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Chief Executive’s Report
Produced by: John Pelly, Chief Executive
Trust Board 30 April 2015
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MOORFIELDS EYE HOSPITAL NHS FOUNDATION TRUST BOARD MEETING – 30 April 2015
Chief Executive’s Report
1. Matters considered by the Trust Management Board (TMB)
TMB has met once since my last report to the Trust Board. The key items discussed at March’s TMB, not including the routine performance reports, are set out below:
a. Review of urgent care and A&E: TMB is considering the Trust-wide model for the provision of urgent care, including a review of City Road’s A&E services. At this stage considerations remain high level. The Board will receive a briefing about this in due course.
b. City Road theatres refurbishment: Mary Sherry reported that the refurbishment of the first pair of theatres had commenced as planned at the beginning of March and was proceeding well and largely to time. Planning had commenced for the
refurbishment of the second pair of theatres. Use of the theatres at the Whittington Hospital for cataract surgery had commenced on time and the team were now working to ensure full utilisation of the theatre lists.
c. Financial planning for 2015/16
TMB discussed in some detail the financial pressures and risks for 2015/16 and noted that more substantial and focussed effort was required across the organisation to identify and implement savings schemes. TMB will be returning to this at its April meeting.
d. Statutory Duty of Candour (DoC) and Being Open policy
Julie Nott, head of risk and safety, and Melanie Hingorani, clinical director for quality and safety, gave a report about how the Trust is meeting the requirements of the DoC through its Being Open policy. Ian Tombleson has written a short briefing in section three of my report which explains this in more detail.
e. Refractive surgery policy and protocol
TMB ratified the policy and procedure that sets out the eligibility criteria, methods for training and the requirements for commencing refractive surgery at Moorfields. 2. Matters considered by the Management Executive (ME)
Three meetings of ME have taken place since my last report to the Board, one meeting having been cancelled due to the Easter break. The main matters discussed are set out below:
a. Transfer of ocular oncology services from Barts Health NHS Trust to Moorfields:
I explained the background and status of this transfer in my last report to the Board. Since then, additional outpatient services have commenced at Moorfields (from 1 April). ME discussed the preparation of a business case for the full transfer of the service which is being considered at April’s TMB - I expect the business case to come to May’s Trust Board.
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b. Quality report/account objectives for 2015/16: ME considered the key quality and safety objectives that form part of the quality report/account for 2015/16. The quality report/account will also be considered at April’s TMB and the Quality and Safety Committee.
c. RTT 18 performance: An update about RTT 18 forms an item on April’s Trust Board
agenda.
d. Outcomes of the KPMG OpenEyes healthcheck and IT programme review: Owen
Brady summarised the purpose and background of the reviews and the key points they had made to assist management’s considerations.
e. Production of the 2014/15 Annual Report: ME agreed a plan for the production of
the 2014/15 Annual Report.
f. Development of the key deliverables and milestones for the corporate priorities
2015/16: ME agreed the draft deliverables and milestones supporting the agreed corporate priorities for 2015/16, and this forms an item on April’s Trust Board agenda.
g. Safeguarding adults training: Members ofME received their safeguarding adults training from Edwina Curtis, the Trust’s safeguarding adults lead. In due course the Trust Board will receive a similar training session that Tracy Luckett will arrange.
h. False or misleading information offence guidance: Ian Tombleson briefed ME
about the requirements of the Care Act 2014 which, from 1 April 2015, creates a new criminal offence applicable to care providers that supply, publish or otherwise make available certain types of information. If that information is deemed false or misleading, organisations and (potentially) senior individuals may be regarded as having
committed an offence and action may be taken. I have asked Ian to provide an organisational briefing about the practical implications of this guidance for staff.
i. European Structural and Investment Fund support: Steve Davies briefed ME about
the new round of ESIF support and how it might be accessed. Potential opportunities may be available in a number of areas, which ME will explore further.
j. Project Oriel: John Pelly briefed ME on progress with the search for a new site for Moorfields and the Institute.
k. Visibility of senior leaders: ME discussed a plan to make senior leaders more visible and accessible within the organisation on a regular basis. This follows analysis of the outputs of the Moorfields Way project, which suggested that senior managers are not sufficiently visible at present. A separate plan to transfer the executive team’s offices from Ebenezer St to the main building is also being developed.
l. Review of legal support for the organisation: Charles Nall presented a paper explaining that, due to the growth in scale and complexity of the organisation over the past few years, the costs of legal advice had grown substantially. In addition, our part time in-house lawyer would be retiring before long. Further consideration of the options open to the Trust will take place, following which a paper will be brought to the Board.
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m. Monitor research programme: ME agreed to sign up for a new Monitor research
programme which is focussed on optimising elective surgical care models and will take place over the summer. Declan Flanagan and Steve Davies will lead this work.
3. Other matters of note
a. CQC draft updated intelligent monitoring tool: Trusts have received the latest version of the CQC’s intelligent monitoring tool. I will ask Ian and Tracy to update the Board about this.
b. Statutory Duty of Candour (DoC) and Being Open policy: A contractual DoC was
introduced from 1 April 2013 in response to recommendation 181 of the Francis inquiry report. The aim of the DoC was, and remains, to ensure that health service bodies are open and transparent when certain incidents occur in relation to the care and
treatment patients receive. This DoC was included in the Trust’s incident policy and subsequently the Trust’s Being Open policy in October 2014, which at the time was compliant with the statutory DoC that was due to come into force from 1 October 2014. The timetable and content of the draft regulations have, however, changed and a statutory DoC was introduced from 27 November 2014, including supporting regulations. It has taken time for lawyers and trusts to understand the practical implications of the duty. The aims of the regulations remain similar to the original contractual DoC, however the specifics have become more detailed. The DoC applies to all incidents that are graded as moderate and above, and these are termed
‘notifiable safety incidents’. Failure to comply with the requirements could result in fines from the CCG and the area will be covered as part of the forthcoming CQC inspection.
In summary the requirements are that the Trust:
Acts in an open and transparent way.
Tells patients as soon as practicable after becoming aware that a notifiable safety incident has occurred and provides support as necessary.
Provides a factual account of the incident.
Advises patients of any further steps necessary to investigate an incident.
Offers an apology.
Writes to patients summarising all the available information.
Keeps a written record of all communications.
Reports the incident on the electronic incident reporting system.
Audit data and reviews of completed Serious Incidents indicate poor compliance with the requirements. TMB considered the DoC and the need to be open in some detail at its April meeting and agreed an updated version of the ‘Being Open and Duty of
Candour’ policy based on the new requirements. In addition the following actions were agreed:
TMB emphasized the need for staff to comply with the requirements of the DoC and this would be reinforced further in trust communications.
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Julie Nott will continue to provide more clinical examples of how the DoC applies, particularly where moderate harm has occurred which is sometimes harder to define.
Sally Storey’s team will explore ways of providing on-line tools to support better understanding of the requirements.
The quality team will perform regular audits to test compliance in this important area.
4. Senior appointments and departures
An update on the recent consultant appointment process in Dubai will be provided at the Board meeting.
Chief Information Officer interviews took place on 22 April and I will report the outcome of these at the Board meeting.
John Pelly Chief Executive
