NHS Orkney Board 22 October 2020 Purpose of Meeting NHS Orkney Board’s purpose is simple, as a Board we aim to optimise health, care and cost Our vision is to 'Be the best remote and rural care provider in the UK' Our Corporate Aims are: Improve the delivery of safe, effective patient centred care and our services; Optimise the health gain for the population through the best use of resources; Pioneer innovative ways of working to meet local health needs and reduce inequalities; Create an environment of service excellence and continuous improvement; and Be trusted at every level of engagement. Quorum: Five members of whom two are Non- Executive Members (one must be chair or vice-chair) and one Executive Member Page 1 of 222 Orkney NHS Board There will be a virtual meeting of Orkney NHS Board on Thursday 22 October 2020 at 10:00 a.m. Meghan McEwen Chair Agenda Near me presentation – Kenny Low, Value and Sustainability Lead Item Topic Lead Paper Purpose Person Number 1 Apologies Chair To note apologies 2 Declaration of Chair To update the Board on interests new general or specific declarations of interest 3 Minutes of Chair To check for accuracy, previous meetings approve and signature by held on 27 August Chair 2020 4 Matters arising Chair To seek assurance that actions from the previous meeting have been progressed 5 Board action log Chief Executive To monitor progress against the actions due by the meeting date and to agree corrective action where required 6 Governance 6.1 Schedule of Chair OHB1920- To approve the schedule of meeting dates 55 dates 2021/22 7 Strategy 7.1 Orkney Winter Plan Chief Quality OHB2021- To approve the Winter 2020/21 Approval Officer 56 Plan Method Options 1 Page 2 of 222 Item Topic Lead Paper Purpose Person Number Report 7.2 Review of Interim Chief OHB2021- To approve Integration Scheme Officer 57 8 Clinical Quality and Safety 8.1 Infection Prevention Director of OHB2021- To review and seek and Control Report Nursing, 58 assurance on performance Midwifery, AHP and Acute Services 8.2 Integration Joint Interim Chief OHB2021- To note the report Board – Annual Officer 59 Performance Report 8.3 Care Homes – Director of Public OHB2021- To seek assurance on Covid-19 Testing Health 60 current testing within care homes 8.4 Joint Inspection of Interim Chief OHB2021- To note the report and Children and Young Officer 61 seek assurance on People Update progress Report 8.5 Area Clinical Forum Area Clinical OHB2021- To seek assurance from Chairs report and Forum Chair 62 the report and adopt the minute from approved minutes meeting held on 7 August 2020 9 Workforce 9.1 Staff Governance Staff OHB2021- To seek assurance from Committee Chairs Governance 63 the report and adopt the report and minute Committee Chair approved minutes from meeting held 25 May and 9 July 2020 10 Organisational Performance 10.1 Financial Director of OHB2021- To review the in year 2 Page 3 of 222 Item Topic Lead Paper Purpose Person Number Management Finance 64 financial position and note Performance the year to date position Report 10.2 Performance Chief Quality OHB2021- To scrutinise the report Management Officer 65 and seek assurance on Report performance 10.3 Chair’s Report – Finance and OHB2021- To seek assurance from Finance and Performance 66 the report and adopt the Performance Committee Chair approved minutes Committee and minute of meeting held on 23 July 2020 11 Risk and Assurance 11.1 Corporate Risk Interim Chief OHB2021- To approve the Register reporting Executive 67 recommendations for to Board future reporting 11.2 Chair’s Report – Audit and Risk OHB2021- To seek assurance from Audit and Risk Committee Chair 68 the report and adopt the Committee and approved minutes minute of meeting held on 25 June and 7 July 2020 12 Any other competent business 13 Items for Information 13.1 Key Legislation Chair OHB2021- To receive a list of key 69 legislation issued since last Board meeting and local implementation / action 13.2 Orkney Partnership To note the minute Board minute 10 June 2020 3 Page 4 of 222 Item Topic Lead Paper Purpose Person Number 13.3 Board Reporting To note the timetable for Timetable 2021/21 2020/21 13.4 Record of To note attendance record Attendance 13.5 Evaluation Reflection on meeting – led by Chair By Standing Invitation: Christina Bichan, Chief Quality Officer Julie Colquhoun, Head of Corporate Services Malcolm Colquhoun, Head of Support Services, Logistics and Contracts Management Gillian Morrison, Interim Chief Officer 4 Page 5 of 222 2 Declaring interests flowchart – Questions to ask yourself What matters are being discussed at the meeting? NO You can Do any relate to my participate in interests? the meeting Yes and vote Is a particular matter close to me? Does it affect: Me NO My partner My relatives My friends NO