Mr P K Corsar, Non Executive Director

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1 Lanarkshire NHS Board 14 Beckford Street Hamilton ML3 0TA Telephone Fax Meeting of Lanarkshire NHS Board, Wednesday 27 May 2009, at 9.30 am in the Board Room, 14 Beckford Street, Hamilton CHAIRMAN: PRESENT: IN ATTENDANCE: Mr P K Corsar, Non Executive Director Mrs L Ace, Director of Finance Mr T Currie, Non Executive Director Mr T Davison, Chief Executive Dr A Graham, Medical Director Mrs L Khindria, Director of Human Resources Dr H S Kohli, Director of Public Health and Health Policy Mrs R Lyness, Director of Acute Services Councillor E McAvoy, Non Executive Director Dr D McCormick, Non Executive Director Mrs N Mahal, Non Executive Director Mrs M Nelson, Non Executive Director Mr C Sloey, Director, North Lanarkshire Community Health Partnership Mrs S Smith, Non Executive Director Mr W Sutherland, Non Executive Director Mr H Sweeney, Employee Director Mr P Wilson OBE, Director for Nurses, Midwives and the Allied Health Professions Mr N J Agnew, Corporate Affairs Manager/ Board Secretary Mrs K Hamilton, Head of Communications Mr C Lauder, Head of Modernisation Ms V Tallon, Co-ordinator, Alcohol and Drug Partnership (for Item 64) APOLOGIES: Mr J A Anning, Non Executive Director Mr D Clark, Non Executive Director Mr A Lawrie, Director, South Lanarkshire Community Health Partnership Councillor J McCabe, Non Executive Director Mr I A Ross, Director of Planning Mr K A Small, Director of Organisational Development 59. CHAIRMAN S REPORT ACTION The Chairman reported that the next meeting of the Cabinet Secretary for Health and Wellbeing with NHS Chairs was scheduled for Monday 1 June 2009, the May meeting having been rearranged due to the Bank Holiday. He advised that there had, nevertheless, been a Minister connection during the month of May, when Shona Robison, Minister for Public Health, had visited Liber8 in Blantyre to see the range of Alcohol Services provided, and to announce nationally additional funds for the local implementation of Alcohol Strategies.

2 60. MINUTES The Minute of the Meeting held on 29 April 2009 was submitted for approval and signature. i) Approved the minute for signature. 61. MATTERS ARISING a) Influenza A (H1N1) The Director of Public Health and Health Policy updated members on the situation nationally and locally, in terms of confirmed, probable and possible cases. He reported on the deliberations of the multi-agency Problem Assessment Group, which continued to meet regularly, and on linkages with other NHS Boards, Health Protection Scotland and the Scottish Government Health Department, towards ensuring an effective contribution from the NHS in Lanarkshire to the national and local containment strategy. He reassured members that careful planning on a number of fronts was underway, particularly in relation to the logistical arrangements for the distribution of antivirals and the mass vaccination programmes. i) Noted the update report on Influenza A (H1N1). ii) Asked to receive a further report. DPHHP b) Medical Workforce The Medical Director updated members on a range of issues associated with Medical Workforce, including appointments under Modernising Medical Careers and compliance with the European Working Time Directive 48 Hour requirement. She outlined the position with regard to the outcome of the February recruitment round and confirmed that the further national round of recruitment during May was progressing. She highlighted the areas in Lanarkshire where vacancies remained and confirmed that further efforts to recruit were in hand, including advertising for 6 Specialty Doctors in Emergency Medicine at Monklands and Hairmryes Hospitals, in order to achieve EWTD rota compliance. She highlighted the fact that achieving compliance by August 2009 would carry implications for services, particularly in outpatients, and she confirmed that detailed consideration was being given to mitigating the impact. She reported that the Postgraduate Medical Education Board (PMETB) from England would undertake a trainee survey visit to Lanarkshire in April She advised that, beyond the further round of recruitment in May, a detailed update report would be brought to the Board in June. The Director of Acute Services reassured the Board of the considerable endeavour within the Division to negate the impact of Modernising Medical Careers and achieving European Working Time Directive compliance on planned care. She advised that the additional recruitment would bring to 11 the number of Specialty Doctor posts in Emergency Medicine. 2

