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Agenda and minutes

Venue: Board Rooms, Trust HQ, Great Western Hospital, Swindon. View directions

Contact: Carole Nicholl  01793 605171

Items
No. Item

1/17

Apologies for Absence and Chairman's Welcome

Minutes:

There were no apologies for absence as everyone expected was present at the meeting.

2/17

Declarations of Interest

Members are reminded of their obligation to declare any interest they may have in any issue arising at the meeting, which might conflict with the business of the Trust.

Minutes:

There were no declarations of interest.

3/17

Questions from the public to the Board relating to the work of the Trust

Minutes:

There were no questions from members of the public although it was noted that Rosemarie Phillips a public governor who occasionally observed the Board meeting had asked the Chairman to request whether everyone present could hear from the back of the room. 

4/17

Minutes pdf icon PDF 475 KB

Roger Hill, Chairman

·        2 March 2017 (public and summary of private minutes)

Minutes:

The minutes of the meeting of the Board held on 2 March 2017 were adopted and signed as a correct record, subject to the following amendments: -

 

Minute 484/16 Chief Executive’s Report - The deletion of the words “pioneering cancer treatments” in the second paragraph and the substitution thereof with the words “pioneering intraoperative radiotherapy treatments”.

 

Minute 485/16 Finance Report - The deletion of the words “In response to a challenge from JS around cash benefit” in the paragraph entitled Asset Revaluation and the substitution thereof with the words “In response to a question from JS around benefit”.

 

Minute 934/16 Safer Staffing – 6 monthly skill mix review - The deletion of the word “challenge” in the last paragraph and the substitution thereof with the word “questioned”.

 

Arising upon consideration of this amendment, CN explained that in using the word “challenge” she had sought to address verbal feedback from inspectors during the recent Care Quality Commission inspection, whereby it had been suggested that the challenge by the non-executive directors was not sufficiently apparent in the minutes.  CN advised that she had explained to the inspectors that the word “questioned” was regularly used in the minutes to reflect the challenge of the non-executive directors.  

5/17

Outstanding actions of the Board (public) pdf icon PDF 383 KB

Minutes:

The Board received and considered the outstanding action list.  The Board noted an update as set out below:-

 

259/16

Quality Report Smoking

OF advised that a new policy was to be launched which included “vapping”.  It was agreed that this item be removed from the action tracker noting that the issue of smoking on the Hospital Site had been discussed by the Executive Directors and OF would report through the Performance, People and Place Committee on actions.

 

The Board agreed that completed actions be removed from the tracker and the updates be noted.

6/17

Chairman's Report, Feedback from the Council of Governors

Roger Hill, Chairman

Minutes:

The Chairman gave a verbal report as follows: -

 

Peter Hill Non-Executive Director

 

The Chairman was joined by all members of the Board in welcoming Peter Hill to his first meeting of the Board. 

 

Activity of the Council of Governors

 

RH explained that in March a meeting of the governor Membership and Governor Training Working Group had been held.  The governors had discussed membership figures; engagement events and delivery of governor training.  Details would be reported through the Quality and Governance Committee.

 

RH reported that he and the Director of Governance & Assurance had met with the Lead and Deputy Lead Governors in March and amongst other issues had focused the discussion on governor effectiveness.  There was a further meeting next week to refine a refreshed approach to reporting from the working groups into the Council of Governors. RH explained that the opportunity had been taken to reflect on the governors’ experience of their meeting with the Care Quality Commission (CQC) inspectors as part of the current inspection and there was a discussion around system pressures and thinking around future planning and ongoing actions.

 

RESOLVED

 

that the report of the Chairman be received.

7/17

Chief Executive's Report pdf icon PDF 201 KB

Nerissa Vaughan, Chief Executive

Minutes:

The Board received and considered a report from the Chief Executive covering the following issues: -

 

·         Planned Care Quality Commission inspection

·         Community healthcare services in Swindon

·         Discharging patients remains a priority

·         Emergency Department update

·         Waiting times for planned procedures

·         Staff survey results

·         Patients experience the lowest number of pressure ulcers in the south west

·         Brighter Futures’ Radiotherapy Appeal reaches half way point.

