28 November am

Transcription

1 Highland NHS Board 30 January 2018 Item 3.2 HIGHLAND NHS BOARD DRAFT MINUTE of BOARD MEETING Board Room, Assynt House, Inverness Assynt House Beechwood Park Inverness IV2 3BW Tel: Fax: November am Present Also present Public: Dr David Alston, Chair Mr James Brander Mr Alasdair Christie Ms Ann Clark Ms Sarah Compton-Bishop Mr Robin Creelman Dr Andrew Evennett Dr Michael Foxley Mr Alasdair Lawton Ms Deirdre Mackay Ms Melanie Newdick Mr Adam Palmer Ms Ann Pascoe Dr Gaener Rodger Prof Elaine Mead, Chief Executive Mr Dave Garden, Interim Director of Finance Dr Rod Harvey, Medical Director Ms Heidi May, Nurse Director Prof. Hugo Van Woerden, Director of Public Health & Health Policy Ms Ruth Daly, Board Secretary Ms Georgia Haire, Deputy Director of Operations Ms Tina Harrigan, Service Manager (Item 3.1) Mr Gavin Hookway, Senior Quality Improvement Lead (Item 3.1) Ms Fiona MacBain, Committee Administrator, Highland Council Ms Joanna MacDonald, Director of Adult Social Care Ms Michelle Johnstone, Area Manager for North & West (item 4.4) Ms Deborah Jones, Director of Strategic Commissioning, Planning and Performance Mr George McCaig, Planning and Performance Manager Ms Gill McVicar, Director of Transformation and Quality Improvement Mr David Park, Director of Operations, Inner Moray Firth Ms Helen Robertson, Service Manager (Item 3.1) Mr Iain Ross, Head of ehealth Ms Maimie Thompson, Head of Public Relations & Engagement Ms Christina West, Chief Officer, Argyll & Bute HSCP (VC) Four members of the public were in attendance including three representatives of Caithness Health Action Team (CHAT) Preliminaries The Chair welcomed the three newly appointed non-executive Board Directors, Alasdair Christie, Sarah Compton-Bishop and James Brander.

2 1 Apologies Apologies were submitted on behalf of Ms Mary-Jean Devon. 2 Declarations of Interest Ms Ann Clark declared a non-financial interest in relation to the Elective Care Centre as her husband was on the Board of Highlands and Islands Enterprise. Mr Alasdair Christie declared financial interests as a Highland Councillor and as a Director of a Third Sector Interface. Ms Deirdre Mackay declared a financial interest, but with dispensation, as a Highland Councillor. 3.1 Tier 1 Report: Elective Care Centre Deborah Jones, Director of Strategic Commissioning, Planning and Performance, with Gavin Hookway, Senior Quality Improvement Lead, Tina Harrigan, Service Manager, and Helen Robertson, Service Manager During the presentation an overview of the project was given and the first Production Preparation Process (3P) Event was summarised: to design an Elective Care Centre (ECC) to deliver world class performance with the patient at the heart of the process of care delivery. The key outputs from the event were highlighted, as were the tight timescales for the project; to submit a full business case in late 2018 and for the facility to be completed by Other key issues covered during the presentation included the 3P process and eventual choice of a triple bottom line design concept to represent our people, our planet, our pound, with the reasons behind the vision explained. Detail was provided on the building model and key principles, which included the seven pillars of Healthcare, as well as key milestones for various pathways, such as arthroplasty and ophthalmology. The next event was due to take place in January The Chair thanked the team for the presentation and the Board voiced their enthusiasm for the project, referring to the large number of outpatients (estimated at 45k per year) that would benefit from the ECC, this being facilitated by the planned new model of care. Issues raised during discussion included: At the moment there was an aspiration that clinical staff might rotate between the ECC and other facilities to meet the needs of patients. The ECC was a regional project and early discussions about this were underway. A capital budget of 27m had been agreed but the revenue consequences were still to be established. Cost awareness had been high during the 3P event, and the architect had participated. A future 3P event would include patient engagement. The Board thanked the team, welcomed the update and noted the Tier 1 Report to the Board 3.2 Minute of Meeting of 26 September 2017 and Action Plan The Board approved the minute. 3.3 Matters Arising In relation to Action 64, the Vaccination Transformation Programme, further concern was expressed about the possible risk of falling vaccination rates in rural communities as a result of immunisations being removed from the new GP contract, and the wider implications for the health service of potential reduced vaccination levels. It was explained that a survey of GPs was imminent to establish whether those in remote and rural areas were willing to continue delivering vaccinations as part of an additional contract. The Director of Public Health had presented his concerns to the Civil Service Policy Leads and would follow this up once the results of the vote on the GP contract were known. The Chief Executive explained 2

