governors support

1.8 Send monthly email update to members and identify ways of obtaining email addresses for more members

Monthly Chair of MDC/Deputy Chairman of CoG/Lead Governor>Trust Secretary's Office

Glossary: CoG Council of Governors MDC Membership Development Committee




Subject:

Changes to Constitution

Section:

For Decision

Author of Paper:



Constitution Joint Working Group, December 2013



X


Approval

Summary:

The Constitution Committee met on 17 December 2013 and agreed proposals for various changes to the Trust’s Constitution. This paper sets out the proposed changes and recommendations from the Constitution Joint Working Group.


N/A


N/A


1

NON-EXECUTIVE DIRECTOR ATTENDANCE AT BOARD OF DIRECTORS' MEETINGS

1. Model Core Constitution 1.1. Background

Prior to merger the Constitution Committee considered whether to adopt the form of Monitor’s Model Core Constitution for the Trust’s Constitution when it was being updated to reflect the Health and Social Care Act 2012. It was decided not to do so at that point in advance of the merger when the Model Core Constitution would have been adopted. The Trust's Constitution is one of the earlier constitutions as the Trust was authorised as a foundation trust in April 2005 and is long and not particularly user-friendly.

1.2. Recommendation It is proposed that the Trust use the Model Core Constitution as the basis for its Constitution and incorporate the existing provisions of the Constitution into that format, subject to any further changes agreed by the Council of Governors. Using the Model Core Constitution will provide greater assurance around compliance with the National Health Service Act 2006 as Monitor will set out any amendments which need to be made to the Model Core Constitution as a result of future changes to legislation. Since the Health and Social Care Act 2012, Monitor no longer review the constitutions submitted to it by foundation trusts for compliance with the legislation.

1.3. Next Steps The Trust Secretary to submit the revised Constitution to the Board of Directors for approval in May 2014.

2. Minimum Age for Members 2.1. Background

Under the Trust’s current Constitution, membership is open to any individual who is over 16 years of age and all members are eligible to vote for Elected Governors in their respective constituencies or classes of a constituency. Only members over 18 years of age are eligible to become a Governor (subject to meeting the other eligibility requirements). Although it does not offer paediatric inpatient services, around 70,000 children are treated by the Trust each year in the Emergency Department, Ophthalmology, Orthodontics, the Dorset Prosthetic Centre and elsewhere in the Trust. The Trust’s Membership Development Strategy also includes a youth strategy as under 21s are currently under-represented in the Trust’s membership. The strategy to improve membership in this group has involved engaging with local secondary schools through careers events and delivering presentations. While this has meant that Governors have met potential members, under the age of 16, they have not been able to recruit them as members due to minimum age limit in the Constitution.


2

2.2. Recommendation

It is proposed that the age for membership is reduced to 12 years of age. Eligibility to vote and to become a Governor will remain at 16 and 18 years of age, respectively. The longer term aim of the youth strategy is to establish a shadow youth Council of Governors at the Trust.

2.3. Next Steps

The Trust Secretary to submit the revised Constitution to the Board of Directors for approval in May 2014. The membership application form will be revised to reflect this change and will include wording to ensure members under the age of 16 seek permission from their parents before becoming a member.

3. Maximum Term of Office for Governors 3.1. Background

Under the Trust’s current Constitution, a Governor may not hold office for more than nine consecutive years. The limit on the term of office for Governors was derived from the maximum term of office for Non-Executive Directors before they would become subject to annual re-appointment in an earlier version of Monitor’s Code for Governance for NHS Foundation Trusts. Monitor’s Code for Governance for NHS Foundation Trusts now specifies six years as the maximum term of office for Non-Executive Directors before they become subject to annual re-appointment, although nine years is still the limit set out in the UK Corporate Governance Code. There is no legislative or regulatory requirement which sets out a maximum number of years that a governor may serve on a council of governors but many trusts choose to impose a limit and, if so, this must be set out in the trust’s constitution. There is a maximum limit of three years for each term of office for elected governors set out in the National Health Service Act 2006. Under the Constitution Governors reaching the maximum term and had stood down could stand for election at the next election. A number of Elected Governors who were elected or appointed on authorisation of the Trust in 2005 will reach the maximum term of office in October 2014.

3.2. Recommendation The Constitution Joint Working Group considered the following options:

increasing the limit removing the limit giving the Council of Governors discretion to increase the limit in

certain circumstances


3

no change The Joint Working Group reviewed data from the first 30 NHS foundation trusts authorised (not including the Trust) as these were thought more likely to have encountered the practical implications of this limit and considered these. 60% of these had a limit of nine years, 20% had a limit of six years and 17% had no limit. We also surveyed a random section of 40 foundation trusts which revealed a similar picture with 53% of foundation trusts having a limit of nine years, 25% with a limit of six years, 5% with no limit and the remaining trusts having limits of seven, eight or ten years. The Joint Working Group consider the risk of losing Governors with valuable knowledge and experience when they reach the maximum term of nine years but also the benefits of having new Governors join the Council of Governors. Some of the Group favoured a maximum term of office of six years but others believed that given the knowledge which Governors needed to acquire to perform the role and the time taken to do this, a term of nine years would allow Governors to contribute more fully to the work of the Council of Governors and the Trust. The majority favoured retaining a maximum term of nine years.


4. Staff Governor Classes 4.1. Background There are currently five classes in the Staff Constituency:

Registered Medical Practitioners and Registered Dentists (one Staff Governor);

nursing and midwifery (including healthcare assistants) (one Staff Governor);

hotel services and estates (one Staff Governor); allied health professionals (one Staff Governor); administrative and clerical/management (one Staff Governor).

4.2. Recommendation It is proposed that the names of the classes are updated as follows to better reflect the staff categories in the Employee Staff Record system from which the information on staff is gathered and are likely to appear more relevant to staff as a result:

Medical and Dental; Nursing, Midwifery and Healthcare Assistants; Estates and Ancillary Services; Allied Health Professions, Scientific and Technical; Administrative, Clerical and Management.


4


5. Appointed Governor for Volunteers 5.1. Background The Council of Governors currently includes a Partnership Governor appointed by The Royal Bournemouth and Christchurch Hospitals Volunteers Group. This reflects the power under the National Health Service Act 2006 for foundation trusts to specify an organisation in the constitution as a partnership organisation to appoint a member of the Council of Governors.

It has been suggested that the group which appoints this Governor be expanded to include all volunteers from all charitable organisations within the Trust rather than the internal Hospital Volunteers only.

Although this would require a change to the Constitution and the Policy on the Composition of the Council of Governors, the real issues to consider are practical in terms of the arrangements which would need to be put in place amongst the volunteer organisations to appoint this Governor. Although this process is agreed by the Trust Secretary on behalf of the Trust, it will be administered by the volunteer organisations.

5.2. Recommendation The proposal has been discussed with the Volunteers Office at the Trust who are supportive of the proposal as a way of improving the links with these organisations and the governance arrangements in respect of the volunteers. The process of appointment of the governor is likely to change from an election to a selection panel with staff, governor and volunteer representation as a result of this change. It is envisaged that this would encourage more applications from individuals who have the required skills but may not be equally well known to all groups of volunteers.

Eligibility of candidates from the voluntary organisations would be subject to having a memorandum of understanding in place with the Trust covering various governance arrangements. It is also proposed that this individual would attend the Heads of Charities meetings, volunteers coffee mornings and quarterly meetings of the voluntary organisations to get feedback from the various voluntary groups.


The supporting arrangements in terms of the selection panel and memorandum of understanding to be agreed and put in place so that a Governor can be appointed to fill the current vacancy.


5

6. Automatic Opt In for Staff Members 6.1. Background Members of staff who have joined the Trust since January 2010 have automatically become members of the relevant class of the Staff Constituency unless they opt out. Staff who joined the Trust before this date must apply to be members.

The National Health Service Act 2006 makes provision for allows for a foundation trust’s constitution to provide that a member of the staff constituency may become a member without an application being made, subject to being able to opt out.

This would require a communication to all members of staff to given them notice of the ability to opt out and to inform staff of the use the data on the Employee Staff Record system for membership purposes.

This process should raise the profile of foundation trust membership and the Staff Governors within the Trust. Increasing the membership of the Staff Constituency could lead to an increase in costs of staff elections as the membership would be much broader than at present. However, since authorisation none of the elections for Staff Governors has been contested.

6.2. Recommendation The Constitution Joint Working Group recommend this change as they believed it was right that all staff should automatically become members of the Trust, with the option to opt out if they wished to do so, as this reflected the importance of staff shaping the vision and values of the Trust and supporting staff in contributing their views more generally.


