approved minutes of the tenth meeting of the governing body of

Transcription

APPROVED MINUTES OF THE TENTH MEETING OF THE GOVERNING BODY
OF HEALTH EDUCATION EAST MIDLANDS (HEEM)
(EAST MIDLANDS LOCAL EDUCATION AND TRAINING BOARD)
HELD AT 1 MERE WAY, RUDDINGTON ON 28 JANUARY 2015
Ms Kaye Burnett (KB)
Independent Chair of Governing Body
Ms Lyn Bacon (LB)
Mr David Farrelly (DF)
Prof Simon Gregory (SG)
Prof Ian Hall (IH)
Mrs Jane Johnson (JJ)
Prof Sheona MacLeod (SM)
Mr Paul O’Connor (POC)
Mrs Anne Marlow (AM)
Mrs Sue Noyes (SN)
Prof Rishabh Prasad (RP)
Ms Amanda Rawlings
Ms Karen Rutter (KR)
Dr Sonia Swart (SS)
Third Sector representative
Local Director, HEEM
Director of Education & Quality, (Midlands and East)
Medical HEI representative
Deputy Director of Workforce, Education and Quality, HEEM
Post Graduate Dean, HEEM
Chair, Nottinghamshire LETC
Director for Innovation, HEEM
Chief Executive, East Midlands Ambulance Service
Director of Primary Care, HEEM
Representing Derbyshire LETC
Head of Finance (Midlands and East)
Chair, Northamptonshire LETC
Apologies:
Mrs Sue James
Ms Jane Lewington
Dr Peter Miller
Chair, Derbyshire LETC
Chair, Lincolnshire LETC
Chair, Leicestershire and Rutland LETC
In attendance:
Mrs Karen Adcock (KA)
Mr Richard Ansell (RA)
Mrs Carole Appleby (CA)
Mrs Jackie Brocklehurst (JB)
Ms Mary Elford
Mr John Keenan (JK)
Mrs Helen Smith (HS)
Workforce Lead, Northamptonshire Workforce Team
Workforce Lead, Leicestershire & Rutland Workforce Team
Head of Marketing and Communications, HEEM
Workforce Lead, Nottinghamshire Workforce Team
Non Executive Director, HEE
Interim Workforce Lead, Derbyshire Workforce Team
Workforce Lead, Lincolnshire Workforce Team
01/15 Welcome
The Chair welcomed the following to the Governing Body (GB) meeting:





Paul O’Connor, Chief Executive, Sherwood Forest Hospitals NHS Trust
(new
Nottinghamshire LETC Chair)
Simon Gregory, Director of Education & Quality, (Midlands and East)
Amanda Rawlings, Derbyshire Community Health Services NHS Trust (representing
Derbyshire LETC)
John Keenan, Interim Workforce Lead, Derbyshire Workforce Team
Mary Elford, Non-Executive Director, Health Education England.
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02/15 Declaration of interests
No new declarations of interest were raised in connection with the items listed on the
agenda.
03/15 Update from the Independent Chair
Opening the meeting KB said that the GB meeting would take a slightly different approach to
previous meetings and that agenda had been designed to enable GB members to start the
year thinking about our forward plan and key priorities. This should help to provide clarity
and a line of sight for performance and assurance conversations around the table.
The ‘Shape of Caring’ Report was due to be published at the end of March; the expectation
was that there would be a greater emphasis on mentoring/preceptorship for nurses. The
HEEM Nursing and Midwifery Summit was planned for 6 February; HEE’s Chief Nurse, Lisa
Bayliss-Pratt was a keynote speaker, alongside HEE’s National Director for Midlands and
East, Janice Stevens (also a former nurse).
The HEE Board (27 January) had agreed to continue to provide pre degree care experience
opportunities for aspiring nurses to gain care experience before entering their studies. This
route is seen as one of the ways to increase the pool of good quality candidates for nursing
degrees, working in tandem with, as examples, values based recruitment, Talent for Care
bands 1-4 progression, and widening participation initiatives. Opportunities to extend this to
Allied Healthcare Professionals would also be explored. HEE had asked colleagues to pass
on their thanks to everyone in the East Midlands who helped make the pilot project a
success.
In connection with the NHS ‘Five Year Forward View’ KB said that HEE’s Chief Executive,
Ian Cumming would be chairing the newly established Workforce Advisory Board; this would
bring together senior national figures in the NHS and would be a valuable opportunity for
HEE to influence this agenda.
KB also wished to congratulate the University of Nottingham’s School of Medicine for their
result in the recent Research Excellence Framework, over 80% of their research was judged
to be ‘world leading’ or ‘internationally excellent’. This was a significant improvement since
the previous Research Assessment Exercise in 2008.
04/15 Review of Governing Body (GB) actions to date
The status of actions was noted; a number of items with update reports appeared later in the
agenda.
05/15 Report of the Local Director
With regard to ‘Beyond Transition’ the formal consultation period had ended on 9 January.
New structures had been developed to support the 20% running cost reduction across HEE.
The structures were due to be released by 2 February following approval at the HEE Board
meeting on 27 January. The impact of this on LETCs would be discussed with LETC Chairs
in a follow up meeting; a timeline for implementation would also be shared.
With regard to Primary Care, DF said that there had been a lot of activity at national level
around three key areas:
(i) The Primary Care Workforce Commission (PCWC) had been established as an
independent Commission to identify good examples of integrated, patient focused,
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primary care. In the East Midlands, Lakeside surgery/Corby Urgent Care Centre
would be an area for review. The PCWC report will inform HEE priorities for
education and training as well as future decisions of commissioners and regulators.
(ii) New Primary Care infrastructure bids: This new fund announced by the
Government in December will lead to a four year investment programme targeted at
increasing capacity in primary care to enable better access to GP and its associated
community services, improving services for the frail and elderly and hence reducing
unnecessary demands on urgent care services, as well as building the foundations
for more integrated care to be delivered in community settings. HEEM would be
staying close to this in order to optimise opportunities for education and training in
the East Midlands.
(iii) 10 point GP plan published earlier in the week: NHS England, HEE, Royal
College of General Practice and the BMA GPs committee were working closely to
ensure a skilled, trained and motivated GP workforce. The plan addressed
immediate issues, and set out initial steps in building the workforce for the future and
new models of care. It is part of the implementation of the Five Year Forward View
and the New Deal for Primary Care, which set out a specific commitment to tackle
workforce issues, alongside a range of other proposals. There are three key strands
to this work: improving recruitment into general practice; retaining doctors within
general practice and supporting those who wish to return to general practice.
Publication of the 10 point GP plan generated high profile national media coverage,
including an interview on BBC Radio 4’s World at One with HEE Director of
Education and Quality, Wendy Reid and HEEM PG Dean, Sheona MacLeod, along
with GP trainees from the East Midlands.
Locally, a video had been made by HEEM to raise the profile of the East Midlands
and
in
particular
highlight
GP
as
a
great
career
choice.
http://em.hee.nhs.uk/workforce/gp-training-in-the-east-midlands-video/
This was
shown to GB members who commented positively on it.
With regard to the paramedic workforce: HEEM would be taking a lead role on the national
programme and will facilitate the work streams supported by national funding.
In November 2014 HEEM worked with the East Midlands Leadership Academy and East
Midlands Academic Health Science Network to host the event “Leading Innovation in
Healthcare.” The collaboration has reported on the event, its outcomes and the next steps.
Slides from the event and a copy of the report including recommendations and next steps
here:
http://www.leadershipeastmidlands.nhs.uk/events/leading-innovation-healthcareconference-king-power-stadium
Action
(a) To receive the report of the Local Director.
(b) To provide GB members with a hyperlink to the new HEEM video about GP recruitment
and the recording of the BBC Radio 4 ‘World at One’ item on the same topic (CA);
(c) To provide GB members with a hyperlink to the ‘Leading Innovation in Healthcare’
Conference.
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06/15 Addendum to Governing Body Constitution
This paper proposed an addendum to the current HEEM Governing Body Constitution
(approved 17 April 2013, reviewed January 2014) due to staff changes resulting from
‘Beyond Transition’. The proposal reflected a transitional position to 31 March 2015.
Action
(a) to adopt the arrangements proposed in paragraph 1 for the period 28 January to 31
March 2015 noting that the role of LETB Post Graduate Dean continues to remain in
place but that the Director of Education and Quality (DEQ) remit of this role is now
undertaken by the Geographic DEQ, with the PG Dean continuing in this role through to
31st March 2015. (For clarity, voting rights are retained in association with the LETB
Post Graduate Dean role.)
(b) to set in place arrangements for suitable appointment of GB members to fulfil the
legislative requirements of becoming a NDPB in April 2015 (Chair).
07/15 Priorities and forward plan for the year ahead
DF set the scene with a number of slides based on the NHS Five Year forward view, pulling
out some thought provoking themes pertinent to workforce, education and training.
RP welcomed the national focus on primary care and actions being taken to address current
issues however the current issue needed a solution now not in two to three years’ time.
LB made the point that the majority of the transformational work was happening not at the
LETB or in LETCS, but among providers, because this was where the actual transformation
was needed in order to meet patients and service needs. What was necessary was a flexible
workforce. In her view it was about actively getting on the ground and seeking to influence
through primary care groups. In order to accelerate transformation she felt it was vital to be
clear about the LETB’s remit (what is ‘in’ and what is ‘out’ and where the true influence lay).
AR said that she currently led across two units of planning around the integrated care
workforce. One of the challenges was that 51% was already committed leaving little scope to
change things. We need to ensure we have an ability to make things happen quickly and to
take speedy decisions to change things. The way we have set up our systems hinders our
ability to deliver change.
SS said that in Northamptonshire, she and colleagues had been trying to reconfigure
services for some time. Success had been limited by a lack of clarity about roles and
entrenchment in existing roles. In reality there was commonality about the things that
needed to change but it was vital to get staff to work in broader roles and in new ways,
across health and social care and across hospital and community. The new NHS ‘Five Year
Forward View’ would provide a lever to make change if it were correctly interpreted. The
NHS seemed to be still ‘waiting to be given permission’.
AR said that there was so much good practice around; what was urgently needed was better
ways to share this across boundaries.
IH expressed concerns about the remit of the HEEM GB; in his view this was to reflect the
‘best guess’ about what workforce, education and training are needed to deliver services,
rather than actually redesign services per se. He felt that the current approach to short-term
planning for education commissioning impacted hugely on HEIs. A recent example was the
change in nurse commissions. This had consequences on HEIs in the medium to long term,
There were also things nationally that added to this volatility e.g. ‘Shape of Training’, this
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would have huge implications for medical education. He felt that locally we needed to come
up with a more medium term plan.
SS’s view was that the role of HEEM was both service Redesign and changing the
workforce; the two were linked. It was possible to do both without destabilising current
things.
SG said that from a HEE perspective, LETBs provided an important link to a provider led
system; it was vital not to lose sight of local stakeholder relationships. HEE and LETBs
needed to consider what workforce might be needed, along with the training to support new
models and the impact of any decisions to reconfigure training and service models.
KB pointed out that LETBs were established as provider-led organisations at the very time
that the NHS system changed to give money to commissioners around service change.
Commissioner involvement was now taking place via the LETCs. The LETB focus was on
the transformation programmes that are happening across the East Midlands’ health & social
care communities.
SN felt that the LETB’s role was twofold. Firstly, for future education provision and ‘here and
now’ development leading to a reliable workforce and secondly around collaborative projects
such as services for the frail elderly.
LB felt that ‘doing the unthinkable’ should be the LETB watchword. In her view a new
workforce was needed, thinking very differently. She challenged the GB to be
transformational. There were exciting things happening outside the NHS. What level of risk
was the GB and HEEM as an organisation prepared to inject to rise to this challenge? What
is our level of ambition?
RA commented that in Leicester, Leicestershire and Rutland (LLR), the LETC business over
the last 12 months had seen a vastly changed agenda and membership, particularly primary
care and CCG representatives. In his view, a key thing about the transformation was about
being ‘brave’ and possibly pushing boundaries to spend some of the LETC allocation on new
‘brave’ and collaborative initiatives that supported this approach.
KR underlined the importance of sharing good practice and making sure we only do things
once. AM added that this was the rationale for the research and innovation network which
was currently being established under HEE as part of the Beyond Transition improvements.
The case studies that are currently available on the HEEM website
(http://heeminnovation.co.uk/projects/) were the tip of a huge pyramid. HEE were also
piloting use of the NHS England Innovation Exchange, an existing repository of best
practice. She said that through the HEEM Innovation Team there were a number of ways of
sharing best practice across the LETCS.
KA was in favour of a governance structure that supported ‘bravery’; this would be the
catalyst for change and transformation. The existing workforce planning process was very
system driven but local creativity, such as that seen recently in Northamptonshire around the
frail elderly work stream, had been a great lever for bringing people together to make a
difference.
SM highlighted the responsibility that HEEM has ensuring the continued delivery of high
quality education and training, as well as our role as an enabler for transformation through
workforce planning and education and training. It is important for the GB to understand the
wider implications of any ‘slippage’ on the workforce plan, the resultant risks to service and
transformation, and approve the agreed plans for mitigation.
5
KB summarised a number of emerging themes from the contributions made:
 HEE becoming a Non-Departmental Public Body on 1 April would bring about a need to
review the GB membership to ensure that this included a doctor, a nurse and an allied
health professional
 ‘Bravery is good’ around transformational leadership
 Clarity needed about where we can move at speed and the ‘rules’ and expectations on
the funding (‘what is in and what is out’)
 Clear agreement and recognition on the advantages and benefits of doing things
differently
 A need to pay attention to wider workforce issues and how commissioners are engaged
in conversations
 Acknowledge that there is a crisis in primary care now and a need to move at speed
 Awareness that while supporting transformation, HEEM must still ensure the effective
delivery and quality management of the education and training we are responsible for.
Action
To take on board the above points and use these to influence future thinking and
conversations.
08/15 Business Intelligence and Performance Report
The Business Intelligence and Performance Report provided assurance to the GB that
HEEM was being effectively managed and updated members on the performance against
key performance indicators and risks to achieving these. KR said that future Reports may
look different in that a standardised approach would be implemented across HEE.
KR highlighted:
 RAG ratings were predominantly green apart from GP recruitment and finance. Health
Visiting was on target locally and nationally.
 Forecast outturn is £31.5m.
 2015/16 LETB allocations were currently being worked out and she anticipated that draft
figures should be available for the next GB meeting.
