COUNCIL OF GOVERNORS MEETING AGENDA

Venue: Board Room, Airedale General Hospital, Skipton Road, Steeton, Keighley, BD20 6TD Date: Wednesday 26 January 2011 Time: 1600 hours

No Item Presenter Paper Ref

1. Apologies for absence Chairman - 2. Declarations of Interest 3. Minutes of meeting held on 26 October 2010 Chairman A 4. Matters arising not covered elsewhere Chairman - on the agenda

STRATEGY & PERFORMANCE 5. Report from the Chief Executive Chief Executive B 6. Quarterly Airedale NHSFT Report (i) Finance Report Director of Finance C (ii) Performance Report Director of Finance D 7. Annual Audit Opinion Letter Director of Finance E 8. Annual Plan 2011/12 update Director of Finance verbal GOVERNANCE 9. Appointments and Remuneration Committee Committee Chair F (i) NEDs Terms and Conditions of Appointment (ii) NEDs Recruitment and Selection process (iii) Reappointment of Mr Adam and Mr Drake (iv) Remuneration Review Report 10. Membership Development Group Group Chair G (i) Terms of Reference (ii) Membership Development Strategy 11. 2011 Elections Report Company Secretary H

ITEMS OF INTEREST 12. Counter Fraud presentation Counter Fraud Specialist verbal

13. NHS Confederation FTN Event Deputy Lead Governor I 14. Airedale Charitable Funds Report Committee Chair J 15. Network meetings Chairman verbal 16. NEDS Update Report Chairman K 17. Items to notify to Governors FT Membership Manager verbal 18. Forward agenda Company Secretary L 19. Members Questions Chairman verbal 20. Any other business 21. Review and close of meeting Date and time of next meeting: 4.00 pm Tuesday 26 April 2010 - Quarterly Council of Governors meeting

Council of Governors meetings are public meetings. Any member of the public can raise questions regarding the business of the Council. Questions need to be submitted in advance of the meeting either: in writing to the Company Secretary, Trust Headquarters, Airedale General Hospital, Skipton Road, Steeton BD20 6TD or by email to jane.downes@anhst.nhs.uk

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MEETING OF THE COUNCIL OF GOVERNORS HELD AT 1600 HOURS ON TUESDAY, 26 OCTOBER 2010

BOARD ROOM, AIREDALE GENERAL HOSPITAL, SKIPTON ROAD, STEETON, KEIGHLEY

PRESENT: Mr Alan Sutton, Non Executive Director (in the Chair) Mr Peter Allen, Public Governor, Skipton Dr Neil Boyle, Public Governor, South Craven Mr Mark Haw-Wells, Public Governor Bingley Mrs Anne Medley, Public Governor, Keighley West Mr Adrian Mornin, Public Governor and Lead Governor, Keighley Central Mr Mohammed Nazam, Keighley Central Mr John Osborn, Public Governor, Rest of England Dr Alan Pick, Public Governor, South Craven Mr John Roberts, Public Governor, Worth Valley Mr Alan Sturgess, Public Governor, Settle and Mid-Craven Mrs Pat Thorpe, Public Governor, Bingley Rural Mr Ray Tremlett, Public Governor, Pendle East and Colne Mrs Valerie Winterburn, Public Governor, Craven Ms Rachel Binks, Staff Governor, Nurses and Midwives Mr David Petyt, Staff Governor, Registered Volunteers Mr Narem Samtaney, Staff Governor, Doctors and Dentists Mrs Karen Swann, Staff Governor, Nurses and Midwives Mrs Pam Essler, Stakeholder Governor and Deputy Lead Governor, NHS Bradford and Airedale Mrs Pauline Sharp, Stakeholder Governor, Bradford Metropolitan District Council Mrs Marcia Turner, Stakeholder Governor, Craven District Council IN ATTENDANCE: Mr David W Adam, Non Executive Director Mrs Helen Barrow, Complaints Manager Ms Della Cannings, Chairman of Yorkshire Ambulance Service Dr Andrew Catto, Medical Director Mr Jeff Colclough, Non Executive Director Mrs Jane Downes, Company Secretary Mr Ron Drake, Non Executive Director Miss Bridget A Fletcher, Chief Executive Mr Adrian Haupt, Volunteer Mrs Sally Houghton, Non Executive Director Mr Chris Newton, member of the public Ms Nichola Powell, Executive Assistant Mrs Sheenagh Powell, Director of Finance Mrs Denise Raven, Communications Manager Mrs Ann Wagner, Director of Strategy and Business Development APOLOGIES FOR ABSENCE: Miss Leanne Clegg, Staff Governor, All Other Staff, Prof Anne Forster, Stakeholder Governor, University of Leeds, Cllr Robert Heseltine, Stakeholder Governor, North Yorkshire County Council, Mr Chris Nolan, Public Governor, West Craven, Mrs Sheila Paget, Public Governor, Ilkley, Mrs Barbara Pavilionis, Public Governor, Skipton, Mr Bill Redlin, Stakeholder Governor, NHS North Yorkshire & York, Mr John Wickham, Public Governor, West Craven

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ACTION 35/10 WELCOME

Mr Alan Sutton, Non Executive Director and Deputy Chairman, submitted apologies for non-attendance on behalf of Mr Colin Millar, Chairman, stating that the recent change in meeting dates had meant an unavoidable clash of diary commitments. Mr Sutton in his capacity as Deputy Chairman would therefore be acting chair for the meeting. The Chair welcomed everybody to the meeting, especially the three members of the public who each gave a brief outline of why they were attending the meeting. He stated that the agenda had been put together in consultation with Adrian Mornin, Lead Governor whose feedback from the Governors was that they take a more active part in the meeting with more time given for discussion. The Chair trusted that these requests were reflected in the agenda format. The Chair informed the meeting that there would be a private meeting following on from the public meeting.

36/10 DECLARATIONS OF INTEREST Bridget Fletcher, Interim Chief Executive declared an interest in agenda item no. 3 in relation to the appointment of Chief Executive.

37/10 APPOINTMENT OF CHIEF EXECUTIVE At this point, Bridget Fletcher left the meeting. The Chair explained that it was a statutory responsibility of the Council of Governors to approve the appointment of the new Chief Executive. He explained that following the resignation of the previous Chief Executive in May 2010, the Board had appointed Miss Bridget Fletcher as Interim Chief Executive. He then asked Chris Lisle, Director of HR to inform the Council of the procedure which had been followed for the appointment of the new Chief Executive. Chris Lisle explained that the Board had established an extensive and rigorous process to appoint a Chief Executive, involving external head hunters being engaged to prepare the process of short listing appropriate candidates. The head hunters had sourced a shortlist of five candidates of which one withdrew prior to the interview stage. This list of candidates had then been forwarded to the Chief Executive of the SHA for Yorkshire and the Humber for approval. The candidates had been thoroughly assessed over a two day period, which included meetings with staff, chairing a senior management group, presenting five year strategic plans for the hospital followed by formal interviews. The interview panel had consisted of an external Chief Executive, Chairman, two Non Executive Directors and the Director of HR. The feedback from the senior management group was consistent with the final appointment decision. Alan Sturgess asked whether the external candidates were aware that internal candidates had applied for the post. Chris Lisle responded that all candidates were aware of who was on the shortlist. Adrian Mornin asked how much the process had cost. Chris Lisle responded by saying that internal HR staff had been involved along with the external head hunters at a cost of £10,000. They had however received quotes from head hunters ranging from £30-50k.

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John Osborne asked what the mix of candidates had been. Chris Lisle said that initially five people had been asked to interview but one had withdrawn. There was a mixture of both nursing staff and professional managers. Adrian Mornin asked what appointments the Appointments and Remuneration Committee (‘ARC’) would be involved in the future. Jane Downes stated that ARC was responsible for the appointment of Non Executive Directors, but that Governors would be informed of all senior appointments. The Chairman asked the meeting whether all Governors had understood the appointment process, and whether they were clear of the rigorous process which had been followed. Adrian Mornin responded as Lead Governor, agreeing that the process had been rigorous and that the Council of Governors supported the appointment of Bridget Fletcher as Chief Executive. The Council of Governors duly approved the appointment of Bridget Fletcher as Chief Executive of Airedale NHS Foundation Trust with effect from 1 November 2010. At this point, Bridget Fletcher re-joined the meeting.

38/10 MINUTES OF THE MEETING HELD ON 28 JULY 2010 The minutes of meeting held on 23 June 2010 were approved subject to the following amendments: Page 1 - In Attendance - Bridget Fletcher, Chief Operating Office/Chief Nurse was amended to Interim Chief Executive. Page 1 - Apologies for Absence – Mrs Pauline Sharpe was amended to Mrs Pauline Sharp. Page 1 – Apologies for Absence – Mr Alan Sutton, Deputy Chairman was added to the list of apologies. Page 10 – Terms of Office – Ann Medley was amended to Anne Medley.

39/10 MATTERS ARISING NOT COVERED ELSEWHERE ON THE AGENDA (i) Appointment of Auditor (minute ref 27/10) Adrian Mornin asked whether the appointment of the Audit Commission was still the right decision given the announcement by the Coalition Government to abolish the Audit Commission. Sheenagh Powell, Director of Finance responded by stating that the Trust initially did have some concerns regarding the appointment and consequently had contacted the Audit Commission to clarify the position. The Audit Commission had confirmed that they would still be auditing health services and that an organisation would be set up at some point to continue in this role. She said that the Trust would be monitoring the Audit Commission’s performance over the forthcoming months. Adrian Mornin asked how often the Audit Committee met. Sally Houghton, Non Executive Director and Chair of the Audit Committee informed the meeting that the Committee met five times per year, and gave assurances that the Audit Committee would be closely monitoring the Audit Commission’s role . She added that the members of the Audit Committee currently currently comprised three Non Executive Directors in line with best practice, and there was no intention of changing this at present. Adrian Mornin stated that there were Governors who attended Audit meetings who would probably like to attend the Audit Committee but agreed that this

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could be looked at later in the year. Pam Essler agreed that it was the role of Governors to have an oversight of audit reporting. (ii) Radio Airedale (minute ref 30/10ii) David Petyt informed the meeting that progress had been made on the issue of headphones but wanted to seek assurance that the Board would try to resolve the problem. The Chair stated that this was an operational issue and had been directed to the appropriate manager.

40/10 REPORT FROM THE CHIEF EXECUTIVE DESIGNATE Bridget Fletcher informed the meeting that two further White Paper Consultation documents had been issued and asked if the Governors would like a briefing on these papers. All agreed that the previous briefings had been extremely useful, therefore, a session to discuss the new documents would be advantageous. Bridget Fletcher stated that an extra £2 billion would be available to social services to ensure that patients were kept well and safe at home. Adrian Mornin stated that no amount of money would assist fully if there were not proper resources in place. Bridget Fletcher said that Bradford & Airedale PCT were currently looking at putting together a joint working agreement for both health and care and it was important that Airedale NHS Foundation Trust took the lead for the development of this work. If care was commissioned differently there could be a much better way of all the services working together as a team which would in turn lead to better care. The Trust would have to work together very closely with local councils to ensure that the health of the community remained good. In the future this would become an integral part of the IBP (Integrated Business Plan). Telemedicine would be a massive help in managing patients in their own homes. It was agreed that different practitioners could use telemedicine in the future. Marcia Turner informed the meeting that the telemedicine hub was up and working very well in Grassington now. However, she thought it was important to work with all local councils. Bridget Fletcher confirmed that the Trust would be working closely with North Yorkshire councils as well. Adrian Mornin asked whether the Trust owned the rights to telemedicine. Bridget Fletcher stated that the intellectual offer was currently being progressed. Ann Wagner said that a company called Medipex, who are a company used by Yorkshire & the Humber to look at intellectual rights, were currently looking into this issue for the Trust. She informed the meeting that the Trust were currently the leaders in telemedicine for prisons, but that Airedale wanted to build on the hub that had been installed in Grassington. Peter Allen asked if discussions with Lancashire were taking place. Bridget Fletcher confirmed that they were. They were currently going ahead with the new commissionings and were very keen to work closely with Airedale NHS Foundation Trust with their GPs wanting to forge closer links with the Trust. A meeting was due to take place to discuss this in the near future. Adrian Mornin stated that the only adverse comment he had received regarding the Open Day was that there were no hand hygiene facilities in the Education Centre. This would be rectified for next year’s event.

J Downes/ A Wagner

41/10 QUARTERLY AIREDALE FT REPORT Sheenagh Powell informed the meeting that the Trust was due to submit its second quarter results to Monitor at the end of October. She stated that both returns were green. As there was currently £362k surplus, the Trust was on plan at the half year point. Work was ongoing to ensure that all financial targets were being met. Sheenagh Powell reported that the Trusts current risk rating was 3.2.

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Sheenagh Powell reported that the Trusts performance indicators were rated as green overall although there had been one failure in relation to cancer standards. This situation was currently being monitored and the reasons for the failure investigated. It was disappointing to note that to date there had been 3 cases of hospital acquired MRSA set against the excellent performance the previous year in which there had been no hospital acquired MRSA cases. The threshold set by Monitor was 6 and therefore the Trust remained within the de-minimum level set by Monitor. Adrian Mornin asked where the three cases had been contracted. Sheenagh Powell confirmed that all were contracted in the hospital. Bridget Fletcher informed the meeting that each case was looked at very carefully and a root cause analysis meetings with Chief Executive attendance ensured a robust and rigorous review of all cases. It had been agreed by the senior managers and clinicians that there had been nothing that could have been done to prevent the first two cases, although the third could have been prevented. A number of actions had been implemented to ensure this situation did not occur in the future. John Osborn stated that the report contained a lot of acronyms. It was agreed that these would be explained in future reports. He also asked what the key risks between now and the end of the year were. Sheenagh Powell stated that the key would be delivering on the currently activity. She added that activity was much higher than had been planned for and therefore discussions were taking place with the PCTs to ensure that activity would be paid for within the year. She stressed it was important that these costs were managed effectively, and whilst challenging she was confident the Trust was still on track for the end of year target. John Osborn enquired if Trust employees would be caught by the health service cost of living pay freeze. Sheenagh Powell stated that the award for April 2011 had not yet been agreed to date. John Osborn asked after looking at the capital planning expenditure schedule whether there were any risks to cash. Sheenagh Powell stated that the planned capital plan was based around the cash balance. The Trust currently had higher activity than anticipated and therefore there was currently a time delay in retrieving the outstanding monies. However, she confirmed that there was no risk to the capital plan for this current year. The Chair asked the Governors if they felt that the two papers – Finance Report and Performance Report had been useful. Ann Medley stated there was some confusion as to the meaning of some of the data including the bridge analysis. Sheenagh Powell explained the data analysis and that this was the budget statement showing what had been received. Ray Tremlett asked for clarification regarding the performance figures relating to the reduction in CDiff infections which had been rated as green.. Bridget Fletcher informed the meeting that the Trust had been given a target to reduce CDiff infections year on year, and for the first 2 quarters of the year it was showing below the trajectory. She stated that the Trust had shown a 90% reduction in CDiff in the past 3 years and at present there had been just 7 cases against a trajectory of 18, which had been a great achievement for the Trust. Sheenagh Powell welcomed any feedback on the two papers. The general feeling from the Governors was however that the papers had been informative.

S Powell

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42/10 APPOINTMENT OF LEAD GOVERNOR AND DEPUTY LEAD GOVERNOR The Chair reported that Adrian Mornin had been elected as Lead Governor and Pam Essler as Deputy Lead Governor. Adrian Mornin stated that there had been a networking session which had given all Governors the opportunity to meet him, and he thanked everybody for electing him as Lead Governor. He said that it was nice to see the Governors providing active support and urged all Governors to attend any networking sessions which were arranged. Pam Essler again thanked all the Governors for their support in electing her to the role of Deputy Lead Governor, and said that it was important to develop the Governor role more in the future.

43/10 COUNCIL STRUCTURE – VACANT SEATS The paper explained the current situation with regard to the two vacant seats was noted and taken as read. Ann Wagner informed the meeting that NHS East Lancashire had been offered a place as a Stakeholder Governor but had declined to take up the seat. The other vacant seat had been offered to Yorkshire Forward however they too had declined to take up the seat given their impending abolition announced by the coalition government. She asked the meeting for views on the proposals put forward in the paper. John Osborne asked if Pendle were to be offered a place now, would it be an option to offer a place to other consortia in the future. The Chair stated that this was quite relevant due to the new commissioning changes taking place at present/in the future. Ann Wagner said that the Governors could wait and see what happened with the new commissioning structure, or Pendle could be invited immediately and as the PCTs are disbanded other consortia could be invited. Ray Tremlett thought anything that added extra weight to Lancashire would be advantageous. Pam Essler asked if the Airedale Partnership had been offered a seat. Ann Wagner said it had been agreed not to ask them as their chair was currently heavily involved in the telemedicine project and it was felt they would not be 100% independent, and it was important to keep the position independent. Pauline Sharp asked how it had been decided who to ask to be Stakeholder Governors. Ann Wagner said that the majority of the Council of Governors had to be made up of public members, representatives from the three PCTs the Trust currently worked with, the five Councils from the areas which the Trust covered and as the Trust had teaching status it was felt a representative from the University would be beneficial. It was then the decision of each organisation as to whom they put forward as Stakeholder Governor. David Petyt informed the meeting that Keighley Chamber of Commerce was no longer in place so he recommended asking the Keighley Town Centre Committee. John Roberts expressed a view that a short term gain could lead to future complications. The Chair asked the meeting to vote on whether to made a decision immediately or to wait until the situation regarding GP commissioning was clearer. The vote was 13 Governors wanted to wait and 8 Governors wanted an immediate decision. Therefore, the majority decision was to wait. This item would be placed on the

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agenda for the next meeting with some preliminary work being undertaken.

J Downes

44/10 COUNCIL OF GOVERNOR COMMITTEES/WORKING GROUPS (i) Appointments and Remuneration Committee (ARC) The first formal meeting of ARC was scheduled for Friday, 29 October.

Committee membership was noted as Colin Millar (Chair), Adrian Mornin, John Roberts, Pauline Sharp, Karen Swann, Peter Beaumont, and David Adam, and Alan Sutton, Non Executive Directors.

(ii) Membership Development Group Adrian Mornin informed the meeting that the Group had met the previous week

in which the Terms of Reference had been agreed and the Membership Development Strategy reviewed. To date a Chairman had not been appointed.

45/10 COMPLAINTS HANDLING PROCESS Helen Barrow, Complaints Manager, gave a presentation on the PALS Team, the Complaints Team and guidance for the Governors regarding the management of complaints and concerns. All Governors had received an information pack. Further information could be sourced via the FT Membership Office. Marcia Turner said that she had received a request from somebody who had been in hospital as to where a compliment should be sent. Helen Barrow stated this could be sent either to the ward/department directly or via the PALS Team. The Chair informed the meeting that the hospital actually received far more compliments than complaints. He also reinforced the point that it was important the Governors did not try to deal with complaints themselves but refer them to either PALS or Complaints. He stated that if Governors were to go on to any Ward and look at the notice boards there would be a number of compliment letters posted there. Ron Drake, Non Executive Director, informed the meeting that he was the Chairman of the Quality, Safety and Assurance Committee. Part of the Committee’s role was to examine the number and types of complaints. He added that each complaint was taken extremely seriously.

