CKWCB 1364c Draft Minutes from Joint ... - NHS Kirklees

Minutes of the NHS West Yorkshire Commissioning Support UnitJoint CommitteeWednesday 6 March 2013Lonsbrough Room, Broad Lea HousePresent: Brian Marsden (BM) Chair, Non Executive Director (NHS ABL)Ann Liston (AL)Non Executive Director( NHS CKW)Alison Hughes (AH) Managing Director (WYCSU)Peter Thomas (PT) Commercial Director (WYCSU)June Goodson-Moore(JGM)Director of Human Resources(ABL/CKW)Maureen Goddard (MG) Principal Associate, OrganisationalDevelopment & Workforce Transition(WYCSU)Andrea McCourt (AM) Senior Associate, Governance and Risk(WYCSU)In Attendance: Pauline Kershaw (PK) Executive Support (WYCSU)David Bolus (DB) Information Governance (WYCSU)– (for item CSS/13/33)CSS/13/29ApologiesApologies for absence were received from Sarah Fatchett, Chief OperatingOfficer (WYCSU), Rachel Carter, Deputy Chief Operating Officer (WYCSU) andAnn Ballarini, Director of Strategy and Commissioning (NHS CKW) .CSS/13/30Managing Directors’ ReportAH presented the paper highlighting the following:The “Go Live” plan has identified issues regarding transfer of capacity, witha significant element of capacity retained in the transition team and/orCCGs. Vacant posts are being reviewed and there is an increasing need forinterim support in certain service areas, particularly in Business Intelligence1

and there is a procedure in place for interim staff to support the organisationnow and post April 2013.• It was noted the Transfer Scheme for staff closes on 11 March 2013, with 10March 2013 being the deadline for any staffing changes to be recordedwithin the scheme.• Original plans for new office furniture have been downsized, with greateruse of existing furniture.• A significant amount of work has been carried out on the service lines,clarifying the offer, understanding the risks to delivery on 1 April 2013 anddeveloping operating manuals for each service, supported by E&Y.Operating plans are expected to be signed off this week. AH acknowledgedthe contribution from Rachel Spilsbury to support this piece of work.• AH explained that there have been a number of instances where senior staffhave been recruited and then go on to secure a post in anotherorganisation, leaving vacancies within the system. MG acknowledged thisproblem, but pointed out that on a positive note, the customer expectationsare still being met. E&Y is carrying out a similar review of the service linesin South Yorkshire and Bassetlaw (SYB) CSU.• Noting that the majority of welcome sessions for staff have been held, MGgave an update on phase 2 of the on-boarding process which enables keymessages about the culture of the organisation to be reiterated to staff. Thefirst of a series of training courses to ensure brilliant customer service beganlast week. Further work on Investors in Excellence, across both West andSouth Yorkshire and Bassetlaw will take place in April. A rough guide to theCSU for staff is being developed which should be completed imminently.• John Wilshaw is heading up the Data Management and Integration Centre(DMIC) across WY and SYB CSUs. AH explained that, as legislation doesnot allow for receiver organisations to handle patient identifiable data from 1April 2013, work is taking place to find a solution to allow for the handling ofdata, such as seconding staff to the Information Centre. New informationgovernance and security compliance issues have meant the need to bringforward investment in a new server. WYCSU have been working with MikePotts, Chief Executive of NHS Calderdale, Kirklees and Wakefield District(NHS CKW) and Angela Monaghan, Chair of NHS CKW, on a tender waiverto procure the service in this financial year to ensure compliant technology isin place.2

• Estates - work is progressing with NHS Property Co. on leases and theissue around affordability of accommodation is being discussed nationally.WYCSU are working towards reducing usage of the estate to reduce estatescosts.• Checkpoint 3 – positive feedback had been given at the checkpoint 3 panel.AH agreed to forward the letter received following the checkpoint 3 panelvisit, to AL and BM.• Checkpoint 4 – Following positive verbal feedback from the visit on 8February 2013, the written feedback is being checked for factual accuracy.The final report is expected on 11 March 2013 and AH agreed to forward toAL and BM upon receipt.• Checkpoint 5 – WYCSU have passed both checkpoints 3 and 4 and detailsof checkpoint 5 are now awaited.It was RESOLVED to note progress on the development of WYCSU, the nextsteps identified and the risk of the staff transfer capacity gaps that haveemerged.CSS/13/31 Minutes of the WYCSU Joint Committee Meeting held on 6 February 2013The minutes of the last meeting held on 6 February 2013, were AGREED asbeing a true and accurate record.It was noted that the majority of actions on the action list had been completedor were on the agenda.At the last meeting, the Joint Committee agreed the Terms of Reference for theAdvisory Board and the appointment of two independent advisors to theAdvisory Board. AH explained that no guidance had been received as yet fromNHS CB, but adverts will be going out for business advisors to the AdvisoryBoard.A Director of Finance has been appointed and is expected to take up the postfrom 1 April 2013.In relation to integration with South Yorkshire and Bassetlaw CSU (SU CSU)AH reported that the two CSUs continue to work together, with synergiesbetween the businesses. It was recognised there are challenges to be facedgoing forward and an integration plan is being developed which will beperformance managed by the Business Development Unit (BDU).3

