minutes of a meeting of the western health & social care ... · pdf filewestern health and...

Western Health and Social Care Trust Board – 2 February 2017

Minutes of a meeting of the Western Health & Social Care Trust Board held on Thursday, 2 February 2017, at 10.00 am in the Doctors’ Library, Postgraduate Medical Centre, Tyrone County Hospital, Omagh PRESENT Mr N Birthistle, Chairman

Mrs E Way, Chief Executive Mr J Campbell, Non-Executive Director Mrs S Cummings, Non-Executive Director Dr G McIlroy, Non-Executive Director Mrs S O’Kane, Non-Executive Director Dr C O’Mullan, Non-Executive Director Mrs M Woods, Non-Executive Director Mr K Downey, Executive Director of Social Work/Director of Women and Children’s Services Mrs G McKay, Director of Acute Services Mr A Corry Finn, Executive Director of Nursing/Director of Primary Care and Older People Dr D Hughes, Medical Director Mrs A McConnell, Director of Human Resources Mrs L Mitchell, Director of Finance and Contracting Mrs T Molloy, Director of Performance and Service Improvement Mr A Moore, Director of Strategic Capital Development

IN ATTENDANCE Mrs M McGinley, Executive Assistant to Chief Executive Mr O Kelly, Head of Communications Mrs R Harkin, Assistant Director Learning Disability Mrs Monaghan, Carer (agenda item 2/17/7-1 only)

Mrs Cathy Magowan, Carers’ Support Coordinator (agenda item 2/17/7-1 only)

2/17/1 CHAIRMAN’S BUSINESS The Chairman welcomed everyone to the February Trust Board meeting in Omagh. He referred to a report of his business from the last meeting.

The Chairman began by advising of the Chief Executive’s decision to retire from the Western Health and Social Care Trust at the end of July 2017. He said it was with considerable regret that he had accepted her intention to retire and said that she had made an enormous contribution in the Western area over the past almost 40 years of service, 22 years as a Chief Executive. He commented that Mrs Way would leave a positive legacy.


The Chairman said the Chief Executive has a strong team around her and asked that they support Mrs Way over the next 6 months.

The Chairman was pleased to attend the Trust’s second annual Nursing and Midwifery Awards on 18 January 2017. He said he was delighted to welcome the Health Minister Michelle O’Neill, Chief Nursing Officer, Professor Charlotte McArdle and the Chief Executive of the Florence Nightingale Foundation Professor Elizabeth Robb to the event, but most of he said he was delighted to welcome nurses and midwives to celebrate all that is excellent and praiseworthy about the Trust’s nursing and midwifery workforce.

Later that afternoon the Chairman was able to welcome the Minister to the Clinical Decision Unit and ED at Altnagelvin Hospital and Butterfly Lodge within Spruce Villa.

Finally the Chairman informed members that the Trust had been shortlisted in the 2017 Advancing Healthcare Awards. The Trust has been shortlisted for the Welsh Government Prudently Advancing Practice award – an award which is sponsored by the Welsh Government and which recognises that advanced practice roles are increasingly seen as key to the development and delivery of healthcare services.

Members were advised that the judging panel would be meeting on Tuesday, 14 February 2017 and the results would be shared at a celebratory event on 31 March.

2/17/2 CHIEF EXECUTIVE’S REPORT Mrs Way referred to her quarterly governance report and drew members’ attention to a number of issues including:-

Members were advised that additional staff had been appointed to both the Trust’s Emergency Departments with an additional 12 nursing staff and 1 emergency medicine consultant appointed in SWAH and an additional 7 nursing staff at Altnagelvin Hospital.

It was noted that the Radiotherapy Service commenced at the end of November 2016 within the North West Cancer Centre. A number of patients are being treated for prostate cancer and patients’ feedback to date has been very good, with an analysis of initial treatments showing a high degree of accuracy between planning and treatment. The number of patients and tumour sites will be increased over the coming months.

Members were advised that a new dementia navigator service had commenced within older people’s mental health with the appointment of 2 navigators. The service will provide an individualised information and signposting service to


people with a diagnosis of dementia. The navigator will map out and connect the individual with dementia and their carer with statutory services and also GPs, voluntary, community and independent providers.

