MINUTEs OF THE MEETING OF FIFE NHS BOARD HELD ON TUESDAY, 30 APRIL 2013 at 10.00 am IN SEMINAR ROOM 1, ST ANDREWS MEDICAL SCHOOL, ST ANDREWS

Present:

Professor J McGoldrick (chairperson) / Mr S Little, Non-Executive Director
Ms M Adams, Non-Executive Director / Dr I Lowles, Non-Executive Director
Mr P Adams, Non-Executive Director / Mrs A McGovern, Non-Executive Director
Ms S Archibald, Non-Executive Director (part) / Mrs J Mitchell, Non-Executive Director
Mr H Blyth, Non-Executive Director / Dr B Montgomery, Medical Director
Mrs C Bowring, Director of Finance / Mr A Morris, Non-Executive Director
Mrs W Brown, Employee Director / Mr A Robertson, Non-Executive Director
Ms A Buchanan, Nurse Director / Cllr A Rodger, Fife Council
Dr K Cheshire, Chairperson, Area Clinical Forum / Ms A Rooney, Non-Executive Director
Mr K Cochran, Non-Executive Director / Mr D Stewart, Non-Executive Director
Dr E Coyle, Director of Public Health / Mr J Wilson, Chief Executive
Mrs F Purdon, Non-Executive Director / Mr J Winton, Non-Executive Director
Ms M Harper, Non-Executive Director

In Attendance:

Mr G Cunningham, Acting Director of Acute Services

Mr D Christie, Director of Organisational Development

Ms A Heyes, Equality & Diversity Lead

Mr R Hinds, Chief Executive, Fife Council (Item 2)

Mrs V Irons, General Manager, Glenrothes & North East Fife Community Health Partnership (CHP)

Mr W John, Public Health Pharmacist (part)

Ms R M King, Director of Human Resources

Mr J Leiper, Director of Estates, Facilities & Capital Services

Professor H MacDougall, Dean of Medicine and Head of the Faculty of Medicine, University of St Andrews

Ms E McPhail, Director of Pharmacy (part)

Mrs S Manion, General Manager, Dunfermline & West Fife CHP

Mr S Moore, Fife Council

Mrs M Porter, Acting General Manager, Kirkcaldy & Levenmouth CHP

Ms N Wilson, Head of Corporate Services

Mrs P M King, Corporate Services Manager (Minutes)

Professor McGoldrick welcomed everyone to the meeting and thanked Professor MacDougall for hosting the NHS Fife Board meeting.

