Transcript

Martin, and Councillor Richard Tear, the representatives for Hampshire County Council, Councillor Dominic Hiscock, and Councillor Bill Weathers, and the representatives for Brackham Forest Borough Council, councillors Caroline Eggleston, and Tony Verger. I also welcome the attendees from Frimley Health NHS Foundation Trust, who are Carol Deans, Director of Communications and Engagement, Alex White, Programme Director, and James Clark, Chief Strategy Officer, and the following attendees from NHS Frimley Integrated Care Board, who are Sam Burrows and Ellie Davies. Thank you to Surrey Heath Borough Council for facilitating this meeting at this venue, and in particular thanks to Eddie Scott, Senior Democratic Services Officer, Surrey Heath Borough Council, and Ellie Merton, Surrey Heath Borough Council. Those attending for the purpose of reporting on the meeting may use social media or mobile devices in silent mode to send electronic messages about the progress of the public parts of the meeting. Anyone who is committed to film or record or take photographs at council meetings with the chairman's consent, please liaise with the council's scrutiny officer listed in the agenda prior to the start of the meeting. That's Sally over there. That's Sally over there. So that the chairman can grant permission and those attending the meeting can be made aware of any filming taking place. If any member or officer would like to speak during a discussion, they must indicate to the chairman of the committee that they wish to speak by raising their hand. When called by the chairman, press the button and speak clearly and directly into the microphone. Members and officers must ensure they've switched off their microphones once they have finished speaking. You can use mobile phones for the purpose of recording or filming the meeting, provided it does not cause interruptions, distractions or interference to the PA or induction loop systems or any general disturbance to the proceedings. The chairman may ask for mobile devices to be switched off in these circumstances. It's requested if you're not using your mobile device for any of the activities that are outlined above. It will be switched off or placed in silent mode during the meeting to prevent interruptions. Item two, apologies for absence. We have received the following apologies. Caroline Hutton, SRO for the new hospital programme, Carla Mawson and Phil North. So item number three is the minutes of the previous meeting. And it's for the select committee to agree the minutes of the previous meeting on the 22nd of November 2024 as a true and accurate record of proceedings. Do we agree? Thank you. Declarations of interest. To receive any declarations of disposable pecuniary or other interest from all members present in respect of any item to be considered at the meeting. So I'll start the process by saying I declare that I am a community representative to Frimley Health, which is a non-pecuniary interest. Councilor with us. My wife works for Surrey Heath NHS. Yeah, I could remind you to use the microphone. Sorry. My wife works for Surrey Heath NHS. Councilor Virgo. I can't remember if I should declare this, Chair, but I'm a volunteer, so that's all the choice. Thank you. Public questions. No public questions were received ahead of the meeting. And the same for members' questions. So we move straight on to item seven, the Frimley Park New Hospital programme. So, Carol, it's over to you. Thank you very much. I'm actually going to hand straight over to my colleagues on my left. I think, Alex, you're starting us off, aren't you, with a general... Oh, sorry. No, that was... That's fine. Yeah, we're going to hand straight over to Alex, who's going to give us a brief update, followed by James, who's going to do an update on the Diagnostic and Inpatient Unit that you asked for an update on. And we're trying to then sort out a visit for that for you as well. But I'll hand over to Alex first of all. Thanks, Carol. Good afternoon, everybody. My name's Alex White. I'm the programme director for the new Frimley Park Hospital, working for the Trust. So we're just going to talk through some updates, recent updates, at national and local level, and explain what that means for us and describe our key priorities moving forward. So just to recap, a review of the new hospital programme, which was the 48 hospitals announced by the previous government across the country, was called in July of last year following the election of the new government. That review concluded at the end of last year, and an announcement was made in January of this year. All RAC hospitals and some of the other hospitals were deemed exempt from that review, and Frimley being a RAC hospital fell within that category because of the risk posed by the RAC concrete structure of the buildings. Nevertheless, the announcement was made on the 20th of January, and all of the 48 schemes were put into different waves. This slide just summarises the first two of those waves and summarises in graphic form the salient points from the announcement. And so what it shows is the schemes that comprise waves one and two and their windows, their indicative windows for starting construction that were set out by the Secretary of State in his announcement on the 20th of January. It also shows the approximate capital budgets for each of the schemes, again within a window, if you like. And you can see that the good news for Frimley is that we were allocated one of the highest budgets, if not the highest ranking budgets across all of the schemes. Our category falls within the 1.5 to 2 billion category. Our exact budget will be determined as we develop our designs and our options and work in conjunction with our colleagues at the centre. We were also given an indicative construction start window of between 2028 and 2029. It's worth pointing out that we are, as you can see from there, an outlier from the rest of the RAC schemes on that start window. And that's probably just reflective of the fact that we were brought into the new hospital programme slightly later than some of the other RAC schemes. And we've been told that we can work with the new hospital programme to improve that start date. There's no constraint on that start date. And if possible, we can bring that forward. And that's certainly our intention. You can see that I've also listed out the second wave of schemes. They don't start until midway through the next decade. But it's just worth pointing out where we sit in relation to them. And no doubt this, like all major programmes, will fluctuate as we move forward. But that's just a graphic representation of the announcement that was made by the Secretary of State on the 20th of January. Our key priority as a programme is to ensure that we have identified our preferred site, as you will no doubt be aware. And we're working hard in the background to do that. As we reported at the last meeting, we've been working hard in terms of establishing our new clinical strategy and ensuring that we have a transformed service that reflects mid-21st century rather than mid-20th century healthcare. And a lot of work has been done on that over the course of the autumn of last year and into the early part of this year. That's enabled us to get the right size of our hospital in terms of the capacity and overall square meterage, which in turn is enabling us to do proper analysis of our options when it comes to sites. So we've been doing that with all of our team, and we're on track to make a decision about our preferred site over the course of the early part of this year, leading to a decision in mid to late spring. As soon as a decision has been made, we will continue to liaise with everybody within this group and within the wider community to ensure we are behaving in a transparent manner. We are using due process in accordance with Treasury guidelines to make this decision. In particular, we are using an objective data-driven comparison of all the different aspects, the costs, the relative risks, the relative benefits, to ensure we've done a full economic appraisal long-term of our preferred option moving forward. Okay, so that's everything for me. I hand over to James. Thank you, Alex. So my slides are just to update the committee on the Frimley Park Hospital Extension update. The reason for this is obviously to give you the latest insight around how we are planning to maintain the current hospital in the timeline that Alex has just described to be able to deal with the additional capacity that will be required over the next few years. I'm really pleased to be able to share with you that we are in the very final stages of the Frimley Park Hospital Extension update, a circa £50 million building programme that's been taking place over the last two years. This will provide a total of 76 further beds to our hospital, which will provide much needed capacity for, as I mentioned, the increase