Item 2 MSISG 6/12/06 DRAFT NHS Greater Glasgow & Clyde Maternity Strategy Implementation Steering Group (MSISG ) Notes of a Meeting of the MSISG held on Wednesday 15 th November 2006 at 2.00 p.m. in Meeting Room B, Dalian House, NHS Greater Glasgow & Clyde, Glasgow Present: Helen Byrne, Director Acute Services Strategy, Implementation and Planning (Chair) Rosslyn Crocket, Director Women’s & Children’s Directorate (Co-Chair) Iain Wallace, Associate Medical Director, Women’s & Children’s Directorate Alan Mathers, Clinical Director, Obstetrics & Gynaecology Tom Turner, Chair – Neonatal Sub-Committee Jonathan Coutts, Clinical Director Neonatology Stein Bjornsson, Chair - Obstetric Sub-Committee Willie Frame, Consultant Anaesthetist, Area Anaesthetics Sub-Committee Stewart Pringle, Chair – Antenatal Sub-Group Lesley McIlrath, General Manager, Obstetrics, Gynaecology and Neonatology Ann Davidson, RCM Steward Fiona Wade, Head of Finance, Capital Finance Dorothy Cafferty, Planning /Women’s & Children’s Acute Services Jamie Redfern, General Manager, Hospital Paediatrics Sue Forsyth, Unison Representative Kate Munro, Community Engagement manager Ann Holmes, Consultant Midwife Mairi McLeod, Planning Manager New Children’s Hospital 1 Apologies Apologies were received from Brian Cowan, Douglas Colville, Ally McLaws, Tony Curran, Eleanor Stenhouse, Anne MacPherson and Noreen Sheilds. 2 Notes of MSISG Meeting held on 19/09/06 The notes were agreed. The notes will be posted on the organisation’s web page. Action: DC 3 Matters Arising 3.1 Gynaecology and Neonatal Bed Models: Lesley McIlrath advised that work is currently being undertaken with Joe Clancy of the Board’s planning function to identify the appropriate bed models for gynaecology and neonatal services. Using the CHKS data, Lesley has held discussions with clinicians to understand the benchmarking information and to define an appropriate in-patient model for Glasgow’s gynaecology service, which is currently assumed to be a 70 in-patient bed capacity. The CHKS bed model assumes that all day patients would transfer to the new ACAD facilities. However, medical terminations require to be treated within an in-patient facility and the beds required to deliver the service are included in the current service proposal for 70 beds. Work is also required to define the service and capacity requirements for delivering services from the new ACAD facilities and this will be progressed in tandem with the work for the acute services bed model. S:\COMMISSIONING\Acute Planning\Andrea LaRoche\Website updates\Website\MSISG notes 2006 2007\MSISG notes 1 15.11.06.doc 06/03/07 NHS Greater Glasgow & Clyde Lesley made a visit to Little France, Edinburgh, in order to compare the gynaecology service provided from the Edinburgh site and which will be used as a source of comparative information. Further detail of the activity is being sourced from CHKS to support the ongoing work for the in- patient model and a paper outlining the proposed bed model will be discussed at the next meeting of the steering group. An internal exercise has also been undertaken to establish the number of neonatal costs required. This has been supported by a “table-top” meeting which Lesley and Jonathan Coutts attended chaired by Patricia Leiser of the West of Scotland Regional Planning Group. A further meeting is planned with Heather Knox and the neonatal bed model will also be discussed at the December meeting of the WOS Regional Planning Group. It was noted that the national project planned to define cot numbers does not take place until the autumn of 2007. An update on progress will be made to the next steering group meeting. Action: LMcI/JC/DC/JC 3.2 Work Streams: Dorothy Cafferty referred to the draft steering group work plan indicating that the draft plan outlines key work streams for the steering group and its sub-groups and invited comments. The plan is divided into quarterly reporting timescales with each sub-group required to develop detailed action plans and associated risk plans to inform the plan. Rosslyn Crocket welcomed the plan and requested that specific target timescales be added to the document. Steering group members were asked to review and amend the draft plan and to notify Dorothy of amendments. Action: ALL/DC 3.3 Key Issues – Risk Log: Dorothy Cafferty advised that to date no key risks had emerged from the work of the sub-groups in order to populate a risk log. Dorothy added that this could be attributed to the fact that some sub-groups were still engaged in initial work to develop their work plans and while risks are discussed as part of the work of the groups these had not yet been fully articulated. It was agreed that the steering group required assurance that risk analysis is being undertaken and the risk analysis model will be reissued to sub-groups to facilitate risk management. Action: DC/Sub-Groups 3.4 Workforce Planning/Organisational Development: In order to take forward the workforce and organisational development component of the steering group’s work plan it was agreed that Ann Crumley should be invited to join the steering Group. Ann will be invited to attend the next meeting of the MSISG. Action:DC 4 Inequalities in Health: NHSGG&C Inequalities Scheme: Unfortunately Dr. Sheilds was unable to attend the meeting. However, it was agreed that the organisation’s inequalities agenda should be embedded into the work of the sub-groups and Dorothy will contact Dr. Sheilds to discuss how this can be taken forward as part of sub-group action plans. Sub-Groups will thereafter be required to incorporate progress as part of their regular progress reports. Action:DC/Sub-Groups 5 Performance Framework - Progress Reports a) High Risk Transfers: Alan Mathers advised that the planned closure of the ward at the QMH and the opening of the new ward at the PRM had been successfully achieved within target timescales. Also, that the service protocol and patient flows are working well, and that staff are settling into their new location. Helen Byrne congratulated all staff in their efforts and participation to secure the smooth transfer of services, and in particular delivering the transfer of service within the target deadline. S:\COMMISSIONING\Acute Planning\Andrea LaRoche\Website updates\Website\MSISG notes 2006 2007\MSISG notes 2 15.11.06.doc 06/03/07 NHS Greater Glasgow & Clyde b) Normality Steering Group: Midwife Led Managed Care: Ann Holmes reported that the group had met for the second time and that the Clyde component of the service is being incorporated into the work of the group. All key stakeholders have now been agreed and the pregnancy year pathway has been discussed and finalised. The group’s work plan covers an 18-month period. It will work to develop a hub and spoke model, outline the patient’s journey and continue to feed into the national agenda. The group will also align its work to other sub- groups, in particular sourcing HR/Communications and organisational development participation to take its work plan forward. Rosslyn Crocket indicated that it was important that the group ensure that expectations are not raised in taking forward its work. In particular the impacts for premises and accommodation, workforce and financial affordability would need to be fully addressed and understood. Rosslyn added that an option appraisal would require to be carried out, with recommendations to the steering group in order that a policy decision can be considered and made. The group’s work should also take account CHP/CHCP and GP services in tackling service issues on a locality basis. Ann agreed to highlight these issues and impacts at the group’s January meeting and to report to the February meeting of the steering group. Action: AH Helen Byrne advised that following discussions regarding Clyde’s health and service strategies that Clyde maternity services discussions would be linked to the work of the steering group. An item for Clyde maternity will be added to the December agenda. Action:DC Antenatal Services - Stewart Pringle reported that the antenatal sub-group continues to meet as a West Glasgow group and specifically to scope the provision of a West Glasgow Maternity Care Centre, including developing an accommodation schedule for a new facility. The clinically led group is currently working with the organisation’s estates department to identify suitable accommodation for the service with options currently being explored. The group is also developing the service model. A diagnostics group has also been set up to discuss requirements from radiology services. A number of public involvement sessions are planned in order to gauge the requirements of the local users of the service in relation to antenatal care provision. Action:SP c) Neonatal Sub-Group: Jonathan Coutts reported that the sub-group continues to meet regularly to scope service requirements and the number of neonatal cots required. A tabletop exercise took place on 25 October 2006 with representatives from some West of Scotland Health Boards in order that the regional planning dimension can be incorporated into the service model requirements, and further work is now being progressed to establish future requirements for neonatal services. Work is also progressing to determine the location of the new neonatal unit that will be built as part of the relocation of service on the closure of the QMH and Sick Children’s Hospital. This work will be dovetailed with planning for the New Children’s Hospital in the hope that an integrated service in the new build facility at the maternity unit at the SGH can be achieved. S:\COMMISSIONING\Acute Planning\Andrea LaRoche\Website updates\Website\MSISG notes 2006 2007\MSISG notes 3 15.11.06.doc 06/03/07 NHS Greater Glasgow & Clyde Service continuity and contingency plans for neonatal intensive care are also being addressed in order that sustainability of service is maintained during the interim period between commissioning of the new facilities at the SGH and closure of the existing facilities at the Yorkhill site.