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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

406.

Apologies for Absence and Chairman's Welcome

Minutes:

Apologies for absence were received from Steve Nowell.

407.

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.

408.

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

Peter Pettit, Public Governor has asked: “According to a recently published CQC report (December 2016), hospitals are failing to investigate far too many deaths and frequently ignore and exclude relatives of patients who have died.  What steps is the GWH NHS Foundation Trust taking to review the content of this report in the light of any investigation it has made into patient deaths at the GWH?”  Guy Rooney, Medical Director to respond.

Minutes:

Question 1

Peter Pettit, a Public Governor had asked “According to a recently published CQC report (December 2016), hospitals are failing to investigate far too many deaths and frequently ignore and exclude relatives of patients who have died. What steps are the GWH NHS Foundation Trust taking to review the content of this report in the light of any investigation it has made into patient deaths at the GWH?””.

 

It was noted that Rosemarie Phillips a Public Governor had also asked the same question but had substituted the word “deaths” for “mistakes in the operating theatre and mistakes in the wards”.

 

GR responded that the recently published CQC report contained Southern Health data. GR explained that there were six pilot sites across the country to look at work going on around avoiding deaths and the Trust was waiting for information on the monitoring of this. GR reported that at this Trust all deaths were looked at and monitored and that the Duty of Candour was applied. GR explained that in terms of mistakes in Theatres these would generate Incident Reports and the Trust had a good record of recording these.   If there was a serious incident a more thorough stipulated investigation was triggered. GR explained that there was a national framework around incident reporting and the Duty of Candour which involved talking to the families. GR commented that data on incidents and serious incidents was reported in the Quality Report.

 

At this point in the meeting the Chairman allowed Rosemarie Phillips to ask a supplementary question on whose role it was to undertake the Duty of Candour. GR responded that there was a very clear framework and this was dependant on the individual circumstances.      

 

Question 2

Rosemarie Phillips a Public Governor had asked “I am reliably informed that in some hospitals Governors are allowed to speak during a Directors meeting and others are requested not to”. CN responded that Governors were effectively members of the public and were entitled to attend the public part of the Board meeting to observe the proceedings in silence.   In addition, Governors were provided with copies of the public part of the Board Agenda. CN explained that there was a clear distinction which needed to be understood in that the Board meeting was a meeting held in public which could be observed but it was not a public meeting where anyone could participate.

 

Question 3

A member of the public had asked “what plans have our local hospital, Great Western Hospital and Swindon Borough Council, as the public authorities responsible for the National Health Service locally made in the years 2017-18 and 2018-19 for hospital provision and General Practitioners to meet the present and the future planned population”.

 

KM responded that the Trust was concerned about the growth in housing in Swindon which was now taking place which would see over 20,000 more people living in Swindon over the next five to ten years. The Trust was already seeing the effect of an  ...  view the full minutes text for item 408.

409.

Minutes pdf icon PDF 288 KB

Roger Hill, Chairman

·        17 November 2016 (public and summary of private minutes)

·        1 December 2016 (public and summary of private minutes)

Additional documents:

Minutes:

The minutes of the meeting of the Board held in public on 17 November 2016 and 1 December 2016 were adopted and signed as a correct record, subject to the following amendments: -

 

Minute 365/16 Minutes – the deletion of the words “AC referred to prioritising the payments to debtors” in the sixth paragraph and the substitution thereof with the words”AC referred to prioritising the payments to creditors”.

 

Minute 369/16 Finance Report – the deletion of the words “delayed payments of Sustainability and Transformation Funding (S&TF)” and the substitution thereof with the words “shortfall of Sustainability and Transformation Funding (S&TF) due to ED performance”.

 

Minute 373/16 Quality Report – the deletion of the words “and therefore this was the service area which received the highest number of complaints” in the sixth paragraph.

 

Minute 380/16 – the deletion of the first two paragraphs and the substitution thereof with “The Board considered a report which a provided an update of progress against the Peoples Strategy approved by the Board in February 2014. In presenting the report OF explained that the Trust has 347 vacancies which resulted in increased pressure on substantive staff and increased the reliance on temporary staff including agency staff”.

