1. education

APPROVED MINUTES OF THE NINTH 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 19 NOVEMBER 2014
Ms Kaye Burnett (KBu)
Independent Chair of Governing Body
Ms Kate Bradley (KBr)
Mr David Farrelly (DF)
Mrs Sue James (SJa)
Mrs Jane Johnson (JJ)
Ms Jane Lewington (JL)
Prof Nick JM London (NL)
Prof Sheona MacLeod (SM)
Mr Nigel Mander (NM)
Mrs Elaine Mitchell (EM)
Mrs Anne Marlow (AM)
Prof Sarah Owen (SO)
Dr Rishabh Prasad (RP)
Ms Karen Rutter (KR)
Mr David Sissling (DS)
Deputy Chair, Leicestershire and Rutland LETC
Local Director, HEEM
Chair, Derbyshire LETC
Deputy Director of Workforce, Education and Quality, HEEM
Chair, Lincolnshire LETC
Deputy Medical HEI representative
Post Graduate Dean/Director of Education & Quality, HEEM
Finance and Enabling Services, HEEM
Deputy Chair, Nottinghamshire LETC
Director for Innovation, HEEM
Non-Medical HEI representative
Director of Primary Care, HEEM
Head of Finance (Midlands and East), HEE
Deputy Chair, Northamptonshire LETC
Apologies:
Ms Lyn Bacon
Prof Ian Hall
Dr Peter Miller
Mrs Sue Noyes
Dr Sonia Swart
Third Sector representative
Medical HEI representative
Chair, Leicestershire and Rutland LETC
Chief Executive, East Midlands Ambulance Service
Chair, Northamptonshire LETC
In attendance:
Mrs Karen Adcock
Mr Richard Ansell
Mrs Carole Appleby
Mrs Jackie Brocklehurst
Mrs Helen Smith
Workforce Lead, Northamptonshire Workforce Team
Workforce Lead, Leicestershire & Rutland Workforce Team
Head of Marketing and Communications, HEEM
Workforce Lead, Nottinghamshire Workforce Team
Workforce Lead, Lincolnshire Workforce Team
65/14 Welcome
The Chair welcomed David Farelly to the meeting in his new role as HEEM Local Director
and Jane Johnson as HEEM Deputy Director of Workforce, Education and Quality. She also
welcomed Karen Rutter, Head of Finance (Midlands and East), Health Education England,
who had recently taken up her post as part of the new ‘Beyond Transition’ arrangements.
Going forward, Karen and other members of the ‘Midlands and East’ senior team at HEE
hoped to attend future GB meetings.
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66/14 Declaration of interests
No new declarations of interest were raised in connection with the items listed on the
agenda.
67/14 Update from the Independent Chair
Opening the meeting KBu shared a roundup of awards short listings which would be
revealed later that week. These were:
 East Midlands Leadership Academy (EMLA) NHS Recognition Awards 2014 in the
category ‘GB of the Year’ – Nottinghamshire LETC; Dr Rakesh Patel for innovative
leadership and HEEM’s emergency medicine programme in the category ‘Outstanding
Collaborative Leadership’
 Health Service Journal award for the HEEM General Practice Nursing programme in the
‘Workforce’ category
 Association for Healthcare Communications and Marketing: Carole Appleby, Head of
Communications
Post meeting note: Awards won were:
 Nottinghamshire LETC for GB of the Year 2014
 Dr Rakesh Patel for ‘Innovative leadership’
 Carole Appleby, Head of Communications for ‘Best freelance Practitioner 2014’
In addition, KBu said that in future she would be encouraging EMAS to send deputies if Sue
Noyes was unable to attend GB meetings. Previously, the invitation has been a personal one
to the Chief Executive.
The December meeting of the GB, rather than the scheduled Development Session, would
be a meeting for LETC Chairs with KBu and DF.
68/14 Review of Governing Body (GB) actions to November 2014
The status of actions was noted; a number of items with update reports appeared later in the
agenda.
Third sector engagement: KBu would be speaking to Lyn Bacon about ways to improve third
sector engagement.
69/14 Report of the Local Director
DF thanked LETC Chairs for their recent input to shaping proposed revised local delivery
arrangements as part of HEE’s ‘Beyond Transition’ (BT) programme. These had been
fundamental in designing principles for future stakeholder relationships within local health
communities. The BT Phase 2 (45 day) consultation process had started on 19 November,
concluding on 9 January. Discussions have commenced with those who are affected by
change. The ‘Midlands and East’ geography was beginning take shape with agreements
about which LETBs will lead on which work streams in order to optimise and share best
practice. DF agreed to share with GB members the consultation document, HR framework
and structures.
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HEEM is leading a new Research and Innovation Network that aims to align national and
local work in implementing the Research and Innovation Strategy. A workshop on 19
September considered how the Beyond Transition programme can improve the pace and
scale of adoption of good practice in HEE.
A national review of the NHS Leadership Academy was also now underway. This tied into
discussions around the EMLA future relationship: the Board-to-Board meeting to ensure
Academy programmes are responsive to changing needs of providers and commissioners
would take place in the New Year. DF tabled a summary of the feedback received from
LETC Chairs; this would also be circulated after the meeting and would feed into the national
review considerations.
