a meeting of the board of directors will take place … · 2020-05-01 · corporate governance :...

A MEETING OF THE BOARD OF DIRECTORS WILL TAKE PLACE ON THURSDAY 7 MAY 2020 at 10:30 am

by Video-conference

BARNSLEY HOSPITAL NHS FOUNDATION TRUST

Please note:- due to the Covid-19 outbreak this meeting will not be held in public.

No Item

Sponsor Ref

1 Apologies and Welcome.

Mr T Lake Chairman

2 To receive any Declarations of Interest. To confirm that due to Covid 19 the Board meeting is not held in public and will be held by secure video-link.

Verbal Assurance

3 To approve the minutes of the meeting of the Board of Directors held in public on 2 April 2020.

20/05/07/03 Approve

4 To approve the action log in relation to progress to date and review any outstanding actions.

20/05/07/04 Approve

ASSURANCE 5 To receive the COVID-19 response update.

Dr R Jenkins

Chief Executive

Verbal Assurance

6 To receive and approve the Chair’s Log for the Quality and Governance Committee (Q&G) held on 29 April 2020.

Ms R Moore Chair of Quality &

Governance Committee

20/05/07/06 Assurance

7 To receive and approve the Chair’s Log for the People, Finance and Performance Committee (PFP) held on 30 April 2020 including.

Mrs K Firth Chair of Finance & Performance

Committee


8 To receive the Chair’s Log for Barnsley Facilities Services (BFS).

Mr F Patton Non-Executive

Director


9 To note the Appointment of Barnsley Facilities Services Director.

Ms M Saunders Director of Corporate

Governance

20/05/07/09 Note

10 To receive and review the Chair’s Log on any escalation issues from the Executive Team (ET).

Dr R Jenkins Chief Executive

Verbal Assurance

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11 To review the monthly Integrated Performance Report (IPR) – Month 12.

Mr B Kirton Chief Delivery Officer/Deputy

Chief Executive


STRATEGY 12 To receive the Chair’s Log for the Barnsley

Integrated Care Partnership Group.

Mr T Lake Chairman

Verbal Note

CULTURE 13 To endorse the report on Celebrating our

People. Mrs E Parkes

Director of Communications

& Marketing

20/05/07/13 Note

OTHER ITEMS 14 To receive and review the monthly report from

the Chairman.

Mr T Lake Chairman

Verbal Note

15 To receive and review the monthly report from the Chief Executive including:- i For information - update on the South

Yorkshire and Bassetlaw Integrated Care System (ICS)

ii Letter from Sir Simon Stevens, Chief Executive NHS England

ii For information – Ethics Terms of Reference (ToR)

Dr R Jenkins Chief Executive

20/05/07/15

20/05/07/15i 20/05/07/15iii 20/05/07/15iv

Note

16 Date of next meeting: - Thursday 4 June 2020, starting at 10.30am, Boardroom, Trust HQ.

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MINUTES OF A MEETING OF THE BOARD OF DIRECTORS

HELD ON THURSDAY 2 APRIL 2020

Due to the current Covid-19 pandemic, the meeting was not held in public PRESENT (via Zoom/Conference call):- Mr T Lake Chairman, Chair Dr R Jenkins Chief Executive Officer Mr C Thickett Director of Finance Mr T Davidson Director of ICT Ms E Parkes Director of Communications, (due to prior commitments left

the meeting at 12 noon) Mr N Mapstone Non-Executive Director Mr P Hudson Non-Executive Director Mr F Patton Non-Executive Director Mrs K Firth Non-Executive Director Mrs S Ellis Non-Executive Director Mr K Clifford Associate Non-Executive Director PRESENT (in person):- Dr S Enright Medical Director Mr R Kirton Chief Delivery Officer & Deputy Chief Executive Mrs J Murphy Director Nursing & Quality Mr S Ned Director of Workforce Ms M Saunders Director of Corporate Governance Miss L J Watson Executive PA to CEO/Chairman (minute taker) 20/46 APOLOGIES & WELCOME

Mr Lake welcomed members to the Board of Directors (BoD) meeting for April 2020. Due to Covid-19 the meeting was not held in the public domain and was held by video/tele conferencing to comply with government guidelines on social distancing and lockdown. The Board formally expressed gratitude to the Executive and appreciation to all colleagues throughout the Trust in its response to the pandemic. The Information Technology (IT) Team was also thanked for enabling the Trust to enhance the virtual working environment within such a limited period. Mr Lake confirmed items for information will be taken as read and will be noted within the minutes to enable maximum discussion of the Trust’s response and management plans responding to the pandemic. In addition Non-Executive Directors, in advance of the meeting, had compiled a list of questions arising from the papers for the Executive team in order to speed up the process.

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20/47 TO RECEIVE ANY DECLARATIONS OF INTEREST The standing declarations of interest were noted from Mrs Firth and Mr Patton as Director of Barnsley Facilities Services (BFS) and Dr R Jenkins, Chief Executive Officer with Barnsley Hospital and The Rotherham NHS Foundation Trust. No declarations of interest were received in relation to agenda items for discussion today.

20/48 MINUTES OF THE LAST MEETING Subject to minor amendments, as per the advanced points which had been circulated prior to the meeting today, the minutes of the meeting held on 5 March 2020 were reviewed and accepted as an accurate record of events.

20/49 ACTION LOG All outstanding actions from the previous meetings were reviewed with updates noted accordingly.

20/50 COVID-19 EMERGENCY PREPAREDNESS UPDATE Dr Jenkins provided a verbal update of the current situation in relation to the exceptional circumstances of the recent Covid-19 outbreak. Currently the Trust is on the upstroke of the curve and it is anticipated significant changes will be encountered over the next fortnight moving towards peak activity. Dr A Snell Director of Public Health recently presented, via the Executive Team Meeting, a Barnsley version of the national modelling which suggested the Trust is two – three weeks from peak activity. In preparation the Trust has implemented the planned major incident response, establishing a Silver Tactical Coordinating Group (TCG) and Gold Strategic Coordinating Group (SCG) with meetings held twice daily, with appropriate escalation and logging between meetings. There is also a daily Barnsley Place Gold SCG teleconference attended by the Trust. The key components of preparation are to ensure staff are appropriately trained to work in a consistent way and have a full understanding and comply with the appropriate safeguards for patients and themselves in terms of Personal Protection Equipment (PPE) and Infection, Prevention and Control (IPC). Following recent national media coverage regarding the current issues related to PPE, a national update is taking place at noon, today. The Trust has complied with the national PPE guidance which has been provided from Public Health England (PHE). An independent decision was made recently across Barnsley and Rotherham Hospitals where it was suggested for all patient contact staff wore a surgical face mask. This decision was made as a number of patients, particular in Rotherham, became Covid-19 positive during an unrelated admission. A webinar will be held today chaired by the National Director for Acute Care, NHS England; members of the Hospital Management Team will participate. The Trust has also reviewed support to staff and have implemented a number of welfare packages. These have included free car parking for staff, providing access to free meals within Colliers Restaurant which has been closed to the general public as hospital visiting has been significantly curtailed. A number of staff are absent from work due to self-isolating with current figures demonstrating a reduction complemented by staff returning to work following a period of isolation. Swabbing of staff has been on-going within the Trust which has been extremely successful resulting in a number of staff being able to return to work following confirmation of a negative result. The Trust may face future challenges with testing

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and this will be monitored on a regular basis. In terms of preparation for peak demand, the Trust will ensure there is adequate Level 3 Critical Care Bed capacity. Currently the Trust has seven Level 3 beds within the Intensive Care Unit (ITU); the modelling NHS England recently shared suggested an additional capacity of 50 Level 3 beds at peak demand. In the interim plans are currently being implemented to extend the current Level 3 capacity from the core ITU into recovery with the facility to incorporate seven of the theatres, each being able to accommodate two patients. This re-ordering will move the Trust towards 30 Level 3 beds enabling demand to be met pending the opening of the new unit. The plan is to utilise Wards 31/32 to increase critical care capacity which involves extensive estates works to ensure the integrity of the air and oxygen infrastructure to meet the anticipated increased demand and be safely maintained via utilisation of bed-side oxygen alarms. It is understood these works will be completed shortly allowing for cleaning and stocking to be finished prior to opening. Staffing models are currently being developed consistent with the Nightingale Hospital, London model. Critical discussions have taken place with external partners at NHS England regarding the requirements for ventilators, ITU equipment including syringe drivers, volumetric pumps and monitoring equipment. The Trust has been informed extra equipment will be provided as and when required, sourced centrally and issued to organisations dependent upon need. The sourcing of supplies, as capacity expands, may present challenges for the Trust however local, regional and national escalation procedures are in place and utilised as required. The Communications Team provides daily updates for all staff communicated via email and the dedicated hub on the hospital intranet site. Mr Kirton informed the Board work continues to implement and develop a dashboard to track the number of Covid-19 positive patients within the Trust. Mr Davidson provided a brief presentation and explanation of the dashboard which provides information regarding current patients tested within the hospital, sub divided into Levels 1 – Level 3. Following a request from NHS Improvement work is currently taking place to include the number of ventilators currently in use within the dashboard. Ms Moore asked if the age distribution is available for the paediatric cases, Mr Davidson clarified this information is not currently available. Mr Kirton also confirmed changes will be effective from today 2 April 2020 within the Emergency Department (ED). The Department is being separated into two different areas Covid-19 ED (hot) located within the existing ED, and none Covid-19 ED (cold) which will be located in the Primary Care and Physiotherapy area. This will be staffed by various teams from across the Trust. Modelling of the Respiratory and Cardiology pathways have been discussed which have been linked to the critical care work. Following discussions regionally clinical teams are currently discussing the paediatric pathway as it appears children are less impacted than adults with the resulting potential to release capacity. The Trust has instigated a number of steps to increase mortuary capacity, on a permanent basis, as it has been recognised to be insufficient prior to the pandemic. Work has been undertaken with the other partner agencies which can provide support with a mobile unit if required. Mr Ned provided a brief overview of support offered to staff during this crucial time.

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A Covid-19 staff reporting line has been established for staff to report symptoms or for those who are self-isolating due to family members exhibiting symptoms. This line is available 7 days a week and is manned predominantly by Human Resources (HR) and Learning & Organisational Development staff with business continuity plans being developed to ensure the service is maintained. Staff unable to work in clinical areas are currently being redeployed within the Trust to provide support in other areas including the Covid-19 response line. On reporting to the hotline staff are prioritised for swabbing. As at 5.00 pm on Wednesday 1 April 2020 a total of 246 staff swabs have been completed, 46 of which reported as a positive result with 23 results pending. Swabbing of clinical staff in ED, ITU and Respiratory services is prioritised. An Occupational Health Welfare hot line has been established to support self-isolating staff. A dedicated retreat room, known as the “Wobble Room”, has been provided for colleagues along with a staff physiological support line. In response to a question Mr Ned confirmed that locally, regionally and nationally Unions are supportive with the response. However a number of concerns have been raised with regards to Personal Protective Equipment (PPE) for staff which are being addressed. Mrs Murphy informed support is being made available for wards and departments to communicate with patients’ relatives and carers due to the visiting restrictions. Volunteers will work with clerical staff, who have expertise in liaising with families/careers, to maintain contact. Electronic devices will be made available to facilitate family support, ensuring patient confidentiality is maintained at all times, and to support conversations with staff regarding care. Dr Enright informed Board a hub has been introduced to facilitate the redeployment of Junior Doctors, supported by the Local British Medical Association (BMA) Representative, to provide additional support throughout the organisation taking into consideration critical areas that require additional resources. Consultant rotas are being reviewed for both physicians and other specialties to provide additional support within ED. This will allow ED consultants to manage and treat the surge of Covid-19 related cases. An Ethics Committee has been established chaired by Mrs Murphy and Dr Enright with clinical and non-clinical members and will meet on a weekly basis during the pandemic. Mr Kirton informed members the Executive Team, in conjunction with the Committee Chairs, had reviewed all the sub-groups reporting into Board Committees and agreed the temporary suspension of a number of groups while maintaining the governance requirements of the Trust. This will be discussed in further detail at the Audit, People, Finance & Performance (P, F & P) and Quality & Governance (Q&G) Committees in April 2020. Mr Lake informed Board a decision had been made to cancel the Council of Governors Meeting (CoG) scheduled for 18 March and the P, F & P CoG subgroup meeting scheduled for 8 April 2020. Mr Patton would provide an update to governors regarding the latter. Mr Lake confirmed an update communication was provided to governors on 27 March 2020 with fortnightly communication planned going forward. Mr Mapstone queried the merit to cross reference the letter recently published by Amanda Pritchard, Chief Operating Officer NHS England & Improvement. Ms

MS FP TL

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Saunders informed members a paper has recently been discussed at the Executive Team Meeting with the intention to circulate to Committees for assurance. Ms Parkes confirmed the Communication Team is supporting both the Silver and Gold Command Meetings and linking into the national and regional communication channels. Daily Covid-19 updates are communicated to staff and well received. Social media has shown a large increase in followers with responses actively managed by the Communication Team. From a general media point of view, the team is proactively working with the Barnsley Chronicle with this week to support an article focused on recruitment, changes to visiting and a social distancing poster. The Amazon Wish List launched yesterday has received an overwhelming response and over £600 has been donated via the Just Giving account for the Covid-19 Fund. Ms Parkes confirmed the Charity team was also providing support to the Communication Team and to the administration of the Amazon Wish List. Mr Lake informed the Board a separate Charity Trustees Meeting is required to ensure appropriate governance is in place and proposed that the Hospital Charity administration and management fee be temporarily suspended which was agreed in principle by members. Following a discussion of The South Yorkshire and Bassetlaw (SY&B) Integrated Care System (ICS) SCG chaired by Sir Andrew Cash, the Terms of Reference (ToR) will be circulated to Board members for information. The Board formally noted the ToR. The Board acknowledged the legislative options available within the Civil Contingencies Act (2004) in responding to the pandemic. Board noted and received the update.

MS TL

20/51 CHAIRS LOG FOR THE QUALITY & GOVERNANCE COMMITTEE (Q&G) Ms Moore as Chair of the Q&G presented the report to provide an update following the meeting held on 25 March 2020. The key point noted from the report was the suspension of the planned April introduction of Medway initiative. Board noted and received the report.

20/52 CHAIRS LOG FOR THE PEOPLE, FINANCE AND PEFORMANCE COMMITTEE (PFP) Mr Patton as Chair of the P, F & P presented the report to provide an update following the meeting held on 26 March 2020. Month 11 shows a deficit position of £0.455m against a planned deficit of £0.412m, £0.033m unfavourable to plan. Year to date the position is a consolidated year to date deficit of £0.388m, against a planned of £0.867m, favourable to plan by £0.479m. It was noted prior to the pandemic the Trust was on track to deliver the year end target. Board noted and received the report. The Organisational Development (OD) Strategy was also presented to Board for approval. In response to questions circulated prior to the meeting today, Mr Ned confirmed:- • Amendments will be made to the reference of the Care Quality Commission

(CQC) quality reviews within the Strategy. • In terms of timescales in normal circumstances, if approval was provided

today, the Strategy would be launched within the Trust. Work is currently

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continuing from the communications perspective regarding the production of a plan on a page, detailing the importance and relevance of the Strategy for the organisation cross referenced with the People Plan. When the Strategy is ready to be launched a communication plan will be developed to ensure accessibility for staff.

Ms Moore had raised a number of concerns relating to the Strategy prior to approval and would liaise with Mr Ned via email or telephone to discuss. Mr Ned informed due to the current circumstances the launch of the strategy has been deferred. There was a general agreement to approve the OD Strategy subject to minor amendments and taking into account comments raised by members today. Once amendments have been finalised, Mr Ned will re-present to the P, F & P Committee at an appropriate time and if recommended at that point re-present to Board for final approval. Board noted and approved the above line of action.

RM/ SN SN

20/53 CHAIRS LOG FOR BARNSLEY FACILITIES SERVICES (BFS) Mr Patton presented the Chair’s Log from the Barnsley Facilities Service (BFS) Board Meeting held on 23 March 2020. Mr Patton confirmed, in response to a previously submitted query, that the LED capital spend would be finalised by year end. Mr Thickett also confirmed no issues to report for this 2019/20. Board noted and received the report.

20/54 CHAIRS LOG EXECUTIVE TEAM Dr Jenkins reported no other business.

20/55 INTEGRATED PERFORMANCE REPORT (IPR) (Month 11) Mr Kirton informed members the IPR for Month 11 was included for information. The report had been discussed by the respective committees. Board noted and received the report.

20/56 CHAIRS LOG FOR THE BARNSLEY INTEGRATED CARE PARTNERSHIP GROUP (ICPG) Mr Lake provided a verbal update regarding the Barnsley ICPG informing Board due to the current situation meetings had temporarily been suspended. A suggestion to hold a high level forum had received a limited response and therefore in discussion with Dr Jenkins a decision was made to temporarily suspend the meetings so as not to conflict with the emergency preparedness lines of communication and structures. The structural benefit of a Barnsley Place meeting of Executive Leads has been superseded by the establishment of the Barnsley Gold Strategic Co-ordinating Group Board noted and received the update.

20/57 CELEBRATING OUR PEOPLE Mrs Parkes presented the report providing an update regarding the Brilliant Award winners as part of the reward and recognition process for celebrating the excellent work within the Trust. Due to the pandemic it was noted both the Brilliant and Heart Awards presentations have been suspended until further notice. The Long Service Awards have also been postponed and will be re-arranged in due course.

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Board members also noted the Trust will recognise and reward staff following the pandemic for all their commitment and hard work. Mrs Firth raised a query regarding comments about the staff nomination process for awards and as the new Chair of the P, F & P Committee will add to the future agenda. Board noted and received the report.

MS

20/58 REPORT OF THE CHAIRMAN The Chairman’s report was received providing a brief summary of key meetings and events recently attended on behalf of the Trust. Board noted and received the report.

20/59 REPORT OF THE CHIEF EXECUTIVE Dr Jenkins provided an overview of recent meetings and events recently undertaken on behalf of the Trust which was noted and received by the Board. Board noted and received the report.

20/60 DATE AND TIME OF NEXT MEETING The next meeting of the Trust Board is scheduled for Thursday 7 May 2020. Under guidance recently circulated from Amanda Pritchard, Chief Operating Officer, NHS England & NHS Improvement regarding the current Covid-19 situation, the meeting will commence at 10.30 – 12.30 pm via Zoom and Conference Line. Due to the Covid-19 outbreak, the meeting will not be held in the public domain.

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REPORT TO THE BOARD OF DIRECTORS REF: BoD: 20/05/07/04

SUBJECT: BOARD ACTION LOG – PUBLIC

DATE: 7 MAY 2020 Private & Confidential

PURPOSE:

Tick as applicable Tick as

applicable For decision/approval Assurance

For review Governance For information Strategy

PREPARED BY: Margaret Saunders, Director of Corporate Governance SPONSORED BY: Trevor Lake, Chairman PRESENTED BY: Trevor Lake, Chairman STRATEGIC CONTEXT

To ensure that actions emerging from Board meetings are progressed and reported to Board in a timely manner.

EXECUTIVE SUMMARY

Current action log arising from Public Board meetings as attached.

RECOMMENDATION The Board of Directors is asked to: a) note and approve reported progress and any verbal updates and b) review any outstanding actions

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Subject: Board Action Log Ref: BoD: 20/05/07/04 ACTIONS ON AGENDA: Table 1 Minute

ref Meeting

date Item Action Owner Due date Done Date Progress report RAG status

20/50 02.04.20 Covid-19 Emergency Preparedness Update

The temporary suspension of governance arrangements for a number of sub groups and meetings will be discussed in further detail at the Audit, Quality & Governance (Q&G) and People, Finance & Performance (P, F & P) Committees in April 2020.

MS 07.05.20 09.04.20

Complete – item Audit, Q&G and P, F & P Committee agendas on 22.04.20, 29.04.20 and 30.04.20

respectively.

Green

Mr Patton to provide a written brief to members of the Governors People, Finance and Performance (P, F & P) sub group due to the cancellation of the meeting on 8 April 2020.

FP 07.05.20 09.04.20 Complete Green

Fortnightly updates to be provided Governors due to meetings temporarily suspended

TL 07.05.20 09.04.20 Complete and ongoing Green

Additional Charity Committee meeting to be arranged to ensure appropriate governance is in place.

TL 07.05.20 07.04.20 Meeting held on 7 April 2002. Green

The South Yorkshire and Bassetlaw (SY&B) Strategic Health Coordination Group Terms of Reference (ToR) to be for information.

MS 07.05.20 02.04.20 Complete. Green

20/52 02.04.20

Chairs Log – People, Finance and Performance Committee –

Organisational Strategy (OD)

Ms Moore had raised a number of concerns relating to the OD Strategy prior to approval and would liaise with Mr Ned via email or telephone to discuss.

SN/RM 07.05.20 30.04.20 A meeting has been arranged

between Ms Moore and Mr Ned to review the OD strategy.

Amber

Key to RAG status Red Action overdue or no update provided Amber Update Provided but action not complete Green Update provided and action complete

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20/52 (cont)

The Organisational Development Strategy (OD) to be re-presented to P,F&P following the necessary amendments at an appropriate time and if necessary, re-present to Trust Board at a later date.

SN 07.05.20 30.04.20

The revised OD strategy will be presented to the People, Finance

and Performance meeting following the meeting detailed above.

Amber

ACTIONS COMPLETED & CLOSED SINCE LAST MEETING: Table 2 – N/A Minute

ref Meeting


20/30 05.03.20 Chairs Log – People,

Finance and Performance

Brief explanation of gender pay gap calculations to be circulated for assurance.

SN April 2020 April 2020 Explanation circulated to Board Members.

Green

20/30 05.03.20 IPR

Mrs Murphy to ensure timelines for incidents investigated by Clinical Governance are included within discussions at the Patient Safety Panel Meeting.

JM April 2020 April 2020 Mrs Murphy confirmed discussions do take place at the Patient Safety Panel Meeting – complete.

Green

20/37 05.03.20 Managing conflicts of interest policy

Mr Mapstone queried if information was available in relation to the possibility of purchasing additional software to manage all policies within the Trust. Ms Saunders to circulate information.

MS 02.04.20 31.03.20 Complete – details emailed. Green

20/15 06.02.20 Update on Trusts Objectives – Quarter 4

The draft Trust Objectives for 2020/21 will be circulated to Board members following the meeting today for review and feedback.

BK 05.03.20 17.02.20

Katherine Sowden Circulated the objectives to Board Members. The item has been added onto the agenda for 05.03.20. 02.04.20 – The Trust’s objectives are currently on hold in light of Covid-19.

Green

ROLLING TRACKER OF OUTSTANDING ACTIONS: Table 3 red = overdue Minute

ref Meeting


20/36 05.03.20 Bi-annual approval of the use of the Trust’s

Seal Register to be signed by Mr Lake. TL May 2020 To be completed once Government

self- isolation restrictions relaxed. Amber


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20/22 06.02.20 Questions from the public

Mr Higgins also sought views of the Board regarding Trust governance in relation to the work of the ICS. Mr Lake will respond to Mr Higgins, as Lead Governor, either via letter or at the next CoG meeting scheduled for 18 March 2020.

TL 05.03.20

28.02.20 - An update meeting with the lead governor and agreed to raise concerns with the ICS. 05.03.20 – Mr Lake has met with Mr Higgins, Lead Governor and will raise these issues at the ICS meeting on 6 April 2020. 02.04.20 – Mr Lake will note this item for discussion following Covid-19, when normal working has been reinstated.

Amber

Abbreviations/acronyms:

• ACS – Accountable Care System • BAF – Board Assurance Framework • CCG – Clinical Commissioning Group • CQC – Care Quality Commissioning Group • CIP – Cost Improvement Programme • Comms – Communications • CRR – Corporate Risk Register • Dir – Director • EqIA – Equality Impact Assessment • ET – Executive Team • F&P – Finance & Performance Committee • FPSG – Finance & Performance Sub-Group (Governors) • ICT – Information & Communications Technology • IPR – Integrated Performance Report • Q&G – Quality & Governance Committee • QGSG – Quality & Governance Sub-Group (Governors) • VTE – Venous Thromboembolism


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SUBJECT: QUALITY AND GOVERNANCE ASSURANCE REPORT

DATE: 7 May 2020

PURPOSE: Tick as

applicable Tick as applicable

For decision/approval Assurance For review Governance For information Strategy

PREPARED BY: Rosalyn Moore, Non Executive Director/Committee Chair SPONSORED BY: Rosalyn Moore, Non Executive Director/Committee Chair PRESENTED BY: Rosalyn Moore, Non Executive Director/Committee Chair STRATEGIC CONTEXT

The Quality & Governance Committee (Q&G) is one of the key committees of the Board responsible for Governance. Its purpose is to provide detailed scrutiny of quality and safety across the Trust in order to provide assurance and raise concerns (if appropriate) to the Board of Directors and to make recommendations, as appropriate, on quality and safety matters to the Board of Directors.

EXECUTIVE SUMMARY

This report provides information to assist the Board on obtaining assurance about the quality of care and rigour of governance. From the Q&G Committee Meeting on the 29th April 2020, the following papers were received:

• Action Log • Matters Delegated from Board • A COVID-19 Sit Report and supporting assurance papers (COVID-19 Trust Governance

Arrangements; Nursing & Midwifery Safe Staffing Report; COVID-19 Participation in National Clinical Trials’; Governance of Telehealth).

• March 2020 IPR recognising that the figures for March were yet to reflect the impact of COVID 19 on performance.

• Patients Safety Reports (Nursing Quality Summary Report; Perfect Ward; Pressure Ulcers Falls)

• Mortality Report noting that current figures are yet to fully reflect the impact of COVID 19 • HSG Minutes and Log with assurances regarding Staff Safety and PPE, Welfare and Support. • Cancer Summary • Infection Prevention and Control

The Committee also considered changes to the forward plan and proposals for handling the annual review of the Q&G Committee and Sub Committees. For the purpose of assurance, the items noted in the log below highlights items for the attention of the Board.

1

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RECOMMENDATION(S)

The Board is asked to receive and review the attached Log.

2

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Subject: QUALITY AND GOVERNANCE ASSURANCE REPORT Ref: BoD: 20/05/07/06 CHAIR’S LOG: Chair’s Key Issues and Assurance Model Committee / Group: Quality and Governance Committee (Q&G) Date: 29th March 2020 Chair: Rosalyn Moore

Ref Agenda Item Issue and Lead Officer Receiving Body, i.e. Board or

Committee

Recommendation / Assurance/ mandate to

receiving body

1. Current situation report regarding COVID-19

The current situation report regarding COVID-19. Currently the Trust is working towards stabilisation and providing a long term resilient supportive approach.

Board of Directors For assurance

2.

Current position and governance arrangements for Telehealth

The Committee was advised on issues pertaining to the use of telephony and telehealth to in clinical care. This was currently limited to OPD. Assurance was provided that a SOP had been approved and IT systems tested prior to COVID-19 and that access to patient information was available to clinicians. Plans were in place to provide a prescribing function.


3.

Covid-19 Trust Governance Arrangements - Short term changes to Governance Structures and Processes

Assurance was provided to Committee regarding the Covid-19 governance arrangements in particular arrangements for managing the work of commmitees and groups that had been stood down temporarily. Assurance was provided that despite significant challenges, nursing and midwifery staffing remained safe. Staff were being managed dynamically and support was in place for early entrants to the clinical professions employed by the Trust. As a result of contradictory guidance from the centre confirmation would be sought from NHS E/I regarding submission of the Quality Report and Accounts and circulated on receipt.


4. Covid-19 Trust Governance Arrangements - Review of COVID Risk Register

Assurance was provided to the Committee regarding the maintenance of a robust COVID-19 risk register. Additional detail


3

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Committee


receiving body

was requsted regarding mitigations to support staff safety in the workplace.

5. Participation in National Clinical Trials

The Trust is mandated by Public Health England (PHE) to take part in all relevant research into COVID-19. Barnsley Hospital is currently participating in 4 national COVID research studies and is currently the highest recruiter in the region. Patients are followed up following trials for safety purposes. Assurance was gained that all ethics and mandatory checks to ensure good governance are taking place.


6.

Quality Summary and related Reports (Quality Summary; PU; Falls: Perfect Ward).

Assurance was provided that measures to report maintain and improve the safety and quality of care during the COVID 19 pandemic had continued. Reports on PU and Falls were scrutinised. Quality measurement and data collection has continued throughout March and the weekly Patient Safety Panel played a key role in the reporting on quality measures and the rapid sharing of learning and improvement. There had been a low utilisation of Perfect Ward (the Trusts nursing quality audit tool) during March, but with an extension to cover Pressure Ulcer Prevention, Infection prevention control and PPE for COVID-19, plans to improve utilisation in April were in place.

Board of Directors

For assurance and information

7.

Proposal to invest in extensions to Perfect Ward

Discussion took place on the use of Perfect Ward. The Trust had in the past planned to replace Perfect Ward with a locally developed tool but this had not taken place. Therefore, the DoN had extended the Perfect Ward licence for a six month period. She is exploring plans for continuing with Perfect Ward and extending its scope to provide a comprehensive suite of quality measures. At the moment she was investigating the cost implications and The Committee supported actions to secure a robust quality audit tool.

Board of Directors For information

8. Cancer Summary Information was provided regarding the reconfiguration of cancer services due to COVID 19 with the aim of maintaining

Board of Directors For information

4

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Committee


receiving body

safety, maximising the reasonable scope of service, and minimise delays for patients with the most urgent needs. Adaptations in the scope and nature of services will continue to be made.

9. Assurance regarding discharge and support of care homes.

Assurance that BHNFT are working effectively with care homes to enable safe discharge and after care was provided noting that an extra unit had been commissioned at Grimethorpe. We are still offering Skype Consultations to advise Care Home staff and offering expertise in areas such as IPC.

Board of Directors

For assurance and information

5

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SUBJECT: PEOPLE, FINANCE AND PERFORMANCE ASSURANCE REPORT

DATE: 7 MAY 2020

PURPOSE:

Tick as applicable

Tick as applicable

For decision/approval x Assurance For review Governance For information Strategy

PREPARED BY: Keely Firth, Non-Executive Director, Chair People, Finance & Performance Committee

SPONSORED BY: Keely Firth, Non-Executive Director, Chair People, Finance & Performance Committee

PRESENTED BY: Keely Firth, Non-Executive Director, Chair People, Finance & Performance Committee

STRATEGIC CONTEXT

The People, Finance & Performance Committee (P,F&P) is one of the key sub committees of the Board responsible for Governance. Its purpose is to provide detailed scrutiny of financial matters, operational performance and indicators relating to our people in order to provide assurance and raise concerns (if appropriate) to the Board of Directors and to make recommendations, as appropriate, on people, financial and performance matters to the Board of Directors.

EXECUTIVE SUMMARY KEY: £k = thousands £m = millions

The aim of this report is to critically analyse and evaluate the people, financial and operational performance of the Trust in order to provide assurance to the Board. This will be accomplished by:

- Critically analysing and evaluating the key people metrics in order to get assurance that are people are being led, managed, developed and looked after appropriately.

- Ensuring that a people plan is in place and being monitored.

- Critically analysing and reviewing the financial performance in order to identify any opportunities or threats.

- Critically analysing and reviewing the Cost Improvement Programme (CIP) in order to get assurance that it is on plan and will deliver the planned savings.

- Critically analysing and reviewing the corporate performance in order to ensure that the Trust is delivering the optimum performance safely and negating any penalties.

- Critically analysing the key people data and reviewing delivery of the People Strategy. - Reviewing business cases at the six months anniversary in order to ensure that they are delivering

planned benefits. - Critically analysing and reviewing the Board Assurance Framework (BAF) in order to ensure any risks

to the strategic plan are identified and mitigated.

This meeting reported the following:

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1. People The committee received the latest workforce insight report with key measures being reported as follows: (i) Sickness – a similar position to last month at 4.72%; (ii) Staff turnover – the rate is at 10.76% and includes people who have retired and returned; (iii) Training compliance – slightly lower than last month at 88.8%; (iv) Appraisals – 91.9% compliance.

2. Operational Performance

(i) Emergency access: decreased in March to 91% from 91.4% - the tenth best nationally; (ii) RTT: A compliant position of 92.15% was achieved in February which was eighth nationally; (iii) Cancer: compliant in February with the standards relating to two-week wait referrals, 31 days and

62-day from GP referral to treatment and the two-week target for symptomatic breast referrals all achieved; Performance against the 38-day inter-provider transfer target has improved but at 71% remained below the required 85% level;

(iv) Diagnostic Waits: Diagnostic access performance remained very strong in March with 100% of patients accessing investigations within 6 weeks.

3. Finance

(i) The Trust has a consolidated year end surplus of £0.431m, against a planned breakeven position which is in line with the prior forecast of £0.448m. Reflected in this position is £0.38m of 2018/19 bonus monies, which NHSI instructed the Trust to be accounted for in 2019/20;

(ii) There are a number of variations to the monthly plans for March pre Covid-19 which have been offset by other changes and arrangements relating to Covid-19;

(iii) Planned Provider Sustainability Funding of £10.4m has been accrued in full; (iv) CIP is £6.82m against a plan of £6.75m, which is £0.77m favourable to plan; (v) Capital plans were completed on plan at £10.7m and include £0.4m Covid-19 expenditure; (vi) The cash position at the end of the year is £15.3m, which is £14.3m ahead of plan.

RECOMMENDATIONS

This report recommends that: - The Board notes the latest workforce performance metrics and the risk of increasing levels of

sickness due to the Covid-19 pandemic; - The Board notes the operational performance and issues with Covid-19 pandemic; - The Board notes the assurances from the committee regarding the revised ICT arrangements

in response to the Covid-19 pandemic; - The Board notes the assurances from the committee regarding the revised governance

arrangements in response to the Covid-19 pandemic; - The Board notes the recommendation from the committee to ratify the changes to the BFS

Board; - The Board notes the end of year financial performance; - The Board notes the changes in approach to budget setting and developments until such time

as the Covid-19 uncertainty has passed.

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Subject: People, Finance and Performance Committee Assurance Report Ref: BoD: 20/05/07/07

CHAIR’S LOG: Chair’s Key Issues and Assurance Model Committee / Group Date 30th April 2020 Chair People, Finance and Performance Committee April 2020 Keely Firth, Non Executive Director KEY: FTE: Full Time Equivalent; £k = thousands; £m = millions

Log Ref Agenda Item Issue and Lead Officer

Receiving Body, i.e. Board or Committee

Recommendation/ Assurance/ mandate to receiving body

1. Workforce Insight Report

The committee considered in depth the report which provides analysis of the issues facing the Trust from a workforce perspective. The key points to be highlighted are as follows: - - Sickness Absence and Wellbeing:

Sickness absence has remained the same as last month at 4.72% with minimal changes in long term and short term sickness. The main reason for sickness absence remains stress, anxiety, depression and other psychiatric illness, with 1,667 FTE days lost in March. This includes the impact of Covid-19 which will be separated out in future months. The cumulative figure is 4.35%. Latest national benchmarking figures available as at November 2019 show the NHS sickness rate on average was at 4.73% which is above the Trust rate in the same month of 4.55%. The delivery of the Trust sickness absence reduction plan and management of the sickness hot spot areas is through People & Engagement Group which is to be reinstated next month.

- Headcount & FTE: The headcount for the month is 4,065 (3,852 excluding bank). The actual FTE is recorded as 3,327. The figure reported this month for funded establishment FTE is 3,479.

- Staff Turnover: The turnover rate is at 10.76% and therefore above the target range of between 7–10%. The areas with higher turnover rates continue to be (i) Prof and Tech at 15.54%; (ii) AHPs at 18.12%; and (iii) Nurses & Midwives at 13.26%. There were 35 leavers in the month with the top reason classified as “Voluntary Resignation Promotion”. Turnover figures include people who have retired and returned to work.

- Mandatory Training: Mandatory Training is at 88.8% (a decrease of 1.2% from last month).The Moving & Handling Back Care Awareness (once only) continues to be the topic with the highest compliance at 97.2%. The Infection Control Level 2 module has the lowest compliance at 79.1% but focussed support is available daily from the IPC team particularly in “hot” areas. IG and Data Security achieved the target at 31 March 2020.

- Appraisals: The appraisal window opened on 1 April 2020 with 91.9% compliance to date.

Board For information and Assurance

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2. Covid-19 Workforce Paper

The committee received a report outlining the key challenges arising from the Covid-19 pandemic and the action undertaken to support our people. The key points are as follows: - - Sickness and swabbing:

The Covid-19 staff absence reporting call centre was operational from 17th March 2020 and operates 6am-7pm, 7 days per week with an average of 75 calls per day. The centre is staff by colleagues from HR, OD, medical staffing and medical education. Data is shared daily to inform silver and gold command and to support rostering and backfill planning. The swabbing service is located at the hospital and also supports other local partners.

- Health and Well-being: The Trust took an early decision to provide free meals for staff and free car parking. The OH team has set up a dedicated service with regular welfare calls to check on the physical and mental health of staff who have reported with Covid-19 related absence. A “wobble room” has been established for staff to take some time out in a relaxing environment and safe space to process their emotions and is supplemented by our fast track referral service into OH and a 24/7 counselling help line for staff.

