Ever watched a meeting of your local hospital governors online? This might explain why you haven’t!

The Cambridge University Hospitals NHS Foundation Trust (Addenbrooke’s) Council of Governors met on the 22nd of February 2017.

A report to the meeting from Chief Executive Roland Sinker stated bed occupancy levels at the hospital were at 99.9% and “levels over 90% impair an organisation’s ability to function effectively”.

Another report to the Governors reported high levels of unfilled posts. For the most recent month for which figures were provided (December 2016) 14.6% of registered nurse positions and 16.7% of healthcare assistant positions were vacant.

Addenbrookes is my local hospital and these are highly concerning statistics. I decided to go along to the Governors Meeting (which is advertised as being in public) to find out if anything is being done to address the problems, and publicise the challenges being faced and how they are being dealt with.

Councillors from Cambridge City Council and Cambridgeshire County Council sit on the Council of Governors and I was particularly interested to see what proposals they might put forward, or support, for addressing matters they have influence over such as the availability, and cost, of staff housing (which may underlie the high levels of vacant posts) and the provision of care outside of hospital, enabling Addenbrookes to discharge those who don’t need to be there.

Ultimately though the NHS in England is very centralised, there’s little democratic influence, strategy setting or accountability locally. Democratic accountability for our local hospital lies with the Secretary of State for Health in London. It doesn’t have to be like this, we could run our society differently and empower local elected representatives.

While board, and Governors’ Council, chair Dr Mike More, told me outside the meeting he was happy to allow filming if the Governors’ themselves didn’t object, Chief Executive Roland Sinker intervened and prevented me from filming. Mr Sinker imposed reporting restrictions which I was physically unable to comply with (asking me to remove my batteries from my cameras – one has an integrated battery) and told me, and me alone, I would need to leave my bag in another room, and I think be banned from having a mobile phone on me, before being allowed to observe and report on the meeting. Despite being prepared – with pencil and paper – in case – as has happened at other NHS meetings – all electrical and mechanical reporting equipment was banned, the restrictions imposed were such I felt unable to safely observe and report on the meeting and left.

Perhaps Chief Executive Roland Sinker didn’t want to be captured on camera saying the hospital is full to capacity or recorded while being held to account by councillors, and others, for his performance.

I don’t know what the rules are on filming a council of Governors meeting as the trust doesn’t appear to publish the Standing Orders for the Council of Governors a request for a copy was not immediately responded to.

If the trust’s Chief Executive imposes reporting restrictions within the hospital which are in excess of those the Council of Governors want to see applied to their meetings then they should meet outside the hospital.

With County Council elections coming up in May I want to see candidates making a commitment to do what they can to improve health services, and I’d like to see them putting forward, or supporting, some strategies.

Given one of the reasons given for a filming ban was an objection to filming patients; I want to say I see no problem in identifying the patient Governors as patients of the hospital (in this context patient means they’ve been a patient, or a carer of a patient at one of the trust’s hospitals at any point since 1948) as they make their status public by virtue of becoming a patient Governor, and they are listed, with their names and photographs, on the trust’s website. I also don’t consider there to be a problem with filming people in and around the main entrance to the hospital which is a highly public area.

I think we all need to take an interest in how our local health service is run; I would like to see more people seeking to effectively report on governors meetings, board meetings at hospitals and at Clinical Commissioning Groups, and other NHS bodies. If NHS governors, boards and committees don’t pro-actively open up their proceedings then I would like to see legislation along the lines of that which is opening up local council meetings.

Full Transcript of my Experience at the Cambridge University Hospitals NHS Foundation Trust (Addenbrooke’s) Council of Governors Meeting – 22 February 2017

