FORMAL BUSINESS

					                            SUBJECT TO RATIFICATION AT THE NEXT MEEETING

                                        NHS BLACKPOOL

              MINUTES OF A MEETING OF NHS BLACKPOOL TRUST BOARD
                     HELD ON WEDNESDAY, 14 SEPTEMBER 2011
            IN THE TRAINING SUITE, SOUTH SHORE PRIMARY CARE CENTRE

                                              PART I

Present:          Mr R Fisher, Chairman
                  Mr G Smith, Vice Chairman
                  Mrs W A Swift, Managing Director
                  Mr DG Edmundson, Non-Executive Director
                  Mr I Taylor, Non-Executive Director (up to 226/11)
                  Mr M Morris, Non-Executive Director
                  Mr C Brown, Locality Director of Finance, Information and Estates
                  Dr A Rajpura, Director of Public Health
                  Mr D Bonson, Director of Strategic Planning and Commissioning

In Attendance:    Mr A Jude, Assistant Chief Executive
                  Mrs H Skerritt, Director of Nursing and Quality
                  Mr R Emmess, Director of Partnerships
                  Miss LJ Talbot, Secretary to the Trust Board

                  Mr S Gornall, Assistant Director Commissioning, Primary Care (for 224/11 and 225/11)
                  Mr H Naylor, Interim Organisational Development Lead
                  Ms C Cassin, Head of Communications, NHS Blackpool
                  Mrs S Moorcroft, Pharmaceutical Representative, Pfizer
                  Ms A Clark, LINks


       FORMAL BUSINESS
       Mr Fisher reminded members that it was the last meeting for Mr Brown and Mr Emmess
       as they would be retiring from NHS Blackpool on 7 October 2011. Mr Fisher commented
       that both Mr Brown and Mr Emmess had had tremendous input to the Board and wished
       them good luck and best wishes for the future. Board members conveyed their best
       wishes.

215/11 APOLOGIES FOR ABSENCE

       Apologies for absence had been received from Dr Doyle, Mr Block, Miss Howard, Dr Calvert
       and Mrs Holt.

216/11 DECLARATIONS OF INTEREST RELATING TO THE ITEMS ON THE AGENDA

       RESOLVED: That the following declarations of interest be noted:

                    • Mr Taylor as a Councillor on Blackpool Council and in relation to the
                      Moor Park Health and Leisure Centre.
                    • Mr Taylor’s wife, Councillor Mrs Sylvia Taylor on Blackpool Council as
                      Chair of the Health Overview and Scrutiny Committee.
                    • Mr Morris as a volunteer of Trinity Hospice

217/11 MINUTES OF THE MEETING HELD ON 13 JULY 2011

       RESOLVED: That the minutes of the meeting held on 13 July 2011 be approved as a
                 correct record.
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218/11 MATTERS ARISING

(a)   180/11(g) The Quarter – Quarter 4 2010/11 – The Secretary had forwarded the recent issue of
      the Quarter to all Board members.

(b)   181/11 Better Payment Practice Code – Mr Brown had conveyed members’ thanks to staff
      regarding the current achievements relating to the Better Payment Practice Code.
(c)   182/11 Quality and Performance Report – Patient Experience – Mrs Skerritt had ensured
      that the full report was made available to Board members.

219/11 CHAIRMAN’S COMMUNICATIONS

      There were no issues.

      The following items were taken out of the order of the agenda.

220/11 FINANCIAL POSITION FOR THE FOUR MONTHS ENDING 31 JULY 2011

      Mr Brown spoke to a circulated report and informed members that the financial position of the
      Trust for period ending 31 July 2011 showed an underspend of £929,000 against its revenue
      resource limit. This was £463,000 greater than the control total requirement.

      The current reported in-year revenue resource limit of £303,118,000 included a required
      planned surplus of £1,399,000 which represented the in year revenue resource limit reported to
      the Board on 9 March 2011 of £303,705,000 adjusted for allocation amendments made in year
      by the Strategic Health Authority.

