NHS GRAMPIAN

Minute of the Grampian Area Partnership Forum (GAPF)

held on Tuesday 24 November 2009at 2.00pm

in the Conference Room, Summerfield House

Present:

Richard Carey, Chief Executive (Chair)

Gordon Stephen, Staff Side Chair/Employee Director

Mike Adams, UCATT

Brigid Aitken, RCN (Video Conferenced)

Jacqui Biddle, RCM (deputy for Kirsten Sawers)

John Brett, Head of Health and Safety

Jim Clark, GMB

Joe Collier, Clinical Nurse Manager

Jon Cresswell, BMA

Laura Gray, Communications Director

Heather Hardisty, SeniorService Manager, Aberdeen City CHP

Anne Inglis, Head of Organisational Development

Bettina Low, UNISON

Deirdre MacIntyre, SOCAP (Video Conferenced)

Anne Ross, Head of Performance and Quality

Clare Ruxton, Head of Human Resources (HR)

Lynn Shand, CSP

Alan Sharp, ADOF - Corporate Finance (deputy for Alan Gall)

Philip Shipman, HR Manager, Moray (deputy for Andrew Fowlie) - (Video Conferenced)

Mark Sinclair, Director of HR and Strategic Change

Jack Stuart, General Manager Aberdeenshire

Joan Anderson, Partnership Support Officer

Observers

Sarah Duncan, Unison Regional Officer

Laura McDonald, Staff Side Health and Safety Chairperson and Staff Side Representative on the Staff Governance Committee

In Attendance

Liz Murphy, Consultant Occupational Physician, Occupational Health Service (OHS) for Item 3a

