Board Matters - October 2014

Board Matters
Welcome to Board Matters
Our October Board meeting opened with an overview of two key events taking place this month. These were the official opening of the new TB centre at The Whittington Hospital by actress Emma Thompson and an event including The Kings Fund who are working with us to develop our new five-year strategy. The chief executive of The Kings Fund, Chris Ham, and his colleague, Hugh Alderwick, would be sharing their perspectives on our journey to date and giving examples of best practice work across the UK and internationally. 

The Board also heard how I will have visited every community health centre and service by the end of October. These have all been very informative and useful.

The Board was also updated on our plans to recognise long-serving colleagues within the organisation. A new process is being developed over the next couple of 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.
Patient story   1
The Board heard Kate Caryer's inspirational story which highlighted the importance of people having a voice through augmentative and alternative communication (AAC).

Kate was born with cerebral palsy after complications at birth. Like many people with the condition, she is unable to coordinate the muscles to control her speech. AAC covers a huge range of techniques which support or replace spoken communication. Kate told how she had used different forms of AAC aids as the technology had improved. She said everything changed when she won her legal claim and she was able to pay for advanced technology and training. She was then able to move to mainstream junior and secondary school, followed by college and university. Kate now has two degrees and is director of the Unspoken Project which aims to provide awareness of communication issues through art, drama and entertainment. Kate said: "I am in control of my life. Without this (AAC aid), I would have limited communication and be very frustrated."

Kate is supported by our speech and language team who play a vital role in AAC assessment and providing patients with the technology. The team recently set up a working group of adult community and learning disability services and children’s services across Haringey, Islington and Camden. Together they are raising awareness, building relationships with local commissioners and developing clear funding arrangements and means of loaning AAC equipment. Board members discussed the importance of people being aware of the technology and reaching those who need it.
Kate Caryer highlighting that communication matters
2   Chief executive's report
Simon Pleydell
Simon told the Board about our significant improvement in the National Cancer Patient Experience Survey 2014. Responses to 13 of the questions put us in the top 20 per cent of trusts in England. We were also the highest performer in London Cancer, a partnership of NHS, academic and cancer specialists dedicated to improving cancer patient outcomes and experience in north central and north east London. Over the last year, we have taken on two additional clinical nurse specialists and strived to improve our patients experience seeking feedback from both patients and their carers to find out what matters most to them. We will be updating our cancer improvement plan and presenting it to the Board. 

We have started work on the final business case for transforming our neonatal and maternity services following initial approval from the NHS Trust Development Authority (TDA) of £10m investment for the £20m project.  The plans include new neonatal intensive care and high dependency care units, a second obstetric theatre and a refurbished labour ward. 

Our flu campaign is underway following last year’s success as the first London NHS trust to achieve the target of vaccinating 75 per cent of our colleagues. This year, we hope to vaccinate more and have set ourselves a target of 80 per cent. 
Our new five-year strategy    3
Deputy chief executive and director of strategy Siobhan Harrington updated members on progress so far on developing our new five-year strategy.

As part of this strategy we are asking our colleagues, local community and stakeholders to be involved in developing a vision that reflects what we are, what we do and the patients we care for.

October and November are key months of engagement for the organisation. We will be discussing our strategy with clinical teams at all business meetings. The strategy work will focus on their services and how they see them developing over the next five years. There will also be a series of workshops based on population groups which will include colleagues and other stakeholders such as GPs and local authority representatives. A number of events across the community will also be held and we will be looking for community patient champions to work with us to develop and tell our story. The Board noted the importance of the work and reinforced their commitment to listening to local people and the community.  
Looking forward
4   Health and social care partnerships
Members of the N19 team
The Board heard an annual report and progress update on partnership working between Whittington Health and Islington and Haringey Councils. The Trust has a long standing relationship with both these councils of working in partnership and pooling health and social care budgets to provide better coordinated care to vulnerable people. These health and social care teams have shared expertise and knowledge which has improved patient care and reduced duplication.

Islington Borough Council
The Board was informed of some of the key achievements over the last year including the N19 Pilot which brought together colleagues from Islington Social Services and Whittington Health to work as a single team for all referrals of people living in the N19 area of Islington. They have seen an improvement in patient experience, with 81 per cent of people very or fairly satisfied with the service, compared to 59 per cent before the project started and a reduction in the number of people requiring on-going support from social services. The project has received interest nationally and the team is now working to bring the model into the normal way of working. 

Haringey Borough Council
Haringey Learning Disability Partnership provides health and social care services to adults with learning disabilities living in Haringey, delivering care within the community. This is an integrated service consisting of health and social care professionals working together to improve outcomes and reduce inequalities. Achievements include a person-centred care pathway, speedy referral process, reviewed management structure, no admissions to specialist hospitals and, as part of their response to Winterbourne View review, they successfully moved eight people back into the community. The team also won the Whittington Health’s Clinical Team of the Year Award.
Safe staffing levels   5
Philippa Davies, director of nursing and patient experience, provides the Board each month with an overview of nursing and midwifery staffing levels on our wards. Reporting on August 2014, Philippa said most areas had more than 95 per cent staffing levels. Some areas were greater than 150 per cent, this was largely because of the use of specials. Two areas fell below 90 per cent which were covered by senior nursing staff (matrons, professional development nurses and specialist nurses) working clinically. Philippa assured the Board that staffing levels are monitored and managed daily and there continues to be an emphasis on recruitment to vacancies to support safe staffing levels.
Assurance of levels
6   Our financial performance
Finance update
Our financial position continues to be tough with a deficit of £4.7m at the end of August, higher than the planned deficit of £1.2m. The Board was told there was a very challenging back-to-balance plan which is aiming to bring the position to break even by the end of the year.

The current position is a combination of reduced income as we continue to operate on a block contract and higher expenditure than planned. We are in discussions with our clinical commissioning groups (CCGs) on the current contract. The Board heard that there have been a number of successful recruitment campaigns for doctors and band five nurses which is expected to reduce expenditure from October.

Working on it!