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Chairman's Bulletin February 2016

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I'd like to begin by thanking all of you who attended our Forward Planning Workshop at the end of January.  It was a very positive and wide-ranging session with plenty of suggestions from Governors, which are contributing to the finalised operational plan for 2016/17 and Quality Report 2015/16.  There will be an update on progress of both the plan and report at the Council of Governors meeting on 2nd March.

As outlined at the workshop, the new forward planning survey was positively received by participants and proved very useful in identifying the key priorities of our members (public and staff) and the public.  As part of this feedback, we also received a range of suggestions to improve our services further, which have been passed on to the relevant teams.

Members' views are important to us, and my thanks go to the Governors who held a second staff member engagement session this week.

Governors who attended the recent Governors' Performance Review meeting provided valuable suggestions and comments on a range of topics. Executive Director of Finance Adrian Roberts gave a detailed presentation about CMFT's financial position (more below), and the steps being taken to reduce costs and increase productivity.  Updates were also given on CPE (Carbapenemase-Producing Enterobacteriaceae) by Andy Dodgson and Julie Cawthorne from the Infection Prevention and Control team, and on Diabetes/Endocrinology Services by Chief Operating Officer Julia Bridgewater.

Each year, we hold a public member recruitment campaign to replace those members lost due to natural attrition as well as addressing any resultant membership profile short-falls.  The 2016 campaign was launched on 15th February and runs for three weeks, with recruiters being based at the Central and Trafford sites as well as key community venues.  I'd like to urge Governors to support this campaign by using their own networks and local community groups to attract new members.  People can use our online application form or contact the Membership Office for paper membership forms.

On the subject of engagement and consultation, can I encourage all Governors to complete the annual Governor questionnaire sent to you recently.  It's an essential tool in planning future Governor development, and helps Governors to self-evaluate their collective performance and effectiveness.  The findings are also used to inform the annual Chairman and Non-Executive Director performance review processes.  Please return completed questionnaires to Donna Beddows by Friday 4th March.

Turning to the national picture, as you know the NHS is experiencing a challenging financial environment. Foundation Trusts across England are recording significant deficits this financial year, including many of our university hospital peers. CMFT has not been immune to this - over the autumn and winter our costs have been exceeding our income, which is unsustainable. The reasons for this include the costs involved in safely managing CPE infection across our hospitals; the increasing number of patients requiring urgent care; the excess costs involved in using agency staff to cover medical and nursing vacancies; and the under-delivery of productivity improvements to our clinical services. (More details about all these costs are in this Board paper).

Therefore the Board have adopted an internal turnaround approach, which will mean greater challenge and scrutiny of all our spending. The Board have put in place a number of immediate schemes and processes to help reduce costs and increase income, with a range of other efficiencies and improvements commencing through February and March. All staff will need to make rapid improvements in every area of the Trust, so that we can stay in control of our strategic choices and continue to make investments not only in our hospitals and services, but also in the future provision of care for the people of Greater Manchester. If we continue to all work together and focus on providing the best possible patient care in the most efficient way, then I'm certain that we can turn this challenging position around. Further progress updates on this important issue will be provided at the Council of Governors meeting on 2nd March.

Following my previous briefing about the Manchester Locality Plan, I would like to focus this month on the equivalent plans in Trafford.  The main feature of the Trafford Locality Plan is the commitment to develop the Trafford Care Coordination Centre (TCCC). Commissioned by Trafford Clinical Commissioning Group (CCG), the TCCC aims to coordinate the health and social care services provided to Trafford residents, making them more effective, improving user experience and providing information for further service redesign and development. We are working with Trafford CCG and the organisation they have commissioned to provide the TCCC function (Computer Science Corporation - CSC) to develop effective information systems and data flows to support the initiative.

In addition to TCCC, the Trafford Locality Plan gives commitments to establish:

  • seven-day working for primary care and an increased role for local pharmacies;
  • an all-age integrated health and social care service delivery model for community based services based in four localities;
  • greater independence for service users by calling upon community assets and individual resources before committing public service resources;
  • improved quality, access and range of support services for people with learning disabilities, autism and mental health needs, to support personal resilience;
  • more effective use of resources by pooling health and social care budgets.

The Trust and the CCG are also working together to look at how urgent care services are provided in Trafford. There are two services in close proximity on the Trafford General site - the Urgent Care Centre (UCC) that the Trust runs, and a GP Walk In Centre (WIC) that the CCG commissions.

The UCC is staffed with specialist doctors and highly-trained nurses and operates from 8.00 am till midnight.  Patients that use the service report a positive experience, but very few of these patients need the skills of a specialist Emergency Care doctor, and later in the evening the numbers attending drop to about two patients per hour. Further data is being collected and analysed, and discussions are on-going with the clinical teams to understand the needs of patients using these services, and to consider how best to provide the clinical care they require.

When this work had just commenced, there was some negative media coverage. It would have been possible to conclude from some of the commentary that the Trust and the CCG intend to close the Trafford UCC, and I want to emphasise to Governors that this is absolutely not the case. The work is still at an early stage, and there are no proposals yet. The outcome from the data-gathering and analysis exercise will be shared with key partners, including Trafford Governors, and there will be ample opportunity to comment before any decisions are made.

Although we face tough challenges in the year ahead, I do want to reflect on the outstanding contribution of our staff and highlight some areas in which CMFT is leading the way.  Congratulations to Executive Director of HR Margot Johnson and her team, named by the NHS Improvement Agency as one of three pilot sites to develop and test practical tools that will help create a good leadership culture, not only within CMFT but across the NHS.  Well done to Royal Manchester Children's Hospital (RMCH) and Manchester Royal Infirmary (MRI), which have been chosen by the Royal College of Physicians to help develop its national Future Hospital Programme in relation to allergy referrals and respiratory care services.  Rheumatology teams from RMCH and MRI also won a Pharmaceutical Marketing Excellence Award (PMEA) for their work to improve the transition of adolescent rheumatology patients to adult services.

Finally, I'd like to encourage as many Governors as possible to attend the Council of Governors' Meeting on 2nd March.  This is a key meeting which will have a number of significant items on the agenda, including strategic and financial updates as well as the progress of our annual plan and quality report. In the meantime, if you have any questions about any of the topics I've mentioned in this bulletin please get in touch on 0161 276 8661 or email me at steve.mycio@cmft.nhs.uk.