Minutes from the Public Council of Governors Meeting – 7 November 2024
Minutes for the Public Council of Governors’ Meeting 7 November 2024 at 1pm
Held via Microsoft Teams
Attendance
Governors
| Name | Role | Apologies |
| Les France | Public Governor | Attended |
| Matthew Knight | Public Governor | Attended |
| Nicola Lister | Public Governor | Attended |
| Dr Ivan Nip | Public Governor | Attended |
| Oliver Beckett | Public Governor | Attended |
| Miranda Arieh | Public Governor | Attended |
| Madhulika Singh | Public Governor | Attended |
| Becky Oxley | Service User Governor | Sent apologies |
| Carole Myers | Service User Governor | Sent apologies |
| Jon Salway | Carer Governor | Attended |
| Peter Ongley | Carer Governor | Attended |
| Nicola Binns | Staff Governor | Attended |
| Dr Gail Harrison | Staff Governor | Attended |
| Amy Pratt | Staff Governor | Attended |
| Adam Redhead | Staff Governor | Attended |
| Anne Toone | Staff Governor | Attended |
| Ian Andrews | Staff Governor | Attended |
| Tessa Denham | Appointed Governor | Attended |
| Gabriella Obeng Nyarko | Appointed Governor | Attended |
| Cllr Fiona Venner | Appointed Governor | Attended |
| Cllr Ian Cuthbertson | Appointed Governor | Attended |
Board members
| Name | Role | Apologies |
| Merran McRae | Chair of the Trust | Attended |
| Zoe Burns Shore | Non-Executive Director | Attended |
| Joanna Forster Adams | Chief Operating Officer | Attended |
| Dawn Hanwell | Chief Financial Officer and Deputy Chief Executive | Attended |
| Cleveland Henry | Non-Executive Director (Senior Independent Director) | Attended |
| Dr Frances Healey | Non-Executive Director | Sent apologies |
| Dr Chris Hosker | Medical Director | Attended |
| Kaneez Khan | Non-Executive Director | Attended |
| Dr Sara Munro | Chief Executive | Attended |
| Darren Skinner | Director of People and Organisational Development | Sent apologies |
| Nichola Sanderson | Director of Nursing and Professions | Attended |
| Katy Wilburn | Non-Executive Director | Sent apologies |
| Martin Wright | Non-Executive Director (Deputy Chair of the Trust) | Attended |
Also in attendance
-
- Kieran Betts – Corporate Governance Officer
- Rose Cooper, Deputy Head of Corporate Governance
- Bill Cunliffe, The Value Circle (observing the meeting)
- Clare Edwards, Associate Director for Corporate Governance
- Josef Faulkner, Head of Operations – Forensic Services
- Dan Hunt, Matron, York Forensic Inpatient Service (for agenda item 4)
- Alison Kenyon, Deputy Director of Service Development
- Kerry McMann, Head of Corporate Governance / Deputy Trust Board Secretary
- Tim Richardson, Interim Deputy Director Children and Young People’s Services (for agenda item 4)
- Vicky Search, Clinical Operations Manager – Community Forensic Services (for agenda item 4)
- Holly Tetley, Associate Director of Employment (deputising for Darren Skinner)
- Dominic Wells, Senior Forensic Psychologist (for agenda item 4)
Minutes
24/058 – Welcome and introductions
Merran McRae opened the meeting at 1pm and welcomed everyone. Merran introduced Bill Cunliffe from The Value Circle and explained that he was observing the meeting as part of the Trust’s Independent Well Led Review.
24/059 – Apologies for absence (agenda item 2)
Apologies were noted from the following governors: Carole Myers (Service User Governor) and Becky Oxley (Service User Governor).
Apologies were received from Darren Skinner, Director of People and Organisational Development. It was noted that Holly Tetley was in attendance to deputise for Darren Skinner. Apologies had also been received from the following Non-executive Directors: Dr Frances Healey and Katy Wilburn.
The meeting was not quorate. The Council noted that, due to this meeting not being quorate, any decisions made would need to be emailed out to governors for endorsement.
24/060 – Changes to any declarations of interest and declaration of any conflicts of interest in respect of agenda items (agenda item 3)
Cllr Fiona Venner informed the Council that her job title had changed to Executive Board Member for Equality, Health and Wellbeing. The Corporate Governance Team noted this and agreed to update the register of interests. The Council noted the update provided.
