Highland NHS Board October 2014 HIGHLAND HEALTH & SOCIAL ... · October 2014 Item 3.2 HIGHLAND...

Highland NHS BoardOctober 2014

Item 3.2

HIGHLAND HEALTH & SOCIAL CARE GOVERNANCE COMMITTEEReport by Deborah Jones, Chief Operating Officer

The Board is asked to:

Note that the Highland Health & Social Care Governance Committee met on Thursday 11September 2014 with attendance as noted below.

Note the Assurance Report and agreed actions resulting from the review of the specifictopics detailed below.

Present:

Myra Duncan, Board Non Executive Director – ChairDr Helen Bryers, Head of MidwiferyMr Quentin Cox, Area Medical Committee Representative – ConsultantAlasdair Christie, Elected Member, Highland CouncilDr Paul Davidson, Chair, Professional Executive CommitteeDavid Garden, Head of Financial PlanningBren Gormley, Elected Member, Highland CouncilLinda Kirkland, Interim Director of Operations, Raigmore HospitalJoanna Macdonald, Director of Adult Social CareMargaret MacRae, Staffside RepresentativeGill McVicar, Director of Operations – North & Mid (Videoconference)Kate Patience-Quate, Lead Nurse RepresentativeNigel Small, Director of Operations – South & MidKate Stephen, Elected Member, Highland CouncilKatherine Sutton, Associate Director, AHPs (from 10.10am)Dr Chris Williams, Area Medical CommitteeMhairi Wylie, Public/Patient Member Representative – Voluntary Sector

In Attendance:

Sally Amor, Child Health Commissioner/Public Health Specialist (from 9.45am)Gillian Grant, Team Leader (Contracts)Sheena MacLeod, Head of Health, Highland Council (Videoconference from 9.45am)George McCaig, Head of Care SupportBrian Mitchell, Board Committee AdministratorKenny Oliver, Board SecretaryAdam Palmer, Employee Director/Staff Side RepresentativeSimon Steer, Head of Community Care IntegrationMaimie Thompson, Head of Public Relations & Engagement

Apologies:

Shirley Christie, Staffside RepresentativeGavin Hogg, Patient/Public RepresentativeDeborah Jones, Chief Operating OfficerFiona MacFarlane, Pharmacist RepresentativeAilsa MacInnes, Optometrist RepresentativeGillian McCreath, Board Non ExecutiveJanet Spence, Chair, Adult Social Care Practice ForumBob Summers, Head of Health & SafetyPhilip Walker, Head of Personnel

lpowe01

Text Box

7

2

AGENDA ITEMS

Chair’s Feedback from Meetings of the NHS Board Since Last Meeting

Redesign of Services in both Badenoch & Strathspey Public Consultation: update onthe Consultation Process

Complaints Review Committee – Resolution of Staff Issues

Committee Self Assessment Review

Membership of Highland Health and Social Care Committee and Finance andPerformance Sub Committee

Financial Position as at 31 July 2014

Adult Services Balanced Scorecard

2014/15 HHSCC HEAT Targets Balanced Scorecard

Childrens Services Assurance and Performance Reports

Verbal Update from Professional Executive Committee (PEC) Meting held on 26 June2014

Operational Unit Reports

Chief Operating Officer Report

An Approach to Building Sustainability of Health and Care Services in Remote andRural Areas – Proposal to Cabinet Secretary for Health and Wellbeing

Update on Hospital Admission Transfer and Discharge for Adults

Adult Services Change and Improvement Plan

Local Unscheduled Care Action Plan (LUCAP2)

Update on Adult Social Care Package Review Processes

Adult Social Care Contract Monitoring Report

Proposed Performance Measures for Children and Young People

Consideration of Future Agenda Items

Committee Function and Administration including Meeting Schedule 2015

DATE OF NEXT MEETING

The next meeting will be held on Thursday 6 November 2014 in the Board Room, Assynt House,Inverness at 9.30pm.

HEALTH AND SOCIAL CARE COMMITTEE – ASSURANCE REPORTMeeting on Thursday 11 September 2014

3

1 TOPIC: Welcome and Declarations of Interest

Issues Assurance Actions

Do members have any interest todeclare in relation to any Item onthe agenda?

Have there been any changes tomembership?

