APPROVED

NHS GRAMPIAN Minute of the Area Clinical Forum Meeting held on Wednesday 14 May 2014 at 5.30pm in the Conference Room, Summerfield House

Present:

Mrs Linda Juroszek, Chair, Area Pharmaceutical Committee (Chair) Mrs Jackie Berry, Chair, Allied Health Professionals Advisory Committee (AHPAC) Mr Norman Binnie, Chair, Consultants’ Sub-Committee (CSC) Mr David Corry, Chair, Area Optometric Committee (AOC) Ms Jenny Gibb, Vice Chair, Grampian Area Nursing & Midwifery Committee (GANMAC) Mr Chris Llewellyn, Chair, Area Healthcare Scientists Committee (HSC) Mrs Jenny McNicol, Chair, GANMAC Dr Helen Moffat, Vice Chair, Grampian Area Applied Psychology Advisory Committee (GAAPAC) Dr Rebecca Riddell, Chair, GP Sub-Committee

In Attendance: Dr Roelf Dijkhuizen, Medical Director Mrs Jenny Ingram, Head of Service Improvement (Item 4.2) Mrs Joyce Leys, Healthcare Science Board Lead Mrs Elinor Smith, Director of Nursing Mr Graeme Smith, Director of Modernisation (Items 4.2 & 5) Mrs Susan Webb, Deputy Director of Public Health Ms Tracey Leete, Minuting Secretary

Item Subject Action 1. Chair’s Welcome

The Chair welcomed everyone to the meeting.

2. Apologies

Mr Richard Carey, Chief Executive Mrs Pamela Cornwallis, Vice Chair, AHPAC Dr Izhar Khan, Chair, Area Medical Committee (AMC) Mr David Shaw, Chair, Area Dental Committee (ADC) Ms Ann Smith, Vice Chair, Area Pharmaceutical Committee (APC)

3. Minute of meeting held on 19 March 2014

The Minute of the previous meeting was approved as an accurate record.

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4. Matters Arising

4.1 Recruitment

Following the last meeting the Board Paper, where recruitment was discussed, was circulated to the Committee for information. It was recognised that the Board is well sighted on NHSG recruitment issues and a lot of work is currently taking place to address the situation.

4.2 Delayed Discharges

Mrs Ingram presented a paper, providing a summary of the discussion and recommendations considered at COMT, to seek the views and support of the advisory structure.

The ACF were asked to review the issues and provide views and comments which will help shape the approach and provide support for further development and implementation of the improvement programme.

The Committee discussed a number of matters to be addressed including timescales for diagnostic tests. Mr Llewellyn highlighted the pressure on diagnostic tests, which is accentuated by current recruitment and training issues in the specialty, and how tests need to be prioritised in line with urgent Waiting Times targets. Mr Binnie advised that electronic access to results is a standing item on CSC. The Committee also raised the need for a co-ordinated system to assist patient flow and discussion with council colleagues to ensure the correct balance of care.

The Chair to circulate Mrs Ingram’s email for individual LJ committees to engage.

4.3 HIS Visit Update

The Chair advised that a number of potential patient safety and governance issues had been raised with the Cabinet Secretary relating to NHSG’s current practice. In response to issues raised a team from HIS interviewed a number of staff in March including the ACF Chair to explore the issues. A minute of a meeting with HIS, NHSG’s Chairman, Chief Executive & Deputy Chief Executive has since been circulated to the staff who had been interviewed. One of the issues highlighted was clinical engagement and how NHSG reviews plans for improvement.

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5. Clinical Advisory Structure Meeting – 10 June 2014

The Clinical Advisory Structure Meeting in June was arranged prior to the HIS validation visit but is now a key focus in developing relationships and interaction between the advisory structure and the Board. Mr Carey’s letter of 2 April stated “given the potential scale of change in the future it is an appropriate time to bring the whole advisory structure together to review the position and identify how its contribution and influence can be enhanced”. The specific aim of the meeting is to develop understanding and clarity of the role and contribution of the advisory structure and management.

In advance of the June meeting, representatives from the Executive Team are attending each of the advisory committees to identify areas for improvement and collate ideas received to issue for 10 June event to discuss, along with challenges faced e.g. Health and Social Care Integration, Primary Care, Workforce and how NHS develops as a tertiary provider. Mr Smith advised it is important to consider how advisory committees are working individually and collectively therefore the event aims to develop ideas and to reach a consensus regarding the way forward.