3 i) Noted the Update Report on Medical Workforce. ii) Asked to receive a further report. Medical Director 62. PATIENT SAFETY HEALTHCARE ASSOCIATED INFECTION The NHS Board considered a report on Healthcare Associated Infection. The Director for Nurses, Midwives and the Allied Health Professions explained that the report provided a further monthly update on performance in relation to Healthcare Associated Infection using the national reporting template, and covered a number of key issues, including: Performance against Health Efficiency Access targets; Infection Prevalence rates; Cleanliness of Clinical Facilities; progress against the national Clostridium Difficile Action Plan; progress against key issues within the HAI Task Force 3 year Delivery Plans: Surgical Site Infection Surveillance and Antimicrobial Prescribing. He reassured members that Healthcare Associated Infections continued to be a key priority within NHS Lanarkshire and was a major focus at a number of different levels across the system. He reported that as a further contribution to the HAI endeavour, additional key policies had been introduced during the month, viz: the Zero Tolerance to Compliance with Hand Hygiene Policy; a Uniform Policy and a Dress Code Policy, and he confirmed that implementation of these Policies would be rigorously applied and monitored. The Medical Director reported in detail on system performance with regard to Staphylococcus Aureus Bacteraemias, and on the progress of initiatives to further reduce the incidence of Staphylococcus Aureus Bacteraemia cases. She also updated members on the position with regard to Clostridium Difficile associated disease, where there had been further, demonstrable progress, and she reaffirmed the current new initiatives that were in place aimed at delivering further improvements in performance. She stressed that promoting Hand Hygiene remained a major focus for attention and outlined current and new initiatives in this regard, including direct involvement of the Hand Hygiene Team with the Scottish Patient Safety Programme Hand Hygiene Spread. She highlighted HAI incidents since the previous report and progress on compliance with the national Healthcare Associated Infection Programme. In an endorsement of the issues highlighted by the Director for Nurses, Midwives and the Allied Health Professions in his introduction, she stressed the priority being accorded to Healthcare Associated Infection within NHS Lanarkshire, which was evidenced not only in the range of initiatives in place, but also in system performance around Staphyloccus Aureus Bacteraemias, Clostridium Difficile associated disease and Hand Hygiene. She assured members that whilst good progress was being made, significant work was required to ensure that the organisation was fully compliant with the national Healthcare Associated Infection agenda over the next 3 years. The Chief Executive reaffirmed the extent to which Healthcare Associated Infection was a priority and stressed that reducing the incidence of HAI should be viewed as a shared responsibility by staff at all levels across the system. i) Noted the update report on Healthcare Associated Infection. ii) Asked to receive a further report. Medical Director 63. CLINICAL GOVERNANCE AND RISK MANAGEMENT 3