- Vulnerable Staff: A risk assessment approach has been in place to establish who may need to shield at home, work at home or be redeployed. It is emerging that there appears to be a disproportionate number of individuals from a Black and Minority Ethnic (BAME) background who have lost their lives to Covid-19 and the SY&B ICS is leading on an approach to ensure that appropriate support is given to our staff.

- Wider system working and Partnership working: The Trust continues to work with the wider system to share knowledge and best practice and try to ensure consistency in relation to the emerging workforce issues linked to Covid-19. A weekly meeting takes place with trade union representatives and HR colleagues to provide assurance and seek views on a range of Covid-19 workforce issues. The Trust has accessed support from a number of student nurses and doctors who have joined the Trust. The Trust has responded to a request to supply clinical and non-clinical staff to support the NHS Nightingale – Harrogate facility. They have been trained and inducted but have not yet been deployed due to the ICU capacity being contained within the existing hospitals.

Following a discussion regarding the overall impact of Covid-19 on sickness levels the committee wishes to highlight the risk of increasing levels of sickness to the Board.

Board

For information, assurance and to note the increased risk to sickness absence levels.

3. Integrated Performance Report

The committee reviewed the IPR focusing on the key performance indicators around patient access, people and finance and thanked everyone in the Trust for their contribution to the strong performance on access to services in a timely manner for our patients. - Emergency access & Patient Flow:

Performance against the four-hour standard decreased in March to 91% from 91.4%. Although


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below target, the Trust’s performance in March was the tenth best nationally. Although Non-elective admissions and ED declined in March, the functioning of ED has been disrupted by arrangements to manage Covid-19.

- RTT: A compliant position of 92.15% was achieved in February which was eighth nationally. - Cancer: The Trust was compliant in February with the standards relating to two-week wait

referrals and 31 days and 62-day from GP referral to treatment. The two-week target for symptomatic breast referrals was also achieved. Performance against the 38-day inter-provider transfer target has improved but at 71% remained below the required 85% level.

- Diagnostic Waits: Diagnostic access performance remained very strong in March with 100% of patients accessing investigations within 6 weeks.

4. ICT Report

The committee wishes to acknowledge the team members who have worked very hard under pressure to facilitate a significant shift in our approach to operational delivery. - System C Medway EPR project - the pause has enabled the testing and deployment of the

latest release of the Maternity module which will ensure compliance with CNST and has enabled a more functional version of Care Plans to be completed by the end of April. A revised training schedule is being developed to provide shorter sessions which are focused on specific areas, supported by access to written material and video guides.

- Measures introduced due to COVID-19 – at this point in time there have been no changes to the system, governance controls or risks during the Covid-19 period. All the work so far has been scaling the existing solutions that are already in place including Zoom and MS Teams Video Conferencing, homeworking, live Oxygen reporting across site, a Covid-19 dashboard showing Covid-19 testing, deaths, self-isolation status and procurement equipment. Work has almost concluded to facilitate safe Video Consultations, Teleconferencing, Electronic Document Management Solutions and Outpatient prescribing solutions formulated to assist clinicians to deliver outpatient clinics remotely from the hospital. Over 400 fully encrypted laptops have been installed.

- Future arrangements – Executive Team colleagues are to reflect and identify areas where the changes can be continued in the future with a planned approach to managing system, governance and risk controls and processes.

- Open referrals data quality – Trust colleagues have validated 8660 records to date and have found no cases of any clinical harm due to the delay. The entire list is expected to be completed by the end of August 2020.


5. Trust Covid-19 Governance

The committee received a helpful update regarding the revised governance arrangements in response to the Covid-19 pandemic. The Trust is following guidance from NHSI/E around specific actions and routine Trust activities will be reviewed in line with silver command approach to an outbreak incident. The Covid-19 Risk Register governance process is reviewed by ET


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fortnightly with any risks requiring escalation during the intervening period added to the next gold command meeting agenda for consideration.

6. BFS Board The committee received a paper setting out changes to the constitution of the BFS Board membership and recommend that the resignations and appointments of the BFS Board of Directors are ratified by the Board.

Board Recommendation

7. Finance

The Trust has a consolidated year end surplus of £0.431m, against a planned breakeven position which is in line with the prior forecast of £0.448m. Reflected in this position is £0.38m of 2018/19 bonus monies, which NHSI instructed the Trust to account for in 2019/20. There are a number of variations to the monthly plans for March pre Covid-19. These have been offset by other changes and arrangements relating to Covid-19. Planned Provider Sustainability Funding of £10.4m has been accrued in full. CIP is £6.82m against a plan of £6.75m, which is £0.77m favourable to plan. Capital plans were completed on plan at £10.7m and include £0.4m Covid-19 expenditure. The cash position at the end of the year is £15.3m, which is £14.3m ahead of plan. Key areas of variance include the timing between capital funding receipts and payments for the services delivered plus the potential repayment of PDC in May. Use of Resources rating is 3.


8. 2020/21 Revised Planning Process

The committee received a paper highlighting the impact of the changes to the national planning cycle and the revised payment mechanism for April – July 2020. The new system will see traditional contracts being replaced with nationally issued block envelopes with an additional top up and rebate mechanism to cover reasonable Covid-19 costs. These revised arrangements do not appear to present any significant risk to the Trust for the period April – July 2020 however there will continue to be a need to build a programme of quality, innovation and productivity schemes to deliver financial benefits. A revised approach to budget setting and developments is being implemented until such time as the Covid-19 uncertainty has passed.


9.

Reforms to the NHS Cash and Capital Regimes for 2020/21

The committee received and noted a paper setting out the new cash and capital regimes effective from 1st April 2020. The changes are supported in the short term by central funding mechanisms but there is a risk that this is a likely future pressure for the Trust which will be added to the register. The support available via Covid-19 measures to obtain new assets is positive but may create recurrent depreciation and maintenance costs so options to minimise the impact are being explored.


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REPORT TO THE BOARD OF DIRECTORS (BHNFT) REF: BoD: 20/05/07/08

SUBJECT: BARNSLEY FACILITIES SERVICES LIMITED (BFS).

DATE: 7 MAY 2020 PRIVATE AND CONFIDENTIAL

PURPOSE:




PREPARED BY: Francis Patton, Chair BFS & Non-Executive Director BHNFT

SPONSORED BY: Francis Patton, Chair, BFS & Non-Executive Director BHNFT

PRESENTED BY: Francis Patton, Chair BFS & Non-Executive Director BHNFT

STRATEGIC CONTEXT

Barnsley Facilities Services Ltd (BFS), (formerly Barnsley Hospital Support Services Limited BHSS), was established in 2012 as a wholly owned subsidiary of BHNFT and became operational from January 2013. It is intended as a vehicle for the Trust to explore and expand commercial opportunities and enhance income streams for the benefit of patient services.

EXECUTIVE SUMMARY The aim of this report is to provide the Trust’s Board of Directors with a regular update on the activities of BFS and to flag any risks or concerns. The enclosed Log reflects discussions from the BFS Board’s meeting in April. In terms of performance the only issue was the need to suspend building works because of Covid-19. Whilst the Performance meeting was not formally held a Performance Report was issued to the Trust for assurance. BFS and the Trust have been fully aligned throughout the period with both parties attending meetings appropriate to the Covid-19 response. BFS would like to thank all of the Trust for the support it has received over the last 6 weeks. From an HR perspective sickness is at 3.32% and training is at 92.2%. BFS Board received an update on the 2019/20 objectives which have, in the main, been delivered, the few that haven’t being delayed by Covid-19 and now moved into the 2020/21 plan. The Board also received an update on the new 5 year plan which will need presenting to Trust Board. RECOMMENDATION

BFS Board recommends that: • The Board of BHNFT notes the attached report and take assurance that the wholly

owned Operated Healthcare Facility is performing to plan and budget.

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REPORT TO THE BOARD OF DIRECTORS AND F&P - BFS (BHSS) Chair’s Log

REF: BoD: 20/05/07/08 CHAIR’S LOG: Chair’s Key Issues and Assurance Model Committee / Group: BFS Board Meeting Date: 20th April 2020 Chair: Francis Patton

Item Issue Receiving Body, i.e. Board or Committee


1. Performance Report

Key highlights from the performance report include: 1. BFS achieved all KPIs across all service areas in

February 2020, apart from an increase in prescription errors for Outpatient Pharmacy.

2. No material performance issues or variances to report against BFS performance measures set by BHNFT.

3. Capital works – Contractors suspended the Children’s Assessment Unit and Paediatric ED works during March 2020 due to Covid-19 but are planning to return to recommence works by 20th April 2020, it is anticipated that this will be at a depleted capacity, so work will remain behind schedule.

4. O-Block – Contractors suspended activity during March 2020 due to implications of the Covid-19 pandemic. As yet all works remain suspended.

5. LED Lighting – due to the impact of Covid-19 emergency changes required on site, delivery of the LED scheme remains on hold until further notice.

Trust Board For Information and Assurance

2. Reverse SLA’s

No meetings were held were held this month because of Covid-19 but very regular contact has been made. BFS would like to thank all departments who provide support to BFS for their help and support over the Month of March and ongoing in April.


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3. BFS 19/20 Business Plan Update

BFS has a 3-year Business Plan (2019 – 22) which is aligned to the Trust Strategic Objectives was signed off by Trust Board in March 2019 and will present a full review of its performance in 2019/20 to Trust Board along with an updated version of that plan in the next two months. This is a brief summary of the key elements offering assurance to Trust Board of progress across 2019/20 against the agreed objectives as set out in the Plan. 26 objectives have completed or closed including - the redesign of a new Leadership and Development programme; continued delivery of staff led initiatives and engagement sessions; improved financial management and reporting; improved cash-flow position and reduction of payment days; procurement of major IT capital schemes; implementation and tracking of the Department of Health and Social Care ‘New Operating Model’ and ordering processes. Specific people related objectives complete include; continuous improvements to the Pulse checks (BFS staff survey); a 93.6% return rate on the Picker Survey (Trust Staff Survey); the recruitment and on-boarding of the BFS Commercial Director in October 2019; people skills-based progression plans and delivery of multi-functional roles, (which has been extremely useful during the Covid-19 period, allowing this workforce to flex). At Q3 2019/20 BFS forecast the completion all 35 objectives agreed in the 2019-2022 Business Plan by year end. A significant capital programme requirement and the impact of COVID-19 pandemic across the end of Q4 has had an impact on completion of some objectives within a Horizon 1 (year 1) timeframe to the end of 2019/20. 9 of the schemes therefore currently have an amber rating due to missing the final deadline for completion, though work remains underway against each objective. Mitigation has been put in place to deliver no later than 3 months post


BoD April 2020 BFS_Chairs Log

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the close of the Covid-19 pandemic – estimated at September 2020. No items are categorised as red. All items identified as amber, will carry forward as objectives for completion into 2020/21, alongside the Horizon 2 objectives and new objectives in the BFS Strategic Business Plan 2020-2025.

4. People

From a HR perspective Key points to note are: • The cumulative turnover rate was 8.16%. There were 4 leavers and eleven new starters during March. • The sickness rate at the end of March is 3.32% which is an increase of 0.35% from a figure of 2.97% in February. • Training compliance is 92.2%. There are several new starters yet to complete Trust induction training, however they have been taken through local induction. • There are a number of vacancies at various stages of the recruitment process. We have adopted a ‘fast track’ recruitment process to recruit key bank workers into Portering, Supplies and Domestic Services through a quicker and efficient process. • Where fast track recruiting is in place to meet the Covid-19 needs, assurance was sought and given regarding appropriate pre-employment checks continuing.


5.

BFS Strategic Business Plan 2020-2025; Quality, Innovation & Growth

BFS Board reviewed a draft of the 2020 – 2025 Strategic Business Plan which is currently under development. Further work is being undertaken on this and then the plan presenting to Trust Board for sign off at a time to be agreed with the Trust Chairman.


BoD April 2020 BFS_Chairs Log

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REPORT TO THE BOARD OF DIRECTORS REF BoD: 20/05/07/09

SUBJECT: BARNSLEY FACILITIES SERVICE BOARD APPOINTMENTS & RESIGNATIONS

DATE: 7 MAY 2020 Private & Confidential

PURPOSE:




PREPARED BY: Margaret Saunders, Director of Corporate Governance SPONSORED BY: Margaret Saunders, Director of Corporate Governance PRESENTED BY: Margaret Saunders, Director of Corporate Governance STRATEGIC CONTEXT

Barnsley Facilities Services Ltd (BFS), company registration 08031875, is a wholly owned subsidiary of Barnsley Hospital NHS Foundation Trust (BHNHSFT). Under the articles governing BFS, any changes to the company’s Board of Directors shall be ratified through the BHNHSFT Board and appropriate committees.

EXECUTIVE SUMMARY

At the 5 December 2019 BHNHSFT Remuneration Committee the resignation of Mr Thickett Director of Finance BHNHSFT from the BFS Board and the appointment of Ms Betts, Commercial Director BFS was approved. Whilst Mr Thickett stood down from the operational role as a Director of BFS with effect 31 December 2019,due to an administrative error his resignation was not formally noted with Companies House until 31 March 2020, detailed below, https://beta.companieshouse.gov.uk/company/08031875/officers The Chair of BFS has confirmed that during the period 1 January 2020 to 31 March 2020 Mr Thickett played no active role in the Board of Directors of BFS. Name Role Action taken Effective date Mrs K Firth Director Resigned 31 March 2020 Mr C Thickett Director Resigned 31 March 2020 Ms M Betts Director Appointed 1 January 2020 Mrs S Ellis Director Appointed 1 April 2020

BoD Front Sheet - template

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https://beta.companieshouse.gov.uk/company/08031875/officers

BFS Insurers have also been notified of the change in Directors. RECOMMENDATION

BHNHSFT Board is recommended to ratify the appointments and resignations of the BFS Board Directors as stated in this report. BHNHSFT Board wishes to thank Mrs Firth and Mr Thickett for their roles in supporting the development of BFS.

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SUBJECT: Integrated Performance Report: March 2020

DATE: 7 May 2020

PURPOSE:


applicable


PREPARED BY: Andrew Potts – Deputy Director of Operations & Information team

SPONSORED BY: Bob Kirton – Chief Delivery Officer

PRESENTED BY: Bob Kirton – Chief Delivery Officer & Executives

STRATEGIC CONTEXT

Strategic Objective 1 – Patients will experience safe care Strategic Objective 3 – People will be proud to work for us Strategic Objective 4 – Performance Matters

EXECUTIVE SUMMARY 1. Patient Access:

Emergency access & Patient Flow: Performance against the four hour standard increased in March was 91.0% compared with 91.4% in February. Although below target, the Trust’s performance in March was the tenth best nationally. RTT: A compliant RTT position of 92.15% was achieved in February. The Trust’s performance in February was the eighth best nationally. Cancer: The Trust was compliant in February with the standards relating to two week wait referrals, 31 days to first treatment, and 62 days from GP referral to treatment. The two week target for symptomatic breast referrals was also achieved. Performance against the 38 day inter-provider transfer target, now being reported according to the Cancer Alliance’s definition based on date of treatment rather than transfer, at 71% remained below the required 85% level. Diagnostic Waits: Diagnostic access performance was very strong in March with all patients provided with investigations within 6 weeks.

2. Quality of Care:

2.1 Patient Safety: Pressure Ulcers

There were six category 2 hospital acquired pressure ulcers reported in March with three resulting from lapses in care, specifically lack of 25 point skin inspections. Perfect Ward audits are still being completed but the schedule was disrupted in March by Covid-19 related staff absence and ward moves.

Incidents:

One incident resulting in death involving a failure to recognise a complication of treatment; Two incidents resulting in severe harm, one involving a lack of clinical assessment and the

other a fall resulting in a fractured neck of femur; Pack Page No. 31

Two serious incidents reported in the month, one involving a delayed diagnosis of lymphoma and the other an incorrect diagnosis of breast cancer;

Falls: In March there were 55 inpatient falls. This represents a reduction compared with 59 in February, likely attributable to the reduced number of inpatients. There was one fall resulting in severe harm with the patient suffering a fractured neck of femur. The investigation for this fall has not yet been completed.

2.2 Patient Experience: During March the Trust received 20 new complaints. The primary theme was clinical care and treatment. All complaints closed in March were within the agreed timeframe. The average number of working days to investigate complaints was 64 days. Of the complaints closed in March, 94% were upheld or partially upheld.

3. People: Sickness: Sickness – The sickness absence rate in March was 4.72%, higher than the equivalent month the previous year when the rate was 4.5%. There were 1,051 episodes of gastrointestinal problems, 768 episodes of cold/cough/influenza, and 550 episodes of anxiety/stress/depression. There were 68 employees on sick leave with infectious disease at the end of March, 18 of whom had confirmed Covis-19. Staff isolating due to Covid-19 are not included in the sickness absence figures. Mandatory Training: Mandatory training compliance dropped below the 90% target in March as a result of a limited number of training opportunities being provided during the Covid-19 pandemic. The course with the highest attendance rate is Moving and Handling/Back Care Awareness at 97.2% with Infection Control training having the lowest level of compliance at 79.3%. Staff Appraisal Rate: The 2020/21 appraisal window which was due to open in April has been postponed as a result of the Covid-19 pandemic. Staff Turnover: The staff groups with the highest turnover remains Allied Health at 18.1% with Scientific & Technical second at 15.5%. Promotion is the most common reason for staff leaving. Career development progression for some Allied Health and Professional & Technical staff is being introduced from April 2020 in accordance with national terms and conditions.

4. Finance:

The Trust achieved a surplus of £431k at the year-end which was in line with previous forecasts. Total income was £11.031m favourable to plan at the year-end. There was a favourable clinical income variance of £8.062m relating to increased activity and accrued reimbursement of additional costs arising from Covid-19. Other income was £2.589m favourable to plan, principally attributable to education and training funds and drug and pathology recharges. There was under-performance against the Cost Improvement Programme target of £0.108m in month but favourable by £0.077m at the year-end. Capital expenditure is £0.009m less than the original plan.

RECOMMENDATIONS

The Board of Directors are asked to receive and endorse the latest IPR.

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Created by: Healthcare Information and Insight Service

Title of report: Integrated Performance Report

Executive Lead: Bob Kirton

`

March 2020

Pack Page No. 33

Exe

cuti

ve S

um

mar

y

1. Purpose of the Report:

The purpose of this report is to inform the Trust Board and sub-committees of the latest position against key performance indicators, including operational and

quality requirements mandated nationally, metrics detailed in the NHSi oversight model and those identified within the BHNFT Operational Plan for 2019/20. In

addition, it provides Trust Board with information relating to activity delivered and finance, which are key drivers for sustainability.

This report details the latest validated information available.

A high level view of the Trust’s performance is available in the at a glance summary. Further details on the domains of quality, people, patient access and finance

are available in more depth as part of the wider document.

