Council of Governors Meeting AGENDA meeting 13... · The minutes from the Council of Governors...

Council of Governors Meeting Open to the public and press

AGENDA

Date: 13 December 2017 Time: 5:30pm – 8:10 pm Venue: Conference Hall, Block 20, Ida Darwin, Fulbourn Hospital, CB21 5EF

Any Other Business: Committee members and attendees are asked to inform the Chair of the meeting, Julie Spence of any items they wish to raise under Any Other Business by 08 December 2017. Opening Business: Questions from the public in relation to agenda items will be taken at the

beginning and end of the meeting.

NO. ITEM LEAD PAPERS TIMING

1. Welcome, Introductions, Apologies for Absence and Declarations of Interest

Julie Spence, Trust Chair

Verbal 17:30

2. Minutes

• To approve the minutes of the meeting held on 13th September 2017

Julie Spence, Trust Chair

Enclosed 17:35

3. Action Log/ Matters Arising Julie Spence, Trust Chair

Enclosed 17:40

REPRESENTING THE INTERESTS OF, AND COMMUNICATING WITH THE TRUST’S MEMBERSHIP

4. Chair's Report Julie Spence, Trust Chair

Enclosed 17:45

5. Chief Executive's Report

• Including Communications Report Tracy Dowling, Chief Executive

Enclosed Enclosed

18:00

6. Sustainability and Transformation Partnership Update Tracy Dowling, Chief Executive

Enclosed 18:10

7. Executive Director update

Melanie Coombes, Director of Nursing and Quality

Verbal 18:25

8.

Trust Strategy Refresh Including Timetable/Engagement Plan

Stephen Legood, Director of People and Business Development

Verbal 18:40

9.

Appointed Governor Update All Appointed Governors

Enclosed 19:00

10. Lead Governor Report

• Governor profile development

Elizabeth Mitchell, Lead Governor

Verbal 19:10

11.

Head to Toe Charity update

Kit Connick, Interim Director of Primary Acre and Corporate Affairs

Enclosed 19:20

12.

Partnership Strategy meeting update

Deborah Cohen, Director of Service Integration / Anna Tuke, Associate Director – Service User, Patient and Stakeholder Partnerships

Verbal 19:35

GOVERNOR QUESTIONS ON PERFORMANCE OF THE TRUST

13. Integrated Performance Report Scott Haldane, Director of Finance

Enclosed 19:40

14. Finance Report Scott Haldane, Director of Finance

Enclosed 19:50

GOVERNANCE

15. Fit and Proper Person Declaration

• Register of Interests Annual Review

Lauren MacIntyre, Trust Secretary

Enclosed 20:00

16. Nominations Committee Terms of Reference Lauren MacIntyre, Trust Secretary

Enclosed 20:05

Close 20:10

Date of Next meeting: Wednesday 25 April 2018

Minutes of the Council of Governors Meeting held on 13 September 2017

from 17.30 until 20.30 at Hinchingbrooke Country Park, Brampton Road, Huntingdon,

PE29 6DB

Members Present Julie Spence Chair Elizabeth Mitchell Lead Governor, Public Governor, Cambridgeshire Margaret Johnson Public Governor, Cambridgeshire Mike Collier Public Governor, Cambridgeshire Dr Charlotte Paddison Public Governor, Cambridgeshire Paul McGhee Public Governor, Cambridgeshire Jo Griffin Public Governor, Cambridgeshire Dr David Over Public Governor, Peterborough Keith Grimwade Carer Governor Mirka Anderson Carer Governor Rebecca Manning Staff Governor Sara Sampson Staff Governor Nora O’Shea Staff Governor Laura Hunt Appointed Governor, Cambridgeshire Constabulary Graham Wilson Appointed Governor, Cambridgeshire County Council Sandra Myers Appointed Governor, Cambridge University

Hospitals NHS Foundation Trust Lesley Crosby Appointed Governor, North West Anglia NHS

Foundation Trust formally Peterborough and Stamford Hospitals NHS Foundation Trust

In attendance Tracy Dowling Chief Executive Stephen Legood Director of People and Business Development Scott Haldane Director of Finance Kit Connick Interim Director of Primary Care and Corporate Affairs Deborah Cohen Director of Service Integration Julie Frake-Harris Interim Director of Operations Mike Hindmarch Non-Executive Director Julian Baust Non-Executive Director Simon Burrows Non-Executive Director Sarah Hamilton Non-Executive Director Lauren MacIntyre Trust Secretary Alexandra Perry Deputy Trust Secretary (minutes) Andrea Grosbois Head of Communications and Marketing Andy Burrows Communications Officer

Dr Jorge Zimbron Consultant in General Adult and Rehabilitation Psychiatry Guardian of Safe Working Hours

Anna Tuke Associate Director. Service User, Patient and Stakeholder Partnerships

Apologies Sue Marshall Public Governor, Cambridgeshire Eric Revell Public Governor, Cambridgeshire Chris York Public Governor, Peterborough Helen Blythe Public Governor, Peterborough Xander Sellers Service User Governor, Rest of England Ruth Cloherty Staff Governor Diana Wood Appointed Governor, University of Cambridge Wendi Ogle-Welbourn Appointed Governor, Peterborough City Council Chess Denman Medical Director Mel Coombes Director of Quality and Nursing Jo Lucas Non- Executive Director Dr. Amit Sethi Non- Executive Director Prof. Peter Jones Non- Executive Director

ITEM DESCRIPTION ACTION BY

1.0 ANNUAL MEMBERS MEETING

1.1 The Trust Chair welcomed those present to the meeting. One minute’s silence was observed in honour of Bernie Gold, who had served as a governor for nine years. The Trust Chair, Chief Executive and Director of Finance presented the Annual Report, Annual Accounts and Quality Report. Transcript of the Trust Chair’s and Chief Executive’s opening speeches and finance slides attached as Appendix 1, 2 and 3.

2.0 Opening Business

Questions from the public in relation to agenda items were taken at the beginning and end of the meeting

2.1

Introduction, Apologies for Absence and Declarations of Interest The Trust Chair welcomed those present to the Council of Governors meeting and noted apologies. Except for the standing interests held by the Trust Secretary, no other conflicts of interest were declared.

2.2 Minutes The minutes from the Council of Governors meeting on the 28 June 2017 were presented. They were agreed as an accurate record, with no amendments. The Trust Chair agreed to sign them off as a true and accurate record.

2.3 Action Log/ Matters Arising Action 2: The Trust Chair advised those present that Alexandra Perry was

3

the newly appointed Governor lead. It was noted that teams across the Trust had been contacted to ensure they were able to present at future Council meetings. Action 5: Due date to be amended to state January 2018. Action 7: Alexandra Perry was drawing up a plan to further previous work with the Governors. This would include the creation of an algorithm.

Action 8: It was noted that following the appointment of Anna Tuke, a Patient and Stakeholder Engagement Group had been set up. This group would review the strategy. An update to be provided in December 2017.

All other actions were noted as complete or not yet due.

Anna Tuke/ Alexandra Perry

3.0 Representing the interests of, and communicating with the Trust’s membership

3.1 Chair’s Report The Trust Chair presented her report providing the following updates. Simon Burrow’s was stepping down as Non Executive Director on 30 September 2017 after serving a three year term. She noted his commitment to the Trust and thanked him for his work. Jo Lucas’ wished to extend her term of office which was concluding on 30 September 2017. The Trust Chair noted that the meeting was Mike Collier’s last as a Governor. She thanked him for his commitment to the Trust, particularly his constructive and investigative questions. As per the Trust’s Constitution, contact had been made with two unsuccessful but highest scoring Governor nominees to offer them positions of Interim Governor until 2018 elections. It was confirmed that Robert McCaighey had accepted the post. The Council of Governors noted the Chair’s Report and approved the reappointment of Jo Lucas for a further three years as Non- Executive Director and Senior Independent Director.

3.2 Chief Executive’s Report including Communications Report The Chief Executive informed the Council of her dual role of Accountable Officer in the Sustainability and Transformation Partnership. She said that notably work was progressing to establish ten community rehabilitation beds to support early discharge for stroke patients. Work was ongoing to reduce the rates of falls. Four of the Trust’s 14 neighbourhood teams were piloting case management in order to evidence its success. It was noted as having had a significant impact on recruitment. The Chief Executive also relayed to the Council that an informative and

productive Board Development session had been held on 7 September 2017. Of particular note was a discussion around Care Quality Commission (CQC) inspection readiness. The Chief Executive assured the Council that the Trust was working to understand the proposed changes to the inspection regime and integrate the requirements whilst ensuring the correct standards of care. The Council of Governors noted the content of the Report.

3.3 Lead Governor update Elizabeth Mitchell formally welcomed Tracy Dowling to the Trust on behalf of the Council. She extended her welcome to the members of public who had joined the meeting; thanking them for voting in the Governor elections and welcomed any discussion around how to further energise the membership. Further highlights were as follows:

At the Lead Governor Area Meeting there had been a willingness

amongst all to investigate a system- wide approach to membership.

There had been a commitment at the recent Governor Induction day

to enable Governors to have useful access to Trust colleagues.

The meeting were reminded that Governors were the main public

voice for the Trust and with this in mind Elizabeth encouraged the

Council to consider what interested them as individuals.

Elizabeth Mitchell thanked Mike Collier in particular for speaking for

the public, particularly carers. His ‘dogged’ approach was admirable.

Finally Elizabeth noted a personal expression of sadness at Bernie

Gold’s passing.

The Council of Governors noted the content of the report.

3.4 Eating Disorders Service Update Keith Grimwade informed the meeting of his recent appointment as Co-Chair of NHS England's East of England Eating Disorders Network. The network had been established to support the strategic and operational development of eating disorders services within the region. Its main functions included:

A clinical opinion forum that addressed and collated issues relating to children, young people and adult eating disorders services.

To act as a consultancy and advisory group for policy, practice guidelines, audit, research and service improvement.

To share best practice across the region and act as a network

To act as a forum to help set priorities for the East of England Clinical Network Future in Mind Steering Group (FIM SG)

Julie Frake- Harris presented the report to the Council of Governors noting that following implementation of the action plan the waiting list had decreased from 70 in June to 40 in September. It was hoped that this would be further reduced with the addition of two new staff commencing in September.

5

David Over expressed concern around the amount of fast food outlets that were in Peterborough City Centre. He asked if there was opportunity for collaborative working with the Council around healthy eating. Deborah Cohen said that this would be a welcome comment for the Director of Public Health which CPFT would be pleased to support. Keith Grimwade welcomed the improvements detailed in the paper. He understood that this was an exceptional case however asked for assurance that the Trust had learned from this instance particularly any early warning signs to preempt a similar situation occurring elsewhere. Julie Frake- Harris confirmed that the Trust had ensured that learning had been taken from the event. A robust plan had been developed in addition to introducing further Key Performance Indicator’s (KPI’s) to ensure that the Trust could monitor all services, particularly small, specialist services. Elizabeth Mitchell asked who could instigate a ‘stop the line’. Julie Frake- Harris confirmed that any member of Trust staff was able to do so. The on call Director would initiate a ‘swarming meeting’ within 48 hours of the request at which point next steps would be agreed. The Council of Governors noted the content of the report.

3.5 Appointed Governor update The following Appointed Governor updates were shared with the Council: Graham Wilson, Cambridgeshire County Council (CCC)

CCC would be seeking views on its five year Business Plan. Like other public authorities, it was facing a challenging future with increasing demand for its services but limited funding. This was an opportunity for CPFT to influence the future direction of services

CCC was looking at various options to increase the number of care home beds in the county; including the development of new homes, extensions to existing ones, and offering longer term bulk contracts. It was likely that there would be opportunities to work with CPFT and other NHS providers on shared developments.

CCC had recently confirmed Wendi Ogle-Welbourn as Executive Director, People and Communities for CCC and Peterborough City Council. The Service Directors had also been appointed including Charlotte Black, Adrian Chapman and Lou Williams.

Lesley Crosby, North West Anglia Foundation Trust

Peterborough and Stamford Hospitals NHS Foundation Trust had recently merged with Hinchingbrooke Hospital to become North West Anglia Foundation Trust (NWAFT). The recent merger had proved exciting as it had provided opportunity for variation in practice and learning and using the best of the respective organisations’ methods and working.

A current recruitment drive was underway and the Council was asked to promote all providers.

Like CPFT and other NHS organisations, NWAFT was preparing for a CQC inspection and wanted to demonstrate their innovative

practices and committed staff. The Chief Executive asked if Heads of Nursing shared processes and lessons learned with others in the system. Lesley Crosby said that it was common practice to share learning and a peer review system would be welcomed by NWAFT. Sandra Myers, Cambridge University Hospitals NHS Foundation Trust

The Trust was also preparing for a CQC visit, ensuring the new regulations became business as usual.

There was ongoing work to create a single strategy with local commissioners, partners and companies.

Sandra Myers said that with partnership working came the opportunity for jointly funded posts and advised that the system should be mindful of the existing capacity within its workforce.

Laura Hunt. Appointed Governor, Cambridgeshire Constabulary (CC)

CC was undertaking a Local Policing Review (LPR) aimed at re-

defining and re-structuring the organisation so as to better respond

to rising demand and issues of high harm.

Her Majesty’s Inspectorate of Constabularies (HMIC) would be

inspecting CC as part of the Police Effectiveness, Efficiency and

Legitimacy (PEEL) Inspection Regime.. Part of the inspection was

concerned with the response to those in mental health crisis. An

independent evaluation of the Integrated Mental Health Team

(IMHT) showed that it was highly effective and contributing to

activities aimed at reducing demand.

Laura Hunt said that the work of the IMHT team was impressive and

she extended her personal thanks and admiration to the team and

their remarkable example of collaborative working.

In addition to the updates above Wendi- Ogle Welbourn provided a presentation that the Council was sharing with Local Authority Manager’s. It detailed the current structures and areas of focus. The presentation is attached to the minutes as appendix 4. The Council of Governors noted the updates provided.

3.6 Membership Report Kit Connick thanked the Council of Governors for their recent feedback provided regarding the proposed Membership Strategy, and confirmed that all of their comments had been considered for inclusion within the strategy. Kit presented the Report, highlights as follows: The Trust’s membership had decreased by 400 due to the database having undergone an extensive data cleanse. Compliance with the new General Data Protection Regulation (GDPR) was a focus within the team and was expected to impact further on membership numbers.

7

The numbers of members aged less than 22 years of age was less than one percent across all constituencies. Furthermore 76% of the membership identified themselves as White British. Work is planned therefore to target future recruitment to address these areas. The Membership Survey found that 50% of members found a newsletter informative. Kit stressed the importance of communication and events to fit the demographic of the membership. This included utilising social media and ensuring that events were accessible to those living throughout the county. Kit noted that there was a potential stigma around service users and wanted to investigate how to tackle this. The new data protection regulation (GDPR) would enforce how the Trust holds its data. Work was underway to review application forms, and opt in recruitment methods. The initial focus of the strategy was identified as ensuring that the Trust was safe and compliant. It was important to gain a greater understanding of why 66% of members remained passive as well as keeping in mind that 30% of members signed up in person. Additionally Kit informed the Council that Elizabeth Mitchell had expressed her disappointment that since taking over the management of the membership the recruitment and engagement had not been an area of great progress. Kit explained that it was vital for the immediate focus to be on the GDPR regulations and that she was keen to work with Governor’s and the Membership Governor Lead. Paul McGhee thanked Kit for the informative presentation and the invitation for comments from Governors around the strategy, noting that the feedback had contributed to the development of the strategy. He noted the complex system of constituencies that the Trust held and asked if consideration had been given to its simplification. Lauren MacIntyre said that in the past the split between public, patients, carers and staff had been useful for directing engagement to specific groups. The Council of Governors noted the content of the report and approved the Membership Strategy

3.7 Head to Toe Charity Kit Connick highlighted the following:

Clare Jones, Charity Manager had succeeded in driving the charity forwards since her appointment in April 2017.

The Charity name had been agreed as ‘Head to Toe’ in July 2017 following extensive consultation with Trust staff. Since then work had been undertaken to develop the brand design.

Whilst separate to the Trust, the Charity mirrored its organisational values of Professionalism, Respect, Innovation, Dignity and Empowerment (PRIDE)

59 separate tasks had been identified within the Charities strategy, with all on track apart from three actions, a verbal update was provided on these.

The Trust Chair thanked Simon Burrows, who in his role as Charitable Funds Committee Chair had identified the need for greater focus on the Charity and recommended the appointment of a Charity Manager. Laura Hunt expressed her approval of the name ‘Head to Toe’ as it summed up cradle to grave care and integrated mental and physical health. Kit Connick confirmed that Clare had met with representatives from ACT and other local charities in order to discuss collaboration. Elizabeth Mitchell asked who the trustees of the charity were. Kit Connick confirmed that it was the Board of Directors. The Council of Governors noted the report.

