In Public Board Minutes - September 2024

PUB24/09/1 WELCOME

The meeting commenced at 09:30

1.1 Mrunal Sisodia, Trust Chair (TC) welcomed those present to the Public Board meeting of the East of England Ambulance Service Trust (EEAST). He introduced Neill Moloney as EEAST’s new Chief Executive Officer and advised that questions received from the public to OCE.EEAST@eastamb.nhs.uk would be addressed at the end of the meeting.

PUB24/09/2 APOLOGIES FOR ABSENCE

2.1 There were no apologies received.

PUB24/09/3 DECLARATIONS OF INTEREST

3.1 There were no new interests declared.

PUB24/09/4 PATIENT STORY

4.1

Simon Chase, Chief Paramedic and Director of Quality (CP-DoQ) introduced a video that addressed handover delays and their impact on the patient experience. He thanked Mr Julian Hammond for participating in the discovery interview.

4.1.1

The CP-DoQ was pleased to note that Mr Hammond had been very positive about the ambulance crews who attended him and the treatment he received; the crew had undertaken a thorough assessment of Mr Hammond upon arrival and been unable to identify the cause of Mr Hammond’s faint. The CP-DoQ considered that the public needed to be aware of the work that was ongoing around hospital delays and the organisation’s focus on clinical supervision, decision-making around non-/conveyance, and timely response in time-critical situations. The CP-DoQ recognised that handover delays would continue to occur and worsen through the Winter period, and EEAST had a role to play in the patient experience during these delays. He added that the Association of Ambulance Chief Executives (AACE) had commissioned a national project to understand the patient experience during handover delays.

4.1.2

Neill Moloney, Chief Executive Officer (CEO) noted that Mr Hammond was returned to the ambulance following initial assessment at the hospital; he asked how this had impacted on the patient experience? The CP-DoQ replied that the NHS minimum care standards were followed; had Mr Hammond not been able to walk, he may not have been returned to the ambulance. A national audit was currently reviewing the gaps in the basic needs provided by ambulance crews.

4.1.3

Chris Brook, Non-Executive Director (NED-CB) recognised that hospital challenges were beyond the Trust’s management and control. He recommended that the Board consider how EEAST could empower its ambulance crews to make a different choice regarding conveyance.

4.1.4

The CP-DoQ replied that an alternative care pathway for Mr Hammond would have resulted in non-conveyance. 20 clinical supervision posts had been introduced across the region as a result of the Time to Lead programme which would inform learning through debrief and professional discussion.

4.1.5

Melissa Dowdeswell, Chief of Clinical Operations (CCO) added that work was being undertaken to inform new care pathways with regional partners.

4.1.6

Dr Simon Walsh, Medical Director (MD) reported that handover delays resulted in poor patient experience and harm, and the Trust’s ability to respond to other emergency calls; this was enhanced through the Winter period. EEAST was working with its regional partners and neighbouring ambulance services to reduce handover delays and minimise the associated risks.

4.1.7

The TC extended his thanks to Mr Hammond and the ambulance crews. He concluded that the Trust was constantly learning from these patient stories and continued to work with its hospital partners to minimise handover delays.

PUB24/09/5 TRUST CHAIR AND NON-EXECUTIVE DIRECTOR’S REPORT

5.1

The Board received and considered the Trust Chair’s report which offered a summary of the work undertaken by the TC and Non-Executive Directors (NEDs) across the region in the past two months; this was closely aligned to the Trust’s priorities, identified risks and strategies. The TC addressed the key points:

• Recruitment of the new CEO had been co-produced with staff and stakeholders. Visibility and engagement would continue and, together with continuing the Trust’s cultural journey and prioritising staff wellbeing, patient voice, and performance improvements, was key to the CEO’s priorities and objectives.
• There was significant Board focus and scrutiny on performance improvements.
• Staff and stakeholders had been engaged in the development of the Trust’s 2025-30 strategy.
• The Freedom to Speak Up (FTSU) service had been outsourced to The Guardian Service, providing greater resilience and independence.
• The organisation had supported its BME colleagues during the summer riots and violence.

