CKWCB-12-199_Draft_Minutes_Cluster_Governance_Committee_held_20_06_12__2_

NHS Calderdale, Kirklees and Wakefield District Cluster

Minutes of the Cluster Governance Committee held on Wednesday 20 June 2012 at 9.30am in the Boardroom, Broad Lea House, Huddersfield

Present: Roger Grasby Roy Coldwell Angela Monaghan Sue Cannon Dr Matt Walsh Carol McKenna Gill Galdins Andrea McCourt In attendance: Dr Judith Hooper Ben Fryer Ian Wilkinson Alison Fearnley GC/12/37

Non Executive Director and Chair Non Executive Director (until 12.15pm) Chair (until 11.30am) Executive Director of Quality and Governance (Executive Nurse) (until 10.30) Shadow Accountable Officer, Calderdale CCG Shadow Accountable Officer, Greater Huddersfield CCG Director of Corporate Development and Transition Head of Corporate Governance (NHS Wakefield)

Director of Public Health (NHS Kirklees) (Agenda item GC/12/45 West Yorkshire Emergency Preparedness Manager (Agenda item GC/12/45) Safety and Security Manager (NHS Calderdale) (Agenda item CG/12/47) Corporate Governance Administrator (NHS Kirklees)

Apologies for Absence Apologies for absence were received from Chris Dowse, Shadow Accountable Officer, North Kirklees CCG, Jo Webster, Shadow Accountable Officer, Wakefield CCG, Damian Riley, Medical Director and Primary Care Lead.

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Declarations of Interest Roger Grasby declared an interest in agenda item GC/12/46 concerning the deaths reported in custody given he was the Chair of Spectrum CIC.

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Minutes of the last meeting held 18 April 2012 The minutes of the Cluster Governance Committee held on the 18 April 2012 were AGREED as a true and accurate record.

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Matters arising and review of progress against actions GC/12/08

Serious Incidents and Never Events Q3 Report

Sue Cannon reported that she had now met with Helen Thompson to discuss the timeliness of serious incident reports from Calderdale and Huddersfield Foundation Trust (CHFT). Sue provided assurance that all outstanding issues had now been resolved and she did not expect CHFT to deviate again. Sue also confirmed that a new Deputy Director of Nursing had been appointed at CHFT who was clear what needed to be reported to the CHFT Quality Board in future. It was noted that Sue and Matt Walsh would discuss establishing appropriate links to the CHFT Quality Board outside of the meeting.

It was AGREED to ensure that appropriate control strategies were included on the Risk Register in terms of timely reporting of SIs. GC/12/32

CQC/Ofsted Inspection Maternity Services – Mid Yorkshire Hospitals Trust

The Governance Committee received a briefing note confirming the follow up action that had been taken in relation to the above. It was noted that all actions identified for Mid Yorkshire Hospital Trust (MYHT) had now been completed. Assurance was provided that progress against the action plan would be scrutinised at the MYHT Quality Board on 21 June.

It was noted that a further Care Quality Commission visit is expected to take place in June.

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Policy for the Accreditation of Practitioners with a Special Interest (PwSI)

It was noted that there was an outstanding action to formally approve the above policy. It was acknowledged that following further development of the policy, requested by the Governance Committee on 15 February, the policy had been considered by the CCEs for a clinical opinion. Matt confirmed that no material changes had been made to the policy since the CCEs had considered this and recommended that the Governance Committee formally approve the policy.

Matt explained the national appraisal process for GPs following a query raised by Angela Monaghan.

The Governance Committee agreed to APPROVE the Policy for the Accreditation of Practitioners with a Special Interest (PwSI).