3.8 World Mental Health Day Celebration Julie Frake- Harris expressed her excitement around the World Mental Health Day celebration on 10 October 2017. Particularly as it was an event that was being co produced as a whole system; contributors included Cambridgeshire County Council, Peterborough City Council, the Clinical Commissioning Group and the Voluntary Sector. Julie Frake- Harris noted particular thanks to Andrea Grosbois and Jorge Zimbron who had led the work. Andrea Grosbois told the group that the Trust had concluded to combine the usual efforts for individual Trust celebrations: the annual members celebration, individual directorate events, health and wellbeing week, the charity launch and recruitment initiatives into one large event. Andrea Grosbois explained that the theme was the health of staff in the workplace as well as integration, driven by each of the three clinical directorates. Key speakers were noted to include representatives from The King’s Fund and Google as well as Dame Carol Black. In addition a rolling program of 40 different workshops would run simultaneously including yoga, art therapy, mental health first aid training and flu jabs. The Head to Toe Charity would be officially launched with a community fundraiser; a step challenge. In the evening a staff band would play the music of Elgar who wrote the music for a mental health asylum when

he was a member of their band in 1880. Andrea emphasised how important awareness of health in the workplace was, highlighting recent statistics that had been published in a report by NHS Digital. Jorge Zimbron added that there three main objectives for the day:

9

1. A useful learning and networking opportunity for staff. 2. A useful learning and networking opportunity for the public and

membership. 3. To further the integration of physical and mental health.

The Council of Governors noted the update.

3.9 Quality Improvement Wendy Llaneza presented the Trust’s work around Quality Improvement (QI) to the Council, highlights as follows:

effective QI should support and promote Clinical Effectiveness, Patient Experience and Patient Safety, it can help to tackle the most complex healthcare problems.

Quality is built on a strong foundation of leadership and a robust QI framework.

QI was the basis of the CQC reporting regulations; safe, effective caring, responsive and well- led.

improving quality does not equate to QI

the key points of QI were identified as:

a different approach to improvement including the trialing of new approach and different ways of working

a systematic methodology and set of tools

empowerment of staff, patients and carers to trial, test and modify practice to find effective solutions

successful QI would require a framework and approach unique to each organisation as well as a cultural shift and strong leadership and commitment.

Wendy invited Governors to become involved in the Trust’s QI initiative; including attending the Regular QI events, taking part in QI projects and providing the QI team with feedback. Graham Wilson said that the Trust should not lose sight of what it was doing well. Furthermore it should ensure that staff felt empowered to implement changes. The Chief Executive said that whilst CPFT was at the beginning of putting the work under the banner of Quality Improvement it was not new to QI. The Trust had a solid foundation from which to build upon. The Council of Governors noted the content of the report.

Wendy Llaneza/ Alexandra Perry

4.0 Governance

4.1 Council of Governors, Terms of Reference Lauren MacIntyre presented the annual review of the Council of Governors Terms of Reference and stated that she had included the previous document for reference as she had made extensive changes. The Terms of Reference had been reformatted and aligned with other committees. Additionally notable inclusions were as follows:

the statutory duties of the Governors

the definition of a Significant Transaction

additional duties such as the Governor lead role and training

more in depth information regarding Council of Governors meetings including membership, attendance and administration

Graham Wilson asked for clarification on ‘Decide whether the Trust’s non NHS work would significantly interfere with its principal purpose’ and noted that the Council knew little of international business. Stephen Legood explained that all significant transactions were approved by the Council of Governors, but no international business had been in this category to date. It was agreed that he would provide an update on international business at a Governor Development session. The Council of Governors approved the updated Terms of Reference.

Stephen Legood

5.0 Governor Questions on Performance of the Trust

5.1 Governor Questions on the Integrated Performance Report (IPR) Scott Haldane presented the Integrated Performance Report. Scott informed the Council that a group had been set up to address issues around data relating to the ‘Council of Governors - Carers Recording’ score. Charlotte Paddison said that whilst measures around the Trust’s innovation were admirable, the Trust should ensure that it did not lose sight of basic measures such as the Vacancy Rate. Stephen Legood assured the Council that substantial work had been completed around recruitment within specific teams in addition to the implementation of Trust wide Recruitment and Retention Strategy. Charlotte Paddison said that she was pleased about the positive work to reduce self harm on Springbank ward and asked if the Trust could learn from this good practice. Jorge Zimbron replied that he would be happy to share good practice with colleagues. The Council of Governors noted the content of this report.

5.2 Governor Questions on the Financial update Scott Haldane presented the Financial update noting a Month 3 deficit of £0.074m and a Year to Date deficit of £0.381m. Charlotte Paddison asked how the Sustainability and Transformation Partnership (STP) was affecting the Trust’s financial position and particularly how the Trust’s strategy fitted with system wide developments. Furthermore was it intended for the system to share any deficit. The Chief Executive said work to progress to an Accountable Care System (ACS) was not sufficiently advanced to have impact in this way. However in order to make a success of an ACS model the system would have to agree

11

to share risk in a way that was safe for each organisation. It was agreed that an STP update would become a standing item at future Council of Governors meetings. Paul McGhee said that after reading the Annual Report and Accounts he felt that it may be beneficial for the accounts relating to the Trust’s physical and mental health services to be separated as there were different associated risks. Scott Haldane agreed to present this analysis break down at the next Council of Governors meeting. The Council of Governors noted the content of this report.

Alexandra Perry/ Chief Executive Scott Haldane

5.3 Commissioning for Quality and Innovation (CQUIN) Stephen Legood presented the high level report to the Council of Governors. He said that the Trust had been paid for a number of schemes as detailed in the report. Furthermore, the internet link within the report provided further detail around the National CQUINS including those relating to the Trust. Julie Spence said that the report was educational and informative. Mike Collier asked what actions were being taken to ensure that CQUIN monies were not lost in Financial Year 17/ 18. Stephen Legood assured the Council that a greater level of scrutiny and oversight had been implemented which included CQUIN having become a standing agenda item at each month’s Performance and Risk Executive (PRE) meeting and the Executive Meeting. The Council of Governors noted the content of the report.

6.0 Closing Business

6.1 Any Other Business No other business was raised or discussed at the meeting.

6.2 Questions from members of the public Local Campaigner, Richard Taylor asked two questions: Firstly, he spoke of having recently attended a residents meeting for Garden Walk supported housing. Concerns were raised that service users placed in the supported housing were causing disturbances to residents. Richard Taylor asked the Trust to review the provision of support, policies in place to determine these placements, the appropriateness of tenure and whether this accommodation was fit for the purpose of higher acuity tenants. Richard Taylor recommended that the Trust worked to improve the lives of those living near the accommodation. Secondly Richard Taylor told the group that he had written to the Trust Chair to ask permission to record the meeting as detailed within the Trust’s Constitution. By recording the meeting he felt that he and others would be able to report more efficiently; by doing so this would further engage the

Trust’s membership and enhance the Trust’s transparency. Richard explained that his understanding was that the Trust Chair had expressly allowed him to record only the answers to the questions that he posed. Deborah Cohen thanked Richard Taylor for his question around Garden Walk and explained that due to a recent change in provider from Metropolitan to Sanctuary Housing (21 September 2017) the supported housing was in a period of transition. The following possible mitigations were noted:

work had begun to review support plans with individuals

a review of the options for alternative accommodation

a waking night opposed to a sleep in service

a named contact whose job it would be to liaise with residents

regular attendance at residents meetings

facility for an open forum such as regular coffee mornings.

Elizabeth Mitchel advised that appropriate housing was key to the recovery of those with Mental Health problems and encouraged the Governors to consider this issue. Paul McGhee said that he felt that it would not be correct for Governors to become involved in the issue operationally. The Trust Chair assured those present that the Executive Team were aware of the issues that the residents of Garden Walk faced and were working with the Council to resolve them With regard to the issue of recording the meeting the Trust Chair said that she was willing for the Trust’s Constitution to be reviewed as she was aware that NHS England recorded and live streamed their public meetings. Conversely she noted that careful consideration would be given as whilst the recording of meetings would promote discussion and debate amongst many individuals it may also inhibit others to speak out. It was agreed that the Board and Council would discuss this further outside the meeting. No other questions were raised.

Trust Chair

Date of next meeting Date: 13 December 2017 Location: TBC Time: 17:30 – 20:00

Signed………………………………………………….Dated……………………………

Julie Spence Trust Chair

1

Agenda Item: 2.1

COUNCIL OF GOVERNORS MEETING

REPORT

Subject: Appendix 1: Trust Chair’s Speech AMM meeting 13 09 2017

Date: 13th December 2017

Author: Alexandra Perry, Deputy Trust Secretary

Lead Director: Julie Spence, Trust Chair

Trust Chair’s speech

Hello and welcome to our Annual Members’ Meeting.

As Chair of this Trust – and as you’ll see in our Annual Report – there are two themes, confidence and

collaboration, which sum up the last 12 months.

When I travel round and meet different teams, I am always impressed with the confidence they have in their

work.

They have the interests of patients, service-users and carers at the heart of everything they do.

There has been a tremendous amount of work behind the scenes to ensure our community services – which

we welcomed 18 months ago – are now fully embedded in how the Trust operates.

It has taken a real team effort to ensure that it has been able to happen but most pleasingly of all has been

the reaction of the people they serve who have been hugely forthcoming in their praise.

There is no better example than in our Joint Emergency Team (JET) service which supports people over the

age of 50 - or those with long-term conditions - in their homes when they become unwell but do not need to

go to hospital.

2

The team carries out an initial assessment and develops a care plan in liaison with the patient’s GP or out-

of-hours GP services. In March, the service was rightly awarded further funding to allow it to expand its work

further.

But that is only part of our story.

Elsewhere, we continue to drive down mental health waiting times for children and young people to ensure

they can receive help at the earliest opportunity and we remain committed to developing and improving our

mental health services for adults who require our support.

Our PRISM service is another major step forward. This new service provides specialist mental health

support for GP surgeries so that patients with mental ill health can access prompt advice and support.

Service-users receive help in a community setting and experience a far more joined-up approach to care.

We are also extremely proud of our research teams, and their ground-breaking work relates directly and

quickly to frontline patient care.

And our social care staff – working alongside colleagues from our local authorities – continue to support

people to achieve their personal goals.

We were also pleased with the results of the Well Led Governance Review carried out at the end of last

year. NHS Improvement, the body responsible for regulating NHS Foundation Trusts, expects Trusts like

ours to carry out reviews like this every three years.

The assessors praised a number of aspects of our work from our emphasis on compassionate care to the

engagement with colleagues and service-users and the open and honest culture among staff. They also

made a number of recommendations that the executive team are progressing via an action plan.

Overall, then, services that have continued to improve, coupled with the feedback from patients, carers and

assessors, has led to that improvement in confidence I have seen across the Trust.

Collaboration has been another key aspect of our work over the last 12 months. No provider in the local

health economy can act alone, and I am proud to say that CPFT has led the way when it has come to

working with others.

We have played a leading role in the Urgent and Emergency Care Vanguard programme in Cambridgeshire

and Peterborough.

NHS organisations - including Cambridgeshire and Peterborough Clinical Commissioning Group - together

with local authorities, Cambridgeshire Police and representatives from the third sector, have also been

involved in setting up projects that aim to improve the way urgent mental health care is delivered and

reduce the pressure on acute hospitals.

Through this we launched the First Response Service in September last year. Anyone who calls the NHS

helpline, 111, and then selects ‘option 2’ can speak to a specially-trained member of our staff who will

discuss with them their mental health care needs.

This not only helps patients but also reduces the strain on our local accident and emergency units where

people often went when in a mental health crisis. In the first six months, the First Response Service

received more than 4,000 calls. At the start of August – 11 months after it began nearly 14,000 calls had

3

been received. The First Response Service has been rightly further funding to allow the service to continue

to develop.

It is directly linked to two ‘safe havens’. Run by mental health charity Cambridgeshire, Peterborough, and

South Lincolnshire Mind, the “Sanctuaries” offer people somewhere to go where they can access emotional

and practical support rather than having to attend hospital.

Since last year, CPFT staff have been based alongside colleagues from Cambridgeshire Police at the force

control room in Hinchingbrooke. The nurses are there to provide officers with clinical advice on the best way

to support people who are undergoing a mental health crisis, and have dealt with more than 800 incidents

per month.

We are rightly proud that the First Response Service and the Integrated Mental Health Team have been

shortlisted in 2017 Royal College of Psychiatrists awards alongside Staff Awards winners the Personality

Disorder Community Service core trainee Dr Mary-Ellen Lynall and Dr Valerie Voon, Honorary Consultant in

Neuropsychiatry.

Our collaborations are not just being noticed locally, but they are also having an impact on the nationwide

stage.

Looking more long-term, we are a key player in the Sustainable Transformation Plan (STP) which is

examining the future of local services to help them meet the changing needs of the local population. This is

a vital piece of work, but all those in the local health economy understand the need to work together to

deliver the changes that are needed.

We have though said goodbye to some significant figures at our Trust this year.

Sir Patrick Sissons died in September last year. As a Non-Executive Director, he was a vital link between

our research work and our day-to-day care for patients and service-users He was an extraordinarily clever

man who was kind and thoughtful and his wise counsel and keen sense of humour are much missed.

John Cranston died in March following a short illness. He has served as a public governor for

Cambridgeshire since 2011. A former accountant, he was passionate about the NHS and serving his

community. He was a real gentleman, and always kept the Executive team on our toes with his expert

knowledge and questioning.

Bernie Gold, who died last month (August) was one of the Trust’s longest serving Governors and had

represented the views of patients and service-users in Cambridgeshire since 2008. He was passionate

about the services provided by CPFT and made many friends during his time at the Trust. Bernie was

always straight-talking and he too will be very missed.

On a happier notes, Professor Peter Jones has joined us as a non-executive director to fill the considerable

shoes of Sir Patrick Sissons.

Peter is director of the National Institute for Health Research Collaboration for Leadership in Applied Health

Research and Care (CLAHRC) East of England and Professor of Psychiatry and Deputy Head of the School

of Clinical Medicine at the University of Cambridge.

4

We have also welcomed Dr Amit Sethi as a non-executive executive. A GP by background, Dr Sethi now

works as the Medical Director for the BUPA Global Leadership team.

I must also welcome all the governors who were successful at the elections earlier this year. Some were re-

elected:

Elizabeth Mitchell, Margaret Johnson (Public Cambridgeshire) and Keith Grimwade(Carer). But we are also

pleased to have new faces; Jo Griffin, Paul McGee, Sue Marshall (Public Cambridgeshire), Xander Sellers

(Service users living in the rest of England), Mirka Anderson (Carer), Becs Manning, Nora O’Shea (Staff)

join the Council.

My other role is to chair the Council of Governors and I must thank all those who have given up their time to

play such a key role with our Trust. Some are appointed from other agencies while the larger and most

active group are the elected governors who represent a range of constituencies – including patients, carers,

staff and geographic areas.

The governors continue to be the public voice and are an important part of our public accountability.

Throughout the next year we continue our search to further their number and ensure all areas of our work

are represented.

We have, in the last month, said goodbye to Chief Executive Aidan Thomas who retired from the NHS after

35 years.

As I say in the annual report, Aidan demonstrated a tireless commitment to improving the quality of our work

for the benefit of service-users and patients, and his leadership, knowledge and good humour has meant

the Trust achieved many milestones which he can be rightly proud of during his time with CPFT.

Aidan’s legacy will be that he has developed an extremely strong leadership team across all levels of the

organisation that will continue to help the Trust go from strength to strength.

As well being the Chief Executive of our Trust, Aidan has been leading two of the key areas of the local

STP, proving how much he will be missed by not just by colleagues here but also by the local health

economy when he retires from the NHS later this year.

In Aidan’s place, we are delighted to welcome Tracy Dowling.

Tracy was the outstanding candidate in a high-calibre field and her background and experience make her

the right choice to take our Trust forward.

She has a proven track-record of developing clear strategies for improving services by working in

partnership with patients, carers, partners and stakeholders, and her knowledge and her commitment to

collaborative leadership makes her the exactly the right choice for our Trust.

Tracy will continue to spend up to two days a week in her role as Accountable Officer for the Sustainability

and Transformation Programme. This will ensure CPFT continues to be at the very centre of developments

in health and social care across Cambridgeshire and Peterborough.

She will receive the full support of the Executive team which is a good moment which is a good moment

thank them formally for their work over the last year.

5

Overall, despite the positivity I find and the successful collaborations we are involved in, there is no doubt

that the twin challenges of demand and funding remain.

But as we continue on our journey to turn our services from ‘good’ to ‘outstanding’, let me assure you we

are as committed as ever to do our best for all those who require our services.

Ends

1

Agenda Item: 2.2


REPORT

Subject: Appendix 2: Chief Executives Speech AMM meeting 13 09 2017



Lead Director: Tracy Dowling, Chief Executive

CEO’s speech

Good afternoon

I’m aware that, at this point, it’s customary for the Chief Executive to talk about the last 12 months,

but – and this may come as some relief to those who have sat through a CEO’s report – I hope

you’ll understand if I can only mention my first four weeks.

Warm welcome

Firstly, I wanted to say thank you for the warm welcome and the many messages of support I have

received so far.

Visiting Teams

As you may know I have a visited a number of teams already and I am highly impressed by what I

have heard and seen so far.

Before I started, I stated publicly how much the Trust is admired – and after meeting colleagues

over the last month I can completely understand why.

Staff have not been slow in sharing their views with me…but that’s what I want.

2

And I have been thoroughly impressed with their ideas for the future of their services – and how

they want to develop their work in conjunction with service-users and patients.

Without exception they have all been focused on the needs of those they support…and that

commitment really shines through.

Despite the pressures they are faced with on a daily basis, I have found a tremendous sense of

optimism and positive morale.

Recovery

I am sure that positivity transmits to the recovery of patients and service-users.

I saw an inspirational example of recovery for myself even before I officially started when I

attended the graduation of latest group of peer support workers.

The 15 graduates had all faced significant mental health challenges of their own, and after

completing the course run by our Recovery College East, they can now apply for roles within our

Trust.

It was a humbling and emotional event – and I want to continue the work to extend that

commitment to recovery to not just mental health but all of our services.

