Public Board of Directors meeting summaries

This is a short summary of the Board of Directors meeting held in public on 22 July 2025.  Minutes of the meeting will be published on the Board meetings page on the Trust website.  

With Trust Chair Selina Ullah unable to attend, the meeting was chaired by Tony Edwards, Deputy Chair. This was also Tony’s final meeting as a Non-Executive Director and the Board paid tribute to Tony’s contributions and support over the last three years and wished him well for the future.  

Patient story  

This month the Board welcomed Kelly, a colleague in the Trust’s Children in Care team, to talk about a young person in care and their experience of trying to access specialist health services.  

The Children in Care team includes doctors, school nurses and health visitors and it undertakes statutory health assessments for children in care and adoption, as well as providing health advice and education to these young people and their carers. The team supports those living in Derby and within a 20-mile radius of the city.  

Kelly explained how, when a child or young person is placed outside the Derby city area, then moves back into Derby, this can impact on where they are placed on waiting lists for certain health services.  The team has improved the co-ordination of mental health services and sexual health services for the children they support, ensuring they are given priority access, but there are still issues at times regarding community paediatrics and neurodevelopmental services. 

Kelly gave an example of an eight-year-old child who was living outside the Derby city area and had been waiting to see a local paediatrician and a clinical psychologist for a number of months about behavioural issues relating to past trauma, and about their sensitivity to light and loud noises. 

Upon moving back into Derby, the young person and their carer were told that they would have to join the start of the queue to see a clinical psychologist, meaning the waiting time might be very long. The Children in Care team were able to intervene on this person’s behalf and work with the Neurodevelopmental Pathway team to back-date the referral. As a result, the young person had their clinical psychology appointment earlier this year, where they were diagnosed as having autism spectrum disorder. 

Kelly and the team wanted to request that all children in care receive this kind of priority access to community paediatric and neurodevelopmental services. The Trust Board made a commitment to prioritise support for children in care in this way, noting the significant health inequalities that children in care already face. Board Members also expressed the importance of reducing waiting times for all children and young people referred to our community paediatric and neurodevelopmental pathways. 

Chief Executive’s report  

In this month’s report, our Chief Executive Mark Powell summarised several national developments affecting the NHS, including the launch of the 10 Year Health Plan for England, the publication of Penny Dash’s review of patient safety, and the refreshing of the NHS Oversight Framework – a one-year regulatory framework for 2025/26 which will assess ICBs and providers against a range of metrics. Mark explained how work was already underway to cross-reference the 10 Year Health Plan with the Trust Strategy, to ensure they align. 

Mark also reflected on news closer to home, including the publication of an inspection report by the CQC (Care Quality Commission) which announced that the Trust’s older adult acute inpatient services are now rated ‘good’ overall and ‘good’ across all the CQC’s key domains; Mark thanked colleagues in these services for their efforts. In addition, Mark welcomed the signing of a new strategic partnership with the University of Derby, to develop a more joined-up approach to the teaching of students and a more research-based approach to the delivery of healthcare; and noted that refurbishment work had now resumed at the Trust’s Radbourne Unit as part of the Making Room for Dignity programme.  

Integrated performance report  

Operations 

Operationally, many Trust services are meeting or exceeding national performance targets, and particular attention was paid at the meeting to the Perinatal (mother and baby) mental health service which is continuing to support high numbers of self-referrals from pregnant women and new mothers every month. Trust teams are also performing well in terms of dementia diagnosis rates and access to child and adolescent mental health services (CAMHS). 

At previous meetings, the number of out-of-area placements – for adults requiring inpatient mental health services, due to acute health needs – had been a cause for concern. However, this number has now been reduced to single figures (as of 22 July). The opening of new buildings through the Making Room for Dignity programme should help to sustain these improvements. 

Waiting times for some services remain an issue, including for adult autistic spectrum disorder assessment (ASD) and for community paediatrics due to rising demand. Efforts to reduce waiting times are making a positive difference in some of these areas, including in adult ASD assessment where the number of completed assessments per month is extremely high.  

Work is underway to analyse and reduce the wait times for callers to the Mental Health Helpline and Support Service.  