Mrs Way referred to the Early Intervention Transformation Programme (EITP) which is an integrated health and education review for children in their pre-school year. It was noted that the EITP represents the coming together of 6 government departments, alongside private philanthropy, as part of the Delivering Social Change initiative. The focus of EITP is on achieving transformative change in how mainstream services are delivered to children and families and is in keeping with the OFMDFM “Making Life Better” Strategy.

Members were advised that all Department of Education funded pre-school education settings in the Western Trust have been assigned a Health Visitor who will work in partnership with education colleagues to support and promote healthy child development and learning.

Mrs Way referred to research that has shown that Looked After Children will not do as well as their peers in education. In an effort to improve this, the Trust has been involved in a number of initiatives including the ‘My Laces Project’ which runs in partnership with Ulster University where social work students provide mentoring and homework clubs for Looked After Children at Keystage 2.

Mrs Way added that this year the Trust’s Looked After Children achieved remarkable examination results from GCSE to degree level. In addition, the Trust has consistently had the highest regional level of post-18 young people involved in education, training and employment. She referred to the introduction of ‘ring fenced’ posts for Looked After/After Care Young People in an effort to improve their employability outcomes. Mrs Way said she was delighted to advise that 2 young people had now secured permanent posts and are doing well within their working environment.

Members were advised that Sow & Grow celebrated 25 years of providing horticultural day opportunities for adults with a learning disability in the Londonderry area.

A comprehensive review of the Trust’s Major Incident Plan was completed with a recommendation that the Trust requires an overarching Emergency Plan detailing activation and escalation procedures with divisions to reflect incident specific information required during a hospital, community or combined response. Mrs Way noted that the revised plan was consulted upon and it will be brought to Trust Board in due course for approval.

Mrs Way referred to a number of initiatives for staff developed by the Trust’s Health Improvement Department. These included the launch of Resilience Tool Kit and supporting Infographic in December 2016 – a resource to enable staff to build and maintain their personal resilience and Choose to Lose challenge which


is a 12 week weight loss and health lifestyle programme aimed at encouraging staff to adopt a healthier lifestyle through health nutrition and regular exercise.

A regional training event hosted by an expert in Information Governance took place on 29 November 2016 which focused on the SIRO role and roles of the Information Asset Owners. The Trust has 2 Mandatory Information Governance (IG) E-learning modules and is currently working with all other Trusts in Northern Ireland to move to a single IG module to drive compliance and uptake of training in this area. Mrs Way advised that Non-Executive Directors should also undertake this training and asked Mrs McGinley to make the necessary arrangements.

Members noted that a 12 week targeted engagement process on the proposed car parking arrangements for the forthcoming Omagh Hospital and Primary Care Complex has now been completed. This process involved engaging with over 280 groups and individuals on the proposed configuration of the 863 car parking spaces on the new site. The engagement closed on 9 January 2017 and the team is currently collating the responses which will then be considered by Trust Board at its March 2017 meeting.

The ICT Department continues to support a number of major projects which are currently being implemented throughout the Trust – these include the North West Cancer Centre, Omagh Hospital and Primary Care Complex, Community Information System and the Northern Ireland Electronic Care Record.

2/17/3 APOLOGIES Apologies were received from Mrs J Doherty, Non-Executive Director and Mr T Millar, Director of Adult Mental Health and Disability Services. It was also noted that Mr Dixon, Patient and Client Council, was also unable to be present. 2/17/4 DECLARATION OF INTERESTS There were no declarations of interest. 2/17/5 MINUTES OF PREVIOUS MEETING The minutes having been previously distributed were approved as a true and accurate record of discussion.