LB asked whether HEEM had a Social Media Strategy with details of how social media might
be optimised to position the East Midlands as an attractive place to train. DF explained that
social media would become part of the HEE nationwide service and that the level of detail
that this service would provide to LETBs was, at the moment, unclear. The new HEE Digital
Team would be leading on social media strategy with effect from April 2015.
Action:
(a) To receive assurance from the Business Intelligence and Performance Report that
HEEM is being managed effectively with action being taken to manage significant under
performance.
(b) To update the Governing Body on social media strategy post Beyond Transition (DF).
09/15 Strategic Risk Register
A paper had been circulated describing top-line information regarding HEEM’s high-level
risks. There were no emerging risks of any significance.
KR explained that the biggest current risk were the structural changes across HEE in
connection with ‘Beyond Transition’. She shared the concerns expressed by GB members
around this. The Governance Team was currently in the process of becoming a nationwide
team, alongside communications and HR and as such HEE were, in effect, reducing the
capacity to manage risk. People at a local level would no longer be in place to help give us
6
the assurance that we have been getting to date. She did point out that LETCS have their
own risk registers and that these that feed through to the overarching HEEM register. KB
said that she had expressed concern at the level of support at LETB level for Governance
and Communication and this concern had been shared by other Chairs at a recent national
Chairs’ meeting.
Action
To understand and gain assurance that all risks are being identified and managed effectively
by the functional area reporting and peer review process.
10/15 Minutes of the meeting of the Governing Body of Health Education East
Midlands held on 19 November 2014
Resolution:
These minutes were accepted as a correct record and signed by the Chair; there were no
matters arising.
11/15 Minutes of meetings of Local Education and Training Councils
Resolution:
To receive, for assurance, the minutes of the following LETC meetings:





Derbyshire: 26 November 2014
Leicester, Leicestershire & Rutland: 10 November 2014
Lincolnshire: 25 November 2014
Northamptonshire: 14 November 2014
Nottinghamshire: 28 October; 3 December 2014
12/15 Items for information:
The following items were received for information:
(a) An update on the arrangements for ongoing quality management in HEEM
(b) An update on the medical trainee redistribution project.
The GB appreciated the work undertaken to deliver each of these aspects of business and
thanked all those who had been involved in it.
13/15 Meeting evaluation
GB members reflected on the meeting and provided the following feedback:
 KR: Of the three LETB meetings I regularly attend across the Midlands and East
geography, I prefer the format of this GB mtg. It flows well and is focused.
 SG: The lack of commissioners around the table was different to other Midlands and
East LETBs. The discussion was interesting and thought provoking. He felt that other
LETB GBs could learn much from each other.
 SG: After the issues raised by the Mid Staffs situation, I was surprised that the quality of
care and training was not discussed. KB gave reassurances that today was not a typical
GB meeting and that the GB had spent a lot of time on this in the past.
 SS: Echoed that the quality of care and education and training are linked. This had been
a topic of much debate at previous meetings.
7
14/15 Other business – resignation of Chair
KB said that she would be standing down as Chair of Health Education East Midlands. It was
with considerable sadness that she had reached this decision as she was still committed to
HEEM and the vital contribution it makes to providing safe and sustainable services for
patients and their families. However, other work commitments were making it increasingly
difficult to give the role the time it requires. She felt optimistic about the future and that
HEEM would be well placed to connect the national and local issues, as well as support the
vital transformational agenda.
HEE would now start the process to recruit a new Chair and this was likely to take until the
end of March.
15/15 Date of next formal Governing Body meeting
The next meeting of the Governing Body will be held on Wednesday 25 February 2015 at
Ruddington.
Post meeting note: The above meeting is postponed to 25 March 2015.
Signed…………………………………………
Ms Kaye Burnett, Independent Chair
Date……………………….…
8
Draft Minutes (v4)
http://kss.hee.nhs.uk
Health Education KSS Governing Body Meeting
Meeting held on 6 March 2015, 1400 – 1700 hrs
HE KSS, Crawley Hospital, Crawley, West Sussex RH11 7DH
Present:
Mark Devlin (MDe), Chair, Health Education KSS
Susan Acott (SA), Chief Executive, Dartford and Gravesham NHS Trust (Kent
Acute representative)
Stuart Bain (SB), Chief Executive, East Kent University Hospitals NHS Foundation
Trust (Kent Acute representative)
Julian Crampton (JCr), Vice-Chancellor, University of Brighton (HEI representative)
Marion Dinwoodie (MDi), Chief Executive, Kent Community Health NHS Foundation Trust
(Community rep)
Fiona Edwards (FE), Chief Executive, Surrey & Borders Partnership NHS Foundation Trust
(Leadership and Mental Health Provider)
Amanda Grindall, Director of Leadership, Health Education KSS
Matthew Kershaw (MK), Chief Executive, Brighton & Sussex University Hospitals
NHS Trust (Sussex Acute representative)
David Maguire (DMa), Vice- Chancellor, University of Greenwich (HEI representative)
Nick Moberly (NM), Chief Executive, Royal Surrey County Hospital NHS Foundation Trust
(Surrey Acute Trust representative)
Mike Parks (MP), Medical Secretary, Kent Local Medical Committee (Primary Care rep)
Michael Wilson (MW), Chief Executive, Surrey and Sussex Healthcare NHS Trust (Surrey
Acute Trust representative)
Philippa Spicer (PS), Local Director, Health Education KSS
Abdol Tavabie (AT), Interim Dean Director, Health Education KSS
By invitation:
Guy Boersma (GB), Managing Director, KSS Academic Health Science Network - item 5.7
Stephen Lambert-Humble (SLH), Dental Dean, Health Education KSS – item 4.1
Geeta Menon (GM), Director of Clinical Education, Frimley Health NHS Foundation
Trust / KSS Head of School for Ophthalmology - item 4.2 only
Apologies:
Darren Grayson (DG), Chief Executive, East Sussex Healthcare NHS Trust (Sussex Acute
representative)
In attendance:
Jane Chopping (JCh), Executive Assistant, Health Education KSS (note taker)
“Through creative partnerships we shape and develop a workforce that impacts positively on health and wellbeing for all”
We are the Local Education and Training Board for Kent, Surrey and Sussex
Developing people for
health and healthcare
1.
Welcome, Introductions and Apologies
Members were welcomed to the meeting which included the additional
attendance of Stephen Lambert-Humble (Dental Dean, HE KSS) and Geeta
Menon (Director of Clinical Education, Frimley Health NHS Foundation Trust /
KSS Head of School for Ophthalmology) who had been invited to attend to
present on Dental and Integrated Multi-Professional Education initiatives
respectively. It was also noted that Guy Boesma (Managing Director of KSS
Academic Health Science Network) would join the meeting in regard to the Ed
Smith Review, NHS Leadership Academy/NHS Improving Quality.
Apologies were recorded from Darren Grayson. It was reported that Chris
Moreton (former Head of Finance, HE KSS) had now left the organisation, and
the Governing Body recorded its thanks to Chris for his excellent financial
stewardship of HE KSS.
Congratulations were offered to Marion Dinwoodie on Kent Community Health
NHS Trust receiving Foundation status.
2.
Register of Declaration of Interest
There were no new declarations of interests reported.
3.
Minutes of HE KSS Governing Body meeting on 16 December 2014
3.1
The minutes of the meeting held on 16 December 2014 were agreed as a
correct record.
3.2
The summary of actions was reviewed noting items either as closed or
referred to on the agenda for further update / discussion.
3.2.1 Health Education England Advisory Group (HEEAG) provider
representative
An update on nomination arrangements was awaited from HEE.
ACTION 1: PS to advise the Governing Body when further information
was received.
3.2.2 Higher Specialty Training (HST) Review
AT provided a progress report updating the Governing Body on actions
implemented around HST and a proposal which outlined the proposed
objective criteria for the distribution of HST posts. The Governing Body
agreed the need to review the distribution of both existing and any new posts
and that this proposed criteria could be used for both. It was recognised that
subject to this review, the agreement to move any existing trainees would
need to be carefully managed. AT was requested to carry out a wider
Page 2 of 9
consultation among Local Education Provider (LEP) Chief Executives seeking
their personal comment and observations on the proposed criteria before
LEPs were formally asked to undergo a self-assessment exercise. It was
suggested the proposal include a further descriptor in terms of the Steering
Group tasked to review the self-assessment approval forms.
ACTION 2: AT to update the proposal and seek comment from LEP Chief
Executive Officers before formal launch of the self-assessment.
3.2.3 Beyond Transition – Postgraduate Dean
The post for a substantive Postgraduate Dean for Kent, Surrey and Sussex
would be advertised in April looking to appoint a post holder by June 2015.
AT confirmed that he would remain in the interim Postgraduate Dean role until
a substantive appointment was made.
3.2.4 Sound of the Student and Trainee Voice, 26 February 2015
PS reported that the Sound of the Student and Trainee Voice event was very
well attended, and well received. The ratio of students to trainers was higher
than the previous event and there was a very positive focus throughout the
day. A formal summary of the event would be produced and circulated in due
course.
ACTION 3: PS to arrange for report to be circulated to the Governing
Body.
3.2.5 Physician Associates
MW reported that the first meeting of the School of Physicians’ Associates
Programme Board had taken place on 6 February 2015. Work with the
Higher Education Institutes was coming together and appeared to be very
positive. It was expected that the date for the first placements would be put
back from September 2015 to January 2016 and organised on a staggered
approach. Abdol Tavabie advised that Dr Hilary Diack (Interim GP Dean and
Head of GP School, HE KSS) had agreed to represent primary care on the
Programme Board. The next Programme Board was scheduled to be held on
2 April 2015.
3.2.6 HEE visit to HE KSS
PS reported that it was expected that Sir Keith Pearson and Professor Ian
Cumming would visit HE KSS in autumn 2015. It was suggested that a
presentation on the work on Physician Associates within KSS could be
considered as a potential showcase.
Page 3 of 9
4.
Quality
4.1
Presentation - Improving the Oral Health of Older Persons
Professor Stephen Lambert-Humble (Dental Dean, HE KSS) gave a
presentation on ‘Improving the Oral Health of Older Persons Initiative’ which
was formally launched with the consent of Earl Howe at the House of
Commons on 3 March 2015. The Governing Body were very impressed by
the initiative. All agreed it would be excellent if the project could be extended
beyond care homes and adopted by all health organisations on a national
scale. It was noted there was ongoing work to embed the initiative within the
curriculum and include within the National Care Certificate. Stephen LambertHumble was congratulated on the initiative and thanked for giving the
presentation.
4.2
Presentation - Integrated Education
Geeta Menon (Director of Clinical Education, Frimley Health NHS Foundation
Trust / KSS Head of School for Ophthalmology) gave a presentation on the
integrated education structure across clinical groups at Frimley with work
being done to set up the same process at Wexham Park. It was noted there
were a number of other LEPs reviewing their educational structures on a
multi-professional level, supported by HE KSS. Geeta Menon was
congratulated on her excellent achievement at Frimley and thanked for her
presentation.
4.3
Proposed Integrated Education Outcomes for LEPs
A paper by Jane Butler (Head of Clinical Learning, HE KSS) detailing
proposed outcomes to make it clearer to LEPs and other stakeholders what
successful integration could look like in practice was reviewed. The
Governing Body Members agreed it was useful to have a cohesive multiprofessional framework to work to and the outputs listed were considered to
be appropriate although the approach and manner of achievement would be
variable between LEPs to suit local need.
4.4
Improving GMC National Training Survey Results
AT provided an update confirming that all LEPs were engaged with the
process to improve GMC National Training Survey results. The additional
funding agreed by the Governing Body to support the four areas (listed below)
which required improvement across all LEPs had been used as proposed by
each LEP.
•
•
Improvement for handover process to support learners.
Improvement for providing and receiving feedback regularly and acting
upon the feedback.
Page 4 of 9
•
•
Learners’ involvement in planning and delivery of effective local teaching
programmes.
Team based education including utilizing technology enhanced learning
methods to support innovation in delivery of excellence in education and
training.
The evaluation of the success of this targeted improvement would begin with
the results of the next Survey, due to be launched on 24 March 2015. It was
recognised that some of the improvements introduced by LEPs, could take
longer to show in improved survey results. AT further reported that he met
with the Regional Industrial Relations Officer of the British Medical
Association and trainee representatives on a regular basis with the next
meeting scheduled towards the end of March.
4.5
General Medical Council (GMC) Regional Review Visit
Preparation for the GMC Regional Review to HE KSS in May/June 2015 was
fully underway with HE KSS and GMC in contact with the four selected LEP
sites (Royal Sussex County Hospital, William Harvey Hospital, East Surrey
Hospital and Worthing Hospital). The GMC team were arranging to visit
Brighton and Sussex Medical School (BSMS) and the LEPs in May 2015
followed by a 2 day visit to HE KSS on 11-12 June 2015. AT had already met
with the four LEP Chief Executives and their senior teams and was in the
process of briefing Directors of Medical Education, Heads of School and
Training Programme Directors for the specialties being visited (Foundation,
Surgery, General Internal Medicine and Emergency Medicine). AT had also
met with Professor Malcolm Reed, Dean, BSMS. Susan Acott, who had
kindly agreed to act as Governing Body sponsor for the visit, had also been
briefed on arrangements to date. AT would consider any further support that
he could offer to the four LEPs over the next 3 months. It was noted that AT
and Professor Elizabeth Hughes were both GMC visitors and that Ian
Bateman, from the London LETBs was providing additional support using his
recent experience of a GMC Visit in London.
ACTION 4: AT to consider further support to be offered to 4 LEPs
leading up to their visit by the GMC in May 2015.
5.
Strategy
5.1
Draft Investment Plan 2015-16
The Governing Body noted and approved the changes to the draft Investment
Plan proposals and accepted the potential reductions to elements of funding.
The changes related to a) an increase in tuition fees for adult and child
nurses, paramedic foundation degrees, additional paramedics and pharmacy,
and b) decrease in placement tariff.
It was noted that the allocation for 15/16 is still not confirmed.
Page 5 of 9
5.2
Five Year Forward View
A paper showing a review of the work of HE KSS against the Five Year
Forward View (5YFV) was presented to provide the Governing Body with
assurance that HE KSS had programmes in place to support the
implementation of the Five Year Forward View. The report was noted and the
recommendations in relation to Mental Health, Learning Disability and Nurse
revalidation were agreed. It was agreed that there was a significant amount
of work already being undertaken within KSS to support the 5YFV strategy.