46/10 FTGA – NATIONAL DEVELOPMENT DAY Pam Essler had attended this event and had found it extremely informative. The day had comprised participating in several workshops. The keynote speech from David Nicholson on the role of the Governors and the challenges facing Governors had focussed on five main themes:

Increased level of accountability

Development of local involvement

Developing contact with Members

Contributing to broader health economy

Development of quality services within the current climate

Pam Essler stated that the main issue for all of the Governors attending the event was how to engage with the membership. The Chair thanked Pam for attending the event.

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47/10 NEDs UPDATE REPORT

The report detailing the activities of Non Executive Directors during the previous month was noted and taken as read.

48/10 ITEMS TO NOTIFY GOVERNORS Jane Downes reminded all Governors to ensure they used their nhs.net e-mail accounts as the addresses had all been advertised to Members. She also stated that from an information governance perspective it was important to ensure information was sent via a secure network. The Trusts Payroll department had confirmed that the Form P46, issued to Governors in their induction pack for claiming expenses was not now required. Copies of the two new consultation documents “Liberating the NHS – An Information Revolution” and “Liberating the NHS – Greater Choice and Control” had been circulated by email. Hard copies were available and can be obtained from the FT Membership Office. Jane Downes had recently attended the newly established Staff Health & Wellbeing Steering Group, where it had agreed to invite a Governor representative to join the Group. Governors were asked to submit expressions of interest to Jane Downes.

Governors

49/10 FORWARD AGENDA Jane Downes drew attention to the date of the Board to Board meeting scheduled for 29 November in which the Board would be looking to develop the Trusts annual plan and therefore it was important for all Governors to attend. Alan Sturgess asked whether the nomination of new Stakeholder Governors should be on the forward agenda. Jane Downes agreed to add it to the plan.

J Downes

50/10 RESPONSE TO MEMBERS QUESTIONS Adrian Mornin informed the meeting that the Governors had met and after discussion a number of questions had been raised. Alan Pick stated that there were lots of challenges and opportunities in the near future and asked whether the Trusts response to the White Paper would be vigorous and how would Consultation with the Governors take place. Ann Wagner reiterated that a meeting would be arranged to discuss the two new consultation documents similar to the previous two discussion meetings held where the Governor’s views had been noted and added to the response. She said if any Governor had an individual response to either of the papers they could respond to these directly. However, the response from the Trust would be discussed at the Board to Board meeting on 29 November. It was agreed that any challenges or threats would be addressed. John Roberts stated that there would be implications arsing from the White Paper, but of more interest was the specific detail around what the role of the Governors would be in being able to influence the strategic direction? Alan Sutton said that this issue would be covered at the Board to Board meeting. Sheenagh Powell stated that along with reviewing the existing business plan which had been put to Monitor, Governors would also be reviewing the plan for next year. That meeting would be the opportunity for the Governors to be involved in those discussions.

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Valerie Winterburn stated that only two groups had met to date and asked when the other meetings would be taking place. Jane Downes had been in touch with all the meeting leads giving them the details of the Governors who would be attending. She agreed to contact the leads again to ensure that contact with Governors took place as soon as possible. Adrian Mornin asked why the Trust was continuing to recruit new members instead of engaging more with the current membership. Ann Wagner stated that it was a requirement by Monitor that the Trust should increase membership. The Trust was currently on target to meet its membership numbers, but it was acknowledged that engagement could be developed further. Chris Lisle, the Trusts Organisational Development lead, was currently looking at how to capitalise more on developing membership, and stressed the importance of working with the Governors to ascertain what methods would work best. All the Governors agreed that this was an important issue and further discussion was required. Ann Medley thought it would be advisable to have a member of HR on the Membership Development Group. David Petyt enquired whether the Trust ensured value for money when procuring goods and services. Sheenagh Powell informed the meeting that the Trust had its own purchasing department who always ensured best value for money.

J Downes Governors

51/10 ANY OTHER BUSINESS There was no other business to consider.

52/10 REVIEW AND CLOSE OF MEETING All agreed that the meeting had been good and informative. The next quarterly meeting would be held on Wednesday, 26 January 2011 at 4.00 pm in the Board Room in the Education Centre. The Board to Board meeting would be held on Monday, 29 November at 4.00 pm in the Board Room in the Education Centre. There being no further business the Chairman declared the meeting closed.

AIREDALE NHS FOUNDATION TRUST

COUNCIL of GOVERNORS 26 January 2011

TITLE: Report of Chief Executive EXECUTIVE DIRECTOR:

Bridget Fletcher Chief Executive

NHS CONSTITUTION PRINCIPLE 7 The NHS is accountable to the public, communities and patients that it serves

AUTHOR: Ann Wagner Director of Strategy and Business Development

Action required by the Council of Governors

• To receive and note the report of the Chief Executive _______________________________________________________________

Council of Governors Report of Chief Executive

Bridget Fletcher Chief Executive

19 January 2011

1 Introduction In this report I have taken the opportunity to update governors on significant national and regional developments occurring during quarter 3 as well as reporting on issues of importance both from the Local Health Economy and Foundation Trust that I want to draw attention to. Details of our financial and service performance to date are covered in the separate report from the Director of Finance. 2 National Developments 2.1 Equity and Excellence: Liberating the NHS: NHS White Paper Governors are aware that the Coalition Government is in the process of leading a major reform programme of the NHS. Following publication of the White Paper last July, there has been a raft of supporting consultation documents, responses, policies and frameworks culminating in the laying before Parliament on 19 January of the Health and Social Care Bill. Given the enormity of the changes proposed and the amount of information out in the public domain, I thought Governors would find it helpful if I included a high level briefing summarising the key changes proposed, together with highlights from the Health and Social Care Bill. The briefing is attached (Appendix 1) The Executive Directors and their teams are assessing the various publications for impact on the Foundation Trust. Documents released for consultation will continue to be shared with governors for their input and inform the Foundation Trust’s response. Our latest response to the consultations on expanding patient choice and the information revolution is attached to the briefing As previously reported, the reforms propose considerable change and are considered to be the most far reaching set of reforms since the NHS was introduced in 1948. Whilst the Health and Social Care Bill works through the legislative system it is clear the Foundation Trust needs to be proactive in its response rather than waiting for further information, for example stepping up its GP and Local Authority engagement plans in preparation for the new commissioning arrangements. Throughout these changes we need to continue our focus on improving quality and outcomes as we also find significant efficiency savings and increase productivity. 2.2 GP Consortia Pathfinder Announcement

On 8 December the Department of Health announced the names of the first phase of 52 new GP consortia to have pathfinder status and spearhead the government’s plans to hand commissioning over to GP consortia. Within our SHA regions two consortia groups were put forward for pathfinder status by NHS Yorkshire and the Humber and twelve by NHS North West – none of the Airedale catchment population GP commissioning consortia were included in this first phase announcement.

On 17 January the Prime Minister announced a further 89 consortia groups had been identified as second wave pathfinders, bringing the total across England to 141, including 17 in Yorkshire and the Humber (including Airedale, Wharfedale and Craven as a consortia) and another 17 in North West (but not yet including Pendle). This latest announcement means 28.6m people (over 50% of the population) are now covered by a pathfinder GP consortia. Within our locality, with the coming together of Airedale and Wharfedale practices with the Craven Consortia, some 90% of our local population will be served by a pathfinder GP consortia.

Rather than waiting for the new Health and Social Care Bill to come into force, the Government has decided to press ahead immediately with pathfinders of emerging consortia so they can test out the new arrangements at an early stage before GP consortia take on statutory responsibilities from April 2013. They will therefore operate under existing legislation, without the full new statutory powers that

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Parliament will consider. The NHS Commissioning Board will start to formally authorise consortia from April 2012 with the aim of having all consortia established as statutory bodies by the end of 2012/13.

The Foundation Trust continues to step up its engagement with GPs, including forging stronger clinical partnerships, in recognition of their enhanced commissioning role.

2.3 PCT sub regional clusters

To ensure capacity and capability is maintained throughout the transition period, the Department of Health has decided to expand the managed consolidation of PCT capacity already taken in London and the North East to the other regions. Here sub regional clusters have been formed by adopting single executive functions serving a number of statutory PCT bodies under existing legislative powers.

We understand in Yorkshire and the Humber some clustering may happen. However, given their population size, NHS North Yorkshire and York and NHS Bradford and Airedale are expected to stay as currently configured for the remainder of the transition. Details regarding arrangements for East Lancashire PCT are to be confirmed.

3 Regional Developments In addition to the GP Consortia Pathfinder announcements and PCT sub regional cluster arrangements reported on as part of my national development update, this month I would like to share the following regional developments: 3.1 Regional Innovation Fund Developments As previously reported, NHS Yorkshire and the Humber is utilising their Regional Innovation Fund (RIF) to encourage innovation across the region to support delivery of their Quality, Innovation, Productivity and Prevention (QUIPP) programme. Funding has been allocated for two telehealth programmes. The first aims to improve the provision of stroke care through the procurement of a telemedicine solution which will be implemented in all A&E departments across the Region. The second aims to improve the quality of health and social care for patients with long term conditions through the further deployment of innovative telehealth, telemonitoring and telemedicine solutions. I am pleased to report that the Foundation Trust has got through to the next round in the tendering process for the regional telemedicine stroke service. I can also confirm that the Foundation Trust has now received confirmation of funding to pump prime the creation of a Regional Telemedicine Hub. 3.2 Regional Reviews The latest position on the regional service reviews reported on previously is as follows: Vascular Services As detailed in my last report, Airedale NHS Foundation Trust has joined together with Bradford Teaching Hospitals NHS Foundation Trust and Calderdale and Huddersfield NHS Foundation Trust to form a collaborative alliance to provide a vascular centre. The vascular centre will operate as a single integrated service and provide a comprehensive range of surgical and interventional radiological procedures twenty four hours a day, seven days a week for a total population of 990,000.

Having confirmed their support for the proposal, NHS Yorkshire and the Humber’s Specialised

Commissioning Group (SPG) began a three month public consultation in October. With regard to consultations relevant to the Airedale population, Bradford Metropolitan District Council’s Health Improvement Committee considered the proposal at their meeting on 15 November and confirmed

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their support. Craven District Council’s Overview and Scrutiny Committee considered the proposals at their meeting on 30 November where they too confirmed their support.

Subject to the outcome of the total consultation, It is anticipated the new service will be established early 2011. Trauma Services At the next regional Chief Executives Forum (28th January) I am expecting an update on Regional Trauma Centres and will therefore provide an update at our meeting Stroke Services Andrew Catto Executive Medical Director, Christine Miles, Interim Director of Operations and I continue to have productive discussions with the Chief Executive, Medical Director and Director of Operations from Harrogate Foundation Trust regarding establishing a shared stroke rota across the two Foundation Trusts in response to the regional specialist commissioning review of stroke services. Whilst this may prove challenging given it crosses two clinical networks and therefore adds a level of complexity, our respective teams are determined to secure a workable solution that will be beneficial to our respective populations and to both organisations. 4 Local Health Economy Developments 4.1 GP Commissioning Consortia Discussions continue locally between GPs and our three main PCTs regarding the establishment of GP Commissioning Consortia. As reported earlier, on 17 January the Prime Minister announced the second wave of pathfinder consortia including an Airedale, Wharfedale and Craven Consortia. This is a very positive development as far as the FT is concerned, given the consortia covers a large majority of our population and complements our vision for integrated.care. The Pendle GPs continue to pursue pathfinder status for their group – however the two DH announcements have not included a separate pathfinder for Pendle. I am meeting with Pendle Consortia on 20th January and will brief the Governors the latest position when we meet on 27th. 4.2 Transforming Community Services (TCS): Update The latest position regarding the transfer of community services by PCT is as follows:

NHS North Yorkshire and York: Following a managed tender process, the PCT Board has confirmed Airedale NHS Foundation Trust as its preferred provider of community services for adults and vulnerable people for the Craven locality. The Trust is currently undertaking due diligence regarding the services, staffing and resources to be transferred. The Board of Directors will consider a report of the due diligence process at its meeting in February. NHS Bradford and Airedale:

The PCT’s preferred option for the majority of community services is to establish an integrated care organisation (ICO). This involves bringing together services provided by Bradford District Care Trust, the Local Authority and the majority of community services from BACHs (the PCT provider arm). This will be supported by an Integration and Transition Committee which will take a whole system, risk based approach to providing better integrated care and deliver the efficiencies required across the whole health and social care system. The Board will be

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chaired by Simon Morrit (NHS Bradford & Airedale Chief Executive) in the first instance and include representation from GP and Local Authority Commissioners and providers including Airedale NHS Foundation Trust. Its role will be to shape the future of integration. The PCT plans to transfer the remaining intermediate care services, community hospitals, GPs with a special interest and some specialist nursing to a combination of providers (Airedale NHS Foundation Trust, Bradford Teaching Hospitals Foundation Trust, primary care providers). The Foundation Trust’s Director of Finance is now leading the due diligence and operational planning phase for the services to be transferred to Airedale. We still await full detail of the resources (people and budgets) to be transferred.

In addition to planning for the transfer of community services, the Trust is also working on the integration and transfer agendas so we achieve our ambition of truly integrated care, with community services at the heart of our service offer. 4.3 Re-ablement Funding On 28 October the Department of Health issued a Local Authority Circular on the Personal Care at Home Act and Charging for Re-ablement. As a result PCTs were given an additional £70 million to spend in the current financial year for post-discharge support. PCTs were tasked with developing local plans in conjunction with the Local Authority and FT/NHS Trusts and community health services on the best way of using this money to facilitate seamless care for patients on discharge from hospital and to prevent avoidable hospital readmissions. I can confirm that earlier this month the Foundation Trust was advised by NHS Bradford & Airedale that it was being allocated £74k to invest in early supported discharge (telemedicine enabled) for COPD patients. In addition, the Airedale & Wharfedale GP Alliance also secured funding from this pot and wants to commission a telemedicine service from the FT to support patients in nursing homes. Subject to evaluation, the funding may be extended into 2011/12. 5 Foundation Trust Developments

5.1 Setting Direction : Call to Action Next Steps As the new Chief Executive I have been gathering my thoughts on setting future direction given the national, regional and local context post white paper and based on my assessment of the organisation’s capacity and capability. On 15 November 2010 I issued a call to action to the senior leadership in the Trust, setting out my early thoughts on our position and the things I believe need to change if we are to maximise opportunities, mitigate risks and be sustainable. I shared this with Governors at our joint meeting with the Board of Directors before Christmas. This month I have begun a series of staff briefings as part of my plan to engage with every member of staff to take them through my call to action, help them understand the scale of the challenge and urge them to get more involved as our future is in our hands – there will be no bail outs. At the time of writing this report, I have spoken with over 350 staff including a large number of senior doctors and am devoting the majority of the remainder of this month to get in front of the rest of staff. The presentation pulls no punches as I describe the financial challenge we face and the need to achieve cost transformation at scale. I want the presentation to stimulate discussion and provoke an imaginative response. Doing more of the same will not achieve the efficiencies required. We need a change in mind set in every area of the organisation if we are to get the FT onto a sustained financial footing. Accompanying the presentation, I have set up a dedicated email account (InOurHands@anhst.nhs.uk) for staff to share with me their ideas so we can track and share what people are doing and empower them to lead their own changes.

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This call to action script will be the key message on which I will base my first Chief Executive blog to staff which will launch later this month. 5.2 Meetings with Key Stakeholders As the new Chief Executive I am also dedicating significant amounts of my time on external stakeholder engagement including meeting GPs, Local Authority officers and elected members, MPs, and NHS and independent sector strategic and business partners. I am finding the meetings very productive in terms of listening to feedback on views on the Foundation Trust and in developing ideas regarding how we can be even more responsive. 5.3 Awards Update I am delighted to advise the Council of Governors the Foundation Trust has won a number of awards in recent months. HSJ Annual Health Service Awards

In my last report I advised the Council of Governors that the Foundation Trust, together with the PCT and Provider Arm, had been shortlisted for a prestigious Health Service Journal (HSJ) Award. The ACCT team was shortlisted by the HSJ under the Partnership category. The ceremony was held in London on 29 November, and I am pleased to confirm that the multi agency team won the award. Enid Feather, our Head of Therapies was there to represent the Foundation Trust. Given our ambition to be an innovative integrated care provider, with community services at the heart of our offer, this award is particularly timely and a reflection of the commitment and dedication and of course partnership working across the combined team.

Health Business Outstanding Achievement in Healthcare Award

At the end of November we were contacted by Health Business magazine who advised us that they had nominated us for their Outstanding Achievement In Healthcare Award. This is an annual award given to an NHS organisation that has achieved success in its role and brought benefits to the wider NHS through the dedication and expertise of its staff. Over 100 NHS Trusts have been evaluated for this award by the magazines researchers using a range of data (Care Quality Commission, Doctor Fosters Guides, Monitor, PEAT) along with further evidence of patient experiences and positive media reports. The Foundation Trust was shortlisted together with Royal Wolverhampton Hospitals NHS Trust, The Christie NHS Foundation Trust, Alder Hey Children's NHS Foundation Trust and University Hospital Birmingham NHS Foundation Trust. Senior matrons, Karen Walker and Linda Beckett were chosen to represent the Foundation Trust at the awards ceremony which took place in London on 9 December. I am delighted to report that the Trust was announced as the overall winner

Dr Foster – Small Trust of the Year I am delighted to report that the Trust has once again been awarded Small Trust of the Year by Dr Foster for its work on quality and safety. The award – the fourth time in the past five years – is a reflection of our quality and safety record, particularly in relation to Hospital Standardised Mortality Rates (HSMR).

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Regional Apprentice of the Year I am also pleased to report that Vicky Hardy from Medical Engineering won the JTL Regional Apprentice of the Year Award on 11 November. Vicky, who is twenty years old and studying electrical and mechanical engineering, received a trophy and £700 and goes forward to the National Awards in the Tower of London next March where she will be considered for the National Apprentice of the Year. 5.4 Appointments I am pleased to inform the Council of Governors that Dr Andrew Catto, our Executive Medical Director, has been invited to be a member of the Yorkshire & Humber Public Health Observatory’s Quality Observatory Steering Group. 5.5 Winter Finally it would be remiss of me not to mention the fantastic effort and commitment displayed by our staff through the recent adverse weather. Due to their dedication and professionalism we were able to maintain a full service throughout, and maintain quality and safety levels. I am sure you join me in thanking them all.

Executive Owner: Bridget Fletcher Chief Executive Report Author: Ann Wagner Director of Strategy & Business Development 19 January 2010

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Appendix 1

Equity and Excellence : Liberating the NHS Briefing Paper

The plethora of guidance, frameworks, consultations and responses to consultations reached a crescendo in December as the Department of Health published over 1600 pages of additional documentation in support of the Coalition Government’s NHS and Social Care reform programme, in preparation for the first reading of the Health and Social Care Bill on 19 January.

