Draft Minutes of the NHS Hartlepool and Stockton-on-Tees
Clinical Commissioning Group Governing Body Meeting (Public)
Held on Tuesday 18 October 2016 at 3:30pm
In Best Western Parkmore Hotel & Leisure Club, 636 Yarm Road, Eaglescliffe, Stockton on Tees TS16 0DH
PresentDr Boleslaw Posmyk / Chair of the Governing Body
Ms Ali Wilson / Chief Officer
Mr Graeme Niven / Chief Finance Officer
Ms Jean Golightly / Executive Nurse
Dr Nick Timlin / Governing Body GP member (Hartlepool).
Dr David Hodges / Governing Body GP Member
Dr Salvi Patel / Governing Body GP Member
Dr Charles Stanley / Governing Body Secondary Care Doctor
Mr Andie Mackay / Lay Member, Primary Care
In Attendance
Mr Andrew Carter / Corporate Governance and Risk Officer
Mrs Sarah Cook-Smith / Corporate Secretary (Minute taker)
Mrs Trina Holcroft / Designated Nurse, Safeguarding Children
Mrs Liz Ward / Senior Clinical Quality Manager, NECS
Members of Public in Attendance
Margaret Wright / Community Health Ambassador for the CCG
Jeff Robinson / NHS Commercial Director, Quintiles IMS
Roger Formby / Business Director, Integrated Care
The Chair welcomed everyone to the meeting and all attendees gave a round of introductions.
GB/95/16 Apologies for Absence
95.1 Apologies for absence were received from Mr John Flook, Lay Member (Audit and Governance), Dr Saleem Hassan, Governing Body GP Member (Stockton), Mrs Hilary Thompson, Governing Body Lay Member (Patient and Public Involvement), and Mrs Louise Wallace, Director of Public Health, Hartlepool Borough Council.
GB/96/16 Declarations of Interests
96.1 There were no interests declared at this point.
GB/97/16 Pre-critique of the Governing Body
97.1 The Chair explained that the aim of the meeting is to seek assurance in the Governing Body (GB) that the CCG are working strategically, and asked that the meeting be conducted with courtesy and respect for other people’s point of view and keep to allotted time for agenda items. The Chair acknowledged the use of acronyms though out the papers and requested presenters to explain any acronyms. Any questions were requested to be raised through the Chair. The Chair highlighted that there will be opportunity or questions from the public at the end of the meeting.
GB/98/16 Minutes of Previous Meeting held on 26 July 2016
The minutes of the previous meeting held on the 26 July 2016 were accepted as a true and accurate record.
The Governing Body ACCEPTED the minutes to be a true and accurate record.
GB/99/16 Matters Arising and Action Log
99.1 It was agreed that the actions marked completed would be closed. Open items on the Action Log were discussed in turn
99.1.1 GB/16/15 – Quality Report, Safeguarding - Mrs Thompson raised concern that the issue of Safeguarding Training at STHFT remains unresolved after being raised with the trust numerous times; Mrs Thompson added that this is also an issue at TEWV Mental Health Trust. Ms Golightly informed the Governing Body that this issue has been raised at every forum possible and for STHFT it is being escalated through the South Tees Contract Management Board process, and for TEWV this is being raised through the CQRG meeting. Ms Golightly added that it is an improving trajectory and the Trusts have to be allowed time for this to improve. Ms Wilson asked for a trajectory for when the Trusts will become compliant. 02/02/2016 Ms Golightly advised that further action has been taken and the issue has been raised at performance meetings and is being discussed with Directors. Ms Golightly added that the contractual escalation process is in place and the issue is being taken forward by the Director of Nursing. It was confirmed that no trajectory has been received to date.29/03/2016 Ongoing. 24/05/2016 Ms Golightly advised this issue remains to be an area of concern and asked for the action to remain open. 19/07/2016 Mrs Ferguson provided updated STHFT training figures which were circulate to GB members. Mrs Ferguson has requested a trajectory but this has not been provided by the Trust as yet, advising they will however, endeavour to receive this is as soon as possible. 26/07/2016 Ms Golightly advised that the CCG is still not assured but confirmed that the TEWV trajectory was continuing to improve. STHFT have been asked to provide data by service area and individual profession groups, Ms Golightly requested this action to be kept open until resolved.18/10/2016 Ms Golightly advised that the information is expected at the end of the week and Ms Golightly will advise further after then, requested action to remain open.
