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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

337/18

Apologies for Absence and Chairman's Welcome

Minutes:

The Chair welcomed all to the Great Western Hospitals NHS Foundation Trust Board meeting.

 

Apologies were received as outlined above.

338/18

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.

339/18

Minutes pdf icon PDF 289 KB

Liam Coleman, Chairman

·        7 February 2019 (public minutes)

Minutes:

The minutes of the meeting of the Board held on 7 February 2019 were adopted and signed as a correct record, subject to the following amendments: -

 

314/18 :  Quality Report : Hospital Standardised Mortality Rate / Summary Hospital Mortality Indicator  -  Change the word ‘target’ to ‘mean’

 

314/18  :  Quality Report  :  Complaints, Concerns and Compliments  -  Change Nick Bishop to Andy Copestake in second paragraph.

340/18

Outstanding actions of the Board (public) pdf icon PDF 294 KB

Minutes:

The Board received and considered the outstanding action list with the following comments:-

 

314/18  :  Quality Report  :  Complaints  -  It was noted that the breakdown between complex and non-complex complaints would be included in the next Quality Report.

 

RESOLVED

 

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

341/18

Questions from the public to the Board relating to the work of the Trust pdf icon PDF 312 KB

Minutes:

The questions from members of the public were considered and the following noted:-

 

·        The question with regard to the Trust’s smoking ban was noted by the Board as follows:-

 

This decision has not been made by the Trust in isolation and is as a direct result of a request by the CCG that all NHS Trusts agree to going ’smoke free’ by the latest 1st January 2019. As a result the Trust signed the NHS Smokefree Pledge which builds on existing commitments set out in the NHS Five Year Forward View and Tobacco Control Plan for England. Amongst others, the Pledge has been endorsed by NHS England, the Public Health Minister and Public Health England.

 

We recognise that smoking is an addiction and the Trust is committed to supporting staff and patients with this addiction. We have a number of interventions in place for staff including Occupational Health and Health & Wellbeing advisor support and we are also working with clinical colleagues to provide them with guidance on how to support patients with a nicotine addiction including the ability to obtain NRT patches and other medication.

 

We have provided vaping shelters for staff and all visitors to the Trust are able to vape outside of buildings as long as they don’t vape in doorways and by open windows, as Public Health Guidance insists e-cigarettes are 95% safer than smoking. There are many articles on line that you can view should you wish to read this evidence for yourself.

 

The Trust recognises that for some people quitting smoking will be difficult which is why we are committed to providing support.”

 

Jemima Milton, Non-Executive Director queried whether this was more a statement rather than an actual question.   Sheridan Flavin, Interim Director of HR replied that the question had also been directed to the Patient and Liaison Services (PALS) and warranted a response.

 

RESOLVED

 

that the questions and responses be noted and it would be agreed that no further action is required to address the issues raised.

 

342/18

Chairman's Report, Feedback from the Council of Governors

Liam Coleman, Chairman

Minutes:

The Chairman gave a verbal report as follows: -

 

·        The appointment of Dr Nick Bishop as Senior Independent Director had been confirmed.

·        A Council of Governors meeting had been held on 7 February 2019 and topics discussed included the Trust’s annual Business Plan with an invite for comments from the Governors, together with the local indicator for the Quality Accounts 2019/20 was approved which formed part of the Annual Accounts.  Furthermore there was a presentation on the latest CQC outcomes, and, on the effectiveness of the Council particularly around enhancing their responsibility of holding the Non-Executive Directors to account for the performance of the Board.

·        Non-Executive Director interviews were held on 1 March 2018 with a preferred candidate selected to progress to the next stage, with final approval by the Council of Governors meeting in April 2019.

 

RESOLVED

 

that the report of the Chairman be received.

343/18

Chief Executive's Report pdf icon PDF 244 KB

Nerissa Vaughan, Chief Executive

Minutes:

The Board received a report from the Chief Executive and highlighted:-

 

·        The power outage that had occurred on 1 February 2019 which had a significant impact on the clinical and telephony systems.  The Board wished to thank staff in getting the systems up and running so quickly.

