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MINUTE of MEETING of the
STAFF GOVERNANCE COMMITTEE
Board Room, Assynt House, Inverness /
22 February 2011 – 10:00
PresentDr David Alston, Non-Executive Director (Chair)
Mr Colin Punler, Non-Executive Director
Mr Ray Stewart, Employee Director
In AttendanceMrs Pamela Cremin, Workforce Planning & Development Manager
Mrs Anne Gent, Director of Human Resources
Ms Judith McKelvie, Head of Learning and Development
Mr Brian Mitchell, Board Committee Administrator
Ms Lindsey Mitchell, Medical Workforce Redesign Manager (for Item 11)
Mr Adam Palmer, UNISON
Mrs Caroline Parr, Partnership Support Officer
Mr Philip Walker, Head of Personnel
1WELCOME AND DECLARATIONS OF INTEREST
Members were asked to consider whether they had an interest to declare in relation to any Item on the Agenda for this meeting. There were no declarations of interest made.
2APOLOGIES
Apologies were noted from Ms Elspeth Caithness, Ms Pam Courcha, Mr Garry Coutts, Mr Ian Gibson, and Ms Elaine Mead.
3MINUTE OF MEETING HELD ON 23 NOVEMBER 2010
The minute of the meeting held on 23 November 2010 was Approved.
4MATTERS ARISING
4.1Counter Fraud Services Training
Mrs A Gent advised that the Counter Fraud Services Training DVD had been shared with members of the NHS Board at their last Development Session.
The CommitteesoNoted.5REPORTS FROM OTHER COMMITTEES
5.1Minute of Meeting of the NHS Highland Partnership Forum held on 17 December 2010
Mr R Stewart advised that‘Planning for Integration’ would remain as a Standing Item on future agendas for the Highland Partnership Forum. An appropriate governance structure for future discussion, on a joint partnership basis, would be established. It had been agreed that there be four Staffside representatives appointed to the Programme Board.
The minute of the meeting of the NHS Highland Partnership Forum held on 17 December 2010 was otherwise noted.
5.2Draft Minute of Meeting of the Health and Safety Committee held on 18 November 2010
On the point raised, Mrs A Gent advised that the South East Highland CHP Health and Safety Group would hold its inaugural meeting the following week. Health and Safety represented an Item on the agenda for all Operational Units.
The minute of the meeting of the Health and Safety Committee held on 18 November 2010 was otherwise noted; this minute had been submitted to the NHS Highland Board on Tuesday 1 February 2011.
The Committee Noted the circulated minutes.The Committee agreed to consider the following Item at this point in the meeting
APPROPRIATELY TRAINED
6IMPLEMENTATION OF KNOWLEDGE AND SKILLS FRAMEWORK
Ms J McKelviespoke to the circulated report which detailed the latest situation on the implementation of the knowledge and skills framework. The HEAT Target stated that 80% of all staff should have a development review completed and recorded on eKSF by March 2011. The position for NHS Highland, as at 21 February 2011, was that 2098 reviews were in progress, a total of 26.28%. With 3585 reviews, 44.91% completed and signed off and 417 reviews, 5.22%, awaiting sign off, total activity stood at 76.42%. Ms J McKelvie advised that in order to meet the required trajectory future activity would require to be increased by 7% each week. To date there had been 51 requests to utilise the Complete on Paper function, representing a total of 164 reviews. The KSF team continued to support managers and staff, with monthly reports issued to operational managers highlighting those areas where little or no progress had been made. At that time it appeared that three CHP areas and Corporate Services were likely to meet the required target. Mid Highland CHP, RaigmoreHospital and Operational Services had been offered additional assistance from the KSF team, including a range of on-site drop in sessions. Weekly reports were provided to managers in those areas where there was a particular concern as to level of activity. Further action at this time included publication of information within Team Update, encouragement of managers to populate eKSF ahead of one to one meetings so as to accelerate that process, and the provision of additional support by Personnel and Development managers.
There followed discussion during which concern was expressed that three areas seemed unlikely to meet the required target despite plans having been submitted to the last meeting giving assurance that this would be the case. The respective managers had indicated that despite current performance they would be able to meet the required target. Whilst progress had been made this had yet to achieve required levels of activity and again concern was expressed as to the quality of the processes being undertaken given the pressure to meet the target. Mr C Punler stated that managers had been aware of the need to meet the required target for some 18 months and that the current position could be considered a failure in performance. Mrs A Gent emphasised that managers had been offered a range of support measures to progress this matter. Given the current position, managers required to be reminded of the assurances they gave at the last meeting of the Committee. They should be advised as to the dissatisfaction of the Committee on progress against relevant action plans to date. It was agreed that the Committee’s concerns should be escalated to the Improvement Committee.