      Mr Brown informed members that progress towards the development of the non-recurrent
      spending plans for 2011/12 was a separate item on the agenda and the delivery of the 2011/12
      control total was dependent upon those plans.

      Mr Brown took members through the report which provided information on:

      •   Secondary Care contracts and Service Level Agreements
      •   Primary and Community Commissioning
      •   Prescribing
      •   Public Health Schemes
      •   Corporate Budgets
      •   Better Payment Practice Code
      •   Cash
      •   Capital

      Mr Brown informed members that at the time of writing, month three of the Hospitals Trust
      activity was available however, since then, month four of activity had been received and
      appeared low.

      Mr Brown drew members’ attention to the Better Payment Practice Code and reported that all
      four targets were being achieved on a cumulative basis for the year to date

      RESOLVED: That members note:

                    •   That the reported financial position of NHS Blackpool to 31 July 2011.
                    •   The requirement to produce the non-recurrent spending plan.
                    •   The fact that the position as reported was largely based on estimates
                        due to significant gaps in activity data for the period to 31 July 2011.


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220/11 CHIEF EXECUTIVE’S BRIEFING REPORT

      Mrs Swift spoke to a circulated briefing report and also provided verbal updates as necessary:

(a)   Joint Working - Mrs Swift had met with Mr Jack who had recently been appointed as Chief
      Executive of Blackpool Council. He would be commencing in post over the next few days. Mrs
      Swift and Mr Fisher had also had a meeting with Mr Jack and they agreed that he should be
      invited to meet Board members in due course.

(b)   Equity and Excellence – Liberating the NHS/Health and Social Care Bill – Members were
      informed that the Health and Social Care Bill had been passed through the House of Lords.

      Clinical Commissioning Group – Formal monthly meetings of the CCG would be held. The
      CCG was starting to make decisions and recommendations to the Board.

      Health and Well Being Board – The first meeting would be held in October at which the draft
      Terms of Reference and Membership would be discussed

(c)   Update from Area Panel Meetings – Mr Emmess informed members that proposals for the
      Fylde Coast Consultation would be taken to Area Panel meetings later in the year. Area Forum
      meetings would be taking place in October.

(d)   Cardiac and Stroke Network – Telestroke – A good news story had been received from a
      patient regarding the telestroke system and this was passed around Board members to read.

(e)   Annual General Meeting 2010/11/ Annual Members and Public Meetings 2010/11 – The
      following meetings would be held:

      - Lancashire Care NHS Foundation Trust – 5.00 pm, Wednesday, 14 September 2011,
        Sponsors’ Lounge, Blackpool Football Club

      - Blackpool Teaching Hospitals NHS Foundation Trust – 6.00 pm, Monday 26 September
        2011, Sponsors’ Lounge, Blackpool Football Club

      - NHS Blackpool AGM - 6.00 pm, Thursday, 29 September 2011, Boardroom, Trust
        Headquarters, Blackpool Stadium

(f)   Retirements – 7 October 2011 – Mrs Swift thanked Mr Brown and Mr Emmess for their
      continued support and hard work since the establishment of the PCT. Mr Brown had been
      instrumental in setting up the PCT. She conveyed her thanks and best wishes to Mr Brown and
      Mr Emmess and reminded members of the retirement presentations at 12 noon on Friday, 7
      October 2011.

(g)   Other Issues:

      HSJ Awards – The Trust had been shortlisted in two categories – Managing Long Term
      Conditions and Data Information.

      Olympics Torch Bearer – A nomination process was underway for torch bearers in relation to
      the Olympic Games for staff involved in NHS Challenge 2012. The closing date for
      nominations was 7 October 2011 and Ms Cassin would be sending out a communication to all
      staff.

      Heart of Blackpool Staff Awards 2011 – Work was taking place in reforming the committee
      with a view to having the Staff Awards at the end of January/beginning of February.

      RESOLVED: That the Board receive the Chief Executive’s update report.

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     The following items reverted back to the order of the agenda.