 

The deletion of the text “ILS English Language assessment” and the substitution thereof with “IELTS, English language assessment” in the third paragraph.

 

The deletion of words “supporting staffing” in the fifth paragraph and the substitution thereof with the words “support staff”.          

410.

Outstanding actions of the Board (public) pdf icon PDF 303 KB

Minutes:

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

 

255/16

Finance Report – IT Schemes

It was explained that the report on IT Schemes and Priorities had been deferred to enable prior consideration by the Performance, People and Place Committee in January. An initial report had been provided to the Executive Committee in December.

 

RB expressed concern around IT generally and the need to understand alignment of IT requirements to service priorities. AGr reported that work was underway around this and that the presentation had been delayed due to the Interim Head of IT leaving the organisation. RB commented on the need to look at IT priorities and the pace of implementation of any new schemes. JS commented that IT provision / systems / infrastructure had been raised at the Audit, Risk and Assurance Committee and remained a concern in terms of the pace of change and prioritisation. It was explained that a service review had been undertaken around cyber security with a reasonable assurance opinion given.

 

It was noted that IT was a key work stream of the Sustainability and Transformation Plan.      

  

328/16

Finance Report – Year End Overpayments

In response to a concern raised by RB, KJ explained that the Trust would not agree to make any pre-payments at year end if it compromised the Trust’s cash position. KJ confirmed that the Trust would not borrow finance in order to make pre-payments.   It was agreed that the action be closed.

 

335/16

Operational Report – Theatre Efficiency

It was noted that additional information on the Theatre Deep-Dive was included in the Operational Performance Report referred to elsewhere on the Agenda and therefore this action was closed.  

380/16

People Strategy Nurse Apprenticeship Schemes

It was noted that a paper covering a range of issues surrounding the relaxation of nurse apprenticeship schemes was included elsewhere on the Agenda and therefore this action was closed.  

 

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

411.

Chairman's Report, Feedback from the Council of Governors

Roger Hill, Chairman

Minutes:

The Chairman gave a verbal report as follows: -

 

Happy New Year and thank you – The Chairman took the opportunity to wish everyone a Happy New Year and was joined by all members of the Board in placing on record thanks to all staff who had, and continued to, work hard during the winter pressures. RH referred to the significant efforts by all staff to keep patients safe in times of increased activity and growth in demand and this was recognised by members of the Board.    

 

Non-Executive Director Recruitment – RH reported that interviews for two Non-Executive Director positions were due to take place later in the month.

 

Council of Governors – RH reported that there had been no meetings of the Council of Governors since the last meeting of the Board. However, a Council of Governor Effectiveness Review event was due to take place later in the month and the Lead Governor had invited Non-Executive Directors to attend. CN undertook to circulate details to Non-Executive Directors outside of the meeting.          

 

RESOLVED

 

that the report of the Chairman be received.

412.

Chief Executive's Report pdf icon PDF 258 KB

Nerissa Vaughan, Chief Executive

Minutes:

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

 

·        Preparing for our next routine CQC inspection

·        Sustainability and Transformation Plan published

·        New location for ambulatory care service at GWH

·        Trust staff benefit from 30 hours of free childcare

·        Staff car park expansion complete

·        Building work has started in the Endoscopy Unit

·        Stem Cell Service receives essential accreditation

·        NHS Swindon Clinical Commissioning Group appoints new Clinical Chair.

 

Ambulatory Care - In presenting the report NV highlighted that in order to help manage an increase in demand, the Ambulatory Care Service based within the hospital would be moved nearer to the Urgent Care Centre and the Emergency Department so that all urgent and emergency care services were located closer together by the end of January.

 

Car Parking - NV highlighted that the staff car park expansion was now completed providing an extra 400 car parking spaces. It was expected that the additional parking spaces would alleviate the pressure on public car parking areas making it easier for patients and visitors to park and reduce long queues of traffic around the hospital site.

