RHONDDA CYNON TAFF TEACHING LOCAL HEALTH BOARD Minutes from the meeting held on: Wednesday 9 th September 2009 Present: Dr CDV Jones Chairman Mrs A Lagier Acting Chief Executive Mrs L Williams Nurse Director Mr M Thomas Director of Finance Mrs K Clarke Dental Representative Mrs A Forte Voluntary Sector Representative Mr S Davies Director of Primary Care Mr R Williams Associate Member Mr S Jones Optometry Representative Miss S Saeed Director of Health Strategy Mr W Vaughan Local Authority Representative Mrs N John Director of Public Health Mrs L Ward Therapist Representative Mr C Barnby Associate Member Dr H V Shah GP Representative Dr K Burkhardt GP Representative Mrs J Murphy Community / Lay Member Mr N Whitehead Associate Member Ms P Wenger Director of Corporate Services / Board Secretary Mr M Forey Local Authority Representative Mrs J Keegan Director of Commissioning and Service Development Dr N Waskett Medical Director Page 1 of 13
In Attendance: Claire Northwell SECTION 1 Executive Assistant to Chair, CEO and Deputy CEO Action 1 PRELIMINARY MATTERS 1.1 Welcome and Apologies Dr Christopher Jones (CDVJ) welcomed members to the meeting and noted apologies from: Dr A Evans, Mrs J Smith, Mrs S J Jones, Mr G Bell, Mr T Young, Mr A Crabbe, Dr C Davies, Cllr A Davies. 1.2 Declaration of Interests There were no declarations of interests received. 1.3 Chairman s Report & Actions (verbal) CDVJ informed members that this has been a challenging and busy time in preparing for the launch of the new organisation as of 1 st October 2009. CDVJ also noted that he had been involved with many interviews, both for executive and non-officer positions. CDVJ confirmed to members that the non-officer positions will be announced once the Minister has received the panel s recommendations and he noted significant interest shown in these roles. It was noted that the interview process had been both complex and difficult with one Independent Assessor Chairing all the interviews. CDVJ reassured members that the Legacy Statement with the new organisation pursuing the Teaching Status. CDVJ formally thanked members for their work, dedication and support over the past years. Page 2 of 13
Page 3 of 13 Agenda Item Number 6 AL also formally thanked executive directors and staff for the way they have worked in the past six months during this challenging time. The impact of transition has been kept as minimal as possible. 1.4 Minutes of Previous Meeting The minutes were agreed as a true and accurate record, with no matters arising. 2. GOVERNANCE 2.1 Update on Local Transitional Arrangements for NHS Reform PW provided an update to members on the transitional arrangements locally. PW highlighted the identified workstreams set up to members for information. It was noted that all products within the workstream, were on target to be delivered by the 1 st October 2009. Briefings following the transitional board will be made available for further information. PW confirmed that AL had been successfully appointed as the Director of Workforce and Organisational Development. Draft Standing Orders and Standing Financial Instructions have also been issued by Welsh Assembly. Resolved: Members were asked to note the contents of this report. 2.2 Complaints Annual Report PW presented the annual complaints report to members outlining the number of complaints received by the tlhb including the Provider Services element. PW outlined the lessons learnt and the ongoing work planned for the next 12 months in relation to how complaints are managed.
Page 4 of 13 Agenda Item Number 6 AF raised the issue of the format that the complaints are monitored and asked if the way in which this is done could be changed to make it more meaningful i.e. response rates, outcomes etc. Resolved: Members were asked to note the content of this report. 2.3 Equality Annual Report PW presented members with the annual equality report for 2008/09. PW highlighted the progress made by the tlhb. It was noted that this report was joint with the tlhb and Merthyr Tydfil LHB with action plans available on request. It was noted that the LHBs have worked closely with the Cwm Taf NHS Trust over the past six months in addressing inequalities. Resolved: Members approved the content of this report for onward submission to the relevant bodies. 2.4 Affixing the Common Seal PW reported to members that the following documents had been affixed with the common seal:- 16 th July 2009 Counterpart Lease 8 Cardiff Road, Mountain Ash 29 th July 2009 Counterpart Lease Medical Centre, Ynyshir Road, Porth Licence to carry out works at the Medical Centre at Ynyshir Road, Porth Licence to under let Medical Centre, Ynyshir Road, Porth 3 rd September 2009 Transfer of Pinewood to RCT tlhb Land Registry Cancellation of entries relating to
a registered charge Agenda Item Number 6 Resolved: Members endorsed the action taken by the Chief Executive to Affix the Common Seal. 2.5 Healthcare Standards Inspection Report 2008/09 LW provided Board Members with an update on the progress of the organisation against the Healthcare Standards during 2008/09. LW advised that this is a requirement of healthcare organisations across Wales on an annual basis to self assess against a common framework of 32 Healthcare Standards and submit the evidence for validation by Health Inspectorate Wales (HIW) for the services they provide and commission. LW reported that for this period monitoring of progress was across 10 of the 32 standards and particularly those relating to Dignity and Respect, Child Protection and Vulnerable Adults. LW added that HIW had noted particular challenges for the tlhb in relation to consistent process for CRB checks, additional work in Child Protection and Vulnerable Adults, including ensuring all staff, not only those directly employed should undertake necessary training. LW highlighted that the tlhb had been commended for its enthusiastic staff that are committed to providing high quality care, were pro-active in progressing work in nutrition and also for ensuring that service users were treated with dignity and respect and maintaining confidentiality. Following discussion CDVJ congratulated the team in their efforts. Resolved: Board Members noted the continued progress of the organisation against the Healthcare Standards during 2008/09. 2.6 Register of Interests Page 5 of 13
PW provided the Board with the Register of Interests for the period 2009/10. PW advised that under the Code of Conduct and Accountability all those serving on NHS Boards must declare interests which are relevant and material. Following discussion it was agreed that the Register would be amended to reflect changes for Dr. K. Burkhardt and Ms. A. Forte. Resolved: Board Members Noted the content of the report; and Endorsed the Register of Interest subject to the above amendments for Members of Rhondda Cynon Taff Teaching Local Health Board 2.7 Update on Primary Care Nursing Team SD provided the Board with an update on the Primary Care Nursing Team for the tlhb, their current areas of activity and future proposed initiatives and innovations. The following areas of activity were highlighted to members:- The clinical aspect involving nurses delivering a service across both RCT and Merthyr Tydfil. The development of workforce and clinical leadership. Both personal and professional development of the Team to ensure they have a wide range of skills to deliver the services and initiatives Future planned initiatives. Resolved: The Board noted the content of the report 3. COMMISSIONING AND PLANNING 3.1 Public Health Update Measles/Swine Flu NJ provided members with a report on the recent measles outbreak that had occurred in Merthyr Tydfil. Page 6 of 13
NJ advised of the background, the current position and the actions taken that had been put in place to limit the spread of the outbreak. Members were also provided with an update on the current position in regards to Swine Flu and advised that members had previously been informed in regards to the Swine Flu pandemic and local action taken to date. NJ referred to the current position and advised that the high levels of flu like illness seen in Wales in July has now reduced through August, coinciding with the school holidays, however it is envisaged that rates will increase again during Autumn. NJ reported that the first wave of the swine flu pandemic has occurred and planning now continues for the expected second phase. Resolved: The Board noted the content of the report 3.2 Swine Flu Special Measure required to legally safeguard access to medicines Dr Nigel Wasket presented the report to Board to provide an update on the special measures that legally safeguard access to medicines. He noted that with the swine flu incidence, there are several measures that are required to assist the NHS in responding to the potential impact of a pandemic situation and as a result the regulations have to be changed or amended. Therefore, the board would need to approve the changes and delegate responsibility to the Chief Executive or Finance Director to enable the changes to the Medicines Act if this was necessary. Dr N Waskett confirmed that the NHS Department for Health has also developed four protocols for the supply and administration for the antiviral for the pandemic influenza and the board are requested to authorise the Chief Executive or Finance Director to sign off the adaptations of the protocols if this was necessary. RESOLVED: Board Members noted contents of the report Page 7 of 13
Agreed delegated responsibility to be given to the Chief Executive or Finance Director to: 1. Sign off amendments of Medicines Act 2. Approve and Sign off local adaptations of National Protocols 4. PERFORMANCE 4.1 National Finance Report Month 4 Mr M Thomas provided the Board with an update in relation to the Health Community s financial position and also the LHB s position at the end of July. Mr M Thomas explained that the Health Community position was summarised on page 4 of the Finance report. The following key points were highlighted: The agreed Control Total/Negative reserve at the start of the year had been reduced from 30.3m to 24.1m which equated to a 6.2m reduction. The variance against plan at Month 4 was 8.2m, which if extrapolated for the full year broadly equated to the Negative reserve balance of 24.1m At Month 4 the Health Community was still forecasting a break even position for the full year. However, there was a very significant risk that that this position may not be achieved for 2009/10. Mr Thomas also noted that in terms of year to end date deficits and forecast positions, the Health Community was not an outlier compared to other areas. In terms of the RCT tlhb position, Mr Thomas noted that the key issues at month 4 were summarised on page 5 of the report. Resolved: The Board noted the contents of this report. 4.2 Performance Report Quarter 1 2009/10 Page 8 of 13
Page 9 of 13 Agenda Item Number 6 Mr M Thomas provided the Board with an update in relation to the National Performance Report. The purpose of the report was to summarise the Merthyr LHB position against the National Targets for the first quarter of 2009/10. The main points highlighted were as follows: A summary of the LHB performance against the 26 targets was shown on page 4of the report. This showed 5 targets as green, 15 amber, 4 red and 2 as information not currently available. As expected at this stage of the year the majority of the targets were amber. In terms of the 4 red targets brief comments were provided in the report. Section 4 of the report also highlights a further 7 targets which are considered to be at risk of changing to Red later in the year. There will be a separate report for RCT tlhb that will be submitted to WAG for month 6. Resolved: The Board noted contents of the report. 4.3 Annual Audit Letter 2008/09 Mr M Thomas explained that the purpose of the Annual Audit letter was to summarise the findings of the 2008/09 audit and to report any significant issues to the Board. Mr Thomas confirmed that the report was positive with no major issues identified and that the report had been discussed in detail at the recent audit Committee meeting. Mr M Thomas highlighted the key audit findings which were explained on page 2 of the report. Resolved: The Board noted contents of the report. 5. PARTNERSHIPS 5.1 Teaching LHB
Page 10 of 13 Agenda Item Number 6 AL presented to the Board the Caerphilly and RCT tlhb s draft Partnership legacy document. AL reported that on the 20 th July 2009 the tlhb Partnership Board between Caerphilly and RCT Teaching LHB s held its final meeting. The Partnership Board considered all ongoing financial commitments including accountability for dedicated staff and current live projects. AL advised that at that meeting the Board also received a draft copy of the legacy paper which is designed to demonstrate the enormous benefits of teaching status and how it has worked in practice to date, how the lessons learned and advantages gained can be carried over into the seven new Local Health Boards in Wales. AL advised that the outgoing Chair of the tlhb Partnership along with the Head of Teaching, learning and Development and Chief Executives of the tlhbs are planned to meet with the Chairs and Chief Executives of Cwm Taf and Aneurin Bevan Health Boards, with the aim of stimulating further discussion and future debate for the new LHBs. It was agreed that the Board write a letter of thanks to the outgoing Chair, Professor Donna Mead. Resolved: Board Members noted the content of the report; and endorsed the draft Legacy Document 5.2 Feedback from Public Forums SS reported to the Board on the content and feedback received from meetings of the Cynon Valley and Rhondda Valleys Fora, which were held in July 2009. SS advised that at both meetings attendees were provided with an update on the following topics:- Local and National NHS Wales reorganisation Building Health Communities Project All Wales Pharmacy Review Local Minor Injuries Unit changes (Cynon Valley
Forum only) Merthyr Tydfil Health Park consultation process (Cynon Valley Forum only) Both meetings were well attended with an extensive range of questions posed and views expressed. The general opinion seemed to indicate that attendees felt that the workshops held had been extremely beneficial and had provided a genuine opportunity to review and comment on the current work being undertaken. Attendees expressed a unanimous wish for continued engagement following the reorganisation of local health services and as the Building Health Communities project progresses Cllr. M. Forey commented that it had been a very well conducted event and was well received by all in attendance. Resolved: Board Members noted the content of the report 5.3 Health, Social Care & Wellbeing Annual Report 2008/09 SS provided Board Members with a summary of progress and achievements made by the RCT Health, Social Care & Well-being Partnership in 2008/09. SS advised that in previous years Health, Social Care & Well-being partnerships have been required to publish annual reports to provide a summary of progress to the Welsh Assembly Government, as well as keeping members of the public and partner agencies informed of developments and achievements. Whilst there was no requirement to produce an annual report for 2008/09 the RCT Health, Social Care & Well-being Partnership felt it was good practice to do so. SS reported that contained within the Annual Report was a summary of progress against each of the themed areas of the strategy, i.e.: Page 11 of 13
Page 12 of 13 Agenda Item Number 6 Community Collaboration and Prevention Mental health and Emotional Wellbeing Work and Health Maintaining Independence Transport and Access Healthy Environments Discussion was held around the healthy lifestyles update, the modernisation of strategies and Local Service Boards. Resolved: Board Members noted the content of the Annual Report and the significant progress made by the Health, Social Care & Well-being Partnership over the last year SECTION 2 6. POLICIES/STRATEGIES FOR RATIFICATION 6.1 Teenage Pregnancy Strategy Board Members ratified this strategy. 6.2 Strategy for the Prevention and management of Fall and Fractures Board Members ratified this strategy. SECTION 3 7. REPORTED MINUTES OF SUB- COMMITTEE/WORKING GROUPS No formal requests were received by CDVJ on issues relating to the minutes of the sub committee and working groups of the tlhb, however, individual officers may be contacted as requested: 7.1 Clinical Governance Committee 7.2 Remuneration and Terms of Service Committee 7.3 Strategic Partnerships and Working Group 7.4 Primary Care Development Committee SD
reported to the Board that a special meeting of this Committee had been called to discuss the future of Penrhys Surgery. SD advised that following the meeting it had been agreed to support the proposal to close the Surgery and commence work with Forest View practice in relation to the three month consultation process Which would cease at the end of October. SECTION 4 8. EXECUTIVE TEAM UPDATE CDVJ informed members that no requests had been made regarding issues of the executive update; however, individual Officers may be contacted as required. The following information was highlighted:- PW reported to Members on the arrangements for the Annual General Meeting which would be held at the Orbit Centre, Merthyr Tydfil on the 30 th September. PW advised that both Annual Reports were almost finalised with minimal copies printed copies as it will be available on the website. CDVJ advised that this was the last meeting before the organisation joined others to become the newly formed Cwm Taf Health Board and gave his thanks and appreciation to everyone. It was also agreed that a letter of thanks should be sent to the Local Authority for the commitment given by Mr. Wynne Vaughan, Local Authority Member as part of the executive group. Page 13 of 13