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NHS Calderdale, Kirklees and Wakefield District Cluster

Minutes of the CKW Cluster Board held on Tuesday 6 December 2011 at 1.30pm in the Manor and Bankfield Rooms at Dean Clough, Halifax Present: Angela Monaghan Roger Grasby Tony Gerrard Keith Wright Sandra Cheseldine Roy Coldwell Ann Liston Mehboob Khan Mike Potts Jonathan Molyneux Ann Ballarini Sue Cannon Dr Matt Walsh Dr Andrew Furber Dr Graham Wardman In attendance: Carol McKenna Julie Lawreniuk Gill Galdins Peter Flynn Sue Ellis Sarah Muckle Dr Raj Aggarwal Karen Whitfield Rachel Spilsbury Daphne Taylor Vicky Pickles Alison Fearnley Jayne Beecham

Chair Non Executive Director and Vice Chair Non Executive Director Non Executive Director Non Executive Director Non Executive Director Non Executive Director Non Executive Director Chief Executive Interim Executive Director of Finance and Efficiency Executive Director of Commissioning and Service Development Executive Director of Quality and Governance (Executive Nurse) Executive Medical Director Executive Director of Public Health (NHS Wakefield District) Executive Director of Public Health (NHS Calderdale)

Chief Operating Officer (NHS Kirklees) Chief Operating Officer (NHS Calderdale) Chief Operating Officer (NHS Wakefield District) Director of Performance and Commissioning Intelligence Director of Human Resources and Organisational Development Consultant in Public Health (NHS Kirklees) General Medical Practitioner, South Elmsall and Rycroft Clinical Commissioning Group Practice Manager, South Elmsall and Rycroft CCG Programme Manager Board Development Consultant Head of Corporate Governance (NHS Calderdale) Corporate Governance Administrator Senior Communications Manager (NHS Wakefield)

In addition there were four members of the public also in attendance. The Chair opened the meeting by welcoming all those in attendance.


Apologies for Absence Apologies for absence were received from Dr Judith Hooper, Executive Director of Public Health and Sheila Dilks, Director of Transition.


Declarations of Interest No Cluster Board members declared interests in any of the agenda items.


Minutes of the last meeting held on 1 November 2011 The minutes of the Cluster Board meeting held on the 1 November 2011 were AGREED as a true and accurate record subject to including the following sentence to agenda item CKWCB/11/29 regarding the Mid Yorkshire Hospitals NHS Trust: Clinical Services Strategy: Keith Wright expressed concern over the deliverability of this strategy in the context of the major financial challenges facing the Trust.


Matters arising from the Minutes of the last meeting CKWCB/11/24

Standing Financial Instructions

Vicky Pickles explained that there was an inconsistency between the Standing Financial Instructions presented to the Board at the November meeting and the Standing Orders approved by the Board at the October meeting relating to failure to comply with Standing Orders. She informed the Board that in order for the wording to be consistent it should read „FAILURE TO COMPLY WITH STANDING FINANCIAL INSTRUCTIONS AND STANDING ORDERS WILL BE REGARDED AS A SERIOUS MATTER THAT COULD RESULT IN DISCIPLINARY ACTION INCLUDING DISMISSAL.’ The Board APPROVED the amended wording. CKWCB/11/53

Public Question Time The Chair gave an opportunity for any members of the public to raise any questions. Hilary Rowbottom from Wakefield Local Involvement Network (LINk) raised the following queries regarding agenda item CKWCB/11/55 regarding NHS 111: How NHS 111 would interface with NHS Direct What would replace NHS Direct What information would be in the public domain and when would the public become involved.

Julie Lawreniuk advised that she would address these points when she presented the NHS 111 report to the Board later in the meeting. CKWCB/11/54

