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North Bristol NHS Trust Trust Board Meeting in Public Thursday 29 September 2016 12.30Pm, Seminar Room 4, Learning and Research Centre, Southmead Hospital Agenda 1

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North Bristol NHS Trust Trust Board Meeting in Public Thursday 29 September 2016 12.30Pm, Seminar Room 4, Learning and Research Centre, Southmead Hospital Agenda 1 North Bristol NHS Trust Trust Board Meeting in Public Thursday 29 September 2016 12.30pm, Seminar Room 4, Learning and Research Centre, Southmead Hospital Agenda 1. Apologies and Declarations of Interest: 2. Questions from Members of the Public Enc 3. Minutes of the Trust Board meeting held on 28 July 2016 Enc 4. Action Log and Matters Arising PR/Enc • Review of SLM Decision - AY 5. Chairman’s Business PR/Verbal 6. Chief Executive’s Report AY/Enc Quality & Performance 7. Patient Story (Information) SJ/Verbal 8. Update on the Major Trauma Service (Information) BW/Presentation 9. Monthly Integrated Performance Report including Finance Report AY/Execs/Enc (Information) Strategy and Development 10. Winter Plan (Approval) KH/To follow 11. Capital Planning Report (Information) SW/Enc Governance & Regulation 12. Health and Safety Annual Report (Approval) SW/Enc 13. Charitable Funds Committee Report (Approval) JD/Enc 14. IM&T Programme High level Executive Summary and Project ND/Enc Status (Information) 15. Sustainable Development Management Report (Information) SW/Enc 16. Trust Management Team Report (Information) AY/Enc 17. Quality & Risk Management Committee Report (Information) RM/Verbal 18. Any Other Business 19. Date of Next Meeting Thursday 24 November 2016, 12.30pm, Learning and Research Centre, Southmead Hospital. North Bristol NHS Trust Minutes of the Trust Board Meeting held in public on 28 July 2016 in Seminar Room 5, Learning and Research Building, Southmead Hospital Present: Mr P Rilett Chairman Ms A Young Chief Executive Prof N Dr C Burton Medical Director Canagarajah Non-Executive Director (until item 07/11) Ms J Davis Non-Executive Director Mr N Darvill Director of Informatics Ms J Fergusson Interim Director of Workforce and OD Mr J Everitt Non-Executive Director Ms K Hannam Director of Operations Mr R Mould Non-Executive Director Mrs S Jones Director of Nursing Dr E Redfern Non-Executive Director Mrs C Phillips Director of Finance Mr A Willis Non-Executive Director Mr S Wood Director of Facilities In Attendance: Ms T Down Head of Capital Mr N Stibbs Corporate Services Planning (until item Manager 07/08) Ms R Sidgwick Fresh Arts Programme Ms R Whitaker Communications Manager (until item Manager 07/08) Observers: Mr D Jarrett, South Gloucestershire Clinical Commissioning Group, Mr C Puckett, Chairman, Staff Side and two members of staff Action TB/16/07/01 Apologies and Declarations of Interest There were no apologies and no interests were declared in the papers presented. TB/16/07/02 Questions from Members of the Public There were no questions from members of the public. TB/16/07/03 Minutes of the Trust Board meeting held on 2 June 2016 The minutes were approved as a true and correct record of the meeting. TB/16/07/04 Action Log The Trust Board approved the closure of actions as stated on the action log and noted progress as follows: Action 28 – Improvement methodology still to be discussed at a Board development session. 1 | Page TB/16/07/05 Chairman’s Report Peter Rilett, Chairman, reported that he had no issues to discuss other than those on the agenda. TB/16/07/06 Chief Executive’s Report Andrea Young, Chief Executive, said that the Board would be aware that the Trust had been placed in ‘financial special measures’ by NHS Improvement (NHSI). This was because the Trust had not accepted the proposed control total and was forecasting a continued deficit for 2016/17. The measures meant that an improvement director would be appointed to report to both her and Stephen Hay, Deputy Director of NHSI, and was expected to be in post for a short period. South Gloucestershire and North Somerset CCGs had also been placed in special measures largely because of their financial position. A preliminary Sustainability and Transformation Plan (STP) for the Bristol, North Somerset and South Gloucestershire (BNSSG) area had been developed and submitted and a final version with its estimated financial impact would be submitted at the end of September. Work on creating a solution to the issues that had arisen in Weston was embedded in the STP. She reported that the Secretary of State for Health, Jeremy Hunt, had visited the Trust’s maternity unit, the safest in the country and was considering giving its PROMPT training system a mandate for adoption across the country. The Trust was also likely to take part in an associate nurse pilot for Band 3 and 4 nurses. Andrea Young said NBT had welcomed 50 F1 doctors that week and a further 50 F2 doctors would commence work in the Trust the following week. TB/16/07/07 Patient Story Simon Wood, Director of Facilities, introduced Ruth Sidgwick who was the programme manager who ran the Fresh Arts programme of live and static arts installations around the Brunel site and Tricia Down, Head of Capital Planning. Ruth Sidgwick said that she would concentrate on one area of the programme all of which was designed to enhance the patient environment to promote the therapeutic and caring functions and the staff environment. It would also help to develop a positive culture of creativity and care in the new building. In 2014 a three day festival to celebrate the opening of the new hospital had been arranged which had included a textile artist who, through the promotion of knitting as a therapeutic action had produced a sense of community for patients who had taken part. The finale of the exercise had been the knitting of a giant jumper which had been put on display at the front of Brunel. The success had brought funding from a charity and the project was into its second year. The artist travelled across the Brunel wards where she left knitting to get on with and also held staff drop-in sessions. The finale for the 2015 festival had been a knitted bus stop outside Brunel. Tricia Down read out some of the many positive comments that had been made by patients and staff. 2 | Page In total, 996 knitters had been involved through the monthly drop-in sessions in 2015. The artist had also worked one to one with stroke rehab patients and neuro-psychiatry, sessions in the eating disorders clinic and teaching new parents in NICU. Academic research showed that arts were capable of reducing pain, depression, panic and anxiety and knitting appeared to work because it was a calming and familiar repetitive task. The Knit with Me project exemplified the five evidence based actions – connectivity, learning, being active, taking noticing and giving that were recognised by a leading think tank as the actions that improved personal and collective wellbeing. She said that plans were being made to expand the project to the diagnostic areas where it was believed it could be of benefit before sessions. Chris Burton, Medical Director, noted that there was evidence that people remembered more of what took place at the end of events. Robert Mould asked if the knitting project had attracted many male participants and Ruth Sidgwick confirmed there had been several including bus drivers during their break time. Simon Wood said that this had been one of several projects overseen by Ruth Sidgwick and he would arrange for a tour of the static installations for members. The Board thanked Ruth Sidgwick and Tricia Down for their story and for the enthusiasm for the Arts Programme. TB/16/07/08 Medical Revalidation and Appraisal Chris Burton introduced the annual report to the Board setting out the processes and outcomes of the medical revalidation and annual appraisal of the 636 NBT designated doctors of varying grades. The processes used for appraisal had been found to be reasonably good and the level of deferrals was similar to other trusts. NHS England had inspected the appraisal systems and rated all domains as excellent. Rob Mould noted that the number of deferrals had increased over the last two years and Chris Burton said that this had largely been addressed in June and the deferrals had been due to poorly completed evidence rather than non-engagement with the process. Sue Jones, Director of Nursing, reported that the nurse appraisal system had been started in April 2016 and 267 nurses had been appraised. A further 152 were due by the end of September. A joint medical and nursing report appraisal report would be made in 2017. The Board approved a statement confirming that the Trust was compliant with 13 issues with regard to medical revalidation and appraisals. TB/16/07/09 Integrated Performance Report The Board received the monthly Integrated Performance Report (IPR) and noted that the Trust had failed to meet the agreed trajectory towards the four hour standard in the Emergency Department but had exceeded the trajectories for achieving the 18 referral to treatment (RTT) target and reducing the number of patients waiting over 18 weeks. Andrea Young also emphasised that the agreed trajectory for 3 | Page achieving diagnostic performance had been exceeded although difficulties in recruitment had continued and seven out of eight cancer targets had been achieved in May. A ‘never event’ in the form of a ‘wrong implant’ and a grade 4 pressure ulcer had been reported whilst expenditure on agency staff had reduced by 15% from May to June. Overall performance had not been consistent and the consultancy firm FTI was working with the Trust on the financial and performance issues. Kate Hannam, Director of Operations, reported that the main reason for the failure to achieve the 62 day first treatment from urgent GP referral for cancer were being investigated but so far the delays in processing pathology had yet to result in breaches.
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