Public Board of Directors papers 27.01.22

The concerns raised in February 2020 were reported to the Board of Directors at its meeting in June 2020 as part of the Freedom to Speak Up Guardian’s regular report. Intervening board meetings had been curtailed, as had many internal meetings, in line with national direction to ensure that The Trust focussed on the operational emergency of the first wave of the COVID pandemic and was able to maintain access to cancer treatments. On 6 th August 2020, an initial response was sent, via the FTSUG to preserve anonymity, to those who had raised concerns. This reply purposefully dealt only with the initial stages of the response and, as pointed out in the covering letter, other matters including allegations of inappropriate behaviour and the review of the CRF remained in progress as part of a comprehensive response. In August 2020, those who had raised a concern expressed their dissatisfaction with the initial response. Their feedback was shared with the executive team on the 11 th August 2020. On the exact same date an individual escalated the matter to the Trust chairman in a widely circulated email which repeated some of the initial allegations and raised a series of further, more serious allegations. In view of this immediate escalation without further discussion with the FTSUG the usual practice of offering a conversation with those raising concerns was pre-empted. In response to the further allegations The Trust chairman commissioned an external review by a senior Trust chairman with a medical background from another region and asked for the audit committee to commission investigations where appropriate. The reviews were not completed and the option to speak to an executive director was not offered at this time (as would be usual practice) because of the further escalation to and intervention by the Regional Office. The Regional Office intervention came about because in August 2020, an external third party who appears to have been contacted by at least some of the staff raising concerns expressed concerns directly to the NHS Regional Office without informing The Trust. This escalation led The Regional Office to commission a “Rapid Review” and require The Trust to stop its own external investigation and the investigations of the audit committee. The Trust was not shown the specific concerns raised with the Regional Office. The Trust was also not consulted on the scope of the “Rapid Review” but was given a set of Terms of Reference which indicated the broad areas of enquiry. These and the composition of the review team, which was also not prospectively discussed with the Trust, are set out in the “Rapid Review” team’s report. In October 2020, The Trust supplied a comprehensive dossier of background information to the ‘Rapid Review” team. Interviews took place with Trust staff selected by the “Rapid Review” team during January and February 2021. The team also interviewed staff who contacted them directly through an email inbox following an open invitation to all staff. In July 2021, some of the Trust staff who had been interviewed by the “Rapid Review” team received short extracts from a draft report asking for comments. The extracts provided information suggestive of the conclusions that the "Rapid Review" team had reached but did not provide the information used to reach these conclusions in a way which made it possible to understand how the conclusions had been arrived at. The chief executive provided the requested coordinated response on 19 th July 2021 after discussion with the board of directors. This 22-page response drew attention to a range of factual errors.

16