24/061 – Sharing Stories: The Trust’s York services (agenda item 4)
Firstly, the Council received a presentation on the York Forensic Service based at Clifton House from Dan Hunt, Vicky Search and Dominic Wells. The presentation provided a brief history of Clifton House, the current provision of the service and the psychological work offered, and an overview of the achievements and challenges. The Council then received a presentation on the York-based Children and Young People’s (CYP) services which included the CYP Mental Health Inpatient Service at Mill Lodge and the Deaf Child and Adolescent Mental Health Service (CAMHS). Tim Richardson provided an overview of the history of the two services and how they function today.
The Council then discussed the information provided. Matthew Knight asked about the demand for inpatient forensic services and if Clifton House had the required resources to cope with this, noting that the service worked within a different provider collaborative and Integrated Care Board (ICB) system compared to the majority of the Trust. The Council heard how Clifton House functioned as the low-secure provider for assessment and treatment as part of the Humber and North Yorkshire Provider Collaborative and was the only provider in the patch delivering women’s forensic services and heard how this affected demand.
The Council then asked how the services experienced being situated in York and if being geographically separate from Leeds-based services caused any operational issues. The Council heard about some of the challenges linked to Clifton House being a standalone service and how these were managed. Tim Richardson explained that Mill Lodge was key to the CYP Mental Health Provider Collaborative in Humber and North Yorkshire but also worked closely with Red Kite View in the West Yorkshire Provider Collaborative. He went on to provide some reassurance to the Council about the developments that had taken place since the service had moved to the standalone site at Mill Lodge.
Joanna Forster Adams then provided some reassurance to the Council on the importance of the connection between the York-based services and their counterparts in Leeds. She also explained how both the York services functioned as part of provider collaboratives which had wider regional footprints and outlined the benefits and challenges associated with this, noting that requests for mutual aid would also be directed to partners within each provider collaborative if required. In addition to this, she highlighted the development of an eating disorders day service at Mill Lodge as an excellent example of working in partnership with provider collaborative colleagues. However, she went on to acknowledge some of the operational challenges experienced by the York services including the pressures linked to staffing and the cost of living in York which had caused some issues in terms of recruiting staff in those areas. In summary, she recognised the challenges but also highlighted the flexible and partnership ways of working which were present in the York services and key to the services functioning as part of the Trust and the wider provider collaboratives.
The Council received the presentations on the Trust’s services based in York and thanked the teams for the information provided.
24/062 – Minutes of the public Council of Governors’ meeting held on the 2 July 2024 (agenda item 5.1)
The minutes of the public Council of Governors’ meeting held on the 2 July 2024 were approved as a true record.
24/063 – Minutes of the Annual Members’ Meeting held on the 30 July 2024 – for information (agenda item 5.2)
The minutes of the Annual Members’ Meeting held on the 30 July 2024 were received for information.
24/064 – Matters arising (agenda item 6)
The Council agreed that there were no matters arising that were not either on the agenda or on the action log.
24/065 – Questions from members of the public for the Council of Governors (agenda item 6.1)
The Council did not receive any questions from members of the public.
24/066 – Cumulative Action Log – actions outstanding from previous public meetings (agenda item 7)
Cllr Venner referred to action log number 24/009 which was a request from the 2024 Annual Members’ Meeting that consideration was given as to whether the Trust would recognise “care experienced” as a protected characteristic at a future Council of Governors’ meeting. She noted that no timeframe had been provided for when this would be discussed, and it was agreed by the Council that this would come back to the February 2025 meeting for consideration. Cllr Venner then offered to contact the person who had started the campaign to recognise “care experienced” as a protected characteristic to ask if they knew of any other trusts that had implemented this approach and if there was any learning that could be shared. Merran thanked Cllr Venner for this offer.
The Council noted that Les France would provide an update on action log number 24/052 as part of his Lead Governor Report later on the agenda.
Tessa Denham noted the response provided for action log number 24/051 and asked what competencies the Trust used to assess for trauma informed practice training as a development need. Nichola Sanderson responded that trauma awareness formed part of the Trust’s standard of care and compassion and in addition to this there were competency standards for Band 5 and Band 6 nurses relating to trauma informed practice. She also informed the Council that the Trust’s psychology department was leading on a longer-term piece of work to deliver trauma informed training throughout the organisation. The Council noted the update provided
The Council received the cumulative action log, noted the updates provided, and agreed the actions reported as complete.
Dawn Hanwell and Amy Pratt joined the meeting.