in demand and also to help us manage any RAP mitigation that will be required over those years. It's an opportunity for us to bring state-of-the-art diagnostic imaging equipment into the hospital, and we're creating a designated one-stop shop for patients that need diagnostics, breast care units, etc., so that they can get earlier access to treatment. We are excited to be able to say that we are opening this unit early April 2025 and we'll open that in a phased approach that starts with the ward areas, then the breast unit, and then the diagnostics centre. As I mentioned, the building has been created using modern methods of construction. We've got a short video in a second to show you what it's looking like. It's a three-storey building that has been created in a modular-type fashion, which has allowed us to do it quickly in a very modern way that reduces carbon emissions and also helps in terms of the many environmental factors, which, again, you'll see on the video. So, it's an exciting time. We would welcome this committee to come and have a look at it before we open it and we're at the point where the builders are just getting it ready to hand it to us. So, we've got a bit of a technical bit just to explain here. We're going to show the video on the screen. The members that are joining over Teams are going to have a link put into the Teams chat. And what we would ask is, if you're viewing over Teams, to click the link because that will open the video for yourselves. And then we'll also be showing it in the room now. It's about one and a half minutes. Okay. Thank you. I'll just pause for ten seconds to allow those online to catch up and potentially join back. So, as I mentioned, that will open early April. I'm really proud to open those up for the local population and community, I think, to make a significant difference. So, now I'll hand to Carol and Ellie and then I think you're going to run your section and then we're going to pause for questions on anything so far. Thank you very much, James. So, what we sent to you in advance, I hope you've all had a chance to have a look at, is a very first draft of our communications and engagement strategy. So, we've developed that, taking on board the feedback that where we came, didn't we? We talked about the approach that we wanted to take, that we wanted to keep things as transparent as possible, that we wanted to have ongoing communications and engagement throughout the whole of the process that we do. So, what we've tried to do is now capture that into something with really clear objectives, really get across that collaborative approach, not just between the trust and the ICB, but all of our system partners and our community. The emphasis on that stakeholder engagement as well as with the patients, the public and our staff. And I know staff was something that came up quite strongly in those initial discussions with yourselves. So, we've tried to capture all of that, make sure we're remembering things like evaluation and ongoing continuous improvement, because that's part of how we will want to do that. And we just put a little nod into crisis management, because not that we're expecting a crisis, but it's always wise, I find, in communications and engagement to be prepared for the worst, if needed. And I guess the context for that really comes from, you know, little things like the government announcement that Alex mentioned, where we were outside of that review, and yet we were still included in part of that report. So, it's just being made sure that we can be agile and able to react and respond. So, that's sort of what we've set out, and we deliberately sent it to you in advance, but do forgive us that it is that very first draft, because we did really want to genuinely get your engagement as we go along. Ellie was just going to touch a little bit more on the sort of seldom heard audiences, and then we'll perhaps open up a bit of discussion about the strategy and any questions you might have on anything we've covered so far. Thank you, Carol. Yeah, critical to this strategy is an approach which is really about creating inclusive and accessible communications, having a dialogue with all of our communities across the system. We know that particular voices often can be a bit absent in decision-making, and we're really keen to make sure that that doesn't happen in this project. So, you'll see through the paper, we try to bring out the elements that will be working in that space, and we'd be really keen to hear your views and see how you can help us to make connections with those communities. A critical part of that will be how we use that insight from those people into our quality impact assessment, which will enable us to plan well and help us kind of mitigate any issues or challenges that come as we progress the programme. So, we hope you'll be able to give us some feedback in terms of how we've set that out today. Thanks, Ellie. So, we've just, from our point of view, selfishly, we've popped some few areas that we thought on the screen there that would be particularly valuable to us to get your views on. So, particularly the bit about the stakeholders and the approach that we're taking around that. It's seldom heard, as Ellie's mentioned there. We have put a section in there about the scrutiny element of the programme, and I think it would be particularly valuable for us to check that we've got the tone of that right and covered what we need to in that section. And then there is a general section there around channels and tools, and we're always open to new and different ideas for how we can make sure that we are communicating and engaging with all of our audiences in the appropriate way at the right time. So, selfishly, those are the things that we would particularly like to hear from you about, but open to any other comments on the strategy. And then I think James is going to guide us through any other questions you might have beyond the comms and engagement strategy. Thank you for that, Carol. I'm going to kick the questions off myself. I think I'll just use Chairman's privilege. So, first one really is in relation to the first part of the presentation. If you could perhaps talk to what the effects have been on the site selection stroke design process from the various NHS policy changes, with the shift towards prevention rather than intervention, because obviously that has serious implications for an acute hospital. The second one that I will pick up, I didn't realise the addition to the building was so large in relation to the rest of the site. And this again underlines hospital design has changed. There's now far more M&A services to take into account. There's the need for actually more space for patients with different arrangements. We're no longer talking about, you know, shared multibed wars. So, it's obviously, you know, something to actually take in to get your head around the difference. Because in, you know, looking at that, the view of Primly as it is now, the old style, versus what the new is going to look like. We start to see the difference, which is why I'm really anxious that we do have the tour. So, that's my bit for now. I'm going to come in on the scrutiny one later. Alex, did you pick up the first bit and then I'll pick up the second bit. Yes, James, thank you. So, the first bit being how has national policy impacted upon everything we're doing. So, I think as described at the last JOSC in November, we have responded to particularly the DASI review, which has got three pillars I would describe them as. And just to recap on those, that's analog to digital, acute to community and care to prevention. And those have been our three guiding lights through the development of our clinical strategy and associated service transformation plan. We've got five key initiatives that I think were described at the last time we met. I'm just trying to remember them off the top of my head. But they included virtual hospital, maximizing our use of virtual hospital and really leaning into that because there's a lot more opportunity for that. Again, the same with system heavy users, focusing a lot of time on system heavy users. There's a lot of potential to improve on the way we provide care to our system heavy users, a more holistic, targeted level of care and making sure we understand who that cohort of patients is, treat them as a whole person, not just a patient, et cetera. Front door, making sure that we are minimizing unnecessary attendances at our front door as well. And I'm struggling to think of the other two. Oh, yes, of course. Elective care, making sure we're delivering care in the right place at the right time. So that particularly means looking at some of our low volume, sorry, high volume, low complexity cases, elective cases. And in particular, potentially moving those to our elective powerhouse, if you like, at Heatherwood and the front. And preventative care, of course, which