NHS Greater Glasgow & Clyde Glasgow City CHP Staff Partnership Forum Minutes from meeting held in William St Clinic Tuesday 1 st April 2014. Item No 15 Paper No 2014/037 PRESENT: Alex MacKenzie (Chair) Glasgow CHP Director Mark Feinmann Director, NE Sector David Walker Director, South Sector Sybil Canavan Head of HR, Glasgow City Dorothy McErlean Society of Chiropodists and Podiatrists Elaine Black Unison Diane Allcock Royal College of Nursing Ross McCulloch Royal College of Nursing Greg Usrey Royal College of Nursing Gary McNally Unison Jill Robertson RCN Linda Delgado Unite David Campbell Senior HR Advisor (note taker) APOLOGIES: Gerry McGowan Stephen Fullerton 1. APOLOGIES Apologies were noted 2. MINUTES OF PREVIOUS MEETING Amendments: Diane Allcock P1 Royal College of Nursing Dorothy McErlean P1 Society of Chiropodists and Podiatrists Greg Usrey - P4 - generification not gentrification Diane Allcock - P5 practicalities not impact Jill Robertson - P8 District, not Distinct Nursing With the amendments stated above, the minutes were agreed as a true record. 3. MATTERS ARISING i. Hosted Functions Specialist Children s Service Update (paper circulated) Mark first updated on mainstream Children s Services services. There had been a lengthy discussion on Children s Services at the last meeting about bringing the planning structures for Mainstream and Specialist Children s Services together. This has been discussed with Stephen in principle, and the plan was to take the paper to the next Partnership Director s meeting then bring it back to the SPF for further discussion. The specification for children s services has just been finalised. Mark will circulate that for comments once final detail has been confirmed. MF
There is work ongoing around the recruitment and retention of health visitors. There are approximately 22 HV vacancies across the Board at present. Annie Hair has been asked to finalise the detail and meet with some of the staff side partners to ensure that staff side are comfortable with the process of matching students with vacancies. On the subject of PACT, Mark stated that there is currently recruitment activity in this service. Mark met with a couple of staff side partners about school nursing to explain the process for school nurse recruitment, and suggested that they set up a small, short life working group around school nursing. On Specialist Children s Services, Mark commented that there is activity around changes to the Medical workforce. Those changes are agreed and we are now in the middle of implementation for each of the professional groups. With reference to Mainstream Children s Services, Ross McCulloch said that he appreciated the need to move forward with the school nursing review, and commented that we need to create a state where we still have a school nursing service. Also in relation to the funding for school nursing services, Ross commented that there is a significant financial resource made available to develop the School Nursing service. Ross asked if that money remains secure for the service and its development, and with regard to the money that has not yet been spent, had it been decided how that will be used. Mark said that was subject to director s approval. He went on to say that Cel 13 required all school nurses to have the appropriate qualification. Of all the SNs we have, only 3 have that qualification. A proposal has been put forward to train the current SNs who are Band 6 and the additional 19 SNs we intend to recruit. This will ensure that the current resource for investment in school nursing remains secure. How many we recruit will depend on how many have the relevant qualification. Elaine Black asked how many Band 6s we are looking for. Mark stated that we are looking for an additional 19. The Board currently has around 40 Band 6 SNs, of whom 3 have the qualification, so we need a programme of training for the remainder. The number we recruit will determine how many we train. We are committed to train all Band 6 staff by September 2016. Mark stated that the meeting that took place with Una Provan and Greg Usrey was to agree that process, and Mark needs to take it through partnership directors for their approval. MF Alex Mackenzie picked up on the point about finance, commenting that of the 2.2m identified for that programme of work, about 1.5m is committed for recruitment. That resource has not been challenged. It is still within the financial plan and is secure. Diane Allcock asked if we had scoped the impact for team leaders if the bands were going up from Band 5 to Band 6. Mark said that they have and that it won t change the numbers of TLs we require. Diane commented that on the paper circulated, there are 22.2 HV vacancies, and asked if these are establishment vacancies, and does it include the money for Healthy Children s Programme. Mark said that it did and that was for the whole Board. Diane asked with reference to the Specialist Children s paper, where does 2