[In a waiting area outside the board room]
Unknown Staff Member : That looks like a camera.
Glenn (Secretary at the Trust) (ID badge concealed in pocket) : Were you hoping to film today Mr Taylor?
Richard Taylor: I’m going to see what happens, yes.
Glenn (Secretary at the Trust) : We do have a policy of no filming at the trust unfortunately.
Richard Taylor: OK.
Glenn (Secretary at the Trust) : So I just thought I’d better pre-warn you of that one.
Richard Taylor: So where is that, where would I find that policy?
Glenn (Secretary at the Trust) : I can send you some information about that tomorrow by all means.
Richard Taylor: What’s your role here today then?
Glenn (Secretary at the Trust) : I’d rather not be filmed if that’s OK.
Richard Taylor: Well you’re the person who is telling me can’t film the Council of Governors’ meeting, I’d like to know who you are and on what authority you’re telling me that I can’t film.
Glenn (Secretary at the Trust) : I can just purely give you the information that the trust has a policy not to film, I can quite happily send you all of the information.
Richard Taylor: What does it have a policy not to film?
Glenn (Secretary at the Trust) : Meetings of the Governors and meetings of the Board of Directors. I can send you that tomorrow by all means.
Richard Taylor: That policy doesn’t appear to be.. it’s not a public published policy of the trust, it’s not on the policies webpage,
Glenn (Secretary at the Trust): Are you still on the same email address Mr Taylor, I can pop that across to you by all means.
Richard Taylor: Well if you won’t tell me who you are and what your role is here today what I’d like to do is see what happens if I try to film the meeting and see what the chair says, and of course I will abide by any ruling from the chair.
Glenn (Secretary at the Trust): Yes, certainly, I can pass that on to the chair, no problem whatsoever.
Richard Taylor: Thank you.

…
Unknown Staff Member : So are you visiting us from the press today?
Richard Taylor: No, I’m just …
Unknown Staff Member : A member of the public.
Richard Taylor: Yes.
Cambridge University Hospitals NHS Foundation Trust (Addenbrooke’s) Council of Governors (and board) Chair Mike More : Sorry, what’s the?
Glenn (Secretary at the Trust): Mr Taylor is a member of the public who has come along for the public session, he did want to film the meeting. I did inform him it is not the policy of the trust to allow filming so I think you would like me to raise it with the chair.
Richard Taylor: Well as you won’t tell me who you are or what your role is here I’ve asked if I can just see what the chair says when the meeting starts.
Glenn (Secretary at the Trust): That’s absolutely fine, once the meeting starts we can raise that with him.
Chair Mike More : Well he doesn’t have to explain who he is, he’s acting as a trust secretary who is acting on behalf of the trust to make sure the meeting runs as well probably. I’m the chair so why do you want to film it.
Richard Taylor: I’d like to see what happens when you’re in the chair in the meeting and see if you will allow me to film the meeting. As to why I’d like to film it, it’s just to promote what’s going on and show people what’s happening at this meeting.
Chair Mike More : Well we have had recordings of the meeting, recordings of the meeting, I think for PhD purposes, I think someone quite a while ago I can’t recall.
Glenn (Secretary at the Trust): I can’t recall.
Unknown Staff Member : Yes we did.
Chair Mike More : I think the normal consensus, had you been notified before that you wanted to do so.
Richard Taylor: Well I’ve looked on the website and you don’t publish your standing orders so it’s not possible for members of the public to see what your rules are for this meeting as far as I can see.
Chair Mike More : It’s a public meeting. You’re welcome to come along to a public meeting. I would seek the understanding of the Council of Governors as to whether they wish to be filmed; if they don’t wish to be filmed then I would honour that wish. You can of course attend the meeting and observe it – it is a public meeting and you are very welcome to do that, and if you wanted to film a meeting occasion again I would be more than happy to pre-prepare people for that. You might find that some people who attend the meeting don’t particularly want to be filmed, that’s not unusual, but if they are content I’ll say yes, if they’re not content I’ll say no, but more than happy to have a conversation in regards of next time if you want to, but of course you can observe the meeting.
Richard Taylor: Well if you impose any reporting restrictions from the chair I will of course abide by them.
Chair Mike More : I’m not, you can report anything, you can say anything, it’s the filming that’s all, and if they’re happy to, yes that’s fine. OK.
Richard Taylor: Well I’ll see what happens when you’re in the chair in the meeting and what restrictions you put in place.
Chair Mike More : I’m not putting any restrictions.
Richard Taylor: Well we’ll see what you do.

…
[I find the boardroom, the meeting venue, and film the door, which has a window in it and there’s a meeting going on inside. It’s the venue for the Council of Governors meeting and it’s well past the published start time. ]
Chair Mike More : Excuse me, I can’t allow you to film. That’s a private meeting.
[I immediately cease filming the door and film the Chair and others waiting to enter the meeting].

..

