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NHS Wakefield District BOARD MEETING Minutes of the Meeting held on Wednesday 28 September 2011 held in the Board Room, White Rose House, West Parade, Wakefield, WF1 1LT Present

In attendance

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Roger Grasby Andy Leary Dr Andrew Furber Dr Matt Walsh Dr Peter Flynn Dr Phil Earnshaw

Chair Executive Director of Finance and Efficiency Director of Public Health Executive Medical Director Director of Performance and Commissioning Intelligence Commissioning Executive Committee Chair

Gill Galdins Heather O’Donnell Jo Webster Mike Potts Rhod Mitchell Sandra Cheseldine Sue Ellis Susan Davis

Chief Operating Officer Non-Executive Director Clinical Commissioning Group Director Chief Executive Non-Executive Director Non-Executive Director Director of HR and Organisational Development Non-Executive Director

Adam Bassett Hilary Rowbottom Marie Gibb

Corporate Risk Manager LINk Representative Minute 11/139 only

Apologies for Absence Apologies for absence were received from Ann Ballarini and Sue Cannon.

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Chair's Opening Remarks The Chair noted that this would be the 57th and final meeting of the NHS Wakefield District (NHSWD) Board and was taking place almost five years to the day of the first meeting. He noted that some Non-Executive colleagues would be departing at the end of September and he wished them well and offered his thanks to all who had been involved in the workings of the Board. The Chair further noted that Andy Leary would be leaving his post of Executive Director of Finance and Efficiency at the end of September and he wished him well for the future. In response Andy Leary thanked the Board and its Committees for the support he had received and noted that even though he was sad to leave he was looking forward to the new challenge he was taking on.


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Minutes of the Meeting held on 2 August 2011 It was RESOLVED that the minutes of the meeting held on 2 August 2011 be confirmed as a correct record.

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Matters Arising There were no matters arising.

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Disclosure of Interests None

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Exclusion of the Press and Public It was RESOLVED that "representatives of the press and other members of the public be excluded from part 2 of this meeting having regard to the confidential nature of the business to be transacted, publicity on which would be prejudicial to the public interest." (Section 1(2) Public Bodies (Admission to meetings) Act 1960)

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Chief Executive's Report Mike Potts introduced this report noting the following: a

SHA Cluster Appointments The Board was advised that a letter had been issued from the Department of Health advising on new appointments to the North of England SHA Cluster. These were as follows: Chief Executive Chief Operating Officer Chief Nurse Director of Finance Medical Director Director of Workforce and Education Director of Public Health

Sir Ian Dalton Richard Barker Jane Cummings Mark Ogden Professor Stephen Singleton Tim Gilpin Professor Paul Johnstone

He also noted that Bill McCarthy would be moving to his new role supporting the development of the NHS Commissioning Board.

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b

Director of Finance The Board was advised that Julie Lawreniuk would be providing short term cover for the Executive Director of Finance role following the departure of Andy Leary. It was reported that interviews had taken place on 27 September for an interim Director of Finance for a period of six months and it was hoped that an announcement would be made shortly.

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NHS Wakefield District Board Mike Potts offered his personal thanks to the NHSWD Board and gave particular thanks to the Chair and Non-Executive Directors for the work they had undertaken over the lifetime of the Board.

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Legacy Document The Board was advised that in response to the structural changes initiated by the White Paper, Liberating the NHS (June 2010) and the known risks associated with large scale change, all PCT Clusters were obliged to ensure that robust handover arrangements were in place to enable a smooth transition to successor organisations. This robust system of handover needed to effectively capture and transfer the organisational memory. A legacy document, attached to the report, for NHSWD aimed to enable this smooth transition and retention of corporate memory. The legacy document detailed areas which had been managed to date by the Board of NHSWD for its local population and confirmed details relating to: Corporate Performance Quality and Safety Finance and QIPP Risk Management Governance It was reported that the document was primarily intended to signpost to the other governance arrangements and papers which had underpinned the business of NHSWD.

It was RESOLVED that the matters set out in the legacy document for NHS Wakefield District be supported.

