A G E N D A€¦ · 20190424 Draft CoG Agenda 17/04/2019 12:38 COUNCIL OF GOVERNORS Meeting to be held on 24th April 2019 6.00pm ± 7.30pm, *RYHUQRUV+DOO 6W7KRPDV¶+ RVSLWDO A G E

20190424 Draft CoG Agenda 17/04/2019 12:38

COUNCIL OF GOVERNORS

Meeting to be held on 24th April 2019 6.00pm – 7.30pm, Governors Hall, St Thomas’ Hospital

A G E N D A

1. Welcome, apologies and opening remarks

2. Minutes of meeting held on 30th January 2019

(CG/19/06)

3. Matters Arising

4. Reflections session on Board of Directors meeting

oral

5. Accountability Session: Questions & Answers report (CG/19/07)

6. 7. 8.

Election of CoG representative to the Evelina London Board Peter Allanson Lead Governor Paper Peter Allanson Report from the Nominations Committee Peter Allanson Governors’ reports – to note and for information

1. Lead Governor report Devon Allison

2. MeDIC (meeting to be rebooked in May2019) Samantha Quaye

3. Quality and Engagement Placida Ojinnaka

4. Service Strategy Annabel Fiddian-Green

(CG/19/08) (CG/19/09)

(CG/19/10)

oral

(CG/19/11)

(CG/19/12)

9. Any other business

10. Date and time of next meeting:

The meetings will be held on 24 July 2019, Robens Suite, Guy’s Hospital

Board of Directors meeting 3.45pm – 5.30pm Council of Governors meeting 6.00pm – 7.30pm

Agenda

1 of 72Council of Governors Meeting, 24th April 2019, 6-7.30pm, Governors Hall, St Thomas' Hospital-24/04/19

CG/19/06 Approved by Chairman

20190130 CoG Minutes 1

Council of Governors

Minutes of the 63rd meeting of the Council of Governors held on Wednesday 30th January 2019 in the Robens Suite, Guy’s Hospital

Present:

Devon Allison Margaret McEvoy Tahzeeb Bhagat William Moses Heather Byron Placida Ojinnaka John Chambers James Palmer Marcia Da Costa Samantha Quaye Jonathan Farley Jenny Stiles Annabel Fiddian-Green Mary Stirling Tony Hulse Jacqui Dyer

Yu Tan Warren Turner

Apologies: John Balazs Vicky Rogers Robert Davidson Sue Slipman Jane Fryer Giuseppe Sollazzo Alice Macdonald Lucilla Poston Anita Macro Matthew Patrick John Porter Bryn Williams Peter Yeh

In Attendance: Executive Directors: Dr Ian Abbs Steven Davies Adam Dunlop Alastair Gourlay Amanda Pritchard Julie Screaton Martin Shaw Eileen Sills

Non Executive Directors: Felicity Harvey John Pelly David Perry Reza Razavi Sheila Shribman Priya Singh Sir Hugh Taylor (Chair) Steve Weiner

Other Attendees: CG/19/01 Welcome, apologies and opening remarks

The Chairman welcomed Elaine Burns to her first meeting of the Council of Governors and Farhan Quadri to his role as Membership Co-ordinator.

Peter Allanson

Trust Secretary and Head of Corporate Affairs

Wendy Doyle Marie McDonald

Head of Complaints Joint Director of Quality and Assurance

Farhan Quadri Membership and Governance Coordinator

Tab 2 Minutes of meeting held on 30th January 2019

2 of 72 Council of Governors Meeting, 24th April 2019, 6-7.30pm, Governors Hall, St Thomas' Hospital-24/04/19

CG/19/06


CG/19/ 02 Minutes of the meeting held on 24th October 2018

The minutes if the meeting held on 24th October 2018 were approved as a true record.

CG/19/03 Matters arising

There were none. CG/19/04 Reflections session on Board of Directors meeting

Governors raised a number of issues arising from the Board meeting and also from other contacts within the Trust. The Chairman emphasised that there would be no lessening of the involvement of Governors in the observation of some Trust activities – such as adult local services which was being run as an executive Strategic Business Unit. There would still be quarterly oversight opportunities. The Trust would work with governors to ensure they felt fully involved. The span of the adult local services would expand to embrace the emergency department’s work. This would also apply to Cancer services when the SBU for these was set up. Governors were interested in the Trust’s response to dealing with patients with mental health problems both in A&E and more generally within the Long Term Plan. The Trust was working very closely with local mental health trusts, including close collaboration with SLaM, had appointed a mental health lead to work in both the A&E department and on wards as well as offering training to staff in how to deal with these patients. A mental health compact, a national initiative, was due to be published which should to validate the Trust’s response to these issues. Other initiatives included the mind and body programme across King’s Health Partners which was now in its third year. There were 150 champions across the Trust covering staff and patients, ensuring that patients were screened for mental health conditions in clinic. Recognising the difficulties for patients was a core responsibility for the Trust and being part of KHP was immensely helpful. It was suggested that the Council looked more closely at this issue. This was an increasing issue for the Trust. The Council noted the impact that the Trust’s effective drug and alcohol team had on the target. Never events – although there had been 3 never events reported recently the Trust’s aim was to eradicate them as far as possible. There had been a year on year reduction with fewer arising in theatres which could be attributable to the more rigorous use of WHO checklists. Similar processes were being put into areas outside theatres particularly for invasive procedures. However, the Trust encouraged reporting of events through the range of options open to staff. IT – staff governors remained concerned that delivery of care was still affected by the continued absence of a single log on to Trust clinical systems. The IT Directorate acknowledged that there were difficulties for clinicians but that issues with infrastructure and work looking at wireless access points and improving local networks would needed before resolving the sign in challenge. It was accepted that progress was slower than ideal. The new Transformation and Major



CG/19/06


Programmes Committee would be meeting for the first time in February and would take an active interest in this. In addition, there was to be a new newsletter to explain what was being done to improve matters. It was noted that the Trust offered support and training to other organisation as part of its system activities – for example in urology. There was scope for more which would help to improve access to services. This would include joint appointments were being made which would also spread knowledge. The Director of the ACN was funded jointly by the sector.

CG/19/05 Complaints: The central team provided support to directorates in responding to complaints.

In preparing for the CQC inspection the recent progress was welcome as there were issues raised by CQC at the last inspection.

Response rates at the time were poor and there were problems that directorates

had not necessarily prioritised dealing with complaints and the position had also been affected by the amount of staff turnover in the complaints team.

The central team had been restructured and the involvement and interest of top

management and NEDs introduced. Over the last year, there had been a 40% improvement in the timeliness of responses and collaboration between directorates and the centre had improved. There were now a range of metrics examined and all were showing improvement.

There were now more effective escalation arrangements in place. Next steps

included work to resolve issues before they became complaints, speaking to complainants to establish what they wanted and what the most effective way of providing it. The service also looked at outcomes, classifying them by using the same criteria as the Ombudsman – not upheld, partially upheld and fully upheld.

The case study set out a number of changes made as a result of the complaint

investigation and a set of improvements put in place. Some of the learning was relevant to other directorates.

There were refreshed arrangements for reporting outcomes via the Trust Risk

and Quality committee including sharing change and outcomes with other parts of the Trust. There would also be a more robust audit trail of actions intended to improve patient care.

Communications was the most complained about issue which was common to

many other trusts. Themes were reviewed every quarter and reported to TRAQ with specific interventions with directorates. Clinical issues and administration were the next set of matters most often raised.

Complaint triaging was now undertaken by the most senior members of the

Complaints team often in conjunction with directorates. The department reported to TRAQ which reported to TME. The Quality and Performance Committee of the Board also reviewed complaints and their handling with non executive directors spending time in the department three times a year. Governors and commissioners also took a regular interest in performance.

It was noted that there were a number of ways to help people complain who did not have the capacity to do so through direct approach. PALs and advocacy



CG/19/06


services. Feedback was focussed on systems rather than individuals and efforts to share and encourage compliments – these were acknowledged by the Chief Executive and sent to the person mentioned. .

The Council thanked the Complaints team for its work and progress over the last year or so and how learning was spread across the Trust. A well responded to complaint would contribute to patient satisfaction. Learning from complaints contributed to the well being and quality of the Trust’s services.

CG/19/06 2019 Council of Governor Elections

The Council noted the report and the launch of the 2019 elections campaign. CG19/07 Governors’ Reports

Lead Governor report The Lead Governor welcomed Elaine Burns and thanked James Palmer for his work as a governor, now he had had to stand down. The Membership Manager, Adeola Ogunlaja, had moved to another role in the Trust was also thanked for her work for the Council. Her replacement, Farhan Quadri, was welcomed. The next edition of Listening Line was about to be published and would be sent to members with the GIST and for the first time would be available on line. The Long Term plan with its welcome emphasis on staff, productivity, locally based integrated care and young people was mentioned by the Lead Governor who encouraged governors to read either the plan itself or one of the useful summaries published by various think tanks. Membership Development, Involvement and Communications Working Group The Council noted that the membership survey would be issued in the spring and also the continuing progress on the implementation of the membership strategy.

Quality and Engagement Working Group Council noted the minutes of the meeting reported Service Strategy Working Group Council noted the minutes of the meeting reported; the timetable for the business plan was even more compressed and the Working Group would be asked to have an in depth discussion as part of its responsibility.

CG/19/08 Questions and answers

It was agreed to rationalise the older questions on the matrix.

CG/19/09 Any other business

The Nominations Committee would be reviewing a number of issues including the succession planning for the Chairman though he was not due to stand down until 2021.



CG/19/06


CG/19/10 Date and time of next meeting

The meetings will be held on 24th April 2019, Robens Suite, Guy’s Hospital Board of Directors meeting 3.45 – 5.30pm Council of Governors meeting 6.00 – 7.30pm

Signed: Date:



24th April 2019 Council of Governors - Questions and answers 1


Questions and Answers

24th April 2019 CG/19/07

This paper is for: Sponsor: Corporate Affairs

Decision Author:

Discussion Reviewed by:

Noting X CEO*

Information ED*

Board Committee*

TME*

Other*

* Specify

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1. Summary This report includes the list of questions raised by governors at the recent Accountability meeting with the Board in March. The questions have been arranged into themes to be answered by the Non-Executive Directors at this meeting. Also included in this report is a list of other queries which have been raised by governors and the answers have been provided to governors. We would like to encourage governors to continue to raise questions. 2. Request to the Council of Governors The Council of Governors is invited to note the report.

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3. Questions raised at the Board and Council of Governors Accountability Meeting, 20th March 2019:

Non-Executive Director / Executive Director

Category Governor Question

John Pelly/ Jon Findlay

Finance How do we resolve the conundrum of financial incentives exist to deliver care in a fragmented way being a barrier to deliver integrated care?

John Pelly / Steve Davies

Finance Has anyone done an analysis to work out we are financially worse off by taking on extra patients?

John Pelly / Steve Davies

Finance Will we continue to be in a financial position to provide support given the cutbacks in the market forces factor and other elements of the Trust budget?

Hugh Taylor Operational How do we ensure that the arrangements with Sir Hugh covering KCH work effectively for GSTT and are we confident that we have all the bases at GST covered?

Priya Singh / Jon Findlay

Operational How is the Trust managing demand and how effective are the various initiatives which have been put in place to deal with the issue?

Priya Singh / Eileen Sills

Operational How do we maintain momentum on the Governor visits/ maximise the opportunities to get direct patient feedback and can Governors receive feedback on what happens as a result of the information they give us?

Steve Weiner / Jon Findlay

Operational Are we confident in our plans for Brexit? What are the implications for staffing and in particular for how our EU staff are feeling?

Felicity Harvey / Julie Screaton

Organisational Development

What strategies can we put in place to encourage more diversity in senior and middle management roles?



Can we ensure the organisational structure and governance are maintained and that the culture of the organisation remains positive for patients?

John Pelly/ Jon Findlay/ Steve Davies


The Trust appears to sub-contract in a number of areas. Is this because we don't have capacity or is it because we need to procure expertise? If the former, how do we develop our workforce to be able to deliver internally? If the latter, how do we ensure that we have the experience to hold the contractor to account?


