GENERAL MEETING OF THE COUNCIL OF GOVERNORS OF … · 2015. 11. 27. · COUNCIL OF GOVERNORS –...

GENERAL MEETING OF THE COUNCIL OF GOVERNORS OF BARNSLEY HOSPITAL NHS FOUNDATION TRUST

5.30-7.30PM, 03 DECEMBER 2015 IN THE EDUCATION CENTRE, BARNSLEY HOSPITAL

AGENDA

1. Apologies & Welcome 2. To invite comments from members of the public 3. To receive any declarations for interest for the meeting 4. To approve Minutes of the General Meeting held on 01 October 2015 and Enc 4a&b

Annual General & Public Members Meeting on 24 September 2015 5. To consider any matters arising from the Minutes of the last General Meeting 6. To receive a briefing on the role of the Director of Strategy & Business Planning; Presentation

to include an overview of the 2016/17 business plan process – Mr B Kirton, Director of Strategy & Business Planning

7. To approve the annual review of the Trust’s Constitution (final) Enc 7 – Ms A Keeney, Assoc Director of Corporate Affairs

8. to receive and approve the following reports from the Nominations Committee Encs 8a&b – Latest update report, from Mr S Wragg, Chairman – Mid Year review of Chairman’s performance, from Mr J Unsworth, Lead Governor

9. To receive a report from the Trust’s Chairman, Mr S Wragg Enc 9 10. To receive a report from the Lead Governor, Mr J Unsworth Enc 10 11. To receive an update report from the Trust’s Chief Executive, Ms D Wake Enc 11 12. To receive latest update report from the Council of Governors’ sub-groups Enc 12

– Mr Ramsey (Chair, Quality & Governance) and Mr D Brannan (Chair, Finance & Performance)

13. To receive and note reports from the Board of Directors Enc 13 – latest Board agenda and Minutes (meetings held in public) – latest monthly integrated performance report – Horizon Scanning report

14. To consider issues raised by Governors – items highlighted in pre-meeting – feedback from recent regional meeting Presentation - Ms A Moody, Mr T Smith & Mr Z Warraich, Public Governors

15. Any other business, including – matters raised by the public – date of the next General Meeting: - to be agreed

16. To resolve that representatives of the press and other members of the public be excluded from the final part of this meeting having regard to the confidential nature of the business to be transacted, publicity on which would be prejudicial to the public interest in accordance with 8.13.2 and 8.13.3 of the Trust’s Constitution.

Signed: ………………….. Chairman 1

COUNCIL OF GOVERNORS – DECEMBER 2015 REF: CG/15/12/04.a

04a

MINUTES OF A GENERAL MEETING OF THE COUNCIL OF GOVERNORS HELD ON 03 OCTOBER 2015, 5.30PM

IN THE EDUCATION CENTRE, BARNSLEY HOSPITAL

Present: Mr D Brannan Partner Governor, Voluntary Action Barnsley Mrs P Buttling Public Governor, Barnsley Public Constituency Mr A Dobell Public Governor, Barnsley Public Constituency Mr A Grierson Public Governor, Barnsley Public Constituency

Mr B F Leabeater Public Governor, Barnsley Public Constituency Mr P Lleshi Partner Governor, Barnsley Together

Mr C Millington Partner Governor, Barnsley Clinical Commissioning Group Ms A Moody Public Governor, Barnsley Public Constituency Mr H Patel Public Governor, Barnsley Public Constituency Mr J Ramsey Staff Governor, Non Clinical Support Staff Mr R Raychaudhuri Staff Governor, Medical & Dental Mrs C Robb Public Governor, Barnsley Public Constituency Mr F Skorrow Public Governor, Barnsley Public Constituency Mr T Smith Public Governor, Barnsley Public Constituency Mr D Thomas Public Governor, Barnsley Public Constituency Mr J Unsworth Lead & Public Governor, Barnsley Public Constituency Mr S Wragg Trust Chairman

In attendance: Ms C Dudley Secretary to the Board Mr J Fernandez Associate Director of HR&OD

Ms A Keeney Associate Director of Corporate Affairs Mr W Robson Patient Safety & Quality Lead * Ms D Wake Chief Executive Mr M Wright Acting Director of Finance * * attended part of meeting

Apologies: Mr P Ardron Partner Governor, Sheffield Universities Mr A Conway Staff Governor, Volunteers Mrs J Gaines Public Governor, Barnsley Public Constituency

Ms R Hewitt Staff Governor, Clinical Support Services Mr M Jackson Partner Governor, Joint Trade Unions Committee

Ms G Morritt Staff Governor, Nursing & Midwifery Mrs D Murray Partner Governor, Barnsley College Mrs J O’Brien Public Governor, Barnsley Public Constituency Cllr J Platts Partner Governor, Barnsley MBC Mrs L Sanderson Staff Governor, Nursing & Midwifery Mr L Steenson Public Governor, Public Constituency O (out of area) Mr Z Warraich Public Governor, Barnsley Public Constituency

CG/15 70 APOLOGIES & WELCOME The Chairman welcomed Governors, Directors, and staff to the meeting. Apologies were noted as above. Apologies had also been received from Mr Mapstone, Non Executive Director.

Action

3

CoG Dec 2015/ 10 Oct Mins 2015 / page 2 of 8

CG/15 71 COMMENTS FROM THE PUBLIC None.

CG/15 72 DECLARATIONS OF INTEREST None

CG/15 73 MINUTES OF LAST MEETING (Enc 4)

The Minutes of the General Meeting held on 6 August 2015 were received and accepted as a true record.

CG/15 74 MATTERS ARISING The following updates were noted:

• CG 15/62 – Chairman’s report Plans were in progress to schedule in more mystery shopper exercises with Governor participation; the first series had proved very useful.

• CG 15/64 – CEO’s report: Financial position/Budget The financial position remained strained and no additional payments had yet been agreed with the Clinical Commissioning Group (CCG). Mr Smith reported on feedback from a recent meeting of the CCG’s Governing Body, at which it had been stated that all attendances at the Emergency Department would be paid for throughout the winter months. This was confirmed but the difficulties related to payments received not at full costs (ie higher activity levels), being unable to plan against unforeseen demands and working in a department built for 250 patients now seeing nearer 280 patients per day. With reference to winter pressures, it was acknowledged that these were becoming increasingly constant, creating greater demands on services with more need for agency support. Service demands in the winter had previously created a higher volume but shorter stays. This had changed, with higher acuity and more complex care needs now being seen. Demand pressures were not always foreseeable and had been impacted recently by the short term closure of 37 beds in one of the community hospitals. Where escalation needs did arise, the Trust drew on staff from other teams to support these areas but this in turn created backfill needs alongside current vacancies. Overall the Trust’s agency spend remained low compared to other trusts but it was still higher than plan and work continued to reduce it where possible. Governors were conscious of the changing profile of patients generally, with more older people and higher levels of dementia patients too. The Chief Executive confirmed that quality of care remained the priority for the Trust. Dementia affected people across every spectrum; the Trust’s Lead Dementia Nurse was very passionate about developing the care of dementia patients of all ages. The need for further investment in primary care and the development of more integrated services was acknowledged. The CCG was looking at options for the way forward and the Trust would continue to offer support wherever possible.

4


CG/15 75 INTRODUCTION TO HUMAN FACTORS Mr Robson introduced a brief presentation on Human Factors – a new focus in patient safety emerging in healthcare, based on learning from a range of other industries, such as airlines, that shared a focus on keeping people safe. Human Factors recognised that care was provided by humans and as such would be fallible, with consequences that could be significant for others. Findings indicated that errors were rarely caused by deficiencies in technical skills but more often related to non-technical skills and limitations. It was important to strengthen staff’s ability to challenge these factors: to develop the right environment and good working practices to reduce risk of human errors and, as both as employers and as individuals, create an awareness and take action against limiting factors such as lack of sleep, poor eating, lack of hydration, etc. Mr Smith enquired if the increase of technology in surgery and production would support this new approach. Mr Robson acknowledged that these and other innovations could go a long way to improving health services but advised that technology alone would not eliminate risks associated with key human factors such as communications and team working, and would still need to be supported by learning from Human Factors. The Governors were pleased to note the work in this field of development. Before leaving the meeting, Mr Robson was thanked for an informative and thought provoking briefing.

CG/15 76 ROLE OF THE DIRECTOR OF FINANCE Continuing the series of briefings on the differing roles of members of the Board and Executive Team, Mr Wright introduced himself as acting Director of Finance. He gave an overview of his background in healthcare in terms of patient experience (personally and family members) and his working career, including 14 years within the NHS: the last two as Deputy Director of Finance at Barnsley Hospital NHSFT (BHNFT) until being appointed to the acting Director role in July 2015. Mr Wright highlighted a number of aspects – not in any order of priority – which he believed were currently key to his remit: • working with commissioners to achieve the best possible settlement and

developing a good relationship with them • accurate and robust data – by clinical or corporate business unit (CBUs)

and service – to identify and respond to good performance and pressure points. It was also important to work with the CBUs to help them use the data to improve performance and effectiveness. Also using it to look at services across the Trust: not every one would directly make a positive contribution but some would still be essential and others may be subject to further review

• review of accounts payable • agency grip (good but could be better) • continued and more learning around cost pressures • delivering the business plan

In response to Governors’ questions, Mr Wright confirmed that the procurement team continued to work well, with savings of £1million achieved in 2014/15 and on track to deliver a further £1 million in 2015/16. The pharmacy robot had supported efficiencies in procurement too, with improved stock management and a reduction in stockholdings; a full report

5


had been shared with the CCG, demonstrating these and other benefit realisations from the pharmacy robot. He also advised that payments to suppliers were challenging in view of the pressures on cashflow but good relationships had been fostered with external suppliers to reach favourable payment terms. Debtors were being well managed too. He confirmed that the Trust did hold a small contingency for voluntary severance but spend against this had been very limited to date (no early retirements). Mr Wright acknowledged that both CIP and finance were behind plan, the first largely due to deferral of the bed reconfiguration scheme but other plans were being developed to ensure the full programme was achieved as it had been in 2014/15. He also emphasised that value for money (VFM) remained high on the Trust’s agenda. Staff across the Trust were aware that the procurement team alone was not responsible for VFM; the team worked closely with the CBUs to ensure best options for the Trust. The briefing was appreciated and Governors looked forwarding to continuing to work with Mr Wright.

CG/15 77 CHAIRMAN’S REPORT (Enc 8) The Chairman’s report on a range of activities carried out on behalf of the Trust since the last General Meeting and items of interest for the Governors was received and noted. Issues highlighted in discussion included: • the ongoing governors’ elections for six seats in the Barnsley Public

Constituency and three seats in the staff constituencies. The Chairman and Mr Unsworth would welcome support at the election workshops, intended to help those who are looking to become governors gain more understanding about the demands and responsibilities of the role,

• the work of the Nominations Committee to progress the appointment/ reappointment of a Non Executive Director from 1st January 2016, and

• Barnsley Hospital Charity.

CG/15 78 CONSTITUTION REVIEW (Enc 9) The report outlined the rationale for the latest review of the Trust’s Constitution. The review had been undertaken by a working group open to Governors and Directors, led by Ms Keeney who expanded on the findings and recommendations set out in the report. The working group had considered a series of issues flagged to them by Governors and by the Trust’s independent election scrutineers as well as changes in the Trust’s working practice and statutory requirements. Following discussion of each of the issues outlined in section 3 of the report, the Committee approved in principle the recommendations to: a) update the election rules to reflect the Model Rules issued by NHS

Providers, which would support a gradual move to electronic voting – subject to further consideration of the suggestions raised by UK-Engage

b) incorporate the “Fit and Proper Persons Requirements (FPPR)” for Directors – and reflect it in the Code of Conduct for Governors, and

c) remove reference to “the initial Chief Executive”, which had been a legacy from when the Trust first became established as a foundation trust but was no longer applicable.

It was confirmed that the proposals had also been reviewed and supported by the Board of Directors. Work on the Election Rules would be progressed

6


with UK-Engage to enable the completed and revised Constitution to be presented to the Council of Governors and Board of Directors at their respective meetings in December, for final approval.

AK

CG/15 79 LEAD GOVERNOR’S REPORT (Enc 9) Mr Unsworth’s report on his activities as Lead Governor over the past two months was received and noted. He repeated his thanks to Mrs Buttling for presenting the Governors’ report at the Annual General & Public Members’ Meeting (AGPMM) in his absence this year. Mr Unsworth also highlighted the continuing development of support for Governors by NHS Providers and encouraged Governors to register on the NHS Providers website and/or follow them on Twitter.

CG/15 80 CHIEF EXECUTIVE’S REPORT (Enc 10) Ms Wake presented and expanded on her report. Governors were pleased to note the further lifting of the Breach of Licence by Monitor at the end of September, leaving the Trust with one remaining endorsement to address – re finance. This was not expected to be lifted until the Trust returned to financial balance. Ms Wake also reported on a recent press release from one of the Unions represented at the Trust. It had been discouraging on a number of levels: firstly the potential reputational damage to the Trust, particularly as the release was inaccurate in several points; secondly on receipt of the initial email outlining the concerns, the CEO and Director of Nursing & Quality had visited the ward in question – none of the staff on the ward supported the report although Ms Wake had herself raised one concern, which she had acted upon immediately; thirdly, there had been an open invitation for the union representative(s) to meet with Ms Wake to discuss the issues further – this had not been taken up; and, lastly, the Unions did have representation on the Council of Governors and could have raised their concerns at the General Meeting. It had been suggested that the staff representative involved (a governor himself) had not issued the release to the press but rather this had been done by his branch office without his knowledge. The action may have been hasty and it was certainly disappointing in view of the CEO’s offer to meet. The Trust had issued a response and reporting to date had been balanced, which was encouraging. Mr Millington also commented on the CEO’s work on raising the profile of the hospital, which he hoped would give weight to the Trust’s comments on the issues. It was stressed that no-one wished to curtail individuals’ rights to express concerns, indeed the Board actively encouraged it – but there were more constructive ways of doing so. Mr Grierson had received reports about the changes proposed for Ward 14. Ms Wake acknowledged that it was always difficult to achieve the right balance between optimum services, patient safety and efficiency. She assured the meeting that the changes had taken account of the demand patterns for the ward and that work would be progressed with the clinicians involved to ensure the pathways were right. The changes would be monitored closely and tested once implemented. The Chairman appreciated that change inevitably created unrest but reaffirmed that no actions would be taken or continued that would compromise patient safety or quality. Nevertheless changes had to be made to deliver care more effectively within the Trust’s financial constraints.

7


Mr Unsworth noted the award of NHS Vanguard status to the Working Together project. Ms Wake advised that the import of this award would become clearer as the work progressed and it was hoped that it would help to raise the hospital’s profile further and draw in more funding too. The risk of this, or similar work elsewhere, being deemed anti competitive had been recognised by commissioners nationally and was expected to be addressed on that basis if/when it arose.

CG/15 81 SUB-GROUP REPORTS (Enc 12) The report on the latest meetings of the Governors’ sub-group – Finance & Performance (FPSG) and Quality & Governance (QGSG) was received and noted. Mr Ramsey reminded Governors of the open invitation to attend sub-group meetings and advised that the next QGSB meeting would be receiving reports on the latest PLACE (Patient Lead Assessment of the Care Environment)/PEAT (Patient Environment Action Team) assessments, from Mrs Christopher, the Associate Director of Estates & Facilities. In relation to this, the Chairman referred to recent feedback regarding limited food options in the hospital restaurant. He and the Chief Executive had since received assurance that this had been addressed: the food offer had been changed after 2pm but there would still be hot food and snacks available in the restaurant throughout the usual opening hours. Nevertheless Mr Smith advised that he had been unable to obtain hot food at 5pm very recently. This was noted and would be reported back to Mrs Christopher. The Chairman encouraged Governors to share any further reports with Mrs Christopher at the forthcoming QGSG meeting. In terms of the work of the FPSG, Mr Brannan reminded Governors of the call for suggestions for this year’s Annual Development Session. He also highlighted the continuing training programme, which had been re-launched in 2015 and had proven very useful to Governors. Mr Dobell was pleased to report on his first attendance at the Trust’s Audit Committee as Audit Liaison Governor. The meeting had been Chaired by Mrs Brain England (NED). The other NED members comprised Mr Mapstone and Ms Moore, both of whom had continually asked penetrating questions, made sensible observations and clearly explored matters from a slightly different angle to the Executive Team. From his observations Mr Dobell had been assured on the work of the Audit Committee. He had also been pleased to hear informal outcomes from an independent review of the external auditors’ work on the Trust’s annual accounts for 2014/15. The review had been commissioned by Monitor and had included a week long inspection of the external auditors. No issues of concern had been identified, which was also assuring to him and should enable Governors to be more confident that the external auditors were working effectively. With reference to external reviews, Ms Wake advised that the Trust had recently received further requests for information for the Clinical Quality Commission’s (CQC) report following their visit to the Trust in July. Most trusts in the region who had been inspected had reported a span of over four months from the visit to receipt of the formal report. It was believed that Monitor would have taken account of informal feedback from the CQC when reviewing the Trust’s governance and it could be an encouraging sign that Monitor had recently lifted the governance endorsement reported earlier.

SW/ DW

8


CG/15 82 BOARD OF DIRECTORS (Enc 13) The agenda (October), Minutes (September) and latest integrated performance report as presented to the Board of Directors’ meeting held in public on 3rd October 2015 were received and noted. Ms Wake drew attention to the reported increase in Clostridium Difficile (C.Diff), with nine cases against the trajectory of 13 for 2015/16. As pointed out by Mr Brannan, this still reflected a significant improvement compared to the Trust’s historic position on infection. It was noted that the increase in C.Diff had been seen nationally and Governors were assured that the Trust’s Infection Prevention & Control Team continued to drive a lot of good work to maintain standards within the Trust. Mr Dobell also noted the report on handwashing – at 98.4%. This did not fully reflect the Governors’ observations during the mystery shopper exercise, although it was also acknowledged that it was not always possible to see every handwashing carried out. Ms Wake agreed that more challenge was needed in the report and undertook to progress this. In response to a query from Mr Leabeater, Ms Wake advised that a lot of work had been progressed around theatre utilisation to maximise efficiency and a revised theatre template had recently been developed as part of this (draft 9). Additionally an external group had been charged to look at three areas – ENT, Orthopaedics and Gynaecology – to analyse consultants and patients’ needs to get a better view of theatre maximisation. This had supported work to move to full day allocations of theatre space by specialities and a shift from 3.5 to 4 hours sessions, allowing consultants a full 8 hours scheduling. This would be introduced from 1st April 2016. The Chairman drew attention to the Quarter 2 result for emergency access, which was just under target despite a lot of hard work. This largely reflected the continued high demands. Staff were aware that achievement in Quarter 3 would be critical for the Trust and would be all the more challenging over key winter periods.

DW

CG/15 83 ISSUES RAISED BY GOVERNORS Mr Unsworth confirmed that all matters raised at the Governors’ pre-meeting had been addressed in discussions noted above. Referring back to discussions about changing work patterns on Ward 14, Mr Skorrow enquired how the shift away from weekend working aligned with the drive for 7-day services. Ms Wake reconfirmed that the changes would be monitored; the closure of the ward at weekend would not mean that essential services were not available 7-days, rather they would be provided differently. In response to a comment from Mr Grierson regarding the impact on staff, Ms Wake also assured the meeting that individual consultation had been carried out with the staff involved so that those who wished to work at weekends would still have the opportunity to do so. Staff protection schemes would also be in place for two years, as with any such changes.

9


CG/15 84 ANY OTHER BUSINESS & DATE OF NEXT MEETING The Chairman reminded Governors of the invitation to attend and participate in the Board of Directors’ meeting (public and private sessions) on 5th November 2015, starting at 9am. There being no further business the meeting ended at 7.25pm. The date of the next General Meeting was confirmed for 3rd December 2015, 5.30-7.30pm.

10

COUNCIL OF GOVERNORS – DECEMBER 2015 REF: CG/15/12/04b

04b

MINUTES OF THE ANNUAL GENERAL MEETING / ANNUAL PUBLIC MEMBERS MEETING HELD ON 24 SEPTEMBER 2015

IN THE EDUCATION CENTRE, BARNSLEY HOSPITAL

Present: Governors Mr D Brannan Partner Governor, Voluntary Action Barnsley Mrs P Buttling Public Governor, Barnsley Public Constituency Mr A Grierson Public Governor, Barnsley Public Constituency

Ms A Moody Public Governor, Barnsley Public Constituency Mr B F Leabeater Public Governor, Barnsley Public Constituency Ms G Morritt Staff Governor, Nursing & Midwifery Mrs J O’Brien Public Governor, Barnsley Public Constituency Mr H Patel Public Governor, Barnsley Public Constituency Mr J Ramsey Staff Governor, Non Clinical Support Staff Mrs C Robb Public Governor, Barnsley Public Constituency Mr F Skorrow Public Governor, Barnsley Public Constituency Mr Z Warraich Public Governor, Barnsley Public Constituency

Board Mrs S Brain England OBE Non Executive Director Mrs L Christon Non Executive Director Dr R Jenkins Medical Director Mrs K Kelly Director of Operations Ms H McNair Director of Nursing & Quality Ms R Moore Non Executive Director Mr F Patton Non Executive Director Mrs H McNair Director of Nursing & Quality Ms D Wake Chief Executive Mr S Wragg Trust Chairman

Apologies: Mr P Ardron Partner Governor, Sheffield Universities Mr A Conway Staff Governor, Volunteers Mr A Dobell Public Governor, Barnsley Public Constituency

Mrs J Gaines Public Governor, Barnsley Public Constituency Ms R Hewitt Staff Governor, Clinical Support Services

Mr M Jackson Partner Governor, Joint Trade Unions Committee Mr P Lleshi Partner Governor, Barnsley Together Mr N Mapstone Non Executive Director Mrs D Murray Partner Governor, Barnsley College Cllr J Platts Partner Governor, Barnsley MBC Mr R Raychaudhuri Staff Governor, Medical & Dental Mrs L Sanderson Staff Governor, Nursing & Midwifery Mr T Smith Public Governor, Barnsley Public Constituency Mr L Steenson Public Governor, Public Constituency O (out of area) Mr D Thomas Public Governor, Barnsley Public Constituency Mr J Unsworth Lead & Public Governor, Barnsley Public Constituency

11

CoG: Dec 2015 – 04(b) AGPMM Mins04b_AGPMM Sep 2015 / page 2 of 5

1. WELCOME & INTRODUCTION

The Chairman welcomed Governors, Directors, patients, members of the public and staff to the Annual General & Public Members Meeting. The meeting was an opportunity to present the Trust’s Annual Report & Accounts for 2014/15 to the Council of Governors and wider audience, report on progress to date, highlight plans for the year ahead and respond to questions anyone may have of the Board.

Action

2. OVERVIEW OF THE YEAR Ms Wake, the Trust’s Chief Executive, gave a brief overview of key highlights from the year, including progress since the deficit position was reported at the end of 2013/14 and endorsement notices issued against the Trust’s Provider Licence. The Trust had been subject to intensive external as well as internal review and had responded with a robust turnaround plan (work on which had commenced ahead of external findings), delivery of the plan to date had driven improvements in a number of areas, not least governance arrangements and performance management framework. The work had resulted in a return to compliance against the emergency access target in the first quarter of 2015/16; achievement of the 2014/15 financial plan; lifting of endorsements in emergency access and governance in 2015, and increase in Care Quality Commission (CQC) rating - from 4 to 5. Ms Wake also provided an overview of the Trust’s performance against 2014/15 key performance indicators, all of which had been met. It was acknowledged that none of this good progress would have been achievable without the engagement and support of the hospital’s great staff. This had been reflected in the development of Listening into Action and Bronze Accreditation for Investors in People (IIP). Ms Wake was pleased to share feedback from staff, governors, public and patients, which demonstrated their continuing support for the Trust, which was invaluable. Ms Wake handed over to the other speakers, each of whom expanded on the Trust’s progress in 2014/15 and plans for the future.

3. LISTENING INTO ACTION Ms Rastall gave a brief presentation on the Trust’s involvement with the Listening into Action (LIA) scheme - a national campaign aimed at engaging with employees to identify more ways to improve patient care. LIA was intended to listen to staff and find out what they thought was needed to improve patients’ experience at Barnsley Hospital and then to become involved in implementing those changes. A series of “quick wins” had already been initiated – including the simple suggestion of clear name badges, supporting the “Hello, my name is…” initiative, making sure staff introduced themselves so that patients knew who was talking to and caring for them. Ms Rastall also highlighted an opportunity for members of the public to get involved too, with a “Patients’ Conversation” event scheduled for 14th November, which everyone was invited to attend. The Trust welcomed this chance to listen to patients, their friends, families and carers, to hear their suggestions for service improvements too.

12


4. ANNUAL REPORT & ACCOUNTS 2014/15 The Annual Report & Accounts were presented and several members of the Board of Directors expanded on sections within the report: • Mrs Kelly, the Director of Operations, outlined the changes made to help

improve emergency access – not just to meet the national target, but to improve the experience for patients presenting at the Emergency Department, getting them cared for and admitted or back to their homes as quickly as possible. She gave an overview of improvements in non emergency medical, surgical, critical care, women’s, children’s and diagnostic services too. Mrs Kelly explained how these had been achieved through extensive efforts and new working practices within the Trust and working with partner organisations.

• Mrs McNair, the Director of Nursing & Quality, reported on the Trust’s Quality Account for 2014/15. This was integral to the Annual Report & Accounts, and gave a detailed insight into the quality of the services provided to patients. With input from staff, governors and members of the public, the Trust had devised a new Quality Strategy in the year, with four central goals: • to deliver patient-centred care • to deliver consistently safe care • to deliver consistently effective care • to build capacity and capability In her presentation she outlined just some of the actions taken to support these goals and the work being continued into 2015/16. Mrs McNair said that she felt privileged to be part of a Board that had kept such a strong focus on quality and patient safety despite the difficulties facing the Trust at this time.

• The Trust’s Medical Director, Dr Jenkins, expanded on the hospital’s ceaseless work around improving patient safety. This had been supported by the continued used and development of NEWS (national early warning system) and “sepsis six”, both of which were intended to ensure patients needs were identified and appropriate actions taken quickly on admission, and detailed review of, and learning from, all serious incidents (and cascading that learning across the Trust). The effectiveness of this work was being evidenced in the low infection rates and improved mortality ratios – but with more work ahead.

• Mr Wright, the acting Director of Finance, gave a detailed report on the Trust’s financial position at the year end for 2014/15 and its plans for the year ahead. The Trust had ended 2013/14 with a deficit, of -£9.9million, which, after taking other factors into account, led to an underlying position to -£20.0million. He explained the actions and the tough cost improvement programme planned and progressed throughout the year to improve the Trust’s financial position. None of the work had been easy but it had all been essential to improve finances and maintain patient safety, and had been supported by distress funding from the Department of Health. During the year the plans had also been impacted by a number of unforeseen costs, as shown in Mr Wright’s presentation. With the projected deficit for the year reduced to -£11.1million, the final year end outcome of -£11.8million was a good position albeit still a deficit one.

13


• Representing the Lead Governor, Mrs Buttling, a Governor from the Barnsley

Public Constituency, gave a brief report on the responsibilities and progress of the Council of Governors in 2014/15. The presentation outlined the core responsibilities of the Governors and just some of the work they had progressed in 2014/15 – including the appointment of two new Non Executive Directors. Governors had appreciated the briefings provided by the Board as the turnaround plan had progressed and training in key areas (including finance and services), to better equip them to deliver their core responsibilities of representing public and staff members and holding the Non Executive Directors to account. They had been closely involved with the governance reviews of the Trust, with the recent CQC inspection and the IIP accreditation assessment. Before closing her presentation, Mrs Buttling drew attention to the annual elections to the Council of Governors and encouraged those interested to attend one of the forthcoming workshops to learn more about becoming a Governor and their important role in the hospital.