No declarations made.

MD welcomed Cllr Alasdair Christie and JoannaMacdonald to their first meeting of the Committee.

Action:

2 TOPIC: Committee Chair Update


What update can the Chair give inrelation to meetings held sincethe last Committee?

MD advised NHS Board met on 12/8/14. Discussionon Tier 1 report out on Orthopaedic loan kits, anupdate on the impact of Lean working, endorsed theiMatter Implementation Plan, Agreed the WorkforceDevelopment Plan and Asset Management Strategy,agreed NHSH Quality Objectives 2014/16, noted theNorth of Scotland Planning Group Annual Report,approved the NHSH Code of Conduct, noted progresson actions to establish the Argyll & Bute Health andSocial Care Partnership body corporate model,discussed the Area Clinical Forum response to theFrancis Report, discussed and endorsed the work todevelop the Highland Care Strategy, noted an updateon work to reduce health inequalities, discussed theoverall financial position and noted a report on theroutine monitoring of infection prevention and control.

Action:


4

3 TOPIC: Assurance Report and Rolling Action Plan – 10 July 2014


Need to update Action Plan Agreed regular updates required from NamedOfficers.

Action: Action Plan to continue to be updated – Named

Officers/ Committee Administrator

4.1TOPIC: Redesign of Services in Badenoch and Strathspey Public Consultation: Update on the Consultation Process – Director ofOperations (South and Mid) and Head of Public Relations and Engagement


What is the latest position on thePublic Consultation relating toBadenoch & Strathspey?

Circulated report indicated consultation exercisecompleted on 21 July 2014. Internal reviewconcluded major service change guidance followedfully. The report gave an update on publicconsultation activities, in relation to an access andtransport evaluation, the background to selection of apotential site for a new hospital at the AviemoreTechnology Park and feedback on the publicconsultation process. It was intended that a full reportwould be provided to the NHS Board at their meetingon 7 October 2014. The Committee acknowledgedthe thorough dissemination of information regardingthe consultation, how people could respond and therange of activities that had taken place for discussionwith the community; it was assured of the process.

Action: Agreed to endorse that the process complied with

Scottish Government major service changeguidance – Dir of Ops (South & Mid)/Head ofPublic Relations and Engagement

Agreed to endorse recommendation to present fullfindings to NHS Board on 7 October 2014 – Dir ofOps (South & Mid)/Head of Public Relations andEngagement


5

4.2 TOPIC: Complaints Review Committee – Resolution of Staff Issues – Director of Operations (South and Mid)


Have staff issues raised by CRCbeen addressed?

NS advised matters resolved.Action:

4.3 TOPIC: Committee Self Assessment Review and Membership – Kenny Oliver, Board Secretary


What is position in relation tomembership of Committee in lightof anticipated legislation relatingto integration?

KO advised activity to map current membership, incontext of anticipated new legislation, underway. Onecurrent vacancy relating to a Public/Patientrepresentative and one Board Non-ExecutiveDirector. Similar activity underway in relation to Argyll& Bute body corporate. Once concluded report to besubmitted to November 2014 meeting.

Action: Agreed full report to November 2014 meeting –

Board Secretary

4.4 TOPIC: Highland Health and Social Care Committee Development Sessions – Committee Administrator


Have Development Sessionsbeen agreed for remainder of2014?

BM advised next Session relating to Self DirectedSupport to be held on 28 October 2014. Venue to beconfirmed.

Action:

The Committee agreed to consider the following Items at this point in the meeting.


6

5.1 TOPIC: Childrens’ Services: Assurance and Performance Reports – Head of Health, Highland Council


What assurance can theCommittee take in relation todelivery of commissionedservices for children?

SM spoke to circulated reports relating to delivery of arange of children’s services by Highland Council onbehalf of NHSH under lead agency model. Had beenconsidered by Highland Council Education, Childrenand Adults Services Committee on 28 August 2014.

