Board of directors minutes December 2025

Present

• Kathryn Lavery, Chair.
• Rachael Blake, Non Executive Director.
• Richard Chillery, Chief Operating Officer.
• Maria Clark, Non Executive Director.
• Dr Richard Falk, Non Executive Director.
• Steve Forsyth, Chief Nurse.
• Sarah Fulton, Tindall Non Executive Director.
• Kathryn Gillatt, Non Executive Director.
• Carlene Holden, Director of People and Organisational Development.
• Toby Lewis, Chief Executive.
• Jill Savoury, Deputy Director of Finance.
• Simon Sheppard, Director of Finance and Estates.
• Dr Diarmid, Sinclair Chief Medical Officer.
• Dave Vallance, Non Executive Director.
• Pauline Vickers, Non Executive Director.

In attendance

• Richard Banks, Director of Health Informatics.
• Philip Gowland, Director of Corporate Assurance and Board Secretary.
• Jo McDonough, Director of Strategic Development.
• Shabir Pandor, NExT Director.
• Jane Charlesworth, Head of Corporate Assurance (minutes).
• 7 members of staff and 3 Governors were in attendance.

Welcome and apologies

Reference

Board public: 25/12/01.

Mrs Lavery welcomed all attendees to the meeting. Apologies for absence were noted from Dr Jude Graham, Director for Psychological Professions and Therapies.

Quoracy

Reference

Board public: 25/12/02.

Mrs Lavery declared the meeting was quorate.

Declarations of interest

Reference

Board public: 25/12/03.

Mrs Lavery presented the declarations of interest report and confirmed there had been amendments to Ms Blake and to Ms Gillat’s declarations of interest to the register since the last meeting.

The board received and noted the changes to the declarations of iInterestreport.

Standing items

Minutes of the previous board of directors meeting held on the 27 November 2025

Reference

Board public: 25/12/04.

The board approved the minutes of the meeting held on the 27 November 2025 as an accurate record.

Matters arising and follow up action log

Reference

Board public: 25/12/05.

The action log was considered. It was noted that most actions were carried forward from November, with three new actions added. One action relating to the appointment of a well led partner was proposed for closure, as the procurement process was nearing completion. This was agreed.

Remaining 2026 and 2027 clinical changes

Reference

Board public: 25/12/06.

Mr Lewis introduced the paper outlining the remaining clinical changes for 2026 to 2027. He explained that the proposals were relatively modest and proportionate in aggregate, these were significant changes for all involved. The board has discussed in November the intention to focus on productivity changes and also changes which tilted delivery towards generalism. There also were changes outlined which altered the number of clinical leaders at team level, removing non-patient facing time. The paper was presented on the same basis as the parallel backbone paper in November but was accompanied by quality and safety impact assessment (QSIA) material across the full programme of work.

Outlining the quality and safety impact assessment process, Mr Forsyth confirmed it included five standards: appreciative challenge, multidisciplinary involvement, dynamic assessment with data checks, use of a standardised tool covering ten domains, and recommendations for ongoing monitoring. Dr Sinclair added that the vast majority of the queries raised during the quality and safety impact assessment process had been resolved following further information from care groups.

Ms Gillatt sought assurance on monitoring and early warning systems, and it was confirmed that thresholds of concern would be defined to trigger intervention if required.

Mr Lewis clarified to Mrs McDonough that the panel did not operate a pass or fail system, but he confirmed that some schemes had been withdrawn prior to it or altered as a reflection of it. Illustratively he mentioned the hospice hairdressing scheme which would now not proceed.

Mr Lewis emphasised that while risks had been assessed, successful implementation would depend on strong leadership and support for behavioural change across teams. He highlighted that these changes were not radical innovations but material adjustments to improve efficiency and sustainability.

Ms Fulton Tindall queried preparations for adaptive leadership and support for managers during implementation given the behavioural change required. Mr Lewis confirmed that a dedicated implementation group, led by Mr Chillery, would focus on readiness and support for team leaders. That would work from January to be ready for April, when schemes go live.

Mr Vallance asked about the impact on treatment efficacy and preventative work. Mr Forsyth noted that generally the ongoing impact of schemes would be considered against thresholds of change viewed through key performance indicators (KPIs). Mr Lewis noted that preventive impacts were considered in the quality and safety impact assessment process too but noted that these changes were not in themselves a left shift.

Ms Holden raised two key questions, regarding band 3 workforce impact and inferred references to transfer of undertakings (protection of employment) (TUPE) transfers. Mr Lewis clarified that only two TUPE transfers were planned (procurement and estates). He felt that reference may be being made to out of hours palliative care where no TUPE situation would arise. He agreed that the impact of change did differ by band and role and committed to analysing societal impact using staff postcodes. Ms Blake requested a positive framing of key performance indicators (KPIs) and inclusion of geographical equity alongside protected characteristics which was agreed and noted that there would checkpoints in respect of key performance indicators, likely at the Quality Committee in January and certainly at the board in March.

With respect to the proposed changes in safeguarding, chaperoning, and assertive outreach, Mr Lewis assured Mrs Vickers and the board that key performance indicators would track these areas and that assertive outreach changes would not impact on maintaining compliance with national guidance.

Mr Lewis drew the board’s attention to the seven highlighted schemes within the paper.

