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BOARD AGENDA – 1st April

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BOARD AGENDA – 1st April Powered By Docstoc
					  MINUTES OF A MEETING OF THE TRUST BOARD HELD ON WEDNESDAY 30 MAY 2007 AT
            9.30am AT THE GARSTANG COUNTRY HOTEL AND GOLF CLUB

                                               PART 1
 Present:     Mr W Bingley, Chairman
              Mrs J Aldridge, PEC Nurse Lead
              Dr F Atherton, Director of Public Health
              Mr I Cumming, Chief Executive
              Mr W Gormley, Non-Executive Director
              Mr M Holder, Non-Executive Director
              Ms J Kennedy, Non-Executive Director
              Mr M Niland, Non-Executive Director
              Mr K Parkinson, Deputy Chief Executive/Director of Finance and Information
              Mrs S Parnaby, Director of Organisation Development and Human Resources
              Mr B Rowe, Non-Executive Director
              Mrs J Woods, Non-Executive Director

 In Attendance:
             Mr E Briggs, PPI Forum
             Mrs J Marsh, PPI Forum
             Mr M Wilson, Staff Representative
             Mrs A Ivett, Personal Assistant to the Chief Executive

 Observers:
              Ms H Clay, Communications Manager
              Mr L Stove, Assistant Project Manager
              Ms J Waite, Assistant Project Manager
              Members of the public

73/07   APOLOGIES FOR ABSENCE

        Apologies for absence were received from Dr J Gardner, Ms C Campbell, Cllr Burgess and
        Mrs P Bowling.

74/07   DECLARATIONS OF INTERESTS

        Declarations of interests were requested that would be relevant to the items to be discussed
        in Part 1 of the Trust Board meeting.

        RESOLVED:
        Mrs J Woods declared an interest in relation to Item 9 Sexual Health Strategy as she
        is currently working with the Lancashire and Cumbria Sexual Health Networking
        Board.

75/07   MINUTES OF PREVIOUS MEETINGS

        (i)   Minutes of the Trust Board meeting held on 21 March 2007

              The minutes of the Trust Board meeting held on 21 March 2007 were approved as a
              correct record.
               RESOLVED:
               That the Minutes of the meeting held on 21 March 2007 be approved as a
               correct record.

        (ii)   Minutes of the extra-ordinary meeting of the Board held on 3 April 2007

               The minutes of the meeting held on 3 April 2007 were approved as a correct record.

               RESOLVED:
               That the Minutes of the meeting held on 3 April 2007 be approved as a correct
               record.

76/07   MATTERS ARISING

        (i)    Standards for Better Health Declaration 2006/07

               The Board noted that the final declaration in respect of the PCT‟s compliance against
               the Standards for Better Health had now been submitted to the Healthcare
               Commission. The Board were asked to note that the PCT declared some of the core
               standards as having insufficient assurance to ensure compliance. This is almost
               entirely due to the effects of the reconfiguration and difficulties identifying evidence
               which is not unusual for merged PCTs. Mr Cumming asked the Board to note that
               we had to declare the lowest denominator for the three former Primary Care Trusts.
               There is however, a high level of confidence in the overall quality of healthcare and
               services and all of the areas declared as having insufficient assurance are expected
               to comply with the standards and evidence compliance throughout 2007/08.

               Mr Bingley expressed his appreciation for the hard work that staff had put into the
               Standards for Better Health.

        (ii)   Choose and Book

               Mr K Parkinson stated that he had spoken to Mr E Briggs outside the meeting.
               A group is being pulled together for North Lancashire which Mr Briggs would be
               invited to attend. Mr W Bingley stated that we must continue to identify this as a key
               issue for North Lancashire PCT.