4 The Medical Director explained that the paper provided a progress report on Quality Assurance, with a focus on Risk Management. She reminded members of discussion at the previous meeting on Systems to Ensure Quality Assurance, which set out an intention to provide a monthly Quality Assurance report to the Board based around the Strengthening Quality in Lanarkshire Clinical Governance Strategy and Work Programme, and confirmed that, on a rotational basis, a more detailed report would be provided on one of the areas of: Clinical Effectiveness and Research and Development; Risk Management; The Scottish Patient Safety Programme. She reported on progress made in line with the Strengthening Quality In Lanarkshire Clinical Governance Strategy, through: the development of a draft Clinical Governance Work Programme for 2009/10; the development of a draft Clinical Effectiveness Strategy and Work Programme; the reconvening of the NHS Lanarkshire NHS Research and Development Committee to oversee the development of the Research and Development Strategy and Work Programme; and the finalisation of the self-assessment for the NHS QIS Clinical Government and Risk Management Review on 1 and 2 September She highlighted pertinent issues in relation to Risk Management, around the ongoing review of the Risk Management Strategy, and reported on the component parts of the Risk Management Framework, including the further development of the Framework around: Incident Reporting System; Risk Register Development; Review of Risk Management Guidance; and monitoring and review of the Framework. She drew members attention to the Key Performance Indicators for Risk Management, progress against which would be reported to the Board as part of the matrix of Quality Assurance measures. She also reported on emerging and current risk issues which were being addressed, in relation to: Policies and Procedures; Compliance Assurance; Positive Patient Identification; Information Governance; Medical Workforce and Hospital Acquired Infection. In discussion, she confirmed that complaints formed a key part of the approach to Risk Management, with performance in this area reported in a number of fora across the system at both a strategic and an operational level. The Director of the North Lanarkshire Community Health Partnership reported on ongoing work with the Local Authorities to develop shared Risk Registers encompassing the key areas of Partnership. The Medical Director acknowledged the need for robust processes leading to the closure of Critical Incidents. She reminded members of the Risk Management Steering Group role in relation to overview of Risk Registers, and advised that the population of the key Performance Indicators would further enhance reporting on Risk Management at a number of levels, including to the NHS Board. She highlighted the 40 day maximum period for closure on Critical Incidents, but sought to reassure the Board that, where appropriate, immediate actions required in response to incidents were identified and addressed rapidly. i) Noted the progress report on Clinical Governance and Risk Management. ii) Asked to receive a further report. Medical Director 64. HEALTH IMPROVEMENT ALCOHOL MISUSE The Director of the North Lanarkshire Community Health Partnership, in his capacity as Chair of the Alcohol and Drug Partnership, and the Alcohol and Drug Partnership Co-ordinator, gave a detailed presentation to the NHS Board on Changing Lanarkshire s Relationship with Alcohol, encompassing: The Framework for Action on Alcohol Problems; Our Challenge: The Case for Change; The Lanarkshire Approach; Reducing the level of Alcohol-related harm 4

5 within the Community; Safeguarding and Promoting the Interests of Children, Families and Young People; and Developing Appropriate Treatment and Support Services for Individuals with Alcohol and Drug Problems. They emphasised that the Alcohol and Drug Partnership Strategy, 3 Year Delivery Plan and Commissioning Strategy outlined how the additional investments in Alcohol Programmes over the next 3 years would be used to improve the outcomes for individuals, Families and local Communities in Lanarkshire by investing in a range of services. These included: Increased Treatment and Prevention/Education Services for Young People; Increased Support to families affected by Alcohol problems; Increasing the capacity and capability of treatment and care services for existing and newly identified dependent drinkers; implementation of brief interventions in Primary Care, via a Local Enhanced Service with General Practitioners, Antenatal and Acute Care settings; and funding Strathclyde Police to continue with Safer Lanarkshire campaigns, and working with the local Licensing Forum to implement a range of measures including ending irresponsible promotions and below cost selling. The Chair of the Alcohol and Drug Partnership highlighted the demonstrated link between deprivation and excess alcohol consumption, but stressed that excess alcohol consumption was an issue also within more affluent communities. The Chief Executive highlighted the fact that available funding for Alcohol and Drug Misuse Services was now weighted more in favour of tackling Alcohol Misuse, given the prevalence within Scotland. The Director of Public Health and Health Policy endorsed the linkages between deprivation and excess alcohol consumption, but highlighted the imperative of decreasing the per capita alcohol consumption across the population, regardless of social class. The ADP Co-ordinator explained that the Alcohol and Drug Partnership had funded a post, as part of the Healthy Working Lives Initiative, to enable staff to be referred to the Occupational Health and Safety Service for help and advice on alcohol issues, as an integral part of the overall approach to absence management. The Chair of the Alcohol and Drug Partnership highlighted the assistance that the ADP provided to employers within the Board s area in developing their own Alcohol Policies. The ADP Co-ordinator acknowledged the legitimate expectation of a higher return for the increased investment in tackling Alcohol Misuse. She explained that shifting the culture and observing the additional impact of increased investment would have a lengthy lead time. She also highlighted the role of Licensing Boards in taking account of Public Health issues when considering License applications. The Chair of the Alcohol and Drug Partnership highlighted the enhanced focus in the approach being pursued in Lanarkshire on individuals affected by the person with the alcohol misuse issue. i) Noted the report on Health Improvement Alcohol Misuse. ii) Endorsed the approach to tackling Alcohol Misuse being taken forward through the Alcohol and Drug Partnership. 65. REFORMING ALCOHOL AND DRUG SERVICES DELIVERY ARRANGEMENTS The NHS Board considered a report on Reforming Alcohol and Drug Delivery Services. 5