The Executive Directors and their teams are currently analysing the detail of what is proposed and assessing the impact for the Foundation Trust. Below is a summary of some of the key documents. Summaries of the remainder will be available at the next meeting of the Council of Governors.

i) Greater Choice and Control and the Information Revolution

Following the discussion at last months Board of Directors meeting which considered staff and Governor views, the Executive Directors submitted the attached response (Attachment 1) on the latest suite of consultation documents, this time focussing on extending patient choice and the information revolution, which were published by the Department of Health (DH) in October to support the reforms set out by the Government in the White Paper.

The DH has confirmed they will consult on choice of treatment later this year which will also impact on the Foundation Trust. A session for Governors to explore the impact of the choice of treatment proposals will be arranged once the proposals are available.

ii) NHS White Paper : Further Supporting Publications

In addition to the initial supporting consultation documents1 published last July and the choice and information revolution consultation documents (referenced above) published last October which Governors have been briefed on and had the opportunity to comment on, during November and December the Department of Health published another suite of documents developing further details of the Government’s agenda for health and social care as follows:

a) Public Health White Paper : Healthy Lives, Healthy People

Published on 30 November 2010 the Public Health White Paper sets out the Government’s long-term vision for the future of public health in England. Building on the principles set out in Equity and Excellence, this white paper outlines their commitment to protecting the population from serious health threats; helping people to live longer, healthier and more fulfilling lives, and improving the health of the poorest, fastest. The plans outlined in Healthy Lives, Healthy People will transform public health and create a wellness service “Public Health England” to meet the health challenges of today. It has been widely reported that current spend on areas likely to be the responsibility of Public Health England could be at least £4bn.

The Governments aim is to create local freedom, accountability and protected funding to ensure public health is responsive to the different needs of each community and able to tackle the preventable causes of ill health.. The white paper sets out how local public health leadership and responsibility will be returned to and strengthened in local government. Under the proposals Directors of Public Health will be based in local government and the proposed Health and Well Being Boards to drive collaboration.

1 Commissioning for Patients; Local Democratic Legitimacy in Health; and Regulating Healthcare Providers published by Department of Health July 2010

Public Health England will be part of the Department of Health, accountable to the Secretary of State for Health. Subject to the passage of the Health and Social Care Bill, it is expected to come into being in April 2012 and to incorporate current functions of the Health Protection Agency and the National Treatment Agency for Substance Misuse. It will work across government and with the NHS Commissioning Board and national partners to support local public health action, including through funding the provision of evidence and data and professional leadership and shifting responsibility for local public health spending to Councils. This funding shift could be substantial – rumoured to be 50% of the total current public health spend.

The main aim of the white paper is to “nudge” people towards healthier lifestyles, for example by handing out prizes to children who walk to school. Work will be carried out with the food industry to encourage people to eat more fruit and vegetables through a public health responsibility deal, to be published early next year.

Local councils will be judged within 5 domains of public health improvement. Indicators will be outlined in a public health outcomes framework. The public health framework will sit alongside separate outcomes frameworks for the NHS - which will be translated into indicators of commissioning performance and linked to consortia income - and social care. They are also publishing shortly their plan to expand and transform health visiting (4200 new Health Visitors planned).

During 2011, the Department of Health will publish documents that build on this new approach, including on mental health, tobacco control, obesity, sexual health, pandemic flu preparedness, health protection and emergency preparedness.

Consultation on the proposals runs until 8 March 2011. As with previous White Paper consultation documents, the Foundation Trust will host consultation events for Governors, members and staff. Feedback from these consultation activities will be reported to the Board of Directors at its February meeting to inform the Boards formal response to the consultation to the Department of Health.

Given our population demographic and projections, we see an opportunity for the Foundation Trust to develop its public health offer as part of our vision to be an integrated care provider, enabled by our telemedicine capabilities which allows us to provide information prescriptions including public health education to our patients and partners. The Executive Directors will review the detail of the proposals to inform our discussion with Board Directors at the February meeting.

b) Liberating the NHS: Legislative Framework and Next Steps

This Command Paper is the Governments response to the consultation on the Equity and Excellence White Paper and the initial supporting consultation documents2 published last July.

The paper, which has been informed by over 6000 responses to the consultations held from July until October last year, sets out how the Government will legislate for and implement their reform program.

As a result of the consultation response, the Government has modified their original proposals in some areas including the following relating to NHS providers:

• allowing a longer and more phased transition period for completing provider reforms eg retaining some of Monitor’s current controls over some Foundation Trusts (FT) while the new system of economic regulation is introduced

• establishing a transitional Provider Development Authority to support the FT pipeline • clarifying governance responsibilities, making the Directors and Governors of FTs more

directly accountable for their decisions and for the performance of their Trust

2 Commissioning for Patients; Local Democratic Legitimacy in Health; and Regulating Healthcare Providers published by Department of Health July 2010

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• strengthening the power of governors by requiring their agreement to any changes in an FT’s constitution and to any merger, acquisition, separation or any other change that the FT’s constitution defines as “significant”

• abolishing statutory borrowing limits • removing the private patient cap – but FTs will be required to produce separate accounts for

their NHS and private services

Other modifications to be reflected in the Bill in light of the consultation response which the Council of Governors should be aware of include:

• strengthening and updating the NHS Constitution – the DH will consult on changes to the NHS Constitution during 2011, prior to a revised version coming into being by April 2012

• creating a clearer, phased approach to the introduction of GP commissioning by setting up a programme of GP consortia pathfinders – latest position highlighted later in this report

• increasing transparency in commissioning by requiring all GP consortia to have a published constitution

• giving GP consortia a stronger role in supporting the NHS Commissioning Board to drive up quality in primary care

• changing the proposal that maternity services should be commissioned by the NHS Commissioning Board - in order to focus on local needs, commissioning maternity services will be the responsibility of GP consortia

• strengthening the role of Local Authority (LA) Health and Well Being Boards and enhancing joint working arrangements through a new responsibility to develop a “joint health and well being strategy” spanning NHS, social care, public health and other local services - LA and NHS commissioners will be required to have regard to this

• accelerating the introduction of health and well being boards through a new programme of early implementers – a verbal update on the local position will be provided at the meeting

• dropping the proposal to merge LA scrutiny functions into health and well being boards and instead extending Council’s formal scrutiny powers to cover all NHS-funded services with greater freedom in how these are exercised

• phasing the timetable for giving LAs responsibility for commissioning NHS complaints advocacy services, and allowing flexibility to commission from other organisations as well as from local HealthWatch

• creating a more distinct identity for HealthWatch England led by a statutory committee within the CQC

• creating an explicit duty for all arms length bodies to co-operate in carrying out their functions – of particular note Monitor and the NHS Commissioning Board will have to work jointly in setting prices rather than have Monitor decide and the Board able to appeal

This paper lays the ground for the Health and Social Care Bill being laid before Parliament for its first reading on 19 January.

c) Managing the Transition; 2011/12 Operating Framework; Government Response to Consultation on Transparency in Outcomes Framework; Amendments to FT Compliance Framework and consultation on additional FT Annual Reporting requirements

On 15 December NHS Chief Executive Sir David Nicholson held a meeting of all NHS Chief Executives to update on White Paper transition in light of the government’s formal response to the White Paper consultation and to launch the 2011/12 NHS Operating Framework. At this event the Secretary of State for Health, Andrew Lansley announced that Sir David Nicholson was to become the Chief Executive of the NHS Commissioning Board. On the same day Monitor also published their consultation documents on amendments to the FT Compliance Framework and additional annual reporting requirements for 2011/12. Later that week the DH also published their response to the consultation Transparency in Outcomes – a framework for the NHS

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Across all these publications, three key themes emerge - quality and effectiveness, focus on safety and improving the patient experience – with the approach to overseeing delivery set to be one that incorporates a mixture of both process and outcome measures to ensure the NHS maintains a grip on performance today whilst building the new system for tomorrow. The Executive Directors are working through the detail of the changes planned through the various frameworks and will update the Council of Governors at the next meeting on the impact for the Foundation Trust. Monitor will publish the final Compliance Framework for 2011/12 at the beginning of April. Governors will be circulated with the final version and be briefed on any significant changes.

f) Liberating the NHS: developing the healthcare workforce

Published on 20 December 2010 this consultation document sets out proposals to establish a new framework for developing the healthcare workforce and seeks views on the systems and processes that will be needed to support it. The final date for responses is 31st March 2011. The Executive Directors are working through the detail of the proposals and will update the Council of Governors at the next meeting on the impact for the Foundation Trust.

The DH recognises implementation of the reform of this magnitude and scale involves the management of a significant and complex set of interconnected changes which will result in a corresponding complex series of moves for staff across the whole system, as well as a significant reduction in management and administration posts. They therefore plan to publish HR Frameworks this month setting out guidance for managers and staff affected by the reforms. Once published these will be assessed for relevance to the FT.

g) The Health and Social Care Bill 2011

The Health and Social Care Bill 2011 was laid before Parliament for its first reading on 19 January and could receive Royal Ascent as early as June this year – subject to an easy passage through Parliament.

The proposed changes are expected to lead to better quality care, more choice and improved outcomes for patients, as well as long-term financial savings for the NHS, which will be available for reinvestment to improve care. Under the new measures there will be, for the first time, a defined legal duty for the NHS and the whole care system to improve continuously the quality of patient care in the areas of effectiveness, safety, and patient experience.

The Health and Social Care Bill 2011 includes proposals to:

• bring commissioning closer to patients by giving responsibility to GP-led groups; • increase accountability for patients and the public by establishing HealthWatch and local health

and wellbeing boards within local councils; • liberate the NHS from political micro-management by supporting all trusts to become

foundation trusts and establishing independent regulation; • improve public health by creating Public Health England; and • reduce bureaucracy by streamlining arm’s-length bodies.

The plans are expected to improve the NHS in five key ways:

• patients would be more involved in decisions about their treatment and care so that it is right for them – there will be ‘no decision about me without me’;

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• the NHS would be more focused on results that are meaningful to patients by measuring outcomes such as how successful their treatment was and their quality of life, not just processes like waiting list targets;

• clinicians would lead the way – GP-led groups will commission services based on what they consider their local patients need, not on what managers feel the NHS can provide;

• there will be real democratic legitimacy, with local councils and clinicians coming together to shape local services; and

• they will allow the best people to deliver the best care for patients – with those on the front-line in control

The DH estimates these measures will save the NHS over £5 billion by 2014/15 and then £1.7 billion every year after that – which they say is enough money to pay for over 40,000 extra nurses, 17,000 extra doctors or over 11,000 extra senior doctors every year. The majority of the savings would come from a significant reduction in bureaucracy following the abolition of strategic health authorities and primary care trusts, and a reduction in management staff by an estimated 24,500 posts. They estimate the changes would pay for themselves by 2012/13 and the subsequent savings would give the NHS a stable financial basis for the future.

The Bill, which has over 200 clauses, is one of the largest ever considered by Parliament. As more detail is revealed and clauses confirmed the Board and Council of Governors will want to review its strategy and plans going forward to ensure alignment and fit and consider the opportunities to be exploited and mitigating actions to address risks. In the interim, the high-level timetable of the key structural changes is attached for information (Attachment 2).

Ann Wagner Director of Strategy & Business Development

19 January 2011

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6

ATTACHMENT 1

Office of the Chief Executive Airedale General Hospital

Skipton Road Steeton KEIGHLEY West Yorkshire

BD20 6TD

Telephone: 01535 294801 email: bridget.fletcher@anhst.nhs.uk

baf/aw/hfg 13 January 2011 Department of Health Email: choiceconsultation@dh.gsi.gov.uk dh.gsi.gov.uk Dear Colleague Equity and Excellence: Greater Choice and Control and An Information Revolution Trust Consultation Response The Foundation Trust welcomes the opportunity to respond to this consultation. This Board of Directors’ response has been informed by discussions with staff, members and governors who have been involved in considering the opportunities and challenges. Key points we would like to make are as follows. Extended Choice – Information Requirements The Foundation Trust welcomes plans to extend choice of provider to all stages of the patient pathway. Pivotal to this will be the availability and accessibility of information so that patients have access to the full range of choices available to them to make an informed choice. The current NHS Choices website will require further development if it is to become the major source of information for patients. The ability of commissioners and providers of health and social care to access and share patient records (shared electronic patient record across primary and secondary care) will be vital so that information about the patient follows the patient through the system, especially in a pathway where a patient may have chosen different providers at each step of their treatment pathway. Continuity of care will be at risk without a smooth handoff of information between licensed service providers. The proposals assume patients will be offered a full range of choices available to them. The current choose and book system allows GP practices to set distance of provider to offer a limited choice of provider menu – this excludes potential providers. Whilst we understand GP practices wanting to be pragmatic – a screen of hundreds of choices of hospitals may be unwieldy and may require some filtering – however using distance as a filter is misleading, eg services could be provided locally through telemedicine so location of hospital is not relevant or travel times/transport links could be the distinguishing factor rather than distance. We would ask that GP Consortia be placed under a duty to offer full choice as part of their terms of authorisation and to indicate service delivery point not just hospital location.

Choice of Consultant – Led Team Whilst the Foundation Trust supports choice of consultant–led team this does pose a logistical challenge in terms of the organisation of medical rotas. Smaller DGHs like ours will have to develop clinical alliances with neighbouring Trusts to ensure appropriate cover arrangements. This development also poses a technology challenge. We understand our new PAS (part of the NPfIT programme) has functionality issues, ie it does not recognise named consultants which would clearly disadvantage any Trust using this particular PAS solution. We have raised this with our SHA and service provider CSC. Choice of consultant could also have an impact on capacity times with the more popular teams attracting a higher level of referrals which will have a knock on effect on waiting times – although we accept this could have a self regulating effect with patients then choosing a different team with shorter waiting times. Choice of Any Willing Provider Clearly this development poses both an opportunity and a threat to providers – we acknowledge and accept the principle that the intention is to drive up quality and encourage continuous improvement. Given the current policy on Transforming Community Services with providers across the country currently engaged in transfer of services and agreeing contracts for the next 3 years, we are unclear how this contractual arrangement aligns with the intention to introduce Any Willing Provider for community services from April 2011. Clarity on this would be welcomed. Information Revolution Achieving the vision set out will require a comprehensive shared electronic health record accessible by health and social care. Achieving this on a national scale will require a coordinated approach and significant investment. With changes to the national programme we would welcome clarity on how this will be taken forward. We welcome proposals to review the plethora of data returns in line with the vision for a self regulated system and look forward to seeing further detail. As part of this review we would welcome the inclusion of information governance toolkit requirements, especially in relation to mandatory training which has become hugely time consuming for little gain. We were pleased to see the reference to use of t-health technologies. The information and IT revolution needs to recognise developments such as telemedicine which through our direct experience of providing telemedicine to prisons across England for the past 5 years clearly demonstrates both quality outcomes and value for money efficiencies. Providers and commissioners could be incentivised to adopt new technologies such as telemedicine which can be deployed at scale to support patients in their own homes by this being reflected in best practice tariff developments. Yours sincerely

Bridget Fletcher Chief Executive

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Attachment 2

Liberating the NHS: high-level timetable of key structural changes1

2010/11: Design and early adoption

• The Department of Health (DH) confirms the design framework, subject to Parliamentary approval

• The DH gives permission to pathfinders and early implementers to model the new arrangements and explore key issues for wider roll-out

• Refinement of HealthWatch following the choice and information consultations

• The DH publishes transition plan setting out the role of LINks in influencing local services while local HealthWatch prepares to start exercising functions

• The Government begins working with local authorities as they prepare for their new role in commissioning support for choice and complaints advocacy

2011/12: Learning and planning for roll-out

• Shadow national arrangements progressively implemented for the NHS Commissioning Board, new Monitor, and the Public Health England programme

• Sharing lessons from the GP consortia pathfinder programme and early implementer health and wellbeing boards

• More pathfinders and early implementers, including local HealthWatch • Plans drawn up for GP consortia, involving all GP practices • Emerging consortia to lead the process for identifying which PCT-employed

staff should be “assigned” to them • Plans to be drawn up for health and wellbeing boards • NHS trusts to apply for foundation trust status, or be planning to apply in

2012/13 • The new Provider Development Authority to be established by 1 April 2012 • SHAs to establish PCT cluster arrangements in preparation for the NHS

Commissioning Board 2012/13: Full dry run

• From April 2012, NHS Commissioning Board and new Monitor come into effect, SHAs are abolished, PCT clusters are accountable to the Board, and the DH will have made substantial progress on its change programme and established Public Health England. The Provider Development Authority will oversee NHS trusts

• More learning from GP pathfinders and health and wellbeing board early implementers

1 Extract from Liberating the NHS: Legislative framework & next steps, Department of Health, December 2010

• Authorisation of comprehensive system of Gp consortia begins, with all practices becoming members, acting under delegated arrangements with PCTs

• Health and wellbeing boards are in place • Comprehensive local HealthWatch arrangements in place • From April 2012, Local Authorities to fund local HealthWatch to deliver most

of their new functions • Consortia notified on 2013/14 allocations • By the end of the year, a significant number of NHS Trusts have achieved

Foundation Trust status • All applications for FT status to be made by end March 2013

2013/14 First full year of the new system

• From April 2013, PCTs abolished and all consortia assume new statutory responsibilities

• From April 2013, health and well being boards assume their statutory responsibilities

• Consortia and health and wellbeing boards learning from their participation in the full dry run

• From April 2013, Monitor’s licensing regime is fully operational, and the Government aims to have the new special administration regime in place

• From April 2013, local authorities to have responsibility for commissioning NHS complaints advocacy

• By end March 2014, the Provider Development Authority ceases to exist • By 1 April 2014, all NHS trusts to have become FTs, and NHS trust legislation

is repealed

AIREDALE NHS FOUNDATION TRUST COUNCIL OF GOVERNORS TITLE:

Finance Report

EXECUTIVE DIRECTOR:

Sheenagh Powell Director of Finance

NHS CONSTITUTION PRINCIPLE 6 The NHS is committed to providing best value for money and the most effective, fair and sustainable use of finite resources

AUTHOR: Andrew Copley Deputy Director of Finance

Action required by the Council of Governors To receive and note. _____________________________________________________________________ Issues for Consideration 1. Year to Date – for the period ending 31 December 2010 As at the end of December 2010 the overall financial position is showing a surplus of £255,000 which

is £499,000 worse than was expected. This is because the growth in income has slowed down considerably over the last two months but

expenditure levels across the clinical (Surgical and Medicine) groups has continued to remain high which has meant the overall financial position has got worse.

Monitor Risk Rating

Dec-10 Dec-10Ratio Business Plan Actual EBITDA margin 5.91% 5.20%EBITDA, % achieved 100.00% 91.51%ROA 5.00% 3.75%I&E surplus margin 0.82% 0.27%Liquidity ratio ( In days) 33.02 34.79

Financial Criteria Plan Actual Underlying Performance 3.00 3.00Achievement of Plan 5.00 4.00Financial Efficiency 3.00 3.00Liquidity 4.00 4.00

Weighted Score 3.45 3.15 Although at the end of Quarter 3 the Trust is showing an overall risk rating of 3, the underlying position

is also creating increased pressures on the levels of liquidity and given that at best we achieve only a

- 1 -

balanced position, there is a real possibility that we may finish with a risk rating of 2.4 at the end of quarter 4, which is worse than expected as the plan was for a score of 3.

