MINUTES OF MEETING - NHS Foundation Trust · MINUTES OF MEETING ... (IQPR), produced on a ... if...

of 14 Trust Board Meeting - Public Session 26.02.15

MINUTES OF MEETING

Meeting: Meeting of the Board of Directors in Public Session

Details: Thursday 26th February 2015

12:30 hours, Meeting Room, Durham Dales Centre, Stanhope

Present:

Mr A J G Winter, Chairman Mr J Fitzpatrick, Non-Executive Director Ms W R Lawson, Non-Executive Director Mr P Wood, Non-Executive Director Mrs H Tucker, Non-Executive Director Mr D Taylor, Non-Executive Director Mrs Catherine Young, Non-Executive Director Mrs Y Ormston, Chief Executive Mrs J Baxter, Director of Clinical Care & Patient Safety Mr R D French, Director of Finance & Resources Mr P L Liversidge, Chief Operating Officer Mrs N Kenny, Associate Director of Strategy, Contracting & Performance and Interim Director of Workforce and Organisational Development Mr K Han, Medical Director

In attendance: Miss K Douglas, Governance Manager Mr M Cotton, Assistant Director of Communications & Engagement Mrs G Elsender, PA to Chairman and Chief Executive (Minutes) Mrs J McKenna , Public Governor, Teesside Members of the Public

No. Action by

1. Apologies

There were no apologies

2. Declaration of Interests

There were no declarations of interest on this occasion.

3. Open Forum

The meeting was attended by over 30 members of the public who were given the opportunity to ask questions regarding the Trust, the detail of which is presented below.

Question raised by Julie Pӧrksen, Liberal Democrat candidate for Berwick. Does the Trust capture times from when the first call is received to the arrival time of each type of NEAS response including first responder, community paramedic and ambulance crew and is the Trust prepared to publish the data for Northumberland and rural Durham for the previous year as well as on an ongoing basis as the situation in rural areas is not reflected in the target times that are issued?


The Chief Operating informed the group of the different categories of calls/response times:

R1 and R2 – life threatening 8 minutes

R19 –19 minutes

G2 – 30 minutes

G3 – 60 minutes

GP Urgents Red calls have nationally commissioned targets of which the Trust is commissioned to meet those targets 75% of the time within 8 minutes. R1 – the clock is started as soon as the call is received and will stop as soon as the first resource arrives on scene. R2 – the clock is started as soon as the vehicle is dispatched or 60 seconds default after the call is received and will stop as soon as the first resource arrives on scene. R19 - the clock is started as soon as the vehicle is dispatched or 60 seconds default after the call is received and will stop as soon as the first resource arrives on scene. The national commissioned target is 19 minutes - 95% of the time. G2 and G3 are based on the same principal as R2 All vehicle data is recorded and all individual responder’s times attending to a call are recorded separately (multiple times). It was clarified that if a Community First Responder is first on scene, the clock would stop. From that point onward it refers to R19 (as above), back up vehicle is measured as 19 minutes 95% of the time. The data is made public via Trust Board meetings through the Integrated Quality & Performance Report (IQPR), produced on a monthly basis. As per the Ambulance Quality Indicators, it is the first resource arriving on scene that can stop the clock for a measurement of performance.

Concern raised by Clement O’Donovan. Mr Donovan was a Community First Responder up until last year; however two weeks prior he was a recipient of the service, when rushed to hospital. He stated that the quality of service that he had received was exemplary. He wished to note his concerns regarding the ambulance provision in rural areas and hoped for genuine consultation with the cultural and community needs of rural areas taken in to consideration. The Chair explained that the Trust was only one part of the whole service and that Commissioners needed to be aware of these concerns also.