Assurance Report gave summary position in relationto the Looked After Children Health Service, AlliedHealth Professionals, Insulin Pump Therapy forpeople with Type 1 Diabetes, funding for HealthVisiting (HV) Posts and School Based Flu VaccineProgramme. Report also included an extract from theproposed revised performance managementframework for commissioned services. There wasreference to the budget transferred to the HighlandCouncil to support the commissioned service and itwas noted a Resource and Commissioning Grouphad been established. It was also reported thatpreventative spend resource had been allocated tocreation of 12 Health Visitor, Trainee Health Visitorand staff nurse posts; to support breastfeedingactivity; and to continue provision of the Family NursePartnership Programme. On HV funding, SM advisedcurrently three trainees in Highland, looking to moveto eight trainees and an eventual total of ten butfunding yet to be confirmed in future years.Recruitment levels are high but there is also a highattrition rate. Hoping local recruitment will assist inability to retain individuals. Recruitment of further twoOccupational Therapists was anticipated to makesignificant impact on current waiting times.

Action:


7

The Committee noted that further detail on waitingtomes for AHP services and the monetary value of theCommission had been requested at the Education,Children’s and Adult Services Committee. In relationto “New Ways” access guidance application it wasnoted this was a manual system and reporting issueswould be reconsidered. Clarification to be sought asto GP notification/update of medical records relatingto Flu Vaccination.

Performance Report provided an update on theperformance framework for Childrens Services.Noted Framework to be superseded followingpublication of For Highland’s Children 4. Reportincluded specific updates on a number of measureswhere performance was not broadly on target orbetter, or was otherwise of note.

The Committee agreed it was assured by the Reportsand its discussion thereof.

Further detail on waiting times for AHP services andthe monetary value of the Commission to beprovided – Head of Health (THC)/Child HealthCommissioner.

Agreed that “New Ways” reporting issue bereconsidered – Head of Health (THC)/Child HealthCommissioner

Agreed clarification be sought in relation torecording and notification of Flu vaccination – ChildHealth Commissioner

Agreed link to For Highlands Children 4 be providedto members – Committee Administrator

5 TOPIC: Proposed Performance Measures for Children and Young People – Report by Sally Amor, Child Health Commissioner


What progress is being made ondevelopment of performancemeasures?

SA spoke to circulated report detailing series ofperformance measures for the children and youngpeople’s service in the directly managed units of theHighland Health and Social Care Partnership, theRaigmore Paediatric service and both north HighlandOperational Units. Represented first iteration ofperformance measures for these directly managedservices in NHSH. Work was to continue in relation todevelopment of relevant data collection systems and

Action:


8

Can effective joint working acrossall sectors be evidenced at thistime?

What other relevant activity isbeing taken forward?

processes. Noted additional measures would beproposed by the Children and Young People’s NeedsAssessment that was nearing completion and thesewere likely to include unscheduled care, childprotection, avoidable injuries and interfaces withtertiary paediatric centres across Scotland and thewider UK. Proposed measures also to be discussedby Children and Young People’s CommissioningGroup, Maternity and Neonatal Strategy and ServicesGroup. Anticipated that the first performance reportwould be submitted to the meeting either in November2014 or January 2015.

Noted national eHealth infrastructure currently limitedand PMS yet to be fully implemented. Noted PrimaryCare colleagues engaged in discussions. ChildProtection Coordination Group looking into ChildProtection training for NHS staff and it was notedthere was a need for improved recording relating tocompletion of training. Recognition of need foreffective information sharing between all relevantgroups and importance of relevant training inemphasising that point. Noted new Highland CouncilFamily Team model should help to embed thatapproach, with Lead Officers taking a key role.

Noted discussion was underway at Adult Resourcesand Commissioning Group in relation to Children’sCare at Home services and associated Self DirectedSupport. Importance of Transitions arrangementswas emphasised and this to be subject of discussionat next meeting. The Assurance report presented tothe Committee would be refined over time.

Agreed report on Transitions be brought to the nextmeeting – Dir of Health and Social Care

Ms Amor and Mrs MacLeod left the meeting at 10.30am


9

The Committee agreed to revert to the original Agenda at this point in the meeting.

6.1 TOPIC: Finance and Performance Sub Committee – 29 August 2014


What arrangements were made inabsence of meeting held on 29August 2014?

MD advised that issues had been considered byImprovement Committee at meeting held on 1September 2014. Financial position remains aconcern at this time. Exception reports included onagenda for this meeting.

Action:

6.2 TOPIC: HHSCC Financial Position as at 31 July 2014 – David Garden, Head of Financial Planning


What is the financial position inyear and where are currentfinancial pressures?

