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Press release: Southampton researchers discover "hidden reservoir of bacteria" in nose linked to chronic sinus infections

Description: Researchers in Southampton have discovered a "hidden reservoir of bacteria" in the nose that can prevent antibiotics being effective in the treatment of chronic sinus infections.
Url: /AboutTheTrust/Newsandpublications/Latestnews/2019/August/Press-release-Southampton-researchers-discover-hidden-reservoir-of-bacteria-in-nose-linked-to-chronic-sinus-infections.aspx

Matt Loxham

Description: Auto Generated Title I first became interested in the lungs during my Pharmacology degree at the University of Sheffield. A final year research project looking at cellular responses to asthma medication led to the offer of staying on in Sheffield as a Research Technician with Dr Peter Peachell, studying mast cell-stabilising properties of various asthma medications. This was my first experience of “ proper ” research science, and one which cemented my desire to study for a PhD. On asking my supervisor about where I should look for a PhD focusing on asthma, Southampton was highly recommended and so, in 2009, I applied for an Integrated PhD in Respiratory Biology. I had no idea of the specific projects on offer at the time, but it turned out that there was an MRC-funded project looking at the toxicology of airborne particulate matter air pollution in underground railway stations. The fact that this project was very interdisciplinary, combining airway cell biology with the opportunity to learn state-of-the-art analytical chemistry techniques, supervised by Profs Donna Davies at UHS, and Damon Teagle and Martin Palmer at NOCS, all leaders in their fields, meant that it was an easy choice. The particulate matter was separated into three sizes, depending on the lung depth to which it penetrates. The smallest fraction, termed “ ultrafine ” , had hardly been discussed in the literature, but the high metal content found in our chemical analyses suggested that it may pose a risk to health, and this was borne out by work in the latter part of my PhD. The media attention and interview opportunities resulting from this also gave me some great opportunities for public engagement. Following my PhD in 2013, I spent three years of postdoctoral research in the Brooke Laboratory at UHS, studying cellular responses to cold virus and allergens, and how these affect cell-cell communication in the airways. However, my overriding interest was always air pollution, and I was fortunate to be given leeway, and some funding from the AAIR Charity, to continue studying the effects of underground railway pollution. I was also keen to progress to other pollution sources; one of the least understood of these is shipping, which contributes significantly to pollution in port and coastal cities, such as Southampton. In late 2016 I was lucky enough to be awarded a Future Leader Fellowship from the Biotechnology and Biological Sciences Research Council (BBSRC) to study the biological effects of particulate emissions from ships and a range of dockside sources. This gives me the chance to establish myself as a research leader and to develop collaborations with a range of researchers. The most rewarding aspect is the opportunity to use the science to develop links with various stakeholders in industry and local government, both of which will prove very mutually beneficial and impactful in the coming years. In this regard, it is fortuitous that air pollution seems to be in the public eye at the moment; there has already been coverage from Inside Out and The One Show (BBC1) and an upcoming Channel 4 feature. I also greatly enjoy working in two very different research environments, which gives me different perspectives on how science I done, even if it can sometimes throw up logistical challenges! I hope this is just the start of my work in this area, which is also being pursued by a growing number of researchers elsewhere in Southampton. Hopefully, in years to come, Southampton will be a renowned centre for air pollution research.
Url: /ClinicalResearchinSouthampton/For-researchers/Education-and-training/Careerpathways/Inspirational-career-stories/Matt-Loxham.aspx

Laboratory medicine investigations rev 25

Description: University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a UHSFT Pathology Laboratory Medicine List of Investigations For information on the basis of reference intervals or decision limits, please contact the laboratory Please note multiple requests and cascade requests have a cumulative effect on turnaround times. Please contact the laboratory if an expected result time is required. DEPARTMENT/TEST Section / Area code Units TAT days(working) Special requirements CHEMICAL PATHOLOGY RAPID TURNAROUND – SEND ONLY 6 ML SERUM SEPARATOR GEL (SST BUFF TOP) BLOOD SAMPLE FOR ALL TESTS UNLESS OTHERWISE STATED. FOR PAEDIATRIC/CHILDREN SEND FULL 2 ML PAEDIATRIC LITHIUM HEPARIN BLOOD SAMPLE RENAL PROFILE SODIUM Automated mmol/L <1 POTASSIUM Automated mmol/L <1 CREATININE Automated umol/L <1 BONE PROFILE CALCIUM (actual NOT adjusted) ALBUMIN Automated mmol/L <1 Automated g/L <1 TOTAL PROTEIN Automated g/L <1 LIVER PROFILE ALT Automated iu/L <1 ALBUMIN Automated g/L <1 ALP Automated iu/L <1 BILIRUBIN (TOTAL) Automated umol/L <1 TOTAL PROTEIN Automated g/L <1 Accreditation Status Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Revision 25 Page 1 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a DEPARTMENT/TEST Section / Area code OTHER AUTOMATED LABORATORY TESTS (EXCLUDING URINE TESTS) ACE Automated AFP Automated ALPHA-1 ANTITRYPSIN Automated AMMONIA Automated AMYLASE Automated AST Automated BICARBONATE Automated BILE ACIDS Automated BILIRUBIN - DIRECT Automated BILIRUBIN - NEONATAL Automated CA 125 Automated CA19-9 Automated CARBAMAZEPINE Automated CEA Automated CHLORIDE Automated CHOLESTEROL Automated CK (creatine kinase) CORTISOL (PLASMA) C-REACTIVE PROTEIN (CRP) DIGOXIN Automated Automated Automated Automated ETHANOL (alcohol) FERRITIN Automated Automated Units iu/L ku/L g/L umol/L iu/L iu/L mmol/L umol/L umol/L umol/L ku/L ku/L mgl/L ug/L mmol/L mmol/L iu/L nmol/L mg/L nmol/L mg/100ml ug/L Revision 25 TAT days(working) Special requirements Accreditation Status <1 SST or CLOTTED Accredited <1 Accredited 2 SST Accredited 1 EDTA-SEND IMMEDIATELY Accredited <1 Accredited <1 Accredited <1 Accredited <1 SST Accredited <1 Accredited <1 Accredited 1 SST Accredited 1 SST Accredited <1 Collect trough level Accredited 1 SST Accredited <1 Accredited Accredited <1 <1 1 SST <1 Accredited Accredited Accredited <1 COLLECT AT LEAST 6 HOURS Accredited POST DOSE 7 FLUORIDE/OXALATE Accredited <1 Accredited Page 2 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a DEPARTMENT/TEST FOLATE (PLASMA) FREE T3 FREE T4 FSH GAMMA GT GLUCOSE HAPTOGLOBIN hCG HDL CHOLESTEROL IRON LDH LH LITHIUM MAGNESIUM METHOTREXATE OESTRADIOL OSMOLALITYSERUM/PLASMA PARACETAMOL PHENOBARBITONE PHENYTOIN PHOSPHATE PROGESTERONE PROLACTIN PSA Revision 25 Section / Area code Automated Automated Automated Automated Automated Automated Automated Automated Automated Automated Automated Automated Automated Automated Automated Automated Automated Automated Automated Automated Automated Automated Automated Automated Units ug/L pmol/L pmol/L iu/L iu/L mmol/L g/L iu/L mmol/L umol/L iu/L iu/L TAT days(working) Special requirements <1 <1 <1 <1 <1 <1 FLUORIDE OXALATE <1 SST <1 <1 <1 <1 <1 Accreditation Status Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited mmol/L <1 mmol/L umol/L pmol/L <1 4 hours <1 mOsm/KgH2O <1 mg/L <1 mg/L <1 mg/L <1 mmol/L <1 mmol/L <1 mu/L <1 ug/L <1 SST or CLOTTED. Collect at least Accredited 10 hrs post dose Accredited SST Accredited Accredited Accredited collect trough level collect trough level Accredited Accredited Accredited Accredited Accredited Accredited Accredited Page 3 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a DEPARTMENT/TEST PTH SALICYLATE Section / Area code Automated Automated Units pmol/L mg/L TAT days(working) Special requirements Accreditation Status 2 LI/HEP - SEND TO LAB WITHIN 8 Accredited HOURS <1 Accredited SHBG Automated nmol/L 1 SST Accredited TESTOSTERONE Automated nmol/L <1 SST Accredited THEOPHYLLINE Automated mg/L <1 collect trough level Accredited TRANSFERIN Automated g/L <1 Accredited TRIGLYCERIDES Automated mmol/L <1 Accredited TROPONIN - I TSH Automated ng/L <1 Automated mu/L <1 SST (routine requests) OR BD Rapid Serum tube (Emergency Department Low risk chest pain pathway ONLY) Accredited Accredited URATE (uric acid) Automated umol/L <1 Accredited UREA (nitrogen) Automated mmol/l <1 Accredited VALPROATE Automated mg/L <1 collect trough level Accredited VITAMIN B 12 Automated ng/L <1 Accredited VITAMIN D, 25-OH VITAMIN Automated D (25-OH- (routine method) nmol/L <1 CHOLECALCIFEROL) GENERAL BIOCHEMISTRY TESTS (including urine tests) 17 OH PROGESTERONE - LC-MS BLOOD SPOT nmol/L 11 17 OH PROGESTERONE – LC-MS SERUM nmol/L 5 5 –HIAA Chromatography umol/24 hours5 ACTH Special Biochem ng/l 2 Accredited SST GUTHRIE CARD Not Accredited SST OR HEPARIN Accredited 24h URINE ONLY – PRESERVED Accredited WITH GLACIAL ACETIC ACID EDTA PLASMA TO BE Accredited RECEIVED IN LAB TO BE Revision 25 Page 4 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a DEPARTMENT/TEST Section / Area code Units ACYL CARNITINES (BLOOD LC-MS SPOT) ALBUMIN (URINE) Automated N/A mg/L ALDOSTERONE Special Biochem pmol/L ALK PHOS ISO ENZYMES ALPHA-1 AT PHENOTYPE AMINO ACIDS (CSF) AMINO ACIDS (PLASMA) AMINO ACIDS (URINE) – FOR CYSTINURIA ONLY ANDROSTENEDIONE (SERUM) C-PEPTIDE CAERULOPLASMIN CALCITONIN CALCIUM (URINE) CARBOXYHAEMOGLOBIN Special Biochem qualitative Special Biochem qualitative Chromatography umol/L Chromatography umol/L Chromatography umol/mmol creat Chromatography nmol/L Special Biochem pmol/L Automated mg/L Special Biochem ng/L Automated mmol/spec mmol/spec mmol/mmol crea Critical Care Lab % TAT days(working) Special requirements Accreditation Status SEPARATED AND FROZEN WITHIN 24 HOURS 5 GUTHRIE CARD (from Li Hep plasma Accredited 1 RANDOM URINE Accredited EDTA IF RENIN ALSO REQUIREDAccredited 5 SST OK IF ALDO REQUEST ONLY 10 SST Accredited 10 SST Accredited 5 CSF Accredited 5 LI/HEP or SST Accredited 5 RANDOM URINE Accredited 5 SST Accredited 5 SST OR LI/HEP - SEND TO LAB Accredited WITHIN 2 HOURS 2 SST Accredited 2 FASTING A.M. PLAIN SAMPLE / Accredited SST / Li HEP Accredited 1 24h PREFERRED, CHILDREN RANDOM Whole blood Lithium Heparin – Accredited 1 Send to Main Lab. CHOLINESTERASE PHENOTYPE CITRATE (URINE) Send Away Automated 10 mmol/spec 6 SST or CLOTTED 24h URINE COLLECTION Accredited Accredited Revision 25 Page 5 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a DEPARTMENT/TEST Section / Area code Units TAT