77/07   ACTION POINTS FROM LAST MEETING

        (i)    Acute Medical Services Review

               It was noted that the outcome of the review into the future utilisation of Westmorland
               General Hospital for acute medicine by the University Hospitals of Morecambe Bay
               NHS Trust was expected at the next Board meeting in July. The outcome was option
               3 of the recommendation paper. It was reported that this would be worked up with
               Cumbria PCT, University Hospitals of Morecambe Bay NHS Trust and North
               Lancashire Primary Care Trust. The Board will then consider the potential impact of
               any proposals for the residents of North Lancashire and in particular the impact on
               the Royal Lancaster Infirmary. The PCT should soon be in receipt of a copy of this
               report and Mr Cumming agreed to circulate it by email once received asking for
               comments which would then be sent back to the Hospitals Trust. A suggestion was
               made to invite a representative from the Hospitals Trust to the next Board Meeting.
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        (ii)    Innovation Fund

                Mr Bingley advised the Board that the North Lancashire Health Innovation Fund
                Panel had received a number of interesting bids for funding. It was clear to the Panel
                that the individuals and teams bidding for funding had invested time and effort into
                their submissions. Mr Bingley was delighted to announce that there had been a
                number of successful bids, each receiving awards of up to £5,000. Once some
                details have been clarified the successful bidders would be publicly announced. The
                Panel were notably impressed by the level of innovation in the North Lancashire and
                a second opportunity to bid for an award will be announced in the Autumn. Mr Briggs
                stated he was impressed with the Innovation Fund and congratulated everyone
                involved. Mr Bingley agreed to keep this as a rolling programme for the future.

        (iii)   Corporate Performance Report

                In relation to the Corporate Performance Report the issue of penalties for non-
                achievement of targets by Provider Trusts was raised. Mr Parkinson explained the
                payment mechanism.

                Also in relation to Corporate Performance it was agreed to invite a representative
                from the Ambulance Trust to a future Board Meeting to discuss ambulance targets.

        RESOLVED:
        That the Board note the content of the Action Sheet.

78/07   CHAIRMAN’S ITEMS

        (i)     Use of Trust Seal

                Seal No 08 was applied on 26 April 2007 to the Plan for attaching to the Lease
                between North Lancashire PCT and Trinity Medical Properties Ltd for Ansdell
                Primary Care Centre.

                Seal No 09 was applied on 26 April 2007 to the Plan for attaching to the Lease
                between North Lancashire PCT and Trinity Medical Properties Ltd for Freckleton
                Primary Care Centre.

                Seal No 10 was applied on 15 May 2007 to the Licence to carry out works between
                North Lancashire PCT and Trinity Medical Properties Ltd for Ansdell Primary Care
                Centre.

                Seal No 11 was applied on 22 May 2007 to the Contract and Land Registry TR1
                relating to the sale of Windsor Road Clinic, Garstang.

                Seal No 12 was applied on 24 May 2007 to the Warranties relating to the West View
                Health Village, Fleetwood

                RESOLVED:
                That the Board note the use of the Trust Seal.

        (ii)    Teaching PCT Status/Meeting with Professor Anne Garden


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         Mr Bingley attended a meeting recently with Professor Anne Garden to discuss
         future partnership working with Lancaster University. Mr Bingley stated that the PCT
         was still awaiting the outcome of the PCT‟s application for Teaching PCT status but
         this was expected to be formally announced next month. It was hoped to bring a
         Memorandum of Understanding with Lancaster University to the next Board Meeting
         to sign off. In was reported that Mr Cumming had been asked to chair an Academy
         for Health Leadership Meeting in the future to which he had agreed. This partnership
         is working primarily with Lancaster University but there will be links with UCLAN as
         well as St Martin‟s College. Mrs Aldridge requested that she and Dr Andy Maddox
         be included in future working regarding this issue.

(iii)    Meeting with Lancashire Constabulary

         Mr Bingley reported that meetings have taken place with Assistant Chief Constable
         Mike Cunningham and Chief Superintendent Gary Stephenson. They are both keen
         to develop collaborative projects where possible. The police gave a very positive
         response at the meetings about working together and their approach fits in well with
         the approach that the PCT would like to take.

(iv)     Meeting with Chair and Chief Executive of the Ambulance Service

         Mr Bingley stated that he and Mr Cumming met with Mrs Mary Whyham and Mr John
         Burnside, the Chair and Chief Executive of the North West Ambulance Service to
         discuss future ways of working. A further meeting has been fixed for the end of the
         year.

(v)      Meeting with Wyre Borough Council

         Mr Bingley and Dr Frank Atherton recently met with Mr Jim Corry, Chief Executive of
         Wyre Borough Council together with Cllr Russell Forsyth.