Action
(a) To receive the report of the Local Director.
(a) To circulate BT Phase 2 consultation documents (DF)
(b) To circulate to LETC Chairs the summary of views around the EMLA proposition (DF).
70/14 Attracting and retaining talent in the East Midlands
SM said that the challenges in attracting and retaining the numbers of medical, dental,
nursing, midwifery and other professional healthcare staff required to deliver services in the
East Midlands (EM) was an issue that education providers, service providers and
commissioners were increasingly aware of. There was considerable collective will for
bringing expertise and resources together to develop creative solutions through partnerships
in the LETB and these had been explored in discussions at both LETC and GB meetings.
The circulated paper updated the GB on the activities initiated within HEEM to address the
situation.
There were a number of areas where HEEM had focussed its energies on promoting specific
training or education programmes, including emergency medicine, practice nurse training,
engaging trainees in promoting General Practice training, local fellowships and Out of
Programme (OOP) opportunities.
From the work to date, it was apparent that a number of challenges exist. Learners may
have a ‘tick list’ of things they are looking for, and it will not be sufficient to excel in one or
two, we need to work on them all. Where we identify that we are not doing something right,
we need to fix it, but there are many occasions when we are already providing excellence
and we need to promote these examples. The overarching issue is a reputational one; this
will require a positive collaborative approach across the EM.
From the discussion at the GB, it was clear that there was significant support for a consistent
and collective ‘East Midlands’ wide approach to a number of initiatives. DS said that the
Northants LETC had supported a co-ordinated approach, possibly linked to branding the EM
as a ‘quality’ area in connection with education and training.
NL said that the feedback results on recent surveys indicated that Nottingham and Leicester
Medical Schools were very poor, possibly due to a feeling that medical education in EMs’
Trusts is not rated as that important and that trainees in the EM are not having too great a
time. He also commented on the impact of social media on trainee’s views; it has a huge and
increasing effect on influencing opinion.
SJa found it difficult to accept that in practice that the EMs was a worse area to train than
other areas therefore this challenge was about perception. She also felt that HEEM needed
to be more transparent in finding out which doctors/which Trusts were not delivering a high
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quality educational placements and disinvest (the SIFT allocation) in these. By putting the
SIFT allocation where the good teaching is this would focus on rewarding high, rather than
poor quality teaching.
SJa asked for a simple summary paper with information about funding and student
feedback, linking medical students, post graduate learners and non-medical undergraduates.
KBu agreed that quality was key; HEEM intended to enhance the accountability of education
providers, so that investment will be dependent upon whether they are delivering the quality
of educational experiences.
The initiatives in the paper had been discussed in some LETCs. KBu suggested that there
had been insufficient medical representation at some of the discussions. SJa suggested that
this should be raised with Medical Directors and SM agreed to pursue this via the East
Midlands Medical Directors Forum.
KBu summarised the agreements reached by the GB:
 Agreeing to a coordinated approach to fellowships and ‘Out of Programme’ opportunities.
 SM and DF to scope how this might work, taking account of the planned summit on the
future medical workforce, and involving both health and local authority partners in
February 2015 to be facilitated by Pat Oakley. GB members to think about who would be
the right people to be at this event.
 This would be a wide reaching programme with a number of work streams.
 The idea of branding is crucial to ensure how we market what we are really good at.
Action
(a) To implement changes within education and training programmes, as a result of
feedback from learners, educators and stakeholder meetings (SM)
(b) To promote the improvements and changes and the current good practice in education
training through the current channels, e.g. webpage, social media, conferences, meetings
(SM)
(c) To develop an understanding of the drivers external to HEEM that we need to promote
(e.g. affordable housing etc.) and work with Local Authorities to promote these (SM)
(d) To integrate the GB ideas into the planned summit on the future medical workforce, to be
facilitated by Pat Oakley. GB members to think about who would be the right people to be at
this event. (GB Members)
Based on findings, to develop a communication strategy to provide information using the
most effective channels (SM)
(e) To produce learner stories in multi media formats to increase the positive peer influences
and make the benefits more tangible at an individual level (SM)
(f) To provide a summary paper to provide correlation between funding and feedback (SM)
(g) To raise the issue of fellowship and OOP co-ordination at the Trust Medical Directors
Forum (SM)
(h) To discuss this issue further in LETCs and identify a lead individual from each LETC to
feed into the further development of the emerging work streams (LETCs/Workforce Leads).
71/14 Quality – Trainee and Student feedback
SM said that following the October GB Development session, members had agreed to raise
the profile about the quality of education being delivered within our providers. Each Trust
had been sent a pack of trainee and student feedback as follows:
 GMC survey results
 National Student Survey feedback on placements for medical students in the East
Midlands
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
National Student Survey feedback on placements for healthcare training in the East
Midlands
This information had been provided to highlight the importance of improving feedback in
order to improve the attractiveness of the region and linked to the discussion minuted above.
From the GMC survey, the East Midlands had improved across 11 out of 12 indicators.
