KIRKLEES PRIMARY CARE TRUST
Minutes of the Trust Board Meeting held on Wednesday 30 January 2008 at 9.15am in Meeting Room 1, Beckside Court, Batley Present: Rob Napier Mike Potts Vanessa Stirum Mehboob Khan Tony Gerrard Rob Millington Imran Patel Valerie Aguirregoicoa Dr David Anderson Bryan Machin Carol McKenna Sheila Dilks Dr Judith Hooper In attendance Robert Flack Peter Flynn Sue Ellis
Chair Chief Executive Non-executive Director and Vice Chair Non-executive Director Non-executive Director Non-executive Director Non-executive Director Non-executive Director (from 9.55am) Chair Professional Executive Committee Executive Director of Finance Executive Director of Commissioning and Strategic Development Executive Director of Patient Care and Professions Executive Director of Public Health Director of Provider Services Director of Performance and Information Director of Human Resources and Organisational Development Chair of the Patient and Public Involvement Forum Observer, Patient and Public Involvement Forum Communications Officer Head of Corporate Governance and Services Executive Assistant Corporate Governance Administrator
David Thompson Bob Thomlinson Helen Haythorne Pat Patrice Pauline Kershaw Alison Fearnley One member of the public David Bundy Kirklees Council Policy Team (item KPCT/08/11) Richard Dunne Kirklees Council Policy Team (item KPCT/08/11) Karen Hemsworth Assistant Director for Safeguarding Children and Young People (item KPCT/08/16) Rob Napier opened the meeting by welcoming all those in attendance. Questions from members of the Public The Chairman gave members of the public an opportunity to raise any questions. No questions were raised.
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KPCT/08/01
Apologies for Absence Apologies for absence were received from Helena Corder, Director of Corporate Services and Sarah Brackwell, Professional Executive Committee member.
KPCT/08/02
Declarations of Interest No Trust Board members declared interests in any of the agenda items.
KPCT/08/03
Minutes of the last meeting held 19 December 2007 The minutes of the Trust Board meeting held on Wednesday 19 December 2007 were AGREED as a true and accurate record.
KPCT/08/04
Matters Arising KPCT/07/229
Corporate Performance Report
Carol McKenna provided a verbal update on performance against the Yorkshire Ambulance Service target. She confirmed that the PCT is part of the Consortia Contract for this service and that Wakefield is the lead PCT. It was noted that ÂŁ1m additional funding had been agreed to support this service however there was still a risk around achievement of this target. Carol reassured the Board that this would continue to be robustly monitored. Mike Potts advised the meeting that the Professional Executive Committee (PEC) had considered an action plan to improve performance against Chlamydia screening. KPCT/07/234
Draft Estate Development Strategy
Vanessa Stirum asked what the timescale was for getting the Strategic Services Development Group operational and what the interim arrangements were. It was noted that the Estates Strategy Committee would remain in existence and continue to monitor estates issues until another forum is established. In addition it was noted that the Estates Strategy would be shared with GP practices following Local Medical Committee (LMC) consultation. KPCT/08/05
Chief Executive’s Report Mike Potts presented his report to the Board highlighting the following:
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KPCT/08/05.1
Joyce Catterick, Chair, Calderdale Primary Care Trust
It was noted that Joyce Catterick will be leaving Calderdale PCT to take up her new post as Chair of South West Yorkshire Mental Health Trust, as from 1 February 2008. Angela Monaghan will be stepping up as Chair at Calderdale PCT. KPCT/08/05.2
Chief Executive, Yorkshire Ambulance Services (YAS)
Martyn Pritchard has been appointed Chief Executive, YAS, with effect from 1 January 2008. KPCT/08/05.3
Postgraduate Dean for Yorkshire and the Humber
Professor Sarah Thomas has been appointed Postgraduate Dean Designate – Yorkshire and the Humber. Sarah will formally take up the post with effect from August 2008. KPCT/08/05.4
South West Yorkshire Mental Health Trust (SWYMHT)
SWYMHT has now been given the go ahead from the Government to go to the next stage of becoming a Foundation Trust. KPCT/08/05.5
NHS Direct
NHS Direct have applied to become an NHS Foundation Trust and would like views on the public consultation which is running from 10 December 2007 to the end of March 2008. A copy of the consultation document is available from the Chief Executive’s Office or a summary version can be accessed on www.nhsdirect.nhs.uk/foundationtrust/summary-consulation. It was AGREED that the Senior Management Team (SMT) would comment on this and feedback to the Board. KPCT/08/05.6
Joint Development Session with Kirklees PCT Senior Management Team and Kirklees Council Executive Management Group
A joint development session is to be arranged in the Spring of 2008 with SMT and EMG. This follows a couple of joint SMT/EMG meetings which have taken place during the last few months.