 

NV commented that she was becoming increasing concerned about staff wellbeing.  In response to a question from PH around the reporting of the results of the staff survey, OF advised that the results had now been published and a report would be presented to the Board next month which would include information on trends and priority areas for focus.

 

NV highlighted the marked improvement in the prevention of pressure ulcers.

 

In response to a question from AC around the accuracy of the number of patients who attended the Emergency Department in February with 65% being treated, transferred or discharged with four hours of arrival, GR explained that this level would be similar to many other Trusts. NLB commented that the dominator was a sicker group of people and therefore the percentage discharge was greater.

 

RESOLVED

 

that the report of the Chief Executive be received.

8/17

Finance Report pdf icon PDF 122 KB

Karen Johnson, Director of Finance

Additional documents:

Minutes:

The Board received and considered a report on finance for month 10, together with a presentation as follows: -

 

Actual Operating costs

In month surplus of £58k. Total surplus of £255k compared to a planned surplus of £234k year to date (variance of £23k above plan).

 

Contractual Income

£21.2m in month and £232.3m year to date (£4.28m above budget year to date).

 

Total Income

£27.3m in month and £292.2m year to date (variance of £1.77m above plan year to date).

Income Activity highlights

·         Elective inpatients below plan (year to date Elective inpatients below plan).

·         Day case activity below plan (year to date Day case activity below plan).

·         Non-elective above plan (year to date Non-elective above plan).

·         Outpatient appointments below plan (YTD Outpatient appointments below plan).

·         A&E below plan (year to date A&E above plan).

 

Total Expenditure

 

£25.3 in month and £269.4m year to date (variance of £3.0m above plan year to date).

Expenditure highlights in month:

·         Drugs £0.28m above plan (£2.1m above plan year to date).

·         Pay £0.6m above plan (£1.9m above plan year to date).

·         Supplies £0.2m above plan (£2.1m above plan year to date).

 

EBITDA

7.7% year to date

Savings

Savings plan of £14.24m of which all had now been identified.

£1.1m Cost Improvement Plans (CIPs) delivered in month against a plan of £1.2m.

£12.0m delivered against a plan of £13.0m year to date (£1.0m below plan).

 

Debtors

£48.3m debtors and stock

£8.8m above plan

 

Creditors

£52.4m creditors

£0.7m above plan

Cash

£5.8m (£0.7m below plan)

 

Loan

No further updates

 

Reserves

Balance as at end of month 11 was £0.341m

 

Forecast

£44k surplus for the year (£556k below plan).

Finance Risk Ratings

Use of Resources (UoR) 3 (Rating 1 now top and 4 now bottom).

 

The Board discussed the report and comments were made as follows: -

 

Sustainability and Transformation Plan Funding (S&TF)

KJ reported that the Trust had received notification from NHS Improvement that it had been successful in achieving S&TF for quarter 2.  An appeal had been submitted in respect of funding for quarter 3.  Reference was made to the control total requirements.  It was noted that the Trust needed to end the year with less than £8m deficit before application of S&TF to achieve S&TF for quarter 4.  KJ advised that she was hopeful that this position would be achieved.

 

AC commented that NHS Improvement was looking at the control total before S&TF and he questioned whether this was the same as the wider public view.  KJ responded no in that the public would look at the total.  In response to a further question regarding NHS Improvement’s position in terms of ability to influence the funding position, KJ advised that nationally NHS Improvement was supportive and that they would match fund pound for pound. It was noted that the national position around finances was very challenging.

 

Activity

KJ advised that the decrease seen in activity in February was due to a shorter month but that peaks of  ...  view the full minutes text for item 8/17

9/17

Chair of Finance & Investment Committee Overview pdf icon PDF 171 KB

Steve Nowell, Non-Executive Director

Minutes:

The Board considered a report which summarised the key issues from a meeting of the Finance and Investment Committee held on 27 March 2017 which it was considered should be drawn to the attention of the Board covering the following: -

 

·         Overall financial performance

·         Income and Activity

·         Cash flow and forecasts

·         Top 10 Capital projects

·         Cost Improvement Programme (CIP) overview

·         PFI Accounting Model Revision and Revaluation – 1 April 2016

·         Diagnostics & Outpatients Division Overview

·         Swindon Community

·         Procurement Strategy

·         NHS Carbon & Energy Fund Project

·         PFI Future Options Business Case

 

In presenting the report, SN highlighted that the Committee had discussed in detail the CIP overview noting that the identification of CIPs was becoming increasingly challenging for next year.  SN highlighted that an area for focus was agency reduction.

