AGENDA COUNCIL OF GOVERNORS Date: 7 April 2016...PRIVATE MEETING OF THE COUNCIL OF GOVERNORS THURSDAY 7 APRIL 2016 18:35-19:05, COMMON ROOM, POSTGRADUATE CENTRE PRELIMINARY MATTERS

AGENDA

COUNCIL OF GOVERNORS

Date: 7 April 2016

Time and Venue:

16:00-18:30 - Common Room Council of Governors’ meeting held in public

18:35-19:05 - Common Room

Private meeting of the Council of Governors

Shena Winning – Chairman

This page has been left intentionally blank.

PUBLIC MEETING OF THE COUNCIL OF GOVERNORS THURSDAY 7 APRIL 2016 16:00 – 18:30, COMMON ROOM, POSTGRADUATE CENTRE

PRELIMINARY MATTERS

16:00 16/04-01 Introduction and opening comments Chairman 16:05 16/04-02 Apologies for absence and quorum check

16:06 16/04-03 Declarations of Interest & Register A

16:07 16/04-04 Minutes of the meeting held on 7 December 2015 B

16:10 16/04-05 Matters Arising - Action Log C

PRESENTATIONS

16:15 16/04-06 Stroke Services at Medway NHS Foundation Trust Presentation Samuel Sanmuganathan Consultant physician in stroke medicine & geriatrics

REPORTS

16:45 16/04-07 Executive Reports D(i) D(ii)

Non-Executive Directors, with support from the Executive Directors

17:20 16/04-08 Quality Account Priorities E Chief Quality Officer

17:30 16/04-09 Governors’ Summary for the Annual Report F Company Secretary

17:40 16/04-10 Membership Engagement Group update including

Revised Terms of Reference

2016/17 Membership Strategy

G Renee Coussens, Governor

17:45 16/04-11 Lead Governor and Governors, Steering Group update Verbal Stella Dick, Lead Governor

17:55 16/04-12 Governor Representative at Board Meetings update Verbal Doreen King, Governor

18:00 16/04-13 Finance and Performance Working Group update Verbal Richard Tripp, Governor

18:05 16/04-14 Community and Patient Engagement Group update including Terms of Reference

HI Stella Dick, Lead Governor

18:10 16/04-15 Quality Working Group update Verbal Vivien Bouttell, Governor

QUESTIONS FROM THE PUBLIC

18:15 16/04-16 Questions from the public

INFORMATION ONLY

18:25 16/04-17 Operational issues raised by Governors JK

16/04-18 Council of Governors’ Annual Planner L

16/04-19 Finance and Performance Working Group Minutes M

16/04-20 Community and Patient Engagement Minutes N

16/04-21 Membership Engagement Group Minutes O

16/04-22 Governors’ Steering Group Minutes PQ

16/04-23 Quality Working Group Minutes R

16/04-24 Dates of next members’ events – 16 April 2016 10am-midday – meet the governors coffee morning Medway Maritime Hospital Restaurant 23 April 2016 10am-midday – meet the governors coffee morning Sittingbourne Memorial Hospital Coffee Room

18:30 16/04-25 Dates of future Council of Governors’ meeting – 13 July 2016, 4pm, Common Room, Postgraduate Centre, Medway Maritime Hospital 6 October 2016, 4pm, Common Room, Postgraduate Centre, Medway Maritime Hospital

EXCLUSION OF THE PRESS AND PUBLIC

Representatives of the press and other members of the public are excluded from the remainder of this meeting having regard to the confidential nature of the business to be transacted, publicity on which would be prejudicial to the public interest (paragraph 3.1 of Annex 5 of Medway NHS Foundation Trust’s constitution - standing orders for the practice and procedure of the Council of Governors).

PRIVATE MEETING OF THE COUNCIL OF GOVERNORS THURSDAY 7 APRIL 2016 18:35-19:05, COMMON ROOM, POSTGRADUATE CENTRE

PRELIMINARY MATTERS

18:35 16/04-26 Minutes of the meeting held on 7 December 2015 S Chairman

18:37 16/04-27 Matters Arising Report T Chairman

18:40 16/04-28 Governors’ Training Plan UV Stella Dick, Lead Governor

18:45 16/04-29 Governor Activity W Stella Dick, Lead Governor

18:55 16/04-30 NED Nominations and Remuneration Committee Report:

Terms of Reference

NED Succession Plan

NED Remuneration

Minutes of Meeting held on 21 March 2016

X Chairman

1

Annex A MEDWAY NHS FOUNDATION TRUST COUNCIL OF GOVERNORS

GOVERNORS’ DECLARED INTERESTS

As at 24 March 2016

Public Governors

Allen, Glyn Medway Nothing Declared

Bouttell Vivien Medway Nothing Declared

Coussens Renee Medway Nothing Declared

Dick, Stella Medway Nothing Declared

Gallimore, Lyn Swale Nothing Declared

Jenner Ruth Swale Nothing Declared

King, Doreen Medway Nothing Declared

Marin, Silvia Swale Nothing Declared

Moseley, Michael Swale Nothing Declared

Ratcliffe Margaret Medway Nothing Declared

Richmond Ann Medway Nothing Declared

Tripp Richard Rest of England and Wales Deputy Chairman for Wateringbury Parish Council

Walker, Paul Medway Nothing Declared

West, Alan Medway Member of MCCG urgent Care Patient Working Group Member of GP Patient Participation Group

Staff Governors

Bushnell, Ann Management Nothing Declared

Cowell, Tim Non-Clinical Nothing Declared

Madhavan, Anil Medical and Dental Nothing Declared

VACANT Allied Health Professionals

VACANT Nursing and Midwifery

Partner Governors

Brake, David Medway Council Elected Member of Medway Council

Crowther Adrian Kent County Council Elected Member of Kent County Council

Harvey, Chris Charities Nothing Declared

Nicholls, Peter University of Kent Nothing Declared

Stevenson, Mandy Greenwich University Nothing Declared

Thurgate, Claire Canterbury Christ Church University Nothing Declared

Draft Public Minutes of the Council of Governors Meeting 7 December 2015 Page 1 of 7

DRAFT

Annex B

PUBLIC MINUTES OF THE MEETING OF THE COUNCIL OF GOVERNORS HELD ON 7 DECEMBER 2015 AT 16:00

COMMON ROOM, POSTGRADUATE CENTRE, MEDWAY MARITIME HOSPITAL, ME7 5NY

Present:

Shena Winning (SW) Glyn Allen (GA) Vivien Bouttell (VB) Renee Coussens (RC) Stella Dick (SD) Lyn Gallimore (LG) Ruth Jenner (RJ) Doreen King (DK) Silvia Marin (SM) Margaret Ratcliffe (MR) Ann Richmond (AR) Richard Tripp (RFT) Paul Walker (PW) Alan West (AW) Adrian Crowther (AC) Chris Harvey (CH) Ann Bushnell (AB) Tim Cowell (TC)

Chair Public Governor, Medway Public Governor, Medway Public Governor, Medway Public Governor, Medway & Senior Governor Public Governor, Swale Public Governor, Swale Public Governor, Medway Public Governor, Swale Public Governor, Medway Public Governor, Medway Public Governor, Rest of England & Wales Public Governor, Medway Public Governor, Medway Partner Governor (Kent County Council) Partner Governor (Charities) Staff Governor Staff Governor

Apologies:

David Brake (DB) Anil Madhavan (AM) Michael Moseley (MM)

Partner Governor (Medway Council) Staff Governor Public Governor, Swale

In attendance:

Trisha Bain (TBn) Ewan Carmichael (EC) Lesley Dwyer (LD) Paul Lehmann (PL) Tony Moore (TM) Jennifer Palmer (JP) Karen Rule (KR) Martine Saker (MS) Sheila Stenson (SS)

Chief Quality Officer Non-Executive Director Chief Executive Director of Communications Non-Executive Director Director of Corporate Governance, Risk, Compliance and Legal Director of Nursing Governor and Membership Lead (and note taker) Deputy Director of Operational Finance

Observers: 1 member of the public

1.0 INTRODUCTION AND OPENING COMMENTS

1.1 The Chairman welcomed everyone to the meeting.

2.0 APOLOGIES FOR ABSENCE AND QUORUM CHECK

2.1

2.2

2.3

Apologies were noted, as indicated above.

The quorum was noted as requiring at least one-third (being 8) of the whole number of Governors (being 23) to be present, including at least one appointed Governor and one elected Governor, with the public Governors in a majority.

The meeting was declared quorate.

3.0 DECLARATIONS OF INTEREST

3.1 No new interests were declared.

4.0 MINUTES OF THE MEETING HELD ON 5 AUGUST 2015 Annex A

4.1 The minutes of the meeting held on 5 August 2015 were agreed as a true and accurate record.


5.0 MATTERS ARISING – ACTION LOG Annex B

5.1

5.2

5.3

The Council of Governors noted the matters arising action log.

With reference to action 10.10 from the meeting held on 5 August 2015, it was noted that the plan to develop closer NED and Governor working would be developed with the Membership Engagement Group.

With reference to action 13.7 from the meeting held on 5 August 2015, it was noted that information regarding how the income from car parking charges had been used would be provided at the next Council of Governors’ meeting.

6.0 QUALITY ACCOUNT PRIORITIES

6.1

6.2

6.3

6.4

6.5

The Chief Quality Officer tabled a presentation which highlighted current status against the 2015/16 Quality Account priorities and advised that a further update would be provided before the 2016/17 Quality Account priorities are published.

The Council of Governors noted the improvement in reducing the number of deaths resulting from septicaemia and was assured that work continued to improve this further.

The Director of Nursing reported that three Grade 3 pressure ulcers attributed to the Trust had all been avoidable. It had been identified that good care was being provided but the skin assessments were not always being carried out by the temporary/agency nurses. The outcome of this was to improve induction training for temporary and agency staff.

During discussion the following points were raised:

In response to a question regarding whether the matrons should be held accountable for any staff issues it was explained that earlier in the year matrons were required to be more available on the wards however this was proving not to be sustainable for the leadership part of their roles.

A new Medical Pathway would be introduced in 2016 which should have a positive impact on patient lengths of stay and the Hospital Standardised Mortality Ratio.

Detailed analysis was underway to understand patient readmissions but the Trust was already starting to see a steady decrease. This would be a focus during 2016/17.

Much more detailed feedback was gathered from staff leavers to help with the retention work. A cohort of 13 Spanish nurses would be joining the Trust in January 2016 and a further recruitment project would be taking place in Greece in the next few weeks.

Following analysis of feedback from the last cohort of Italian nurses and would be providing help opening bank accounts. Some of the nursing residencies had also been renovated to allow a relaxing area for people to socialise.

Assurance was provided that all foreign nurses were assessed for their English literacy and numeracy skills.

The Trust Chairman requested that the Director of Nursing presented an update at the next Council of Governors meeting regarding the new EU requirements for nursing staff revalidation.

Action: Director of Nursing to provide an update regarding the new EU requirements for nursing staff revalidation at the next Council of Governors’ meeting.

The Chief Quality Officer outlined the proposed Quality Account priorities for 2016/17 and explained that the Governors needed to select one as a Governors’ priority by the end of January 2016.

Action: Council of Governors to select one Quality Account priority for 2016/17.

7.0 CHIEF EXECUTIVE’S REPORT Annex C

7.1

The Chief Executive presented her report and highlighted the following key points:

The draft CQC report had now been received and was being checked for factual accuracies. The Quality Summit would likely be taking place on 8 January 2016 together with the Risk Summit and it was also likely that the report would be published before the Summits took


place.

Monitor had asked the Trust to suspend national referral to treatment reporting. Assurance was provided that the data being recorded and reported was accurate but the concern was regarding the large backlog volume. Local reporting would continue and the aim was to recommence national reporting in March 2016.

The new minors area in the Emergency Department was now open and initial feedback from users had been positive. The Trust was still reviewing options regarding the decant required to enable the refurbishment works within the majors and resus areas.

Lynne Sheridan had been appointed Director of Strategy and Partnerships and there were now positive steps being taken to build partnerships within the community.

There were no junior doctor strikes were expected until after the negotiations have been completed in January 2016. The Chairman and Chief Executive have met with the junior doctors and assured them that the Trust does understand and respect the views on the situation and also asked in return that the junior doctors respected the Trust’s situation in needing to treat the patients.

The Chief Executive had a successful meeting with Medway Council’s public health team regarding the Trust’s aim to make the hospital site a completely smoke free zone. The Trust would take into account the work carried out by the Governors so far. The aim was to get the clinicians on board with the idea and to start communication the Trust’s intentions in the New Year.

8.0 QUALITY, PERFORMANCE AND RECOVERY Annexes D and E

8.1

8.2

8.3

8.4

8.5

8.6

8.7

The Chief Quality Officer reported that a review of the clinical governance structure had been undertaken and would be launched on 14 December 2015. A new Serious Incident Framework would be launched on 17 December 2015. She also referred to the Remedial Action Plan updates provided by the Chief Executive in her report.

There had been five falls resulting in harm on one particular ward and a plan had been developed to reduce the risks and improvements were now evident.

Monthly audits of standards of care were being piloted which were matron and sister lead. The aim would be to roll out these audits across all clinical areas. Daily rounds took place on each ward where each patient was spoken to, to ensure their needs were being met.

There had been a number of mixed sex accommodation breaches on the Acute Medical Unit and a review was underway regarding how to reduce the risk of breaches. The commissioners were supporting action plans in place.

An outbreak of Norovirus on Nelson ward had been managed extremely well with early identification and prevention undertaken. The ward closed to new admission to allow the flooring to be replaced and was now open again.

The Chair of the Quality Assurance Committee advised that deep dive topics had been agreed for the Committee to review. These topics included the stroke pathway, identifying and managing the deteriorating patient and cancer pathways. The Committee would undertake two deep dive reviews each month.

In response to a query regarding the staff take up of the flu vaccinations it was noted that the Trust’s staff uptake at 35% was slightly higher than 30% national uptake of professional healthcare staff. The Trust would need to review the areas of risk and introduce new techniques for encouraging take up of the vaccination. One option may be to restrict access to patients for staff that does not have the vaccination.

9.0 FINANCE, AUDIT, INVESTMENT AND CONTRACTS Annex F

9.1

9.2

9.3

The Deputy Director of Finance presented the financial position as at Month 7, explaining that year to date the deficit was £31.4m, which included the cost of outsourcing work.

It was highlighted that the deficit also included a high level of fines imposed by the Clinical Commissioning Group for missing targets.

It was noted that the escalation wards were still open and still full and that the Trust received only a marginal rate. Of the patients on those wards 39 were classed as delayed transfer of care and


9.4

9.5

9.6

9.7

9.8

115 patients no longer required acute care and were awaiting appropriate placements in the community. The majority of these patients lived in the Medway area. The Council of Governors was assured that a large team of people were working every day to help identify the appropriate pathways for those patients.

A snapshot was outlined of Sapphire Ward were the patients averaged 80 years of age. The lengths of stay averaged 40 days, up to 119 days. There was a large reliance on agency staff on this ward and discussions regarding funding for the patient son Sapphire ward were ongoing with the Clinical Commissioning Group.

The Chair of the Investment and Contracts Committee commented that the major contributor to the Trust’s deficit was the cost of agency nursing in order to maintain safe staffing on the wards. Escalation beds that had been opened during the previous winter remained open and were predominantly staffed by agency nurses. The Investment and Contracts Committee Chair explained that the pressures of the cost of agency nurses would reduce once the new medical model had been implemented, which should result in a reduction of around 100 beds across the hospital.

The Investment and Contracts Committee Chair explained that the recent experience of very high agency staff usage, Clinical Commisioning Group fines and a reduction in the level of income received, the Trust had revised its finanacial forecast for the year. It was noted that it would still be a challenge to meet the reforecast, given the current high level of demand on the hospital and the level of substantive nursing and medical vacancies which resulted in high agency spend.

The Chief Executive explained that a national cap of 12% had been placed on agency spending which the Trust was not yet achieving. By March 2016 the management of temporary bank staff would be brought back in house, following the appointment of a new payroll provider who could provide weekly pay runs as well as monthly pay runs.

The Council of Governors requested clarity around where the Trust expected to be at the end of the Financial year.

10.0 CHARITABLE FUNDS ADVISORY COMMITTEE UPDATE Annex G

10.1 The Chair of the Charitable Funds Advisory Committee presented his report and advised that the next meeting would be taking place on 9 December 2015.

11.0 LEAD GOVERNOR REPORT

11.1

11.2

11.3

11.4

11.5

The Lead Governor thanked her colleagues for completing the skills audit and explained the responses would be used to form the basis for a training schedule. The Membership Engagement Group had reviewed the responses and identified three key areas for training: What it means to be a governor; understanding finance matters; and miscellaneous issues which could be covered at Council meetings in short sessions.

