Minutes of the North Kirklees Governing Body Meeting held on Wednesday 31st October 9.00am – 12.30pm, The Barn, Northorpe Hall 1)
Present: David Kelly (DK) Chris Dowse (CD) Helen Severns (HS) Ilse Newsome (IN) Deborah Turner Tony Gerrard (TG) Jackie Holdich (JH) Sarah Muckle (SM) Steve Brennan (SB) David Boothroyd (DB) Ajit Mehrotra (AM) Joanne Crewe (JC) Kath Greaves (KG) Farhad Kohi (FK) Nadeem Ghafoor (NG)
CCG - Chair Designate Chief Officer Head of Service Improvement Interim Governance Manager Head of Quality and Safety Non-executive Associate Head of Practice Consultant in Public Health Chief Finance Officer Head of Contracting CCG Board Member Nurse Lay member CCG Board Member CCG Board Member CCG Board Member
In-attendance; Sarah Carlile Keith Smith Anne McPherson
Adult Safeguarding Program Manager Assistant Director Assistant Director, Safeguarding Adults
Minutes: Natasha Brown (NB)
Personal Assistant to NHS North Kirklees Clinical Commissioning Group
Welcome & Apologies Jan Randall (JR) Khalid Naeem (KN) Yasar Mahmood (YM) Rachael Kilburn (RK) Valerie Aguirregoicoa (VA) Alison O’Sullivan (AS) Imran Patel (IP)
Head of Strategic Development & Business Planning CCG member CCG member CCG Member Non-executive Associate – Chair Director of Children and Adults, Kirklees Council Non-executive Associate
The Chair opened the meeting by welcoming all those in attendance. 2)
Declarations of Interest TG declared interests as the Lay member designate for GHCCG and Safeguarding agenda item. All GP Board members declared an interest in Primary Care Investment and Enhanced Services.
3)
Accuracy of minutes from last meeting Wednesday 26th September 2012 The minutes of the Clinical Commissioning Executive meeting held 26th September 2012 were accepted as a true and accurate record. It was noted that the chair will formally sign off the minutes in future Governing Body meetings once they have been ratified and agreed as an accurate record.
4)
Live Action Sheet The group reviewed the action log from the previous meeting. Agenda item – 8.4 TG agreed to email NB with wording that reflects a true and accurate record of what discussions took place in relation to the Governing Body Member Remuneration at the Governing Body meeting, held on 22nd August 2012. High Level Risk Log ACTION – DT and TG agreed to take the High Level Risk log to the Audit and Governance Committee. Governing Body Member It was noted that the Governing Body tenure will be taken to the LMC meeting and member practices will be updated at the GP forum on 20th November 2012. Quoracy It was agreed that quoracy of Committee will be discussed at a future SMT. ACTION – SB/CD to ensure Sub-Committee quoracy is on a future SMT agenda.
5)
Quality and Safety Report – Private For reasons of confidentiality this section of the minutes has been separated and is attached for full board members only.
6)
Quality & Safety Report DT presented the Quality and Safety Report and highlighted the key areas. Elimination of Mixed Sex Accommodation (EMSA) There have been no EMSA breaches in the month of September 2012. Healthcare Associated Infections HCAI MYHT reported two post 48hour MRSA cases in September. There have been 4 reported MRSA cases year to date. DT informed the Governing body that work is continuing with the Infection Prevention and Control team to address findings from the Root Cause Analysis (RCA). Venous Thromboembolism (VTE) VTE targets have been introduced as part of CQUIN schemes in 2010/2011. In March 2012, 241 providers reported that at least 90% of adult admissions were risk assessed for VTE, compared with 221 in December 2011.