(vi)     McKinsey Workshop

         Mr Bingley stated that he attended a SHA/LCC Workshop on 10th May held by
         McKinseys entitled “Knowledge Exchange Event” regarding co-operating and
         partnership working. Mr Bingley agreed to circulate the handouts from that meeting
         which shows relative performance against other areas.

(vii)    Fitness for Purpose Review

         The Development Plan was approved by the Strategic Health Authority and is being
         monitored by a sub-group of the Integrated Governance Committee.

(viii)   Public Health

         Mr B Rowe updated the Board in relation to Public Health issues.

(ix)     Secretary of State

         Mr B Gormley reported back on the meeting with the Secretary of State. The
         emphasis was on building strategic partnerships particularly with local government.
         Concern was expressed that a few PCTs had not developed as much as expected
         and the Secretary of State would come down hard on those PCTs. It was
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                emphasised that the new direction of the NHS was supported by the Government.
                The event was very well received.

79/07   CHIEF EXECUTIVE’S ITEMS

        (i)     Government

                Mr Cumming stated that a new Prime Minister was expected to be appointed in a few
                weeks‟ time. It was reported that the NHS would continue in the same direction of
                travel although there would possibly be more emphasis on the Public Health agenda.

        (ii)    Independent Sector/CATS

                Following an agreement in principle with Capio Healthcare, Mr Cumming reported
                that implementation of Independent Sector elective surgery work (providing extra
                capacity to the NHS) will take place across Cumbria and Lancashire. There would
                be a phased implementation across Cumbria and Lancashire. The contract has
                been agreed in principle and has gone to the Treasury at the Department of Health.

                A phased start up of the programme will commence and this would take
                approximately 12-18 months at Westmorland General Hospital. A definite start date
                has not yet been confirmed, this can be up to 11 weeks although this should be on
                stream by Autumn this year.

                The Department of Health is currently in contract negotiations with Netcare UK
                regarding CATS and finalising the contracts. It is expected that significant progress
                on the IS agenda will be reported at the next Board meeting. There was an
                approximate timescale of four weeks from now for the contracts to close and be
                finalised followed by an 11 week period for Treasury approval. It is likely that the
                contracts will come on stream in approximately November of December this year.

        (iii)   Partnership Working

                Mr Cumming reported that, in agreement with the Prison Governors, a single Prison
                Health Partnership Board Meeting will be established for North Lancashire. This will
                bring the three prisons in North Lancashire; Kirkham, Lancaster Castle and
                Lancaster Farms Young Offenders Unit together and enable the development of a
                common health strategy. The first meeting of this Board is scheduled to take place in
                the new few weeks. Mr Cumming stated that at a future Board Meeting we would
                have a specific agenda item in relation to Prison Health in order to update the Board.

        (iv)    Cumbria Network Board

                Mr Cumming reported that the Chairman and himself recently attended the second
                meeting of the Cumbria Health Network Board, as observers. A long discussion and
                debate took place at that meeting regarding the way forward. Mr Cumming assured
                the Board that the PCT would continue to be represented at all future meetings as
                Commissioning decisions by the Network Board would have a potential impact on
                services in North Lancashire especially those delivered across multiple sites (Barrow,
                Kendal and Lancaster). It was agreed that when the agenda is received Mr
                Cumming would identify the most appropriate representative to attend.



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        (v)      Director of Commissioning

                 Mr Cumming was pleased to inform the Board that Mr Kevin McGee had been
                 appointed as Director of Commissioning for North Lancashire PCT. It had been
                 agreed with the University Hospitals of Morecambe Bay NHS Trust that Mr McGee
                 would be joining the PCT with effect from 1 July 2007. As part of his induction
                 programme Mr McGee will work up to two days per week in June with the PCT and
                 arrangements would be made for him to meet PEC and Board members as part of
                 his induction.

        (vi)     US International Film and Video Festival Award

                 Mr Cumming was delighted to announce that the PCT together with partners has
                 won a Hollywood award securing 3rd place (out of 1200 entrants) in the 'Public
                 Issues and Concerns' category of the US International Film and Video Festival. The
                 video was made to raise awareness of drink driving with young men and was
                 produced by Lancaster District Alcohol Partnership whose members include the
                 PCT, Lancaster City Council and the Police. The video is available on You Tube
                 (18 Certificate) and has had over 235,000 views. Mr Cumming stated if anyone
                 would like the link to view the video please contact him and it would be emailed out.