 

Endoscopy Unit - NV highlighted that building work had started in the Endoscopy Unit and it was expected that the new design would improve patient flow and would improve the privacy and dignity of patients and facilities for staff in the unit. It was explained that the Joint Advisory Group (JAG) (part of the Royal College of Physicians) was supportive of the work proposed to ensure JAG Accreditation.

 

Free Child Care Pilot - JS referred to the pilot of 30 hours of free child care and in response to a question raised OF advised that the intention was that this pilot would have a positive impact on recruitment although this has not been specifically tested. OF explained that the pilot has been extensively advertised and would be rolled out nationally in September.

 

Integrated Performance Dashboard - In response to a question raised by JS, NV advised that there needed to be a discussion about the purpose and benefits of including a dash board in this report. NV highlighted that each of the main detailed reports also included an executive summary and as such it was difficult to find the right balance between information which was too high level and information that provided too much detail. AGr commented that in other Trusts it was usual to have either detailed reports or a very comprehensive performance dashboard. It was agreed that discussion of the purpose and benefits of an integrated performance dashboard be considered by the Chief Executive and Chair outside of the meeting. RB commented that the executive summaries were beneficial at drawing attention to the key issues and urged the need to avoid duplicating information.

 

Stem Cell Service - In response to a question from AC regarding the Stem Cell Service, NV advised that the number of patients was normal and that the service was sustainable noting that most of the service was  ...  view the full minutes text for item 412.

413.

Finance Report pdf icon PDF 112 KB

Karen Johnson, Director of Finance

Additional documents:

Minutes:

The Board received and considered a report on finance for month 8, together with a presentation as follows: -

 

Actual Operating costs

In month deficit of £5k. Total surplus of £106k compared to a target surplus of £527k. YTD (variance of £421k worse than plan).

Contractual Income

£20.8m in month and £175.8m YTD (£0.4m below budget YTD).

Total Income

£26.6m in month and £211.9m YTD (variance of £1.3m below budget YTD).

Income Activity highlights

·        Elective inpatients above plan (YTD Elective inpatients above plan).

·        Day case activity above plan (YTD Day case activity below plan).

·        Non-elective above plan (YTD Non-elective above plan).

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

·        A&E was above plan (YTD A&E was above plan).

Total Expenditure

 

£26.6 in month and £211.8m YTD (variance of £0.8m below budget YTD).

Expenditure highlights in month:

·        Drugs £0.1m above budget (£1.2m above budget YTD).

·        Pay £0.4m above budget (£1.0m above budget YTD).

·        Supplies £0.2m above budget (£1.4m above budget YTD).

EBITDA

7.8% YTD

Savings

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

£1.0m CIPS delivered in month against a budget of £1.1m.

£8.6m delivered against a budget of £9.5m YTD (£0.9m below budget).

Debtors

£55.2m debtors and stock

£15.8m above plan

Creditors

£58.8m creditors

£5.1m above plan

Cash

£6.2m (£1.0m under plan)

Loan

No Further Loans Agreed

Reserves

£1.2m

Forecast

£0.2m deficit for the year (£0.8m below plan).

Finance Risk Ratings

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

 

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

 

Financial performance – At month 8 the overall financial performance was behind plan by £421k including Sustainability and Transformation Funding (S&TF) of £5,470k resulting in an underlying position of £5,364k deficit. The reduction in performance was partly due to recognition of the position of S&TF not achieved for A&E performance in July-November equating to £463k. The full year effect had been included in the forecast position which was why the Trust had moved from a planned surplus of £600k to a deficit of £234k.

 

Activity – KJ referred to activity advising that this had risen in November compared to October in elected day case admissions, elected in-patient admissions and outpatient appointments. Activity in A&E, non-elective admissions, elective inpatient admissions and GP referrals, and outpatient appointments was above plan in month. Elective activity had been achieved through the use of both internal and external outsourcing which was currently under review. AGr commented that the number of outliers had come down. 