Care Quality Commission (CQC) Activity CQC have published their report from an inspection in September. MYHT have put measures in place to address the CQC response, and the action plan was taken to the Executive Contract Board. The action plans are being led by the infection control team. DK attended a Risk Summit on Thursday 25th October where the CCGs, SHA and Cluster members were present. DK informed the Governing Body that the meeting went well, and issues were raised and explored. The Governing Body • RECEIVED and NOTED the report on quality performance information for HCAI, EMSA, VTE 6.2) 6.3)
Adult Safeguarding Scoping Paper DT presented the Adult Safeguarding Scoping paper to the Governing Body. The Governing Body noted that the Safeguarding Adult Board is led by the Kirklees Council. The Board are currently preparing to become a statutory board in 2014, in light of the passing of the Health and Social Care Bill. YM has been appointed as the Executive Board Lead member of the Safeguarding Adult Board and will be requested to sign a membership agreement which is based on the Kirklees Safeguarding Adult Board (KSAB) constitution to comply with the KSAB membership. The Governing Body noted that a Safeguarding training sessions were given to the Governing Body by Christina Fairhead. Concerns were raised regarding the current model of Adult Safeguarding utilised by NHS Kirklees and this was a matrix model of Safeguarding with elements of the Adult Safeguarding agenda, which is managed by a number of directorates and elements covering NHS Calderdale and NHS Kirklees. A gap analysis and a base line position would be presented to NHS North Kirklees Clinical Commissioning Group (NHS NKCCG), against the standards set in the “Arrangements to secure children and adult safeguarding in the future NHS, the new accountability and assurance Frame work”. The Governing Body noted that processes are being developed to ensure that commissioners can make Adult Care Placements, in or out of area, based on knowledge of standards of care and safeguarding concerns. The Governing Body noted that commissioners are developing arrangements to review the quality of care in their local care homes. This will include joint working with CQC and local audits. Plans are being developed to address the needs of the service users. Next steps Concerns were expressed around the capacity and resource of the Safeguarding team for North Kirklees. A brief outline of the current position was given and it was agreed that discussions would take place outside the meeting to prepare an option appraisal to take forward this issue.
The Governing Body noted that there are significant increases in the adult safeguarding referrals and more dementia patients are being seen. The complexity of Adult Safeguarding has increased and Keith and Sarah are working with DT to look at preventing abuse and other areas of concern. ACTION - It was agreed that the options will be discussed at SMT and DT will work with Anne and Sarah regarding developing the options. The CCE delegated the decision making to the SMT and report back the Governing Body in 1 month.
6.4) 6.5)
Risk Management DT presented the Risk Register outputs to the Governing Body and highlighted the current risks on the register. It was noted that whilst the risk register was being developed specifically for CCGs, there may be elements of duplication which will be addressed as part of the review process. It was noted that two further risks would be added to the register to ensure a comprehensive position continues to be monitored. The Governing Body; NOTED the content of the Risk Register outputs
7)
Contracting and Finance report SB presented the Contracting and Finance report. All GB members were content with the report and no questions were asked. The Governing Body; RECEIVED the report and NOTED the financial position SUPPORTS the on-going work with QIPP NOTED the reserves position Enhanced Services JH gave the Governing Body an update on Enhanced Services at the CSG meeting on 10th October; it was agreed at the CSG meeting that this would be discussed at the Primary Care Strategy Group. It was noted that NG is a member of the Primary Care Strategy Group. JH informed the Governing Body that a formal report will be made to the meeting in November 2012. JH confirmed that she has attended meetings with the CSU regarding moving this piece of work forward. Action – JH to produce a report on Enhanced Serviced and ensure it is on the Governing Body agenda on 28th November 2012.
Any Qualified Provider (AQP) Process update DB presented this paper to the Governing Body for information only. DB informed the Governing Body that there are issues regarding AQP services being on Choose and Book. DB stated that services that are not on Choose and Book, will not receive referrals. The AQP services are now live; however it was acknowledged that it will take time to set these services up. All member practices have been informed of the AQP services. 2012/2013 Non Recurrent Spend SB presented the summary of proposals paper. The Cluster Board have requested to keep a tight grip on the Non Recurrent monies available, and would like to be assured that across CKW; the money is being used effectively. SB confirmed that the Summary of Proposals will be taken to the Cluster Board meeting. The Governing Body noted that a task and finish group has been established and are working on the proposals. The Governing Body had discussions regarding the proposals; Proposals for Primary and Voluntary sector - it was confirmed that a group is to be established to look at these areas and review any bids that are made. It was confirmed that all Governing Body members are content for work to continue with the task and finish group. NG requested clarity around a review panel and to ensure benefits are reviewed to ensure these are effective for the CCG. SB stated that the members, who are leading on the bids, would be expected to look at the benefits of each proposal. It was highlighted that Member Practices and the Voluntary Sectors are to be informed of the processes and to be informed on what they can bid on. SB agreed to bring the proposals template to SMT. ACTION – SB to take the proposals template to SMT. NG informed the Governing Body that some practices were already aware that the non-recurrent monies are available. DK informed the Governing Body that this was discussed at a LMC meeting and the practices may have had sight of the minutes. It was noted that the CCG need to ask practices what they wish to spend future non-recurrent monies on. It was noted that the non-recurrent monies are to support and improve the CCG as an organisation and also member practices. JH proposed that the Governing Body request that Jan Randall is to manage the process on the list of proposals. It was agreed that this will be discussed at SMT. ACTION – JH to ensure the list of proposals will be discussed at SMT.
