GRAMPIAN NHS BOARD
Minute of Meeting of GRAMPIAN NHS BOARD held in Open Session on Tuesday 3 May 2005 at 11.15am in the Conference Room, Summerfield House, Aberdeen
Present
/Mr Jim Royan
/ ChairmanMr David Benton / Director of Nursing
Councillor Raymond Bisset / Non-Executive Board Member
Mrs Barbara Bruce / Non-Executive Board Member
Ms Margaret Burns / Non-Executive Board Member
Dr David Cameron / Non-Executive Board Member
Mrs Anne Campbell / Non-Executive Board Member
Mr Richard Carey / Chief Operating Officer
Dr Roelf Dijkhuizen / Medical Director
Mr Alan Gall / Director of Finance
Mrs Judith Hendry / 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
By Invitation / Mr Steve Conway / Chief Executive, NHS Orkney
Mrs Laura Gray / Director of Corporate Communications
Dr Bob Hamilton / Chair, Area Dental Committee (Item 14 a (i) )
Dr Annie Ingram / Regional Planning and Workforce Co-ordinator, NoSPG (Item 12a)
Ms Susan Jappy / Deputy Director of Public Health (Items 8-14)
Mr Gordon Morrice / Director of Human Resources
Dr Gordon Peterkin / Associate Medical Director (Item 14 a (i) )
Dr John Reid / Chair, Area Medical Committee
Mr Ed Rennie / Head of Staff Governance and Partnership (Item 15 b (ii) )
Mr Ewan Robertson / Board Secretary/Director of Performance Improvement
Ms Anne Ross / Head of Performance and Quality Improvement
Mr Gordon Stephen / GAPF Co-ordinator (deputising for Mr A Gordon)
Mr David Sullivan / Director of Corporate Planning (Items 8-14)
Attending / Miss Lesley Hall / Assistant Board Secretary
Ms Glenys Wren / Personal Assistant, Board Secretariat
Item / Subject /
Action
8 / CHAIRMAN’S WELCOME AND ANNOUNCEMENTSThe Chairman welcomed Mr Steve Conway, Chief Executive, NHS Orkney to the meeting. He advised that, unfortunately, Dr Baijal was unable to attend what would have been his last meeting. The Chairman wished to record thanks on behalf of the Board for Dr Baijal’s commitment and significant contribution to NHS Grampian over the last four years.
The Chairman referred to papers which he had circulated with the agenda, from the NHS Scotland Chairs meeting on 18 April 2005. In particular, he drew Board Members’ attention to the Statement of Accountability for NHS Board Chairs, many points of which were relevant to Board Members in their role as members of a Board of Governance.
9 /
APOLOGIES
Apologies were received from Dr Eric Baijal, Councillor Kate Dean, Mr Angus Gordon and Professor Neva Haites.10 /
MINUTE OF MEETING OF GRAMPIAN NHS BOARD HELD ON 1 MARCH 2005
The Minute was approved.11 /
MATTERS ARISING
An issue was raised regarding clinical targets for GP practices, which Dr Watson agreed to pursue. / S Watson12
13
14
15 / PLANNING
a. Regional Planning
The Chairman welcomed Dr Annie Ingram, Regional Planning and Workforce Co-ordinator, North of Scotland Planning Group (NoSPG), to the meeting to provide an update on the NoSPG. Dr Ingram tabled the Annual Report 2004/05, explaining that the Group had been in its current format for one year. She highlighted the drivers behind regional planning, in particular the Regional Planning HDL (2004) 46. She highlighted the main aspects of the Annual Report and the nine main objectives which had been identified. She stressed the issue of governance and clarified that the role of the Regional Planning Group was to help Boards to take forward those parts of the Health Plan for which they needed assistance on a regional basis. She outlined the future plans for NosPG and the various projects to be taken forward, including a number of national initiatives. She outlined the timetable for the proposed planning process for 2005 and beyond, which included reporting to Boards and to the Minister in September 2005.
She advised that a number of common themes had emerged from an event held in March 2004, including:
- Best Use of Resources
- Cross Boundary Flows
- eHealth
- Workforce Planning
- Integration and Redesign
- Transport
- Unscheduled Care
HEALTH IMPROVEMENT/HEALTH PLAN
- Health Plan update including Capital & Revenue budget 2005/06
Mr Sullivan provided an update on the Health Plan development, advising that the major consultation exercise had been completed and that a package for the launch of the Health Plan was being prepared. He reported that work was ongoing on a range of projects under the Change and Innovation Programme. He advised that the proposed timetable included key meetings of the Service Strategy and Redesign Committee (SSRC), which was leading the development of the Health Plan, during May and June. The aim was to present the final Plan to the Board in June 2005, thus ensuring the timetable tied in with the publication of the National Framework and key meetings with the Scottish Executive. The proposed timetable would ensure that the Board had sufficient time to consider the Plan before its endorsement.
