Agenda and supporting papers - Plymouth Hospitals NHS Trust

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Item 3 • Noted the financial position of the Trust as at 30 April 2013. • Approved a deficit budget of £13m for 2013/14. There was a break between 1.05 pm and 1.10 pm. D Mr Teape’s report set out the proposed capital programme for 2013/14. The programme had been subject to extensive review by the Investment Panel, the Capital Steering Group and the FPIC, all of which included clinical representation. Mr Teape stated that it would be unwise to approve R individual elements of the programme at the expense of others and recommended that the Board approved the full plan with the expectation that cash flow would be tightly managed. The Trust’s Scheme of Delegation defined those individual elements within the overall plan that must come back to the Board for approval. Progress with the capital plan delivery was reported monthly to the Board and was subject A to FPIC oversight. 112/13 Capital Budget Report 2013/14 Mr Budge noted the Medical Equipment Rolling Replacement Programme budget of £1.7m and queried the criteria used to assess the risks and whether the Board could be assured that equipment for patients would not fail. Dr Mayor explained the risk assessment employed by the Medical F Devices Strategy Group and expressed his confidence in their decision making process. Mr Teape referred the Board to section 6 of the report which set out where capital spend would be focused if additional resources were available. After reviewing the details the Board took the view that it was not for Board members T to second guess others’ best informed decisions. They should instead seek assurance of the integrity of the process in bringing forward these recommendations and that the investments proposed were strategically and clinically important. Mr Douglas stated that FPIC had reviewed the proposed programme twice. There were risks associated with it but there was also contingency and FPIC supported the programme proposed. Dr Williams queried the degree to which leasing arrangements were available. Mr Teape stated that FPIC had previously reviewed this but it would be picked up as part of the longer term procurement strategy. Echoing earlier discussions, the Board noted that: • Linking the capital plan with the site development plan to be developed as part of the strategy implementation would be welcome. 13
Item 3 • Careful communication of the spending associated with the plan was important given the mixed messages to staff and public that could arise. The Board: • Approved a capital programme of £15m consisting of precommitments of £4.1m and additional proposed schemes of £11.4m on D the understanding that £0.5m of slippage would be identified as the year progressed. • Agreed that this approval would be kept under review in recognition that affordability was dependent on the Trust’s cash position. R • Noted the table of reserve bids in the event that additional funding could be secured. • Noted that all other schemes would come back to the Board as Full Business Cases on the basis that they were loan funded. A 113/13 Theatre Safety Improvement Plan This report set out actions to minimise risk to patients following five Never Events which occurred between November 2012 and March 2013. In addition to the immediate actions described, Dr Mayor explained the remit of the Surgical Safety Improvement Programme to F disseminate medium and long term interventions to improve patient safety. Dr Williams queried the initiatives within teamwork interventions. Dr Mayor cited the introduction of formal theatre debriefing sessions associated with the WHO checklist and Human T Factors training. Mr Dix outlined the key changes resulting from the Theatre Safety Improvement Plan under the domains of resources, communication, Five Steps Safe Surgery and training and education. The report detailed the changes expecting during the coming month. The Trust would be subject to national expert review at the end of June with recommendations reported in July. Whilst there had been some overall slippage with the Plan, he was confident that the Trust’s new organisational structure, including the appointment of a service line lead for Theatres, would bring this back on track. The Board welcomed the external involvement detailed in the report and requested periodic reports on progress. The Board noted the report. 14
Page 1 and 2: Trust Board Friday 5 July 2013, 9.0
Page 3 and 4: Members of Plymouth Hospitals NHS T
Page 5 and 6: Item 3 observer. The Chairman requi
Page 7 and 8: Item 3 Board oversight of contribut
Page 9 and 10: Item 3 the Board next month. • Th
Page 11 and 12: Item 3 been involved and there was
Page 13 and 14: Item 3 continuing to build. Mr Babe
Page 15: Item 3 to Norovirus, Professor Lewi
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Page 21 and 22: Updated: prior to July Board Item 4
Page 23 and 24: Updated: prior to July Board Item 4
Page 25 and 26: Item 8 Quality Impact Assessment Pa
Page 27 and 28: Item 8 3.2 Quarterly Summary Hospit
Page 29 and 30: Item 8 4.4 Monthly Proportion of Pa
Page 31 and 32: Item 8 Inpatient falls are currentl
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Page 37 and 38: Item 8 The graphs below illustrate
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Page 43 and 44: Item 8 Observations The essence of
Page 45 and 46: Item 8a SUMMARY REPORT Trust Board
Page 47 and 48: Annex 2 Item 8a Summary of Serious
Page 49 and 50: Item 9 Key Recommendations The Trus
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Page 53 and 54: Item 9 Description 31 days from 'de
Page 55 and 56: Item 9 4.6 Non Elective Activity is
Page 57 and 58: Item 9 Summary of performance excep
Page 59 and 60: Item 9 Ensure that all patients adm
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Page 63 and 64: Item 9 Update on previous actions C
Page 65 and 66: Contents EXECUTIVE SUMMARY D FINANC
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B1 Safe care Description Hospital S
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Response Rate Recommender Score B3
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B5 Other safety & quality metrics D
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C2 Non-Elective Activity Descriptio
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C4 Referral To Treatment (RTT) Desc
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C6 Other access & activity metrics
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D2 Cost improvement programme (CIP)
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D4 Cash Management Description Revi
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E1 Staffing numbers Description Est
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E3 Sickness absence PERFORMANCE IND
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Risk Rating F2 Monitor's Financial
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Item 10 DETAILED REPORT Trust Board
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Item 10 4. Key Issues for the Board
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Item 11 SUMMARY REPORT Trust Board
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Item 11 DETAILED REPORT Trust Board
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Item 11 • Challenge in respect of
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Item 11 Over the past two years, me
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Item 11 Getting it Right Charter An
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Item 11 Outcome of review with exte
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Item 11 Learning Disabilities Natio
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Item 11 Peer Review 2.5 Peer Review
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Item 12 Next Steps 1. Conversation
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Item 12 2. Board Inclusion Developm
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Item 12 EDS Grades and E & D Object
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Item 12 Plymouth Hospitals Trust -
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Item 12 3.6 The workforce is suppor
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Item 13 Key Recommendations The Tru
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Item 13 Telephone conversations.
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Item 13 19. The Medical Director ha
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Item 15 incident investigations to
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Item 15, Annex 1 3. Review of Actio
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Item 15, Annex 1 • Top three issu
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Item 15, Annex 1 The Chair asked SS
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Item 16 COMMITTEE MINUTES Finance,
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Item 16 pay and staffing, highlight
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Item 16 • PACS contract - likely
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Item 17 Terms and Conditions of Emp
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Item 17, Annex 1 29/2013 Minutes an
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Item 17, Annex 1 31/2013 Francis Re
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Item 18 Next Steps The Audit Commit
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Item 18, Annex 1 Matters arising 4/
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Item 18, Annex 1 time to embed and
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Item 18, Annex 1 Payroll & Expenses
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Item 18, Annex 1 The Committee note
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Item 18, Annex 1 Going Concern Revi
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Item 18, Annex 1 if Internal Audit
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Agenda and supporting papers - Plymouth Hospitals NHS Trust

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