Report to: Board of Directors (Public)

Paper number: 4.1

Report for: Information

Report type: Strategy and operational performance

Date: 30 July 2015

Report author: Ms Wendy Wallace, Chief Executive

Report of: Ms Wendy Wallace, Chief Executive

FoI status: Report can be made public

Title: Chief Executive’s Report

Executive Summary The Chief Executive has a duty to keep the Board informed on all matters relating to the health of the organisation and provide a status and progress report on the use of the Trust seal, key strategic developments and significant events since the last board meeting. This report includes updates supplied by members of the Foundation Trust Executive and the Trust Secretary.

Trust Strategic Priorities Supported by this Paper

Excellence

Continually improve the quality and safety of service delivery, service user experience and improving outcomes.

Delivering the highest level of quality and financial performance.

Innovation

Rapidly adopt best practice and maintain a culture of innovation in service development.

Growth

Pursue organic and inorganic growth opportunities through strategic partnerships and research and development.

Recommendation to the Board The Board of Directors is requested to:

receive and accept the contents of this report; and

ratify the use of the Trust seal.

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Risk Implications The paper covers developments in areas already identified within the risk register. Legal and Compliance Implications

The report includes a summary of national developments which will affect the Trust’s compliance requirements.

Finance Implications

There are no specific financial implications identified by this report.

Single Equalities Impact Assessment

As this report summarised the external environment and internal issues it does not of itself require a SEIA, although elements within the report may and would be conducted as part of their separate governance processes.

Requirement of External Assessor/Regulator

Monitor is responsible for ensuring that foundation trusts are well governed. Best practice guidance concerning board governance includes an expectation that the board is kept fully appraised about the external environment, the strategic implications for the trust and internal matters. This report contributes to this requirement.

CHIEF EXECUTIVE’S REPORT

1. STRATEGIC ENVIRONMENT

NATIONAL

1.1 There have been a whole host of announcements through June and July as the new government has settled in and the desire to ensure announcements are made before the summer recess.

NHS Financial Pressures

Many of the recent announcements have been focused ion reversing the rapid decline in NHS finances. The DH announced national measures to control agency spending and reduce the volume of very high cost staff. We have been required to submit reports on very senior managers pay and senior contractors. As a Trust we have and continue to be taking action to reduce agency spend.

NHS England recently announced changes to a small number of waiting time targets which have created perverse incentives. These changes should help both financially and clinically.

NHS England have also requested all CCGs to work together on a locality estates plan with a view to significantly reducing the NHS ‘spare’ estate and increasing the land available for housing.

1.2 Monitor and Trust Development Authority (TDA) merger

In June the Department of Health announced that Monitor and the TDA will share a joint Chief Executive. This was followed in early July by a further announcement that these two organisations will merge and also take on the functions of patient safety and improvement work. The patient safety arm aims to be the equivalent to the air investigation authority. The new body will be called NHS Improvement. The Secretary of State has also announced that the work concerning safe staffing levels will be taken over by this ‘body’. NHS Improvement will still have to undertake the statutory functions of both Monitor and the TDA as there has been no change in primary legislation. Monitor currently has strong financial skills but does not have the type of skills implied by this change. The new Chair will be Ed Smith who is currently Vice Chair of NHS England.

1.3 Risk Assessment Framework consultation, alignment of national bodies and Success Regime announced

Monitor is already consulting on a revised Risk Assessment Framework; the Director of Finance has commented on this in the finance report and at Resources Committee. If implemented it is likely to significantly increase the number of trusts which are subject to regulatory intervention. The rules and approaches to regulatory intervention are different for Monitor and the TDA. The DH has announced that they wish to align the intervention approaches between the major national bodies. The Monitor TDA merger will clearly enhance this process. The CQC have also incorporated financial aspects into their regime.

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In June the DH announced three geographic areas to be part of the new ‘success regime’. These are Essex, Devon and north Cumbria. The regime will start with a ‘diagnosis’, which it is believed may take many months. The success regime will work with all the commissioners and providers within the area with a view to ensuring that the area is in financial balance.

1.4 Five Year Forward View: Time to Deliver

The arm’s length bodies (NHS England, Monitor, TDA, CQC, Public Health England and Health Education England) have published Five Year Forward View: Time to Deliver in June. The focus is on a financially sustainable basis this year, redesign of Urgent and Emergency Networks (and announcement of a vanguard programme), focus on prevention and new ways of working both locally and nationally. A Simon Stevens speech shortly after publication emphasised that there will not be any additional funding beyond the additional £2bn already announced for this year and that all areas need to ensure that the level of activity and capacity is contained within the resources available.

