The Minutes of a Council of Governors' Meeting held at The Learning & Development Centre, Sleaford on Thursday, 24 January 2019 - Lincolnshire ...
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The Minutes of a
Council of Governors’ Meeting
held at
The Learning & Development Centre, Sleaford
on Thursday, 24 January 2019
PRESENT:
Paul Devlin Trust Chair
Debbie Abrams OBE Public – South Kesteven
Milly Allinson Service User/Carer – Service User
Jane Avison Service User/Carer – Service User
John Bains Stakeholder – Healthwatch, Lincolnshire
David Bray Service User/Carer – Service User & Deputy Lead Governor
Cllr Kate Cook Stakeholder, Lincolnshire County Council
Christine Coupar Staff – Adult Community Services
Sophie Ford Staff – Corporate Services
Ingrid Gill Service User/Carer – Service User
Alan Gurbutt Public - East Lindsey
Paul Kenny Public – Borough of Boston
Lisa Leonard Stakeholder – SHINE Network
Linda Lowndes Public – North Kesteven
Pauline Mountain Service User/Carer – Carer
Evelyn Nicholls Service User/Carer – Service User
Lisa Norris Staff – Specialist Services
Cllr Ron Oxby Stakeholder - Lincolnshire County Council
Michael Regan Service User/Carer – Service User
Jacky Tyson Staff – Older Adult Services
IN ATTENDANCE:
Chris Ashwell Divisional Manager, Community Services
Joanna Briley Board Administrator (up to refreshment break)
Mary Dowglass Non-Executive Director
Mark Halsall Head of Quality & Safety
Peter Howie Trust Secretary
Philip Jackson Non-Executive Director
Anita Lewin Interim Director of Nursing, AHPs & Quality
Tim Ludlow Non-Executive Director
Jane Marshall Director of Strategy
Anne-Maria Newham Interim Chief Executive
Karen Scott Assistant Trust Secretary
Andrew (Andy) Spring Member of the public
Samantha Swindell Governor & Membership Officer
Agnieszka Zychowicz Communications Officer
1APOLOGIES RECEIVED FROM:
Liam Cheevers Staff – Adult Community Services
Dr Kevin Hill Stakeholder – Clinical Commissioning Groups
Mark McKeown Service User/Carer – Service User
Emma Reilly Service User/Carer – Service User
Susanne Ridley Staff – Older Adult Services
Susan Swinburn Service User/Carer - Carer
The Trust Chair welcomed everyone to the meeting, and in particular, Anne-Maria Newham,
who would be attending her first Council meeting as the Trust’s Interim Chief Executive, Anita
Lewin, who, since the last meeting had been appointed as Interim Director of Nursing, AHPs &
Quality, and Chris Ashwell, who would be attending the meeting on behalf of the Director of
Operations.
The Chair highlighted that this would be Non-Executive Director, Tim Ludlow’s last Council
meeting before he left the Trust at the end of the month.
CG(19)001 APOLOGIES FOR ABSENCE
These were received as above.
CG(19)002 DECLARATIONS OF INTEREST
Cllr Kate Cook confirmed her membership of Lincolnshire County Council’s (LCC) Health
Scrutiny Committee (HSC).
CG(19)003 MINUTES OF THE COUNCIL OF GOVERNORS’ MEETING HELD ON 18
OCTOBER 2018
The minutes of the previous meeting were approved and signed as an accurate and true record
of the meeting.
The Council RESOLVED:
To approve the minutes as an accurate and true record of the meeting amendment.
CG(19)004 MATTERS ARISING FROM THE MINUTES
There were no matters arising from the minutes.
CG(19)005 SCHEDULE OF ACTIONS
The Council noted that all actions had either been closed or completed since the last meeting.
Any further actions arising from the meeting would be added to the schedule.
Action: Karen Scott
The Council RESOLVED:
To receive the Schedule of Actions.
CG(19)006 BOARD OF DIRECTORS’ MINUTES: 6 DECEMBER 2018
The Council received the draft minutes.
2The Council RESOLVED:
To receive the minutes.
CG(19)007 CHAIR’S COMMENTS
Care Quality Commission Inspection
The Trust Chair highlighted the Trust’s excellent news regarding the results of the Care Quality
Commission’s (CQC) well led inspection of the Trust, which had been carried out in November
2018, the full report for which had now been issued to Governors.
