South east highland community health partnership committee

	South East Highland Community Health Partnership Alder House Cradlehall Business Park Inverness IV2 5GH Tel: 01463 – 706948 Fax: 01463 – 794712 www.show.scot.nhs.uk/nhshighland
UNCONFIRMED MINUTES of MEETING of the SOUTH EAST HIGHLAND COMMUNITY HEALTH PARTNERSHIP COMMITTEE Board Room, Assynt House, Beechwood Park, Inverness	Thursday 6 September 2007 – 2.00pm

Present Mr Ian Gibson, Chair and Non Executive Director

Mr Nigel Small, General Manager

Mr Jean Pierre Sieczkarek, Assistant General Manager

Mr David Garden, Head of Finance

Dr Freda Charters, Clinical Lead, Inverness

Dr Adrian Baker, Clinical Lead, Nairn and Ardersier

Mr Brian Robertson, Area Community Care Manager, Highland Council

Mr William Gilfilan, Corporate Manager, Highland Council

Ms Margaret MacRae, Partnership Representative

Mr Thomas Ross, CHP Pharmacist

Mrs Cathy Lush, Clinical Dental Manager

Mr Graham Marsden, Councillor

Mrs Gillian McCreath, Non Executive Director, NHS Highland

Mrs Ailsa MacInnes, Optometry Representative

Mr Hamish Wood, Public Patient Forum Representative
In Attendance Mr Ian MacNeill, Training & Development Officer, Partnership for Wellbeing

Ms Ros Philip, Primary Care Advisor

Mr Colin Yau, PA to General Manager & Clinical Director (Minutes)
1 APOLOGIES
Apologies were received from Mr S Denholm, Ms Jackie Agnew, Dr Ian Scott, Mrs Jo Veasey, Mrs Fiona Grant, Mrs Hilda Hope, Mrs Anne Mackenzie, Mrs Tina Morrow, Mr Douglas Johnston and Mr John Holden.
2 CONFLICTS OF INTEREST
The Chair asked the Committee for any outstanding Conflict of Interest forms to be returned to CHP HQ as soon as possible, and should anyone require forms to contact CHP HQ.
3 MINUTES OF MEETING HELD ON 12 JULY 2007

The Committee: Approved the minutes of the last meeting held on 12 July 2007.

4 MATTERS ARISING
4.1 DENTAL
Cathy Lush talked to a tabled paper on Dental Health Improvement. She had been asked to provide details following queries at the previous meeting.
She discussed tooth decay and the tooth-brushing schemes across SE Highland CHP. She confirmed that there are strong links between tooth decay and inequalities. There is support being put into non-targeted as well as targeted schools to address this. Cathy confirmed that the initiatives were on target to enable the CHP to meet dental HEAT targets
After discussion, the Chair, with the Committee’s approval, agreed to check with the Chair of NHS Highland on the current position regarding Dental services in Grantown. It was understood that Mr Coutts had been personally involved in discussions with the Highland Council.

4.2 AUDIT SCOTLAND: NATIONAL CHP REVIEW UP-DATE

Nigel Small informed the Committee that he had expected a copy of the Audit Scotland report however this had not yet arrived. He agreed to report back at the next meeting.

5 IMPROVING SERVICES & CLINICAL ISSUES
5.1 LONG-TERM CONDITIONS: SELF-MANAGEMENT PROGRAMME
Ian McNeil, Training & Development Officer, Highland Self Management Programme, Partnerships for Wellbeing, gave a presentation on “Self Management in the Highlands – A Pilot Programme”.
He circulated amongst Committee members, leaflets on a practical self care course for people with long-term conditions.
Ian confirmed that after the pilot, they will be looking for alternative sources of funding. The evaluation of its success would determine future funding.
It was confirmed that the initiative was important in helping the CHP to achieve the requirements of the Long Term Conditions Toolkit.
The Chair thanked Ian for his presentation and looked forward to a report back in 6 months time.
5.2 COMMUNITY HEALTH INDEX
Ros Philip talked to a previously circulated paper on ‘CHI in the Community’.
She commented on the priority areas for action and increased coverage of CHI. A NHS Highland CHI Workshop has been arranged for 2 October 2007.
She mentioned that the purpose of bringing CHI to the Committee was to obtain the Committee’s endorsement for the initiative prior to the further roll-out. She confirmed that this is part of a national campaign which supports increased clinical governance.
Some concerns were expressed that a number of different patient/client numbers were being used both in the NHS and within the Council. Members asked why NI numbers could not be used universally. It was agreed that this is a national not a local issue.
The Chair asked Ros for a progress report in six months time.