19/13 / DECLARATION OF MEMBERS’ INTERESTS
None.
20/13 / INTEGRATED SHADOW BOARD
Mr Hinds, Chief Executive, Fife Council was welcomed to the meeting to jointly present the paper.
Mr Wilson introduced the paper which had also been previously presented to Fife Council Executive Committee on 16 April 2013 setting out the joint work that had been undertaken in preparing for the integration of Health and Social Care Services in Fife. The move towards integration was in line with Scottish Government policy and legislation would be produced in due course. This would mean significant changes for Community Health Partnerships (CHPs), which would be replaced by a Health and Social Care Board. There would be no change to the CHP structure until legislation was enacted.
Partnerships had been encouraged in advance where possible on the clear understanding that arrangements might need to be amended once legislation was produced. The paper had been jointly prepared to ask the Board to consider the establishment of an Integrated Health and Social Care Partnership Board in shadow form. If there were any issues arising from the detail and how the Board should function this would be remitted back. It proposed that the Shadow Board comprise eight members of NHS Fife and eight members of Fife Council along with representatives attending from the third and independent sectors. The paper presented to Fife Council had been referred to the Education, Social and Communities Scrutiny Committee for clarification on a number of issues.
An Interim Director of Health and Social Care had been appointed as part of the arrangements towards moving to an integrated health and social care model for Fife. This post had an agreed remit which would come to an end once a substantive appointment had been made to the “Jointly Accountable Officer” post, accountable to both the Chief Executive of Fife Council and NHS Fife; this appointment would be made following legislation.
Mr Hinds took the opportunity to thank the Board for allowing him to be present at the Board meeting as he felt it was important for the two Chief Executives to take a lead on such an important issue. He paid tribute to members of NHS Fife and Fife Council staff that had played a significant part in getting work to this stage. Since the inception of the work the partnership had tried to do better for the people within its care and although staff were doing a good job in the circumstances in which they worked, the aim was to put staff in a better position to work more effectively in the interests of the people of Fife and improve outcomes.
Members raised a number of queries which were responded to as follows:
·  Guidance available from SG suggested that a Partnership Board should have a minimum of three members from each organisation. The proposal to have eight members from NHS Fife and eight members from Fife Council was explained and was mainly due to the need for Fife Council to have each of the political groups represented, matched with an equal number from NHS Fife.
·  It was understood that there might be a process to bring legislation into play next year but this was not clear. In order to maintain momentum the Programme Board had suggested that the Shadow Board meet from June 2013 onwards but there was a need to take time to tighten up the detail of membership and other aspects. It was noted that the Bill was currently in draft form and would be forwarded to Parliament for scrutiny in due course.
·  There was a need to consider carefully the language used as it could be confusing.
·  There was a commitment to organise a Development Session between NHS Fife Board and Fife Council to discuss the relevant issues and what these would mean for services and staff. The need for continued development sessions as the process evolved was also emphasised.
·  A patient/public involvement group had been established. The Public Reference Group, chaired by Mrs Doreen Bell, had membership from a wide range of individuals and representative groups across Fife and reported to the Programme Board.
·  The issue of resources had been considered and an indication of the budgets applicable to the services which were envisaged as being managed within the new arrangement had been identified. It was recognised that there were opportunities to maximise efficiencies by avoiding duplication, being flexible about how resources could be used, etc, but the responsibility for the money that Fife Council spends on social work which was allocated by the Council and money for health services which were allocated by the Board would continue. Mr Hinds reassured Members that the principle to be adhered to was that of transparency on both sides and he highlighted the importance of building trust.
Cllr Rodger emphasised the need to focus on the patient/client to ensure person centred care. He was pleased at the way integration was being taken forward and referred to the Health and Social Care Partnership which had been running for many years and although this was heading into a different structure, the bedrock was there to be taken forward. There was already good work being done together around Integrated Community Assessment and Support Services (ICASS), Hospital at Home, etc, and staff were trying hard to do the best for the people of Fife.
Mr Hinds confirmed that many of the concerns raised had also been expressed by Fife Council. This was new territory and moving organisations the size of NHS Fife and Fife Council was a major challenge. He asked Members to recognise the purpose of integration which was being advanced without the benefit of guidance but the direction of travel was clear and he hoped work could be undertaken together to move ahead.
The Board:
·  noted progress being made in developing the integration of health and social care; and
·  agreed to establish a Shadow Health and Social Care Partnership Board with membership as suggested noting that further discussion would take place around the composition from each organisation. Further detail would be addressed by the Shadow Board when established in June 2013 following a development session to be organised prior to this. A paper on the questions raised would be submitted to the Shadow Board for consideration.