Finance 

The Trust had an overall adjusted deficit of £1.3m at the end of May, which is in line with planned projections. The current forecast is that the Trust will achieve its break-even plan for the 2025/26 financial year, in line with regional and national requirements. Agency and bank spend continues to decrease, also in line with national requirements.  

The delay in the opening of the Carsington Unit has impacted on costs associated with out-of-area placements for the year so far, but it has been possible to contain the financial pressure and the costs should begin to decrease now that the unit is open. 

People  

Further improvements have been made in staff training levels and in the percentage of colleagues receiving an annual appraisal and regular supervision. The turnover of staff remains in line with other similar Trusts both regionally and nationally. The monthly sickness absence rate has fallen but is continuing to be monitored, with the establishment of an absence oversight group. The use of agency staff has reduced significantly over recent months and continues to remain low. 

The Director of People, Inclusion and Organisational Effectiveness highlighted the potential impact of the resident doctors’ industrial action on rates of training and appraisal. The Board also discussed the recent changes to visa and immigration rules, which have started to affect the Trust’s ability to recruit to healthcare assistant roles. 

Quality  

The data indicated that the Trust is performing well in areas such as medication safety, falls prevention and complaints handling.  

More work is needed to ensure that targets are met when it comes to our Care Programme Approach (CPA) and the review of care plans; Trust services with lower rates have put actions in place to remedy this, and there are now weekly ‘crosscheck’ meetings in both adult and older adult community mental health services. 

In our inpatient services, the use of seclusion has risen slightly in recent weeks. This may be due to the opening of the Derwent Unit, which has its own seclusion suite, unlike the previous building in Chesterfield (the Hartington Unit). Further work will be done with inpatient teams to ensure the use of seclusion is minimised. 

Corporate cost reduction 

All NHS trusts have been asked to reduce corporate costs. The reduction must be 50% of the perceived growth between 2018/19 and 2023/24.  

The Trust’s Finance team has reported back to NHS England to confirm that the Trust is on track to make this saving. 

Fit and Proper Persons Test  

Every year, the Trust Chair must check that all Board Directors meet the Fit and Proper Persons Test (FPPT). A report provided full assurance that all Board Directors meet the fitness test and do not meet any of the ‘unfit’ criteria, confirming that the Board is fit and proper. 

Winter planning 

The Trust has worked with partners in the Derby and Derbyshire health and care system to develop a winter plan, both at a Trust and system level. This is in preparation for increased pressures during the winter due to factors like the rise in flu and respiratory illnesses, and a peak in demand for the services we provide during school holidays and the new year period. The Trust is projecting a 4% increase in demand for inpatient admissions; the plan presented to Board showed how that increase in demand could be met on our own inpatient wards and with the use of out-of-area beds if required, supported by crisis services in the community who can wrap care around people and prevent hospitalisations.  

The Trust will also learn from a recent self-assessment of urgent mental health care, overseen by NHS England, to identify any gaps within pathways and make improvements in time for the winter. 

Fundamental standards of care 

The Board received a report on how the Trust is performing against the standards set out by the Care Quality Commission (CQC). Amongst the positives noted in the report were the recent CQC inspection of older adult inpatient services (see above), the safe staffing levels achieved in inpatient areas and the successful implementation of a refreshed smokefree policy across our sites.  

The Trust has also recently launched a new training course covering suicide prevention, risk assessment and safety training, co-produced by an expert by experience and one of the Trust’s mental health nurses. The training has been recognised nationally for its innovative approach and is receiving good feedback from Trust colleagues. 

In addition, the Trust is increasing the number of ‘fundamentals of care’ visits to teams, to see how care is being delivered in practice. In future, individuals with lived experience will join the directors and governors who go on these visits.  

Board members discussed the value of triangulating data in order to have full assurance that the standards are being met across all services.  

Quality Delivery Plan 

The Board ratified this new three-year plan (2025-28) which describes how we will achieve our strategic priority of being ‘patient-focused’, as set out in the Trust Strategy. The new plan describes the three pillars of quality care that apply across all our services:  

• Effectiveness – providing evidence-based care to improve patient outcomes 

• Safety – providing care that will not cause harm and is timely 

• Experience – providing an experience that is personalised, compassionate, respectful and dignified. 

