APPROVED

NHS GRAMPIAN

Minute of Meeting of GRAMPIAN NHS BOARD held in Open Session

on Tuesday 5 December 2006 at 10.00am

in the Conference Room, Aberdeen Foyer, Marywell Street, Aberdeen

Present

/

Mr Jim Royan

/ Chairman
Councillor Raymond Bisset / Non-Executive Board Member
Mrs Barbara Bruce / Non-Executive Board Member
Ms Margaret Burns / Non-Executive Board Member
Dr David Cameron / Non-Executive Board Member
Mr Richard Carey / Chief Executive
Councillor Kate Dean / Non-Executive Board Member
Dr Roelf Dijkhuizen / Medical Director
Mr Alan Gall / Director of Finance
Mrs Judith Hendry / Non-Executive Board Member
Mrs Elizabeth McDade / Non-Executive Board Member
Professor Val Maehle / Non-Executive Board Member (from 11.10am)
Mrs Elinor Smith / Director of Nursing
Mr Gordon Stephen / Non-Executive Board Member
Dr Stuart Watson / Non-Executive Board Member
Dr Lesley Wilkie / Director of Public Health
By Invitation / Mrs Sharon Duncan / Manager, Corporate Communications
Mrs Laura Gray / Director of Corporate Communications
Mr Nigel Firth / Equality and Diversity Manager (Item 6.4)
Dr Helen Howie / Consultant in Public Health Medicine (Item 5.1)
Ms Susan Jappy / Deputy Director of Public Health
Ms Jennifer Mack / Organisational Development Manager
Dr John Reid / Chair, Area Medical Committee
Mr Ewan Robertson / Director of Performance Improvement/Board Secretary
Mr Graeme Smith / Director of Service Development (Item 6.5)
Dr Pauline Strachan / Assistant Medical Director (Item 7.3)
Mr David Sullivan / Director of Corporate Planning
Attending / Miss Lesley Hall / Assistant Board Secretary
Mrs Glenys Wells / Personal Assistant, Board Secretariat
Item / Subject / Action /
1. /

