AGENDA ITEM 7.1 MINUTES OF THE JOINT COMMITTEE MEETING HELD 25 MARCH 2014 AT MEETING ROOM, BOWEL SCREENING WALES, PONTYCLUN, CF72 8XT PRESENT Members: Mr John Hill-Tout Dr Geoffrey Carroll Mr Stuart Davies Dr Andrew Goodall Mr Stephen Harrhy Mr Bob Hudson Ms Sian Marie James Mr David Jenkins Mr Paul Roberts Mrs Allison Williams Associate Members: Professor Simon Smail Interim Chair Medical Director, WHSSC Finance and Information, WHSSC Chief Executive, Aneurin Bevan UHB Interim Specialised and Tertiary Services Chief Executive, Powys THB Independent Member Independent Member Chief Executive, Abertawe Bro Morgannwg UHB Chief Executive, Cwm Taf UHB Independent Member and Chair of Quality and Safety Committee and Gender Partnership Board In Attendance: Page 1 of 29 6 May 2014
Mr Carl James Mr Bob Evans Mr Ian Langfield Ms Karen Miles Mr Daniel Phillips Mrs Cathie Steele Mr David Wilmott PRELIMINARY MATTERS Planning, Velindre NHS Trust (for Mr Simon Dean) Assistant Finance, Betsi Cadwaladr UHB (for Mr Geoff Lang) Assistant Planning, WHSSC All-Wales Finance Lead and Finance, Hywel Dda LHB Planning, WHSSC and Chair of Posture and Mobility Partnership Board Corporate Governance Manager, WHSSC Head of Nursing and Quality, WHSSC Action WHSSC13/50 WELCOME AND INTRODUCTIONS The Interim Chair WELCOMED all to the Joint Committee meeting. Mr John Hill-Tout reported that he had been appointed by the Minister for Health and Social Services as Interim Chair for a period of six months, during which time a recruitment exercise for a permanent chair was to take place. The Chair welcomed Ms Sian Marie James, Independent Member and Vice Chair of Hywel Dda LHB to her first Joint Committee meeting. He also welcomed Mr Carl James, Planning for Velindre NHS Trust who was attending on behalf of Mr Simon Dean and Mr Bob Evans, Assistant Finance for Betsi Cadwaladr UHB who was Page 2 of 29 6 May 2014
attending on behalf of Mr Geoff Lang. WHSSC13/51 WHSSC13/52 APOLOGIES FOR ABSENCE Apologies for absence were received from: Mr Adam Cairns, Cardiff and Vale UHB; Mr Simon Dean, Velindre NHS Trust; Ms Karen Howell, Hywel Dda LHB; and Mr Elwyn Price-Morris, Welsh Ambulance Services NHS Trust. DECLARATIONS OF INTEREST The Interim Chair reminded Members of how interests would be dealt with in accordance with the Standing Orders. There were no declarations of interest. WHSSC13/53 MINUTES OF THE MEETING HELD ON 26 NOVEMBER 2013 The minutes of the last meeting were AGREED as a true and accurate record subject to the amendment of a few typographical errors. WHSSC13/54 MATTERS ARISING Members NOTED the progress against the Action Log and RECEIVED the Decision Log. WHSSC13/55 TO RECEIVE A REPORT FROM THE CHAIR Members RECEIVED a verbal report from Mr John Hill-Tout, Interim Chair of Joint Committee. The Interim Chair reported that the WHSSC Directions and Regulations allow Independent Members of the Joint Page 3 of 29 6 May 2014
Committee to be appointed for a maximum period of four years. Mr David Jenkins and he had held office since April 2010. Therefore he AGREED to write to all Local Health Boards seeking nominations for two placement non-executive members of the Committee. Chair NOTE the contents of the verbal report. WHSSC13/56 RECEIVE A REPORT FROM THE INTERIM DIRECTOR OF SPECIALISED AND TERTIARY SERVICES Members RECEIVED a verbal report from Mr Stephen Harrhy, Interim Specialised and Tertiary Services. Mr Harrhy reported that a specialised services strategy is being developed within NHS England. He AGREED to provide a paper on the development of a specialised services strategy for Wales. NOTE the contents of the verbal report. Interim Specialised and Tertiary Services FOR DISCUSSION AND DECISION WHSSC13/57 TO RECEIVE A REPORT ON THE INTEGRATED COMMISSIONING PLAN FOR SPECIALISED SERVICES 2014/15 TO 2016/17 Members RECEIVED a presentation on the integrated commissioning plan for specialised services for 2014/15 to 2016/17 from Mr Page 4 of 29 6 May 2014
