Public BoD papers 28.04.22

Board of Directors meeting Thursday 28 th April 2022 at 12.45 pm By virtual means Agenda Clinical presentation: Proton Beam Therapy Service - John Archer, Clinical Services Manager

Public items


15/22 Standard business a Apologies

Chair Chair Chair

b Declarations of interest

* *

c Minutes of previous meeting – 31 st March 2022 d Action plan rolling programme, action log & matters arising



16/22 Reports

* * * *

a Chief executive’s report

CEO 12 COO 22 DoR 60 FTSUG 70

b Integrated performance, quality & finance report c Medical directors report - Research update d Freedom to Speak Up 6 monthly report

17/22 Board assurance

a Board assurance framework 2021/22 b Board effectiveness review c Register of matters approved by the board

* v *

CEO 93


CEO 98

* Committee Chair

d Audit Committee report


18/22 Any other business

Date and time of the next meeting Thursday 26 th May 2022 at 12:45pm


Chief Executive Officer Chief Operating Officer Director of Research Freedom to Speak Up Guardian

* paper attached v verbal p presentation


Public meeting of the Board of Directors Thursday 31 st March at 12.45 pm By virtual means

Present: Chair: Chris Outram (CO), Chairman

Kathryn Riddle (KR), Non-executive director Dr Jane Maher (JM), Non-executive Director Robert Ainsworth (RA), Non-executive Director Prof Kieran Walshe (KW), Non-executive Director Grenville Page (GP), Non-executive Director Alveena Malik (AM), Non-executive Director Roger Spencer (RS), Chief Executive Bernie Delahoyde (BD), Chief Operating Officer Eve Lightfoot (EL), Director of Workforce Prof Chris Harrison (CJH), Medical Director and Deputy CEO Prof Janelle Yorke (JY), Executive Chief Nurse Dr Neil Bayman (NB), Executive Medical Director Sally Parkinson (SP), Interim Director of Finance Prof Richard Fuller (RF), Director of Education Prof Fiona Blackhall (FB), Director of Research

In attendance: Jo D’Arcy, Assistant Company Secretary Scott Davies, Public Governor Salford

Helen Hunter, Assistant Director North West, NHS Confederation Alistair Reid-Pearson, Interim Chief Information Officer


Louise Westcott (LW), Company Secretary

Clinical presentation: Critical Care and Outreach Service - Vidiya Kasapandian (VK), Consultant in Acute & Critical Care, Kerry Millington (KM), Ward Manager, Acute & Critical Care, Jude McLellan (JMc) Outreach Nurse Specialist Lead and Seema Rahman (SR), Senior Physiotherapist VK introduced herself and oriented the meeting to where the Oncology Critical Care Unit (OCCU) is within the Trust. She showed the new changing room that was created by the Estates Team to decontaminate prior to entry to the unit. VK also showed the new oxygen flow meter that helps the staff to assess oxygen use to ensure it doesn’t run out. VK showed the 4 negative pressure side rooms – Royal College approved standard. One of the side rooms was shown and new techniques outlined such as walkie talkies and white boards to communicate with staff outside of the rooms when treating covid positive patients. During Covid, 2 additional side rooms were created for management of non-aerosol generating procedures to enable the team to look after more patients and not have to escalate out of the unit. KM introduced Maureen the Domestic on the unit who is an essential and integral member of the team. VK noted that other CCU’s have created 2 areas for covid/non-covid patients. We have managed within our footprint. Staff were moving between covid and non-covid patients and showering in between. JM was introduced as outreach lead, this is the bridge between the wards and OCCU. Patients are referred to the team to be assessed and they facilitate the transfer in and out and follow them up. Education & training of staff was key during covid to support the ward teams as well as the OCCU staff. JM talked about the camaraderie amongst the staff throughout the period. Acute care training continued, and no sessions were dropped. The team are 12 staff covering 24/7.