What are the particular costpressures within Operational Unitsat this time?

DG Garden spoke to circulated report outlining NHSHighland financial position, highlighting a currentprojected out-turn overspend of £15.6m. Reporthighlighted significant effort required to break-evenand outlined progress on savings plans. Particularareas of overspend were indicated, including in-yearcost pressures of approximately £6.3m. LeadershipGroup continued to discuss a range of issues,including use of supplementary staffing.

Circulated report outlined key pressures contributingto forecast overspends within Units. In North andWest, the redesign of Out of Hours services an issueas any service introduced unlikely to meet theaspirations of patients and residents. In Raigmore,patient flow remains an issue to be resolved, rangeof redesign initiatives being taken forward, and lackof comprehensive reporting through PMS havingimpact on ability to respond to live data.

Action: Agreed need for continued scrutiny of financial

performance – Finance and Performance SubCommittee


10

In South and Mid, capacity to deliver Adult SocialCare packages and associated costs remain arecurring issue, and a level of unachieved savings inyear was a likely year end position. PD advised PECscheduled to consider issues relating toUnscheduled Care Programme.

Committee remain concerned about the financialposition and notes and is support of service redesignto achieve improvements and efficiencies.

Agreed concern regarding PMS implementationand data reporting be relayed to NHS Board –Committee Chair

6.3 TOPIC: Adult Services Balanced Scorecard


What is current performanceagainst targets?

Circulated report outlined progress against relevanttargets. It was confirmed that relevant matters weremonitored by the Improvement Committee andFinance & Performance Sub Committee. NotedImprovement Committee to receive report in relationto Respite Care at next meeting.

Action:

6.4 TOPIC: HHSC HEAT Targets Balanced Scorecard – Kenny Oliver, Board Secretary


What are HEAT Targets relevantto Health and Social Care andwhat is current performanceagainst these?

Copy of Balanced Scorecard circulated, along withexception reports relating to Patient ManagementSystem (PMS) Implementation, Stroke and waitingTimes for Alcohol & Drug Treatment. Referencemade to report on Stroke and agreed this wouldbenefit from inclusion of narrative relating to locationsand access to dedicated stroke units/staff resource toput the information in context.

Action:

Agreed to consider addition of narrative relating toStroke services – Dir of Ops (North & West)


11

What are the main concerns inrelation to PMS?

Stated that elements with clinical implications anddirect patient impact required to be prioritised at thistime, including follow up appointments. NotedeHealth service leading on IT issues and ProgrammeBoard in place.

Agreed relevant concerns be relayed to NHS Boardand PMS Programme Board – Committee Chair

The Committee adjourned at 11.00am and reconvened at 11.10am.

6.5 TOPIC: Professional Executive Committee – Meeting held on 28 August 2014 – Dr Paul Davidson


What issues were considered bythe PEC at this meeting?

PD advised had not attended meeting which waschaired by Dr Cameron Stark. Particular updateswere received in relation to the Raigmore HospitalRecovery Plan, Oncology Service and Pan HighlandGeneral Surgical Services. KS gave a presentationon the current Musculoskeletal Redesign activity andthis had led to strong discussion on issues such asvariation of care delivery across NHSH and how bestto deliver services and ensure access to resource.Waiting times for access to Physiotherapy a particularcurrent focus, a pilot of telephone assessment havingbeen successful and being considered for applicationacross the service. The key was to ensure effectiveand efficient service delivery. Occupational Therapystaff were working with the Orthopaedic service toensure patients were directed to the most appropriatecare for their particular condition, and the support ofPEC for this activity had been welcomed. PDemphasised PEC a newly established Committee andwould be seeking to review effectiveness of changesreported moving forward.

Action:


12

What are particular issues relatingto Physiotherapy services?

QC advised Physio waits an issue and can belocation specific. Joint triage arrangements need toensure avoidance of duplication of effort to releasecapacity. Telephone triage helps but not ideal in allcircumstances. More efficient admin process andsystems would be of benefit. KS acknowledged workstill to be done and advised some elements nowbeing considered for first time in detail and in real-time. Physio staff working with Orthopaedic Surgeonto ensure consistency of decision making and thisshould help to release capacity. LK emphasised needto ensure sustainability of service. CW stressed theimportance of self referral and GP referral direct toPhysiotherapy.