The Committee: Noted the progress on CHI Monitoring Phase 2. Endorsed the proposed Action Plan to achieve 100% compliance across all professions for the routine utilisation of CHI on all clinical communications within community based services.

5.3 PRESCRIBING AND PHARMACY
Thomas Ross talked to a previously circulated paper “Prescribing and Pharmacy Report to 27 August 2007’.
He discussed the Prescribing budgets, CHP Pharmacy Team structure and the further work that has been done, since the last CHP Committee meeting, to establish a Quality Prescribing Framework for the CHP.
He informed the Committee of the first meeting of the CHP Clinical Forum on the 25 September 2007.
Hamish Wood highlighted certain practices’ high spending. Thomas confirmed that prescribing spend is closely monitored and where necessary target visits take place, but certain factors need to be taken into account such as demographics.

The Committee: Noted the updates in the Prescribing and Pharmacy Report Supported the CHP Quality Prescribing Framework.

6 PERFORMANCE
6.1 FINANCE
David Garden talked to a previously circulated paper ‘Finance Report to 31 July 2007’.
He stated that although particularly challenging this year, the CHP remains confident that it will meet its financial targets for the year subject to the risks he’d mentioned in his report and in the absence of any significant cost pressures. He commented on localities, in particular Badenoch and Strathspey, in which locality management is managing some new cost pressures.
He commented on the savings in mental health due to the reduction in sickness levels and reduced use of bank, agency and overtime.
He mentioned that a collaborative contracting presentation was planned for the next Committee meeting in November, subject to further discussions at Board level.

The Committee: Noted current projections indicate a break-even forecast for 2007/08. Noted the potential risks around prescribing and primary care budgets. Noted the progress made in CRS savings targets.

2. 
   PERFORMANCE REPORT
   

Nigel Small talked to a previously circulated report on ‘Performance Monitoring ’.

In particular, he mentioned that delayed discharges have been averaging around 10 patients, with the bulk being in New Craigs Hospital. He confirmed that significant work was being undertaken with partner organisations to maintain and improve performance.
The CHP’s performance on complaints was discussed and it was confirmed that this was exceeding the NHS Highland target.
In response to a query at the previous meeting about AHP and other non-target waits, Nigel Small informed the Committee that Heidi May, Board Nurse Director, is leading a project on developing a waiting times and activity recording process for services where activity and waiting data is not currently recorded or monitored in a systematic manner. This was due to report in Spring 2008.

The Committee: Noted the latest performance report for SE Highland CHP.

6.3 GENERAL MANAGER’S REPORT
Nigel Small talked to a previously circulated paper ‘General Manager’s Report’.
Some particular points were noted:
He mentioned the service continuity plans had been developed for each hospital site. These were in an advanced ‘draft’ state and would hopefully be signed off by the NHS Highland Emergency Planning Group. The plans include details on issues like power failure, IT problems, flooding, food problems, staff shortages etc
Nigel Small commented briefly on the Mental Health Officers dispute, and the monitoring of service implications. Brian Robertson confirmed that the dispute is still unresolved.
He informed the Committee that NHS Highland’s Management On-call arrangements were currently being reviewed. It was confirmed that revised arrangements to cover the CHP may be covered by SE Highland only. The current arrangements involve a Highland wide arrangement; further details would be brought to a future meeting.