VK introduced SR one of the senior physiotherapists who talked about MDT training around intubation of covid patients. SR outlined the role on OCCU including helping patients maintain their chests and clear secretions and teaching breathlessness management and mobility and muscle strength. Proning (lying on their front) of patients was used to support breathlessness. It takes about 5 or 6 staff to prone a patient. The physio team were also part of the fit testing team. KM noted how important the physio team were in supporting the nursing team and thanks were extended. VK stressed the collaborative nature of the support. CO thanked the team for their hard work over this period and for the presentation. JM asked what the biggest challenge was. SR responded that keeping up with the constantly changing guidelines and doing the right thing. KM thought it would be difficult to get staff doing what they had to do but this was not a problem, and everyone pulled together brilliantly. Covid is a constant pressure, in terms of staffing as well as the patient challenge. It’s a challenge to look after staff going forward and keep everyone going. JM noted how brilliantly the team communicated and how clear this was and how well led the service is. VK noted that the emotional burden as a result of families not being able to be come in was huge. Staff are now doing P&A training which is about restorative supervision and caring for staff’s mental health. VK noted that the support from Management Board and CAG was fantastic. JY noted the exceptional leadership from the Critical Care nursing team and thanked them for their amazing work. CH observed that the impact of the critical care unit in the hospital has been massive since its development. CH asked about the Critical Care network and the ICNARC evidence (national audit). VK noted we are part of a network of 13 Trusts, this guided the use of the resource across the patch and many options were looked at in terms of us caring for long term covid patients or no covid at all. We have taken on cancer work from across the patch and the resultant critical care needs. The national audits give us exceptional results, we are one of the best functioning units nationally. CO thanked the staff for their fantastic presentation. CO noted the sad and untimely death of the Chair of the Northern Care Alliance Professor Michael Luger. Item Action 10/22 Standard business a Apologies Apologies were received from Tarun Kapur (TK), Non-executive Director b Declarations of Interest No declarations of interest noted. c Minutes of the previous meeting – 28 th January 2022 The minutes were accepted as a correct record.

d Action plan rolling programme, action log & matters arising All items from the rolling programme are noted on the agenda. 11/22 Key Reports a Chief executive’s report

RS noted his report and outlined the current situation in the Trust. Acute Care across GM is impacted by high rates of covid. There is an increase in demand for covid inpatients (16%) and staff absence is up as high as 17%. We remain in


a level 4 incident and continue to provide mutual aid in surgical care and some diagnostics. Today there are 133 staff absent and 20 covid positive inpatients. All services are continuing to be delivered. We do not have a build up of patients waiting but are dealing with some late referrals that we are treating as quickly as possible. RS noted the item on the GM position and continued movement to a GM ICS which will come into being on 1 st July. The CEO and Chair have been appointed. b Integrated performance, quality & finance report BD outlined the key points from the report for month 11. Safe: 1 SI incident, 0 Never Events, 1 Major & 4 moderate incidents, 3 Corporate risk 15+, 2 risks at 20 – cyber security and staff health & wellbeing, 1 risk at 15 Effective: 0 cases MRSA bacteraemia, 3 cases C.diff with no lapses in care, 1 case E-Coli post 48 hours, 0 Covid nosocomial infections Responsive: 8 new complaints received in month (1 above average), 47 PALS contacts, 4 Inquest requests, average LOS is 6.29 days, 3 cancelled operations on the day in month due to CCU capacity. Access: 18 Weeks 99.0%, 62-day performance has improved to 76.0%, 24 day performance 83.0%, 31 day performance 97.5%, we have 23 ‘104 day’ waiters, and referrals are within the predicted range. There is a consultation taking place on the Cancer Waiting Times, Standards – replacing the 2 week wait with a faster diagnosis 28 day standard (FDS). Merging the 31/62 day standards. Further guidance on upgrades and looking at including other cancers not previously in scope. We are responding through GM Cancer. Activity is predominantly back to 2019/20 levels. Surgical operations are behind plan due to a reduction in minor surgery cases (plastics). HR metrics – there is a continued dip in PDR and training rates impacted by increased levels of sickness due to covid. Focus has been on maintaining services. Each area has a plan for getting on track with PDRs and training. There are no swings or changes in our financial position. Surplus £1.076m against plan, EBITDA surplus £41.961m, I&E surplus £17.411m, Cash balance £167,227k, Debtor days of 13, Capital expenditure at 91% against the NHSI plan and at 95.1% against the reduced £2.5m NHSI plan. BD invited questions. CO asked about long waiters and what the issues are for us. BD noted that many need their diagnostics repeating that creates a delay. Capacity is not the issue, but flow can cause issues with Covid impact etc. RA asked about settlement costs in claims and if this was paid by the NHSLA. BD to feed back. GP asked about the workforce challenges and gaps nationally. BD noted that we have a good pipeline of recruitment coming through and future planning and strategies going forward. We are looking at local opportunities and the use of transformation projects, so we use professionals in the best way with innovative staffing models. Report noted. BD c Six monthly compliance with NICE safe staffing guidelines JY noted the report and the professional perspectives of the ward leaders. This