7.1 TOPIC: Operational Unit Reports – Directors of Operations


North & West Operational UnitFinancial Position

Chronic Pain

Committee noted position in year showed currentoverspend of £1.1m. Senior management andAccountants meeting regularly with managers to formplans to bring down relevant costs and achieve CashReleasing Savings targets. A number of costpressures had been carried forward from 2013/2014,with new minibus purchases for Care Homes,Delayed Discharges and embargoed beds all havingan impact. Out of Hours, locums and vacant practiceissues continued. Agreed need for greaterconsideration of integrated transport arrangementsand for communities to be involved in discussions.

Noted challenging staffing position continues andwould be exacerbated by further planned sick leave.A difficult position was being managed well by

Action:

Agreed to discuss integrated transport at a futuremeeting – Committee Administrator


13

Review of Adult Services,Caithness

Skye, Lochalsh and Wester RossRedesign

Riverbank Medical Practice,Thurso

Integrated Team LeaderDevelopment Programme

Out of Hours Service

South & Mid Operational UnitWhat are the current key issuesaffecting the Operational Unit?

relevant staff but the situation was unsustainable andwork was ongoing to consider how best to redesignthe service into the future.

A copy of newsletter and flash reports providingupdates on relevant workstreams had beencirculated.

Advised consultation period extended to end August2014. Questionnaire distributed and media activityundertaken encouraging all to participate. Over 1500responses had now been received.

A Practice Manager had been appointed andrecruitment processes for salaried GPs underway.

Confirmed first training cohort complete and continueto meet regularly. Training to be delivered to secondcohort. Key was a mutual learning approach and thatis being embedded in teams.

North & West service overspent and continues to bechallenge in recruiting staff. Work ongoing tointroduce more multi-professional team that is lessdoctor-dependent. Will mean change to wherepeople are based. Support for Clinical decisions anduse of technology to be embedded in service delivery.

NS spoke to circulated report giving updates inrelation to Tain Health Centre, Community Pull Team,financial position, Clinical Director role, buildingdevelopments, redesign of medical care inCommunity Hospitals, management of CommunityMental Health teams, Health & Safety activity, andissues relating to exceptional weather whichhighlighted concerns at Nairn Hospital.


14

Tain Health Centre

Nairn Hospital

Raigmore Operational UnitFinancial Position

Safety and Quality

Access and Waiting Times

Noted Health Centre part of HubCo package anddiscussion was ongoing in relation to contractualimplications arising from the 25 year agreement.

Advised recent adverse weather had raised issuesrelating to building maintenance. Hospital was thirdparty development and circumstances highlightedneed for clarification on respective responsibilitieswithin legal agreement. Meeting arranged withNexus, building owners, to discuss concerns.

Report indicated small positive movement in positionevidenced. Significant redesign activity underway,including in relation to theatres, bed complement, trialof ambulatory care and 23 hour beds, and anextended outpatient antibiotic service. It wasexpected this activity would minimise cancellationsand requirement for boarding of patients. Rosteringhad emerged as an issue and principles of good rotamanagement are being reinforced, with support beinggiven to wards, theatres and reception.

Noted deterioration in performance against 4 hourtarget and small working group of managers andclinicians meeting to test improvements such asreview of patients at 4pm so as to expedite dischargeand avoid accident and emergency medical receiving.

Noted significant staffing issues within number ofspecialties impacting on performance. Particularissues within Anaesthetics, OMFS, Orthopaedics,Cancer and Ophthalmology. Plans in place for eachservice and working with NoSPG to seek alternativesolutions where appropriate.

Agreed to highlight this issue in assurance report tothe NHS Board – Committee Chair


15

Management Capacity

Work also underway with Service Planning to scopedemand and capacity for Orthopaedics, with backlogarrangements being implemented through utilisationof Golden Jubilee, Belford Hospital and someSaturday service.

Noted Management Team depleted for variety ofreasons and has been restructured to try andcompensate. Interim additions to Team have beenmade and active recruitment underway in relation tosenior management positions. The Associate MedicalDirector’s position vacant at this time.