• The Child and adolescent mental health service (CAMHS) medical staffing proposal was to operate with the same number of doctors as current but noted this was fewer than the establishment. He emphasised the need for further detail and assurance before agreeing to proceed due to the scheme’s significance and complexity.
• The at-risk mental state (ARMS) pathway in North Lincolnshire, previously funded as an investment, was proposed to be integrated into general teams,
• Assertive outreach changes in Rotherham and Doncaster focus on workflow redesign and reducing handover periods, with staff involvement acknowledged. He recognised that the profile of Assertive Outreach team (AOT) meant it was right that the Board understood was proposed.
• Physiotherapy adjustments in learning disability therapies were considered acceptable however the speech and language therapy changes required further review due to potential clinical risk.
• Reduction in medical input and disestablishment of child sexual exploitation posts was proposed with responsibilities redistributed across the safeguarding team.
• Alterations to chaperone arrangements and change to specialist palliative care services within physical health services would represent significant practical and cultural change, with the quality safety impact assessment panel influenced by management team’s analysis of impact which was detailed and considered.
• The integration of health and wellbeing pathway into community mental health team structures in Rotherham had no material risks identified but was understandably opposed by some of those involved. This would move the trust into a more consistent position across Rotherham, Doncaster and South Humber NHS Foundation Trust (RDaSH).

Responding to Dr Falk regarding GP engagement and whether it could be relied upon, particularly in relation to morale and its potential influence on wider service delivery requirements such as seven day working, Mr Lewis confirmed that no schemes were being implemented that transferred work to GPs and stressed the need to avoid this occurring inadvertently. He noted that some GP groupings had already been briefed on the proposed changes and outlined a process scheduled for the first three weeks of January to engage partners on changes, focusing on neighbourhood physical health initiatives and the health and well-being pathway. Mr Lewis concluded that it was too early to determine the level of GP support and clarified that there was no dependency on GPs within the current proposals.

Mrs Vickers questioned whether human resources and other teams had the skills and capacity to manage quarter 4 changes and how they would be supported. Mr Lewis confirmed staff would not be expected to balance their day job with change work, explaining that a small group of managers and human resources staff would be identified to work exclusively on this change and consultation process. He acknowledged potential gaps and committed to bringing in additional expertise where needed. Mr Lewis noted the cultural shift toward closer management could lead to varied reactions, including sickness absence, and stressed that readiness, including policies and processes, must be in place by April, as success depends on maintaining projected sickness rates, certainly from quarter 2.

The board received and noted the processes of development and review undertaken by care group directors and quality safety impact assessment (QSIA) panel. The board considered the issues raised by those processes and seven schemes set out in the paper.

The board agreed to pursuing schemes outlined and delegated minor variation to the chief executive.

A private meeting would be held in January to finalise details of consultation and selection and to consider the overall capacity and capability to take this forward amid all of the other priorities the service faces.

Planning submission 2026 to 2028

Reference

Board public: 25/12/07.

Mr Lewis presented the planning submission, covering financial, workforce, and operational considerations. He reminded board colleagues of the trust’s MTFM from September as well as other relevant planning documents. He made the following comments:

• a balanced financial plan for 2026 to 2027 and from 2027 to 2028 would be submitted without deficit support, although a gap between income expectations by the trust, with very modest growth, and the ICB initial offer, existed. The true gap currently was estimated at £3.6m, recognising that CVs and the HDRU sums were in addition to that
• capital submissions did now reflect the phasing of land sale and receipt, which the board had accepted as the right planning submission, notwithstanding that the outline business case was due for consideration later in 2025 and 2026
• operational delivery showed further improvement on current positions, including for out of area placements, albeit the forward improvement was modest as we needed to stabilise what had been achieved. There was not an intention to offer to see improvement in clinical outcomes in talking therapies given the inequalities faced by those we were seeking to improve access from. Mr Lewis also noted ongoing confusion over the reporting of neurodiversity patients which would not be resolved for the 17 December submission
• board members would recognise the challenge posed by sickness, and it was only towards the end of the planning period that the trust was indicated with external bodies might see as compliance (at 4.1%)

Scenario modelling and contingencies were discussed, with the main financial contingency being improved performance in out of area placements. Mr Lewis responded to Mr Pandor and confirmed that the existing 2023 to 2028 strategy would be submitted if required in February with suitable annotation, as the December submission did not mandate a separate clinical strategy.

Mr Lewis noted that a more assertive negotiating approach may be necessary in early January due to the absence of contract offers for years two and three, and the lack of any information from colleagues in Humber and North Yorkshire.

Mr Vallance questioned whether we were overstating our assurance on the improvement capability within the organisation. Mrs Lavery recognised the challenge offered also over email between board members. Having discussed this with colleagues she understood that the strong majority view retained the assurance as presented.

The board received and noted the proposed board assurance statements outlined, and recognised the oversight of contracting implied within them.

The board delegated to the chief executive pursuit of further clarity on year 2 or 3 contracting, with recognition of thanks to colleagues in finance, people and organisation development, and operations for rapid work to populate the spreadsheets.

Closing items

Any other urgent business

Reference

Board public: 25/12/08.

There was no further business raised.

Public questions

Reference

Board public: 25/12/09.

There were no public questions.

Close

Reference

Board public: 25/12/10.

Mrs Lavery thanked members of the board for their engagement and contributions and confirmed that a further private meeting would be held in January to address outstanding details.

Page last reviewed: February 04, 2026
Next review due: February 04, 2027

Problem with this page?

Please tell us about any problems you have found with this web page.

Report a problem