It is requested that implementation of this change is delayed until 1 July 2014 to allow time to communicate the change to staff.

COUNCIL OF GOVERNORS Meeting Date and Part:


Subject:

Forward Plan and Private Patient Income

Section:

For Decision

Author of Paper:



Council of Governors – January 2014 Governor Training - April 2014

Key Purpose: Patient Experience


X X X X


To determine whether the carrying on of the non-NHS activity will not to any significant extent interfere with the fulfilment by the Trust of its principal purpose or the performance of its other functions.

Summary:

Under the Health and Social Care Act 2012 the Council of Governors of the Trust must, in relation to the Trust’s forward plans,:

determine whether it is satisfied that the carrying on of the non-NHS activity will not to any significant extent interfere with the fulfilment by the trust of its principal purpose or the performance of its other functions; and

notify the directors of the Trust of its determination. The determination will be notified to the Board of Directors by the Trust Secretary on behalf of the Council of Governors.


N/A


N/A

COUNCIL OF GOVERNORS Meeting Date and Part:


Subject:

Guidance for Governors when in Clinical Areas

Section:

For Decision

Author of Paper:



Council of Governors – January 2011 and January 2014

Key Purpose: Patient Experience


X X X


For Approval

Summary:

The Guidance for Governors when in Clinical Areas was approved by the Council of Governors in January 2011. A revised version was presented to the Council of Governors in January 2014 and further amendments were requested which have now been incorporated. The draft attached shows all the amendments to version approved in January 2011.


N/A


N/A

Council of Governors Meeting – Part 1 24 January 2011

Guidance for Governors when in Clinical Areas This guidance has been designed to support all Governors when they are carrying out their duties in the Trust within clinical areas, collating speaking the views ofto staff, patients or visitors patients and visitors to informas part of their role the Trust Board. The conduct of Governors is a large contributing factor to creating a successful Trust, the impact of an individual’s behaviour can affect the reputation of the Council of Governors and the Trust. The main expectation that the Board of Directors hasis that for Governors’ conduct is that they support the Board of Directors Trust,and staff and to promote the Trust’s philosophy vision of ‘Putting Patients First’ through positive behaviours and supporting all staff. It is the responsibility of all governors to comply with Health & Safety regulations and follow Trust policypolicies on data protection and confidentiality, these are available on request. Governors are expected to be reliable once a commitment has been made, as others may depend on this. We would hope that Governors will initiate conversation with patients and visitors staff and respond as appropriate, in a friendly manner. Having sought agreement with the clinical lead, Governors are welcome to approach patients in all agreed areas. Always speak to the Ward Sister/Charge Nurse on the ward about which patients and/or visitors to speak to as there may be reasons why certain patients or their visitors should not be approached at particular times. Smart appearance Please ensure that you are of smart appearance when in the role of a Governor and in the clinical areas. Please wear your Volunteer / Governor badge at all times. Infection control Please respect the Trust Policy to help us protect patients against infection:

Apply hand gel on entering and leaving the ward as this reassures patients, visitors and staff that you are aware of the need for good hand hygiene and it sets a good example. When Governors are meeting or speaking to patients and visitors on the wards, they may


also need to apply hand gel if they have been in contact with patients, such as shaking hands, or in contact with the patient's surroundings.

Wear short sleeves to be bare below the elbows Short and clean nails No jewellery, including watches, – other than wedding rings Please do not bring valuables with you into the Trust where

possible, however provision can be made for safe keeping if absolutely necessary

Do not enter wards which are closed to visiting to help control infection and follow any other infection control measures in place

Prior to visiting a clinical area Governors should, out of courtesy ensure previous agreement with the clinical lead for convenience of a visit either as an individual or through the Governors coordinator. Those Governors who support the Trust through engaging with the ‘Real Time Patient Feedback’ sessions have prior agreement as described during their training. Introductions Arrangements prior to visiting and introduction when arriving in a clinical area Prior to visiting a clinical area Governors should ensure previous agreement with the Ward Sister, Charge Nurse or directorate management team for convenience of a visit either as an individual or through the Governor Co-ordinator. Those Governors who support the Trust through engaging with the ‘Real Time Patient Feedback’ have prior agreement as described during their training. On arrival in the clinical area please introduce yourself and your role to the clinical leader / nurse in chargeWard Sister or Charge Nurse and explain your role:

Ensure it is appropriate to be in the clinical area at that time – occasionally a ward may be closed.

Check with the Ward Sister/Charge Nurse on the ward if there are any patients and/or visitors who you should not speak to at that time. Do not approach patients identified by clinical staff as inappropriate.

Introduce yourself to each patient / relativemembers of staff, and patients and visitors, as appropriate, and explain your role as Governor or volunteer.

Remember to assure the patient member of staff, patient or visitor that all feedback is voluntary and confidential.

Do not approach patients identified by clinical staff as inappropriate. Please approach a wide range of patients so we may gain a

diversity of patient’s views. Please do not discriminate against any patient for any reason.


It is acceptable to approach patients with visitors but please check with the patient and visitors first.

Please remember the impact of your approach, a smile and a kind word with some reassurance can have a very positive impact on a patient.

Listening to the views of our patients staff and patients and their relatives and carers informs your feedback to the Board of Directors and the Trust.

Confidentiality All information about patients, staff and some information about the Trust is to be maintained in the strictest of confidence; this includes the visit / admission to the hospital of any patient.

Everybody has a legal duty to maintain patient confidentiality. The fact that a patient is in hospital is a matter of confidentiality so

please do not approach patients or relatives that you know if you see them in a clinical area or disclose that you have seen them in hospital to anyone else as they may not want other people to know.

Information and data – pPlease comply with hospital policies. Please remember that email is not a secure form of communication

when sending information of a confidential nature.

If you have any urgent concerns Please report them to a member of staff, preferably the Ward Sister or nurse in Ccharge Nurse as soon as you can. If this is not possible possible or appropriate:

between 8.30am and 4.30pm, please contact the Governor Co-ordinator who will notify the relevant Senior Nurse, General Manager or Executive Director;

outside these hours, please contact the Clinical Site team (you can use any internal phone to contact the Clinical Site Team – just press 0 to speak to the hospital operator and ask to be put through). The Clinical Site team will then contact the General Manager and/or Executive Director on call.make sure they are escalated through Governor channels.

Examples of urgent issues may include.

Concerns about the quality of patient care for immediate escalation Any strangers / members of staff without ID badges please report to

the clinical leader / nurse in charge Poor standards of cCleanliness Health and safety issues


All non-urgent concerns should be directed to the Governor Co-ordinator. Managing enquiries/complaints

Please do NOT engage try to resolve with any complaints by yourself, pass thembut highlight these to a member of staffthe nurse in charge or , to PALS or other appropriate person or provide details to the patient or relative of how they can do this..

Please do not actively deter patients or relatives from making a complaint if they wish but do point out the other ways in which they can raise concerns with the nurse in charge on the ward or with PALS.

If you have any concerns please inform the clinical leader / nurse. Please provide constructive response’s to challenge. Please listen as appropriate but do remain neutral NEUTRAL. It is important not to respond to a complaint but to listen.

Infection control . Please ensure you are seen to wash / clean hands between each

patient you speak with. Do not sit on beds.

Time of visits

Please respect hospital policiesy’s including protective protected meal times.

Certain clinical areas may be closed without warning due to unexpected events such as a medical emergency.

Unable to attend

If you are unable to attend an agreed visit, please ensure you

inform your link person i.e. Dily Rufferthe Governor Co-ordinator as soon as possible.

If you are collecting Real Time Patient Feedback please contact Andrea Smithson so that resources can be reallocated or another Governor can be approached to cover for you.

Top Tips


Do not give food or drink to patients unless with clinical permission Do not help lift a patient in anyway Remember you play a vital role in infection control. Engaging with patients / relatives / visitorsstaff, patients, relatives

and carers is crucial to our continual improvement with the Trust..

Approach a wide variety of staff patients, relatives and carers to obtain views, depending on the nature of the visit, provided that the staff on the Ward have not said it would be inappropriate to do so.

Approach a wide variety of patients / age / sex / culture etc.

Do not interrupt any clinical care.

If patients require food, drink or other assistance please tell a member of staff.

Your constructive feedback to staff is welcomed when appropriate.

You will get a better response from patients if you approach them

with a welcoming smile, and a kind disposition.