1.5 Right here, Right now

In June the CQC published a report ‘Right here, Right now’ about service users experience of crisis care in England. The report found People who are having a mental health crisis are not always receiving care and support when and where they need it.

They raised concerns that public services, such as local authorities, NHS trusts and clinical commissioning groups, are failing to work together to make sure that people in their local areas have access to crisis care around the clock. Also, it found that healthcare professionals, such as those in A&E, can appear to lack compassion and warmth in how to care for and speak to people who are having a crisis, including those who have harmed themselves.

As part of its review, CQC sought views from people who have experienced different types of mental health crisis care. It found that while 86% of those who had received care and support from charities and volunteers felt that their concerns had been taken seriously by them, only 37% said that they felt this from A&E staff, 44% Crisis team and 48% CMHT staff. This is worrying as these professionals should be trained in how to care for and respond to them. In particular, people often reported poor attitudes from staff towards their injuries caused by self-harm. Overall, only 14% of people thought the care they received provided the right response and helped them to resolve their crisis.

As well as staff training, CQC has identified that there is a clear need for better 24-hour support for people having a crisis, particularly during the hours of 11pm and 5am, as CQC found that during these hours availability and accessibility is poor. This means that people often have to go to A&E departments or even to police cells while a ‘place of safety’ is found for them, rather than receive specialist care straight away.

1.6 Mental Health Task Force

The mental health taskforce was due to publish an interim report by July. This has been delayed, partly as they had over 20,000 submissions. They have almost completed an analysis of the themes. They have also commissioned two other pieces of work around where money is spent across government on mental health. The annual spend is £34bn (excluding dementia and PLD). They have conducted three ‘deep dives’, these are into secure services, diabetes and employment. For secure they have found

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fragmentation of the pathways leading to longer lengths of stay. They are looking to improve the pathway and reduce overall costs. From the diabetes work they are looking across physical health conditions for the ‘best buys’, where inclusion of a mental health element will improve quality and cuts costs, it was estimated that £200m could be saved from diabetes.

The taskforce was set up to drive improvements, they are currently aligning around:

hope, dignity and respect – how to get kindness and compassion as standard;

prevention and empowerment – how people look after themselves and reduction in stigma;

access and effective interventions – looking a quicker access, making sure better linkages/ step down care, access for hard to reach groups; and

integrated care and support.

1.7 Secretary of State’s speech – ’25 Year Vision for the NHS’

In the middle of July, Jeremy Hunt set out his 25 year vision for the NHS. Whilst the press focused on weekend working and the challenge to the BMA, the speech was much wider. In this he proposed that there should be ‘intelligent transparency’ in return for reduced targets. He described trying to create a system which was self-policing and harnesses the desire of most clinicians to improve. He focused on data publication to drive individual, team and organisational improvement and patient choice. In his announcement he identified five trusts to be part of ‘buddying’ with international organisations to support improvement. The five trusts are ‘buddied’ with Virginia Mason, an American Care organisation.

LOCAL ENVIRONMENT

1.8 Islington whole system Employment Pilot

The Deputy Chief Executive of Islington Council has been seconded to NHS England for a day per week working on employment. As a consequence of this Islington will be piloting a whole system approach to reducing the numbers of people with long term conditions who are unemployed. The pilot will involve the Trust, DWP, local employers, employment support providers, social care, primary care, voluntary organisations and local businesses. It will be a whole system focus with mental health very much at the heart, as 50% of those claiming long term sickness benefit do so due to mental ill health. The Carnell Farrar work has analysed the Trust’s figures for people with a psychosis in employment, rather than the narrow figure of people on a CPA in employment. They have found that 39% of service users in our psychosis services are employed, which is a very encouraging figure.

1.9 Carnell Farrar

The Carnell Farrar work in north central London is continuing. Carnell Farrar are collecting a significant amount of data on both costs and some performance measures. These are mainly focused on psychosis. At present the data needs more work as it is not clear that the comparisons are comparing like with like. At the last meeting it was agreed to have a technical meeting involving all the key players to ensure that the data quality and conclusions are comparable.