Patient Care How do we maintain the balance between the needs of local patients and those from wider geographies accessing specialist services?

Steve Weiner / Neil Goulbourne

Patient Care How are patients engaged in transformation?

Priya Singh / Julie Screaton

Patient Care Violence and aggression to staff - how do we protect staff and support them when they do experience incidents? Including if their loved ones have been involved. This was borne out of recent news items about the rise of knife crime

Priya Singh / Eileen Sills

Patient Care How can we address the increasing challenge of patients presenting in A&E with mental health issues?

Sheila Shribman / Ian Abbs

Patient Care How could we guide the public to seek earlier advice and guidance for their symptoms? Is there a role for the CoG?

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Service Delivery Why can't we do more one stop shop style of delivery rather than making people come multiple times?


Service Delivery What are we doing about waiting times in outpatient clinics? Appointments often run late, with a knock on impact for everyone still waiting to be seen.


Staff Engagement Are we incentivising staff fairly for additional work, particularly in comparison to other organisations?

Sheila Shribman / Eileen Sills

Staff Engagement Infection prevention across the board is important so how do we maintain momentum with regards getting the basics right? E.g. Mandatory training is how we monitor this so how do we ensure rates of completion do not dip post CQC visit

Responses to the above stated questions will be provided by the NeD’s at the meeting

4. Other questions raised: Note: Governors are asked to send any queries to the Membership and Governance Co‐ordinator or Peter Allanson and not directly to directorates. We will log questions and ensure they are properly handled.

Matters of interest/question Issue number & date raised

Responses Progress/further information

Completed date

Who sets the rules on vehicles using bus lanes?

18/20026 2019-01-30 Devon Allison

1. My take on this is that TfL lay out the rules on bus lanes and their use. If you go to their website, and search for bus lanes, it will list the permitted vehicles. https://tfl.gov.uk/modes/driving/red-routes/rules-of-red-routes/bus-lanes

It’s worth remembering that bus lanes are generally time governed, so

the restrictions to use apply for set hours. Ambulances are not listed

as a permitted vehicle. We have in the recent past, written to TfL and

they have confirmed that ‘only NHS ambulances or vehicles providing

a response to an emergency at the request of an NHS ambulance

service are allowed to use bus lanes at any time without being issued

with a PCN (penalty charge notice)’.

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https://tfl.gov.uk/modes/driving/red-routes/rules-of-red-routes/bus-lanes

https://tfl.gov.uk/modes/driving/red-routes/rules-of-red-routes/bus-lanes




Completed date

2. The London Ambulance Service (LAS) guidance, dated November 2018, for ambulance drivers says;

Bus Lanes and Cycle Lanes/Superhighways

6.11.1. Drivers are permitted to use bus lanes for Ambulance Purposes and in accordance with any local arrangements. It will be for the driver to justify their Ambulance Purpose. 6.11.2. Generally, when engaged on an emergency call a vehicle can be driven, with care, in a bus lane. When not engaged on a call, driving in bus lanes should be avoided.

Whilst we have ambulances, with trained crews, we are only doing

planned work and do not do emergency work or operate under a blue

light. Our interpretation is that we do not have a legitimate ‘ambulance

purpose’ nor do we perform emergency services, and therefore we

should avoid bus lanes in the same way that the LAS are advised to

do.

3. I have also checked with 3 of our supply partners and they have all confirmed the same. One said; ‘We are not exempt to bus lane penalties as a non-emergency

provider and any incursion into a bus lane would incur a penalty

charge notice being issued. We would in some instances challenge if

a patient was on board and was on the way to an appointment and

this needed to be effected quickly but we would be unlikely to win.’

4. I also note that there was a petition in parliament last year. It ran for 6 months to October 2018 and the petition was as follows; ‘Allow Ambulances on non-emergency journeys to use Bus Lanes.

Make a nationwide policy to allow NHS Ambulances on non-

emergency journeys to use Bus Lanes at all times. This would

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recognise that Ambulance journeys are important. Ambulances sitting

in queues of traffic while Bus Lanes are free doesn't make much

sense. This would save the NHS money.’

https://petition.parliament.uk/petitions/216673

It received 18 votes of support over the 6 month period and was

therefore taken no further.

5. I am sorry there is rather a lot of information here, but I have tried to gather as much as I can to give you a sense of the broader landscape. I am aware that there has been press coverage in other parts of the country, where councils have applied PCN’s to blue light services using bus lanes. The picture however is mixed and I have only heard of very occasional cases in the SE/London. https://www.yorkpress.co.uk/news/17568291.ambulance-crews-are-being-fined-for-driving-in-bus-lanes/

https://metro.co.uk/2018/03/02/ambulance-service-fined-900-every-

day-using-bus-lane-outside-hospital-7356907/

https://www.union-news.co.uk/unison-anger-as-ambulance-crews-hit-

with-fines-for-using-bus-lanes/

So, to conclude, TfL have jurisdiction in London and the advice from TfL is

clear and we work within their guidelines.

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https://petition.parliament.uk/petitions/216673

https://www.yorkpress.co.uk/news/17568291.ambulance-crews-are-being-fined-for-driving-in-bus-lanes/

https://www.yorkpress.co.uk/news/17568291.ambulance-crews-are-being-fined-for-driving-in-bus-lanes/

https://metro.co.uk/2018/03/02/ambulance-service-fined-900-every-day-using-bus-lane-outside-hospital-7356907/

https://metro.co.uk/2018/03/02/ambulance-service-fined-900-every-day-using-bus-lane-outside-hospital-7356907/

https://www.union-news.co.uk/unison-anger-as-ambulance-crews-hit-with-fines-for-using-bus-lanes/

https://www.union-news.co.uk/unison-anger-as-ambulance-crews-hit-with-fines-for-using-bus-lanes/




Completed date

Could the Trust publicise more widely the requirements for use of the Trust free transport?

18/20026 2019-02-21 John Porter

A tele-meeting was arranged with John Porter and Peter George-Jones, the Director of Operations on 28.02.2019 & John kindly provided the following update: I had a constructive conversation with Peter George-Jones, specifically centred around the Guys problems. I see the dilemmas he faces with money, ccgs and our clinical requirements about which he was quite realistic. He hopes the new contracts structure will improve the situation. He did agree to let me have a copy of the NHS guidelines for patient transport provision and to look at how these were promulgated to both patients and staff. I took the opportunity to raise with him the seemingly intractable problem of access to Guys (yesterday my taxi on arrival was not allowed into the forecourt and I had to stagger on my crutches from the road outside. I also pointed out that the nearest taxi rank is outside the Shard, some stagger, to get my return. Even booking a taxi is difficult with the limitations on mobile signal in the Guys arrival area 2019-02-28

Does Essentia have data on satisfaction of ‘customers’ within the Trust for works being undertaken (e.g. new computer points, painting a clinical room, inserting a new was-basin) e.g. time to obtain quotes, time to completion of job, value for money.

18/20026 2018-10-25 John Chambers

Essentia does not routinely gather and report detailed data on the satisfaction of customers in respect of works carried out. However, a review of the minor works process is currently being carried out which includes how we gather customer feedback which we are aiming to be completed by the beginning of April 2019. In addition to overall quality and satisfaction, this will also survey other key performance indicators such as time to quote and complete work and value for money. The expectation is that through our helpdesk and building management system we will send out a survey link on completion of all jobs, the output of which will be included in Essentia’s IQPR. 2019-01-08

There are 3 ways in which we seek feedback on IT Satisfaction: 1. The first is through our day to day Incident Management Process. We don’t have a specific process document but below is an extract from the incident management process that describes it at a high level. In essence we ask the user via the resolution email. Process Extract: 8.7.3 Customer Survey and Incident Ticket Closure. The resolution email includes survey questions to measure the users satisfaction with IT on the handling of the Incident or request “Were you satisfied with IT’s handling and resolution of your Incident or request? YES/NO”. IT Service Desk follows up all negative responses to understand how IT Service Support

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can be improved. All positive feedback will be given to the individual, and their Team Leader. 2. The second is via a formal feedback process which covers the formal

complaints, compliments and general feedback. 3. The third is via our Business Relationship Managers and the Heads of

Service of the areas that they support. 2019-01-15

At the Trust Board Meeting yesterday, 24 Oct, Julie Screaton referred to low morale in middle management. Would it improve this to encourage management by people who have learned the job by career growth within the service e.g. secretaries managed by senior secretaries. This is seen as a positive feature of Essentia. Secondly the manager could be encouraged to be actively engaged with the clinical service. Many managers do not visit the clinical area they manage and often do not know how the system works. This leads to inefficiencies to which the response is to appoint progressively more assistant service managers. This has led to a large cadre of managers separate from the clinicians, secretaries and clerks who deal directly with patients. Do you think that reducing the number of managers and more closely integrating them into clinical teams might improve efficiency and morale?

18/20025 2018-10-25 John Chambers

We have promoted the development of staff from all backgrounds and

professional groups into management careers and are especially proud of

our internal graduate scheme which takes staff with potential onto a fast

track programme. Staff do not need to be graduates to be on the scheme

(despite the name!) and so we have a wide range of people taking part.

We are clear that all staff with managerial responsibility must be visible

and available to their staff and promote the monthly email free Friday

where EDs are ‘out and about’. I will talk to CDs about the concerns you

raise about managers not being au fait with their services as you suggest

as this is not something I was aware of. The morale issue we believe

stems from increasing workload and competing priorities as it is often the

volume of email traffic that gets in the way of our middle managers being

able to keep on top of the busy operational work. I don’t think we are over

managed but I do think we need to focus more on the development and

support of those less senior managers at the early stages of their careers.

2019-01-02

Please can DPJ share the list of as well as demographics within, of the groups / audiences that it has consulted to understand what patients want from their ‘digital’ journeys at GSTT in the future? A recent paper presented to the digital committee made a number of patient statements and it would be useful to

18/20024 2018-07-25 Heather Byron

Awaiting further details from Heather Byron

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understand how representative of our overall patient group those views are, or if they are specific to certain groups.

The GSTT Governors wish to know whether any GSTT or Community staff has lost their jobs as a result of the Home Office policy requiring employers to confirm residency rights, now widely referred to as the 'Windrush scandal', and if they have, what steps are being taken to rectify the situation for those employees?

18/0023 2018-06-07 Devon Allison

We do not record any dismissals through this category, but we have no record of appeals on that basis. 2018-07-03

Is the Trust aware of any applicants who might have been denied employment for the same reasons?

18/0022 2018-06-07 Devon Allison

Similarly, we would not know of any applicants that had been denied employment on that basis but I can confirm that no offers of employment have been withdrawn due to right to work status. 2018-07-03

The organisation seems to work in a hierarchical way, could this be unhelpful when thinking about the future and changes/transformation?

18/0021 2018-02-21

The organisational structure has been given a considerable amount of

careful thought over the past three years as we have started to move into

a ‘group-like’ structure. The main purpose of the shift towards the

Strategic Business Unit model, starting with the Evelina London, was to

move decision-making closer to the front-line so that the organisation can

become more agile and respond to the significant transformation agenda.

The next phase of the SBUs was discussed at Trust Management

Executive on 17 May 2018, which includes Integrated Care and Cancer

SBUs being mobilised for April 2019.

2018-05-31

What impact will the technology of tomorrow (AI/robotics) have on the staff of today?

18/0020 2018-02-21

Data, Technology & Information (DT&i) continue to track and engage with technological advances, from Gartner Hype cycles, trade articles, Industry demonstrations and research. This thought leadership informs the refreshing of the Digital, Technology and Information strategies. The use of these technologies is already occurring beyond the bounds of traditional IT, in medical and pharmaceutical equipment. The Trust deploys robotics live today in Pharmacy, and theatres and we will continue to explore way they can help in other areas. This will be supported by the necessary change and transformation activity to ensure maximum impact is seen across the Trust. Artificial Intelligence (AI) is an area we have already started to look in to through exploring with industry

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and research partners different ways data can help with the delivery of care throughout the Trust (Care Re-Design – is an example). We are also looking in to how the industry can help accelerate our maturity. It is expected that EHR will significantly help our ability to use data moving forward. 2018-05-31

Does the digital committee focus enough on current IT issues?