is one of the key key pillars as well. So all that, along with the general left shift, are some of the key aspects of our service transformation and are what have informed our demand and capacity modelling and therefore the shape of our hospital moving forward. Thank you for that. And also thank you to Fleet Community Hospitals. They looked after me very well last week. And if I just build just slightly on the sort of the other opportunities we have in the community in the short term, it's something somewhat really exciting. As Alex mentioned, a lot of this is about the new hospital, but a lot of the plan is also about using existing space in a better way and bringing diagnostic services, for example, into the heart of the community, into high streets, bringing care closer to home. So actively, we've got plans on top of the new hospital programme to open more diagnostic centres in the community. We're actually opening one in Slough patch at the moment as part of our trust and looking at where we can improve diagnostics in the patch around this area as well. We also run, as you mentioned, a lot of community sites. So we have some great facilities out in the community already. So looking at what services can we continue to promote and provide in the community. And if people have got outpatient appointments, for example, not bringing them into a Frimley Park Hospital for a half an hour outpatient appointment, actually, can that be done in the high street and high street locations? So exciting opportunities, I think. The other piece was, you know, how much bigger the addition was. So large, isn't it? Do you want to talk about the size of the difference? Yeah, I think, well, the analogy we tend to use is that cars don't get any smaller, do they? The more the technology you put in them and the more ventilation you put in them, the more safety measures you put in them, they get bigger. And the same thing seems to be happening to buildings and in particular to hospital buildings. So the more technology we put in, for example, automated guided vehicles, we're having to make sure that we've got space in our corridors for robots running around delivering all of our various bits and pieces. That's one example. The other thing is, funnily enough, the impact of new building regulations, environmental building regulations, means that we need to run all our fans a lot slower in our mechanical and electrical systems, which means the ducts need to be bigger because the fans are running slower. So that has an impact on the overall size of the building as well. So while the capacity of the hospital will increase by X, the size of the hospital will increase by X times whatever as a result of all those new measures that are coming through. And that's that's life and that's progress. OK, I can't slow with us. Thank you, chair. Just a couple. You mentioned ducts in the sense of air circulation. Does the new bit have the ability to exchange the air in the various departments six times an hour, for example, which is coming to Portsmouth? It does. Yes. Yes. So the new the new design, the new that you saw on the video has got all of the latest the latest air exchanges, environmental, you saw solar panels on the roof, et cetera. So has been built as per the highest spec that is available today. And that also enables you to shut down departments. Correct. So as part of obviously the five year plan, we will need to reinforce certain wards for the RAC work. So at a time we'll probably have to take somewhere between 20 to 30 beds out of the let's call it the old, but the current Frimley Park Hospital to enable that to be reinforced for the RAC. So once we've got that, it enables us to do that with extra capacity as well. Yeah, actually meant because of COVID, a lot of the new bills can actually shut off each department so that you can contain any. Oh, absolutely. Yeah, absolutely. And the single the single ward, single bedrooms will also help for infection control as well. OK. Does it also have a separate entrance or do they still have to come through the main entrance? So it's linked to the it's linked to the hospital in two different points. I'm trying to think whether it has its own entrance at the moment, because it does at the moment. It does. Yeah, it does. It does at the moment. Yeah. So that is going to stay. And in talking to the elements that are going into the community, are you going to have any elective hubs in the community so that you're separating elective from critical emergency? You know, I'm happy to say this one, Bill. So clearly hitting the government kind of priority on increasing our ability to lower waiting times for elective care is a key part next few years ahead. Given that we've got the absolutely fantastic assets of Heather Wood already in the geography, which has no emergency based services running there already. The opportunity for that to be our hub, essentially, and to increase the throughput of the surgical based work we do there gives us that fantastic opportunity. Please don't fight. Please don't fight. We'll give you both a turn. We're very calm, Chairman. Councillor Virgo was two seconds ahead. I've just got three if that's possible. I just wanted what we still have a problem with this generally with all hospitals is the discharge problem of people. And we can build a new hospital. We might be the same problem with a new hospital. I just wondered how we were doing with that and the strategy for that. A general question about the car park, because the current car park, because I noticed a lot of spaces are kind of screened off. Is this the rack problem as well? Because, you know, it seems that, you know, there's such a shortage of space. That's another slight problem to the whole running of the hospital. And just one last question. And that's about the I mean, we talked about it in the room. And I just like reassurance that no plans had changed about single rooms, given the money and the budget. Just some reassurance that you're still going on that on that journey. That's all great. Yeah, thank you. Sam's going to take discharge. I'll take car park. Do you want to take some room? Yeah, thank you, James. Thanks, Councillor Virgo. So, yes, on discharge is obviously is a really core part of our focus, given the challenge it provides to the whole health and care system. When patients who are ready to go home or to their usual place of residence can't get there at the end of their their stay. And clearly there we can normally split those into two different types of reasons. Those that happen because of things inside the hospital and those of things that happen outside and outside could be anything ranging from patient transport to move somebody back to where they need to go. They haven't got access to their own vehicle or they require some kind of particular specialist vehicle access to social care and delays to the social care system. Or even sometimes it's something as simple as is the right family supports in place for someone ready for them to go home. And the good news is we've made tremendous strides on this over the last few years. So the Christmas, it's just gone. The number of patients who had what we refer to as no criteria to reside as the technical definition of those waiting to go were 40 percent lower than two Christmases ago. So the actual trajectory of those patients, number of patients and the days that are lost for the hospital of that challenge has been on a steep downward trend for probably two and a half years now. It's a really good news story for our system. I think from some really impressive internal improvement work at family health, but also from some really good partnership working, particularly with the five local authorities who have got social care in their portfolios as well. And it's a great opportunity for me to say thank you to colleagues from adult social care for all the work they've been doing around that for the last couple of years. But the new hospital also gives great new opportunities to improve the discharge process as well. So Alex has already mentioned the use of automated vehicles, for example. So for things like getting medicines to people to the bedside more quickly from the pharmacy, for example, great chance of the new hospital to be able to take advantage of something like that. And we'll be working through all of those as we go. But I think the main takeaway for you is it's one of the things that we focus on most heavily in terms of our joint work together. And I think we've demonstrated that by making it a really singular and joint focus, you can make great improvements as well. Thank you. If I pick up the car park later. So you may recall in the Jayhoss prior to Christmas, we had quite a long conversation about car park and what we needed to do for congestion around the Portsmouth Road and various other areas. And it's been actively being worked on, I would say, over the last few months. So