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Agenda Item: 10 Enclosure: CKWCB/13/18 DATE OF MEETING:

Category of Paper Tick()

22 January 2013 Paper Title:

Decision and Approval

Governance and Risk Report

Position statement

Responsible Director:

Discussion

Gill Galdins, Director of Corporate Development and Transition

Information

Paper Author:

FOI Status: Open

Andrea McCourt, Head of Corporate Governance Executive Summary:

This report provides information to the Cluster Board on governance and risk arrangements, and requests decisions on a number of related issues. The report covers: •

Update on Wakefield Public Health transfer agreement

CCG recruitment and meetings in public meeting

Governance arrangements with the West Yorkshire Area Team

Use of the seal within the Cluster

Chair’s Actions since the last Board meeting

Critical risks

Outcome of Equality Impact Assessment:

N/A

Sub Group/Committee:

Governance Committee Clinical Commissioning Executive Committees Audit Committee


Recommendation (s):

Appendices

It is recommended that the Board: i.

Note the position regarding the transfer of Public Health services to Wakefield Council

ii.

note the position on CCG lay recruitment

iii.

note the West Yorkshire Local Area Team governance arrangements

iv

note the use of the seal by the three PCTs for April to December 2012

v

ratify Chair’s actions relating to Health Inequalities, expenditure of non recurrent reserves and West Yorkshire Area Team office accommodation

vi

note the critical risks identified from the Risk Register

vii

note that the Governance Committee will review the Mid Yorkshire Hospitals Trust Outline Business Case Consultation Document.

Appendix 1 – Use of the Seal Report Appendix 2 – Critical Risk Report


1.0

Purpose of Report This report provides information on governance and risk across the Cluster and asks for the Board to approve a number of recommendations.

2.0

Governance Update 2.1

Public Health Transfer

At the Board meeting on 27 September 2012 it was agreed that the Governance Committee would be given delegated authority to approve Section 75 agreements with local authorities if required. The Governance Committee considered the use of a Section 75 agreement for the transfer of Public Health services to Wakefield Council at its meeting on 10 October 2012 and agreed to seek legal advice regarding authority to novate contracts as proposed under the Section 75 agreement. It was subsequently confirmed that a Section 75 agreement would not be implemented prior to the transfer on 1 April 2013 as originally proposed, following further discussion with Wakefield Council. Recommendation for the Board i to note the updated position regarding the transfer of Public Health services to Wakefield Council . 2.2 Clinical Commissioning Groups (CCGs) At the meeting in September the Board was informed of recruitment to one of the lay member posts in NHS Calderdale. The current position regarding the recruitment of further lay members within the four CCGs is given below: NHS Calderdale CCG

– Kate Smith

NHS North Kirklees

- Julie Elliott, Tony Gerrard, Val Aguirregoicoa

NHS Greater Huddersfield - Tony Gerrard, Moira Wilson NHS Wakefield

- Stephen Hardy, two further lay member appointments to be confirmed

In preparation for taking up roles as statutory organisations, meetings in public are scheduled for NHS Calderdale CCG in January 2013 and NHS Wakefield in February 2013. Recommendations for the Board ii to note the position regarding lay recruitment for CCGs


2.3 NHS Commissioning Board Local Area Team The cluster leadership team is now meeting on a weekly basis in Leeds jointly with the emerging West Yorkshire Area Team members. This ensures that decisions take account of the two clusters in the West Yorkshire Area (NHS Airedale, Bradford and Leeds and NHS Calderdale, Kirklees and Wakefield District) and documentation of these decisions provides an audit trail. The following Directors have been appointed to the West Yorkshire Area Team: • • • •

Dr Damian Riley, Medical Director Ian Currell, Director of Finance Sue Cannon, Director of Nursing Elaine Wyllie, Director of Clinical Commissioning Group Assurance and Operations

Recruitment is in hand for the post of Director of Commissioning and the overall Director role, which is being covered by Mike Potts in the interim. Recommendations for the Board iii to note the governance arrangements with the West Yorkshire Local Area Team 2.4 Governance Committee The Governance Committee has met monthly within its revised terms of reference since October 2012 and minutes of the three meetings held on 10 October, 23 November and 18 December are presented to this Board meeting in the minutes section of the agenda. 2.5 Procurement Committee The newly established Procurement Committee has met twice and considered the following procurements: NHS Calderdale

Equitable Access to Primary Care Calderdale and Huddersfield Health and Social Care Strategic Review Programme Support

NHS Kirklees (Greater Huddersfield CCG area) NHS Wakefield

Chronic Pain Service Procurement for an Intermediate Care Service at HMP Wakefield

The minutes of the Procurement Committees held are presented in the minutes section of the agenda.


