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Gallows traction - patient information

Description: Gallows traction Information for patients, parents and guardians We’ve given you this factsheet because your child is due
Url: /Media/UHS-website-2019/Patientinformation/Childhealth/Gallows-traction-2163-PIL.pdf

Papers Sept 2020 held in closed session due to Covid-19

Description: Date Time Location Chair Agenda - Trust Board Meeting 29/09/2020 9:00 - 16:00 Microsoft Teams Peter Hollins 1 Chair
Url: /Media/UHS-website-2019/Docs/About-the-Trust/Trust-governance-and-corporate-docs/2020/papers-sept-2020-held-in-closed-session-due-to-covid-19.pdf

Robotic gynaecological surgery - patient information

Description: information about robotic gynaecological surgery to the female pelvic region: the uterus, ovaries, cervix, fallopian tubes, vagina and vulva.
Url: /Media/UHS-website-2019/Patientinformation/Womenshealth/Robotic-gynaecological-surgery-3779-PIL.pdf

Robotic upper gastrointestinal (UGI) surgery - patient information

Description: This factsheet explains what robotic surgery is, what it involves, and what the possible advantages and risks are.
Url: /Media/UHS-website-2019/Patientinformation/Surgery/Robotic-upper-gastrointestinal-UGI-surgery-3512-PIL.pdf

Robotic colorectal surgery - patient information

Description: This factsheet explains what robotic colorectal surgery is, what it involves, and what the possible advantages and risks are.
Url: /Media/UHS-website-2019/Patientinformation/Surgery/Robotic-colorectal-surgery-3279-PIL.pdf

Robotic HPB surgery - patient information

Description: This factsheet explains what robotic HPB surgery is, what it involves, and what the potential advantages and risks are.
Url: /Media/UHS-website-2019/Patientinformation/Surgery/Robotic-HPB-surgery-3027-PIL.pdf

Septic arthritis - patient information

Description: Your child has recently been diagnosed with septic arthritis and you have been given this factsheet to explain the condition and its treatment.
Url: /Media/UHS-website-2019/Patientinformation/Childhealth/Septicarthritis-1213-PIL.pdf

Distinguishing mental disorder from mental incapacity: a brief guide

Description: Distinguishing mental disorder from mental incapacity poses a problem for clinicians.
Url: /HealthProfessionals/Clinical-law-updates/Distinguishing-mental-disorder-from-mental-incapacity.aspx