 

SN explained that the public finance initiative (pfi) accounting model had boosted the Trust’s financial position.  KJ was discussing the details with NHS Improvement.  SN commented that the technical adjustment resulted in a paper surplus and not a cash surplus.  KJ commented that she had yet to receive an indication around adjustments of the control total.

 

SN advised that contractual discussions with Swindon Clinical Commissioning Group continued around Swindon Adult Community Services in that there was a financial gap of £900k.

 

SN explained that the Committee had supported a 15 year contract with Imtech around a carbon and energy project which was aimed at reducing carbon emissions. KM reported that he had taken legal advice around matters which would impact on inflation rates and energy rate assumption costs which the Trust had assumed would continue to grow.  SN suggested that it might be worth KM modelling this to understand at what point this would impact on the £115k assumed savings per annum.

 

With reference to the overall financial position set out in the report, NLB questioned the Sustainability and Transformation Funding (S&TF) position. It was clarified that there should be an amendment to the report in that the Trust remained on target to achieve a planned year-end deficit of £8.3m prior to S&TF and that with S&TF the Trust would be a in small surplus position.   KJ advised that it had been assumed that S&TF funding would be achieved.  KJ reported that a cash injection for this and next year had been assumed with an expectation that within 2 years the Trust should be cash neutral.

 

OF commented that the new IR35 (intermediaries legislation) had caused concerns around financial impact notably for staff in Haematology and in order to protect patients the Trust had incurred financial risk in the short term. In this area, the Trust was looking for a longer term solution with Oxford.

 

SN advised that the Committee had acknowledged concerns regarding agency costs.

 

NV commented that a hospital could not be run on £13m agency and that there needed to be further focus on how the Trust recruited and retained staff and workforce models and how agency costs could be brought down.  The current agency levels  ...  view the full minutes text for item 9/17

10/17

Chair of Audit, Risk & Assurance Committee Overview pdf icon PDF 173 KB

Julie Soutter, Non-Executive Director

Minutes:

The Board considered a report which summarised the key issues from a meeting of the Audit, Risk & Assurance Committee held on 16 March 2017 which it was considered should be drawn to the attention of the Board covering the following: -

 

·         15+ Risk Register / Board Assurance Framework – Strategic Risks

·         IR35 (Intermediaries Legislation)

·         External Audit progress report and technical update / External Audit Interim Findings

·         Internal Audit Progress Report 2016-17 / Client Briefings

·         Counter Fraud Progress Report 2016/17

·         Staff Code of Conduct - update

·         Contracts, Waivers and Extensions

·         Losses and Compensation Payments Q3 Report

·         Audit, Risk & Assurance Committee Effectiveness Review 2016/17

 

15+ Risk Register / Board Assurance Framework (BAF) - JS highlighted that the Committee recognised the amount of work undertaken to improve risk management over recent months noting that embedding consistent processes would take time.  The Committee noted that there were a number of overdue actions and overdue reviews. It was noted that there was continuing work underway to look at risks.    The Committee had noted that risks from the Operational Plan approved in January had been added to the BAF and that further metrics and sources of assurance had been added to reflect latest guidance.

 

IR35 legislation – It was noted that the Committee had sought an update on the implications of the new IR35 legislation and the arrangements in place to meet requirements.  The Committee was satisfied that processes were in place and there was awareness of additional impact.

 

External auditor (KPMG) progress update – The Committee had considered a technical update and had noted particularly that 73% of trusts had now successfully reduced their agency spend and over half of those had reduced by more than a quarter.  The Committee therefore concurred with the views of the Finance & Investment Committee and the Chief Executive on the need to drive down agency costs.

 

It was noted that the Council of Governors had agreed critical medicines as the quality account indicator and furthermore KPMG had noted the technical adjustments which they would look at.

