Trust Board Monday, 27 March 2017 at 1.00pm Lecture Theatre, St Ann’s Hospital, St Ann’s Road, London, N15 3TH A G E N D A (Meeting of the Trust Board held in public) Time Item Agenda Item Page Lead Number Number 1. General Business 1.00 1.1 Chairman’s welcome Verbal Michael Fox 1.02 1.2 Apologies for Absence Verbal Michael Fox 1.04 1.3 Declarations of Interest and of any Conflicts of Interest Verbal Michael Fox To review the attached Summary of Board Members’ declarations of interest and to declare at the meeting any conflicts. 1.05 1.4 Minutes of the Board Meeting held on 30 January 2017 Page Michael 1 Fox To confirm the minutes of the last meeting as a true record. 1.08 1.5 Matters arising from the Minutes Page Michael 13 Fox To review progress set out in the attached written report and to discuss any other matters raised by Board Members. 1.10 1.6 Staff Survey Verbal Mark Vaughan / To receive a presentation outlining the 2015 / 2016 Staff Rose Minty- Tutton Survey Results. 1.40 1.7 Chairman’s Report Verbal Michael Fox To receive the Chairman’s verbal report. 1.45 1.8 Chief Executive’s Report Page Maria 17 Kane To receive an update on Trust matters. Time Item Agenda Item Page Lead Number Number 2.00 1.9 Chief Operating Officer / Executive Director of Patient Page Andy Services’ Report 25 Graham To receive an update on Operational matters. 2. Risk and Performance 2.10 2.1 Board Assurance Framework Page Barry 33 Ray To consider the Board Assurance Framework. 2.20 2.2 Integrated Quality and Performance Report Page Andy 73 Graham To review the Integrated Quality and Performance. 2.30 2.3 Financial Performance: Month 11 (February 2017) Page Lisa 79 Marsh To receive an update on recent financial performance. 2.35 2.4 Reference Costs 2015 / 2016 Publication Page Lisa 93 Marsh To note the publication of reference costs for 2015 / 2016 and the Trust’s Reference Cost Index score. 3. Quality and Safety 2.40 3.1 Clinical, Quality and Safety Report Page Mary 99 Sexton To receive an update on Clinical, Quality and Safety matters. 2.50 3.2 Safe Staffing Levels Page Mary 111 Sexton To note the Safe Staffing Levels report and the actions being taken. 4. Strategy 3.00 4.1 Budget Setting To Lisa Follow Marsh To agree the 2017 / 2018 Budget and note the deficit position and the unidentified CIP target. 3.10 4.2 Capital Investment Programme Verbal Lisa Marsh To note the progress on the capital expenditure plans for 2016 / 2017, and approve the Capital Investment Programme for 2017 / 2018. 5. Governance and Assurance 3.20 5.1 Medical Director’s Report Page Jonathan 133 Bindman To receive an update on Medical matters. 3.30 5.2 Information Governance Annual Declaration Page Maria 139 Kane To receive assurance on the Trust’s compliance with the requirements of the Information Governance Toolkit. 3.35 6. Other Items 6.1 Any Other Urgent Business The Chairman will be asked to consider any other urgent business which he has been previously notified of in advance of the meeting, but which has not been provided for on the agenda. 6.2 Date and Time of Next Meeting Monday, 30 May 2017 at 1.00 pm Lecture Theatre, St Ann's Hospital Reports scheduled for consideration at the next meeting, include: • Chairman’s Report • Chief Executive’s Report • Chief Operating Officer’s Report • Board Assurance Framework • Integrated Performance Dashboard • Financial Performance • Clinical, Quality and Safety Report • Safe Staffing Report • Quality Account • Patient Experience Strategy • Medical Director’s Report • Research and Development Annual Report 7. Exclusion of the Press and the Public 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, publicity on which would be prejudicial to the public interest (Section 1(2) Public Bodies (Admission to Meetings) Act 1960). Michael Fox Trust Chairman BOARD OF DIRECTORS’ REGISTER OF INTERESTS Board Member: Interest Declared: Michael Fox • None. Trust Chairman Jonathan Bindman • Married to a GP currently working in Newham Community Services, Medical Director managed by East London Foundation Trust and undertaking locum work in Tower Hamlets. • Unpaid adviser to Raphael, a Jewish counselling service based in Barnet. Frank Devoy • Director and shareholder of Building Change Ltd, a strategic real estate Non Executive Director consultancy (no previous or expected work with the NHS). • Director and shareholder of Waverley Investments Ltd, a property developer. • Wife is a Community Pharmacist. Paul Farrimond • Director of P.F. Consultancy Ltd. Non-Executive Director • Specialist Advisor on Mental Health for NHS Providers • Member of the Care Quality Commission’s (CQC) Mental Health Act External Advisory Group. • Member of the CQC’s Deprivation of Liberty Safeguards Advisory Group. • Member of the CQC’s review of how NHS Trusts investigate and learn from deaths expert advisory group. • Member of the Department of Health’s Mental Health Workforce Programme Board. Cedi Frederick • Non-Executive Director of ‘Independence and Wellbeing (Enfield), a local Designated Non Executive authority trading company established by LB Enfield to provide a range of Director community and possibly residential/nursing homes delivering care and support services that may be commissioned by the NHS. • Owner of Article Consulting Ltd, a health and social care consultancy (not currently working with the NHS). • Member of the Labour Party. Simon Goodwin • Married to a senior manager at East London NHS Foundation Trust. Chief Finance and Investment Officer Andy Graham • Partner is a Director at InHealth, which provides diagnostic services to the Executive Director of NHS. Patient Services Cathy Hamlyn • Executive Associate Director in Nudge Associates (provision of Non-Executive Director consultancy services to the NHS and local authorities in relation to sexual health; HIV and in addressing sexual violence). • Chair of MEDFASH (Medical Foundation for AIDS and Sexual Health). • Member of the Labour Party. Board Member: Interest Declared: Catherine Jervis • Non Executive Director for First Community Health and Care, a not for Non-Executive Director profit company providing community health services (primarily to the NHS) in East Surrey. • Trustee and Treasurer for First Community Trust (supporting the provision of health and social care in Surrey). • Advisor to CEO for Achievement for All, a national education charity providing services to schools and other educational settings in collaboration with partners from the health field (e.g. Place2Be and Young Minds). Maria Kane • Trustee (unremunerated) of Young Minds (a small national charity Chief Executive supporting better mental wellbeing for children and young people). • Member of Information Committee of Lullaby Trust. • Stake Holder Member (unremunerated) to the Health Education England London and South East Local Education and Training Board Paul Ryb • Managing Director, The BIGlittle Co. Ltd. Non Executive Director • Non Exec Chairman, Depositit.com, a leader in Cyber insurance protection plans for SMEs • Non Executive Director, Kings Access Technology Ltd, a leading provider of accessible technology for the blind and partially sighted community. • Co-Owner Anytime Fitness Mill Hill 24/hour Gym, North London • Trustee for Macular Society • Finance Committee member for the Thomas Pocklington Trust Mary Sexton • Honorary Clinical Professor, Middlesex University. Executive Director of • Clinical and Professional Advisor, CQC. Nursing, Quality and Governance Ruchi Singh • Director, Kaleidoscope Transformations Ltd, a strategy consulting Non Executive Director company. Mark Vaughan • None. Executive Director of Workforce Charles Waddicor • Director / Owner of SAMRO health and social care solutions Non-Executive Director • Chair / Trustee of The Primary Care Respiratory Society UK. • Mental Health Clinical Advisor to the care Quality Commission. • Small shareholding in Ventura Group. • Chair of a Board, operated by Social Finance, overseeing projects running in Haringey, Tower Hamlets, and Staffordshire, supporting people with mental health problems into employment. This page is intentionally left blank BEH-MHT – Trust Board – 27.03.2017 1.4 – Minutes of the Board Meeting – 30 January 2017 Minutes of the Board Meeting held on Monday, 30 January 2017 in the Lecture Theatre, St Ann’s Hospital, St Ann’s Road, London, N15 3TH The meeting commenced at 1.00 pm and closed at 3.20 pm Present: Michael Fox Trust Chairman Maria Kane Chief Executive Jonathan Bindman Medical Director Frank Devoy Non-Executive Director Paul Farrimond Non-Executive Director Simon Goodwin Chief Finance and Investment Officer Andy Graham Executive Director of Patient Services Cathy Hamlyn Non-Executive Director Christine Harvey Non-Executive Director Catherine Jervis Non-Executive Director Ruchi Singh Non-Executive Director Jackie Stephen Deputy Director of Organisational Development and Learning (in place of Mark Vaughan) Charles Waddicor Non-Executive Director In attendance: Barry Ray Trust Board Secretary Cedi Frederick Designated Non-Executive Director Paul Ryb Designated Non-Executive Director Nicola Davey Specialist Musculoskeletal Podiatrist - Biomechanics and Paediatrics (for Minute Item 1.6) One member of the public Item Minute Item Actions No. 1. General Business 1.1 Chairman’s Welcome Michael Fox welcomed everyone to the meeting, particularly Ruchi Singh, Cedi Frederick and Paul Ryb to their first Trust Board Meeting. 