agenda - kmpt.nhs.uk€¦ · venue boardrooms a & b, farm villa and video conferencing agenda...

Key: DL: Diligent Reference FA- For Approval, FD - For Discussion, FN – For Noting, FI – For Information

AGENDA

Title of Meeting Trust Board Meeting (Public)

Date 29th October 2020

Time 12:30 to 13:00

Venue Boardrooms A & B, Farm Villa and video conferencing

Agenda Item DL Description FOR Format Lead Time

TB/20-21/96 1. Welcome, Introductions & Apologies Verbal Chair 12:30

TB/20-21/97 2. Declaration of Interest Verbal Chair

STANDING ITEMS

TB/20-21/98 3. Minutes of the previous meeting – 24/09/2020 FA Paper Chair 12:35

TB/20-21/99 4. Action Log & Matters Arising FN Paper Chair

TB/20-21/100 5. Chief Executive Report FI Paper HG

OPERATIONAL ASSURANCE

TB/20-21/101 6. KMPT-KCHFT Memorandum of Understanding FA Paper HG 12:40

TB/20-21/102 7. CQC Update FD Verbal MM 12:50

CONSENT ITEMS

TB/20-21/103 8.

Executive Assurance Committee Terms of

Reference

FA Paper HG 12:55

TB/20-21/104 9. Any Other Business Chair

Date of Next Meeting: 26th November 2020

Agenda

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Key: DL: Diligent Reference FA- For Approval, FD - For Discussion, FN – For Noting, FI – For Information

Members:

Dr Jackie Craissati JC Interim Trust Chair

Venu Branch VB Interim Deputy Trust Chair

Peter Conway PC Non-Executive Director

Tom Phillips TP Non-Executive Director

Rod Ashurst RA Non-Executive Director

Anne-Marie Dean A-MD Non-Executive Director

Catherine Walker CW Non-Executive Director (Interim Senior Independent Director)

Sean Bone-Knell SB-K Associate Non-Executive Director

Mickola Wilson MW Associate Non-Executive Director

Fiona Carragher FC Associate Non-Executive Director

Kim Lowe KL Associate Non-Executive Director

Mark Bryant MB Associate Non-Executive Director

Helen Greatorex CE Chief Executive

Vincent Badu VB2 Executive Director of Partnership and Strategy/(Deputy CEO)

Dr Afifa Qazi AQ Executive Medical Director

Jacquie Mowbray-Gould JMG Chief Operating Officer (COO)

Mary Mumvuri MM Executive Director of Nursing & Quality

Sheila Stenson SS Executive Director of Finance & Performance

Sandra Goatley SG Director of Workforce & Communication

In attendance:

Tony Saroy TS Trust Secretary (Minutes)

Kelly August KA Assistant Director of Communications

Apologies:

Agenda

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Kent and Medway NHS and Social Care Partnership Trust Board of Directors (Public) Minutes of the meeting held at 1230 to 1430hrs on Thursday 24th September 2020

at the Orchards, East Malling

Members:

Dr Jackie Craissati JC Interim Trust Chair

Mark Bryant MB Non-Executive Director

Catherine Walker CW Non-Executive Director (Interim Senior Independent Director)

Anne-Marie Dean A-MD Non-Executive Director

Rod Ashurst RA Non-Executive Director

Venu Branch VB Non-Executive Director (Interim Deputy Trust Chair)

Tom Phillips TP Non-Executive Director

Sean Bone-Knell SB-K Associate Non-Executive Director

Fiona Carragher FC Non-Executive Director

Peter Conway PC Non-Executive Director

Kim Lowe KL Non-Executive Director

Mickola Wilson MW Associate Non-Executive Director

Helen Greatorex HG Chief Executive (CEO)

Vincent Badu VB2 Executive Director Partnerships & Strategy/Deputy CEO

Mary Mumvuri MM Executive Director of Nursing and Quality

Dr Afifa Qazi AQ Executive Medical Director

Jacquie Mowbray-Gould JMG Chief Operating Officer (COO)

Sandra Goatley SG Director of Workforce and Communications

Sheila Stenson SS Executive Director of Finance and Performance

Attendees:

Tony Saroy TS Trust Secretary (Minutes)

Observers:

Kelly August KA

Georgie Grassom GG

Apologies

Item Subject Action

TB/20-21/78 Welcome, Introduction and Apologies The Chair welcomed all to the meeting, which was both livestreamed and in-person. No apologies were received.

TB/20-21/79 Declarations of Interest No declarations of interest were made.

