Central and North West London

COG /2013 Central and North West London NHS Foundation Trust

Council of Governors Meeting and Annual General Meeting

16 September 2013

Draft Minutes

Minutes of a meeting of the Council of Governors, held at 5pm in public on 16 September 2013 at Cavendish Conference Centre, London.

Members Present:

Dame Ruth Runciman (Chair) Mr. Jatinder Saran Cllr. Ketan Sheth Ms. Molly Bandah Mr. Paul Byrne Ms. Angela Hook Mr. John Clark Ms. Charlotte Green Ms. Elvira De Sousa Ms. Carina Sheridan Mr. Stephen Chamberlain Mr. Samuel Whiteside Ms. Janet Seale Dr. Karim Dar Mr. Timothy Seale Mr. Henry Arthurs Ms. Irene Leeman Cllr. Christopher Buckmaster Mr. Michael O’Dwyer Cllr. Sheila D’Souza Ms. Ann Sheridan Ms. Daisy Ellis Mr. Horton Kennedy Ms. Cheryl Prax Mr. Howard McFarlane Dr. Lina Christopoulou

In Attendance:

Prof. Dorothy Griffiths Non-Executive Director Mr. Ian Holder Non-Executive Director Mr. Laks Khangura Non-Executive Director Ms. Claire Murdoch Chief Executive Dr. Alex Lewis Medical Director and Director of Quality Mr. John Vaughan Director of Strategic Planning and Community Services Mr. Andy Mattin Director of Operations and Nursing Mr. Trevor Shipman Director of Finance Ms. Louise Norris Director of Human Resources Mr. Richard Vergez Associate Director, Corporate Governance Ms. Christine Baldwinson Trust Secretary Mr. Nick Bell Deputy Trust Secretary Ms. Anna Shaw Head of Communications and Marketing Mr. Chris Bumstead Head of Patient and Public Involvement

1. Welcome a The Chair welcomed Governors, colleagues from the Board of Directors, staff colleagues, and members of the public, to the meeting which, as well as being a regular Council of Governor meeting, was also the Trust’s Annual General Meeting. The Chair also advised that this was the first AGM since Milton Keynes Community Health Services had joined the Trust, and welcomed them to the meeting. 1 b The Chair thanked Governors personally and on behalf of the Trust for their important contribution to CNWL during the past year. She drew attention to the review of the year that was being considered as part of the agenda, which provided a vivid illustration of the range of work to which Governors have contributed.

2. Presentation: Listening To Our Patients a The Chief Executive introduced the item and advised that the Council of Governors would receive a video and 3 brief presentations from staff and service users on how the Trust listens to its patients. The Chief Executive added that it has never been more important than in the current difficult climate to be listening to patients, and there is a huge evidence base that doing so improves their lives. The Trust is always striving to ensure it provides the best possible service to patients and learn from those occasions where patients are either dissatisfied and satisfied with the service received. b The Council of Governors watched a video which detailed various user, carer and staff experiences of listening to patients and how it impacts on the care they receive. The Chair thanked everyone who took part in the making of the video and agreed to share their experiences. c The Council of Governors next received a presentation from Selena Cox and Shalinie Tewarie on the Urgent Advice Line, set up in February 2013. They gave a history of out- of-hours crisis response prior to the introduction of the Urgent Advice Line, the challenges the Urgent Advice Line faced, the progress it had made, and the work moving forward. In particular, it was noted that a Service User / Carer reference group had been set up, and a new crisis card developed. The presentation also provided analysis of the calls received and the reasons calls are being made, such as medication queries or distressed individuals, and the satisfaction levels with the service. d The second presentation was provided by Anita Gundecha and Alan Butler. It considered the work in which addictions service users are involved and how services have been developed as a result of service user input, such as the development of recovery cafes, a dedicated recovery budget, and improvements to service user care planning. Alan Butler provided detail of his own story as a service user and peer support worker. Alan advised that he provides other service users with advice on what to expect and what they need to consider as part of their detoxification and recovery. This also benefits Alan himself as a way to reframe life and consider his own life. e Cathy Walker provided the third presentation on the Friends and Family Test. Cathy provided brief detail on Milton Keynes services, and introduced the Friends and Family Test, which essentially asks service users whether they would recommend the service to their friends and family. This included considering the satisfaction levels, the comments from those that were dissatisfied, the development of patient stories and how these are used. f The Chief Executive advised that these presentations provide a brief flavour of the ways in which the Trust listens to service users and carers, and acts on the feedback received. We recognise that we do not always get things right and when this happens lessons must be learned, but we are always striving to improve performance and are proud of the good work we do. g A Governor requested that copies of the presentations be sent to all Governors. 2 h A Governor queried how easy it was to find the number for the Urgent Advice Line. It was noted that there are various information sources and fora through which the number can be found but other means of promoting it and raising awareness are always being sought. It was also noted that the majority of calls were from service users in the Community Recovery service line which was not surprising. However, further ways of ensuring awareness in the other service lines were being explored. i A Governor asked how the Trust’s community health services learn from each other. CW advised that there were a lot of similarities between Milton Keynes, Camden and Hillingdon, and a lot that can be shared and learned from. Recent examples include learning across dental services and wheelchair services, and there will be more work taking this forward in the future. There is also a forthcoming community survey across the three areas to gain further feedback. j Following a question from a Governor regarding those service users severely in crisis and how they are dealt with, the Council of Governors were advised that the urgent care pathway was being reviewed in conjunction with the London Ambulance Service and the Police and in partnership with NHS England, and was looking at how people in crisis are cared for, and looking at other ways of approaching this care. k The Chairman thanked all participants for providing a rich and interesting session.