shows good and safe nurse ratios. There have been some difficult shifts, but mitigations are in place to move staff around. We have very resilient leaders who support each other. CO thanked the team for the report and the immense professionalism that comes across. KR noted the terrific report and noted that it is very honest, and the estate issues are also clear. Need a plan to upgrade the environment where possible. JY noted there has been a lot of investment in inpatient areas. The care is safe and of good quality, but we must also plan the improvements to the estate. KW noted the quality of the report. He asked about the increased acuity that’s noted and how this is planned for and what has caused it. JY noted that ward movements has meant higher acuity on certain wards and the skill mix has been adjusted as a result. There is also a feeling that patients are coming in later and are therefore more poorly. This is being looked at. The role of the night practitioner has been looked at to support wards at night which is when we are most vulnerable. We’re looking at how we can recruit nurses in different ways to address the need. It seems to be working well so far. d Responsible Officer Report: Appraisal and Revalidation 2021-22 NB presented the report for the last year. Medical appraisal is an annual requirement for licencing with the GMC. Revalidation is required on a 5 yearly cycle that shows evidence of fitness to practice. Medical appraisal has been uninterrupted this last year in a supportive model minimising paperwork and considering the health & wellbeing of colleagues. We have very good engagement. There is currently a shortfall in trained appraisers, and this is being addressed. There have also been some delays with appraisals, there is a plan to address this. Revalidation deferrals have been slightly higher this year but there are no concerns around any of these. This is as a result of covid. Dr Dan Saunders is the RO for the organisation. KW asked about the connection across providers to address concerns and links with TCPC and other providers. NB noted that TCPC have their own RO who is in close contact with Dan Saunders. There is a requirement to gather information around private practice and this is reviewed alongside the NHS data as part of appraisal. The recommendations from the Paterson Enquiry are considered by the appraisal group. e Workforce update EL presented the quarterly report. EL outlined the risk around workforce and noted that we have got some ERF funding that will support recruitment and the work we are doing around making us as an employer of choice. We’ve also been awarded some money for international nursing recruitment. EL also noted some developments with our EDI work. The EDI Summit took place in December and had excellent feedback. There is also an EDI accelerator that is a programme that staff can dip in and out of across the year. JM noted the culture and values work and asked if there were any surprises from the feedback. EL noted that there was confusion around our values / behaviours, and we are working now to clarify this and embed it across the Trust with Board engagement. AM asked about the branding / recruitment and the culture work. EL responded


that we are looking at recruiting a diverse workforce and looking at our processes across recruitment and on boarding. f Staff survey 2021 results EL noted a 44% response rate (48% last year), this is below average, and we will focus on improving this for the next survey. We are above average or average in all areas apart from 2. National trends and comparative breakdown was shown with specific examples from each area. Comparisons with other oncology providers show us on a level with both. Going forward the team are working with areas on wellbeing and the RESPECT campaign. EL noted the listening events, staff network groups, nurse and new starter forums. The results are used alongside these other mechanisms. Next steps and timelines were outlined. AM asked how EL felt about the results and the impact of external factors. EL expected some deterioration and Covid has had an impact. Pay is also an impact. Staff are feeling tired, but we do need to ensure we are delivering the best experience possible to our staff despite the external factors that are outside of our control. GP noted his appreciation of the recognition of internal factors as well as external. GP asked about getting staff to generate the priorities and what they want. EL noted this is the approach we are taking, and our priorities will be based on conversations with staff. This will determine focus and solutions locally. CO noted the importance of our staff in everything we do. g Digital update BD noted the update, more focus will come to a future Board Time Out to look at the Digital Strategy. BD also noted that the CIO post is out for advert. ARP outlined the objectives and progress against them. He focused on the increased likelihood of a cyber-attack. We continue to respond to asks from NHS Digital and a lot of work is underway to defend the Trust against these threats. A task force is in place to address. BD noted that all business continuity plans are being reviewed with cyber-attack threats in mind. We have successfully bid for £5m over 3 years for digital projects. We have secured a 2-year plan to develop our EPR. The last 6-month period we have had a new Clinical Chief Information Officer (CCIO), Dr Nash Gupta who has made an immediate impact. AM asked about the internal risks and progress. ARP noted there has been good progress and placement students are coming into the Trust to support staff. Workforce related issues are being addressed. Infrastructure engineers are at a shortfall across GM, but we are managing the risks. RA thanked the team for the report and noted the improvement in the content. He asked about the vacancies. ARP noted that there has been a focus on maximising recruitment to vacancies across all departments. JM asked how our EPR connects with the wider patch. ARP noted we are speaking to the Cheshire to improve links; we are following the national strategy and do have the links. NHS Digital want to use us a case study. JM asked if all junior staff have access to Attend Anywhere and whether we have renewed the contract. ARP noted that he will look at all junior staff having this access and we have renewed the contract.