 

Internal auditor’s progress report – JS advised that this was the last meeting for TIAA (internal auditors) as a new internal auditor “BDO” had been appointed.  Some of TIAA’s service review reports were awaiting management actions.   The new auditor would review the internal audit plan. It was noted that this was also the last meeting for the counter fraud provider.

 

Staff Code on Conduct – The Committee received an update on the roll out of the staff code of conduct policy noting that a new national policy was expected.

 

RESOLVED

 

that the report be received.

11/17

Improvement Plan Update pdf icon PDF 237 KB

Hilary Walker, Chief Nurse

Minutes:

The Board considered a report which provided an update on progress of “must do” milestone actions to deliver the required improvements in response to the Care Quality Commission (CQC) Inspection report received in January 2016.

 

It was noted that there would be one more meeting of the Committee in April to reflect on the committee’s effectiveness and to prepare a formal handover of business to the Patient Quality Committee.  Thanks to Helen Jones who had chaired the meeting throughout were recorded by the Board.

 

RESOLVED

 

that the report be received.

12/17

Quality Report pdf icon PDF 235 KB

Hilary Walker, Chief Nurse

·        NHS/Patient Safety Alert – Nasogastric tube patient safety alert

Additional documents:

Minutes:

The Board received and considered a report which provided commentary and progress on activity associated with key safety and quality indicators. The key points to note for February were as follows: -

 

  • The twelve month period April 2016 to November 2016 provided the Trust with a Hospital Standard Mortality Rate (HSMR) of 99.18.
  • There were 4 cases of Clostridium difficile during February 2017 and 1 in March 2017 which meant that the Trust had exceeded the trajectory of 20 for 2016/17 (21 in total).
  • There were 20 incidents over 90 days overdue and all were either no harm or low harm. Trust reporting of incidents had increased by 10%.
  • There were further mixed sex accommodation breaches in February (4 in the Medical Assessment Unit and 15 on the Day Assessment Unit).
  • There were 3 high / extreme complaints received during February and a further 4 cases re-opened.

 

In presenting the report the following comments were made: -

 

Hospital Standard Mortality Rate (HSMR)

It was highlighted that the HSMR rate was as expected and that the Trust benchmarked in the middle of the pack for Trust’s in the South West region.  It was reported that the Care Quality Commission (CQC) had hosted a national meeting looking at mortality.  A summary of the event would be reported through the Board Committees.  It was noted that the Trust had been one of the pilot sites and therefore was further forward than other organisations on progressing some of the initiatives.

 

In response to a question from RH, GR explained that as the whole country improved at saving lives the HSMR moved.  Other trusts were now performing equally well around Sepsis.  GR commented that the Trust was agains looking at coding but significantly there were action underway to focus on Sepsis and Acute Kidney Injury. HW commented that it was also considered that the roll out of electronic observations would have an impact on mortality.  RH questioned when this would be achieved and HW responded that there had been a meeting with prospective companies earlier in the week, as the Trust was currently in a procurement process.

 

NLB questioned whether the Board was reassured that work on Sepsis and Acute Kidney Injury would help keep the Trust’s mortality rate below 100, noting that in the last quarter the Trust had exceeded 100.  It was noted that the Trust was not an outlier and that there were a number of factors which contributed towards reducing mortality in addition actions to improve Sepsis and Acute Kidney Injury.

 

National audits

NLB drew the Board’s attention to the clinical audit and effectiveness information set out in the report and sought clarification on the decision making around the audit programme.  GR responded that the 6 national audits deemed not applicable for this Trust to participate in related to services which the Trust did not supply.  GR commented that there were 146 national audits last year which had increased to 240 this year.  This created additional pressure on staff and resources.  ...  view the full minutes text for item 12/17

13/17

Chair of Quality & Governance Committee Overview pdf icon PDF 172 KB

Nick Bishop, Non-Executive Director

Minutes:

The Board received a report from NLB the Chair of the Quality & Governance Committee which summarised key issues considered by that Committee at its meeting held on 23 March 2017 covering the following: -

 

·         Improvement Plan Update

·         Quality Report

·         Safer Staffing Monthly Exception Report

·         Swindon Community Health Services

 

NLB advised that the work of the Improvement Committee would continue to be driven at Divisional level.

