Paper 1

Ayrshire and Arran NHS Board Minute of a public meeting on 25 March 2019 9.15am, Rooms 2A-C, Education Centre, University Hospital Crosshouse

Present: Dr Martin Cheyne (Chair) Non-Executive Members: Mrs Lesley Bowie (Vice Chair) Mrs Margaret Anderson Cllr Joe Cullinane Mr Stewart Donnelly Mr Bob Martin Dr Janet McKay Mr Alistair McKie Cllr Douglas Reid Ms Linda Semple Miss Lisa Tennant Mr Ian Welsh

Executive Members: Mr John Burns (Chief Executive) Dr Alison Graham (Medical Director) Mr Derek Lindsay (Director of Finance)

Board Advisors/Ex-Officios: Mr Stephen Brown (Director of Health and Social Care, North ) Mrs Kirstin Dickson (Director of Transformation and Sustainability) Mrs Joanne Edwards (Director for Acute Services) Mr Eddie Fraser (Director of Health and Social Care, East Ayrshire) Ms Laura Harvey (Quality Improvement Lead, Customer Care) Ms Patricia Leiser (Human Resources Director) Mrs Lynne McNiven (interim Director of Public Health) Mr Mark Taylor (Improvement Director) Mr David Thomson (Associate Nurse Director, Lead Nurse for North Ayrshire Health and Social Care Partnership) Mr John Wright (Director for Corporate Support Services)

In attendance: Mrs Shona McCulloch (Head of Corporate Governance) Mrs Miriam Porte (Communications Manager) Mrs Angela O’Mahony (Committee Secretary) minutes

The Chairman welcomed Mrs Joanne Edwards who was attending her first Board meeting having recently taken on the role of Director for Acute Services.

1. Apologies

Apologies were noted from Cllr Laura Brennan-Whitefield, Mr John Rainey, Prof Hazel Borland, Mr Tim Eltringham, Dr Crawford McGuffie and Dr Joy Tomlinson.

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2. Declaration of interests (028/2019)

Ms Linda Semple declared a standing interest as a Non-Executive Director of the Board of the NHS Golden Jubilee Foundation.

3. Minute of the meeting of the NHS Board held on 4 February 2019 (029/2019)

The minute was approved as an accurate record of the discussions.

4. Matters arising (030/2019)

Paper 2 - Action Log The Board action log was circulated to Board Members in advance of the meeting and all actions were noted.

The Chairman advised in relation to item 8.1, Public Health priorities, that the Head of Corporate Governance would meet in the near future with the joint interim Directors of Public Health to agree a date for the Board workshop.

5. Chairman and Chief Executive’s report

5.1 Chief Executive’s report (031/2019)

 The Chief Executive advised that the Ministerial Strategy Group had issued a set of proposals in response to the Audit Scotland report on Health and Social Care integration. There were a total of 25 proposals put forward by the Integration Leadership group and a self-evaluation document had been developed for discussion with the Health and Social Care Partnerships (HSCPs), to enable a swift response to be sent to the Ministerial Strategy Group, with feedback expected in late May. The Chief Executive advised that this was an important piece of work in taking forward integrated arrangements and to identify any learning and improvements for individual HSCPs across Scotland.  The Chief Executive reported that the West of Scotland (WoS) Programme Board had met on 15 February and the Board’s Director for Transformation and Sustainability and Head of Property Services, Strategy and Partnerships had presented NHS Ayrshire & Arran’s strategic needs assessment. This had provided an important early opportunity to position Board’s strategic intent within the WoS model of care and to demonstrate the work being done, linked to and informed by activities taking place in terms of wider population planning. It had been agreed that there would be ongoing dialogue as Board’s strategic plans were developed.  The Chief Executive reported that the Chief Scientist’s Office had provided funding for each of the three Regional Boards to support innovation. WoS would develop and progress this work in 2019-20 through the Glasgow Innovation Centre based at the Queen Elizabeth University Hospital, linked to existing innovation activities within individual Boards. The Chief Executive would keep Board Members updated.  The Chief Executive advised that the WoS Board will develop a Delivery Plan for 2019-20 clearly setting out workstreams to be taken forward during the year and building on work that had taken place during the last 12 months.  The Chief Executive had attended the East Ayrshire Community Planning Partnership (CPP) meeting when the joint interim Director of Public Health,

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Mrs Lynne McNiven, had presented on adverse childhood experience, a significant issue that was being widely discussed by community planning partners. There had also been the opportunity to endorse a corporate parenting promise when the group had heard from care experienced young people.