Membership Where appropriate tell staff, patients, relatives and carers about membership of the Trust and how to get a please offer Trust membership application forms or apply to become a member on the Trust website to patients and other visitors. Patients wishing to give written feedback As appropriate ask patients / relatives / visitors to complete a patient experience card (PEC) if they wish to share additional information or make a written comment on their views. Maintaining Governors Note takings If Governors maintain notes for feedback to the Trust please ensure that they are protected and remain confidential. It is useful to collate objective data for example direct quotes / or specific observations and ensure these are appropriately anonymised.


This document is meant to be a supportive framework for our Governors who engage with our patients and publicstaff and patients and their relatives throughout the Trust to provide us with high quality feedback.


Appendix R

Hospital at Night

to follow




Subject:

Forward Planner

Section:

For Information

Author of Paper:

Karen Flaherty


None



X X


Note for information

Summary:

Copy of the Council of Governors Forward Programme



N/A

Council of Governors Forward Programme 2014

What Who Where Before Jan Apr Jul Oct Where AfterAnnual PlanAnnual Plan - Draft for Public Consultation RR TMB Part 2 BoDAnnual Plan - Feedback from Consultation to COG RR TMB BoDAssurance Framework PS BoD Part 2 Part 2 Part 2 Part 2 N/A

Annual Report & AccountsAnnual Report & Accounts First Draft SH BoD Part 2 BoDAnnual Report & Accounts - Final draft presented SH BoD & Audit Cttee Monitor/Parliament

QualityInpatient Survey Results PS BoD N/AOutpatient Survey Results PS BoD N/APatient Safety and Quality Dashboard PS BoD Part 2 Part 2 Part 2 Part 2PLACE Inspection PS HAC N/AQuality Accounts - First Draft PS Clinical Governance Part 2 N/AQuality Accounts - Final Draft presented PS Clinical Governance Publication

Election ResultsDeputy Chair Election DR N/A N/APublic Governor Election DR N/A AMMStaff Governor (Medical) DR N/A AMM

Infection ControlInfection Control - Annual Report PS BoD N/A

Constitutional DocumentsConstitution KF Constitution Ctte/BoD MonitorStanding Orders KF Constitution Ctte/BoD MonitorMembership Development Strategy DT MDC BoDPolicy on Composition of COG KF N/A N/APolicy on NED Composition KF NED RemCo BoD

GovernanceRegister of Interests KF Trust Secretary FileMeeting Dates for Next Year KF Trust Secretary N/AForward Programme KF Trust Secretary N/AActions Matrix KF Trust Secretary N/AAnnual Members' Meeting KF MDC 24-Sep N/AGovernor Attendance KF NED Remuneration Part 2 Part 2 Part 2 Part 2 N/AAnnual Governor Budget KF Trust Secretary Part 2 Part 2 Part 2 Part 2 N/A

Reports from COG Committees/Groups

What Who Where Before Jan Apr Jul Oct Where AfterConstitution Committee KF N/A N/AGovernor Training Committee SB N/A N/AGovernor Involvement and Patient and Public Engagement Committee GB N/A N/AMembership Development Committee DT N/A N/ANomination Committee JS N/A N/ANon-Executive Director Remuneration Committee EF N/A Part 2 Part 2 Part 2 Part 2 N/AGovernors' Scrutiny Committee SCB N/A N/A

Reports from Trust-led Committees/GroupsCarbon Management Committee MAll N/A N/ACarers Forum JB N/A N/ACharitable Funds Committee GS N/A N/ADiversity Committee Vacancy N/A N/AEditorial Group Various N/A N/AEnd of Life Strategy Group GB N/A N/AFinance Briefing Group GS/EF/Vac N/A N/AHealthcare Assurance Committee SCB/EW N/A N/AInfection Prevention and Control Committee KM N/A N/AOrgan Transplant Committee EW N/A N/APatient Engagement and Communications Committee SB/EF N/A N/APatient Information Group KM N/A N/AValuing Staff and Wellbeing KM/SB N/A N/A

Performance ReportingFinancial Reporting SH BoD N/APerformance Reporting HL BoD N/AQuality Reporting PS BoD N/AGovernors' Work Programme Chairs Relevant Committees BoDGovernors' Activity Reports All N/A N/A

Review Performance & Terms of Reference of Subordinate Committees and GroupsConstitution Committee KF N/A N/AGovernor Training Committee SB N/A N/AGovernor Involvement and Patient and Public Engagement Committee GB N/A N/AMembership Development Committee DT N/A N/ANomination Committee JS N/A N/ANon Executive Director Remuneration Committee SB N/A N/AGovernors' Scrutiny Committee SCB N/A N/A

Reports on TrainingFTGA All N/A N/ASWGEN All N/A N/A




Subject:

End of Year Report on Governor Work Programme 2013-14

Section:

For Information

Author of Paper:

Governor Committees


None



X X X X


For information

Summary:

An update on the Council of Governors' Work Programme in 2013-14 from the various committees of the Council of Governors.


N/A


N/A

Annual Report from Committees

MDC Annual Report to Council of Governors

1.1 Completed a programme of constituency Health Talks. It was agreed to set dates for future events at the start of the year so that these can be incorporated in a more extensive communication plan.

1.2 A target of 300 new public members was set in 2013/14. It was agreed to set a target of 350 for 2014/15. Approximately 600 members will leave the Trust each year so attracting new members remains an important focus.

1.3 Work to improve the Governor pages on the website is ongoing and Governors have been requested to provide shorter, updated profiles.

1.4 The process for submission of the annual plan has changed this year but this will be developed using the Membership Engagement Strategy, as approved, and developed in the training sessions with Governors.

1.5 The section in the Annual Report is being drafted and will be circulated to Governors for comment.

1.6 The recent activity by Staff Governors has been very successful with 150 feedback forms collected from staff as well as 50 staff visiting the stand outside the restaurant, the noticeboard, the email address, the item on the Board agenda, a higher profile on induction and the Staff Governor pages on the intranet.

1.7 Regular emails to members are being sent out and the focus on hard to reach groups, including the youth strategy has developed well. The twice yearly visits to Outpatients also began as a membership engagement activity but will now be taken forward as patient engagement.

GTC Annual Report to Council of Governors

Planned and delivered:

ongoing training for Governors Governor induction training the prospective new governors meeting prior to election review/evaluation of training.

GIPPE Annual Report to Council of Governors

(the following is also included in the main body of the CoG papers (Appendix K))

GIPPE was reconstituted following agreement at the July 2013 Council of Governors meeting in order to become more inclusive involving not only patients but the wider context of relatives, carers and our constituents. Public engagement and the recognition of the key role to be played by Governors is an essential part of Governors’ expanded responsibility under the Health & Social Care Act 2012. This is

particularly pertinent following the CQC Inspection and the priority for the Trust to improve its listening.

There is a greater need for cohesion across the Trust between the various engagement activities and for key messages and for common themes to be identified and acted upon. As part of this, the Patient Engagement & Voluntary Services Manager is working with Governors in conjunction with key stakeholders and partners to establish a Patient and Public Involvement Strategy/Framework. It has also been recognised that a model needs to be developed to ensure the Trust has a cohesive programme of engagement and this is now in progress.

At this stage, given that there has been only three meetings since the change in remit it is difficult to measure outcomes, however a series of actions and an embryonic work programme for the 2014/15 year has been developed and is attached. Our aim is to ensure that key messages/themes which are identified via the listening/engagement programme are reported to the Trust’s Public Engagement and Communication Committee (PECC) for action and that a feedback loop is ensured.

Governors' Scrutiny Committee Annual Report to Council of Governors

(the following is also included in the main body of the CoG papers (Appendix L))

Completed Hospital at Night Report which was submitted to the Board of Directors with recommendations. An update will be given at the April 2014 CoG meeting. The beginning of the year was spent finalising the questionnaires and arrangements for the ‘culture of elderly care’ topic that was agreed at the January CoG. A great deal of work was put into this, however, it became clear that it was not going to be possible to go ahead with it at this time. Elderly care was under a great deal of pressure and our surveys were extensive and time consuming. We agreed to delay our elderly care project until the autumn when other work would be finished and it would serve better as a scrutiny topic.

The scrutiny committee had also been discussing the degree of focus on elderly care and the possible side effect of this on the rest of the Trust – are there any other departments that would benefit more from scrutiny oversight at this time? On referring back to the CQC report, two areas were considered worth looking at more closely. We discussed this with Paula Shobbrook, Director of Nursing, who agreed that surgery and outpatients might appreciate some scrutiny work.

The scrutiny committee discussed these two areas at a meeting on April 8th and we would like to propose a change of topic to the Council for a short project to be completed by the end of the summer. The working title for this is:

How is care delivered in the surgical directorate? Can the experience for patients and staff be improved?