The Board noted the report.

ACTION: Report to be updated and republished post-meeting to include all Non-Executive Director activity.

PUB24/09/6 CHIEF EXECUTIVE OFFICER’S REPORT

6.1

The Board received and considered the CEO’s report. Marika Stephenson, Director of People Services (DoPS) and Interim Deputy Chief Executive Officer, provided an update on the following points:

• Regulatory Update – NHS England (NHSE) had confirmed that there would be changes to oversight and scrutiny following the Trust’s removal from NOF4.
• Bereavements – the Board’s sympathies were extended to the families and friends of the three colleagues who had passed during the Summer: Tracy Winder, Tafseer Ahmad and Bonita Richards.
• Celebrations:
  • Arrival of the international nurses from the Philippines
  • Silver Dyslexia award
  • HSJ award nomination – EEAST had been shortlisted in the Provider Collaboration of the Year category for its partnership with regional fire and rescue services.

6.1.1

The CEO thanked the Board for the warm welcome he had received; his first week had been spent visiting sites across the region, including the Senior Leaders Away Day. He had identified three key areas of focus:

• Collaboration with partners to ensure that patients received the right treatment, the first time, every time; pathways should be developed to ensure the best patient outcomes.
• Performance was a priority, particularly C2: changes should be implemented to improve performance, while working with partners.
• Culture – significant progress had been made to attract and retain staff.

The Board noted the report.

PUB24/09/7 MINUTES OF THE PREVIOUS MEETING

7.1 The minutes of the meeting held on 10 July 2024 were approved as an accurate record.

PUB24/09/8 MATTERS ARISING AND ACTION TRACKER

8.1

PUB24/02/9.1 – Integrated Performance Report (IPR) Executive team to provide the Board with detailed and digestible intelligence at a more local-level to inform the Trust’s longer-term strategy and empower local managers.

Reporting continued to be refined and made available at a more local level, informing conversations with the ICBs. Jo Cripps, Interim Director of Corporate Affairs and Performance (IDoCAP) reported that the Operational Performance Improvement Plan (OPIP) had been expanded to sector-level, and there were elements of sector relevance within the IPR but further work was needed to refine and provide more focus

The TC noted the significant improvement that had been made in the provision of management information, however this success had resulted in the IPR becoming unwieldy. He proposed that a meeting be held to discuss what was required from the IPR going forward and to determine whether this action could be closed.

8.2

PUB24/07/10.1.3.4 – EOC Statistics and Performance Chief of Clinical Operations to ensure there was increased scrutiny and planning between EOC statistics and performance

The CCO reported that the modelling required had been completed by the EOC Clinical Operations and Workforce teams, and the work was now with IT to generate the performance metrics; IT priorities determined completion.

8.3

The Board resolved to close the following actions: PUB24/02/9.1.3 – Fleet Data PUB24/05/11.1 – 2023 NHS Staff Survey

PUB24/09/9 PERFORMANCE, RISK AND GOVERNANCE

9.1

Integrated Performance Report (IPR) The Board received and considered the Integrated Performance Report. The TC asked the Executive Directors to focus their reports on key areas of improvement and concern.

9.1.1

Marika Stephenson, Director of People Services (DoPS), highlighted the main points for People Services: • Key Performance Indicators (KPIs) were improving. • Staff turnover continued to decline – starters and leavers profiles, and EDI data were now being reviewed • Sickness absence was on target, however there were areas within the Trust that required improvement. • Work was ongoing to address Duty Sick. • Employee Relations (ER) cases totalled 134 (target 130) although the closing rate was improving month-on-month and 76% of closures were within policy timescale. • Analysis demonstrated that the new Time to Lead appointments were effectively managing their teams’ performance and behaviours; although this impacted negatively on casework volume, the increase was seen as a positive change. • Time to Lead – LAMs appointed and under-going training; Team Leader recruitment was live. • Employment tribunals had reduced from 24 to 13; learning from these case reviews would be shared across the organisation.