GP asked about checks on people relating to their access to systems. ARP noted that there is no access to printing at home, staff can only connect to systems via VPN and those who have lots of access can only do so through 10 administrative accounts that are monitored very closely and audited. Our controls are very good. CH thanked ARP for his leadership and how he has dealt with legacy issues. Thanks were extended to NEDs for their support. As part of the process of recruitment to the CIO post Digital has moved into the Chief Operating Officer’s portfolio. EL also noted that whenever access is granted to anybody to internal systems this is monitored closely, and authorisation is needed. CO thanked ARP for the report. 12/22 Approvals a Board governance i Directors letters of representation General data protection requirement (GDPR) CO noted that the documents will be sent through to each Board member to sign and return. CO noted the requirement to confirm independence. This will be determined once the documents are completed and returned. b Annual reporting cycle 2022/23 RS noted that this is part of the normal governance process for the year. We need to cover these items as part of the requirements of our licence. Approved. c Corporate objectives and board assurance framework 2022/23 RS presented next year’s annual objectives in the context of a suspended planning arrangement due to the level 4 incident. The BAF for next year is presented that takes account of MIAA’s recommendations from their review in 2021/22. RS noted that we will look again at this after the July Board sessions when there is further clarity from NHSE around de-escalation and a new financial regime. Approved. 13/22 Board Assurance a Board assurance framework 2021/22 RS noted the BAF 2021/22. There are several updates to the risks, and this will be finalised and presented next month. No questions. b Staff engagement activities RS noted that this is a tracker of some of the engagement activities that have taken place across the Trust in recent months. This is not an exhaustive list. KR asked how many people attend the Medical Staff Committee. NB responded that it varies, the last meeting had about 30 consultants. BD noted that there are ii Register of directors’ interests iii Fit & proper persons declaration iv Declaration of independence v


about 30 in the daily huddles. The Tuesday Trust-wide huddle has about 70 people. KR noted that Coffee with Roger is a great idea. CO applauded the Trust on the efforts to maintain communication. c Audit Committee report GP noted that there are no items to escalate. The committee agreed the draft internal audit plan in this meeting. d Quality Assurance Committee report KW noted the report of the last committee meeting. There were no formal escalations. KW noted that there was a report with the progress with the NHSEI Review action plan on R&I. The key point was that the response to the review is complete. There are agreed actions against all the recommendations. It was also noted that there is continued work around this including the R&I Strategy that will come back to Board as well as the OD plans. Oversight will continue through the committees and Board. CO noted the importance of research at The Christie and with that in mind it is extremely important for the Board to support FB and the R&I teams. FB noted that there was a meeting of 120 R&I staff yesterday where the report was discussed, and the feedback has been very positive. There was recognition of the work that’s been undertaken and work that needs to be done. Freedom to speak was stressed and there was a lot of openness and honesty. It showed major progress with the culture in the division. FB noted that a lot of the added value of working at The Christie comes from our research division to support the ambitions of staff. This supports our recruitment. Noted. 14/22 Any other business No items raised.

Date and time of the next meeting Thursday 28 th April 2022 at 12:45pm


Agenda item 15/22d

Meeting of the Board of Directors - April 2022 Action plan rolling programme after March 2022 meeting


From Agenda No


Responsible Director


To Agenda no

Annual reporting cycle Integrated performance & quality report and finance report


Monthly report

16/22b 18/22c 16/22c 16/22d 16/22a 18/22b 16/22d 16/22e

Register of matters approved by the board

April 2020 to March 2021

Annual reporting cycle Medical directors report - Research update (key issues, progress against objectives and future plans)


April 2022

Annual reporting cycle Annual Corporate Objectives

Review 2020/21 progress

Modern Slavery Act update Board effectiveness review


Chairman FTSUG CN&EDoQ

Undertake survey Quarterly update Review & report

Freedom to speak up Guardian report

Ockenden report response

Annual reporting cycle Integrated performance & quality report and finance report


Monthly report

Provider licence

Self certification declarations


To approve the declarations Declaration / approval

Annual reporting cycle Annual compliance with the CQC requirements Annual reporting cycle Medical directors report - Education update

May 2022


Review Update

Annual sustainability report


Annual reporting cycle Annual reports from audit & quality assurance committees

Committee chairs


Emergency Preparedness, Resilience and Response (EPRR) annual report 2021-22


For approval

Annual reporting cycle Integrated performance & quality report and finance report


Monthly report

Workforce update incl FTSU development session

Quarterly review / training

Digital update

CIO/CCIO/CCIO (nursing) Progress report


Trust Draft Sustainable Development Management Plan 2021 - 2024



Annual reporting cycle Annual report, financial statements and quality accounts (incl Annual governance statement / Statement on code of governance)





From Agenda No


Responsible Director


To Agenda no


Monthly report

By email

Integrated performance & quality report and finance report

July 2022 - no meeting

Integrated performance & quality report and finance report


Monthly report

By email

August 2022 - no meeting


Monthly report Six month review

Annual reporting cycle Integrated performance & quality report and finance report

Compliance with NICE Safe Staffing Guidelines


Emergency Preparedness, Resilience and Response assurance process

Sepember 2022

Annual reporting cycle


Approval of compliance status Provide update to Board

MIAA audit recommendation Anti-bribery briefing

Annual reporting cycle Corporate objectives & board assurance framework


Interim review Monthly report Six month review Progress report Quarterly review Annual report Monthly report Six month review

Integrated performance & quality report and finance report

Annual reporting cycle Executive medical directors report - Research review (key issues, progress against objectives and future plans)