6 The Director of the North Lanarkshire Community Health Partnership, in his capacity as Chair of the Alcohol and Drug Partnership, explained that the report had been prepared to advise members of the implications of change to Alcohol and Drug Action Teams arising from the Scottish Government Framework for Local Partnerships on Alcohol and Drugs, which explicitly set out the requirements for NHS Board and Local Authority Partnerships. He reminded members of the background and the national context for the change and outlined for members the collective and individual responsibilities of NHS Boards and Local Authorities. He advised that the Scottish Government had endorsed an approach in Lanarkshire involving rebranding the Alcohol and Drug Action Team as the Lanarkshire Alcohol and Drug Partnership, with effect from 1 April He also reported agreement that he should retain the Chair of the Alcohol and Drug Partnership. He highlighted the extent to which the new arrangements would ensure the effective monitoring of services commissioned and delivered at NHS Board level and enable NHS Lanarkshire to fulfil its reporting arrangements to the Scottish Government, including in relation to the current and emerging HEAT Targets for Alcohol and Drugs. He also stressed that links with Community Planning arrangements would be retained and strengthened through the existing structures that operated in both North and South Lanarkshire Partnerships, with performance data reported back through the Health and Care Partnerships, thereby ensuring that there would be in place an overall Governance and Accountability process linked to the Single Outcome Agreements. i) Recognised that the requirement to establish Alcohol and Drug Partnerships had been agreed with existing Alcohol and Drug Action Team Members. ii) iii) iv) Recognised that these arrangements had been agreed with the Scottish Government. Noted that the Lanarkshire Strategy for Alcohol and Drug Services was already in place. Noted that the requisite outcomes focussed Delivery Plan was in place. 66. CURAM v) Noted that the Governance and Accountability arrangements required in the new Framework for Local Partnerships in Alcohol and Drugs, to assure performance, were in place for both the Single Outcome Agreement and HEAT Targets. The NHS Board considered a report on CURAM (Caring), NHS Scotland s Policy for Developing Nursing, Midwifery and Allied Health Profession Services. 6