Gerry Lawrie, Workforce Manager for Item 7

Helen Cheyne, KSF Project manager, for Item 8a

Linda McKerron, Learning and Development Manager for Item 11

Item / Subject / Action
1 / Apologies
Apologies were received fromAlan Gall, Director of Finance (Alan Sharp deputised),Andrew Fowlie, General Manager Moray(Phil Shipman deputised), Alisdair Chisholm, General Manger Acute (and Vincent Shields), Kirsten Sawers, RCM (Jacqui Biddle deputised),Sandra-Dee Masson, BAOT (No deputy available), Eric Murray (and Gary Mortimer), Jen Pittendreigh, BDA (No deputy), Mike Scott, Staff Governance Committee (no deputy available), Sharon Duncan (no deputy)
2 / Minute of Meeting held on 17 September 2009
The minute of meeting held on 17 September 2009was approved subject to two amendments as follows:
Add Mike Scott, Staff Governance Committee to the Apologies list.
Final paragraph in Item 2 to read as follows:
“Developments to the NHS Grampian Occupational Health Service counselling provision were welcomed as they now include telephone counselling.”
3 / Matters Arising
a.Pandemic Influenza Update
Liz Murphy, Consultant Occupational Physician, OHS, attended the meeting to update on the vaccination programme. There had been almost 10,000 requests for both seasonal flu and swine flu vaccinations. A total of 6000 vaccinations had been given to staff, other health care staff, university staff, etc. Three quarters of these 6000 were NHS Grampian Staff. Demand for vaccinations continue but seems to have eased a little. Twice as many vaccinations have been undertaken than the usual seasonal flu vaccine.
Peripheral clinics were arranged to enable staff to access vaccinations easily. Some clinics were really busy and others were not so. Now that things have eased off slightly there will be a move to do more of the vaccinations centrally.
Teaching and learning support staff in special schools are to be vaccinated and this will take about one week.
There are about 100 offshore pilots and medics to be vaccinated soon.
It is expected that about 200 vaccinations a day will continue until the New Year. This work is obviously having an impact on the other work of OHS and it is hoped that this will go back to nearer normal after Christmas.
The symptoms following vaccination have been mainly minor eg a sore arm and sometimes a headache.
No clinics have taken place yet for staff with egg allergies but the numbers in this category are very low.
Richard Carey expressed the appreciation the forum had for the work of Liz and the Team who have delivered this service in very large numbers.
a.i.Pandemic Influenza Procedure for the Management of the
Workforce
The update to the Pandemic Influenza Procedure for the Management of the Workforce Policy was approved.
b.Continuous Service Improvement Update
Mark Sinclair explained that a leaflet had been drafted and comments were requested. It was hoped to circulate the leaflet soon, with payslips if possible. The leaflet is for all staff to try and get them more engaged with CSI.
The Best Value for Procurement Review had just been completed. 40 to 50 staff were involved in this process. A plan had been developed for the next 6-9 months to Best Value for Procurement. This should make significant savings.
Other projects include community hospital length of stay where the length of stay in hospital had been reduced by 15% in the community of Turriff and it was hoped to role this out to other community hospitals.
It is necessary to keep staff informed and on board with all 14 CSI projects. The leaflet should help with this and awareness sessions have started as well.
c.Voluntary Early Release Scheme(VERS)/Voluntary Severance (VS)
The VERS/VS process is almost complete. All applicants received a letter early November informing them of whether they were successful or not.
660 noted interest received
440 applications were received
125 applications were supported by managers
62 staff were successful
Staff who were successful are discussing with their managers when they can leave. Everyone must have left by 31 March 2010.
As this scheme was accepted as a pilot by the Scottish Government, it has been agreed that PricewaterhouseCoopers (PWC) will undertake an audit. Terms of reference were being discussed and would be agreed by the Staff Governance Committee. It is hoped that the audit will be complete quickly. It will go then to the Management Steering Group (MSG) and if supported, to Scottish Terms and Conditions (STAC). If supported it is hoped to ask for an extension to the variation order so that NHS Grampian can run the VERS/VS scheme again.
Some other Boards are not in support of our VERS/VS scheme and this may hold up or stop us taking forward another round. It is hoped that the audit will demonstrate that this scheme is a win/win process rather than having to use Section 16 of the Agenda for Change handbook. The Cabinet Secretary Nicola Sturgeon asked at the Annual Review on 2 November about this scheme and has been asking through MSG if anyone would like to use it.
It has been demonstrated in partnership that this can work and this round of VERS/VS will make a saving of £1.5m from £2010/11.
4 / Any Other Competent Business Determination
Health and Safety Inspections.
5 / Financial Report
a.NHS Grampian Reports
Alan Sharp reported on the October Finance Report. This report is encouraging with a small overspend in October which is the second month that NHS Grampian (NHSG) have almost broken even. The big overspends in the early months of the financial year appear to have stopped. There is still a big challenge to recover the £3.25m overspend incurred to date between now and the end of the financial year.
The difference between actual staff numbers in post and those there is funding for continues to reduce. This does put pressure on certain areas because of staffing levels.
There are two major financial risks:
The first one is that NHSG is making a case to receive more funding for waiting times from the Access Unit. The costs of dealing with Waiting Times are already being incurred so if we don’t receive extra funding there will be a financial shortfall.
The second is the degree of money being made good against earmarked funding for specific projects. In the past specific funding unspent could be carried forward into the next financial year and then made good. This has taken place but we are not achieving slippage on new specific funding to balance the making good.
Capital Funding – we have spent 30% in the first 7 months which is an improvement on previous years but still a few areas which need to be pushed forward.
2010/2011 and beyond will continue to be a challenging time. 2.3% uplift is much lower than previous years. The third year of the Agenda for Change Pay Deal takes place in 2010 at 2.4% and there are all sorts of other increases in costs so the funding uplift will not cover these increases in costs which leads to a huge challenge in 2010 and beyond.
The Budget Steering Group and management are looking at how to deal with this. Partnership will play a crucial role in the financial challenge.
It is still hoped NHSG can break even at the end of this financial year as long as Sectors continue the performance delivered in the last two months.
b.Efficiency and Productivity Programme Management Office (EPPMO)
The EPPMO will be focussing on operational issues to make savings by bringing in ideas from elsewhere and developing a work plan. Alan Gall and Jack Stuart will lead on this and the work plan will be signed off by the Board. Work will start in the new year.
c.Financial Reports from Sectors
Aberdeen City – Heather Hardisty gave a report on Aberdeen City CHP as follows:
The City CHP has a devolvedoperating budget of £80 million as at 31 October 2009. There are four service components - Community Services (including Salaried Practices and the Links Unit), Combined Child Health, Elderly & Rehab and Resource Transfer with respective budgets of £27m, £18m, £19m and £16m. GMS and Prescribing budgets are reported on a Grampian wide basis and not included in the devolved budget.
Setting aside the Resource Transfer budget which is reported as break even, each of the other service areas is reporting a substantial deficit against budget, both for the period and forecast for the financial year.
For the 7 months to 31 October a collective deficit of £0.97 million has been reported, compared to £0.89 million the previous month. This is better than anticipated and less than incrementally expected. A significant factor in the overspending is the cost reduction requirement for the period of £2.47 million which all services are finding difficult to meet in full.
The most recent forecast is based on the financial results for month 6 (month 7 forecast will not be ready until 25 November). A collective deficit of £2.11 million is projected. The collective annual cost reduction requirement is £4.24 million. Approximately 50% of this is being absorbed in the forecast position. Each area has prepared a cost reduction programme which has yet to impact and is expected to improve the position as the year progresses. Some elements of these programmes have still to be firmed up. Approximate estimate of benefit is £1.0 million. The beneficial impact will be incorporated in the forecast once it is clear these programmes will deliver savings.
Aberdeenshire – Jack Stuart reported that Aberdeenshire and Mental Health Services had a total target of £5.3m cost savings between allocated target and budget realignment.Currently the CHP is underspent by £82k and Mental Health is over by£313K. By year end they should be around breakeven.
There are overspends in Acute, Children’s, Dr Gray’s Acute and Facilities. Corporate Sector is on track.
All Sectors are meeting set targets but this year is particularly challenging.
6
* / Face to Face Roadshows
Laura Gray gave a presentation on the face to face roadshows (slides attached). There were 29 face to face sessions. Most of these were organised by NHS Grampian globally and a few were specially requested by teams.
The roadshows reported on the vision and values, financial position and CSI. A full written report will be produced and circulated round the organisation.
Staff appreciated the face to face sessions. There will now be a brand of communication using the face to face name and logo. / LG
7
* / North of Scotland Regional Workforce Planning Workshop
Gerry Lawrie attended the meeting to update on Regional Workforce Planning. We have worked regionally in the past but it has not really worked until recently. Now there is a real appetite for this. NHS Grampian have challenges in remote and rural, training and sustainability. How do you combine all the information to get more value than the sums of all the parts? This is what is being worked on.
A co-ordinated workforce plan is required either at Board level or Regional level. The Regional Workforce Plan has 17 programmes with lots of priorities within it.
There was a workshop on 15 June which got all the stakeholders together to agree how, when, who, etc.
The next workshop is on 21 and 22 January 2010 (paper attached). Invites will be sent out shortly and there will be every type of staff involved including partnership representatives and representatives from education.
Local Delivery Plans will be developed around January time but this would be too early to add to the Local Delivery Plans from the work of the workshops and the workforce planning but connections need to be made.
It was noted that it was difficult to have a workforce plan at a time of such financial control and cutting back on staffing.
8 / Agenda for Change
a.Knowledge and Skills Framework (KSF) HEAT Target
Helen Cheyne, KSF Project Manager, attended the meeting to update the forum on KSF. The Heat Target for KSF had been reworded which meant that bank staff are removed from the target figure. This does not mean that bank staff are excluded from KSF, but that there is more time to deal with them. There will be a 12 month pilot for the nurse bank and at the end of the 12 months good practice guidelines will be compiled. Then it will be up to Boards to take forward. Boards have to show they are actively seeking solutions for bank staff.
Currently our staffing numbers are 17041 for KSF. Approximately 6000 will be removed for bank staff which will then make us ahead of trajectory. We will be 18.8% towards the HEAT Target by the end of November. We need to be 25% between now and March 2010. This is positive early steps.
The benefits realisation part of KSF needs to now come to the fore and management need to see how this will benefit their department.
Thanks were given to Helen on the good progress made.
b.Job Evaluation/Review Update
Gordon Stephen reported that we will be 98% complete for Agenda for Change Job Evaluation and Review by the end of November. This will be as close to 100% as NHSG will probably ever get because of some posts which will near be complete.
All reviews and reassimilations will be complete by Payroll by 31 March 2010.
NHS Grampian is much further ahead on Agenda for Change than the majority of other NHS Boards.
9 / Annual Review
Richard Carey reported on the Annual Review on 2 November with the Cabinet Secretary. The feedback from the morning meeting both from the Cabinet Secretary and the GAPF Reps attending the meeting was all positive. Mike Adams had made the point that a lot of good things were in place in NHS Grampian for the up-keep of the buildings but this is not a quick fix. Buildings have to be brought up to a standard to be able to be maintained and there is not enough staff to undertake this amount of work.
Nicola Sturgeon had been asked for her commitment to Partnership and had given that unequivocally.
The afternoon had not been well planned as there was 2.5 hours of questions to the Board by the Cabinet Secretary and her Team before the public got their chance to ask questions. Richard Carey submitted a request to have the public session first next year so that any of the public who do not want to stay for the Board section can go away.
The final letter is awaited and will be circulated when it arrives. / AR
10 / NHS Grampian Management Review
Some interim management changes have been made to plan for changes eg David Sullivan’s retiral next year. These will go to the Board for approval at their December meeting.
A formal management review will result in significant revenue savings. This will include Executive Bands and Agenda for Change Bands 8a and above.
There are some duplicate management structures and these will be examined to establish if they are required or not. The plan is to be as efficient as possible.
There is also a large number of senior staff over the age of 50, so succession planning needs to be put into place now so that when these staff are ready to retire, they can be replaced.
All management units are being asked to produce an organogram. A small group made up of Mark Sinclair, Gordon Stephen, Pauline Strachan and Alan Gall will look at the structures to see how to organise more effectively. Protection will be in place for any members of staff who are redeployed as part of this exercise.
Partnership and non-executive input is integral into this process.
11 / Statutory and Mandatory Training List