The report was an excellent read and had highlighted the good performance of Trust services
across the board, with previous ‘requires improvement’ ratings for individual areas being re-
rated as ‘good’. Of particular note was that the Learning Disability (LD) service had been rated
‘outstanding’ in the well led domain and given the previous difficult decisions made by the Trust
around this service, this was a strong message.
The Trust’s overall rating had remained ‘good’ and the Council noted that the CQC had not
visited all of the Trust’s core services, however, the next inspection would include an inspection
of those areas not visited in 2018. Following staff’s disappointment regarding their services
not being visited, the Trust was currently in liaison with the CQC regarding an engagement
process which would provide staff with an opportunity to describe their service improvements
with the CQC.
Jane Avison was struck by the positive message of services wanting the CQC to visit them.
The CQC had rated the Trust as ‘outstanding’ for well led, which was an excellent outcome for
leaders of the organisation, and the Chair extended his congratulations to all involved in
achieving this result.
The Chair went on to thank Governors, highlighting that the CQC had recognised how well they
worked together and commented on their effectiveness. The CQC had found Governors’
engagement in the inspection process to be helpful and informative and the CQC was very
positive about the Council.
Acknowledging that this was a great result for the Trust, the Chair stressed that there was
further work to be done and the Trust would continue on its improvement journey.
Board Level Recruitment
The Chair provided the Council with an update on Board level recruitment, commenting that
since the last meeting there had been some significant progress. The Trust had now appointed
Dr Ananta Dave as the new Medical Director and she would commence her employment in
May 2019. The Chair thanked Governors for their involvement in this competitive recruitment
process.
A very robust recruitment process had been undertaken for new Non-Executive Directors
(NEDs) and this would be discussed in more detail under a later agenda item. Once again,
Governors were thanked for their involvement in this.
The process for the recruitment of a new Chief Executive was well under way and there were
further opportunities for Governors to be involved in this.
Referring to the appointment of senior interim posts, the Chair highlighted that these had all
been made from within the Trust through competitive processes and this was another
demonstration of the positive position of the Trust.
3Stonewall Index
The Chair was delighted and proud to highlight the recent news that the Trust had been placed
in the top 100 of Stonewall’s Workplace Equality Index. The index measured the progress of
organisations on lesbian, gay, bisexual and transgender inclusion in the workplace and the
Trust had been ranked 77th, among UK organisations taking part, and 4th in the health and
social care sector.
Alan Gurbutt stated that this result encouraged others to work for the Trust and highlighted that
this important achievement related to other areas of protected characteristic, eg disability.
Milly Allinson commented on the supportive environment within the Trust and the inclusivity of
management.
Pauline Mountain commented on this excellent start to the New Year for the Trust.
The Council RESOLVED:
To receive the verbal update.
CG(19)008 GOVERNOR MENTORS FOR TRAINEE NURSING ASSOCIATES
The Interim Director of Nursing, AHPs & Quality presented the report which outlined the
background which had led to the establishment of the nursing associate role and the Trust
becoming a pilot site for Health Education England (HEE) in January 2017.
The Trust had supported five of its existing staff to access training through the University of
Lincoln and had since supported 14 more staff to commence their training as nursing
associates. Governors were informed that the first group of staff had graduated that afternoon.
Following an issue raised on the Governors’ iLog which suggested that staff did not always
understand the role of the Governor, the report outlined the Trust’s proposal to pilot a scheme
whereby two current trainee nursing associates were linked with a Governor, in order that they
were able to learn from one another and raise the profile of each other’s role within the
organisation. It was suggested that once connected, the member of staff and Governor would
meet up to three to four times a year.
Governors were very supportive of this idea and Alan Gurbutt commented on the benefits of
‘learning by doing’. Michael Regan highlighted that this would be mutually beneficial and
Governors could help staff to understand the Trust’s ethos at an early stage, which should
demonstrate good results.
Milly Allinson asked if there was any potential for group work to be set up rather than having to
make a full commitment throughout the year and the Interim Director of Nursing, AHPs &
Quality responded that this would be entirely feasible as the pilot developed.
The Trust Chair summarised that there was a strong sense that this would be welcomed and
the Trust would develop a robust process through which Governors could volunteer, or register
an interest. Action: Anita Lewin
The Council RESOLVED:
To receive the report.
To approve a pilot learning scheme for Governors to work with trainee Nursing
Associates.
4CG(19)009 CHIEF EXECUTIVE’S REPORT
The Interim Chief Executive presented her first report, following her appointment in December
2018, which provided an overview of the key strategic, operational and performance issues
facing the Trust and a summary of the activities since the last meeting.