Papers Trust Board 27 May 2021

Description: Date Time Location Chair Agenda Trust Board – Open Session 27/05/2021 9:00 - 13:00 Microsoft Teams Peter Hollins 1 Chair’s Welcome, Apologies and Declarations of Interest 9:00 To note apologies for absence, and to hear any declarations of interest relating to any item on the Agenda. 2 Staff Story The patient or staff story provides an opportunity for the Board to reflect on the experiences of patients and staff within the Trust and understand what the Trust could do better. 3 Minutes of Previous Meeting held on 30 March 2021 9:15 4 Matters Arising and Summary of Agreed Actions To discuss any matters arising from the minutes, and to agree on the status of any actions assigned at the previous meeting. 5 QUALITY, PERFORMANCE and FINANCE Quality includes: clinical effectiveness, patient safety, and patient experience 5.1 Briefing from the Chair of the Charitable Funds Committee (Oral) 9:25 Dave Bennett, Chair 5.2 Briefing from the Chair of the Finance and Investment Committee (Oral) 9:30 Dave Bennett, Chair 5.3 Briefing from the Chair of the Quality Committee (Oral) 9:35 Tim Peachey, Chair 5.4 Chief Executive Officer's Update (Oral) 9:40 Sponsor: David French, Chief Executive Officer 5.5 Integrated Performance Report for Month 1 10:00 To review the Trust's performance as reported in the Integrated Performance Report Sponsor: David French, Chief Executive Officer 5.6 Equality and Diversity Update (WRES and WDES) 10:45 Sponsor: Steve Harris, Chief People Officer Attendee: Gemma Genco, Head of Equality, Diversity & Inclusivity 5.7 Gender Pay Gap Reporting 2020 11:05 Sponsor: Steve Harris, Chief People Officer Attendee: Kirsty Durrant, Strategic HR Projects Manager 5.8 Freedom to Speak Up Report 11:25 Sponsor: Gail Byrne, Chief Nursing Officer Attendee: Christine Mbabazi, Equality & Inclusion Adviser/Freedom to Speak Up Guardian 5.9 Finance Report for Month 1 11:45 Sponsor: Ian Howard, Interim Chief Financial Officer 6 STRATEGY and BUSINESS PLANNING 6.1 CRN: Wessex 2020/21 Annual Report and 2021/22 Annual Plan 11:55 Sponsor: Paul Grundy, Chief Medical Officer Attendees: Rebecca McKay, Chief Operating Officer, CRN: Wessex/Clare Rook, Deputy COO, CRN: Wessex 7 CORPORATE GOVERNANCE, RISK and INTERNAL CONTROL 7.1 Register of Seals and Chair's Actions 12:15 In compliance with the Trust Standing Orders, Standing Financial Instructions, and the Scheme of Reservation and Delegation. Sponsor: Peter Hollins, Trust Chair 7.2 Emergency Planning and Business Continuity Annual Report 2020/21 12:20 Sponsor: Joe Teape, Chief Operating Officer 7.3 Charitable Funds Committee Terms of Reference 12:30 Sponsor: Peter Hollins, Trust Chair Attendee: Karen Flaherty, Associate Director of Corporate Affairs and Company Secretary 7.4 Trust Executive Committee Terms of Reference 12:35 Sponsor: David French, Chief Executive Officer Attendee: Karen Flaherty, Associate Director of Corporate Affairs and Company Secretary 8 Any Other Business 12:40 To raise any relevant or urgent matters that are not on the agenda 9 To note the date of the next meeting: 29 July 2021 Page 2 10 Resolution regarding the Press, Public and Others Sponsor: Peter Hollins, Chair To agree, as permitted by the National Health Service Act 2006 (as amended), the Trust's Constitution and the Standing Orders of the Board of Directors, that representatives of the press, members of the public and others not invited to attend to the next part of the meeting be excluded due to the confidential nature of the business to be transacted. 11 Follow-up discussion with governors 12:45 Page 3 3 Minutes of Previous Meeting held on 30 March 2021 1 Minutes TB 30 March 2021 OS Minutes Trust Board – Open Session Date Time Location Chair Present 30/03/2021 9:00 - 12:05 Microsoft Teams Peter Hollins (PH) Dave Bennett (DB), Non-Executive Director (NED) Gail Byrne (GB), Chief Nursing Officer Cyrus Cooper (CC), NED Keith Evans (KE), NED David French (DAF), Interim Chief Executive Officer Paul Grundy (PG), Interim Chief Medical Officer Steve Harris (SH), Chief People Officer Jane Harwood (JH), NED (until item 5.10) Ian Howard (IH), Interim Chief Financial Officer Tim Peachey (TP), NED and Senior Independent Director/Deputy Chair Joe Teape (JT), Chief Operating Officer In attendance Brenda Carter (BC), Assistant Director of People (for item 5.8) Ellen Copson (EC), Associate Professor of Medical Oncology, University of Southampton and Honorary Medical Oncology Consultant (for item 2) Kirsty Durrant (KD), Strategic HR Projects Manager (for item 5.8) Karen Flaherty (KF), Associate Director or Corporate Affairs and Company Secretary Sarah Herbert (SHe), Divisional Head of Nursing and Professions, Division B (for item 5.9) Sandra Hodgkyns (SHo), Head of Emergency Planning Response and Resilience/Security (for item 5.9) Stephanie Ramsey (SR), Director of Quality and Integration (Chief Quality Officer and Chief Nurse), NHS Southampton City CCG (for item 5.6) 3 governors (observing) 3 members of the public (observing) 5 members of staff (observing) 1 member of the public (for item 2) 1 Chair’s Welcome, Apologies and Declarations of Interest The Chairman welcomed all those attending to the meeting. The following declaration of interests for GB were reported to the Board: • Chair of the Directors of Nursing Group, University Hospital Association; • Chair of the Wessex Patient Safety Collaborative; and • Member of the Policy Board, NHS Employers. The Board also noted that DB was no longer a director of Davox Consulting Limited. 2 Patient Story The patient story was told by the husband of a patient who sadly died in early 2020 following treatment for cancer at the Trust. As a result of the treatment she had received at the Trust following a diagnosis in April 2017, her life had been extended by over three years. In terms of areas for improvement, better communication of his wife’s initial diagnosis would have helped her and her family to come to terms with the diagnosis more quickly. Following their arrival at hospital, they were being asked lots of questions and his wife was being sent for tests and scans without being given information about what concerns the clinicians had or potential diagnoses. The diagnosis was also delivered on the ward just prior to a visit from a relative and with better planning this could have been done more sensitively by providing a better environment in which to have the conversation and more time for his wife to absorb the information. Once his wife met the specialist team, including the specialist nurse, she felt more reassured and was given hope by the availability of different treatment options. The Trust’s appointment of a dedicated specialist nurse for his wife’s particular cancer shortly after her diagnosis made a huge difference. The specialist nurse was always present when his wife met the consultants and would check if there was anything he or his wife needed and provided practical advice and support, which meant that he and his wife were able to spend more time together. GB reiterated the importance of specialist nurses across different patient pathways and the Trust continued to invest in more specialist nurses. While acknowledging that there was a shortage of private spaces to speak with patients and their families, through its End of Life Care Steering Group the Trust had identified a number of rooms across the hospitals to enable clinicians to go somewhere private in situations like these. The cancer service also continued to adapt to changes in cancer care and the needs of patients, with patients now living longer. Maggie’s Southampton had recently opened at the Southampton General Hospital site to provide help and support for those living with cancer, although the services it offered were currently reduced as a result of the Covid-19 pandemic. The Board expressed its gratitude for sharing the story with such strength and dignity. 3 Minutes of Previous Meeting held on 28 January 2021 The minutes of the meeting held on 28 January 2021 were approved as an accurate record of that meeting. 4 Matters Arising and Summary of Agreed Actions The updates on the actions were noted. The action relating to cancelled appointments in ophthalmology (reference 354) had been followed up and could be closed, as could the actions relating to patients medically optimised for discharge (reference 351 and 393) and the Ockenden report (reference 395), which were included as items on the agenda later in the meeting. The action relating to patient nutrition (reference 394) would be reviewed at the next meeting of the Quality Committee, which would then report to the Board. The Board agreed that the actions relating to specialty outcomes (reference 350 and reference 326) should be combined, with the paper due to be presented to the Board at its meeting in April 2021. Page 2 5 QUALITY, PERFORMANCE and FINANCE 5.1 Briefing from the Chair of the Audit and Risk Committee KE updated the Board on the meeting of the Audit and Risk Committee held on 15 March 2021: • the external audit work had commenced and there were no issues to report at this early stage; • the internal auditors had reviewed referral to treatment (RTT) data quality and while data inaccuracies had been identified in the sample testing, these had not impacted on patients clinical treatment or on Trust’s the overall performance against the RTT target, and in most instances had resulted in the Trust overreporting on pathways; and • updates had been provided on progress against the recommendations in the board governance review and the ongoing review of the data security and protection toolkit. 5.2 Briefing from the Chair of the Finance and Investment Committee DB provided an overview of the Finance and Investment Committee meeting the previous day, highlighting: • that funding for the loss of other income and additional accruals of annual leave that staff had been unable to take due to the Covid-19 pandemic had been received; • the update on the planning process for 2021/22 following the publication of new national guidance that sought to achieve a balance between restoring services and reducing backlogs while supporting staff recovery; • the review of the most recent operational productivity dashboard, from which it had been difficult to draw any meaningful conclusions given the impact of the Trust’s response to the most recent wave of the Covid-19 pandemic in the previous months; and • the business case for the expansion of the outpatients area in ophthalmology, which would be considered by the Board later in the meeting. 5.3 Briefing from the Chair of the Quality Committee TP provided an update on the meeting of the Quality Committee held on 15 March 2021 focusing on the following areas: • the increase in waiting times for diagnostics and plans to recover performance, with a review of patient harm to be completed once patients who had waited longer than six weeks had been seen; • the review of a ‘never event’ relating to a retained swab including the recommendations for a number of sensible actions that had already been implemented; • the latest update on experience of care including the Trust’s accreditation as a Veteran Aware NHS trust; • the recommendations for reporting on maternity safety following the Ockenden review of maternity services at Shrewsbury and Telford Hospital NHS Trust, which would be considered by the Board later in the meeting; • the urgent investigation of aspergillus infections in the intensive care unit to establish whether there was a link to an earlier leak in a pipe above the ceiling in that area; • the latest report on clinical outcomes, with the Board to receive a full Page 3 report at its meeting in April 2021; and • the review of the committee’s effectiveness. 5.4 Chief Executive Officer’s Update The Trust had taken part in the national day of reflection and one minute’s silence on 23 March 2021 to commemorate the anniversary of the first national lockdown due to the Covid-19 pandemic. This had given staff an opportunity to pause and reflect on the loss of life over the previous year, including patients and staff. There were currently 20 patients in the hospital who had tested positive for Covid-19, three of which were in intensive care. An average of three or four patients with Covid-19 were being admitted daily, which highlighted the importance of continuing to follow the rules as lockdown measures were eased. Staff were being encouraged to take annual leave and wellbeing conversations were taking place with every member of staff. Second doses of the Covid-19 vaccine were being administered to Trust staff and staff at health and social care partners. 