Minutes of the previous meeting


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Item Subject Action

TB/20-21/80 Award winning Vocational Rehabilitation Services – Transforming Lives Jeanette Freeman, Vocational Rehabilitation Service Lead, and Jody Nash, Occupational Therapist, were welcomed to the Board Meeting. Jeanette set out the role of the Vocational Rehabilitation Service, the number of service users it had helped and the nationally & locally recognised successes of the Service. Jody recounted her personal story and how the opportunity of doing a job taster gave her the confidence and skills to become a member of staff with KMPT. Jody is about to move from the Crisis Resolution and Home Treatment Team to the Vocational Rehabilitation Service. The Board reflected on the presentation and discussions centred on:

How the Vocational Rehabilitation Services had adapted over the Covid-19 period;

Jeanette’s aim to expand the service as some parts of the counties are not covered yet;

The development of a pathway for service users to become Peer Support Workers; and

The Service working in partnership with third-sector organisations. The Board thanked Jeanette and Jody for attending the meeting. The Chair and Chief Executive formally presented the national HSJ award and certificate that the Vocational Rehabilitation Service had recently won in the Best Value category.

TB/20-21/81 Minutes of Previous Meeting The Board approved the previous minutes as an accurate reflection of the meeting, save that amendments were noted at:

TB/20-21/62 - the words ‘Works backlog” to be replaced with “Estates backlog”; and

TB/20-21/64 - the words “so the Trust is being supported” to be replaced with “so the CCG is being supported”.

The Board approved those minutes subject to those changes being made.

TB/20-21/82 Action Log & Matters Arising The Board agreed the Action Log as it stood, save that: Action TB/20-21/43 – Chief Executive’s Report – regular update on Recovery and Transform work: The Board agreed that updates will be received quarterly as interim updates are provided to Committees. Action: HG to share a table setting out which Committees have oversight over which aspects of Recovery and Transform programme. Table to be appended to the November Chief Executive’s report. Action TB/20-21/63 – Chief Operating Officer’s report – invitation to George Matuska to present at Board: Date amended from October 2020 to November

HG



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Item Subject Action

2020.

TB/20-21/83 Chair’s Report The Board received the Chair’s report, which was noted. The Board also endorsed the appointment of VB as the Interim Deputy Trust Chair and CW as the Interim Senior Independent Director. The Chair also set out that the Board acts collectively with parity given to all Board members. Any Board member’s non-voting status will only be formally recognised where there is a requirement to do so. The Board discussed matters that arose out of NED site visits. It was confirmed that works at Fern Ward and Rivendell are on the Estates work-plan. The Trust is also looking at electronic methods to deal with patients’ monies. The Board noted the Chair’s Report.

TB/20-21/84 Chief Executive’s Report The Chief Executive’s Report was received by the Board for discussion, with the CEO highlighting:

The Kent and Medway Medical School opened in September with 105 founding medical students, one of whom has been sponsored for the whole of their training by KMPT. The CEO will be meeting with the sponsored student, Mimosa Osmani, once she has settled into her new course; and

Getting It Right First Time (GiRFT) Rehabilitation Care Group review took place in early September. There was clear recognition and acknowledgement that the Trust has started to address many of the key themes that form the national strategy for rehabilitation services. The Trust continues to work with the GiRFT team to drive improvements

The Board noted the Chief Executive’s Report.

TB/20-21/85 Integrated Quality & Performance Report (IQPR) The Board received the IQPR and the Board considered each of the IQPR’s sections. Safe

The target for patients receiving a formal 12 Month Care Programme Approach (CPA) review has been met or exceeded since May 2020 despite the impact of Covid-19. The result for August 2020 was 96%.

97% of all admissions had a physical health check on admission; this is against a local target of 90%. The only exceptions are individuals who refuse to consent for these tests, which may happen due to their mental state.

The number of Serious Incidents reported to STEIS in the last three months has been above the yearly average of 13.7 incidents per month. In August, 24 incidents were reported. The Trust is monitoring matters and Quality Committee will be updated on findings and actions.

In terms of Restrictive Practice, there were 159 incidents in August, an



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Item Subject Action

increase of 30 from July. There were 10 prone restraints in August 2020. Each of these instances is carefully reviewed and any learning shared. There were no reported patient injuries as a result of prone restraint and the majority of the restraints were brief, lasting less than 4 minutes. As a matter of good practice, the Trust is having its Restrictive Practices peer reviewed, which is due to conclude in four weeks’ time. Quality Committee will be updated in due course.

Effective

In August a total of 44 days were used for male private PICU beds. These bed days were needed for 6 patients, the majority of whom were repatriated back to the Willow Suite within days of admission. This was an increase in month by 13 days. Three females are in out of area PICU beds due to the acuity of their needs - autism is either a primary or co-occurring condition - and there is a need to for the right service to meet their needs. The Trust always looks to see if care can be provided in-house, but due to the level of acuity it is appropriate for a small number of patients to be placed out-of-area for a short time.

In respect of the proportion of patients with a valid CPA Care Plan or Crisis Plan, the data is above the IQPR targets. Developments across community services continue to ensure that the improvements made are sustainable across both standards over the next 6 months.

