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MINUTE of MEETING of the
PAY MODERNISATION AND WORKFORCE PLANNING BOARD
Board Room, Assynt House, Inverness /Friday 15 June 2007 – 10.00 am
Present: / Ray Stewart, Employee Director (Joint Chair)Ruth Cleland, Head of Internal Communications
Tony Cowan-Martin, Service Development Manager, OH and H & S
Pamela Cremin, Workforce Planning Manager
Diane Fraser, RCN (from 10.30 am)
Anne Gent, Director of Human Resources
Derek Leslie, Director of Planning and Performance (from 10.35 am.)
David Logue, Human Resources Manager, Argyll and Bute CHP
Catherine Mackay, UNISON
Judith McKelvie, Learning and Modernisation Manager
David McRonald, Head of Financial Management (from 10.40 am)
Mary Morton, Head of Community Pharmaceutical Services
Caroline Parr, Partnership Support Officer
Dr Ken Proctor, Associate Medical Director (Primary Care)
Donald Shiach, Pay Modernisation Manager
Christina Stewart, Royal College of Midwives
In Attendance: / Brian Mitchell, Board Committee Administrator
1 / WELCOME & APOLOGIES
Apologies were received from Dr Ian Bashford, Sheena Craig, Dr Roger Gibbins, Brian Houston, John Huband, Heidi May, Gill McVicar, Adam Palmer, and Nigel Small.
At the commencement of the meeting Mrs Gent expressed concern from a governance perspective that there was no representation present from the operational side. This point would be discussed with the Chief Executive. Mr R Stewart also raised the fact that at the last meeting of the Area Partnership Forum the issue of overall attendance was raised as a concern.
2 / MINUTE OF MEETING HELD ON 20 APRIL 2007
The Pay Modernisation Board approved the Minute.
3 / MATTERS ARISING
There were no matters raised under this Item.
The Committee agreed the following Items be taken at this stage in the meeting
5 / PAY MODERNISATION – IMPLEMENTATION
5.1 / Agenda for Change
5.1.1 / Agenda for Change – Update on Assimilation, Payment of Arrears and Reviews
Mr Shiach spoke to the circulated report which gave an overall summary of progress in implementing Agenda for Change in NHS Highland in that the figures for assimilation and arrears paid as at the end of May 2007 were 7862 and 4451 respectively for the old Highland area and 1106 and 470 for the Argyll and Bute CHP area. It was advised that as assimilation progressed managers were taking the opportunity to redraft a number of job descriptions and this was having an effect on the work of the matching panels. A number of descriptions remained unmatched and the panels were working on the basis of one week on these and one week on backlog priority posts. As such Reviews were being balanced with job matching as appropriate. On the point raised by Mrs Gent, it was confirmed that panels were now handling the matching process for new Argyll and Bute CHP posts, this point being confirmed by Mr Logue. With specific reference to Argyll and Bute CHP, Mr Shiach advised that progress had not been as hoped. An Action Plan was to be produced to address the existing position, however, before that could be prepared the exact position required to be established and in this respect the team in Paisley had been requested to provide relevant information. The team in Paisley had been integrated into that for NHS Greater Glasgow and Clyde and at the recent NHS Highland Board meeting, it had been agreed to write to Mr Ian Reid to establish whether additional resources were required for Argyll and Bute, this to be made available from within existing budgeted resources in Highland. Mr Logue advised that this had also been discussed at the CHP Management meeting. Mr R Stewart emphasised the need for progress to be maintained. Mrs Gent advised that she had requested the relevant information be gathered prior to the meeting of the Argyll and Bute CHP Committee to be held on 12 July 2007.
Discussion then moved onto the matter of preparation for Reviews and Mr Shiach advised that there had yet to be established a schedule for Panel meetings. The circulated report indicated that additional process information had now been included on the Intranet site. In Partnership, it had been agreed that Review Panels would only proceed where four members were present (2 Staffside nominations and 2 management nominations), and that all submitted Reviews will be considered valid unless agreed, again in Partnership, examples of invalid submissions also having been included on the Intranet site. It had been agreed to start Reviews on 7 August 2007 and those for staff on protection as a result of matching were to be prioritised. Proposals to run Panels 5 days per week were proving a difficult exercise in identifying trained matchers. Mr Shiach advised that there was a need to consider whether Review Panels should meet only in Inverness, and whether an additional consistency checking phase should be included following Reviews. On the latter point advice from the Scottish Pay Modernisation Team had been that there was no requirement to submit Review outcomes for monitoring or scrutiny at a national level, however, it was suggested that a process be in place to ensure that the principle of equal pay was not compromised by particular Review outcomes. With regard to panels Catherine Mackay stated that the resource implications included aspects relating to staff time as well as financial and Mrs Gent advised that discussions were underway with regard to identifying appropriate resource. In respect of consistency checking Mr Shiach stated that he favoured the inclusion of an additional stage and this point was echoed by Mr R Stewart but clarification was required on what stage of the process has the final decision. During discussion it was agreed that while any consistency checking process during the Reviews may offer advice and further guidance to the Review Panels the final decision rested with the Review Panel. Mr Cowan-Martin referred to the position in relation to the process for new posts and was advised that these would not require to be checked at a national level as this would be undertaken at local level. Mrs Gent added that where there was concern over outcomes in this group then individual members of staff required to discuss this with their respective managers prior to requesting reviews. With regard to the exploratory stage of the process there was discussion as to management involvement and Mrs Gent requested that further information on the process be provided. Mrs Parr advised that the Terms and Conditions Group were to discuss issues the following week including aspects relating to appointment to new job descriptions and the relevant process of incremental progression.
