BIRMINGHAM SOLIHULL MENTAL HEALTH NHS FOUNDATION TRUST

MINUTES OF THE ASSEMBLY OF GOVERNORS MEETING

5TH DECEMBER 2008 10:15 – 13:00 HIGBURY HALL

PUBLIC SESSION

Meeting commenced at 10:15 hours at Highbury Hall.

Governors In Attendance:

Sally Selvey Nursing Staff Governor Darren Cooper Nursing Staff Governor Vinod Mehta Other and AHP Staff Governor Naomi Hawkins Non-Clinical Staff Governor Joe Aldred East and North Public Governor Renganathan Ramamoorthy Birmingham East and North Public Governor Bridie Nugent South Birmingham Public Governor Bernadette Murray South Birmingham Public Governor Khalid Ali Rest of and Wales Public Governor Brian Sheppard Solihull Public Governor Sue Rose Solihull Public Governor Lynda Smith South Birmingham Service User Governor John Robinson Birmingham East and North Service User Governor Peter Brown Solihull Service User Governor Loris Tapper Carer Governor Lawrence Innis Carer Governor June Green Carer Governor Anne McKenzie Carer Governor Ann Davis Stakeholder: Lilieth Williams Stakeholder: Birmingham City University Charles Zuckerman Stakeholder: Local Medical Committee Jane Morel Stakeholder: Terrance Higgins Trust Robin Felton Stakeholder: Alzheimer’s Society Lynne Jones Stakeholder: MP Sue Anderson Stakeholder: Sue Nixon Stakeholder: PCT Commissioners

Trust Staff:

Sue Turner Chief Executive Peter Marquis Chairman Gary Crellin Trust Secretary Karen Martin Deputy CEO/Director of Organisational and Workforce Development Alan Kenny Director of Commercial Services and Asset Management Jonathan Lloyd Director of Strategic Delivery (Adults of Working Age) Ros Alstead Director of Nursing

1 Neil Deuchar Medical Director Lakhvir Rellon Director of Diversity Rachael Vowles Director of Communication and Marketing David Boden Deputy Chair/Non-Executive Director Stella Layton Non-Executive Director Laura Hollingsworth Foundation Trust Assistant

Apologies for Absence:

Faheem Uddin Heart of Birmingham Service User Governor Dr Asaf Khan Medical Staff Governor Sat Pal Heart of Birmingham Public Governor Kenneth Jeffers Heart of Birmingham Public Governor Rhonda Allen Rest of England and Wales Service User Governor Kate Wild Stakeholder: Solihull Metropolitan Borough Council Carl Foulkes Stakeholder: West Midlands Police

1. Minutes of the Last Meeting: Held Friday 5th September 2008

These minutes were approved as an accurate record, bar the incorrect spelling of one of the Governors names, Anne McKenzie.

2. Matters Arising

The supplied Annual Plan was incomplete. The Governors requested a re-issue of the Annual Plan. Action: Trust Secretary

The Governors have a statutory duty under the Health & Social Care (Community Health and Standards) Act 2003 – as superseded by the 2006 Act to have the annual accounts, any auditor report on them and the annual report of the Foundation Trust presented to them at a General Meeting. In preparing the annual plan, the Act states that Directors must have regard to the views of the Governors (Schedule 1 para 27(3)). This is similarly reflected in our Constitution (para 36). A process for engaging Governors proactively would be considered by the Trust and reported at the next meeting.

Action: The Chair

Patient Support Group, Zinnia Centre: Action discharged

Patient Property: Action not discharged, to be considered outside the meeting.

An issues log would be established from the next meeting. Action: Trust Secretary

3. Chair’s Report to the Governors

The Chair’s report was received by the Assembly. The Assembly noted:- i. The progress being made to discharge the Healthcare Commissions Inpatient review plan.

2 ii. The successful Annual Health Check results. iii. The Chair’s attendance at the Solihull Positive Mental Health Group. iv. The appointment of Chief Superintendent Carl Foulkes as the West Midlands Police Partnership Governor, replacing Chief Superintendent Steve Rowell. v. The appointment of Naomi Hawkins as the Staff Governor (Non-Clinical) replacing Karen Biles.

The Governors sought clarity on how they can be assured that the Trust is operating effectively within its terms of authorisation and noted that:- i. The External Auditor can provide additional assurance to the Assembly of Governors on the financial standing of the Trust and its internal control procedures. The External Auditor produces an Annual Audit Letter, to which the Trust responds. A copy of the Annual Audit Letter is lodged onto the Trust’s website, in the public interest. Copies would be sent to Governors.

Action: Trust Secretary ii. In relation to a suggested calendar of Assembly Business, a mid year review of the Annual Health Check and Standards for Better Health would be welcomed to support the agenda’d coverage of the Monitor Compliance Returns that the Trust has to make to the Regulator.

Action: Trust Secretary iii. A presentation from the External Auditor on the role and function of Audit would be arranged for the next meeting.

Action: Trust Secretary

4. Trust Performance Review

A. Resources Report

The Chair presented this report on behalf of the Director of Resources.

The Assembly requested clarification on the following issues:- i. Cash Releasing Efficiency Savings (CRES)

Cllr Anderson (Partnership Governor - BCC) asked whether a 3% CRES is affecting front line services and whether or not there was any impact on third sector partners.

The Chair clarified that all CRES programmes are risk rated. The efficiency saving model is currently changing from a flat rate across the Trust to one where capacity to deliver savings is taken into account.

The Chief Executive advised the Assembly of the position with public sector investment by Government, and the need to demonstrate cost efficiencies and benefits from the above inflation rate of investment. In relation to the third sector, there are no plans to levy a CRES approach, at this stage, on third sector organisations working with, or under contract from, the Foundation Trust.

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A CRES update will be shared with the Assembly at the next meeting.

Action: Trust Secretary via Director of Resources ii. The Extent of Vacancies Being Held Open

The Chair reported that the holding of vacancies in itself was not a cash releasing saving. Some posts are hard to recruit into and vacancies tend to be recruited at pre-set times of the year – i.e. after graduation of staff in the professions allied to medicine or nursing categories. Other posts may be held open pending organisational change or pathway redesign to aid service improvement. iii. Interest Earned on our Budgetary Income

The Governors were advised that our cash holding is managed in accordance with our approved Treasury Management Policy. No offshore investment has been entered into. iv. Monitor Risk Rating

In response to a question from Lynne Jones, MP Partnership Governor, the Chair advised that the Trust’s finance risk rating at Level 4 was the maximum achievable the first year of FT status. v. Capital Programme

In response to a question regarding the Trust’s Capital programme from Robin Felton (Partnership Governor - Voluntary Sector), the phasing of the capital spend was described.

The issue of the Underwood Centre (referred to by John Robinson, User Governor - BEN) would be addressed outside the meeting.

Action: Chair vi. Charitable Funds

In response to a question regarding the success of the launch of the Wellbeing Fund from Peter Brown (Service User Governor - Solihull) The Chair described how the Trust receives and manages charitable donations which are held in trust for departments, wards and for research. The Trusts' charities are registered with the Charity Commission and are authorised to raise funds for the Trust. These funds are dispensed by the Trustees, including all the Non Executive Directors, in accordance with donor wishes, where these are known. The Trust Board did not have access to or responsibility for allocations of charitable donations.

A report on the role and remit of the Wellbeing Fund will be presented at the next meeting.

Action: Trust Secretary

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B. Monitor Compliance Return

The Report on the Trust’s compliance with its Terms of Authorisation, including key performance indicators, was noted by the Assembly.

Further to a point raised by Sally Selvey Staff (Governor-Nursing),the Assembly thought that it was important, that in order to discharge its legal duties, that it should be advised if any area of the Compliance Framework or the Terms of Authorisation were giving the Directors significant cause for concern.

In addition, noting that this was a Trust wide picture, it was suggested that Patch/Geographical Governors should be advised of any significant issues affecting the key geographical areas of the Trust (HoB, BEN, South, Solihull in particular).

Action: Trust Secretary

C. Clinical Services Report

The Governors sought clarification on the following:- i. The development of the integrated care record – how was it being introduced and what actions were in place to audit its effective use. ii. What general themes were arising from the complaints received by the Trust? iii. How are infection control measures uniformly rolled out across the Trust?

The issues raised by the Governors would be subject to a further report at the next Assembly meeting.

Action: Trust Secretary via Director of Nursing

5. For Assembly Discussion

A. Development of the Trust’s Strategic Business Plan

The Assembly received a presentation from Stella Layton, Non Executive Director, and Jonathan Lloyd, Director of Strategic Delivery (Adults of Working Age), on the work in progress to produce a revised Strategic Business Plan for the Trust.

The Assembly welcomed the briefing and offered to contribute further, in particular in regard to Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis, although it was agreed that further discussion at the Assembly would be most constructive when a fuller draft was available.

Action: The Chair

B. Ensuring Transparency and Accountability

The Chair presented his paper on the view of the Board about the future of open/closed Board of Directors meetings and the proposed way ahead for optimising effective public accountability and transparency of Board Business.

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The Board remains committed to ensuring transparency and openness to the public, but believe that this would be better achieved through use of the Assembly of Governors as the main focus for public engagement and accountability.

