NHS Grampian Approved Board Min 12 06 12

APPROVED NHS GRAMPIAN

Minute of Meeting of GRAMPIAN NHS BOARD held in Open Session on Tuesday 12 June 2012 at 10.00am in Caroline/Rosemount Rooms, 1st floor, CLAN, Westburn Road, Aberdeen

Present Councillor Bill Howatson Chairman Mr Raymond Bisset Non-Executive Board Member Mr Richard Carey Chief Executive Dr Roelf Dijkhuizen Medical Director Mrs Sharon Duncan Non-Executive Board Member Mr Alan Gray Director of Finance Mrs Jenny Greener Non-Executive Board Member Mrs Linda Juroszek Non-Executive Board Member Mrs Christine Lester Non-Executive Board Member Mr Terry Mackie Non-Executive Board Member Mr Charles Muir Non-Executive Board Member Sir Lewis Ritchie Director of Public Health Mr Mike Scott Non-Executive Board Member Mrs Elinor Smith Director of Nursing and Quality

By Invitation Councillor Barney Crockett Non-Executive Board Member (Designate) Mrs Laura Dodds Public Involvement Manager (item 6 only) Mr Gerry Donald Head of Physical Planning (item 6 only) Ms Carole Finnigan Scottish Government Mr Nigel Firth Equality and Diversity Manager (item 8.6 only) Ms Fiona Francey Divisional General Manager, Women and Children Mrs Laura Gray Director of Corporate Communications/Board Secretary Dr Helen Howie Consultant in Public Health (item 7 only) Dr Annie Ingram Director of Workforce Mr Graeme Legge Property Strategy and Information Manager (item 6 only) Councillor Anne McKay Non-Executive Board Member (Designate) Ms Jenny McNicol Head of Midwifery Mr Gary Mortimer General Manager, Facilities and Estates (item 6 only) Ms Jane Raitt Clinical Midwifery Manager (item 6 only) Councillor Anne Robertson Non-Executive Board Member (Designate) Mr Graeme Robertson Head of Radiotherapy Physics (item 6 only) Mr Graeme Smith Director of Modernisation Dr Pauline Strachan Chief Operating Officer/ Deputy Chief Executive Mr Malcolm Summers Scottish Government

Attending Miss Lesley Hall Assistant Board Secretary Mrs Glenys Wells PA, Board Secretariat

Item Subject 1 Apologies

These were received from Mr David Anderson, Professor Neva Haites and Professor Val Maehle.

1 Item Subject

2 Chairman’s update The Chairman welcomed the three local authority nominees to the Board who were awaiting appointment letters from the Cabinet Secretary.

The Chairman reported that he had introduced the excellent NHS Grampian Quality and Safety In Heathcare 2012 event and had attended the sod cutting ceremony for the Aberdeen Health and Care Village. He reported on a positive meeting with local MPs and MSPs on 1 June.

Chief Executive’s update Mr Carey advised of meetings with Local Authority partners to discuss the integration of the Health and Social Care agenda. He had also attended the sod cutting ceremony for the Moray Life Sciences Centre; Emergency Care Centre event and the Elgin South Area Forum to discuss health services at Dr Gray’s Hospital and the Elgin area.

3 Minute of Meeting held on 3 April 2012

This was approved subject to amendment of typographical errors:

, Item 7 – reference to Combined Heat (not Health) and Power Association.

, Item 10.5 - replace “alighted” with “aligned”.

4 Matters Arising

There were no matters arising.

5 Quality – Person Centred, Safe and Effective: Patient Story

5.1 Patient Story

Mrs Smith gave a verbal story told by a maternity service user. She explained that this tied in with the quality ambition of being person-centred and with the subsequent item on the review of maternity services.

In response to a query from Mr Muir about how services use these stories, Mrs Smith advised that they were used at staff meetings for learning purposes and discussed at supervisors’ meetings to reflect on how improvements could be made. She added the caveat that patient stories were very much one person’s experience.