2/17/6 MATTERS ARISING There were no matters arising. 2/17/7 QUALITY AND SAFETY Patient Story – Primary Care and Older People

The Chairman welcomed Mrs Monaghan, Carer, and Mrs Cathy Magowan, Carers’ Support Co-ordinator to the meeting. Mrs Magowan and Mrs Monaghan shared Mrs Monaghan’s experience of being a carer for both her mother and husband. She shared her story detailing their illnesses and the challenge of meeting both their individual needs. Mrs Monaghan advised that through Carers’ Support she had been allocated a Development Worker who was able to signpost her to social services. Through this contact Mrs Monaghan said that she was able to avail of services that she had not realised she could access and she was signposted to services which resulted in her getting aids which facilitated the care of her mother at home. She said that she was also able to access Direct Payments which helped care for her mother. Mrs Monaghan also advised that her Development Worker had also made a referral to the Alzheimer’s Society and to Me Unlimited (Unltd). She said through Me Unlimited she had participated in the Inspire Me programme 2016/17. When asked about challenges she had faced, Mrs Monaghan advised that she believed there had been communication issues between some services. She said that quite often she found that a particular service focussed only on the client and did not look at the bigger picture in relation to the carer. Mrs Way referred to the dementia navigators which have been recently appointed and said that these postholders would refer carers to services also. Mrs Magowan welcomed this service and said that they would also refer to Carers’ Support which she greatly welcomed. Mr Downey said that it is important for services to “Think Family” when dealing with individual needs. He said the practice in Family and Child Care services is to do this when dealing with children who have parents with mental health issues. He said this needed to be cascaded into other services and that he would take this back to adult services through his Excellence in Community Care forum. The Chairman thanked Mrs Monaghan for sharing her story today.


Quality Improvement Monitoring - Falls Dr Hughes referred members to the quarterly report in respect of falls. He began by commending the Assistant Director of Nursing for her passion for evidenced-based nursing practice which was important in ensuring patient safety. Dr Hughes said that while falls continued to be the top incident reported, significant work was on-going to raise awareness of falls prevention across all care settings of the Trust. He said that this included participation in the National Falls Prevention Day with targeted engagement with the public and partnership working with the voluntary agencies. Dr Hughes said he was also pleased to report that recurring funding for the post of a Falls Co-ordinator had been secured and would be advertised in March. Members were advised that falls prevention work with the Public Health Agency (PHA) was on-going with 2 wards piloting a revised incident reporting and learning template during January and February 2017. He added that a falls improvement plan had been developed with a spread and implementation plan in place. Dr Hughes advised that the Trust was required to make a 10% reduction in the number of patients in the Acute inpatient setting who experience moderate to severe harm as defined by the PHA. He advised that the Trust’s performance rate per 1,000 bed days was 0.07 as at September 2016. The regional harm rate recorded ranged between 0.12 and 0.20. Dr Hughes added that the overall Trust compliance with the Fallsafe Bundle for October 2016 was 94% for Part A and 92% for Part B. He advised that compliance for each adult inpatient ward was demonstrated in the information within members’ papers. Infection Prevention and Control Update Dr Hughes referred members to an update in respect of infection prevention and control. Dr Hughes reminded members that the Trust’s reduction target for Clostridium difficile associated disease in 2016/17 was 48; a reduction of 16 cases or 25% compared to last year. He stated that it was likely that this challenging reduction target would not be achieved as to date 46 cases had been reported. Members were advised that 28 of the cases were classified as healthcare-acquired or associated, as they had occurred more than 48 hours after admission to hospital (definition used by the Public Health Agency (PHA)). However, this is not always an accurate predictor of being healthcare-associated. The remainder were classified as community-acquired as the patients presented with symptoms within a 48 hour period after admission. Members were reminded that the MRSA bacteraemia target for 2016/17 was 7 - a reduction of 2 cases or 22.22% on the previous year’s performance. Dr Hughes stated that there had been 3 cases reported so far this year, all of which had been categorised as community-associated.


