MINUTES OF THE 15TH MEETING OF THE COUNCIL OF GOVERNORS OF THE ROYAL DEVON & EXETER NHS FOUNDATION TRUST

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1 MINUTES OF THE 15TH MEETING OF THE COUNCIL OF GOVERNORS OF THE ROYAL DEVON & EXETER NHS FOUNDATION TRUST Held on 10 October 2007 at 1400 in The FlyBe Suite, St James Centre, Exeter City AFC Present: Angela Ballatti - Chairman Public & Staff Governors East Devon, Dorset & Somerset Margaret Green Linda Fryer Christopher D Oyly Steve Rampersad Malcolm Harrington Stan White Trish McKenzie Mid, North, West Devon & Cornwall Ivor Watts Roger Smith Pam Roud Alan Griffiths Appointed Governors Derek Hathaway - Devon PCT Val Dixon Exeter City Council Ray Bloxham - East Devon District Council Roy Lucas North Devon District Council Apologies Sally Morgan Martin Perry Imraan Jhetam Exeter & South Devon Brian Perriss Rachel Jackson Linda Gibbons Miles Kinchin Terry Roberts Andrew Webber Staff Monica Overy - Nursing & Midwifery Brian Croft Hotel & Estates Mike Jeffreys Medical & Dental In Attendance: Angela Pedder - Chief Executive Mike Stevens - Director of Finance & Business Development Pete Adey Acting Director of Operations Tony Taylor - FT Secretary Did not attend Sue Greenall APOLOGIES AND QUORUM CHECK Apologies were noted as listed above. The meeting was therefore quorate MINUTES OF PREVIOUS MEETING The minutes of the meeting held on 11 July 2007 were approved as a true record. MATTERS ARISING There were no matters arising NOTIFICATIONS OF INTEREST Margaret Green (Deputy Chairman of Governors) reported that she had been elected as Chairman of Hospicecare (Exeter & Mid Devon) Stan White (East Devon, Dorset & Somerset) reported that he was a member of the East Devon Voluntary Services Association (EDVSA) Page 1 of 9

2 SECRETARY S NOTES The Secretary reported the following: a. A new list of meeting dates was tabled. This adds three dates to the list issued last month: Wed 14 Nov Tue 5 Feb Wed 10 Sep Wed 8 Oct Development Day at 0930 at St James Centre. Extraordinary CoG in Ctee Rm, NSH from This is a closed meeting for governors only Annual Members Meeting Quarterly General Meeting b. An updated contacts list was tabled to replace the current version in Section 1 of the governors reference file. The Council of Governors noted the Secretary s Notes CHAIRMAN S REMARKS The Chairman started by welcoming our new governors to their first meeting: Kate Caldwell (Exeter & South Devon) Linda Gibbons (Exeter & South Devon) Malcolm Harrington (East Devon, Dorset & Somerset) Mike Jeffreys (Staff Medical & Dental) Pamela Roud (Mid, North, West Devon & Cornwall) Steve Rampersad (East Devon, Dorset & Somerset) Bob Deed (Mid Devon District Council) Roy Lucas (North Devon, Teignbridge & Torridge District Councils) She went on to report that: a. Professor Janice Kay, who was the appointed governor for the Peninsula Medical School, has decided to resign as she feels she cannot give the role the attention that it deserves. We await the nomination of a replacement and once this is made, the Secretary will conduct an election for the vacant appointed governor position on the Nominations Committee. c. Currently 29 out of 31 governor posts are filled. The other vacant post is Staff Governor for Allied Health Professionals. This will be discussed with the existing staff governors about whether there is a need to hold a bye-election or wait until next summer to fill this post. d. On the Trust Board, Mr Pete Adey has been appointed as Acting Director of Operations to stand in for Elaine Hobson while she is on secondment in New Zealand and Australia for the next three months. Mr Adey was formerly the Directorate Manager for Women & Child Health. The Council of Governors noted the Chairman s remarks QUARTERLY PERFORMANCE UPDATE A) Finance Mr Stevens reported a sound financial position for the year to date. The Income & Expenditure variance was 1.1m favourable to budget. Income was 1.3m down on the expected figure but work towards meeting the 18-week target is expected to pick up and recover this. Page 2 of 9

