Board Matters - June 2014

Board Matters
Welcome to Board Matters
Welcome to this edition of Board Matters.

This month’s meeting was opened by thanking non-executive, Jane Dacre, for all the  work she has done here.  Jane is a UCL nominated non-executive director and I have been meeting with them to discuss her replacement.

The Board also welcomed Richard Jennings, who has taken on the role of medical director for up to a year. This will allow for a new chief executive to be appointed who will then make a substantive appointment. The Board also thanked Jill Foster for her work as interim nursing director, this was her last Trust Board meeting before she moves onto a permanent role at another Trust.

I have continued my visits to services across the community, recently going on some home visits with district nursing teams from Lordship Lane in Haringey and City Road in Islington. I visited the improving Access to Psychological Therapies (IAPT) service at Lansdowne Rd, Tottenham and I also visited Stuart Crescent, Bingfield Road and Tynemouth Road. It is impossible not to be impressed by the skill and commitment of our staff.

I've also met with the leaders and chief executives of both Haringey and Islington Council's to discuss a partnership between us and NHS Blood and Transplant (NHSBT) to promote and support organ donation.

My first 'breakfast' with staff, held for people whose birthday is in the same month, was a success with staff from across the organisation discussing a range of issues with me.
Steve Hitchins
Chair of Whittington Health
I would like to hear your thoughts
If you have any comments or views on any agenda items, please get in touch by clicking on the ‘email Steve’ button below or give me a ring on 0780 1106860.
Patient story   1
This month’s patient story was from Alison, a patient of our Islington Stop Smoking Service.

The service aims to improve people’s health by supporting smokers to quit and preventing young people from starting smoking. With their help people are up to four times more likely to quit than if they go it alone. People can be seen across the community, The Whittington Hospital and in most GP practices.

Alison contacted the team after being diagnosed with a thyroid problem and her consultant advising her to stop smoking. She had been cigarette free since January 2012. After having tried several different approaches to quitting which were not right for her. Alison joined a stop smoking group run by the service, where each patient sets the date they will quit.  Alison welcomed the support of these sessions where she was able to swap tips with people in the same position. A specialist supported her with quit goals and milestones.  She thanked the team, who helped her to get to where she is today. So far she has saved £1500 by not smoking. The programme runs for seven weeks, however Alison felt it would be useful to run these sessions for more weeks. More information on stopping smoking
Using the service made
a difference
2   Chief executive update 
Siobhan Harrington
Deputy chief executive, Siobhan Harrington,  presented the chief executive's report to the Board. She outlined the recent successes of our nurse recruitment campaign aimed at reducing our reliance on agency staff. In the last few weeks an additional 53 nurses have been recruited following recruitment events in Glasgow and Dublin.

Siobhan highlighted the incorrect coverage in the Camden New Journal about cancer and cardiac services. NHS England are proposing changes to specialist services. There are no plans to change the provision of our cancer or cardiac services.

A successful bid to the nursing technology fund is providing IPADs for each community nurse and health visitor. There are also additional IPADS for ward areas. This is part of our strategy towards a paperless organisation. We will also be submitting an application for e-rostering as part of the £500 million ‘Integrated Digital Care Fund’ round. 

Additional nurses   3
Jill Foster, interim director of nursing, presented a paper to the Board on a review of nurse staffing levels on acute adult wards in response to the Francis Report. This proposed an additional 39 nurses at a cost of £1.9m to formalise current ward arrangements which bring nurse staffing levels in line with recommendations.

Jill told the Board that there is a clear link between nurse: patient ratios, skill mix and patient outcomes. The levels on our wards have been reviewed using the latest methodology and include an allowance for all  leave and sickness. The investment will reduce agency spending and result in a £185k reduction of annual nurse pay costs. 
More nurses on wards
4   Update on district nursing 
Changes to the service
The Board heard a presentation on our district nursing service. The service carried out 275,672 patient visits in 2013/14. This is 10 per cent higher than last year and a 30 per cent increase over the last three years. The presentation told the Board about a district nursing improvement project that is underway and includes:
  • Recruiting and retaining the best nurses -  a recruitment campaign has halved the number of vacancies in the past 12 weeks
  • Improving effective communication with local GPs and other stakeholders
  • Improving customer experience including ensuring patients have written information cards telling them who their nurses are and how to contact them
  • Efficient team structure - teams are being restructured to fit better with our local GP networks
  • Improved productivity - pilot of a senior administrator post that will release senior nurse time for advanced clinical care. We are also introducing more electric cars, bicycles and IPADS
Greg Battle, medical director for integrated care, told the Board to expect further demand for these services.
Our emergency department performance    5
The Board heard from staff in our emergency department (ED). The team discussed our performance against the target of seeing 95 per cent of patients within four hours. May was our eighth consecutive month that the team achieved and exceeded  the standard. Recently they have implemented a number of improvements including:
  • Different staffing rotas that match demand and capacity throughout the year
  • Real time data that supports patient movement through the department
  • Early identification of surges and issues
  • Improved processes for escalation of any problems both in and out of hours
  • Expanded ambulatory care
  • Increased support from specialty teams including community services
The team are working closer with other teams across the Trust which has resulted in positive outcome for patients.
Four hour target met
6   Our financial performance 
Deficit for April
Our chief finance officer, Simon Wombwelll, reported a £600k deficit against a planned £350k deficit for April. The shortfall reflected a slow start to the Trust's savings targets largely because of continued high use of agency staff. It is important for the organisation to get an early grip on finances as we do not have reserves to cushion us this year. Meetings to discuss the first month's results have taken place with senior managers. Action plans have been agreed to bring our financial position in budget. 

The Board agreed that the financial position for the first month of the financial year has been disappointing and we need to take action to tighten control of our finances.
Working on it!