• Looking at the current year, the Chief Executive outlined just some of the challenges being addressed to continue the return to a better financial position whilst still delivering – and improving – high quality services for Barnsley. Some of the good progress already achieved had been highlighted earlier and more hard work lay ahead. There would be a continued focus on achieving performance targets despite increased demands on services. No success was achievable without the support of a strong and committed workforce and the Board welcomed the opportunity to recognise at least some of the excellent staff involved with the monthly BRILLIANT Staff Awards and the annual HEART Award – a great way to celebrate their achievements.

• In closing presentation of the Annual Report & Accounts 2014/15, the Chairman thanked everyone involved for their contribution to the Trust, including the staff, volunteers, the executive team, Board, governors and members, all of whom continued to support their local hospital. The meeting was opened to questions from the floor.

5. QUESTIONS • Mr Warraich, a public Governor, enquired about the import of targets and

the Chairman acknowledged that views could vary – seeing them as both good and bad. Overall, however, he believed they were a welcome aide to ensure trusts delivered and maintained a good quality of care. He gave an example of hip operations, the waiting time for which had been reduced from 1-2 years in some areas to weeks with the advent of 18 week waiting time targets.

• It was queried how rigid cost improvement plans were managed and it was confirmed that these would be flexible when necessary. For instance there had been plans for a bed reconfiguration but this had been deferred due to operational pressures, and other efficiencies identified to offset the savings in year. The Chairman emphasised that no CIP scheme was progressed on financial benefits alone; each proposal was subject to stringent assessment to ensure the quality impacts were also taken into account. Quality remained the Board’s top priority.

14


• A member of the audience asked about staffing levels. It was acknowledged that all staff were working under pressure but the Board had agreed and maintained a better than average nurse staffing ratio, ably supported by healthcare auxiliaries.

• A gentleman in the audience pointed out the potential embarrassment for male patients attending breast clinics and having to enter the “women’s services” block to do so. This was accepted as a very valid observation and the Chairman and Chief Executive gave an assurance that this would be given further consideration with the service team.

• The gentleman also questioned why patients were not required to bathe before an operation, as had been the practice historically. The Chief Executive explained that systems had changed and more patients now attended for surgery as day patients or were only admitted on the day of their operation. She and the Director of Nursing & Quality stressed that patient’s skin would be cleaned and swabbed as part of their preparation for surgery, in accordance with the Trust’s infection prevention and control procedures.

• In response to a question from Mr Grierson, Public Governor, the Chief Executive confirmed that the Trust would be proceeding with plans to develop a 5-day ward in one area, if it was sensible to do so. Preparatory work had indicated this could be done in line with current patterns of patient needs. Support would be put in place to ensure safe cover for patients for that area who needed to stay in over a weekend. Work on this plan was expected to commence in November.

• The Chief Executive and Chairman also responded to questions and comments about electronic patient records (EPR). Continuing growth of EPR was a long established aim across the NHS and was underpinned by the Government’s directive of a paperless NHS by 2020. The Trust had introduced a new central computer system in 2014 as part of its move to more electronic recordkeeping. It was not a simple development and the need to ensure protection of patients’ data was imperative. Options were also being explored, both locally and nationally, for the best way to transfer or store historic records.

• A member of the audience queried the availability of NHS care for patients after being discharged from hospital. She cited the case of an elderly lady who had been sent home following an operation and had experienced very poor after care. It was acknowledged that this was difficult as patients were dependent on care in the community after discharge and it too was facing pressures. Where gaps were known, this often led to extended hospital stays for patients until appropriate care was available at or nearer to their home. Community care was outside of the hospital’s remit although it tried to work with and support partner organisations to ensure a community-wide approach to healthcare wherever possible. The Chief Executive offered to liaise with the enquirer to look at needs of the patient involved.

CEO

6. CLOSE OF MEETING The Chairman thanked everyone for attending and for showing their interest in and support for the hospital. He also reminded everyone of the opportunity to attend the “Patient Conversation” on 14th November and about the Governors’ elections now open. There being no further business, the meeting closed at 11.30am.

15


16

CoG Dec 2015: Constitution

COUNCIL OF GOVERNORS – DECEMBER 2015

REF: CG/15/12/07

REVIEW OF CONSTITUTION

1. INTRODUCTION 1.1. Governors are reminded that In accordance with the NHS Act (Section 37), any

changes must be subject to approval of more than half of the Governors present and voting and more than half of the Board of Directors voting. If any amendments proposed would affect the powers and duties of the Council of Governors, they would also require the further approval by the FT’s membership at the next Annual Members Meeting.

1.2. Once approved, any changes would come into immediate effect. 1.3. Approval by Monitor, the sector regulator, is no longer a requirement but FTs are

required to provide to Monitor “copies of any document establishing or amending its constitution within 28 days of being adopted” (Condition FT1, under section 6 of the Provider Licence).

1.4. At the last General meeting, the changes outlined in report CG/15/10/09 – as recommended by the Constitution Review working group – were reviewed and approved. The process was not, however, completed as one of the changes required further work.

1.5. The recommendations agreed at the last meeting were that:

• the “Fit and Proper Persons Requirements” (FPPR) should be included in the Constitution for Board Directors as compliance is now a statutory requirement and to reflect the same standards for Governors in the Code of Conduct for Governors, and

• reference to “the initial Chief Executive” should be removed as it is no longer applicable.

1.6. The third recommendation unanimously supported was to adopt the new Model Rules issued by NHS Providers in 2014 – subject to consideration of further amendments raised by the Trust’s independent election scrutineers, UK-Engage. With the Council of Governors’ support, further detail has been sought from UK-Engage. This is outlined below and reflected in appendix 1 attached.

2. PROPOSED CHANGES FOR ELECTION RULES 2.1. During 2014 NHS Providers introduced an updated version of the Department of

Health Model Rules for Elections. The rules were originally written between 2004 and 2006 and made no provision for advances in electoral technology such as secure internet, telephone and SMS text message voting (often known collectively as ‘e-voting’).

2.2. The updated rules allow Trusts to use e-voting technology alongside or instead of the traditional postal voting system. Monitor have indicated that aspirant Trusts holding elections to their inaugural Council of Governors must use the new model

07

17


rules as published. However once Foundation Trust status has been achieved Trusts are free to amend the rules as they wish. Indeed there is no obligation for existing Foundation Trusts to adopt the new rules.

2.3. UK Engage believe that the new model rules are largely fit for purpose but would suggest that some minor alterations would benefit Barnsley Hospital NHS Foundation Trust and help to maintain and hopefully improve levels of engagement with members.

2.4. UK Engage has pointed out that there has always been a significant anomaly in the model rules. Staff members of the Trust (who are auto enrolled as members unless they choose to opt out of membership) have not been required to complete a declaration of identity when voting while public members (who choose to become members) have been required to complete a declaration.

2.5. The usefulness of the declaration of identity is limited from the Returning Officer’s perspective. Unlike local authority postal voting arrangements which require the voter to complete a security statement containing a signature and date of birth, which is then scanned and checked against a database including that information on return, Foundation Trust Retuning Officers do not have the right to hold members’ signatures on file. Indeed even if the right existed the cost to each Trust of the necessary software and additional processing time would be prohibitive. A Foundation Trust Returning Officer in receipt of a completed declaration of identity knows only that someone has signed it but has no way of proving who signed it. The Returning Officer has no powers of investigation.

2.6. Consequently UK Engage has suggested that Barnsley Hospital consider whether the declaration of identity serves any real purpose and recommend that the rules relating to the inclusion of the declaration are amended (UK Engage will provide guidance on this at no additional cost to standard election fees). UK Engage would recommend that the election of Governors to take office in January 2017 (or any by elections called in 2016 - not the current elections for 2016) is conducted without declarations of identity and that the effectiveness is reviewed with the Returning Officer thereafter.

2.7. The practical benefit for public members is that it would be harder to spoil a vote due to overlooking the declaration and some members who are concerned about signing and returning a document by post may be more inclined to vote. The voting process would be easier because no separate ballot paper envelope would be required. This will also result in a cost saving for the Trust.

2.8. For public members who choose to vote online the process will also be simpler as they will not have to confirm their identity before voting. UK Engage recommend that instead of the online declaration an optional request to provide an email address is included for public members so they can opt to receive all future election material by email rather than post. This will also have a cost benefit for the Trust because as the number of members providing email addresses increases the volume of printed election packs can be reduced. This will save money on both printing and postage. The effect of these savings will increase in subsequent years as the number of members using email increases.

2.9. The Model Rules published by NHS Providers are attached. It is mainly section 21 that would be affected by the proposals outlined by UK-Engage.

18


3. RECOMMENDATIONS

3.1. The Council of Governors is asked to:

(a) confirm its approval of the changes outlined in October and reiterated in 1.5 above, and

(b) approve adoption of the new Model Rules issued by NHS Providers, subject to the exception recommended by UK-Engage in section 2.6 above, to be applicable for future elections

Angela Keeney Assoc Director of Corporate Affairs December 2015

Appendix: Model Rules as published by NHS Providers, August 2014

19

2

MODEL ELECTION RULES 2014 PART 1: INTERPRETATION 1. Interpretation PART 2: TIMETABLE FOR ELECTION 2. Timetable 3. Computation of time PART 3: RETURNING OFFICER 4. Returning officer 5. Staff 6. Expenditure 7. Duty of co-operation PART 4: STAGES COMMON TO CONTESTED AND UNCONTESTED ELECTIONS 8. Notice of election 9. Nomination of candidates 10. Candidate’s particulars 11. Declaration of interests 12. Declaration of eligibility 13. Signature of candidate 14. Decisions as to validity of nomination forms 15. Publication of statement of nominated candidates 16. Inspection of statement of nominated candidates and nomination forms 17. Withdrawal of candidates 18. Method of election PART 5: CONTESTED ELECTIONS 19. Poll to be taken by ballot 20. The ballot paper 21. The declaration of identity (public and patient constituencies) Action to be taken before the poll 22. List of eligible voters 23. Notice of poll 24. Issue of voting information by returning officer 25. Ballot paper envelope and covering envelope 26. E-voting systems

The poll

20

3

27. Eligibility to vote 28. Voting by persons who require assistance 29. Spoilt ballot papers and spoilt text message votes 30. Lost voting information 31. Issue of replacement voting information 32. ID declaration form for replacement ballot papers (public and patient constituencies) 33 Procedure for remote voting by internet 34. Procedure for remote voting by telephone 35. Procedure for remote voting by text message Procedure for receipt of envelopes, internet votes, telephone vote and text message votes 36. Receipt of voting documents 37. Validity of votes 38. Declaration of identity but no ballot (public and patient constituency) 39. De-duplication of votes 40. Sealing of packets PART 6: COUNTING THE VOTES STV41. Interpretation of Part 6 42. Arrangements for counting of the votes 43. The count STV44. Rejected ballot papers and rejected text voting records FPP44. Rejected ballot papers and rejected text voting records STV45. First stage STV46. The quota STV47 Transfer of votes STV48. Supplementary provisions on transfer STV49. Exclusion of candidates STV50. Filling of last vacancies STV51. Order of election of candidates FPP51. Equality of votes PART 7: FINAL PROCEEDINGS IN CONTESTED AND UNCONTESTED ELECTIONS FPP52. Declaration of result for contested elections STV52. Declaration of result for contested elections 53. Declaration of result for uncontested elections PART 8: DISPOSAL OF DOCUMENTS 54. Sealing up of documents relating to the poll 55. Delivery of documents 56. Forwarding of documents received after close of the poll 57. Retention and public inspection of documents 58. Application for inspection of certain documents relating to election

21

4

PART 9: DEATH OF A CANDIDATE DURING A CONTESTED ELECTION FPP59. Countermand or abandonment of poll on death of candidate STV59. Countermand or abandonment of poll on death of candidate PART 10: ELECTION EXPENSES AND PUBLICITY Expenses 60. Election expenses 61. Expenses and payments by candidates 62. Expenses incurred by other persons Publicity 63. Publicity about election by the corporation 64. Information about candidates for inclusion with voting information 65. Meaning of “for the purposes of an election” PART 11: QUESTIONING ELECTIONS AND IRREGULARITIES 66. Application to question an election PART 12: MISCELLANEOUS 67. Secrecy 68. Prohibition of disclosure of vote 69. Disqualification 70. Delay in postal service through industrial action or unforeseen event

22

5

PART 1: INTERPRETATION

1. Interpretation 1.1 In these rules, unless the context otherwise requires:

“2006 Act” means the National Health Service Act 2006;

“corporation” means the public benefit corporation subject to this constitution;

“council of governors” means the council of governors of the corporation;

“declaration of identity” has the meaning set out in rule 21.1;

“election” means an election by a constituency, or by a class within a constituency, to fill a vacancy among one or more posts on the council of governors;

“e-voting” means voting using either the internet, telephone or text message;

“e-voting information” has the meaning set out in rule 24.2;

“ID declaration form” has the meaning set out in Rule 21.1; “internet voting record” has the meaning set out in rule 26.4(d);

“internet voting system” means such computer hardware and software, data other equipment and services as may be provided by the returning officer for the purpose of enabling voters to cast their votes using the internet;

“lead governor” means the governor nominated by the corporation to fulfil the role described in Appendix B to The NHS Foundation Trust Code of Governance (Monitor, December 2013) or any later version of such code.

“list of eligible voters” means the list referred to in rule 22.1, containing the information in rule 22.2;

“method of polling” means a method of casting a vote in a poll, which may be by post, internet, text message or telephone;

“Monitor” means the corporate body known as Monitor as provided by section 61 of the 2012 Act; “numerical voting code” has the meaning set out in rule 64.2(b)

“polling website” has the meaning set out in rule 26.1;

“postal voting information” has the meaning set out in rule 24.1;

“telephone short code” means a short telephone number used for the purposes of submitting a vote by text message;

“telephone voting facility” has the meaning set out in rule 26.2;

“telephone voting record” has the meaning set out in rule 26.5 (d);

“text message voting facility” has the meaning set out in rule 26.3;

“text voting record” has the meaning set out in rule 26.6 (d); 23

6

“the telephone voting system” means such telephone voting facility as may be provided by the returning officer for the purpose of enabling voters to cast their votes by telephone;

“the text message voting system” means such text messaging voting facility as may be provided by the returning officer for the purpose of enabling voters to cast their votes by text message;

“voter ID number” means a unique, randomly generated numeric identifier allocated to each voter by the Returning Officer for the purpose of e-voting,

“voting information” means postal voting information and/or e-voting information

1.2 Other expressions used in these rules and in Schedule 7 to the NHS Act 2006 have

the same meaning in these rules as in that Schedule.

24

7

PART 2: TIMETABLE FOR ELECTIONS

2. Timetable 2.1 The proceedings at an election shall be conducted in accordance with the following

timetable:

Proceeding Time

Publication of notice of election Not later than the fortieth day before the day of the close of the poll.

Final day for delivery of nomination forms to returning officer

Not later than the twenty eighth day before the day of the close of the poll.

Publication of statement of nominated candidates

Not later than the twenty seventh day before the day of the close of the poll.

Final day for delivery of notices of withdrawals by candidates from election

Not later than twenty fifth day before the day of the close of the poll.

Notice of the poll Not later than the fifteenth day before the day of the close of the poll.

Close of the poll By 5.00pm on the final day of the election.

3. Computation of time 3.1 In computing any period of time for the purposes of the timetable:

(a) a Saturday or Sunday;

(b) Christmas day, Good Friday, or a bank holiday, or

(c) a day appointed for public thanksgiving or mourning,

shall be disregarded, and any such day shall not be treated as a day for the purpose of any proceedings up to the completion of the poll, nor shall the returning officer be obliged to proceed with the counting of votes on such a day.

3.2 In this rule, “bank holiday” means a day which is a bank holiday under the Banking

and Financial Dealings Act 1971 in England and Wales.

25

8

PART 3: RETURNING OFFICER

4. Returning Officer

4.1 Subject to rule 69, the returning officer for an election is to be appointed by the corporation.

4.2 Where two or more elections are to be held concurrently, the same returning officer

may be appointed for all those elections. 5. Staff 5.1 Subject to rule 69, the returning officer may appoint and pay such staff, including

such technical advisers, as he or she considers necessary for the purposes of the election.

6. Expenditure 6.1 The corporation is to pay the returning officer:

(a) any expenses incurred by that officer in the exercise of his or her functions under these rules,

(b) such remuneration and other expenses as the corporation may determine.

7. Duty of co-operation 7.1 The corporation is to co-operate with the returning officer in the exercise of his or

her functions under these rules.

26

9

PART 4: STAGES COMMON TO CONTESTED AND UNCONTESTED ELECTIONS

8. Notice of election

8.1 The returning officer is to publish a notice of the election stating:

(a) the constituency, or class within a constituency, for which the election is being held,

(b) the number of members of the council of governors to be elected from that constituency, or class within that constituency,

(c) the details of any nomination committee that has been established by the corporation,

(d) the address and times at which nomination forms may be obtained;

(e) the address for return of nomination forms (including, where the return of nomination forms in an electronic format will be permitted, the e-mail address for such return) and the date and time by which they must be received by the returning officer,

(f) the date and time by which any notice of withdrawal must be received by the returning officer

(g) the contact details of the returning officer

(h) the date and time of the close of the poll in the event of a contest.

9. Nomination of candidates

9.1 Subject to rule 9.2, each candidate must nominate themselves on a single nomination form.

9.2 The returning officer:

(a) is to supply any member of the corporation with a nomination form, and

(b) is to prepare a nomination form for signature at the request of any member of the corporation,

but it is not necessary for a nomination to be on a form supplied by the returning officer and a nomination can, subject to rule 13, be in an electronic format.

10. Candidate’s particulars 10.1 The nomination form must state the candidate’s:

(a) full name,

(b) contact address in full (which should be a postal address although an e-mail address may also be provided for the purposes of electronic communication), and

(c) constituency, or class within a constituency, of which the candidate is a member.

27

10

11. Declaration of interests 11.1 The nomination form must state:

(a) any financial interest that the candidate has in the corporation, and

(b) whether the candidate is a member of a political party, and if so, which party,

and if the candidate has no such interests, the paper must include a statement to that effect.

12. Declaration of eligibility 12.1 The nomination form must include a declaration made by the candidate:

(a) that he or she is not prevented from being a member of the council of governors by paragraph 8 of Schedule 7 of the 2006 Act or by any provision of the constitution; and,

(b) for a member of the public or patient constituency, of the particulars of his or her qualification to vote as a member of that constituency, or class within that constituency, for which the election is being held.

13. Signature of candidate 13.1 The nomination form must be signed and dated by the candidate, in a manner

prescribed by the returning officer, indicating that:

(a) they wish to stand as a candidate,

(b) their declaration of interests as required under rule 11, is true and correct, and

(c) their declaration of eligibility, as required under rule 12, is true and correct.

13.2 Where the return of nomination forms in an electronic format is permitted, the

returning officer shall specify the particular signature formalities (if any) that will need to be complied with by the candidate.

14. Decisions as to the validity of nomination 14.1 Where a nomination form is received by the returning officer in accordance with

these rules, the candidate is deemed to stand for election unless and until the returning officer:

(a) decides that the candidate is not eligible to stand,

(b) decides that the nomination form is invalid,

(c) receives satisfactory proof that the candidate has died, or

(d) receives a written request by the candidate of their withdrawal from candidacy.

14.2 The returning officer is entitled to decide that a nomination form is invalid only on

one of the following grounds:

28

11

(a) that the paper is not received on or before the final time and date for return of

nomination forms, as specified in the notice of the election,

(b) that the paper does not contain the candidate’s particulars, as required by rule 10;

(c) that the paper does not contain a declaration of the interests of the candidate, as required by rule 11,

(d) that the paper does not include a declaration of eligibility as required by rule 12, or

(e) that the paper is not signed and dated by the candidate, if required by rule 13.

14.3 The returning officer is to examine each nomination form as soon as is practicable

after he or she has received it, and decide whether the candidate has been validly nominated.

14.4 Where the returning officer decides that a nomination is invalid, the returning officer

must endorse this on the nomination form, stating the reasons for their decision. 14.5 The returning officer is to send notice of the decision as to whether a nomination is

valid or invalid to the candidate at the contact address given in the candidate’s nomination form. If an e-mail address has been given in the candidate’s nomination form (in addition to the candidate’s postal address), the returning officer may send notice of the decision to that address.

15. Publication of statement of candidates 15.1 The returning officer is to prepare and publish a statement showing the candidates

who are standing for election. 15.2 The statement must show:

(a) the name, contact address (which shall be the candidate’s postal address),

and constituency or class within a constituency of each candidate standing, and

(b) the declared interests of each candidate standing,

as given in their nomination form.

15.3 The statement must list the candidates standing for election in alphabetical order

by surname. 15.4 The returning officer must send a copy of the statement of candidates and copies of

the nomination forms to the corporation as soon as is practicable after publishing the statement.

16. Inspection of statement of nominated candidates and nomination forms 16.1 The corporation is to make the statement of the candidates and the nomination

forms supplied by the returning officer under rule 15.4 available for inspection by

29

12

members of the corporation free of charge at all reasonable times. 16.2 If a member of the corporation requests a copy or extract of the statement of

candidates or their nomination forms, the corporation is to provide that member with the copy or extract free of charge.

17. Withdrawal of candidates 17.1 A candidate may withdraw from election on or before the date and time for

withdrawal by candidates, by providing to the returning officer a written notice of withdrawal which is signed by the candidate and attested by a witness.

18. Method of election 18.1 If the number of candidates remaining validly nominated for an election after any

withdrawals under these rules is greater than the number of members to be elected to the council of governors, a poll is to be taken in accordance with Parts 5 and 6 of these rules.

18.2 If the number of candidates remaining validly nominated for an election after any

withdrawals under these rules is equal to the number of members to be elected to the council of governors, those candidates are to be declared elected in accordance with Part 7 of these rules.

18.3 If the number of candidates remaining validly nominated for an election after any

withdrawals under these rules is less than the number of members to be elected to be council of governors, then:

(a) the candidates who remain validly nominated are to be declared elected in

accordance with Part 7 of these rules, and

(b) the returning officer is to order a new election to fill any vacancy which remains unfilled, on a day appointed by him or her in consultation with the corporation.

30

13

PART 5: CONTESTED ELECTIONS

19. Poll to be taken by ballot 19.1 The votes at the poll must be given by secret ballot. 19.2 The votes are to be counted and the result of the poll determined in accordance

with Part 6 of these rules. 19.3 The corporation may decide that voters within a constituency or class within a

constituency, may, subject to rule 19.4, cast their votes at the poll using such different methods of polling in any combination as the corporation may determine.

19.4 The corporation may decide that voters within a constituency or class within a

constituency for whom an e-mail address is included in the list of eligible voters may only cast their votes at the poll using an e-voting method of polling.

19.5 Before the corporation decides, in accordance with rule 19.3 that one or more e-

voting methods of polling will be made available for the purposes of the poll, the corporation must satisfy itself that:

(a) if internet voting is to be a method of polling, the internet voting system to be

used for the purpose of the election is:

(i) configured in accordance with these rules; and

(ii) will create an accurate internet voting record in respect of any voter who casts his or her vote using the internet voting system;

(b) if telephone voting to be a method of polling, the telephone voting system to be used for the purpose of the election is:


(ii) will create an accurate telephone voting record in respect of any voter who casts his or her vote using the telephone voting system;

(c) if text message voting is to be a method of polling, the text message voting system to be used for the purpose of the election is:


(ii) will create an accurate text voting record in respect of any voter who casts his or her vote using the text message voting system.

20. The ballot paper 20.1 The ballot of each voter (other than a voter who casts his or her ballot by an e-

voting method of polling) is to consist of a ballot paper with the persons remaining validly nominated for an election after any withdrawals under these rules, and no others, inserted in the paper.

20.2 Every ballot paper must specify:

(a) the name of the corporation,

31

14

(b) the constituency, or class within a constituency, for which the election is being held,

(c) the number of members of the council of governors to be elected from that constituency, or class within that constituency,

(d) the names and other particulars of the candidates standing for election, with the details and order being the same as in the statement of nominated candidates,

(e) instructions on how to vote by all available methods of polling, including the relevant voter’s voter ID number if one or more e-voting methods of polling are available,

(f) if the ballot paper is to be returned by post, the address for its return and the date and time of the close of the poll, and

(g) the contact details of the returning officer.

20.3 Each ballot paper must have a unique identifier. 20.4 Each ballot paper must have features incorporated into it to prevent it from being

reproduced. 21. The declaration of identity (public and patient constituencies) 21.1 The corporation shall require each voter who participates in an election for a public

or patient constituency to make a declaration confirming:

(a) that the voter is the person:

(i) to whom the ballot paper was addressed, and/or

(ii) to whom the voter ID number contained within the e-voting information was allocated,

(b) that he or she has not marked or returned any other voting information in the election, and

(c) the particulars of his or her qualification to vote as a member of the

constituency or class within the constituency for which the election is being held,

(“declaration of identity”)

and the corporation shall make such arrangements as it considers appropriate to facilitate the making and the return of a declaration of identity by each voter, whether by the completion of a paper form (“ID declaration form”) or the use of an electronic method.

21.2 The voter must be required to return his or her declaration of identity with his or her

ballot. 21.3 The voting information shall caution the voter that if the declaration of identity is not

duly returned or is returned without having been made correctly, any vote cast by the voter may be declared invalid.

32

15

Action to be taken before the poll 22. List of eligible voters 22.1 The corporation is to provide the returning officer with a list of the members of the

constituency or class within a constituency for which the election is being held who are eligible to vote by virtue of rule 27 as soon as is reasonably practicable after the final date for the delivery of notices of withdrawals by candidates from an election.

22.2 The list is to include, for each member:

(a) a postal address; and, (b) the member’s e-mail address, if this has been provided to which his or her voting information may, subject to rule 22.3, be sent.

22.3 The corporation may decide that the e-voting information is to be sent only by e-

mail to those members in the list of eligible voters for whom an e-mail address is included in that list.

23. Notice of poll 23.1 The returning officer is to publish a notice of the poll stating:

(a) the name of the corporation,

(b) the constituency, or class within a constituency, for which the election is being held,

(c) the number of members of the council of governors to be elected from that constituency, or class with that constituency,

(d) the names, contact addresses, and other particulars of the candidates standing for election, with the details and order being the same as in the statement of nominated candidates,

(e) that the ballot papers for the election are to be issued and returned, if appropriate, by post,

(f) the methods of polling by which votes may be cast at the election by voters in a constituency or class within a constituency, as determined by the corporation in accordance with rule 19.3,

(g) the address for return of the ballot papers,

(h) the uniform resource locator (url) where, if internet voting is a method of polling, the polling website is located;

(i) the telephone number where, if telephone voting is a method of polling, the telephone voting facility is located,

(j) the telephone number or telephone short code where, if text message voting is a method of polling, the text message voting facility is located,

(k) the date and time of the close of the poll,

(l) the address and final dates for applications for replacement voting information, and

33

16

(m) the contact details of the returning officer.

24. Issue of voting information by returning officer 24.1 Subject to rule 24.3, as soon as is reasonably practicable on or after the publication

of the notice of the poll, the returning officer is to send the following information by post to each member of the corporation named in the list of eligible voters: (a) a ballot paper and ballot paper envelope,

(b) the ID declaration form (if required),

(c) information about each candidate standing for election, pursuant to rule 61 of these rules, and

(d) a covering envelope;

(“postal voting information”).

