GRAMPIAN NHS BOARD
Minute of Meeting of GRAMPIAN NHS BOARD held in Open Session on Tuesday 2 November 2004 at 10.00am in the Stewart’s Hall, Huntly
Present
/Mr Jim Royan
/ ChairmanDr Eric Baijal / Director of Public Health
Mr David Benton / Director of Nursing
Councillor Raymond Bisset / Non-Executive Board Member
Mrs Barbara Bruce / Non-Executive Board Member
Mrs Anne Campbell / Non-Executive Board Member
Mr Richard Carey / Chief Operating Officer
Councillor Kate Dean / Non-Executive Board Member (from 10.50am)
Dr Roelf Dijkhuizen / Medical Director
Mr Alan Gall / Director of Finance
Mr Angus Gordon / Non-Executive Board Member
Mrs Elizabeth McDade / Non-Executive Board Member
Mr George McIntyre / Non-Executive Board Member
Professor Val Maehle / Non-Executive Board Member
Mr Alex Smith / Interim Chief Executive
Mr Tony Ward / Non-Executive Board Member
Dr Stuart Watson / Non-Executive Board Member
Professor J Weir / Non-Executive Board Member
By Invitation / Dr George Crooks / Director of Primary Care
Mrs Laura Gray / Director of Corporate Communications
Mrs Judith Hendry / Chair, Allied Health Professions Committee
Ms Susan Jappy / Assistant Director of Public Health
Mrs Sue Kinsey / Chair, Grampian Local Health Council
Miss Jennifer Mack / Organisational Development Manager (from 11.15am)
Mr Gordon Morrice / Director of Human Resources
Mr Ewan Robertson / Board Secretary/Director of Performance Improvement
Ms Anne Ross / Head of Performance and Quality Improvement
Mr Gordon Stephen / Grampian Area Partnership Forum Co-ordinator
Mr David Sullivan / Director of Corporate Planning
Attending / Miss Lesley Hall / Assistant Board Secretary
Ms Glenys Wren / Personal Assistant, Board Secretariat
Item / Subject /
Action
1 / CHAIRMAN'S WELCOME/ANNOUNCEMENTSThe Chairman welcomed everyone to the meeting and conveyed his thanks to the Huntly community for hosting this Board meeting. He also welcomed Richard Carey, Chief Operating Officer, and George McIntyre, Moray Local Authority representative, to their first formal Board meeting.
Mr Royan informed Board Members that Andy Kerr had been appointed as the new Health Minister, supported by Rhona Brankin. Mr Royan and Mr Smith had attended a meeting with other Chairs and Chief Executives in Edinburgh recently and reported that a letter to all Boards dated 8 October 2004 had been received from Mr Kerr. He had requested a report by the end October explaining what Boards had achieved with the additional resources provided over the last two years. A copy of this letter was made available to Board Members along with a copy of the response signed by Mr Royan.
Mr Royan reported on several events he had attended:
Rural Health, Inverness, to look at the rural health agenda
Forensic Psychiatry Conference, hosted by NHS Grampian
Scotland’s Health At Work launch event on Mental Health
Daily Record Health Awards
Final year medical students training
Mr Royan informed that issues around Board development would be taken under AOCB.
2 /
APOLOGIES
Apologies were received from Ms Margaret Burns and Professor Neva Haites. Councillor Kate Dean had informed that she would be late and arrived before item 5.3.3 /
MINUTES OF MEETINGS OF GRAMPIAN NHS BOARD HELD ON 7 AND 16 SEPTEMBER 2004
The Minute of the meeting held in Open Session on 7 September 2004 was approved subject to changing “organisational” to “operational” at the end of paragraph 6.2b on page 5. The Minute of the meeting held in Open Session on 16 September 2004 was approved.4 /
MATTERS ARISING
Mrs Gray, Director of Corporate Communications, gave an update on the Out of Hours (OOH) consultation and confirmed that a number of actions had been followed through since the Board’s approval of the arrangements at the 16 September 2004 meeting. She reported that the consultation feedback paper had been widely distributed to all who had participated. A leaflet had been produced following consultation with all stakeholders. This will be distributed by the Post Office to all households in Grampian, as well as GP practices, dentists, voluntary organisations, community councils etc. Mrs Gray will continue to work with the local press to ensure ongoing coverage of this issue.Dr Crooks, Director of Primary Care, reported on the significant amount of work done by the team to ensure the service was ready to go live two months ahead of time. He confirmed the infrastructure had been in place by 6pm on 1 November 2004, including the repositioning of cars and transport vehicles. The service to date had received 218 contacts, mainly from NHS 24, with no requirement yet for patient transport. Communications with NHS 24 had worked seamlessly and patient feedback had confirmed a high degree of satisfaction. He assured Councillor Bisset that there would be regular monitoring of activity and confirmed that 13 GPs had been recruited to work in the OOH service. He clarified arrangements for populating the rota. He gave assurances that managers with eight years’ experience of out of hours’ rotas in Grampian were confident these would be populated appropriately for delivery of a clinically safe service.
