COUNCIL OF GOVERNORS PAPER
Meeting date: 13 October 2010
Title:
Agenda item: 8.2 Part I
Board performance and update
Purpose:
To update the Council of Governors on key Board issues, Board
performance and external engagement by the Board.
Background: This paper sets out:
(i)
an overview of the key issues that the Board has been focusing on over the
previous three months. The report sets out some of the key discussions and
the processes undertaken by the Board to seek assurance as necessary;
(ii)
an update on some of the development work undertaken by the Board to
enhance its performance;
(iii)
an update on Board appointments and recruitment issues;
(iv) an update of key external engagement opportunities undertaken by the Board.
This report has been developed in line with the outcomes from the fundamental
review and is the first time it has been developed. Feedback from the COG on
whether this is a useful overview of Board assurance, development and
performance would be welcome as the report is developed further.
Key Board Issues:
The report covers the Board meetings in September and July (there was no Board
meeting in August).
The main focus for discussions over the last three months included:
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A first overview of the recently published White Paper and the consultation
process at the July meeting followed by a seminar in September.
The Board discussed the emerging RD&E vision and values and requested
that this was developed to take into account the discussion at the Board.
In July, the Board looked in detail at a number of issues emerging from the
performance report including a focus on finances, staff head counts and
turnover, and incident reporting. The Board looked in detail at the
underperformance in the Trust’s cost reduction programme in July. At its
meeting in September the Board identified the information it would need to
monitor effectively efforts to improve performance on the Cost Improvement
Programme.
The Board focused on the dry run assurance of the quality report undertaken
by the auditors and looked in detail at the assurance issues underpinning
performance data.
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The Board also looked in detail at work underway within the Medicine Division
on new ways of working to reduce length of stay in hospital, reduce medical
outliers, achieve greater consistency in care, and improve discharge.
In July, the Board met with Governors to discuss the outcomes of the
fundamental review.
On the issue of patient experience the Board discussed specific proposals to
improve ‘ward to board’ reporting and plans to improve the use of lessons
learned from complaints and compliments to inform future practice.
The Board also had a discussion about the implications of the Transforming
Community Services initiative for both the RD&E and the wider regional health
economy. Whilst plans for specific services have not been finalised the Board
agreed that the principle that should underpin the RD&E’s approach to the
TCS agenda should be co-operative and mutual in the best interests of
patients and the wider community.
Board development
In February the Board agreed a development plan based on an earlier development
day which focused on a self assessment of Board performance linked to some of
the strategic challenges that the Board would face over the coming year or more.
The Board identified four key areas that would enable it to be sufficiently equipped.
These four areas were:
 Skills/capacities
 Common purpose/unitary approach
 Board processes
 Information & knowledge
Since then the Board has been undertaking a programme of development activity
linked to the priorities it identified in February. For example, earlier this year it held
a seminar on the issue of NHS transactions. Over recent months it has:
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Received an overview in July from a PCT staff member, as part of its strategy
refresh work, on some of the demographic drivers that will impact on
healthcare over coming years. This was identified as one of the issues where
the Board required more information.
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Used elements of scenario planning in its strategic analysis of options
available to the Trust under the Transforming Communities/post-White paper
agenda
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Held a session in late June on understanding Board behaviours and the
drivers of top team performance as part of the ongoing development of the
Board.
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Holding regular lunchtime discussions and afternoon seminars on specific
issues relevant to the strategic direction of the Trust.
I am also leading a process – the Board Improvement Programme – which will help
deliver the continuous development of the Board. More details on this programme
will be developed in due course and shared with the governors.
The Board also met with Governors at the joint development day last month where
we looked at various issues of mutual interest.
Board structure
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Appraisals of the Executive Directors both for their operational and Board roles
have been completed by the Chief Executive and reported to the Executive Director
Remuneration Committee. I have in addition completed the appraisals of the Non
Executive Directors. All these appraisals were satisfactory. The SID is also
undertaking my appraisal and he will report to the COG in January. David
Robertson, the new Non executive Board member, begins work on 1 October
before taking up his role proper on the 1 November. David has agreed in principle
to Chair the Audit committee but this has yet to be ratified by the Board. Gerald
Sturtridge will step down from the Board at the end of October. Those on the
Nominations Committee will know that a process to appoint a new NED to replace
David Bishop has already begun and an evening event for prospective NEDs to find
out more about the Trust and its Board is being held on the 27 October (any
governors who wish to attend should notify Bernadette). As David is the SID, a
process in which the COG ratifies a new SID appointment will be undertaken at the
COG meeting in January 2011.
Engagement
Various members of the Board met with a wide range of stakeholders during the
period. The White Paper and the Transforming Community Services agenda meant
that there were a number of meetings held with the Department including the
Secretary of State as well as a wide ranging partnership with NHS Devon. The
executive in particular has spent considerable time over recent months talking to
GP consortia. Members of the Board have also met the Chair of Monitor during this
period. In addition, the NEDs continued with their regular visits to parts of the
hospital.
Recommendation: For comment and noting.
Presented by: Angela Ballatti, Chairman
Monitoring information: (Please specify CQC standard numbers and tick other
boxes as appropriate)
Care Quality Commission Standards
Monitor
Service Development Strategy
Local Delivery Plan
Assurance Framework
Other (Please specify)
 Finance
Performance
Management
Business Planning
Complaints
Equality, diversity, human
rights implications
assessed
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