Despite this it was ranked 13th out of 13 LETBs across a number of factors. There were also
some areas where we are doing well. Of particular note were the results for Nottinghamshire
Healthcare and the Royal Derby hospitals FT, both featuring above the national outliers for
overall satisfaction. Three Trusts were above the national outlier for ‘workload’, as a balance
between training and service: these were the Derbyshire Healthcare Trust, Lincolnshire
Partnership Trust and Northampton Healthcare Trust.
KBu asked to what extent Trusts were talking about the quality of the training and education
environment and practice in their organisations; the information had been provided to enable
these to take place. KBu agreed to write to individual Trust chairs to highlight the importance
of the Trust Boards gaining assurance on this issue.
Action
ACTION
(a) KBu to write to the Chairs of Boards of individual Trusts to enable different kinds of
conversations about the quality of education and training; this supported the new HEEM
approach to the delivery of Trust quality visits (KBu)
(b) Receive the information on results which reflect learner perceptions of the quality of
education and training in the region
(c) Discuss in LETCs how to promote high quality education and training in the region in
order to allow HEEM to compete with other areas in attracting learners
(LETCs/Workforce Leads)
(d) Feedback on initiatives in LETCs, which could be coordinated regionally to improve
training and improve the regional profile (LETCs/Workforce Leads).
72/14 Updates from the Local Education and Training Councils (LETCs)
LETC Chairs provided a brief round-up of key strategic priorities, best practice, risks and
challenges; summary slides from each LETC to be circulated.
KB thanked the LETCs for their comprehensive updates. Hearing from local stakeholders in
this way helped set the context for everything the LETB needed to focus on.
Action
To note the progress updates from the LETCs.
73/14 Primary Care update
The newly formed Primary Care Steering Group had recently met; DF explained that this
was constituted as an East Midlands-wide forum since all areas face similar issues. Chaired
by Doug Black from the Derbyshire and Nottinghamshire Area Team, the group comprised a
clinical lead, chief officer and LMC representative from each county as well as area team
and HEEM representatives. Discussion had focussed around what could be done to tackle
recruitment and retention of GPs and ways to work on integrated capacity across settings to
optimise the current workforce, recognising the need for different roles in the future if
recruitment to the GP workforce remained an issue. The next meeting is on 10 December.
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RP drew attention to issues ‘on the horizon’ which would merit attention in the months
ahead, most significantly the fact that practices were beginning to form collectives known as
‘chambers’. These were in their early stages and were completely new organisations, with
whom it was likely that the LETB would need to engage.
Action
To note the Primary Care update.
74/14 HEI members’ update
SO thanked SM and JJ for the opportunity to comment on earlier drafts of the papers which
had been submitted to the GB. With regard to the current round of HEI Contract Review
meetings, these had been well received as was the new Draft Advanced Clinical Practice
Framework. The requirement for all HEIs to introduce values-based recruitment (VBR) to
new programmes by March 2015 was being implemented with training in early Dec.
Rachel Munton, the MD of the East Midlands AHSN had attended the last HE Strategic
Liaison Group; the AHSN were keen to commission a piece of work for HEIs working
together to support quality improvement initiatives. A bid had been submitted; the outcome
was awaited.
The next meeting of the HE Strategic Liaison Group was in January.
Action:
To receive the update from the HEI representative.
75/14 Third sector update
In the absence of Lyn Bacon, no third sector report was available.
76/14 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. The Report had been scrutinised
following feedback from GB members at the last meeting; improved and more detailed data
had now been incorporated.
NM particularly highlighted:
 General Practice: identified as ‘amber’ due to the fact that HEEM had aspired to recruit
to a figure of 50, whereas only 10 had been achieved. This was a greater number than
any other region. This would impact in future years, however within the HEEM
Investment plan we are seeking to reinvest into integrated care and community-based
projects.
 From a financial viewpoint, the shortfall had increased in total to £8m reinvested to date,
still leaving a £2m gap on what we expected to spend and what we are planning to
spend. This explains why the finance line was rated as ‘amber’. This money needed to
be reinvested in the training of the future workforce. A further HEEM ‘Money matters’
meeting would address this on 2 December.
KBu requested that NM provide a summary of key points around the reinvestment plan for
discussion at the December LETC chairs session.
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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 provide a summary of key points around the reinvestment plan for discussion at the
December LETC chairs session (NM).
77/14 Strategic Risk Register
A paper had been circulated describing top-line information regarding HEEM’s high-level
risks. NM said that the HEEM Risk and Assurance Committee had met in October. There
were no emerging risks of any significance.
GB members had previously commented on the RAG ratings system and with regard to this,
NM would be looking at the higher rated risks to confirm they should still show as ‘red’. The
Risk Register was seeing a continuing trend of the efficacy of the mitigating actions being
taken with the effect that the number of risks was decreasing.
Action
(a) To understand and gain assurance that all risks are being identified and managed
effectively by the functional area reporting and peer review process
(b) To be assured that the HEEM Risk and Assurance Committee is now established with
representation from HEEM Senior Management Team and each of the five local health
communities.
