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MINUTES OF A MEETING OF THE COUNCIL OF GOVERNORS
HELD IN PUBLIC ON THURSDAY 29 NOVEMBER 2012 AT 4.30PM
IN LECTURE HALL 1, GREAT WESTERN HOSPITAL, SWINDON
Present
Governors:
Bruce Laurie (BL)
Clive Bassett (CB)
Harry Dale (HD)
Geraint Day (GD)
Jon Elliman (JE)
Godfrey Fowler (GF)
Bill Fishlock (BF)
Marcus Galea (MG)
Mike Halliwell (MH)
Peter Hanson (PH)
Janet Jarmin (JJ)
Brian Mattock (BM)
Jemima Milton (JM)
Srini Madhaven (SM)
David Stevens (DS)
Kevin Parry (KP)
Rosemarie Phillips (RP)
Phil Prentice (PP)
Margaret White (MW)
Chairman of the Trust
Nominated Governor (Prospect Hospice)
Public Governor (Swindon Constituency and Lead Governor)
Public Governor (Swindon Constituency)
Nominated Governor (The Academy)
Public Governor (Wiltshire Constituency)
Nominated Governor (Swindon PCT)
Staff Governor
Public Governor (Northern Wiltshire)
Staff Governor
Public Governor (Central Wiltshire)
Nominated Governor (Swindon Council)
Nominated Governor (Wiltshire Council)
Public Governor (West Berks and Oxon)
Nominated Governor (Wiltshire PCT)
Public Governor (Swindon Constituency)
Public Governor (Swindon Constituency)
Public Governor (Swindon Constituency)
Public Governor (Wiltshire Constituency)
Also in attendance:
Robert Burns (RB)
Rowland Cobbald (RC)
Roger Hill (RH)
Angela Gillibrand (AG)
Claire Litchfield (CL)
Julie Marshman (JM)
Kevin McNamara (KM)
Carole Nicholl (CN)
Roger Thomas (RT)
Dr Kate Tredgett (KT)
Nerissa Vaughan (NV)
Hilary Walker (HW)
Non Executive Director
Non Executive Director
Non Executive Director
Non Executive Director and Deputy Chair of the Trust
Governance Officer
Matron (part of meeting)
Head of Communications and Stakeholder Engagement (part of meeting)
Company Secretary and Head of Corporate Governance
Interim Director of Estates and Facilities (part of meeting)
Consultant, Palliative Care (part of meeting)
Chief Executive
Interim Chief Nurse
Members of the public – 2
PUBLIC PART OF MEETING
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94/12 Chairman’s Welcome and apologies for absence
The Chairman welcomed everyone to the meeting, and in particular noted the attendance of
new governors, Mike Halliwell and Rosemarie Phillips.
Apologies were noted from:
Vicki Barnett;
Lisa Campisano; and
Ros Thomson.
95/12 Results of 2012 Governor Elections/Reappointments/Nominations
The Chairman reported that following approval of the constitution by Monitor making
changes to eligibility criteria, Bill Fishlock and David Stevens had been re-appointed as
governors.
CN introduced Paper 1, which outlined the results of the elections held in 2012. It was
reported that the election result was as follows:
Lisa Campisano (Staff constituency)
Mike Halliwell (Northern Wiltshire)
VACANT (Northern Wiltshire)
Janet Jarmin (Central Wiltshire)
Roger Johnson (Gloucestershire and BANES)
Rosemarie Phillips (Swindon)
Phil Prentice (Swindon)
Margaret White (Central Wiltshire)
A paper showing the composition of the Council of Governors was circulated at the meeting.
It was reported that Roger Johnson, who had been elected to the seat in Gloucestershire and
BANES had sadly died before taking up office, and therefore a vacancy remained.
96/12 Lead and Deputy Lead Governor Elections
CN reported that, in accordance with the requirements of the Constitution, two public
governors had nominated themselves for the positions of Lead and Deputy Lead Governor.
CN advised that as there had been one nomination per position a secret ballot was not
required and the nominated individuals stood appointed in accordance with the provisions of
the Constitution. A paper setting out the candidates and their supporting statements was
circulated at the meeting.