Tier 2 CAMHS sit? There is reference in a paper to HVs and SNs picking up work at Tier 2, but it is not discussed and articulated in this paper so we have a full overview. Mark responded that the Tier 2 proposal is not agreed yet. Basic proposition is that HVs will have on their caseload, parents with significant mental health issues. And we want to ensure that HVs can access advice from Tier 2 CAMHS workers to work with the HV around mothers with significant mental health problems. So it is to support the HV rather than give them additional responsibilities. Diane felt that it was more a call for assistance, rather than supporting the HV to deliver another stream of work like CBT. Mark commented that it may be that a HV will have those skills but that discussion will need to take place Prison Healthcare Sybil Canavan confirmed that no recent issues had been raised with H R. Greg Usrey said that there was a plan for the workforce group to meet this week, but that was cancelled because no staff side were available. This has been rescheduled, so there will be an update in time for the next SPF. Alex asked if we could bring Prison Healthcare and Custody Suites back to the next meeting as a standing item. Family Nurse Partnership Mark said that there were no updates on FNP, and asked if any others were aware of issues of concern. Ross said that he understood the funding arrangements were 50/50 split between central and local funding. He asked if that was included in financial planning and if we could afford it. Alex said that his understanding was that FNP would be funded for a period of time, and now the funding had ceased and we would be expected to pick it up. It would be identified as a risk in the financial plan. Greg said that it was his understanding that we were looking at HV recruitment across the Board to cover all these vacancies. Mark said that we have a central HV recruitment framework for health and social care, with each recruiting their own. Alex stated that he won t be on the FNP Board. There will be a Co-ordinating Director, still to be identified. Sybil said that Stephen Fullerton is on the Programme Board. Alex asked Mark to get an update from the Programme Board and bring FNP back as part of his briefing. MF Provision of Healthcare to Police Custody Suites No update. Alex asked for an update to next the meeting as standing item. Care Homes Service Sybil stated that there had been some recent discussions with nursing staff in particular to agree a transition period. There were some staff concerns about the geography and working arrangements due to come into effect from this month. There will be a transitional period of up to a month to work on practicalities. Greg said that there was a plan to move from the existing geography of working which is part of the old Greater Glasgow construct to all of Greater 3
Glasgow & Clyde. That revised geography comes into place today, 1 st April. On 1 st October we should have a new LES in place regarding the medical arrangements which will be a change in service. Staff are concerned about the transition between these arrangements. They have agreed to a month or longer as necessary to transition to the new interim roles. It s getting there but has not been as smooth as was hoped. Sybil said that they have also arranged to have discussions with BMA and Medical staff to clarify process and undertake the necessary redeployment processes. Lanarkshire Boundary Changes Sybil said there is an APF secretariat tomorrow. Main points to note are that the financial position has been finalised with money transferred from Glasgow to South Lanarkshire. There seems to be general agreement about the wide range of service level agreements in place. At the last HR sub group there was discussion and we were not in full agreement with Lanarkshire about money being transferred across. We now need service managers to liaise with staff, particularly in Children s services. Paper going to secretariat tomorrow and will share that with the group. Healthy Working Lives Redesign Sybil gave an update that Greg is the nominated rep and there has only been one meeting to date. Greg said that they have had the first meeting which was to look at team structure and the delivery of the service to businesses in GG&C, given that one third of funding will be wiped out in next year. Alex asked if the papers would come to the SPF. Greg stated that final papers would go to the APF, but said that he had asked for staff briefings which would be appropriate for wider circulation, so will bring them back here. GU Alex asked who was leading on that piece of work. Sybil stated that it was Fiona Moss and Anna Baxendale. Ross commented on this section of the agenda, not specifically in relation to HWL, what we have had is 6 verbal updates from 7 agenda items across Greater Glasgow & Clyde, and commented on his concerns about the robustness of the process. What would be more helpful would be to receive the most recent minutes from the items. This would give a level of visibility of the work being taken forward. Alex commented that we should pull some of these items out of Matters Arising and get written updates of status and have them attached to the agenda. Alex went on to suggest that we should also reflect on that and keep verbal updates brief and have more time to spend on the more substantive items on the main agenda. ii. CHP Admin Review Sybil said that she would bring an update from the last Admin Review meeting, at which a presentation was given on the progress to date and the work underway. Sybil will circulate that presentation for the next SPF. 4