BM queried whether there were gaps between CCG expectations and CSUplans for delivery. AH confirmed that detailed discussions with customers havebeen taking place by service line and this informs the operating manuals.There are a number of gaps which have been identified across differentservices which are being worked through. The importance of communicationwith customers over the next couple of months has been recognised.AH updated the meeting regarding recent bids for new pieces of work andprogress to date.WYCSU have attended the meetings of the collective Clinical CommissioningGroups (CCGs), known as 10CC, a forum for discussing strategic issues acrossWest Yorkshire. These meetings have been positive with regard to bothbehaviours and also a commitment to work together in the future.CSS/13/32Risk ManagementPT provided an update around progress with the risk register. At the lastmeeting, it was agreed to review the risk register and look at key operationalbusiness risks faced as a CSU. Work is in progress with KPMG to populate therisk register. There are approximately 50 risks rated.The key risks relate to:• Cultural change required by staff.• Capacity (staff and resourcing), both in terms of vacancies in the structureand also in understanding what is required to deliver the services.• Financial pressures caused by either or both reduction in income orincrease in costs.The risk register will be brought to the first meeting of the Advisory Board.The team developing the CSU risk register have considered how to make thereporting of risks more meaningful and an example including the use of chartswas presented for comment. AM also described the functionality of theelectronic risk register system which is in place in NHS CKW. The importanceof training on the risk register and consistent scoring was highlighted.The Joint Committee NOTED the current position regarding the risk register.4

CSS/13/33Finance / Non Clinical Asset TransferPT tabled the finance update and explained that regular discussions are takingplace around control totals with PCTs and CCGs across ABL and CKW.It was noted that there was a small underspend of £40K against the £2.4 millionbudget.Primary Care IT was highlighted as one of the largest financial risks and it wasnoted that discussions regarding the funding are ongoing. WYCSU is engagingwith all CCGs regarding IT provision and service specifications. Ian Currell,West Yorkshire Area Team Director of Finance, is keen to take a WY approachto this and ensure appropriate recovery across West Yorkshire CCGs.Discussion took place around there being no monies from 1 April 2013 and theproblems that may arise regarding period 13 invoices if funds flow was noteffectively organised.In terms of the pay budget, the number of interim staff has increased, as anumber of staff have not flipped the system in practical terms, with a highnumber of CSU staff still working in their old roles.It was noted that there were some delays in releasing accommodation for CSUuse at Douglas Mill. JGM to pick this up with Kevin Howells.It was noted that operational and financial reporting was picked up under theBalanced Scorecard item later on the agenda.A paper detailing the risks regarding non clinical contract and asset transfers tothe CSU was tabled and presented by PT. PT described work within the CSU toassess which contracts and assets are transferring to the CSU. Details on typesof contracts and leads for this area of work were given in the paper. A numberof principles have been developed regarding contract transfer, detailed atsection 2.6, and discussion with the closedown teams are taking place. Thekey risks for WYCSU relating to the non clinical contracts were given at section3.1. It was noted that there were gaps in information regarding contract valuesand obligations. There was also a lack of guidance on the relationship betweenthe NHS CB and the CSU. There is to be an arbitration process, detailsawaited.BM queried the extent to which there were disputes and PT advised that therewere not many areas of dispute, with the majority of contracts relating to IT.Details were shared regarding a dispute with a provider where there had not5

