CCDHB Public 20 September AGENDA

Transcription

1 CCDHB Public 20 September AGENDA CAPITAL & COAST DISTRICT HEALTH BOARD Public Agenda 20 SEPTEMBER th Floor Boardroom, Grace Neill Block, Wellington Regional Hospital at 12noon. ITEM ACTION PRESENTER MIN TIME PG 1 PROCEDURAL BUSINESS 12noon 1.1 Karakia 1.2 Apologies Record A Blair 1.3 Continuous disclosure - Interest Register - Conflicts of Interest 1.4 Confirmation of draft Minutes 23 August 2017 Confirm Accept A Blair A Blair 1.5 Matters arising Note A Blair Approve A Blair Action list Note A Blair CCDHB Work plan 2017/18 Note A Blair Chair s report (verbal) Note A Blair Chief Executive s report Financial summary, July ADVISORY COMMITTEE Note D Chin Māori Partnership Board Note T Wall Māori Health Services (Patient story) Note A Gray 10 3 DECISION 3.1 Refreshing the 3DHB CPHAC/DSAC Approach Approve R Haggerty FOR DISCUSSION 4.1 Health and Safety Monthly Report Note T Davis SIP Bi-Monthly Report Note R Haggerty Ministry of Health Quarter 4 Performance Report 5 OTHER 5.1 General Business Note R Haggerty Note A Blair CCDHB Board and Committee 66 Meeting Schedule Meeting Schedule 5.2 Resolution to Exclude the Public Approve A Blair 5 68 ADJOURN APPENDICES 4.3 MoH Q4 2016/17 20 DHB Health Target Results Letter from Minister of Health Health Targets Capital & Coast District Health Board 1

2 CCDHB Public 20 September Item 1.3 Continuous disclosure CAPITAL & COAST DISTRICT HEALTH BOARD Interest Register 20 SEPTEMBER 2017 Name Mr Andrew Blair Chairperson Dame Fran Wilde Deputy Chairperson Mr Roger Jarrold Member Interest Chair, Southern Partnership Group (appointed jointly by Ministers of Finance and Health to provide governance for the redevelopment of Dunedin Hospital) Chair, Hutt Valley District Health Board (from 5 December 2016) Director, Safer Sleep Ltd Director, Safer Sleep LLC Ltd Advisor to the Board, Forte Health Limited, Christchurch Owner and Director of Andrew Blair Consulting Limited, a Company which from time to time provides governance and advisory services to various businesses and organisations, include those in the health sector Former Member of the Hawkes Bay District Health Board ( ) Former Chair, Cancer Control ( ) Former CEO Acurity Health Group Limited Deputy Chair, Capital & Coast District Health Board Chair, Remuneration Authority Deputy Chair NZ Transport Agency Chair Wellington Lifelines Group Director Museum of NZ Te Papa Tongarewa Member Whitireia-Weltec Council Director Business Mentors NZ Ltd Director Frequency Projects Ltd Chief Crown Negotiator Ngati Mutunga and Moriori Treaty of Waitangi Claims Chair Wellington Culinary Events Trust Chair National Military Heritage Trust Co-Convenor 2018 NZ Population Health Congress Ambassador Cancer Society Hope Fellowship Member, Capital & Coast District Health Board Chair, Capital & Coast DHB FRAC committee Trustee, Auckland District Health Board Charitable Trust Employee CFO, Downer New Zealand Ltd Director, Downer New Zealand Ltd Director, Works Infrastructure Cortex Resources JV Ltd Director, Works Infrastructure Harker Underground Construction JV Ltd Director, Works Finance (NZ) Ltd Director, DGL Investments Ltd Director, TSE Wall Arlidge Ltd Director, Waste Solutions Ltd Employer (Downer NZ) subcontracts to Spotless Director, Underground Locators Ltd Member, Finance and Risk Committee, Health Research Council Capital & Coast District Health Board 20 September

3 CCDHB Public 20 September Item 1.3 Continuous disclosure Name Mr Darrin Sykes Member Ms Sue Kedgley Member Dr Roger Blakeley Member Ms Kim Ngarimu Member Interest Past member, Ministry of Health Audit and Risk Committee (resigned 6 December 2013) Director, Downer Utilities Alliance New Zealand Ltd Director, Downer Utilities New Zealand Ltd Requested to undertake some work at ADHB regarding cost management Employer, Downer NZ Ltd, has acquired the part of the trading assets of Hawkins Group and now trades as Hawkins 2017 Ltd Employer, Downer owns 85% shares in Spotless Australasia. Member, Capital & Coast District Health Board Deputy Chair, Capital & Coast District Health Board, FRAC committee Trustee, Wellington Regional; Sports Education Trust (trading as Sports Wellington) Member, Sport and Recreation New Zealand (trading as Sport NZ) Chief Executive, Crown Forestry Rental Trust Member, Capital & Coast District Health Board Member, CCDHB CPHAC/DSAC committee Member, Greater Wellington Regional Council Member, Consumer New Zealand Board Deputy Chair, Consumer New Zealand Environment spokesperson and Chair of Environment committee, Wellington Regional Council Step son works in middle management of Fletcher Steel Member of Capital and Coast District Health Board Deputy Chair, Wellington Regional Strategy Committee Councillor, Greater Wellington Regional Council Director, Port Investments Ltd Director, Greater Wellington Rail Ltd Economic Development and Infrastructure Portfolio Lead, Greater Wellington Regional Council Member, Harkness Fellowships Trust Board Independent Consultant Brother-in-law is a medical doctor (anaesthetist), and niece is a medical doctor, both working in the health sector in Auckland Son is Deputy Chief Executive (insights and Investment) of Ministry of Social Development, Wellington Invited to join the Board of the Wesley Community Action Group. Member of Capital and Coast District Health Board Member, Medical Council of New Zealand (MCNZ) Member, Māori Heritage Council Board Member, Te Māngai Pāhō (Māori Broadcasting Agency) Board Member Eastern Institute of Technology Board Member Heritage New Zealand Alternate Crown Trustee, Crown Forestry Rental Trust Director, Taaua Ltd (Public policy and management consulting company) Trustee, Judith and Taina Ngarimu Whānau Trust (has shareholdings in various health related companies share acquisition and sale is independently managed) Capital & Coast District Health Board 3

4 CCDHB Public 20 September Item 1.3 Continuous disclosure Name Ms Ana Coffey Member Ms Eileen Brown Member Dr Kathryn Adams Member Ms Sue Driver Member Interest Member of Capital & Coast District Health Board Councillor, Porirua City Council Director, Dunstan Lake District Limited Trustee, Whitireia Foundation Member of Capital & Coast District Health Board Board member (until Feb. 2017), Newtown Union Health Service Board Employee of New Zealand Council of Trade Unions Senior Policy Analyst at the Council of Trade Unions (CTU). CTU affiliated members include NZNO, PSA, E tū, ASMS, MERAS and First Union. God daughter/family friend employed as a solicitor at specialist health law firm, Claro. Member, Capital & Coast District Health Board Fellow, College of Nurses Aotearoa (NZ) Reviewer, Editorial Board, Nursing Praxis in New Zealand School Nurse Vaccinator (casual) Regional Public Health, HVDHB Workplace Health Assessments and seasonal influenza vaccinator, Artemis Health Secretary, National Party Ohariu Electorate Director, Agree Holdings Ltd, family owned small engineering business, Tokoroa Community representative, Australian and NZ College of Anaesthetists Board Member of Kaibosh Daughter, Policy Advisor, College of Physicians Former Chair, Robinson Seismic (base isolators, Wgtn Hospital) Advisor to various NGOs Capital & Coast District Health Board 4

5 CCDHB Public 20 September Item 1.3 Continuous disclosure CAPITAL & COAST DISTRICT HEALTH BOARD Interest Register EXECUTIVE LEADERSHIP TEAM 20 SEPTEMBER 2017 Debbie Chin Chief Executive Officer Chris Lowry General Manager Hospital and Healthcare Services Rachel Haggerty General Manager, Strategy Innovation & Performance Donna Hickey General Manager, People and Capability Thomas Davis General Manager, Corporate Services Nigel Fairley General Manager of 3DHB Mental Health, Addictions and Intellectual Disability Services Mr John Tait Chief Medical Officer Catherine Epps Executive Director of Allied Health, Technical & Scientific Andrea McCance Executive Director of Nursing & Midwifery 20 September 2017 Member, Rotary Trustee, Wellington Hospitals Foundation DHB lead CE for sector performance frameworks Trustee on Life Flight Trust Board Son works at HVDHB Chair, Takanini Care Ltd Director, Haggety & Associates Partner is an employee of CCDHB Sister is a nurse, working for Plunket None President, Australian and NZ Association of Psychiatry, Psychology and Law Trustee, Porirua Hospital Museum Fellow, NZ College of Clinical Psychologists Director and shareholder, Gerney Limited Vice President RANZCOG Chair, National Maternity Monitoring Group Co-Chair Maternity Morbidity Working Group Member, ACC taskforce neonatal encephalopathy Member, Waikato Women s service taskforce Board member, Wellington Hospitals Foundation Board member Asia Oceanic Federation of Obstetrician and Gynaecology Deputy Chair, National DHB Directors Allied Health Expert Advisor (Leadership) to New Zealand Speech-Language Therapists Association Brother is employed at Waikato and Waitemata DHBs Partner is the Programme Manager for the Children s Hospital project Trustee, Mary Potter Hospice 5

6 CCDHB Public 20 September Item 1.3 Continuous disclosure Roger Palairet Chief Legal Counsel Shayne Hunter Chief Information Officer Technology, 3 DHB Dr Pauline Boyles Director of Disability Strategy and Performance Arawhetu Grey Director Māori Health Services/Manager Planning & Funding Mental Health and Addiction Services Taima Fagaloa Director of Pacific Peoples Health/Manager Planning & Funding, Child & Population Jannel Fisher Communications Manager Robyn Fitzgerald Board Secretary Chair and Trustee of Carers NZ (non-profit organisation promoting the interests of family carers; funders include MoH, MSD and Waitemata DHB) Sister-in-law is a paediatric nurse at CCDHB Currently in transition from a role at the Ministry of Health and assisting Rillstone Wells on the RHIP/CRISP review Member on the Ministry of Health National Advisory Group for Review of Behaviour Support Services Past President/ Advisor to Board, Wellington Riding for the Disabled Managing Director, Dream Achievers Ltd Co-chair, Health Quality Safety Commission Maternal Morbidity Working Group Director, Gray Partners Cousin works as a community health worker for Ora Toa Health Director, TCF Consulting Limited Mother-in-law and sister-in-law are a Bureau nurse and Healthcare assistant respectively Another sister-in-law is a nurse at CCDHB Daughter is a nurse at HVDHB 6

7 CCDHB Public 20 September Item 1.4 Draft Minutes 23 August 2017 CAPITAL AND COAST DISTRICT HEALTH BOARD DRAFT Minutes of the Board Held on Wednesday 23 August 2017 at 1.00pm Boardroom, Level 11, Grace Neill Block, Wellington Regional Hospital SECTION PRESENT: BOARD IN ATTENDANCE: STAFF: Mr A Blair (Chair) Dame F Wilde (Deputy Chair) Dr K Adams Ms E Brown Mr R Blakeley Mr R Jarrold Mr D Sykes Mrs S Driver Ms K Ngarimu Ms A Coffey Ms S Kedgley Mrs D Chin (Chief Executive) Mr J Tait (Chief Medical Officer) Mrs R Fitzgerald (Board Secretary) Mr T Davis (General Manager, Corporate Services Ms J Fisher (Communications Officer) Ms C Lowry (General Manager Hospital and Healthcare Services) Ms R Haggerty (Director, Strategy Innovation and Performance) Mr N Fairley (General Manager, 3DHB MHAIDS) Ms C Epps (Executive Director of Allied Health, Technical and Scientific Ms S Williams, Manager, Wellness and Long Term Conditions MEMBER OF : One member of the general public (left 2.10pm). 1 PROCEDURAL BUSINESS Item 1.1 Item 1.2 PROCEDURAL Karakia was led by Darrin Sykes. Chair, Andrew Blair, welcomed the general public, Board members and Executive team. APOLOGIES Nil. CCDHB Minutes 23 August

8 CCDHB Public 20 September Item 1.4 Draft Minutes 23 August 2017 Item 1.3 INTERESTS REGISTER OF INTERESTS The following Board members provided an update to the register of interests: Sue Kedgley has sold her Green Cross Shares. Kim Ngarimu is now a Board member of Eastern Institute of Technology and Heritage New Zealand Andrew Blair is no longer a Director of St Marks Women s Health (Remuera) Limited and Breastscreen Auckland Limited. CONFLICTS RELATED TO ITEMS ON THE AGENDA No other conflicts were foreshadowed in respect of items on the current agenda but there would be an additional opportunity at the beginning of each item for members to declare conflicts of interest. Action: 1. Board Secretary to make adjustments to Interest Register. Item 1.4 MINUTES OF PREVIOUS MEETING 28 June 2017 RESOLVED THAT: The minutes of the CCDHB Board meeting held on 28 June 2017, taken with the public present are confirmed as a true and correct record. Moved: Darrin Sykes Seconded: Roger Blakeley CARRIED Item 1.5 Item 1.6 MATTERS ARISING UPDATE Nil. ACTION LIST The reporting timeframes on the other open action items were NOTED. Item 1.7 CCDHB WORK PLAN 2017 Changes noted. Item 1.8 CHAIR S REPORT The Chair s verbal report was noted. Inward Mail Wellington Hospital Foundation (WHF) cheque of $4,347 for the purchase of a Welch Allyn Monitor for Kapiti Health Centre Wellington Hospital Foundation cheque of $6,656 for salary support towards the Protecting Vulnerable babies Brains research project State Services Commission re Crown Entity Chief Executive Remuneration Honourable Dr Jonathan Coleman, Minister of Health re the progress made by DHBs and Pharmaceutical Management Agency (PHARMAC) in implementing market share procurement approaches for hospital medical devices Wellington Hospital Foundation confirmation of the purchase of a Voyager Neonatal Transport Incubator (NZD$192,880.17) and a Stryker M1 Stretcher (NZD$10,049.00) for NICU funded by WHF and donated to CCDHB CCDHB Minutes 23 August