Dr Hughes advised members that the Rehabilitation Unit, Tyrone County Hospital (TCH), had been closed to admissions from 20 January 2017 due to a confirmed Norovirus outbreak, currently affecting 11 patients and 9 staff. He assured members that increased infection prevention and control (IP&C) measures had been put in place. He added that Ward 7, Altnagelvin Hospital, had also experienced an increase in the number of patients with vomiting and/or diarrhoea and that no causative organism had been identified yet. Members were advised that the ward remained open but some bays had been closed. Continuing, Dr Hughes advised members that there had been a need to change the current Infection Prevention and Control policy due to increased bed pressures resulting in other patient risk issues. He stated that in certain circumstances bays were being utilised for admissions where patients had been symptom free for 72 hours rather than only allowing admissions to the ward when the ward was 72 hours symptom free. Dr Hughes said this was not without risk and such decisions were taken based on an individual ward situation and only in circumstances where there are other competing patient risks. Discussion continued on the Quality Improvement Plan and Mrs Way assured members that the Plan is discussed in detail at each Chief Executive HCAI Accountability meeting. Mrs O’Kane confirmed these discussions as the NED who attends these meeting. Environmental Cleanliness Update Mr Corry Finn referred members to the audit report for December 2016 and said that this showed significant progress. He commended the collaborative work of the cleaning, estates and nursing staff for the outturn. Referring to bi-monthly reports Mr Corry Finn advised that there was overall compliance of 92% with 8% not carrying out the audit as per the standard of 2 audits per month. In relation to quarterly audits members were advised that the end of quarter compliance was 90% with 10% of audits still to be completed during the quarter. Members were advised that in respect of the 6 monthly audits compliance had been 53%. Mr Corry Finn assured members that this outturn was due to the increased pressures on wards however said for the next report he hoped to see a significantly improved position. Corporate Risk Register and Board Assurance Framework Dr Hughes referred members to the Corporate Risk Register and Board Assurance Framework and said that there were currently 27 corporate risks as agreed by Governance Committee at its meeting on 14 December 2016. Dr Hughes shared with members for approval a proposal to combine 2 risks ID284 and ID285 in respect of information governance. It was noted that the risk rating for


the combined risk would remain high. Dr Hughes shared the controls/assurances and gaps against the risk and an action plan which had been identified for the new combined risk. Following consideration members approved combining the 2 risks. While Mr Campbell supported the combination of the 2 risks, he emphasised that both parts of the risk were very important as they had been highlighted in a recent audit report. 2/17/8 FINANCIAL PERFORMANCE REPORT FOR MONTH ENDED 31 DECEMBER 2016 Mrs Mitchell referred members to the report on the financial performance of the Trust for the month ended 31 December 2016 contained in the papers. Mrs Mitchell advised that the Trust continued to report a projected year end deficit of £11.168m. Mrs Mitchell stated that the Trust had advised the HSCB/DoH through the draft Trust Delivery Plan of the projected year-end deficit for 2016/17. She advised that discussions are continuing with HSCB/DoH in relation to how the Trust will achieve breakeven in 2016/17. Mrs Mitchell highlighted that the Chairman had written to the Permanent Secretary on 16 January 2017 advising that in the absence of formal Trust Delivery Plan approval, the Trust will work towards containing the deficit within £11.168m. Mrs Mitchell reported that the Trust is reporting a deficit of £8.495m as at 31 December 2016. Mrs Mitchell advised that the DoH had requested a further contingency plan amounting to £2.5m which had been submitted on 18 November 2016 and that they had advised that the retention of the elective care monies was not approved. Mrs Mitchell advised that the Trust awaits communication in relation to the other proposals contained within the contingency plan. Mrs Mitchell referred members to Table 2 and advised that the Acute and PCOP Directorates had increased their overspends from the previous month mainly due to the ongoing financial pressures relating to Domiciliary Care and hospital flow. She further reported that the Women and Children’s Directorate had reduced its overspend compared to the previous month with Adult Mental Health and Disability in a breakeven position. Mrs Mitchell highlighted the reduction in the corporate unfunded budgets. Mrs Mitchell highlighted the continuing increasing spend on medical locums and specifically the graph on page 8. Mrs Mitchell directed members to Section 6 on Financial Targets Monitoring.