This is to be approved by the Council of Governors at the April 2014 meeting (item 10.5)




Subject:

Governor Sub-Committee Meetings Report

Section:

For Information

Author of Paper:

Chairs of the Sub-Committees


None



X X X X


To note

Summary:

Reports from the Chairman regarding the progress of the Governor Sub-Committees


N/A


N/A

Council of Governors Meeting Part 1 29 April 2014

Governor Sub-Committee Meeting Reports Page 1 of 4 20 January – 29 April 2014

GOVERNOR SUB-COMMITTEE MEETINGS REPORTS

20 January – 29 April 2014

MEMBERSHIP DEVELOPMENT COMMITTEE (MDC) Chair: David Triplow Meeting Date: 12 March 2014

Key Committee Decisions/Discussions 1. We have been invited by Dorset Race Equality Council to one of their meetings. 2. New membership forms will be printed after the COG decides if they wish to reduce the minimum age of members to 12. 3. Peter Gill, Tracey Hall and Cy Dewhurst discussed communication and web development. Eric Fisher and Bob Gee will

join a cross Trust web development group 4. Target for new members will be 350 for 2014 to 2015.

Activities and Events in Previous Quarter Description Date Attendance and Outcome Understanding Dementia 17 April Good selection of governors, full of members Parkstone Careers convention 18th March Lots of advice given and young members signed up Session in training morning 10th April New ideas to inform membership engagement strategy Future Activities and Events Description Date Location Opportunities for

Governors to be involved* Bransgore fete Burley Village Fete

5 May 2 August

Bransgore Burley

yes

Careers talk 10 June 25 June

St Peters School Brockenhurst College

yes

Young members careers in NHS day 26 November Education Centre yes Hospital Open day 11 June yes *Please contact Governor Co-ordinator if you are interested in getting involved in a particular event



GOVERNOR TRAINING COMMITTEE (GTC) Chair: Sue Bungey Meeting Date: 11 March 2014 Key Committee Decisions/Discussions

1. Agreed Work Programme 2014 - 15 2. Process for Mandatory Training Agreed 3. Governor Training 10 April 4. Governor Election programme agreed

Activities and Events in Previous Quarter Description Date Attendance and Outcome Governor Training Evaluation 19 February Good feedback Future Activities and Events Description Date Location Opportunities for Governors to be

Involved* BOD/COG Away Day 19 June Education Centre All Governors Prospective new Governor Programme

To be confirmed Education Centre GTC Governors

Department Tours List to be issued RBCH All Governors *Please contact Governor Co-ordinator if you are interested in getting involved in a particular event



GOVERNOR INVOLVEMENT with PATIENT and PUBLIC ENGAGEMENT (GIPPE) Chair: Glenys Brown Meeting Dates: 24 January and 7 March 2014 Key Committee Decisions/Discussions

1. Collated responses from the Outpatients survey carried out in November 2013 have been sent to the relevant managers by Ellen Bull and the resulting action plan will go to PEC. The next Outpatient survey will be carried out following the department visits ie mid to late June

2. FT members are to be surveyed via Survey Monkey in order to determine public perception of the trust. The aim is to finalise this at the next meeting.

3. Two governors are liaising with Ellen Bull and Sue Mellor in preparation of the Patient Engagement and Strategy meeting with stakeholders to assist in planning this event.

4. The governor co-ordinator is in the process of adding governor action/involvement to the trust diary of events in order to ensure better use of resources and minimise overlap. Please note: the Work Programme is in the Annual Review for GIPPE

Activities and Events in Previous Quarter Description Date Attendance and Outcome Committee meeting 24 January 2014 Key messages are taken to PEC following each

meeting and are reflected above. Committee meeting 7 March 2014 As above Future Activities and Events Description Date Location Opportunities for Governors to be

Involved* Committee meeting 2 May 2014 Consultants Lounge NB Louisa from Healthwatch is

attending this meeting Committee meeting 4 July 2014 Consultants lounge Committee meeting 5 September 2014 Consultants lounge *Please contact Governor Co-ordinator if you are interested in getting involved in a particular event



GOVERNORS' SCRUTINY COMMITTEE Chair: Sharon Carr-Brown Meeting Dates: Various Key Committee Decisions/Discussions

1. Initially, we were working towards finalising the questionnaires for our topic of ‘the culture of elderly care’. This proved impossible and it we were unable to find a way forwards with this topic at this time.

2. After discussions with the committee, the chairman and the Director of Nursing, we have decided to postpone our work looking at the culture of elderly care at RBH until the autumn. Elderly care is currently under extensive scrutiny by governors and external parties.

3. Not wishing to lose a whole year of scrutiny work, we consulted with the Director of Nursing and are proposing a new topic for a short project this summer. The working title for this is: How is care delivered in the surgical directorate? Can the experience for patients and staff be improved?

4. We are also proposing to postpone our review of the effectiveness of scrutiny projects until next year. Activities and Events in Previous Quarter Description Date Attendance and Outcome VARIOUS MEETINGS VARIOUS DATES Future Activities and Events Description Date Location Opportunities for Governors to be Involved* *Please contact Governor Co-ordinator if you are interested in getting involved in a particular event




Subject:

Trust Committee Meetings Report

Section:

For Information

Author of Paper:

Representatives of the Trust Committees/Groups


None



X X X X


To note

Summary:

Reports from the representatives regarding the progress of the Trust Committees


N/A


N/A


Trust Committee Meeting Reports Page 1 of 4

TRUST COMMITTEE MEETING REPORTS 20 January – 29 April 2014

CARBON MANAGEMENT COMMITTEE Governor Representatives: Mike Allen Meeting Dates: 25 February 2014 Key Decisions/Discussions/Actions 1 Negotiations with Energy supplier are now looking 5+ years ahead. 2 Transport Welcome Pack being written. 3 Electric vehicle charging points may be extended to staff. 4 Traditional allotments could be run by staff and patients in courtyards in

main blocks. CARER’S FORUM Governor Representatives: Jayne Baker Meeting Dates: 10 April l2014 Key Decisions/Discussions/Actions

1 Carer’s Passport and work undertaken on malnutrition by Pat Vinycomb, both agreed as standalone elements and Sue Mellor will endeavour to secure a slot on ward sisters meeting.

2 Carers Café. Difficulty in finding room in the Trust to increase uptake 3 Carer’s Event booked 21st June 2014. Format to be advised. 4 Carers Policy. Policy changed again to facilitate the Trust corporate

policy re standardisation of policies. CHARITABLE FUNDS COMMITTEE Governor Representatives: Graham Swetman Meeting Dates: 28 February 2014 Key Decisions/Discussions/Actions

1. Directorates with large outstanding balances presented plans 2. Approved cardiology labyrinth communications software. 3. Approved 8 operating trolleys – reduced patient transfers. 4. Approved new reception area – main outpatients

DIVERSITY COMMITTEE Governor Representative: Vacancy Meeting Dates: Key Decisions/Discussions/Actions

1. No Governor Representative available to attend the meeting(s) held.



EDITORIAL GROUP Governor Representative: Mike Allen, Dean Feegrade, Bob Gee, David Bellamy, Doreen Holford and Judith Adda Meeting Dates: 2 April 2014 Key Decisions/Discussions/Actions

1. Theme for next edition will be: Investing in our future END OF LIFE STRATEGY GROUP Governor Representatives: Glenys Brown Meeting Dates: 11 April 2014 Key Decisions/Discussions/Actions

1. Glenys Brown took part in a Walkround with the Hospital Chaplain and Senior Nurse for Elderly Care Services following the pathway for bereaved relatives/carers.

2. A report was submitted to the End of Life Strategy Group for consideration of the following key points:

Review the location for receiving relatives of the deceased Provide a second room in order to give privacy to those waiting for

an appointment Create a warmer environment including a coffee machine or

similar Provide an alternative to the plastic bag for the belongings (Under

review) Consider how access to the mortuary/ viewing room might be

improved, possibly from a different entry point GOVERNOR FINANCE BRIEFING GROUP Governors: Graham Swetman; Eric Fisher, Vacancy Meeting Dates: 13 February 2014 Key Decisions/Discussions/Actions

1. The costs of additional staff were reviewed, and the effect on the current forecast and outlook for the next year.

2. The effect of the slippage in the Transformation Programme was discussed.

3. Monitor confirmed the Trust as having the lowest risk rating – 4. 4. With the Jigsaw and IT contracts started, the capital spend is now

forecast at £9.4 million for the year just ended.