Councillor Anita Savory – Durham County Council Independent Group Councillor Savory briefed the group regarding the on-going debate for the provision of an ambulance for Weardale stating that residents have voiced opinions over distances from Weardale to Darlington Memorial Hospital (DMH) and University Hospital of North Durham (UHND). She spoke of the geographical area and narrow highways. The Councillor then spoke of a specific incident from 3

rd January 2015 which detailed the time line of a patient

requiring ambulance provision which resulted in the air ambulance being called. The crew that also arrived on scene had travelled from Stockton. Regrettably the patient did not survive. She expressed concern of both Weardale and Teesdale areas being left without an ambulance. She requested that an ambulance be stationed in Weardale in order for ambulance response times to be met to reassure both residents and visitors of Weardale that there is adequate ambulance provision should it be required.

The Chair advised that individual cases could not be discussed however the Chief Operating Officer addressed the group, by firstly expressing his sympathies for the family concerned. He advised that group that rural ambulance provision was a challenge and much debate had taken place to ensure that ambulances are used appropriately in the area. He advised of the ongoing work regarding Integrated care and Transport (ICaT) and the Trust trying to get the buy-in from other NHS providers as well as form Commissioners. The group were advised that approximately 10% of activity related to life threatening calls.


This left approximately 90% of calls which could be serviced by alternative pathways of care, and providing an additional ambulance may not be the ultimate solution.

In response to Councillor Savory requesting a written response relating to the location of ambulances on the 3

rd January, the Director of Clinical Care & Patient safety advised that

a full investigation on the incident was underway and the complainant would receive the response accordingly.

Tony Cooke – Dales Ambulance Monitoring Group Mr Cooke referred to his recent experience and felt that there needed to be more joined up working between of health service providers to ensure that the right type of vehicles are dispatched to varying incidents.

Joy Urwin – Dales Ambulance Monitoring Group Mrs Urwin briefed members of the history of the group and referred to the geographical area of Weardale, paying particular attention to the distances of the nearest hospitals. She referred to the receipt of ambulance data which had been withdrawn since December 2014 and asked for the data to be reinstated to the ambulance monitoring group.

The Associate Director of Strategy, Contracting & Performance addressed the group, advising that the process and type of data that could be provided was currently being reviewed within the Trust. The Chief Executive also offered to meet with Mrs Urwin on a one to one basis to fully understand the local issues and discuss what kind of data would be most beneficial.

Tom Nattress – Resident of Eastgate Mr Nattress informed the group that the Trust was currently trailing a co-responder scheme with the Fire Service and questioned whether the fire service. He questioned that if the scheme was successful would form part of the first response team therefore affecting the ambulance provision within the dales.

The Chief Operating Officer addressed the group. He confirmed that there was a participating co-responder scheme in Stanhope. He advised that this was an additional resource and not a substitute. It was noted that although a co-responder could attend to an incident there would always be a secondary response / backup provided by the ambulance service.

The Director of Clinical Care & Patient Safety also added that the Trust was working with Commissioners to transform the provision of emergency care. The Trust was keen to introduce the role of an Advanced Practice Paramedic which would reduce the need for conveyance to hospital.

Sandra Thompson – Stanhope Parish Council Ms Thompson spoke on behalf of a user of the Patient Transport Service and the difficulties they were experiencing with regard to booking transport. A letter detailing the individual concerns was handed to the Board. This would be responded to through the normal complaints procedure.

Mike Urwin – Dales Ambulance Monitoring Group Mr Urwin referred to ‘right care, right time, right place’ and suggested that one service model does not fit all, especially for rural patients.

The Chief Operating Officer advised that there was a different operating model to take account of the needs of patients in rural areas, compared to the needs of patients in urban areas and this model would hopefully decrease the need for hospital. By providing local


enhanced care within the rural area, this would result in keeping the ambulance resource within the area to respond to life threatening calls.

Jean Heatherington - Dales Ambulance Monitoring Group Mrs Heatherington raised her concern regarding the removal of the dedicated Double Crewed Ambulance (DCA) 24 hours provision for Weardale. The concerns were noted.

Stanley Bell – St Johns Chapel Mr Bell referred to the ambulance base at St Johns Chapel and questioned future plans. The Chief Operating Officer advised that there were no plans with regard to physical resources other than the refurbishment of the sluice room.