2. Background and Introduction:

The well-led framework used by NHSi identifies effective oversight by Trust Boards as essential to ensuring Trusts consistently deliver safe, sustainable and high

quality care for patients.

BHNFT provides an integrated performance report to Trust Board each month for assurance. The report outlines key performance against a number of quality,

operational, financial and activity based indicators. The purpose of the report is to ensure Trust Board has timely and robust oversight of performance in key

areas along with actions being taken to address required improvements.

Executive Summary March 2020

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1 2 3 9 10 16 17 18 19 20 21

Capital Plan

The Trust has a consolidated year to date surplus of £0.431m against a breakeven plan, giving a favourable variance of £0.431m. This is distorted by £0.379m bonus

PSF relating to 2018/19 and £0.052m donated income relating to charitable donations for assets, leaving a net breakeven position.

Total income is £16.870m favourable to plan for the year. Clinical income variances total £13.901m above plan as a consequence of the increased activity seen,

accrued reimbursement of additional costs incurred as a consequence of COVID-19 from NHS England (NHSE) and accrued offset to additional NHS Pensions

employer contributions paid by NHSE on behalf of NHS organisations throughout the year which they have requested is accounted for locally in month 12. Other

income is £2.589m above plan mainly due to education and training (higher training numbers and one-off receipts); along with drug and pathology recharges (offset

by expenditure).

CIP has under achieved by £0.108m in-month but is favourable to plan by £0.077m for the year.

Cash is £14.296m favourable to plan which is £0.523m higher than last month. This increase is due to the receipt of external capital funding in the form of Public

Dividend Capital (PDC) before the cash payments have been made.

Capital expenditure for the year is in line with the values forecast in previous months and is £0.009m less than plan.

Has remained the same as last month and is higher than this time last year when sickness was at 4.50%. There were 1,051 episodes of gastrointestinal problems, 768

episodes of cold, cough and flu, and 550 episodes of anxiety, stress & depression. All CBUs remain in red with the exception of Corporate and BFS. The People &

Engagement Group March meeting was cancelled due to the coronavirus outbreak and so the actions agreed last month, to support the sickness absence reduction

plan will be carried over to the next People & Engagement Group meeting. There were 68 employees off sick with infectious diseases as at 31 March of which 18

were confirmed Covid sickness.

Has dropped below the 90% target this month due to an approved restricted mandatory training programme of 5 priority e-learning training topics in place at present

during the coronavirus crisis, with the remaining 5 topics to be completed at a later date . The topic area with the highest compliance remains Moving and Handling

Back Care Awareness (once only) at 97.20% and the lowest compliance is in Infection Control Level 2 at 79.30%.

The 2020/21 appraisal window which was due to open on 1 April has been postponed due to the current coronavirus crisis.

Highest staff group turnover remains Allied Health Professionals at 18.12% , followed by Scientific & Technical staff at 15.54%. Use of provision within national terms

and conditions to offer career development progression for some AHP and S&T band 5s to band 6s (OT, Physio, Dietetics, Pathology) is due to be introduced from

April.

Referral To Treatment (18 weeks)

Pat

ien

t A

cce

ssP

eo

ple

Fin

ance

Emergency Access

Planned Cash Position

Planned Financial Position

Income

Cost Improvement Programme

Cancer

Diagnostic Waits

Sickness Absence

Mandatory Training

Staff Turnover

Staff Appraisal Rates

Performance against the Emergency Department 4 hour standard in March was 91.0% compared with 91.4% in February. Although below target, the

Trust’s performance was the tenth best nationally. Although ED attendance and non-elective admission activity declined in March, the functioning of ED

has been disrupted by arrangements to manage Covid-19.

A compliant RTT position of 92.15% was achieved in February. The Trust’s performance was the eighth best nationally.

The Trust achieved standards in February with regard to 2 week wait referrals, 31days for first treatment, and 62 days from GP referral to first

treatment. The target for symptomatic breast referrals was achieved but the 38 day target for inter-provider referrals was not achieved.

Diagnostic waiting time performance was very strong in March with 100% of investigations provided within six weeks.

Patients Partnerships People Performance

BHNFT At-a-Glance March 2020

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1 2 9 10 16 17 18 19 20 21

Qu

alit

yPatient

Experience

Clinical

Effectiveness

SHMI - Latest data - 99.4

HSMR Rolling 12 month - 96.5

Patient

Safety

Complaints

During March the Trust received 20 new complaints. The complaints were allocated as follows: CBU 1 – 8, CBU 2 – 10, CBU 3 – 1 and Corporate Services - 1. The primary theme was clinical care and

treatment. The percentage of cases closed within agreed timeframe or agreed extension for the month was 100%. The average number of working days to investigate complaints was 64 days. 94% of

complaints closed within March were upheld or partly upheld. The PA&C Team dealt with 185 concerns and 97 general enquiries (total 282) during the month. There has been an increase in general

enquires in relation to COVID-19.

Incidents

Two incidents resulting in severe harm

• Lack of clinical assessment on AMU (incident under review)

• Inpatient fall on ward 22 resulting in a fracture neck of femur (Falls RCA is underway)

One incident resulting in death

• Failure in recognising complication of treatment

Two serious incidents reported in the month

• 2020/4451– Delayed diagnosis of lymphoma (incident occurred in February 2020)

• 2020/5378 – Incorrect diagnosis of breast cancer (incident occurred in March 2020)

Patient Safety

Pressure Ulcers

There have been 6 category 2 hospital acquired pressure ulcers reported this month. Of these, 3 was found to have lapses in care. This was mainly due to lack of 25 point skin inspections..

Perfect ward audits are still being completed when they can.

There has been 2 hospital acquired medical device related pressure ulcers, one of which was due to a result of lapses in care. These were inconsistent skin assessments. Lack of RN oversight and moisturising

cream being applied under device.

Falls

For this month, there were 55 falls reported, this is a low number due to the reduced admissions in relation to COVID 19. there was one fall resulting in severe harm. The patient suffered a fractured neck of

femur, the root cause analysis investigation has not been completed at this time of reporting.

There was a reduction in total number of falls and repeat falls reported for 2019/20 in comparison to last year. There was also a reduction in the number of falls resulting in moderate harm or greater from

last year and there were no falls resulting in death reported this year.

Safety Thermometer

In March 2020, the following statements were issued by NHS Improvement on the Safety Thermometer website;

Organisations should no longer collect ‘classic’ or ‘next generation’ Safety Thermometer data or submit it to the Safety Thermometer portal. Recent evaluations, research and feedback has shown that the

data was incomplete, and it was no longer able to support improvement in the intended way. All data collection for the ‘classic’ Safety Thermometer and the ‘next generation’ Safety Thermometers will

therefore stop after March 2020.

for february the national average for new harm free care was 97.7%

the Trust was better than the national average with 98.1%


BHNFT At-a-Glance March 2020

Pack Page No. 36

2 3 4 6 7

Domain KPI StandardStandard(Month)

Set By Current Qtr. Year to DateYear-End

Forecast Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Jan-20 Feb-20 Mar-20

Falls 785 (<) 65 BHNFT 203 828 828 70 66 72 76 71 55 70 47 75 73 77 81 88 60 55

Repeat Falls n/a BHNFT 44 168 168 14 11 19 17 17 5 13 5 16 14 15 22 21 12 11

Falls resulting in moderate harm or above 20 (<) 1 BHNFT 6 17 17 1 1 0 2 0 2 1 2 0 1 0 3 1 4 1

Hand washing 95% (>) National 97% 97% 97% - - - 94% 97% 97% 96% 99% 99% 97% 97% 96% 96% 96% 98%

Pressure Ulcers category 2 (Lapses in care) G < 30, R >30 0 BHNFT 17 29 29 2 5 5 4 7 6 3 4 10 13 1 3

To eliminate pressure ulcers resulting from medical devices resulting in lapses of care. 2 9 9 4 3 0 2 0 0 1 3 1 1 0 1

Safety thermometer harm free care - National 97.7% 97.7% - 97.7% 97.7%

Safety thermometer harm free care - Barnsley Hospital - - National 96.6% 96.6% - 96.6% 98.1%

Q - Hospital Acquired Clostridium Difficile 19 (<) 1 NHSE 5 22 22 0 2 2 1 1 2 2 4 3 2 1 1 2 3 0

Q - Serious Incidents - NHSE 6 27 - 2 2 5 2 0 2 2 3 3 1 4 4 2 2 2

Q- Total Number of Incidents Resulting in Death 0 0 National 1 3 - 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1

Q-Total Number of Incidents Resulting in Severe Harm 0 0 National 5 17 - 1 1 0 1 0 2 3 0 0 1 1 4 0 3 2

Q- FFT Response Rate ED G >= 10%, R < 10% BHNFT 6.1% 3.0% - 1.3% 1.5% 6.2% 3.1% 0.4% 0.4% 0.9% 1.5% 3.5% 5.9% 6.2% 6.2%

Q - FFT Response Rate IP G >= 10%, R < 10% BHNFT 34% 32% - 32% 35% 38% 44% 31% 31% 32% 31% 18% 39% 41% 21%

Q- FFT Response Rate MAT G >= 10%, R < 10% BHNFT 39.6% 43.9% - 32.6% 39.9% 61.6% 45.2% 50.2% 37.0% 57.6% 34.4% 40.5% 40.0% 26.6% 9.6%

Q- FFT Positivity Rates - EDG >87.5%, A >=82.5%-87.5%, R

<82.5% (> )BHNFT 87% 84% 84% 79% 61% 84% 86% 94% 95% 88% 81% 96% 84% 63% 53% 87% 85% 87%

Q- FFT Positivity Rates - IPG >87.5%, A >=82.5%-87.5%, R

<82.5% (> )BHNFT 97% 97.4% 97.4% 97% 99% 98% 98% 98% 99% 98% 98% 92% 98% 98% 99% 96% 97% 96%

Q- FFT Positivity Rates - OPG >87.5%, A >=82.5%-87.5%, R

<82.5% (> )BHNFT 96.4% 95.9% 95.9% 96% 94% 96% 94% 96% 95% 96% 96% 96% 97% 97% 95% 96% 97% 97%

Q- FFT Positivity Rates -StaffG >87.5%, A >=82.5%-87.5%, R

<82.5% (> )BHNFT 72.1% 82.0%

Complaints closed within target or agreed extension % G >90%, A >=70%-90%, R <70% (>) BHNFT 100% 100% 100.0% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%

Q- Single Sex Breaches 0 0 National 0 0 - 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Q - Duty of Candour Breaches 0 0 National 0 0 - 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Q - VTE Screening Compliance G>= 95%, R < 95% NHSE 97.2% 97.8% 97.8% 98.1% 98% 97.8% 98.1% 98.2% 98.5% 98.2% 98.5% 98.2% 97.4% 96.6% 98.4% 98.0% 97.0% 96.3%

Q - Sepsis-Antibiotics given within Hour of diagnosis G >= 90%, R < 90% National 92.9% 87.8% 85.5% 83.2% 85.8%

Q - HSMR (Rolling 12 months) Latest Data is January 2020 - - - 102.8 100.5 99.2 96.9 96.9 97.9 95.4 94.2 94.8 97.3 98.8 98.4 96.5

Crude Mortality (Number of Deaths) - - - 114 96 92 100 88 79 65 69 80 81 104 104 95 84 100

SHMI (Rolling 12 months) Latest Data is September 2019 - - - 99.3 101.0 99.4

RAG Description

RED Failed Target

AMBER Failed by <5% (This tolerance does not apply to Cancer & A&E targets which will be RED if the target is not

achieved)

GREEN Achieved Target

< Less Is Good

> More is good

Q KPI is in the Quality Schedule for 2019/20 to be defined and included in IPR from May 2019

Quality Performance Scorecard

Patient Safety

Patient Experience

Clinical

Effectiveness

Patients will experience safe care


5Pack Page No. 37

People and Patient Access Scorecard

Domain KPI StandardStandard(Month)

Set By Current Qtr. Year to DateYear-End

Forecast Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Jan-20 Feb-20 Mar-20

People will be proud to work for us

Staff Turnover (Rolling 12 months) G <=10%, A >10%-11%, R >11% (<) BHNFT 10.8% 10.8% 10.8% 9.3% 9.2% 9.3% 9.3% 9.7% 10.1% 10% 10.4% 10.5% 10.8% 10.6% 10.5% 10.8% 10.9% 10.8%

Staff Appraisal Rate G >90%, A >=70%-90%, R <70% (>) BHNFT 92.2% 80% 80% 90.7% 90.2% 89.9% 7.6% 31.4% 86.5% 91.2% 92.8% 93.0% 93.0% 93.2% 92.9% 92.6% 92.2% 91.9%

Mandatory Training G >90%, A >=85%-90%, R <85% (>) BHNFT 89.8% 90% 90% 88% 89% 90.3% 90.9% 91.3% 91.2% 90.7% 90.3% 89.8% 90.4% 90.6% 91.2% 90.6% 90.0% 88.8%

Sickness Absence (In Month)G <=3.75%, A >3.75%-4.25%, R >4.25%

(<)BHNFT 4.87% 4.12% 4.12% 5.03% 4.85% 4.63% 4.12% 4.10% 4.02% 4.31% 3.85% 3.97% 4.29% 4.50% 5.05% 5.16% 4.73% 4.72%

Performance matters - Key Performance Indicators

RTT Incomplete Pathways (February 2020) 92% (>) National 93.3% 93.2% 93.6% 95.7% 95.6% 95.2% 95.0% 94.7% 94.3% 93.5% 93.3% 93.8% 93.6% 93.7% 92.7% 92.5% 92.1%

Q - Cancer 2 Week Waits 93% (>) National 92.5% 92.5% 93% 96.4% 95.6% 95.6% 93.4% 94.8% 85.8% 87.8% 93.3% 93.7% 91.9% 92.9% 92.9% 94.9% 96.5%

Q - Symptomatic Breast 2 Week Waits 93% (>) National 93.8% 84.8% 86% 94.4% 95.3% 94.6% 92.1% 94.9% 48.4% 57.9% 82.8% 98.1% 94.6% 92.6% 94.1% 91.8% 97.3%

Q - 31 Day - 1st Definitive Treatment 96% (>) National 100% 98% 97.8% 99% 94% 99% 95% 92% 97% 100% 97% 100% 100% 100% 100% 99% 98%

Q - 31 Day - Subsequent Treatment (Surgery) 94% (>) National 100% 94% 91.0% 91% 100% 83% 91% 100% 100% 100% 100% 100% 100% 100% 100% 80% 75%

Q - 31 Day - Subsequent Treatment (Chemotherapy) 98% (>) National 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%

Q - 38 Day - Inter-Provider Transfer 85% (>) BHNFT 63.6% 63.1% 57% 66.7% 50.0% 58.6% 61.9% 63.6% 70% 55.9% 70.6% 65.2% 59.4% 68.8% 66.7% 60.0% 39.1%

Q - 62 Day - GP Referral to Treatment 85% (>) National 87.2% 85% 85% 85.4% 94% 89.2% 93.2% 78.0% 73.3% 88.8% 78.5% 93.5% 85.1% 87.0% 91.1% 82.4% 87.9%

Q - 62 Day - Screening Referral to Treatment 90% (>) National 90.9% 92.1% 85% 89.5% 93.8% 100% 100% 79% 100% 100% 94% 100% 88% 94% 90% 86% 92%

Q - 62 Day - Consultant Upgrade to Treatment 85% (>) BHNFT 71.4% 85% 84% 91% 100% 100% 100% 100% 75% 94% 100% 83% 80% 38% 89% 77% 100%

Emergency % Patients Waiting <4 Hours 95% (>) National 89.6% 91.5% 91.5% 91.1% 92.9% 96% 96% 95.6% 95.6% 93.5% 91.3% 96.3% 95.2% 85.7% 80.7% 86.9% 91.4% 91.0%

Average Length of Stay - Elective (Spell) G <=3.45, A >3.45-3.91, R >3.91 (<) BHNFT 2.13 2.40 - 2.88 2.32 2.72 2.65 2.20 2.94 3.00 2.67 2.56 2.41 1.79 2.13 2.04 2.15 2.20

Average Length of Stay - Non-Elective (Spell) G <=3.45, A >3.45-3.91, R >3.91 (<) BHNFT 3.67 3.28 - 3.48 3.37 3.38 3.07 3.16 3.06 3.04 3.07 3.09 3.18 3.18 3.48 3.67 3.55 3.80

Re-admissions % (Validated) 8% BHNFT - 7.5% 8.4% 7.2% 8.4% 8.5% 8.9% 8.3% 8.4% 7.2% 7.6% 8.7% 8.0% 8.5% 7.1% 6.8%

Cancelled Operations - Breaches of the 28 day rule 0 0 National 9 12 12 0 0 0 0 0 0 0 0 0 1 0 2 0 0 9

Cancelled Operations - Sitrep Reportable 0.8% BHNFT 0.8% 0.6% 0.6% 0.8% 0.2% 1.1% 0.5% 0.7% 0.4% 0.7% 0.5% 0.6% 0.4% 0.4% 1.0% 0.5% 0.6% 0.9%

DNA Outpatient DNA RatesG <=7.2%, A >7.3%-8.5%, R >8.6%

(<)7.2% BHNFT 7.0% 6.9% 6.9% 6.4% 6% 6.5% 6.8% 6.9% 6.7% 6.6% 6.7% 7.1% 6.8% 6.5% 7.5% 7.5% 6.5% 7.1%

RAG Description

RED Failed Target

AMBER Failed by <5% (This tolerance does not apply to Cancer & ED targets which will be RED if the target is not

achieved)

GREEN Achieved Target

< Less Is Good

> More is good

Q KPI is in the Quality Schedule

NOTE: National Indicators such as Cancer, RTT, Cancelled Ops, etc. are considered as being either Achieved or Failed. These are therefore RAG rated as Green or Red.

All other indicators are classed as Achieved or Failed with the exception of all Workforce KPIs, Average Length of Stay & DNA rates which detail the tolerances applied in the Target column.

Operational

Efficiency

Workforce

Elective Access

Cancer


6Pack Page No. 38

Performance Matters (KPIs)Operational Efficiency

The Trust failed to deliver the Emergency access standard in the month of January at 91.1%. Activity is now 14% above plan for emergency department attendances and 6% above plan for non-elective admissions. Year to date, delivery is at 94.7% with a organisational effort focusing on the delivery of the 95% standard at year end

Comments:

The outpatient DNA rate increased to 7.1% in March. The increase is likely to be attributable to

concerns on the part of patients regarding Covid-19.

Bre

ast

Sym

pto

ma

tic

The loss of operating theatres in March to enable expansion of Critical Care capacity resulted in 9 breaches of the standard that patients whose operation is cancelled by

the hospital be provided with another appointment date within 28 days. The rate of cancelled operations increased in March to 0.9%. The increase is attributable to

patients requesting deferral of planned surgery due to concerns regarding Covid-19. Diagnostic access performance was very strong in March with all investigations

provided within six weeks.