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Review of Governance Committee: Membership, Terms of Reference and Work plan The Governance Committee discussed its role and future working, with reference to the revised Terms of Reference and work plan. Members recognised that there was a need for change given the current transition arrangements, capacity and resilience issues and the need to retain public accountability. A discussion ensued which covered: existing reporting arrangements within the Cluster for Clinical Commissioning Groups (CCGs), the need for the Governance Committee to work in a more flexible way, the need to focus on governance of transition issues such as public health, primary care and the Commissioning Support Service, assurance relating to quality and safety in CCGs. The Governance Committee AGREED: • • •

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to cancel the next meeting scheduled for 29 August; to consider establishing formal links between the Audit Committee members and Governance Committee Non Executive Directors; and to consider a flexible approach on future ways of working, e.g. establishing a scrutiny panel

Clinical Commissioning Group Reports The Governance Committee received an update on the CCG authorisation process for each of the CCG areas following the Board to Board meetings with CCGs held in May 2012, identifying risks between now and authorisation.

A verbal update was received from Carol McKenna for Greater Huddersfield. Carol highlighted the following key areas for development following the Board to Board meeting in May: the CCG’s role as employer, financial risks relating to budget separation within Kirklees, joint commissioning relationships with the local authority, interface with other commissioning partners (e.g Yorkshire & Humber Specialised Commissioning Group, West Yorkshire collaborative, NHS Commissioning Board) and commissioning with the third sector.

It was highlighted that timely and accurate reporting was fundamental at Board sub-committee level. It was recognised that there were some capacity and resilience issues concerning this.

A discussion also took place regarding a risk on the Calderdale risk register relating to the Commissioning Support Service (CSS) which is scored at 15. It was acknowledged that there needed to be a discussion with all four CCGs on whether this was a common risk. It was AGREED that Gill would discuss this point with Ann Ballarini.

It was also noted that this risk relating to the CSS should be considered when reviewing the Board Assurance Framework.

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The Governance Committee RECEIVED and NOTED the Clinical Commissioning Group reports for Calderdale, Greater Huddersfield, North Kirklees and Wakefield.

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Review of Internal Audit Report on Governance The Governance Committee RECEIVED and NOTED the findings from an internal audit review of governance arrangements across the NHS Calderdale, Kirklees and Wakefield District Cluster. It was noted that the report provided significant assurance on the governance arrangements.

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Individual Funding Requests (IRFs) The Governance Committee received a report that outlined the revised arrangements for the handling of Individual Funding Requests across the Kirklees and Wakefield PCT areas.

The Governance Committee noted the arrangements for the delivery of a shared service for IFRs across Kirklees and Wakefield District. It was noted that Calderdale also wished to consider shared IFR arrangements at some point in the future.

The Governance Committee APPROVED that IFR panels in NHS Kirklees and NHS Wakefield District can consider requests and make decisions relating to patients from either PCT.

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Board Assurance Framework presentation - Emergency Preparedness Dr Judith Hooper and Ben Fryer joined the meeting to provide a presentation on risks relating to emergency preparedness across the cluster identified in the Board Assurance Framework.

Significant risks were highlighted relating to under-resourcing of staffing across the two West Yorkshire clusters and Ben explained the proposals to address this. The preferred option (3) has been approved by NHS Airedale, Bradford and Leeds and NHS Calderdale, Kirklees and Wakefield District Clusters’ cluster leadership teams. It was noted that the preferred option required an overall increase in resource to mitigate the risks.

A committee member queried why the capacity risk score was higher in Wakefield. Ben was unable to clarify this point but AGREED to determine this following the meeting.

Judith and Ben shared the proposed new health architecture emergency operating model with the group.

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It was recognised that ongoing assurance would be provided to the Cluster Board regarding emergency preparedness particularly in the run up to the Olympics. The Governance Committee was reassured regarding the level of emergency preparedness and that there were no significant concerns should an unforeseen incident occur. In addition the Committee was reassured that progress would continue to be made on the areas of weakness identified.

A discussion ensued regarding the role of CCGs and public health transition. It was recognised that GPs have a responsibility to respond from Gold Command for their resources eg CCGs have a legal duty as a category two responder to co-operate with lead responders and to share information with those authorities.

The committee requested that CCGs are sighted on emergency preparedness and that the scoring on the Board Assurance Framework relating to capacity is revised following the action identified above regarding Wakefield.

