TRUST BOARD MEETING IN PUBLIC Wednesday 25 March 2020 At 09:30 VENUE: Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth PLEASE NOTE: Public attendance is not allowed at this event given current guidance 1 of 133 2 of 133 TRUST BOARD MEETING IN PUBLIC Wednesday 25th March 2020 09:30 – 12.30 Oasis Centre, Queen Alexandra Hospital, Southwick Hill Road, Cosham PO6 3LY A G E N D A Item Time Item Enclosure Presented No. Y/N & by Number 048.20 09.30 Welcome, Apologies and Declaration of N Chair Interests (to ascertain whether any Board Member has any conflict of interest with any items on the Agenda) Minutes of the last meeting – 26th February 049.20 09.32 1 Chair 2020 050.20 09.35 Matters Arising/Summary of agreed actions 2 Chair 051.20 09.42 Notification of any other business N/A Chair 052.20 09.45 Chair’s opening remarks N/A Chair 053.20 09.55 Chief Executive’s Report 3 CEO STRATEGY 054.20 10.10 Operating Plan 2020 – 21 4 DSP 055.20 10.30 NHS Improvement Undertakings 5 DGR FINANCE AND INFRASTRUCTURE Finance and Infrastructure Committee feedback Committee 056.20 10.35 25th February 2020 (for information) 6 Chair 17th March 2020 o Operating Budget 2020 – 21 057.20 10.45 Financial performance report analysis N** CFO QUALITY, SAFETY AND PERFORMANCE Quality and Performance Committee feedback Committee 058.20 10.55 19th March 2020 7 Chair o Safer Staffing o Information Governance Toolkit o Trust response to Paterson Inquiry 3 of 133 Safety, quality and operational performance MD / COO 059.20 11.05 N** report analysis / CN WORKFORCE AND ORGANISATIONAL DEVELOPMENT Workforce and Organisational Development Committee feedback 18th March 2020 Committee 060.20 11.20 o National Staff Survey 8 Chair o Equality, Diversity and Inclusion Annual Report Workforce and Organisational Development 061.20 11.30 N** DWOD performance report analysis FOR NOTING / INFORMATION 062.20 11.40 Record of attendance 9 Chair 063.20 11.50 Any other business N Chair Opportunity for the public to ask questions 064.20 11.55 N Chair relating to today’s Board meeting Conclusions on key messages from the 065.20 12.00 meeting – The Trust Board is asked to consider how it supported staff to look after patients and N Chair made decisions on the key challenges faced by the Trust. Appropriate actions in response should also be identified. Additions to Board Assurance Framework 066.20 and Risk Register – The Trust Board is asked N All to consider whether, in light of matters discussed at the meeting, any further additions should be made to the Board Assurance Framework and/or Risk Register Date of next meeting: Wednesday 27th May N Chair 2020, Oasis Centre, Queen Alexandra Hospital, Southwick Hill Road PO6 3LY ** Supported by the IPR Data Pack 4 of 133 Trust Board Meeting in Public Held on Wednesday 26th February 2020 Cosham Baptist Church, 48 Havant Road, Portsmouth PO6 2QZ MINUTES Present: Melloney Poole Chairman Roger Burke-Hamilton Non-Executive Director Gary Hay Non-Executive Director David Parfitt Non-Executive Director Martin Rolfe Non-Executive Director Christine Slaymaker Non-Executive Director Mark Cubbon Chief Executive Officer (CEO) Nigel Kee Interim Chief Operating Officer (COO) John Knighton Medical Director (MD) Mark Orchard Chief Financial Officer (CFO) Liz Rix Chief Nurse (CN) In Attendance: Nicole Cornelius Director of Workforce and Organisational Development (DWOD) Penny Emerit Director of Strategy and Performance (DSP) Lois Howell Director of Governance and Risk (DGR) Hannah Chadwick Matron for Clinical Standards (for minute 028.20) Nicky Hardman Trust Facilities Monitoring Manager (for minute 028.20) Sarah Williams Head of Dietetics (for minute 028.20) Lee Wiltshire Engie Facilities General Manager (for minute 028.20) Dave Gordon Committee Clerk (minutes) Item No Minute 027.20 Welcome, apologies and declarations of interest The Chairman welcomed everyone to the meeting; apologies were received from Inga Kennedy (Non-Executive Director). No declarations of interest were made. 028.20 Patient Story – Nutrition The Matron for Clinical Standards provided the story of a patient who had been an in- patient in the Trust for several weeks; during this time, he had been moved between a number of different wards. Whilst he had been satisfied with most of the care provided, he felt less confident that his nutritional needs had been fully met. In particular, it seemed that the staff caring for him on each new ward were unaware of his dietary requirements. These included dairy-free products and management of his diabetes. However, this information did not seem to be relayed to any new care setting during his stay at the Trust; progress would be made whilst he stayed in one ward, only to be lost upon transfer. 