days(working) Special requirements Accreditation Status CITRATE (RANDOM URINE) Automated mmol/mmol creat 6 RANDOM URINE Accredited CORTISOL (BLOOD SPOT) Special Biochem nmol/L 10 GUTHRIE CARD Not Accredited CORTISOL (SALIVA) Special Biochem nmol/L 10 SALIVA Accredited CORTISOL (URINE) Special Biochem nmol/spec 5 24h URINE COLLECTION Accredited CREATININE CLEARANCE Automated mL/min 1 24h URINE COLLECTION AND Accredited SST CREATININE (URINE) Automated mmol/L 1 URINE Accredited CREATININE (FLUID) Automated umol/L 1 24h URINE COLLECTION Accredited CICLOSPORIN Automated ug/L 1 EDTA Accredited CYSTINE Chromatography umol/mmol creat 10 URINE Accredited DHEA-SULPHATE Chromatography umol/L 5 SST Accredited DRUG SCREEN Toxicology 7 RANDOM URINE Accredited ELF test (enhanced liver fibrosis) Special Biochem None SST / SERUM ONLY REQUIRES HA, P3NP & TIMP ANALYSIS Accredited ERYTHROPOIETIN (EPO) Special Biochem IU/L 2 SST Accredited FAECAL ELASTASE Special Biochem ug E1/g stool 5 RANDOM FAECES Accredited FAECAL IMMUNOCHEMICAL TESTING (FIT) Special Biochem ug Hb /g Stool 11 FIT sample Collection KIT Accredited GROWTH HORMONE (SERUM) Special Biochem ug /L 2 SST Accredited Special Biochem Lithium heparin plasma or EDTA Accredited plasma. Patients must be fasting Homocysteine umol/l 5 and the sample separated and frozen at -20 C within 30 minutes of collection. Revision 25 Page 6 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a DEPARTMENT/TEST HAEM PIGMENTS Section / Area code Automated Units Abs Unit TAT days(working) Special requirements 4 hours Accreditation Status Accredited HMMA & HVA (neuroblastoma screen in children) Chromatography umol/mmol creat 5 Special Biochem HYALURONIC ACID ug/L 5 Accredited RANDOM URINE - Frozen if sent from an external laboratory. SST ONLY Accredited HYDROXYBUTYRATE IGF-1 INSULIN LACTATE (BLOOD) Toxicology mmol/L 12 Special Biochem nmol/L 2 Special Biochem mu/L 5 Critical Care Lab mmol/L 1 LACTATE (CSF) Critical Care Lab mmol/L 1 MAGNESIUM (URINE) Automated mmol/L 1 METANEPHRINES - URINE Chromatography umol/24 hr (Normetanephrine, Metanephrine and 3- or umol/mmol 5 Methoxytyramine) creatinine METHAEMALBUMIN Automated 2 Critical Care lab METHAEMOGLOBIN % 2 CLOTTED Accredited SST Accredited SST - SEND TO LAB WITHIN 2 Accredited HOURS Lithium heparin or SST – SEND TO Accredited LAB WITHIN 10 MINUTES of venesection. Plain sample only (no Accredited anticoagulant) - SEND TO LAB WITHIN 10 MINUTES of venesection 24 HR URINE COLLECTION: Bottle preserved with 20mL 6M HCl. 24h URINE COLLECTION IN ACETIC ACID (Adults) or RANDOM URINE (Children, for phaeochromocytoma screen only) LI/HEP Accredited Whole blood Lithium Heparin – Accredited Send to Main Lab Accredited Accredited Revision 25 Page 7 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a DEPARTMENT/TEST MICROSCOPY (FAECAL, FAT GLOBULES, PAEDIATRIC) NT-ProBNP ORGANIC ACIDS (URINE) Section / Area code Automated Units Special Biochem ng/L Chromatography OSMOLALITY - URINE OXALATE (TIMED URINE) Automated Automated mosmol/kg (H20) mmol/24h Automated OXALATE (RANDOM URINE) mmol/mmol creat P3NP (Intact N-terminal propeptide of type III collagen) Special Biochem ug/L Chromatography pH (FAECES) pH units pH (URINE) Chromatography pH units PHENYLALANINE (BLOODSPOT) Send Away µmol/L Chromatography PLASMA METANEPHRINES pmol/L PORPHOBILINOGEN PORPHYRIN (URINE) PROTEIN CREATININE RATIO (URINE) Automated Send Away Automated qualitative nmol/L g/L TAT days(working) Special requirements 3 FRESH FAECES Accreditation Status Accredited 2 MUST BE Lithium Heparin Plasma Accredited 5 RANDOM URINE, FRESH Accredited 1 RANDOM URINE Accredited 6 24h URINE COLLECTION Accredited 6 RANDOM URINE Accredited 5 SST ONLY Accredited A MINIMUM 1g OF FAECES.W Accredited HICH MUST REACH THE 5 LABORATORY AND BE HANDED DIRECTLY TO A MEMBER OF STAFF WITHIN 1 HOUR OF COLLECTION. 1 FRESH SAMPLE REQUIRED Accredited 2 MONITORING KNOWN CASES Accredited OF PHENYLKETONURIA ONLY Send immediately. Samples to be Accredited 5 separated and frozen within 30 minutes of collection. 1 RANDOM URINE, FRESH PROTECT FROM LIGHT Accredited 1 EARLY MORNING URINE Accredited Accredited Revision 25 Page 8 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a DEPARTMENT/TEST PROTEIN (URINE) PROTEIN (CSF) RENIN SOMATOMEDIN C (IGF-1) STONE ANALYSIS SWEAT CHLORIDE Section / Area code Units Automated mg/L Automated mg/L Special Biochem mU/L Special Biochem nmol/L Special Biochem Trace Elements mmol/L SOLUBLE TRANSFERIN RECEPTOR TACROLIMUS TIMP-1 (Tissue inhibitor of matrix metalloproteinase-1) THYROGLOBULIN THYROGLOBULIN ANTIBODIES TYROSINE (BLOODSPOT) nmol/L Send Away ug/L Special Biochem µg/L Special Biochem ug/L Special Biochem KU/L Chromatography µmol/L VITAMIN A Chromatography μmol/L Chromatography VITAMIN E μmol/L POINT OF CARE TESTS Revision 25 TAT days(working) Special requirements 1 RANDOM URINE 1 CSF IN PLAIN CONTAINER 5 EDTA, SEP, FREEZE WITHIN 30 MINS 1 SST Accreditation Status Accredited Accredited Accredited Accredited 10 RENAL CALCULUS Accredited Accredited 2 WESCOR MACRODUCT 30 EDTA Accredited 4 Accredited SST ONLY Accredited 5 ONLY available as part of ELF test 2 SST Accredited 2 SST Accredited MONITORING KNOWN CASES Accredited 3 OF PHENYLKETONURIA OR TYROSINAEMIA ONLY 5 SST Accredited SST - Vitamin E concentration is Accredited affected by plasma lipids. Vitamin E 5 to total cholesterol ratio is a better indicator of status (Adult ref: 1.3- 16.2 umol/mmol) Page 9 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a DEPARTMENT/TEST Section / Area code Units TAT days(working) Special requirements Accreditation Status BLOOD GAS (Arterial, VenousPOCT or Capillary whole blood) N/A 1 Heparinised syringe on blood gas analyser. Whole blood Lithium Heparin – CARBOXYHAEMOGLOBIN POCT % Saturation 1 SEND TO LAB or Heparinised syringe on blood-gas analyser. Lithium heparin or SST – SEND TO LACTATE (BLOOD) mmol/L 1 LAB WITHIN 10 MINUTES of venesection or Heparinised syringe POCT on blood-gas analyser Plain sample only (no LACTATE (CSF) POCT mmol/L 1 anticoagulant) - SEND TO LAB WITHIN 10 MINUTES of venesection METHAEMOGLOBIN POCT % 2 Whole blood Lithium Heparin – SEND TO LAB or Heparinised syringe on blood-gas analyser. TRACE ELEMENT LABORATORY TESTS Trace Elements 6ml Greiner Trace Element Na Hep Accredited ALUMINIUM umol/L 5 tube (Royal blue top) ANTIMONY (BLOOD) ANTIMONY (URINE) ARSENIC (BLOOD) Trace Elements 5 Trace Elements 5 Trace Elements umol/L 5 Adults: 6ml Greiner Trace Element Accredited Na Hep tube (Royal blue top) Paed: 2ml Teklab Hep TE tube Accredited 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection Lithium heparin, sodium heparin or Accredited EDTA Revision 25 Page 10 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a DEPARTMENT/TEST ARSENIC (URINE) BARIUM BERYLLIUM (URINE) BISMUTH (BLOOD) BISMUTH (URINE) BORON (PLASMA) BORON (URINE) CADMIUM (BLOOD) CADMIUM (URINE) CHROMIUM (BLOOD) CHROMIUM (PLASMA) CHROMIUM (URINE) COBALT (BLOOD) COBALT (PLASMA) COBALT (URINE) Revision 25 Section / Area code Units Trace Elements Trace Elements nmol/L Trace Elements nmol/L Trace Elements nmol/L Trace Elements Trace Elements umol/L Trace Elements Trace Elements nmol/L Trace Elements Trace Elements nmo/L Trace Elements nmo/L Trace Elements Trace Elements nmol/L Trace Elements nmol/L Trace Elements TAT days(working) Special requirements Accreditation Status 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection 5 6ml Greiner Trace Element Na Hep Accredited tube (Royal blue top) 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection 5 Lithium heparin or EDTA Accredited 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection 5 6ml Greiner Trace Element Na Hep Accredited tube (Royal blue top) 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection 5 Lithium heparin, sodium heparin or Accredited EDTA 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection 5 6ml Greiner Trace Element Na Hep Accredited tube (Royal blue top) 5 6ml Greiner Trace Element Na Hep Accredited tube (Royal blue top) 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection 5 6ml Greiner Trace Element Na Hep Accredited tube (Royal blue top) 5 6ml Greiner Trace Element Na Hep Accredited tube (Royal blue top) 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection Page 11 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a DEPARTMENT/TEST COPPER (PLASMA) COPPER (URINE) GOLD (PLASMA) GOLD (URINE) IODINE (URINE) IRON (URINE) LEAD (BLOOD) LEAD (URINE) MANGANESE (BLOOD) MERCURY (BLOOD) MERCURY (URINE) MOLYBDENUM (PLASMA) Section / Area code Units Trace Elements umol/L Trace Elements umol/24hr Trace Elements umol/L Trace Elements Trace Elements umol/L Trace Elements umol/24 hr Trace Elements umol/L Trace Elements nmol/mmol creatinine Trace Elements nmol/L Trace Elements nmol/L Trace Elements nmol/mmol creatinine Trace Elements nmo/L TAT days(working) Special requirements Accreditation Status Adults: 6ml Greiner Trace Element Accredited Na Hep tube (Royal blue top) 4 Accredited Paed: 2ml Teklab Hep TE tube 24 hour collection in a 2.5 litre Accredited 5 container with no preservative added. 5 6ml Greiner Trace Element Na Hep Accredited tube (Royal blue top) 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection 24 hour collection in a 2.5 litre Accredited 5 container with no preservative added. 