Mrs Mitchell referred to table 6 documenting capital expenditure planned for 2016/17. Mrs Way stated that the Month 9 financial performance report was indicating that the Trust was on target to contain expenditure within the reported projected year end deficit. Dr McIlroy said that it was imperative that patient safety came first and he recognised the efforts being made by Directorates to contain expenditure against increasing pressures such as Looked After Children. Mrs Way advised the board that there would be an increased level of expenditure in January 2017 given that business continuity arrangements were in place for the 2 acute hospitals since 14 December 2016. She said that the pressures had continued into January and said that pressure was also being experienced in the Primary Care and Older People’s Directorate who had to put on the ground more packages of care. She said that the cost of these would continue into 2017/18. Dr McIlroy referred to expenditure between November and December and said given the added pressures in December it was commendable that expenditure had decreased. He also commended staff in both finance and performance for supporting front line staff in achieving this outturn. Mrs Way supported Dr McIlroy’s comments and said that staff on the ground were making difficult decisions daily. Dr O’Mullan queried as to whether the Trust was confident of a reply to the Chairman’s letter dated 16 January 2017. Mrs Mitchell advised that she understood that the Trust would receive a formal reply in coming weeks however advised that there had been discussions since the letter had been sent. Mrs Way advised that she believed that since the SRaFa process the Department of Health understood the exceptional circumstances relating to the Western Trust. 2/17/9 PERFORMANCE MANAGEMENT INFORMATION Mrs Molloy referred members to the Trust’s performance management information for the period ending December 2016. Commencing with the performance of cancer services, Mrs Molloy said that the Trust’s performance against the 14 day breast target continued to be 100%, and 100% in respect of the 31 day cancer target - continued exceptional performance. The Chairman referred to the regional position with regard to these targets and said the he was pleased to see an improving position in other Trusts. Mrs Molloy referred to the work done collaboratively across a number of Trusts to deal with the underperformance against this target earlier in the year. Mrs Molloy referred to the 62 day target and said that the Trust’s performance for end of November had been 81%. It was noted that there were 10 breaches which were primarily urology patients. Members noted that the Western Trust was the best


performing Trust in Northern Ireland against this target in this year so far, and that other Trusts were now coming close to this level of performance. Against the standard that 95% of patients, where clinically appropriate, will wait no longer than 48 hours for inpatient treatment for hip fractures, members noted the Trust’s performance of 93% during December 2016. Mrs Molloy said that 100% of all fractures were treated within 7 days. Members were advised that during the month there had been increased demand and decreased bed capacity and the Trust was still able to deliver an excellent performance, and that the service should be commended for achieving this performance, particularly given the challenge of ward closures due to Norovirus. Mrs McKay advised that as the Trust receives fractures patients from the Northern part of the Northern Trust, staff at Causeway hospital had worked positively with the Trust to take their patients back as soon after surgery as possible to free up beds in Altnagelvin, and enable patients to be treated quickly. Mrs Molloy referred to performance against the Unscheduled Care standards and said that against the standard that 95% of patients attending any type 1, 2 or 3 Emergency Department are either treated and discharged home or admitted within 4 hours of their arrival in the department, the Trust’s overall performance at end of December had been 67%. Members were advised that performance had been 60% in Altnagelvin and 66% in the South West Acute Hospital against this 4 hour standard. Members noted that there had been 102 breaches of the 12 hour standard during December. Against the standard that at least 80% of patients should have commenced treatment following triage within 2 hours, the Trust’s performance had again been 89%. The deterioration in overall performance was typical for this period, but had been compounded by the difficulties with ward closures in Altnagelvin due to Norovirus, and the Trust had been operating business continuity measures since the middle of December 2016 due to the challenges in maintaining patient flow, and that staff were working very hard across all services to deal with these. Mrs Molloy continued to share hospital pressures comparators in unscheduled care for the period December 2015 – December 2016 which had been discussed with the Finance and Performance Committee. She said that ED attendances in Altnagelvin Hospital had reduced by 1% however the number of 75 years olds attending ED had increased by 16% and while the number of admissions from ED had decreased by 7%, the number of over 75 year olds admitted had increased by 10%, with an increased length of stay of 0.47 bed days. She reminded the Board that there had been a significant increase in the previous year, and that new level of attendances had been factored into the Trusts winter plan. The hospital was however seeing and treating increasingly complex and elderly patients during winter, and the outbreak of Norovirus had prevented discharges in some cases, which also affected length of stay. In relation to the South West Acute Hospital, members were advised that ED attendances had increased by 5% with a 24% increase in the number of over 75 years old attending. It was noted that admissions had also increased by 6% with the number of over 75 year olds being admitted increasing by 29%. It was noted that