The Average Length of Stay for patients has reduced for both Younger Adults and Older Adults (Acute). This is thanks to an effective Patient Flow team.

A report regarding readmission rates is currently being produced and is anticipated to be completed in October. A copy of that report will be submitted to the Quality Committee.

Workforce

Dealt with in Workforce Report section.

Finance

Dealt with in Finance Report section. Caring

There was a slight reduction in the number of complaints and PALS enquiries received since the last report. Acute Care Group saw a small drop in the number of reportable complaints, although did see a slight increase in PALS enquiries, all of which were responded to in a timely manner. There

were no complaints from Older Adults services. 100% of complaints were acknowledged within three days, with just one re-opened complaint in due to additional questions being raised from the findings and outcome.

The Quality Committee agreed that the Trust should focus on ‘customer care’ as improvements in this area will have a significant impact. The Trust will be rolling out refresher training on this theme.

The Parliamentary and Health Service Ombudsman (PHSO) has just re-started operating following suspension during the pandemic There was one contact from PHSO advising they had completed consideration of a complaint and a decision made not to take forward the investigation. There are currently four open PHSO cases which will be progressed.

A re-launch of the Patient Reported Experience Measure (PREM) commenced from September. Although the NHS Patients Friends and Family Test will recommence nationally in December, feedback will be



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Item Subject Action

available immediately via the PREM.

Healthwatch Kent and Medway and the Integrated Care System led a review of people’s experience of accessing health services across the system during peak of Covid. The findings are similar to locally reported experience whereby a menu of access options needs to be offered to individuals. These insights are being fully considered in the co-production of digital solutions that underpin care as not all patients respond positively to care through technology.

As part of the IQPR, the Trust will begin to start theming compliments so that the Board can consider the number of complaints in context.

Action: MM to include themed compliments within the Caring domain in the IQPR by November 2020. Responsive

The Trust continues to deliver the national standard for Early Intervention in Psychosis (EIP), delivering a performance of 85.7% in August. The Trust has completed a business case that has been sent to the commissioners, requesting investment in this service as part of the Mental Health Investment Standard (MHIS) and aligned with the Long Term Plan (LTP) which will ensure the service is Level 3 NICE compliant.

Performance against the 4 week standard has decreased in month, but performance against the 18 week standard has increased in month. 83.9% for 4 week wait performance and 78% for 18 week performance. The teams are completing demand and capacity modelling with the Performance and Information teams as part of the Recover and Transform work.

The Board reflected on the 4 week standard and 18 week standard data set, noting that there is significant variance between teams in both younger and older adult community services. During the Covid-19 period, Memory Assessment Services were suspended and the CMHSOPs had a backlog. The Board pressed the COO on when performance results will be back on track. With a new Head of Service in post and the Trust looking to redesign the service, it was anticipated that an update regarding performance improvement would be provided to the Board in six weeks’ time. The Chief Executive asked that a more detailed discussion take place outside the meeting, focused on speedy recovery and a clear trajectory.

Action: HG and JMG to discuss performance improvement plan with respect to the 4 week standard and 18 week standard, with Board to be updated in October 2020.

The Board discussed the high percentage (20%) of first appointments reported in the IQPR to have been cancelled by the Trust. In October, the Trust’s Finance and Performance Committee will be reviewing data quality in respect of referrals, Trust cancellations and Did Not Attends.

The Board recommended that for national targets that had been met all year, the Trust should create local targets that would further improve performance

The Board NOTED the Integrated Quality and Performance Report.

TB/20-21/86 Finance Report: Month 5 Finance Report



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Item Subject Action

The Board received the Finance Report (Month 5), with the following matters highlighted:

Income and Expenditure: KMPT is continuing to report a breakeven position. Patient Care Income is included as advised nationally, with an additional £3.2m year to date to reflect additional COVID-19 related costs, and £0.7m top up to deliver breakeven.

Agency Spend: Agency spend has remained high since April, reflective of staffing pressures experienced due to vacancies and COVID-19, with spend this year totalling £3.5m. Of this, £0.3m is directly related to COVID-19. The draft plan indicated from NHS Improvement that the ceiling set for the Trust in 2020/21 was a reduced total of £5m (£6.1m last year), so against this target, the Trust has exceeded year to date.

Cost Improvement Programme: The programme for this year is £5.9m. At the end of August £2.0m of this remains unidentified, an in-month reduction of £300k. National guidance removed the efficiency expectation from block contract payments for at least the first four months of this financial year. However KMPT is continuing to work on productivity and efficiency initiatives where possible, and is progressing plans that were already under development in the draft submission

Single Oversight Framework: Due to changes in the financial architecture nationally, no risk ratings are being reported national for any trust. KMPT has therefore suspended its own reporting until Trusts are advised nationally which metrics they are to be measured against.