Cliff Dalton – resident of Weardale Mr Dalton referred to the current provision of the DCA in Weardale which was introduced following a clinical safety review in 2008/09 and his understanding that this provision could not be removed without public consultation. Mr Dalton asked for assurance form the Board that this arrangement would not be changed without full public consultation including a meeting with the public from the dales.

The Chief Operating Officer explained that the implementation of the DCA was at the request of the Durham Primary Care Trust (at the time), who commission the service. The Clinical Commissioning Group (CCG) is now reviewing that model. A clinical senate has been organised with an evaluation being undertaken evaluating a DCA versus as crew consisting of one paramedic and one emergency care technician. The CCG is leading on the review and following the outcome of the evaluation further discussions will be held with the CCG.

Julie Pӧrksen - Liberal Democrat candidate for Berwick Miss Pӧrksen expressed some concern regarding a number of responses that had been provided and questioned the Trusts internal procedures for dealing with service failures or incidents.

The Chief Operating Officer assured the group that internal investigations were implemented for reasons other than complaints from service users. The Director of Clinical Care & Patient Safety advised the group of internal procedures that are carried out within the Trust detailing the following:

Incident reporting by external reporting or by Trust Staff via Ulysses electronic reporting system

Clinical Audit of incidents not reached with 8 minutes or 19 minutes target

Trust obliged to be open, honest and transparent under the Duty of Candour

It was noted that if an incident is raised by a person or organisation other than the patient, consent is needed from the patient before an investigation can be carried out.

The group were informed that changes are made to practice as a result of learning from listening. It was also reiterated that every effort is made to retain resources in the dales. When a resource does have to travel out of the area to a hospital, this resource is not called upon on the return journey (unless it is a life threatening call).

Janet Lonsdale In response to Ms Lonsdale’s question regarding cost cutting, members were advised that there was no cost cutting exercise with regard to ambulance provision within the dales.

Nigel Mitchell - Dales Ambulance Monitoring Group Mr Mitchell referred to the new Emergency Care Clinical Manager (ECCM) role and


questioned whether there would be a reduction in frontline paramedics as a result of implementation.

The Chief Operating Officer briefed the group on the role of the ECCM and the model that was to be implemented with an investment of £2m, giving assurance that overall service provision would not be affected. This investment would allow the Trust to develop, coach and mentor staff. It was confirmed that the ECCM would be a third person to the crew in order to maintain clinical competency.

Joy Urwin – Dales Ambulance Monitoring Group Mrs Urwin reiterated the point that lessons must be learned from serious incidents to prevent a reoccurrence.

The Chair thanked the members of the public for their contribution and for presenting their questions to the Board first hand which had proved to be very valuable.

The Chief Executive reiterated the importance of working with local communities to understand the pattern of provision in different areas and was willing to meet with the Dales Ambulance Monitoring Group on a more informal basis.

Y Ormston

Following the open forum debate it was agreed to discuss Item 14 on the Agenda first.

4. Minutes of the Trust Board Meeting held on 29th

January 2015

The minutes from the previous meeting held on the 29th January 2014 were agreed to be a

true record with the following amendments: Item 16.i Board Assurance Framework (BAF) should read ‘2014/15’ and not ‘2014/25’. The BAF would be presented to the Board on a monthly basis and not quarterly. Item 20.i Should read Ray Stephenson and not Stevenson.

5. Action log

The contents of the Board Action Log were reviewed, updated and its on-going development was noted.

Actions 6, 8, 9, 11 and 12 were closed out. Action 7 – Staff Assaults The Chief Executive advised that this was still being investigated and an update would be given at the next Board meeting in March. A Non-Executive Director suggested reviewing the Lone Worker Policy as part of the process.

6. Matters arising

Whilst discussing Action 7, a Non-Executive Director noted that assaults on female paramedics were four times more than those of male and questioned the possible reason for this. The Director of Clinical Care & Patient Safety advised that females were more likely to report an assault.

Quality, Safety & Patient Experience

7. Staff or Patient Story

Evidence of one compliment and one complaint for Emergency Care was provided. As stated at the previous meeting the learning from each incident was added to the


documentation of the report. Members reviewed the patients’ experience.

The patient’s experience was discussed with the following learning being noted: Complaint to Emergency Care Service

Local resolution meeting held with the Head of Clinical Care & Patient Safety which the complainant found really helpful

Dispatch officer received coaching and wider learning with that learning being shared across the whole of the Dispatch Team – not learning in isolation

Working closely with Commissioners with regard to Special Patients Notes to ensure that patients with care packages in place are known to the Trust which will help in triage

introduction of prioritising elderly patients- specifically over 65 who may be outside

In response to a question from a Non-Executive Director, the Director of Clinical Care & Patient Safety advised that the complainant had received formal notification of the learning that had been implemented and that the Board were receiving the report for information. They did not expect a written response from the Board.

A Non-Executive Director questioned the process for auditing the dispatch induction being mindful that a number of complaints relate to incorrect dispatch. The Director of Clinical Care & Patient Safety advised that emphasis was now being placed on all staff receiving identical coaching and training and that themes and trends would be picked up via the Ulysses system. It was noted that dispatch staff now attended the Trust Corporate Induction.

Compliment to Emergency Care

Following feedback from crews the Complaints Team would change its name to the Patient Experience Team. The change would be communicated throughout the Trust. The Director of Clinical Care & Patient Safety had been working very closely with the Chief operating Officer to ensure that individuals concerned receive a personal letter and that it is communicated and celebrated via the Communications Team.

M Cotton

The Chair reiterated the importance of celebrating a received compliment. It was also noted that as many compliments as complaints were being received.

A Non-Executive Director questioned how the compliments were shared; paying particular attention to the one in the report, stating that this was an exemplary example. The Director of Clinical Care & Patient Safety advised that she was working with the Communications Team to promote ‘Good News’ stories which would include interviewing the individuals.

The Assistant Director of Communications & Engagement added that the stories were also being added to the Team Briefing newsletter as well as being communicated through the joint Senior Manager and Executive Team Briefings which are held at ambulance headquarters one week after the Trust Board.

The Chief Executive felt that there need to be more external public relations and had experienced extreme gratitude and thanks from patients whilst out on observations.

Jeff Fitzpatrick, Non-Executive Director questioned the progress of public relations and reporting of said items being mindful of recent capacity issues in the Communications & Engagement Team. The Assistant Director of Communications & Engagement advised that pressure had eased and the latest edition of Ambulance Matters had been emailed out that morning. The Board were advised to contact the Assistant Director of

All to note


Communications & Engagement if they had not received the email and they would be added to the distribution list.

8. Learning From Listening

The report provided the number of complaints received from the 1st to 31

st January 2015.

The top three themes for complaints remained as previously reported:

Ambulance and transport delay

Quality of care

Staff attitude

The Director of Clinical Care & Patient Safety referred to the report noting the following:

complaints in relation to ambulance delays for Urgent and Emergency Care vehicles had decreased by 43% for January 2015

the result from learning from complaints and the introduction of prioritising calls for falls in elderly patients over 65 years has made an impact

Passenger Transport Service (PTS) had seen a decrease in complaints in January particularly around being late for appointments

The marked increase in response times to complaints was disappointing however it was recognised that the Trust was at Resource Escalation Action Plan (REAP) Level 4

Appreciations showed an increase in trend showing an 8.8% increase on the same period as last year

The Chair questioned the time frame for returning to answering 100% of the complaints within the twenty five day period. The Chief Operating Officer advised that three Complaints Managers within the Contact Centre had been appointed; the backlog was decreasing and was currently standing at 12.

In response to a question from a Non-Executive Director, the Chief Operating Officer advised that the Trust was now at REAP Level 3. This had been communicated via the press and on the Trust Intranet.

A Non-Executive Director referred to Figure 2 on page 4 of the report and questioned the ‘unknown’ reason for the complaint. The Director of Clinical Care & Patient Safety would investigate outwith the meeting and feedback to the Board.