        (vii)    North Lancs PCT Trust HQ Accommodation

                 Mr Cumming stated that discussions were progressing regarding accommodation
                 issues. The PCT has now vacated one of the „Barns‟ in Lancaster and plans are
                 progressing for twin site accommodation, with bases in both Lancaster and Wesham.
                 It was proposed that a paper with further detail would be brought back to next
                 month‟s Board Meeting.

        (viii)   Prince‟s Trust

                 Mr Cumming advised the Board that the PCT were exploring the possibility of
                 working in partnership with the Prince‟s Trust and stated that a paper would be
                 presented to the next Board. This initiative is set up by HRH to help disadvantaged
                 people come back to work or after release from prison and would provide the PCT
                 with the opportunity to work with young people in our most disadvantaged areas.
                 The Prince‟s Trust provides mentorship, programmes for people who have been in
                 difficulty and work experience.

80/07   STRATEGIC INTENT

        Mr Cumming stated that the North Lancashire PCT Strategic Intent document aims to
        create and communicate a transparent vision for the delivery of health care services. The
        PCT aims to engage the public, staff and stakeholders in the future vision of the
        organisation by obtaining views on the content of the document. Mr Cumming updated the
        Board and explained the priorities for 2007/08 and stated he proposed to arrange a number
        of meetings tailored to North Lancashire. The paper sets out the proposed timescales.

        Mr Cumming explained the “Battle Bus” initiative and stated the need to engage with the
        public in order to ascertain the views of all sections of North Lancashire‟s population, staff
        and stakeholders in the future vision of the PCT. The Board were in agreement to
        progressing this initiative.
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        It was agreed that the Terms of Engagement need to be very clear. Mr K Parkinson agreed
        to involve Practice Based Commissioners. Mr Cumming agreed he would email to Board
        members next week an engagement document asking for comments to be returned to him
        as soon as possible.

        Mr Cumming was asked how involved media had been in good news stories. It was agreed
        that a “Big Brother” style Bus would generate interest. Members agreed that it would have
        to be timely, appropriate and stakeholders would need to be targeted individually.

        RESOLVED:
        1.  That the Board note the content of the paper.
        2.  That the Board approve the proposed Action Plan subject to the comments
            made above.

81/07   CHOOSING HEALTH DELIVERY PLAN

        Dr Atherton presented the Choosing Health Delivery Plan and stated that the paper
        provided an outline as to how the Plan was going to be delivered systematically. He
        outlined the plan, which has been developed to set out the way in which the Choosing
        Health agenda will be progressed for, and with, the population of North Lancashire.

        The Board approved the PCT‟s delivery plan for the White Paper “Choosing Health: Making
        Healthy Choices Easier.” The main focus of the White Paper is to improve health and save
        lives by supporting people to adopt healthier lifestyles, tackling issues such as healthy
        eating, physical activity and smoking. The Board noted that the PCT did approve the
        financial allocations in March.

        Members asked about schools and how the PCT engages with non-state schools. Dr
        Atherton confirmed that the PCT does engage with all schools. Discussion took place
        regarding the 18-45 year age group.

        RESOLVED:
        1.  That the Board adopt the Choosing Health Delivery Plan.
        2.  That the Board note the financial investment which had been approved within
            the PCT’s local delivery plan.

