MEETING OF THE COUNCIL OF GOVERNORS HELD AT 1600 HOURS ON WEDNESDAY 28 JULY 2010 BOARD ROOM, AIREDALE GENERAL HOSPITAL, SKIPTON ROAD, STEETON, KEIGHLEY

PRESENT: Mr Colin S Millar, Chairman (in the Chair)

Mr Peter Allen, Public Governor, Skipton Dr Neil Boyle, Public Governor, South Mrs Anne Medley, Public Governor, Keighley West Mr Adrian Mornin, Public Governor, Keighley Central Mr John Osborn, Public Governor, Rest of Mrs Sheila Paget, Public Governor, Ilkley Mrs Barbara Pavilionis, Public Governor, Skipton Mr Alan Pick, Public Governor, South Craven Mrs Shirley Shields, Public Governor, Keighley West Mr Alan Sturgess, Public Governor, Settle and Mid-Craven Mrs Pat Thorpe, Public Governor, Bingley Rural Mr Ray Tremlett, Public Governor, Pendle East and Colne Mr John Wickham, Public Governor, West Craven Mrs Valerie Winterburn, Public Governor, Craven

Ms Rachel Binks, Staff Governor, Nurses and Midwives Miss Leanne Clegg, Staff Governor, All Other Staff Mr David Petyt, Staff Governor, Registered Volunteers Mrs Karen Swann, Staff Governor, Nurses and Midwives

Mrs Pam Essler, Stakeholder Governor, NHS Bradford and Airedale Professor Anne Forster, Stakeholder Governor, University of Leeds Cllr Robert Heseltine, Stakeholder Governor, North County Council Ms Anne Kerrigan, Stakeholder Governor, Pendle Borough Council Mrs Marcia Turner, Stakeholder Governor, Craven District Council

IN ATTENDANCE: Mr David W Adam, Non Executive Director Mrs Marie Buchan, IT Project Manager Mr Jeff Colclough, Non Executive Director Mrs Jane Downes, Company Secretary Miss Bridget A Fletcher, Interim Chief Executive Mrs Sally Houghton, Non Executive Director Mrs Fiona Page, FT Membership Manager Ms Nichola Powell, Executive Assistant Mrs Sheenagh Powell, Director of Finance Mrs Ann Wagner, Director of Strategy and Business Development

APOLOGIES FOR ABSENCE: Mr Peter Beaumont, Wharfedale, Mr Terry Gudgeon, Lower Wharfe Valley, Mr Mohammed Nazam, Keighley Central, Mr Chris Nolan, West Craven, Mr John Roberts, Public Governor, Worth Valley, Mrs Pauline Sharp, Stakeholder Governor, Bradford Metropolitan District Council, Alan Sutton, Non Executive Director and Mr Alan Walshaw, Staff Governor, Allied Health Professionals and Scientists

1 ACTION 18/10 WELCOME

The Chairman reflected on the meeting which was held on 23 June and advised that comments had been taken on board regarding the layout of the room hence the more formal layout for this meeting. He also reminded the Governors that the Council of Governor meetings were public meetings.

He informed the meeting that Agenda item 13(iii) would be postponed due to the fact that Helen Barrow, the Complaints Manager, was currently off work. This would be placed on the Agenda in October.

19/10 DECLARATIONS OF INTEREST

There were no declarations of interest.

20/10 MINUTES OF THE MEETING HELD ON 23 JUNE 2010

The minutes of meeting held on 23 June 2010 were approved as a correct record.

21/10 MATTERS ARISING NOT ON THE AGENDA

There were no matters arising.

22/10 REPORT FROM THE INTERIM CHIEF EXECUTIVE

Bridget Fletcher informed the meeting that her paper gave the Council of Governors a flavour of what the Trust had undertaken over the past few months and also informed them of national, local and Trust changes. She stated that large scale changes were due to take place in the NHS over the forthcoming months.

i) National Developments As most people were now aware Andrew Lansley had been appointed Secretary of State for Health, although he had been undertaking this role in shadow form for a number of years. The Trust wanted to have close links MPs and had written to all the local MPs to invite them to visit the Trust over the next few months.

