GHA BOARD MEETING AGENDA Venue: University of Gibraltar, Seminar Room 05 Wednesday 26th July 2017 at 2pm 1. Apologies for absence 2. Minutes of the meeting held on Friday 2nd June 2017 3. Matters arising 4. Statement by Minister 5. Matters for report 5.1 Report: Executive Summary - Medical Director 5.2 Report: Director of Public Health 5.3 Report: Medical Director 5.4 Report: Head of Estates and Clinical Engineering 5.5 Report: Director of Nursing 5.6 Report: Director of Human Resources 5.7 Report: SBH – Operations Manager 5.8 Report: Primary Care Services – Deputy Medical Director 5.9 Report: Mental Health – General Manager 5.10 Report: Director of Information Management and Technology 5.11 Report: School of Health Studies 6. Date and time of next meeting 7. In Camera session GHA Board Report 2nd Quarter 2017 (April to June 2017) Page 1 GHA Board Report 2nd Quarter 2017 (April to June 2017) Page 2 Minutes of the meeting held on Friday 2nd June 2017 GIBRALTAR HEALTH AUTHORITY Minutes of Meeting held on Friday 2nd June 2017 at 2.30 pm in the Charles Hunt Room, John Mackintosh Hall. Present: The Hon. N F. Costa (MH) - Chairman Dr F Morillo (FM) - Medical Member Mr J Zammit (JZ) - Medical Member Mr E Gomez (EG) - Chief Secretary Mrs P Galliano (PG) - Non-Executive Member Mr E Lima (EL) - Non-Executive Member Apologies: Mr C Lavarello (CL) - Non-Executive Member Mr A Mena (AM) - Financial Secretary Mr L Gonzalez (LG) - GTC Member In Attendance: Mrs Jessica Montado - Director of Finance & Procurement (Ag) Mr A Wink - General Manager Primary Care Centre Mr H Watson - Director IM&T Mr Christian Sanchez - Director of Human Resources Mr C Chipolina - General Manager Mental Health Dr Krish Rawal – Deputy Medical Director Mrs Evelyn Cervan – Principal Secretary Dr Danny Cassaglia – Medical Director Mr Darion Figueredo - SBH – Operations Manager Mr Tony Dolding - Head of Estates and Clinical Engineering Secretary: Miss N Alvarez (NA) and Mr David Santos (DS) 1. Apologies for absence: Mr C Lavarello (CL) - Non-Executive Member Mr A Mena (AM) - Financial Secretary Mr L Gonzalez (LG) - GTC Member Welcome from Chairman: The GHA Chairman opened meeting. GHA Board Report 2nd Quarter 2017 (April to June 2017) Page 3 2. Minutes: Minutes of meeting held Wednesday 21 September 2016 approved as a true record. 3. Matters arising: No matters arising. 4. Statement by the Minister: Welcomed new board members to the team – Mr Fabian Morillo and Mr Jonathan Zammitt. Apologies given for the absence of meetings since September 16 so the reports cover July 16 to March 17. Apologies also given to Board members for the late submissions of the GHA board papers. The next meeting will take place on Wednesday 26th July 2017 at the University of Gibraltar. 5. Matters for Report: Chief Executive’s Report: (As per published in Board Report) The Medical Director went through the July 2016 to September 2016 executive summary report that had been devised by the previous CEO. Emails sent to Minister Costa with respect to new services mentioned how staff were doing an excellent job on this. With respect to the Early Pregnancy Unit, there is a UK trainer who will be delivering training for this. Bed Management – weekly bed management meetings are taking place and there has been a great improvement throughout. There is a need to use resources as effectively and efficiently as possible and meet the clinical demands to reduce waiting lists. Day Surgery is seeing huge success rates with 90% of all surgeries completed via Day Surgery with a very high satisfaction rate. Early Warning Signs (EWS) – this has been implemented resulting in the improvement of patient safety. Increasing repertoire of detecting problems in pregnancy. WIFI system – up and running. GHA Board Report 2nd Quarter 2017 (April to June 2017) Page 4 The Medical Director went through the October 16 to March 17 executive summary report. There has been significant improvements with respect to Primary Care, including a repeat prescription service and a telephone service for sick notes. The Patient Advocacy and Liaison Service (PALS) was launched on 30th November 2016, which provides advice, support and information to patients, service users and the public. Chemotherapy Unit – became fully operational during October 2016 providing local, in-house treatment and support for cancer patients. Elderly Residential Services – three part time doctors were appointed to work in the elderly residential service to provide personalised care to all residents of Mount Alvernia, John Macintosh Wing, Hillside Dementia Residential centre and Bella Vista Day Centre. All Directors’ Reports were taken as accepted. Question Time: None this meeting Meeting ended with agreement to reconvene on Wednesday 26 July 2017 at 2pm. With no further business, the meeting closed. GHA Board Report 2nd Quarter 2017 (April to June 2017) Page 5 5.1 Executive Summary - Medical Director April to June 2017 Mr Chairman, Board members, this report refers to the 2nd quarter of 2017 (April to June) and the 1st quarter for financial year 2017/2018. The following is a summary of the Director’s reports, which are enclosed in the main body of this document. 