5.3
SDS Achievements and Proposals
The Governing Body noted the many positive achievements of year 2 of the
implementation of the 5 year Skills Development Strategy programme. The
paper demonstrated the extent of the work that has been undertaken over the
first two years and the improvements that have been made to education and
training in these areas. The Governing Body confirmed its support for the
continuation of the programme into year 3 of delivery including delegation of
delivery to respective Stakeholder Programme Boards as agreed within the
governance structure of the programme. The resource for year 3 was
identified and agreed within the Draft Investment Plan.
5.4
Human Factors Programme
The Governing Body endorsed the proposed strategic direction for HE KSS
Human Factors Programme 2015/16. Local Education Providers would be
offered the opportunity of HE KSS assistance around the second proposal on
‘Supporting Pioneers’ to change culture which was welcomed by the
Governing Body.
ACTION 5: Governing Body members to consider whether they as LEPs
wanted to put themselves forward as a Pioneer.
5.5
Post Graduate Medical and Dental Education Integration
The Governing Body noted the paper prepared by the four Postgraduate
Deans across London and the South East, proposing the integration of the
education support systems of the Post Graduate Medical and Dental
Education teams.
A formal programme was being established to bring together London and
South East PGMDE functions. The Senior Responsible Officers for this
programme were agreed as Philippa Spicer, representing the LETB Directors
and Liz Hughes Geographical Director of Education and Quality.
Page 6 of 9
The Governing Body noted and endorsed this proposal.
5.6
Workforce Development for People with Intellectual Difficulties
The Governing Body agreed in principle the recommendations proposed
within a paper prepared by George Matuska (Lead Nurse, Learning
Disabilities, Kent Community Health Foundation Trust). The
recommendations would bring Intellectual Difficulties nursing needs to the fore
in workforce planning. PS undertook to discuss further with George Matuska
in terms of acting as project manager for this initiative. FE mentioned that her
trust was already engaged in conversation with Health Educational Institutes
on this matter.
ACTION 6: PS to discuss next steps with George Matuska.
5.7
Headline report on findings from the Ed Smith Review, NHS Leadership
Academy/NHS Improving Quality
5.7.1 Guy Boersma (Managing Director, KSS AHSN) spoke on the recent
review led by Ed Smith, deputy chair of NHS England which was set up
to look at how current arrangements for improvement and leadership
development work across health and social care and how best they
should be carried out in the future. It was evident there would be much
closer coordination between leadership organisations and concerted
effort for faster improvements. The uncertainty this was causing for
staff was acknowledged. The full recommendations from the report
would be published on 20 March 2015 setting out future direction for
the NHS Leadership Academy, NHS Improving Quality and other
partnership bodies. Once the recommendations and future direction
was known then the relationship of the NHS Leadership Academy with
HE KSS would be reviewed. It was expected that proposals for going
forward would be available for the next Governing Body on 19 June
2015.
5.7.2 It was noted the selection of the ‘Vanguard’ pilots was expected to be
announced imminently. A total of 6 bids had been submitted by
organisations within KSS.
Members of the Governing Body discussed the ‘Vanguard’ pilots in
relation to workforce and the need to understand the impact of such
changes on education and training. The need to recognise that any
changes to current services will impact on the workforce and that it is
essentially one workforce across health and social care, and with so
many struggling we need to find a way to coordinate strategies.
PS reported on recent conversations with both Providers and CCGs
and the need to look at future workforce in a different way. HE KSS
had done modelling which suggests that we need to work with our
Page 7 of 9
system to show the maximum number of, for example, nurse
commissions we can manage, as we do have limitations in both
number of placements and funding for fees, placement tariff and
bursary. This would enable us to identify the maximum supply we can
plan for and collectively work towards new roles, e.g. Physicians
Associates, or the development of existing roles, e.g. extension of the
role of pharmacists, or assistant practitioners.
It was agreed that the Governing Body would debate this issue with
more information at the June meeting, which would ensure robust
challenge at an early point within the 15/16 workforce planning round.
Action 7: PS to present the early information from the 15/16 workforce
planning round and the analysis against supply as discussed for the
June GB meeting.
5.7.3 MDe thanked Guy Boersma for his attendance at the meeting and
suggested that it may be helpful to have a regular slot on the agenda
for a regional round up of leadership/improvement activity or time set
aside to discuss specific issues.
6.
Finance, Performance and Risk
6.1
Financial Report 2014 -15, Period 10
The Governing Body received the Financial Report 2014-15, Period 10 for HE
KSS. It was noted that at present time, HE KSS was forecast to spend in line
with the overall budget for the year apart from a predicted underspend in
future workforce and running costs as outlined in the report.
6.2
Corporate Performance Report
The Governing Body noted the Corporate Performance Report outlining HE
KSS status against national performance metrics together with a summary of
developments on performance reporting going forwards.
6.3
Risk Management Strategy Board
The Governing Body received a Risk Management Strategy Board Report as
at 1 March 2015 providing an update on items discussed under the risk
register. It was noted that phase two of the Beyond Transition consultation
had now concluded with new staffing structures published. Staff retention
continued to be a concern, and it was hoped that his would improve as soon
as certainty could be given in relation to the base of various staff and teams
working for HE KSS.
Page 8 of 9
7.
Vote of Thanks
It was noted that Stuart Bain (Chief Executive, East Kent Hospitals University
NHS Trust) was retiring in late March so this was his last HE KSS Governing
Body meeting. A vote of thanks was recorded to SB for his commitment and
contribution to the Governing Body since establishment. SB commented that
the Governing Body was an important forum for education and training
discussion which brought together senior executive representation from LEPs
and HEIs across the region. SB remarked that he was always impressed by
the high level of attendance at Governing Body meetings and the discussion
was always of significant importance looking at the current changes facing
NHS organisations. SB wished the Governing Body well and may it continue
to shape and increase the health professional workforce for the South East. It
was noted that Stuart Bain’s successor as Chief Executive was Chris Bown
who would commence in post at EKHUFT on 23 March 2015. Stuart Bain’s
successor on the Governing Body would be Glen Douglas, Chief Executive of
Maidstone and Tunbridge Wells NHS Trust.
8.
Date, time and venue of next Governing Body meeting
Friday 19 June 2015, 1400 to 1700 hours, Crawley Hospital
Page 9 of 9
http://kss.hee.nhs.uk
Health Education Kent, Surrey and Sussex
Governing Body Meeting
6 March 2015
DRAFT Actions_v4
Date
Mar
No
1
Mar
2
Mar
3
Mar
4
Mar
5
Mar
6
Mar
7
Action
PS to advise status update of HEEAG to the
Governing Body when known from HEE.
AT to seek observations and comment from LEP
Chief Executives in view of HST self-assessment
exercise.
PS to distribute report of Sound of the Student
and Trainee Voice conference (26 Feb 2015) to
the Governing Body.
AT to consider additional support to be offered to
4 LEPs leading up to the GMC visit in May 2015.
Governing Body members to consider whether
they as LEPs wanted to put themselves forward
as a “Pioneer” in regard to Human Factors
initiative.
PS to discuss next steps with George Matuska in
regard to bringing Intellectual Difficulties nursing
needs to the fore in workforce planning.
PS to present the early information from the 15/16
workforce planning round and the analysis
against supply as discussed for the June GB
meeting.
Who
PS
Status
AT
PS
AT
Governing
Body
members
PS
PS
“Through creative partnerships we shape and develop a workforce that impacts positively on health and wellbeing for all”
We are the Local Education and Training Board for Kent, Surrey and Sussex
Developing people for
health and healthcare
Minutes
HENE Governing Body
Local Education and Training Board
Date: 27 February 2015
Time: 13.30 – 16.30
Members of meeting:
Chair: Professor Oliver James
In Attendance
Derek Marshall (Chief Workforce Strategist & Planner
HENE)
Paul McLaughlan (Chief Operating Officer HENE)
Michelle Roach (Finance HENE)
Lisa Simmonette (Note Taker HENE)
Venue: Bourne House, Durham
Apologies:
Yvonne Ormston (NEAS)
Ian Frame (South Tyneside FT)
Dr Julie Birch (Local Medical
Committee)
Calum Pallister (HEE)
Attendees
Martin Barkley (Tees, Esk and Wear Valley NHS FT)
Professor Richard Bellamy (South Tees NHS FT)
Dr Jane Metcalf (North Tees and Hartlepool NHS FT)
John Hanley (Newcastle Upon Tyne Hospitals NHS FT)
Lisa Crichton-Jones (Northumberland, Tyne & Wear NHS
Trust)
Ken Bremner (Sunderland City Hospitals NHS FT)
Alex Glover (Local Director HENE)
Professor Namita Kumar (Postgraduate Dean HENE)
Professor Paul Keane (Teesside University)
Ann Stringer (Northumbria Healthcare NHS FT)
Susan Watson (Gateshead Health NHS FT)
Dr Jonathan Smith (Primary Care)
Paul Cummings (County Durham & Darlington NHS FT)
Professor Julia Newton (Newcastle University)
Laura Roberts (HEE)
Item
No.
1
Discussion
Strategic
Welcome and apologies, declaration of interest
The Chair welcomed everyone to the meeting including Laura Roberts
(HEE), Paul Cummings representing (CDDFT) and Susan Watson for
(Gateshead Health).
Action
1
2
2.1 Minutes of 23 January 2014 meeting
Members agreed that the minutes were a true reflection of the meeting.
2.2 Actions
Action log circulated. All completed actions will be removed.
Apps Development
Discussed under agenda item 8.
GP special interest
No update.
Sponsorship Proposal
Establishing how to run the course.
PH Workforce
Strategy document complete.
2.3 Matters arising
Letter concerning Workforce documentation
The Chairs letter to Professor Ian Cumming was circulated before the
meeting. It was agreed to also circulate Professor Cummings response with
the minutes.
LS
ACTION: LS to circulate response letter.
3
4
Partnership Council update – 12 January 2014
Professor James informed the Board that he would be writing the draft
Partnership Council Constitution with a view to bring this to the next
meeting on 16 March and then to the Board on 27 March.
Announcement
The Chair informed the group of the new Technical School (£10m) due to
be built in Byker in the North East. This will open in 2017 and Sunderland
University will be its sponsor. The school which will accommodate 14-16
year olds will be the first of its type to open in the country and will prove
to be a great resource for the North East in the future.
National update
Laura Roberts updated the group on national activity and is hoping to
bring a more structured HEE update to future meetings. She added that
the first quarter reviews had taken place with Sir Keith Pearson and
Professor Ian Cumming. During the meeting discussions included items
working well and what challenges were being faced:2
Working well
o Clinical Academic Career
o Libraries
o NHS Careers
o Advance Practice
o Health Visiting
o Performance Reporting Tool
Challenges
o GP Recruitment
o Urgent Care – physicians associates positions
o Nursing shortages
o Development – proposals in greater Manchester
o Health and Equality
o Widening Participation
Other updates from Laura included:o HEE scheduled visits to all LETBS from Sir Keith Pearson and
Professor Ian Cumming
o National Audit Office – reviews will be taking place to understand
the geography, beyond transition and contracts with HEIs.
o Talent for Care – national champions launch to be held on 4 March
in London
o Apprenticeship week – local event 12 March at Durham Cricket Club
In respect of apprentices, Derek Marshall suggested the possibility of
getting a small working group together to share views on how to get the
right people into trusts and how things could be improved for the future.
ACTION: DM to bring suggestions to a future meeting in the next few
months.
5
DM
Alex Glover made reference to IAPT numbers and backfill arrangements
and the issues around this. Martin Barkley added that an increase from
workforce was expected.
Education Commissioning for Quality (ECQ) metrics
Derek Marshall presented the paper asking the Board to review
continuation of funding for ECQ Metrics for 2015/16 and beyond. In April
2013 discussions took place at the Board regarding ECQ metrics and the
possibility of phasing out. It was then discussed further in October 2014
when it was agreed to defer discussions, whilst there were on-going
3
national discussions on benchmark price. Those discussions have now
concluded and agreement reached for BMP for 2014/15 and
2015/16. Derek proposed to the group that ECQ payment be formally
phased out with 2015/16 being the final year of payments.
Paul Keane – understood the position to phase out payments however
emphasised that this would be yet another reduction to Universities. He
asked if this proposal was in line with other NHS funding challenges and to
consider further before reaching a decision.
Richard Bellamy – asked if the quality in the north east was of a higher
standard due to the payments and if HENE was the only LETB still making
these payments.
Martin Barkley – suggested looking at this issue in two ways. Firstly he
asked if there were options to look at quality impact and assessment
looking at the possible consequences. Secondly it could be reviewed
through CQUINS. He then asked the universities what they thought would
be the consequences if the payment was removed.
Professor James – added that if agreement could not be reached the £1m
saving from these payments would then need to come out of the HENE
training budget and confirmed that no other HEIs in the country receive
these payments. Derek Marshall agreed adding that if payments are
continued that it would have an impact on other areas. Professor James
then proposed:
1. Agreement to the 2015/16 proposal
2. July – to ask the 4 Universities (Northumbria, Teesside, New College
Durham and Newcastle) to produce an impact assessment of the
removal of these payments.
The group agreed that more evidence was required before agreeing the
final proposal.
6
ACTION: Alex Glover to write to those Universities not present at the
meeting with an update on discussion.
Finance updates
Michelle Roach indicated a £2,431K forecast underspend of which £1,531k
remains available to be utilised in 2014/15 with the remaining £900k due
to be returned to HEE. The two key areas being slippage on
AG
4
apprenticeships and the project for older people with complex needs.
Further discussion followed regarding the underspend and the possibility
of using this to help resolve the ECQ issues within universities. However if
universities do not achieved the ECQ metrics the money would need to be
retrieved.
Bands 1-4 Investment
The information provided in the paper updated the Board on the HENE
Vocational Education and Training Tariff. The proposal was for a nonrecurrent in year additional allocation to support bands 1-4 education and
training. The proposal will put in place a £200k in year payment this
financial year to be split between all 11 FTs or could alternatively be split
between 8 FTs with 3 regional schemes. This will help with some of the
financial challenges and activity being faced by employers, partly due to
the activity levels, but also partly due to the complexity of tariff and the
SFA contract.