5 Lithium heparin, sodium heparin or Accredited EDTA 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection Adults: 6ml Greiner Trace Element Accredited Na Hep tube (Royal blue top) 5 Paed: 2ml Teklab Hep TE tube Accredited 5 Lithium heparin, sodium heparin or Accredited EDTA 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection 5 2ml Teklab Li Hep Trace Element Accredited tube Revision 25 Page 12 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a DEPARTMENT/TEST MOLYBDENUM (BLOOD) Section / Area code Units Trace Elements nmo/L NICKEL (PLASMA) Trace Elements nmol/L NICKEL (URINE) Trace Elements PLATINUM (BLOOD) Trace Elements nmol/L PLATINUM (URINE) Trace Elements Trace Elements RELATIVE EXCHANGABLE COPPER (PLASMA) % SELENIUM (PLASMA) Trace Elements umol/L SELENIUM (URINE) SILVER (BLOOD) SILVER (URINE) STRONTIUM (PLASMA) THALLIUM (BLOOD) THALLIUM (URINE) Revision 25 Trace Elements Trace Elements nmol/L Trace Elements Trace Elements umol/L Trace Elements nmol/L Trace Elements TAT days(working) Special requirements Accreditation Status 5 6ml Greiner Trace Element Na Hep Accredited tube (Royal blue top) 5 6ml Greiner Trace Element Na Hep Accredited tube (Royal blue top) 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection 5 Lithium heparin, sodium heparin or Accredited EDTA 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection Adults: 6ml Greiner Trace Element Accredited 4 Na Hep tube (Royal blue top) Paed: 2ml Teklab Hep TE tube Send immediately Adults:6ml Greiner Trace Element Accredited Na Hep tube (Royal blue top) 5 Paed: 2ml Teklab Hep TE tube Accredited 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection 5 Lithium heparin, sodium heparin or Accredited EDTA 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection 5 6ml Greiner Trace Element Na Hep Accredited tube (Royal blue top) 5 Lithium heparin, sodium heparin or Accredited EDTA 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection Page 13 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a DEPARTMENT/TEST TIN (PLASMA) TIN (URINE) TITANIUM (PLASMA) TITANIUM (URINE) VANADIUM (URINE) URANIUM (URINE) ZINC (PLASMA) Section / Area code Units Trace Elements umol/L Trace Elements Trace Elements nmol/L Trace Elements Trace Elements nmol/L Trace Elements pmol/L Trace Elements µmol/l Trace Elements TOXIC METALS SCREEN (BLOOD) Trace Elements TOXIC METALS SCREEN (URINE) Revision 25 TAT days(working) Special requirements Accreditation Status 5 6ml Greiner Trace Element Na Hep Accredited tube (Royal blue top) 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection 5 6ml Greiner Trace Element Na Hep Accredited tube (Royal blue top) 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection 5 20ml ‘Sterilin’ Universal container, Accredited or 24hr collection Adults: 6ml Greiner Trace Element Accredited 4 Na Hep tube (Royal blue top) Accredited Paed: 2ml Teklab Hep TE tube 6ml Greiner Trace Element Na Hep Accredited tube (Royal blue top) Please send with paired random 2 urine sample. Blood sample is primary sample required for TMS analysis. Urine will only be tested if required. 20ml ‘Sterilin’ Universal container Accredited Please send with paired whole blood sample. Blood sample is 2 primary sample required for TMS analysis. Urine will not be tested unless received with a blood sample. Page 14 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a DEPARTMENT/TEST HAEMATOLOGY ESR FULL BLOOD COUNT – INCLUDING: HAEMOGLOBIN WBC - WHITE CELL COUNT RBC - RED CELL COUNT PLATELETS PCV MCV MCH MCHC NEUTROPHILS LYMPHOCYTES EOSINOPHILS BASOPHILS MONOCYTES BLOOD FILM G6PD SCREEN PYRUVATE KINASE Units TAT Special Lab sample days(working) requirements storage time mm/1st hour <1 <1 g/L x10^9/L x10^12/L x10^9/L L/L fl pg g/L x10^9/L x10^9/L x10^9/L x10^9/L x10^9/L Normal/deficient 2 Normal/deficient 30 2mL EDTA. 36-48 hours Please ensure maximum fill EDTA 36-48 hours 1 week EDTA 3 days Sent away to KingsPath Accreditation Status Accredited Accredited Accredited Accredited Accredited Revision 25 Page 15 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE IM SCREEN Pos/Neg 1 EDTA 36-48 hours MALARIAL SCREEN Pos/Neg <1 EDTA 36-48 hours ABSOLUTE RETICULOCYTES x10^9/L <1 EDTA 36-48 hours SICKLE SCREEN Pos/Neg <1 EDTA 3 days CSF CYTOSPIN HBA1c Cells present/absent <1 mmol/mol 2 CSF EDTA 1 week 36-48 hours HAEMOSTASIS (1 x 2.7 ml citrate (blue top) bottle required unless otherwise indicated) HEPARIN (ANTI-Xa ASSAY) for monitoring LMW Heparin Anti Xa assay for Rivaroxaban Anti Xa assay for Apixaban See report 2 Anti Xa assay for Edoxaban 1 day Deliver straight to lab Accredited Accredited Accredited Accredited Accredited Accredited Accredited Dilute Thrombin Time assay for Dabigatran D-DIMER ASSAY ugFEU/ml <1 FACTOR X ASSAY u/dL 30 FACTOR XI ASSAY u/dL 30 FACTOR XII ASSAY u/dL 30 FACTOR II ASSAY u/dL 30 FACTOR V ASSAY u/dL 30 FACTOR VII ASSAY u/dL 30 FACTOR VIII ASSAY u/dL 7 Accredited Needs to be Accredited delivered Accredited directly to the coagulation laboratory Stored for up to 6 months in -70oC Freezer Accredited Accredited within 30 Accredited minutes of Accredited venesection Accredited G3.7a Revision 25 Page 16 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE FACTOR VIII INHIBITOR Bethesda 30 FACTOR IX ASSAY u/dL 30 FACTOR XIII SCREEN 30 HEPARIN (APTR) Ratio <1 HEPARIN-INDUCED (HIT) SCREEN THROMBOCYTOPENIA Pos/Neg 1 ACTIVATED PARTIAL THROMBOPLASTIN RATIO (APTR) ratio <1 INR - INTERNATIONAL NORMALISED RATIO ratio <1 FIBRINOGEN (DERIVED) g/L <1 LUPUS ANTICOAGULANT Pos/Neg 2 WARFARIN (INR) Ratio <1 Revision 25 G3.7a Accredited Needs to be delivered Stored for up to 6 directly to the months in -70oC coagulation Freezer laboratory within 30 minutes of venesection Accredited 2 x 2.7ml citrate 6mL Plain clotted 2 x 2.7 ml citrate 1 day 1 day 1 day 1 day 1 day 1 day 1 day Accredited Accredited Accredited Accredited Accredited Not Accredited Accredited Accredited Page 17 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE THROMBOPHILLIA SCREEN must be authorised by Haematology medic Includes; Clotting screen, APCR, Protein C &S, Antithrombin, Thrombin Time See individual tests 30 ANTITHROMBIN IU/dL 30 PROTEIN C IU/dL 30 1 x EDTA, Accredited 4 x citrate Stored for up to 6 Needs to be months in -70oC delivered Freezer directly to the coagulation laboratory within 30 minutes of venesection 1 x citrate Stored for up to 6 Accredited Needs to be months in -70oC delivered Freezer directly to the coagulation laboratory within 30 minutes of venesection 1 x citrate Stored for up to 6 Accredited Needs to be months in -70oC delivered Freezer directly to the coagulation laboratory within 30 minutes of venesection G3.7a Revision 25 Page 18 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE PROTEIN S IU/dL 30 THROMBIN TIME Ratio 30 THROMBOELASTOGRAPH (TEG) 1 VON WILLEBRAND SCREEN Includes; clotting screen, Factor CBA & RiCof if indicated VIII, VWF Ag, See individual tests 30 Revision 25 1 x citrate Stored for up to 6 Accredited Needs to be months in -70oC delivered Freezer directly to the coagulation laboratory within 30 minutes of venesection Stored for up to 6 Accredited 1 x citrate months in -70oC Freezer 2 x citrate Stored for up to 6 Accredited Needs to be months in -70oC delivered Freezer directly to the coagulation laboratory within 30 minutes of venesection 4 x citrate Stored for up to 6 Accredited Needs to be months in -70oC delivered Freezer directly to the coagulation laboratory within 30 minutes of venesection G3.7a Page 19 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE VON WILLEBRAND ANTIGEN IU/dL 30 ADAMTS13 (also known as von Willebrand Cleavage Protease) % (IU/dL) 1 COLLAGEN BINDING ASSAY (CBA) IU/dL 30 1 x citrate Stored for up to 6 Accredited Needs to be months in -70oC delivered Freezer directly to the coagulation laboratory within 30 minutes of venesection 1 x citrate Accredited Needs to be delivered directly to the coagulation laboratory within 30 minutes of venesection 1 x citrate Stored for up to 6 Accredited Needs to be months in -70oC delivered Freezer directly to the coagulation laboratory within 30 minutes of venesection G3.7a Revision 25 Page 20 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a RISTOCETIN CO-FACTOR ASSAY (RICOF) IU/dL PFA-200 seconds Platelet Aggregation Screen DEPARTMENT/TEST Units BLOOD TRANSFUSION Units ANTIBODY SCREEN (AUTOMATED) BLOOD GROUP (AUTOMATED) AUTOMATED GROUP & SCREEN Revision 25 30 1 1 TAT days(working) TAT days(working) 1 1 1 1 x citrate Stored for up to 6 Accredited Needs to be months in -70oC delivered Freezer directly to the coagulation laboratory within 30 minutes of venesection 2 x citrate Stored for up to 6 Accredited Needs to be months in -70oC delivered Freezer directly to the coagulation laboratory within 30 minutes of venesection Must be by prior arrangement with laboratory 4xcitrate samples must be delivered straight to lab Accredited Special Lab sample requirements storage time Accreditation Status Special requirements 6mL EDTA 10 days Accredited 6mL EDTA 10 days Accredited 6mL EDTA 10 days Accredited Page 21 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a FMH ml GROUP AND DIRECT ANTIGLOBULIN TEST (DAT) CROSS MATCH DIRECT ANTIGLOBULIN TEST (DAT) Foetal Maternal Haemorrhage Estimation (FMH) INVESTIGATION OF TRANSFUSION REACTIONS ANTI-A/ANTI-B TITRES Revision 25 3 or 6 ml EDTA TUBE Cord sample: 10 days 6mL EDTA 1 Neonatal sample: 0.5mL 6mL EDTA 10 days Based on clinical need. If atypical antibodies requires 1-2 working days 1 2 To be received in advance of blood requirement complying with BCSH sample validity guidelines 6mL EDTA 6mL EDTA 10 days 10 days See Transfusion Record for details 10 days Variable 2 To be sent upon discussion with laboratory ASAP after suspected reaction 6mL EDTA 10 days Accredited Accredited Accredited Accredited Accredited Accredited Page 22 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE ANTENATAL ANTIBODY TITRE OR QUANTITATION 10 6mL EDTA ANTIBODY INVESTIGATION & EXTENDED PHENOTYPING 1 6mL EDTA CELL FREE FOETAL DNA TESTING 16 6ml EDTA ALL TESTS LISTED BELOW MUST BE AUTHORISED BY A HAEMATOLOGY MEDIC HEPARIN-INDUCED THROMBOCYTOPENIA (HIT) ELISA (Confirmatory test) 1 6mL Plain clotted HLA ANTIBODY SCREEN HLA CLASS 1 TYPING FOR PLATELET REFACTIVENESS 13 10mL Plain clotted 2 x 6mL 13 EDTA 10mL Plain clotted PLATELET ANTIBODIES (AUTO OR ALLO) 3 x 6mL EDTA 10mL Plain clotted 10 If drug- related, a sample of drug is required Referred Accredited 10 days Accredited testing carried out if antibody screen is positive Referred Accredited 10 days Accredited Referred Referred Accredited Accredited Referred Accredited G3.7a Revision 25 Page 23 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE FOETAL/NEONATAL ALLO-IMMUNE THROMBOCYTOPENIA 10 NEONATAL ALLO-IMMUNE NEUTROPENIA 30 NEUTROPHIL/GRANULOCYTE ANTIBODIES 30 DONATH LANDSTEINER 10 Revision 25 Maternal: 6mLReferred EDTA 10mL Plain clotted Paternal: 6mL EDTA Neonatal: 1mL EDTA Maternal: 6mLReferred EDTA 10mL Plain clotted Paternal: 6mL EDTA Neonatal: 1mL EDTA 10mL Plain Referred clotted 6mL Plain clotted plus 6mL EDTA To be arranged with Lab for transport at 37’c. Must arrive within 30 minutes of venesection at 37’c Accredited Accredited Accredited Accredited G3.7a Page 24 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a HERIDATRY SPHEROCYTOSIS (EMA BINDING) 3ml EDTA Referred Accredited 7 To be sent mon-wed only with required blood film DEPARTMENT/TEST Units TAT Special days(working) requirements IMMUNOLOGY 6 ML SERUM SEPARATOR GEL (SST BUFF TOP) BLOOD SAMPLE FOR ALL TESTS UNLESS OTHERWISE STATED ACETYL CHOLINE RECEPTOR ANTIBODY nmol/L 20 Sent away if results are borderline ADRENAL ANTIBODIES Pos/Neg 15 ACLA (ANTI CARDIOLIPIN ABS) u/mL 10 B2GP1 reflex tested if pos ALLERGEN SPECIFIC IGE (RAST) kUA/L 5 ANA (see CONNECTIVE TISSUE ANA SCREEN) ANCA (ANTINEUTROPHIL ANTIBODY) CYTOPLASMIC Pos/Neg 5 ANTI COLLAGEN TYPE 2 (send away) Pos/Neg 20 ANTI CHOLINESTERASE (send away) Pos/Neg 20 AMYLOID –A (send away) Pos/Neg 20 ANTI C1Q (send away) Pos/Neg 20 ANTI-GLUTAMIC DECARBOXYLASE U/mL 20 ANTI-IGA (send away) Pos/Neg 20 ASPERGILLUS PRECIPITINS mg/L 10 AVIAN PRECIPITINS mg/L 10 Lab Storage time Accreditation Status Accredited Accredited Accredited Not Accredited Accredited