3 that the issue had been considered by the Strategic Risk Management Group and it had not been put on the Strategic Risk Register because mitigating actions were underway but it was included on the Corporate Risk Register. Dr Foxley urged support of the actions being taken by the Director of Public Health to address the situation. Dr Evennett pointed out that the direction of travel was fully underway with the support of the Cabinet Secretary and that more would be known in January Dr Rodger pointed out that the matter was also being monitored through the Clinical Governance Committee. In relation to Action 63, the first meeting of the multi-disciplinary Radiology Short Life Working Group had been held and terms of reference agreed. A further meeting was scheduled for the following week, with Gaener Rodgers acting as a patient proxy until other patient representative(s) could be added to the group. The Board noted the updates and that the terms of reference for the Finance Sub-Committee had been approved by the Board according to the provisions set out in Standing Orders for approval of matters between meetings. 3.4 Appointments Attention was drawn a tabled list of appointments to governance committees, with changes and additions, particularly in light of the recent recruitment of three new non-executive board Directors, highlighted. There remained one unfilled vacancy on the Highland Health and Social Care Committee but this was would be filled in due course. One vacancy not listed on the tabled report was for the Pharmacy Practices Committee and Alasdair Christie was proposed for it. The Board approved the tabled list of appointments, as appended to this minute. 4.1 ehealth Update Iain Ross, Head of ehealth, on behalf of Deborah Jones, Director of Strategic Commissioning, Planning and Performance Part of the remit of the ehealth Delivery Group was to provide six monthly updates to the Board and six key areas were covered as follows: 1. Delivery of a clinical information sharing solution across primary, secondary, community and social care that would display a patient centric view of clinical information. 2. Delivery of an information sharing solution within the community sector which would reduce the duplication of information being recorded thereby increasing the time available to care for patients. 3. Delivery of a patient status (production board) view of a patient which would allow staff to view the current status of all patients under their care from GP/Community care, into hospital care and back to GP / Community. 4. Support for the Technology Enabled Care (TEC) Programme. 5. Delivery of electronic information gathering functionality within the clinical setting to replace the need for paper. 6. Delivery of a solution that would allow primary and secondary care clinicians to have an online clinical dialogue about a patient with a view to reducing outpatient attendances Other points made included the following: A meeting was scheduled on 1 December 2017 to consider the development of a regional clinical portal that would be linked to other systems such as SCI store and Trakcare PMS. In the future the aim would be to include Social Care and Primary Care in the portal. Trials were underway to enable community staff to use ipads to take records to patients homes without requiring network access, with eventual synchronisation of data upon their return. This would be rolled out in due course. Investigations were underway to improve uptake of various View products, with a relaunch planned in the new year. Support for the TEC programme included the Attend Anywhere initiative to facilitate remote appointments. Efforts were being made to link the Florence system, text message monitoring, to electronic patient records. 3

