APPROVED

NHS GRAMPIAN

Note of the Performance Governance Committee held on

Friday 20 May 2011at 2pm in the Seminar Room, Summerfield House

Present:

David Cameron (Chair), Non-Executive Board Member, NHS Grampian

Val Maehle, Non-Executive Board Member

Charles Muir, Non-Executive Board Member

Gordon Stephen, Non-Executive Board Member

In Attendance:

Roelf Dijkhuizen, Medical Director

John Miller, Communications Manager (item 5.2.1 only)

Clark Paterson, Senior Finance Manager (item 5.3.1 only)

Anne Ross, Head of Performance and Quality Improvement

Pauline Strachan, Chief Operating Officer

Glenys Wells, Personal Assistant - Minuting Secretary

Item / Subject / Action
1. / Apologies
Apologieswere received from Bill Howatson, Richard Carey and Alan Gall.
2. / Healthstat
The Healthstat section of the meeting was covered in a separate paper (attached).
3. / Minute of Meeting held on 21 March 2011and Matters Arising
This was approved and no matters arising were reported.
4 / Assurance Framework
Reports from Governance and CHP Committees:
4.1 / Staff Governance Committee – 22 March 2011
Mr Stephen reported that the People Strategy had been completed and implementation would be monitored regularly. The Health and Safety strategy had been ratified and a work plan produced including blended training opportunities. NHSGrampian continued to meet targets for KSF. He advised that the self assessment audit tool had been completed in draft. Sickness absence was currently 4.2% with attendance management work continuing including the Intelligent Attendance Management project.
4.2 / Patient Focus and Public Involvement – 11 May 2011
Dr Cameron advised about the potential impact on implementation of Patient Rights Bill caused by national delay in transition of Independent Advice and Support Service to Patient Advice and Support Service Proposals for parking on the Foresterhill site were being considered and the public and staff had been involved in the work. Recommendations would be submitted to the Board in due course.
4.3 / Moray CH&SCP – 18 March 2011
Mr Muir reported on a good discussion about the maternity review and advised that the committee continued to be updated on issuesrelating to Dr Gray’s, Leanchoil hospital and community pharmacy. He reported on his/Andrew Fowlie’s attendance at Ministry of Defence base discussions.
4.4 / Aberdeen City CHP – 18 April 2011
Dr Cameron reported that the Committee had heard that the Timmer Market facility was now open. An extra £25K investment had been approved for the Advocacy service. Work was continuing around the committee structure within the existing Scheme of Establishment.
5. / May 2011 Overall Performance and ‘At A Glance’
Ms Ross provided an update on performance against key measures.
Alcohol Brief Interventions had been delivered in full, assisted greatly by actions within Accident and Emergency and the sexual health service.
The target for cardiovascular interventions had been exceeded.
Child Health Weight interventions had also been delivered in full.
Successful smoking cessations was believed to have been met but final data was awaited
Fluoride Varnishing and dental registration targetshad not been met in full and the lower rate for Moray was noted. It was confirmed that salaried dentists activity was not included in this measure.
There were still some problems around full delivery of the 62 daycancer access target, however the main staffing issues had been resolved so it was expected that future quarters would show a more positive position.
87% performance had been reported against the 18 weeks referral to treatment target in March. The manual clean up of data was continuing.
Progress was being made with the drug treatment access targets Scottish Government performance team had requested a meeting soon.
Data for performance against the new HEAT target for access to stroke unit would be available in the next report.
MRSA/ MSSA rates were at lowest recorded and cDiff target was delivered in full.
Performance against the 4 hour A&E target was now back on track.
Non electivelength of stay continuedto fall.
The BADS daycase targethad been exceeded.
The preoperative stay target had been met.
There had been no delayed dischargesof greater than 6 weeks reported in April.
Sickness absence had reduced to 4.2%
Members noted that overall it was a very positive performance picture. Dr Strachan advised that this was the result of considerable effort by staff across the organisation.
5.1 / Improving the Public’s Health and Reducing Inequalities
5.1.1 / Delivering 2011/12 ‘H’ Measures
Mrs Webb’s paper to OMT was noted. Dr Strachan referred to the huge effort across the organisation during the latter half of the year to improve performance which had generally ensured2010/11delivery. The paper reported on the different challenges for 2011/12 and Dr Strachan confirmedthat there would be close performance management of delivery.
5.2 / Delivering safe, effective & timely care in the right place
5.2.1 / Media Report (Strategic Risk 858)