the length of stay had decreased by 0.18 bed days, helping the hospital to deal with this increased pressure. Mrs Molloy said that the information was evidence that the acuity and frailty of patients attending both hospitals had increased as compared to last year. She referred to the significant investments made during the year in community services, in particular in Acute Care at Home and the Rapid Response community nursing Team who have been increasing services provided to patients in their home or community. Mrs Woods referred to the significant increase in the South West Acute Hospital and Mrs Molloy advised that there is a higher older people’s population in that geography. She also advised that the community infrastructure was being progressively enhanced, but that services such as Acute Care at Home had not yet been rolled out in the southern sector of the Trust, there were also acknowledged difficulties with availability of GP services in Fermanagh particularly. Moving on Mrs Molloy referred to elective access in respect of outpatients. Members noted that the Trust’s performance at end of December had reduced to 33% with the longest waiting patients being for gastroenterology, orthopaedics and general surgery. Mrs Molloy advised that the Trust had received additional funding from the Health and Social Care Board for In House waiting list initiative work for quarters 3 and 4 and said the waiting list initiative plan would not have any significant impact on performance in December, as the Trust had paused this work pending clarification on the 2016/17 savings plan from DoH. Mrs Molloy advised that the GP validation exercise had commenced and it was expected that any impact on patients waiting over 52 weeks would be seen in February 2017. It was noted that the regional average position was 31% in December. Mrs Molloy advised members that there had been 1,727 appointments cancelled year to date, a reduced position on the previous month. Mrs Molloy said the Trust had come close to meeting the target in December, showing the impact of increased controls put in place around consultant leave and authorisation of cancellation. She reminded members that not all cancelled appointments had a direct impact on patients and that on average 55% of all cancelled appointments has a direct impact on the patient to September 16. Following discussion Mrs Molloy advised that she would continue to give a full briefing to the Finance and Performance Committee along with a summary to Trust Board on this area at the end of the year. Mrs Molloy referred to elective access in respect of inpatient/day case. She said that against the standard that at least 55% of inpatients and day cases should be treated within 13 weeks and no patient waits longer than 52 weeks for treatment the Trust’s performance at December was 42%. She said that during December there had been cancellations due to the impact of Norovirus and unscheduled pressures. She added that routine elective patients requiring an inpatient stay, and a number of routine day cases had been cancelled from 14 December as part of the Trust’s business continuity measures, and further booking of routine patients was currently paused. She however assured members that patients who were on cancer


pathways and assessed as clinically urgent by the consultant were being given priority, and that this was reviewed daily. Mrs Molloy referred to acute core activity against the Service and Budget Agreement. She said in respect of elective inpatients/day cases the Trust’s performance was -8.5%; new outpatients -10.6 %; and review outpatients -1.3%. Mrs Molloy advised that improvement plans had been submitted to the Health and Social Care Board however there continued to be significant challenges in some areas. In respect of the regional position Mrs Molloy advised that in respect of elective inpatients/day cases the position was -5.8% and in respect of new outpatients the position was -8.6%. Moving to diagnostics Mrs Molloy advised that the Trust’s performance was 76% of patients waited less than the 9 week standard. She said that in relation to the standard that all urgent diagnostic tests are reported on within 2 days of the test being undertaken the Trust’s performance was 93%. Mrs Molloy advised members that there was a growing issue within cardiac assessment and that waiting list initiative support was being sought. She advised that the Trust’s performance against a standard that 75% of patients should wait no longer than 9 weeks for an endoscopy, the Trust had 221 breaches, an increase from November. She said that this position was being supported by considerable waiting list initiative funding from the Health and Social Care Board and that to continue to maintain the current performance the Trust required recurring funding. Continuing with children’s services targets, Mrs Molloy advised that at end of December, 268 children were waiting longer than the 9 week standard for their first Community Paediatrics appointment and 2 children were waiting longer than 52 weeks. Consultant shortages continue to be the primary cause of these breaches. In respect of CAMHS, 87 children were waiting longer than 9 weeks to access the Child and Adolescent Mental Health Service, all but 9 of these are referrals for ADHD assessment. Mr Downey said that a new pathways was being agreed for all ADHD referrals, and on that basis he hoped to be at a zero breach position by year end. Mrs Molloy shared outturn against standards in respect of stroke, dementia, direct payments and carers' assessment and members were asked to note the significantly improved position in respect of direct payments and carers’ assessments. Members noted the gradual improvements in breaches within Allied Health Professional services had deteriorated in December, primarily due to staff leave over the Christmas period. Improvements are expected to continue in the last quarter of the year. Moving to mental health and learning disability services members noted that in respect of standard that no patient waits longer than 9 weeks to access adult mental health services, 57 people waited longer than the 9 week standard. Continuing with psychological therapies, members noted that in respect of the 13 week standard,