There was brief discussion as to requirements in 2011/2012, in respect of which Mrs A Gent advised that eKSF was not to be a national HEAT target for NHS Boards. Ms J McKelvie advised that it was anticipated that this would form part of activity relating to the Appropriately Trained Staff Governance Standard. It was stated that there was a need to begin preparation of action plans for 2011/2012 at an early date with a view to giving assurance that appropriate systems were being embedded across the organisation. Mr R Stewart stated he would be seeking assurance as to the quality of the processes being employed.
The Committee:- Notedthe position.
- Agreed that General Managers be advised as to Committee dissatisfaction with current performance against agreed eKSF action plans.
- Agreed that the Improvement Committee consider current progress at their next meeting.
- Agreed action plans for 2011/2012 be submitted to the meeting on 24 May 2011.
IMPLEMENTATION OF NHS HIGHLAND STRATEGIC FRAMEWORK AND BOARD VISION
7WORKFORCE WORK PROGRAMME
Mrs A Gent spoke to the circulated Workforce Work Programme document, this having been established to support the implementation of the NHS Highland Strategic Framework and Board Vision, and presented to the Highland Partnership Forum at their meeting held on 18 February 2011. It was stated the Partnership Forum had agreed that two or three key themes would be discussed at each meeting with a view to establishing this as a live document for staff and ensuring that actions from the SAAT and Staff Survey are integrated. It was stated that further work was required to consider the size, shapeand cost of the workforce going forward and to ensure there was risk assessment in relation to issues of service quality. In terms of performance and accountability, there would be a need to emphasise key themes such as elimination of waste and increased productivity. These elements would require the current draft programme to be amended and the updated iteration would be presented to the next meeting of the Committee and further discussed at the next NHS Board Strategy Event.
During discussion, there was reference to the purpose of the Programme document, as to whether this was an operational document or a governance action plan. The document itself set out actions to be taken but did not reference activity already being taken forward. There was a need to ensure actions would be taken forward and that there was no disconnect between Committee and operational level. Mrs A Gent advised that Local Partnership Fora would have a key role to play in this regard and agreed there was a need to reflect on these issues. The next iteration of the document could be adjusted to reflect accountability and responsibility for local level implementation, including by relevant line management. Mr A Palmer referred to the challenging staff savings that required to be achieved in 2011/2012, these carrying a degree of organisational risk. On this point, Mrs P Cremin emphasised that it was important that the Programme be agreed so that appropriate early action can be taken in order that these could be achieved.
After discussion, the CommitteeNoted a revised version of the Workforce Work Programme would be submitted to the next meeting.
8COMMUNICATION AND ENGAGEMENT PLAN
Mrs A Gent spoke to the circulated report giving a summary update on progress to date in promoting effective communications around the NHS Board Vision and Aims, and the implications for services, service redesign and staff. The report indicated that a joint letter from the former Chief Executive and Employee Director had been issued to all staff that reflected the importance attached to staff participation in delivering the changes required, and highlighted the Board commitment to good staff governance through the changes ahead. A further letter from the new Chief Executive sought to reinforce the core themes from the original letter, emphasise the focus on quality of care and services, and highlight the importance of staff engagement in delivering change. The Communications Team were also operating a staff mailbox as an additional means of supporting staff feedback. As part of relevant awareness raising activity, key messages had been discussed with a range of NHS Highland Committees. In terms of day to day activity in this area, General Managers were facilitating local discussion events, the effectiveness of which was being demonstrated through feedback from Kaizen events where staff participants were demonstrating a clear understanding of, and commitment to, the principles of quality, consistency and safety. On the issue of communication as part of the leadership process, this had been identified as a challenge for the organisation and as such local leaders and managers were identified as a key group for targeted action, through a series of leadership events facilitated by the Chief Executive. The first event had been held in November 2010, was well attended, had been positive in nature, included a dialogue session, and had helped to inform preparation of subsequent sessions. The same applied in relation to the event held on 14 January 2011. With regard to engagement with clinicians, a half day event had been held the previous day and had presented an opportunity to bring together clinical leaders from across the organisation to explore how the NHS Board Vision and Aims translate into clinical care and services. This would help to support and complement the clinical engagement in service improvement and change work taking place day to day across NHS services. On the general issue of communication with staff it was confirmed that there would be access to the range of views expressed, through the Intranet site. Mr R Stewart advised that no potential approach to communication with staff would be discounted.