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1.10 Camden OSC Mental Health Panel

Camden OSC have produced draft terms of reference for a mental health panel. This has arisen following the Trust’s CQC inspection last year. The terms of reference will be agreed in September. The panel of four councillors will be supported by a reference group who will lead the work and provide the evidence. The scope of the panel is very broad. I have written to the chair of scrutiny offering our full support in this work.

2. SERVICE DEVELOPMENTS & OPERATIONS

2.1 New Accessible Information Standard

A new standard has been published by NHS England. The Accessible Information Standard will be implemented on 31 July 2016 and aims to provide people who have a disability, impairment or sensory loss with information that they can easily read or understand. This means trusts need to ensure people get information in different formats, for example in large print, braille or via a British Sign Language (BSL) interpreter.

All organisations that provide NHS or adult social care are required to follow the new standard, including NHS trusts and foundation trusts, and GP practices. As part of the accessible information standard, provider organisations must do five things:

ask people if they have any information or communication needs, and find out how to meet their needs;

record those needs clearly and in a set way;

highlight or ‘flag’ the person’s file or notes so it is clear that they have information or communication needs and how those needs should be met;

share information about people’s information and communication needs with other providers of NHS and adult social care, when they have consent or permission to do so; and

take steps to ensure that people receive information which they can access and understand, and receive communication support if they need it.

This new standard will be considered at the next meeting of the Equality and Diversity Committee who will take the lead in developing the Trust’s implementation plan to meet the July 2016 implementation date.

2.2 Electronic Patient Record update

The Trust’s transition to Care Notes (the replacement for RiO) has reached a critical stage, with the changeover still being planned for early September. Significant amounts of data have been transferred from RiO to Care Notes, with the most important migration being successfully completed in early July. This has meant that the system is available for people to train on. The training programme began in the second week of July, and the entire programme will take about eleven weeks to complete. We need to train around 1,800 staff over this period, and at two weeks into the training programme, nearly 1,100 people had booked training slots. Champion users have also been trained, so that they are able to support colleagues to use the system. The level of commitment to the training process from Trust staff has been very encouraging, with people realising that if they make themselves familiar with the new system before “Go-Live”, they will be able to get maximum benefit from it when it becomes available in September. As well as having all of the key features of RiO, service users and staff will benefit from a waiting list module, and a much improved capacity for mobile working.

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2.3 Trust launches 24-hour crisis line

C&I has launched a new 24 hour round the clock “crisis call line” to help patients and stakeholders access the right help in a crisis more effectively. In addition there is an amalgamated line for the Camden and Islington Crisis Resolution and Home Treatment Teams and a separate line to deal directly and exclusively with calls from the Police.

Prior to the new telephone line going live there has not been a single telephone number which patients or stakeholders could ring. Previously it was dependent on which Borough you lived and sometimes specifically whether you lived in the north or south of Camden or Islington. Also for routine referrals from either GPs or service users and carers, staff have had to use a pager system, which created a delay in response times. The Trust, with the help of its commissioners, is now providing single access numbers for the crisis teams, for all urgent help, and a direct line for the police.

In all there will be three new numbers. These numbers are for different stakeholders as explained below:

Single Access Number for all urgent calls

020 3317 6777 – The C&I Crisis Line - This number will replace the old Trust out of hours 0800 988 2149. Anyone can call this number 24 hours a day if they require urgent help for a mental health condition. People can also self-refer to the Crisis Resolution and Home Treatment Teams via this number. This new number will appear on literature and on the Trust’s website.

Direct referrals to the three Camden and Islington Crisis Resolution and Home Treatment Teams.

020 3317 6333 - This is the new amalgamated number for the three Crisis and Resolution teams. It will eliminate the need for a pager system. This number is more specifically to be used by GPs, or for service users already known to the Trust and who are suffering a crisis. All calls will be answered by a clinician.

Police Only Hotline

This number is for the Police only. It provides direct access to the crisis teams on a 24/7 basis. It will only be publicised to the police.

Any routine or non-urgent matters which come through to any of the three numbers will be diverted to the Trust switchboard (020 3317 3500) which also provides a 24-hour response.

2.4 Primary Care Services in Kingston

We have agreed a service enhancement with commissioners in Kingston to provide a primary care mental health service as part of the Kingston Wellbeing Service from Autumn of this year.

2.5 Camden Substance Misuse Service tender

The Tender process for SMS services in Camden is underway and the Trust has submitted a PQQ and is working with partners to develop an offer as part of this.