5.2 Chairman’s report (032/2019)

 The Chairman advised that the deadline for receipt of applications for Ayrshire Achieves was 3 May and he encouraged Members to attend the award event being held on 25 June 2019.  The Chairman reported that the Annual Review took place on 18 March 2019 with the Minister for Public Health, Sport and Wellbeing, Mr Joe FitzPatrick and the NHS Scotland Clinical Director, Mr Jason Leitch. The Chief Executive and Chairman had met the Minister to discuss NHS Ayrshire & Arran’s performance. Following the Annual Review, Scottish Government will write to Board to outline any actions to be taken forward.  The Chairman advised that a high level WoS Health Sciences network was being established to bring together academia, NHS Boards, healthcare and the private sector. The group had met on 10 March 2019 to develop terms of reference for a Delivery board and Oversight board and to establish membership for these groups. The Chairman had emphasised the need to link innovation activity in WoS with the Ayrshire Growth Deal to maximise the important opportunities being provided.  The Chairman reported that he had been appointed to the National Evaluation Committee whose role was to evaluate jobs and job grades at a senior level across Scotland.

6. Quality

6.1 Patient Story (033/2019)

In the absence of the Nurse Director, the Director for Acute Services introduced the patient story. She invited the Quality Improvement Lead for Customer Care, Ms Laura Harvey, to describe the events that had taken place following Mr Letton’s collapse outside University Hospital Ayr when he was resuscitated by the nurse who only moments earlier had been treating him in the eye clinic. Ms Harvey also shared the story from the perspective of Mr Letton’s wife and Staff Nurse Sharon Carson, who had resuscitated Mr Letton following his collapse.

Board Members were advised that Mr Letton’s story will be shared on the NHS Board website, to encourage staff and the public to participate in Resuscita tion or Emergency Life Support skills training. Members recognised the need for clinical staff to ensure that their training on cardiopulmonary resuscitation was kept up -to- date and the value of Heartstart basic life support training for staff and the public.

Outcome: Board Members noted this very positive patient story and thanked Mr Letton for allowing his story to be shared. Members welcomed the positive health outcome for Mr Letton which reflected the Board’s values of caring, safe and respectful.

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6.2 Patient Experience (034/2019)

The Associate Nurse Director, Mr David Thomson, presented a report on organisational activity in relation to patient, carer and family feedback and complaints during Quarter 3 (October to December 2018) and compliance with the complaint handling process.

The Associate Nurse Director advised that the vast majority of Care Opinion (CO) received was positive and there had been continued spread of CO responders across all services. In response to a question from a Board Member, the Associate Nurse Director agreed to provide a comparison of CO responders against other Boards and this would be reported through the Healthcare Governance Committee (HGC).

The Associate Nurse Director reported that there had been improvement in complaint handling and response timeliness and consistent progress was being made in relation to evidencing consistent improvement from feedback and complaints. He explained that complainant feedback was now being collected on a regular basis and he provided details of ongoing activity to redesign local complaint handling processes.

The Associate Nurse Director provided detailed data in relation to complaints and concerns per directorate.

Board Members discussed the main themes from complaints and the increase in complaints related to clinical treatment during the reporting period. The Director of Health and Social Care, EA HSCP, Mr Eddie Fraser, explained that complaints for EA HSCP included Prison Services and a high number of these complaints related to clinical decisions on medication requests from prisoners. The Associate Nurse Director provided assurance that all complaints were taken seriously regardless of the individual making the complaint or the type of complaint being made. Members received assurance that despite the rise in the number of complaints being referred to the Ombudsman, the number of complaints being investigated further had gone down.

Outcome: Board Members considered and noted the Patient Experience Quarter 3 report. Members were encouraged by the positive and significant improvements made in the complaint handling process and it was anticipated that Board would continue on this improvement trajectory.