24.2 Subject to rules 24.3 and 24.4, as soon as is reasonably practicable on or after the publication of the notice of the poll, the returning officer is to send the following information by e-mail and/ or by post to each member of the corporation named in the list of eligible voters whom the corporation determines in accordance with rule 19.3 and/ or rule 19.4 may cast his or her vote by an e-voting method of polling: (a) instructions on how to vote and how to make a declaration of identity (if

required),

(b) the voter’s voter ID number,

(c) information about each candidate standing for election, pursuant to rule 64 of these rules, or details of where this information is readily available on the internet or available in such other formats as the Returning Officer thinks appropriate, (d) contact details of the returning officer,

(“e-voting information”).

24.3 The corporation may determine that any member of the corporation shall:

(a) only be sent postal voting information; or

(b) only be sent e-voting information; or

(c) be sent both postal voting information and e-voting information; for the purposes of the poll.

24.4 If the corporation determines, in accordance with rule 22.3, that the e-voting information is to be sent only by e-mail to those members in the list of eligible voters for whom an e-mail address is included in that list, then the returning officer shall only send that information by e-mail.

24.5 The voting information is to be sent to the postal address and/ or e-mail address for

each member, as specified in the list of eligible voters.

34

17

25. Ballot paper envelope and covering envelope 25.1 The ballot paper envelope must have clear instructions to the voter printed on it,

instructing the voter to seal the ballot paper inside the envelope once the ballot paper has been marked.

25.2 The covering envelope is to have:

(a) the address for return of the ballot paper printed on it, and

(b) pre-paid postage for return to that address.

25.3 There should be clear instructions, either printed on the covering envelope or elsewhere, instructing the voter to seal the following documents inside the covering envelope and return it to the returning officer –

(a) the completed ID declaration form if required, and

(b) the ballot paper envelope, with the ballot paper sealed inside it.

26. E-voting systems 26.1 If internet voting is a method of polling for the relevant election then the returning

officer must provide a website for the purpose of voting over the internet (in these rules referred to as "the polling website").

26.2 If telephone voting is a method of polling for the relevant election then the returning

officer must provide an automated telephone system for the purpose of voting by the use of a touch-tone telephone (in these rules referred to as “the telephone voting facility”).

26.3 If text message voting is a method of polling for the relevant election then the

returning officer must provide an automated text messaging system for the purpose of voting by text message (in these rules referred to as “the text message voting facility”).

26.4 The returning officer shall ensure that the polling website and internet voting

system provided will:

(a) require a voter to:

(i) enter his or her voter ID number; and

(ii) where the election is for a public or patient constituency, make a declaration of identity;

in order to be able to cast his or her vote;

(b) specify:

(i) the name of the corporation,

(ii) the constituency, or class within a constituency, for which the election is being held,

(iii) the number of members of the council of governors to be elected from that constituency, or class within that constituency,

35

18

(iv) the names and other particulars of the candidates standing for election, with the details and order being the same as in the statement of nominated candidates,

(v) instructions on how to vote and how to make a declaration of identity,

(vi) the date and time of the close of the poll, and

(vii) the contact details of the returning officer;

(c) prevent a voter from voting for more candidates than he or she is entitled to at the election;

(d) create a record ("internet voting record") that is stored in the internet voting system in respect of each vote cast by a voter using the internet that comprises of-

(i) the voter’s voter ID number;

(ii) the voter’s declaration of identity (where required);

(iii) the candidate or candidates for whom the voter has voted; and

(iv) the date and time of the voter’s vote,

(e) if the voter’s vote has been duly cast and recorded, provide the voter with confirmation of this; and

(f) prevent any voter from voting after the close of poll. 26.5 The returning officer shall ensure that the telephone voting facility and telephone

voting system provided will:

(a) require a voter to

(i) enter his or her voter ID number in order to be able to cast his or her vote; and


(b) specify:

(i) the name of the corporation,

(ii) the constituency, or class within a constituency, for which the election is being held,

(iii) the number of members of the council of governors to be elected from that constituency, or class within that constituency,

(iv) instructions on how to vote and how to make a declaration of identity,

(v) the date and time of the close of the poll, and

(vi) the contact details of the returning officer; (c) prevent a voter from voting for more candidates than he or she is entitled to at

the election;

(d) create a record ("telephone voting record") that is stored in the telephone voting system in respect of each vote cast by a voter using the telephone that comprises of:

36

19



(iii) the candidate or candidates for whom the voter has voted; and

(iv) the date and time of the voter’s vote (e) if the voter’s vote has been duly cast and recorded, provide the voter with

confirmation of this;

(f) prevent any voter from voting after the close of poll.

26.6 The returning officer shall ensure that the text message voting facility and text messaging voting system provided will:

(a) require a voter to:

(i) provide his or her voter ID number; and


in order to be able to cast his or her vote;

(b) prevent a voter from voting for more candidates than he or she is entitled to at the election;

(d) create a record ("text voting record") that is stored in the text messaging voting system in respect of each vote cast by a voter by text message that comprises of:



(ii) the candidate or candidates for whom the voter has voted; and

(iii) the date and time of the voter’s vote

(e) if the voter’s vote has been duly cast and recorded, provide the voter with confirmation of this;

(f) prevent any voter from voting after the close of poll. The poll 27. Eligibility to vote 27.1 An individual who becomes a member of the corporation on or before the closing

date for the receipt of nominations by candidates for the election, is eligible to vote in that election.

28. Voting by persons who require assistance 28.1 The returning officer is to put in place arrangements to enable requests for

assistance to vote to be made. 28.2 Where the returning officer receives a request from a voter who requires assistance

to vote, the returning officer is to make such arrangements as he or she considers necessary to enable that voter to vote.

37

20

29. Spoilt ballot papers and spoilt text message votes 29.1 If a voter has dealt with his or her ballot paper in such a manner that it cannot be

accepted as a ballot paper (referred to as a “spoilt ballot paper”), that voter may apply to the returning officer for a replacement ballot paper.

29.2 On receiving an application, the returning officer is to obtain the details of the

unique identifier on the spoilt ballot paper, if he or she can obtain it. 29.3 The returning officer may not issue a replacement ballot paper for a spoilt ballot

paper unless he or she:

(a) is satisfied as to the voter’s identity; and (b) has ensured that the completed ID declaration form, if required, has not been

returned. 29.4 After issuing a replacement ballot paper for a spoilt ballot paper, the returning

officer shall enter in a list (“the list of spoilt ballot papers”):

(a) the name of the voter, and (b) the details of the unique identifier of the spoilt ballot paper (if that officer was

able to obtain it), and (c) the details of the unique identifier of the replacement ballot paper.

29.5 If a voter has dealt with his or her text message vote in such a manner that it

cannot be accepted as a vote (referred to as a “spoilt text message vote”), that voter may apply to the returning officer for a replacement voter ID number.

29.6 On receiving an application, the returning officer is to obtain the details of the voter

ID number on the spoilt text message vote, if he or she can obtain it. 29.7 The returning officer may not issue a replacement voter ID number in respect of a

spoilt text message vote unless he or she is satisfied as to the voter’s identity. 29.8 After issuing a replacement voter ID number in respect of a spoilt text message

vote, the returning officer shall enter in a list (“the list of spoilt text message votes”):

(a) the name of the voter, and (b) the details of the voter ID number on the spoilt text message vote (if that

officer was able to obtain it), and (c) the details of the replacement voter ID number issued to the voter.

30. Lost voting information 30.1 Where a voter has not received his or her voting information by the tenth day

before the close of the poll, that voter may apply to the returning officer for replacement voting information.

38

21

30.2 The returning officer may not issue replacement voting information in respect of lost voting information unless he or she:

(a) is satisfied as to the voter’s identity,

(b) has no reason to doubt that the voter did not receive the original voting information,

(c) has ensured that no declaration of identity, if required, has been returned.

30.3 After issuing replacement voting information in respect of lost voting information, the returning officer shall enter in a list (“the list of lost ballot documents”):

(a) the name of the voter

(b) the details of the unique identifier of the replacement ballot paper, if applicable, and

(c) the voter ID number of the voter. 31. Issue of replacement voting information 31.1 If a person applies for replacement voting information under rule 29 or 30 and a

declaration of identity has already been received by the returning officer in the name of that voter, the returning officer may not issue replacement voting information unless, in addition to the requirements imposed by rule 29.3 or 30.2, he or she is also satisfied that that person has not already voted in the election, notwithstanding the fact that a declaration of identity if required has already been received by the returning officer in the name of that voter.

31.2 After issuing replacement voting information under this rule, the returning officer

shall enter in a list (“the list of tendered voting information”): (a) the name of the voter,

(b) the unique identifier of any replacement ballot paper issued under this rule;

(c) the voter ID number of the voter.

32. ID declaration form for replacement ballot papers (public and patient constituencies)

32.1 In respect of an election for a public or patient constituency an ID declaration form

must be issued with each replacement ballot paper requiring the voter to make a declaration of identity.

Polling by internet, telephone or text 33. Procedure for remote voting by internet 33.1 To cast his or her vote using the internet, a voter will need to gain access to the

polling website by keying in the url of the polling website provided in the voting information.

33.2 When prompted to do so, the voter will need to enter his or her voter ID number.

39

22

33.3 If the internet voting system authenticates the voter ID number, the system will give the voter access to the polling website for the election in which the voter is eligible to vote.

33.4 To cast his or her vote, the voter will need to key in a mark on the screen opposite the particulars of the candidate or candidates for whom he or she wishes to cast his or her vote.

33.5 The voter will not be able to access the internet voting system for an election once

his or her vote at that election has been cast. 34. Voting procedure for remote voting by telephone 34.1 To cast his or her vote by telephone, the voter will need to gain access to the

telephone voting facility by calling the designated telephone number provided in the voter information using a telephone with a touch-tone keypad.

34.2 When prompted to do so, the voter will need to enter his or her voter ID number

using the keypad. 34.3 If the telephone voting facility authenticates the voter ID number, the voter will be

prompted to vote in the election.

34.4 When prompted to do so the voter may then cast his or her vote by keying in the numerical voting code of the candidate or candidates, for whom he or she wishes to vote.

34.5 The voter will not be able to access the telephone voting facility for an election

once his or her vote at that election has been cast. 35. Voting procedure for remote voting by text message 35.1 To cast his or her vote by text message the voter will need to gain access to the

text message voting facility by sending a text message to the designated telephone number or telephone short code provided in the voter information.

35.2 The text message sent by the voter must contain his or her voter ID number and the numerical voting code for the candidate or candidates, for whom he or she wishes to vote.

35.3 The text message sent by the voter will need to be structured in accordance with

the instructions on how to vote contained in the voter information, otherwise the vote will not be cast.

Procedure for receipt of envelopes, internet votes, telephone votes and text message votes 36. Receipt of voting documents 36.1 Where the returning officer receives:

(a) a covering envelope, or

(b) any other envelope containing an ID declaration form if required, a ballot

40

23

paper envelope, or a ballot paper,

before the close of the poll, that officer is to open it as soon as is practicable; and rules 37 and 38 are to apply.

36.2 The returning officer may open any covering envelope or any ballot paper envelope

for the purposes of rules 37 and 38, but must make arrangements to ensure that no person obtains or communicates information as to:

(a) the candidate for whom a voter has voted, or

(b) the unique identifier on a ballot paper. 36.3 The returning officer must make arrangements to ensure the safety and security of

the ballot papers and other documents. 37. Validity of votes 37.1 A ballot paper shall not be taken to be duly returned unless the returning officer is

satisfied that it has been received by the returning officer before the close of the poll, with an ID declaration form if required that has been correctly completed, signed and dated.

37.2 Where the returning officer is satisfied that rule 37.1 has been fulfilled, he or she is to:

(a) put the ID declaration form if required in a separate packet, and

(b) put the ballot paper aside for counting after the close of the poll.

37.3 Where the returning officer is not satisfied that rule 37.1 has been fulfilled, he or she is to:

(a) mark the ballot paper “disqualified”,

(b) if there is an ID declaration form accompanying the ballot paper, mark it “disqualified” and attach it to the ballot paper,

(c) record the unique identifier on the ballot paper in a list of disqualified documents (the “list of disqualified documents”); and

(d) place the document or documents in a separate packet.

37.4 An internet, telephone or text message vote shall not be taken to be duly returned unless the returning officer is satisfied that the internet voting record, telephone voting record or text voting record (as applicable) has been received by the returning officer before the close of the poll, with a declaration of identity if required that has been correctly made.

37.5 Where the returning officer is satisfied that rule 37.4 has been fulfilled, he or she is

to put the internet voting record, telephone voting record or text voting record (as applicable) aside for counting after the close of the poll.

37.6 Where the returning officer is not satisfied that rule 37.4 has been fulfilled, he or

she is to:

41

24

(a) mark the internet voting record, telephone voting record or text voting record (as applicable) “disqualified”,

(b) record the voter ID number on the internet voting record, telephone voting record or text voting record (as applicable) in the list of disqualified documents; and

(c) place the document or documents in a separate packet.

38. Declaration of identity but no ballot paper (public and patient constituency)1 38.1 Where the returning officer receives an ID declaration form if required but no ballot

paper, the returning officer is to: (a) mark the ID declaration form “disqualified”,

(b) record the name of the voter in the list of disqualified documents, indicating that a declaration of identity was received from the voter without a ballot paper, and

(c) place the ID declaration form in a separate packet.

39. De-duplication of votes 39.1 Where different methods of polling are being used in an election, the returning

officer shall examine all votes cast to ascertain if a voter ID number has been used more than once to cast a vote in the election.

39.2 If the returning officer ascertains that a voter ID number has been used more than once to cast a vote in the election he or she shall:

(a) only accept as duly returned the first vote received that was cast using the

relevant voter ID number; and

(b) mark as “disqualified” all other votes that were cast using the relevant voter ID number

39.3 Where a ballot paper is disqualified under this rule the returning officer shall:

(a) mark the ballot paper “disqualified”,

(b) if there is an ID declaration form accompanying the ballot paper, mark it “disqualified” and attach it to the ballot paper,

(c) record the unique identifier and the voter ID number on the ballot paper in the list of disqualified documents;

(d) place the document or documents in a separate packet; and

(e) disregard the ballot paper when counting the votes in accordance with these rules.

39.4 Where an internet voting record, telephone voting record or text voting record is

disqualified under this rule the returning officer shall:

(a) mark the internet voting record, telephone voting record or text voting record

1 It should not be possible, technically, to make a declaration of identity electronically without also submitting a vote.

42

25

(as applicable) “disqualified”,

(b) record the voter ID number on the internet voting record, telephone voting record or text voting record (as applicable) in the list of disqualified documents;

(c) place the internet voting record, telephone voting record or text voting record (as applicable) in a separate packet, and

(d) disregard the internet voting record, telephone voting record or text voting record (as applicable) when counting the votes in accordance with these rules.

40. Sealing of packets 40.1 As soon as is possible after the close of the poll and after the completion of the

procedure under rules 37 and 38, the returning officer is to seal the packets containing:

(a) the disqualified documents, together with the list of disqualified documents

inside it,

(b) the ID declaration forms, if required,

(c) the list of spoilt ballot papers and the list of spoilt text message votes,

(d) the list of lost ballot documents,

(e) the list of eligible voters, and

(f) the list of tendered voting information and ensure that complete electronic copies of the internet voting records, telephone voting records and text voting records created in accordance with rule 26 are held in a device suitable for the purpose of storage.

43

26

PART 6: COUNTING THE VOTES

STV41. Interpretation of Part 6 STV41.1 In Part 6 of these rules:

“ballot document” means a ballot paper, internet voting record, telephone voting record or text voting record.

“continuing candidate” means any candidate not deemed to be elected, and not excluded,

“count” means all the operations involved in counting of the first preferences recorded for candidates, the transfer of the surpluses of elected candidates, and the transfer of the votes of the excluded candidates,

“deemed to be elected” means deemed to be elected for the purposes of counting of votes but without prejudice to the declaration of the result of the poll,

“mark” means a figure, an identifiable written word, or a mark such as “X”,

“non-transferable vote” means a ballot document:

(a) on which no second or subsequent preference is recorded for a continuing candidate,

or

(b) which is excluded by the returning officer under rule STV49,

“preference” as used in the following contexts has the meaning assigned below:

(a) “first preference” means the figure “1” or any mark or word which clearly indicates a first (or only) preference,

(b) “next available preference” means a preference which is the second, or as

the case may be, subsequent preference recorded in consecutive order for a continuing candidate (any candidate who is deemed to be elected or is excluded thereby being ignored); and

(c) in this context, a “second preference” is shown by the figure “2” or any mark

or word which clearly indicates a second preference, and a third preference by the figure “3” or any mark or word which clearly indicates a third preference, and so on,

“quota” means the number calculated in accordance with rule STV46,

“surplus” means the number of votes by which the total number of votes for any candidate (whether first preference or transferred votes, or a combination of both) exceeds the quota; but references in these rules to the transfer of the surplus means the transfer (at a transfer value) of all transferable ballot documents from the candidate who has the surplus,

44

27

“stage of the count” means:

(a) the determination of the first preference vote of each candidate, (b) the transfer of a surplus of a candidate deemed to be elected, or (c) the exclusion of one or more candidates at any given time,

“transferable vote” means a ballot document on which, following a first preference, a second or subsequent preference is recorded in consecutive numerical order for a continuing candidate,

“transferred vote” means a vote derived from a ballot document on which a second or subsequent preference is recorded for the candidate to whom that ballot document has been transferred, and

“transfer value” means the value of a transferred vote calculated in accordance with rules STV47.4 or STV47.7.

42. Arrangements for counting of the votes 42.1 The returning officer is to make arrangements for counting the votes as soon as is

practicable after the close of the poll. 42.2 The returning officer may make arrangements for any votes to be counted using

vote counting software where:

(a) the board of directors and the council of governors of the corporation have approved:

(i) the use of such software for the purpose of counting votes in the relevant election, and

(ii) a policy governing the use of such software, and

(b) the corporation and the returning officer are satisfied that the use of such software will produce an accurate result.

43. The count 43.1 The returning officer is to:

(a) count and record the number of:

(iii) ballot papers that have been returned; and

(iv) the number of internet voting records, telephone voting records and/or text voting records that have been created, and

(b) count the votes according to the provisions in this Part of the rules and/or the provisions of any policy approved pursuant to rule 42.2(ii) where vote counting software is being used.

43.2 The returning officer, while counting and recording the number of ballot papers,

internet voting records, telephone voting records and/or text voting records and counting the votes, must make arrangements to ensure that no person obtains or communicates information as to the unique identifier on a ballot paper or the voter

45

28

ID number on an internet voting record, telephone voting record or text voting record.

43.3 The returning officer is to proceed continuously with counting the votes as far as is

practicable. STV44. Rejected ballot papers and rejected text voting records STV44.1 Any ballot paper:

(a) which does not bear the features that have been incorporated into the other ballot papers to prevent them from being reproduced,

(b) on which the figure “1” standing alone is not placed so as to indicate a first preference for any candidate,

(c) on which anything is written or marked by which the voter can be identified except the unique identifier, or

(d) which is unmarked or rejected because of uncertainty,

shall be rejected and not counted, but the ballot paper shall not be rejected by reason only of carrying the words “one”, “two”, “three” and so on, or any other mark instead of a figure if, in the opinion of the returning officer, the word or mark clearly indicates a preference or preferences.

STV44.2 The returning officer is to endorse the word “rejected” on any ballot paper which

under this rule is not to be counted. STV44.3 Any text voting record:

(a) on which the figure “1” standing alone is not placed so as to indicate a first preference for any candidate,

(b) on which anything is written or marked by which the voter can be identified except the unique identifier, or

(c) which is unmarked or rejected because of uncertainty,

shall be rejected and not counted, but the text voting record shall not be rejected by reason only of carrying the words “one”, “two”, “three” and so on, or any other mark instead of a figure if, in the opinion of the returning officer, the word or mark clearly indicates a preference or preferences.

STV44.4 The returning officer is to endorse the word “rejected” on any text voting record

which under this rule is not to be counted. STV44.5 The returning officer is to draw up a statement showing the number of ballot papers

rejected by him or her under each of the subparagraphs (a) to (d) of rule STV44.1 and the number of text voting records rejected by him or her under each of the sub-paragraphs (a) to (c) of rule STV44.3.

46

29

FPP44. Rejected ballot papers and rejected text voting records FPP44.1 Any ballot paper:

(a) which does not bear the features that have been incorporated into the other ballot papers to prevent them from being reproduced,

(b) on which votes are given for more candidates than the voter is entitled to vote,

(c) on which anything is written or marked by which the voter can be identified except the unique identifier, or

(d) which is unmarked or rejected because of uncertainty,

shall, subject to rules FPP44.2 and FPP44.3, be rejected and not counted. FPP44.2 Where the voter is entitled to vote for more than one candidate, a ballot paper is not

to be rejected because of uncertainty in respect of any vote where no uncertainty arises, and that vote is to be counted.

FPP44.3 A ballot paper on which a vote is marked:

(a) elsewhere than in the proper place,

(b) otherwise than by means of a clear mark,

(c) by more than one mark,

is not to be rejected for such reason (either wholly or in respect of that vote) if an intention that the vote shall be for one or other of the candidates clearly appears, and the way the paper is marked does not itself identify the voter and it is not shown that he or she can be identified by it.

FPP44.4 The returning officer is to:

(a) endorse the word “rejected” on any ballot paper which under this rule is not to be counted, and

(b) in the case of a ballot paper on which any vote is counted under rules FPP44.2 and FPP 44.3, endorse the words “rejected in part” on the ballot paper and indicate which vote or votes have been counted.

FPP44.5 The returning officer is to draw up a statement showing the number of rejected

ballot papers under the following headings:

(a) does not bear proper features that have been incorporated into the ballot paper,

(b) voting for more candidates than the voter is entitled to,

(c) writing or mark by which voter could be identified, and

(d) unmarked or rejected because of uncertainty,

and, where applicable, each heading must record the number of ballot papers rejected in part.

47

30

FPP44.6 Any text voting record: (a) on which votes are given for more candidates than the voter is entitled to

vote,

(b) on which anything is written or marked by which the voter can be identified except the voter ID number, or

(c) which is unmarked or rejected because of uncertainty,

shall, subject to rules FPP44.7 and FPP44.8, be rejected and not counted. FPP44.7 Where the voter is entitled to vote for more than one candidate, a text voting record

is not to be rejected because of uncertainty in respect of any vote where no uncertainty arises, and that vote is to be counted.

FPP448 A text voting record on which a vote is marked:

(a) otherwise than by means of a clear mark,

(b) by more than one mark,

is not to be rejected for such reason (either wholly or in respect of that vote) if an intention that the vote shall be for one or other of the candidates clearly appears, and the way the text voting record is marked does not itself identify the voter and it is not shown that he or she can be identified by it.


(a) endorse the word “rejected” on any text voting record which under this rule is not to be counted, and

(b) in the case of a text voting record on which any vote is counted under rules FPP44.7 and FPP 44.8, endorse the words “rejected in part” on the text voting record and indicate which vote or votes have been counted.

FPP44.10 The returning officer is to draw up a statement showing the number of rejected text

voting records under the following headings:

(a) voting for more candidates than the voter is entitled to,

(b) writing or mark by which voter could be identified, and

(c) unmarked or rejected because of uncertainty,

and, where applicable, each heading must record the number of text voting records rejected in part.

STV45. First stage STV45.1 The returning officer is to sort the ballot documents into parcels according to the

candidates for whom the first preference votes are given. STV45.2 The returning officer is to then count the number of first preference votes given on

ballot documents for each candidate, and is to record those numbers.

48

31

STV45.3 The returning officer is to also ascertain and record the number of valid ballot documents.

STV46. The quota STV46.1 The returning officer is to divide the number of valid ballot documents by a number

exceeding by one the number of members to be elected. STV46.2 The result, increased by one, of the division under rule STV46.1 (any fraction being

disregarded) shall be the number of votes sufficient to secure the election of a candidate (in these rules referred to as “the quota”).

STV46.3 At any stage of the count a candidate whose total votes equals or exceeds the

quota shall be deemed to be elected, except that any election where there is only one vacancy a candidate shall not be deemed to be elected until the procedure set out in rules STV47.1 to STV47.3 has been complied with.

STV47. Transfer of votes STV47.1 Where the number of first preference votes for any candidate exceeds the quota,

the returning officer is to sort all the ballot documents on which first preference votes are given for that candidate into sub- parcels so that they are grouped:

(a) according to next available preference given on those ballot documents for

any continuing candidate, or

(b) where no such preference is given, as the sub-parcel of non-transferable votes.

STV47.2 The returning officer is to count the number of ballot documents in each parcel

referred to in rule STV47.1. STV47.3 The returning officer is, in accordance with this rule and rule STV48, to transfer

each sub-parcel of ballot documents referred to in rule STV47.1(a) to the candidate for whom the next available preference is given on those ballot documents.

STV47.4 The vote on each ballot document transferred under rule STV47.3 shall be at a

value (“the transfer value”) which:

(a) reduces the value of each vote transferred so that the total value of all such votes does not exceed the surplus, and

(b) is calculated by dividing the surplus of the candidate from whom the votes are being transferred by the total number of the ballot documents on which those votes are given, the calculation being made to two decimal places (ignoring the remainder if any).

STV47.5 Where at the end of any stage of the count involving the transfer of ballot

documents, the number of votes for any candidate exceeds the quota, the returning officer is to sort the ballot documents in the sub-parcel of transferred votes which was last received by that candidate into separate sub-parcels so that they are grouped:

49

32

(a) according to the next available preference given on those ballot documents for any continuing candidate, or

(b) where no such preference is given, as the sub-parcel of non-transferable votes.

STV47.6 The returning officer is, in accordance with this rule and rule STV48, to transfer

each sub-parcel of ballot documents referred to in rule STV47.5(a) to the candidate for whom the next available preference is given on those ballot documents.

STV47.7 The vote on each ballot document transferred under rule STV47.6 shall be at:

(a) a transfer value calculated as set out in rule STV47.4(b), or

(b) at the value at which that vote was received by the candidate from whom it is now being transferred,

whichever is the less.

STV47.8 Each transfer of a surplus constitutes a stage in the count. STV47.9 Subject to rule STV47.10, the returning officer shall proceed to transfer transferable

ballot documents until no candidate who is deemed to be elected has a surplus or all the vacancies have been filled.

STV47.10 Transferable ballot documents shall not be liable to be transferred where any

surplus or surpluses which, at a particular stage of the count, have not already been transferred, are:

(a) less than the difference between the total vote then credited to the continuing

candidate with the lowest recorded vote and the vote of the candidate with the next lowest recorded vote, or

(b) less than the difference between the total votes of the two or more continuing candidates, credited at that stage of the count with the lowest recorded total numbers of votes and the candidate next above such candidates.

STV47.11 This rule does not apply at an election where there is only one vacancy.

STV48. Supplementary provisions on transfer STV48.1 If, at any stage of the count, two or more candidates have surpluses, the

transferable ballot documents of the candidate with the highest surplus shall be transferred first, and if:

(a) The surpluses determined in respect of two or more candidates are equal, the

transferable ballot documents of the candidate who had the highest recorded vote at the earliest preceding stage at which they had unequal votes shall be transferred first, and

(b) the votes credited to two or more candidates were equal at all stages of the count, the returning officer shall decide between those candidates by lot, and the transferable ballot documents of the candidate on whom the lot falls shall be transferred first.