J Baxter

A Non-Executive Director questioned the reason for extensions to answering complaints and was advised by the Director of Clinical Care & Patient Safety that this was due to capacity issues within the Contact Centre as well as the Trust being at REAP Level 4.

The Chair referred to complaints regarding staff attitude and questioned if any programme was in place to cascade these and the learning outcomes to staff. The Director of Clinical Care & Patient Safety advised that part of the new Emergency Care Clinical Manager role will be to create a ‘perfect station’ but assured the Board that one to one learning was being carried out at present.

The Chief Executive informed the Board that having read some of the complaint letters regarding staff attitude, it was clear that some patients have been quite challenging, therefore asked members to be mindful of this.

9. Performance Summary – Reporting Period January 2015


The report saw the start of the development of a new approach to performance reporting, recognising the need to dovetail reporting with separate Quality and Finance Reports and to provide additional assurances that actions were being taken to address deteriorating performances.

In terms of Emergency Care performance there was non-achievement for R1 and R19 targets for the month of January, however R2 was achieved. There was currently a strong performance for R2 and R19 for the month of February. R1 was still proving to be somewhat challenging

Activity was slightly below contract and delays over 20minutes for Red calls were recovering albeit higher than the same period last year.

There had been an improvement in Urgent responses; Green 2 and Green 3 also showed recovery.

Through recovery planning, the Contact Centre performance had started to improve with Emergency care above target although NHS111 remained below target.

Northern Doctors Urgent Care (NDUC) continued to underperform and there had been a decrease in the number of clinicians available.

Sickness absence had reduced although still remained high and a Task and Finish Group had been established. This is one of the key areas that had been recognised that needs to be transformed with the reviewing of policies and procedures.

In terms of assurance regarding DBS Safeguarding issues, the nine outstanding cases were referred to the DBS on the 20

th February, meeting the agreed deadline.

Moving forward, some of the charts included in the IQPR would be included in the report, cross referencing with the Quality report. It was noted that although available, the IQPR in its current format would not be presented to the Board.

In response to a question from a Non-Executive Director, the Associate Director of Strategy, Contracting & Performance advised that the Task & Finish Group for Sickness Absence was scheduled to meet week commencing 2

nd March. A number of

Transformational Programmes regarding service and cost improvement had also been discussed earlier in the week.

A Non-Executive Director referred to item 2.6 of the report. The Director of Clinical Care & Patient Safety advised that a statistically appropriate sample of emergency responses is audited as well as every death to identify whether the delay in responding may have been a contributing factor.

A Non-Executive Director questioned whether there was any intention to look at Pathways as the call rate for life threatening cases was almost 50% which appeared to be extraordinarily high. The Chief Operating Officer advised that he had recently been invited to sit on the National Pathways Programme Board and would hope to influence some changes to assist in reducing this outcome.

In response to a question from a Non-Executive Director regarding expected outturn for performance the Chief Operating Officer advised the following:

R1 – huge improvement needed to achieve year end performance

R2 – very close to achieving year end performance

R 19 – achievable year end performance


The Chair referred to the spike in duty of candour referrals for January 2015. The Director of Clinical Care & Patient Safety advised that this was due to now having to report moderate harm as well as serious harm.

The Chair showed some concern regarding the decrease in the survival to discharge rate month on month. The Director of Clinical Care & Patient Safety advised that that this reporting was dependent on hospital data, therefore the figures were not a true representation. Moving forward, the Clinical Audit Manager would indicate (as a percentage) the Trusts that had supplied data.

J Duckett / J Baxter

In response to a question from a Non-Executive Director regarding vehicles cleanliness, the Director of Finance & Resources gave assurance to the Board that the cleanliness of the vehicles was compliant.

A Non-Executive Director referred to the PPCI compliance rate on page 5 of the report and expressed concern of the downward trend and questioned if this was a result of REAP Level 4. The Director of Clinical Care & Patient Safety advised that the figures were retrospective by 3 months. The Consultant Paramedic had implemented a plan to improve this trend, the outcome of which would be reported through Quality Committee.

