Annual members' meeting

Annual members' meeting - Wednesday 22 November 2023

By virtual means

Attendees - 43

• Edward Astle – Chairman
• Roger Spencer – Chief Executive
• Louise Westcott – Company Secretary (Minutes)

1. Welcome and introduction

Edward Astle (EA) introduced himself as the new chair of the Trust and welcomed our members, governors, staff and volunteers to the meeting. This is our Annual Members meeting where we will be looking at the work and achievements of the Trust in 2022/23. We are virtual this year and are having our meeting a little later than usual for reasons that will be explained.

The Christie has responded in its usual committed and determined way to ensure the best possible cancer care. We have seen innovation and developments happen in the way we treat patients, as well as big steps taken towards our mission of providing world beating care, research and education. People and patients are at the centre of all this, and EA thanked everyone for their support.

I hope you enjoy the meeting and if you would like to find out more about the achievements in 2022/23 the annual report and accounts are available for you to access on our website on our Annual report and highlights of the year - 2022/23 page.

2. Report from the Chairman
   • Minutes
     EA noted that the minutes for the previous annual members meeting from 4 October 2022 have been available on the website prior to today’s meeting. No corrections have been received so we will accept these as an accurate record.
   • Governor elections and thanks
     Sam Vickerman for the Tameside and Glossop constituency and Rachael Bailey for the other clinical professional staff constituency were both re-elected for a second term.
     Philip Ormesher was elected to the Cheshire constituency, and we welcome back Susan Mee to the Oldham constituency.
     We also have a new staff governor, Catherine O’Hara who has been elected as the governor for non-clinical staff.
     Unfortunately, we did not fill 4 of our public constituencies and will look to fill these seats going forward.
     We would like to congratulate our existing governors on being re-elected and extend a very warm welcome to our new governors.
     On behalf of the Trust and the Council of Governors EA thanked our outgoing governors:
     Alice Choi - completed 9 years as public governor for Cheshire and a member of the Development and Sustainability Committee
     Dr Mohammad Qureshi – also completed 9 years as a public governor for Bury and a member of the Patient Safety and Experience Committee
     Janice Moss - resigned as the partner governor for The Christie Charity in February 2023 after completing 5 and a half years as a governor and member of the Patient Safety and Experience Committee
     Alison Calnan - resigned as the public governor for the Northwest in November 2022.
     EA thanked our outgoing governors very much for their involvement and hope that you keep in touch.
   • Appointment of Directors
     EA updated the meeting on appointments and changes to the Board of Directors in 2022/23.
     During 2022/23, there were no changes to the Board of Directors.
     Further details about all the members of the Board of Directors are available on our website.
     I can confirm that during 2022/23 the Nominations Committee recommended to the Council of Governors the reappointment of Kathryn Riddle, Jane Maher, Kieran Walshe, Tarun Kapur and Robert Ainsworth for a further 1 year. They also recommended a further 1-year term for Chris Outram as Chair.
     These extensions were agreed by the Council of Governors.
     EA noted that there have been some changes this year and these will be reported to the next meeting.
   • Amendments to Trust constitution
     EA noted that there were no changes to the constitution in 2022/23.
3. Report from the council of governors
   • EA noted that he is presenting this summary of the work of the council of governors and its committees in 2022/23. He thanked the Council of Governors for its continued commitment to carry on supporting the Trust.
     Amongst other things the council has reviewed the appraisals of the non-executive
     directors including the chairman and heard detail of the refreshed strategy of the Trust.
     Much of the work of the council is done through their committees.
     First off, the Membership and Community Engagement Committee has developed and been working to the Membership Strategy 2019 to 2023. This continues the work of the previous strategy with the focus on increasing engagement and representation in the membership. At the end of the year 2022/23, our total membership was 12,586 members (this is including staff and volunteers) - this has been reduced from around 30,000 members. The target membership is now 10,000 engaged members.
     The Patient Safety and Experience Committee reviewed issues relating to patient safety, clinical effectiveness, and patient experience - the core strengths of the Trust. The ‘talking to patients’ initiative that has been so successful over the years and gives the governors direct engagement with patients, carers and frontline staff, continues to be popular and successful.
     The Development and Sustainability Committee has been involved with the Annual Planning process in its changed form and has worked on reviewing progress against the Trust Strategy. This committee has also provided governor input to major capital programme developments including the now completed Paterson site redevelopment, as well as receiving updates on the changed financial planning process.
     The Nominations Committee have recommended reappointments and the appointment of the new chair.
     The council of governors had a busy and productive year. Meetings have been very well attended both in person and virtually.
     I would now like to hand over to Roger Spencer, The Christie chief executive who will talk a bit more about the annual report and accounts 2022/23.
4. Report of the Chief Executive
   • Annual report and accounts, and future
     RS introduced the summary of the annual report & accounts for the year 2022/23.