50

33

STV48.2 The returning officer shall, on each transfer of transferable ballot documents under rule STV47:

(a) record the total value of the votes transferred to each candidate,

(b) add that value to the previous total of votes recorded for each candidate and record the new total,

(c) record as non-transferable votes the difference between the surplus and the total transfer value of the transferred votes and add that difference to the previously recorded total of non-transferable votes, and

(d) compare:

(i) the total number of votes then recorded for all of the candidates, together with the total number of non-transferable votes, with

(ii) the recorded total of valid first preference votes. STV48.3 All ballot documents transferred under rule STV47 or STV49 shall be clearly

marked, either individually or as a sub-parcel, so as to indicate the transfer value recorded at that time to each vote on that ballot document or, as the case may be, all the ballot documents in that sub-parcel.

STV48.4 Where a ballot document is so marked that it is unclear to the returning officer at

any stage of the count under rule STV47 or STV49 for which candidate the next preference is recorded, the returning officer shall treat any vote on that ballot document as a non-transferable vote; and votes on a ballot document shall be so treated where, for example, the names of two or more candidates (whether continuing candidates or not) are so marked that, in the opinion of the returning officer, the same order of preference is indicated or the numerical sequence is broken.

STV49. Exclusion of candidates STV49.1 If:

(a) all transferable ballot documents which under the provisions of rule STV47 (including that rule as applied by rule STV49.11) and this rule are required to be transferred, have been transferred, and

(b) subject to rule STV50, one or more vacancies remain to be filled, the returning officer shall exclude from the election at that stage the candidate with the then lowest vote (or, where rule STV49.12 applies, the candidates with the then lowest votes).

STV9.2 The returning officer shall sort all the ballot documents on which first preference

votes are given for the candidate or candidates excluded under rule STV49.1 into two sub-parcels so that they are grouped as:

(a) ballot documents on which a next available preference is given, and

(b) ballot documents on which no such preference is given (thereby including ballot documents on which preferences are given only for candidates who are deemed to be elected or are excluded).

51

34

STV49.3 The returning officer shall, in accordance with this rule and rule STV48, transfer each sub-parcel of ballot documents referred to in rule STV49.2 to the candidate for whom the next available preference is given on those ballot documents.

STV49.4 The exclusion of a candidate, or of two or more candidates together, constitutes a

further stage of the count. STV49.5 If, subject to rule STV50, one or more vacancies still remain to be filled, the

returning officer shall then sort the transferable ballot documents, if any, which had been transferred to any candidate excluded under rule STV49.1 into sub- parcels according to their transfer value.

STV49.6 The returning officer shall transfer those ballot documents in the sub-parcel of

transferable ballot documents with the highest transfer value to the continuing candidates in accordance with the next available preferences given on those ballot documents (thereby passing over candidates who are deemed to be elected or are excluded).

STV49.7 The vote on each transferable ballot document transferred under rule STV49.6 shall

be at the value at which that vote was received by the candidate excluded under rule STV49.1.

STV9.8 Any ballot documents on which no next available preferences have been expressed

shall be set aside as non-transferable votes. STV49.9 After the returning officer has completed the transfer of the ballot documents in the

sub-parcel of ballot documents with the highest transfer value he or she shall proceed to transfer in the same way the sub-parcel of ballot documents with the next highest value and so on until he has dealt with each sub-parcel of a candidate excluded under rule STV49.1.

STV49.10 The returning officer shall after each stage of the count completed under this rule:

(a) record:

(i) the total value of votes, or

(ii) the total transfer value of votes transferred to each candidate,

(b) add that total to the previous total of votes recorded for each candidate and record the new total,

(c) record the value of non-transferable votes and add that value to the previous non-transferable votes total, and

(d) compare:

(i) the total number of votes then recorded for each candidate together with the total number of non-transferable votes, with

(ii) the recorded total of valid first preference votes. STV49.11 If after a transfer of votes under any provision of this rule, a candidate has a

surplus, that surplus shall be dealt with in accordance with rules STV47.5 to STV47.10 and rule STV48.

52

35

STV49.12 Where the total of the votes of the two or more lowest candidates, together with any surpluses not transferred, is less than the number of votes credited to the next lowest candidate, the returning officer shall in one operation exclude such two or more candidates.

STV49.13 If when a candidate has to be excluded under this rule, two or more candidates

each have the same number of votes and are lowest:

(a) regard shall be had to the total number of votes credited to those candidates at the earliest stage of the count at which they had an unequal number of votes and the candidate with the lowest number of votes at that stage shall be excluded, and

(b) where the number of votes credited to those candidates was equal at all stages, the returning officer shall decide between the candidates by lot and the candidate on whom the lot falls shall be excluded.

STV50. Filling of last vacancies STV50.1 Where the number of continuing candidates is equal to the number of vacancies

remaining unfilled the continuing candidates shall thereupon be deemed to be elected.

STV50.2 Where only one vacancy remains unfilled and the votes of any one continuing

candidate are equal to or greater than the total of votes credited to other continuing candidates together with any surplus not transferred, the candidate shall thereupon be deemed to be elected.

STV50.3 Where the last vacancies can be filled under this rule, no further transfer of votes

shall be made. STV51. Order of election of candidates STV51.1 The order in which candidates whose votes equal or exceed the quota are deemed

to be elected shall be the order in which their respective surpluses were transferred, or would have been transferred but for rule STV47.10.

STV51.2 A candidate credited with a number of votes equal to, and not greater than, the

quota shall, for the purposes of this rule, be regarded as having had the smallest surplus at the stage of the count at which he obtained the quota.

STV51.3 Where the surpluses of two or more candidates are equal and are not required to

be transferred, regard shall be had to the total number of votes credited to such candidates at the earliest stage of the count at which they had an unequal number of votes and the surplus of the candidate who had the greatest number of votes at that stage shall be deemed to be the largest.

STV51.4 Where the number of votes credited to two or more candidates were equal at all

stages of the count, the returning officer shall decide between them by lot and the candidate on whom the lot falls shall be deemed to have been elected first.

53

36

FPP51. Equality of votes FPP51.1 Where, after the counting of votes is completed, an equality of votes is found to

exist between any candidates and the addition of a vote would entitle any of those candidates to be declared elected, the returning officer is to decide between those candidates by a lot, and proceed as if the candidate on whom the lot falls had received an additional vote.

54

37

PART 7: FINAL PROCEEDINGS IN CONTESTED AND UNCONTESTED ELECTIONS

FPP52. Declaration of result for contested elections FPP52.1 In a contested election, when the result of the poll has been ascertained, the

returning officer is to:

(a) declare the candidate or candidates whom more votes have been given than for the other candidates, up to the number of vacancies to be filled on the council of governors from the constituency, or class within a constituency, for which the election is being held to be elected,

(b) give notice of the name of each candidate who he or she has declared elected:

(i) where the election is held under a proposed constitution pursuant to powers conferred on the [insert name] NHS Trust by section 33(4) of the 2006 Act, to the chairman of the NHS Trust, or

(ii) in any other case, to the chairman of the corporation; and

(c) give public notice of the name of each candidate whom he or she has declared elected.

FPP52.2 The returning officer is to make:

(a) the total number of votes given for each candidate (whether elected or not), and

(b) the number of rejected ballot papers under each of the headings in rule FPP44.5,

(c) the number of rejected text voting records under each of the headings in rule FPP44.10,

available on request.

STV52. Declaration of result for contested elections STV52.1 In a contested election, when the result of the poll has been ascertained, the

returning officer is to:

(a) declare the candidates who are deemed to be elected under Part 6 of these rules as elected,

(b) give notice of the name of each candidate who he or she has declared elected –

(i) where the election is held under a proposed constitution pursuant to powers conferred on the [insert name] NHS Trust by section 33(4) of the 2006 Act, to the chairman of the NHS Trust, or

(ii) in any other case, to the chairman of the corporation, and

(c) give public notice of the name of each candidate who he or she has declared elected.

55

38

STV52.2 The returning officer is to make:

(a) the number of first preference votes for each candidate whether elected or not,

(b) any transfer of votes,

(c) the total number of votes for each candidate at each stage of the count at which such transfer took place,

(d) the order in which the successful candidates were elected, and

(e) the number of rejected ballot papers under each of the headings in rule STV44.1,

(f) the number of rejected text voting records under each of the headings in rule STV44.3,

available on request.

53. Declaration of result for uncontested elections 53.1 In an uncontested election, the returning officer is to as soon as is practicable after

final day for the delivery of notices of withdrawals by candidates from the election:

(a) declare the candidate or candidates remaining validly nominated to be elected,

(b) give notice of the name of each candidate who he or she has declared

elected to the chairman of the corporation, and (c) give public notice of the name of each candidate who he or she has declared

elected.

56

39

PART 8: DISPOSAL OF DOCUMENTS

54. Sealing up of documents relating to the poll 54.1 On completion of the counting at a contested election, the returning officer is to

seal up the following documents in separate packets:

(a) the counted ballot papers, internet voting records, telephone voting records and text voting records,

(b) the ballot papers and text voting records endorsed with “rejected in part”,

(c) the rejected ballot papers and text voting records, and

(d) the statement of rejected ballot papers and the statement of rejected text voting records,

and ensure that complete electronic copies of the internet voting records, telephone voting records and text voting records created in accordance with rule 26 are held in a device suitable for the purpose of storage.

54.2 The returning officer must not open the sealed packets of:

(a) the disqualified documents, with the list of disqualified documents inside it,

(b) the list of spoilt ballot papers and the list of spoilt text message votes,

(c) the list of lost ballot documents, and

(d) the list of eligible voters, or access the complete electronic copies of the internet voting records, telephone voting records and text voting records created in accordance with rule 26 and held in a device suitable for the purpose of storage.

54.3 The returning officer must endorse on each packet a description of:

(a) its contents,

(b) the date of the publication of notice of the election,

(c) the name of the corporation to which the election relates, and

(d) the constituency, or class within a constituency, to which the election relates. 55. Delivery of documents 55.1 Once the documents relating to the poll have been sealed up and endorsed

pursuant to rule 56, the returning officer is to forward them to the chair of the corporation.

56. Forwarding of documents received after close of the poll 56.1 Where:

(a) any voting documents are received by the returning officer after the close of

57

40

the poll, or

(b) any envelopes addressed to eligible voters are returned as undelivered too late to be resent, or

(c) any applications for replacement voting information are made too late to enable new voting information to be issued,

the returning officer is to put them in a separate packet, seal it up, and endorse and forward it to the chairman of the corporation.

57. Retention and public inspection of documents 57.1 The corporation is to retain the documents relating to an election that are forwarded

to the chair by the returning officer under these rules for one year, and then, unless otherwise directed by the board of directors of the corporation, cause them to be destroyed.

57.2 With the exception of the documents listed in rule 58.1, the documents relating to

an election that are held by the corporation shall be available for inspection by members of the public at all reasonable times.

57.3 A person may request a copy or extract from the documents relating to an election

that are held by the corporation, and the corporation is to provide it, and may impose a reasonable charge for doing so.

58. Application for inspection of certain documents relating to an election 58.1 The corporation may not allow:

(a) the inspection of, or the opening of any sealed packet containing –

(i) any rejected ballot papers, including ballot papers rejected in part,

(ii) any rejected text voting records, including text voting records rejected in part,

(iii) any disqualified documents, or the list of disqualified documents,

(iv) any counted ballot papers, internet voting records, telephone voting records or text voting records, or

(v) the list of eligible voters, or

(b) access to or the inspection of the complete electronic copies of the internet voting records, telephone voting records and text voting records created in accordance with rule 26 and held in a device suitable for the purpose of storage,

by any person without the consent of the board of directors of the corporation. 58.2 A person may apply to the board of directors of the corporation to inspect any of

the documents listed in rule 58.1, and the board of directors of the corporation may only consent to such inspection if it is satisfied that it is necessary for the purpose of questioning an election pursuant to Part 11.

58.3 The board of directors of the corporation’s consent may be on any terms or

58

41

conditions that it thinks necessary, including conditions as to –

(a) persons,

(b) time,

(c) place and mode of inspection,

(d) production or opening,

and the corporation must only make the documents available for inspection in accordance with those terms and conditions.

58.4 On an application to inspect any of the documents listed in rule 58.1 the board of

directors of the corporation must:

(a) in giving its consent, and

(b) in making the documents available for inspection ensure that the way in which the vote of any particular member has been given shall not be disclosed, until it has been established –

(i) that his or her vote was given, and

(ii) that Monitor has declared that the vote was invalid.

59

42

PART 9: DEATH OF A CANDIDATE DURING A CONTESTED ELECTION

FPP59. Countermand or abandonment of poll on death of candidate FPP59.1 If at a contested election, proof is given to the returning officer’s satisfaction before

the result of the election is declared that one of the persons named or to be named as a candidate has died, then the returning officer is to:

(a) countermand notice of the poll, or, if voting information has been issued,

direct that the poll be abandoned within that constituency or class, and

(b) order a new election, on a date to be appointed by him or her in consultation with the corporation, within the period of 40 days, computed in accordance with rule 3 of these rules, beginning with the day that the poll was countermanded or abandoned.

FPP59.2 Where a new election is ordered under rule FPP59.1, no fresh nomination is

necessary for any candidate who was validly nominated for the election where the poll was countermanded or abandoned but further candidates shall be invited for that constituency or class.

FPP59.3 Where a poll is abandoned under rule FPP59.1(a), rules FPP59.4 to FPP59.7 are

to apply. FPP59.4 The returning officer shall not take any step or further step to open envelopes or

deal with their contents in accordance with rules 38 and 39, and is to make up separate sealed packets in accordance with rule 40.


(a) count and record the number of ballot papers, internet voting records, telephone voting records and text voting records that have been received,

(b) seal up the ballot papers, internet voting records, telephone voting records and text voting records into packets, along with the records of the number of ballot papers, internet voting records, telephone voting records and text voting records and

ensure that complete electronic copies of the internet voting records telephone voting records and text voting records created in accordance with rule 26 are held in a device suitable for the purpose of storage.

FPP59.6 The returning officer is to endorse on each packet a description of:

(a) its contents,

(b) the date of the publication of notice of the election,

(c) the name of the corporation to which the election relates, and

(d) the constituency, or class within a constituency, to which the election relates. FPP59.7 Once the documents relating to the poll have been sealed up and endorsed

60

43

pursuant to rules FPP59.4 to FPP59.6, the returning officer is to deliver them to the chairman of the corporation, and rules 57 and 58 are to apply.

STV59. Countermand or abandonment of poll on death of candidate STV59.1 If, at a contested election, proof is given to the returning officer’s satisfaction before

the result of the election is declared that one of the persons named or to be named as a candidate has died, then the returning officer is to:

(a) publish a notice stating that the candidate has died, and

(b) proceed with the counting of the votes as if that candidate had been excluded from the count so that –

(i) ballot documents which only have a first preference recorded for the candidate that has died, and no preferences for any other candidates, are not to be counted, and

(ii) ballot documents which have preferences recorded for other candidates are to be counted according to the consecutive order of those preferences, passing over preferences marked for the candidate who has died.

STV59.2 The ballot documents which have preferences recorded for the candidate who has

died are to be sealed with the other counted ballot documents pursuant to rule 54.1(a).

61

44

PART 10: ELECTION EXPENSES AND PUBLICITY

Election expenses 60. Election expenses 60.1 Any expenses incurred, or payments made, for the purposes of an election which

contravene this Part are an electoral irregularity, which may only be questioned in an application made to Monitor under Part 11 of these rules.

61. Expenses and payments by candidates 61.1 A candidate may not incur any expenses or make a payment (of whatever nature)

for the purposes of an election, other than expenses or payments that relate to:

(a) personal expenses,

(b) travelling expenses, and expenses incurred while living away from home, and

(c) expenses for stationery, postage, telephone, internet(or any similar means of communication) and other petty expenses, to a limit of £100.

62. Election expenses incurred by other persons 62.1 No person may:

(a) incur any expenses or make a payment (of whatever nature) for the purposes of a candidate’s election, whether on that candidate’s behalf or otherwise, or

(b) give a candidate or his or her family any money or property (whether as a gift, donation, loan, or otherwise) to meet or contribute to expenses incurred by or on behalf of the candidate for the purposes of an election.

62.2 Nothing in this rule is to prevent the corporation from incurring such expenses, and

making such payments, as it considers necessary pursuant to rules 63 and 64. Publicity 63. Publicity about election by the corporation 63.1 The corporation may:

(a) compile and distribute such information about the candidates, and

(b) organise and hold such meetings to enable the candidates to speak and respond to questions,

as it considers necessary.

63.2 Any information provided by the corporation about the candidates, including

information compiled by the corporation under rule 64, must be:

(a) objective, balanced and fair,

62

45

(b) equivalent in size and content for all candidates,

(c) compiled and distributed in consultation with all of the candidates standing for election, and

(d) must not seek to promote or procure the election of a specific candidate or candidates, at the expense of the electoral prospects of one or more other candidates.

63.3 Where the corporation proposes to hold a meeting to enable the candidates to

speak, the corporation must ensure that all of the candidates are invited to attend, and in organising and holding such a meeting, the corporation must not seek to promote or procure the election of a specific candidate or candidates at the expense of the electoral prospects of one or more other candidates.

64. Information about candidates for inclusion with voting information 64.1 The corporation must compile information about the candidates standing for

election, to be distributed by the returning officer pursuant to rule 24 of these rules. 64.2 The information must consist of:

(a) a statement submitted by the candidate of no more than 250 words,

(b) if voting by telephone or text message is a method of polling for the election, the numerical voting code allocated by the returning officer to each candidate, for the purpose of recording votes using the telephone voting facility or the text message voting facility (“numerical voting code”), and

(c) a photograph of the candidate. 65. Meaning of “for the purposes of an election” 65.1 In this Part, the phrase “for the purposes of an election” means with a view to, or

otherwise in connection with, promoting or procuring a candidate’s election, including the prejudicing of another candidate’s electoral prospects; and the phrase “for the purposes of a candidate’s election” is to be construed accordingly.

65.2 The provision by any individual of his or her own services voluntarily, on his or her

own time, and free of charge is not to be considered an expense for the purposes of this Part.

63

46

PART 11: QUESTIONING ELECTIONS AND THE CONSEQUENCE OF IRREGULARITIES

66. Application to question an election 66.1 An application alleging a breach of these rules, including an electoral irregularity

under Part 10, may be made to Monitor for the purpose of seeking a referral to the independent election arbitration panel ( IEAP).

66.2 An application may only be made once the outcome of the election has been

declared by the returning officer. 66.3 An application may only be made to Monitor by:

(a) a person who voted at the election or who claimed to have had the right to vote, or

(b) a candidate, or a person claiming to have had a right to be elected at the election.

66.4 The application must:

(a) describe the alleged breach of the rules or electoral irregularity, and

(b) be in such a form as the independent panel may require. 66.5 The application must be presented in writing within 21 days of the declaration of the

result of the election. Monitor will refer the application to the independent election arbitration panel appointed by Monitor.

66.6 If the independent election arbitration panel requests further information from the

applicant, then that person must provide it as soon as is reasonably practicable. 66.7 Monitor shall delegate the determination of an application to a person or panel of

persons to be nominated for the purpose. 66.8 The determination by the IEAP shall be binding on and shall be given effect by the

corporation, the applicant and the members of the constituency (or class within a constituency) including all the candidates for the election to which the application relates.

66.9 The IEAP may prescribe rules of procedure for the determination of an application

including costs.

64

47

PART 12: MISCELLANEOUS

67. Secrecy 67.1 The following persons:

(a) the returning officer,

(b) the returning officer’s staff,

must maintain and aid in maintaining the secrecy of the voting and the counting of the votes, and must not, except for some purpose authorised by law, communicate to any person any information as to:

(i) the name of any member of the corporation who has or has not been given

voting information or who has or has not voted,

(ii) the unique identifier on any ballot paper,

(iii) the voter ID number allocated to any voter,

(iv) the candidate(s) for whom any member has voted. 67.2 No person may obtain or attempt to obtain information as to the candidate(s) for

whom a voter is about to vote or has voted, or communicate such information to any person at any time, including the unique identifier on a ballot paper given to a voter or the voter ID number allocated to a voter.

67.3 The returning officer is to make such arrangements as he or she thinks fit to ensure

that the individuals who are affected by this provision are aware of the duties it imposes.

68. Prohibition of disclosure of vote 68.1 No person who has voted at an election shall, in any legal or other proceedings to

question the election, be required to state for whom he or she has voted. 69. Disqualification 69.1 A person may not be appointed as a returning officer, or as staff of the returning

officer pursuant to these rules, if that person is:

(a) a member of the corporation,

(b) an employee of the corporation,

(c) a director of the corporation, or

(d) employed by or on behalf of a person who has been nominated for election.

65

48

70. Delay in postal service through industrial action or unforeseen event 70.1 If industrial action, or some other unforeseen event, results in a delay in:

(a) the delivery of the documents in rule 24, or

(b) the return of the ballot papers,

the returning officer may extend the time between the publication of the notice of the poll and the close of the poll by such period as he or she considers appropriate.

66


REF: CoG/15/12/08(a)

08a

NOMINATIONS COMMITTEE – UPDATE REPORT

1. INTRODUCTION

1.1 The Nominations Committee (the Committee), comprises six Governors and the Trust Chairman and is mandated by the Council of Governors to lead work on the appointment, review and terms and conditions of the Non-Executive Directors (NEDs), including the Chairman.

1.2 This report provides an update from the Committee’s latest meetings held in November 2015 – encompassing the mid year review outcomes for the Non Executive Directors (excluding the Chairman), and the continuing appointment process for a new Non Executive Director from 1st January 2017.

1.3 As Governors are aware, the performance reviews of the Non Executive Director team are undertaken twice a year. The review of the Non Executive Directors is led by the Trust Chairman. Mr Joe Unsworth, as Lead Governor, and Mr Francis Patton, as Senior Independent Director, jointly lead the work on the Chairman’s review.

1.4 Outcomes from the Chairman’s mid year review will be presented separately by the Lead Governor.

2. MID YEAR REVIEWS 2.1 Over the past 12-18 months, the NED appraisals have been slightly out of sync with

the usual schedule in order to be able to take on board feedback from external governance reviews as well as the 360° reviews commissioned at the Council of Governors’ request. This resulted in Governors only receiving the final 2014/15 review feedback reports in August.

2.2 In view of this, and in order to bring the reporting schedule back into order, the 2015/16 mid year reviews were completed, reported to and evaluated by the Nominations Committee in November, and the process was deliberately less formal than the 2014/15 year end review

2.3 As Chairman, I met with all of the Non Executive Directors, with the exception of Mrs Linda Christon, to complete their mid year reviews. The team’s work has been supported by the two NEDs who joined the Trust on 1st April 2015, who have clearly worked hard to hit the ground running. The longer serving NEDs continued to deliver their roles well. As agreed previously the NEDs’ objectives are aligned with my own (approved by the Council in 2015/16), and delivery to the end of October has been effective.

2.4 The Nominations Committee endorsed my opinion that the NEDs continue to make a good job of bringing scrutiny and challenge to the Board to gain robust assurance and that their performance to date remained good overall.

67

CoG December 2015: Nom Com (a)

3. NON EXECUTIVE APPOINTMENT PROCESS 3.1 NED appointments are led by the Nominations Committee, as mandated by the

Council of Governors. In accordance with the Committee’s Terms of Reference, all appointments must be referred to open competition after the second term albeit NEDs are eligible to seek re-appointment alongside other applicants.

3.2 The vacancy for a new NED arises from the end of Mrs Linda Christon’s current (second) term of office at 31st December 2015. Largely for family reasons, Linda has chosen not to seek reappointment and will leave the Board at the end of 2015. It is therefore timely for me to record a note of sincere thanks to Linda; her contribution to the Board has been greatly valued and I know I can speak for my colleagues, many members of staff, volunteers and patients, and I am sure the Governors too, when I say that she will be missed. She leaves with our best wishes for the future.

3.3 The Committee received a good response to the advertisement for the NED vacancies, with many of the applications seeming to arise from web and social media links, such as LinkedIn and Guardian OnLine.

3.4 We had over 20 applications, from which a field of five strong candidates attended interviews on 24th November 2015.

3.5 As usual, the recommendations from those interviews will be presented to the Governors in the private part of the General Meeting.

4. RECOMMENDATIONS

The Council of Governors is asked to receive this report and: a) note and endorse the outcome of the mid year review for the Non-Executive

Directors b) endorse the note of thanks to Mrs Linda Christon for her valued contribution to

the Trust over the past six years, and c) note the progress of the Non Executive Director appointment

Stephen Wragg CHAIRMAN For and on behalf of the Nominations Committee December 2015

68


REF: CoG/15/12/08b

08b

NOMINATIONS COMMITTEE – CHAIRMAN’S MID YEAR REVIEW

1. INTRODUCTION 1.1 In accordance with the Trust’s Constitution and the Terms of Reference for the

Nominations Committee, the Trust’s Chairman also serves as Chair of the Nominations Committee unless, of course, it relates to his role, in which case the Committee is led either by the Vice Chairman or the Lead Governor, as appropriate.

1.2 As agreed with the Council of Governors, the review of the Chairman is jointly led by the Senior Independent Director and Lead Governor and closely scrutinised by the Nominations Committee. The process is also supported throughout by the Trust’s HR leads. This report reflects that review process and the outcome.

1.3 The process is in accordance with Monitor’s guidance.

2. MID YEAR REVIEW 2.1 Governors will recall that they received the Chairman’s year end review for 2014/15

in August and approved his objectives for 2015/16 at the same meeting. 2.2 In October, as Lead Governor I emailed all Governors to invite input to the

Chairman’s mid year review for 2015/16. I explained that in view of the proximity of the 2014/15 review and the extensive 360 feedback carried out then, Mr Francis Patton, as Senior Independent Director (SID), and I proposed to adopt a “light touch” approach for the mid year review. This seemed to be well received. The SID liaised with his fellow Non Executive Directors to invite their input to the Chairman’s review and with the Chief Executive, who also provided feedback on behalf of the Executive Team.

2.3 Based on feedback received and our own observations, the report from the Lead Governor and the SID took account of the Chairman’s delivery against his agreed objectives for 2015/16 as well as his performance for April-October 2015.

2.4 Following discussion, there was a clear consensus from the Committee that the Chairman’s performance overall continued to be satisfactory and that he had made good progress against his objectives. The review outcomes have been discussed with the Chairman, who continues to focus on areas for development and progress, not just achievements to date.

3. RECOMMENDATIONS

The Council of Governors is asked to receive this report and accept the outcome of the mid year review for the Chairman, Mr Stephen Wragg.

Joe Unsworth Francis Patton LEAD GOVERNOR SENIOR INDEPDENT DIRECTOR for and on behalf of the Nominations Committee December 2015 69

COUNCIL OF GOVERNORS – DECEMBER 2015 REF: CG/15/12/09

CoG Dec/ Chairmans Report

09

CHAIRMAN’S REPORT

1. INTRODUCTION

1.1 This report is intended to give a brief outline of some of the work and activities undertaken as Trust Chairman over the past month and highlight a number of items of interest.

1.2 The items reported are not shown in any order of priority.

2. BOARD AWARD 2.1 I am very pleased to note here that the Board were finalists for Board of the Year in

Regional NHS Leadership recognition awards, the ceremony took place on 25 November 2015. Bradford Care Trust won the award.

3. COMPREHENSIVE SPENDING REVIEW 3.1 You will have seen this documented in other areas – as well as in the briefing attached

to this paper. On the face of it, the NHS has done very well in settlement terms, with £3.8 billion being invested into the NHS over the next two years. However we do not yet know if this will have an effect on the finances of our Trust as the detail of where and how the funding will be applied is not yet apparent. Nevertheless the settlement also means that there is an efficiency savings target nationally of £22 billion, and we will have to continue to work hard to find our share of those efficiencies.