STP

I want to echo Julie’s views that we cannot operate alone. We need to continue to work with our

partners in the local health economy to ensure people receive truly joined-up services and reduce

the financial gap we face locally.

For those reasons I will be continuing in my role as Accountable Officer for the Sustainability and

Transformation Programme. There has been a lot of good work which has already been put in

place, and I think it’s vital that CPFT continues to be front and centre of those improvements.

Goals

That’s just one of my goals for my time here, and there are four others

1. To be the provider that excellent staff want to work for – its only through excellent staff that

we can deliver excellent services. This means investing in those staff, their training and

development, the technology they have to do their work, and how we use data an

information to help them to improve the health of those we care for

2. To really listen to those we support and to respond to their needs both in how we deliver

services now – but also how we develop services into the future – I want us to undertake

this development with those who use, or who have recently used , our services

3. I want to make CPFT the place that people look to invest in for leading edge mental health

and out of hospital physical health care – for all ages. I want us to be recognised for our

research and for how we rapidly translate this learning into best evidenced practice. We are

so well placed with our partners in the Universities, with CUHFT and with the life sciences

investments in this region that we can truly lead the way, regionally, nationally and globally

3

4. I want to make sure we are an organisation that works in partnership in an exemplary way –

with our service users and our population, with our colleagues in our health and care system

and with our colleagues in industry. We will not always get everything right – but we will

strive to do this – to continuously improve and to learn together so that we really do make

the difference which we all get out of bed for every day.

Support of Execs, Governors and Members

Aidan Thomas has left me with a tremendous legacy, and the support and input from my fellow

Executives, from Governors and Members will be vital to the future.

First choice

Overall, I want CPFT to continue to be the first choice for patients and service-users where they

receive care of the highest quality…and also the first choice for staff who want to work for a

compassionate, innovative and forward-thinking organisation.

Thank you. (Ends)

Scott HaldaneDirector of Finance

Agenda Item: 2.3

Delivered planned control total of £1.4m

Received additional STF bonus of £0.8m

Invested £3.3m in Trust infrastructure

(Includes investment in IT, Mobile Working and Improving the Patient Environment)

Performance against the Use of Resources metric was a 2 as planned

Unqualified audit opinion on accounts

Overall achieved a good set of financial results from a

financially challenging year

Performance against key financial targets 2016-17

Income analysis 2016-17: Total income £199mWhere the CPFT’s money came from :

Block Contract income41%

Community Services Income

34%

Clinical Partnerships income (s75 Agreements)

7%

Cost and Volume Contract income

5%Education and training

3%

Other non-protected clinical income

3%Research and development

2%

Other2%

Private patient income 0%

STF fund1%

Spend analysis 2016-17: total spend £197.5m

Where the Trust’s money went :

Employee expenses

70%

Premises & equipment11% Supplies and services

8%

Other costs7%

Finance costs2%

Share of loss on joint venture

2%

Planned surplus of £2.2m

(Month 4 position is a deficit of £1.1m against a planned surplus of £0.1m)

Cost Improvement Plan Target of £7.6m

(Month 4 position is savings of £1.5m against planned savings of £2.2m)

Planned investment of £5.3m in Trust infrastructure (Month 4 position is £1m)

Planned Financial Sustainability Risk Rating of 2 for the year

(Month 4 position is a 3)

2017-18 forward look

Planned surplus of £2.2m

(Month 4 position is a deficit of £1.1m against a planned surplus of £0.1m)

Cost Improvement Plan target of £7.6m

(Month 4 position is savings of £1.5m against planned savings of £2.2m)

Planned investment of £5.3m in Trust infrastructure (Month 4 position is £1m)

Planned Financial Sustainability Risk Rating of 2 for the year

(Month 4 position is a 3)

Challenging year with the aim of successful delivery against all of our financial targets in 2017-18

2017-18 forward look

PEOPLE & COMMUNITIES

Agenda Item: 2.4

THE WAY WE DO THINGSTHE BIG CONVERSATION

WENDI OGLE-WELBOURN

Executive Director People & Communities

Cambridgeshire & Peterborough Councils

WHAT MATTERS TO ME

“Putting people at the heart of a system that makes sense to them”

“Championing equality and diversity in our communities”

“Working together –seeing success as collective – if one part is failing we all are”

“Being ambitious and creative – can do - not cannot do approach ”

“DRIVING DELIVERY OF

▶ The right services

▶ To the right people, families and communities

▶ By the right people

▶ At the right time

▶ In the right place

▶ At the right cost”

LEADERSHIP VALUES / BEHAVIOURS

Outcomes focused – not organisation focused

Getting done what needs to be done by who is best to do it

Empathy - understanding and appreciating the perspectives of all parties

Openness and transparency – putting cards on the table

Using evidence based sources and best practice to ensure what we deliver has the best chance of success

Working together, not undermining each other

Speaking well of each other, in public and private

Behaving well, especially when things go wrong

Keeping our promises – small and large

Speaking with candour and courage

Delivering on promises made

Seeing success as collective not as a tribe

LEADERSHIP MATTERS

“The quality of service is not determined by levels of funding or deprivation in the local area, or size of the authority; it is leadership that matters” Ofsted

• Changes to the way we get our funding and what we get

• Growing population and demand for services

• Increased complexities

• We can’t change the weather but we do have options…….

CONTEXT

• Carry on as we are and hope everything works out for the best…

OPTION 1

• Transformation: do things differently, do things together, invest in enablers e.g. technology, supporting our staff and community better….. better, but not as easy…

OPTION 2: Take a different approach altogether…

INSPECTION PREPARATIONCambridgeshire County Council

FUTURE INSPECTIONS

Joint Targeted Area Inspection (JTAI)

New theme every 6 months

Led by Ofsted (Social Care) and involves Care Quality Commission, HMI Probation, HMI Constabulary and Ofsted Education

Inspection of Local Authority Childrens Services (ILACS)

Launches January 2018 (replaces Single Inspection Framework)

Single agency inspection of local authority by Ofsted Social Care

Care Quality Commission local system reviews of health and social care, reablement and day services

PREPARATION

Ofsted Preparation Group

Meets monthly to discuss key service preparations

Membership includes local authority staff and partners from Health, Police and Probation

Co-ordinates preparation of service self assessment and service action plans

Reviews data quality, performance, evidence libraries, good practice cases

Peterborough and Cambridgeshire Councils working together to prepare for CQC Area Review

Current focus is how to support staff across the local authority and partner organisations to be prepared for the new culture of inspections

WHAT CAN WE DO TO SUPPORT YOU?

Regular updates in team meetings Easily accessible suite of useful documents to include

inspection frameworks, handbooks, top tips Regular communications Programme of themed audits with 121 time with auditors Peer to peer support Work with partners and the system to prepare for CQC Area

Review Gather knowledge from local authorities who have been

inspected Our aim is to ensure all staff across the system are prepared for

an Ofsted or CQC inspection

FOCUS AREAS

Key focus will be frontline practice

What we know about the quality of practice, how do we know,

how we are maintaining and improving

Inspectors will spend almost all of their time observing direct practice and speaking to staff – this can feel overwhelming

Know your cases (have at least 3 good practice cases ready), be confident, use examples of multi agency working, clear on outcomes, SMART plans

What else can we do? Email to [email protected]

mailto:[email protected]

SELF EVALUATION

My vision for Adults Services in ten years time - what needs to happen to achieve this and how I will deliver that vision in this role across Cambridgeshire and Peterborough

CHARLOTTE BLACK

ADULTS AND SAFEGUARDING

‘Care, safety and happiness are the three main components of Adult Social Care.

Key factors that influence happiness are people, places and things.

Most of us would choose to put people ahead of places and things.’

Sir James Munby

ADASS Spring Seminar 2017

All adults in Cambridgeshire and Peterborough are supported to live as independently as possible within

their family, at home and in the community.

Any support we provide builds on their strengths and support networks. If longer term support is needed we will work with them to plan ahead and respond

flexibly as their needs change.

Those supporting them will work as one team.

MY VISION AS DIRECTOR OF ADULTS SERVICES

A VISION OF THE TEAM AROUND THE PERSON

Reduced need for long term care and support

More adults living independently in the community

Reduced isolation and loneliness

Quality experience for service users, patients and carers

Key performance indicators improving- for all partners

Costs reduced and benchmarked

Stronger voluntary and community sector and networks

Staff recruitment, retention and morale improved

Diverse range of sources of high quality affordable care

Education and employment opportunities increased

Availability of suitable accommodation increased

OUTCOMES – MAJOR INDICATORS OF SUCCESS

Shared vision we all recognise

Relationships and trust

A collaborative approach

Mandate - Members, partners, service users and staff

Plan for implementation and capacity to deliver

Data and metrics to monitor impact

Strong and flexible team - positive behaviour

Checks and balances to tell us when we need to change our approach

Produce self assessment to help us direct our priorities and resource. We will monitor progress and impact

Joint work with staff and partners across the county to be prepared for a CQC Area Review Inspection

To deliver this vision we will work with partners, Members and staff to develop..

Working as one team - regardless of role or organisational structure

Be prepared to challenge, question ‘how we do things’

Be open to challenge and ready to learn and think/ behave differently

Focus on outcomes and solutions

Think.. what would I want for my family member/ neighbour

Mutual support and collaboration

Key behaviours we will all need to adopt to deliver this vision

In ten years time…

The right services delivered in the right way, in the right place, at the right time, at

the right cost with the right partners.

JOINT SERVICE DIRECTOR: CHILDREN AND FAMILIES SERVICE

LOU WILLIAMS

INTRODUCTION

In this brief presentation I aim to:

Tell you a bit about myself;

Give you my view of where children’s services should aim to be in 10 years time;

Give you a sense of who I am, my leadership style and how I help to make things happen;

Provide you with confidence in my ability to deliver improved outcomes for children and young people.

‘It is difficult to make predictions…. especially about the future…’

Karl Kristian Steincke

This is particularly the case in times that some commentators call VUCA:

Volatility

Uncertainty

Complexity

Ambiguity

And where leaders need:

Vision

Understanding

Clarity

[intellectual] Agility

But recent history can still help us to understand the future

10 years ago, investment in prevention and early help services were at a peak;

One key measure of the success of such investment should include reduced numbers of children coming into care, but numbers continued to increase;

The availability of money hid the fact that many services remained inefficient and ineffective;

Opportunities to transform outcomes for vulnerable children and families were missed, and many services continued to operate in silos;

Silo working has reduced since, but not always as quickly as it needs to.

OPPORTUNITIES FOR THE FUTURE…

We have an obligation to ensure that services deliver and offer value for money;

Preventative services are important – but they must demonstrate that they do more than support the ‘worried well’;

For children and young people with more complex needs, multi-disciplinary working, shared priorities and aligned or pooled budgets are the way forward;

Services need to be sufficiently agile to meet the diverse needs of people in both authorities.

DEPRIVATION: CITIES OF PETERBOROUGH AND CAMBRIDGE

• Lots of diversity;

• Deprived areas in the City;

• Deprivation in March and the Fens;

• Pockets of deprivation elsewhere, in St Neots and surrounding area as well as Huntingdon and in to the north of Cottenham;

• Rurality also affects accessibility of services.

CAMBRIDGESHIRE

THIS ROLE IS ABOUT TRANSFORMATION….

Both councils serve very diverse populations with different needs;

There are significant opportunities to make a real difference in outcomes by bringing services for children and their families together;

Two different systems of social care and early help can learn from one another, and develop models that take the best features of each;

We can also join some services where this makes sense;

Closer working relationships between the two authorities will also bring closer working relationships with key partners –health and police specifically – but also with voluntary and community sector services as well as the district council tier;

This offers us the opportunity to do more things better together and hopefully for less.

EDUCATION SERVICES IN CAMBRIDGESHIRE: FUTURE

DIRECTIONS

KEITH GRIMWADE

NATIONAL CHANGES

• The government’s ambition that over a period of time all schools will become academies, independent of the local authority

• The further development of a school-led school improvement system

• Significant changes in school funding• Statutory responsibilities with regards to home to school

transport, admissions, place planning and SEND commissioning; and to be a champion for children and families, especially the most vulnerable

THE LOCAL CONTEXT

• An improvement in Ofsted outcomes over the last two years but primary schools are still below the national average

• Improvements in attainment across the age range for almost all groups

• However, the gap between most groups vulnerable to underachievement and their class mates is too wide and is not closing fast enough

OUR PRIORITIES

• Increase the percentage of schools that are good or outstanding

• Accelerate the achievement of vulnerable groups

• Improve writing at key stages 1 and 2 and maths at key stage 2

• The recruitment and retention of a high quality schools’ workforce

• To secure suitable and sufficient early years, childcare, state-funded school and post-16 places to meet the needs of Cambridgeshire’s children, young people and families

WHAT DOES THIS MEAN FOR THE FUTURE?

• A re-defined role for the local authority: a reduced number of statutory duties but an enhanced role as champion, commissioner, facilitator, broker, signposter... System leadership

• Joint working with Peterborough, and with other local authorities

• Traded Services may be organised differently, even arms length to the Council

TO MAKE THIS HAPPEN WILL REQUIRE

• Partnership working• Collaboration• Networking• Creativity and innovation• Local solutions

The whole system working together to

achieve the best outcome for every child

STAFF ROADSHOWS

COMMISSIONING AND THE FINANCIAL POSITION

Will Patten Service Director – Commissioning

COMMISSIONING

Ensure all services are commissioned to deliver the right outcomes, to the right people, at the right cost and by the right provider – getting value for money in every

instance

COMMISSIONING PRIORITIES

Income and Commercialisation - identifying opportunities to bring in new sources of income which can fund crucial public services without raising taxes and to operate every area of the Council in a business-like way

Strategic Partnerships – acting as ‘one public service’ with our partner organisations in the public sector and forming new and deeper partnerships with communities, the voluntary sector and business

Demand Management – working to give people early help so that their needs don’t escalate the point where they need to rely heavily on public sector support – this is about supporting people to remain as healthy and independent as possible

Modernisation – ensuring the organisation is as lean and efficient as possible, taking advantage of the latest technologies and most creative and dynamic ways of working to deliver the most value for the least cost.

THE CAMBRIDGESHIRE CHALLENGE – FY18/19

Corporate gap of c. £37m in Fy18/19

P&C notional contribution (80%) £29m

Current position

Green £15m

Amber £8m

Red £3.5m

Assuming 50% of Amber, currently at £20m

CCC P&C plans falling short of notional contribution & assumes fy17/18 delivers on plan

CONSIDERATIONS

Best way for teams to contribute to increasing the funnel?

Best way to identify more investment related plans?

Best way to identify and fully leverage economies from joint working?

OUR VISION FOR COMMUNITY AND SAFETY SERVICES

ADRIAN CHAPMAN

SERVICE DIRECTOR

In 10 years….

Cambridgeshire and Peterborough….a thriving, vibrant community of people and organisations with ambition, aspiration and confidence living and working in some of the safest neighbourhoods in the country where inequality and isolation is the exception and where those most in need can get the help they need quickly…

A place where businesses choose to invest because of our highly skilled population…

A place where the differences between people is respected and celebrated…

A place with a national reputation for supporting communities to do the very best they can

HOUSING AND HOMELESSNESS

Safe, warm and affordable housing for all of our residents

Working closely with Growth teams, district councils, housing providers and the Combined Authority to ensure provision of the right housing in the right place

Building the skills and improving the wellbeing of our residents to enable them to sustain their own homes

Addressing the problems in poor quality housing

Working with social care and NHS partners to support people to live at home longer

Working with voluntary and faith sector partners to support those sleeping rough to move away from the streets

SAFER COMMUNITIES

Communities that feel safe and are safe

Achieving a single view of public protection and community safety for Cambridgeshire and Peterborough, and maintaining the security of our population

Ensuring the issues that matter to people are resolved swiftly and effectively

Communities taking more responsibility for lower level issues in their neighbourhood

Delivering effective drugs and alcohol services to remove dependency

Delivering domestic abuse and sexual violence services that support victims and that change the behaviours of perpetrators

Identifying early those most at risk of becoming victims of crime or ASB

SKILLS AND EMPLOYMENT

A ‘go to’ place for business to invest as a result of a well skilled, motivated and aspirational population and a robust infrastructure

Delivering a local adult skills offer that fosters ambition and aspiration, including maximising the potential from a Peterborough University

Maximising the value of devolved funding to create bespoke skills and employment programmes aligned to local business need

Addressing worklessness and barriers to employment

Reducing dependency on welfare benefits

Encouraging a social enterprise and small business economy

Improving wellbeing and reducing isolation through learning for leisure

COMMUNITIES IN ACTION

Communities doing things for themselves and taking responsibility for things that happen in their neighbourhood

Reversing the reliance communities have on public services providing all of the answers

Agreeing a new relationship with the civil society sector built on mutual trust and respect

Closing the gap between community organisations and the public sector through data sharing, collaboration and joint problem-solving

Creating ways for communities to act as the eyes and ears within a neighbourhood, including helping to identify those most at risk of harm or in need

Strengthening the role of parish and local councils to enable them to deliver services locally that better meet the needs of their population

REDUCING INEQUALITIES

A place where the health, wellbeing and social inequality gaps between communities is closed

Working closely with Public Health to deliver sustained programmes in the areas where inequality is at its greatest

Reducing poverty by encouraging volunteering, building skills, improving health and enabling social enterprise

Maximising the opportunities from growth

Identifying people who are isolated or lonely, or who are at risk of becoming so, and connecting them to services or networks

Working with communities to become connected – digitally, socially, financially, environmentally

COMMUNITY COHESION

Communities that get along well with each other, and where difference is accepted and respected

Building communities alongside building houses

Forming strong relationships with leaders across faith organisations and with leaders of communities of interest and communities of place

Responding well and together in times of pressure

Tackling hate and extremism at the very earliest opportunity

Bringing different communities together for celebration or to help agree policy or strategy

Recognising, valuing and retaining the unique identities of different communities

Your Role in Delivering this Vision

Owning the vision

Finding the best ways of addressing issues regardless of organisational boundaries

Encouraging, enabling and delivering honest dialogue

Supporting councillors to fulfil their role as community leaders

Developing and maintaining highly effective relationships with colleagues

Encouraging and enabling innovation to create new ways for communities to engage in the design and delivery of public service in their areas

IN SUMMARY…

…a unique and exciting opportunity to work with, support and deliver in communities and with our partners to enable people and places to grow, to retain their own characteristics and to be the very best they can.