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NHS Wakefield District Board Assurance Framework Gill Galdins introduced a report which enclosed the Board Assurance Framework for NHSWD. A summary was attached at Appendix 1 and the report detailed the specific risks which provided the current position statement on risks facing NHSWD as at September 2011. It was reported that as part of the move to establish Cluster Board governance arrangements from October 2011, this document provided information on the local risks affecting the Wakefield district for onward management with the Cluster to ensure that risks were appropriately managed. The Board Assurance Framework (Appendix 2) had been reviewed by the lead Directors for respective risks and was brought to the Board for approval. It was reported that, with the proposed changes of two risks being removed and one new risk relating to infection prevention and MRSA, there were now 14 risks on the Board Assurance Framework. The Board noted that there were also some issues in the Assurance Framework which required updating, such as references to previous years and risks which could be combined. It was also acknowledged that a single Assurance Framework was to be created for the Cluster. Board members highlighted that there were inconsistencies in scoring across the Cluster and that there had been conflicting advice from Internal Audit and from the SHA regarding scoring. It was agreed that Sue Cannon would be asked to examine these issues as part of the development of the Cluster Board Assurance Framework. It was RESOLVED that i

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Board members approved the Board Assurance Framework, including the additions and removals noted within the report; and the Director of Quality and Governance (Nursing) be asked to review the scoring as part of the development of a Cluster-wide Assurance Framework.

Proposed Governance Arrangements for the NHS Calderdale, NHS Kirklees and NHS Wakefield District Cluster Board Mike Potts introduced a report which provided a description of the governance arrangements being developed to support a single Cluster Board for NHS Calderdale, NHS Kirklees and NHS Wakefield District. The report set out the key elements of work being undertaken and the timetable for sign-off and implementation of the new arrangements. 4


It was reported that from 1 October 2011 there would be a single Cluster Board. As part of this process a Legacy Report had been produced which set out the key areas of performance and delivery and the issues and actions to be addressed by the Cluster Board and its sub-committees. Attached to the report were details of the proposed governance arrangements for the Cluster Board. Appendix 2 contained details of the transition of Board Committees, Appendix 3 provided a Legacy Report for NHSWD Board Committees and Appendix 4 contained a description of the role of the Non-Executive Associate. The Chair asked for clarification on the future role of the Public Involvement and Patient Experience Committee (PIPEC) meeting. It was acknowledged that this Committee would continue and would report to the Commissioning Executive Committee. The Board also agreed that Heather O'Donnell and Rhod Mitchell be appointed to the role of Non-Executive Associate. It was RESOLVED that i

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the report setting out the proposed governance arrangements to support the establishment of the Cluster Board be received and noted; the Cluster Board and Board Committee structure would take on the statutory responsibilities of the NHSWD Board and its Board Committee structure, which was therefore disestablished; the Non-Executive Director appointments to the Cluster Board be approved; and the appointments of the Non-Executive Associates for the Wakefield district be approved.

Finance Report Month 4 2011/12 Andy Leary introduced a report which showed the financial position at the end of July and the forecast outturn position for 2011/12. The Board was advised that NHSWD was on course to achieve each of its key financial performance indicators. It was reported that at the end of July NHSWD was showing a position to date of ÂŁ554k underspend with a forecast year-end position of breakeven. The forecast outturn was after achieving the target surplus of ÂŁ3,100k as required by the Strategic Health Authority (SHA). Andy Leary highlighted that NHSWD faced areas of financial risk which were continually being monitored and managed. These areas were outlined within the report.

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It was RESOLVED that i ii

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the revenue financial position at the end of July and forecast year-end position be noted; and the plan to invest in the prioritised capital schemes within the funding available throughout the financial year be noted.

Finance Report Month 5 2011/12 Andy Leary introduced a report which showed the financial position at the end of August and the forecast outturn position for 2011/12. The Board was advised that NHSWD was on course to achieve each of its key financial performance indicators. It was reported that at the end of August NHSWD was showing a position to date of £1,212k underspend with a forecast year-end position of breakeven. The forecast outturn was after achieving the target surplus of £3,100k as required by the SHA. Andy Leary highlighted that NHSWD faced areas of financial risk which were continually being monitored and managed. These areas were outlined within the report. The Board was also provided with an update on the capital position and was advised that there had been no capital income or expenditure during the month. Proceeds had been received for Rosegarth and Upton Health Centre to the value of £318k. It was RESOLVED that the revenue financial position at the end of August and forecast year-end position be noted.

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Annual Audit Letter Andy Leary introduced a report which summarised the findings of the District Auditor on the 2010/11 external audit review. These findings had been discussed and accepted by the Audit Committee and the annual accounting statements for 2010/11 had been accepted and adopted by the Board and this was the final stage in the completion of the 2010/11 audit review. It was RESOLVED that the Annual Audit Letter for 2010/11 be received.