3.2 I have also attached a copy of the members briefing issued by NHS Providers in November, when the Quarter 2 financial position was published by Monitor. This highlights the increasing financial pressures facing every foundation trust. It is by no means a reason for us to accept the position but gives some ore context to the challenges we are all facing as the Board continues its drive to deliver our turnaround plans.

4. TRUST POSITION 4.1 We must continue to give confidence to the population of Barnsley and our key

stakeholders that care will not be compromised and we will turn this current situation around. I will keep reiterating this message as I think it should be constantly in people’s minds. Whilst we are bringing about our return to stability, we must not compromise on quality of care and patient safety.

4.2 We must also give confidence to our staff that the Trust is doing everything it can to improve patient experience and the quality of care our patients receive. In addition we continue to pay tribute to all our staff for the work they are doing to conceive new ideas to deliver better care, but also the work that they have done to bring our transformation to life.

70

CoG Dec/ Chairmans Report/p2

4.3 We must, however, also be conscious of the continuing pressures on the hospital, including activity and cost improvement plans. It is becoming more difficult to ensure we keep on track to return to financial balance whilst protecting the quality of our services for our patients and meaningful staff engagement. However we need to redouble our efforts to be innovative and transform our services so that we continue to improve the quality of services but reduce the cost of providing them.

5. BOARD OF DIRECTORS 5.1 As her second term of office is complete in December, Linda Christon has decided not

to seek a further term, largely in order to be able to spend a bit more time with her family. She will be moving on to Yorkshire Housing as a Non-Executive Director, where the time commitment is a little less than required at BHNFT.

5.2 I am certain that you will join me in firstly thanking Linda for the service that she has given to the Trust, as a NED, a volunteer and a very committed citizen of the borough. I am certain the Yorkshire Housing will benefit from Linda’s experience. Secondly I know you will join me in wishing Linda well in her new role.

5.3 I am pleased to be able to welcome Michael Wright to the Board of Directors as substantive Director of Finance, with effect from 1st December 2015. Michael worked with the Trust for several years as Deputy Director of Finance and more recently has taken on the role of acting Director of Finance. His appointment as an Executive Director reflects our confidence in his abilities to continue to help the Board steer the Trust back to a stronger financial position.

5.4 The Board was pleased to welcome Governors to its meeting on 5th November. It is a welcome opportunity each year for the Directors and Governors to sit around a table and explore issues together. I hope you all found it interesting; thank you for your participation.

5.1 I have pursued feedback about the acoustics in the meeting room and am assured this will be improved by our first meeting in the new year.

6. COUNCIL OF GOVERNORS 6.1 Nominations Committee

The Committee met on 3 November to shortlist for the recruitment of a Non-Executive Director (NED), as Linda Christon’s second term will be complete at the end of this year. Interviews took place on 24 November and a candidate will be recommended to the next Council of Governors (on 3 December), for approval. Appointment of Non Executive Directors is one of key responsibilities of the Council of Governors.

6.2 Finance and Performance Sub-Group (FPSG) The sub-group met twice in November, firstly they met on 10 November, where they expressed a number of concerns about several issues in the Trust. Unfortunately there were no NEDs available on that evening to answer the concerns, therefore a second meeting was arranged on 17 November, when I was joined by Francis Patton and Michael Wright to respond to the concerns raised.

6.3 At FPSG on 10th November, Governors looked at meeting dates for the sub-group for 2016, with the suggestion to roll forward the schedule from this year – ie the first Tuesday after each Board meeting. It was also agreed that it would be good to move the Council of Governors’ General Meetings away from Board meeting days, to give Governors more opportunity to come along and observe these meetings throughout the year. The group also supported the proposal to roll forward its meeting schedules on Tuesdays (first Tuesday after Board meetings, to ensure timely discussion of Board feedback on relevant papers) and to use the following Tuesday for the General Meetings.

71


6.4 Since then, however, there has been more reflection on (a) some requests for a different day of the week to be considered and (b) the need for Non Executive attendance at every sub-group meeting, which might be a little easier with a different weekday. I know that no weekday or series of dates will suit everyone’s diaries – but the schedule attached as appendix 3 give two options – Tuesdays (building on the 2015 schedule for sub-group meetings) or Wednesdays, as a switch.

6.5 We will finalise this at our meeting on 3rd December, so that we can confirm the schedule for 2016.

6.6 Annual Elections Voting for the annual elections for the Council of Governors is approaching the closing date of 11th December. Results will be announced shortly afterwards – please don’t forget to complete and return your vote if you have received one.

6.7 We have six seats going to ballot in the Barnsley Public Constituency (with eight nominations) and one in the Non Clinical Support Staff Constituency (with two nominations). Nominations in Medical & Dental Staff Constituency and for the Volunteers Staff Constituency were appointed without contest. It is therefore timely for me to thank both Mr Ray Raychaudhuri and Mr Tony Conway for seeking re-election and to congratulate them on their success. I am sure I can speak for us all when I say that we look forward to continuing to work with them.

7. NEWS & EVENTS

7.1 On Wednesday 4 November I attended the EHI informatics conference in Birmingham to listen to a number of presentations on how digital technology can transform healthcare

7.2 8 November was the annual remembrance day parade in Barnsley town centre, where I was privileged to lay a wreath on behalf of the Trust.

7.3 On 10th and 11th of November I attended with the CEO and other Directors, the NHS Providers annual conference. The conference provided a lot of useful information and debate about the future of healthcare and its funding.

7.4 11th November was the annual celebration of long service in the NHS. The CEO and I presented over 30 certificates, including two to staff who had served for over 40 years. One of these was presented posthumously to the son of Diane Turner, who had recently passed away. Each year we are delighted to celebrate the long service of our staff, and take the opportunity to thanks them for their service.

7.5 On 13th November I attended the Proud of Barnsley awards ceremony on behalf of the Trust where I presented the Hospital Hero award to the Special Care Baby Unit.

7.6 17th November was world prematurity day, and our neonatal staff held an event to celebrate that and raise funds for the Tiny Hearts appeal. We were joined by both ITV and BBC and they both gave a fair amount of time to the Trust on their bulletins later that day. We are hoping that this will push the Tiny Hearts appeal to the next stage, as we have currently achieved 10% of our target.

8. BARNSLEY HOSPITAL CHARITY 8.1 The generosity of local people and the support for our Charity continues to grow. 8.2 As you will have read above the Tiny Hearts Charity is a popular choice with local

fundraisers and I continue to receive funds on behalf of the charity, the figures from April 1 to November 12 this year are listed below:

72


• Donations £303,445.01

• Legacies £5,000.00

• Other income £4,717.86 Total £313,162.87

8.3 My own charity appeal this week raised £482

Stephen Wragg CHAIRMAN December 2015

Appendices:

1 Briefing report on Comprehensive Spending Review 2 Press release on Q2 (national) 3 Draft schedule of Governors’ meetings - 2016

73

74

https://www.gov.uk/government/topical-events/autumn-statement-and-spending-review-2015

DudleyC

Typewritten Text

Appendix 1

DudleyC

Typewritten Text

DudleyC

Typewritten Text

DudleyC

Typewritten Text

DudleyC

Typewritten Text

DudleyC

Typewritten Text

DudleyC

Typewritten Text

DudleyC

Typewritten Text

DudleyC

Typewritten Text

DudleyC

Typewritten Text

DudleyC

Typewritten Text

DudleyC

Typewritten Text

o

o

o

↑

↑

↑

↑

↑

↑

76

↑

↑

↑

↑

↑

↑

77

•

•

•

•

•

•

•

80

•

•

o o o o

o

o o

o

81

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/479566/Further_devolution_manchester_nov_2015.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/479566/Further_devolution_manchester_nov_2015.pdf

o

o

83

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/478632/Quarterly_report_on_the_performance_of_the_NHS_foundation_trusts_and_NHS_trusts_-_6_months_ended_30_September_2015_-_Overview_paper.pdf

http://www.ntda.nhs.uk/wp-content/uploads/2015/09/Paper-C-Q2-NHS-Trust-Performance-Report-Board-191115.pdf

DudleyC

Typewritten Text

Appendix 2

DudleyC

Typewritten Text

↓ ↓

↓

↓ ↑

↓ ↑

↓ ↑

↓ ↓

o

o

84

HONESTY AND REALISM NEEDED: LATEST NHS

FIGURES PUBLISHED BY MONITOR AND THE TDA

85

CoG 2016 Meeting Dates (draft)

*all meeting dates = Tuesday except January (Annual Development Session) and November joint meeting with Board

AGPMM = Annual General & Public Members meeting

Council of Governors

DRAFT 2016 schedule of meetings Option A: Tuesday Meeting Dates

Venue: all in Education Centre (Unless otherwise indicated)

General Meetings Training Sub-group meetings

Finance & Performance Quality & Governance

5.30 – 7.30pm LT1 & 2

5.30-7pm room 10

5.30-7.30pm Room 10

14th January* Annual Development Session 19th January

16th February 9th February

15th March 8th March

19th April 12th April

17th May 10th May

14th June 7th June

19th July 12th July

16th August 9th August

AGPMM date to be advised 13th September 6th September

18th October 11th October

3rd November* 9am invitation to Board

meeting 15th November 8th November

13th December 6th December

Appendix 3

86

CoG 2016 Meeting Dates (draft)

*all meeting dates = Wednesdays except January Annual Development Session and November meeting with Board

AGPMM = Annual General & Public Members meeting

Council of Governors

DRAFT 2016 schedule of meetings Option B: Wednesday Meeting Dates

Venue: all in Education Centre (Unless otherwise indicated)

General Meetings Training Sub-group meetings

Finance & Performance

Quality & Governance

5.30 – 7.30pm LT1 & 2

5.30-7pm room 10

5.30-7.30pm Room 10

14th January* Annual Development Session 20th January

17th February 10th February

16th March 9th March

20th April 13th April

18th May 11th May

15th June 8th June

20th July 13th July

17th August 10th August

AGPMM date to be advised 14th September 7th September

19th October 12th October

3rd November* 9am invitation to Board

meeting 16th November 9th November

14th December 7th December

87


REF: CG/15/12/10

CoG Dec 15: Lead Gov

LEAD GOVERNOR’S REPORT 1. INTRODUCTION

1.1. This is my usual summary of key events and activities since the last Council of Governors meeting from my perspective as lead governor.

2. ACTIVITIES AND EVENTS 2.1. The Trust again used UK Engage, independent election scrutineers, to organise the

annual governor elections and on the 8th October two workshop sessions were arranged for prospective candidates to meet the Chairman, myself, and Tony Slater from UK Engage. As I write there are eight candidates competing for the six public governor seats. For the staff governor seats Dr Ray Raychaudhuri (Medical and Dental Constituency) and Tony Conway (Volunteers Constituency) have been returned unopposed and there are two candidates for the Non Clinical Support Constituency seat.

2.2. The annual joint meeting with the Board on 5rd November was well attended by Governors. Legally this meeting is a meeting of the Board with governors attending by invitation. The governors present took the opportunity to ask questions and contribute to the discussion in both the public and private sessions.

2.3. I attended the Quality & Governance sub-group meeting on 8th October and the Finance & Performance sub-group meeting on 10th November. Unusually no Non-Executive Directors (NEDs) were able to get to the Finance & Performance sub-group meeting. This was unfortunate because issues were raised on bed utilisation and the financial position of the Trust without a NED to respond, and the meeting became somewhat spirited. Most of the matters raised, particularly those relating to the financial position, had been addressed at the joint meeting with the Board only five days previously or were included in the Annual Report & Accounts 2014/15. Subsequently it was agreed that the F&P sub-group meeting be reconvened on Tuesday 17th November, replacing the scheduled development session, with the Chairman, Francis Patton (the Chair of the Board’s F&P committee) and Michael Wright (Acting Director of Finance) present.

2.4. The development session was postponed to 14th January to replace the scheduled training session on that day. In discussions with David Brannan and Carol Dudley we agreed that this development session would be on the theme of the effective governor. This will be an interactive session with breakout groups. Please put this date in your diary.

2.5. The Nominations Committee met on 3rd November to shortlist the applicants for the Non-Executive post and to consider the mid-year reviews of the Chairman and the Non-Executive Directors. My report on the Chairman’s mid-year review is on the agenda for this Council of Governors’ meeting.

10

88

CoG Dec 15: Lead Gov

2.6. The interviews were held on 24th November. The recommendation for appointment is also a report on this Council of Governors agenda.

2.7. Linda Christon is leaving the Trust at the end of the year after completing her second term of office as a Non-Executive Director. Linda has given great service to Barnsley Hospital and became a regular attender at our Quality & Governance sub-group meetings. I am sure all governors will join with me in thanking Linda and wishing her well.

3. ANNUAL DEVELOPMENT SESSION 3.1. NHS Providers is the membership organisation for all NHS service providers including

acute, community, mental health, and ambulance FT and non-FT Trusts, and is now providing significant support to FT governors.

3.2. NHS Providers has begun sending out quarterly Governor Focus newsletters to Trust Secretaries. The first newsletter was sent out in August. You will have recently received by email the October newsletter from Carol Dudley. This announces the second governor focus conference to be held in London on 20 April 2016. Further details will follow.

3.3. There are also now regional governor workshops. The first was held in Durham in September and the second in Doncaster on 27th October. The Doncaster conference was attended by Annie Moody, Trevor Smith, and Zubair Warraich, and they are to give a short presentation on this conference. The return of regional governor meetings is very welcome. Hearing presentations from regional and national speakers, meeting governors from other Foundation Trusts and exchanging ideas and experience is very useful.

4. RECOMMENDATION The Council of Governors is recommended to receive this report.

Joe Unsworth Lead Governor December 2015

89


REF: CG/15/12/11

11

CHIEF EXECUTIVE’S REPORT

1. INTRODUCTION 1.1 This report is intended to give a brief outline of some of the key activities undertaken

as Chief Executive since last month’s report and highlight a number of items of interest.

1.2 The items below are not reported in any order of priority. 2. NHS PROVIDERS ANNUAL CONFERENCE

2.1 The Chief Executive together with the Chairman, Director of Operations, Director of Strategy and Business Development (10th November) and Director of Nursing and Quality (11th November) attended the NHS Providers Annual Conference on 10th and 11th November 2015.

2.2 This year’s conference provided a platform for senior leaders to debate new ways of working across local health and social care systems and the best ways to innovate, improve and provide.

2.3 Taking place six months after the general election, the event was a key opportunity for NHS leaders to discuss the latest health policy developments with the new government and to reflect on progress a year after the publication of the NHS Five Year Forward View.

3. BOARD TO BOARD MEETING WITH BARNSLEY CLINICAL COMMISSIONING GROUP GOVERNING BODY 3.1 Board members attended a meeting with the Clinical Commissioning Group (CCG)

Governing Body on 12th November 2015 to discuss progress year to date, challenges and priorities going forward for both organisations.

3.2 There is a clear shared vision to support the needs of the local population and ensure that decisions about healthcare provision remain at a local level.

3.3 A great deal of progress has been made against a shared agenda to ensure there are high quality and productive elective services and a responsive approach to emergency demand. This work needs to continue at pace with an increasingly integrated approach.

3.4 We are looking forward to progressing this shared agenda with the CCG in what is becomingly an increasingly challenged financial context.

4. MEETING WITH THE DEPARTMENT OF HEALTH 4.1 The Department of Health requested a meeting with the Chief Executive and the

Director of Finance to discuss the financial position based on the Trust breaching Monitor’s stretch target. They will consider future cash draw downs on a month by month basis although indicated that funds to support deficits in excess of the stretch target would not be available.

90

5. MEETING WITH THE CARE QUALITY COMMISSION (CQC) 5.1 The Chief Executive and the Director of Nursing and Quality met with Cathy Wynn,

Inspections Manager, and Amanda Stanford, Head of Hospitals Inspections, on 18th November 2015 to discuss the Factual Accuracy Checks previously submitted to the CQC.

5.2 On the day the CQC took the opportunity to visit a few areas of the Trust.

6. INTERNAL STAKEHOLDER STRATEGY EVENT 19TH NOVEMBER 2015 6.1 An Internal Stakeholder Strategy Event was held on the evening of 19th November

2015. 6.2 This was an interactive, informal event to provide the Clinical Business Units (CBU)

and their services the chance to share and learn from each other as well as providing an opportunity to communicate with key internal stakeholders.

6.3 There was the opportunity to capture suggestions and new ideas that could further develop and improve the services that we provide to our patients.

7. REGIONAL LEADERSHIP RECOGNITION AWARDS 7.1 The Board of Directors was shortlisted as a finalist in the NHS Regional Leadership

Awards 2015, for the category ‘Board of the year’. Members of the Board attended the awards ceremony on 25 November. Bradford Teaching Hospitals NHSFT won the award but the Barnsley Board was praised for the way they place patients and quality at the heart of decision making and for the Trust’s approach to engagement with staff.

8. JUNIOR DOCTORS 8.1 The BMA (British Medical Association) has announced there will be three days of

industrial action by junior doctors - the 1st, 8th and 16th of December. On the first day, the junior doctors will provide a 'Christmas Day' level service but for the second two days there will be a complete strike between 08:00-17:00 hrs.

8.2 A planning group has been instituted in the Trust and CBU management teams have put arrangements in place to ensure safe care and essential services are maintained, largely through other medical staff flexibility. At the time of writing, it appears that the total loss of clinical activity for the first day will be three clinics; the second and third days would be more significant but manageable. Cancelled patients will be telephoned with alternative arrangements. Internal and external communications are in progress. Plans are being finalised for the other strike days but given that both sides in the dispute have now agreed to work with ACAS, it is possible that the industrial action will to all go ahead

9. CONSULTANT APPOINTMENTS 9.1 I would like the Board of Directors to note the progress on the following Consultant

appointments:-

• The replacement posts for Consultants within AMU have been advertised with a closing date of 6th December 2015. One candidate has currently applied and one is in the application stage. No shortlisting or interview dates have currently been arranged.

• The replacement posts for Consultants in Colorectal Surgery have been advertised with a closing date of 19th November 2015. Interview dates have been arranged for 8th December 2015.

• The interview for the Consultant in Emergency Medicine has been arranged for 26th November 2015.

91

• The post for Consultant in Trauma and Orthopaedics has been advertised with a closing date of 15th November 2015. Interview dates have been arranged for 2nd December 2015.

• Interviews for the final Consultant Urology post will be held on 30th November 2015.

Diane Wake Chief Executive December 2015

92


REF: CG/15/12/12

CoG Dec 2015: 12_Sub-groups report

12

STRATEGIC SUB-GROUPS

1 INTRODUCTION

1.1 This report provides an update on the work and discussions of the Council of Governors’ Quality & Governance sub-group (QGSG) and Finance & Performance sub-group (FPSG) meetings held in October and November respectively.

2 SUB-GROUP LEADERSHIP & MEMBERSHIP 2.1 David Brannan and Jordan Ramsey are Chairs for FPSG and QGSG respectively;

Trevor Smith is the Vice-Chair for both sub-groups. 2.2 Membership of the sub-groups remains informal. Governors are welcome to attend

the sub-group meetings regularly or on an ad hoc basis if preferred. If any Governor wishes to raise an item through either of the sub-groups, the Chairs would be pleased to hear from you ahead of the next meeting’s agenda.

3 WORK OF THE SUB-GROUPS 3.1 One of the primary objectives of the sub-groups is to support the Governors’ role of

holding the Non Executive Directors (NEDs) – and through them, the Board – to account for the Trust’s performance. As part of this, the sub-groups continue to review progress against the strategic aims and objectives underpinning the Trust’s business plan.

3.2 In addition to the Chair’s Logs received from the Board’s Finance & Performance and Quality & Governance Committees, Board reports on a range of issues of interest to Governors continue to be shared at sub-group meetings and other information can be presented on request.

3.3 The sub-group meetings also provide a valuable opportunity for Governors to share feedback from their constituencies (public, partners and staff) as well as their own experiences and observations of the hospital’s services. Minutes from the sub-groups are shared with all Governors by email. Printed copies are available to Governors on request and key points from each meeting are reported at General Meetings (see below).

3.4 As stated previously, sub-group meetings are intended to supplement and support the work of the wider Council of Governors. Other information will also continue to be available to Governors via formal and informal updates from the Chairman and Chief Executive, Governor attendance at Board meetings held in public, the annual joint meeting of the Governors and Board (held in November), briefings received at General Meetings, private briefing sessions for Governors, and the Board’s responses to any questions raised by Governors.

93

CoG Dec 2015: 12 sub-group report (2)

4 REPORT ON SUB-GROUP MEETINGS 4.1 Quality & Governance (QGSG)

This group’s latest meeting was held on 6th October and was chaired by Jordan Ramsey. Key issues discussed are noted below.

• Good response from the “mystery shopper” exercise, led by Governors – with plans for this to be repeated on a quarterly basis in 2016.

• Feedback on the Trust’s PLACE (patient led assessment of care environment) inspection. Mrs Lorraine Christopher, the Associate Director of Estates & Facilities attended the meeting to explain the difference between the PLACE and the previous PEAT (Patient Environment Action Team) processes, with the new system having an increased emphasis on the environment in which care is provided. The results showed the Trust’s position compared with regional peers and national reporting, areas for improvement, and aspects for learning with the new system. The Governors acknowledged the planned further improvements, they were confident that the Trust’s environment remained of a high standard and agreed that this needed to be reflected more accurately in future assessments to support more equitable reporting.

• Mrs Christopher also gave an overview on capital projects since January 2014 and looking ahead to November 2016 supporting the Trust’s infrastructure, environment and service improvements – including the birthing centre (which several Governors reported had been very well received in the community) and developments such as assistive technology (refurbishments planned to support service growth) and kitchen wards (refurbishment works, to improve facilities for staff and patients). It was acknowledged that the programme had been impacted by the Trust’s financial position and the right balance was always sought to ensure critical backlog continued to be managed well and whilst at the same time allowing invest to save schemes on service developments to be progressed.

• The Chair’s Logs from the latest meetings of the Board’s Quality & Governance Committee were presented by Linda Christon, Non Executive Director and Committee Chair. She also presented and expanded on the quality issues within the Integrated Performance Report. The Committee’s discussed inpatient Falls and the programme now being led by the Director of Nursing & Quality, focussed on improving multifactorial assessments and continuous training. Mrs Christon also highlighted National Falls Week, which had been promoted in the Trust. Other key factors included the national increase reported on Clostridium Difficile (Barnsley had recorded 9 cases against the full year trajectory of 12), the impact of bed closures in the community (albeit short term), and clarification on the reporting and import of “never events”.

• Governors also received and reviewed the annual report from the Quality & Governance Committee

4.3 Finance & Performance (FPSG) The latest FPSG meeting was Chaired by David Brannan and held over two dates; 10th and 17th November. Unfortunately no Non Executive Directors were able to attend on 10th November and Governors appreciated the option to reconvene on 17th with the Chairman, Non Executive Director/Chair of the Board’s Finance & Performance Committee and the Director of Finance present to address a number of issues raised on the 10th. Key issues discussed across both dates included:

• Work on the 2016/17 business plan – at the first meeting, Ms Sowden, Head of Business Planning, provided a briefing to outline the Trust’s approach to

94


business planning for the coming year, the work already underway (building on progress to date and continuing to delivery the 5 year strategy) and the implications for the cost improvement programme (CIP). Governors were assured that all CIP proposals continued to be subject to quality impact assessment to ensure that quality and patient safety remained a priority. She also gave assurance that regular reports on business planning would continue to be shared with the Governors and that Governors would be invited to future stakeholder events to get involved with the planning that way too.

• There was lengthy discussion at both meetings on the reported financial position for month 6 (£2.9m adverse to plan) and revised forecast for the year. Governors appreciated that the Non Executive Directors continued to robustly scrutinise and seek assurance on every aspect of delivery of the Trust’s plans. It was acknowledged that the financial position for the NHS was tough everywhere and that, at this stage of the planning, every NHS organisation faced numerous unknown factors – including, but by no means limited to, changes to the national tariff, NHSLA premiums and the likely impact of national action to be taken by Junior Doctors. Ms Sowden had given assurance that all known factors would be taken into account as much as possible in the forward planning with some contingency (within reasonable limits) built in for unknown factors too. Board members reiterated their determination to explore more options to deliver further improvements in the financial position for Barnsley. The Clinical Commissioning Group (CCG) had provided some non-recurrent funding recently to support part of the escalation costs to date, which was appreciated, and the Trust would continue to work with them and other community partners to try to address the growing pressures together.

• Mr Smith reported his observations from a recent Quality & Safety visit, which had given rise to concerns that financial pressures were impacting on service quality, particularly in escalation wards. The Board’s commitment to quality was reiterated and it was acknowledged that actions had been taken since the time of the visit and more robust escalation plans were in place, as reported at the joint meeting with the Board and Governors. It was, however, undeniable that staff and services were facing increasing demands. Nevertheless the Trust would continue to strive to keep its doors open for all patients.

• Recent media reports on the interim Director of Finance arrangements established in 2014 were discussed. The Chairman reaffirmed that the appointment, as reported previously, had been essential at the start of the turnaround process to deliver improvements in the Trust’s finances and underpinning financial systems. The new Director of Finance, Mr Wright, was committed to continuing the good work achieved to date.

• Activity levels were also discussed, as were plans to catch up on the outpatient follow up backlog (reported earlier in the year). This would require some extra clinics but costs would be kept to a minimum

• The impact of the new agency cap on nursing and medical staffing was also reviewed. This was expected to bring some benefits to the Trust but again Governors were assured that, whilst the cap would be adhered to as much as possible, it would not be pursued at the cost of patient safety.

• Several Governors repeated problems with the acoustics in the room used for the Board and Governors’ General Meetings. Work would be progressed to try to improve this early in the new year.

95


• The Committee considered the Governors’ draft meeting programme for 2016. This will be revisited under the Chairman’s report (agenda item 9).

5 GOVERNORS’ TRAINING 5.1 To accommodate the additional FPSG meeting, the Annual Development Session

was rescheduled to January 2016. 5.2 The training programme for Governors will be continued throughout 2016, with the

content to be reviewed as part of the ADS in January.

6 CONCLUSION & RECOMMENDATIONS 6.1 The notes above are by no means a full reflection of the meetings’ business.

Governors are encouraged to come along to hear more and contribute to the sub-groups’ discussions and work.

6.2 Governors are asked to: a) note and support this report, and b) note the rescheduling of the Annual Development Session

David Brannan Jordan Ramsey Finance & Performance Quality & Governance SUB-GROUP CHAIRS November 2015

96

COUNCIL OF GOVERNORS – DECEMBER 2015 REF: COG/15/12/13

CoG Dec 2015/BoD Reports

13

BOARD OF DIRECTORS

1 MEETING PAPERS & AGENDA

1.1 The Agenda for the meeting of the Board of Directors to be held in public on 3rd December 2015, is attached for information. The minutes of the previous meeting, held in November are also attached (nb: these will be subject to approval at the Board’s meeting on 3rd December).

1.2 The latest performance report is enclosed too. This is still in a developing format, which will be further refined over the next few months.

1.3 Progress against delivery of the strategic objectives for the 2015/16 Business Plan will continue to be monitored through the Governors’ sub-groups. Any questions or comments on the performance report would also be welcomed at the General Meeting.

1.4 Additionally this month I have attached the Horizon Scanning report. This is provided each month by our communications lead, to add to the Board’s awareness of news items and upcoming national and regional issues. If it would be of interest to you, I would be pleased to ensure this is shared with Governors regularly too.

1.5 Copies of the full reports from all Board meetings held in public are available on the Trust’s website (www.barnsleyhospital.nhs.uk) or on request from the Secretary to the Board (Carol Dudley, 01226 431818 or email [email protected]).

