COLCHESTER HOSPITAL UNIVERSITY NHS FOUNDATION TRUST MINUTES OF THE FIRST ANNUAL GENERAL MEETING OF COLCHESTER HOSPITAL UNIVERSITY NHS FOUNDATION TRUST HELD ON THURSDAY, 11 SEPTEMBER 2008 AT 4:30 PM IN THE LECTURE THEATRE, POSTGRADUATE MEDICAL CENTRE, COLCHESTER GENERAL HOSPITAL Present: Mr. R. Bourne, Chair

Members’ Council: Mr. F. Baker, Public Governor, Tendring Mrs. H. Law, Public Governor, Tendring Mr. A. Patrick, Public Governor, Tendring Ms. C. Askham, Public Governor, Colchester Mrs. V. Haddow, Public Governor, Colchester Ms. S. Laycock, Public Governor, Colchester Mr. D. McCarron, Public Governor, Colchester Mr. J. Buckley-Saxon, Public Governor, Halstead & Colne Valley Mr. J. Dann, Public Governor, Halstead & Colne Valley Mrs. D. Booton, Staff Governor, Nursing & Midwifery Mrs. C. Tyler, Staff Governor, Nursing & Midwifery Mr. J. Eddy, Staff Governor, Medical & Dental Ms. V. Asker, Staff Governor, Support Staff Mr. I. Ferneyhough, Staff Governor, AHP/Healthcare Scientist Cllr. M. Hunt, Stakeholder Governor Col. N. Strowbridge, Stakeholder Governor, Colchester Garrison Cllr. D. Finch, Stakeholder Governor, Essex County Council Board of Directors: Mr. W. Craig, Non-Executive Director Mr. J. Addison, Non-Executive Director Dr. P. Cavenagh, Non-Executive Director Mr. P. Murphy, Chief Executive Mrs. S. Watson, Director of Finance & Performance Mrs. D. Hagel, Director of Nursing

In Attendance: Mr. D. Hewitt, Director of Facilities, Planning & Development

Mrs. R. Start, Board Business Manager (Trust Secretary) 31 Members of Staff/Public

Apologies: Members’ Council: Mr. M. Lowdell, Public Governor, Tendring Mrs. J. Smith, Public Governor, Tendring Mr. R. Cole, Public Governor, Colchester Mrs. T. Sivyer, Public Governor, Halstead & Colne Valley Mr. M. Bushell, Stakeholder Governor, North East Essex PCT Cllr. L. Double, Stakeholder Governor, Tendring District Council Board of Directors: Mrs. H. Parr, Non-Executive Director Mr. I. Pettitt, Non-Executive Director Dr. M. Wood, Medical Director Mr. A. McLaughlin, Chief Operating Officer Mr. R. Bowman, Director of Workforce

1

Prior to commencement of the meeting, members of the public and staff had an opportunity to meet with the newly-appointed Governors who took up office on 1 May 2008 upon Authorisation of Essex Rivers Healthcare NHS Trust as an NHS Foundation Trust to be known as Colchester Hospital University NHS Foundation Trust. Individual copies of the Annual Report and Accounts for 2007/8 for Essex Rivers Healthcare NHS Trust were made available to members of the public and staff before commencement of the meeting and reference was also made to the NHS Constitution public consultation exercise which was currently underway. A promotional film on views and experiences of users of the service was shown to the audience. 1. CHAIRMAN’S INTRODUCTION