·        A new sunflower lanyard pilot to support children with hidden disabilities had been introduced.The Trust was the first in the country to pilot an innovative scheme that offered extra support to young patients with a hidden disability.

·        The Trauma and Orthopaedic team had won the ‘Golden Hip Award’ in recognition of significant and sustained improvements in hip fracture care.

Liam Coleman, Chair confirmed that further review in terms of the power outage incident would be through the Performance, People and Place Committee with any escalation to Board as appropriate.

 

Peter Hill, Non-Executive Director added that the Golden Hip Award achievement should not be under estimated and was excellent news.

 

RESOLVED

 

that the report of the Chief Executive be received.

344/18

Finance Report pdf icon PDF 115 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

The report does not contain any data relating to Provider Sustainability Funding (PSF formerly STF) and represents the Trust Control Total only.

In month deficit of £464k compared to a target deficit of £113k.Year to date deficit of £10,294k compared to planned deficit of £9,949k. Year to date variance £345k adverse.

NHS Clinical Income

£24.6m in month and £236m YTD (£2.2m above plan YTD)

Total Income

£27.5m in month and £263.6m YTD (£4.4m above plan YTD)

Income Activity highlights for the month (based on estimated activity):

·        Elective inpatients above plan

·        Day case activity above plan

·        Outpatient appointments below plan

·        Non-elective activity above plan

·        A&E above plan

Total Operating Expenditure

 

£26.1m in month and £254.7m YTD (£4.7m above plan YTD)

Expenditure highlights in month:

·        Drugs £0.1m above plan (£1.8m above plan ytd)

·        Pay is £0.4m below plan (£1.4m below plan ytd)

·        Supplies £0.2m above plan (£2.6m above plan ytd)

·        Other Costs £0.9m above plan (£1.5m above plan ytd)

EBITDA

3.4% YTD which was 0.2% below plan

Savings

Savings plan of £11.611m of which £7.4m forecast to be delivered

£0.7m CIPS delivered in month against a plan of £1.2m

Debtors

£49.7m debtors and stock

£7.6m above plan

Creditors

£55.3m creditors and borrowings

£10.3m above plan

Cash

£1.5m

£0.5m above plan

Loan

Loan drawdown of £3.757m in month

Finance Risk Ratings

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

 

The report was reviewed and the following highlighted:-

 

·        The year to date position was a deficit of £10.3m against a forecast of £9.9m.  As anticipated the Trust deviated from its Control Total as previously reported in month 9 when the Trust formally reported a deviation of £1.1m.  As a result the Trust would not achieve its PSF in Q4 with a loss of income of £2.5m.

·        With a 10% increase in ED attendance there was significant pressure in terms of performance and therefore a risk to year end position of £2-3k.  The Trust were working with the commissioners and divisions to mitigate.

·        Cost Improvement Programme (CIP) delivery impacted on the overall financial position however this was in line with previous months at 64% delivery.  This continued to be a significant challenge which would continue into the next financial year.

·        With regard to cash, a drawdown of £8m was required to support the cash position which was supported by the Department of Health.

Julie Soutter, Non-Executive Director asked what pressures the finance team were under to manage both the cash position in terms of creditors and end of year.  Karen Johnson, Director of Finance replied that as part of the deviation plan of £1.1m the Trust was receiving extra cash from the commissioners to support winter pressures and therefore there would not be an issue in terms of cash.  However managing creditors had long been a historical issue  ...  view the full minutes text for item 344/18

345/18

Chair of Finance & Investment Committee Overview pdf icon PDF 188 KB

Andy Copestake, Non-Executive Director

Minutes:

The Board received a report from the Chair of the Finance & Investment Committee which summarised the key issues considered by the Committee at its meeting held on 28 January and 25 February 2019 and highlighted:-

 

·        The progress in the budget setting process, in particular the challenge around CIPs.