My job or my employer Companies where I am a director of where I have a shareholding of more than £25,000 (face value) or 1/100th Personal Interest Personal of the capital My partnerships My entries in the register of interests More than other people in the area? YES You may Declare have a your personal interest in interest the matter NO Would a member of the public – if he or You may she knew all the facts – reasonably think have a that the personal interest was so prejudicial important that my decision on the matter interest YES would be affected by it Prejudicial Interest Prejudicial YES Withdraw from the meeting by leaving the room. Do not try to improperly influence the decision Page 6 of 222 3 Orkney NHS Board Minute of meeting of Orkney NHS Board held Virtually on Thursday 27 August 2020 at 10:00 am Present Meghan McEwen, Chair David Drever, Vice Chair Davie Campbell, Non Executive Board Member Michael Dickson, Interim Chief Executive Mark Doyle, Director of Finance Caroline Evans, Non Executive Board Member Issy Grieve, Non Executive Board Member Steven Johnston, Non Executive Board Member Fiona MacKellar, Employee Director David McArthur, Director of Nursing, Midwifery, AHP and Acute Services Marthinus Roos, Medical Director James Stockan, Non Executive Board Member Jason Taylor, Non Executive Board Member Louise Wilson, Director of Public Health In Attendance Christina Bichan, Chief Quality Officer Emma West, Corporate Services Manager (minute taker) 576 Apologies Apologies were noted from Julie Colquhoun. 577 Declarations of interests No declarations of interest on agenda items or in general were made. 578 Minute of previous meeting held on 16 July 2020 The minute of the meeting held on 16 July 2020 was accepted as an accurate record of the meeting, subject to a minor typographical error and was approved. 579 Matters Arising Improvement work The Interim Chief Executive advised that serious steps were being taken to approach the concerns raised in R Dijkhuizen’s letter and previously in the Gibbins report. He had engaged with the Digital Health and Care Institute who would act as an independent body to listen to staff and understand rationale. A number of enabled workshops had been proposed to facilitate this, with the outcomes then being used to build an action and improvement plan, this work was scheduled to be concluded by the end of 2020. Following this there would be a need for fundamental cultural change within the organisation and a need to ensure that this was embedded before moving forward. It was noted that there was often the desire to move quickly for rapid change but this rarely worked as there was a need to fully understand problems and build on structures to support change. Members were advised that the design draft would be shared with the Board and Staff Side representatives. 1 Page 7 of 222 3 S Johnston noted the importance of acknowledging that the rate of change may not be what some staff desired and effective communication with staff was vital so that their views were not lost or forgotten. Staff Wellbeing - Covid trees S Johnston welcomed a progress update and noted the need to listen to those staff outside the Balfour and those working from home, he asked for this to be addressed through Area Partnership Forum and Staff Governance Committee. The Employee Director agreed that the Area Partnership Forum would be a facilitator forum for this work. 580 Board Action Log The action log was reviewed and corrective action agreed on outstanding issues (see action log for details). Governance 581 Corporate Governance arrangements – OHB2021-45 The Chair presented the report seeking Board approval to return to standard corporate governance following a period of temporary arrangements while the organisation was dealing with the COVID-19 pandemic, this included the re-establishing of Board Development Sessions. The Interim Chief Executive noted that the Board meeting on a monthly basis was too tight a timescale to demonstrate meaningful discussion and learning should be taken from this moving forward. Until the Board had a clear picture from the Scottish Governance around active governance and what changes his would entail he recommended that the Board should remain within normal timetabling. Members welcomed the return to development sessions to allow training and support to take place along with honest and robust conversations. D Drever agreed that training was an important ongoing issue for all Board Members, there was also the need for Board Members to have the time to challenge behaviour and consider in detail the work around staff health and wellbeing. He noted that there had been very limited opportunity for informal discussion in recent months and sharing thoughts and ideas in this forum would be welcomed.