There was reference to Planning for Integration and it was stated this would be a key element of the change required to meet the aims for patients and other service users. Initial staff briefings had been held and NHS Highland staff had shown a general recognition of the value of the proposed approach. There had however been a degree of concern within Children’s Services staff, including concern that change may undermine gains achieved through collaborative working on GIRFEC. Both NHS Highland and the Highland Council have recognised the importance of staff engagement and to date joint actions included two short seminars for managers and affected staff. There was to be established a complementary communication plan for this area of activity and this would be led by the Highland Council. On the point raised by Mr C Punler, it was advised that Mrs J Baird, Director ofCommunity Care had been appointed as Transition Director and that future reports would be submitted to both the Staff Governance Committee and NHS Highland Partnership Forum.
The Committee otherwise Noted the position.
9ROLE OF THE HIGHLANDPARTNERSHIP FORUM
Mr Stewart reported that Ms E Mead, Chief Executive had taken up the position of Co-Chair of the NHS Highland Partnership Forum.
The Committee so Noted.
10PLANNING FOR INTEGRATION
Mrs A Gent confirmed that Planning for Integration now formed a Standing Item on NHS Highland Partnership Forum agendas.
The Committee so Noted.
The Committee agreed to consider the following Item at this point in the meeting
11HOSPITAL LOCUMS
Ms L Mitchell spoke to the circulated report providing detail around the expenditure associated with locum use within NHS Highland in 2009/2010. Data had been supplied by operational units although gaps did exist in the data in relation to hours worked and cost incurred. It was stated that where cover was provided by a substantive employee the associated cost was not recorded as locum expenditure. It was further advised that in a number of RGH’s it was common practice to provide locum cover for periods of annual leave and at weekends to support the 1:3 Consultant rota in Medicine, Anaesthetics and Surgery. The report indicated a total spend on locum provision in 2009/2010 of £3,717,160 and for each operational areaboth the grade of locum used, and the reason for this was outlined. The report included a proposed action plan to further consider a number of aspects of this activity in greater detail, and Ms L Mitchell advised that External Audit had requested sight of this. This would be discussed at the meeting of the Medical Workforce Planning Board the following day.
During discussion, Mrs A Gent emphasised that the costs outlined did exclude substantive employee cover and advised that the Workforce Savings Plan included a range of activity in relation to locums and associated additional staff expenditure levels. Mr A Palmer expressed concern at the level of spend in South East CHP and was advised that this represented an improved position. On the point raised by Mr C Punler on the variances evidenced on hours against cost, Ms L Mitchell advised that this resulted from differing negotiations with individual agencies. She added that there was national consideration being given to the establishment of a Medical Workforce Bank. Mr R Stewart stated there should be greater consideration given to redesign of services as opposed to continued locum employment. Mr A Palmer suggested that a ‘planned spend’ approach should be taken, as for Nursing and AHP activity, and on this point Mrs P Cremin confirmed that similar work would be extended to medical staffing groups in due course.
The Committee:
- Noted the analysis into locum use within NHS Highland.
- Noted the proposed action plan would be presented to the Medical Workforce Planning Board and Workforce Planning and Development Sub Group.
- Agreed further detail in relation to additional expenditure levels, over funded establishment, would be submitted to the next meeting.
STAFF GOVERNANCE
11STAFF SURVEY 2010
Mrs C Parr spoke to the circulated report detailing initial analysis of the Staff Survey Highlights Report with a view to identifying the main overall themes in relation to how staff feel they are being managed within NHS Highland. It was advised there had been a 22% response rate. The circulated report indicated those areas where improvement had been made since the last Survey in 2008, as well as those areas where it was considered further progress was required. There was to be carried out further detailed analysis of Survey results, including a comparison of the results from each of the operational units. Any remedial actions would be incorporated within the overall 2011/2012 NHS Highland Staff Governance Action Plan. Mrs C Parr advised that a different service provider had conducted this Survey and, consequently, detailed contextual analysis of results was proving to be a little more complicated to achieve. Mr R Stewart emphasised to the Committee that the Staff Survey provide a snapshot analysis and as such could only give broad themes for consideration.
During discussion, Mrs A Gent advised that there would need to be consideration given to comparison with national results, in addition to comparison with results from the Survey undertaken in 2008. Mr R Stewart highlighted the importance of being able to provide detailed analysis down to operational unit level, to enable work with Local Partnership Fora to identify future action. Mr C Punler emphasised the need to be able to evidence to staff that there has been full consideration of the results and that the organisation is responding to those matters that have been raised.
After discussion, the Committee:
- Noted a short highlight report would be presented to the NHS Highland Partnership Forum meeting to be held on 18 March 2011.
- Agreed there be developed an Action Plan to address any areas of concern highlighted.
- Noted a report would be presented to the meeting of the NHS Board on 5 April 2011.
12STAFF GOVERNANCE STANDARD SAAT RETURN REPORT AND ACTION PLAN