78/14 Minutes of the meeting of the Governing Body of Health Education East
Midlands held on 17 September 2014
Resolution:
These minutes were accepted as a correct record and signed by the Chair; there were no
matters arising.
79/14 Minutes of meetings of Local Education and Training Councils
Resolution:
To receive, for assurance, the minutes of the following LETC meetings:
(a)
(b)
(c)
(d)
(e)
Derbyshire: 24 September 2014
Leicestershire & Rutland: 8 September; 6 October 2014
Lincolnshire: 23 September 2014
Northamptonshire: 12 September 2014
Nottinghamshire: 28 October 2014
80/14 Minutes of the meeting of the Higher Education Strategic Liaison Forum
(HESLF) held on 7 October 2014
Resolution:
To receive, for assurance, the minutes of the HESLF held on 7 October 2014.
81/14 An update on the medical trainee redistribution project
SM had provided, for information, an update paper at the October GB Development session;
the rationale for this item’s inclusion was to bring a status report formally to the GB because
of the importance of the programme to all the five LETCs.
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82/14 Changing landscape in Healthcare Education
JJ said that the event held on 24 September had been a result of previous papers to the GB
around commissioning differently. It had been externally facilitated with representation
across NHS services, HEIs and HEEM. There had been a particularly disappointing
representation from frontline NHS services. The paper circulated for information provided
outcomes from the discussions and identified a series of themes and next steps. These
would be debated further at next HESLF in January then reported back to a future GB.
83/14 Items for information:
The following items were received for information:
(a)
(b)
(c)
(d)
An update on International Recruitment
Embedding the principles of prevention in the education HEEM invests in
Review of efficiency in spending by HEEM - ‘Dreaming Results’
Outputs from the October Governing Body Development session
The GB appreciated the work undertaken to deliver each of these aspects of business and
thanked all those who had been involved in it.
84/14 Meeting evaluation
GB members reflected on the meeting and provided the following feedback:
 SJ: Executive summary for each paper to be improved and more succinct.
 KR: Commented favourably on agenda flow and time keeping; the discussion had been
high quality and focussed. She particularly valued to updates from each LETC. She
would share with the other two LETBs on her ‘Midlands and East’ geography the good
practice from this meeting.
 JL: endorsed KR’s comments that the flow of the agenda was much improved.
85/14 Date of next formal Governing Body meeting
The next meeting of the Governing Body will be held on Wednesday 28 January 2015 at
Ruddington.
Signed…………………………………………
Ms Kaye Burnett, Independent Chair
Date……………………….…
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Minutes
HENE Governing Body
Local Education and Training Board
Date: 23 January 2015
Time: 13.30 – 16.30
Venue: Bourne House, Durham
Members of meeting:
Apologies:
Chair: Professor Oliver James
Dr Julie Birch (Local Medical
Committee)
In Attendance
Professor Chris Day (Newcastle
Derek Marshall (Chief Workforce Strategist and Planner
University)
HENE)
Paul McLaughlan (Chief Operating
Lisa Simmonette (Note Taker)
Officer HENE)
Michelle Roach (Finance HENE)
Mike Wright (CDDFT)
Laura Roberts (HEE)
Attendees
Calum Pallister (HEE)
Martin Barkley (Tees, Esk and Wear Valley NHS FT)
Ged Byrne (HEE)
Professor Richard Bellamy (South Tees Hospitals FT)
Ann Burrell (North Tees and Hartlepool NHS FT)
Dee Fawcett (NUTH NHS FT)
Ian Frame (South Tyneside FT)
Dr Douglas Gee (Northumberland, Tyne & Wear NHS
Trust)
Kath Griffin (Sunderland City Hospitals FT)
Alex Glover (Local Director HENE)
Professor Namita Kumar (Postgraduate Dean
HENE)Professor Paul Keane (Teesside University)
Kelly Angus (Northumbria Healthcare NHS FT)
Jo Baxter (NEAS)
Ian Renwick (Gateshead Health NHS FT)
Dr Jonathan Smith (Primary Care)
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Item
No.
Discussion
Action
Strategic
1
Welcome and apologies, declaration of interest
The Chair welcomed everyone to the meeting including deputies Kelly
Angus, Jo Baxter, and Dr Douglas Gee who arrived later in the meeting.
He also welcomed Michelle Roach who will be attending future meetings
to represent finance from HENE.
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2.1 Minutes of 28 November 2014 meeting
Members agreed that the minutes were a true reflection of the meeting.
2.2 Actions
Action log circulated.
Apps Development for Junior Doctors Induction/Statutory and
Mandatory Training
Kelly Angus gave a brief update commenting that so far positive
feedback had been received. Further scoping work is required with a
view to report back to the Board in February.
ACTION: Links to be circulated to Board.
KA/LS
Draft Workforce Plans
Derek Marshall currently drafting an appeal to HEE in respect of the
planned expansion in acute medicine which was rejected by HEE.
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Biomedical Science Histopathology
Awaiting funding.
Constitution
Currently being amended to reflect voting rights for HENE’s Local
Director and Postgraduate Dean.
Attrition
Kath Griffin measured this on a 3 year rolling basis.
Lead Employer for GP
Costs have now been reduced by the LET incorporating the removal of
one Band 4 post. The arrangements were then agreed by the Board.