92% of frontline staff and 90% of all staff had received at least one dose of the vaccine, including 88% of BAME (Black and Minority Ethnic) staff. Staff who had not yet received the vaccination were being contacted individually to understand the reasons for this and provide additional information where appropriate. As well as planning for the recovery of services in the short term, the Trust was carrying out long-term modelling of future demand and capacity supported by external consultants and architects, which would form the basis of the Trust’s estates masterplan for the main hospital site. In advance of this work, the corporate objectives for 2021/22 would be presented to the Board at its meeting in April 2021. The Trust had performed exceptionally well in its recent external accreditation of endoscopy by the Joint Advisory Group on GI Endoscopy (JAG), providing one of the best submissions reviewed by JAG. Each of the executive directors provided an update in turn, covering the following areas: • reopening of theatres in Southampton General and Princess Anne Hospitals, replacing the current additional capacity in the independent sector from 1 April 2021; • four ‘Always Improving’ quality improvement projects relating to the emergency department (ED), discharge of patients medically optimised for discharge (MOFD), theatres and outpatients; • the launch of the ‘Always Improving’ strategy with staff in June 2021; • the review of patients who had been waiting for surgery, in particular those in priority level 2 (surgery that can be deferred for up to four weeks); • modelling of the potential impact on the waiting list of GP referrals returning to more normal levels and patients potentially presenting with more advanced disease than if they had seen their GP earlier; • the business intelligence programme to improve prospective as well as retrospective reporting; • allowing time for teams to readjust to working together as part of the recovery process with additional support from the Trust for those teams experiencing challenges; • plans to safely reopen the hospitals to visitors, particularly while the Page 4 Trust continued to admit patients with Covid-19; • re-energising the COVID ZERO campaign to ensure that the infection control measures continued to be followed rigorously even as the number of cases reduced, with a nosocomial infection the previous week acting as a timely reminder of the risk; • the successful renegotiation of the limit on expenditure (CDEL) for 2020/21 through which the Trust had been able to access additional capital and the negotiation of the allocation of CDEL across the integrated care system (ICS) for 2021/22; and • the current projects in development including theatres, the private patient unit, ophthalmology and the pathology laboratory information system. The Board noted that that the Trust would need to establish how it would balance the needs of those patients who had been waiting longest for treatment with the clinical prioritisation process already in place as it planned for the recovery of activity. 5.5 Integrated Performance Report for Month 11 The integrated performance report (IPR) for month 11 was noted. During February 2021 the direct impact of Covid-19 infections upon the Trust continued to be significant. There were 263 patients in the hospital with Covid19 at the start of February and 129 at the end of the month. The number of patients in intensive care reduced from 67 at the beginning of the month to 39 by the end of February. This compared to the first wave of Covid-19 pandemic, when the number of patients with Covid-19 in the hospital peaked at 173 and 38 in intensive care. This also had an impact on elective activity within the Trust, which was 42% of the level in February 2020. The Board discussed the following areas: Responsive • while the Trust’s ED was performing well comparatively, it was not meeting the performance target on the length of time patients spent in ED, despite attendances at 71% of the normal level; • this was principally due to patients presenting with mental health conditions and surges of high acuity patients, however, new junior doctors had also joined ED in February who were not used to the level of attendances; • leadership in ED was central to managing the department in these situations particularly the effective operation of the consultant of the day model to ensure that decisions regarding patients were made in a timely manner; • performance in ED had improved overall as 87% of patients were currently seen within four hours with an average daily attendance of 345 patients compared to 78% of patients two years ago when the average daily attendance was 350 patients; • to continue to improve performance and the flow of patients through ED the Trust was ensuring that specialties adhered to the one hour standard for referrals; • infection control measures remained in place, including respiratory assessment and rapid testing in ED and the acute medical unit, although it was difficult to establish whether this had a material impact on performance as ED had performed consistently well during the Page 5 period of the pandemic; • activity in ED had increased in March 2021 as lockdown restrictions had eased; • while the number of non-face-to-face outpatient appointments had increased following the first wave of the pandemic, some of these had not been full appointments but rather an opportunity to check in with patients; • the use of non-face-to face outpatient appointments varied by condition and specialty and was more appropriate for some of these than others, however, the Trust was seeking to learn from those clinicians who had used these types of appointment successfully as part of its quality improvement work in outpatients; • feedback from patients non-face-to face appointments had been positive on the basis that their care was continuing, however, limited work had been done to assess effectiveness in terms of the experience and outcome of these appointments; and • although cancer performance measures remained stable, both the Trust and the Wessex Cancer Alliance had performed well comparatively and ranked as second highest performing in their respective peer groups. Safe • • the unusually high number of medication incidents reported with moderate or severe harm in February and the actions taken in response to these; and ensuring that staff continued to report incidents, particularly as they returned to their normal areas of work following the pandemic. Caring • the number of overnight ward moves for non-clinical reasons given that most patient moves during this period would be related to patients admitted with Covid-19; • the percentage of patients with a disability or additional needs reporting that those needs were met had reduced and there were resource challenges in this area currently with a vacancy in one of the two adult learning disabilities nursing roles, although the recruitment process was underway; and • increasing the number of vulnerable women on a continuity of carer pathway given the benefit to all these women in terms of the quality of oversight in maternity. ACTIONS: (1) GB would review the non-clinical reasons for overnight ward moves and provide an overview to the Quality Committee. (2) The Quality Committee would review the resourcing required to increase the percentage of vulnerable women on a continuity of carer pathway and update the Board. Well-led • the impact of research activity on outcomes, more detail of which would be provided in the report on clinical outcomes at the meeting of the Board in April 2021. The Board’s review of the IPR, led by TP, would report to the Board in May 2021 with a candidate IPR. Page 6 5.6 Inpatient Flow - Medically Optimised for Discharge Update SR joined the meeting for this item. The Board noted the current performance against the process improvement trajectories and key performance indicators agreed by the system, system plans in the light of current performance and the Trust’s internal work programme for MOFD. The Board was interested to learn what the Trust could be doing differently or better in order to help improve performance as a system. The work to date had made a significant impact as the system responded to discharge an increased number of patients with more complex needs such as stroke patients, patients with challenging behaviours, patients requiring more intensive therapy and homeless patients. There was a specific issue with discharging to care homes at weekends and providing the necessary clinical support to these care homes to enable discharge. The main areas of focus for the Trust were to speed up processes and ensure patients MOFD were ready to be discharged earlier in the day as this would make it easier for services in the community to respond. While there was a target to get to 40-60 patients MOFD in hospital, no specific timescales had been set. ACTION: JT agreed to include a trajectory for MOFD patients in the regular reports to the Finance and Investment Committee. Funding was also likely to be an issue in the future as additional national funding provided during the Covid-19 pandemic to support the discharge of patients would be withdrawn at the end of June 2021. The Board recognised that system partners were aligned in their aim to address the delays in discharging patients MOFD and prevent potential patient harm as a result. However, the Board suggested a more holistic view of the issue would be beneficial when reviewing future resourcing, taking into account the revenue and capital implications and the consequences in terms of hospital capacity and addressing the current backlog of patients waiting for treatment. This analysis may identify where investment was needed to support discharge, including additional capacity, albeit that the ambition remained ‘home first’ when discharging patients in order to assess ongoing needs more accurately and reduce dependency. The meeting was adjourned briefly to allow for a break. 5.7 Ockenden Review of Maternity Services The Board noted the update on progress on the emerging findings and recommendations of the independent review of maternity services at the Shrewsbury and Telford Hospital NHS Trust released on 10 December 2020. The Trust had rated its progress against two of the recommendations as red, with no actions currently in place, and nine of the recommendations as amber, where actions were still in progress. Completion of these recommendations was dependent the Trust’s submission to NHS Resolution’s maternity incentive scheme which would be made by mid-July 2021 and therefore other trusts would be in a similar position. The Trust had received feedback on the information submitted to NHS England and NHS Improvement, which had been positive overall. A template had been designed to report to the Board and the local maternity Page 7 service (LMS) on maternity safety, which would incorporate a summary of serious incidents (SIs) and moderate harm incidents. This report would be submitted to the Board maternity safety champions and LMS on a monthly basis. The Board maternity safety champions would also meet with complainants before the referral of a complaint to the Parliamentary and Health Service Ombudsman. It was proposed that reporting to the Board on maternity safety issues including SIs and moderate harm incidents, the perinatal mortality report tool, early notification scheme, red flag incidents, staff concerns and evidence of listening to families including complaints would take place quarterly following review of the information by the Quality Committee. The frequency of reporting to the Board was in line with the recommendations in the Ockenden review although not with the guidance issued subsequently. The Board was keen to ensure it maintained a good understanding of the culture and patient experience in the maternity service given the impact of each on the quality of the service. Proposals to regularly survey staff would be considered later in the meeting. In addition the Board requested that the regular patient story should include maternity at least once annually. ACTION: KF to arrange a patient story from a patient using the maternity service at least once annually. DECISION: The Board agreed: • to receive a quarterly report on maternity safety issues; and • that all SIs and moderate harm incidents would be provided to the Board maternity safety champions and LMS. 5.8 UHS Staff Survey Results 2020 Report BC and KD joined the meeting for this item. The results of the NHS staff survey 2020 were noted by the Board. The survey had been completed by staff between September and November 2020. Overall the Trust’s results were at or above the acute trust average in nine out of ten themes. 