 

Pay costs – It was explained that Agency Spend continued to be high in line with previous months as a result of covering vacancies and sickness, providing close support and meeting the 4 hour access standard in the Emergency Department, meeting Referral to Treatment targets in Planned Care and staff escalation areas. KJ advised that in month there had been a shift in bank and agency spend which provided better value  ...  view the full minutes text for item 413.

414.

Chair of Finance, Investment & Performance Committee Overview pdf icon PDF 154 KB

Liam Coleman, Non-Executive Director

Minutes:

The Board considered a report which summarised the key issues from a meeting of the Finance, Investment and Performance Committee held on 23 December 2016 which it was considered should be drawn to the attention of the Board covering the following: -

 

·        PFI Business Case

·        Overall financial performance

·        Income and Activity

·        Year End Forecast

·        Creditors

·        Rolling Cash forecast

·        Cost Improvement Programme (CIP) overview

·        Operational Performance report

·        Swindon Community Services

 

RESOLVED

 

that the report be received.

415.

Improvement Plan Update pdf icon PDF 200 KB

Hilary Walker, Chief Nurse

Minutes:

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

 

Arising upon consideration of this item it was noted that the Care Quality Commission (CQC) and NHS Improvement had issued consultation documents on the next phase of Regulation and Well Led / Use of Resources Assessments. CN advised that a report on the consultations would be presented to the Quality and Governance Committee later in the month. However, as referred to above CN undertook to circulate the report and consultation documents to all members of the Board after this meeting for their information and comments.      

 

RESOLVED

 

that the report be received.

416.

Quality Report pdf icon PDF 146 KB

Hilary Walker, Chief Nurse

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 November were as follows: -

 

·        Most recent HSMR = 98.86 (12 month period September 2015 to August 2016)

·        There was 1 case of Clostridium difficile during November 2016, the current rate is 10.05 per 100,000 bed days.

·        1 Serious Incident was reported during November 2016 within Swindon Community Health Services.

·        There are 277 overdue investigations into incidents (by more than 14 days, 236 of these relate to clinical incidents.

·        No Freedom to speak up alerts were received during November 2016

 

Hospital Standardised Mortality Rate (HSMR) – GR flagged that the Trust’s HMSR was 98.86% which was in the mid-range of the 34 Acute Trusts in the former South West Strategic Health Authority Area and in the South of England Area for the period September 2015 to August 2016. It was hoped that following re-basing the HSMR would come down. In response to a question from JS, GR confirmed that the HSMR basing took into account factors such as social, deprivation and population growth.

 

National Falls and Fragility Fracture Audit Programme (FFFAP) – GR highlighted that the FFFAP had been launched. It was hoped that there would be positive outcomes from the programme which would be monitored.

 

Infection Prevention and Control – GR highlighted that Trust attributable clostridium difficile rate was as expected with the year to date rate (to the end of October) being 10.49 per 100,000 bed days with 12 cases being reported. This was above the 9.4 per 100,000 bed days average but was commendable given the position of neighbouring organisations. GR commended staff that were following infection prevention and control processes to contain infection rates.

 

Blood Culture Contamination Rate – It was noted that the Blood Culture Contamination Rate for November was 2.4%. JS referred to the text in the report which stated that i.e. employees with blood hound badges (a personal identifier when obtaining tests) were allowing employees without a badge to use theirs which potentially invalidated the tracing system.  JS questioned whether this was a disciplinary matter. It was explained that it was a matter for the local teams to manage and OF undertook to follow this up to ensure that correct procedures were applied.                 

 

Swindon Community Health Services – HW explained that quality data relating to Swindon Community Health Services was as yet not routinely included in this report. However, HW was satisfied with the work underway to improve quality and that there was oversight of the quality issues.  It was noted that there were areas of concern identified and improvement plans were underway to address these.

 

Cleaning Standards – HW was pleased to report that the overall average cleaning score for November 2016 was 96.8% which was an improvement from October. It was explained that on-going monitoring was robust. At this point in the meeting KM reported that a member of Carillion staff who had  ...  view the full minutes text for item 416.

417.

