APPROVED
APPROVED
NHS GRAMPIAN
Note of the Performance Governance Committee held on
Thursday 18 November 2010 at 10.30am in the Conference Room, Summerfield House
Present:
David Cameron (Chair), Non-Executive Board Member, NHS Grampian
Bill Howatson, Non-Executive Board Member
Charles Muir, Non-Executive Board Member
Gordon Stephen, Non-Executive Board Member
In Attendance:
Richard Carey, Chief Executive
Roelf Dijkhuizen, Medical Director
Alan Gall, Director of Finance
John Miller, Corporate Communications Manager (item 5.2.2only)
Anne Ross, Head of Performance and Quality Improvement
Mark Sinclair, Director of HR and Strategic Change (item 5.2.3 only)
Pauline Strachan, Chief Operating Officer
Glenys Wells, Personal Assistant - Minuting Secretary
Item / Subject / Action1. / Apologies
Apologies were received fromVal Maehle and Elizabeth McDade.
2. / Healthstat
The Healthstat section of the meeting was covered in a separate paper (attached).
3 / Minute of Meeting held on 17 September and Matters Arising
This wasapproved and no matters arising were reported.
4. / Assurance Framework Reports
Reports from Governance Committees:
4.1 / Moray CH&SCP – 17 September
Mr Muir reported that the partnership meeting had been told of good progress generally with dental services whilst acknowledging that the access by children target still required further action. There had beenconsiderable action following the HEI report and also on child protection. Good progress was now being reported in relation to meeting the alcohol and smoking targets. Financial performance remained the greatest challenge. A visit from the Joint Improvement Team to look at the function and structure of the CHP had taken place. Work was ongoing regarding the the impact of RAF base closures.
Dr Dijkhuizen updated PGC on a variety of actions that had been put in place to strengthen child protection arrangements in Moray.
Dr Cameron advised that he would write to Moray Council relating to the absence of commitment by the Council to contributing to the funding the Moray LifeScience Centre. / CM
4.2 / Patient Focus and Public Involvement – 10 November
Mr Muir advised that public representative members had raised concerns about the withdrawal of “NHS News” for financial reasons but acknowledged that alternative means of communicating with the public were being explored. The Committee had noted that the inpatient survey“Better Together”would be re-run in early 2011 which meant there had been limited time to learn and implement improvements outlined in the report received in September.
4.3 / Aberdeen City CHP – 26 October
Councillor Howatson gave an update on the Aberdeen City CHP workshop held on 17 November which had looked at reshaping the committee. A joint paper was agreed at the workshop and covered the constitution, format of meetings etc. In the future it was planned that the Committee would meet in workshop mode in order to concentrate on key issues and focus more on delivery. Mr Carey confirmed that this fitted in with local and national discussions on pooled resources and planned redesign of health and social care. Councillor Howatson advised that a report would be presented to a future Board meeting.
4.4 / Aberdeenshire CHP – 15 September
No report provided. To be submitted to January 2011 meeting.
5. / November Overall Performance and ‘At A Glance’
Ms Ross presented topics from the overall performance report. She drew attention to the following key points not covered elsewhere in the meeting:
Child fluoride varnishing applicationtarget – data beginning to be reported
Average length of stay – above Scottish average but falling substantially and well on way to meet trajectory
Pre operative stay – still highest in Scotland butfalling
Cancer targets quarter to September – this was above 98% targetalthough it was known that there had been some breaches recently.
A&E attendance – slightly above trajectory and low in Scottish terms.
cDifficile- continued fall in this
A&E 4 hours target – doing well at 98%
Delayed Discharges – October dropped back to two longer than 6 weeks. Will continue to be included in performance report.
KSF and Sickness – doing well on both targets
5.1 / Delivering safe, effective & timely care in the right place
5.1.1 / Progress Towards 18 weeks Referral to Treatment (Strategic Risk 851)
Dr Strachan confirmed that current access targets continued to be delivered in full. Work was progressing towards the 18 week referral to treatment target. This was being progressed in accordance with national guidance relating to availability of patients. As a consequence a backlog of unavailable patients was building up. It was expected that a tolerance level would be set around the target to take account of this. Dr Strachan confirmed that clinical need remained paramount in admission practice.
