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MINUTE of MEETING of the
NHS HIGHLAND PARTNERSHIP FORUM (Performance)
Board Room, Assynt House /23 October 2009 – 10.40 am
PresentDr Roger Gibbins, Chief Executive (Joint Chair)
Mr Ray Stewart, Employee Director (Joint Chair)
Ms Elspeth Caithness, RCN
Mrs Ann Clarke, Staff Governance Committee Chair (Videoconference)
Ms Jennifer Dowling, CSP
Mrs Anne Gent, Director of Human Resources
Mrs Margaret MacRae, RCN
Mrs Janette McQuiston, UNISON
Mr Douglas Seago, Head of Facilities
Ms Nichola Summers, Dir. General Manager (Medical), RaigmoreHospital
Mr A Wilson, MiP
In
AttendanceMr David Garden, Head of Financial Planning
Mr Brian Houston, Payroll Manager
Mr John Huband, Head of Recruitment and Employment Services
Mrs Linda Kirkland, Business Transformation Manager
Mrs Judith McKelvie, Head of Learning and Modernisation
Mr Brian Mitchell, Board Committee Administrator
Mrs Helen Morrison, Associate Director, Clinical Workforce Development (from 10.55 am)
1WELCOME AND APOLOGIES
Apologies were received from Ian Brown, Pamela Cremin, Garry Coutts, Emma Currer, Helen Duthie, Georgia Haire, Malcolm Iredale, Gill Keel, Derek Leslie, David Logue, Callum Macdonald, Etta Mackay, Gill McVicar, Adam Palmer, Donald Shiach, Nigel Small, Bob Summers, and Philip Walker.
2MINUTE OF MEETING HELD ON 18 SEPTEMBER 2009
The Minute of Meeting held on 18 September 2009 was Approved.
Dr R Gibbins suggested, and the Partnership Forum Agreed, that future associated Action Plans be formatted on a rolling basis.
3MATTERS ARISING
3.1Work for Efficiency and Effectiveness (PIN Policies) – 18 Week Procedures
Mr R Stewart advised that the circulated documentation, including a Conducting Investigation Template, Time Line for dealing with Conduct Cases, Guidance on Conducting and Investigation, and Guidance on Suspension had been considered by the HR Sub Group and issued to General Managers. On the point raised in relation to exceptions to the Time Line it was stated that this would be assessed at the 9 Week stage and agreement sought on any delays as appropriate. There was reference made to the ‘receiving manager’ report and it was confirmed that the associated notification period etc had been discussed with the Head of Personnel. Further discussion would be held on clarification as to wording around the Week 12 Investigation stage and whether this was the commencement or conclusion stage.
The Partnership Forum otherwise Noted the circulated documentation.
3.2 Fixed Term Contracts
Mrs A Gent advised that clarification was being sought in relation to associated legal issues around Contracts and that an appropriate letter outlining this would be issued to Managers as well as outlining relevant responsibilities and links with the Redeployment Policy etc.
The Partnership ForumNoted the position.
3.3Pandemic Swine Flu
Mrs A Gent advised that staff were to be advised as to access to vaccination in early course, that there would be limitation as to the number that could initially be given, and that relevant plans were being finalised. Mr J Huband advised that letters were to be issued to 140 previous staff members, who had retired within the last year, seeking assistance with arrangements relating to Swine Flu. There had been a positive response to date.
The Partnership Forum Noted the position.
3.4NHS Scotland National Uniform Contract
Mr R Stewart advised that relevant comments on the draft Dress Code should be relayed by 30 October 2009 to Judith Catherwood, Associate AHP Director and that a final report would be brought back to the Partnership Forum.
The Partnership Forum Noted the position.
3.5Argyll and Bute CHP Local Partnership Forum Joint Chair
Mr R Stewart advised that the position of Joint Chair remained vacant at this time.
The Partnership Forum Noted the position.