5.1 Strategic Review of Maternity Services

Following a brief introduction by the Chairman, Mrs Smith introduced the members of the team in attendance for this item: Jenny McNicol, Head of Midwifery; Laura Dodds, Public Involvement Manager; Fiona Francey, Divisional General Manager, Women and Children’s Directorate; Jane Raitt, Clinical

2 Item Subject Midwifery Manager, Aberdeenshire.

Mrs Smith explained the background to the maternity review which began in April 2010 with the aim of supporting staff to continue to improve the quality of care provided to women and families, both now and in the future. She advised that the strategic context was the Health and Care Framework and that the maternity service review was one of the pathfinder projects. It was aligned to the NHS Grampian 2020 Vision as well as to national strategies, including the Quality Strategy and the suite of maternity related policies launched in January 2011. She reminded Board Members of the process since April 2010, including the option appraisal, which had resulted in a list of nine benefits which any proposal required to deliver. She advised that the current service ranked ninth out of eleven models.

Following the Board’s decision to approve a formal consultation at its December 2011 meeting, a public consultation had taken place from 9 December 2011 to 22 March 2012. The Scottish Health Council had quality assured the consultation process and was satisfied that Government guidance on Informing, Engaging and Consulting People in Developing Health and Community Care Services had been followed. Mrs Smith explained that change was required to ensure that the service was safer, more sustainable, better met the needs of all women, used resources more fairly, effectively and efficiently and also met changes in population.

Mrs Smith outlined what the current service provision was and explained why change was needed.

The proposed service model was a Grampian-wide managed service provided from a number of locations:

 Two consultant units: one in Aberdeen and one in Elgin  Three Community Maternity units (CMUs): one in Aberdeen, one in Inverurie and one in Peterhead  A home birth service across Grampian  Integrated community maternity teams across Grampian  Scanning and screening services and community based consultant clinics  Longer term aim to relocate Aberdeen Maternity Hospital on the Foresterhill site

The finalised proposals have been equality and diversity impact assessed in accordance with NHS Reform (Scotland) Act 2004.

Mrs Smith explained the capital implications including the recognition that the Aberdeen Maternity Hospital required to be replaced. This work would be done as part of the Foresterhill master planning process. The replacement of the maternity hospital will be a significant investment and part of the next stage of major infrastructure investment at Foresterhill between 2020 and 2025. In the short-term work would be done to theatres to provide increased capacity and improve standards and reorganisation of facilities to provide a community 3 Item Subject maternity unit (CMU) within the existing facilities was planned. She advised of proposals for both Peterhead Community Hospital and Inverurie. She then went on to explain the revenue implications, advising that these were minimal for the proposed changes.

Mrs Smith advised that staff and partnership representatives had been involved throughout the process and the main implications for the workforce to move to integrated teams was described more fully in the consultation proposal paper.

Following the analysis of the responses received to the consultation, a high level of support for the overall aims and specific aspects of the proposals had been shown.

Mrs Dodds continued by explaining the process that had been followed, with reference to her report of the formal consultation. She advised that it had been an inclusive option appraisal process which had followed up the CMU location review. She advised of the range of ways by which awareness had been raised. Almost 300 feedback questionnaires had been completed. Public meetings had taken place in 9 locations, with 171 participants. There had been discussion groups in communities. An opportunity had been given for people to provide open responses and 29 of these had been received. Presentations had been made to 30 groups and committees and briefings given to staff. The Scottish Health Council was satisfied the process of the formal consultation had met the national guidelines.

Board Members had been given the opportunity to see all the responses to the consultation in which over 500 people had taken part.

Mrs Dodds advised that there had been a high level of support for the aims of the proposal, with recognition that the service needed to change to address the challenges faced. Although there was less opposition than anticipated, there had been some opposition. A high level of support had been given to a number of aspects: CMU models, improvements at AMH, retention of consultants’ unit at Dr Gray’s Hospital; continuing with home birth service; continuity of consultant outreach across Grampian – Banchory; continuing with scanning and screening services across Grampian.