24/067 – Volunteering in Inpatient Services (agenda item 8)
The Council received an update on the role of volunteers within inpatient services and an overview of the next steps for the development of volunteers within the Trust. Alison Kenyon summarised the main points in the paper, referencing the work of the Care Services Strategic Plan and the launch of NHS England’s Inpatient Culture of Care initiative both of which would provide opportunities to increase the number of volunteers within inpatient services. She added that work was ongoing to ensure there was the appropriate infrastructure in place to support a growing number of volunteers in the Trust. The Council then discussed some of the reasons why people with lived experience may want to volunteer in the organisation which for some could be a step back into employment and heard about the different ways that the Trust involved people with lived experience.
Anne Toone asked if the Trust had encountered any barriers to volunteering and how these were overcome. Alison explained the integral role that Christine Heath, Voluntary Services Manager, and the Voluntary Services Team had in developing the infrastructure to enable people to volunteer in the Trust which included an induction programme as well as ongoing support. She also explained that the team worked with HR and other colleagues to ensure there were robust processes in place to support both the volunteers and the services where they are placed. Madhulika Singh asked if there was any provision to link with universities in order to give students the opportunity to volunteer in an NHS setting to build up their skills before applying for jobs upon graduation. Alison confirmed that the Trust regularly linked with universities in the area and attended university fairs to talk about volunteering opportunities. Alison then drew the Council’s attention to the update that 28 new Leeds University sports volunteers would be starting with the Trust across sites in Leeds and York in the coming months.
Merran noted that when the Voluntary Services Team had presented at the Council meeting in November 2023, some staff governors had commented that not all staff were aware that volunteers were available to inpatient services. She then asked that part of this work continued to be raising the profile of the Voluntary Services Team and what they can offer.
The Council noted the update provided.
24/069 – Report from the Chair of the Trust (agenda item 9)
Merran McRae presented her report and highlighted the key points. The Council noted that, since its last meeting, Helen Pyne had stepped down as a public governor, Leila Abadi-Bulmer had stepped down as a carer governor, and Joseph Riach had stepped down as a service user governor.
The Council noted the report from the Chair of the Trust.
24/069 – Report from the Chief Executive (agenda item 10)
Dr Sara Munro presented her report and summarised the key points for the Council to note. She referenced the Trust’s Independent Well Led Review and noted that once the final version of the report and recommendations had been received then an update would be brought to a future Council meeting. She also noted that the Trust’s Five-Year Strategy was now in the final stages of completion and included consideration of the feedback provided by governors at its recent meetings. She added that the next step would be to look at providing the strategy in a variety of accessible formats as suggested by governors. She then referenced the government’s intention to develop a new 10-year plan for health and noted that she would keep governors updated on this and any opportunities for input. She also referenced the launch of Career Compass Leeds which was an innovative platform to support people to find personalised opportunities in health and care roles in Leeds and agreed to circulate the link to governors for them to share across their health and care networks. Sara then invited governors to ask questions on the updates provided.
Gabriella Obeng Nyarko noted the information provided on community mental health transformation and the success of the early adopter sites and asked if there was an update on the plan for it to be rolled out city-wide. Sara confirmed that the next stage was to roll out the model across all the other primary care networks over the coming months. It was agreed that a more detailed update on the community transformation programme would be scheduled for a future Council of Governors’ meeting.
The Council then had a detailed discussion on the Trust’s decision to temporarily suspend new non-urgent referrals to the Trust’s Adult Attention Deficit Hyperactivity Disorder (ADHD) service from 11 October 2024 due to the long waiting times and unsustainable level of demand. Ivan Nip asked what the Trust’s plans were to review the existing service model in order to better meet the current level of demand. Sara explained that within Leeds they were currently piloting a different pathway for the assessment and treatment of adults with ADHD with primary care colleagues to try to meet people’s needs more effectively. However, she cautioned that this may not be able to address all the demand, and it was unclear at this stage if there would be a significant shift in the level of resources being made available for this service. She added that any learning from different approaches happening in other organisations was being shared across the Mental Health Network.
Tessa Denham noted the reference to the Right to Choose pathway and asked what the impact of this was for the Trust. Sara explained that it was a legal entitlement for people seeking access to diagnostic services for ADHD which was why it had been mentioned as part of the communications regarding the Trust’s pause to new non-urgent referrals. She went on to explain the indirect impact of Right to Choose on the Trust and the NHS more widely. In response to a question from Peter Ongley about demand, Sara provided some information on the work commissioned by NHS England to understand the increase in the demand for ADHD services at both a national and international level and how this was being responded to. Cllr Venner then queried why governors had not been informed in advance about the decision to pause to new non-urgent ADHD referrals given the significance of the decision and its implications for the people of Leeds. Sara thanked Cllr Venner for the feedback and explained that a detailed communications plan had been put in place but acknowledged that there had been a timing issue with the update to the governors. The Council noted that further updates on access to the Trust’s ADHD service would be provided in due course.
