CWM TAF LOCAL HEALTH BOARD MINUTES OF THE MEETING OF THE FINANCE AND PERFORMANCE COMMITTEE HELD ON 25 JULY 2013 AT 2PM, AT YNYSMEURIG HOUSE, ABERCYNON

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1 CWM TAF LOCAL HEALTH BOARD MINUTES OF THE MEETING OF THE FINANCE AND PERFORMANCE COMMITTEE HELD ON 25 JULY 2013 AT 2PM, AT YNYSMEURIG HOUSE, ABERCYNON PRESENT: Mr John Hill-Tout Cllr Clive Jones Mrs Maria Thomas Mr Stephen Harrhy Mr Steve Webster IN ATTENDANCE: Ms Debbie Evans Mr Alan Lewis Mr Stuart Duncan Mr Chris Kalinka Mrs Kathrine Davies Independent Member (Chair) Independent Member Independent Member Director of Corporate Services/Board Secretary Director of Finance Assistant Director of Performance & Information Directorate Manager Anaesthetics (Item 12) Directorate Support Manager Anaesthetics (Item 12) Directorate Manager Radiology (Item 13) PA to Director of Planning & Performance FP/13/98 APOLOGIES FOR ABSENCE Apologies for absence were received from Mr John Palmer, Mr Anthony Seculer, Ms Ruth Treharne, Mr Chris White and Mr Craige Wilson FP/13/99 WELCOME & INTRODUCTIONS The Chair welcomed everyone to the meeting including Mr Alan Lewis and Mr Stewart Duncan who would be presenting Item 12 and Mr Chris Kalinka presenting Item 13. FP/13/100 DECLARATIONS OF INTEREST There were no declarations of interest to report. 1

2 FP/13/101 MINUTES OF THE MEETING HELD ON THE 27 JUNE 2013 Matter of accuracy - (Minute No FP/13/89 refers) Page 6, Fourth paragraph, line 3 should read as recent weeks. Matter of accuracy - (Minute No FP/13/90 refers) Page 7, 5 th paragraph, line 3 should read as on all parts. Members AGREED to APPROVE the minutes of the meeting held on the 27 June 2013 following the above amendments. FP/13/102 MATTERS ARISING FP/13/85 Members asked for an update on the dilapidation charges for Triangle Business Park. Ms Deb Evans advised that this would be reported to the next meeting. FP/13/91 Cllr Clive Jones asked for an update on the waiting lists for Ophthalmology. The Chair advised that there was a detailed report on the agenda for today s meeting. FP/13/103 ACTION LOG Members RECEIVED the Finance and Performance Committee Action Log. NOTE the action log AGREED that a paper on Hospital Acquired infections/rami should be brought to the September meeting FP/13/104 UPDATE REPORT ON DIAGNOSTIC WAITING TIMES Mr Chris Kalinka presented the report to members on behalf of Mr Chris White, Chief Operating Officer. Members were advised that waiting times have grown in Radiology, particularly in MRI and Ultrasound 2

3 scanning over the past 18 months. Demand in MRI has grown across the Health Board and particularly at Prince Charles Hospital which has seen a 40% increase in demand over the past 3 years. Mr Kalinka advised that the number of waiting list initiatives in radiology had reduced at the same time, so capacity outside core capacity had also reduced. Mr Kalinka reported that Radiology waits are now affecting Referral to Treatment (RTT), particularly in MRI and Ultrasound. Members were referred to the current activity versus demand for both Royal Glamorgan Hospital and Prince Charles Hospital. Mr Kalinka referred members to a number of options contained within the paper to reduce MRI and Ultrasound list to 8 weeks by introducing additional capacity whilst additional work on a sustainable solution was progressed. Members of the Committee discussed in detail benchmarking in terms of demand capacity and the utilisation of staffing levels. Following discussion, the Chair thanked Mr Kalinka for presenting the report. ADVISE the Board that the Committee were pleased to note that additional work was being undertaken with the involvement of the Director of Finance on Demand Capacity and benchmarking. AGREED that the options contained within the report would need to be further considered by the Executive Board once this additional work had been completed. FP/13/105 REPORT OF THE FINANCE & PERFORMANCE COMMITTEE S FINANCIAL REPORT FOR 2012/13 TO THE EXECUTIVE BOARD The report of the Director of Finance, updating the Committee on the response from the Executive Board to their Financial Report for 2012/13 that was presented to the meeting held on the 19 June 2013, 3

4 was received. The Chair reported back to the Committee on the recent meeting held with the Chief Executive and Director of Finance relating to the performance of the Organisation. Following discussion, NOTE the response of the Executive Committee. NOTE the feedback from the Chair on the recent meeting held with the Chief Executive and Director of Finance. ASSURED to see the continued action on the part of the Executive Board in adjusting the organisation to meet the challenges. RECOMMEND that the Performance Framework needs to be looked at in further detail. FP/13/105 FOCUS ON THEATRE EFFICIENCY Mr Alan Lewis and Mr Stewart Duncan gave a presentation to the Committee on the Theatre Quality Improvement Team. Members were advised that the presentation outlined a retrospective review of the theatre utilisation rates from April to December 2012 for both Prince Charles Hospital and Royal Glamorgan Hospital and were broken down into categories of Directorate, Speciality and Consultant. The Committee discussed in detail the process of backfilling cancellations of theatre lists, elective day cases and core capacity. Following discussion, COMMEND the team on the content of the presentation. ADVISE the Board that the Committee have fully reviewed theatre efficiencies and recognise that there are significant areas for improvement. The Executive Board are recommended to encourage Clinicians to review the content of this presentation. AGREED that this would be reviewed by the 4