Regulatory
Care Quality Commission (CQC)
The Interim Chief Executive formally recorded her thanks to Governors, staff, volunteers and
carers who had provided feedback and shared their views with the CQC during the well led
inspection process. The CQC had commented that the focus groups organised within the Trust
had been the best contingency they had had and had been extremely impressed.
National
NHS Long Term Plan
Following previous delays, this had now been published. The Interim Chief Executive
commented on the aspirational nature of the document and encouragingly, that mental health
featured significantly within it.
The Plan included a guarantee that over the next five years, investment in primary medical and
community services would grow faster than the overall NHS budget, creating a ring-fenced
local fund worth at least an additional £4-5bn per annum by 2023/24.
Encouragingly, mental health featured significantly within the Plan and built on the Mental
Health Five Year Forward View (MH5YFV), proposing to increase the budget for mental health,
in real terms, by a further £2-3bn per annum by 2023/24.
Following the Plan’s statement that by 2023/24, at least an additional 345k children and young
people would be able to access support via NHS funded mental health services and
school/college based mental health support teams, Milly Allinson asked to what extent the
Trust would be involved in this service growth.
The Interim Chief Executive responded that as the Trust currently provided the Healthy Minds
service, commissioned by LCC, it was at the forefront of development nationally.
John Bains asked if there was currently any indication regarding the momentum of increase in
funding for children and young people’s mental health services, referred to within the Plan, and
the Interim Chief Executive believed that this was very aspirational at this stage. Under the
Mental Health Investment Standard commissioners were required to be transparent about
where they were spending mental health funds and would need to start demonstrating the
money flow.
The Trust Chair stated that in due course the Trust would receive more detail about the Plan
and would need to ensure that commissioners were held to account for any references to
mental and health and LD. Trust officers were in discussion with commissioners and NHS
Improvement (NHSI) and NHS England (NHSE) regarding what this meant for the Trust.
Commenting on the reference made to NHS 111 being a single point of access for people
experiencing mental health crisis, by 2023/24, Cllr Kate Cook asked if the Trust could confirm if
call handlers would be trained in mental health, or if a mental health nurse would be in the call
centre, similar to the current situation for the Police control room.
The Trust did not have any further details regarding the plans for this but would try to influence
the conversation to ensure that staff were appropriately trained.
5In response to a query regarding if the Trust had had any involvement in the Library of
Information & Services, developed to provide a central repository of services and functions
across the county, Pauline Mountain was informed that it had and this was an important
development. The Trust would have some responsibility to ensure that this was kept up to date
and further information would be presented to the Governors at either a future meeting of the
Council or the Representation Committee. Action: Jane Marshall
Lincolnshire
Sustainability & Transformation Partnership (STP)
The work to reduce the number of people having to travel out of Lincolnshire for acute mental
health care had been presented to Lincolnshire County Council’s (LCC) Health Scrutiny
Committee (HSC) in October 2018. Key outcomes of this work included:
- The establishment of the ten bedded Psychiatric Intensive Care Unit (PICU) for male
patients had enabled all male patients requiring this level of care to be managed within
the county over the last twelve months, with no out of area placements being made.
- The Psychiatric Clinical Decisions Unit (PCDU), opened in the New Year of 2018,
provided a 24hr assessment period at Lincoln County Hospital to ensure patients were
assessed in a specialist unit, rather than remaining in A&E for long periods of time. In
the first five months of operation, 464 patients had been assessed, with only 18
requiring an admission, demonstrating its success.
- Resource within the Bed Managers Team had been increased in order to provide a
seven day a week service to improve the way patients were supported and planned for.
This increase had led to a reduction in the length of time people were spending out of
county and people spending shorter periods of time in a bed when they did not need
admitting.
System Executive Leaders’ Forum: 26 November 2018
This group of all executive leaders from all seven NHS organisations within Lincolnshire had
now met three times, in a bid to develop the way in which all parties worked together.
At the November session, agreement had been reached to work on developing a set of system
wide commissioning intentions for 2019/20 and the meeting was informed that the Trust’s
Director of Strategy was playing an active role in leading on much of this work. The next piece
of work would focus on bringing mental health patients receiving rehabilitation services outside
Lincolnshire, back into the county, in the same way as for patients at the PICU. Further
updates on these developments would be provided to Governors.