I'm really proud and pleased to say that we will be increasing patient car parking at the current site by 10 percent. So we'll be adding another 44 spaces to for patients. And that's the work that you will see if you're there at the moment. In order to make that happen, we had to close a staff car park and relocate those staff to a different area. I wasn't the most popular person for a couple of weeks, but I think people have got over that now. And we've also taken the opportunity of doing that work to upgrade all the lighting in the patient car park as well, because the lighting was quite been in there. It was quite old and quite poor and dark. But the electricians need to get into certain areas at certain times. So that's why there are areas closed off. So all of that work will be completed by the end of Easter. So sort of end of April time. And at that point, we'll have an extra 44 spaces. We're hoping that makes a difference to congestion on the Portsmouth Road because the queue won't come through. And we're continuing to look at off site, further off site parking with park and ride for anything that comes up. So that's good news to us. Yeah. Thank you, James. So in response to the question regarding single beds, the short answer is yes. Our wards will be configured to be 32 beds or 100% single rooms that's mandated by central government policy. And that is as a result, our intention and will be our intention unless, of course, there is a change to government policy. Councillor Eggleston, it's your turn. Thank you. And so regarding the extension, is it fully staffed? It will be by the end of April. So we are doing all of the recruitment, well, have been doing all of the recruitment up to this day. So some of it will be existing and there's about 100 or so new roles as well. Excellent. And with the new technology, has that meant the same amount of staff or less staff because of the technology? It's it's it's it's we've not had made loads less yet. And actually the single single room configuration points will put will actually mean that we need a few more nurses and health care assistance for the management of it. But we are continually kind of looking opportunities to see see what we can do to be more productive. And I think the it will be a really good learning curve for us as well around how do you operate, particularly with the workforce that have been a lot of the workforce that have been there for a long time. How do you operate in quite a different a different way? Yeah, thank you. And last question. With all this IT and these little things dashing around delivering stuff, if they go wrong, are they mended on site? Yes. And that creates another space challenge because we need garages and maintenance shops for them. But yes. Thank you. Councillor Richard Teer. Chair, can I go back to the communication part as it's still up on the screen? Please do. Thank you. We seem to have drifted into various other corners of the world. We talk about the seldom heard. And the seldom heard are often the greatest users because they don't communicate through social media. And they don't totally perhaps understand because they don't do that what's happening and what's going on. What's going to be the process to communicate with the seldom heard? How are we going to reach them? How are we going to get to them? How are we going to make sure they understand what's going on and what the process is, please? Thank you. Obviously setting out the full plan for that is the piece of work we're doing at the moment. We've recently, as a system, undergone a big engagement exercise across our communities in response to the government changes. We've had a great response to that. We've built through our excellent voluntary sector relationships we have anyway. We've been out with some really different groups and communities that we don't normally get to. So I think we've started that work to really get out in a different kind of way. And we know that we are not always necessarily the right people to have those conversations. So working with the voluntary sector, working with community groups is often our real access point in. So we will be designing the specifics of that work. And we're really open to anybody who has suggestions or particular groups that we can get in touch with. And we'll be out doing that work over the coming months. Thank you. Can you please make use of Surrey County Council's socially engaged officers that are throughout our divisions? And we have a particularly good one locally. And please, please tap into us and use us as a channel too. Thank you. I think the council is referring to our community link officers. And I can provide you with the necessary email for that one. Thank you. That's really helpful. And, you know, our partners are critical to us doing this well. So all of our local authorities will be linked in. But any specifics, thank you very much. Just one supplementary. I'm on a bit of a roll. I do apologise. Minority groups and communications in other minority languages. Can we please make sure we don't miss that as we go along? Yes, that's also a critical part. We have a lot of languages that are spoke across the system. There are five main ones. But we've been thinking around not just translations, but actually how you make culturally appropriate communications. So that's something that's coming out of our recent work with our communities and definitely something that will feature heavily in this. I think perhaps, sorry, I do apologise. The opening of the new Sikh temple in Cambly is an obvious conduit that could be used to get the message out there. Thank you. Thank you. Really helpful. I'll come in as well that, you know, the Sikh and the Pauly communities in Cambly are particularly important and difficult to reach, but they are substantial enough to be worth the attention. Actually, I would just add to that, that community were incredibly supportive to our Frimley Park Hospital based staff during COVID. So we have got quite strong links with that community already. But absolutely, it's about building that, making use of the community leaders as that access point as well. Councillor Dominic Hiscock and then Councillor Rose Chadder as well. Thank you very much, Chair. Following on from Councillor Tear's question. You have the whole business of stakeholder engagement and so on in your risk assessment, and you have a mitigation, but I'm just wondering how you know when to stop. How do you know when you've consulted everybody and particularly with the minority groups? Great question. The answer is, our intention is to not stop. So what we want to be able to do is have ongoing communication and engagement, so that when we've then got something that we need to, I guess, deep dive into getting a lot of views about, we haven't got to restart those relationships. We haven't got to scrabble about and work it out. We're planning something that would be that ongoing engagement that we might build it up a bit more and we might tear it down a little bit. But effectively, we would be looking at having constant communications and engagement throughout the whole time of the development of the hospital, because there will always be things that our communities or our stakeholders will want to know or we might want to know from them. So it might not be, you know, a full blown consultation exercise. But it will be really important that we keep that information flowing through, hearing the feedback, because if we if we're not out there all the time, we're not going to get that feedback early enough. And so that's that's our intention is it'll be constant. That's a continued dialogue. Great answer. Thank you very much. Councillor Rose, Chad. Thank you. Just following on from the communication questions, actually, and putting my children's services hat on at Hampshire County Council, the engagement with our young people and our up and coming adults is really important. I'm just wondering if we can if you can just give me some information on that and how that's been done, because actually to move to that more preventive approach, that's it's it's going to be a massive change for us. And I'm apologies for everyone around the table, but it's a real culture and generation change almost that actually it's important to get capture those young people now so that they enforce it going forward. Thank you. Interestingly, we've got a new lead nurse for transition from from young people to adult services. And I had a conversation with her probably about a month ago just talking about starting to talk about exactly that is is how do we have those conversations? How do we get access to those people when majority even those that are quite regular users of our services don't really want to talk to us about that? They want to, you know, do what they have to do and they don't want to get involved. So so she's just starting a piece of work that I'll be supporting and my team and