Capital programme: The capital programme spent £60k in August. The year to date performance is currently £0.5m ahead of the year to date plan, with a total spend of £1.5m. This is 7% of the overall programme for this year. The profile increases considerably in the latter months with initial delays due to the pandemic.

Cash: The new cash regime has resulted in the monthly block income being paid one month in advance. The Trust has therefore been holding an average of £30m cash in the bank since April. For cashflow purposes it is assumed that the Trust will not receive any block income in November to unwind this arrangement. Once guidance has been issued this will be amended.

The Board was updated that the Phase 3 planning guidance had been released by NHS England and there is a potential £5million deficit. As the Trust currently holds a potential £1million deficit, a £4million gap has been identified. The Board discussed how the £4million gap could be closed, by way of reviewing the workforce models to reduce agency staff. The Trust is currently serving notice on all employment agencies that are providing staff at rates above the cap. The Trust may need to buy in more resources to look different models of working, including a revisit of Golden Key. The Board noted the Finance Report for Month 5.

TB/20-21/87 Chief Operating Officer’s Report The Board received the Chief Operating Officer’s Report: The COO highlighted:

With a likely resurgence of Covid-19 into the autumn and over winter the



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Item Subject Action

COO is working closely with the local system and Executive colleagues in preparation for winter including: agile and digitally enabled Community Mental Health Teams; Flu vaccination campaign and provision of enhanced clinical response to prevent hospital admission to the acute general hospital sites. The Trust is already responding to the new restrictions imposed as a result of Covid-19.

The business case regarding the 24/7 Crisis Line is on the Commissioner’s priority list and the Trust will look to recruit to the team within the next four weeks.

The Board noted the Chief Operating Officer’s Report.

TB/20-21/88 Workforce Report The Board received the Workforce Report

The NHS national Plan “We are the NHS: People Plan 2020/21” was published in August. The Trust will review its own People Plan according to the revised National People Strategy and will present it to the Workforce and Organisational Development Committee in November;

KL has been appointed at the Trust’s NED Well-being Guardian.

The Vacancy rate is 15% against a target of 11.85%, with vacancy hotspots being nursing and medical staff in Acute Services and Older Adults;

Trust has a new cohort of 10 Trainee Nurse Associates and first group of 9 Registered Nurse Degree Apprenticeships. There is also a cohort of another 3 Occupational Therapist Degree Apprenticeships.

The August staff turnover rate is 10.2% against a target of 10.5%. Areas of high turnover are Older Adults and Acute Services. Activities are underway to reduce staff turnover.

The Trust is analysing the completed BAME Covid-19 risk assessments. 98.8% of those assessments have been completed.

Staff sickness rate is 4.1% compared to the target of 4.22%. Without Covid-19, the staff sickness rate is 3.83%. There are only 18 members of staff that are out of the business due to Covid-19.

The Board reflected on the Workforce Report. It was suggested the Trust should look into targeting recruitment campaigns to those who have left the military locally. HR will be providing support to members of staff who do not have allocated IT equipment so that the Staff Survey can be completed.

TB/20-21/89 Workforce and Organisational Development (WFODC) Committee Report The Board received and noted the content of the WFODC report.

TB/20-21/90 Quality Committee (QC) Report The Board received and noted the content of the QC report

TB/20-21/91 Integrated Audit and Risk Committee The Board received and noted the content of the IARC report.



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Item Subject Action

TB/20-21/92 Finance and Performance Committee (FPC) Report The Board received and noted the content of the FPC report.

TB/20-21/93 Board Assurance Framework The Board received the Board Assurance Framework, which was taken as read. The Board was informed that there was one new risk – rated moderate - which is related to the Risk ID 6485: Clinical Engagement for the Clinical Technology Strategy. It was suggested that Risk ID 5875 CHMTs Demand and Capacity (9 High) should be removed and replaced as the risk is not solely related to the CMHTs. The Board was informed that there needs to be continued development of services both adult and older adult over the next 12 months, which will be addressed through delivery of the community mental health framework. The recommendation was to close the risk and have a fully revised risk added. Any revised risks to Demand and Capacity should separate Older Adults and Younger Adults as each warrants its own risk rating. The Board approved the Board Assurance Framework.

TB/20-21/94 Any Other Business There was no Any Other Business.

TB/20-21/95 Questions from Public Due to members of the public viewing a one-way livestream of the meeting, there were no questions from the Public.

Date of Next Meeting The next meeting of the Board would be held on Friday 30th October 2020.

Signed ………………………………………………………….. (Chair)

Date ……………………………………………………………..



BOARD OF DIRECTORS ACTION LOG UPDATED AS AT: 22/10/2020

Key DUE IN

PROGRESS NOT DUE CLOSED

1 Action Log v2

Meeting Date

Minute Reference

Agenda Item Action Point Lead Date Revised Date Comments Status

ACTIONS DUE IN OCTOBER 2020

24/09/2020 TB/20-21/85 IQPR (Responsive)

HG and JMG to discuss performance improvement plan

with respect to the 4 week standard and 18 week

standard, with Board to be updated in October 2020.

HG & JMG

October 2020 Update for Board has been scheduled Complete

25/06/2020 TB/20-21/39

Patient Story – Simon Cook presentation re KMPT Black Lives Matter

Action: Chief Executive to update board on progress

towards becoming an anti racist organisation HG Oct 2020 Included within Chief Executive Report Complete

30/01/2020 TB/19-20/146 WFODC Report (FTSU activity profile and effectiveness)

CEO, SG and TS to allocate Board time for self-

assessment in relation to Freedom To Speak Up TS Mar 2020 October 2020 Self Assessment process is scheduled for October 2020

Complete

ACTIONS NOT DUE OR IN PROGRESS

24/09/2020 TB/20-21/82 Action Log & Matters arising (Recovery & Transform Work)

HG to share a table setting out which Committees have

oversight over which aspects of Recovery and Transform

programme. Table to be appended to the November

Chief Executive’s report.

HG November 2020 Not due

24/09/2020 TB/20-21/85 IQPR (Caring)

MM to include themed compliments within the Caring

domain in the IQPR by November 2020. MM November 2020

30/07/2020 TB/20-21/63

Chief Operating

Officer’s report

TS to arrange for George Matuska to present Overview

of Learning Disability and Autism position in Kent in

October 2020.

TS Oct 2020 November 2020 Not due

CLOSED AT LAST MEETING OR COMPLETED BETWEEN MEETINGS

25/06/2020 TB/20-21/44 Consideration of MoU – Kent Community Health Foundation

Action:

(1) AQ to liaise with the Community medical

AQ

Sept 2020

Update: AQ: To be presented at the Board

Action Log &

Matters A

rising

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BOARD OF DIRECTORS ACTION LOG UPDATED AS AT: 22/10/2020

Key DUE IN

PROGRESS NOT DUE CLOSED

2 Action Log v2

Meeting Date

Minute Reference

Agenda Item Action Point Lead Date Revised Date Comments Status

Trust & KMPT director in order to provide written examples of possible

joint working;

(2) TS to arrange a post-Board discussion to be

held in September or 2020 regarding partnerships.

Discussion to be led by JC and VB

TS Sept 2020 Seminar TS: Board Seminar regarding partnerships scheduled for 24th Sept

30/04/2020 TB/20-21/07

Trust Strategy

The Board agreed to have a development session to

discuss the plan and how to work with third parties. TS to

work with the Executive Management Team to arrange

that Board Development Session.

TS June 2020 September

2020 Update: TS: Board Seminar regarding partnerships scheduled for 24th Sept

30/07/2020 TB/20-21/76 Any Other Business

HG & TS to make available the news article regarding

the Trade Bill amendment being voted down into the

Diligent Reading Room. HG/TS Sept 2020 Uploaded on to Diligent

25/06/2020 TB/20-21/43

Chief Executive’s Report (regular update on recovery and transform work)

Action: JC, HG and VB2 to discuss as to how to present

the Recovery and Transform work regularly to Board in

terms of format and timing.

JC,HG, VB2

Sept 2020 Verbal update provided at Board

30/07/2020 TB/20-21/68

Finance Report

Month 3

HG to update Board in September 2020 regarding CCGs

and their fulfilment of their Mental Health Investment

Standard obligations.

HG Sept 2020 Verbal update provided at Board

Action Log &

Matters A

rising

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Front Sheet

Title of Meeting Trust Board meeting Date 29 October 2020

Title of Paper Chief Executive’s Report

Author Helen Greatorex, Chief Executive

Executive Director

Purpose: the paper is for: Delete as applicable

Information and Noting

Recommendation:

The Board is asked to note the content of the report.

Summary of Key Issues: No more than five bullet points

This is the Chief Executive’s thirty fifth report to the Board. Key Items include

Update on BAME

CCG Appointments

Reverse Mentoring

Maternal Mental Health Bid

Strategic Objectives: Select as applicable

☒ Consistently deliver an outstanding quality of care

☒ Recruit retain and develop the best staff making KMPT a great place to work

☒ Put continuous improvement at the heart of what we do

☒ Develop and extend our research and innovation work

☒ Maximise the use of digital technology

☒ Meet or exceed requirements set out in the Five Year Forward View

☒ Deliver financial balance and organisational sustainability

☒ Develop our core business and enter new markets through increased

Chief Executive’s Officer's Report


partnership working

☒ Ensure success of our system-wide sustainability plans through active

participation, partnership and leadership

Implications / Impact:

Patient Safety: N/A.

Identified Risks and Risk Management Action: N/A

Resource and Financial Implications: N/A

Legal/ Regulatory: N/A

Engagement and Consultation: N/A

Equality: N/A

Quality Impact Assessment Form Completed: Yes/ No

1. Introduction

Since the board’s last meeting at the end of September, a number of notable events both in

the Trust and beyond it, have taken place.

