Workforce and Organisational Development Committee Minutes of the meeting held on 13.3.14 in the Board Room, Ysbyty Gwynedd and via videoconference Present: Dr P Higson Ms J Dean Dr C Tillson Mr K McDonogh Chairman (Chair) [PH] Independent Member [JD] Independent Member [CT] Independent Member [KMc] In Attendance: Mrs T Cooper Mr B Evans Mr G Lang Mr J M Jones Ms Lesley Hall Prof M Makin Mrs K Parry Mr D Phillips Mr M Sykes Agenda Item Assistant Director Nursing [TC] part meeting Acting Director of Finance [BE] Acting Chief Executive [] Executive Director of Workforce & OD [JMJ] Assistant Director Employment Strategies & Practices [] Executive Medical Director [MM] Acting Head of Corporate Affairs [KP] Head of North Wales GP Out of Hours Service [DP] part meeting Assistant Director Organisation Development [MS] Action WOD14/18 APOLOGIES FOR ABSENCE Mr H Owen-Jones and Mrs M Hanson. WOD14/19 DRAFT MINUTES OF MEETING HELD ON 9 th JANUARY 2014 Dr C Tillson proposed, Mr K McDonogh seconded, and the minutes were approved as an accurate record of discussions held. WOD14/3 MATTERS ARISING AND SUMMARY ACTION PLAN Matters arising were discussed, and the action plan updated accordingly. WOD14/21.2 INFECTION PREVENTION TRAINING UPDATE [agenda item taken out of sequence at Chair s discretion] WOD14/21.2.1 Mrs Tracey Cooper was in attendance to present the update paper which provided an overview of training and education available, planned developments, opportunities and challenges. Mrs Cooper highlighted that the lack of training rooms in Ysbyty Glan Clwyd (YGC) was a significant issue as it necessitated staff having to travel to Abergele Hospital for face to face training. Mr G Lang undertook to speak to Mr N Bradshaw to determine if anything could be done to release space and capacity within the postgraduate centre on the YGC site. KP WOD14/21.2.2 Mrs Cooper indicated that there were two options for the provision of infection prevention training - face to face sessions, and e-learning which was available BCUHB WOD minutes PUBLIC 13.3.14 v1.0 Page 1 of 7
from any web-enabled PC. Mr M Sykes undertook to work with Mrs Cooper to check the links between the NHS Wales Learning programme and ESR, to ensure that all training undertaken was being captured. Mr G Lang suggested that potentially the e-learning package could be made available to primary care contractor staff. Dr P Higson was keen to see this progressed. Mrs Cooper also referred to web based modules for doctors which Prof M Makin was hoping could be adapted for use for BCUHB doctors. It was noted that the most significant barrier to improving take up of training was the release of staff, and Mrs Cooper suggested that managers needed to be held to account to ensure that this training was prioritised within key staff groups. WOD14/21.2.3 Dr C Tillson enquired as to the level of infection control training covered as part of the locum induction process. Mrs Cooper undertook to follow this up. MS TC TC WOD14/21.2.4 Ms J Dean felt it was essential to clarify which staff required which level and type of training, and that in terms of releasing staff to attend it was very often preferable to provide a whole day package of mandatory training rather than several separate absences. WOD14/21.2.5 Mr K McDonogh enquired whether there were capacity implications in terms of the identified plan for the next 12 months. Mrs Cooper indicated that delivery would depend very much upon recruitment to the revised infection nursing team structure. She also outlined future implications through the planned roll out to care homes and a similar model to support medical and dental practices. WOD14/21.2.6 Dr P Higson reminded the Committee that Professor Brian Duerden would be returning to the Board in June, and it was essential that a reasonable level of progress could be demonstrated. It was noted that the Quality & Safety Committee was responsible for overseeing the response to Prof Duerden s report and that the Board would continue to receive monthly updates also. WOD14/21.2.7 The Committee: Noted the training currently available, the development planned over the next 6-12 months, and the future opportunities being explored for longer term implementation. Supported a range of management actions as outlined above, and clarified that the Board itself had a clear expectation that uptake of infection control and prevention training was enabled, improved and maintained. Mrs T Cooper left the meeting WOD14/022 OUT OF HOURS HONORARY CONTRACT AND WELSH RISK POOL (WRP) INDEMNITY COVER [agenda item taken out of sequence at Chair s discretion] WOD14/022.1 Prof M Makin reminded the Committee that it had previously approved a paper to enable those GPs who undertook sessional work for the Health Board to be covered by WRP medical indemnity, and that the paper sought an extension to this arrangement based on the risks identified. WOD14/022.2 Mr David Phillips was in attendance for this item and reported that the Minister had requested an All Wales model for out of hours doctors, however, local proposals had been developed to manage the situation in the interim. BCUHB WOD minutes PUBLIC 13.3.14 v1.0 Page 2 of 7