The White Paper recently published set out the changes due to take place over the next few years. A number of consultation documents were due to be released shortly with 6 already being released. Due to the forecast increase in demand in healthcare the White Paper had set out the importance of consistency of care.

Miss Fletcher concluded there would be huge financial pressures in the NHS with £15 - 20 billion having to be saved over the next 5 years.

ii) Trust Developments The IBP (Integrated Business Plan), which was in place for the Trusts FT authorisation meant that the Trust was ‘Fit for Purpose’, however this would be reviewed over the forthcoming months to ensure that the Trust would continue to be Fit for Purpose when all the proposed changes take place.

At this point the Chairman asked for any comments or questions relating to these items.

2 Adrian Mornin enquired what the new rules on reconfiguration were. Bridget Fletcher responded by stating that local GPs/Service Users will would be consulted when a reconfiguration takes place to ensure they understood and could contribute to the changes.

Neil Boyle enquired whether the Governors would be involved in any of the consultation documents and what the timescale for responses were. Bridget Fletcher responded by saying that the paper had only been released the previous week and a response was due in October. Jane Downes informed the Governors that a briefing on the White Paper had been arranged early September.

Valerie Winterburn asked what impact the savings would have on the Trust. Bridget Fletcher stated that in the current business plan there would be a 4% savings year on year for the next 5 years. iii) Operating Framework Bridget Fletcher explained how the Operating Framework worked and its purpose, and reported on the recent revision to the original Framework which meant there was less bureaucracy and targets. The national A&E 4 hour waiting time target had now been reduced to 95% but as a Trust Airedale were working very closely with clinicians to see how to take this forward for the benefit of the Trust and patients. The 18 week target, there to ensure that patients are seen and treated within 18 weeks from referral, had been modified. She said there was slight confusion nationally regarding this target at present but the Trust wanted to ensure that all patients received good treatment. The new tariff system introduced would be a much clearer process. Sheenagh Powell stated that the detail had not yet been released to date but currently the system was based on an average price countrywide, whereas in the future it would be based on best practice. More information would become available in January 2011.

John Osborne enquired whether the 4% savings the Trust had to make included inflation. Bridget Fletcher said this was the case. iv) Transforming Community Services (TCS) Bridget Fletcher explained that the services provided under the banner of TCS were currently part of the PCT which dealt with services delivered outside the hospital. The forthcoming changes would mean that the provision of care would have to be separated from the commissioning of care. This would be something that would be embedded in the way in which the Trust would work in the future. Airedale was currently working very closely with its PCTs to support this process. For & York the proposals would be issued at the end of July, and for Bradford & Airedale it was expected that the details would be known in September.

Pam Essler enquired about East Lancashire plans. Bridget Fletcher stated that the current proposal was that East Lancashire would join Central Lancashire and form a ‘Community Foundation Trust’.

Peter Allen asked what impact that would have on the Trust. Bridget Fletcher said that she was meeting with the East Lancashire GPs to discuss their proposal with them. She said that the Trust viewed this as an opportunity which would develop over time.

Alan Sturgess commented that the proposed changes looked like there would be less bureaucracy if GPs became commissioners, however, there could be a risk that the GPs then became mini-PCTs. Pam Essler responded by stating that NHS Bradford & Airedale were developing the forthcoming changes positively. Bridget Fletcher also agreed that some of the layers of bureaucracy would be removed but the Trust was keen to work with all GPs.

3 Adrian Mornin stated that there could be a risk of the larger GPs having more power than the smaller ones. Bridget Fletcher agreed that this would have to be monitored but she stated that there would be a national commissioning board which would be set up to look at the commissioning. Pam Essler stated that the local GPs held Airedale in high regard.

Ray Tremlett thought that the changes would lead to competition and also could also lead to “cherry picking”. Bridget Fletcher was aware that this could be one of the risks but Airedale was in a good position to deal with the more complex work.

v) Catering Bridget Fletcher gave a brief update on the current position with regard to the catering service at the Trust. Following the initial patient survey in which the results had been disappointing, a further survey had recently taken place whereby 97% of the responses had classed the food as excellent/good. She concluded by stating that the Trust would continue to work closely with Sodexo to ensure the high standards were maintained.

vi) Vascular Services Bridget Fletcher explained that vascular services dealt with problems of varicose veins through to the more serious cases of aortic aneurysms. A review of this service provision at Airedale and other neighbouring Trust by the Royal College of Surgeons had deemed that it was no longer advisable to provide this service independently and therefore, a network had been developed with Bradford and Calderdale and Huddersfield whereby an on-call rota was now in place.

