Board Matters - July 2014

Board Matters
Welcome to Board Matters
This month’s Board meeting was opened with an update on the chief executive appointment. We have since announced that Simon Pleydell will be staying on until Christmas with a new recruitment process in the autumn. 

Philippa Davies has been appointed as director of nursing and patient experience on a one-year secondment starting next month. For the last five years, Philippa has been deputy director of nursing for East and North Hertfordshire NHS Trust and has extensive experience of working in senior management roles in complex trusts. Many thanks to Jill Foster, who left at the end of June, for all her work and significant contribution over the last three months.
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.
Emily's story   1
The Board heard Emily's emotional story of her difficulties navigating and receiving care across all parts of the NHS.

Emily developed pelvic girdle pain in her pregnancy which has since left her unable to walk very far and participate in usual parent activities like taking her child to the park. She described how she felt the NHS system had let her down and despite receiving physiotherapy initially as part of our maternity services, she had struggled to receive support afterwards. Emily has repeatedly gone back to her GP and sought referrals to different specialists. She spoke highly of our pain clinic which she discovered through her own persistence to find her way round the system. Emily has also been receiving physiotherapy but said the sessions were months apart and she was restricted to six sessions. 

The Board thanked Emily for telling her story, which they viewed as critical to the Trust improving as a learning organisation, and agreed to discuss the next steps that need to be taken to support Emily. Simon Pleydell described her account as a powerful story which should be heard by the whole health community.
Patient story: Emily
2   Chief executive update 
Simon Pleydell
Simon told the Board about a new infection control campaign encouraging the effective management of all diarrhea cases. We have had six Clostridium difficile trust attributable cases so far this year against an objective of no more than 19. Effective management of diarrhea is a key safety issue and one we are taking very seriously. 
We have been working very closely with Public Health England (PHE) over a baby diagnosed in June with the bacterial infection ‘bacillus cereus’. The baby had received the potentially affected intravenous liquid (total parenteral nutrition, TPN) and was one of a number of cases in hospitals across England. We also had another possible case. Our priority throughout the outbreak was to communicate, informing them of what had happened and offering support.  Investigations to date suggest the source of the infection was the contamination of intravenous liquid products during a single day of production which are no longer in production. 

Congratulations to the N19 pilot team, a multi-agency team comprising health and social care staff from Islington Council and Whittington Health, who won Team of the Year Award at Islington Council’s EPIC Staff Awards on 17 June. The award recognises the team that has made an outstanding contribution to a fairer Islington. The nomination highlighted the team’s energy and drive and their demonstration that high quality safe services can be achieved regardless of the financial challenge.
Haringey health visiting   3
The Board heard the improvements Haringey's health visiting team had been making to see more families within the national standards.  NHS England introduced a national 95 per cent target to carry out new birth visits (NBV) within 10 to 14 days. During the visit, health visitors carry out an assessment to identify health needs within the family, for example feeding problems, parents health and well being.   

The service said that in April this year,  91.3 per cent of new birth visits in Haringey were completed within the 10-14 day time frame, a vast improvement on the first quarter of 2011 when the figure was  21.5 per cent. A range of improvements including clearer pathways, prioritisation and health visitor recruitment had led to this rise. To reach the 95 per cent target, we are focusing on continued recruitment, a review of every visit that is below the target and closer working with other teams including midwifery and the child health information service.   
Health visitors
4   Stakeholder engagement strategy
Engaging patients, staff and community
The Trust's engagement strategy was presented to the Board. Strengthening engagement is critical for the Trust’s future - for accountability, trust, confidence, reputation and organisational culture.
The strategy has three key areas of engagement:
• Patient engagement
• Staff engagement
• Engagement with the community and other key stakeholders
It includes 11 core objectives and our commitment to engage more effectively. The paper also outlines who is accountable for delivery and how we will monitor and report progress. Action plans will now be developed with patients, staff and the community.
New education strategy unveiled     5
The Board heard details of a new strategy to deliver inter-professional education encompassing the full extent of integrated care. It follows the launch of an Education Strategy Group (ESG) which was set up to design and agree on a strategy for education.

The main aim of the strategy is for the Trust to be recognised as a preferred provider for education for Islington, Haringey, and beyond.  It aims to expand educational income and develop the Trust’s reputation as an education provider and centre of innovation. The strategy covers five strands: 

• An education programme on what integrated care means 
• Further exploration of the educational opportunities offered by integrated care 
• An exploration of the workforce requirements to deliver integrated care and
  integrated and inter-professional education 
• Creating an education ‘brand’ for Whittington Health to the extent that we
  become synonymous with integrated care and inter-professional education 
• Developing an intergrated style of working to govern how education is led,
  developed, run and evaluated across the Trust. 
The Board heard there was the potential to raise £16m income from education.
Being a preferred provider for education
6   Our financial performance 
Finance update
The Board heard how our position two months into the financial year continues to show us behind our plan, which is disappointing. At the end of May, we were £700k worse than projected, against a planned deficit of £0.8m. A deficit was planned for the first half of the year as a greater proportion of savings are due to deliver after September.

Greater scrutiny of Trust expenditure is being carried out particularly in non-clinical areas, discretionary spending and non-clinical vacant posts. Our cost improvement programme steering group is meeting every fortnight and we continue to review agency staffing spend. We knew this would be a challenging year financially for the Trust in line with much of the rest of the NHS. The Trust is making every effort to increase its grip on costs and draw upon new income sources. All savings plans are assessed to ensure there will be no impact on the safety and quality of the services we provide to our patients and users of our services.  
Working on it!