9 CCDHB Public 20 September Item 1.4 Draft Minutes 23 August 2017 The Medical Reference Group acknowledging the commitment, support and high regard for Debbie Chin, CEO who has recently resigned. Outward Mail: Wellington Hospital Foundation congratulating Bill Day and the volunteers of the WHF on achieving the overall winner of the 2017 Minister of Health Volunteer Awards. Wellington Hospital Foundation thanking them for their various donations. Meetings: Numerous meetings with the Ministry of Health, Treasury, the Health Minister and the Prime Minister regarding a new Children s Hospital leading up to the July 10 official announcement of the new build of the Children s Hospital. In attendance were the benefactor Mr Mark Dunajtschik, Ms Dorothy Spotswood, Prime Minister Hon Bill English; Minister of Health Dr Jonathan Coleman; Director- General of Health Chia Chuah, Board members, other dignitaries, guests, staff from the current Children and Paediatric wards, children from the Children s ward, and the general public MIF meetings with the Ministry of Health. Meetings Pending: 30 August CCDHB Board Workshop 4 September Joint CCDHB and HVDHB Workshop. The CEO and Chair of Wairarapa District Health Board have been invited to attend. Board Evaluation: Board and board member evaluation to be done electronically in October or November, facilitated by the Institute of Directors, and conducted consistently with a regional approach. The verbal report was received. Item 1.9 CEO S REPORT The paper was taken as read. The Board noted the report. 2 PRESENTATION Item 2.0 Wellington Hospital Foundation Handover of Voyager Neonatal Transport Incubator Mr Bill Day, Chair Wellington Hospital Foundation; Ms Rosemary Escott, Charge Nurse Manager of ICU, and Mr Albert Mahapure, Technician, and Sara Ellis. The Chair thanked Mr Day, the Wellington Hospital Foundation or the donation of the incubator and also congratulated Mr Day and the team of volunteers for achieving success at the 2017 Minister of Health Volunteer Awards. CCDHB Minutes 23 August

10 CCDHB Public 20 September Item 1.4 Draft Minutes 23 August 2017 Item 2.2 Shared Goals of Care Dr Mark Beehre, Consultant Physician in Internal Medicine and Dr Jonathan Adler, Palliative Care Consultant presented to the board. The Chair thanked Dr Beehre for his presentation and acknowledged the work that Dr Beehre, Dr Adler and others have been done in this area. The patient stories were examples of why we need to focus on the patient and their goals of care. 3 DECISIONS Item 3.1 Board schedule, workplan and committee memberships 2018 The paper was taken as read. The Board: a) Noted that the dates and timings of Hutt Valley District Health Board meetings will align with CCDHB, given that the two Boards have a shared Chair and FRAC Chair b) Noted to continue to hold FRAC meetings during the morning of the fourth Wednesday of each month, and Board meetings during the afternoon of that same day c) Noted that Hospital Advisory Committee (HAC) related business will be dealt with by the full Board at its meetings rather than through separate HAC meetings with HAC only meeting if required d) Noted that a separate paper will be presented to the Board recommending the DHB level and membership of the CPHAC and DSAC committees in 2018 e) Agreed to the current structure of committees f) Agreed to the memberships as set out in this paper for the statutory committees, FRACs, and RGG g) Agreed to proposed 2018 CCDHB Work plan. Moved: Roger Blakeley Seconded: Ana Coffey CARRIED Action: 2. Board members requested an extension before finalising the 2018 meeting schedule. Feedback to Chair and Board Secretary by 15 September. Item 3.2 CCDHB Birthing Facilities and Models of Care In attendance and presenting to the Board were Ms Suzi Hume, Ms Vida Rye, Ms Mary-Lou Harris, Ms Susan Lennox and Mr Duncan Abernethy representing Birth Hub a group of parents, midwives, childbirth educators, and other members of the Wellington birthing community who promote physiological birth and are advocates for the development of a home-like midwifery birth centre in the Wellington region. The Chair thanked the group for their presentation. The paper was taken as read. CCDHB Minutes 23 August

11 CCDHB Public 20 September Item 1.4 Draft Minutes 23 August 2017 The Board: (a) Noted that the majority of CCDHB women give birth at Wellington Regional Hospital (which provides primary, secondary and tertiary perinatal and maternity care), with 9.1% choosing one of the two available primary maternity units at Kenepuru Community Hospital and Kāpiti Health Centre. (b) Noted that a higher proportion of women living in Kāpiti Coast and Porirua utilise the primary birthing facilities and Māori and Pacific families are also more likely to choose primary birthing facilities. (c) Noted that there is consumer and interest group support for the development of an additional primary birthing unit close to the Wellington Regional Hospital. (d) Endorsed investigating the development of a primary birthing unit closer to the Wellington Regional Hospital. This investigation will include the completion of a feasibility study for consideration by the Board in February (e) Noted that the maternity workforce and women, and their families, will be engaged in the feasibility study. Moved: Ana Coffey Seconded: Sue Kedgley CARRIED Item 3.3 Proposal for establishment of a Citizens Health Council A member of the public, Ms Debbie Leyland had requested an opportunity to speak this paper and was invited to speak from the floor. Ms Leyland endorsed the proposal to establish a Citizens Health Council. The paper was taken as read. The Board: a) Agreed to the establishment of a Citizens Health Council b) Endorsed the draft terms of reference c) Noted that: The Chief Executive in consultation with the Board sponsor and any other delegated Board members, will appoint an interim Chair to help guide the establishment of the Board A workshop with key stakeholders will be held in September to finalise the structure of the Council Secretariat support for during and after the establishment phase will be provided by the Service Innovation and Planning Unit, and the Executive Leadership Team. Moved: Roger Blakeley Seconded: Sue Kedgley CARRIED Action: 3. The Citizens Health Council to provide an update to the Board. When established the advice to the Board should be on a regular basis by way of a written report and attendance of the Council Chair. 4 DISCUSSION 4.1 Health and Safety Monthly Report The paper was taken as read. CCDHB Minutes 23 August

12 CCDHB Public 20 September Item 1.4 Draft Minutes 23 August 2017 The Board: (a) Noted that the number of reported Health & Safety incidents has slightly decreased this month (b) Noted that there were no reported Notifiable Events this month, continuing a nine month trend (c) Noted MHAIDS had no lost time injuries in July while there were seven for the DHB overall, an increase of one from last month. (d) Noted 62.4% of employees have currently received the annual influenza vaccination (e) Noted the current Health and Safety Risks. The Board noted the report DHB MHAIDS Bi-monthly Update The paper was taken as read. The Board: a) Noted the Mental Health and Addictions work programme b) Noted the progress update from MHAID Service Advisory Group c) Noted the development of the Crisis Resolution Service. 4.3 Hospital and Healthcare Services Bi-monthly Update The paper was taken as read. The Board: (a) Noted improvements in acute flow are being achieved although high occupancy levels are impacting on patient flow, staff workloads and compliance with the Shorter Stays in ED target (b) Noted the electives health target was achieved for 2016/17 (c) Note the detailed planning for the ICU expansion is progressing (d) Noted significant improvements have been made in the Ophthalmology services which will improve access for patients and assist with managing the increasing demand. 5. INFORMATION Item 5.1 The Board: 2DHB Population Health Bi-monthly Update The paper was taken as read. (a) Noted the Regional Dental Service continues to improve performance on a number of key measures including pre-school enrolments and arrears (ensuring children receive their check up on time) (b) Noted that dental therapists applied fluoride varnish (a means of re-mineralising existing early caries and reducing the risk of new caries in children) to 84 percent of primary school enrolled with the service during 2016 CCDHB Minutes 23 August

13 CCDHB Public 20 September Item 1.4 Draft Minutes 23 August 2017 (c) Noted the Regional Dental Service has trialled offering school holiday/late night appointments as a way of reducing the amount of school-aged and pre-school children who are overdue for the annual check-ups; the trials in Porirua have been successful, and the service is planning on rolling this initiative out to other high deprivation areas in the next school holidays (d) Noted Regional Public Health (RPH) has established a formal working relationship Wellington Water Limited and the Greater Wellington Regional Council that will help to strengthen the management of drinking water safety by the three agencies (e) Noted that that the Well Homes service continues to receive a high number of referrals, which have increased following the implementation of an automated referral process in January 2017; (f) Noted that following a 2016 survey of schools, a working group developed a toolkit (based on that of MidCentral DHB) to help schools become water-only (g) Note the uptake of the Human Papilloma Virus (HPV) Gardasil vaccine by boys has been higher than estimated, with 73 percent of year eight boys in Capital & Coast DHB area, 75 percent in the Hutt Valley area, and ~79 percent in the Wairarapa DHB area having received their first vaccinations (h) Noted Breast Screening Central exceeded the 2016/17 target of 70 percent for all women (i) Noted that breast screening rates for Māori and Pacific women in the sub-region have increased since the 2014/15 year, while cervical screening rates have remained static; these women will continue to be a priority with concrete initiatives such as mobile screening and Saturday clinics being used to help ensure the gap reduces. The Board noted the report. Item 5.2 3DHB CPHAC/DSAC report (verbal) The Board noted the minutes of 3 July. 6. 0THER Item 6.1 Item 6.2 GENERAL BUSINESS Nil. RESOLUTION TO EXCLUDE THE The Board NOTED and RESOLVED to: (a) AGREE that as provided by Clause 32(a), of Schedule 3 of the New Zealand Public Health and Disability Act 2000, the public are excluded from the meeting for the following reasons: SUBJECT REASON REFERENCE Public Excluded Minutes Public Excluded Matters Arising from previous Public Excluded meeting Chair s report CEO s report For the reasons set out in the respective public excluded papers For the reasons set out in respective public excluded papers Papers contain information and advice that is likely to prejudice or disadvantage commercial activities and/or disadvantage negotiations 9(2)(i)(j) CCDHB Minutes 23 August

14 CCDHB Public 20 September Item 1.4 Draft Minutes 23 August 2017 FRAC report Children s Hospital Update Update on Total Energy Centre Resilience and Risk Mitigation Measures Sub-Regional Inter District Flows (IDFs) Sub-Regional Services Stocktake Mental Health Integration Plan Lowe Case Supreme Court decision Maintain legal professional privilege 9(2)(h) Moved: Andrew Blair Seconded: Roger Blakeley CARRIED The meeting closed at 3.12pm. 7 DATE OF NEXT MEETING 20 September 2017, 11 th Floor Board Room, Grace Neill Block, Wellington Regional Hospital. CONFIRMED that these minutes constitute a true and correct record of the proceedings of the meeting DATED this...day of Andrew Blair CCDHB BOARD CHAIR CCDHB Minutes 23 August

15 CCDHB Public 20 September Item 1.6 Action List Meeting Type: BOARD Action No Date of meeting Agenda item number P Board schedule, workplan and committee memberships 2018 P Proposal for establishment of a Citizens Health Council SCHEDULE OF ACTION POINTS MEETING Topic Action Designated to Provide feedback of draft 2018 CCDHB Meeting Schedule to Chair and Board Secretary The Citizens Health Council to provide regular feedback to the Board. Board members Dir SIP How dealt with Feedback Place into CEO s Report until Council established, then report direct to Board Delivery date September September 15

16 CCDHB Public 20 September Item 1.6 Action List CLOSED since last meeting 23 August 2017 Action No P0005 P0013 Date of meeting 26 April August 2017 Agenda item number 5.2 Population Health Update Topic Action Designate d to Provide traffic lights on issues such as rheumatic fever, dental work and breast screening. 1.3 Register of Interests Update Interest Register Board Secretary How dealt with Delivery date Dir SIP Paper September quarterly report update Edit register September P June DHB CPHAC/DSAC Recommendations Chair to bring the principles presented to CPHAC/DSAC to the next Board meeting. FRAC Chair Paper August 2017 P Health and Safety Monthly Report Management to synchronise Health and Safety reports between FRAC and the Board GM CS Discuss with FRAC Chair August 2017 P May Cognitive Institute Partnership P April Consumer Engagement and Consumer Council Management to provide further information on: Costs of program Obtain the value to the organisation of this programme from organisations who have participated in this programme Identify the measures of success that will be monitored. Provide terms of reference, work programme and timeline to Board GM PC Paper August 2017 Dir SIP Paper August

17 CCDHB Public 20 September Item 1.7 Work plan 2017 Capital & Coast Health District Health Board Workplan 2017 Regular monthly items: (Public) Chair s Report; CEO s Report; Health & Safety Report; Resolution to Exclude (Public Excluded): Chair s Report; CEO s Report; FRAC recommendations; FRAC minutes. January February March April May June July - cancelled August September October November December 2017 Board Loan rollover Integrated Support Disability Strategy Final Draft Annual Plan Final Draft Regional Annual Plan and Draft Annual Work services plan (Revised) 2017/18 Services Plan 2017/18 Capital Budget Report 2016/17 programme 2017/18 Sustainability Plans 17/20 DECISION CPHAC- DSAC membership and meeting timetable Insurance renewals Annual Planning Health System Plan Draft Annual Plan Overview Regional Services Plan Risk Management Children s Hospital Policy and Framework Business Case Public disclosures Risk Management ICU Business Case Policy CPHAC/DSDAC membership Cognitive Institute Partnership 3DHB Mental Health electronic client management system Conflict of management plan Long Term Investment Plan (LTIP) ICU and Surgery Business Case DHB Strategic Planning Board ½ day planning workshop 2018 Board Schedule and workplan 3DHB Healthy Food and Beverage Policy Allied Laundry AGM TAS AGM Surplus Property External Audit Comment [ ]: Added after 30 August Workshop Comment [ ]: 3DHB CEOs agreed to add to agenda. Commentary included in CEO s Report. Sustainability Plan Options 16/17 Sustainability Plan Options 16/17 Sustainability Plan Workforce DISCUSSION Quarterly performance report Quality and safety Quality and safety Quarter 3 performance report Porirua and Kapiti Community response Population Health update Health System Plan IDF and 3DHB stocktake Consumer Council Terms of Reference and project Population Health update Quarter 4 performance report Quality and Safety Quarter 1 performance report Population Health update Formatted: Indent: Left: -0.04" INFORMATION Hospital and Health Services update 3DHB provider arm MHAIDS update Hospital and Health Services update 3DHB provider arm MHAIDS update 3DHB funder arm MHAIDS update Hospital and Health Services update SIP update Bi-monthly Hospital and Health Services update 3DHB MHAIDS Bimonthly update SIP Bi-monthly update Bi-monthly Hospital and Health Services update including quality reporting 3DHB MHAIDS Bimonthly update including quality reporting SIP Bi-monthly update Include traffic lights on issues such as rheumatic fever, dental work and breast Bi-monthly Hospital and Health Services update Comment [ ]: Added to bi-monthly reporting regime as other directorates V2:24/1/