2.3 Matters arising
Lead Employer Trust
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As above in actions section.
Partnership Council update – 12 January 2014
Professor Oliver James gave the group an update following the recent
Partnership Council meeting. The meeting mainly focused on
discussion around the future of the council and the proposals. The
three taskforce groups also gave verbal updates and discussion was
held on the draft Public Health document. Inputs from the Partnership
Council had been incorporated into the relevant documents on these
issues presented to the Board to be discussed later in the agenda.
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4
National update
Beyond Transition
Alex Glover confirmed that Beyond Transition staff consultation had
now come to a close. She also added that HEE will be considering
voluntary redundancy for the 4 members of staff from HENE who had
applied. The HEE Board will meet on 27 January to sign off new
structures.
Alan Robson/DH visit update
Alan Robson from DH visited HENE from 12-14 January. Due to the
short notice given an itinerary was set around current meetings already
scheduled for these dates. Alex added that during the 3 days Alan
spent at HENE he attended the Partnership Council, a CPD review
meeting, a visit to a local Trust and also met with Dr Graham Rutt
(HENE) to discuss GP recruitment issues in the north east and Derek
Marshall to discuss workforce planning. Alex Glover confirmed that
Alan was very reassured by what he had seen and heard during his visit,
both in terms of HENE and of the workings “on the ground” of HEE
itself.
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Finance update
Michelle Roach gave an update on the current finance position.
Following submission of a revised forecast an underspend of £900k has
been agreed with HEE against the Future Workforce allocation and
which will be reflected as the forecast outturn for 2014/15. In addition
HENE received a further allocation of £900k for Workforce Development
to offset the forecast pressure in respect of funding identified against
the expenditure for the three task forces.
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Taskforce updates
Professor James commented that funds were available for the majority
of the taskforce proposals to help shape the workforce over the short
term. He also added that further discussion would take place later in
the year to look at more long-term solutions.
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Primary Care
Following the November meeting Derek Marshall presented the group
with the proposals from the taskforce group:o Development of the career start scheme for GPs - this funding
likely to be in the form of an education grant
o Development of GPs with additional interests - grant basis
o Practice manager development programme - looking at
programme with North East Leadership Academy which will run
over circa 18 to 24 months.
o Level 1 dementia training for all primary care staff - access over
18 months to training
o Practice nurse development - discussion took place to expand
and look at all options
Following discussion the board agreed all of the above proposals.
Mental Health
This paper presented details of X proposals which the possible working
party had put forward to make a difference as soon as consideration
had been given to wider longer term issues.
Professor Namita Kumar informed the group that funds were available
to support the short term proposals. Professor James asked the Board
if they could consider and agree the short term proposals. He
confirmed that all bids had been scored by the exec team using the
relevant scoring matrix. Oliver suggested that bids on the prioritisation
grid scoring under 26.5 should not be funded at this stage and that all
other bids be reviewed in the medium term.
The Partnership Council had indicated that the IAPT bid needs further
review of work and it was removed, pro term.
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ACTION AGREED:
1. Short term bids scoring greater than 26 approved
2. Longer term work streams to be further considered and returned
to the Board when ready.
Emergency Care
The governing body were reminded that representation for this Task
Force was from governing body members, was multi professional and
involved individuals from both primary and secondary care. The 4 major
areas of work undertaken were presented.
1) GPs with Special Interest
The board was informed that the GPs with special interest (GPwSI)
proposal had come from GPs themselves and currently 6 applications
had been received although the deadline has been extended by one
week. A fair process for allocation would be established.
Professor Kumar stated that the core for the work was looking at the
skills required of the individuals who are needed to work in these areas.
ACTION: NK to update the board in a future meeting on the final
numbers of applications
2) Physician Associates
NK
The paper was presented and included the skills that these individuals
would be taught so they could work in Emergency care. Option B was
the taskforces suggestion and put forward to the Board for their
consideration.
Members of the Board discussed the options and agreed in general on
the PA position and felt that the course description was clear.
Dee Fawcett asked if any explanatory conversations had taken place
with HEIs and it was confirmed that HEIs attended the taskforce group.
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She also raised concerns over students leaving and possible options of
payback and contracts to tie in students for a length of time. Ian
Renwick supported Dee’s comment. It was agreed that whilst option A
could offer the opportunity to tie students into employment after
completion it would be more expensive as it would result in a salary
whilst undertaking the training. Option B was felt to be more cost
effective and trusts could consider sponsoring students (ie: fund their
tuition costs) to encourage retention.
The aim would be to have a Sept 2015 start and there was agreement
that consideration should be given to setting a time limit for students
to complete (ie: 2 years). Any such limit would need to be made
explicit to the students.
The Board agreed option B in principal with a request for an additional
paper on sponsorship proposals to return to the board.
Action: NK to seek more views from trusts in respect of sponsorship
and bring these proposals back to the board.
3) Advanced Training for Paramedics
Professor Kumar informed the group that consultation between NEAS
NK
and Paul Fell had helped form the funding options for this paper. She
added that option C was the preferred option and Jo Baxter agreed this
was the direction of travel. Ian Renwick fully supported option C and
highlighted the large benefits for career paths in NEAS.