District Nursing Review David Walker updated that the last meeting of the District Nursing Review Board was 2/3 weeks ago. At that meeting it was confirmed that there was an engagement process underway, which technically ended yesterday, but with some flexibility on into April. There have been comments back from partnerships, from RCN and others and are awaiting a response from the LNC. Still issues being raised with regard to skill mix and use of the national workload tool. Broad agreement on agile working and background preparations are underway. Also going forward with the training of Band 5s to fill gaps where Band 6s retire over the next 5 years. These are the headline points. We are due to go back to the APF and report to the next meeting of the District Nursing Review Board. David has suggested that there should be a plan to meet with RCN to get agreement on these points. Alex asked for any updates to be brought back here. DW Greg commented that at the APF when it was known that there would be a consultation period, it was asked if some compilation could be done. David said that would be done and there had been some flexibility allowed and an extended period to allow people to have their formal meeting. Sybil commented on the survey monkey that had been used and said that it would be useful to get some feedback on how the consultation process had gone. Jill Robertson said that it had gone out specifically to RCN members only, and that staff had to request the survey if they hadn t received it. David said that it would be useful to see an aggregate of questions and responses. Jill Robertson commented that we got better responses because we asked specific questions. An update regarding consultation responses would be brought back when available. DW Change Fund David updated that it was scheduled to end in March 2015. There is currently a debate ongoing in Scottish Government about end point of the Change Fund. There are some strong views from the National Health and Community Care Delivery Group that the change fund should not end in March 2015. There was discussed about the planned Integration Fund but there is uncertainty about what the integration fund will actually involve/ cover. David commented as reassurance to colleagues that a decision was taken at the outset of the change fund to employ people on permanent contracts, where other partnerships in Scotland took the decision to employ people on temporary contracts. We will safeguard services until 2015. If the change fund does end on that date, we will prepare an exit strategy for the services and employee rights will be safeguarded with alternative employment opportunities and redeployment processes. Alex asked when it is likely to be concluded. David said that there were no specific timescales as yet. Alex asked for the item to be kept on the agenda as standing item for verbal updates. PACT DW See update above on Children s Services. Staff Survey/FTFT action plan Sybil stated that there is a summary document with a supplementary 5
document containing an audit of the CHP Team Brief. The covering paper reflects a short discussion at the Staff Survey Group. Sybil said that they were keen to focus on the main issues, and having reviewed all the results around staff engagement. Specifically how do we engage more effectively with staff? Also Yvonne Campbell from OD spoke about the North East stress audit results. Sybil said that at the CHP Management Team, they were asked to consider the audit of team brief, and how effectively we use the team brief process. This is to provoke discussion and reflect on the activity around staff engagement. We need to look at how we take it through sectors, through focus groups for example. We have a lot of information, we need to discuss how best to use it. Alex commented that there had been discussion and some suggestions at the Management Team how best to respond to the team brief audit. We need to take the action to reinforce it in Sector Management Teams. We also agreed that when the SMT meets we should have an agenda item at the end to agree what goes into the team brief. Also the team brief is viewed as a one way process and we want material coming back, with people having the opportunity to ask questions. SMTs Alex asked for comments. Ross commented that it was helpful to have reflection on how engagement with staff can be improved. He went on to say that focus groups need to be structured in the way we approach them. Material generated as a result of the process, we need to do something with. Ross asked if the further staff survey planned for 2015 was internal to Glasgow City. Dorothy McErlean commented that it was not yet clear when that would happen because of the referendum and the Scottish Government having other matters to deal with. But the survey should happen annually. Sybil commented that there were plenty of initiatives coming out, and the key is trying to find ways to be economic to get the best from the process. Sybil asked if we should be considering anything else. Dorothy suggested focus groups to get the response from staff and how staff feel about it and does the team brief give them anything. Alex asked if we could confirm we had agreement that focus groups would be used. Ross said he would agree with that. Ross said that it is reassuring for staff to see leadership and management on floor together, with senior manager going out to staff and speaking to them. The structured nature of some team brief processes can be quite intimidating. It would be less intimidating to ask staff how they carry out their role, is their job enjoyable, can we do it differently. Also in relation to Robert s recent article on shadowing and coaching, Ross said he has seen no evidence of that so far. Ross suggested that it should be encouraged for Heads of Service to engage in shadowing, which would possibly soften the hierarchical perception of the organisation. Dorothy commented on the Podiatry service which is a hosted service, and in that service, the Head of Service goes out to staff with a Footnote Live session with small groups of staff. He has an hour set aside and he discusses what is happening and they can bring issues. As it is a small group, it is less intimidating. David suggested that we don t promote enough of what we do. He said that 6