21/13 / CHAIRPERSON’S WELCOME AND OPENING REMARKS
A list of events that the Chairman had attended since the last meeting had been tabled. The Chairman referred to the recent appointments of Mr Stephen Moore, Interim Director of Health and Social Care and Dr Scott McLean, Executive Director of Nursing. Mr Allan Burns, had been appointed as the new Chair of NHS Fife with effect from 1 May 2013. Mr Burns was formerly Chair of Scottish Enterprise Fife and Executive Director of Diageo in Scotland and Global Procurement Director.
(a) / Board Development Session – 26 March 2013
The Board noted the report on the Development Session
22/13 / APOLOGIES FOR ABSENCE
There were no apologies for absence.
23/13 / MINUTE OF PREVIOUS MEETINGS HELD ON:
(a) / 26 FEBRUARY 2013
The Minute of the previous meeting was approved as a true record.
(b) / SPECIAL MEETING OF THE BOARD HELD ON 26 MARCH 2013
The Minute of the previous meeting was approved as a true record.
24/13 / MATTERS ARISING
There were no matters arising.
25/13 / STATUTORY AND OTHER COMMITTEE MINUTES
(a) / Area Clinical Forum dated 14 March 2013 (unconfirmed)
Dr Cheshire advised that discussion was taking place around the direction of travel for the Area Clinical Forum particularly around integration of health and social care. The establishment of a Professional Reference Group was also highlighted.
(b) / Area Partnership Forum dated 22 February 2013 (unconfirmed)
The minute had been confirmed. Ms Brown explained that the Home Computing Scheme was run a few years ago whereby members of staff could lease a computer and consideration was being given to running the scheme again.
Ms Buchanan confirmed that a major piece of work had been undertaken following the situation in NHS Ayrshire & Arran related to the reporting of adverse incidents and Health Improvement Scotland had also undertaken a review about how to manage adverse events in totality. NHS Fife had robust systems in place for clinical adverse reporting but these would be supplemented and progress reported through the Clinical Governance Committee. Ms Buchanan reassured Members that she was comfortable most of the untoward incidents were captured and resolved.
(ci) / Audit Committee dated 20 September 2012
There was nothing to add.
(cii) / Audit Committee dated 21 March 2013 (unconfirmed)
Ms Rooney drew attention to concern about the way in which audit reports had been issued to the Audit Committee, the numbers of policies which had lapsed review dates and that Equality Impact Assessment forms had not been routinely attached and that the Annual Internal Audit Plan had not been fully approved but was subject to seeing the report on Policy and Procedures at the next meeting of the Audit Committee.
(d) / Clinical Governance Committee dated 13 February 2013 (unconfirmed)
Mr Cochran reported that the meeting had not been quorate therefore the minutes would be homologated at the next meeting. Dr Lowles would be requesting a meeting with the new Chair to discuss Membership of the Committee in due course.
(e) / Dunfermline & West Fife CHP Committee dated 14 March 2013 (unconfirmed)
Ms Adams drew attention to the updates provided on the Primary Care Out of Hours Treatment Centres and the Family Nurse Partnership. The Minister for Children & Young People had launched NHS Fife’s ‘Bumps and Babies’ day which was part of the innovative work of the Family Nurse Partnership and it had been good to see the relationship between mothers and their partners and the nurses.
Mrs Manion outlined the consultation process for the Primary Care Emergency Service (PCES) and confirmed that open meetings had been arranged for May and June. An agenda had been discussed with Mr E Byiers, Chair of the meetings. Work had been undertaken and an option appraisal was being prepared for discussion and comment at the meetings. Comments received would be incorporated into the final paper for the NHS Fife Board meeting scheduled for August 2013. The option appraisal would form one element of the overall paper being prepared to go to the Board.
Ms Brown pointed out that Ms Lynne Parsons was the Local Partnership Forum Representative, not the Area Partnership Forum Representative.
(f) / Fife Health & Wellbeing Alliance dated 13 March 2013 (unconfirmed)
There were no comments made. Professor McGoldrick recorded thanks to Ms Vivienne Brown, Health Improvement Adviser, the main officer that supported this Committee.
(g) / Fife Partnership Board dated 19 February 2013 (unconfirmed)
Professor McGoldrick advised that a peer review discussion of the community planning partnership had taken place at the meeting attended by the Chair of the National Community Planning Group and the Minister for Local Government and Planning.
(h) / Finance & Resources Committee – Part 1 dated 26 March 2013 (unconfirmed)
Mr Adams stated that this meeting had been followed by the Special Board Meeting and a number of Board Members had attended. Those in attendance should also list Mrs Purdon and Mr Winton.
(i) / Glenrothes & North East Fife CHP Committee dated 6 March 2013 (unconfirmed)
Mr Morris highlighted that the Xray Equipment at Glenrothes Hospital would be operational in July 2013, the sod cutting ceremony for the new Glenwood Health Centre had taken place and the work at Adamson Community Café had been completed.
In response to Mr Winton, Mrs Irons confirmed that progress was being made for the commencement of Hospital at Home in Glenrothes & North East Fife but there had been issues with consultant cover. A more primary care led service was being discussed and draft proposals would be submitted to the Committee in due course. This was quite a significant change and would be noted at the Committee.
(j) / Health & Social Care Integration Programme Board dated 7 February 2013 (unconfirmed)
Mr Wilson advised that the main item of discussion had been preparation of the paper discussed earlier today under item 2.