16/03/05 - Bradford Teaching Hospitals NHS Foundation Trust

Minutes of the meeting of theBoard of Governors 16 th March 2005Present:Peter Garland – in the ChairNon-Executive Directors Executive DirectorsDebbie Carrol David Jackson - Chief ExecutiveNadira Mirza John Rushfirth - Financial AdvisorPeter Noble Malcolm Poad - Director of Planning & PerformanceRichard Wilson Rose Stephens - Chief Nurse/Director of Hospital ServicesDuncan Newton - Medical DirectorPartner GovernorsNorman RoperJacky DoyleRobert TooleColin SloaneAlison O’SullivanMaggie HelliwellGrace AldersonNorth Bradford Primary Care TrustWorkforce Development ConfederationBradford City Primary Care TrustPatient ForumBradford MDC, Social ServicesAiredale Primary Care TrustUniversity of BradfordElected GovernorsLevi Hall Bradford South Astrid Hansen ShipleyTerry Baker Keighley Matt Palmer ShipleyMarjorie Gardner Bradford West Peter Sale ShipleyNora Whitham Bradford West Deidre Naylor AHPs/ScientistsJohn Speight Out of Area John Sidebottom All other staffMary Nelson Out of Area Janette Reynolds Nurse/MidwivesShamsul Khan Bradford North Sheila Nolan Nurse/MidwivesAbsentMohammed Razaq BaigAnna FrazerEdward HillhouseBradford SouthBradford NorthThe University of LeedsIn attendanceBob Dugdale – Secretary to the TrustSarah Goleby - PA to Bob DugdaleThe Chairman, Peter Garland, opened the meeting by referring to the recent speculation in the pressregarding David Jackson. He confirmed that a letter had been sent to the Governors advising thatDavid was retiring, together with a copy of press release, and advised that copies were available atthe end of the meeting should anyone wish to collect one.He went on to say that David had a long and distinguished service in the NHS and during the 13years he had worked in Bradford his achievements had been considerable and had included:• Teaching status• Three Star status for 4 consecutive years

That is why I firmly believe that my decision to announce my retirement now is in the best interestsof Bradford Teaching Hospitals and indeed for myself and my family. It has not been an easydecision – I have thoroughly enjoyed my job as Chief Executive which I have often described as“the best job in Bradford”. It has been both a pleasure and a privilege to have so many excellentcolleagues right across Bradford Teaching Hospitals who have generated the successes of the last13 years – but it is the right decision.Over the last few days I have had enormous support not only from the Board of Directors and myimmediate colleagues, but from the medical staff, members of staff generally, patients and of courseGovernors. The messages of goodwill that I have received from so many of you are greatlyappreciated and I thank you.”1. ApologiesApologies were received from Balbir Singh, Phil Corrigan, Con Egan, Dorothy Clamp, GhulamRabani, Ian Beck, Alan Scott, David Walker, Amjad Ali Zaman2. Approval of the minutes of the meeting held on the 8 th December 2004Accepted subject to an amendment that Balbir Singh, Non-Executive Director, was in attendanceProposed: Terry Baker Seconded: Marjorie Gardner3. Approval of the minutes of the meeting held on the 14 th December 2004There was discussion regarding a comment that had been made by one of the Governors but themeeting agreed that it would be an inappropriate amendment. The minutes were therefore acceptedsubject to an amendment that Balbir Singh, Non-Executive Director, was in attendanceProposed: John Sidebottom Seconded: Janette Reynolds4. Approval of the minutes of the meeting held on the 28 th March 2004Accepted subject to an amendment that Balbir Singh was in attendanceProposed: Nora Whitham Seconded: Terry Baker5. Matters ArisingThe Chairman advised that when David Jackson had announced his retirement, the Board ofDirectors had agreed that the most appropriate replacement, in an acting capacity, would be RoseStephens as she will be able to provide strong leadership through this difficult time. Theorganisation will move quickly to institute the search for a new Chief Executive, subject to allowingtime for the new Chairman to be involved in the recruitment. A motion was made that:“The Board of Governors approves the appointment of the Non-Executive Directors of Mrs RoseStephens as Acting Chief Executive from 1 st April 2005 for a period of six months”Proposed: Colin Sloane Seconded: Mary NelsonThe motion was accepted by the Governors following a request by the Chairman for a vote by ashow of hands.6. A Smoke-Free HospitalMany people will be aware that recently Government announced that the NHS will be smoke-freeby 2006. Bradford Teaching Hospitals has been moving towards being smoke-free for some timeand wants to be in the forefront. David Jackson asked the Governors to note that the paper,circulated with the agenda, stated that smoke will not be permitted anywhere in the hospitalpremises or grounds. It will not prohibit all patients from smoking but it will be strictly restrictedthus benefiting both patients and staff. Consultation on this paper has taken place over the last 3months and subject to some details being resolved a new policy will be implemented in January2006 or earlier. Comments were requested.