The Governors’ Steering Group had also discussed the training and recommended the two private Council of Governor meetings to take place each year should be used for training.

Regarding the vacant seats on the Council of Governors, discussions had been undertaken with each of the local universities and each had registered in putting a representative forward. A further discussion around this would take place with the Council of Governors in private

The Lead Governor had met with the Lead Governor of Guys and St Thomas’ Hospitals NHS FT which had proved very informative with useful ideas regarding Governor Engagement with the community.

The Lead Governor attended a seminar in November run by the External Auditors Deloitte which focussed on data collection and how the data was used. It was a very interesting session and it was identified that other Foundation Trusts also had financial problems and staffing difficulties. Deloitte forecast that by 2020 all of the public sector will be on an upturn.


12.0 GOVERNORS’ STEERING GROUP

12.1

12.2

12.3

12.4

The Lead Governor reported that the Governors’ Steering Group had reviewed the priorities of the Board and the Board level committees and identified 13 topics that were high on all the agendas. It was suggested that the Council of Governors focussed on those priorities at its meetings.

The Governors’ Steering Group had also requested the 2016 schedule of Governor meetings be circulated as soon as possible. The Governor and Membership Lead advised that the work was almost complete and aimed to distribute the dates in the next two weeks.

Action: Governor and Membership Lead to distribute the 2016 Governor meeting dates within the next two weeks.

It was requested that one of the governor training topics should be how to assess risk.

The Governors’ Steering Group requested that any Governor queries be passed to Doreen King, who will be representing the Council at Trust Board meetings. She would then raise any Governor concerns at Trust Board meetings.

13.0 GOVERNOR REPRESENTATIVE AT BOARD MEETINGS

13.1

13.2

The Governor Representative at Board meetings requested the Council agreed which questions she should take to the Board meeting 17 December and provided an update on the questions raised at the November Board meeting:

Imaging – a recent backlog had occurred due to an issue with the rotas on one particular day. Staff were working extra hours to reduce the backlog. The Governor Representative had met with imaging staff who reported that the number of bullying incidents had reduced and staff were much more content. The Governor Representative had been invited back to meet the imaging staff again.

CT scanner – the Trust was currently hiring a mobile CT scanner and the Chief Executive advised that the Trust was in the process of purchasing a replacement scanner. The increased workload on the existing CT scanner meant that it required its regular service more often and the next service would take place the following weekend.

The Governor Representative advised that she would circulate an update to the Governors after each Board meeting.

14.0 FINANCE AND PERFORMANCE WORKING GROUP

14.1 RFT advised that the signing conventions within the finance reportswere inconsistent and led to confusion. The Finance Team would ensure consistency in the future.

15.0 MEMBERSHIP ENGAGEMENT GROUP

15.1

15.2

15.3

15.4

The Chair of the Membership Engagement Group explained that at the Membership Engagement Group’s last scheduled meeting in September the Group commended the new monthly News@Medway newspaper and it was agreed that a further discussion was required with the Communications Team as to how to make the newspaper more accessible to the members. A subsequent meeting with a representative from the Communications resulted in a new members’ section with the newspaper.

The Group met again in November to discuss governor training which the Lead Governor also attended. Following a detailed discussion it was agreed training sessions should take place covering as many of the topics as possible identified through the Governors’ skills audit.

A training schedule together with a schedule of members’ events for 2016 would be developed as soon as possible.

The aim was also to hold some ‘Meet the Governors’ coffee mornings early 2016.

16.0 QUALITY WORKING GROUP

16.1

The Chair of the Quality Working Group advised that the Group’s September meeting had to be cancelled as there was no Non-Executive Director available to attend. Ewan Carmichael attended the Group’s December meeting.


16.2

16.3

16.4

The Group’s Chair requested Governors attending any Trust Group meetings such as health and safety meetings, patient safety committee meetings, to provide an update on their observations/participation to the Quality Working Group. This could be either written or verbally at one of the Group’s meetings.

Action: Governors participating in any Trust Group meetings/activities to provide an update on observations/participation to the Quality Working Group meetings.

The Quality Working Group discussed the Governors’ log at their December meeting, in particular discussing the quality of some of the responses and that some queries were closed when a holding response was given where a response that resolved the query was required.

It was agreed that more definitive answers with timelines were required before a query could be closed.

17.0 QUESTIONS FROM THE PUBLIC

17.1

17.2

17.3

A member of staff raised a concern regarding access to obtaining ID badges for new and agency staff outside of office hours. Assurance was provided that there is an out of hours protocol for issuing ID badges outside of normal office hours.

Concern was also raised around recruitment procedures not being secure enough to stop the recruitment of agency/locum staff deemed not of the required standard for working at the Trust. The Chief Executive advised that all locum and agency recruitment was now centralised which would reduce the risk of rejected candidates being selected.

The Chief Executive also explained that Trust had difficulty attracting staff to come to work here which was a problem that Guys and St. Thomas’ Hospitals NHS FT did not have. The two Trusts were therefore looking at the possibility of running joint recruitment exercises and suggested the Director of Workforce and Medical Director provided an update on progress at the next Council of Governors’ meeting.

Action: Director of Workforce and Medical Director to provide an update on progress regarding joint recruitment exercises with Guys and St Thomas’ Hospitals NHS FT.

18.0 OPERATIONAL ISSUES RAISED BY GOVERNORS Annex JK

18.1

18.2

The log of operational issues raised by Governors was reviewed:

GL/15/15 – it was noted that an internal in-depth review was underway to ensure the Trust was charging appropriately for all services provided.

GL/16/15 – It was agreed that this enquiry would remain open until feedback had been received from the Chair of the Quality Assurance Committee regarding the improvements required within the breast care unit.

GL/18/15 – It was agreed that this enquiry would remain open as fourteen wheelchairs were still being stored in the outdoor space behind outpatient area one without any protection against the weather.

GL/19/15 – The Chief Executive advised that the Trust needed to undertake a value for money exercise regarding the laundry service. If outsourced, the contracts would include clauses in relation to any failure in the service. The Trust needed more space and the outsourcing of the laundry would mean that a large footprint could potentially be redeveloped. Any staff would be TUPED over to the new provider.

GL/21/15 – The Chief Executive confirmed that Emergency Department staff did require Stroke training. 100% of nursing staff had undertaken fundamentals training and competency assessments.

GL/27/15 – It was noted that the query had not been answered and the Chief Executive advised that the Trust received information regarding the response rate to the staff survey by department so was aware of which areas did not traditionally participate. However the Trust did not have access to responses and did not know what each individual had fed back. Assurance had been provided to staff the previous week that their responses would be treated confidentially by the survey provider. The Chief Executive expected an action plan to address any issues identified within the survey to be developed with staff.

It was agreed that going forward, any response to Governors’ queries were to be approved by an


executive director before being forwarded to the Governors.

Action: Governor and Membership Lead to ensure all response to Governors’ queries were approved by an executive director before being distributed.

19.1 COUNCIL OF GOVERNORS’ ANNUAL PLANNER Annex L

19.1 The Council of Governors noted the annual work plan for 2015/16.

20.0 FINANCE AND PERFORMANCE WORKING GROUP MINUTES Annex M

20.1 The draft minutes of the Finance and Performance Working Group meeting which took place on 22 September 2015 were noted.

21.0 MEMBERSHIP ENGAGEMENT GROUP MINUTES Annex N

21.1 The draft minutes of the Membership Engagement Group meetings which took place on 7 September 2015, 21 September 2015 and 9 November 2015 were noted.

22.0 GOVERNORS’ STEERING GROUP MINUTES Annex O

22.1 The draft minutes of the Governors’ Steering Group meeting which took place on 27 May 2015 were noted.

23.0 DATE OF NEXT MEMBERS’ EVENTS

23.1 It was noted that the schedule for the 2016 members’ events was still being developed.

24.0 DATE OF NEXT COUNCIL OF GOVERNORS’ MEETING

24.1

24.2

MS proposed that the next Council of Governors’ meeting would take place in April 2016 at 16:00, Common Room, Postgraduate Centre, Medway Maritime Hospital. The exact date would be confirmed in due course.

In response to a request for a schedule of 2016 Governor meetings, MS advised that this was still in the progress of being developed and she aimed to circulate the proposed dates within the next two weeks.

The meeting closed at 18:40

1

ANNEX C CoG/16/04-05

For Information

COUNCIL OF GOVERNORS MEETING (PUBLIC) – 7 April 2016 Lead: Shena Winning, Chairman Author : Martine Saker, Governor and Membership Lead

MATTERS ARISING REPORT

The Council of Governors is asked to note the following:

Purpose of the paper presented: To provide assurance that actions agreed have been implemented and to maintain an audit trail of actions and updates.

Outcomes required: The Council of Governors is requested to note the final priorities chosen.

Time required: 5 minutes

Summary of the Key Points: The report details the following: -

the date of the meeting

the minute reference where the action was agreed

the lead for each action

what the action is

details of progress towards achieving the action

status of the action following the RAG rating (red – outstanding, amber – partially complete, green – complete)

Key Risks (if yes explain risk and proposed management)

Clinical Risks , Business Risks , Environmental risks , Finance & Performance risks , Reputation risks Governance risks Monitor risks (double click in each box that applies and select default value as ‘checked’)

Resources required:

None

Prior Discussion: Matters arising are discussed at each Trust Board meeting.

2

MATTERS ARISING REPORT – Council of Governors Meetings Minute

Ref MINUTE ITEM AND ACTION REQUIRED LEAD DATE

DUE UPDATE RAG

Rating

Council of Governors Meeting held on 5 August 2015

9.3 Prove and update to the Council of Governors on the Service project.

Chief Nurse/Director of Workforce

7/12/15 To be provided within the executive report at the April 2016 meeting.

Closed (green)

10.10 To develop a plan to implement closer working between the Governors and the Non-Executive Directors.

Company Secretary/ Governor and Membership Lead

7/12/15 RC to provide an update within her Membership Engagement Group update

Closed (green)

13.7 To arrange for posters to be produced to show what the income from car parking had been used for.

Chief Operating Officer

5/12/15 Dir Of Communications advises ‘In 2014/15 total car parking income from the public was £1.4m. For 2015/16 we are expecting to receive £1.6m. This does not include any income from staff paying for permits. In terms of comparison, £1.6m equates to:

38 ward based nursing staff

28 registrars

15 consultants The Communications team is currently looking into a suitable location to display this information.

Closed (green)

Council of Governors Meeting held on 7 December 2015

6.4 To provide an update regarding the new EU requirements for nursing staff revalidation at the next Council of Governors’ meeting.

Director of Nursing

7/4/16 To be provided within the executive report at the April meeting.

6.5 To select one Quality Account priority for 2016/17. Council of Governors

Jan 2016 Completed. Closed (green)

12.2 To distribute the 2016 Governor meeting dates within the next two weeks.

Governor and Membership Lead

31/12/15 2016 schedule distributed to all Governors 8/12/15 Closed (green)

16.2 To provide an update on observations/participation of Trust Groups to the Quality Working Group meetings.

All Governors Ongoing All Governors have been made aware of the requirement.

Closed (green)

17.3 To provide an update on progress regarding joint recruitment exercises with Guys and St Thomas’ Hospitals NHS FT.

Director of Workforce/ Medical Director

7/4/16 To be provided within the executive report at the April 2016 meeting.

Closed (green)

18.2 To ensure all response to Governors’ queries were approved by an executive director before being distributed.


Ongoing All Executive Directors have been made aware of the requirement.

Closed (green)

Looking Forward 2016 / 17 Quality Account Priorities

Looking Forward: Priorities for improvement 2016/17

Table 1: Looking Forward – Priorities for improvement for 2016/17

PATIENT SAFETY 1a Meeting National Access Targets as set out in South Eastern Tripartite Expectations for Improvement

Standard Current

Performance South Regional Tripartite Expectations for

Improvement Expectation of

delivery

A&E 76.1%

(Feb 2016)

All trusts performing above 95% maintain at that level through 2016/17

N/A

All trusts below 89% achieve at least 89% by the end of September 2016

Continue to monitor performance

Develop bespoke trajectories for all remaining trusts which, as a minimum, deliver a 3% improvement on 2015/16 Q2 performance in each month from the end of September 2016 until such time that the standard is met.


RTT 68.0%

(Feb 2016)

All Trusts performing above 93% to at least maintain 2015/16 level of performance through 2016/17

N/A

Trusts delivering between 92 and 93% to deliver an improvement exceeding 93% by the end of September 2016

N/A

The operating standard for all providers is 92% and any deviation below this must be specifically agreed with the provider regulator and commissioners


Where there are known capacity problems it is the commissioners responsibility to secure enough capacity to achieve the 92% standard

N/A

Where there are over 52 week waiters, develop trajectories to eliminate all over 52 week waiters as soon as possible and by no later than March 2017.


62 Day Cancer

83.58% (Q2 15/16)

All Trusts performing above 85% to at least maintain that level through 2016/17

N/A

Develop bespoke trajectories for all remaining trusts which as a minimum deliver 85% by the end of September 2016. Note - where there are over 104 day waiters, trajectories should include the elimination of these long waiters.


Diagnostic 6 week waiting times

90.7% (Feb 2016)

All Trusts performing 1% or below to at least maintain that level through 2016/17


Develop bespoke trajectories for all remaining trusts which as a minimum delivers 1% or below by the end of September 2016


1b Continue to improve mortality rates in septacemia

Current Performance Expectation of delivery Linked to Recovery programme

SHMI 115 ( as at Dec 2015)

To be within benchmarked limits by March 2017

Deteriorating Patient Medical Model Emergency Pathway

HSMR 106 (as at March 2015)

Reduction on March 2015 baseline to =< 100

Deteriorating Patient Medical Model Emergency Pathway

1c: Learning from Serious Incidents

Current performance Expectation of delivery Linked to recovery programme

2 trust-wide learning events as of March 2015 20% SI relate to deteriorating patient

Increased number of Learning Events both at Trust & Directorate level Reduction of serious incidents relating to deteriorating patient

Deteriorating Patient

2: PATIENT EXPERIENCE


Action plan developed to improve End of Life care pathway management

100% achievement against action plan

Deteriorating Patient

Friends and family test response to recommend currently 72.28%

85% or above by March 2017

Emergency Pathway Medical Model

Current assessment rates for MCA and DoLs (Safeguarding ) is XXX and XXX respectively *

Improvement in reporting from April 2016 baseline

Nursing Strategy: Improving care for vulnerable patients

1. CLINICAL EFFECTIVENESS


Non Elective Length of Stay (NELOS) for patients over 65yr as of March 2016 is 11.6

Reduce the NELOS from April 2016 baseline

Medical Model Emergency Pathway

Readmissions within 28 days currently at XXX *

Reduction on April 2016 baseline

Medical Model Emergency Pathway

Number of in-hospital cardiac arrests XX per month *

10% reduction on April 2016 baseline

Deteriorating patient

*Awaiting Final Data

1

ANNEX F CoG/16/04-09

For Information COUNCIL OF GOVERNORS MEETING (PUBLIC) – 7 April 2016

Lead: David Rice, Company Secretary Name: Martine Saker Designation: Governor and Membership Lead

GOVERNORS’ SUMMARY FOR THE 2015/16 ANNUAL REPORT


Purpose of the paper presented:

To present the Council of Governors’ summary for the 2015/16 annual report.

Outcomes required:

The Council of Governors is requested to note Council of Governors’ summary for the 2015/16 annual report.

Time required:

5 minutes

Summary of the Key Points:

Each year the Trust is required to include a summary of the Council of Governors within its annual report. The summary is attached as appendix A.

At the time of writing this report it was not possible to include the final membership numbers with effect from 31 March 2016 (see page 5). The summary will be updated with the correct data prior to submission as part of the final annual report.

A list of governor attendance at formal meetings throughout 2015/16 was circulated to governors prior to the writing of this report to give governors the opportunity to query any possible discrepancies with their attendance record.

The Council of Governors is asked to note that there were six formal meetings during 2015/16, comprising four Council of Governor meetings held in public, the Annual Members Meeting held in September 2015 and one private session of the Council of Governors held in October 2015.