Stephen Harrhy, Interim Specialised and Tertiary Services. Mr Harrhy confirmed that the integrated commissioning plan for specialised services forms part of the Health Boards'and key providers' integrated plans. This link has been highlighted by Welsh Government. He noted that the Integrated Commissioning Plan for specialised services had been reviewed by Welsh Government only recently and that this had impacted on getting the final plan out to Members. Mr Harrhy provided Members with information on how the integrated commissioning plan had been developed. He reported that the business cases received from providers had been reviewed and would need to be discussed further, once amendments had been received, at a future Joint Committee. Mr Harrhy reported that there are five streams of priorities within the integrated commissioning plan. These are patient safety and outcomes, ministerial priorities, evidence assessment, new business cases, and decisions in year that have a future impact. He noted that the during the three year cycle all services included within the plan will be subject to the key commissioning process which includes: Evidence Assessment; Commissioning Policies; Service Specifications; Quality and Outcome Measures; Impact Assessment; Performance Management/Contracting; Page 5 of 29 6 May 2014
and Review and Evaluation. In a response to Mr Bob Hudson, Mr Harrhy reported that for patient engagement a number of national specialised groups are consulted, as well as the CHCs. It was noted that the baseline net costs within the integrated plan reflect the costs agreed for 2013/14 rather than the outturn for 2013/14. At present the costs do include emergency ambulance services. Mrs Allison Williams reported the feedback she had received from the Cwm Taf UHB members who sit on the Management Group and indicated that she is not satisfied that the scrutiny process is complete. In response Mr Harrhy noted the steps that had been taken to align the integrated commissioning plan for specialised services with Health Board plans. He also noted that Management Group members had been asked at the last meeting to feedback their comments ahead of the papers being prepared for this Joint Committee and that no comments had been received. Therefore it had been concluded that the integrated commissioning plan for specialised services was consistent with Health Board plans. Mr Harrhy confirmed that all providers have been informed that business cases will not be accepted in year unless there are exceptional circumstances. Members discussed the financial implications of the plan, the assumptions made and the processes followed within Health Boards. Members also discussed what assumptions in Page 6 of 29 6 May 2014
relation to specialised services had been included within the Health Board plans and the possible impact of not adopting the plan. The impact of the discussions on the evidence appraisal approach was also noted. Members also noted the need to consider actions that could be taken, for example where performance in specialised services is not improving Mr Harrhy continued the presentation, reporting that performance, quality and patient experience had been included within the plan. He provided Members with specific examples. In response to a question on managing expectations, Mr Harrhy noted that WHSSC have been learning from past experience and the current approach is to be open and honest with pressure groups. The mechanisms used have been dependent on the specialty. Mr Harrhy also noted the links with Health Board arrangements. Mr David Wilmott provided Members with a specific example by highlighting that in the Gender Partnership Board it has been made clear that the pathway redesign needs to be within the current funds. Mr Harrhy drew attention to the new treatments considered through evidence appraisal providing Members with examples. He also noted the prudent healthcare work where demand reduction is being considered. Mr Harrhy continued the presentation by drawing Members attention to the top 10 priorities within plan. He noted the need to consider the key risks and ensure that these are included within the plan. Page 7 of 29 6 May 2014
The implementation of the plan was also raised by Mr Harrhy. He noted the LHB requirements and emphasised the links to the specialised services integrated commissioning plan. Mr Harrhy also noted the provider requirements, the need to assess the risk and impact of the plans and the steps required to mitigate risks and finally the link to Collaborative Commissioning. Mr Harrhy highlighted that in order to provide financial discipline, WHSSC needs some degree of certainty around financial assumptions. This will ensure that the best value is achieved through the commissioning plan. It was AGREED that the WAST issues would be included in the legacy statement from WHSSC to