9.1.1.2

TC asked if there was correlation between high sickness absence, high staff turnover, low appraisal completion and the Staff Survey results? The DoPS replied that there were hot-spots for ER cases but this was not consistent across the region. The DoSCE added that A&E was struggling with appraisals, however staff feedback indicated that these conversations were welcomed. The Trust was working with and supporting teams in some regions to address the compliance challenges.

9.1.1.3

Wendy Thomas, Non-Executive Director (NED-WT) confirmed that People Committee was monitoring appraisal compliance, and there had been a lengthy discussion at the July meeting around the Operations directorate action plan for appraisals and how to improve the completion rate. The Board noted that progress against this plan had not yet materialised. The CCO reported that the plan was on target for all senior leaders to have completed their appraisals before 30 September, leading by example. The TC requested that progress was seen before the next Board meeting.

9.1.1.4

NED-GL noted an increase in staff sickness due to mental health issues from 25% to 27%; he asked if staff were using the many resources that were available to them? The DoPS suggested that the increase could be linked to the high volume of ER cases. Also, the number of staff with post-traumatic stress was increasing, and this was a lengthy support process. There was still a stigma attached to seeking help and support for mental health issues, and the Trust was continually working to raise the profile of the available resources.

9.1.1.5

In response to a question from the TC, the DoPS confirmed that Duty Sick had a huge impact on sickness statistics. Duty Sick had not been previously recorded or monitored, but the policy had been updated and communicated to all managers. This was a cultural challenge for the organisation but significant progress had been made to date and work continued to further reduce.

9.1.1.6

The TC requested that benchmarking be undertaken against the NHS and other ambulance Trusts for both sickness and Duty Sick absence.

ACTIONS:

• Progress in staff appraisal compliance to be recorded before the 09 October Board Meeting. • Sickness absence and Duty Sick benchmarking to be undertaken against the NHS and other ambulance Trusts.

9.1.2

Dr Hein Scheffer, Director of Strategy, Culture and Education (DoSCE) provided an update on Strategy, Culture and Education:

• Mandatory training remained at 84% (1% below target); no change in 3-months.
• Resuscitation compliance was at 87%; challenges identified within Patient Transport Services (PTS) were being addressed by the team.
• The number of declared disabilities was increasing; this was seen as an indicator of improved trust.
• Appraisals – 60% completion (80% target); the Trust continued to work towards the introduction of a robust digital appraisal tool. In the meantime, there were areas within the organisation where appraisals were an issue and work was ongoing, particularly with the Operations directorate, to achieve 80% compliance before the Winter.

9.1.2.1

Omid Shiraji, Associate Non-Executive Director (NED-OS) was concerned at the low level and downward trajectory of Information Governance training compliance, particularly in relation to the increased cyber-security risk; he asked what was being done to address this? The DoSCE confirmed that this was being communicated across the wider organisation; the support of all senior managers was required to enforce the restrictions proposed for non-compliance.

9.1.3

Melissa Dowdeswell, Chief of Clinical Operations (CCO) provided an update on Operations:

• Slight improvements were noted in both C1 and C2 performance.
• Out of Service was lower than recorded in the previous 12-months, this was testament to the work undertaken.
• The Operational Performance Improvement Plan (OPIP) portal had been rolled-out, the impact of this should be seen within 2-3 months.
• C1 licence delays were reducing.

9.1.3.1

In response to a question from George Lynn, Non-Executive Director (NED-GL) regarding the vehicle delivery programme, Anthony Brett, Deputy Chief of Clinical Operations (DCCO) confirmed that this was on schedule: the first 27 vehicles were operational and 40 Renault vehicles would be delivered over the next 3-months; the first were already operational with no issues reported. The final batch of MANs would be delivered in December/January.

9.1.3.2

NED-OS asked what was being done to address the reducing average mobilisation time? The CCO replied that this was an area of focus, and discussions were ongoing with the Local Operations Managers (LOMs).