RESOLVED
(a) That Harry Dale (seconded by Phil Prentice) be appointed Lead Governor until the
Annual Meeting of the Council of Governors in November 2013
(b) That Ros Thomson (seconded by Harry Dale) be appointed Deputy Lead Governor
until the Annual Meeting of the Council of Governors in November 2013.
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97/12 Declaration of Interests
None.
98/12 Public Minutes of Council of Governors held 8 October 2012
The minutes of the part of the Council of Governor’s meeting held in public on 8 October 2012
were adopted and signed as a correct record.
RESOLVED
That the minutes of the meeting held in public on 8 October 2012 be adopted and signed as
a correct record.
99/12 Action Tracker
The governors noted the position with outstanding actions.
RESOLVED
that the Action Tracker be received
100/12 Questions from Public
None.
101/12 Questions from Governors
This item was considered with Listening to our patients, (minute 106/12 refers). A number of
questions had been submitted in advance of the meeting by RP. CL had circulated a list of the
questions and answers to those questions. BL advised that any outstanding responses to the
questions raised would be circulated outside of the meeting. The Chairman advised that he
did not intend to read the questions and answers individually, and this was supported by the
Council of Governors.
1. “The Autumn edition of Horizon is splendid – it is written in columns which a visually
impaired person (VIP) can put under a reading machine to read. These magazines are
distributed in e.g. the neurology department – would it be possible to have 2 or 3
large print copies in the ophthalmology outpatients? Have you explored putting it on
Talking Newspapers so it becomes more accessible?”
“We did have a few large print copies previously. These were professionally done but
at a high cost – around £25 per copy. We can look at a cheaper alternative. With
regards to talking newspapers, we have not considered this, but will look into it to
understand costs and practicalities and will keep you informed – action,
Communications Team.”
2. “I understand that £45,000 has been put aside to upgrade the hospital signage. When
will this be done? I assume it will be in accordance with the April 2011 report written
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by Chris Fielding from the RNIB”.
“Yes, a meeting was held on 23 November to discuss signage and agree priorities. The
RNIB report was used as the basis of the meeting the early agreement was to increase
Braille signage near toilets etc. For signage to the eye clinic to be black writing on a
yellow background.”
3. “As you will be aware, many hospitals have an eye care liaison officer (ECLO). For
those not familiar with the post of an eye care liaison officer, it is a post that forms a
bridge between the hospital and finding resources in the community to support the
patient who may well be in shock after having a difficult diagnosis. Is the FT working
with the CCG on obtaining funding for this important post?”
“Currently we have a one off amount of money to train a person (volunteer or
member of staff) from the trust to be an ECLO. We have yet to identify someone who
can perform this role. This training will be duplicated by a volunteer from Wiltshire
Blind, giving 2 trained persons available for some time during a week.
There is no funding from the PCT or social services to add this as a new, full time and
recurrent post. We are currently grading the job to discover how much the role would
cost for a permanent post, but have no money to fund this from the trust with
commissioners funding.”
4. “One resource that you will be aware is available is the register of registered blind
people held by the Council. Do you have a data sharing agreement in place so this
register can be used across the health economy?”
“We provide the data to the council for this register in the form of blind registrations
by our doctors. We keep copies of the registrations on file, but have no further
information from the council. We do not use their register and have no sharing
agreement”.
RESOLVED
That the questions raised and answers given be noted.
102/12 Report of the Chairman
Death of Roger Johnson
The Chairman welcomed the new governors to the meeting and announced the sad news that
Roger Johnson, who had been elected as the Governor for Gloucestershire and BANES had
passed away on 20 November. BL advised that Roger had been a very active member of
Friends of Fairford Hospital and that he had been looking forward to working with Roger on
the Council of Governors. BL expressed his condolences to Roger’s family and friends.
Outgoing Governors
BL expressed his sincere thanks for the contribution of Godfrey Fowler, Marcus Galea and
Geraint Day, who would no longer be part of the Council of Governors. BL wished each of
them well for the future on behalf of the Council.
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BL advised that the revisions to the Constitution had been approved by Monitor and that the
changes were now in effect, the result being that both Bill Fishlock and David Stevens had
been reinstated as governors.