Professor James commented that money paid now could help trusts with
their infrastructures, but must be viewed as an in year allocation. Further
information on the longer term funding methodology would need to be
informed by the review being led by Norman Glover (HENE) regarding the
Skills Funding Agency contracts. The Board were clear with the proposals
and discussed the 2 options.
Professor Bellamy – agreed that it was logical to base this around activity
but asked if the figures were correct.
Professor Kumar – was in favour of the right hand section of the table re
the additional bands 1-4 allocation for all 11 FTs. Professor James, Michelle
Roach and Professor Newton also agreed that this would be in the best
interests of the region and a more equitable approach.
The Board agreed to fund an additional bands 1-4 allocation split across all
11 FTs.
ACTION– DM will write to all 11 FTs outlining the decision, and will ask
each to provide a plan on how this funding will be spent to provide
additionality and sustainability in supporting the bands 1- 4 workforce.
DM
Foundation Degree Investment
Derek Marshall briefed members that in September 2014 HENE identified
Workforce Development Funding of £135k for investment in foundation
degrees and higher apprenticeships. Some organisations had begun
providing foundation degrees before this additional funding was available
5
and these FTs were authorised by HENE to use their HENE Continuing
Professional Development (CPD tier 2) allocation to fund this. Many did
not do this outlining that the CPD of their bands 5+ staff should not be
diminished. Consequently three FTs have asked for £252k funding for the
financial impact, as they feel they have been disadvantaged in light of the
allocation agreed in September 2014. Derek asked the group to consider
the proposals but more importantly acknowledge the appropriateness of
reviewing and potentially ‘back engineering’ previous board decisions,
especially as this may set a precedent for other decisions.
Martin Barkley – suggested if it would be fair to pro-rata the original
£135k to ensure equality. Professor James agreed.
Ken Bremner – emphasised the need to be very careful not to go back on
previous decisions made by the Board as this could have as yet unseen
implications on future decisions.
Martin Barkley – agreed in principle with Ken Bremner however current
circumstances and having the funding available makes this a difficult
decision.
Ann Stringer – commented that this was an issue around timing rather
than principle. John Hanley agreed.
Susan Watson – asked for clarification if the £135k had already been given
to the 3 FTs.
Dr Metcalf – asked if funding is available from slippage then a discussion
should take place.
Paul McLaughlan – added that the £135k was made available to all 11 FTs.
Martin Barkley – asked if the 3 FTs had received any funding as yet or if the
£135k came at a later date.
Professor Kumar – there are other options to spend the funding, which fell
outside of this discussion but needed to be considered in the wider
context.
Lisa Crichton-Jones – expressed that this was an uncomfortable governance
issue.
Following discussion Professor James asked Derek Marshall to bring further
information back to the next Board, including a fuller time line of who had
had access to what funding and at what time.
7
ACTION: DM to bring further information to the next meeting (27 March).
Performance Dashboard
Paul McLaughlan gave an overview on key areas including:Page 2 – 2 red indicators regarding GP training which is currently also
logged on the Risk Register.
DM
6
Page 7 – Dementia currently ahead of target
Page 5 – IAPT outputs
8
Apps Development from Northumbria Healthcare NHS FT
Ann Stringer on behalf of Kelly Angus at Northumbria Healthcare NHS FT
presented the document. She informed members that the apps could be
adopted by other trusts but IT support would be required within their
organisation.
1. Junior Doctors Induction
2. Statutory and Mandatory Training
Dr Metcalf supported the Apps and the streamline effect they would have
and asked if the links could be shared. She also suggested the LET use
these as part of trainees inductions.
Professor Kumar – asked members to bear in mind that HEE national could
also have things in development which could be out in the next few
months or later in the year.
Paul Cummings – was interested in seeing the link to the apps.
Ken Bremner – asked if there was a way in which the apps could be
standardised in the region.
Derek Marshall – suggested that work could be contracted out to help
with any IT issues.
Professor James – asked if would be possible to have the apps streamlined
ready for August and Paul McLaughlan responded that the LET could look
into this until national apps are produced. Paul Cummings advised that an
August 2015 start date may not be achievable. Professor James then
proposed option 2 to the group. Following discussion it was agreed that
HENE would work in collaboration with the LET. Further discussion took
place on how the trusts could use the apps and make them work with their
own IT resources.
It was agreed that development work was required for the LET induction
and that a budget of £50k would be allocated. HENE would notify all
trusts that they could liaise with Northumbria Healthcare NHS FT if they
wished to take forward and fund any induction app developments
themselves.
ACTION - Apps link to be circulated.
9
AS/LS
Further actions Re: Partnership Council
Professor James informed the group that work on governance and the
constitution would be available for the Partnership Council on 16 March
7
10
11
and then follow at the next Board on 27 March for comment. All
suggestions from previous meetings will be incorporated into the
documents. He also confirmed that letters had gone out to all members at
trusts regarding membership of the new Council.
Find your Place – recruitment campaign
This current campaign is based on the live and train campaign in which all
trusts are represented. Claire Riley is leading up the campaign. Advertising
has now been secured with the BMJ and other work on the campaign
includes showcases, information available on the website and careers fair
with stands from trusts. Paul McLaughlan confirmed that the website had
over 450 hits so far.
ACTION: LS to circulate link to website with the minutes.
5 Year Workforce Strategy
Derek Marshall presented the document which is the first draft with high
level detail. The 3 main themes cover:-
LS
1. New ways and places of working
2. Live, train and retain
3. Patient experience at the heat of what we do
In principle there are 10 work streams for consideration by the Board
before work can begin within the subgroups. This will enable the
subgroups to plan and support the high level streamlines.
Professor James commented that this was an excellent piece of work and
accepted Derek's suggestions and asked if members could feed their own
comments directly back to Derek.
Professor Metcalf - thought the document was very good and was
enthusiastic and asked if the document would be used by all 3 LETBS in the
north. She also asked if the out of care information could be made a
priority.
Professor Newton - made an additional comment that the region was the
best in the country for clinical research and agreed to drop a note on this
to Derek.
Ken Bremner – complimented Derek on his work but stressed the need to
ensure subgroups had the right people to carry out the work. Professor
James responded that work was on-going regarding subgroups.
Professor Kumar – suggested that the subgroup chairs could be advertised
to give clear governance and allocated resource. She added that the chairs
should be accountable for driving the work and strategy forward for the
8
subgroups. The group discussed the issue however Martin Barkley pointed
out that the HENE officer should be their person accountable for the
strategy and that the chair was an advisory position. Alex Glover
confirmed that HENE Executives were responsible for the delivery of the
strategy with the support from the subgroups and Professor James added
that he would be drafting a constitution for the Partnership Council as
discussed during agenda item 3.
ACTION: LS to add document for discussion at the Partnership Council on
16 March.
ACTION: DM to write to trusts advising them of current subgroup
membership.
ACTION: HENE Board members to feedback views and comments to DM
directly.
12
13
LS
DM
DM
Research network
It was agreed to move this item to the next meeting on 27 March.
GP Recruitment Strategy
Professor Kumar presented the paper confirming responsibility for training
and recruitment to the level of CCT. Post CCT recruitment would sit with
Derek Marshall, but clearly there was much joint work in progress. The
document reflects the longstanding work in place and reflects the
maturity of both the work streams and thoughts behind them. Future
proposals to maintain and extend training were highlighted including:o
o
o
o
Page 2 – Areas for prioritising expansion.
Page 3 – Extension of training/added value training.
Page 5 – Foundation Year – tasters.
Page 7 – Return to Practice/Induction fresher.
She then asked the Board for approval to continue with this work and the
new proposals. Professor James suggested the group look through the
proposals and the costs attached. Alex Glover added that the potential
underspend from not recruiting to target could be used to fund these
proposals as it would sit under recruitment and that Steve Clark had
agreed to consider such requests. Professor James asked the Board for
agreement and Ken Bremner asked if the funding could be used for all
trusts’ costs within the paper. Laura Roberts agreed that HEE would be
sympathetic to this suggestion.
It was agreed that a proposal should go to HEE to cover all costs.
9
14
15
Pre Nursing Experience – post pilot phase
Derek Marshall informed members that HEE had agreed to a fourth round
of intakes for this programme and asked for the Board’s agreement. The
Board agreed.
A.O.B.
Alex Glover asked the group their thoughts on making meetings bimonthly. Dr Metcalf thought alternate months would be better than
monthly. Alex confirmed the 27 March meeting would go ahead as
planned and that a list of proposed meeting dates would be presented for
approval.
AG/LS
Lisa Crichton-Jones – informed the Board of the closure of Learning
Disability beds.
Future agenda items
Details of future meetings
Friday 27 March 2015 (Bourne House)
Friday 22 May 2015 (Bourne House)
Minutes completed by:
Minutes confirmed by:
Lisa Simmonette
Alex Glover
Professor Oliver James
Date: 09/03/15
Date 18/03/15
Date: 27/03/15
10
Health Education South London: Board
16 December 2014
Minutes
Members:
Richard Sumray (Chair)
Aurea Jones
Martin Livesey
Diana Hamilton-Fairley
Nav Chana
Geraldine Walters
Kate Grimes
Gabrielle Kingsley
Madeleine Long
Ash Soni
Theodora Kalentzi
Marilyn Plant
Anne Greenough
Julius Weinberg
Jane Clegg
Ruth Wallis
John Isitt
Tom Brown
Rafik Taibjee
Ron Kerr
Item
1
Associate Members:
Rima Makarem
Chris Streather
Also in attendance:
Andrew Frankel
Jennie Friswell
Graeme Jeffs
Vicky Lorimer
Agenda Item
Owner
Welcome and introductions:
The Chair (RS) welcomed everyone to the meeting and reminded Board
Members that the January meeting had been cancelled.
The next meeting will be a Development Seminar and will focus on
Widening Participation and Bands 1-4.
2
Apologies:
Apologies were received from:
Julius Weinberg
Ron Kerr
Madeleine Long
John Isitt
Geraldine Walters
Madeleine Long
3
Adoption of previous minutes and review of action log:
Developing people
for health and
healthcare
The Local Education and Training Board for South London
www.southlondon.hee.nhs.uk
info@southlondon.hee.nhs.uk
The board agreed the minutes of meeting on 21 October.
4
Matters arising (not appearing elsewhere on the agenda)
Action 110 – Foundation Training - AF reported that meetings are
underway and that HESL have invested in a community post and have
received some really exciting bids. An update on Broadening Foundation
will be given at the March Board meeting
5
Declarations of Interest:
No conflicts of interest were declared.
6
Directors update:
Aurea Jones (AJ) went through her report and asked the Board to note the
updates given.
The Q3 Performance report was presented and AJ was quite confident that
HESL will meet its apprenticeship target. Next year’s target will be
challenging as there is a big increase and we may have already flooded
our stakeholders with apprentices. However the LETB expertise sits within
HESL which is an advantage
There has been discussion around whether the staff retention target is
sensible for small organisations like LETBs, and Julie Screaton will
feedback this to HEE. As HESL is now working even closer with the other
LETBs in the geography the performance report will be amended in future
so its more uniform across the 4 LETBs.
AJ reported that the allocation of investment funds process was more
robust as a result of producing clear specifications and seeking proposals
against these. Confirmation of approval was given to proposals totaling
£1.65m, plus an additional £175k to fund Strategic Clinical Network
projects to be delivered within the same timeframe.
The Chair of the Investment Committee (Anne Greenough - AG) had
already recommended the investment outcomes to the Chair of the Board,
who approved under Chair’s action to enable maximum delivery of benefits
in-year. All applicants have been informed of the decisions regarding their
proposals and the majority of funding would be distributed through the LDA
in Q4.
Of the £5.3m of available funding previously notified to the Board, the
remaining £3.5m was agreed to be distributed as additional CPPD funding
for 2014/15.
AJ gave an update on the Beyond Transition Programme and reported that
the structure submitted for HESL would deliver the 20% running cost
savings but would not incur any redundancies if implemented. Existing
staff will only be affected by a change in either their line management or
Developing people
for health and
healthcare
job content.
The biggest issue relating to BT currently is the pressure on finance
support staff due to the vacancy freeze. Turnover is really starting to bite,
as vacancies are now approaching 50% of establishment. Peter Holt
(Geographic HoF) has obtained agreement from Steve Clarke (HEE
Finance Director) that agency staff can be brought in as the situation is not
sustainable.
Consultation ends on 9 January 2015 and a final decision is due later in
January, when LETBs can then begin to implement their new structures.
Decision:
The Board agreed to the proposed amendment to the HESL Board Terms
of Reference
7
Health Education South London Finance update
Martin Livesey (ML) presented HESL’s month 8 financial position reporting
an underspend of £1.6m (0.6%) against year to date budget. The majority
of this underspend is attributed to Student support which has been
reflected in the year to date position for the first time this month.
ML informed the board of budget movements since the last finance report,
and explained that these had been expected and therefore wouldn’t affect
the forecast out-turn as they had been anticipated when planning 2014/15.
HESL’s current expectation is that no significant change to the allocation
methodology for Future Workforce funding will be implemented before
2016/17. Despite this however, and as previously discussed with the
Board, there remains a significant risk to education funding and activity in
London, should changes to the current approach to resource distribution be
eventually implemented along the lines previously proposed.
ML reported a pan London counting issue around commissions which has
resulted in a further potential underspend in HESL of around £4m (c £10m
in total across London). This is disappointing as a lot of effort has been put
in to improve the system. The reasons behind this discrepancy will
however, be investigated to avoid a similar issue arising again in the future.
This additional contingency will be discussed at the January meeting of the
Investment Committee. It was agreed a Chairs action could be used again
to ensure a swift decision can be made.
The board noted the contents of the report.
8
Health Education South London Workforce Education Plan:
Aurea Jones (AJ) introduced Jennie Friswell (JF) who had pulled together
all the learning from this year’s workforce planning round.
It is a requirement of HEE that all LETBs publish a local Workforce &
Developing people
for health and
healthcare
Education plan. JF informed the Board that the plan presented is the local
plan to support the HEE National Plan for England. The plan is in final draft
and it is expected that there will not be any major changes prior to
publication, but will need to reflect the tone of the national plan. Once
published the document will be sent out stakeholders engaged in the
workforce planning process and it will be available via the website
The plan contains information previously reported to the Board and JF
highlighted key issues.
There was a discussion about the medical workforce and concern was
raised regarding recruiting consultants in some areas. JF said that she
would follow up on the point raised and informed the Board that she will be
working with Andrew Frankel (AF) to look at the shape of the future
medical workforce and how this can help meet service needs.