Action: Anne-Maria Newham
LPFT
Flu Uptake - this year the Trust aspired to exceed the previous year’s total, when over 79% of
staff had decided to protect themselves and their patients from catching flu. The figure for flu
jab uptake, within frontline staff, as of 15 January 2019, was 63.73%, which was very positive.
Executive Recruitment Update – building on the Trust Chair’s earlier update, the Interim Chief
Executive thanked Dr Jaz Phull for his contribution as the Trust’s Interim Medical Director,
which he would continue pending the commencement of new Medical Director Dr Ananta
Dave.
With the imminent retirement of Ian Jerams, Director of Operations, at the end of March 2019,
and following a competitive internal recruitment process, the Trust had appointed Chris
Higgins, substantive Deputy Director of Operations, as the Interim Director of Operations, with
effect from 3 March 2019.
Financial – the Trust’s income and expenditure position at month eight demonstrated a net
surplus position of £1.19m, which was £0.16m favourable to plan. This was largely driven by
6underspend within pay and non-pay categories and an unplanned gain on the sale of property
on St Anne’s Road, Lincoln.
The Trust continued to report against its revised financial plan year end surplus of £2.096m,
which included the potential receipt of additional Provider Sustainability Fund (PSF) Incentive
income of £0.68m. Governors noted that this bonus would only be paid if the Trust achieved
the revised financial target at month twelve, and the forecast position was currently in line with
the revised plan.
Pleasing to note was that agency expenditure was forecast to be £1.89m at month twelve,
which was below the planned level of £2.5m and also below the Trust’s full year agency ceiling
limit of £1.99m, set by NHSI.
The Interim Chief Executive commented on the exceptional work to reduce the Trust’s agency
spend and thanked the Medical HR staff for this.
Alan Gurbutt asked if some further information could be provided regarding the age
demographic for East Lindsey and it was agreed that this would be followed up outside the
meeting. Action: Karen Scott/Sam Swindell
The Council RESOLVED:
To receive the report.
CG(19)010 PERFORMANCE ASSURANCE REPORT
The report was presented by Tim Ludlow, Deputy Chair, who confirmed that a more detailed
version of this report was presented to each of the Board of Directors’ meetings and also
discussed by each of the Board’s Committees. He recommended that Governors took the
opportunity to read the minutes of Board meetings, which would demonstrate the robust
scrutiny of the Trust’s performance.
Governors’ attention was drawn to the use of statistical process control (SPC) charts in trend
analysis reporting, which helped to identify variations in performance, what was causing this
variation and the reasons for it. This helped to focus readers’ attention on the main areas of
importance and had been introduced to the Trust’s Board of Directors by NHSI at a Board
development session. NHSI had subsequently been complimentary of the Trust regarding the
speed at which it had implemented this different way of reporting.
The Council noted that if the Trust achieved its Control Total (CT), as it was currently
forecasting to, it would earn a bonus payment from the PSF, and a subsequent extra bonus
payment if the Trust achieved its revised financial target at month twelve.
Tim Ludlow highlighted that the Trust’s positive cash position was due to the delayed capital
projects and that this cash was committed for capital spend.
As reported previously by the Interim Chief Executive, the Trust was performing well against its
NHSI agency ceiling and Governors were informed that the Trust had successfully re-
negotiated the way in which medical agency staff were paid and increased the use of bank
staff.
Extending her thanks for a clear and understandable presentation of the report, Debbie Abrams
asked if it was the Board’s expectation that the red ratings within the financial summary would
become green. Tim Ludlow responded that achievement of the CT was key at the end of the
financial year and as the Trust had committed to over achieve on this, this was what the Trust
would be measured against with a view to receiving additional non-recurrent funding. He went
7on to say that whilst additional money would ensure further investment in services, the Board
had repeatedly stated that patient safety would always be the Trust’s priority.
Alan Gurbutt asked at what point the Trust would know if it had any contingency and Tim
Ludlow responded that this would not be confirmed until February 2019. In December 2018,
the Trust had needed to take a decision regarding whether or not it over committed on its CT,
which would provide a 2:1 bonus payment.
Lisa Leonard asked if the Trust had planned for winter pressures in its costings, eg staffing,
and was informed that this was factored into the Trust’s financial planning on an annual basis,
along with other factors throughout the year.
Mary Dowglass highlighted that many trusts were not achieving their CTs and had in fact
negotiated these down. If fewer trusts achieved their CT, the PSF would be split between
fewer organisations, however, Tim Ludlow stressed that the rules for these payments did
sometimes change.
The Council RESOLVED:
To receive the report.