9.1.4

Simon Chase, Chief Paramedic and Director of Quality (CP-DoQ) and Dr Simon Walsh, Medical Director (MD) provided an update on Clinical Quality and Safety:

• Quality indicators – a strong position was being maintained around the number of compliments received (5 to each complaint).
• Patient outcomes – the return for spontaneous circulation of witnessed or shockable cardiac arrests was maintained at 50%; a third of these patients were discharged from hospital within 30-days, well above the national average, and work was ongoing to achieve further improvement. High quality treatment was being provided despite the increased demand on the service.
• Safeguarding training figures continued to be monitored; Level 1 Safeguarding was now part of the mandatory training suite.
• Complaints – a reduction in the response rate was attributed to issues with staff capacity. A large number of complaints had been received for PTS, however it was not expected that this would continue as the new PTS leadership team was now in post and fully trained.

9.1.4.1

In response to a question from NED-CB, the CP-DoQ confirmed that ~50% of the complaints received were linked to PTS, predominantly in relation to late collection and poor communication. A large proportion of the journeys in Cambridgeshire and Peterborough (C&P) could not be fulfilled.

9.1.4.2

Chris McGregor, Interim Director of Integration and Commercial Services (IDoICS) explained that all four PTS contracts needed to be remodelled as none had sufficient capacity to meet the demand. The PTS teams were therefore prioritising those most in need, and a decision had been taken to withdraw the PTS service from C&P. System partners were keen to work with EEAST to change and improve the contracts to better support the current demand. NED-CB requested that the new PTS contracts clearly expressed the expected response times and level of communication required. The CEO expressed concern that vulnerable patients were being denied transport; he requested further discussion to address this.

9.1.4.3

In response to a question from Catherine Glickman, Non-Executive Director (NED-CG) regarding the continuation of issues with the transfer of the C&P contract to another provider, the IDoICS replied that modelling of the tender specification confirmed that EEAST could not provide a quality service and value for money. The service was therefore being decommissioned and readied for hand-over to a new provider; the Trust was mindful that there would likely be a transfer in demand as a result of this change.

9.1.4.4

The TC reflected that there had been extensive discussion around PTS at both Public and Private Board during 2024, balancing the acceptable risks against what the Trust could deliver without compromising its values, red-lines, and staff welfare.

9.1.4.5

The CP-DoQ added that PTS were completing a lot of journeys with positive outcomes; he commended the IDoICS and the PTS team in tacking the outstanding complaints.

9.1.5

Chris McGregor, Interim Director of Integration and Commercial Services (IDoICS) provided an update on Integration:

• Access to the Stack acceptance rates varied between 65-88% across the region; processes were working and access to decline rates remained low. Data was being used to drive progress, and conversations were ongoing with system partners.
• Unscheduled Care Co-ordination Hubs – EEAST worked in partnership with this ICB resource which would be standardised and embedded regionally. Good progress had been made through partnership working; it was important that EEAST should continue to maximise these ICB partnerships, identifying through audit missed opportunities for development, expanding and evolving the services offered, and improving performance.
• Patient Transport Services (PTS) – a new data-set was presented through the IPR. The digital infrastructure was being improved and CLERIC would go live on 01 October, significantly improving the co-ordination of the service and reducing risk.
• Celebrating success – colleagues in the Bedford PTS had been commended by Bedfordshire, Luton and Milton Keynes (BLMK) following a major incident; their reaction had resulted in a seamless move and no loss of service.
• PTS budgets showed, for the first time, a financial contribution to EEAST of ~£150K; this was attributed to the significant work undertaken in recent months.
• Community First Responders (CFRs) continued to provide valuable support to EEAST, although the number of available hours was declining month-on-month. This was being addressed through an availability vs. utilisation report which confirmed that less than 20% of the available volunteer hours were used.

9.1.5.1

In response to a question from NED-CG regarding the under-utilisation of volunteer hours, the CCO agreed that understanding what volunteer skills and hours were available, mapped against what the Trust needed from its volunteers and where within the region, would help to increase the level of utilisation. The Trust needed to view its activity as a whole, rather than in segments. The IDoICS added that 88% of utilised volunteer hours were first on-scene, with more than 50% to C1 calls, providing rapid intervention and impacting on positive patient outcomes.