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KPCT/08/05.7
World Class Commissioning
It was noted that the PCT had not received any further guidance on how World Class Commissioning will be rolled out and what is expected of the PCT. It is therefore proposed that the Board Development session on this subject is postponed until the PCT has received further guidance from either the Department of Health or the Strategic Health Authority (SHA). KPCT/08/05.8
Mobile Operating Theatre
A mobile operating theatre has been commissioned for a period of 6 weeks to help reduce waiting times in dermatology and podiatry which is located at Holme Valley Memorial Hospital. The PCT is one of the first to commission this facility in Yorkshire and the Humber. KPCT/08/05.9
2008/09 Planning Process – Timeline
The Board was advised that the process was progressing well. One of the key milestones was the discussion between the PEC and the Practice Based Commissioning (PBC) Consortia leads on the development proposals for next year. Proposals for 2008/09 will be presented to the Board on 27 February 2008 as originally agreed. KPCT/08/05.10
Kathryn Riddle, Chair of Yorkshire & the Humber Strategic Health Authority
Rob Napier provided feedback on Kathryn’s recent visit to the PCT and said it was a successful and enjoyable day. KPCT/08/05.11
Fire Safety Holme Valley Memorial Hospital
Mike advised the meeting that he had received a letter from West Yorkshire Fire Service stating that the PCT is not fully compliant with the current Fire Safety regulations at Holme Valley Memorial Hospital. He confirmed an action plan had been put together to address the issues which will be robustly performance monitored by the Provider Board. Mike also confirmed he was responsible for signing an annual Fire Safety Certificate for the PCT and confirmed there was nothing significant to report.
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KPCT/08/05.12
Obesity Strategy - Health Weight, Health Lives: A cross-government Strategy for England
Mike advised the Board that a copy of the Obesity Strategy is available from the Chief Executive’s Office at St Luke’s House if anyone is interested. The Board RECEIVED and NOTED the contents of the Chief Executive’s Report. KPCT/08/06
PEC Chair’s Report Dr David Anderson presented his report highlighting the following: The interviews for Clinical Leads had taken place and the following posts had been filled: • • • • •
Cardiovascular – Dr Chris Beith Mental health – Dr Nicholas Kaye Diabetes – Dr Mark Freeman Respiratory – Dr Handa Obesity – Gill Hawksworth
The HIT teams will make contact with the individual leads to develop the role. A process for filling the additional lead areas will be defined, which include; long term conditions, musculoskeletal rheumatology and pain, cancer, stroke neurology. It was noted that David Wood had agreed to be the Deputy PEC Chair. The PEC had its first joint meeting with PBC colleagues on 16 January 2008. Time was spent considering the factors influencing the strategic direction of the PCT and the role of the PEC and PBC in defining this and how they might best work together in the future. The second part of the meeting focused on the consideration of over 20 business plans seeking clinical support and recommendation. The PEC then considered issues around Chlamydia screening. The PEC will be working with the Communications Team in developing a Newsletter for frontline clinicians. Finally David briefed the Board regarding the negotiations which are taking place between the General Medical Council (GMC) and Department of Health (DH) around the General Medical Service (GMS) Contract. He explained that there was an area of conflict around the new contract which could be imposed on 1 April 2008. Page 5 of 14
It was noted that David would try and put forward the PCT’s position at the next Local Medical Committee (LMC) meeting. The Board RECEIVED and NOTED the contents of the PEC Chair’s Report. KPCT/08/07
Finance Report Bryan Machin presented the Finance Report which updated the Board on the current financial position. He advised the Board that the 2007/08 forecast surplus had increased from £7m to £7.4m. It was noted that the PCT is still negotiating with the Strategic Health Authority concerning the level of surplus that can be carried forward. Bryan summarised the changes to the financial forecasts. These changes include: • •
An increase in Acute NHS Commissioning costs An increase in Public Health Commissioning costs
These have been in the main offset by: • • •
A reduction in the prescribing expenditure as forecast by the Prescribing Pricing Agency A reduction in dental expenditure A forecast underspend of reserves
It was noted that performance against the Public Sector Payment target had increased in November to 91% and had increased further in December to 95%. The Board RECEVIED the report and NOTED: •
The income and expenditure position of the PCT and the associated risks; and
•
Forecast performance against the PCT’s other key financial duties/targets.