1) GHA Management A Bill was published on 18th May 2017 to amend the Medical (Gibraltar Health Authority) Act 1987 in line with the Government policy to abolish the post of Chief Executive of the GHA. This change will lead to significant restructuring of the GHA management team. The Bill will be read and debated in parliament on 12th July 2017. 2) Primary Care Centre The improvements in Primary care continue with consolidation of the repeat prescription and sick note telephone line service. This initiative is releasing on average 443+215= 658 extra GP appointments per month. The scanning of all paper notes in primary care is continuing with over 2000 notes now in digital format and accessible to the GPs on the Electronic record system. 3) New GHA Website The new look GHA website was launched on 13th June 2017. Redesigned and developed in-house, it provides information on all aspects of healthcare available at the GHA. It was developed using the latest website technology available. This includes a news feed on GHA related matters, availability of useful information (e.g. contact information, guides, information leaflets). A new careers section will publish GHA job vacancies and will allow applicants to interact with the HR department on- line. 4) Medical Regulation From 1st April 2017, all doctors in Gibraltar are required to have up to date registration with the General Medical Council UK (GMC) with a licence to practise. GMC registered doctors are required to revalidate every 5 years, this requires proof that the doctors are up to date and fit to practise. GHA Board Report 2nd Quarter 2017 (April to June 2017) Page 6 5) Sponsored Patients All sponsored patient referrals now need to be processed through a new IT system when the decision is made to refer a patient out of the GHA. As from 4th May 2017, all new referrals are reviewed by the Tertiary Referrals Board (composed of a group of senior medical & nursing clinicians) before the referral is allowed to proceed. This process ensures that patients are referred appropriately and to the best possible partner hospital/centre. 6) Bed Management This quarter marked the consolidation of the active bed management process and weekly bed management meetings. Bed occupancy decreased significantly with the transfer of over 40 elderly, long-stay patients to the Hillside Dementia residential unit. Ward bed numbers have returned to normal levels and the temporary 7-bedded unit will be converted back to a Gym. There have been no operations cancelled due to lack of beds this quarter and the numbers of patients admitted for major surgery have approximately doubled compared to the same period last year indicating greater patient throughput and more efficient use of theatres. 7) School of Health Studies An awards ceremony was held in May for a wide range of staff across the GHA. They received a range of vocational awards. The GHA is committed to on-going education and training for all its staff. I would like to personally congratulate all those members of staff who received an award and also encourage all staff actively engaged in education and training to continue with their personal and professional development. 8) Repatriation of Services Work continues to expand our locally available clinical services to enable as many patients as possible to receive the care they require close to home and avoid the need to travel abroad. This is particularly important in the light of Brexit and the need to modernise our clinical services in order to become as self-sufficient as possible in the coming years. Respectfully Submitted - Dr D Cassaglia, Medical Director, July 2017 GHA Board Report 2nd Quarter 2017 (April to June 2017) Page 7 5.2 Director of Public Health April to June 2017 Screening Programmes Colorectal Cancer During the period spanning the months of April to June, a total of 806 invitations were mailed to eligible participants inviting them to take part in the Colorectal Cancer Screening Programme. In addition, 5 persons over the screening age limit (75+ years) requested to participate in the programme as a result of the bowel health awareness campaign. During this same period, 866 test-kits were prepared and mailed to the participants and 393 samples were returned to the hospital laboratory for analysis. The breakdown of the results is as follows: 309 Negative for occult blood 59 Inconclusive for occult blood 25 Positive for occult blood Of those who underwent endoscopy, 11 Adenomas were found in this period.