9.1.5.2

Julie Thallon, Non-Executive Director (NED-JT) noted that Access to the Stack patient acceptance numbers were reducing; she sought assurance that this would be addressed within the Winter Plans, both EEAST’s and the ICBs, as success was dependent upon all the systems engaging and committing resources. In relation to same-day emergency care services in the acute hospitals, the hubs could refer patients directly, by-passing the Emergency Department and reducing conveyance. She urged that this be included in the Winter Planning conversation with ICBs.

9.1.5.3

The IDoICS replied that hub governance had changed as a result of national guidance. The focus had transferred to operational delivery and continuous improvement, with a sub-section on hub utilisation, particularly Access to the Stack, and the focus was on preparing for Winter. The hubs were undertaking audits on urgent care access and capacity; this was the route for conversation around demand and identified gaps.

9.1.5.4

The CCO reinforced the importance of hub improvements being data-led. She agreed that utilisation could be improved and the number of patients referred to the hubs increased, but EEAST must continue to work with ICB partners to ensure that they had the capacity and understanding of what was required, otherwise the right care pathways would not be in place.

9.1.6

Kevin Smith, Director of Finance (DoF) delivered an update on Finance at July 2024, month 4 of the 2024-25 financial year:

• Expenditure was slightly above plan, linked to the overtime incentives requested by NHSE; further income was expected.
• Quality Cost Improvement Plan (QCIP) – £4.9M achieved and on target, although the savings identified were mainly non-recurrent.
• Work was ongoing to reduce spending in two areas of Operational Support: Make Ready, and Fleet and Vehicle Maintenance.
• The PTS overspend was reducing month-on-month; this was a positive change.
• Reasonable assurance was offered, however there were risks to achieving the budget plan: non-recurrent QCIP, and higher expenditure through the Winter.
• EEAST was working with PA Consulting on the underlying spend and 2025-26 financial position – to be discussed in detail at Private Board.
• Staff Pay Award – this would impact on the Trust’s financial position but was fully funded by NHSE.
• The Capital spend would be fully utilised.
• The Cash position was comfortable and being monitored.

9.1.6.1

NED-GL asked how the government-initiated spending reviews would impact on EEAST? The CEO replied that a review was being undertaken by Lord Darzi around the future funding of the NHS; EEAST’s financial envelope for 2024-25 was unlikely to increase. The DoF added that the government’s focus was on NHS productivity, which was being addressed by EEAST; the Trust was on-plan financially so there were no spending controls in place.

9.1.6.2

In response to a question from the DoSCE about the impact of non-recurrent QCIP savings on the next financial year, the DoF replied that the impact on the 2025-26 budget would be ~£8M, not allowing for the efficiency targets imposed for the new financial year. The DoSCE recommended that funds be withheld from directorates so they had less to spend. The CEO recommended that, as QCIP was cumulative, work should commence in the current financial year; to be addressed by ELT through the business planning process.

The Board noted the report.

9.2

Organisational Performance Improvement Plan (OPIP)

9.2.1

The Board received and considered the Organisational Performance Improvement Plan (OPIP). The TC requested an overview of OPIP for public transparency.

9.2.2

Established a year ago to review demand and capacity and drive forward performance improvements, the CCO reported that the OPIP was very detailed and, with input from staff and stakeholders, it continued to evolve. The following key points were recorded:

• Four key areas of focus:
• On-scene time
• Patient-facing staff hours (PFSH)
• Hear and Treat
• Vehicle availability
• Clinical Assessment Service – the appointment of new clinical supervision staff would benefit the Hear and Treat service where trajectories were not being met.
• Staff sickness was reducing and the new focus on Duty Sick would positively impact on PFSH.
• Vehicle availability – the fleet was aging but the vehicle replacement scheme would help to improve reliability.
• Vehicle Technicians – the current recruitment campaign would further enhance vehicle reliability.
• Communication and Engagement – a Communications Plan would be launched on 16 September to keep staff and stakeholders informed of progress against the OPIP.