18 CCDHB Public 20 September Item 1.7 Work plan 2017 January February March April May June July - cancelled August September October November December screening 3D Mental Health Working Group Report Mental Health Integration Plan Comment [ ]: Included in August report Formatted: Indent: Left: -0.04", Space After: 0 pt, Line spacing: single Health & Safety Health & Safety Health & Safety Health & Safety Health & Safety Health & Safety Health & Safety Health & Safety Health & Safety Staff engagement survey Rheumatic fever Legal update Legal update Legal update Legal update CPHAC/DSAC update Disability Strategy/Equity 3DHB ICT update 3DHB ICT update 3DHB ICT update CPHAC/DSAC update Primary Birthing Mental Health, Addictions Unit Initiative and Intellectual Disability CPHAC/DSAC update Health of Older People/End of Life Care/Advanced Care Planning/Equity 3DHB CPHAC/DSAC Options paper CPHAC/DSAC update Public health, localities and social investment/equity Comment [ ]: Replaced with options paper Maori Partnership Board SRDAG SRPSHAG Goals of Care MPB Advance Care Planning (Patient story) Health and Safety Healthcare Homes Public Health Organisation - PHO Wellington Hospital Foundation (WHF)update SRDAG NZHPL Board only SRSPHAG WHF Comment [ ]: Removed as similar to Goals of Care PRESENTATION Emergency Preparedness Sapere Presentation (David Moore)` Service Reviews MHAID S patient story BOARD SITE VISITS 11.45am pm ICU Children s Facilities Visit Te Maara Board only meeting 5.00pm- 5.45pm V2:24/1/

19 CCDHB Public 20 September Item 1.9 Chief Executive's Report BOARD PROCEDURAL Date: 8 August 2017 Author Subject Debbie Chin, Chief Executive Capital & Coast DHB CHIEF EXECUTIVE S REPORT RECOMMENDATION It is recommended that the Board: a) Note the contents of this report. APPENDICES 1. Financial Summary. 1. FINANCIAL UPDATE 1.1 Financial overview The DHB has a board approved deficit target of ($21m) for the 2017/18 financial year. The DHB result for the period ending July 2017 is $176k favourable to budget and a deficit of ($525k). In July 2016 the variance was $104k favourable, with a deficit of ($288k). Activity movement compared to last year As reported in MoH MIF report Jul-17 Jul-16 Variances Month Months % change YTD 17/18 YTD 16/17 Variances YTD YTD % change Discharges 5,216 5, % 5,216 5, % Caseweights (Excl MH) 5,772 5, % 5,772 5, % Bed Days (calculated from Hours) 13,067 12,345 (722) -5.8% 13,067 12,345 (722) -5.8% Length of Stay (excluding day patients) (0.10) -2.6% (0.10) -2.6% ED Presentations 5,476 5,336 (140) -2.6% 5,476 5,336 (140) -2.6% ED Admissions 1,927 1,877 (50) -2.7% 1,927 1,877 (50) -2.7% Theatre Throughput (Hospital) 1,180 1, % 1,180 1, % Financial Results As reported in MoH MIF report Jul-17 Jul-16 Variances Month Months % change YTD 17/18 YTD 16/17 Variances YTD YTD % change Discharges 5,216 5, % 5,216 5, % Caseweights (Excl MH) 5,772 5, % 5,772 5, % Bed Days (calculated from Hours) 13,067 12,345 (722) -5.8% 13,067 12,345 (722) -5.8% Length of Stay (excluding day patients) (0.10) -2.6% (0.10) -2.6% ED Presentations 5,476 5,336 (140) -2.6% 5,476 5,336 (140) -2.6% ED Admissions 1,927 1,877 (50) -2.7% 1,927 1,877 (50) -2.7% Theatre Throughput (Hospital) 1,180 1, % 1,180 1, % Capital & Coast District Health Board 19

20 CCDHB Public 20 September Item 1.9 Chief Executive's Report 2 HEALTH TARGETS 2.1 Acute Flow Shorter stays in emergency department (SSiED) Target: 95% of patients will be admitted, discharged, or transferred from the Emergency Department within six hours SSIED and Flow Results CCDHB performance against the SSiED target for August 2017 was 92.0%. 95% of all patients presenting to the department were seen and discharged or transferred within 6.85 hours. This is a reduction from 8.15 hours last month and the lowest ever for the month of August as outlined in the graph below. The result is a significant improvement on the result for July 2017 and when compared with August This was despite an increase in presentations, a similar number of admissions and the same bed days as August There has also been a reduction in patients leaving ED before being seen, a reduction in corridor patients, and a reduction in complaints and aggression incidents in ED. The strategies implemented to manage over the busier winter months together with the improvement strategies under implementation has also seen a reduction in overall occupancy levels and has supported an improvement in patient flow across the organisation. CCDHB has been an outlier for this month compared to other DHBs who have suffered overcrowding to a greater extent. Other initiatives that have also supported improvement this month include: The trial in the interventional radiology ward where cardiology patients are being managed who would have previously been managed in the short stay unit (SSU) continues to be a success for the service providing capacity to improve wait times and therefore access for regional patients The trial of the ED Observation unit (previously known as the SSU) has also impacted on ED and reduced overcrowding MHAID has also increased the presence of an SMO in ED which has improved the response time for assessment and reduced the overall time in ED for MHAID patients Capital & Coast District Health Board 20

21 CCDHB Public 20 September Item 1.9 Chief Executive's Report 2.2 Elective Services Elective Discharges Health Target The DHB is 11 discharges ahead of the electives target for the month. This is comprised of 6 discharges below target for the elective surgery purchase unit and 17 discharges ahead of the elective and arranged non-surgical purchase unit. This has improved the YTD position to 58 discharges behind target. 76 more elective operations were performed in August compared to August last year. Of these there were 6% (39) more completed at WRH and 14% (37) more at Kenepuru. The greatest increases at WRH were Cardiothoracic up 121% (17) Neurosurgery up 45% (14). At Kenepuru Orthopaedic was up 77% (33) and Gynaecology up 63% (15) Elective Services Performance Indicator (ESPI) compliance August ESPI 2 (First Specialist Assessment), and ESPI 5 (specialist treatment) results are not yet confirmed by the MoH however our internal reporting identifies that we remain within the threshold for compliance Cardiothoracic waiting list Currently the cardiac waitlist is sitting at 55, 16 below the maximum of 71. Numbers have fluctuated between 55 and 68 during the month. There continues to be an issue with ICU capacity. The strategies to minimise this risk have been reviewed and a number of additional actions identified have been progressed. The service is actively balancing the treatment of patients within the clinical treat by date and length of time waiting overall. 2.3 Faster cancer treatment Day Cancer Target: Target 85% The target is that patients receive their first cancer treatment within 62 days of being referred with a high suspicion of cancer and the triaging clinician believes the patient needs to be seen within two weeks. The 62-day wait is measured from receipt of the referral to the date of the patient s first cancer treatment (or other management). From June 2017, 90% of patients meeting the criteria should commence treatment within 62 days. Approximately 25 per cent of newly-diagnosed cancer patients will be covered by the 62-day target. A large proportion of newly-diagnosed cancer patients will continue to access treatment through pathways not covered by the target. The Ministry of Health have also made changes to 2017/18 target definitions. Under new definitions, FCT records breaching the 62 day timeframe with a delay code of patient reason or clinical consideration will be removed from the denominator when calculating DHBs achievement level. With the redefined target in place CCDHB is currently sitting at 87.5%. Capital & Coast District Health Board 21

22 CCDHB Public 20 September Item 1.9 Chief Executive's Report Day Indicator Patients with a confirmed diagnosis of cancer to receive their first cancer treatment within 31 days. In August 67 patients were included at time of reporting. 64 patients (96%) were within the indicator timeframe with 88.4% achievement against the 31day indicator. Strategies to improve performance Work continues on the two key areas that are contributing to our current performance: Timeliness of triage and not all patients are being identified at the point of triage Variation in time for treatment for patients requiring surgery is impacted on by surgeon leave The process to support achievement of the 62 target has been mapped and improvements identified to ensure patients are identified early and systems are then in place to ensure they are seen as soon as possible. The areas of focus being worked on by the teams across the organisation include: Identification of patients with a high suspicion of cancer Systems and processes within the patient administration services are being redefined to support improved management of referral Processes are being implemented within specialties with high numbers of referrals of patients with a suspicion of cancer to ensure referrals are triaged in a more timely manner and patients identified earlier in the referral process Development of a prospective tracking tool to support the monitoring of patients once identified is also being progressed The booking of patients once triaged is also being reviewed to ensure patients can then be booked as soon as possible Improve production planning for first specialist assessments. This together with improved triage processes and flagging within the reports will ensure there are no delays in this stage of the journey. 2.4 Radiology CT and MRI Ministry of Health (MoH) Targets CT performance for August was 78% against a target of 95%. This is similar to performance in previous months Urgent CT Out Patient imaging results are available within the targeted 2 week timeframe. Routine out patient referrals are being scanned and reported within 8 weeks maximum against a 6 week target. MRI performance for July remains at 37% against a target of 85%. Output continues to increase however given the increasing demand; performance against the MOH indicator has remained at 37-40%. MRI and CT diagnostics are continuing to see a large increase in demand. This together with the number of staffing vacancies is impacting on access and waiting times. Workforce shortages in radiology are a national issue. A plan is in place to support an improvement in access and is currently under review. Actions include a continued focus on staff recruitment, use of capacity at Hutt Valley DHB and outsourcing to private. Discussions are being progressed with HVDHB that will support DHB of domicile scanning which will also relieve pressure on the service. This will then be extended across the region ensuring patients are scanned close to where they live where possible and improved Capital & Coast District Health Board 22

23 CCDHB Public 20 September Item 1.9 Chief Executive's Report utilisation of capacity across the region. Work also continues on demand and referral management strategies with the clinical teams. 3 CLINICAL UPDATE 3.1 Flu Vaccinations The final data for flu vaccinations for winter 2017 have been collated. Total uptake for CCDHB staff was 71%. This result is a really pleasing one, and reflects the additional effort to make use a roving vaccinator this year, as well as our usual use of champions, and multi-site clinics. This is the highest uptake for more than four years. 3.2 Growing our Workforce A number of staff have presented their work both nationally and internationally in recent weeks. A shining example was the work of Jo Walling on 'How healthcare professionals describe patient safety; explored differences between work imagined and work as done in NZ tertiary hospital acute care environments and the impact on safety culture' which she presented at The International Resilient Healthcare Meeting in Vancouver. 3.3 Implementing the new Nurse Prescriber Roles at CCDHB The first two nurse prescribers at CCDHB have also been able to commence in their new scope of practice this month. We have one nurse prescriber in the community, working in the area of diabetes health and longer term conditions in the Porirua region. The second one is in the acute hospital setting. 3.4 Clinical Council Papers to be reviewed by the Clinical Council in preparation for the September Board meeting are: Services for Young People with Alcohol and Other Drugs and Co-Existing Mental Health problems, and Community Verification of Death. A verbal report will be given to the Board as the September Clinical Council meeting date is scheduled after the Board report has been finalised. 3.5 Open for Leadership Award Wellington Regional Hospital physiotherapist Tom Bond s new rehabilitation monitoring tool for long-stay intensive care unit (ICU) patients has won him a Health Quality & Safety Commission (HQSC) Open for Leadership award. Associate Health Minister Peter Dunne presented the award to Tom at Wellington Hospital this morning. So often in health, we focus on pouring money and energy into amenities and equipment, and we forget how crucial the people are. It s people like you who contribute significantly to this sector, Minister Dunne told Tom. The driver behind the establishment of the tool was the lack of any consistent measurement tool or method of passing on information specific to the rehabilitation progress of long-stay ICU patients. Capital & Coast District Health Board 23

24 CCDHB Public 20 September Item 1.9 Chief Executive's Report 4 COMMUNICATIONS ACTIVITY 4.1 Media Media enquiries and releases There were 53 media enquiries in August. Around 28 percent related to patient condition updates. Key matters for the other media enquiries were: Influenza hospitalisation rates Mental health (various aspects) Five pitches and media releases were issued. Coverage includes: A transplant in a heartbeat: the heart surgery that has you out of bed a day later * Major expansion plans for Wellington Hospital ICU will add six beds * Bigger and better ICU for Wellington CCDHB to add six ICU beds * Front page of Dominion Post print edition. 4.2 OIA requests 4.3 Website Requests received in August 20 Requests sent in August 26 Responses sent on time 60% In August, the website was visited 62,484 times by 26,890 people. Visitor numbers were comparable with July traffic. Capital & Coast District Health Board 24