Concerns were also raised regarding:
• The plan doesn’t reflect the community sector properly. JF
responded by updating Board Members that HEE were starting a
piece of work to get accurate community numbers and that HESL
would start to look at non NHS services too so future plans are
better informed.
• The modeling is based on existing models of care rather than new.
JF reported that HESL have been part of the national Workforce
Information Architecture (WIA) project to develop a minimum dataset for
primary care. Health Education Yorkshire & Humber have developed a tool
that can support practices in completing the census return. Some
practices have been piloting the tool – including those in Richmond. HESL
will work with CEPNs to support GP practices with completing the return.
Theodora Kalentzi (TK) reported that she had received some worrying
responses from practices regarding the data that is being requested. JF
noted the concerns raised.
JF concluded by highlighting new innovation in the plan:
• Commissioning advanced practitioners ourselves
• Physician Associates – commissioning and increasing numbers
across London to deliver service change
• Plan to look at the shape of the medical workforce we need in the
future
• Primary care – HESL need to work with CEPNs to develop their
capability to workforce plan
AF felt it was important that HESL skills itself and it’s stakeholders in
modern workforce planning and works as a team combining both medical
and non-medical teams.
The Chair thanked the Board for a very interesting discussion.
Developing people
for health and
healthcare
Action:
Follow up on point raised by GK on difficulty with recruiting consultants in
some areas.
Jennie Friswell
Decision:
The Board approved the Workforce Education Plan and acknowledged
there may be some minor amendments prior to publication
9
Health Education South London Workforce Delivery Plan 2015/16:
Graeme Jeffs (GJ) led the discussion and set out the context of the plan,
the proposed timeline and asked the board if there were any omissions that
needed rectifying.
The Board discussed the Plan ‘on a page’ which gave high areas of
content and suggested the following amendments:
• To change the CEPN bullet to read “Enable” instead of “Utilise”
• Expand the point about working with CCGS
• Amend the point about the five year forward view to explain that if
implemented would require significant workforce change
• Need to talk more about pathways, integrated care and new models
of care
• Make a direct reference to apprenticeships as such a key mandate
requirement
• Include a point about Enabling technologies and promoting selfmanagement - educating patients/public in self-management and
also healthcare professionals to educate the patients
The Chair thanked Board members for the useful discussion and said it
would be important to keep in touch with CCGs and providers and both
lead and keep abreast of the discussions taking place.
Actions:
Make amendments as suggested by the Board
10
Graeme Jeffs
Multi-Professional Quality Committee (MPQC) Report:
Diana Hamilton-Fairley (DHF) thanked Gabrielle Kingsley (GK) for chairing
the MPQC for the last year and Vicky Lorimer (VL) for writing the report for
presentation to the Board.
DHF went through the key points of the report.
The GMC Biannual return was submitted on time and the data provided in
the report is fully available on the GMC website so nothing was redacted.
Some Board members felt that the information published isn’t very clear
and that they should be encouraged to review what they publish. The
return reflects the changes in SE London where the initial turbulence is
settling down.
Developing people
for health and
healthcare
The Chair thanked DHF for all her work as the HESL SRO on the
Committee. He advised Board members that a new SRO would take over
in the new year, but. DHF would stay on with HESL in a clinical advisor
role.
11
Health Education South London Board Assurance Framework (BAF):
Rima Makarem (RM) presented the latest HESL Board Assurance
Framework for the Board to note. The Risk Assurance Committee (RAC)
reviewed and challenged the full risk register at their November meeting
and were assured that the risk management process is embedded and
working well.
All the risks contained in the BAF had previously been reported to the
Board and continue to be managed.
AJ explained that HESL45 on Beyond Transition was red post mitigation
due to the issue with finance staff vacancies but was hoping to lower this
score shortly once agency staff have been brought in to help relieve the
problem.
AF reported that the Oriel hadn’t been as big a problem as had anticipated
due to the hard work of the Operations department.
It was suggested that there may be some risks coming out of the London
Health Commission report and the NHS Five Year Forward View for HESL
and that the Senior Leadership Team/RAC should discuss this and identify
any possible risks.
AOB
There was no other business.
Developing people
for health and
healthcare
Minutes of the meeting of the Governing Body held on
13 January 2015
Meeting Date
17 March 2015
Report Title
Minutes of the meeting of the Governing Body held on 13 January 2015
Paper Number
Paper B
Report Author
Head of Strategy and Corporate Services
Lead Director
LETB Director South West
Report Summary
Purpose
Decision
Approval

Information

Assurance

Recommendation
Objectives
supported
Mandate
Workforce Skills
and Development
Strategy
Education
Outcomes
Framework
Enabler

Resource
Assessment
Quality Impact
Assessment
The impact assessment showed that this policy had a neutral effect on each
of the equality strands.
The Local Education and Training Board for the South West
Developing people
for health and
healthcare
www.southwest.hee.nhs.uk
Part 1
1.
Present
Jane Barrie
Ann James
Stephen Waite
Robert Woolley
Mark Sanford-Wood
Lee Salkeld
Janice Kay
Sally Taylor
Jill Crook
Ken Wenman
Derek Sprague
Chair, Health Education South West (HESW)
Chief Executive, Plymouth Hospitals NHS Trust
Chief Executive, Plymouth Community Healthcare Community
Interest Company
Chief Executive, University Hospitals Bristol NHS
Foundation Trust
General Practitioner and Member of Devon Local Medical
Committee
General Practitioner and member of Avon Local medical
Committee
Deputy Vice-Chancellor, University of Exeter
Chief Executive, St Luke’s Hospice
Director of Nursing and Quality, NHS England
Chief Executive, South Western Ambulance Service NHS
Foundation Trust
LETB Director South West
In Attendance:
Colin McInnes
Clare Hines
Deborah Evans
Martin Beaman
Jonathan Cramp
Clare Chivers
Hannah Darley
Suzie Potter
Head of Finance and Business Intelligence, HESW
Head of Strategy and Corporate Affairs, Health Education
South West
Managing Director, West of England Academic Health
Science Network
Postgraduate Dean, HESW
Communications Manager, HESW
Deputy Director of Education and Quality
Communications Assistant, HESW
Secretary, HESW
Apologies:
Becky Pollard
Martin Jones
Clare Steel
Shaun Clee
Renny Leach
Debi Carpanini
Christina Quinn
Director of Public Health, North Somerset County Council
General Practitioner Chair of Bristol Clinical Commissioning
Group
Director of Adult Social Services, Somerset County Council
Chief Executive, 2Gether NHS Foundation Trust
Managing Director, South West Academic Health Science
Network
Head of Performance, HESW
Head of Leadership Development, NHS South West Leadership
Academy
2.
Introduction
2.1
The Chair welcomed the Governing Body to the meeting.
Page 2 of 13
Very Best Care – Excellent Training & Development
2.2
Clare Chivers, Deputy Director of Education and Quality, attended her first
meeting.
2.3
Hannah Darley, Communications Assistant supporting Jonathan Cramp,
Communications Manager, attended the meeting as part of her ongoing
development.
2.4
No members of the public were in attendance. Apologies were noted.
3.
Declaration of Interests
3.1
There were no new declarations of interest.
3.2
Ann James informed the Governing Body that she was no longer a Trustee of
Exeter Royal Academy for Deaf Education.
3.3
It was agreed that Deborah Evans, Managing Director, West of England
Academic Health Science Network and Renny Leach, Managing Director, South
West Academic Health Science Network would be included on the Register.
Action: Head of Strategy & Corporate Services
3.4
The updated Register of Interests was received and noted.
4.
Minutes of the 14 October 2014 Governing Body meeting
4.1
The minutes were agreed as a true and accurate record.
5.
Actions and Matters arising from the Governing Body meeting
on 14 October 2014
5.1
Item 6.15; members of the national Genomics team will be attending a future
Governing Body meeting as part of the national remit to ensure Local Education
and Training Boards are educated and informed.
5.2
Item 7.12; Beyond Transition has taken more time than had been anticipated
resulting in continuing activity on the Workforce Skills and Development
Strategy. This will be on the Agenda for the Governing Body meeting on 17
March 2015.
5.3
All other matters arising from the meeting on 14 October 2014 have been
completed.
5.4
The matters arising from the Action Log were all noted.
6.
Report from the Independent Chair and LETB Director South
West
Beyond Transition
6.1
Phase 1 concluded on 7 November 2014. Phase 2 consultation started on 19
November 2014 and the 45-day consultation period ended on 9 January 2015.
Page 3 of 13
HEE’s Board will meet to review the consultation outcomes on 27 January 2015
and publish a formal response on 29 January 2015.
6.2
Full details of any establishment changes will be shared at the next Governing
Body meeting.
HEE mandate Incubator Programme (national) Dementia Awareness
Training
6.3
There was a significant increase in the number of NHS staff receiving Dementia
training. The HESW LETB year-end target of 29,777 was exceeded in Quarter 2
with the total number of staff trained standing at 59,983.
6.4
As part of the HEE Mandate objectives, the aim is that by September 2015, all
undergraduate and pre-registration courses for health and social care workers
includes training in dementia.
6.5
The Peninsula Collaboration for Leadership in Applied Health Research and
Care (PenCLAHRC) was commissioned by HESW to report on the existing
dementia education and curricula. As a result ten principles in dementia
education and their standards were developed. These will be aligned with the
Dementia Core Skills and Knowledge framework that is under development.
6.6
Janice Kay raised the query as to who owned the intellectual property relating to
Dementia education materials.
The response was that the national dementia e-learning course is owned solely
by Health Education England (HEE). Learning4Health courses are owned by
Capita and Tribal. When the Capita contract ends March 2016 all health and
social care organisations will have free access to dementia e-learning courses
via HEE.
The NHS 5-year Forward View into Action: Planning for 2015/16
6.7
HESW is committed to its role in ensuring the success of the Forward View and
attendance at a planning conference on 21 January 2015 in Taunton has been
confirmed by the LETB Director South West and the Head of Strategy and
Corporate Affairs. HEE will be leading a Workforce Advisory Board; Simon
Stephens, Chief Executive, NHS England and Ian Cummings, Chief Executive,
Health Education England will be members.
Report from the Chair
6.8
The Chair informed the Governing Body that this would be Jill Crook’s final
meeting. She was thanked for her membership, attendance and input and good
wishes were passed to her on behalf of the Governing Body. It was confirmed
that Lindsey Scott, Director of Nursing, NHS England South West Regional
Team, had been nominated as a potential replacement. The Chair informed the
Governing Body that she would be meeting with Lindsey. Lindsey would join the
Governing Body at its March meeting.
6.9
The meeting was informed that the current dates of the Governing Body clash
with HEE Executive Team meetings and/or national Director of Education and
Page 4 of 13
Quality meetings, the consequence being that neither Paul Holmes, Regional
Director (South) nor John Clark, Director of Education and Quality (South) were
able to attend any of the meetings.
6.10
It was agreed that the arranged meetings for 2015 would remain in place, but
consideration would be given to possibly changing the days of the meetings in
June and October 2015.
Action: Secretary
6.11
The Chair attended a LETB Chairs’ meeting at Portland House in London
recently. She drew the Governing Body’s attention to the fact that with the
election taking place this year, HESW may be viewed as part of the civil service.
The Chair asked that if any approach was made to them as a member of the
HESW Governing Body regarding workforce issues, Una O’Brien, Permanent
Secretary at the Department of Health, should be informed.
6.12
As reported in the Governing Body minutes taken at the meeting on 14 October
2014, Steve Waite was nominated to sit on the HEEAG subject to sight of the
Terms of Reference. The Terms of Reference have not been received. The
Chairs are pursuing this.
Action: Chair
6.13
The Governing Body noted the report.
7.
Education and Quality Report
7.1
The Governing Body noted that this report had been discussed in detail at the
Quality Improvement Committee (QIC) 3 December 2014.
Community and Primary Care Workforce Strategy
7.2
Recruitment to GP Expansion numbers in the south west did not fill completely in
2014 and, although compared with the national position HESW did well, there
are still a number of vacant places.
7.3
Phase 2 will need to remain flexible and responsive to service commissioners.
There is a need to create education opportunities for inter-professional staff
development to support the integration of the health and social care agenda.
Non-Medical Annual Education Contract Performance Management
meetings
7.4
The annual education contract performance management meetings with
universities holding contracts with HEE took place in September 2014. Following
the meetings, each Higher Education Institute (HEI) had a series of actions to
complete.
7.5
It was agreed that the Quality Improvement Committee (QIC) will receive
exception reports following education contract performance monitoring activity
and decide if further actions or information was required.
Page 5 of 13
Practice Placement Quality Strategy
7.6
It was noted that there is a large number of high quality practice placements and
that plans have been developed to move this forward into 2015.
7.7
Through engagement with Membership Councils, it was agreed that there was a
need to develop an open and transparent way of working between HESW,
practice placements and education providers to further develop the activities
which support the implementation of the working principles.
7.8
The Deputy Director of Education and Quality is continuing to work with Directors
of Nursing to finalise the strategy. The intention is to achieve sign off on 20
March 2015.
Acute and Urgent Care Education Tender
7.9
To achieve year-on-year acute and urgent care workforce development and in
order to respond to the changing needs of patients, HESW has commenced an
education tender exercise for Advanced Healthcare workforce development.
Delivery will commence in April 2015.
Postgraduate Medical Education (PGME) Quality Framework
7.10
HESW has a duty to quality-manage PGME within its footprint and has been
working towards the harmonisation of management and processes. A joint
Quality Framework is being planned and will be shared with the Governing Body
on completion.
Quality Advisory Board
7.11
A joint HESW Quality Advisory Board (QAB) has been established which covers
both Severn and Peninsula PGMEs. There is non-medical representation on the
Board to help support the alignment of medical/non-medical activities in the
future. It is intended that dentistry will be included and Jane Luker, Postgraduate
Dental Dean, will be invited to attend.
7.12
The QAB is one of the key central initiatives which will help progress and drive
forward the wide range of harmonisation activities taking place across the quality
management function of HESW.
7.13
The meetings will take place twice a year and will include representation from
both PGME centres. John Clark, Director of Education and Quality (South) has
been invited to attend future QAB meetings.
GMC visits
7.14
The GMC planned a number of visits to local education providers (LEPs) across
the UK to consider undermining and bullying in surgery and obstetrics.
7.15
Plymouth Hospitals NHS Trust and Northern Devon Healthcare NHS Trust were
visited. No cases of bullying or undermining were noted on either site in the
departments visited.
