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Trust-Board-In-Public-Meeting-Papers BERKSHIRE HEALTHCARE NHS FOUNDATION TRUST TRUST BOARD MEETING HELD IN PUBLIC 10:30am on Tuesday 13 February 2018 Boardroom, Fitzwilliam House, Skimped Hill Lane, Bracknell, RG12 1BQ AGENDA No Item Presenter Enc. OPENING BUSINESS 1. Chairman’s Welcome Martin Earwicker, Chair Verbal 2. Apologies Martin Earwicker, Chair Verbal 3. Declaration of Any Other Business Martin Earwicker, Chair Verbal Declarations of Interest 4. i. Amendments to the Register Martin Earwicker, Chair Verbal ii. Agenda Items Minutes of Meeting held on 12 5.1 Martin Earwicker, Chair Enc. December 2017 5.2 Action Log and Matters Arising Martin Earwicker, Chair Enc. QUALITY Helen Mackenzie, Director of Nursing 6.1 Patient Story Enc. and Governance Patient Experience Report Quarter 3 Helen Mackenzie, Director of Nursing 6.2 Enc. Report and Governance EXECUTIVE UPDATE 7.1 Executive Report Julian Emms, Chief Executive Enc. PERFORMANCE 8.1 Month 09 2017/18 Finance Report* Alex Gild, Chief Financial Officer Enc. Month 09 2017/18 Performance 8.2 Alex Gild, Chief Financial Officer Enc. Report* Finance, Investment and Performance Committee Meeting on 31 January Naomi Coxwell, Chair of the Finance, 8.3 2018 Investment and Performance Verbal *The Month 9 Finance and Performance Committee Reports were reviewed by the FIP Committee STRATEGY Strategy Implementation Plan 2017-18 Bev Searle, Director of Corporate 9.1 Enc. – Update Report Affairs Equality Strategy 6 monthly update for Bev Searle, Director of Corporate 9.2 Enc. the Board Affairs Corporate Governance David Townsend, Chief Operating 10.1 Annual Health and Safety Report Enc. Officer MEETING PAGE NO. 1 No Item Presenter Enc. 10.2 Use of the Trust Seal Alex Gild, Chief Financial Officer Enc. Audit Committee Minutes – 31 January Chris Fisher, Chair of the Audit 10.3 Enc. 2018 Committee 10.4 Annual Declarations of Interest Julie Hill, Company Secretary Enc. 10.5 Constitutional Changes Report Julie Hill, Company Secretary Enc. 10.6 Annual Trust Board Meeting Planner Julie Hill, Company Secretary Enc. 10.7 Council of Governors Update Martin Earwicker, Chair Verbal Closing Business 11. Any Other Business Martin Earwicker, Chair Verbal Date of the Next Public Trust Board 12. Martin Earwicker, Chair Verbal Meeting – 10 April 2018 CONFIDENTIAL ISSUES: To consider a resolution to exclude press and public from the remainder of 13. the meeting, as publicity would be Martin Earwicker, Chair Verbal prejudicial to the public interest by reason of the confidential nature of the business to be conducted. MEETING PAGE NO. 2 AGENDA ITEM 5.1 Unconfirmed minutes BERKSHIRE HEALTHCARE NHS FOUNDATION TRUST Minutes of a Board Meeting held in Public on Tuesday 12 December 2017 Boardroom, Fitzwilliam House Present: Martin Earwicker Chair David Buckle Non-Executive Director Mark Day Non-Executive Director Julian Emms Chief Executive Chris Fisher Non-Executive Director Alex Gild Chief Financial Officer Dr Minoo Irani Medical Director Mark Lejman Non-Executive Director Ruth Lysons Non-Executive Director Helen Mackenzie Director of Nursing and Governance Mehmuda Mian Non-Executive Director Bev Searle Director of Corporate Affairs David Townsend Chief Operating Officer In attendance: Julie Hill Company Secretary Naomi Coxwell Non-Executive Director (Elect) Louella Johnson Director of Human Resources (present for item 9.1) 17/217 Welcome (agenda item 1) Martin Earwicker, Chair welcomed everyone, including the observers: Krupa Patel, Public Governor, June Carmichael, Staff Governor, Mary Waight, Occupational Therapist and Blessing Gombedza (member of the public). 17/218 Apologies (agenda item 2) There were no apologies. 17/219 Declaration of Any Other Business (agenda item 3) There was no other business declared. 17/220 Declarations of Interest (agenda item 4) i. Amendments to Register – none ii. Agenda Items – none 17/221 Minutes of the previous meeting – 14 November 2017 (agenda item 5.1) 1 MEETING PAGE NO. 3 The Chair thanked Mark Lejman, Vice Chair for chairing the November 2017 meeting. The Minutes of the Trust Board meeting held in public on Tuesday 14 November 2017 were approved as a correct record of the meeting after the following correction had been to minute 17/193: “Month 4” was amended to read: “Month 6” (bottom of page 9 of the agenda pack). 17/222 Action Log and Matters Arising (agenda item 5.2) The schedule of actions had been circulated. The Trust Board: noted the schedule of actions. 