2. Key Issues The main issues are as follows:

• Expenditure levels across the clinical groups and their ability to manage within their financial plans.

• CIP delivery across the groups, notably conversion of non recurrent measures to recurrent plans.

• Critical area of concern remains the Surgical Group and management of expenditure levels in

the Medical group in future months and delivery of the 18 week targets.

• Managing contract performance targets and assurance from the PCT of ability to pay the overtrade position if not managed down through reduced activity.

• Ensure the delivery of CQUIN within efficient use of resources.

• PCT QIPP intentions for 2010/11 above the agreed contract position.

3. Actions Being Taken to Ensure Delivery of the Financial Targets Executive Directors and the management team, with clinical engagement, are working to identify what

levels of productivity could be improved to sustain income levels whilst also reducing costs. 4. Risks/Impacts Key risks remain: 1. Attainment of cost reduction and productivity requirements through 2010/11 to manage within the

Trust’s ongoing contract income forecasts. 2. Validation and assurance of income with PCTs through improving data quality, understanding

and ownership at service/departmental level. 3. Need to ensure we can meet contract performance requirements and ensure resources are used

more efficiently in delivering improved performance. 4. Failure to achieve a risk rating of 3. 5. Recommendation The Council of Governors should note the underlying position across the clinical groups, including the

requirement to continue to increase productivity and ensure CIP delivery to plan. They should also note that the forecast position is based on the PCTs paying for work completed.

A Copley Deputy Director of Finance 17 January 2010 December Accounts Month 09 2010/11 - 2 -

FINANCE REPORT FOR COUNCIL OF GOVERNORS for the period ending 31 December 2010

Income and Expenditure

Summary/Overview

Budget to the end of December

Actual to the end of December

Variance

£,000 £,000 £,000

Income 91,871 95,473 3,602 Expenditure -91,117- -95,218- -4,101 I&E Surplus 755 255 -499-

As at the end of December 2010, the overall financial position is showing a surplus of £255,000, which is £499,000 worse than was expected. This is because the growth in income has slowed down considerably over the last two months but expenditure levels across the clinical (Surgical and Medicine) groups have continued to remain high, which has meant the overall financial position has got worse.

Surplus Cumulative Variance

(200)

0

200

400

600

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

£000

`s

Forecasting The deterioration in the underlying position is also affecting the forecast position and this has increased the risk of not achieving a surplus. The Forecast graphs below indicate that at best, we may only end up at a breakeven position at the end of the financial year.

Page 1 of 5

(1,500)

(1,000)

(500)

0

500

1,000

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

Plan

Forecast Model underlying trend

Forecast Model after contingencies

Actions Being Taken The executive team are working with the groups to manage expenditure levels down and identify with clinical leads what levels of productivity could be improved to sustain income levels. The delivery of Cost Improvement Programmes (savings planned) has been reviewed with the groups in order to improve their performance. This month now shows 87% of the plans to date being achieved, although it should be noted that 36% of this is only temporary for this year and needs to be made permanent for next year. Progress on efficiency plans for 2011/12 is also being reviewed through the Delivery Assurance Group meetings, with the expectation that delivery of some of these schemes will commence from January 2011. Contracting Performance This table shows the contract position with the Primary Care Trusts: PCT Position Year to date Annual Plan Actual Variance Plan Dec-10 Dec-10 £000`s £000`s £000`s £000`s KIRKLEES PCT 113 85 117 32 NORTH YORKSHIRE & YORK PCT 25,412 19,114 19,622 509 LEEDS PCT 1,034 776 972 196 EAST LANCASHIRE PCT 12,191 9,167 9,306 139 CALDERDALE PCT 134 101 117 16 BRADFORD & AIREDALE PCT 63,811 47,988 50,449 2,461 NCAS 829 624 775 152 Total 103,523 77,854 81,358 3,504 The level of overtrade with the PCTs has slowed down over the last few months and a revised forecast has been shared with the PCTs.

Page 2 of 5

Organisational Performance Group Performance

Budget to the end of December

Actual To the end Of December

Variance

HealthCare Service Income 85,334 89,130 3,797 Medical Group -20,690 -23,134 -2,445 Diagnostics & Therapeutic Group -15,025 -16,030 -1,005 Surgical Group -25,057 -27,815 -2,758 Support Services -926 -939 -13 Corporate Services -12,468 -11,236 1,232 Facilities -5,024 -4,935 88 Reserves & Technical -5,389 -4,785 604 Total Position 755 255 -499

Note Income is shown positive and a positive variance is good. Clearly there are expenditure pressures across the clinical groups, which in part is linked to increased activity levels but there are also shortfalls on permanent saving plans. As noted above the executive are working with clinicians and managers to improve productivity. Cost Improvement Plan (CIP) Performance for 9 Months ending 30 December 2010

Annual TargetPlanned

Savings to date

Actual Savings to

dateVariance

£000`s £000`s £000`s

Medical Division 1,363 1,022 1,018 -4

Diagnostic Division 899 674 751 77

Surgical Division 1,684 1,263 704 -559

Service Delivery 67 50 29 -21

Corporate Directorates 915 687 687 0

Facilities 367 275 274 -1

Total 5,295 3,971 3,463 -508 The overall CIP performance is 87% with a shortfall to date of £509,000, which is impacting on the underlying position. Performance has remained stable this month and the groups are working to ensure that they have robust plans for reducing the level of non recurrent support and ensure this becomes recurrent for 2011-12.

Page 3 of 5

The forecast trends on CIP delivery from the clinical groups are indicating risks in not achieving their year end targets. The forecast position would indicate a potential shortfall of £758,833, notably in the Surgical Group. Monitor Risk Rating

Dec-10 Dec-10Ratio Business Plan Actual EBITDA margin 5.91% 5.20%EBITDA, % achieved 100.00% 91.51%ROA 5.00% 3.75%I&E surplus margin 0.82% 0.27%Liquidity ratio ( In days) 33.02 34.79

Financial Criteria Plan Actual Underlying Performance 3.00 3.00Achievement of Plan 5.00 4.00Financial Efficiency 3.00 3.00Liquidity 4.00 4.00

Weighted Score 3.45 3.15 As at the end of December 2010 (Period 09), the Trust is delivering an overall risk score of 3. However, the underlying position is also creating increased pressures on our levels of liquidity (cash) and given that at best we achieve a breakeven position, we may have a final risk rating of 2.4 at the end of quarter 4, whereas Monitor would be expecting a risk rating of 3, which would be worse than expected. Balance sheet issues Total Non Current Assets (Buildings & Equipment) Actual figures are less than plan due to delays in the commencement of the Electrical Infrastructure Project. This scheme is now progressing well and expenditure will increase dramatically when the switchgear and generators are delivered next month. Last month, projected in-year capital expenditure was put at £7.4 million. The Valuation Office Agency has now completed its work on valuing the site on a Modern Equivalent Asset basis. The outcome of this is that the value of our assets will fall by £6.25M and that £0.5M will have to be treated as impairment which a technical adjustment to the accounts. It should be noted that none of this will detrimentally affect the Trust’s cash position or underlying risk rating with Monitor. Cash Cash levels are lower than plan due to outstanding income not received from the PCTs for work done and the high levels of expenditure being incurred. This continues to be offset by the relatively low levels of capital expenditure, which will change by the end of March and by this time, the cash position will be under greater pressure and payments to suppliers will have to continue to slow if the Trust is to maintain a relatively healthy cash balance. A C Copley Deputy Director of Finance 19 January 2010 December Accounts Month 09 2010~11

Page 4 of 5

GLOSSARY Amortisation Amortisation is the allocation of the cost of an item over the life of the item CQUIN Commissioning for Quality and Innovation EBITDA Earnings before interest, tax, depreciation and amortisation I&E Income and expenditure NCAS Patient activity outside the existing contracts with the Commisioners Non Recurrent Temporary and short term QIPP Quality, Innovation, Productivity and Prevention Recurrent Permanent and long term ROA Return on assets

Page 5 of 5

AIREDALE NHS FOUNDATION TRUST

COUNCIL OF GOVERNORS 26 January 2011

TITLE: Performance Report December 2010

NHS CONSTITUTION PRINCIPLE ALL

EXECUTIVE DIRECTOR:

Sheenagh Powell Director of Finance

AUTHOR: Stuart Shaw Head of Planning and Performance

Action required by the Council of Governors To receive and note the attached Performance Report cumulative to December 2010. _____________________________________________________________________ The attached Performance Report shows the position to December 2010 for the Monitor Compliance Framework requirements for Service Performance as part of the Foundation Trusts quarterly Governance declaration. Performance is shown against the required threshold or trajectory for each indicator assessed as part of the framework. Key messages to December 2010 include;

• The Monitor Compliance Framework Quarter 3 rating for Service Performance is Green.

• All of the standards were delivered for Quarter 3.

• There have been no hospital acquired MRSA bacteraemias and just two

Clostridium Difficile infections during this period.

• Focus on hospital acquired infections continues through a series of specific actions promoting both education and learning and seeking assurance from ward and departmental leads that controls are in place.

• The proportion of patients that were admitted, treated or discharged within 4

hours of arriving at Accident and Emergency in Quarter 3 was 98.0%.

• The Quarter 3 performance for all of the cancer standards is projected to be above the required thresholds.

• The Foundation Trust delivered its aggregate 18 Weeks requirements for Quarter

3. There are three specialties currently not achieving the target levels and work is focusing on reducing the backlog of cases in these areas to improve the position.

The Council of Governors is asked to receive and note the Performance Report to December 2010.

Council of Governors Wednesday 26th January 2011 Performance Report December 2010 1. Introduction The attached Performance Report shows the position to December 2010 for the Monitor Compliance Framework requirements for Service Performance as part of the Foundation Trusts quarterly Governance declaration. Performance is shown against the required threshold or trajectory for each indicator assessed. Traffic light ratings are then applied to show the level of risk using the following criteria; Green Performance achieving the required threshold/trajectory Amber Performance not achieving the required threshold/trajectory but within

acceptable tolerances allowed Red Performance not achieving the required threshold/trajectory This summary provides a high level overview of the position and includes details of any corrective action being taken where required. The revisions to the Operating Framework 2010/2011 (and subsequent updates to the Monitor Compliance Framework) have been incorporated into the attached report. 2. Monitor Compliance Framework Governance The Compliance Framework outlines Monitor’s risk-based approach to regulating NHS Foundation Trusts. Foundation Trusts are assessed quarterly on Service Performance and this contributes to the overall Governance ratings. Ratings are awarded on a four point scale; Green, Amber/Green, Amber/Red and Red. The Foundation Trust Terms of Authorisation expect it to achieve quarterly ratings of Amber/Green or above.

Performance Report December 2010 1

The Foundation Trust was rated Green for Governance for Quarters 1 and 2. The Foundation Trust is also preparing to declare a Green rating for Governance for Quarter 3. All of the standards are being achieved. Key performance highlights include;

• The Foundation Trust is within the required limit for both MRSA bacteraemias and Clostridium Difficile infections for Quarter 3. There have been no hospital acquired MRSA bacteraemias and just two Clostridium Difficile infections during this period.

• 18 Weeks - The Foundation Trust is projected to achieve both the admitted

and non-admitted elements of the assessment for Quarter 3.

• The proportion of patients that were admitted, treated or discharged within 4 hours of arriving at Accident and Emergency in Quarter 3 was 98.0%. This is set against a national requirement of 95%. The year to date position for this indicator is achieving 98.5%.

• The Quarter 3 performance for all of the cancer standards is projected to be

above the required thresholds. MRSA There were three hospital acquired MRSA bacteraemias in the first two quarters of the year. A de minimis rule of 6 applies for this standard (i.e. no penalty points are applied until the number of cases across the year exceeds 6). The focus on hospital acquired infections continues to be raised through a series of specific actions promoting both education and learning and seeking assurance from ward and departmental leads that controls are in place. There were no hospital acquired MRSA bacteraemias in Quarter 3. 18 Weeks One of the updates to the Compliance Framework for 2010/2011 (resulting from the revisions to the Operating Framework) is that the 18 Weeks standard is no longer part of the scored assessment. Foundation Trusts are however expected to continue delivering their contractual requirements (i.e. delivering an aggregate performance of 90% of admitted patients and 95% of non-admitted patients being treated within 18 weeks of their referral date, each individual month). The aggregate 18 Weeks position for admitted patients in April was below the 90% requirement. This had been projected at the start of the year as a result of treating

Performance Report December 2010 2

some longer waiting patients on the list. The position was discussed and agreed in advance with Monitor, the StHA and the PCT’s. For Quarter 3 the overall aggregate performance for both admitted and non-admitted patients has been delivered each month. The Foundation Trust is currently delivering in all specialities apart from Urology, Oral Surgery and Ophthalmology for admitted patients. Further work is ongoing to reduce the backlog of cases in these specialties and improve the percentage of patients being treated within 18 weeks. Stuart Shaw Head of Planning and Performance January 2011

Performance Report December 2010 3

Targets – weighted 1.0 (National requirements)

Threshold 2010/2011 Quarter 1

2010/2011 Quarter 2

2010/2011 Quarter 3 (to date)

Clostridium Difficile year on year reduction (to fit the trajectory for the year as agreed with PCT – assumed a 15% reduction if no level

agreed in PCT contract) 12 per Quarter 6 7 2

MRSA maintaining the annual number of MRSA bloodstream infections at less than half the 2003/04 level (assumed target is 50%

of 2003/04 level if no level agreed in PCT contract)

Q1 and Q3 (1) Q2 and Q4 (2)

1 (de minimis rule of

6 applies)

2 (de minimis rule of

6 applies)

0 (de minimis rule of

6 applies)

Maximum waiting time of 31 days for subsequent treatments for all cancer treatments

94% Surgery 98% Drug

96.3% 100%

100.0% 100%

100.0% 100%

Maximum waiting time of 62 days from referral to treatment for all cancer treatments

85%Referrals 90%Screening

98.1% 100.0%

86.1% 100.0%

95.0% 100.0%

Admitted patients: Maximum time of 18 weeks from point of referral to treatment

90% April not achieved

2 Spec not achieved

Aggregate achieved 2 Spec not achieved

Aggregate achieved 3 Spec not achieved

Non-admitted patients: Maximum time of 18 weeks from point of referral to treatment

95% Aggregate achieved

2 Spec not achieved

Aggregate achieved 1 Spec not achieved

Aggregate achieved 0 Spec not achieved

Targets – weighted 0.5 (Existing healthcare targets)

2010/2011 Quarter 1

2010/2011 Quarter 2

2010/2011 Quarter 3 (to date)

Maximum waiting time of four hours in A&E from arrival to admission, transfer or discharge 95% 99.0% 98.4% 98.0%

Maximum waiting time of 31 days from diagnosis to treatment for all cancers 96% 97.9% 98.8% 100.0%

Maximum waiting time of two weeks from urgent GP referral to date first seen for all urgent suspect cancer referrals

93% Referral 93% Breast

94.9% 95.8%

93.9% 92.3%

97.0% 97.3%

Screening all elective Inpatients for MRSA 100% 100% 100%

Access to healthcare for patients with learning disabilities 100% 100% 100%

Overall Service Performance Rating GREEN GREEN GREEN

AIREDALE NHS FOUNDATION TRUST

COUNCIL OF GOVERNORS 26 January 2011

TITLE: Annual Audit Opinion Letter

EXECUTIVE DIRECTOR:

Sheenagh Powell Director of Finance 01535 294804

NHS CONSTITUTION PRINCIPLE 7 The NHS is accountable to the public, communities and patients that it serves

Action required by the Council of Governors To receive and note the attached documents ______________________________________________________________

- 1 -

Annual Audit Letter Airedale NHS Trust Audit 2009/10 September 2010

Contents

Key messages .................................................................................................................... 3 Audit Opinion ....................................................................................................................... 3

Financial statements ............................................................................................................ 3

Use of resources .................................................................................................................. 3

Current and future challenges facing the Foundation Trust ................................................. 3

Audit Fees ............................................................................................................................ 4

Independence ...................................................................................................................... 4

Financial statements and statement on internal control ................................................ 5

Audit Opinion ....................................................................................................................... 5

Restatement of 2008/09 accounts under IFRS .................................................................... 5

2009/10 financial statements ............................................................................................... 5

Internal control ..................................................................................................................... 6

Charitable Funds ................................................................................................................. 6

Use of resources ................................................................................................................ 7

ALE Judgements ................................................................................................................. 7

VFM conclusion ................................................................................................................... 8

Payment by Result (PbR) Data Assurance Framework ................................................ 10

Closing remarks ............................................................................................................... 12

Copies of this report ........................................................................................................... 13

The Statement of Responsibilities of Auditors and Audited Bodies issued by the Audit Commission explains the respective responsibilities of auditors and of the audited body. Reports prepared by appointed auditors are addressed to non-executive directors/members or officers. They are prepared for the sole use of the audited body. Auditors accept no responsibility to:

• any director/member or officer in their individual capacity; or • any third party.

Key messages

Key messages This report summarises the findings from my 2009/10 audit. It includes messages arising from the audit of your financial statements and the results of the work I have undertaken to assess your arrangements to secure value for money in your use of resources.

Audit Opinion 1 I issued an unqualified standard opinion on the 10th June 2010.

Financial statements 2 Your financial statements were free from material error.

3 In line with NHS accounting requirements, the Trust properly prepared its financial statements under International Financial Reporting Standards.

Use of resources 4 I assessed your arrangements to secure economy efficiency and effectiveness in your

use of resources against criteria specified by the Audit Commission.

5 I issued an unqualified conclusion stating that the Trust had adequate arrangements to secure economy efficiency and effectiveness in the use of its resources.

Current and future challenges facing the Foundation Trust 6 2009/10 was a challenging but extremely successful year. The Trust delivered a

surplus of £605,000* together with a cost improvement programme of £4million whilst continuing to receive national recognition for the quality of its services. The year culminated with authorisation as an NHS Foundation Status (from 1 June 2010) following a rigorous review by the regulator Monitor.

7 Foundation Trust status brings a number of financial freedoms to the Trust, most significantly the freedom to invest financial surpluses in the development of local facilities and services. This will be key factor when facing the external challenges of the future.

8 The NHS White Paper "Equity and Excellence: Liberating the NHS" emphasises the continued financial challenges facing all NHS organisations. The underlying theme of the White Paper is a drive to make the NHS more efficient by cutting costs, to deliver more for less and re-investing savings into front line service delivery. All trusts will need to strengthen their arrangements for financial, operational and quality delivery.

∗ Before exceptional costs relating to fixed asset impairments of £4.4 million

3 Airedale NHS Trust

Key messages

9 The White Paper plans significant changes to the structure of the NHS and the way it operates. Primary Care Trusts will be abolished and replaced by GP Consortia. One of your key challenges emerging from these changes will be to ensure that Airedale Foundation Trust is best placed to respond to these changes. You will need to ensure that you can maximise the opportunities the changes will inevitably present whilst at the same time seeking to deliver your core business to a high standard. You will need to review the Trust's capacity and capability to contract and deal with an increased number of 'purchasers' for your services.