Chair of Governance Committee Overview pdf icon PDF 171 KB

Nick Bishop, Non-Executive Director

Minutes:

The Committee received a report from the Chair of the Governance Committee which summarised key issues considered by that Committee at its meeting held on 22 December 2016 covering the following: -

 

·        Improvement Plan Update

·        Quality Report

·        Cleaning Report

·        Review of Investigation Processes

·        Clinical Audit Activity Q3 Report

·        Safer Staffing Monthly Exception Report

·        Safeguarding Children 6 monthly update

·        Safeguarding Adults 6 monthly update

·        Code of Governance Compliance update

·        Provider Licence Compliance update

 

In presenting the report NLB commented that the report was self-explanatory but that the areas he wished to highlight were that a report updating on the actions being undertaken to maintain a clean and appropriate environment in managed premises that facilitated the prevention and control of infection had been received. Regular auditing of cleaning standards was undertaken and that Carillion cleaning teams had provided extended cover during the day and an improved ownership of the building zones. Furthermore, the Committee had considered a report summarising the work by the Trust Children’s Safeguarding Forum and had noted that an effective mechanism had been established to lead and direct safeguarding activity across the Trust and monitor performance and progress against agreed actions.

 

Finally, NLB highlighted that the Committee had considered a report on compliance with the Provider Licence and the Code of Governance and that the Trust continued to be in breach of its licence as it remained under Enforcement Undertakings with NHS Improvement. The Committee had noted areas flagged for potential further breach of licence conditions relating to use of resources and ED performance.             

 

RESOLVED

 

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

418.

Operational Performance Report pdf icon PDF 259 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: -

 

Emergency Department (ED) 4 hour standard (95%)  (combined – Emergency Department, Minor Injuries Unit (MIU) & Urgent Care Centre (UCC))

 

November 85.3% (not achieved)

Referral to Treatment +Incomplete standard (92%)

November 92.1% (achieved)

6 Week Diagnostic Wait

November 99.07% (achieved)

Cancer Targets

2 Week Waits, 31 Day & 62 Day

October Achieved

 

In presenting the report, the following points were highlighted: -

 

Emergency Department (ED) 4 hour standard

AGr highlighted that performance against the standard in November was 83.2% against a 92% trajectory. The Board was reminded of the actions planned to address this, details of which were set out in the report.

 

AGr reported that meetings were being held three times a day to consider ways of managing outliers. It had been necessary to cancel clinics and AGr was worried about the impact on Referral to Treatment Times (RTT) performance due to the need to cancel elective activity in order to manage non-elective activity.         

 

AGr highlighted that the performance position had been compounded by a higher number of Delayed Transfers of Care (DTOCs) and general delays. AGr was concerned about clinical outliers and ensuring patients got home as quickly as possible. OF referred to the closure of partner services during the Christmas period which had impacted on the DTOC position. Details of pressures experienced by Trust partners were summaries in the report.  

 

Reference was made to social care provision, noting that patient assessments were being delayed. It was noted that a meeting had been held to look at the work of social workers notably around their face to face work. Whilst there was sympathy with the pressures on social workers in terms of volume of workload, the corresponding impact on the Trust needed to be noted.

 

AGr explained that the 83.2% ED 4 hour patient access standard achievement in November included Urgent Care Centre activity. It was explained that the position was understated by about 3% and the national position for November was 81%.

 

In response to a question from JS around Key Performance Indicators for the Emergency Department, AGr responded that he had yet to review the KPI’s and was looking to include other quality metrics also.

 

In response to a question from RH, it was noted that NHS Improvement would be visiting the Trust to support the Emergency Department performance. AGr commented that it was hoped that re-siting the Ambulatory Care Unit would have a positive impact. Furthermore, there would be improvements in the way the medical take was managed with the establishment of an assessment area. However, there would be resource implications and a phasing in of improvements.

 

Home to Assess

AGr advised that this had reduced over the Christmas period and would be an area of focus for this month. AGr commented that Home to Assess was a good model  ...  view the full minutes text for item 418.

419.