17/223 Board Visit (Orchid Ward, Prospect Park Hospital) (agenda item 6.1) Ruth Lysons, Non-Executive Director reported back on a recent visit to Orchid Ward, Prospect Park Hospital, a ward for older adults with functional mental health problems. Ms Lysons said that it had been a very positive visit and that she had been pleased to observe one of the new style daily bed management meetings. Ms Lysons said that staff had informed her that the staffing situation on the ward had improved following the focused recruitment work at Prospect Park Hospital. Ms Lysons said that staff were extremely enthusiastic about the introduction of the electronic prescribing and medicines administration system. It was also noted that many patients on Orchid Ward had physical as well as mental health problems and that this led to patients regularly transferring to the Royal Berkshire Hospital NHS Foundation Trust for treatment. The Director of Nursing and Governance reported that the Trust was hoping that the management of people with both physical and mental health conditions would be improved by the appointment of a Physical Health Lead Nurse. Naomi Coxwell, Non-Executive Director (Elect) welcomed the appointment of a Physical Health Lead Nurse, but asked whether there were systems in place to identify patients whose physical health needs required treatment at an acute hospital. The Director of Nursing and Governance reported that the Trust used the national Early Warning Score (NEWS) which identified when a patient’s health was deteriorating. The Director of Nursing and Governance reported that the role of the Physical Health Lead Nurse would be to provide advice on the management of long term conditions, such as Diabetes and Asthma. Ms Lysons said that patients on Orchid Ward were particularly at risk of choking and from falls. It was noted that falls prevention technology which required cables was not a practical option for Orchid Ward given the mix of patients. The Director of Nursing and Governance reported that the Trust was investigating a wireless falls prevention system. On behalf of the Trust Board, the Chair thanked Ms Lysons for sharing her observations from her recent Board visit. 2 MEETING PAGE NO. 4 Bluebell Ward, Prospect Park Hospital, Bed Closure Option Appraisal (agenda item 17/224 6.2) The Director of Nursing and Governance presented the paper and highlighted the following points: • In June 2017, the decision to close five beds on Bluebell Ward was taken in the light of quality and safety concerns. • The report provided details of a literature review, benchmarking information regarding bed numbers and occupancy levels and the options available to the Trust regarding the number of beds on Bluebell Ward. • From the information available, the Trust Board was recommended to permanently close five beds on Bluebell Ward. The Chair commented that Bluebell Ward was originally a 27 bedded ward which had been temporarily reduced to 22 beds (which was still over the recommended maximum ward size of 18 beds) and asked why the Trust had not taken action sooner to reduce the number of beds in line with national best practice. The Director of Nursing and Governance said that the literature review had highlighted that all Mental Health Trusts had large wards, but over time, they had reduced the number of beds. The Chief Executive pointed out that the recommended maximum of ward size of 18 beds was contained in a national report which had only been published in shadow form for the first time and that the figure of 18 beds had come as a surprise. The Director of Nursing and Governance confirmed that she had informed the Care Quality Commission about the recommendation to permanently close five beds and that the Care Quality Commission had supported the decision and had raised no concerns about a ward size of 22 beds. Mehmuda Mian, Non-Executive Director asked whether the Trust was confident that it could manage without the five beds. The Chief Operating Officer said that a key objective of the Bed Optimisation Project was to reduce bed occupancy to 85% and that if this could be achieved and sustained, the Trust would not require any additional beds. The Director of Nursing and Governance reported that the Trust had looked at opening another ward, but given the current workforce shortages, it would not be possible to staff another ward. In addition, benchmarking data had highlighted that the Trust had a relatively higher than average length of stay and that it was better for patients if they stayed in hospital for the minimum amount of time. Mark Lejman, Non-Executive Director reported that the Finance, Investment and Performance Committee received regular updates on the Bed Optimisation Project and reported that the Trust was commissioning a strategic review of beds in the new year to identify the required bed base in five to ten years’ time. The Director of Nursing and Governance reported that the Quality Executive Group had reviewed the options and had recommended option 2 which was closing the five beds on Bluebell Ward permanently. 3 MEETING PAGE NO. 5 The Trust Board: endorsed the recommendation from the Quality Executive Group that the five beds temporarily closed on Bluebell Ward be closed permanently. This would create a 22 bedded ward which would more readily meet the needs of patients and prevent regulatory enforcement action by the Care Quality Commission.
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