<p> North Highland Community Health Partnership Caithness General Hospital Bankhead Road Wick KW1 5NS Telephone: 01955 605050 Fax: 01955 604606 www.nhshighland.scot.nhs.uk</p><p>MINUTE of MEETING of the CHP MANAGEMENT TEAM 12 June 2007 – 10.30 am Naver Business Centre, Thurso</p><p>Present Mrs Sheena Craig, General Manager (Chair) Dr Gavin Burnett, Clinical Lead - Caithness Mrs Lorraine Coe, Nurse Manager, Sutherland Mr Tony Cowan-Martin, Health & Safety Advisor Mrs Pauline Craw, Assistant General Manager-Caithness Mrs Georgia Haire, Assistant General Manager-Sutherland Dr Andreas Herfurt, Clinical Lead – North & West Sutherland Mr Mark Kerr, Personnel Advisor Mr Ross Mackenzie, North Highland CHP Accountant Mr Alan Miller, Scottish Ambulance Services Mrs Lynn Ross, Clinical Lead, East Sutherland Mr Bob Silverwood, Area Community Care Manager Mrs Linda Sinclair, Lead Nurse Dr Cameron Stark, Consultant in Public Health Mrs Christine Tait, Practice Managers’ Representative Ms Claire Wood, AHP Representative</p><p>In Attendance Ms Kay Oswald, CHP Support Manager</p><p>Mrs Sheena Craig welcomed everyone to the meeting. </p><p>1 APOLOGIES </p><p>Apologies had been received from Mrs Fiona Duff, Mr Paul Fisher, Dr Moray Fraser, Mrs Pam Garbe, Mrs Rachel Hill and Mr Bill Reid.</p><p>2 MINUTES OF MEETING HELD ON 8 MAY 2007 </p><p>The minutes of the meeting held on 8 May 2007 were agreed as a true record of business subject to clarification of page 7, AOCB, Agenda Item 10.2 – Cognitive Behavioural Therapy Service Pilot – it was agreed to roll out the service to all GP practices.</p><p>The Team:</p><p> Agreed the minutes of the meeting.</p><p>Working with you to make Highland the healthy place to be 3 MATTERS ARISING </p><p>Consultant Psychiatrist Vacancy</p><p>Sheena Craig confirmed that discussions had been held with Jackie Agnew, Service Manager at New Craigs. It was agreed that a paper should be put to the Management Team indicating the proposals from New Craigs regarding the intentions for the service in North CHP. Initial indications are that will recruit for 1 staff grade Psychiatrist and 2 0.5 WTE Consultants – 1 for adults service and 1 for older adults service. It was noted that the flow of information from Mental Health Services to GPs has been non-existent and there has been lack of information regarding the locum consultants and replacements. Sheena Craig agreed to reflect this back to New Craigs and agree a mechanism for the dissemination of information. Information on the skills and abilities of individuals is requested.</p><p>The Team:</p><p> Agreed that communication format for future regarding Mental Health services to be agreed with New Craigs.</p><p>Scottish Ambulance Services – Patient Transport</p><p>Confirmed that patients are now booking own transport and leaflets are being distributed with appointments informing patients of procedure. Sheena Craig advised that electronic on-line booking system has been restored. It was agreed that all practices and community hospitals should be informed of this and asked whether web based training was required as SAS are willing to roll out this training to more practices.</p><p>The Team:</p><p> Agreed that GP practices and Community Hospitals should be notified that on-line booking system has been restored and the web based training is available from SAS.</p><p>Blood Transfusion Services update</p><p>Sheena Craig confirmed that BTS at Caithness General hospital have been reinstated following the reinspection by the MHRA on 12 April 2007 and the subsequent meeting of the Inspectors Action Group on 1 May 2007. It was noted that a follow up inspection will take place later in the year. </p><p>Sheena Craig advised that as an application for Clinical Pathology accreditation will be made later in the year an action plan will be developed prior to application and refurbishment and upgrading work carried out prior to this. It was agreed to keep Laboratory Services as an future agenda item. </p><p>The Team:</p><p> Noted the reinstatement of the Blood Transfusion Services.  Agreed to keep Laboratory Services as an agenda item.</p><p>2 CT Scanner update</p><p>Sheena Craig advised that date for evaluation of tenders has been delayed as site visits have not been completed by all the participating parties.