Bryan also presented a report to the Board on the Approval of Capital Budgets. He explained that the purpose of the report was to seek approval from the Board for a number of additional capital budgets and to request delegated authority to approve capital expenditure. Attention was drawn to the budget approval sought for new schemes and overspends on schemes: These included:
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Capital budgets proposed for approval - new schemes: • • • •
£20k Slaithwaite Health Centre – Residual Cost £80k Podiatry Saw – for use in Provider Podiatry services £10k Holme Valley Memorial Hospital – Minor works £9k New Boiler Golcar Clinic
Capital budgets proposed for approval – overspends on schemes: • • •
£60k Community Equipment Store – to meet enhanced health and safety requirements £257k Digital Hearing Aids – potential call on capital funds subject to clarification of account treatment £11k Trash Screen Cleckheaton – additional work required to successfully complete scheme
A discussion ensued regarding the approval limits. It was recognised at present the Board is formally required to approve all capital expenditure. However on occasion it is necessary to react quickly to events or to make quick decisions in the interests of the service. To enable this to happen it was proposed that the Board delegate authority to the Chief Executive and the Director of Finance, acting jointly, to approve additional capital expenditure required either on existing schemes or new projects to the value of £50k. The Board AGREED to:
KPCT/08/08
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Approve the capital budgets outlined above.
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Delegate authority (£50k) to the Chief Executive and Director of Finance to approve additional capital expenditure.
Performance Report Peter Flynn presented the Corporate Performance Report to the Board. He explained that the January report is the first report produced by the Performance Accelerator system and is split into four sections. Section one summarises performance against all key targets. Section two is the Exception Report provided directly from Performance Accelerator as those areas where performance is traffic lighted as red or amber. The third section gives more details against targets in graphical format. The fourth, details Breaches. There was a discussion regarding performance against the 18 week waiting time target. Peter explained the work which is being undertaken to achieve this target.
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Rob Millington explained that the Finance and Performance Committee had a presentation on the 18 week waiting time target and confirmed that the Committee gained assurance that the PCT is on line with the reporting mechanisms that match the Operating Framework. There was a discussion regarding Primary Care Access. Mehboob Khan explained that it had been brought to his attention that some GP surgeries were not offering appointments ahead of time and that patients were only able to access an appointment on the day of calling. It was AGREED that Carol McKenna would look into this issue if Mehboob provided her with the patients’ details. Peter explained that one of the reasons why performance against Chlamydia screening is not on target is due to the process of data collection. It was noted that the screening programme is working with the labs to identify all screens that are processed and identify if they can be incorporated into the programme. Mike Potts agreed to discuss joint representation regarding GUM targets with Chief Executive colleagues. Valerie Aguirregoicoa enquired why GPs were not interested in signing up to Choose and Book. Carol McKenna explained that there were a range of reasons including concerns about the IT system. Robert Flack updated the Board on progress toward recruiting more Community Matrons. He advised that three new members of staff were due to take up appointments within the next few weeks with a further three due to commence in the next couple of months. In addition two Community Matrons Roadshow events had been organised for 6 and 14 February where interested nurses can come along and find out about the duties, qualifications and training and chat to existing Community Matrons. Sheila Dilks advised the Board that a whole system redesign for long-term conditions will be taking place and a report would be brought to a future Board meeting for discussion. Finally it was noted that Performance Accelerator training would be given to Board members at the next Non-executive Director meeting in February. The Board RECEIVED and NOTED the Corporate Performance Report.