25 CCDHB Public 20 September Item 1.9 Chief Executive's Report The 5 most visited website pages in August were: Website page Page views Staff login 41,979 (32%) Homepage 32,439 (27%) Careers 5,531 (4%) Wellington Regional Hospital 3,609 (3%) Search 3,566 (3%) 4.4 Social media The number of people following us on Facebook continues to increase and is now just under 2,000. Our number of page likes rose by 6% during August. The post which reached the most people in August was about Wellington physiotherapist Tom Bond receiving an HQSC award. Capital & Coast District Health Board 25

26 CCDHB Public 20 September Item 1.9 Chief Executive's Report 4.5 Internal communications Health Matters staff newsletter The latest copy of the Health Matters staff newsletter is attached as appendix 1. The August edition includes articles about: Leading the way on infection control Tips on how to manage stress EECA partnership assists with energy savings Keeping patient information safe when ing Big tick to move forward with CCDM programme Internal campaigns The hand hygiene campaign continued in August. We also promoted International Language Day and the importance of using interpreters for deaf patients. Capital & Coast District Health Board 26

27 CCDHB Public 20 September Item 1.9 Chief Executive's Report 5 HEALTHY FOOD AND BEVERAGE GUIDELINES Since 2015, the 3DHBs have implemented the 3DHB Food and Beverage Environments Guidelines. This has been successful and five of the six implementation phases have been completed. The Guidelines have created healthier food environments in our hospitals and changed the offerings of our food vendors, with the healthy choice now predominantly being the easy choice. A national network of DHBs and other stakeholder representatives has developed a nationally consistent National Healthy Food and Drink Policy for use across DHB settings (and potentially other settings). Our Executive Team has approved the move to align our DHB with this National Capital & Coast District Health Board 27

28 CCDHB Public 20 September Item 1.9 Chief Executive's Report Policy with one exception: the National Policy allows the sale of still/carbonated drinks sweetened with intense sweeteners (i.e. artificially sweetened ) of 300ml, but we intend to continue not providing artificially-sweetened drinks here as per our current position. An implementation group will be formed and over the next nine to twelve months, will align the 3DHBs with the national policy, while retaining the 3DHB position of no sugar-sweetened beverages or artificially sweetened carbonated, e.g. 'lite' or 'diet', beverages. We will update the Board once this is completed with a view to confirming the current guidelines as the DHB s policy. 6 CLIENT PATHWAY PROJECT UPDATE The MHAIDS 3DHB Client Pathway Project is implementing a new Client Pathway and the ICT solutions that will enable it. The Client Pathway project, including the process improvements and development and implementation of supporting ICT enablers was formally established in June 2017, after budget approval by the 3 District Health Boards. Work was carried out designing the new Client Pathway process and identifying requirements for some of the system functionality required to support it before the Project was formalised via the establishment of a Steering Group and their approval of a Project Terms of Reference. The Client Pathway recognizes the specific needs of all sectors working in mental health, addictions and intellectual disability. It provides a guide for a person s experience of engaging with MHAIDS, and establishes expectations for the consistent processes staff will use when supporting a person. The key principle being followed in implementing this interim digital solution is ensuring that as much as possible of a person s mental health record is available in one place, to ensure staff can access the correct information, no matter where they are located or when they wish to access it. The Project is being managed in stages. The first formalised Stage is drawing to a close, identifying how long development and implementation is expected to take. The key deliverables are: o o o o Client Pathway process design the foundation pathway has been confirmed and work is underway testing lower level processes, and how the changes will work in the different sectors and teams. ICT enablers Online MHAIDS Progress Note: a version of this is in use by the general medical community nurses within Allied Health, CCDHB. An updated version is being developed which will be rolled out to HVDHB Allied Health, and which will incorporate improvements identified for the final version that will be used by MHAIDS. Intake and Initial Assessment SMTs: these have been designed as prototype forms ready for testing. Transfer of Care SMTs: a simple form to aid understanding of where a person s transfer of care is at a point in time is in development. Living Comprehensive Assessment/Treatment Plan documents: these documents will be developed by external software provider Whanau Tahi. Estimates of costs and timeframes are being worked through. Additional devices and network infrastructure upgrade being analysed and confirmed to ensure they will meet the needs of the revised pathway and its ICT enablers. Capital & Coast District Health Board 28

29 CCDHB Public 20 September Item 1.9 Chief Executive's Report Staff training a training plan is being developed and timeframes are being estimated. 7 CITIZEN S HEALTH COUNCIL In August the Board endorsed the establishment of a Citizens Health Council (the Council) and agreed the proposed Terms of Reference (ToR). A Workshop to consider the ToR and appointment process to the Council was held 13th September at CCDHB. The workshop involved delegated board members, clinical partners and governance advisory group partners. Recommendations will be presented to the Board at its October 2017 meeting. 8 EMPLOYEE ENGAGEMENT SURVEY The report on the Staff Engagement Survey was reported at the June 2017 Board meeting. The areas identified requiring the most focus were: Development opportunities for our Allied Health Scientific and Technical and non-clinical profession groups Supporting staff to cope with the demands of their work Eliminating bullying and unwarranted behaviour in our workplace Ensuring quality communication. Management will provide an update at the Board meeting. Capital & Coast District Health Board 29

30 CCDHB Public 20 September Item 1.9 Chief Executive's Report Capital & Coast DHB Board Financial Overview July 2017 Debbie Chin, Chief Executive Officer Tony Hickmott, Chief Financial Officer CCDHB Financial Overview Page 1 July

31 CCDHB Public 20 September Item 1.9 Chief Executive's Report FINANCIAL PERFORMANCE RESULT AND OVERVIEW Summary The DHB has a board approved deficit target of ($21m) for the 2017/18 financial year. The DHB result for the period ending July 2017 is $176k favourable to budget and a deficit of ($525k). In July 2016 the variance was $104k favourable, with a deficit of ($288k). The DHB activity related revenue for July is set to budget due to roll over of national collection and coding systems. Result for Period ended Jul 2017 Jun 2017 Year to Date 2017/18 Account Type in $000s Actual Budget Variance Actual Budget Variance Annual Budget Revenue 89,852 90,100 (248) 89,852 90,100 (248) 1,076,515 Labour Costs 37,447 38, ,447 38, ,935 Outsourced Services 1,928 1,927 (1) 1,928 1,927 (1) 23,621 Clinical Supplies 10,265 10,226 (39) 10,265 10,226 (39) 118,545 Infrastructure & Non-Clinical 9,879 9,637 (242) 9,879 9,637 (242) 113,260 Other Providers 30,858 30, ,858 30, ,153 Total (525) (701) 176 (525) (701) 176 (21,000) YTD Variances against Budget Revenue Unfavourable ($248k) against budget. The DHB has a stretched IDF revenue target of $125k for the month, which has yet to be realised. The other areas contributing to the unfavourable variance are revenues from non residents and other patient co-payments ($70k), and donations ($86k). Labour Costs- Favourable $703k against budget, made up of medical $302k, nursing $130k, Allied $98k and $174k in support and management /admin due to vacancies and some reduction in annual leave provision. Infrastructure & Non Clinical - Unfavourable ($238k) against budget, due to stock adjustments, increased recovery of special funds, and costs of sustainability projects. CCDHB Financial Overview Page 2 July

32 CCDHB Public 20 September Item 1.9 Chief Executive's Report External Providers Review Month - July 2017 Variance Capital & Coast DHB - Funder Ext Provider Payments - $000s Year to Date Variance Actual vs Budget Actual vs Last year YTD July 2017 The external provider payments are as per plan. The main drivers for these variances are: Actual vs Budget Actual vs Last year Actual Budget Last year Actual Budget Last year External Provider Payments: 5,557 5,570 6, Pharmaceuticals 5,557 5,570 6, Laboratory Transition ,545 5,481 5,152 (64) (394) - Capitation 5,545 5,481 5,152 (64) (394) 1,749 1,692 1,467 (56) (281) - ARC-Rest Home Level 1,749 1,692 1,467 (56) (281) 3,735 3,794 3, ARC-Hospital Level 3,735 3,794 3, ,590 1,629 2, Other HoP 1,590 1,629 2, ,819 1,839 1, Mental Health 1,819 1,839 1, Palliative Care/Fertility/Comm Rad ,171 2,163 2,300 (8) Other 2,171 2,163 2,300 (8) 129 7,995 7,995 6,916 0 (1,079) - IDF Outflows 7,995 7,995 6,916 0 (1,079) 30,858 30,861 31, Total Expenditure 30,858 30,861 31, Capitation costs are ($64k) adverse mainly due to MOH unbudgeted programmes (mainly Care-Plus Services, VCLA and free under 13). These are all offset by MoH additional revenue for new contracts. ARC rest home and hospital services have a net favourable variance. Services are volume driven and subject to a review process. CCDHB Financial Overview Page 3 July

33 CCDHB Public 20 September Item 1.9 Chief Executive's Report Employee FTE Financial Reporting to Ministry of Health (MOH Accrued FTE) For financial accounting purposes MOH require an accrued FTE measure (as shown in the table below). This measure includes all hours on an accrual basis including leave accruals, overtime and casual hours. As an FTE measure this is highly volatile for a 24/7 facility due to the divisor being set based on the number of working days in the month. The year to date total is an average for the year. The average dollars per FTE year on year is impacted by MECA increases. Month - July 2017 Variance Capital & Coast DHB MOH Accrued FTE Year to Date Variance Actual vs Budget Actual vs Last year YTD July 2017 Actual vs Budget Actual vs Last year Actual Budget Last year Actual Budget Last year FTE (2) (8) Medical (2) (8) 2,324 2,324 2,227 1 (97) Nursing 2,324 2,324 2,227 1 (97) (31) Allied Health (31) (6) Support (6) (36) (12) Management & Administration (36) (12) 4,881 4,855 4,728 (25) (153) Total FTE 4,881 4,855 4,728 (25) (153) Average $ per FTE 13,382 13,868 13, (378) Medical 13,382 13,868 13, (378) 6,530 6,582 6, (13) Nursing 6,530 6,582 6, (13) 6,308 6,360 6, (91) Allied Health 6,308 6,360 6, (91) 4,333 4,298 4,173 (35) (160) Support 4,333 4,298 4,173 (35) (160) 5,744 6,365 5, (63) Management & Administration 5,744 6,365 5, (63) 7,489 7,715 7, (77) Cost per FTE all Staff 7,489 7,715 7, (77) CCDHB Financial Overview Page 4 July

34 CCDHB Public 20 September Item 1.9 Chief Executive's Report CCDHB STATEMENTS OF FINANCIAL POSITION Jun -17 Actual Actual Budget At July 2016 Month : July 17 At June 2017 Actual vs Budget Variance Actual vs Jul Bank 20,302 26,082 20,534 11,943 20,302 5,548 14,139 1 Bank NZHP 8,409 8,664 8,409 7,583 8, ,081 1 Trust funds 43,962 43,335 44,690 40,327 43,962 (1,356) 3,008 2 Accounts receivable 8,602 8,108 8,602 7,108 8,602 (494) 1,001 Inventory/Stock 5,632 7,543 5,632 4,920 5,632 1,910 2,623 2 Prepayments 87,009 93,833 87,969 71,974 87,009 5,863 21,859 Total current assets 466, , , , ,918 (2,379) (14,637) Fixed assets Not es Capital & Coast DHB Balance Sheet YTD July ,859 9,859 8,360 4,862 8,360 1,499 4,997 Work in Progress - CRISP 5,613 6,715 9,557 17,431 15,472 (2,842) (10,716) Work in progress 481, , , , ,750 (3,721) (20,356) 3 Total fixed assets 6,468 6,468 6,468 6,468 6,468 (0) 0 Investments in New Zealand Health Partnership 1,150 1,150 1,150 1,150 1, Investment in Allied Laundry 7,618 7,618 7,618 7,618 7, Total investments 576, , , , ,377 2,142 1,504 Total Assets Bank overdraft HBL 66,440 69,171 67,619 60,591 66,440 (1,552) (8,580) 4 Accounts payable, Accruals and provisions , ,000 7 Loans - Current portion 0 2,057 2, (1,434) 6 Capital Charge payable (593) Insurance liability 20,969 19,984 20,969 15,614 20, (4,370) 5 Current Employee Provisions 45,507 45,034 45,507 41,921 45, (3,113) 5 Accrued Employee Leave 11,819 14,077 11,819 11,859 11,819 (2,258) (2,217) 5 Accrued Employee salary & Wages 145, , , , ,654 (1,963) 41,693 Total current liabilities , ,326 7 Crown loans 8,488 8,746 8,488 7,757 8,488 (258) (989) Restricted special funds (376) Insurance liability 5,868 5,868 5,868 5,765 5,868 0 (103) Long-term employee provisions 15,263 15,521 15, ,379 15,263 (258) 275,858 Total non-current liabilities 160, , , , ,917 (2,221) 317,552 Total Liabilities 415, , ,759 95, ,460 (79) 319,055 Net Assets 773, , , , , ,339 7 Crown Equity (3,484) (3,484) 0 0 Capital repaid Deficit support Capital Injection 23,677 23,351 23,677 23,255 23,677 (326) 96 Reserves (377,968) (378,494) (378,669) (353,113) (377,968) 175 (25,380) Retained earnings 415, , ,759 95, ,460 (80) 319,055 Total Equity CCDHB Financial Overview Page 5 July