·        The contractual gap going into next year although hard work was being undertaken to close the gap, the position was not closed yet.

·        A useful paper on EU exit plans with assurance that the Team were as prepared as they could be.

Karen Johnson, Director of Finance added that the deadline to close contracts was 21 March 2019 and confirmed that the gap had been reduced and would be closed by the deadline.

 

Liam Coleman, Chair expanded on the Brexit issue in that during an NHS Improvement meeting this week the Trust had re-enforced that all appropriate planning around Brexit had been undertaken and was subject to on-going review.   Local and national plans had been discussed through the relevant committees and a significant amount of work had been undertaken to ensure the Trust was as ready as it could be, not knowing the outcome, with controls and contingency plans in place if a ‘no-deal’ scenario emerged.  The Trusts risk register had been updated to reflect the increased possibility of a ‘no-deal’ Brexit.  

 

RESOLVED

 

that the report be received.

346/18

Chair of Audit, Risk & Assurance Committee Overview pdf icon PDF 175 KB

Julie Soutter, Non-Executive Director

Minutes:

The Board received a report from the Chair of the Audit, Risk & Assurance Committee which summarised the key issues considered by the Committee at its meeting held on 17 January 2019.

 

RESOLVED

 

that the report be received.

347/18

Chair of Charitable Funds Committee Overview pdf icon PDF 173 KB

Jemima Milton, Non-Executive Director

Minutes:

The Board received a report from the Chair of the Charitable Funds Committee which summarised the key issues considered by the Committee at its meeting held on 6 February 2019 and highlighted the lack of unrestricted funds which would continue to be a challenge in the next financial year.

 

RESOLVED

 

that the report be received.

348/18

Quality Report pdf icon PDF 112 KB

Julie Marshman, Chief Nurse

Guy Rooney, Medical Director

Additional documents:

Minutes:

The Board received and considered a monthly report which provided commentary and progress on activity associated with key safety and quality indicators. The key points to note for February 2019 were as follows: -

 

Hospital Standardised Mortality Rate (HSMR) / Summary Hospital Mortality Indictor (SHMI)   Both the HSMR rolling rate and year end rate continued to maintain a good story and the Trust showed improvements in mortality rates against other key trusts within the South West region.  The SHMI reflected the same picture.

 

Infection Prevention and Control – Two good news stories in terms of achieving 100%  sepsis  for a number of months and the Golden Hip Award.  These outcomes triangulated with the HSMR/SHMI in demonstrating the Trust’s reduction in expected deaths. 

 

In terms of clostridium difficile this continued to be a moving picture.  Following a visit from NHS Improvement as a ‘critical friend’ an action plan was produced and was currently being worked through.  However, it was worth noting the correlation of sepsis care initiatives leading to higher clostridium difficile rates.

 

Mortality Alerts  -  A list of Mortality Alerts with comments had been included in the report as a response from a Board request. 

 

National Audits  -  The number of overdue items had reduced.  The perinatal mortality rate at GWH continued to be 10% lower than the UK national average, and in terms of regional benchmarking with other Trusts in the South West region showed the stillbirth rate for GWH was the lowest in the region, another good news story..

 

The hip fracture database triangulated with the Golden Hip Award, another indicator of the Trust’s success in this area.

 

Liam Coleman, Chair commented that the perinatal performance appeared to be a long term improving result and asked what the good underlying factors were driving performance that helped achieve this result.   Guy Rooney, Medical Director advised that the Trust was fortunate enough to have enthusiastic obstetricians and paediatricians who had launched a campaign to implement key actions when delivering small babies which overtime had added up to the overall figures, which also could be said about the hip fracture team.  Nerissa Vaughan, Chief Executive said that there were a number of these initiatives around the Trust and requested a paper be pulled together to show all these examples of Quality Initiatives (QIs) for the Board to note.

