Enclosure 1

BIRMINGHAM AND SOLIHULL MENTAL HEALTH NHS FOUNDATION TRUST

MINUTES OF THE ASSEMBLY OF GOVERNORS MEETING HELD ON THURSDAY 3rd JUNE 2010, 1030-1500 AT UFFCULME CENTRE, MOSELEY,

In Attendance

Governors:

Sally Selvey Staff Governor - Nursing Asaf Khan Staff Governor – Medical Darren Cooper Staff Governor – Nursing John Robinson Service User Governor – BEN Peter Brown Service User Governor - Solihull Faheem Uddin Service User Governor – HoB Lynda Smith Service User Governor – South Elsie Gayle Service User Governor – Rest of & Wales Anne McKenzie Carer Governor Loris Tapper Carer Governor Sue Nixon Stakeholder Governor - PCT Commissioners Lynne Jones Stakeholder Governor - MP Jane Morel Stakeholder Governor – Terrance Higgins Trust Ann Davis Stakeholder Governor – University Birmingham Peter Lea Stakeholder Governor – Solihull Metropolitan Borough Council Tessa Griffiths Stakeholder Governor – Future Health & Social Care Renganathan Ramamoorthy Public Governor – BEN Brian Sheppard Public Governor – Solihull Maureen Johnson Public Governor – Solihull Joe Aldred Public Governor – BEN Bridie Nugent Public Governor - South

Trust Staff:

Peter Marquis Chairman Sue Turner Chief Executive Peter Lewis Executive Medical Director Georgina Dean Director of Finance Frances Allcock Director of Organisational Development & Performance Improvement Denise Wilson Director of Quality Improvement & Patient Experience Sarah Smith Senior Communications & Marketing Manager Jonathan Lloyd Director of Strategic Delivery – AWA Glynis Markham Director of Strategic Delivery - MHSOP Peter Hughes Associate Director of Governance David Boden Non Executive Director Sukhbinder Singh-Heer Non Executive Director Gill Harrad Trust Solicitor Charlotte Maybury Governor Liaison (Notes)

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1. Apologies for absence

Vinod Mehta Staff Governor - Other and AHP Naomi Hawkins Staff Governor - Non-Clinical Charles Zuckerman Stakeholder Governor - Local Medical Committees Carl Foulkes Stakeholder Governor - West Midlands Police Paul Illingworth Stakeholder Governor - Birmingham City University Sue Anderson Stakeholder Governor – Bernadette Murray Public Governor - South Gerry Moynihan Public Governor – HoB Lawrence Innis Carer Governor

Peter Marquis, Chair, welcomed everyone to the meeting, including Tessa Griffiths, new Stakeholder Governor from Future Health & Social Care and Steve Parsons from the Women’s Hospital Trust.

2. Minutes of Last Meeting (4th March 2010)

The minutes of 4 March were agreed as accurate.

3. Matters Arising/Review of Actions

The view was expressed that the response by Andrew Donald to the question about the ‘gap’ in services (page 7, third question) was not true and that there is a gap in services.

The following actions were discharged:

• Mar 10, Item 5 – Chairman’s Report : A number of Governors attended the March Trust Board. • Dec 09, Item 6 – Resources Report/Finance Dashboard: An email response was sent to Dr Khan by Georgina Dean on 3 March 2010 in relation to the over-spend figures. • Sept 09, Item 6 – Performance Report: Staff Satisfaction seminar arranged for 17 August 2010. • Sept 09, Item 5 – Clinical Service Quality Update Report: A presentation on Complaints Process taking place on 15 June 2010. • Dec 09, Item 3 – Matters Arising/Review of Actions: A number of Governor training/ awareness sessions have been scheduled throughout the remainder of the year. • Mar 10, Item 3 – Matters Arising/Review of Actions: It was reported that Berni Matthews, CMHT Manager has agreed that Governors can use a pre-bookable PC at the Lyndon Centre but has advised that it would be advisable to telephone in advance. • Mar 10, Item 7 – Clinical Services Quality Update: A meeting has been arranged to discuss the format of this report on 4 August 2010. • Mar 10, Item 9 – Governor Q & A: The subject of Governor Communications is on the Agenda, item 13. • Mar 10, Item 9 – Governor Q & A: Meetings have been arranged with Service User and Carer Governors on 29 June 2010 and with Staff and Public Governors on 17 August 2010, to discuss any further support Governors may require.