6.3 Healthcare Associated Infection (HAI) report (035/2019)

The joint Medical Director, Dr Alison Graham, presented the HAI performance report for the period 1 April 2018 to 31 January 2019. She provided assurance that considerable improvement activity was taking place across the organisation to reduce HAIs and HAI data was being scrutinised in detail at HGC.

The joint Medical Director reported HAI performance in relation to Staphylococcus aureus bacteraemia (SAB) and advised that the Board will not attain the 2018-19 target. She highlighted that for the majority of SAB cases, the points of entry were skin and blood culture (BC) contaminants and she outlined the improvement activity

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taking place to reduce peripheral vascular catheters and BC contaminant related SABs. Staff training was being provided on the new BC testing equipment being introduced from 1 April 2019. Committee members had asked for more in-depth work to take place to improve understanding of the causes for community acquired SAB and to consider possible areas for improvement and this would be monitored through HGC.

The joint Medical Director advised that Board was on target to attain the Clostridium difficile infection (CDI) 2018-19 target.

Outcome: Board Members considered and noted the HAI data as well as the ongoing work within the organisation to reduce HAI rates.

6.4 Scottish Patient Safety Programme (SPSP) - Maternity & Children (036/2019) Quality Improvement Collaborative (MCQIC)

The Director for Acute Services provided an update on the SPSP MCQIC programme. The aim of the programme was to improve and reduce inequalities in outcomes by providing a safe, high quality care experience for all women, babies, children and families across all care settings in Scotland.

The Director for Acute Services advised that the Board had signed a partnership agreement with MCQIC in relation to the way forward with new measurements signed off and sent to all relevant parties on 21 December 2018. Moving forward, there would be a step down approach to reporting in areas of sustained improvement. Some existing measures would continue to be collected to ensure improvement was driven forward and maintained, with a smaller selection of core measures reported to MCQIC.

The Director for Acute Services highlighted improvements made within the Gynaecology workstream. She highlighted that there had been a data input error in May 2018 which had indicated a drop in PVC bundle compliance to 75% but this had been investigated and corrected and 100% compliance had been observed and recorded since that date.

Outcome: Board Members noted the ongoing work of quality improvement in the Maternity, Neonatal and Paediatric services. Members acknowledged the significant improvement activity taking place across the programme and commended all staff involved for the work being done.

6.5 Impact report on Dementia Friendly (037/2019)

Mr Ian Welsh outlined the background and context to the impact report on Dementia Friendly Prestwick launched in June 2016. He highlighted the community led improvement work being taken forward in partnership over the last two years to reduce health inequalities and social isolation, complementing other local work and the national focus on dementia supported by Alzheimer Scotland. There were proposals to extend this activity to other parts of and discussion was also taking place with colleagues in North Ayrshire.

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Mr Welsh highlighted the broader programme of third sector engagement that had taken place over the last decade in the particular context of Integration Joint Boards and through programmes such as reshaping care for older people and integrated care fund activity. He highlighted that the number of people living with dementia in South Ayrshire was predicted to rise significantly over the next 10-20 years and a co- production approach was required to meet this challenge.

The Associate Nurse Director gave assurance to Board Members that NHS Ayrshire & Arran had achieved over 90% compliance in regard to post-diagnostic support for dementia.

Outcome: Board Members noted the Dementia Friendly Prestwick Impact Report and Members recognised the benefits being provided for individuals living with dementia in Prestwick and their families and carers.

7. Corporate Governance

7.1 NHS Ayrshire & Arran corporate governance (038/2019)

The Chairman and Chief Executive reminded Members that a workshop would take place immediately following the Board meeting to enable Members to review the results of the self-assessment of Board’s corporate governance arrangements and to agree any further actions to be included in the improvement plan developed in October 2018. This would inform the Board report to be submitted to Scottish Government by end April 2019. A formal report will be submitted to Board on 27 May. Members were content with this approach.

The Chief Executive advised that national Once for Scotland templates were being developed and once available, these would be reviewed to ensure Board was complying appropriately, whilst not diluting the strength of existing local governance arrangements. The Chief Executive explained that consideration was being given to the timing for the annual review of the Code of Corporate Governance given the national work taking place and he would keep Board Members apprised of progress in taking forward this work.