Finally it was noted that Emergency Planning exercises would be carried out during October/November.

The Governance Committee was satisfied with the level of assurance given on emergency preparedness.

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Serious Incident (SIs)/Never Events Report The Governance Committee received a summary of the number of SIs and Never Events across the cluster by provider for the period January to March 2012, including comparative data with previous quarters. The committee noted that during quarter 4 there were: • • • •

24 new SIs, of which four were safeguarding incidents (3 children and one adult) None of the SIs were Never Events 96 open SIs across the cluster at 31 March 2012 (which is consistent with the end of Quarter 3) 12 SIs relate to Serous Case Reviews

It was noted that in the financial year 2011/12 there were 81 SIs and two never events.

The committee received a report under separate cover regarding Serious Case Reviews.

The Governance Committee NOTED Serious Incident and Never Event activity for Quarter 4, 2011/12 and the comparative information on Serious Incidents.

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Corporate Risk Register and High Level Risk log (HLRL) Ian Wilkinson joined the meeting to present the high level risk log to the Governance Committee. Ian provided a live demonstration of the HLRL, highlighted the benefits of the system and explained how this was continuing to be developed as we moved through the transition process. In addition it was acknowledged that Non Executive Directors and Clinical Commissioning group members were being given access to the system. It was recognised that feedback from staff on the new system to date had been positive.

The Governance Committee RECEIVED and NOTED the report as a true risk position in May 2012.

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Serious Case Review Report (SCRs) Sue Cannon provided an overview of all the open serious case reviews for NHS Calderdale, Kirklees and Wakefield District.

Sue provided a comprehensive overview of the reporting mechanism and governance arrangements and described the management support for overseeing these following a query raised by a committee member. It was recognised that the Safeguarding Board was the overarching body and calls in health Internal Management Reviews (IRMs).

The committee was reassured that there was a robust system in place.

Sue confirmed that a review of Wakefield SCRs with a member of staff from NHS North of England had confirmed that no themes could be identified relating to the cluster of SCRs in Wakefield.

Discussion took place about the need for CCGs ongoing involvement in this area and it was noted that Shadow Accountable Officer reports to the Board cover SCRs. It was recognised that there were some resilience issues. It was also acknowledged that relationships relating to safeguarding, for example with local authorities, need to be more clearly defined.

It was noted that a safeguarding briefing session was planned into the Board work plan which would provide additional assurance to the Board regarding the management of SCRs. It was recognised that continued enthusiasm for the management of SCRs was fundamental as well as continued awareness around safeguarding training.

Finally it was noted that the committee would continue to receive regular updates via a regular report.

The Governance Committee RECEIVED and NOTED the contents of the report.

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Organisational Readiness for GP Revalidation The Governance Committee received an overview on the progress towards GP revalidation the areas for development, key risks and additional costs required to support and implement revalidation.

The Governance Committee RECEIVED and NOTED the report and NOTED the risks and issues presented.

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Policy on Managing Concerns re Healthcare professionals It was noted that the above policy was being presented to the July Board for formal approval.

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Maintaining Quality during Transition The Governance Committee received a report that described the latest requirements from the National Quality Board for PCT clusters to develop a plan outlining their intentions to handover quality information during transition from PCT clusters to the receiving organisations (such as the emerging clinical commissioning groups, NHS Commissioning Board and local authorities). It was recognised that the plan included key requirements, milestones and governance arrangements.

It was recommended that the document focused on hard factual information and that a timeline for Board approval needed to be clearly logged.

The Governance Committee APPROVED the proposed plan to transfer quality information between sender and receiver organisations.

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Items to be escalated to the Board •

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Policy on Managing Concerns re Healthcare professionals

Any Other Business There were no items of any other urgent business.

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Date and time of the next meeting It was AGREED that the meeting of the 29 August would be cancelled and that details of further meetings would be confirmed following the conclusion of discussions about the future working of the Governance Committee.

The next formal scheduled meeting of the Governance Committee is between 10.00am and 12.30pm on the 10 October 2012 in the Stewart Room at Broad Lea House.

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