Action  :  Chief Nurse

 

Paul Lewis, Non-Executive Director commented that it was good to see the overdue national audits reducing however would like to see an indication on when the overdue audits would be closed.  Julie Marshman, Chief Nurse responded that there had been an update at the recent Patient Quality Committee and some long overdue audits had now closed and therefore the Board would see further improvements next month.  Guy Rooney, Medical Director added that to put this into context there were over 300 national audits which had increased over the years.

 

Cleaning Standards – There was an improving picture in the patient care equipment self- audits with the introduction  ...  view the full minutes text for item 348/18

349/18

Chair of Quality & Governance Committee Overview pdf icon PDF 236 KB

Nick Bishop, Non-Executive Director

Minutes:

The Committee received a report from the Chair of the Quality & Governance Committee which summarised key issues considered by that Committee at its meeting held on 24 January and 21 February 2019 and highlighted:-

 

·        A presentation on clostridium difficle on current practices and actions being taken to prevent further cases. Positive feedback had been received following a visit by NHS Improvement to look at the Trust’s infection prevention and control policies and

practices.

·        A progress report on the management of the ophthalmology hold file which continued to be monitored and the Committee was assured that actions were in place for the sustained management of a reduction of patients overdue a follow up.

 

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.

350/18

Operational Performance Report pdf icon PDF 273 KB

Jim O’Connell, Chief Operating Officer

Kevin McNamara, Director of Strategy & Community Services

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: -

 

ED 4 hour standard (95%)

(combined - ED, MIU & UCC)

 

January 85.7%

Under Achieving

RTT Waiting List Size

 

Waiting list size (December) 20,804 against 20,959

trajectory (-155)

 

 

*NHS central guidance has changed to size of waiting list at year end rather than

% delivery

6 Week Diagnostic Wait (99%)

December 93.32%

Failing

 

Cancer Targets:

December

 

 

2 Week Waits (93%)

95.7%

Achieved

 

2 Week Wait Breast Symptomatic (93%)

97.5%

Achieved

 

31 Day Treatment (96%)

100%

Achieved

 

62 Day Treatment (85%)

83.6%

Failing

 

 

The report was reviewed and the following highlighted:-

 

Emergency Department (ED)  -  Performance compared to last year had maintained an overall 7% improvement despite the continued pressures.  It was noted that winter pressures had continued into February 2019 due to continued increase in attendance, up by 9.2%, together with the snow and power outage at the beginning of the month.

 

Julie Soutter, Non-Executive Director asked what was driving the Trust continually being in Operational Pressures Escalation Level (OPEL) 4 status. Jim O’Connell, Chief Operating Officer replied there were a number of factors, one being the increase in attendances  particularly in ‘major’ admissions.  The Trust was working with the commissioners to understand the reason for the increase in reviewing the system as a whole.  Jemima Milton, Non-Executive Director added that one potential cause was waiting longer for GP appointments and the impact on ED.

 

Liam Coleman, Chair commented that knowing ‘major’ attendances had increased with the baseline remaining the same as last year breaches were a likely impact but the continued focus of the Trust was key in keeping people safe.   Jim O’Connell, Chief Operating Officer replied that the regulators were being reasonable however the focus was more on  stranded patients and length of stay to influence a local change as well as a review of NHS system as a whole.

 

Referral to Treatment Time (RTT)  - Overall RTT performance had remained relatively stable and ahead of trajectory.

 

Liam Coleman, Chair asked if the deadlines in the next steps in the appointments slot issue had been completed.  Jim O’Connell, Chief Operating Officer replied that he was confident that they had been met however would double check.

 

Cancer  -  All standards had been met except for 62 day target which had marginally dropped to failing and this would continue into Q4 due to the Urology issue which was also reflected nationally as well as locally.  The issue was partly due to the complexity of the pathway and partially to tertiary referrals and the Trust’s ability to deliver.  Also there had been a few colorectal breaches which were small in number however significantly impacted the percentage.