Outcome: Board Members were content with this approach.

7.2 Membership of Board committees and Integration Joint Boards (039/2019)

The Chairman explained that there had been a delay in the Non Executive appointment process. Succession planning discussions were ongoing to appoint to committee vacancies and a formal paper will come to Board on 27 May to advise of these arrangements and to seek formal Board support.

Outcome: Board Members noted the delay in appointments to committee vacancies that will arise from 1 April and agreed the process to appoint to IJB and committee vacancies. Members ratified the appointment of Miss Lisa Tennant as a member of the East Ayrshire IJB from 1 March 2019.

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7.3 Audit Committee (040/2019)

The Audit Committee Chair, Mr Alistair McKie, provided a verbal update from the Audit Committee meeting held on 20 March 2019. The draft minute will be provided at the next Board meeting.

Mr McKie reported that Audit Scotland had provided a presentation on the Integration of Health and Social Care report published in November 2018. The Board’s internal auditor had reported progress made by management in closing agreed management actions and recommendations had been agreed to ensure outstanding actions were completed. The Chief Executive provided assurance that he had written to all Directors setting out clear expectations for the management of internal audit report actions and reporting mechanisms to Governance Committees to ensure that actions were followed up appropriately. Mr McKie advised that Committee had also discussed and approved the Strategic Risk Register.

Outcome: Board Members noted this update.

7.4 Healthcare Governance Committee (HGC) (041/2019)

The HGC Committee Chair, Ms Linda Semple, provided a verbal update from the HGC meeting held on 4 March 2019. The minute will be provided at the next Board meeting.

Ms Semple reported that there had been detailed discussion on HAI, specifically SAB performance. A report on SPSP MCQIC had been presented and members had been impressed at the improvement activity taking place. Committee had discussed a report on leadership walkrounds and members had received assurance around the process for dealing with actions highlighted following walkrounds. Board Members commented that participation in leadership walkrounds was very useful in enabling them to visit areas where they would not normally work and to share values and principles.

Outcome: Board Members noted this update.

7.5 Information Governance Committee (IGC) (042/2019)

The IGC Committee Chair, Miss Lisa Tennant, presented the draft minute of the IGC meeting held on 18 February 2019. IGC had received a report on progress to fulfil the requirements of the Public Records (Scotland) Act 2011. There was discussion on performance in responding to Freedom of Information requests and members had been impressed by the organisation’s excellent performance. Progress continued to fulfil the requirements of the General Data Protection Regulation. Members had reviewed and approved the IG Strategic Risk Register and more detailed discussion on IG risks was planned for a future meeting. IGC had agreed that governance matters related to the Information Security Policy Framework would be discussed at the next IGC meeting.

Outcome: Board Members considered and noted the minute.

7.6 Performance Governance Committee (PGC) (043/2019)

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The PGC Committee Chair, Mr Bob Martin, presented the approved minute of the extraordinary PGC meeting held on 21 February 2019. PGC had received a report on the Board’s financial performance at Month 10 and had discussed three year financial planning and performance in detail.

Mr Martin presented the draft minute of the PGC meeting held on 11 March 2019 when there had been focused and useful discussion on finance and service performance and planning for 2019/20. The Chief Executive and Chairman both reiterated that this had been a helpful and constructive meeting which had provided the opportunity to discuss and explore issues and to develop planning as part of the scrutiny and assurance process prior to Board discussion.

Outcome: Board Members considered and noted the minutes.

8. Service

8.1 Annual Operational Plan 2019-20 (044/2019)

The Director for Transformation and Sustainability presented guidance for the Annual Operational Plan 2019-20 which had been issued by Scottish Government. The plan required information on performance, planning, health improvement and finance and it replaced the Local Delivery Plan that NHS Boards had previously been asked to produce. A draft plan was being prepared for Scottish Government and once feedback had been received the plan would be submitted to Board. The Chief Executive explained that once developed, the plan would form part of the Board’s Health and Care Delivery Plan.

Outcome: Board Members noted the approach being taken to develop the Annual Operational Plan 2019-20 for submission to Scottish Government by 31 March 2019.