5 of 133 In addition, despite the availability of suitable options, he was not offered these on several occasions. Whilst the Trust can provide alternatives that are not on the main menu, staff knowledge and clear communication on the matter appeared limited. The Trust website also provided limited information regarding dietary provision, whilst the potential of the WiFi system at the Trust to signpost relevant sites was not being maximised. The first of these issues would be raised by the Chief Executive Officer with the Communications Team at the Trust. Whilst a Patient Feeding Charter had been launched at ward level, the momentum for such initiatives had been lost and may require revisiting. The forthcoming Nutrition and Hydration week (starting 16th March 2020) could prove a suitable platform for this. The Chief Nurse noted the discussion on this and associated issues which had taken place at Quality Delivery Group, with a view to developing metrics to report performance to Trust Board. Divisions were also involved in the consideration of the matter, whilst efforts to increase the prominence of nutrition amongst staff included activities such as meal tasting sessions as part of staff induction. Whilst complaints regarding food were relatively rare and the standard of meals offered was good, concerns arose when flexibility was required to meet individual patients’ dietary requirements. The Medical Director concurred that the profile of patient nutrition required raising to ensure existing services were used as effectively as possible. Daily discussions with patients regarding diet as part of general ward duties (even if only as a short check in most cases) may be one method of achieving this, as would offering greater empowerment to patients to raise their specific needs. The Chief Executive Officer added that the context of this discussion shared some notable characteristics with the recent patient story regarding autism, in terms of the need for individualised care. The Board noted the patient story. 029.20 Minutes of the last meeting – 29th January 2020 The minutes of the meeting of 29th January 2020 were approved as a true and accurate record. 030.20 Matters arising / summary of agreed actions The Board noted the action log. The revised operating model (minute 006.20) was still in development, whilst cyber security (minute 009.20) had been considered as part of the Board Risk Register and could be included in records of existing operational risks. 031.20 Notification of any other business No supplementary business was raised. 032.20 Chairman’s opening remarks The Chairman referred to the operational pressures which had been faced by the Trust during winter 2019 – 20, with particular reference to their impact on delays in ambulance handovers and bed occupancy levels. The positive results from the National Staff Survey were welcomed, and the recent Care Quality Commission report’s findings also indicated the progress being made by the Trust. 6 of 133 This meeting included an agenda item on the response to the recent Well-led Review (minute 034.20). Should the new arrangements proposed in this report be adopted, it would have a significant impact on how Trust Board conducted its business. However, the process of evolution would be on-going and further modifications were possible. The recent discussion which had led to the formulation of these proposals had been productive and all involved were thanked for their contribution. 033.20 Chief Executive’s Report The Chief Executive Officer addressed the following key issues: Operational pressures: The recent Operational Pressure Escalation Levels (OPEL) experienced by the Trust had reflected high levels of activity throughout January 2020. Whilst clinical triage and prioritisation processes had ensured that urgent cases were dealt with in a timely manner, the situation had not been as desired for patients. Given this, work was being undertaken across Portsmouth and South East Hampshire to ameliorate the pressure. Additional capacity had been opened in December 2019, which had allowed more patients to receive care after discharge by the Trust. Nevertheless, the efficacy of post discharge care had reduced in recent months. Front door services at the Trust were being evaluated with a view to reducing unnecessary admissions, whilst daily meetings were held with system partners. These focused on referring patients who were medically fit for discharge to other care settings. National Staff Survey 2019: The results had recently been published, with the Trust having seen a significant rise in nine out of the 11 areas measured by the survey. This was a very positive development and also provided an excellent platform for continued improvement. This would be the subject of a comprehensive report, via the Workforce and Organisational Development Committee, to Trust Board on 25th March 2020. Environment: Given the Trust’s position as a major employer in South Hampshire, it would be launching a campaign to reduce its consumption of single use plastics. This would involve a pledge, and making use of the support available from the University of Portsmouth.