KIRKLEES COMMUNITY HEALTHCARE SERVICE BOARD
Minutes of the KCHS BOARD (KCHSB) held on 24th September 2010 at 8:30pm – 12:00pm in Meeting Room 2 Beckside Court Present:
Suzy Brain England OBE, (Chair) (SBE) Robert Flack, Managing Director (RF) Patricia Drake, Non-Executive Director (PD) Munir Ahmed, Non-Executive Director (MA) Janice Boucher – Finance and Performance Lead (JB) Laura Campbell - Assistant Director of Workforce, Commissioning & Policy (LC)
In attendance:
Karen Fisher - Minute Taker (KF) Apologies for Absence Tina Quinn, Clinical and Operations Lead of KCHS (TQ) Gwen Ruddlesdin – Head of Integrated Governance (GR) Declaration of Interest LC declared that she is she works for NHS Kirklees as well as Kirklees Community Healthcare Services.
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Minutes of The Previous Meeting The minutes of the Kirklees CHS Board meeting held 30th July 2010 were agreed as a true and accurate record and were signed by the Chair of KCHS Board.
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Matters Arising Matters arising from minutes dated 30th July 2010 have been recorded on the attached sheet KCHSB 10 186c
Presentation
Guest Speaker Kate Bell – Equality and diversity The presentation was deferred.
Presentation
Guest Speaker Kath Evans – Single Point of Access The presentation was deferred.
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Organisational Form Update Business Plan The Board discussed the draft Organisational Form Business Plan.
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Managing Directors Report RF summarised his tabled report highlighting to the KCHS Board the following points:There have been discussions on KCHS whole IT spend (including capital) which is approximately £1.4m. An organisation will be 1
appointed to investigate this spend and to identify potential savings. There are national concerns about the ability for organisational form to be delivered by April 2011 and also that some of the detail around the key policies is likely to be a further year away. One of the key risks is there is still no clarity on estates – which might be moved into the community provider. The KCHSB RECEIVED and NOTED the Managing Directors Report KCHSB 10 190
Finance and Performance Lead’s Report Finance Report JB summarised the financial report to update the Board on: August 2010 Financial Position. Overall costs were £3k favourable in the month, the favourable total of £178k in the report is an error, and £217k favourable Year To Date. Contracted headcount has continued to fall a further 6.5 in month, and is now 55.9 WTE below budget. This has resulted in £469k cost savings to date. The pay savings and income benefit have been partially offset through the following risks: - New risk of £40k identified this month following the purchase of 11 beds for KICES due to increased demand. - In addition, previously identified risks of £261k due to : CQC registration, £30k, District Nurse Messaging Services for 09/10 and 10/11, £75k, QOF costs, £33k, Locum Cover, £40k, Tough books revenue costs of £83k. Full year risk of £28k, includes risks on District Nursing Equipment £100k, which is to be resolved with NHSK as part of on-going contract and overhead discussions. On resolution, the underlying position will be £63k favourable. There has been limited progress with the contract variations but KCHS have been assured by NHS Kirklees that there will be a summit in the next few weeks to resolve all overheads. Cost Improvement Plans Overall Cost Improvement Plans on track with full year target, although there are shortfalls in travel. DN Efficiency Project has agreed an Optimal Team Time Waterfall, which will yield annualised savings of £1.2m compared against the original target of £1.4m. Currently on track to deliver financial benefits through headcount reduction, although there are challenges delivering the target clinical time. Action 1 – JB to share DN Waterfall with DN teams. Performance Report Overall performance on track with targets, with on-going exceptions in 2
Community OT, Acute OT and Speech & Language. Some improvements demonstrated. Immunisations for children aged 5 are below target but there are some changes to scheduling to drive up the numbers. HPV target will not be achieved as only 86.4% of target population achieved the first dose. There is a need to understand the business implications. DN Project – clinical time delivered is showing marginal improvements over last 3 months, but looks to be at risk of the 45% target by Dec. Contacts per WTE is not increasing sufficiently towards the target. HPV target will not be achieved as only 86.4% of target population achieved the first dose – need to understand the business implications. Action 2 – RF to investigate if the Immunisation Team have flexible hours to accommodate the fluctuations in demand for immunisations. Management Costs The Voluntary schemes have been offered to T30 managers, but costs significantly outweigh the benefit. The implementation of the scheme depends on whether KCHS receives central funding. The KCHSB RECEIVED and NOTED the Finance and Performance Lead’s Report KCHSB 10 191