Mrs Gray and Dr Crooks agreed to provide Board Members with a briefing note in the next two weeks. A briefing will be provided at the January 2005 Board meeting, with NHS 24 and SAS in attendance, in order to understand any impact on those services.
Mr Smith asked for a detailed review to be undertaken by the Performance Governance Committee and to give an update at the 7 December 2004 Board Seminar.
Mr Smith confirmed to Councillors Bisset and McIntyre that the minute of the Special Board meeting held on 16 September 2004 was now an open document and therefore available to share with other council members.
Board Members commended Mrs Gray, Dr Crooks and their respective teams for enabling NHS Grampian to reach this position.
Mrs Kinsey advised that a piece of work was being undertaken by the Health Council regarding the initiative. She confirmed that a report would be produced and made available to the Board in due course.
The Board noted the position. /
L Gray/
G Crooks5 / SERVICE STRATEGY AND REDESIGN
1. Grampian Health Plan 04/05 Update
Mr Smith reminded members that the Grampian Health Plan for 2004/05 had taken time to complete because of the financial plan requiring further development. However this was now in place and he reported that the Grampian Health Plan for 2004/05 was now ready for signing off, after an exchange of correspondence with the SEHD had taken place.
- Grampian Health Plan 05/06 Consultation Draft
The third stage is decision-making. She explained that the Board and the SSRC were having a joint meeting on 1 February 2005 to consider feedback. With regard to financial impact, the balanced scorecard will be brought back to that meeting at which the corporate objectives forming the basis of the 05/06 Health Plan will be presented for approval.
Ms Jappy agreed to liaise with Councillor Bisset outwith the meeting to take forward his suggestions on how to present the process to local authority stakeholders. Mr Gall reminded members that the mechanism for involving local authorities would be through the Joint Future programme, which from 1 April 2005 would be subsumed under the Community Health Partnership (CHP) process.
Mr Smith explained the significant clinical input to the process, which was important for ownership of the process. Dr Watson explained that the SSRC was working hard to ensure clinical engagement and leadership of the process.
With regard to the development of the Grampian Health Plan 2005/06, Ms Jappy explained the working title was “Tomorrow’s Health Today” and that there was an opportunity to consider and debate an appropriate title.
The draft plan will be presented to the SSRC with their comments and feedback to be incorporated. The content will be discussed further at the Board Seminar in December.
The consultation paper set out the rationale for change including the following nine actions:
- Health Inequalities
- Self care
- Unscheduled care
- Planned care
- Integrated care
- Developed Clinical infrastructure
- Intermediate care
- Workforce development
- Strategy for Aberdeen
Professor Weir explained that from the Advisory Committees’ point of view, the process was exciting and introduced realism into the process. He stressed the need for the plans to be acceptable, achievable and affordable and associated with decisions made in an appropriate forum or committee.
Professor Maehle stressed the importance of engaging with the Higher and Further Education sectors in the process. Mr Smith explained that discussions were underway to refocus the NHS/Universities Group which would use the Health Plan as a key reference point. Once the arrangements with the University principals had been signed off, this would be taken to the Board.
Mr Smith advised that the Health Plan had to be underpinned by financial planning to ensure affordability and work would be done on this during the next 3-4 months. He explained that work was ongoing regarding financial sustainability.
Mr Gall stressed the need for local authority colleagues to be involved in the Health Planning process, particularly relating to health inequalities. Mr Smith felt the issue around the interface with community planning required to be clarified in the paper for discussion and at the December seminar. Ms Jappy agreed to build this into the paper for the seminar.
