Report to: Council of Governors Agenda item: 15 Date of Meeting: 6th December 2016

Governor Strategy & Business Planning Working Group Title of Report: Update Report Status: For Information Helen Rogers, Public Governor, North East Sponsor: (Chair) Author: Roxy Poultney, Membership & Governance Manager Appendix 1: Non-Executive Director Assurance Appendices Appendix 2: Governor Engagement Groups

Purpose To provide the Council of Governors with an update following the Governor Strategy & Business Planning Working Group held on 31st October 2016.

Background The report is prepared to inform the Council of Governors on the salient issues discussed and agreed at the Governor Strategy & Business Planning Working Group.

Business Undertaken The Working Group received the following updates: • Re-review list of Governor engagement groups • Corporate Projects Update • It was confirmed that NHS BaNES Clinical Commissioning Group and BaNES Council had endorsed the award of a seven year contract to Virgin Care to deliver community health and care services in Bath and North East Somerset. • Strategic Planning and Business Plan Update • Lessons learnt from past bids (key themes from recent bids) • 2016/17 Trust priorities quarterly update

Key Decisions

Governor Away Day The working group discussed how they would like the joint BoD and Governor Away Day structured. It was noted that last year Governors felt “talked at” rather than involved.

The Commercial Director has put some further thought to some themes which the CoG and BoD might usefully discuss together at the away day in December. There will therefore be 3 discussion tables looking at the issues of “income”, “cost” and “quality”. Within these themes we can tackle areas such as STP, self-care,

Author : Roxy Poultney, Membership & Governance Manager Date: 01 December 2016 Document Approved by: Helen Rogers, Public Governor, North East Somerset (Chair) Version:1.1 Agenda Item: 15 Page 1 of 4

workforce challenges, alternative income, estates etc. and it would be particularly useful to hear Governor’s views on topics such as private patients, any areas where you feel we may be “wasting” money or duplicating resources, meeting the needs of our constituencies within the declining resource envelope, how to work with other organisations etc.

The Council of Governors are asked to note the proposal for the away day on 12th December.

Governor Engagement Groups The working group received an update on the list of Governor Engagement Groups which had been presented at the last meeting. A pivot table had been created to enable the spreadsheet to be used in a way that could split groups by constituency.

The working group confirmed that they were happy with the categories but recognised that whilst most stakeholders had been captured it was likely that more could be identified in future. Governors were asked to inform Roxy if this was the case. A copy is attached at appendix 2 for your information.

Exceptions and Challenges

Corporate Projects The working group discussed the Virgin Care contract and expressed concern that the public had expressed discontent in the decision to award the Your Care, Your Way contract to a private provider.

Governance and Other Business Strategic Planning and Business Plan Update The working group received an update on the Strategic Plan and noted that there were three overarching plans as follows:

The Trust would develop working relationships with Virgin Care which would positively address key pathway challenges and support primary care in the development of accountable care delivery units in Mendip.

Author : Roxy Poultney, Membership & Governance Manager Date: 01 December 2016 Document Approved by: Helen Rogers, Public Governor, North East Somerset (Chair) Version:1.1 Agenda Item: 15 Page 2 of 4

There would be a continued focus on income capture for private and overseas patients to ensure that the Trust maximised non-NHS income. The working group questioned the extent of the problem to RUH in relation to monies owed in relation to Foreign Nationals. The following update was received:

As at the end of Oct-16 the Trust was owed £162,094.21 from a total of 59 overseas patients. 82% of this debt is over 91 days old. All of this debt is being actively chased by our debt collectors. Although it sometimes takes a long time to recover this debt, based on 2013/14 data we do comparably well with debt recovery of overseas patients and recover over 75%. A full paper went to Audit Committee in May, which Bill Aiken will have seen.

Business Planning update: • The NHS Operational Planning and Contracting Guidance 2017 – 2019. • There were shorter timescale for planning this year: . 24 November Draft operational plan submission . 23 December Final operational plan submission, contracts signed

Membership of working group Hassan El-Wakeel, Staff Governor, joined the working group for the remainder of his Staff Governor term.

Future Business In line with the Governor Strategy & Business Planning Working Group work plan.

Recommendations The Council of Governors is asked to: 1. Note the update report 2. Note the proposal for the away day on 12th December. 3. Note the Non-Executive Assurance (appendix 1) 4. Note the list of stakeholders (appendix 2)

Author : Roxy Poultney, Membership & Governance Manager Date: 01 December 2016 Document Approved by: Helen Rogers, Public Governor, North East Somerset (Chair) Version:1.1 Agenda Item: 15 Page 3 of 4

Appendix 1: Non-Executive Director Assurance

The following question was forwarded to Moira Brennan following the Strategy & Business Planning Working Group on 4th August 2016:

At its meeting in August, the Strategy & Business Planning Working Group was made aware that the estimated spend on the new therapies unit was now greater than previously estimated. The working group would like assurance that this overspend can be met without causing detriment to the overall finances of the Trust, that the overspend is not likely to increase and that the therapies unit is still on track for completion within agreed timescales?

At the CoG meeting in September, Moira provided assurance that she would be asking this question of the Board of Directors but may not have a response in September. Moira sent the following update to the working group in September:

Given the increase in build cost and the changes in the Trusts finances I am seeking assurance regarding the affordability of the current capital programme including the build of the Therapies building. To get that assurance I have asked that the Board receive an update on the Long Term Financial Plan. This plan is currently being updated in line with the NHSI planning timeline. I have agreed with the Finance Team that there is little value in the Board reviewing the plan until it has been updated. I therefore expect the plan to be brought to the Board in October.

On the morning of 31st October 2016 assurance was received from Moira as follows:

Further to the October Private Board Meeting I can confirm that the Board reviewed the capital plan for the period covering the construction of the Cancer Centre and the Therapies Centre. We also reviewed the affordability of the plan and the risks and sensitivities to that affordability. The Board was assured that based on our current financial plan, the capital programme is affordable. As always we are aware that the financial environment is challenging and our aspiration to significantly redevelop the site will only be affordable if we continue to deliver operating surpluses in line with our financial plan.

Moira

The working group discussed the assurance provided by Moira and felt comfortable with the response. However it was noted that the working group may wish to seek further assurance in relation to affordability and the overarching financial plan in the future.

Author : Roxy Poultney, Membership & Governance Manager Date: 01 December 2016 Document Approved by: Helen Rogers, Public Governor, North East Somerset (Chair) Version:1.1 Agenda Item: 15 Page 4 of 4

Organisation Sector Type of organisation Location Governor patch

Bath University Education University Bath City of Bath Education College Bath City of Bath North Education University Bath City of Bath South Wiltshire University of West of England Education University Other Mendp Norton College Education College City of Bath North East Somerset Education College City of Bath; Regional City of Bath New College Education College City of Bath Other Wiltshire College Education College City of Bath; Regional Education College Cirencester City of Bath Stroud College Education College Stroud City of Bath; Regional University of Gloucester Education University Education High school Hayesfield Girls School Education High school Hayesfield Girls School Education High school Education High school Lansdown School Education High school Bath Education High school Bath B&NES CCG Healthcare Clinical Commissioning Group Bath Wiltshire CCG Healthcare Clinical Commissioning Group Devizes Somerset CCG Healthcare Clinical Commissioning Group Somerset County Council Council County Council B&NES Council Council County Council Wiltshire Council Council County Council Adcroft Practice Healthcare GP Practice GP practices B&NES, Wilts, Somerset and other relevant areas Healthcare Healthwatch B&NES Healthcare Healthwatch Healthwatch Somerset Healthcare Healthwatch Healthwatch Wiltshire Healthcare Healthwatch B&NES Health and Wellbeing Board Healthcare Health and Wellbeing Board Wiltshire Health and Wellbeing Board Healthcare Health and Wellbeing Board Somerset Health and Wellbeing Board Healthcare Health and Wellbeing Board North Bristol NHS Trust Healthcare Acute Hospital Bristol Other University Hospitals Bristol NHS Foundation Trust Healthcare Acute Hospital Bristol Other Weston Area Healthcare Trust Healthcare Acute Hospital Weston Super Mare Other Great Western Hospital NHS Foundation Trust Healthcare Acute Hospital Swindon North Wiltshire Salisbury NHS Foundation Trust Healthcare Acute Hospital Salisbury South Wiltshire Private sector providers Healthcare Public Health - B&NES, Wiltshire, Somerset Healthcare Social services Healthcare Severn Deanery Education Deanery All Academic Health Science Network (AHSN) Research Research network Bristol All Health Management Centre Research University Bath All Sirona Health and Social Care Healthcare Community provider Bath City of Bath, North East Somerset South West Ambulance Service NHS Foundation Trust Healthcare Ambulance Trust All Carers Forum Voluntary Members Public Patients and carers Public University of the Third Age Voluntary Bath Chronicle Local media Newspaper Bath City of Bath, North East Somerset Wiltshire Times Local media Newspaper Gazette and Herald Local media Newspaper Somerset Live Local media Newspaper Frome Standard Local media Newspaper Frome BBC Radio Bristol Local media Radio Bristol BBC Radio Somerset Local media Radio BBC Radio Wiltshire Local media Radio BBC Points West Local media TV Brisol ITV West Local media TV MP for Bath MP MP MP for South West Wiltshire MP MP MP for North Wiltshire MP MP MP for North Somerset MP MP MP for North East Somerset MP MP MP for Devizes MP MP MP for Wells MP MP Friends of the Min Voluntary Friends of the RUH Voluntary Volunteers Voluntary Bath Institute for Rheumatic Diseases