4 The first phase of the Paper to Digital project was being developed, to remove the need to access patient records, with the second element being to stop generating paper. A pilot for the Clinical Dialogue initiative to facilitate discussion between primary and secondary care physicians was underway in surgeries. An update was provided on recovery progress following the flooding incident at Raigmore Hospital on the evening of Sunday, 1 October 2017 where the server room located in the basement had been damaged by water causing approximately 500k worth of damage. The Board commended the work being undertaken by ehealth and during discussion the following points were raised: ehealth was involved in gathering information from Florence into the NHS IT systems, and further information on ongoing work with Florence could be provided to any new Directors as required. The current lack of a failover (a procedure by which a system automatically transfers control to a duplicate system when it detects a fault or failure) as a result of the flood had been added as a high risk to the Risk Register. Funds had been received from the Scottish Government contingency fund to replace the equipment, for which an alternative location was being sought. The Chief Executive thanked staff for their work to rectify the problems caused by the flood. The Board noted the report and that a further update would be provided in six months. 4.2 Financial Report Dave Garden, Interim Director of Finance The forecasted potential overspend had moved adversely by 0.8m to 19.3m, 10.8m of which was due to savings not achieving or as yet unidentified, with the balance being additional cost pressures, mainly locum and drug expenses, and pressures within adult social care budgets. It was pointed out that 25.3m of savings had already been achieved by Month 7, which was an improvement on previous years, however a significant amount of the current year s projected overall savings were non-recurrent, which was of concern. The newly created Finance Committee had scrutinised the detail of the report which summarised the efforts that were being put into the development of a longer term recovery plan over a rolling 3 year period, which was due to be discussed with the Scottish Government on 4 December Work would be ongoing to reduce the in-year overspend to 15m. The Chief Executive acknowledged and thanked staff for their commendable efforts which had facilitated the 25.3m of savings already achieved in the financial year. She emphasised the urgent need to improve sustainability of services through changing the models of care, with reference to planning work being undertaken to reduce the organisation s footprint, including buildings and beds, to improve recruitment, especially in remote and rural areas, to maximise the use of technology and to ensure staff were working at the top of their licences. Plans were being considered to contain rising drug costs, tied into primary care and realistic medicine, and to address the increasing cost of Adult Social Care. During discussion the following issues were considered: The increase in drug costs was an international issue, partly due to problems in the supply chain. With regard to the aim of moving 50% of the budget to the community, it was explained that a considerable amount of the budget was already being spent in the community, as opposed to in acute care. If the Scottish Government was not able to agree to the rolling three year recovery plan, other options were not yet established. With the high level of expenditure on workforce, it was important that staff time was used differently to make best use of current resources, through reconfiguration of services. Discussion ensued on actions being taken by other Scottish Boards, none of which had the same financial responsibility for delivery of Adult Social Care as NHS Highland, due to the Lead Agency Model. External scrutiny of NHS Highland s budget had not been able to identify further actions that could be taken other than those already underway. The driver for change would remain the Highland Quality Approach to care and changing models of care rather than making across the board cuts as some Boards were doing. Rurality was a particular challenge for NHS Highland. In response to a request for information about what was expected from staff who were already working under considerable pressure, and with the risks that entailed, particularly in Raigmore, which 4

5 was on red alert on the day of the meeting, the Chief Executive responded that she had a simple message for staff which was to carry on doing what they had been doing keeping their patients safe. Full wards could not get any fuller and staff should continue to do the best that they could for the patients in front of them while management considered the flow through the system, and to continue to work to move people out of hospitals. The Director of Operations added that management were not expecting more effort from staff, and fully recognised the amount of conscientious effort that was being exerted every day. Improvement work in recent years had demonstrated how things could be done better, using less effort to get a better results. The RPIW work and value management work which was being embedded and spread would help, and continued staff involvement in this was encouraged and valued. Dr Foxley asked that the Scottish Government be reminded that the three Rural General Hospitals had not come with additional funding for recruitment and training. The Chair summarised the plan to approach the Scottish Government with a three year rolling plan, to include highlighting the risk being carried by NHS Highland for Adult Social Care and that consideration be given to an appropriate level of expenditure for this. The elimination of waste, harm and variation as part of the ongoing commitment to the Highland Quality Approach was reiterated. The Vice Chair suggested that the three year plan be drawn up regardless of the outcome of the meeting with the Scottish Government. The Board: Confirmed it was content with the accuracy of the financial position as set out in this report Noted the financial position as at October 2017 (Month 7) which reported a potential overspend of 19.3m, with an adverse 0.8m movement in the overall position from month 6. Acknowledged the need for a longer term sustainable service plan, supported by appropriate financial and workforce plans. Noted the need to now move to engage closely with SG to develop a three year plan with progress on this to be monitored and followed up through further review by the Finance Committee in December 4.3 Caithness Maternity Services Update Mrs Mary Burnside, Lead Midwife North Highland, Dr Helen Bryers, Head of Midwifery, and Dr Lucy Caird, NHS Highland Interim Clinical Lead for Obstetrics and Gynaecology, on behalf of Dr Roderick Harvey, Board Medical Director The report was summarised, with reference to activities undertaken since May 2017 and the transition to a Community Midwife Unit (CMU) being now complete. In the previous eleven months, there had been 218 births, with 18 having taken place in the CMU and the remainder at Raigmore. These percentages were broadly similar to those in other Highland CMUs. Transfers and retrievals were summarised, and remaining areas of work were mainly around the further development of the Hub and Spokes in order to have a fully functioning integrated North Highland maternity and neonatal service, the detail of which was included in the report. During discussion, the following issues were considered: Although the original paper on the creation of a CMU had suggested there might be a need for additional staff at Raigmore, the extra births had been accommodated into the existing workforce, partly because ongoing previous vacancies had now been filled. Staffing requirements were monitored on an ongoing basis. The relatively high level of C-section births in Caithness was partly an historical issue, with second or third babies after a C-section more likely to require the procedure. It was anticipated that this would return to more average rates in due course. This in turn might result in fewer mothers having to give birth in Raigmore. The accommodation available for fathers and other family members accompanying mothers to Raigmore was summarised and any incidents of people having to sleep in vehicles should be reported as this was not acceptable. Further updates on the matter would be referred to the Highland Health and Social Care Committee, including the service user feedback which had been detailed in the Board action sheet. Academic research about preferences on place of birth was ongoing. 5