77% of staff would recommend the Trust as a place to work and 87% of staff agreed that care of patients was the top priority for the Trust. Performance on health and wellbeing had significantly increased compared to 2019. However, the survey had also identified some areas for improvement. The areas with statistically significant decreases in performance compared to the 2019 staff survey results were: • Equality, diversity and inclusion; • Immediate managers; • Violence; and • Team working. In response to a question from a NED, it was clarified that only a small number of incidents of violence against staff from managers and colleagues reflected in the staff survey results were reported leading to an investigation. The reporting through the Trust’s Freedom to Speak Up processes had identified incidents involving microaggressions rather than acts of violence. Work was also ongoing to improve leadership skills within the organisation, which would set out expectations regarding values and behaviours. Over 1,000 free text comments had been submitted from staff as part of the survey and a national analysis of themes was being prepared, which would Page 8 provide further insight into how staff were feeling following the first wave of the pandemic. The Board supported more regular surveying of staff, particularly around the areas of improvement identified, recognising that things had changed since the survey was carried out six months ago and would continue to change. 5.9 Plan to Address Violence and Aggression against Staff SHe and SHo joined the meeting for this item. The Board noted the update on the progress made since the previous update in September 2020. This included closer working with Hampshire Constabulary, proposed changes to security arrangements, staff training and staff support. These plans aimed to reduce incidents of violence and aggression against staff and provide support to staff in the management of violence and aggression and following any incidents. The Board recognised that violence and aggression against staff would never be eliminated entirely as the Trust provided care to individuals with mental health issues, brain injuries, dementia and who lacked capacity who may find it difficult to control their behaviour. It was important, however, that violent and aggressive behaviour was challenged consistently when appropriate. The Board supported the approach to exclude violent and aggressive individuals from the Trust when they repeatedly displayed unacceptable behaviour that it was not possible to manage through de-escalation, anticipatory care planning and the challenging behaviour protocol. While not formally approving the funding for the plans set out in the paper, the Board noted the importance of investment in this area in order to support staff. A further update on progress would be provided in December 2021. 5.10 Finance Report for Month 11 The finance report for month 11 was noted. The following areas were highlighted: • the Trust has received the payments for the loss of other income, additional accruals of annual leave that staff had been unable to take due to the Covid-19 pandemic and the elective incentive scheme; • the Trust remained on track to achieve a breakeven position for 2020/21 as did the other trusts in the Hampshire and Isle of Wight ICS; and • the Trust’s balance sheet position remained strong, which placed the Trust in a good position to address likely pressures in 2021/22. 6 CORPORATE GOVERNANCE, RISK and INTERNAL CONTROL 6.1 Register of Seals and Chair's Actions for ratification DECISION: The Board ratified the application of the Trust seal and the Chair’s actions set out in the report. ACTION: IH would follow up on the Wessex Clinical Research Network and the assisted conception service items in the paper as these were not single tender actions required to be reported in accordance with the Trust’s Standing Financial Instructions. 6.2 Amendment to Constitution for CCG Merger With effect from 1 April 2021, the individual Clinical Commissioning Groups Page 9 (CCGs) within Hampshire and the Isle of Wight were to merge to create a new NHS Hampshire, Southampton and Isle of Wight CCG. The Council of Governors (CoG) included an appointed governor from each of NHS Southampton City CCG and NHS West Hampshire CCG and as a result of the merger these two organisations would cease to exist. It was proposed that the Trust should reflect the merger in the composition of the CoG, by amending the composition of the CoG in Annex 3 of the Trust’s constitution to remove the Appointed Governor from each of NHS Southampton City CCG and NHS West Hampshire CCG and include an Appointed Governor from NHS Hampshire, Southampton and Isle of Wight CCG in their place. A separate review of the composition of the CoG would be undertaken as part of the annual review of the Trust’s constitution to ensure that the overall composition of the CoG remains representative and reflected the changes to NHS governance structures. DECISION: The Board approved the amendment to the Trust’s constitution with effect from 1 April 2021, subject to the approval of the CoG at its meeting on 31 March 2021. 7 Any Other Business There was no other business. 8 To note the date of the next meeting: 27 May 2021 9 Resolution regarding the Press, Public and Others DECISION: The Board resolved that, as permitted by the National Health Service Act 2006 (as amended), the Trust's Constitution and the Standing Orders for the Practice and Procedure of the Board of Directors, representatives of the press, members of the public and others not invited to attend to the next part of the meeting be excluded due to the confidential nature of the business to be transacted. The meeting was adjourned. Page 10 4 Matters Arising and Summary of Agreed Actions 1 List of Action Items List of action items Agenda item Assigned to Deadline Status Trust Board – Open Session 30/03/2021 5.5 Integrated Performance Report for Month 11 426. Caring - overnight ward moves Byrne, Gail Peachey, Tim 27/05/2021 Pending Explanation action item GB would review the non-clinical reasons for overnight ward moves and provide an overview to the Quality Committee. 427. Caring - vulnerable women Byrne, Gail Peachey, Tim 27/05/2021 Pending Explanation action item The Quality Committee would review the resourcing required to increase the percentage of vulnerable women on a continuity of carer pathway and update the Board. Trust Board – Open Session 30/03/2021 5.6 Inpatient Flow - Medically Optimised for Discharge Update 428. Trajectory for MOFD patients Teape, Joe 27/05/2021 Pending Explanation action item JT agreed to include a trajectory for MOFD patients in the regular reports to the Finance and Investment Committee. Trust Board – Open Session 30/03/2021 5.7 Ockenden Review of Maternity Services 429. Patient story Flaherty, Karen 31/03/2022 Pending Explanation action item KF to arrange a patient story from a patient using the maternity service at least once annually. Page 1 of 2 Agenda item Assigned to Deadline Status Trust Board – Open Session 30/03/2021 6.1 Register of Seals and Chair's Actions for ratification 430. Follow up Howard, Ian 27/05/2021 Pending Explanation action item IH would follow up on the Wessex Clinical Research Network and the assisted conception service items in the paper as these were not single tender actions required to be reported in accordance with the Trust’s Standing Financial Instructions. Page 2 of 2 Report to the Trust Board of Directors Title: Agenda item: Sponsor: Date: Purpose Issue to be addressed: Integrated Performance Report 2021/22 Month 1 5.5 David French, Chief Executive Officer 27 May 2021 Assurance Approval or reassurance Y Ratification Information This report is intended to support the Trust Board in assuring that: • the care we provide is safe, caring, effective, responsive and well led in the context of the COVID-19 pandemic • at the same time we continue our journey toward our vision of World Class Care for Everyone. Response to the issue: The Integrated Performance Report reflects the current operating environment and is aligned with the Care Quality Commission Key Lines of Enquiry. Implications: This report covers a broad range of trust services and activities. It is (Clinical, Organisational, intended to assist the Board in assuring that the Trust meets regulatory Governance, Legal?) requirements and corporate objectives. Risks: (Top 3) of carrying This report is provided for the purpose of assurance. out the change / or not: Summary: Conclusion This report is provided for the purpose of assurance. and/or recommendation Page 1 of 1 Integrated KPI Board Report covering up to April 2021 Sponsor - Andrew Asquith, Director of Planning, Performance and Productivity, andrew.asquith@uhs.nhs.uk Chart Type Cumulative Column Example Cumulative Column Year on Year Line Benchmarked Line & bar Benchmarked Control Chart 100% 0% 66.8% Variance from Target Report Guide Explanation A cumulative column chart is used to represent a total count of the variable and shows how the total count increases over time. This example shows quarterly updates. A cumulative year on year column chart is used to represent a total count of the variable throughout the year. The variable value is reset to zero at the start of the year because the target for the metric is yearly. The line benchmarked chart shows our performance compared to the average performance of a peer group. The number at the bottom of the chart shows where we are ranked in the group (1 would mean ranked 1st that month). 66.49% The line shows our performance and the bar underneath represents the range of performance of benchmarked trusts (bottom = lowest performance, top = highest performance) A control chart shows movement of a variable in relation to its control limits (the 3 lines = Upper control limit, Mean and Lower control limit). When the value shows special variation (not expected) then it is highlighted green (leading to a good outcome) or red (leading to a bad outcome). Values are considered to show special variation if they -Go outside control limits -Have 6 points in a row above or below the mean, -Trend for 6 points, -Have 2 out of 3 points past 2/3 of the control limit, -Show a significant movement (greater than the average moving range). Variance from target charts are used to show how far away a variable is from its target each month. Green bars represent the value the metric is achieving better than target and the red bars represent the distance a metric is away from achieving its target. 2 Report to Trust Board in May 2021 Introduction The Integrated Performance Report is presented to the Trust Board each month. The report aims to: • Provide assurance that the care we provide is safe, caring, effective, responsive and well led in the context of the COVID-19 pandemic • Ensure that at the same time we continue our journey toward our vision of World Class Care for Everyone. We adjust / add to these indicators – informing the Board and keeping a comparative narrative – as the situation changes as we work through these unusual circumstances. The structure of the report is currently being reviewed in order that it can better reflect the ambitions within ‘Our Strategy 2025’, and to support the strategic discussions of the Board. April 2021 Summary During April the direct impact of COVID-19 infections upon the Trust reduced further. Patients with a confirmed COVID-19 diagnosis during their admission: • Started the month at 48 (11 of which were in intensive care / high care) • Finished the month at 24 (5 of which were in intensive care / high care) The phased resumption of the elective admissions continued within NHS facilities, and the additional access to independent sector theatres and beds that had been secured by NHS England during the pandemic terminated at the end March. 