Mrs Dodds explained that the areas of concern, or where clarification was needed, included home birth service, the proposed locations of CMUs, removal of clinics from Huntly, birth unit closures, transport, improvements at AMH, capital funding and the timeline for implementation.

She summarised the views on :

The proposed changes as a whole:  43% fully support  47% partly support  10% do not support

4 Item Subject

Which model of care best meets needs of all women and families in Grampian:  54% proposed service  16% current service  30% unsure

In response to a query from Mr Bisset, Mrs Smith advised that safety was uppermost, with an emphasis on the future service being safer than the current arrangements. In reply to a query from Mr Scott, Mrs Dodds advised that the consultation report was available on the website and responses will be provided to those who asked questions.

Mrs Dodds acknowledged that stakeholder input had been very important and that public representatives had informed the consultation methods used.

Ms McNicol went on to explain the final proposal and the challenges around this. She outlined the challenges facing the service including the ability to meet the needs of a changing population i.e. the increased number of babies being born in Grampian and the greater numbers of women with more complicated health and social needs requiring greater input into their care from the maternity team. She explained the current variance in caseloads across Grampian. This was unfair to women, challenging to midwives and significantly impacted on the ability to meet the needs of women and families. The aim was for more consistent one to one care in labour and provision of care closer to home throughout pregnancy.

Ms McNicol explained the final proposals for the Grampian-wide maternity service which would have one budget and one management structure. This would lead to improved communication between staff; lead to women receiving more consistent care and advice; and ensuring resources were more fairly distributed and used more efficiently and effectively. The proposed service would have two consultant units, as at present, in Aberdeen and Elgin. Integrated community teams would be developed across Grampian. All community midwives would provide labour and birth care and have manageable caseloads. The aim would be to provide 30 minute quality consultations for all women during pregnancy. Midwives would be supported to maintain their confidence and skills in all aspects of care, particularly labour and birth.

There would be three CMUs in Aberdeen, Peterhead and Inverurie. This would mean the loss of birth units at Aboyne, Fraserburgh and Banff. The CMU model and proposed locations were an integral part of the proposals. Ms McNicol explained these would be a focal point of maternity care, providing labour and birth facilities for women who were likely to have an uncomplicated normal birth, but also maternity care for women during pregnancy and after giving birth. She explained the services which would be offered by the CMU including: access 7 days per week, 24 hours a day; scanning and screening appointments; advice and support; community based consultant and specialist clinics and dedicated facilities to labour and to give birth. She advised that transport and access

5 Item Subject issues had been used to inform the development of the proposals, which would reduce the total number of women having to travel and the total number and distance of journeys made when accessing maternity services. The proposals would also reduce the pressure of high workload for Aberdeen Maternity Hospital and Dr Gray’s Hospital, where approximately 6,000 births occurred each year, therefore improving the quality of care and experience for women and families using those facilities.

Ms McNicol stressed that the home birth service across Grampian will continue. She also confirmed the longer term aim of relocating Aberdeen Maternity Hospital within the Foresterhill site.

Ms McNicol advised that the proposals would mean the loss of highly valued labour and birth facilities in Aboyne and Fraserbugh. It was important to recognise the strength of feeling about the closure of birth units based on positive and personal experiences, but these had to be set in the context of wider ranging benefits which would result from the full set of proposals. She stressed the importance of the dependency on delivering the package of proposals rather than the individual parts, to ensure wider benefits.

In response to a query about the service being safer, Ms McNicol advised that the majority of women already travelled to give birth and that these arrangements were managed very well. If facilities were provided in CMUs throughout the whole pregnancy, this would result in less travel. She advised that currently small community teams had a lack of labour/birth experience which impacted on their confidence and skills, which could affect decision- making.

Ms McNicol explained there was very little difference in a birth at home and in a birth unit setting. She advised that data reinforced that a local based consultant/scanning/public screening service resulted in decreased travel and improved access in Deeside.