82/07   EMERGENCY PLANNING UPDATE

        The Board were invited to adopt the Major Incident Plan for North Lancashire and agree the
        priority actions required. The document sets out the way in which the PCT would respond
        in the event of a major incident. The Emergency Planning Update for the PCT, a Category
        1 responder for major incidents, summarises the legal and performance framework within
        which the PCT operates, provides an overview of progress in the former PCTs and
        identifies priorities for future action to protect our population. These include an update on
        planning for Pandemic Influenza, Heatwave, local training and business continuity. It was
        agreed that there was a need to ensure that this document is regularly updated as it is a
        “living” document and that it comes back to the Board on an annual basis. Members also
        agreed there was a need to develop a training plan for Major Incidents which needed
        testing. Dr Atherton confirmed that work is currently ongoing jointly with Blackpool PCT in
        relation to Flu Planning. In relation to Heatwave Planning it was agreed to reissue the plan
        and it was noted that Dr Emer Coffey is progressing this and would ensure that care homes,
        vulnerable patients and other relevant groups are familiar with the plan.
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        Dr Atherton agreed to check that the Out of Hours services were included within the
        document. It was agreed to bring a progress report back to the Board on this issue in six
        months‟ time. Mr Bingley expressed this thanks for the work involved in this issue.

        RESOLVED:
        1.  That the Board note the current status of major incident planning.
        2.  That the Board adopt North Lancashire PCT’s Major Incident Plan.
        3.  That the Board agree the priority actions for further development in North
            Lancashire.

83/07   CORPORATE PERFORMANCE REPORT

        1.    Financial Performance for the year April 2006 to March 2007

              Kevin Parkinson reported that the financial position of the PCT for the financial year
              April 2006 to March 2007 showed an underspend of £872,000. Subject to audit, it is
              expected that the PCT will have achieved its principal financial duty of achieving
              financial balance, and will exceed this by achieving a surplus. This has been reported
              to the Strategic Health Authority, so that any underspend will be returned to the PCT
              in 2007/08.

              Mr Parkinson stated that all matters referred to within the report are subject to audit.
              The figures detailed in the paper are therefore still in a draft form.

              Mr Bingley asked whether the formal disaggregation of Morecambe Bay PCT was
              complete. Mr Parkinson stated that once the accounts are updated it should be
              finished although there would probably be some ongoing discussions informally. Mr
              Bingley then asked when the Capital Budget would come back to the Board. Mr
              Parkinson stated that an Estates Committee had been established and this would
              therefore be brought back to the next Board. It was also agreed to discuss capital
              schemes at the next Board Briefing session.

              RESOLVED:
              That the Board note the draft financial position of the PCT for the financial year
              2006/2007.

        2.    Financial Performance for the month ending 30 April 2007

              The financial position of the PCT for April 2007 shows an overall underspend of
              £21,000, which is line with the planned performance of the PCT. There are a number
              of key variables at this stage in the financial year. These include prescribing and
              dental costs; commissioning; additional investments agreed through the Local
              Delivery Plan to meet targets and commissioning priorities and additional recurrent
              pressures such as learning disabilities pooled funds and high cost patients/
              continuing care. Mrs Marsh asked whether the PCT was allowed a certain leeway.
              Mr Parkinson reported that there was now some flexibility in that we were allowed to
              underspend but not overspend.

              RESOLVED:
              That the Board note the financial position of the PCT.



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        3.    Performance Report

              In relation to the scorecard Mr Parkinson explained the year end projections. Mr
              Parkinson confirmed that he had written to the Ambulance Trust following the last
              meeting, the response to which he did circulate. Ambulance targets were discussed
              in detail and it was agreed to make this high priority to invite a representative from
              the Ambulance Trust to come and discuss this issue with the Board. Mr Bingley
              confirmed that this would be arranged. Discussions took place regarding other
              individual targets to which Mr Parkinson responded accordingly. In relation to waiting
              times Mr Parkinson explained that this target was changed recently and explained
              the 18-week target in further detail. Mr Parkinson agreed to include further
              information on the direction of travel in next month‟s report.

              RESOLVED:
              That the Board receive the performance report.

84/07   COMPLAINTS UPDATE REPORT

        Mrs Jane Waite was invited to present the Complaints and Compliments Update paper.
        The Board were advised that the PCT received 37 written complaints between 1 January
        and 31 March 2007. Thirteen complaints relate to services provided by independent
        contractors and twenty four relate to services provided by the PCT. Ten verbal complaints
        had been received. All complaints were responded to within 25 working days. The PCT
        received twenty two letters of appreciation. Mrs Waite agreed to provide a more
        comprehensive breakdown in the next report providing further analysis.