Perhaps the most significant is the upturn nationally in the number of cases of Covid 19 and

the impact that has had on the country as a whole. In KMPT, we had been prepared for such

an eventuality and the news that cases were rising, has further sharpened our resolve to

retain our strict adherence to the 2 metre rule, the use of face coverings in all inside spaces

and careful management of rotas and compliance with all government required measures.

Allied to this sustained vigilance has been the focus on vaccinating as many of us as

possible against seasonal influenza. Members of the board received their vaccination at the

last board meeting and since then, the rolling programme of staff vaccination has continued.

This month, the Care Quality Commission has published its consultation document and set

out the potential future of healthcare regulation. The new approach sees the end of the

traditional approach to Well Led and other CQC inspections, introducing instead, themed

reviews or risk based assessments informed by data and intelligence. We await further

information about what this will mean for KMPT’s planned Well Led inspection which had

been scheduled for March and then suspended due to the pandemic. Also this month, the

annual NHS Providers Conference took place virtually.



The experience of people (staff and patients) from a Black Asian and Minority Ethnic (BAME)

background was prominent, as was the theme of recovery and sustainability. Addresses by

the Secretary of State for Health and other keynote speakers will be made available to board

members in the Reading Room.

Finally, the Queen’s Birthday Honours List was published in early October. Included in the

honours list was our own, new Associate Non Executive Director Sean Bone-Knell, who was

awarded the prestigious Queen’s Fire Service Medal. The Board will want to formally record,

congratulations.

2. County Wide

Mental Health Improvement Board

The second meeting of the newly established Mental Health Improvement Board took place

in October. The November Board meeting will receive a detailed update on the work of the

Improvement Board, set against the Integrated Care System, Integrated Care Partnerships

and Primary Care Networks.

In the meantime, the Mental Health Improvement Board has agreed its Terms of Reference

and a set of priorities including delivery of The Long Term Plan for Mental Health.

Black And Minority Ethnic (BAME) County-wide Group Update

This group has now met three times and is preparing a paper that will be presented to each

of the six provider trusts across the county. The paper will seek from each of the six boards,

not only the endorsement of the group’s work but a commitment made in public, to

significantly change and improve each trust’s approach addressing BAME inequalities in all

forms, and to proactively identifying and addressing racism.

Our own, KMPT BAME network goes from strength to strength and has been at the heart of

celebrating and commemorating Black History Month. An update report on the progress we

have made since our BAME Chair, Simon Cook’s open letter to the board in July, will be

presented at the November Board meeting.

Clinical Commissioning Group Appointments Process

Over recent months, the process of dismantling eight Clinical Commissioning Groups

(CCGs) and forming one, strategic commissioner has continued. A significant number of

staff from the CCGs are directly and personally affected and the impact for them as

individuals, and for the organisations around them is hard to over- estimate. Senior KMPT

staff have continued to support the process, joining selection and interview panels as well as

offering informal support to colleagues. It is hoped that we are now nearing the end of this

disruptive and distracting phase of activity that will lead to a stable leadership and through

that, support the delivery of some extremely important areas of work.



3. In House

Reverse Mentoring

The Executive Management Team and their nine deputies will be embarking in November on

a new Reverse Mentoring programme. The programme will link each executive and deputy

with a junior BAME colleague to learn in particular about their experience of working in

KMPT. The aim of the programme is to understand and explore the challenges faced by

BAME staff at KMPT and the communities they are part of, share feedback and engage on

ways to further develop the organisation’s culture, equity and inclusivity.

The programme will be provided by TPC Health, who have run a successful programme for

the last 3 years for the London Ambulance Trust. We will be partnering with Maidstone and

Tunbridge Wells Trust, allowing us to both share the learning and enable our mentors to

receive training alongside other colleagues and support from both trusts’ BAME staff

networks.

Mentors will receive accredited training with the first pairings starting to work in January

2021.

Maternal Mental Health - Successful Bid

We heard in early October that our Specialist Mother and Infant Mental Health Service (MIMHS) is one of only two trusts nationally who have been successful in their application to become an early implementer for providing a new 'Maternal Mental Health' Service.

This service, which will initially be piloted in East Kent, will offer NICE recommended treatments for women who experience trauma resulting from their maternity experience; specifically birth trauma and birth loss.

This service will be provided in partnership between MIMHS and Specialist Midwives from East Kent University Hospital Foundation Trust.

Annual Staff Awards 3rd December 2020

Judging for this year’s annual celebration is underway and members of the board are fully involved in the preparation for what is set to be a positive and uplifting end to KMPT’s 2020.