Resources required:

None

Prior Discussion:

None

2

Council of Governors Summary

Council of Governors The Council is made up of elected and appointed Governors who provide an important link between the Trust, local people and key stakeholder organisations. They share information and views that can influence and shape the way hospital services are provided by the hospital and they work together with the Trust’s Board of Directors to ensure that the Foundation Trust delivers a high quality of healthcare within a strict framework of governance whilst achieving financial balance and planning for the future. There are 23 seats on the Council of Governors, 19 of which are elected public and staff member representatives and 4 are appointed by the partner organisations. A full breakdown of the Council of Governors is detailed later in the report. All public and staff governors are elected for a maximum term of three years and are able to seek re-election. The public governors each represent a constituency. Medway Constituency has 9 public governors; Swale Constituency has 4 public governors; Rest of England and Wales has 1 public governor. The staff governors are elected to represent staff in each directorate of which there are 5 in the Trust: nursing and midwifery; allied health professionals, medical and dental; non-clinical; and management. Partner governors are nominated by their organisation and serve a term of office of three years. These governors can be replaced by their organisation during this time and existing representatives can be nominated to serve further terms of three years. Governors are required to attend regular meetings of the Council of Governors – normally at least five a year which includes the Members’ Annual Meeting. Extraordinary meetings are also held from time to time when an urgent decision is required outside of the normal schedule of meetings. The governors have some specific statutory requirements to fulfil. These include to:

• Hold the non-executive directors individually and collectively to account for the performance of the board of directors;

• Represent the interests of the members of the Trust as a whole and the interests of the public; • Appoint and, if appropriate, remove the chairman and non-executive directors; • Approve (or not) the appointment of any new chief executive; • Decide on remuneration and allowances and other terms and conditions of office of the chairman

and non-executive directors; • Receive the annual accounts, any report of the auditor, and the annual report at a general meeting

of the Council of governors; • Appoint and, if appropriate, or remove the foundation trust’s auditor; • Approve ‘significant transactions’; • Approve an application by the Trust to enter into a merger, acquisition, separation or dissolution; • Decide whether the Trust’s non-NHS work would significantly interfere with its principal purpose,

which is to provide goods and services for the health service in England, or performing its other functions; and

• Approve amendments to the Trust’s constitution. The Council has established one steering group, four working groups and one committee. These are listed below with a brief overview of each group’s responsibilities: Governors’ Steering Group: To act in an advisory capacity to support and facilitate the work of the Council of Governors generally and specifically in respect of fulfilling their statutory duties as laid out in Monitor’s Code of Governance. The Chair and Company Secretary attend the meeting. Community and Patient Engagement Group: To oversee the engagement between the Governors and the community including but not limited to patients, community groups, key stakeholders, etc, and the wider public and reports back on the subject (with or without recommendation) to the Council of Governors.

3

Membership Engagement Group: To develop, implement and review the Trust’s membership strategy as well as being accountable on behalf of the governors for ensuring that the elections are fair and true; review any issues brought to the Working Group’s attention that relate to the members and membership, including complaints from members about membership and adjudicating on any application for disqualification from membership and to be involved in overseeing the arrangements of the Trust’s Annual Members’ Meeting. One non-executive director attends meetings to provide additional support. Finance and Performance Working Group: To make recommendations to the Council of Governors with respect to the appointment of the Trust’s external auditor and to report to the Council of Governors with respect to the auditor’s Annual Report, the Trust’s forward plan and the quality accounts; to hold the Board’s Performance and Investment Committee and the Integrated Audit Committee to account. The Chairs of the two Committees regularly attend the Working Group meetings for this purpose. Quality Working Group: To receive quarterly reports from the Board’s Quality Committee on the work around Patient Safety, Patient Experience and other aspects of quality including the Trust’s Quality Accounts; to scrutinise the decisions made, or actions taken, in connection with the Quality Committee; make recommendations to the Council of Governors arising from the outcome of the scrutiny process. The Chair of the Quality Committee regularly attends Working Group meetings to provide updates and answer questions. Governors’ Nominations and Remuneration Committee: To review the remuneration of the non-executive directors on an annual basis, to be involved in the nomination process for all non-executive directors including the chairman, to receive confirmation that appraisals have been carried out for the Chairman and non-executive directors. Attendance of committee members is detailed below:

Attendee Attendance

Shena Winning , Chairman 4 out of 4

Stella Dick, Lead Governor (appointed August 2015) 2 out of 2

Ruth Jenner, Senior Governor (retired July 2015) 2 out of 2

Michael Moseley, Swale Governor 1 out of 4

Margaret Ratcliffe, Medway Governor 4 out of 4

Ann Richmond, Medway Governor 3 out of 4

David Brake, Partner Governor 2 out of 4

Kevin Griffin, Staff Governor (resigned August 2015) 2 out of 2

Claire Thurgate 0 out of 0

Dr Peter Nicholls 0 out of 0

Mandy Stevenson 0 out of 0

The 2015 elections took place in June 2015. There were 10 seats up for election: 4 Medway seats, 3 Swale seats and 3 staff seats. The information below outlines details of all governors on the Council during the year 2015/16 together with their record of attendance which includes the 5 scheduled Council of Governor meetings and the Annual Members’ Meeting:

Name Constituency Term of office

Attendance

Glyn Allen Medway Next placed successful candidate from the 2015 elections, appointed to take over from James Devine who resigned in September 2015. Remaining term of office for 2 years and 10 months

1 out of 1

Vivien Bouttell

Medway Elected 2010. Re-elected March 2014, for 3 years with effect from 1 July 2014

5 out of 6

Renee Coussens

Medway Elected 2008. Re-elected June 2011. Re-elected March 2014 for 1 year 6 months with effect from 1 April 2014

6 out of 6

Stella Dick Medway Elected 2014 for 2 years and 3 months, with effect from 1 April 2014

6 out of 6

4

Doreen King

Medway Elected 2015 for 3 years with effect from 1 July 2015

4 out of 4

Margaret Ratcliffe

Medway Elected 2008. Re-elected June 2011. Re-elected March 2014 for 3 years with effect from 1 July 2014

5 out of 6

Ann Richmond

Medway Elected 2007. Re-elected June 2008. Re-elected March 2014 for 3 years with effect from 1 July 2014

5 out of 6

Paul Walker

Medway Elected 2015 for 2 years with effect from 1 July 2015

3 out of 4

Alan West Medway Elected 2014 for 2 years and 3 months, with effect from 1 April 2014

6 out of 6

Lyn Gallimore

Swale Elected 2015 for 2 years with effect from 1 July 2015

4 out of 4

Ruth Jenner

Swale Elected unopposed 2009. Re-elected unopposed June 2012. Re-elected July 2015 for 3 years

6 out of 6

Silvia Marin

Swale Elected 2015 for 3 years with effect from 1 July 2015

1 out of 4

Michael Moseley

Swale Elected 2014 for 2 years 3 months, with effect from 1 April 2014

4 out of 6

Richard Tripp

Rest of England and Wales

Elected unopposed 2010. Re-elected March 2014 for 2 years 3 months, with effect from 1 April 2014

4 out of 6

VACANT Staff: Nursing and Midwifery

Seat currently Vacant

VACANT Staff: Allied Health Professionals

Seat currently Vacant

Ann Bushnell

Staff: Management

Elected 2015 for 2 years with effect from 1 July 2015

3 out of 4

Tim Cowell

Staff: Non Clinical

Elected 2015 for 3 years with effect from 1 July 2015

4 out of 4

Dr Anil Madhavan

Staff: Medical & Dental Class

Elected unopposed 2014 for 2 years and 3 months, from 1 April 2014

1 out of 6

Cllr David Brake

Medway Council Health and Wellbeing Board

Appointed May 2013 for 3 years 3 out of 6

Adrian Crowther

Kent County Council Appointed June 2007. Re-appointed June 2010. Re-appointed June 2013 for 3 years

6 out of 6

Mandy Stevenson

Greenwich University representing Medway Universities

Appointed February 2016 for 3 years 0 out of 0

Claire Thurgate

Canterbury Christ Church University

Appointed February 2016 for 3 years 0 out of 0

Dr Peter Nicholls

University of Kent Appointed February 2016 for 3 years 0 out of 0

Christine Harvey

Medway League of Friends representing Charities

Appointed June 2015 for 3 years 4 out of 6

Former Governors during 2015/16 Attendance

Paul Bennett

Medway Elected 2014 for 1 year and 3 months, with effect from 1 April 2014, resigned April 2015

1 out of 1

James Devine

Medway Elected 2015 for 3 years, resigned September 2015

1 out of 1

Ann Smart Medway Elected June 2012 for 3 years, resigned July 1 out of 2

5

2015

Dawn Cockburn

Swale Next placed successful candidate from the 2014, appointed to take over from Paul Wood for 1 year and 1 month with effect from May 2014. Resigned June 2015

1 out of 2

Kevin Griffin

Staff: Allied Health Professionals

Elected March 2014 for 2 years and 3 months with effect from 1 April 2014, resigned August 2015 Seat currently Vacant

3 out of 3

Viv Parker Staff: Non Clinical

Elected unopposed June 2012 for 3 years, resigned June 2015

2 out of 2

A register of Governor’s interests is held at the Trust and can be obtained by contacting the Governor and Membership Lead, Level 1 Postgraduate Centre, Medway NHS Foundation Trust, Windmill Road, Gillingham, Kent, ME7 5NY, or email [email protected]. Membership Anyone aged 16 and over and is not employed by the Trust can become a public member. Every member of staff automatically becomes a member unless they choose to opt out. As at 31 March 2016, the Trust has 11,026 public members and 4,207 staff members which gives a total of 15,153 members. In the last 12 months, a total of 613 public members were recruited. The breakdown of our public membership base per constituency is listed below.

Constituency Total

Medway 6,863

Swale 1,845

Rest of England and Wales

2,318

Membership Total 11,026

A programme of 13 members’ events took place during 2015/2016. Two events were held in Swale which were duplicates of events run in Medway seeking feedback from members and governors regarding the priorities to be included in the Trust’s Annual Plan and Quality Accounts. One event was the Trust’s Annual Members Meeting. Members received quarterly newsletters and monthly e-bulletins during 2015 and from 2016 receive the Trust’s News@Medway newspaper by email, which is also available for collection from various newsstands around the hospital. The Council of Governors is chaired by the Chairman of the Trust and its meetings are also attended by the Chief Executive, who presents a report on performance and current issues. Other executive directors along with the non-executive directors also attend the Council of Governors meetings and working groups on a regular basis to provide updates as and when requested by the governors. The Council of Governors has undertaken scrutiny of a variety of subjects during the year 2015/16, including:

The Trust’s performance against the annual plan

The Trust’s performance against the Quality Accounts

Progress of the Trust’s Recovery Plan

mailto:[email protected]

6

Director attendance at Council of Governors meetings (including the Annual Members’ Meeting) 1 April 2015 to 31 March 2016

Current Board members during 2014/15 Attendance

Shena Winning, Chairman 6 out of 6

Patricia Bain, Chief Quality Officer 4 out of 6

Ewan Carmichael, Non-Executive Director 1 out of 1

Darren Cattell, Director of Finance 0 out of 0

Stephen Clark, Non-Executive Director 0 out of 0

Lesley Dwyer, Chief Executive 5 out of 5

Diana Hamilton-Fairley, Medical Director 1 out of 1

Martin Jamieson, Non-Executive Director 3 out of 6

Paul Lehmann, Director of Communications 1 out of 1

Tony Moore, Non-Executive Director 6 out of 6

Joanne Palmer, Non-Executive Director 1 out of 1

Karen Rule, Medical Director 1 out of 1

Jan Stephens, Non-Executive Director 5 out of 6

Lynne Stuart, Director of Corporate Governance, Compliance, Legal and Risk 0 out of 0

Former Board members during 2014/15 Attendance

Helen Astle, Director of Corporate Governance 1 out of 1

Roberta Barker, Director of Workforce 5 out of 6

Phil Barnes, Acting Chief Executive 1 out of 1

Steve Beaumont, Chief Nurse 3 out of 5

Tim Bolot, Interim Director of Finance 3 out of 6

Andrew Burnett, Non-Executive Director 2 out of 4

Morag Jackson, Chief Operating Officer 2 out of 3

Kirti Mukherjee, Acting Medical Director 1 out of 2

Jennifer Palmer, Director of Corporate Governance, Compliance, Legal & Risk 1 out of 1

Ghada Ramadan, Acting Medical Director 1 out of 2

Paul Ryan, Acting Medical Director 0 out of 1

Andrew Silverman, Director of Communications 1 out of 1

Non-Executive Director attendance at Governors’ Working Group/Committee meetings 1 April 2015 to 31 March 2016

Current and former Non-Executive Directors Attendance

Shena Winning 6 out of 10

Andrew Burnett (former non-executive director) 0 out of 1

Ewan Carmichael 3 out of 3

Martin Jamieson 3 out of 5

Tony Moore 5 out of 5

Jan Stephens 5 out of 6

Governors are invited to take part in various Trust Groups and Committees in order to communicate the views and concerns of their members. These Groups include:

Emergency Department Patient Focus Group

End of Life Care Steering Group

Outpatient Improvement Group

Patient Safety Committee

Patient Experience Task Group

Health and Safety Committee One representative from the Council of Governors regularly attends the Trust Board meetings to observe proceedings raise questions and concerns relating to the agenda directly with the Board. The Governor

7

Representative then reports back at each Council of Governors meeting on her observations from the Board meetings. Governors keep a log of any queries raised with executive directors outside of their scheduled meetings. The Council of Governors appointed three new Non-Executive Directors in 2015, following a robust appointment process that was approved by the Council of Governors. A headhunting organisation was appointed to seek appropriate candidates and a shortlist was approved by the Governors’ Nominations and Remuneration Committee prior to interviews commencing. Governors were invited to join a stakeholder group which had the opportunity to meet with each of the applicants prior to the interview. The interview panel comprised the Trust Chairman, Lead Governor, two other public governors. Human Resources provided support for the process. In the event of disputes between the Council of Governors and the Board of Directors, the following Dispute Resolution Procedure shall apply:

a) in the first instance the Chair on the advice of the Company Secretary, and such other advice as the Chair may see fit to obtain, shall seek to resolve the dispute;

b) if the Chair is unable to resolve the dispute the individual shall refer the dispute to the Secretary who shall appoint a joint special committee constituted as a committee of the Board of Directors and a committee of the Council of Governors, both comprising equal numbers, to consider the circumstances and to make recommendations to the Council of Governors and the Board of Directors with a view to resolving the dispute;

c) if the recommendations (if any) of the joint special committee are unsuccessful in resolving the dispute, the Chair may refer the dispute back to the Board of Directors who shall make the final decision.

This dispute resolution procedure is set out in the Trust’s Constitution which is available on the Trust’s website. Members may contact Governors or Board members through the membership office by telephone on 01634 825292, by email to [email protected], in writing to Membership Office, Level 1 Postgraduate Centre, Medway NHS Foundation Trust, Windmill Road, Gillingham, Kent, ME7 5NY, or via our website www.medway.nhs.uk.

mailto:[email protected]

http://www.medway.nhs.uk/

1

ANNEX G CoG/16/04-10

For Discussion & Approval

COUNCIL OF GOVERNORS MEETING (PUBLIC) – 7 April 2016 Lead: Renee Coussens, Membership Engagement Group Lead

Name: Martine Saker Designation: Governor and Membership Lead

MEMBERSHIP ENGAGEMENT GROUP UPDATE


Purpose of the paper presented: To present the Membership Engagement Group’s revised terms of reference. To present the 2016/17 Membership Strategy.

Outcomes required: The Council of Governors is requested to review and approved the Membership Engagement Group’s revised terms of reference. The Council of Governors is requested to review the proposed 2016/17 Membership Strategy with a view to approving the document prior to submission to the May 2016 Trust Board meeting.


Terms of Reference: The Membership Engagement Group requested an update to its terms of reference at its meeting in September 2015 to remove the duty of seeking assurance regarding engagement issues raised in action plans following concerns exposed in patient/staff surveys. It was felt that this would fit better under the remit of a patient experience group. The revised terms of reference are attached as appendix A Membership Strategy: The Membership Engagement Group reviewed the Trust’s Membership Strategy at its meeting held on 29 February 2016. The draft 2016/17 Membership Strategy is attached as appendix B. A summary of the amendments proposed are detailed below:

Page Details of Amendment

Page 1 Date amended to 2016/17. Other dates to record when the strategy has been approved to be added in due course.

Page 4, paragraph 2 The word ‘now’ has been inserted

Page 4, paragraphs 3 and 4, and table of data after paragraph 4

Data updated and additional wording added, to reflect the estimated population figures obtained from data within Kent County Council’s Strategy Forecast. Membership numbers updated to reflect numbers as at 10 March 2016. These will be updated further to reflect the membership data as at 1 April 2016, as soon as the data is available.

2

Page 4, footnote Updated to reflect the source of population statistics used on page 4 of the strategy

Pages 5 and 6 Wording updated to reflect when the Trust reached its target membership of 10,500 members. Membership data updated to reflect the numbers and percentage breakdown as at 10 March 2016. These will be updated further to reflect the membership data as at 1 April 2016, as soon as the data is available. Note: Estimated Ethnicity breakdown of the population for 2016 is not available, therefore the target is based on the ethnic breakdown within the 2011 census. Additional wording added to explain that the strategy is to improve the diversity of the public membership.

Page 7, last paragraph Paragraph updated to reflect the change in membership communications. News@Medway is now emailed to members each month. The Trust Chairman will also send an e-bulletin to members each month.

Page 9, first paragraph Information regarding the budget has been updated to reflect the amount available for membership management, member/governor communications and events, governor elections and governor training.



Resources required:

None

Prior Discussion: Prior to the present meeting, this matter has been considered by the Membership Engagement Group.

Revised Terms of Reference – Governors’ Membership Engagement Group v11 Date revised Terms of Reference were agreed: 05/08/2015 Page 1 of 4

TTEERRMMSS OOFF RREEFFEERREENNCCEE

GOVERNORS’ MEMBERSHIP ENGAGEMENT GROUP

1 CONSTITUTION ........................................................................................................... 2

2 ACCOUNTABILITY/REPORTING ARRANGEMENTS .................................................. 2

3 CHAIRMANSHIP ........................................................................................................... 2

4 MEMBERSHIP .............................................................................................................. 2

5 ATTENDANCE (IF ADDITIONAL TO MEMBERSHIP) .................................................. 2

6 QUORUM ...................................................................................................................... 2

7 FREQUENCY OF MEETINGS/ATTENDANCE OF MEMBERS .................................... 2

8 PURPOSE ..................................................................................................................... 3

9 RESPONSIBILITY/OBJECTIVES/DUTIES ................................................................... 3

10 PROCESS FOR MONITORING COMPLIANCE WITH TERMS OF REFERENCE ...... 4

11 REVIEW DATE ............................................................................................................. 4

TERMS OF REFERENCE GOVERNORS’ MEMBERSHIP ENGAGEMENT GROUP

Terms of Reference – Governors’ Membership Engagement Working Group v11 Page 2 of 4

1 Constitution

1.1 The Working Group has been constituted by the Council of Governors to support

Governors in carrying out their scrutiny duties as laid out in Monitor’s Code of Governance.

2 Accountability/Reporting Arrangements

2.1 The Working Group will be accountable, and report to, the Council of Governors.

3 Chairmanship

3.1 The Lead of the Working Group will be a Governor and will be selected on an

annual basis by other members of the Working Group.

4 Membership

4.1 The membership will comprise at least:

One Swale Governor Two Medway Governors One Staff Governor One Partner Governor

4.2 In the absence of the Lead, the Lead will choose a deputy for that meeting.

5 Attendance (if additional to membership)

5.1 The Communications Lead for the Trust, or his/her representative.

5.2 A Non-Executive Director or their representative. 5.3 The Executive Directors, or their representatives (as requested). 5.4 The Trust Chairman and/or the Company Secretary and the Governor and

Membership Lead will be in attendance to service and advise the Working Group.

5.5 The Working Group may request the attendance of any member of staff who can inform the discussions on engagement.

6 Quorum

6.1 A quorum will be two members of the total membership.

7 Frequency of Meetings/Attendance of Members

7.1 Meetings will be held quarterly, with further meetings if required.



7.2 Members would be expected to attend at least 75% of all meetings in one calendar

year.

8 Purpose 8.1 The Working Group is the body which oversees the engagement between the Trust

and its members and the wider public and reports back on the subject (with or without recommendation) to the Council of Governors.

9 Responsibility/Objectives/Duties

9.1 Annual review of the Trust’s Membership Strategy.

9.2 Half yearly review of membership numbers and demographic profile compared with

available information about community demographics and develop appropriate strategies and proposals for increasing membership in underrepresented groups.

9.3 Quarterly review of media activity.

9.4 Review any issues brought to the Working Group’s attention that relate to the members and membership, including complaints from members about membership and adjudicating on any application for disqualification from membership.

9.5 Review key communication tools, particularly members’ newsletter and make suggestions about future content.

9.6 Formulate an annual programme of Members’ meetings.

9.7 Review of demographic profile of the membership of the Council of Governors and compare with available info about community demographics and develop appropriate strategies and proposals for increasing membership in underrepresented groups.

9.8 Make reports and/or recommendations to the Council of Governors in connection with its review/scrutiny process.

9.9 Oversee planning for and review of Annual Members’ Meetings.

9.10 Provide an annual report to the Council of Governors on the work of the Engagement Group and make recommendations for future work programmes.

9.11 Where necessary, consult with their members and other representative bodies (e.g. Stakeholders and volunteers).

9.12 The Working Group can establish ad hoc ‘task and finish project groups’ as and when required, as long as this is within the remit of its objectives.



10 Process for Monitoring compliance with Terms of Reference 10.1 The Working Group will carry out an annual review of its Terms of Reference.

11 Review Date 11.1 The outcome of each annual review of the Terms of Reference is to be recorded

below:

What will be monitored

How/method Frequency Lead Reporting to

Deficiencies/gaps Recommendations and actions

Implementation of any required changes

Terms of Reference

By a report to the Council of Governors

Annually

Chair of the Working Group

Council of Governors

Will be addressed by the Council of Governors

Medway NHS Foundation Trust Membership Strategy 2015/16 Reviewed February 2015 Page 1 of 10

Membership Strategy 2016/17

Reviewed by the Membership Engagement Group: February 2016

Proposed and agreed by the Council of Governors:

Approved by Trust Board:

Review date: March 2017


CONTENTS

1. Introduction………………………………….…………………………. Page 3

2. Membership …………………………………………………………… Page 3

3. Membership Recruitment ……………………….………………….. Page 7

4. Engaging Members ………………………………………………….. Page 7

5. Membership Development…………………………………………... Page 8

6. Managing the Membership ……..…………………………………... Page 8


MEDWAY NHS FOUNDATION TRUST

MEMBERSHIP STRATEGY 1. INTRODUCTION This document describes Medway NHS Foundation Trust’s strategy to attract, retain, engage and develop a representative and diverse membership. As a public benefit organisation we believe this type of membership will enable us to deliver better health care services that are more appropriate to a wide range of people. Our aim is that Medway NHS Foundation Trust becomes an exemplar membership organisation and that our membership is truly reflective of our community in terms of gender, age, disability, sexuality, ethnic background and faith. We acknowledge that the process of building an appropriate membership will take time, resource and commitment and that both the Trust and the Council of Governors have a responsibility to support, lead and develop this important area of work. 2. MEMBERSHIP Membership of Medway NHS Foundation Trust comprises members of the Medway community and beyond, and Trust staff. We believe that having a strong, active membership will mean that Medway NHS Foundation Trust will be better equipped to deliver services that are cognisant of the needs of people in Medway. This will be achieved by:

Actively engaging with members and listening to what they have to say

Consulting with members about important developments and changes

Developing an effective Governing Council Public membership is available for any individual member of the public aged 16 and over who lives in Medway, Swale or the rest of England and Wales. Members are invited to “opt in” by completing an application form. We are eager to involve our current and past patients and their carers and other members of our local community. We are also keen to involve those who live outside our community and who wish to become involved because they live within easy travelling distance, have some current or past connection with the Trust or may use health care services provided by the Trust. Members abide by the Trust’s code of conduct and public service values. Members may be disqualified if:

They have perpetrated a serious incident or violence in the past five years, towards any hospital or healthcare facilities or against any of the Trust’s staff, Non Executive Directors, Council of Governors, in accordance with the relevant Trust’s policy for withholding treatment from violent/aggressive behaviour

They have been confirmed as a “persistant complainant” in accordance with the relevant Trust’s policy

Breached the Trust’s code of conduct


Local Demographics The demographics of the local population are set out below.

Medway and Swale have a younger population than average for England, but older people are now living longer and more independently. This means there will be an increasing demand for health and social care for older people and at the same time high demand for services for children and young people compared to other areas.

The population of Medway and Swale is predominantly white, being 89.64% and 96.55% respectively although ethnic minority communities are diverse and include several groups whose first language is not English.

The population of Medway is expected to reach 218,1001 in 2016, with a growth forecast up to 237,8001 expected by 2033. The population of Swale is expected to reach 112,8001 in 2016 with a growth forecast up to 126,9001 expected by 2033. The Trust has calculated the population for Medway and Swale1 to determine the percentage in each area. This percentage has then been set as the target percentage for the Trust’s membership in Medway and Swale. The table also highlights the current membership total reached, converted to a percentage:

Population Percentage split of combined population

Membership as at 10/03/16 As %

Medway 218,100 66.02% 6,779 78.64%

Swale 112,800 33.98% 1,841 21.36%

Although the Trust’s services are available to the whole of Swale, it is noted that not all Swale residents would automatically attend Medway Maritime Hospital or receive services that it provides in the community. There appears to be a natural geographical divide where residents were more likely to travel to Canterbury. It would be predominately people from Newington, Lower Halstow, Iwade, Sittingbourne and the Isle of Sheppey that would use Medway Hospital. Staff Membership - Staff are eligible to become staff members if they have a permanent contract, a 12 month or longer fixed term contract, have an honorary contract or are employed by the Trust although they work with other NHS organisations locally. Staff will automatically become members unless they opt out. Staff members may be disqualified on the same basis as public members. In addition a staff member may be asked to temporarily cease membership activities during any period of suspension under the Trust’s code of conduct and associated staff policies and professional codes. Corporate Membership For other organisations such as local businesses who would like to be involved more closely with the Trust, it is likely that areas of fundraising, training and volunteering may provide appropriate opportunities to harness their interest. There is no opportunity within Foundation Trust status to offer corporate membership.

1 2011 Census data (27/3/2011Kent County Council Strategy Forecast (October 2014) from the Office

of National Statistics (ONS) © Crown Copyright


Membership Targets The Trust set itself a target of recruiting 10,500 members within the first three years authorised as a Foundation Trust. This target was achieved in September 2011. The absolute minimum number of public members is defined in our constitution as 400. Membership

Totals as at 1 April 2015

Membership Totals as at 10 March 2016

Medway Swale Rest of England & Wales Public

6,778 1,844 2,321

10,943

6,779 1,841 2,272

10,892

Staff

4,207

Total

15,150

In order to ensure the public membership is representative of the population it serves, the information provided below details targets within each constituency based on gender, age and ethnicity, together with details of current membership percentages for those who disclosed the relevant information. The ethnicity targets are based on the 2011 Census data (27/3/2011) from the Office of National Statistics (ONS) © Crown Copyright. The gender and age targets are based on 2016 forecasted population data provided by Kent County Council Strategy Forecast (2014): Medway Constituency

Gender Target Current Membership As at 10/03/16

Male 49.38% 30.81%

Female 50.62% 69.19%

Age Target Current Membership As at 10/03/16

16 1.56% 0.04%

17-21 7.89% 4.18%

22+ 90.51% 95.78%

Ethnicity Target Current Membership As at 10/03/16

White 89.64% 88.66%

Mixed 1.96% 1.26%

Asian or Asian British 5.16% 5.63%

Black or Black British 2.52% 4.11%

Other Ethnic Groups 0.72% 0.34%


Swale Constituency

Gender Target Current Membership As at 10/03/16

Male 49.02% 34.61%

Female 50.98% 65.39%

Age Target Current Membership As at 10/03/16

16 1.51% 0%

17-21 6.83% 1.63%

22+ 91.67% 98.37%

Ethnicity Target Current Membership As at 10/03/16

White 96.55% 95.92%

Mixed 1.16% 0.79%

Asian or Asian British 1.10% 1.45%

Black or Black British 1.03% 1.78%

Other Ethnic Groups 0.16% 0.07%

The details above highlight that further recruitment is required in various categories and the aim will be to improve the diversity of the public membership over the next 12 months. Whilst the Trust has not set a target for the Rest of England and Wales constituency, the membership figures are also analysed and recorded. The percentages listed below are based on the total public membership across all three public constituencies, where the relevant information has been disclosed: Rest of England and Wales Constituency

Gender Current Membership As at 10/03/16

Male 32.75%

Female 67.25%

Age Current Membership As at 10/03/16

16 0.15%

17-21 6.26%

22+ 93.59%

Ethnicity Current Membership As at 10/03/16

White 75.46%

Mixed 2.52%

Asian or Asian British 11.86%

Black or Black British 9.34%

Other Ethnic Groups 0.82%


The Council of Governors consists of 14 public (9 from Medway, 4 Swale, 1 rest of England and Wales), 5 staff and 4 partner governors. Staff representatives may be disqualified on the same basis as public members or have their membership temporarily suspended during any period of formal suspension under the Trust’s code of conduct and associated staff policies and professional codes. The 4 places on the Council of Governors for partner organisations comprise:

Local Authority (represented by a member of the Medway Health and Wellbeing Board) x 1

Local Authority (represented by a member of the Kent Health and Wellbeing Board) x 1

Charities x 1 (seat currently represented by Medway Hospital League of Friends)

Universities of Medway x 1 (currently represented by University of Greenwich) 3. MEMBERSHIP RECRUITMENT Our aim is to recruit a wide range of members, which represent the local community which the Trust serves. We do this by:

Raising awareness of membership in all the qualifying communities within Medway and Swale

Providing a simple, accessible and publicised process for becoming a membership application

Ensuring that the composition of the membership reflects the diversity of the local communities

Recognising and using members as a valuable resource

Developing both external and internal publications to promote membership

Targeting recruitment at specific groups or areas, for example, community groups, education institutions

Displaying leaflets and application forms in areas of the hospital that have the greatest footfall

High profile advertisement on site and on the Trust’s internet

Engaging staff and volunteers in recruiting public members

Engaging health economy partner organisations

Using local media to promote the campaign

Developing the trusts electronic interface with the public e.g. pop up reminders

The recruitment and engagement plan is attached as appendix A. 4. ENGAGING MEMBERS We aim to focus on the quality and level of involvement of our members. We acknowledge that members will desire different levels of involvement, depending on their needs and reason they became members. It is important to ascertain at the outset what these levels of involvement are likely to be and to regularly check this is as members’ circumstances change. Early information is collected via the membership application form. The Trust also distributes a monthly newspaper called News@Medway which is available for people and members to pick up at from newsstands at various locations within Medway Hospital as well as at Medway Council Hubs. The newspaper is also available electronically on the Trust’s website and members who have registerd to receive e-communications from the Trust receive notification of each News@Medway edition as well as a monthly e-bulletin from the Trust Chairman.


The Annual General Meeting provides an opportunity for members to meet governors (their representatives) and senior staff of the Trust. It provides a good opportunity for the Foundation Trust to market itself and for increasing membership. Members’ Meetings also take place at least eight times a year, the purpose of which is to inform, consult and engage with members. The Trust issues a membership card on which key information about the Trust is provided. The intention here is to promote a sense of belonging. In addition, from time to time the Trust holds member focus groups on particular issues. We have developed a members’ section on the main website www.medway.nhs.uk via which members are able to make comments and ask questions. 5. MEMBERSHIP DEVELOPMENT A detailed membership development strategy is outlined below:

To increase the quality and level of participation in the Medway NHS Foundation Trust’s democratic structures to enable the Trust to achieve its objectives and to ensure good governance.

To increase the number of active, informed members who are representative of the local communities.

To encourage more members to stand for election to the Medway NHS Foundation Trust Council of Governors.

To adopt electoral processes which encourage the participation of all active members.

To strive for the Medway NHS Foundation Trust Membership and Council of Governors to be diverse in their composition.

To ensure the culture of membership is attractive to potential new generations of activists.

To enable elected representatives to fulfil their designated roles and responsibilities and facilitate their participation in influencing decisions.

To foster a partnership approach between members and management to encourage constructive working relationships and dialogue.

To provide appropriate learning and development opportunities to members to facilitate their fulfilment of their roles and responsibilities.

To provide appropriate learning and development opportunities to employees to further their understanding of the NHS Foundation Trust’s values and principles as a public benefit corporation and membership organisation.

6. MANAGING THE MEMBERSHIP The Trust has a responsibility to communicate with members. To this end the Trust and its Council of Governors will champion and promote membership as widely as possible. The Council of Governors will receive regular updates on the membership base from the Membership Engagement Group. The work of the Membership Engagement Group is supported by the Trust’s Governor and Membership Lead, who acts as the membership secretary and his/her office is the main point of contact. Resourcing the Membership Strategy We need to adequately resource our membership function and to ensure that it is appropriately integrated with the organisation. This requires a commitment to providing

http://www.medway.nhs.uk/


membership services over the long term, developing them as required and supporting skills development. A budget of approximately £31,000 has been set for 2016/17 to cover the cost of membership management, member/governor communications and events, governor elections and governor training. Evaluation The Governor and Membership Lead will provide a half yearly progress report on performance against this strategy to the Membership Engagement Group. The Membership Engagement Group will provide an update on performance against this strategy to the Council of Governors on an annual basis.

Appendix A Medway NHS Foundation Trust

Membership Recruitment and Engagement Plan

Aim Action Lead Timescales

Increase membership, particularly in underrepresented categories

Design and deliver at least 8 members’ events per year in response to current issues, including the following topics:

o Quality Accounts; and o Annual Plan

Explore venues which are consistent with underrepresented categories

Attend local college and university freshers’ fairs

Invite staff leavers to become members

Invite membership via advert on the Trust’s website


Ongoing

Engage members in Medway NHS FT’s annual plan and activities

Produce and deliver monthly News@Medway via collection points and email

Produce and deliver regular e-bulletins

Provide information via the Trust’s website

Engagement at the regular members’ events

Promote participation in the annual Governor elections

Invite members to participate in in-house focus groups or committees, as appropriate.