99.1.2 GB/22/16 – PPI Report - Community Health Ambassadors - GB was informed that the last Peer Group Meeting was held on 19th July in Billingham Community Centre and some new CHAs were welcomed. The theme/training this time was in on-line GP services, patient online access and electronic prescribing. A new smart phone app specific to CHAs is being worked on and ID badges are being processed. Mrs Thompson added that the CHAs are looking forward to the evaluation of the CHA programme, which will come to the September GB meeting. 11/10/2016 – Mr Carter advised still awaiting evaluation report from Catalyst Stockton., now to be brought to November meeting. 18/10/2016 Ms Wilson confirmed that he report will be brought to the 29th November meeting. Action complete.
99.1.3 GB/25/16 – Governance and Assurance Report - The GB noted that In December 2015 a report was presented to the Audit Committee, “What keeps CCG Governing Bodies awake at night? Mr Carter informed the GB that the report raised 6 key questions. The questions were presented to the Governance and Risk Committee who discussed each question in turn and considered how the CCG will take forward any actions identified as part of the Governing Body Assurance Framework review. The committee concluded that there was a robust process in place, and that the draft 2016/17 framework will be presented to the Governance and Risk Committee on 13th September 2016, followed by Audit Committee for comment on 20th September and finally Governing Body approval on 27th September 2016. 11/10/2016 - GB Assurance Framework development has been delayed due to ongoing discussions regarding shared management structure with Darlington CCG. 18/10/2016 Ongoing.
99.1.4 The Following actions were closed:
· GB/13/16
· GB/23/16
· GB/24/16
· GB/26/16
GB/100/16 Chair’s Report
100.1 Dr Posmyk provided the GB with an update on progress and events since retiring and being appointed and returning to the Chair role:
100.2 The Chair advised he is representing the CCG at various meetings, and was due to attend an Excellent CCGS meeting for lessons to share but this has now been postponed. The Chair also attended the North East Ambulance Service (NEAS) Annual General Meeting.
100.3 The Chair explained that due to the changes in the Sustainability and Transformation Planning footprint which relate to the Better Health Programme (BHP) the Chair is still providing a degree of clinical support for continuity.
The Governing Body NOTED the Chair’s Report
GB/101/16 Chief Officer’s Report
101.1 Ms Wilson provided the GB with an update on progress made since the last meeting and highlighted the following issues:
101.2 CCG Governing Body Appointments
Ms Wilson advised that the CCG appointed a GB Chair at the July meeting. Dr Posmyk, having returned to general practice put himself forward for the vacant GP role on the CCG GB and was successfully appointed to the Chair as the only candidate to make themselves available for election. The CCG also welcomes 2 new lay members to the GB, Mr John Flook as Lay Member Audit and Governance following the departure of Mr Steve Smith and Mr Andie Mackay in the newly created post of Lay Member Primary Care Commissioning. The additional lay member appointment has been made in direct response to the requirements of the managing conflicts of interest statutory guidance issued June 2016. Mr Flook has also been appointed the CCG’s Conflicts of Interest Guardian, a requirement of the managing conflicts of interest statutory guidance issued June 2016.
101.3 Community Health Ambassadors
From June to August 2016, the community health ambassadors undertook a health services survey engaging the community across HaST CCG. The Health Services Survey was co-designed by the CHA volunteers and the CCG to ensure content was effectively and appropriately pitched to suit the needs of local residents. Ms Wilson advised that the survey covered 3 areas, Primary Care, Urgent care, and planned Care. The information will be fed into the CCG’s commissioning intentions process and demonstrates the reach Community Health Ambassadors have into our community. Ms Wilson added that the CHAs have been a real asset to the CCG.
101.4 Better Health Programme (BHP) Public Engagement Events – Phase 4
The GB was informed that during October, the BHP will be undertaking Phase 4 of the public engagement events. Within our CCG area, there are two events scheduled, one on 24th October 2016 at Hartlepool College of Further Education and one on 28th October at South Thornaby Community and Resource Centre. These events are still pre-engagement events and formal consultation is now expected to take place in 2017. Ms Wilson highlighted that feedback has been that the event invitations are not reaching everyone so the CCG are looking at how else to publicise and engagement work to continue throughout consultation.