The Governors considered each of the recommendations:-

1. To enhance public accountability and awareness of Board activities there should be:

a. In addition to the Annual General Meeting, a mid year Public / Member Board Review with appropriate opportunities for debate and questions from the members and the public.

b. Board approved papers and Minutes, with the exception of those identified as commercially confidential, should be made publicly available through the Trust Web site or a hard copy upon reasonable request.

The Assembly agreed to this recommendation

2. To ensure that Governors can objectively and effectively hold the Board to account and work in effective partnership with the Board:

a. After each Board meeting Governors should receive the approved Minutes of the previous Board meeting and a Chair’s brief on key items and decisions of the current meeting.

b. Governors and Board should agree an appropriate publicly available package of data on high level key performance data, relating to clinical services and resources, which will form a standing agenda item at each Assembly of Governors.

c. The Board business calendar, which is currently under review, should formally include identified input from and consultation with Governors on the following:-

i. Trust Strategy ii. Trust Annual Business Plan iii. Significant Investment and Divestment Decisions iv. Community Engagement v. Membership Engagement

The Assembly agreed to this recommendation

d. The Assembly of Governors should have the opportunity to submit items/topics for consideration by the Board and propose items for discussion at a Board Seminar. The Assembly of Governors will therefore need a mechanism to nominate five Governors to attend any particular seminar and for those Governors to feedback to the wider Assembly.

The Assembly agreed to this recommendation

e. A least once a year there should be a joint Board / Governors away day.

The Assembly agreed to this recommendation

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3. All Board Meetings should therefore be closed to the public.

The Governors considered this recommendation carefully and sought clarification on:- i. The number of public attendees at recent public Board meetings - the Chair report this had diminished considerably over the last 18 months, as referred to in his report. ii. The potential to engage with Governors with Board directors on specific topics, as referred to in the recommendations was discussed. iii. Briefings to Governors on key Board decisions would be a way of further developing transparency and would assist in local dialogue with members.

The Assembly debated the issue at length with several Governors expressing concern both as a matter of principle and also the loss of potential public accountability. Governors also acknowledged that the efficiency of the Board was not enhanced by the necessity to meet in public as well as in private, with the inevitable risk of duplication and restrained debate. Several Governors also commented to exclude any opportunity for the Board to meet in public could limit the Trusts options for public engagement on specific issues. Brian Sheppard (Public Governor, Solihull) also observed that meeting in private also represented a lost opportunity for Governors to observe and learn more about how the Trust Board functioned. In response, the Chair drew Governors attention to proposals from the Board to develop more Board Assembly events, such as away days

With this discussion and clarity, the Assembly agreed to the recommendation but requested that the Board considers retaining the option to meet in public should it determine this to be in the public interest.

The Chair confirmed that the views of the Assembly would be reported to the Board for decision.

C. Healthcare Commission Inpatient Review

The Governors received and noted the Chief Executive’s update report.

6. Questions for the Foundation Trust

Governors raised the following issues with the Foundation Trust:-

A. Issue of the Availability of Care Plans for Carers (Anne McKenzie – Carer Governor) The Care Plan Card was described and copies of this would be supplied to Governors for information. Action: Trust Secretary

B. Closure of the Solihull Intensive Care Unit (Peter Brown – Solihull User Governor) Peter Brown voiced concern that with the closure of the Solihull ICU, with the result that Commissioners were now utilising ICU facilities out of area. The Chief Executive advised the Assembly that the Trust has three ICU facilities which can provide care closer to home.

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C. The Instigation of the Patient Advice Line 24/7: have all staff been adequately trained on how to handle calls from Service Users? (John Robinson – BEN User Governor) The Chief Executive agreed to provide a summary report on the issue.

Action: Trust Secretary via Head of PALS

D. Information on the Organisational Change Process (Naomi Hawkins – Non- Clinical Staff Governor) The Chief Executive responded with the view that regular briefings for staff in general were lodged on the Trust intranet.

E. Could the Governors have Feedback on the Annual “Count Me In” Census? (Joe Aldred – BEN Public Governor)

Action: Trust Secretary via Director of Diversity/Medical Director

7. Report from Governor Sub-Committees i. Membership

The Report from the Trust Secretary was noted

8. Any Other Business i. Calendar of Meetings

A calendar of meetings and suggested venues would be circulated for 2009/10.

Action: Trust Secretary ii. Update on Voluntary Sector Questionnaire Pilot

Deferred to next meeting.

9. Date, Time and Venue of Next Meeting

Thursday 5th March 2009 9:30 am – 3:30 pm Highbury Hall

Gary Crellin Trust Secretary Secretary to the Assembly of Governors

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