8.2 Health, Safety and Wellbeing Strategy 2016-19 (045/2019)

The HR Director provided a detailed report on performance against the identified goals and objectives contained within the Board’s Health, Safety and Wellbeing Strategy 2016-19.

The HR Director described the integrated approach adopted in developing the Health, Safety and Wellbeing Strategy which helped to support implementation of Board’s legal duties in accordance with Health and Safety at Work, etc Act 1974 and subordinate legislation, and key aspects of Board’s health and wellbeing agenda. The HR Director outlined the strategy’s long term strategic goals for 2016-19 and the wide range of achievements and progress made against identified objectives. She emphasised the importance that Board placed on this key aspect of the people agenda. Board Members were advised that work was underway to develop the Board’s 2019-22 Health, Safety and Wellbeing Strategy and detailed progress updates were being reported to SGC.

Board Members welcomed this important strategy, progress being made and activities taking place to encourage people to maintain their own health and wellbeing. Members welcomed the improved staff uptake for Flu vaccination and the HR Director gave assurance that efforts continued to further improve uptake. She explained, in response to a question form a Member, that there were financial

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pressures related to the increased cost of Flu vaccine and she was grateful for the financial support provided by Endowment Committee. She provided assurance that should there be any issues related to implementation of the strategy these would be discussed through the Corporate Management Team as required.

Board Members emphasised the need to continue to promote staff health and wellbeing, to support staff to meet pressures and challenges being faced and to enable them to continue to deliver services and provide good outcomes for patients.

Outcome: Board Members noted and recognised the progress being made across the health and care system against identified goals and objectives contained within the Health, Safety and Wellbeing Strategy 2016-19.

9. Performance

9.1 Unscheduled Care (046/2019)

The Director of Health and Social Care for East Ayrshire, Mr Eddie Fraser, presented the Unscheduled Care report and provided an overview of planned actions and transformational priorities to improve the management of Unscheduled Care.

Mr Fraser advised that as reported at previous Board meetings, unscheduled care demand continued to increase within the Ayrshire Health and Social Care system and this could result in increased demand for community services and hospital care beyond current resources.

Mr Fraser reported Unscheduled Care performance at hospital site level. Board Members received a detailed report on performance across HSCPs against the Ministerial Strategic Group Health and Community Care indicators. Mr Fraser advised that consolidated progress had been made by HSCPs across these indicators over the past three years.

Board Members discussed ED performance at both hospital sites. Mr Fraser outlined the work being done through Caring for Ayrshire to develop a clinical model to provide appropriate facilities through Acute and Primary Care services to manage urgent but non-emergency care. The Chief Executive advised that while ED performance data accurately reflected national reporting standards, there was a need to draw a distinction between ED attendance and admission data, including CAU admissions, to fully understand changing patient flow through both hospital sites and to properly reflect activity levels. PGC would consider further and provide clarity in relation to ED performance data going forward.

Board Members discussed compliance against the 4 hour waiting time standard which was below target in January 2019, despite the efforts by staff across the health and social care system who continued to provide high quality care for people every day. The Chief Executive advised that this performance was disappointing and there was a need to understand and interrogate what could be done differently in 2019-20 to improve compliance. He outlined the improvement activity planned to manage Board’s Unscheduled Care performance. He had recently met the Unscheduled Care Director at Scottish Government to set out the approach being adopted within NHS Ayrshire & Arran.

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Mr Fraser provided assurance, that Integrated Care Team progress had recently been reported to PGC and while this was at an early stage, these teams would be fully embedded in work being taken forward across the organisation.

Outcome: Board Members noted the Unscheduled Care report and the planned actions and transformational priorities to improve the management of Unscheduled Care.

9.2 Planned Care (047/2019)

The Director for Transformation and Sustainability, Ms Kirsti Dickson, presented the Board with an updated position on Planned Care performance and set out NHS Ayrshire & Arran’s progress in relation to the Scottish Government Waiting Times improvement Plan and progress towards achieving waiting time and other access targets.

Ms Dickson advised that the Planned Care report provided a new info-graphic which had been developed to provide Board Members with an at a glance overview of Planned Care performance and to ensure that Members were sighted on the corresponding impact of underperformance. She advised that there were future plans to provide an integrated Unscheduled and Planned care report to Board, similar to the integrated report recently discussed at PGC.