</p><p>Sheena Craig advised that slippage will occur in several schemes across NHS Highland as a result of the review of NHS Highland Capital Plan. The effect on the CT Scanner project is that the building work, staff recruitment and training will take place in this financial year but the procurement of the scanner will take place in next year’s Financial Plan. </p><p>The Team:</p><p> Noted the current position re the CT Scanner.</p><p>Proposed Management and Leadership Structure for Nursing in Caithness</p><p>Linda Sinclair confirmed that agreed costings for the proposal have still to be finalised.</p><p>The Team:</p><p> Noted the current position.</p><p>Collaborative Contracting Update</p><p>It was advised that there are a number of subgroups looking at activity and tariffs and the resulting costs and income which could be generated. A decision on whether to go with National tariffs or a proposed NHS Highland tariff has yet to be made. The DHS Management Team has been asked to work up proposal as to how it will look and what it means. There is ongoing debate as to whether CHPs can go alone or whether has to be standard across the NHS Highland. This would mean budgets being devolved and service level agreements set up for agreed levels of activity for different services. The positive outcome from this would be that any savings made would be kept within the CHP.</p><p>The Team:</p><p> Noted the current position re Collaborative Contracting.</p><p>4 NHS HIGHLAND LOCAL DELIVERY PLAN 2007/08 and DRAFT CHP DELIVERING FOR HEALTH ACTION PLAN</p><p>Copies of the NHS Highland Local Delivery Plan 2007/08 and the Draft CHP Delivering for Health Action Plan had been distributed for information. Sheena Craig advised that the documents would be discussed at the forthcoming CHP Development Day and needed the Management Team to sign up to the CHP Action plan. It was noted that Learning Disabilities and Delayed Discharges does not feature in the draft plan and it was agreed that these would be added. </p><p>The Team:</p><p> Agreed to include Learning Disabilities and Delayed Discharges in the CHP Action Plan.</p><p>3 5 PERFORMANCE AGAINST HEAT TARGETS</p><p>Sheena Craig advised that a Performance Management Review Group had been set up. The group will look at a few HEAT targets per meeting, looking at the performances of each area against the targets and against each other and looking for accountability to address any shortfalls. At the first meeting of the group the targets looked at were:- Absence; Cancer; Childhood Vaccinations; Dental; Outpatients/Availability Status Codes and Smoking Cessation.</p><p>Absence – Sheena Craig confirmed that the CHP is not meeting the local target. The CHP is charged with producing a detailed Action Plan to address this. There was general discussion over the statistics available to the CHP and the reasons for absence. It was suggested that Occupational Health Services would be more effective if the quality of information provided to them was improved and there was better communication. Mark Kerr was identified to take the lead on the production of the action plan and it was agreed that Georgia Haire and Tony Cowan-Martin would assist with this.</p><p>Cancer- It was confirmed that the North CHP is achieving the 62 day pathway deadline set for the patients we manage with breast cancer and colorectal cancer. Performance for urology cancers however is disappointing.</p><p>Childhood Vaccinations – Uptake of MMR vaccinations at 5 years old should be 95% and North CHP is slightly below this target. Agreed that need action plan to target GP practices who are not achieving 95% target.</p><p>Dental – Based on the evidence from the National Dental Improvement Plan surveys it is expected that the target of “60% of 5 year old children will have no signs of dental disease by 2010” will be achieved across NHS Highland.</p><p>Outpatient/Availaiblity Status Codes – North CHP is on target for 6 month waiting times and on way to meeting 18 week target set for 31 December 2007.</p><p>Smoking Cessation – There are issues as to how to measure this target and Lorraine Coe has agreed to lead on this on behalf of the CHP.</p><p>The Team:</p><p> Agreed that action plans were required for Absence and Smoking Cessation to ensure targets will be achieved.</p><p>6 PROPOSAL FOR INTEGRATED MIDWIFERY SERVICE </p><p>It was agreed to defer this agenda item.