Mr Gall gave an update on the capital and revenue budget position.
The Chairman concluded that important work was ongoing and that the Board would be kept abreast of progress by Executive Directors. He encouraged Board Members to participate in the forthcoming series of meetings.
The Board noted the update.
PERFORMANCE GOVERNANCE
- Performance Management Interim Report for year ended 31 March 2005
She advised that the Annual Review would take place on 27 July 2005, for which a comprehensive performance assessment would be produced.
Board Members were encouraged to attend the Annual Review, which will be chaired by the Health Minister and to which the public will be invited to attend.
Mr Gall provided an update on the financial position, advising that the revenue plan had been achieved for 2004/05. He explained that the £10.7m deficit was within the limits agreed with the Scottish Executive and would be completely repaid in 2006/07. He advised of the huge commitment and effort by staff in NHS Grampian to achieve this position within an extremely tight financial environment.
The Board noted the report and wished to endorse the message of thanks to staff for their efforts in achieving targets.
(i) Dental Issues Update – presentation
The Chairman welcomed Dr Gordon Peterkin, Associate Medical Director, and MrBobHamilton, Chair, Area Dental Committee, to the meeting. Mr Carey introduced the item, explaining that dentistry was a very high profile issue, with problems of availability and access to dental services. Some of the issues relating to contractual matters were not restricted to Grampian and required to be taken forward on a national basis. He explained that in Grampian, there was a need to focus on the areas which could be changed locally. He advised that the Oral Health Implementation Group (OHIG) had been empowered with the task to move forward primary and secondary care dental services for NHS Grampian.
Dr Peterkin referred Board Members to a diagram which showed the interaction between the various elements of a managed clinical network for dentistry.
He explained that a Dental Healthfit event had been held in June 2003. A number of actions had come out of this event which had been greeted with enthusiasm. However, there had been no resource to take actions forward at that time. He was pleased to report that funding of £150m in Scotland had recently been made available and advised of the proposals for Grampian’s allocation . Board members were advised of several developments to improve the service. For example, NHS Education Scotland was providing postgraduate training for all grades of staff as well as organising training for dental nurses. He explained that discussions were ongoing regarding the provision of more effective Public Health dentistry arrangements for Grampian. He advised of plans for an outreach training centre from the Dundee Dental Hospital in Aberdeen, which would provide benefits by establishing a teaching centre and allow practical dental treatments. He also advised of plans to establish lead management for dental services in Grampian.
Board members were advised of the document “Improving Oral Health and Modernising NHS Dental Services” which set the targets to be developed.
Mr Hamilton advised the Board about specific issues in primary care dentistry and explained that general dental practitioners (GDPs) were independent contractors running their own businesses. Two thirds of Grampian residents did not have access to a general dental practitioner and 28,000 children were unregistered. The lack of secondary care services to which GDPs could refer was also recognised as a problem because of gaps in the hospital specialisms of orthodontics, maxillofacial and restorative dentistry. It was noted that the majority of GDPs provided a mix of NHS and private care, but many were moving towards all private practice. The roles of salaried dentists and the community dental service, which provides a public health role, were outlined. The out of hours service had stiff targets to meet. It was noted that the GDENS service saw approximately 24 patients per night, but there was no real out of hours service outwith the Aberdeen area.
Board Members discussed the need to promote dentistry as a career and to address the need for incentives for dentists to come to the area.
Mr Carey concluded this section by thanking Dr Peterkin and Mr Hamilton for their comprehensive report. He advised it was necessary for the Board to support the delivery of plans to improve the situation in Grampian. The process would be monitored through the Performance Governance Committee.
He pointed out that staff in the organisation were working extremely hard to sustain the best service they could in the circumstances. He stressed how important it was for the organisation to give encouragement and support. Without the limited staff who were in place, the situation would be more parlous than at present. He explained it was a top priority for him, as Chief Operating Officer, to get as much benefit as possible from the funding available for dental services.
The Board supported the action being taken to improve dental services.
CORPORATE GOVERNANCE
- Clinical Governance
The Chairman welcomed Mrs Judith Hendry, Chair of the Area Clinical Forum to her first formal Board meeting as a Board member. Mrs Hendry highlighted the key issues in her letter, explaining that the ACF was particularly concerned about laboratory services. Although a review had taken place around 18 months ago, there had been little progress made. Mr Carey explained there had been an increase in the number of laboratory tests, resulting from the implementation of the new general medical services contract. He advised that a group had been set up to look at how the service could be redesigned to manage this situation. He advised that additional staff had been appointed using non-recurring funding, pending redesign of the service.
With regard to the specific issues raised in the letter, dental services had been discussed in detail under the previous item. Mr Carey and Mr Smith agreed to meet the ACF to discuss the issues raised about accommodation at Aberdeen Royal Infirmary and Healthcare Associated Infection (HAI). With regard to the Acute Medical Assessment Unit (AMAU) this was the Board’s highest development priority and discussions would be held on a regular basis with the ACF. The issue under the heading “Single System Working” was noted and Mr Smith explained that he would want to examine this in more detail.