2.6 Use of the Seal Report In line with Standing Orders, section 8.3, the use of the seal is required to be reported to the Board. Reports on the use of the seal for the three PCTs within the cluster are attached at Appendix 1. Within the three PCT areas the seal report is presented to the Audit and Governance Groups and the reports enclosed for NHS Kirklees and NHS Calderdale will be reported to these groups in January 2013. Within NHS Wakefield District the use of the seal has been reported up to the end of October to date, with a further report is scheduled for February 2013. Recommendations for the Board iv to note the use of the seal for the period April to December 2012 2.7

Chair’s Action

On behalf of the Board, Chair’s Action has been taken in three instances since the 27 September Board meeting. These are summarised below: NHS Wakefield - Health Inequalities Chair’s action was sought to use the PMS contractual framework to target additional resources and services in more deprived communities to tackle health inequalities’ in Wakefield using an agreed model for assigning the funds to practices based on the Index of Multiple Deprivation 2010 (IMD 2010) Score. Cluster Board sign off was required due to the total amount of funding involved (£575K per annum) and also the changed use of the PMS funding. NHS Kirklees (on behalf of the five PCTs in West Yorkshire) - West Yorkshire Area Team Accommodation Chair’s action was sought to approve the one off assignment costs of the remaining term of the lease for 3 Leeds City Office Park from the Audit commission to NHS Kirklees PCT on behalf of the five PCTs within West Yorkshire and fit out costs estimated at £469K in 2012/13 funded pro rata across the two clusters. This was subject to written confirmation from NHS Commissioning Board North and receipt of a positive value for money opinion from a District Valuer. NHS Calderdale, Kirklees and Wakefield District – Non Recurrent Expenditure Proposals Following discussion of schemes for non recurrent expenditure at the Board business meeting on 6 November 2012, Chair’s action was sought to approve schemes for nonrecurrent expenditure for 2012/13 from the four Clinical Commissioning Executive Committees (CCE) of the CCGs within the cluster. A number of changes were made to the schemes following discussion on 6 November. Assurance was given to the Chair in writing that all proposals had the required support.


Approval was given subject to a more detailed business case review at local CCE level, acknowledging that compliance with procurement processes and regulations for the scheme is the responsibility of CCEs. Recommendations v it is recommended that the Board ratify the above Chair’s actions 2.8

Mid Yorkshire Hospitals Trust – Outline Business Case Consultation Document

Given its role in managing the transition to new arrangements and the future responsibilities of Wakefield and North Kirklees Clinical Commissioning Groups regarding the MYHT Clinical Services Strategy, the Governance Committee, on behalf of the Board, will review the MYHT OBC consultation document at its meeting on 13 February 2013. Consultation is expected to commence on 1 March 2013. 3.0

Risk Management Update 3.1 Risk Register Review The cluster operates a single risk register database that is populated by all three PCTs. The review cycle for December 2012 has been completed and the cluster Board can be assured that; •

Each organisation has reviewed the risk register within risk owner, senior manager and Head of Service /Director deadlines

Senior management teams within each organisation have reviewed and agreed the high level risk log (i.e. those with a risk score of 15 or above) for their own organisation including the triangulation of finance and performance reporting

Organisations board sub groups have received and approved the HLRL for its own organisation

Cluster executive have received, reviewed and approved the HLRL on behalf of the cluster for Cluster Board. Discussion is scheduled for the Cluster Leadership Team to ensure that during the transition period the risks for the existing statutory organisations are managed appropriately. To support the transition process work is on-going to identify the future risk destinations within the CKW risk register. Regular risk reports will be presented to the Governance Committee for more detailed consideration. In addition the four CCGs have been developing their own risk agendas and Board Assurance Frameworks. Regular reports to the Cluster Board, via the Designate Chief Officer report, ensures that the Board is sighted on governance and risk issues in CCGs as well as risks relating to authorisation.


