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