10. Health & Safety – Position Statement

The Board discussed the recommendations contained with the paper and agreed that health and safety would become a regular item on the Board agenda on a quarterly basis.

It was agreed that the Executive Team, in the first instance would undertake the Britsafe Health and Safety course (an online course costing £95.00 per person).

Executive Team

11. Strategy, Planning and Policy

Finance Performance Report

The Report summarised the Trusts financial performance for the Ten months ended January 2015. It outlined the current deficit position of -£0.757m compared to the plan of £-1.254m on a normalised basis, with a forecast outturn for the year of a deficit position of -£1.754m compared to a plan of -£1.519m. The provision for penalties of £300k in respect of hand over delays had been included.

A significant change since producing the report was the expected profit to asset disposal of Durham Ambulance Station of £540k. This was expected to be realised in May 2015.

It was explained that the cash balance was artificially high due to the delay of PTS vehicles. There were also another 17 Emergency Care vehicles expected in March as well as 10 new chassis. This meant that a third of the fleet had been refreshed.

It was noted that the outturn forecast had increased to £9.415m due to the purchase of the Blucher site, which was anticipated to complete prior to 31

st March 2015.

The Director of Finance & Resources advised that negotiations with Commissioners were challenging and that a favourable year end settlement was dependent on agreeing 2015/16 contracts.

There were no anticipated exceptions with regard to debtors or creditors however it was felt that the Trust could be more proactive in terms of requesting and receiving payments


from CCG’s.

12. Draft Annual Plan 2015/16

The paper provided a recap of the Monitor reporting requirements for 2015/16 which included a three page Draft operational Plan. The plan had been revised since the last iteration presented to the Board in January. Information was also provided regarding the review and assessment process.

Due to no national agreement on Tariffs the whole planning submission timetable had changed from Monitor. The three page draft plan would now be submitted early to mid-April. Following feedback, the twenty page plan would be submitted in May.

The Associate Director of Strategy, Contracting & Performance confirmed that the report should read Paramedic re-banding and not rebranding (page 2, 5

th bullet point).

A Non-Executive Director referred to previous discussions regarding Hear & Treat and by increasing Hear & Treat performance the Trust was in effect being penalised. The Chief Executive explained that what was being discussed and recommended at a national level regarding the reduction of conveyance and the increase in Hear & Treat and See & Treat (thus funding the re-banding of paramedics) was not being reflected in discussions by Commissioners at a local level.

The contents of the plan were noted.

13. Chief Executive Update

The Chief Executive provided an update for Board members with the following being noted:

Jennifer Boyle had been appointed as the new Trust secretary and would commence with the Trust on the 5

th May. The Chief Executive took this

opportunity to thank Kelly Douglas for all the support she had provided during her secondment with the Trust.

Karen Forsyth the Head of HR would also be commencing with the Trust on the 1

st May.

The post of Director of Strategy, Transformation and Workforce had been advertised with a closing date of the 8

th March 2015

Donna Hunwick – HR Legal representative had commenced a 3 months secondment from Sinton, with plans to recruit on a fixed term basis for two years

The Chief Executive and the Chairman attended a meeting of the Association of North East Councils and presented an update on ambulance provision which was well received. They were very supportive and keen to engage the Trust in ‘Better Care Funds’

The Chief Executive and the Chairman had attended a meeting of local MP’s, CCG’s and Acute Trusts in County Durham which proved more challenging.