3.2 Critical Risks The Cluster Board is notified of any risks on the risk register scoring 20 or above. The current risk cycle continues from the previous cycle. There is one new critical risk (scoring 20) for NHS Wakefield (risk 2975) relating to reputational and adverse publicity regarding service redesign at MYHT. The details of this risk are enclosed in the critical risk report for information at Appendix 2. NHS Calderdale (risk 290) relating to a risk of breaching the MRSA target for 2012/13 has been downgraded from Critical to Serious within the last review cycle. Board Assurance Framework An updated Board Assurance Framework for the cluster has been reviewed by the Governance Committee and Audit Committee members in November and December 2012 and is presented to the Board at this meeting. Recommendations for the Board vi to note the critical risk identified from the Risk Register 4.0

Recommendations It is recommended that the Board receive the Governance and Risk report and note its contents, in particular: i.

Note the position regarding the transfer of Public Health services to Wakefield Council

ii

note the position on CCG lay recruitment and meetings in public

iii

note the West Yorkshire Local Area Team governance arrangements

iv

note the use of the seal by the three PCTs for April to December 2012

v

5.0

ratify Chair’s actions relating to Health Inequalities, expenditure of non recurrent reserves and West Yorkshire Area Team office accommodation

vi

note the critical risks identified from the Risk Register

vii

note that the Governance Committee will review the MYHT OBC Consultation Document. Appendices Appendix 1 – Use of the Seal Report Appendix 2 – Critical Risk Report


Appendix 2

NHS Wakefield District Critical Risk - Risk Number: 2975 RISK Risk of damage to NHS reputation from negative publicity and political fall-out from Mid Yorkshire Hospital Trust’s Outline Business Plan for the Clinical Services Strategy. Programme Area: communications and engagement Programme Lead: Head of Communication and Engagement Performance Indicator: Period Covered: current Date Updated: November 2012 Updated By: Senior Communications Manager Data Source: Current Risk Status (Score): Critical (20) Reduced Risk Score (after mitigation): High (12) Context and Targets: In 2011 the local health economy carried out public engagement around five options for MYHT’s clinical services strategy (CSS). It had originally been intended that there would be public consultation at the end of the year, leading to a decision and implementation, although this was postponed to early 2013 and has not yet taken place. At the beginning of this year the financial situation (and the FT position) at the Trust meant that the CSS had to be reviewed. As a result, by June 2012, there were just two options on the table. The most radical of the original five options became the least radical of the two new ones, involving major changes to A&E, maternity, children’s services and the provision of elective v emergency services. Intensive awareness raising and engagement with stakeholders has taken place through the remainder of the year. Particularly in North Kirklees this has resulted in public campaigns led primarily by local councillors and the local paper opposing the proposals. Petitions have been submitted on behalf of the campaigns. An Outline Business Case is currently being finalised, with a decision due to be taken by commissioners (through the. Cluster Board) in January 2013. If a decision is taken to adopt the more radical of the options this is likely to cause extremely negative publicity. This has the potential to damage the reputation of the NHS, to hamper our ability to act and to cause significant time pressure in dealing with political fallout. Mitigating Actions Chief Executives and other Directors (MYHT and Cluster), have proactively and regularly met with MPs, OSCs and other key stakeholders. Trust, Cluster and CCG representatives have also attended a range of stakeholder, community and public meetings. A major awareness raising campaign has taken place in November and early December, involving radio, web, double page newspaper advertising, market research surveys, roadshows and a large deliberative event.


A patient and public involvement network (Your Health Your Say) has been set up by both CCGs (N Kirklees and Wakefield) and the Trust and membership has been actively promoted. Preparations are now under way to handle the publication of the Outline Business Case. Following the decision by the Board at its meeting on 10 January 2013 planning is about to begin for the formal consultation which is now scheduled to take place in March 2013. Governance The Clinical Service Strategy is part of the Mid Yorkshire Health and Social Care Transformation Programme. A programme board and programme executive meet monthly to monitor progress. The communications and engagement work-stream reports in to both these meetings. The Cluster Chair and Chief Executive, the CCG Chief Officers and Chair all sit on the programme board.


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