Front Sheet

Title of Meeting Trust Board meeting Date 29 October 2020

Title of Paper KMPT / KCHFT : Memorandum of Understanding

Author Helen Greatorex, Chief Executive

Executive Director


Discussion and approval

Recommendation:

The Board is asked to confirm its agreement that a Memorandum of Understanding with Kent Community Health Foundation Trust (KCHFT) should be signed, in order to further strengthen joint working.


The Board considered at its June 2020 meeting, the potential benefits of establishing a Memorandum of Understanding (MoU) with KCHFT. It was agreed that further work would be undertaken by the respective Executive Medical Directors in order to establish the potential benefits after consideration of which the Board would revisit the decision to sign a MoU..

The September Board heard in detail, the three areas of focus suggested by the two respective Medical Directors and unanimously agreed their value. The three areas of focus were;

o Dementia o Neurodevelopmental pathways for adults o Physical health for learning disability and Serious Mental Illness

The Board is asked to formally commit to the signing of the MoU


☒ Consistently deliver an outstanding quality of care

☒ Recruit retain and develop the best staff making KMPT a great place to work

☒ Put continuous improvement at the heart of what we do

☒ Develop and extend our research and innovation work

KMPT-KCHFT Memorandum of Understanding


☒ Maximise the use of digital technology

☒ Meet or exceed requirements set out in the Five Year Forward View



partnership working

☒ Ensure success of our system-wide sustainability plans through active



Patient Safety: N/A.

Identified Risks and Risk Management Action: N/A

Resource and Financial Implications: N/A

Legal/ Regulatory: N/A

Engagement and Consultation: N/A

Equality: N/A


KMPT-KCHFT Memorandum of Understanding


Front sheet 03/2018

Front Sheet

Title of Meeting Public Trust Board Date 29th October 2020

Title of Paper Executive Assurance Committee Terms of Reference

Author Tony Saroy, Trust Secretary

Executive Director

Helen Greatorex, Chief Executive


Approval

Recommendation:

The Board is asked to approve the attached Terms of Reference for the Executive Assurance Committee.


At its meeting in July 2020, the Integrated Audit and Risk Committee (IARC) requested that the Executive Management Team consider adjustments to its Terms of Reference so as to allow business cases to be approved by the Business Care Review Group, which is a subordinate group that reports into the EAC.

An amended Terms of Reference for EAC, as attached, was approved by EAC on 7th October 2020.

Amendments include regularising the membership of EAC; inclusion of performance and IQPR matters as part of EAC’s Purpose; and formal delegation of business case approval to the Business Case Review Group with a reporting requirement by the Business Case Review group.

Report History:

Executive Assurance Committee


☐ Consistently deliver an outstanding quality of care

☐ Recruit retain and develop the best staff making KMPT a great place to work

☐ Put continuous improvement at the heart of what we do

☐ Develop and extend our research and innovation work

Executive Assurance Committee Terms of Reference


Front sheet 03/2018

☐ Maximise the use of digital technology

☐ Meet or exceed requirements set out in the Five Year Forward View



partnership working

☐ Ensure success of our system-wide sustainability plans through active



Patient Safety:

Identified Risks and Risk Management Action:

Resource and Financial Implications: The amended Terms of Reference allows for the governance journey for business cases to be unhindered.

Legal/ Regulatory: All committees are required to operate in accordance with the Trust’s Standing Orders and their Terms of Reference

Engagement and Consultation:

Equality:




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Terms of Reference – October 2020

Name of Committee Executive Assurance CommitteeDate 22nd October 2020Version V03

ApprovalEAC Date: 7th October 2020Trust Board Date: 29th October 2020

Next review due July 2021

Review - Document Control

1. ConstitutionThe Chief Executive constituted the Executive Assurance Committee as the vehicle by which the executive members of the Board supported by their direct reports and other senior colleagues exercise their collective authority to make arrangements and decisions on the ongoing operation of the Trust business. Their executive authority is delegated from the powers of the full Board and decisions made are subject to full Board scrutiny through being held to account for the resulting performance. The SOs and SFIs define the financial limits of executive authority and the business of EAC is brought to the Board by subject matter specific decisions or individual executives remit.

The Trust Board agreed the formation of EAC as part of its Board Business Framework in December 2016.

Version Status Date Author Summary of Changes

V01 Final 12.09.18Asst Trust Sec

Transferred onto new template with minor amendments approved by EAC.

V02 22.05.19Chief Executive

General overview of meeting

V02.1 21.06.19Chief Executive

Amendments to reflect EAC discussion 5.06.19

V03 Final 13.07.20Chief Executive

Revised frequency of meetings reflected

V03.1 Draft 07.10.20Trust Secretary

Delegated authority to Business CaseReview Group to approve business cases, amendment to Membership and amendment to Purpose to include performance matters & IQPR.



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2. Purpose

The Executive Assurance Committee (EAC) is the key point of progress and assurance testing for the executive.

