Ali round apologies - NHS Devon

EAST DEVON PRIMARY CARE TRUST
Minutes of the East Devon Primary Care Trust Board
Held on Wednesday, 1 st December 2004
At the Conference Room, East Devon Business Centre, Honiton
1. Attendance
Present: Lynda Price Chair
Iain Tulley Chief Executive (Acting CEO of DPT)
Hugh Groves Acting Chief Executive
Liz Smith Head of Nursing and HR
Tracey Hector Head of Performance
Mark Neville-Smith Acting Director of Finance
Ali Round Director of Public Health
Tony Wilkinson Non Executive Director
Jean Nicholls Non Executive Director
Julie Austin Non Executive Director
Jan Ingram Head of Health and Social Care
Trevor Brown Non Executive Director
John Coop Commissioning GP
Mike Jeans Non Executive Director
Apologies: Sue Pocklington Medical Director
In attendance: Laurence Blight Senior Performance Manager
East Devon District Council
PPE
2. Register of Interests
Members were invited to view the Register of Interests.
It was reported that Mrs Brown is no longer member of PPI and this is to be removed from
the Register.
3. Minutes of last meeting – 13 th October 2004
(04/119)
The following amendments were made to the minutes of the last meeting:
• P3. Remove the sentence in the second bullet regarding the Seaton public meeting.
• P4. Re-word sentence ‘predicting to …..to read ‘And the PCT is more sure of the
spending position.’
• P8. In the sentence referring to ‘after 18 th October’, remove ‘and comes from’, and put
in ‘due to’
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• P5. Media Coverage – Remove ‘that needed advertising and were not at all
appropriately’ so the sentence reads ‘other than the advertisement of the public
meetings for CSDP’.
Subject to the above amendments being made, the Board approved the minutes as a
true and accurate record of the last meeting.
4. Matters Arising
(04/120)
• P5. CHI Star Ratings – As of 30 th November, a consultation was started with the
Healthcare Commission regarding the ongoing assessment of Primary Care Trusts. A
paper will be prepared for the Board in February and Tracey Hector and Laurence Blight
will represent the Trust at any stage of the work in this area until then.
• P8. HQ Relocation – The lease was signed for the ground floor in early November. The
PCT is now awaiting tenders back from contractors, which are due on 6 th December
2004. It is still hoped that the move across to the new site will take place in April 2005.
Notice has been given to Exeter PCT for East Devon PCT moving out of DCH, and a
method of dealing with running costs has been also discussed with Exeter PCT and is to
be confirmed in the coming months.
• Social Services has agreement in principle lease into the first floor of the building. This
work is ongoing and is excellent news for both organisations as we increase integration
in our working and organisational structures.
The Board noted the Matters Arising.
5. Chair and Chief Executive’s Announcements
(04/121)
Iain Tulley thanked Hugh Groves, Mark Neville-Smith and all who are supporting him in
acting roles while he is Acting CEO at the Devon Partnership Trust.
• Iain’s work at the Partnership Trust is proving challenging and interesting and Iain
expressed his gratitude for the support he has received from the PCT while he
undertakes this role.
• Congratulations were extended to both Les Hickman and Lily Chapman on their new
roles within the PCT.
• Thanks were expressed to Jenny McNeill, in advance of her move to Mid Devon PCT on
a year’s secondment. At this point in the meeting, concerns was expressed around
expertise being lost to secondments and people leaving the organisation at the same
time. It was noted that Ali Round is back to full time hours, whilst Sue Pocklington is
absent from work. The Board thanked Ali for this additional commitment to the PCT.
Hugh Groves outlined the measures that were being taken to prevent capacity issues at
a time when several people are leaving the organisation.
• The Devolved Budgets work is ongoing and this initiative appears to be populating parts
of the national guidance being produced on practice led commissioning. We are also
repeatedly being asked to contribute to national conferences on both this initiative and
Payment by Results. It was emphasised as very positive for the organisation to be
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ecognised for its innovation in these areas. The PCT is now preparing for its own
practice led commissioning conference / workshop event in 2005.
• Seaton Hospital is due to reopen this weekend, following the recent Norwalk outbreak.