 

NLB explained that the Quality Report had been discussed in detail.  There was a focus on improving the number of Friends and Family responses.

 

Safer staffing was considered and notably the high rate of agency use which was not satisfactory from both a clinical and financial perspective. 

 

Finally, NLB advised that the Committee would continue to have oversight of Swindon Community Health Services.

 

RESOLVED

 

that the report be received and it be noted that the Quality & Governance Committee will continue to scrutinise and challenge the delivery of actions to drive improvements.

14/17

Operational Performance Report pdf icon PDF 192 KB

Adrian Griffiths, Interim Chief Operating Officer

Additional documents:

Minutes:

The Board considered the operational performance report which provided an update on performance against key national and local performance standards in addition to progress against key work streams and remedial recovery plans with headlines as follows: -

 

Standard                 

Standard required

Performance

Target

Trust 4 Hour Performance

95%

February - 79.8%

Not achieved

Referral to Treatment (RTT)

92%

January - 91.1%

Not achieved

Diagnostic Waiting Times

99%

February - 99.1%

Achieved

Cancer

2 Week Wait

31 Day

62 Day

 

93%

96%

85%

January

82.1%

96.2%

85.4%

 

Not achieved Achieved

Achieved

 

Emergency Department (ED) 4 hour access target

AGr advised that February had been the most challenging month in terms of winter pressures and although attendances and admissions went down in February, there were peaks in activity and operational performance was compromised by the acuity and dependency of patients being admitted. AGr commented on the flow of patients which had been challenging with it taking longer to stabilise patients.

 

JS questioned whether there were any consequences for not meeting the February performance target.  AGr confirmed that there were no direct consequences and that he was in constant discussion with regulators and commissioners around possible improvement options.

 

NV advised that there had been much higher scrutiny of performance this winter because nationally achievement of the 4 hour access performance target was very challenging.  NV commented on the need to drive improvements internally, explaining that the Trust’s internal processes were very complicated.  There were improvements needed around coding patient’s treatments and the speed at which patients received treatment, resulting in more timely care.  Furthermore, NV commented that there were further improvement opportunities working with partners. NV commented that she believed that there was more which could be done around the 4 hour access target.  There was flow in the Hospital but delays in the Emergency Department and these needed to be addressed.

 

RH questioned whether the acuity of patients in A&E could be measured.  AGr responded that there was a tool “BEST” which provided some acuity measures.

 

Ambulatory Care - AGr reminded the Board that the Ambulatory Care Unit had been relocated to the Urgent Care Centre and that the numbers of patients being seen was increasing with 400 patients seen in February.  In response to a question from GR, AGr advised that these patient numbers were included in the A&E performance figures.

 

AGr commented that the Neurology hot clinics were successful and that a wider workforce plan was needed. AGr commented that the Trust needed to get to a point where the take was being managed.  Rosters were being worked through.

 

AGr referred to a package of measures to drive improvements advising that £1m had been agreed towards these.

 

Urgency care centre and streaming – AGr commented that there was a belief that streaming to primary care would solve the operational challenges in the Emergency Department (ED). AGr advised that he thought this was a contributory factor but not a solution in itself.  It was reported that a bid was being  ...  view the full minutes text for item 14/17

15/17

Chair of Performance, People & Place Committee Overview pdf icon PDF 155 KB

Steve Nowell, Non-Executive Director

Additional documents:

Minutes:

The Board received a report from the Chair of the Performance, People & Place Committee which summarised key issues considered by that Committee at its meeting held on 29 March 2017 covering the following: -

 

·         Operational Performance Report

·         Diagrammatical Information on Patient Flow

·         ED Action Plan

·         Workforce Report

·         Forward agenda

SN referred to the ongoing work of the Committee as set out in the forward plan appended to the report.  SN was keen to ensure reporting through the Committee was as scheduled. SN commented that he wanted the Committee to focus on considering IT during June and July and this approach was supported.

 

Reference was made to a forthcoming presentation on the E-rostering system later in April to which all members of the Board were invited to attend.