October 2022

Digital update Workforce update

Freedom to speak up guardian


Annual reporting cycle Integrated performance & quality report and finance report Annual reporting cycle Executive medical directors report - Education review (key issues, progress against objectives and future plans)


November 2022


December 2022 - no meeting

Integrated performance & quality report and finance report


Monthly report

By email

Annual reporting cycle Integrated performance report Annual reporting cycle Risk Management strategy 2021-24


Monthly report Annual Review

January 2023


Integrated performance & quality report and finance report


Monthly report

By email

February 2023 - no meeting

Annual reporting cycle Corporate planning (corporate objectives / BAF 2022/23) Annual reporting cycle Letter of representation & independence Annual reporting cycle Integrated performance & quality report and finance report Annual reporting cycle Declaration of independence (non-executive directors only) Annual reporting cycle Register of directors interests

Executive directors

Approve next year's BAF

Chair Chair COO Chair DoW IEMD

Directors to sign Report for approval

Monthly report

For completion by NEDs

March 2023

Digital Update Workforce update

EMD/Dep CEO Update

Quarterly review

Responsible Officer report

Medical Appraisal & Revalidation Annual report

Annual reporting cycle


Approve Review

Six monthly compliance with NICE safe staffing guidelines



Agenda item: 15/22d

Action log following the Board of Directors meetings held on Thursday 31 st March 2022

No. Agenda


By who


Board review

Confirm whether the settlement costs in claims as noted within the integrated performance, quality & finance report were paid by NHSLA.

1 11/22b





Agenda item 16/22a

Meeting of the Board of Directors Thursday 28 th April 2022

Subject / Title

Chief executives report


Chief executive

Presented by

Roger Spencer

Summary / purpose of paper

To keep the board of directors updated on key external developments & relationships The board is asked to note the contents of the paper


Background Papers


Risk Score


Link to: 

Achievement of corporate plan and objectives

Trust’s Strategic Direction

Corporate Objectives

CNS - Clinical Nurse Specialists SOS - Supporting our Staff PPE - Personal Protective Equipment

You are reminded not to use acronyms or abbreviations wherever possible. However, if they appear in the attached paper, please list them in the adjacent box.


Agenda item 16/22a

Meeting of the Board of Directors Thursday 28 th April 2022 Chief executive’s report

1. Situation Report Our Trust escalation remains at level 2. There has been a decrease in patients with Covid and staff absences due to Covid. We have continued to provide all cancer care and treatment for our patients, including those who have been affected by Covid. In line with the national change in managing the pandemic to “living with Covid” we have reviewed our biosecurity measures via the clinical advisory group. Changes to our testing regimes, in line with national guidance, including a managed approach for visitors on site were implemented from 4 th April 2022. We continue to monitor plans including revised infection and prevention control measures to ensure sustained delivery of our services going forward as well as supporting the full recovery of cancer services together with other care providers. 2. Planning 2022/23 Work continues with partners in our Greater Manchester system to submit plans for the current year. Good progress has been made to agree activity and workforce plans that will deliver against constitutional standards. Further work continues on system funding and finalised submissions will be made at the end of April, within the parameters previously reviewed by our Board of Directors. 3. The Ockenden Report The final report of the independent review of maternity services at Shrewsbury and Telford NHS Foundation Trust was published on 30 th March 2022. The report is a difficult read and will be deeply upsetting for anyone involved in the delivery of healthcare. At The Christie we recognise that important lessons within the report translate beyond maternity care alone. The Trust is committed to demonstrating excellent and equitable clinical outcomes and patient safety, patient experience and clinical effectiveness, and will take time to carefully reflect upon the findings of the report. A review of the report’s immediate and essential actions is underway, and a relevant action plan and assurance processes will be undertaken for the Board. Further information can be found at Final report of the Ockenden review - GOV.UK ( 4. The Modern Slavery Act 2015 The Modern Slavery Act 2015 (the Act) establishes a duty for commercial organisations to prepare an annual slavery and human trafficking statement. This is a statement of the steps the organisation has/is taking to ensure that slavery and human trafficking is not taking place in any of its supply chains or in any part of its own business. Part of the requirement of the Act is to produce a statement that is approved by the board and published on the website. The updated statement for this financial year is appended to this report for approval. Following Board approval the statement

will be published on the trust website. Further information can be found at


5. Greater Manchester NHSI/E have confirmed the intention to transition to Integrated care systems on the 1 st of July, this remains dependent on the passage of the health and care bill through parliament. Greater Manchester system has progressed the appointment of the statutory Integrated Care Board posts. Confirmed Appointments to Greater Manchester Integrated Care Board and progress with its development are set out in a stakeholder briefing appended to this report.