Mr Carey explained that the integration of community maternity teams would benefit patients with more local services being available. Service would be safer because of the availability of more confident midwives.

Sir Lewis Ritchie emphasised that the proposals would reduce health inequalities. He advised that poor antenatal care contributed to health inequalities and there was compelling evidence that early intervention before a baby was born maximised life chances. He stressed the need to work with social care and for health to integrate with partners.

Dr Dijkhuizen stated he was satisfied the proposals were safer than the current situation. Integrated working of teams would give access to expertise and improve the experience of women using the service.

Dr Ingram highlighted the benefits of the proposals to NHS Grampian as an employer. She explained that small teams were fragile. This integrated

6 Item Subject approach would ensure more even workloads which would help with recruitment and retention.

The work of the public representatives who had contributed a tremendous amount of time during the review was acknowledged.

Councillor Robertson asked if stakeholders would be kept involved in the process. She recommended involvement of local community planning groups in the future.

Following the presentations and discussion, the Board considered the following recommendations in the covering paper

The Board: 1. considered the consultation results 2. noted the Scottish Health Council’s approval of the consultation process 3. considered and supported the full proposal paper 4. agreed to the submission of the final proposal to the Scottish Government for Ministerial consideration.

6 Modernisation

6.1 Property and Asset Management Plan 2012 – 2021

Mr Gray explained that the covering paper related to three separate items to be discussed under the Modernisation headings. Mr Donald, Head of Physical Planning, gave a powerpoint presentation on the Property and Asset Management Plan (PAMS). He explained the background, including CEL 35 (2010) - A Policy for Property and Asset Management in NHS Scotland and the State of the NHS Scotland Estate Report. With reference to a map, he advised that NHS Grampian owned and leased 99 properties with a net book value of £343m. He stressed that the PAMS required to be consistent with the Local Delivery Plan. He highlighted the main issues including the age of premises and the percentage of properties in an unsatisfactory condition or not functionally suitable compared to current standards. He advised that the current estimated backlog maintenance was £161m, £59m of which was of a significant or high risk. He listed the NHS Grampian investment for 2011/12 and the proposed investment for 2012/2013. He referred to the letter to NHS Boards from the Chief Executive of the NHS in Scotland on 10 February 2012 highlighting that the expectation was that formula allocations received by Boards would be directed to those areas of high and significant risk as well as equipment replacement.

Mr Donald gave a breakdown of total planned expenditure on backlog maintenance from 2012/13 to 2016/17, totalling £56.219m over the next five years.

Board members were given the opportunity to ask questions on the PAMS.

7 Item Subject During the discussion, Mr Bisset asked about the timescale for developing a new health centre for Inverurie and sought clarification of the timescale for the outline business case and full business case for this project. Mr Smith responded that following a prioritisation process by the Asset Management Group, the two highest priorities had been identified as the Denburn and Inverurie Health Centres, which were included in the Local Delivery Plan. It was proposed to start the option appraisal, to include the public and local authority partners, within the current financial year.

The Board considered and approved the Property and Asset Management Plan 2012 – 2021 for submission to the Scottish Government Health and Social Care Directorate (SGHSCD).

6.2 Initial Agreement – Aberdeen Royal Infirmary (ARI) Reconfiguration and Backlog Maintenance

Mr Mortimer gave a powerpoint presentation on the project, explaining its context in the development of the overall reconfiguration of ARI. He advised that the two stages related to the Emergency Care Centre occupation and space consolidation on the site. He highlighted the planned activity to deal with backlog maintenance issues over the next five years and the key challenges relating to redesign and technical issues. In response to a query from Mrs Duncan, Mr Mortimer explained that clear messages would be communicated to staff affected by the moves through the Acute Sector Management Team.

Mr Smith explained the importance of maintaining high levels of communication about that the Emergency Care Project as part of the Aberdeen Royal Infirmary/Foresterhill development over the next 5-10 years. He emphasised that the overall reconfiguration of ARI was consistent with the 2020 Vision.

Mr Scott advised that following recent visits to most of the wards in ARI, there was a high degree of awareness amongst staff of the changes. He emphasised the need to maintain high levels of communication.

Mr Smith explained the project’s structure and advised that the project board reported to the Asset Management Group and fed into other governance arrangements. Dr Dijkhuizen explained that the changes on the Foresterhill site were profound and it was necessary to keep the Board updated on developments.

In response to a query from Mr Mackie about the danger of temporary moves becoming permanent, Mr Smith assured the Board that the aim was to move out of facilities which had no strategic fit or did not help deliver the 2020 Vision. He stressed the importance of controlling accommodation across NHS Grampian.

The Board considered and approved the initial agreement for the ARI Reconfiguration Project.

6.3 Outline Business Case – Replacement Linear Accelerator Project (Phase 2)

8 Item Subject

Mr Smith advised that the Outline Business Case (OBC) was part of the radiotherapy plan and was consistent with the development of a cancer centre on the ARI site. The OBC was similar to the one approved by the Board the previous year relating to Phase 1. He advised that the cost of Phase 2 (£8.5m) was completely funded by the Scottish Government. Work would begin at the end of the current financial year and would be concluded by the following financial year.

The Board noted that the two additional linac bunkers would provide more resilience by having three treatment machines and a spare bunker.

The Board approved the Outline Business Case for replacement linear accelerator project (Phase 2) for submission to the Scottish Government Health and Social Care Directorates (SGHSCD).

7 Public Health

7.1 Joint Health Protection Plan 2012 – 2014

Following an introduction by Sir Lewis, in which he expressed appreciation for the work of the Health Protection Team, particularly around recent significant incidents, Dr Howie presented on the Joint Health Protection Plan 2012-2014. She advised that this reiterated the duty to co-operate with local authorities to produce the joint plan. She explained that health protection described the work that encompassed surveillance, control and prevention of communicable disease and environmental hazards to human health. The main section described national and local priorities and the appendices gave more detail on planning infrastructure, resources and operational arrangements, capacity and resilience and public involvement.

Mr Carey stated that the comprehensive report reflected a huge amount of work to ensure the public health was protected and was evidence of effective working between NHS Grampian and its local authority partners to protect public health.

Dr Howie responded to questions on specific public health issues such as outbreaks of legionnaires disease, e-coli and pandemic flu.

The Board approved the Grampian Joint Health Protection Plan for 2012- 2014.

The Chairman thanked Dr Howie and asked her to pass on thanks to the team for all their work in connection with health protection. He suggested it would be helpful to have a Board seminar discussion on the Joint Health Protection Plan and Sir Lewis welcomed the opportunity to bring public health matters to the Board.

7.2 Immunisation Programmes Annual Report 2010/11

9 Item Subject Dr Howie advised that the report had been prepared by her colleague, Dr Diana Webster. She highlighted the key messages in the report which described the immunisation uptakes during 2010 – 2011, progress with implementation of key actions identified for that period, issues arising locally during the delivery of the immunisation programme and key actions that were taken forward during 2011 – 2012. She identified the key risks and concluded that delivering the immunisation programme remained a priority to ensure protection against serious infectious disease.

Dr Howie advised that uptake rates for childhood vaccinations were high and that the uptake of the flu vaccination in over-65 age group was above target. She responded to queries about hepatitis B, ante natal screening and uptake rates for HPV vaccination.

The Board noted the NHS Grampian Immunisation Programmes Annual Report 2010/11.

8 Corporate Governance

8.1 Performance Governance

8.1.1 Performance Governance Committee Report

The Chairman highlighted the main items discussed at the committee meeting on 18 May 2012. The committee had noted that the 18 weeks referral to treatment target had been sustained since November 2011. There had been external scrutiny of NHS Grampian’s approach to patients’ unavailability, which was a consideration in the delivery of the 18 weeks referral to treatment target. This had been subject to external scrutiny by the Scottish Government and Information Services Division and Audit Scotland was undertaking a Scotland-wide review.