</p><p>7 PHYSIOTHERAPY SERVICES – FUTURE VISION FOR THE CHP</p><p>A paper outlining the current physiotherapy service provision and recommendations to carry out an initial scoping exercise to ascertain the capacity for services to be redesigned had been distributed for information. The paper highlighted the increasing demand for outpatient services and examined the rehabilitation services for neurological conditions and shifting the balance of care from acute services to community based care. Temporary funded services such as women’s health services were also highlighted. The paper suggested adopting a triage model within an outpatient physiotherapy service to meet the increasing demand. If this is done from existing resources it may mean an increase in waiting times, currently 6 -8 weeks, whilst training takes</p><p>4 place. The Management team agreed to this in principle but also suggested that an application for waiting times monies be explored.</p><p>During discussion the position of paediatrics within the service was raised. It was agreed that Children’s Services as a whole should be looked at and the links with the CHP. Sheena Craig agreed to invite Andrew Ward, General Manager of Women & Child Health Services and Dawn Grant, Social Work to a future strategic meeting of the Management Team.</p><p>The Team:</p><p> Agreed in principle to adopting a triage model for outpatient physiotherapy services and asked that an application for waiting times monies be explored.  Agreed that Children’s Services and links should be a future agenda item for a Management Team strategic meeting.</p><p>8 CLINICAL GOVERNANCE AND RISK MANAGEMENT UPDATE</p><p>A report by Rachel Hill had been distributed for information.</p><p>The Team:</p><p> Noted the content of the report.</p><p>9 NORTH CHP MENTAL HEALTH SERVICES DEVELOPMENT DAY</p><p>Cameron Stark fed back on the Development Day and thanked Georgia Haire and Kay Oswald for their assistance in organising the day. The tone of the day was generally positive with everyone being clear on the challenges arising from the Mental Health Delivery Plan. Existing problems within the service were highlighted with particular issues around Integrated Care Pathways and Crisis Standards. It was acknowledged that changes in services are required as current structure cannot support challenges of delivering on the plan. A further meeting is being planned for August/September with actions agreed for this date.</p><p>The Team:</p><p> Noted the information provided.</p><p>10 AOCB</p><p>10.1 Re-provision of Migdale Hospital</p><p>Sheena Craig advised that NHS Highland had met to agree the detail of the capital plan for the next year and the outline of subsequent years. The board were required to reconsider the phasing of a number of key projects to ensure that the capital costs associated with the wide range of projects were affordable and beneath the agreed ceiling of annual expenditure defined by the SEHD. The Migdale project was one of the projects affected by this. Copies of briefing papers were distributed. Some changes to the wording of the documents were suggested and this will be fed back to the Chairman. It was stressed that the commitment to the project remains. It was agreed that a list of all schemes which have been affected should be made available to staff.</p><p>5 The Team:</p><p> Noted the updated position regarding the Migdale project.  Agreed to obtain list of all affected schemes.</p><p>10.2 Long Term Conditions Management – CHP Self Assessment Tool</p><p>A copy of the Long Term Conditions Management, CHP Self Assessment Tool had been distributed for information. A CHP Long Term Conditions Action Group has been set up and a meeting has been arranged for 22 June.</p><p>The Team:</p><p> Noted the information provided.</p><p>10.3 CHP Boundaries</p><p>It was queried whether there had been any progress re the misalignment of the CHP geographical boundaries with the Highland Council management areas. It was confirmed that no further information was available.</p><p>11 DATE OF MEXT MEETING</p><p>The next meeting will be a strategic planning meeting looking at the CHP Property Strategy and will be held on Tuesday 10 July 2007 at 10.30 am in the Seminar Room at Caithness General Hospital. The next routine Management Team meeting will be held on Tuesday 11 August 2007 at 10.30 am in the Seminar Room at Caithness General Hospital. </p><p>6</p>