Staff were thanked for the way in which they had managed the incident.
• A productive joint directors event was held with Exeter PCT and indications of areas for
joint working were identified.
• Budleigh Hospital to reopen to patients on 17 th January 2005, with a formal opening
ceremony on the 11 th . Press releases and information on the reopening are to be
released shortly.
Chair
• Lynda Price reported having received a letter of thanks from Keith Portlock, Chair of
Devon Partnership Trust, thanking the PCT’s Board for releasing Iain to help them at this
time.
• The Public Health White Paper has been published and is available on the DoH website
should anyone wish to access it.
• The Chairman’s Award 2005 has been launched. Lynda Price extended thanks to the
Charitable Funds Committee who have supported the Award both for 2004 and now for
2005. Four categories are being used this year to judge nominees –
• Promoting equality and diversity
• Patient Champion
• Promoting Diversity
• Innovation
The Board noted the Chair and Chief Executive’s Announcement.
6. Finance Report
(04/122)
Mark Neville-Smith presented the report and the following key points were highlighted:
• Prescribing is showing an underspend, but this doesn’t incorporate the new reduced cost
of generics, which may lead to a further underspend by the year end.
• Cash – There is an error in the papers and it should read ‘we have sufficient cash to
enable it to fulfil…’ and not if as stated. East Devon PCT has been asked to contribute
£170,000 of its cash limit to help solve the community problem. This was agreed.
• Capital – The full programme is committed for this year. The PCT has now withdrawn its
request for brokerage from the Strategic Health Authority.
• Potential risks around the PMS / GMS contract work were discussed, but an accurate
picture cannot be predicted at this early stage of the contract implementation process.
• The new Pharmacy contract was also discussed and it was agreed that a detailed paper
would come to a future Board meeting.
• Hugh Groves highlighted the positive way in which complex care cases are being
managed – this is due to a manager being in post to lead on this work.
The Board noted the Finance Report.
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7. Professional Executive Committee Report
(04/123)
Dr John Coop, Acting PEC Chair presented the report and the following key points were
highlighted:
• Thanks were extended to Mike Slot on the huge amount of work he has undertaken on
the Out of Hours project.
• These minutes need to be marked “Draft”.
The Board noted the PEC report in draft form only.
8. Performance Report
(04/124)
Tracey Hector presented the Performance Report and the following key points were
highlighted:
i) Communications
• Patient Prospectus – We have to provide this document, however the Communications
Team is now hoping to alter the document to be much more informative and robust. This
also aligns with the PCT’s current service development initiatives around Older Peoples
Mental Health Services and the CSDP.
• The Communications Team is supporting Les Hickman and the Modern Matrons in
arranging the Budleigh Salterton opening ceremony on 11 th January.
• The team are also involved in the Out of Hours changes which are moving ahead well.
• The Team brief is receiving positive regular feedback. Further work is now to be done
with Shirley Matthews in the audit team, to check that discussions are organised by
heads of departments with teams on the brief, rather than just an information handout of
the document with no liaison.
• The Reporter newsletter is moving on well, and the Team is in the process of evaluating
the Reporter’s use and value through a staff opinion review. Results of this will be
reported at the next meeting.
• The Team is also supporting the Matrons in the Essence of Care work and
commendation was extended to Eileen Stuart, Janet McKay and Soo Sims for their hard
work in the Essence of Care project. Further update to be reported at a future Joint
Briefing meeting.
ii) Staff Survey
• Liz Smith is to report on the formal staff survey that feeds into the Healthcare
Commission ratings. However, there was an internal staff survey on communication run
in 2001 with help from internal audit. This exercise is to be revisited to ascertain staff
opinion on what they feel the PCT has achieved in communications. This will be run in
January and report will come to the February Board.
iii) Freedom of Information
• is now to transfer out of the Performance Directorate and into Clinical Governance, led
by Sue Smith, the Information Governance Manager.
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iv) Performance Balanced Scorecard/Improvement Plan
• Laurence Blight reported on the Performance Balanced Scorecard / Improvement Plan
and discussions ensued on details for clarification and update. In 4.1 of the report, it was
clarified that the 800 stated are to be delivered in a full running year.
