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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7<br />
<strong>2012</strong>/053 TRANSFORMATION BOARD UPDATE<br />
Mrs Hosein informed the <strong>Board</strong> that against the CIP target of £23.1m, the <strong>Trust</strong> had identified £17.6m,<br />
following a review carried out by Ernst & Young. Further schemes were being worked on to address the<br />
gap <strong>and</strong> the Project Management Office/Service Transformation Team was working with the Workstream<br />
Leads to strengthen the existing schemes, in order to ensure delivery.<br />
The Programme had delivered the target for last month <strong>and</strong> would be working towards achieving a £2m run<br />
rate by the end of March. One Ward had been closed <strong>and</strong> the Team was currently working up a further<br />
proposal to close another Ward. Accountability meetings with the SRO’s were continuing to ensure the<br />
Programme was kept on track. The <strong>Board</strong> was asked to refer to a table within the Finance Report, which<br />
set out the workstreams <strong>and</strong> the deliverables for the CIP.<br />
Mr Langley raised the issue of improving <strong>and</strong> embedding controls in relation to bank <strong>and</strong> agency staff <strong>and</strong><br />
Mrs Hosein confirmed that a lot of work had been put into this with the Wards <strong>and</strong> they would now be<br />
concentrating <strong>and</strong> drilling down on the medical spend. Each Directorate had been asked to identify their<br />
medical staff expenditure <strong>and</strong> to come back with their short, medium <strong>and</strong> long term actions on how they<br />
would reduce their bank <strong>and</strong> agency spend in this area, albeit there were obviously still recruitment issues<br />
in some areas, e.g. Emergency Department.<br />
The <strong>Trust</strong> <strong>Board</strong> noted the update report.<br />
<strong>2012</strong>/054 ANNUAL AUDIT LETTER 2011/12<br />
The <strong>Trust</strong> <strong>Board</strong> noted the Annual Audit Letter 2011/12 submitted to the <strong>Trust</strong> from the Audit Commission.<br />
<strong>2012</strong>/055 END OF LIFE CARE ADVISORY BOARD – BRIEFING PAPER<br />
Ms Heather Wright, Team Leader for Palliative Care <strong>and</strong> Dr Andrew Gage, Palliative Care Consultant<br />
presented their end of life video. Dr Gage informed the <strong>Board</strong> that along with Dr Claire Bates, they had<br />
developed the End of Life Care (EOLC) Advisory <strong>Board</strong> (ELCAB), which aimed to facilitate the<br />
implementation of the EOLC Strategy (2008) <strong>and</strong> NICE End of Life Quality St<strong>and</strong>ards (2011) within the<br />
<strong>Trust</strong>. The Strategy was comprehensive <strong>and</strong> would assist the <strong>Trust</strong> in improving practices in the short term<br />
<strong>and</strong> for the longer term change the culture of End of Life Care. Dr Gage highlighted that there were a high<br />
number of deaths in Outer North East London (ONEL), compared with the rest of the Country <strong>and</strong> the<br />
ONEL community palliative care services were poorly resourced, with inequity across the Boroughs. The<br />
<strong>Board</strong> noted that there was a CQUIN for EOLC, which commenced in April this year following negotiation<br />
with the Commissioners to ensure there was a realistic, but challenging goal agreed (c.£478k to the <strong>Trust</strong>).<br />
It was acknowledged that the education of Doctors was important <strong>and</strong> they had developed a bespoke DVD<br />
for the ‘Dying Matters Week’ in order to empower <strong>and</strong> support <strong>Trust</strong> clinicians to take on the responsibility<br />
themselves. Ms Wright informed the <strong>Board</strong> that the Dying Matters Coalition wanted to put the <strong>Trust</strong>’s DVD<br />
on their website, after addressing any copyright issues.<br />
The <strong>Board</strong> was advised that there were Borough Facilitators who trained staff in the nursing <strong>and</strong> residential<br />
homes, but access to specialist palliative care seven days a week, or ’out of hours’, was difficult, as the<br />
community <strong>and</strong> the acute sector were not joined up at the moment.<br />
The Directorate had been highlighting since 2004 the requirement for an additional nurse at the <strong>Trust</strong>. The<br />
organisation also needed to address the under resourcing of specialist beds. The number of in hospital<br />
deaths occurring on the Liverpool Care Pathway was raised by the Interim Chairman, as well as the<br />
available bed base. Dr Gage confirmed that the current figure for these beds in this locality was three per<br />
100k population, against seven in Tower Hamlets <strong>and</strong> 4.55 for the <strong>Trust</strong>, which was below the National<br />
average. Dr Gage also informed the <strong>Board</strong> that Redbridge <strong>and</strong> Waltham Forest were under resourced for<br />
24 hour cover. Mr Wood would take this up outside of the meeting, in order to assist in moving things<br />
forward in this area.<br />
It was noted that this paper had not been through the normal channels <strong>and</strong> discussions had not taken<br />
place at Executive Director level. The Quality & Safety Committee would therefore review the issues<br />
raised <strong>and</strong> recommend the appropriate actions to be taken.<br />
<strong>Trust</strong> <strong>Board</strong> Minutes Part I – 5 September <strong>2012</strong>