WOD14/022.3 Dr C Tillson felt this was a significant issue for the Board and he would support the paper. WOD14/022.4 Dr P Higson requested a future paper around the contracts and controls in place. MM DP WOD14/022.5 The Committee approved the extension of the current arrangements for Honorary Contracts and WRPS medical indemnity until the 30 th June 2014. WOD14/21.1 MANDATORY TRAINING BRIEFING WOD14/21.1.1 Mr M Sykes presented the briefing paper, and confirmed that it included a mix of statutory and mandatory/required training, with any additions requiring the approval of the Committee. He indicated that the determination of levels and the priority for attendance would need to be driven by line managers having assessed an employee s role. Mr Sykes also referred members to the Statutory & Mandatory Training Policy & Procedure. [Prof M Makin left the meeting] WOD14/21.1.2 Members expressed a range of concerns and comments around - the need to ensure training was targeted and appropriate for individuals and job roles; a refresh of what was deemed mandatory; the need to ensure that compliance monitoring only reported on those staff groups for whom the training had been prioritised; a desire to see training needs more closely linked to appraisal and PADR; and an awareness that compliance against mandatory training is an important metric that the organisation will be measured against. WOD14/21.1.3 Mr. Jones suggested that the Executive sponsor for each of the areas of Mandatory and Statutory training should be asked to prepare a paper detailing the source of the underpinning legislation and what this required organisations to do to comply with the legislation. Mr G Lang suggested that once the Committee had received and considered these briefings, a mapping exercise could be undertaken against two or three broad staff roles to determine reasonableness and deliverability. WOD14/21.1.4 The Committee noted the briefing paper, and agreed that further papers should be sought on each of the areas of Mandatory and Statutory training for the April meeting of the Committee. WOD14/24 ALL WALES STANDARDS FOR ACCESSIBLE COMMUNICATION & INFORMATION FOR PEOPLE WITH SENSORY LOSS [agenda item taken out of sequence at Chair s discretion] JMJ MS WOD14/24.1 Mr M Sykes presented the paper which provided an indication of the Board s current position against the All Wales Standards, identified areas for improvement and outlined some indicative costs. WOD14/24.2 Dr P Higson wished to declare a potential interest in that he had been involved previously in a working group looking at similar standards. He welcomed the paper and the principles of adapting services to be more accessible, and noted a personal wish to see improvements made to basic signage across Health Board premises. WOD14/24.3 Dr C Tillson referred to a clinical governance tool which was utilised in primary care and which was a useful resource. There was a discussion around the status BCUHB WOD minutes PUBLIC 13.3.14 v1.0 Page 3 of 7
of independent contractors and how this affected discharge of the Board s statutory equality duties. [Prof M Makin rejoined the meeting] WOD14/24.4 Ms J Dean suggested that design principles from the YGC development should be replicated in other sites wherever possible. WOD14/24.5 Dr P Higson suggested that the recommendations of the paper be reviewed to reflect the discussion, particularly to ensure there was a clear understanding of the Board s legal and statutory responsibilities and how these transferred to services delivered by its contractors. Dr Higson also suggested that the reporting mechanism for this area of work also needed to be identified. [Mr G Lang left the meeting] WOD14/23 JOB PLANNING & REVALIDATION PROGRESS REPORT FOR CONSULTANT AND SAS DOCTORS MS WOD14/23.1 Prof M Makin introduced the paper, indicating that it was his intention to further develop and improve the style and format of future papers of this nature. He highlighted a concern over the number of consultants who were working over 13 sessions, and felt that this working environment did not offer an appropriate work-life balance. Prof Makin stated he would wish to drill down into these particular job plans and encourage an approach where excessive sessions within a particular specialty were actively addressed. WOD14/23.2 With regards to appraisal rates, Prof Makin noted particular concerns relating to SAS Doctors. He confirmed that this group of Doctors were valued and had recently been included in departmental medical meetings, but that the lack of an annual appraisal process was not helpful. WOD14/23.3 Ms J Dean agreed that improvements were needed to the presentation of this data for the Committee, and that she would wish to see not only quantitative data, but also assurance around the quality of the job plans and whether the professional activities were aligned to organisational objectives. She was also unclear from the data as presented as to whether the current performance met the target percentage of doctors requiring revalidation, and whether there were any risks to the delivery of care where revalidation had not. Dr C Tillson suggested that job plans needed to be aligned to the Health Board s Three Year Plan, and be able to demonstrate how they fitted in with clinical variation. Mr K McDonogh noted that whilst productivity and efficiency could be tackled as part of appraisal and job planning, the current reporting to the Committee did not provide a feel for how this was being addressed. Prof M Makin would take these points on board for future reports. MM [Mr G Lang rejoined the meeting] WOD14/23.4 Dr P Higson noted with concern that two different recording systems for job planning would be maintained. Prof Makin indicated that the All Wales system was the longer term solution, however, there was a transition period due to immediacy of issues encountered in the previous year. Dr Higson suggested that the Committee would at some point require a trajectory of when the Board would move to the All Wales system. MM WOD14/23.5 The Committee noted the progress to date. BCUHB WOD minutes PUBLIC 13.3.14 v1.0 Page 4 of 7
WOD14/25 WORKFORCE & OD POLICIES Dr P Higson requested that where revised policies were submitted in future, a summary of the changes made be included. WOD14/25.1 WP13 FLEXIBLE WORKING POLICY & PROCEDURE WOD14/25.1.1 Mr J M Jones indicated that the policy had been reviewed in partnership and was presented for adoption on behalf of the Board. Ms J Dean advised that it was important to be able to report on the number of applications for flexible working and whether they were approved, to determine whether there were any equality or discrimination issues [Prof M Makin left the meeting] WOD14/25.1.2 The Committee adopted the revised Policy and Procedure. WOD14/25.2 WP30 STATUTORY & MANDATORY TRAINING POLICY & PROCEDURE WOD14/25.2.1 Mr J M Jones indicated that the policy had been reviewed in partnership and was presented for adoption on behalf of the Board. Bearing in mind the earlier discussions around mandatory training, Mr Jones recommended the Policy be approved for 3 months to allow the further work to be undertaken as discussed. WOD14/25.2.2 The Committee adopted the revised Policy and Procedure for a period of 3 months pending further review. WOD14/25.3 WP31 SMOKE FREE POLICY WOD14/25.3.1 Mr J M Jones indicated that the policy had been reviewed in partnership and was presented for adoption on behalf of the Board. He noted that the Policy covered both patients and staff. Ms J Dean suggested that the coversheet should also refer to a range of health and safety and workforce policies aimed at protecting staff. Dr P Higson enquired about policy arrangements for alcohol, and Mr Jones confirmed there was a separate procedure on the management of drug and alcohol (substance misuse). WOD14/25.3.2 The Committee adopted the revised Policy. WOD14/25.4 WP40 ALL WALES EMPLOYMENT BREAK POLICY WOD14/25.4.1 Mr J M Jones presented a new all Wales policy for adoption. WOD14/25.4.2 The Committee adopted the Policy. WOD14/25.5 WP41 ALL WALES RECRUITMENT & RETENTION PAYMENT PROTOCOL WOD14/25.5.1 Mr J M Jones presented a new all Wales protocol for adoption. WOD14/25.5.2 The Committee adopted the Protocol. WOD14/26 WORKFORCE & ORGANISATIONAL DEVELOPMENT REPORT WOD14/26.1 Mr J M Jones presented the regular detailed report, drawing members attention to the issues of significance which were highlighted on the coversheet. He suggested that a separate paper on sickness absence management be prepared for the April committee meeting; this was agreed. JMJ BCUHB WOD minutes PUBLIC 13.3.14 v1.0 Page 5 of 7
WOD14/26.2 Ms J Dean was concerned to see that a decision was still awaited as to the delivery of the Supporting You recruitment module for managers. Mr M Sykes undertook to establish the current position. WOD14/26.3 Dr P Higson expressed concern that there were Disclosure & Barring Service checks outstanding on a number of new starters and would wish to see the number of employees who commence their post without the necessary checks reduced to zero with any exceptions for urgent and essential appointments going through the correct procedure to receive Executive Director approval. In response to a question from Mr K McDonogh, Mr Jones indicated there was no programme to undertake DBS checks for staff appointed before DBS requirements were introduced, but checks were made when staff changed post. He reminded members that DBS checks was an important safeguard but only one aspect of a range of processes to reduce the risks. Members noted the letter sent by Mr G Lang to senior managers on the 18.2.14 regarding safe recruitment and selection, but felt that the Committee required a further level of assurance that the current unacceptable practice of allowing a small number of staff to commence in post without DBS checks had been completed was not was not putting patients at risk of harm. Dr Higson proposed that in each such case there should be assurances provided in writing by relevant managers that the member of staff would not be allowed unsupervised access to patients or access to patients records and personal details until the DBS check had been completed and was acceptable. MS JMJ [Prof M Makin rejoined the meeting] WOD14/26.4 Ms J Dean indicated she would appreciate some compliance reporting against key performance indicators for occupational health. Ms L Hall confirmed this would be provided but given the short time since the three units had been on the same database suggested that a report later in the year might be more helpful. The meeting agreed that a report should be provided to the October meeting of the Committee. JMJ WOD14/26.5 Ms J Dean referred to the outstanding issues at a national level regarding learning technologies. Mr M Sykes acknowledged this was of concern to BCUHB and had been flagged nationally. WOD14/26.6 Dr P Higson requested that the issues of significance on the coversheet be further developed in future reports to alert members to the actual issue or concern, not just the topic. WOD14/26.7 The Committee noted and received the report. WOD14/27 PRIMARY CARE SUPPORT UNIT WORKFORCE PAPER WOD14/27.1 Mr G Lang presented the report which had been prepared following a request by the Committee to be further informed on primary care workforce issues. He indicated that there was a challenge in that the Health Board did not hold a great deal of relevant data specific to the primary care workforce, and he would welcome the Committee s perspective on what it felt should be the priority areas. WOD14/27.2 Mr J M Jones referred to a paper produced by Dr F Campbell (Assistant Medical Director Primary Care West), noting that the supporting information had been heavily based on a 2012 survey and national studies in the absence of more local data. Mr Jones felt that the relationship between the Board and primary care needed to move BCUHB WOD minutes PUBLIC 13.3.14 v1.0 Page 6 of 7
closer in future years, but an increased level of workforce intelligence would be required. Dr C Tillson would welcome more information on trend analysis and skill mix, and he felt there was more information to draw upon out in primary care. WOD14/27.3 Dr P Higson felt there was a strong message that primary care was vital to the success of the Health Board s strategic direction and that the Committee would need to be assured around the ability and capacity of the primary care workforce to deliver what it needs to do. WOD14/27.4 The Committee noted the briefing provided and agreed that further assurances, including the work of the General Medical Services Workforce Task & Finish Group, be provided to the Committee at a later date. [Dr C Tillson left the meeting] WOD14/28 FOR INFORMATION Mr J M Jones introduced the following items, all of which were received and noted by the Committee. For Information from Summary Action Plan: 14/28.1a Ref:14/5.3 Staff Appraisal Acting Chief Executive e-mail 14/28.1b Ref:14/7.7 Occupational Health sickness KPI s 14/28.1c Ref:14/7.11 Pre-employment checks letter from Acting Chief Executive For Information 14/28.2 Commissioning Reports 2012/13 14/28.3 Working Differently Working Together Products issued to date. 14/28.4 LIFT - Tackling Workless Households Programme Update January 2014 14/28.5 Public Services (Workforce)[Wales] 14//28.6 Disclosure and Barring Service (DBS) [Mr G Lang left the meeting] WOD14/29 ISSUES OF SIGNIFICANCE TO BE NOTIFIED TO THE HEALTH BOARD To be collated from minutes. WOD14/30 ANY OTHER BUSINESS KP It was noted that an issue pertaining to challenges to consultants from England on the English consultant contract taking up the amendment to the Consultant Contract in Wales would be taken as part of the In Committee meeting. IN COMMITTEE ITEMS CONFIDENTIAL (items WOD14/31-35) WOD14/36 DATE OF NEXT MEETING Monday 14 th April 2014 @ 10.00am in the Boardroom, Ysbyty Gwynedd (no video conferencing from April onwards) Disclosure: Betsi Cadwaladr University Health Board is the operational name of Betsi Cadwaladr University Local Health Board Signed (Chairman): Date: BCUHB WOD minutes PUBLIC 13.3.14 v1.0 Page 7 of 7