The plan has objectives and delivery measures for each of these pillars, with digital seen as a key enabler. There are a series of co-produced pledges that underpin the plan, together with examples of real-life experiences from patients and colleagues. 

Board Committee assurance reports  

These were shared following recent meetings of the Mental Health Act Committee, People and Culture Committee, Audit and Risk Committee, Finance and Performance Committee and the Quality and Safeguarding Committee.  
 

The next meeting of the Board of Directors will take place in public on 23 September 2025 from 9.30am. Details will be available on the Board meetings page ahead of the meeting. 

This is a short summary of the Board of Directors meeting held in public on 3 June 2025.  Minutes of the meeting will be published on the Trust website. 

Patient story 

This month the Board welcomed Adam and Alyson to talk about health literacy and the need to ensure the information we produce is accessible and relevant to our audiences.  A project focused on how we create easy read materials is underway, to ensure we have consistent approaches to developing letters and patient information that people with a learning disability (and wider literacy/accessibility requirements) can read, understand and remember.  Adam and Alyson will be raising awareness of the project amongst colleagues as it develops, and ask everyone to consider the needs of our patients and communities when creating written information. 

Chair’s update  

Selina Ullah provided an update on her recent visits to Trust services including the Derwent Unit and Crisis and Liaison team and reflected on the great care our teams provide, often whilst under great pressure.  Selina also provided an update on the official opening of Bluebell Ward, which took place in May. 

Selina reflected on the number of changes taking place across the NHS and her participation in conversations across the Joined Up Care Derbyshire system.  She continues to receive regular feedback from Trust governors, including how the changes affecting Trust colleagues are being experienced. 

Recruitment of two new Non-Executive Directors is underway, given the terms of office for Tony Edwards and Geoff Lewins will come to an end later this year.  Selina has recently undertaken appraisals for all Non-Executive Directors and the Chief Executive and new objectives are in place for the coming year. 

Chief Executive’s report 

Vikki Ashton Taylor provided the CEO update in the absence of Mark Powell this month.  The report provided a national update on changes taking place across the NHS, together with new developments, including a best practice suicide safety toolkit. 

The CQC (Care Quality Commission) had recently visited the Trust’s older adult acute inpatient services and shared positive feedback which commended colleagues working in these services.  We now await a formal report from the visit. 

Vikki provided an update on Derbyshire’s NHS Talking Therapies services which will be provided by Vita Health Group from 1 July 2025, with the support of Everyturn, following a new tender process being undertaken.  Vikki thanked all Trust colleagues who have provided an excellent service through the Talking Mental Health Derbyshire team over recent years. 

Integrated performance report 

Many Trust services are meeting or exceeding national performance levels, with dementia diagnosis rates, community mental health contacts and individual placement and support (IPS) figures being given as examples of particularly high performance. 

Challenges continue to be experienced in waiting times to access adult autism spectrum disorder (ASD) assessments, and in reducing the number of out of area placements.  It is anticipated that the opening of the new acute units will support this reduction in the coming months. 

The Trust ended last year with a financial deficit. As a result of bringing the new inpatient facilities into use through the Making Room for Dignity programme (see below), a valuation led to an impairment of £23.8m which was the main driver of a reported out-turn deficit of £25.2m (before adjusting for technical adjustments). A number of required technical adjustments offset this deficit to return the Trust to its adjusted break-even position. From a performance perspective, the Trust delivered a break-even position against a £6.4m deficit plan.   

Our cost improvement plan for 2024/25 was delivered in full, making higher than anticipated savings in some areas including through the reduced use of agency staffing.  We know the current financial year will be challenging as we work to achieve financial balance.  The Trust currently has a £400,000 savings gap to identify from the overall target of £14.7m this year. 

People metrics confirmed improvements in tools to manage staff absence and occupational health processes, with access to fast-track support being available to colleagues who are affected by organisational change.  This week the Trust welcomed colleagues who are joining Derbyshire Healthcare to create an in-house Employee Relations team (moving away from the service being offered through the People Services joint venture).  This change is in order to provide prompt resolution to any ER cases within our services, supporting teams and colleagues when any issues arise through a compassionate approach. 

Quality and safety data shows a decrease in the number of complaints being received about Trust services, and a positive increase in the number of risk assessments and care plans in place.  Use of seclusion has increased, which has coincided with the opening of the Trust’s new services and further focus will be placed on how we better use activities and de-escalation facilities in the new units. 

A new style performance report will be developed ahead of the next Board meeting, to report performance in line with the new NHS Performance Assessment Framework. 

Making Room for Dignity programme update 

An update on the various elements of the Making Room for Dignity programme was shared with the Board, who thanked all colleagues who had been involved in the programme to date. 

• Bluebell Ward – which offers 12 beds for older adults with functional mental health diagnoses, opened in January.  An official opening of the new ward, which is located on the Walton Hospital site in Chesterfield, took place in May.  Positive feedback has been shared by patients, carers and colleagues and the Board noted a recent benefits realisation report which confirmed the new environment had resulted in a reduction in the number of risks registered. 

• Derwent Unit – the new 54 bedded acute inpatient unit opened in March on the Chesterfield Royal Hospital site. 

• Carsington Unit - the new 54 bedded acute inpatient unit opened in May on the Kingsway Hospital site in Derby. 

• Radbourne Unit – refurbishment of the Radbourne Unit on the Royal Derby Hospital site is due to commence shortly.  Two wards supporting male patients will remain at the site although internal moves have taken place to minimise potential disruption to patient facing services. 

• Audrey House (Enhanced Care Unit) and Kingfisher House (Psychiatric Intensive Care Unit or PICU) are in the final stages of completion and will open to patients in the coming months. 

The new units are designed to promote a therapeutic model of care which will promote recovery and reduce people’s length of stay in our services.  The new acute units and PICU will also provide additional capacity to support people within Derbyshire, thereby reducing the number of people being supported out of area. 

NHS homicide review 

The Board received an update on the Trust’s plans to implement learning following the serious incident in Nottingham in June 2023.  Funding has not been identified to create a standalone assertive outreach team and risks are currently being mitigated within the current model of care. 

Other papers shared for information 

The Trust Board also received reports on the following topics, in line with the Board’s Forward Plan: 

• Gender pay gap 

• Medical appraisal and revalidation 

• Learning from deaths 

• SEND annual report 

• Modern slavery statement. 

Board Committee assurance reports 
These were shared following recent meetings of the Mental Health Act Committee, People and Culture Committee, Audit and Risk Committee, Finance and Performance Committee and the Quality and Safeguarding Committee. 

The next meeting of the Board of Directors will take place in public on Tuesday 22 July from 9.30am.  Details will be available on the Trust website ahead of the meeting. 

Patient story

This month the Board welcomed Richard to the meeting, to share his experience of the Trust’s Living Well services in Derby (Derby Wellbeing).  Richard spoke about how the flexibility offered by the service supported his individual needs, building his confidence and understanding of his condition. 

Richard also highlighted the value of receiving advice from people who also had lived experience of mental health conditions and how he would be working with the Trust to support the future training of junior doctors, from an expert by experience perspective.  Richard also spoke about the flexibility of Living Well offering support in non-clinical spaces and the therapeutic benefits of spending time outdoors and focusing on his own fitness.  

Chair’s update

Selina shared details of her engagement activities over recent months, including several service visits to teams which provided detailed insight into Trust services.  She had recently spent time with the Trust’s finance team, adult crisis team and colleagues in the Mental Health Act Office.  Selina reflected on the level of risk managed within our services and the tremendous work our teams do in supporting people in their home environments.  

Selina also spoke about a recent Board Development session that had taken place in a community setting, to explore how we can better engage with local communities and tackle health inequalities.  She also thanked the family of Barry Whitehead for their kind donation to the Trust’s Dementia Rapid Response Team.  Barry’s grandson, Jack, had raised money to donate to the team in his memory, by completing a half marathon.  