APOLOGIES

These were received from Councillor George McIntyre and ProfessorNevaHaites.
2. / CHAIRMAN’S WELCOME
The Chairman welcomed everyone to the meeting, particularly the members of the public, a number of whom were involved with NHS Grampian in the development of the Carers’ Information Strategy and the Disability Equality Scheme items which were on the agenda.
3. / MINUTE OF MEETING HELD ON 3 OCOTOBER 2006
Subject to adding Ms Burns as an attendee, the minute was approved.
4. / MATTERS ARISING
The Chairman advised that an announcement from the Minister for Health and Social Care was expected soon on the Aberdeenshire Community Health Partnership (CHP) proposals which the Board had endorsed at its meeting on 1 August 2006.
5. / PUBLIC HEALTH
5.1  Outbreak Reports
Dr Wilkie introduced this item by explaining that Scottish Executive guidance required Incident Control Team reports to be submitted to the Board. She pointed out the important roles of the Health Protection Team in prevention and surveillance. She invited Dr Helen Howie, Consultant in Public Health, who had chaired the Outbreak Control Teams, to speak to the two reports on (1) Outbreak of E coli O157 in Insch and (2) Outbreak of Clostridium perfringens infection at an Aberdeen Restaurant.
Dr Howie advised that both outbreaks had taken place in high risk settings. In both cases, recommendations had been taken forward or were being taken forward.
Dr Cameron declared an interest in the second report, as he had been involved in the training of food handlers subsequent to the incident.
He pointed out that lessons could be learned from the incidents and that there was a role for the Chairs of CHPs.
The Board reviewed the two reports and noted the recommendations.
6. / PLANNING
6.1  Grampian Health Plan
Ms Jappy reported that a representative group had met to frame the 2007/08 Health Plan and to review the corporate objectives. The group was suggesting a different approach to the usual consultation process. From the staff survey 40% of staff reported participation in implementing Healthfit, therefore further work had to be done to engage with the remaining 60% of staff. The intention of the recommended way forward was to consolidate NHS Grampian’s performance improvements and modernisation programme and to take forward a communication plan with both staff and the public. The paper proposed holding a series of focus groups and Ms Jappy confirmed that the aim was to hold 21 of these with representation from across Grampian including the three CHPs, the acute sector and staff groups. There would be a mix across age ranges and the groups would take account of the diversity agenda. In response to a query from Mrs Bruce, Ms Jappy agreed to explore the possibility of having an online focus group.
Paper 1 provided an update on progress 2006 and Paper 2 provided a first draft of the corporate objectives for 07/08 which would be consulted on as part of the development process.
The Chairman supported the recommended approach and concluded that the proposed series of focus groups could be as effective as a formal consultation with both staff and the public.
The Board:
·  Endorsed the Health Plan Update report to be used as part of the ongoing communication programme with staff and members of the public
·  Supported the proposal not to undertake a formal consultation process this year, but to deliver focus groups to build up an insight of the customer base
·  Noted the draft corporate objectives to be consulted on as part of the communication programme / S Jappy
6.2  Winter Plan
Mr Carey advised that NHS Grampian had submitted its Joint Winter Plan to the Scottish Executive Health Department (SEHD) which had received approval. The three Local Authority/CHPs and the acute sector had also developed local action plans to reduce the number of delayed discharges over 6 weeks to zero by April 2008. Work was ongoing to reduce numbers as much as possible.
He was pleased to report that the Acute Medical Assessment Unit (AMAU) at Aberdeen Royal Infirmary (ARI) had moved from portacabin accommodation to refurbished ward accommodation which would significantly improve the experience for patients, relatives and staff. He commended the acute management team for this achievement.
He reported that GMED had also prepared a detailed Out of Hours Service Winter Plan 2006/07 which had been assessed as robust by a national group of experts. It was noted that additional resources would be deployed to meet anticipated demand during the two periods of four consecutive days when GP practices would be closed.
Mr Carey assured the Board that plans were in place, ready to be implemented and being implemented already. He advised that there were contingency plans to deal with the situation at ARI when requirements for beds coincided with a high level of elective admissions. He advised that discharge policies had to be managed more effectively to deal with bulges in demand for beds. He reported that no major procedures had been cancelled because of lack of beds. The situation was being monitored and managed on a daily basis.
The Board noted that comprehensive winter plans were in place to deal with extra pressures on services and that work was ongoing to deal with any issues as they arose over the winter period.

6.3  Carers Information Strategy

Mrs Gray introduced the item explaining the national legislative context of the Community Care And Health (Scotland) Act 2002 which required Boards to produce a strategy to promote the identification of carers and to meet their needs for information. She advised that work had started in Grampian in 2004 and had been placed on hold pending guidance which was received on 24 April 2006 as HDL (2006) 22. This guidance required Boards to prepare and submit a Carers Information Strategy by 31 December 2006. She acknowledged Mrs McDade’s significant input to the process and invited Mrs Duncan, Corporate Communications Manager, to report to the Board.
Mrs Duncan explained how the Strategy had been developed and the consultations which had been undertaken on the original 2004 draft and the current draft. She advised that all constructive comments received had been included in the strategy and would form part of the future action plan.
Mrs McDade advised that the strategy not only contained the elements prescribed in the guidance but also additional elements. She thanked Mrs Duncan, Corporate Communications staff and Mrs Rieta Vilar, Joint Future Planning Manager, for their contribution to the process.
Board members welcomed the strategy and agreed that it was important to recognise the crucial role of unpaid carers as key partners in providing care. The involvement of Local Authority, Voluntary sector and general practice partners was stressed. Mrs McDade advised that a number of meetings had been set up at the start of 2007 for GPs and practice managers to be informed how best to identify carers in their practices.
Dr Wilkie stressed the importance of addressing the needs of children acting as unpaid carers for misusers of drugs of alcohol. Mrs Burns emphasised the need to ensure that the strategy was implemented. She advised that the Patient Focus and Public Involvement (PFPI) Committee, which she had previously chaired, had a role to oversee the action plan and would report on progress to the Board. Mrs McDade, as chair of the PFPI Committee, advised that it was intended to review progress on a six-monthly basis.
The Board endorsed the Carers Information Strategy prior to being sent to the Minister for Heath and Social Care by 31 December 2006.
The Board also called for a report from the PFPI Committee on progress of the strategy on a half yearly basis to ensure the strategy’s implementation and review. / E McDade