2 FUTURE MEETINGS 2.1 Governors, staff and members of the public are welcome to come along to observe

any meetings of the Board held in public. Meeting papers will be provided on the Trust’s website and at the meeting.

2.2 The Board of Directors’ regular meetings are usually held on the first Thursday of every month but there are exceptions and Governors are advised to check with the Governors’ Office or on the Trust’s website for further details.

2.3 The next Board of Directors’ meeting to be held in public is scheduled for 14th January 2016 (one of the exceptions mentioned above, as this is the second Thursday in the month), commencing at 9am.

3. RECOMMENDATION Governors are asked to receive and note this report.

Stephen Wragg CHAIRMAN December 2015

97

A MEETING OF THE BOARD OF DIRECTORS

WILL TAKE PLACE ON THURSDAY 03 DECEMBER 2015, 9AM IN THE EDUCATION CENTRE, BARNSLEY HOSPITAL

AGENDA

No Item Sponsor Ref

1. Apologies and Welcome

S Wragg, Chairman

2. To receive any declarations of interests

3. To approve the Minutes of the meeting of the Board of Directors held in public on 05 November 2015 15/12/P-03

4. To approve the Action Log in relation to progress to date and review any outstanding actions 15/12/P-04

Strategic Aim 1: Patients will experience safe care

5. To receive and review latest Patient’s Story H McNair Dir of Nursing & Quality Presentation

6. To receive and endorse the Chair’s Log and assurance from the Quality & Governance Committee

L Christon Committee Chair 15/12/P-06

7. To approve the National Cancer Waiting Time 8 Key Priorities Improvement Plans for Colorectal, Lung and Head and Neck Cancer Teams

K Kelly Director of Operations 15/12/P-07

8. For information to receive a briefing on Safety Huddles H McNair

Dir of Nursing & Quality

Presentation

9. To review and endorse six monthly review on Nursing & Midwifery staffing levels and skillmix 15/12/P-09

10. To review the Chair’s Log on any escalation issues from the Executive Team

D Wake Chief Executive

11. To receive and endorse the Chair’s Log and assurance from the Audit Committee

S Brain England OBE Committee Chair 15/12/P-11

Strategic Aim 2: Partnership will be our strength

12. To note the monthly report from the Chairman S Wragg, Chairman 15/12/P-12

13. To note and endorse monthly report from Chief Executive D Wake, Chief Executive 15/12/P-13

14. To approve the annual review of the Trust’s Constitution A Keeney Assoc Dir of Corp Affairs 15/12/P-14

Strategic Aim 3: People will be proud to work for us Strategic Aim 4: Performance matters

15. To receive and endorse the Chair’s Log and assurance from the Finance & Performance Committee

F Patton Committee Chair 15/12/P-15

16. To review the integrated performance report (month 7) Executive Team 15/12/P-16

17. To review and consider the impact of the national Comprehensive Spending Review

B Kirton Dir of Strategy &

Business Development 15/12/P-17

Cont/…

98

No Item Sponsor Ref

18. To note intelligence reporting/horizon scanning for the Board E Parkes

Director of Marketing & Communications

15/12/P-18

19. In accordance with the Trust’s Standing Orders and Constitution, to resolve that representatives of the press and other members of the public be excluded from the remainder of the meeting, having regard to the confidential nature of the business to be transacted. 2016 Schedule of meetings:

• 14 January 2016 • 04 February 2016 • 03 March 2016 • 07 April 2016 • 05 May 2016 • 02 June 2016 • 07 July 2016 • 04 August 2016 • 01 September 2016 • 06 October 2016 • 03 November 2016 • 01 December 2016 All meetings starting at 9am

Signed: ………..…………………… Chairman

Please see reference section at back of papers for key to business plan and glossary of terms/acronyms

99

Created by: Management Information Services

Title of report: Integrated Performance Report

Executive Lead: Karen Kelly

October 2015

Integrated Performance Report

100

Contents

Executive Summary……………………………… 3

Summary…………………………………………….. 7

Patients will experience Safe Care………. 9

Partnerships will be our Strength………. 23

People will be proud to work for us…… 24

Performance Matters………………………… 27

a) Key Performance Indicators……………… 28

b) Data Quality……………………………………… 36

c) Activity……………………………………………… 40

d) Financial Overview……………………………. 42

101

Executive Summary by Exception

RAG Key Messages

YTD 1 Patients will experience safe care Committee: Q&G Page: 9-22

Quality & Patient Experience:-

Falls

Pressure Ulcers

Complaints

Complaint performance at the end of October 2015 shows that 42% of complaint cases have been closed within target with the year to date average being

69%. This is against a target of 90% of all complaints being responded to within agreed timeframe. Performance has dipped due to the fact that some

complaints have not been responded to within the agreed timeframe and short term extensions have been negotiated. This has been due in part to a high level

of complaints for CBU 1 and some complex joint complaint/serious incident investigations. Also wider operational pressures impacting on the time available to

IOs to do investigations.

The Complaints Team are now working closely with CBU 1 & 3 to improve performance and Clinical Governance Facilitator resource has been allocated to CBU 1

to support investigation of complaints and preparation of draft responses. CBU management teams are working hard to improve performance against agree

timeframes.

October has been the second month in the last three where the Trust has had no significant harm from a fall incident in the month. This is a real improvement in

the incidence of moderate harm and above in the organisation. National falls audit data just received demonstrate we have a lower incidence of significant

harm from falls than the national average. This is some assurance we are moving in the right direction.

General falls incident numbers, however, remain at the same level. This level is on par with the national average. In recent months this is an increase in numbers

from the good progress achieved previously. In September the Trust introduced a number of new falls management strategies, however, early feedback is that

this is taking some embedding.

A grade 2 heel pressure ulcer was identified on a patient whilst on SAU. The patient had existing leg ulcers and was extremely oedematous, which led to the skin

on her lower legs becoming vulnerable. She was nursed in multiple areas prior to the identification of the ulcer, and documentation around the skin integrity of

the heel was poor.

Of the 2 avoidable grade 2 pressure ulcers identified in October, a grade 2 device related pressure ulcer to the ear caused by oxygen tubing was identified on

ward 24.

Patients Partnerships People Performance

Page 3 of 45 102

Executive Summary by Exception cont.

RAG Key Messages

YTD 1 Patients will experience safe care cont. Committee: Q&G Page: 9-22

SafetyMedication Errors

The number of medicines incidents reported is above target but there were no incidents resulting in harm during October.

Serious Incidents

Incidents resulting in death

MortalityHSMR

YTD 3 People will be proud to work for us Committee: F&P Page: 24-26Staff Turnover

Mandatory Training

Sickness Absence

Sickness Absence is reported as risen this month to 4.35% and in a red position, despite retaining an amber position of less than 4% for consecutive months

since March 2015. A significant factor relates to the non-receipt by payroll of completed Sickness Absence Notification (SAN) Forms by payroll inputting deadline

resulting in a higher rate of absence as staff appear to remain off sick when they have returned to work. Work is underway to identify the late forms and follow

up with the managers responsible to ensure accurate and timely completion to improve our performance next month.

There were 4 SIs logged in October 2015 - one of these was a pressure ulcer SI.

2015/ 32504 Elderly male admitted with AKI stage 2.

2015/33737 unexpected admission of a baby < 37 weeks to neonatal intensive care unit.

2015/33947 Lack of escalation.

There were three incidents resulting in death reported in October. All of these were cardiac arrests. Ward 23, 30 and ED. The cardiac arrest on ward 23 has

since been judged to be the result of an acute cardiac event that was not preventable and has been downgraded to no harm. The death in ED was a patient with

hyperkalaemia and this is now being investigated as a high level investigation.

The rolling 12 month HSMR to June 2015 is 104.62. This is on trajectory for target of 100 by March 2016. The financial year to date HSMR is 97.21.

Staff turnover is just within the expected range. A number of ED leavers in September and the TUPE transfer out of GUM staff earlier in the year means staff

turnover has been high and this is reflected in the rolling 12 months %.

Only one CBU, Estates and Facilities, has achieved compliance of 95.8%. However, the remaining CBUs' performance is improving and ranges between 81 - 89%.

Also mandatory trainers continue to offer and explore more flexible methods of training delivery to improve compliance.


Page 4 of 45 103


RAG Key MessagesYTD 4 Performance Matters Committee: F&P Page: 27-35

a) Key Performance Indicators

Diagnostic Waits Over 6 Weeks

YTD Qtr A&E 4 Hour Waits

Average Length of Stay - Elective

The average length of stay for elective inpatients has decrease from 2.86 days in September to 2.46 days in October.Average Length of Stay - Non-Elective

The average length of stay for non-elective inpatients has decrease from 3.73 days in September to 3.51 days in October.Outpatient DNA RatesOutpatient DNA Rates reduced slightly in October to 10.6% against a target of 10%. The year to date position stands at 11%.

YTD Qtr Cancer Reporting

There were 6 breaches of the Diagnostic 6 week wait in October. These were all awaiting echocardiography. The team are completing a last set of evening echo

sessions to reduce the waiting list back down to 4 weeks. The additional capacity from the recent expansion in the service will come online in January in full with

additional sessions commencing from December to maintain 6 week wait times.

The number of attendances continue to be consistently above 6,700. October saw the highest number of ambulance attendances in the last 12 months with the

number of ambulance breaches correlating with the challenging 4 hour performance. Additional CBU management has been on site until 10pm to support

patient flow ensuring that all breach threats are escalated and plans to resolve put in place.

Quarter 2 end position demonstrated compliance across all key performance indicators for cancer including the 'GP 62 day referral to treatment' target. This

included reallocation of one shared pathway breach with the tertiary centre in Sheffield.In September, the GP 62 day target was not achieved across the majority of tumour groups - Lung, Head+Neck, Lower GI, Upper GI, Urology and Gynae. Only

breast and skin achieved the target during this month. Breach analysis showed a variety of breach reasons including several relating to the tertiary centre part of

the pathway. However, breaches continue to be attributable in part to pathway inefficiencies and delays in the diagnostic processes. Improvement plans are in

place for those pathways demonstrating consistent difficulties in meeting this target.

The Trust remains actively engaged in the network review of shared pathway performance and is committed to improving this with the tertiary centre in

Sheffield. Currently, late referral from District Generals (including BHNFT) are resulting in the tertiary centre unable to deliver compliant GP 62 day pathways; as

such Sheffield Teaching Hospitals did not achieve this target at quarter 2 end (2015/16). A trajectory has now been developed for all providers to achieve 85% of

referrals to the tertiary centre by Day 38 - to be achieved by March 2016. Whilst shared pathway performance for October did not meet the required rate (58%

actual versus 65% trajectory), the last few months have shown a significant improvement in BHNFT's performance. Full implementation of the national Cancer

Waiting Times 8 Key Priorities should help to achieve the desired position and make us a credible partner in shared cancer pathways."


Page 5 of 45 104


RAG Key MessagesYTD 4 Performance matters cont. Committee: F&P Page: 42-45

b) Financial overview

The Trust has a year to date deficit position of £10.5m that is £3.3m adverse to the plan. This is driven by several key factors:- risks, adjustments and penalties

incurred of £0.5m and a £0.8m adverse position to date on 2015/16 CIP achievement. There is also CIP from 2014/15 that was not achieved on a recurrent basis.

In addition there is significant pressure on pay costs driven by agency spend linked to escalation. Urgent action has been and will continue to be taken to

reduce adverse variances and identify new CIPs. The cash position is £0.2m favourable to plan which is driven by lower capital spend, working capital

management and the advanced receipt of working capital funding.


Page 6 of 45 105

1 2 3 4 6 15 16 17 18 19 20 21 22 23 24 25 26

Domain KPI Target Set ByCurrent

Qtr

Year to

DateNov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Trend

FFT Positivity Rates - EDG >85%, A >=80%-

85%, R <80%BHNFT 89.9% 94.7% 80.6% 88.7% 92.7% 90.3% 89.0% 78.3% 70.6% 81.4% 85.4% 93.8% 92.1%

FFT Positivity Rates - IPG >85%, A >=80%-

85%, R <80%BHNFT 97.5% 95.3% 95.6% 97.9% 93.7% 97.0% 96.7% 97.8% 96.5% 97.5% 98.2% 97.9% 97.8%

FFT Positivity Rates - OPG >85%, A >=80%-

85%, R <80%BHNFT 92.6% n/a n/a n/a n/a n/a 98.9% 90.0% 91.5% 90.7% 95.3% 92.5% 92.8%

FFT Positivity Rates - MATG >85%, A >=80%-

85%, R <80%BHNFT 97.5% 97.5% 98.1% 98.1% 97.3% 97.3% 97.1% 99.0% 96.5% 98.7% 96.0% 96.4% 97.9%

Complaints closed within targetG >90%, A >=70%-

90%, R <70%BHNFT 69.3% n/a n/a n/a n/a n/a 55.0% 63.0% 88.9% 76.5% 78.9% 66.7% 41.7%

Dementia - Find/Assess 90% National 94.9% n/a n/a n/a n/a n/a 91.3% 97.5% 95.0% 94.3% 94.3% 95.2% 95.5%

Dementia - Investigate 90% National 100% n/a n/a n/a n/a n/a 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

Dementia - Refer 90% National 100% n/a n/a n/a n/a n/a 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

Falls 515 BHNFT 515 58 75 85 86 76 68 67 72 82 76 73 77

Multiple Falls 128 BHNFT 120 9 11 21 21 19 16 15 12 18 16 22 21

Falls resulting in moderate harm or above 20 BHNFT 13 n/a n/a n/a n/a n/a 2 3 6 1 0 1 0

Hand washing 95% National 98.8% 99.4% 98.4% 99.4% 100.0% 99.6% 99.6% 99.6% 98.2% 96.3% 98.6% 99.6% 99.5%

Pressure Ulcers Grade 3 & 4 0 BHNFT 9 1 0 1 1 1 0 1 2 3 1 1 1

Pressure Ulcers Grade 2 0 BHNFT 41 n/a n/a n/a n/a n/a 5 6 8 3 4 6 9

Single Sex Breaches 0 National 0 0 0 0 0 0 0 0 0 0 0 0 0

Hospital Acquired Clostridium Difficile 13 NHSE 9 1 2 0 1 1 1 0 1 1 4 2 0

MRSA 0 NHSE 0 0 0 0 0 0 0 0 0 0 0 0 0

VTE Screening Compliance 95% NHSE 95.6% 95.1% 95.5% 95.6% 95.5% 95.8% 95.1% 95.3% 95.8% 96.1% 95.5% 95.6% 95.5%

Incidence of Medication Errors - All 400 National 255 51 49 32 34 38 34 28 28 40 36 39 50

Incidence of Medication Errors - No adverse outcome 241 National 174 28 40 22 18 22 23 18 19 23 27 25 39

Incidence of Medication Errors - Near misses 63 National 72 22 9 9 13 15 8 9 8 14 8 14 11

Incidence of Medication Errors - Causing harm 10 National 9 1 0 1 3 1 3 1 1 3 1 0 0

Never Events 0 NHSE 2 0 0 0 0 0 1 0 1 0 0 0 0

Serious Incidents 66 NHSE 49 7 4 4 6 7 6 3 11 11 5 9 4

Death 0 National 10 1 0 1 5 0 1 0 4 1 1 0 3

Severe 0 National 11 0 0 0 1 2 2 4 3 1 0 1 0

Percentage of Incidents Causing Harm <28% BHNFT 7.5% 7.4% 7.6% 7.0% 10.6% 6.3% 8.2% 6.2% 8.2% 8.1% 6.1% 7.7% 8.0%

Total (All) 7400 National 4848 707 641 591 612 613 673 659 693 791 663 669 700

HSMR (Rolling 12 months) 100 National 104.6 101.7 101.1 102.7 103.6 103.4 102.3 102.7 104.1 104.6

SHMI (Rolling 12 months) 105 National 99.2 102.5 99.2

HSMR (Year to date) 100 93.22 95.5 99.0 103.6 104.5 103.3 93.97 86.95 93.22 97.21

Summary

Quality & Patient

Experience

Patients will experience safe care

Mortality

Patient Safety


Page 7 of 45 106

Domain KPI Target Set ByYear to

DateNov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Trend

Staff Turnover (Rolling 12 months)G <=10%, A >10%-

11%, R >11%BHNFT 9.88% 8.09% 7.85% 7.94% 7.93% 8.88% 9.09% 9.66% 9.85% 9.63% 9.81% 10.08% 9.88%

Appraisals (Rolling 12 months)G >90%, A >=70%-

90%, R <70%BHNFT 89.88% 93.11% 92.59% 92.26% 91.29% 91.47% 12.60% 30.32% 83.02% 88.69% 89.27% 90.07% 89.88%

Mandatory Training (Rolling 12 months)G >90%, A >=85%-

90%, R <85%BHNFT 85.42% 84.79% 84.44% 83.40% 82.83% 82.32% 82.24% 84.30% 86.48% 86.80% 86.91% 86.22% 85.42%

Sickness Absence (Rolling 12 months)G <=3.5%, A >3.5%-

4%, R >4%BHNFT 4.18% 4.69% 5.06% 4.81% 4.62% 3.96% 3.74% 3.61% 3.56% 3.87% 3.99% 3.92% 4.35%

RTT Admitted 90% National 94.6% 96.2% 94.5% 94.2% 98.3% 95.4% 94.9% 96.9% 96.8% 94.0% 98.1% 97.6% 95.6% 94.6%

RTT Non-Admitted 95% National 97.3% 97.5% 100.0% 97.2% 96.6% 96.6% 98.2% 97.7% 97.3% 97.9% 98.3% 98.2% 94.9% 97.3%

RTT Incomplete Pathways 92% National 95.4% 93.9% 93.2% 94.4% 93.0% 94.5% 92.5% 91.3% 92.5% 94.6% 95.7% 94.5% 94.5% 95.4%

Diagnostic patients waiting more than 6 weeks 0 National 37 18 60 84 3 16 2 7 3 0 12 7 6

Cancer 2 Week Waits 93% National 98.0% 97.5% 97.7% 98.5% 99.6% 98.6% 99.3% 99.3% 98.1% 98.4% 96.9% 95.4% 96.5% 98.0%

Symptomatic Breast 2 Week Waits 93% National 97.8% 94.7% 95.8% 98.1% 94.3% 98.8% 95.7% 96.3% 93.2% 95.1% 89.2% 92.0% 98.1% 97.8%

31 Day - 1st Definitive Treatment 96% National 100.0% 99.2% 100.0% 100.0% 100.0% 100.0% 98.7% 98.8% 100.0% 100.0% 98.5% 100.0% 97.3% 100.0%

31 Day - Subsequent Treatment (Surgery) 94% National 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

31 Day - Subsequent Treatment (Chemotherapy) 98% National 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

62 Day - GP Referral to Treatment 85% National 87.5% 85.4% 91.7% 94.4% 81.4% 82.5% 89.9% 88.0% 84.1% 83.2% 77.2% 91.6% 85.3% 87.5%

62 Day - Screening Referral to Treatment 90% National 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

62 Day - Consultant Upgrade to Treatment 85% BHNFT 100.0% 89.2% 100.0% 66.7% 100.0% 100.0% 88.9% 100.0% 92.3% 81.8% 88.9% 66.7% 92.3% 100.0%

Emergency % Patients Waiting <4 Hours 95% National 90.9% 94.1% 95.5% 90.3% 93.7% 96.2% 97.3% 91.7% 96.3% 97.2% 93.2% 95.4% 94.1% 90.9%

Average Length of Stay - ElectiveG <=2.42, A >2.42-

2.67, R >2.67BHNFT 2.67 2.78 2.44 2.72 3.14 2.63 2.46 3.24 2.94 2.40 2.35 2.86 2.46

Average Length of Stay - Non-ElectiveG <=3.44, A >3.44-

3.69, R >3.69BHNFT 3.53 3.57 3.95 3.67 3.53 3.60 3.10 3.62 3.50 3.63 3.61 3.73 3.51

Cancelled Operations - Breaches of the 28 day rule 0 National 1 0 0 0 0 0 0 0 1 0 0 0 0

DNA Outpatient DNA RatesG <=10%, A >10%-

11%, R >11%BHNFT 11.0% 12.3% 12.4% 12.1% 10.9% 10.9% 11.2% 11.6% 11.1% 11.0% 11.0% 10.7% 10.6%

RAG Description

RED Failed Target

AMBER Failed by <5% (This tolerance does not apply to Cancer & A&E targets

which will be RED if the target is not achieved)

GREEN Achieved Target

NOTE: National Indicators such as Cancer, RTT, Cancelled Ops, etc. are considered as being either Achieved or Failed. These are therefore RAG rated as Green or Red.

All other indicators are classed as Achieved or Failed with the exception of all Workforce KPIs, Average Length of Stay & DNA rates which detail the tolerances applied in the Target column.

Elective Access

Cancer

Operational

Efficiency

Performance matters - Key Performance Indicators

People will be proud to work for us

Workforce

Summary


Page 8 of 45 107

1 2 3 4 5 12 18 19 20 # 22 # 24 25 26 33 39 40 41 # #

Patients will experience safe care - "At a glance"

Target

15/16

Target

YTDOct-15

Actual

YTDTrend

YTD

Status

Target

15/16

Target

YTDOct-15

Actual

YTDTrend

YTD

Status

Friends & Family Test (Quality Strategy Goal 1) Mortality (Quality Strategy Goal 3)

Friends & Family Test - ED 85% 85% 900.0% 89.9% ↑ 89.9% HSMR Rolling 12 months (Latest data July 15) 100 103.3 104.62 104.62 ↑ 104.6

Friends & Family Test - Inpatients 85% 85% 97.8% 97.5% ↓ 97.5% SHMI Rolling 12 months (Latest data Mar 15) 105 105 99.2 99.2 ↑ 99.2

Friends & Family Test - Maternity 85% 85% 97.9% 97.5% ↑ 97.5% HSMR Year to date (Latest data July 15) 100 100 97.2 97.2 ↑ 1

Friends & Family Test - Outpatients 85% 85% 92.8% 92.6% ↑ 92.6%

VTE Screening Compliance (Quality Strategy Goal 2) 95% 95% 95.5% 95.6% ↓ 95.6%

Complaints (Quality Strategy Goal 1)

Total no. of complaints N/A N/A 19 131 ↓ Medication Incidents (Quality Strategy Goal 2)

Complaints closed within target 90% 90% 41.7% 69.3% ↓ 69.3% Incidence of medication errors - All 400 233 50 255 ↓ 0

Complaints re-opened N/A N/A 0 8 ↑ Incidence of medication errors - No adverse outcome 241 141 39 174 ↓ 0

Incidence of medication errors - Near misses 63 37 11 72 ↑ 0

Dementia (Quality Strategy Goal 1) Incidence of medication errors - Causing harm 10 6 0 9 ↔ 0

Find/Assess 90% 90% 95.5% 94.9% ↑ 94.9%

Investigate 90% 90% 100.0% 100.0% ↔ 100.0% Serious Incidents (Quality Strategy Goal 2)

Refer 90% 90% 100.0% 100.0% ↔ 100.0% Never Events 0 0 0 2 ↔ 0

Serious Incidents 66 11 4 49 ↑ 0

Falls (Quality Strategy Goal 2)

No. of Falls 515 300 77 515 ↓ 0 Incident Grading (Quality Strategy Goal 2)

No. of Multiple Falls 128 75 21 120 ↑ 0 Death 0 0 3 10 ↓ 0

Falls resulting in moderate harm or above 20 12 0 13 ↑ 0 Severe 0 0 0 11 ↑ 0

Moderate N/A N/A 13 59 ↓

Hand washing (Quality Strategy Goal 2) 95% 95% 99.5% 98.8% ↓ 98.8% Low N/A N/A 40 282 ↑

No Harm N/A N/A 644 4444 ↓

Pressure Ulcers (Quality Strategy Goal 2) Percentage of incidents causing harm <28% 28% 8.0% 7.5% ↓ 7.5%

Grades 3 & 4 # 0 0 1 9 ↔ 0

Grade 2 Post ## 0 0 9 41 ↓ 0

Patient Safety (Quality Strategy Goal 2)

Single Sex Breaches (Quality Strategy Goal 1) 0 0 0 0 ↔ 1 Total Incidents 7400 4317 700 4848 ↑ 0

Infections (Quality Strategy Goal 2)

Hospital Acquired Clostridium Difficile 13 8 0 9 ↑ 0

MSSA N/A N/A 1 3 ↔

MRSA 0 0 0 0 ↔ 1

Ecoli - Total hospital N/A N/A 1 14 ↑

Patients will experience safe care - Quality & Experience Patients will experience safe care - Patient Safety

# Relates to a patient currently at NGH, therefore RCA will not be completed until the patients medical notes are next avalible for review.

## 4 of the G2 were unavoidable.


Page 9 of 45 108

Patients will experience safe care (Quality & Experience)

Friends & Family Test (Quality Strategy - Goal 1: Delivering Patient Centred Care)

7

9

Frie

nd

s &

Fam

ily T

est

Frie

nd

s &

Fam

ily T

est


0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

Pe

rce

nta

ge P

osi

tivi

ty

Friends & Family Test Positivity Rates

ED Actual IP Actual OP Actual MAT Actual Target

88.0% 95% 94%

73%

86% 84% 89% 88% 87%

95% 87%

92% 83% 85% 81%

0%

20%

40%

60%

80%

100%

Friends & Family Test - A&E Benchmarking (Latest NHS England Published Data -

Sept 2015)

Peer…

95.0% 97% 98% 99% 97% 97% 94% 95% 94% 97% 97%

76%

97% 98% 97%

0%

20%

40%

60%

80%

100%

120%

Friends & Family Test - Inpatient Benchmarking (Latest NHS England Published Data - Sept 2015)

Peer Group Local Target

95.1%

99% 96%

99% 99%

94%

99%

88%

96% 98%

90%

94%

99% 98%

75%

80%

85%

90%

95%

100%

Friends & Family Test - Maternity Benchmarking (Latest NHS England Published Data -Sept 2015)

Peer Group Local Target

Page 10 of 45 109



Complaints (Quality Strategy - Goal 1: Delivering Patient Centred Care)

Comments:

Co

mp

lain

tsC

om

pla

ints

Co

mp

lain

ts

Complaint performance at the end of October 2015 shows that 42% of complaint cases have

been closed within target with the year to date average being 69%. This is against a target of

90% of all complaints being responded to within agreed timeframe.

0

5

10

15

20

25

30

Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16

Complaints by Category

Patient Care Access, Appts, etc Communication

Medical Records Medication Falls

Infection Control Infrastructure Other

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Pe

rce

nta

ge w

ith

in t

arge

t

Complaints Closed within Target

% closed Target

0

50

100

150

200

250

0

5

10

15

20

25

30

Complaints and PALS Enquiries

Complaints Re-opened PALS

Page 11 of 45 110



Dementia (Quality Strategy - Goal 1: Delivering Patient Centred Care)

Comments:

All target have been met

De

me

nti

aD

eme

nti

a -

Be

nch

mar

kin

g

Dem

enti

a -

Ben

chm

arki

ng

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Find/Assess Actual Investigate Actual Refer Actual Target

91% 94%

92% 90% 91%

87%

97% 98% 95%

91%

100% 98%

75%

80%

85%

90%

95%

100%

Percentage of Cases Identified (Latest NHS England published data August

2015)

Peer Group Target

91%

100% 100% 100% 100% 100% 100%

98%

100% 100% 100% 100%

84%86%88%90%92%94%96%98%

100%102%

Percentage of Cases with Diagnostic Assessment (Latest NHS England

Published data August 2015)

Peer Group Target

Page 12 of 45 111



Falls (Quality Strategy - Goal 2: Delivering Consistently Safe Care)

Comments:

Falls

res

ult

ing

in m

od

era

te h

arm

or

abo

veFa

lls

Mu

ltip

le F

alls

October has been the second month in the last three where the Trust has had no significant

harm from a fall incident in the month. This is a real improvement in the incidence of

moderate harm and above in the organisation. National falls audit data just received

demonstrate we have a lower incidence of significant harm from falls than the national

average. This is some assurance we are moving in the right direction.