Professional accountability framework Joan Booth (JEB) summarised the professional accountability framework (nursing) report. JEB in her capacity as KCHS Lead Nurse attends national and regional nursing meetings. She attends meetings with the Director of Patient and Professions (NHS Kirklees) and KCHS Professional Lead and meetings with the KCHS Professional Lead and Head of Integrated Governance. JEB updates registered nurses on professional issues. She is also shadowing front line staff. The mechanism for cascading alerts has been made more robust. Professional fora have been planned. JEB will be encouraging staff to sign up to the 6 key CNO High Impact Actions which mostly fit in with KCHS CQuIN targets. JEB alerted the Board to the significant amount of work required of a professional lead in a small organisation and gave examples of the need for Infection Control, Safeguarding and Training to be incorporated into that role. Action 3 – TQ to incorporate an update on nursing into every Clinical and Operational Lead’s Board Report. Action 4 – TQ to ensure there is a scheme of delegation of authority from the Director of Patient and Professions (NHS Kirklees) to designated staff in KCHS. Action 5 – JEB to ensure that notes of cascade meetings with staff are fed into the Governance Committee Action 6 – JEB to consider how to link professional standards and training with the business standards and strategic objectives. Action 7 – TQ to link accountability to Integrated Governance. Action 8 – GR to ensure that professional self-regulation policy is 3
completed. The KCHSB RECEIVED and NOTED the Professional Accountability Framework (Nursing) Report KCHSB 10 192
HR Quarterly board Report LC asked the Board to inform her if there should be alterations to the structure of her report. LC presented the HR Quarterly Board Report. KCHS turnover of staff is consistent at approximately 10% during 2010/11. The latest sickness figures available are from July 2010. These indicate that sickness absence in KCHS has risen for the second month in a row, and stands at 4.6%. This figure is higher than the regional PCT average sickness absence rate. Managers are working with HR staff to bring the level of sickness down. Action 9 – LC to investigate if sickness reporting is electronic or paper based and that all reports are included in the statistics. LC to report to the Workforce Committee. PD asked about costs for disciplinary hearings. KCHS pay the costs including legal costs. These are taken from department budgets. Action 10 – LC to ask Terry Service which costs are picked up by the Litigation Authority. Action 11 – LC to inform the Board if any pending employment Tribunal cases against KCHS. SBE said that disciplinary issues should be dealt with by KCHS not NHS Kirklees. LC and RF confirmed that KCHS managers hear KCHS cases wherever possible. Action 12 – Disciplinary issues will be discussed at the next meeting between the Chair and Managing Director of KCHS and the Chair and Chief Executive of NHS Kirklees. LC reported that the Governance Team are to host a Future Jobs Fund placement. RF will be discussing Management Training and E-KSF with LC. The KCHS Board RECEIVED AND NOTED the Workforce Report.
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HR Policy Review paper for information The KCHS Board RECEIVED AND NOTED the HR Policy Review Paper.
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HR Strategy for approval PD would like a KCHS Director to be the lead for the KCHS Human Resources Strategy. The Board agreed RF is the responsible Director. The KCHS Board APPROVED the KCHS Human Resources Strategy 2010 – 2015. 4
MINUTES FOR INFORMATION KCHSB 10 193
Finance, Performance & Business Development Minutes of meeting held 19th August 2010 The KCHS Board RECEIVED and NOTED the Draft Minutes of the Finance, Performance & Business Development.
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Governance Committee Minutes of meeting held 3rd June 2010 The KCHS Board RECEIVED and NOTED the Minutes of the Governance Committee
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Workforce Committee Minutes of meeting held 3rd September 2010 – Draft The KCHS Board RECEIVED and NOTED the Draft Minutes of the Workforce Committee. Any Other Business There was no any other business. Date and Time of Next Meeting 28th October 2010 08:30 – 12:00 Beckside Court MR 2
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