The reporting of re-admissions is being reviewed to ensure consistency between the Trust and Barnsley CCG

and changes will be made as required following the review. An audit of re-admissions has been undertaken

and a report issued in draft form. Actions will be agreed between partners in response to the report and the

final report and action plan will be shared in due course.

DN

A R

ate

s

Re

-ad

mis

sio

ns


6.8% 7.1% 7.6% 7.2% 7.3% 7.0% 6.9% 7.0% 7.3% 6.4% 6.0% 6.5% 6.8% 6.9% 6.7% 6.6% 6.7% 7.1% 6.8% 6.5%

7.5% 7.5% 6.5% 7.1%

0%

5%

10%

% o

f D

NA

Rat

es

DNA Rates

New Follow Up Total Standard 2017/18

Cancelled Operations target is '0'

0.6%

0.4%

0.6%

0.8% 0.8%

0.6%

0.3%

0.4% 0.3%

0.8%

0.2%

1.1%

0.5%

0.7%

0.4%

0.7%

0.5% 0.6%

0.4% 0.4%

1.0%

0.5%

0.6%

0.9%

-0.1%

0.1%

0.3%

0.5%

0.7%

0.9%

1.1%

1.3%

1.5%

% o

f C

ance

lled

Op

era

tio

ns

Cancelled Operations

28 Day Breaches % Cancelled Ops Standard

Cancelled Operations Target '0'

7.6% 8.1% 7.1% 7.2%

7.8% 7.1% 6.8%

6.2%

7.7% 7.5% 8.4%

7.2% 8.4% 8.5% 8.9% 8.3% 8.4%

7.2% 7.6% 8.7%

8.0% 8.5% 7.1% 6.8%

0.00%

5.00%

10.00%

Cumulative Validated Re-admissions

0.1% 0.2%

0.5%

0.0% 0.0%

0.5%

0.1%

0.5%

0.3% 0.2%

0.0% 0.0% 0.1%

0.0% 0.1%

0.3%

0.1% 0.1% 0.0% 0.0%

0.3%

0.1% 0.2%

0.0%

0.0%

0.5%

1.0%

1.5%

2.0%

Pe

rce

nta

ge o

ver

6 w

ee

ks

Diagnostic Tests over 6 Weeks

Standard Actual % 1920

7Pack Page No. 39

Performance Matters (KPIs)


Emergency Access and Patient Flow (1)

Co

mm

enta

ryED

4 H

ou

r W

ait

Performance against the 4 hour standard in March was 91.0% compared with 91.4% in February. Although below target, the Trust’s

performance was the tenth best nationally. ED attendance and non-elective admission activity declined in March after an extended

period in which activity levels were well above plan. The functioning of the Emergency Department was disrupted in March by the

new arrangements for management of Covid-19.

The recording of ambulance handover times has been adversely affected by workload pressures arising from Covid-19. Handover

performance remains generally strong with an average handover time of around 15 minutes.

GP streaming at the ED front door was suspended from Monday 30th March to enable the reconfiguration of the Emergency

Department into Covid-19 “hot” and “cold areas”. Patients attending as walk-ins are seen in a tent at the front by a nurse and

Consultant 24/7. Any patients presenting with primary care needs are provided with advice and/or a request to liaise with their GP.

85.5%

89.9% 91.1%

90.3%

93.0%

95.4%

92.1%

97.2%

98.6%

95.4%

97.44% 96.70%

91.09%

92.85%

96.04% 95.97% 95.64% 95.56%

93.45%

91.26%

96.32% 95.20%

85.67%

80.72%

86.92%

91.43% 91.03%

80%

82%

84%

86%

88%

90%

92%

94%

96%

98%

100%

0

2000

4000

6000

8000

10000

12000

Within 4Hrs Total Activity Target 4h Emergency Access PerformanceStandard

8Pack Page No. 40




A&E benchmarking

A&

E 4

Ho

ur

Wai

t -

Be

nch

mar

kin

g

Am

bu

lan

ce H

and

ove

rsIn

pat

ien

t A

cuit

y -

Am

ber

(EW

S sc

ore

5-6

)

Acuity analysis shows an expected increase as measured by EWS scores above. This is reflected in increased bed occupancy and mitigated by the flexible use of inpatient capacity

Inp

atie

nt

Acu

ity

- R

ed

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

50.0% No. Ambulance Handover Times (Pre-validated YAS)

No. between 15 & 30 mins No. between 30 & 60 mins No. between 60 & 120 mins No. over 120 mins Not recorded

EWS = Amber only

0

5

10

15

20

25

Occ

up

ancy

(1

2p

m)

Red R_AVG

0

5

10

15

20

25

30

35

40

45

Mar

/20

18

Ap

r/2

01

8

May

/20

18

Jun

/20

18

Jul/

20

18

Au

g/2

01

8

Sep

/20

18

Oct

/20

18

No

v/2

01

8

Dec

/20

18

Jan

/20

19

Feb

/20

19

Mar

/20

19

Ap

r/2

01

9

May

/20

19

Jun

/20

19

Jul/

20

19

Au

g/2

01

9

Sep

/20

19

Oct

/20

19

No

v/2

01

9

Dec

/20

19

Jan

/20

20

Feb

/20

20

Mar

/20

20

Occ

up

ancy

(1

2p

m)

Amber A_AVG

9Pack Page No. 41




ED Delivery Dashboard V4

Tru

st B

ed O

ccu

pan

cy (

Med

ical

)

Len

gth

of

Stay

(Sp

ell)

GP

Str

eam

ing

0

1

2

3

4

5

LoS

(Day

s)

EL_LOS NEL_LOS

100

200

300

400

10Pack Page No. 42



Regulatory Performance - 18 Week Referral to Treatment

As stated

RTT 18 Week Performance - February 2020

Validated Position

CommentsSpecialty <18 >18 Total %

CARDIOLOGY 485 4 489 99.18%DERMATOLOGY 793 62 855 92.75%E N T 1211 51 1262 95.96%GASTROENTEROLOGY 897 3 900 99.67%GENERAL MEDICINE 214 1 215 99.53%GENERAL SURGERY 1750 310 2060 84.95%GERIATRIC MEDICINE 134 0 134 100.00%GYNAECOLOGY 914 47 961 95.11%OPHTHALMOLOGY 1094 24 1118 97.85%ORAL SURGERY 1063 258 1321 80.47%OTHERS 756 22 778 97.17%RESPIRATORY MEDICINE 284 0 284 100.00%RHEUMATOLOGY 261 12 273 95.60%TRAUMA AND ORTHOPAEDICS 1049 137 1186 88.45%UROLOGY 726 60 786 92.37%Total 11631 991 12622 92.15%

Co

nsu

ltan

t 1

8 W

eek

Ref

err

al t

o

Trea

tme

nt

Incompletes - Standard 92%

A compliant RTT position of 92.15% was achieved in February. The Trust’s

performance was the eighth best nationally.

The loss of operating theatres in March to enable expansion of Critical Care

capacity adversely affected RTT performance with a non-compliant position of

88.8% expected to be reported for March. Performance is expected to

deteriorate further to around 80% in April.

90% 93.37% 93.57% 94.35% 94.70% 95.08% 95.86% 95.32% 95.06% 95.71% 95.59% 95.20% 95.00% 94.74% 94.27% 94.8% 93.35% 93.83% 93.57% 93.70% 92.66% 92.48% 92.15%

80%82%84%86%88%90%92%94%96%98%

100%

Pe

rce

nta

ge P

osi

tivi

ty

Incomplete Pathways

Actual Standard

11Pack Page No. 43



Regulatory Performance - Cancer

Inte

r p

rovi

der

Tra

nsf

er

Bre

ast

Sym

pto

ma

tic

All

Ca

nce

r 2

Wee

k W

aits

40%

50%

60%

70%

80%

90%

100%

Pe

rce

nta

ge P

osi

tivi

ty

Actual Standard

75%

80%

85%

90%

95%

100%

Pe

rce

nta

ge P

osi

tivi

ty

Actual Standard

38 Day Inter-Provider Transfers

Due to changes to the Cancer Alliance data request the parameters around calculation of the Inter Provider Transfer (IPT) have been adjusted. The compliance against 38 days IPT is now calculated on patients that have been treated ‘in month’. This has been back dated to April 2019 for consistency of approach.

72%

86%

77%

67% 66% 71%

81%

90% 93%

67% 68%

84%

70%

56%

45%

63%

45%

52%

58%

44%

76%

61%

44%

69%

43%

71%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Shared pathway performance between Barnsley and Sheffield Rolling 12 month

Transferred within 38Days

12Pack Page No. 44



Regulatory Performance - Cancer

Graph to follow from Cancer services

Graph to follow from Cancer services

62

Da

y C

ance

r Ta

rget

s6

2 D

ay C

ance

r Ta

rget

s

60%

65%

70%

75%

80%

85%

90%

95%

100%

Pe

rce

nta

ge P

osi

tivi

ty

62 Day - Urgent GP Referral to Treatment

Actual Standard

0%

20%

40%

60%

80%

100%

Pe

rce

nta

ge P

osi

tivi

ty

62 Day - Screening Programme

Actual Standard

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Pe

rce

nta

ge P

osi

tivi

ty

62 Day - Consultant Upgrades

Actual Standard

13Pack Page No. 45



Cancer Narrative

Furt

her

In

form

atio

n

Two Week Wait

Performance in February was strong with a validated position of 96.5% against the national target of 93%, Notably, each tumour group achieved compliance. There were 27 breaches in total; attributable to patient choice (x15),

capacity issues (x11), and administrative error (x1).

Breast Symptomatic

February’s validated position was compliant at 97.3% against the national target of 93.0%. Two breaches in total due to the trust not being able to offer a further appointment within target after the patient was unable to attend the

original allocated slot and patient choice.

62 Day GP Referral to Treatment

February performance for 62 day GP referral to treatment was compliant with 87.9% against a target of 85% with five tumour sites performing at 100% (Lung, Skin, Breast, Upper GI and Gynaecology).

Of the 10 breaches, x3 were local and x7 were shared.

Local – Urology due to provider initiated delay (treat day 70), Haematology due to patient choice (treat day 101) and Lower GI due to capacity issues (treat day 78).

Shared – Four breaches transferred within target therefore the treating provider receives full allocation of the breach. The remaining x3 were due to a delay to diagnostic testing (x1 transferred day 55) and patient choice (x2

transferred days 65 and 67).

62 Day Screening Referral to Treatment

The February validated position for 62 day screening was compliant at 91.7% against a target of 90%. Breast achieved 100% with the only breach (local pathway) occurring within Lower GI due to inadequate surgical capacity.

62 Day Consultant Upgrade to Treatment

Performance for February Consultant Upgrades was compliant with 100%.

14Pack Page No. 46

High Level Summary Sickness - Has remained the same as last month and is higher than this time last year when sickness was at 4.50%. There were 1,051 episodes of gastrointestinal problems, 768 episodes of cold, cough and flu, and 550 episodes of anxiety, stress & depression. All CBUs remain in red with the exception of Corporate and BFS. The People & Engagement Group March meeting was cancelled due to the coronavirus outbreak and so the actions agreed last month, to support the sickness absence reduction plan will be carried over to the next People & Engagement Group meeting. There were 68 employees off sick with infectious diseases as at 31 March of which 18 were confirmed Covid sickness. Staff Turnover— Highest staff group turnover remains Allied Health Professionals at 18.12% , followed by Scientific & Technical staff at 15.54%. Use of provision within national terms and conditions to offer career development progression for some AHP and S&T band 5s to band 6s (OT, Physio, Dietetics, Pathology) is due to be introduced from April. Mandatory Training - Has dropped below the 90% target this month due to an approved restricted mandatory training programme of 5 priority e-learning training topics in place at present during the coronavirus crisis, with the remaining 5 topic s to be completed at a later date . The topic area with the highest compliance remains Moving and Handling Back Care Awareness (once only) at 97.20% and the lowest compliance is in Infection Control Level 2 at 79.30%. Staff Appraisal Rate - The 2020/21 appraisal window which was due to open on 1 April has been postponed due to the current coronavirus crisis.

15Pack Page No. 47

People - Trend Analysis Si

ckn

ess

(Tru

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Please the latest Sickness absence benchmarking data is only available up to December 2018

16Pack Page No. 48

Performance MattersActivity

18/19 19/20 19/20

Actual Plan Actual Variance %

Elective Daycases 27,735 27,570 29,162 1592 6%

Elective Inpatients 3,304 3,313 3,794 481 15%

Elective Total 31,039 30,883 32,956 2073 7%

Non Elective Total 40,702 41,044 42,595 1551 4%

Maternity Pathway Total 6,351 6,341 6,469 128 2%

A&E Total 97,128 100,150 102,047 1897 2%

Outpatients Total 338,941 330,024 348,068 18044 5%

* Please note excess bed days are not included in these figures. 2019/20 Activity Plan

2019/20 Activity Actual

2019/20 Activity Plan 2019/20 Activity Plan

2019/20 Activity Actual 2019/20 Activity Actual

Act

ivit

y

Day

Cas

es

Obstetric outpatient attendances are excluded as they are covered by the Maternity Pathways

Ele

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17Pack Page No. 49

Performance MattersActivity

2019/20 Activity Plan 2019/20 Activity Plan

2019/20 Activity Actual 2019/20 Activity Actual

Comments:

2019/20 Activity Plan

2019/20 Activity Actual

Ou

tpat

ien

ts

The main area of over performance is outpatient activity:

New attendances are over performing by 4,220 mainly in General Surgery +775, Ophthalmology +818,

T&O +594, Gynaecology +792 and Dermatology +688.

Follow up attendances are over performing by 13,742 mainly in Dermatology +4,210, Anticoagulant

+4,521, General Medicine +1,429, Gynaecology +2,024 and Ophthalmology 6,159.

Day case over performance is Urology +411, Gastroenterology +523 and Dermatology +571. The main

areas of under peformance are Clinical Haematology -289 and T&O -409.

Elective The main areas of over performance are Gynaecology +120, Clinical Haematology +151 and

General Surgery +135. T&O is under performing by -127 and Colorectal Surgery by -48.

Non-elective main areas of over performance sre in Endocrinology +851, Diabetes +241, Cardiology

+251, Elderly +194, Obstetrics +290, Neonatology +180 and Gynaecology +162. The main area of

under achievement is Paediatrics -323 and General Medicine -610.

Mat

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ED A

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ED

18Pack Page No. 50

SUMMARY

Trust Ove

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aset

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Eth

nic

cat

ego

ry

Gen

eral

Med

ical

Pra

ctic

e C

od

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NH

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um

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Po

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of

Uu

sual

Ad

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ss

Sou

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of

Ref

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& E

Ove

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Trea

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Co

de

Ad

mis

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n M

eth

od

Dis

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ge D

ate

Pri

mar

y D

iagn

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s (I

CD

)

Sou

rce

Of

Ad

mis

sio

n C

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Ove

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dat

aset

sco

re

Trea

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Co

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Mai

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od

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National data item average - - 79.5 90.5 87.7 90.9 72.6 - 96.7 97.5 97.8 89.6 96.7 - 96.7 95.6 92.2 94.4 92.5

Barnsley NHS FT 97.6 99.4 96.5 98.4 99.3 100 100 96 100 100 100 98.3 100 98.9 100 100 93.5 100 95.3

The Rotherham NHS FT 92.1 88.8 99.8 100 99.5 100 0 97 100 100 100 94.8 100 99.8 100 100 100 100 99.8

Chesterfield Royal NHS FT 91.7 99.8 99.4 100 99.5 99.7 100 96.9 100 100 100 98.2 100 100 100 100 100 100 100

Sheffield Teaching NHS FT 96.6 99.6 97.3 100 99.1 99.9 100 99.8 100 100 100 99.1 100 99.5 100 100 97.5 100 100

Doncaster & Bassetlaw FT 99.6 99.2 96.1 99.5 97.1 99.9 100 99.7 100 100 100 98.2 100 99.6 100 100 99.7 100 100

Mid Yorks Hospital 94.3 99.6 100 99.8 99.2 100 97.6 96.8 100 100 100 98.7 100 98 100 100 82 100 100

Definitions

Ethnic category - as stated by the patient

General Medicine Practice code - the organisation code of the GP Practice that the patient is registered with

NHS number - unique patient identifier

Source of referral for A&E - the source of referral of each A & E episode

Treatment Function Code - recorded to report the specialised service within which the patient is treated.

Admission Method - The method of admission to a hospital provider spell. For example, elective, emergency, maternity.

Discharge Date - The date a patient was discharged from a hospital provider spell.

Primary Diagnosis (ICD) - the International Classification of Diseases (ICD) code used to identify the primary diagnosis.

Source Of Admission Code - to a Hospital Provider Spell or a Nursing Episode when the patient is in a Hospital Site or a Care Home.

Consultant Code - code uniquely identifying a consultant

Gender - patient's current gender.

Source of Referral for Outpatients - source of referral of each Consultant Out-Patient Episode

The Trust now has a well-established Data Quality Group that aims to ensure the Trust’s core electronic patient record system is up-to-date and accurate. This group comprises operational and ICT staff and

reports directly into senior operational groups on progress and ensures delivery of action plans associated with emergent and pre-existing data quality issues.

The Data Quality Maturity Index (DQMI) is a quarterly NHS Digital publication intended to highlight the importance of data quality in the NHS. The most recent data is August 2019.

Postcode of usual address - the postcode of the address nominated by the patient where the address association type is 'Main Permanent Residence' or 'Other Permanent Residence'

Main Speciality Code - the specialty in which the consultant is contracted or recognised. Main speciality classifies clinical work divisions more precisely for a limited number of specialties.

Comments - Barnsley is better than the national average across all areas of mandated data. Outpatient consultant codes will improve when we implement

Medway as Lorenzo allows none standardised consultant codes (J Codes).