The committee had noted that following the launch of the Detecting Cancer Early programme, there had been an increase in referrals in Grampian. It was important to ensure the right referrals were made at the right time.

The Board noted the Performance Governance Committee report.

8.1.2 Healthcare Associated Infection Report

Dr Dijkhuizen referred to the report and advised that NHS Grampian was on target to meet HEAT targets for clostridium difficile (cDiff) and staphylococcus aureus bacteraemias (SABs). He advised there had been issues with reporting of hand hygiene compliance as not all wards had submitted figures. This issue was being addressed locally. He referred to a number of recent public health issues and incidents, explaining that a prevalence of norovirus had logistical implications because of ward closures to new admissions. He explained that such

10 Item Subject matters would be easier to deal with once patients were moved into the Emergency Care Centre because of the increased number of single rooms.

Mr Carey concluded that the organisation was making progress in tackling HAI. He advised that the annual Champions Challenged event, which was strongly supported by clinical staff, provided a real opportunity to congratulate staff on these achievements. He wished to use the report to highlight key successes about improvements in MRSA and cDiff.

The Board noted the content of the bimonthly Healthcare Associated Infection Report for March 2012

8.2 Staff Governance

8.2.1 Staff Governance Report

Mr Scott explained that the Committee considers one risk from the strategic risk register at each meeting. The risk discussed at the most recent meeting referred to retaining a sustainable workforce in times of financial challenge. There had been a very good discussion on that, with the Committee being assured that it continued to be a risk to the organisation but was being managed appropriately. He advised that a people’s strategy/workforce 2020 vision development workshop was being arranged for 27 September 2012. He advised that the process for submitting workforce plans was being reviewed to ensure that information was submitted timeously. Mr Scott advised that the Committee needed to be involved in relevant audits and to ensure links between the Staff Governance and Audit Committees.

Mr Gray explained that the Executive Directors were looking in detail at individual strategic risks which would be fed through the Committee structure and to the Board as appropriate.

The Board noted the Staff Governance Committee report.

8.2.2 Workforce Plan

Dr Ingram advised that the Board was required to submit a workforce plan annually by 30 June. The plan presented to the Board was a refresh of previous years’ plans and reflected the Health Plan. It would be reviewed to ensure that it fitted with the 2020 Vision.

Mrs Lawrie explained that CEL 32 (2011), the National Workforce Planning Framework, required the plan to follow the six steps of integrated workforce planning methodology. She emphasised that the plan linked to the key strategies of the 2020 Vision, Healthfit, Health and Social Care Integration, the Health Village and the opening of the

11 Item Subject Emergency Care Centre. The plan described how NHS Grampian worked with its wider partners. It included forces and drivers and took account of social expectations, technology and the economic situation. The plan described how the workforce would change with the requirement for a more flexible workforce. The plan highlighted that 83% of the workforce was female, turnover was 10% and that there were certain issues relating to recruitment of particular groups of staff. In response to a query about any specific staff shortages, Mrs Lawrie advised that recruitment of health visitors in Aberdeenshire was a problem.

Mr Scott advised the Board that the Staff Governance Committee had the opportunity to discuss aspects of the Workforce Plan in more detail.

Queries were raised about the use of bank staff and Mr Carey advised that bank staff allowed flexibility, however it was important not to rely too heavily on bank staff. By using the nursing bank, this avoided the additional cost of agency spend, but continual scrutiny was required to ensure the balance was right.

Mrs Lawrie stressed the importance of developing staff to ensure that they were appropriately trained and qualified. Dr Ingram advised of the challenges of ensuring the correct mix of staff and identifying what skills were required to deliver care across the public sector. Work was being done with local authority colleagues to ensure an integrated workforce.

The Board approved the NHS Grampian Workforce Plan 2012 and agreed to its publication and submission in the required timescales.

The Chairman thanked Mrs Lawrie for pulling together the plan and producing it in such a coherent format.

