Item 14 FPG minutes 11 Feb 2014

Accepted at meeting on 22 April 2014
Cambridge University Hospitals NHS Foundation Trust
Minutes of the meeting of the Governor/Director Forward Planning Group held on
11 February 2014 at 16.00 in the Boardroom, Addenbrooke’s Hospital.
PRESENT:
Peter Lester (vice chair)
Frances Cousins
Judy Ewer
Gillian Francis
Elizabeth Howe
Elizabeth Hunt (from 16.20)
Fred Jacobsberg
Andrew Lever
Wendy Menon
Mike More
Eric Revell
Brian Walker
John Wells
Staff Governor
Chief Operating Officer
Public Governor
Public Governor
Patient Governor
Staff Governor
Patient Governor
Partnership Governor
Public Governor
Non-executive director
Public Governor
Patient Governor
Partnership Governor
IN ATTENDANCE:
Lawrence Ashelford
Carrie Armitage
Angela Broekhuizen
Caroline Rogers
Director of Strategy, Policy & Planning
eHospital Programme Director
Director of Estates & Facilities
Senior Corporate Committee Secretary
IN ATTENDANCE FOR PARTICULAR ITEMS:
Alex Gimson
Divisional Director, Integrated Care
Sandra Myers
Programme Director, Integrated Care
Rachel Northfield
Associate Director of Estates & facilities
Keith Spencer
Director of Business Development, CPFT
Derek Ward
Uniting Care Partnerships
APOLOGIES:
Richard Eley
Roger Hickford
Ann-Marie Ingle
Mike Knapton
Jonathan Nicholls
Geogina Pharaoh
Patrick Smith (chair)
John Wallwork
01/14
Interim Chief Financial Officer
Partnership Governor
Interim Chief Nurse
Non-executive director
Partnership Governor
Patient Governor
Public Governor
Advisor, Papworth
Welcome and introductions
Peter Lester welcomed everyone and explained that, due to the absence of John
Wallwork, there was no Papworth item at this meeting.
Guy Edwards, a Cambridge University PhD research student who had recorded
the previous meeting for his investigation into the management and governance
of committees, was to record the meeting from the beginning of item 05/14.
02/14
Minutes of the last meeting
Mike More gave retrospective apologies for the last meeting.
The minutes of the meeting held on 4 September 2013 were accepted as an
accurate record of the meeting with an amendment to 42/13 paragraph 6:
“Elizabeth Howe had been informed that a car park attendant had advised a
nurse to park in local streets…”
There were no matters arising.
03/14
Declarations of interest
Judy Ewer – spouse is Chief Executive of Laing plc, partners in the development
of the Forum, and she is also an ACT Trustee.
04/14
Update on the tender for integrated care
A presentation (Appendix A) by Derek Ward of Uniting Care Partnerships, Keith
Spencer (bid director), Alex Gimson (divisional director for integrated care) and
Sandra Myers (programme director).
Noted
1.
A Board to Board meeting had taken place earlier on 11 February between
the CCG and representatives of Uniting Care Partnerships (CUH, CPFT and
MITIE).
2.
The invitation to submit outline solutions (ISOS) had been in January 2014
and shortlisting of approved bidders would take place in March. The
deadline for receipt of the final solutions (ISFS) was to have been 21 April
but had been put back to 21 July because the CCG had taken advice and
had decided to go out to public consultation. The CCG’s approval of the
preferred bidder was now expected on 15 September. Social care was
excluded from the tender at this point, but the Trust was actively working
with the City Council on these issues for current operational services, and
also to promote joint working in the future.
3.
Integrated care would be a care pathway rather than care from one
organisation and would be centred around the patient / service user’s
needs. Built around GP practices, the proposed integrated community and
neighbourhood teams would work intensively with those at risk of being
admitted to hospital. This could involve overnight ‘sitting’ services, for
example if a carer was taken into hospital. There would also be joint
emergency teams.
4.