DQ

MI

ED Admitted Patient Care Outpatients


19Pack Page No. 51

Performance - "At a glance"

Month

Plan

Month

ActualVariance % Variance Plan YTD Actual YTD

Variance

%Variance

Month

Plan

Month

ActualVariance % Variance Plan YTD

Actual

YTD

Variance

%Variance

ACTIVITY LEVELS (PROVISIONAL) Cost Improvement Plan (CIP) £'000 £'000 £'000 £'000 £'000 £'000

Elective inpatients 293 263 -10.24% (30) 3,313 3,794 14.52% 481 Income 249 230 -7.62% (19) 2,029 3,463 70.68% 1,434

Day Cases 2,410 1,949 -19.13% (461) 27,570 29,162 5.77% 1,592 Pay 112 99 -11.37% (13) 2,356 1,798 -23.67% (558)

Outpatients 28,200 22,939 -18.66% (5,261) 327,138 345,100 5.49% 17,962 Non-Pay 193 116 -39.65% (77) 2,358 1,558 -33.91% (800)

Non-elective inpatients 3,540 3,038 -14.18% (502) 41,254 42,803 3.75% 1,549 Total CIP 554 446 -19.53% (108) 6,743 6,820 1.14% 77

A&E 8,811 6,423 -27.10% (2,388) 100,150 102,047 1.89% 1,897

Other (excludes direct access tests) 8,958 8,326 -7.06% (632) 104,860 106,113 1.19% 1,253 Statement of Financial Position (SOFP) £'000 £'000 £'000 £'000 £'000 £'000

Total activity 52,212 42,938 -17.76% (9,274) 604,285 629,019 4.09% 24,734 Capital Spend (2,753) (5,666) -105.81% (2,913) (10,740) (10,731) 0.08% 9

Inventory 2,725 3,731 36.92% (1,006)

INCOME £'000 £'000 £'000 £'000 £'000 £'000 Receivables 13,746 12,955 -5.75% 791

Elective inpatients 908 666 -26.67% (242) 9,996 10,780 2.96% 784 Payables (inc. Accruals) (15,931) (28,941) -81.66% 13,010

Day Cases 1,524 1,227 -19.52% (297) 17,126 18,061 5.46% 935 Other Net Liabilities (348) (1,460) -319.54% 1,112

Outpatients 2,909 2,401 -17.47% (508) 33,631 35,322 5.03% 1,691

Non-elective inpatients 6,631 6,099 -8.01% (531) 75,912 79,316 4.48% 3,404 Cash & Loan Funding £'000 £'000 £'000

A&E 1,259 940 -25.34% (319) 14,307 14,462 1.09% 155 Cash 1,000 15,296 1429.60% 14,296

Other Clinical 4,874 14,622 200.03% 9,749 56,466 63,397 12.28% 6,931 Loan Funding (70,246) (67,376) 4.09% 2,870

PSF Funding 1,141 1,141 0.00% 0 10,435 10,814 3.64% 379

Other 1,408 1,746 24.02% 338 16,877 19,466 15.34% 2,589 KPIs

Total income 20,653 28,841 39.65% 8,189 234,750 251,620 7.19% 16,870 EBITDA % 7.06% 4.56% -35.42% -2.50% 2.97% 2.89% -2.49% -0.07%

Surplus / (Deficit) % 4.20% 2.84% -32.34% -1.36% 0.00% 0.17% 0.17%

OPERATING COSTS £'000 £'000 £'000 £'000 £'000 £'000 Receivable Days 23.1 20.9 -9.43% 2.2

Pay (13,837) (21,724) -57.00% (7,887) (163,433) (175,712) -7.51% (12,279) Payable (excluding accruals) Days 76.1 33.4 -56.12% -42.7

Drugs (1,340) (1,322) 1.37% 18 (16,080) (16,097) -0.10% (17) Payable (including accruals) Days 76.1 89.0 16.99% 13

Non-Pay (4,017) (4,480) -11.53% (463) (48,269) (52,528) -8.82% (4,259) Use of Resources rating (after overrides) 2 3 1

Total Costs (19,194) (27,526) -43.41% (8,332) (227,782) (244,337) -7.27% (16,555) Use of Resources rating (before overrides) 2 2 0

Capital service cover rating 1 3 2

EBITDA 1,459 1,315 -9.82% (143) 6,968 7,282 4.51% 314 Liquidity rating 2 4 2

Depreciation (493) (480) 2.61% 13 (5,798) (5,745) 0.92% 53 I&E margin rating 2 2 0

Non Operating Expenditure (99) (16) 83.48% 83 (1,170) (1,107) 5.39% 63 I&E margin: distance from financial plan 1 1

Surplus / (Deficit) 867 819 -5.51% (47) 0 431 431 Agency rating 1 2 1

Performance - Financial Overview Performance - Financial Overview


Page 20 of 21Pack Page No. 52

Performance Matters - Finance

March 20 Summary

Summary Performance:


Commentary Key to RAG Rating The RAG rating applied to Variance % is based on the following criteria: • Green equating to 0% or greater • Amber behind plan by up to 5% • Red greater than 5% behind plan

The key points derived from this table are as follows: • The Trust has a consolidated year to date surplus of £0.431m against a breakeven plan, giving a favourable variance of £0.431m. This is distorted by £0.379m bonus PSF relating to 2018/19

and £0.052m donated income relating to charitable donations for assets, leaving a net breakeven position.

• Total activity in-month is down on plan across all points of delivery due to focusing activity on business critical areas in response to COVID-19. Total activity for the year remains above plan reflecting the high level of demand seen on services across the Trust prior to the COVID-19 outbreak.

• Total income is £16.870m favourable to plan for the year. Clinical income variances total £13.901m above plan as a consequence of the increased activity seen, accrued reimbursement of additional costs incurred as a consequence of COVID-19 from NHS England (NHSE) and accrued offset to additional NHS Pensions employer contributions paid by NHSE on behalf of NHS organisations throughout the year which they have requested is accounted for locally in month 12. Other income is £2.589m above plan mainly due to education and training (higher training numbers and one-off receipts); along with drug and pathology recharges (offset by expenditure).

• Operating costs are £16.555m adverse to plan in total. Pay is £12.279m adverse mainly due to activity pressures , agency spend, unachieved CIP, additional costs incurred as a consequence of COVID-19 and additional NHS Pensions employer contributions paid by NHSE on behalf of NHS organisations throughout the year but accounted for locally in month 12. Non-pay costs are £4.276m adverse mainly due to activity pressures, outsourcing, unachieved CIP and additional costs incurred as a consequence of COVID-19..

• CIP has under achieved by £0.108m in-month but is favourable to plan by £0.077m for the year.

• Capital expenditure for the year is in line with the values forecast in previous months and is £0.009m less than plan.

• Total payables including accruals are £13.010m higher than plan. This is £5.425m higher than last month and is mainly due to an increase in capital creditors & accruals as a consequence of the size of the capital programme delivered in March.

• Cash is £14.296m favourable to plan which is £0.523m higher than last month. This increase is due to the receipt of external capital funding in the form of Public Dividend Capital (PDC) before the cash payments have been made.

• Loans remain at £2.870m below plan due to an unplanned loan repayment to the Department of Health in May.

• Debtor days are 20.9 which is 2.3 days favourable to plan, mainly due to the receipt of CCG overtrade monies in previous months.

• Payable days (excluding accruals) are 33.3 which is 42.9 days favourable to plan and continue to show the managed reduction in the creditors position. Payable days have been calculated excluding accruals, because whilst accruals include certainties in respect of future payments, the timing of these payments is uncertain. Expenditure has been calculated as operating costs,

Page 21 of 21Pack Page No. 53

EXECUTIVE SUMMARY

RECOMMENDATIONS

STRATEGIC CONTEXT


SUBJECT: CELEBRATING OUR PEOPLE

DATE: 7 MAY 2020

PURPOSE:

Tick as applicable

Tick as applicable


PREPARED BY: Katie Claydon

SPONSORED BY: Richard Jenkins, Chief Executive

PRESENTED BY: Emma Parkes, Director of Marketing & Communications

To provide an update to the Board on the different ways our staff have been celebrated during the Covid-19 outbreak.

The Trust employs almost 4,000 people, each of whom play an integral role in the hospital’s overall performance and successful achievement of strategy and objectives.

This report is usually intended to celebrate the Trust’s Brilliant Award nominees and winners. Due to alternative methods of working during the response to Covi-19, the Brilliant Awards have been temporarily suspended.

This report provides an opportunity to inform the Board of examples of other sources of support for staff and patients during this time.

The Board is asked to review and note the content of this report.

BoD Mayl2020: Celebrating our People Pack Page No. 54

Subject: CELEBRATING OUR PEOPLE REPORT Ref: BoD: 20/05/07/13 1. #ThankYouNHS

1.1 The Trust is participating in the national #ThankYouNHS social media campaign

which asks the public to give their thanks to staff and teams in the Trust. We have uploaded a post on Facebook asking for people to comment their thanks. Social media posts have resulted in over 100 messages of support and thanks. A website form has been created to further enable the general public to express their support. Messages are collated into a #ThanksYouNHS e-bulletin issued to all staff on a fortnightly basis. Appendix 1 provides an example of the latest e-bulletin.

2. Thank You Artwork 2.1 A rainbow symbol has become synonymous with the NHS and its work. A large

number of people within Barnsley, including local children, have sent in their artwork for our Wobble Room. These have been laminated and put on the wall as symbols of support and encouragement for staff. All artwork received is being shared on the Trust’s social media feeds.

2.2 In conjunction with the Patient Experience

team, artwork received is attached to the newly introduced message cards that the public can use to send a message to their relatives who are patients in the Trust. Local primary schools such as St John the Baptist School in Dodworth are supporting this initiative.

2.3 Thank you Certificate

To say thank you to children for painting rainbows to raise the spirits of staff, the Trust has made a certificate of achievement that parents can download and print.


3. Donations and Support

The Trust has received unprecedented support from members of the public and businesses. The Trust, together with Barnsley Hospital Charity, would like to thank all donors for their generosity in supporting the hospital, staff and patients during this time. 3.1 Amazon Wish List

An Amazon wish list has been established to provide items to support staff during their working hours at the hospital. This has received an overwhelming response with the majority of items being repeatedly sold out. The donations have been taken to all clinical and non-clinical areas of the Trust and a stock has been put in the Wobble Room for staff to help themselves to during their time out. The overall monetary value of the items received from the wish list is over £11,000. All donations are recorded on the Barnsley Hospital Charity Gift in Kind Register.

3.2 Just Giving Donations A Just Giving account has enabled those who wish to donate funds rather than items to do so with ease and confidence in support of staff and patients.

3.3 Corporate Support ASOS, based in Barnsley has worked in partnership with Barnsley Hospital Charity to produce a specially designed ‘Heroes’ clothing range with profits being donated to the charity in support of staff and patients. ASOS further donated a significant number of loungewear sets and washable tote bags for clinical staff. This donation was welcomed by staff.

3.4 Knitted Hearts Members of the public have knitted and donated pairs of hearts. One heart is given to a patient in the Intensive Care Unit and the matching heart in the pair is given to the patient’s family. We have received very positive feedback on this from relatives on this initiative.

3.5 The Wobble Room The new ‘Wobble Room’ is a place to enable staff to unwind before, during and after their day. The 'wobble room' has already proven to be such a useful resource, offering respite to staff during the challenges they currently face in the workplace. The Wobble Room sign has been kindly donated by a local business.


4. International Day of the Midwife and Nurse

To celebrate the International Day of the Midwife and Nurse, 5th and 12th May respectively, The Trust is working with Barnsley Chronicle to celebrate staff, share positive outcomes for patients and messages of gratitude.

5. Social Media Engagement

5.1 Increased Engagement The Trust is proactively posting on Facebook and Twitter at multiple points on a daily basis to ensure members of the public are informed of the latest information at a local and national level. Since the beginning of the Covid-19 period, the Trust has seen significant increases in the numbers of followers and engagement reach on both channels.

5.2 Positive Messages The Trust has received an overwhelming number of positive messages on social media. These include comments thanking staff members and teams and messages to the private inbox sharing their positive experiences.

5.3 Celebrating our staff on social media

Staff achievements, thank yous and feedback are posted on social media. Local organisations including the Barnsley Chronicle, Barnsley Metropolitan Borough Council, Barnsley Clinical Commissioning Group and South West Yorkshire Partnership NHS Foundation Trust are proactively sharing posts, including staff related posts, widening the total reach. ‘We Are Barnsley’ publish daily thanks to different key workers across Barnsley. This has paid thanks to several of the Trust’s staff and teams, with each post receiving a significant amount of likes and comments. The Trust recently showcased a story about James Dickson, the hospital’s first Covid-19 patient who needed intensive care, being discharged. This highlighted the excellent work by the ICU team involved in James’ care as well as other teams such as the Speech and Language and Physiotherapy Teams.

6. Working Differently to Support Staff

6.1 Technology With many staff working at home and social distancing practices the Trust has changed the approach to staff communications. In April Dr Richard Jenkins, Chief Executive held the first digital Team Brief via Microsoft Teams. Dr Jenkins presented topics and answered staff questions in real time whilst other staff listened in and were able to contribute using the chat option.


People have been sharing their thanks to our staff using the #ThankYouNHS hashtag on social media.

We have been overwhelmed by the amount of positive messages about Barnsley Hospital shared by

patients and the Barnsley public. We’re sharing these kind words with you all.

Messages from the public on social media #ThankYouNHS

“Thank you for everything you’re doing putting yourselves in the front line and yourselves at

risk you’re all hero's in my book thank you to all the NHS for everything u do stay safe all of u

god knows what we'd do without u x”

“A huge thanks from all at

@Umbrella5ways for all your hard work at this very difficult

time #ThankYouNHS”

“A massive thank you to

every single one of you. You're all doing a fantastic job. Well done”

“Thankyou to all staff including those we don't see even though not on

the frontline we need them also xxx”

“ Thanks to everyone who works or volunteers at the

hospital, and especially Ward 34 where I had a full

hip replacement a couple of weeks ago - so that includes

Mr Abdlslam, the anaesthetist, all the nurses,

the health workers, the physios, the OTs, the

cleaners and especially not forgetting the lovely lady who brought our meal”

“NHS gets a lot of negative press but got to say the few times we have had to come to Barnsley hospital the service from over

worked doctors and nurses has been fantastic.

You deserve so much more than everyone’s thanks but for now

#ThankYouNHS You are all heroes.”


“Thank you does not seem anywhere close to enough but Thank you stay safe and well”

“Thank you, you're doing so amazing... Keep safe...”

“A massive thank you, you'll never know how important

you are & how grateful we all are of you! ❤ Stay safe x”

“Thank you to all of you , so much respect , stay strong xxx”

“You guys are all doing an amazing job n we the people in Barnsley are very

grateful. Praying for strength n protection for you all during this crisis xx”

“ Thank you to every single member of

staff at Barnsley

Hospital for the amazing

work they are doing”

“Thank you for everything you are doing stay safe and such a

fabulous hospital and such brilliant staff.”

“Thank you to every single member of staff at Barnsley Hospital for the amazing work they are doing, not

just to fight Covid 19 but every single day, 365 days a year

#ThankYouNHS”

“Absolute Diamonds.

Thankyou seems inadequate, stay safe, stay well.”

“Thank you to our amazing NHS staff, risking life and limb to keep us safe! This is about to get very real in the next few weeks and selflessly you are going to be there to do all you can to

help people as best you can. Putting yourself and family at risk, many wouldn't want to be in your shoes! I hope you manage to stay safe at this testing time. Thank you from the bottom of

my heart, I for one appreciate all that you are doing for us!”

“THANKYOU! If any hospital staff want to park their car outside Stella's hairdressers on Pogmoor Road while we're closed please feel free”

“Thank you to every one of you that are

working to keep us all safe. We will never be able to thank you enough”

“Thank you to all staff cleaners included could

not get better without all your help”

“#ThankYouNHS for thanking me today at BARNSLEY antenatal for going to my ultrasound

scan alone, thank you to the nurse who had a small bit of lotion in her pocket but could see my hands

were as dry as bone from panic cleaning and i can’t get any fragrance free moisturiser, she gave me

some of hers! Lovely attitude at BARNSLEY hospital today should be proud all of you! Stay

safe! Xxxxx”

“#ThankYouNHS for thanking me today at BARNSLEY antenatal for going to my ultrasound scan alone, thank you to the

nurse who had a small bit of lotion in her pocket but could see my hands

were as dry as bone from panic cleaning and i can’t get any fragrance free moisturiser, she gave me some of

hers! Lovely attitude at BARNSLEY hospital today should be proud all of

you! Stay safe! Xxxxx”


“Thank you to everyone working through this awful time. We cannot thank you enough for putting

yourselves on the front line. Take care and stay safe”

“I can't even think where this country would be without you. Heroes every one

of you no matter what job you do”

“Thank you to every single one of you from the volunteers, student nurses, cleaners, doctors and

surgeons. You're a phenomenal hospital and I hope you're all managing to stay positive and safe through all of this. We are so grateful xx”

“We are all so grateful. People once taken for

granted are now proving their true worth. You guys haven’t chosen any of this,

but you choose to remain on the front line. We are all so

proud of you and the service and passion you bring. Thank

you.”

“ A massive thank you to all Barnsley NHS &staff

especially the A&E & chemotherapy ward 24

absolutely truly amazing caring & supporting us

both while my partner is going through Hogdkins lymphoma cancer at age

of 31”

“Absolutely amazing each and everyone who works there. I’m

gutted I’m not able to carry on with my volunteering due to being in the at risk category, but I will be back afterwards and will treat the A&E

team with some goodies to eat! Stay safe each and everyone one of you.”

“Hugs and love to all the hardworking staff and with the greatest respect I hope I don't

see you any time soon.”

“Thank you for your selfless hard work all of

you. Let’s hope this awful virus is soon

past. Thank you again.”

“A big thank you to all the staff for absolutely everything they have done and everything

they are doing. I would like to make a special thanks to Dr Kapur/Dr Mehmood and all surgical ward staff that was amazing and have saved my life twice wouldn't be here

without them. THANK YOU xxx”

“Thank you all your hard work and bravery. Having been a nurse I know

how that you are thinking of your patients - heroes each and everyone

of you from the top and everyone else who make a hospital run”

“Heroes, every one of them. From

receptionists to cleaners and surgeons to doctors and

nurses.”