HEALTHCARE ASSURANCE COMMITTEE Governor Representatives: Sharon Carr-Brown and Emma Willett Meeting Dates: 27 February and 27 March 2014 Key Decisions/Discussions/Actions

1. There is now a senior nurses rota for weekends 2. Directorates are invited to attend HAC and present their quality reports to

the committee. So far from there have been presentations from the Surgical Directorate focusing on the Vascular Ward and Cardiology Directorate.

3. The HAC meeting has been extended to 3 hours duration INFECTION PREVENTION AND CONTROL COMMITTEE Governor Representative: Keith Mitchell Meeting Dates: 23 January and 17 April 2014 Key Decisions/Discussions/Actions

1. No report submitted ORGAN TRANSPLANT COMMITTEE Governor Representative: Dexter Perry Meeting Dates: Key Decisions/Discussions/Actions

1. No report submitted PATIENT ENGAGEMENT AND COMMUNICATIONS COMMITTEE Governor Representatives: Sue Bungey / Eric Fisher / David Triplow / Glenys Brown Meeting Dates: 7 March 2014 Key Decisions/Discussions/Actions

1. No report submitted PATIENT INFORMATION GROUP (PIG) Governor Representative: Keith Mitchell Meeting Dates: Monthly Key Decisions/Discussions/Actions

1. Please see the latest leaflets to be published following this report VALUING STAFF AND WELLBEING Governor Representative: Keith Mitchell and Sue Bungey Meeting Dates: Key Decisions/Discussions/Actions

1. No report submitted

Department of Clinical Nutrition & DieteticsRe-introduction of higher

foods after a low residue dietYour Dietitian is:The Royal Bournemouth Hospital: 01202 704732Christchurch Hospital: 01202 705477

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 buildup 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 oneIntroduce 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 fruitone cupful of grapes/cherriesthree tbsp vegetablessmall glass of fruit juice

Week twoTry replacing your normal portion of white bread with wholemeal bread. Remember that granary bread should still be avoided.

Week threeTry a higher fibre breakfast cereal e.g. Weetabix, Shredded Wheat, Bran Flakes.

Week fourIf 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 supplementsFive 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.

FluidFibre 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.

cs/ljs/sharedfile/dietsheets/low residuereintro of higher fibre foods/Feb2014

Website: www.rbch.nhs.uk n Tel: 01202 303626

Our VisionPutting 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: April 2014 Version: One Review date: April 2017 Ref: 021/14

Department of Clinical Nutrition & Dietetics

Calcium in the dietWhy is calcium important?Calcium is essential for strong bones and teeth. Lack of calcium can lead to osteopenia or osteoporo-sis sometimes described as (thinning of the bones). The amount of calcium that we need depends on our age, or if we have conditions such as Crohn’s disease, ulcerative colitis, coeliac disease or osteo-porosis.

Daily Calcium Requirements

Adults (19years+) 700mg

Adults with Osteoporosis 1200mg

Adults with Crohns disease or ulcerative colitis 1000-1500mg

Adults with Coeliac disease or dermatitis herpetiformis 1000mg

Breastfeeding mums an extra 550mg

Postmenopausal women and men over 55 years of age 1200mg

Absorbing calciumVitamin D helps the body absorb calcium. Most of the vitamin D we need comes from sunlight. Having 15-20 minutes of sun exposure on the arms and face (without sun cream) between April to September will provide all the vitamin D needed for the whole year. Make sure that you take steps to avoid sunburn if out for longer than this. Vitamin D can also be obtained in small amounts from the diet. Rich sources include:• fortifiedbreakfastcereals• eggs• margarines• oilyfish(egmackerel,salmon,sardines).

SomepeopleareparticularlyatriskofvitaminDdeficiency.A10microgramsupplementshould be considered if you fall into the following groups, and you should speak with your doctor for more information about this:• people aged 65 years old or over• pregnant and breastfeeding women• people from ethnic minorities who have darker skin• people who rarely go outside or cover their skin

Sources of calciumCalcium comes mainly from dairy products. Low fat sources such as skimmed milk and low fat cheese contain as much calcium as the full-fat options. There are plenty of non-dairy sources of calciumtoo,suchaspulses,greenleafyvegetables,driedfruit,nutsandtinnedfish(ifyoueatthebones). The list below shows the main sources of calcium.

Foods containing calcium Calcium content (mg)

1/3 pint (200mls) cows milk (full fat, semi or skimmed)1/3pint(200mls)fortifiedsoya/nut/oatmilk1/3pint(200mls)organic/unfortifiedsoyamilk1oz (25g) cheddar or other hard cheese6oz (150g) pot yoghurt4oz (100g) pot fromage frais3oz (75g) cottage cheeseFortifiedyogurt(e.g.Cal-in,Dannon)4tablespoon (50g) skimmed milk powder

24030026

2002258555

400600

4oz (100g) ice creamserving custard (120g semi skimmed milk)

120140

2oz (50g) sardines (tinned with bones)4oz (100g) tinned salmon2oz (50g) shelled prawns

2309375

two slices breadtwoslicesofglutenfreebread(fortifiedwithcalcium)

6060

4oz (100g) spring cabbage4oz (100g) broccoli4oz (100g) baked beans

344080

one medium orangefivedriedfigs

58250

2oz (50g) almonds2oz (50g) peanuts1oz (25g) sesame seeds2oz (50g) dried apricots

12530

19036

220g macaroni cheese 374

200g rice pudding 185

Should I take a calcium supplement?You should aim to get all the calcium you need from your diet, however, there are some people who may struggle to take the recommended amount. For those people it is sensible to take a supplement. It is important to consider that excessive intakes of more than 2500mg per day should be avoided. Speak with your doctor or dietitian if you feel you need to take a supplement.

General recommendations for bone healthInadditiontohavingsufficientcalcium,eatingavarieddietisalsoimportantforgoodbonehealthto ensure that you have a wide range of other nutrients. You should aim to limit your salt intake, and avoid smoking and excessive alcohol, as they can contribute to osteoporosis.




Pleasecontacttheauthorifyouwouldlikedetailsoftheevidenceintheproductionofthisleaflet.We can supply this information in other formats, in larger print, on audiotape, or have it translated for you.


Author: Annie Griffiths Date: April 2014 Version: One Review date: April 2017 Ref: 022/14

Department of Clinical Nutrition & Dietetics

Low Oxalate Diet SheetYour Dietitian is:The Royal Bournemouth Hospital: 01202 704732

What is Oxalate and why do I need a low oxalate diet?Oxalate is a chemical found in a variety of plants. You may need to follow a low oxalate diet if you have kidney stones.

What should I do?Avoid foods in the high oxalate food list. You may eat foods from the moderate list three to five times a week, and foods from the low oxalate list as often as you want. Please ensure you drink plenty of fluids during the day - except coffee and strong tea which should be limited to one cup a day,and cola which should be limited to one can. If you take a vitamin C supplement do not take more than 1000 milligrams (one gram) a day.

High oxalate foods Moderate oxalate foods Low oxalate foods

Beverages: chocolate milk, chocolate drink mixers, hot cocoa, tea, fruit juice.

Beverages:: buttermilk, lemonade or limeade without added vitamin C. Milk (all types), water, squashes.

Fruits: berries of all kinds: currants, fruit cocktail, lemon, lemon and orange peels, marmalade, grapes, rhubarb, tangerine, juices from above fruits.

Fruits: apricots, blackcurrants, cherries, cranberry juice, grape juice, orange, orange juice, peaches, pears, pineapple, prunes, purple plums, jelly or jam.

Fruits: all those not listed. Juices, jams, jellies and preserves made with those fruits allowed eg.apples, banana.

Vegetables: beans: green, dried. Beets eg beetroot. Celery, chives, cucumbers, aubergine, green peppers, greens of all kinds, kale, leeks, okra, parsley, spinach, summer squash, swiss chard, watercress, tomato soup, vegetable soup.

Vegetables: (1/2 cup cooked, 1 cup raw). Asparagus, broccoli, brussel sprouts, carrots, corn, green peas - canned, lettuce, lima beans, parsnips, tomato (1 small, 4oz/1/2 cup juice), turnips.

Vegetables: avocado, cabbage, cauliflower, mushrooms, onions, peas (fresh or frozen), potatoes, radishes.

High oxalate foods Moderate oxalate foods Low oxalate foods

Starches: amaranth, fruit cake, soybean products, sweet potatoes, wheatgerm and bran.

Starches: cornbread, sponge cake, spaghetti (fresh, dried or tinned).

Starches: bread - made without bran, wheat germ or wholegrain. Breakfast cereals, macaroni, noodles, rice, spaghetti (plain).

Meats and protein substitutes: baked beans in tomato sauce. peanut butter, tofu.

Meats and protein substitutes: Sardines.