Finally, Selina welcomed new members of the Council of Governors, following the elections that took place at the start of the year. 

Chief Executive’s report

Mark confirmed that Bluebell Ward in Chesterfield had opened since the Board last met in public, and that positive feedback about the new environment had been received by people who are receiving support from the team and their carers. The new Derwent and Carsington Units are also due to open in the coming weeks. 

Last month the Integrated Care Board (ICB) confirmed the new provider of Talking Therapy services as Vita Health.  As one of many local providers, the Trust is engaging with the new provider to ensure a safe transfer of the service for both staff and patients.  In the coming weeks the Trust would need to close its waiting list for Talking Therapy services as part of this transition on 1 July 2025. 

Mark’s report also provided a national update including the new planning guidance that had been issued at the end of January.  This outlines ambitions for neighbourhood health models, which build upon the neighbourhood health services already in place across Derbyshire.  Whilst sharing his disappointment about some of the de-prioritisation of national targets for mental health, learning disability and children’s services, Mark confirmed that the Trust’s Strategy and delivery plan outlines local priorities in line with the new planning guidance. 

Integrated performance report 

• The Trust is in line with its financial plan to deliver a £6.4m deficit by the end of 2024/25.  Key risks to achieving this position are being carefully managed and include the number of people receiving care out of area and an increased acuity of patients on our wards, leading to higher than usual observation levels. 

• The Board were pleased to note that occurrences of restrictive practices including restraint and seclusion had reduced in line with teams’ focus on patient safety and environmental improvements.  A focus on supporting people who are clinically ready to be discharged from our services with their wider housing and social care needs was seeing a reduction in the length of time people stay in the Trust’s inpatient wards. 

• Operational performance continues to be strong, with increasing number of people receiving dementia diagnoses, accessing services for children and young people and perinatal support.  Some areas of high demand continue to experience waiting times to access appropriate support. 

• Turnover amongst Trust staff had started to reduce, with a focus on stay surveys as well as exit interviews to understand more about the reasons why people choose to stay or leave their role in the Trust.  Absence rates had slightly increased over the winter months and additional wellbeing support was being provided. 

Strategic Plan 2025-28

The Strategic Plan was approved by the Board of Directors.  This outlines how we will achieve the actions in the new Trust Strategy over the next three years and follows ongoing engagement with colleagues.

Freedom to Speak Up

The half-yearly report to the Trust’s Board of Directors reflects trends in data over the last six months, and steps being taken to support a speaking up culture. Recent data reflected that patient safety concerns remain relatively low, as are concerns reported around bullying and harassment.  Of note, the guardian had experienced an increase in the number of queries being received by Trust staff, with worker safety and wellbeing being an emerging theme.  The Board agreed to triangulate this feedback alongside the results received in the recent staff survey and ensure HR support is in place for any people related issues or concerns. 

Staff Survey

Whilst the national staff survey results remain under embargo, the Trust’s Board of Directors discussed ways to act upon the feedback received through the most recent survey, to make meaningful changes in response to Trust staff. 

Board Committee assurance reports

These were shared following recent meetings of the Mental Health Act Committee, People and Culture Committee, Finance and Performance Committee and the Quality and Safeguarding Committee. 

Wider reports were shared for information/approval including an updated version of the Trust’s Constitution, details of the Joined Up Care Derbyshire Provider Collaborative and the regular learning from deaths report.   

The next meeting of the Board of Directors will take place in public on Tuesday 3 June from 9.30am.  Details will be available on the Trust website ahead of the meeting. 

Summary of the Board of Directors meeting in public, January 2025

This is a short summary of the Board of Directors meeting held in public on 14 January 2025.  Minutes of the meeting will be published on the Board Meetings page on the Trust website. 

Trust Chair, Selina Ullah, opened the first meeting of 2025 sharing how much she is looking forward to the year ahead.  Whilst acknowledging there will be challenges, particularly with restricted funding, Selina shared her optimism about potential opportunities and achievements for the Trust during the coming year.   