The Chairman, Mr. Richard Bourne, opened by thanking healthcare and academic representatives and members of the general public and staff for attending the meeting. This was the first Annual General Meeting of Colchester Hospital University NHS Foundation Trust and, for the transition period, would consider the Annual Report and Accounts for Essex Rivers Healthcare NHS Trust for the year ended 31 March 2008. The Chairman described the establishment of the NHS Foundation Trust and the role of Governors. Commendation was made to all staff on the significant achievement of attainment of NHS Foundation Trust status and the work which had been done. This now enabled the Trust to move forward as a financially stable and sustainable organisation which generated opportunities for the business in future years. This was a cause for celebration. Throughout the last 4 years, in working towards a debt-free organisation, there had been no major service cuts or redundancy programmes implemented and the Trust had continued to achieve its performance targets, particularly a sustained reduction in infection rates. It had also continued to achieve high standards in external inspections and all credit was due to the Management Team and staff across every sector of the organisation in achieving this success. He went on to acknowledge that no organisation was perfect and, indeed, this organisation had many changes to make, the staff and patient experience surveys being 2 indicators from which the Trust continuously reviewed its systems and processes and its engagement practices. Much work was being done to learn from these reports. The Chairman indicated that NHS Employers had expressed an interest in the approach taken on staff engagement by the Trust and were looking to showcase this as an example of good practice. The quality of care within the organisation was good and could be evidenced, but the whole patient journey against which the Trust’s patients viewed their experience needed to be developed further. Reference was made to the first Members’ Council meeting where Governors debated the patient experience and considered options for ways in which the organisation could take this forward. In closing statements, the Chairman paid tribute to the staff on the exceptional performance of the Trust during 2007/8 and welcomed the opportunity of working with the Members’ Council in order to achieve the common objectives of the organisation which were to ensure that the patient, carers and their families had a successful interface with the organisation and would recommend it to others as their first choice. Thanks and appreciation were also extended to members of the voluntary and partnership organisations for their continued support.

2

2. 2007/8 ANNUAL ACCOUNTS

The Director of Finance and Performance, Mrs. S. Watson, drew the audience’s attention to the Annual Report and Accounts available. Particular reference was made to the following key areas: (a) Statutory Financial Duties

• Breakeven: Against an income of £180.0m the Trust had an expenditure of £177.0m resulting in a surplus of £3m. Reference was made to the planned support of £15.1m which the Trust had received from the Essex Health Economy. This covered the 2003/4 deficit (£5.9m), the 2004/5 deficit (£7.8m) and the 2005/6 deficit (£1.4m). The Trust repaid £8.6m against its outstanding debt in 2006/7, leaving £6.5m to be repaid in 2007/8, which was successfully achieved. The Trust was therefore debt-free at the end of 2007/8.

• External Financing Limit (EFL): The Trust was required to meet the EFL

which was a cash control mechanism. The target for the year was £686k which was achieved.

• Capital Absorption Rate: The Trust was required to absorb the cost of

capital at a rate of 3.5% of average relevant net assets. The Trust achieved 3.4% which was within the tolerance allowed by the Department of Health of +/- 0.5%.

• An unqualified audit opinion had been given by the Trust’s external

auditors, PricewaterhouseCoopers LLP.

(b) Capital Expenditure

During 2007/8 the Trust had made £8.8m capital investment, all of which contributed to improved patient care. The schemes included: • Healthcare Records: £1.9m • Minor schemes (including estate upgrade): £2.2m • Medical equipment: £1.5m • Information Technology equipment £1.3m • Car Parking £0.9m • Endoscopes £0.7m

-------- Total: £8.8m

===== 3. 2007/8 ACHIEVEMENTS AND FUTURE PLANS

The Chief Executive, Mr. P. Murphy, echoed the Chairman’s comments on the outstanding performance of the Trust’s staff and the collaborative work with other healthcare and voluntary bodies, both locally and nationally. Throughout 2007/8 the Trust had achieved an outstanding record on clinical performance and had met all its existing targets. Service and cost improvement plans had been developed and acted upon resulting in a £3m surplus which, as previously confirmed by the Director of Finance and Performance, had meant that the Trust had repaid its debt as well as achieving a surplus in-year. Against this backdrop, the Trust had achieved NHS Foundation Trust status and been Authorised

3

on 1 May 2008. The key themes of the organisation: improvement in the patient’s experience through new and better services, accountability, safety and sustainability, were maintained. Specific details on the ways the Trust had achieved the themes described were contained within the Annual Report. In summary, these included: • New healthcare records centre to centralise health records • Opening of an Isolation Ward for patients with hospital acquired infection • Working together with the PPI Forum and Complaints Management Team to

deliver improvements in services • Improvement in performance on tackling infection and attainment of full

compliance for clinical governance • Commencement of a major 10-year programme of maintenance improvements to

ensure the Trust’s services were reliable and of good quality • Continued improvement in partnership working The Trust valued its staff and had sought to improve its communication methods and the results of the National Staff Survey for 2007 showed a significant improvement over the results for 2006. The Trust achieved the top 20% in: • Effective action towards violence and harassment • Job-relevant training, learning or development • Harmful errors, near misses or incidents