7.2 TOPIC: Chief Operating Officer Report – Deborah Jones, Chief Operating Officer (COO)


Delayed Discharge

NHSH and Highland CouncilYoung Carers Strategy 2014

Noted key issues relating to non complex casesremain unresolved in relation to Care Home and Careat Home services. At the time of reporting there were95 people subject to delayed discharge, 29 of whomwere classified as complex. NHSH was progressingnationally recognised work to expand Care at Homecapacity and to support elevation of Care Homequality grades across all sectors.

Highland Young Carer Improvement Group aiming todevelop Strategy to accurately reflect range ofexperiences of young carers in Highland. This willpave way for development of clear implementationplan to enable and support young carers to continuethe valuable contribution they make to the lives ofthose that they care for.

Action:


16

Patient Management System Noted number of data quality issues identified relatingto system and to data migrated from the two legacypatient administration systems. Several challengesalso experienced in relation to reporting work streamsresulting in an inability to report fully on activity.Robust programme of remedial action underwayunder direction of PMS Programme Board and workstreams initiated, progressed and being monitoredwithin formal project management structure. ChiefOperating Officer in receipt of weekly progressreports. Phase 2 implementation relating to bedmanagement, eVetting of referrals and ordercommunications been temporarily deferred to enablePhase 1 issues to be addressed.

8.1TOPIC: An Approach to Building Sustainability of Health and Care Services in Remote and Rural Areas – Proposal to CabinetSecretary for Health & Wellbeing – Director of Operations (North & West)


What progress has been made indevelopment of formal proposal?

GMcV gave presentation on circulated proposaldocument which reflected required changes atcommunity level, building on the previous ChristieReport which highlighted the need for “workingclosely with individuals and communities tounderstand their needs, maximise talents andresources, support self reliance and build resilience”.Current workstreams were in relation to recruitmentand retention, training and education, communityresilience, and evaluation and action research. Testareas had been identified within Argyll and Bute andWest Lochaber. In relation to West Lochaber it wasnoted that new proposals were based on a multi-disciplinary Rural Support Team approach includingdoctors from Skye, noting that there was no residentdoctor or nurse on the isle of Eigg, and with the aim

Action:


17

of building community resilience. The new model willstart in November.

Learning from a recent trip to Alaska to experiencethe delivery of services to vast and remote areahighlighted the need for innovative approaches torecruitment and retention as well as service delivery.It was noted that flexibility of employment would be akey aspect alongside the requirement to work withcommunities and understand relevant culturalconsiderations. Activity relating to training andeducation was outlined. In terms of communityresilience, the ability to provide emergency responsewas crucial, as was the provision of communitylearning and implementing self care in partnership.In terms of evaluation and action research it wasreported that attempts to recruit a Health Economisthad been unsuccessful. It was noted in relation tocommunication and sharing activity, remote and ruralhealthcare provision was now seen as a global issue.

The Committee welcomed activity to date in this area,noting the key principle of ensuring communityservices are in place, are maintained and provide anearly response to Care at Home needs. Short noticePalliative Care service provision would require furtherconsideration. Community expectations wouldrequire to be managed through engendering trustamong the general public and in communities as awhole. Flexibility on both sides would be key aswould the ability to “grow your own resources” toensure sustainability. Committee recognised the timeinvested in working with the community. EmphasisedNHS is one stakeholder in the overall solution,highlighting need for partnership working by allinterested parties to ensure public resource


18

effectively utilised for benefit of remote and ruralcommunities and their residents.

8.2 TOPIC: Update on Hospital Admission Transfer and Discharge for Adults – Kate Patience-Quate, Lead Nurse (South & Mid)


What progress has been made inrevising the Operational Guidancefor hospital admission, transferand discharge for adults?

KPQ spoke to the circulated revised operationalguidance document and gave a presentation to theCommittee advising this had been reviewed at therequest of the Director of Adult Care. A core grouphad been established to undertake an initial review ofimplementation of the original 2010 policy andsubsequent update. The Policy had been developedin partnership and was supported by a guidance andtraining pack developed to aid implementation. Thereview had included consideration of a range ofassociated data and patient/clinician feedback. TheCommittee was asked to endorse the refresh andlaunch of the revised guidance document, plans for aseries of ATD workshops, implementation of ADTAction Cards and Discharge Planning Records (DPR),completion of development of a personal informationleaflet and development of a training directory.

There was a view that DPR detail could be improvedby inclusion of elements relating to patient rights andgreater information on personal circumstances suchas benefits receipt and housing status. It wasrequested that consideration be given to using analternative phrase to “Discharge”.

Action:


19

8.3 TOPIC: Adult Services Change and Improvement Plan – Jan Baird, Director of Adult Care


What is position in relation to ASChange and Improvement Plan?

Circulated report indicated revised Plan continues tobe developed at local level and will require to beconsidered within the context of the Public Bodies(Joint Working)(Scotland) Act 2014 which may impacton the agreed timescales and work required.Relevant issues would be further considered by theStrategic Commissioning Group.

Action:

8.4 TOPIC: Local Unscheduled Care Action Plan (LUCAP2) – Deborah Jones, Chief Operating Officer


What progress is being made inrelation to development of theLocal Unscheduled Care ActionPlan?

KS spoke to circulated report relating to developmentof a second Local Unscheduled Care Action Plan asrequired by the Scottish Government. The initial draftPlan had been returned with commentary and arequest for inclusion of a comprehensive FinancialPlan containing details of what funding would berequired in 2014/15 to enable NHSH to meet theexpectation of achieving the 4 Hour Waiting TimesA&E HEAT target of 98%. The report outlined the fiveStrategic Themes upon which NHS Boards were todevelop their Action and Financial Plans. It wasnoted local plans support the strategic aims of theNHS Board and articulate a way forward in relation todelivery of a core strategy. Relevant workstreamspick up planned activity highlighted within OperationalUnit Development Plans and provided focus onsupporting flow across the whole system. Therelevant Key Workstreams, and their respective LeadOfficers, were outlined in the report.

Action:


20

In terms of resource, it was reported NHSH hadreceived £506,572 to help pump prime relevantservice change activity, with a further £300k allocatedto support work to improve performance in dischargefrom hospital. Internal funding allocation wasdependent upon Key Project Charter submission byOperational Units and this would be confirmed in earlycourse. A LUCAP Programme Board, chaired by theChief Operating Officer, had been established.

Agreed Committee receive regular updates onprogress – Chief Operating Officer

9.1 TOPIC: Adult Social Care Package Review Processes – Joanna Macdonald, Director of Adult Social Care Services


What progress is being made inrelation to review of ASC CarePackages in Highland?

JM advised that a report by the Chief Social WorkOfficer would be presented to the meeting onNovember 2014. Care Package review would providefocus on an individual’s resilience levels as well asfamily, carer and community resources. The statutoryfunction of any review should include consideration ofissues relating to good practice and quality of care.The key aim was to ensure the most effective andefficient delivery of the best outcomes for clients. Itwas acknowledged that detailed Care Package reviewcan involve difficult discussion by staff and clients andas such public education, and a robust discussionframework, was important. Support for staff would bekey to ensuring a consistent message was given toclients, families and carers that the aim was to ensurethe appropriate level of care provision.

Action:


21

9.2 TOPIC: Monitoring the Delivery of Adult Social Care Contracted Services – George McCaig, Head of Care Support


What are the outcomes of the firstquarter reviews? What progressmade resolving issues fromprevious reviews?

What work is being undertaken inresponse to earlier Internal AuditReview?

What arrangements exist wherean Adult Support and Protectioncase arises?

Circulated report summarised outcomes from 39contracts monitored during Q1 and the progressmade in resolving issues previously highlighted.In terms of issue resolution, from a total of 76issues, 15 have been resolved and 61 remainlive at this time.

Noted the process for independent inspection ofbase data submitted by providers was in placeand subject to current evaluation in terms ofassociated additional workload and the effect onthe overall contract review timetable. Work toidentify Designated Managers complete andthese now allocated for all contracts. Furtherwork was required to finalise the role and explorethe relevant capacity and engagement issues.The Adult Services Commissioning Group hasundertaken to develop an appropriate balancedScorecard and performance indicator framework.

Advised that where any issues arise or areencountered these are immediately reported.