The Board agreed option C but in future baseline numbers from an
initial 37 trainees would reduce.
4) Advanced Nurse Practitioner in Emergency Care
Professor Kumar outlined the options available to the Board adding that
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the taskforce was in favour of option C. Professor James asked
members for comments and both Kath Griffin and Ian Renwick
suggested this be fully funded. Alex Glover added that backfill would
not be paid.
The Board agreed option C.
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Risk Register
Kath Griffin presented the register in Paul McLaughlan’s absence which
was for information only. She added that no new risks had been added
this quarter. Risk 10 will be reviewed following the discussions at this
meeting on the taskforce proposals. Closed risks included:o Risk 8. Limited capability to identify workforce/recruitment
shortages until LETB structure embedded.
o Risk 18. Failure to deliver outcomes associated with the national
programme for developing postgraduate training for older people
with complex needs.
No new risks proposed for closure.
Dee Fawcett raised concerns over copyright for the “Find Your Place”
campaign with Northumbria Healthcare Foundation Trust. During
discussions it was pointed out that there would certainly be no financial
or other implications for this within HENE.
See Post Meeting Notes at the end of these minutes.
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Revalidation Report
Professor Kumar presented the report to give assurance to the board
that her role as responsible officer was being discharged appropriately.
The difference in deferral rates between LETBs was highlighted. Page 2
indicates reasons for deferrals. The report provided an audit and paper
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trail which also includes analysis of incident reporting by LEPs. She
confirmed that quality sampling had been carried out during the
process. Concerns arose around junior doctors doing trust locums, and
requirements for appraisals in this role was highlighted. Further work
was being undertaken in this area.
Professor James commented on the striking differences between Trusts.
Professor Kumar added that work was underway on thresholds at which
incidents were reported and there would be a plan moving forward.
This initial apparent variation is common among many new initiatives of
this type.
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GMC Narrative Reports
The below GMC survey reports were circulated in advance of the
meeting for information. Professor Kumar made reference to key areas.
Patient Safety
Page 19 – responses to question `help us understand more about local
reporting systems and comment on why you have not previously
reported this concern’. These concerns show a national position and
are not necessarily reflective of the north east.
Bullying and undermining
Page 6 – indicator scores for respondents who reported being bullied
every day (83%)
Page 14 – statistics indicating that management bullying is increasing.
Professor Kumar informed the group that a HENE wide, cross
organisational and multi professional anti bullying and cultural
awareness group had been set up to help support all involved in such
issues.
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Cultivating Compassion in End Of Life (EOL) care
Derek Marshall presented the information on a proposal to develop an
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EOL Training resource proposed by Dr Colette Hawkins (Consultant in
Palliative Medicine at CDDFT). He then asked the group for approval
commenting that should the programme be agreed HENE would own
the property rights with the funds being released in 3 phases to ensure
quality.
Further discussion took place around the licence fee under “one HEE”,
but with clarity that the product should be available for healthcare
organisations in the North East with no charge.
The proposal was supported.
11
2015 Planning Round for 2016/17
Derek Marshall presented the paper which proposed the 2015 planning
round as a baseline with which to identify appropriate investment levels
in the 2016/17 financial year. The proposal included moving to an eportfolio which would allow Trusts to return their data directly, but also
set up local passwords and thus have a system in their own
organisation which could be distributed FT wide, but also become a
rolling planning tool.
He outlined that the launch would be 4 February and highlighted the
timelines within his report.
The group discussed having to supply information in various formats to
multiple organisations and asked if the template could be streamlined
in future. Professor James suggested writing to Ian Cumming (HEE).
OJ/AG
ACTION: Professor James and Alex Glover to write to HEE regarding
Trusts concerns of providing data in multiple formats.
12
CPD Strategic Review update
Derek Marshall confirmed that notice had been given on these CPD
contracts. At the previous CPD review group meeting, discussion was
held about what CPD investment trusts make in addition to their tier 1
10
and tier 2 funding which is allocated via HENE. He proposed asking
trust leads what additional local FT funding was used, when contracting
with education providers, and from this it would be possible to
understand what the overall buying power was of the organisations in
the north east. This may then be used to maximise the value for
money in the region. The board agreed to Derek’s suggestion although
it was noted that the trusts may only be able to provide an estimated
figure.
13
Flexible Nurse Degree update
Derek Marshall presented the report which provided an update on the
implementation of flexible workplace based routes into nursing in the
north east. He confirmed 50 places had been agreed with the Open
University, of which 25 had been recruited to for the adult branch,
starting in September 2015. A further 25 would be recruited to via the
Open University (OU) for a September 2016 start.
Dee Fawcett asked if this was a block contract and Derek responded
that it wasn’t and so costs will only be incurred for the recruited places.
This was agreed with the OU on the understanding that the second
cohort in September 2016 would take place.
It was noted that a proposal will come to the Board to consider funding
the equivalent of a student bursary for these places since backfill of the
salary costs is not being funded. As part of this, consideration would
need to be given to any back dating of funds if the decision was made
after the first cohort starts. Professor James asked that Nurse Directors
be involved in this.
