Steve Combe, Director of Corporate Governance. Andrew Davies, Chairman & Alex Howells, Interim Chief Executive

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1 MAIN REPORT ABM University Meeting On 8 th December 2017 AGENDA ITEM: 1 (vi) Subject Prepared by Approved & Presented by Chairman and Chief Executive s Report Steve Combe, Director of Corporate Governance Andrew Davies, Chairman & Alex Howells, Interim Chief Executive 1. PURPOSE To advise Board members of issues impacting on the. 2. KEY ISSUES a. Proposed Changes to Bridgend Boundary Members will be aware that, as part of his announcement on Local Government reform (July 2017), the Cabinet Secretary for Finance and Local Government identified the inclusion of Bridgend County Council within the Cardiff City region. At the same time, he advised of the intention to consult on the consequential realignment of boundaries to preserve the principle of co-terminosity between health and social care. It is anticipated that the consultation will commence in early December 2017 and will last for 3 months. This will be led by Welsh Government and a decision will be made in Spring 2018 on the way forward. Board members will be kept fully advised on this matter. b. Review of Long Waiting Patients A review of the impact of long waits for patients awaiting planned care on a referral to treatment (RTT) pathway has been commissioned by the Welsh Government via the Delivery Unit as part of the work programme. This review will take place in several health boards and feedback is planned to health boards during February In ABMU work has already been undertaken during 17/18 to clinically review all long waiting patients to inform plans going forward and ensure that safety is a key focus in RTT delivery plans. c. Joint Regional Planning & Delivery Forum The South Central & East, Joint Regional Planning and Delivery Forum (JRPDF) has been established as a joint committee of Aneurin Bevan, Cardiff & Vale, Cwm Taf, ABMU and Powys teaching Local s. This is a similar arrangement to the one between ABMU and Hywel Dda health boards. The terms of reference are attached. These have been considered and agreed by the Forum and require Board approval. 1

2 d. Seasonal Plan The ABMU Seasonal (Winter) plan was submitted to Welsh Government on 22nd September 2017, and is available to board members via the resource centre. The plan has been supported by the Regional Partnership Board and Welsh Ambulance Service Trust (WAST). The plan was developed using the lessons learnt from 2016/17 winter evaluation which was shared with WAST and the local authority partners to inform the planning arrangements for 2017/18. The winter plan is a component part of our overall plan to improve unscheduled care services, through the on-going development of system wide sustainable models of care. The key components of this plan focus on pre hospital pathways of care, frailty services, ambulatory models of care. In addition the Board continues to encourage and embed the adoption of the, SAFER bundle approach which focuses on Senior Review, All patients have an expected date of discharge, Flow from assessment units, Early Discharge, Review of patients with extended length of stay. We can already see evidence of the impact of the SAFER bundle on lengths of stay in a number of Units. The investment of an additional 600k from the Intermediate care fund has been provided to support additional service capacity within our frailty servicesthe Health Board has also invested an additional 500k on a non recurrent basis to improve patient flow and capacity from January During the month of January we will be adopting a Breaking the Cycle approach which is aimed at releasing clinical and non clinical capacity to support front line teams to deliver the best possible care to patients, by helping to unlock any constraints that impede flow through the system. This will require the cancellation of all non essential meetings and activities to ensure that there is a floor to board approach. As in previous years, a formal evaluation will be undertaken in due course on the impact and effectiveness of the 2017/18 Winter Plan, to inform the development of future planning arrangements. e. Non-Officer Member (NOM) Arrangements Since the last meeting the Cabinet Secretary has confirmed two further NOM/Independent Member appointments; Mark Child (who replaces the vacancy resulting from Cllr Melvyn Nott stepping down in May 2017) as local authority member and Tom Crick (who has taken over from Debbie Williams who also stepped down last Spring) as Information Communication and Technology (ICT) member. This means that apart from the Third Sector position, which is due to be readvertised in due course, we have now appointed to all our vacant NOM positions. f. Executive Team Update Since the last meeting Rory Farrelly, Interim Chief Operating Officer (COO)/Deputy Chief Executive / Director of Nursing & Patient Experience has left to take up a new position in Ireland. We are delighted to welcome Chris White as the Interim COO as of 4 th December We are also delighted to confirm that Angela Hopkins has 2