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Director of Public Health Annual Report 2011 Dr Andrew Furber introduced the Director of Public Health Annual Report 2011 which looked at progress on reducing health inequalities in the district. The report had a particular focus on those factors which made some people more vulnerable to poor health and wellbeing. Learning disability was used as an exemplar of local progress. To assist in presenting the report Dr Furber was joined by Marie Gibb, Strategic Health Facilitator. As part of the report, the Board was shown one of three videos about people living and using services in the Wakefield district. This focused on Tim who lived in Featherstone and was one of nine other people living in a residential care home for people who have learning difficulties. The video provided an overview of his experience with Annual Health Checks. It was highlighted that the report, together with the videos, would be available on the NHSWD website. The report also provided a summary of three recommendations from the report and an outline of how it would be known if these had been implemented. The recommendations were as follows: Commissioners and providers of health and social care need to recognise and address the needs of vulnerable individuals and groups. Commissioners and providers of health and social care need to build on the good progress made in supporting people with learning disabilities so that health and wellbeing is further improved. Wakefield Together partners need to reflect on the latest data from the Health Equity Audit and Index of Multiple Deprivation and use these to inform decision-making. The Board noted the recommendations and requested that a mechanism be found to ensure that the feedback on these was captured in future organisational arrangements. The report also provided review on the recommendations of the 2010 report and provided an update on progress. It was RESOLVED that the content and recommendations of the Director of Public Health's Annual Report 2011 be noted.

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Minutes of the Audit Committee Meeting held on 3 June 2011 It was RESOLVED that the minutes of the Audit Committee meeting held on 3 June 2011 be noted.

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Minutes of the Audit Committee Meeting held on 16 September 2011 Sandra Cheseldine informed the Board that this meeting had received the Annual Audit Letter and considered Cluster governance arrangements. She also noted an Internal Audit report which had given 'full assurance' on their review of public and patient involvement. It was RESOLVED that the minutes of the Audit Committee meeting held on 16 September 2011 be noted.

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Minutes of the Commissioning Executive Committee Meeting held on 7 July 2011 Dr Phil Earnshaw advised that this meeting had considered the Mid Yorkshire Hospitals NHS Trust (MYHT) Hyperacute Stroke and Transient Ischemic Attack Business Case. It was RESOLVED that the minutes of the Commissioning Executive Committee meeting held on 7 July 2011 be noted.

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Minutes of the Commissioning Executive Committee Meeting held on 1 September 2011 Dr Phil Earnshaw noted that an informal meeting of the Commissioning Executive Committee had also taken place on 4 August 2011. The meeting held on 1 September 2011 had considered the Community Specialist Obesity Service for Adults. It was RESOLVED that the minutes of the Commissioning Executive Committee meeting held on 1 September 2011 be noted.

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Minutes of the Finance and QIPP Committee Meeting held on 20 September 2011 Rhod Mitchell advised that the emphasis of this meeting had been on taking the QIPP agenda forward and focusing on those items which would deliver the greatest savings. He further advised that there was a requirement to focus on plans for next year. Mike Potts acknowledged that there was now a requirement to focus QIPP on the large transformational issues. He noted that the Cluster Board would shortly have a session on QIPP. It was RESOLVED that the minutes of the Finance and QIPP Committee meeting held on 20 September 2011 be noted.

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Minutes of the Governance, Performance and Risk Committee Meeting held on 8 September 2011 Heather O'Donnell informed the Board that this meeting had considered an update to the Corporate Risk Register and had received an update from Dr Johnson D'Souza on the Revalidation of GPs. It was RESOLVED that the minutes of the Governance, Performance and Risk Committee meeting held on 8 September 2011 be noted.

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Minutes of the Annual General Meeting held on 19 July 2011 at St Catherine's Church, Wakefield The Chair informed the Board that this event had gone well and had received some very positive feedback It was RESOLVED that the minutes of the Annual General Meeting held on 19 July 2011 at St Catherine's Church, Wakefield be noted.

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Minutes of the Public Involvement and Patient Experience Committee Meeting held on 8 September 2011 The Chair advised that this meeting had considered an Alcohol Place Budgeting Project and an update from Dr Phil Earnshaw on clinical commissioning. It was RESOLVED that the minutes of the Public Involvement and Patient Experience Committee meeting held on 8 September 2011 be noted. 9


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Yorkshire and the Humber Specialised Commissioning Group Meeting held on 22 July 2011 It was RESOLVED that the minutes of the Yorkshire and the Humber Specialised Commissioning Group meeting held on 22 July 2011 be noted.

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Any Other Business The Chair closed the final NHSWD Board meeting by wishing all those who had been involved in the Board every success for the future.

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Date and Time of Next Meeting The next Cluster Board meeting will be held on Tuesday 4 October 2011 at 9.00am at St Catherine's Church & Centre, Belle Vue, Doncaster Road, Wakefield, WF1 5HL.

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