Forever Friends NHS Urgent Care Centre (Bath and North East Somerset Doctors Urgent Care) NHS Twitter followers Public Staff – (split as appropriate – executive/managers/clinical/nursing/admin/auxiliary Retired staff Public Bath Hospital Radio Local media Avon and Wiltshire Mental Health Partnership Healthcare Mental Health Bath All Bathampton Parish Council Council Parish Council Bathford Parish Council Council Parish Council · Whitchurch Parish Council Council Parish Council · West Harptree Parish Council Council Parish Council · Town Council Council Town Council · Batheaston Town Council Council Town Council · Timsbury Parish Council Council Parish Council · Freshford Parish Council Council Parish Council · Claverton Parish Council Council Parish Council · Wellow Parish Council Council Parish Council · Combe Hay Parish Council Council Parish Council · Chew Magna Parish Council Council Parish Council · Newton St Loe Parish Council Council Parish Council · Parish Council Council Parish Council · Englishcombe Parish Council Council Parish Council · Amesbury Parish Council Council Parish Council · Box Parish Council Council Parish Council · Clutton Parish Council Council Parish Council · Corsham Parish Council Council Parish Council · Trowbridge Town Council Council Town Council · Saltford Parish Council Council Parish Council · Bradford-on-Avon Town Council Council Town Council · Monkton Combe Parish Council Council Parish Council · Pensford Parish Council Council Parish Council · Shoscombe Parish Council Council Parish Council · Coleford Parish Council Council Parish Council · Chilcompton Parish Council Council Parish Council · Priddy Parish Council Council Parish Council · Batcombe Parish Council Council Parish Council · Norton St Philip Parish Council Council Parish Council · Glastonbury Town Council Council Town Council · Frome Town Council Council Town Council · Wells City Council Council Town Council · Town Council Council Town Council · Hanham Parish Council Council Parish Council · Oldland Parish Council Council Parish Council · Westerleigh Parish Council Council Parish Council · Yate Town Council Council Town Council · Wickwar Parish Council Council Parish Council · Thornbury Town Council Council Town Council · Almondsbury Parish Council Council Parish Council Avon Federation of Womens Institutes Community Community groups Bath Federation of Town's Women's Guild Community Community groups Towns Woman's Guild Community Community groups Towns Woman's Guild Community Community groups Towns Woman's Guild Community Community groups Lions Club of Bradford on Avon Community Community groups Lions Club of Salisbury Community Community groups Council for Voluntary Service North Wilts Community Community groups Dorothy House Hospice Community Community groups YFC offices Community Community groups YFC offices Community Community groups Somerset YFC Community Community groups Wiltshire People First Community Community groups YMCA Community Community groups · Rotary Club of Corsham Community Rotary clubs · Rotary Club of Chippenham Community Rotary clubs · Rotary Club of Bradford on Avon Community Rotary clubs · Rotary Club of Salisbury Community Rotary clubs · Rotary Club of Melksham Community Rotary clubs · Rotary Club of Trowbridge Community Rotary clubs · Rotary Club of Warminster Community Rotary clubs · Rotary Club of Westbury Community Rotary clubs · B&NES Volunteer Centre Voluntary Volunteer Bureau · Community First (Wiltshire volunteers) Voluntary Volunteer Bureau · South Somerset Association for Voluntary and Community Action Voluntary Volunteer Bureau The Bath Business Club Community Business Networks Martini Community Business Networks Bath Mums Community Website · Positive Action on Cancer (Frome) Charities, Support and User Groups · Psoriatic Arthritis Support Group PsaZZ Charities, Support and User Groups · National Charities, Support and User Groups · Lupus UK Charities, Support and User Groups · Association for Young People with ME (AYME) Charities, Support and User Groups · National Osteoporosis Society (NOS) Charities, Support and User Groups · National Association for Ankylosing Spondylitis (NASS) Charities, Support and User Groups · National Rheumatic Arthritis Society (NRAS) Charities, Support and User Groups · Dementia UK, Alzheimer’s Society Charities, Support and User Groups · Bath Cancer Support Group Charities, Support and User Groups · Macmillan Charities, Support and User Groups