Tape recording of meetings
BL advised that a query had been received as to whether it would be permissible for a
governor to tape record meetings as an aide memoire. BL stated that the Constitution was
silent on this point and that it had been custom and practice not to record meetings, but to
produce contemporaneous minutes. BL stated that the Company Secretary advised against
the tape recording as it was not usual practice at public meetings and that people might have
feel inclined to speak freely and openly if they were aware that they were being recorded.
RESOLVED
(a) That the report of the Chairman be received; and
(b) That it be agreed that the tape recording of meetings be not permitted.
103/12 Report of the Chief Executive
The Chief Executive provided Governors with a brief update as follows:
Monitor
NV advised that some of the Board members had met with Monitor regarding some concerns
Monitor had regarding this Trust’s ability to deliver its Annual Plan and to discuss the transfer
of assets from former Wiltshire Community Health Services (WCHS) sites to this Trust. NV
reported that this had been a positive meeting.
Health Service Journal Awards
NV reported that the Trust had received two nominations for awards by the Health Service
Journal, in two separate categories. NV advised that she was very proud of this achievement,
which recognised the work of the Trust. NV stated that nominations had been received for
both the work around the “Think Drink” campaign, and the Ambulatory Care Unit. NV
reported that staff had attended the awards, and although had not won, it was a fantastic
achievement to be nominated.
Nursing Strategy
NV advised that work was ongoing with regards to the Nursing Strategy, and that Governors
would receive a presentation later in the meeting from the newly appointed Chief Nurse,
Hilary Walker.
RESOLVED
That the report of the Chief Executive be received.
104/12 Liverpool Care Pathway
The Council of Governors received a presentation on the Liverpool Care Pathway, by Dr Kate
Tredgett and Julie Marshman, Senior Nurse. BL advised that he had requested the inclusion of
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this presentation, following recent reports in the press around the pathway and he wished
governors to have a better understanding.
The presentation about the Liverpool Care Pathway (LCP) covered the following:  Communication
 Medication
 Symptoms
 Comfort
 Reduced need for food and drink
 Supporting care in the last hours of life
 Decision making
 Documentation
 Assessment
 Care after death
 Family support
A number of key points were drawn from the presentation notably:  Diagnosis of dying was made before implementation of the LCP.
 The LCP had developed over time and was based on research based evidence of best
practice.
 There was a need to make the dying experience the best it could be for the patient
and family.
 Regular review of any patient on the LCP was a key component.
 The patient needed to understand and agree to what happened on the LCP.
 Communication was a key element of the LCP.
 Consideration was given as to whether treatment should continue and often the focus
was on keeping a patient comfortable.
 Where appropriate patients were fed and provided with drinks. However, artificial
nutrition was different. It was explained that increased fluids could often result in
greater secretions, rattle and discomfort to the patient.
 The median time on the LCP was 27 hours with the median age of patients being 83
years old.
 40% of deaths were supported by the LCP.
 All deaths were reviewed to determine whether they were expected or not.
 Often patients were frightened but there were proactive teams on wards who were
able to offer advice and reassurance.
KT advised that the Liverpool Care Pathway (LCP) provided benefits for both the patients and
the staff providing their care. KT advised that the pathway improved the confidence of nurses,
helped to manage the patient’s symptoms and improved multi-disciplinary team working, by
ensuring that all members of the team delivering care were aware of the plan. KT advised that
using the LCP provided improved documentation of the care delivered and enabled
anticipatory prescribing of medications for the 5 key symptoms that could develop for
patients.
KT confirmed that in order for patients to be placed on the LCP, a senior clinician had to
provide a diagnosis of dying for the patient and that a full explanation of the plan of care had
to be given to the patient. KT advised that by using the LCP the Trust had accessed
educational support, mandatory e.learning modules, biannual study days, preceptorship
training and link nurse training.
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KT reported that most patients who were placed on the pathway were on it for 24-48 hours.
In addition, she reported that the pathway was fluid, and so if any changes were detected
which would change the diagnosis of dying then the position would be reviewed.
KT circulated at copy of the LCP document, so that the governors could understand its
content. KT confirmed that the LCP was used as it was nationally recognised and members of
the public had an understanding of what it meant.