8.2.3 Grampian Area Partnership Forum Report

Mrs Duncan highlighted the main items discussed at the recent Forum meeting. She explained that progress had been made with awarding car parking permits for the Foresterhill site and the shuttle bus service which had been introduced to alleviate parking problems had proved popular. Staff were being encouraged to use the service. The Forum intended to go out and about later in the year to link with local partnership forums. She advised that action had been taken to re- invigorate eKSF to ensure completion of documentation within timescales. A proposal for a staff award scheme was currently under consideration. A review of 12 hour shifts was to be carried out.

The Board noted the GAPF report.

12 Item Subject 8.3 Area Clinical Forum (ACF) Report

Mrs Juroszek advised that the ACF would respond to the consultation on the Charter of Patients’ Rights and Responsibilities The Forum continued to support the NHS Grampian 2020 Vision. The ACF had concerns about the Patients Rights (Treatment Time Guarantee) (Scotland) Regulations 2012 if, as a result, clinicians lost the ability to prioritise and resources were then diverted

from other clinical priorities. The challenge to achieve targets was not underestimated.

The Board noted the ACF report.

8.4 Clinical Governance Committee Report

Mr Muir advised that the Committee continued to extract risks from the strategic risk register for consideration. He advised that the Committee had discussed prison health and the challenges and risks around transferring the delivery of care from the Scottish Prison Services (SPS) to NHS Boards. The Committee had received a report on the Patient Safety Programme in Primary Care, looking specifically at communications from outpatient clinics at Dr Gray’s Hospital to GP practices in Moray and then ultimately to the patient. The Committee had scrutinised the very full and detailed report on Healthcare Associated Infection and welcomed the positive messages. The Committee was assured by the continued progress being made across all NHS Grampian sites. A paper had been presented on the stroke managed clinical network which was making progress, although some inequities had to be addressed. The Committee would be kept informed of progress. The Committee had also heard about risk mitigation in Mental Health services and were advised that additional staff had been recruited to the Crathes Ward. Under 18 year old admissions will continue to be monitored by the Child and Adolescent Mental Health Services management team.

The Board noted the CGC report.

8.5 Endowment Committee Report

Mr Bisset advised that a national review was underway on specific areas of expenditure following feedback from a recent review by the Office of the Scottish Charity Regulator (OSCR). Legal advice was awaited, but in the meantime the Committee had agreed that certain areas of expenditure deemed to provide a direct financial benefit to staff were suspended. Mr Gray advised that there would be further discussion on the issue at the next Committee meeting and an update would be provided at the Endowment Annual General Meeting later in 2012.

The Board noted the report from the Endowment Committee.

13 Item Subject 8.6 Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012

Mr Firth attended for this item and explained the requirements of the legislation and the action required to be taken by NHS Grampian to comply. He advised that a number of the specific quality duties restated or expanded upon existing requirements. The Equality and Human Rights Commission in Scotland may issue some further guidance. Mrs Gray advised that the assurance route was through the Patient Focus and Public Involvement Committee. She thanked

Mr Firth and his team for the work done in connection with this important area of the work of the Board.

The Board noted the report.

9 Items for noting 2011/2012

The Board noted the following items:

9.1 Area Clinical Forum – 29 February 9.2 Area Partnership Forum – 15 March and 19 April

Approved Minutes 2011/2012 9.3 Clinical Governance Committee – 24 February 9.4 Performance Governance Committee – 16 March 9.5 Aberdeen City CHP – 8 February 9.6 Patient Focus and Public Involvement Committee – 8 February 9.7 Spiritual Care Committee– 3 February 9.8 Staff Governance Committee – 20 March 9.9 North of Scotland Planning Group – 29 February 9.10 Aberdeenshire CHP - 14 December 2011 9.11 Moray CH&SCP – 16 September 2011

Chief Executive Letters

9.12 Chief Executive Letters received since 3 April 2012

10 AOCB

There was none.

11 Dates of Next Meetings

Tuesday 7 August 2012 (Meeting) Tuesday 4 September 2012 (Seminar)

14 Signed ………………………………………. Date ………………………………… Chairman