KIRKLEES COMMUNITY HEALTHCARE SERVICE BOARD
Minutes of the KCHS BOARD (KCHSB) held on 30th July 2010 at 8:30pm – 12:00pm in Meeting Room 2 Beckside Court Present:
Suzy Brain England OBE, (Chair) (SBE) Robert Flack, Managing Director (RF) Tina Quinn, Clinical and Operations Lead of KCHS (TQ) Patricia Drake, , Non-Executive Director (PD) Gwen Ruddlesdin – Head of Integrated Governance (GR) Ian Hazlehurst – Senior HR Manager (IH), rep for Laura Campbell Michael Crowther – Head of Business Development and Performance rep for Janice Boucher Helen Rees – Finance Manager rep for Janice Boucher
In attendance:
Lyn Milnes - Minute Taker (LM) Amanda Thomas – Communication Manager (AT) Murray Forest – LTC Development Facilitator (MF)
KCHSB/09/001
Apologies for Absence Apologies for absence were received from: Janice Boucher – Finance and Performance Lead (JB) Munir Ahmed, Non-Executive Director (MA) Laura Campbell - Assistant Director of Workforce, Commissioning & Policy (LC) Declaration of Interest Declarations of Interests are recorded and held with the KCHS Board Secretary.
KCHSB 10 177b
Minutes of The Previous Meeting The minutes of the Kirklees CHS Board meeting held 24th June 2010 were agreed as a true and accurate record and were signed by the Chair of KCHS Board.
KCHSB 10 177c
Matters Arising Matters arising from minutes dated 24th June 2010 have been recorded on the attached sheet KCHSB 10 177c. Minutes of The Previous Meeting
KCHSB 10 177e
The minutes of the Kirklees CHS Board meeting held 15th July 2010 were agreed as a true and accurate record Matters Arising
KCHSB 10 177f
Matters arising from minutes dated 15th July 2010 have been recorded on the attached sheet KCHSB 10 177f.
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Guest Speaker Murray Forest – Predictive risk tool Predictive risk tool is to be distributed to staff and will highlight what is urgent and what is not. 69 practices have signed up to predictive risk covering 387,942 patients Still in negotiation with 3 practices that have not signed up Murray showed snapshots that can be obtained from the tool and information that can be pulled out Slides compared practices and long term illnesses. This will be a good tool for GP‟s and KCHS. This tool should allow community matrons to identify NHS numbers and patients that are high risk of admission to hospital and enable these admissions to be prevented. We are committed to driving this tool at the start. This is a change of working and leading GP‟s in some cases. Provides information on how to manage people successfully. The KCHSB agreed this would be a good tool to invest in. Action 1 - MC to talk to Joanne Crewe to explore how data can be available to us Helen Frain to look at operational use of information The Chair thanked Murray Forest for his informative presentation. Tabled
Directors Report Robert Flack summarised his tabled report highlighting to the KCHS Board the following points:
Right to request submitted 28.7.10 Response expected 27.8.10 PCT have concerns about talking to staff Worked with SHA about timescales Health and Equalities and Public Health areas need changing for PCT – Action 2 - RF to pick this up in next few days 6 months has not been triggered yet Approval expected in August Outline business plan Final approval in December from PCT Then go to final SMT and Board by January
RF to work with Jim Barwick and Mike Potts - assuming approval given KCHS will receive 3 or 5 year contract the KCHS Board supports. The KCHSB recommends seeking to establish the new organisation in the event of August approval, steps to be taken to set up company by 1st April 2011. RF informed the KCHSB this in the white paper it states that should provider fail– it will into a special authority status. Services are still covered by NHS Board as a safety net for services. RF has talked with solicitors about a proposal of GP‟s becoming 2
members of the new organisation. KCHS still has to prove to NHS Kirklees that staff are in agreement of a Social Enterprise. Road shows now in progress. Action 3 - The KCHSB to meet with unions RF also reported on: MSK – There are big issues with short term contracts which need resolving Issue around stroke - commissioners think there is not enough done in the community. Action 4 - SBE and RF to talk to Rob Napier and Mike Potts KCHSB 10 179
Finance Report Helen Rees summarised the financial report to update the Board on: June 2010 Financial Position Overall costs were £13k favourable in the month, and £30k favourable Year To Date Contracted headcount has continued to fall a further 6.6 in month, and is now 38.6 WTE below budget. This has resulted in £245k cost savings in first quarter. The pay savings have been partially offset through the following risks: - New risk of £50k identified this month following the cost benefit analysis for Tough Books, and the omission of the additional revenue costs. This equates to £200k Full Year. -
In addition, previously identified risks of £153k due to CQC registration, £30k and District Nurse Messaging Services for 2009/10 and current year,£70k plus the QOF costs of £26k and Telephones of £22k
Full year risk of £161k, includes risks on Telephones £126k and District Nursing Equipment £100k, which are to be resolved with NHSK as part of on going contract and overhead discussions. On resolution, the underlying position will be £65k favourable. Action 5 - Helen to keep the KCHS Board informed of the negotiations with commissioners to resolve the telephones and DN equipment issues. Cost improvement plans Cost Improvements Plans on track with full year target, although some shortfalls in some areas e.g. travel, but trending upwards. Performance report June 2010 Chlamydia – KCHS are responsible for the level of activities and share of targets. Currently measuring against last year‟s target, and showing a shortfall this month after a positive start to the year. The KCHSB questioned is it clear what the targets are and do the 3
functions carried out help to achieve the targets MC explained that the achievement of the target for 2010-11 was currently being negotiated with the commissioners at NHS Kirklees and NHS Calderdale respectively. The Vital Signs target (VSB13-03) of 35% for 2010-11 is the commissioners‟ target and at present neither commissioner has allocated funding to achieve this target. KCHS is responsible for achieving the local target (LC07/LC08), this is monitored in the performance report is calculated as the share the target that has been apportioned to KCHS services. The agreement with commissioners at present is at 2009-10 levels of achievement (i.e. a share of 25%) until the negotiations for 2010-11 are finalised. Action 6 – MC to Report back to the next board on Chlamydia targets. Management costs Operating Framework details a 45% reduction in Management Costs over the next 4 years. The PCT Target is 12.35% reduction against 09/10 actual management costs as per the audited accounts definition. This definition includes an element of overhead costs for KCHS, and equates to £513k saving. Excluding the overhead allocation not yet transferred, the saving required is £284k An email has been sent to T30 offering a voluntary package. Talks are taking place and work on going to reduce management costs The KCHSB need to know any actions and know if the PCT are going to stop any money. Action 7 – RF to confirm the point at which Contract froze - can the PCT ask us to deliver 12.35% of cuts. Action 8 - Management costs to go on next FP&BD agenda. LM to inform KF. Quality measures TQ led a discussion regarding the KCHS strategic objective aimed at developing sounder measures of Quality for KCHS services. TQ made reference to the recent Department of Health publication “Transparency in outcomes - a framework for the NHS”, which is a consultation document regarding the development of a quality framework for the NHS. One of the strategic work streams initiated in KCHS this year is the KCHS Quality Journey, which is seeking to develop quality measures for all services. TQ recommended that the board ask the project to adopt the framework that is illustrated in the document, including five domains that cover Clinical Effectiveness, Patient Experience and Patient safety.
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It was agreed that the project should adopt this method and the clinical areas that should be prioritised were Adult Nursing services to support the development of Community Care Teams, Children and Family Services and Intermediate Care. Action 9 – MC to take forward as part of KCHS Quality Journey work stream. RF informed The KCHS Board that there were concerns with-Specific work with immunisations the immunisation team has got to be held responsible for sorting the problems out Action 10 – TQ to report to September KCHS Board about the immunisation team‟s action plan.