The Pay Modernisation Board:
· Noted the overall position.
· Agreed that Review Panels meet solely in Inverness.
· Agreed that additional consistency checking stage following Reviews be introduced but that the final decision remains with the Review Panel.
· Agreed that further advice and information be provided in relation to the Review process.
Catherine Mackay left the meeting at 10.45 am.
5.1.2 / Financial Impact
Mr McRonald spoke to the circulated report which detailed monitoring of the actual recurring budget amendments required for assimilated staff, and sought to forecast the final outturn inclusive of arrears against NHS Board reserves. The report gave detail in relation to budget amendments for old Highland staff to year end 2006/07 and an assimilation summary detailing the percentage basic pay increases to end of May 2007. Moving forward forecast recurring costs would be monitored on a bi-monthly basis from July 2007. Mr McRonald advised that further work would be required to establish the Non Recurrent and Recurrent position following the recent high level of numbers of assimilations and arrears payments and this should be clearer around September 2007. Mr R Stewart reminded the Committee that Reviews would present a further additional cost pressure. It was advised that the percentage of staff members on protection to date was 2.9%, on standstill basis was 5.8%, and those in receipt of higher basic pay was 91.3%. Mrs Cleland stated that the 2.9% figure for those on protection was useful in putting the overall results of Agenda for Change in perspective and it was agreed that Mrs Cleland, Mr R Stewart, Mr Shiach, and Mr McRonald discuss further how to indicate the bigger picture to staff.
The Pay Modernisation Board:
· Noted the budget amendment report for Old Highland staff to year end 2006/07.
· Noted the assimilation summary of percentage basic pay increases to May 2007.
· Noted that forecast recurring costs would be monitored on a bi-monthly basis.
· Agreed that the report Appendices be circulated by the Committee Administrator.
5.2 / New Pharmacy Contract
Ms Morton gave a presentation to the Committee in relation to the ePharmacy delivery Programme that was to underpin and support the delivery of the new Community Pharmacy Contract (nCPC) and in particular introduction of the Electronic Transmission of Prescriptions (ETP) and the support required to change the end to end prescribing, dispensing and payment process. Of the four core elements of nCPC three would be supported by IT and these were the Minor Ailment Service (eMAS), Acute Medication Service (eAMS), and Chronic Medication Service (eCMS) with the technology also supporting initiatives such as ePay and the Shipman requirements. Clearly these changes would impact on all organisations involved in service provision and the ePharmacy Programme had been structured to reflect this. The core components of the system would include an appropriate network connection, a central message store, central patient registration system, changes to the GPASS and Community Pharmacy systems, and an ePay functionality. With particular regard to the Acute Medication Service Ms Morton advised as to the eAMS element of the nCPC and outlined how this was to impact on general practice arrangements. IT would be used to produce barcoded AMS GP10 forms, would send corresponding messages to the ePharmacy Message store, and prescribers would continue to use their system native drug dictionary until such time as national Dictionary of Medicines and Devices was enabled. To date five GP computer systems suppliers had completed the testing process, rollout had began in January 2007, the ePharmacy message store was ready, as was the NSS systems, and the Pharmacy systems were being introduced shortly. In terms of implementation necessary communication was ongoing with all involved, rollout was progressing as indicated and ongoing support was being provided. Where ETP was in operation this would provide the organisation with a source of additional and more detailed data for analysis purposes.
Ms Morton stated that registrations for the Minor Ailments Service (MAS) had reached 30,000 and that in relation to the introduction of Public Health Service, Level 2 was to be introduced from July 2007 including a publicity campaign for MAS. It was stated that the issue of prescription charges may be of concern as this should reflect the number Exemptions as a result of Chronic Conditions although the complex funding arrangements for this made detailed consideration difficult at this stage. Ms Morton confirmed that she had discussed this matter with the Finance Service, however, to date central data and information had been limited.
The Pay Modernisation Board Noted the position.
5.3 / nGMS Contract – Update on Implementation
Dr Proctor advised that positive progress was being made with regard to the Diabetic Directly Enhanced Service. In addition, consideration of the Scottish resource allocation for Directly Enhanced Services had been delayed to October 2007 so as to allow national debate on the appropriate area(s) of spend. One suggestion that had been made was that GP services be provided night and day although this was not likely to be a realistic outcome.
The Pay Modernisation Board Noted the position.
5.4 / Out of Hours Service
Mr Leslie spoke to a circulated report which had been considered by the NHS Board at their meeting held on 5 June 2007 and which outlined the background and challenges to the development of the Out of Hours Service. The key driver in the process was the sustainability of Primary Care services and as a result there had been extensive and detailed discussion and engagement with the public as to what they expected from the proposed service. Mr Leslie advised that the vision for the service was based on the assumption that NHS24 would be the first point of contact, that any response would be by the most appropriately skilled practitioner, that services be integrated and networked and based on QIS and access standards, that emergency response would be within the remit of Scottish Ambulance Service, and that all services would be cost effective and represent value for money. Overall the framework for the development of future Out of Hours services was based on principles that these were clinically safe and effective whilst meeting the needs of patients and supporting appropriate access, meet required standards, be cost effective, be built on a sustainable and multi disciplinary resource provision, be flexible and based on integrated structures, and deliver pan-Highland consistency with the flexibility to reflect local needs where required all as more detailed. In terms of service risk development had concentrated on those areas that had opted out GPs, however several remote areas may also seek to opt out and this would have a significant impact on the ability of NHS Highland to provide these services within the existing budget. The next steps were outlined as follows: