Agenda item

-        Chair and Acting Chief Executive to report

The Chairman welcomed Michael Morgan (Interim Chief Executive), Peter Lee (Trust Board Chairman), Juliette Greenwood (chief Nurse), George Thompson (Medical Director) and Dr. Tricia Bain (Executive Health Informatics Officer) to the meeting.

Michael gave the following presentation:-

-          The Trust had been able to comply with all Monitor’s requests for information

-          Strategic plan to be submitted to Monitor by the end of September that completely underpinned the recovery for the organisation over the next 3 years.  The first year of the plan was in the process of being put into place

-          The next 2 years would see a complete revamp of the organisational structure, especially on the clinical side.  As a result 135 individuals from the Trust had met with the Executive to look at restructuring the organisation

-          Proposed move from 11 to 4 Directorates – Planned Care and Surgery, Emergency Care and Medicine, Women and Children and Diagnostics and Support – would allow for agile working

-          Would provide a real oversight of the management of the organisation from the standpoint of accountability

-          Community and acute services are not yet fully integrated  – hopefully the new structure and Directorates would see a full integration

Discussion ensued with the following issues raised/clarified:-

·           The Directorates would be clinically lead across a range of disciplines

·           The Senior Nurses and Midwifery Committee met monthly to discuss issues.  The Committee would be pulling together a strategy on how the Trust was going to change areas in the acute part of the hospital/work differently  

·           Community Nursing was a very important aspect.  The Trust included health care and the patient care path in the acute hospital and in the community setting

·           The proposed structure would be considered by the Board at the end of June.  There would then be 30 days consultation

·           The provisional leadership roles in the new structure were quite different e.g. matrons would not just manage Wards but would be looking at the pathway of care and if there were the right colleagues working with the right leadership and right representation.  It recognised the uniqueness of professionals that worked in the Community and ensured they were heard.   A staff engagement strategy was being developed.

·           Staff morale was low, ranked within the bottom 20% of acute trusts, could this have any potential impact on services?  In a recovery situation communication with staff had to be improved, having an inclusive and participative leadership style contributes towards this.

·           Important to reiterate that the Trust had to take almost 25% out of the operating budget, and that there were some fixed costs so radical change was required in how front line teams work

·           The Government was clear that tele-health had a key part to play in the future.  The Trust echoed this and said it would play a part in reducing  barriers between hospital and community.

·           There was a working group working across the region looking at collaboration with other hospitals.  Already Weston Park Hospital provided specialist cancer services and the Hallamshire Hospital provided neurosurgery.  Due to the constant strive to do better, there would be a requirement in the future that there was far more co-operative work

·           Another area for possible collaborative working in the future was the use of locum medical staff - a theme up and down the country.  There were discussions across the region with regard to having a pool of medical staff in the region who were willing to work as locums that could be called upon at short notice and at far less cost

·           All options had to be considered within the strategic planning process to ensure each service provided at the Hospital was sustainable.  However, the Hospital would never close given the population and the volume of patients that the Hospital took care of

·           If other providers were going to specialise there was an opportunity for Rotherham to specialise and when looking at the whole issue and process from a regional basis, there was probably much more opportunity for things to be done at Rotherham on a localised basis than what may go out to other areas.  It may be that Rotherham became more of a “well baby” delivery hospital and the more problematic deliveries went elsewhere

·           1 strength the Trust had was its integrated care organisation.  It may well be that other Trusts in the area followed/used the model

·           If specialists were shared across a bigger area there would be a larger number of patients and would be able to run an on call rota

·           At present there was no list of services that the Hospital would not be offering any more

·           Consideration had been given to bringing in other private sector organisations to help with service delivery but, following analysis of price and inconvenience, it was decided to retain inhouse.  It may be the Trust would provide services to others and bring in revenue

·           The Trust had picked up from what was being put into place at the end of 2012 and looked at the corporate spend side of the organisation and that had now been completed.  Consultation had taken place and those employees that had been made redundant had left the organisation.  There was also tactical control which was considering spending on specific items.

·           Over the next 3 years the public would see £50M taken out of the organisation with no new services/revenue coming into the organisation.  There would be less people working at the Hospital as 70% of the costs were staff; the other 30% was, supplies and the expenses of the organisation.  However, the public would see staff working smarter, working together and doing things differently.  35 people had left the organisation and the process was now to work through how those jobs were going to be taken care of.  The Trust had been increasing the number of patient care givers within the organisation at the same time as making the changes.  The Board had agreed that the nursing vacancies needed to be filled and the process of recruitment had been in place several months. 

The Chairman thanked everyone for their attendance and contributions.