TRUST BOARD1 Thursday 25 June 2015 at 1500 Boardroom, Chief Executive’s Office, 2nd floor, Royal Free Hospital ITEM LEAD PAPER ADMINISTRATIVE ITEMS 2015/105 Apologies for absence D Dodd 2015/106 Minutes of meeting held on 28 May 2015 D Dodd 1. 2015/107 Matters arising report D Dodd 2. 2015/108 Record of items discussed at the Part II board meeting on 28 May D Dodd 3. 2015 2015/109 Declaration of interests D Dodd 2015/110 Yvonne Coghill OBE, workforce race equality scheme D Sanders implementation, NHS England PATIENT SAFETY AND EXPERIENCE 2015/111 Patient safety – learning from serious incidents S Powis C Laing 2015/112 Patients’ voices S Ainger ORGANISATIONAL AGENDA 2015/113 Referral to treatment (RTT) progress report K Slemeck 4. 2015/114 Nursing/midwifery staffing monthly report – April 2015 D Sanders 5. 2015/115 National patients’ survey D Sanders 6. OPERATIONAL AGENDA 2015/116 Chair’s and chief executive’s report D Dodd / 7. D Sloman 2015/117 Trust performance dashboard W Smart 8. 2015/118 Financial performance report C Clarke 9. Governance and Regulation: reports from board committees 2015/119 Strategy and investment committee (11 June 2015) D Dodd 10. 2015/120 Finance and performance committee (18 June 2015) D Finch 11. 2015/121 Patient safety committee (11 June 2015) S Ainger 12. OTHER BUSINESS 2015/122 Questions from the public D Dodd 2015/123 Any other business D Dodd 2015/124 Date of next meeting – 29 July 2015 D Dodd 1 In accordance with the Health & Social Care Act 2012, all Trust Board meetings must be held in public. All decisions which require the board’s collective approval can only be made at a Trust Board (or a Part II meeting held in closed session to discuss confidential matters). List of members and attendees Members Dominic Dodd Non‐executive director and Chairman Stephen Ainger Non‐executive director Dean Finch Non‐executive director Deborah Oakley Non‐executive director Jenny Owen Non‐executive director Prof Anthony Schapira Non‐executive director David Sloman Chief executive Caroline Clarke Chief finance officer and deputy chief executive Prof Stephen Powis Medical director Deborah Sanders Director of nursing Kate Slemeck Chief operating officer In attendance Katie Donlevy Director of service transformation Kim Fleming Director of planning David Grantham Director of workforce and organisational development Dr Mike Greenberg Divisional director of women’s and children’s services Prof George Hamilton Divisional director of surgery and associated services Emma Kearney Director of corporate affairs and communications Andrew Panniker Director of capital and estates Dr Steve Shaw Divisional director of urgent care William Smart Chief information officer Dr Robin Woolfson Divisional director of transplant and specialist services Alison Macdonald Acting trust secretary Paper 1 MINUTES OF THE TRUST BOARD HELD ON 28 MAY 2015 Present Mr D Dodd chairman Mr D Sloman chief executive Prof S Powis medical director Ms D Sanders director of nursing Mr D Finch non-executive director Ms J Owen non-executive director Mr S Ainger non-executive director Invited to attend Ms K Donlevy director of service transformation Mr K Fleming director of planning Mr D Grantham director of workforce and organisational development Dr M Greenberg divisional director for women’s and children’s services Mr A Panniker director of capital and estates Dr S Shaw divisional director for urgent care Mr W Smart chief information officer Dr R Woolfson divisional director for transplant and surgery services Ms A Macdonald acting trust secretary (minutes) Others in attendance Mr M Dinan director of financial operations (for C Clarke) Ms S Dobbing divisional director of operations for women’s and children’s services (for K Slemeck) Mr P Kimber assistant director of finance – financial control Dr C Laing associate medical director, patient safety (for item 2015/89 only) 2015/84 APOLOGIES FOR ABSENCE AND WELCOME Action Apologies for absence were received from: Caroline Clarke – chief finance officer and deputy chief executive Kate Slemeck – chief operating officer Prof Anthony Schapira – non-executive director George Hamilton – divisional director for surgery and associated services Emma Kearney – director of corporate affairs and communication Deborah Oakley – non-executive director The chairman welcomed those present to the meeting. 2015/85 MINUTES OF MEETING HELD ON 29 APRIL 2015 The minutes were accepted as an accurate record of the meeting. 2015/86 MATTERS ARISING REPORT It was noted that the staffing levels for the Chase Farm escalation wards would be included in the June nurse staffing report and that the post implementation review 1 Paper 1 of EDRM would be submitted to the June meeting. It was also noted that it had previously been agreed that the board would have a discussion on the wider issue of equality, leadership and representation and that this should be added to the matters arising log. 2015/87 RECORD OF ITEMS DISCUSSED AT PART II BOARD MEETING ON 29 APRIL 2015 The report was noted. 