Board Meeting: 21 September 2011

SUMMARY REPORT

Chief Executive’s Report

EXTERNAL

Hertfordshire Community Trust
The Community Trust continues to pursue its future as a Foundation Trust and is currently advertising for a new CEO, Director of Finance and Director of HR.

Reform: Health and Social Care Bill
The Bill has now moved on to be debated in the House of Lords. New amendments to the Bill in the committee and report stage have clarified the “failure” regime whereby trusts would be put into administration.

SHA Clusters
On 3 October 2011 the current SHAs will move to four cluster organisations:

  • London: Chief Exec Dame Ruth Carnell, Chair Mike Spyer
  • North of England (comprising North West, North East and Yorks &Humberside): Chief Exec Ian Dalton, Chair Kathryn Riddle
  • Midlands & East (West Mids, East Mids & East of England): Chief Exec  Sir Neil McKay, Chair Sarah Boulton
  • South of England (S.West, S Central and S East Coast.): Chief Exec Sir Ian Carruthers, Chair Dr Geoff Harris.

These areas will also provide the initial footprint for the NHS Commissioning Board’s commissioning sectors from April 2013.

Norfolk and Suffolk Mental Health Services Proposed Merger
The proposed merger of Norfolk & Suffolk Mental Health Services remains the subject of much debate.  The Competitions Panel’s initial response to this proposed merger suggested that it should not go through because of the lack of competition for these services in the area.

INTERNAL

Leading By Design
The Board noted the progress being made in the key areas of this programme including:

  • Single Point of Access currently being trialled in Stevenage and as we learn from this experience further trialling and testing will take place over the Autumn in Watford/Three Rivers and Bishops Stortford and Cheshunt
  • Recovery Care Pathways a number of these pathways are about to be trialled across services in Hertfordshire.
  • Estates the Kingsley Green new build planning remains on track.  Poplars (Norfolk) design is nearing conclusion with completion in the autumn of 2012.  Hubs and Spokes is near conclusion and an outline programme of estates rationalisation over the next three years is being developed.
  • Bed capacity much work has been undertaken to determine future bed capacity requirements and locations.  Agreement with Commissioners on this matter is expected by end September and will then require future consultation with key stakeholders.

Big Listen Event
On 9 September 2011 the Trust held the second Big Listen Event for its staff.  Feedback has been very positive.   Part of the session was “meet the Executive Team Unscripted” which allowed front line staff to ask questions of the Exec Team in relation to concerns or areas of improvement.  Staff also had the opportunity to leave video messages in the form of a Big Brother diary which will be reviewed by the Exec Team.  These Big Listen events will become a regular feature and will be complimented by Little Listens which will be held locally within services using a similar format.

Annual Members Day
This is scheduled for 8 October at Campus West, Welwyn Garden City.  The event has been widely publicised and invitations sent to all key stakeholders.  Appointed and public Governors have been involved with the organisation of the day which will include workshops, information about HPFT as well as entertainment for those attending.  As the event is being held on a Saturday it is hoped to attract a wide audience and will also act as the launch for all our events in the following week celebrating World Mental Health Day.

Annual Plan
Our Annual Plan has been accepted by Monitor and we have been notified that our risk ratings are 3 for Finance and Green for Governance. 

Performance

1  Q1 2011/12
Key areas raised as requiring additional focus are:

  • Adults on CPA with a Care Review
  • IAPT Performance (Quality Schedule)
  • Sickness & Mandatory Training performance

Service Streams have provided actions to address all these areas.

2  Finance/Cost Improvement Programme
The position on Trust’s budgets to 31 August 2011 shows a slight shortfall against the plan.

  • Social Care Secondary Commissioning August showed a slight deterioration in the run rate due to an increase in placements
  • Health Care Secondary Commissioning pressure continues in relation to medium and low secure/rehab adult mental health services
  • LD and Forensic Services some improvement in August resulting to a broadly breakeven position for the month
  • Specialist Services cost pressures continue on dementia drugs and this is being followed up with Commissioners

The CIP run rate is behind target and in order to provide further assurance that schemes are on track and opportunities recognised and actioned, the CIP status is being monitored on a weekly basis by the Executive Team.

Service User Survey
The CQC have published the outcomes of the service user survey. The Board was disappointed with the Trust performance which was generally average overall. An updated report will be presented to the November Board for further discussion.

Information Governance
Good progress has been made on the action plan towards reaching Level 2 by March 2012.  To support our self-assessment of progress external IG auditors will review our progress in October 2011.

CQC Inspections
The Board noted that following safeguarding issues within the learning disability services on the Kingsley Green site, staff have worked extremely hard with the CQC who have carried out a review of the service. We have now been advised by the CQC that we are fully compliant with ‘no concerns’.  The reports will be published on the CQC web site.  This situation also affected our statement concerning compliance to Monitor. The timing was such that whilst we reported in our self-assessment for Q1 to Monitor the concerns of the CQC we were also able to report a return to full compliance prior to the risk rating for Q1 being published. This has meant that we have remained at a “green” rating for Governance.
Regular inspections by the CQC at other sites eg Stamford Avenue, have not highlighted any concerns to date.

Executive Team Structure
Following the decision of the Executive Director Service Delivery and Transformation to retire at end of March 2012, the current Executive Team arrangements have been reviewed.  The Board noted the process underway to recruit to the new structure.
The Board noted the appointment of Anni Hartley-Walder to the Director of Transformation post on a 2 year fixed contract and will formally take up the post in mid October.
The Board was reminded of the current review of the remainder of the operational structure in line with the Leading by Design programme which will be through Strategic Business Units, each managed by a Managing Director supported by a Clinical Director. Interviews for these posts are scheduled for mid-October.

Patient Safety Q1 2011/12
The Board discussed the overview report on patient safety issues during the first quarter of 2011/12 and was pleased to note that overall the number of SUIs has declined. Also discussed was an appendix on  Whistleblowing which clarified the role of the Whistleblowing Champion; the Board agreed that there will be quarterly meetings of the Strategy Group which includes the Head of Patient Safety, Risk Manager, Senior HR Manager together with the Whistleblowing Champion.

Quality Report Q1 2011/12 (report attached)
The Report summarising key events in Q1 in terms of quality of services provided by the Trust was discussed. The Board was interested to hear about the new electronic system for capturing feedback from service users Meridian.

Customer Experience Report Q1 2011/12 (report attached)
The report giving an overview of service user and carer experience within the Trust for the first quarter was noted. The Board found the new format of the report to be helpful and suggested that the report should be shared with the Governors’ Quality Group.

Chair’s Action
The Board ratified Chair’s Action taken to approve release of funding in order to progress with the first phase to support delivery of the Single Point of Access programme.
The Board ratified Chair’s Action taken to approve a new Mental Health Act Manager.

Date of Next Meeting: 19 October 2011