KCHSB/10/179a
QIPP MC presented a briefing paper to the KCHSB. The purpose of this paper is to raise awareness of the KCHS Board to the approach being led by the Department of Health - being badged under the acronym QIPP – and to consider how this impacts on the KCHS.
KCHSB/10/179b
Chlamydia MC reported on Chlamydia screening. The purpose of the report is to provide information about responsibilities around Chlamydia and Targets and to provide information on the current risks to KCHS in terms of the Chlamydia Screening Service
KCHSB/10/179c
CQuIN MC presented a briefing paper to the KCHSB. The purpose of this paper is to raise awareness of the KCHS Board to the approach being led by the Department of Health - being badged under the acronym CQuIN – and to present how this impacts on the KCHS.
KCHSB/180
Clinical and Operational Lead’s update TQ presented her report informing the KCHSB about: Fieldhead Park Intermediate Care Beds As previously reported to the KCHSB an inspection showed an acceptable standard of care is not being met. KCHS have 10 intermediate care beds located in this home and have to ensure the safety of the patients in this setting. A detailed action plan is now in place after several unannounced visits to the IC setting. Staffing levels are being monitored. If issues are not addressed admissions will be stopped. Regular meetings are being held with the Commissioners and they are supportive of all actions. Action 11 - TQ to update The Board on Fieldhead at the September KCHSB meeting 5
Incident reports The KCHSB can now be assured that incident reports are now are now up to date. Next steps: Run reports to show trends and take necessary actions. Enable colleagues to complete the incident form on line. Appoint administration support for this process. Action 12 - TQ to give a regular feedback to the Governance Committee and KCHSB twice a year. Professional update We are working with the 10 high impact actions for Nursing and Midwifery. The intention is to link these with CQuIN and extend these to include other professional colleagues. Also encouraging colleagues to join Webex conferences that are now being held nationally to look at each of the high impact actions and to consider how these can drive forward changes in practice. The KCHSB RECEIVED and NOTED the Clinical and Operational Lead‟s update. KCHSB/180a
Business continuity GR updated the KCHSB on business continuity plans. A Kirklees wide health and social care business continuity plan has been in existence for a number of years, particularly to meet increased pressures during winter months. This has been reviewed each Autumn to ensure that it continues to meet the needs of the Kirklees population. Our services have both contributed to this overall plan and developed internal business continuity plans. The internal plan was originally called the „Snow Plan‟ as it was specifically designed to ameliorate the effects of adverse weather in winter. However, this work was subsequently expanded to ensure that KCHS had robust plans to meet all foreseeable internal and external adverse events that could impact on service delivery. Work is now taking place to review the Standard Operating Procedure so that it can be formally reviewed and re-approved in September 2010. Senior Management team do not have a business continuity plan in place. The KCHSB RECEIVED and NOTED the business continuity report.
Strategic Business Plan The KCHSB was sent a hard copy of the Strategic Business Plan for final amendments before publication. 6
The KCHSB ACCEPTED and RECEIVED the Strategic Business Plan for publication. Action 13 – Suzy Flintoff to write the Integrated business plan for September. MINUTES FOR INFORMATION KCHSB 10 181
Finance, Performance & Business Development Minutes of meeting held 17th June 2010 The KCHS Board RECEIVED and NOTED the Minutes of the Finance, Performance & Business Development. Any Other Business Pat Drake would like to pass her thanks on to the staff that she visited who made her very welcome. Key messages Emphasis on money saving ideas and need to keep it up. Work to save money is appreciated by the KCHS Board Road shows Predictive risk tool Business Plan Safeguarding Issues – contacting on call manager Action 14 – AT to liaise with TQ - Standby media response re: Field Park issues Action 15 – LM to arrange meetings with Unions and Non Executive.
KCHSB/09/014
Date and Time of Next Meeting 2nd September 2010 – KCHSB Away day at Beech House Lunch provided
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