        Mr Gormley stated that appreciation was not noted enough. Following his recent visits
        around the patch he noted that patients and staff really did appreciate what the PCT were
        doing. A suggestion was made about possibly asking people what they think after having
        received treatment. Mr Cumming noted that there was already an annual national
        satisfaction survey and that it would be worth thinking about our own surveys with the North
        Lancashire area. Mrs Aldridge reported that work looking at the quality of services received
        was beginning. Mr Bingley also asked for a report on on-going litigations to be brought
        back to a future Board meeting.

        RESOLVED:
        1.  That the Board approve the extended complaints policy review date.
        2.  That the Board note and receive the report.

85/07   PEC UPDATE REPORT

        Mrs Aldridge gave a verbal update on PEC issues in the absence of Dr Gardner and stated
        she was delighted to report the appointment of Sean Mackey as Pharmacist Representative
        to the PEC, which now completed membership of the PEC. The May meeting covered two
        key topics: diabetes commissioning and the implementation of independent sector
        contracts. The PEC‟s terms of reference and work plan for the year ahead will be discussed
        at an away day session planned for 13 June 2007. Dr Gardner is currently undertaking 1:1
        sessions with all the clinical leads to set out their objectives for the year ahead. To date Dr
        Paul Hutchence and Dr Mark Spencer are to work with Mrs Clare Wild on a review of
        community optometry provision. Dr Spencer is to be the PEC GP adviser to the PCT
        Diabetes Strategy Group. Dr Jeremy Marriott has begun work with Mrs Wild on a review of
        the GP Enhanced Services. Dr Spencer and Dr Marriott are providing clinical advice to the
        Independent Sector Implementation Group. Finally, it was reported that Dr Paul Rees
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        would be working with the Directorate of Quality, Standards and Effectiveness on clinical
        governance issues and that Dr Gardner was proposing him as PEC GP adviser to an
        anticipated PCT Cardiovascular Strategy Group.

        RESOLVED:
        That the Board note and receive the verbal update.

86/07   PROVIDER BOARD – TERMS OF REFERENCE AND UPDATE

        Mr Niland was invited to present the Provider Board Report. The Provider Services Board
        was established to oversee the development and implementation of a strategy for Provider
        Services. The Board agreed the draft terms of reference and endorsed the overall
        approach being taken by the Provider Board. A strategy for the future direction of Provider
        Services is expected to be submitted to the Trust Board by the autumn. Mr Niland stated
        that the work undertaken by Mrs Ruth Roberts and her team was exceptionally good and
        wished to express his thanks for this work. Mr Niland also stated that the visits around the
        patch by Mr Bingley and the Non-Executive Directors have been extremely useful.
        Mr Bingley also acknowledged the excellent work that had been done.

        RESOLVED:
        1.  That the Board agree the draft terms of reference for the Provider Board
        2.  That the Board endorse the overall approach being taken by the Provider
            Board

87/07   MEDIA POLICY

        Mr Cumming invited Ms Clay, Communications Manager, to present the Media Policy which
        applies to all staff and sets out guidelines for working with the media. The policy provides a
        broad corporate framework to maintain and develop a positive two-way relationship with the
        media. Staff will be asked to note that all media contact must be co-ordinated by the
        Communications Team.           Ms Clay advised the Board that a „Rough Guide to
        Communications‟ would be available shortly. The Board approved the media policy which
        will be communicated to all staff within the PCT so that they are aware of how to deal with
        the media and what to do if they receive an enquiry from the press.

        Ms Clay was asked if the media had been invited to a media day at the Trust. Ms Clay
        clarified that the PCT did invite members of the press to the launch day in December but
        this could be re-investigated. It was confirmed that 1:1 meetings with the media did take
        place.

        RESOLVED:
        That the Board approve the North Lancashire Media Policy.

88/07   MINUTES OF THE OPERATIONAL MANAGEMENT EXECUTIVE COMMITTEE HELD ON
        16 APRIL 2007

        Members reviewed and noted the contents of the Minutes of the Operational Management
        Executive Committee held on 16 April 2007. Mr Cumming updated the Board on the
        purpose of the OMEC Meetings and stated that these meetings were still developing as this
        was the first meeting.

        RESOLVED:


                                                  10
        That the Board receive the minutes of the Operational Management Executive
        Committee held on 16 April 2007.