The Chairman thanked Dr Tredgett and Julie Marshman for their presentation.
RESOLVED
That the presentation be received
105/12
Listening to our patients (eyes and ears)
(this item was considered with the Questions from Governors (minute 102/12 refers)
It was noted that RP had submitted some issues that she wished to be considered under this
item. The questions raised are detailed below, along with the Trust’s response.
1. “Concern has been expressed to me about the lack of a timely response by staff to letters
sent in by patients. Are there standards for people to respond to patient letters, in
particular the governors and PALS?”
“Responses to patient letters to PALS are monitored. We can provide you with the Patient
Experience Working Group Dashboard so that you can see current performance”.
2. “Some patients are unable to read the usual font size for letters being sent out from the
hospital. When will letters sent to patients be in a font that they can read for themselves
(including Braille)?”
“Appointment letters are being reviewed as described in the response to question 4.
Ophthalmology letters have been reviewed with clinical staff and two patient’s feedback. The
conclusion was that all Ophthalmology Letters would be sent in font size 16 and this is being
implemented. In addition all letters will have a clear directive at the bottom explaining how
patients requiring larger font/brail can contact the Eye department to arrange this
communication. Please find attached some meeting notes and prescriptive changes sent to IT
for implementation.”
3. “I have been contacted by a few people who have had a poor experience of care at the
hospital. When they have tried to say something, the staff member has been abrupt and
dismissive. It would be useful to know what training is given to staff at all levels including
those on temporary contracts or locums on how to deal with such feedback. I also think
that we as Governors should have the opportunity to see the positive feedback that I
know many patients give to the staff. How do you check that the training in relation to
patient feedback has worked? What feedback do you give the Swindon residents about
the complaints you have received as a Foundation Trust?”
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“We share complaints information with Governors through the patient experience working
group, and through the annual report but this is perhaps an area we can do more on. We are
currently running customer service training and will review complaints in those areas to look
at impact. Our “Goldfish bowl” training has also just started which is to be aimed at senior
clinical staff. It is still in its early days but progress will be monitored.”
4. “I am aware that patients get their appointments cancelled. Several people have said to
me that when they are notified of the cancellation they would really like another date for
the appointment in the same letter.”
“The Outpatient ‘Eyes to the Future Project’ is systematically reviewing the outpatient
departments and is starting with Ophthalmology, Respiratory and ENT. This work streams
from this review are informed by Patient and Staff workshops and questionnaires. David
Moss, Outpatient Manager has communicated this to all booking staff to ensure whenever
possible an appointment is reallocated at the same time as the cancellation is actioned.
Whilst this is best practice, this is not always possible if future clinics have not been
timetabled.”
5. “Patients who need regular appointments (e.g. for those needing Lucentis) would
appreciate having their next appointment before they leave the hospital. It would be very
helpful if the receptionist could make these appointments for people.”
“We are trying to add more capacity into the department to enable more appointments to be
available so that the reception staff can book appointments at the time. For most of this year
we have had vacancies for doctors that we have had difficulties filling. Good quality eye
doctors are currently in short supply, and we remain optimistic that we will recruit to the
vacant positions soon.”
6.
“Along with other people, I have difficulty in reading some communications from the
hospital. You always put at the end ‘if you can’t read this ...’. Could this be at the beginning? It
would also be good if acronyms were at the beginning as well.”
We can ensure that this is included in agendas and paperwork sent out to members through
the membership office. Investigations will be made as to whether it is possible for other areas
to follow.
7. “Some people with Advance Directives are concerned that the staff may not always be
aware that one exists. It would be helpful if reference to these was made on the front of
the notes, rather than on the inside front cover. Would it be possible to know where
reference is made to the Advance Directive on patient’s computerised notes?”
“We have a policy of not recording anything other than the patient demographics on the front
cover of the case notes for confidentiality reasons. Instead, a red ‘warning’ label should be
attached to the front cover indicating that an alert or allergy is recorded on the inside. There
is a customised box printed on the inside front cover of the notes to record any such alerts or
allergies. An Advance Directive would be recorded in this way – as an alert.