[Inside the meeting venue – the boardroom]

Chair Mike More : Right, good afternoon.
Cambridge University Hospitals NHS Foundation Trust (Addenbrooke’s) Chief Executive Roland Sinker : Sorry, I’m the Chief Executive, can I just be sure you’re not filming at the moment. Sorry can I just be clear you’re not filming at the moment.
Richard Taylor: I am filming at the moment. Yes.
CEO Roland Sinker : I’m the Chief Executive of the hospital, I have to ask you not to film without the consent of the members in the room. I’m the Chief Executive. I can call security if that’s a problem for you.
Richard Taylor: So can I wait and see what happens when the chair starts the meeting and whether the chair is happy with filming, or not?
CEO Roland Sinker : I’m afraid I’m the Chief Executive of the hospital, I’m the accountable office, there are issues around consent when you are filming, I have to ask you to turn the camera off, very respectfully, if you don’t do that I will have to call security.
Richard Taylor: OK, and what I’ve just asked you is, would you mind, given this is a meeting of the Council of Governors, would you mind just seeing what the chair says when the meeting starts?
CEO Roland Sinker : I’m afraid we have to have consent and have the conversation with the chair before I can allow you to start filming. OK. I’m going to ask you one more time to turn the camera off or I’m going to have to ask security to come and deal with it. I’d much rather not do that. We can have the conversation without the camera on, with the chair present, and then we can decide what we’re going to do.
Richard Taylor: So just to be clear what is it you’re not permitting at the moment; and why have you approached me I’d like to ask please?

CEO Roland Sinker : So as the accountable officer of the hospital there are very strict rules on the filming of people on hospital premises, there are people in this room who are patients.
Richard Taylor: Can you just tell me what rules you are referring to please?
CEO Roland Sinker : I’m the accountable officer of the organisation I can make that decision.
Richard Taylor: Can I ask why you’ve approached me today?
CEO Roland Sinker : Because you have a camera here that is running in a meeting of the organisation.
Richard Taylor: I suspect that may well be true of many people here, who’ve got mobile phones for example. Have you approached me because I’m overtly filming today?
CEO Roland Sinker : I’ve approached you because you’ve got a camera running live in a hospital where there are many patients, there are members of staff, it is not appropriate to be filming.
Richard Taylor: OK.
CEO Roland Sinker : So I have to ask you to turn the camera off or I’m afraid I’m going to have to get security to come and ask you to turn off the camera. I’m very happy for you to turn the camera off, have the conversation with the chairman and then we’ll see what we’re going to do.
Richard Taylor: I’m rather confused by what’s going on here given we’ve got a chairman of the Council of Governors, surely he’s in charge today, of the meeting.
CEO Roland Sinker : I’m the accountable officer responsible for very strict rules around the hospital and how the hospital functions; I’m the person responsible for making this decision and I’m very happy to do so.
Richard Taylor: OK.
CEO Roland Sinker : So are you prepared to turn the camera off, or are we going to have to stop the meeting. I may have to ask everyone to leave the room, so in the absence of their consent they’re not being filmed, and I’ll have to ask security to come and deal with you.
Richard Taylor: In which case, if the problem is filming,
CEO Roland Sinker : Yes.
Richard Taylor: I will take my cameras down.