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• Mar 10, Item 10 – Main House Consultation: Details of the level of future investment in Tier 1, 2 & 3 services was obtained from Andrew Donald and circulated to Governors on 19 May. The level of investment reported was £0.5m. • Mar 10, Item 12 – Governors Scrutiny Work Plan: A half day session has been scheduled for 7 July 2010 to agree topics for the work plan. • Mar 10, Item 11 – Annual Plan 2010/11: An awareness session for Governors has been scheduled for 16 November 2010.

The Chair reported that the action in relation to a presentation by the Spiritual Care service will be arranged in liaison with the Acting Head of Spiritual Care. This will be arranged for the September Assembly if possible.

4. Declarations of Interests

Darren Cooper declared his interests in matters relating to Sandwell Council.

5. Chairman’s Report and Board Update

The Chair formally welcomed Tessa Griffiths, Chair/Director of Future Health and Social Care CIC to the Assembly as a stakeholder governor.

The Chair reported that as Lynne Jones did not stand at the recent general election, it was necessary to consult the elected MPs about the stakeholder MP governor post. The Chair formally thanked Lynne on behalf of the Trust for the contribution she has made both to the Trust but also as a leading national advocate for improving the quality of mental health services. Lynne has agreed to remain on the assembly until the position of MP stakeholder governor is resolved.

The following comments/questions were raised:

Foundation Trusts Governors Association

Q. It was asked what the benefits were to joining the FTGA and would it provide any additional training for governors. A. It was stated that more information was needed about membership of FTGA, but it was felt that being a member may hold significant value in relation to shared experiences and ideas. If the assembly concluded that joining the FTGA was desirable, the Chair and CEO would need to discuss the financial costs involved. The Chair pointed out that membership would only allow 2-3 members to attend events at any one time, so there would be a need for those attending events to feed back to the wider assembly.

• The view was expressed that BSMHFT were noted in their absence of the FTGA for the West Midlands region. It was also stated that it was good to learn from other Trusts’ experiences, both good and bad, and that the FTGA display a good level of impartiality.

• It was felt that how the information from the FTGA is cascaded to governors needs to be carefully thought through if the Trust become members.

The Chair stated that as the meeting appeared to be very positive about joining the FTGA, he proposed that he and the CEO would explore taking this forward. Action: Chair/CEO

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Governor Development Programme

• It was asked that some understanding be shown to those governors who are not able to attend additional meetings/workshops. The Chair acknowledged this point.

The Chair reported that he had received a positive initial response from Heart of England Foundation Trust regarding holding a joint workshop, but that it was requested by them that this be discussed further in a few months time. Action: Chair to follow-up in August

Non Executive Director Re-appointment

The Chair requested that the assembly agree that the Nomination and Remuneration Committee to initiate the process for re-appointment of NEDs, subject to the Assembly approving the process in September and to review the clustering of expiry dates for terms of office, on behalf of the assembly.

The assembly agreed.

6. Use of Resources Report

Georgina Dean, Director of Finance, informed the assembly that the Annual Accounts were approved by Trust Board in May. She stated that a full set of financial statements is available to any governors who wish to see them.

Comments and questions were invited.

Q. It was commented that the reduced risk rating is worrying and in particular the large spend on bank and agency. A. It was explained that the spend on bank and agency at year end was higher than anticipated and also the expenditure in relation to the closure of Main House all contributed to the reduced risk rating. The Chair added that other Trusts are in a similar position.

• It was noted that as 08/09 was a part year due to FT status beginning in July 2008, this made some of the comparisons difficult. Georgina Dean offered to meet with any governors who wished to go through the figures in more detail.

Q. It was queried how overall pay spend was under, when bank and agency had increased, and if this compromised quality. A. An explanation was given about the implementation of Functionalisation across the Trust and how planned bank, agency and locum use has been incorporated into this to maintain continuity of care. Further more detailed work is being undertaken to analyse each area to see if there are any areas with particular problems in relation to holding vacant posts.