The Council then asked questions on other aspects of Sara’s report. Tessa Denham queried why the Equality Impact Assessment box on cover sheets was not always completed and asked what guidance was given to paper authors about this process. Sara acknowledged the issue and assured Tessa that the consistent application of the impact assessment and guidance around how to do this had been identified as one of the key actions of the Trust’s Health Equity Strategy. Tessa also requested some information on the interviews and focus groups that had been held as part of the Well Led Review and Sara provided the details. In response to a question from Cllr Venner, Sara confirmed that the Trust and wider system would be responding to the consultation following Lord Darzi’s report on the current performance of the NHS. Cllr Venner then asked for an update on out of area placements (OAPs) and Joanna informed the Council that the Trust was now off-plan in terms of its trajectory to reduce OAPs. She outlined the current position and what had contributed to this and explained how they were continuing to work with colleagues across the health and care system to improve patient flow.
Due to time constraints, Merran asked that any remaining questions were added to the chat function to be responded to outside of the meeting.
The Council received the report from the Chief Executive and noted the updates provided.
24/070 – Report from the Lead Governor (agenda item 11)
Firstly, Les noted that it was his last report to the Council as Lead Governor and thanked those on the call for their support while he carried out this role. He also thanked Ian Andrews for putting himself forward to be the next Lead Governor.
Les then reported back on the discussion that had taken place at the governor pre-meet on the format of the papers for Council meetings and the performance data that is provided to governors. He acknowledged that a few different approaches had been trialled in recent months and suggested that going forward a more detailed executive summary was provided for the performance report which included key data alongside supporting narrative, possibly utilising Artificial Intelligence (AI) tools to produce this summary. He went on to suggest that the full data sets were provided as an appendix for those governors who wished to read more of the detail. Anne Toone provided positive feedback on her experience of trialling AI tools to produce document summaries in her own area of work. Ian Andrews offered to provide more detail on this and the various options available and Merran asked that the Corporate Governance Team discuss this further with Ian Andrews outside of the meeting.
Les also reported on the Governor Focus Conference that he had attended in July 2024 and outlined the key information provided and the areas that were discussed.
The Council noted the updates and formally thanked Les for his commitment and the contributions that he had made whilst undertaking the additional role of Lead Governor.
24/071 – Finance Update (agenda item 12)
Dawn Hanwell provided a verbal update on the financial position of the Trust and the West Yorkshire Integrated Care System (ICS). She reminded the Council that, as per the new statutory arrangements, the Trust now functioned as part of the West Yorkshire ICS which consisted of 10 NHS statutory providers and five Integrated Care Board (ICB) ‘places’ which meant that the financial position of the Trust was linked to the other organisations in the system. She then gave an update on the Trust’s financial position at month 6, which was broadly on plan and highlighted the Trust’s efforts to improve its efficiency and productivity which were helping to support this position. However, she cautioned this by saying that there were risks associated with the Trust’s position and areas causing financial pressure, such as OAPs.
Dawn then discussed the National Oversight Framework which had been put in place by NHS England to categorise the financial performance of both trusts and ICBs, with level 1 being the lowest level of concern around the delivery of a financial plan and level 4 being the highest level of concern. She explained that level 4 meant individual organisations or ICBs would be subject to increased external scrutiny. She informed the Council that the West Yorkshire ICB had moved into a level 3+ rating based on its financial position at month 6. She explained that as part of this move to level 3+, all organisations in the West Yorkshire ICB had volunteered to receive an external assessment of their financial governance and controls which had been carried out by Pricewaterhouse Coopers (PwC) who would be providing a full report to the Trust on their findings. Dawn then invited governors to ask questions on the update provided.
Ivan Nip asked if there was a contingency plan in place to support the Trust’s finances for the remainder of the financial year. Dawn explained that the Trust had carried out a risk assessment of any areas of spend that could deteriorate further over the coming months and any areas requiring further improvement and acceleration. She confirmed that she was reasonably confident that based on the current risk assessment the Trust could deliver its financial plan this year. Gabriella then asked if it was known how the government’s new budget would impact on the Trust’s finances. Dawn responded that the detail of the impact for the next financial year was still unclear, but she provided some indication of what changes the new budget might bring.