35 CCDHB Public 20 September Item 1.9 Chief Executive's Report Month : July 17 Actual Budget Last year Actual vs Budget Variance Actual vs Last year No tes Capital & Coast DHB Statement of Cashflows Operating Activities YTD July 2017 Actual Budget Last year Actual vs Budget Actual vs Last year 92,517 92,303 92, Receipts 92,517 92,303 92, Payments 34,051 38,570 34,469 4, Payments to employees 34,051 38,570 34,469 4, ,424 50,758 53,568 (1,666) 1,144 Payments to suppliers 52,424 50,758 53,568 (1,666) 1, Capital Charge paid (878) 258 1,910 1,136 2,788 GST (net) (878) 258 1,910 1,136 2,788 85,596 89,586 89,947 3,989 4,351 Payments - total 85,596 89,586 89,947 3,989 4,351 6,921 2,718 2,061 4,203 4,860 8 Net cash flow from operating Activities 6,921 2,718 2,061 4,203 4,860 Investing Activities Receipts - Interest (70) 0 (70) 0 Receipts - Other 0 (70) 0 (70) (26) 95 Receipts - total (26) 95 Payments 0 (70) (351) (70) (351) Investment in associates 0 (70) (351) (70) (351) 962 2,500 3,064 1,538 2,102 Purchase of fixed assets 962 2,500 3,064 1,538 2, ,430 2,713 1,468 1,751 Payments - total 962 2,430 2,713 1,468 1,751 (886) (2,380) (2,542) 1,442 1,846 9 Net cash flow from investing Activities (886) (2,380) (2,542) 1,442 1,846 Financing Activities Equity - Capital Other Equity Movement (27) 0 (27) 0 Other 0 (27) 0 (27) 0 0 (27) Receipts - total 0 (27) Payments Year to Date Variance Interest payments Payments - total (35) Net cash flow from financing Activities 0 (35) , (481) 5,680 6,706 Net inflow/(outflow) of CCDHB funds 6, (481) 5,680 6,706 28,812 28,812 20,100 0 (8,712) Opening cash 28,812 28,812 20,100 0 (8,712) 92,593 92,326 92, Net inflow funds 92,593 92,326 92, ,558 92,094 92,660 5,466 6,102 Net (outflow) funds 86,558 92,094 92,660 5,466 6,102 6, (481) 5,680 6,706 Net inflow/(outflow) of CCDHB funds 6, (481) 5,680 6,706 34,847 29,044 19,619 5,803 15,228 Closing cash 34,847 29,044 19,619 5,803 15,228 CCDHB Financial Overview Page 6 July

36 CCDHB Public 20 September Item 1.9 Chief Executive's Report Notes to the Balance Sheet and Cashflows A) Notes to Balance Sheet: 1. The DHB s cash balance at the end of July is higher than budget mainly due to timing differences. All surplus funds are invested by New Zealand Health Partnerships in short term investments; 2. Accounts receivable is lower than budget due to timing differences. Some of the main customers include Ministry of Health $3.9m, Hutt Valley DHB $1.7m, ACC $0.4m; 3. Total non-current assets is less than budget due to less than expected capital spend; 4. Accounts payable, accruals and provisions is higher than the budget due to timing differences. Some of main suppliers include Marsh $1.8m, Healthcare Logistics $0.5m, various SIDU related accruals $24m; 5. Accrued employee salary & wages is higher than budget due to MECA settlements. 6. Crown loans and equity are in line with budget. The comparative previous year balances are different due to the conversion of all Crown loans to equity in February B) Notes to Cash flow statement: 1. The net cash flow from operating activities is higher than budget due to timing differences; 2. The net cash flow from investment activities is less than the budget due to less than expected capital spend; 3. The net cash flow from financing activities is in line with the budget. C) Ratios 1. Current Ratio This ratio determines the DHB s ability to pay back its short term liabilities. DHB s current ratio is 0.62 (June 17: 0.62); 2. Debt to Equity Ratio - This ratio determines how the DHB has financed the asset base. DHB s total liability to equity ratio is 29:71 (June 17 27:73). CCDHB Financial Overview Page 7 July

37 CCDHB Public 20 September Item 1.9 Chief Executive's Report Cash Forecast We have projected our cash position based on the proposed capital budget and a forecast deficit of $21m for 2017/18. However, any deterioration in these forecasts may put the facility limit at risk and we continue to monitor this closely. The working capital facility limit is approximately $55m. CCDHB Financial Overview Page 8 July

38 CCDHB Public 20 September ADVISORY COMMITTEE MĀORI PARTNERSHIP BOARD Ma Tini, Ma Mano, Ka Rapa Te Whai ADVISORY COMMITTEE REPORT Date: September 2017 Author Endorsed by Subject Teresa Wall, Chair, Māori Partnership Board Arawhetu Gray, Director Māori Health Services, Manager Mental Health and Addictions Funding and Planning UPDATE FROM THE CCDHB MĀORI PARTNERSHIP BOARD RECOMMENDATION It is recommended that the Board: a) Note the contents of this paper. 1. PURPOSE This paper updates the Capital and Coast District Health Board (CCDHB) members on matters that have been discussed and progressed at the Māori Partnership Board (MPB) meetings of 12 April and 14 July UPDATES FROM THE MPB 2.1 Change in Chair At the Māori Partnership Board meeting of 12 April 2017, Jack Rikihana stood down as Chair and I was nominated. The nomination was endorsed by the Māori Partnership Board. 2.2 Partnership Agreement between the MPB and the Board of CCDHB At the last Capital and Coast District Health Board meeting that the Māori Partnership Board attended, Jack Rikihana provided the Board with a short introduction of the Māori Partnership Board, and a brief description of the agreement with the Capital and Coast District Health Board. The Māori Partnership Board has been reviewing the agreement to ensure that it is fit for purpose. Most of the agreement is still useful but it was agreed that the purpose, the principles, and the roles and responsibilities needed to reflect the governance role of the Māori Partnership Board. The current agreement purpose, principles, roles and responsibilities makes the Māori Partnership Board responsible and accountable for the improvement of Māori health in the district of Capital and Coast, and this is inappropriate. The purpose of the agreement has been redrafted to better reflect the legislative requirements of District Health Boards with respect to Māori, and how the agreement with the Māori Partnership Board might assist Capital and Coast District Health Board, and reads: the purpose of the agreement is to establish and maintain processes to enable Māori to participate in, and contribute to, strategies for achieving Māori health equity and improvement, and provide a forum to enable Māori to influence health decisions. Capital & Coast District Health Board Page 1 [September 2017] 38

39 CCDHB Public 20 September ADVISORY COMMITTEE The principles have been refined with a focus on facilitating an excellent working relationship that will evolve and mature over time on the basis of mutual respect and understanding, and includes: Rangapuu Hui Tahi Whakapono Tika Mana Tangata Partnership Consultation Good Faith Honesty Integrity There have also been changes to the roles and responsibilities so that they give effect to the purpose and principles set out in the agreement, concentrating on achieving Māori health equity and improvement: providing input and support to setting Capital and Coast District Health Board s strategic direction for Māori health support organisational Māori leadership support organisational accountability and transparency bring depth and breadth of understanding of Māori concerns/issues contribute diverse Māori views to assist wise decisions, and support Capital and Coast District Health Board to manage Māori stakeholder relationships, as required The agreement re-affirms that there will be two representatives from the three Iwi Te Atiawa, Ngati Toa Rangatira and Te Atiawa ki Whakarongotai, and from Taura Here (Māori people who live in the area but do not whakapapa to mana whenua). It was agreed that the three Iwi would nominate Taura Here representatives, and that the Māori Partnership Board would make the final selection. Nominations from the Iwi needed to include a supporting letter from the Iwi, a copy of the candidate s CV, along with evidence that the candidate has most of the following attributes (at least four): 1. Proven ability to influence 2. Evidence of knowledge of the health sector 3. Can demonstrate strategic and analytical thinking 4. Knows how to influence policy and strategy 5. Has links to Māori /Iwi, and 6. Demonstrates an understanding of the social determinants of health. 2.3 Representation on Advisory Committees It was agreed that Dr Tristram Ingham continue to be the Māori Partnership Board representative on the CPHAC/DSAC committee. A letter of confirmation was sent to the Chair of the 3DHB CPHA and DSA Committees, Dame Fran Wilde. As Chair, I would represent Capital and Coast DHB Māori Partnership Board on Te Whiti Ki te Uru, the collective central region Māori iwi relationship group. Jack Rikihana and I would attend RAGM - the Research Advisory Group Māori. 2.4 Māori Relationship Arrangements in the Hutt Valley District Health Board The Māori Partnership Board was asked to consider the appropriateness of it exercising a similar role with the Hutt Valley District Health Board (HVDHB). After consultation with Ngati Toa Rangatira and Te Capital & Coast District Health Board Page 2 [September 2017] 39

40 CCDHB Public 20 September ADVISORY COMMITTEE Atiawa, it was advised that a Māori relationship arrangement with the HVDHB needed to comprise representatives from Ngati Rangatahi, Te Atiawa and Ngati Toa Rangatira, and Taura Here. 2.5 Priorities for the CCDHB and MPB 2017/18 At the last Capital and Coast District Health Board meeting that the Māori Partnership Board attended, Jack Rikihana and I suggested that the following areas be the priorities for Capital and Coast District Health Board with the support of the Māori Partnership Board in the coming year: What is CCDHB doing to ensure that its workforce reflects the population makeup of the community that they serve? What is CCDHB doing to achieve equity for Māori? How is CCDHB purchasing for improved Māori outcomes? The Māori Development Group is developing a work programme to increase effort across the organisation to achieve equity for Māori, and other population groups. Dame Fran Wilde is attending the 13 September Māori Partnership Board meeting to talk about the committee and its focus on equity. At the meeting Dr George Gray will be presenting Trendly. Trendly is a health performance monitoring website, its major transformative purpose is to improve health outcomes for all New Zealanders by: providing the right information, to the right people. Board members might like a verbal update on Trendly and the discussion with Dame Fran Wilde held at the 13 September meeting. Capital & Coast District Health Board Page 3 [September 2017] 40

41 CCDHB Public 20 September DECISION BOARD DECISION 11 September 2017 Authors Endorsed By Subject Rachel Haggerty, Director, Strategy Innovation and Performance, CCDHB Helene Carbonatto, HVDHB Nigel Broom, Wairarapa DHB Adri Isbister, Chief Executive, Wairarapa District Health Board Ashley Bloomfield, Chief Executive, Hutt Valley District Health Board Debbie Chin, Chief Executive, Capital & Coast District Health Board REFRESHING THE 3DHB CPHAC-DSAC APPROACH RECOMMENDATIONS It is recommended that the Boards: 1. Note that on 1 September 2017 CPHAC-DSAC discussed whether the current 3DHB model for these statutory committees is meeting the needs of individual DHBs and endorsed the following recommendations for Boards to consider a) Note that CPHAC-DSAC as a combined 3DHB Committee is challenged to effectively fulfil its obligations to each of the DHBs in a meaningful way and concerns have been raised by members and DHB planning and funding teams b) Agree that DSAC is retained as a 3DHB Committee, meeting quarterly, with a focus on relevant areas managed and delivered across the sub-region being mental health and disability support services c) Agree that CPHAC is managed locally at an individual DHB level enabling a focus on the health needs of local populations including equity, enabling prioritisation of localised health strategies and investment requirements d) Invite the three Chief Executives to consider how strategic planning across the sub-region can be advanced, and discussed and monitored at a Governance level, should Boards agree to implement three local Community and Public Health Advisory Committees. 2. Agree that any changes take effect from the start of the 2018 calendar year. 1 PURPOSE This paper advises Boards of the outcome of the Community Public Health Advisory (CPHAC) and Disability Advisory Committee (DSAC) discussion on 1 September 2017 about the optimal approach to obtaining the best value from CPHAC-DSAC and the challenges of a 3DHB model for these statutory committees. 2 BACKGROUND The appended paper was considered by CPHAC-DSAC on 1 September to inform a discussion about concerns that the 3DHB model for CPHAC-DSAC was no longer meeting the needs of individual DHBs following the re-establishment of separate planning and funding functions. The paper proposes a return to individual CPHACs for each DHB while retaining a sub-regional DSAC to support Boards oversight of disability support services and mental health services. Wairarapa, Hutt Valley and Capital & Coast District Health Board 41

42 CCDHB Public 20 September DECISION 2.1 CPHAC-DSAC Discussion The paper generated wide ranging discussion from members, recognising the challenges associated with servicing a 3DHB Committee in the new environment of separate planning and funding teams. This requires a focus on both district service commissioning and integration and sub-regional planning and service development. There is limited opportunity for the Committee to genuinely advise on the direction and outcomes of initiatives within each DHB.. At the same time, members were also concerned about the loss of a 3DHB forum to shape and guide opportunities for collaboration, collective activity and strengthened integration where appropriate. There was widespread agreement that there needs to be an on-going focus on subregional approaches and planning outside of a CPHAC approach. Staff noted the extent to which the three DHBs are working collectively across a range of initiatives outside of the CPHAC-DSAC process and considered there are a range of formal and informal opportunities for collaboration. The 3 DHBs are involved in a wide range of subregional planning activities together including complex care arrangements, mental health services, planning for the new Children s hospital at CCDHB, HVDHB s Clinical Services Plan and many more. There was some interest in why a 3DHB approach to DSAC remained feasible if it wasn t working for CPHAC. The Committee discussed the difference in service delivery and planning approaches, where there is a clear 3DHB planning and monitoring arrangement for disability giving DSAC a stronger mandate to influence the direction of the service. Similarly with mental health, there is a 3DHB MHAIDS service that ensures we are collectively involved in future planning, though there is also a strong work programme of local integration being developed. In other areas, the main (but not exclusive) focus of planning work is local, with the respective planning and funding teams advancing different service improvements and approaches to cater to local needs and priorities. In these cases, CPHAC s ability to make recommendations to the individual Boards is restricted. The Committee agreed to endorse the three recommendations put to it and recommend to respective Boards: Note that CPHAC DSAC as a combined 3DHB Committee is challenged to effectively fulfil its obligations to each of the DHBs in a meaningful way and concerns have been raised by members and DHB planning and funding teams. A paper was requested by CPHAC DSAC to consider the issues. Recommend to their respective Boards that DSAC is maintained at a sub-regional level, meeting quarterly, and focus on those areas managed and delivered across the sub-region being mental health and disability support services. Recommend to their respective Boards that CPHAC is managed locally at an individual DHB level enabling a focus on the needs of local populations including equity, enabling prioritisation of localised health strategies and investment requirements. Alongside the above recommendations, the Committee also resolved to recommend that the three Chief Executives consider how strategic planning across the sub-region continues to be advanced, and discussed and monitored at a governance level, should the respective Boards agree to move to local CPHAC structures. Wairarapa, Hutt Valley and Capital & Coast District Health Board 42