The Partnership Forum Agreed to consider the following Item at this point in the Meeting
11NURSE BANK MONITORING REPORT
Mrs H Morrison spoke to the circulated report outlining progress in implementing the NHS Highland Unified Nursing Bank in NHS Highland, this having commenced in May 2008 and piloted in Raigmore and NewCraigsHospitals, Inverness. The pilot exercise had highlighted a number of operational issues that were being addressed and at this time full rollout had yet to be achieved. The issues highlighted were indicated, including in relation to IT and payroll. Mrs H Morrison advised that an Operational Group Risk Register/Action Plan had been established. It was advised that where introduced the unified Bank had resulted in a reduced Bank usage rate and that introduction of a web based module had considerably improved relevant accessibility. The priority areas for roll out were indicated and it was stated that to date, Caithness Community and Argyll and Bute Hospitals, The Belford Hospital and South East Highland CHP had yet to be unified, with roll out deferred until existing barriers to effective service delivery have been addressed. In this regard a key stakeholder event was to be held to scope the current status of the unified bank, identify successes and barriers to effective service delivery, and agree joint solutions to support the implementation process and future sustainability. One of the key objectives for the Nurse Bank was to improve quality and clinical standards in the Nurse Bank workforce and an early user service evaluation was undertaken to review ease of use of service and give an opportunity to comment on the service in general from both staff and Bank perspectives. This evaluation was supported by the Clinical Effectiveness Team and whilst response rates were low, and this was undertaken at an early stage, the general findings had been positive. This work had led to the creation of an Action Plan and this was monitored through the Nurse and Midwifery Bank Operational Group (NMBOG), the membership of which had been extended to include Mr J Huband and Ms B Munro. Processes were being developed to support recruitment and retention of Bank Nurses externally, and those with substantive posts, and a relevant Handbook was to be prepared. Access to, and availability of, mandatory training for Bank Nurses had been identified as a risk. With regard to the production of statistical information it was stated that the Management System has limited capability although Raigmore and New Craigs were able to benefit from local reports, on request, based on consolidated data availability. This inflexibility within the system had been raised at a national level. With regard to the issue of communication, the web based system had proved to be a positive addition to support the Bank and this was being rolled out to all hospitals. An extra direct line had been added as a back up for Argyll and Bute CHP.
During discussion, there was reference to the authorisation process for Bank usage and it was stated that this remained at CHP level, with the Bank system then administering. This was an area that was still to be fully agreed. It was stated that documentary evidence of authorisation would be important for audit purposes. Mrs H Morrison advised that an appropriate authorisation process was in place in Raigmore and at CHP level, that this subject was being discussed at a national level, and that the main issue related to the subsequent access to the Nurse Bank. Further assurance would be sought in this regard. There was concern expressed that there may be a lack of consistency in relation to present payment and leave entitlement issues and in this regard Mr J Huband advised that guidance for Nurse Managers was required, including the outline of responsibilities in this regard. Mr Houston advised that a spreadsheet was available on the Intranet site that would assist in calculation of leave entitlement. He added that the SSTS system would address this issue however this required the Unified Nurse Bank to be operational. On the point raised as to achievement of a unified position, Mrs H Morrison advised work was required to scope bank system capability, CHP Level responsibilities, and associated resource issues.
Mrs H Morrison undertook to address the problems relating to the annual leave issues by involving the relevant parties with a view to achieving an agreed solution.
The Partnership Forum:
- Noted the progress in implementing the Unified Nurse Bank.
- Noted further assurance would be sought on an auditable authorisation process.
- Agreed the NMBOG, in association with Messrs Houston and Huband further consider issues relating to payment and leave entitlement calculation.
- Agreed that a detailed plan for implementation of the Unified Nurse Bank be submitted to a future meeting.
4CHANGING FOR THE BETTER
4.1Update on Service Improvement Programmes
Mrs L Kirkland advised there were a number of workstreams currently underway relating to waiting list management, organisational change, training and development, eHealth, and patient contact. Individuals had been assigned responsibility for each of these as indicated. Associated work involved activity relating to Long Term Conditions and with the Mental Health Collaboration. Mrs Kirkland advised that LEAN use proposals had been submitted to the Scottish Government and that a framework was anticipated to assist in a range of areas, including leadership style. There had been established a timetable for introduction of Patient Focused Booking (PFB), including for Allied Health Professions, by July 2010 and this was being progressed through a recently established PFB Team. This work involved a pilot for Theatre booking and was proving to be more complex a subject than first envisaged. Mrs Kirkland stated that introduction of digital dictation activity had proved successful and this was now being widely utilised. This linked to a number of current activities, including mapping of patient pathways, the mechanisms for which were being considered by the eHealth Group. From December 2009 the introduction of a clinical letter system should allow for electronic contact with GPs and it was anticipated this would accrue a financial benefit to the organisation. She advised that as part of the relevant communications exercise there was to be held a Change Party staff event on 3 December 2009. In this regard Mrs A Gent stated that well managed communicationswould be key in engaging staff through the change process and it was encouraging that staff were actively making contributions to date. Dr R Gibbins stated that practical examples of positive staff suggestions would help to embed this culture and allow staff to witness the contribution that they can make.
After discussion, the Partnership Forum:
- Noted the position.
- Noted details of the Change Party event would be distributed to members.
4.2Financial Position
Mr D Gardenspoke to a circulated finance report, as at 31 August 2009 and further advised that it was anticipated that all operational areas would achieve a year end break even position, with the exception of Raigmore Hospital where an overspend was still projected, the same applying to Tertiary services. Dr R Gibbins advised that support was being given to the Raigmore Management Team to enable an appropriate action plan to be established to address the financial position, that there had been good progress to date, and that this was being undertaken in context of delivery in relation to HEAT targets. Ms N Summers confirmed that a number of meetings with senior staff had recently been held, with focus on achieving required non-recurrent savings and stated that Partnership working would be very important moving forward. Mr R Stewart had agreed to engage in this process. Mrs A Gent advised that the General Manager, RaigmoreHospital was preparing a summary report of the present position and this would be widely circulated when finalised.