The Board agreed the process to consult widely before drafting the 2005/06 Grampian Health Plan which would form part of the discussion at the Board Seminar in December.
The Board approved the consultation paper and to progress to the consultation with staff, patients, carers, communities and partner organisations. /
A Smith
S Jappy
3. Change and Innovation Programme UpdateMr Sullivan explained that the Change and Innovation Programme formed a key part of the Health Plan and brought together the Change and Innovation Programme and the sustainability plan in the context of the 05/06 Health Plan. He explained that Mr Graeme Smith, Head of Service Development, was co-ordinating the programme and reviewing remits for various projects, to enable activity to be prioritised. He explained that the first draft of the programme for 05/06 would be presented to the December meeting of the SSRC. He advised that PricewaterhouseCoopers (PWC) were involved to provide external and independent scrutiny to ensure that the system was on track and were assisting with the complex financial modelling. Mr Royan explained that the Health Plan was the “what” and the Change and Innovation Programme provided the “how”.
The Board noted the key issues with the Change and Innovation Programme and agreed that the programme would be subject to further discussion at the December Board seminar.
4.National Framework for Service Change – Communication Debate
Mrs Gray explained that work was underway to develop a national framework for service change. She confirmed that the work required to be completed by March 2005, with input from a variety of people in Grampian. The forces and drivers emerging were consistent with the recent Healthfit. She reported that communication had been identified as a critical component of the framework and advised that a national newsletter will be available soon and widely distributed to the Grampian population, informing how people in Scotland can engage in this debate. Five regional events have been planned, one of which will be held in Aberdeen during the evening of 15 December, in the Aberdeen Exhibition and Conference Centre (AECC). This will be advertised to maximise attendance and it is proposed to work with existing networks to raise awareness of this event. This will be used as an opportunity to debate the issues in the Health Plan/Change and Innovation Programme. Mrs McDade felt there would be added value if the Patient Focus and Public Involvement Committee was involved on behalf of the Board. There were opportunities with technology for links with Orkney and Shetland, and consideration will be given to the provision of local transport for access to the AECC. Mr Carey stressed the importance of dovetailing with work being done locally on the Change and Innovation Programme.The Board noted the paper.
6. /
CORPORATE GOVERNANCE
- Clinical Governance
Professor Weir summarised several issues outlined in his letter to the Board. He highlighted the desire to work with the public and visitors to the hospital to improve aspects of infection control. To raise awareness of this issue, it is proposed that a social conduct code will be produced, using information from the Microbiology Department and with advice from the Corporate Communications Department. The Board agreed that it had a responsibility to address the concerns highlighted and will look to the Patient Focus and Public Involvement Committee for assistance.
With regard to prioritisation, he stressed the need for the decision making process to include the appropriate level of clinical input and for decisions to be made in appropriate fora. Regarding prioritisation beyond the contingency fund, the Chief Executive and colleagues were pursuing this issue and will report back to the ACF and the Board.
Professor Weir warned that dental services would be compromised if a replacement were not found for a forthcoming orthodontist’s retirement. The Board noted the concerns and was advised that the issue will be followed up by the Chief Operating Officer who will report back to the ACF.
He confirmed that the ACF felt there had been a successful start to the Out of Hours service in Grampian.
Members were advised of the future arrangements for Chairs of the Area Clinical Forum (Mrs Judith Hendry) and Area Medical Committee (Dr John Reid) with effect from 1 April 2005.
The Board noted the letter and agreed to the actions.
- Clinical Governance Committee issues/update
- Pay modernisation.
- Exercise Black Rain – action plan leads assigned.
- The appointment of Pam Tavendale as Head of Clinical Governance Support Unit with effect from1 November 2004.
- The first meeting of the Operational Clinical Governance Committee, chaired by Dr Gordon Peterkin, Associate Medical Director, which had taken place on 20 September 2004
- The breast waiting times action plan which was being closely monitored.
- Infection Control – paper outlining the initiative had been noted
The Board noted the letter. / PFPI Committee
A Smith
R Carey
E Robertson2. Staff Governance
- Grampian Area Partnership Forum (GAPF) update/letter
The Board noted concerns regarding shared services and the HR Director will ensure these are addressed in the work of the Shared Services Liaison Group. It was noted that Agenda for Change also had a huge impact on staff affected by proposals for shared services.
The Board noted the letter.
b.Staff Governance Report