43 CCDHB Public 20 September FOR DISCUSSION BOARD DISCUSSION Date: 11 September 2017 Author: Endorsed By: Dave Lewis, Health & Safety Manager Thomas Davis, General Manager Corporate Services Subject: CCDHB HEALTH AND SAFETY REPORT (FOR THE MONTH OF AUGUST 2017) RECOMMENDATIONS It is recommended that the Board: a) Note the number of reported Health & Safety incidents has decreased slightly this month b) Note that there were no reported Notifiable Events this month, continuing a ten month trend c) Note the number of incidents resulting in lost time injuries has decreased for General incidents and slightly increased for MHAIDS d) Note 71% of employees have received the annual influenza vaccination compared with only 58% last year. e) Note the current Health and Safety Risks. All information accurate at time of report production 01/09/2017 EXECUTIVE SUMMARY 1. RISK REGISTER There are currently 14 active health and safety risks identified on the risk register. One new risk has been added: - The on-going increase in demand and complexity of CT & MR referrals along with the pressure to meet MOH waitlist targets has led to staff working additional hours. This is leading to increased and unsustainable risk to staff wellness. The H&S risk register is available in pages of the August Risk Report. 2. INCIDENTS Higher reporting indicates a stronger health and safety culture and provides a more realistic picture of the exposure to hazards experienced by our workers. It is the actual work injury claims that accurately reflect the level of harm that is occurring. Physical assaults on workers were the highest category of reported incident, with blood and body fluid exposure incidents second. The number of incidents reported for verbal abuse/ threatening behaviour declined this month. 43

44 CCDHB Public 20 September FOR DISCUSSION 2.1 Performance Summary Performance Indicator Increased - Decreased - No Change Current Month Previous Month Status Trend (Past 12 months) H&S Incidents Total Number of Reported Incidents Number of Reported Incidents - Non MHAIDS Number of Reported Incidents - MHAIDS Number of Notifiable Events 0 0 Number of Incidents involving visitors 3 0 Number of Incidents involving contractors 1 2 H&S Incident Lag Indicators Blood or Body Fluid Exposure Slips, Trips, Falls 11 8 Physical Assault of Workers - Excluding MHAIDS 11 9 Physical Assault of Workers - MHAIDS Patient Handling Object Handling 2 6 Performance Indicator - Meeting Target - Below Target Current Month Previous Month % of Pre-Employment Health Screening completed prior to start + 85% 81% 100% % of H&S Fundamentals Managers completed 81% 80% 90% % of Managers Injury Management completed 49% 40% 90% Target Status Trend (Past 12 months) % of H&S Incidents investigated within 14 days* 57% 61% 100% + Pre-employment Health Declarations being returned with less than the required 2 weeks notice is the cause of this *A two month lag in reporting is required to allow for accurate reporting 44

45 CCDHB Public 20 September FOR DISCUSSION Claims & Injury Statistics current period General excluding MHAIDS MHAIDS Trend General (Past 12 months) Trend - MHAIDS (Past 12 months) Number of ACC45 Injury Claims 17 4 Number of Medical Fees Only Claims 12 3 Number of Lost Time Injuries 5 1 Number of Lost Days Lost Time Injury Frequency Rate month average Injury Claims - Any work related injury resulting in an ACC claim Medical Fee Only Claims - Any work related injury which results in an ACC claim for treatment but with no lost time Lost Time Injury - Any incident which results in an ACC lost time injury Lost Time Injury Frequency Rate - The number of lost-time injuries (per million hours worked) within a given accounting period relative to the total number of hours worked in the same accounting period. 2.2 Lost Time Injuries (LTI) Current Month Category of Incident Physical Assault MHAIDS Directorate Department Ngā Taiohi (Youth Secure Forensic Unit) Pain & Discomfort Medicine, Cancer and Community Cardiology Outpatients 9 Slip, Trip, Fall Medicine, Cancer & Community Community Health Nursing Services - Wellington Pain & Discomfort Surgery, Women & Children s ICU 7 Ran into Object Clinical & Support Services Administration Services (Ward) 2 Slip, Trip, Fall Clinical & Support Services Kenepuru Non-clinical - General 2 Past 12 months Days Lost to Date 19 7 General LTI's MHAIDS LTI's Linear (General LTI's) Linear (MHAIDS LTI's) 45

46 CCDHB Public 20 September FOR DISCUSSION 2.3 Notifiable Events No Notifiable Event incidents were reported in August 2017 There has been only one Notifiable Event in the past 12 months. 2.4 Serious Injury Reduction The Government has set a target of reducing serious injuries and fatalities in the workplace by at least 25% by As can be seen from 2.3 above, CCDHB has a very low incidence of Notifiable Events (serious injuries and fatalities). 3. EMPLOYEE ASSISTANCE PROGRAMME 3.1 EAP The number of employees referring to EAP has increased this month Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Total number of Clients: New clients: Total number of Sessions: Despite the increase in total referrals for the month, the number of referrals for work related reasons decreased from 40 in July to 33 this month. The increase is due to the number of non-work related referrals. This increased from 45 in July to 82 this month. 3.2 Monthly Referrals to EAP: Reasons for Referrals (as stated by worker) by Directorate 46

47 CCDHB Public 20 September FOR DISCUSSION 4. WORKPLACE INJURY MANAGEMENT 4.1 Cost Over Past Twelve Months $70, $60, $50, $40, $30, $20, $10, $0.00 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 ACCPP Case & Claims Management Medical Fees Statistics Patient handling and object handling injuries continue to be the most common causes for claims, accounting for 48% of all claims Lumbar sprain injuries remain the most frequent type of injury reported There have been 283 injury claims in the past 12 months Claims by Directorate past 12 months 5. EMPLOYEE PARTICIPATION AND ENGAGEMENT 5.1 Health & Safety Representatives (HSRs) HSR training continues to be delivered using an external training provider. All planned courses up until October are currently full. Further sessions are being arranged. 6. OTHER BUSINESS 6.1 Policies and Procedures The updated Management of Workplace and Aggression and Lone and Community Worker Procedures are presently going through the final approval and sign off processes prior to implementation. The new First Aid at Work Procedure has been approved and will shortly be communicated to workers following the addition of a new page to the H&S Intranet site which will provide additional information and resources. 6.2 Online Hazard Reporting and Risk Assessment/Register System Work has commenced on designing a risk assessment/register system using SQUARE. This will replace the current hazard registers. 47

48 CCDHB Public 20 September FOR DISCUSSION 6.3 Workplace Violence and Aggression The workplace violence & security steering committee is meeting on a monthly basis and is in the process of developing a work plan. 6.4 Annual Influenza Campaign The annual influenza vaccination campaign officially closed on the 31st August and at this date, 67% of employees had been vaccinated in house with a further 4% being vaccinated elsewhere. This makes the total number of employees being vaccinated as 71%; an increase of 10% in-house vaccinations and a 22% overall increase of employees being vaccinated in comparison to

49 CCDHB Public 20 September Item 4.2 SIP Bi-Monthly Report BOARD DISCUSSION Date: 20 September 2017 Author Jenny Langton, Senior System Development Manager Endorsed By Subject Rachel Haggerty, Director, Strategy Innovation and Performance STRATEGY INNOVATION AND PERFORMANCE DIRECTORATE BI-MONTHLY UPDATE RECOMMENDATION It is recommended that the Board a) Note the contents of this report, which updates the Board on priority activity for the Strategy Innovation and Performance (SIP) Directorate. ADDENDUM 1. Improving Health Outcomes for the CCDHB Population. 1 PURPOSE This paper updates the Board on the Strategy Innovation and Performance (SIP) Directorate s priority activity and issues during July to September. SIP has a comprehensive work programme that includes managing investment across CCDHB through commissioning, procurement and contracting, and managing performance across both CCDHB and the health system funded by CCDHB. 2 CONTRACT ACTIVITY 2.1 Community Pharmacy contract The new Community Pharmacy Contract, which came into effect on 1 July 2017, includes three new services; workforce development, extension of the long term conditions (LTC) support to patients with Mental Health conditions and smoking cessation delivered via community pharmacies. Nationally, DHBs agreed to fund an additional 9520 LTC patients. This means CCDHB will fund an additional 542 LTC patients focusing on people with mental health conditions. With regards to smoking cessation PHARMAC has proposed that Community Pharmacists can supply publicly funded NRT without a prescription; a final decision will be released this month with an expected implementation date of 1 October Pharmacists in CCDHB would refer smokers on to Tākiri Mai te Ata, the regional provider for Smoking cessation. As funding is limited, the local areas with the highest smoking rates would be targeted. These areas include Porirua East, Titahi Bay, Paraparaumu and parts of Wellington South. 2.2 Pay Equity We expect guaranteed hours in the Home Care Support Services (HCSS) sector and pay equity will have a positive effect on recruitment and retention of key support workers in both HCSS and Aged Capital & Coast District Health Board 49

50 CCDHB Public 20 September Item 4.2 SIP Bi-Monthly Report Residential Care (ARC). It will also improve the quality of services as employers attract more qualified staff. However, it remains unclear what the medium term financial impact of pay equity will be on the aged care sector as pay equity funding has been passed through the facilities on an average rate. Facilities whose workforce was lower paid initially will benefit from the funding, while facilities with more experienced, higher paid staff will be penalised. The full impact of pay equity on aged care facilities that were already vulnerable through vacancies is unknown. There are concerns it may increase private charges in residential facilities and smaller facilities are financially pressured. These issues have been raised with the Ministry of Health (the Ministry) and we are monitoring the local impact. The Ministry has asked providers who are experiencing issues of sustainability to approach their DHB. To date, two providers have formally approached the DHB and agreed to share the impact of pay equity on their financial viability. We are currently speaking with one provider. The issues are not all attributable to pay equity. The impact of Pay Equity on mental health workers and options for resolution are being considered by the Ministry and the national Chief Executives. 3 SYSTEM PERFORMANCE 3.1 More Heart and Diabetes Checks In 2017/18 the DHB is realigning funding for early detection of cardiovascular disease and diabetes - More Heart and Diabetes Checks - to improve health equity for Māori men aged years. This funding was previously targeted to the total eligible population as part of the health target 90% of the eligible population have received a CVD risk assessment within the last five years. The change in focus is accompanied by a new achievement-based component to the funding available to our PHOs. The PHOs are taking up the challenge and working with practices to improve engagement to reach the Māori men in their populations. 3.2 Tobacco Control In July the DHB submitted the 2017/18 Tobacco Control Plan to the Ministry of Health for approval. The plan focuses on achieving the Better Help for Smokers to Quit health targets in Primary Care and Maternity, and engaging our partner agencies in promoting smoking cessation services within our community. In addition, we will be working with our own teams to refresh the Smokefree message and policies throughout the DHB. The draft one-page summary of the plan is attached (see Addendum). We are prioritising action for Māori and Pacific peoples who are over represented in smoking statistics making smoking a significant contributor to inequitable health outcomes. We are also focused on actions that will reach smokers in our DHB facilities. The aim is to increase consumer awareness and engagement with smoking cessation services, improve staff knowledge of the CCDHB Smokefree policy, improve our systems, support staff to give advice on smoking to the people using our hospital facilities and increase collaboration with our partners to improve the reach of cessation services. 3.3 Health of Older People (HOP) CCDHB expects to spend $68 million on ARC facilities during 2017/18. Aged care services cover rest home level care, hospital level care and dementia level care. Clients can be charged for additional costs over and above this care, with aged care facilities charging anything from $0 to $60 per day. CCDHB contracts with 33 facilities. We continue to closely monitor admissions to ARC and keep a watch on flow on effects to other services. We have been working with our Needs Assessment Service Coordination Service (NASC) and Capital & Coast District Health Board 50

51 CCDHB Public 20 September Item 4.2 SIP Bi-Monthly Report Hospital Older Peoples services to improve the system of discharge and assessment to ensure we support people to live in the community (in their own homes) as long as possible. The graph overleaf shows lower number of admissions to ARC facilities over the last 12 months in line with the focussed efforts. HOP Funded new Residential Care admissions by month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Average (prev 3 yrs) Average (prev 3 yrs) Quality Improvement is a continuous process all aged care providers of DHB funded services are required to undertake. Quality Improvement efforts have contributed to every aged care facility in CCDHB having three or four year certification. Quality Improvement initiatives include: Professional Development and Recognition Programme for registered nurses Specialist input for residential staff education and help with planning the care of complex residents Advanced Care Planning discussions and proactive support across facilities Regular meetings with ARC and HCSS providers to monitor quality markers for the sector HOP representation at the CCDHB Primary-Secondary Clinical Governance meeting and support to develop a report to understand quality care markers for the sector. Following the CPHAC DSAC meeting on 1 September, work has begun on a collection of quality indicators for ARC providers to ensure the Board has a clearer picture of quality standards in the sector. 3.4 Quality and Safety SIP is integrating its activity with the CCDHB organisational quality framework for managing complaints and reportable events and to use the updated risk register. We have a focus on more strongly embedding these elements of quality into our practice and are amending organisational policy to enable SIP reporting to be integrated into the wider organisational framework. This work will include using such processes to understand and monitor feedback, reported events and risk of providers including NGOs and Aged Residential Care facilities. Capital & Coast District Health Board 51