101.5 Local A&E Delivery Board (LADB)
On the 1st September 2016, the Hartlepool and Stockton-on-Tees System Resilience Group became the Local A&E Delivery Board (LADB). and will act as a forum where partners from across the health and social care economy come together to discuss strategic aims and objectives in relation to improving Accident and Emergency (A&E) performance. The Board has to now have chief Executive and Chief Officer attendance to demonstrate the importance and include senior leadership. This transformation was mandated by NHS England in their correspondence to CCG Accountable Officers, dated July 26th 2016.
101.6 Care Coordinators
Ms Wilson advised that the CCG has commissioned a pilot service which will provide a personalised and coordinated, proactive and reactive approach in supporting the top 2% of patients identified as being at high risk of hospital admission or re-admission to develop and manage their care plan. It will be available to all GP practices in HaST CCG. In order to ensure equity of access the service will be allocated across practices based on patient list size and care co-ordinators will lead on the development of the care plans. Ms Wilson confirmed that the first care co-ordinators have now been recruited and Ms Wilson had the pleasure of meeting them during their training program and was incredibly impressed with their enthusiasm and also the diverse experience and expertise in the team.
101.7 Regional Bid to become a nursing associate test site
Ms Wilson reported that the CCG has made a Regional Bid to become a nursing associate test site which will formalise existing effective partnership working in place between its acute, mental health and community service providers, primary care and the education providers who deliver pre-registration nursing education and training.
101.8 Association for Public Service Excellence (APSE) Award
At the APSE Service Awards 2016, Stockton Borough Council won the Best Health and Wellbeing Initiative Award in relation to the Multi-disciplinary Service (MDS). The MDS is part of the Better Care Fund, which is operated jointly by the CCG and Stockton and Hartlepool Borough Councils. These awards, designed to recognise excellence in local government frontline services, are eagerly anticipated by councils across the UK. They specifically highlight local councils that have embraced change, innovation and best practice in order to continually offer outstanding services, despite budget cuts.
101.9 Working with Darlington CCG
Ms Wilson explained that in order to strengthen the agreed formal collaboration between DCCG and HaST CCG a shared management structure has recently been consulted on with both CCG’s staff. Whilst each CCG will remain a statutory organisation in their own right greater collaboration, including a shared management arrangement, will be beneficial. The staff consultation has now concluded and the GB will be assessing the outcome prior to progressing to the next stage of implementation.
101.10 North East Leadership Academy (NELA)
The CCG is a partnership member of the North East Leadership Academy (NELA) and following a member voting process, Ms Wilson was appointed Chair of the Academy.
101.11 Hartlepool Assisted Reproduction Unit
Following the GB’s decision to pursue option one which was to have a comprehensive reproduction service, including the licensed and unlicensed provision to remain at Hartlepool hospital delivered by an alternative provider, the CCG is now progressing the process to secure a suitable alternative provider.
101.12 Sustainability and Transformation Plans and 2017-2019 Planning
Ms Wilson outlined that the Five Year Forward View set out the shared ambition to improve health, quality of care and efficiency within the resources given to NHS England by Parliament. This ‘triple aim’ will only be achieved through local health and social care organisations working together in partnership with the active involvement of patients, stakeholders, clinicians and staff. Sustainability and Transformation Plans are the means of delivering these objectives in each local health and care system. Ms Wilson explained that there has been a lot of anxiety around the STPs for the public, and local authorities are not sure if they want to be part of the planning. Ms Wilson advised that the CCG have been working with the local authorities to helps shape some of the Governance arrangements around the STPs.
101.13 Hartlepool Local Health and Social Care Plan
Ms Wilson confirmed that the final report of the working group was presented to the Health and WellBeing Board on 17th October and the plan is being brought to the GB on 24th October for consideration of a response to the report. Hartlepool Borough Full Council will consider the plan on 27th October.
15:53pm ~ Ms Golightly joined the meeting
101.14 Managing conflicts of Interest in the NHS: A Consultation (NHS England)
Ms Wilson summarised that NHS England is launching a major consultation on proposals to strengthen the management of conflicts of interest, clamp down on inappropriate behaviour and ensure that the NHS is one of the leading healthcare organisations in the world in tackling these issues. The six-week consultation is an opportunity for all interested parties to make their voices heard about these proposals which cover gifts, hospitality, employment, sponsorship and other interests. Ms Wilson advised that Mr Carter, Corporate Governance and Risk Officer will be drafting a response.