Work continues on the transition arrangements and the role of the provider collaborative as a part of the system. Agreement on the cancer model coordinated via the Cancer Alliance has been approved. The Cancer Alliance has initiated recruitment to a locality planning role which supersedes the cancer commissioning CCG function. This is a significant step in the single system approach for the planning and delivery of cancer services for the Greater Manchester population. 6. Complementary Health Team Award Congratulations to our complementary health and wellbeing team which recently won a Mental Health award at the Integrative Health Convention in recognition for the staff service it has provided since the start of the pandemic. The SOS (Supporting our Staff) initiative, uses complementary therapies to enhance resilience and wellbeing. Set up due to the complex pressures causes by COVID-19, this service continues to deliver both virtual and face to face interventions, providing bespoke physiological and psychological support. Over 200 staff have accessed the service so far, with staff reporting the benefits in both their work and home life. A common quote is ‘life changing’, especially after supporting staff who felt claustrophobic, enabling them to wear PPE, and remain working onsite. This service is confidential and free to Christie employees. Staff can self-refer, or have a colleague or manager complete the form which can be found at CH&W Hive page.


7. Data Quality Award The Christie clinical coding team won the CHKS Data Quality Award for specialist hospital is for excellence in data quality based on the following indicators:

Average diagnoses per finished consultant episode Percentage of non-specific diagnoses Percentage of un-coded finished consultant episodes

• • •

• Percentage of episodes with a ‘sign or symptom’ primary diagnosis

The organisation giving the award stated “The awards were established to recognise and celebrate the important roles our clients have played and their ability to continue to deliver high quality care throughout the last two years. The nominees’ commitment to the healthcare industry is a testament to the resilience and dedication, and we wish to commend this.” We are really proud of the team’s achievement and for maintaining their excellent service despite all the challenges of the last two years. Further information can be found at awards-2022/ 8. Clinical Nurse Specialist Day We celebrated the first UK cancer clinical nurse specialists (CNS) day in March. The aim of the day was to promote the role of clinical nurse specialists in cancer care. We had a poster board in the Oak Road main entrance area where staff and patients could share their thoughts and experiences of the work of our clinical nurse specialists. Some of the comments included: “they are my lifeline” and an “absolute key part of the team caring for our patients.” The day was promoted nationally though social media and Professor Janelle Yorke recorded a short video 9. Estate Developments Work continues on the Paterson facility with the project remaining on budget and to time. Two on-going projects are close to completion: • The tiered car park has now been handed over to the Trust from the contractor and the section 278 works to the surrounding area are due to commence shortly. • The Macclesfield project is complete with a few minor completion areas outstanding Works continues on the energy centre, installation of the MR scanner and pharmacy outpatients facility with all three of the projects due for completion later in the financial year.

More information about our new developments can be found at:


Building on Greater Manchester’s devolution integration experience: forming a statutory integrated care system Stakeholder briefing note 20 April 2022 Introduction Welcome to the next update regarding Greater Manchester’s ongoing transition to a statutory integrated care system from 1 July 2022. We previously shared an update with you in January and want to give you a further update on progress, including an overview of why things are changing, how the new system fits together in the wider context, recruitment, and some of the work to date. Why are things changing? Across the country, integrated care partnerships (ICP) are being set up to help organisations work better with the public to keep everyone healthier; plan and deliver health services more effectively; make sure everyone is treated equally and fairly; help the NHS become as efficient as possible, and also help it contribute to the wider economy. The intention is that this will: • improve the health of children and young people • support people to stay well and independent • help health and care services act sooner to help those with preventable conditions • get the best from collective resources so people get care as quickly as possible. Here in Greater Manchester the new arrangements mark the latest stage in the city region’s journey to more joined up working, which has developed since our health and social care devolution deal in February 2015. How does our Greater Manchester system fit together? Our system will be called GM Integrated Care Partnership and will be made up of two statutory elements: • Greater Manchester Integrated Care Partnership Board, involving all the different organisations which support people’s health and care • NHS Greater Manchester Integrated Care, a new organisation, overseen by a Board, to support integration within the NHS to take a joint approach to agreeing and delivering ambitions for the health of the population In addition there will be similar partnerships in each of GM’s ten districts or localities. Our system partnership will operate at three levels: neighbourhood, locality and Greater Manchester and will have a single vision and strategy. Hospitals, GPs, community services and other providers will come together to form collaboratives within all 3 levels. • support those with long-term conditions or mental health issues • care for those with multiple conditions, particularly as people get older