Ellie's team will be supporting to really look at how we do that. So she's looking to re-energize what we used to have around some youth panels so that we can have a range of young people that are contributing and we can use them to access their peers. We've also doing some work with our foundation trust membership, so we have members representative of our whole area, and we are constantly looking at how do we get that younger age going. So we run sessions for young people, sort of college age, so not really young ones, but college age, where we find we get a lot more engagement. So we run sessions with with them when they come for a few hours, look around the hospitals, hear about different aspects of what we're doing. So we'll use a bit of the transition nurse and the work that she's going to be doing, a bit of the stuff that we're doing already with our membership and and getting them encourage, encouraging them to become members and find out more. And then the other bit will then just be they are another seldom held group. So the work that Ellie talked about will cover young people and you've got the links with the voluntary sector there for that, haven't you, Ellie? Yes, definitely. And we've had some really interesting young people get involved in some of the work I've just talked to. And it's been fascinating to see the things that they're coming back and saying. The other thing I'd say is, you know, you're in an excellent position as an access point. And, you know, if there was something that we could do to work together to think about how can we access people across young people across Hampshire, we'd be really interested in facilitating something like that. Absolutely. Sounds perfect. OK, I'm going to use my chairman's gold card and come back in again now and pick up on the last two points. First, communications channels. I'll take the last one first. I think this is something that's really important that it's every possible communications channel. And also bearing in mind the recent select committee report on digital exclusion of the elderly and others in a health context where the evidence, the select committee was of the order of 20% of the population missed out on the communications or couldn't communicate by that route. So I think it's absolutely vital that that's taken into account during this process. Just because people don't like using it doesn't mean that you can't talk to them. You have to actually find ways to do so. So I'll make that point very strongly to yourselves. Yeah, I'll talk about scrutiny as well, because then because I think that actually plays into the communications as well. Obviously, this committee has a statutory responsibility and statutory powers in relation to health. But I think we also need to actually bear in mind that the boroughs and districts affected have their own scrutiny process. It's particularly important in relation to primary care within their areas. And given the government's agenda to push prevention, which happens more primary care than it does secondary care. It's again, very important that those scrutiny committees are actually at least have a session that's informational gives tells them what's going on and has the basic discussion with them about what more can be done locally. So I think that's really important. So I'll shut up there and allow for an answer. Yeah, if I could make a really quick point about digital exclusions, it's such an important issue. And you will know one of the hats I wear is the chief digital officer for the ICB as well. And it's something we pay a lot of attention to. The point I would just make in addition rather than in opposition to what you said, Chair, is actually the importance of us not holding any preconceptions on who are the digitally excluded. And we are really fortunate to have the evidence base that you refer to. And there's been some really good work done in that space. But we almost need to take a view that anyone could be digitally excluded and work back from there. And certainly when we look at some of our data locally, the link between deprivation and digital exclusion is clearly incredibly strong. We know that we have a very active digital user group in the elderly space, which is something which is really important to us. But also understanding that for those who live in deprivation deciles one to four, they are 100 percent more likely to be admitted to hospital. And actually, so what is our route to ensuring that messages on prevention, on proactive care, on support to better public services, which keep them well for longer, comes to all the different channels which you described. So I think we should take a really broad view on digital exclusion and make sure that we're not missing anything. Yeah, it's very important to include literacy in there because it's actually a much larger proportion of the population and realize that struggle with literacy, that struggle with long words, that can't cope with the NHS love of acronyms. And it needs to be put in the right way, it needs to be put in a simple, accessible way, and it needs to be by as many channels as possible to get through. So I'm just, you know, keep reiterating this point that you need to talk to people. Slow with us. Yes, if I can just endorse what you've said there, Chairman, because recently at a meeting, a number of people said they haven't understood a word that's been said on that presentation by the NHS. And I said, well, we do actually at Hampshire ask them to produce an index. So we can, because the police, the armed forces, the fire service all have their own acronyms. So it can be very important. We've talked about the importance of communication and recently on Health Watch and the Health and Wellbeing Board in Hampshire, and Sam was there, we talked about generation XYZ language. And I pointed out that the Sunday Times had produced that Curry's was the number one selling agency in electrical goods. And that was mainly they turned around the business due to using the language that was understand by teenagers and above some of you people here, which is critical. So I think you've got to also on your social media and your meetings going out actually speak the language and have your leaflets and everything identified for that, that, that age group. The other thing is that we would we talked about the different nationalities and everything else. But there are things like the food hub where we now have Nepalese people and other people that speak different languages. I think in some areas there's over 100 languages being spoken. There's 28 languages in our schools. So it is important we get into those areas where the deprived people we've been talking about go the food hubs, the warm hubs, the libraries, you know, the children's, the expected mums, postnatal and everything else where we can send that message. Because the importance of knowing, you know, if the GP, the PCN is not working, they go to Frimley, you may go to the UTC, all those sort of things take time to explain. And that will happen, you know, with the new hospital. Interesting what you were saying about IT there. I think some of the things we we need to really explain a bit more is AI is actually proving to be successful on the administration side in hospitals, reducing the amount of work done by the staff. That's certainly the case in Portsmouth. But I think people need to understand what you see AI being used for in the future and simple little things like, you know, the pill box in the rooms, the reception on each floor, actually having sensors, pickups for each room so they know what people are doing. All those sorts of things will give, you know, help explain their success and the importance of the individual room as opposed to big wards. So I think that's a very important communication bit as well. Thank you. I'll highly recommend the use of chat GPT, but you can actually just tell it. Can you take this and turn it into wording for an eight year old? Works perfectly and makes it really accessible. Any more? Okay. I think we then move on to the next item, the overarching friendly health strategy. Thank you, Chair. So I wanted to give a brief overview of our overarching strategy, which is currently out for engagement. And this is our strategy for our organization. So Alex mentioned that this will be supported by our clinical strategy, which talks about what we plan to do with all of our health services. But this is the overarching organizational strategy. And I'll start with a little bit of a little bit of context. So personally, this is the third organization strategy I've been involved in writing, but in three very different worlds. First was with the John Lewis partnership in retail. Second was within the Home Office and central government now in the NHS. But there is something that connects all of those three strategies together. And that is that this strategy has been written with a focus on our communities