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3. REGULATION & LEGISLATION

3.1 Care Quality Commission (CQC)

The Trust’s service at Stacey Street had an unannounced CQC inspection a couple of weeks ago. This was part of the adult social care comprehensive inspection of an adult social care setting. The Trust is awaiting the draft inspection report which when finalised will be the first formal rating of the Trust which will be published on the Trust website and clearly displayed at the Stacey Street location.

4. EXTERNAL PROFILE

4.1 C&I shortlisted for the Top 100 places to work in the HSJ

This is the second year the Trust has made it into the top 100.

The list is compiled based on the staff survey and a full breakdown will be issued later in the year.

4.2 C&I shortlisted in The Nursing Times Awards

The Trust has been shortlisted for Improving Staff Experience for its Change and Inspire Health and Wellbeing Programme in this year’s prestigious Nursing Times Awards.

The nomination recognises the work we are doing to help staff lead healthier lifestyles through structured initiatives which are designed to encourage better diet and healthier eating, increased physical activity, and better mental health.

NHS staff are often seen as role models for health. A poll commissioned in 2014 by the Royal Society of Public Health found patients are less likely to make a lifestyle change if the professionals providing advice do not lead healthy lifestyles themselves (for example, are overweight). The programme focuses on putting wellbeing at the heart of the business and on improving staff engagement and satisfaction, team work, productivity and reducing sickness absence, which all impact on patient care.

4.3 Expert talks: Club drugs and legal highs

June’s Medicine for Members event, delivered by the Grip Clinic, was very well attended by the public and other partners, such as the police and ambulance services. The Grip Clinic is our club drugs service and the event described the treatment and support C&I provides.

4.4 Isledon Road hosted event as part of Creativity and Wellbeing week

As part of Creativity and Wellbeing week (London Arts in Health Forum) Isledon Road Mental Health Resource Centre hosted an event on Friday 12 June.

The Centre showcased the recovery work of members through art, creative writing, mindfulness and other activities.

http://www.candi.nhs.uk/news/ci-shortlisted-nursing-times-awards

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4.5 The Network for Psychiatric Nursing Research

The Network for Psychiatric Nursing Research is an influential international conference showcasing the best in mental health nursing and interdisciplinary research in the UK and abroad. Eleven delegates from C&I attended last year which was the largest representation from any organisation. Several Trust led studies were presented by some of our new cohort of Clinical Research Network (CRN) research nurses. NPNR will take pace this year in Manchester in September with even stronger representation from the Trust. Twelve delegates are attending, all of whom are presenting research studies. The group is headed by Fiona Nolan, Deputy Director of Nursing and Research, who will be speaking during the conference about the Trust programme of research capacity building in nursing. A full report of the event will be disseminated at the end of September. The programme can be found here .

4.6 C&I nurse wins ‘dignity in care award’

Staff nurse, Vilma Toledo, has won the Great British Care Awards for Dignity in Care 2015. Vilma has been working at Camden and Islington NHS Foundation Trust’s Stacey Street for 12 years.

“I won the regional award first for the borough of Islington, followed by the national. I was a little bit nervous in front of the judges but it was a great experience,” she said.

“The awards judges asked me how I understand dignity. For me, dignity is about being worthy, treating people as unique individuals and providing them with the right kind of care to meet their needs.”

Stacey Street provides support for anyone over 55 who requires accommodation, screening and treatment for mental and physical health conditions which can be debilitating in nature.

4.7 Media Profile

4.7.1 A new Stephen Fry documentary was part filmed at C&I’s Assertive Outreach Team Greenland Road

Film makers Matchlight are producing a documentary for BBC1 with the working title 'Stephen Fry: 10 years on - the not so secret life of a manic depressive'. The documentary will show Stephen Fry reflecting on his mental condition a decade after

making his first film on the subject.

As part of the documentary the crew filmed a Key Changes live musical mix-tape session with C&I service users from the Assertive Outreach Team at Greenland Road.

The BBC filmed the piece to illustrate some of the great ways the NHS and mental health charities are working together.

http://www.rcn.org.uk/__data/assets/pdf_file/0008/632384/FOR-WEBSITE-Programme-at-a-glance-NPNR15-09_07_15.pdf

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4.7.2 Out of area placements for patients

The online journal Community Care sent Freedom of Information requests to all 56 English mental health trusts and wrote a story following this.

C&I had the second biggest increase in patients treated out of area from 2013-14 to 2014-15:

Avon and Wiltshire: 162 to 446; and

Camden and Islington: 154 to 338.