“Just wanted to say a massive thank you to all NHS staff your all Angel's, not just for everything that is happening at the moment but for everything

you do day in day out. Love to you all”

“My family have always been well looked after by Barnsley Hospital. From the bottom of

my I heart I thank you all, for all that you have done for us, all that you are doing now and more importantly for taking

care of your patients in what is a very trying time for

everyone”

“What would we do without our wonderful NHS? Not all heroes wear capes! Thank you for all you do particularly at such a

time. Stay safe”

“Big thank you to all at Barnsley Hospital! Hope you

are staying safe, fit and healthy whilst being worked off your feet! Proper Heroes

all of you x”

“I always have loads of thanks for all the Barnsley hospital

crew. You have saved my life many times. Truly amazing

people. Thank you for everything”


A message from Mayor of Sheffield Dan Jarvis I want to express my profound and heartfelt gratitude to all of you on the front line of the most serious public health crisis any of us have faced. The Coronavirus crisis has placed enormous strain on all of our lives. Our NHS is at the sharp end of protecting the most vulnerable and keeping our communities safe. Simply put, none of this could happen without you: the people who are keeping our NHS going. The nurses, cleaners, administrators, porters and doctors: every day you are showing just why the NHS is so often seen as representing the very best of our country. This crisis has undoubtedly brought out the best in people. Those who are stepping up to the plate to make sure their elderly neighbour gets the food and medicine they need. Clinical and support staff who are digging out blind to keep our health service going. The trade unions, like UNISON, who are standing up for their members’ rights and supporting the national interest. All of you deserve our profound and heartfelt gratitude. But there is more that needs to be done to support those at the sharp end of keeping our country going. I’m campaigning hard to ensure that you get the equipment and support you need to do your jobs, ensuring that your personal safety is paramount throughout this crisis. And I’ve raised the issue of free parking for NHS key workers with the Government, because you should have the right to park at your place of work, free of charge, for as long as this crisis lasts. I will continue to stand up for you throughout this period of crisis to make sure you have the tools to do your job; and, when we, together, overcome this disease, I will always fight for better pay, terms and conditions for all of our health workers and for our NHS to get the resources it needs and deserves. The Coronavirus crisis has truly underlined that the NHS is the jewel in the crown of our public services. Thank you for your continued service, hard-work and dedication throughout this most difficult of times. We will all be forever in your debt. With best wishes, Dan


EXECUTIVE SUMMARY

RECOMMENDATIONS

STRATEGIC CONTEXT


SUBJECT: CHIEF EXECUTIVE’S REPORT DATE: 7 MAY 2020

PURPOSE:

Tick as applicable

Tick as applicable

For decision/approval

Assurance


PREPARED BY: Emma Parkes, Director of Marketing & Communications SPONSORED BY: Dr Richard Jenkins, Chief Executive PRESENTED BY: Dr Richard Jenkins, Chief Executive

To report particular events, meetings publications and decisions that the Chief Executive would like to bring to the Board’s attention.

This report is intended to give a brief outline of some of the key activities undertaken as Chief Executive since the last meeting and highlight a number of items of interest. The items are not reported in any order of priority.

The Board of Directors is asked to receive and note this report.

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Subject: CHIEF EXECUTIVE’S REPORT Ref: BoD: 20/05/07/15 1. BARNSLEY HOSPITAL

1.1 CORONAVIRUS (COVID-19) UPDATE

Barnsley Hospital continues to work in alignment with national NHS preparations to support staff and patients during the Covid-19 global pandemic. A two tier command and communication structure remains in place to manage all activity relation to Covid-19. These include operational, human resources, and communications activity to ensure staff are prepared, informed and have access to the latest advice and information. I would like to record my gratitude to all staff at Barnsley Hospital for their continued efforts during this time.

1.2 COVID-19 ACTIVITY

Below is a summary of some of the activity during the month of April:

1.2.1 New Critical Care Landing

The Trust has opened a new critical care landing on wards 31/32, which includes an 8 bedded respiratory care facility and a 44 bedded critical care unit. This new facility includes a 7 bed unit for non Covid-19 patients. These beds will be used flexibly providing level 2/3 care as necessary.

1.2.2 Emergency Children’s Surgery

In partnership with other hospitals and commissioners in South Yorkshire and Bassetlaw, with effect from Thursday 16 April all emergency children’s surgery that would ordinarily have taken place at Barnsley Hospital now temporarily takes place at Sheffield Children’s Hospital for the duration of the Covid-19 period. The exception is children who have very time-critical conditions, such as torsion of the testes, who will still be received here. This has been developed with input and support from paediatricians, managers, nurses from all Trusts, including ours, and NHS transport services.

Like all other UK hospitals, Sheffield Children’s has undertaken extensive preparation work and is in a position to assist its neighbouring trusts, as the illness tends to be less severe in children. This then will allow children’s surgery to continue in a centre of excellence without fear of disruption by the general Covid-19 arrangements in place in district general hospitals. All other local children’s services will continue as normal.

1.2.3 Children’s Emergency Department and Clinical Assessment Unit

I am pleased to report that work has resumed on the new unit. We closed the site in March to allow focus on other priorities, though continued to work on design development of the project. The four week suspension afforded us unexpected time to re-examine various engineering aspects of the design such as structures, mechanical and electrical design. The construction industry as a whole is having to work how to carry out various construction operations safely. We are working with the contractor’s health and safety

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team and our Infection Prevention and Control team to look at the impact of social distancing on construction operations and the overall programme.

1.2.4 Testing patients discharged from hospital to a care home

As set out in the Coronavirus Adult and Social Care Action Plan, Barnsley Hospital is now testing all patients discharged to a care home regardless of whether they were residents of the care home previously or not. To ensure testing does not delay a timely discharge, testing for patients due to be discharged to a care home is planned up to 48 hours before the scheduled discharge time.

1.2.5 Outpatients Phlebotomy Relocation

From Monday 20 April, the Phlebotomy Outpatients Department at Barnsley Hospital has relocated to the Roundhouse Centre, Athersley. This move supports Government social distancing guidance and is to protect our vulnerable patients who require vital blood tests.

1.2.6 International Workers Memorial Day

The Trust observed a minutes silence on Tuesday 28 April to allow those who wish to, to take a minute to remember NHS and other key workers who have lost their lives to Coronavirus.

1.2.7 Ethics Group

The Trust has established an Ethics Group to provide guidance on ethical issues that may emerge from the Covid-19 pandemic. The Terms of Reference are attached for noting.

1.3. COMMUNICATIONS AND INFORMATION

1.3.1 Public information

Public information is communicated daily on the Trust’s website and social media channels. Support from local media has ensured a regular flow of information to the general public. In response to the reduction of visiting patients at Barnsley Hospital, the Patient Experience Team are supporting people to send a message to and arrange a video call/telephone call with a relative in hospital.

1.3.2 Helping to explain Covid-19 to someone with a Learning Disability or

Autism

At Barnsley Hospital we recognise people with learning disabilities and or autism have additional needs. Easy read information to help patients, family and carers in understanding Covid-19, and what changes they may see when attending the hospital is now available.

1.3.3 Information for staff Daily communications regarding all aspects of Covid-19 remain in place to

inform staff of the rapidly changing information. During April, I successfully undertook the first digitalised live Team Brief session using Microsoft Teams.

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1.3.4 #ThankyouNHS The weekly #ClapforCarers continues to be a source of support and

encouragement for staff at Barnsley Hospital. Alongside this, an incredible show of support for our staff in the form of social media messages, emails and videos are communicated to staff using a new #ThankyouNHS bulletin. I would like to thank members of the public for their messages of support and appreciations.

1.3.5 Donations and Support The Trust has received many generous donations and support to support

patients and staff. I would like to express my thanks to everyone who has contributed.

2. PARTNERSHIP WORKING

The Trust continues to work with partners locally, regionally and at a national level to deliver a co-ordinated and consistent approach to the effective management of COVID-19.

Dr Richard Jenkins Chief Executive 07 May 2020

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CHIEF EXECUTIVE REPORT

April 2020

Author(s) Andrew Cash, Chief Executive Officer

Sponsor Is your report for Approval / Consideration / Noting For noting and discussion Links to the STP (please tick)

Reduce inequalities

Join up health and care

Invest and grow primary and community care

Treat the whole person, mental and physical

Standardise acute hospital care

Simplify urgent and emergency care

Develop our workforce

Use the best technology

Create financial sustainability

Work with patients and the public to do this

Are there any resource implications (including Financial, Staffing etc)? N/A Summary of key issues This monthly paper from the Chief Executive of the South Yorkshire and Bassetlaw Integrated Care System (SYB ICS) provides a summary update on the work of the SYB ICS for the month of March 2020. Recommendations The SYB ICS Health Executive Group (HEG) partners are asked to note the update and Chief Executives and Accountable Officers are asked to share the paper with their individual Boards, Governing Bodies and Committees.

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South Yorkshire and Bassetlaw Integrated Care System

CHIEF EXECUTIVE REPORT

April 2020

1. Purpose

This paper from the South Yorkshire and Bassetlaw Integrated Care System Chief Executive provides an update on the work of the South Yorkshire and Bassetlaw Integrated Care System for the month of March 2020. 2. Summary update for activity during March 2020 2.1 Coronavirus (Covid-19) 2.1.1 The national and South Yorkshire and Bassetlaw position There has been good preparation to cope with Covid-19 in all places and organisations in South Yorkshire and Bassetlaw (SYB). In primary care, GP practices have offered telephone and video consultations and seen suspected Covid-19 patients in specially designated areas or arranged to visit patients in their own homes. Community services have supported the discharge of patients and hospitals have built their critical care capacity while simultaneously managing urgent hospital work. Yorkshire and Humber is approximately one to two weeks behind London but it looks like the peak for SYB may have been reached over the Easter weekend and demand is now beginning to flatten. All efforts to reduce physical contact and stop the spread of the infection seem to be having some effect. The coming weeks are crucial. If things continue to improve, expectations are that there will be a peak in activity for hospitals towards the end of April and into May. But during this time the number of cases detected, admissions and death may still rise due to the nature of this disease. A continuance of physical distancing to stop the spread now seems inevitable and services in the community are having to prepare for further months of working with shielded vulnerable patients, and the complexity of caring for people that are in household isolation. 2.1.2 Role of the ICS during Covid-19 The ICS has two key roles: Supporting the local system command and control response to COVID-19 Leading on recovery and transformation, fast tracking innovative solutions in response to COVID-19 With agreement between ICS Leaders and the NHS England/Improvement Regional Director, a Strategic Health Coordinating Group (SHCG) has been established to help connect ICS health partners and the national incident response Chain of Command (see Appendix 1). A collaborative Incident Management Team (IMT) has been stood up to support the SHCG and a process of daily checkpoints with ICS Leadership put in place. It meets daily and the SHCG meets every Tuesday.

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The purpose of the SHCG and IMT is:

• To ensure that partners and management leads have up to date information on the epidemic in SYB and its impact on healthcare

• To provide a forum for management leads to share, by exception, progress on their workstreams and to request support from other working groups

• To identify issues for escalation (to SHCG, Incident Control Centre or Local Resilience Forum)

• To discuss mutual aid across partners • To co-ordinate the management response to the incident and the actions arising from the

SHCG meetings. The ICS transformation team is adapting to support local organisations and each transformation programme has undertaken a review of priorities that need to be accelerated, continued, slowed or stopped during the Covid-19 pandemic. This important work to refocus our transformation priorities will support and enable sustainable changes to new ways of working particularly using digital technology and innovative solutions in patient care and treatment that can be done at scale across our five places. We are using our innovation hub to engage and work with local industry partners and the SYB procurement team on solutions to increase PPE and other equipment for the front line. Some examples of the accelerated priorities being undertaken by the ICS Transformation Programme Management Office to support the Covid-19 crisis include the use of the independent sector capacity and facilities; enabling equitable access to cancer treatments and other care pathways; at scale radical use of digital IT in primary care consultations; facilitating mutual aid across SYB partners to support continuity of services including temporarily reconfiguring some service pathways to ensure critical services are able to continue and increasing critical care capacity across the SYB footprint. A regular transformation update will be provided to the SHCG and the HEG on the re-focussed ICS transformation agenda highlighting the support it is providing to super-charge and build on the innovative solutions that colleagues across the system are finding as a result of the crisis. 2.1.3 Cells At a national and regional level, nine cells have formed to respond quickly to issues. These include clinical advice, critical care, workforce, hospital care, procurement and logistics, finance and recovery, discharge, community care and social care, primary care and mental health and learning disabilities. At an SYB level, Senior Responsible Officers have been aligned to the regional cells and are progressing key issues highlighted by the SHCG. These include: critical care capacity, primary and community care, mental health, hospital care and social care issues. SYB partners are dealing with the immediate impact of Covid-19 and are also beginning to put plans in place for recovery and the slow and careful reintroduction of some health services that were paused at the onset of the pandemic. 3. 2019/20 End of year financial position and Covid-19 financial scheme The ICS is currently forecasting that it will achieve the system control total for 2019/20 but there is very little margin for error. The system is managing deficits against plan in the final quarter of the year with two trusts. This is being managed through over-performance in a number of other provider and commissioners. Once the 2019/20 system control total is achieved funding for

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approximately £19m of Provider Sustainability Funding (PSF) and Financial Recovery Funding will be received. 3.1 Covid-19 As a result of Covid-19, ‘Payment by Results’ has effectively been suspended for the period from 1 April to 31 July and replaced by block payments, top up payments and reimbursement of Covid-19 impacts. In addition, returns have been sent to providers and commissioners to capture revenue costs for 2019/20 and capital costs for 2019/20 and estimated capital costs for 2020/21. Capital costs less than £250k will be authorised by the region retrospectively subject to a reasonableness test. Capital costs greater than £250k require Regional Finance Director sign off. Further detail is still being worked up nationally particularly around the 2020/21 revenue reimbursement. Andrew Cash Chief Executive, South Yorkshire and Bassetlaw Integrated Care System Date 14 April 2020

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OFFICIAL 1

1. NHS Incident Command Structure

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2.2 Regional Command Cell and SYB Leadership Alignment

OFFICIAL 2

2. SYB ICS Incident Team

Clinical Advice Critical Care Workforce Hospital Care

Finance,

recovery,

information,

analytics

Procurement,

Logisitcs

Discharge,

community care,

social care

Primary Care

Ambulance,

Patient Transport

Mental Health

and LD

Regional IMT Cell Regional SRO SRO Operational Lead

1. Clinical Advice David Black

2. Critical Care David Black, Margaret Kitching

3. Workforce Daniel Hartley

4. Hospital Care Idris Griffiths Alexandra NorrishCancer Lesley Smith Julia JessopPathology Services Richard Parker Sarah Bayliss

5. Info, analytics, finance and recovery Tim Savage

6. Procurement Robert Cornall Paul Ralston Andy Baker

7. Discharge, community and social care Margaret Kitching Chris Edwards Mandy Philbin

8. Primary care Alex Morton Jackie Pederson Karen Curran

9. Ambulance service and patient transport TBC Brian Hughes Rachel Gillot

10. Mental health, LD and H&J Robert Cornall Kathryn Singh Sarah Boul

SYB

Warren Brown

Des Breen

Des Breen

Kevan Taylor

Jeremy Cook,Lisa Kell

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Skipton House 80 London Road London SE1 6LH

[email protected]

From the Chief Executive Sir Simon Stevens & Chief Operating Officer Amanda Pritchard

To: Chief executives of all NHS trusts and foundation trusts CCG Accountable Officers GP practices and Primary Care Networks Providers of community health services NHS 111 providers Copy to: NHS Regional Directors Chairs of ICSs and STPs Chairs of NHS trusts, foundation trusts and CCG governing bodies Local authority chief executives and directors of adult social care Chairs of Local Resilience Forums

29 April 2020

Dear Colleague, IMPORTANT - FOR ACTION - SECOND PHASE OF NHS RESPONSE TO COVID19 We are writing to thank you and your teams for everything you have achieved and are doing in securing the remarkable NHS response to the greatest global health emergency in our history. On 30th January the first phase of the NHS’s preparation and response to Covid19 was triggered with the declaration of a Level 4 National Incident. Then in the light of the latest SAGE advice and Government decisions, on 17th March we wrote to initiate what has been the fastest and most far reaching repurposing of NHS services, staffing and capacity in our 72-year history. This has enabled us in the space of the past six weeks to go from looking after zero such patients to caring for 19,000 confirmed Covid19-positive inpatients per day, many of whom have needed rapidly expanded critical care support. Alongside this, the majority of patients the Health Service has continued to look after have been receiving care for other important health conditions. Despite real concern going in to the pandemic – following difficult international experience – every coronavirus patient needing hospital care, including ventilation, has been able to receive it. This has largely been possible as a result of the unparalleled commitment and flexibility of NHS staff, combined with the public’s ‘social distancing’ which remains in

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place to cut the spread of the virus. We have also been greatly strengthened by over 10,000 returning health professionals; 27,000 student nurses, doctors and other health professionals starting their NHS careers early; 607,000 NHS volunteers; and the work of our partners in local government, social care, the military, the voluntary sector, hospices, and the private sector. Sadly coronavirus looks set to be with the us for some time to come, so we will need continuing vigilance. We are, however, now coming through this peak of hospitalisations, as seen by the drop of nearly 5,000 in the daily number of confirmed Covid19-positive patients in hospitals across England over the past fortnight.

Patients with confirmed Covid19 in hospital beds, England

As the Prime Minister set out on Monday, we are therefore now entering the second phase in the NHS’s response. We continue to be in a Level 4 National Incident with all the altered operating disciplines that requires. NHS organisations therefore need to fully retain their EPRR incident coordination functions given the uncertainty and ongoing need. The purpose of this letter is to set out the broad operating environment and approach that we will all be working within over the coming weeks. Based on advice from SAGE, we still expect to be looking after several thousand Covid19-positive patients, though hopefully with continuing weekly decreases. This means:

- Ongoing and consistent application of PHE/NHS Infection Prevention and Control guidance in all NHS organisations, with appropriate cohorting of Covid/non-Covid patients (https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control).

- In response to the global shortage, DHSC and the Cabinet Office together with BEIS (for UK manufacture) and DIT (for international suppliers) continue to expand the sourcing and procurement of HSE/PHE-recommended PPE for the NHS, social care and other affected sectors of the UK economy, but it is likely that current Covid-specific logistics and distribution arrangements will need to continue for the time being.

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https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control

https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control

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- Increased lab capacity now enables testing of all non-elective inpatients at point of admission, the introduction of pre-admission testing of all elective patients, testing prior to discharge to a care home, as well as expanded testing for staff. The corollary is the operational importance of fast turnaround times for test result reporting.

The pressure on many of our staff will remain unprecedented, and they will need enhanced and active support from their NHS employers to ensure their wellbeing and safety.

- Increased testing capacity means that we will now be able to extend the offer

of regular testing to asymptomatic staff, guided by PHE and clinical advice. This approach is being piloted in a number of acute, community and mental health providers this week, which will inform further roll out from next week.

- As set out in our letter of 17th March, NHS organisations should continue to assess staff who may be at increased risk - including older colleagues, pregnant women, returnees, and those with underlying health conditions - and make adjustments including working remotely or in a lower risk area. Educational material, training and appropriate protection should be inclusive and accessible for our whole workforce, including our non-clinical colleagues such as cleaners and porters.

- Emerging UK and international data suggest that people from Black, Asian and Minority Ethnic (BAME) backgrounds are also being disproportionately affected by Covid19. Public Health England have been asked by DHSC to investigate this. In advance of their report and guidance, on a precautionary basis we recommend employers should risk-assess staff at potentially greater risk and make appropriate arrangements accordingly.

- Now more than ever a safety and learning culture is vital. All our staff should feel able to raise concerns safely. Local Freedom to Speak Up Guardians are able to provide guidance and support with this for any concerned member of staff. As we know, diverse and inclusive teams make better decisions, including in the Covid19 response.

- Employers are also asked to complete the process of employment offers, induction and any necessary top-up training within the next fortnight for all prospective ‘returners’ who have been notified to them.