3. Apologies for Absence a Apologies for absence were received from Bob Walker, Ezzat Jalili, Dr Mike Crawford, Cllr Peter Kemp, Cllr Debbie Brock, and Cllr Patricia Callaghan.

4. Governor Election, Appointment, Resignation and Termination updates since last meeting a The Trust Secretary advised that there were a number of new Governors appointed since the last meeting: Daisy Ellis, appointed for the Terrence Higgins Trust, Cllr Sheila D’Souza, appointed for the London Borough of Westminster, Cllr Debbie Brock, appointed for Milton Keynes Local Authority, and Cllr Pat Callaghan, appointed for the London Borough of Camden. b The Trust Secretary also advised that Bridget Clarence-Smith had resigned from her Governor position for Nursing staff, and therefore Carina Sheridan had taken on this role as the next candidate from the previous election.

5. Minutes of the meetings held on 20 June 2013 and 3 July 2013 a The minutes of the meeting held on 20 June 2013 were considered for matters of accuracy and were confirmed as an accurate record. b The minutes of the meeting held on 3 July 2013 were considered for matters of accuracy. Under item 5a, it was noted that Prof Dot Griffiths would begin in her role as Chairman on 1 January 2014, with Dame Ruth Runciman finishing her term as Chairman on 31 December 2013. With this correction the minutes were agreed as an accurate record.

3 6. Matters Arising a The minutes of the meeting 20 June 2013 were considered for matters arising. b In relation to item 6c, Milton Keynes telecare service, it was requested that information regarding this be circulated. c In relation to item 10a, complaints process review, it was clarified that an initial meeting had been held to launch the review, and a project timeline was in the process of being developed which would include the involvement of Governors. d In relation to item 10e, the new name for the Trust, the Chief Executive advised that they were still in dialogue with the Department of Health over the requirement for the Trust’s geographical location to be identified as part of the name. The Board of Directors will continue to challenge the Department of Health over this requirement, given that the Trust now provides services in many locations. Once finalised a shortlist of names will be circulated to the Council of Governors for consideration. e There were no matters arising from the minutes of the meeting 3 July 2013.

7. Annual Report and Accounts including the Quality Account for the period 1 April 2012 to 31 March 2013 a The Medical Director introduced the Quality Account and provided detail on what its purpose is, how the Trust performed compared to 2011/12 and details of the priorities for the coming year. It was noted that, although the Trust did not quite achieve the target around HIV monitoring, it was a very technical target that the Trust had only narrowly missed, and had still performed well above the national average. The Medical Director also considered the Trust’s Quality Strategy, which included the Trust vision, values, quality strategy and quality focus. The Medical Director advised that all details are within the Quality Account, including an easy-to-read version, and further details, including contact points within the Trust, can also be found in the report. b The Director of Finance introduced the Annual Accounts and the Annual Report. He provided a summary of the financial results for 2012/13, the capital investment made, the key financial information of the Trust’s risk rating, income, expenditure and cash, and the challenges facing the Trust moving forward. c Following a question from a Governor regarding the PDC calculation, the Director of Finance advised that the Trust is obliged to pay a dividend to the Secretary of State equivalent to 3.5% of its average balance sheet value for the year.

8. Chief Executive’s Report a The Chief Executive introduced the report and advised that, in relation to Whole Systems Integration, the Trust was not asked to be involved in these discussions in Hillingdon. The Trust is therefore writing to Hillingdon Council as we feel we should be more involved, given that we have contact with a quarter of Hillingdon residents through our various services.

4 b The Chief Executive advised that the Director of Nursing is setting up a group to take forward further analysis and debate around restraint. It was noted that any feedback from users can be passed on anonymously via Trust Governors or via the Director of Nursing. c In relation to organisational learning, the Chief Executive advised that the Board of Directors had discussed the findings, and the emergent themes were provided within this report. The Chief Executive also advised that annual reports for Complaints, PALs, Incidents and Serious Incidents would be provided on the Trust website. d The Chief Executive noted that the Service Line review was ongoing, and contact details were provided for the Programme Director, Sarah Khan, for any Governor who wished to become involved. e It was requested that contact details for the Carers’ Council Chair, Molly Bandah, be provided to Governors. Queries can also be directed via the Trust Secretary. f It was noted that some LGBT meetings had been held with staff recently, and more were planned for October and November.

9. Council of Governors’ Review of the Year a The Trust Secretary introduced the review and noted that the additional responsibilities under the new Health and Social Care Act had been taken on by Governors without any issues. The Trust Secretary advised there would be a full programme of dates for the coming year, including training opportunities to ensure Governors are kept abreast of their responsibilities.

10.Finance Update a The Director of Finance introduced the Finance Report, which provided a summary of financial performance for the four months of the financial year to 31 July 2013. The Director of Finance advised that the Trust is still on track financially, although there are huge challenges around the Cost Improvement Programme. The delivery of these savings will be achieved through a mix of recurrent and non-recurrent savings, and work is ongoing to ensure as much of the savings as possible is achieved through recurrent means. b The Director of Finance advised sign-off of contracts for the 2013/14 year was taking a long time due to the new commissioning structures that are in place, and advised that currently the Trust has two-thirds of its contracts signed off. c The Director of Finance advised that Monitor had been informed that the Trust was on plan at the end of quarter 1. Currently the Trust is on plan for quarter 2.

11.Quality and Performance Report a The Director of Strategic Development and Community Services introduced the Report and advised that in quarter 1 the Trust had achieved 12 out of the 13 Monitor targets. The target that had not been achieved was access to healthcare for people with a learning disability. Work is in place to address this and it is anticipated the target will be achieved in quarter 2. 5 b The Director of Strategic Development and Community Services also advised that the Trust had not met all of its quality priority targets in quarter 1. In particular, he noted that the target around care planning had not been achieved, which was disappointing, but for which a wealth of work was being taken forward to improve performance. c The Director of Strategic Development and Community Services advised that the quality indicators were being refreshed to ensure they are reflective of the whole Trust.

12.Election of Lead Governor a The Chairman introduced the item and thanked Cllr Ketan Sheth for his excellent, dedicated performance as Lead Governor over the last two years. The Chairman invited Governors to put themselves forward for the Lead Governor position and advised that Cllr Sheth was standing for re-election. If any other Governors want to put themselves forward as Lead Governor they need to advise the Trust Secretary prior to 30 September, and if there is more than one Governor candidate an election will be arranged.

13.Questions from Members of the Public a Following a question regarding the links and connections between various care services, the Chief Executive advised that there was an opportunity through the work of the Whole Systems Integration project to look at organisations working across organisational barriers. Internally the Trust continues to look at the role of the care coordinator and support them as well as possible, and is also working with colleges to address issues through nurse training. b Following a question regarding the publication of the complaints review, the Chief Executive advised that the Board had held a full discussion in public regarding complaints. The Complaints Annual Report, which considers the themes and trends from complaints, will be published on the Trust website. c A request was made that members of the public attending meetings be recorded. d Following a comment regarding the theme of listening to patients compared to the member of the public’s own experiences, and how the expansion of the Trust may impact on this and on standards and practice across the Trust, the Chief Executive advised that part of the theme of the discussions around listening to patients, as well as celebrating the Trust’s good work in this area, is recognising when we do not get it right, learning from that, and continually trying to improve. In relation to growth, the Chief Executive commented that the Board of Directors gives very serious consideration to the impact of taking on a new service on the existing Trust and its services, to ensure focus is not lost on service users and carers. However the Trust is a successful Trust that can bring an expertise in a number of areas to the wider geography, and become a bigger voice in the provision of healthcare. It also benefits the Trust in delivering the financial efficiencies required and ensuring as much funding as possible remains service user facing. e Following a question regarding sharing of information across professionals to avoid service users having to complete multiple forms, the Director of Finance advised that part of the Trust’s investment in IT is to look to develop systems that better communicate with

6 each other so information can be shared. There is also a lot of work being undertaken to bring health and social care information together.

14.Any Other Business a There was no other business. The Chairman thanked everyone for attending the meeting and reiterated her thanks to those who had provided presentations.

15.Date of Next Meeting a The date of the next meeting is at 5pm on 5 December 2013 at Trust Headquarters, Stephenson House.

The meeting was declared closed at 7.00 p.m.