     Annual report and accounts 2022/23 & forward planning information
     RS noted that we are passionately committed to improving the outcomes and experiences for cancer patients. In 2022/23 our team has delivered an outstanding set of results. In a moment I'm going to show you a short film that describes some of the highlights, but first I want to tell you about some of the details.
     RS updated on key elements of the delivery of the Trusts requirements.
   • Quality Standards
     In 2022/23, The Christie continued to perform very well against our required quality standards including our safety measures such as extremely low infection rates, and carried on monitoring our waiting time targets to ensure that our patients continued to be seen as quickly as possible. We also worked across the system in Greater Manchester to prioritise cancer patients where there are still some long waits because of the ongoing impact of the pandemic. But most importantly we have received excellent feedback from our patients throughout the year giving us excellent outcome and experience results. You will hear more about this shortly.
   • In terms of our Financial Performance
     In 2022/23 the Trust has continued to operate under the same financial regime which was introduced in 2020/21. This financial regime was a simplification of the funding flows which was introduced, due to the coronavirus pandemic. The NHS providers and their commissioners moved to a financial framework funding on block contracts and system partnership arrangements. The trust continues to have a strong grip on managing the finances.
     For 2022/23, we made a consolidated surplus of £12.1m (this includes the Charity, The Christie Pharmacy (a subsidiary company of the Trust) and the Trust). NHS commissioners and NHS England have invested £36.9m more in patient treatments than in the previous year. The additional investment includes £10.3m of Elective Recovery Funding, this funding is to assist the Trust in achieving elective activity recovery with the aim of reducing the increased waiting lists and times resulting from the impact of the COVID-19 pandemic.
     During this financial year, the Charity received £16.2m total income and funded £0.5m of Capital projects.
     We have invested £74.7m on new assets including: the completion of an integrated research facility to replace the fire damaged Paterson research building, the commencement of a multi-year replacement programme of our fleet of linear accelerators starting with the Oldham site, new information technology, and estates maintenance to ensure effective patient care.
   • Auditors Opinion
     We have been given a clean bill of health by our auditors who set out in their report that our accounts are a true representation, and we pass the required efficient effective and economic tests.
     In respect to one transaction in-year relating to The Christie Charity, the Trust’s external auditor reported that in their view there was a significant weakness in the Trust’s governance arrangements relating to a single transaction. This related to the Trust not receiving approval from HM Treasury. The Trust had received legal advice that we could go ahead with this transaction and there was an understanding that other Trusts had entered similar transactions. However, the external auditor recommended the Trust seeks advice from NHS England and HM Treasury regarding its compliance with Managing Public Money. The Trust has discussed this matter with NHS England and sought retrospective approval for the transaction from HM Treasury. This approval has not been received at the date of this report. The external auditor also recommended that, prior to making any similar transactions in the future, the Trust seeks advice and/or approval, as applicable, from NHS England and HM Treasury as part of its assessment of compliance with HM Treasury’s Managing Public Money.
     This delayed our ability to lay the Annual Report & Accounts before parliament thus delaying the meeting. This has now been done and is resolved.
   • Regulators Assessment
     We have complied with the required standards as well as achieving the best possible rating (1) in the System Oversight Framework which assesses performance across quality of care, finance and use of resources, operational performance, strategic change, and leadership and improvement capability.
   • CQC
     In October 2022, the CQC undertook a routine inspection of a core service, medical services. The well led part of the inspection followed in November 2022 and the Trust received the outcome report and rating in May 2023, the overall rating received was Good. An action plan was submitted in response to the report, which has been published on the Trust's website.
     The Review of the Year video was shown.
5. Questions
   Questions and comments were invited.
   • Question: What are you building next to the Patterson building on Oak side.
     Response: Ee have submitted a planning application for an Advanced Scanning and Imaging Centre, with associated clinical accommodation. It is a 3-storey building that will replace the current outdated accommodation for CT scanning to allow for a much better patient experience and to accommodate the latest equipment. There will also be scope to use the upper floors for more up-to-date inpatient accommodation in the future.
   • Comments:
     • This video is amazing.
     • Stacey's story has brought a tear to my eye, what an amazing woman.
     • What a fantastic overview of The Christie services!

Annual members' meeting - Wednesday 4 October 2022

By virtual means

Attendees - 45

• Chris Outram – Chairman
• Roger Spencer – Chief Executive
• Neil Bayman – Executive Medical Director
• Sally Parkinson – Interim Executive Medical Director
• Louise Westcott – Company Secretary (Minutes)

1. Welcome and introduction

CO welcomed our members, governors, staff and volunteers. This is our third virtual Annual Members meeting and we will be looking at the work and achievements of the trust in 2021/22.

