Highland Health & Social Care Governance
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1 HIGHLAND HEALTH & SOCIAL CARE GOVERNANCE COMMITTEE Report by Directors of Operations The Board is asked to: Note that the Highland Health & Social Care Governance Committee met on Thursday 1 March 2018 with attendance as noted below. Note the Assurance Report and agreed actions resulting from the review of the specific topics detailed below. Present: Melanie Newdick, Board Non-Executive Director – In the Chair James Brander, Board Non-Executive Director Ann Clark, Board Non-Executive Director (Videoconference) Georgia Haire, Area Manager (Mid Division)(Videoconference) Alison Hudson, Area Clinical Forum Representative (Videoconference) Tracy Ligema, Deputy Director of Operations, North and West Joanna Macdonald, Director of Adult Social Care Cllr Ronald MacDonald, The Highland Council (Teleconference) Deirdre MacKay, Board Non-Exec Director (Teleconference) Margaret MacRae, Staffside Representative David Park, Chief Officer, The Highland Partnership Ann Pascoe, Board Non-Executive Director Kenny Rodgers, Interim Head of Financial Planning. Michael Simpson, Public/Patient Representative Cllr Nicola Sinclair, The Highland Council (Videoconference) Cllr Kate Stephen, The Highland Council In Attendance: Gaye Boyd, Deputy Director of Human Resources (Videoconference) George McCaig, Head of Business Support Brian Mitchell, Board Committee Administrator Donna Smith, Head of Planning and Performance (Videoconference) Simon Steer, Head of Strategic Commissioning Apologies: Adam Palmer, Board Non-Executive Director Shirley Christie, Staffside Representative Norman Houston, Carer Representative Donna Mitchell, Public/Patient Representative Dr Chris Williams, Area Medical Committee Representative Mhairi Wylie, Public/Patient Member Representative – Voluntary Sector 2 AGENDA ITEMS Appointment of Committee Vice Chair Carers Act and Self-Directed Support Policy for the Management of Return Outpatients in NHS Highland Arrangements for Adult Social Care Fee Setting Assurance Report from 11 January 2018 Sub Committee Reports Performance Information Operational Units Report Monitoring the Delivery of Adult Social Care Contracted Services Care Inspectorate Summary Report Director of Adult Social Care Report Financial Position as at 31 January 2018 Children’s Services DATE OF NEXT MEETING The next meeting will be held on Thursday 3 May at Caithness General Hospital. 3 1 WELCOME AND DECLARATIONS OF INTEREST At the commencement of the meeting the following Declarations of Interest were received: Melanie Newdick – Family members in receipt of care. Ann Pascoe – Chair of Dementia Friendly Communities (Helmsdale) Nicola Sinclair – Founder member of Caithness Health Action Team (CHAT) Kate Stephen - Employed by University of Highlands and Islands The Committee so Noted. 2 STRATEGY AND HORIZON SCANNING 2.1 Policy for the Management of Return Outpatients in NHS Highland D Smith spoke to the circulated draft Policy document, representing an Addendum to the NHSH Local Patient Access Policy, and which sought to modernise Outpatient activity in Highland. She advised the document outlined a variable and flexible approach, and stated not all elements would apply to all specialties. The NHS Board would be asked to ratify the final Policy document at their meeting to be held in May 2018. She added a number of NHS Boards in North Scotland were also considering adoption of this document. During discussion, concern was expressed regarding Policy elements relating to “patients not incurring unnecessary inconvenience” and patients who “Did Not Attend”, in particular how these could potentially impact individuals with Mental Health conditions. Noting that there were mitigating processes in place in relation to these matters, D Smith agreed to reflect further on the points made in discussion. Whilst reminding members that the Policy would apply to existing patients, it was confirmed that patients could opt to wait for more local appointments, as per the Local Patient Access Policy, where clinically appropriate. Discussion moved on to the current consultation process in relation to new Policies and it was noted the closing date for comments would be end March 2018. D Park directed that the draft document also be considered by all Operational Unit Senior Management Teams. The Committee otherwise Noted the draft Policy document. D Smith left the meeting at 12.50pm 2.2 Appointment of Committee Vice-Chair M Newdick advised the Committee had, to date, been operating without a Vice-Chair and asked that members consider the appointment of the same. After discussion, K Stephen Proposed the Motion that A Pascoe be appointed Committee Vice-Chair, this being Seconded by J Brander. There being no counter proposals, the Motion was carried. The Committee Approved the appointment of A Pascoe as Vice-Chair. 