LNCCG Governance, Performance & Risk Committee Tuesday 22 nd March 2016, 10:00-12:00 Boardroom Leafield House, Leeds Minutes

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1 LNCCG Governance, Performance & Risk Committee Tuesday 22 nd March 2016, 10:00-12:00 Boardroom Leafield House, Leeds Minutes Chair: Martin Wright Minutes: Jenny Chambers Members Initials Role Present Apologies Nigel Gray NG Chief Officer Martin Wright MW Chief Financial Officer Dr Manjit Purewal MP Clinical Director Graham Prestwich GPr Lay Member PPI Dr Nick Ibbotson NI GP Non-executive Director Dr Simon Robinson SR GP Non-executive Director Clare Linley CL Director of Nursing Rob Goodyear RG Deputy Director of Commissioning In Attendance Initials Role Apologies Joanna Howard JH Head of Governance (City wide) Stephen Gregg SG Head of Governance and Corporate Services Russell Hart-Davies RHD Head of Quality (City wide) Jenny Chambers PA to Executives Simon Harris SH Business Intelligence Manager Jenny Baines JB Urgent Care Stuart Barnes SB Communications & Engagement Lead Item No. AGENDA ITEM Action 303/2016 Welcome and apologies The Chair welcomed the members to the Committee. Apologies were noted as above. 304/2016 Declarations of Interest There were no declarations of interest. 305/2016 Draft Minutes from 7 January 2016 With slight amendment to the wording on Item 290/2016 and 293/2016, the minutes were accepted as an accurate record. Page 1 of 6

2 306/2016 Actions and Matters Arising from 7 January 2016 The action log was addressed and updated accordingly. GPR Committee requested that in future all actions be followed up prior to the meeting and that deadlines be added to all actions. SG/NS 307/2016 IG Update AC presented the annual refresh of the IG Vision and Framework which captures the organisation s stance on IG culture/continuous improvement. The cross city IG process outlines accountabilities and board responsibilities, details of enhanced third party contracts and the addition of cyber incidents to the framework Closure of Y&H Commissioning Support Unit: AC pleased to report that the CCG was in the position of a fully signed off contract with new IG provider, embed. It is anticipated that current IG staff will TUPE across to embed so operationally it will be business as usual. IG agreements currently being signed with embed still awaiting some forms signing by NHSE which may affect data flows. AC confirmed that GPR Committee can be assured that the new arrangements in place are robust. Cyber security: Nationally, cyber security is a real threat in the UK and is noted as a risk on the CCG Corporate Risk Register. NHSE is taking the threat very seriously and a review is being implemented to highlight threats. The CCG has received assurance from suppliers that they are dealing adequately with cyber threats and are acting upon any security briefings. In the long term the CCG are looking at working closely with Leeds City Council to invest in some cyber expertise and staff awareness is being promoted on how to avoid/minimise the threat of an attack. IG Toolkit: The CCG is on track to achieve the required minimum score of level 2 for each component and investigations are being conducted on root cause analysis of incidents. GPr stated that he would like to see root cause analysis to be turned around swiftly when an incident occurs to gain a better understanding of the issues. JH confirmed that the rewrite of the incidents process would also include root cause analysis. Noted the Information Governance report. 308/2016 Performance Report (including CAMHS) SH presented the main indicators of the report by exception for January: HCAIs: 5 C.Difficile cases reported in January (above CCG profile target) but no cases of MRSA were reported. Page 2 of 6

3 A&E waiting times: LTHT performance 86.6% against 95% standard -YTD performance below at 93.6% HDFT performance 93.4% -YTD below at 94.9% 18 weeks RTT: Incomplete pathway standard achieved 93.5% (Target incomplete - 82% patients seen within 18 weeks and standard is still slipping) Cancer 62 day RTT: 95% achieved vs 85% standard Cancer 2 week waits: 1 st outpatient appointment target achieved 89.8% 2 week breast symptoms performance achieved 95.1% Diagnostic Tests: IAPT: Ambulance Response times: Not achieved % vs 99% standard Achieved 50.6% vs 50% target Red One, Red Two responses not achieved. Performance 67.3%, 71.3% respectively vs 75% target. Quality Premiums Covered under Item 309/ /16: Diagnostics: YAS failed 8 min target which affects LN Quality Premium performance. SH confirmed that next year the measures will be by geographical area and will highlight the LN patch. SH highlighted that IAPT achieved target for the first time in two years. Noted the performance report 309/2016 Quality Premiums 2016/17 SH provided an update on the 2016/17 Quality Premiums for which guidance had recently been released. There are a number of changes to the scheme. National Constitution indicators will need to align to the Sustainability and Transformation Plan of the provider if they have been required to develop local trajectories. Many of the national requirements have been removed and replaced with new indicators. These are around Early Detection of Cancer, E Referral Rates and Patient Experience of making an appointment. Three local indicators are required and need to be selected from a list of suggested Right Care areas. A small team has been established to look at suitable areas to work on. Submission of the local indicators within CCG plans required by 11 th April Quality Premiums 2015/16: SH advised that the payment for the 15/16 scheme will be known in November It is anticipated, based on current information that this will be approximately 450k - 500k. However, this is subject to change. Page 3 of 6

4 Discussion took place on the GP Patient Survey (MORI poll) which equates to 20% of the quality premium. The CCG is required to reach a level of 85% or increase by 3 percentage points over the July 16 position on the Overall experience of making an appointment. Currently the CCG is well below the 85% level. SR would like to see improved response rates and the survey being promoted more widely. SH to provide response rates for Leeds North patients and investigate promoting the survey to Council of Members so that GP practices are aware. SH Noted the update on Quality Premiums 2016/17 and the position statement for Quality Premiums 2015/ /2016 Board Assurance Framework update JH presented the Board Assurance Framework and provided a summary of the risks which had been updated since the last meeting: Risks 3 and 7 have reduced in score as additional controls and assurances have been received. Risk 6 has increased in score due to the 2016/17 allocations and the long term risk to the CCG JH confirmed that mitigating actions had been identified with regard to the risks. MW noted that the CCG were operating outside of their risk appetite and that the Board would like all risk owners to be encouraged to operate a realistic score in conjunction with their risk appetite. JH confirmed that work was progressing on this and to ensure that risks did not escalate above 12 before immediate action is taken to address. Committee asked for some of the graphs in the report to be updated. They also commented that they would like to see the graphs presented on one sheet to enable them to determine what action is needed to improve risks. JH SR commented that the new reporting format made it easier to identify nonimprovement of risks. GPr commented financially difficult times make it more important to identify emerging risks and the need to improve to ensure that we are fit for purpose. MW asked how best to proceed. GPR Committee felt that a longer debate would be useful and that there might be value in focusing on the subject with risk owners at a Board Workshop. Approved the revised Board Assurance Framework. SG/JH 311/2016 Corporate Risk Register JH presented the Corporate Risk Register and confirmed that two red risks - Ambulance standards and Systems Resilience - will be taken to Board. JH briefly outlined the amber risks which would not be taken to board level but would continue to be monitored and brought to GPR Committee. Accepted the current corporate red risks and noted the amber risks Page 4 of 6

5 312/2016 Public Sector Equality Duty/ NHS Equality Delivery System MW briefly outlined the papers for discussion. RG was not in attendance and would be invited to next GPR meeting on 12 May for further discussion. Noted the evidence presented and requested further discussion at the May committee meeting 313/2016 Whistle blowing policy MW confirmed that the Whistle Blowing Policy was due for review in the light of recent national guidance. The policy would be reviewed after this has been published. Noted the current policy and expected to receive an update at a future GPR meeting 314/2016 Trade Union Recognition and Time Off Policy SG/NS SG MW confirmed that a review had taken place and that no changes had been recommended to the current policy. It was recommended that, subject to any changes in legislation, the policy be rolled over for review in three years time. Accepted the Trade Union Recognition and Time Off Policy and noted the timescale and conditions for further review. 315/2016 Patient and public expenses policy MW introduced the Patient and Public Expenses Policy and confirmed that changes had been made since the last meeting. After discussion GPR Committee agreed that further changes were needed to 3.2 and 3.9. These points should refer to expenses rather than fees. It was also recommended that Section 7 be taken out of the policy. The policy will go live as from 1 April Approved the policy subject to the above amendments. 316/2016 Children s continuing care policy 317/2016 MW introduced the Children s Continuing Care Policy produced by LSE CCG, which has been approved by LW CCG. GPr felt that the policy would be strengthened by being more person-centred and containing comments on quality of service rather than process. The Committee also commented that they would like the opportunity to comment/make changes to the content of the policy before it comes through to GPR Committee for approval. Approved the policy but recommended that Appendix 10, Quality should reflect feedback on patient experience. Standards of Business Conduct Policy Current policy in place until new guidance received. Noted that the current policy will remain in place until new guidance is received to refresh the Standards of Business Conduct Policy. SB SG Page 5 of 6

6 318/2016 Approval of the Information Governance Strategic Vision, Policy and Framework AC updated that information asset risk management and staff training plan are included in the document. The policy has been presented to IG Committee and approved by the Caldicott Guardian. The next step in the process is the annual reminder/sharing of the policy with staff. CL queried whether the move to co-commissioning in April will have any impact on IG Governance. AC confirmed that all commissioned services will be required to comply and any new flows of information will be monitored. SR commented that GP practices were responsible for their own information governance, but the interface between the two can be a grey area. He would like to see this issue raised at Target or Council of Members to ensure better education on the overlap. CL did not feel that it was appropriate to combine vision within a policy document and that staff and patient care need to be looked at separately. AC to address these issues. AC AC IG Committee: Approved the policy 319/2016 Any Other Business No items were raised under Any Other Business 320/2016 Review of meeting The Committee members reflected on the meeting and raised the following issues: The Chair commented that Member attendance was low. This made discussion of some items difficult because not all risk owners were present. It was also noted that some attendees were not available to present their agenda item/review their action points from the previous meeting. Date of next meeting: , Thursday 12 May 2016 Venue: Boardroom, Leafield House Page 6 of 6

Minutes Audit Committee Meeting 27 th January 2016, 13:00pm Civic Centre, Arnold

Minutes Audit Committee Meeting 27 th January 2016, 13:00pm Civic Centre, Arnold Present Terry Allen (TA) Janet Champion (JC) In Attendance Jonathan Bemrose (JB) Hazel Buchanan (HB) Tony Crawley (TC) Richard