It was a difficult year with the ongoing impact of the COVID-19 global pandemic.

The Christie has responded in its usual committed and determined way to ensure cancer care has safely continued where possible throughout this time. The pandemic has meant that we have worked differently and we have seen innovation and developments happen in the way we treat patients, as well as big steps taken towards our mission of providing world beating care, research and education. People – and patients are at the centre of all this and I thank you all for your support.

I hope you enjoy the meeting and if you would like to find out more about the achievements in 2021/22 the annual report and accounts are available for you to access on our website.

2. Report from the Chairman
   • Minutes
     CO noted that the minutes for the previous annual members meeting from 3 November 2021 have been available on the website prior to today’s meeting. No corrections have been received so we will accept these as an accurate record.
   • Governor elections and thanks
     CO announced the results of the governor elections;
     Paula Turner was re-elected in the Manchester constituency.
     Alison Calnan was elected to the Northwest constituency, Andrew Butler to the Remainder of England and Wales, Michael Molete to Manchester and Linda Seddon to Trafford.
     We also have 2 new staff governors, Gemma Jones has been elected as the governor for registered nurses and Dr Kantappa Gajanan has been elected as the governor for registered medical professionals.
     Unfortunately we did not fill 2 of our public constituencies – Bolton and Rochdale, and will look to fill these seats going forward.
     We would like to congratulate our existing governor on being re-elected and extend a very warm welcome to our new governors.
     On behalf of the Trust and the Council of Governors I would like to thank our outgoing governors;
     Colin Bamford completed 3 years as public governor for Trafford and a member of the Development and Sustainability Committee
     Victoria Hallam completed 3 years as a public governor for the Remainder of England & Wales and a member of the Quality Committee
     Janet Morley completed 2½ years as a public governor for Manchester and a member of the Membership and Community Engagement Committee
     Matt Bilney completed 6 years as a staff governor for the Registered Nurses and was a very valued member of the Quality Committee.
     We also very sadly lost Prof Amit Patel, who passed away in October 2021. Amit was one of our consultants and a hugely talented and valued member of staff. Amit was our staff governor for the registered medical practitioners’ constituency from 2020.
     CO thanked our outgoing governors very much for their involvement.
   • Appointment of Directors
     CO updated the meeting on appointments and changes to the Board of Directors in 2021/22.
     From our executive directors; Joanne Fitzpatrick retired as Director of Finance in December 2021.
     Joanne sadly passed away in January 2022 having worked at The Christie for over 30 years, during this time she worked closely with a range of teams both at The Christie and in other trusts across Greater Manchester. She was a trusted and valued colleague who made a hugely positive impact on all who knew her, as well as having a major influence on our organisation. She is very much missed.
     Sally Parkinson was appointed as the Interim Director of Finance from July 2021.
     Dr Wendy Makin retired as Executive Medical Director at the end of April 2021 having worked at The Christie since the 1980s. Her contribution to the Board and the organisation as a clinician was significant and I’d like to thank her here for her huge contribution over those years.
     Dr Neil Bayman was appointed as Executive Medical Director in September 2021 and came in to post from 1 November 2021.
     From our non-executive directors’; Neil Large came to the end of his term after 8 years on the Board on 31 October 2021, Grenville Page started with the Board on 1 September 2021 and Alveena Malik was appointed as a non-executive director from 1 October 2021. We welcome both of you to the Board.
     Further details about all the members of the Board of Directors are available on our website.
     CO confirmed that during 2021/22 the Nominations Committee recommended to the Council of Governors the reappointment of Neil Large, Kathryn Riddle, Jane Maher, Kieran Walshe, Tarun Kapur and Robert Ainsworth for a further 1 year. They also recommended a further 1-year term for me as Chair. These extensions were agreed by the council of governors.
   • Amendments to trust constitution
     CO updated on changes that have been made to the Trust Constitution in 2021/22.
     There have been minor updates throughout the document to references to NHSEI (previously NHSE / Monitor) and updates to descriptions of job titles to bring them in line with current descriptions. There have been no other major changes.
3. Report from the council of governors
   • CO noted a brief summary of the work of the council of governors and its committees in 2021/22. She thanked the Council of Governors for its continued commitment and ability to adapt to the virtual ways of working throughout 2021/22. Members have continued to work virtually in their committees in order to carry on supporting the Trust.
     The Membership & Community Engagement Committee has developed and been working to the Membership Strategy 2019 – 2022, as a result of the Covid-19 pandemic the strategy has been extended to run to the end of March 2023. This continues the work of the previous strategy with the main focus on increasing engagement and representation in the membership. At the end of the year 2021/22 our total membership was 13,998 members (this is including staff and volunteers), this has been reduced from around 30,000 members. The target membership is now 10,000 engaged members.