CEO Roland Sinker : So what I’d like you to do if you don’t mind is move the camera out of the room so there’s no evidence of any recording and then we can have a conversation.
Richard Taylor: Will that be something that everyone who has got a mobile phone for example that is capable of filming, will that be applied to everybody equally here today?
CEO Roland Sinker : You want everybody to move their phones out… in this current set of circumstances I’m fairly sure you’re still recording, I’m not assured that everybody else is. I will be asking you directly to take the camera out of the room.
Richard Taylor: Well I can.
[I put my cameras in my bag]
CEO Roland Sinker : Or if you can take the bag [out]
Richard Taylor: I have put them in my bag.
CEO Roland Sinker : What would be helpful is if you can take them through there where I know it’s absolutely safe.
Richard Taylor: I’d like to keep it with me; it’s got for example it’s got my pen and paper in, to report, it’s got my ability to report on the meeting.
CEO Roland Sinker : If what you could do is take the battery out of the camera
Richard Taylor: I can’t be recording in a sealed bag, there’s clearly no filming. This gentleman here could be recording, this lady here could have something in her jewellery.
CEO Roland Sinker : Quite possibly, but I want to be sure you’re not recording.
Richard Taylor: Why me?
CEO Roland Sinker : [inaudible] where I have patients, members of staff, and I’m the accountable officer of the organisation. So what I’m going to ask you to do now, and we’re going to draw this to a close, is I’m going to ask you to take the battery out of the camera, so we can have a conversation with the chairman and decide whether you’re going to be able to film, if you’re going to be able to film. If you’re not prepared to do that I’m going to have to stop the meeting as the Chief Executive Officer of the hospital and ask security to come and have a conversation with you.
[In retrospect I could have stepped out while a decision was made, and then sought to re-enter later – but I didn’t think of that at the time]
Richard Taylor: So just to be really clear, you’re not allowing me to be present, with a mobile telephone, in this meeting?
CEO Roland Sinker : What I’m saying to you is I’m not comfortable with you filming the meeting.
Richard Taylor: I’m clearly not filming. I’ve put my camera, and all equipment that I’ve got which is capable of filming, in my bag.
CEO Roland Sinker : You are capable of recording through whatever’s in the microphone in there, that’s also an issue for us.
Richard Taylor: So what’s going to happen next? Are you going to expel everyone with a mobile phone?
CEO Roland Sinker : No I’m not, no.
Richard Taylor: So why are you particularly focusing on me is my question.
CEO Roland Sinker : So now I have to say I’m actually quite concerned about your engagement with the organisation. Your behaviour is unusual.
Richard Taylor: Is that a particular problem? There clearly aren’t very many members of the public here today, so it’s [my presence is] clearly unusual isn’t it.
CEO Roland Sinker : It’s unusual in a hospital setting where we have patients and members of staff and I’m now getting to the point where I’m concerned about your behaviour. If necessary I will call security and there will be a different sort of a conversation with you.
Richard Taylor: Well can you explain the threat, that’s actually quite a threatening comment there.
CEO Roland Sinker : No, no it isn’t.
Richard Taylor: What do you mean by a different sort of conversation.
CEO Roland Sinker : So there are very strict rules.
Richard Taylor: I’ve asked you what are these rules.
CEO Roland Sinker : They’re very comprehensive.
Richard Taylor: Where? What are you referring to, are you referring to a law, standing orders?
CEO Roland Sinker : I’m referring to the law.
Richard Taylor: Well can you give me an example.
CEO Roland Sinker : No, I don’t need to.
Richard Taylor: Well I think you might be making it up.
CEO Roland Sinker : No. I’m the Chief Executive.
CEO Roland Sinker : I now think your behaviour on the hospital site is not necessarily reasonable; I’m going to have to ask you to take the battery out of the camera or I’m going ask security to come and remove you.
Richard Taylor: Well my experience here is this meeting does not appear to be open to the public; I cannot practically report on what is going on.
CEO Roland Sinker : The meeting is open to the public; it’s a meeting in public, it’s not the same as filming people who may not have given their consent.
Richard Taylor: It doesn’t seam to to be practical to report it.
CEO Roland Sinker : What I’m going to do now is ask you; well the best thing is probably if you will just leave. [inaudable] security, it’s up to you.
Richard Taylor: I’m certainly not going to take the battery out of my camera, no. I am going to leave now, because you’ve essentially prevented me from being able to effectively report on this meeting.

[We leave the boardroom, CEO Roland Sinker continues to talk to me while I’m in the corridor ]

CEO Roland Sinker : Well if that’s your view, if you’d like to …. if you’d like to make an appointment to see me as the Chief Executive I’d be very happy to do so.
Richard Taylor: I’d like to, I sought to, report on this meeting and share with the people served by this hospital what the hospital is doing, what you’re doing, when you’ve got such a problem in the hospital, that’s why I came here today. I read your report to the meeting, I wanted to see you present it, I wanted to see our representatives and our councillors challenge you find out what your plans are.

CEO Roland Sinker : Yes. So very happy for you to be in the meeting. The big issue, and it’s important this is clear, is it is very very testing and challenging to be filming in a hospital setting and you have to understand how serious an issue that is. There are people in that room who are patients at the hospital, there are serious issues around filming and consent, that go across the board in a hospital, if it’s something you’d like to be in, I’d be absolutely delighted for you to be in the room but filming is a serious issue for us in the organisation, OK. Now if you want to be in the meeting that’s great but the camera has to be turned off and the battery has to be out.
Richard Taylor: OK. Well you didn’t just prevent filming, you prevented recording, and even me having a mobile phone with me in the meeting, and practically that prevents reporting in my opinion.

CEO Roland Sinker : Well all the best to you, if you want to write to me and have a conversation about this further, I’m very happy to meet with you.
Richard Taylor: Well I have sought the publication of the standing orders of the Council of Governors because it’s not something which is published on the website.