52 CCDHB Public 20 September Item 4.2 SIP Bi-Monthly Report 4 STRATEGIC PLANNING AND SERVICE DEVELOPMENT 4.1 Advance care planning and Pacific Peoples Advance care planning (ACP) gives people an opportunity to think about and document what makes life meaningful to them and how they would like to be treated and cared for at the end of their lives, particularly if they are unable to speak for themselves. It has emerged internationally in recognition that dying has become highly medicalised over recent decades resulting in prolonged dying rather than a focus on maximising quality of life. Pacific advance care planning (ACP) brochures in six languages (Tongan, Samoan, Niuean, Fijian, Cook Islands Māori, and Tokelauan) were launched in early September at the Wellington Region Pasifika Services Café programme. The CCDHB Pacific Health Directorate sponsored the development of these brochures as there are no national ACP resources in Pacific languages. A local Pacific ACP group suggested a useful way to encourage Pacific peoples to think about ACP was to provide some written information in Pacific languages and to present verbally to Pacific community groups to encourage fanau to discuss this subject. Pacific leaders and ACP health practitioners in CCDHB are asking families to prepare well for future health deterioration and end of life by appointing an enduring power of attorney or health spokesperson and by starting ACP conversations early, at home, before a health crisis occurs. 4.2 Health Care Home The first four Health Care Home (HCH) Tranche 1 practices have achieved their annual milestones. An anniversary celebration was held recently for these practices and they have also had their Year 2 plans endorsed by the HCH Practice Oversight Group. Early results show positive trends in measures such as hospital admissions, patient portal uptake and ED presentations (see graphs). In Year 2, these practices must maintain the required service elements as well as be working to a number of targets outlined in the HCH Year 2 Target Setting Framework. This framework was developed in collaboration with the HCH Practice Oversight group and includes targets for ASH, ED, Total Admissions, Portal In bound Activity and Time to Next Available Appointment. These measures were selected as indicators of improved access and health status for the practice populations. Tranche 2 is also progressing with Island Bay Medical Centre and Newtown Medical Centre launched on 1 July 2017 and four practices working on their implementation plans for a 1 Oct 2017 launch. The process to enable the faster roll-out of the HCH for 2017/18 is underway with the selection of seven additional practices through an EOI process completed in September. This will enable the HCH model to reach a further 43,178 people. This would result in the CCDHB HCH coverage to reach just over 52% of the CCDHB population by the end of 2017/18. Community Service Integration with the HCH is delivering positive results, with one GP noting that Multidisciplinary team meetings are worth their weight in gold. Over 200 people with complex needs have been covered in these multidisciplinary team meetings between the HCH teams, District Nurses and ORA Allied Health. To support these teams to work with the HCH practices, there has been an extended roll-out of ipads and the ORA Allied Health team are piloting electronic notes. Capital & Coast District Health Board 52

53 CCDHB Public 20 September Item 4.2 SIP Bi-Monthly Report 4.3 3DHB Community Falls Prevention Model project The 3DHB Community Falls Model project aims to enhance the health and wellbeing of our frail elderly population in an evidence-based way. Three 3DHB HealthPathways have been written to guide practitioners; Falls Risk Assessment and Reduction, Fragility Fracture and Osteoporosis. General practice teams will proactively screen older patients for falls risk and then actively manage people at risk. There will be a focus on referral to lower limb strength and balance providers both in group and individual home settings. Bone health will also be a focus, with bone strengthening medication prescribed, as indicated, especially for those who have already fallen and suffered a fracture. This model will also enable the establishment of a primary care Fracture Liaison Service that will close the loop in following up people who have had a low impact fracture and support their management in line with best practice. The contract will provide CCDHB with $311,105 in annual funding for three years that will be used to support a local CCDHB service and contribute to sub-regional services. 4.4 Localities Approach Improving health and wellbeing requires effort across communities, and is not concentrated in single organisations or within the boundaries of traditional health and social services. There is growing evidence that a localities approach can help engage communities in their own care and organise more effective local responses to improve results. SIP is developing a localities map for CCDHB, which will include elements such as local communities of interest, health needs, alignment with other agency/government boundaries and use of health care facilities. We anticipate that in areas with relatively low needs the locality will be larger and our focus will be opportunities to simplify care. In other areas, with higher needs, localities may be smaller to allow for a closer relationship with communities and more intensive responses to health needs. 4.5 Proactive analytics We are starting to develop a whole of system approach to analytics and proactively using data to generate information for more sophisticated strategic planning and monitoring. We are looking for opportunities to join up data systems to enhance the quality of information we have available to underpin our activity. A key area of focus is the use of GIS in our localities scoping work. The analytical team have a number of other proactive projects underway including Whole of Life NASC, MHAIDs Integration and confirming expected Inter District Flows for 2018/ Palliative Care Whole of System Approach Rising demand for palliative care and persistent inequity requires improved integration of existing services and greater pro-active planning for individual patients palliative care needs. CCDHB s Health System Plan recognises this and the Lower North Island Palliative Care Network has released a Strategy for a Palliative Care Approach. The Ministry has recently released the Health Aging Strategy, which has a focus on respectful end of life. We are considering each of these strategies and action plans in developing a local palliative care whole of system approach. We are working to complete the design and development of the palliative care whole of system model including any changes by the end of the third quarter 2017/18 for implementing in the first quarter of 2018/ DHB Disability Strategy The Health Passport is a booklet that people can carry with them when attending hospitals or other providers of health and disability services. A Health Passport contains information about how people want to be communicated with and supported. Following a meeting with the Director-General of Capital & Coast District Health Board 53

54 CCDHB Public 20 September Item 4.2 SIP Bi-Monthly Report Health in April 2017, the Ministry offered us an opportunity to work with Price Waterhouse Cooper (PWC) on a sprint approach to design an App or other electronic version of the Health Passport. A proposal from PWC involving a two stage co-design process is being considered by Health and Disability Commissioner (HDC) and the sub regional DHBs. Funding is guaranteed for the first two parts of the proposal and the Ministry will need a new business case addressing outcomes of the New Zealand Health Strategy for any subsequent funding to complete the development. We are focused on our goal of achieving a prototype for sub regional testing by early 2018 and expect that evaluation of this could inform a national rollout in 2018/19 alongside other national stakeholders within the health and disability sector. Capital & Coast District Health Board 54

55 CCDHB Public 20 September Item 4.2 SIP Bi-Monthly Report ADDENDUM Capital & Coast District Health Board 55

56 CCDHB Public 20 September Item 4.3 Ministry of Health Quarter 4 Performance Report BOARD DISCUSSION Date: 20 September 2017 Author Endorsed by Subject Rachel Haggerty, Director Strategy Innovation & Performance Debbie Chin, Chief Executive Officer MINISTRY OF HEALTH QUARTERLY PERFORMANCE MONITORING REPORTS RECOMMENDATIONS It is recommended that the Board: a) Note the performance of CCDHB in the quarter four report against the seven priority health targets with two achieved and five partially achieved b) Note that the Surgery, Woman s and Children s Directorate achieved the Better Help for Smokers to Quit (Maternity) and Improved Access to Electives targets c) Endorse the revised action plan for CCDHB to achieve the remaining five priority health targets d) Note that of the 55 non-financial performance indicators reported against 41 were achieved, 12 were partially achieved and 2 were not achieved. APPENDICES 1. MOH Q4 2016/17 20 DHB Health Target Results 2. Minister of Health s 4 September letter to the CCDHB Board Chair 1. PURPOSE To update the Board on the DHB s quarter four priority health target results and to seek your endorsement of the action plans to achieve the five health targets which have a partially achieved status. Performance in these targets for the 20 DHBs is included in Appendix one. The PHO dashboard, which is also normally attached as an appendix, had not been received from the Ministry at the time of writing. 2. OVERVIEW OF PERFORMANCE CCDHB s result in quarter four was two achieved health targets and five partially achieved targets. Two of these targets have been particularly challenging being the Faster Cancer Treatment and Shorter Stays in Emergency Department targets. In addition the Faster Cancer Treatment target will increase from 85% to 90% in quarter one. The Minister has identified the ED target as requiring sustained focus on activities to improve acute patient flow. The Ministry is seeking improvements with the Cancer target to drive target achievement. The Minister s letter is attached as Appendix two. In the comprehensive assessment using 55 targets CCDHB has performed better. Two targets are a focus for intensive work Children Caries Free at 5 Years of Age and Better Help for Smokers to Quit in Public Hospitals. It is worth noting that DHB performance in the seven health targets is high in elective services, where there is a financial incentive. This does not detract from the critical performance of achieving an improved result. As part of improving performance we will be working across the organisation to embed Capital & Coast District Health Board Page 1 September

57 CCDHB Public 20 September Item 4.3 Ministry of Health Quarter 4 Performance Report the achievement of the Health Targets and the comprehensive assessment into a performance measurement system to strengthen the approach to accountability and achievement of these targets. 3. CCDHB COMPREHENSIVE PERFORMANCE In addition to the seven Health Targets there are 55 non-financial performance indicators the DHB is required to report on to the Ministry of Health. These indicators include Government Policy Priorities, specific Crown Funding Agreement and System Integration obligations. The MoH Dashboard, which is normally attached as an appendix to this report, was not available for inclusion at the time of writing. 0 indicators have an O (outstanding) status 41 indicators have an A (achieved) or S (satisfactory) status 12 indicators have a P (partially achieved) status 2 indicators have an N (not achieved) status Of the 14 P and N indicators 12 have resolution plans in place to ensure A status is attained. Of the remaining 2 indicators a resolution plan is in the process of being agreed. Resolution for services delivered by regional providers and/ or where the indicators are reported infrequently is more complex. CCDHB has reached a status of achieved or satisfactory in the following 42 indicators: Delivery Outputs MoH Descriptor Ownership Policy Priority System Integration Crown Funding Agreement Indicator Improving Patient Experience Mental Health Output Delivery Against Plan National Health Index National Collections Improving the Quality of the Programme for the Integration of Mental Health Data Inpatient Average Length of Stay Acute Oral Health DMFT Score at Year 8 Improving the Number of Children Enrolled in DHB Funded Dental Services Long Term Conditions Diabetes Services Acute Heart Services Immunisation Coverage Human Papilloma Virus (HPV) Improving System Integration and System Level Measures Mental Health Prime Minister s Youth Mental Health Project Mental Health Primary Mental Health Mental Health District Suicide Prevention and Postvention Mental Health Improving Crisis Response Services Mental Health Improving Outcomes for Children Mental Health Improving Employment and Physical Needs of People with Low Prevalence Conditions Supporting Vulnerable Children Reducing the Incidence of First Episode of Rheumatic Fever Facilitating Effective Follow up of Rheumatic Fever Cases Improving Waiting Times for Diagnostic Services Coronary Angiography Faster Cancer Treatment 31 Day Indicator Faster Cancer Treatment Part B Radiotherapy and Chemotherapy Improving the Health Status of People with Severe Mental Illness / Improved Access Ambulatory Sensitive Hospitalisations (ASH) Ensuring Delivery of Service Coverage Delivery of Whanau Ora Appoint Cancer Nurse Coordinators Appoint Cancer Psychological and Social Support Workers Appoint Regional Cancer Centre Clinical Psychologists B4 School Check Disability Support Services Funding Increase Elective Initiative and Ambulatory Initiative Immunisation Coordination Service Capital & Coast District Health Board Page 2 September

58 CCDHB Public 20 September Item 4.3 Ministry of Health Quarter 4 Performance Report Health Strategy National Immunisation Register (NIR) On going Administration Services National Patient Flow Health Services for Emergency Quota Refugees Well Child/ Tamariki Ora Services Supporting Delivery of the New Zealand Health Strategy CCDHB has reached a status of some aspects still need development / or the DHB is not tracking to target but has an appropriate resolution plan in the following 12 indicators: MoH Descriptor Ownership Policy Priority System Integration Indicator Inpatient Average Length of Stay Elective Utilisation of DHB Funded Dental Services by Adolescents from School Year 9 up to and Including 17 Years of Age Cardiovascular Health (previous CVD Health Target) Stroke Services Immunisation Coverage at 24 Months and 5 Years Old Improving Wrap Around Services Health of Older People Improving Waiting Times for Diagnostic Services Colonoscopy Improving Waiting Times for Diagnostic Services CT/ MRI Improving Mental Health Services using Transition Discharge Planning Shorter Waits for non-urgent Mental Health and Addiction Services for 0-19 Year Olds Delivery of Regional Service Plans Standardised Intervention Rates CCDHB has reached a status of DHB is not on track to meet the target and does not have an appropriate resolution plan in the following two indicators: MoH Descriptor Policy Priority Indicator Children Caries Free at 5 Years of Age Better Help for Smokers to Quit in Public Hospitals (previous Health Target) These two key areas have a plan being developed. The dental service is provided by Hutt Valley DHB, on our behalf and highlights the previous under performance against the dental targets. We are seeking improvement for younger children, and will continue to work with HVDHB to improve against this target. In both of these targets ethnic inequalities have been identified as contributing to non-performance. The providers of these services are now engaged in a performance improvement programme for 2017/ PRIORITY HEALTH TARGET The table below outlines the performance of CCDHB as measured by the seven Health Targets. CCDHB has achieved the Better Help for Smokers to Quit (Maternity) and Improved Access to Elective Surgery targets. It has five partially achieved targets with no targets not achieved. CCDHB has made significant improvement against the Better Help for Smokers to Quit (Primary) target. CCDHB expects to be on target in quarter one for all other targets except the Faster Cancer Treatment and Shorter Stays in Emergency Department targets. Both targets remain a challenge. The Minister specifically identifies the Shorter Stays in Emergency Department target as requiring sustained focus by the DHB while the Ministry is seeking improvement against the Faster Cancer Treatment target particularly as the target will increase from 85% to 90% in quarter one (with some changes to exclusions in the new target). Work to identify and implement further efforts to achieve these targets is being intensified as per the summary below. Capital & Coast District Health Board Page 3 September