A single point of contact, the Uniting Care Centre, would give users one
telephone number to access all care providers, whether they were calling
from their own home or elsewhere in England.
5.
A similar system was already in operation in Bedfordshire.
6.
Arthur Rank, Marie Curie and Sue Ryder had put together a joint proposal
for working with Uniting Care Partnerships (UCP), and other third sector
organisations were planning a coordinated approach. One of the expected
outcomes of the pathway was management of palliative care, allowing more
people to die in the place of their choice.
7.
The top three risks were system level resistance, failure to integrate social
care, and cultural change.
8.
In answer to a question from the governors concerning how safe care could
be ensured through sub-contractors, it was stressed that all staff would be
given specific training in working in teams to quality measures and would
be monitored very carefully. Rewards for sub-contractors would be based
on collaboration i.e. if the whole system delivered rather than one
contractor.
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05/14
9.
Another question concerned training for those manning the Uniting Care
Centre (UCC) and governors were assured that those employed would be
experienced, for example community matrons. The UCC would be much
more than a call centre.
10.
Mrs Cousins reported that the CUH Board of Directors would commission an
independent options appraisal of the opportunities, risks and mitigations
presented by the procurement for CUH, which would be reported at their
meeting in September 2014.
11.
An update on the tender would be brought to the governor/director working
group on forward planning in April.
The Annual Plan
Lawrence Ashelford, Director of Strategy, Policy & Planning, spoke to the
Operational Plan Document which had been circulated. (Draft 1 had been
circulated and Draft 2 was tabled)
Noted
1.
The operational plan covered the two year period for 2014/15 and 2015/16,
and was required to show 40% savings. The first segment needed to be
delivered by 4 April 2014.
2.
Draft 2 (tabled) had more detail on workforce strategy than draft 1.
3.
A number of elements in the Trust’s plan would be common to all those
across Cambridgeshire & Peterborough. The guidance from Monitor
exhorted organisations to link their plans and consider pathways rather
than individual services, but competition rules would still apply and the
Office of Fair Trading could possibly have different views from those of
Monitor.
4.
Engagement with governors had in the past been through a small group,
but due to the tight timescale volunteers to read the plan were requested.
5.
Mrs Ewer asked about engagement with the public. It was thought that this
would require careful consideration and some confidential information
would need to be redacted. A properly organised public consultation would
take more time than was available. It was stressed that the information in
the plan was only proposed and a consultation could therefore take place if
any proposals were subsequently taken forward.
Agreed
06/14
1.
Wendy Menon, Fred Jacobsberg and Judy Ewer volunteered to read draft 2
of the plan and to contact Lawrence Ashelford with any comments.
2.
Judy Ewer would work with Lawrence on possible public engagement.
Dementia Project for C6
Rachel Northfield spoke to the plans that had been circulated.
Noted
1.
From 2014 PLACE (patient-led assessments of the care environment) audits
included the environment provided for dementia patients.
2.
£1m had been received from the Dementia Capital Fund and it had been
decided to refurbish ward C6. This ward had undergone some work 8-9
years previously and already had piped medical gases in place.
3
07/14
3.
The plans, which incorporated suggestions from the patient/carer focus
group, illustrated the vision for C6, including an improved and secure
entrance and the creation of a reception area. There would be a trial of
nurses stations being in small “pods” rather than one large desk area.
Navigation aids in the form of signage and pictures would be introduced,
and patients would be able to personalise their bed space.
4.
Patient tagging would be introduced to enable patients to walk around
safely.
5.
Construction work was planned to begin in April 2014 and it was hoped the
ward would be operational by the end of July 2014.
6.
In answer to questions from the governors, Ms Northfield explained that the
patients on C6 would be from the Department of Medicine for the Elderly,
therefore not purely those with dementia, but that priority would be given
to the physically unwell who also had dementia, and that there would be
two beds less on the ward than previously.
7.
Where possible, en suite toilets would be converted to toilets with showers.
On ward F4, length of stay had been reduced when the number of beds was
reduced and bathrooms were increased.
eHospital Update
Carrie Armitage, programme director, spoke to the January 2014 highlight
report, which had been circulated.
Noted
1.
The Epic build achievement had not achieved the overall completion target
of 75% by the end of December 2013, but had reached 72% by 27 January
2014. Many areas had achieved 90% but some teams remained a concern.
2.
A remedial plan had been developed and there was confidence that, with
some additional support from Epic, the work flow and clinical content builds
would be complete by the end of March 2014, when testing was scheduled
to show whether all modules were working together.
3.
The team were feeling under pressure but eight people had been offered, at
no cost to the Trust, by an American consultancy firm who were interested
in experiencing Epic implementation outside the USA. Another organisation
had offered 12 reserve trainers, to be trained with the Trust’s but at no cost
unless used as back up.
4.
Confirmation was still awaited from the Department of Health Technology
Fund regarding funding to support the integration engine.
5.
The managed print project was running three months late and more project
managers had been introduced.
6.
The roll-out of the new HP desktop would begin in April 2014 and continue
until August. This would introduce Microsoft 2010 and a sharepoint file
space. Information would be circulated to staff with March payslips about
available e-learning tools which could assess and improve computer skills.
Ms Hunt reported that many staff were concerned about the amount of time
that would be available for learning the new systems. Ms Armitage reported
that 98,000 hours of training were planned.
7.
In response to a question concerning the possibility of using staff who had
been made redundant to assist/cover, Mrs Cousins confirmed that of 121
staff who had been made redundant, all but 12 had been redeployed.
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08/14
8.
Dr More reported that the Board of Directors were aware that many areas
of change were happening at the same time, for example eHospital and the
divisional restructure, and Mrs Cousins confirmed that potential pressures
and risks had been identified.
9.
In answer to a question about possible concerns, Ms Armitage stated that
the main concern was around stretched resources and managing
expectations. There would be 24 hour cover from floor walkers and
telephone support lines.
Forum and AstraZeneca
Angela Broekhuizen, Director of Estates & Facilities, reported.
Noted
A.
Forum
1. Construction would start once car park 2 opens at the end of May.
2. The ancillary space would have retail outlets. Cambridge University
Health Partners (CUHP) would oversee all campus retail possibilities and
an update would be brought to a future meeting.
B.
AstraZeneca
1. The contract had been signed and an architect appointed. Designs
would be available in late summer 2014, with work on the site planned
to commence at the beginning of 2015.
2. An archaeological survey would take place shortly.
3. Mr Wells reported that Cancer Research UK had agreed for 60 scientists
from AstraZeneca to be accommodated in the CRUK building until the
AstraZeneca building was ready.
09/14
Children’s Services and Strategy Development
The project mandate for Children’s Services was tabled (see Appendix B)
Noted
10/14
1.
The project mandate was to be discussed by the Board of Directors shortly,
with the strategic outline case (SOC) then going to the Finance &
Performance Committee in April/May 2014 and to the Board of Directors in
July 2014.
2.
If changes to Children’s Services were implemented, different facilities
would be needed. Two other proposals, for Neurosciences and an
Ambulatory Cancer Centre (see Appendix C & D), would also be submitted
to the Board who would review the benefits, including capacity and legacy
space, and decide which proposal(s) to take forward.
3.
In answer to a question from Mr Lester, Mrs Cousins confirmed that a
‘stand alone’ emergency department for children would be part of the
debate.
Agenda points for next meeting
1.
Ms Broekhuizen would report on the Addenbrooke’s Centre for Clinical
Investigation.
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2.
11/14
Campus Development Programme – this would include all three SOCs (see
item 09/14 above)
Items for the Board of Directors’ report
Mrs Ewer would highlight the concerns raised.
12/14
Date of next meeting
Tuesday, 22nd April at 16.00 in the Boardroom
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