I am extremely supportive of the policy, it is challenging but worthwhile. How will thedefinition be made as to which patients will be allowed to smoke?The Department of Health have produced extensive guidance and the assumption is that patientsshould not smoke. In addition patients would be encouraged to use their stay as an opportunity tostop smoking and we would provide whatever assistance we can.I am concerned that if you do not have a smoking zone then the gates are where people willcongregate and will leave their cigarette stubs. How will the Trust police this to ensure it doesnot happen?This is one of the items the Working Group will need to addressIt is understood how difficult it is for people to stop. What happens about members of staffwho work long hours if there is no-where on the grounds that they can go?The Department of Health’s definition is very clear that should include all staff and groundsIt was acknowledged that it there will be difficult issues but the Trust will need to find a way toimplement the policy sensitively.7. Financial Recovery PlanThe Financial Recovery Plan had been discussed in detail at the previous meeting and thereforeDavid Jackson was asked to provide an update on progress. He advised that the plan would beimplemented in 3 different stages: the first to introduce cost reductions and reach stability; thesecond stage is improvement and the third is to ensure sustainability. All the work undertaken mustbe sustainable for both the Trust and the PCTs. The forecast at outturn will be within the £11.3moverspend discussed and it is hoped that it may be below that. Currently month-on-month income isexceeding expenditure. A large exercise is being undertaken with the budget holders for next year toensure that cost reductions are sustainable. Dialogue continues with the PCTs and 95% of thebusiness has been agreed, although the remaining 5% could be difficult. A full draft of the Plan isbeing compiled that is expected to be completed around the end of March, and discussions areplanned with Monitor in April. At that stage the Trust will be in a position to share the informationwith Governors and Partners. Between April and October work will continue with the PCTsregarding activity and what the PCTs expect to purchase. Once this is complete and we are satisfiedthat the PCTs have clarified their requirements then we must consider what reductions need to bemade within the Trust and how we manage the risks. It is expected that there will be substantialpressures within the system. We will need to launch some performance improvement work,involving treating patients in a different way and this may be around the 10 high impact changes,but may also involve other improvement work. As the Trust moves into the next year there will beheavy focus on how service is delivered. The Governors were then invited to comment:Did the Trust have to pay the £150,000 fee from A&M?Yes, subject to being satisfied that certain conditions were met. The Trust was successful in gettinga reduction in the bill.At PCT Board meetings a balance sheet is distributed. Is it appropriate that the Governorsreceive a balance sheet. We receive figures in the abstract but it is not clear where allreductions etc are made.When the Financial Recovery Plan is issued in the next few weeks it will include this kind ofinformation.

Letters have been received from employees who are concerned about jobs. What action hasthe Trust taken to ensure that staff are aware of and are happy with the Recovery Plan?Briefing sessions take place within 24 hours of Board of Directors meetings. Staff have receivedregular briefings and regular meetings have taken place with Unions who are expected tocommunicate with their members. As soon as the Financial Recovery Plan is available we will holdmeetings for staff similar to the ones held at the latter part of next year.It is felt that emphasis should be placed on the need for the contract with the PCTs to besettled early on this year so that there is no repeat of past experiences.We are optimistic that things will be resolved in the next few weeks although there are still somedifficult issues to work throughAre you able to confirm that as part of the Financial Recovery Plan impact within thecommunity and on Social Services has been considered and that this is viewed from afinancial perspective as well as quality?Yes, there are key issue we are working through.As the next meeting is not scheduled until June, will their be an opportunity to review anddiscuss the Plan before then?It was agreed that an additional meeting at the end of April or early May would be arranged withone item only on the agenda.8i Compliance monitoring regime 2005/06With the assistance of slides, copies of which had been distributed, Malcolm Poad explainedMonitor’s proposed regime for monitoring compliance by Foundation Trusts with their Terms ofAuthorisation, and for interventions in the event of failure to comply.It was clarified that the ‘Board’ referred to in the slides was the Board of Directors.A suggestion was made that as comment and approval of the Annual Plan will be sought from theGovernors, this should be a second item on the agenda for the additional meeting discussed earlier.To ensure that the Annual Plan will be available it was proposed that the meeting takes place inearly May.Malcolm confirmed he would be leading on the Working Group covering performance and one ofthe items that will be covered by the Group will be how to monitor compliance and this will includewhat information would be brought to the meetings of the Board of Governors. It was suggestedtherefore that the Working Group propose the data that is made available to the Governors.8ii Formation of Search Committee for Chairman. Progress ReportAll the nominations received were included on the Search Committee and the first meeting willfollow on from the meeting of the Board of Governors. This will agree the application pack for theChairman. The Governors on the Search Committee consists of:John SidebottomMatt PalmerNora WhithamNorman RoperDavid WalkerShamsul KhanStaff GovernorShipleyBradford WestNorth Bradford PCTBradford NorthBradford North