Meats and protein substitutes: beef, lamb, pork, poultry, eggs, cheese, bacon, fish and shellfish.

Fats and oils: nuts (peanut, almonds, pecans, cashews, walnuts). Nut butters, sesame seeds, tahini.

Fats and oils: butter, margarine, mayonnaise, salad dressing, vegetable oils.

Other: carob, chocolate, cocoa.

Miscellaneous: coconut, lemon or lime juice, salt, sugar or sweeteners.

ah/ljs c: diet sheets/ low oxalate/ Sept09






Author: Orla Kearney Date: April 2014 Version: One Review date: April 2017 Ref: 023/14

Outpatient Department Patient InformationThis leaflet contains information which you may find useful regarding your forthcoming appointment.

Your appointmentIt is the Trusts responsibility to provide timely clinical care therefore it is important you keep your appointment.

If you wish to Cancel or Rebook your appointment, please contact us by:l Telephoning the Outpatient Appointment Line on 01202 704738 09.00 - 16.30 and choosing the appropriate option. l Visiting the hospital website at www.rbch.nhs.uk. If you click on ‘coming to hospital for an appointment’ on the homepage, you will be taken to a form to complete.

If you are unable to keep your appointment and do not inform us, another appointment may not be made for you and you may be referred back to your GP. Please be aware you are only able to rebook your ap-pointment twice.

The Trust is now offering patients the opportunity to have their outpatient appointment letter emailed to them. If you would like more information about how you can access this service please visit www.rbch.nhs.uk/email

Can I bring someone with me to my appointment?Yes you are welcome to have a relative or friend accompany you for your appointment.

Is my personal information confidential?Yes. The Data Protection Act 1998 also gives you the right to see any information we hold on you. If you would like to apply to see your details, or would like more information about your rights under the Act, please write to The Medico Legal Manager at the hospital who will be happy to help.

How do I prepare for my appointment?Please bring the following items with you for your appointment:l Your appointment letter.l Details of any current medication you are taking.l A list of questions you may wish to ask the doctor.l Your diary in case you require any future appointments or treatments.

What if I have specific requirements for my appointment?If you have any specific requirements e.g. language and need assistance, please contact the telephone number on your appointment letter and we will be happy to assist you. Please note the Main Outpatient area has a hearing loop system.

What do I do when I arrive for my appointment?Please allow plenty of time to book in for your appointment. Patient self check-in screens are located in the waiting area for you to check in quickly for your appointment. Alternatively you can book in at the reception desk. Please note you will be asked if you been lawfully resident in the UK for the last 12 months.

You are being asked this question because the Trust has a duty to protect NHS resources by identifying those patients who are not ordinarily resident in the UK and may be chargeable for the care they receive.

How long will I be at the hospital for?Please allow up to 2 hours for your appointment, should you need tests or assessment for surgery.

If you require any investigations before your appointment, you will be directed to the appropriate department.

We hope that you will be seen at your appointment time or within 30 minutes of that time. Occasionally there are unavoidable delays, though the clinic staff will keep you informed. If the clinic is delayed and you are unable to wait, please report to the receptionist who will be happy to advise you about making a further appointment.

What happens during my consultation?You may not see the Consultant on each visit however the doctor who treats you will be a member of the consultant’s team and be fully able to continue your treatment and care. If you need a Fit for Work Certificate, please ask the doctor before you leave.

What if I need an operation, treatment or investigations?If you require any of these the doctor will discuss this with you during your appointment and explain what is going to happen. You may need to sign a consent form which the doctor will discuss with you. Before signing, please ask any questions you may have if you are not sure or do not understand anything.

Can I have a copy of the clinic letter which is sent to my GP?You are entitled to a copy of the letter which is sent to your GP after your appointment. We will be happy to send you a copy if you wish, please ask your Consultant who will ensure a copy is sent to you.

What happens after my appointment?If you require another appointment you will be asked to go to the reception desk. If your next appointment is over six weeks, an appointment will be sent to you in the post nearer the time. We will aim to arrange an appointment for a mutually convenient date and time.

How long will I have to wait if I need treatment or an operation?The Trust will endeavour to ensure patients first definitive treatment will be within the 18 week time frame. For more information please visit www.nhs.uk/choiceintheNHS and search for ‘waiting times’.

What if I have some comments and suggestions to make?We welcome all comments as they let us know when we get it right as well as when there is room for improvement. If you have any feedback on our service, please put a note in the Suggestion Box located in the Main Outpatients waiting area.

If there is any aspect of your care or service with which you have not been satisfied, please talk to the nurse in charge so that any problems can be solved straight away. If you are still unhappy, please contact PALS (Patient Advice and Liaison Service) on Telephone 01202 704886 or email: [email protected] Alternatively you can speak or write to the Complaints Manager at the Hospital who will deal with your complaint.

What do I do if I need an Outpatient Prescription?Please be aware you will only be issued a prescription to take to the hospital pharmacy if a medicine is:l Required urgently.l Only available from the hospital, or requiring specialist supervision.

For all other prescriptions the doctor will write to your GP to recommend the treatment. You will need to visit your GP surgery in a couple of weeks to collect a prescription. You should not need to make a separate appointment to see your GP. Please allow a couple of weeks for the letter from Outpatients to reach your GP.

Is there any additional information I need to know?l Travelling to the hospital - for the most up to date information, please visit www.rbch.nhs.uk Click on ‘Patients and visitors’ and then ‘Travelling to hospital’l Wheelchairs are available for patient use. Please ask a member of staff if you are unable to find one.l Refreshments can be purchased within the Outpatients Department.l Disabled toilets and Baby Changing Facilities are located in Main Outpatients, Eye Unit and Orthopaedic departments. l Mobile Telephones - please refrain from using your mobile telephone within the Outpatient department.l Smoking - The Hospital is non-smoking, apart from designated smoking areas situated outside our hospital buildings. For details on the location of the smoking areas please ask a member of staff.

Is this leaflet available on other formats?We can supply this information in larger print, on audiotape, or have it translated for you. Please call PALS on 01202 704886.






Author: Karen Turtle, Karen Molloy and Carol Barlow Date: April 2014 Version: One Review date: April 2017 Ref: 024/14

Our VisionPutting 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: Jo HeatonDate: April 2014 Version: One Review date: April 2017 Ref: 1449/14

Hom

e treatment for genital w

arts


Home treatment for

genital warts

Department of Genitourinary Medicine,Royal Bournemouth Hospital, 01202 704644

l do not use shower gel, feminine washing products, Lynx or “anti bacterial” products

l showering is better than bathingl if you bath, never wash your hair in the bath. Avoid bubble bath,

bath salts, salt, Dettol etc. Keep the water as clear as possiblel do not use moist toilet wipes, baby wipes or feminine wipesl for underwear use a non biological washing powder.

Avoid fabric conditioner.l if you use sanitary towels or panty liners, buy basic products.

Tampons may be better. Hypoallergenic products are available. l do not use products which cause any discomfort. l there are a variety of creams (from pharmacy counters) which

can be used to wash, protect, cleanse and moisturise the skin. It is worth trying different ones to find one that suits you. eg Epaderm or Hydromol ointment,Dermol 200, Doublebase or Oilatum shower gel

l moisturise the area regularly with a simple unscented cream like the creams suggested above. Check the expiry date

Hom


arts

Hom


artsHome Warts Treatment (Warticon or Condylline)Do not use if you could be pregnant.You must be using contraception for it to be safe to use home treatment.