6.4  Disability Equality Scheme

Mrs Gray introduced Mr Firth, Equality and Diversity Manager, who had co-ordinated the production and publication of the scheme, which was a requirement of the Disability Discrimination Act 2005. A number of the members of the NHS Grampian Disability Discrimination Action Review Group who had developed the scheme were in attendance at the meeting including Mr Tony Miller, Mrs Linda Miller and Mrs Agnes Stewart. The Chairman welcomed them to the meeting and invited them to contribute to the discussion of this item. Mr Firth advised of the opportunity to engage with the disabled people of Grampian to find out what their priorities were. The draft strategy had been circulated with the papers and Mr Firth tabled the final version at the meeting. The group members agreed that it was important for the scheme to be implemented and that they would wish to be involved in that process. Mrs Burns suggested that implementation needed to be monitored and actions prioritised. Mr Miller advised that the review group continued to have meetings and would ensure implementation of the scheme. Mr Firth confirmed that there would be an annual action plan with specific, measurable and costed aims with named people to take forward actions.
Dr Dijkhuizen pointed out the link between this work and other items on the agenda. With reference to the Health Campus project, he felt there was an opportunity to involve disabled people at the outset to ensure that the facilities being developed were suitable for them as it was more expensive to turn non-accessible facilities into accessible facilities.
With reference to staff training, Mr Miller advised that the review group was devising disability awareness training for staff, to be delivered by disabled people as they had a better perspective of the issues. He suggested this method would be both effective and cost-effective.
Mrs McDade thanked everyone involved who had brought a wealth of experience on disability issues to the process. She commended the scheme as a readable and down to earth document.
Dr Wilkie reminded the Board of its role in addressing inequalities in health which not only related to poorer areas, but included the general health of disabled people. She stressed the need to look at the health needs of disabled people and health difficulties accessing healthcare because of their disabilities. She cited examples of blind people not having someone to read letters or deaf people being left waiting because they did not hear their name being called at a clinic. Mr Firth welcomed involvement from public health colleagues and agreed to extend an invitation to the review group’s next meeting.
Mr Stephen pointed that the issues were appropriate for staff as well as the public and that disabled staff should be given equal opportunities with e.g. access, induction loops etc.
Mr Carey congratulated those involved in the development of the scheme and agreed that it demonstrated meaningful involvement of people. He recognised that there was a lot of work to do and that it was necessary to build on the achievements so far. It was necessary to deliver the actions in the plan and he was confident that would be done.
The Board:
·  Noted the overall positive position of NHS Grampian in relation to compliance with the immediate requirements of the Disability Discrimination Act 2005 which came into force on 4 December 2005
·  Endorsed the NHS Grampian Disability Equality Scheme 2007-2010
·  Endorsed the NHS Grampian Disability Equality Action Plan 2007/08 / N Firth

6.5  Health Campus Project – Programme Initial Agreement

Dr Dijkhuizen, Clinical Sponsor of the Health Campus Project, referred to the paper he had prepared with Mr Graeme Smith, Project Director who was in attendance for this item. He explained the importance of the project as part of the Change and Innovation programme element of the Health Plan and how it had to comply with NHS Grampian’s capital investment objectives.
Mr Smith then went on to explain that the project had been launched earlier in the year and involved the development of the Foresterhill site and other main sites over the next 5-10 years. He pointed out that these changes were not being carried out in isolation, but as part of a co-ordinated process as part of the Change and Innovation programme.