Ray Tremlett enquired whether patients would still be treated at Airedale. Bridget Fletcher informed the meeting that the surgeons would come to Airedale and treat patients locally, however, this would always be dealt with on a case-by-case basis, with the option to transfer patients to either Bradford or Calderdale and Huddersfield if appropriate.

Alan Sturgess asked whether patients would get a choice of where they would be treated. Bridget Fletcher stated that this arrangement would mean patients would be treated and would stay at Airedale. She agreed it was important to ensure the communication regarding the new service was accurate.

vii) Equality & Diversity Bridget Fletcher reported that the Trust was committed to ensuring the Trust embraced the equality and diversity requirements. It was felt that this could be enhanced by having a Governor on the Equality & Diversity Steering Group.

viii) Disability Equality Scheme Bridget Fletcher informed the group that the Trust was progressing well with the requirements of the Disability Equality Scheme in order to ensure patient needs were maintained.

23/10 QUARTERLY AIREDALE FT REPORT

i) Executive Performance Report June 2010 Sheenagh Powell informed the meeting that the style of report was that which the Trust Board currently received. She acknowledged that there was more detail than the Governors would probably require. She requested feedback on the report from All the Governors for future meetings.

Sheenagh Powell reported that the Trust had been rated ‘green’ against Monitor’s reporting requirements for the first quarter. Of note was the ‘red’ rating for 18 weeks in April, although the overall assessment for the quarter had outturned as ‘green’.

4 The monitoring process was duly explained. She added that the Quarter 1 information would be submitted to Monitor at the end of July.

The Trust’s performance against the Care Quality Commission performance standards were explained. Of note was the ‘red’ rating against breastfeeding and smoking in pregnancy. The Trust was currently working with the PCT to improve performance. She informed the Governors that all red scores were looked at very closely to see what performance improvements could be made.

Adrian Mornin enquired what the relevance of weighting was together with the financial penalties attached to the red ratings. Sheenagh Powell explained the areas which had more weight added.

Neil Boyle enquired about the Patient and Staff Survey. Sheenagh Powell commented that the survey was carried out each year and duly explained the process. The scores showed where the Trust was in the top 20% and in the lower 20% benchmarked against other Trusts.

Alan Pick asked whether the Patient Survey was undertaken on discharge. Sheenagh Powell responded stating these were sent to the patient’s home address.

Neil Boyle queried the two outcomes from maternity services which were currently at red namely, breastfeeding and smoking during pregnancy, stating that these measures were slightly different as it was a matter of personal choice for the mother. Bridget Fletcher concurred with these comments, stating that it was an ongoing educational issue that was discussed with expectant mothers at each visit however it was an issue the Trust took very seriously.

Marcia Turner commented that these ratings were what the current PCTs currently require, and asked whether the new system would require the same performance measures. Sheenagh Powell responded by saying that the GPs would in the future still be the commissioners but it would depend on what performance measures they required. The current ratings were set nationally and locally, and she anticipated that this would remain unchanged but with more focus on local issues.

A number of comments were made regarding the presentation of the performance report including:

• could the report be printed in landscape and enlarge the print • could the report be e-mailed instead of sending hard copy

Sheenagh Powell agreed to take these two issues into consideration for future SPowell/ reports and asked if Governors had any further feedback to contact Jane Downes. All

The Chairman reiterated that this was an important report and if the Governors required it in a different format it was important to receive feedback. ii) Finance Report Sheenagh Powell explained that the report was again part of the submission to Monitor for Quarter 1. The report shows that the Trust currently had a surplus of £65k due to increased trading undertaken in the first three months. A slight overspend in expenditure was being monitored. The cash balance had fallen slightly but was still within the £5m limit which Monitor required for Foundation Trusts.