there had been 319 breaches. The capacity within the service was the primary reason for this position, and it was noted that this position was consistent with the region. Mrs Molloy advised that support from HSCB had been sought to undertake additional work in the last quarter to improve the position. Mrs Molloy referred to discharges within mental health and learning disability and advised that there were 3 breaches in mental health and 1 breach in learning disability. It was noted that the breaches in mental health were concerned with the availability of EMI beds, which was an ongoing challenge for the Trust. Performance on hospital discharges in acute hospitals continued to be mixed, and Mrs Molloy advised that in relation to complex discharges there had been 42 breaches in respect of the target that no complex discharge takes longer than 7 days. It was noted that the outbreak of norovirus had impacted on the ability to discharge from Altnagelvin Hospital and the prevalence of Norovoirus in the community had prevented some homes from receiving discharges. In respect of the standard regarding non-complex discharges the Trust’s performance had been 96%. 2/17/10 NOTES FROM THE FINANCE AND PERFORMANCE COMMITTEE FROM 10 JANUARY 2017 Mrs Cummings referred members to the notes of a meeting of the above Committee held on 10 January 2017. She referred to the most recent meeting where information in respect of the stroke pathway was shared with members and she suggested that this be shared with her colleague Non-Executive Directors. Mrs McGinley agreed to take this forward. 2/17/11 REVISED TERMS OF REFERENCE FOR FINANCE & PERFORMANCE COMMITTEE Mrs Cummings referred to revised terms of reference for approval. She advised that were 2 proposed changes – one in respect of increasing the membership of the Committee by a further Non-Executive Director and secondly frequency of meetings stating that the Committee would meet on a monthly basis prior to a scheduled Trust Board meeting. Members approved the proposed amendments. The Chairman referred to an additional NED being nominated to sit on the Committee and said he would consider this and advise in due course.


2/17/12 MINUTES OF ENDOWMENT AND GIFTS COMMITTEE DATED 10 JANUARY 2017 Dr McIlroy referred members to the notes of an Endowment and Gifts Committee held on 10 January for information. He said he was pleased to report that there was a reduction in some of the Fund balances. However, Dr McIlroy encouraged Directors to look at Funds and consider areas for expenditure. 2/17/13 OMAGH TRAVEL PLAN AND TRANSLINK BUS SCHEDULE It was noted this item had been taken forward by the Corporate Management Team. 2/17/14 INFECTION PREVENTION & CONTROL STANDARD PRECAUTIONS POLICY Following consideration members unanimously approved the above policy. 2/17/15 INFECTION PREVENTION & CONTROL ANNUAL REPORT 2015-16 Following consideration members noted the above annual report. 2/17/16 TENDER AWARDS There were no tender awards for consideration. 2/17/17 TRUST FUNDS Support of a Nursing Practise Educator post for 2 years in the Radiotherapy Unit/Cancer Services Mrs McKay shared with members a proposal to support a 2 year nursing practice educator post for the North West Cancer Centre. She said the cost of the post was £50,000 per annum and outlined the enormous benefit to the nursing staff within the NWCC. Following consideration members unanimously support the proposal.


2/17/18 ISSUES FROM THE PATIENT AND CLIENT COUNCIL As Mr Dixon was not present there were no issues raised by the Patient and Client Council. 2/17/19 CONFIDENTIAL ITEMS 2/17/20 ANY OTHER BUSINESS There were no further items of business. 2/17/21 DATE OF NEXT MEETING The next meeting of the Western Health and Social Care Trust Board will take place on Thursday, 2 March 2017 at 10.00 am in the Denis Desmond Room, Trust Headquarters, MDEC Building, Altnagelvin Hospital, Londonderry.

______________________________

Mr N Birthistle Acting Chairman

2 March 2017

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