• With regards to the Star Ratings process, the Board requested that work was done in a
review of our performance in comparison to other three star trusts, particularly at this
stage, before national information / targets are clear to us. At the moment, it is not
possible to predict accurately what the Healthcare Commission is going to set as targets
so a benchmarking against other organisations seems to be a sensible plan of action.
The Board noted the Performance Report.
9. Commissioning Report
(04/125)
Hugh Groves presented the Commissioning Report on behalf of Simon Bell and the
following key points were highlighted:
• RD&E Contract- The level of activity has increased, particularly around non-elective
cases, which has in turn increased spending but is still within our limit of affordability.
This is being closely monitored by the Commissioning Team.
• DPT – There is a meeting with DPT and the Devon PCTs at the end of this week to
discuss the overall commissioning targets for both this year and next year and to look at
the DPT recovery position.
• The PCT is party to a risk sharing arrangement across Devon for some specialist and
high cost patient treatments and the cost associated with this has increased to us this
year. However this has been managed within our financial plan.
• Work is ongoing with regard to the Pursuing Perfection initiative and with the Ambulance
Trust around Patient Transport.
• The long waiter target has slipped to red in our Improvement Plan – action to be taken
with the R D & E.
The Board noted the Commissioning Report.
10. Health and Social Care Report
(04/126)
Jan Ingram presented the Health and Social Care Report and the following key points were
highlighted:
• Public Access Pilot – This pilot has been really successful and is to be rolled out across
Devon in the future.
• The Single Assessment Process project continues. Jan Ingram is the lead across the
three southern PCTs and the project is currently looking at the IT impacts / issues around
the new process. Kevin Grady is assisting in this work as it runs alongside
implementation of the EPR within the PCTs.
• The Sainsbury Project report is due to be published in late December. Jan
recommended that Richard Anderson be invited to one of the future Joint Briefings to
brief the Board on the current status of the Older People Mental Health Services work.
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Iain Tulley outlined how important the integration work has been, seeing the PCT, Social
Services and the Partnership Trust delivering mental health services together.
• Social Services are also looking at their performance indicators to raise their star rating
from the one star they received this year.
• Integration – Jan Ingram expressed her excitement at the fact that the work has finally
progressed to this point. The integrated management team is almost formed and Jan
explained to the Board how the new structure is to work. The Board made suggestions of
areas to consider when nominating representatives onto existing working groups across
localities.
• Iain Tulley congratulated Jan and her team for the successful work done.
The Board noted the Health and Social Care Report and agreed to invite Richard
Anderson to a future briefing.
11. Assurance Report
(04/127)
Tracey Hector presented the Board Action Plan to the Board and followed this with Item 12.
Assurance Framework.
Tracey outlined that the Board Action Plan is designed to deliver a progress report on how
risks are being managed by the organisation. In future the key Board reports are going to
come to meetings in a more robust format. This also aligns to the new Standards for Better
Health guidelines.
Also tabled at the meeting for the Board members was ‘Appendix 8 – Embedding
Performance Management to Provide Assurance and Deliver Performance’ showing a
graphical flow of performance management and how it is to work under this new framework.
Following concerns expressed regarding the volume of information the Board are required to
read through in advance of meetings, it was confirmed that the Board Action Plan is the only
document of the three tabled today that will come to every meeting of the Board.
It was emphasised that the requirements of assurance come from national guidance from
the Department of Health and Healthcare Commission, and are not a local PCT initiative. It
was reported that all the information will be held on the PCT’s website.
Tracey detailed that the Strategy Map will be displayed in each of the community hospitals,
so that this information is accessible to the public It was also confirmed that each of the
Directors have been aligned within their work programmes to the Standards for Better
Health.
The Board approved the following recommendations:
- To approve and adopt the Strategy Map as the strategic programme of
work for the trust
- To approve and adopt the new Assurance Framework
- To approve and adopt the new Reporting Framework
- To approve and ratify the amended Risk Management Strategy
- To note and agree the future work required to align the Principle Risks
for the Trust and Board Action Plan
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13. Public Health Report
(04/129)
Dr Ali Round presented the Public Health Report and the following key points were
highlighted:
• Mumps is continuing to be a problem. Currently four out of the six secondary schools
have taken up the vaccination programmes. It is not known what impact that this will
have on the local GPs.
