WMAS Board Meeting Minutes – Wednesday 29th October 2025

Present

Minutes

10/25/01 – Welcome, Apologies and Chairman’s Matters

Apologies for absence were received from Mrs Julie Jasper, and Mr Mohammed Fessal.

The Chairman welcomed everyone to the meeting.

10/25/02 – Declarations of Interest

There were no conflicts of interest declared by anyone attending the meeting in relation to any matters on the agenda.

10/25/03 – Board Capability Self-Assessment

A report of the Strategy & Engagement Director was submitted.

The Strategy & Engagement Director advised the Board that the Provider Capability Assessment is part of the wider NHS oversight / performance assessment framework. It aims to assess how capable NHS providers are of delivering improvements without extra support from NHS England. It helps decide what kind of oversight/support/intervention a provider may need, in conjunction with metrics of performance. NHS boards are asked to assess their organisations capability against a range of expectations across six areas derived from “the insightful provider board”.

The self-assessment must be accompanied by evidence (e.g., board papers) demonstrating performance in each domain, including where criteria are not met and what remedial actions are planned or underway.  At a recent NHSE briefing, the regional team gave a steer on how the evidence was to be pulled together, the expectation is only existing documentation is submitted.

The completed self-assessment and evidence are to be submitted to the regional NHSE oversight team. The team reviews and triangulates with other sources of information.   Based on all of that, NHSE assigns a capability rating. The capability rating is used alongside the provider’s performance/segmentation (how they perform on outcome metrics) to decide where extra support or intervention is needed. Providers with low capability and low performance may be placed in programmes for improvement.

It was agreed to update the self-assessment for the following items:

• Financial performance and oversight – update this item to reflect that following the mediation the Trust has agreed the main ICB contract, and this is pending signature from the ICB. 
• User feedback section – Mrs Banks asked for this section to be strengthened.  The CEO pointed out that the Trust has undertaken work on sepsis, maternity and also the work with the Daniel Baird Foundation.  The Strategy & Engagement Director will review and update this section.

After discussion, the Board of Directors gave approval for the Chairman and CEO to sign the submission once complete.

10/25/04

A report by the Director of Finance was submitted.

The Director of Finance advised the Board that the Trust is reporting breakeven at month 6 and a balanced plan for the full year forecast.
Following work on the underlying position (assuming that the handover income is recurrent) the deficit is estimated at £7.2m, if not it is £30m.
The position reflects pressures from workforce costs, non-pay inflation and income shortfalls from the response required to meet the increasing hours lost to handover delays.
Key mitigating actions both in place and under development include cost containment measures, accelerating CIPs where possible and transformation opportunities. NHSE are focusing on organisations’ underlying financial positions (UFP), as this provides clarity on the true financial health/sustainability of an organisation and the extent to which future plans improve/worsen their UFP. As part of the planning work currently being undertaken, and following the month 6 close, an updated UFP has been produced.  This will continue to be refined and updated as part of the planning process and as further information is available.

A meeting is planned with Black Country ICB to review the updated UFP as reported at Month 6.  This is to ensure that national guidance is being followed and to be clear on any actions required to be taken.

The areas to be reviewed are:

• Governance & Oversight – to Finance and Performance Committees and to the Board of Directors.
• Treatment of allocations and income – recurrent v non-recurrent.
• Interest receivable – ensuring that this income is included in plans.
• In year pressures and offsets – ensure a recovery plan is developed where applicable.
• CIP principles – ensure full year effect is reported, NR schemes have appropriate sign off.

The UFP is included in each month end Finance pack which is discussed at EMB, Finance and Performance Committee and the Board meetings. 

Updates to the reported UFP and the route to a balanced plan will continue to be included. 

The CEO pointed out that lost hours are out of control.  They are considerably worse than this time last year and year to date and October is the worst month.  If the remaining months mirror last year’s lost hours, then we will end up with 410,000 lost hours for the year.  This could be more if lost hours increased in the remaining few months and could go up to 420,000. 

However, the CEO was confident that the Trust would achieve the 28-minute Cat 2 target.  He noted the need to balance keeping patients safe as well as achieving the CIP target, corporate growth and break even. 

Mr Nat thanked the Director of Finance for highlighting the risks, especially around overtime, and asked for more content on this and how this will be managed.  The Director of Finance advised the Board that this is not around individual staff overtime requests.  The c£4-6m is based on overtime levels in the second half of last year.  The Director of Finance explained that the process is for the Director of Finance and Chief Operating Officer to review the available overtime weekly.  We have a difficult couple of weeks ahead of us.  We will find a way to offset the funding.  The Chief Operating Officer informed the Board that there is firm robust plan going forward into Winter and Q4.  He explained that the Trust had moved into Reap 3 last week this was not due to activity but the lost hours at hospital.  The Chief Operating Officer confirmed 15,000 hours had been put out on overtime for October 2025.  Mandatory training finishes in November which will put more resources back into the system.

The CEO Chief of Staff & Head of Service Transformation informed the Board that at Month 6 the non-recurrent part of the CIP is £5.2m. This will be reduced to £2m in Month 7 and we will continue to reduce this further. 

The Director of Finance pointed out that there is immense scrutiny from NHS England on this with lots of returns and meetings required.  We need to be able to demonstrate that this is fully discussed at Board level and the Board understands all the risks. The Director of Finance will submit updates to all Board meetings as well as EMB and Finance & Performance Committee.

The Chairman asked if hospital handover delays were predominantly resolved and we were achieving 45 minutes for hospital handover how would that affect the Trust’s financial position.  It was noted that 400,000 lost hours equate to about £32m.

The CEO explained that if hospital handover delays reverted to pre pandemic levels the Trust would be achieving sub 18 minutes for Cat 2. The CEO reminded Board Members that 2 years ago during the worst of the delays 157 patients died due to hospital handover delays. The Chief Operating Officer explained that the trust would also be achieving its Cat 3 target. 

10/25/05 – Any Other Business

There was no other business.

10/25/06 – The Date of the Next Meeting

Next Public Board meeting is Wednesday 26 November 2025. 

There being no other business for this meeting the Chairman brought proceedings to a close and thanked members for their attendance.