Communications Team/Governor and Membership Lead

Ongoing

Ensure that the Council of Governors’ development needs are identified and addressed as part of an annual development plan

Coordinate and facilitate an induction programme for new Governors

Conduct a training needs analysis aligned to Governors’ groups/committees

Offer relevant development and training for individual governors

Plan and deliver an annual Council of Governors’ development programme

Governor and Membership Lead & Membership Engagement Group

Annual

1

ANNEX HI CoG/16/04-14

For Discussion & Approval

COUNCIL OF GOVERNORS MEETING (PUBLIC) – 7 April 2016 Lead: Stella Dick, Lead Governor

Name: Martine Saker Designation: Governor and Membership Lead

COMMUNITY AND PATIENT ENGAGEMENT GROUP UPDATE


Purpose of the paper presented: To present the terms of reference for the Community and Patient Engagement Group.

Outcomes required: The Council of Governors is requested to review and approved the Community and Patient Engagement Group’s revised terms of reference, attached as appendix A. The Council of Governors is requested note the verbal update to be provided at the meeting, covering the work of the Group to date. The Council of Governors is asked to confirm which ‘meet the governors’ coffee morning date or dates they will be attending in April.


Terms of Reference and update: The Community and Patient Engagement Group first met on 13 January 2016, where it set out its terms of reference (attached as appendix A), which are now presented to the Council of Governors for approval. Meet the governors coffee mornings: At that meeting it was agreed that ‘meet the governors’ coffee mornings be arranged to allow the community, patients, members and other stakeholders the opportunity to share their experiences with governors. A trial of two coffee mornings to take place on Saturdays in April was agreed, one to take place at Medway Maritime Hospital and one to take place at Sittingbourne Memorial Hospital. A subsequent meeting of the Group took place on 26 January 2016 to develop a crib sheet for governors to use at those coffee mornings (attached as appendix B), together with information regarding the Trust’s public commitments (attached as appendix C). The dates for the first two coffee mornings have been arranged and an email was sent to Governors, advising them of the coffee mornings and requesting that they advise the Governor and Membership Lead which date or dates they would be attending. A summary of governor attendance confirmed for each coffee morning is detailed below:

2

Saturday 16 April, 10am-midday – Medway Maritime Hospital Restaurant: Renee Coussens Stella Dick Glyn Allen Vivien Bouttell Adrian Crowther Doreen King Ann Richmond Paul Walker Alan West Saturday 23 April 10am-midday – Coffee Room at Sittingbourne Memorial Hospital: Renee Coussens Adrian Crowther Stella Dick Lyn Gallimore Doreen King Silvia Marin (subject to work commitments) At a recent Membership Engagement Group meeting it was suggested that a further coffee morning at Sheppey Community Hospital could be trialled. Subsequently an email was sent to Swale Governors and the Kent County Council partner governor with a request for their availability during May 2016 for the Sheppey Community Hospital coffee morning. Taking into consideration May bank holiday weekends, The two options are either Saturday 14 May or Saturday 21 May. Adrian Crowther has confirmed he is available for both dates. Silvia Marin has confirmed she will aim to attend whichever date is chosen, subject to her work commitments. Once a date has been selected that suits the majority of Swale Governors, the date will be circulated to the rest of the Governing Board requesting their availability to attend.



Resources required:

None

Prior Discussion: Prior to the present meeting, this matter has been considered by the Community and Patient Engagement Group.

Terms of Reference – Governors’ Community and Patient Engagement Group v1 Date Terms of Reference were agreed: … Page 1 of 3

TTEERRMMSS OOFF RREEFFEERREENNCCEE

GOVERNORS’ COMMUNITY AND PATIENT AND ENGAGEMENT GROUP

1 CONSTITUTION ........................................................................................................... 2

2 ACCOUNTABILITY/REPORTING ARRANGEMENTS .................................................. 2

3 CHAIRMANSHIP ........................................................................................................... 2

4 MEMBERSHIP .............................................................................................................. 2

5 ATTENDANCE (IF ADDITIONAL TO MEMBERSHIP) .................................................. 2

6 QUORUM ...................................................................................................................... 2

7 FREQUENCY OF MEETINGS/ATTENDANCE OF MEMBERS .................................... 2

8 PURPOSE ..................................................................................................................... 3

9 RESPONSIBILITY/OBJECTIVES/DUTIES ................................................................... 3

10 PROCESS FOR MONITORING COMPLIANCE WITH TERMS OF REFERENCE ...... 3

11 REVIEW DATE ............................................................................................................. 3

TERMS OF REFERENCE GOVERNORS’ COMMUNITY AND PATIENT ENGAGEMENT GROUP

Terms of Reference – Governors’ Community and Patient Engagement Group v1 Page 2 of 3

1 Constitution

1.1 The Group has been constituted by the Council of Governors to support Governors in

carrying its engagement with the community and patients.

2 Accountability/Reporting Arrangements

2.1 The Group will be accountable, and report to, the Council of Governors.

3 Chairmanship

3.1 The Trust Chairman will chair the meetings.

4 Membership

4.1 The membership will comprise at least:

Lead Governor One Public Governor One Staff Governor

4.2 In the absence of the Trust Chairman, a Non-Executive Director will chair the meetings.

5 Attendance (if additional to membership)

5.1 The Communications Lead for the Trust, or his/her representative.

5.2 The Executive Directors, or their representatives (as requested). 5.3 The Company Secretary and/or the Governor and Membership Lead will be in

attendance to service and advise the Group.

5.4 The Group may request the attendance of representatives from Healthwatch, Patient Experience team, local pharmacies and local universities

5.5 The Group may request the attendance of any member of staff who can inform the discussions on engagement.

6 Quorum

6.1 A quorum will be two members of the total membership and one Non-Executive Director.

7 Frequency of Meetings/Attendance of Members

7.1 Meetings will be held quarterly, with further meetings if required.

TERMS OF REFERENCE GOVERNORS’ COMMUNITY AND PATIENT ENGAGEMENT GROUP

Terms of Reference – Governors’ Community and Patient Engagement Group v1 Page 3 of 3

7.2 Members would be expected to attend at least 75% of all meetings in one calendar

year.

8 Purpose 8.1 The Group is the body which oversees the engagement between the Governors and

the community including but not limited to patients, community groups, key stakeholders, staff, etc, and the wider public and reports back on its activity (with or without recommendation) to the Council of Governors.

9 Responsibility/Objectives/Duties

9.1 Have input into the Governor Engagement elements of the Trust’s Engagement

Strategy.

9.2 Identifying with the Trust which topics the Trust needs feedback from the community and arranging for the feedback to be gathered and shared with the Trust.

9.3 Develop a plan of community, staff and patient engagement for the Council of Governors.

9.4 Regular review of how effective Governor Engagement is with the community, including and not limited to patients, community groups, key stakeholders, staff, etc.

9.5 The Working Group can establish ad hoc ‘task and finish project groups’ as and when

required, as long as this is within the remit of its objectives.

10 Process for Monitoring compliance with Terms of Reference 10.1 The Working Group will carry out an annual review of its Terms of Reference.

11 Review Date 11.1 The outcome of each annual review of the Terms of Reference is to be recorded

below:

What will be monitored

How/method Frequency Lead Reporting to

Deficiencies/gaps Recommendations and actions

Implementation of any required changes

Terms of Reference

By a report to the Council of Governors

Annually

Chair of the Working Group

Council of Governors

Will be addressed by the Council of Governors

Annex HI – Appendix B What is a governor / what is your role? Medway Foundation Trust, which runs Medway Maritime Hospital, has a council of governors who provide a link between the hospital and the community. We are elected by people in Medway / Swale [where appropriate]. We are independent of the management of the hospital but play a role in ensuring that the hospital is run effectively. Part of our role is to listen to patients’ and the community’s view of the hospital and the services and treatment it provides and feed that back to the management so that they can take action. Why are you here? We want to hear about your experiences of the hospital, both good and bad, whether you were a patient, family, friend or visitor. We want to know what your care and treatment was like, if you used the hospital recently, and we would also like to know what improvements you think we could make at the hospital. Are there any additional services you’d like to see there? Would you know how to put in a complaint, comment or compliment? We don’t actually work for the hospital, we are independent of management, so we are a great way of feeding back any concerns or thoughts you have. Didn’t the hospital get a lot of criticism recently? What’s happening there? The hospital was inspected last summer by the Care Quality Commission, the national organisation responsible for inspecting hospitals. Although it found that the staff are caring and compassionate, it highlighted a lot of areas for improvement. Although I as a governor am not directly responsible for responding to the report, I know that the management has had an improvement plan for in place for some months and are stepping up their efforts to respond to the report and ensure that the hospital provides the highest possible standards of care. We as governors will be monitoring the progress of the plan closely and are there to feed in comments and concerns from members of the public. So we want to hear your views. What did the report find? What’s happening in response? Among other things, the report found that the hospital was not led as well as it should be, that it takes longer for patients to be seen than they should be and that improvements are needed within the Emergency Department. It’s important to remember that the hospital has a new management team in place, with a new chief executive, who are determined to make improvements. Some of the things they are focusing on include: - Modernising the Emergency Department - Reducing the number of different doctors that patients see when they come into the

hospital, which will improve their care - Improving waiting times for cancer patients We as governors will be monitoring the progress of the plan closely and are there to feed in comments and concerns from members of the public. So we want to hear your views.

Annex HI – Appendix C

Medway NHS Foundation Trust’s 6 public commitments

Modernising our Emergency Department, reducing the time it takes for patients to be seen and assessed

Improving patient safety and care by minimising the number of different doctors that patients see during their stay in hospital

Accelerating our recruitment drive to bring in the right people with the right skills. This will ensure consistent high quality care by reducing our dependency on interims and agency staff

Continuing to improve our corporate and clinical governance, which will support both safe and high quality patient care and a productive working culture for staff

Improving care for patients with cancer, reducing waiting times, replacing our scanners and providing additional capacity for patients to see specialists

Working closely with our healthcare partners to ensure patients receive the right care in the community, when they are ready to leave hospital. This will free up beds for people coming into the hospital.

1

ANNEX JK CoG/16/04-17

For Information COUNCIL OF GOVERNORS MEETING (PUBLIC) – 7 April 2016

Lead: Shena Winning, Chairman Name: Martine Saker Designation: Governor and Membership Lead

LOG OF OPERATIONAL ISSUES RAISED BY GOVERNORS


Purpose of the paper presented:

To inform the Council of Governors of operational issues raised by Governors outside of their scheduled meetings.

Outcomes required:

The Council of Governors is requested to note the issues raised.

Time required:

5 minutes

Summary of the Key Points:

The log includes two worksheets. The first details the current/recent (“active”) queries, the date the query was raised, by whom and who to, together with the response received. The second worksheet contains queries that have received responses and are now deemed as closed. Only the “active” worksheet (appendix 1) is presented for information. This document shows the updates and new queries received since the August Council of Governors meeting.

The queries are rated accordingly: Red/Pending Query raised, no response yet received. Amber/Pending Partial response received. Green/Closed Response received, item now closed and will be moved to the “closed” worksheet after the log has been presented to the Council of Governors.



Resources required:

None

Prior Discussion:

The Log is presented to the Quality Working Group at each of their quarterly meetings.

2

Date Ref Governor Query / Concern / Issue Comments Actions Taken Query

answered?

Response includig name of person responding

06/10/2015 GL/16/15 Vivien

Bouttell

Some time ago governors were made aware that the

accommodation in the Breast Care Unit was poor and

cramped and did not meet the professional

standards. The matter was pursued by the trust's

Quality Assurance Committee but no progress was

made and about a year ago we were told that a site-

wide survey of all buildings was being made and that

this might flag up more appropriate accommodation.

We have heard nothing since - has the survey been

completed and is improved accommodation for the

department still under review?

08/10/15 - email to Phil

Griffiths

26/10/15 - response

chased

25/2/16 - email to new

Dir of Finance chasing

an update

Pending

(red)

04/11/15 response to VB - The review of accommodation has

commenced with desk top analysis and on site survey. The initial

results of this stage have been feedback to a working session the

then Directors of Operations or their representative. The next

stage to be completed is feedback from all operational areas

regarding ideal adjacencies following which proposed tactical

relocation or alteration will be developed.

Due to organisational changes and operational pressures there is

now a need to revisit some of the process with new stakeholders,

which is likely to take place by the end of December.

As the special pressures relating to the Breast Care Unit are

critical, resource is being allocated to consider concurrently with

the overall review, any physical intervention that can be

undertaken to provide earlier relief.

7/12/15 - CoG agreed query to remain open - QAC chair to take

forward.

15/10/2015 GL/18/15 Vivien

Bouttell

Wheelchairs in need of repair are kept in an area off

the main corridor, outside and open to the elements.

The chairs have been screened off from view from the

corridor but are still visible from consulting room

windows in OPD Area 1 and there is no roof cover. I

understand there are currently about 18 chairs

awaiting repair: a) in view of the fact that shortage of

wheelchairs is a recurring complaint can a rolling

repair programme be installed to ensure more speedy

turnround and b) in view of the cost of the chairs can

the area be roofed as quickly as possible to prevent

weather damage.

Although the yellow wheelchairs have a coin operated

release, the new folding wheelchairs do not. Why is

this? What system has been put in place to prevent

the public from simply loading the folding chairs into

cars and vans? Have any disappeared since they

were purchased?

16/10/2015 - email to

Phil Griffiths

26/10/15 - response

chased



an update

Pending

(red)

04/11/15 response to VB - This is something that was also a

concern of mine and to that end have now arranged for [1]. The

storage of defective wheelchairs to be reviewed and moved to a

more appropriate location or adequate protection to be provided

(preferably the former); [2]. Our in house equipment engineers will

be addressing all defective wheelchairs, (commenced); [3].

Regular planned inspections and programme of maintenance is

being implemented; [4]. We are reviewing whether modifications

to folding wheelchairs can be undertaken (although if this is not a

manufacturer fit it is unlikely that this will be achievable). As part

of the introduction of the planned inspection an audit of

wheelchairs is to be completed that will identify whether any of

the recent purchases have disappeared.

7/12/15 - CoG agreed query to remain open as wheelchairs still

being stored outside with no protection against the weather.

GOVERNORS' LOG OF OPERATIONAL ISSUES

3

26/10/2015 GL/22/15 Ruth

Jenner

Following the cessation by the Trust of the Smoke

Free Hospital focus group and promise that by

October a way forward would have been established,

what if any progress is there to report

Query passed to

JL/SW 26/10/15

Closed

(green)

First Smoke-Free Committee meeting has taken place.

Committee includes Governor representation.

13/11/2015 GL/24/15 Tim Cowell Query received from a member of staff:

"Why is it taking so long for us to recruit junior

doctors? I understand we interviewed for the next

batch of SHO’s in August but the first one is only

starting next week, 3 months later and the length of

time it is taking has resulted in some doctors

deciding to go elsewhere"

Query passed to RB

and Rebecca Bradd

13/11/15

Forwarded to S Ahmad

in HR for a response

25/2/16 - chased

16/3/16 chased

Closed

(green)

20/03/16 - response from Director of Workforce, forwarded to Tim

Cowell: Junior doctors are allocated to us from HEKSS and on

occasion we do not receive our complete allocation. This can be

for a number of reasons and can be at short notice. When this

occurs the Trust then undertakes its own recruitment process.

This results in delays to our new starts particularly if there are

visa requirements. The Trust endeavours to ensure that its

recruitment checks are expedited and is currently reviewing its

process to identify where there is opportunity to streamline

processes whilst ensuring robust and compliance checking of all

new staff

13/11/2015 GL/26/15 Vivien

Bouttell

Following the recent report on unhealthy food being

provided in vending machines in all Kent hospitals, I

have checked with Catering and have been advised

that the only machines they manage are in the Post

Graduate Centre and provide healthy options. It

appears that there may be other machines, however,

which have been installed directly by departments or

specialties which do not come under their remit. Are

the locations of these other machines documented,

along with details of cleaning, costs, etc., and please

can we be assured that they also supply healthy

options

Query passed to TB.

PG and Karen West

13/11/15



an update

16/3/16 chased

Pending

(red)

15/01/2016 GL/01/16 Vivien

Bouttell

The CQC report highlights urgent action required to

replace the doorframes in Imaging. What risk is

currently posed to our staff and patients? When will

they be replaced?