Not Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Revision 25 Page 25 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE BENCE JONES PROTEIN present/absent 10 BETA 2 MICROGLOBULIN mg/L 5 BETA 2 GLYCOPROTEIN u/mL 15 C1 ESTERASE INHIBITOR (ANTIGENIC) g/L 10 C1 ESTERASE INHIBITOR (FUNCTIONAL) % 20 C3 NEPHRITIC FACTOR (sent away) Pos/Neg 20 CALPROTECTIN ug/g 15 CARDIAC MUSCLE ANTIBODY (send away) Pos/Neg 20 CARTILAGE AUTOANTIBODY (send away) Pos/Neg 20 CENTROMERE ANTIBODIES Pos/Neg 5 CCP ANTIBODY u/mL 5 COMPLEMENT C3/C4 g/L 5 SPECIALIST COMPLEMENT COMPONENTS (Send away) 20 COMPLEMENT PATHWAY FUNCTION CH50 % 20 ALTERNATIVE AP50 COMPLEMENT PATHWAY % 20 Revision 25 10 ML URINE (MSU) SAMPLE NEEDS FREEZING WITHIN 6 HOURS Only sent away for testing if C4 is normal range and C3 is below normal FAECAL SAMPLE SAMPLE NEEDS FREEZING WITHIN 6 HOURS SAMPLE NEEDS FREEZING WITHIN 6 HOURS SAMPLE NEEDS G3.7a Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Not Accredited Accredited Page 26 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE ALTERNATIVE FACTOR H COMPLEMENT PATHWAY mg/L 20 CONNECTIVE TISSUE ANA SCREEN Pos/Neg 5 COMPONENT RESOLVED DIAGNOSIS interpretive 25 CRYOGLOBULIN pos.neg 10 DNA ANTIBODIES IU/mL 5 ENA ANTIBODY SCREEN Pos/Neg 5 ENA ANTIBODY PROFILE Pos/Neg 5 ENA EXTENDED SCREEN Pos/Neg 15 EXTENDED LIVER AUTOANTIBODY BLOT Pos/Neg 10 ENDOMYSIAL ANTIBODIES Pos/Neg 15 FARMERS LUNG PRECIPITINS mg/L 10 FREE LIGHT CHAINS/LIGHT CHAIN RATIO mg/l 20 GANGLIOSIDE AUTO ANTIBODY Pos/Neg 20 GLOMERULAR BASEMENT MEMBRANE ANTIBODY U/mL 5 HEP2 SCREEN interpretive 10 HISTONE AUTOANTIBODY U/mL 20 HIB FUNCTIONAL ANTIBODYS mg/L 15 IMMUNOGLOBULINS + SERUM ELECTROPHORESIS g/L 5 IMMUNOGLOGULIN E (TOTAL) ku/L 5 IMMUNOGLOBULIN G SUBCLASSES g/L 20 IMMUNOGLOBULIN A –LOW CONCENTRATION g/L 20 Revision 25 FREEZING WITHIN 6 HOURS SPECIALIST REQUEST, IMM CONSULTANTS ONLY MUST BE KEPT AT 37C PRIOR TO SEP’N REFLEX TEST REFLEX TEST G3.7a Accredited Accredited Accredited Not Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Page 27 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE IMMUNOFIXATION INTRINSIC FACTOR ANTIBODIES KAPPA INDEX (CSFAND SERUM) LIVER AUTOANTIBODY SCREEN interpretive report 10 U/ml 10 mg/L and Index 15 Pos/Neg 5 MAST CELL TRYPTASE u/ml 10 MITOCHONDRIAL (M2) ANTIBODIES u/ml 10 MYELOPEROXIDASE (MPO) ANTIBODIES u/ml 5 MUSCLE SPECIFIC KINASE AUTOANTIBODY (send away) Pos/Neg 20 MYELIN ASSOCIATED GLYCOPROTEIN (send away) BTU 20 MYOSITIS Pos/Neg 20 NMDA Pos/Neg 20 NUCLEOSOME AUTOANTIBODY U/mL 20 OLIGOCLONAL BANDS interpretive result 10 OVARIAN AUTOANTIBODY Pos/Neg 20 PARATHYROID AUTOANTIBODY (send away) Pos/Neg 20 PEMPHIGOID/PEMPHIGUS (SKIN) ANTIBODIES Pos/Neg 10 PNEUMOCOCCAL (functional antibodies) mg/ml 15 PREVNAR SEROTYPES 20 PROTEINASE 3 (PR3) ANTIBODIES u/ml 5 Revision 25 REFLEX TEST Paired CSF and Serum samples required 2 samples req’d. 1st at event, 2nd 24hrs post event SEND AWAY REFLEX TEST Paired serum/CSF sample required SEND AWAY G3.7a Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Page 28 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE PURKINJE ) CELL AUTOANTIBODY (Hu,Yo Pos/Neg 15 PARANEOPLASTIC AUTOANTIBODIES Pos/Neg 25 RHEUMATOID FACTOR QUANTITATION iu/mL 5 SCANNED MONOCLONAL COMPONENT g/L 5 SCLERODERMA Pos/Neg 20 SKELETAL MUSCLE ANTIBODIES Pos/Neg 10 TETANUS ANTIBODIES iu/ml 10 THYROID PEROXIDASE ANTIBODIES u/ml 5 TISSUE TRANSGLUTAMINASE ANTIBODIES IgA u/ml 5 TISSUE TRANSGLUTAMINASE ANTIBODIES IgG u/ml 5 VGCC ANTIBODIES pmol/L 20 VGKC ANTIBODIES pmol/L 20 Total protein essential SEND AWAY SEND AWAY Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited Accredited G3.7a Revision 25 Page 29 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE G3.7a DEPARTMENT/TEST Units FLOW CYTOMETRY TAT Special Lab Storage time Accreditation Status days(working) requirements LEUKAEMIA/LYMPHOMA SCREEN interpretive report Lymphocyte Subsets (T, B and NK Subsets) Interpretive comment Neutrophil Oxidative Burst Interpretive comment PNH Screen Interpretive comment Neutrophil Phagocytosis Interpretive comment T cell receptor (TCR) repertoire (TCR V) EDTA 4.5 mL or Bone Marrow, <72 5 hrs old Monday – Friday 12:00 pm EDTA 4.5 ml, <72 10 hrs old Monday – Friday 12:00 pm Lithium Heparin 3ml <48 hrs old 5 Monday – Wednesday By appointment only EDTA 4.5 ml, <72 5 hrs old Monday – Friday 12:00 pm Lithium Heparin 3ml <48 hrs old 5 Monday – Wednesday By appointment only EDTA 4.5 ml, <72 4 hrs old Monday – Friday 12:00 pm Not Accredited Revision 25 Page 30 of 31 University Hospital Southampton NHS Foundation Trust LABORATORY MEDICINE Memory B cell subsets (CVID) Memory T cell Subsets Hairy Cell Leukaemia Screen T Cell Subsets (CD4 count) Therapeutic Antibody Evaluation Rituximab (Rituxan) (CD20) % B memory Subsets % T memory Subsets interpretive report % & Abs count B cells % & Abs Count EDTA 4.5 ml, <72 10 hrs old Monday – Friday 12:00 pm EDTA 4.5 ml, <72 10 hrs old Monday – Friday 12:00 pm EDTA 4.5 ml, <72 5 hrs old Monday – Friday 12:00 pm EDTA 4.5, <72 hrs old 5 Send FBC result. Monday – Friday 12:00 pm EDTA 4.5, <72 hrs 5 old Monday – Friday 12:00 pm • Test turnaround times defined by National Test directory at NHSE G3.7a Revision 25 Page 31 of 31
Url: /Media/UHS-website-2019/Docs/Services/Pathology/Lab-med/Laboratory-medicine-investigations.pdf

Papers Trust Board - 13 May 2025

Description: Agenda Trust Board – Open Session Date Time Location Chair Apologies In attendance 13/05/2025 9:00 - 13:00 Conference Room, Heartbeat Education Centre Jenni Douglas-Todd Keith Evans, Alison Tattersall Helena Blake, Head of Clinical Quality Assurance (shadowing Gail Byrne) Raquel Domene Luque, Interim Lead Matron, Ophthalmology (shadowing Gail Byrne) 1 Chair’s Welcome, Apologies and Declarations of Interest 9:00 Note apologies for absence, and to hear any declarations of interest relating to any item on the Agenda. 2 Patient Story (This item has been postponed until the next meeting) The patient 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 11 March 2025 Approve the minutes of the previous meeting held on 11 March 2025 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 Audit and Risk Committee 9:10 Keith Evans, Chair 5.2 Briefing from the Chair of the Finance and Investment Committee 9:15 Dave Bennett, Chair 5.3 Briefing from the Chair of the People and Organisational Development 9:20 Committee Jane Harwood, Chair 5.4 Briefing from the Chair of the Quality Committee 9:25 Tim Peachey, Chair including Maternity and Neonatal Safety 2024-25 Quarter 3 Report 5.5 9:30 5.6 10:00 5.7 10:40 5.8 10:55 5.9 11:05 5.10 11:10 5.11 11:20 5.12 11:30 5.13 11:40 6 6.1 11:50 Chief Executive Officer's Report Receive and note the report Sponsor: David French, Chief Executive Officer Performance KPI Report for Month 12 Review and discuss the report Sponsor: David French, Chief Executive Officer Break Finance Report for Month 12 Review and discuss the report Sponsor: Ian Howard, Chief Financial Officer ICS Finance Report for Month 12 Receive and discuss the report Sponsor: Ian Howard, Chief Financial Officer People Report for Month 12 Review and discuss the report Sponsor: Steve Harris, Chief People Officer UHS Annual Staff Survey Results 2024 Report Discuss and note the report Sponsor: Steve Harris, Chief People Officer Attendees: Ceri Connor, Director of OD and Inclusion/Sophie Limb, HR Project Manager Guardian of Safe Working Hours Quarterly Report Receive and discuss the report Sponsor: Paul Grundy, Chief Medical Officer Attendee: Diana Hulbert, Guardian of Safe Working Hours and Emergency Department Consultant Learning from Deaths 2024-25 Quarter 3 and 4 Reports Review and discuss the reports Sponsor: Paul Grundy, Chief Medical Officer Attendee: Jenny Milner, Associate Director of Patient Experience STRATEGY and BUSINESS PLANNING Corporate Objectives 2024-25 Quarter 4 Review Review and feedback on the corporate objectives Sponsor: David French, Chief Executive Officer Attendees: Martin De Sousa, Director of Strategy and Partnerships/Kelly Kent, Head of Strategy and Partnerships Page 2 6.2 Board Assurance Framework (BAF) Update 12:00 Review and discuss the update Sponsor: Gail Byrne, Chief Nursing Officer Attendees: Craig Machell, Associate Director of Corporate Affairs and Company Secretary/Lauren Anderson, Corporate Governance and Risk Manager 6.3 South Central Regional Research Delivery Network (SC RRDN) 2024-25 12:10 Annual Performance Review and 2025-26 Annual Plan Receive and note the annual report and plan Sponsor: Paul Grundy, Chief Medical Officer Attendee: Clare Rook, Chief Operating Officer, CRN: Wessex 7 CORPORATE GOVERNANCE, RISK and INTERNAL CONTROL 7.1 Feedback from the Council of Governors' (CoG) meeting 29 April 2025 12:25 (Oral) Sponsor: Jenni Douglas-Todd, Trust Chair 7.2 Register of Seals and Chair's Actions Report 12:30 Receive and ratify In compliance with the Trust Standing Orders, Financial Instructions, and the Scheme of Reservation and Delegation. Sponsor: Jenni Douglas-Todd, Trust Chair 8 Any other business 12:35 Raise any relevant or urgent matters that are not on the agenda 9 Note the date of the next meeting: 15 July 2025 10 Resolution regarding the Press, Public and Others Sponsor: Jenni Douglas-Todd, Trust 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 12:40 Page 3 Agenda links to the Board Assurance Framework (BAF) 13 May 2025 – Open Session Overview of the BAF Risk 1a: Lack of capacity to appropriately respond to emergency demand, manage the increasing waiting lists for elective demand, and provide timely diagnostics, that results in avoidable harm to patients. 1b: Due to the current challenges, we fail to provide patients and their families / carers with a high-quality experience of care and positive patient outcomes. 1c: We do not effectively plan for and implement infection prevention and control measures that reduce the number of hospital-acquired infections and limit the number of nosocomial outbreaks of infection. 2a: We do not take full advantage of our position as a leading University teaching hospital with a growing, reputable, and innovative research and development portfolio, attracting the best staff and efficiently delivering the best possible treatments and care for our patients. 3a: We are unable to meet current and planned service requirements due to the unavailability of staff to fulfil key roles. 3b: We fail to develop a diverse, compassionate, and inclusive workforce, providing a more positive staff experience for all staff. 