3 been appointed as our interim Director of Nursing & Patient Experience who also joined us on 4 th December. Last week interviews were held for our Chief Executive post and it is hoped to advise Members of the outcome of the interviews at the Board meeting. We have also recently announced that Alex Howells has been appointed by Welsh Government to be the first Chief Executive of a brand new special health authority Health Education and Improvement Wales. This will oversee the training and education of professions in NHS Wales. The handover arrangements and the planned starting date for Alex in her new role have yet to be confirmed but on behalf of the Board we all wish Alex every success in her new role and to thank her for the tremendous work she has done in the health board as Chief Operating Officer and more recently as Interim Chief Executive. Following interviews held at the end of September, Pam Wenger was appointed to the post of Director of Corporate Governance/ Board Secretary and is due to take up post in January In the interim, we wish to take this opportunity to extend thanks to Steve Combe who currently holds this post for the pivotal role he has played over many years and for the direction and advice he has provided on an all- Wales basis. g. Nursing and Midwifery Strategy Board members will recall the Strategy was discussed at the October 2017 board development session. A series of events took place around the launch of the Strategy during November across our six service delivery units and drop-in sessions have been held with staff. Feedback from clinical staff has been positive and attendance excellent. A key theme of the strategy is improving nursing recruitment and retention which will have a positive impact on patient care. This is a key factor in meeting the statutory requirements of the Nurse Staffing Levels (Wales) Act An implementation workshop has been arranged via the November Nursing & Midwifery Board, where members will generate ideas for the first year implementation programme. The Board is asked to ratify the Strategy which is available in the resource centre. h. Awards/Staff Recognition Departments and individuals who have received awards and/or recognition since the board last met include: - A number of staff members and teams from Singleton Hospital were recognised at Cardiff University s School of Healthcare Sciences ceremony for partnerships with practice; Radiotherapy services manager Maureen Noonan received the inaugural Special Recognition Award; The musculoskeletal outpatient physiotherapy team won the Physiotherapy Best Placement Team Award; The radiology department narrowly missed out on the team award in its category, being voted second best placement for radiography students; Also named runner-up was radiotherapy radiographer Catherine Davies, who was shortlisted as Best Placement Educator/Mentor for radiotherapy and oncology. 3

4 - Morriston Hospital s cardiac centre celebrated its 20 th birthday; - A Wales-wide diabetes programme for children and young people which ABMU experts helped to develop won a Quality in Care Diabetes Award; - Jennifer Torkington, cardiac physiologist at Princess of Wales Hospital, was presented with the Lynda McGurk Award for Welsh Cardiac Physiologist of the Year; - Senior renal pharmacy technician, Dafydd James, was recognised with the Association of Pharmacy Technicians UK s Digital Pharmacy Technician Award for Digital Innovation for the renal service s vision of a paper-free system; and - Eirlys Thomas (head of nursing, women and child health) and Cheryl Rowlands (operational team leader for the community resource team) who were both named runners-up in their categories at the recent Royal College of Nursing Wales Nurse of the Year Awards; - The Emergency Medical Retrieval and Transfer Service (EMRTS) was recognised with the special incident award by the Association of Air Ambulances for the second consecutive year. 3. RECOMMENDATION The Board is asked to note the foregoing and: Adopt the terms of reference of the JRPDF Ratify the Nursing & Midwifery Strategy 4

5 Cwm Taf University Cardiff & Vale University Aneurin Bevan University Powys Teaching Abertawe Bro Morgannwg University Velindre Trust WAST JOINT REGIONAL PLANNING AND DELIVERY FORUM Version Issued To Date Comments TERMS OF REFERENCE V1.0 Issued electronically to inform Chairs and Chief Executives Conference Call re the establishment of the Forum May 2017 Agreed following receipt of comments V1.0 Issued to inaugural meeting of the Joint Regional Planning and Delivery Forum Further significant Amendments proposed V.2.0 V.3.0 Issued to 15 September 2017 meeting of the Joint Regional Planning and Delivery Forum for Approval Draft approved subject to some minor changes ie: membership and frequency of meetings For Approval at September meeting Approved V.4.0 Approved Terms of Reference sent to full members of NHS Boards for endorsement of their respected Board Members Scheduled for Board meetings in November 1

6 JOINT REGIONAL PLANNING AND DELIVERY FORUM 1. Constitution 1.1 The South Central and East, Joint Regional Planning and Delivery Forum (JRPDF) has been established as a working forum of Aneurin Bevan, Cardiff & Vale, Cwm Taf, Abertawe Bro Morgannwg University s and Powys teaching Local, constituted from September Membership 1.2 To ensure the Joint Regional Planning and Delivery Forum undertakes its role effectively, its members are asked to: Attend planned meetings; Adopt an open and constructively challenging approach within meetings; Promptly follow up on actions and commitments; and Participate in electronic and virtual channels established to allow a continuous flow of information between forum members. Member Maria Battle Len Richards Dr Chris Jones Prof. Marcus Longley Allison Williams Ann Lloyd Judith Paget Prof Andrew Davies Alex Howells In Attendance Dr Andrew Goodall or nominated senior representative Governance Advice/ Support Peter Welsh Robert Williams Richard Bevan Position/Organisation Chair, Cardiff & Vale University (Chair) Chief Executive, Cardiff & Vale University Chair, Cwm Taf University Chair Designate, Cwm Taf University Chief Executive, Cwm Taf University Chair, Aneurin Bevan University Chief Executive, Aneurin Bevan University Chair, Abertawe Bro Morgannwg University Chief Executive, Abertawe Bro Morgannwg University Director General for Health and Social Services/ NHS Wales Chief Executive, Welsh Government Board Secretary, Cardiff & Vale UHB Board Secretary, Cwm Taf UHB Board Secretary, Aneurin Bevan UHB Invitation to attend to discuss work programme areas requiring wider collaboration Mick Gianassi Chair, Welsh Ambulance Services NHS Trust Tracy Myhill Chief Executive, Welsh Ambulance Services NHS Trust Prof Viv Harpwood Chair, Powys Teaching Carol Shillabeer Chief Executive, Powys Teaching Rosemary Kennedy Chair, Velindre NHS Trust Steve Ham Chief Executive, Velindre NHS Trust 1.3 Whilst the Membership of the Forum will be reviewed on an annual basis. The business of the Forum will determine and influence appropriate attendees at each meeting. 2

