NHS GRAMPIAN
Minute of the Grampian Area Partnership Forum (GAPF)
held on Thursday 24 November 2011 at 2.00pm
in the Conference Room, Summerfield House
Present:
Gordon Stephen, Employee Director (Chairperson)
Richard Carey, Chief Executive
Mike Adams, UCATT
Jim Clark, GMB
Bill Cowling, Project ManagerMental Health
Sharon Duncan, Unite
Frances Dunne, Nurse Manager, Aberdeen City CHP
Sandy Dustan, General Manager Aberdeenshire
Andrew Fowlie, General Manager, Moray Health Services
Alistair Grant, RCN
Alan Gray, Director of Finance
Laura Gray, Director of Corporate Communications
Joe Collier, Clinical Nurse Manager
Deirdre McIntyre, SOCAP (VC)
Martin McKay, UNISON
Sandra-Dee Masson, BAOT
Stewart Rogerson, Head of Soft Facilities Management (deputy for Gary Mortimer)
Anne Ross, Head of Performance & Quality Improvement
Clare Ruxton, Interim Director of Human Resources
Vincent Shields, General Manager Acute Services
Pauline Strachan, Chief Operating Officer
Elaine Stuart, SOR (deputy for Gemma Barclay)
Joan Anderson, Partnership Support Officer
In Attendance:
Gary Newbiggin, Primary Care Programme Manager - Item 2
Ann Cheyne, Joint Chairperson, Moray Partnership Forum – item 5
Item / Subject / Action1 / Apologies
Apologies were received from Kirsten Sawers, RCM (no deputy),Ian Francis, CSP (no deputy), Shona McDougall, BDA (no deputy available), Jane Starley, BIOS (no deputy), Gary Mortimer, General Manager Facilities and Estates (Stewart Rogerson deputised), Eileen Grant, GHP (no deputy), Gemma Barclay, SOR (Elaine Stuart deputy), Duncan Stephen, ACB (no deputy), Jenny Greener, non-executive director (no deputy), Mike Scott, Chair of the Staff Governance Committee (no deputy)
2 / Cluster Working
Gary Newbiggin attended the meeting to explain the work he was involved in regarding clusters. At the head of the Health and Care Framework and the 2020 vision was Primary Care. Clusters were communities that already exist working together. These included NHS, Local Authorities, parent groups, GPs, carers groups etc. Once fully integrated the plan was for these groups to work together in one service.
AberdeenCity was divided up into four clusters based on geography and GP relationships and had approximately 50 to 60 thousand people within each cluster. Each area had a GP clinical lead.
Aberdeenshire and Moray were also moving to clusters. They all started from a different point and were working towards a similar end.
GPs were working together in their cluster to offer shared services which opened up opportunities and made better use of space.
It was acknowledged that there were barriers but also opportunities to deliver the 2020 vision.
It was thought that the public already thought services were offered in this way from discussions at a public forum meeting.
It was agreed that further discussion should take place at GAPF on how to make this issue live, useful, relevant and meaningful for staff at a future meeting.
Gary was happy for suggestions to be made as to an alternative name for clusters.
3
* / Mental Health Partnership Forum Presentation
Bill Cowling and Martin McKay presented the work of the Mental Health Partnership Forum (presentation attached).
There was a long history of Partnership working in Mental Health Services. The forum had a range of members, staff side, management and Moray representation.
The Safe Affordable Workforce (SAW) project was undertaken in partnership with hospital and community staff and it was open and inclusive. The group tried to use the full name Safe Affordable Workforce rather than SAW to give staff reassurance. Some areas were easier than others to work through.
Partnership working style was well accepted in Mental Health so when it came to discussing some difficult issues eg 12 hour shifts, a process was already there. A group was set up, risks were discussed, the implementation date was extended to allow more time to sort issues. The group still existed to deal with ongoing issues and concerns regarding 12 hour shift working.
Older redesigns had been undertaken in Partnership eg the Redesign of Old Age Psychiatry and Old Age CPN Skill mix. All the managers involved were at the meetings so communications worked well and the redesign was delivered in 3 months.
More recently the forum had been involved in the AHP Review and Clinical Psychology redesign. These groups worked well from the start and communication and willingness to build relationships assisted the process to be successful.
The Mental Health Collaborative Programme and HEAT Targets were regularly discussed at the Partnership Forum thereby picking up early indications that there were issues.
Currently they had a staff survey ad-hoc group working on the action plan with names of leads and timescales and this would be discussed at the Sector Partnership Forum.