Page 6 of 13
7.16
The query was raised as to the criteria used and the reason these two hospitals
were selected for a visit.
The response was that the GMC was working on trainee feedback from their
survey and that this was perhaps a benchmarking exercise, the result of which
was that nationally general surgery and obstetrics ‘stood out’ and 12 Trusts were
selected randomly for ‘spot-checking’.
Cardiology Triggered Visit: Severn Postgraduate Medical Education
7.17
Significant concerns were raised with regard to the quality of the cardiology
programme across Severn PGME, identified through trainee feedback, quality
panel reports and the GMC National Trainee Survey (NTS) which has reported
issues across a number of years. The Cardiology Programme is currently rated
Amber on Severn’s Quality Register.
7.18
Two representatives from the Cardiology Specialist Advisory Committee were
invited to attend a comprehensive Triggered Visit at Severn PGME on 21
November 2014 to review training across Acute Trusts and agree an action plan
with the aim of improving the quality of the programme. A number of trainees
were invited to give their views at the meeting.
7.19
The findings were published on 17 December 2014 and the issues relating to the
individual Trusts addressed. Clear action plans have been put in place and it
was noted that HESW is the only LETB with no enhanced monitoring.
7.20
The Cardiology programme and each of the six training sites have been asked to
provide a progress report by 30 January 2015.
2014/15 Contract meetings
7.21
HESW undertakes Annual and Interim Contract meetings with each Local
Education Provider (LEP) to ensure that the GMC’s standards and requirements
are being met and to promote quality improvements within the LEP and training
programmes.
7.22
The purpose is to establish that satisfactory progress is being made with the
relevant Quality Register and that a suitable way forward is put in place to
resolve any identified areas of concern and share good practice locally and
nationally.
7.23
The Chair of the Quality Improvement Committee (QIC) informed the Governing
Body that these were discussed in detail at the QIC meetings.
7.24
The query was raised as to whether quality processes described referred solely
to postgraduates.
The response was that it aligned postgraduate medical and non-medical
undergraduate placements. Links to assess the quality of undergraduate medical
placements were not available in the same way. This could be considered by the
Education Expert Reference group.
7.25
Page 7 of 13
8.
Innovation Fund 2014/15 Update
8.1
The paper provided an update for the Governing Body on the identification and
award of innovation funds for service-led activities in 2014/15.
8.2
A total of 68 proposals were submitted and evaluated in September 2014 by 18
members from across service disciplines in the South West. 19 successful
proposals have been awarded funding and activity commenced.
8.3
The query was raised as to what criteria had been used to assess proposals.
The response was that for 2014 this was set locally by the Membership Councils;
In 2015 the expectation is that HESW would build on the successes, but also be
more focussed on longer term sustainable outcomes. It was also important not to
lose the links across to innovation activity supported by partner organisations
such as the Academic Health Science Networks.
8.4
A query was raised as to how the benefits and learning from the successful
proposals would be shared and embedded.
The response was that each project provides quarterly reports and that the
sharing of knowledge is important. Progress reports on all funded proposals will
be presented at Membership Councils, but it was noted that projects have only
recently commenced. The intention is to ensure that there is a learning event
later in the year to help ensure future activity builds on successes, as long term
sustainability of benefits is key.
8.5
It was agreed that large scale collaborative projects that would demonstrate
sustainable innovation across the South West should be encouraged rather than
many smaller, sometimes niche projects that may not be scalable or
transferrable. This will be emphasised in guidance sent to prospective
applicants.
8.6
9.
HESW Finance Report Month 8
9.1
Colin McInnes presented the finance report as at 30 November 2014. This
showed that the allocation had increased by £1 million since the previous
meeting of the Governing Body. The programme budget is now £331.9 million
for the year, with an under-spend to date of £197,000 and a forecast outturn of
breakeven.
9.2
For the running costs budget of £4.547 million, there is a £200,000 underspend
to date and a forecast outturn of £298,000 underspend. This latter underspend
will contribute to Health Education England’s costs for Beyond Transition.
9.3
Colin McInnes informed the Governing Body that since the previous meeting in
October 2014 there had been slippage on some items in the programme and
requested that the Governing Body provide strategic direction on the priorities in
Page 8 of 13
which it would like to invest, bearing in mind that the year-end was less than
three months away. The savings identified were around £2-3 million.
9.4
A number of priorities for activity already identified were shared and discussed
and the Governing Body asked for their priorities to support workforce
transformation. Clare Hines was asked to develop a proposal which would be
circulated electronically for agreement by the Governing Body.
9.5
10.
HESW Annual Business Plan 2015/16 – Update
10.1
The Governing Body was given a final update on the development of the Annual
Business Plan (ABP) 2015/16 prior to sign off in March 2015. There had been a
good level of feedback from Trusts and no changes to the recommendations for
non-medical education commissions already presented made.
10.2
It was noted that paramedic workforce supply is gaining increased interest
nationally, though not currently commissioned by HESW. The Governing Body
was informed that should HESW move to commission directly, this will be a cost
pressure and may need to be included in the 2016/17 plans.
10.3
The query was raised as to how we balance the budgets when we have to
consider Health Education Wessex (HEW) and Health Education Thames Valley
(HETV) being part of the Southern footprint.
The response was that the programme budgets are individual to the LETBs and
that HESW has its own budget and is not dependent upon how HETV and HEW
allocate their budgets.
10.4
It was requested that the ABP 2015/16 also include proposed activity that could
be funded from in-year slippage should it occur.
10.5
The Governing Body noted the confirmation of the education commissions;
potential adjustments to the medical and dental trainee numbers; and the
potential plans for consideration upon confirmation of the final HEE allocation
should they be required.
11.
Integrated performance Report 2014/15 Q2
11.1
In the absence of the Head of Performance, the Head of Finance (South) spoke
to the report.
11.2
The paper provided the report for Quarter 2 of the Integrated Performance
Framework based on the national developments and the information currently
measured and available in HESW. It outlined a high level summary of progress
made against each key deliverable and related activity and stated how HESW
will monitor and measure progress to drive forward continued improvements.
Page 9 of 13
11.3
Areas of concern and potential risks to the delivery of key operational and
strategic objectives were addressed and remedial action plans put in place to
mitigate the likelihood and/or impact in the form of an exception report.
11.4
It was noted that the report was retrospective as it was Q2 and that perhaps in
future a verbal update or tabled paper could be brought to the meeting to ‘bridge
the gap’ between the end of the quarter and the meetings.
It was agreed that consideration would be given as to how this could be
provided.
Action: Head of Performance
11.5
It was noted that HESW had already been considering the spacing of Governing
Body meetings and that from January 2016 onwards these may be adjusted to
provide better alignment to key dates in the business cycle whilst also providing
sufficient time between meetings. An update will be provided at the March
meeting.
11.6
It was noted that the Integrated Health and Social Care Stakeholder Accelerated
Solutions Event which had been discussed with CapGemini and the South
Devon and Torbay Clinical Workforce Redesign Team to develop the vision for
integrated care in the south west had been overtaken by Beyond Transition and
the business case not supported. Current work is developing a wider approach to
the Integration agenda including Integrated Personal Commissioning.
11.7
It was suggested that in future, rather than looking externally, it would be
preferable to look internally and use our own teams to set up events.
11.8
The Governing Body noted the current position for 2014/15 financial Quarter 2
and the exception reports and relevant actions to return performance back on
track against plan.
12.
Board Summary of the meeting of the Quality Improvement
Committee
12.1
The Chair of the Quality Improvement committee gave a brief summary of the
meeting held on 3 December 2014 and it was noted that the Terms of Reference
had been changed to include the Dental Training representative.
12.2
Particular attention was drawn to a discussion regarding the two models of the
Learning and Development Agreement (LDA) which had been developed. It is
hoped that these will be signed by the end of March 2015.
12.3
The Governing Body noted the QIC summary.
Page 10 of 13
13.
Constitution of Health Education South West - 2015
13.1
The Head of Strategy & Corporate Affairs had been asked to update the HESW
Constitution to reflect infrastructure changes and any other new developments
which impacted on the Constitution.
13.2
The revised Constitution reflected:
13.2.1 the changes to the Governing Body created by the HEE Beyond
Transition organisational change programme;
13.2.2 inclusion of the position of Vice Chair;
13.2.3 agreements from the Stakeholder Engagement Strategy which affect the
Constitution – new advisory body.
13.3
Final amendments were agreed and the final update version of the Constitution
to be presented to the March Governing Body meeting for sign off. It was agreed
that a summary of changes would be included.
Action: Head of Strategy & Corporate Affairs
14.
HESW Risk Register – Month 8
14.1
The paper provided the Governing body with the 2014/15 Month 8 Risk Register.
This was approved by the Quality Improvement Committee on 3 December
2014.
14.2
There have been no new risks or significant changes in current risks since the
October meeting. There remain two risks on the Organisational Risk register.
These are:
14.2.1 Business Objectives is an Amber risk. This replaces and updates this risk
to reflect the new position due to Beyond Transition. The issue is the
ability to deliver business and services during the consultation process
due to the impact of central vacancy controls, the risk of low morale and
increased absences.
14.2.2 Adult nursing workforce is an Amber risk as demand is outstripping supply
for the registered adult nursing workforce in the South West.
14.3
It has been agreed that an additional paper would be tabled if there were
significant changes since the QIC meeting but there were none to report.
14.4
The query was raised as to how far we are capturing operational versus strategic
risks, were we keeping sight of these.
The operational process issues are tracked in the Assurance Framework – this
had not recently been updated as the new processes which would be in place
after Beyond Transition were not yet known. It was agreed that the Assurance
Framework would in future be presented alongside the Risk Register.
Action: Head of Strategy & Corporate Affairs
Page 11 of 13
14.5
The Governing Body noted the Month 8 risk Register.
15.
South West Peninsula Membership Council meeting
15.1
Steve Waite Chaired this meeting for Ann James’ in her absence. He provided a
short report to the Governing Body outlining items discussed, areas to note and
actions agreed.
15.2
Attention was drawn to the issue that Occupational Therapy and Physiotherapy
leaders in community services would contact Ian Bramley to ensure out of
Hospital leadership for therapy was included.
15.3
16.
West of England Membership Council meeting
16.1
A short summary report was presented to the Governing Body outlining items
discussed, areas to note and actions agreed.
16.2
A key item discussed at the Membership Council was Workforce Transformation.
Discussions included:
•
Boundary issues for Healthcare professions
•
Health & Social Care Coordinator for all the agencies and professions that
need to look after the Frail or complex/long terms needs patients.
•
Engaging the RCN and other professional bodies on the required culture
change.
•
A generic role which encompasses physical, mental and social health.
•
Introduction of a common foundation course to support the development of a
multi-professional role that understood all processes.
16.3
17.
Education Expert Reference Group 9 December 2014
17.1
The Chair of the Education Expert Reference Group provided the Governing
Body with a short report on the above meeting outlining items discussed; areas
to note and actions agreed.
17.2
A key discussion item had been placement quality. Clarity was still required
regarding drivers for change to current placement processes. This would be
discussed again at future EERG meetings.
17.3
18.
Any Other Business
18.1
The item listed under Any Other Business regarding Intellectual Property has
been conjoined to Dementia and can be seen at Paragraph: 6.6.
Page 12 of 13
18.2
There being no further business, Part 1 of the meeting was closed.
19.
Next meeting of the Governing Body
19.1
The next meeting of the Governing Body will take place on Tuesday 17 March
2015 starting at 1000 hrs and finishing at 1300 hrs. The venue will be: Meeting
Rooms 1 and 2 at South West House, Blackbrook Park Avenue, Taunton,
Somerset TA1 2PX. The meeting will be open to the public.
Page 13 of 13
Draft Minutes of the Health Education Thames Valley Board Meeting
Thursday 22 January 2015 10.00-12.30
Thames Valley House, Oxford Business Park
Members:
John Caldwell
Pauline Brown
Peter Sullivan
Mark Power
Michael Bannon
Carol Trower
Will Hancock
June Girvin
Jan Fowler
Ogechi Emeadi
Julian Emms
John Rawlinson
Chair, Health Education Thames Valley
Local Director, Health Education Thames Valley
Oxford University Medical School
Director of OD & Workforce, Oxford University Hospitals NHS Trust
Postgraduate Dean, Health Education Thames Valley
Primary Care Representative
Chief Executive, South Central Ambulance Service NHS FT
Chair, Expert Education Reference Group
Local Area Team representative
Director of Workforce, Milton Keynes Hospital NHS FT
Chief Executive, Berkshire Healthcare NHS FT
GP representative
Attendees:
Colin McInnes
Caroline Chipperfield
Chris Fisher
Abigail Changer
Tim Wiseman
Zoe Scullard
Ros Alstead
Angela Baker
Gillian Lee
Gary Ford
Felicity Hargreaves
Sam Donohue
Gemma Brown
Jan Zietara
Head of Finance, HEE South
Director, Thames Valley and Wessex Leadership Academy
Independent Chair Assurance Committee
Corporate Governance Manager, Health Education Thames Valley (minutes)
Head of Communications and Stakeholder Engagement, HETV
Associate Dean for Interdisciplinary Education
Director of Nursing and Clinical Standards
Head of Health Improvement, Public Health England
Specialist Registrar shadowing Julian Emms
CEO Oxford AHSN
Quality Manager
Commissioning Manager
Quality Manager
Acting Head of Education Commissioning
Apologies:
Stuart Bell
Mark Warner
Geeta Menon
Alistair Flowerdew
Adrian Hayter
Alex Lewis
Val Messenger
Chief Executive, Oxford Health NHS FT
Director of Human Resources, Buckinghamshire Healthcare NHS Trust
Director of Clinical Education, Frimley Park
Medical Director, Royal Berkshire Hospital NHS Foundation Trust
CCG representative, Clinical Leader and Chair of Governing Body, Windsor
and Maidenhead
Medical Director, Central North West London NHS Trust - Milton Keynes
Deputy Director of Public Health, Oxfordshire County Council
Agenda Item
Discussion points
1. Chair welcome
and apologies
J Caldwell welcomed those present and the deputies for usual HETV
board members.
Apologies were noted as above.
Nil declared for the items on the agenda at the meeting.