221/11 QUALITY AND PERFORMANCE REPORT

     Mr Jude and Mrs Skerritt spoke to a circulated report which informed members of the progress
     being made in achieving targets and standards that were used by the Care Quality Commission
     in its annual periodic review of PCTs. The report also informed members of the progress being
     made on the Commissioning Strategic Plan Priority Outcomes and an update with regard to
     developments relating to CQUIN, Healthcare Infections Targets and Health and Safety.

     Mr Jude referred to the first half of the report relating to:

     •   Performance Information
     •   Other Vital Signs
     •   Commissioning Strategic Plan/World Class Commissioning Priorities
     •   Measuring and Monitoring Performance in 2011/12
     •   Aligning the Trust’s Corporate Objectives 2011/12 and the Monthly Quality and
         Performance Reports.

     Mrs Skerritt took members through the sections relating to:

     •   Commissioning for Quality and Innovation (CQUIN) and informed members that future
         CQUIN reports and evaluation of CQUIN achievements were reported to the Clinical
         Commissioning Group.
     •   The North West Ambulance Service (NWAS) CQUIN for 2011/12 scheme had been agreed
         for both Patient Transport Services and Patient Emergency Services. Due to the delay in
         agreement, the performance at quarter 2 would be the first evaluation against the quality
         indicators which were based on the domains of quality, patient safety, patient experience
         and clinical effectiveness.
     •   Healthcare Associated Infection was currently under the trajectory. Dr Rajpura informed
         members that only three bacteraemia were allowable for the whole year. The current
         position was at two however, significant progress was being made to avoid further
         bacteraemia.
     •   RAG Schedule – Mrs Skerritt informed members that there had been a breach on the mixed
         sex accommodation target. This related to a Blackpool patient at South Warwickshire and
         was, therefore, an out of area issue. Mrs Skerritt reassured members that the local hospital
         maintained no breaches.
     •   Diabetic Retinopathy Screening – Mr Morris sought clarification on the targets. Dr Rajpura
         informed members that notice had been served on NHS Blackpool and a procurement
         exercise had been undertaken. The service had commenced in June, therefore, there was
         some downtime however, he reassured members that there would be improvements in the
         target.
     •   Members were reminded that the Clinical Commissioning Group had recommended the
         report to the Board and there would be a requirement in due course for the disestablishment
         of the Quality and Performance Scrutiny Committee however, this would be reviewed with a
         view to it being possibly being disestablished in three month’s time.
     •   Health and Safety and Security – There had been no Health and Safety Executive, Fire
         Authority, Environment Agency Enforcement/Contravention Notices served on NHS
         Blackpool to date.

     RESOLVED: That the Board receive the report noting the future intention for the
               disestablishment of the Quality and Performance Scrutiny Committee in
               due course.




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222/11 JOINT COMMITTEE OF PAN LANCASHIRE PRIMARY CARE TRUSTS – CLUSTER BOARD
       – ESTABLISHMENT AGREEMENT AND SCHEME OF RESERVATION AND DELEGATION
       OF POWERS

     Mrs Swift spoke to a circulated report and reminded members of the 2011/12 NHS Operating
     Framework which set out the conclusion that it would not be possible to retain effective
     management capacity in all PCTs until their abolition in 2013, presenting unacceptable risks to
     quality and financial management. In response, PCTs would be retained as statutory
     organisations but there would be a consolidation of management capacity, with single executive
     teams each managing a cluster of Primary Care Trusts.

     The Pan Lancashire Cluster comprises of the member organisations of NHS Blackburn with
     Darwen Care Trust Plus, NHS Blackpool, NHS Central Lancashire, NHS East Lancashire and
     NHS North Lancashire.

     Mrs Swift informed members that the purpose of the report was to seek members’ agreement to
     establish a Joint Committee of Pan Lancashire PCTs to which they may delegate functions in
     accordance with the regulations as defined and described in the Establishment Agreement.
     The purpose was also to seek members’ approval for the Cluster Scheme of Reservation and
     Delegation of Powers.

     Members were mindful of the input they had had into the finalising of the Establishment
     Agreement and Scheme of Reservation and Delegation of Powers.