3 Report to Trust Board in May 2021 Key aspects of performance for consideration this month include: • The total number of patients on the RTT waiting list increased by over 1,000 patients to 37,613 in April. There are over 3,000 patients waiting over 52 weeks for treatment and over 500 patients waiting over 78 weeks. Our benchmarking confirms that we are continuing to perform well in comparison to our peer group. • The crude mortality rate and Hospital Standardised Mortality Ratio (HSMR) both increased significantly in January (though HSMR remained significantly better than would be expected on average in the NHS). Patient details have been requested in order that the recorded diagnosis can be checked as a first step in investigation. It may be relevant that January saw a peak in COVID-19 occupancy. • UHS 62 day performance (RE 23) improved to 86.5% (better than our local target and the national target applying to the majority of 62 day pathways). UHS was the best performing trust amongst our 10 ‘peer’ teaching hospitals in March. 4 Report to Trust Board in May 2021 RESPONSIVE • Emergency Department timeliness deteriorated slightly to 87% (RE 9) whilst remaining 3rd best amongst 8 benchmark trusts. Attendance numbers increased further to the highest levels since the COVID-19 pandemic started (RE 8). • Elective spell volumes (excluding daycases, at SGH/PAH only) (RE 13) recovered further, yet remained below those in Autumn 2020. Two SGH theatres are currently closed due to building works and are due to reopen in June. • The total number of patients on the RTT waiting list increased by over 1,000 patients this month. The cohort of patients who have waited over 52 weeks (RE 16) reduced by over 300 patients, whilst those waiting over 78 weeks (RE 17) increased by over 100 patients. We remain concerned by this situation and are focussed on improving the situation as soon as possible for our patients. Our benchmarking (in a group of 20 Teaching hospitals) confirms that we are continuing to perform well in comparison to our peer group. • Cancer performance measures for March indicate continued improvement in performance: o UHS 62 day performance (RE 23) improved to 86.5% (better than our local target and the national target applying to the majority of 62 day pathways). UHS was the best performing trust amongst our 10 ‘peer’ teaching hospitals again this month. o 31 day performance (RE 24) was maintained above the target at 97.6%. 5 Report to Trust Board in May 2021 RESPONSIVE RE1 Non-elective Spells (discharged, including CDU) Non Elective LOS RE2-L Rolling 12 months (Solid) Monthly (Dashed) Number of inpatients that were RE3 medically optimised for discharge (monthly average) Monthly Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr target 6,800 6,292 4,000 7.5 6.0 4,128 6.49 - 5.45 - 4.5 250 76 0 122 - Longer LOS Census average RE4-N (Patients with LOS > =21days) 203.38 160.86 118.33 73 145 - RE5-l RE6 RE7 Adult midday bed occupancy Last minute cancelled operations not readmitted within 28 days Last minute cancelled operations 100% 98.2% 84.6% 71.1% 82.6% 40% 55 40 0 150 5 0 79.0% 90-95% - 6 35 - 6 Report to Trust Board in May 2021 RESPONSIVE Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr QTD 12,000 10663 RE8 Total ED Attendances - 5735 5,000 RE9-N Patients spending less than 4hrs in ED SGH Main ED (Type 1 and UCH) 92% 84% Major Trauma Centres (Type 1) 76% 90.2% 87.2% 81.30% 87.2% Rank of 8-> RE10-N Patients spending less than 4hrs in ED UHS Total (includes SGH all types) - 532533422111233 92.22% 85.5% 78.82% 91.1% 91.1% 88.0% 88.0% Q target - 95% 95% RE11-N Total time Total spent in ED - Percentiles UHS RE12 27,000 Accepted Referrals (excluding -initiated by consultant responsible) 0 RE13 2,000 Elective spells (excluding daycase, onsite SGH/PAH only) 0 90th, 4:00 Mean, 2:45 8,013 446 90th, 4:59 - - Mean, 3:04 19,100 - - 1,438 - - 7 Report to Trust Board in May 2021 RESPONSIVE Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan 100% % Patients on an open 18 week pathway 66.8% RE14-N (within 18 weeks ) with teaching hospital min-max range and rank (of 20) 18 12 14 14 7 6 7 7 10 10 10 9 30% 38,000 Total number of patients on a waiting RE15-N list (18 week referral to treatment 33106 pathway) 30,000 Patients on an open 18 week pathway 9,000 RE16-N (waiting 52 weeks+ ) with teaching hospital min-max range and rank (of 20) 0 15 154 13 13 13 11 11 11 10 9 6 6 6 1000 RE17 Patients on an open 18 week pathway (waiting 78 weeks+ ) 500 0 0 65,000 RE18 Face to face outpatient attendances 40,105 Feb Mar Apr 66.5% 9 8 37613 3108 5 4 553 34,415 Target > =92% - 0 65,000 RE19 Non-face to face outpatient attendances 15,703 0 RE19 - Latest month is awaiting approx ~3k outpatient attendances to be reported 18,748 - RE20-N Average weeks waited for first outpatient appointment 12.00 10.47 8.89 10.3 7.00 7.30 8.5 - 8 Report to Trust Board in May 2021 7.00 7.30 RESPONSIVE Target Patients to Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar /Apr recover target QTD 11,000 9563 RE21-N Patients waiting for diagnostics - 4317 4,000 80% % of Patients waiting over 6 weeks for RE22-N diagnostics with teaching hospital min- 45.2% 27.2% 90% N = 7 L= L=> 0 of 197 80% 85% 69.1% UHS Total ………………….Rank(of 10)-> 6 5 3 1 1 1 1 1 5 7 4 2 1 1 0.5 31 day cancer wait performance RE24-N (Latest data held by UHS, Combined measure – First and Subsequent Treatments of Cancer) 97.1% 93.2% 89.4% 92.2% 97.6% N=> 96% N=0 of 948 97.41% RE25-N Snapshot of waits > 104 days (from referral on a 62 day pathway) 36 27 29 25 11 17 9 11 25 24 17 13 16 22 - - - RE26-N 28 Day Faster Diagnosis 100% 70% 82.7% 87.5% => 75 % - 84.16% 9 Report to Trust Board in May 2021 RESPONSIVE RE27 My Medical Record - UHS patient logins Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr Monthly target 20,000 18,182 10,000 5,566 - 0 2,500 RE28 Number of Estates Help desk requests 900 and percentage completed on time 100% 85% 997 89.6% 1,592 - 84.7% > 85% 50% Elective inpatient activity - % of same month pre COVID-19 100% RE29 UHS Corporate peer average ------------------------------Rank--> 20% Non-elective inpatient activity - % of same month pre COVID-19 100% RE30 UHS Corporate peer average ------------------------------Rank--> 50% 1st outpatient attendances - % of same month pre COVID-19 100% RE31 UHS Corporate peer average ------------------------------Rank--> 30% Follow up outpatient attendances - 110% % of same month pre COVID-19 RE32 UHS Corporate peer average ------------------------------Rank--> 50% RE29-32 corporate peers group size = 7 90.4% 85.1% 35.23% 3 2 2 2 2 2 1 1 4 4 2 95.0% 66.6% 95.42% 534422232254 96.2% 51.7% 93.77% 47.20%2 2 2 2 2 2 2 2 2 2 2 3 70.3% 108.9% 102.8% - 63.6% 6 3 2 2 1 1 2 2 1 1 4 5 QTD - 86.2% - 10 Report to Trust Board in May 2021 SAFE • Only a single case of probable hospital associated COVID-19 acquisition > 7 days occurred in April (SA 6). • Our measure related to pressure ulcers was amended this month to distinguish between category 2 and 3 ulcers, regardless of level of ‘harm’ (SA 7/8). Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr Target YTD SA1-N Cumulative Clostridium difficile 2 SA2 MRSA bacteraemia 0 100 SA3 Clinical cleaning scores for very high risk areas 95 100 SA4 Serco cleaning scores for very high risk areas 95 Healthcare-acquired COVID 35 SA5 infection: COVID-positive sample taken > 14days after admission (validated) 0 Probable hospital-associated 80 SA6 COVID infection: COVID-positive sample taken > 7 days and 95% - 93.4% YTD target 95% 12 Report to Trust Board in May 2021 CARING • Inpatient feedback (CA 1) continues to be good and significantly better than target. • Maternity patient negative feedback (CA 2) continues to be worse than target; 6.6% compared to the target of =70% 41.5% 65.6% 14 Report to Trust Board in May 2021 0% CARING Monthly Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr target Total vulnerable women (living 100% CA8 within 10% most deprived decile) booked onto a continuity of carer 40.0% pathway 0% 100% % Patients reporting being CA9 involved in decisions about care and treatment 50% 86.0% 85.0% > =90% CA10 100% % Patients reporting finding somebody to talk to about worries and fears 50% 97.0% % Patients with a disability/ 100% additional needs reporting those 81.0% CA11 needs/adjustments were met (total number questioned included at chart base) 30 165 39 50% 57 153 215 133 164 174 178 240 77 CA11 - Performance is a scored metric with a "Yes" response scoring 1, "Yes, to some extent" receiving 0.5 score and other responses scoring 0. Overnight ward moves with a 100 CA12 reason marked as non-clinical (excludes moves from admitting 75.58 44.08 10 wards with LOS =90% 89.0% > =90% 63 110 289 29 - 10.8 - 15 Report to Trust Board in May 2021 EFFECTIVE • The crude mortality rate (EF 4) and Hospital Standardised Mortality Ratio (HSMR) (EF 3), both increased significantly in January (though HSMR remained significantly better than would be expected on average in the NHS). More deaths than ‘expected’ are reported in General Medicine, Respiratory Medicine and Medicine for Older People, with a primary diagnosis of ‘viral infection’. Information for 97 patients has been requested in order that the recorded diagnosis can be checked as a first step in investigation. • Measures relating to patients screened for smoking and harmful alcohol consumption (EF 5), with those found to smoke and given brief advice or a medication offer (EF 7), stalled in their recovery following the COVID-19 peak in January and are currently slightly below target. EF1-L Cumulative Specialities with Outcome Measures Developed EF2 Developed Outcomes RAG ratings EF3-N HSMR - UHS HSMR - SGH EF4 HSMR - Crude Mortality Rate Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr 53 54 56 56 57 255 260 285 305 332 100% 75% 80% 81% 79% 77% 76% 50% 85 82.2 81.5 75 3.5% 3.0% 2.5% Monthly target +1 - 80% EF6-N % patients screened & found to 100% have either moderate or high alcohol dependence given advice or referral 80% 96.7% 95.7% > 90% 100% % patients screened & found to EF7-N smoke given brief advice or a medication offer 60% 83.6% 88.9% > 90% 17 Report to Trust Board in May 2021 WELL LED • Non-medical appraisal rates (WL 2) have continued their modest rate of recovery to 81%, but still remain significantly below the target of 92%. • Overall sickness absence (WL 6) reduced to 3%, which is within target, whilst COVID-19 related absence (WL 7) reduced to 1% of employed time during the month of April. WL1-L Substantive Staff - Turnover Monthly Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr Target 13.63% 12.92% 12.22% 13.4% 12.3% 92% 95.0% 3.4% 12.4% =76% WL9-N Response rate of - staff recommend UHS 60% as a place to work: UHS Quarterly staff FFT National NHS Staff Survey 20% 50.0% 30% 11% WL10-L % of Band 7+ staff who are Black and Minority Ethnic 9.2% 10.0% 15% by 2023 7% WL11 14% % of Band 7+ Staff who have declared a disability or long term health condition 13.3% 13.6% - 12% WL12- QI training programme, and reporting, is currently temporarily suspended as team members support urgent change programmes as part of our Covid 19 response and recovery WL12-L Statutory & Mandatory Training Achieving Target 7 7 7 6 6 6 6 6 6 6 6 6 6 6 6 - 5 5 5 6 6 6 6 6 6 6 6 6 6 6 6 100 WL13-L Number of Apprenticeship Starts 44 49 59 23 - 0 19 Report to Trust Board in May 2021 0 WELL LED Monthly Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr target WL14-L Comparative CRN Recruitment Performance by clinical specialty 56% 52% 28% 36% 40% > =70.0% WL15-L Comparative CRN Recruitment Performance - weighted WL16-L Comparative CRN Recruitment - contract commercial WL17-L Proportion of studies closing in FY on time and to recruitment target non-commercial WL18 NIHR CRF & BRC cumulative quarterly publications 2 5 13 88% 13 50% 600 137 120 0 2 17 43% 246 261 7 7 45% 424 329 Top 5 8 2 Top 10 42% 452 562 > =80% 20 Report to Trust Board in May 2021 Changes and Corrections Section Responsive Safe Safe Caring Caring KPI KPI Name Type RE29-32 Activity metrics - % of same month pre COVID-19, UHS and corporate peer average change SA7 Pressure ulcers category 2 per 1000 bed days change SA8 Pressure ulcers category 3 and above per 1000 bed days change CA11 % Patients with a disability/ additional needs reporting those needs/adjustments were met correction (total number questioned included at
Url: /Media/UHS-website-2019/Docs/About-the-Trust/Trust-governance-and-corporate-docs/2021-Trust-document/TB-papers/Papers-Trust-Board-27-May-2021.pdf