7 The Director for Nurses, Midwives and the Allied Health Professions explained that the report was presented to inform the Board of the Policy document and give an assessment of the NHS Lanarkshire position against the Work Programme for Scotland He advised that the Scottish Government Strategy for developing Nursing, Midwifery and Allied Health Professions contribution to the implementation of Delivering Care, Enabling Health, included a 26 point Action Plan which had now been made smarter (specific, measurable, achievable, realistic and time limited), and published under the banner CURAM. He referred members to the assessment of where NHS Lanarkshire was positioned in relation to the CURAM Work Programme, which showed that of the 25 aims in the national Work Programme , 16 were complete or on target, 7 were underway but underdeveloped and 2 had little or no relevant action. He stressed that, overall, good progress was being made in Lanarkshire against the Work Programme, and confirmed that a further progress report would be brought to the Board in October i) Noted the report on CURAM the contribution of Nurses, Midwives and the Allied Health Professions to Working for Scotland s Health. ii) Agreed to consider a further progress report in October Director NMAHP 67. CARING AND COMPASSIONATE PRACTICE The NHS Board considered a paper on Caring and Compassionate Practice. The Director for Nurses, Midwives and the Allied Health Professions explained that the paper linked to the previous item, and was provided to inform the Board of the development of the Clinical Practice Statement which was to be implemented across all areas of Nursing, Midwifery and Allied Health Profession Practice during the course of 2009, and would serve as a foundation for the development of other areas of Practice in future years. He highlighted as essential a positive relationship between clinicians and patient if the effectiveness of Clinical interventions was to be realised. He advised that the Clinical Practice Statement had, amongst other things, taken account of the Board s own statement of values and the Nursing and Midwifery Council and Health Professions Council Codes of Conduct. He reported that the Government s Quality Strategy, to be published in the near future, would include Caring and Compassionate Healthcare as one of its 6 key measures of quality. He highlighted the principles and standards included in the Clinical Practice Statement and outlined the way in which these would be effected. He reaffirmed that the Statement was an important start in emphasising that Care and Compassion lay at the heart of establishing positive therapeutic relationships with patients, in turn, bringing well-evidenced benefits to patients. The Medical Director endorsed the initiative. She acknowledged its relevance also, to medical staff, and undertook to ask the Director of Medical Education to consider its wider application. Medical Director The Chief Executive confirmed that the issue had recently been considered by the Corporate Management Team, when there had been recognition of the linkages to Better Together The Patient Experience Programme. He suggested that these issues, together, should feature as a measure of qualitative analysis of performance, reported to the Board on a regular basis, and including digital stories. i) Noted the report on Caring and Compassionate Practice. 7

8 ii) Endorsed the need for the development of action on this issue. iii) iv) Noted that a progress report would be brought before the Board at its meeting in October as part of the progress report on CURAM. Noted that progress on this issue would also be part of the report to the Board on: Development of the Clinical Governance Strategy; Implementation of the Better Care Patient Experience Programme; the Board response to the forthcoming Government Quality Improvement Strategy. 68. MANAGING HEALTHCARE CONTRACTS WITH INDEPENDENT SECTOR PROVIDERS The NHS Board considered a report on Managing Healthcare Contracts with Independent Sector Providers. The Director for Nurses, Midwives and the Allied Health Professions explained that the Board had a portfolio of contracts with Independent Sector Providers which, in 2008/9 had a contract value of 11.5m. He highlighted the requirement for the contracting process to have a standardised approach throughout NHS Lanarkshire, and advised that the submitted policy sought to achieve this aim. He highlighted in particular from the policy the strengthened arrangements for performance review, contract management and quality assurance, including the establishment of a Contract Review Group for performance oversight, reporting to the Board through the Director of Planning as part of the established Performance Management arrangements. The Chief Executive commended the policy to the Board. He highlighted the demographic projections and their implications for the Health Service and for Residential Care for the Elderly, and undertook to bring further information to the Board in this regard. The Director of Acute Services confirmed that this issue would also be considered further by the Older Peoples Services Board. i) Approved the Policy on Managing Healthcare Contracts with Independent Sector Providers. ii) Noted that the Policy would be subject to review no later than April 2012 and sooner if necessary. iii) iv) Noted that similar consideration would be given to strengthening arrangements for Service Level Agreements between NHS Lanarkshire and other NHS Social Care Providers. Agreed to give further consideration at a future meeting to the implications of demographic change and Care of the Elderly. Chief Executive 69. PATIENT FOCUS PUBLIC INVOLVEMENT The Board considered the Patient Focus Public Involvement Action Plan 2009/

9 The Head of Modernisation explained that the paper provided an update to the Board on implementation of the Patient Focus Public Involvement Strategy He reminded members that the PFPI Strategy reflected the Board s commitment to work in partnership with the people of Lanarkshire to improve Health, reduce health inequalities and build trust and confidence in the Board s relationships with the public, staff and organisations with whom it worked. He advised that the Action Plan presented provided a summary of a range of Workstreams, each with individual Action Plans and Governance arrangements to ensure their implementation, and reflected progress made to the end of April He advised that 3 main indicators had been identified as measures of overall achievement in relation to Patient Focus Public Involvement, viz: patient feedback through the Better Together Programme; Public and Patient Partnership Forum feedback utilising surveys; The Scottish Health Council Annual PFPI Assessment. He highlighted, in particular from the Action Plan, the Carer Information Strategy, extensive work in relation to the Investing In Volunteers Standard; and a new model for engagement with the Scottish Health Council. i) Noted the update report on the Patient Focus Public Involvement Strategy Action Plan. ii) Asked to receive further progress reports. Director of Planning 70. COMMUNICATIONS STRATEGY The NHS Board considered a revised Communications Strategy. The Head of Communications reported that the revised Strategy built on the earlier Strategy approved in November 2005, and included: NHS Lanarkshire s Values and Principles for Communication; where NHS Lanarkshire was now with communications; where NHS Lanarkshire wished to be; and the mechanisms for performance monitoring and evaluation on an ongoing basis. She stressed that the revised Strategy was developed taking into account feedback from: the Public Engagement and Communication Audit 2007/08; the Staff Survey 2008/09; the Scottish Consumer Council Report 2007 on the experience of members of the public in contacting their NHS Board; and a Communications Strategy Workshop held in March In addition to these measures, a Press Release and Staff Briefing were issued on 17 April inviting comments on the draft Strategy and articles appeared in 5 Lanarkshire newspapers. The Strategy was also made available on the NHS Lanarkshire Website and comments were invited from: General Practitioners; Public Partnership Forum; Members of the Scottish Parliament; West of Scotland NHS Communication colleagues; the Area Clinical Forum; and the Area Partnership Forum. She advised that comments received had been supportive of the Strategy and had identified support for more face to face engagement, promotion of involvement opportunities through the Public Partnership Forums and better access to for General Practitioners. She advised also that the draft Strategy had been approved by the Stakeholder Engagement Group on 5 May 2009 and by the Corporate Management Team on 14 May 2009, and confirmed that an Equality and Diversity Impact Assessment of the Strategy had been carried out. In discussion, members highlighted the recently launched updated NHS Lanarkshire Public Website, and encouraged the further development of the Website as an important medium for accessing key information about Health and Health Services and the Board s performance in delivering its objectives. The need was highlighted, also, for clear information to be available to the public about the role of Hospitals and Primary Care in the provision of Health Services. 9

10 i) Approved the Communication Strategy , subject to the development of an Action Plan to provide reassurance on monitoring. Head of Communications 71. PERFORMANCE MONITORING The NHS Board considered a Quarterly Corporate Performance Report for the period to 31 March The Head of Modernisation advised that the report focussed on: the HEAT Template; Healthcare Acquired Infection; The Scottish Patient Safety Programme; Child Protection; the Senior Charge Nurses Review; and the proposed Programme and content of reports for 2009/2010, and was intended to enable the Board to review performance and consider any further action required particularly in relation to those areas which were currently below target. He advised that a traffic light system had been adopted for ease of highlighting variance, and drew members attention to those targets which were amber, being below trajectory, but expected to recover in-year. He stressed that the report demonstrated encouraging progress on delivery across the range of performance areas, and advised that the report had recently been considered and endorsed by the Corporate Management Team on 14 May He highlighted the proposed performance reporting programme and the proposed content of Quarterly Corporate Performance reports for 2009/10, and confirmed that reporting would be refined to reflect further developments in this area. i) Noted the Quarterly Performance Report to the period to 31 March ii) Asked to receive a Quarterly Corporate Performance Report for the period to 30 June 2009 at a future meeting. Director of Planning 72. LOCAL DELIVERY PLAN PERFORMANCE REPORTS 2009/10 The NHS Board considered Performance Reports, as follows: a) Waiting Times The Board considered a report on Waiting Times Performance to 30 April The Director of Acute Services reported that the Scottish Government had introduced a number of improved Waiting Time targets with an expectation that targets delivered at 31 March 2009 would be sustained. She reminded members that the Board had set out in the Local Delivery Plan for 2009/10 trajectories against each Waiting Time target, and confirmed that progress in the delivery of these targets would be reported through the application of a traffic light system of Performance Monitoring. She reported that all HEAT Waiting Time Guarantees delivered at 31 March 2009 had been sustained during April 2009, with no outpatients, inpatients or day cases waiting over 12 weeks at 30 April She advised that the same performance applied to diagnostics, with a maximum wait of 6 weeks at 30 April She also highlighted: Cancer Performance across all tumour types at 30 April of 95.8%, ensuring compliance with the national target for the second consecutive month; performance against the 4 hour A&E target of 98% in April; work in progress to identify capacity implications of 10

11 delivery of all targets; continued improvement with compliance with New Ways; and delivery of the Delayed Discharge Guarantees at the census date of 15 April She highlighted the particular challenges which the system faced in delivering the new Cancer target of 31 days from diagnosis to treatment and the 18 week referral to treatment target and confirmed that substantial work was underway to ensure that the system could move incrementally towards full compliance by the nationally set target dates. She highlighted as a priority obtaining from the Scottish Government confirmation of outstanding targets and measurement of performance, as this would inform the remaining trajectories and an assessment of the work that needed to be done to achieve delivery. She also reported on progress in introducing LEAN technology in a number of key areas, and advised that a robust tendering exercise had resulted in the appointment of GE Healthcare as the partner to work with the Division in the delivery of LEAN technology. She advised that further information in this regard would be brought to a future meeting of the Board. i) Noted the report on Waiting Times Performance to 30 April 2009 and the improved targets to be delivered during 2009/10. ii) Asked to receive a further report. Director of Acute Services b) Primary Care Out-of-Hours Services The NHS Board considered a report on performance of the Out-of-Hours Service for April The Director of the North Lanarkshire Community Health Partnership reported that the Service had experienced a busy Easter period but, overall, had coped well with the pressures. He highlighted the ongoing work to set up the On-Line Rota System which was expected to be fully operational by the end of June, and would contribute to the efficient and effective management of available Out-of-Hours manpower, particularly medical staff. He also highlighted the continuing input of the Out-of-Hours Service to providing the HPV Vaccination Programme to School-Leavers who could not access the vaccination at their GP Practice. i) Noted the Primary Care Out-of-Hours report for April ii) Asked to receive a further report. Director SLCHP c) Sickness Absence The NHS Board considered a progress report on the achievement of the 4% Sickness Absence target by March The Director of Human Resources reported that the position in March was 4.25%, representing a further improvement from the February position. She also highlighted the further actions being taken and planned towards sustaining the improvement in Sickness Absence performance. The Employee Director reported that the EASY Sickness Absence Management Project had been submitted for consideration for a national Government Award in the category of Staff Health and Wellbeing. 11

12 73. GOVERNANCE MINUTES i) Noted the Progress Report on achievement of the 4% Sickness Absence Target by March ii) Asked to receive a further report. Director of Human Resources a) Health and Clinical Governance Committee 20 April 2009 The NHS Board received and noted the Minute of the Meeting of the Health and Clinical Governance Committee held on 20 April Mrs Nelson, Committee Chair, reported that the Committee was scheduled to meet again on 15 June DATE OF NEXT MEETING Wednesday 24 June MOTION TO MOVE INTO PRIVATE SESSION The NHS Board approved a Motion to move into Private Session due to the Commercial In Confidence nature of the matters. 76. PHARMACY PRACTICES COMMITTEE The NHS Board considered and noted the Minutes of Meetings of the Pharmacy Practices Committee, as follows: a) Pharmacy Practices Committee 5 December 2008 b) Pharmacy Practices Committee - 15 January 2009 c) Pharmacy Practices Committee 27 February 2009 d) Pharmacy Practices Committee 27 February 2009 e) Pharmacy Practices Committee 27 February 2009 Mr Sutherland, Committee Chair, highlighted the reasons for which the Committee had met, the issues considered and the Committee decisions. He also briefed the Board on key issues related to Pharmacy applications, within the wider context of the new Pharmacy Contract and the Pharmaceutical Services Strategy. NJA/OD 22 June

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