General falls incident numbers, however, remain at the same level. This level is on par with

the national average. In recent months this is an increase in numbers from the good progress

achieved previously. In September the Trust introduced a number of new falls management

strategies, however, early feedback is that this is taking some embedding.

0

10

20

30

40

50

60

70

80

90

No

. of

Falls

No. of Falls

Actual Target

0

5

10

15

20

25

No

. of

Mu

ltip

le F

alls

Multiple Falls

Actual Target

0

1

2

3

4

5

6

7

No

. of

Falls

Falls resulting in moderate harm or above

Actual Target

Page 13 of 45 112



Pressure Ulcers (Quality Strategy - Goal 2: Delivering Consistently Safe Care)

Comments:

Grade 2:

Grade 3:

Pre

ssu

re U

lce

rs -

Gra

de

2P

ress

ure

Ulc

ers

- G

rad

e 3

& 4

Of the 2 avoidable grade 2 pressure ulcers identified in October, a grade 2 device related

pressure ulcer to the ear caused by oxygen tubing was identified on ward 24.

A grade 2 heel pressure ulcer was identified on a patient whilst on SAU. The patient had

existing leg ulcers and was extremely oedematous, which led to the skin on her lower legs

becoming vulnerable. She was nursed in multiple areas prior to the identification of the ulcer,

and documentation around the skin integrity of the heel was poor.

0

1

2

3

4

5

6

7

8

9

10

Grade 2 Actual Target

0

1

2

3

4

Avoidable Grade 3 & 4 Pressure Ulcers

Grade 3 Grade 4 Target

Page 14 of 45 113



Infections (Quality Strategy - Goal 2: Delivering Consistently Safe Care)

Comments:

Ho

spit

al A

cqu

ired

Clo

stri

diu

m D

iffi

cile

Eco

li

0

1

2

3

4

5

0

2

4

6

8

10

12

14

Hospital Acquired Clostridium Difficile (cumulative

position)

Tolerance Actual

Page 15 of 45 114



Nursing Staffing Fill Rate (Quality Strategy - Goal 4: Building on Capacity and Capability)

Comments:

14 92.5% 84.9% 100.0% 100.0% Registered Nurses

17 91.0% 100.2% 103.2% 199.5% Registered Midwives

18 88.0% 120.4% 98.4% 171.0% Unregistered health care/midwifery care assistants

19/20 79.0% 97.7% 100.0% 121.5% Unregistered nursing/midwifery auxiliaries.

AMU 86.2% 96.1% 100.8% 100.7%

Acute Stroke 84.5% 71.7% 83.5% 114.1%

24 93.1% 112.8% 98.1%

28 82.1% 90.6% 100.0% 124.2%

31 72.2% 129.3% 96.8% 97.3%

32 86.4% 134.8% 100.0% 100.0%

34 71.3% 93.9% 91.9% 107.5%

ITU 83.6% 53.8% 97.7%

SHDU 99.5% 59.6% 101.1%

CCU 101.9% 89.6% 103.6%

AN/PN 94.7% 101.6% 91.9% 90.6%

Birthing Centre 91.8% 106.5% 86.2% 79.4%

37 91.5% 77.9% 89.4% 100.0%

15 91.4% 66.7% 90.3% 83.9%

This allows for contingency plans to be made where the roster identifies that

the planned staffing falls short of the minimum requirement, for example

where there are vacant nursing posts or staff appointed have not started in

post. These contingency plans can include: moving staff from a shift which is

above the minimum required level, moving staff from another ward/area which

is above the minimum required level, or the use of flexible/temporary staffing

from the Trust’s internal bank or via an external nursing agency.

320 - CARDIOLOGY

340 - RESPIRATORY MEDICINE

430 - GERIATRIC MEDICINE

502 - GYNAECOLOGY

192 - CRITICAL CARE MEDICINE

Ave fill rate

Care staff (%)

Ave fill rate

Registered

The areas that currently have the most vacancies in nursing continue to be in

CBU 1 and in particular wards 19 and 20 )Care of the Elderly and ward 33/34

(Trauma and Orthopaedics).

BHNFT is committed to ensuring that levels of nursing staff, match the acuity

and dependency needs of patients in order to provide safe and effective care.

Nurse staffing includes:

The Trust uses an e-rostering system with duty rosters created eight weeks in

advance to ensure the levels and skill mix of the nursing staff on duty are

appropriate for providing safe and effective care.

NightDay

Specialty

Nu

rsin

g St

affi

ng

Fill

Rat

e

300 - GENERAL MEDICINE

300 - GENERAL MEDICINE

370 - MEDICAL ONCOLOGY

301 - GASTROENTEROLOGY

100 - GENERAL SURGERY

100 - GENERAL SURGERY

110 - TRAUMA & ORTHOPAEDICS

420 - PAEDIATRICS

422- NEONATOLOGY

Ward

name

Ave fill rate

Registered

Ave fill rate

Care staff (%)

192 - CRITICAL CARE MEDICINE

320 - CARDIOLOGY

501 - OBSTETRICS

501 - OBSTETRICS

Page 16 of 45 115

Patients will experience safe care (Safety)

Mortality (Quality Strategy - Goal 3: Delivering Consistently Effective Care)

HSMR rolling 12 month target HSMR peer group benchmarking

HSM

RH

SMR


80

85

90

95

100

105

Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15

HSMR Year to date

Year to date Target

Page 17 of 45 116



HSMR rolling 12 month target

Comments

HSMR

SHM

I an

d C

rud

e M

ort

alit

yC

rud

e M

ort

alit

y

The rolling 12 month HSMR to June 2015 is 104.62. This is on trajectory for target of 100

by March 2016. The financial year to date HSMR is 97.21.

Page 18 of 45 117



Incidents (Quality Strategy - Goal 2: Delivering Consistently Safe Care)

See narrative provided with Heatmap data See narrative provided with Heatmap data

See narrative provided with Heatmap data See narrative provided with Heatmap data

Me

dic

atio

n In

cid

en

ts -

Cau

sin

g h

arm

Ne

ver

Eve

nts

& S

eri

ou

s In

cid

en

ts

Inci

den

t G

rad

ing

Pat

ien

t Sa

fety

Inci

de

nts

(A

ll)

0

10

20

30

40

50

60

0

2

4

6

8

10

12

Total Medication Incidents Cumulative Target Cumulative actual

0

2

4

6

8

10

12

Serious Incidents Never Events SI Target Never Event Target

0

100

200

300

400

500

600

700

800

900

Actual Target

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

9.0%

0

10

20

30

40

50

60

70

Pe

rce

nta

ge C

ausi

ng

Har

m

Gra

din

g

Low Moderate Severe Death % Causing Harm

Page 19 of 45 118

Patients will experience safe careHeatmap Oct-15

MR

SA

C D

iff

Falls

- N

o A

dve

rse

Ou

tco

me

Falls

- A

dver

se

Out

com

e

Mu

ltip

le f

alls

- N

o

Ad

vers

e O

utc

om

e

Mu

ltip

le f

alls

-

Ad

vers

e O

utc

om

e

Med

icat

ion

Err

ors

- N

o A

dve

rse

Ou

tco

me

Med

icat

ion

Err

ors

- N

ear

mis

s

Med

icat

ion

Err

ors

- C

ausi

ng

Har

m

Nu

mb

er o

f

Seri

ou

s In

cid

ents

Nu

mb

er o

f N

ever

Even

ts

Pre

ssu

re U

lcer

s

Gra

de

2

Pre

ssu

re U

lcer

s

Gra

de

3

Pre

ssu

re U

lcer

s

Gra

de

4

Inci

den

ts -

Dea

th

Inci

den

ts -

Sev

ere

Inci

den

ts -

Mo

der

ate

Inci

den

ts -

Lo

w

Inci

den

ts -

No

Har

m

Trust 0 0 60 17 15 6 39 10 0 3 0 7 1 0 3 0 11 40 625

CDU 1 2 16ARU 1Therapy Services 4Fracture Clinic 2ED 4 1 3 113Ward 19 14 4 2 2 2 5 25Ward 20 8 2 3 2 1 2 1 5 19Ward 23 4 1 1 1 1 1 18Ward 33 3 1 2 1 1 2 17Ward 34 2 5 11Day Surgery 4Hospital at Night 2Pld Investigation UnitPre Assessment Unit 12ICU 1 1 1 1SHDU 1Theatres 1 19Theatres Recovery 3AMU 5 9 1 1 3 1 94CCU 1 2 5Dermatology 3Diabetes Centre 1Endoscopy 1 2NeurologyRheumatologyWard 17 2 1 1 1 1 6Ward 18 7 2 4 1 2 1 2 21Ward 24 2 2 1 1 3 6Ward 28 4 2 2 1 1 1 2 16Chemo Unit 1Urol Inv UnitBreast SurgeryENT Outpatients 1Ophthalmology OPD 1 3Orthoptics OPD 1PIUSAU 2 1 1 1 1 2 2 11SDA 7Ward 29 2Ward 30 2 2 1 6Ward 31 3 2 1 1 1 3 13Ward 32 1 2 1 1 8Breast Outpatients 1Breast Screening 1Medical Imaging 1 2 4Med Records/New StoreMain Outpatients 2Main Reception 1Medical Outpatients 1Nuclear Medicine 5PathologyPharmacy 3 3Surgical Outpatients 6Ultrasound 1Ultrasound (Maternity) 1Labour Suite 1 1 67Antenatal Clinic 1Antenatal Day UnitCommunity Midwifery 5Community Paediatrics 3Gynaecology OPD 2Obstetric Theatre 2PN/AN Ward 1 1 1 17Ward 14 1 1 12Ward 15 4Ward 37 1 7Women's & Children's Reception 1Paediatric OPD 4

CB

U 6

CB

U 1

CB

U 2

CB

U 3

CB

U 4

CB

U 5


Page 20 of 45119

Patients will experience safe careHeatmap

Ward 20Ward 23Ward 19EDWard 33CDUWard 34ARUTherapy ServicesFracture ClinicICUTheatresDay SurgeryHospital at NightPre Assessment UnitSHDUTheatres RecoveryPld Investigation UnitWard 28Ward 17Ward 18AMUWard 24CCUEndoscopyDermatologyDiabetes CentreChemo UnitNeurologyRheumatologySAUWard 31Ward 30Ward 32Ophthalmology OPDENT OutpatientsOrthoptics OPDSDAWard 29Urol Inv UnitBreast SurgeryPIUMedical ImagingPharmacyBreast OutpatientsBreast ScreeningMain OutpatientsMain ReceptionMedical OutpatientsNuclear MedicineSurgical OutpatientsUltrasoundUltrasound (Maternity)Med Records/New StorePathologyPN/AN WardLabour SuiteWard 14Ward 37Antenatal ClinicCommunity MidwiferyCommunity PaediatricsGynaecology OPDObstetric TheatreWard 15Women's & Children's ReceptionPaediatric OPDAntenatal Day Unit

CB

U 1

CB

U 3

CB

U 4

CB

U 5

CB

U 6

CB

U 2


Page 21 of 45120

Patients will experience safe careHeatmap

Reporting Month#REF!

Executive lead :Heather McNair

Comments

The number of medicines incidents reported is above target and there were no incidents resulting in harm during October.

Falls

Indicator Name

2015/ 32504 Elderly male admitted with AKI stage 2.

2015/33737 unexpected admission of a baby < 37 weeks to neonatal intensive care unit.

2015/33947 Lack of escalation.

There were three incidents resulting in death reported in October. All of these were cardiac arrests. Ward 23, 30 and ED. The cardiac arrest on ward 23 has since been judged to be the result of an acute cardiac event that was not preventable and has been downgraded to no harm. The death in ED was a

patient with hpyerkalaeamia and this is now being investigated as a high level investigation.

October has been the second month in the last three where the Trust has had no significant harm from a fall incident in the month. This is a real improvement in the incidence of moderate harm and above in the organisation. National falls audit data just received demonstrate we have a lower incidence

of significant harm from falls than the national average. This is some assurance we are moving in the right direction.

General falls incident numbers, however, remain at the same level. This level is on par with the national average. In recent months this is an increase in numbers from the good progress achieved previously. In September the Trust introduced a number of new falls management strategies, however, early

feedback is that this is taking some embedding.

Of the 2 avoidable grade 2 pressure ulcers identified in October, a grade 2 device related pressure ulcer to the ear caused by oxygen tubing was identified on ward 24.

A grade 2 heel pressure ulcer was identified on a patient whilst on SAU. The patient had existing leg ulcers and was extremely oedematous, which led to the skin on her lower legs becoming vulnerable. She was nursed in multiple areas prior to the identification of the ulcer, and documentation around the

skin integrity of the heel was poor.

Medication Errors

Incidents resulting in death

Serious incidents

Pressure Ulcers


Page 22 of 45121

# 1 2 3 4 5 12 18 19 20 # 22

Partnerships will be our strength - "At a glance"

Target Target Actual YTD

15/16 YTD Oct-15 YTD Trend Status

Key Issues

Better Care Fund - Emergency Admissions 22302 7704 0 8149 8149

(Latest data Q1)

Partnerships


Page 23 of 45 122

0 1 2 3 4 5 12 18 19 20 # 22

People - "At a glance"

Target Target Actual YTD

15/16 YTD Oct-15 YTD Trend Status

Workforce (Quality Strategy - Goal 4: Building on Capacity and Capability)

Sickness Absence Rate 3.50% 3.50% 4.35% 4.18% ↓ 4.18%

Staff Turnover 10.0% 10.0% 9.9% 9.9% ↑ 9.88%

Mandatory Training 90.0% 90.0% 85.4% 85.4% ↓ 85.42%

Appraisal Rates - Medical 90.0% 90.0% 93.1% 93.1% ↓ 93.10%

Appraisal Rates - Non Medical 90.0% 90.0% 89.7% 89.7% ↓ 89.65%

Appraisal Rates - Total 90.0% 90.0% 89.9% 89.9% ↓ 89.88%

Recruitment - Medical 90.0% 90.0% 0.0% 0.0% ↓

Recruitment - Non-Medical 90.0% 90.0% 83.3% 83.3% ↓

People


Page 24 of 45 123

People will be proud to work for usWorkforce (Quality Strategy - Goal 4: Building on Capacity and Capability)

FTE FTE Variance Maternity Sickness

Budget Contracted Count

Appraisals Non Medical

Trust

Diagnostic & Clinical

Support Services CBU

Staf

f Tu

rno

ver

Vac

ancy

Le

vels

2692.9

449.14

Staff turnover is just within the expected range. A number of ED leavers in September and the

TUPE transfer out of GUM staff earlier in the year means staff turnover has been high and

this is reflected in the rolling 12 months %.

CBU 5 – Vacancy factor remains high because of recruitment difficulties for Healthcare Scientists

within the Labs and in Radiology where there are particular issues with recruiting radiographers .

These are both national issues. Recruitment is on-going to attract staff.

2594.9 3.64% 76 4.35%

10.46% 9 3.10%402.16

Re

cru

itm

en

t

Recruitment - Non medical

The recruitment of a Specialty doctor in dermatology completed this month. The recruitment commenced

in March but took until October to complete due to the candidate’s visa application being rejected 3 times

before finally being accepted on the 4th time.

Overall compliance is 89.7% CBU’s who have not achieved compliance are corporate services 84.3%,

theatres and anaesthetics 88.2% and diagnostics 87.6%. The remainder are as follows. Estates and facilities

96.6%, Emergencies 90.1%, general and specialist medicine92.5%, General and specialist surgery 91.1%

and women’s and children’s 93.0%

24 campaigns completed for October 2015, of which 4 were outside the timeline standard due in part to

delays in manager notifications and production of a job description. Recruiting managers are contacted

after every breach to advise them for future improvements in managing the process

Recruitment - Medical


5.0%6.0%7.0%8.0%9.0%

10.0%

Pe

rce

nta

ge P

osi

tivi

ty

Staff Turnover

Actual Target

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Non-Medical Target

Page 25 of 45 124

People will be proud to work for usWorkforce (Quality Strategy - Goal 4: Building on Capacity and Capability)

Appraisals Medical

CBU 1 92.6% CBU 2 100.00% CBU 3 90.9%

CBU 4 91.3% CBU 5 93.30% CBU 6 90.5%

Trust Sickness YvY

Sick

ne

ss A

bse

nce

Sick

ne

ss A

bse

nce

Man

dat

ory

Tra

inin

g

Ap

pra

isal

s

Overall compliance as of the 31st of October is 85.4%. Estates and Facilities are the only CBU to achieve

compliance of 95.8%. The remainder are as follows, corporate services, 81.2%, emergencies 81.8%, general and

specialist medicine 84.6%, Theatres and anaesthetics 89.8%, general and specialist surgery 83.8%, diagnostics 88.6%

and women's and children’s 88.9%

Sickness has risen this month to 4.35%,an increase of 0.52% over last month. Only Diagnostics CBU and Corporate

show continuing good performance towards the 3.5% target. Theatres CBU has recorded the lowest rate of

absence in 4 months at 3.71%. CBU 1, 3 ,4 and 6 and Estates show rises in the sickness absence rate, though a

significant factor in the increase in the CBUs 1,3 and 6 relates to the non receipt by payroll of completed Sickness

Absence Notification forms by payroll shutdown deadline resulting in a higher rate of absence as staff appear to

remain off sick when they have returned to work. Upon revision of the figures for next month it is anticipated that

the overall sickness absence rate for October will fall . HR are to work with CBUs to monitor and chase Sickness

Absence Forms to ensure they are completed and with payroll in a timely manner.

50%

60%

70%

80%

90%

100%

Pe

rce

nta

ge P

osi

tivi

ty

Mandatory Training

Actual Target


0%

20%

40%

60%

80%

100%

Appraisals

Total Non-Medical Medical Target

0%

5%

Pe

rce

nta

ge

Po

siti

vity

Sickness Absence

Actual Target

Page 26 of 45 125

1 2 3 4 5 12 19 20 # 22 # 24 25 26 33 39 40 41 # #

Performance - "At a glance"

Target

15/16

Target

YTDOct-15 Trend

Current

Qtr

Qtr

Status

YTD

Status

Target

15/16

Target

YTDOct-15

Actual

YTDTrend

YTD

Status

Cancer Reporting Cancelled Operations

All Cancer 2 week waits 93% 93% 98.0% ↑ 98.0% 98.0% 97.5% % Cancelled Operations 1% 1% 0.6% 0.8% ↑ 0.8%

2 week wait - Breast Symptomatic 93% 93% 97.8% ↓ 97.8% 97.8% 94.7% Urgent operations - cancelled twice 0 0 0 0 ↔ 0

31 day diagnostic to 1st treatment 96% 96% 100.0% ↑ 100.0% 100.0% 99.2% Cancelled operations - breaches of 28 day rule 0 0 0 1 ↔ 1

31 day subsequent treatment - Surgery 94% 94% 100.0% ↔ 100.0% 100.0% 100.0%

31 day subsequent treatment - Drugs 94% 94% 100.0% ↔ 100.0% 100.0% 100.0% Theatre Utilisation

62 day urgent GP referral to treatment 85% 85% 87.5% ↑ 87.5% 87.5% 85.4% Theatre Utilisation - Day 80.6% 82.0% ↓ 82.0%

62 day screening programme 90% 90% 100.0% ↔ 100.0% 100.0% 100.0% Theatre Utilisation - Main 91.4% 93.7% ↓ 93.7%

62 day consultant upgrades 85% 85% 100.0% ↑ 100.0% 100.0% 89.2% Theatre Utilisation - Trauma 83.0% 90.5% ↓ 90.5%

Breast Screening GP Referrals

Screening to offer of 1st assessment <=3 weeks 90% 90% ↑ 91.9% GP Written Referrals - made 4544 29342 ↓ 29342

Screening to 1st assessment 90% 90% ↑ 82.1% GP Written Referrals - seen 4057 26781 ↑ 26781

Screening to issue of normal results <=2 weeks 90% 90% ↑ 96.3% Other Referrals - Made 1895 10841 ↑ 10841

GP referral rate year on year (2014/15 & 2015/16) -607 357 ↓ 357

Referral to Treatment Total referral rate year on year (2014/15 & 2015/16) -976 -5302 ↓ -5302

RTT Admitted - % treatment within 18 weeks 90% 90% 94.6% ↓ 94.6% 94.6% 96.2%

RTT Non Admitted - % treatment within 18 weeks 95% 95% 97.3% ↑ 97.3% 97.3% 97.5% DNA Rates

RTT Incomplete Pathways - % still waiting 92% 92% 95.4% ↑ 95.4% 95.4% 93.9% New outpatient appointment DNA rate 10% 10% 11.0% 11.2% ↓ 11.2%

Follow-up outpatient appointment DNA rate 10% 10% 10.4% 10.9% ↑ 10.9%

Diagnostics Total outpatient appointment DNA rate 10% 10% 10.6% 11.0% ↑ 11.0%

No. of diagnostic tests waiting over 6 weeks 0 0 6 ↑ 37

% of diagnostic tests waiting over 6 weeks 0% 0% 0.2% ↑ 0.2% Appointment Slot Issues

No. of appointment slot issues 0 0 n/a 2617 ↔ 2617

ED % of appointment slot issues 4.0% 4.0% n/a 30.7% ↔ 30.7%

Percentage of patients treated in less than 4 hours 95% 95% 90.9% ↓ 90.9% 90.9% 94.1%

Emergency Department Attendances 6715 ↓ 6715 Average Length of stay (Quality Strategy Goal 3)

12 Hours Trolley Waits 0 0 0 ↔ 0 0 Average Length of Stay - Elective 2.42 2.42 2.46 2.67 ↑ 2.67

Average Length of Stay - Non-Elective 3.44 3.44 3.51 3.53 ↑ 3.53

Ambulance to ED Handover Time

% under 15 mins 60.5% ↓ 64.3%

% between 15 and 30 mins 24.7% ↑ 17.7%

% between 30 and 60 mins 4.3% ↑ 2.2%

% between 60 and 120 mins 0.4% ↑ 0.2%

Over 120 mins (SI) 0.0% ↔ 0.0%

% Not Recorded 10.1% ↑ 15.6%

Total Ambulance Handovers 1985 ↑ 12689

Performance - Key Performance Indicators Performance - Key Performance Indicators cont.


Page 27 of 45 126

Performance Matters (KPIs)Operational Efficiency

7

9

Data currently unavailable due to technical issues following migration to e-

Referral system

Ave

rage

Le

ngt

h o

f St

ay

Bre

ast

Sym

pto

mat

ic

Ap

po

intm

en

t Sl

ot

Issu

es

Can

celle

d O

pe

rati

on

s


0.0%

0.5%

1.0%

1.5%

2.0%

0

1

2

3

28 Day Breaches Target % Cancelled Ops

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00


Average Length of Stay (Quality Strategy - Goal 3: Delivering Consistently Effective Care)

Elective Non-Elective Elective Target Non-Elective Target

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

0

200

400

600

800

1000

1200

1400

1600

No. Slot Issues % Slot Issues

Page 28 of 45 127

Performance Matters (KPIs)


Operational EfficiencyTh

eat

re U

tilis

atio

nG

P R

efe

rral

s

DN

A R

ate

s

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%


Theatre Utilisation

Day Main Trauma

0.0%

5.0%

10.0%

15.0%

DNA Rates

New Follow Up Total Target0

1000

2000

3000

4000

5000

6000

GP Referrals Made & Seen

15/16 Made 15/16 Seen 14/15 Made 14/15 Seen

Page 29 of 45 128



Diagnostics

Comments:

There were 6 breaches of the Diagnostic 6 week wait in October. These were all awaiting

echocardiography. The team are completing a last set of evening echo sessions to reduce

the waiting list back down to 4 weeks. The additional capacity from the recent expansion in

the service will come online in January in full with additional sessions commencing from

December to maintain 6 week wait times.

Dia

gno

stic

Tes

ts o

ver

6 w

eeks

(D

M0

1)

0.0%

0.1%

0.2%

0.3%

0.4%

0.5%

0.6%

0

2

4

6

8

10

12

14

Pe

rce

nta

ge o

ver

6 w

ee

ks

No

. ove

r 6

we

eks

Target Actual Actual

Page 30 of 45 129



Regulatory Performance - ED

Comments

A&E benchmarking

A&

E 4

Ho

ur

Wai

tA

&E

4 H

ou

r W

ait

- B

en

chm

arki

ng

The number of attendances continue to be consistently above 6,700. October saw the

highest number of ambulance attendances in the last 12 months with the number of

ambulance breaches correlating with the challenging 4 hour performance. Additional CBU

management has been on site until 10pm to support patient flow ensuring that all breach

threats are escalated and plans to resolve put in place.

0

500

1000

1500

2000

2500 No. Ambulance Handover Times (pre-validated YAS)

No. under 15 mins No. between 15 & 30 minsNo. between 30 & 60 mins No. between 60 & 120 minsNo. over 120 mins Not recorded

0

1000

2000

3000

4000

5000

6000

7000

8000

87.0%88.0%89.0%90.0%91.0%92.0%93.0%94.0%95.0%96.0%97.0%98.0%

Within 4 Hours Total Attendances

% Achievement Target

80.0%

85.0%

90.0%

95.0%

100.0%

Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16

A&E Benchmarking (NHS England latest published data

September 2015)

Doncaster Sheffield Rotherham

Barnsley Harrogate Airedale

Page 31 of 45 130



Regulatory Performance - 18 Week Referral to Treatment

RTT 18 Week Performance -October 2015Final Position

Specialty <18 >18 Total % <18 >18 Total % <18 >18 Total %

General Surgery 212 16 228 93.0% 227 13 240 94.6% 1079 68 1147 94.1%Urology 29 5 34 85.3% 67 1 68 98.5% 433 31 464 93.3%Trauma & Orthopaedics 142 9 151 94.0% 86 6 92 93.5% 939 56 995 94.4%ENT 24 0 24 100.0% 420 6 426 98.6% 987 38 1025 96.3%Oral Surgery 50 6 56 89.3% 112 1 113 99.1% 840 42 882 95.2%General Medicine 62 0 62 100.0% 2 0 2 100.0% 279 10 289 96.5%Gastroenterology 8 0 8 100.0% 106 7 113 93.8% 501 19 520 96.3%Cardiology 12 0 12 100.0% 149 5 154 96.8% 610 15 625 97.6%Dermatology 41 2 43 95.3% 228 8 236 96.6% 1301 45 1346 96.7%Respiratory 6 0 6 100.0% 90 0 90 100.0% 161 5 166 97.0%Rheumatology 57 3 60 95.0% 64 3 67 95.5%Geriatric Medicine 0 0 0 63 0 63 100.0% 177 8 185 95.7%Gynaecology 47 1 48 97.9% 161 2 163 98.8% 537 40 577 93.1%Other 47 0 47 100.0% 215 4 219 98.2% 768 34 802 95.8%Total 680 39 719 94.6% 1983 56 2039 97.3% 8676 414 9090 95.4%

Incompletes - Target 92%

Co

nsu

ltan

t 1

8 W

ee

k R

efe

rral

to

Tre

atm

en

t

Admitted - Target 90% Non-Admitted - Target 95%

75%

80%

85%

90%

95%

100%

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

Dec

-15

Jan

-16

Feb

-16

Mar

-16

Pe

rce

nta

ge P

osi

tivi

ty

Non-Admitted Pathways

Actual Target

75%

80%

85%

90%

95%

100%

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

Dec

-15

Jan

-16

Feb

-16

Mar

-16

Pe

rce

nta

ge P

osi

tivi

ty

Incomplete Pathways

Actual Target

75%

80%

85%

90%

95%

100%

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

Dec

-15

Jan

-16

Feb

-16

Mar

-16

Pe

rce

nta

ge P

osi

tivi

ty

Admitted Pathways

Actual Target

Page 32 of 45 131



Regulatory Performance - Cancer3

1 D

ay -

Tar

gets

31

Day

- S

ub

seq

ue

nt

Tre

atm

en

t (S

urg

ery

)B

reas

t Sy

mp

tom

atic

All

Can

cer

2 W

ee

k W

aits

75%

80%

85%

90%

95%

100%P

erc

en

tage

Po

siti

vity

Actual Target

75%

80%

85%

90%

95%

100%

Pe

rce

nta

ge P

osi

tivi

ty

Actual Target

75%

80%

85%

90%

95%

100%

Pe

rce

nta

ge P

osi

tivi

ty

31 Day Diagnostic to Treatment

Actual Target

75%

80%

85%

90%

95%

100%

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Pe

rce

nta

ge P

osi

tivi

ty

31 Day Subsequent Treatment (Drugs)

Actual Target

75%

80%

85%

90%

95%

100%

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Pe

rce

nta

ge P

osi

tivi

ty

31 Day Subsequent Treatment (Surgery)

Actual Target

Page 33 of 45 132



Regulatory Performance - Cancer

Comments

Can

cer

Pe

rfo

rman

ce b

y Tu

mo

ur

Site

62

Day

Can

cer

Targ

ets

62

Day

- S

cre

en

ing

Pro

gram

me

75%

80%

85%

90%

95%

100%

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

Dec

-15

Jan

-16

Feb

-16

Mar

-16

Pe

rce

nta

ge P

osi

tivi

ty

62 Day - Urgent GP Referral to Treatment

Actual Target

75%

80%

85%

90%

95%

100%

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

De

c-1

5

Jan

-16

Feb

-16

Mar

-16

Pe

rce

nta

ge P

osi

tivi

ty

61 Day - Screening Programme

Actual Target

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Ap

r-1

5

May

-15

Jun

-15

Jul-

15

Au

g-1

5

Sep

-15

Oct

-15

No

v-1

5

Dec

-15

Jan

-16

Feb

-16

Mar

-16

Pe

rce

nta

ge P

osi

tivi

ty

61 Day - Consultant Upgrades

Actual Target

Page 34 of 45 133



Regulatory Performance - Breast Cancer Screening

The target has been missed due to patient choice.

Comments:

Scre

en

ing

to is

sue

of

no

rmal

re

sult

s

<=2

we

eks

Scre

en

ing

to 1

st a

sse

ssm

en

t

Scre

en

ing

to o

ffe

r o

f 1

st a

sse

ssm

en

t

<=3

we

eks

75%

80%

85%

90%

95%

100%P

erc

en

tage

Po

siti

vity

Actual Target

75%

80%

85%

90%

95%

100%

Pe

rce

nta

ge P

osi

tivi

ty

Actual Target

75%

80%

85%

90%

95%

100%

Pe

rce

nta

ge P

osi

tivi

ty

Actual Target

Page 35 of 45 134

Performance Matters Data Quality

Uncoded Episodes (As at 18th November) Missing Outcomes (Top 10 Specialties)

Treatment Specialty Sep Oct Nov Total Specialty Apr-Jul Aug Sept Oct Total

ACCIDENT AND EMERGENCY 2 6 8 ORAL SURGERY 0 145 145

BREAST SURGERY 2 2 OPHTHALMOLOGY 5 1 2 123 136

CARDIOLOGY 1 43 44 RHEUMATOLOGY 21 3 1 69 115

CLINICAL HAEMATOLOGY 2 25 27 PAEDIATRICS 2 3 7 65 79

CLINICAL ONCOLOGY 14 14 ORTHODONTICS 0 74 74

DERMATOLOGY 66 66 GENERAL SURGERY 7 4 4 26 48

ENDOCRINOLOGY 4 4 TRAUMA & ORTHOPAEDICS 4 7 22 37

ENT 13 13 DERMATOLOGY 0 32 32

GASTROENTEROLOGY 4 60 64 ENT 1 1 23 26

GENERAL MEDICINE 33 169 202 UROLOGY 1 1 2 17 22

GENERAL SURGERY 2 138 140

GERIATRIC MEDICINE 2 2 3 7

GYNAECOLOGY 19 19

NEONATOLOGY 9 9

OBSTETRICS 5 75 80

OPHTHALMOLOGY 2 32 34

ORAL SURGERY 19 19

PAEDIATRIC EAR NOSE AND THROAT 6

PAEDIATRICS 3 49

RESPIRATORY MEDICINE 10

RHEUMATOLOGY 7 7

Stroke Medicine 2 2

TRAUMA AND ORTHOPAEDICS 59 59

UROLOGY 30 30

VASCULAR SURGERY 1 1

WELL BABIES 36 36

Total 2 56 897 887


Page 36 of 45 135

Performance Matters Data Quality - Secondary Uses Service (SUS) DashboardLatest data available - July 2015

Ad

mit

ted

Pat

ien

t C

are

CD

S

Ad

mit

ted

Pat

ien

t C

are

CD

S

Ad

mit

ted

Pat

ien

t C

are

CD

S

Barnsley is currently unable to flow the RTT patient pathway data in the APC & OP datasets, hence

the reduced data quality score.


99.6% 99.1% 98.5% 96.6% 93.9% 87.6%

70.9%

96.0% 97.7%

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

Doncaster& Bassetlaw

SheffieldChildren's

SheffieldTeaching

Rotherham Barnsley RDASH St Luke'sHospice

NationalAverage

Area Team

Data validity summary average of all fields in SUS Dashboard April-July

2015

99.8% 99.8% 99.8% 99.8% 99.8%

98.9%

100.0%

99.20%

99.60%

98.2%98.4%98.6%98.8%99.0%99.2%99.4%99.6%99.8%

100.0%100.2%

NHS Number

100.0%

99.5%

100.0%

99.6%

100.0%

99.9%

100.0%

99.90%

100.00%

99.2%99.3%99.4%99.5%99.6%99.7%99.8%99.9%

100.0%100.1%

Registered GP Practice

99.9% 99.9%

100.0%

99.7%

100.0% 100.0% 100.0%

99.80%

99.70%

99.6%99.6%99.7%99.7%99.8%99.8%99.9%99.9%

100.0%100.0%100.1%

Postcode

Page 37 of 45 136


Ou

tpa

tien

ts C

DS

Ou

tpa

tien

ts C

DS

Ou

tpa

tien

ts C

DS

Ou

tpa

tien

ts C

DS


99.9% 99.9%

99.8%

99.9%

99.8%

99.40%

99.80%

99.1%

99.2%

99.3%

99.4%

99.5%

99.6%

99.7%

99.8%

99.9%

100.0%

Barnsley SheffieldChildren's

SheffieldTeaching

Rotherham Doncaster &Bassetlaw

NationalAverage

Area TeamAverage

NHS Number

100.0%

99.6%

100.0%

99.7%

100.0%

99.90%

100.00%

99.4%

99.5%

99.6%

99.7%

99.8%

99.9%

100.0%

100.1%


SheffieldTeaching


NationalAverage

Area TeamAverage


100.0% 100.0% 100.0%

99.9%

100.0%

99.80%

99.90%

99.7%

99.8%

99.8%

99.9%

99.9%

100.0%

100.0%

100.1%


SheffieldTeaching


NationalAverage

Area TeamAverage

Postcode

95.1%

100.0% 99.7% 99.6%

99.9%

97.20%

98.70%

92.0%

93.0%

94.0%

95.0%

96.0%

97.0%

98.0%

99.0%

100.0%

101.0%


SheffieldTeaching


NationalAverage

Area TeamAverage

Attendance Outcome

Page 38 of 45 137


Acc

iden

t &

Em

erge

ncy

CD

S

Acc

iden

t &

Em

erge

ncy

CD

S

Acc

iden

t &

Em

erge

ncy

CD

S

Acc

iden

t &

Em

erge

ncy

CD

S


99.1% 99.7% 98.8%

87.0%

98.2%

95.30%

98.00%

80.0%

85.0%

90.0%

95.0%

100.0%

105.0%


SheffieldTeaching


NationalAverage

Area TeamAverage

NHS Number

100.0% 99.9%

100.0%

98.6%

99.9%

99.60%

99.90%

97.5%

98.0%

98.5%

99.0%

99.5%

100.0%

100.5%


SheffieldTeaching


NationalAverage

Area TeamAverage


99.9% 99.9% 100.0%

99.2%

100.0%

98.60%

97.90%

96.5%

97.0%

97.5%

98.0%

98.5%

99.0%

99.5%

100.0%

100.5%


SheffieldTeaching


NationalAverage

Area TeamAverage

Postcode

100.0% 100.0% 100.0%

0.0%

98.00% 91.90%

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%


SheffieldTeaching


NationalAverage

Area TeamAverage

Attendance Disposal

Page 39 of 45 138

Performance MattersActivity

14/15 15/16 15/16

Actual Plan Actual Variance %

Elective Day cases 13184 13846 13693 -153 -1%

Elective Inpatients 2189 2285 2446 161 7%

Elective Total 15373 16131 16139 8 0%

Non Elective 20665 20128 20821 693 3%

Maternity Pathway 3622 3616 3515 -101 -3%

A&E Attendances 47146 47421 47152 -269 -1%

Outpatients 146186 148696 139225 -9471 -6%

* Please note excess bed days are not included in these figures. 2015/16 Activity Plan

2015/16 Activity Actual

2014/15 Outturn

2015/16 Activity Plan 2015/16 Activity Plan

2015/16 Activity Actual 2015/16 Activity Actual

2014/15 Outturn 2014/15 Outturn

Act

ivit

y

Day

Cas

es

Obstetric outpatient attendances are excluded as they are covered by the Maternity Pathways

Ele

ctiv

e In

pat

ien

ts

No

n-E

lect

ive

Inp

atie

nts


Page 40 of 45 139

Performance MattersActivity

2015/16 Activity Plan 2015/16 Activity Plan

2015/16 Activity Actual 2015/16 Activity Actual

2014/15 Outturn 2014/15 Outturn

Comments:

2015/16 Activity Plan

2015/16 Activity Actual2014/15 Outturn

Ou

tpat

ien

ts

Main area's of overperformance are Elective and NEL Inpatients, new outpatients are 819

over achieved but overall outpatients are under performing. Electives:- highest over

performances against plans are Urology (50.44%), Gastro (41.89%), Cardiology (40.47%) and

Paediatrics (110.81%). For non-electives the mains areas of over performance are in

Gastroenterology, Cardiology, Repiratory, Geriatric Medicine and Gynaecology.

Outpatients:- There is a general underperformance against follow-up plans across most

specialties with the highest variances (against aggregated attendances and procedure plans)

in Endocrinology -689, Paediatrics -497, Diabetes -1004, Respiratory -745, Rheumatology DM -

530 and Gynaecology -849.

Mat

ern

ity

Pat

hw

ay

A&

E A

tte

nd

ance

s


Page 41 of 45 140

Performance (Financial Overview) - "At a glance"

Month

Plan

Month

Actual

Variance

%Variance Plan YTD

Actual

YTD

Variance

%Variance

Month

Plan

Month

Actual

Variance

%Variance

Plan

YTD

Actual

YTD

Variance

%Variance

ACTIVITY LEVELS £'000 £'000 £'000 £'000 £'000 £'000

Elective inpatients 340 394 15.88% 54 2,285 2,446 7.05% 161 EBITDA 90 -387 -530.00% -477 -2,499 -6,160 -146.50% -3,661

Day Cases 2,059 2,010 -2.38% -49 13,846 13,693 -1.11% -153 Depreciation -490 -472 3.67% 18 -3,354 -3,298 1.67% 56

Non-elective inpatients 2,956 2,999 1.45% 43 20,149 20,830 3.38% 681 Restructuring & Other -42 0 100.00% 42 -294 -57 80.61% 237

Outpatients 24,835 21,704 -12.61% -3,131 167,472 147,303 -12.04% -20,169 Financing Costs -147 -161 -9.52% -14 -1,030 -1,005 2.43% 25

A&E 6,737 6,716 -0.31% -21 47,421 47,152 -0.57% -269 SURPLUS/(DEFICIT) -589 -1,020 -73.17% -431 -7,177 -10,520 -46.58% -3,343

'Clinical' Activity

Other (excludes direct access tests) 11,442 9,732 -14.94% -1,710 77,064 70,694 -8.27% -6,370 SOFP £'000 £'000 £'000 £'000 £'000 £'000

Total activity 48,369 43,555 -9.95% -4,814 328,237 302,118 -7.96% -26,119 Capital Spend -665 121 -118.20% 786 -2,371 -863 -63.60% 1,508

Inventory 1,702 1,446 15.04% 256

CIP £'000 £'000 £'000 £'000 £'000 £'000 Receivables & Prepayments 8,661 8,107 6.40% 554

Income 207 150 -27.54% -57 1,247 1,055 -15.40% -192 Payables & Accruals -18,109 -18,674 3.12% 565

Pay 221 219 -0.90% -2 1,260 769 -38.97% -491 Deferred Income -969 -1,032 6.50% 63

Non-Pay 166 171 3.01% 5 1,034 909 -12.09% -125

Total CIP 594 540 -9.09% -54 3,541 2,733 -22.82% -808 Cash & Loan Funding £'000 £'000 £'000 £'000 £'000 £'000

Cash 1,204 1,369 13.70% 165

INCOME £'000 £'000 £'000 £'000 £'000 £'000 Loan Funding -25,225 -25,097 0.51% 128

Clinical (Activity) 9,222 9,480 2.80% 258 62,782 63,990 1.92% 1,208

Other Clinical 3,077 3,015 -2.01% -62 21,107 20,593 -2.44% -514 KPIs

CQUINS 274 274 0.00% 0 1,918 1,918 0.00% 0 EBITDA % 0.62% -2.62% -520.55% -3.25% -2.54% -6.25% -145.98% -3.71%

Risks & Penalties 0 -67 -67 0 -487 -487 Deficit % -4.08% -6.92% -69.37% -2.83% -7.30% -10.67% -46.27% -3.38%

Business Cases 145 558 284.83% 413 1,009 2,023 100.50% 1,014 Receivable Days 18.4 17.2 6.40% 1.2

Other 1,706 1,488 -12.78% -218 11,557 10,544 -8.77% -1,013 Payable (including accruals) Days 93.4 96.3 3.12% 2.9

Total income 14,424 14,748 2.25% 324 98,373 98,581 0.21% 208 Continuity Of Service Rating 1 1 0.00% 0

OPERATING COSTS £'000 £'000 £'000 £'000 £'000 £'000

Pay -9,667 -10,245 -5.98% -578 -68,067 -71,171 -4.56% -3,104

Drugs -1,081 -1,245 -15.17% -164 -7,568 -7,709 -1.86% -141

Non-Pay -3,586 -3,645 -1.65% -59 -25,237 -25,861 -2.47% -624

Total Costs -14,334 -15,135 -5.59% -801 -100,872 -104,741 -3.84% -3,869

Performance - Financial Overview Performance - Financial Overview


Page 42 of 45 141

Performance Matters - Finance

October 2015 Summary

Summary Performance:


Page 43 of 45 142

Performance Matters (Financial Overview)

Actual Income Analysis Clinical Income per day

Comments:

Pay as a % of income

Clinical income per day - this is favourable to plan for October 2015.

Act

ual

Inco

me

An

alys

is

Clin

ical

Inco

me

Pe

r D

ay

Pay

as

a %

of

Inco

me

Income analysis - this graph analyses the split of income on a monthly basis and

demonstrates the variability of clinical income.

Pay as a % of clinical income is favourable to plan for Octoberber 2015 and reflects a

reduction in agency spend in month.


Page 44 of 45 143

Performance Matters (Financial Overview)


Agency Monthly Spend CIP achievement

Comments:

Deficit Trend Analysis

CIP is adverse to plan with the key driver being the bed utilisation scheme.

Age

ncy

Mo

nth

ly S

pe

nd

CIP

Ach

ieve

me

nt

- C

um

ula

tive

De

fici

t Tr

en

d A

nal

ysis

Agency monthly spend - this graph indicates that the agency costs have started to fall.

Agency expenditure is now being reviewed in depth.

Deficit trend analysis - this graph highlights the gap between plan and actual at month 6.

The deficit is deteriorating.

Page 45 of 45 144

13(iv) Horizon Scanner for Board Dec2015

EXECUTIVE SUMMARY

RECOMMENDATIONS

STRATEGIC CONTEXT

REPORT TO THE BOARD OF DIRECTORS REF: 15/12/P-18 SUBJECT: HORIZON SCANNER DATE: DECEMBER 2015

PURPOSE:

Tick as applicable Tick as

applicable For decision/approval Assurance For review X Governance For information X Strategy X

PREPARED BY: Emma Parkes, Director of Marketing & Communications SPONSORED BY: Diane Wake, Chief Executive PRESENTED BY: Emma Parkes, Director of Marketing & Communications

To provide a brief overview of key developments and initiatives across the national and regional healthcare landscape which may impact or influence the Trust’s strategic direction.

Summary of content:

• MY NHS/NHS Choices for November 2015 • Foreigners to pay for emergency healthcare • Ofsted-style NHS ratings aim to reduce bureaucracy • Trust CQC fees could increase by up to 75% • NHS England to rate providers on technological capabilities • KPMG awarded £1m contract to design NHS Improvement • NHS trust pleads guilty over Stafford hospital deaths • Four in ten care homes are failing • NHS England gives CCGs orders to impose provider fines • Kings Fund say CCGs should be brought together • CQC inspectors spent over £50,000 on accommodation while inspecting Lancashire

Care Foundation Trust, • Foreign nurses are being drafted on to hospital wards in Yorkshire

The Board of Directors is asked to receive the contents of this report for information.

145


Subject: INTELLIGENCE MONITORING/HORIZON SCANNING* Ref: 15/12/18

*please note that this is not an exhaustive report, submissions welcome to [email protected] Date / publication

Detail Impact/ Action/ Owner / Will Board be involved?

My NHS/NHS Choices

UDATE FOR THE MONTH OF NOVEMBER My NHS: All indicators ‘OK’ - Recommended by staff; Open and honest reporting; Infection control and cleanliness; Mortality rate; Food: Choice and Quality. NHS Choices User Rating – 4* (5* is Excellent) Feedback in November: A & E Was taken into A & E early hours of this morning ("17th of November) with a suspected heart attack. Was really impressed with the staff and the cleanliness of the place. I felt I was kept informed of everything and treated with respect and dignity. Thankfully it wasn't what suspected. Everything was clear. Feel such a ninny now for wasting time. Thank you very much. Visited in November 2015. Posted on 17 November 2015 FIRST CLASS I live in Wakefield and at the very start of my treatment was offered a choice of Pinderfields in Wakefield, Dewsbury or Barnsley. I have had several bad experiences at both Pinderields and Dewsbury and had heard that Barnsley had a good reputation I initially had an outpatients appointment with which I was very impressed with, I had a further follow up appointment for a colonoscopy. I went for this appointment on Friday 6th November and can only sing the praises of the hospital and its staff. It was timely, I was treated with the utmost respect and at every stage of moving on, absolutely everything was explained and the treatment I received was impeccable and truly professional. I cannot state how highly impressed I was and in future I would always attend Barnsley instead of any of the others and would always recommend it to anyone. Congratulations to Barnsley hospital and all the staff involved in my treatment, you should be proud of yourselves. Visited in November 2015. Posted on 11 November 2015

Potential impact on reputation / All postings responded to / Board to note for information

2/11/15 The Times

Foreigners to pay for emergency healthcare Health Secretary Jeremy Hunt is expected to announce charges for emergency treatment and travel on all non-British residents for the first time next month. Hunt believes that the charges, combined with the present fees for foreigners’ routine care, could help the NHS recoup £500m a year. Emergency care should not be delayed by the need for payment, officials said, but any treatment judged non-urgent - even by A&E departments – should be withheld until fees are paid.

Director of Finance to note / potential impact on financial plan

146


Date / publication


Visitors from the EU must present a European Health Insurance Card so the NHS can charge their government, while those from outside Europe will be chased for the fees. However, the government concedes that little can be done if patients leave the country and ignore a letter demanding payment. The Department of Health said: “International visitors are welcome to use the NHS, provided they pay for it – just as families living in the UK do through their taxes.”

2/11/15 Ofsted-style NHS ratings aim to reduce bureaucracy New Ofsted-style ratings will rate local service performance in key areas from next year as part of a series of reforms being introduced today to tackle unnecessary bureaucracy and reliance on paper, as well as to empower patients by enhancing choice and naming clinicians for each individual person. The ratings will look at cancer, dementia, diabetes, mental health, learning disabilities and maternity care services, broken down by CCG. Ratings will be based on local data and verified by healthcare experts, including the chief executive of Cancer Research UK, Harpal Kumar, and the government’s Mental Health Taskforce chairman and Mind boss, Paul Farmer. They will lead cancer and mental health ratings respectively. The first ratings, based on the current CCG assessments, will be published in June 2016. They will identify both examples of best practice and underperformance across the service in order to create a more complete picture of care quality in the NHS.

Director of Nursing and Quality to report on progress and potential impact to quality strategy.

3/11/15 HSJ

Trust CQC fees could increase by up to 75% The fees that NHS providers pay to the CQC could be increased by up to 75% next year. In a consultation document, the regulator outlines two scenarios for future provider fees, which help fund the running of the CQC. The first scenario would see the CQC move to “full cost recovery” over just two years. This would mean an NHS trust with a turnover of £125m-£225m would see its fee rise from £78,208 this year, to £136,864 in 2016/17 – a 75% increase – before increasing further to £215,835 in 2017/18 – a 176% increase on the 2015/16 fees. A more conservative scenario for the same trust would see its fee rise by 40% next year to £109,491, and while it would still eventually rise to £215,835, this would be staggered over four years.

Director of Finance to monitor/report. Potential impact on financial plan

4/11/15 HSJ

NHS England to rate providers on technological capabilities A new index will rate NHS providers’ technological capabilities and eventually be part of the statutory regulatory regime. NHS England director of digital technology, Beverley Bryant, said a first iteration of the digital maturity index is scheduled to be published later this financial year. It will be based on information collated by NHS England, which is sending questionnaires to NHS organisations to gather baseline data about their existing digital capabilities. The move follows NHS organisations being told to form clusters across local health economies to draw up “digital roadmaps” outlining how they plan to achieve a paperless system by 2020 and will index will be used to benchmark progress towards a paperless system.

Director of ITC to monitor and report on progress

147


Date / publication


5/11/15 HSJ

KPMG awarded £1m contract to design NHS Improvement Monitor has confirmed that the contract to design how NHS Improvement will be created and function has been awarded to KPMG. In a joint statement, Monitor and the NHS Trust Development Authority said: “Monitor and the NHS Trust Development Authority have created a joint programme office to oversee the development of NHS Improvement. KPMG has been appointed to support this work and provide independent advice and challenge, as well as ensure that both organisations can continue to focus on their important business as usual functions.”

Board to note for information

5/11/15 The Times

NHS trust pleads guilty over Stafford hospital deaths Mid Staffordshire NHS Foundation Trust, which ran Stafford hospital, has admitted to repeating “very significant” health and safety breaches in connection to four patient deaths. The NHS trust pleaded guilty to criminal charges following the deaths of three patients from falls and one patient being administered with penicillin – despite advising she was allergic. A Solicitor stood for the trust, pleading guilty to the charges and offered his sincere condolences to the families. The case will now to go the crown court with a date yet to be set.

Board to note – follow up from item in October Horizon Scanner Report

9/11/15 National media

Four in ten care homes are failing Care homes for the elderly fall below expected standards, according to a damning assessment by the official regulator. The Government’s chief inspector of care homes claims four in 10 care homes do not meet regulations, while one in three social care facilities is rated as requiring improvement and an additional seven per cent are rated ‘inadequate’. Andrea Sutcliffe, the Care Quality Commission’s chief inspector for adult social care, warned that a combination of cuts in funding, rising costs and increasing demand for care among an aging population has placed an enormous strain on social care providers.


11/11/15 HSJ

NHS England gives CCGs orders to impose provider fines HSJ reports seeing guidance sent to CCGs from NHS England’s Midlands and East regional leaders instructing them to impose the fines. The guidance says the normal financial penalties in the NHS standard contract are not sufficient to incentivise providers to hit performance targets such as waiting times for elective procedures or emergency care. It recommends using general condition nine of the standard contract, which allows withholding 2% of the contract value if a “remedial action plan” to improve performance cannot be agreed. It is understood the approach has varied according to region, with CCGs in the Midlands and East and in the South receiving particularly strict orders to impose fines.


12/11/15 HSJ

The King’s Fund say CCGs should be ‘brought together’ The King’s Fund has recommended that NHS commissioning should be carried out on footprints bigger than current clinical commissioning groups, with a report finding that “Scarce commissioning expertise needs to be brought together in footprints much bigger than those typically covered by [CCGs], while retaining the local knowledge and clinical understanding of general practitioners.”

Director of Strategy and Business Development to monitor.

148


Date / publication


The report stops short of specifically saying whether CCGs should merge or not in order to achieve this joint working. The report says the move is necessary to enable providers to “establish place based ‘systems of care’ in which they work together to improve health and care for the populations they serve”. It is expected that NHS England and NHS Improvement are expected to ask NHS providers and commissioners to work jointly as “health systems” to produce multi-year “financial sustainability and service transformation plans” by next summer.

18/11/15 Lancashire media - online

CQC inspectors spent over £50,000 on accommodation while inspecting Lancashire Care Foundation Trust, New figures show that the CQC spent four times its annual budget on hotels, travel and meals, an investigation has found. Teams from the CQC spent £4.4 million on travel and subsistence in 2014/15 against a budget of £1.1 million. The CQC said the overspend was due to the fact the budget was based on a previous, lighter touch inspection regime. The figures, obtained under the Freedom of Information Act by the Health Service Journal show that up to £80,000 was spent on accommodation during a single inspection. In some cases, more than 100 inspectors attended one visit. In total, £921,279.98 was spent on hotels in 2014/15 for 36 inspections.

Board to Note for information

23/11/15 Yorkshire Post

Foreign nurses are being drafted on to hospital wards in Yorkshire Nurses from the Philippines are the latest to join the region’s hospitals due to increasing problems finding staff in the UK and Europe. By Easter, more than 800 nurses from at least 10 countries will be in place following recruitment drives by 12 of the 15 hospital trusts in the region. Figures obtained by The Yorkshire Post show the Northern Lincolnshire and Goole NHS trust has already employed 120 foreign nurses in the last two years. A further 80 are due to join including recruits from the Philippines where the Bradford, and Doncaster and Bassetlaw trusts are also looking for more staff. Hull and East Yorkshire NHS trust, which has faced criticism from the Care Quality Commission over ward staffing shortages, has recruited a total of 116 nurses in the last two years from Spain, Portugal, Croatia, Romania, Holland, Italy and Greece, with more planned. The Mid Yorkshire trust is employing nurses from India amid plans to recruit up to 120 more overseas nurses in the new year.


149

GENERAL MEETING OF THE COUNCIL OF GOVERNORS OF … · 2015. 11. 27. · COUNCIL OF GOVERNORS –...

Documents

Transcript of GENERAL MEETING OF THE COUNCIL OF GOVERNORS OF … · 2015. 11. 27. · COUNCIL OF GOVERNORS –...