6 The Board noted: The further progress made in the implementation of the Community Maternity Unit in Caithness. The progress made and proposal for future development of a Highland wide Hub and Spoke model of maternity & neonatal care in NHS Highland. 4.4 Caithness Redesign Update Michelle Johnstone, Area Manager for North & West (and Interim Project Director for the Redesign) for David Park, Chief Officer, Highland Health and Social Care Partnership This Project Initiation Document (PID) for the Caithness Redesign Project which aimed to modernise health and social care services that would be sustainable for the next 10 to 20 years was summarised. It was explained that despite all the effort to date NHS Highland appeared not to have been successful in communicating the case for change and the local population did not appear to have accepted the case for change. As a result, this had caused angst, including for staff, and it was felt by the stakeholders that there was a need to restart the process. Going forward there would be a clear focus on explaining the case for change and a more inclusive approach as to how models of care could be designed which were fit for the future. The Chair thanked all staff who had been engaged in the process and to the stakeholders who had participated. He referred to the passion people felt for health services and felt this was the common ground on which the redesign process would be engaged for the future. Deidre Mackay referred to the breakdown in trust that had occurred between the local community and the NHS. She emphasised the need to draw a line in the sand to move forward cooperatively to ensure safe and sustainable services could be co-designed. This would need a clear programme of work with timescales for any changes based on best available evidence. Adam Palmer also referred to the ideas and commitment from the staff who should be fully involved in the process. Ann Clark thanked the local community and the three CHAT representatives who attended the meeting for their commitment. She also referred to the benefits of the redesign work as well as the difficulties facing the NHS in the coming years. The Board approved the approach, as set out in the Project Initiation Document, to major service redesign in Caithness (Appendix 1). 4.5 Outline Business Case (OBC) for Badenoch & Strathspey, Skye & Lochalsh and South West Ross Maimie Thompson, Head of Public Relations and Engagement on behalf of Deborah Jones, Strategic Commissioning, Planning and Performance and Senior Responsible Officer for the Project The report was summarised and the work undertaken by the various teams was commended. Dr Foxley suggested that service delivery be kept under review as the process unfolded and asked that the need for bilingual signage be taken into account in the OBC. The OBC, which had already been scrutinised by the Asset Management Group, would now be submitted to the Scottish Government s Capital Investment Group. The Board approved the Outline Business Case. 4.6 Reducing the Number of Inappropriate Deaths in Acute Care Beds in NHS Highland Hugo Van Woerden, Director of Public Health and Policy It was important that patients were supported with end of life care in a context that was most appropriate to their needs. It was currently considered that too high a proportion of patients were dying in acute care beds, which was often not the best from a quality of life perspective. Work to address this had been delayed due to staff retiral but was underway again, with the issue identified as a mission critical area. An end of life framework was being developed that would be presented to the Board in due course. In Badenoch and Strathspey a pilot project was working to improve links between hospital and community teams to facilitate person-focussed centralised community care and preventing unnecessary hospital admissions. 6