The Chief Executive had met with all Chief Fire Officers across the region and were keen to meet as a forum moving forward

The Chief Executive and the Chief Operating Officer were attending an event on 3

rd March which was a national collaboration of emergency services

A second Surge Pressures meeting had taken place with CCG’s, NECs and Acute Trusts as a reaction to winter pressures. All Acute Trusts were now providing information for the ‘flight deck’

The second Joint Senior Manager and Executive Team meeting had taken place which went well and produced some good feedback


The Chief Executive had attended a number of staff visits on an individual basis as well as visits to crews including Wideopen and Berwick

The Chief Executive had spent some time in resource scheduling where there was a sense of not caring for staff. There was a need to do some work around counselling / debrief and it was felt the ECCM’s once in post would make a big difference. There needed to be focus on the Health and Wellbeing Strategy

Members discussed the impact of the opening of the new Emergency Care Hospital in Cramlington. The Assistant Director of Communications & Engagement advised that concern had been raised with regard to ambulance response times particularly in the West Northumberland and Tyne Valley areas.

14. Petition on Ambulance Responses in Berwick

The Assistant Director of Communications & Engagement briefed the Board on a petition received by the Trust that had originally been submitted to Northumberland County Council. It was instigated by a member of the public who had arrived on scene of an incident in Berwick on the evening of 30

th January 2015 where a 16 year old boy travelling

on a scooter had been struck by a car.

Following the 999 call received at 22:02 a Rapid Response Vehicle (RRV) was dispatched from Wooler immediately, backed up by a Double Crewed Ambulance (DCA) from Berwick arriving on scene at 22:28 hours. Despite the efforts of the crew and the on call clinician in the control room, unfortunately the boy did not survive the collision.

The petition had originally called for an additional ambulance to be brought into the Berwick area, later clarified by the petitioner, for an ambulance to be available to take patients to hospital in the Berwick area, rather than specifically having additional resources.

Since writing the report the petition had attracted further support and now showed a total of 4154 advocates.

The Board were informed that the petitioner had since withdrawn from the petition due to strain. In view of this and following the terms of the Trust’s standing orders the petition had been brought before the Board.

Although the petition was originally submitted to Northumberland County Council it is not an issue that particularly relates to the council. As such, it was recommended that the Board consider the petition and the comments made and forward the petition to the Northumberland Clinical Commissioning Group (CCG) for action.

Julie Pӧrksen, Liberal Democrat candidate was invited to comment where she informed the Board that there was another petition running in the Berwick constituency calling for an additional ambulance to be in use during evenings as the above was not an isolated incident.

The Chief Executive confirmed her personal acceptance of the petition. It had been a very difficult case, which had also affected the crews who were in attendance and went on to express her sincere sympathies and condolences for the family of the victim

The Chief Executive explained that it was the intention to discuss services that are commissioned by Northumberland CCG, looking at what local services are available in totality in Berwick, including the Berwick hospital, GP Practice provision, Walk-in Centre provision and the community paramedic in Wooler, in order to increase the effectiveness


of all the health services by working together.

The Chief Operating Officer briefed members on the proposed model for Integrated Care and Transport (ICAT) as well as continued work with Northumberland CCG regarding the Advanced Practice Paramedic role (APP). He also confirmed that ambulances returning to the Berwick area from Wansbeck Hospital are not disturbed (unless a life threatening call is received).

A Non-executive Director questioned whether rural performance formed part of the agenda for the forthcoming commissioning round. The Associate Director of Strategy, Contracting & Performance advised that this was not the case at present. It was explained that the ICAT model was being piloted in Northumberland and Durham, with Commissioners viewing this as an alternative to extra resource.

A Non-executive Director expressed concern at rural performance being at its worst since becoming a Board member and sought assurance that this would improve as a result of the recent recruitment campaign.

The Chief Operating Officer advised that performance in rural areas was currently at 60%, a drop of 6% on the same period as last year. Contributing factors included pressures in recruitment, internal inefficiencies, as well as continuing hospital delays and diverts, contrary to assurances given by hospitals. He also reiterated that this had been the worst winter known to him in his 30 years’ service.

He informed the Board that performance had suffered as a consequence of the above and due to low levels of activity in rural areas, as a percentage to performance this would appear worse. The Non-Executive Director asked that this be fedback to Commissioners.

The Associate Director of Strategy, Contracting & Performance advised that the Trust does bring rural performance issues to the attention of the Commissioners.

