Trust Board papers November 2012 - Barking Havering and ...

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forecast in terms of community bed requirements, including the plans the Cluster was going to put in place
to bridge the gap in available community beds. It was noted that the Trust was developing its own Winter
Plan and it was agreed that the Director of Transformation would bring back the composite plan, based on
credible data, to the next meeting, in order to provide the Board with the evidence it required. Executive
Directors of BHRUT would be meeting with the Cluster for a Clinical Strategy Day on the 21 September, in
order to share the work on their different Workstreams and use it as a good opportunity to highlight the
issues; admission criteria into nursing homes and lack of community beds. This engagement would assist
in bringing all of this to a conclusion before Winter arrived.
Dr Dalziel raised the issue of how the organisation presented performance information and whether targets
were right, as with the Trust’s previous experience, it should have more of a feel around realistic targets
and should not be over estimating what is considered to be an achievable target/performance level. She
felt that the Trust should be transparent about what was reasonable and how it presented this externally,
otherwise it would always look like it had failed.
The Chief Executive informed the Board that she would be attending a meeting tomorrow with the
Consultant Physicians regarding seven day working. There was also a Surgery ‘Awayday’ planned for
tomorrow where they would be looking at how the Surgeons would provide 7/7 working. The Board noted
that by the end of the financial year, the Consultants should be working twelve hour shifts and have 7/7
working in place.
The Outline Business Case (OBC), which included the closure of the Emergency Department at King
George Hospital, had not yet been completed, but Ernst & Young was working with the Trust to put
together a plan for Queen’s and King George Hospitals, which would include the cost of moving A&E
across from KGH to Queen’s. The OBC should be completed by the end of October/beginning of
November and would be made available for the public to review.
The Trust Board noted the update.
Action: Averil Dongworth 7.11.12
Dorothy Hosein 7.11.12
2012/048 MATERNITY SERVICES UPDATE
The Trust Board noted the content of the Maternity Services Monthly Performance Report covering the
period 1 July to 31 July 2012. At previous Board meetings Ms Wright had raised the issue of data
recorded for the ‘Out of Hours’ Obstetric Assessment Unit (OAU) not being robust and wanted to know
when this would be addressed, as there did not appear to be any explanation for her to know that this was
being handled appropriately and the Board had reliable information to monitor performance against. In the
current format it was difficult to assess whether there had been any improvement, or not.
The timing of Caesarean Section (C/S) Deliveries according to acuity were discussed and it was noted by
the Board that delays attributed to clinicians/anaesthetists required elsewhere, due to a busy Labour Ward
and Theatres, was stated as being in the top three reasons for delays. The Board agreed that it would be
helpful for them to understand the proportion of these delays by Grade 1, Grade 2 and Grades 3 & 4 and
what took precedence over these C/S’s. The Chief Executive agreed to look into this and to report back to
the Trust Board. Mrs Dongworth would also seek assurance from the Directorate that the clinical fellow
pathway had been implemented on the 30 July 2012.
The transfer of some of the Trust’s midwives, due to the changes in boundaries, was discussed and the
Chief Executive informed the Board that there would be further discussions regarding this later this week.
Mr Mahoney highlighted to the Board that he had concerns around the TUPE across of midwives to other
Trusts in the Cluster, when the births at BHRUT had increased for the second month and the organisation
was still delivering over 9k, although the Trust had been assured by the Commissioners that this would not
be the case by the end of the financial year.
The Board agreed that it was important to have agreement on the Workforce Plan for the future, in order to
ensure a safe service was operating, but the Directorate was not over resourced and left with stranded
costs. The Board noted that the Clinical Director for Maternity and the Director of Midwifery had been
Trust Board Minutes Part I – 5 September 2012