Q. How flexible is the system in relation to continuity of care during hospital admission. A. It was stated that Functionalisation should assist in providing continuity of care, including during hospital admission. This aspect of care is being continually reviewed in order to continue to improve this.

The Chair suggested that Governors may wish to include continuity of care as one of the topics for the Scrutiny Work Plan.

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• It was stated by a number of service user governors that this area had improved in recent years and that continuity of care has been in place during hospital admission and during the introduction of functionalisation.

• The view was also expressed that functionalisation is a much better system and should improve things greatly.

Q. It was asked if any of the Divisions did not achieve their CRES savings. A. It was reported that the shortfall in CRES schemes was fairly evenly spread across all three divisions.

7. Appointment of External Auditors

Sukhbinder Singh-Heer, Chair of the Audit Committee, provided the background and context to appointing new external auditors. He also explained the process of shortlisting and the reasons for the recommendation made.

The following comments/questions were raised:

Q. It was asked what the conflict of interest was for KPMG. A. It was reported that as KPMG manage a Trust very geographically close, and providing similar services to BSMHFT.

Q. It was asked if there was an exit clause in the 3 year contract period. A. It was stated that a 3 year contract is the usual term, but Sukhbinder stated that he will explore further if there is an exit clause in the contract Action: SSH – September AoG

• The view was expressed that it was a good idea to appoint new auditors who would hopefully bring with them fresh ideas and approaches.

• It was reported that, if appointed, PricewaterhouseCoopers would attend all governors meetings and will engage more fully with governors.

The assembly approved the recommendation of the Chair of the Audit Committee to appoint PricewaterhouseCoopers as our new external auditors for the period of 3 years from 2010/11 to 2012/13 at a fee of £55,000 per annum.

8. Clinical Services Quality Update

Denise Wilson advised the assembly that the Trust Board have approved the quality priorities at May Trust Board.

The following comments/queries were raised:

Q. It was asked if perhaps more training could be provided to inpatient staff in relation to staff attitudes, especially towards carers. A. Jonathan Lloyd offered to discuss this issue outside the meeting. Denise Wilson added that the Trust has set an objective to work more closely with carers in the future.

Q. Concern was raised in relation to the areas of non-compliance and the lack of detail about these in the report. A. The circumstances around non-compliance of the prison contract were explained and that the Care Quality Commission had been informed about the position and

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advised of the actions being taken by the trust. It was reported that a report should be available in approximately two weeks, which can be circulated to Governors. Action: DW – July

Q. It was reported that concern has been raised by service users that initial telephone calls are not being handled appropriately and staff seem ill-prepared to deal with these calls. A. Glynis Markham suggested that mystery shopping could perhaps be used to establish how broad this issue is. Action: Liaison with mystery shoppers – GM

• It was stated that the report was not very clear in what it was trying to say. Peter Lewis stated that work is ongoing to improve the presentation and user- friendliness of the report.

9. Performance Report

The report was received and there were no points raised.

10. Governor Q & A Session

Q. Concern was raised about the future pattern and funding of services within Solihull Care Trust. A. It was reported that the trust were engaged in constructive discussions with Solihull Care Trust as to how we could work in partnership to address the significant resourcing pressures faced by SCT. In these discussions it was recognised that there was a shared desire for the Trust to remain a provider for Solihull, although opportunities for partnership working with third sector organisations was also being considered. Issues being considered included the enhancement of community and home treatment services and whether in some instances other service provisions be identified for Solihull residents, but not necessarily located in Solihull. The outcomes of these discussions will be reported to the Assembly.

• It was stated that it would be helpful if governors could be kept informed of developments so they are better informed to deal with questions from their constituents.

Governors were asked to note that any significant changes to services will be subject to public consultation.

Q. It was asked if there is a way for governors to get the latest situation before attending external meetings where they may be asked questions. A. It was stated that due to the uncertainty of the situation this was not always possible at present. Assurance was given that as soon as more detail is available it will be given to governors. It was also stated that governors are welcome to call the Chair to see if the situation has changed at any point.

• The view was expressed that governors should have more involvement and communication with User Voice.