CEO Roland Sinker : Well if you could write directly to me, I’m Roland Sinker, Roland dot Sinker at NHS.net write directly to me, and if I have your name, you may not want to give it to me, just say I’m the guy you met at the Council of Governors meeting on the night of it must be the 23rd, the 24th
Richard Taylor: It’s the 22nd of February I think
CEO Roland Sinker : If you could write to me and say I was the person you met, these are the things I’d like to know I can absolutely give them. I’m very sorry you were not able to stay for the meeting. It would be great if you could but filming is going to be an issue.
Richard Taylor: OK, thank you very much.

Some final thoughts:

• I think it’s important to stress that when Roland Sinker refers to being “in a hospital setting” we were in a boardroom and a suite of meeting rooms just off the main entrance to the hospital, at a public meeting. I don’t think that environment is what most people would envisage when the term “in a hospital setting” is used.
• There was apparently private meeting (perhaps a secret meeting, perhaps a pre-meeting) of some sort, going on, before the publicly advertised meeting – the secretary notably referred to the “public session”, and I was told by the chair not to film the board room prior to the meeting.
• The Governing Body has actually set some rules for the conduct of its meeting; however despite my best efforts I’ve not been able to find them.
• Not being able to report from the meeting means as a resident of Cambridge while I could just go and listen to councillors and others discuss the state of the local hospital, I wouldn’t be able to act on what I heard. I wouldn’t be able to present clips, or audio, to elected representatives, to MPs, I wouldn’t be able to publicise what had happened and encourage people to make fixing our local hospital an important matter in upcoming elections.
• I’m very happy that I took the action I did both in attending the meeting, and in my lobbying and publicity in the run-up. I couldn’t sit back and do-nothing after reading that my local hospital is at 99.9% capacity – a status which renders it unable to function as effectively as it should.

I have made a longer video than the one embedded above available which has been edited only to speed up parts where nothing substantive happened.

Key Tweets in Run-Up to the Meeting:

CEO @addenbrookes @CUH_NHS Roland Sinker reporting 99.9% bed occupancy to Governors on Wednesday. Needs to be <90% https://t.co/pHowERF9LU pic.twitter.com/rNbnzdifbx

— Richard Taylor (@RTaylorUK) February 19, 2017

Chair @CUH_NHS governors offers councillors “full support” in revising approach to adult social care and health https://t.co/YwBpJIP5sm pic.twitter.com/Y7FiGHVQPe

— Richard Taylor (@RTaylorUK) February 19, 2017

Over 1 in 10 nurse positions; and ~ 1 in 6 healthcare assistant positions @addenbrookes @CUH_NHS unfilled https://t.co/39nAqaoSjv pic.twitter.com/TTSt6ImZ69

— Richard Taylor (@RTaylorUK) February 19, 2017

Quicker @EastEnglandAmb handover protocol adaopted @addenbrookes @CUH_NHS according to report to Governors mtng Weds https://t.co/CBeCwvFDGq pic.twitter.com/Sa6vGahwT3

— Richard Taylor (@RTaylorUK) February 19, 2017

Council of Governors members @addenbrookes @CUH_NHS on Twitter: @DarylJBrown @mr_h_richardson @ruthft1 https://t.co/kXkkpMD8pS

— Richard Taylor (@RTaylorUK) February 19, 2017

With many unfilled nursing and healthcare assistant posts unfilled it’s surprising key @CUH_NHS jobs page is broken https://t.co/IvmgXANiwy pic.twitter.com/O0PY0m9w4l

— Richard Taylor (@RTaylorUK) February 20, 2017

Housing minister in Cambridge today. Will he observe @CUH_NHS Governors mtng & hear of difficulty filling jobs in part due to housing costs? https://t.co/da5TKNXAAO

— Richard Taylor (@RTaylorUK) February 22, 2017

Could prospective health/medicine students be encouraged to apply for healthcare assistant roles? @DarylJBrown @mr_h_richardson @ruthft1 https://t.co/IvmgXANiwy

— Richard Taylor (@RTaylorUK) February 20, 2017

What strategy for addressing this will cllr governors be proposing/supporting on Wednesday? @CllrKevinPrice @cllrmartinsmart @fiflowertot https://t.co/kXkkpMD8pS

— Richard Taylor (@RTaylorUK) February 19, 2017

It’s notable that there was no engagement in response to my tweets either from my own local councillors, those Governors on Twitter themselves or the trust itsself. I don’t expect responses to tweets, but the lack of engagement is still notable.

See also other tweets mentioning me and the hospital trust.

There were no tweets on the day from the trust mentioning, never mind reporting, the Council of Governors meeting.