All members of the clinical advisory committees are urged to ALL attend on 10 June from 2.00pm.

6. Review of Advisory Structure

Reviewing & Updating of all Committee Constitutions

It was recognised that all constitutions are in need of review in line with the Scottish Government Circular ‘CEL 16 (2010) – Area Clinical Forums’, which had been issued after all constitutions were reviewed in 2008 by PwC. It was agreed a review would need to be undertaken after 10 June event.

Ms Leete to add ‘CEL 16 (2010)’ to ACF website and circulate link, TL given recent ACF members were not aware of document.

7. Health and Social Care Integration

Mr Smith provided a brief summary regarding the new partnerships to integrate health and social care which have now been passed with new partnerships to be established April 2015 to March 2016. Over the next six months it will be necessary to confirm the scope of services that will be reflected in the Integrated Schemes for each of the three new Health and Social Care Partnerships (HSCPs).

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Mr Smith circulated a paper for discussion regarding how services will be organised on the establishment of the new arrangements acknowledging that this will be reviewed continuously thereafter. A proposed meeting of NHSG and representatives of the three TLGs is required by the Bill to consider cross partnership issues. Mr Smith advised that all senior clinical leaders need to participate to work on the agenda determined by the group to ensure good engagement.

The Committee acknowledged the large agenda ahead and the urgent need to integrate primary and secondary care within NHSG before integration with social care. Members asked how the clinical advisory structure would fit into the new structure and if it would include social care colleagues, as it would prove difficult to link together due to different understanding and cultures. Mr Smith advised of a definite need for advisory structure to fit but need to discuss where. Discussion highlighted that there would be common ground so will be more patient centred focus but urgent need with strategic planning as the Integration agenda will be fast paced resulting in a new culture and new way of working for all.

Mr Smith advised that a readable summary of the paper is being GS prepared and will be circulated once complete.

Health and Social Care Integration to feature throughout the ALL advisory structure agenda.

8. Chair’s Update

The Chair gave a brief update on key events and issues since the last meeting as follows:

 Last Board meeting discussed A&E and recruitment.  HIS Event 7 May - ‘National Approach to Learning and Adverse Events’.  Accountability review will be different in future.  National Feedback policy to be devised – would be useful to discuss feedback and patient stories at individual advisory committees i.e. committees to keep on agenda.

Report to the Board: April 2014

Circulated.

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Clarification of Process

At the March AMC meeting, members had raised concern that there was not sufficient detail in the ACF reports to the Board and asked for clarity around the process for Committee Chairs. Members were also concerned that reports were being vetted by the Board Secretary.

The Chair clarified that the ACF Report to the Board is available in the public domain and is therefore checked by the Board Secretariat to ensure content is not open to misinterpretation or has any impact on staff and confidence. While the Board Secretary sometimes provides recommendations it is the author who has the final decision and reports are in no way diluted as advisory advice needs to be unvarnished.

It was agreed to discuss clarification of process, roles and ALL responsibilities at 10 June event.

Items for June 2014 Board Meeting

The Chair to include in report to the Board:

- Whole System Patient Flow - Health and Social Care Integration - Role of Advisory Structure

The Chair to share draft report to Board to members. LJ

9. Director of Public Health Report

The latest report was circulated for information.

10. Updates from the Advisory Committees

Brief updates from the Advisory Committees covered the following areas:

 GANMAC – Workforce, recruitment and retention, moving nursing staff around. RGU impact on students and quality of mentorship ie. is NHSG seen as attractive employer.  HCS – Mandatory/statutory training. Workforce and recruitment issues – senior ‘experts’ due to retire and no-one to replace.  CSC – A&E, HIS. Mr Binnie to put form of words that is supportive of Dr Russell’s support to NHSG over the next six months. A number of letters received stating no confidence in medical management which needs to be included in Dr LJ

5 APPROVED

Russell’s work. Dr Russell to include GPs and Dr Provan to liaise. AMC Chair to be invited to Board Meetings.  GAAPAC – Health and Social Care Integration Event 30 May.

11. Minutes

Recent minutes were circulated for information.

12. AOCB

None.

13. Date of Next Meeting

The next meeting will be held on Wednesday 2 July 2014 at 5.30pm in the Conference Room, Summerfield House.

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