This was also published on the BBC News website and we were not approached for comment. The main reason we have seen a rise in out of area placements is our major ward refurbishment programme. The programme began in the autumn of 2014 and has meant that our number of beds available has been reduced meaning that alternative beds have been used. This has affected around 130 patients. We have also seen a significant rise in new patients, partly down to increased pressure as a result of the recession and also the growing number of people using legal highs.

This has meant we have had to use alternative beds in London as a result. Even beds in neighbouring boroughs are counted in these out of area figures – for part of this time we used beds at East London Foundation Trust, for example, to minimise using beds further afield. Once our refurbishment programme has been completed in Spring 2016 we fully expect our out of area placements to decrease significantly.

4.7.3 Netherwood celebrates 25 years of helping people in the community

The Camden New Journal highlighted the excellent work done at Netherwood, our dementia day service based in Kilburn, which celebrated 25 years of helping people in the community.

Dementia expert, Dr Nori Graham, showed her support for the service as she spoke about wonderful staff and its unique service and the Mayor of Camden also applauded the work done at the centre.

4.7.4 Health Service Journal coverage of Inquest

The HSJ has published a piece following an inquest into the death of a service user in November 2014.

The service user died before an assessment could take place for referral to the Rivers Crisis House. The coroner criticised the delay in this referral being organised.

C&I had known the service user for many years and had a good relationship with him, successfully reducing his drug dependency, often in the community and with the help of our crisis houses.

A Grade 1 investigation into the incident took place and the Trust has revised its communication processes and regular sharing of information between crisis houses to minimise any risk of a delay taking place again.

http://www.communitycare.co.uk/2015/07/15/mental-health-patients-sent-hundreds-miles-beds-area-placements-rise-23-per-cent/

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4.7.5 Terry: A carers story – Feature highlighting Carers Week

The Camden New Journal published a piece on Terry, a 72-year-old man, who learned to look after his wife following her diagnosis of dementia with the help of iCope’s START programme.

He described the talking therapy sessions which last 8 weeks and highlighted how some of techniques he learnt helped him cope better.

It was published during carers' week to highlight local services which are available for carers in the area who may need support.

5. INTERNAL EVENTS

5.1 C&I star awards for June and July

Congratulations to Chryssa Chalkia who was named as June’s C&I Star of the Month. Chryssa is an Assistant Practitioner at the Recovery Centre, Isledon Road, Islington who has been working at the centre for nearly three years.

Her nomination was from a service user called James who explained how Chryssa had provided outstanding care to his partner. In his nomination James said:

“Chryssa picked up that my partner has not been engaging with her activities at the centre for a few weeks … Chryssa supported her to re-engage with her existing activities … She felt respected and understood from Chryssa … Thank you

Chryssa. My partner now is enjoying her activities and her mood has been improved due to your professionalism and kind nature.”

Isledon Road provides care and support for people who are on their way to recovery and provides group activities such as art, music, creative writing, literacy complementary therapies and exercise classes.

Gillian Paterson, Service Manager for the North Camden Drugs Service, was named July’s C&I Star of the Month.

She was nominated by a member of her team. Her nomination read: “Gillian is a fantastic manager. Since the moment I started working at Response (over two years ago now) she has been very supportive and kind. Gillian really is a rare kind.

“She is very empathetic and helpful. Of her many striking personal attributes the one that has helped us most is being a team player. I have always felt that ‘we are a team’. No matter what changes come our way (and there always is e.g. new policies, protocols, staff changes or just new ways of doing things), Gillian always makes sure that we are supported.

http://cift-ap05/wordpress/wp-content/uploads/2015/06/isledon-road-wendy-and-chryssa.jpghttp://cift-ap05/wordpress/wp-content/uploads/2015/07/Wendy-giving-Gillian-certificate.jpg

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“Furthermore, she has a positive ‘can do’ attitude which is very inspiring. She has confidence in her staff and makes me feel like I can accomplish anything. I really would like her to be recognised for her personal qualities as well as for her management style.”

I presented Chryssa and Gillian with a £25 M&S voucher, a special C&I star pin badge and a certificate.

5.2 We shared our thanks to everyone who helped out for National Volunteers Week

It was national volunteers' week between 1 – 5 June. Joanne Scott, our Voluntary Services Manager hosted a Volunteer thank you event at the Recovery College on Wednesday 3rd June. This gave our volunteers a chance to share their experience and provide us with feedback so that we’re able to use that to improve their experience.