3c: We fail to create a sustainable and innovative education and development response to meet the current and future workforce needs identified in the Trust’s longer-term workforce plan. 4a: We do not implement effective models to deliver integrated and networked care, resulting in sub-optimal patient experience and outcomes, increased numbers of admissions and increases in patients’ length of stay. 5a: We are unable to deliver a financial breakeven position, resulting in: inability to move out of the NHS England Recovery Support Programme, NHS England imposing additional controls/undertakings, and a reducing cash balance impacting the Trust’s ability to invest in line with its capital plan, estates/digital strategies, and in transformation initiatives. 5b: We do not adequately maintain, improve and develop our estate to deliver our clinical services and increase capacity. 5c: Our digital technology or infrastructure fails to the extent that it impacts our ability to deliver care effectively and safely within the organisation, 5d: We fail to prioritise green initiatives to deliver a trajectory that will reduce our direct and indirect carbon footprint by 80% by 2028-2032 (compared with a 1990 baseline) and reach net zero direct carbon emissions by 2040 and net zero indirect carbon emissions by 2045. Agenda links to the BAF No Item Linked BAF risk(s) 5.6 Performance KPI Report for Month 12 5.8 Finance Report for Month 12 5.9 ICS Finance Report for Month 12 5.10 People Report for Month 12 5.11 UHS Staff Survey Results 2024 Report 5.12 Guardian of Safe Working Hours Quarter 3 Report 6.1 Corporate Objectives 2024-5 Quarter 3 Review 6.3 South Central Regional Research Delivery Network Annual Performance Review and 2025-26 Annual Plan 1a, 1b, 1c 5a 5a 3a, 3b, 3c 3b 3b, 3c All 1b, 2a Appetite (Category) Minimal (Safety) Current risk rating 4x5 20 Cautious (Experience) Minimal (Safety) 3x3 9 4x4 16 Open (Technology & Innovation) 3x3 9 Open (workforce) Open (workforce) Open (workforce) 4x5 20 4x3 12 4x4 16 Cautious (Effectiveness) 3x3 9 Cautious (Finance) 4x5 20 Target risk rating 4 x 2 Apr 6 27 3 x 2 Mar 6 26 2 x 3 Apr 6 27 3 x 2 Dec 6 25 4 x 3 Mar 12 26 4 x 2 Mar 8 27 3 x 2 Mar 6 29 3 x 2 Dec 6 25 3 x 3 Apr 9 30 Cautious (Effectiveness) Open (Technology & Innovation) Open (Technology & Innovation) 4x5 20 3x4 12 2x3 6 4 x 2 Apr 8 30 3 x 2 Apr 6 27 2 x 2 Dec 4 27 Does this item facilitate movement towards or away from the intended target risk score and appetite? Towards Away Neither X X X X X X X X Minutes Trust Board – Open Session Date Time 11/03/2025 9:00 – 13:00 Location Chair Conference Room, Heartbeat/Microsoft Teams Jenni Douglas-Todd (JD-T) Present Dave Bennett, NED (DB) Gail Byrne, Chief Nursing Officer (GB) Jenni Douglas-Todd, Chair (JD-T) Diana Eccles, NED (DE) Keith Evans, Deputy Chair and NED (KE) David French, Chief Executive Officer (DAF) Paul Grundy, Chief Medical Officer (PG) Steve Harris, Chief People Officer (SH) Jane Harwood, NED/Senior Independent Director (JH) Ian Howard, Chief Financial Officer (IH) Duncan Linning-Karp, Interim Chief Operating Officer (DL-K) David Liverseidge, NED (DL) Tim Peachey, NED (TP) Alison Tattersall, NED (AT) In attendance Martin De Sousa, Director of Strategy and Partnerships (MDeS) Craig Machell, Associate Director of Corporate Affairs and Company Secretary (CM) Lauren Anderson, Corporate Governance and Risk Manager (LA) (item 6.2) Kelly Kent, Head of Strategy and Partnerships (KK) (item 6.1) 2 members of the public (item 2) 5 governors (observing) 7 members of staff (observing) 1 members of the public (observing) 1. Chair’s Welcome, Apologies and Declarations of Interest The Chair welcomed attendees to the meeting. There were no interests to declare in the business to be transacted at the meeting. 2. Patient Story Gregg and Serra [SURNAME] were invited to present their experience as the parents of a child who underwent successful open-heart surgery at Southampton General Hospital in September 2024, having been diagnosed with an atrioventricular septal defect in 2023. It was noted that: • The care provided by the Trust’s staff had been exceptional, including for being able to put matters into layman’s terms to assist understanding. • The interaction between staff and the child patient was also praised, with the parents reporting that their child had been viewed first of all as a person, rather than as simply another patient. 3. Minutes of the Previous Meeting held on 7 January 2025 The draft minutes tabled to the meeting were agreed to be an accurate record of the meeting held on 7 January 2025. Page 1 4. Matters Arising and Summary of Agreed Actions An update was provided in respect of the following actions: • 1200: it was noted that discussions had been had with Natasha Watts and Jenny Milner and the action was ongoing. • 1201: it was noted that an update would be presented in the closed session of the meeting. • 1202: the Trust had written to the Integrated Care Board. • 1203: it was noted that a meeting had been arranged to discuss Freedom to Speak Up on 21 March 2025. 5. QUALITY, PERFORMANCE and FINANCE 5.1 Briefing from the Chair of the Audit and Risk Committee The chair of the Audit and Risk Committee was invited to present the Committee Chair’s Report in respect of the meeting held on 20 January 2025, the content of which was noted. It was further noted that: • The committee considered the accounting policies and management judgements for the 2024/25 annual accounts. • The committee reviewed the Trust’s compliance with the Code of Governance for NHS Provider Trusts, noting that the Trust was compliant in all areas or had appropriate explanations for the few areas of non-compliance. • The committee had received a report on cyber risk, noting that the main risk was from suppliers not having adequate protection and the Trust’s operations being impacted as a result of the loss of service. • The committee considered a report in respect of the risk of individuals impersonating agency staff and noted the Trust’s controls to mitigate against this risk. 5.2 Briefing from the Chair of the Finance and Investment Committee The chair of the Finance and Investment Committee was invited to present the Committee Chair’s Reports in respect of the meetings held on 27 January and 24 February 2025, the content of which was noted. It was further noted that: • The committee reviewed the Finance Report for Month 10 (item 5.8), noting that the Trust was forecasting a year-end deficit of £17.65m and delivery of £76m in efficiencies under the Cost Improvement Programme. • It was further noted that the Trust was anticipating that it would have carried out c.£40m of unpaid activity by the end of the year. • The committee considered a draft of the Trust’s annual plan submission, noting that 2025/26 would present a significant challenge. 5.3 Briefing from the Chair of the People and Organisational Development Committee The chair of the People and Organisational Development Committee was invited to present the Committee Chair’s Reports in respect of the meetings held on 24 January and 24 February 2025, the content of which was noted. It was further noted that: • The committee reviewed the People Report for Month 10 (item 5.10), noting that whilst the Trust was forecasting to be 125 whole-time-equivalents (WTE) above its 2024/25 plan, the total substantive workforce would be 50 WTE lower than in March 2024. • There had been high levels of sickness absence over the period, which had resulted in increased use of bank staff. Concern was expressed in respect of the low uptake rate for vaccinations by staff compared to previous years. Page 2 • Appraisal rates were lower than anticipated, but it was possible that this was due to issues with the transfer of recording of appraisals to the Virtual Learning Environment system. 5.4 Briefing from the Chair of the Quality Committee The chair of the Quality Committee was invited to present the Committee Chair’s Report in respect of the meeting held on 27 January 2025, the content of which was noted. It was further noted that: • The committee had received an update in respect of the ‘Fundamentals of Care’ programme and noted that the programme was progressing well. • The committee reviewed the progress of the Always Improving outpatients and discharge programmes. • The committee reviewed the interim Maternity and Neonatal Safety Report, noting that there was nothing to escalate to the Board. 5.5 Chief Executive Officer’s Report David French was invited to present the Chief Executive Officer’s Report, the content of which was noted. It was further noted that: • There had been significant changes in the leadership of NHS England with effectively all executive directors having resigned. Furthermore, there were expected to be significant reductions in the NHS England workforce and changes in the relationship between NHS England and the Department for Health and Social Care. • The Trust had received a request to provide feedback on a proposed management and leadership standard for the NHS. The Trust intended to respond to the consultation. • Concerns had been raised in respect of the Trust’s adult cardiac waiting list due to a mismatch in referrals against operations performed, which had resulted in an improvement plan being submitted to NHS South East Region and a quality visit on 4 February 2025. The Trust’s congenital cardiac team was also under pressure due to insufficient capacity. • Positive feedback had been received following a visit to the Trust’s maternity services by NHS South East Region and the Local Maternity and Neonatal System team. • On 28 February 2025, the Trust had announced the opening of the refurbished Muslim prayer room facilities. • The Trust’s mechanical thrombectomy service was now a 24/7 service and that it was expected that the service would treat up to 1,200 patients a year over the next five years. • Dr Stephen Harden, a consultant in cardiothoracic radiology at the Trust, had been elected as the incoming president of the Royal College of Radiologists for a three-year term commencing on 1 September 2025. 