9.2.3

The DoSCE enquired about the ideal position for on-scene time. The CCO replied that this was addressed nationally, with targets based on trajectory and benchmarking. EEAST had engaged another ambulance service as a critical friend to assess this work.

9.2.4

In response to a question from NED-GL around the development of mathematical models to measure probability and the impact on the four key objectives, the CCO confirmed that initial conversations had taken place regarding the employment of a statistician. The DoF added that PA Consulting had started this work; to be discussed in more detail at Private Board.

The Board noted the report.

9.3

External Audit Annual Management Letter 2023-24

9.3.1

The Board received and noted the External Audit Annual Management Letter for the 2023-24 financial year.

9.4

Southern Ambulance Services Collaboration – Manifesto

9.4.1

The Board received and considered the Southern Ambulance Services Collaboration (SASC) Manifesto for 2024-25. The DoPS outlined the background of the SASC, a collaboration between EEAST, London (LAS), South Central (SCAS), South-East Coast (SECAMB), and South-Western (SWAST) ambulance services, with an aim to create efficiencies through collaboration. The 07 June workshop was attended by senior leaders from the five ambulance services, an agreed collaboration and governance structure was in place, and three areas of focus had been agreed for the first year:

• Shared procurement
• Best use of AI in EOCs
• Ambulance resources – develop an optimal model for a DCA shift

The Board noted the report.

PUB24/09/10 OBJECTIVE 1: BE AN EXCEPTIONAL PLACE TO WORK, VOLUNTEER AND LEARN

10.1

Freedom to Speak Up (FTSU) Report

10.1.1

The Board received and considered the first Freedom to Speak Up (FTSU) report from The Guardian Service (TGS). Guardians, Danielle Marshall (DM) and Kimberley Gillingham (KG), joined the meeting and reported that 13 concerns had been raised since the service commenced on 05 August 2024.

10.1.2

In response to questions posed by the Board, the following points were recorded:

• Information was being carefully monitored to ensure anonymity, however it was anticipated that future reports would evolve to provide more meaningful reporting.
• TGS would work with EEAST to address recommendations and suggestions based on the information received through the concerns raised.
• The guardians would become more visible and able to build understanding and trust with EEAST staff; future TGS reports would show pro-active engagement and visibility.
• TGS was working with EEAST’s Marketing and Communications team to promote the service to staff during October, speaking-up month.

10.1.4

NED-WT noted that the report did not include legacy cases; she asked how many remained outstanding and enquired about the process for closure? NED-CG confirmed that FTSU legacy cases were being managed through Liz Cunnell, Chief of Staff; she agreed that a report was required on legacy case closure and communication with the affected staff.

10.1.6

The TC reinforced the importance of FTSU to the Board and wider organisation; he requested an update from TGS for every Public Board meeting and asked that any concerns or challenges faced by TGS be directed to either the TC, CEO or NED-CG. A Board Workshop was planned with the National Guardian’s Office in December 2024; Stanley Mukwenya, Deputy Director of Corporate Affairs (DDoCA) to communicate the workshop dates, once confirmed.

The Board noted the report.

ACTIONS:

• Chief of Staff to submit a report to the October Private Board meeting on the closure of FTSU legacy cases and communication with the affected staff.
• Stanley Mukwenya, Deputy Director of Corporate Affairs to communicate the National Guardian’s Office Board Workshop dates.

10.2

People Committee Assurance Report

10.2.1

The Board received and considered the People Committee assurance report. In the absence of Wendy Thomas, Non-Executive Director and Committee Chair, NED-GL provided the following update from the meeting held on 31 July 2024:

• Multi-Faith Network – this inclusive group was supporting the “Let’s Talk” campaign and linking with the Trust’s pre- and postvention project.
• All Women EEAST Network – current work was focussed on pregnancy.
• Transformation Programmes – progressing to plan; a business case was being developed for Anaplan as part of the Planning and Resourcing Programme.
• Board Assurance Framework – the level of risk had been reduced due to the progress made.