2. Declarations of
interest
Actions
3. Minutes of the
last meeting
4. Action Tracker
5. Matters Arising
6 i. Chair’s
Update
The minutes were agreed as an accurate record of the meeting held on
20 November 2014.
P Brown reported the following against the items on the action tracker:
• Ogechi Emeadi had agreed to take up the role of board sponsor
for midwifery which was positive news
• Board seminar: Stuart Bell would be giving a talk on the Five
Year Forward View which would help the board think about
priorities and opportunities in terms of future workforce.
• GP return to practice numbers: for 2015/16 HETV had
identified £300k funding for six GP returners with the aim of
reviewing at month 6 to see if funding could be identified for a
further six returners.
• Finance and Performance report: a ‘new look’ performance
report was being developed for the next board meeting which
will endeavour to deliver a more systematic approach to
performance monitoring and management.
J Girvin made a point of correction: she had not had input into the
Physician Associate paper as stated. P Brown apologised for the error
and acknowledged that J Girvin’s input would be vital as this piece of
work moved forward.
J Caldwell reported on his engagement meetings with various groups of
stakeholders around Thames Valley. He highlighted his attendance at
the recent Collaboration for Leadership in Applied Health Research and
Care (CLAHRC) event and a multiprofessional Management in
Medicine seminar at Greens Templeton College, Oxford University.
It was also noted that he had attended the NHS Chairs meeting earlier
in the week at which Simon Stevens and Sir Keith Pearson had spoken.
The key points included the need to ensure patient engagement and
involvement in our work and a fresh emphasis on recruitment, retention
and reducing attrition. There had been mention of introducing a
commitment from learners to staying in NHS employment for a period of
time. The Five Year Forward Plan had also been discussed and the
need to ensure the linkage between service redesign and job redesign.
P Brown presented the Beyond Transition update. She also highlighted
ii. Local Director’s the following:
update
• Workforce planning: HEE had issued their second Workforce
Plan for England. The plan highlights immediate workforce
pressures and sets out the actions being taken to support
further transformation. There was recognition of the significant
issues in the paramedic workforce.
• Five Year Forward View (5YFV): P Brown had been on a series
of engagement meetings with commissioners and CEOs to
discuss how best to support the 5YFV. The next board seminar
would focus on this topic and would include a talk from Stuart
Bell followed by a debate on the perspective that Stuart gives.
• There had been several expressions of interest locally for the
national Emergency Department pharmacy pilot.
• HETV were working to align the Local Delivery Plan to the
refreshed HEE Business Plan and Mandate and intended to
work with the board over the coming months to identify
investment priorities.
Items for discussion/decision
7. Learner Voice
F Hargreaves presented the update. Hearing and acting on the learner
update
voice was identified in 2013 as one of HETV board’s three key priorities.
A Task and Finish group was established across Thames Valley and
Wessex to take the workstream forward.
HETV Board Minutes 22 January 2015
Page 2 of 7
A pilot project was set up with core questions themed beneath six
priority areas with the aim of measuring quality of education in practice
and out of that a direct link with quality of patient care. Over 250
learners participated between March and August 2014 and provided
feedback on the pilot which helped to reduce the list of questions. Over
90% agreed that the questions measured the quality of their practice
learning.
The plan was to embed the Placement Evaluation Framework into
existing processes.
F Hargreaves set out the recommended next steps and requested
support in rolling out the process. It was noted that one of the
challenges was the existence of different IT systems to support the
process within organisations; this needed scoping.
Discussion took place about the importance of ensuring the feedback
loop was closed by providing feedback to both the learning
environments and the learners using a range of opportunities.
Other key areas picked up in the discussion included:
• The importance of this work as a key metric for HETV.
• The power of being able to prove that learners are listened to.
• How do we identify what good looks like in learning
environments?
• The work required with learners to ensure they give feedback
responsibly. The board noted the initiative of providing feedback
cards from learners to mentors and supervisors. It was
acknowledged that this may potentially alienate mentors.
• A multiprofessional view of learning environments was needed
and consideration should be given as to how this work could link
to the GMC trainee survey and NMC revalidation processes.
F Hargreaves reported that she would be circulating the initial pilot
evaluation report to stakeholders followed by a meeting in early March
to establish timelines for further developing and embedding the
approach. She would also link with C Chipperfield regarding how this
work would fit with the NHS Management Training Scheme.
The board agreed that it would be helpful to bring back an update on
progress to May board followed by a fuller report in September to
discuss the benefits of the approach, value added and its wider
implementation.
8. Talent for Care
and Widening
Participation
S Donohue presented the paper; it was noted that the board had
approved a Support Worker Strategy in June 2014. Since then there
had been the launch of the national strategies: Talent for Care (TfC)
and Widening Participation (WP). It was noted that it was fitting for
HETV to have a broader strategy as the WP strategy covered more
than just the support workforce.
The TfC Strategy included three categories:
Get in – this is where the WP strategy overlapped with the intent of
providing opportunities to people to start their career in a support role.
Get On – ensuring the workforce we have is competent to do the work
expected of them. The Care Certificate is integral to this; from April
2015 all staff who deliver direct patient care and are new to caring will
be expected to achieve it. A significant rise in the apprenticeships target
was expected next year.
Page 3 of 7
F
Hargreave
s
May 2015
Go Further –provision of opportunities for career progression.
There were some schools and colleges providing good choices for work
experience and outreach activities (Health Ambassadors etc) however
there was significant variation and a more cohesive approach was
needed. The Partnership Council meeting on 11 February would be
focussed on the WP theme; schools, colleges, HEIs, industry
representatives and all four Local Enterprise Partnerships had been
invited. Following the Partnership Council there would be further events
within the counties to establish what is already out there, existing
networks and how to best move forward.
It was noted that the Department of Health had released more money
for the WP strategy; for HEIs to look into WP and for schools to support
them. S Donohue also suggested that HETV could work with the Local
Enterprise Partnerships.
Discussion took place regarding the need to identify the barriers to
workplace placements so that they could be alleviated where possible
(e.g. DBS checks). It was also noted that there were some excellent
health technology developments to simulate workplaces such as dental
practices.
9. Physician
Associates
The board approved the strategy.
P Brown presented the paper which set out the background and
explored some of the options around the introduction of Physician
Associate roles in Thames Valley and how the role could be used to
support some of the workforce issues.
She highlighted the option of conversion of the existing workforce. The
paper also set out potential barriers around accountability, prescribing
and a lack of compulsory registration. Reading University had already
prepared a validated programme however this was not yet
commissioned and there were cost implications (outside tariff). The
paper set out a series of recommendations, the main one being the
setting up of an event to inform future strategic case.
Lengthy discussion took place regarding the paper with several board
members expressing opinions. The main points made were as follows:
• The role could provide the opportunity to free up junior doctors
for more diagnosis and management. Physician Associates
complement advanced nurse practitioner and junior doctor roles
and provide a level of stability within the workforce.
• Organisations that had introduced the role had seen substantial
improvements in standards and patient safety.
• Need to explore what could be done to upskill existing staff and
develop roles.
• Clarification needed as to how the role would be funded.
• Resistance to the idea of creating another professional grouping
which will require its own career progression. Need to consider
the problem to be addressed, options and alternative models,
skills and competencies required and then structure the
provision accordingly.
• Concern regarding the high banding of the posts.
• If other disciplines were used to fill the gaps this may create
further shortages. No strategic case for these roles.
J
The board agreed that a wider scoping event would be useful (with Anderson
engagement from Reading University) and some work around funding March
Page 4 of 7
2015
models.
Items for Approval
10. Assurance
C Fisher updated the board following the latest meeting of the
Committee Report Assurance Committee. He highlighted that all the red risks on the Board
including BAF
Assurance Framework had now been reduced to amber or green risks
as programmes of work had been managed. The HETV Senior
Leadership Team would be undertaking a full review of the risk register
in early February which would then be discussed at the February
Assurance Committee.
It was noted that presentations on IT and the website had been
received at the November Assurance Committee; the presentations
highlighted the challenge of local needs being met within the new
structure where many decisions would be made at a national level.
C Fisher outlined the situation that occurred with the deanery website
last summer which was resolved at the time but was potentially a risk to
reputation. The current platform was outdated and a new one was
needed. HETV’s website was critical to business and the importance of
pushing the ownership of content down into departments was
emphasised. Care was needed to ensure that the website management
was covered in the new structure.
C Fisher highlighted a need to influence the speed at which HETV could
influence the transfer from old to new technology.
J Caldwell noted the vulnerability with the website and agreed that
efforts should be made to push down on content ownership.
Board approved the report.
Items for Information/Noting
11. Beyond
P Brown highlighted the HETV response to HEE regarding Phase 2 of
Transition: Phase Beyond Transition. The final decisions regarding structures were due to
2 consultation
made at HEE’s board on 27 January. She highlighted that a strong
outcome
leadership team was now in place in the south and that the structure
enabled delivery. A six month evaluation of how the enabling functions
were serving the LETBs had been built into the process.
12. Finance
Report
C McInnes presented the finance report (providing the position as at the
end of November 2014); it was noted that the 2014/15 financial position
would be reported in more detail at the February Assurance Committee.
He thanked the HETV finance team for their support and efforts during
the challenging handover time.
J Girvin declared a conflict of interest for section 3.4.2 of the report.
C McInnes highlighted the £243k underspend within running costs
which would be handed back to HEE to assist with restructuring costs.
The underspend had been achieved as a result of the recruitment
freeze.
He reported that the forecast for year end was for a break even position
however there had been greater savings to date than expected and
there was potential underspend of approximately £800k in ‘special
projects’ in the investment plan. There were therefore some decisions
to take. The potential underspend included the PVI payments but not
the quality payments to HEIs.
One of the proposals for spending any slippage was for investment in
paramedic training (recosted to £450k).
Page 5 of 7
C McInnes proposed to board that the PVI payments and HEI quality
payments should be funded in order to achieve breakeven. He asked
for a steer from the board in terms of priorities if there was any spend
remaining.
J Girvin was then asked to leave the board room and a discussion then
followed about the HEI quality payments. It was noted that Thames
Valley and Wessex were the only LETBs to still be paying quality
payments to HEIs. He proposed that the payment should be made this
year but not in subsequent years. The board agreed this decision. J
Girvin was asked to return to the board room.
Discussion took place about the proposed investment into paramedic
training: W Hancock highlighted the acute shortage of paramedics
locally. There was a robust action in place between HETV and SCAS
and W Hancock was due to provide an update to board in March. Any
investment would be made on the understanding that there would be
clear outcomes.
It was agreed that an equitable and rigorous process needed to be in
place for investments and that better tracking was required. C Fisher
agreed that the Assurance Committee would undertake a deep dive into
the processes (value for money, allocation of investment etc).
13. Performance
Report
C McInnes asked the board to note the report however he highlighted
that the format of the report was being revised; a ‘dummy’ report in the
new format would be brought to the March meeting. C Fisher raised
concern that the issues flagged within the report were not accompanied
by sufficient narrative; for discussion at the February Assurance
Committee.
14. Workforce
Education and
Development
update
Z Scullard presented the update and highlighted the following:
• Dementia Tier 1 training targets were exceeded and HETV’s
aspirational target was now within reach. The huge amount of
work carried out within trusts to achieve this was recognised and
Will Hancock was thanked for his support as board sponsor.
• The Dementia Academic Action Group (DAAG) had published
their summary report highlighting the excellent practice in place
and areas for development. Phases 2 and 3 of the project
included evaluation of training and on site delivery of training.
• Older people and End of Life Care: a consultation exercise took
place in the summer including a stocktake of courses. As a
result of consultation some course content would be
strengthened, some additional content and new courses
developed. Courses for bands 1-4 were especially called for and
also courses on communication within End of Life Care. Once it
was known how trusts wanted to address recommendations
then HETV would look at how best to support.
• HETV was in the process of recruiting to a Clinical Fellow for
End of Life Care.
15. Academic
Health Science
Network update
G Ford presented an update on the work underway and planned within
the Oxford AHSN. He highlighted their investment in a number of
clinical networks, their engagement with Emergency Care departments
looking for ways to improve the four hour wait and their excellent
partnership working with HETV in a number of areas (for example the
Patient Safety Academy).
Page 6 of 7
Discussion took place regarding whether it would be worthwhile to
evaluate training implications for the innovations. The board noted that
a key issue for the AHSN was their relationship with commissioners;
efforts were being made to engage. The NHS England review of the
NHS improvement architecture was also noted and potential impact on
the AHSN. The board noted G Ford’s presentation and thanked him for
attending to provide it.
16. GMC visit
update
M Bannon presented the report and highlighted that the GMC had
commended HETV on the preparation for and openness during the visit
and the use of an engaged board sponsor. The draft report would be
sent to HETV during the week beginning 26 January. The initial
feedback did not highlight any serious concerns however there would
be improvement actions identified in the report. Issues that had already
been raised included job planning and educational supervision.
C Trower, board sponsor for the GMC visit, commented that the visit
meeting with the GMC had been a very open one and the visit team had
been very appreciative of the work the team had done in preparation for
the visit; this was acknowledged by the board.
17. Final
Education
Commissioning
and Training Plan
(ECAT)
P Brown presented the final version of the ECAT. She highlighted that
the launch of the workforce network had been very positive. The
planning process would start even earlier this year and funding was
being identified to undertake some of the workforce transformation
pieces. It was noted that upskilling existing staff was key.
18. Values Based
Recruitment
update
J Emms, board sponsor for VBR, presented the update and highlighted
that the priority and focus of work was on compliance with the national
VBR framework by March 15. He reported that the majority of the HEIs
were compliant as at the end of November with 25% yet to achieve
compliance. The HEIs yet to achieve compliance were adjusting
recruitment processes and there was confidence that compliance would
be achieved by the deadline.
He also encouraged engagement with the Community of Practice and
Development Network for VBR and Employment. C Chipperfield
commented that organisations had been open to supporting this area of
work with the Leadership Academy and Talentworks. Their focus
during 2015/16 would be on spreading and adoption of best practice.
19. Thames Valley
and Wessex
Leadership
Academy update
20. Board
Forward Plan
Any Other
Business
C Chipperfield asked board to note the update. She highlighted that the
responses to the reviews into the Leadership Academy (LA) had been
taken to the LA Board the previous week. She thanked those who had
contributed to the reviews and was pleased to report that hosting
arrangements (i.e. hosting by HETV) would be remaining the same with
the second choice of arrangement being hosted by a Foundation Trust.
The plan was noted.