5.6 Performance KPI Report for Month 10 Duncan Linning-Karp was invited to present the Performance KPI Report for Month 10, the content of which was noted. It was further noted that: • The Emergency Department remained under significant pressure due to the level of attendances (11,728 during January 2025), with performance against the four-hour wait target being 61% in January 2025 and 55% in February 2025. • The average number of patients having no criteria to reside was 232 during January 2025. • The Trust’s performance in respect of the 62- and 28-day cancer targets remained high at 79.1% and 83.6% respectively for December 2024. The Page 3 Trust’s performance in these areas was higher than the national targets for March 2026. • Compared to equivalent teaching hospitals, the Trust was second in the country for 65-week waits and joint first in the country for 78-week waits. It was expected that the outstanding 65-week wait patients at March 2025 would be limited to those awaiting material for corneal transplants, of which there was a national shortage, and a small number of complex patients. • The Trust’s mortality rate had fallen as expected and the Trust was ranked as having one of the lowest mortality rates in England. • There had been an increase in the number of incidents of pressure ulcers during January and February 2025. It was noted that often there was an increased number of patients with co-morbidities during the winter months, who were at greater risk of developing pressure ulcers. • Whilst staffing levels had been problematic during September and October 2024 in the Maternity service, the situation had since improved as newlyqualified nurses became substantive. • Further work was ongoing to promote wider use of virtual clinics as an alternative to face-to-face appointments. • The Trust was intending to spend £1.5m on hardware by the end of the year to address the issues caused by the average age of the Trust’s IT estate. Action Craig Machell agreed to add A/I to a future Trust Board Study Session agenda. Gail Byrne agreed to present a deep-dive on pressure ulcers to the Quality Committee. 5.7 Break 5.8 Finance Report for Month 10 Ian Howard was invited to present the Finance Report for Month 10, the content of which was noted. It was further noted that: • The Trust had been working with system partners to agree a ‘landing plan’ for the system for 2024/25 to deliver a break-even position. The Trust’s forecast was for a year-end deficit of £17.65m. • The Trust had recorded a £7.5m in-month surplus and a year-to-date deficit of £15.2m, £11.8m behind its plan. However, there remained an underlying deficit of c.£6.5m, which would pose a significant challenge for 2025/26. • The Trust was forecasting to have insufficient cash in May 2025 and therefore would require additional cash support. It was noted that cash support would require certain commitments from applicants and that requests were not always fulfilled. • The messaging from NHS England appeared to be that difficult decisions would be required to deliver a financially sustainable NHS and that there would be no additional funding. It was noted that a number of these decisions would be better made at a national level to ensure consistency across the country. 5.9 ICB Finance Report for Month 10 The ICB Finance Report for Month 10 was noted. 5.10 People Report for Month 10 Steve Harris was invited to present the People Report for Month 10, the content of which was noted. It was further noted that: Page 4 • Unison had put an offer to its members to resolve the dispute over Band 2/3 pay. It was expected that the vote would conclude at the end of March 2025. • The consultation in respect of the transfer of staff to UHS Estates Limited had progressed well, with the transfer expected to take place on 1 April 2025. • Progress continued to be made in respect of the action plan agreed with portering staff. • The Trust had exceeded its workforce plan by 153 whole-time-equivalents (WTE) at the end of January 2025. There had been a significant increase in use of bank staff due to continued high levels of sickness absence and the need to open surge capacity. • It was forecast that the Trust would be 125 WTE above its plan for 2024/25. It was noted that the Trust had anticipated a reduction in staffing numbers of c.220 WTE due to reductions in patients having no criteria to reside and delivery of system transformation programmes. However, these assumptions had not materialised. 5.11 Mortuary Standards Compliance Update Gail Byrne was invited to provide an update in respect of the actions required following the Fuller Inquiry, the content of which was noted. It was further noted that: • The action plan and outputs from the Fuller Inquiry had been presented to the Board at its meeting held on 6 June 2024. • It was noted that all the actions identified had been completed. 6. STRATEGY and BUSINESS PLANNING 6.1 Corporate Objectives 2024-25 Quarter 3 Review Martin De Sousa and Kelly Kent were invited to present the ‘Corporate Objectives 2024-25 Quarter 3 Review’, the content of which was noted. It was further noted that fifty per cent of objectives were on track to be delivered in full (a reduction compared to the second quarter), 37.5% were amber and 12.5% were red. 6.2 Board Assurance Framework (BAF) Update Lauren Anderson was invited to present the Board Assurance Framework Update, the content of which was noted. It was further noted that: • There were six risks rated as ‘critical’ (i.e. 15 or above), with one risk (risk 3c) having been upgraded from 12 due to increased likelihood given reductions in the available funding and workforce. • The target dates for six risks had also been extended, including two out to April 2030 due in part to uncertainty in respect of funding availability. 7. CORPORATE GOVERNANCE, RISK and INTERNAL CONTROL 7.1 Feedback from the Council of Governors’ (CoG) meeting 29 January 2025 The Chair presented a summary of the Council of Governors’ meeting held on 29 January 2025. It was noted that the meeting had considered the following matters: • Chief Executive Officer’s Performance Report Page 5 • Chair and Non-Executive Director Appraisal Process • Audit and Risk Committee Terms of Reference • Governors’ Nomination Committee Terms of Reference • Annual Business Plan • Noting the appointment of David Liverseidge following the original approval given in 2024. • Governor Attendance • Membership Engagement 7.2 Register of Seals and Chair’s Actions Report The paper ‘Register of Seals and Chair’s Actions Report’ was presented to the meeting, the content of which was noted. It was further noted that the following items had been sealed on 7 March 2025: • TP1 Land Registry between University Hospital Southampton NHS Foundation Trust and Prime Infrastructure Management Services 4 Limited (the Transferor) and University Hospital Southampton NHS Foundation Trust (Transferee) relating to Land forming part of an accessway adjoining Plot 2, Bargain Farm, Frogmore Lane, Nursling, Southampton, Hampshire SO16 0XS. Seal number 291 on 7 March 2025 • TP1 Land Registry between University Hospital Southampton NHS Foundation Trust and Prime Infrastructure Management Services 4 Limited (Transferor) and University Hospital Southampton NHS Foundation Trust (the Transferee) relating to Land forming part of an accessway adjoining Plot 2, Bargain Farm, Frogmore Lane, Nursling, Southampton, Hampshire SO16 0XS. Seal number 292 on 7 March 2025. • Underlease between Just Retirement Limited (the Landlord) and University Hospital Southampton NHS Foundation Trust (the Tenant) relating to Aseptic Pharmacy and Offices on the Ground, 1st and 2nd Floors at Plot 2 Adanac Health and Innovation Campus, Nursling, Southampton, Hampshire SO16 0XS. Seal number 293 on 7 March 2025. • Reversionary Underlease between Just Retirement Limited (the Landlord) and University Hospital NHS Foundation Trust (the Tenant) relating to Ground and first Floor Sterile Services Unit and Offices at Plot 2 Adanac Health and Innovation Campus, Nursling, Southampton, Hampshire SO16 0XS. Seal number 294 on 7 March 2025. • Underlease between Just Retirement Limited (the Landlord), IHSS Limited (the Tenant) and University Hospital Southampton NHS Foundation Trust (the Trust) relating to Ground and first Floor Sterile Services Unit and Offices at Plot 2 Adanac Health and Innovation Campus, Nursling, Southampton, Hampshire SO16 0XS. Seal number 295 on 7 March 2025. • Sub-Underlease between University Hospital NHS Foundation Trust (Landlord) and UHS Estates Limited (Tenant) of Aseptic Pharmacy and Offices on the Ground, 1st and 2nd Floors at Plot 2 Adanac Health and Innovation Campus, Nursling, Southampton, Hampshire SO16 0XS. Seal number 296 on 7 March 2025. Page 6 Decision: The Board agreed to ratify the application of the Trust Seal to the documents listed in the ‘Register of Seals and Chair’s Actions Report’ and in respect of the items listed above. 7.3 Audit and Risk Committee Terms of Reference Craig Machell was invited to present the proposed changes to the Audit and Risk Committee’s Terms of Reference, the content of which was noted. It was further noted that: • The Audit and Risk Committee had reviewed its terms of reference at its meeting on 20 January 2025, following which input had been sought from the Council of Governors at its meeting held on 29 January 2025. • It was proposed to amend a reference in paragraph 10.2 and to update Appendix A. Decision Having considered the proposed amendments to the Audit and Risk Committee’s Terms of Reference, the Board approved the changes. 7.4 Finance and Investment Committee Terms of Reference Craig Machell was invited to present the proposed changes to the Finance and Investment Committee’s Terms of Reference, the content of which was noted. It was further noted that: • The Finance and Investment Committee had reviewed its terms of reference at its meeting on 27 January 2025. • It was proposed to update Appendix A. Decision Having considered the proposed amendments to the Finance and Investment Committee’s Terms of Reference, the Board approved the changes. 7.5 Quality Committee Terms of Reference Craig Machell was invited to present the proposed changes to the Quality Committee’s Terms of Reference, the content of which was noted. It was further noted that: • The Quality Committee had reviewed its terms of reference at its meeting on 27 January 2025. • It was proposed to amend a reference in paragraph 10.2 and to update Appendix A. Decision Having considered the proposed amendments to the Quality Committee’s Terms of Reference, the Board approved the changes. 7.6 Remuneration and Appointment Committee Terms of Reference Craig Machell was invited to present the Remuneration and Appointment Committee’s Terms of Reference, the content of which was noted. It was further noted that: Page 7 • The Remuneration and Appointment Committee had reviewed its terms of reference at its meeting on 11 March 2025. • No changes were proposed. Decision Having considered the Remuneration and Appointment Committee’s Terms of Reference, the Board approved the terms of reference. 7.7 Trust Executive Committee Terms of Reference Craig Machell was invited to present the proposed changes to the Trust Executive Committee’s Terms of Reference, the content of which was noted. It was further noted that: • The Trust Executive Committee (TEC) had reviewed its terms of reference at its meeting on 12 February 2025. • It was noted that the most significant amendments were in respect of the following: o Introduction of the pre-TEC process for business cases requiring additional expenditure; o The role of the TEC as a forum for discussion of significant strategic matters; o The TEC’s role in identification of opportunities for system collaboration; o Updates to reflect the current role of the Trust Investment Group and the TEC under the Standing Financial Instructions; and o Other amendments to add clarity about the TEC’s operation and reports received. Decision Having considered the proposed amendments to the Trust Executive Committee’s Terms of Reference, the Board approved the changes. 