Safer Staffing Monthly Exception Report pdf icon PDF 228 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 November the position was as follows: -

 

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

 

Registered Nurses

Auxiliary Nurses

Day Shift

91.5%

101.6%

Night Shift

103.6%        

99.8%

 

Average skill mix ratio (day): -

Registered Nurse Staff

62.3%

Care staff

37.7%

 

HW advised that there had been an increase in the day fill rate which was positive. HW referred to the context of the report in that the skills mix across Trust wards was normal staffing levels. The Trust had accepted that it would not be able to fill to those normal levels so minimum numbers were identified.  Therefore the Trust was reporting against minimum numbers and not what had been agreed. Also the Board was asked to note that there were a number of additional patients on each ward.  Therefore, the context of the report was that there were fewer nursing staff than had been agreed was required and there were more patients on each ward for those nurses to care for.

 

It was noted that the average skill mix ratio had improved.

 

HW highlighted that a National Quality Board Safer Staffing Guidance had been updated in July 2016. A number of recommendations had been included for ensuring that an organisation had the right culture, leadership and skills in place for safe sustainable and productive staffing. The Trust was compliant with the recommendations except comparing staffing with external peers which would be facilitated by the set-up of the Model Hospital Portal.

 

In response to a question from RH, HW advised that acuity and dependency were factors which had been built in to the national nurse to patient ratio.

 

In response to a question from OF, HW undertook to consider the data sources to advise whether over time was included.      

 

RESOLVED

 

that the report be received

420.

Nursing Workforce Futures pdf icon PDF 184 KB

Hilary Walker, Chief Nurse

Minutes:

The Board considered a report which provided details of development of the nursing workforce over the next two years.

 

HW explained that the report outlined the national and local picture. HW highlighted that the Francis Report, NICE Guidance and other issues had all driven an increase in the number of registered nursing posts required across the NHS and particularly in acute provision. A graph showing the trend in nurse to patient ratio, admissions and length of stay from 2010 to 2015 was set out in the report. HW commented that it was known that activity had increased and that admissions had gone up although length of stay had decreased. HW commented that admissions and discharges were labour intensive for registered nurses.

 

HW highlighted that registered nurses had increased between 2013/14 and 2014/15 although in 2015/16 there had been a decrease due to the introduction of Band 4 Associate Practitioner roles. HW commented on the on-going difficulties in recruiting registered nurses and highlighted that it was worth noting the concerns around the English language test and that the pass rate of 10%. Reference was made to International Recruitment and it was noted that one applicant from India had now joined the Trust but they were not nurse registered yet. OF commented on the resource intensive processes around international recruitment notably maintaining links with interested persons over a long application process. HW highlighted that the Nursing and Midwifery Council (NMC) had adopted the International English Language Test System (IELTS) to assess nurses seeking to work in the UK and had determined that level seven attainment was required across four domains notably listening, reading, writing and speaking; details of which were described in the report. HW advised that the Senior Team at this Trust believed that level seven was not appropriate in that it was too difficult and irrelevant and this view had been shared. However, the NMC had restated their position on this.

 

The report set out retention efforts and training for registered nurses. HW flagged that the demand for nurses outstripped supply nationally. In the Comprehensive Spending Review next year nursing bursaries had changed with the introduction of student loans. It was flagged that applications to date showed a 20% reduction from the previous year for the take up of training places. It was highlighted that the Secretary of State had referred to an opportunity for people to take up an apprenticeship to obtain a nursing degree but as yet it was unclear who would fund the degree and supernumery apprentices.

 

The report set out enhancing the roles of Health Care Support Workers and HW advised that a curriculum had been developed to understand what this role would look like. It was highlighted that there was professional disagreement around the role in that there was little difference in the curriculum between Registered Nursing and the Nursing Associate role. HW commented that the registered nursing workforce needed to look very different in the future. It was explained that plans were in place  ...  view the full minutes text for item 420.

421.