• The Health Development Agency (HDA) has published a report on the prevalence of
smoking across the country. East Devon appears to be an area of low prevalence, but
figures suggest that there are still 22% of the adult population who smoke.
• The Domestic Violence Awareness Week took place and it was reported that the
campaign appears to have had positive impact.
• Screening – The PCT is still working on Breast Screening and is hoped that there may
be the possibility of independent sector procurement of this service. There is still no lead
commissioning arrangement for cervical screening; this is about the quality assurance of
the screening and not the delivery of the service itself. Ali Round attended last month’s
Joint Commissioning Executive but no lead organisation has yet stood forward to
undertake the work. The Board asked that action be taken.
• Neonatal hearing screening – This is a National Programme and Ali Round is currently
responsible for the implementation of the programme.
The Board noted the Public Health Report.
14. LDP Progress Report
(04/130)
Laurence Blight presented the LDP Progress Report and the following key points were
highlighted:
• The complete document is available should Board members wish to see it and the
progress report provided summarises the key areas.
• Every directorate is making significant progress and most of the delivery plan is on track.
• Access was emphasized, with particular reference to the national 2007/08 target of
purchasing £2m of elective care from the independent sector.
The Board noted the LDP Progress Report.
15. Emergency Plan
(04/131)
Tracey Hector presented the Emergency Plan and the following key points were highlighted:
• This comes to the Board for ratification before submission to the Strategic Health
Authority.
• A ‘test’ tabletop exercise will be coordinated next year to test the robustness of the
Emergency Plan. It will then be refined as a result of the exercise and rolled out across
the PCT.
• The Incident Control Room will be at Jerrard Wing, Honiton Hospital until HQ relocates
and then the new HQ will become the new control room.
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The Board agreed to ratify the Emergency Plan in its current form and the Chair and
Chief Executive signed the plan off.
16. Community Services Development Plan
(04/132)
Lynda Price welcomed Jenny McNeill, thanked her for her hard work and wished her luck in
her secondment with Mid Devon PCT.
Jenny McNeill presented the CSDP update and the following key points were highlighted:
• The report details the early communications process adopted and also details the
progress on early implementation requirements.
• There are a number of issues for Board approval and consideration:
o Axminster MIU Opening Hours – These were described in the original plan and
two public meetings have been held in Axminster, neither of which were
particularly well attended. At the last meeting, the public wished to be reassured
that communication around the new opening hours would be widespread so that
people would know not to arrive. Jenny is to meet with Axminster Town Council
next week, to discuss this further.
o Clear Feedback Mechanisms for new services – Local people have been asking
about how they will be informed about whether the plan’s implementation has
resulted in success. There is a need for ongoing involvement of the public in every
stage of the CSDP process.
o Stroke Unit – This needs to be monitored as it is developed. There is a need to
ensure that there is no negative impact on other local services. The PCT also
needs to consider the Standards for Better Heath in the development of this
service.
• Hugh Groves commented on the Strategic Estates Development Plan and its links with
the Community Services Development Plan. This should be monitored closely by
Directors and the Board.
• It was commented that this has been an excellent and notably successful exercise and
the benefits from the plan are already being seen. This exercise has transformed the
level of cooperation, involvement and confidence of the general public within the PCT’s
work.
• It was requested that details of who is going to be responsible for which elements of
work in Jenny’s absence are circulated as soon as possible.
The Board noted the CSDP report and agreed to approve the proposals contained in
the paper, subject to an action plan being agreed with the local clinicians for the
Axminster Minor Injury Unit.
17. CNST / RPST: NHSLA Risk Management Standards for PCTs
(04/133)
In Janet Ashworth’s absence, Dr John Coop presented the report on Risk Management
Standards and the following key points were highlighted:
• The summary in the papers shows the progress made so far.
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• Current performance is being logged but in addition recommendations are made on the
action plan to take this work forward.
• It was clarified that there were only two areas that the PCT did not meet the 75% target.