     Members were reminded that Mrs Soo-Chung, Chief Executive, NHS Lancashire Cluster was
     the Accountable Officer for NHS Blackpool and Mr Wharfe, Director of Finance, NHS
     Lancashire Cluster with the Accountable Finance Officer for NHS Blackpool. Following
     discussion, it was,

     RESOLVED: That the Board:

                   •   Approve the Establishment Agreement.
                   •   Approve the Scheme of Reservation and Delegation of Powers.

223/11 NON-RECURRENT INVESTMENT PROGRAMME

     Mr Brown informed members that a budgetary review was taking place in relation to the non-
     recurrent investment programme.

     RESOLVED: That the Board note the arrangements for the non-recurrent investment
               programme.

     COMMISSIONING ISSUES

     Mr Gornall joined the meeting.

224/11 NHS HEALTH CHECKS – LOCAL ENHANCED SERVICE

     Mr Bonson spoke to a circulated report which had been approved by the Primary Care
     Commissioning Group, Executive Directors and supported by the Clinical Commissioning
     Group and was recommended to the Board for implementation. Members were informed that
     the NHS Health Check Local Enhanced Service (LES) was part of a wider screening
     programme and there was general support for it to be implemented. A service specification
     was appended with the report.

     Mr Edmundson commented that it suggested it would only cover 70% of the target population.
     Mrs Skerritt reassured Mr Edmundson and other Board members that 100% of patients would
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     be contacted but we were anticipating that there would be a 70% uptake as patients have to
     attend surgeries. Mr Gornall commented that evidence from the CVD LES also showed an
     approximate 70% uptake. This would cost £178,427 annually.

     Mrs Swift asked what the incentive was to reach the target and Dr Rajpura explained the
     process undertaken regarding the CVD LES. The question was also asked as to how the hard
     to reach patients were targeted. Dr Rajpura commented that if GPs did not wish to take it
     forward, NHS Blackpool would need to look at how to target those people through alternative
     providers. Dr Rajpura also described the work of the Public Health MOT Teams within public
     health.

     Discussion ensued regarding the role of the CCG and the Primary Care Commissioning Group
     and members were informed that work was taking place in looking at their remit.

     Mr Edmundson asked if patients who are not targeted could be looked at in more detail.

     Following discussion it was,

     RESOLVED: That the Board approve the NHS Healthcheck Local Enhanced Service
               implementation in October 2011 but also addressing the hard to reach
               people.

225/11 ATRIAL FIBRILATION SCREENING IN PRIMARY CARE – LOCAL ENHANCED SERVICE

     Mr Gornall spoke to a circulated report and explained that the Atrial Fibrilation Screening in
     Primary Care Local Enhanced Service had been taken through the Executive Team and
     supported by the Clinical Commissioning Group and the Primary Care Commissioning Group
     along with Public Health colleagues with appropriate clinical input.

     Dr Rajpura informed members that 12,500 strokes occur nationally each year caused by Atrial
     Fibrillation.

     Members were advised that the funding for the scheme would be on a non-recurrent basis for
     six months between October 2011 and March 2012. The costs were based on the eligible
     population being screened and 1% being diagnosed with Atrial Fibrilation. The total was
     £43,242.

     A comment was made that throughout the specification it refers to a DES and it was noted that
     this was a Local Enhanced Service and would be amended accordingly.

     RESOLVED: That subject to the amendment to the service specification, the Board
               approved the Atrial Fibrilation Local Enhanced Service for immediate roll
               out for sign up and commencement on 1 October 2011.

     PROVIDER ISSUES
226/11 UPDATE ON TRANSFORMING COMMUNITY SERVICES

     Mrs Swift informed members that Monitor had delayed the decision for the transfer of the NHS
     Blackpool and NHS North Lancashire Community Health Services staff to the Blackpool
     Teaching Hospitals NHS Foundation Trust. Further work was taking place regarding the
     transfer and members would be kept updated accordingly.

     Mr Taylor left the meeting.