5.3 Employment Support Day

C&I held an Employment Support Day on the 9 July at St Pancras Hospital which was aimed at helping service users get back into work. Despite the tube strike on this day the event was well attended.

On the day there was free advice and information on training, in work support, volunteering and employment options.

There were also success stories told by people who have got into work and guest speakers from Access to Work Mental Health Support Scheme, The Recovery College and other support agencies.

Thanks go in particular to Sarah Bradfield, Occupational Therapist, for organising this.

5.4 Service User and Carer Engagement event to inform the development of the Clinical Strategy

On the 3rd July a specific service user and carer engagement event was held at St Pancras Hospital Conference Centre. Invites for this event were sent to service user and carer groups from both inside and outside of the Trust as well as to individual service users. There were 34 attendees at this event who contributed a range of positive views and ideas in relation to improving services and care in the Trust.

6. COUNCIL OF GOVERNORS

6.1 Council meetings

The next Council of Governors meeting is on 8 September 2015. In the last couple of months, the governors have had meetings of their working groups and the Council Nominations and Remuneration Committee has been taking forward the recruitment process for another Non-Executive Director. The final interviews for this position where held on 23 July and a recommendation will be made to the Council meeting on 8 September 2015.

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6.2 Governor elections

The Board is reminded that nominations for this year’s Council of Governors are now open. Anyone wishing to stand for elections (including Governors who are up for re-election) must submit their nomination to Electoral Reform Services by no later than Wednesday 12 August, 2015 for this to be valid. There will be an information session on becoming a Governor which will be held on Monday 3 August from 5:30-6:30pm in the Conference Hall at St Pancras Hospital. This will include presentations from myself, the Chair, and David Barry (Lead Governor).

Other important dates to note are as follows:

Notice of Election / nomination open Wednesday, 15 Jul 2015

Information Session on Becoming a Governor

Monday, 3 Aug 2015

Nominations deadline Wednesday, 12 Aug 2015

Summary of valid nominated candidates published

Thursday, 13 Aug 2015

Final date for candidate withdrawal Monday, 17 Aug 2015

Notice of Poll published Thursday, 3 Sep 2015

Close of election Tuesday, 29 Sep 2015

Declaration of results Wednesday, 30 Sep 2015

7. STAFF APPOINTMENTS AND CHANGES

7.1 Consultant appointments

Two new Consultants were appointed in June. They are Dr Matteo Pizzo (Barnet Primary Care MH team) and Dr Neil Sarkar (Islington Primary Care MH Team).

I am also pleased to report that Dr Koye Odutoye has been appointed as Deputy Medical Director.

8. SERVICE VISITS

8.1 Since my last report at the end of May 2015, I have visited the following services:

Cornwallis;

Drayton Park; and

154 Camden Road.

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9. FTE and SENIOR LEADERSHIP MEETINGS (20 May to 22 July 2015)

9.1 The following table gives a brief summary of the areas covered in the weekly Foundation Trust Executive meetings and monthly senior leadership meetings since the last Board meeting.

Item: Purpose:

Estates item relating to a community site

Agreed the approach to developing proposals for this site

Medical records storage Considered and agreed short term resources to address immediate issues and agreed a process to develop strategic proposals and the role of advances in technology

Cofely contract Agreed to recommend an extension to the Cofely contract

Procurement strategy Considered a draft strategy and potential efficiencies

Ligature risk assessments Approved guidance relating to community based residential services

New Monitor Guidance Considered impact of new guidance on expenditure contracts

Rehab and Residential management re-structure proposals

Approved proposals

Recruitment and Retention Considered an update report

NHS Benchmarking Data Reviewed the detail of a benchmarking submission to ensure accuracy of data

Membership Implementation Plan Reviewed plan for 2015/16 and agreed resources to support the implementation plan

Strategic Developments Considered a number of reports relating to local and national strategic developments and C&I’s vision for the future.

Financial performance Reviewed monthly performance reports

Clinical strategy Held discussions with the senior leadership team which contributed to the development of the refreshed strategy.

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10. USE OF TRUST SEAL

10.1 The seal has been used twice since my last report to the Board.

84 26 June 2015 Telecommunication Lease – South Wing, St Pancras Hospital

85 8 July 2015 (1) Leopard Guernsey Archway Limited

(2) Camden and Islington NHS Foundation Trust – deed of surrender of lease of 5th floor, Hill House, Highgate Hill N19 5NA