and our patients. In John Lewis, it was very much the customers and also our staff and how we can make things better for our people to provide excellent service. Where we have been this, the strategy has not been written in a dark room. There's been significant engagement that has taken place over the last 18 months. A lot of it predates my time in the NHS. And you'll see on the slide, it gives a little bit of a snippet of the different groups that have been engaged along the way. We've had over three and a half thousand sessions or piece of feedback from patients and the local community. There's been sessions with our foundation trust members and members of the public. We've run open board sessions in our public boards as well. We've done a lot of internal engagement. That's with our 13 and a half thousand people that work in the organization. Everybody from cleaners, porters to consultants have had a chance to talk about our future and the sort of things that they would like us to be focused on. And it's been scrutinized throughout that period by our own board of directors, non-exec directors and our elected council of governors as well. So that's the sort of the background. And if we move to the next slide and I'll talk through very briefly some of the things in our strategy and the full draft strategy that's out for engagement is available to download from our website if anybody wants to have a read. And lots of the feedback earlier around keeping it really simple and clean and easy to understand has been taken on board. Our vision is to be compassionate, effective and modern in all that we do. So let me bring to life what that means, what that means to me. And then hopefully those words would mean something slightly different to everybody in this room. But compassionate is about the care that we give, how we treat our people, our communities and how we deal with all of our patients that come through our door. Effective for me means that we drive the right outcomes, we operate, to Councillor Edgerton's point earlier, productively. We don't take, that we use, you know, the most modern, the most effective techniques of healthcare as healthcare develops to get the better results for our patients, whether that might be robotic surgery or whether that might be AI to produce quicker results. And modern is about a variety of different terms, how we behave, our facilities, some of the tools and the techniques that we might use. So our vision is to be compassionate, effective and modern in all that we do. And how will we do this so we can move one slide? We'll have four strategic objectives that will help us to achieve those. And the way that it's been drawn up is what I would describe as a virtuous circle. And it's a virtuous circle that will ensure that our patients are satisfied by focusing on the amazing people that we have in our organization, so that the high quality clinical outcomes in great infrastructure to make Frimley Health a great place to get care or receive care. And there are four strands, as I mentioned, to that. And you can start really wherever you'd like to on the diagram. But the first strand is about making sure that we have really engaged people, make sure that all of our 13,500 people that work for the organization feel that it's a really great place to work, that they feel listened to, that they feel that they can contribute their views, and that they feel that they're getting the right development for whatever is right for their career at that time. We put those people in the best modern infrastructure that we can offer. So we've talked a lot this morning, sorry, this afternoon about the new hospital. Sam has obviously mentioned Heatherwoods, which was voted the best elective hub in the country. And obviously we've got Wexham Park near Slough as well that we can look to develop to really bring some of the best buildings, so that those staff working in those buildings feel proud that they're in their great infrastructure. In turn, they can deliver excellent quality, a culture where quality and safety are paramount. It doesn't take an expert to work out that over the next few years budgets are going to get tighter and our resources will get more constrained. But it was really important in our strategy to say that when we're having to make tough financial decisions, we will never make a financial decision that could impact quality or patient safety, and they are paramount and will be a pillar of our strategy. And in return, we hope that we would deliver highly satisfied patients where every single interaction with our organization matters. So those are sort of how we're going to achieve the vision. The values are how we will ask our staff to behave every day. They're the values that were developed by our staff five years ago in our previous strategy, and we are going to retain them. So there's a thread between the old strategy and the new strategy. And those three values are committed to excellence. This is about people that want to work in an excellent organization working together. So people that don't see it as I but see it as we. And people that want to face the future and embrace technology and new ways of working. So those are the sort of behaviors you would expect. A link to that strategy, each member of staff will receive their annual review. Half of that annual review will be based against how they almost behave against these values. So what would, you know, what would a great behavior for somebody that's demonstrating these? We'll get that. We'll get that release so that people can kind of really bring that to life in day to day behavior. I'm going to spend a couple of minutes just explaining those those four strands and those objectives just to hopefully bring them to life. But again, as I say, the detail is in the organization strategy. But undersatisfied patients will be known for putting patients at the heart of everything that we do. This for me is about an organization that almost leaves an empty seat at the table when you're making decisions to make sure that every decision you make is reflecting the decision that a patient would expect. And reminding ourselves that we're here for our patients. We exist for our patients. So our patients being at the heart of everything we do. And we want everybody that walks into our organization or has interaction with our organization to be satisfied in what they in that interaction, what they receive. How we're going to do it is about joining up care, providing compassionate care, timely access to services, bringing care closer to home. We've talked about it this afternoon, but bringing care closer to the community. Really being at the forefront of digital innovation to maximize the benefit of technology and allowing patients to be really empowered in the choices that they make and not having necessarily their care dictated to them by a clinician, but being able to have a two way conversation about about those. And we want to be known as an organization. Every interaction that people have with us really matters. The second strand to just explain briefly is engaged people. We are ambitious in this strand. We want to be the best place to work in the NHS. We want all of our 13 and a half thousand people that work for us to be really happy at work and feel that they come to work with a smile, because if they do, they are likely to deliver good outcomes for our patients and how we're going to do that. We want to really equip them for the future, whether that be with tools and technology in the best laptop or whether that be with the right training in terms of what they may need for their roles. We want them to feel valued and supported and listened to. So while we're while this session is going on, there's a session being held with our staff at the hospital around, you know, being able to just talk about all of the things that are going on. We're planning to run something next week as an example of a large sort of survey that says, how can we make your experience even better at the organization? So not necessarily pay everyone 10 percent more, but what are the things we can do on our doorstep to make people's lives better? We want to train our leaders with the best leadership training that we've got and really capitalize on our relationships with the military to support some of the training that we can offer to our leaders. Use our resources really well, as I say, live our values, provide people with modern facilities, celebrate success and look at modern benefits. So back to the generational conversation we had earlier, what are benefits that people would expect in a in a modern organization? It might not just be a large pension, but access to things like gyms, et cetera, on site might be something that we are that we might consider to try and get people as happy as they can be. Third strand, modern infrastructure. This is about, as I mentioned, not just buildings, but making