10 Your financial health remains strong but the economic downturn is having a significant impact on all public finances. An immediate impact has been felt by most Trusts through the zero per cent uplift in commissioning contracts, at the same time you have an ambitious Cost Improvement Plan to deliver in 2010/11. The Board will need to be prepared to take difficult and challenging decisions in order to secure the continued and future success of the Foundation Trust.

Audit Fees 11 My audit fee for the 2009/10 audit was £125,000 and this remained unchanged

throughout the year.

Table 1 Audit fees

Code area Actual (£) Proposed (£) Variance (£)

Financial statements 55,000 55,000 0

Value for money work 70,000 70,000 0

Total audit fees 125,000 125,000 0

Independence 12 I can confirm that my team and I conducted the audit in accordance with the

Audit Commission’s policies on integrity, objectivity and independence.

Airedale NHS Trust 4

Financial statements and statement on internal control

Financial statements and statement on internal control The Trust's financial statements and the statement on internal control are an important means by which the Trust accounts for its stewardship of public funds.

Audit Opinion 13 I issued an unqualified (ie clean) opinion on the Trust's financial statements on 10th

June 2010 in advance of the Department of Health's deadline of 11th June 2010.

Restatement of 2008/09 accounts under IFRS 14 I established early dialogue with senior finance staff to understand the major

implications for the Trust of the adoption of IFRS. I assessed the Trust's arrangements to provide IFRS compliant accounts as adequate in March 2009 and issued an unmodified opinion on the Trust's 2008/09 comparatives restated under IFRS in October 2009.

2009/10 financial statements 15 My audit planning identified a number of areas of audit risk in relation to:

• the potential for manipulation of the financial statements to meet financial targets; • preparation of the financial statements on an IFRS basis; • the valuation basis of the Trust’s asset base;

16 I considered each of these risks specifically as part of my audit and was able to gain sufficient audit assurance against each of the issues for opinion purposes. My Annual Governance Report presented to the Trust's Audit Committee on 3 June 2010 sets out these assurances in detail.

17 The Trust's 2009/10 financial statements are the first prepared under International Financial Reporting Standards (IFRS). Despite the extensive changes in disclosures, and additional work required to support them, my audit findings demonstrated the Trust had prepared well. Only a few minor errors were identified and these were corrected by management.

18 The working papers supporting the financial statements were of a consistent high standard and finance staff provided prompt and comprehensive responses to our queries.

5 Airedale NHS Trust

Financial statements and statement on internal control

Internal control 19 I did not identify any weakness in the design or operation of an internal control that

might result in a material error in your financial statements.

Charitable Funds 20 The Charity Commission's deadline for certifying the Charitable Fund accounts is ten

months after the financial year end.

21 The 2008/09 Charitable Fund accounts were audited in November 2009 and I issued an unqualified opinion upon the financial statements within the required deadline in line with the timetable agreed by the Trust.

22 For 2009/10, the Trust has prepared the Charitable Fund financial statements and I will carry out the audit in October 2010 in order to meet the Charity Commission's deadline of 31 January 2011.

Airedale NHS Trust 6

Use of resources

Use of resources I considered how well the Trust is managing and using its resources to deliver value for money and gave a scored Auditor's Local Evaluation (ALE) judgement. I also assessed whether the Trust put in place adequate corporate arrangements for securing economy, efficiency and effectiveness in its use of resources. This is known as the value for money (VFM) conclusion.

ALE Judgements 23 In forming my scored ALE judgements, I have used the methodology set out in the

Audit Commission’s 'ALE for Trusts' guidance. Judgements have been made for each key line of enquiry (KLOE) using the Audit Commission’s current four point scale from 1 to 4, with 4 being the highest. Level 1 represents a failure to meet the minimum requirements at level 2.

24 For 2009/10 the ALE approach was more risk based and we carried out less work on ALE at the best performing trusts. Where trusts scored a 3 or 4 in any individual theme in 2008/09, we did not reassess that theme in 2009/10 but carried forward the score from 2008/09. Trusts were able to request a theme review where they believed that their performance had improved further.

25 In order to mitigate the risk of an undetected deterioration in performance, we kept a number of key issues or ‘triggers’ under review at every trust. If one of these triggers indicated that a trust might not be performing at the level evident in 2008/09 then auditors carried out appropriate work on that theme in 2009/10.

26 The Trust's ALE scores for the five key areas are shown in Table 2

Table 2 ALE Scores

Key area Score 2009/10

Score 2008/09

Score 2007/08

Score 2006/07

Financial reporting 3 3 3 3

Financial management 3 3 3 2

Financial standing 4 4 3 2

Internal control 3 3 3 2

Value for money 3 3 3 2

Overall Trust Score 3 3 3 3

7 Airedale NHS Trust

Use of resources

27 The Trust continues to perform well or strongly for all five themes and whilst the overall theme scores remain the same as in previous years, there has been further improvement in underlying scores for the 'value for money' for:

• Communicating with the public and engaging with 'hard to reach' groups; and • Data quality and clinical coding.

VFM conclusion 28 I assessed your arrangements to secure economy, efficiency and effectiveness in your

use of resources against 12 criteria specified by the Audit Commission. This work is integrated with my work on ALE (described above).

29 The Trust continued to exceed minimum requirements for all relevant criteria in 2009/10. As a result, I was able to issue an unqualified conclusion stating that the Trust had adequate arrangements to secure economy, efficiency and effectiveness in its use of resources.

30 I also carried out additional work to support my opinion in the following areas:

• Day case surgery benchmarking; and • Medical staffing benchmarking.

Day Case and Short Stay Surgery Benchmarking 31 A wide range of non-emergency surgical operations can be carried out as day surgery

with considerable advantages for patients, the public and the NHS:

• waiting times are usually shorter and there is less risk of cancellation; • there is less disruption to patients’ lives and the comfort of recovering at home; • there is reduced risk of cross-infection and less stress for patients if they are not

mixed with the acutely ill; • it is cheaper and more efficient because procedures can be scheduled more

predictably; and • outcomes are at least as good as for the same procedures carried out on in-

patients.

32 Traditional 'Day Case' surgery takes place when a patient is admitted to hospital, has surgery and is discharged on the same day, without having to stay overnight. 'Short Stay' surgery comprises the following two additional categories:

• "23 hour stay surgery" occurs when a patient is admitted and discharged within 24 hours.

• "Under 72 hour stay" surgery is when admission and discharge are completed within 72 hours.

33 Our review was designed to:

• provide high level trust-wide and specialty-level comparative performance data for day case and short stay surgery;

Airedale NHS Trust 8

Use of resources

• produce detailed performance analyses for 188 procedures accepted as suitable for day case and short stay surgery;

• identify opportunities for releasing pressure on in-patient beds; and • estimate financial savings from increasing day case rates and reducing length of

stay for in-patient procedures. • Our review identified that: • the Trust is in the top 25 per cent for day case rate overall with a rate of 81% which

is well above average, although the report highlights some areas where improvements could be made; and

• Length of stay overall appears high at 2.5 days on average. The impact of a high length of stay is that it restricts capacity in the system. A lower length of stay can lead to the creation of greater capacity. A robust discharge process can have a positive impact on the length of stay for some hospital trusts.

34 The Trust has agreed an action plan to investigate and address the issues raised in our report.

Medical staffing benchmarking 35 Medical staff are key to all aspects of an acute hospital’s work:

• hospital doctors are central to the delivery of high quality patient care; • they largely determine what a hospital does, and the resources used; • their direct costs alone account for 13% of the acute hospital budget; and • their working practices have an important bearing upon contract activity and

performance.

36 There are few national standards or guidelines for the numbers of doctors required by acute hospitals. Our review offered the Trust a comparative analysis of a range of medical staffing indicators against national benchmarks to provide a valuable aid for the Trust in examining the appropriateness of medical staff numbers and skill-mix.

37 The results of the analysis need to be interpreted in the local context, however key factors identified were:

• Inpatient and outpatient activity per doctor is below average indicating staff capacity is not being fully utilised, although consultants have a relatively high proportion of direct patient care activities in their job plans;

• The proportion of expenditure on long term locums is relatively high; • Whilst the overall numbers of medical staff are comparatively lower than at other

trusts, the grade mix is relatively high with fewer trainee grades and a higher proportion of specialist registrar grades.

38 Our benchmarking report has raised a number of issues which the Trust is now exploring in more depth.

9 Airedale NHS Trust

Payment by Result (PbR) Data Assurance Framework

Payment by Result (PbR) Data Assurance Framework 39 The aim of Payment by Results (PbR) is to provide a fair, transparent, rules-based

system for paying trusts, rewarding efficiency and quality. It does this by paying a nationally set price or tariff for each procedure, classified by Healthcare Resource Group (HRG).

40 Payment by results requires good quality data on costs and clinical activity to be available.

• The Department of Health (DH) needs reliable cost and activity data in order to set a fair and accurate tariff.

• Trusts need good quality activity data for billing purposes and accurate knowledge of their costs.

• PCTs make payments based on information from trusts and so need to know that data is correct and fair in terms of activity volume and case-mix.

41 The PbR Data Assurance Framework is designed to support the improvement of data quality standards that underpin the accuracy of coding and payments under PbR. The Framework, delivered as part of PCT audits and associated fees, is now in its third year. It includes a rolling programme of independent, targeted external clinical coding audits covering all Acute Trusts in England.

Payment by Results (PbR) Data Assurance Framework - Inpatients 42 We reviewed the way the Trust records the treatments patients receive. In the NHS

hospitals receive payments under a national tariff system (Payment by Results) from their service commissioners (Primary Care Trusts). The payments are linked to the complexity of the treatments and the length of stay within the hospital.

43 It is therefore critical that the hospital accurately records the type and extent of individual treatments patients receive (clinical coding). Our audit assesses the accuracy of such patient level data and compares the Trust's performance against the national average.

44 We issued a report to the Trust and its lead service commissioner (Bradford and Airedale PCT) on the results of our admitted patient care clinical coding audit at the Trust.

45 The review found that the Trust is performing well compared to other trusts nationally. An overall error rate of 7.3 per cent was identified, which is below the national average of 8.8 percent, and is a further improvement on the error rate identified in last year's audit (8.1 per cent).

46 The majority of recommendations from the previous year's audit had been fully implemented, however one recommendation - the provision of full case notes as source documentation for all specialities, had not yet been completed and the factors

Airedale NHS Trust 10

Payment by Result (PbR) Data Assurance Framework

associated with it were still having an impact on data quality. This action has now been agreed by the Trust as a priority, together with further recommendations on staff training.

Payment by Results (PbR) Data Assurance Framework - Outpatients 47 Outpatient PbR data assurance is an audit designed to test the quality of outpatient

data in support of PbR, through:

• a review of the Trust's overall arrangements for managing the quality of outpatient data using the Audit Commission's Key Lines of Enquiry (KLOE) t make scored judgements on accountability, policies and procedures, data entry and IT systems;

• a comparative analysis of outpatient data; and • testing the accuracy of key data items underpinning payments made under PbR by

checking these back to source records.

48 We found that the Trust's data quality arrangements met all the requirements for the arrangements we tested.

49 Our data testing demonstrated adequate standards of outpatient data recording. Whilst we found a total of 17 errors out of 150 data items, these were mainly errors with coding Gastroenterology appointments as General Medicine.

50 An action plan to further improve the quality of coding of outpatient data has been agreed with the Trust.

11 Airedale NHS Trust

Closing remarks

Closing remarks 51 I have discussed and agreed this letter with the Interim Chief Executive and the

Director of Finance. I presented this letter to the Audit Committee on 23 September 2010 and have issued it to the Trust's Board. I would also welcome the opportunity to present the letter to the Foundation Trust Committee of Governors.

52 I set out more detailed findings, conclusions and recommendation on the areas covered by my audit in the reports issued to the Trust during the year.

Table 3 Reports issued

Report Date issued

Audit fee letter February 2009

IFRS: Auditors' review of the restated 1 April 2008 Balance Sheet November 2009

Payment by results data assurance framework – Outpatients January 2010

Payment by results data assurance framework – Inpatients February 2010

Opinion audit plan March 2010

Day case Surgery benchmarking report April 2010

Report to those charged with governance June 2010

Opinion on financial statements June 2010

Value for money conclusion June 2010

Medical Staffing benchmarking report August 2010

Auditor's Local Evaluation September 2010

Annual Audit Letter October 2010

53 The Trust has taken a positive and constructive approach to my audit. I therefore wish to thank the Trust’s directors, managers and staff for their support and cooperation.

Damian Murray Engagement Lead

September 2010

Airedale NHS Trust 12

The Audit Commission The Audit Commission is an independent watchdog, driving economy, efficiency and effectiveness in local public services to deliver better outcomes for everyone. Our work across local government, health, housing, community safety and fire and rescue services means that we have a unique perspective. We promote value for money for taxpayers, auditing the £200 billion spent by 11,000 local public bodies. As a force for improvement, we work in partnership to assess local public services and make practical recommendations for promoting a better quality of life for local people.

Copies of this report If you require further copies of this report, or a copy in large print, in Braille, audio, or in a language other than English, please call 0844 798 7070. © Audit Commission 2010 For further information on the work of the Commission please contact: Audit Commission, 1st Floor, Millbank Tower, Millbank, London SW1P 4HQ Tel: 0844 798 1212, Fax: 0844 798 2945, Textphone (minicom): 0844 798 2946 www.audit-commission.gov.uk

Airedale NHS Foundation Trust

Chairman

Terms and Conditions of Appointment The terms of appointment are based on the Monitor NHS Foundation Trust Code of Governance and the Airedale NHS Foundation Trust Standing Orders and incorporate the NHS Constitution and Nolan Principles. 1 Appointment 1.1 Your appointment as Chairman of the Board of Directors has been made on merit

and based on objective criteria. 1.2 You will have been assessed as having the relevant skills and experience and time

to devote to the job. 1.3 You should have a description of the role and capabilities required – a generic job

description is attached. 1.4 Your appointment does not create a contract of service or contract for services

between you and the Trust. 1.5 Your appointment is for a term of 3 years subject to reappointment thereafter at

intervals of no more than 3 years. 1.6 Any term beyond 6 years will be subject to rigorous review and should take

account of the need to refresh the Board. 1.7 In exceptional circumstances you may serve longer than 6 years, up to a maximum

of 9 years, but this will be subject to annual re-appointment. 1.8 Your appointment is not within the jurisdiction of Employment Tribunals, nor is

there any entitlement for compensation for loss of office through employment law. 2 Time Commitment 2.1 As Chairman the expectation is that you will be required to devote an average of

no less than 3 days per normal working week on your Board responsibilities. 2.2 You should give an undertaking that you will have sufficient time to meet what is

expected of you in the role. 2.3 You should disclose to the Council of Governors, prior to appointment, any other

significant commitments and the broad time involved; and inform the Council of Governors of subsequent changes.

1

3 Induction, information and professional development 3.1 On taking up your role you will receive a full, formal and appropriate induction. 3.2 The Deputy Chairman is responsible for ensuring you receive accurate, timely and

clear information to be able to perform. You should seek clarification or amplification where necessary.

3.3 You should continually update your skills, knowledge and familiarity with the NHS

and the Foundation Trust and will be supported to do so. You will have access to independent professional advice at the Trust’s expense and to training courses and materials consistent with your individual and collective development needs.

4 Appraisal and performance evaluation 4.1 Your performance will be appraised and evaluated in line with the process agreed

by the Council of Governors. It will aim to show that you continue to contribute effectively, demonstrate commitment and have the relevant skills for the role (including commitment of time).

4.2 The evaluation will be used by the Senior Independent Director to consider

performance needs and determine individual and collective development needs. 5 Remuneration 5.1 You are entitled to remuneration for as long as you continue to hold office as

Chairman. You are entitled to receive remuneration only in relation to the period you hold office. There is no entitlement to compensation for loss of office.

5.2 The Appointments and Remuneration Committee will decide your remuneration

taking into account the position of the Foundation Trust in relation to other Trusts and comparable organisations; as well as being sensitive to pay and employment conditions elsewhere in the Trust.

5.3 Your remuneration will reflect the time commitment and the responsibility of your

role. 5.4 The Trust may pay additional allowance to NEDs who are appointed to chair a

significant Board Committee. 5.5 The current rates are shown in Appendix 1. Remuneration is taxable under

Schedule E, and subject to Class 1 National Insurance Contributions. 6 Expenses 6.1 You can claim allowances for travel and subsistence costs necessarily incurred on

Trust business. All allowances may be subject to review and may change from time to time. The current rates are shown in Appendix 1.

2

7 Conduct 7.1 You will be expected to conduct yourself at all times in a manner befitting a Board

Director and in accordance with the Nolan Principles (attached), NHS Constitution, NHS Values and NHS Code of Conduct for Managers. Failure to comply may result in your termination from office.

7.2 You should not normally make political speeches or engage in political activities

unless prior approval has been granted by the Deputy Chairman. 7.3 You must declare on appointment any material interest as defined under

paragraph 6 of the standing orders for the practice and procedure of the Board of Directors (attached)

8 Resignation 8.1 You may resign at any time by giving notice to the Deputy Chairman and Council

of Governors. You should give 3 months notice to enable the recruitment of a replacement without significant impact on service. You will be expected to continue in service during the 3 month period unless otherwise agreed with the Deputy Chairman.

9 Termination of appointment 9.1 Your appointment may be terminated if:

• You are or become disqualified for appointment as defined by the Constitution of Airedale NHS Foundation Trust;

• It is considered that it is not in the interests of the health service that you continue in office;

• You do not attend two consecutive meetings of the Board of Directors; • You do not comply with the requirements with regard to pecuniary interests in

matters under discussion at meetings of the Trust (e.g. failure to disclose an interest).

9.2 When considering whether it is not in the interests of the health service for you to

continue in office the Council of Governors will take account of factors such as:

• Unsatisfactory appraisals; • Whether you no longer enjoy the confidence of the Board/Council of

Governors; • Whether you have lost the confidence of the public or local community in a

substantial way; • Failure to deliver against agreed targets or objectives; • A terminal breakdown in essential relationships, e.g. between the Non

Executive Directors and Deputy Chair or rest of the Board.

9.3 You can be suspended from performing your functions whilst consideration is given to whether your appointment should be terminated. You will receive remuneration during the period of suspension unless otherwise advised.

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9.4 Upon termination of appointment you will return all documentation and property

owned by the Trust.

4

APPENDIX 1

Allowances for Chairs of Board Committees

Audit Committee £2,500 per annum Clinical Quality and Safety Committee (QSAC) £2,500 per annum [Subject to approval by the Council of Governors]

Allowances for travel and subsistence rates

1. Actual amount of travel expense if using public transport at standard tariffs; or mileage expenses.

Mileage rates are: 43p per mile for engines up to 1500cc for first 7,500 miles and then 18.3p per mile thereafter. 53p per mile for engines over 1500cc for the first 7,500 miles and then 20.5p per mile thereafter.