Papers CoG 23.10.2024

Description: Date Time Location Chair Agenda Council of Governors 23/10/2024 14:35 - 16:15 Conference Room, Heartbeat/Microsoft Teams Jenni Douglas-Todd 1 Chair’s Welcome and Opening Comments 14:35 2 Declarations of Interest 14:39 3 Minutes of Previous Meeting 14:40 Approve the minutes of the previous meeting held on 24 July 2024 4 Matters Arising/Summary of Agreed Actions 14:42 5 Strategy, Quality and Performance 5.1 Chief Executive Officer's Performance Report 14:44 Receive and note the report Sponsor: David French, Chief Executive Officer 15.04 Break 6 Governance 6.1 Governor Attendance at Council of Governors' Meetings 15:14 Review governor attendance at Council of Governors' meetings Sponsor: Jenni Douglas-Todd, Trust Chair Attendee: Craig Machell, Associate Director of Corporate Affairs and Company Secretary and Karen Russell, Council of Governors' Business Manager 6.2 Appointment to the Governors' Nomination Committee 15:19 Note the appointment of Jenny Lawrie to the Governors' Nomination Committee Sponsor: Sponsor: Jenni Douglas-Todd, Trust Chair Attendee: Karen Russell, Council of Governors' Business Manager 6.3 Meeting with the Hampshire and IoW ICB - Chair Appointments (Oral) 15:21 Receive details of the background to this meeting Sponsor: Sponsor: Jenni Douglas-Todd, Trust Chair 6.4 Strategy Session Planning (Oral) 15:31 Discuss plans for the Strategy Session on Wednesday, 11 December 2024 Sponsor: Jenni Douglas-Todd, Trust Chair 7 Membership Engagement and Governor Activity 7.1 Membership Engagement 15:41 Receive and note the report Sponsor: David French, Chief Executive Officer Attendee: Sam Dolton, Events and Membership Officer 7.2 Feedback from Strategy and Finance Working Group 15:51 Chair: Mandy Fader 7.3 Feedback from Patient and Staff Experience Working Group 15:56 Chair: Sandra Gidley 7.4 Feedback from Membership and Engagement Working Group 16:01 Chair: Patricia Crates 8 Review of Meeting 16:06 Review and feedback on the content of this meeting Sponsor: Jenni Douglas-Todd, Trust Chair 9 Any Other Business 16:09 Raise any relevant or urgent matters that are not on the agenda 10 Date of Next Meeting: 29 January 2025 16:14 Note the date of the next meeting Page 2 Minutes - Council of Governors (CoG) Open Session Date Time Location Chair Present 24 July 2024 14.00-15:45 Conference Room, Heartbeat Education Centre and Microsoft Teams Jenni Douglas-Todd, Trust Chair Jenni Douglas-Todd, Trust Chair JDT Theresa Airiemiokhale, Elected, Southampton City TA Shirley Anderson, Elected, New Forest, Eastleigh and Test Valley SA Katherine Barbour, Elected, Southampton City KB Patricia Crates, Elected, New Forest, Eastleigh and Test Valley PC Helen Eggleton, Hampshire and Isle of Wight Integrated Care HE Board (ICB) Professor Mandy Fader, Appointed, University of Southampton MF Lesley Gilder, Elected, Southampton City LG Sandra Gidley, Elected, New Forest, Eastleigh and Test Valley SG Jenny Lawrie, Elected, Southampton City JL Brian Lovell, Elected, Rest of England and Wales BL Esther O’Sullivan, Elected, New Forest, Eastleigh and Test Valley EO Jake Smokcum, Elected, Nursing and Midwifery Staff JS Liz Taylor, Elected, Non-Clinical and Support Staff LT In attendance Jessica Burnett, Associate Governor JB Tracey Burt, Minutes TB Sam Dolton, Events and Membership Officer SD David French, Chief Executive Officer (for item 5.1) DF Ian Howard, Chief Financial Officer (for item 5.2) IH Craig Machell, Associate Director of Corporate Affairs and CM Company Secretary Neylia Mustafapour, Associate Governor NM Karen Russell, Council of Governors’ Business Manager KR Apologies Sathish Harinarayanan, Elected, Medical Practitioners and Dental Staff Linda Hebdige, Elected, Southampton City Councillor Edward Heron, Appointed, Hampshire County Council Councillor Pam Kenny, Appointed, Southampton City Council Catherine Rushworth, Elected, Isle of Wight Professor Emma Wadsworth, Appointed, Solent University Mike Williams, Elected, New Forest, Eastleigh and Test Valley Quintin van Wyk, Elected, Rest of England and Wales SH LH EH PK CR EW MW QvW 1 Chair’s Welcome and Opening Comments The Chair welcomed everyone to the meeting and congratulated SA on her appointment as the new Lead Governor, following Kelly Lloyd’s move away from UHS. 1 2 Declarations of Interest There were no new declarations of interest relating to matters on the agenda. 3 Minutes of Previous Meeting The minutes of the meeting held on 1 May 2024 were approved as an accurate record of the meeting. 4 Matters Arising/Summary of Agreed Actions All actions had been completed. The Chair noted the following: No. 1116 - During the discussion between governors and NEDs, prior to the CoG meeting, Tim Peachey, NED, had provided an update regarding security at the PAH and had advised that improvements had been made. No. 1128 - Staff had been thanked for their hard work and achievements and a message would be included in the next executive briefing. 5 Strategy, Quality and Performance 5.1 Chief Executive Officer’s Performance Report The Chair welcomed DAF, Chief Executive Officer. He noted that his report had been circulated prior to the meeting and said that he would be happy to take any questions from governors. DAF advised that he had met with the new Secretary of State for Health on 19 July 2024 and he had said that government would focus on emergency waiting times and the size of waiting lists. DAF advised governors that at the end of the year UHS had been in the top ten peer teaching hospitals for its ED 4-hour performance and had been awarded £5.5m to improve facilities, which was a testament to the work being done by staff. He also noted that the better the outcomes and reputation of the hospital, the more people wanted to come to UHS, which increased the pressure on waiting lists. The Trust had ranked in the top 5 teaching hospitals nationally for its elective activity and had delivered 123% of 2019/20 levels, which was 10% above its own target. The Chair added that many hospitals were still struggling to achieve 100%. DAF advised that UHS was working hard to reduce its waiting lists and had a particular focus on those who had waited the longest. He advised that the Trust had some patients who had waited18-months for corneal grafts but the availability of donor tissue was controlled nationally. There was also a national target to have no patients waiting over 65 weeks by the end of September 2024. The Secretary of State had appointed Lord Darzi to undertake a 10-year review of the NHS and he had been clear that it would look at a shift into the community, the prevention of sickness and a move from analogue to digital. DAF advised that capital funding may become available for digital transformation and UHS would be ready for that. DAF advised that nationally the NHS was overspent at the end of Month 2 by approximately £1b. UHS was part of that overspend and had reported an £8m deficit after two months, which was £2m worse than plan. The number of patients in the hospital not meeting the criteria to reside (CTR) remained between 200 and 250 each day. Also, whilst UHS was a low spending 2 hospital on agency staff, most of that spend related to caring for patients with mental health issues, who it had less ability to discharge. On a more positive note, DAF advised that the hospital’s transformation programmes for the year around inpatient flow, outpatient pathways and getting more patients through theatres, were proving to be successful. In response to questions from governors, DAF advised that: • the Trust was so overwhelmed with treating sick people, it was struggling to make sufficient progress in relation to the government’s strategy for prevention. However, the LifeLab programmes at SGH were very successful and provided an excellent opportunity for school children to go into the hospital to learn about health, diet, activity and mobility. • general practice was overwhelmed and the demands on health services were increasing faster than the NHS could cope with. 5.2 Operating Plan 2024/25 The Chair welcomed IH, Chief Financial Officer, to the meeting. He advised that there had been significant pressure on NHS finances last year with systems similar to the Hampshire and Isle of Wight (HIOW) ICB, off plan by around £1.5b nationally. UHS had delivered a deficit position of £29m in 2023/24 but had then received cash support of £25m, which meant that it had ended the year with a cash deficit of £4.5m. Driving those pressures had been industrial action, unfunded pay awards and system pressures, e.g. patients no longer meeting the CTR and those with mental health needs. On a more positive front the Trust had delivered 118% of its Elective Recovery Fund (ERF) baseline last year, which placed it within the top seven Trusts in the country. It had a savings programme of £65m and some of its transformation programmes were gaining traction. However, some non-recurrent, one-off support, had been removed but the Trust was committed to maintaining the quality of the services it offered to patients. There was, therefore, a focus on stretch improvements that could be made within UHS and collectively, across the HIOW system. In response to questions from governors, IH advised that: • the stretch improvements were a step up from last year but if UHS was to ask NHSE for cash support, the hospital would be unable to maintain its capital programme/investment. • only a small number of staff were funded by industry but there were some military staff and a few linked to charities. NHSE was keen for UHS to reduce its staffing levels by 2% but the Trust had a long-term workforce plan to increase staffing. • the Trust had ambitious plans to generate income from IP (Intellectual Property) but those would take time. 5.3 Annual Report Update CM advised that due to delays in the Standing Orders process, the Trust had not been able to meet the 28 June submission deadline to NHSE. The Trust had informed NHSE, who had asked for some draft information by that date, with the rest to follow. The annual report and accounts had, however, been submitted to NHSE on 19 July 2024 and would be laid before parliament in September, when they returned from their summer recess. 3 The Trust’s auditors had signed off the hospital’s audit report last week and had raised two points: • the size of the Cost Improvement Programme (CIP), which they considered a risk as a large proportion of it was unidentified. CM advised that they had raised the same concern last year. • governance around the finance process which had required a complete rebuild regarding supporting information and had delayed the provision of information to the auditors. 6 Governance 6.1 Appointment of Lead Governor The Chair noted that two governors had expressed an interest in becoming Lead Governor, following the departure of Kelly Lloyd from the Trust. Their statements had been circulated to governors and SA had been appointed by majority decision. The Chair congratulated SA on her appointment. Decision: The CoG noted the appointment of SA as Lead Governor with effect from 1 July 2024. 6.2 Confirmation of Election of the Membership and Engagement Working Group Chair Following the departure of Kelly Lloyd from the Trust, KR advised that PC had been the only governor who had expressed an interest in becoming Chair of the Membership and Engagement Working Group. The working group had voted unanimously, to appoint her to the role. Decision: The CoG confirmed the appointment of PC as Chair of the Membership and Engagement Working Group. 6.3 Governors’ Nomination Committee Terms of Reference CM advised that the Governors’ Nomination Committee (GNC) had reviewed its Terms of Reference (ToR), in order to provide greater flexibility related to the composition of its membership. The ToR had therefore been amended to state that at least three members of the committee were governors elected by the members of either the public or staff constituencies. Decision: The CoG approved the proposed changes to the GNC Terms of Reference. 7 Membership Engagement and Governor Activity 7.1 Membership Engagement SD introduced the membership engagement report. He advised that membership numbers were down and that the Communications Team had reduced by three, which meant that they had been unable to attend as many events as they would have liked to. They had, however, been looking to see which other teams/organisations they could partner with. Engagement with public members had continued with a monthly newsletter to keep members updated and a quarterly Connect digital magazine. The latest edition of Connect had gone out 23.7.24 and the already been opened by 42% of the membership. In May the Trust had hosted a virtual event ‘Choosing the right healthcare for your child’ together with South Central Ambulance Service and in July it had hosted the 4 second virtual event in the series ‘Transforming lives and healthcare through research’. Both had been well received, with over 130 watching the recording of the latter. There had been good engagement with the staff recognition programme, which included the sending of a High 5 certificate to a colleague, the monthly UHS Stars award (presented by DAF) and the annual award ceremony. Nominations for the latter would close on 26.7.24 and 500 nominations had already been received. SD advised that Trust members had the opportunity to nominate a member of staff for the UHS Champions Award at the annual award ceremony. The Communications Team had also been busy supporting the CoG elections and he thanked SA for her support. She, in turn, thanked him for his work and enthusiasm. He also thanked PC and JL for their support at the Mela events in recent weeks. MF advised that the Trust had, in previous years, been successful in recruiting members from Southampton University and she suggested that SD considered making contact with them. The Chair also suggested that he spoke to EW about the possibility of a campaign at Solent University. Action: SD to look into the possibility of campaigns at Southampton and Solent universities to recruit members. 7.2 Annual Members’ Meeting Update SD advised that for the first time in five years, the annual members’ meeting would be in person, rather than virtual. It would include:• the presentation of the annual report and accounts in the Heartbeat Lecture Theatre (which would be recorded). • an open evening with a chance to show case what was happening and what services the Trust offered outside of the hospital. • support for the preventative agenda. • an opportunity to chat with UHS teams about what they offered. Details were still being worked on but it was hoped that governors would be actively involved in the evening, which would be held on 21 November 2024. 