During discussion, it was stated that staff were voicing concern as to staffing resources and service quality issues. There was a need to emphasise that service quality required to be maintained through this challenging period. In response, Ms Summers confirmed that staffing levels were assessed on a daily basis to ensure safe levels were maintained. The view was expressed that in general it was easier to identify pressure points than identify those areas/times where this was not the case, and where associated resource could possibly be released. Ms Caithnessstated that consideration of theses points should be undertaken in partnership and as such staff should be involved in discussion at the earliest possible stage. Dr R Gibbins emphasised the opportunities that existed for strong staff engagement during this time, allowing for positive staff contribution, and the need to ensure strong partnership working arrangements. Trust would be very important and a primary message would be that whilst change was required this would not be at the expense of key activity. Mr A Wilson suggested that there should be greater and more regular communication of successes and positive initiatives, perhaps through a regular Bulletin, recognising that not all staff had access to electronic communication. Mrs A Clark stated that the previously discussed proposed staff event represented a real opportunity for engagement with staff and suggested that if this proved to be a success then this could possibly be rolled out across the organisation.
The Partnership Forum:
- Noted the position.
- Agreed the need for strong staff engagement.
- Agreed that Changing for the Better remain an Item on the Agenda for future meetings.
Mr Garden, Mr Houston, Mr Huband, and Mrs Kirkland left the meeting at 11.45 am
5NHS HIGHLAND ANNUAL REVIEW – 7 DECEMBER 2009
Mrs A Gent confirmed that the NHS Highland Annual Review was to be held on 7 December 2009, and would be conducted by Nicola Sturgeon, Cabinet Secretary for Health and Wellbeing. Mrs P Cremin would update the relevant submission, including the ‘At a Glance paper’.
The Partnership Forum soNoted.
6WORKFORCE REPORT
There had been circulated Workforce Report to 31 August 2009. Dr R Gibbins sought clarification around figures relating to the Treated Fairly and Consistently element of the report and Mrs A Gent undertook to raise this point with the Head of Personnel.
The Partnership Forum otherwiseNoted the Workforce Report.
7WORKFORCE PLAN PROGRESS REPORT
Mrs A Gent advised that the final version of the NHS Highland Workforce Plan was to be submitted to the Staff Governance Committee meeting to be held on 17 November 2009.
The Partnership ForumNoted the position.
8KNOWLEDGE AND SKILLS FRAMEWORK PROGRESS REPORT
Mrs McKelvie spoke to the circulated report outlining progress against the Knowledge and Skills Framework (KSK) Implementation Plan. With specific reference to eKSF implementation and the 2009/2011 HEAT target (E10) 80% of all staff to have a development review completed and agreed on eKSF, current data indicated that this had been achieved for 3% of staff compared to the trajectory figure of 10%. Discussion with managers on issues relating to trajectories and required support arrangements was continuing, and associated Development Reviews were taking place. It was stated that revised targets were being discussed at a national level and further guidance may be issued around clarification of the existing target and applicability to bank staff and those not on a permanent contract. It was emphasised that Review discussions with staff remained the key aspect requiring completion. With a view to meeting the 2011 target, Mrs McKelvie advised that a ‘complete on paper’ function of eKSF could be activated that would require a reviewer, following relevant staff discussion and paper based agreement, to complete minimal inputs confirming electronically that the discussion had been held and the paperwork completed. This approach would allow for monitoring of PDP reviews but would not bring the full training and development benefits of eKSF. Mrs McKelvieadded that existing paperwork was being revamped, to better align this to eKSF and help to provide consistency for staff. It was further stated that 3,097 outlines had been placed on eKSF and that 7,991 staff had them assigned. 148 outlines remained outstanding at end September 2009 and discussion with managers was being held with a view to agreeing local eKSF implementation plans and trajectories.
During discussion, Mr R Stewart emphasised the need for meaningful Review discussions to be held with staff although he expressed concern with regard to associated monitoring arrangements in respect of which Mrs McKelvie advised an appropriate process could be established. Mrs A Gent advised that this matter had been discussed at the Improvement Committee at which General Managers had indicated that they favoured a staged approach in moving to eKSF. A range of guidance documentation was being developed that would show, in simple steps, how eKSF was to be completed. Dr R Gibbins stated that existing barriers to eKSF use should be scoped to establish what these were, given the importance of this in terms of organisational Learning and Development. Utilisation of Information Technology would be vital across a range of issues within NHS Highland moving forward. Mrs McKelvie stated it was hoped that eKSF would act as a driver for access to and use of IT. Issues to be considered would relate to existing IT skills, access to relevant training, a lack of access to eMail, managerial feedback issues, and managerial capacity to undertake Reviews/time commitment. There was a view expressed that at this moment the ‘complete on paper’ function should not be utilised and that full eKSF implementation at an early stage should still be the aim with this being driven by the need for access to training.