 

Arising upon consideration of this report OF reported that there had been a very negative reaction from staff to the 1% national pay rise, particularly in the context that minister had received 1.6% and the inflation and price index was 2.3%.  OF commented that this was the seventh year running where pay increases for NHS staff were below the rate of inflation.  Furthermore pension contributions had increase and expenses payable for travel had gone down.

 

RESOLVED

 

that the report be noted.

16/17

Safer Staffing Monthly Exception Report pdf icon PDF 338 KB

Hilary Walker, Chief Nurse

Additional documents:

Minutes:

The Board considered a report which provided the monthly exception reporting on actual nursing and midwifery staffing compared to that planned, together with associated quality impacts. In February the position was as follows: -

 

Proportion of actual versus planned nursing hours (fill rate):

 

Registered Nurses

Auxiliary Nurses

Day Shift

90.6%

105.3%

Night Shift

100.9%

103%

 

Average skill mix ratio (day): -

RN

61.3%

Care staff

38.7%

 

RESOLVED

 

that the report be received.

17/17

Ratification of Decisions made via Board Circular/Board Workshop

Carole Nicholl, Company Secretary & Head of Corporate Governance

Minutes:

None.

18/17

Report from West of England Health Science Network Board Meeting - 8 March 2017 (to note) pdf icon PDF 108 KB

Guy Rooney, Medical Director

Minutes:

The Board considered a report of the Board meeting of the West of England Academic Health Science Network (AHSN) held in March 2017 covering the following: -

 

·         Highlights of our work in Quarter 2 2016/17

·         Learning from Deaths Conference 21 March 2017

·         Business Plan 2017/18

·         AHSN Re-licensing Process

·         Test beds 2

 

RESOLVED

 

that the report from the West of England Academic Health Science Network Board be received

19/17

Urgent Public Business (if any)

To consider any business which the Chairman has agreed should be considered as an item of urgent business and to note the reasons for the urgency.

Minutes:

None.

20/17

Date and Time of next meeting

Date: 4 May 2017

Time: 9:30am

Venue: Trust Management Boardrooms, Trust HQ, 2nd Floor, Great Western Hospital

Minutes:

It was noted that the next meeting of the Board would be held on 4 May 2017 at 9:30am in Trust Boardrooms, Trust HQ, Great Western Hospital, Swindon.

21/17

Exclusion of the Public and Press

The Board is asked to resolve:-

 

that representatives of the press and other members of the public be excluded from the remainder of this meeting having regard to the confidential nature of the business to be transacted, publicity of which would be prejudicial to the public interest” when the following items are considered: -

·        Minutes

·        PFI Update

·        Expanding Hospital Capacity

·        Swindon Community Contract 2017/18

·        15+ Risk Register

·        Developing new models of care in Swindon

·        Wiltshire Health & Care update

·        Audit, Risk & Assurance Committee Minutes

·        Charitable Funds Committee Minutes

·        Executive Committee Minutes

·        Finance & Investment Committee Minutes

·        Performance, People & Place Committee Minutes

·        Quality & Governance Committee Minutes

·        Remuneration Committee update

·        Urgent Private Business (if any)

Minutes:

RESOLVED

 

that representatives of the press and other members of the public be excluded from the remainder of this meeting having regard to the confidential nature of the business to be transacted, publicity of which would be prejudicial to the public interest when the following items are considered: -

 

·         Minutes

·         Outstanding Actions of the Board (Private)

·         PFI

·         Expanding Hospital Capacity

·         Swindon Community Contract 2017/18

·         15+ Risk Register

·         Developing new models of care in Swindon

·         Wiltshire Health & Care - update

·         Audit, Risk and Assurance Committee Minutes

·         Charitable Funds Committee Minutes

·         Executive Committee Minutes

·         Finance & Investment Committee Minutes

·         Performance, People & Place Committee minutes

·         Quality & Governance Committee Minutes

·         Remuneration Committee Minutes

·         Urgent Private Business – Wiltshire Community Estate

 

 

22/17

Minutes

Roger Hill, Chairman

·        2 March 2017 (private)

Minutes:

The minutes of the meeting of the Board held in private on 2 March 2017 were adopted and signed as a correct record subject to amendments.