It is designed to ensure that agreed work is delivering as expected, to identify and remedy exceptions and ensure a clear line of sight from the executive to risk of all types.

The remit of the Committee will include but not be limited to decisions relating to and monitoring of:

∑ Trust-wide Strategies (prior to Board Committee or Trust Board approval)∑ Service and Operational Business Cases∑ Annual Operational Plan∑ Board Assurance Framework (BAF): contents, rating, mitigation∑ Trust Risk Register (TRR)∑ Integrated Quality and Performance Report (IQPR)∑ Performance matters

∑ Finance Report∑ Workforce Report∑ Cost Improvement Programme (CIP): progress, problems, and resolutions.∑ Internal Audit Reports and the Annual Audit Programme.∑ CQUIN∑ Care Pathways Change Programme∑ Care Quality Commission (CQC) preparation, gaps and actions.∑ Learning from Serious Incidents, external reports and the embeddedness of

required changes.

3. Aims

To ensure communication of Board decisions and directions, priorities and strategic intent.

The Committee will seek to gain consensus and approval from the members on matters put before them prior to submission to the Board for approval where necessary.

4. Objectives

To ensure a clear line of sight on all workstreams, taking remedial action as required line of sight on all workstreams, taking remedial action as required.

5. Membership

The meeting will be chaired by the Chief Executive or Deputy Chief Executive

Membership will consist of core members, regular attendees and those invited to attend



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according to substance of agenda items

EAC will have a core membership of

Chief Executive (Chair)Deputy CEO/Director of Partnerships and StrategyChief Operating OfficerDirector of WF and CommsExecutive Director of FinanceExecutive Medical DirectorExecutive Director of Nursing and QualityDeputy Director of FinanceDeputy COOsDeputy Medical Director (operations)Assistant Director Acute Care GroupHead of Service, Forensic Care GroupHead of Service CRCGHead of Service OACGDirector of Performance and ContractingDeputy Director of FinanceDeputy Director of Workforce and ODAMD (FSCG) AMD (ACG)AMD Older AdultsAMD CRCGAssistant Director of Communications

It is anticipated that other attendees will be invited to join the meeting for specific items.

∑ Director of Capital Planning and Estates∑ Director of ICT∑ Chief Pharmacist∑ Head of Psychological Practice∑ Trust Professional Lead for Allied Health Professionals∑ Deputy Director of Safety and Quality∑ Assistant Director of Transformation

Deputies for Core members will be accepted at the meeting with prior agreement of the chair.

The committee will meet bi-monthly for two hours. Meetings will be programmed to ensure that discussions and agreed actions can be used to inform Board papers

6. Quorum

A quorum shall be a minimum of 6 members including 2 executive directors one of which must be CEO or Deputy CEO.



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7. Methodology (Duties, Reporting, Annual Workplan,)

A summary of items discussed and actions agreed, will be presented to board meetings (via the CEO Report). Formal minutes of the meetings will be made available to all board members on Diligent.

Executive Board members will share key messages from the Trust Board.

Each meeting will agree key messages to be shared across the Trust and a standardised template and timing for this will be agreed.

Those in regular attendance shall also receive a full copy of the meeting pack.

An annual work plan will be produced covering the following categories:

∑ Horizon (external) scanning, strategy & communications∑ Quality∑ Finance, performance & operations∑ Workforce & leadership∑ Governance & risk

The work plan will be aligned to Trust Strategic objectives and priorities

8. Accountability and Reporting – Group Structure

Full Governance Structure is available on i-connect

9. Committee rules and administration arrangements

The Executive Assurance Committee will be supported administratively via Trust Secretariat Team in respect of:

∑ Agreement of agenda with Chair, and collation of papers∑ Taking the minutes and keeping a record of matters arising and issues to be

carried forward



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∑ Arrangements with additional attendees∑ Reporting relevant matters and response to and from the relevant Board and

sub committees.∑ Drafting of section for Chief Exec Report to Trust Board

Meetings shall be held every other month. The Chair may request additional meetings if they consider it necessary.

The Business Case Review Group (BCRG) has the delegated authority to approve business cases on behalf of EAC. BCRG will provide a report to EAC after each meeting regarding any business cases that have been approved.

If needed, meetings by conference telephone call and/or video conference are acceptable with the approval of the Committee Chair.

10.Accountability and Reporting Arrangements (Annual Effectiveness Report)

The Committee is accountable to the Trust Board via its Executive members.

The minutes of Committee meetings shall be formally recorded and made available to the Board.

The Committee will provide an annual report to the Trust Board.

11.Review and Monitoring

The Executive Assurance Committee will undertake and evidence a review of its performance against its purpose in order to evaluate its effectiveness, the fulfilment of its functions in connection with these terms of reference and achievement of its duties annually.

These Terms of Reference will be reviewed annually or sooner if required and recommendations made to the Trust Board for approval.



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