Minutes of Board Meeting held on
21 August 2008
Present In attendance
Evelyn Asante-Mensah, Chair Ian Brisbane, NAPP
Graham Aitken, Non-Executive Director Brook Cain, NAPP
Sally Bradley, Director of Public Health Michelle Featherstone, Manchester PCT
Zoe Cohen, Director of Corporate Affairs Ben Glaizner, Manchester LiNK
Gabrielle Cox, Non-Executive Director Steve Henderson, GP, South PBC Hub
Andrew Crook, Non-Executive Director Michael Kelly, Manchester LiNK
Brian Harrison, Non-Executive Director Chris Pearson, Manchester PCT
Paul Martin, Non-Executive Director Catherine Regan, Manchester PCT
Debbie Nixon, Director of Commissioning Bill Tamkin, Chair South PBC
Gary Raphael, Director of Finance
147/08 Public Open Forum
No questions were received from members of the public.
148/08 Apologies for absence/introductions
Apologies had been received from Mr I Bell, Mr J Harrop, Mr P Huggon, Dr L
McGrogan, Dr R Madhok, Ms Laura Roberts, Dr M Eeckelaers and Dr M Whiting.
149/08 Minutes of previous meeting held on 2 July 2008
Item 138/08 – World Class Commissioning: Ms Cox asked for clarification as to
whether it would be possible to refresh the outcomes once agreed. Ms Cohen
explained that the Commissioning Strategic Plan was a five year plan and the
guidance stated it should be completely refreshed at the three year stage with annual
The Board approved the minutes as a true and accurate record.
150/08 Chair’s Report
Ms Asante-Mensah reminded board members of forthcoming meetings during
September. It was agreed to circulate the schedule of dates.
The Board noted the verbal update.
151/08 Commissioning Strategic Plan Update
Ms Cohen reminded Board members of the previous discussion at the July board
meeting where it had been agreed to provide regular updates on WCC/CSP. She
outlined the World Class Commissioning/Commissioning Strategic Plan (WCC/CSP)
“line of sight” which followed a logical process – needs and context; vision; objectives;
outcomes; goals; initiatives; delivery plans, which capitulated the purpose of CSP.
Ms Cohen updated members on progress so far which included identification of
health outcomes, goals and metrics. She advised that strategic initiatives had been
drafted and work was being undertaken to incorporate these into detailed action
plans. She outlined the list of priorities which had been refined to ensure that the
metrics were achievable. Ms Cohen explained that life expectancy and health
inequalities were mandated measures that all PCTs were required to include with the
remaining eight options to be decided by individual PCTs. Further in-depth
discussion would take place at the event scheduled to take place on 4 September.
Ms Cohen stated that as part of the process it would be necessary to obtain a board
declaration prior to the 11 October submission date to the Department of Health. She
outlined the next steps, highlighting the key milestones leading up to the WCC
assessment panel day on 11 November 2008.
Ms Asante-Mensah asked for further detail on the 4 September event and whether
the Board would have an opportunity to comment on the PCT’s self assessment. Ms
Cohen informed board members that the Joint/PEC board would have an opportunity
to have a more detailed discussion on the three plans (CSP/finance/OD). The CSP
would be submitted for comments and constructive feedback at this event prior to
submission to the SHA on 5 September. She explained that the PCT was required to
have an 80-90% completed document for submission by 5 September. Due to the
timescale involved it was agreed to circulate the self assessment to Board
The board noted the commissioning strategic plan update.
152/08 Organisational Development Plan Update
Ms Cohen presented the paper and requested comments from Board members on
the key OD priorities that had been identified. She advised that a completed draft
plan would be submitted to the October board for approval.
Ms Asante-Mensah reported that Mr P Huggon would undertake the non-executive
director lead role to challenge the PCT and ensure additional rigour for the Board.
She advised that the OD plan incorporated whole board development. Ms Cohen
indicated that she was currently investigating options to progress board development
further. Mr Crook noted the challenge faced by the PCT especially in relation to
culture and how to deliver world class commissioning.
Ms Cohen welcomed participation from Non-Executive Directors if they wished to be
involved in the development of the OD plan.
The Board noted progress to date and agreed with the OD priorities and next steps
153/08 Operational Plan 2008/09, 209/10
Ms Nixon referred to the operational plan which was a key supporting element of
World Class Commissioning. She advised that following previous board discussion
the plan had been submitted to the Strategic Health Authority in March 2008. Ms
Nixon explained that it was a requirement to publicise the plan on an annual basis,
consequently a revision of the document would be undertaken during December
2008-March 2009. Ms Nixon advised that PCT officers had been tasked with
reviewing the document ensuring alignment to priorities of the PCT’s core business.
She extended an invitation to Non-Executive Directors to participate in the group.
Mr Crook stated that the production of the CSP provided clarity on how PCT priorities
would be developed and linked to its strategies. Ms Cohen agreed stating that all
plans underpin the CSP ensuring an understanding of the PCT model.
It was noted that the PCT did not underspend by £7m as indicated within the
Operational Plan 2008/09. The correct figure was £1m.