It was also felt that this should be fedback to the public to give them assurance that the Board had presented these issues to the CCG’s and tried everything possible to influence Commissioners’ decisions.

Whilst acknowledging the above the Director of Finance & Resources informed members of the difficulty in talking to Commissioners directly, and advised that negotiations are carried out through North East Commissioning Support (NECS).

In response to a question from a Non-executive Director regarding third party providers, the Chief Operating Officer advised that third party providers are predominantly used in urban areas as opposed to rural.

Summing up the Chair asked the Board to approve the recommendations contained within the report, to forward the petition to the Northumberland Clinical Commissioning Group (CCG) for action including the suggestions of the Chief Executive. This was agreed by the Board.

The Chair asked for Julie Pӧrksen to pass on the condolences of the Board to Chris Munro (the petitioner) as well as anyone who had been involved in the incident.

15. Directorships – Declarations of Interest

In line with the NHS Code of Accountability, Board members are required to declare interests which are relevant and material to the NHS FT Board of which they are a


member. The report listed those interests declared by Douglas Taylor Non-Executive Director and Catherine Young Non-Executive Director: Douglas Taylor appointed to the Trust on the 1

st February 2015

NONE Catherine Young appointed to the Trust on the 1

st February 2015

Governor at University Of Sunderland (Non-Executive Director)

Commissioner of Port of Blyth (Non-Executive Director)

Chair of Audit Committee – Breast Cancer Care

Director of Wetton Young Ltd (Chartered Accountants)

Associate Leathers LLP (Chartered Accountants)

16. Board Assurance Framework 2014/15 - Review

The Board Assurance Framework (BAF) for 2014/15 had been reviewed and update by the Executive Directors in order for it to be finalised against the 14/15 objectives. As a result some of the risk levels have reduced.

There was an event planned for the Executive Team on Monday 2nd

March to look at the new corporate objectives and the risks against delivery to start populating the BAF for 2015/16. It will then be brought to the Board.

Moving forward the BAF will be a key item on the Board Agenda and it will be managed electronically ion the Ulysses system. There will also be a session on risk management at the Board meeting in March 2015.

17. Any Other Business

17.i Assistant Director of Communications & Engagement advised the Board that he had just received notification that the Health Secretary would be Meeting with Sir Alan Beith MP to debate cross border issues. Whilst the investigation into the Serious Incident continued it was known that the crew who responded were on a break at the time and mobilised following contact from the community paramedic. The Health Minister has been asked about the issue of meal breaks. He was advised that the Trust complies with Agenda for Change. He will be asked to consider whether ambulance crews should be paid for disturbing their meal break in order to respond.

17. ii A briefing from NHS Providers had been upload to the reading room of the Board pad regarding the General Election and the purdah period.

17. iii It was noted that a photographer from the Weardale Gazette had been present, taking photographs during the open forum of the meeting which the Trust had not been given prior notice to. The Assistant Director of Communications & Engagement would follow this up outwith the meeting.

M Cotton

18. Date, Time and Venue of Next Meeting

Thursday 26th March @ 12:30 hours. Venue to be determined.

19. Resolution to exclude the Press and Members of the Public


Signed ___________________________________ CHAIRMAN Date ___________________________________

Members resolved, in accordance with the Trust’s Constitution (9.11.2): ‘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 on which would be prejudicial to the public interest’.

ALL

20. Review of Meeting

The Chair asked members for feedback of how the meeting had been conducted. The following items were noted:

Douglas Taylor, Non-Executive Director informed members that as he become more familiar with the organisation he would be able to make a better contribution

Catherine Young, Non-Executive Director felt that there was too much material and would expect everything that was presented to the Board to have already been analysed in detail and dealt with at committee level

Wendy Lawson, Non-Executive Director, suggested that for logistical purposes during the open forum part of the meeting, questions for the Board should be submitted prior to the date of the meeting

MINUTES OF MEETING - NHS Foundation Trust · MINUTES OF MEETING ... (IQPR), produced on a ... if...

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