Ms Dickson provided a detailed report outlining progress in the phased implementation of the Waiting Times Improvement Plan and she highlighted key planned care performance data.

Board Members were advised that progress in relation to the improvement plans and trajectories would be monitored through the Board’s performance system to support reporting to Board and Scottish Government.

Outcome: Board Members noted progress in relation to the Scottish Government Waiting Times Improvement Plan and noted performance against the national waiting times and access targets.

9.3 Financial Management Report (048/2019)

The Director of Finance presented the Financial Management Report for the 11 months to 28 February 2019. The deficit for month 11 was £0.8 million and this reflected improvements made during the year and one off benefits. The cumulative deficit was £19.2 million.

The Director of Finance highlighted key messages in relation to the 2018/2019 revenue plan. The projected outturn for 2018/19 was £20.0 million, in line with the Annual Operational Plan submitted to Scottish Government in March 2018.

The Director of Finance outlined areas of overspend in relation to Acute Services, nursing pay and new medicine costs. He advised that the Health and Social Care Partnerships were £0.9 million underspent as at February 2019. The Chief Executive explained that there had been constructive discussion with Chief Officers to agree the approach to be taken while collectively supporting wider

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Board and IJB performance and virement would take place in accordance with Integration Joint Scheme Guidance.

Outcome: Board Members noted the financial position for the 11 months to 28 February 2019, progress on delivering on transformation, cost avoidance and cash releasing efficiency savings and the projected outturn of £20.0 million deficit for the year.

Board Members endorsed the financial management approach proposed and Members agreed that the Chief Executive should write to Scottish Government to formally request £20.0 million brokerage for 2018/19.

10. Decision/Approval

10.1 Health and Care delivery plan (049/2019)

The Director for Transformation and Sustainability presented the Health and Care Delivery Plan which reflected an integrated planning approach for health and social care within Ayrshire & Arran for three years beginning 2019-20, in line with the Cabinet Secretary’s requirements for Boards to produce a balanced three year finance and improvement plan in her statement on 4 October 2018. Board had agreed this approach in February 2019 to ensure congruence across planning areas and to inform the revenue component of the plan. A series of Board discussions/workshops had taken place to discuss the plan whilst this was being developed.

The Chief Executive explained that a number of detailed service plans sat behind this executive summary to provide discipline and clarity to the process for planning and delivering future health and care services and the plan had been shared with the Scottish Government Board Recovery Team. The plan will be presented to East, North and South Ayrshire Integration Joint Board (IJB) meetings in March and April 2019 to seek approval.

Outcome: Board Members approved the Health and Care Delivery Plan 2019-2022 for submission to Scottish Government at the end of March 2019.

10.2 Revenue plan 2019/20 (050/2019)

The Chief Executive introduced the Revenue Plan for 2019/20 and highlighted the challenges for Board in achieving financial balance in 2019/20 given the forecast outturn. He advised that there were risks related to identifying and delivering cash releasing efficiency savings and the Board’s spend profile in 2019/20 would require to be carefully managed to deliver the Revenue plan. There were focused programmes of work being scoped in the first quarter of 2019/20 as part of a continuous transformation improvement plan and discussion was ongoing with the Board Recovery Team.

The Director of Finance highlighted key points from the Revenue plan as detailed within the report.

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Board Members were advised that discussions had taken place with Integration Joint Board Chief Officers to agree the funding proposed for 2019/20. The allocation letter from the NHS Scotland Director of Finance had set out the approach to be taken to uplift IJB baseline funding. The funding proposal would see baseline budgets for the three IJBs uplifted by £5.1million in line with the direction in the allocation letter.

Board Members discussed and recognised the difficult challenge for Board in achieving 3% cash releasing efficiency savings. Members were encouraged by the work being done within older people’s services and emphasised that this integrated approach would be key to delivering future services.