It was agreed that Steve Brennan, David Kelly and Chris Dowse will sign the proposal list where appropriate. Priderm The Governing Body received an update from DB on work that is on-going with the Priderm Service.. JH informed the Governing Body that the current Priderm Service has become a success with practices, and feedback has proved member practices are happy with the quality of the service. Within the report, they were 2 options given to the Governing Body; Option One) to extend the Priderm contract until March 2013 and start a procurement process immediately. Option Two) to extend the contract until March 2014 and start a procurement process in September 2013 after an assessment of the service. DB informed the Governing Body that if the contract is extended to March 2014, the service cannot then be changed to AQP and requested the Governing Body is mindful of this. It was confirmed that the monitoring of this service also needs to be looked at and an evaluation is required for this service to move forward. . It was suggested that an action plan is developed with HS and NG. This would then be used as evidence if the Priderm Service goes to tender in the future. ACTION – HS and NG to develop action plans for the Priderm service. The Governing Body AGREED to continue and extend the Priderm Service for a further 18months, however, discussions with Priderm are to take place to run the service on a 6 monthly basis.
Compact Agreement with Wakefield CCG SB presented the Wakefield CCG Commissioning Intentions report and stated that arrangement have been agreed with Wakefield CCG to work on shared posts and resources to minimise unnecessary duplication of effort managing the Mid Yorkshire Health Economy. DB stated that Memorandum of Understanding (MOU) for contracting does not meet the job description. ACTION – SB and HS to work on the Job Description and MOU. The Governing Body noted how NKCCG and WCCG will work together to manage MYHT acute contract. There have been three posts that have been agreed to be shared across the two CCGs; Contracting, Quality and Development and Transformation. The Governing Body noted that the proposal is for this agreement to commence in November 2012 and run initially for 18 months. The Governing Body RECEIVED, NOTED and APPROVED the content of the Compact Agreement with Wakefield CCG. Contracting Intentions
DB questioned if the Contracting Intensions paper should brought to future Governing Body meetings. It was noted that the full detail of the report is not required and it was noted that the full detail will be taken to SMT meetings to be scrutinised. The Governing Body was assured that all members are aware of the Commissioning Intentions. 7.1)
Performance Report DB presented the high level Performance report on behalf of Natalie Ackroyd. The Governing Body noted that these reports are taken to numerous meetings, and it was agreed that action plans are to be brought to the Governing Body meeting to show what is going on behind the scenes to give the Governing Board assurance that work is on going. Action – DB to inform NA to include the action plans for future meetings to give the Governing Body assurance that actions are being acted upon areas that are flagging as red. It was acknowledged that the detail in the enclosed Finance & Performance Committee minutes, do not cover the actions which mitigate risks generating the red sections of the report.
8.0
Corporate Affairs
8.1)
Designate Chief Officer’s and Chairman’s report CD presented the Designate Chief Officer’s and Chairman’s report. The Health and Wellbeing Board will be presenting a presentation to MYHT. CD will also be holding a presentation regarding care closer to home and urgent care. CCG Staffing Structures CD confirmed that pooling and matching has commenced, these are being undertaken function by function. CD confirmed that she will keep the Governing Body updated on the outcomes from the pooling and matching. The Governing Body were content with the report and all members endorsed the strategic objectives.