Nil
Date of Next Meeting: 26 March 2015 10.00-12.30
Page 7 of 7
HEYH Jan 15.01
MINUTES of the MEETING of the BOARD of
HEALTH EDUCATION YORKSHIRE and the HUMBER
Held on 22 January 2015 at the National Coal Mining Museum, Wakefield
Present:
Kathryn Riddle
Mike Curtis
Chris Bain
Steve Ball
David Brown
Karen Bryan
Chris Butler
Shirley Congdon
Linda Crofts
Pam Dawson
Stuart Haines
Philip Marshall
Tony Weetman
David Wilkinson
In attendance:
Jonathan Brown
Ged Byrne
Jo Dally
Amanda Fisher
Andrew Gibson
Rebecca Smith
Kathryn Winterburn
Independent Chair
LETB Director, HEYH
Chief Executive, Rotherham, Doncaster and South Humber
NHS FT
GP Representative (South Yorkshire)
GP Representative (West Yorkshire)
Pro Vice-Chancellor, Faculty of Health and Wellbeing,
Sheffield Hallam University
Chief Executive, Leeds Partnership NHS FT
Pro Vice-Chancellor Learning and Teaching, Dean of School
of Health Studies, University of Bradford
Head of Learning and Development, Sheffield Teaching
Hospitals NHS FT (for Sir Andrew Cash)
Dean of Faculty of Health & Life Sciences, York St John
University
General Manager, Leeds Teaching Hospitals (for Yvette
Oade)
Director of Workforce and OD, Harrogate and District NHS FT
Pro-Vice Chancellor for Medicine, University of Sheffield
Postgraduate Dean, HEYH
Associate Director – Strategic Workforce Planning, HEYH
Director of Education and Quality for North
Corporate Governance Manager, HEYH (Secretary)
Education Commissioning Lead, HEYH
Dep. Medical Director, Sheffield Teaching Hospitals NHS FT
Head of Engagement, NHS Employers
Head of Leadership & Organisation Development, HEYH
Apologies:
Sue Cannon
Sir Andrew Cash
Juliette Greenwood
Julian Hartley
Sue Holden
Mike Holmes
Clive Kay
Chris Long
Yvette Oade
Steve Walmsley
Director of Nursing, NHS West and South Yorkshire and
Bassetlaw CSU
Chief Executive, Sheffield Teaching Hospitals NHS FT
Chief Nurse, Rotherham NHS Foundation Trust
Chief Executive, Leeds Teaching Hospitals NHS Trust
Director of Corporate Development & HR, York Teaching
Hospitals NHS FT
GP Representative (North and East Yorkshire and North
Lincolnshire)
Interim Chief Executive, Bradford Teaching Hospitals NHS FT
Chief Executive, Hull and East Yorkshire Hospitals NHS Trust
Medical Director, Leeds Teaching Hospitals NHS Trust
Deputy Chief Executive, Workforce and OD, Local Govt.
Yorkshire and the Humber
1
HEYH15/01
Welcome and Introductions
The Chairman welcomed all those present and specifically, Professor Ged Byrne,
Director of Education and Quality for the North.
Professor Byrne outlined his role, with particular reference to commissioning to
achieve workforce transformation. He expressed a keen desire to look at the range
of innovative practices for which the north of England had a positive reputation.
HEYH15/02
Apologies for Absence
Apologies were noted as above.
HEYH15/03
Declarations of Interest
The Chairman requested the declaration of interests in any matters scheduled for
discussion and any interests in addition to those previously recorded in the relevant
register.
No additional interests were declared.
HEYH15/04
Minutes of the Last Meeting
The minutes of the meeting of Yorkshire and the Humber LETB Board held on 20
November 2014 were approved as a correct record.
HEYH15/05
Matters Arising
There were no matters arising.
HEYH15/06
System-wide Workforce Strategies: Sheffield Teaching Hospitals NHS FT –
Presentation on Acute Workforce Strategy
Linda Crofts and Andrew Gibson of STHFT gave a presentation on the Trust’s
Workforce Strategy, outlining the range of factors impacting on the workforce and
how the Trust had responded.
Factors impacting on the Trust’s workforce included:
 Expansion of community services
 Increasing demand for acute services
 7 day services
 Health inequalities across Sheffield
 Financial constraints – cost improvement requirements
 Investment in technology
 Shortages of ‘conventional’ workforce
 Modernising Scientific Careers
 Reduction in junior doctor and training grades
The Trust’s response to these challenges included a range of innovative workforce
developments including:
 Provision of a foundation programme for clinical support workers and a
progression agreement with higher education
 The development of early advanced practice roles in 2006 to address the
EWTD
 Support for physicians assistants in anaesthesia since 2008
2


A well-established Learning & Development department, including practice
development, leadership and OD
A service improvement programme that includes a microsystems academy
Measures to enable the Trust to maintain safe staffing levels at a time where
demand could not be matched to the current supply of qualified nurses were
outlined, including close working with education providers to maximise the newlyqualified base.
With support from HEYH the Trust had developed a successful regional apprentice
scheme to ensure some continuity of the medical science workforce and was
working towards a higher apprenticeship programme.
Redesign of the acute medical model was key to meeting current demand and was
not achievable within the Trust’s current workforce configuration. New modelling
was dependant on the development and employment of Advanced Nurse
Practitioners and Physician’s Assistants and the Trust had recognised the need to
develop a Faculty to quality assure the practice elements of the programme to
ensure consistency across the organisation.
The Trust was a partner in Right First Time, which aimed to develop integrated
health and social care services across Sheffield. The Programme, which was
focused on keeping people well in the community, avoiding hospital admission and
ensuring speedy appropriate discharge from hospital, was being supported by a
workforce review in every service, including the introduction of two new roles:
Community Support Workers and Rehabilitation Assistants.
Key messages from the Trust’s perspective were:
 Workforce planning needed to be more responsive to real time service
requirements, as well as future need
 Strategies should not be based on staff where there was no, or limited
supply – better to work with staff that could be recruited and develop them
 Development of the ‘unregulated’ workforce increased flexibility but required
strong governance, including clarity of roles and responsibilities,
competencies and supervision
 The Calderdale Framework was useful in the design of new roles to meet
fast-changing service needs
The Board was invited to discuss the presentation. Questions were posed about
the impact of being an integrated acute and community Trust. Dr Gibson explained
that the Trust had developed the concept of ‘Community at Night’. This had led to a
re-examination of roles and reconfiguration of services to support the effective
delivery of care.
Dr Gibson was asked about back-filling ACPs and the potential depletion of ward
capability. The Trust had recognised a need to develop a 3rd workforce, sitting
between Consultant and Ward manager to cover roles that did not need to be
carried out by junior doctors.
A question was raised about evidence to support the importance of a learning and
development infrastructure. STHT’s experience was that this infrastructure enabled
the rapid development of workforce solutions, particularly where an urgent pressure
was identified. This infrastructure was also utilised as a hub by other organisations
to prevent the need for duplication.
The Chairman thanked Ms Crofts and Dr Gibson for their presentation.
3
HEYH15/07
International Recruitment
Philip Marshall gave a presentation on how Harrogate and District NHS FT had
responded to workforce challenges, specifically associated with difficult to fill
medical specialities, namely Emergency Department middle grades; and Medical
and Surgical ward-based nursing.
In common with STHT, Harrogate was moving to a supply-based approach to
workforce planning.
The Trust had developed a local solution to the ED middle grades issue, which
included ongoing efforts to maximise cost savings and efficiencies arising from the
adoption of a Comensura Neutral Vendor method of locum booking.
Mr Marshall asked that the LETB explore the potential for this and other initiatives
outlined with providers across Yorkshire and the Humber.
Dr Gibson commented that in South Yorkshire, organisations had agreed internal
bank and locum rates. If a regional approach could be adopted to the management
of market forces, this could make a significant difference.
Jonathan Brown reported that around 220 international nurses had been recruited in
Yorkshire and the Humber in 2014/15, mostly into the more geographicallychallenged organisations. Adult nurse recruitment in Yorkshire and the Humber had
reduced from 2011 levels and there was a need to work with Trusts to better
understand nurse volumes.
Dr Gibson said that generic skill sets, rather than silo-working within specialties,
were required. There was a need to consider how best to support non-ED and nonGeneral Internal Medicine staff to support the take out of hours.
Mr Wilkinson commented that there was support, as a principle, for this approach as
a model to address acute medical issues. However, it did require a consideration of
the whole workforce and the inclusion of robust induction and supervision.
Mr Butler highlighted the regulatory requirements specific to Mental Health and
Learning Disabilities, which precluded the straight assimilation of international nurse
recruits in these areas.
Ms Smith said that NHS Employers were planning events and supportive tools to
assist organisations intending to recruit abroad.
Prof. Byrne confirmed HEE’s very strong mandate to look at educational
transformation to increase the resilience of the workforce. Allowing the workforce to
act across boundaries would maximise flexibility and efficiency. A number of
initiatives were underway within HEE to increase workforce supply in urgent care.
However, the situation was complex and the willingness of providers to work
collaboratively, as had been expressed in the meeting, would be a key enabler.
Going forward, analysis needed to be on the basis of skills, rather than individual
workforce. All LETBs were having similar conversations. The challenge to HEE
was to respond effectively.
However, Prof Byrne reiterated that HEE was predominantly an organisation
focussed on future workforce and was not resourced to look fully at CPD for the
current workforce.
4
Mr Wilkinson confirmed that HEE was undertaking a piece of work following the
EWTD Taskforce report, to look at the use of EWTD opt out amongst acute
providers.
Mr Curtis thanked Mr Marshall for his presentation. Commenting on the many
issues that had been highlighted in the ensuing discussion, the LETB Director
confirmed that the development of a programme-based approach to key work
streams, which had been previously shared with the Board, would be the means by
which these issues would be explored and addressed.
HEYH15/08
LETB Director’s Report
The Board received and noted the report of the LETB Director that provided updates
on the following:
 Beyond Transition
 2015/16 Planning
 Tuition, contracts and tariffs
 Service commissioning
 Board membership and development
 Non-departmental public body status
 Forthcoming events
A point of clarification was made by Prof Bryan in respect of the update on progress
to reach agreement to maintain the benchmark price paid for University tuition. It
was noted that there was a commitment by both parties to seek to negotiate a new
contractual framework with a view to applying that from 1 April 2016; however, if
that was not successful, current contracts were intra vires and could only be
terminated or varied in accordance with their terms.
The date of Sir Keith Pearson’s visit to HEYH was amended to 9 February 2015.
HEYH15/09
Corporate Delivery Report
The Board received and noted the Corporate Delivery Report (CDR) for December
2014, which incorporated the following national metrics:
 Administration costs within agreed limits
 Forecast under/overspend against allocation
 Health Visitors
 Health Care Apprentices
 Attendance rates of HEE staff
 Retention rates of HEE staff
The report also set out the position in respect of the following priorities:
 Values-based recruitment
 Dementia training
 Healthcare Science – ESR conversion
 GP tool – primary care workforce staffing data
 Pharmacy staffing establishment and vacancy survey
 eWorkforce tool
The report noted a small shortfall in the number of Health Visitors as at November
2014, against the target set for achievement by March 2015.
Amanda Fisher said that the year-end position was expected to be a small oversupply. However, it was acknowledged that the position in West Yorkshire was
5
significantly less positive than in the other two areas at the time of the report. The
position in West Yorkshire was reported to have improved in the interim.
HEYH15/10
Quality Report
The Board received a report from the Postgraduate Dean, which comprised: a
report on aspects of the Quality Framework, specifically trainee feedback from
postgraduate medical trainees and non-medical undergraduate students presented
by provider, a summary of the Dean’s report for the last 6 months to the GMC;
Incident exception reports by organisation and the draft findings of the recent GMC
visit.
Mr Wilkinson confirmed that the undergraduate student data shown in table 1 had
been derived from PPQA.
Mr Wilkinson noted that in respect of the Incident Reports data, a total of 423
exception reports had been received by HEYH from the period April 2013 to the
present. There were very significant variations in the numbers of incidents being
reported between organisations. These variances did not triangulate with other
metrics on patient safety or on the quality of medical training.
This is not a new problem, differences in reporting thresholds had previously been
identified – and as a result a Quality Summit had taken place with Bradford
Teaching Hospitals NHS FT, which had arisen following variances identified within
the STEIS system.
From the data presented it was not possible to determine the spread of reporting
over the period and whether the variance that had triggered the Quality Summit,
might explain a similar variance in exception reporting. Acknowledging the Board’s
Duty of Candour, Mr Wilkinson assured the Board that the exception reporting data
would be reflected back to organisations and further explored in the context of a
discussion about consistency of reporting thresholds.
Prof. Congdon requested that where data was subject to caveats and qualification,
this should be included within the body of the report alongside the data. Data
source and size calibrations would also enhance the presentation of data and assist
the Board’s understanding.
Mr Wilkinson undertook to discuss and agree principles around quality data
reporting and presentation methodology at a forthcoming meeting with Non-medical
Deans.
In respect of the GMC Review, a meeting was scheduled for 3 February at which
HEYH plans to address the areas for improvement would be set out.
Dr Ball asked whether the visit had identified any issues in respect of the quality
assurance of placements.
Mr Wilkinson confirmed that a number of serious concerns identified during the
Review had been addressed immediately.
Mr Curtis commented that strategic relationships with Medical Schools were one of
the areas for improvement identified by the GMC. Prof. Weetman had agreed to
undertake a piece of work to help HEYH to address this.
Mr Wilkinson confirmed that the GMC was keen to see the inclusion of
undergraduate student feedback data in future Quality reporting. Stuart Haines said
6
that Leeds Teaching Hospitals had been working with Leeds University to analyse
student feedback data and offered to support work being undertaken to enable the
inclusion of undergraduate data.
The Board noted the Quality report and the further work outlined above.
Action: David Wilkinson
HEYH15/11
HEYH15/12
Risk Management
i.
Corporate Risk Register 2014/15
The Board received and noted the current iteration of the Corporate Risk
Register.
ii.
Identification of Additional Corporate or Operational Risks
No additional items requiring inclusion on the Risk Register were identified.
Any Other Business
Regional Leadership Awards
The Board congratulated the recipients of the Regional Leadership Awards.
HEYH15/13
Date of Next Meeting
The next meeting of Yorkshire and the Humber LETB was scheduled for 2.00pm on
Tuesday, 17 March 2015 at the National Coal Mining Museum, Wakefield.
7

approved minutes of the tenth meeting of the governing body of

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