The Board noted the report.

PUB24/09/11 OBJECTIVE 2: PROVIDE OUTSTANDING QUALITY OF CARE AND PERFORMANCE

11.1

CQC Quality Improvement Plan – Progress Report

11.1.1

The Board received and considered the CQC Quality Improvement Plan Progress Report which showed the progress made against the MUST Dos and SHOULD Dos since the CQC core inspection in 2022. The CP-DoQ reported the following points:

• Work continued on the MUST and SHOULD dos.
• Improvement notice – the CQC had confirmed that the evidence submitted was subject to a delay of up to 10-weeks.
• The CQC had submitted a formal request under the Health and Social Care Act (section 64) asking EEAST to explain the change in FTSU provider from in-house to external. Six areas had been identified by the CQC, including the change in formal arrangements and outstanding/legacy cases. The requested evidence was submitted to the CQC in August.

11.1.2

The Executive Directors confirmed that that they would be attending the departmental meetings arranged by TGS.

11.1.3

The TC concluded that one long-term MUST do remained outstanding: appraisals. This was a key area of focus for the Board.

The Board noted the report.

PUB24/09/12 OBJECTIVE 4: BE AN ENVIRONMENTALLY AND FINANCIALLY SUSTAINABLE ORGANISATION

12.1

Audit Committee Assurance Report

12.1.1

The Board received and considered the Audit Committee assurance report. NED-GL (Committee Chair) provided the following update from the meeting held on 24 July 2024:

• Risk Management – the Committee had discussed the assessment and reporting of risk, and two risks had subsequently been reduced. Committee members to attend some of the sub-group meetings that underpinned Audit Committee to better understand the decision-making process around risk.
• Out of Meeting approvals and late papers – to be discussed in more detail at Private Board. The absence or late involvement of the Procurement team was a major cause of late papers; the introduction of the Procurement Act in October 2024 would impact positively on compliance.
• Information Governance and Security Management – the improved used of systems and digitisation was recommended.
• Counter Fraud and Internal Audit – both services were outsourced to external partners. The Counter Fraud report offered a detailed review of potential fraud within the organisation, and the Internal Audit team would review the cost improvement and Transformation Programme plans. NED-GL proposed that Counter Fraud and Internal Audit be discussed in more detail at a future Board meeting, for improved oversight. The TC agreed to discuss with NED-GL offline.

12.1.2

With regard to the Sustainability Working Group, NED-JT expressed concerned that sustainability governance would be overlooked. The DDoCA confirmed that a Board Workshop on sustainability was being co-ordinated with Katherine Middleton, Environment and Sustainability Manager, and external providers. The DoSCE added that sustainability would be included within the 2025-30 Strategy.

The Board noted the report.

PUB24/07/13 CLOSING ADMINISTRATION

13.1

Items Referred to/from Other Committees

None

13.2

Key Messages and Identified Risks

13.2.1

The TC summarised the focus of the meeting as:

• Patient experience.
• Staff wellbeing – training, appraisals and sickness.
• Data and analytical capability – a common theme for the Board, and an area of organisational weakness. NED-OS proposed that the Board should dedicate workshop time in December.

13.3

Questions received from the Public

There were no questions received from the Public

13.4

Reflection on Meeting

13.4.1

The DoSCE offered the following reflections:

• The meeting pack was too large, he proposed that the papers be rationalised.
• He welcomed the TC’s comments regarding staff support during the Summer riots.
• The DoPS’s tribute to those colleagues who had passed was acknowledged.
• Silver Award for Dyslexia – the team was working toward Gold status.
• There was good challenge and debate; colleagues should continue to challenge for improved Board assurance.
• All papers should carry the Trust’s new logo showing the King’s crescent.

13.5

Date of Next Meeting

Wednesday 06 November 2024 (09:30 – 12:30) The meeting was formally closed at 12:30