 

Stroke  -  The good news was direct admissions had moved to achieving, however direct admissions within 4 hours had not met the standard.  This was due  ...  view the full minutes text for item 350/18

351/18

Chair of Performance, People & Place Committee Overview pdf icon PDF 261 KB

Peter Hill, Non-Executive Director

Minutes:

The Board received a report from the Performance, People & Place Committee which summarised the key issues considered by the Committee at its meeting held on 18  December 2018 and 30 January 2019 and highlighted that the January meeting focussed on the outage and holding SERCO to account.  The next meeting would review the Key Performance Indicators (KPIs) for 2019/20.

 

RESOLVED

 

(a)        that the report be received and it be noted that the Performance, People & Place Committee will continue to scrutinise and challenge the delivery of         actions to drive improvements, and;

 

(b)        Commissioners full report on cardiophysiology to Performance, People & Place     Committee.

352/18

7 day standards Board assurance pdf icon PDF 220 KB

Guy Rooney, Medical Director

Additional documents:

Minutes:

The Board received a paper that outlined the improvements achieved and the steps necessary to meet the delivery of the 7 day working standard by March 2020.  The following was highlighted:-

 

·        It is the Trust’s ambition to move to the proposed 10 standards by 2020 however the current focus was to deliver plans for the 4 minimum standards.

·        These 4 standards were monitored by a series of nationally led audits with the first request to submit the first template to Board by March 2019.

·        The Trust continued to meet 2 of the 4 standards.  There was particular difficulty with meeting standard 2 (patients wait no longer than 14 hours to initial consultant review.

·        It was noted that some pathways had not been changed as this would slow down the pathway for example hip.

·        Next step was to maintain perspectives audit of data and to include in the Trust’s Business Plans.

 

Liam Coleman, Chair agreed with the point of not changing the pathway just to achieve 100% if it worked against us.  Peter Hill, Non-Executive Director added that on a visit to Lamu ward recently this was evidenced in that fast diagnostics resulted in the ability for the ward to now be able to see more patients.

 

RESOLVED

 

to approve the on-going development of plans to achieve the standards.

353/18

Safer Staffing - 6 monthly skill mix review pdf icon PDF 390 KB

Julie Marshman, Chief Nurse

Minutes:

The Board received and considered a paper that outlined the changes by exception following the six monthly staff skill mix review and highlighted the following:-

 

·        A number of the proposals were being worked up for the Trust Business Improvement Group (BIG)

·     A number of minor changes were being managed within Divisional budgets

·        Other proposals were being scoped

·        The attached appendices outlined each Division.   There were a number of changes within Community which had been put forward to the Clinical Commissioning Group (CCG)

·        A new reporting system had been introduced following instructions from NHSI, moving from Allocate Safe Care to Shelford’s Safer Nursing Care Tool.

·        Nationally, the first cohort undertaking the nursing associate (NA) qualification completed in December 2018.  The Trust recruited 21 trainee NAs who started in September 2018 with a further 6 in December 2018.

·        There are plans for Nursing Apprenticeships being developed through the STP which was essential as another key route into the registered nurse role, however there would be some costs attached.

 

Julie Soutter, Non-Executive Director noticed that Gloucester had been carrying out local advertising for nurses.  Sheridan Flavin, Interim Director of HR replied that the Trust was also undertaking a big campaign though the radio, social media and bus backs.

 

Andy Copestake, Non-Executive Director asked for clarity on the request from the Board for this paper as there was no specific conclusion.  Julie Marshman, Chief Nurse noted the comment and recognised that the paper required revision however assured the Board that actions were being taken and the Trust had safe staffing levels.

 

Karen Johnson, Director of Finance clarified that any proposals for business development would have to be included in the Division’s business plans and not go through the Trust’s Business Development Group.

 

RESOLVED

 

(a)        to note the actions being taken to ensure nurse staffing levels are safe, and;

 

(b)        to note this as assurance of compliance against the expectations of the

National Quality Board 2016.