18/0019 2018-02-21

Chief Digital Information Officer and DT&I Senior Leadership Team provide an Operational update to the 16 May 18 Digital Committee, these are planned as routine updates twice a year, and follows on from the update in Dec 17. The Agenda is re-focussed to provide an operational and current issues at these meetings, over the routine strategic updates and decisions that the Digital Committee focusses upon across its agenda. These operational updates focussed on key issues and the DT&i strategy to address through a series of taskforces looking to stabilise services. The Committee received updates on and discussed the improvements to Wi-Fi (Wireless point refresh); Networks (replacing end of life equipment and reconfiguring for reliability); Monitoring (now monitoring key applications to predict and address issues); Cyber security (responses and plans to the reviews on risk and capability); Desktop Services (addressing Windows10 usability and optimization) and Mobile devices (progressing usability and use). DT&i also shared their Directorate scorecard across all KPIs and performance. 2018-05-31

How can we get our IT people out into clinical services so the requirements of EHR are better understood?

18/0018 2018-02-21

EHR requirements will not be gathered by sending IT people out in to clinical services to better understand requirements. The approach we intend to take is to a) set up structures and forums that will allow clinical services colleagues to define or validate EHR requirements alongside IT colleagues and b) ensure that EHR requirements are understood by all relevant parties prior to EHR requirements being signed off for use in an EHR procurement. 2018-05-31

How are we going to manage the transformation associated with EHR/IT implementation?

18/0017 2018-02-21

Alongside the Outline business case for the EHR, the trust has created a transformation plan which aims to realise our vision for the future. The costs of that plan were considered and ratified alongside the EHR OBC and we are now moving into implementation. The transformation plan brings together our existing resources and initiatives, coordinating them around a single agenda and dovetailing with the IT implementation.

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2018-05-31

How aware do you think the Trust is to the level of change that is required to achieve the current agenda and the level of effort it will take?

18/0016 2018-02-21

Our Team Brief system, senior leadership conferences and listening exercises help ensure we are well connected to staff providing front line services. However, we know there is more to do to ensure we are agile enough to respond to the changing world we live in. Technology will be a key driver of change and the implementation of a new EHR will require a large transformation programme that is currently in development. 2018-05-31

How equipped are we to manage the cultural change needed to effectively implement EHR?

18/0015 2018-02-21

The size of programme and cultural change that EHR requires has not been undertaken by the Trust before and therefore needs careful planning. We are fundamentally changing the way the majority of our staff experience work and with that in mind a full, underpinning HR and OD programme is currently in the planning. We will learn from others who have gone through this change and our approach is to engage staff at all levels and work with them to develop our new ways of working in a co-developed way to ensure ownership and buy in from the outset. 2018-05-31

Are the clinical outcomes we achieve visible enough and do we have the focus we should?

18/0014 2018-02-21

Increasingly in recent years there has been a focus on transparency and publishing more clinical data, both in terms of outcomes but also around incidents and lessons learnt. Asa a Trust we report positively and we report to the Board through quality & performance committee our clinical performance on a range of things, from our pressure ulcer rate, falls with harm, hospital acquired infections and our mortality rates. We have as a Trust supported the national requirements tom publish some clinical outcome data, but in doing so we are conscious it must be accurate but also presented in a way that is meaningful, accurate and responsible, so that members of the public can use it in the right way. 2018-05-31

How do we balance the pressure to focus less on long term follow up of our patients with the push to see new cases - doesn't this reduce access to meaningful outcome data of what matters to patients?

18/0013 2018-02-21

Our clinicians will only discharge back to the GP when it is clinically appropriate to do so. There are very few patients who have or require long term - lifelong follow up and this has always been the case. Therefore in terms of meaningful outcome data this has and will continue to be a challenge until we have one integrated clinical record 2018-05-31

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How well are the governors able to hold the NEDs to account - does the Council of Governors do its job effectively?

18/0012 2018-02-21

We are always looking for suggestions from governors about what we can do differently to support them to discharge their duties more effectively. Currently we encourage all governors to attend public Board meetings, include governors in Board Committee meetings, hold accountability sessions twice a year and support three working groups. We will be putting together a programme of visits within the Trust for NEDs and governors. To the extent that the Trust continues to be financially successful, to have a good reputation for quality and service and an effective board regularly looking at risk, strategy, culture and patient experience I hope that suggests that we have got the make-up, calibre and quality of the Board team right and as the governors recruit and appraise the non-execs, we can conclude that in this respect, the governors are doing an effective job. 2018-05-31

Would informal meetings with Governors and the NEDs be useful?

18/0011 2018-02-21

This is not something we’ve done though other trusts facilitate this type of encounter. Overall, we think there are enough opportunities for governors to observe and interact with directors at board meetings, committees, council and working group sessions. Our accountability sessions are different to what any other trust does and we will continue to work on their format so that they provide a more effective platform for discussion. 2018-05-31

How effectively do you think NEDs influence the executive members of the Trust - is the Board is driven by a few personalities?

18/0010 2018-02-21

The Nominations Committee has worked closely with us to make sure that we have a Board that is diverse, capable and balanced – the non-executives and executives sit together as a unitary group each with an individual and distinctive voice. How each and every vacancy is to be filled is agreed with the Nominations Committee and the person specification adjusted accordingly. We generally use external recruitment advisers to help to search out the right people. There are some new people around the board table and it always takes some time for the group to reform itself after any change but we feel that it is working well and will be a powerful, supportive and challenging group – everybody is willing to ask questions and seek assurance. This is an important group in a large organisation – we think we have the right balance at the moment to move the Trust forward in powerful ways that will be good for our patients and local residents. 2018-05-31

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What is the overall strategy of the Trust and do the NEDs have an impact on the strategy? Is there a forum where NEDs get briefed on the strategies of the Trust?

18/0009 2018-02-21

As governors may recall, in addition to the quarterly public meetings, the Board meets “in committee” several times a year and has 2 away days every year 1 day in March and 2 days in September. The bulk of these events are dedicated to longer term plans and ideas. Some matters develop, others do not and there are also opportunistic possibilities that present themselves. Some of our commercial activities are strategic and innovative – the recently announced agreement with Johnson and Johnson to modernise orthopaedics and improve quality and purchasing is an example – and are developed privately until they can be shared more widely and there is NED involvement. The Chairman has a small group of executive and non-executive colleagues who meet from time to time to talk about strategy so overall there are ample opportunities for NEDs to be involved and influential in the strategic arena. 2018-05-31

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Do you think, as a Board, that the Trust is doing enough long term planning (10/20 year plans)?

18/0008 2018-02-21

We will be launching our strategy refresh in July. Whilst this concentrates on the next few years there is a huge amount of work going on around planning what the estate might look like to support care in the next 10-15 years – we shared this with governors at a recent Council meeting and will continue to do so over the next couple of years. The scale of ambition is huge and our delivery plans are innovative. In the context of the clinical and academic ambitions of the Trust, an estate development strategy has been developed in conjunction with King’s College London (KCL) and the Guys and St Thomas’ Charity that will facilitate the delivery of that strategy over the next 15 to 20 years, subject to financing being available. This strategy was approved by the Trust Board in March 2018. At St Thomas’, in partnership with KCL, we will be refurbishing the building known as Block 9 to create a comprehensive education and training centre within the next 5 years. Our ambition for the expansion of the Evelina London Children’s Hospital will also involve the construction of a new building adjacent to the existing building within a five year period. In the longer term, in support of our partnership agreement with Royal Brompton and Harefield NHS Trust and our strategy to improve our cardiovascular service with King’s College Hospital, we are developing estate plans that will see the replacement of Gassiot House within a 10 year timeframe. At Guy’s, our clinical and academic strategy focuses on cancer and cell regeneration. The Estate development plan for Guy’s involves the demolition and re-provision of Borough Wing, which is at the end of its useful life, and the construction of taller buildings on the site which, in conjunction with KCL, will enable biomedical partner organisations to work with us in translational medicine and the life sciences agenda looking to the next generation of healthcare practice. 2018-05-31

Why don't we focus more on research and education and not just clinical services when looking at strategy and performance - how do we measure research performance?

18/0007 2018-02-21

We can assure governors that the Board does focus on research and education, as we focus on Clinical Quality and performance, as part of the Boards commitment to the tripartite agenda. As an academic foundation trust this tripartite agenda of commitment to excellence clinical care, research and education underpins our strategic and tactical plan. Specifically, in research we have made major investments with our

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university partners in the creation of infrastructure both on the Guys and St Thomas’ campuses to facilitate world class research. This is recognised in our relationship with NIHR from whom we have received considerable funding both for BRC and other NIHR Infrastructure. The commitment to research is not only an Infrastructure development. In addition to capital investment we have made significant investment to support our workforce to undertake research, a commitment that has been recognised by many by the awards for academic appointment within the university for NHS consultants. In education, we have committed considerable investment to enhance education delivery on both campuses. Importantly the Trust is committed to the development of St Thomas’s education centre, a £45 million joint investment. 2018-05-31

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Essentia doesn't seem to be talked about a lot at Board level, would like the NEDs to ask more about this area - understanding the roles and the differences between Essentia core services and Essentia TL would be helpful

18/0006 2018-02-21

Essentia is the Capital, Estates and Facilities Directorate in the Trust

providing services ranging from catering, cleaning, transport and

portering, to building, engineering, capital planning and asset

management, as a dedicated in-house resource. The name “Essentia”

was adopted in 2012, emphasising the essential services we provide to

the acute sites and across the community for GSTT and other Trusts. Our

purpose is focused on creating the best possible patient environment and

supporting the best possible patient care. We provide quarterly updates to

the Board of Directors through:

• the Quality & Performance Committee which primarily focuses on

performance of Essentia services against agreed KPIs and allows

Essentia the opportunity to highlight issues that may have had an adverse

impact on performance.

• the Corporate Management Committee where on a quarterly basis an

update is provided on progress with capital projects currently underway

and the investment strategy which primarily is about how the Estate may

be configured in the future to ensure it is fit for purpose and aligned to

advances in clinical and research activity.

Essentia Trading Limited is a wholly owned subsidiary of Guy’s and St

Thomas’ NHS FT and was created in response to demand from other

NHS trusts and public sector organisations seeking advice in how to

become more efficient and more effective. It employs approximately 60

members of staff and turns over about £7m, this has increased each year

since its creation and all profits are provided back to Guy’s and St

Thomas’ NHS FT. Essentia Trading also makes a contribution to the

revenue plan that Essentia has to deliver and by doing so, it protects the

quality of services currently being provided by Essentia at Guy’s & St

Thomas’ NHS FT. 2018-05-31

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We appear to be very acute focused - why don't we discuss community services more?

18/0005 2018-02-21

From an adult perspective, community services are discussed at the Adult Local Services Committee which includes three governors in its membership. The minutes are shared with the Board. Local services and integration are a key strategic priority for the Trust and there have been occasions when governor working groups have had presentations on community services. If governors would like to hear more about community services, we are very happy to attend appropriate meetings. We are currently working towards a presentation at the July public board/council of governors meeting. Similarly, Children’s Community Services are regularly discussed at the Evelina London Board, which 2 governors attend. Integrated local child health services are one of Evelina London’s four strategic priorities, and there are a range of initiatives supporting this, including our contribution to partnership programmes in Lambeth & Southwark. 2018-05-31

Are we doing enough about succession planning for EDs and senior managers?