89/07   MINUTES OF THE AUDIT COMMITTEE HELD ON 3 MAY 2007

        Members reviewed and noted the contents of the Minutes of the Audit Committee held on
        3 May 2007. It was reported that the Committee had encouraged the Internal Auditors to
        draw up a timescale of when to expect some of these reports.

        RESOLVED:
        That the Board receive the minutes of the Audit Committee held on 3 May 2007.

90/07   MINUTES OF THE PROFESSIONAL EXECUTIVE COMMITTEE HELD ON 14 MARCH
        2007 AND 11 APRIL 2007

        Members reviewed and noted the contents of the Minutes of the Professional Executive
        Committee held on 14 March and 11 April 2007. Mr Niland asked what a First Choice
        Eyecare Scheme was to which Mrs Aldridge gave an explanation and agreed to forward a
        copy of the presentation regarding this to Mr Niland.

        RESOLVED:
        That the Board receive the minutes of the Professional Executive Committee held on
        14 March and 11 April 2007.

91/07   MINUTES OF THE PROVIDER SERVICES BOARD HELD ON 20 MARCH 2007 AND 24
        APRIL 2007

        Members reviewed and noted the contents of the Minutes of the Provider Services Board
        meetings held on 20 March 2007 and 24 April 2007.

        RESOLVED:
        That the Board receive the minutes of the Provider Services Board meetings held on
        20 March 2007 and 24 April 2007.

92/07   MINUTES OF THE INTEGRATED GOVERNANCE COMMITTEE HELD ON 28 MARCH
        2007 AND 25 APRIL 2007

        Members reviewed and noted the contents of the Minutes of the Integrated Governance
        Committee meetings held on 28 March 2007 and 25 April 2007.

        RESOLVED:
        That the Board receive the minutes of the Integrated Governance Committee
        meetings held on 28 March 2007 and 25 April 2007

93/07   MINUTES OF THE INDEPENDENT SECTOR COMMISSIONING BOARD HELD ON 21
        FEBRUARY 2007 AND 21 MARCH 2007

        Members reviewed and noted the contents of the Minutes of the Independent Sector
        Commissioning Board held on 21 February 2007 and 21 March 2007. In relation the
        21 March minutes the Board were asked to confirm that they were in agreement with the
        15 recommendations as listed.

        RESOLVED:
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        That the Board receive the minutes of the Independent Sector Commissioning Board
        held on 21 February and 21 March 2007 and confirmed they were in agreement with
        the 15 recommendations listed in the 21 March minutes.

94/07   MINUTES OF THE CONTROL OF ENTRY COMMITTEE HELD ON 11 APRIL 2007 AND 9
        MAY 2007

        Members reviewed and noted the contents of the Minutes of the Control of Entry Committee
        held on 11 April 2007 and 9 May 2007. Mrs Kennedy stated that the Committee were
        currently in the process of developing a clear strategy for receipt of the minutes by the
        Board. A meeting has been scheduled with the lawyers to discuss this further.

        Mr Bingley confirmed to the Board that in relation to the meeting on 11 April 2007 under
        item 5.1 Mr Cumming and Mr Bingley had taken a Chairman‟s Action and ratified on behalf
        of the Board a decision in order for the applications in relation to CR Healthcare Ltd to be
        informed.

        RESOLVED:
        1.  That the Board receive the minutes of the Control of Entry Committee meeting
            held on 11 April 2007
        2.  That the Board receive the minutes of the Control of Entry Committee meeting
            held on 9 May 2007.
        3.  That the Board approve the recommendations made by the Control of Entry
            Committee held on 9 May 2007.

95/07   ANY OTHER BUSINESS

        (i)   PPI Forum

              Mr Briggs stated that the “demise” of the PPI Forum would not be until 2008.
              Mr Briggs agreed to keep the meeting updated and the Board would look forward to
              receiving a presentation in relation to future proposals.

96/07   DATE, TIME AND VENUE OF THE NEXT MEETING:
           Wednesday 25 July 2007
           9.30 am
           Committee Room B, Lancaster Town Hall, Dalton Square, Lancaster.

97/07   EXCLUSION OF THE PRESS AND MEMBERS OF THE PUBLIC
        RESOLVED:
        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.




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