How Do I Use It?l Apply to warts twice a day - morning and night for 3 daysl Stop treatment for 4 days to let your skin recoverl Do not use if too sore (mild discomfort is normal)

How Long Do I Treat For?l Repeat the 7 day cycle (3 days treatment,4 days rest) until

there are no more visible wartsl If the warts don’t change at all after 4 weeks of treatment,

make an appointment at the clinic for a review

What Do I Do If The Warts Come Back?l If you don’t think you need another sexual health check up or

have any other concerns, you could start using the home treatment again

l Make sure you are not at risk of pregnancyl Follow instructions as beforel You should return to the clinic if the treatment doesn’t clear the

warts after two, 4-week cycles of treatment

Advice for care of the genital areaMany genital conditions are caused or made worse by inappropriate washing.In addition to eczema, thrush, warts and herpes will be more likely to reoccur if the skin is stressed by overwashing. It can make your skin sore.Skin problems attract bacteria so washing more will tend to make smells worse. Your body is constantly changing so you need to adapt your washing habits.l avoid washing with bubbly, fragranced products l use plain water for your genitals

Visible warts

Start home treatment

Home treatment is Warticon Cream or Condylline Solution

No warts

No further action

No warts

Warts persist

Repeat 7 day cycle until warts go

Leave for 4 days for skin to recover

Apply carefully to wart morning and night for 3 days

Visible wart

Hospital treatment (“freezing” or cryotherapy)

Check warts at home after 7days




Subject:

Governor Activity Report

Section:

For Information

Author of Paper:

Written by Governors Compiled by Dily Ruffer


None



X X X X


To note

Summary:

Full activities of Governors since the last Council of Governors meeting held in January 2014


N/A


N/A

Council of Governors Activity Report 29 April 2014

Council of Governors Activity Report

20 January – 29 April 2014

John Adams (JaA), Judith Adda (JuA), Mike Allen (MA), Chris Archibold (CA), Jayne Baker (JB), David Bellamy (DB), Glenys Brown (GB), Sue Bungey (SB), Sharon Carr-Brown (SCB), Derek Chaffey (DC), Carole Deas (CD), Derek Dundas (DD), Dean Feegrade (DF), Eric Fisher (EF), Lee Foord (LF), Bob Gee (BG), Phil Goodall (PG), Alf Hall (AF), Doreen Holford (DH), Colin Jamieson (CJ), Tom Knight (TK), Ian Knox (IK), Keith Mitchell (KM), Richard Owen (RO), Dexter Perry (DP), Graham Swetman (GS), Gail Thomas (GT), David Triplow (DT), Emma Willett (EW)

Date Activity/Event/Meeting Governors Attending 20 January Council of Governors meeting Part 1

JuA, MA, CA, JB, DB, GB, SB, SCB, DC, CD, DD, DF, EF, BG, PG, AF, DH, CJ, TK, KM, RO, DP, GS, GT

20 January Council of Governors meeting Part 2

JuA, MA, CA, JB, DB, GB, SB, SCB, DC, CD, DD, DF, EF, BG, PG, AH, DH, KM, RO, GS

20 January Scrutiny Meeting JB, DB, SCB 22 January PLACE Ward 22 MA, 22 January PLACE Training KM 22 January Scrutiny Committee – Culture of Care Medicine for the Elderly EF 23 January Care Audit Campaign EF 23 January Infection Control Meeting KM 23 January Scrutiny JB 24 January Governor Involvement with Patient and Public Engagement

Committee (GIPPE) Meeting GB, EF

24 January Walk Round SB 24 January Elderly Care Committee KM 30 January HAC SCB 30 January Jigsaw Development Visit EF 30 January Scrutiny Committee – W3 letter distribution EF 31 January Staff Drop In Session RO, EW, DF 31 January Visit Jigsaw Site MA 31 January Open Clinic with Jane Stitchbury and Staff EW January Elderly Care – relative feedback x 2 days KM February Jigsaw Building visit DT 3 February Trust Induction DB, GB, SB, SCB, GS 4 February Valuing Staff Committee SB 4 February Scrutiny Meeting JB, DB, SCB 6 February Scrutiny Meeting with PS JB, DB, SCB


6 February NHS Sustainability Road Show MA, RO 7 February Patient Engagement Committee GB 10 February Meeting with Sir Ian Carruthers SB, DD, EF, EW 10 February PLACE training JuA, EF 11 February Feedback from Board with Richard Renault RO 11 February Meeting with Communication Team EW 12 February Staff Briefing RO 12 February Staff Meeting with JS EW 12 February Listening Event MA 13 February Governors Finance Sub-Group DD, EF, GS 13 February Meet the Chair RO 14 February Board of Directors Meeting MA, DB, GB, SB, DD, EF, KM, RO, GS, DT 14 February Elderly Care Committee KM 14 February End of Life Strategy Committee GB 17 February Meeting with Auditors DD 17 February Governors Values Workshop MA, DB, SCB, DD, EF, KM, RO, DT, EW 19 February CEO Meeting DD 19 February Governor 1-2-2s DD 19 February Governor Training JuA, MA, JB, DB, GB, SB, SCB, DD, EF, BG, AF,

DH, KM, GS, DT 19 February Hospital Photo KM 19 February Patient Care Audit GB 20 February ‘Meet the Governors’ EW 20 February Care Audit Campaign EF 24 February Vision and Values Meeting with the public MA, SB 25 February Carbon Group Meeting MA 25 February PIG Meeting KM 27 February NEDS Roundtable SB, SCB 27 February HAC SCB, EW 27 February Governor – NED Meeting DD, EF, KM, EW 27 February Understanding Health Talk DB, DD, KM, 27 February Care Audit Campaign EF 27 February Values Workshop with Patients/Carers EF 27 February Charity Event DD 28 February Charitable Funds Committee GS


February Elderly Care – relative feedback x 7 days KM 2 March March for Men KM 3 March Patient Care Audit GB 3 March Trust Induction DD, KM, DT 4 March Staff Reward and Recognition Group RO, EW 5 March Health Watch KM 5 March Maurine KM 6 March Care Audit Campaign EF 6 March Values Workshop with Patients/Carers EF 7 March Governor Involvement with Patient and Public Engagement

Committee (GIPPE) Meeting GB, EF, DH, DC

7 March PECC Meeting SB 7 March Care Audit JB 8 March Governor Scrutiny Committee Meeting DB, SCB, GB 10 March Care Audit JB 11 March Governor Training Committee (GTC) Meeting JB, GB, SB, DD, DT 11 March Governor Chairs Meeting GB, SB, SCB, DD, DT 12 March Membership Development Committee (MDC) Meeting DT, EF, BG, DD, JB, RO 12 March Staff Briefing RO 14 March Elderly Care Feedback Committee KM 14 March Board of Directors Meeting MA, DB, GB, SB, SCB, DD, EF, KM, DT, RO 14 March End of Life Strategy Committee GB 18 March Meeting with head of catering and dietician KM 18 March Careers Convention at Parkstone Grammar School DT 19 March CEO Meeting DD 19 March Carers Café KM 20 March Care Audit Campaign EF 20 March Atrium – Hydration & Nutrition EF 22 March League of Friends Coffee Morning KM 23 March PLACE Meeting MA, KM 25 March Scrutiny Meeting JB, DB 25 March PLACE Inspection MA, EF, KM 26 March PLACE Inspection DB, EF 26 March Foundation Trust Governor Association (FTGA) Development Day

held in London SCB, BG


26 March Hospital Letters Meeting SB 26 March CoG Report on GIPPE Meeting GB, EF, DH 27 March HAC EW 31 March Deloittes meeting held in London EF March Elderly Care – relative feedback x 10 days KM 1 April Day Working on W4 KM 1 April Volunteer Coffee Morning KM 2 April FT Focus Meeting MA 3 April Care Audit Campaign EF 3 April Planning Meeting EF 3 April Editorial Committee DB 5 April Patient Safety Walkabout KM 7 April NED Remco Meeting SB, EF 7 April Core Training SB 7 April Volunteer Committee KM 7 April Meeting with Chair EF 8 April Governor Scrutiny Committee Meeting JB 9 April Hospital Letters Meeting SB 9 April Residents Meeting with Tony Spotswood SB 9 April Staff Briefing with TS EW 10 April Meeting with Paula Shobbrook KM 10 April Governor Training JaA, JuA, MA, JB, DB, SB, SCB, DC, DF EF, BG,

DH, IK, KM, RO, GS, DT 11 April Board of Directors Meeting DB, SB, SCB, EF, KM, GS, DT 14 April Improvement Launch Event RO 14 April CoG Agenda Setting EF 17 April Understanding Health in the Community Health Talk - Dementia SCB, EF, DT 17 April Infection Control Walkabout KM 20 April Elderly Care Thank You KM 22 April Nominations Meeting SB 22 April PIG Committee KM 23 April Hospital Letters Meeting SB 24 April Care Audit Campaign EF 24 April HAC SCB, EW 24 April Vitalpac Demo/Tour DB, SCB, KM


25 April Conference Planning Call on forthcoming workshop GB, EF, DH April Elderly Care – relative feedback x 7 days KM


1

FTGA Development Day 26 March 2014

London Copies of all slides can be found on the FTGA website and these notes should be read in conjunction with these slides. Keynote 1 - Lord Hunt, Chair, Heart of England FT The FTGA has a critical role in developing the role of governors – it needs to write some sort of manifesto for governors. Lord Hunt made clear his support for the FTGA as a source of ‘good ideas’. The future strength of FTs is in their governance arrangements and their membership. He reflected on the start of FTs. Post-NHS Plan in 2000. It was the start of the conversation about local NHS services and their relationship with central government. It was felt that a membership model was required if accountability was going to go straight to the Secretary of State. FTs are owned and accountable to the people who use them. 'The great weakness of FTs at the moment is their small scale membership and the fact that many of them are quite happy with that.' Heart of England FT, of which he is Chair, has split its 100,000 odd membership into 3 levels – level 3- basic, level 2- more involved, level 1- active. He didn’t say how this was done. They have around 900 active members, level 2 the same amount, but their passive membership - level 3 - is around 88,000 with 10,000 staff, who are not categorised as to their level of activity. This level of membership was brought about by signing up every in-patient with the option to opt-out. This strategy was not met with universal approval. They are thinking of piloting working with local authority youth workers to set up a youth panel to see how that could feed into the work of the CoG. They have taken part in some local events where young people talked about health. He admits that they haven't done enough with staff members. He’d previously found it very helpful that the 'lead' staff governor was also chair of the staff side group in the trust.