een recovery of full costs for the service provided. The importance of charginga commercial rate for services was reiterated.AH said the WYCSU IT service is very competitive and it is the preference ofWYCSU to have an integrated IT offer for all CCGs. The current challenge is towork with the CCGs and see what is achievable within the current financialenvelope, however, it is recognised that baseline service contracts differ acrossthe patch.BM highlighted the need for proper sign off regarding the contracts and that alist of contracts, with a RAG rating was required. As part of the next steps,WYCSU is assessing what is being done in terms of risk. Assurances arerequired from Transition and Closedown teams in relation to any legacy risksthere may be aware of around transferring assets and contracts. The processaround transfer and sign off at the end of March needs to be agreed.The Joint Committee NOTED the assets and contracts transferring to the NHSCB that have been aligned to WYCSU, the principles being adopted and therisks.The next steps have been NOTED, though the details for sign off of the finaltransfer order between 21 and 25 March 2013 require clarification.CSS/13/33PoliciesA paper was presented sharing 22 draft local Information Governance and fourRisk and Governance policies. These draft policies supplemented the nationalpolicies which were presented to the Joint Committee at the last meeting. Thepaper also gave an update around ongoing work with HR policies.David Bolus attended the meeting to present the Information Governancepolicies and gave an assurance about the robustness of the policies, noting thatthese drew on policies used across West Yorkshire that have been compliantwith the IG toolkit and met statutory requirements.David confirmed the intention to provide every member of WYCSU staff with anInformation Governance handbook which will link in with the requirements ofthe IG toolkit. It was suggested it would be helpful if the handbook containedhyperlinks to relevant information.Draft policies have been circulated to the leadership and governance teamsand their comments have been incorporated. The policies have been6

acceptable to auditors in the past, therefore, it had been agreed these are fit forpurpose going forward and are robust in terms of assurance from 1 April 2013.It was stressed that staff need to be aware of these policies and one of thechallenges faced is how to bring policies alive in the new organisation.Staff moving across to CSU should be up-to-date with their IG training. The IGtraining tool, which the PCTs use to train staff, will be bulk transferred.In terms of the next few weeks, it was agreed it would be useful to circulate anemail around to support the safe transfer of patient identifiable information.It was proposed to bring back a report to the CSU Board in April highlightingany outstanding training requirements or any issues which have been identified.Discussion took place on who the Senior Information Responsible Officer(SIRO) in the CSU is and it was noted that confirmation of the SIRO andCaldicott Guardian was needed by the Department of Health.AM presented the four Risk and Governance policies, which are local policiesfor the CSU, complementing the national policies approved at the meeting on 6February. The governance team have developed the policies using policieswhich have been previously audited. AM noted that there had not yet been anopportunity to consult on these policies.AM highlighted that the Health and Safety policy confirms who fulfils the Healthand Safety Manager role and proposes a Health and Safety Group for the CSU,reporting to the Governance, Audit and Risk Group. Mike Harrop wasconfirmed as the Health and Safety Manager and the H&S group will reviewand approve more detailed supporting health and safety policies, eg manualhandling, lone working.The Business Continuity Procedure has a framework and templates which eachof the services will need to develop. Further details are to be added to thisprocedure, however, progress was noted and the Joint Committee wereprovided with assurance.Any comments around the policies should be forwarded to AM.AH gave an update around the national progress of the Scheme of Delegation.It is expected that NHS CB will sign off the Scheme of Delegation this week.SFIs are also awaited nationally and local SFIs cannot be developed until theseare received.7

MG gave an update around the HR policies and explained that CSUs had beenrequested to consult with their local Partnership Forum. An interim HRmanager has been looking at the employment policies in partnership with theunions and the focus has been on the six policies deemed contractuallysignificant. HR Directors will be discussing this at a teleconference later thisweek and MG will then provide a further update.JGM is to circulate a copy of a letter which had been received from Sir DavidNicholson which states there could be no changes around employment policiesfor two years. MG is to ensure that WYCSU has copies of all the policies fromthe 10 CCGs across WY and SY&B.Although there will not be consultation around the policies, MG said there willbe consultation with staff on measures as a whole.The Joint Committee AGREED to adopt the local policies listed on the paper,noting that further consultation is required.CSS/13/34Balanced ScorecardPT presented this paper, the proposed corporate Balanced Scorecard, notingthe six domains within it:• Business (finance and operations)• Community• Customer• Service• Staff and resourcesIt was noted that 21 strategic objectives have been identified as the basis forthe Balanced Scorecard.Discussion took place around the number of strategic objectives identified onthe Balanced Scorecard and AL expressed concern that there were too many.AL proposed that the number of strategic objectives should be reduced to amore manageable number to enable focus on strategic objectives.This was supported and it was agreed that further work on the scorecard wouldidentify which objectives were business critical and which were lead and lagindicators. It was agreed that the Advisory Board level required the rightinformation to provide assurance, with the detail reviewed at the Resources andDelivery Group.8