18/0004 2018-02-21

The Leadership and Management framework allows the Trust to identify and develop potential future leaders and senior managers to fill business critical positions in the short and long term. Succession planning is a crucial issue not just for senior managers but also for a pipeline for business critical roles. We have developed a leadership and development programme available for operational leaders band 7-8a, non-clinical and clinical leaders to support this and we are building on this in 2018/19 with the development of the Operational Excellence programme. We have focussed on team development in our senior roles with our Leading for the Future programme. With the exception of clinical senior roles, until the recent appointment of the CEO we have traditionally recruited externally for key Executive posts due to the stretch in requirement, however the development of the Strategic Business Units and the requirement for different leadership capabilities has meant that we are currently considering our approach to talent management at senior levels and are approaching this with other members of the Association of Health and Care Provider Groups and working closely with NHSI and the Leadership Academy. 2018-05-31

How do we prepare for the workforce of tomorrow?

18/0003 2018-02-21

To ensure we can continue to deliver services to our patients and populations, we need to both retain and develop our existing staff as well as ensuring that we continue to recruit new people. We undertook some

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research on what different generational groups want from work found that our younger workforce want more of a portfolio and flexible career. We are therefore trying to think differently about job design and career paths as well as building better links with our communities and schools so we get more local people into employment. 2018-05-31

How do we obtain staff views - how is the resilience of all staff groups (but particularly those in less visible areas) assessed and supported at a time of unrelenting pressure?

18/0002 2018-02-21

We get intelligence from the annual NHS staff survey, the quarterly Friends and Family test. We are launching 'Big Conversation' this month with a focus on diversity and inclusion. Our staff survey is full census every year to allow directorates to specifically take responsibility for their own staff and hear from them. Our Speak Up Guardian also play a vital role. We are currently exploring how we 'test the silence' with different staff groups and undertake temperature tests without overwhelming the staff, who already fill in between 4 and 6 surveys per year. 2018-05-31

What options are there to address the affordable housing issue for our staff - many of whom travel long distances to work here - what collective response could be offered in partnership with others?

18/0001 2018-02-21

The Trust has 324 room available for nurses and AHPs to occupy on short term leases to support recruitment. We offer interest free loan rental deposit loans to nurses and AHP staff (around 20 have taken up the offer). We have discussed with Estates a longer term strategy and discussions have taken place with developers within Lambeth & Southwark to have an allocation of units within the current new housing developments. The developers are keen to work in partnership on this. We are also working with Corporation of London to develop ideas to provide affordable homes on land owned by the Trust in the community. 2018-05-31

I wonder whether the below is something we can support either as a CoG or raise up to the Children's Services committee given it has impacted the clinical process and patients? Problem Statement: The lab is facing some lapse in service from the Royal Mail around a business delivery service that is in place for the prompt delivery of new-born screening / monitoring blood spot tests. Whilst this hasn't yet a systemic

16/0016 2016-07-28 (Heather Byron)

The Head of Nursing for Children's Medicine & Neonatology responded as follows: I have some insight into this, as this must originate from the paediatric metabolic service - she worked in this team for many years, & is well used to the challenges of bloodspot screening, ongoing monitoring & Royal Mail. Just in terms of assurance with regards to delays in NBBS after birth, the national “fail safe” system does provide some reassurance and ensure if a sample is mislaid or significantly delayed a baby would have a repeat sample taken in a timely way.

Further update has been sought.

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problem, talking to the lab and the dietitians, there have been a number of incidents which clearly causes concern both from the perspective of delay to patients on results but also any potential risk / harm resulting from tests which do not arrive or can’t be read in the lab. Context / Risk: It is hard to quantify the scale of late delivery of the risk to new-born’s / patients as the lab never knows exactly how many new-born screening / monitoring blood tests are being sent in. However, we know the implications of a late results, especially in the new-born screening where in many of the conditions being screened for require immediate intervention / treatment. Its concerning that we may not receive a sample and isn't clear whether there are robust processes in place across the community network to identify promptly if a new-born test results hadn't been returned and therefore a further test taken. I fear, more often than not, it would be missed for some time, which could have medical and/or quality of life implications. Whats next: There are a number of things which could happen to support the labs in dealing with the problem so that the service becomes reliable and they are spending valuable time chasing RM.

develop a simple, consistent escalation process to Royal Mail (admin driven not lab driven) so that we are consistent in our escalations and have a clearer audit behind us

I will look into the other issues raised with the teams involved and will feedback progress around these points. Thank you again for sharing this with us. (26-08-2016)

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of the issues encountered (this could be a simple form on the portal for example)

as part of the wider Royal Mail relationship drive some escalation discussions (the sense is that in isolation this isn't 'important enough' to deal with by the RM.

review whether Royal Mail is the right partner to be responsible for the delivery of such important blood samples or whether a commercial agreement should be made with another party (whilst on the surface the 'cost' of the RM business reply service may seem competitive, I wonder when you look at the total cost including the courier costs to bring post from RM to GSST, it may not be... not to mention the slightly unreliable nature of the service.

I am very happy to support any next steps, but wanted to share with you for your guidance as to whether this is something we are at liberty to raise awareness to and have the possibility to help resolve?

Governors understand, from documentation released at Board Committee meetings, that Consultants are helping to identify cost improvement opportunities for FY 2016/17 and that Lord Carter has similarly identified savings opportunities. Could the Board outline the nature of these opportunities and give some understanding of the impact they would have on the operation of the FT.

16/0011 2016-06-22 (John Porter)

The Trust commissioned PWC, following a tender process, to perform a six week diagnostic study to identify and quantify in year savings opportunities for the Trust in 2016/17. The report shows a number of cost saving opportunities over and above existing savings schemes. PWC and the Carter team have provided benchmark data demonstrating potential efficiency savings for the Trust when compared to other similar service providers. This output forms part of the continuing cost improvement plan.

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The CEO says that there is a programme of work underway by the Medical Director to address "hospital at night concerns". What progress I wonder? I realise how difficult it is to control events at night in a busy hospital, but I have had recent experience of unnecessary noise at night in the wards

2014-04-29 Hospital at Night is about the clinical operating model for looking after patients out of hours. We are currently looking at the future clinical model that will be required at GSTT and the implications this will have for our workforce, given activity changes and the anticipated shift towards a 24/7 care model at a national level.

A further response/update has been sought.

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1 24th April 2019 Council of Governors - Election of CoG representative to the Evelina London Board


Election of CoG representative to the Evelina London Board

24th April 2019 CG/19/08

This paper is for: Sponsor: Trust Chairman

Decision X Author: Trust Secretary


Noting CEO*

Information ED*

Board Committee*

TME*

Other*

* Specify

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1. Summary The Evelina London Board is one of the Trust’s bodies where governors have a seat, on similar lines to the Board’s unitary committees. Devon Allison has been the representative for some time but is now standing down. We anticipated that a number of governors would be interested in taking up this role, so felt that an informal election at the Council of Governors meeting on the 24th April 2019 would be the best way to resolve this position. Governors wishing to be considered were asked to submit a personal statement of up to 150 words. 2. Governor statements The following governors wish to be considered for the seat on the Evelina London Board:

Mary Stirling Patient Governor Evelina London cares for children and young people from across South London and South East England offering a unique range of services both in hospital and in the local community. I am a qualified and experienced early years' teacher who has also been a governor of a primary school for 3 years. My mother also trained as a teacher and taught the sick children at Mayday Hospital for over 21 years. I know she found this role immensely rewarding. I have seven nieces and a nephew and also, most recently a great niece. I am now Great Aunt Mary, a role I really love. I see my great niece on a regular basis and it is so exciting to see her development over such a short period of time. I would like to become involved in this world renowned Children’s Hospital particularly during the ambitious development and expansion programme.

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Heather Byron Patient Governor I am an Evelina mum. The staff at the Evelina have cared for our 4-year-old, Grace, since she was born at St. Thomas’. They are part of our family. I see the incredible work the Evelina does each time we attend a clinic and am excited for the future growth ambition that has been shared. I support the hospital as a fundraiser and have been deputy on the Evelina committee since the start. I am a passionate advocate, but also a pragmatist – there is more we can and need to do. I’d like the opportunity to sit on the Evelina London Board so that my passion to ensure the true voice of the patient and carers of patients is injected into every board meeting and, that commitments to deliver outcomes to further improve patient experience are realised. From Grace and others like her, thank you for making sure their voice is heard.

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Marcia Da Costa Public Governor I would like to be the Governor representative on the Evelina London Board because of my association with Evelina Children’s Hospital (up to 2001) while managing the Lambeth Children and Families Social Service at St Thomas’ Hospital. As a senior manager and head of department I was a member of the hospital planning board in the early phases of the hospital’s development. Since then I have followed its expansion and work with great interest. My work experiences have equipped me with the knowledge and skills necessary to contribute to the work of the Board. For example, I have developed multi-agency hospital and community partnerships for client groups up to age 18. The work I managed also related to all aspects of safeguarding children, young people, and family issues. Additionally, I managed Local Authority Children’s Services and budgets in general hospitals in Lewisham, Hounslow, Bedfordshire and Kings College Hospital. Annabel Fiddian-Green Public Governor I first encountered the impact of paediatric healthcare when my son was diagnosed aged 16 months with urinary/kidney problems. Over the next few years, he was in and out of hospital, sometimes for two-three weeks at a time. Additional bad luck was appendicitis at only eight years old. I was in awe – and hugely reassured – by the extraordinary dedication the whole paediatric team showed in treating, caring for and calming my son. I shall never forget the sight of him, on a good day and aged about five, running around with a catheter bag slung over each shoulder, involved in some great game with the nurses! Ben is now 6’4” so at times it’s difficult to remember that vulnerable little boy. But I do vividly remember the worry and fear and would love to do anything I could in my Governor role to help support Evelina.

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24th April 2019 Council of Governors - Lead Governor


Lead Governor Succession

24th April 2019 CG/19/09




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1. Summary A number of governors have expressed their concerns that it is difficult for a new Council of Governors to elect a Lead Governor as soon as they themselves take up their role as governor. This paper proposes a solution that requires Governor approval but will not entail a change to the Trust’s constitution. 2. Request to the Council of Governors

The Council is invited to agree to the nomination by the Trust of the current Lead Governor to remain on the council for a year following the end of her tenure, to defer the election of the new lead governor until January 2020 and to consider the election of a deputy lead governor at the same time.

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3. Lead Governor Succession In circumstances where the current Lead Governor comes to the end of their second term of appointment at which other governors are also standing down, there are obvious difficulties for the Council of Governors in electing a successor at either the July or October meetings because the newly elected governors will have had limited opportunity to familiarise themselves with the role or the potential candidates. Other trusts go some way to obviating this situation by also electing a deputy lead governor who is able to take some of the load off the lead governor and gain valuable experience in shadowing the role for a period – though of course there should be no assumption that they should or would want to be elected as lead governor. We find ourselves in these circumstances at present and following representations from a number of colleagues I would like to propose the following way forward: Devon Allison, the current lead governor, should be asked to remain on the Council of Governors as a nominated (by the Trust) non-voting governor for a period of up to a maximum of 12 months from the end of her second term of election. She would act as a lead governor until the Council meeting in January 2020 when there would be an election for the post of lead governor, and if the Council felt it was appropriate, a deputy lead governor as well. At her discretion, and with the agreement of the Council, Devon could remain on the Council for the remainder of the 12 month period to provide support and mentorship for her successors, if this was thought to be helpful.

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24th April 2019 Council of Governors - Report from the Nominations Committee 1


Report from the Nominations Committee

24th April 2019 CG/19/10



Discussion X Reviewed by:

Noting CEO*

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TME*

Other*

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1. Summary The Nominations Committee met on 26th February and considered three items: the chairman’s review of Non Executive directors’ performance, NED remuneration and NED recruitment. 2. Request to the Council of Governors Council is asked to note the review, proposals for changes to NED remuneration and to approve the proposals for recruitment during 2019, including the draft job descriptions.