the newly formed Emergency Ambulance Services Committee. Members also AGREED that very detailed scrutiny on the business cases for cardiac and liver was required. Members discussed the plan at length and raised a range of issues, following which the Interim Chair summarised the key points of the discussions: Members could not approve the integrated commissioning plan for specialised services at this stage because the financial position for NHS Wales is not yet balanced; Members did broadly support the direction of the plan. However further work was required to limit some of the costs including: Finance Interim Specialised and Tertiary Service Page 8 of 29 6 May 2014
o Reassurance on some of the demand costs; o A small working group representing the Directors of Finance to be established, led by Ms Karen Miles, to ensure that the financial risks are contained; o The need to ensure value for money in relation to the WAST arrangements before these are handed over to EASC as part of the legacy statement; and o The need to ensure that there is detailed scrutiny of the business cases for cardiac surgery and liver surgery. Members recognised that the bulk of the spending in the plan consisted of established service delivery, which is ongoing but further work is required by WHSSC to review the areas of potential unfunded growth and to limit expenditure. Members also requested that it be made clear how in year pressures would be handled. Mr Harrhy noted that Members will be required to make difficult decisions regarding the provision of services to achieve the financial requirements discussed. It was AGREED that the points raised would be further discussed at the Management Group and the amended Integrated Commissioning Plan would be received at the next Joint Committee. Interim Specialised and Tertiary Service The Interim Chair commended the WHSSC team on the professional plan presented. SUPPORT the overall direction set Page 9 of 29 6 May 2014
out in the plan; RECEIVE the revised plan at the next Joint Committee following further discussion at the Management Group meeting. NOT TO RATIFY the Integrated Commissioning Plan for Specialised Services for Wales for 2014/15 to 2016/17 until the overall financial plan for Wales is settled. WHSSC13/58 TO RECEIVE A REPORT ON THE ESTABLISHMENT AND WORK PROGRAMME OF CLINICAL EVIDENCE REFERENCE GROUPS (CERGS) AND CLINICAL EVIDENCE AND PRIORITISATION Members RECEIVED a verbal report on the establishment and work programme of Clinical Evidence Reference Groups (CERGS) and clinical evidence and prioritisation work from Dr Carroll, Medical WHSSC. Dr Carroll drew Members attention to the following key points: Rather than use the NHS England Clinical Reference Groups, specific groups have been established within Wales to ensure that there is focus in particular areas relevant to Wales; and The links with prudent health care and the need to work with the Chief Medical Officer, her deputy and others. NOTE the contents of the report; NOTE the establishment of the Clinical Page 10 of 29 6 May 2014
Evidence Reference Groups, NOTE the current action and work programme for 2014/15. WHSSC13/59 REPORT ON CARDIAC SURGERY WAITING TIMES (RISK REFERENCE CT/003) Members RECEIVED an introduction from Mr Stephen Harrhy, Interim Specialised and Tertiary Services to a tabled report with regards to a risk previously reported to Joint Committee Members. Mr Harrhy confirmed that the paper will be added to the Joint Committee papers on the WHSSC website. Mr Phillips provided further information in relation to the paper. Members discussed further the following points: Current capacity issues; Current agreed LTA/SLA; Equity of access and potential halo effect. Members AGREED that all patients regardless of LHB of residence must be treated equally and equitably outsourced as appropriate; Having confidence that the providers can deliver agreed LTAs in future; Current situation with regards to the business cases received from the Welsh providers. Mr Stuart Davies confirmed that the business cases have been shared with the Directors of Finance and that a subgroup had been formed. He also noted that at present the further information is required to progress the business cases. It was Page 11 of 29 6 May 2014
AGREED that following discussion at Management Group the business cases would be brought be discussed at a future Joint Committee for ratification. It was also AGREED that the business cases would be shared with the Chief Executives at an early stage before discussion at the Joint Committee; Previous funding provided by WHSSC to ABMU for two additional critical care beds which have not been opened. Therefore it was AGREED that there is a need to understand why these beds were not opened; Need for commissioners and providers to work collaboratively to resolve the issues and ensure patients receive treatment within appropriate timescales; Link with South Wales Plan; Agree and implement protocols for referrals including scrutiny of patients who are being referred to the cardiac surgery waiting lists. It was AGREED that thresholds would be agreed collaboratively and that this work would be lead by WHSSC on behalf of the LHBs; Provision of timely performance figures from the Welsh providers; Members also AGREED that whilst this work is ongoing that outsourcing must continue. Interim Specialised and Tertiary Services Interim Specialised and Tertiary Services Interim Specialised and Tertiary Services SUPPORT the plans to increase cardiac surgery capacity, within Cardiff and Vale UHB and Abertawe Bro Morgannwg UHB, to meet recurrent demand for cardiac surgery, subject to further scrutiny of the both business cases and Page 12 of 29 6 May 2014
further negotiation on the costs and agreement on a new robust, transparent and equitable contractual framework; SUPPORT Abertawe Bro Morgannwg UHB and Cardiff and Vale UHB capital developments to increase internal cardiac surgery capacity, subject to further scrutiny of the both business cases; APPROVE the continuation of outsourcing to address the most urgent and highest clinical risk patients for south east Wales; APPROVE outsourcing of capacity to London to address the most urgent and highest clinical risk patients for mid and west Wales; SUPPORT proposals to outsource routine patients from mid and west Wales during 2014/15 to meet recurrent demand while building works are undertaken to increase capacity at Abertawe Bro Morgannwg UHB; SUPPORT further dialogue with the Minister and officials on proposals to reduce waiting times and introduce differential waiting times target; SUPPORT further work planned to: Agree and implement new robust, transparent and equitable contract arrangements; Assess the longer term (5-10 year) demand for cardiac surgery including subs-specialisation; and Review the access criteria for cardiac surgery to ensure equity of access and consistency with prudent medicine. Page 13 of 29 6 May 2014
WHSSC13/60 TO RECEIVE A REPORT ON WELSH AMBULANCE SERVICES NHS TRUST Members RECEIVED an update report on the commissioning of services from the Welsh Ambulance Services NHS Trust from Mr Stephen Harrhy, Interim Specialised and Tertiary Services. Mr Harrhy reported that an end of year settlement had been achieved and that a legacy statement will be produced as a hand over to EASC. He AGREED to ensure that a copy of the legacy statement is shared with the WHSS Joint Committee. Mr Harrhy noted that the EAS Joint Committee will come into existence on 01 April 2014 and therefore the WHSSC role will end on 31 March 2014. Interim Specialised and Tertiary Services Mrs Williams stressed the need to utilise the WHSS team resources to support EASC, rather than duplicating. She also reported the expectation that the LHBs will fund the Chief Ambulance Commissioner and that this will need to be either through WHSSC funds or additional funding will be required. It was also highlighted that the Chief Ambulance Commissioner will need an infrastructure to support the work. NOTE to the contents of the report. WHSSC13/61 TO RECEIVE A REPORT ON THE GOVERNANCE AND ACCOUNTABILITY FRAMEWORK Members RECEIVED a report on the Governance and Accountability Framework Page 14 of 29 6 May 2014
including Standing Orders from Mrs Cathie Steele, Corporate Governance Manager for WHSSC. Mrs Steele noted that the WHSSC Governance and Accountability Framework, which includes the Standing Orders and Standing Financial Instructions, have been reviewed and updated. She drew Members attention to the changes listed within the paper. She also highlighted that it is proposed that, given the core elements within the governance and accountability framework and the fact that the WHSSC governance and accountability is currently under review, there be one governance and accountability framework for the two joint committees (Welsh Health Specialised Services Committee (WHSSC) and Emergency Ambulance Services Committee (EASC)) which will consist of three parts, the core elements, the elements specific to WHSSC and the elements specific to EASC. Mrs Steele reported that the draft framework has been shared with the Board Secretaries ahead of this meeting and the shadow EAS Joint Committee meeting which is scheduled to be held on 25 March 2014 (afternoon). The elements specific to EASC will be considered at their shadow meeting and then ratified at the first formal EAS Joint Committee in April. The Governance and Accountability Framework will be circulated to all Health Boards following its ratification. Members discussed further the implications of the EAS Joint Committee and the infrastructure arrangements to be put in Page 15 of 29 6 May 2014
place to avoid duplication and to reduce resource implications. Members noted that, in view of the work currently underway to review Networks and Advisory Groups, changes in year maybe required to the framework. NOTE the contents of the report; NOTE the decision of the Minister in regards to need for separate Joint Committees; NOTE the changes made to the Standing Orders and to the Standing Financial Instructions; SUPPORT the ongoing work to develop a Joint Committees (WHSSC and EASC) Governance and Accountability Framework. WHSSC13/62 TO RECEIVE A REPORT ON THE REVISIONS TO THE ALL WALES POSTURE & MOBILITY PARTNERSHIP BOARD TERMS OF REFERENCE Members received a report on the revisions to the All Wales Posture and Mobility Partnership Board Terms of Reference, from Mr Daniel Phillips, Chair of the All Wales Posture and Mobility Partnership Board and Planning, WHSSC. Mr Phillips provided the background to the review of the terms of reference. He noted that the purpose behind the revision to the terms of reference is to focus the work of partnership board and to enable it to establish working groups to take forward specific tasks. The requirements for user Page 16 of 29 6 May 2014
representatives have been refreshed to ensure that these individuals are able to bring forward the views of and link with other users of the service. He also noted the need for interagency working and the inclusion of the Directors of Housing within the membership. In response to Mrs Williams, Mr Phillips confirmed that the Partnership Board does not manage the performance through monitoring the Key Performance Indicators (KPIs) and it was AGREED that this element of the terms of reference will be clarified. Mr Ian Langfield provided Members with an update of the meeting recently held. He noted that there were a series of actions for the LHBs agreed at the Partnership Board and AGREED to circulate this information to Members. Chair of the Posture & Mobility Partnership Board Assistant Planning NOTE the contents of the report; and RATIFY the revised Terms of Reference for the All Wales Posture and Mobility Partnership Board subject to minor amendments. WHSSC13/63 TO RECEIVE A REPORT ON THE FINANCIAL PERFORMANCE POSITION Members RECEIVED a report, from Mr Stuart Davies, Finance, on the WHSSC financial performance for the 11 months ending 28 th February 2014. Mr Davies drew Members attention to the outturn forecast. He reported that the key movements include IPFR position, Welsh Page 17 of 29 6 May 2014
provider risk, English contracts performance, CAMHS tier four and cardiac outsourcing. In response to a query regarding disputed issues with Cardiff and Vale UHB, Mr Harrhy reported that further information has been requested with regard to the critical care activity. This information is awaited from the LHB. It was AGREED that this review will be undertaken in conjunction with the LHB teams. Mr Davies also AGREED to share the information with Cwm Taf LHB and Aneurin Bevan UHB, as main users of the speciality, before any year end decision is made. Mr Davies noted that no provision has been made for an increase in activity therefore there maybe a small deterioration in the position. Finance Finance Dr Goodall drew attention to a few specialities for which the financial position may change, for example cardiac surgery and ALAS. Mr Davies provided further information regarding the possibility for challenge and the work that will be undertaken to reach a final year end figure. NOTE the current financial position against the budget; NOTE the level of underlying financial pressure consistent with the annual plan forecasts and the additional transparency regarding provider disputes and reporting differences. The Joint Committee confirmed the WHSSC position regarding the ICU and ALAS disputes with CVUHB; NOTE the risk from increased activity in English providers and review whether there are additional local actions that Page 18 of 29 6 May 2014
need to be taken to increase awareness of cost and the need to follow only appropriate pathways optimising the use of Welsh services NOTE the additional scale of commitments in the summary table in relation to cardiac surgery outsourcing, the likely much lower level of financial liability for 2013/14 and the recommended outcome regarding risk sharing. NOTE the work to be undertaken between WHSSC and LHB financial officers to reach a year end position. WHSSC13/64 TO RECEIVE A REPORT ON PATIENT CARE AND QUALITY Members RECEIVED a report, from Mr David Wilmott, Head of Nursing and Quality, on patient care and quality. Mr Wilmott drew Members attention to key points within the report which included quality dashboards, the planned internal audit review, the Individual Patient Funding Requests (IPFR) for specialised services, the review of paediatric cardiac surgery and the CQC report into a CAMHS tier 4 provider. In relation to the all Wales IPFR, Mr Wilmott particularly noted that the function of the panel is an element that needs review. He reported that due to constantly changing LHB representatives at the panel, which is impacting on the ability of the panel to make consistent decisions, Mr Harrhy has written to all LHBs. Mr Wilmott reported that the current review Page 19 of 29 6 May 2014
of Paediatric Cardiac Surgery in Bristol which has been of recent media interest, relates to historic cases dating back to 2010 to 2012. He reported that he has been working closely with the provider and that their reports have been discussed and shared with WHSSC. In response to Mrs Williams, Mr Wilmott confirmed that he is finalising the risk assessment in relation to this service at present. It was AGREED that this risk will be added to the Risk Register within a short timeframe. Mr Wilmott reported that the concern is being monitored through Executive Board. It was also AGREED that a formal report will be discussed at the Quality and Patient Safety Committee. With regards to the CQC report for St Andrews Healthcare, Mr Wilmott reported that the main concerns of the CQC relate to the facilities rather than the provision of care. It was AGREED that a risk assessment will be complete within a short time frame and that the concern will be added to the Risk Register. He noted that the national shortage of places is impacting on the ability to place CAMHS tier 4 patients elsewhere. Members REQUESTED that the Mental Health and Learning Disability Collaborative Commissioning Group review CAMHS tier 4, including Eating Disorders, as a priority. Members also discussed the role of the Welsh regulators Head of Nursing & Quality Head of Nursing & Quality Head of Nursing & Quality Chair of MH & LD Collaborativ e Commissioni ng Group NOTE the contents of the report; RECEIVE the risk register at the next Joint Committee which will include the new risk assessments requested; REQUEST that the Mental Health and Learning Disability Collaborative Page 20 of 29 6 May 2014
FOR INFORMATION Commissioning Group review CAMHS tier 4, including Eating Disorders. WHSSC13/65 TO RECEIVE A REPORT FROM THE CHAIRS OF THE SUB COMMITTEES AND SUB GROUPS a) Integrated Governance Committee Members RECEIVED a report from the Interim Chair with regards to items discussed at the Integrated Governance Committee. He reported that the committee had discussed support for the Quality and Patient Safety Committee and that this would be discussed further under the report from the Chair of the Quality and Patient Safety Committee. NOTE the contents of the report. b) Cwm Taf LHB Audit Committee Members RECEIVED a report from Mr John Hill-Tout, Independent Member and WHSSC Audit Lead. NOTE the contents of the report. c) Management Group Members RECEIVED a report from Mr Page 21 of 29 6 May 2014
Stephen Harrhy, Chair of the Management Group. NOTE the contents of the report; and RECEIVE the confirmed minutes of the Management Groups held on 16 th January 2014. d) Quality and Patient Safety Members RECEIVED a report from Professor Simon Smail, Chair of the Quality and Patient Safety Committee. Professor Smail confirmed that the committee has received reports from the programme teams. Good quality service provision is a major objective and good data and information is essential so that each service can be assessed. Professor Smail reported that certain services are providing good information; he drew particular reference to the report from the Women and Children Programme team presented to the last meeting. Professor Smail also highlighted that information in some areas is patchy; this is partly due to organisational issues, partly the lack of agreement of information to be measured and partly internal reporting, for example no information is available for adult Cystic Fibrosis. Professor Smail highlighted again to Members the absence of a link between Quality and Patient Safety committees due to lack of an all Wales Quality and Patient Safety Chairs forum. He noted that Cardiff and Vale UHB have indicated that they would Page 22 of 29 6 May 2014
be willing to meet with WHSSC regularly to discuss quality and patient safety issues. He also noted that Mr Harrhy has written to Welsh Government and that it has been agreed that WHSSC will join the quality and delivery meetings between Welsh Government and LHBs. In response to Mr Paul Roberts, Mr Phillips reported that WHSSC are clear that there is an expectation that for the adult Cystic Fibrosis service, the outcome and other data is submitted through the national database. The failure of the service to do this has been raised as a concern with the provider. Members AGREED that there needs to be transparency about whether providers of specialised services are reporting through national databases, national audits or other mandatory monitoring arrangements. Mr Harrhy AGREED to ensure that these issues were discussed at the monthly meetings between WHSSC and the Welsh providers. Interim Specialised and Tertiary Services Professor Smail drew Members attention to issues included within the WHSSC Integrated Commissioning Plan where there is inequity of access, for example provision of PCI in North Wales. Professor Smail closed his report by noting that this would be Mr Wilmott s last Joint Committee meeting. Professor Smail thanked Mr Wilmott for the work he has undertaken whilst in WHSSC, in taking forward the quality agenda. It was AGREED that the Interim Chair would meet with Mr Harrhy and Professor Smail outside of the Joint Committee to discuss development of a support framework to Interim Chair, Chair of QPS and Interim Page 23 of 29 6 May 2014
ensure that the Quality and Patient Safety Committee receives the information it requires. Specialised and Tertiary Services NOTE the contents of the report; SUPPORT the establishment of Quality and Safety meetings between WHSSC and the two main Welsh providers; SUPPORT the inclusion of WHSSC at the Quality Delivery Meetings held between Welsh Government and the LHBs; and RECEIVE the confirmed minutes of the Quality and Patient Safety Committee held on 12 th December 2013. e) All Wales Individual Patient Funding Request Panel Members RECEIVED a verbal report from Mr David Wilmott, Head of Nursing and Quality on behalf of Mr Paul Newman, Chair of the All Wales Individual Patient Funding Panel. Mr Wilmott noted that there is currently an ongoing review by Welsh Government into Individual Patient Funding Requests and a report is expected towards the end of March. It was AGREED that this report will be shared with Members when received. Head of Nursing & Quality NOTE the contents of the report f) Welsh Renal Clinical Network Members RECEIVED a report from Mr Stuart Davies, on behalf of Professor John Williams, Chair of the Welsh Renal Clinical Network. Page 24 of 29 6 May 2014
Mr Davies noted that there has been a delay in the retendering process for the three independent providers in south west Wales. It is expected that this process will be complete by end of April/May. Mr Davies noted that there is some political pressure regarding this delay. Ms Karen Miles AGREED to ensure actions are in place within Hywel Dda LHB. Mr Davies reported, however, that there are no concerns from a clinical perspective; the service is currently being provided in a temporary building. Mr Davies reported that, with regards to procurement of immunosuppressant therapy, the transfer of services has occurred and this is being monitored through the Network. Detailed reports will shortly be provided to LHBs. Mr Davies highlighted that some of the Lead Pharmacist (3 posts) vacancies are being held up within the LHBs and that this is impacting on the provision of this service. It was AGREED that Mr Davies would escalate to the relevant Chief Executive Officers. Mrs Williams questioned whether payment to patients receiving home dialysis for their home telephone rental is an appropriate use of resources. She noted that this is setting a precedence which could impact on other specialities and services. It was AGREED that Mr Davies would discuss this further with the Network. Finance, Hywel Dda LHB Finance Finance Members present RESOLVED to: NOTE the contents of the report; and RECEIVE the confirmed minutes of the Welsh Renal Clinical Network Board held on 18 th December 2013. Page 25 of 29 6 May 2014
g) All Wales Neonatal Network Steering Group Members RECEIVED a report from Mr Daniel Phillips, on behalf of Mrs Ruth Treharne, Chair of the all-wales Neonatal Network Steering Group. Members present RESOLVED to: NOTE the contents of the report; and RECEIVE the confirmed minutes of the All Wales Neonatal Network Steering Group held on 22 nd October 2013. h) All Wales Posture and Mobility Partnership Board Members RECEIVED a verbal report from Mr Daniel Phillips, Chair of the All Wales Posture and Mobility Partnership Board. NOTE the contents of the report. i) Gender Dysphoria Partnership Board Members RECEIVED a report from Professor Simon Smail, Chair of the Gender Dysphoria Partnership Board. Professor Smail noted that the Partnership Board had now held several meetings and is now beginning to develop a clinical pathway from Primary Care through to specialised surgery. Professor Smail reported that this service is not always recognised in the job plans of the few accredited clinicians within Wales. Page 26 of 29 6 May 2014
NOTE the contents of the report. RECEIVE the confirmed minutes of the Gender Dysphoria Partnership Boards held on 30 th September 2013 and 18 th December 2013. j) Mental Health and Learning Disability Collaborative Commissioning Group (formerly Secure Services Delivery and Assurance Group) The Chair noted that Ms Karen Howell had given apologies for the meeting. He drew attention to the report RECEIVED from her in her role as Chair of the Mental Health and Learning Disability Collaborative Commissioning Group. Mr Harrhy reported that the Minister has approved framework agreements and that these have been sent out. He noted that these savings are included in the Integrated Commissioning Plan. Mrs Williams recommended that given track record of the Collaborative Commissioning Group this committee ask the group to provide a plan on enabling them to accelerate the work in other areas. It was AGREED that this would be taken forward by Mr Harrhy. NOTE the contents of this report. Interim Specialised and Tertiary Services WHSSC13/66 TO RECEIVE THE RISK REGISTER ANNUAL REPORT 2012/13 Members RECEIVED the risk register from Page 27 of 29 6 May 2014
Mrs Cathie Steele, Corporate Governance Manager. Mrs Steele noted the additional risk assessments that have previously been discussed and agreed for inclusion on the register. The Chair highlighted that the risk register is scrutinised by various sub committees. NOTE the contents of this report. WHSSC13/66 TO RECEIVE THE WHSSC SELF ASSESSMENT AGAINST THE STANDARDS FOR HEALTH SERVICES IN WALES Members RECEIVED a report providing the Joint Committee with the completed Annual Self-Assessment for 2013/14 against the Standards for Health Services in Wales from Mrs Cathie Steele, Corporate Governance Manager. Mrs Steele noted that the process for completion of the assessment has changed during the year to embed the standards within WHSSC and to address a recommendation made following last year s review by Internal Audit. She reported that the self assessment has been scrutinised by sub committees of the Joint Committee and the recommendations of the sub committees discussed at the Integrated Governance Committee. NOTE the contents of the report; NOTE the ongoing Internal Audit review Page 28 of 29 6 May 2014
OTHER MATTERS of the assessment; and ADOPT the completed self assessment. WHSSC13/67 Any other business There were no other matters. WHSSC13/68 Date of next meeting The date of the next meeting was confirmed as 24 June 2014. Signed Date (Chair) Page 29 of 29 6 May 2014