Agenda Item: 3

Council of Governors

ACTION LOG updated from the meeting held on 13th September 2017

Action log

number Date of Meeting

Agenda Item

Action Due Date Lead Status

1. 13 09 2017 3.9. Quality Improvement

Wendy Llaneza to discuss with Alexandra Perry what exactly Governors could do to assist the Quality Improvement initiative.

13 12 2017 Wendy Llaneza

ONGOING: Wendy Llaneza and Alex Perry are to meet to discuss. Verbal update to be provided at the meeting on 13 12 2017.

2. 13 09 2017 4.1 Council of Governors, Terms of Reference

A workshop around significant transactions to be held. An update around new transactions to be presented to a future Council of Governors meeting.

13 12 2017 Stephen Legood/ Scott Haldane

COMPLETE: It has been agreed for this to form part of the Development session on 08 02 2017.

3. 13 09 2017 5.2. Governor Questions on the Financial Update

An item around STP to become a standing item at future Council of Governors meetings.

13 12 2017 Alexandra Perry/ Chief Executive

COMPLETE: This has been added to the Cycle of Business and an update will be provided at the meeting on 13 12 2017 (Agenda Item 6)

4. 13 09 2017 6.2. Questions from members of the public

The Trust Chair to discuss with the Board and Council the possibility of recording/ live streaming future Public meetings.

13 12 2017 Trust Chair

COMPLETE: It has been agreed for this to form part of the Development session on 08 02 2017.

5. 28 June 2017 2.6 STP discussions around the proposed STP Stakeholder group to be communicated to Governors at the earliest opportunity.

September 2017

Scott Haldane

ONGOING: The revised STP governance model will be agreed at the first STP Board Meeting to be held on 14th September. This will include proposals as to how best to involve Governors in the proposed Stakeholder Group for the STP. Further details will be provided following this meeting.

6. 7 September 2016

3.1 To produce a skills matrix/audit for the Governor roles.

13 12 17 Trust Secretariat

UPDATED: work around the skills matric to be progressed by the Trust Secretariat and discussed at a development session in February 2018.

3

7. 14 December 2016

2.4 Development of an algorithm for Governor concerns.


UPDATED: Following completion of the skills matrix work to develop an algorithm will be commenced. Update to be provided at the meeting on 13 12 2017.

8. 14 December 2016

2.6 Final ratified Patient Engagement Strategy to be circulated and included on the agenda for the CoG meeting in April 2017.


ONGOING: The Patient Engagement Strategy is to be re-written - The expected date of conclusion is December 2017. Update to be provided at the meeting on 13 12 2017.

1

Agenda Item: 4


REPORT

Subject: Chair’s Report Date: 13 December 2017

Author: Julie Spence, Trust Chair


Executive Summary: This report contains the following items:

1. Non- Executive Directors 2. Strategy Refresh 3. Board Annual Evaluation of Effectiveness 4. Board to Board with Cambridge Community Services re: Integration of Children’s Services

Recommendations:

The Council of Governors is asked to note the content of the report.

2

Relevant Strategic Goals and Objectives (please mark in bold)

The development, commissioning and implementation of a new integrated service strategy from April 2016: We will work with patients, carers and key stakeholders to change our services to deliver innovative, integrated person centred care and support that represents the highest possible standards in safety, effectiveness and personal experience of our services.

The design, development and implementation of the future CPFT workforce: Our staff will be a highly engaged, well trained, flexible and productive workforce who are

able to deliver more at better value

Maximising the contribution of IT and the Trust estate: We will develop highly innovative and effective ways to use technology and the Trust estate in support of person-centred care and maximising the financial benefit for CPFT

A commercial and financial sustainability strategy: We will ensure sustainable services through delivery of a financial strategy based on increased cost effectiveness, value for money, growth and investment by 2019

Links to BAF / Corporate Risk Register As detailed above.

Details of additional risks associated with this paper (may include CQC Fundamental standards, NHSLA, NHS Constitution)

N/A

Financial implications / impact

Whilst this report does not have a direct financial impact on the Trust items discussed may have a financial impact on the Trust.

Legal implications / impact

Whilst this report does not have a direct legal impact on the Trust items discussed provide update around issues that may have a legal impact on the Trust.

Partnership working and public engagement implications / impact

The ongoing work with CCS as well as elements of the Strategy will have an impact on the Trust’s working and public engagement.

Committees / groups where this item has been presented before

None

Has a QIA been completed? If yes provide brief details

N/a

3

Chair’s report Non- Executive Directors The Board has two vacancies due to the resignation of Simon Burrows, due to relocation out of county, and Amit Sethi due to taking up a new position which reduced his time available to fulfil the necessary commitments of the role. Consequently, the Nominations Committee agreed to advertise widely for Non- Executive Directors to fill the skill gaps identified in our skills matrix - marketing, developing patient centric services, human resources and business development. From the 66 applications, the Nominations Committee subsequently shortlisted 6 applicants, who were interviewed on 10th November 2017. As a result, two candidates have been offered roles subject to references and ratification by the Council of Governors meeting today. Council of Governors are asked to ratify Geoff Turral and Brian Bennyworth as Non- Executive Directors on CPFT Board It is expected they will start with the Board in January 2018. Strategy Refresh At the Board Development session on 13th November we commenced a strategy refresh to bring it up to date. This will include important new context i.e. the Sustainability and Transformation Partnership and working with others, as part of a system, to deliver Services to the residents of Cambridgeshire and Peterborough and our strategic approach to quality initiatives. This is on the agenda today and will be led by Stephen Legood.

Board Annual Evaluation of Effectiveness

In line with the main principles outlined in The NHS Foundation Trust Code of Governance, the Board of Directors must:

“Undertake a formal and rigorous annual evaluation of its own performance and that of its committees and individual directors.” One of the supporting principles states “The evaluation of the Board of Directors should consider the balance of skills, experience, independence and knowledge of the NHS Foundation Trust on the Board, its diversity, including gender, how the Board works together as a unit, and other factors relevant to its effectiveness. This should be reported to the Council of Governors with a specific focus on what changes are needed for improvement.”

In support of this approach, the Trust has developed a self evaluation framework. The framework has been drafted in line with NHS Improvement’s Well-Led Framework which focuses on the CQC’s Key Lines of Enquiry (KLOEs). This is currently being completed and the findings and any areas for improvement will be notified to the Council.

4

Board to Board with Cambridge Community Services re: Integration of Children’s Services. The focus was on how we do the best we can for the children of Cambridgeshire and there was unanimous agreement that it was ‘better together’ than working in isolation. Indeed, we coined the phrase ‘2 is 1’ we must become 2 organisations joined at the Cambridgeshire hip! The meeting focused on the joint vision, how the new joint children’s partnership board will work with our individual boards and importantly on the progress made by the professional leads on the operating model. The boards challenged the operations directors to ensure that all the services designed fitted the needs of individual children and their families and in so doing dovetailed with the other statutory and non-statutory services so the recipients received a seamless service. We plan to have our next meeting at the end of March. This is a real opportunity to deliver the best for children in the county there is much to do but we were grateful for the obvious hard work done to date. Non- Executive Director Activity Logs

Julie Spence

Sep 2017 AM PM EVENING

1.9.17 Emails and correspondence

4.9.17 Discussion with ARM re MH

5.9.17 Meeting Becs Manning Meeting CCS – CEO & chair

Meeting Lead Governor

6.9.17 Board Agenda Meeting Meeting Secretariat Prep for Board Development

7.9.17 Board Development Board Development

8.9.17 Service visit Trafford ward Wisbech Neighbourhood

11.9.17 Catch up Chess Denman

12.9.17 Gillian Beasley CEO Joint Meeting re: CUHP chair

13.9.17 Papworth Trust Council of Governors

14.9.17 STP Board @ Huntingdon

15.9.17 Farewell to University VC

18.9.17 Spirituality forum, Wisbech Chaplaincy video

19.9.17 Office catch up Papworth Trust event

20.9.17 Emails & correspondence

21.9.17 NHS providers chairs/ CEO conf

NHS providers chairs/CEO

Emails & correspondence


5

26.9.17 Board of Directors – prep Headway Event

27.9.17 Board of Directors Board of Directors Meet CEO/ retirement ex

28.9.17 Performance review with NHSI Arthur rank hospice

29.9.17 Meeting Cambridge Uni Cadets Meeting Simon Burrows

Emails and Correspondence

Oct 2017 AM PM EVENING

2.10.17 Meeting Anna Tuke Patient Smoke free launch

3.10.17 Meeting Kings Fund / Executive




28.10.17 NED shortlisting

29.10.17 NED Shortlisting Recognising organ donation

30.10.17 NED Shortlisting Board Agenda setting Emails and Correspondence

Nov 2017 AM PM EVENING

1.11.17 Meeting Tracy Dowling Meeting Mike Hindmarch

Mtg CEO Cambridge

2.11.17 In the Trust Luch Cavendish College

6.11.17 Meetings Secretariat Citizen Advice AGM

7.11.17 Meeting CEO Combined Visit Sue Ryder Hospice

CUHP chair search @CUH

8.11.17 Mtg Fenland Council CEO

9.11.17 Mtg re board agendas Visit Sue Ryder Hospice Constabulary Awards

10.11.17 NED Interviews NED Interviews NED Interviews

11.11.17 Writing Papers for Board

12.11.17 Board Development Prep


14.11.17 Visit Community Forensics PB

High Sheriffs Awards

15.11.17 Mtg Astra Zeneca Visit Arthur Rank Donors

16.11.17 Art for change

6

17.11.17 Meeting CCS Chair & CEO Meeting East Cambs Council CEO

20.11.17 Meeting South Cambs CEO

21.11.17 Safeguarding Training Safeguarding Training

22.11.17 Magistrates Swearing in Emails and Correspondence

23.11.17 Emails and Correspondence

24.11.17 Emails and Correspondence

25.11.17 Board of Directors prep

27.11.17 Telecoms with Trust Cambridgeshire Community

28.11.17 Board to Board CCS Board of Directors prep

29.11.17 Board of Directors Board of Directors

30.11.17 Meeting Tracy Dowling STP Board Anglia Ruskin Event

Julian Baust

Sept 2017 AM PM EVENING

4.9.17 Board Dev prep/charity

7.9.17 Board Dev Board Dev

10.9.17 Govs papers/admin

11.9.17 Govs papers

12.9.17 B&P report

13.9.17 Governors

18.9.17 Quality survey feedback meeting

21.9.17 Board prep

23.9.17 Board prep

24.9.17 Board Prep

27.9.17 Board Board


3/10/17 Visit to DUK with CPFT team

8/10/17 Audit prep

9/10/17 Audit prep

10/10/17 Staff wellbeing conference

11/10/17 Audit & Assurance

17/10/17 CBC strategy prep

19/10/17 CBC strategy board Admin

20/10/17 Admin


10/11/17 NED recruitment NED recruitment

13/11/17 Board Dev Board Dev

7

20/11/17 CPFT learning event

22/11/17 Cathy Walsh call Board prep

23/11/17 Board Prep Board Prep

24/11/17 Board to Board prep

28/11/17 Board to Board

29/11/17 Board Board

Jo Lucas




9.9.17 Charity Branding

12.9.17 COG prep

13.9.17 COG meeting

14.9.17 Charitable Funds prep

15.9.17 Charitable funds meeting

18.9.17 NED seminar – STP NED seminar – STP

24.9.17 Board Prep

25.9.17 Service visit – Children’s services Peterborough

Board prep

27.9.17 Board Meeting Board meeting


3.10.17 Complaints oversight report SI review

4.10.17 Reading SI reports

5.10.17 Prof practice review oversight call

10.10.17 wellbeing day 2 hours Re-reading appeal paperwork

11.10.17 Appeal hearing Appeal hearing Reviewing final letter

18.10.17 NHS charitable funds event

19.10.17

Prof practice oversight call. CPFT admin and follow up Charitable funds notes

25.10.17 Reading consultant application forms

27.10.17 Consultant interviews QS &G papers

28.10.17 QS&G papers

8

Mike Hindmarch


6.9.17 Board Development prep


9.9.17 Charity Branding

12.9.17 COG prep

13.9.17 COG meeting

14.9.17 Charitable Funds prep

15.9.17 Charitable funds meeting

18.9.17 NED seminars - STP NED seminar - STP

25.9.17 Service visit – Children’s services Peterborough

Board prep

27.9.17 Board meeting Board meeting


1.11.17 B&P prep

2.11.17 B&P Committee

3.11.17 Audit Committee Action Log



16.11.17 Board Development

26.11.17 Internal Audit Tender Prep

27.11.17 Internal Audit Tender Board Prep

28.11.17 CCS Board to Board Board prep

29.11.17 Board Meeting Board Meeting

Sarah Hamilton

Sep 2017 AM PM EVENING

4.9.17 Attend Coroner’s Inquest Attend Coroner’s Inquest

10.9.17 Amend and approve QSG minute

11.9.17 Draft QSG report

12.9.17 Read council of Gov Papers

13.9.17 Attend Coroner’s Inquest Attend Coroner’s Inquest

24.9.17 Read Board papers Read board papers

25.9.17 NED visit NED visit

27.9.17 Board meeting Board meeting

29.9.17 NED Service visit Peterborough

Draft NED Service report

9

30.9.17 QSG Committee meeting B&P committee meeting


10.10.17 Well-Being at work Well-Being at work

12.10.17 Read Appeal Board papers Read appeal board papers

13.10.17 Trust appeal (cancelled on morning)

28.10.17 Read B&P papers Read B&P papers

30.10.17 Read QS&G papers Read QS&G papers


1/11/17 Read QSG papers Read B&P papers

2/11/17 QSG Committee B&P Committee

8/11/17 Attend coroner’s inquest

9/11/17 Attend Coroner’s inquest Attend coroner’s inquest

27/11/17 Read board papers Read board papers

28/11/17 Board to Board St Ives

29/11/17 Public board meeting Private board meeting

1

Agenda Item: 5


REPORT

Subject: Chief Executive’s Report Date: 13 December 2017

Author: Tracy Dowling, Chief Executive Officer

Lead Director: Tracy Dowling, Chief Executive Officer

Executive Summary: This report summarises key activities undertaken since the last report to the Council of Governors on 13 September, and specifically informs the Council of the work of the Executive Committee.

Recommendations:

The Council of Governors is asked to note the contents of the Report.

2







Links to BAF / Corporate Risk Register As above


Financial implications / impact The purpose of this report is to inform the Council of the financial implications of the topics within.

Legal implications / impact The purpose of this report is to inform the Council of the legal implications of the topics within.


The report informs the Council of key areas of partnership working and public engagement implications; particularly in relation to partnership working with STP partners, and with staff and service users.


Board of Directors meeting 29 11 2017


No

3

Chief Executive’s Report

December 2017

1. Purpose

The purpose of this report is to update the Council of Governors of the activities of the Chief Executive

since commencing in post.

2. Service Visits and Listening Events

Since the last report I have continued my programme of service visits. Since September I have visited

the Cambridge Centre for Paediatric Neuropsychological Rehabilitation (CCPNR); and accompanied

Baroness Dido Harding, Chair of NHS Improvement, on visits to Denbigh Ward and Springbank Ward.

I have also visited the First Response Service Sanctuary at Mind on Chesterton Road, the Chitra Sethi

Autism Centre, and hosted the Wider Leadership Event where I fed back themes from the 18 listening

events I have held across Cambridgeshire and Peterborough for staff.

The themes emerging from the listening events were largely positive and constructive. Staff attended

from across all areas of the Trust, and all staff groups. Many staff were clearly proud of the work that

they do and I often heard how much people like working at CPFT, and many had either worked for

CPFT for many years, or had left and then returned.

Staff and volunteers who attended were specifically asked about what we should prioritise, and what

issues prevent them delivering the best care that they can. The following themes were clear:

• Training and development is critical for retention of all staff groups

• Recruitment processes need to improve

• Workload concerns from growing demand, increasing patient complexity and capacity constraints due to vacancy rates

• We need one IT system across the Trust

• We need to share data across the health and care system to direct care

• Agile technology is good but needs full roll out and evaluation to address some unintended consequences emerging now this is in use

• Clinical staff want to be involved in designing service change more directly

• Staff recognise the need for change but mixed feedback on how much they are involved in this

• Mixed reviews of the admin hubs, although recognition that it is in the early stages of implementation

• Need to have clarity about interfaces with, and service levels we can expect, from Serco

• Need to develop use of digital solutions to increase time to care

• Staff wellbeing is really important to staff

• Staff are keen to be involved in quality improvement work

On Tuesday 10th October we hosted an event for staff across the trust, CCG and County Council for

World Mental Health Day. The event focussed on how to support and develop a workforce with good

physical and mental health. There was a wide range of presentations, lectures, market place style

stands and workshops throughout the day. The event was well attended and enjoyed by all.