GM Integrated Care Partnership will bring together all the different organisations which support people’s health and care and, working with our people and communities, will create and oversee our region’s overall integrated care strategy which the wider system will work to deliver. Members of the Partnership (which is an evolution of the longstanding Health and Social Care Partnership) come from all ten parts of GM, including all NHS organisations, councils, GM Combined Authority, organisations from across the voluntary, community, faith and social enterprise sectors and others all working together to help achieve our common vision. The Board steering the work will be chaired by GM political lead for health and care, and Tameside Council leader Councillor Brenda Warrington. 10 Local Integrated Care Partnerships, 66 Neighbourhoods Much of someone’s life will be spent within a few miles of where they live, shopping, working, going to school, visiting friends and family, and socialising. Likewise, if people do need support around their health and care, friends and family are often very involved, and people may also use their local pharmacy, GP, voluntary groups, district nurses, community mental health services or home care staff. And sometimes they may need a hospital visit or a care home. Some people may also link in with education, probation, employment or social services. Virtually all of this will happen relatively locally. This is why our ten places and 66 neighbourhoods are at the heart of our integration work. We’ll have local integrated care partnerships, overseen by a Board with people from the council, NHS, voluntary sector and wider partners reflective of each place. One person – a ‘place based lead’ will coordinate all of this. NHS Greater Manchester Integrated Care The NHS sees and treats thousands of people every day in Greater Manchester at its many different services; most are in the local community, including GPs, dentists, pharmacist,


optometrists, district nursing, physiotherapy, occupational therapy, diagnostics and many more. Some more specialised services are based in hospitals. From July 1 a new organisation, called NHS Greater Manchester Integrated Care will take over from our 10 Clinical Commissioning Groups (which will close down their work) to become responsible for the allocation of, and accounting for, NHS resources. It will create and oversee a plan for all NHS services in our city region. Sir Richard Leese has been confirmed as Chair designate and Mark Fisher as Chief Executive designate. Staff from the new organisation will work across Greater Manchester; some within the local partnerships and some more centrally.

Recruitment to key leadership roles As of 20 April, the position is as follows: • Designate Chair – Sir Richard Leese • Statutory Non-Executive – Richard Paver and Shazad Sarwar

• Chief Executive Officer – Mark Fisher • Chief Finance Officer – Sam Simpson • Chief Medical Director – Manisha Kumar • Chief People Officer – Janet Wilkinson • Chief Nurse – in progress • Place-based leads – in progress • Other defined executive posts will commence recruitment once a final structure has been agreed by the Chief Executive Officer About the new appointments Mark Fisher – Chief Executive Officer Working at director level for several years at the Department of Work

and Pensions, Mark currently leads the Grenfell Tower Public Inquiry, engaging with the local community and wider public and creating a model for similarly challenging public inquiries. He was previously director of the office for civil society and innovation in the Cabinet Office, responsible for the Government’s relationship with the voluntary and community sector, and programme director for the award-winning Work Programme and the Future Jobs Fund, building the regime that kept national unemployment down throughout the 2009 recession.

Mark said: “It’s a huge privilege to be appointed as the first chief executive of NHS Greater Manchester Integrated Care. The region has a long history of collaboration and partnership working, and we now have a real opportunity to make further change: to better address health inequalities, further improve clinical outcomes, and contribute to the wider social and economic development of Greater Manchester.” Manisha Kumar – Chief Medical Director

Currently Medical Director at Manchester Health and Care Commissioning, Manisha trained as a doctor in Manchester, qualifying in 1995, becoming a GP in 2001 and joining the Robert Darbishire Practice in Rusholme in 2004, where she still practises and is a GP Trainer. Manisha has held clinical leadership roles since 2006; working in system redesign and development, locality and neighbourhood roles. For the last five years she has held executive responsibility for primary care commissioning, safeguarding and clinical leadership –


more recently focused on the response to COVID, as well being the Clinical Senior Responsible Officer for Manchester’s COVID vaccination programme. Manisha said: “I am really pleased to have been appointed as Chief Medical Director Designate for NHS Greater Manchester Integrated Care at such an exciting and important time for our health and care services. The last two years have showcased how crucial resilient, high quality care is for all of us. I am looking forward to continuing our integration journey across Greater Manchester and supporting the critical ambition to reduce health inequalities for our population.” Sam Simpson – Chief Finance Officer Having worked in the NHS for over 25 years, since joining the North West Financial Management Training Scheme, Sam brings extensive NHS and senior finance experience.

Sam has held senior finance roles in commissioner, provider and strategic health authority, all in the North West. Prior to joining Tameside and Glossop Integrated Care NHS FT, Sam was the Director of Finance for the Cheshire and Merseyside Sustainability Transformation Partnership.

She spent two years at Greater Manchester Police and also has experience of working in local authorities and the education sector. Sam is currently the Chair of the Greater Manchester NHS Provider Directors of Finance. Sam said: “I am delighted to have been appointed as Chief Finance Officer Designate for NHS Greater Manchester Integrated Care. It is a privilege and an honour and I am looking forward to working with partners across Greater Manchester to achieve the best we can for our population.” Janet Wilkinson – Chief People Officer