354/18

Safer Staffing Bi-Monthly Exception Report pdf icon PDF 647 KB

Julie Marshman, 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 and highlighted the following:-

 

·        The fill rate chart continued to be impacted by the NHSI reporting guidance, where Assistant Practitioners (APs) were excluded, therefore the numbers were reduced.  However the Board could be assured that the gaps were being filled and there were no concerns to report.

·        There had been an increase in complaints siting nursing and midwifery.  A detailed review had been undertaken to understand the reasons and found that this was more linked to escalation areas, and clostridium difficle and not directly to staffing levels.

·        The average skill mix ratio was moving towards a right staff right time approach as opposed to the 1:8 ratio.

·        The Care Hours per Patient Day overall shows a steady position except in January 2019 which was the result of the removal of the Assistant Practitioners.

 

Julie Soutter, Non-Executive Director asked if the previous data could be revised to exclude Assistant Practitioner roles.  Julie Marshman, Chief Nurse agreed to restate the figures.

Action  :  Chief Nurse

 

RESOLVED

 

(a)        that the report be noted, and;

 

(b)        previous data (pre January 2019) be restated to exclude Assistant Practitioners.

355/18

Research & Innovation Progress Report pdf icon PDF 141 KB

Dr Badri Chandrasekaran, R&I Director/Clinical Lead, to attend (11.00am)

Minutes:

Dr Badri Chandrasekaran, Consultant Cardiologist joined the meeting.

 

The Board received and considered a report, together with a supporting presentation which provided an overview of the status of Research and Innovation. 

 

Dr Chandrasekaran firstly apologised for an error in the report with regarding wording and hoped the presentation would clarify the position. 

 

The presentation covered a range of topics which included R&I’s role, structure, current activity through to opportunities and challenges. 

 

Liam Coleman, Chair thanked Dr Chandrasekaran for his excellent presentation and emphasised that it was clear from the Board’s perspective the current situation and challenges faced by the research and innovation department were.  Research and innovation was an important aspect of the organisation and the Board would support the department where it was possible going forward.  It was acknowledged that space was a current challenge to the Trust due to demand on services and options were being explored.

 

Peter Hill, Non-Executive Director also thanked Dr Chandrasekaran for a good presentation as research and innovation was often poorly understood in non-teaching hospitals and also noted that national money had decreased.  It was obvious that the author had frustrations and it would be good to know if there were any other issues or concerns that had not been voiced in the report.  Dr Chandrasekaran replied that the major concern was space and there were no other issues to report.

 

A discussion followed on the changes to funding and what was required to generate  opportunities, which included commercial, community workstreams and collaborative working. Both Kevin McNamara, Director of Strategy and Community Services and Julie Soutter, Non-Executive Director agreed to pick up the discussion outside the meeting, particularly around community and sources of funding.

 

Andy Copestake, Non-Executive Director recognised that it was not all about the money, however was interested to know what contribution research made to the bottom line. Dr Chandrasekaran replied that the contribution was £60k.

 

RESOLVED

 

to agree and support further development of Research and Innovation.

 

 

356/18

Ratification of Decisions made via Board Circular/Board Workshop

Carole Nicholl, Director of Governance & Assurance

Minutes:

The Board was requested to ratify the decision made via Board Circular for a loan agreement from the Department of Health as identified in the Trust’s annual plan for 2018/19.

 

RESOLVED

 

(a)            that the Board ratify the terms of, and the transactions contemplated by, the Finance Documents to which the Trust is a party and resolves that the Finance Documents to which it is a party be executed;

 

(b)            that the Chief Executive or Director of Finance be authorised to execute the Finance Documents to which the Trust is a party on its behalf;

 

(c)            that the Director of Finance or the Deputy Director of Finance on the Trust’s behalf, be authorised to sign and/or despatch all documents and notices (including, if relevant, any Utilisation Request) and to be signed and/or despatched by the Trust under or in connection with the Finance Documents to which the Trust is a party, and;

 

(d)       the Trust will comply with the additional Terms and Conditions of the Loan as set out in Schedule 8.