1.2 Apologies for Absence  Mary Sexton, Executive Director of Nursing, Quality and Governance  Mark Vaughan, Executive Director of Workforce Michael Fox noted that Mark Vaughan had submitted his apology as he was on paternity leave following the birth of a baby boy. Michael Fox requested that the best wishes of the Trust Board be passed on to Mark Vaughan. Page 1 BEH-MHT – Trust Board – 27.03.2017 1.4 – Minutes of the Board Meeting – 30 January 2017 1.3 Declarations of Interest and Declarations of any Conflicts of Interest The Trust Board agreed to note that there were no conflicts of interest declared in relation to items on the agenda. 1.4 Minutes of the Meeting held on 28 November 2016 The Board confirmed the minutes of the last meeting as a true record. 1.5 Matters Arising from the Minutes of the Meeting held on 28 November 2016 The Board noted the written report on matters arising and accepted the updates. 1.6 Patient Focus – The Joint Paediatric Foot and Movement Clinic: Musculoskeletal Podiatry and Paediatric Physiotherapy working together for improved patient care Nicola Davey gave a presentation which outlined how the joint working between the Musculoskeletal Podiatry and the Paediatric Physiotherapy teams improved the experience of patients. The presentation highlighted:  The reasons for establishing a joint clinic, which came about through recognising the link between musculoskeletal and podiatry needs to address certain service users’ underlining issues.  The common conditions, the treatments provided and the benefits of holding a joint clinic, which included unified patient management and better targeting of resources.  The positive feedback received from service users, including recognition of a whole body approach to diagnosing and addressing issues, which saved service users from having to attend separate clinics.  Results from an audit of the joint clinic approach. Charles Waddicor asked how staff knew that they were making a difference to the care provided to service users. Nicola Davy stated that through experience she was able to advise that the service was making a difference as the service was seeing far fewer repeat visits. The results of the clinical audit and patient experience survey also confirmed that the joint service was valued by service users. In response to questions from Maria Kane, Nicola Davy advised that the average waiting time to access the joint service had been increased from four to eight weeks. This was in response to a high number of service users who did not attend their appointments as four weeks was considered too short notice. Referrals to the joint service were made internally by staff from either of the two disciplines. In response to a question from Andy Graham, Nicola Davy outline examples in other Trusts where Podiatry teams were able to provide more services in the community which reduced the need for services to be provided in hospitals, including closer working relations with Orthopaedic services. Jonathan Bindman asked whether the joint service model was unique. Nicola Davy commented that she felt that this was a unique approach and that she was publicising this when undertaking talks to undergraduates at universities. Page 2 BEH-MHT – Trust Board – 27.03.2017 1.4 – Minutes of the Board Meeting – 30 January 2017 The Trust Board agreed to note the Patient Focus on the Joint Paediatric Foot and Movement Clinic: Musculoskeletal Podiatry and Paediatric Physiotherapy working together for improved patient care. 1.7 Chairman’s Report Michael Fox referred to an article published by The King’s Fund entitled ‘How hospital activity in the NHS in England has changed over time’. Michael Fox advised that the article was useful in articulating the challenges faced by the NHS. Michael Fox was pleased to note that the Trust’s response rate to the national Staff Survey had exceeded 50%, which was in his opinion a positive indicator that staff were engaging with the Trust. Michael Fox noted that the results of the Staff Survey were expected at the end of February. Michael Fox informed Board members that he meets with and writes to all local Members of Parliament on a regular basis to provide an update on the work of and challenges faced by the Trust. He agreed to circulate a copy of his recent letter to all Board members. Michael Fox noted that the Trust had undertaken a second annual Quality Review Week