sure that we are known to be a digital leader and we have really sustainable facilities across our trusts and use the opportunity that's been put to us by the new hospital to to be one of the most environmental, sustainable organizations again in the in the NHS. This is about investing in Wexham Park Hospital. So we want to have three amazing hospitals, the new build. We want to have Heatherwood, which is, say, an amazing electric center, but also use our I describe our business as usual capital to really bring Wexham Park up to date over the next five years. Continually invest in the community and in out of hospital facilities, be a digital leader and also look at things like commercial opportunities. So where can we drive greater commercial income for from our buildings and from our facilities to reinvest back into the patient experience and the patient journey? So that's what our modern infrastructure strand of our strategy is all about. And last but not least, quality, as I mentioned, a culture where quality and safety are paramount. This is about providing the right care in the right place at the right time, learning quickly from any mistakes and any learning to continually improve. There's some detail in here about health inequalities and some of the work that we want to do to make a difference to health inequalities and continue our programs around improving our quality. So we have a program in Fernley and the Trust called Frimley Excellence, which is a continuous improvement program that we have a number of people training. You'll see the different color lanyards based on their training, but really using those to improve our services every single day. And then finally, I would just explain sort of making our strategy reality. It's quite hard to see on the screen what this is all about. But what we've done to try and be transparent and I guess so people can hold us to account is to put three metrics for each one of those strands so that people externally can look at us and say, are you on track to achieve those things? And I won't read them all out because they're quite small and in the version that's in the strategy, you'll see the slightly larger one. But it's things like satisfied patients. We will do a survey with all of our patients and we want 90% of people to rate their experience in the organization as positive. We want to make sure that by 2030 95% of our patients are seen within four hours of walking into our accident emergency department and that 92% of our patients are seen within 18 weeks of being referred. So really making a step change in some of our waiting times because we know from engagement those are the things that matter to our patients. We want 75% of our patients to use the My Frimley Health app. So it's a it's a brilliant app at the moment. It's got four and a half stars on the App Store and on the Google Play. But actually, we haven't we've only got about 45% of our patients using it. So really on the ante in use of that. There's other metrics around things like staff making sure 80% of our staff would recommend the organization is a good place to work because we know actually if somebody says, do you know what Frimley Health is a great place to work? It generally means that they're going to answer positively to a lot of their other experiences. And there are there are also scores for measuring us in quality. This is about accreditation external views. And as I mentioned, completing the training in the continuous quality improvement program. So that's a whistle stop tour of our strategy in sort of 10 minutes. I'd encourage anybody to have a look at it on the website. And there's also a form on there for providing any comments when you've read the detail. And we plan, as you see, the timescale here is that we're still in the final sort of chapter of engagement with people to get views. And I plan to launch that strategy in line with the new financial year at the end of March, so that we've got some things to focus on over the next five years alongside building a new hospital. Thank you, Chad. Thank you very much for that presentation. I particularly like the fact you started with compassion. It's something that's sometimes forgotten in the process of doing all the nice technology bits, and the rush of dealing with a crisis with a patient that somebody just holding their hand and saying, you know, has a huge impact. So, yeah, I'll really say that. And I'll also pick up on something at the end, which is the MyFrimly Health app. It is really good. My suggestion is to actually really push the biometric access because people won't remember the password because they need it every six months. And when they need it, they really need it. So, yeah, biometric access is the route to go, frankly, because your finger is your password. I'd like to congratulate James for getting through so much in such a short period of time. In fact, you got through it so quickly. Is there any chance, Chad, we can revisit this at some stage in the future? I think that would be a good thing to do. I think maybe a separate session that just takes us through this might be a good idea. Very impressive. Thank you. Any more? I've run them into silence, I think. But I think actually it's a really good presentation. And I think there's also one slide towards the beginning that really says it in terms of the patient. Yeah, if we can roll back along the slides just a little bit. Yeah, that's one, the seamless care. Because I think, you know, that's one of the things that, you know, making it seamless for the patient. It doesn't matter who sees them, they've got access to their records because of my family health, which is just bottom corner, opposite corner. But that seamless access, that access to information so the clinician can actually, you know, not restart the entire conversation. Hugely important. It makes the whole thing go much quicker. But it also means that information isn't lost and forgotten in the process. No, absolutely. The patient feels, you know something about them, you've thought about them because you've got the information in front of you. One of the most common patient in part of the engagement for, you know, what do you want us, what do you want us to focus on over the next few years? The patient said to us is exactly that, which is don't make me come for my outpatient appointment and have to go through everything all over again. But also make sure that, you know, I can park my car when I arrive or there's transport into the hospital and make sure I don't have to wait six months for that appointment in the first place. You know, they sound really simple, but they're not that easy to fix. And so that's part of what we need to do. It's all those things, including I've made an appointment for 10.30 and at 12.30 I'm still sitting here. That's not what we want. So, yeah, all of this stuff really counts. Councillor Hiscon. Thank you very much. I'm sorry to come in late. There's one, well, there's several actually questions, but I won't bore everybody. One of the things that interests me most on that is the question of staff satisfaction and you want everybody to recommend you. And that's obviously commendable and be nice to do. Can I just ask, where are you now on that? And do you know what you've got to do to improve it? So we're currently at 65%, which is, I would say, average for the NHS, probably in maybe in the top, the top half, but not, not anywhere near the top. The, and that will be based on the amount, also the amount of people that have done the survey. So out of the 13 and a half thousand people that do our survey, not every single person fills in the survey. So one of the things that we need to also do is improve the amount of people that fill in the survey because you don't might be disengaged in the first place. The main pieces that come through are basic things you'd expect an employer to get right. Listen, you know, listen to my views, create a two way channel with line managers that genuinely care about people as a person. Make sure that people know me and know what, you know, what works for me and not necessarily, you know, treat me as an individual, not just as a, you know, number. But there's a, there's a big action plan that sits behind it, behind our survey. And moving the dial from 65 to 85 won't be that easy, but I think is achievable over, over the time. So all of the targets that we've got are stretching, probably some of the biggest stretching around the waiting list ones as well. With, as we mentioned, I think previously we've got over 80,000 on there at the moment. So big piece of work to get that down to 18 weeks. But the whole question of patient waiting list, presumably that's one of the causes of frustration for your staff as well, isn't it? Yeah, absolutely. Correct. Correct. You know, it's not pleasant, I guess, when, when somebody comes in and the first interaction they have with somebody has been almost