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3. Non Executive Director Appraisals The Chairman confirmed that he had undertaken appraisals with all NED colleagues, including those most recently appointed. He outlined the arrangements he had put in place in support of his taking on the chairmanship of King’s College Hospital NHS Foundation Trust: Sheila Shribman would continue in her role as vice chair and in effect as Senior Independent Director

undertaking the Chairman’s appraisal in due course and leading the Evelina London board. Steve Weiner was

standing down as Audit committee Chairman and would be supporting the Chairman in his role at King’s. He

was also taking up the chairmanship of the new Transformation and Major Programmes Committee. Priya Singh

would continue to lead on quality matters and serious incidents at the Trust through her chairmanship of the

Quality and Performance Committee and the Serious Incident Assessment Panel and so would effectively

deputize for the Chairman on quality matters. Girda Niles would continue supporting the Integrated Care

Strategic Business Unit. Felicity Harvey was to be asked to chair the Strategy and Major Partnerships

Committee and John Pelly had taken up the chairmanship of the Audit and Risk Committee.

The Committee noted that Priya’s first term of office would come to a close later this year and Girda would be

standing down at the end of her second term at the end of 2019.

4. NED Remuneration

NED remuneration was last increased in 2008. In the light of the additional responsibilities all had been asked to

take on, the Committee agreed the Chairman’s proposal that all NEDs should be paid the same rate – currently

the Chairman of the Audit Committee received a small enhancement – of £20,000 with effect from 1st April 2019.

In percentage terms, this was similar to the increases to Agenda for Change salaries paid to most NHS staff.

The Chairman’s remuneration was to be reduced to reflect his changed commitment to the Trust from 3.5 days

per week to 2.5 whilst he also chaired KCH.

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5. Non Executive Director Recruitment

The Committee agreed to begin the process replace Girda Niles who was due to step down at the end of the

year later in the spring with the aim of maintaining the diversity mix on the Board if possible and have someone

from within the local community. Workforce expertise would also need to be available once Girda and later the

Chairman had stood down; this was an important agenda for the Board. It was agreed to appoint Green Park to

assist with this search and the Secretary asked to begin this process. The draft role specification is attached for

comment.

There was potential for a further appointment as the decision to replace Emma Duncan had been deferred.

There were skills gaps on the Board around technology and digital issues – there was no non-executive in depth

knowledge and no permanent executive capability. The Committee noted that non-executive directors were first

and foremost directors of the Trust and would be expected to fulfil that remit; any subject expertise was regarded

as supplementary.

Replacing David Perry, a non-executive adviser who had stood down on 31st March 2019, with another adviser

would be more flexible in that they would not need to meet the membership criteria applied to NEDs, but the

Committee was quizzical as to whether anyone other than a director would be able to influence the depth and

range of the current digital and technology agenda. It agreed to test the market for a non-executive director as a

first step. Given the importance of technology to the future of the NHS resolving both the executive and non-

executive problems was urgent. It was agreed to ask Odgers Berndtson to undertake this work and the

recruitment pack, including the draft role specification is attached for comment. If this is not fruitful a search for a

non-executive advisor would be considered.

Finally, Priya Singh’s reappointment would be considered later in the year with a recommendation from the

Committee put to the Council of Governors’ meeting in July.

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Appendix 1

Candidate brief for the position of Non-Executive Director (April2019)

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Non-Executive Director | Guy's and St Thomas' NHS Foundation Trust

odgersberndtson.com 1

Candidate brief for the position of

Non-Executive Director

Guy's and St Thomas' NHS Foundation

Trust

April 2019

Tab 8.1 Appendix 1 NeD Candidate Brief




Contents

About Guy’s and St Thomas’ NHS Foundation Trust 3

Job Description 13

Person Specification 15

How to Apply 17

odgersberndtson.com





About Guy's and St Thomas' NHS

Foundation Trust Background

Who are we?

Guy’s and St Thomas’ is one of the largest, busiest and most successful NHS foundation trusts in England. We are an

integrated healthcare organisation providing a full range of adult and children’s specialist, elective, emergency and local

community services. We are committed to providing excellence in clinical care, research and education.

Our location

Our services are provided from multiple locations that are easily accessible from across London and southern England,

including St Thomas’ Hospital and Evelina London Children’s Hospital, close to Waterloo, Guy’s Hospital, close to London

Bridge, and over fifty community locations in Southwark and Lambeth. We are home to the largest dental hospital in

Europe and our £160mn Cancer centre opened in 2016. We also provide local services in GP practices, schools, people’s

homes, nursing homes and children’s and leisure centres. A part of our commitment to provide care closer to home, we

offer specialist services in other hospitals across south east London, West Kent, Surrey, Sussex and beyond including

cancer and renal services at Queen Mary’s Sidcup. St Thomas’ has one of the largest critical care units in the UL and one

of the busiest emergency departments in London.

Our Key Facts

We have over 2.5mn patient contacts every year, 810,000 of which are in the community. We see around 111,000 day case

patients, 89,000 inpatients and 1.28mn outpatients. Over 6,500 babies were born last year in the Trust and our turnover is

over £1.5bn.

Our staff

We employ around 16,200 staff, nearly 40% of whom live locally. They are our most valuable asset. Their skills, knowledge

and experience underpin all our clinical, research, education and commercial activities. We are a major employer,

educator and trainer for London, southern England and the NHS as a whole with 1,343 undergraduate doctors, dentists

and nurses, 533 postgraduate doctors, and dentists and 330 trainee allied health professionals such as physiotherapists.

Research

The Trust is also a pre-eminent research hub. We host one of the National Institute of Health Research (NIHR) Biomedical

Research Centres (BRC), established with King’s College London in 2007. King’s Health Partners is one of six academic

health science centres in collaboration with King’s College London and King’s College Hospital NHS Foundation Trust and,

uniquely, the South London and Maudsley NHS Mental Health Foundation Trust. World-class research, education and

clinical practice are brought together for the benefit of patients. We translate cutting-edge research and existing best

practice into excellent patient care.





Our mission

Our values

Our values have been developed in close collaboration with staff who strive to provide our patients with exceptional care

every day.





Our strategy

Together We Care Trust strategy 2018 – 2023

Together we have identified three overall priorities for our organisation, under which sit a number of more detailed

strategic objectives. These are the things we care about most and will be central to achieving our vision:

1 Transforming our relationships with our patients and the populations we serve by:

involving patients as partners in their own health, wellbeing and care and placing patient and public engagement at the

heart of everything we do. We aim to meet their expectations of 21st century healthcare, using digital technology to

improve access and services.

2 Supporting our staff to improve the way we work and securing our finances for the future by:

investing in our staff, securing and retaining the outstanding teams we will need for the future of our organisation and

the wider system, supporting their education, development and wellbeing and improving our diversity at all levels of the

organisation.

delivering consistently excellent care that is quality focused, best practice and data driven, efficient, consistent and

supported by the latest digital technologies.

securing our finances for the future, by making the most of the location and value of our estate, improving our efficiency

and broadening our income base.

3 Building new partnerships and strengthening existing relationships by:

creating world class clinical academic services and taking them to a higher level by building and supporting networks of

specialist services in South East England, with centres of excellence for cancer, children’s, cardiovascular and other

services.

developing integrated local services by working together with local partners to enable people to stay well for longer,

help meet growing demand and to co-ordinate care and prevention.

accelerating the introduction of world leading advanced therapeutics, experimental medicine and medical technology,

collaborating with academic commercial partners to work at the cutting edge of new approaches to medicine and

delivering new treatments for our patients more quickly.

How we are led

Board of Directors

The role of the Board

Sets the overall strategic direction of the Trust, within the context of NHS priorities.

Monitors our performance against objectives.

Provides effective financial stewardship through value for money, financial control and financial planning.

Through clinical governance, ensures that we provide high quality, effective and patient-focused services.





Ensures high standards of corporate governance and personal conduct.

Promotes effective dialogue with the local communities we serve.

Our Executive Directors:

Amanda Pritchard – Chief Executive and Accountable Officer

Amanda Pritchard was appointed as Chief Executive in January 2016, having been Acting

Chief Executive since October 2015. Prior to that she served as Chief Operating Officer at the

Trust for three and a half years.

Amanda joined Guy's and St Thomas' from Chelsea and Westminster NHS Foundation Trust

where she spent six years as Deputy Chief Executive having previously held a variety of senior

strategic and operational management roles there, including Director of Strategy and Service

Development.

Amanda spent 10 months leading the health team in the Prime Minister’s Delivery Unit in 2006, and has also held a

number of other NHS management positions.

Amanda has three children, the youngest of which was born at St Thomas' Hospital in 2014.

Julie Screaton – Chief People Officer

Julie Screaton was appointed as Director of Workforce and Organisational Development in

June 2017 and made Chief People Officer in 2018.

Julie has wide ranging experience of leading workforce and organisational development

teams in the NHS, having worked extensively at a regional, and also a Trust level, in roles

spanning operational and strategic responsibilities.

In her previous position, as Regional Director, London and the South East for Health

Education England, Julie was responsible for £1.4 billion of investment in education, training

and workforce development across London, Kent, Surrey and Sussex. Her role included providing support to eight

Sustainability and Transformation Plans within this geographical area.

Dr Ian Abbs – Chief Medical Officer

Ian Abbs became Chief Medical Officer in January 2011.

He joined the Trust as a consultant renal physician and honorary senior lecturer at King’s

College London in 1994 and has had a distinguished clinical and academic career, which has

included a broad range of senior management positions.

In addition to his clinical work, Ian has played a key role in the development of Clinical

Academic Groups, the management units of King’s Health Partners, and was closely involved

in work to integrate with Lambeth and Southwark community services.





Jon Findlay – Chief Operating Officer

Jon Findlay was appointed as Chief Operating Officer for Guy’s and St Thomas’ NHS

Foundation Trust in January 2017.

Previously Jon was Chief Operating Officer and Deputy Chief Executive at Southend

University Hospital NHS Foundation Trust, an Executive Director role he held since January

2014.

Before working at Southend, he was Director of Operations at Guy’s and St Thomas’ where

he was responsible for operational performance and the strategic development of clinical

services across the two hospital sites.

Jon has 14 years’ experience working at Director level. His roles have spanned clinical operations, service modernisation,

performance improvement, human resources and workforce planning, as well as initiatives such as the National Patient

Access Team and NHS franchising.

Martin Shaw – Chief Financial Officer

Martin Shaw joined the NHS in 1981. He joined West Lambeth Health Authority in 1983, where

he held a variety of posts and was Deputy Director of Finance there until 1993 when he

joined Guy’s and St Thomas’ as Business and Financial Planning Manager, before becoming

Strategy Director and Projects Director. He was appointed Finance Director of the Trust in

1998 and made Chief Financial Officer in 2017.

Martin chairs the Healthcare Financial Management Association’s Finance Directors’ Group

and the Shelford and Project Diamond Finance Directors’ Groups.

Dame Eileen Sills DBE – Chief Nurse and Director of Patient Experience and Infection Control

Dame Eileen Sills was appointed Chief Nurse in 2005. Having qualified as a registered nurse

in 1983, Eileen has held a number of general management and senior nursing leadership

posts in London. She was awarded a CBE in 2003 for services to nursing, and a DBE in

January 2015.

Eileen holds two visiting professorships, at King’s College London and London South Bank

Universities. She is a member of the NHS Employers policy board and the Chair of the grant

committee for the Burdett Trust for Nursing. Eileen has a national reputation for strong,

visible, clinical leadership, and her drive to take senior nurses back to the bedside has earned her a national reputation for

her Clinical Fridays initiative.

In August 2013 Eileen was appointed as the Clinical Director for London’s Strategic Network for Dementia.

Jackie Parrott – Chief Strategy Officer

Jackie Parrott was made Chief Strategy Officer in April 2019.

Jackie has over 32 years NHS experience having started her career as a management trainee

in south east London. Having managed surgical services and some medical specialties she

joined Guy’s and Lewisham Trust in 1991 as a general manager for women’s services at Guy’s

Hospital. When Guy’s and St Thomas’ was formed she then moved on to manage a wide

range of specialist services including cancer, medical physics, haemophilia/haematology,





cardiothoracic and renal services.

Her career has spanned both operational and strategic management with a number of policy, planning and partnership

roles held from 2000 and as part of a job share from 2002. In 2010 she became Joint Director of Strategy and then

Director of Strategy since 2013.