John Osborn asked what the forecast for the year end was and what the major risks were. Sheenagh Powell stated that it was £559k and the Trust was currently still on track to achieve this. She also mentioned that the phasing in for the Quarter 1 was worked out on actual working days and also took note of the Bank Holidays in the

5 quarter. Some of the major risks were whether the workload would continue to come through and the underlying expenditure in areas. Of note was that Monitor had given the Trust an overall risk rating score of 3.

The Council of Governors received and noted the financial report.

24/10 LEAD GOVERNOR – APPOINTMENT PROCESS

Jane Downes presented the Lead Governor appointments process which had incorporated all comments received at the previous meeting. These were reviewed in turn.

i) Job Description The Chairman asked for comments on the proposed Job Description for Lead and Deputy Lead Governor. There being no comments the Job Description was agreed.

ii) Person Specification The Chairman asked for comments on the Person Specification for Lead and Deputy Lead Governor. There being no comments the Person Specification was agreed.

iii) Eligibility Process Adrian Mornin asked a question on behalf of Pauline Sharp as she had been unable to attend the meeting. At the previous meeting she thought it had been agreed that the person coming second in the Lead Governor process would automatically become the Deputy Lead Governor. All agreed that this was not the case as the Lead Governor process was only open to Public/Staff Governors and the Deputy Lead Governor included all Governors.

John Wickham stated that his recollection was that it had been agreed only the Public Governor would be eligible to become Lead/Deputy Lead Governor. All agreed that this was not the case, however, Anne Medley stated that there was some confusion around the previous discussions and she had not been sure of the final outcome.

Following discussion the Chairman asked for any amendment to the eligibility process. There being no further amendments the paper was approved.

iv) Nomination Process Ann Kerrigan asked whether a Governor would require to be seconded for either position. Jane Downes stated that this was originally the case but in order to simplify the process, a seconder would no longer be required.

The Council of Governors agreed the nomination process.

v) Appointment Process John Wickham commented that if there was a tie for either position, the drawing of lots did not seem to be an equitable process. He asked if this could be done by looking at who received the most votes in the initial election. Jane Downes stated that this could be carried out but would be a complicated process.

Robert Heseltine commented that in these situations the drawing of lots was standard practice in public office.

There being no further comments, the Council of Governors approved the appointment process.

6 25/10 GOVERNOR – TERMS OF OFFICE

The proposed terms of office proposal was presented. The Chairman explained that the term of office for Governors was 3 years, however, in accordance with best practice the first 3 years of office for Governors would be staggered to avoid the possibility of losing all Governors at the same time. This would be the only time this would happen and in the future all Governors would sit for a minimum of 3 years. It was noted that If there was more than one Governor in an area due for election the proposal was to draw lots.

Rachel Binks asked if the person due for election could put themselves forward again for re-election. Jane Downes agreed that this was the case.

Neil Boyle asked if lots would need to be drawn if the two people in the constituency agreed who would stand down after one year. Jane Downes agreed that if there was mutual consent between the Governors this would be acceptable.

Adrian Mornin commented that if one of the Governors to stand down was the Lead Governor this would mean their period of office as Lead Governor would have to be brought forward. Jane Downes confirmed that this would be the case.

Alan Sturgess stated that holding the elections early could have an impact on the growth of the membership. Fiona Page confirmed this to be the case and also stated that recruitment was ongoing and the Meet the Chairman events would be recommencing in October for members who might be interested in putting themselves forward for election.

After due consideration the terms of office process was approved.

26/10 GOVERNOR COMMITTEES/WORKING GROUPS

i) Appointments and Remuneration Committee Jane Downes stated that this was a follow up to the paper which had been submitted to the meeting in June, and she thanked everybody who had put themselves forward for nomination. However, as there were more expressions of interest from Public and Stakeholder Governors than was required, it was suggested that lots should be drawn to decide membership.

All interested parties confirmed their ongoing interest and all agreed that the appointment of committee members should be decided by the drawing of lots.

ii) Membership Development Group and Open Event/AGM Group The proposal put forward was that the Open Event Working Group should become a sub group of the Membership Development Group. The Council of Governors JDownes approved this amendment.

iii) Other Working Groups Jane Downes stated that the Trust was keen to involve Governors in a number of other working groups which she had listed in the paper. She said that this was an initial list which would expand over time. She asked if any Governor would be interested in putting themselves forward to one of these groups to contact her by Friday 20 August. Again, if there was more interest in any of the groups then places All would be decided by the drawing of lots.