5 Committee in a further six months time. FP/13/106 MONTH 3 FINANCE REPORT Mr S Webster presented the report to members on the Month 3 financial position. Members noted a Month 3 reported deficit of 2.6m which represented a 0.4m adverse variance against the target profile of 2.2m. The year to date deficit of 7.8m represented an adverse variance of 1.2m compared to the target profile of 6.6m. Members were advised of the Month 3 savings targets, gross savings and probability adjusted savings by Directorate and Mr Webster advised that it should be noted that further improvement in the identification and delivery of savings is critical for the achievement of the overall planned out-turn of 19.3m. Mr Webster referred the Committee to the pay expenditure variances and non pay variances by Directorate. The Committee were informed of the forecast revenue position of 20.8m at Month 3 and were advised that in order to achieve the Welsh Government expectation of 19.3m further savings of 5.1m will need to be achieved. NOTE the contents of the Month 3 Finance report and the worsening position which demonstrates further work to be done to achieve the 19.3m Welsh Government expected position. FP/13/107 UPDATE ON LESSONS LEARNT FROM FACILITIES Mr S Harrhy presented the report on the Facilities finance and performance report exploring the variance of the end of year position against the Month 10 forecasts. In presenting the report Mr Harrhy advised that the report provided a response to comments raised during the Finance and Performance Committee Meeting held 5

6 on 28 March The Committee were provided with an explanation as to the 2012/13 end of year variation against forecast and any resultant recurrent or non recurrent consequences for 2013/14 together with the lessons learnt. Following discussion, the Committee RESOLVED to: NOTE the content of the report and actions taken. FP/13/108 PERFORMANCE DASHBOARD Ms D Evans presented the report on behalf of Ms R Treharne and updated members on recent performance against the key delivery framework measures. Ms Evans advised that contained within the report were two new performance indicators on: Smoking Cessation, and Disease Specific Mortality Members noted that the Health Board was still experiencing poor performance against tier 1 targets for unscheduled care, Referral to Treatment and Cancer. In relation to unscheduled care, Ms Evans advised that the access targets had been sustained, although the availability of beds for emergency medical admissions remained an issue. Members were advised that a more detailed review of performance against the Unscheduled Care Delivery Plan and improvement trajectories was due to be discussed at the September meeting together with a presentation on the recent points prevalence study carried out. Members noted that the Health Board s performance against the RTT access targets had seen a slight improvement this month. At the end of June the Health Board had reported 72 patients waiting in excess of 52 weeks, a decrease of 20 from the previous months. The number of patients waiting over 36 weeks had also reduced from 1642 to

7 Members noted that during May there were 5 urgent suspected cancer breaches. The number of breaches against the 31 day target was higher than usual during May with 3 patients waiting over 31 days. In relation to Mortality and Clinical Coding Ms Evans advised the Committee that the Welsh Audit Office had completed a Clinical Coding Audit at Prince Charles Hospital. Members noted that the Stroke performance was proving to be challenging, particularly in care bundles 2 and 3, with a number of improvement actions underway. Discussion was also held on hospital acquired infections (HCI s) with the Committee looking at the detail on the numbers of HCI s. NOTE the contents of the report. ADVISE the Board that the Committee were pleased to note that the Clinical Governance Committee would be examining Hospital Acquired Infections/RAMI in further detail ADVISE the Board that the Committee were pleased to note the improvement in the Ambulance Handover and will be meeting with the Welsh Ambulance Trust at the October Meeting. FP/13/109 RTT UPDATE Ms D Evans provided members with an update on the latest position on behalf of the Chief Operating Officer. Members noted that the Health Board is reporting a slight improvement in performance, with 72 patients waiting in excess of 52 weeks, a decrease of 20 from the previous month With regard to the 36 week target Members were informed that demand and capacity plans for each speciality had now been completed as well the individual delivery plans for each speciality or consultant. Further work was being undertaken to identify the productivity and efficiency gains that could 7

8 be achieved. Members were informed that in regard to Radiology, a detailed demand and capacity analysis would be undertaken to examine the position. In the interim the directorate had been asked to develop a plan of short term interventions to address the current problem. NOTE the contents of the report. ADVISE the Board that the Committee were pleased to note that there was a slight improvement in Unscheduled Care and will receive the Unscheduled Care Plan at the September Meeting. FP/13/110 MINUTES FROM THE CWM TAF QUALITY AND DELIVERY GROUP MEETING HELD ON THE 12 JUNE 2013 NOTE the minutes from the Cwm Taf Quality & Delivery Group meeting held on the 12 June FP/13/111 FORWARD LOOK FOR 2013/14 To receive a six month update report on Theatre Efficiency in January To receive an update report on Outpatients at the November Meeting. To receive a report on the review of the Welsh Ambulance Service Performance for Cwm Taf at the January/February 2014 meeting. FP/13/78 DATE OF NEXT MEETING The next meeting of the Finance & Performance Committee will be held on Thursday 26 September at 2.00pm, in Ynysmeurig House, Navigation Park, Abercynon. 8

9 SIGNED. Mr John Hill-Tout, CHAIRMAN DATE 9