2. Subsistence rates are:

5-10 hours (1 meal) £5 10-12 hours (2 meals) £10 Over 12 hours (3 meals) £15 Overnight rates are: Bed and breakfast outside London – receipts up to £100 Bed and breakfast London – receipts up to £120 Meal Allowance £22.50 Non commercial arrangement of staying with friends or relatives £27.50

January 2011

5

Airedale NHS Foundation Trust

Non Executive Directors

Terms and Conditions of Appointment The terms of appointment are based on the Monitor NHS Foundation Trust Code of Governance and the Airedale NHS Foundation Trust Standing Orders and incorporate the NHS Constitution and Nolan Principles. 1 Appointment 1.1 Your appointment to the Board of Directors has been made on merit and based on

objective criteria. 1.2 You will have been assessed as having the relevant skills and experience and time

to devote to the job. 1.3 You should have a description of the role and capabilities required – a generic job

description is attached. 1.4 Your appointment does not create a contract of service or contract for services

between you and the Trust. 1.5 Your appointment is for a term of 3 years subject to reappointment thereafter at

intervals of no more than 3 years. 1.6 Any term beyond 6 years will be subject to rigorous review and should take

account of the need to refresh the Board. 1.7 In exceptional circumstances you may serve longer than 6 years, up to a maximum

of 9 years, but this will be subject to annual re-appointment. 1.8 Your appointment is not within the jurisdiction of Employment Tribunals, nor is their

any entitlement for compensation for loss of office through employment law. 2 Time Commitment 2.1 As a Non Executive Director you are expected to devote an average of 5 days per

month on your Board responsibilities. 2.2 You should give an undertaking that you will have sufficient time to meet what is

expected of you in the role. 2.3 You should disclose to the Council of Governors, prior to appointment, any other

significant commitments and the broad time involved; and inform the Council of Governors of subsequent changes.

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3 Induction, information and professional development 3.1 On taking up your role you will receive a full, formal and appropriate induction. 3.2 The Chairman is responsible for ensuring you receive accurate, timely and clear

information to be able to perform. You should seek clarification or amplification where necessary.

3.3 You should continually update your skills, knowledge and familiarity with the NHS

and the Foundation Trust and will be supported to do so. You will have access to independent professional advice at the Trust’s expense and to training courses and materials consistent with your individual and collective development needs.

4 Appraisal and performance evaluation 4.1 Your performance will be appraised and evaluated in line with the process agreed

by the Council of Governors. It will aim to show that you continue to contribute effectively, demonstrate commitment and have the relevant skills for the role (including commitment of time).

4.2 The evaluation will be used by the Chairman to consider performance needs and

determine individual and collective development needs. 5 Remuneration 5.1 You are entitled to remuneration for as long as you continue to hold office as a non

executive director. You are entitled to receive remuneration only in relation to the period you hold office. There is no entitlement to compensation for loss of office.

5.2 The Appointments and Remuneration Committee will decide your remuneration

taking into account the position of the Foundation Trust in relation to other Trusts and comparable organisations; as well as being sensitive to pay and employment conditions elsewhere in the Trust.

5.3 Your remuneration will reflect the time commitment and the responsibility of your

role. 5.4 The Trust may pay additional allowance to NEDs who are appointed to chair a

significant Board Committee 5.5 The current rates are shown in Appendix 1. Remuneration is taxable under

Schedule E, and subject to Class 1 National Insurance Contributions. 6 Expenses 6.1 You can claim allowances for travel and subsistence costs necessarily incurred on

Trust business. All allowances may be subject to review and may change from time to time. The current rates are shown in Appendix 1.

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7 Conduct 7.1 You will be expected to conduct yourself at all times in a manner befitting a Board

Director and in accordance with the Nolan Principles (attached), NHS Constitution, NHS Values and NHS Code of Conduct for Managers. Failure to comply may result in your termination from office.

7.2 You should not normally make political speeches or engage in political activities

directly related to the NHS or to Airedale NHS FT, unless prior approval has been granted by the Chairman, or in the case of the Chairman, by the Deputy Chairman.

7.3 You must declare on appointment any material interest as defined under

paragraph 6 of the standing orders for the practice and procedure of the Board of Directors (attached)

8 Resignation 8.1 You may resign at any time by giving notice to the Chairman and Council of

Governors. You should give 3 months notice to enable the recruitment of a replacement without significant impact on service. You will be expected to continue in service during the 3 month period unless otherwise agreed with the Chairman, or in the case of the Chairman, by the Deputy Chairman.

9 Termination of appointment 9.1 Your appointment may be terminated if:

• You are or become disqualified for appointment as defined by the Constitution of Airedale NHS Foundation Trust;

• It is considered that it is not in the interests of the health service that you continue in office;

• You do not attend two consecutive meetings of the Board of Directors; • You do not comply with the requirements with regard to pecuniary interests in

matters under discussion at meetings of the Trust (e.g. failure to disclose an interest).

9.2 When considering whether it is not in the interests of the health service for you to

continue in office the Council of Governors will take account of factors such as:

• Unsatisfactory appraisals; • Whether you no longer enjoy the confidence of the Board/Council of

Governors; • Whether you have lost the confidence of the public or local community in a

substantial way; • Failure to deliver against agreed targets or objectives; • A terminal breakdown in essential relationships, e.g. between the Non

Executive Directors and Chair or rest of the Board.

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9.3 You can be suspended from performing your functions whilst consideration is given to whether your appointment should be terminated. You will receive remuneration during the period of suspension unless otherwise advised.

9.4 Upon termination of appointment you will return all documentation and property

owned by the Trust.

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APPENDIX 1

Allowances for Chairs of Board Committees

Audit Committee £2,500 per annum Clinical Quality and Safety Committee (QSAC) £2,500 per annum [Subject to approval by the Council of Governors]

Allowances for travel and subsistence rates

1. Actual amount of travel expense if using public transport at standard tariffs; or mileage expenses. Mileage rates are:

43p per mile for engines up to 1500cc for first 7,500 miles and then 18.3p per mile thereafter. 53p per mile for engines over 1500cc for the first 7,500 miles and then 20.5p per mile thereafter.

2. Subsistence rates are:

5-10 hours (1 meal) £5 10-12 hours (2 meals) £10 Over 12 hours (3 meals) £15 Overnight rates are: Bed and breakfast outside London – receipts up to £100 Bed and breakfast London – receipts up to £120 Meal Allowance £22.50 Non commercial arrangement of staying with friends or relatives £27.50

January 2011

5

Airedale NHS Foundation Trust

Recruitment and Selection of Chairman 1 Introduction 1.1 Recruitment and Selection will be conducted in a manner that is consistent with

the NHS Foundation Trust Code of Governance; and best HR practice. 1.2 There will be a formal, rigorous and transparent procedure for the appointment

of the Chairman. 1.3 Appointments to the Board should be made on merit and based on objective

criteria 1.4 Care will be taken to ensure that appointees have the relevant skills and

experience to complement other members of the Board and enough time to devote to the job

1.5 Recruitment and selection of the Chairman will be the responsibility of the

Appointment and Remuneration Committee (ARC). They will make recommendations to the Council of Governors.

Process 2 Advert 2.1 The ARC will approve a job and person specification covering the role, time

commitment and the skills, experience and qualifications required. The specifications will take into account the views of the Board of Directors.

2.2 The ARC will use the professional services of the Trust’s HR Department to

secure a field of suitable applicants through external advert and the use of head hunters as appropriate.

3 Selection process 3.1 The Trust will ensure due diligence through the selection process. 3.2 The processes used will:

• Add value to the selection • Be proportionate to the role • Make use of reasonable and reliable information sources • Be conducted in an objective and fair manner for all candidates • Be conducted in a way that is open to scrutiny • Comply with the data protection act; the Foundation Trust Code of

Governance; and appropriate legislation.

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4 Information from candidates 4.1 Candidates will be asked to provide a range of information about their

suitability for the post through their application and at any subsequent interview.

4.2 Candidates will be asked to declare any convictions that would lead to them

being disqualified from appointment. If any are advised their application will not be considered further.

4.3 Candidates will also be asked to declare any other current or past issues

that may be a barrier to their appointment or cause embarrassment to the Foundation Trust.

4.4 The selection panel will seek advice from HR about the relevance to the

role. They will be required to explain and record their decision. The same rules will apply to non executives seeking re appointment.

5 References 5.1 Suitable references will be sought from two referees, to be determined by

the nominated members of the ARC... The reference will follow a structured format.

6 Information from Executive Search companies 6.1 It may be appropriate to use Executive Search companies as part of the

selection process. 6.2 Any information provided about candidates should be shared with all

selection panel members and recorded for audit purposes. 6.3 On occasions the Executive Search Company can also be asked to

interview long or short listed candidates for the position before the final selection interview. The outcomes should be recorded for audit purposes.

7 Structured checking 7.1 Structured checking will take place before an offer is confirmed. This will

include: employment history, memberships of professional bodies, qualifications, and convictions.

7.2 Candidates should be informed that structured checking will be undertaken

and that any issues identified will be raised with them before a decision about their suitability for appointment is made.

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8 Final Selection Process 8.1 The final selection process may vary depending on the nature of the

appointment, but will always include a selection interview. This will be chaired by the Deputy Chair for the appointment of a new Chairman, or if the Deputy Chair is a candidate then the Senior Independent Director. For the appointment of the Chairman the ARC will seek the services of an Independent Assessor.

8.2 The selection panel will consist of the Deputy Chair, except in the situation

whereby the Deputy Chair is a candidate, and nominated members of the ARC (as determined by the ARC), supported by the HR Director.

8.3 The selection process will consider suitability against the skills, experience,

qualities and qualifications in the job and person specifications. 8.4 The Selection Panel will make recommendations to the ARC regarding

suitability for appointment. The ARC will make the recommendation to the Council of Governors to appoint.

January 2010v4

3

Airedale NHS Foundation Trust

Recruitment and Selection of Non Executive Directors 1 Introduction 1.1 Recruitment and Selection will be conducted in a manner that is consistent with

the NHS Foundation Trust Code of Governance; and best HR practice. 1.2 There will be a formal, rigorous and transparent procedure for the appointment

of Non Executive Directors. 1.3 Appointments to the Board should be made on merit and based on objective

criteria 1.4 Care will be taken to ensure that appointees have the relevant skills and

experience to complement other members of the Board and enough time to devote to the job

1.5 Recruitment and selection of the Non Executive Directors will be the

responsibility of the Appointment and Remuneration Committee (ARC). They will make recommendations to the Council of Governors.

Process 2 Advert 2.1 The ARC will approve a job and person specification covering the role, time

commitment and the skills, experience and qualifications required. The specifications will take into account the views of the Board of Directors.

2.2 The ARC will use the professional services of the Trust’s HR Department to

secure a field of suitable applicants through external advert and the use of head hunters as appropriate.

3 Selection process 3.1 The Trust will ensure due diligence through the selection process. 3.2 The processes used will:

• Add value to the selection • Be proportionate to the role • Make use of reasonable and reliable information sources • Be conducted in an objective and fair manner for all candidates • Be conducted in a way that is open to scrutiny • Comply with the data protection act; the Foundation Trust Code of

Governance; and appropriate legislation.

1

4 Information from candidates 4.1 Candidates will be asked to provide a range of information about their

suitability for the post through their application and at any subsequent interview.

4.2 Candidates will be asked to declare any convictions that would lead to them

being disqualified from appointment. If any are advised their application will not be considered further.

4.3 Candidates will also be asked to declare any other current or past issues

that may be a barrier to their appointment or cause embarrassment to the Foundation Trust.

4.4 The selection panel will seek advice from HR about the relevance to the

role. They will be required to explain and record their decision. The same rules will apply to non executives seeking re appointment.

5 References 5.1 Suitable references will be sought from two referees, to be determined by

the nominated members of the ARC. The reference will follow a structured format.

6 Information from Executive Search companies 6.1 It may be appropriate to use Executive Search companies as part of the

selection process. 6.2 Any information provided about candidates should be shared with all

selection panel members and recorded for audit purposes. 6.3 On occasions the Executive Search Company can also be asked to

interview long or short listed candidates for the position before the final selection interview. The outcomes should be recorded for audit purposes.

7 Structured checking 7.1 Structured checking will take place before an offer is confirmed. This will

include: employment history, memberships of professional bodies, qualifications and convictions.

7.2 Candidates should be informed that structured checking will be undertaken

and that any issues identified will be raised with them before a decision about their suitability for appointment is made.

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8 Final Selection Process 8.1 The final selection process may vary depending on the nature of the

appointment, but will always include a selection interview. This will be chaired by the Chairman for Non Executive Director Appointments.

8.2 The selection panel will consist of the Chair and nominated members of the

ARC (as determined by the ARC), supported by the HR Director. 8.3 The selection process will consider suitability against the skills, experience,

qualities and qualifications in the job and person specifications. 8.4 The Selection Panel will make recommendations to the ARC regarding

suitability for appointment. The ARC will make the recommendation to the Council of Governors to appoint.

January 2011 v2

3

AIREDALE NHS FOUNDATION TRUST

COUNCIL OF GOVERNORS 26 January 2011

TITLE: Re-appointment of Mr D W Adam as a Non-Executive Director

EXECUTIVE DIRECTOR:

Colin Millar Chairman

NHS CONSTITUTION PRINCIPLE 7 The NHS is accountable to the public, communities and patients that it serves

Action required by the Council of Governors To approve the recommendation. _______________________________________________________________ Background David Adam was appointed by the NHS Appointments Commission as a Non-Executive Director of Airedale NHS Trust for a four year term of office with effect from 7 February 2007. He is eligible for re-appointment to the Board of Directors of Airedale NHS FT for a second term of three years. Overall he may serve a maximum of nine years as a Non-Executive Director of the Trust. Summary Profile David Adam is 62, married and lives in Ilkley. He is a Chartered Accountant with an MA from Sheffield University. He has been Finance Director or Managing Director of a number of industrial companies (Chloride Group, Pergamon, Carlco, Silentnight). From 2003 to 2006 he was a Non-Executive Director and, for a time, Chairman of Silentnight Group. He retired in 2006. He has been Treasurer of Ilkley Rugby Club and Captain of Ilkley Chess Club. His mother was a nurse. His son was born at Airedale. He has been a patient at Airedale. Consideration by Appointments & Remuneration Committee On behalf of the Council of Governors, the Appointments & Remuneration Committee considered the re-appointment of David Adam at its meeting on 17 January. In that consideration the Committee took account of his:

o Qualifications and experience o Annual appraisal performance ratings o Record of activity as a Director o Contribution to the Board of Directors as assessed by the Chairman

On the basis of its consideration, the Appointments & Remuneration Committee resolved to recommend to the Council of Governors that David Adam be re-appointed as a Non-Executive Director to serve for a term of three years with effect from 7 February 2011. Supporting Considerations David Adam has indicated his willingness to serve for a further term. He has confirmed that he has the time to fulfil the requirements of being a Director. His re-appointment has the support of his Executive and Non-Executive colleagues. His re-appointment has the support of the Chairman. Recommendation Mr D W Adam be re-appointed as a Non-Executive Director to serve for a term of three years with effect from 7 February 2011.

AIREDALE NHS FOUNDATION TRUST

COUNCIL OF GOVERNORS 26 January 2011

TITLE: Re-appointment of Mr R S Drake as a Non-Executive Director

EXECUTIVE DIRECTOR:

Colin Millar Chairman

NHS CONSTITUTION PRINCIPLE 7 The NHS is accountable to the public, communities and patients that it serves

Action required by the Council of Governors To approve the recommendation. _______________________________________________________________ Background Ron Drake was appointed by the NHS Appointments Commission as a Non-Executive Director of Airedale NHS Trust for a four year term of office with effect from 7 February 2007. He is eligible for re-appointment to the Board of Directors of Airedale NHS FT for a second term of three years. Overall he may serve a maximum of nine years as a Non-Executive Director of the Trust. Summary Profile Ron Drake is 58, married and lives in Bingley. He was educated at Bradford Grammar School and has an LLB from Manchester University. He is a specialist in employment law. He was a solicitor and, latterly, Partner at Hammond Suddards Solicitors until 1990 and is currently a Partner & Principal at Cobbetts Solicitors in Leeds. He is also a part-time Employment Tribunal Chairman. He has been a Trustee & Non-Executive Director of Yorkshire & Humberside Business in the Arts and a Non-Executive Director of Music & the Deaf. He is a member of Keighley Vocal Union. His mother was a nurse. His sister is a nurse at Bradford Royal Infirmary. Consideration by Appointments & Remuneration Committee On behalf of the Council of Governors, the Appointments & Remuneration Committee considered the re-appointment of Ron Drake at its meeting on 17 January. In that consideration the Committee took account of his:

o Qualifications and experience o Annual appraisal performance ratings o Record of activity as a Director o Contribution to the Board of Directors as assessed by the Chairman

On the basis of its consideration, the Appointments & Remuneration Committee resolved to recommend to the Council of Governors that Ron Drake be re-appointed as a Non-Executive Director to serve for a term of three years with effect from 7 February 2011. Supporting Considerations Ron Drake has indicated his willingness to serve for a further term. He has confirmed that he has the time to fulfil the requirements of being a Director. His re-appointment has the support of his Executive and Non-Executive colleagues. His re-appointment has the support of the Chairman. Recommendation Mr R S Drake be re-appointed as a Non-Executive Director to serve for a term of three years with effect from 7 February 2011.

AIREDALE NHS FOUNDATION TRUST

APPOINTMENTS & REMUNERATION COMMITTEE OF THE COUNCIL OF GOVERNORS 7 December 2010

TITLE: Remuneration of Chair & Non Executive Directors

EXECUTIVE DIRECTOR:

Chris Lisle HR Director

AUTHOR: Chris Lisle HR Director

Action required by the Appointments & Remuneration Committee of the Council of Governors To formally approve these Appointments and Remuneration Committee recommendations. _______________________________________________________________ 1. Background 1.1 Airedale NHS FT was established on 1/6/2010. The remuneration for the Foundation Trust

non executive Board members has been reviewed in light of the change to independent FT status and the accompanying additional requirements placed upon Board members.

1.2 Responsibility for recommending appropriate remuneration for Non Executives and the

Chair of the Board of Directors rests with the Appointments and Remuneration Committee of the Council of Governors.

In reaching their recommendation, the ARC were required to take professional HR advice and take account of external independent intelligence about pay. The HR Director was available to provide professional advice to the committee. External benchmarking was also available for consideration. The benchmarking data referred to included the Foundation Trust Chair & NED Remuneration Survey 2010, which is the industry benchmark and includes data from approximately half of the Foundation Trusts in England. In addition, the Appointments Commission October 2009 review of remuneration and time commitment for non executives of Foundation Trusts – ‘Time Is Precious’, was also used to cross reference possible rates. For example, this review showed that 69% of NEDs were paid in the £12k - £15k range and 67% of Chairs were paid in the £40k - £49,999k range [2008/9 rates].

1.3 As some Non Executive members of the Board whose remuneration was under consideration, are ARC members, they were not present for the part of the meeting relating to their fees.