Sally Houghton, Non Executive Director and chair of the Airedale NHSFT Charitable Funds Sub Committee added that she wanted to make the group much more proactive and felt that by having one of the Governors involved would be of benefit.

7 An Organ Donation Group had recently been established within the hospital and David Adam, Non Executive Director and SID, had been appointed Chairman. He said Members of the group would include clinicians and senior nurses and again he felt having a Governor involved would be of benefit.

27/10 PROPOSED AGM AGENDA (INCLUDING APPOINTMENT OF AUDITOR)

The proposed agenda for the Annual General Meeting on Thursday, 2 September was presented.

The Chairman asked for and received the Governors approval.

Sheenagh Powell reiterated the fact that at the previous meeting the Governors agreed to re-appoint the Audit Commission as the Trust’s Auditors until the end of 2011/12. This timescale was due to the procurement process involved in appointing an Auditor. Sally Houghton stated that the re-appointment of the Audit Commission was the recommendation by the Audit Committee.

The Council of Governors approved the re-appointment process including the re- appointment of the Audit Commission until the conclusion of the 2011/12 audit.

28/10 REGISTER OF INTERESTS

Jane Downes stated that the Register of Interests as presented set out those interests declared by the Governors at the time of the election. Governors were asked to submit any amendments to the Register of Interest to Jane Downes as soon All as possible.

It was noted that the Register of Interests was a public document and would also be made available for inspection at the annual general meeting.

29/10 FORWARD AGENDA

The Chairman stated that the Lead Governor once in post would be involved in the process of agreeing the formal agenda for Council of Governors meetings.

Jane Downes brought to the attention of the Governors some dates which had not been published to date. The Board to Board meetings had been planned around the annual planning process, hence the November and March dates. Actual dates had however yet to be agreed and these would be publicised shortly. The Chairman stated that these dates were key meetings for Governors.

Governors were asked to bear in mind that this was a work in progress and dates would be added over the next few months. The paper would also be brought to each meeting.

Adrian Mornin asked what the search committee was. Jane Downes stated that due to the fact that Alan Sutton, Non Executive Director, would end his term of office next year the Governors would be tasked with his replacement, therefore, a search committee would need to be established as the Appointments and Remuneration Committee.

The Council of Governors received and noted the paper.

At this point, Mrs Naz Kazmi, Stakeholder Governor, Voluntary Services joined the meeting.

8 30/10 PRESENTATIONS

i) FT Governor’s Association The Chairman welcomed Ian Clay and John Wild from the Foundation Trust Governor’s Association who gave a presentation on the work they undertake.

Following the presentation the Chairman thanked them both for attending the meeting.

ii) Volunteers Annual Report Debra Fairley, Interim Chief Nurse presented the Volunteers 2009/10 Annual Report. She thanked all the Volunteers for the work they had undertaken during the year for the hospital. Over the past year recruitment for Volunteers has been paramount and their numbers were now at 416.

There were a number of significant work streams the Volunteers were involved in, one of which was the Real Time Patient Survey which started in 2008. Debra Fairley explained that all patients on discharge, are given the opportunity to complete a survey on their experience whilst an in-patient, the results of which are then fed back to the wards on a daily basis. She added that this would not be possible without the assistance of the Volunteers.

Both The Friends of Airedale and Airedale New Venture raised over £236k during 2009/10, which helped purchase extra equipment for the hospital. They also raised over £300k for the refurbishment of the Children’s Ward which was opened last year. Another area of particular importance was the setting up the Privacy and Dignity room which supplied clothes, slippers, toiletries to patients who arrive at Airedale without adequate clothing and have no relatives to assist them.

Debra Fairley concluded by reporting that a new Voluntary Services Manager had been appointed and would be commencing in September.

David Petyt added Radio Airedale had been reintroduced however the wards which had recently been refurbished were unable to access the service. He also mentioned that there was a huge problem with headphones which went missing regularly.

iii) PALS As referred to earlier, a presentation by the Patient Advice Liaison Service (PALS) had been deferred.