The Joint Committee APPROVED the Balanced Scorecard domains and KPIsand signed off progress to date. The next steps were AGREED,acknowledging that the strategic objectives are to be aggregated to a higherlevel.CSS/13/35Quality and Safety HandoverJGM suggested it would be useful to include Damian Riley, WYAT MedicalDirector and Sue Cannon, WYAT Director of Nursing, in this discussion.Therefore, it was agreed to pick this item up outside this meeting.PT said the discussion was more around transfer of assets and liabilities andrisk from the old organisations to the new organisations.CSS/13/36Workforce TransitionJGM said there is a set of principles in place that have been developedregarding staffing and there was, therefore, no Memorandum of Understandingto present.JGM gave an update on trade union recognition by CCGs, noting that there wasan issue with this in one CCG in Leeds, meaning this particular CCG may wishto undertake consultation slightly differently to the other nine CCGs. This willbe discussed at the 10CC group.It has been suggested that there is one Partnership Forum across WestYorkshire and MG is to draft Terms of Reference for this group.JGM said a report had gone to local Remuneration Committee meeting thisweek regarding the number of redundancies across the patch. JGM noted thatshe would be producing a report for WYCSU, each CCG and the Cluster Board.CSS/13/37CSU Additional Resourcing RequirementsA range of additional support has been required to mitigate the current risksrelating to the successful “Go Live” requirements of the CSU.The paper details the issues relating to staff transfer and impact on capacity forthe CSU, as staff are not able to be released from their current roles as early as9

was first anticipated. Additional support has, therefore, been required inparticular areas.Approval was sought to request tender waivers from Angela Monaghan, Chair,NHS Calderdale, Kirklees and Wakefield District cluster (NHS CKW), underNHS Kirklees Standing Financial Instructions for additional capacity in threespecific areas:• Extension of contract for consultancy support from Ernst & Young/Blackswan to support business transformation and DMIC (datamanagement and integration) – an additional £200k has been requested inaddition to the base contract. As this work includes support for integrationwith South Yorkshire and Bassetlaw CSU (SY&B CSU) the respective costswill be recharged to SY&B CSU.• Extension of contract for KPMG for financial and commercial developmentsupport for approximately £25K – additional support was required to provideexpertise in the absence of a key financial manager over a period of sixweeks to support checkpoints 3 and 4 which focussed on financialgovernance.• Extension of contract for support for business intelligence work fromArramar – additional support for £20k, due to the Head of BusinessIntelligence securing a post in another organisation. It was noted that threequotes had been sought prior to this extension.The above figures exclude VAT.AL queried the reasons for the tender waiver and noted that this would need tobe specified within the tender waiver forms. PT confirmed that the rationalewas the need for continuity of service and the short timeframe. A tender waiverform is to be completed for each of these contract extensions. Mike Potts hasbeen briefed and PT is to meet with Angela Monaghan next week.PT also noted that interim support from the NHS agency, IMAS, has beenrequired due to vacancies in the system, and that by securing resourcesthrough IMAS rather than the private sector, additional staffing costs have beenminimised.PT apologised for the delay in producing this paper. The NEDs raisedconcerns about this request for additional support being raised retrospectivelyand commented that it would have been helpful to have been alerted at an10

earlier stage to the additional support required. It was suggested that AL, as anNHS CKW NED, may be able to sign the tender waiver together with the Chair.The Joint Committee NOTED the operational risks identified and mitigationplans put in place to reduce the risks.Members SUPPORTED the tender waiver for additional resources noting thebusiness rationale captured in the paper and NOTED that the tender waiverswould be presented, in line with NHS Kirklees Standing Financial Instructions,to the NHS CKW Chair.The Joint Committee AGREED that staff need to transition in full from thecurrent system to the CSU with immediate effect and mitigation plans aredeveloped from sender organisations not receiver organisations where themajority of the risk still resides.CSS/13/38Date and Time of Next MeetingAs this was the last meeting of the WYCSU Joint Committee, AH thanked BMand AL for their support and commitment.11