Next, Gail Harrison asked how the system way of working that Dawn had described could impact on the parity of esteem between mental and physical healthcare and if mental health trusts which may be in a better financial position could be asked to support other trusts that may be struggling. Dawn provided some assurance that, although the Trust may be asked to contribute to the wider system balance, this would be done on a non-recurrent basis, and the Trust’s baseline funding and resource allocations would remain protected. Gail then noted that the workforce was integral to providing mental health services and treatment and received confirmation that this was being taken into account as part of the financial negotiations at ICB level.
Amy Pratt then noted that the Trust’s messaging around the current financial constraints may be having a negative impact on staff morale. She also asked if it was known how the increased scrutiny associated with level 4 of the National Oversight Framework might affect staff. Dawn explained that the scrutiny would instead focus on the organisation’s financial systems and thresholds and reassured the Council that the Trust was not approaching this scale of intervention.
The Council thanked Dawn for the update but queried why it was provided as a verbal report given the complex nature of both the Trust and system finances and asked to receive a written update at future meetings as good governance. It was agreed that Dawn would provide a written finance report going forward.
Dawn then provided a verbal response to action log number 24/031 relating to the Trust’s procurement processes. She explained some of the challenges that had contributed to delays in this area and outlined the ongoing work to improve requisition turnaround time and ensure the timely payment of invoices. She noted that significant progress had been made in recent months towards achieving the key performance indicators. The Council thanked Dawn for the update and assurance provided.
The Council received the update on the Trust’s financial position and assurance on the work to improve the Trust’s procurement processes.
Jon Salway left the meeting.
24/072 – Presentation from the Workforce Committee (agenda item 13)
The Council received the presentation from the Workforce Committee which provided an overview of the key performance areas and associated data as reviewed by the Committee ahead of the September Board of Directors’ meeting. It also explained how the Committee monitored performance in these areas and what actions were being taken to improve performance further.
The Council first discussed the diversity and inclusion section of the presentation and noted that the Trust had improved its performance in six of the nine Workforce Race Equality Standard (WRES) metrics and worsened in three of the metrics. The Council noted that the metrics which had seen unfavourable changes were the relative likelihood of white staff being appointed from shortlisting compared to that of Black Minority Ethnic (BME) staff; the relative likelihood of BME staff entering the formal disciplinary process compared to white staff; and the percentage difference between the organisation’s Board voting membership and its overall workforce (BME representation). The Council heard what factors may have contributed to the unfavourable changes and received some assurance from Holly Tetley and Zoe Burns-Shore about what plans were being put in place to address performance in these areas. Zoe also explained that some of the metrics used small data sets which meant that a decline in score when compared to 2023 data may not always be statistically significant, particularly with regard to disciplinary data as in this instance the overall number of cases had reduced.
The Council then discussed the information provided on non-medical agency usage. Zoe talked governors through the graph provided on page 13 of the presentation and explained that the blue line referred to the Trust’s non-medical agency usage over the last calendar year which had seen a significant reduction and outlined how the Trust had achieved this. She explained that the grey line depicted usage in 2023 which had remained fairly static at around 8%. The Council noted that good progress had been made to reduce non-medical agency usage over the last year which was having a positive impact on the Trust’s financial position and that the Trust now only used agency for clinical staff.
The Council also received an update on the Spotlight platform and understood that this had become a key part of the Reward and Recognition Strategy for staff now that the Trust was working in a more financially constrained way. Zoe informed the Council that the platform had been well received and thanked colleagues for their efforts to engage staff with the platform.
The Council noted this report for information and assurance.
24/073 – Council of Governors’ Meeting Governance: Review of the Terms of Reference (agenda item 14.1)
The Council was assured that the Terms of Reference had been reviewed to ensure they continue to be fit for purpose and approved the updates as per the cover sheet.
24/074 – Council of Governors’ Meeting Governance: Annual Cycle of Business for 2025 (agenda item 14.2)
The Council received its Annual Cycle of Business for 2025; was assured that it included all the statutory duties which the Council must carry out and was assured that the areas which governors had asked to be kept informed on had been captured. The Council approved the Annual Cycle of Business for 2025, with the understanding that two of the items were still under review by the Council and the timing of one item was subject to approval at the private Council of Governors’ meeting in November.
24/075 – Council of Governors’ Meeting Governance: 2025 and 2026 Meeting Dates (agenda item 14.3)
The Council noted its meeting dates for 2025 and 2026 and the request to inform the Corporate Governance Team if they were unable to attend any of the meetings.
The Chair of the meeting closed the public meeting of the Council of Governors of Leeds and York Partnership NHS Foundation Trust at 3:36pm. She thanked governors and members of the public for their attendance.