Chief Executive’s Report Mike Potts presented his report to the Board highlighting the following: Infant Mortality Report The Board noted that NHS Kirklees and Kirklees Council had published a report, “Infant Deaths in Kirklees 2002-2008”, which provides an updated picture of the pattern of infant death across the district since the 2008 audit for North Kirklees. It was acknowledged that the rate of infant death is now reducing in Kirklees. 2012-13 Operating Framework Mike confirmed that the 2012-13 Operating Framework was published by the Department of Health on 24 November 2011 setting out the planning, performance and financial requirements for NHS organisations. The Board was provided with an overview of the key announcements and a flowchart that illustrated national priorities for local delivery. Safe and Sustainable – Review of Paediatric Congenital Cardiac Services The Board noted a letter dated 24 November 2011, from Sir Neil McKay, Chairman of the Joint Committee of PCTs (JCPCT), confirming that an appeal was being made by the JCPCT against the outcome of the judicial review. It was noted that if the appeal is not successful the consultation will have to be re-run. It was recognised that a decision will be made about services during 2012. Sue Ellis – Leaving Mike reported that Sue Ellis, Director of Human Resources and Organisational Development, would be leaving the Cluster towards the end of January 2012. It was noted that June Goodson-Moore from NHS Airedale, Bradford and Leeds will be developing a West Yorkshire wide HROD and Communications and Engagement service and will attend future CKW Cluster Board meetings. Dr Foster Report Mike advised that the Dr Foster report on the state of care in NHS providers had been published and did not single out any of the local areas as being either extremely bad or good. However he emphasised the importance of the report and confirmed that Sue Cannon would be reporting on the key findings from this within the next Quality and Patient Safety Report.

Industrial Action – 30 November 2011 Sue Ellis provided feedback from the day of industrial action that had taken place on 30 November. It was recognised that business continuity arrangements were well planned and that there were no significant incidents. Sue also thanked all staff regarding how they had conducted themselves on the day. Cluster Board meetings The Chair advised that the Cluster was still going through significant change and that the pace was not diminishing. She therefore proposed that the public Board meetings be held monthly rather than bi-monthly. The Board subsequently AGREED this proposal. The Board RECEIVED and NOTED the contents of the Chief Executive‟s Report. CKWCB/11/55

NHS 111 Julie Lawreniuk introduced the NHS 111 report to the Board. She explained that the report provided the Board with information regarding the background and programme implementation plan for the Yorkshire and Humber region to enable the service to be in place by 1 April 2013. Julie explained that NHS 111 is a free to call number available 24 hours per day; 7 days per week; 365 days per annum to respond to people‟s healthcare needs. Julie went on to describe the range of benefits that the service is expected to deliver and the programme management arrangements that have been put in place to deliver the procurement of NHS 111 by 2013. In response to the earlier questions raised by Hilary Rowbottom, Julie explained that information about 111 was in the public domain with the exception of the Business Case and service specification at this stage due to commercial sensitivity of the procurement process. However she provided assurance that additional information would be made available to the public as the timetable for the procurement process rolled out. In addition it was acknowledged that a robust communication plan was also being developed. Julie offered to provide further information to the Local Involvement Network following the meeting. It was recognised that there may be some confusion between the 999 emergency telephone number, NHS 111 and the new Police service non-emergency number 101, which is due to replace the present local 0845 non-emergency telephone number. Julie explained that page 34 of the report described this and that NHS 111 was to improve access to urgent care. The communication plan would make clear the differences. Julie also explained that call handlers would have access to a Directory of Services (DoS) to

enable them to assess callersâ€&#x; needs and determine the best course of action. Roy Coldwell expressed concern regarding the timescale of the implementation plan and asked for clarification regarding the review process. Julie advised that the timescales were challenging but provided assurance that the Programme Management Board was confident that all necessary steps had been taken to enable the timescales to be achieved. She also clarified that the review process was built into the contract arrangements. It was recognised that if a patient was assessed as requiring emergency assistance, referrals could be made from NHS 111 direct to emergency services without delay. Tony Gerrard enquired whether emergency services had a similar facility in place to refer patients not requiring emergency treatment back to NHS 111. It was recognised that this needed to be explored and Mike Potts AGREED to raise this at the next Programme Management Board meeting. The Board AGREED the following, subject to further discussion regarding the Business Case in private session: Support the direction of travel in taking the work forward to implementation; and Delegate approval of further development of the Service Specification and Business Case of NHS111 to the Yorkshire and Humber NHS 111 Programme Management Board. CKWCB/11/56

Scheme of Delegation and the Development of Clinical Commissioning Executives Anne Ballarini presented the proposed schemes of delegation for all the Clinical Commissioning Executives, including delegated budgets; revised terms of reference for the Wakefield Alliance CCE, Greater Huddersfield CCE and the North Kirklees Health Alliance CCE. The Board reviewed the initial delegation of Budget Lines to CCEs based on 2011/12 budgets. Jonathan Molyneux provided clarity regarding the allocations to Public Health following a query raised by Andrew Furber. In addition it was noted that the allocation to Calderdale for prisons should be removed and allocated to Kirklees. Roger Grasby asked for clarity regarding the different elements that in combination comprise the scheme of delegation. Vicky Pickles explained this in more detail confirming this comprised of all the Terms of Reference, Standing Orders, Standing Financial Instructions, delegation to accountable individuals and the delegated budgets. She confirmed that the Board had received and approved all of these items.