7 3. Quorum and Attendance 3.1 A quorum shall consist of no less than 50% of the membership, including a minimum of one Chair and one Chief Executive Officer of Member organisations. 3.2 Any senior officer of the UHBs or partner organisation may, where appropriate, be invited to attend, for either all or part of a meeting to assist with discussions on a particular matter. 3.3 Should any member be unavailable to attend, they may nominate an appropriately briefed Executive Director (for Chief Executives) or Vice Chair to attend in their place, subject to the agreement of the Forum Chair. 3.4 The Forum will be chaired by a Chair from the Member Organisations and along with membership will be reviewed on an annual basis. 4. Aim 4.1 The Joint Regional Planning and Delivery Forum (JRPDF) has been established to provide joint leadership for the regional planning, commissioning and delivery of services for Aneurin Bevan, Cardiff & Vale, Cwm Taf, Abertawe Bro Morgannwg University s and Powys teaching Local. 4.2 The JRPDF will have a key role to drive forward a range of projects that have been identified by partner organisations as priorities for joint working at pace, and aligned to Ministerial priorities, to deliver agreed clinical service solutions for patients on a Regional footprint. 4.3 It will bring together in one place all the projects, which will deliver significant in-year progress and pace in delivery in the health and care system for the Region. 5. Objectives The following objectives are within the scope of the JRPDF: 5.1 Consider and prioritise the regional projects included within the JRPDF programme, approving Project Initiation Documents (PIDs) and Business Cases, and identifying and agreeing any further projects to be included in the JRPDF programme. 5.2 Manage high-level interdependencies and risks associated with all the JRPDF projects and consider in the context of any wider more strategic service change plans. 5.3 Ensure projects deliver against their outcomes and timescales, and deliver against the quality measures and programme benefits, as identified in their PIDs and or Business Cases. 5.4 Ensure that the all the JRPDF projects are aligned with respective University strategic priorities and clinical strategies, and are also aligned to the strategic direction of Welsh Government and other partners (University s, NHS Wales Collaborative), remaining cognisant of and responding to the changing requirements within the wider environment of the Health Service in Wales. 3

8 5.5 Providing a vehicle to progress work programmes within the remit of the JRPDF without unnecessary recourse elsewhere to ensure pace. 6. Out of Scope 6.1 The following are outside the scope of the Joint Regional Planning & Delivery Forum: Replacement of existing University sovereignty or governance structures; Delivery of existing local services; or Replacement of existing planning, governance, or due diligence arrangements. 7. Engagement 7.1 In respect of the JRPDF projects, consider the patient, public and stakeholder engagement requirements, and provide assurance and advice to the respective University s on engagement and communication activities. 7.2 Promote patient and public engagement in the review and redesign of NHS services ensuring that the JRPDF can evidence where patient experience has influenced change. 7.3 Promote understanding of the aims, objectives and deliverables of the JRPDF programme. 8. Governance 8.1 Pro-actively manage the appropriate risks identified within the JRPDF programme, being accountable to the respective University s and in alignment to the deliverables of the respective approved Integrated Medium Term Plan, and/or Annual Plan or equivalent. 9. Agenda and Papers 9.1 The agenda will be based around the Forum s work plan, identified risks, matters arising from previous meetings, issues emerging throughout the year, and requests from members. 9.2 The agenda and papers will be distributed seven days in advance of the meeting. 10. Frequency of Meetings 10.1 The Forum will initially aim to meet bi-monthly and shall agree an annual schedule of meetings. Any additional meetings will be arranged as determined by the Chair of the Forum. 11. Accountability, Responsibility and Authority 11.1 Although, as set out within these terms of reference, the Board has delegated authority to the Forum for the exercise of certain functions, it retains overall responsibility and accountability for ensuring the quality and safety of healthcare for its citizens, through the effective governance of the organisation. 4

9 11.2 The Forum is directly accountable to the respective University s for its performance in exercising the functions set out in these terms of reference. 12. Reporting 12.1 Through the Chief Executive Officer Board update reports to respective Boards, and through respective Committee structures responsible for planning Regular joint updates will be provided to respective Community Health Council Service Planning Committees, with opportunity to present at joint statutory CHC meetings to provide ongoing briefings. 13. Secretarial Support 13.1 The Committee Secretary shall be jointly determined by the Board Secretaries from Aneurin Bevan, Cardiff & Vale and Cwm Taf University s. 14. Review Date 14.1 These terms of reference and operating arrangements shall be reviewed on at least an annual basis by the Forum for approval by the respective University s. Version 2.0 for Approval September