Our Non-Executive Directors

Sir Hugh Taylor – Chairman

Sir Hugh was appointed as Chairman of Guy’s and St Thomas’ in February 2011. He had a

long and distinguished career in the civil service which included senior roles in the

Department of Health and NHS Executive, the Cabinet Office and the Home Office.

His most recent appointment before joining the Trust was as Permanent Secretary at the

Department of Health, from which he retired in July 2010.

Sir Hugh chairs the Cancer Services, Corporate Management and Remuneration Committees

as well as the Board. Sir Hugh is also interim chair of King’s College Hospital NHS Foundation

Trust. He is a resident of Southwark.

Dr Felicity Harvey CBE – Non-Executive Director

Felicity has considerable senior leadership and strategic planning experience. She was

director general for public and international health, until her retirement from the civil service

at the end of June 2016. Prior to that, she was director of the Prime Minister's delivery unit.

After qualifying in medicine in 1980 at St Bartholomew's Medical College, London, Dr Harvey

completed an International MBA before taking on a series of positions working at the highest

levels of Government.

Her previous roles include private secretary to the chief medical officer, head of quality

management at NHS Executive, director of prison health and a member of the HM Prison Service board at HM Prison

Service and head of medicines, Pharmacy and Industry Group at the Department of Health. She is also a visiting professor

at the Institute of Global Health Innovation at Imperial College London.

Girda Niles – Non-Executive Director

Girda is a local social business coach specialising in strategy for social businesses and those

who want to make a social difference.

She has extensive experience in strategy in the community and voluntary sectors, social

enterprise, financial management and training. Through her previous role as a Non-Executive

Director of Lambeth Primary Care Trust, she has a thorough understanding of how health

and social care systems work.

Girda joined the Board in January 2012 and chairs the Integrated Care Strategic Business Unit.





John Pelly – Non-Executive Director

John Pelly qualified as an accountant in 1978 and spent the early part of his career in the

commercial sector, notably with Rank Xerox Ltd where he held a number of financial

management and marketing positions.

He joined the NHS in 1990 as Finance Director of West Lambeth Health Authority, becoming

Finance Director of Guy’s and St Thomas’ NHS Trust on the two hospitals’ merger in 1993.

John was appointed Chief Operating Officer of Guy’s and St Thomas’ NHS Trust in 1998,

where he remained until 2004 when he took up the position of Chief Executive of Queen

Elizabeth Hospital NHS Trust in south London.

After four years there John was appointed Chief Executive of Moorfields Eye Hospital NHS Foundation Trust in early 2008,

a position he held until his retirement from the NHS in November 2015. John was awarded an OBE in the 2016 Queen’s

Birthday Honours.

John joined the Board in January 2017, and chairs the Audit & Risk Committee

Professor Reza Razavi – Non-Executive Director

Professor Razavi is Assistant Principal for Research and Innovation at King’s College London.

He is also Director of Research at King’s Health Partners and a children's cardiologist at

Evelina London Children’s Hospital.

His research focus is on imaging and biomedical engineering related to cardiovascular

disease. With many years of experience in this field, Professor Razavi helped to establish the

Trust’s cardiovascular MRI service and developed the world’s first cardiovascular MRI cardiac

catheterisation programme.

Reza joined the Board in May 2016.

Priya Singh – Non-Executive Director

Dr Priya Singh was formerly an Executive Director at the Medical Protection Society and has a

background in general practice. She brings substantial medico-legal, risk and strategic

experience to her role on the Board.

Priya's career at the Medical Protection Society spanned more than 20 years and she was

responsible for the provision of professional services to 290,000 doctors, dentists, and other

health professionals around the world.

Priya joined the Board in November 2015 and chairs the Quality & Performance Committee.





Dr Sheila Shribman CBE – Non-Executive Director

Dr Sheila Shribman CBE was the Department of Health’s National Clinical Director for

Children, Young People and Maternity for seven years until March 2013.

She was a consultant paediatrician for more than 25 years and was Medical Director of

Northampton General Hospital for 11 years. She led the successful integration of children’s

services in hospital, community and mental health settings, working closely with the local

authority.

Sheila is Vice Chairman and also chairs the Evelina London Board.

Steve Weiner – Non-Executive Director

Steve Weiner lives locally in Southwark. He has spent most of his career in finance with

international consumer goods group, Unilever. He is now Group Controller and part of

Unilever's finance leadership team.

He has extensive experience in making operational and commercial decisions involving large

budgets and complex financial constraints and in leading and developing multi-cultural

teams.

Steve joined the Board in July 2014 and chairs the Transformation & Major Programmes

Committee.

iCare – The Trust’s Technology Strategy

The Technology Strategy has been created with the understanding of the Trust’s current and likely future needs. The

introduction of an EHR, Strategic Business Units, and Integrated Care Systems (ICS) are addressed by the Technology

Strategy. They ensure the Trust is setup to interoperate across the health system and deliver the underpinning

infrastructure to support each of these strategic goals.

We see technology as a vital enabler for change rather than an end in itself. To make the most of its potential requires

change in other dimensions of our operating model, including people, process, and how we use space. Through our Fit

for the Future initiative, hundreds of staff engage every year in improving the quality of their services, supported by

training and mentoring. This ‘bottom-up’ change is complemented by a coordinated portfolio of Trust-wide programmes

of transformational change. The design, planning and delivery of transformation, often digitally-enabled, is overseen

through our Transformation, Improvement and Digital executive committee, which reports to the Transformation and

Major Programmes Board (a Board committee).

Interoperability is not currently possible at the Trust because the IT systems are designed to support the delivery of care

within the organisation. The systems don’t allow easy access to the underlying information as they are closed and this will

hinder the Trust as the organisation attempts to work across the health and social care system. As the development of

Integrated Care Systems continues the ease of sharing information between IT systems will become fundamental to the

future provision of integrated care pathways.





Technology Strategy High Level Plan

Short (12 months) Medium (12-24 months) Longer (24-48 months)

Empower the patient Continue the use of and

enhance Dr Doctor (tactical

portal).

Create a GSTT patient

record solution.

Invest in modern bedside

solutions

Provide access to the GSTT

patient record in the NHS

app.

Implement bed apps and

entertainment

Invest in our staff Improve access to online

learning solutions.

Flexible working.

Improve intranet / internet

sites.

Integrated and faster

technical platform.

Integrated user experience.

Offline, synchronised

working.

Deliver excellent care Implement new e-Noting

modules to digitalise

workflow.

Update network solutions

(introduce cloud).

Procure non-EHR solutions

such as e-Consent to

improve Trust wide

capability.

Update communication

solutions (hybrid cloud).

Deploy integrated EHR

platform, integrated with

transport and portering.

Cloud first, care accessible

anywhere.

Secure our finances Improve coding and

diagnostic mapping

(SNOMED).

Introduce digital solutions

to meet minimal contract

requirements (TOC).

Implement new finance and

HR IT systems.

Provide STP wide solutions.

Trial point of care and

wireless diagnostics.

Optimise finance and HR

solutions.

Automate workflows.

AI driven avoidable harm.

Create world class clinical

services

Institute planning and

business case development.

Institute support and pilots. Institute implementation

and optimisation.

Integrated Local Services Connectivity and device

deployment.

Access to cloud services

and procure new solution.

Implementation of new

solutions with offline

synchronised working.

Accelerate Innovation Tactical health analytics and

research.

Establish architecture of

imagine and bio-informatics

institute.

National language data

store implementation.

Integrated research

repository, point of care

decision support.

Translate learning into

patient pathways.

Machine supported

pathways.

The Trust’s Technology Strategy is to provide the underpinning foundations and interoperable data services, allowing the

Trust to deliver its strategic ambitions for the next 3-5 years.





The Strategy is aligned to the NHS ten-year plan, focusing on the provision of the digital services so care can be delivered

from any device in any location. This approach allows the Trust to adapt care pathways without restriction.

A modern Electronic Health Record (EHR) is paramount to the Trust’s Technology Strategy. Without a modernised EHR,

the Trust will be unable to consolidate the information silos that currently exist across the organisation. The new EHR must

be interoperable across all healthcare settings, easily connect to medical devices (patient and Trust owned), and be

accessible from all clinical and patient settings. It will not be possible to deliver the Trust’s institute and research ambitions

unless there is a consolidated core EHR and data platform.

It’s important the Trust includes the replacement and automation of non-clinical workflows in the strategic plan and we will

adopt appropriate cloud-based technologies. Adoption of the cloud will allow the Trust to focus on the delivery of

innovative healthcare rather than the ‘tin and wires’.

The future of healthcare is in the introduction of clinical tools to support preventative patient or device led monitoring with

machine supported diagnostic and decision support, as well as event driven preventative healthcare, driven through

population health solutions. Whether it’s Artificial Intelligence or Machine Learning, access to a data platform that allows

clinical, patient, research and robotic access is the single denominator to the future provision of innovative health services.

Our Partners

We work closely with a range of partners to develop and deliver services that meet the needs of our local and wider

patient communities.

As outlined above, one of our main partnerships is King's Health Partners.

Our academic partners also include London South Bank University, Greenwich University, and Lambeth and Southwark

Further Education Colleges. We work most closely with the London Borough of Lambeth, London Borough of Southwark,

our local clinical commissioning groups and the local Health and Wellbeing Boards. We are the Guy's and St Thomas'

Charity's partner and principal beneficiary.

We lead the Guy’s and St. Thomas’ Healthcare Alliance aimed at improving the quality of our health and care systems for

the benefit of our patients and populations, whilst improving efficiency for tax-payers through organisations working

together. The Healthcare Alliance provides like-minded trusts with a forum for identifying and jointly pursuing

opportunities that will improve patient outcomes and the sustainability of their services.

We are exploring the benefits of a ‘third way’, which allows organisations to access the benefits of a merger, while

maintaining local sovereignty and accountability, without the risk and cost of a transaction.





Job Description The successful candidate for this post will join the Guys and St Thomas’ NHS Foundation Trust (GSTT) Board of Directors

Role Summary

Non-executive directors make an important contribution to the effective running of GSTT. Their role is to provide effective

oversight of the agreed GSTT plan in pursuit of its vision to provide top quality patient care, excellent education and

world-class research. Non–executive directors should help develop strategy and scrutinise performance and satisfy

themselves as to the integrity of clinical, financial and other information presented to them. In carrying out that role, non-

executive directors must promote integrity, one of the Trust’s values, encouraging the highest standards of corporate

governance.

A non-executive director is an ambassador for GSTT and will have a key role providing leadership inside the Trust.

Role description

To ensure GSTT promotes high quality care and shows a genuine interest in its patients, the local community and the NHS;

4 To take corporate and personal responsibility as a Board member for assurance of all the Trust’s activities;

5 To support the Chairman, Chief Executive and executive directors in the leadership of GSTT including to

promote the Trust’s values and in doing so hold them to account for the performance of the Trust;

6 To promote equality of opportunity and recognise diversity when dealing with patients, staff and stakeholders;

7 To contribute to the development of strategy ensuring the necessary resources (financial and human) are in

place to meet Trust objectives;

8 To scrutinise thoroughly and regularly review performance against agreed goals and objectives;

9 To ensure strategies and actions approved by the Board are implemented effectively by the management

team;

10 To offer constructive challenge to the executive members of the Board, whilst respecting executive

responsibility;

11 To share responsibility for communicating decisions of the Board;

12 To be a member of, and in some cases chair, at least one other Board committee and recruitment panels;

13 To develop an understanding of the external environment in which GSTT operates;

14 To strengthen and maintain engagement with the local community, patients and stakeholders and represent

GSTT externally;

15 To establish and develop a constructive relationship with Governors and the Governing Body, having due

regard to their opinions, as appropriate;

16 To determine the levels of remuneration for the executive directors, be responsible for the appointment of the

Chief Executive, and have a role in the appointment of other executives; and

17 To develop and refresh knowledge and skills.





Requirements of the role

Skills, knowledge and experience

In addition to the requirements outlined in the person specification, the candidate should also have a proven track record

of achievement in the following areas.

