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v Trust Board Summary: 29 March 2023

A summary of discussions that took place during the Board meeting held on Wednesday 29 March 2023.

Item Lead  




Patient Story Chief Nurse ‘David’s Story’ available here

The story of David, told by his wife Katie, following an admission with a stroke. Following an inpatient transfer from Wycombe Hospital to Oxford University Hospital, David suffered a seizure as a result of not being administered his anti-seizure medication. The actions put in place by the clinical teams at Wycombe Hospital were outlined to ensure better communication of current medication in future transfers of care. These included a transfer checklist and changes to junior doctor induction.

The Board noted the importance of understanding where things do not go well and how they are able to support improvement actions.

The benefits of complaints review processes were acknowledged as well as future plans for an EPR and e-prescribing. The Board discussed the benefits of a discharge follow up call.

David, Katie and their family were thanked for their willingness to share their experiences.

Chief Executive Report Chief Executive Officer An update on key developments during February 2023 both nationally and locally, in line with the Trust strategic priorities.

The Place Based Growth Board and governance structure was highlighted as the vehicle for ground breaking work planned across the local community with our local, external, partners.

The recent pay increase letter was discussed and the mechanism by which colleagues within PFI partner companies were being supported through the cost of living crisis.

The Board acknowledged and commended the work of colleagues Trust wide both ahead of and during recent industrial action. Lessons learned would now be considered for future industrial action planned.

CARE award winners were congratulated, noting the plan for these individuals to attend Board in future months.




Committee Chair Reports Committee Chairs Update from the Non-Executive Director Chairs from March Board Committee meetings. These include a summary of key items discussed with escalation to Board as appropriate:

–        Audit Committee – the Committee had focussed on the pending internal audit opinion and the lack of external auditors for the Trust. The Board were informed a potential external auditor had been found to conduct the 2022-23 audit slightly later than usual.

The Board approved the Audit Committee Terms of Reference (ToR).

–        Finance & Business Performance Committee – teams were commended on the improvements in 78-week wait position; congratulations offered to all teams and the revised IPR to reflect breakthrough objectives and business priorities was awaited by the Committee.

–        Quality & Clinical Governance Committee – risks related to an increase in falls and pressure ulcers and the processing of DoLs applications were escalated to the Board noting the mitigations that were being/had been put in place.

–        Strategic People Committee – risks related to key areas of the staff survey were escalated to Board and discussed further in the Staff Survey item.




Integrated Performance Report (IPR) Chief Operating Officer Monthly reporting on Trust performance metrics and progress with actions/progress with actions to address negative variance. Reporting defined by NHS System Oversight Framework, BHT Strategic Priorities and the 2022/23 Operating Plan.

Focussed discussions took place related to delays in diagnostics, alternatives to the postal service for patient letters and delays in the current pathway, numbers of Medically Optimised for Discharge (MOfD) patients and impact on colleague workload and Referral-to-Treatment (RTT) benchmarking and the need to focus on not just the longest of waiters.

The reduction in vacancy rates was noted against the international shortage of healthcare workers and a need to focus on and track retention all across colleague groups including the conversation rate of junior doctors to consultants.

Monthly Finance Report Chief Finance Officer Update on financial position at M11 including year to date (YTD) headline position, divisional forecasts and capital, balance sheet and cash flow analysis.

The Board were informed the Trust was reporting a £13.0m deficit; £0.1m favourable to the agreed £14.3m deficit plan for 2022-23. The capital spend was also reported to be in line with the budgeted plan.

Ongoing issues were highlighted with agency spend and further review and discussion were required on cost control and expenditure and adverse variances following the pandemic.

BHT Operating Plan 2023-24 Chief Digital Information Officer Overview of the medium-tern strategic goals and Trust wide areas of focus for 2023-24.

The Board welcomed the streamlined set of core objectives underpinned by clear transformational programmes and milestones to support a clear focus and high impact change.

Significant financial challenges for 2023-24 were highlighted including year end deficit plan and capital requirements.

GPVTS Approval Chief People Officer Approval requested to raise a Purchase Order (PO) for trainees for 2023-24 as part of the GP Vocational Training Scheme (GPVTS).

The Board noted the reduction in number of trainees.

Staff Survey Chief People Officer Overview of the National Staff Survey results following the 2022 survey. The Board recognised the increased engagement and positive wellbeing scores alongside the worsening reports on verbal and aggression toward colleagues from patients and the public, experiences more broadly by BME colleagues and rates of recommendation of the Trust as a place to receive treatment.

Focussed discussions took place related to productivity metrics related to colleague wellbeing, further actions to support colleagues and a reduction in violence and aggression and a need to understand the detail of responses from colleagues within the medical and dental group, those who had indicated they were considering leaving in the next 12 months and those feeling unable to speak up.

Wycombe Strategic Plan Chief Commercial Officer Request for Board approval to commence a Wycombe Tower decant plan and redevelop the site to provide modern healthcare facilities over the next five years.

The Board discussed capital requirements broadly for the Trust as well as specifically related to the decant of the Wycombe Tower. The Board acknowledged the importance of colleague engagement and working with external partners as well as the complexities of this piece of work and focussed EPRR support so far.

Organisational Risk Trust Board Business Manager Overview of current risk in the organisation, considering both strategic and operational risks (through the Board Assurance Framework and Corporate Risk Register respectively), mapped against the Board’s appetite for risk for each of the strategic objectives. Assured
FPPR Compliance Chief People Officer The Fit and Proper Person Regulation (FPPR) requires the Trust to ensure that all directors are fit to undertake the responsibilities of their role.

The Board were informed Trust processes were in line with recommendations and all current Board members were compliant with the regulation.

Private Board Summary Report Trust Board Business Manager Summary of matters discussed at the Trust Board meeting in private in February 2023 Noted


To read more on the Staff Survey please use the following links:

Benchmark Report

Breakdown Report