there are a lot of visits out to services by Directors and Heads of Service in all three sectors, talking to front line staff. There are some staff engagement sessions over lunchtime talking about recent topics, which have been well attended. He said that it is hoped that team briefs would galvanise the team meetings, but there may be too few team meetings. We need to follow up on that. David said that there are also service level events, for example in Children s Services where the service manager and meet with team leaders from health visiting and PACT to review the service in totality. David agreed that the structure and formality of that is not promoted well enough, as well as the mentoring and shadowing. Alex said that he understands that there has been a trawl for new mentors and for those who want to be mentored, and it may be that it is not visible enough. Sybil said that there was a proposal to run focus groups and work up a process. Greg commented that focus groups are smaller and more spread out rather than one large group. Diane commented on focus groups, saying that we don t always get the best out of these meetings and suggested that a package of support and a structure around them, then people may be more willing to participate. Mark asked if at some point, we need to feed the integration elements into that. Is this an NHS agenda only or is something that should be widened. Alex said that there a number of issues for the team to think about and respond to and should be brought back.. iii. Sector Updates ALL South David said there was nothing specific to update on. Ross commented that there was a South issue raised at the last meeting about a practice based in Gorbals HC, whether it was a matter of organisational change. Elaine Black commented that it was recently raised at the South SMT. This has just started and appropriate processes are in place, and there will be minimal disruption for staff involved. Ross asked if it was likely to trigger Organisational Change. Elaine said it would not. North East No update North West No update 4. FINANCE Alex commented on the paper provided by Jeanne Middleton which gives a finance update to the end of February 2014. Alex commented that the forum will have been sighted on this document and that it hasn t changed significantly over the year, in that it predicts a break even position at year end. The document also describes some of the work ongoing as part of the capital programme. Alex asked if there were any questions. Ross commented on Section 4/Page 3 in relation to savings performance. In particular the 1.4m unachieved savings, and the same figure recorded as sourced from nonrecurring sources, which means 1.4m inherited exposure that we still need to secure. Alex in response, commented that in Parkhead EMI beds there was slippage of 807k. That move has now happened and the savings have been realised. There are other changes too, and the fact that these changes have occurred in year, there is not a recurring deficit 7
being carried forward. Alex went on to say that there was Board seminar this morning that he had participated in. The Board still have to realise a 32m efficiency savings. The view is that there will be a similar challenge the following year, and possibly a figure of up to 100m in 2016/17. For 2014/15, Partnerships challenge was in the region of 6m. We are currently at the point of finalising PIDS to secure that saving. View is that it goes to the Director of Finance and to a Board seminar in May. So the Board will have sight of the challenge, then it would be brought here. We have a meeting on15 th May, so that might tie with that meeting. Update from last year is that we reached balance. We should spend time in May going through PIDs and getting comfortable with that. 5. INTEGRATION OF HEALTH AND SOCIAL CARE Alex updated that there will be a fully integrated partnership of both children and adult services that will be delivered via the body Corporate model. Alex stated that there is a Board remuneration committee coming up. Subject to that there will be an advert going out for chief officer post. It is proposed that there will be an internal recruitment process first, and subject to the outcome of that the partnership may go external. There was a meeting of the Joint Partnership Board in the last week. It was proposed that that we would start the first shadow board for the new partnership at start of summer. There are two main documents that need to be populated; the integration plan, and the joint commissioning strategy. Ross commented that he wanted to understand the challenges that would be faced in the next year. In terms of locality modelling, Ross asked if there had been any thoughts about that. Also, in terms of internal selection process for the post, is it internal to NHS or NHS and local authority. Ross said that would help understanding of the depth of integration. Alex in response said that the current working assumption is that there