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KPCT/08/09
NHS Review update Mike Potts provided a verbal update on progress with the NHS Review. He advised the Board that PCTs had been requested by the Strategic Health Authority to have local discussions following on from the work done by the Clinical Pathway Groups, as part of the NHS Review. A half day, economy wide event has been arranged on Tuesday 5 February 2008, 1.00pm to 5.00pm, at Cedar Court Hotel, Ainley Top, Huddersfield. The event will include key people, such as local senior clinicians, PCT directors, Clinical pathway representatives, representatives from the Local Authority, Voluntary sector and PPI Forum. A similar event has been organised by Wakefield PCT on Thursday 7 February 10.00am to 1.00pm at Featherstone Rovers. Carol McKenna briefed the Board on the Primary Care procurement process. She explained that plans for a GP led Health Centre had to be submitted to the Strategic Health Authority that would result in such a centre being operational by December 2008. It was recognised that the timescales for achieving this were challenging.
KPCT/08/10
Voluntary and Community Sector Draft Strategy Mike Potts presented the Draft Voluntary and Community Sector Strategy. He explained that the strategy presents a five year vision for the Kirklees Partnership which has been developed by a wide partnership of organisations and individuals in the voluntary, community and statutory sector to set out priorities and commitments to each other to make ambitions a reality. The Board RECEIVED and ENDORSED the Voluntary and Community Sector Draft Strategy.
KPCT/08/11
Kirklees Partnership Community Cohesion Strategy The Chairman welcomed David Bundy and Richard Dunne from Kirklees Council Policy Team, Policy and Governance Service, who gave a presentation to be Board on the development and implementation of the Kirklees Partnership Community Cohesion Strategy. David briefed the Board on the five themes within the strategy and circulated the draft priority ‘outcomes’ and ‘actions’ to the Board. These themes include: • • • • •
Leadership and Communication Young People Community, Diversity, Faith and Voluntary sector Shared Places/Opportunities for All Preventing/Managing Tensions/High Risk Areas Page 9 of 14
He explained that the strategy would be launched on 7 March 2008 and emphasised that it needs to be embraced and embedded with all partnership organisations across all services and partners. It was recognised that the PCT’s contribution was fundamental to addressing the underlying issues that prevent cohesion such as tacking health inequalities. It was noted that the strategy covers all communities and delivery of the outcomes will be facilitated through the locality agenda. It was recognised that the strategy will empower neighbourhoods and address issues of segregation and isolation. David emphasised that the strategy is a framework with which to work with that will evolve over time and highlighted that we need to build on capacity that already exists in a more coherent way. The Board emphasised the need for a consistent approach across all partnerships. In addition it was recognised that locality working would be an essential element to embedding the strategy with frontline staff and clinicians as well as involving wider leadership from GPs, Dentists and Pharmacists etc. The Board welcomed the strategy and AGREED to:
KPCT/08/12
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Adopt the community cohesion strategy on behalf of the PCT.
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Along with other partners and the council work towards embedding and implementing cohesion outcomes into the core business of the PCT.
Equality and Diversity Update This Agenda item was withdrawn from the meeting. Mike Potts advised this would be presented to the Board at a future date.
KPCT/08/13
Use of the PCT Seal The Board APPROVED the use of the PCT’s Seal to be applied to an inherited agreement from Huddersfield Central PCT between the PCT, the Council and Fresh Horizons – relating to the ‘Building for the Future’ Project. The Board APPROVED the use of the PCT’s Seal in confirming the conditional contract for sale to Oakdale Developments in the sum of £405,000.
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KPCT/08/14
Review of the Patient and Public Involvement (PPI) Committee Pat Patrice presented the Board with revised Terms of Reference for the Patient and Public Involvement Committee for approval. She explained that a review had been undertaken of the Communications and PPI function to meet internal PCT need and external factors such as national policy direction to support World Class Commissioning and the focus in the Operating Framework. Pat explained that the first sentence of the Terms of Reference should read ‘The PCT was established in October 2006, during the summer months of 2007 the PCT’s governance arrangements have been reviewed’. The Board acknowledged that the title of the Committee had been changed from Patient and Public Involvement Committee to Communications and Public Relations Committee. It was noted there was inconsistency in the title of the Committee within the Terms of Reference which would be amended. Imran Patel confirmed he was the nominated Non-executive Director who would represent this Committee. The Board APPROVED the revised title and Terms of Reference of the Patient and Public Involvement Committee to the Communications and Public Relations Committee.