CG(19)011 COMMUNITY MENTAL HEALTH SERVICE USER SURVEY RESULTS
The Divisional Manager for Adult Community Services presented the report which provided the
Council with the results of the 2018 Community Mental Health Service User Survey and the
actions being taken by the Trust to address the outcomes.
The survey was undertaken on an annual basis by the CQC and the latest results had been
published in November 2018. Responses had been received from a small sample; 32% of
those sent the survey, and included patients who had been in contact with services between 1
September and 30 November 2018.
The Trust had improved in one out of the 28 questions (reviewing care), remained static in 20
and declined in three areas (support and wellbeing).
Overall the results continued to indicate that significant improvement was required in a number
of areas and the Divisional Manager reported that the Trust had been identified as an outlier in
2018 for ‘worse than expected’.
Outcomes for older adult community services were better than for those of working age.
The report provided detail of those areas which would require specific focus (support to find
and keep work, and supporting patients to take part in local activities) and a number of other
general themes where further work was required.
Details regarding the actions being taken by the Trust to ensure improvement were provided
and Governors were informed that positive work had been undertaken by the adult community
mental health teams (CMHTs) to improve patient experience through the use of the Royal
College of Psychiatrists’ Accreditation for Community Mental Health Services (ACOMHS),
which provided a good indicator of the level of quality.
The Older Adult Mental Health division had carried out an immediate follow up to the national
survey, which had concentrated on nine questions and whilst the division continued to theme
the results, the main areas for further development related to people being able to contact the
services, especially when in crisis, and physical healthcare.
8The Divisional Manager confirmed that these had been disappointing results, noting that all
CMHTs had been rated good by the CQC, and the division needed to ensure that it could
improve the survey results in line with this.
Acknowledging that improvements took time to become embedded across services, it was
anticipated that improvements would be identified in the 2019 survey.
Highlighting the changes that had been implemented within the teams, Lisa Leonard asked if
these results had been fed back to GP services and the public and if there was a way of
communicating this information more effectively.
Lisa went on to ask if there was a crisis service and the Divisional Manager responded that
there was, however, demand had far outweighed the commissioned service and there was
insufficient resource. Whilst referrals were made through GPs, people could go through the
Trust’s Single Point of Access (SPA). Lisa suggested that when someone was in crisis they
might not be able to access this service and therefore this might result in presentation at A&E,
which was not ideal.
The Divisional Manager confirmed that the transformation work implemented within the CMHTs
had been communicated to stakeholders, who had also been invited to the Trust’s Continuous
Quality Improvement (CQI) meetings.
Referring to supporting people to find and keep work, Cllr Kate Cook, understood that the Trust
had an Individual Placement Service (IPS) in place and asked what had happened regarding
this. The Director of Strategy confirmed that the Trust had been awarded the funding for this
service and there was an advisor within each of the teams, including people with lived mental
health experience. Unfortunately the community survey had been conducted prior to the
service being expanded.
Milly Allinson referred to information regarding the Trust’s involvement in the establishment of a
hub where people could go to get advice on a range of things, including benefits and work and
the Director of Strategy confirmed that under the Mental Health Crisis Care Concordat, the
Trust had received funding to establish a crisis hub and this would be available to a wide range
of services.
John Bains asked if the survey results took account of peoples’ different expectations and was
informed that this was not the case and was based simply on metrics.
Pauline Mountain asked if the Trust had a formal mechanism by which to refer carers and was
informed that currently it was up to the clinician to decide whether a referral was required and
therefore there was some variation. Pauline went on to ask if there was anything that could be
done to improve this situation and establish something more formal. Trust officers responded
that the facilities did exist but were not necessarily utilised effectively. It was acknowledged
that a better directory of services was required and the Director of Strategy highlighted that
whilst it was not the Trust’s expertise to support carers, it did have access to those that could
and staff were able to refer carers to Carers First.
Linda Lowndes asked who the Trust obtained benefit advice from, highlighting that funding for
Citizens Advice Bureau (CAB) service had recently been reduced. Staff were collaborating
with the Department for Work & Pensions (DWP), but were directly offering advice to people.
Cllr Ron Oxby was able to confirm that the budget for CAB had been recently discussed by
LCC’s Community & Public Safety Scrutiny Panel and was pleased to confirm that funding of
£278k had been agreed.
9Staff Governor for Adult Community Services, Christine Coupar, informed Governors that the
Job Centre had provided training for Trust staff in Grantham and would always offer support in
the case of concern.
Alan Gurbutt stated that there were significant challenges for those in the east of the county
and asked if the Trust had any capacity to promote positive mental health in GP surgeries,
schools, etc, which could help to save money. He was informed that whilst health promotion
was on the agenda, the Trust had to deal with the immediate demand.
Tim Ludlow welcomed comments and views from Governors and confirmed that this report had
not yet been presented to the Board of Directors and would be the subject of robust scrutiny in
due course. The Trust was not happy with these results and acknowledged the need to take
improvement action.
He highlighted that it was not feasible to consider the results in isolation as some of the worst
performing trusts, from a CQC rating perspective, were performing very well in their community
patient surveys.
The Trust Chair commented that these results did not reflect the effort being made by the
teams, but confirmed that a further report would be presented to Governors regarding the
Trust’s agreed actions. Action: Chris Higgins
The Council RESOLVED:
To receive the report.
To receive a further report regarding the actions being taken to address this position.
CG(19)012 DRAFT MINUTES OF A REPRESENTATION COMMITTEE MEETING HELD
ON 10 DECEMBER 2018
The Deputy Lead Governor presented the draft minutes to the Council for information.
The Council RESOLVED:
To receive the draft minutes.
Mr Andy Spring left the meeting for the next item.
CG(19)013 APPOINTMENT OF NON-EXECUTIVE DIRECTORS (NEDs)
The Trust Chair presented the report which outlined the recent recruitment process for three
new NEDs, which a number of Governors had been involved in, and a recommendation to
appoint following this process.
Governors were aware that Tim Ludlow would be leaving the Trust at the end of January 2019
and Mary Dowglass and Malcolm Burch would be leaving at the end of May 2019.
The Nominations & Remunerations Committee had put in place processes to ensure that any
transition between outgoing and new NEDs was managed appropriately and it had been
agreed to bring forward the recruitment process to replace Malcolm Burch and Mary Dowglass,
in order to coincide with the recruitment for Tim Ludlow’s replacement, resulting in one
process.
The Trust had considered an excellent number of candidates and shortlisting had proven
difficult. Fourteen individuals had been invited to the assessment centres and four candidates
had subsequently withdrawn due to personal circumstances. A total of ten candidates were
10assessed, the calibre of applicants being high, and this had resulted in eight candidates being
interviewed. Two of these were specifically for the role of Audit Committee Chair and the
remaining six for the two general posts.
The interview panel had recommended three appointments to the Nominations &
Remunerations Committee, on which it had agreed.
- Sharon Robson, with effect from 1 February 2019 for a period of three years, ending 31
January 2022
- Andy Spring, with effect from 1 February 2019, for a period of three years, ending 31
January 2022, and
- Adrian Carridice-Davids, with effect from 1 February 2019 for a period of two years and
three months, up to 30 April 2021.
The NOMS Committee had suggested a staggered recruitment and given the changes within
the Board of Directors, agreed it made sense to bring forward the two appointments, in order to
create an overlap with existing NEDs.
The Trust Chair highlighted that Tim Ludlow was currently the Deputy Chair and he proposed
to present a report to the Council of Governors’ April 2019 meeting with a recommendation for
a new Deputy Chair. Action: Paul Devlin
Jacky Tyson, who had been involved in the assessment centre, stated how fascinating she had
found the process and encouraged colleague Governors to become involved in future similar
opportunities.
The Trust Chair commented on how smoothly this recruitment process worked, which had
been used for some number of years within the Trust, and informed Governors that NHS
Providers had indicated it wished to utilise this for involving governors.
Lisa Leonard extended the Council’s thanks to Trust staff for their organisation of the process.
The Council RESOLVED:
To unanimously approve the appointment of Sharon Robson, Andy Spring and Adrian
Carridice-Davids, as outlined above.
Mr Andy Spring returned to the meeting.
CG(19)014 REVIEW OF TRUST CONSTITUTION
The Trust Secretary presented the report which provided the Council with further information,
on which to reach a decision on the proposal to merge the Older Adults and Learning
Disabilities Carer classes into the main Carer class. This proposal would afford all members
the ability to elect representative governors at the next election, as currently there were no
elected representatives within the Council of Governors for the forty to fifty members of these
classes.
Following the Council’s meeting in October 2018 and a request to provide further information to
determine if the current carer classes were sustainable and fit for purpose, a presentation had
been made to the Governors’ Representation Committee.
The Trust Secretary highlighted that the Constitution could be amended at any point and was
reviewed annually.
