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Questions from the floor

<p>The board answer questions raised from the floor at the 2011 AMM</p>

Dave Mellish:
Now we’ve been firing an awful lot of information and bullets at you for the last hour, hour and 20 minutes or so, now is the time for you to get your own back and ask any questions that you have at all that might be on your mind about what has been said to you today or any information that has been said or any other issue or concern about the future or how Oxleas is going to confront that. So if any of you would like to ask a question please raise your hand. There are roving mics around in the auditorium here and we’ll do our best to try and answer them sensibly.

Jane Grant:
Hi, my name is Jane Grant, I’m a massive fan of Oxleas further I think boosted up by today like most of us will feel. But I just have a question. I read Oxleas Exchange and I read it for excellence and innovation in mental health and I was slightly nonplussed I’m not sure if it was the last edition to find a long article on high tech treatment of burns and on the career of a foot doctor. Now I’m not saying these aren’t important, they are important and I am sure the work is excellent but their relationship to mental health seems slightly obscure and they seem to frankly dilute or even devalue the work of Oxleas on mental health. When mental health is a Cinderella service considered nationally it needs all the advocates and champions it can get and my question is: Shouldn’t oxleas remain a champion, I know it is a champion, but should remain solely a champion on mental health because we need you for that?

Dave Mellish:
Thank you Jane. Stephen do you want to answer?

Stephen Firn:
I’ll have a go. Jane I agree entirely with your point that we must do nothing to dilute the mental health and learning disability services that we provide and we should continue to do all that we can to champion resources for those services. But I think, as I hopefully tried to sketch out there, I think we can provide better services for people by joining up our care plans, joining up our assessments and pooling the expertise of people who work in the community. My experience is the majority of people don’t think of themselves as having one set of mental health problems and one set of ohysical health problems, they are often intertwined and they can often be better met by more people working closely together and I think you get more difficult access to care, including people with mental health problems, if you’ve got one service over here providing physical health, one service over here doing primary care etc. So I think there is huge strengths from us coming together but I agree with you, we should at the same time make sure we maintain and enhance the particular expertise of colleagues in each part of the trust.

APPLAUSE

Dave Mellish:
The gentleman down here.

Alex:
Hi, my name is Alex.

Dave Mellish:
Hi, Alex

Alex:
I just wonder what the panel think about the abuse in Oxleas NHS Trust, particularly at Oxleas House in Woolwich, the over heavy handed arrogant attitude and abusiveness of the staff physically and both verbally of patients within the trust for apparently little or no reason.

Stephen Firn:
Thank you Alex. Well I would say straight off if ever there are cases where patients are physically or verbally abused then that is entirely unacceptable. None of us would accept that or tolerate that. I review every complaint that we receive every week and when, all complaints are important, but any that involve abuse of patients I pay particular close attention and if we do uphold complaints then we will take action. So if you have particular instances or complaints then I would be very very happy to talk to you afterwards as I’m sure would Trevor Eldridge the Director for Oxleas House. What Dr Okocha said earlier as well, without going into lots of detail is that we are seeking to get more information and feedback from patients in all the services and in Oxleas House we have had, over the last year, anonymous surveys of everyone who was discharged and 49% have been returned and the satisfaction rating is around about 80% of people saying they are satisfied with the service they receive. But interestingly of the five areas we ask about attitude of staff was the lowest one. It was still over 70% but it was the lowest in Oxleas House so we are very focused on that and I would be happy to talk to you afterwards.

Dave Mellish:
Thanks Alex. The gentleman down here.

Lindsay:
The name’s Lindsay Clarke.

Dave Mellish:
Hello Lindsay

Lindsay:
I just want you to know I’m really happy here today.

Stephen Firn:
Thanks

APPLAUSE

Dave Mellish:
I said we hoped you enjoyed it, I really do hope you are happy yeah. There’s a question down here, the gentleman in the black shirt.

Gentleman 1:
I didn’t quite understand the figures on the survey where you – 252 surveys were returned and I was looking at the arithmetic I couldn’t work out this marking system that went from one to five apparently and how that was proportional to the results you got. Could you also put it in the context, as you did with that last answer of whether it was a voluntary survey or whether people had to fill it out. I believe it was service users themselves or inpatients. Could you go over that again and put it in its context proportionally?