Ms Cox felt that the Board should have an opportunity to comment on the document
prior to submission in March 2009. It was agreed that the document would be
submitted to the February 2009 board meeting. Additionally, if appropriate, an
additional informal non-executive director session would take place prior to this date
to ensure board members had an opportunity to comment and discuss the revised
The Board noted the report.
154/08 Integrated Governance Strategy 2008/09
Ms Cohen explained that the strategy had been submitted to the board for final
approval. She reported that the PCT had convened an Executive Performance
Group with the first meeting taking place in September. The remaining actions would
be actioned following approval of the strategy.
Mr Crook felt that the paper suggested that establishing an autonomous provider
would represent insurmountable difficulties for the PCT in relation to governance. He
agreed that there were issues facing the PCT but these did not create a risk.
Mr Aitken referred to the terms of reference of the audit and governance committees
and queried why the recommendations did not include a review of the audit
committee terms of reference. He felt that if a risk was identified then a mitigating
action should be included within the action plan. Mr Crook explained that the audit
committee had already undertaken a review and there were no changes to its terms
Ms Cohen clarified that paragraph 12 highlighted potential risks only.
Mr Aitken mentioned the regular reporting to the Board from MCH and stated that the
Board should acknowledge and approve MCH business plan in order to provide it
with a direction of travel.
Mr Aitken referred to the governance relationship with nPEC / PBC hubs and the
provider arm. He asked whether a governance framework had been developed to
minimise the risk of conflicts of interest. Ms Nixon confirmed that the issues had
been raised and it was necessary to ensure that a proposal and policy was submitted
to the Governance Committee. A framework was currently being produced.
Ms Cox referred to the discussion at the July board in relation to conflict of interest,
whereby Dr McGrogan voluntarily departed from business case discussions. She
advised that Dr McGrogan technically remained a member of the business case
committee, consequently if a separation was to take place, a formal agreement would
be required by the Board.
The Board approved the strategy, subject to the above points being taken into
consideration. It was agreed a final version of the document would be circulated to
155/08 NHS Compact Update
Ms Nixon reminded members of a previous board discussion in March. She reported
that she and Mr Crook had attended a meeting with the SHA to discuss the final
version which had not changed dramatically from the original document. The NHS
Compact was about developing a confident board. Mr Crook commented that the
document was about creating effective relationships between Trusts and the SHA
that were open and transparent.
Ms Cox said that Board members should be aware that subsidiarityy was about the
lowest appropriate level. Mr Kelly stated there was no mention within the document
about public engagement.
The Board noted the paper.
156/08 Assessment of Mental Health Services
Ms Nixon reported that the paper focused on the way forward, next steps and set out
clear recommendations on how this would be achieved. She informed Board
members that an interim Chief Executive had been appointed at Manchester Mental
Health and Social Care Trust. Ms Nixon advised that the Care Trust, Manchester
City Council and the PCT had produced a summary action plan and following a
workshop at the end of August a more detailed action plan. This would be submitted
to the October Board.
Ms Nixon assured the Board that progress would not be delayed in relation to work
that was currently ongoing (ie. out of hours placements/length of stay).
Mr Martin pointed out that the terminology may cause confusion and could possibly
be misleading. He stated that voluntary sector organisations should be integral to
discussions. Mr Harrison felt that the report described the challenges and issues. He
reinforced the importance of joint working partnerships. Ms Nixon advised that
discussions would be taking place at the end of August on how the three
organisations can maximise opportunities that have not yet come to fruitition.
Ms Asante-Mensah explained that the report highlighted failings within the system
and acknowledging the root causes, partnership working and integration of services.
She stated that as commissioners it was essential to take on the responsibility to
ensure real system reform and change.
The Board noted the contents of the report and agreed to receive a full action plan at
the October board meeting.
157/08 Improving Health in Manchester Healthy Lifestyle Strategy
Dr Bradley presented the report, explaining that the paper set out the direction of
travel and delivery mechanisms to improve lifestyles in Manchester. She informed
board members that the programme focused on three levels of activity – community
development, primary care and specialist support. Dr Bradley stated that the
programme was not a short-term high impact change and would require industrial
scale change over a period of time.
Dr Bradley advised that business case proposals were being developed, however
further work was required. She explained that individual bids were being submitted to
the business case committee, however a whole system approach was required to
ensure linkages were made. Ms Cox stated that if the PCT was to invest in
community development it was essential that detailed information was available to
ensure there was a understanding of where and how services are delivered.
Mr Martin recommended that the paper be disseminated through different networks
across the city. He suggested that the PCT work in partnership with other investors
to create investment and influence where resources are directed. Mr Martin
mentioned the possibility of exploring health promotion within the city and encouraged
the PCT to work with the voluntary sector as equal partners focusing discussion on
Ms Cohen welcomed the summary which was key content for the CSP. She
mentioned the Manchester health “loyalty card”, advising board members that the
PCT had progressed to the final round to receive significant DOH funding.
The Board noted the paper
158/08 Date and time of next meeting
3 September 2008, 4.45 pm, Lesbian and Gay Foundation, 105-107 Princess Street,
159/08 Exclusion of the Public
The Board resolved that publicity would be prejudicial to the public interest by reason
of the confidential nature of the business to be transacted and that the public be