 

23/17

Outstanding Actions of the Board (Private)

Minutes:

The Board received and considered the outstanding actions list.  The Board noted progress against the actions and agreed that completed actions be removed.

24/17

PFI

Kevin McNamara, Director of Strategy

Minutes:

The Board received a paper regarding the Private Finance Initiative (PFI).

25/17

Expanding Hospital Capacity

Kevin McNamara, Director of Strategy

Minutes:

The Board received and considered a report which provided an update on work that was commencing on developing a business case to explore options for additional hospital capacity to meet future demand.

26/17

Swindon Community Contract 2017/18

Karen Johnson, Director of Finance

Minutes:

The Board received a report update regarding the contract negotiations for Swindon Community Services. 

27/17

15+ Risk Register

Carole Nicholl, Company Secretary & Head of Corporate Governance

Minutes:

The Board received and considered a report which set out a summary of risks scoring 15+ (extreme risks). The Board took assurance from the Audit, Risk & Assurance Committee that processes and systems for managing risk within the organisation continue to remain effective.

 

28/17

Developing new models of care in Swindon

Kevin McNamara, Director of Strategy

Minutes:

The Board received a report which provided an update on work taking place to develop a new model of care in Swindon

29/17

Wiltshire Health & Care - update

Hilary Walker, Chief Nurse

Minutes:

The Board received and considered a report which provided an update from Wiltshire Health and Care (WH&C) on matters of relevance to the Trust. The Board noted the report.

30/17

Audit, Risk and Assurance Committee

Julie Soutter – Committee Chair

·        16 March 2017 (written report)

·        19 January 2017 (enclosure)

Minutes:

The minutes of the meeting of the Audit, Risk and Assurance Committee held on 19 January 2017 were received.  Furthermore, it was noted that a meeting of the Audit, Risk and Assurance Committee had been held on 16 March 2017.

31/17

Charitable Funds Committee

Jemima Milton – Committee Chair

·        1 February 2017 (enclosure)

Minutes:

The minutes of the meeting of the Charitable Funds Committee held on 1 February 2017 were received. 

32/17

Executive Committee

Nerissa Vaughan – Committee Chair

·        21st March 2017 (verbal report)

·        14th February 2017 (enclosure)

Minutes:

The minutes of the meeting of the Executive Committee held on 14 February 2017 were received.  It was noted that the meeting of the Executive Committee scheduled for 21 March 2017 had not taken place due to the Care Quality Commission inspection.

33/17

Finance & Investment Committee

Steve Nowell – Committee Chair

·        27 March 2017 (written report)

·        20 February 2017 (enclosure)

Minutes:

The minutes of the meeting of the Finance & Investment Committee held on 20 February 2017 were received.  Furthermore, it was noted that a meeting of the Finance & Investment Committee had been held on 27 March 2017.

34/17

Performance, People & Place Committee

Steve Nowell, Non-Executive Director

·        29 March 2017 (written report)

·        22 February 2017 (enclosure)

Minutes:

The minutes of the meeting of the Performance, People & Place Committee held on 22 February 2017 were received.  Furthermore, it was noted that a meeting of the Performance, People & Place Committee had been held on 29 March 2017.

35/17

Quality & Governance Committee

Nick Bishop - Committee Chair

·        23 March 2017 (written report)

·        16 February 2017 (enclosure)

Minutes:

The minutes of the meeting of the Quality & Governance Committee held on 16 February 2017 were received.  Furthermore, it was noted that a meeting of the Quality & Governance Committee had been held on 23 March 2017.

36/17

Remuneration Committee

Steve Nowell – Committee Chair

·        27 March 2016 (verbal report)

Minutes:

The Board received a verbal report of the meeting of the Remuneration Committee held on 27 March 2017.

37/17

Urgent Business (Private) - Wiltshire Community Estate

To consider any business which the Chairman has agreed should be considered as an item of urgent business.

Minutes:

Prior to the meeting, the Chairman had agreed to accept this as an item of urgent business in view of the need for a decision to be made prior to the next meeting of the Board.

 

The Committee considered an urgent report regarding Wiltshire Community Estate.