18 Previous executive or non-executive experience in a large and complex organisation;

19 Experience of designing and delivering major technology and digital programmes;

20 Senior management or board level experience and considerable exposure to complex issues in an organisation

(whether in the public, private or third sectors) of scale and complexity including an understanding of the

scrutiny function;

21 Evidence of showing leadership and inspiration, resilience in the face of challenge and difficulty and the ability

to inspire confidence and enthusiasm;

22 Experience of organisational performance management, and a broad range of strategic decision-making

experience on a scale which is relevant and would add value to GSTT;

23 Evidence of having worked in an organisation that delivers high quality and efficient services, which meet the

demands of a diverse range of clients.

GSTT places considerable emphasis on diversity at Board level, and would particularly encourage applications from

appropriately qualified candidates from all sections of the community, and from people with diverse experience and

backgrounds.





Person Specification Personal criteria

Commitment to the public service values of accountability, probity, openness and equality of opportunity;

Commitment to the Trust’s values

Commitment to the needs of the public and patients served by the Trust

An appreciation of the importance of research and education within healthcare

Understanding of a complex organisation and the processes of planning, financial control, communications,

performance management and assurance that deliver the objectives of one of the largest and most prestigious NHS

Foundation Trusts;

Excellent communication skills with the ability to listen sensitively to the views of others and - through their use - the

ability to relate to and understand the staff and service partners who provide services and the patients and carers who

receive them;

Able to work as an effective member of a unitary Board all of whose members are equally and jointly responsible for its

decisions.

The ability to absorb and interpret complex data and information and reach informed judgments - including a strong

understanding of audit and risk management, a strong understanding of finance, budgeting and control, an

understanding of the relationship between resources and quality and sound knowledge of corporate governance

Proven strategic decision making skills

Independent judgement, common sense and diplomacy

Politically astute, with the ability to grasp relevant issues

A clear understanding of the responsibilities of a non-executive director and sufficient time and commitment to fulfil the

role

Eligibility

Only a candidate who is a public or patient member of GSTT or can qualify as a member is eligible for appointment as a

non-executive director. To qualify as a public member, you must be a resident of one of the London Boroughs of

Lambeth, Southwark, Lewisham, Wandsworth or Westminster. To qualify as patient member, you must be a patient, or

carer of a patient, who has attended GSTT in the last five years. You will not be eligible for interview until this has been

confirmed although, if eligible, you may submit an application for Trust membership with your application but may not be

interviewed or appointed unless and until you have been added to the register of members.

Ineligibility

You cannot become a non-executive director if you:

Have been dismissed within the last two years other than by reason of redundancy from any paid employment with a

Health Service Body

Are a non-executive director of an NHS body including another foundation trust





Have been the subject of a bankruptcy restriction order or an interim order

Have made an arrangement with creditors which has not been discharged

Have received a prison sentence or a suspended sentence of 3 months or more in the last five years

Are disqualified under the Company Directors Disqualification Act 1986

Candidates must be willing and able to declare that they regard themselves as “fit and proper persons” to take up this

appointment as required by the Care Quality Commission.

Duration and Time Commitment

The position will be for an initial period of four years and may be renewable for a second term subject to continuing

satisfactory performance and the needs of GSTT.

The candidate will be expected to devote up to 2-3 days per month plus some discretionary time for preparation and

reading to the role.

Remuneration

Remuneration is determined by the Nominations Committee and is currently £20,000 a year. In addition travel and

subsistence expenses will be reimbursed.





How to Apply Key Dates

Closing date for applications: Friday 3rd May 2019.

Following a long list meeting of the Selection Panel,

successful candidates will be invited to attend

preliminary interviews with Odgers Berndtson w/c 13th

and 20th May.

The final interview process with Guy's and St Thomas'

NHS Foundation Trust will take place on a date to be

confirmed during w/c 10th June 2019.

How to apply

In order to apply, please submit a comprehensive CV

along with a covering letter which sets out your interest

in the role and encapsulates the aspects of your

experience relevant to the required criteria. Please

include current salary details and the names and

addresses of three referees. Referees will not be

approached until the final stages and not without prior

permission from candidates.

The preferred method of application is online at:

www.odgers.com/71980

If you are unable to apply online please email:

[email protected]

All applications will receive an automated response.

Any postal applications should be sent direct to Carmel

Gibbons, Odgers Berndtson, 20 Cannon Street, London,

EC4M 6XD. All candidates are also requested to

complete an online Equal Opportunities Monitoring

Form which will be found at the end of the application

process. This will assist Guy’s and St Thomas’ NHS

Foundation Trust in monitoring selection decisions to

assess whether equality of opportunity is being achieved.

Any information collated from the Equal Opportunities

Monitoring Forms will not be used as part of the

selection process and will be treated as strictly

confidential.

Personal data

In line with GDPR, we ask that you do NOT send us any

information that can identify children or any of your

Sensitive Personal Data (racial or ethnic origin, political

opinions, religious or philosophical beliefs, trade union

membership, data concerning health or sex life and

sexual orientation, genetic and / or biometric data) in

your CV and application documentation. Following this

notice, any inclusion of your Sensitive Personal Data in

your CV/application documentation will be understood

by us as your express consent to process this

information going forward. Please also remember to not

mention anyone’s information or details (e.g. referees)

who have not previously agreed to their inclusion.

Contact details

For a conversation in confidence, please contact:

Carmel Gibbons

[email protected]

We are committed to ensuring everyone can access our

website and application processes. This includes people

with sight loss, hearing, mobility and cognitive

impairments. Should you require access to these

documents in alternative formats, please contact

[email protected].

Also, if you have any comments and/or suggestions

about improving access to our application processes

please don't hesitate to contact us

[email protected].



http://www.odgers.com/71980

mailto:[email protected]



20 Cannon Street

London EC4M 6XD

UK

+44 20 7529 1111

[email protected]

https://www.odgersberndtson.com/en-gb



24th April 2019 Council of Governors - Quality and Engagement Working Group Report (February 2019) 1


Quality and Engagement Working Group report (February 2019)

24th April 2019 CG/19/12

This paper is for: Sponsor:

Decision Author: Mark Tsagli, QWEG Secretariat

Discussion Reviewed by: Placida Ojinnaka, QWEG Lead

Noting CEO*

Information X ED*

Board Committee*

TME*

Other*

* Specify

Tab 9.3 Q

uality and Engagem

ent

58 of 72C



, Governors H

all, St T

homas' H

ospital-24/04/19


1. Introduction This report details the meeting of the Quality and Engagement Working Group (QEWG) which took place on 25th February 2019 at the Burfoot Court Room, Counting House, Guy's Hospital. 2. Attendance This meeting was attended by: Sarah Allen (Head of Patient Experience), Devon Allison (Lead Governor), Andrea Carney (Trust Patient and Public Engagement Manager), Jonathan Farley, Donna Holder (DPJ Programme Manager), Daryl Humberstone (Patient Feedback Facilitator), Alison Knox (Deputy Director of Quality and Assurance), Margaret McEvoy, Tony Hulse, Anna Grinbergs - Saul (Patient and Public Engagement Specialist), Placida Ojinnaka (QEWG Lead), Priya Sahni (Project Manager - Digital Letters Project) Mary Stirling, Mark Tsagli (Patient Experience Specialist), Fatimah Vali (Patient and Public Engagement Specialist), Bryn Williams. Apologies were received from: Tahzeeb Bhagat, Marcia Da Costa, Annabel Fiddian-Green, Felicity Harvey (Non-Executive Director), Anita Macro, William Moses, John Porter, Vicky Rogers, Dr. Priya Singh (Non-Executive Director), Jenny Stiles, Yu Tan, Peter Yeh. 3. Notes from the last meeting The notes were approved as an accurate record of the last meeting.

Tab 9.3 Q

uality and Engagem

ent

59 of 72C



, Governors H

all, St T

homas' H

ospital-24/04/19


4. QEWG - 2019 Work Planning session The Head of Patient Experience and the Patient Public and Engagement Manager facilitated the work planning session for governors to identify topics for the coming year. The session was structured around the trust's three strategic priorities - Patients, People, and Partnerships. Topics of interest discussed included, but not limited to the following: Patients:

Person centred care: o Mind body, considering the psychological and physical needs of patients. o Using learnings from the community nursing teams to inform other areas of care.

Prevention - smoking cessation, weight management, diabetes, etc.

Transition from children to adult services - supporting vulnerable patients for e.g. intensive care patients, children with neurological issues and mental health challenges.

Discharge challenges - Delays in receipt of medication after discharge.

Transport - Identity barriers to discharging properly, challenges with patient transport, identify factors that work well and those that do not.

End of Life Care (EoLC) - Identify metrics for measuring the impact of EOLC initiatives, key measures to be used aside of Complaints. Promoting and raising awareness in the trust through death cafes, liaising with community, organising community events and seminars.

Governors agreed it will be useful to have a seminar at some point about 'death'.

People: Measure the effective use of volunteers in the trust.

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Partnerships:

Measuring the impact of local partnerships e.g. Kings Health Partners.

Focus on how community staff, services, GPs, liaise and work together.

Partnerships with local authorities, how the trust is liaising with authorities responsible for public health. The Head of Patient Experience and the Trust's Patient and Public Engagement Manager will circulate feedback and suggestions provided and work with the QEWG Lead to draft work plan for members to review. 5. Quality update

The Deputy Director of Quality and Assurance undertook to update governors on progress of the development of the Trust Quality Strategy and the Trust’s Quality Account and priorities. The following were noted:

The final Quality Strategy (2018-2023) setting out the trust's quality improvement plans for the next five years has been sent to all governors by email and print.

Locally selected indicator for audit by governors: The group were informed that the NHSI has strongly recommended the local indicator for trusts providing acute services for 2018 /2019 to be the Summary Hospital-level Mortality Indicator (SHMI)*

Governor Bryn Williams provided an explanation of the SHMI and what it represents. The group were informed that the Trust performs very well against other benchmarks and our SHMI is one of the lowest in the NHS. This may not be an appropriate indicator to audit given the other areas of interest and concern to governors.

Following further discussion, it was agreed that the group choose another indicator for audit. *SHMI - indicator of healthcare quality that measures whether the number of deaths in hospital, or within 30 days of patients leaving hospital, is higher or lower than to be expected.

Regarding the *Quality Priorities for 2019/2020, the group discussed a number of indicators to monitor: o SEPSIS, Mental health, medication incidents, transition from children to adult services. o Adult bereavement services, acute kidney injury (as a result of medications).

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As governors had recently only received the Quality Strategy they asked to have time to further consider the priorities.

Action: The Deputy Director of Quality and Assurance to identify the indicators that will be relevant to the Quality Priorities, highlighting where the trust is doing well and not so well to enable the group decide on the priorities and respond before the end of March when this is due.

6. Patient Experience (PE) Report Update As time was limited the Head of Patient Experience drew attention to the report circulated to governors and asked that any questions are forwarded on.

7. Patient and Public Engagement (PPE) Update

The Trust Patient and Public Engagement Manager provided a brief update on patient and public engagement

activities completed to inform the Royal Brompton & Harefield and King’s Health PartnersPartnership. The

following activities were completed between January and February 2019:

A Patient Public Reference Group was established, whose membership includes heart and lung patients,

parents and carers, a governor from each trust and charities with an interest heart and lung care

Three workshops, attended by 85 patients and carers at each of the three trusts - Guy's and St Thomas’,

King's College Hospital and Royal Brompton & Harefield Foundation Trust.

A postal and online survey (257 responses)

A webinar (23 participants)a

The final report is expected to be sent to NHSE on Thursday 28th February.