3 43% of brought forward savings, and 17% of the current year savings target had been met. The cash balance was 31.5m and our financial risk rating was assessed as 5 (the best possible rating). The forecast outturn for the end of year is now 6.9m, up slightly on plan of 6.5m. It is expected that the cash balance will be 14m against plan of 9.2m and the forecast underspend on capital will be carried forward to next year. The end of year financial risk rating is forecast at 4. Strategic Investment Fund. The intention to create this investment fund had been included in the Annual Plan. In previous years, any surpluses have been used to repay debt but this year almost 4m will be reinvested in healthcare. The items selected and approved by the Board have been drawn from a list of priorities submitted by governors, members and staff and relate to high visibility strategic objectives. They are of a non-recurring nature, i.e. the spend is for the current year only and not successive years. Release of funds will be dependent on in year finances. The investment items will relate to one or more of the Key Areas outlined in the draft Strategic Directions which will be issued shortly, which are: Improving quality of patient care Eliminating avoidable infection Improving patient safety Improving the environment Staff Development and welfare Reducing waiting Improving efficiency In particular Mr Stevens mentioned the initiative to replace all the hospital beds with new state of the art electric beds, single sex washing facilities and improvements to the main entrance. He concluded with a round-up of capital schemes: Centre for Women s Health complete and operational ICU expansion complete and operational Endoscopy improvements building work complete. Special washer to clean instruments to be fitted in Nov/Dec Liner Accelerator expected to complete Spring 08 Emergency Hub business case to Board in Jan 08 The Governors noted the finance quarterly update B) Performance Mr Adey reported that the Trust had met all the key healthcare targets in the last quarter. There had been just one case of MRSA bacteraemia reported in the quarter bringing the total for the year to date to 8 against a year end target of 20, putting the Trust ahead of trajectory for this target. He confirmed that the postal strike had affected the Trust s ability to contact patients for appointments etc, but a telephone follow-up system had been put in place as a double check where possible. Margaret Green (Deputy Chairman) asked whether Choose & Book had reduced the number of patients who Did not attend (DNA). Mrs Pedder said that there had been a significant reduction in the number of DNAs as a result. Miss Green also asked about C.diff targets. Mrs Pedder replied that national requirement is a data reporting Page 3 of 9

4 remit only, which the Trust is meeting. Locally a target has been agreed with Devon PCT of 1.47 cases/1000 bed days. At present the Trust is running at a rate of 2.19 cases/1000 bed days. By 2010 the national target is expected to be 1.4 cases/1000 bed days. Mr Adey reported the Trust was suffering outbreaks of Norovirus in various wards. The situation was changing daily and affected wards were subject to deep cleaning before reopening. He reiterated that many of the outbreaks had been traced back to visitors bringing the virus into hospital. Miss Caldwell (Exeter & South Devon) was informed that the full range of the diagnostic tests was subject to the current 13-week maximum wait. These were a mix of GP and Consultant referrals. Val Dixon (Exeter City Council) asked if the 13-week target was per test, or, for all tests relating to a patient and was informed it was per test. However in the future, referrals for different tests for the same condition will be subject to one single maximum wait period. Mrs Pedder concluded by advising governors that the Trust had been subject to a random visit by the Healthcare Commission (HCC) to verify submitted data which had confirmed our assessments. The HCC had been very satisfied with the information provided. The results of this year s assessment will be announced next week and governors will be informed as soon as possible. The Council of Governors noted the Quarterly Performance Update FOUNDATION TRUST GOVERNORS ASSOCIATION INAUGURAL MEETINGS Mr Roger Smith (Mid, North, West Devon & Cornwall and Member of the FTGA Executive Council) gave a verbal report on the first meeting of the Executive Council. There would be an associated website ( and governors are encouraged to interact with other governors via the site and ask questions. Only 45 out of over 70 FTs were currently members and recruitment of more was essential. Other items discussed were: Governor training and best practice Rules and Regulations for the Association Formation of working groups LINks -and he encouraged governors to register with that website for LINks bulletins at Consultation document to be issued shortly about governors role in public and patient involvement Creation of the Patient-Citizens exchange (please register onto this website at Lin Fryer (East Devon, Dorset & Somerset) then reported on the first Plenary Meeting of the Association which she had recently attended. A number of items were discussed which would be drawn into one paper and discussed at a forthcoming development day. Action: PM Malcolm Harrington (East Devon, Dorset & Somerset) asked what the purpose of the FTGA was. Mr Smith replied that the aim of the FTGA was to have a uniform approach to matters across the FT sector. He also provided a copy of a letter from the FTGA Chairman to Mr Ben Bradshaw (Minister of State for health) which suggested that the governors should have a statutory role (via LINks) in the inspection and oversight role that LINks will have. This letter is attached to these minutes. The Chairman felt it would be useful to revisit this topic at a development day and asked if the Constitution of the Association could be circulated. Action: TT/RS The Chairman also felt that one size fits all was not necessarily appropriate as there would always be differing needs among FTs. Mrs Pedder reinforced this by adding that the governance arrangements of the FTGA must Page 4 of 9

