Health Education Wessex Board Meeting 28 th July 2015 2.00 pm 5.00 pm Beech, Southern House Board Members: Jacqueline Swift DL, Chair, Health Education Wessex JS Ruth Monger, Local Director, Health Education Wessex - RM Simon Plint, Postgraduate Dean, Health Education Wessex - SP Nigel Watson, Chief Executive, Wessex Local Medical Committee NW Amanda Moores, Chief Officer, Dorset LPC AM Sarah Schofield, Chairman, West Hampshire CCG SS Karen Baker, Chief Executive, NHS Isle of Wight KB Stephen Tomkins, Clinical Programme Director, Dorset CCG - ST Attendance on behalf of Board Members: Karen Allman, Director of HR, Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust KA Alison Kingscott, Director of Human Resources, Salisbury NHS Foundation Trust - AKs Liz Mearns, Medical Director, NHS England (Wessex) LM Jane Hazlegrove, Director of Education, Southern Health NHS Foundation Trust JH Judy Gillow, Director of Transformation and Improvement, University Hospital Southampton NHS Foundation Trust JG Dave Meehan, Deputy CEO and Director of Partnerships, Wessex Academic Health Sciences Network DM Ceri Connor, Associate Director of Workforce Development, Solent NHS Trust CC John Harding, Head of Organisational Development, Poole Hospital NHS Foundation Trust - JHa In Attendance: Paul Holmes, Director, Health Education England (South) PHs Colin McInnes, Head of Finance, Health Education England (South) CM Gail Doran, Assistant Director for Education Quality and Learning GD Caroline Chipperfield, Director, Thames Valley and Wessex Leadership Academy CCH Simon Baughan, Governance Lead, Health Education England (South) SB John Burdett, Non-Executive Director, Health Education Wessex JB Debi Carpanini, Chief Information Officer, Health Education England (South) DC Anna Prygodzicz, Commissioning Manager, Health Education Wessex - AP Fleur Kitsell, Health Dean, Health Education Wessex FK Claire Parker, Governance Officer, Health Education Wessex - CP [Notes] Stuart Ward, Head of Primary Care Taskforce, Health Education England SW Sue Hill, Education and Commissioning Manager, Health Education Wessex SH Apologies: Katrina Percy, Chief Executive, Southern Health NHS Foundation Trust - KP Lawrence Brad, Education Lead for Dorset, Dorset CCG - LB Martin Stephens, Managing Director, Wessex Academic Health Science Network MS Sue Harriman, Chief Executive, Solent NHS Trust SH Andrew Mortimore, Director of Public Health, Southampton Council AM Mary Edwards, Chief Executive, Hampshire Hospitals NHS Foundation Trust - MEd Debbie Fleming, Chief Executive, Poole Hospital NHS Foundation Trust - DF Peter Hill, Chief Executive, Salisbury NHS Foundation Trust - PH Patricia Miller, Chief Executive, Dorset County Hospital NHS Foundation Trust - PM David Phillips, Transition Director, and Director of Public Health, Dorset County Council - DP Ron Shields, Chief Executive, Dorset HealthCare University Hospitals NHS Foundation Trust - RS Tony Spotswood, Chief Executive, Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust - TS Ursula Ward, Chief Executive, Portsmouth Hospitals NHS Trust UW Fiona Dalton, Chief Executive, University Hospital Southampton NHS Foundation Trust FD Dominic Hardy, Director of Commissioning and Operations, NHS England (Wessex) DH Graham Galbraith, Postgraduate Dean, University of Portsmouth - GG Tim Powell, Director of Workforce and Organisational Development, Portsmouth Hospitals NHS Trust TP Judy Saunders, Interim Director of Human Resources, Poole Hospitals NHS Foundation Trust JS Paul Newell, Assistant Director of Workforce Transformation and Strategy, Health Education Wessex - PN Professor John Clark, Director of Quality and Education, Health Education England (South) Page 1 of 10
Agenda Item Actions Chair Welcome & Apologies Jacqueline Swift DL (Independent Chair) JS welcomed everyone to the Health Education Wessex (HEW) July Board meeting and introduced new members attending the Board. Stephen Tomkins has replaced Lawrence Brad as representative for Dorset Clinical Commissioning Group (CCG) and John Burdett, Head of Audit Committee and Health Education Wessex Non-Executive Director attended the meeting. Items for Business JS noted that it was JGs last Board meeting. JS thanked JG for her contribution and support of HEW. Apologies were received in advance of the meeting and are recorded above. Declaration of interests Notes of previous meeting 14 th April 2015 Matters arising No declarations of interests were made. It was agreed that these were an accurate and true record. JS informed the Board that Professor Dame Jessica Corner has now been appointed as the Pro-Vice Chancellor for the University of Nottingham and thanked Professor Dame Corner for her contribution to Health Education Wessex. New Integrated Performance Report SP updated the Board that this will be presented today and was on the Board agenda. Interim Governance Framework SB informed the Board that this work is continuing and is part of the governance work plan. Partnership Council RM updated the Board that the Partnership Council had met the previous week and a verbal update is on the agenda. A further meeting has been set up for February 2016. Learning Environment Quality Report GD updated the Board that an email had been sent to all Trusts and dates for review meetings are in the process of being organised. Primary Care Taskforce FK updated all that an appointment had been made for lead for Primary Care Taskforce and Dr Stuart Ward will be attending later in the meeting and will present a detailed update at the October Board. Shine Awards JS has received a number of nominations to date. These examples of good practice from across Wessex will be summarised and shared with the Board in October. Page 2 of 10
National Update - PH on agenda to present update. Capita Contract - it was confirmed that the Capita Learning Beyond Registration contract will cease in March 2016. The funding for this contract is 579k in 2015/16. This funding is part of the HEW allocation. Local Director s Report RM provided an update to the Board on developments within HEW over past 3 months. Beyond Transition RM updated all that Health Education England (HEE) has now finished its restructuring as part of Beyond Transition. Moving forward there are reviews taking place of processes and procedures. There have been legal changes with HEE now becoming a Non Departmental Public Body (NDPB) and as part of this it is a requirement that all Local Education Training Boards (LETBs) have three members with clinical experience. RM confirmed that HEW Board meets these criteria. DF has now been appointed as Vice-Chair for HEW Board. JS has also been reappointed as HEW Independent Chair. National Update PH provided the Board with a national update. Discussion took place regarding recent speeches made by Secretary of State with the main focus being on Primary Care and greater integration between social care and primary care. An increase in workforce was also a theme of the speech with 10,000 extra primary care staff over a 5 year period and nationally an extra 5000 GP s. HEE has an additional 1000 GP s to recruit this year. NW commented that this will be a challenge for HEE. JB also noted that this will be a challenge to recruit a higher number of GP s. PH updated the Board on plans to transfer the NHS Leadership Academy (TVWLA) to HEE from April 2016. CCh commented that from a HEW perspective there will be no major changes and TVWLA will continue to work closely with HEE. CCh noted that DF was also the Chair for the Leadership Academy. CCh will keep the Board updated with any further changes. PH noted that nationally LETB s were supporting various Vanguard sites. HEE Directors have been appointed to lead on various elements of the Five Year Forward View. NW raised concerns how national leads will link into local areas and how this will be achieved. PH felt that with current structure this will work and will give opportunity for good areas of practice nationally to link into local areas and vice versa. Nursing Summit RM updated all on the recent Nursing Summit that had taken place for organisations across the South to share good areas of practice and develop action plans. HEW and NHS England (Wessex) also ran a workshop with Directors of Nursing in May and RM/RW has drawn up an action plan following this. Page 3 of 10
Non-European Overseas Nurses RM updated the Board on the proposed changes to immigration rules from 2017 that will require people from outside the European Union to be earning 35,000 or more. This may potentially impact on nursing staff in Wessex. RM informed the Board that employers can submit their views to the Migration Advisory Committee. KB queried whether the Board are collectively responding to this. JS asked Board members to send responses through to HEW who will collate a collective response. It was noted by KB that nursing is not listed on the Shortage Occupation list. LM also noted that shortage of GP s was not on the list. SP informed Board that psychiatry is on the list, but GP s are not on list as there is not an equivalent role in other countries. 2016/17 Adult Nursing Provision RM updated all on the adult nursing forum that took place on 16 th July to discuss in detail future education commissions required in Wessex and also the development of undergraduate nurse education in Wessex. The group agreed that HEW should produce a specification for new nursing provision that would be locally available to employers on the east side of Wessex. Allied Health Professionals (AHP) RM noted that an AHP event took place in April with over 100 people from 12 AHP professions attending the event. There were a number of presentations of areas of good practice discussed. An AHP network has been established with FK leading on this. Wessex Trainees Patient Safety Conference The Patient Safety Conference took place on 3 rd July. The event was very well attended with trainees providing presentations on a wide range of projects. Southampton, Hampshire, Isle of Wight and Portsmouth (SHIP) and Dorset and South Wiltshire (DSW) Local Workforce Development Group (LWDG) Both SHIP and DSW met in July. Both groups were very well attended with some informative discussions. The theme of both meetings was Quality and Excellence of the current workforce with focus on leadership development. Strategic / Developmental Supporting the Five Year Forward View HEW Delivery Plan 2015/16 RM presented an update to the Board on the HEW Delivery Plan 2015/16. The plan highlights areas of work that HEW will be focusing on in the coming year which are: Primary and Community Care Mental Health Birth, Children and Young People Public Health and Prevention Talent for Care Shape of Training Page 4 of 10
Widening Participation Shape of Caring The areas for focus mirror the Department of Health s Mandate to HEE. At each Board there will be a focus on one of the areas of work. The Board today will focus around Primary and Community Care. Development of Support Worker Roles Across the System AP presented to the Board the national strategies relating to the development of the support workforce and the relevant deliverables and their impact on existing and ongoing work in HEW as part of the Talent for Care: National Strategic Framework. AP updated the Board on where all Trusts were on the local actions to deliver the Talent For Care Pledge. The Board discussed the proposals within Shape of Caring to create a Band 3 Associate Nurse Role. AP discussed with members whether a Band 3 role should be established and how this might impact on the current Band 4 Associate Practitioner role. LM noted it does not seem appropriate to stop with the Band 4 role. JG informed all within her Trust they have development of Band 2, 3 and 4 roles, as well as a number of apprenticeships. JG feels that it may cause confusion to have both a Band 3 associate nurse and the Band 4 role which is well understood and established. JG expressed concern that any development of a Band 3 role would need to be considered as part of nursing career pathways so there was not too much of a jump for Band 3 s wishing to then move on into a registered nurses role. NW informed all that currently these types of role are not common in general practice and AP agreed to provide NW with information on what had been developed in primary care. SS queried if this was seen as a step-up to nursing and other nonnursing roles. AP confirmed they could use this role as a step-up into any role. Action: AP to provide NW with further information on health care assistant roles in primary care. AP JG and RW are happy to feed back the proposals to their respective areas and feed back to PH for him to update HEE and NHS England. Action: PH to collate feedback from JG and RW and update HEE/NHS England. PH KA will find out what is happening with other Trusts in relation to the proposals and feed back into the next LWDG s. AP to put on agenda for discussion at both SHIP and DSW LWDG s. Action: KA/AP to feed back to next LWDG s KA/AP Development of Primary and Community Care RM presented paper to the Board outlining what HEW know to date on the development of Primary and Community Care Locality Training Hubs within the Wessex area. As part of the ten point GP Plan, point Page 5 of 10
Locality Training Hubs in Wessex 3 focuses on the development of training hubs. Bids from LETB s have been invited during August for submission in September 2015. RM and Richard Weaver are currently reviewing what other LETB s are doing and the various models in place. Olivia Falgayrac-Jones (OFJ) will be pulling the bid together for HEW, and attended meeting to discuss with members. AM stated there is work underway as part of Dorset Clinical Service Review that should align with training hubs. Also pharmacists should also be included within the hubs. ST informed all that Dorset are very keen to have hubs in place and discussed having a centralised hub that compliments what HEW are doing. NW work is underway within the Lymington / New Forest area to establish training across community and primary care. Members discussed work currently being undertaken in areas across Wessex that could come under the umbrella of this proposal. FK there could be work already underway within acute Trusts which other areas could learn from. NW highlighted initial funding is not high for this and a focus would need to be on building a multi-disciplinary training hub and bringing together various streams of money and linking these together. SW informed all he will be working on this as part of his new role as Primary Care Taskforce Lead. SP invited proposals from the various areas and SW and OFJ will meet to discuss how to take the bid forward for HEW and will update all at the next Board. Action: SW and OFJ to meet to take forward bid for HEW. SW/OFJ Development of Extended Roles: Clinical Pharmacy in General Practice RW presented a paper to the Board on the national initiative to pilot the use of clinical pharmacists within General Practice. It is important for all to note that this is a pilot and needs to link in with other initiatives taking place. RW asked members if any areas were currently piloting this as bids would need to be in by September 2015. SW noted Portsmouth was currently piloting this model. AM - GP practices will need to develop a business case for the model. There have also been discussions with CCG s and support will be provided to GP practices to develop bids. ST stated that some practices in Dorset have had a clinical pharmacist in post for some time. KA informed all that pharmacy roles were part of the discussions that took place at LWDG and Royal Bournemouth Hospital were relooking at the use of pharmacy roles within the acute setting. LM expressed concern about the complexity of the NHS England Page 6 of 10
bidding process. RM suggested there was a need to gain an understanding of how pharmacists are currently being used in primary care and also to review the training model in HE South West where pre registration pharmacists have experience in acute, community and primary care, to see if this could be taken forward in Wessex. Action: HEW to map the current range of pharmacy roles in primary care and explore the option of training pre-registration pharmacists with experience across primary, community and acute settings. PN/GD HEE Medical Workforce Planning New Process to Improve Post Graduate Medical Planning SP presented paper outlining the new process for post-graduate medical workforce planning. In 2015/16 HEE nationally and locally will focus on developing a three year commissioning plan for a defined list of selected specialties. The five specialties will be: Clinical Radiology Paediatrics Emergency Medicine Obstetrics and Gynaecology General Practice HEW will locally also be looking at Paediatric Cardiology. KB queried how the specialities get chosen as from a Trust perspective Medicine would be a priority, along with Histopathology and Haematology. SP agreed to feedback to HEE national team and report back to the Board in October. Action: SP to report back to the Board in October on how specialities were prioritised. SP There was a general discussion about the need to plan medical specialties very differently, and whether this planning approach would take account of this. NW noted that the workforce will need to be used in a different way especially within general medicine. JG was in agreement. KB noted that the posts will need to work across community settings. Expert Education Advisory Group (EEAG) GD provided an update to the Board on the recent EEAG that took place in July. There was good attendance at the meeting and Higher Education Institutes (HEI s) are keen to get involved, especially around the development of local training hubs. Topics discussed: Shape of Caring Raising the Bar Discussion with all regarding the Lord Willis Report. Five Year Forward Plan an overview of service plans in Wessex and developing education solutions Primary and community care becoming further integrated and how do training establishments support this. Discussion by all at meeting regarding involvement by education providers at early stages. Learner Voice Project Page 7 of 10
Have established core questions regarding student experience and will be embedded within existing feedback methods. To be implemented from January 2016. New Information Systems Bursary Unit & Audits Intrepid learner database (ILD) to replace current system (ISIS), data currently being uploaded into system at present. Partnership Council (PC) Update to the Board RW updated members on the recent Partnership Council that took place in July. The Health Education Wessex Partnership Council meets twice a year and includes representatives from across health and social care. This includes representatives from NHS organisations, professions, the trainee advisory group, local authorities, hospices and elected Councillors who play a part in Health and Wellbeing Boards. Its role is to advise the Health Education Wessex Board and senior management team. Topics discussed were: Development of Community and Primary Care Training Hubs Priorities for the development of the existing workforce Development of public health skills in the health and social care workforce RM noted that the focus on public health had been very useful and suggested that this could be the theme for the Board in October. Action: Public health to be focus of October Board RM Board Assurance: Driving Improvement HEW Finance Report CM presented to the Board a paper outlining the 2014/15 Outturn for HEW and the summary position for HEE South and HEE National for 2014/15. CM also provided an update on 2015/16 finance issues including Month 2 position and key risks and mitigation. During 2014/15 there was a planned under spend within HEW of 163,000. As at Month 2 for 2015/16 there is currently an under spend of 48,000. Two risks have been identified for this financial year which relate to attrition and student bursaries. CM informed members that if HEW under spend within a programme budget that we will not be able to automatically allocate the excess funding to another area as nationally there is likely to be shortfall. With regards to workforce development there is uncertainty regarding funding for 2016/17. AK queried whether funding for national initiatives would be available to HEW. RM explained that there are a number of national programmes taking place for example Return to Practice, and that funding has been allocated nationally to these, HEW is anticipating some funding for local work from these but this has not been confirmed. Action: PH to provide list to the Board of all national initiatives and what levels of monies are allocated against each initiative. PH Integrated DC presented to the Board the new Integrated Performance Report. Page 8 of 10
Performance Reporting Quarter 1 The report outlines progress against measureable plans for 2015/16 for HEW. All activities are assigned a local responsible officer and a lead. Out of 184 deliverables 127 are currently rated green (deliverable is on track and likely to be attained). 41 deliverables are rated grey (HEW are reviewing requirements and formulating appropriate methodology for monitoring performance). 13 deliverables are noted as Red or Amber (Red deliverable is unachievable or significantly behind schedule. Amber deliverable under review, action plans off track or key milestones under development). Red deliverables are: Psychiatry Recruitment GP Recruitment Each deliverable rated Red or Amber has an exception report. SP updated members on the above 2 red deliverables. There are significant recruitment problems in both areas. These deliverables are likely to remain red throughout the rest of the year as there are limited opportunities to now fill vacant places. HEW has currently filled 112 out of 142 GP training places, a third recruitment round is planned which may mean the shortfall is decreased. A number of other initiatives to mitigate the issues that arise from not filling training places are underway, these are return to practice and other actions that will be taken forward by the primary care workforce task force. The Psychiatry training recruitment rate is at 65%. A lead for the mental health taskforce has been appointed and an action plan is being developed. DC asked Board members to provide any comments on the new format of the Integrated Performance Report. GD suggested that the report could include more trend analysis and comparative benchmarking information. DC confirmed that there are plans in the future to include this within the report. HEW Quality Board Report 2015 SP presented to the Board a new report providing an overview of quality monitoring processes currently in place across HEW, outlining the work of the HEW Quality Board and proposals on how quality of education and training will be reported to HEW Board. Appendix 1 provided a summary of the General Medical Council national training survey Discussions took place on how the National Student Survey is reported back to the Quality Board. SP asked the Board to: Agree the quality board report be a standard agenda item To discuss how HEW could assist the Board members with any recommendations following Care Quality Commission (CQC) visits in relation to Education and Training. SS queried if this would also include support to General Practice if appropriate following CQC visits. SP confirmed it would. The Board agreed that support from HEW would be appropriate. It was agreed that HEW will write to organisations (trusts and GPs) Page 9 of 10
following publication of CQC reports to offer support as appropriate. It was agreed by all that HEW Quality Report will be a standing item. Action: HEW Quality Board to be added as standing agenda item. Action: HEW to write to organisations following publications of CQC report to offer support. CP SP HEW Risk Report July 2015 CP presented to the Board the risks outlined in last quarter that are associated with HEW. Currently 2 risks that are red which link in with the red deliverables outlined in the Performance Report. CP highlighted amber risks. JB queried is there a local lead for the Trainee Information System (TIS) project that is being developed nationally. DC confirmed that there is a Steering Group and TIS champion for HEW is Jo Stevens. RM confirmed that the risk outlined within the register regarding the Intrepid Leaner Database was a risk concerning information governance concerns regarding use of NI numbers. This is being addressed at national level. Any Other Business JH wished to raise at the Board the concerns regarding the proposed revisions in the non-medical tariff. The proposal has come from HEE. GD provided further information to the Board outlining that the HEW model is currently based on WTE being 37 weeks however it is proposed that this is standardised nationally to 45 weeks; effectively reducing the weekly Tariff amount. JH expressed concern that this would have a major impact on Southern Health. JS queried if this would affect all Trusts and GD confirmed it would. CM to investigate this further and provide information to all Trusts within Wessex and to provide an update to JS and the Board regarding this. CM Action: CM to provide further information to all Trusts within Wessex and provide update to the Chair and the Board in October 2015. Date and time of next meeting Date: Tuesday 27 th October 2015 Time: 2 5pm Venue: Southern House, Otterbourne Page 10 of 10