8. Any other business There was no other business. 9. Note the date of the next meeting: 13 May 2025 10. Items circulated to the Board for reading The item circulated to the Board for reading was noted. There being no further business, the meeting concluded. 10. 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 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. The meeting was adjourned. Page 8 List of action items Agenda item Assigned to Deadline Status Trust Board – Open Session 25/07/2024 5.4 Briefing from the Chair of the Quality Committee (Oral) 1163. Impact of technology Machell, Craig 03/06/2025 Pending Explanation action item Craig Machell agreed to add an item covering the impact of technology over the next 5-10 years to a future Trust Board Study Session agenda. Update: Item deferred to Study Session on 03/06/2025. Trust Board – Open Session 07/01/2025 5.13 Infection Prevention and Control 2024-25 Quarter 2 Report 1204. Infection prevention Byrne, Gail 03/06/2025 Pending Explanation action item Gail Byrne agreed to include an item on infection prevention control at a future Trust Board Study Session to include details of an Australian study, point of care testing, and progress on the roll out of the Fundamentals of Care programme. Update: Item tentatively scheduled for TBSS on 03/06/2025. Trust Board – Open Session 11/03/2025 5.6 Performance KPI Report for Month 10 1217. Artificial Intelligence (A/I) Machell, Craig Explanation action item Craig Machell agreed to add A/I to a future Trust Board Study Session agenda. 03/06/2025 Pending Update: Tentatively scheduled for TBSS on 03/06/2024. Agenda item Assigned to Trust Board – Open Session 11/03/2025 5.6 Performance KPI Report for Month 10 1218. Pressure ulcers Byrne, Gail Explanation action item Gail Byrne agreed to present a deep-dive on pressure ulcers to the Quality Committee. Deadline Status 13/05/2025 Pending Page 2 of 2 Agenda item 5.1 Committee Chair’s Report to the Trust Board of Directors 13 May 2025 Committee: Audit & Risk Committee Meeting Date: 17 March 2025 Key Messages: • • • • • • The committee considered the going concern assessment for the 2024/25 accounts and agreed that the accounts should be prepared on a ‘going concern’ basis. The external auditor reported that there had been no significant issues resulting from the transfer to a new finance system. The committee received a report on losses and special payments during 2024/25 and noted that the levels were similar to previous years. These payments were generally related to lost patient property. The committee reviewed the Trust’s Treasury Policy, confirmed the current bank mandate and approved certain minor changes to the Treasury Policy. An update was received in respect of Information Governance. It was noted that the Trust – in common with most others – was not expected to meet the standards set out in the Data Security and Protection Toolkit for 2024/25 due to the introduction of the Cyber Assurance Framework. The Trust had reported six breaches to the Information Commissioner since 1 January 2024, but none of the incidents resulted in further action on the part of the regulator. The committee agreed the Fraud team’s work plan for 2025/26. Assurance: (Reports/Papers reviewed by the Committee also appearing on the Board agenda) 6.2 Board Assurance Framework (BAF) Update Assurance Rating: Risk Rating: Substantial N/A • All risks had been reviewed with the relevant executive director(s). • It was suggested that Risk 3c should be reconsidered in terms of what the main risk was given the increase in risk rating to 16, particularly whether the main concern was running out of trained staff as opposed to being unable to deliver training and development. Any Other Matters: • The committee reviewed the outputs from the internal audit reports in respect of rostering, the discharge process, and core financial controls noting that there was nothing significant which required escalation to the Board. Assurance Rating: Substantial There is a robust series of suitably designed internal controls in place upon Assurance which the organisation relies to manage the risk of failure of the continuous and effective achievement of the objectives of the process, which at the time of our review were being consistently applied. Reasonable There is a series of controls in place, however there are potential risks that Assurance may not be sufficient to ensure that the individual objectives of the process are achieved in a continuous and effective manner. Improvements are required to enhance the adequacy and effectiveness of the controls to mitigate these risks. Limited Assurance Controls in place are not sufficient to ensure that the organisation can rely upon them to manage the risks to the continuous and effective achievement of the objectives of the process. Significant improvements are required to improve the adequacy and effectiveness of the controls. Page 1 of 2 No Assurance Not Applicable Risk Rating: Low Medium High Not Applicable There is a fundamental breakdown or absence of core internal controls such that the organisation cannot rely upon them to manage the risks to the continuous and effective achievement of the objectives of the process. Immediate action is required to improve the adequacy and effectiveness of controls. Where assurance is not required and/or relevant. Based on the report considered by the committee, there is little or no concern that the Trust will be unable to meet its stated objectives and/or plans. There is some concern that the Trust might not be able to fully meet its stated objectives and/or plans based on the information contained in the report considered by the committee. There is a significant risk that the Trust will not be able to meet its stated objectives and/or plans based on the information contained in the report considered by the committee. Where risk rating is not relevant. Page 2 of 2 Agenda Item 5.2 i) Committee Chair’s Report to the Trust Board of Directors 13 May 2025 Committee: Finance & Investment Committee Meeting Date: 24 March 2025 Key Messages: • • • • • • The committee received an update in respect of the Trust’s 2025/26 annual plan. It was noted that the NHS in England was forecasting a deficit of £6.6bn, which had resulted in significant intervention by Government, including the abolition of NHS England and 50% reductions in integrated care boards’ costs. These reductions would be supplemented by a national mutually agreed resignation scheme. The Trust anticipated running out of cash in May 2025, but it was understood that cash support would no longer be provided. The Hampshire and Isle of Wight Integrated Care System was aiming to reach a breakeven position in 2025/26. This would necessitate additional controls on recruitment and 5-10% reductions in expenditure/headcount as well as achievement of challenging Cost Improvement Programme targets. The committee reviewed the Finance Report for Month 11. It was noted that the Trust had recorded an in-month surplus of £8.2m due to a number of one-off items. There had been an increase in the use of bank staff due to the need to open surge capacity and the demand resulting from patients with mental health issues. The committee received an update in respect of the transformation plans regarding the ‘living within our means’, urgent and emergency care, and elective care recovery workstreams. The committee reviewed the quarterly update from Estates, Facilities and Capital Development. It was noted that there was a plan for removal of all reinforced autoclaved aerated concrete (RAAC) on the Southampton General Hospital site. It was further noted that the steam ducts on the site continued to be an issue and there was a risk that the Trust was at the limit for electricity usage on the site. Assurance: (Reports/Papers reviewed by the Committee also appearing on the Board agenda) N/A Any Other Matters: The committee considered a business case in respect of a Hampshire and Isle of Wight Elective Hub in Winchester. It was noted that this proposal was reviewed and approved at the Trust Board meeting on 25 March 2025. Assurance Rating: Substantial There is a robust series of suitably designed internal controls in place upon Assurance which the organisation relies to manage the risk of failure of the continuous and effective achievement of the objectives of the process, which at the time of our review were being consistently applied. Page 1 of 2 Reasonable Assurance Limited Assurance No Assurance Not Applicable There is a series of controls in place, however there are potential risks that may not be sufficient to ensure that the individual objectives of the process are achieved in a continuous and effective manner. Improvements are required to enhance the adequacy and effectiveness of the controls to mitigate these risks. Controls in place are not sufficient to ensure that the organisation can rely upon them to manage the risks to the continuous and effective achievement of the objectives of the process. Significant improvements are required to improve the adequacy and effectiveness of the controls. There is a fundamental breakdown or absence of core internal controls such that the organisation cannot rely upon them to manage the risks to the continuous and effective achievement of the objectives of the process. Immediate action is required to improve the adequacy and effectiveness of controls. Where assurance is not required and/or relevant. Risk Rating: Low Medium High Not Applicable Based on the report considered by the committee, there is little or no concern that the Trust will be unable to meet its stated objectives and/or plans. There is some concern that the Trust might not be able to fully meet its stated objectives and/or plans based on the information contained in the report considered by the committee. There is a significant risk that the Trust will not be able to meet its stated objectives and/or plans based on the information contained in the report considered by the committee. Where risk rating is not relevant. Page 2 of 2 Agenda Item 5.2 ii) Committee Chair’s Report to the Trust Board of Directors 13 May 2025 Committee: Finance and Investment Committee Meeting Date: 28 April 2025 Key Messages: • • • • • • • The committee reviewed the Finance Report for Month 12 (see below). The committee received an update in respect of the Trust’s cash position, noting that the Trust’s cash position had been relatively