357/18

Terms of Reference of Committees pdf icon PDF 207 KB

Carole Nicholl, Director of Governance & Assurance

Additional documents:

Minutes:

The Board received and reviewed a paper to consider the annual review for the Board Committee structure and the terms of reference for each Board Committee.  The following was noted:-

 

·        Each Board Committee had undertaken an open discussion to consider their effectiveness, including terms of reference.

·        There were no issues or concerns to draw to the attention of the Board, however some suggestions were made around attendance of meetings, overlap/duplication of business and Chair’s reports that would be taken forward.

·        The terms of reference of the Committees were circulated showing where minor amendments had been made.

·        The Policy Group terms of reference were also circulated as Board approval was also required.

 

RESOLVED

 

(a)        that it be agreed that there are no changes proposed to the Board Committee         structure set out in this report, and;

 

(b)        that the Terms of Reference for each Committee as circulated separately with the agenda be approved, which included the Policy Group terms of reference.

358/18

Powers Reserved to the Board / Scheme of Delegation pdf icon PDF 100 KB

Carole Nicholl, Director of Governance & Assurance

Additional documents:

Minutes:

The Board received and considered a report that contained the Powers reserved to the Board and the Scheme of Delegation for annual review. The following was highlighted:-

 

·        There was one slight amendment to the Reservation of Powers to the Board which was to add the ‘approval of expenditure in excess of £15m with NHS Improvement approval, as requested by NHSI.

·        There were no changes to the Scheme of Delegation.

·        Any changes in year to address any outcomes of Brexit would be reported to the Board as necessary.

·        Both documents had been considered by Quality & Governance and Finance & Investment Committees.

 

RESOLVED

 

that the Powers Reserved to the Board and Scheme of Delegation be approved.

359/18

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.

360/18

Date and Time of next meeting

Date: 4 April 2019

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 April 2019 at 9:30am in Trust Management Boardrooms, Trust HQ, 2nd Floor, Great Western Hospital

361/18

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”

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.

 

362/18

Minutes

Liam Coleman, Chairman

·        7 February 2019 (private minutes)

363/18

Outstanding Actions of the Board (Private)

364/18

Final Trust Operational Plan 2019/20

Kevin McNamara, Director of Strategy & Community Services

·        The Board is asked to delegate authority to the Finance & Investment Committee to sign off the Trust Operational Plan 2019/20 to enable submission to NHSi within the current timeframe.

365/18

Trust Strategy

Kevin McNamara, Director of Strategy & Community Services

366/18

GWH Master Planning

Kevin McNamara, Director of Strategy & Community Services

Rupert Turk, Director of Estates & Facilities Management

367/18

Budget 2019/20 - verbal update

Karen Johnson, Director of Finance

368/18

Imaging Equipment Replacement - Outline Business Case

Karen Johnson, Director of Finance

Sarah, Head of Imaging, and Adam Dougherty, Head of Transformation, Anne-Marie Howroyd, Deputy Director of Finance to attend (1.00pm)

369/18

15+ Risk Register

Carole Nicholl, Director of Governance & Assurance

370/18

Board Assurance Framework Q3

Carole Nicholl, Director of Governance & Assurance

371/18

Executive Committee

Nerissa Vaughan – Committee Chair

·        19 February 2019 (verbal report)

·        22 January 2019 (enclosure)

372/18

Finance and Investment Committee

Andy Copestake – Committee Chair

·        25 February 2019 (written report)

·        28 January 2019 (enclosure)

373/18

Mental Health Governance Committee

Nick Bishop – Committee Chair

·        4 January 2019 (enclosure)

374/18

Performance, People & Place Committee

Peter Hill – Committee Chair

·        27 February 2019 (written report)

·        30 January 2019 (enclosure)

375/18

Quality & Governance Committee

Nick Bishop - Committee Chair

·        21 February 2019 (written report)

·        24 January 2019 (enclosure)

376/18

Urgent Business (Private) (if any)

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