1.4 It was noted that all non executive Board Directors have been working twice the number of

days originally contracted. The terms of service for future NEDs will reflect the required time commitment more accurately.

1.5 It was also noted that whilst additional commitments have been undertaken for a lengthy

period, it was not intended to recommend back dating of the recommended awards nor automatic annual uplifts. An annual review will take place where recommendations will be formulated for the forthcoming financial year.

2. Recommended Fee Rates

After very thorough consideration of the equitable rate for the role, economic factors, and the time commitment given, the ARC recommend the following fee rates for Non Executive members of the Board of Directors with effect from 1 February 2011:

2.1 Chair - £42, 500 pa 2.2 Non Executive Directors - £12,500 pa 2.3 Chair of Audit Committee and Chair of Quality & Safety Assurance Committee – additional

responsibility supplement of £2,500 pa 3. Recommendation

That the Council of Governors approve the recommended remuneration levels for the Chair of the Board of Directors and for Non Executive members of the Board of Directors.

January 2011

AIREDALE NHS FOUNDATION TRUST

COUNCIL OF GOVERNORS 26 January 2011

TITLE: Membership Development Group EXECUTIVE DIRECTOR:

Ann Wagner Director of Strategy & Business Development

NHS CONSTITUTION PRINCIPLE 7 The NHS is accountable to the public, communities and patients that it serves

AUTHOR: Jane Downes Company Secretary

Action required by the Council of Governors To review and approve the following documents:

i) Terms of Reference ii) Membership Development Strategy

_______________________________________________________________

i) Terms of Reference The Terms of Reference have been considered and reviewed in detail by the Membership Development Group. The Terms of Reference are recommended for approval by the Council of Governors. Recommendation To approve the Terms of Reference of the Membership Development Group. ii) Membership Development Strategy The Membership Development Strategy has been considered and reviewed in detail by the Membership Development Group. The Membership Development Strategy is recommended for approval by the Council of Governors. Recommendation To approve the Membership Development Strategy.

COUNCIL OF GOVERNORS MEMBERSHIP DEVELOPMENT GROUP TERMS OF REFERENCE

1. Accountability The Membership Development Group is accountable to the Council of Governors. 2. Purpose The Membership Development Group is appointed and authorised by the Council of Governors to support, assist and report on all aspects of membership development within the Airedale NHS Foundation Trust membership area. The Membership Development Group will focus on developing strategies to increase the Public Membership, encourage involvement from Members and ensure the retention of members. 3. Powers The Council of Governors own the Membership Strategy. 4. Duties and responsibilities The duties and responsibilities shall be:

• Participate in the ongoing development and implementation of the Membership Development Strategy on behalf of the Council of Governors.

• Regularly review the Membership Strategy to ensure it meets the criteria for growing an inclusive representative membership.

• Make recommendations to the Council of Governors on membership development plans and initiatives.

• Provide regular updates on the progress of the membership development to the Council of Governors and at the Annual General Meeting.

• Participate in the ongoing development of Membership communication including but not restricted to the newsletter and FT section of the website.

• Evaluate and review the success of membership communications and activities from membership feedback.

5. Reporting Responsibilities

The Chair of the Membership Development Group shall report to the Council of Governors on a quarterly basis.

6. Membership Membership to the Group will be restricted to a maximum of 10 Governors, which should include a Staff Governor.

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Membership of the Group will include the Company Secretary and the Foundation Trust Membership Manager. A list of the Current members is shown in Schedule A. The Trust’s Communication Manager will be invited to attend as required. 7. Chair The Chair of the Group will be elected from the Council of Governors on an annual basis. If the Chair is unable to attend a meeting, the members present shall nominate and appoint an acting Chair for the meeting. 8. Secretary The Foundation Trust Membership Manager or their nominee shall act as the secretary.

9. Quorum The quorum necessary for the transaction of business shall be 3 members, of which 2 will be Governors. A duly convened meeting at which a quorum is present shall be competent to exercise all or any of the authorities, powers and discretions vested in or exercisable by the Group. 10. Frequency of Meetings The Group shall normally meet on a monthly basis. 11. Notice of Meetings Meetings, other than those regularly scheduled as above, shall be summoned by the secretary of the Group at the request of the Chair. Not less than 5 business days notice shall be given.

12. Conduct of Meetings Except as outlined above, meetings shall be conducted in accordance with the provisions of the Council of Governors Standing Orders governing the proceedings of Governors. 13. Minutes of Meetings The secretary shall minute the proceedings of all meetings, including recording the names of those present and in attendance. Minutes of meetings shall be circulated promptly to all members, and once agreed to the Council of Governors. December 2010 v4

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SCHEDULE A

Mr Peter Allen Skipton Ms Rachel Binks Nurses and Midwives Mrs Pam Essler NHS Bradford & Airedale Mrs Anne Medley Keighley West Mr Adrian Mornin Keighley Central Mrs Sheila Paget Ilkley Mrs Barbara Pavilionis Skipton Mrs Pauline Sharp Bradford MDC Mrs Pat Thorpe Bingley Rural Mrs Jane Downes Company Secretary Mrs Fiona Page FT Membership Manager

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COUNCIL OF GOVERNORS – MEMBERSHIP DEVELOPMENT STRATEGY Background Monitor’s Code of Governance (B.1.4) states: The roles and responsibility of the Council of Governors should be set out in a written document. This statement should include a clear explanation of the responsibilities of the Council of Governors towards members and other stakeholders and how Governors will seek their views and inform them. The purpose of the Membership Development Strategy is to provide a link between the requirements of the Monitor Code of Governance and the role of the Council of Governors. Introduction Airedale NHS Foundation Trust was authorised on 1 June 2010. In preparation for achieving FT status, the Trust established a membership development strategy. The objectives of the strategy included increasing membership and improving demographic representation as well as encouraging interest from members to stand as Governors. The Trust has now achieved a public membership base of over 8,000 members and a staff membership base of over 2,500 members, and is committed to establishing and maintaining robust engagement with the members to whichever level of involvement they are prepared to commit. The Trust is required to report annually to Monitor with regard to the membership and its representativeness. To support this process the Trust has implemented a structure and process. The Council of Governors has established a Membership Development Group whose objectives are: to support the development and implementation of the Membership Development Strategy, covering specific areas in relation to recruitment, retention and development. The need to refresh and renew the strategy now the Council of Governors is in place is paramount.

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Membership Development Strategy

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1. Purpose of the Membership Development Strategy The Membership Development Strategy is to develop a representative membership and clarifies the way in which the Council of Governors, Membership Development Group, FT Membership Office and the members themselves will be involved with upholding the Trust’s corporate and business objectives. The Membership Development Strategy will complement the Trust’s Equality and Diversity policy, the Communications Plan and the overarching values of the Trust. It will also link to other key Trust strategies and policies as they emerge and are developed, as set out in the Trust’s Integrated Business Plan. 2. Overview of the Membership Development Strategy As part of the Trust’s commitment to its members, there is a constant need to not only think about current membership challenges, but also forward plan to meet future demands including the inevitable changes in reporting requirements and compliance standards. NHS Foundation Trusts need to work closely with patients, the public and local communities to develop ways of providing health services which are responsive to their local needs. This involvement needs to be approached in a strategic and meaningful manner in order to provide benefits to both the Trust and the local population. A cohesive Membership Development Strategy, closely linked with the Communications Plan, will ensure that the membership is:

• fully represented at all levels • clearly informed • used appropriately in decision making around service provision

The Membership Development Strategy aims to:

• ensure public membership is representative of the community it serves (in terms of nationality, gender, ethnic origin, age, social background, geographical spread and social deprivation)

• ensure that all staff groups are given equal opportunity to become involved • identify levels of involvement and participation within the membership according to the

wishes and needs of individuals • ensure a continuous approach to the development of the membership in terms of both

numbers and level of engagement 3. Scope of the Membership Development Strategy This strategy, and any associated work plans, will be delivered by the Membership Development Group; supported by the FT Office and the wider Council of Governors, as they are the key individuals responsible for planning, developing, managing, and improving Trust membership. The Membership Development Strategy is a public document and should also be seen as relevant to key Trust partners in service commissioning and provision. Successful implementation of the Membership Development Strategy involves serious commitment in time and resource, therefore the responsibilities of the FT Office, the Membership Development Group and the wider Council of Governors will be clarified and identified. However, although the delivery of this plan is the responsibility of the aforementioned, it is essential to

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recognise that success will require close joint working and communication with the Board of Directors. 4. What is membership? Throughout this document, the term ‘member’ encompasses individuals who have joined the Trust as public or staff members. As a Foundation Trust, we will adopt a new style of working. Our members, recruited from the local community, join us in deciding how we will improve services. We will plan and deliver services with local people rather than give them what we think is best for them. Being an NHS Foundation Trust means control is transferred away from the Government to the local community. The Trust will continually seek to involve service users and carers in how it delivers and develops its services and use feedback from: local and national patient surveys, the Patient & Public Involvement & Experience Group and joint work with local service user and carer support groups, in its decision making. 5. What it means to be a member Our membership is made up of local people with an interest in the Trust and the services we provide and our staff. We are keen that our membership is representative of the wide range of people who we care for and their carers, those who work for us, and those who live in the communities we serve. By becoming a member, people will be demonstrating their interest in, and desire to be more closely involved with, the Trust. Members will:

• receive information about the performance of the Trust and updates on a wide range of health matters

• be invited to help shape the local service provision • be eligible to stand for election as a Governor, or vote for others to represent them • have greater opportunities, through the Council of Governors, to ensure their views are

taken into account when decisions are made regarding the future direction of the Trust’s services in collaboration with local health partners

• participate in surveys • attend general meetings of the Trust and events of interest

Whichever level of participation an individual member chooses (ie receive regular information; attend events and focus groups; interest in becoming a governor), it will give them a bigger say in what the Trust does, and the Membership Development Strategy will ensure their views are counted. 6. Who can become a member? The Trust is committed to developing its membership to ensure it is fully representative in terms of disability, age, gender, sexuality, ethnic background, faith and social deprivation. Membership is open to anyone over the age of 16. Constituencies represented are as follows:

• The public • Staff (including volunteers)

The Trust has made a conscious decision to recruit public members by a positive opt-in method using face to face contact at recruitment events and exhibitions.

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The Trust also has a number of Stakeholder Governors and Governor representatives from both the business and voluntary sectors. Staff members are automatically opted into membership if they work for Airedale NHS FT and have a permanent contract of employment or a fixed term contract for 12 months or longer. Staff membership includes those working for contracted out services, such as domestic services, but not staff in a different organisation providing a discrete service (i.e. contracted cleaning companies). Staff can opt out if they do not wish to become members but will not be able to join another constituency. The Trust has approximately 400 volunteers actively participating in helping the Trust. It was a conscious decision to therefore offer a place on the Council of Governors to a volunteer representative. Volunteers positively opt in to become a member and membership is open to all volunteers. All members are eligible to vote for a Governor to represent them on the Council of Governors. 7. Membership objectives It is important that the Trust does not view the notion of membership as tokenism, but that members have a real and valued role to play as part of the Trust’s development. The organisation intends to continue to recognise and use members as a valuable resource by working closely with the FT Office, the Council of Governors, and its Membership Development Group. Having a clear, strategic Membership Development Strategy in place will allow for targeted recruitment, engagement and information sharing based on local intelligence and statutory reporting requirements. Forward planning will enable effective delivery of the Membership Development Strategy. The Membership Development Strategy must ultimately underpin the Trust’s strategic and business objectives. 8. Strategic objectives

• To provide world class care • To have a highly involved workforce • To be efficiently and effectively run • To be the provider of choice

9. Business objectives

• To ensure safe, high quality, compassionate and affordable care • To make it safe • To develop new products and services • To eliminate non value adding services • To create the right culture and climate • To ensure employee health and wellbeing • To prepare for the future • To ensure revenue growth - understand customer needs and differentiate accordingly • To ensure productivity – maximise use of all resources

To successfully embed the Trust’s objectives into the heart of the Membership Development Strategy, a number of objectives have been identified which will, in turn, lead to the work streams for identified leads to follow. These objectives are as follows:

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• To develop and grow the membership in terms of numbers and engagement levels • To involve the membership in planning, monitoring and development of Trust services to

improve the quality of care wherever possible • To encourage members to stand for election to Airedale NHS Foundation Trust’s Council of

Governors • To evaluate active membership for reporting purposes • To provide appropriate learning opportunities for members • To raise awareness in the minds of staff of both the reasons for, and benefits of,

membership and the Council of Governors • To support the Council of Governors in undertaking their day to day role by identifying

training needs and resource requests 10. Achieving our objectives Successful delivery of this Membership Development Strategy requires not only commitment from staff and Governors, but to have robust support systems and processes in place at a strategic level, thus enabling a high quality and consistent approach. Requirements can be summarised as follows:

• A comprehensive Membership Development Plan and subsequent work streams • Senior commitment and leadership • Appropriate resource and support within financial constraints • Clear roles, responsibilities and accountability • A clear commitment to partnership working • Effective mechanisms for monitoring and evaluation • Recognition that additional efforts and joint working are required to ensure the work of the

Membership Development Group, FT Office and Council of Governors reflect equality and diversity issues

11. How will we get there? The Membership Development Strategy uses existing processes as its foundation and sets out three work streams to generate and support planned, sustainable and effective membership recruitment and engagement:

• Communication • Recruitment & Retention • Engagement (including elections)

11.1 Work stream 1: Communication Good communication is vital to ensure members are able to contribute effectively. For membership to thrive, maintaining a continual two-way dialogue, both formal and informal, is essential. Communication with the membership must move forward in line with improvements in technology. Appropriate written communication needs to be produced in plain English and, based on successful past practice, needs to be relevant to current topics highlighted in the local and national media. Written communication will, undoubtedly require to be produced at short notice in response to media coverage and therefore a close working relationship with the Communications Team is essential. Communication needs to be produced in a variety of formats to meet people’s differing communication needs. E-communication should be actively encouraged, such as e-mail and use

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of the internet, not only to save postage and printing costs but to bring the membership in line with the Trust’s environmental policy. A more targeted and cohesive approach to communicating with the members will be implemented through providing information with specific, identified areas of interest; which, in turn, will lead not only to an increase in attendance levels and positive feedback, but also to cost savings relating to venues, advertising and postage. The Trust needs to be sensitive to the needs of the different cultural groups represented in the membership. Meetings and events should be scheduled to avoid religious festivals and holy days were possible. However, events should also be planned to link with specific national awareness days and cultural celebrations where appropriate. Communication channels will include:

• Letters (sent via e-mail wherever possible) • Members’ area within the Trust website • Members’ magazine • Annual members’ meeting • Membership Office – telephone contact • Council of Governors • Targeted ‘focus on’ events • Meet your Governor sessions • Attendance at local, regional and national conferences • Attendance at local events

11.2 Work stream 2: Recruiting and Retaining As a Trust we are committed to providing the best care to our local community. It is anticipated that a key motivator for people to sign up as a member of the Trust will be to help retain and improve services provided by the Trust. Areas of low representation in terms of age, gender and ethnicity will be identified and appropriate recruitment campaigns developed by the Membership Development Group and the FT Office to target these areas. Experience has shown that young people ie those under 25, is an example of a difficult group to target. Therefore a concerted effort to identify appropriate opportunities to engage with this and other groups must be made. Recruitment campaigns need to be tailored to the audience and different formats should be investigated, i.e. street campaigns, advertising and attendance at events/meetings. Value for money should be considered at all times, in terms of volume of membership and recruitment activities. (i) Advertising A variety of communication methods have been used in previous recruitment campaigns but the need for more targeted advertising and promotion to heighten interest has been identified. The use of the following communication channels will be investigated:

• Social networking sites (e.g. Facebook/Twitter)

These have proved to be effective tools for a number of other Trusts and should be considered carefully by the Membership Development Group.

• Student Unions/Student Services

Tapping into the further and higher education providers in the area could lead to an increase in members and would increase the under represented area of under 25s. It

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would also assist with raising awareness of the importance of health and wellbeing at an earlier age.

• Targeted advertising campaigns

Whilst specific targeted advertising campaigns could be used, there are financial limitations restricting this particular means of recruiting.

(ii) Retaining The drop-out rate as a result of members e.g. changing address is approximately [ ] % per year. It is hoped that the increasing use of e-mail addresses will help to reduce the number of members ‘lost’ in this way. 11.3 Work stream 3: Engagement The membership is an invaluable resource made up of individuals who have clearly declared their interest in the Trust. Following the successful growth in membership, it would be pertinent to begin fully realising the benefits of having an active membership by increasing the number of opportunities for members to contribute to future plans for the Trust. Central to the achievement of this objective is the need to promote the membership and the importance of, reasons for, and benefits of using members’ feedback in decision making to key individuals within the Trust. The FT Office will work closely with the Public & Patient Involvement and Experience Project Lead to ensure that the membership is fully informed of the levels of involvement they can choose to participate in and are given regular opportunities to do so, thus showing our commitment to them. (i) Demonstrating engagement: It would be prudent to make the assumption that Monitor will alter Foundation Trust’s (FTs) reporting requirements to show hard evidence of how the Trust has engaged with its membership. These areas could be split into the following categories:

• Empowering Ensuring the majority views of the membership influence the decision making process

• Collaborating

Partnering with members in decision making; including the development of alternatives

• Involving Working directly with members to ensure aspirations/concerns are understood and considered

(these are classed as engaged members)

• Consulting Asking members for feedback or advice on an issue(s)

• Informing

Giving members information on an issue(s) (these are classed as contact members)

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Since starting the journey to FT status, the focus has been on recruiting members and keeping them updated on news and developments within Airedale and it has been recognised that this engagement needs to develop into a more meaningful two way dialogue. Engaging members successfully can be undertaken in a number of ways, such as providing members with the chance to influence decisions issues. This is a tangible example of their power to make a difference and, in turn, can prove very productive in increasing overall engagement and combating disinterest. Specific areas of engagement and information sharing with the membership which have been identified are as follows: (ii) ‘Focus on’ events Holding quarterly ‘focus on’ events is something that Airedale has established with considerable success. This has helped in engaging with members and also providing an opportunity for the public to visit the hospital and to find out information about the services provided, the teams involved and wider health issues. ‘Behind the scenes’ opportunities have proven successful in helping to explain the workings of the Trust. ‘Focus on’ sessions for 2010/11 have already been scheduled. The Membership Development Group will in future be involved in deciding the subject areas and scheduling of these events. (iii) ‘Meet your Governor’ sessions It is essential that members are given the opportunity to access all Governors. These are being established and will be run in as informal a way as possible to encourage relaxed discussion on a one-to-one basis or in groups. Drop-in Sessions for members to meet Governors have already been scheduled to be held prior to the ‘focus on’ events. These sessions will provide members with a forum in which to air their concerns, share their views and find out further information about the Trust and how they can become more involved. Sessions are planned in advance and the dates published in our members’ magazine, the Trust website, local media (‘what’s on guides’) and by mail shot to the local members. A representative from the FT Office will also be in attendance to facilitate the session and to encourage members to take the next step in becoming an involved member of the Trust. (iv) Members’ Newsletter The members’ newsletter was launched in 2007, and publishes articles which are relevant to current Trust issues, as well as local issues. The FT Office has identified the need for two way dialogue between Governors and the members and is exploring the possibility of including bespoke information from Governors to their constituency. Others areas for consideration include the initiation of a letters page to be incorporated in each issue, thus showing how the Governors have taken their feedback on board and used it to influence decision making. It is hoped this will encourage debate and feedback from members which can then be fed back to the Council of Governors where appropriate. The magazine distribution will be widened to include local GP surgeries, libraries, council offices, our partner organisations and local support groups and charities.