14
Draft Public Health Workforce Strategy
Professor James asked the group to consider the recommendations
following recent work carried out by Derek Marshall and David
Chappel. He added that Public Health England (PHE) is currently in reorganisation and asked how they could deliver PH in the north east and
11
demonstrate value for money.
1. The 10 recommendations within the report were considered with
recommendation numbers 1, 2, 3 and 8 deemed to be the
highest priorities. It was suggested that recommendation number
2 requiring a specification for a clinical educator should also
include that clinical educators should visit going to schools as
well as trusts. The comments and recommendations made by
Professor James and Derek Marshall concerning the other
recommendations were also agreed.
Martin Barkley agreed with the proposed recommendations but raised
concerns whether PH would have the resource to deliver.
Professor James suggested the document provided by Derek Marshall
and himself concerning all 10 recommendations made in the PH
Workforce strategy document should go to Roberta Marshall at PHE, as
well as to the PH Subgroup.
ACTION: Derek Marshall to forward the draft strategy to Roberta
Marshall at PHE for consideration.
15
DM
Constitution – New Partnership Council
Professor James presented firm proposals to the group on the future of
the Partnership Council including the membership being reduced from
30 to 22 representatives, removing Trust members:He added that MDAG would have 2 representatives due the group being
large however the Board felt this was not necessary and it was agreed
that it would be equitable to remain as 1 member.
12
Consideration was given to whether lay representatives should attend
and whether they would be more effective as a separate subgroup.
Professor Kumar suggested that a lay member from the lay rep forum
could attend as they have been trained and are very effective in other
HENE groups.
Further proposals included intranet access to documents and a
summary from the subgroup meetings to go the Partnership Council. It
was agreed that members of any task forces would also have access to
this intranet to ensure they are linked in with work undertaken by other
colleagues.
The Board agreed these proposals.
16
Development Session Proposals
Alex Glover commented that she had given thought to future
development sessions and proposed that both Calum Pallister and
Professor Ged Byrne could attend to deliver sessions of finance and
education and quality. She asked the Board if this would be useful and
added that perhaps a full day could be arranged incorporating the
Board meeting.
The Board agreed and a future date in May or June will be proposed.
ACTION: Alex Glover to arrange a suitable date and invite Calum and
AG
Ged to present.
17
A.O.B.
Professor Oliver James informed the group that he would be retiring
from HENE on 31 March. Sir Keith Pearson (HEE Chair) has asked for
replacement recommendations to appoint as soon as possible. An
interview panel will be set and it is proposed that this will include Sir
Keith Pearson, Martin Barkley or Jim. Professor Kumar suggested that a
13
clinical person should sit on the panel and Professor James
acknowledged this and agreed to speak with Alex Glover and Sir Keith.
18
Post meeting notes
Find your Place Campaign
Following the HENE Governing Body meeting and the query about
copyright for this campaign Kelly Angus confirmed on 26 January with
Claire Riley that this is not the case and the IP for this campaign does
not sit with Northumbria Healthcare Foundation Trust.
Future agenda items
Details of future meetings
Friday 27 February 2015 (Bourne House)
Friday 27 March 2015 (Bourne House)
Friday 24 April 2015 (Bourne House)
Friday 22 May 2015 (Bourne House)
Minutes completed by: Lisa Simmonette
Minutes confirmed by: Alex Glover
Professor Oliver James
Date: 29.01.15
Date 30.01.15
Date: 12.02.15
14
Approved Minutes on 04/02/15
Minutes of the Health Education North West London Board Meeting
nd
Room 24, 2
3rd December 2014, 08:30 – 11:00
Floor Events Centre, Stewart House, Russell Square, London WC1B 5DN
Board Members:
Marcia Saunders, Independent Chair (MS)
Lizzie Smith for Therese Davis Interim LETB Director NWL
Non-Executive Members:
Dr. Carole Amobi, GP Educator/Provider Member (CA)
Shane DeGaris, Acute Trust CEO (SDG)
Prof. Jenny Higham, HEI Member Imperial (JH)
Dr. Andrew Howe, Public Health Member (AH)
Sally Malin, Independent Member – Public & Patient Engagement (SM)
Adrian Bull, Associate Member – Managing Director, AHSN (AB)
In attendance:
Dr. Julia Whiteman, Health Education Dean (JW)
Jane Pauley, Deputy Head of Finance (JP)
Kathryn Jones, Deputy Director of Education & Quality (KJ)
Cheryl Crespo, Governance Support Officer
Also in
attendance:
Yinka Kuye, Regional Pharmacy Tutor London, Member of the Public
Prof Shelley Heard, Independent Member – Assurance (SH)
Claire Murdoch, Community/Mental Health CEO Member (CM)
Professor Janice Sigsworth, Joint Nurse Director Member (JS)
Prof. Jeremy Levy, Director of Multi-Professional Education and Quality (JL)
Dr. Tim Spicer, CCG Member, (TS)
Nina Singh, HR Director Member (NS)
Clare Parker, Finance Director Member (CP)
Thérèse Davis, Interim LETB Director (TD)
Apologies:
Ref.