Nigel Small commented briefly on a recent review of mortuary facilities at the community hospitals. A few required actions were identified in order to ensure compliance and these had now been addressed.

The Committee:

• 
  Noted the contents of the General Manager’s report.
  

7. 
   IMPROVING HEALTH
   

1. 
   BREAST FEEDING AUDIT
   

In Hilda Hope’s absence, Nigel Small talked briefly to a previously circulated paper regarding a ‘Breast-Feeding Audit’.

He highlighted the SE Highland CHP’s efforts for the 3-year period of 43%, 43% and 37% to the national target of 40% of mothers to be breast-feeding at 6/8 weeks of their child’s age.

The Committee: Noted the plans to progress the promotion of breast feeding as the infant feeding method of choice.

8 PARTNERSHIP

1. 
   HIGHLAND COUNCIL RE-ORGANISATION
   

William Gilfilan circulated a paper to the Committee.

He discussed the Highland Council’s recent re-organisation and re-structuring and mentioned that the Highland Council was now split into 22 wards. There were now a lot of new people in post including a new Chief Executive, some new Directors and new Councillors. New structures and systems were now beginning to operate.
There was a discussion about the opportunities to create robust links at CHP and local level to develop partnership working. It was agreed that Nigel Small and William Gilfilan will bring an initial mapping of links to the next Committee meeting in November.

2. 
   PUBLIC/PATIENT INVOLVEMENT
   

Hamish Wood confirmed that he had been part of a group who met the SNP Shadow Health Minister Shona Robison at the recent accountability review ministerial visit, in which amongst other things they discussed mental health issues, the renal service and cancer waiting times.

He confirmed that he had enquired about non-target waits. The Minister confirmed that NHS Scotland will be moving towards a 12-week wait for all patients.
He informed the Committee that the Minister had mentioned that there are future plans to review the Scottish Health Council’s organisational functions.

2. 
   VOLUNTARY SECTOR
   

Neither Voluntary Sector representatives were available to comment.

9. 
   STAFF GOVERNANCE
   

1. 
   HR ISSUES
   

Personnel representative was unavailable to comment.

2. 
   WORKFORCE REPORT
   

In Douglas Johnston’s absence, Nigel Small talked to a previously circulated ‘Monthly Workforce Report’.

He asked the Committee to note that SE Highland CHP is currently exceeding the national sickness rate target of 4.0%. The SE Highland CHP’s sickness rate is 3.68% compared to the NHS Highland average of 4.83%. He confirmed he had asked the Workforce Information Officer, Jim McKay, for annual comparative data in response to concerns raised at the July Committee meeting.
The Chair asked for a breakdown trend between long-term and episodic sickness across the CHP.
The Committee:

• 
  Noted the contents of the monthly workforce report.
  
• 
  Noted a request for more comparative data had been submitted to the Workforce Information Officer, and a further request for more detailed sickness information.
  

9. 
   ORGANISATIONAL ISSUES
   

10.1 NHS HIGHLAND BOARD MEETING: ISSUES OF RELEVANCE TO THE CHP
The Chair fedback to the Committee from the recent NHS Highland Board meeting –

• 
  Announcement of the new website.
  
• 
  Tobacco Policy – The Board has re-affirmed the ban on smoking on hospital premises and grounds.
  
• 
  The Scottish Government (formerly known as the ‘Scottish Executive’) has produced a ‘Better Health, Better Care’ document which is accessible via its website or a copy may be requested from CHP HQ.
  

The Chair announced that he would be stepping down as Chair of the SE Highland CHP Committee to take up his post as Vice Chair of the NHS Highland Board. The process to appoint a replacement is underway.

9. AOCB

Nil.

12 DATE, TIME & VENUE OF THE NEXT MEETING:

The next meeting of the Committee will be held on Thursday 15 November at 2.00 pm in the Board Room, Assynt House, Beechwood Park, Inverness.
The meeting closed at 4:30pm

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