Query passed to JP

20/1/16



an update

16/3/16 chased

Pending

(red)

15/01/2016 GL/02/16 Vivien

Bouttell

Cleaning in some clinical areas is highlighted in the

CQC report as being inadequate. Does the

Housekeeping Department still provide the checklists

for ward and departmental managers to assure

themselves that the cleaning has been carried out?

What inspections are carried out?

Query passed to JP

20/1/16



an update

16/3/16 chased

Pending

(red)

Page 1 of 1

Annex L

COUNCIL OF GOVERNORS ANNUAL WORK PLAN 2016-2017

PUBLIC MEETING 7 Apr 2016 13 Jul 2016 6 Oct 2016 Jan 2017 TBC

Previous CoG Minutes X X X X

Matters Arising Report X X X X

Chairman’s Report X X X X

CE Report X X X X

Governors’ Log of Issues raised outside of meetings X X X X

Reports from the Board, led by NEDs

Executive Directors’ Report (summary based on board papers)

Non-Executive Directors’ Report (summary based on board papers, including committee chair reports to the Board)

X X X X

Lead Governor & Governors’ Steering Group update X X X X

Governor Representative at Board meetings – update X X X X

Quality Working Group verbal update X X X X

Membership Engagement Group verbal update X X X X

Finance and Performance Working Group verbal update X X X X

Governors’ Steering Group verbal update X X X X

Community and Patient Engagement Group update X X X X

Register of Governor Interests X

Quality Account Priorities X

Forward Plan Priorities X

Non-NHS income X

Governors’ Annual Report X

Annual Review of Membership Strategy X

Financial Plans X

Stroke Pathway presentation X

Quality WG ToR X

AGM Arrangements X

External auditor report on quality accounts X

Review of Governors Code of Conduct X

Review of AGM X

Election of Lead Governor representative & review of role description (SD elected Sept 2015 for max 3 years)

X

Finance & Performance ToR X

Membership Engagement Group ToR X

Governors’ Steering Group ToR X

Annual appraisal of External Auditor (incl in F&P WG update)

X

Community and Patient Engagement Group ToR X

Finance & Performance Minutes X X X X

Quality WG Minutes X X X

Membership Engagement Group Minutes X X X X

Community and Patient Engagement Group Minutes X X X

Governors’ Steering Group Minutes X X X X

PRIVATE MEETING 7 Apr 2016 13 Jul 2016 6 Oct 2016 Jan 2017 TBC

Chair’s Report X X X X

Confidential Minutes of the previous meeting X X X X

Confidential Matters Arising Report X X X X

NED Succession Planning/Appointments X X X X

NED Nom & Rem Minutes X X X X

NED Noms & Rem ToR X

NED Remuneration X

Annual Review of NED & Chair expense claims X

NED Appraisals – confirmation taken place X

Chairs’ Appraisal – confirmation taken place X

Constitution, as and when required

Finance and Performance Working Group meeting, 22 December 2015 Page 1 of 4

Annex M

MINUTES OF THE COUNCIL OF GOVERNORS’

FINANCE AND PERFORMANCE WORKING GROUP HELD AT 4.30PM ON 21 DECEMBER 2015 IN THE BOARDROOM, MEDWAY MARITIME

HOSPITAL

Present: In attendance: Apologies:

Richard Tripp (RFT) Adrian Crowther (AC) Stella Dick (SD) Lyn Gallimore (LG) Ruth Jenner (RJ) Doreen King (DK) Alan West (AW) Glyn Allen (GA) Martin Jamieson (MJ) Martine Saker (MS) Tony Moore (TM) Tim Cowell (TC)

Public Governor, Rest of England and Wales (Chair) Partner Governor, KCC Public Governor, Medway Public Governor, Swale Public Governor, Swale Public Governor, Medway Public Governor, Medway Public Governor, Medway Foundation Trust NED/Chair of the Integrated Audit Committee Governor & Member Lead (note taker) NED/Chair of the Investment & Contracts Committee Staff Governor

Items were taken out of order but for the purpose of the minutes, items follow the order of the agenda. 1. WELCOME AND APOLOGIES FOR ABSENCE 1.1. RFT welcomed those present. 1.2. Apologies were noted as listed above.

2. MINUTES OF THE MEETINGS HELD ON 22 SEPTEMBER 2015 AND MATTERS

ARISING REPORT Annexes A & B 2.1. The minutes of the meeting held on 22 September 2015 were agreed as an accurate

record subject to the following amendments:

add of the word ‘substantive’ prior to ‘WTE in paragraph 3.7.

Change paragraph 3.24 to read ‘...on the report showed a significant increase in staffing (primarily in agency) in the last two years.’

Change paragraph 3.25 to read ‘.identified that ward sisters were not paying enough attention to the calibre of agency staff used at night, considering the ward sister is responsible for the care of patients. TM…’

2.2. The matters arising report was noted and the following updates provided:

2.3. Action 7.5 from the meeting held on 1 July 2015 and action 2.3 from the meeting held on

22 September 2015 – actions could now be closed – MJ advised that the Integrated Audit Committee had received a very good summary of actions being taken regarding mortality and had concluded that the Trust was finally beginning to get a sense of the entirety of the problem. Some consultants still insisted that the mortality rate was compounded by the inherent health of the population, despite evidence of a series of actions that reduced the risk of mortality. As a result of work being undertaken, the number of deaths was now starting to reduce.


2.4. The new Medical Director was taking mortality very seriously and had explained that the

aim was to bring the mortality ratio to 100 by the end of April 2016. Although it was acknowledged that the Trust would not meet this target, the Trust should be able to see a significant downward trend.

2.5. In response to a question regarding whether the current backlogs of referral to treatment could also be impacting on mortality MJ explained that there was a link with patient flow and expected a significant positive impact on mortality once the patient flow issues were resolved. Actions were being taken to address the referral to treatment backlogs to ensure the current delays did not continue.

2.6. In response to a question regarding what the Trust was prioritising, MJ explained that the Medical Director was targeting the main areas such as Sepsis, Acute Kidney Infection as well as targeting patient flow. The Trust Board had received a presentation from Guys and St Thomas’ Hospitals NHS FT (GSTT) on the actions that needed to be taken to improve patient flow. Delivery of the plan would require a change of culture and attitude.

2.7. TM advised that a new Clinical Council had been established and the first meeting was extremely positive. It was suggested that an update on mortality be provided at the April Council of Governors meeting as well as an update on the medical pathway.

Action: MS to put forward a request for a mortality update and medical pathway update to be presented to the Council of Governors in April 2016. 2.8. Action 3.1 from the previous meeting – MS advised that she has now received the

strategic projects list which is a document called “18 month forward view”. She would forward the document to the Group as soon as possible. The action could be closed.

2.9. Action 3.16 from the previous meeting – TM advised that he was still to follow this up.

2.10. Action 3.32 from the previous meeting – RFT repeated the invitation for Governors to observe the Investment and Contracts Committee. TM advised that the frequency of meetings was under review as a new Finance and Performance Committee would be meeting monthly, chaired by the Trust Chairman. RFT requested that Governors be allowed to observe the new Committee and TM agreed to take the request forward.

Action: TM to take the request from the Governors to the Trust Chairman regarding allowing Governors to observe the new Finance and Performance Committee meetings. 3. SCRUTINY OF THE INVESTMENT & CONTRACTS COMMITTEE (ICC) Annex C 3.1. Tm advised that the Committee had reviewed the Trust’s performance and was pleased

with progress being made. The aim going forward was to improve operational attendance at meetings.

3.2. It was acknowledged that progress to change the culture and attitude within the Trust was slow and performance was still variable. The outcome of the CQC report was awaited with interest.

3.3. During the subsequent discussion the Medical Director and Director of Nursing were commended for being very motivational.

3.4. In response to concern regarding the quality of matrons, their leadership and management skills it was explained that the Board of Directors had acknowledged the need to invest more into staff training and had stressed the importance of ensure the right people with the right level of skills were doing the jobs they were tasked to do.


3.5. TM highlighted the key points from the finance report: a deficit of £4m per month needed to improve in order for the Trust to meet the reforecast. The finances had been discussed robustly at the Trust Board meeting.

3.6. LG advised that she had trouble understanding all the acronyms used in the report and MS agreed to take this forward with the request to the Company Secretary.

Action: MS to request to the Company Secretary that minimal acronyms are used in Board reports. 3.7. Concern was raised around the number of patient falls occurring at the Trust and TM

suggested inviting the Chair of the Quality Committee to provide an update to this Working Group. MS explained that the Quality Committee Chair already provided regular updates to the Quality Working Group and suggested it may be possible to invite the Finance and Performance Working Group to a future Quality Working Group.

Action: MS to arrange for the Finance and Performance Working Group to attend a future Quality Working Group meeting to receive an update on the work to reduce patient falls. 3.8. RFT was pleased to note that the Charitable Funds Advisory Committee would be

recommending the Trust employed a person to manage fund raising activities.

3.9. TM explained that the Trustees would be meeting in January to approve the charitable accounts. A February meeting would also be arranged to receive any further recommendations. The aim was to become more efficient with raising funds.

4. SCRUTINY OF THE INTEGRATED AUDIT COMMITTEE (IAC) 4.1 TM provided an update on the last Integrated Audit Committee meeting which he chaired

on behalf of MJ explaining that the finance report now included progress against conditions of loan agreements. One third of the Trust’s deficit was due to financial penalties against performance which translated into the Clinical Commissioning Group would not pay as much to the Trust at the end of each financial Quarter.

4.2 TM explained that half of all Foundation Trusts were in deficit for the financial year

2014/15. Currently eight out of ten Foundation Trusts carried a deficit which indicated that there was a fundamental problem with the funding for providers of health services.

4.3 MJ advised the Trust was outsourcing a large amount of the backlog to avoid it building up

but there was a financial cost to the Trust for doing this. 4.4 TM advised that the Director of Finance would be leaving the Trust in the next few weeks

and the aim was to appoint a new Director of Finance in post within the first four weeks of 2016.

4.5 The Working Group noted that the external auditors had given a positive review of the

financial controls the Trust had in place and the new internal auditors would be looking at clinical audits as well as financial audits.

4.6 The Integrated Audit Committee had raised concern around the financial forecasting

process and would review this again once the new Director of Finance was in post. A review would also be undertaken to ensure robust revenue recognition was in place as there appeared to be an issue with the Trust underestimating its activity.

4.7 RJ highlighted a comment made by a member of staff at the last Council of Governors’

meeting that the Trust was wasting money as a result of agency staff turning up at the Trust for work but were not sufficiently trained. They did not have the correct skill set, had


not received their induction training but the agency still charged the Trust for providing those staff. She had an email that she would forward to MS and TM to review.

Action: RJ to forward an email regarding concerns around the Trust being charged by agencies for inadequately trained staff to MS and TM. 4.8 It was explained that the new Director of Corporate Affairs was carrying out a review of

corporate governance to ensure there was correct focus on the correct areas. All risks would be brought together.

4.9 It was acknowledged that the Trust was now appointing more nurses than it was losing

and the new cohort of foreign nurses arriving in the New Year would help reduce the nurse agency spend. Campaigns for medics and nurses were starting to be beneficial.

5. FUTURE AGENDA ITEMS Annex D 5.1. The Working Group noted the annual work plan for 2016/17. 6. ANY OTHER BUSINESS 6.1. The Working Group requested clarification regarding information it had received that the

Trust had installed hot water clarifiers that may not be meeting the statutory requirements. MS agreed to pass the request for clarification to the relevant department.

Action: MS to request clarification on behalf of the Working Group regarding hot water clarifiers installed that may not be meeting the statutory requirements. 7. FEEDBACK TO COUNCIL OF GOVERNORS’ MEETING 7.1. The Council of Governors would receive the minutes of the meeting and a verbal update

on the key points from the meeting.

8. DATE OF FUTURE MEETINGS 8.1. It was noted that next meeting would take place on Wednesday 23 March 2016,

5.00pm-7.00pm in the Boardroom. The meeting closed at 18:35

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Annex N

MINUTES OF THE COMMUNITY AND PATIENT ENGAGEMENT GROUP MEDWAY NHS FOUNDATION TRUST

Wednesday 13 January 2016, Boardroom, Postgraduate Centre, Medway Maritime Hospital

Present: Shena Winning (SW) Trust Chairman Glyn Allen (GA) Public Governor, Medway Ann Bushnell (AB) Staff Governor Stella Dick (SD) Public Governor, Medway & Lead Governor Lyn Gallimore (LG) Public Governor, Swale Paul Walker (PW) Public Governor, Medway Alan West (AW) Public Governor, Medway

In attendance: Heidi Butcher (HB) Medway Healthwatch Manager Stephen Clark (SC) Non-Executive Director Cath Foad (CF) Medway Healthwatch Chair Dr Sohail Karim (SK) Hempstead Pharmacist Zoe Goodman (ZG) Volunteers Manager Paul Lehmann (PL) Director of Communications Martine Saker (MS) Governor & Membership Lead / Note Taker Apologies: Dr P Nichols University of Kent representative

1. CHAIRMAN’S WELCOME AND APOLOGIES FOR ABSENCE:

1.1 SW welcomed everyone to the meeting and introductions were made.

1.2 SW explained that the aim of this group was to set up governor activity around engagement

with the wider community. The Membership Engagement Group would continue to focus on member-specific engagement.

2. WORKING GROUP OBJECTIVES AND PROPOSED TERMS OF REFERENCE Annex A 2.1 The Group’s objectives were discussed under item four.

2.2 During a discussion around the terms of reference the following amendments were agreed:

1.1 amend to read “… support Governors in carrying its engagement with the community staff and patients.

4.1 amend the Governor membership to read “Lead Governor, one public Governor, one staff Governor”.

5.4 add an extra paragraph to read “Representation from Healthwatch, Patient Experience eam, local pharmacies and local universities”.

8.1 add “staff” after the word “stakeholders” and change “the subject” to “it’s activity”.

9.3 add “staff” after the word “community”.

9.4 add “staff” after the “key stakeholders”. 3. FEEDBACK FROM DISCUSSIONS WITH HEALTHWATCH 3.1 Healthwatch had indicated that they would be happy to support any engagement endeavours

and the Trust’s Communication Team would help facilitate meetings and assist with providing responses with questions.

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3.2 SD advised that she had spent time that day with Healthwatch in the main entrance foyer to listen to feedback from the patients and visitors. She found it helped to identify patient and community needs and how they want to react with the Trust.

3.3 The Group acknowledged that Healthwatch may be able to help the Trust by taking any issues

that the Trust cannot resolve forward to find other opportunities to resolve them.

4. GOVERNOR ENGAGEMENT WITH THE COMMUNITY AND PATIENTS 4.1 A discussion took place around the group’s objectives and it was identified that some

engagement activity was already in place in the form of staff/patient/visitor feedback left in the post boxes in the main entrance foyer; feedback passed to the volunteers, which had now improved to a majority of compliments where previously this had been a majority of complaints.

4.2 It was agreed that governors needed to get out into the community to gather feedback from various groups. The group also needed to understand the current feedback processes and how governors could enhance those processes.

4.3 AB advised that she would be developing staff engagement opportunities with the other staff

governors.

4.4 SD advised that she and Renee Coussens had discussed arranging Meet the Governor sessions and coffee mornings.

4.5 The group understood that patient and visitor feedback was fed back to the relevant staff but it

was not clear what happened after that. SW agreed to follow this up with the Director of Workforce. ZG would also check with the Patient Experience Manager.

4.6 SW acknowledged that there needed to be better reporting pertaining to

collection/dissemination/action/feedback management and would follow this up with the Communications Team and provide feedback to the group at a future meeting on how governors could get involved.

Action: SW/PL to improve the reporting pertaining to collection/dissemination/action and feedback management and provide feedback to the group at a future meeting on how governors could get involved. 4.7 SW explained it was important to gather useful feedback and then to use that information to

make improvements and then provide feedback to the community on the outcomes. Governors could then challenge the Trust on what it does with the feedback it receives. The Trust needed to communicate to the community that it was open to receiving feedback and would take necessary actions to make the necessary improvements.

4.8 It was noted that pharmacists also receive a lot of feedback from patients.

4.9 SW suggested governors visited the ambulance service to determine any feedback they received from patients.

4.10 It was agreed that any sessions should be properly structured with themes in order to keep the

sessions focussed but also allowing for general feedback to be gathered.

4.11 It was acknowledged that the Trust needed to get the little things fixed quickly to prove to the community that the Trust did take feedback seriously.

5. ANNUAL WORK PLAN AND ITEMS FOR NEXT AGENDA

5.1 It was suggested that a task group be set up to formulate a plan of two or three engagement

activities. A script would be required to explain why governors were engaging and how any

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feedback would be taken forward and how responses from the Trust would be communicated back to the community. It was important to convey that the community believed it can help the Trust make a difference.