It was agreed that the debate at Board meetings would be captured and a response given to the Chair of the ACF. The Chair advised that the Board would also be looking for solutions to problems from the ACF.
The Board noted the letter and the Board Secretary agreed to provide a response.
(ii)Clinical Governance Committee issues/update
Councillor Bisset tabled a paper outlining the main points discussed at the most recent meeting. Dr Dijkhuizen advised that the agenda items were all being taken forward, although the recent operational Clinical Governance meeting had to be cancelled. The importance of the Clinical Governance Committee and attendance at its meetings was stressed. Mr Smith, Dr Dijkhuizen and Councillor Bisset agreed to discuss this outwith the Board meeting.
The Board noted the report.
- Staff Governance
Mr Stephen highlighted the section on finance and stressed the need to ensure that the effect on staff of action in pursuit of financial balance was mitigated as far as possible. It was important to continue to recognise that the staff were the organisation’s greatest resource. He advised that there was a capacity issue regarding the delivery of Agenda for Change. He highlighted the concerns about control measures regarding smoking on NHS Grampian sites and the essential requirement to educate on the dangers of smoking and to assist smoking cessation.
The Chairman pointed out that partnership working was a high priority of the Scottish Executive.
The Board noted the report and the Board Secretary agreed to provide a response.
(ii)Pay Modernisation Report including Agenda for Change presentation
Professor Maehle referred to the written report which highlighted the main issues around implementation of the various strands of Pay Modernisation. She advised that the Staff Governance Committee had received a presentation on Agenda for Change (AfC) from Mr Ed Rennie, Project Lead for Agenda for Change, which it had felt would be useful for Board Members.
The Chairman welcomed Mr Rennie to the meeting. Mr Rennie made a brief presentation on Agenda for Change. He explained the purpose of the overview was to increase awareness and understanding, outline progress within NHS Grampian and suggest how the Board could help. He explained that AfC was the biggest single ongoing change management initiative. He outlined the job evaluation process, explained the changes to terms and conditions and outlined the Knowledge and Skills Framework. He also put the Grampian work in the context of the national dimension. He explained that benefits realisation was more cost effective and improved quality of patient care. He concluded that the Board could help by remaining well informed, being supportive and ensuring that this initiative figured in the objectives of managers at all levels.
The Board noted the presentation and agreed to provide support for this issue of importance.
- Audit Committee Report
The Board noted the report.
- Corporate Governance Protocols Annual Review
1. The Board approved the following protocols:
- Standing Orders
- Register of Interests
- Standards of Business Conduct
- Standing Financial Instructions
- Schedule of Reserved Decisions
- Banking Arrangements
- Insurance Arrangements
3. The Board requested the Board Secretary and the Assistant Board Secretary to ensure that all revised constitutions were in order and made available.
4. The Board approved the Committee membership changes as notified, in accordance with Standing Orders.
5. The Board approved the appointment of Dr Sheila Simpson as Chair of the Research Ethics Committee 2. / E Robertson
Executive Directors
A Campbell/ E Robertson
E Robertson
A Smith/
R Dijkhuizen/
R BissetE Robertson
R Carey
16 / NHS REFORM (SCOTLAND) ACT – Single System Development
- CHPs Development
The Board:
- noted approval by the Scottish Ministers of the NHS Grampian Community Health Partnerships scheme of establishment
- noted that the Community Health Partnerships in Aberdeen City, Aberdeenshire and Moray were now formally established
- prepared to approve appointment of Chairs and Members to the CHPs
- agreed to make arrangements to monitor the effectiveness of
17 /
ITEMS FOR NOTING
The Board noted the following items:a. Forum Minutes
(i) Area Clinical Forum: Minutes of meetings held on 26 January, 23 February and 23 March 2005
(ii) Area Partnership Forum: Minutes of Meetings held on 10 February and 10 March 2005
b. Board Committee Approved Minutes
(i)
(ii)
(iii)
(iv)
(v)
(vi)
(vii) / Service Strategy and Redesign Committee held on 8 February 2005
Patient Focus and Public Involvement Committee held on 3 February 2005
Audit Committee held on 13 December 2004
Clinical Ethics Committee held on 13 December 2004 and 14 March 2005
Research Ethics Committees held on 25 November 2004 27 January, 10 and 24 February and 17 March 2005
Endowment Committee held on 20 December 2004 and 7 February 2005
Clinical Governance Committee held on 7 February 2005
Performance Governance Committee held on 15 February 2005
18 /
INFORMATION EXCHANGE
The Board noted the following items:- HDLs received since 17 February 2005
- NoSPG meeting held on 26 January 2005
19 /
ANY OTHER COMPETENT BUSINESS
There was no other competent business.20 /
PROPOSED DATE OF NEXT MEETING