*Quality priorities are set annually and shorter term goals that will support the delivery of the quality goals in the Quality Strategy

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8. Digital letters project (Priya Sahni - Project Manager - Digital Letters Project) The Project Manager of the Digital Letters project gave a short update on the project. The group were seeking governors' views on the content of the messaging and also thoughts and ideas to help raise awareness and publicise this change to patients. Due to the small size of images displayed on the overhead screen, governors were unable to read the contents and have a fuller discussion on this. It was agreed that the presentation would be amended and recirculated to the group for feedback. Action: The project team to send amended presentation to the QEWG coordinator to circulate to governors. 9. Reports from committees (those attended by Governors) Quality and Performance Committee: Appended to notes Adult Local Services Committee: Appended to notes Children’s Services Committee: Appended to notes Evelina:

Appended to notes

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End of Life Care Committee (EoLC): Governor Representative attending highlighted a few points from the meeting:

Importance of raising awareness of the range of faiths the Spiritual Care Team can support.

Dying Matters Week coming up in May - Governor asked for expressions of interest to help raise and improve the profile of EoLC.

Cancer Services Development Committee No notes tabled 10. Any other business Action: A member raised the need for clarification on where committee reports should be reported in governor

meetings. The Head of Patient Experience requested that committee reports be sent to the Membership

Coordinator to circulate to the group.

11. Date of next meeting:

Tuesday, 21st May 2019, Burfoot Court Room, Counting House, Guy's Hospital, London Bridge.

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24th April 2019 Council of Governors - Service Strategy Working Group Report (April 2019) 1


Service Strategy Working Group report (April 2019)

24th April 2019 CG/19/13

This paper is for: Sponsor: Annabel Fiddian-Green, SSWG Lead

Decision Author: Edgar Hime, SSWG Secretariat

Discussion Reviewed by: Annabel Fiddian-Green, SSWG Lead

Noting CEO*

Information X ED*

Board Committee*

TME*

Other*

* Specify

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1. Attendees: Annabel Fiddian-Green (Chair), Bryn Williams, Devon Allison, John Balazs, Tahzeeb Bhagat, Marcia da Costa and Tony Hulse. Ian Abbs (Chief Medical Officer), Jackie Parrott (Chief Strategy Officer), Julie Screaton (Chief People Officer), Manal Sadik (Head of Equality Diversity and Inclusion), Neil Goulbourne (Deputy Director of Improvement), Rob Godfrey (Head of Medical Education Programmes), Sarah Morgan (Director of Organisational Development), Farhan Quadri (Membership and Governance Coordinator) and Edgar Hime (Strategy Project Support Officer) attended from Guy’s and St Thomas’. Apologies were received from John Pelly, Margaret McEvoy, Placida Ojinnaka, Giuseppe Sollazzo, Yu Tan, Anita Macro, Peter Yeh, Mary Stirling, Lucilla Poston, Elaine Burns and Vicky Rogers.

2. Notes of the previous meeting and matters arising

2.1 Annabel Fiddian-Green thanked Margaret McEvoy for chairing the previous meeting in Annabel’s absence.

2.2. The room change of the meeting from Burfoot Court to the Education Centre, York Road, was clarified as being due to the CQC Inspections. It was noted that future SSWG meetings would be held back at Burfoot Court, Guy’s Site, unless otherwise stated.

2.3 The notes of the meeting held on the 15th of January 2019 were approved as a true record.

3. People Strategy 2019-2023

3.1 Julie Screaton (Chief People Officer), Manal Sadik (Head of Equality Diversity and Inclusion), Rob Godfrey

(Head of Medical Education Programmes) and Sarah Morgan (Director of Organisational Development) joined the meeting for this item.

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3.2 Julie Screaton provided an initial overview of the People Strategy 2019-2023. It was discussed how the new People Strategy had been developed off the back of the Trust’s ‘Together We Care’ Strategy that was introduced in 2018. A large focus of the People Strategy was on developing the ‘Make a Difference’ pillar, which was led by Manal Sadik.

3.3. The new People Strategy was taken to the Trust’s Strategy and Partnerships Oversight Group (S&POG) in March and was presented at the most recent Trust Management Executive meeting (April 2019). The themes within the strategy had been confirmed, however it was open to development and therefore Julie Screaton encouraged the governors to challenge aspects where appropriate.

3.4 Julie Screaton provided an overview on the four pillars within the Strategy: Learn with us, Join us, Stay and Grow, Make a difference. Special attention was provided on the need for improving recruitment and staff retention. The ‘Stay and grow’ section was developed to speak to every employee within the organisation irrespective of their role or seniority. A golden thread runs through the People Strategy in conjunction with Patient, People and Partnerships as outlined with the Trust’s Strategy. The example of system working was given to ensure partnerships across our networks within SE London, as well as national and internationally, collaborate to help achieve this strategy.

3.5 Rob Godfrey provided an overview of the ‘Learn with us’ pillar. Special attention was paid to the importance of building upon our relationships with local universities to ensure we get the best from our learners as well as recruit into our workforce gaps. Establishing a Trust-wide framework is needed to ensure education is provided across clinical systems and the pipeline of employees entering the organisation is correct. This included apprenticeships for new starters and upskilling the current workforce. The People Strategy had been too focused on clinicians but was developed further to ensure it is now equally relevant for all staff.

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3.6 Sarah Morgan reiterated that health, wellbeing and diversity underpin the strategy throughout and that it is important to bring passion and purpose to the workforce. Cohesive corporate responsibility is also needed across King’s Health Partners to ensure our societal duties are met across a range of local issues including air pollution. It was noted that professionally some of our staff are very specialist and are tied to Guy’s and St Thomas’ (GSTT). Therefore, it is important for us to ensure those who may not have the option to go elsewhere are happy at the Trust.

3.7 Manal Sadiq reiterated the importance of encouraging young people to work and develop at the Trust by showcasing the broad diversity of roles at GSTT. It is especially important to encourage applicants from BAME backgrounds, as well as balancing age and gender, to ensure everyone who comes into the organisation has opportunities such as secondments or acting-up. It is important to plant the seed into prospective employees’ minds that GSTT is a good place to work and it was reiterated that health and wellbeing underpins the new overall People Strategy as well as the importance of putting measures and systems in place to ensure everyone feels supported. Recent initiatives including the ‘hidden disabilities lanyard’ were provided as an example of ensuring the supportive culture is further developed.

During questions and discussion the following were highlighted:

The governors commended the ambition of the People Strategy but highlighted the breadth and depth of the Strategy would mean there could be a need to prioritise certain aspects such as staff recruitment and retention. The importance of both internal and external communications was also reiterated to ensure collaboration across partners is achieved.

The importance of sharing expertise across corporate departments and with front-line operational staff within the Trust was reiterated to ensure we can foster interest in new skills. Education needs to be prominent for all-staff and to ensure people feel valued as well encouraged to share their skills. It was agreed that currently the Trust could do more to encourage staff to share their skills and expertise across the organisation. Role-profiling was given as an example to ensure staff are able to learn who people are across the Trust.

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The importance of resource was reiterated and that there would be a need to ensure staff are provided with the allocated time and headspace needed to be trained and learn new skills.

The focus on improving diversity and inclusion was commended but other aspects such as class were highlighted as other potential areas that could be improved upon. The importance of understanding our limitations, in terms of what is set-out within the Strategy and what is possible within the specific time-frame, was also reiterated by the governors.

It is important to get young people interested in apprenticeships at the Trust through developing further partnerships with local authorities as well as institutions such as London South Bank University and other academic partners. A strong link with both Lambeth and Southwark CCG was also discussed as well as the Trust’s other stakeholders within the community such as GPs and primary care practice.

The potential role for social clubs within the Trust was noted in order to allow people with similar interests to come together and foster shared learning and interests. The importance of initiatives such as email-free Friday were also noted, however it was accepted that the feasibility for the adherence to this across the Trust was limited.

There is a need to ensure consultants are retained by encouraging them to actively take part in research and teaching. This includes the importance of including research time within job plans if desired, as well as better joining up their academic and clinical work. However, it was noted that financial sustainability would be an inhibiting factor in achieving this.

4. Electronic Health Records

4.1 Ian Abbs (Chief Medical Officer) and Neil Goulbourne (Deputy Director of Improvement) joined the meeting for this item.

4.2 An overview of the paper was provided by Ian Abbs. It was noted that this item would specifically focus on providing an update to the transformation work and timelines associated with the upcoming procurement phase of the Electronic Health Records (EHR) system. The EHR will have considerable benefits but it also comes with significant risks. We currently have a number of systems that are not interactive with each other

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and are unable to communicate directly with our patients or partners outside the Trust; this creates a fragmented patient experience. There are also areas within the Trust that still combine historical paper systems alongside a number of different electronic systems. This creates a high manual workload and inefficiencies across admin processes, as well as potential risks in how we manage our patients.

4.3 An Outline Business Case will be developed into a Full Business Case for the procurement of a new integrated EHR. This would help replace our core electronic systems as well as integrate more specialist systems. This process is about everyone’s (patients’ and the clinicians’) experience of giving and receiving care as well as improving efficiency and the quality of care received. The importance and reliance on future communications regarding this project was reiterated. Ultimately the goal is to make it easier to do the right thing as well as shift towards being a data-driven organisation as we currently do not use data as affectively as we should.

4.4. Important to empower patients to enable them to interact as much as they want to with their own healthcare if they wish e.g. by viewing their results or clinical records online. This new system has to be more than just a passive system and must instead promote interaction between patients and their healthcare. It also needs to add to the user experience for clinicians as the current electronic systems are eroding staff morale. The transformation of how we work will be very important, enhancing the experience of our clinicians and patients’. The current and future states for how we work as a Trust are very important e.g. what is the operating model of this future health system going to look like?

4.5 Neil Goulbourne provided an overview of the EHR timeline and confirmed that the Trust is about to enter the formal procurement process. We are not seeing this as just an IT procurement project but also an exercise in changing the ways we work. To this end, we have created a set of hypothetical patient stories, which involved the engagement of over 200 staff and patients, to demonstrate how we want our systems to work in the future. These will be used when testing prospective vendors and will provide a better guide as to how we want the system to work. The stories reflect our patients’ experiences as well as the currently complex

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clinical pathways. They include the aspects of care that we currently provide, but also the new aspects of care we hope will be enabled by this new technology. One of the cross cutting themes is that it will be very important to be able to work across systems. The importance of research also came out strongly within our patient stories. Overall this has been a successful exercise in guiding the run-up to the procurement process.

4.6 Patient public workshops have been held where patients welcomed the sharing of their information, providing the correct safe-guarding processes are in place. There are also five smaller focus groups lined up in March and April 2019 to further increase patient input prior to the procurement of this new system. Future activities will then include demonstrations by different vendors which will ensure we are able to build the specifications in partnership with the vendor as we progress through to procurement. There will also be a key focus on delivery i.e. how do we make the most of the systems we currently have and ensure we don’t stand still whilst we develop the new EHR. We also need to ensure we operate differently in the future and start to make changes in the lead-up to the roll-out of EHR instead of waiting until the system is fully implemented.

4.7 Ian Abbs summarised the importance of also getting staff stories to ensure feedback is collated from the people using the new systems as well as our partners. Cultural change will be as important as implementing the new technology.

During questions and discussion the following was highlighted:

Important to understand how the public wishes to engage in data-sharing as well as understand who owns

the data the Trust holds. The aggregation of data will be important in driving further understanding of our

patient populations.

The governors commended the work presented and the potential impact the new EHR could have. The

benefit that local GPs have already had in moving to paperless systems was noted. The integration of

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patient information with other systems will be very important in the future to ensure we are able to connect

pathways of care.

The Trust needs to learn how other industries manage sensitive data to allow transfer of patient data for

their benefit. The ideal scenario would involve being able to broadly share systems across a number of

organisations allowing clinical and admin processes to be linked between partners. This could allow

patients to be offered enhanced options associated with their care e.g. choosing an MRI appointment

across a wider selection of sites.

5. Any other business

5.1 The working group suggested the following future agenda items;

Sustainability and Transformation Partnership Update

Integrated Care Strategic Business Unit

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Documents

A G E N D A€¦ · 20190424 Draft CoG Agenda 17/04/2019 12:38 COUNCIL OF GOVERNORS Meeting to be held on 24th April 2019 6.00pm ± 7.30pm, *RYHUQRUV+DOO 6W7KRPDV¶+ RVSLWDO A G E