Ratification of Decisions made via Board Circular/Board Workshop

Carole Nicholl, Director of Governance & Assurance / Company Secretary

·        Terms of Reference; Powers Reserved to the Board; Scheme of Delegation; Policy on Policies; Non Executive Director Appointments (Board Circulars refers)

Minutes:

RESOLVED

 

that the Powers Reserved to the Board, the Scheme of Delegation, the Terms of Reference of Board Committees, the Policy on Policies and Non-Executive Director appointments be ratified as per the Board Circular Approvals.

422.

Report from West of England Health Science Network Board Meeting - 7 December 2016 (to note) pdf icon PDF 256 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 December 2016 covering the following: -

·        Highlights of our work in Quarter 2 2016/17

·        Future of AHSNs

·        Stakeholder survey

 

RESOLVED

 

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

423.

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.

424.

Date and Time of next meeting

Date: 2 February 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 2 February 2017 at 9:30am in Trust Management Boardrooms, Trust HQ, 2nd Floor, Great Western Hospital

425.

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

·        Swindon Community Health Services – Due Diligence Report

·        Community Estate – verbal update

·        7 Day Working

·        Wiltshire Health & Care - Update

·        Audit, Risk and Assurance Committee Minutes

·        Charitable Funds Committee Minutes

·        Executive Committee Minutes

·        Finance, Investment and Performance Committee Minutes

·        Governance Committee Minutes

·        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)

·        Swindon Community Health Services – Due Diligence Report

·        Community Estate – Verbal update

·        7 Day Working

·        Wiltshire Health & Care – Update

·        Audit, Risk and Assurance Committee Minutes

·        Charitable Funds Committee Minutes

·        Executive Committee Minutes

·        Finance, Investment and Performance Committee Minutes

·        Governance Committee Minutes

·        Urgent Private Business (if any)

426.

Minutes

Roger Hill, Chairman

·        17 November 2016 (private)

·        1 December 2016 (private)

Minutes:

The minutes of the meeting of the Board held in private on 17 November 2016 and 1 December 2016 were adopted and signed as a correct record.

427.

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. 

428.

Swindon Community Health Services - Due Diligence Report

Kevin McNamara, Director of Strategy

Minutes:

The Board received and considered a report which provided an update on Swindon Community Health Services.

429.

Community Estate - verbal update

Kevin McNamara, Director of Strategy

Minutes:

The Board received and considered a report which provided an update on the community estate.

430.

7 Day Working

Guy Rooney, Medical Director

Minutes:

The Board received and considered a report which provided details of the Trust’s proposal for the delivery of its first phase enhanced 7 day services.

431.

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 which included a performance report.

432.

Audit, Risk and Assurance Committee

Julie Soutter – Committee Chair

·        17 November 2016 (enclosure)

Minutes:

The minutes of the meeting of the Audit, Risk and Assurance Committee held on 17 November 2016 were received. 

433.

Charitable Funds Committee

Steve Nowell – Committee Chair

·        21 September 2016 (enclosure)

Minutes:

The minutes of the meeting of the Charitable Funds Committee held on 21 September 2016 were received. 

434.

Executive Committee

Nerissa Vaughan – Committee Chair

·        20 December 2016 (verbal report)

·        15 November 2016 (enclosure)

Minutes:

The minutes of the meeting of the Executive Committee held on 15 November 2016 were received.  Furthermore, it was noted that a meeting of the Executive Committee had been held on 20 December 2016.

435.

Finance, Investment and Performance Committee

Steve – Committee Chair

·        23 December 2016 (written report)

·        21 November 2016 (enclosure)

Minutes:

The minutes of the meeting of the Finance, Investment and Performance Committee held on 21 November 2016 were received.  Furthermore, it was noted that a meeting of the Finance, Investment and Performance Committee had been held on 23 December 2016.

436.

Governance Committee

Nick Bishop - Committee Chair

·        22 December 2016 (written report)

·        17 November 2016 (enclosure)

Minutes:

The minutes of the meeting of the Governance Committee held on 17 November 2016 were received.  Furthermore, it was noted that a meeting of the Governance Committee had been held on 22 December 2016.

437.

Urgent Business (Private) (if any)

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

Minutes:

None.