AgendaDate: 17 October 2018

Enquiries to:Ms L Godsell

Direct Line:01592 643355 x 28138

A MEETING OF THE ACUTE SERVICES DIVISION CLINICAL GOVERNANCE COMMITTEE WILL BE HELD ONWEDNESDAY 2nd JULY 2014 AT 2.00PM IN THEBOARD ROOM, HAYFIELD CLINIC, VICTORIA HOSPITAL

Chairman–Professor I Campbell

Welcome and Introductions
Apologies for Absence:
Ms Lynn Barker, Head of Nursing
Dr G Birnie, Associate Medical Director – Acute Services Division
Ms H Knox, Director of Acute Services
Unconfirmed Minute of ASD CGC Meeting Held on 2nd April 2014 / Attached
Matters Arising
(4.1) / Action List / Attached
Executive Leads’ Clinical Governance Reports
(5.1) / Acute Services Division’s Associate Medical Director’s Report(Dr G Birnie) / Attached
(5.2) / Acute Services Division’s Director of Nursing’s Report (Ms M Gardner) / Attached
Governance Items
EmergencyCare Directorate
(6.1) / Clinical Director/Nursing Directorate Report / Attached
(6.2) / NHS QIS Neurological Standards Implementation Update and Neurological Health Services Action Plan(Noted within Directorate report) / N/A
(6.3) / Annual Cancer Reports – Lung (Noted within Directorate report – not printed) / Attached
(6.4) / Annual Cancer Reports – Melanoma (Noted within Directorate report – not printed) / Attached
Planned Care Directorate
(6.5) / Clinical Director/Nursing Directorate Report / Attached
(6.6) / Annual Cancer Reports – Ovarian(Noted within Directorate report – not printed) / N/A
(6.7) / Annual Cancer Reports - Upper GI(Noted within Directorate report – not printed) / N/A
(6.8) / Annual Cancer Reports – Breast (Noted within Directorate report – not printed) / N/A
(6.9) / Annual Cancer Reports – Colorectal (Noted within Directorate report – not printed) / N/A
(6.10) / Resuscitation Department Annual Report 2013/2014 (Noted within Directorate report – not printed) / N/A
(6.11) / Scottish Audit Surgical Mortality – b/f frm April 2014 – Report not yet published / N/A
(6.12) / Scottish Perinatal & Infant Mortality & Morbidity Report 2012 – b/f frm April 2014 (Noted within Directorate report – not printed) / N/A
Ambulatory Care Directorate
(6.13) / Clinical Director/Nursing Directorate Report / Attached
(6.14) / Endorse 6 month update – N/A - c/f to October 2014 / N/A
Clinical Governance Team
(6.15) / 6 monthly ASD Clinical Governance Risk Reports / Attached
(6.16) / 6 monthly Incident Report / Attached
(6.17) / 6 monthly Medication Incidents Report / Attached
(6.18) / Medinet Quarterly Report/s / Attached
(6.19) / BMI Healthcare Report / Attached
(6.20) / Stracathro Report / Attached
(6.21) / ASD CGC Workplan 2014/15 / Attached
(6.22) / NHS HIS Update / Attached
(6.23) / List of Outstanding Items on the ASDCGC Branch of the Clinical Governance Map 13/14 / Attached
(6.24) / Learning Summary Reports / Attached
Items for Information only:
(7.1) / Infection Control Committee Minute of 2ndApril 2014 / Attached
(7.2) / SRTC Clinical Governance Minutes of 24th April 2014 / Attached
(7.3) / Quality, Safety & Governance Group Minute of 26th February 2014 (confirmed) & 30th April 2014 (unconfirmed) / Attached
(7.4) / Antimicrobial Management Team Minute of 12th March 2014 (draft) & 28th May 2014 – N/A – meeting cancelled / Attached/N/A
(7.5) / NHS Fife Clinical Policy and Procedure Authorisation and Coordination Group Minute of 11th March 2014 (Confirmed) 26th May 2014(unconfirmed) / Attached
(7.6) / Hospital Transfusion Committee of 2nd April 2014 (unconfirmed) / Attached
(7.7) / Resuscitation Committee of 30th January 2014 (unconfirmed) / Attached
Items for Chair to Raise with NHS Fife Clinical Governance Committee
(Prof. I Campbell)
AOCB
Date of Next Meeting
The next meeting is scheduled to take place on Wednesday 1ST October 2014 at 10.00am within the Board Room, Hayfield Clinic

Distribution:

Name / Designation
Nick Barber / Public Partnership Forum Representative
Lynn Barker / Head of Nursing, Emergency Care Directorate
Dr Gordon Birnie / Medical Director, NHS Fife Acute Services Division
Prof Ian W Campbell / Emeritus Professor of Medicine, University of St Andrews
Dr Rob Cargill / Clinical Director, Emergency Care Directorate
Catherine Cummings / Directorate Nurse Manager, Planned Care Directorate
Morag Gardner / Acting Director of Nursing, Acute Services Division
Heather Knox / Director of Acute Services
Dr Steven Monaghan / Clinical Director, Planned Care Directorate
Elizabeth Muir / Clinical Effectiveness Co-ordinator NHS Fife
Roy Nelson / Public Partnership Forum Representative
Arlene Saunderson / Directorate Nurse Manager, Ambulatory Care Directorate
Dr Susan Smith / Clinical Director, Ambulatory Care
Maureen Speedie / Directorate Nurse Manager, Planned Care Directorate
Helen Woodburn / Head of Quality & Clinical Governance
ASDCGC / Version :FINAL / Date: 100314
Medical Director’s Directorate / Page 1 of 3 / Review: N/A