7 During discussion the following points were considered: Inappropriate place of death was a more appropriate term than inappropriate death. There was a need to balance public health versus service delivery approaches and to encourage communities to come together in a slightly more formal way to help people in the last phase of their lives. Reference was made to supporting initiatives such as Compassionate Communities which could help with early interventions to avoid or postpone people going into acute care towards the end of their life, with particular reference to dementia-friendly models of care. Support for community initiatives was essential as the balance of care was moved away from acute into community-centred care. Effective partnerships with the third sector were important. Reference was made to the concept of Last Aid, similar to First Aid. Consideration was also required for how death was handled in acute care, including for the patient and their family, for example having homely settings where possible. The Board noted the initial plan to reduce instances of inappropriate place of deaths in acute care beds across NHS Highland. 4.7 Realistic Medicine: Director Of Public Health Annual Report Progress on realising Realistic Medicine Hugo van Woerden, Director of Public Health & Policy and Roderick Harvey, Board Medical Director The 6 core elements of Realistic Medicine (RM) were: shared decision making, personalised approach to care, reducing unwarranted variation, reducing harm and waste, managing risk better, and making innovative improvements. Key slides included in the presentation were as follows: The international perspective The increasing percentage of the UK s GDP that was being spent on health The need for sustainable staffing in the face of growing dependency of the population What can we do about it? Support more people to live at home longer through: piloting new models of neighbourhood nursing, considering new extra care housing options, empowering communities to support each other (eco-mapping) and supporting the Compassionate Communities movement The use of Telepresence Robots Eco-mapping learning about individual s lives Tackling frailty What NHS Highland was doing to implement the principles of RM: o Holding an education event in 2018 to raise awareness, promote discussion and showcase examples o Developing a public communication and engagement plan o Developing and evaluating posters and promotional material for clinics and primary care environments o Promoting discussion (hospital & GP clusters) via a standard presentation and discussion material o Developing educational material including videos for the effective use of medicines o Developing a bank of case studies of real life practice, illustrative of both good and poor practice o Developing scenario based training of advanced consultation skills for clinicians Other projects included: o Medicines substitution a programme to substitute less expensive, but equally effective medicines o Biosimilar drugs, such as melatonin o A new consent form and two-step process for obtaining consent o A standardised poor prognosis letter to be exchanged between secondary and primary care, when life expectancy was predicted to be less than one year. In conclusion, the challenges and approaches of RM were not new, with an array of aligned work already occurring in NHS Highland. Added value could be gained by considering social justice and equity in the application of RM. 7

8 During discussion the following topics were considered: The new 2-stage consent form fitted with the RM approach. In terms of the bigger picture, part of the approach was to spend funds on the right person in the right place and in the right location as part of new models of care. The approach should be integral at an early stage to any service redesign. Social justice and equality should underpin all activities, to empower individuals to express their opinions, including staff, patients and the public. The point was made that patients were experts in their own lives. The importance of ongoing education to the public and to care givers of all kinds was key. The removal of waste from systems was essential. RM was a national initiative. The Board received the report, recognised the work that has been undertaken to develop Realistic Medicine in NHS Highland, acknowledged the plans for further implementation of Realistic Medicine and supported the dissemination of the report and its findings. 4.8 Performance (a) Performance against targets for North Highland George McCaig, on behalf of Deborah Jones, Director of Strategic Commissioning, Planning and Performance The Board reviewed the balanced scorecards identifying any areas requiring further information or future exemption reports and noted the on-going development of the reporting arrangements for LDP scorecard. (b) Performance against targets for Argyll & Bute Stephen Whiston, Head of Strategic Planning & Performance on behalf of Christina West, Chief Officer The Board noted the report. (c) Hospital Standardised Mortality Ratio Dr Rod Harvey, Medical Director The Board noted: The principles on which the HSMR was calculated. That for the quarter ending 30th June 2017 none of the four acute hospitals in Highland was an outlier for HSMR compared to the Scottish average. The progress for each hospital against the target of a 10% reduction in HSMR by the end of Infection Prevention and Control Report Catherine Stokoe, Infection Control Manager and Dr Vanda Plecko, Consultant Microbiologist/Infection Control Doctor on behalf of Heidi May, Board Nurse Director & Executive Lead for Infection Control The new streamed report was summarised, with the key summary data being as follows: Group Target NHS Highland HEAT rate 8