Stephen Firn:
Yes, that particular national survey, that’s the one carried out by the Care Quality Commission (CQC) and that’s the one that goes on the website and is nationally known. So that’s different to what I was just talking to Alex about, about our own discharge survey because we try and do additional ones. On this one I believe it is 750 patients who receive – they are randomly selected from people using community mental health services – so the CQC set the parameters and I did encourage as far as possible people to respond and we paid £10 for each questionnaire that was returned to the CQC but its still only about a third did. And they sent them straight to the CQC or the survey company not to us. I’m sorry those figures weren’t very clear. I can go through them afterwards but essentially there were 38 different questions so in some of the categories like where it said care planning, I think there were five questions. That’s why there were five in the middle and in some categories like psychological therapy there was only one question and that’s why that was in the middle so the figures in the middle were the number of questions rather than responses. It’s quite hard to explain without having the slide there but I’m happy to go through them with you and actually we could send you a full copy of the survey.

Gentleman 1:
If it’s on the website I can find it.


Stephen Firn:
Sure.

Gentleman:
Thanks

Dave Mellish:
Are there any other questions at all? Gentleman

John Crowley:
I’m John Crowley, I’m a resident of Greenwich and a supporter of Oxleas. I guess my question is around the election or the change in Constitution to three by three terms. I guess how is the Board going to monitor that there is not a degree of stagnation or stability going to come into the monitoring process because I guess the frequency of having change brings in freshness? I know there is a positive side but I guess there is an alert as well.

Dave Mellish:
Are you talking about the change for the governors or non execs or both?

John Crowley:
To both really.

Dave Mellish:
Well I think the argument probably applies to both. We found that initially when we became a foundation trust in 2006 we agreed with the Council of Governors that their term of office elected should be a maximum of two periods and that ranged from four years to six years. When we first became a foundation trust those with the least number of votes were only in office for a year before having to be re-elected so it was a rolling year on year election for elected governors. Discussing with the Council of Governors we felt with so much going on and after five or six years as those twelve who’ve stood down they are only really just getting on top of the job. We were on a huge learning curve when we became a foundation trust. The governors were, and indeed we were. We were the first mental health trust, we couldn’t look at anyone else and see what they were doing. We had to sort of plough our own furrow and I think our experience has shown that probably two terms was too small a period and we thought it’d be much better to extend it to three terms. As far as the non executive directors are concerned, in 2006 when we agreed with the governors the period of office for governors we agreed that the period of office for non executive directors should mirror that and only have two by three year periods for non executive directors. As we are changing the governors we thought we should change the non executive directors as well and just as an aside that puts us bang square with Monitor, our overseer in relation to what we are doing with regards compliance and constitution and the advice from Monitor is that no non executive director should be in post for more than nine years. So we’re bang in line with that John. It reflected all that is going on with the trust and, thinking very personally and maybe selfishly I’m delighted that those constitutional changes have risen because over the next two to three years we are facing so many changes and so many pressures coming in to us it will be really useful to have a more stable Council of Governors to report back to a more stable Board to make those decisions so that’s where we are coming from John.

The gentleman there and then one at the back.

Gentleman 2:
Ah, that’s better everybody can hear me now, I’ve only ever done karaoke and I didn’t like it. I’d just like to take this opportunity to the trust and everyone here today. As a service user I’ve had a lot of opportunities ie voluntary work, research network, one thing or the other which is really good from my point of view. If you help others you’re really helping yourself that’s what I’ve found. I wanted to take the opportunity now, I’ve probably been now about four years and I’ve had 100% support. Someone said to me the other day that I’d been lucky, I don’t see it that way I just can’t thank the people that have helped me enough. Yeah. And this includes all of you so put your hands together and give yourselves a pat on the back and a clap.

APPLAUSE

Dave Mellish:
Thank you very much. That would be a really good and positive note to finish on. We are running out of time but there is a gentleman here who had his hand up so we will take one last question and then we will call it a day and move on to the Staff Recognition Awards.

Gentleman 2:
My question is have you any new PFI agreements at the moment in work that haven’t been signed and if so, how many and how much is involved?

Stephen Firn:
Thank you, I think Richard you can have the last word before you leave the stage.

Richard Page:
Very simply, no. We haven’t got any more. If you look at our balance sheet the statement of financial position we are strong enough to finance practically anything that is likely to come along with our own cash and certainly our borrowings because we’ve got enough to do whatever is likely on the horizon.

Gentleman 2:
That was what I was picking up on – the fact you’ve got £35 million you don’t need to get involved in PFIs if you can avoid it.

Dave Mellish:
Thank you very much.