in a queue for a very long time. It's almost like probably being complaints handled or almost on a phone desk. But it's, so it's sort of getting the whole infrastructure right, you know, from, because, you know, at the moment somebody might come into Frimley Park and have had to wait half an hour, 40 minutes to park their car. They've been waiting six months for an appointment. They've come into a fairly unmodern building that's got lots of things closed. And by the time they see the clinician, it's the frustration that then probably comes at the first contact. So it's sort of fixing, I describe, a lot of the hygiene factors around that to try and make the journey more seamless that we can then provide better care. Councillor Bill with us. Thank you, Chair. Excellent presentation. It's always easy at this stage. As someone said to me the other day, the guy that wrote the paper on devolution will probably be knighted, but the guy who wrote it on local government reform won't be recognized at all. And, you know, it's a very good presentation. The proof of the pudding is actually putting it into action. Linked in with that. I mean, I was interested in what you were saying about the Frimley app is that not all the PCN apps work very well. And your big problem is obviously the amount of patients you can't get in the PCN, who can't be seen early, that come forward. And I know in Hampshire on the ICB website now, we're interrogating it at the Health and Adults Social Care Scrutiny Committee and seeing where the big critical problems are to aid the hospitals within the county. And the deprived areas are the areas where actually, as we've said, 60% of cancer comes from out of the total cancer patients and the amount of appointments over 28 days, which then puts further pressure on the hospitals. So the link between your system and improving their systems, you know, is of great importance. I mean, my NHS app is good, but my GP didn't know why my medication was stopped. So, you know, internally, externally, it's going to be critical on how we communicate with our patients of all ages. And I think feedback at every stage of what you're proposing to do is critical and adjusting that template. And it's important that as far as Josh is concerned, that we see the results of that and see the adjustments and the reasons why. Because I know in Frimley, you can have people who were seen in 11 minutes on one day and then they're there for eight hours the next. So, you know, critical phases change very quickly. So I think communication is important. The IT is important. The apps are very important. And it's getting the public aware of how efficient those apps are by using local radio and everything. I'm just going to hop in if that's okay on the app questions. It's really important. And we do have a broad aspiration as a partnership that the NHS app is the sort of digital front door for a lot of our population. And it actually has a fabulously wide user base already. You may recall for a large part of our population, it was the only way you could leave your house for a while during the COVID pandemic was to get a QR code through that app. And it did have the effect of ensuring that people actually did download and install it. So the interoperability between that particular digital system, the My Frimley Health app, the primary care system that sits underneath it and ensure that it becomes more useful to the population is a really important part of our digital strategy. Fully acceptable. I think it's spot on. Yeah, I'd actually say the Surrey Adults and Health Select Committee also has primary care and access to primary care as an app in its next session. And we also have the urgent treatment centres and the move to urgent treatment centres in there as well. So it's a common core issue right away across is what I would say. And there's Councillor Virgo. Thanks, Jeremy. I was just going... Sorry, Caroline. Sorry. You two just did it again. Let me be the gentleman. Mine was just an observation because I've been to Heatherwood quite a lot. And I don't know, it just seems to me that you've got a new hospital there and people are happier. You know, that's what I think. And we get a new hospital and I think the same thing will apply. The communication is really difficult when you've got a hospital that was built many years ago and it's very confusing to find anything. You know, no matter what you do. But it did strike me because the reception... I think there were three reception people at Heatherwood, which does seem rather a lot, but they're going to be cut to one, I think. And the thing that I suppose most people feel, you come into Heatherwood and, you know, you don't... It's a bit alien, like all these things are, and people just are confused thinking about what's going to happen to them when they come to the hospital. And it just seems to me that you should be very careful in that direction because there are some volunteers sometimes which help people. But without that, it can be a bit alienating. And I just think you should be careful then, you know, not destroying the image of the hospital because they don't know where they're going and all that stuff. No, I entirely agree. I think what we will probably move in the direction is, you know, if I had it my word, just remove the desk but keep the people. So almost you bring the people out more into the centre so there isn't the barrier sometimes between the patient and the desk. And you sort of, where we use more digital check-in screens and that sort of thing, you don't just put them in place and take the people away. And you actually bring the person almost a bit like TfL have done it in tube stations where actually, you know, there's lots of ticket machines. But there's also the people in orange jackets that are helping people through those processes. So I think that's the, that's the journey that I think we'll go on, particularly where we can use technology to make it easy. Councillor Eggerson, I'm going to let you have the last word on this because we need to take a break very shortly. Certainly. So I'm going back to the app. Is there any hope that Epic can talk to EMIS? Are they going to become friends at some point? Because at the moment, it's like two parallel universes. If we could bring secondary care and PCN together, then people would be able to see their paperwork more easily. Thank you. Great question. Thank you. Short answer. Yes. There is a module which exists to link the two systems together. And we're actively working with both of those suppliers to ensure that we can deploy that locally. So that is coming. You'll be very pleased to hear. And the longer answer is that actually interoperability in this part of the NHS in the Frimley system is probably further ahead than most parts of the country. Now, that might be sort of not necessarily exactly the message which gives the most reassurance. But however, we do already have some really, really good information sharing between the systems that we've got in place. There's more we can do. And you hit on one of the solutions that we're working on. OK, thank you. We're going to move on to recommendations and what we'll do is we will just note recommendations that any of the members of the committee come up with. Go away, do the drafting and then circulate them to the committee for approval and do it that way because editing in committee is not a good idea. So I will kick the process off with the need for a recommendation around digital exclusion and minority groups that we make sure that we do absolutely everything that we can on the communications front. And open to the floor. Councillor with us. Chair, would you like to note the first recommendation is to note the presentations have been agreed by everybody here? Yep, I think we agreed with noting the presentations. Yep, I'm a huge thank you actually to the Frimley team for the work they've done on this. So, yep. And any other recommendations to add? It looks like we are done there. Thank you for the presentations in the first bit. We've obviously got a part two piece. So, a short 10 minute break will follow and when we will return we'll hold the next segment of this meeting as part two in private. That under section 100A of the Local Government Act 1972 the public be excluded from the meeting for following items of business on the grounds that they involve the likely disclosure of exempt information under the relevant paragraphs of part one of schedule 12A of the Act. Do we agree that the next section will be in part two? That's agreed. Thank you. And so, I'm going to bring this piece past the meeting to a close and therefore ask that any members of the public in the public gallery and press, please kindly vacate this room for the remainder of the meeting. And can I ask the panel and the attendees to return for the in private session in 10 minutes. The recording can now be stopped. Thank you, everybody. .