9 Group Target NHS Highland HEAT rate Clostridium difficile Age 15 and over HEAT rate of 32.0 cases per 100,000 OBDs to be achieved by year ending 03/18 July-Sept Green (Not validated HPS) yet by Staphylococcus aureus bacteraemia HEAT rate of 24.0 cases per 100,000 AOBDs to be achieved by yea ending 03/18 9 July-Sept MRSA Clinical 90% or above compliance July Sept 2017 Green Risk Assessment 94% Hand Hygiene 95% 95% Green Cleaning 92% 96% Green Estates 95% 97% Green Red (Not yet validated by HPS) At the request of the Chair the Nurse Director explained the infection rate data for the benefit of the new Board Directors. In future a shortened version of the glossary of terms that had been included in the longer version of the report would be added. The Board noted the report and progress to reduce and manage healthcare associated infections Records Management Plan (RMP) Ruth Daly, Board Secretary, on behalf of Elaine Mead, Chief Executive Followed suggested changes to the draft Plan in August 2017, the RMP had now been approved on the basis of it being an Improvement Plan. There would be a local annual review with an opportunity to provide additional information to Scotland s Keeper of the Records, a formal five year review, and the Plan was included on the Corporate Risk Register. The Board noted: progress made in developing NHS Highland s Records Management Plan and its approval by the Keeper of the Records of Scotland. that annual update reports associated with the RMP would be submitted to the Board Chief Executive s and Directors Report Emerging Issues and Updates Report by Elaine Mead, Chief Executive This month s report incorporated updates on: a. NHS Highland Staff Win Awards b. International Visitors c. Initial Agreement Approved for Elective Care Centre d. Clinical Dialogue Pilot Underway e. Joint Thematic Review of Adult Support and Protection in Highland f. My Home Life g. Dementia Champions The Chair commended Laura Menzies, Midwifery Team Leader (Henderson Maternity Unit at NHS Highland s Caithness General Hospital), who had won the Healthcare Professional Category at the first Highland Heroes award ceremony organised by the Scottish Provincial Press. Ann Pascoe welcomed the news that over 50 staff across the NHS Highland board area had graduated from the national Dementia Champions training programmes. The Board noted the Emerging Issues and Updates Report. 5.1 Argyll & Bute Integration Joint Board of 2 August 2017

10 It was pointed out that the report was considerably out of date. Recent developments included interviews for a GP vacancy had attracted three appointable candidates which was positive. A&B were facing similar cost pressures to North Highland. 5.2 Asset Management Group of 19 September and 31 October 2017 There were no additional comments. 5.3 Area Clinical Forum of 21 September 2017 The Director of Transformation and Quality Improvement would attend meetings for the immediate future to consider ongoing work in relation to the Quality and Sustainability Plan. 5.4 Audit Committee of 12 September 2017 There were no additional comments. 5.5 Highland Health & Social Care Governance Committee of 9 November (one page summary by Chair) and the minutes of 6 July 2017 and 8 September 2017 (one page summaries having previously been submitted to the Board) Additional comments made included: The importance of timely reports being submitted. The usefulness of the balanced scorecard outcomes being available on the HHSCC website. In relation to the Chair s summary being subjective, the key issue was for areas of concern to be flagged to the Board. Following discussion on a recent incident where a manager was quoted in the media about a possible care home closure, it was clarified that any care home closures would be subject to a preagreed process that included presenting the matter to the HHSCC. 5.6 Adult Social Care Practice Forum of 2 November 2017 Additional comments included: The relatively low attendance at the meeting having been due to a simultaneous inspection that had taken place. The review of care packages was ongoing. Discussions in relation to strengthening links between the ASCPF and the Area Clinical Forum were ongoing, with complications resulting from the ACF being pan-highland while the ASCPF was for North Highland. 5.7 Additional Item: Finance Committee of 17 November 2017 No additional comments were made. The Board: (a) Confirmed adequate assurance has been provided from the Governance Reports. (b) Noted the Assurance Reports and agreed actions from the Audit and Highland Health & Social Care Governance Committees. 6.1 Date of next meeting The next meeting of the Board would be held on 30 January 2018 in the Board Room, Assynt House, Inverness. 6.2 Any Other Competent Business 10