11At its meeting in December 2018, the Board of Directors had been supportive of the proposed
change, however, agreement from the Council of Governors was also required.
Recognising that in the event that the proposal was agreed, someone who came forward for
nomination could represent the whole class, Pauline Mountain expressed some concern that a
merger might do a disservice to LD members. She asked if there was any way in which this
group could be uniquely identified within the general Carer class.
Milly Allinson asked if there was any way of implementing a feature that could prioritise anyone
with LD in order that they could be referred to people with LD experience.
Highlighting that the Trust had not been able to recruit anyone after six years, Michael Regan
asked what the likelihood was of someone coming forward. He suggested that as part of the
advertising for governor elections, the Trust could ensure that the narrative included that the
Trust was looking for someone who could learn about LD as well as potentially have existing
LD experience.
The Trust Secretary confirmed that when the Trust was recruiting, it could ask people to
comment on particular aspects of the role and also specify that it was looking to recruit for
carers across the whole range of services. He went on to state that more detail regarding
equality and diversity could be included in the governor recruitment.
Pauline Mountain asked if the merged class would be called ‘General Carer Class’ and the
Trust Secretary responded that this was the generic term used.
Jacky Tyson highlighted that there was already a buddy system within the Council of
Governors, covering all of these categories, and there were lots of people who could offer new
governors support.
Lisa Leonard suggested that as carers were busy caring, they did not have the time to attend
meetings, etc, and therefore did not stand for election and the meeting was informed that the
Trust’s Involvement Team was working to involve Governors in other involvement forums.
The Chair commented that whilst this situation might not be ideal, it was a fact and suggested
that the Council should approve the recommendation and at the point of the annual
Constitution reviews, review if the membership landscape had changed sufficiently to warrant
further change.
The Council RESOLVED:
To approve the proposal to merge the Older Adults and Learning Disability Carer
classes into the general Carer class.
To review the position during annual reviews of the Trust Constitution.
CG(19)015 ANNUAL QUALITY REPORT BRIEFING
The Head of Quality & Safety presented the report which updated Governors on the process
for producing the Trust’s annual Quality Report and provided an overview of the report plan for
comment.
The draft report would be available from April 2019 for consultation and stakeholders would be
able to access a copy, via a web link, in order to provide feedback and comment. The final
report would be submitted for sign off by the Board of Directors at its meeting in April 2019 and
was required to be submitted to NHSI and the Department of Health (DoH) by 29 May 2019.
12The Council of Governors had previously approved the two nationally mandated indicators for
2018/19 and whilst NHSI had not yet published the detailed guidance for external assurance on
quality reports, the mandated indicators were not yet confirmed. It was therefore assumed, at
this stage, that there would be no change to the choice of reporting and following this approach
required the recommendation to Governors to select the same two mandated indicators in
2019/20, namely:
- The proportion of people experiencing first episode psychosis or ‘at risk mental state’ who
wait two weeks or less to start NICE recommended package of care, and
- The total number of bed days patients have spent inappropriately out of area.
The report set out a further recommendation for Governors to select one local mandated
indicator, this being:
- To increase the accuracy and quality of recording restraint incidents.
This would support the work of the Trust in the reduction of restraint in inpatient areas during
2019/20.
The Head of Quality & Safety highlighted that consultation on the Trust’s quality priorities for
2019/21 had commenced at the joint Council of Governors & Board of Directors’ meeting in
November 2018, and this process had continued by publishing the draft priorities on the Trust’s
internal and external web sites and via social media, in order to collect the view of patients,
carers, staff and stakeholders.
Feedback on the priorities was required by 3 February 2019 and any comments should be
provided to the Head of Quality & Safety. It was agreed that a ‘click email’ would be sent to
those members of the Trust with an email address. Action: Sam Swindell
Cllr Kate Cook asked if the Community Mental Health Survey results would be factored into the
quality priorities and was informed that the survey would be one measure within priority Patient
Experience Q4.
Governors were informed that the draft report would be presented to the Council’s meeting in
April 2019 and the Trust Secretary confirmed that a formal letter from the Council was provided
for the finally submitted report. Action: Mark Halsall
The Council RESOLVED:
To receive the report.
To approve the two nationally mandated indicators, as set out above.
To approve the local mandated indicator, as set out above.
To receive the draft Quality Report at the April 2019 meeting.