Board Members raised concern that an Equality Impact Assessment (EQIA) or risk assessment was not included in the Revenue Plan that they were being asked to approve. The Director for Transformation and Sustainability gave Members assurance that EQIA would be provided for individual service plans. The Chief Executive reiterated the challenges in setting the Revenue Plan. He provided assurance that the Health and Care Delivery plan would enable robust planning and risk assessment to allow Board to understand the impact on workforce, infrastructure, quality and safety of any future changes to service delivery and their influence on the revenue position. The Chief Executive would meet Scottish Government on 10 April to discuss Board’s Annual Operating Plan and Revenue Plan. The Chief Executive and Chairman would consider points raised by Members in relation to the process followed in developing the plan and future reporting requirements.

Outcome: Board members approved the Revenue Plan 2019/20 and the £14.7 million deficit budget. Members approved the budget increase for 2019/2020 to be delegated to Integration Joint Boards. The Chief Executive would confirm budgets for Directorates and IJBs and would write to Chief Officers formally on funding proposals.

10.3 Equality and Diversity mainstreaming report (051/2019)

The HR Director presented the Equality and Diversity mainstreaming report 2017/19 which incorporated the Equality Outcome Progress Report and Workforce Information.

Board Members were advised of plans to embed equality into business functions and activities across five key areas of the organisation, in line with legislative requirements and duties under the Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012. The HR Director provided assurance that Board was making good progress in delivering shared Equality Outcomes as well as bi-annual Workforce Information. She highlighted positive examples of partnership work taking place locally and she emphasised the importance of adopting integrated arrangements going forward.

Outcome: Board Members commended the Equality and Diversity activity taking place. Members supported the content of the report as NHS Ayrshire & Arran’s accountability for mainstreaming equality over the last two years.

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10.4 Capital Programme 2019-20 (052/2019)

The Director for Corporate Support Services presented the Capital Programme for 2019-20 which was approved by the Capital Programme Management Group (CPMG) on 28 February 2019.

The Director for Corporate Support Services explained that funding sources for 2019/20 took account of the annual Core Capital allocation and earmarked funding for the Whole Systems Estate Programme; Business Case Strategy Funding; Chief Medical Officer allocation for Sexual Assault Forensic Centre; Brokerage carried forward from 2018/19; and the National Secure Adolescent Inpatient Service at Ayrshire Central Hospital. He advised that enhanced revenue allocation was provided for Estates and other formula allocations. Board Members received details of recommended capital allocations for the proposed Capital Programme 2019/20 to meet clinical and other investment requirements.

The Director for Corporate Support Services advised that the proposals had been subject to consultation through CPMG and CMT and he highlighted that in 2019/20 there would be a greater focus to ensure that benefits identified for capital projects were realised in practice through improved service delivery and benefits for patients and staff. CMT would track progress in delivering these improvements.

Outcome: Board Members endorsed the Capital Programme for 2019/20.

10.5 Area Drug and Therapeutics Committee (ADTC) (053/2019)

The joint Medical Director outlined changes to the ADTC’s remit and constitution and the change of ADTC chairperson to Dr Jon Staines (Consultant Paediatrician and Neonatologist). The proposed changes had been discussed and supported by HGC. The joint Medical Director acknowledged the excellent work done by Dr John Gemmill (Consultant Cardiologist) during his time as ADTC Chair.

Outcome: Board Members approved the revised remit and constitution for the Area Drug and Therapeutics Committee and supported the change of chairperson from Dr John Gemmill to Dr Jon Staines.

11. For information

11.1 Board briefing (054/2019)

Board Members noted the content of the briefing.

11.2 East Ayrshire Integration Joint Board (055/2019)

The draft minute of the meeting held on 13 February 2019 was not available.

11.3 North Ayrshire Integration Joint Board (056/2019)

Board Members noted the minute of the meeting held on 14 February 2019.

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11.4 South Ayrshire Integration Joint Board (057/2019)

Board Members noted the minute of the meeting held on 13 February 2019.

12. Any Other Competent Business (058/2019)

The Chairman advised that the Improvement Director, Mr Mark Taylor, and Non- Executive Board Members, Mr Ian Welsh and Mr Alistair McKie, would be leaving Board at the end of March and he thanked them for their contribution to Board and wished them well for the future.

13. Date of Next Meeting

The next meeting of the NHS Ayrshire and Arran Board will take place at 9.15 am on Monday 27 May 2019, Rooms 2A-C, Education Centre, University Hospital Crosshouse

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