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Q. It was reported that there are currently recruitment problems with User Voice in BEN. A. Faheem Uddin reported that recruitment to BEN and HoB is currently being undertaken.

Q. The view was expressed that there is a feeling that User Voice does not have a future. A. The CEO acknowledged that there are rumours and that the importance of User Voice differs between organisations. However, the Trust regards User Voice as a valuable service.

11. Annual Report

No comments were received.

It was suggested that the subject of fuel/resource economy within the Trust be an agenda item for a future meeting. Action: Agenda Item for September – CM

12. Governor Site Visits

The Chair provided the background to the paper and invited comments/questions.

The following was raised:

Q. Clarification was sought as to whether governors can or cannot go to a site unannounced. A. The Chair commented that, with the exception of Mystery Shopping, all staff would check that it was convenient before visiting a site, recognising that some circumstances might make visits at particular times difficult, for example protected meal times or untoward events. He therefore encouraged governors to adopt a similar approach but also encouraged governors to take part in the mystery shopping scheme. The Chair stressed that governors were not being discouraged from visiting sites, but that this proposal is about introducing an etiquette to the process.

Q. How long is the training for mystery shopping? A. A couple of hours.

• It was suggested that Mark Hillier, Head of Patient and Public Involvement, would be a good person to talk to governors about mystery shopping. • Faheem Uddin advised that mystery shoppers design their own questions and also now use electronic ‘real time’ devices to record feedback.

Q. How long does a mystery shopping exercise take? A. This depends on what level of involvement you wish to make.

The Chair reported that the reports from mystery shopping are fed back to the Clinical Governance Committee and then to Trust Board. Action: Mystery Shopping training session to be arranged for interested governors – CM

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The Chair asked for the governors views on whether governors should be allowed to undertake unannounced site visits.

The following comments were made:

• The point was made that staff are not allowed to just turn up at any site and be allowed access. • It was asked if a governor was visiting a site as a member of the public, would this be classed as an unannounced visit. The Chair stated that this would not be classed as an unannounced visit, but obviously if a governor had concerns whilst visiting as a member of the public, then these could be reported under their role as a governor. • It was stated that the follow-up of any issues identified was important.

The governors agreed with the principles set out in the report.

13. Governor Communications

The Chair asked the governors to consider the Trust’s current approaches to communication with governors:

1. Governors Assembly Papers 2. Trust Board Summaries. 3. Trust Board Minutes (following the meeting at which the minutes are approved) 4. Letters about events from Charlotte Maybury & Chair. 5. Annual report and Accounts. 6. Trust Talk (every 2 months). 7. Availability on the Web of Trust Board Papers & Agenda, subject to omission of matters of commercial confidentiality and data protection.

Governors were asked to use a table-based discussion to respond to the following questions for each of the approaches 1-7:

1. Is the approach useful and should it be maintained? 2. How can the approach be improved, for example timing or quality of the language used. 3. What additional communication approaches could improve your ability to act as a governor.

Responses

Table 1

• No Board minutes, just the summary with minutes by individuals request. • Summary should be in larger print and a different font. • A dictionary for governors was suggested containing meanings and examples of their use. • Electronic documents for meetings to save paper. • Segmenting information to relevant groups only ie. By locality or governor constituency.

Table 2

• To be sent as a minimum, statutory papers only ie. AoG/Annual Report etc. Other papers to be sent in a format requested by individuals. • Standard formats for papers. Page 8 of 9 Enclosure 1

Table 3

• AoG papers – high postage cost – email instead where possible. • Only information needed to be supplied. • Plain English approach where possible. • Draft Board minutes if possible. • Role of Governors to be communicated to wider public. • Like Trust Talk.

The Chair summarised the above feedback and the following was proposed:

1. Governors dictionary to be explored further. 2. Less not more – paper and information. 3. Timely information.

Action: Governors Dictionary – PMM/CM – Sept

14. Any Other Business

None.

15. Date, Time and Venue of the Next Meeting

Thursday 9th September 2010, 10.30am – 2pm

Venue: Tavistock Room, Uffculme Centre, Moseley

Charlotte Maybury Membership Services and Governor Liaison

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