We are going to see increased demand for Covid19 aftercare and support in community health services, primary care, and mental health. Community health services will need to support the increase in patients who have recovered from Covid and who having been discharged from hospital need ongoing health support. High priority actions for mental health providers in this next phase are set out in the Annex. General practice will need to continue to stratify and proactively contact their high-risk patients with ongoing care needs, including those in the ‘shielding’ cohort to ensure they are accessing needed care and are receiving their medications.

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Given the scale of the challenges they face, we must also continue to partner with local authorities and Local Resilience Forums (LRFs) in providing mutual aid with our colleagues in social care, including care homes. This includes:

- Continuing to ensure that all patients safely and appropriately being

discharged from hospital to a care home are first tested for Covid19; care homes can also check that these tests have been carried out.

- Under the direction of the LRF, local authority public health departments and CCG infection control nurses can help ‘train the trainers’ in care homes about PHE’s recommended approach to infection prevention and control - particularly focusing on those care homes that lack the infrastructure of the bigger regional and national chains.

- To further support care homes, the NHS will bring forward from October to May 2020 the national roll out of key elements of the primary and community health service-led Enhanced Health in Care Homes service. Further detail will be set out shortly.

- Opportunities to support care homes should also be provided to younger health professional ‘returnees’ and public volunteers who have offered to help (subject to appropriate personal risk assessment, as described above).

As also seen in a number of other countries, emergency activity has sharply reduced in recent weeks. Last week emergency hospital admissions were at 63% of their level in the same week last year. This is likely due to a combination of: a) changed healthcare seeking behaviour by patients, b) reductions in the incidence of some health problems such as major trauma and road traffic accidents, c) clinical judgements about the balance of risk between care in different settings, and d) some NHS care being provided through alternative access routes (eg ambulance ‘see and treat’, online appointments). There is therefore considerable uncertainty as to the timing and extent of the likely rebound in emergency demand. To the extent it happens, non-elective patients will potentially reoccupy tens of thousands of hospital beds which have not had to be used for that purpose over the past month or so. This means we need to retain our demonstrated ability to quickly repurpose and ‘surge’ capacity locally and regionally, should it be needed again. It will also be prudent, at least for the time being, to consider retaining extra capacity that has been brought on line - including access to independent hospitals and Nightingale hospitals. The national Nightingale team will work with Regions and host trusts to develop and assure regional proposals for the potential ongoing availability and function of the Nightingale Hospitals. Independent hospitals and diagnostics should be used for the remainder of the current contract which runs to the end of June. Please also start now to build a plan for each STP/ICS for the service type and activity volumes that you think could be needed beyond the end of June, which can inform discussions during May about possible contract extensions with the independent sector.

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Over the next six weeks and beyond we have the opportunity to begin to release and redeploy some of the treatment capacity that could have been needed while the number of Covid19 patients was rising so sharply. This means we are now asking all NHS local systems and organisations working with regional colleagues fully to step up non-Covid19 urgent services as soon as possible over the next six weeks, including those set out in the Annex. This needs to be a safe restart with full attention to infection prevention and control as the guiding principle. In addition, you should now work across local systems and with your regional teams over the next 10 days to make judgements on whether you have further capacity for at least some routine non-urgent elective care. Provisional plans will need to factor-in the availability of associated medicines, PPE, blood, consumables, equipment and other needed supplies. We will continue to provide new ventilators to trusts over the coming weeks so as to sustain critical care ‘surge’ capacity should it again be needed in future, while progressively returning operating theatres and recovery suites to their normal use. We should also take this opportunity to ‘lock in’ beneficial changes that we’ve collectively brought about in recent weeks. This includes backing local initiative and flexibility; enhanced local system working; strong clinical leadership; flexible and remote working where appropriate; and rapid scaling of new technology-enabled service delivery options such as digital consultations. In terms of wider action that will also be underway, DHSC will be designing and establishing its new ‘Test, Track & Trace’ service. The leadership and resourcing of local authority public health departments will be vital. Trusts and primary care networks should continue to support clinicians to enrol patients in the three major phase III clinical trials now underway across the NHS, initially testing ten potential Covid19 treatments. In addition, at least 112 Covid19 vaccines are currently in development globally. We also expect an expanded winter flu vaccination campaign alongside a school immunisation ‘catch up programme’. Looking forward, at the right time and following decision by Government, we will then need to move into the NHS’s phase three ‘recovery’ period for the balance of the 2020/21 financial year, and we will write further at that point. In the meantime, please accept our personal thanks and support for the extraordinary way in which you and your staff have risen to this unprecedented global health challenge. With best wishes,

Simon Stevens Amanda Pritchard NHS Chief Executive NHS Chief Operating Officer

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ANNEX

ACTIONS RECOMMENDED FOR URGENT CLINICAL SERVICES OVER THE NEXT SIX WEEKS Urgent and routine surgery and care

• Strengthen 111 capacity and sustain appropriate ambulance services ‘hear and treat’ and ‘see and treat’ models. Increase the availability of booked appointments and open up new secondary care dispositions (SDEC, hot specialty clinic, frailty services) that allow patients to bypass the emergency department altogether where clinically appropriate.

• Provide local support to the new national NHS communications campaign encouraging people who should be seeking emergency or urgent care to contact their GP, go online to NHS 111 or call 999 if necessary.

• Provide urgent outpatient and diagnostic appointments (including direct access diagnostics available to GPs) at pre-Covid19 levels.

• Ensure that urgent and time-critical surgery and non-surgical procedures can be provided at pre-Covid19 levels of capacity. The Royal College of Surgeons has produced helpful advice on surgical prioritisation available at: (https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0221-specialty-guide-surgical-prioritisation-v1.pdf)

• In the absence of face-to-face visits, primary and secondary care clinicians should stratify and proactively contact their high risk patients to educate on specific symptoms/circumstances needing urgent hospital care, and ensure appropriate ongoing care plans are delivered.

• Solid organ transplant services should continue to operate in conjunction with the clinical guidance developed and published by NHS Blood and Transplant.

• Where additional capacity is available, restart routine electives, prioritising long waiters first. Make full use of all contracted independent sector hospital and diagnostic capacity.

• All NHS acute and community hospitals should ensure all admitted patients are assessed daily for discharge, against each of the Reasons to Reside; and that every patient who does not need to be in a hospital bed is included in a complete and timely Hospital Discharge List, to enable the community Discharge Service to achieve safe and appropriate same day discharge.

Cancer

• Providers have previously been asked to maintain access to essential cancer surgery and other treatment throughout the Covid19 pandemic, in line with guidance from the Academy of Medical Royal Colleges and the NHS (https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/04/C0239-Specialty-guide-Essential-Cancer-surgery-and-coronavirus-v1-70420.pdf and https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/04/C0239-Specialty-guide-Essential-Cancer-surgery-and-coronavirus-v1-70420.pdf ). An exception has been where clinicians consider that for an individual patient the risk of the procedure at the current time outweighs the benefit to the patient.

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https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0221-specialty-guide-surgical-prioritisation-v1.pdf)



https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/04/C0239-Specialty-guide-Essential-Cancer-surgery-and-coronavirus-v1-70420.pdf






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• Local systems and Cancer Alliances must continue to identify ring-fenced diagnostic and surgical capacity for cancer, and providers must protect and deliver cancer surgery and cancer treatment by ensuring that cancer surgery hubs are fully operational. Full use should be made of the available contracted independent sector hospital and diagnostic capacity locally and regionally. Regional cancer SROs must now provide assurance that these arrangements are in place everywhere.

• Referrals, diagnostics (including direct access diagnostics available to GPs) and treatment must be brought back to pre-pandemic levels at the earliest opportunity to minimise potential harm, and to reduce the scale of the post-pandemic surge in demand. Urgent action should be taken by hospitals to receive new two-week wait referrals and provide two-week wait outpatient and diagnostic appointments at pre-Covid19 levels in Covid19 protected hubs/environments.

• High priority BMT and CAR-T procedures should be able to continue, where critical care capacity is available.

Cardiovascular Disease, Heart Attacks and Stroke

• Hospitals to prioritise capacity for acute cardiac surgery, cardiology services for PCI and PPCI and interventional neuroradiology for mechanical thrombectomy.

• Secondary care to prioritise capacity for urgent arrhythmia services plus management of patients with severe heart failure and severe valve disease.

• Primary care clinicians to continue to identify and refer patients acutely to cardiac and stroke services which continue to operate throughout the Covid19 response.

• Hospitals to prioritise capacity for stroke services for admission to hyperacute and acute stroke units, for stroke thrombolysis and for mechanical thrombectomy.

Maternity

• Providers to make direct and regular contact with all women receiving antenatal and postnatal care, explaining how to access maternity services for scheduled and unscheduled care, emphasising the importance of sharing any concerns so that the maternity team can advise and reassure women of the best and safest place to receive care.

• Ensure obstetric units have appropriate staffing levels including anaesthetic cover.

Primary Care

• Ensure patients have clear information on how to access primary care services and are confident about making appointments (virtual or if appropriate, face-to-face) for current concerns.

• Complete work on implementing digital and video consultations, so that all patients and practices can benefit.

• Given the reduction of face-to-face visits, stratify and proactively contact their high-risk patients with ongoing care needs, to ensure appropriate ongoing care and support plans are delivered through multidisciplinary teams. In

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particular, proactively contact all those in the ‘shielding’ cohort of patients who are clinically extremely vulnerable to Covid19, ensure they know how to access care, are receiving their medications, and provide safe home visiting wherever clinically necessary.

• To further support care homes, the NHS will bring forward a package of support to care homes drawing on key components of the Enhanced Care in Care Homes service and delivered as a collaboration between community and general practice teams. This should include a weekly virtual ‘care home round’ of residents needing clinical support.

• Make two-week wait cancer, urgent and routine referrals to secondary care as normal, using ‘advice and guidance’ options where appropriate.

• Deliver as much routine and preventative work as can be provided safely including vaccinations immunisations, and screening.

Community Services

• Sustain the Hospital Discharge Service, working across secondary care and community providers in partnership with social care. Includes daily reviews of all patients in a hospital bed on the Hospital Discharge List; prompt and safe discharges when clinically and in line with infection control requirements with the planning of ongoing care needs arranged in people’s own homes; and making full use of available hospice care.

• Prepare to support the increase in patients who have recovered from Covid and who having been discharged from hospital need ongoing community health support.

• Essential community health services must continue to be provided, with other services phased back in wherever local capacity is available. Prioritise home visits where there is a child safeguarding concern.

Mental Health and Learning Disability/ Autism services

• Establish all-age open access crisis services and helplines and promote them locally working with partners such as local authorities, voluntary and community sector and 111 services.

• For existing patients known to mental health services, continue to ensure they are contacted proactively and supported. This will continue to be particularly important for those who have been recently discharged from inpatient services and those who are shielding.

• Ensure that children and young people continue to have access to mental health services, liaising with your local partners to ensure referral routes are understood, particularly where children and young people are not at school.

• Prepare for a possible longer-term increase in demand as a consequence of the pandemic, including by actively recruiting in line with the NHS Long Term Plan.

• Annual health checks for people with a learning disability should continue to be completed.

• Ensure enhanced psychological support is available for all NHS staff who need it.

• Ensure that you continue to take account of inequalities in access to mental health services, and in particular the needs of BAME communities.

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• Care (Education) and Treatment Reviews should continue, using online/digital approaches.

Screening and Immunisations

• Ensure as a first priority that screening services continue to be available for the recognised highest risk groups, as identified in individual screening programmes.

• Increase the delivery of diagnostic pathways (including endoscopy) to catch up with the backlog of those already in an active screening pathway, followed by the rescheduling of any deferred appointments.

• Antenatal and Newborn Screening Services must be maintained because this is a time critical service.

• Providers and commissioners must maintain good vaccine uptake and coverage of immunisations. It is also likely that the Autumn/Winter flu immunisation programme will be substantially expanded this year, subject to DHSC decision shortly.

Reduce the risk of cross-infection and support the safe switch-on of services by scaling up the use of technology-enabled care

• In response to Covid19, general practice has moved from carrying out c.90% of consultations with patients as face-to-face appointments to managing more than 85% of consultations remotely. 95% of practices now having video consultation capability live and the remaining few percent in the process of implementation or procurement of a solution. GP Practices should continue to triage patient contacts and to use online consultation so that patients can be directed to the most appropriate member of the practice team straight away, demand can be prioritised based on clinical need and greater convenience for patients can be maintained.

• Referral streaming of new outpatient referrals is important to ensure they are being managed in the most appropriate setting, and this should be coupled with Advice and Guidance provision, so that patients can avoid an outpatient referral if their primary care service can access specialist advice (usually via phone, video too).

• All NHS secondary care providers now have access to video consultation technology to deliver some clinical care without the need for in-person contact. As far as practicable, video or telephone appointments should be offered by default for all outpatient activity without a procedure, and unless there are clinical or patient choice reasons to change to replace with in-person contact. Trusts should use remote appointments - including video consultations - as a default to triage their elective backlog. They should implement a ‘patient initiated follow up’ approach for suitable appointments - providing patients the means of self-accessing services if required.

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BARNSLEY HOSPITAL NHS FOUNDATION TRUST

TERMS OF REFERENCE

ETHICS REFERENCE GROUP – COVID-19

1. PURPOSE

We are approaching a clinical environment in the UK where there is a realistic possibility for medical services to be overwhelmed. Applying generic guidance that has been issued by National organisations to provide an ethical policy framework to clinicians and to ensure compliance with professional and ethical standards during this period

2. AIMS

The ethics reference group will assist / advise with decision making related to the COVID-19 pandemic and the impact on Barnsley Hospital. The purpose is not taking over the responsibility of the COVID-19 planning group, but is to provide a forum for discussion around any difficult ethical questions. The group will: • Provide a multi-disciplinary forum including a range of clinicians

and non-clinicians, but will not primarily offer technical clinical advice.

• Advisory and not executive • Provide ethics input into Trust policy and guidelines around patient

care • Comment on and clarify existing national policies and guidelines • Framework for those making difficult decisions about the care of

patients. • Decision making and support oversight • Reduce/streamline bureaucracy and paperwork involved in

decision making process • Collate, assess and disseminate national guidance • Provide general advice to clinicians There is the potential for the group to open links with partner hospitals and potentially (e.g. neighboring Trusts and the ICS). This could be to strengthen the Trust’s position to justify our legal stance by acting in accordance with a consensus of clinical staff in identical circumstances across our geographical area

COVID-19 Ethics Group – April 2020 1 Pack Page No. 81

3. AUTHORITY

• The group has delegated authority from the Executive in respect of the functions and powers set out in these Terms of Reference.

• The group has authority to advise on any matter within its Terms of Reference and to obtain such information as it may require from any partner, officer or employee.

4. FUNCTIONS AND RESPONSIBILITIES

• This may include, but is not limited to, decisions: - Pharmacy Provision – in particular the process for delivering

medications - Potential derogation of non-essential processes - Staffing and staff support - Bed Capacity – including Critical Care and inpatient bed base - Decision making around treatment options - Treatment options for vulnerable users - Decision making around visitors to patients affected by COVID-

19 - Discharge arrangements - Compliance with any relevant statutes or clinical guidance

• Communicate to operational teams the outcome of the group’s conclusions relating to the specific care of patients who have contracted the virus.

• Support and protect individual clinical decision makers. • Involved in and advise on the allocation of resources / treatment

based on clinical need. • Advise staff who are communicating with patients and their

relatives about the specifics of their care. 5. MEMBERSHIP - Please see Appendix 1

6. TERM OF OFFICE

Unless otherwise determined by the Executive, the duration of appointments of the group and of co-opted members shall be for the period of the Covid-19 pandemic which may be extended by the Executive for an additional period if required


7. MEETINGS OF THE GROUP

The Group will meet weekly for the duration of the pandemic, meetings will be 1 hour and 30 mins in duration. Should any issues require decisions before the group can meet the Chair(s) will have authority to act under chairs actions. A number of members of the group are part of daily silver and gold command meetings; any daily requirements from an ethics perspective may/can be discussed in these meetings. A review of the operation, Terms of Reference (ToR) and meeting frequency of the Group will take place three months from the date of the first meeting.

8. QUORUM

• Quorum shall be: - Chair or Deputy Chair - X1 ICU Consultant - X3 other members

• A duly convened meeting of the group at which a quorum is present shall be competent to exercise all or any of the authorities, powers and discretions vested in or excisable by the Executive.

• In the event of difficulty in forming a quorum, the group may co-opt members for individual meetings.

9. ATTENDEES

• Members of the group and any clinicians seeking advice have the right to attend group meetings

• The group shall reach decisions by a simple majority of those voting on the issue in question. If the numbers of votes for and against a certain proposal are equal, the group Chair shall have a casting vote

10. REPORTING ARRANGEMENTS

The Medical Director and Director of Nursing will report on a weekly basis the activities of the group through to the Executive Team via the Chair’s log and minutes of the meeting. There will also be a regular update (verbal) to Quality & Governance (Q&G) Committee as required.


APPROVAL Chief Executive:……………………………………………………….. Medical Director:……………………………………………………… Director of Nursing and Quality:…………………………………….. 24/04/20 Date:............................................................................................. Approved: 15 April 2020 (BHNFT Executive Team) Review: Every three months This review: N/A Next review: July 2020


APPENDIX 1 • Chair(s):

- Mrs Jackie Murphy – Director of Nursing and Quality - Dr Simon Enright – Medical Director

• Representatives:

- Mr Steve Ned – Director of Workforce - Mr Kevin Clifford – Associate Non-Executive Director - Dr James Griffiths – Clinical Director – CBU1 / ED Consultant - Dr Timothy Wenham – Critical Care Consultant / AMD COVID - Dr Sughrat Siddiqui – Critical Care Consultant / Director of Medical

Education - Dr Joanne Butterworth – Critical Care Consultant / Clinical Director CBU3 - Dr Claire Farrington – Palliative Care Consultant - Mrs Nathalie Jooty – Trust Solicitor - Dr Yee Pang – Consultant Microbiologist - Mrs Helen Green – Associate Director of Nursing – CBU2 - Mrs Elizabeth Dunwell – Matron – CBU2 - Mr Colin Brotherston-Barnett – Equality and Diversity Lead - Mrs Sara Andrews – Macmillan Clinical Nurse Specialist - Mr Peter Merchant – Solicitor – DAC Beachcroft - Dr Mark Longshaw – Consultant Respiratory Physician - BREATH - Co-opted Members could be pulled from but not limited to: Academic representation GP representative and CCG/ commissioning representative Patient Experience Governance

• Support: - Mr Andrew Wiles – Business Manager – Medical Directorate - Trust Headquarters PA Team – Administration Support


a meeting of the board of directors will take place … · 2020-05-01 · corporate governance :...

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