2

This large membership costs around £180,000 per year to maintain. Wants to spend more to increase membership to 250,000! What's the make up of the committees in terms of NED and ED participation? They use EDs as secretaries to each of the governor committees. If EDs are doing this work, how are governors holding the board to account via the NEDs as the 2012 act says? This question was asked and he admitted it was a good point because it wasn’t their approach. Lord Hunt made it clear he felt Noms committees should ONLY have governors on them, not just a majority. Monitor has been immovable on changing the wording on this in their guidance for governors. He said that one of their best innovations has been a 1.5 hour breakfast for governors with the chairman on the last Friday of every month. NEDs also attend this and it helps with the governor-NED interaction. He was asked why his FT has no CCG stakeholder governor – because he can’t see the point! Their stakeholder interaction is focussed very much on the local authorities. He outlined what he felt were the successes of governors:

Governors 'keep the Board honest.' An invaluable sounding board. They can legitimise major change. Eyes and ears for the Board, can raise safety issues. ‘You can't

have too many people seeing what's going on.’ He felt that the Board-council debate over the 5-year plan is an invaluable exercise for FTs and asked whether members themselves should be more engaged in decisions - such as in the 5-year plan? His other thoughts touched on whether the FTGA should be developing peer group review of governing bodies. He would welcome it. He thinks the CQC should review quality of CoGs as part of their reviews – something the FTGA argued for in private years ago with the CQC’s predecessor. He also felt that the FTN should be encouraged to support governors and their role more, remembering it's the members who 'own' the FT. Mention was made concerning the merger of the FTN and the FTGA.


3

Break out 1 - CoGs and BoDs - governors getting involved in strategic decisions East London chair said they have aligned the board and council forward plan such that governors’ discussions on a topic can be reported to the board by the chair. Governors need to assure themselves that the board is acting strategically first. Governors can have a formal committee structure to support strategic work, such as strategy and business planning. This committee can then monitor the implementation of the strategy. Do you think strategic discussions should be on a case-by-case basis or ongoing? - Ongoing. Governors must also understand both sides of the business. A few trusts have Board and council strategy committees and they work well together. Governors must be a critical friend to their Boards. The idea of unannounced governor ward visits was suggested and most supported this. Keynote 2 - Jonathan Benger - emergency care review Emergency care has developed piecemeal since the inception of the NHS and this is the first time we’re having sensible conversations about how to change it, with the greatest degree of agreement ever. ‘Change will be radical - everywhere, everything, everybody has to change.’ There are 120 million emergency care visits to GPs each year. In contrast, there are 5.2 million to hospital but that's where the money's spent. Hospitals have limited control over who comes in their front door. Have to therefore influence the arrival of patients at the hospital in the first place with other options. If we want GPs to do more, we have to encourage them to work differently and ensure their workload is manageable. What can they do less of? Talked about having reliable, assured health information - NHS Choices should do this.


4

Urgent care centres will be based in primary care but work hours and have capabilities closer to A&E provision. Hospitals should be more clearly designated as emergency and major emergency care centres. Need to ensure rural provision is as good as it can be. Create specialist centres but also perhaps more local higher-level emergency care centres, possibly based on networks. Urgent care network needs around 1-2 million population to be large enough. Sense check any proposals against the needs of children, frail elderly and those with mental health needs. If a proposal doesn't work for these groups it's not adopted. FTs need to work beyond their walls. Need expertise of hospitals applied in the community. Clinicians have a responsibility for the community provision of their care, not just within hospital. FTs will lose money if they don't. He didn’t address the role of the CCGs and commissioning with regards to this. The whole review process has to be cost neutral. Strongly recommending the co-location of urgent care centres with emergency care centres. This seems to be the best model. Break out 2 - Significant transactions This was taken more from the perspective of the recent guidance that Monitor put out about how they will assess significant transactions in the future. Monitor is changing its consideration of significant - now more nuanced and not just about financial percentages. They realised that some transactions were above 25% but didn't have the risk that would make them significant and vice versa. More of a risk-based approach required. Monitor will publish the results of their review in 2015/16. The FTGA’s significant transactions essential brief mirrors largely Monitor's approach. Peterborough governors have used it three times this year to approve significant transactions. Breakout 3 - Independent Panel for Advising Governors


5

Linda Nash: Appointed Chair of the Advisory Panel for Governors by Monitor. Issues that the Panel should consider will be either that the Council feels that there has been a breach by the Board of its Constitution or Chapter 5 of the NHS Act 2006. The independent panel brought in by Monitor to coincide with the 2012 Act has not yet been used in full by a council of Governors. A number of individuals have approached the panel, however in all cases they have been asked to approach the panel as a ‘Council’ and not as individuals. None has returned to the panel. In practice, a majority of Governors should be in agreement to approach the Panel. All issues raised by the appellant are confidential to the Chair. The aim of the Council should always be for resolution not confrontation. Overall impressions The networking opportunities remain excellent and hearing what other governors are doing from around the country is stimulating and eye opening. The speakers were good and interesting and would not have been available in any other format. However, the FTGA is clearly suffering at the moment and needs an injection of vigour and vision if it is to survive. The next six months will be critical. The executive are unclear as to how to get the support the organisation needs within the very small financial envelope they have at their disposal. Governors will need to realise that if they want an independent body to represent them, they will have to support it and be prepared to pay for it. No doubt the suggestion of a merger of the FTGA and the FTN is a possible way forward.




Subject:

Action Matrix

Section:

For Information

Author of Paper:

Dily Ruffer


None



X


To note

Summary:

Progress report of Trust Secretary’s Office actions from Governor Committee Meetings


N/A


N/A

Governor Committee Action Matrix as at 6/1/14

Key CompletedIn ProgressStill to Action

Committee Date Raised Person Responsible

Action Update on action

MDC 5.6.2013 KF 13/14vi) 13/08 Hard to Reach update Ongoing

MDC 04.09.2013 DR 13/47 Membership Form - The form will be updated after the Competition Commission decision has been announced. DR will ask Tracey Hall for updated statements to be used

Awaiting decision at the April Council of Governors meeting re: Constitution changes

GIT 14/11/2013 DR 13/37i) 13/27 CORE and TRUST MANDATORY INDUCTION One full day Trust Mandatory Training for all Governors would be implemented in 2014

Activated in February and the Governor Training Committee (GTC) reviewed feedback. In future only new Governors will attend Trust Induction and on re-election, attend non-clinical one day mandatory training

GIT 14/11/2013 DR 13/40 eNews Full Demonstration – Included in AMM as talk to the public. Sarah Allaway offered small group presentations on the wards. DR to take forward.

Completed. 24 April 2014

GIT 14/11/2013 DR 13/41 Becoming a Governor Booklet Changes as stated in minutes to be made Completed.

MDC 06/11/2013 KF 13/38vii) 13/25 2013/14 Work Programme Progress. KF to prompt for profiles at next Governor Induction, prior to end of year.

Completed. Governor profiles have a "new look" on the website

Committee Date Raised Person Responsible

Action Update on action

GTC 07/01/2014 KF14/15 14/09 Customer Services Training KF stated she had not received feedback about the proposed training suggested to be delivered by an external provider for governors on patient engagement. However it is hoped to be able to include this in a training session later on in the year.

Customer Service training has been included on the GTC training schedule

GTC 11/03/2014 KF 14/17 Annual Report The annual report was discussed and KF said that this can be merged with the work programme. The main objective is to ensure governors had training which is appropriate for them to do their role and the Trust to support them.

Completed

GTC 11/03/2014 DR 14/25 Department Tours DR stated that the datesare coming together and will be sent out shortly. Completed. Department visits are

currently taking place and will complete in June 2014

A G E N D A - Royal Bournemouth Hospital · Council of Governors Meeting Agenda - Part 1 April 2014...

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