will still be services delivered in three sectors in the City, and that the delivery vehicle we currently have makes sense. In response to the recruitment and the level of integration, Alex commented that the job description for the Chief Officer does not have that level of detail on structure as yet. Ross commented that it was his understanding that we are triggering an organisational change process and with that in mind, we need to understand the consequences of that and what we need to do and how quickly. That would mean a significant commitment for all of us in committing time to that. Sybil responded saying we need to pick up on the detail around that depending on displacements and subsequent placements. Alex said that his current position was on an interim basis until the end of September and subject to discussion thereafter. Sybil confirmed that the proposed date for the HR Sub Group was 24 th April 2014, at 10.00am. 6. STAFF GOVERNANCE Sybil ran through the detail of the report provided including detail on Workforce Planning, Healthy Working Lives, staff Governance and H R Activity. 8
Jill Robertson commented on HR activity, asking if bullying and harassment suspensions are included with disciplinary and conduct. Sybil commented that this is reflected in the report for Staff Governance purposes and we collate figures on a standard basis. The suspensions are listed as reflecting all at that particular time, so it would be reasonable to assume that these are part of the conduct numbers. Ross commented on the low number listed under bullying and harassment, which was 3, and asked what the trend was. For example how many were there this time last year. Sybil said that the figures are constant from memory but we can give a breakdown of that. Alex said that if this was an annual report, we could maybe give that breakdown either six-monthly or annually. Ross brought up the eksf reporting against the service standard. There was a request in a paper from a previous meeting around the PDP review being applicable to the individual s job. If insufficient staff are having that, that number will be low and be of concern and it needs to be prioritised. Greg asked what the number 7 against attendance management mean. Sybil confirmed that it was the number being formally managed through the attendance management process that would not be a return to work meeting, but where specific action had been taken with regard to absence. Greg commented that it seemed remarkably low. Sybil said that she doesn t have the breakdown to hand to comment. 7. CHP SERVICE IMPROVEMENT NETWORK David commented that the essence of the paper on Service Improvement is how we take a more coordinated and less formalised approach to service improvement. Service improvement is important at all levels from local to Board level. David said that we already commit a range of resources to it. The paper indicates what we have done in the last year and makes proposals on how we take that further. The service improvement network has brought together that range of people that have an input to service improvement and allows them to look at how we might learn from other organisations. In terms of staff implications, there aren t many. It is more about how we organise a pool of staff who are already contributing to service improvement. And as a Community Health partnership, how we get a more unified approach. We looked at other organisations and other Health Boards who tended to adopt a more formal approach to this, in contrast to the informality of ours. We tried to give consideration to those involved in service improvement had access to the methodologies and the skills they need. More developed organisations have that. Dorothy commented that as we were talking about service improvement and methodology, and asked could there be a union learning rep involved in that? Alex asked if staff side could take that action. Dorothy agreed. DM 8. CHP DEVELOPMENT PLAN Alex referred to the draft development plan for the year, which is an 9
accountability document for the Board, and which captures everything we need to do. This has been submitted and we await comments. Alex asked the group how they would you like to use it. He suggested that we might work through it at a dedicated session. 9. AOCB Ross commented that there may be assistance the SPF could offer, and it might be more useful to take it to a workshop. Alex commented we need to identify the main tasks that we need to focus on. We could spend time on it if we had a summary of the core issues. Ross agreed that that would be helpful. Alex suggested that we start to construct something for mid May, and deal with the issues at a dedicated session. Alex said that comments should be forwarded to Hamish Battye. Ross commented on the Rehab job description process. Ross stated that there was a central group overseeing the process. The group has since ceased and outstanding work has been tasked to the SPF had to take forward. Ross said that we need to understand where we are in terms of timescales and process. Sybil said that she chaired the Rehab group, and did share the work that had been done to date across partnerships. Sybil is aware of discussions in NW sector, but not aware of wider discussions. Sybil said she would be happy to find a baseline status on how we all do and bring it back. 10. DATE AND TIME OF NEXT MEETING Thursday 15 th May 2014, 10.00am in the Boardroom, J B Russell House (staff side from 9.00am) 10