stable during the fourth quarter due to receipt of additional one-off funding and careful supplier payment management. However, the Trust was highly likely to require cash support in either Q1 or Q2. The committee noted the report from the Trust’s digital services, noting the successful negotiation of a discount for purchasing new laptops due to the number required. In addition, there had been a leak in GICU which had impacted the switch network, but which had since been rectified. It was further noted that, during the first months of the year, the Trust had blocked more attempted cyber attacks than in the whole of 2024. It was noted that trusts had been set challenging targets for reducing the size of their corporate services, and as such were expected to reduce the size of these services by 50% of the growth since 2018/19. The committee received an update on the Trust’s 2025/26 capital plan, noting that the plan was under review owing to the Trust’s cash position. In addition, it had been agreed to prioritise maintaining the Trust’s level of expenditure on strategic maintenance and to defer the refurbishment of the neuro theatres. The committee reviewed the update from the Trust’s commercial team, including in respect of private and overseas patients, the proposed private patient unit, and Adanac Park. The committee supported the Trust’s participation in the proposed Elective Hub at Winchester. Assurance: (Reports/Papers reviewed by the Committee also appearing on the Board agenda) 5.8 Finance Report for Month 12 Assurance Rating: Risk Rating: Substantial High • The Trust had successfully ended the year at where it expected to do so with a deficit of £7m at year end. • The Trust’s underlying position remained a concern with a £6.9m deficit recorded during the month. • The committee reviewed the high use of bank staff during months 8 to 12, noting that the Trust had opened surge capacity during this period and was experiencing significant demand. • The Trust had achieved 127% elective recovery performance against the national target of 113%, and had also delivered its 2024/25 Cost Improvement Programme target in full (£85m). • The Trust had also spent £96m of capital during 2024/25. 6.2 Board Assurance Framework (BAF) Update Assurance Rating: Risk Rating: Substantial N/A • Risks 5a, 5b and 5c have been updated, following discussions with the respective Executive Director(s). Page 1 of 2 Any Other Matters: • The committee discussed whether the 2030 target for risk 5b was realistic and whether the rating to be achieved by 2030 should be increased. N/A Assurance Rating: Substantial There is a robust series of suitably designed internal controls in place upon Assurance which the organisation relies to manage the risk of failure of the continuous and effective achievement of the objectives of the process, which at the time of our review were being consistently applied. Reasonable There is a series of controls in place, however there are potential risks that Assurance may not be sufficient to ensure that the individual objectives of the process are achieved in a continuous and effective manner. Improvements are required to enhance the adequacy and effectiveness of the controls to mitigate these risks. Limited Assurance Controls in place are not sufficient to ensure that the organisation can rely upon them to manage the risks to the continuous and effective achievement of the objectives of the process. Significant improvements are required to improve the adequacy and effectiveness of the controls. No Assurance There is a fundamental breakdown or absence of core internal controls such that the organisation cannot rely upon them to manage the risks to the continuous and effective achievement of the objectives of the process. Immediate action is required to improve the adequacy and effectiveness of controls. Not Applicable Where assurance is not required and/or relevant. Risk Rating: Low Medium High Not Applicable Based on the report considered by the committee, there is little or no concern that the Trust will be unable to meet its stated objectives and/or plans. There is some concern that the Trust might not be able to fully meet its stated objectives and/or plans based on the information contained in the report considered by the committee. There is a significant risk that the Trust will not be able to meet its stated objectives and/or plans based on the information contained in the report considered by the committee. Where risk rating is not relevant. Page 2 of 2 Agenda Item 5.3 i) Committee Chair’s Report to the Trust Board of Directors 13 May 2025 Committee: People & Organisational Development Committee Meeting Date: 24 March 2025 Key Messages: • • The committee reviewed the People Report for Month 11. It was noted that February 2025 had continued to be challenging due to high sickness rates, with the Trust close to calling a critical incident. This had driven much higher bank rates. There had been a lower than forecast number of leavers during the month (44 whole-timeequivalents (WTE) against a forecast of 100). The Trust was 267 WTE above its plan. The Trust’s draft Workforce Plan for 2025/26 was reviewed. The Trust was required to deliver a breakeven plan. Accordingly, the Trust was anticipating a freeze on all non-clinical vacancies and holding 30% of clinical vacancies. In addition, there would potentially be a target to reduce headcount by 5-10% as well as additional reductions in use of bank and agency staff. It was further proposed to reorganise the four existing Divisions into three in order to deliver efficiencies. It was noted that even if the Trust achieved fully against all performance targets and implemented the restrictions and reductions above, there would still be a deficit. Assurance: (Reports/Papers reviewed by the Committee also appearing on the Board agenda) 5.11 UHS Staff Survey Results 2024 Report Assurance Rating: Risk Rating: Reasonable Low • The committee reviewed the Staff Survey results for 2024. • The Trust had maintained its above average position across all of the People Promise domains. • The Trust’s results remained broadly similar to those in 2023, although there had been improvements in some areas, such as satisfaction with immediate managers, flexible working, appraisals, and confidence in reporting unsafe practice, violence, bullying and harassment. • The participation rate was low at 39%, which gave rise to some concern about how reflective of the workforce the results were. A significant difference in engagement between non-clinical and clinical staff was noted. 6.2 Board Assurance Framework Assurance Rating: Risk Rating: Update Substantial N/A • Risks 3a, 3b and 3c had been updated, following discussions with the respective Executive Director(s). • Risk 3c had been upgraded from 12 to 16 to reflect the reduction in national funding for education and training and the more restrictive funding framework. In addition, it was noted that the intended reduction in NHS corporate infrastructure would impact training and development staff. • The committee agreed to review the Board Assurance Framework again once the 2025/26 plan had been approved. Any Other Matters: • The committee received an update in respect of the Band 2/3 pay dispute and in respect of the portering department. Page 1 of 2 Assurance Rating: Substantial There is a robust series of suitably designed internal controls in place upon Assurance which the organisation relies to manage the risk of failure of the continuous and effective achievement of the objectives of the process, which at the time of our review were being consistently applied. Reasonable There is a series of controls in place, however there are potential risks that Assurance may not be sufficient to ensure that the individual objectives of the process are achieved in a continuous and effective manner. Improvements are required to enhance the adequacy and effectiveness of the controls to mitigate these risks. Limited Assurance Controls in place are not sufficient to ensure that the organisation can rely upon them to manage the risks to the continuous and effective achievement of the objectives of the process. Significant improvements are required to improve the adequacy and effectiveness of the controls. No Assurance There is a fundamental breakdown or absence of core internal controls such that the organisation cannot rely upon them to manage the risks to the continuous and effective achievement of the objectives of the process. Immediate action is required to improve the adequacy and effectiveness of controls. Not Applicable Where assurance is not required and/or relevant. Risk Rating: Low Medium High Not Applicable Based on the report considered by the committee, there is little or no concern that the Trust will be unable to meet its stated objectives and/or plans. There is some concern that the Trust might not be able to fully meet its stated objectives and/or plans based on the information contained in the report considered by the committee. There is a significant risk that the Trust will not be able to meet its stated objectives and/or plans based on the information contained in the report considered by the committee. Where risk rating is not relevant. Page 2 of 2 Agenda Item 5.3 ii) Committee Chair’s Report to the Trust Board of Directors 13 May 2025 Committee: People & Organisational Development Committee Meeting Date: 25 April 2025 Key Messages: • • • • • • • The committee reviewed the People Report for Month 12 (see below). The committee noted the significant challenges for 2025/26 in delivering the Trust’s Annual Plan and the implications for its workforce. In particular, the Trust was anticipating having to reduce its overall workforce by 6% during the year, coupled with a 20% reduction in bank staff and 30% reduction in agency staff. It was noted that the organisational changes would need to happen at pace, but that there was not presently central funding to support this. The Trust had implemented strict recruitment controls, including a freeze on all non-clinical recruitment and would hold 30% of clinical vacancies. Delivery of the Trust’s 2025/26 plan also assumed significant reductions in the numbers of mental health patients and in patients having no criteria to reside. It had been announced that the Trust would be restructuring its divisions, reducing from four to three. It was anticipated that this would be completed by 1 July 2025. Furthermore, the Trust had a medium- to long-term objective of developing and implementing shared services with other organisations in the Hampshire and Isle of Wight Integrated Care System. The organisational and workforce changes envisaged were to be supported by both an equality and a quality impact asse
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