Programme Board
DRAFT Minutes of meeting
Held on Thursday 10th March 2016, 9.30 – 12.30pm
Boardroom, Voreda House, Penrith
Chair
Sir Neil Mckay
Present
Nicky O’Connor
David Blacklock
Peter Rooney
In Attendance
Andrew Mason
Saffron Pineger
Neil Chapman
Lydia Bullivant
David Stout
Rick Shaw
Christian Norris
Cosima Pettinicchio
Lisa Gibbons
Sara Woolley
Programme Chair (NMC)
Programme Director (NOC)
Chief Executive, Healthwatch (DB)
Interim Chief Operating Officer, Cumbria
CCG (PR)
Liz Rogerson
Assistant Director, Specialised
Commssioning (LR)
Tim Rideout
Director of Commissioning Operations, NHS
England (TR)
Stephen Eames
Chief Executive, NCUH (SE)
David Evans
Chief Executive, Northumbria Healthcare FT
(DE)
Jo Atkinson,
AD Commissioning and Integration, Cumbria
County Council
Helen Jervis
1st Care Cumbria (HJ)
Michael Smillie
Director of Strategy and Support Services
(MS)
Prof Stephen Singleton Medical Director (SS) (add into Present
section)
GP, LMC (AM)
Director, Freshwater UK (SP)
Finance Advisor (NC)
Business Manager (LB)
Transformation Director, Cumbria CCG (DS)
Service Development Manager, NWAS (RS)
Deloittes (CN)
Deloittes (CP)
Supporting SR Clinical Strategy (LG)
Programme Manager SR (SW)
1. Welcome & Apologies
Chair’s briefing
Apologies were received from Alex Docton, Derek Cartwright, Hugh Reeve, Louise
Robson, Sally Burton, Laura Roberts and Claire Molloy.
NMC welcomed members to the meeting and thanked everyone for their help
regarding the recent successful public launch. He added that we all need to build on
the work already done.
NMC added that he and NOC had a constructive discussion with the tripartite
yesterday, where they thanked the success regime colleagues for their work and are
satisfied with progress to date. Clearly there is no complacency and there is still a
huge amount of work to do.
2. Declarations of Interest
There were no declarations of interest made.
3. Minutes of the last meeting held on 11th February 2016 and matters arising
The minutes were accepted as an accurate record. The matters arising were also
discussed and agreed.
4. Draft Clinical Strategy for CQC by end of March 2016
NMC advised that CQC had cancelled the planned call yesterday so haven’t received
any feedback so far, however the call has been rearranged for Friday 11th of March.
NMC added that the report has to be submitted to CQC by 31st March 2016. NOC
apologised for the various versions of the report and explained why chapter 4 had
been tabled. The purpose of the report is to directly address Sir Mike Richards’
concerns. Services need to be safe, affordable and deliverable. Issues being
addressed are those arising from CQC inspections. NOC invited comments from the
Board.
MS added that we need to focus on stability. In the future there should be a focus
on longterm. Currently there is a balance on the document and we need to perfect
the principles of it for longer term strategy and workforce.
DE asked if affordability should be more upfront in the document, it needs to stay
within the resource allocation. There was a larger discussion around the affordability
issue.
NMC and SS agreed that we need to be upfront and honest with the public about it
being a huge challenge and it will be difficult to implement with radical changes. TR
added cultural issues are key. SS added it’s about changing the way people work
together.
DB has had helpful conversations with various people and they like the fact that
there is a vision.
NOC gave an overview of chapter 2 of the document and again invited comments.
NMC asked if all were content with the emerging thinking on ICCs. MS added that it
is fundamentally more radical and much more engaged with Local Authorities. It is
valuable for all organisations to understand it’s different to past ideas. NMC
confirmed the link with LA’s is essential. HJ added that the key is working differently
with governance and IT. DS added that we would need to appoint a single manager
for each site to implement and take forward. NMC confirmed that we need to work
within our resource allocation. SE suggested that there should be real life examples
within the document and DB agreed the need for comparisons and personal
accounts.
There was a discussion about community hospitals, DS advised there were current
working groups and a workshop is planned in the next few weeks to discuss how
they can connect to ICCs. The purpose of the workshop is to debate the options and
examine them through the pros and cons.
Action: To bring back to a future Board – DS
CN added to the discussion that there needs to be better links. Deloitte will discuss
with DS to see how the planned workshop can be linked in. HJ added that the main
link to community beds is with better social care provision. JA agreed there needs to
be a tier built in under care homes. NMC added the strategy needs to describe the
difference between the old and new models.
NOC gave an overview of transforming services across the whole care system. JA
reassured the board that plans are underway and being shaped with ICCs in mind.
NOC continued with an overview of the primary care section of the document. The
GP development plan produced by Caroline Rea was discussed and it was agreed
that this would be shared with board members as not everyone had seen it. HJ
asked that Mental Health be treated the same way as children and families. PR
added that he thought it would be helpful to talk about what has already been
achieved and set up for example previous investments and give assurances. PR also
referred to the bed issue in NCUH, saying we can reference it and the ability to
relieve pressure through good liaisons. NMC added that the ICCs are the corner
stone of the strategy.
Action: GP development plan to be circulated.
Action: NMC and NOC to have a call with Stephen Welfare, Dr Kathy McLean and
Tim Gilpin to discuss Doctors in Partnership
There was a short discussion around specialised services, where NMC advised that
the issue needs to be addressed.
Action: A detailed description of how recruitment will be aided through
relationships with a specialist provider
Potential future scenarios were discussed, these to be used for modelling purposes
Action: Board to advise of any changes to scenarios by Monday 14th March
NC updated the Board on the current financial position, he advised that the
numbers continue to be refined taking account of baseline positions and efficiency
opportunities. Finance Directors meet weekly with Deloitte to discuss finance and
various other issues. NC advised that there is a current financial gap of £50million
with the 1st of April to mid May being a crucial time. He added that SE had appointed
Ernst & Young to provide support and work with NCUH. The Finance Directors are
producing a financial taskforce with the SR funding it in 16/17. Six staff will be
redirected to NCUH to provide support and three staff for the clinical workstreams.
NMC added there needs to be some collective thinking about how to close the
financial gap. TR added that we need to see the plan which would include the
structural deficit. Credible cost reductions are needed in the next few weeks and we
need to see the 16/17 proposition. A proper informed discussion is needed. CN
wrapped up the discussion with an overview of the current position. Amendments
will be made over the next few weeks.
Action: Comments on document to be sent to CP and CN by early next week
5. Engagement Plan
NMC noted that the number of contributions received to date had been reasonable
and we need to build on the momentum. SP gave an update about recent events
and future planned engagement. Various papers were tabled showing the future
events including two for stakeholders. SP advised that the recent public briefing
went well and was widely picked up by the media and the public through social
media. People were engaged and the reporting was balanced. SP confirmed that we
can now proceed with follow up public meetings and there are two planned in each
of the districts. Staff engagement is also being held by the individual organisations
and SR communications are liaising with the various communication leads.
Responses are also being logged from the various websites and letters etc.
Action: Media cuttings/summary to be circulated to all
Agreed to publish SR PB Agendas and minutes on the website
DB added that mental health is absent from the document. He and Healthwatch
colleagues have had discussions with 1500 people and if you include maternity
nearly 3000 people. They have been to 44 different locations across the county to
engage with the public and the process has been extended by four weeks. There was
a general consensus that information for the public needs to be accessible and
succinct. DB added that he thinks we need to be more creative and innovative.
NMC expressed his thanks to Healthwatch for their help and engagement. There
was a suggestion that clinicians should maybe front some events. All were in
agreement that staffside are in important element and need to be engaged.
Action: SP to have a discussion with DB about future events
6. Key Milestones
NOC asked the Board members to advise if they felt any were incorrect.
7. Programme Governance
NOC advised that there was a national conversation being had about budget for the
SRs. The other two SRs feel they should be allocated more money and we should
take a reduction.
Action: NOC and NC to discuss further about suggested reduction in funding.
8. Any other business
SE advised that there is the annual Deanery visit scheduled for the 24th of March and
he wanted to flag that it could impact on training and infrastructure.
SE also gave a quick overview of the fire risk slides circulated to the Board. A brief
discussion was held.
Date and Time of next Board meeting:
Wednesday 30th of March 9.30-12.30, Conference Room, Rosehill