On Medway, the hospital’s computerised records system; a Medical Alert is added to indicate
the presence of an Advance Directive. The existence of an Alert will be displayed when anyone
accesses that particular record.”
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RESOLVED
That the issues raised and the responses given be noted.
106/12
Nursing Strategy
The Governors received a presentation from the Chief Nurse, Hilary Walker regarding the new
Nursing Strategy.
HW shared the vision and aims of the strategy with the governors. explaining that it was built
around 6 “C”s:
Care; compassion; commitment; courage; competence and communication.
HW commented that the national narrative was woven into this strategy, with these 6 “c”s
having been identified by the new Chief Nursing Officer, Jane Cummings. HW explained that it
was intended that the strategy should be a working document, which would be easily
accessible by members of staff.
MG commented that it was important that record keeping was part of the strategy, as it was
an important part of the nursing role. HW commented that record keeping was a work stream
in the strategy.
DS commented that he would have expected to see “empowerment” within the strategy. He
commented that it was important that nurses felt that they could take ownership, particularly
when dealing with complaints. HW commented that a bespoke leadership development
programme would be developed and would commence in January.
GD questioned whether there had been any dialogue with the local education board. HW
commented that there had not, however she recognised that this was important. HW
confirmed that the Local Involvement Networks had been invited to comment on the
strategy.
JM commented that it would have been helpful if the strategy had been received in advance
of the meeting, so that the governors could have considered it fully. This comment was noted.
RESOLVED
107/12
CL to add
That the Nursing Strategy be received and that Hilary Walker be invited to return to the to the
Council of Governors in six months time in order to report on progress.
action
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Bus Services Update
Governors received a report from Roger Thomas, Interim Director of Estates regarding bus
services to Great Western Hospital.
It was reported that the Section 106 agreement monies from developers that had been used
to subsidise bus services to the Great Western Hospital would cease at the end of the year. He
commented that the subsidy to run bus services to GWH for 10 years had amounted to £7
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million. RT advised that from January 2013, only commercially viable buses would run to the
GWH, as neither the Trust nor Swindon Borough Council would be able to put funds towards
subsidy.
RT advised that there was likely to be an impact on car parking, as there was insufficient space
on the site to accommodate those now likely to travel by car, in the absence of bus services.
RT advised that a meeting had been held between the Trust and Swindon Borough Council to
discuss the position. RT advised that there was some space available to develop for car
parking on site which was being explored.
RT
Governors questioned whether the bus companies had been involved in discussions around
the future provision of services. It was suggested that a meeting be arranged with
Thamesdown Transport, the estates team and Swindon Borough Council. To assist the matter
it was further suggested that consideration should be given to representatives from
Thamesdown to the next council of governors meeting, although this was not supported,
noting that the matter would first need to be discussed by all parties. BM, the appointed
governor for Swindon Borough Council commented that he was happy to assist in the
facilitation of such a meeting.
BM suggested that the gap in services needed to be understood and that sponsorship might
be a possibility to explore. He suggested that section 106 monies might be available from a
neighbouring development site which should be looked into. BL undertook to talk to BM
outside of the meeting on how to progress this, including a meeting with all bus service
providers. HD expressed concern that this matter had only just been reported to the
governors. BL responded that this had been the first Council of Governors meeting since he
had become aware of the issue. HD suggested that concerns should be drawn to the attention
of local MPs but no specific action was agreed on this comment.
KP questioned how many additional car parking spaces the Trust could accommodate.
RT commented that a plan would have to be worked out, but that the gravel car park could be
stretched and that more disabled spaces could be available to the front of the hospital.
RESOLVED
that the update be received
109/12
Membership Strategy
The governors received a paper from the Governance Officer outlining the revised
membership strategy.
CN introduced the paper, noting that there was a change of focus towards maintaining and
providing meaningful opportunities for engagement and contact between governors and
members, rather than solely increasing numbers. It was noted that a range of initiatives
would be introduced, such as public lectures and community events.
It was noted that an action plan would be developed and would be monitored by the
Membership Working Group.
GD commented that he thought the strategy was excellent, particularly the development of
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Clinical Lectures and that the election turnout had been good when compared to other recent
elections.