2015/88 DECLARATION OF INTERESTS The board confirmed that there was no change to the register of interests. 2015/89 PATIENT SAFETY – LEARNING FROM A SERIOUS INCIDENT Dr Chris Laing, associate medical director, patient safety, described a patient safety incident which had also been the subject of an inquest in December 2014. This had occurred in the Royal Free critical care unit, when a patient who had a dialysis catheter line in situ had been transferred to the imaging department for a scan. The catheter became dislodged but this was not immediately identified and the patient’s condition deteriorated again. They were successfully resuscitated but deteriorated after some days and sadly subsequently died. A serious incident investigation took place to establish whether the patient safety incident had contributed to their death. Following the investigation a number of measures were put in place including clarifying clinical responsibility for patients being taken to the scanner, transfer safety checks and a strengthened major haemorrhage protocol. The results of the investigation had been shared with the patient’s family, who were satisfied with the outcome. At the inquest the coroner had congratulated the trust for the very thorough investigation and the transparency of the approach, describing this as a ‘master class in learning’. The verdict had been death due to natural causes. The coroner had asked that the findings of the investigation be shared with the wider critical care community, which had been done. 2015/90 PATIENTS’ VOICES Ms J Owen, non-executive director, read out a complaint which concerned a long wait for orthopaedic surgery which the patient believed had resulted in their having to have a more serious operation than would otherwise have been required. They had received two sessions of physiotherapy following the surgery but required additional sessions. However they were told that they would have to ask their GP to refer them to the hospital for this, resulting in further delay and a worsening of their condition. Ms Owen then read out a compliment which concerned the endoscopy unit at Barnet Hospital where staff had responded quickly and efficiently to the patient experiencing post-operative pain. Mr Ainger agreed to present this item next time. 2 Paper 1 2015/91 MEMORANDUM OF UNDERSTANDING The chief executive introduced this item, explaining that it related to working jointly with the Royal National Orthopaedic Hospital (RNOH), part of which would be to investigate providing additional routine orthopaedic surgery on the Chase Farm site. This would build on previous collaboration between the two organisations, for example on pathology services, and the work would be clinically led by the two medical directors. The medical director advised that he had had discussions with his opposite number about the governance arrangements. Mr S Ainger, non-executive director, asked how long the agreement was for and when the board would be reviewing the proposals. The chief executive responded that RNOH was not yet an FT and there was an expectation from the Trust Development Authority that the first piece of work would be completed by October. Ms Owen suggested that it was important to be specific about the benefits of the collaboration in terms of patient experience and outcomes but also any potential downsides and mitigations. The chief executive said that RNOH had led national work on the benefits to be gained from consolidating routine orthopaedic work. The board confirmed its support for partnership work with the Royal National Orthopaedic Hospital and approved the memorandum of understanding. 2015/92 REFERRAL TO TREATMENT 2015/92 i Waiting times progress report The director of planning introduced this item, noting that there had been an increase in the number of patients treated via outsourcing in April as planned. The board noted the report. 2015/92 ii Resumption of national reporting The director of planning introduced this item, stating that the purpose of the paper was to discuss the resumption of national reporting of waiting time information. He stated that it would be a very important milestone in the integration of the enlarged organisation when the two patient tracking lists (PTLs) were brought together, which would signal that the trust would have reliable data on which to forecast when it returned to national standards for waiting times. He added that this was not a unique problem but the acquisition had meant that the trust faced a more complex situation in terms of two separate waiting lists, multiple sites and complex services. The trust had adopted a painstaking approach to dealing with this issue because it directly affected patients and the national experts were working with the trust. However at the conclusion of this work the trust would have the most accurate possible waiting list and the challenge was to maintain this high standard.