Board Paper – Agenda Item 7 – Suggested Format

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					                                                               AGENDA ITEM NUMBER
                                         HCC STANDARD(S)                 TO APPROVE



DIRECTOR RESPONSIBLE:              John Chuter, Chairman
                                   Tel: (01274) 237700

Issue to be discussed

The frequency and format of tPCT Board meetings.


The Board is recommended to confirm that:

(i)     Board meetings will continue at their current frequency of one per
(ii)    Beginning in January 2008 every other Board meeting will be held in
        public unless Board business dictates otherwise.
(iii)   Board meetings not held in public will concentrate on the central issues
        for addressing health inequalities across Bradford and Airedale and will
        invite other contributors to the debate as required.


(A)     Thus far Board meetings have been held one each month. Meetings
        have taken place in the afternoon in public with a private Board
        development session in the morning. Such frequency and format has
        served the Board well bearing in mind the business it has undertaken
        during the first year and the necessary to bring the Board together and
        focus its activities. Much of the business has required decisions to be
        taken that required to be debated in public. These have largely
        included decisions affecting primary care services and investments
        initiated and placed in the public domain before the tPCT was formed
(B)     Board development sessions held on the same day as Board meetings
        have supplemented more formal training for Board members
        undertaken on an individual basis. The recruitment of Board members,
      both executive and non-executive, over the first six months and the
      inexorable pace of reform in the NHS has reinforced the requirement
      for continuous full Board development.

Current situation

(C)   The initial decision taking load consequent on business left over from
      the four previous PCTs has abated. The tPCT has since completed
      the ‘Fitness for Purpose’ (FfP) exercise which has signalled the
      requirement for a number of areas for improvement and set the
      direction of travel. The Board has also refined its vision and purpose in
      line with FfP and emergent departmental policy particularly around the
      commissioning function. As a direct result the Clinical Executive has
      been re-formed together with a number of Board statutory and non-
      statutory committees. These are wholly accountable to the Board and
      are currently undergoing review. The intention is to progressively
      delegate more responsibility to them leaving the Board to concentrate
      more on strategic issues.
(D)   The combined effect of the changes and intentions outlined above has
      been to reduce the frequency of Board meetings where decisions
      directly affecting the public need to be taken. In turn this has reduced
      the requirement for the number of Board meetings held in public to
      roughly half. It has also freed up more time for Board development and
      debate on the central issue, ie how best to deploy resources in
      order to improve health and well being and reduce health
      inequalities across Bradford and Airedale. Such debate needs to
      be uninhibited, free flowing and broad and is therefore initially not
      suited to the more formal format of a Board meeting in public.
      However such a broad agenda cannot be successfully tackled without
      some structure, documentation and, above all, the inclusion of others in
      the debate. The Local Authority, voluntary organisations, clinicians,
      public, patients and others will all have a part to play. Therefore it will
      still be necessary to invite as broad a spectrum of local opinion as
      required to contribute to tPCT Board meetings particularly those
      mapping out the long term development of services. The overall
      frequency of Board meetings should therefore not reduce.


(E)   The above points suggest a rebalancing of Board business but there
      remains a requirement for a monthly Board meeting and that should
      not change. However the necessity for Board meetings to be held in
      public will reduce to about half the present number each year.
(F)   Those Board meetings not held in public need to concentrate on the
      central issue articulated in Paragraph (D) above and draw others into
      the debate as required. These will remain structured, minuted events
      with an agenda.

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