8iii Report from Search Committee for Non-Executive DirectorsThe Search Committee for the Non-Executive Directors had met in early February and agreed theJob Description and Person Specification for the Chairman. They had also agreed that in the interestof economy the posts of Non-Executive Directors and Chairman would be jointly advertisedthrough an external company who would assist with the recruitment. The closing date forapplications will be 1 st April. The Governors on the Search Committee consist of:Marjorie GardnerNora WhithamDavid WalkerTerry BakerBradford West (Vice Chair)Bradford WestBradford NorthKeighley8iv Voluntary Services ReportAt a previous meeting it was agreed to produce a progress report on Voluntary Services. The reportwas circulated with the agenda and it shows that voluntary services contribute significantly to thework of the organisation. They are involved in many areas in the organisation and also in groups ofpatients who provide feedback. The volunteers have grown enormously and we now have 150people involved. Management is under by Oksana Wolstenholme who will be arranging forcoordinating groups to be set up and would welcome some Governor involvement.The amount of work involved in bringing together such a comprehensive document wasacknowledged. It was felt that it was appropriate that the Board of Governors record their thanks tothe people who volunteer their services and do sterling work for the Trust and a request was madethat this was arranged through Oksana.8v Governors Working Group UpdateThe dates for the three Working Groups had been circulated. These are:Performance 22 nd March led by Malcolm Poad will be discussing the NHS targetinformationService Development 19 th April led by Rose Stephens will be reviewing the performance ofA&E with a site visitBTH in the community 11 th May. The programme for this group is being finalised and the leadwill be advised as soon as possible.At the last meeting of the Governors there was a request to define the information that is providedto the Governors. The suggestion was made therefore that the Working Group led by Malcolmshould investigate this area and provide recommendations to the Governors in respect of whatshould be received routinely by the Governors.9i Equality and DiversityDilshad Khan gave an informative presentation on the work undertaken by the Department ofEquality and Diversity and comments and questions were invited:It is obviously a very challenging agenda I understand that at a national level the Trust has avery strong reputation and is seen as setting the standard.

Your comments regarding the workforce representing the local community were noted. Whatdoes the Trust do to educate the people of Bradford in the employment opportunities that areopen to all members of the society?We have worked hard with colleagues within schools to promote all professions within the NHS tolet them know that there are more staff in a hospital than just doctors and nurses. With ourcolleagues in the PCTS we have identified 12 professionals who promote their areas of expertiseand work closely with the school career guidance teachers. We also join forces with otherorganisation such as POSH (Promoting Opportunities in Social Care and Health) to allow ourmessage to be spread as widely as possible.Deidre Naylor advised that during the day she had been interviewing for the next batch ofpharmacists and she understood that there was good representation from the local community.9ii Expansion of medical education in BradfordIt had been agreed to postpone the item on medical education. Partly because there was rather a fullagenda and partly due some staff not being available. We hope therefore that this item will be puton a future agenda.10 Any other businessA remark was made that it was felt inappropriate for individual Governors to make statements to thepress. It was suggested that perhaps this should be clarified in the Code of Conduct for Governors.There was a comment from a Governor in the Telegraph and Argus on the article concerning DavidJackson’s retirement that stated “it’s good news for patients and the people of Bradford”. It shouldbe made clear that this Governor did not speak for the whole Board. Patients are more concernedabout quality of care received rather than who leads the organisation.A request was made that a note of thanks to David Jackson was recorded together with the goodwishes of the Board of Governors. Rose Stephens was welcomed into the new role she will beundertaking in April.11. Date of the next meeting25 th May 2005 at 6pm in the Recreation Hall, Field House, BRI