The sale of the older part of the Royal Cornhill Site was on the agenda currently anddiscussions were ongoing with a preferred bidder.
The substance misuse service had been redesigned because of a national driver and the work with the Aberdeen City CHP Clusters. This work included the Local Authorities, GPs, Criminal Justice, etc. It gave a good grounding for future work with other agencies.
The Partnership Forum felt they had developed over the years, learned from experience and other partnership groups and were keen to hear from other Sector Partnership Groups on good practice.
There was an opportunity to use Partnership Forums to develop better communications to staff of NHS Grampian wide issues. This would be added to the agenda setting process of Sector Partnership Groups.
Woodend Partnership Forum was working well and had taken on its own identity.
Mike Adams reported that the Facilities Partnership Forum had just completed a review and had adapted to fit the current period. / Sector Pship Forums
4
* / Policies and Procedures Sub-Group Presentation
Philip Shipman updated the group on the work of the Policies and Procedures Sub-Group (presentation attached).
The Group prioritised policy reviews using the following criteria:
- PIN Policy Schedule
- Legislative Changes
- Requests to Group
- Policy Review Date
- Request review group lead
- Seek review group membership (via Delivery Team, Human Resources Operational Teams, Staff Side and British Medical Association)
- Undertake review
- Consult
- GAPF for endorsement
- Special Leave
- Retirement
- Paternity Leave
- Ill Health Termination
- Dignity at Work
- Gender Based Violence
•Career Break
•Capability
•Conduct
Policies about to be reviewed:
•Voicing Concerns
•Professional Registration
PIN Policies due for publication:
•Facilities Arrangements
•Fixed Term Contracts
•Capability
•Conduct
•Redeployment
•Secondment
5 / Moray Partnership Forum Presentation
Andrew Fowlie and Ann Cheyne presented the work of the Moray Partnership Forum.
The Moray Partnership Forum had been involved in Dr Gray’s Hospital redesign, Forres, RAF, etc. They had discussed SAW, greater productivity and 12 hour shifts. It was acknowledged that staff side and management did not always agree but stuck with the topics and found compromises and as a result projects were worked through, for example the 12 hour shifts were taken forward differently from the start of the project.
Communication to staff was being worked on to improve this.
Moray had received the Gold Award for Healthy Working Lives gained through joint effort of all staff to provide a healthier workforce.
Planning for the future, ideas were being gathered to look not only at directly provided and managed services but including Local Authority, GP Groups and other individual contractors eg dentists and pharmacists.
Communications regarding the move of Dr Gray’s Hospital to unified acute services had taken up most of the summer. Now there was a need to configure robust facilities, Moray Health Services and other partnerships across NHS Grampian. Dr Gray’s staff would feed into the Acute Sector Partnership Forum. Agreement had been reached to keep a Moray Partnership Forum for pan Moray issues and this group would feed into other relevant groups.
One of the big projects the forum had been involved in was Dr Gray’s reconfiguration. A number of open house events were held at all times of the day and night for every staff group. Views were gathered and attributed. Communications for the open house events was done by a variety of ways to ensure all staff received the information, these included local global emails and letters. For the first time senior and front line managers signed off on the change. This style would be learned from and used again in future changes pan Moray eg Forres.
There had been initial difficulties at Leanchoil, Forres. It had closed very rapidly and staff were moved around Moray and a lot of staff were filling gaps. There were communications issues because staff were scattered around which led to rumours being spread.
A Steering Group had been set up and wide consultation had taken place regarding what services would be offered at Leanchoil. The decision was taken to have nine beds and day cases. The criteria for the kind of patient was changed to being much more about re-enablement and rehabilitation helping people stay in the community and reduce admission to larger hospitals in Grampian.
The different services meant there was issues for the existing staff. Staff were communicated by email and letters and meetings for staff were well attended. Work would be finished on Leanchoil by 5 December and the number of staff required were already identified. Staff had been through the reorganisation process. It was hoped that there would be posts available soon for all staff unsuccessful at interview via the vacancy process. Successful staff would receive training regarding the new type of services to be offered.
There was learning for Dr Gray’s Reconfiguration, staff would have to move in the interim and it would be ensured that staff were well informed about proposed changes.
Andrew Fowlie stated that for half of the year there were no Sector Partnership Forum meetings in Moray mainly because of the changing management structures. If it had met some of the initial problems with staff from Leanchoil may have been avoided. However, things were back on track and discussions were taking place about the new role of the Moray Partnership Forum.