     The Quality Committee reviewed issues relating to patient safety, clinical effectiveness and patient experience. The ‘talking to patients’ initiative that has been so successful over the years and gives the governors direct engagement with patients, carers and frontline staff, continued to be paused throughout 2021/22. This was due to the necessary restrictions that were in place onsite and the reduced footfall through the Trust. The Quality Committee also received and reviewed the quality accounts for the year.
     The Development & Sustainability Committee has been involved with the Annual Planning process in its changed form and has worked on reviewing progress against the Trust Strategy. This committee has also provided governor input to major capital programme developments including the Paterson site redevelopment, Christie at Macclesfield Cancer Centre and the tiered car park, as well as receiving updates on the changed financial planning process.
     The council of governors as a whole had a good and busy year despite the restrictions. Meetings have been very well attended virtually. Amongst other things the council has reviewed the appraisals of the non-executive directors including the chairman and heard detail of the refreshed strategy of the Trust and the ongoing management of the COVID-19 pandemic at the Trust.
     Another busy and productive year for the council of governors.
     CO handed over to Roger Spencer The Christie Chief Executive to talk a bit more about the annual report and accounts 2021/22.
4. Report of the Chief Executive
   • Annual report & accounts and future plans
     Annual report and accounts 2021/22 & forward planning information
     RS noted that at The Christie we are passionately committed to improving the outcomes and experiences for cancer patients. In 2021/22 our team has delivered an outstanding set of results under very difficult circumstances. RS noted that we will show a short film that describes some of the highlights, but first outlined some of the details.
     Quality Standards
     Due to the continued impact of the COVID-19 pandemic, there was a change to the reporting requirements for key standards as the energy of the NHS continued to deal with the impact of the pandemic. At The Christie, we continued to monitor all of our required quality standards across the year including our safety measures such as extremely low infection rates and carried on monitoring our waiting time targets to ensure that our patients continued to be seen as quickly as possible. We also worked across the system in Greater Manchester to prioritise cancer patients and continue to ensure cancer surgery was undertaken. But most importantly we have received excellent feedback from our patients throughout the year giving us excellent outcome and experience results.
     In terms of our Financial Performance – In 2021/22 the Trust has continued to operate under the same financial regime which was introduced in the previous year.
     This financial regime was a simplification of the funding flows which was introduced, due to the coronavirus pandemic. The NHS providers and their commissioners moved to a financial framework funding mainly on block contracts and system partnership arrangements. The trust continues to have a strong grip on managing the finances during this unprecedented time.
     For 2021/22, we made a consolidated surplus of £22.6m (this includes the charity, The Christie Pharmacy (a subsidiary company of the Trust) and the Trust).
     NHS commissioners and NHS England have invested £22.7m more in patient treatments than in the previous year. The additional investment includes £4.4m Elective Recovery Funding, this funding is to assist the Trust in achieving elective activity recovery with the aim of reducing the increased waiting lists and times resulting from the impact of the COVID-19 pandemic. The additional investment also includes £8.1m relating to the Block contact/System Envelope Funding which was agreed at an Integrated Care System level.
     During this financial year the charity received £13.2m total income and funded £15.6m of capital projects. Charity capital contribution in 2021/22 related to the development of the Christie at Macclesfield cancer centre which opened in December 2021.
     We have invested £100.2m on new assets including: Continuing development of an integrated research facility to replace the fire damaged Paterson research building (completion due 2022-23), new information technology and estates maintenance to ensure effective patient care.
     Auditors Opinion
     We have been given a clean bill of health by our auditors – who set out in their report that our accounts are a true representation and we pass the required efficient effective and economic tests.
     Regulators Assessment
     We have complied with the required standards as well as achieving the best possible rating (1) in the Single Oversight Framework which assesses performance across quality of care, finance and use of resources, operational performance, strategic change and leadership and improvement capability.
     A short film was shown that focused on the experience of a number of patients who were treated in 2021/22.
5. Questions
   Questions and comments were invited.
   • Are patients being seen within 24 days after referred for treatment, need some data for this question?
     RS responded that the up-to-date information on our performance targets is available in the Public Board papers on the Trust website in the Integrated Performance, Quality amd Finance Report.
   • What a fabulous film. Really reflects what The Christie is all about
   • What are the long-term plans for the Palatine Rd site (former Bridge Club)?
     There are currently no plans for this site.
   • Thank you both for a very interesting presentation!
   • Are you planning any more centres like Macclesfield?
     There are currently no plans for a further centre like Macclesfield.

CO thanked everyone for attending and for the support given in very difficult times. CO noted we will continue to educate, research and care for patients.

Meeting closed.