RESOLVED
That the Membership Strategy be approved
110/12
Calendar of Meetings
The Council of Governors noted the Calendar of meetings for the forthcoming year.
JJ commented that she had not been consulted and the dates of some of the meetings were
unsuitable for her.
RESOLVED
that the calendar of meetings be approved.
111/12
Membership of Working Groups
Governors received a paper setting out the membership of working groups for the year
2012/13 and the terms of reference for each.
It was agreed that governors should indicate to the lead governor, Harry Dale, which groups
they wished to be involved in.
RESOLVED
That the Terms of Reference of the working groups be approved together with the
membership subject to any amendments notified to the Lead Governors and Company
Secretary during the course of the year.
113/12
Review of the Constitution
The Governors received and considered a report from the Company Secretary which sought
views on proposed changes to the Constitution. These changes were to divide the staff
constituency into classes to better reflect the composition of the Trust’s staff base and to add
other partnership organisations for the purpose of nominating governors, noting the expected
abolition of Primary Care Trusts (PCTs) in 2013.
The Company Secretary draw attention to the report which reminded the Council of
Governors of the previous suggestion for the staff constituency split agreed in 2010.
However, since that time, the staff base of the Trust had changed and therefore in
consultation with the Director of Workforce and Education, the proposed classes were as
follows, details of which were circulated at the meeting:


Hospital nursing and therapy staff
Community nursing and therapy staff
Doctors and dentists
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Administrators, maintenance, auxiliary and volunteers
It was noted that the number of staff governors would increase from three to four. The
proposed staff classes were supported.
With regard to the pending abolition of PCTs there was an opportunity to consider other
partnership organisations which might nominate governors. Clinical Commissioning Groups
had been mentioned but not formally discussed and therefore the Council of Governors was
asked to express a view on this. Governors supported NHS Swindon Clinical Commission
Group and NHS Wiltshire Clinical Commissioning Group as partnership organisations for the
purpose of nominating governors as these would be organisations which the Trust would
work in close partnership with.
It was recorded that more than half of the Governors were present and the proposed changes
were endorsed unanimously.
RESOLVED
that the Board be advised that the proposed changes to the Constitution are supported by
the Council of Governors as follows: -
114/12
Change
Division of the Staff Constituency into classes
as follows with an increase from 3 governors
to 4: Hospital nursing and therapy staff
 Community nursing and therapy staff
 Doctors and dentists
 Administrators, maintenance, auxiliary
and volunteers
1 governor each with a minimum membership
of 100.
Reason
To ensure the staff constituency
reflects the composition of the
staff base.
The addition of two other partnership
governors, namely from NHS Swindon Clinical
Commission Group and NHS Wiltshire Clinical
Commissioning Group
To ensure the appointed governors
are from relevant partnership
organisations.
Dates of next meeting
It was noted that the date of the next meeting was 18 February 2013 at 4.30pm in Lecture
Hall 2, The Academy.
115/12
Resolution of the Council of Governors to exclude the public and the press
RESOLVED
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That members of the public and the press be excluded from the remainder of the meeting,
having regard to the confidential nature of the business to be conducted.
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PUBLIC SUMMARY OF ITEMS CONSIDERED IN PRIVATE PART OF THE JOINT TRUST BOARD AND COUNCIL
OF GOVERNORS MEETING HELD ON 29 NOVEMBER 2012 16.30
Public
Summary
No.
PS/116
Minute
Private Minutes
The minutes of the private part of the Council of Governors meeting held in private on 8 October
2012 were adopted and signed as a correct record.
PS/117
Minutes of Working Groups
The minutes of the following Joint Committees were received:
Joint Nominations Committee - 5 November
Joint Nominations Committee - 28 November 2012, the recommendations contained therein were
approved (Minute PS/118 refers)
PS/118
Appointment of Non Executive Directors
Further to the receipt of the minutes of the Joint Nominations Committee, which met on 28
November 2012 and the recommendation contained therein the Council of Governors
RESOLVED
that Professor Dame Janet Husband DBE and Philippa Green be appointed as Non Executive
Directors of the Trust for a period of three years commencing on 1 January 2013.
PS/119
Private Urgent Business
None.
Chairman_____________________
Date
_____________________________
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