59 CCDHB Public 20 September Item 4.3 Ministry of Health Quarter 4 Performance Report 4.1 Quarter Three 2016/17 Health Target Results Health Target Target Quarter One Result Quarter Two Result Quarter Three Result Quarter Four Result Change from Previous Quarter DHBs Achieving Target out of 20 CCDHB Rank out of 20 DHBs Action Plan Better Help for Smokers to Quit (Maternity) Better Help for Smokers to Quit (Primary) 90% 94% (A) 97% (A) 97% (A) 100%(A) N/C N/A N/A 90% 85% (P) 86% (P) 86% (P) 89% (P) 3% Achieving target. Maintain performance. Moving towards target. Compass Health are providing weekly feedback to all practices and will continue to put additional Health Care Assistant, Pacific Navigator and/ or nursing time into practices that need additional assistance to achieve the target. The merger of Well Health Practices into Compass Health will assist to ensure this target is achieved. Capital & Coast District Health Board Page 4 September

60 CCDHB Public 20 September Item 4.3 Ministry of Health Quarter 4 Performance Report Health Target Target Quarter One Result Quarter Two Result Quarter Three Result Quarter Four Result Change from Previous Quarter DHBs Achieving Target out of 20 CCDHB Rank out of 20 DHBs Action Plan Faster Cancer Treatment 85% 84% (P) 82% (P) 78% (P) 79% (P) 1% 4 10 Challenged by target. Governance - the Operational and Clinical Executive Directors, the Chief Medical Officer and the General Manager Hospital Services meet regularly to review progress. Working Group Priority Areas for Improvement are: a. Triage - Improve time to triage, with a soft target set at 3days. b. HSCan - Improve identification of HSCan at the start of the pathway. The Faster Cancer Treatment button on outlook enables identification and prospective tracking of patients. A coordinated effort to increase use of the button is being implemented. c. ICT - Prospective Tracking Tool is in development. d. Cancer Nurse Capital & Coast District Health Board Page 5 September

61 CCDHB Public 20 September Item 4.3 Ministry of Health Quarter 4 Performance Report Coordinators These roles now prospectively track more patients to prevent breaches. The new CNC Triage tool helps to identify high needs patients. The Faster Cancer Treatment Tracker role is now full time and its scope expanded to cover live tracking of patient pathways. e. Production planning To improve patient pathways is being scoped. Improved Access to Elective Surgery Achieve volume target. -72 (P) -254 (P) -184 (P) 72 (A) Achieving target. Maintain performance. Capital & Coast District Health Board Page 6 September

62 CCDHB Public 20 September Item 4.3 Ministry of Health Quarter 4 Performance Report Health Target Target Quarter One Result Quarter Two Result Quarter Three Result Quarter Four Result Change from Previous Quarter DHBs Achieving Target out of 20 CCDHB Rank out of 20 DHBs Action Plan Increased Immunisation Raising Healthy Kids 95% 94% (P) 95% (A) 93% (P) 93% (P) N/C % 25% (P) 47% (P) 73% (P) 77% (P) 4% 6 16 Moving towards target. The merger of Well Health and Compass PHOs will deliver an improvement in immunisation coverage for Māori. Initiatives are being developed with Ora Toa and Compass Health. Information on Datamart has been disseminated to staff to prevent recurrence of the data issues reported on in quarter three. CCDHB has instigated a monthly monitoring forum with PHOs to continuously target solutions to barriers that prevent achievement of the target. Moving towards target. Achievement has improved against this target. CCDHB has instigated a monthly monitoring forum with the PHOs and Plunket to identify solutions to barriers that prevent achievement of the Capital & Coast District Health Board Page 7 September

63 CCDHB Public 20 September Item 4.3 Ministry of Health Quarter 4 Performance Report target. This includes appropriate data sharing and undertaking an environmental check to ensure pathways are working well. In July the MOH approved the 'patient navigator' being PHO led. Recommendations by the Health Navigator will accompany the referral to the GP to ensure the GP is aware of the range of services available. Work is underway to analyse families who decline support to ensure the outcomes of this target are achieved. Capital & Coast District Health Board Page 8 September

64 CCDHB Public 20 September Item 4.3 Ministry of Health Quarter 4 Performance Report Health Target Targe t Quarte r One Result Quarte r Two Result Quarte r Three Result Quarte r Four Result Change from Previou s Quarter DHBs Achievin g Target out of 20 CCDH B Rank out of 20 DHBs Action Plan Challenged by target. Work streams include: Continuing the Frances Group work programme for ED, Medicine, Surgery and Mental Health with a focus on: Shorter Stays in Emergency Department s 95% 85% (P) 88% (P) 92% (P) 90% (P) -2% 9 18 o o o o o early senior medical staff assessment in the Emergency Department to reduce delays. Reducing delays between the ED and MAPU Achieving a 30% increase in same day discharge Creating capacity in inpatient wards through initiatives including nurse led discharge Working with the Mental Health team on streaming of inpatients through ED as they also recruit the additional staff needed. Complete the roll out of Capacity Planner to provide a Capital & Coast District Health Board Page 9 September

65 CCDHB Public 20 September Item 4.3 Ministry of Health Quarter 4 Performance Report complete picture of patient demand, staffing and resources on a prospective basis. Continue the development of Care Capacity Demand Management with the implementation of the next phase following completion of the council and discovery phases. Capital & Coast District Health Board Page 10 September

66 CCDHB Public 20 September Item 5.1 General BOARD DECISION Date: 14 September 2017 Author Andrew Blair, Capital & Coast and Hutt Valley DHB Chair Subject BOARD AND COMMITTEE MEETING SCHEDULE 2018 RECOMMENDATIONS It is recommended that the Board: a) Agree to the 2018 Board and Workshop dates in the schedule attached b) Agree to the dates of the committee meetings as proposed in the 2018 schedule attached. APPENDIX 1. Schedule of Board and committee meetings BACKGROUND The purpose of this paper is to recommend to the Board the dates of committee and workshop meetings as proposed in the 2018 schedule. The initial draft 2018 CCDHB meeting schedule was presented to the Board in August. Board members requested an extension of time to identify if these dates would clash with other meetings outside of the CCDHB. Feedback to the Board Secretary was provided and only one change was made the date for the April meeting was originally scheduled for Monday 23 April. It has been changed to Wednesday 2 May. Capital & Coast District Health Board Version 66

67 CCDHB Public 20 September Item 5.1 General WEEK ONE WEEK TWO WEEK THREE WEEK FOUR WEEK FIVE MON TUES WED THURS FRI SAT SUN MON TUES WED THURS FRI SAT SUN MON TUES WED THURS FRI SAT SUN MON TUES WED THURS FRI SAT SUN MON TUES WED THURS FRI SAT SUN JANUARY CCDHB Annual HVDHB Annual DAY AFTER NYD OBSERVED WGTN ANN. Planning Planning NYD workshop workshop Key School holidays CCDHB HVDHB CCDHB FRAC meeting HVDHB FRAC meeting FEBRUARY WAITANGI DAY Board meeting Board meeting MARCH MPB CCDHB FRAC meeting HVDHB FRAC meeting GOOD FRIDAY Board meeting Board meeting EASTER MONDAY ANZAC DAY HVDHB FRAC meeting Board meeting MAY CCDHB CCDHB FRAC HVDHB FRAC FRAC meeting meeting meeting Board meeting Board meeting Board meeting JUNE CCDHB HVDHB FRAC FRAC meeting QUEENS meeting BIRTHDAY Board Board meeting meeting JULY MPB CCDHB FRAC meeting HVDHB FRAC meeting Board meeting Board meeting AUGUST CCDHB HVDHB FRAC FRAC meeting CCDHB FRAC HVDHB FRAC meeting meeting meeting Board Board meeting meeting SEPTEMBER HVDHB W/S or Meeting CCDHB FRAC meeting HVDHB FRAC meeting Board meeting Board meeting OCTOBER LABOUR DAY CCDHB FRAC meeting HVDHB FRAC meeting Board meeting Board meeting NOVEMBER MPB CCDHB FRAC meeting HVDHB FRAC meeting Board meeting Board meeting CCDHB FRAC HVDHB FRAC meeting meeting Board meeting Board meeting XMAS DAY BOXING DAY 67

68 CCDHB Public 20 September Item 5.2 Resolution to Exclude the Public BOARD DECISION Date: 12 September 2017 Author Subject Andrew Blair, Capital & Coast District Health Board Chair RESOLUTION TO EXCLUDE THE RECOMMENDATION It is recommended that the Board: a) Agree that as provided by Clause 32(a), of Schedule 3 of the New Zealand Public Health and Disability Act 2000, the public are excluded from the meeting for the following reasons: Public Excluded Minutes SUBJECT REASON REFERENCE Public Excluded Matters Arising from previous Public Excluded meeting Chair s report CEO s report FRAC report National Oracle Solution Programme Investment in Alcohol and other drugs/coexisting problems (AODCEP) services Sustainability Plan Demolition of Riddiford House, Recreation Centre and Chapel Children s Hospital Development Project Bulk and Location Children s Hospital Project Status Report For the reasons set out in the respective public excluded papers For the reasons set out in respective public excluded papers Papers contain information and advice that is likely to prejudice or disadvantage commercial activities and/or disadvantage negotiations 9(2)(i)(j) Litigation and Legal Risk Update Maintain legal professional privilege 9(2)(h) * Official Information Act Capital & Coast District Health Board 68

69 Quarter four performance How to read the graphs My District 00 District Health Board 00% Health Board 2016/17 QUARTER FOUR (APRIL JUNE 2017) RESULTS Ranking CCDHB Public 20 September APPENDICIES DHB current performance GOAL Progress Shorter stays in Emergency Departments Shorter stays in Emergency Departments The target is 95 percent of patients will be admitted, discharged, or transferred from an Emergency Department (ED) within six hours. The target is a measure of the efficiency of flow of acute (urgent) patients through public hospitals, and home again. Quarter four performance (%) Change from previous quarter 1 West Coast 99 2 Wairarapa 97 3 Waitemata 97 4 South Canterbury 96 5 Bay of Plenty 95 6 Nelson Marlborough 95 7 Hawke s Bay 95 8 Tairawhiti 95 9 Whanganui Canterbury Lakes Taranaki Northland Auckland Counties Manukau Hutt Valley Southern Capital & Coast MidCentral Waikato 86 Improved access to Elective Surgery Improved access to elective surgery The target is an increase in the volume of elective surgery by an average of 4,000 discharges per year. DHBs planned to deliver 192,237 discharges for the year to date, and have delivered 11,798 more. Quarter four performance (%) Progress against plan (discharges) 1 Northland Waikato Taranaki Waitemata Tairawhiti Hutt Valley Whanganui Bay of Plenty Counties Manukau Nelson Marlborough MidCentral South Canterbury West Coast Canterbury Lakes Hawke s Bay Wairarapa Capital & Coast Southern Auckland 98 Faster cancer treatment The target is 85 percent of patients receive their first cancer treatment (or other management) within 62 days of being referred with a high suspicion of cancer and a need to be seen within two weeks. Results cover those patients who received their first cancer treatment between 1 January to 30 June Note: From 1 July 2017 the faster cancer treatment target goal will increase to 90 percent. Quarter one 2017/18 results will be against the 90 percent target. Quarter four performance (%) All DHBs 93 All DHBs 106 All DHBs 81 95% 100% 85% Faster Cancer Treatment Change from previous quarter 1 Waitemata 90 2 Waikato 86 3 Canterbury 85 4 Nelson Marlborough 85 5 MidCentral 83 6 Auckland 81 7 Taranaki 80 8 Hutt Valley 80 9 Northland Capital & Coast Southern Counties Manukau Lakes Bay of Plenty Hawke s Bay Wairarapa South Canterbury Tairawhiti Whanganui West Coast 56 Increased Immunisation Increased Immunisation The national immunisation target is 95 percent of eightmonth-olds have their primary course of immunisation at six weeks, three months and five months on time. This quarterly progress result includes children who turned eightmonths between 1 April and 30 June 2017 and who were fully immunised at that stage. Quarter four performance (%) Change from previous quarter 1 Auckland 95 2 Hawke s Bay 95 3 Canterbury 95 4 South Canterbury 95 5 Counties Manukau 94 6 Southern 94 7 Wairarapa 94 8 Capital & Coast 93 9 MidCentral Waitemata Hutt Valley Lakes Nelson Marlborough Taranaki Waikato Whanganui Northland Tairawhiti Bay of Plenty West Coast 80 This information should be read in conjunction with the details on the website Better help for Smokers to Quit Better help for smokers to quit The target is 90 percent of PHO enrolled patients who smoke have been offered help to quit smoking by a health care practitioner in the last 15 months. Quarter four performance (%) Change from previous quarter 1 Tairawhiti 93 2 Counties Manukau 92 3 Auckland 92 4 Hawke s Bay 91 5 West Coast 91 6 Wairarapa 90 7 Waitemata 90 8 Bay of Plenty 90 9 Canterbury MidCentral Lakes Capital & Coast South Canterbury Nelson Marlborough Waikato Hutt Valley Taranaki Whanganui Southern Northland 82 Raising healthy kids The target is that by December 2017, 95 percent of obese children identified in the Before School Check programme will be offered a referral to a health professional for clinical assessment and family based nutrition, activity and lifestyle interventions. Data is based on all acknowledged referrals for obese children up to the end of the quarter from Before School Checks occurring in the six months between 1 December 2016 to 31 May Quarter four performance (%) All DHBs 92 All DHBs 89 All DHBs 91 95% 90% 95% Health target results are sourced from individual DHB reports, national collections systems and information provided by primary care organisations. 69 Raising Healthy Kids Change from previous quarter 1 Waitemata Auckland Counties Manukau 98 4 Canterbury 95 5 Hawke s Bay 95 6 Northland 95 7 MidCentral 92 8 Lakes 88 9 Taranaki Hutt Valley Southern Whanganui West Coast Waikato South Canterbury Capital & Coast Bay of Plenty Tairawhiti Nelson Marlborough Wairarapa 74

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