4

3. Executive Committee report to the Council of Governors

The Executive Committee meets weekly, with Associate Directors joining for a wider meeting on

alternate weeks. The following sections inform the Council of the main agenda items considered each

week:

• 3rd October meeting:

• The Executive considered a review of Denbigh ward and was pleased to note the

significant progress made under the four themes of communication, leadership, physical

healthcare and medical cover. There are no immediate concerns, although there is further

work to consider capital improvements to the estate to be a better ‘dementia friendly’

environment.

• Melanie Coombes presented an update on preparations to meet the new requirements of

the CQC.

• Nick White reported progress on the development of an ‘all age’ eating disorder pathway.

He also updated on improvements made to waiting times for the community eating disorder

service and informed the executive that the service would re-open to referrals on 9th

October.

• The Adult and Specialist Mental Health Directorate updated on the redesign of adult mental

health services to include the full roll out of the PRISM service in primary care. It was

agreed that a step change model of implementation with phases of delivery, but clarity

about the end point, would be the most sensible way to progress implementation.

• The PICU development of the seclusion room was reported to complete on 9th October

and then to re-open.

• It was agreed to stand down the STP Oversight Committee as the STP would now report

to each Board meeting.

• 17th October meeting:

• The Children’s Services Directorate reported on the Speech and Language Therapy

waiting list. This has increased as the level of demand exceeds the core resource.

Commissioners have agreed to commission sufficient capacity to meet demand until year

end. The waiting list should be back to within 18 weeks by December 2017.

• The Adult and Specialist Mental Health Directorate reported in detail on the waiting list

position for the Psychological Wellbeing Service (IAPT). The service is ahead of the

planned recovery trajectory, 16 new fully funded trainees have been recruited, and the

waiting time is now 8-14 weeks depending on location or service choice. The only patients

waiting over 18 weeks are due to patient choice.

• Melanie Coombes presented the action plan for environmental health on the in patient

wards.

• Kit Connick presented the proposed audit of inpatient windows and doors and structure.

The audit was planned to be complete for all areas by the end of November 2017.

• An update on progress with the implementation of the STP projects was presented.

• It was agreed that the local authority request to replace the Children’s Services Section 75

with a formal agreement could be complied with.

• Dr Cathy Walsh presented the Evelyn Trust service to support doctors with mental health

problems. This was supported as good practice.

• The mental health five year forward view (MH5YFV) was presented in order to consider

and prioritise services for development and commissioner investment for future years. It

was agreed that the national leads for mental health should be invited to the trust in order

5

for us to showcase some of our areas of good practice, and areas where we are leading

delivery in line with the national strategy.

• It was agreed that Dr Chess Denman and Deborah Cohen would represent the Trust on

the review of the Mental Health Act which is being undertaken nationally.

• 24th October meeting:

• There was an update on flu vaccine rates, and on CQUIN delivery. The rate was running

at 29%. Nicola Sharp went through the action plan and it was agreed to discuss further at

directorate performance meetings to agree actions to maximise take-up of the vaccine

across the trust. These actions include developing active communications to explain to

staff why having the flu vaccination is so beneficial for their patients and themselves.

• A report was received summarising the outcomes of the recent CQC Mental Health Act

visits to a number of the inpatient wards. The findings were largely positive but the report

highlighted areas where there was an occasional lapse, such as one patient who had not

had their physical health checks completed; an issue with a lack of a separate male TV

lounge and female TV lounge on Maple1, and a need to improve the development of care

plans with service users. There are actions to address each of the issues found.

• The delay to implementing the concentration of podiatry services to a smaller number of

sites was considered. The CCG was asked to confirm that this could go ahead. A final

confirmation is still awaited from the CCG.

• A new process for pre weekend on call coordination teleconferences was proposed. This

is now in place.

• A proposal to align the Board Assurance Framework and the Operational Risk Register

was considered. This was agreed.

• A presentation on the process to progress the mental health clinical systems procurement

was given. There is a two year contract extension in place for the existing system and

directorates were asked for clinical nominations to join the programme to ensure we

procure and develop a system which is integral to the delivery of high quality physical and

mental healthcare.

• 31st October meeting:

• It was reported that full payment had been received for CQUIN in Q1. A strong evidence

pack had been presented for Q2. We await the evaluation by the CCG.

• The new process for sign off of minor works was described. This has clinical involvement

to ensure correct prioritisation of works within budget.

• There was a presentation on the benefits of Office 365 which is being rolled out across the

trust. This will enable use of technology like Skype for Business, will improve document

version control, and support agile and collaborative working.

• A paper was received on the potential development of a female PICU. The market analysis

demonstrates a need, and currently the trust spends over £500,000 on out of area

placements. It was greed that there was a need for further exploration of the risks,

development of options for the clinical service model and discussion with commissioners,

both NHS England and the CCG.

• An annual report from the integrated mental health initiative in the Police control room was

received. This service has been a major success and has supported over 10,000 cases in

the last year. The main issue identified was with waiting times for ambulances, and with

adherence to the multiagency handover policy. It was agreed to escalate sign off of this

policy at CEO to CEO level.

6

• A proposed monthly cycle for the weekly executive meeting business was proposed. This

will ensure full wider executive review of the trustwide financial, quality and safety, and

performance delivery each month; and will relocate the directorate PRE meetings to a

Tuesday to ensure full executive assurance and support for the directorates. When there

is a five week month the additional meeting will be used to undertake a strategy delivery

review with the wider executive. Meetings between trust wide delivery and directorate

reviews will be for business papers.

• Dr Cathy Walsh presented a case for the expansion of the psychiatric liaison services to

meet Core 24 standards. As the Cambridge case did not have full funding it was deferred

until discussions with the CCG and with CUHFT had concluded. The case for NWAFT was

approved as it is being delivered within the level of funding approved nationally as part of

the delivery plan for the Mental Health 5YFV

• 7th November meeting:

• Mel Coombes presented an update on preparations for the expected future CQC

inspection. There is a trust wide task and finish group which is chaired by the chief

executive. This group meets monthly at present, and the CQC project team, led by the

Director of Nursing, are leading on the work to complete preparations for this inspection.

• The Board Assurance Framework and Operational Risk Register were reviewed.

• Mel Coombes reported on the recent environmental health inspection of in-patient wards

on the Fulbourn site, and reported that all areas received the highest rating of 5.

• Phase 2 of the administration review was presented. This project aims to increase the

professional identity of the corporate administration teams, to provide learning and

development opportunities for administration staff, and to ensure the administration

support function is both efficient and effective in supporting corporate functions. This was

an interim report.

• There was an update on progress of the STP projects, including project risks, and

confirmation of the financial drawdowns.

• 14th November meeting:

• Kit Connick presented the outcomes of the recent audit of inpatient window and door

safety. The review has been undertaken following recent inquests, patient safety alerts

(with particular regard to anti-barricade fittings), and the ongoing risk of patient absconsion.

The report is not complete as there are four remaining inpatient wards to finish their audits.

There was a list of agreed actions and a further compliance report will be presented to the

executive on 28th November. A final report will be presented to the Patient Safety and

Clinical Governance Committee and then on to the Quality, Safety and Governance board

sub-committee.

• Scott Haldane and Stephen Legood updated on the business planning process for 2018-

19.

• Nick White presented a paper outlining concerns regarding future nurse staffing levels on

the Phoenix Unit. It was agreed to progress the recommendation to join the Phoenix and

Darwin units, and to develop enhanced levels of community eating disorder services. This

will need discussion with NHS England, but is in line with the direction of service

development to reduce admissions of young people by developing enhanced service levels

in the community.

• Feedback from the board development day on approaches to Quality Improvement and

development of the strategy for the Trust were presented to the executive team.

7

4. Well Led Governance Review

Many of the recommendations from the well led governance review have been completed. There is

an informal executive team meeting each week, the board has development sessions on alternate

months to ensure a strategic and forward looking focus, the workforce strategy has been developed

and the Director of People and Business Development, is the deputy chair of the STP HR Director’s

Workforce Committee. The structure of the Board Assurance Framework and Operational Risk

Register has been completed, and the Integrated Performance Report continues to improve.

There has been a review of committee meetings throughout the trust and changes have been made

establishing formal weekly executive meetings, with a wider senior staff membership on alternate

weeks. The trust has established a wider leadership forum which meets regularly and aims to share

learning and transformation across the trust. This is part of the approach to developing a style of

collective and collaborative leadership.

A review of the trust strategy is underway, led by the wider leadership forum; the portfolios of executive

directors are also under review at present, in view of the developing strategic priorities and the need

to develop a culture of continuous quality improvement, informed by service users and their carers.

The Board will continue to be updated as the delivery of the well-led governance review continues.

5. Care Quality Commission (CQC) Inspection Notification

On 15th November emails were received from the Care Quality Commission requesting that the trust

begin the process to submit information to inform the forthcoming CQC inspection of the trust. The

request is the Provider Information Request (PIR) and we have been asked to submit this by 5th

December 2017.

As this is part of the new inspection process we can expect core service visits to commence in

approximately 9 weeks time and the well led announced inspection to be approximately 12 weeks

after this date. The Board will be kept updated on preparations for the respective stages of the

inspection process.

Tracy Dowling

1

Agenda Item: 6


REPORT

Subject: Sustainability and Transformation Partnership update

Date: 13 December 2017

Author: Tracy Dowling, Chief Executive Officer

Lead Director: Tracy Dowling, Chief Executive Officer

Executive Summary: This report summarises key activities within the Sustainability and Transformation Partnership since September 2017.

Recommendations:

The Council of Governors is asked to note the contents of the Report.

2









Financial implications / impact The purpose of this report is to inform the Council of the financial implications of the topics within.

Legal implications / impact The purpose of this report is to inform the Council of the legal implications of the topics within.


The report informs the Council of key areas of partnership working and public engagement implications of STP.


Board of Directors meeting 29 11 2017


No

3

Chief Executive’s Report

December 2017

1. Purpose

The purpose of this report is to update the Council of Governors of the activities of the Sustainability

and Transformation Partnership (STP).

2. STP Update

The STP Board met on 16th October 2017. The focus of the meeting was on the vision for the STP,

the approach to developing as an accountable care system and the priorities for impact on the health

of the population of Cambridgeshire and Peterborough.

In addition to the STP Board, the Health and Care Executive has continued to meet; we also had a

bi-partite meeting with the regional director of NHS England to review progress.

Over the last two months we have established the programme delivery board, chaired by the STP

programme director to oversee all of the STP projects; we have developed priorities for 2018-19. We

are also engaging more fully with the office of the Combined Authority, particularly given the significant

population growth of over 280,000 people over the next decade, and the need to work together across

the public sector to respond to this.

The STP priorities for 2018-19 include delivering fully on the initiatives commenced in 2017-18

including community based respiratory services, heart failure services, diabetes services, falls

prevention, discharge to assess, expansion of JET, development of early supported stroke discharge

services, cardiology clinical pathway redesign and demand management.

We are also prioritising the national ‘must-do’s’ in urgent and emergency care, in mental health

services, in cancer care and in primary care.

The development of plans to commission and deliver these service levels are currently in progress.

This includes developing strategic commissioning models and delivery models across providers –

working in partnership - to deliver as an accountable care system. There will be a formal report from

the STP at the next meeting of the Board of Directors.

Tracy Dowling

1

Agenda Item: 9


REPORT

Subject: Appointed Governor Update Date: 13th December 2017



Executive Summary:

• Laura HUNT, Superintendent 822, Head of Partnerships and Operational Support, Cambridgeshire Constabulary

• Lesley Crosby, Deputy Chief Nurse, North West Anglia NHS Foundation Trust • All other appointed Governor updates will be provided verbally at the meeting on 13 12

2017

Recommendations:

• The Council of Governors is asked to note the content of this report

2

Relevant Strategic Goals and Objectives


The design, development and implementation of the future CPFT workforce: Our staff will be a highly engaged, well trained, flexible and productive workforce who are able to

deliver more at better value





N/A

Financial implications / impact N/A

Legal implications / impact N/A


N/A


N/A


No

3

Laura HUNT, Superintendent 822, Head of Partnerships and Operational Support, Cambridgeshire Constabulary Local Policing Review (LPR) The LPR has involved a review of current force structures, operation, resource allocation and governance. It has also involved the commissioning of a detailed review and analysis of current demand with a view to informing recommendations for a sustainable policing model for Cambridgeshire Constabulary for the next 3-5 years that both supports delivery against the Police and Crime Plan and achieves the financial savings to deliver a balanced budget. The current status of the LPR, given that the full roll-out of a new model must happen in April 2018 in order to best ensure the successful introduction of Athena (the single case, custody, crime and intelligence system that by May 2018 will operate across nine forces) is as follows:-

• The organisation’s Chief Officer Group (COG) have agreed the business cases that set out proposals for the new policing model;

• Some police staff members have been out at risk of redundancy, and, given recent press coverage of the PCSO situation in Norfolk, please note that whilst the constabulary’s actual PCSO number is more like 125 against an establishment of 150, there is no intention to make the organisation’s PCSOs in such a position;

• The model will comprise one chief superintendent (down from two), seven superintendents (down from eight) and twelve chief inspectors (down from fifteen);

• There will be no change in the inspectors’ numbers (48.5) and sergeants’ numbers will be reduced by twenty (to 144.5);

• The intention is to increase constables’ numbers. In order to better meet and respond to our demands a Demand Hub will be established. This will bring together the Force Control Room (FCR) and Police Service Centre (PSC) functions; it will also seek to better manage and reduce demand at the front end through better triaging arrangements, and, where possible, dealing with the call demands at the first point of contact. There will be two geographic units to serve Cambridgeshire: the NORTH Area covering what is also known as Peterborough and Fenland; the SOUTH Area covering what is also known as Cambridge City, South Cambridgeshire, East Cambridgeshire and Huntingdonshire. Cambridgeshire Constabulary is very keen to retain its commitment to neighbourhood policing, but, intends to deliver a more consistent neighbourhood policing model throughout the county. Of course, there will continue to be a firm focus on public protection and areas of high harm and vulnerability. There will also continue to be a centralised intelligence function: the Central Intelligence Bureau. With both the introduction of Athena and a new policing model, it is fair to state that Cambridgeshire Constabulary finds itself in a period of significant change. Further updates on the changes will be provided in future Appointed Governor Updates. Retirement of Inspector Terri GRIFFIN

4

On 30th NOVEMBER 2017 Terri completed thirty years’ service as a police officer; having served in the Metropolitan Police Service and, more recently, in Cambridgeshire Constabulary. For the past four years’ of her service Terri operated as the organisation’s Mental Health Co-ordinator. She, more than any other person, ensured that the introduction of the Integrated Mental Health Team (IMHT) was a success. She will be sorely missed but work continues to best ensure a relatively seamless transition from her to another in support and furtherance of the essential mental health agenda. Introduction of changes to the Mental Health Act 1983 brought about by Policing and Crime Act 2017 On 11th DECEMBER 2017 the much-discussed and anticipated changes to the mental health act are introduced. This means, for instance, that from this date juveniles (those aged 18 and under) are not to be brought into police custody when they have been detained under section 136 of the Mental Health Act 1983. Through the Crisis Care Concordat Delivery Group partners have been well-engaged and well-versed with these changes, and, moreover, what they mean to their own organisations and service delivery. Work will take place to monitor the legislative changes, and, as with the LPR, progress will be provided through future Appointed Governor Updates. Laura HUNT, the Appointed Governor, is willing to discuss further and answer any questions raised within the meeting. Lesley Crosby, Deputy Chief Nurse, North West Anglia NHS Foundation Trust It is now 9 months since we merged with Hinchingbrooke. During this time we have shared good practice from both sides and continue to work hard to merge and integrate departments, pathways and services. Our position around performance on both sites, regarding the ED target, remains challenging as we see a rise in admissions and the acuity of patients remains high. We are as always looking at ways to improve pathways and continue to work closely with our Commissioners to do this. Release of additional winter pressures money from the budget has been well received and we have some plans we would like to put in place as we bid for the money to help us over this winter period. We are also working hard around integration of the Acute Psychiatric Liaison Service (APLS) at both Hinchingbrooke and PCH to ensure we are working as one organisation in respect of the amazing work this group of staff continues to do. We know from feedback our patients who access APLS have found this service excellent. We are still currently recruiting nurses and currently have a team out in the Philippines where we are hoping to recruit approximately 60 nurses. We are also looking at local recruitment initiatives as well. As I said before the CQC are due anytime (a lovely Xmas gift). We submitted our data at the beginning of November and expect them to be in anytime soon.

1

Agenda Item: 11


REPORT

Subject: Charity update


Author: Clare Jones, Charity Manager

Lead Director: Kit Connick, Interim Director of Primary Care and Corporate Affairs

Executive Summary: Update of fundraising progress at Head to Toe Charity including an updated operating plan to show overall progress for 2017/18 against the Charity’s three year strategic plan.

Recommendations:

The Council of Governors is asked to note the update.

2




deliver more at better value.

Maximising the contribution of IT and the Trust estate: We will develop highly innovative and effective ways to use technology and the Trust estate in support of person-centred care and maximising the financial benefit for CPFT.

A commercial and financial sustainability strategy: We will ensure sustainable services through delivery of a financial strategy based on increased cost effectiveness, value for money, growth and investment by 2019.