11 6.3 The Board noted there would be a meeting of the Endowment Fund Trustees immediately following the open Board meeting. Close of meeting: 11.55am 11

12 Appendix: BOARD GOVERNANCE COMMITTEE MEMBERSHIPS, APPOINTMENT OF VICE-CHAIR AND GOVERNANCE COMMITTEE CHAIRS Revised list of memberships and Chairs The Board is invited to approve the following revisions to memberships of Committees etc. revisions highlighted in italics: Proposed new membership Highland Health & Social Care Committee 6 NHS Board non executives, one of whom is the Highland Council nominee on the Board 1. Melanie Newdick Chair 2. Andrew Evennett 3. Ann Pascoe 4. Deirdre Mackay 5. James Brander 6. Vacancy * Argyll and Bute Integration Joint Board Robin Creelman - Chair Gaener Rodger David Alston Sarah Compton Bishop * Membership listed for information appointed for a 3 year term maximum Governance Committees (nos. of non Exec) Proposed new membership Audit Committee 5 Non Executives 1. Alasdair Christie Chair 2. Ann Clark 3. Adam Palmer 4. Ann Pascoe 5. Mary Jean Devon Finance Committee 1. Alastair Lawton Chair 2. Board Chair 3. Board Vice Chair 4. IJB Chair 5. HHSCC Chair Clinical Governance Committee (4) 4 Non Executives And Chair ACF 1. Gaener Rodger Chair 2. Ann Clark 3. Michael Foxley 4. Deirdre MacKay Andrew Evennett (ACF Representative) Staff Governance Committee 4 Non Executives And Employee Director 1. Alasdair Lawton Chair 2. Robin Creelman 3. Sarah Compton Bishop 4. James Brander Adam Palmer (as Employee Director) Endowment Funds Committee 4 Non Executives including Employee Director 1. Ann Pascoe - Chair (determined by Endowment Trustees) 2. Adam Palmer (as Employee Director) 3. Gaener Roger 4. Mary Jean Devon 12

13 Remuneration Sub-Committee David Alston Chair Melanie Newdick Robin Creelman Alasdair Lawton Adam Palmer (as Employee Director) Non-Executive Representation on other NHS Highland Committees Committee Proposed new membership Control of Infection Committee Robin Creelman Chair Andrew Evennett 2 Non Executives Health & Safety Committee (1) Melanie Newdick Chair Pharmacy Practices Committee Asset Management Group (2 1 of whom is to Chair the Group) Organ Donation Committee Carbon Management Board Alasdair Christie Chair Gaener Roger Alasdair Lawton Chair Michael Foxley Deirdre MacKay Michael Foxley Non-Executive Representation on other Committees/Groups National Appeal Panel for Entry to Pharmaceutical Lists Highland Council Committee Education, Children and Adult Services Committee Melanie Newdick Hugo Van Woerden Joanna MacDonald 2 Community Empowerment Act Local Community Partnerships The Highland Community Planning Partnership Board is proposing to take forward the new duties of the Community Empowerment Act by establishing 9 Local Community Partnerships on which each partner will be represented. The proposals include NHS Highland chairing the Lochaber and Mid Ross Local Community Partnerships and participating in the remaining 7. The following representation is proposed: Local Community Partnerships Lead agency Proposed Representation Caithness HIE Ann Pascoe Sutherland Police Deirdre MacKay East Ross Fire Alasdair Lawton Mid Ross NHS Ann Clark Skye, Lochalsh and West Ross HIE Melanie Newdick Lochaber NHS Michael Foxley Inverness Council Adam Palmer Nairn Police Andrew Evennett Badenoch and Strathspey Fire Gaener Rodger Ruth Daly Board Secretary, 28 November

14