Minutes of the Finance & Performance Committee held on 18 November 2009 in the Committee Room, St Luke’s House Present
Steve Brennan, Deputy Director of Finance Helena Corder, Director of Corporate Services Peter Flynn, Director of Performance & Information Tony Gerard, Non-Executive Director Judith Hooper, Director of Public Health (left at 3pm) Carol McKenna, Director of Commissioning Bryan Machin, Director of Finance Samantha Williamson, Head of Strategic Business Planning David Wood, PEC member
Amanda Bryson, PA to Bryan Machin (Minute Taker)
Apologies for Absence Sheila Dilks, Mike Potts, Alex Wilson
Minutes of the Last Meeting & Action Checklist Tony Gerrard commented that item FPC/95/09 did not reflect the extent of the debate and Bryan agreed to amend the minutes based on the original notes. The minutes were therefore amended as follows: “Bryan commented that the PCT was working constructively with the Trusts to understand and try and reduce the overtrades but he advised that there could be no guarantee that those negotiations would deliver a result that delivered financial targets. The Committee then discussed the seriousness of the position and the mitigating actions that could be and were being taken”. Tony also asked that under 97/09 – YAS update, it was noted that the Committee had advised Simon Worthington that YAS performance was unacceptable and the minutes should therefore be amended to read “in conclusion, Bryan Machin stated on behalf of the Committee that the performance of YAS was not acceptable”. The Action Checklist was modified as follows: FPC59/09 Terms of Reference – The Governance Committee had commented that the PCTs risk management arrangements would be improved if risk management became a became a monthly agenda item for SMT. It was also the responsibility of each sub-committee of the Board to summarise specific risk to be escalated to the Risk Register. Ongoing. 1
ACTION: Amanda to ensure that Escalation to Risk Register becomes a standard item on F&P Committee agenda. FPC/59/09 Chlamydia Screening – Ongoing. FPC/60/09 Finance Reporting Pack - The improvement of the Finance Reporting pack still required action by Bryan. FPC/96/09 – Performance Report – This action was agreed as complete by the Committee. FPC/96/09 – Acknowledgement of Staff Efforts - This action was agreed as complete by the Committee. FPC/97/09 – Change in YAS Contract - Carol McKenna updated the Committee that this was now complete and there would be a move to cost per case from next year. FPC/104/09
Matters Arising Judith Hooper commented that at a recent meeting with the Council, it was claimed that the PCT was not sharing information with the Council regarding performance. Peter Flynn assured the Committee that information was being shared and the performance accelerator could be accessed. Peter is to discuss this with Andy Simcox, KMC directly.
Continuing Care Vicky Dutchburn (Assistant Director for Mental Health, Learning Disabilities and Continuing Care) updated the Committee on the forecasted overspend on Continuing Care. The overspend has been reduced in month 7 due to accruals made in favourable position. Vicky advised that two legislative changes have been made in the last four years making the criteria for continuing care funding easier to achieve. A large area of concern is the transition of children with learning disabilities moving into adult services. There is a projection that there will be 40 additional cases transferred into adult services next year costing approximately £1700 per adult per week. There is also a growing aging population and all patients cared for in nursing or care homes cost the PCT £101 per week, regardless of their area of origin. It is projected that there will be an additional 640 nursing/care home beds opening in Kirklees within the next 12 months. There is also a move to more specialist units opening in Kirklees. Patients become registered as a resident of Kirklees after a 3 month stay and the PCT are then responsible for paying for their care. Vicky has been in 2
discussions with KMC re setting local criteria with regards to planning applications but this has not been productive. Judith Hooper said that she would also raise this area of concern with the planning department. Vicky concluded that she would continue to work on ideas on how the overspend could be reduced. FPC/106/09
Performance Report Peter Flynn presented the Performance Report to the Committee. He explained that the key points to note were; ambulance targets, revascularisation maximum wait and 18 weeks. In relation to ambulance targets, Peter explained that YAS was formally in turnaround and a recovery plan was in place. With regards to revascularisation, the maximum wait is 13 weeks and we currently have a patient who has been waiting 11 â€“ 12 weeks. A status report for this has been requested. Overall performance remains strong on 18 weeks but at present, neurology and dermatology are under-performing and this has been raised with the provider. Peter asked the Committee to note that MYHT had had 250 breaches of A&E waiting times in one day at Pontefract Hospital. Carol McKenna distributed a paper on the performance of CAHMS.
Finance Report Bryan Machin presented the Finance Report to the Committee. He advised that at the end of October the PCT were still forecasting to deliver its year end surplus of ÂŁ2.9m and meet the agreed control total. He explained there had been a number of improvements since last month mainly due to work on the acute contract, outstanding invoices being chased, an improvement in GP prescribing and work done to clarify the position on continuing care placements. Bryan distributed a paper showing the slippage on agreed investment. Discussion took place regarding the likelihood of being able to deliver the year end control total and the management actions that would be required to enable it to be reached. Tony Gerrard asked about the work that was taking place to challenge the reported acute overtrade. Bryan and Carol outlined the approach to negotiations and the analyst work being undertaken.
QIPP Bryan Machin advised the Committee that the Senior Management Team had met to discuss efficiency and potential saving schemes. Efficiency Boards have been set up with both providers.
Teenage Conception Rachel Spencer, Senior Public Health Manager updated the Committee on Teenage Conception rates. She advised that a group has been established in order to collect more accurate data in order to show any changes in trend. Rachel stated that the current data from 2008 suggests that the vital sign target for 2009/10 will not be met. However, 2009 figures for Quarters 1 and 2 show an improvement. She advised that the National Support Team had recently visited and recommendations from them were expected in the near future.
Ratified minutes from Business & Financial Planning Group The minutes from the Business & Financial Planning Group meeting held on 29 September were distributed.
Any Other Business Escalation to Risk Register - YAS, 18 weeks, Financial Risk
Date & Time of Next Meeting Although the next Finance & Performance Committee meeting has been cancelled due to the Trust Board meeting being early, it is noted that sufficient time should be left on the Trust Board agenda for discussion of the medium term financial plan. The next meeting will be held on Wednesday 20 January 2009, 2.00pm in the Committee Room, St Lukeâ€™s House.