8.2)
Mid Yorkshire Hospitals Trust Update on Transformation A session was held at woodlands for the Governing Body, where conversations took place regarding the Outline Business Case (OBC). A further discussion has taken place with DOH and Wakefield CCG. It was discussed that DOH wish for MYHT to be a foundation trust, however, this has yet to be confirmed. Outline Business Case Work is continuing with Wakefield and the Cluster Board, looking at the reduction in beds and length of stay. Work is still needed on reductions, to look at what this means to the CCG and community services in order to meet and manage the demand. The anticipation is to have completed the work by the end of November where the OBC will be taken to the MYHT Board and Cluster Board for support. CD
confirmed that she will be attending this meeting and advised that she will be approaching Governing Body members to accompany her at this meeting. Action – CD to ensure the OBC is on the agenda for November. DK suggested that the OBC will be discussed at the GP Forum in November, as member practices have not had the opportunity to have conversations regarding the options. NG highlighted his issues regarding Dewsbury District Hospital and the work force. If A&E is taken away, the acute structure in speciality areas will not be attracted to DDH. It was agreed that the workforce issues are to be discussed with member Practices. SB stated that we need to take the Member practices on the journey that the Governing Body has experienced and highlight that the Governing Body have not made any decisions. Clinical Lock-In meetings have been arranged, where GP and clinical input is required. DK attended the first Clinical Lock-in meeting and stated that the meeting was very positive and useful debates took place. CD recommended that Governing Board are to be involved in these meetings. CD has had conversations with Caroline Griffiths, and MYHT would like our help to ensure that services that are required do stay at DDH. SB is working on the site of DDH and what is required and what potential uses are at DDH. More work is required on this and will be shared at a future meeting. SB acknowledged that MYHT conversations are taking place in different meetings, and suggested that someone is required to pull all the work together and also feed this back to member practices. A conversation was held regarding what future services will run from DDH. It was agreed that Farhad and Chris will be attending the Transformational meeting on 20th November. 8.3) Authorisation update IN clarified that they appeared to be a lack of clarity on progress towards Authorisation and in order to rectify the Authorisation meeting later today has been opened up to all the Governing Body members to allow them to have an update. Case Studies These have to be submitted tomorrow. It was suggested that this is discussed at the authorisation meeting. ACTION - All members to feedback any comments to IN. The Governing Body noted that the submission date for authorisation day is tomorrow. Sign posting of documents will be reviewed prior to submission by the Internal Auditors. IN circulated copies of the draft strategic plan and encourages members to read through the document and familiarise themselves with the content.
8.4) North Kirklees Talent Management and Succession Planning The head of Organisational and Development has requested that this is plan is brought to the Governing Body for approval. All Governing Body members APPROVED the document. 5)
Memorandum of Understanding SM stated that this has been to SMT and CSG. The CSG agreed the content of the MOU and asked the GB to formally ratify this document. The Governing Body APPROVED the content of the Memorandum of Understanding
8.6)
Deputy for Clinical Lead IN clarified the differences between the Vice Chair of the Governing Body and Deputy Clinical Chair. It was noted that the regulations are for a lay member to have an interest in public involvement as Vice Chair. This will mean that a Deputy Clinical Chair will be required on the occasion that the Vice Chair leads a meeting. The Governing Body; All AGREED for Farhad Kohi to continue as Clinical Vice Chair
8.7)
Business Case for Parkinson’s Disease Specialist Nurse JH presented the business case for the Parkinson ’s disease Specialist Nuse to the Governing Body. The aim is to improve the services provided to people with Parkinson’s disease in North Kirklees, by appointing a Parkinson’s Specialist Nurse. JH advised that the bid is for two years and will then require mainstream funding. The Governing Body noted that the Parkinson’s Nurse will provide specialist education and support to the community and Primary Care staff in North Kirklees, reduce admissions, support carers and support clinicians. FK questioned the continuity of the service and what would happen if the nurse was on sick leave. It was agreed that this could be built into to business case. The base for the Parkinson’s Nurse would be at Eddercliffe Centre. The Governing Body; APPROVED the business case and support on going work.
11.
Matters for Escalation to the Cluster Board •
12.
Risks of no support from membership practices and support for MYHT OBC
AOB
•
13.
Contract Board meeting minutes for Locala to be included in the minute’s section for future Governing Body meetings. Receipt of Minutes Draft Minutes from the Finance and Performance Subgroup The draft minutes from the Finance and Performance Subgroup held on 17th October were RECEIVED and NOTED by the Governing Body. Draft minutes from the Clinical Strategy Group The draft minutes from the Clinical Strategy Group held on 10th October 2012 were RECEIVED and NOTED by the Governing Body. Minutes from the Quality Review Group The minutes from the Quality Review Group held on 13th September 2012 were RECEIVED and NOTED by the Governing Body. Minutes from the Joint PCT/LMC.CCG Interface Meeting The minutes from the Joint PCT/LMC.CCG Interface Meeting Group held on 11th September 2012 were RECEIVED and NOTED by the Governing Body. Minutes from the Audit and Governance Subgroup The minutes from the Audit and Governance Subgroup held on 26th July 2012 were RECEIVED and NOTED by the Governing Body. Minutes from the MYHT Executive Contract Board The minutes from the MYHT Executive Contract Board held on 20th September 2012 were RECEIVED and NOTED by the Governing Body.
13.
Date and Time of Next Meeting Wednesday 28th November 2012 9.00am – 12.30pm The Board Room, Broad Lea House
This concluded the content of the Governing Body meeting and the Chair declared the meeting CLOSED at approximately
Chairman’s Signature:
Date: