SOUTH AREA: BADENOCH AND STRATHSPEY PROJECT BOARD. APPROVED MINUTE of MEETING

SOUTH AREA: BADENOCH AND STRATHSPEY PROJECT BOARD APPROVED MINUTE of MEETING Board Room, Assynt House, Beechwood Business Park, Inverness Wednesday 6 th July 2016 1.30pm PRESENT: Eric Green (EG) Head of Estates (Chair) Kenny Rodgers (KR) Head of Finance, South & Mid Unit Maimie Thompson (MT) Head of Public Relations & Engagement Joanna MacDonald (JMac) Director of Adult Social Care Jaci Douglas (JD) Councillor for Badenoch & Strathspey Alex Murray (AM) Service User (Locality Representative) Stewart MacPherson (SM) Clinical Director, South & Mid Unit Georgia Haire (GH) Deputy Director of Operations, South & Mid Unit Mairi Palmer (MP) Service User (Locality Representative) IN ATTENDANCE: Diane Forsyth (DFo) Project Manager, Estates (minutes) Heather Cameron (HC) Senior Project Manager, Estates Mairi Simpson-Taylor (MST) Project Administrator, Estates APOLOGIES: Deborah Jones (DJ) Director of Strategic Commissioning, Planning and Performance DID NOT ATTEND: Dan Fraser (DFr) Senior Charge Nurse (Locality Representative) ITEM 1. WELCOME AND APOLOGIES ACTION Eric Green welcomed everyone to meeting and the above apologies were noted. 2. MINUTE OF MEETING AND MATTERS ARISING (attached) ACTION 2.1 The minutes of 20 th April 2016 were approved as an accurate record. Highland Council District Partnership Structure 2.2 2.3 JD updated Board Members advising it has been agreed to move forward with Local Community Planning Partnerships and dissolving District Partnerships. B&S will now be a single community partnership uncoupled from Nairn and will be chaired by one of five agencies (HIE, Fire, Police, Highland Council, NHSH). Currently plans are being set up for: Children s Plan, Adults Plan and Community Learning Development Plan. This is to be set up by and reported back to Scottish Government (SG) by October 2016. JD also confirmed that Patient requests and Asset Transfer requests will come to this locality partnership and heard locally. Research Study Projections of Health Care in B&S 2.4 GH advised that external Demographer will present the findings of his report to Project Team and DJ on 8 th July. 1

2.5 It was agreed that decision would be made after the meeting on value of his report and whether he should attend the Project Board in October. GH to confirm attendance / provide feedback at next Project Board. GH 3. NOTES OF PROJECT TEAM MEETINGS ACTION 3.1 3.2 3.3 AM raised query on Page 9 End of Life Care (April Project Team notes) asking if palliative care beds would be in addition to the flexible use beds in Grantown and Wade Centre. GH confirmed they are not additional beds but the same flexible use beds would be used for palliative care/end of life. KR highlighted that it was important to note section 4a.ii of the project team notes was a presentation given by Highland Hospice and others, what the future of palliative care would look like from their perspective and not referenced to B&S but a holistic view. Item 4c Page 9 Build Procurement (April Project Team notes) New Project Request (NPR) is to go to Project Board for approval on 6 th July. DF highlighted that this was from an earlier team meeting which did not reflect the changing timescales of the project. HC confirmed that NPR will be completed in August and sent to Project Board for approval as an extraordinary paper due to size and technical detail of the document. 4. PROJECT SUB GROUPS ACTION 4a 4a.1 4a.2 Workforce Plan The Workforce Plan has been circulated to Board Members for approval. GH stated that a large amount of work has gone into this based around the Service and Clinical Plan and using the 6 step workforce planning methodology. The document circulated is a combination of two workshops and meetings with staff groups. External challenge has also been provided which has introduced a better national picture and allowed benchmarking with service change elsewhere. The Workforce Plan is a working document and the Project Board is asked to approve the plan at this point in time. Further development is required on: Inpatient Nursing comparison against national benchmarking for 24 bedded unit Medical Workforce for inpatient and minor injuries this is well underway. We have requested expressions of interest from GPs (including local GPs) to provide inpatient services. GH confirmed that Out of Hours will be in line with how this is provided across NHS Highland. 4a.3 4a.4 4a.5 Appendix 2 of the document shows a noticeable shift in staffing towards community services, in particular community nursing, mental health and allied health professionals. The proposed changes are affordable, with a drop of 10 whole time equivalent (WTE) overall, but with resource being used differently. GH reiterated that NHS Highland has a no redundancy policy and we would be seeking to match staff to suitable jobs. KR advised that an early financial sense check indicates that we are on track within the affordability envelope. As yet the unitary charge for the new building is unknown. This will be clarified at Outline Business Case 2

(OBC) providing greater certainty. 4a.6 4a.7 4a.8 4a.9 4a.10 4a.i.1 4a.i.2 4a.i.3 4a.i.4 4b JD queried the current overspend on Out of Hours and whether this was reflected in the figures. KR advised that we were trying not to solve historic overspend issues within the remit of this project and that the Operational Unit was exploring other means of addressing this. MT advised that a paper on Out of Hours was going to the next NHS H Board meeting. JD asked whether advances in technology were reflected in the plan. GH advised that there is an ehealth strand to the work, and that the Head of ehealth has joined the Project Team. Telehealth is being looked at more widely across NHS H. Telecare team to be asked to do a demo at next Project Board. AM noted that 24 beds was being used as a baseline, and queried whether a reduction to 20 beds was still being considered. GH advised that the balance of beds vs. community services was still being explored although this was nearing conclusion, and the demographic study would inform this. MP informed the group that the definition of step up / step down beds is very good (page 43) and that this should be used when communicating with the public, as they are unclear as to what they actually are. The Project Team has proposed that they are renamed Heather beds. The Project Board approved the Workforce Plan. Inpatient Mental Health GH advised that the Operational Unit were seeking approval to progress this work stream now with a move of older adult inpatient mental health services to New Craigs this financial year. The current service is difficult to sustain, and the proposed model is significantly better. Staff impacted by the change have seen the clinical plan and DJ is supportive of the proposals. MT reiterated that the service change was a process of evolution, and that changes would be made throughout the lifetime of the project, not waiting until the new hospital is in place. GH confirmed that the Project Board would also be involved in any other opportunities to implement service change ahead of the new hospital build. JD requested that we ensure that all information going out to public and staff is consistent. The Project Board supported the above approach. Business Case Process (paper circulated) GH referred to the paper and advised that the OBC is being worked upon through this financial year. DF 4b.i 4b.i.1 Benefits Realisation (paper circulated) Two workshops have been held to identify the project benefits (output circulated for information) and we are now at the stage of measuring these benefits. Measures used will include softer data such as user experience in addition to management system data. 3

4b.i.2 4b.ii 4b.ii.1 4c 4c.1 EG advised that the Benefits Realisation document will be used as part of the post project evaluation process. Gateway Review Two group sessions have been arranged on 30 th August and 5 th September 2016 in order to provide a greater understanding of the requirements of Gateway Review. These will be attended by key members of the SLWR and B&S projects who are required to attend one session only. A formal external Gateway Review will be undertaken during the final stages of OBC preparation. Build and Site Procurement (paper circulated for information) The NPR is the first stage of the Build Procurement process and work is underway in producing documentation compiling this. Two main sections form part of the document; Authority Construction Requirements which includes clinical and technical specification stipulating what standards we want applied to the design and construction of the building. Affordability Cap which will show likely cost of the building. Reference projects of a comparable facility will be looked at to work out an affordability cap. It is at this stage that negotiations will commence with Scottish Futures Trust (who manage the Hub pipeline on behalf of Scottish Government) regarding the budget for the building. 4c.2 4c.3 4c.4 4c.5 4d 4d.1 HC confirmed that site investigations have been carried out on the preferred site and the results have been positive; the site has good load bearing capacity with no evidence of flooding and overall is a good site. Negotiations are continuing with the owner of the site regarding purchase, and they have agreed in principle to sell to NHSH. EG advised it is a prescriptive process to purchase the site and we have appointed an independent valuer to carry out the price negotiations. Concerns were raised on the length of time negotiations were taking and how long we should wait for negotiations to continue. EG advised there may be many reasons accounting for the length of time the negotiations are taking, for example owner may have difficulty in establishing exact site boundary due to length of time the site has been under their ownership, but reaffirmed there are no indications to suspect we would not secure the site. The site purchase is not on the critical path (i.e. it is not holding up any other work) and meantime legal paperwork has been prepared by our Central Legal Office to be issued on conclusion of price negotiations. MP asked if there was a finite amount we are able to offer for the site and if this was separate from the funding to develop the site. EG confirmed that the 2 funding streams are different, and to ensure value for money an independent valuer will negotiate an acceptable price. HC confirmed that money is in the NHS H capital plan for this year to purchase the site. Support Services GH advised that the option appraisal to identify a preferred catering model is not yet completed despite being considered by the Project Team several 4

times. Advice is sought from the Project Board on how to progress with this, as this is currently on the critical path with regard to build procurement as it impacts on workforce and building design. 4d.2 4d.3 4d.4 Sustainability is an issue particularly in remote and rural areas due to recruitment and retention of qualified cooks and the catering model needs to adequately address this. EG proposed that we ask catering experts in Health Facilities Scotland to independently review the catering options, and requested Project Board support. The Project Board supported asking an external specialist to review the catering options. EG to contact Health Facilities Scotland to bring in external expertise. EG 5. RISK REGISTER (paper circulated) ACTION 5.1 5.2 The draft note and output (risk register) of the extra-ordinary Project Board meeting on 10 th June 2016 was circulated for approval. No comments were received. The risk register will continue to be updated as the project progresses and will be reviewed by the Project Team every six months. GH summarised the key red (very high) risks. These are; Procurement Risk 1.2.1: Project delay and increase in cost due to a delay in the dependency project (Skye, Lochalsh & South West Ross); EG advised that the Skye Project is progressing well and by OBC will be realigned with B&S. Risk rating to be reviewed at that point. Financial Risk 4.1.1 Potential for the construction costs to exceed the funding allocation from Scottish Government; This risk will be ongoing until we have absolute certainty on final costs. The first affordability test will be at NPR when the affordability cap will provide an initial indication of likely construction cost. Financial Risk 4.1.7 No funding identified in the NHS H Board capital plan for works at the health centres in Grantown and Kingussie. This is in NHSH capital plan and costs will be confirmed once requirements are agreed with stakeholders. The SG is supportive and there is no indication that this will not be approved. 5.3 The European Referendum result was discussed and whether this should be added to the risk register. It was agreed this risk is beyond our control with no current indication that there will be any specific impact to consider. 6. KEY PROJECT MILESTONES AND ACTIONS (paper circulated) ACTION 6.1 6.2 The Workforce Plan has been approved and work is underway for NPR submission to Hub North Scotland Ltd in October 2016 following internal / external approvals. Status of remaining key milestones will change as dependency pieces of work are completed. JD queried if work on the Minor Injuries Unit at Grantown Health Centre is likely to happen before the new hospital opens and if budget is available. 5

EG advised that option work is currently ongoing with Grantown and Kingussie Health Centres and firm proposals will be brought back to this Project Board. It is hoped to finalise floor plans this year and then move to appraisal of the implementation options. HC confirmed that the Minor Injuries Unit will remain in Ian Charles Hospital and there will be continuity of service during any refurbishment works. 6.3 The Kingussie building is owned by the GP practice and NHS H is supporting them with a proposed solution. 7. PUBLIC AND STAFF ENGAGEMENT (paper circulated) ACTION 7.1 7.2 7.3 7.4 7.5 MT advised that Community Council meeting was held in Grantown on 24 th May and attended by MT/KR and Rhiannon Pitt, Area Manager. MT confirmed the Community Council will be updated monthly and a further session is planned to discuss Care at Home. MT advised that programme is being drafted for meetings with Community Councils and this will be shared with members. MT to inform public representatives of any dates in their area. Staff engagement is continuing with newsletters being sent out after each Project Team meeting. Councillors and MSP s are also being updated. The Cairngorms National Park Authority is running a consultation on the big 9 issues. MT will report back any findings. MT confirmed Researcher from Edinburgh University carrying out research on hospital closures, will be contacting people who have voiced they are unhappy with hospital closures. MT highlighted that we have a responsibility to write this up and for people to have their say. MT MT 8. ANY OTHER COMPETENT BUSINESS ACTION 8.1 8.2 Query was raised around the potential for a cafe / retail facility in the new hospital. KR clarified that there would be no catered facility as this would need to be self funding, but that there is potential for vending machines. EG highlighted that there is a NHS Scotland strategy to look at retail opportunities in hospitals but from advice sought, retail from a hospital of this size was unlikely to be viable. MP asked about outside space for the new hospital and if this would be designed in partnership with the Forestry Commission. EG advised the project will have a strategy for external spaces which will set out partners. 9. DATE OF NEXT MEETING ACTION 9.1 Wednesday 5 th October 2016 at 1.30-3.00pm in the Board Room, Assynt House, Beechwood Park, Inverness 6