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(v) The Trust website The Trust website is an invaluable source of communication and must be utilised to its full potential as a major channel for sharing information with our members and the wider public. It is recognised that this is not currently the case. A plan to improve engagement with members will be put in place complementary to the Trust’s Communications Plan. (vi) Annual Members’ Meeting The Trust will hold a Members’ meeting every year, incorporating a presentation from the Board of Directors on a number of items as set out in the Constitution. (vii) Elections It is recognised that the Trust has to work hard to create interest among its members for future elections to the Council of Governors. Providing clear information about the role of a Governor prior to election is essential and will reduce vacancies arising mid-term, as well as ensuring that the candidates standing for election are fully aware of the demands of the role. Use of the website and blanket mailing to the relevant members has been used for previous elections, as has ‘meet the chairman’ events, which were established in 2009 and proved successful in encouraging interest from members wishing to stand as governors. Consideration will be given to compiling a list of ‘frequently asked questions’ (FAQs) for potential governors. Quotes from existing governors about their role would also be useful. An annual Council of Governors update for the members’ magazine will be explored, outlining the ways in which the governors have helped influence decision making in the Trust and therefore highlighting to potential governors the real changes that governors can make. (viii) Key priorities The Membership Development Group has identified the following key priorities to focus on during the next 12 months. These priorities are directly related to the work streams identified and are:

• Recruitment and Retention The Membership Development Group has identified the need to engage and communicate with under represented groups and to make use of local community venues and events when recruiting.

• Universities/Colleges/Schools

Targeted campaigns and engagement events focusing on young people – the governors of the future.

12. Roles and Responsibilities (i) Council of Governors Every NHS Foundation Trust has a Council of Governors whose main purpose is to represent the views and opinions of the members. Governors work in partnership with the Board of Directors and agree what needs to be done to meet the needs of the community. The Trust’s Constitution allows for the Council of Governors to establish committees or sub committees to assist in carrying out its functions and the Membership Development Group is one example of this.

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(ii) The Membership Development Group The purpose of the Membership Development Group, which is made up of a number of Governors and some key Trust staff, is to support the development and implementation of the Membership Plan covering:

• membership recruitment and development • member retention and engagement with the Trust • member engagement with the Governors • member communication and feedback

The Membership Development Group is required to develop and monitor an annual work plan which will link directly to the work streams identified within the Membership Plan. (iii) The FT Office The FT Office is there to provide a universal point of contact and to assist the Governors as much as possible with communication and information distribution. The FT Office will provide the support required to enable the Membership Development Group to deliver the objectives set out in the Membership Development Strategy. 13. Membership rules Full details of the eligibility for, and the exclusions from, membership are included in the Constitution of Airedale NHS Foundation Trust which can be found on our website www.airedale-trust.nhs.uk. 14. Legislative and regulatory context The NHS Act (2006) sets out the statutory requirements of Foundation Trusts. 15. Monitor Monitor is the independent regulator for FTs. Monitor was established in 2004 and is responsible for authorising and regulating FTs, ensuring they are well managed and financially strong so that they can deliver excellent healthcare. Monitor produces a certificate of authorisation for each FT, along with the Terms of Authorisation which includes the Trust’s Constitution. This acts as a ‘licence’ and is what the FT must adhere to

Council of Governors

Time limited specific groups

Membership Development

Group

Appointments and Remuneration

Committee

Governor Representation on

other Groups

Issues Groups

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and Monitor is responsible for ensuring that they comply. Members, Governors and staff must all comply with the requirements set down by Monitor. 16. The Care Quality Commission (CQC) The Care Quality Commission is the independent regulator of health and social care in England, whether provided by the NHS, local authorities, private companies or voluntary organisations. It is the role of the CQC to implement systems and processes that register health and social care providers in England. The CQC has statutory powers to regulate the performance of all health and social care providers. Please see the following websites for further information: http://www.monitor-nhsft.gov.uk http://www.cqc.org.uk www.dh.gov.uk November 2010 v2

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AIREDALE NHS FOUNDATION TRUST

COUNCIL OF GOVERNORS 26 January 2011

TITLE: 2011 ELECTIONS REPORT EXECUTIVE DIRECTOR:

Ann Wagner Director of Strategy & Business Development

NHS CONSTITUTION PRINCIPLE 7 The NHS is accountable to the public, communities and patients that it serves

AUTHOR: Jane Downes Company Secretary

Action required by the Council of Governors To consider and approve the elections process for 2011. _______________________________________________________________ i) Elections Timetable The elections for those Governors whose terms of office are for a one year period will commence in March 2011. Opt2Vote will again run the elections on the Foundation Trust’s behalf. All Governors may stand for re-election. Elected Governors will start their three year term of office on 1st June 2011. The proposed election timetable is attached in Appendix 1.

For clarity the Governors whose terms of office were agreed as one year are shown below. Elections will therefore be held in these constituencies. In addition, Mrs Shirley Shields (Keighley East) has signaled her intentions to stand down at the conclusion of her first year term of office and therefore an election will also be held in the Keighley East constituency.

CONSTITUENCY NAME TERM OF OFFICE

Keighley West Ann Medley One year

Lower Wharfe Valley Terry Gudgeon One year

Settle & Mid Craven Alan Sturgess One year

South Craven Neil Boyle One year

West Craven John Wickham One year

Recommendation

That the election timetable is approved.

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ii) Terms of Office

The Trust signaled its intentions during the induction programme to hold annual elections in line with best practice for the first three years in order to ensure the governors terms of office are staggered. It was agreed at the Council of Governors meeting held on 28 July 2010, that the rotation of Governors terms of office would apply to Public Governor seats and Staff Governor seats.

Since then, Governors have indicated that the terms of office for Staff Governors should be for a minimum of two years. It is therefore proposed that the terms of office for Mr Naren Samtaney (Doctors & Dentists), Mr Alan Walshaw (Allied Health Professional) and Mrs Rachel Binks (Nurses & Midwives) should be extended from one year to two years.

Recommendation

That the terms of office for Mr Naren Samtaney (Doctors & Dentists), Mr Alan Walshaw (Allied Health Professional) and Mrs Rachel Binks (Nurses & Midwives) should be extended from one year to two years.

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APPENDIX 1

Airedale NHS Foundation Trust Election Timetable 2011

Description

Model Rules Date

Notice of Election published no later than fortieth day before the day of the close of the poll

Monday 21st March 2011

Final day of delivery of nomination papers to OPT2VOTE

no later than twenty eighth day before the day of the close of the poll

Wednesday 6th April 2011

Publication of statement of nominated candidates

no later than twenty seventh day before the day of the close of the poll

Thursday 7th April 2011

Final day for candidate withdrawal

No later than twenty fifth day before the day of the close of the poll

Monday 11th April 2011

Notice of Poll No later than fifteenth day before the day of the close of the poll

Wednesday 27th April 2011

Close of the Poll No Later than the fortieth day after the notice of election

Friday 20th May 2011

Notice of election result sent to Trust chairman

Monday 23rd May 2011

Public notice of election result provided

Monday 23rd May 2011

Notification to Candidates Tuesday 24th May 2011

AIREDALE NHS FOUNDATION TRUST

COUNCIL of GOVERNORS 26 January 2011

TITLE: NHS Confederation Foundation Trust Network - Shadow Governor’s Event

EXECUTIVE DIRECTOR:

Ann Wagner Director of Strategy & Business Development

NHS CONSTITUTION PRINCIPLE 7 The NHS is accountable to the public, communities and patients that it serves

AUTHOR: Pam Essler NHS Bradford & Airedale Stakeholder Governor

Action required by the Council of Governors

• To receive and note the report of the NHS Bradford & Airedale Stakeholder Governor _______________________________________________________________

NHS Confederation Foundation Trust Network Shadow Governor’s Event I was recently invited to attend a Shadow Governor’s Event run by the NHS Confederation Foundation Trust Network. There were about 40 delegates mainly Governors but with some membership secretaries. Some had been shadow governors for two years or more due to rejection of foundation status often due to financial viability and often at the last moment. I was asked to give a very personal view of the first six months of being a governor so I began by describing the conflicting emotions of anticipation, excitement, frustration and tension that I felt during the shadow period and the early days of incorporation. For me the key things had been the following

• Building a relationship with 35 fellow governors in a short period of time so that we could work effectively together.

• Understanding what the statutory duties meant in reality and how they could be delivered effectively.

• What is the right balance of information to deliver the scrutiny role and how the specific skills of governors can be related to this.

• Exploring how the governor role could be made more active rather than a passive, receptive one. How do we get past the mountains of paper? How do we get into the business cycle?

• The balance between a dogmatic approach – this is how we will do it – and a democratic one – how do you want to do it?

• What it really means to be inward facing to the organisation and outward facing to the members.

• How do we add value to the organisation? There were a number of short presentations after this focusing on specific issues such as

• The relation with the board - a specific issue being private board meetings! • Delivering the statutory duties in a meaningful way • Broader engagement with the membership – an example was the use of the

membership in a mental health trust to help allocate funding for projects. • Membership recruitment – a real problem for some of the more specialised

London hospitals where there is no local ownership. All the speakers and delegates I spoke to had experienced the same feelings and issues that I described. They had found a variety of solutions that worked for them and they all agreed that it takes a 12 month business cycle to begin to get it right! Pam Essler NHS Bradford & Airedale and Deputy Lead Governor

AIREDALE NHS FOUNDATION TRUST

COUNCIL OF GOVERNORS 26 January 2011

TITLE: CHARITABLE FUNDS QUARTERLY REPORT

DIRECTOR: Sally Houghton Non Executive Director

NHS CONSTITUTION PRINCIPLE 7 The NHS is accountable to the public, communities and patients that it serves

AUTHOR: Jane Downes Company Secretary

Action required by the Council of Governors To receive and note the quarterly report from the Airedale NHSFT Charitable Funds Committee. _______________________________________________________________ Charitable Funds – Income During the quarter (October to December 2010), the Airedale NHSFT Charitable Funds received donations/legacies of £33,000 including:

£8,000 from Sovereign Health for the Sovereign Health Training/Equipment Fund

Individual donations totalling £2,750 for the HODU Trust Fund

£1,350 for the Medicine & Elderly Trust Fund

£1,625 for the Urgent Care Trust Fund Charitable Funds – Expenditure During the quarter (October to December 2010), the Airedale NHSFT Charitable Funds spent £11,775.51 including the following items of note:

£1,395 for medicine trolleys from the Medicine & Elderly Trust Fund

£1,200 for splinter packs from the Rainbow Room Trust Fund Project Approvals During the quarter (October to December 2010), the Airedale NHSFT Charitable Funds contributed to the following project:

£23,000 for the HODU refurbishment/upgrade from the HODU Trust Fund

AIREDALE NHS FOUNDATION TRUST

COUNCIL OF GOVERNORS 26 January 2010

TITLE: Non Executive Directors – Update Reports

EXECUTIVE DIRECTOR:

Ann Wagner Director of Strategy & Business Development

NHS CONSTITUTION PRINCIPLE 7 The NHS is accountable to the public, communities and patients that it serves

AUTHOR: Jane Downes Company Secretary

Action required by the Council of Governors To note the activity reports from Non Executive Directors . _______________________________________________________________ Introduction The reports from Non Executive Directors showing meetings attended for the period October to December 2010 on behalf of the Trust are attached. Recommendation To receive and note the reports from Non Executive Directors.

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NAME: David Adam PERIOD: October 2010 to December 2010

DATE ACTIVITY

05 October Interview prospective CEs 25 October Finance Committee and pre–meeting Appts.& Rem.Committee 26 October Council of Governors’ meeting 28 October Board meeting 29 October Appts.& Rem.Committee 01 November Board strategy day 16 November “Walkround” 25 November Board meeting 29 November Farewell lunch for JG 06 December Organ Donation meeting 07 December Appointments & Remuneration Committee 09 December Audit Committee meeting 10 December CEA meeting 13 December Electrical Infrastructure Review meeting 16 December Audit Committee meeting 16 December Board meeting 16 December Business Planning meeting with Council of Governors 22 December Interview prospective NED Note: The quarterly schedule includes time actually spent on NED duties at Airedale or other appropriate locations. It takes no account of preparation for meetings, background reading and more general correspondence on hospital business.

NAME: David Adam PERIOD: October 2010 to December 2010

DATE ACTIVITY

05 October Interview prospective CEs 25 October Finance Committee and pre–meeting Appts.& Rem.Committee 26 October Council of Governors’ meeting 28 October Board meeting 29 October Appts.& Rem.Committee 01 November Board strategy day 16 November “Walkround” 25 November Board meeting 29 November Farewell lunch for JG 06 December Organ Donation meeting 07 December Appointments & Remuneration Committee 09 December Audit Committee meeting 10 December CEA meeting 13 December Electrical Infrastructure Review meeting 16 December Audit Committee meeting 16 December Board meeting 16 December Business Planning meeting with Council of Governors 22 December Interview prospective NED Note: The quarterly schedule includes time actually spent on NED duties at Airedale or other appropriate locations. It takes no account of preparation for meetings, background reading and more general correspondence on hospital business.

NAME: Jeff Colclough PERIOD: October 2010 to December 2010 DATE ACTIVITY

8 October IOD Workshop – Role of Company Director. National Mining Museum, Wakefield

13 October Chairman/NED meeting with Monitor 22 October NHS strategy workshop, Sheffield 25 October Finance Committee 26 October Council of Governors meeting 28 October Board meeting 1 November Board strategy day 2 November NHS ‘Scanning the Horizon’ workshop, Leeds 11 November Audit Committee – meeting to review internal audit tenders 25 November Board meeting 7 December Ward 13 ‘Walkaround’ 9 December Audit Committee meeting 16 December Audit Committee meeting 16 December Trust Board 16 December Board to Board meeting with Council of Governors 20 December Remuneration Committee NOTE – The quarterly schedule includes time actually spent on NED duties at Airedale or other appropriate locations. It takes no account of preparation for meetings, background reading and more general correspondence on hospital business.

NAME: Ron Drake PERIOD: October 2010 to December 2010 DATE ACTIVITY

7 October Attending Informal Meeting with newly appointed CEO 7 October Meeting with Director of S&D to discuss draft Telemedicine JV

Agreement 11 October Assisting Chairman at “Meet the Chairman” Event – “Choose and Book” 13 October Meeting with Monitor Panel 20 October Attending “Airedale New Venture” AGM 25 October Attending Finance Committee 26 October Observing at Council of Governors meeting 27 October October Board 1 November Attending Board Strategy Meeting (Internal Issues) 2 November Attending NHS Confederation Meeting (Policy Horizon) 5 November Chairing QSAC 8 November Attending Resuscitation Committee Meeting 24 November Hosting Members Event – “Mental Health” 25 November Trust Board Meeting 16 December Trust Board Meeting 16 December Board to Board meeting with Council of Governors 20 December Attending Remuneration and Appointments Committee 20 December QSAC Strategy Meeting with Deputy Head of Healthcare Governance NOTE – The quarterly schedule includes time actually spent on NED duties at Airedale or other appropriate locations. It takes no account of preparation for meetings, background reading and more general correspondence on hospital business.

NAME: Sally Houghton PERIOD: October 2010 to December 2010 DATE ACTIVITY

5 October Chief Executive Appointment – feedback session 6 October Chief Executive Appointment – interviews 13 October Member Event – NED host 21 October Charities Sub-Committee (chaired) 25 October Finance Committee 26 October Council of Governors 28 October Trust Board meeting 1 November Board Strategy Day 10 November Member Event – NED host 11 November Internal Audit – Tender Evaluation Team 18 November Charities meeting 18 November Meeting with Sheenagh Powell 25 November Trust Board meeting 9 December Audit Committee (chaired) 16 December Audit Committee (chaired) 16 December Trust Board meeting 16 December Board to Board meeting with Council of Governors (part) NOTE – The quarterly schedule includes time actually spent on NED duties at Airedale or other appropriate locations. It takes no account of preparation for meetings, background reading and more general correspondence on hospital business.

NAME: Alan Sutton PERIOD: October 2010 to December 2010 DATE ACTIVITY

30 September Trust Board 5/6 October CEO Recruitment 21 October Preparation for Co. of Gov. meeting 25 October Finance Committee 26 October Council of Governors meeting 28 October Trust Board 29 October ARC Meeting 1 November Board strategy day 2 November NHS ‘Scanning the Horizon’ workshop, Leeds 5 November QSAC Meeting 10 November Meeting with ECO 11 November FT Chairs meeting Rotherham 18 November Meeting with Consultant for HR 25 November Trust Board 26 November Conference Wakefield 6 December Chaired – Meet the Chairman Event for Members 7 December ARC meeting 9 December Meeting with Medical Director 16 December Audit Committee meeting 16 December Trust Board 16 December Board to Board meeting with Council of Governors 20 December Remuneration Meeting NOTE – The quarterly schedule includes time actually spent on NED duties at Airedale or other appropriate locations. It takes no account of preparation for meetings, background reading and more general correspondence on hospital business.

AIREDALE NHS FOUNDATION TRUST

COUNCIL OF GOVERNORS 26 January 2011

TITLE: Agenda plan EXECUTIVE DIRECTOR:

Ann Wagner Director of Strategy & Business Development

NHS CONSTITUTION PRINCIPLE 7 The NHS is accountable to the public, communities and patients that it serves

AUTHOR: Jane Downes Company Secretary

Action required by the Council of Governors To receive and note the agenda forward plan. _______________________________________________________________ Governors are asked to receive and note that attached forward agenda plan. The agenda plan is flexible and will change to meet the requirements of the Council of Governors.

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Airedale NHS Foundation Trust Council of Governors Forward Agenda Plan 2011

Agenda item 26 January

Quarterly meeting

March Board to

Board

26 April Quarterly meeting

27 July Quarterly meeting

26 October Quarterly meeting

November Board to

Board Quarterly Airedale FT Report X X X X Chief Executive’s Report X X X X Quality Accounts X X Annual Report and Accounts X X Auditors Report X Annual Plan X X X Forward Agenda X X Governor events – feedback X X X X AGM /open event X AGM debrief X Feedback from Governor Groups X X X X Annual Audit Letter X Annual Audit Plan X Annual Report – Infection Control X Register of Interests X Ad hoc reports/presentations X X X Review of vacant stakeholder seats X Review of Lead Governor Process X Appointment of Lead Governor X NED appointment/re-appointment process

X

Appointment of new NED X Re-appointment of David Adam/Ron Drake

X

Appointment of members of Appointments and Remuneration Committee

X