CG(19)016 QUALITY COMMITTEE ANNUAL REPORT 2017/18
As Quality Committee Chair, Mary Dowglass presented the report which provided a summary
of the Committee’s work during 2017/18, highlighting that this did not cover the meeting held in
November 2018, due to reporting timescales.
Governors were informed that deep dive exercises had been developed throughout the year
and had been extremely valuable.
13With regard to the future and in light of the CQC’s well led rating of the Trust, Mary explained
that she was minded to review ‘co-production and involvement’ to see how this could be
applied to the Committee structure and, in particular the Quality Committee.
The Council RESOLVED:
To receive the report.
CG(19)017 FINANCE & PERFORMANCE COMMITTEE ANNUAL REPORT 2017/18
Finance & Performance Committee Chair, Philip Jackson, presented the report, highlighting
that this was another vehicle by which the Governors could hold the NEDs to account for the
performance of the Trust.
The report focussed on those areas of assurance provided to the Board of Directors and the
Council was informed that whilst the self-assessment undertaken by the Committee had been
very positive, it had also identified some areas for improvement and action had been taken
address these.
The Council RESOLVED:
To receive the report.
CG(19)018 GOVERNORS’ ACTIVITY REPORT
The Governor & Membership Officer presented the report which set out the substantial
engagement of Governors in undertaking their duties to hold the Board to account and to
represent the members and wider public.
Governors had undertaken significant work to determine the recruitment and selection of new
NEDs, contributed to the Trust’s CQI programmes, service user engagement, recruitment of
staff and equality and diversity work.
The Council RESOLVED:
To note the report.
CG(19)019 THE iLOG
Governors were presented with the quarterly iLog report and welcomed the revised format. It
was noted that all of the year to date entries had been included as the new format enabled the
results to be identified better.
The Council RESOLVED;
To note the report.
CG(19)020 ANY OTHER BUSINESS
020.1
The Interim Chief Executive informed Governors that the Trust had had to temporarily close
Carholme Court and the PICU, due to the detection of Legionella, following routine water
sampling.
Assurance was provided that the systems in place to detect this had been effective in
identifying this issue, and as soon as this had been highlighted, the Trust had responded
quickly.
14As a result of the necessary temporary closure of the affected buildings, patients from the PICU
had been moved to alternative safe and appropriate accommodation, outpatient clinics had
been relocated on the St George’s site and staff had moved to other Trust locations, including
Trust headquarters.
Testing of all patients, and those staff who had wished to be tested, had not detected any
cases of Legionella.
The Trust had informed its regulators of the incident who had been happy with the Trust’s
approach to, and handling of, the situation.
Governors were informed that this issue was due to low water pressure and water pumps had
been ordered and would be installed by mid-February 2019. It was noted that following
installation works, robust water testing would be required over a number of weeks and
therefore it would take some time before the buildings could be re-opened. The Trust was
extremely clear that it would compromise patient and staff safety.
020.2
The Trust Chair highlighted that this would be Tim Ludlow’s last Council meeting prior to him
leaving the Trust at the end of January 2019.
Tim had been the Audit Committee Chair for his five and half years’ service and had set the bar
extremely high for his successor, Andy Spring. A number of Governors had worked with him
for a long time.
The Trust Chair highlighted that it was not only Tim’s financial acumen which had been so
valuable, but his ability to explain things in a way that others, without that financial knowledge,
could understand.
His role as Audit Committee Chair had not simply focussed on the financial aspects of the
Trust, but also on his ability to ensure that the Committee had scrutinised the quality aspects
too, which had enabled the Trust to have such strong audit reports.
Tim’s level of scrutiny as a NED had been exemplary and he had always provided Directors
with his questions in advance of meetings, which had been very supportive of colleagues and
was well received.
The Trust Chair had also welcomed Tim’s sense of humour and would miss him very much.
Tim responded that he had enjoyed his time with the Trust and he had learned much from
Directors and Governors. He hoped that other might have learned from him. He wished the
Trust well for the future and hoped it would continue to thrive and flourish.
CG(19)021 DATE & TIME OF NEXT MEETING
There would be an extra ordinary meeting of the Council on Thursday, 28 February 201 at
10.00am, at the Think Tank, Ruston Way, Lincoln, LN6 7FL.
The next ordinary meeting would be held on Thursday, 11 April 2019 at 4.00pm, at The
Learning & Development Centre, Unit 3, The Reservation, East Road, Sleaford, NG34 7BY.
15There being no further business the meeting was closed.
Signed: ………………………………………………….
(Chair)
Date: ……………………………………………………..
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