The Board agreed the proposed action plan and congratulated Janet on progress to
date.
17a. HR Report
(04/133)
Liz Smith presented the tabled HR Report and the following key points were highlighted:
• The next Equality and Diversity meeting is now set for January.
• One Bank Coordinator has been appointed and another is to be appointed shortly.
• The Agenda for Change initiative is ongoing and a job matching exercise is currently
being undertaken. From January, new Job Descriptions are being produced for those
employees who did not originally agree with their current ones.
• A further £90,000 has been allocated for East Devon PCT’s Agenda for Change
initiative, which was reported as a very positive message for EDPCT. It was clarified that
this money is the maximum figure ring fenced for Agenda for Change and can be used
for backfill, where backfill cannot be organised locally. National money is also coming to
us for the initiative.
• Lily Chapman in her new role is going to be recruiting new job evaluators and has
already begun this process.
• Diane Phillips is the new part time appointment working on the A4C Project.
Education
• KSF – We now have four members of staff working with dedicated time to the KSF. 106
staff members have attended KSF awareness meetings and Paul Norrish is now working
to arrange specific KSF sessions for catering and domestic staff. Eileen Stuart is the new
management lead on the KSF.
• 57 managers have undertaken Appraisal Training which will continue into the New Year.
• IWL Practice Plus status – The date set for the assessment is now the third week in
September 2005. The Assessors will be validating the self-assessment we will have
done in the PCT in both February and June 2005. Lynda Price is to be representing the
Non Executives on the IWL Steering Group.
• (ESR) Electronic Staff Records – We are now in the pre-implementation phase and
working with the DPT on this initiative. This is key in the CNST work to get to 100% in the
target.
• The PCT is going to advert for a new HR Manager to support this additional work as
Kerrie Devine is subsumed in the Agenda for Change work.
• A workforce workshop is booked for December for a wide range of managers to discuss
workforce issues.
• The Directorate is currently looking to set up a ‘helpdesk’ to aid dealing with HR issues
during this busy time.
• The December Joint Briefing is to be dedicated to Workforce and IWL.
• The Staff Opinion Survey as of today was at 60.5% so the PCT has met the response
target of 60%.
The Board noted the HR, Education and Training Report.
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18. Minutes for Ratification and Ratified Policies
(04/134)
The Board approved the following minutes:
- Risk Management Committee, October 2004
It was requested that the minutes reflect the PCT’s compliance with Level
1.
- Audit Committee, October 2004
The Annual Audit letter is being finalised to come to the Board.
4.1.4 Action is incorrect. It was agreed the letter would be amended.
19. Funding Requests 2005 – 2008 LDP
(04/135)
Dr Ali Round presented the paper on funding requests for the LDP.
• The full document is very large and Marion Young will have copies sent out if necessary.
• The funding requests were extracted for the Board’s information. It was reported that the
PEC worked through these at their last meeting.
• The Board was asked to consider whether it would like to change any of the PEC’s
prioritisations. Comments were made and amendments were noted by Ali Round. It was
requested that this comes to the December 15 th Joint Briefing for the Board and PEC to
consider alongside financial implications.
The Board noted the report and agreed the funding prioritisations subject to
clarifications given at the December 15 th Joint Briefing. The Board agreed to use the
Health Inequalities Framework to guide the work.
20. Any Other Business
a) Part 2 Board Minutes – The Board agreed the Part 2 Minutes of the last Board
meeting.
b) This being Laura McMahon’s last Board meeting, she was thanked for her services
and wished well in her new job as Support Manager for Operation Vanguard.
Date of the Next Meeting
The next meeting of the Board is to be held on February 9 th 2005 at 9.30am in the
Conference Room, East Devon Business Centre, Honiton.
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ACTIONS FROM BOARD MEETING ON 1 st DECEMBER 2004
NO. ACTION PERSON
Final consideration regarding changed opening hours
for Axminster Minor Injury Unit.
REPORT SCHEDULE (coming from meeting)
Jenny McNeill
REPORT MEETING PERSON
Board Action Plan and Principle
Risks
Laura McMahon
PA to Chief Executive & Chair / Office Manager
December 2004
Board – Every Meeting Tracey Hector
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