during January, and that several Board members had attended visits to services. Michael Fox informed that he had undertaken a visit to Trust staff providing mental health services at HMP Wormwood Scrubs, and highlighted that the Trust was now one of the largest providers of mental health services in prisons. In response to a question from Paul Farrimond, Michael Fox noted that there was a need for the Trust to ensure the safety of staff and the provision of services were not unduly affected by staff shortages in the prison service. Andy Graham advised that Trust staff do try to ensure treatment is maintained through various means during periods when prison staff are not available to escort prisoners to clinics. Ruchi Singh highlighted the reconfiguration of the prison service that was taking place. In response to a question from Frank Devoy, Andy Graham advised that the impact of the shortage of prison staff availability was included on local prison’s Risk Registers, but that he would confirm this. The Trust Board agreed: 1. To note the Chairman’s verbal report. 2. That a copy of a recent letter from the Chairman to all local Members of Michael Parliament be circulated to all Board members. Fox 3. To receive assurance that the potential impact on services as a result Andy of shortages in the number of prison staff is listed on relevant local Graham Risk Registers and that staff are not unduly being put at risk. 1.8 Chief Executive’s Report Maria Kane presented her report on Trust Matters and highlighted the following:  Rebecca Harrington, Non-Executive Director, came to the end of her appointment and left the Trust on 3 January. Christine Harvey, Non- Executive Director, was due to come to the end of her appointment on 8 February. Page 3 BEH-MHT – Trust Board – 27.03.2017 1.4 – Minutes of the Board Meeting – 30 January 2017  Ruchi Singh was appointed as a Non-Executive Director to replace Rebecca Harrington and started on 16 January. Paul Ryb has been appointed as a Non-Executive Director to replace Christine Harvey and was due to take up his position from 10 February. Cedi Frederick has been appointed as a Non-Executive Director with effect from 1 April.  The Trust’s annual Celebrating Excellence Awards Night took place on 1 December 2016. Details of all award winners and staff receiving long service awards were set out in the report, including recognition of 50 years service to the NHS by Susan Jowett, Service Manager in the Enfield East Older People Community Mental Health Team.  Contracts with the main Clinical Commissioning Groups (CCGs) and NHS England (NHSE) were signed on 23 December 2016. Both include a Longstop list of issues to be settled. The CCG contracts for mental health services included demographic and non-demographic growth equivalent to 3% per CCG, with non-demographic growth of £1.3m. The NHSE contract also incorporated an element of growth, though not to the same extent as the CCG contract.  The Trust has been selected as one of 23 Trusts nationally to take part in Lord Carter’s review into hospital efficiency and savings. The purpose of the Review is to help determine how savings can be made through improving productivity and reducing non-pay spend.  The Trust has signed up to the European Community based Mental health Service providers (EuCoMS) Network’s Consensus on Values and Ambition. The Consensus set out a statement of intention to strengthen community mental health services and to provide effective alternatives to inpatient care.  The Trust has received the Mayor of London’s Healthy Workplace Award in recognition of the initiatives developed by the Workforce Directorate under the BEHWell programme to get employees thinking about their mental and physical health.  The report outlined details of communication activity since the last report, which now included a notional news value assigned to each aspect of communications. Maria Kane also informed the Board that Mary Sexton, Executive Director of Nursing, Quality and Governance, celebrated 30 years as a registered nurse in January. In response to a question from Charles Waddicor, Maria Kane provided an overview of the EuCoMS Network meeting which provided an opportunity to hear presentations from representatives from a number of countries about the way in which they approached community mental health services. The Trust Board agreed to note the Chief Executive’s report. 1.9 Chief Operating Officer / Executive Director of Patient Services’ Report Andy Graham presented the Chief Operating Officer / Executive Director of Patient Services’ report and highlighted the following: Page 4