John Miller reported that there had been no significant media issuesduring March and April. He gave some examples of topics covered. The Marie Curie out of hours topic had started negatively but was turned around, issues with the PMS launch had been covered as well as their resolution.There had been wide local coverage about Leanchoil hospital and ongoing reporting on parking at ARI. A letter of dissatisfaction had been sent to the P&J over its inaccurate reporting on management costs. Members agreed that the new format of reporting provided a better perspective on events.
Dr Strachan advised that It had been agreed to reinstate the weekly health programme on SHMU radio. Mr Miller also advised that Corporate Communications would be exploring the benefits of using Facebook and Twitter for communication.
5.2.2 / CSI Performance Report (Strategic Risk 854)
Ms Marsland reported on the new monthly CSI reporting format which identified business problems along with thebenefits being delivered. She advised on the “disengage” phase for the acute pharmacy workstream which would now move to operational implementation. Dr Dijkhuizen had agreed to be the executive lead for unscheduled care where the focus was currently on developing workstreams tobe progressed. The Staff Governance Committee had been made aware that there was currently no CSI team resource to support the maternity project but a business case for this would be produced. A critical phase had been reached in the theatres work with a proof of concept day imminent. If successful the changes made would be rolled out across theatres. Length of Stay project work was continuing and an example of improvement was the reduction in abortive journeys by the Scottish Ambulance Service. A review of community midwifery as part of the productive community was planned. This would not impact on the maternity review. Members agreed that the report was positive and Ms Marsland agreed to remove the reference to “hoshin” in the title.
5.3 / Improving Efficiency, Productivity and Sustainability
5.3.1 / End March Financial Report (Strategic Risk 851)
Clark Paterson reported that,subject to audit, all financial targets for the year ending March 2011 had been achieved. There was a small revenue underspend of £32K on an overall budget of £900m. Mr Paterson outlined the variances within this which included an overspend on pay. There was an increase in volume and price for GP prescribing which resulted in a £1.3m overspend. Other cost pressures included work for other Boards, all of which had been identified in the budget setting process for next year. Most of the 2010/11 £60m capital budget had been spent with very little to be returned to the Scottish Government for NHSGrampian use next year. Staff throughout the organisation had been thanked for delivering this significant achievement.
The significant challenges for the new financial year, including a savings target of £20m, were discussed.
Dr Dijkhuizen referred to the tavi procedure and how it would in due course replace open cardiac surgery. He also advised on David Pfleger’s work around prescribing incentive schemes for GPs.
Dr Strachan reinforced the excellent performance in 2010/11.
5.3.2 / Same Day Surgery
The report showed clearly the improvement that had been delivered in same day surgery as well as related measures such as extent of pre-assessment. Dr Strachan advised that there was continued work around admin processes to further facilitate day cases. The positive position was welcomed.
6. / Performance Governance Committee Action Plan 2010/11 outturn and 2011/12 draft
Ms Ross presented the final 2010/11 plan for sign off. There was one item outstanding in relation to monitoring the OMT’s management of system issues which Ms Ross and Dr Strachan would discuss outwith the meeting. Members agreed to sign off the 2010/11 Action Plan.
The draft 2011/12 plan was also based on the Committee’s remit. Members were invited to contact Ms Ross with any comments/additions to the plan.
7. / Performance Management Key Performance Indicators (KPIs)
Ms Ross reported on full delivery of the performance management KPIs for 2010/11. These would continue to be monitored in 2011/12.
8. / Statement on Internal Control – assurance statement from PGC
Members noted this paper.
9. / Strategic Risk Control Plan
Ms Ross advised that although the risks had not changed, the comments had been updated. Diane Donald will attend the July meeting to discuss the civil contingency risk. It was agreed that providing a link to the plan would be more efficient than printing.
10. / To consider content of June 2011 Board Report
- H targets
- Financial report
- Same day surgery
- Performance outturn
11 / AOCB
Dr Strachan advised on the reports produced by Janet Seaton on high and catastrophic incidents and external scrutiny. She would follow up on the logistics of these reports being presented to PGC.
Date of Next Meeting
Tuesday 19 July, 10.30am – 1pm, SeminarRoom, Summerfield House

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