31/10 ITEMS TO NOTIFY GOVERNORS

Fiona Page, FT Membership Manager, informed the Governors of the following items:

• Parking Permits – all parking permits would expire at the end of July however, they would remain valid until replacements were issued.

• Nhs.net E-mails – all public Governor nhs.net e-mail addresses had been recently published in the newsletter recently. If any Governor had a problem with their accounts they were asked to please contact the IT Helpdesk.

• Guidance for Communicating with Members/Public – these had been issued by e-mail to all Governors.

• Expense Forms – again these had been issued by e-mail to all Governors.

9 • Future Meetings – meetings for the 7th and 28th September had been arranged. The first would be to give an update on the White Paper and the second would incorporate a debrief following the Open Day. Both meetings would have time for informal networking between Governors.

• Feedback on Governor Recruitment – two joint recruitment events had now taken place and both had gone very well. All Governors would be contacted over the next few months to see if they could offer an hour of their time to help with recruitment and engage with members when recruiting in their areas.

• Weekly Governor’s Briefing – a new briefing had been planned which will include new documentation, dates for diaries, links to press releases on the website etc. This will be distributed on a weekly basis from 9 August.

Alan Sturgess suggested that all Governors get into the habit of checking their nhs.net e-mail accounts a couple of time a week as there was no option for a flag to show in private e-mail addresses to let them know they had received an e-mail.

Barbara Pavilionis enquired whether any future recruitment dates had been arranged. Fiona Page stated that this was ongoing and Governors would be contacted for their assistance.

Governors requiring any further information were asked to contact either Fiona Page or Nichola Powell in the Membership Office.

32/10 ANY OTHER BUSINESS

i) Stakeholder Governor – NHS North Yorkshire & York The Chairman informed the Council of Governors that due to a reorganisation at NHS North Yorkshire & York, Gary Hardman would no longer be their Stakeholder Governor. A replacement representative was currently being sought.

ii) Meeting time allocation Alan Sturgess commented that this was the second meeting which had now exceeded the allotted 2 hour time schedule, and suggested changing the time to 4.00 pm – 6.30 pm.

iii) Terms of Office Jane Downes informed the meeting that lots for Term of Office had been drawn in the meeting break and the results were as follows:

CONSTITUENCY NAME TERM OF OFFICE Keighley West Anne Medley One year Lower Wharfe Valley Terry Gudgeon One year Settle & Mid Craven Alan Sturgess One year South Craven Neil Boyle One year West Craven John Wickham One year Doctors & Dentists Naren Samtaney One year Allied Health Professionals Alan Walshaw One year Nurses and Midwives Rachel Binks One year Nurses and Midwives Karen Swann Two years Craven Valerie Winterburn Two years Keighley Central Adrian Mornin Two years Skipton Barbara Pavilionis Two years Other staff Leanne Clegg Two years South Craven Alan Pick Two years West Craven Chris Nolan Two years 10 Bingley Mark Haw-Wells Three years Bingley Rural Patricia Thorpe Three years Ilkley Sheila Paget Three years Keighley Central Mohammed Nazam Three years Keighley East Shirley Shields Three years Pendle & East Colne Ray Tremlett Three years Rest of England John Osborn Three years Skipton Peter Allen Three years Wharfedale Peter Beaumont Three years Worth Valley John Roberts Three years Volunteers David Petyt Three years

It was noted that Dr Neil Boyle and Dr Alan Pick, Governors for South Craven and Rachel Binks and Karen Swann, Staff Governors (nurses and midwives), had reached mutual consent regarding their terms of office.

33/10 REVIEW AND CLOSE OF MEETING

All Governors agreed that it had been a good meeting and commented that the current table layout was preferable.

34/10 DATE AND TIME OF NEXT MEETING

The Annual General Meeting would be held on Thursday, 2 September at 6.00 pm in the Lecture Theatre, Education Centre.

The next quarterly meeting would be held on Tuesday, 26 October at 4.00 pm in the Board Room in the Education Centre.

There being no further business the Chairman declared the meeting closed.

11