The Trust had also undertaken an extensive approach to staff engagement which had been commended by the NHS Employers organisation. In moving forward into the current financial year the Trust planned to: • Have no-one waiting more than 18 weeks from GP referral to appointment • Meet and exceed the Department of Health Standards for Better Health • Develop the estate and services • Achieve a planned surplus of £9.9m • Respond to Lord Darzi’s next stage review • Continue to work towards the vision of the organisation which was “People who

use our hospitals will recommend us to their family and friends.” 4. IMPROVING THE PATIENT EXPERIENCE

The Director of Nursing introduced Ward Managers from across the Trust and Practice Development Nurses who would present 2 projects being implemented as examples of work being undertaken to improve the patient experience. These had recently been discussed at a “Sharing Good Practice” internal learning event. (a) Releasing Time to Care – The Lean Productive Ward

Apologies were received from Rachel Hearn, but welcome was extended by the Chairman to Helen Edwardson and Jacquie Bloomfield, Ward Managers for Birch and Great Tey Wards respectively. A project which focused on improved productivity and release of time for ward staff to give more care to patients was described.

4

(b) Patient Experience Trackers

The Chairman welcomed Ms. L. Timms and Mr. K. O’Hart, Practice Development Nurses and particularly thanked Ms. Timms for returning to the organisation to deliver the presentation. Patient tracking was a systematic patient feedback system. The target input was 12 per ward per day, flexed subject to the type of ward area, which gave feedback on a weekly basis to Ward Managers to develop localised action plans to address any untoward comments made or give positive feedback on experience gained. The programme was also operational within Outpatients and A&E Departments and, since its introduction in June 2008, the learning from this system was in its infancy, but it was accepted by staff as a significant step forward to that previously available. Future developments were being evaluated, including extending the survey to post-discharged patients.

5. QUESTION AND ANSWER SESSION

The Chairman thanked the Director of Finance and Performance, the Chief Executive, Mrs. Edwardson, Mrs. Bloomfield, Ms. Timms and Mr. O’Hart for their presentations and opened the meeting to the public to seek questions of the Board of Directors. At the end of the “round robin” discussions, a summary of questions were taken as follows: (a) Clarification was sought on the selection of patients for the systematic

input of information on the Patient Tracker system

A Ward Manager in the audience sought the Chairman’s leave to answer the question from an operational point of view. It was reported that the Ward Clerk systematically reviewed the length of stay and the timing of distribution of questionnaires to patients, some of which coincided with visiting times to allow patients’ visitors to assist in completion of data entry. The system was still at pilot stage and the organisation was continuing to learn the best way to progress, but this was a huge step forward in developing a systematic way to give timely and relevant information to wards and departments on the treatment of its patients one week after data entry.

(b) Had there been a change in the number of qualified nurses at ward level

as part of the project on Releasing Time to Care? The Director of Nursing indicated that the Releasing Time to Care Project was

not influential in the number of qualified or unqualified nurses on the wards, the basis for which was calculated using a number of factors relating to number of beds and type of ward, the methodology for which was used at a national level. The Releasing Time to Care Project was about organising the ward differently and utilising staff in a more productive way.

(c) Had the adjustment to visiting hours, recently implemented by the Trust,

resulted in improvements, particularly for cleaning? The Director of Nursing indicated that the revised visiting arrangements had

enabled an adjustment to the cleaning programmes and this had been successful. Again, with leave of the Chairman, a Ward Manager from the audience described operationally the impact of the change and advised that restrictions on visiting were flexed as required to meet individual needs wherever possible.

5

(d) Where was the Trust in its strategic plans for the development of Essex County Hospital?

The Chief Executive indicated that a group of clinical staff were currently

reviewing the Darzi strategy and looking at the alignment of this and the impact, if any, on the Trust’s current service strategy. It was still the Trust’s intention to centralise Cancer Services on the Colchester General Hospital site, but the decision to sell or retain Essex County Hospital was currently under review and a decision on this would be taken once the gap analysis had been completed for the Darzi review. The Board of Directors would consult with its Members’ Council as part of the annual planning cycle and, in turn, review through its membership its ongoing plans.

6. CLOSING REMARKS

The Chairman thanked those present for attending and participating in the meeting. Should anyone wish further information about the Trust or its operations, they were welcome to contact the Chief Executive’s office.

The meeting was declared closed at 6:50 pm. Signed……………………….. R Bourne, Chairman

6