2.3 Carers Act and Self-Directed Support J Macdonald advised key aspects related to the role of NHS Highland staff in completing assessments and appraising individuals as to the 4 Support Options available. The level of funding available, and what this could be applied to, remained the subject of discussion. 4 There continued to be national discussion on a number of these aspects at which NHSH was appropriately represented. She advised that the relevant funding had not been specifically allocated to the Carers Act itself. D Park added that Carers may have a raised expectation as to the level of funding that may be allocated and as such it would be essential to ensure appropriate guidelines as to equity and reasonableness of allocations; and with a view to protecting overall affordability for the NHS Board. It was noted that relevant legislation would come in to effect from 1 April 2018. A Pascoe stated the underlying aim of the Act was to ensure the voice of Carers was heard and was advised a Carers Improvement Group had been established. A small group of senior managers from both NHSH and THC, led by J Macdonald, had met Carers Groups to provisionally discuss relevant points and this activity would continue. K Stephen referenced aspects relating to Care Plan production, and the role of “Connecting Carers”, adding there would clearly be a need for consideration to be given as to eventual allocation levels. The Committee: Noted the position outlined. Agreed there be further discussion at the July 2018 meeting. 2.4 Arrangements for Adult Social Care Fee Setting D Park introduced the circulated report, outlining the way in which Fees for Adult Social Care were considered and planned for, and how the contracts/business support team were provided with direction to undertake negotiations and transactions with Care Providers. The Adult Social Care Fees – Commissioning, Briefing and Instruction Group had been established in 2017 to ensure consistency of approach across the North Highland Partnership area. The report outlined a proposed Role, Remit and Reporting schedule for the Instruction Group, with the aim that this would consider all Adult Social Care Fee related issues and prepare fee and contract recommendations for consideration by the Finance and Performance Sub Committee of this Committee. There followed discussion, during which issues relating to process transparency were raised. Mr Park advised the proposal sought to formalise the process that already took place out with the Committee framework, and provide appropriate governance oversight. After discussion, the Committee: Agreed to Approve the proposed reporting route via the Finance and Performance Sub Committee. Noted the Finance and Performance Sub Committee meeting schedule would shortly be issued to relevant members. 3 PERFORMANCE AND DELIVERY 3.1 Assurance Report from Meeting held on 9 November 2017 There had been circulated draft Assurance Report from the meeting of the Committee held on 11 January 2018. The Committee Approved the circulated draft Assurance Report. 5 3.2 Matters Arising 3.2.1 Timeframe for Review of Payment Levels for Home Carers J Macdonald advised the Adult Social Care Commissioning Group had picked up this issue and were considering matters relating to both fee payment levels and associated impact. She advised Stephen Pennington, Managing Director of Highland Home Carers would be leading the relevant Working Group. 3.2.2 Update on Care at Home Planning Outcome Based Approach J Macdonald advised NHS Highland continued to work with Care at Home service providers to ensure daily discussion was held in relation to individual care level requirements, thereby enabling flex of the same and the provision of less or more support as identified. G Haire indicated activity to date had resulted in increased care packages and further work was required to ensure packages both decreased and increased according to identified need. J Macdonald emphasised the importance of engaging and building relationships with care providers to ensure success in this area. 3.2.3 Verification of Outpatient Waiting Times Data G McCaig confirmed the relevant dataset was complete and would be reported under Item 3.4 on the agenda. 3.2.4 Clarification of CNORIS Payback Criteria K Rodgers advised the criteria applied in relation to payback from the national CNORIS Fund was the same as that applied in relation to initial annual contributions, this being proportionate to the relative risk assessed for each member organisation. The Committee otherwise Noted the updates provided on the matters raised. 3.3 Sub Committee Reports The Chair advised there were no updates for the meeting, with Sub Committees having yet