Action: PW and PL to draft a script for Governors to use, explaining the aims and objectives of the engagement opportunities. 5.2 PW agreed to consult with the KCC service desk, to determine how their system worked, which

was said to be exemplary. Action: PW to consult with the KCC Service desk, on how their system worked. 5.3 LG agreed to consult with Healthwatch Kent to determine whether they were running any

consultation events that the Governors could take part in. Action: LG to consult with Healthwatch Kent to determine whether they were running any consultation events that the Governors could take part in. 5.4 It was suggested that the Governors consulted with Governors at other Foundation Trusts to

determine how they engaged with the community.

5.5 SW agreed to approach Medway Youth Parliament to determine whether they or one of their sub-committees would be interested in engaging with the Governors. SW would also write to the local MPs to explain the Governors’ intentions.

Action: SW to approach MYP to determine if they would be interested in engaging with Governors and write to the local MPs explaining the Governors’ intentions.

6. ITEMS FOR NEXT AGENDA 6.1 The following items were agreed for the next meeting, which would be a meeting of the task

group:

Governors’ script

First engagement sessions

7. ANY ITEMS TO BE DRAWN TO THE ATTENTION OF THE COUNCIL OF GOVERNORS 7.1 The Governors will receive the minutes of the meeting. 8. ANY OTHER BUSINESS 8.1 No other business was discussed.

9. DATE OF THE NEXT MEETINGS: 9.1 The Group noted the schedule of meetings for 2016:

Thursday 21 April 2016, 4.30pm-6.30pm Boardroom

Wednesday 20 July 2016, 4.30pm-6.30pm Boardroom

Wednesday 19 October 2016, 4.30pm-6.30pm Boardroom

9.2 A task group meeting would take place on 26 January 2016 at 4.30pm.


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NOTES OF THE COMMUNITY AND PATIENT ENGAGEMENT GROUP’S TASK GROUP MEETING MEDWAY NHS FOUNDATION TRUST

Tuesday 26 January 2016, Boardroom, Postgraduate Centre, Medway Maritime Hospital

Present: Stella Dick (SD) Public Governor, Medway & Lead Governor Glyn Allen (GA) Public Governor, Medway Ann Bushnell (AB) Staff Governor Lyn Gallimore (LG) Public Governor, Swale Paul Walker (PW) Public Governor, Medway Alan West (AW) Public Governor, Medway

In attendance: Paul Lehmann (PL) Director of Communications Martine Saker (MS) Governor & Membership Lead / Note Taker Don Lawrence (DL) Medway NHS FT Volunteer

10. CHAIRMAN’S WELCOME:

2.1 SD welcomed everyone to the meeting.

11. DISCUSSION ON COMMUNITY ENGAGEMENT 9.1 AB outlined the staff governors’ plans for engaging with staff:

Engagement piece around bullying and harassment based on the outcome of the staff survey

Engagement piece around the staff survey and to promote the new vision and values to be launched by the Trust

To run a stand in the staff canteen at lunch times to raise awareness amongst staff of who the staff governors are and to promote the role of the governor with a view to filling the staff governor vacancies

To organise an article in the News@Medway newspaper focussed at staff

To communicate with staff via the global email system

9.2 AW advised that a local Patient Participation Group had agreed that governors could attend one of their meetings and the Chair would be aiming to add governor engagement to their March agenda.

9.3 PL & PW had worked together to produce a draft script for the Group to review. One document tabled highlighted the Trust’s six public commitments and it was agreed that the document also needed to include a list of what had already improved.

9.4 PW tabled three further documents produced by KCC: customer service excellence; customer

service policy and a Q&A sheet for governor engagement.

9.5 It was agreed that Suzanne Brooker be invited to join the Engagement Group

9.6 It was agreed that a coffee afternoon be organised to take place in the staff restaurant in April, which could be advertised in the March News@Medway newspaper, the Trust’s website and social media. A second coffee afternoon to also be arranged to take place at Sittingbourne Memorial Hospital in April. Ideally the sessions should take place at the weekend.

Action: MS to arrange the two engagement sessions to take place in April on a weekend and liaise with PL to get the sessions advertised.

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9.7 It was suggested that “hello my name is..” badges be ordered for the Governors and for more business cards to be ordered.

Action: MS to arrange for “hello my name is..” badges to be ordered for Governors and for more business cards to be ordered. 9.8 It was agreed that the Governors would find a group to trial an engagement session and liaise

with MS and PL for their support planning the session. Action: Governors to find a group to trial an engagement session and liaise with MS and PL for support planning the session. The meeting closed at 18:30

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ANNEX O MINUTES OF THE MEMBERSHIP ENGAGEMENT GROUP

MEDWAY NHS FOUNDATION TRUST Thursday 10 December 2015, Boardroom, Postgraduate Centre, Medway Maritime Hospital

Present: Renee Coussens (RC) Chair / Public Governor, Medway Glyn Allen (GA) Public Governor, Medway Foundation Trust Ann Bushnell (AB) Staff Governor Alan West (AW) Public Governor, Medway

In attendance: Stella Dick (SD) Public Governor, Medway & Lead Governor Paul Lehmann (PL) Director of Communications Martine Saker (MS) Governor & Membership Lead / Note Taker Jan Stephens (JSt) Non-Executive Director Apologies: None


1.1 RC welcomed those present to the meeting and advised that Tim Cowell had decided not to join

the Membership Engagement Group.

2. MINUTES OF THE MEETINGS HELD ON 7 SEPTEMBER 2015, 21 SEPTEMBER 2015 AND 9 NOVEMBER 2015: Annexes A, B, and C

2.1 The minutes of the meetings held on 7 September 2015 and 21 September 2015 were agreed

as true and accurate records.

2.2 The minutes of the meeting held on 9 November 2015 were approved as a true and accurate record, subject to the following amendment:

Paragraph 2.11 – add ‘Working Group Leads after ‘Governors’.

3. MATTERS ARISING REPORT: Annex D

3.1 The matters arising report was noted and the following updates were provided:

With reference to action 2.3 from the meeting held in March 2014, PL advised that this would be taken forward in the New Year.

With reference to action 2.4 from the meeting held on 18 March 2015, MS explained that she had not yet made any progress on this and aimed to take this forward in the New Year.

With reference to action 5.1 from the meeting held on 7 September 2015, it was noted that the communications team would now be providing any press releases to MS for her to forward on to all Governors. The action could now be closed.

With reference to action 2.3 from the meeting held on 21 September 2015, it was noted that this was still being investigated. RC suggested the newspaper be distributed to Will Adams health centre and other community health centres and PL agreed to follow this up.

With reference to action 2.8 from the meeting held on 21 September 2015, PL advised that due to the current financial situation he was not sure it would be suitable to continue buying space in the council’s Medway Matters magazine, particularly as the Trust now produced its own monthly newspaper. The action could now be closed.

It was agreed that action 2.10 from the meeting held on 21 September 2015 could be closed.

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4. MEDIA UPDATE: Annex E 4.1 PL presented his media update and provided an update on activity undertaken since the report

had been written:

The Chief Executive had attended a one hour phone-in session on BBC Radio Kent and given a television interview on the same day. That day Medway NHS FT was covered in the main news all day.

The media had attended the opening of the new Emergency Department, which was also covered in the news.

Local MP Kelly Tolhurst visited the new Emergency Department.

A new Nursing Mothers bay opened 10 December which provided a special area for mothers wishing to breastfeed their babies.

Work continued to build stakeholder relations.

The Chief Executive held a lunch with staff.

Executives had held question and answer sessions around the hospital with staff. 4.2 During the following discussion the following points were raised:

RC suggested that a representative from the Communications Team attended future governor and member meetings held in public.

Lunchtime news that day had reported on Trusts missing the Emergency Department four-hour wait target, although Medway NHS FT had not been specifically mentioned. It was mentioned that the three Trusts in special measures were not the worst performing for this target. PL advised that the Trust had not received any media enquiries following that news coverage.

PL provided assurance that the communications team did have regular contact with the local MPs via their offices.

In response to a query as to how the Trust knew what level of social media activity there had been PL advised that there were analysis tools that showed how many ‘hits’ a tweet or a Facebook status received.

5. MEMBERSHIP NEWSLETTER: Annex F 5.1 MS presented her report which outlined her views on how to communicate with members going

forward.

5.2 During the subsequent conversation the Working Group agreed that the monthly newspaper provided a better view of the activity within the hospital than the four-page quarterly newsletter produced for members. The Working Group supported option 2, where a letter, signed by the Chairman together with the latest edition of the newspaper be sent to all members preferring communications by post, encouraging them to register an email address with the membership office in order to receive the monthly newspaper electronically. In addition to this, all new members would be sent the latest copy of the newsletter with the same request for an email address. Both letters would also include information on where the member would be able to pick up a copy of the latest newsletter when they are in the hospital. The aim was to have a final decision on the way forward by the end of January 2016.

5.3 PL advised that a letter would be sent to all members advising them of the CQC August

inspection report as soon as the report was available.

6. MEMBERSHIP UPDATE: Annex G 6.1 MS presented her report and advised that since the report had been written, another 15

members had been added via the Trust’s website. The Working Group noted the membership update.

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7. MEMBER EVENT PLANNING FOR 2016: Annex H 7.1 MS presented her report and advised that she had not yet made any progress with finalising

dates for these events. It was noted that the letter to be sent to members about the CQC report will also include the date for the briefing session for members.

7.2 During the subsequent discussion it was suggested that other positive paediatric stories be included with the paediatric emergency department services event. It was also suggested that this event be promoted externally to mother and children groups.

7.3 MS explained that the aim would be to advertise all events via the local media and social media.

7.4 RC advised that she would like to set up a coffee morning for members to come and meet

Governors in a suitable location and for a ‘meet your Governors’ stand in the main entrance foyer. MS suggested RC and SD talk with fellow Governors to agree some dates for when they would like this to take place and MS would then arrange to book the spaces and get the sessions advertised.

Action: RC and SD to agree some dates for governor/member coffee mornings and ‘meet your Governors’ sessions for MS to then book relevant spaces and advertise the sessions. 8. UPDATE ON GOVERNOR TRAINING: 8.1 MS advised that she and the Director of Corporate Governance, Risk, Compliance and Legal

would be taking this forward but no dates had been set yet for any training. 9. ANNUAL WORK PLAN AND ITEMS FOR NEXT AGENDA: Annex G 9.1 The annual work plan was noted. MS advised that the months on the plan were incorrect and

these should read February, May, August and November. 10. ANY OTHER BUSINESS 10.1 The Membership Engagement Group raised concern regarding the additional workload of

administering the Trust Board meetings allocated to MS which was preventing her from being able to complete her governor and membership lead duties. The Group also registered their frustration that the dates for the 2016 member events and governor training had not yet been set.

11. ITEMS TO BE DRAWN TO THE ATTENTION OF THE COUNCIL OF GOVERNORS: 11.1 The Council of Governors would receive the draft minutes of the meeting.

12. DATE OF THE NEXT MEETINGS: 12.1 The Membership Engagement Group noted the schedule of meetings for 2016:

Monday 29 February 2016, 4pm-6pm Boardroom

Wednesday 11 May 2016, 4pm-6pm Boardroom

Monday 15 August 2016, 4pm-6pm Boardroom

Wednesday 9 November 2016, 4pm-6pm Boardroom


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Annex A

MINUTES OF THE MEMBERSHIP ENGAGEMENT GROUP MEDWAY NHS FOUNDATION TRUST

Monday 29 February 2016, Boardroom, Postgraduate Centre, Medway Maritime Hospital

Present: Renee Coussens (RC) Chair / Public Governor, Medway Glyn Allen (GA) Public Governor, Medway Foundation Trust Ann Bushnell (AB) Staff Governor

In attendance: Stella Dick (SD) Public Governor, Medway & Lead Governor Paul Lehmann (PL) Director of Communications David Rice (DR) Company Secretary Martine Saker (MS) Governor & Membership Lead / Note Taker Jan Stephens (JSt) Non-Executive Director Shena Winning (SW) Trust Chairman Apologies: Alan West (AW) Public Governor, Medway


13.1 RC welcomed those present to the meeting.

13.2 Apologies were noted, as detailed above.

14. MINUTES OF THE MEETING HELD ON 10 DECEMBER 2015: Annex A 4.1 The minutes of the meeting held on 10 December 2015 were agreed as a true and accurate

record. 15. MATTERS ARISING REPORT: Annex B

5.1 The matters arising report was noted and the following updates were provided:

RC asked for the status column to state whether each action was open or closed and not to use the word ‘pending.

With reference to action 2.3 from the meeting held in March 2014, PL advised that most photos had now been taken and arrangements were being made to put photos up in the main entrance foyer in the next 2 or 3 weeks of the Trust Board and the Council of Governors. The communications team would liaise with MS to aim to arrange for photographs to be taken of the last remaining Governors.

With reference to action 2.4 from the meeting held on 18 March 2015, MS explained that she had not yet made any progress on this due to other work pressures. Now that the new Company Secretary was in post, she hoped to make some headway with this soon. SW suggested that a membership talk also be given to teachers and to run a members’ event specifically targeting the younger members.

With reference to action 2.3 from the meeting held on 21 September 2015, it was noted that Medway Council had now agreed to allow the News@Medway to be available at their hubs but talks still needed to take place with Swale Council and Medical Centres

Action 2.6 from the meeting held on 21 September 2015 would be discussed later on the agenda. The action could now be closed.

Action 7.4 from the meeting held on 10 December 2015 could be closed as dates for the first coffee mornings had been organised for 17 April at Medway Hospital and 23 April at Sittingbourne Memorial Hospital. Posters would be displayed in each hospital advertising the coffee mornings. SW requested that a third coffee morning be organised to take place

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in Sheerness. Communications Team to advertise coffee mornings via local media and social media.

Actions: MS to arrange a third coffee morning to take place in Sheerness. Communications Team to advertise coffee mornings via local media and via social media. 5.2 During the conversation around engaging with young members SD explained that three young

members from Chatham Grammar School were keen to get involved but were unable to volunteer as they are under the age of 18. They would like the opportunity of work experience but SD was having trouble getting a response from the HR team. DR agreed to follow this up with the Director of Workforce.

Action: DR to follow up with the Director of Workforce any opportunities for young people to undertake work experience at the hospital. 16. MEDIA UPDATE: Annex C 16.1 PL presented his media update and provided an update on activity undertaken since the report

had been written:

The BBC and ITV had covered overseas nursing recruitment.

BBC and ITV to run a feature on women and children’s services.

The Emergency Department triage system had started and a new waiting area for majors’ patients had opened.

A media plan had been developed between now and the CQC visit scheduled to take place in March.

Radio Kent had interviewed the Director of Nursing that morning. 16.2 The Membership Engagement Group were encouraged by the proactive work being undertaken

by the Communications Team and welcomed the news that the Trust Chairman would start sending out a monthly briefing to Governors and Members after each Board meeting.

17. MEMBERSHIP COMMUNICATION: Annex D 17.1 MS presented her report and explained that the last four-page membership newsletter had been

produced in the summer of 2015. It was noted that the monthly News@Medway now contained a members’ corner, which could be expanded to include more member-specific content. Those pages would also include the dates of any meetings the public may observe, medicine for members’ events and the coffee morning. The recommendation was to write to all members, giving them a copy of the latest News@Medway, encouraging members to share their email address with the Trust to receive future editions as well as providing information on the location of where members can pick up a physical copy of the newspaper. It was noted that the cost to do this would be around £2,500 including postage costs. Going forward, all new members would receive a copy of the newspaper in their welcome pack, encouraging them to register an email address.

17.2 During the subsequent discussion it was noted that a letter had been sent to all members at the beginning of the year announcing the release of the CQC report. The letter invited members to attend a briefing hosted by the Trust Chairman and the Chief Executive as well as requested that members provided their email addresses in order to receive future copies of News@Medway. The event had been very well attended by around 60 people. The request for email addresses prompted an increase of approximately 170 members happy to receive e-communications. However this still meant that the majority of members (8,500) had not provided an email address.

17.3 Following a thorough discussion, the Membership Engagement Group approved the

recommendation to send a physical copy of News@Medway to all members without email addresses with the request to provide an email address. The letter would be drafted by MS and

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PL, to be approved by SW before distribution. It was agreed that people who prefer to receive physical copies of the newspaper will be asked to write to the membership office informing them of their preference.

Action: MS and PL to draft a letter to members currently receiving postal communication from the Trust. Letter to include the latest edition of News@Medway with the request to contact the membership office with their email address/preference for physical copies. 18. ANNUAL REVIEW OF MEMBERSHIP STRATEGY: Annex E 18.1 MS presented her report and the slightly revised membership strategy for 2016/17. It was

noted that membership numbers would be updated to reflect the numbers as at 1 April, as soon as they were available.

18.2 Following a detailed discussion the Membership Engagement Group agreed that, if estimated Medway and Swale population figures were available for 2016/17 that these be updated in the Membership Strategy. It was noted that the membership targets were based on the population breakdowns from the 2011 census data and it was agreed that if estimated breakdowns be available that the Membership Strategy be updated to reflect the new targets based on estimated information.