7.3 Governors’ Nomination Committee Feedback KR advised that the Trust would be looking to recruit another public governor to join the GNC. 7.4 Feedback from Strategy and Finance Working Group MF advised that Martin De Sousa, Director of Strategy and Partnerships, had attended the meeting to provide a general update on strategy. He had presented a large slide deck which had been circulated to all governors and she commended it to them. She said that there had been a good discussion and that he had been very open about the achievements that had been made but also the challenges. 7.5 Feedback from Patient and Staff Experience Working Group SG advised that Steve Harris, Chief People Officer, Anita Esser, Head of Education, Training and Development and Ceri Connor, Director of OD and Inclusion had attended the meeting. They had talked about staff turnover (which had decreased), apprenticeships, improving leadership and wellbeing and the staff survey. She had, in particular, been struck by the way in which staff, on apprenticeships, had then been able to progress in the Trust. 5 7.6 Feedback from Membership and Engagement Working Group PC advised that Southampton Mela had been reasonably well attended and the hospital team had been able to engage with the public and hand out leaflets. Southampton Pride was coming up and a couple of governors had already said that they would attend. The team had also held a joint meeting with the Diabetic Association. Governors discussed the importance of having an activity (a hook) to draw people in at events and noted that whilst this was something that UHS did well, some teams struggled. KB noted that Solent University had been taking blood pressures at an event, which had caught people’s attention. The possibility of an occasional slot on Radio Solent had been suggested by governors and also whether it would be possible for them to spend some time on the Reception desk, at the main entrance to the hospital, to talk to visitors and patients. SA asked SD whether there would be an opportunity to fill the staff gaps in his team. He advised that clinical posts were currently the priority but said that it was a good team, who supported one another well and he was exploring opportunities to work alongside the Experience of Care Team. PC thanked SD for his unfailing enthusiasm and said that he and his team provided excellent programmes. 8 Review of Meeting Governors noted the significant financial pressures on the Trust, even though UHS was one of the best performing hospitals nationally and also the challenges due to issues related to social care. The difficulties with the poor sound quality during CoG meetings, both in the conference room and for those joining via Teams was raised. The Chair said that this was a long-standing issue that was being looked into but any solution was likely to be expensive. 9 Any Other Business The Chair noted this was JB’s last CoG meeting as she would be going to Sheffield University. She thanked JB for her work as an Associate Governor and wished her well for the future. She also noted that NM had just completed her A level exams and was awaiting the results. NM advised that she intended to remain in Southampton and that she would, therefore, be keen to continue as an Associate Governor. SA thanked both students for their contributions during meetings and at events, which she said had been invaluable. Two governors were reaching the end of their terms of office. BL advised that he intended to stand again for election but KR advised that QVW would be standing down. It was noted that there had been a lot of interest in the vacancy for a staff governor to replace Kelly Lloyd and nominations were to close on 31 July 2024. The Chair thanked colleagues for their contributions during the meeting and said that she hoped everyone had a good summer. 10 Date of Next Meeting The next meeting of the CoG would be held on 23 October 2024. 6 List of action items Agenda item Assigned to Deadline Status Council of Governors 24/07/2024 7.1 Membership Engagement 1153 SD to look into the possibility of membership campaigns at . Southampton and Solent universities to recruit members. Sam Dolton 23/10/2024 Completed Explanation MF advised that the Trust had, in previous years, been successful in recruiting members from Southampton University and she suggested that SD considered making contact with them. The Chair also suggested that he spoke to EW about the possibility of a campaign at Solent University. SD is arranging a Teams meeting with EW regarding the possibility of a campaign at Solent University. MF is standing down with effect from 25 October 2024 due to her retirement from the University of Southampton, so SD will arrange a meeting with her successor once they are appointed. SD also advised that has had a couple of discussions with UHS teams about freshers fairs, but none of them had the capacity. However, SD has confirmed that the Research and Development team attended the University of Southampton freshers fair on 27 September 2024 to take part in a joint partnership stand with the University. Report to the Council of Governors Title: Agenda item: Sponsor: Author: Date: Purpose Chief Executive Officer’s Performance Report 5.1 David French, Chief Executive Officer Sam Dale, Associate Director of Data and Analytics 23 October 2024 Assurance Approval or reassurance Ratification Information Y Issue to be addressed: Information about Trust performance supports the Council of Governors in their role. Response to the issue: This report is intended to inform the Council of Governors about aspects of the Trust’s performance. Implications: This report provides performance information relating to a broad range of Trust services and activities. There are no specific implications. Risks: This report is provided for the purpose of information. Summary: This report is provided for the purpose of information. UHS Council of Governors October 2024 Chief Executive’s Performance Report 1. Purpose and Context The purpose of this report is to summarise the Trust’s performance against a range of key indicators. Where available, this report covers data from the period July 2024 to September 2024, noting that some quarterly performance data is reported further in arrears. Notable features of the last quarter include: • The financial environment remains extremely challenging. The annual plan for 2024/25 was originally approved as a £14.5m deficit, and as at M5 the Trust was reporting a £20.6m deficit. We are however expecting additional funding in M6, including £11.2m of national support towards our planned deficit. • Despite the financial challenges, the organisation has made significant progress in controlling workforce growth and remains on target to invest its full capital allocation. • The trust has delivered elective activity at 126% of 2019/20 levels and continues to drive incremental improvements in theatre utilisation, outpatient productivity and length of stay reduction. • Improving patient flow throughout the hospital remains one of our highest priorities as the number of patients attending the emergency department increased by 3% compared to quarter two in 2023/24. Whilst the volume of patients in the hospital not meeting the criteria to reside (nCTR) did reduce in July and August, it remains above 200 each day and has since increased. • Despite the operational challenges, the hospital is benchmarking well on performance targets for elective waiting lists, emergency waiting times and cancer pathways despite a recent increase in referrals. UHS is consistently in the top quarter for most key waiting time metrics when compared to peer teaching hospitals across the UK. • The organisation continues to prioritise clinically urgent and long waiting patients and reported just 18 patients waiting over 65 weeks at the end of September with 89% of these caused by a national shortage of transplant tissue. Our ambition and focus for the remainder of the year has already transitioned to treating all patients waiting over 52 weeks. 2. Safety Infection Control Clostridium Difficile infection MRSA Bacterium infection Target 78.0% EDs (Types 1 & 2) (Mar’25) Jul 2024 72.8% Aug 2024 Sep 2024 69.9% 67.9% Attendances to the Emergency Department (ED) continue to remain high, averaging 421 per day across July, August and September in 2024. Whilst this does represent a small decrease against the previous quarter, it is a 3% increase against the equivalent summer period last year. There were periods of significant pressure on the service in late September 2024. Whilst this presents flow challenges for the organisation, UHS maintained a four hour performance position of 70% when averaged across quarter two. The hospital’s ED performance continues to rank comparatively - ranking 4th for September 2024 when compared to 20 peer teaching hospitals across the UK (for Type 1 attendances). Page 3 of 7 Referral to Treatment (RTT) % incomplete pathways within 18 weeks in month Total patients on a waiting list Target => 92% Jul 2024 64.39 60461 Aug 2024 63.23 59649 Sep 2024 TBC TBC The trust’s RTT waiting list saw a month on month increase across quarter 1, however this levelled off in July 2024 and marginally reduced back to below 60,000 in August 2024. The recent pressure on the waiting list remains within the referral element of patient pathways, whereas the volume of patients waiting for a planned admission or diagnostics are stable or have reduced. A significant proportion of the referral growth sits within a small number of specialties as they look to flex existing capacity and staffing levels with the increased referral demand. Overall, the hospital continues to benchmark well for the proportion of patients who have been waiting over 18 weeks for treatment, with UHS ranking in fourth place for August 2024 when compared to 20 peer teaching hospitals. The organisation has made strong progress against the national waiting time cohorts and associated targets. The trust has consistently reported zero patients waiting over two years. The only cohort of patients waiting over 78 weeks (2 in September 2024) remain those impacted by the national shortage of corneal tissue which is managed nationally. Similarly the trust reported 18 patients waiting over 65 weeks for September 2024 and 16 of these were corneal transplants. Further corneal tissue is about to released from the national team which will support the trust’s ambition to have zero patients waiting over 65 weeks as we transition focus on patients waiting over 52 weeks. The organisation ranked in first place for the volume of patients waiting over 65 weeks in August 2024 when compared to peer teaching hospitals. Cancer Faster Diagnosis - within 28 days 31 Day target - decision to treat to first definitive treatment 62 day target - urgent referral to first definitive treatment Target > =77% => 96% => 70% Jun 2024 82.43 88.03 74.12 Jul 2024 80.78 93.37 74.54 Aug 2024 82.00 96.09 77.61 The organisation continues to prioritise cancer patients and their treatments for all tumour sites and cancer types. Pathway efficiencies particularly around pathology and diagnostics are constantly being explored as well as regular dialogue with Wessex Cancer Alliance and the ICB on improvements and innovative techniques to ensure referrals are appropriate and timely. There has been a small decline in Cancer performance for 28 day faster diagnosis (80.78% in August 2024) but a significant improvement in the 31 day standard (93.4%). The Trust ranks in the top half when compared to peer teaching hospitals for all key cancer metrics for the latest available month (August 2024). 5. Finance UHS reported a headline financial position of: • Month 5 - £3.8m deficit (£2.1m adverse to plan) • Year to date - £20.6m deficit (£7.6m adverse to plan) Whilst the position remains extremely challenging, there continues to be an improving month on month trend with the in-month deficit reducing from £3.9m to £3.8m. Underlying financial improvement remains more significant with month-on-month improvement being illustrated over the first five months of 2024/25. Page 4 of 7 Overall Narrative The Trust is continuing to substantively deliver on financial improvements where outcomes are within its direct control. For example: • The Trust has delivered LOS improvements for P0 patients of 5%, supporting surge capacity to remain closed. • We have delivered an increase in First Outpatient appointments of 10% and Advice and Guidance of 10%, supported by a reduction in follow-up appointments of 9%. Our Outpatient First/Procedure to Follow-up ratio has improved to 53%, above the 46% national target. • The Trust has implemented new workforce controls embedded within Divisions, which have been widely supported. We are significantly below our pay expenditure plan. • We are currently utilising agency for 0.6% of our total workforce, significantly below the national target of 3.2%. • Our temporary staffing (bank and agency) is below plan by £4m, and £6m below than the same point in 23/24. • UHS is performing well on ERF activity through transformation programmes and other initiatives, with YTD performance at 126% of baselines, above the overall national target of 107% (although marginally below our plan). • UHS has delivered £25m CIP by M5, which is £4m above the trajectory from 23/24. • Since March 24, our ERF performance has increased by 9%, and at the same time our staffing levels have reduced by 2%. However, a number of issues have presented in year which has created a financial variance, some of which are outside of the organisations full control: • Industrial Action (£1.5m) – the junior doctor strike in late June / early July has dampened the level of ERF income by c£1m and resulted in additional direct costs of c£0.5m. • Consultant pay award (£0.9m YTD) – there is a gap between funding and estimated cost of implementing the consultant pay award. • Increase to the Specialist Commissioning ERF Target (£0.5m YTD) – due to a national imbalance a further increase was applied to the ERF target for UHS that will result in unremunerated activity of £1.2m for 24/25. • System Related CIPs undelivered (£3.9m) – the four system related CIP schemes (reducing NCTR patients / reducing MH patients / Corporate cost reductions / additional service development fund income) are working collaboratively across the system; however, output metrics that support reduction in provider costs have not yet materialised. • UHS have YTD performed circa £13.5m of activity above block contract levels, which is unfunded. Further to this, within the Trust a pay underspend YTD is offsetting non pay pressures and income shortfalls against plan. Additionally, several one-off benefits have helped support the position with a VAT benefit from prior years delivering £0.7m in month. Funding Uncertainty There are a number of items expected to impact the financial position in M6 or future months. These include: • Non-recurrent deficit support funding has recently been confirmed to be received in M6. This will result in a revised financial plan from M6-M12. UHS is anticipating receiving c£11m. • ERF final performance for 2023/24 has yet to be confirmed. We are expecting a reduction to our 24/25 target, which will give an upside to our current reported position. • ERF performance to date in 2024/25 has yet to be shared – it is normally 3 months in arrears. We are estimating performance using local data. For every month that information is delayed we are increasing the level of risk and potential variation within our reported numbers. Page 5 of 7 • Industrial action – we are anticipating a share of national funding, which would improve our current position. • Specialised Commissioning ERF target – as mentioned above, this was increased unexpectedly in 24/25. We have submitted a challenge nationally as part of the contractual process for 24/25 and are awaiting the outcome. • Pay award funding – we are awaiting confirmation of the value of funding to be received in relation to confirmed 24/25 pay awards, including cash to support backdated payments being made in M6. These factors could cause some volatility in reported financial positions in coming months. We will ensure our underlying position takes these movements into account. Cash The Trusts underlying deficit continues to drive a deterioration in the month-on-month cash position. August ended with a cash balance of £23.8m that is marginally higher than the recently reforecast position. As per previous updates the cash recovery plan has been enacted and close working with commissioners has helped ensure cash inflows are timely. Capital Capital expenditure of £14.2m YTD is slightly behind plan (£1.9m variance), however leaves over £44m to be spent across the remainder of 24/25. Changes to the Building Safety Act have created delays and overspends in several key projects notably the Neonatal expansion. Trust Investment Group reviewed the most likely forecast that illustrated a high degree of certainty that the capital expenditure plan for 24/25 would be delivered, however did create challenge for 25/26 with slippage greater than planned. This will be reviewed in the context of capital planning and prioritisation for 25/26 over the coming months. 6. Human Resources Staff Survey Results Indicator Q1 24/25 Staff recommend UHS as a place to work % 63.8% Staff survey engagement score (out of 10) 6.85 Q2 24/25 64.1% 6.84 The recommendation as a place to work measure has increased marginally, as it did in the previous report. This quarterly survey received a response rate of 21% (over 3000 of our staff). The quarterly surveys enable us to track engagement measures throughout the year, as a Trust and in particular teams and departments. This quarter, the Trust’s engagement score fell slightly. We hope to see this increase in the annual staff survey launching end of September. Turnover: Indicator Staff Turnover (internal target; rolling 12 month) Sickness absence 12 month rolling (internal target) Target <=13.6% <=3.9% Jul 2024 11.2% 3.9% Aug 2024 11.1% 3.9% Sep 2024 TBC TBC In August 2024 there were a total of 110 WTE leavers. The highest number of leavers was in Division B, with Page 6 of 7 34 WTE leavers. Within Division B, the Nursing and Midwifery Registered staff group had the highest number of leavers (12 WTE), followed by the Additional Clinical Services staff group at 11 WTE. Division D and C had the second and third highest number of leavers (23 and 22 WTE respectively); with the largest numbers being Nursing and Midwifery Registered staff group in both Divisions (11 WTE leavers in Div D and 7 WTE leavers in Div C). Sickness: The 12-month rolling sickness absence rate has hit the Trust’s target at 3.9% from month 4 to month 5 (July to August 2024), after a consistent downtrend from the January 2024 sickness rate which stood at 4.2%. Page 7 of 7 Item 6.1 Report to the Council of Governors - 23 October 2024 Title: Governor Attendance at Council of Governors’ Meetings Sponsor: Jenni Douglas-Todd, Trust Chair Author: Karen Russell, Council of Governors’ Business Manager Purpose (type an ‘x’ in the appropriate box(es)) (Re)Assurance Approval Ratification Information x Strategic Theme (type an ‘x’ in the appropriate box(es)) Outstanding patient Pioneering research World class people outcomes, safety and innovation and experience Integrated networks and collaboration Foundations for the future N/A N/A N/A N/A N/A Executive Summary: Under the Trust’s constitution (paragraph 2.1 of Annex 5) if a governor fails to attend two successive meetings of the council of governors, his or her tenure of office is to be immediately terminated by the council of governors (CoG) unless the CoG is satisfied that: • the absences were due to reasonable cause; and • he/she will be able to attend meetings of the CoG within such a period as the CoG considers reasonable. Following the recent review, there was one governor who had failed to attend two successive ordinary meetings of the CoG. Reasons for non-attendance were provided and were due to reasonable causes. In order to ensure that the CoG considers the situation when a governor fails to attend two successive ordinary meetings of the CoG, the process is for the Chair or Company Secretary contact the governor to understand the reasons for this if these have not already been provided. The Chair or Company Secretary would then provide confirmation to the CoG as to whether this was due to reasonable causes and the governor’s ability to attend future meetings. This would also help to identify any steps that the Trust could take to facilitate attendance. The CoG is asked to confirm that it is satisfied that the failure of one current governor to attend two successive meetings of the CoG was due to reasonable causes and that they would be able to attend future meetings within a reasonable period so that no termination of a current governor’s tenure of office is required or occurs. Contents: N/A Risk(s): N/A Equality Impact Consideration: N/A Item 6.2 Report to the Council of Governors Title: Appointment to the Governors' Nomination Committee Sponsor: Jenni Douglas-Todd, Trust Chair Author: Karen Russell, Council of Governors’ Business Manager Purpose (type an ‘x’ in the appropriate box(es)) (Re)Assurance Approval Ratification Information Y Strategic Theme (type an ‘x’ in the appropriate box(es)) Outstanding patient Pioneering research World class people outcomes, safety and innovation and experience Integrated networks and collaboration Foundations for the future N/A N/A N/A N/A N/A Executive Summary: A vacancy arose on the Governors’ Nomination Committee as Kelly Lloyd stood down on leaving her employment at the Trust on 30 June 2024. Governors were asked to express an interest if they were willing to join the Governors’ Nomination Committee. Jenny Lawrie expressed an interest in taking on this additional role. The Council of Governors is responsible for appointing the members of the Governors’ Nomination Committee and has decided by a unanimous vote to approve her appointment. The Council of Governors is asked to note the appointment of Jenny Lawrie to the Governors’ Nomination Committee. Contents: N/A Risk(s): N/A Equality Impact Consideration: N/A Report to the Council of Governors Title: Agenda item: Sponsor: Author: Date: Purpose Membership Engagement 7.1 Jenni Douglas-Todd, Trust Chair Sam Dolton, events and membership officer 23 October 2024 Assurance Approval or reassurance Ratification Information Y Issue to be addressed: Information about engagement with Trust members supports the Council of Governors in their role. Response to the issue: This report aims to update the council on Trust membership and recent and planned engagement activities. Implications: (Clinical, Organisational, Governance, Legal?) This report provides engagement information, there are no specific implications. Risks: (Top 3) of carrying out the change / or not: This report is provided for the purpose of information. Summary: Conclusion This report is provided for the purpose of information. and/or recommendation Page 1 of 5 Overview of engagement Over the last three months we have continued to be proactive in engaging with our members. Membership updates Our routine membership updates have continued to be split into two different formats: • A monthly newsletter to keep public members updated on what’s happening across the Trust and the ways they can get involved in various projects, with September and October editions produced. • A quarterly Connect digital magazine which mainly focuses on patient stories, UHS successes and individual/team achievements, with the Summer 2024 edition going out in July. Update Summer 2024 September 2024 October 2024 Type Quarterly magazine Monthly update Monthly update Date sent 23/07/2024 10/09/2024 02/10/2024 Sent to 2988 2978 2958 Bounces 59 60 64 Opens* 49% 49% 47% Targeted emails We sent three targeted emails to smaller sections of our database. In August all public members who registered to attend February’s Spotlight on dementia research virtual event were invited to take part in a survey to explore public perspectives on the use of AI in dementia diagnosis. The study is led by Dr Sofia Michopoulou, head of nuclear medicine physics at UHS and one of the speakers in the Spotlight on dementia research virtual event. At the end of September we were asked to promote an upcoming winter wellness webinar hosted by Wessex Research Hubs to public members between the ages of 50 and 65. And the topic for University of Southampton’s upcoming Annual Wade Lecture this year is Neuroimaging and its spectacular insights into brain health and disease, with guest speaker Professor Joanna Wardlaw, so all public members who registered to attend February’s Spotlight on dementia research virtual event were invited to attend either online or in person. Email Artificial intelligence in dementia diagnosis survey Wessex Research Hubs Winter wellness webinar Annual Wade Lecture 2024 Date sent 14/08/2024 30/09/2024 01/10/2024 Sent to 146 639 142 Page 2 of 5 Bounces 1 20 2 Opens* 73% 46% 66% Other emails At the start of September we invited public members to attend our annual members’ meeting, which will take place in person along with an open evening on Thursday 21 November. Email Invitation to annual members’ meeting Date sent 02/09/2024 Sent to 2978 Bounces 64 Opens* 45% * All open rates as of 15 October 2024 Public engagement on social Impressions = number of times a post has been displayed Engagement = number of likes, shares, comments We have been active across our social media channels. Content with high engagement included: Emergency department pressure In September we asked people to share that our emergency department (ED) was exceptionally busy, with 700 patients seen in a day and a half. Posts advised people to only attend ED in life-threatening emergencies and consider local urgent treatment centres for less-severe conditions. 75,479 impressions 11,992 engagements Appeal for clothing donations In August we asked our community to donate second hand clothing for patients to go home in. Our clothes bank can be supported by donations of clean, loose-fitting clothes such as jumpers, t-shirts, trousers, shorts, dresses, skirts and jogging bottoms. 40,550 impressions 1,537 engagements UHS finalists for NHS Chef of the Year Our talented UHS chef team of Christoffer Dopico Alles and second chef Alex Cavallaro have progressed to the final of a prestigious cooking competition, NHS Chef 2024, which takes place later in October. 20,653 impressions 3,346 engagements Page 3 of 5 Member analysis Age breakdown (and number of new members since 24 July 2024) 16-21 141 (4) 22-29 232 (3) 30-39 480 (10) 40-49 580 (2) 50-59 820 (2) 60-74 1923 (3) 75+ 3628 (3) Not stated 252 Gender breakdown (and number of new members since 24 July 2024) Unspecified 53 Male 3099 (9) Female 4790 (13) Transgender 6 Non-binary 3 (2) Prefer not to say 104 (3) Prefer to self-describe 1 Ethnicity breakdown (and number of new members since 24 July 2024) White - English, Welsh, Scottish, Northern Irish, British 6874 (15) White - Irish 8 White - Gypsy or Irish Traveller 0 White - Other 93 (5) Mixed - White and Black Caribbean 4 (1) Mixed - White and Black African 9 Mixed - White and Asian 10 (1) Mixed - Other Mixed 47 Asian or Asian British - Indian 105 (2) Asian or Asian British - Pakistani 14 Asian or Asian British - Bangladeshi 11 Asian or Asian British - Chinese 27 Asian or Asian British - Other Asian 203 Black or Black British - African 51 Black or Black British - Caribbean 4 Black or Black British - Other Black 75 Other Ethnic Group - Arab 9 Other Ethnic Group - Any Other Ethnic Group 56 (1) Not stated 456 (2) Member recruitment As of 15 October 2024, there are 8,056 public members. Since the last Council of Governors meeting on 24 July 2024, 27 new members have joined the Trust. Recruitment has been driven by attending the Southampton Pride in August and encouraging attendees to sign up via an iPad. Conclusion Our immediate focus is to: • Produce the Connect quarterly digital magazine for autumn and continue monthly updates. • Plan and deliver the in person annual member’s meeting and open evening on 21 November 2024. • Continue our virtual event research series with an upcoming event on healthy ageing. Page 4 of 5 Our long-term focus remains on implementing the membership engagement strategy 20212025. Recommendation This paper aims to update the Council of Governors on Trust membership and recent and planned engagement activities. Page 5 of 5
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