Janet is currently executive lead for workforce, OD & system leadership at Greater Manchester Health and Social Care Partnership, who she joined as Director of Workforce in October 2017. Janet has been an executive director for 20 years and her most recent post was Director of Human Resources, Organisational Development and Education at University Hospital of South Manchester NHS Foundation Trust. Janet said: “I am delighted to be appointed into the role and am

looking forward to leading and supporting the Greater Manchester system in developing and implementing ambitious people strategies, as well as creating a positive and inclusive culture for NHS Greater Manchester Integrated Care and it’s 2,000 staff.” Progress The 10 Clinical Commissioning Groups in Greater Manchester, which will cease to exist from July 2022, continue to work with colleagues in Greater Manchester Health and Social Care Partnership and Greater Manchester Shared Services to ensure a smooth closedown process and smooth transfer to new arrangements. This change will have no impact on where or how people receive care. Colleagues in all organisations are currently being consulted on arrangements to transfer everybody beneath boardroom level into NHS Greater Manchester Integrated Care. All colleagues have also been involved in a ‘cultural audit’ to build the strong foundations for the culture of the new organisation. 19

Engagement experts from Greater Manchester’s voluntary, community and faith sector, the NHS and locality authorities came together to explore a shared involvement framework for Greater Manchester. This is in order to develop a people and communities strategy and build on national principles developed by NHS England. A process has begun for the selection of a Place Lead for Health and Care Integration in each of Greater Manchester’s 10 localities and an Equality and Inclusion (E&I) framework and strategic E&I function for NHS Greater Manchester Integrated Care is being established. A commitment to being a leading population health system is to be further strengthened through the formalisation of the ICS. We have been developing our population health approach for a number of years, are a Marmot City Region and have also set out our central commitment to tackling inequalities, through the Independent Inequalities Commission report. The Big Conversation People are beginning to take part in a conversation about the future of health and care for themselves and their families. The Big Conversation survey launched on Monday 28 March and anyone who lives or works in the 10 Greater Manchester boroughs can take part. Running until Sunday 8 May , you can find out more about the Big Conversation at and go straight to the survey by following this link:


SLAVERY AND HUMAN TRAFFICKING STATEMENT Introduction from the Board We are committed to improving our practices to combat slavery and human trafficking. Organisations Structure The Christie is a specialist cancer centre serving a population of 3.2 million across Greater Manchester and Cheshire covering 14 Clinical Commissioning Groups (CCG’s). We are an NHS Foundation Trust with approximately 3,000 employees and an annual turnover of approximately £350m. Our business We are a specialist cancer centre and we treat approximately 60,000 patients a year. We are a world pioneer in the care, treatment and research of cancer. We operate out of our main site in Withington, South Manchester and have satellite radiotherapy centres at Salford, Oldham and Macclesfield as well as chemotherapy and outpatient services at sites across 14 other sites in Greater Manchester and Cheshire. We also provide a mobile chemotherapy service and treatment in patients’ homes. Our policies on slavery and human trafficking We are committed to ensuring that there is no modern slavery or human trafficking in any part of our business and in so far as is possible we require our suppliers to hold a similar ethos. The Christie NHS Foundation Trusts’ guidance on Modern Slavery is to: • Comply with legislation and regulatory requirements • Make suppliers and service providers aware that we promote the requirements of the legislation • Consider modern slavery factors when making procurement decisions • Develop awareness of modern slavery issues We will: • Aim to include modern slavery conditions or criteria in specification and tender documents wherever possible, • Evaluate specifications and tenders with appropriate weight given to modern slavery points, • Encourage suppliers and contractors to take their own action and understand their obligations to the new requirements. Trust staff must: • Contact and work with the Procurement department when looking to work with new suppliers so appropriate checks can be undertaken. Procurement staff will: • Undertake awareness training where possible. • Aim to check and draft specifications to include a commitment from suppliers to support the requirements of the act. • Will not award contracts where suppliers do not demonstrate their commitment to ensuring that slavery and human trafficking are not taking place in their own business or supply chains. This statement is made pursuant to section 54(1) of the Modern Slavery Act 2015 and constitutes our slavery and human trafficking statement for the financial year ending 31 March 2021. SIGNATURE:


Chief Executive Officer, The Christie NHS Foundation Trust

28 th April 2022



Integrated Performance Quality & Finance Report






Well Led



Safe •Incident Reporting •Serious Incidents & Never Events •Moderate Incidents •Learning from Incidents •Radiation Incidents

Caring •Patient Experience •Friends & Family

Responsive •Cancer Standards •Referral Analysis •Length of Stay •Activity •Complaints/PALS •Inquests •Claims

Effective •Healthcare Associated Infections •Covid Testing •Mortality Indicators & Survival Rates •Quality Improvement & Clinical Audit •NICE Guidance •HR Metrics – Sickness •HR Metrics – PDRs & Essential Training

Well-Led •Finance – Executive Summary •Finance – Income •Finance – Expenditure •Finance – Capital •Finance – COVID Revenue & Capital

•Harm Free Care •Pressure Ulcers •Inpatient Falls •Corporate Risks •Safe Staffing

•Workforce Metrics •Research Metrics


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