Roy Coldwell pointed out that there were slight differences in each of the Terms of Reference under paragraph 3.6 concerning Conflicts of Interest and asked if these should be standardised. It was AGREED that Vicky Pickles and Angela Monaghan would review these and unless there were any significant changes required the Terms of Reference would not be represented to the Board. Finally, it was noted that a further discussion would take place during the private part of the meeting regarding the letter received from the Grange practice requesting that the Cluster support their development as an emerging CCG, as the information to support this was not yet publicly available. The Board AGREED to: APPROVE the schedule of budget lines that will be delegated as the final part of the scheme of delegation as outlined in Appendix A of the report subject to the requested amendment outlined above; and APPROVE the amendments to the Terms of Reference for the Wakefield Alliance CCE, Greater Huddersfield CCE and the North Kirklees Health Alliance CCE subject to the Chair reviewing the slight differences under paragraph 3.6 of each of the Terms of Reference concerning Conflicts of Interest. CKWCB/11/57

Proposed Governance Arrangements for Specialised Commissioning Transition Board Ann Ballarini presented the proposed governance arrangements for the Specialised Commissioning Transition Board to the Cluster Board for approval. She explained the proposed new governance arrangements to establish a single North of England Specialised Commissioning Transition Board and summarised the benefits. It was recognised that the proposed arrangements supported the Shared Operating Models for PCTs and that a single Establishment Agreement would also need to be agreed. Roger Grasby was concerned that moving to a single SCG would have the potential to cause a post-code lottery and other inconsistencies. Mike Potts provided clarity regarding the proposed process. It was acknowledged that the proposed arrangements could pose some issues and that these would be considered collectively and addressed as necessary. Angela Monaghan pointed out some inaccuracies on page 94 of the report under paragraphs 27 and 31concerning the numbers of primary care trust clusters representing the number of primary care trusts in Yorkshire and the Humber. These were acknowledged by the Board.

Finally, it was recognised that the Cluster Board would welcome the opportunity for a Non Executive Director to sit on the Specialised Commissioning Transition Board in a non-voting capacity. The Board AGREED to: ENDORSE the proposed governance arrangements that replace the existing governance or specialised commissioning across the North of England. NOTE that John Devlin had been appointed to interim Chief Officer and the intention to appoint a North of England Senior Leadership Team so as to support both the Transition Board and the three regional operational groups. NOTE that, for financial governance and audit purposes, the use of resources will remain with the current governance arrangements via the three host primary care trust audit committees. NOTE that staff will continue to be employed by the host primary care trust – until such time as these responsibilities transfer to the NHS Commissioning Board. CKWCB/11/58

Tendering for a community based chronic pain service Sarah Muckle presented the previously circulated report regarding tendering for a community based chronic pain service. She explained that a decision to support and tender for this service was made by Greater Huddersfield Clinical Commissioning Executive (GHCCE) first in September 2011 and then in October 2011 (when the CCE had the delegated power to make commissioning decisions). However there was a delay in the Scheme of Delegation being agreed and therefore approval was needed from the Cluster Board for the commissioning of this service in line with Standing Financial Instructions as the total cost of this service over 3 years is ÂŁ543,909. Roy Coldwell enquired whether there was any benefit to rolling this service out across the cluster. It was recognised that there was a similar service in North Kirklees however other commissioning groups did not want to pursue this at present. Sue Ellis requested that when the project plan is put in place TUPE implications are considered. Sarah reassured the Board this would be taken into consideration. The Cluster Board AGREED to set up a sub-committee to consider the Business Case so that the tendering process could continue in partnership and with the full support of GHCCG. Following further discussion it was suggested that membership of the sub-committee should comprise of 2 Non Executive Directors and 2 Executive Directors.


Date and time of the next meeting It was AGREED that the next meeting of the Cluster Board would take place between 9.00am and 1.00pm on Tuesday 17 January 2012 at St Catherine‟s Church Centre, Doncaster Road, Wakefield.


Exclusion of the Press and Public It was RESOVED that: “representatives of the press and other members of the public be excluded from part two 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.