Highland Health & Social Care Committee 20 March 2014 Item 3 HIGHLAND HEALTH & SOCIAL CARE GOVERNANCE COMMITTEE Report B

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Highland Health & Social Care Committee 20 March 2014 Item 3 HIGHLAND HEALTH & SOCIAL CARE GOVERNANCE COMMITTEE Report B Highland Health & Social Care Committee 20 March 2014 Item 3 HIGHLAND HEALTH & SOCIAL CARE GOVERNANCE COMMITTEE Report by Deborah Jones, Chief Operating Officer The Board is asked to: Note that the Highland Health & Social Care Governance Committee met on Thursday 9 January 2014 with attendance as noted below. Note the Assurance Report and agreed actions resulting from the review of the specific topics detailed below. Present: Myra Duncan, Board Non Executive Director – Chair Jan Baird, Director of Adult Care Helen Bryers, Head of Midwifery Shirley Christie, Staffside Representative Mr Quentin Cox, Area Medical Committee Representative – Consultant Dr Paul Davidson, Chair, Professional Executive Committee David Flear, Patient/Public Representative Gavin Hogg, Patient/Public Representative Deborah Jones, Chief Operating Officer Linda Kirkland, Interim Director of Operations, Raigmore Hospital Rhona MacDonald, Board Non Executive Director Margaret MacRae, Staffside Representative Gillian McCreath, Board Non Executive Gill McVicar, Director of Operations – North & Mid Brian Robertson, Head of Adult Social Care Nigel Small, Director of Operations – South & Mid Kate Stephen, Elected Member, Highland Council Katherine Sutton, Associate Director, AHPs Dr Chris Williams, Area Medical Committee Representative – GP In Attendance: David Alston, Board Non Executive (to 12.15pm) Garry Coutts, Board Chair (from 11.30am) Dr Michael Foxley, Board Non Executive (from 9.45am) Gillian Grant, Team Leader (Contracts)(from 10.30am) Nick Kenton, Director of Finance (from 9.45am) George McCaig, Head of Business Support, Adult Social Care Brian Mitchell, Board Committee Administrator Kenny Oliver, Board Secretary Dr Margaret Somerville, Director of Public Health Simon Steer, Head of Strategic Commissioning (from 1030am) Maimie Thompson, Head of Public Relations and Engagement Apologies: Dave Garden, Head of Financial Planning Bren Gormley, Elected Member, Highland Council Linda Munro, Elected Member, Highland Council Adam Palmer, Staff Side Representative Bob Summers, Head of Health & Safety Philip Walker, Head of Personnel Sarah Wedgwood, Board Vice Chair Mhairi Wylie, Public/Patient Member Representative – Voluntary Sector AGENDA ITEMS Feedback from Development Session on 1 November 2013 Possible Major Service Redesign Update Financial Position Report as at 31 October 2013 Adult Services Balanced Scorecard 2013/2014 Highland Health and Social Care HEAT Targets Balanced Scorecard and Exception Reports from Improvement Committee Strategic Commissioning Plan and Commissioning Intentions Review of NHS Highland Response to Deterioration in the Quality of Care in an Independent Care Home Establishment of a Commissioning Hub Augmentative and Alternative Communication Update Chief Operating Officer Report Operational Unit Reports Consideration of Future Agenda Items Committee Function and Administration DATE OF NEXT MEETING The next meeting will be held on Thursday 20 March 2014 in the Board Room, Assynt House, Inverness at 9.30pm. 2 HEALTH AND SOCIAL CARE COMMITTEE – ASSURANCE REPORT Meeting on Thursday 9 January 2014 1 TOPIC: Declarations of Interest Issues Assurance Actions Do members have any interest to No declarations were made. declare in relation to any Item on the agenda? 2 TOPIC: Assurance Report and Rolling Action Plan – 7 November 2013 Issues Assurance Actions Need to update Rolling Action Agreed regular updates required from Named Action: Plan Officers. Action Plan to continue to be updated – Named Officers/ Committee Administrator 3.1 TOPIC: Area Clinical Forum Membership Issues Assurance Actions Are Healthcare Science and Area QC had requested assurance that these groups Psychology Fora represented on were represented and it was confirmed this was the membership of ACF? the case. 3.2 TOPIC: Professional Executive Committee – Verbal Update – Dr Paul Davidson, PEC Chair Issues Assurance Actions What progress is being made in PD advised first meeting had been held. relation to PEC? Committee comprised a small membership and would meet every two months. Officers with areas of special interest may be invited to attend and contribute. Guidance and feedback would be sought from this Committee. 3.3 TOPIC: Update on Performance and Finance Sub Committee Issues Assurance Actions What progress is being made in It was advised that a schedule of meetings for relation to Sub Committee? 2014 had been established and that Dr Rhona MacDonald had agreed to Chair. 