KPCT/08/15
Infant Deaths in north Kirklees Dr Judith Hooper presented the Infant Deaths in north Kirklees Report to the Board. She explained that the report is an investigation into the factors which affect infant mortality in parts of Batley, Dewsbury and Spen and describes recommended actions for how such tragedies could be reduced. Judith explained that the common themes coming out of their research, which had a direct impact on the local rate of infant death, included poor maternal health and nutrition before and during pregnancy with specific concerns being around smoking. An additional factor was a relatively high rate of congenital abnormalities which can occur for a variety of reasons. It was noted that the PCT is working with staff to make sure the right information is available to women thinking about having a baby as well as those who are already pregnant. Topics will include giving up smoking, nutrition advice, alcohol consumption and antenatal care. The Board APPROVED the following:
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KPCT/08/16
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Supporting healthy personal behaviours of women of child bearing age, across the public sector in Kirklees.
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To work with relevant local people in understanding the impact of genetics which may cause infant death or disability.
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Good accessible and holistic antenatal care.
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For the local NHS to improve systems, processes and data.
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To support any further relevant research.
Annual Report: Safeguarding Children & Young People The Board welcomed Karen Hemsworth, Assistant Director for Safeguarding Children and Vulnerable Adults, to the meeting to present the Safeguarding Children and Young People Annual Report. Karen explained that the report illustrates the current picture across Kirklees and outlines the safeguarding provisions that are in place. Karen highlighted the key achievements over 2007 and the areas for further development in 2008. The Board acknowledged that safeguarding children is at the core of everything we do as a PCT and recognised the importance of partnership working. There was a discussion regarding the number of children reregistered on the child protection register. Karen confirmed that the Safeguarding Children’s Board are planning an event to consider all Serious Case Review trends and would review issues concerning communication and sharing of information. Mike Potts enquired whether there was any assessment about the Local Authority’s role in Corporate Parenting. Karen advised that the Local Authority had established a Corporate Parenting Panel. Mehboob Khan said it would be useful for the Council to receive an analysis of where the likely trends are which would assist with financial planning. It was noted that the Board would welcome a robust work programme for 2008. The Board RECEIVED and NOTED the Safeguarding Children and Young People Annual Report.
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KPCT/08/17
The Joint Area Review Carol McKenna presented the Joint Area Review final report and actions required. She explained that the report summaries the priority areas which require action. It was noted there are two priority areas for action and three actions for Kirklees PCT identified as well as the PCT playing a key role within the Kirklees strategic partnerships. The two priority areas are the improvement of interpreting services within the PCT and the need to develop a consistent approach across Kirklees for high level interpreting services, especially within face to face contacts. The second priority area is the reduction of autism assessment waiting times. It was recognised that the PCT is working towards introducing interpreting services into areas where it has not traditionally been available. The Board RECEIVED and ENDORSED the actions to be taken.
KPCT/08/18
Community Hospitals Programme Carol McKenna provided the Board with a verbal update on the Community Hospitals Programme. She advised the PCT is working with Practice Based Commissioners regarding the strategy and programme which will fit with a whole range of services. Proposals in the original bid were for three sites in the Huddersfield area, however the phasing of the programme is now being reviewed and it may be some amendments need to be made to the programme. Carol confirmed this topic would be subject to discussion at the Board Development session in March 2008.
KPCT/08/19
Minutes of the Professional Executive Committee The Board RECEIVED and NOTED the minutes of the PEC meeting held on the 5 December 2007.
KPCT/08/20
Minutes of the Finance and Performance Committee The Board RECEIVED and NOTED the minutes of the Finance and Performance Committee held on the 21 November 2007.
KPCT/08/21
Minutes of the Audit Committee The Board RECEIVED and NOTED the minutes of the Audit Committee held on the 19 November 2007. Page 13 of 14
KPCT/08/22
Minutes of the HR/OD Shared Service Governance Board The Board RECEIVED and NOTED the minutes of the HR/OD Shared Service Governance Board meeting held on 27 November 2007.
KPCT/08/23
Any Other Business There were no other items of business.
KPCT/08/24
Date and time of the next meeting It was AGREED that the next meeting of the Kirklees PCT Trust Board would take place between 9.15am and 1.00pm on Wednesday 27 February 2008 in the Board Room at St Luke’s House, Huddersfield.
Questions from the Public The Chairman gave a final opportunity for members of the public to raise any questions regarding the business of the day. No questions were raised.
Chairman’s Signature: ………………………………….
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Date: ………………