Links to BAF / Operational Risk Register None identified at this time


None identified at this time

Financial implications / impact N/A

Legal implications / impact None identified at this time


None identified at this time


None


No

3

Charity fundraising update December 2017

1. Branding Further to ratification of the new name of ‘Head to Toe Charity’ in August, the Board ratified the new brand design, mission, vision and values for the Charity in September, as recommended by the Charitable Funds Management Committee. The new brand has now been implemented, with adherence to a set of brand guidelines as provided by our external design agency. Our vision, mission and values are now promoted on the Charity’s website and will be included in the Charity’s next annual report. They are: Our vision Everyone who needs CPFT’s services receives the best possible care and support. Our mission Our mission is to enhance CPFT’s ability to improve the health and well-being of the people it serves and the staff who care for them. Thanks to the generosity of our supporters, we do this by raising funds and investing these in four key areas across CPFT’s services: 1. Enhancing care and treatment for individuals and families. 2. Providing hope and support for patients, service users, their families, carers and staff. 3. Funding pioneering research and innovation to transform healthcare, now and in the future. 4. Raising public awareness and understanding of mental health and long-term physical conditions.

Our values Our values mirror those of the NHS Trust we support: PRIDE Professionalism, Respect, Innovation, Dignity, Empowerment

2. Official launch Head to Toe Charity was officially launched at CPFT’s Wellbeing at Work event for World Mental Health Day on 10 October 2017. The Charity had a stall throughout the day, with a bake sale, and raised £347.09 for the Charity’s general fund TMA01.

4

The Charity was officially launched by Kit Connick, as Director for the Charity and member of the Trustee with a promotional video showing a summary of the Charity and how the Charity uses donations to support CPFT’s services, with a short clip about the recently funded Kung Fu and family support group supporting children and families affected by brain injury at CPFT’s Cambridge Centre for Paediatric Neuropsychological Rehabilitation (CCPNR).

3. Steptacular event Steptacular is the Charity’s first official fundraising event and was introduced at the Charity’s launch. This step challenge was chosen as the Charity’s limited resource capacity means that a mass participation event with minimum staff input was needed and an active event linked well with the Trust’s current focus on staff wellbeing at work. Steptacular is a month long challenge, finishing on the 30 November 2017. Steptacular has received an excellent response for a first fundraising event, with 287 individuals including 48 teams taking part and raising sponsorship. The majority of participants have been CPFT staff, friends and families. To date, the event has raised £4,016.60 for the Charity’s unrestricted fund, to be used where the need is greatest within CPFT.

4. Engagement Engagement with key stakeholders and potential collaborators is a constant priority for the Charity Manager. Engagement of note includes: Voluntary Services Discussions with the Voluntary Services Manager have led to a mutually beneficial arrangement for both the Charity and the CPFT Voluntary Services team. The Voluntary Services team are keen to promote the Charity and going forward, volunteers will have Charity Champion duties written into their job descriptions. This will include promoting the Charity to patients, service users and their families across the Trust and ensuring Charity materials are kept well-stocked and up-to-date across the different Trust sites. In return, the Charity is looking to fund t-shirts as a “uniform” for the Trust volunteers with the Charity’s logo of prominence, which will provide important promotion of the Charity’s brand across the Trust. Capital Park café Clare Jones and Kit Connick approached the new café at Capital Park, which is now run by the Gog Magog Farm Shop. The café now displays a Charity collection tin and leaflets at its till, with further mutual support arrangements between the Trust and the café being discussed. An NHS staff discount for all CPFT staff, to be promoted through the Trust’s communication channels, is being discussed with an update to be provided at the next Council of Governors meeting in April 2018. Collaboration with local charities in the area Focus has been given to collaborations with Addenbrooke’s Charitable Trust (ACT) - a supporting charity of the Trust - and Papworth Hospital Charity, as fellow NHS charities in the Cambridgeshire and Peterborough area. The Charity Manager has arranged quarterly meetings with both Trusts to discuss potential joint projects and fundraising focus for each charity.

5

ACT is particularly focused on liaison psychiatry funding at the moment, with a number of grants being discussed and made to the Trust’s Liaison Psychiatry team through Cathy Walsh. With the 70th anniversary of the NHS and of the first transplant operation at Addenbrooke’s in 2018, this focus is set to continue with a grant to funds psychological support for transplant patients at CUH being discussed. Papworth Hospital Charity is focused on their move to the Addenbrooke’s site and would like to do a fundraising appeal for new equipment to furnish their new building, linked to the 70th anniversary of the NHS. Given the Charity’s current financial situation, it cannot hope to provide financial support to these ventures but has offered community fundraising support for a joint appeal, should this take place. An exciting partnership with Cambridgeshire charity Living Sport has been formed, further to the Charity’s launch. Living Sport employee, Michael Firek, made contact with the Charity Manager at the launch event and has subsequently pledged the charity’s support for Steptacular and a public partnership with Head to Toe Charity. Five teams took part in Steptacular and the CPFT communications team is working on a joint press release to publicise the new charity collaboration. The Charity Manager continues to liaise with supporting charities of the Trust. She regularly attends committee meetings of the Friends of Fulbourn Hospital and Community, which has resulted in more targeted grant-making from the charity. Examples include the new sensory garden at Willow Ward and committed funding for the final £1,000 required for the new cardio activity wall at Mulberry 2 ward. Research and Development at CPFT With enhancement of the research and development a key objective of the Trust, the Charity Manager has recently met with Iliana Rokkou, User and Carer Research Manager, to discuss potential projects for charitable support. The R&D Leadership Team have also shown interest in discussions. There are no current projects for support, and the Charity’s current financial situation would prevent any immediate funding, however the R&D team are keen to work with the Charity and discussions will continue.

5. GDPR With the new General Data Protection Regulations (GDPR) due to replace the Data Protection Act 1998 on the 25 May 2018, the Charity needs to focus on ensuring it is compliant with these new regulations. Preparation is centred on a CRM database that can accommodate the new requirements. One of the reasons that eTapestry was chosen as the Charity’s new database was its development work on enabling charities to easily adhere to the new GDPR. The Charity Manager is working with Blackbaud (provider of eTapestry) to set up the new database according to GDPR regulations. This is in conjunction with Kay Taylor, the Trust’s Information Governance Manager. The Charity will be required to produce a comprehensive Privacy Policy. Discussions with Kay Taylor have confirmed that this will need to be separate to the Trust’s policies on privacy, confidentiality and data protection to avoid confusion for the general public and to address specific fundraising regulation and GDPR needs.

6

The Charity Manager will be meeting with Kay Taylor in December 2018 to discuss the Charity’s expected data flow and requirements and will ensure that all Charity data protection and privacy statements (for points of personal data collection e.g. registration forms) and its Privacy Policy adhere to GDPR and the Trust’s GDPR requirements. The Charity Manager is also a member of the Trust’s GDPR Work Group, with the first meeting of the group scheduled for January 2018. The Council of Governors will be kept updated with the progress of Charity’s GDPR compliance work at the next meeting in April 2018.

6. Operating plan The attached operating plan (see Appendix 1) gives an oversight of completed work and work due to commence, to date, against the Charity’s three year strategic plan. Out of the 59 actions within the plan; 22 are complete and 35 are on track with two actions delayed due to capacity issues. The updates since the last version of the plan are marked in red.

Version as of 25 November 2017 7

Charity Operating Plan 2017/18 Status legend

Completed Progress slow or delayed Progressing on track with timeline Objective may not be met

Objective O1 Establish a fundraising charity for the Trust, complete with new name, brand, vision, mission and values by September 2017. Tasks

Status Objective task Owner Deadline Comments

Work with CPFT staff, service users and members to establish the Charity’s vision, mission and values.

CJ Sept 2017

Sept 2017 Vision, mission and values approved by the Board of Directors.

Work with the CPFT Communications team to develop a name, logo and brand for the Charity.

CJ Sept 2017

Sept 2017 Brand design approved by the Board of Directors. July 2017 New name of Head to Toe Charity approved by the Board of Directors.

Objective O2 Create strong foundations for the Charity with the development of robust governance and working procedures by March 2018. Tasks


Review and refresh the current procedures for receiving donations (both cash and online) and their acknowledgement with Serco, ensuring all donors are thanked within 48 hours.

CJ Sept 2017

Ongoing but all supporters who provide contact details are thanked within 48 hours.

Appendix 1



Support CPFT in the restructure of its Charitable Funds Management Committee and creation of a Charity Fundraising Policy.

CJ Dec 2017

December 2017 Draft Charity Policy with accompanying Charitable Funds Guide to be presented to the CFMC for review and comment. CFMC restructure ongoing with CFMC Chair and Trust Secretariat. June 2017 Draft fundraising policy now with the Trust Secretariat for comment.

Invest in a charity-specific Customer Relationship Management (CRM) database.

CJ Sept 2017

September 2017 eTapestry charity CRM database purchased. Approval delays and capacity issues mean the database is not yet fully functioning. Anticipated to be fully operational by the beginning of 2018. September 2017 Written approval from Kay Taylor, Head of Information Governance. August 2017 Written approval received from Richard Matt, Associate Director of Business Technology. July 2017 Information required for approval provided to both Richard Matt and Kay Taylor. June 2017 Purchase of the charity CRM database, eTapestry approved by the CFMC subject to approval from IT and Information Governance. Verbal approval from Richard Matt already obtained.



With directorate managers and fund advisors, review the current funds, merging and closing inactive funds to reduce the overall number of funds.

CJ Mar 2018

December 2017 In progress. Capacity proving to be an issue, support from Finance team should resolve this issue. DMc/MB working on this. June 2017 In progress

With directorate manager and fund advisors, refresh procedures for managing funds and fund advisors. Ensure all fund advisors are relevant and each fund has at least two in place.

CJ Mar 2018

December 2017 Charitable Funds Guide to be presented to the CFMC for review and comment. June 2017 In progress

Produce guidelines for all fund advisors to ensure they know how to manage, access and promote the funds they hold.

CJ Mar 2018

December 2017 Fund Advisors Guide to be presented to the CFMC for review and comment. June 2017 In progress

Join the membership of relevant fundraising organisations including The Fundraising Regulator and the Association of NHS Charities.

CJ Dec 2017

September 2017 Head to Toe Charity is now a member of the Association of NHS Charities and is registered with The Fundraising Regulator.

Objective O3 Understand the needs and goals of CPFT staff, service users and carers to build a strong partnership between the Trust and Charity by March 2018. Tasks


Identify between 2 – 4 “beacon areas” within the Trust and work with them (staff and service users) to promote the Charity across their area and provide grant support for their projects.

CJ Ongoing December 2017 In progress

Charity Manager to attend between 4 – 6 existing patient/carer/family support groups per year to keep in touch with the needs of this audience.

CJ Ongoing June 2017 One meeting attended.



Charity Manager to attend between 6 - 8 department meetings per year to foster greater mutual understanding and partnership working.

CJ Ongoing

June 2017 13 meetings attended due to the needs of the brand and identity work.

Charity Manager to attend between 8 - 10 meetings of the Rising Roses WI to keep in touch, promote support of the Charity and to ensure any new members are aware of the Charity’s involvement.

CJ Ongoing

December 2017 Future of the group is under discussion. Charity Manager liaising with Social Recovery Manager to establish progress. June 2017 One meeting attended.

Charity Manager to attend the weekly CPFT Comms team meeting.

CJ Ongoing December 2017 All comms team meetings attended, to date.

Charity Manager to attend between 4 – 6 governor meetings each year to keep the governors informed.

CJ Ongoing June 2017 One meeting attended.

Charity Manager to set up monthly meetings with CPFT Chief Executive.

CJ Dec 2017

December 2017 Initial meeting with Chief Executive arranged. September 2017 Tracey Dowling now in post as Chief Executive. Meeting to be arranged a.s.a.p. June 2017 As current Chief Executive is retiring, deadline extended to allow for introduction of new Chief Executive.

Charity to have a stall at corporate induction to ensure all new CPFT staff are introduced to the charity and how it can help them and their patients/service users.

CJ Dec 2017

December 2017 In progress. Charity to provide bags with Charity materials for all inductees and ensure the Charity is mentioned in the Chief Executive’s presentation.



Produce an online survey for all CPFT staff and for members to introduce the new fundraising charity and ask for their thoughts and ideas regarding the Charity’s identity and what their needs and goals are for the Charity.

CJ Jun

2017

Produce bi-annual online survey for key audience groups and supporters to provide feedback on the Charity’s work, any changes in their work focus that the Charity can support and suggestions for improvements.

CJ Mar 2018

Objective O4 Re-design the existing grant-making process to maximise the impact of grants for service user benefit by December 2017. Tasks


Consult fund advisors on perceived problems in accessing charitable funds.

CJ Dec 2017

September 2017 In progress as part of fund consolidation and updating work.

Speak with fund advisors about notifying the Charity and the Trust Secretariat about purchases under £1000 and how they have benefited patients/services users.

CJ Dec 2017

September 2017 In progress as part of fund consolidation and updating work.

Review the current grant application forms and amend where necessary to make the application process as quick and efficient as possible for both applicants and Charity.

CJ Dec 2017

December 2017 Draft application form to be presented to CFMC for review and comment. September 2017 Application form to be updated for review by the CFMC at the December meeting. June 2017 Evidence report reviewed, updated and approved for use by the CFMC.

Produce a comprehensive guidance document for grant applicants, to guide them through the application process.

CJ Dec 2017

December 2017 In progress

Where possible, the Charity Manager to proactively support applicants, to ensure the submission of high quality bids only.

CJ Ongoing



Produce, agree and implement a Grants Strategy to give direction and focus to the Charity’s grant-making and to reflect the needs of the Charity core audience.

CJ Jan

2018

Ensure that all grant terms include agreed publicity, income generation (ongoing) through the “give/get” principle and strongly highlight the consequences of not providing comprehensive feedback to the Charity on how the funding has benefited service users.

CJ Ongoing

Objective O5 Position the Charity for long term growth and eventual sustainability by balancing income and expenditure in the short term and generating income growth and diversification in the long term by March 2020. Tasks


Review the Charity’s funding priorities, spending commitments and annual financial needs.

DMc Jun

2017

Review grant making levels and core costs and balance these with income in the short term. Assess the possibility of closing the general fund to applications on a temporary basis whilst income generation processes are established.

DMc Jun

2017

June 2017 CFMC agreed £10,000 budget for the Charity Manager to administer for smaller “good-will” grants for CFPT projects. Mar 2017 General fund closed to applications until further notice.

Develop plans for fund-spending and fund-raising with each “beacon area” on an annual basis.

CJ Ongoing

Objective O6 Maximise the Charity’s long term income generation by continually improving engagement with our core audience (service users, carers, staff and members) and through new fundraising and communication initiatives by March 2020. O6.1 Cash and committed giving Work is needed to refresh the income processing and acknowledgement procedures to ensure all donors feel appreciated and good about making their donation. This helps to encourage repeat cash donations and lowers the rate of attrition.


A key element of this is nurturing cash donors by providing opportunities for them to support in other ways, for example, committed giving, fundraising or volunteering. Tasks


Create a series of thank you letter templates, ensuring all donors are shown appreciation for their support and given examples of how their donation has made a difference for service users and carers.

CJ Oct

2017

May 2017 Template for general fund now in place.

Establish a procedure for asking donors if they are eligible for Gift Aid, ensuring all declarations are correctly and legally stored and Gift Aid is claimed regularly from HMRC.

CJ Oct

2017

December 2017 Gift Aid declaration form approved by SH and KT and in use. June 2017 Temporary Gift Aid form for single donations now in place. This will be updated once name and identity are confirmed.

Introduce a welcome pack and calls to improve first contact and lower attrition rates.

CJ Mar 2018

Establish a “donor journey” so all cash donors are welcomed and appreciated, receive appropriate and relevant communications and are given the opportunity to convert to a committed giving programme.

CJ Dec 2017

Review current methods available for supporters to make cash donations (online and offline) and add to those, where appropriate, to make it as easy as possible for supporters to donate.

CJ Sept 2017

September 2017 Review complete. PayPal account to be set up for online and card donations. Virgin Money Giving account to be replaced with JustGiving account.



Work with on-site cashiers, making sure they are prepared to take donations (e.g. thank you leaflets and Gift Aid declaration forms for donors) and are confident in how to process donations quickly and with the relevant information (e.g. donor contact details and fund details).

CJ Dec 2017

December 2017 Meeting with Cherril Boughen and Onika Patrick-Redhead regarding cashiers’ support of the Charity. Resource issues mean cashiers’ support may be limited, especially regarding cash donations. Highlighted to DMc and MB who will look at solutions. September 2017 In progress – cashiers now provide donation information to the Charity Manager each week after work with Rosemary Walker. Charity Manager to meet with cashiers once brand in place to discuss donor care and donations via cashiers.

Make the CPFT Charity Fundraising Policy available to all staff via the intranet to ensure they know what to do when they are given donations and the importance of paying in any donations quickly and with contact details. This will be promoted via an all staff email and mentioned in the CPFT Comms Staff Bulletin.

CJ Dec 2017

December 2017 Draft Charity Policy to be presented to CFMC for review and comment.

Work with the Elizabeth House Receptionist to meet with staff on receptions across all CPFT sites are equipped for promoting the Charity and for directing supporters to make donation or to fundraise.

CJ Dec 2017

December 2017 In progress September 2017 Rebecca Wiles part of the charity project group and ready to support further work with receptionists in other areas once brand is in place and the charity is launched.

Operate one cash appeal for Christmas 2018. This should be profitable in its own right and also generate leads for potential cash to committed conversion programmes.

CJ Dec 2018



Introduce new supporters through a mailing to all CPFT members to introduce the Charity and ask for their support.

CJ

Dec 2017 Feb 2018

December 2017 Capacity issues mean this will probably be in the New Year. September 2017 Issues with the membership database and the charity’s capacity has pushed this deadline back slightly from October to December.

Research donor acquisition programmes, focusing on a potential Charity lottery.

CJ Mar 2018

Research mass fundraising products e.g. MIND’s Crafternoon

CJ Mar 2018

December 2017 Steptacular – a step challenge – was launched in October and started on the 1 November. It is anticipated this will be a regular event for the Charity. September 2017 Head to Toe will launch its new fundraising event – a step challenge – at the launch in October. A mass participation event was chosen for the launch due to capacity restrictions and the desire for an “opening event” especially for staff to get behind. A step challenge also linked well with the Trust’s work around staff’s wellbeing at work. The event is co-ordinated by new charity volunteer, Jess Mackenzie-Denman.

O6.2 Community and event fundraising A vibrant, supportive community fundraising operation is often a supporter’s first contact with the Charity and third party fundraisers recruited this way can often remain loyal for years. It’s important, therefore, that we establish this operation early on and that we focus attention on the care of these supporters, promoting local fundraising opportunities to our core audience and supporting them throughout their activities.


Tasks


Contract and populate one bespoke fundraising events, such as skydives and wing-walks.

CJ Mar 2018

O6.3 Corporate fundraising Objectives for engaging with local companies will include: Tasks


Secure sponsorship for the Charity’s bi-annual newsletter.

CJ Mar 2018

O6.4 Trusts and Foundations Any progress with Trusts and Foundations depends on having clear projects to fundraise for and securing projects with sufficient notice. However, it is a good fundraising area for small charities starting out as it can mean a great deal of return for relatively little resource, should the projects be there. Tasks


Identify and account manage between 1 - 2 trusts and foundations that make them “natural” ongoing partners and whose purposes make them likely partners on a regular basis.

CJ Ongoing

September 2017 Charity Manager met with the Director of The Evelyn Trust, Bill Pike. The meeting was to introduce the Charity and the work it supports at CPFT. The Evelyn Trust showed willing to support CPFT projects that were very clearly charitable and innovative. Charity Manager to contact Bill Pike in the near future when a suitable project arises. June 2017 Meeting with The Evelyn Trust arranged for September.

Identify suitable current projects for Trust funding within our “beacon areas” and make between 1 – 2 applications for funding.

CJ Ongoing December 2017 In progress


O6.5 Legacies

Historically, CPFT’s charitable funds have been fortunate to be the statutory recipient of a few legacies. Legacies can provide significant income for low resource cost but are unreliable as an income stream. The establishment of an excellent community fundraising programme contributes to a legacy strategy but it can take many years for the income, if any, to materialise. However, it is prudent to ensure the Charity makes itself available to receive such legacies and proactively promotes this by developing and adopting a legacy strategy to promote and secure legacies specifically for CPFT against our articulated mission and values. Tasks


Research and adopt a legacy promotion strategy.

CJ Mar 2018

Purchase membership of Smee & Ford’s Named Legacy Report service.

CJ Dec 2017

December 2017 In progress

O6.6 PR & Communications

The communication activity of the Charity will work towards delivering our strategic objectives by showcasing our work and encouraging the public to engage and support. Tasks


Develop and produce a bi-annual newsletter, general leaflet and general donation envelope.

CJ/AB Dec 2017

December 2017 General leaflet printed and distributed. Donation envelope in progress. Newsletter postponed due to capacity issues. Sept 2017 General leaflet to be rebranded in line with the new charity brand. Other printed materials will also follow in preparation for the charity launch in October. June 2017 General leaflet designed and in use.



Produce Charity promotional signage, including donation envelopes/leaflet holders, for Elizabeth House reception and the Cavell Centre reception to increase the Charity’s presence on site.

CJ/AB Ongoing

October 2017 Leaflets and pull-up banners now in place at Elizabeth House, Cavell Centre and Newtown Centre receptions. Further permanent signage to be installed as part of the comms team’s rebranding project throughout 2017/18.

Identify a further two “high footfall” areas across CPFT sites for Charity signage and promotional materials.

CJ Ongoing October 2017 In progress

Create an attractive, simple website that is easy to navigate and enables visitors to easily donate and/or find out more about us and how to support us. This will include an option for supporter feedback.

CJ/AK Mar 2018

September 2017 www.headtotoecharity.org up and running. Work still required and maintenance is ongoing. Aug 2017 Domain name headtotoecharity.org plus associated versions purchased. AK to redirect charity website to this URL and build website according to Charity Manager’s design brief.

Encourage people to engage with us on social media by setting up accounts for the Charity on Twitter, Facebook and LinkedIn.

CJ/KB Dec 2017

July 2017 Facebook and Twitter accounts set up and in use. LinkedIn and Youtube channels to follow.To be maintained with support from Katherine Buggy in the comms team.

Develop a social media strategy in conjunction with the CPFT Comms team.

CJ/KB Mar 2018

September 2017 In progress



Launch the Charity at the next CPFT AGM. CJ Oct

2017

October 2017 Head to Toe Charity successfully launched at CPFT’s Wellbeing at Work event. September 2017 Head to Toe Charity will be launched at the Trust’s Wellbeing at Work event on 10 Oct 2017 at IWM Duxford. This means the deadline is slightly overdue in order to launch at the right Trust event. Charity launch is co-ordinated by new charity volunteer, Jess Mackenzie-Denman. June 2017 Potential CPFT event for staff and the public on the 10 October may prove a more suitable launching event. Awaiting further details.

O6.7 Major donors

Objectives for developing a major donors programme include:


Charity Manager to approach Cambridge University Health Partners as an existing partner, looking to work together for mutual benefit.

CJ Jun

2017

September 2017 Hugh O’Donnell invited to Board meetings by Trust Secretariat but no response as yet. June 2017 Hugh O’Donnell met with CJ and KC to discuss working with the charity. Hugh has been contacted with future Board meeting dates to arrange his attendance.

Charity Manager to liaise with Hugh O’Donnell and the University Health Partners team regarding charity projects that may be suitable for major donor support.

CJ Ongoing



Develop a major donors stewardship programme

CJ Mar 2018

Objective O7

Approach other local like-minded and charitable organisations in the spirit of collaboration and co-operation for the benefit of all NHS users in the areas we serve by December 2017. Tasks


Charity Manager to approach Addenbrooke’s Charitable Trust (ACT) and Papworth Hospital Charity as fellow NHS charities who can work together.

CJ Jun

2017

September 2017 Charity Manager now attends regular quarterly meeting with ACT and Papworth Hospital Charity to discuss possible joint fundraising and funding opportunities.

Charity Manager to approach charities which support CPFT services and, therefore, will be working with the Charity.

CJ Jun

2017

September 2017 Charity Manager approached Dreamdrops Charity but no response as yet. September 2017 Charity Manager has made contact with: Hospital at Home, No Gain No Pain, Paintings in Hospitals and Arts in Minds. Meetings have been arranged where appropriate and these relationships will be maintained.

1

Agenda Item: 13


REPORT

Subject: Integrated Performance Report Summary


Author: Jonathon Artingstall, Head of Information and Performance

Lead Director: Scott Haldane, Director of Finance

Executive Summary: The Integrated Performance Report (IPR) is the mechanism the Trust uses to monitor performance and compliance against a number of metrics. This paper offers a summary of the key issues, and provides further insight into any problems and remedial actions plans in place.

The report also aims to provide a balance to any areas of concern by highlighting performance

successes reported via the IPR.

The data in this summary relates to the reporting period of Q2 2017-18.

Recommendations:

The Council of Governors is asked to note the content of this report.

2




deliver more at better value





n/a

Financial implications / impact n/a

Legal implications / impact n/a


n/a


Business and Performance Committee


n/a

1

Agenda Item: 13.1 Current Issues – Q2 2017-18 – Key messages

Indicator Lead

Director

This Period YTD Target Root Cause

Remedial Actions and Trajectory for Improvement

Recovery Date

CAMHS Full Waiting List - waiting for Assessment (First Appointment) - (% >18 weeks)

Julie Frake-Harris (COO)

12.1% (43)

12.1% (43)

0%

• Neurodevelopment pathway capacity in the north

• Small impact through awaiting for specialist group attendance

• Staffing issues (maternity, leavers and medical capacity) impacting factors

• Weekly waiting list management process continues, with monitoring of appointment dates of all longer waiters

• Additional clinics created to support workload

• Repeat of trajectory exercise underway to provide WL management insight

Q3 1718

Joint Emergency Team service (JET) referral rate


695 referrals

registered (M6)

3928 referrals

registered

4826 referrals

registered

• Recently commissioned countywide community service intended to prevent patient admission to hospital

• Stakeholders in system may not be aware of service, or may not be enabling service to be a primary response when patient need meets service criteria

• Weekly operational reviewmeetings held with CCG commissioners to influence utilisation of available capacity

• Continued promotion of service with all stakeholders

Q3 1718

Diagnosis recording

Chess Denman (MD)

84.5% 84.5% >=95.0%

• Mental health diagnosis not being recorded as part of standard RiO process

• Clinical Dashboard usage not universal across small number of staff

• Continued focus on individual Clinical Dashboards available on-line for all staff, outlining missing KPIs including diagnosis

• Strong performance against national average (28%, MHSDS M2 1718)

Q4 1718

2

Indicator Lead

Director

This Period YTD Target Root Cause

Remedial Actions and Trajectory for Improvement

Recovery Date

Triangle of Care -Carers


14.7% 14.7% >60%

• Query about suitability of measure for demonstrating carer involvement.

• Inability to report and remove people without carers from metric

• RiO form redesign in place from November; exclusions now can be removed.

• Performance monitored and progressed through PRE, whilst discussion ongoing about more suitable measure.

Q1 1819

Mandatory Training compliance

Stephen Legood

(DoBD&P) 93.6% 93.6% >95%

• Review of Learning Codes for individuals highlighted need for refresh (complete)

• Disconnect between future booked appointments and actual attendance

• Benchmarking suggests very high target.

• Clinician level report available for all staff.

• Re-promotion via Staff News of available training course dates.

• Issue mainly with the refresh of non clinical training courses.

Q4 1718

Finance - Use of Resources

Scott Haldane (DOF)

3 3 <=2 • Use of agency staff triggering

override, although all metrics behind plan at end of Q2

• Clinical and corporate directorates reviewing contingency plans to ensure recurrent CIP savings.

• See Finance report for more details.

Q4 1718

3

A selection of areas of postive performance

Indicator Lead Director This

Period YTD Target Comments

CRHT Gate Keeping


99.8% 100% >=95.0%

• Measures crisis team assessment and involvement in the decision to admit a person into an inpatient bed, thereby maximising care solutions in the community

• Robust gatekeeping processes and methods in place

• NHS Improvement reviewing this measure with a view to retiring from the Standard Operating Framework.

Safe Staffing Levels (Registered and Unregistered)

Melanie Coombes (DoN)

101.5% (M6)

101.5% >80.0%

• Trust wide results confirm compliance against this patient safety measure, demonstrating ward staff rotas are being fulfilled as planned

• Reporting includes the physical and mental health wards across all Directorates

• Data warehouse reporting now providing additional operational support.

Early Intervention in Psychosis - % Waiting < 2 weeks


94.1% (Q2)

85.6% >=50.0% • NHS I requirement to commence treatment within 2 weeks of referral

• Consistent performance above target for all age groups with suspect first episode psychosis.

Care Program Approach - 7 Day Follow Up

Chess Denman (MD)

95.8% (M6)

96.0% >= 95.0% • NHS Improvement target showing the follow up of people in the community, following

discharge from a mental health inpatient setting.

• Small denominator (~100 pm) require close monitoring; processes proving successful.

% of Inpatients Physical Health check within 24 hrs admissions


96.6% 96.6% >95%

• Timely recording of physical health assessment following admission exceeding target.

• Small issues with out of core hours admissions being monitored

• Measure to extend to the community services shortly.

% Sickness Rate Stephen Legood

(DoBD&P) 3.8% 3.8% <4.35%

• FY 1718 showing positive performance on sickness rates.

• Performance shows positive and effective management of sickness throughout all directorates in the Trust.

1

Agenda Item: 14


REPORT

Subject: Finance Report – Month 7


Author: Derek McNally, Deputy Director of Finance

Lead Director: Scott Haldane, Director of Finance

Executive Summary: The attached report is a Summary Finance Report for Month 7, which shows the key data for this reporting period. The Summary Report highlights the following: -

• Month 7 surplus of £0.025m against a planned surplus of £0.296m; • YTD deficit of £1.176m against a planned surplus of £0.646m; • Use of Resources Metric for the month is a 3, against a planned 2. This is due to the

Agency trigger override, although all metrics are behind plan at this stage;

• Cash balance above plan at the end of the month by £0.4m; • As a result of the continuing deficit run rate position the Clinical Directorates and Corporate

areas are developing contingency plans to ensure that CIP savings targets are delivered on a recurrent basis, and that the Control Total of a £2.249m surplus can be achieved in the year;

Recommendations:

The Council of Governors is asked to note the finance Report for Month 7.

2




deliver more at better value.



Links to BAF / Operational Risk Register N/A


N/A


Report on progress against financial plan for FY18 as at Month 7

Legal implications / impact N/A


N/A


Trust Board


N/A

Summary Finance Report to 31 October 2017 (Month 7)

aperry

Typewritten Text

Agenda Item: 14.1

aperry

Typewritten Text

aperry

Typewritten Text

aperry

Typewritten Text

aperry

Typewritten Text

aperry

Typewritten Text

2

Summary Finance Report to 31 October 2017

Contents:

Executive Summary

Appendix 1 – Use of Resources Metric

Appendix 2 – Directorate Report

Appendix 3 – Cost Improvement Programme

Scott Haldane

Director of Finance

3

Executive SummarySummary of PerformanceAt the end of period 7, the Trust is reporting a deficit of £1.176m, against a planned surplus of £0.646m. This financial performance generates a

performance of 3 against the Use of Resources Metric. The financial performance continues to be monitored in detail at the PRE meetings and

Clinical Directorates are actively progressing plans to ensure delivery of the CIP target and the planned Control Total. There are also detailed

reviews across all areas of Corporate spend and CIP plans.

Key I&E issues:

• Income – ahead of plan in month 7 by £0.539m, including

funded STP developments of £0.240m. Shortfall in year to

date of £0.216m, including £0.594m under-recovery of STF

funding.

• Operating Expenditure – Pay Costs are £0.389m behind

plan in the ytd, although Agency costs are at a level 57%

above the Agency ‘cap’ set by NHSI. Non-pay costs are

overspent by £1.916m in the ytd.

Key Directorate issues:

• Clinical – underspend in month 7 of £0.094m, mainly due to

increased levels of income for service developments and

variable income generated by Tier 4 and Springbank wards.

See Appendix 2 for detailed analysis.

• Corporate – overspend of £0.004m in month 7. Again, see

Appendix 2 for detailed analysis.

Key Balance Sheet issues:

• Capex – Capital expenditure is behind plan by £0.604m at

the end of month 7, although spend in the period was above

plan. Business Cases are agreed through the Capital and

Infrastructure Committee on a monthly basis.

• Cash – actual cash held at the end of month 7 is £0.4m

ahead of plan, with a number of outstanding debts with C&P

CCG having now been settled.

Use of Resources Metric:

• Performance against the Use of Resources Metric is a

3 for the period against a planned 2. The Agency

Spend Metric is a 4 which triggers the over-ride and

thus the maximum rating can only be a 3.

CIP:

• Under-delivery of £163k in month 7, bringing YTD performance to £1.096m

behind plan – for further information please see Appendix 3.

• Directorates and Corporate areas are reviewing and refreshing CIP plans to

address the in-year underperformance and identify recurring savings to

ensure the balance c/f into FY19 is minimised.

Key Risks and Actions:

• Income – non-payment of CQUIN due to failure to meet targets.

• Expenditure – continue to focus reduction in Agency expenditure. Comprehensive

review of non-pay costs. Contingency plans to ensure Control Total is met.

• CIP – further work to deliver recurring savings and address unidentified gap.

A detailed Finance Report is provided to members of the Business and Performance

Committee on a monthly basis.

Summary Key Financial Performance Indicators

Month 7 & Year to date Plan Actual

Plan to

Date

Actual to

Date

£m £m £m £m £m £m

Income 16.689 17.228 0.539 119.201 118.985 (0.216)

Operating Expenditure (15.661) (16.450) (0.789) (113.423) (114.949) (1.526)

EBITDA 1.028 0.778 (0.250) 5.778 4.036 (1.742)

Financing (0.732) (0.753) (0.021) (5.132) (5.212) (0.080)

Net Surplus/(deficit) 0.296 0.025 (0.271) 0.646 (1.176) (1.822)

EBITDA % 6.16% 4.52% -1.64% 4.85% 3.39% -1.46%

I&E Surplus Margin % 1.77% 0.15% -1.63% 0.54% -0.99% -1.53%

Agency Spend (0.564) (0.786) (0.222) (3.834) (5.782) (1.948)

Agency Spend % 4.7% 6.3% -1.6% 4.5% 6.8% -2.3%

Capex (0.456) (0.657) (0.201) (2.846) (2.242) 0.604

Cash and Cash Equivalents 12.1 12.5 0.4

Use of Resources 2 3

Month 7 Year to Date

Variance

Favourable

/ (Adverse)

Variance

Favourable

/ (Adverse)

Use Of Resource Metric for CPFT

4

Appendix 1 – Use of Resources Metric (UoR)

The Use of Resources Metric is used to assess the financial performance of all NHS Provider Organisations.. This includes a range of financial planning metrics,

including performance against the Agency Cap in the overall rating. The scoring is a range from 1 to 4 with 1 being the best performance.

The metrics and associated weightings are highlighted in Table 1, with the Trusts performance highlighted in Table 2. Actual performance is behind plan at the end of

the period. Should this continue then NHSI may take a more active interest in the Trusts financial position.

Table 1: Finance and use of resources metrics Table 2: CPFT Performance

Rating at Month 7 is a 3 as a result of the level of

Agency Spend against ceiling and the I&E

Margin rating delivering a 4, and triggering the

override so maximum rating can only be a 3.

Extract from Single Oversight Framework

The overall finance and use of resources score is a mean average of the scores of the

individual metrics under this theme, subject to any support needs being identified in value for

money – except that:

- if a provider scores 4 on any individual finance and use of resources metric, their overall

use of resources score is at least a 3 – i.e. cannot be a 1 or 2 – triggering a potential

support need

- if a provider has not agreed a control total, then where they are planning a deficit their

use of resources score will be at least 3 (i.e. it will be 3 or 4). Where they are planning a

surplus their use of resources score will be at least 2 (i.e. it will be 2, 3 or 4).

As we continue to develop a shared approach to use of resources with CQC we may seek to

revise the finance and use of resources metrics used in the Single Oversight Framework. If

we do so, we will consult as needed.

Finance and use of resources rating 03PLANYTD 03ACTYTD

Plan Actual

Plan Actual

31/10/2017 31/10/2017

YTD YTD

£'000 £'000

Capital service cover rating 2 3

Liquidity rating 3 3

I&E margin rating 2 4

I&E margin: distance from financial plan 3

Agency rating 2 4

Overall rating unrounded 3.40

If unrounded score ends in 0.5 0.00

Plan risk ratings before overrides 3

Plan risk ratings overrides:

Any ratings in table 6 with a score of 4 override -

if any 4s "trigger" will show hereTrigger

Any ratings in table 6 with a score of 4 override -

maximum score override of 33

Control total override - Control total accepted Yes

Control total override - Planned or Forecast

deficitYes

Control total override - Maximum score (0 = N/A) 0

Is Trust under financial special measures No

Risk ratings after overrides 3

5

Appendix 2 - Directorate AnalysisIn-Month Variations

The Clinical Directorates are reporting a £94k

favourable variance in-month against Plan, with

a £10k favourable variance for the year to date.

- Adult & Specialist Mental Health has an

underspend of £80k in-month. This includes

additional Income on Springbank Ward

(£28k) and for FRS (£36k). There are

continuing vacancies across a range of

services which are helping offset the OATS

spend above plan in the month (£58k) where

there were 9 OOA placements at the end of

Oct.

- Children, Young People and Families has

a £54k underspend in the month. This

includes additional income for Neuro

Development service (£30k) and over

performance for Tier 4 income due to

increased activity on Darwin (£19k).

- Older People’s and Adult Community has

an overspend of £40k in month. This includes

Increased temp staff costs on

Denbigh/Welney wards, plus additional costs

for 2 x Consultant appointments. Savings

from Community team vacancies continue to

mitigate CIP.

The Executive Portfolios are collectively

reporting an overspend of £4k in the month.

CEO includes £23k for Annual Members

meeting/election costs, and £10k for World MH

day. Minor works spend was as planned in the

month. The YTD position includes £850k unmet

CIP.

The Block Contract Income variance is mainly

the STF funding not recovered. To date, this

amounts to £592k.

Directorate / ServiceAnnual

PlanPlan Actual

Plan to

Date

Actual to

Date

£m £m £m £m % £m £m £m %

Clinical Directorates

Adult and Specialist Mental Health (37.911) (2.963) (2.883) 0.080 2.7% (22.286) (22.185) 0.101 0.5%

Children, Young People and Families (12.279) (0.994) (0.940) 0.054 5.4% (7.317) (7.374) (0.058) (0.8%)

Older People's and Adult Community (58.709) (4.880) (4.920) (0.040) (0.8%) (34.666) (34.700) (0.034) (0.1%)

Total Clinical Directorates (108.899) (8.837) (8.743) 0.094 1.1% (64.269) (64.259) 0.010 0.0%

Executive Portfolios

Chief Executive Office (1.369) (0.114) (0.153) (0.039) (33.8%) (0.799) (0.989) (0.190) (23.8%)

Chief Operating Officer (0.411) 0.010 (0.001) (0.011) 111.4% (0.240) (0.450) (0.210) (87.4%)

Director of Finance (31.947) (2.589) (2.514) 0.075 2.9% (18.558) (18.742) (0.184) (1.0%)

Director of Nursing (2.698) (0.263) (0.283) (0.020) (7.7%) (1.655) (1.811) (0.157) (9.5%)

Director of People Services (5.545) (0.462) (0.494) (0.032) (6.9%) (3.235) (3.428) (0.193) (6.0%)

Medical Director (1.967) (0.164) (0.157) 0.007 4.2% (1.148) (1.116) 0.032 2.8%

Social Care & Integration (0.960) (0.130) (0.114) 0.016 12.1% (0.513) (0.583) (0.070) (13.5%)

Total Executive Portfolios (44.898) (3.712) (3.716) (0.004) (0.1%) (26.147) (27.120) (0.972) (3.7%)

Trust Financing 1.149 0.096 0.064 (0.032) (33.4%) 0.670 0.450 (0.220) (32.8%)

Research & Development (0.157) (0.000) (0.001) (0.001) 228.4% (0.149) (0.151) (0.002) 1.6%

Reserves 0.057 0.212 0.000 (0.212) (100.0%) 0.065 0.098 0.034 52.0%

CIP Risk Reserve (0.339) (0.034) 0.000 0.034 (100.0%) (0.163) 0.000 0.163 (100.0%)

Total Net Expenditure (153.088) (12.275) (12.396) (0.121) -1.0% (89.993) (90.982) (0.989) -1.1%

Block Contract Income 155.337 12.571 12.421 (0.150) (1.2%) 90.639 89.805 (0.834) (0.9%)

Net Surplus / (Deficit) 2.249 0.296 0.025 (0.271) 0.646 (1.177) (1.823)

Variance

Favourable /

(Adverse)

Variance

Favourable /

(Adverse)

Month 7 YTD Month 7

6

Month 7 delivery is adverse to plan, bringing the

YTD delivery to £1,096k behind plan.

Of the performance in the year to date, 49% of the

delivery is mitigating savings and not savings as

per the original plan. Unmet savings c/fwd to FY19

business planning are anticipated to be £2.1m,

28% of total CIP plan. Directorates have been

asked to continue to progress delivery of their

recurring plan, and also to ensure that the

unidentified balance is addressed.

Scheme

Annual

Savings

Target

Value

Unidentified

Balance

Target

Savings

YTD

Total

Savings

YTD

Variance

YTD

FYE

Savings

FY19

Unmet CIP

C/fwd FY19

Plans by Directorate

Adult & Specialist 2,393 903 1,191 1,292 101 2,169 -224

Older Peoples & Adults Community 2,361 -187 1,377 1,338 -40 2,049 -312

Childrens 880 331 356 133 -222 774 -106

Corporate 1,801 211 1,050 201 -850 442 -1,359

Non Recurrent Trust Wide 486 486 284 -284 0 -486

CIP Risk Reserve -339 -339 -198 0 198 339

TOTAL 7,581 1,405 4,060 2,964 -1,096 5,434 -2,147

Appendix 3 – Cost Improvement Plan Analysis

1

Agenda Item: 15


REPORT

Subject: Fit and Proper Person Declaration


Author: Lauren MacIntyre, Trust Secretary


Executive Summary: In line with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 5; all Directors and equivalents, on appointment to the Trust must be ‘Fit and Proper Persons’. The Trust Secretary has completed the Trust’s annual Fit and Proper Person review of the Board of Directors.

Considering the information obtained, the Trust Chair in her responsibility to discharge the requirement placed on the Trust to ensure that all directors meet the fitness test, is content that the Board of Directors remains Fit and Proper.

Recommendations:


2




able to deliver more at better value.



Links to BAF / Operational Risk Register

Fit and Proper Person checks provide some assurance that the Board of Directors is able to carry out their duties effectively.


This would impact CQC standards of ensuring that the Trust was safe, effective, caring, responsive and well led.


Fit and Proper Person checks provide some assurance that the Board of Directors is able to carry out their duties effectively. If they are not fit to do so this would have financial consequences for the Trust.

Legal implications / impact Without assurance that each member of the Board of Directors is a Fit and Proper Person, The Trust would

3

breach the Health and Social Care Act 2012


The Trust must be transparent that all Board members are Fit and Proper Persons to enhance public and stakeholder confidence in the Trust


Board of Directors


No

Fit and Proper Person Annual Declaration

1. Purpose

To ensure that all members of the Board of Directors are Fit and Proper Persons and therefore able to carry out their duties effectively.

2. Background

In line with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014:

Regulation 5; all Directors and equivalents, on appointment to the Trust must be fit and proper

persons. This means that they must meet the below criteria:

a. the individual is of good character,

b. the individual has the qualifications, competence, skills and experience which are necessary for the relevant office or position or the work for which they are employed,

c. the individual is able by reason of their health, after reasonable adjustments are made, of

properly performing tasks which are intrinsic to the office or position for which they are

appointed or to the work for which they are employed,

d. the individual has not been responsible for, been privy to, contributed to or facilitated any

serious misconduct or mismanagement (whether unlawful or not) in the course of carrying

on a regulated activity or providing a service elsewhere which, if provided in England, would

be a regulated activity, and

e. none of the grounds of unfitness specified below apply to the individual:

1. The person is an undischarged bankrupt or a person whose estate has had

sequestration awarded in respect of it and who has not been discharged.

2. The person is the subject of a bankruptcy restrictions order or an interim bankruptcy

restrictions order or an order to like effect made in Scotland or Northern Ireland.

4

3. The person is a person to whom a moratorium period under a debt relief order applies under Part VIIA (debt relief orders) of the Insolvency Act 1986.

4. The person has made a composition or arrangement with, or granted a trust deed for, creditors and not been discharged in respect of it.

5. The person is included in the children's barred list or the adults' barred list maintained under section 2 of the Safeguarding Vulnerable Groups Act 2006, or in any corresponding list maintained under an equivalent enactment in force in Scotland or Northern Ireland.

6. The person is prohibited from holding the relevant office or position, or in the case of an individual from carrying on the regulated activity, by or under any enactment.

3. Audit

The Trust Secretary has completed the annual review of the Board of Directors, including:

Insolvency / Bankruptcy Register Annual Clearance

Disqualified Directors Register Annual Clearance

Board Code of Conduct

Annual Fit and Proper Person Declaration

DBS

Appraisal forms

Declarations of Interest

Personal file checks to ensure they contain employment history, qualifications, proof of ID, references etc

Considering the information obtained, the Trust Chair in her responsibility to discharge the requirement placed on the Trust to ensure that all directors meet the fitness test, is content that the Board of Directors remains Fit and Proper.

It is Trust policy to renew DBS checks every three years so some Board members are currently completing this process.

In line with best practice all decision making individuals, including governors, should be Fit and Proper Persons. Therefore the Trust Secretariat will continue to work with governors to ensure that this requirement is met. The Trust Secretariat is also completing a thorough personal file audit for members of the Board of Directors and Council of Governors to ensure that these files remain fit for purpose and contain all of the required information.

4. Council Action


1

Agenda Item: 16


REPORT

Subject: Nomination Committee Terms of Reference




Executive Summary: Executive Summary: The attached Nomination Committee reviewed its Terms of Reference at its meeting on the 02 June 2017. It is required to review and updated the Terms of Reference annually. All suggested changes have been highlighted within the attached document. Recommendations: The Council of Governors is asked to review and approve the updated Terms of Reference, subject to any requested amendments.

2







Links to BAF / Corporate Risk Register Strategic Goal and Objective two.


The Terms of Reference is linked with the Trust’s Constitution.


Yes, The Board and Council of

Governors must be assured that the Nomination Committee has considered Non- Executive performance and objectives so that the Trust can maintain its financial integrity.

Legal implications / impact Non-compliance with the NHS Foundation Trust Code of Governance


N/a


None


N/a

COUNCIL OF GOVERNORS’ NOMINATIONS COMMITTEE

TERMS OF REFERENCE 1. CONSTITUTION

1.1 The Board of Directors hereby resolves to establish a Committee of the

Council of Governors to be known as the Nominations Committee (‘the Committee’).

1.2 The Constitution and Terms of Reference of the Committee shall be as set

out below, subject to amendment by the Council of Governors.

1.3 The Standing Orders of the Council of Governors, as far as they are

applicable, shall apply with appropriate alteration to meetings of the Committee.

2. PURPOSE

The Committee shall:

2.1 From time to time, and not less than every three years, rReview the experience and skills mix of the Non-Executive Directors

2.2 Receive the views of the Board of Directors about the skills and experience

required of Non-Executive Directors.

2.3 Be responsible for selecting candidates through open competition to fill Non-

Executive Director vacancies, taking account of the skills and experience required. Make recommendations to a general meeting of the Council of Governors for approval of the appointment as and when required.

2.4 Receive reports on behalf of the Council of Governors on the process and

outcome of appraisal for the Chair and Non-Executive Directors.

2.5 Make recommendations to a Council of Governors meeting concerning the reappointment of any Non-Executive Director at the conclusion of their specified terms of office giving due regard to their performance and ability to continue to contribute to the Board in the light of knowledge, skills and experience required.

2.6 Provide recommendations to the Council of Governors on remuneration and

allowances for the Chair and Non-Executive Directors.

2.7 Keep the Board of Directors and the Council of Governors informed of the process, procedures and timetable for nominations.

2.8 Ensure that any Non Executive Director appointed meets ‘Fit and Proper Person’ requirements in line with Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 5.

3. DUTIES

The functions of the Committee are set out within the Trust’s Constitution, Standing Orders for the Board Council of Governors and paragraph 2 above.

4. COMMITTEE SECRETARY/ADMINISTRATION 4.1 The Trust Secretariat shall minute the proceedings and resolutions of all

Committee meetings, including the names of the committee present and those in attendance.

4.2 A member of the Committee shall not disclose a matter dealt with, by, or

brought before the Committee without its permission until the Committee has reported to the Council of Governors or has otherwise concluded that matter.

4.3 A member of the Committee shall not disclose any matter reported to, or

otherwise dealt with by the Committee, notwithstanding that the matter has been reported or action has been concluded, if the Council of Governors or the Committee shall resolve that it is confidential.

4.4 The minutes of each meeting will be signed by the Chair and retained by the Trust Secretariat as a true and accurate record of discussions. All minutes are to be held securely by members of the Committee. The Trust Secretariat will maintain the official Nominations Committee file for record purposes. 5. CHAIR The Chair of the Committee shall be the Chair of the Trust (or the Deputy Chair), unless the Committee is discussing the appraisal, remuneration or appointment of the Non-Executive position of Trust Chair (or Deputy Chair), in which case the Chair/ Deputy Chair shall not be present during the discussion and the Committee shall be chaired as provided for by the Trust’s constitution and Standing Orders for the Council of Governors. 6. MEMBERSHIP

6.1 Membership of the Committee shall consist of Governors appointed by the Council of Governors and shall be in accordance with the Constitution and shall be composed of

• Chair of the Trust (Chair) or Deputy Chair – unless standing for appointment

• 3 elected Governors (one of these to be the Lead Governor by virtue of office)

• 1 appointed Governor

6.2 Appointments to the Committee shall be for a period of up to three years, which may be extended for a further three year period. Membership of this Committee will end in advance of this should the individuals leave their Governor/Non-Executive Director role before the end of their Term of Office. 6.3 For periods of Non- Executive recruitment the Committee may co opt

additional Governors to sit upon any selection and interview panels. 7. ATTENDEES 7.1 Only members of the Committee have the right to attend meetings. However,

other individuals such as the Chief Executive, Director of People & Business Development, Trust Secretary and external advisers as and when required by the Committee may be invited to attend for all or part of any meeting.

7.2 The Committee may appoint, in conjunction with the Director of People &

Business Development, external independent specialist advisers. 8. QUORUM

Two out of four governors should be present. 9. ACCOUNTABILITIES

9.1 The Committee is accountable and responsible to the Council of Governors 9.2 The Committee is expected to conduct its affairs in accordance with the

Trust’s values, the Standing Orders for the Council of Governors and the Code of Conduct.

10. REPORTING ARRANGEMENTS FROM THE COMMITTEE

The Committee shall report to the Council of Governors by means of reports setting out the matters discussed and the Committee’s recommendations to the Council of Governors.

11. MEETING FREQUENCY

The Committee will meet at least annually and/or as required to fulfil its duties as the Chair shall decide.

12. KEY RELATIONSHIPS

• Council of Governors

• Board of Directors

• Director of People and Business Development

• Chief Executive

• Trust Secretariat

13. REVIEW The Terms of Reference will be reviewed on an annual basis by the members of the Committee and shall be approved by the Council of Governors.

Council of Governors Meeting AGENDA meeting 13... · The minutes from the Council of Governors...

Documents

Transcript of Council of Governors Meeting AGENDA meeting 13... · The minutes from the Council of Governors...