5.1.2 / Promotion of Success/Media Report (Strategic Risk 858)
Mr Miller presented the print media report. He explained that the report format had been revised to focus on key news stories and he advised on some of the current issues:
- a high court trial which was being monitored closely
- the high media interest in the nurse shift patterns
- An upheld ombudsman complaint
- positive coverage regarding the linear accelerator
- Out of Hours Service
There was some discussion about how successes could be better promoted. Mr Miller provided a background on how the media officers promoted good news etc and drew attention to some of the limiting factors. The media inevitably focused on more negative stories and there was a difficult balance to be achieved between responding to these and letting them run their course. It was agreed that factual inaccuracies should be corrected.
5.2 / Improving Efficiency, Productivity and Sustainability
5.2.1 / End September 2010 Financial Report and October oral update (Strategic Risk 851)
Mr Gall reported on the end October position and confirmed an overall revenue overspend of £2.8m. This included a breakeven position on some budgets and it was anticipated that this would continue. A major effort was ongoing to achieve difficult savings targets applied to all operational budgets. Mr Gall stressed that the recovery may slow down givenpossible winter pressures. Acute had performed well and although Moray was struggling (£1m overspend after 10 months) theirlocum costs had reduced. GP prescribing showed little movement although there was some benefit being delivered through national pricing. Alisdair Chisholm was leading on SLA work relating to services to Boards outwith Grampian. Mr Gall was hopeful of meeting targets and breaking even whilst acknowledging some pressure areas. The three big capital projects were on target and capital spend generally should be achieved.
5.2.2 / Implementation of a new Patient Management System (PMS) (Strategic Risk 749)
Mr Robertson reminded members of his presentation to PGC six months previously and confirmed that the project remained on track for delivery. Mrs Hawkins advised of the many strands of work underway and the risks which changed daily but continued to be appropriately managed.
The contract had recently been signed and all Boards were working together to implement. Clevermed had been implemented within AberdeenMaternityHospitalon 15 November and all had gone smoothly. The next stage of implementation related to core PMS and a lot of effort was being made to ensure the 14 February 2011 live date would be achieved. Risk was managed and assessed by the PMS Steering Group and it had recently been agreed that PriceWaterhouseCoopers would undertake an independent audit of the project. Mrs Hawkins advised that the project will be risk reviewed at the December Board meeting. She explained that the greatest risk related to training requirements and the capacity within sectors to release staff for this.
5.2.3 / CSI Performance Report
Mr Sinclair presented the new format CSI report and explained that a further column was to be inserted to indicate whether a project was on track or not. This was welcomed.
5.2.4 / Initiative Led Funding (Strategic Risk 860)
Mr Gall updated PGC on how this risk was being managed. He explained that new earmarked funding was reviewed at each budget setting meeting to ensure it was applied to best effect. This ensured that members were aware of the funding purpose, how it was to be allocated and used. He believed the risk was being managed appropriately.
6. / Quality Outcome Measures and HEAT Targets 2011 – 12
Ms Ross referred to John Connaghan’s letter which sought comments on suggested HEAT targets for 2011-12. There was a new proposed measure around access to stroke services and a change from the over 65s emergency bed days to over 75s. Final targets and measures would be announced at the end of November, along with Local Delivery Planguidance. The accompanying slides outlined how proposed targets related to delivery of the Quality Strategy aims and outcomes. There was support for the Government’s proposed reduction in the number of measures (to 17) but there was as yet no indication as to whether those removed would become HEAT standards
7. / 2009/10 Annual Report Proposals
Ms Ross reported that arrangements were in hand to produce the 2009/10 Annual report now that the Annual Review had taken place. A document similar to the 2008/09 one was being proposed which identifyied main issues from the Annual Review and signposted to other key documents. The draft would be available for comment in the next few weeks prior to the festive break. The printed version would be ready for the January PGC meeting and the February NHS Board meeting. A limited number would be printed and a copy would be available on the NHSGrampianwebsite.
8. / Strategic Risk Control Plan
Ms Ross reported that PGC had now reviewed all the risks for which it had responsibility.
9. / To consider content of December 2010 Board report
CSI performance report
PMS
Finance
Aberdeen City Council CHP development
Waiting Times
Strategic Report
10. / AOCB
There was none.
11. / Date of Next Meeting
Friday 21 January 2011, 1.30 – 4pm, Conference Room, Summerfield House
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