Vincent Shields agreed to report back to GAPF on the integration of Dr Gray’s into Acute Services. Vincent explained that they planned to make the Acute Partnership Forum an ARI one as these were the issues it discussed and have a separate Acute Sector Partnership Forum covering the whole service. / VS
6 / Minute of Last Meeting held on 25 October 2011
The minute of 25 October 2011 was approved.
7 / Matters Arising
a.AHP Review
Staff side requested the current process for applications and interviews for the AHP Review be put on hold while discussions could take place on concerns that had arisen. They had been in discussion with Management and HR since the letters had been sent to members of staff. Following a lengthy debate the following was agreed:
There were still issues still to be worked on. The job applications still to be submitted by Friday 25 November as previously agreed. The process would be then be paused to allow for a clarification of the issues. Staff would be reassured that they would not be disadvantaged by the process and if it was changed they would have the opportunity to review their application.
b.Directors Review Update
The adverts had been circulated for the posts of Director of Workforce and Director of Public Health with a closing date of 19 December 2011. Interviews were planned for early January 2012. Work was still ongoing on proposals around a modernisation team. Fiona Francey was leading this and holding a workshop for those directly affected to input into the process. The staff involved would all be current staff and there would be no new posts created.
John Brett, Head of Health and Safety, was leaving to go to a new post with a private company. His post would be replaced and work was ongoing around this.
8 / Industrial Action Planning Update
Pauline Strachan explained that when it was known that there were to be ballots for industrial action a small sub-group was formed in Partnership to plan for possible industrial action.. The purpose of the group was not to influence or interfere as staff side and management had different agendas. The management agenda was to run a service for the public and the industrial action was to cause disruption to services to raise awareness of the cause. The sub-group had been meeting for four weeks. The industrial action was aimed at the UK Government, not at NHS Grampian, regarding the changes to the pension schemes.
Information from outwith NHS Grampian was scant and information had been expected from Human Resources Directors Group but this draft had only been received last week and it didn’t answer all the questions. So NHS Grampian had to do all the work themselves.
Up to 8 days ago the information received was that some other Boards had cancelled all elective services with some services being protected eg cancer treatments and care, renal, front door maternity and accident and emergency. The National Chief Executives meeting then discussed this issue and it was discovered that not all Boards were cancelling elective services.
A communication had gone out to staff last week and this week regarding what the arrangements would be and what taking industrial action would mean to staff. This communication was to put out a management position message and therefore did not have Partnership involvement. It was recognised that staff side were in agreement with some parts of the communication and some they were not.
Management were trying to ascertain how many staff would be in on the day and they planned to run an as normal service as possible ensuring safety. Staff Side cautioned them regarding the risk around doing this as staff could make up their mind or change their mind right up until the day of action regarding whether they would take part in the strike action or not. Management wanted to fulfil their obligation to patients if possible rather than cancelling services for patients if enough staff turned up to run the service.
Staff Side would guarantee enough staff to run a selected exception list of essential services only (Sunday level activity). They asked for reassurance that non-striking staff would not be moved from essential services to non-essential services so that management could ask the Trade Unions to provide staff for these essential services. Management gave this reassurance and clearly stated they would not do this.
Staff Side had been led to believe that NHS Grampian would run their service as Sunday level of activity and were waiting for numbers from management regarding how many were required to run essential services as if it were a Sunday service. The Sunday level of activity would only apply to numbers and not additional payments for the day. Staff Side gave a commitment that patient care would not be compromised if staffing levels were set at a Sunday service.
Staff Side view was that union members had voted overwhelmingly for industrial action in a secret ballot and therefore they had decided what they wanted to do and would come out on strike.
Management gave a commitment to make a decision by the end of the day on 24 November regarding how much elective work would be cancelled.
Mike Adams reported that following the communication that had just gone out to staff he had been inundated with questions from non-union members regarding not wanting to cross the picket lines. Staff Side would be encouraging staff to join a Trade Union/Professional Organisation right up to and including the day of action.
Confirmation was requested and given that management stood by the statement in the communication to staff that non-union members not wishing to cross a picket line would not be subject to disciplinary action.
Alistair Grant explained the Royal College of Nursing (RCN) position. RCN advice was that RCN members would not take on roles of staff who were striking. Management requested a copy of this advice which would be given to them for information. Alistair noted his support for the industrial action but as RCN had decided not to ballot its members he would be available to give advice to members and management on the day.