18.3 It was also agreed that the main strategy should state that the Trust would continue to grow and

increase the diversity of its membership.

Action: MS to update the Membership Strategy with updated strategy statement, estimated population numbers and estimated percentage breakdowns (which translate into membership targets).

18.4 SW explained that all three Universities based in Medway were keen to have a seat on the

Council of Governors and welcomed the opportunity to bring all three of them onto the Council. It was noted that as only one official partner governor seat was available to universities, it would be arranged that they would only have one vote between them in relation to any Council of Governors’ business.

SW left the meeting 18.5 During the discussion the following amendments were also identified:

Page 2, paragraph 2 – ensure the sentence reflects Medway and Swale.

Page 7, item 4 – information regarding the members’ newsletter to be updated to reflect the new arrangements regarding News@Medway discussed earlier in the meeting.

Page 8 – only show the portion of the budget available specifically for membership engagement/strategy.

Appendix A – update information regarding the distribution of the newsletter; reflect the inclusion of a members’ section within News@Medway; add the Chairman’s new monthly e-briefing.

AB and PL left the meeting 19. REVIEW OF GOVERNOR INDUCTION PROCESS: Annex F 19.1 MS presented her report and advised that she had not received any feedback from Governors

who had experienced the induction session the previous year. She also explained that she would liaise with the SW and DR regarding the format and content for the 2016 governor induction.

19.2 During the subsequent conversation:

SD requested that information on understanding the different nursing uniforms would be useful.

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RC requested more governor involvement in both deciding the content of the induction and the actual induction session. She explained that in the past, a task group comprising a new governor, one governor who had served 2-3 years and one long serving governor to review the proposed content of the induction session and make suggestions for changes.

MS would send a list of induction topics from previous years to all governors, requesting feedback regarding other topics to include.

Actions: MS to liaise with DR and SW regarding new governor induction content, taking into consideration the requests detailed under paragraph 7.2 and share a list of induction topics from previous years to all governors for feedback on other topics to include.

19.3 JSt queried whether the national vote in June regarding the EU Referendum would affect the

governor elections timetable. MS agreed to follow this up and amend the timetable if required. Action: MS to determine whether the national vote in June regarding the EU Referendum will impact on the governor elections timetable. 20. ANNUAL WORK PLAN AND ITEMS FOR NEXT AGENDA: Annex G 20.1 The annual work plan was noted and the Membership Engagement Group agreed the agenda

item entitled Membership Communications should include information on topics to be covered in future editions of News@Medway and in particular suggestions regarding what to cover in the members’ corner.

Action: PL to provide an update under the Membership Communications Agenda item on what topics would be covered in the future editions of News@Medway, in particular suggestions regarding what to cover in the members’ corner. 21. ANY OTHER BUSINESS 21.1 No other business was discussed.

22. ITEMS TO BE DRAWN TO THE ATTENTION OF THE COUNCIL OF GOVERNORS: 22.1 The Council of Governors would receive

draft minutes of the meeting

update regarding changes to membership communication,

update regarding governor training and member events

Revised Membership Strategy

Revised Terms of Reference (as agreed at the September Group meeting)

23. DATE OF THE NEXT MEETINGS: 23.1 The Membership Engagement Group noted the schedule of meetings for 2016:

Wednesday 11 May 2016, 4pm-6pm Boardroom

Monday 15 August 2016, 4pm-6pm Boardroom

Wednesday 9 November 2016, 4pm-6pm Boardroom


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ANNEX PQ

MINUTES OF THE GOVERNORS’ STEERING GROUP MEETING MEDWAY NHS FOUNDATION TRUST

Tuesday 22 March 2016, 9.30am, Common Room, Postgraduate Centre, Medway Maritime Hospital

Present: Stella Dick (SD) Lead Governor / Chair Renee Coussens (RC) Membership Engagement Group Lead Doreen King (DK) Governor Representative at Board Meetings In attendance: David Rice (DR) Company Secretary Martine Saker (MS) Governor & Membership Lead / Note Taker Shena Winning (SW) Chairman Apologies: Vivien Bouttell (VB) Quality Working Group Lead

Richard Tripp (RFT) Finance and Performance Working Group Lead

1. WELCOME AND APOLOGIES FOR ABSENCE:

1.1 SW welcomed everyone to the meeting and apologies were noted as listed above. 2. MINUTES OF THE MEETING HELD ON 16 NOVEMBER 2015 AND NOTES OF THE

MEETING HELD ON 23 FEBRUARY 2016:

2.1 The minutes of the meeting held on 16 November 2015 were agreed as a true and accurate record.

2.2 The notes of the previous meeting held on 23 January 2016 were agreed as a true and accurate record, subject to paragraph 3.9 being amended to record that RC and SD did not agree that Governor Only meetings should be held.

3. MATTERS ARISING REPORT:

3.1 Regarding action number 4 from the meeting held in May 2015, it was noted that the Trust

would be reviewing how it asses risk in April 2016 and a presentation could be arrange for governors after that review had taken place.

3.2 Regarding action number 7.7 from the meeting held on 16 November 2015, the Lead Governor advised that the new Finance Director had agreed to provide a finance training session for governors in May 2016. SD would pass information to the Finance Director regarding what governors would like to see covered in that training session.

Actions:

Company Secretary to set a date for finance training to take place in May 2016.

Lead Governor to inform the Finance Director what governors want the session to cover.

3.3 Regarding action number 3.3 from the meeting held on 23 February 2016, the Governors Steering Group requested that the Non-Executive Directors be invited to new governor induction sessions to introduce themselves and explain what the role of a Non-Executive Director is. The Chairman advised that Andrew Corbett-Nolan from the Good Governance Institute would also be providing support for the new governor induction sessions and suggested the Lead Governor liaised with him directly.

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4. COUNCIL OF GOVERNORS’ AGENDA FOR THE MEETING ON 7 APRIL 2016:

4.1 The Chairman explained that a new report was being prepared for the Council of Governors’ meeting summarising the March Board meeting and would be presented by the Non-Executive Directors, with support from the executive team. She explained that it was the role of the Non-Executive Directors to provide assurance to the governors as to how they held the Executive Directors to account and how satisfied they were with the Board’s performance.

4.2 It was explained that each Non-Executive Director was paired with an Executive Director reviewing key workstreams and that the pairing would rotate on a regular basis.

4.3 The Governors’ Steering Group reviewed the draft agenda for the next Council of Governors’ meeting taking place on 7 April 2016 and agreed the following amendments:

Add two new agenda items to the private session: governor training and governor activity.

Items covering NED succession planning, remuneration, Committee Terms of Reference and Committee minutes should be combined into one agenda item headed ‘NED Nominations and Remuneration Committee Report’.

5. REVIEW OF WORKING GROUP MEMBERSHIP:

5.1 The Steering Group discussed Working Group membership and noted that there was little

change in membership over the years. The Steering Group agreed that membership of Working Groups should be rotated on a regular basis to allow progressive refreshment of Governors’ skills and knowledge which would be very beneficial to the work of the Council of Governors as a whole. Due to the statutory nature of the NED Nominations and Remuneration Committee, The Steering Group agreed that members should also be allocated membership of one of the four Working Groups. These recommendations would be presented during the private session of April Council of Governors’ meeting.

5.2 The Governors’ Steering Group also agreed that a discussion should take place during the private session of the April Council of Governors meeting to review the effectiveness of Governor Representation on Trust Groups. The Council of Governors needed to ensure that any Governor representation on Trust Groups would benefit the work of the Council of Governors as a whole.

5.3 The Chairman advised that the Trust would be reviewing the number of Groups in operation

with a view to reducing the quantity and introducing time limited task and finish groups as and when required.

6. DATES OF FUTURE MEETINGS:

6.1 The next Governors Steering Group meeting would take place on Tuesday 28 June 2016 at

2.30pm in the Boardroom. 7. ANY OTHER BUSINESS: 7.1 DK raised concern that there had been an increase in the number of patients suffering from

delirium due to dehydration on the orthopaedic wards. 7.2 DK explained that the call system on the dementia ward was extremely outdated and Staff were

suffering from hearing loss and agitation resulting from prolonged exposure to low level noise. DK suggested the Trust liaised with the local tech college to identify a better solution to the problems the patients and staff were encountering on that ward.


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Annex R MINUTES OF THE QUALITY WORKING GROUP OF THE MEDWAY NHS FOUNDATION

TRUST COUNCIL OF GOVERNORS

1 December 2015, 4.30pm, Boardroom Post Graduate Centre

Present: Vivien Bouttell (VB) Chair/Public Governor, Medway Glyn Allen (GA) Public Governor, Medway Foundation Trust Chris Harvey (CH) Partner Governor, Charities Paul Walker (PW) Public Governor, Medway Foundation Trust Alan West (AW) Public Governor, Medway Apologies: Renee Coussens Public Governor, Medway Anil Madhavan Staff Governor, Medical and Dental In attendance: Ewan Carmichael (EC) Non-Executive Director/ Chair of Quality Assurance Committee Martine Saker (MS) Governor & Membership Lead and Minute Taker Items were taken out of order but the minutes correspond to the agenda order. 1. ANNUAL ELECTION OF THE WORKING GROUP LEAD: 1.1 VB expressed an interest in continuing as the Working Group Lead. There were no

other nominations. VB was unanimously elected to continue as the Working Group Lead.

2. WELCOME AND APOLOGIES FOR ABSENCE: 2.1 VB welcomed those present to the meeting.

2.2 Absences were noted as detailed above. 3. MINUTES OF THE MEETING HELD ON 3 JUNE 2015 AND MATTERS ARISING

REPORT Annexes A & B

3.1 The minutes of the meeting held on 3 June 2015 were agreed as a true and accurate record.

3.2 The matters arising report was noted.

4. SCRUTINY OF THE QUALITY ASSURANCE COMMITTEE: Annex C 4.1 The Quality Working Group noted the Quality Assurance Committee Chair’s report that

was presented to the November Trust Board meeting. 4.2 EC stated that he did not yet fully understand his relationship with the Quality Working

Group and MS agreed to forward him the Group’s Terms of Reference. Action: MS to forward the Quality Working Group’s terms of reference to EC.

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4.3 EC explained that formation of the Quality Improvement and Compliance Group(QICG) (which looked at latest statistics and trends, addressing any concerns) allowed the Quality Assurance Committee (QAC) to focus on assurance and undertake deep dives into various activities. He listed the proposed schedule of deep dive topics for the first six months of 2016, with two topics per month:

January – deteriorating patient/stroke

February – patient experience/quality gap

March – End of Life Care/capacity and demand

April – Antibiotic stewardship/perinatal mortality

May – violence prevention/update on patient services

June – quality of estates/medicines management

4.4 The Working Group noted that further topics were likely to be added following the imminent publication of the CQC report on the August inspection.

4.5 EC advised that the Quality Assurance Committee received a detailed report on the Critical Care Department, based on Intensive Care National Audit and Research Centre data and referred to his Committee report which highlighted the key points.

4.6 EC explained that a new Medical Pathway was being developed with support from the buddying trust, Guys & St Thomas’ Hospitals NHS FT, which would include weekend and bank holiday cover and should help to unclog the hospital.

4.7 EC reported that the Committee was keen to have a patient representative and the request had been passed to the executives who would determine who could be put forward. EC noted a recommendation from PW that his wife would be interested in being the patient representative role as she had regular attendance at the hospital and is a social worker.

4.8 VB explained that she attended the QAC meetings and AW attended the QICG meetings.

4.9 In response to a question as to why both the QICG and the Board reviewed the integrated quality and performance report it was explained that QICG provided the executive oversight whilst the Board had a high level overview.

4.10 In response to a question as to how the Governors could support the Quality Assurance Committee, EC advised that the regular report to the Quality Working Group was a useful took tool for him to receive feedback from Governors and he also welcomed other members of the Group to attend the Quality Assurance Committee meetings. Although it was noted that Governor attendance would be limited each month to one or two representatives. EC also encouraged Governors to suggest topics for the Quality Assurance Committee deep dive topics.

4.11 In response to concern raised around the poor quality of the estate, EC explained that he and the Director of Nursing would be aiming to carry out a walkabout of the Trust and he would be happy for governors to join them. He would provide some dates as soon as they are available.

Action: EC to provide dates of planned estate walkabouts in order for MS to send an invitation to Governors to attend.

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4.12 AW explained about the previous walkabouts that took place, advising that there was still a list of outstanding estates work that had not been dealt with. MS reminded AW that the Chief Executive had asked for him to forward the list to her.

Action: AW to forward his list of outstanding estates work to the Chief Executive. 5. UPDATE FROM GOVERNORS ON ACTIVITIES SINCE THE LAST QUALITY

WORKING GROUP MEETING: Annex E

5.1 Patient Experience Group Aw tabled his observations from the last two patient experience group meetings held on 8 September 2015 and 29 October 2015, adding that he could not attend the October meeting therefore his observations were based on the reports distributed ahead of that meeting.

5.2 During the Working Group’s subsequent discussion, concern was raised that volunteers did not have access to the ‘call a porter’ facility on the Trust’s intranet site querying what actions were being taken and whether the executive team were aware of the issue. EC agreed to follow this up.

Action: EC to bring to the executives’ attention the issue with volunteers not being able to use the ‘call a porter’ facility on the Trust’s intranet site. 5.3 AW advised that the elderly care wards would be returning to paper based

questionnaires for the patient surveys in an attempt to improve the response rates.

5.4 AW explained that the dementia score within the PLACE assessments may be inaccurate as it appeared that not all assessors were clear on what was required to make an environment dementia friendly. He gave an example of shiny floors where some dementia patients would see this as water and be scared to walk on it. He advised that there would be a significant cost involved to make the hospital 100% dementia friendly.

5.5 Patient Safety Group AW reported that the last meeting had taken place on 5 November and he tabled a document containing a summary of his observations.

5.6 He highlighted in particular that some handovers within the last few months had resulted in a patient safety issues and it was concluded that handover did not appear on the risk register.

5.7 EC advised that nutrition would be a topic for a future deep dive to be undertaken by the Quality Assurance Committee.

5.8 A discussion followed regarding nursing staff and MS advised that the first cohort of foreign nurses would be joining the Trust in January 2016 and the Director of Workforce had assured the Board that a programme was in place to assist the new staff during the first year. In response to concerns regarding any language barriers, it was explained that a language skills test was part of the recruitment process.

5.9 The Working Group noted VB’s updates distributed with the agenda ahead of the

meeting and during a short discussion the following points were made:

DRAFT

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CH pointed out that the sign above the Stroke Unit had been miss-spelt. VB would take this forward.

VB explained that the moving forward the Trust would be reviewing appointment letters alongside signage to ensure any information was consistent throughout the Trust. Therefore signage had moved out of the estates remit and would fall under communications remit. The director of estates and facilities would be handing the work over to the new Director of Communications.

6. GOVERNORS’ LOG: Annex F 6.1 The log of operational issues was noted and VB advised that reference GL15/15 and

GL/16/15 had arisen from a Quality Assurance Committee meeting.

6.2 With reference to log number GL/25/15, DK advised that she had raised this at the last Board meeting and it was suggested the concern also be raised at the next Council of Governors’ meeting taking place on 7 December 2015.

6.3 It was suggested that going forward, the name of the person providing the response be included on the log.

Action: MS to ensure the name of the person responding to queries raised via the Governors’ Log is included in the response column. 7. ANY OTHER BUSINESS: 7.1 AW raised concern regarding end of life care and the issues with staff continuity

effecting the continuity of care. Issue also with moving patients from the hospital to residential care or nursing homes as the electronic discharge note did not include end of life care or do not resuscitate information. This was also missing from the information provided to the GPs.

8. FEEDBACK TO THE COUNCIL OF GOVERNORS’ MEETING 8.1 The Council of Governors would receive a verbal update from VB at the meeting on 7

December 2015. The minutes would be provided at a future Council of Governors’ meeting.

9. ANNUAL WORK PLAN FOR 2015/16: 9.1 The Working Group NOTED the annual work plan for 2016/17. 10. DATES OF FUTURE MEETINGS: 10.1 The Working Group noted the proposed schedule for 2016 meetings and VB advised

that she would prefer meetings not to be held on Tuesdays. MS to review the dates as the list did not include the day of the week and rearrange if necessary.

[Post meeting note: all the proposed dates are a Tuesday. All dates therefore to be rearranged. Revised schedule to follow in due course.] The meeting closed at 18:25

Documents

AGENDA COUNCIL OF GOVERNORS Date: 7 April 2016...PRIVATE MEETING OF THE COUNCIL OF GOVERNORS THURSDAY 7 APRIL 2016 18:35-19:05, COMMON ROOM, POSTGRADUATE CENTRE PRELIMINARY MATTERS