Selina welcomed new Non-Executive Director, Andrew Harkness, to his first meeting of the Board of Directors.  Andrew started in post this week and brings a wealth of experience in population health management and health inequalities. 

Staff story

This month’s meeting opened with a focus on our internationally qualified colleagues, working in the Hartington Unit in Chesterfield.  The Board welcomed Faisal, Ansha and Abirami who joined the Trust in 2024 from India and Pakistan. 

The team shared the collective experiences of seven international nurses who started working on the wards at the Hartington Unit last year, discussing learning and recommendations including the value of pastoral support and the suggestion to include a buddy system, together with the need to provide more information on local housing and cultural adaptations.   

Chair’s update

Selina shared details of her engagement activities from November – January, including several service visits to teams which provided detailed insight into Trust services.  She recognised colleagues were passionate about our services and working hard in face of various challenges to deliver high quality care. 

Selina had also visited the teams based at the Radbourne Unit as part of the Trust’s annual Christmas competition.  She reflected on the diversity of people supported by the unit and the positive feedback she received. 

Finally, Selina shared her thanks with governors who would shortly be ending their term of office and stepping down from the Council of Governors. 

Chief Executive’s report 

Mark also shared details of service visits and confirmed he would be meeting colleagues and patients at the new Bluebell Ward later this week. He thanked everyone who had supported the successful opening on the new Bluebell Ward for older adults on 7 January.  He confirmed that wider learning would be used to inform the subsequent moves of our acute inpatient services. 

Mark’s report provided a national update on the ongoing Change NHS engagement ahead of the new 10-year health plan this Spring.  He also shared details of a recent report from the Centre for Mental Health, focused on care beyond beds. 

An update from the East Midlands Alliance was shared with all partner providers.  Mark noted positive development in CAMHS services across the East Midlands supporting a greater number of children and young people in the community. 

Integrated performance report 

• In partnership with East Midlands Ambulance Service (EMAS), a new Derbyshire mental health response vehicle commenced in October and is dispatched to mental health-related incidents between 4pm and midnight, seven days a week. The initiative aims to provide support in the community, reducing the number of people attending A&E for mental health needs.  To date the results are promising: in 2023, 55% of the patients with a mental health need seen by EMAS were conveyed to hospital. In November 2024, following the launch of the mental health response vehicle, this figure had reduced to 12% and the latest data places this between 7-9%. 
   

• The Trust is providing levels of Talking Therapies support that is above locally commissioned activity.  We currently await the outcome of a recent ICB procurement process and will work with future providers to support ongoing service delivery.  The Board noted concerns about local people waiting to access the service, with current waiting lists already high.  The Trust is working hard to discuss management of the forthcoming transition for both patients and colleagues. 

• The number of inappropriate out of area placements remains an ongoing challenge and the Board acknowledged the impact of this on patients and families.  Teams are also proactively managing high lengths of stay, people who are clinically ready for discharge and opportunities wider than admission. The pilot of a new seven day a week community mental health service has also commenced.   

• The Trust’s financial position is on track to deliver the planned deficit.  Training and appraisals compliance has increased and the Trust is part of a national review of statutory and mandatory training.  From a quality perspective, seclusion rates are reducing in our inpatient services, leading to restrictive practice as required. 

• The CQC re-visited the Trust’s acute inpatient units in December.  Following this visit we received positive verbal feedback on the improvements put in place since their visit in spring 2024.  This reflects significant progress at both the Radbourne and Hartington Units, which we expect will be confirmed in a new report shortly.  The Board thanked colleagues involved in making these positive changes across our acute units.  Whilst there is still work to do to embed these changes and continue our improvements, this is really positive news and reflects the progress made by our teams. 

Board Committee assurance reports 

These were shared following recent meetings of the Mental Health Act Committee, People and Culture Committee, Finance and Performance Committee and the Quality and Safeguarding Committee. 

Wider reports were shared for information including the regular learning from deaths report and an update from the Trust’s guardian of safe working.   

The next meeting of the Board of Directors will take place in public on Tuesday 4 March from 9.30am.  Details will be available on the Board Meetings page on the Trust website ahead of the meeting.