Action:

Agreed that a quality and contracting report be subjectto routine schedule for submission to Committee –Head of Care Support

10.2 TOPIC: Minute of Meeting of Highland Quality Approach Leadership Group held on 30 July 2014


Any issues arising from Minute? No Issues reported. Action: Noted Minute.


22

10.3 TOPIC: Minute of Meeting of Adult Social Care Practice Forum held on 19 May 2014


Any issues arising from Minute? No Issues reported. Action: Noted Minute.

11 TOPIC: Committee Function and Administration


Have all members been notifiedas to dates for meetings in 2015?

Noted provisional dates had been agreed at previousmeeting, with no changes noted to date.

Action: Agreed 2015 meeting schedule be formally

circulated – Committee Administrator


23

12 FUTURE AGENDA ITEMS AND DEVELOPMENT SESSION TOPICS

Meeting on 6 November 2014: Local Delivery Plans Six Monthly Update – Directors of Operations For Highlands Children Services Plan – Director of Public Health Care at Home Tariff - ?? Update on Progress on Transitions Strategy – Director of Health and Social Care (Highland Council) Committee Self Assessment Review and Membership – Chair/Board Secretary Chief Social Work Officers Report – Director of Adult Social Care

Items for 6 November 2014 – from Assurance Report: Review of Oncology Services (COOs Report) – Chief Operating Officer

Future Meetings: Quarterly – Risk Registers – Directors of Operations in Operational Unit Reports then quarterly thereafter Quarterly – Care Inspectorate Inspection Reports in Highland (incl comparator data pre and post integration, Action plans, timescales for

action and interim support arrangements) – Chair of Adult Social Care Practice Forum Standing – Adult Support and Protection Committee Minutes Standing – Suspension of Admissions to Care Homes – Exception Reports – Director of Adult Social Care Standing – Assurance Report from Finance and Performance Sub Committee – Adult Social Care Balanced Scorecard, financial position,

HEAT targets and standards Standing - Minutes/Assurance report from Professional Executive Committee Presentations by Dirs of Operations on Service change projects in area – all Directors of Operations Update on Augmentative and Alternative Communication (AAC) Update – Director of Adult Care Report on Implications of Welfare Reform on Charging for Social Care Services (include relevant trends, risks etc) – Chair of Adult Social

Care Practice Forum Highland Hospice Presentation on End of Life/Palliative Care service Transformation – Kenny Steele – originally due July 2014 Reablement Strategy – Chair of Adult Social Care Practice Forum Local Delivery Plans Six Monthly Update – due May 2015 – Directors of Operations Care Home Risk Management Processes – Head of Care Support Strategic Commissioning and Training 2014-2019 – Chief Operating Officer (COOs Report Item) Managing Patient Choice Communications Plan – Chief Operating Officer


24

Update on associated activity affecting Maternity Services, including pre-birth activity – Director of Care & Learning, Highland Council Consideration of Patient Feedback/Stories Infection Control Arrangements within Care Homes Anticipatory Care Planning Activity – Associate Medical Director (Primary Care) Report on Adult Support – Jan Baird Update on monitoring of Care Home contracts, single point of contact and escalation routes – Director of Adult Care Draft Commission for Integrating Care in the Highlands Legal Services – Director of Adult Care CAMHS Need Assessment Outcome – Child Health Commissioner Updates on Moray Firth Master Plan – Director of Finance / Head of Estates Clinical Care Strategy – Director of Public Health SPSP Mental Health Updates Patient Management System Updates on Local Unscheduled Care Action Plan – Chief Operating Officer Balanced Scorecard reports on Adult Social Care Contracted Services Integrated Transport – Director of Adult Social Care

Development Sessions: Self Directed Support (DVD Presentation) – RAS monitoring, management of identified risks, identification of ‘What Ifs’, and Staff Awareness

– October 2014 Primary Care – February 2015 Care Inspectorate Inspection Criteria

18 DATE OF NEXT MEETING

The next meeting of the Committee will take place on Thursday, 6 November 2014 in the Board Room, Assynt House, Inverness at 9.30am.

Highland NHS Board October 2014 HIGHLAND HEALTH & SOCIAL ... · October 2014 Item 3.2 HIGHLAND...

Documents

Transcript of Highland NHS Board October 2014 HIGHLAND HEALTH & SOCIAL ... · October 2014 Item 3.2 HIGHLAND...