     An additional item was discussed as follows:


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227/11 NHS 111

      Mrs Swift informed members that work was taking place in looking at a pilot for the national
      initiative as explained in the Operating Framework of a new NHS number “111” which would
      deal with less serious ambulance calls. The 111 number would be in place from 1 April 2013
      and a pilot would be undertaken in Lancashire and Cumbria. The pilot would involve a
      consortium of providers, NHS Direct, North West Ambulance Service for Fylde Coast Medical
      Services. They will handle the calls and signpost people accordingly. Mrs Swift reported that
      work had already commenced in this area. There would be a cost to the pilot for 111 for
      2012/13. From now to 31 March 2012, the SHA would pick up the cost of the pilot.

      Mrs Swift sought members’ approval for the PCT to spend £330,114 as their share of the pilot
      for 2012/13. The CCG had approved this for recommendation to the Trust Board.

      RESOLVED: That the Board approve the use of £330,114 as NHS Blackpool’s share of
                the 111 pilot for 2012/13.

228/11 MINUTES OF COMMITTEE MEETINGS AND ASSOCIATED DOCUMENTS

(a)   Governance Committee

      (i) Minutes of the meeting held on 27 July 2011:

      RESOLVED: That the minutes of the meeting of the Governance Committee held on 27
                July 2011 be approved as a correct record.

      (ii) Annual Report of the Governance Committee 2010/11:

      RESOLVED: That the Board approve the Annual Report of the Governance Committee
                for 2010/11.

      Mrs Swift informed members that discussions had been held at the July meeting regarding the
      format of the Governance Committee however, as TCS had not taken place, the Governance
      Committee would continue in its current form until such time as the transfer took place.

(b)   Quality/Performance Scrutiny Committee:

      (i) Minutes of the meeting held on 3 August 2011:

      RESOLVED: That the Board receive the minutes of the meeting of the Quality/
                Performance Scrutiny Committee held on 3 August 2011.

      (ii) Minutes of the meeting held on 7 September 2011 – Mr Bonson made reference to the
           QIPP savings and reported that NHS Blackpool was the only PCT in the Cluster to score a
           green rating on the QIPP plan. This will also be reported by the Cluster. A performance
           report, QIPP report and the position would be submitted to the next Trust Board meeting.

      RESOLVED: That the Board receive the minutes of the meeting of                           the
                Quality/Performance Scrutiny Committee held on 7 September 2011.

(c)   Patient and Public Involvement Committee:

      (i) Minutes of the meeting held on 17 August 2011:

      RESOLVED: That the Board note that the PPI Committee was not quorate at the meeting
                held on 17 August 2011. The Board received the minutes of the meeting of
                the PPI Committee held on 17 August 2011.

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      (ii) Annual Report of the Patient and Public Involvement Committee 2010/11:

      RESOLVED: That the Board approve the Annual Report of the Patient and Public
                Involvement Committee for 2010/11.

(d)   Provider Services Committee:

      (i) Minutes of the meeting held on 27 July 2011
      and
      (ii) Minutes of the meeting held on 24 August 2011:

      RESOLVED: That the minutes the meetings of the Provider Services Committee held on
                27 July 2011 and 24 August 2011 be received.

(e)   Formal Clinical Commissioning Group meeting held on 6 September 2011:

      RESOLVED: That the minutes of the meeting of the Formal Clinical Commissioning
                Group held on 6 September 2011 be received.

229/11 ANY OTHER BUSINESS

      There were no issues.

230/11 DATE, TIME AND VENUE OFTHE NEXT MEETING

      The next meeting would be held on Wednesday, 12 October 2011 at 9.00 am in the
      Boardroom, Trust Headquarters, Seasiders Way, Blackpool.

      EXCLUSION OF THE PUBLIC

      “That representatives of the press and other members of the public be excluded from
      the remainder of this meeting having regard to the confidential nature of the business to
      be transacted, publicity on which would be prejudicial to the public interest”. (Section
      1(2) Public Bodies (Admission to Meetings) Act 1960).




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