3.4 TOPIC: Provision of Services to Ex Military Service Personnel Issues Assurance Actions What are the implications of Not seen as a cost pressure by the Board as part Action: providing services for ex-military of the general population that we have Agreed detail of Briefing be circulated to members service personnel? responsibility for caring for. Treatment prioritised – Committee Administrator if condition linked to active service and no one in general population with greater need. No specialist services specifically for ex military servicemen (specialist service may require out of area referral) however do employ staff with specific skill sets to be able to care for certain conditions such as limb damage. 4 3.5 TOPIC: HHSCC Development Session 1 November 2013 – Formal Feedback – Myra Duncan, HHSCC Chair Issues Assurance Actions What were the outcomes from the Circulated report by Chair summarised Action: Development Session on Review discussion and outlined a series of questions for Agreed full discussion notes be circulated to of Governance? members to consider as part of a review of members – Committee Administrator governance role of Committee. Noted need to consider Partnership Agreement and Commissioning Group aspects as part of review. Agreed Local Delivery Plan (LDP) to form basis for future HHSCC activity. What is the position in relation to NHSH still host number of relevant services. Agreed report outlining scope of services for Childrens Services? Commissioning Group would benefit from Children and Young People be submitted to next discussion at and reporting to this Committee. meeting – Director of Public Health DPH annual report includes feedback from children and young people. View expressed Committee need to seek assurance from those who are commissioning services to enable informed decisions to be taken and direction to be given. How should matters be taken Overall agenda structure and scheduling to be Agreed report on agenda restructuring and linkages forward? further considered. Links with other relevant be submitted to next meeting – Chair/Chief Governance Committees to be further Operating Officer considered and discussed. 5 4 TOPIC: Possible Major Service Re-Design Update – Directors of Operations (South and Mid & North and West) Issues Assurance Actions What are the strategic cases for Circulated report indicated that the four hospitals Action: service redesign and are these subject to review no longer conducive to delivery Agreed to ratify strategic case for change across regarded as Major Service of modern, integrated health and social care. Badenoch & Strathspey and Skye, Lochalsh and Change? Service redesign process subject to separate Wester Ross – G McVicar/N Small engagement exercises with local communities over previous 18 months. Reviews being Agreed to ratify the approach taken to conducted under advice from Scottish Health communications and engagement. Council Service Change Advisors and in line with national Guidance. Consultation established broad consensus for significant organisational and service change and likely this will be designated as Major Service Change. This means proposals must be subject to formal public consultation and a final Ministerial decision. Robust formal Options appraisal exercise on short list of options to be undertaken and outcomes reported to NHS Board. Once agreed Options identified then Business Case processes will commence. What are the preferred Options? Circulated report outlined high level descriptions Noted the preferred Options for each area. of the short list of Options for each area which would be subject to detailed appraisal exercises. In North and West area the Community Resource Hub and Spoke approach was the preferred Option however additional consideration of aspects of potential radical redesign of services had been requested. In Badenoch and Strathspey, the Community Resource Hub approach was favoured and although this involved a series of access issues there would be no impact on existing GP/GDS services. They had been fully engaged to date. 6 5.1 TOPIC: HHSCC Financial Position as at 31 October 2013 – Nick Kenton, Director of Finance Issues Assurance Actions What is the financial position in Report indicated position to 31 October 2013, Action: year and where are current highlighting forecast overall breakeven position financial pressures? by 31 March 2014, subject to the improvement of £6.5m required to deliver the forecast. A break down of the current reported overspend forecast was given, including positive movement since last reporting. It was reported negotiation continued with Highland Council in relation to possible additional funding for Adult Social Care. Much work was required in the final quarter to achieve overall financial balance and a number of specific actions taken to date were outlined. It was emphasised that clinical and care needs of service users were paramount in decision making relating to expenditure. Can NHSH demonstrate any NK confirmed existing reporting arrangements
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