5 be clear as this would in part influence the links to the various memberships. The Chairman reminded everyone that RD&E governors had only agreed to sign up for one year initially and would need to review benefits and value for money before deciding on renewal. The CoG noted Mr Smith s and Mrs Fryer s verbal briefings on Foundation Trust Governors Association meetings Review of the Policy for the Composition of Non-Executive Directors on the Board of Directors (Version 4) Mr Taylor (FT Secretary) presented this item which was for CoG approval following a review by the Board of Directors. He stated that the only changes were: a. To add marketing as an experience category in paragraph 4b (Commerce) of the policy, and b. To reword paragraph 7 (Term of Office) as follows: Terms of office will be in accordance with the guidance contained in Monitor s Code of Governance The CoG approved Version 4 of the Policy for the Composition of Non-Executive Directors on the Board of Directors RESULTS OF COMMITTEE ELECTIONS Mr Taylor presented this item. Elections had been held for positions on the Nominations and NED Remuneration Committees. The election were required because most existing members of the committees had been in office 3 years (the maximum term) since the creation of the committees in July The committee elections had been delayed slightly until after the results of the annual round of governor elections were known so that candidates were drawn from the new body of governors. The results were: Nominations Committee Rachel Jackson (Exeter & South Devon) Lin Fryer (East Devon, Dorset & Somerset) Roger Smith (Mid, North, West Devon & Cornwall) [elected unopposed] Mike Jeffreys (Staff) NED Remuneration Committee Miles Kinchin (Exeter & South Devon) Pam Roud (Mid, North, West Devon & Cornwall) [elected unopposed] Monica Overy (Staff) [elected unopposed] [Christopher D Oyly (East Devon, Dorset & Somerset) remains in post because he has not served a full 3 years on the committee] The CoG noted the results of the committee elections FACILITIES DIRECTORATE ANNUAL REPORT Mrs Linda Hall (Director of Facilities) gave this report. The key issues she mentioned were: Service developments relating to infection control Preparation for the implementation of cook/freeze patient meals Building works Lessons learned Page 5 of 9

6 Infection control developments have included: New vinyl flooring installed in both hospital streets Special outbreak deep cleaning team established Housekeeper uniforms introduced Patient Action Environment Team (PEAT) awarded a GOOD rating for both sites. A governor was included in the inspection team for the first time External cleanliness audit by staff from Torbay Hospital scored 92.5% Quarterly internal cleanliness audits scored 86%, 91%, 92% and 95% in each of the four quarters which correlates well with the external audit. Change to Cook/Freeze meals: Preparation for introduction took one year 32 surplus catering posts - staff redeployed elsewhere within the hospital Significant electrical work involved Feedback positive food is hot portion adjusted to appetite staff can observe what patients eat Ward housekeepers who serve food receive food safety awareness training Domestic assistants who clean sanitary are not involved in food/drink services Building works: Centre for Women s Health opened in June Expansion of Intensive Care Unit (ICU) Bunker for 3 rd Linear Accelerator Chimney demolition Lessons learned: Fire in housekeeping store on Christmas Eve cost 20k Staff followed fire procedures - no injuries but big clean up Plans for 07/08: Refurbishment of public areas and lifts Improvements to Main Entrance Bird proofing measures Additional cleaning staff for public areas and toilets Greater focus on recycling and green initiatives Christopher D Oyly (East Devon, Dorset & Somerset) asked about the hospital s mobile phone policy. Mrs Hall replied that mobile phones can be used in specifically designated areas of the Centre for Women s Health, and in the ITU relatives room but it was intended to keep the current ban in wards for the time being while the policy is being reviewed. Noise disturbance is one of the most significant problems. Margaret Green (Deputy Chairman) asked about the use of coloured food trays. These are used to identify patients who need help eating. Nursing staff now monitor whether patients actually eat their meals. In addition nutritional advice is provided by Dieticians and Therapists. The CoG noted the Facilities Directorate Annual Report DATE OF NEXT MEETINGS a. Wednesday 16 January 2008 from to be held at the Flybe Suite, St James Centre, Exeter City FC b. Tuesday 5 February 2008 from to be held in the Committee Room, Noy Scott House, RD&E Wonford. This is a closed meting for governors only. Page 6 of 9

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