12/14.1
Item
Action
Welcome and Introduction
MS welcomed all attendees, and advised members of new colleague Clare
Parker who had been recently appointed as the Finance Director Associate
Board Member. Clare had already taken part on the recent audit committee
meeting.
MS was pleased to announce that Professor Jeremy Levy had been appointed
as Director of multi-professional clinical academic training programmes at
Imperial College on a part time basis and would continue to remain heavily
engaged with the LETB. Therese Davis would be meeting with JL over the
coming weeks to review his work load to avoid potential conflicts of interests.
Recruitment for the joint nurse director member post to replace Louise Ashley
was in hand.
The Board welcomed and confirmed the appointment of Sally Malin,
Independent Member for Public Engagement, as the LETB vice-chair.
MS reported on the following new developments:
o
A number of national and local activities would be centralised and report
direct to the HEE Director of People and Communications, but
TD
MS, TD
o
o
o
o
o
outposted to LETBs and region – specifically the enabling functions of
governance and communications. The purpose, effect and efficacy of
this would be explored during the Phase 2 consultation
Chris Fowler, Managing Director of HENCEL, had taken on a
secondment to Barking, Havering and Redbridge University Hospitals
NHS Trust and Margaret Murphy had been appointed as the interim
LETB Director for NCEL until 31st March. Interviews had been arranged
for the 8th of December for the substantive NCEL LETB Director with
view for the post to commence on the 1st of April 2015
HEE central personnel currently in Portland House were expected to
move to Stewart House before the end of the financial year
The Joint Planning and Assurance Committee met on 1st November.
Comprised of LETB Chairs, Directors and the regional London and
South East team, the purpose and core business of the committee was
confirmed. It would focus on risk management, oversight of
collaboration on regional issues and programmes and specific areas of
interest to the whole of London and the South East
Three HENWL programmes were finalists in the current Health Service
Journal awards, 2 Community Education Provider Networks (CEPN)
Connecting Care for Children (CEPN) and the Brent and Harrow
Community Education Provider Network (CEPN) for narrative education
in care homes, under the Primary Care & Community Service Redesign
category. Health Education England and North West Thames
Foundation School were the recipients of the Value and Improvement in
Communication Award for the development of the Dr Toolbox
HENWL was now the host, on behalf of HEE, of the National School of
Occupational Health. This is the first national school and the first multiprofessional. The HENWL Postgraduate Dean and Independent Chair
were directly involved with the School as was the regional Director of
Education and Quality, Liz Hughes.
In the discussion that followed Board members sought clarification on the
impact of both phases of Beyond Transition, the restructuring commenced in
February 2014 and expected to conclude in January 2015. They were
particularly concerned about:



The impact on staff and staff morale of a prolonged period of
uncertainty. This was a concern. Levels of sickness were being
monitored.
Potential dilution LETB responsibilities for workforce planning and
investment
The impact on HENWL of the added complexity resulting from the
formation of a regional tier. The need for regional coherence was fully
acknowledged. In discussion it was stressed that budgets and
accountability would continue to sit with the individual LETBs and each
would continue to produce individual investment plans. Despite the
restructure as a result of Beyond Transition, it was largely business as
usual and basic changes were more subtle, e.g. one Director of
Education and Quality for the region which not only represented a loss
of local senior clinical leadership but would have an impact on the role
of the Postgraduate Dean.
12/14.2
MS noted apologies as above.
12/14.3
Register and Declarations of Interests
MS reminded members to keep the register of interests up to date.
12/14.4
Approval of Minutes of Board Meeting on 01st October 2014
The minutes of the meeting held on 1st of October were agreed as an accurate
record.
10/14.5
Board Action Tracker
Action 14/45 - Education Forum
JL to liaise with JH and provide a progress report in due course. It was
recommended that this action remained open.
JL / JH
Action 14/41 - Annual Review
The final report had been circulated to all relevant stakeholders and therefore
this action could be closed.
Action 14/35 – Workforce Development Investment
A meeting to be arranged between AH, KJ and the Miriam Samuel, new
Education Fellow, to develop a project on health visiting. A verbal report would
be provided at the February Board meeting. The action would be kept open.
Action 14/34 – Workforce Development Investment Simulation
The simulation strategy had been produced, workshop held and specific
projects were under way - the model has created lots of interest. It was agreed
that this action remain open.
Action 14/28 – Shaping a Healthier Future
The relevant issue had been addressed at the 5 November development
session (see below 10.14.6). It was agreed that this action could be closed.
Action 14/20 – Local Finance Network
The opportunities of the establishment of a local finance network would be
explored with Peter Holt, Head of Finance for London and London and South
East. This action would be kept open.
The Board approved closure of all completed actions and received the progress
report.
10/14.6
HENWL Director’s Report
LS reported on the following key developments:
Beyond Transition
KJ, AH
LS reported on the completion of Phase 1 of Beyond Transition and confirmed
all appointments made at director level. Consultation for Phase 2 was launched
on the 19th of November and would run for 45 days until the 9th of January.
Several adjustments had been made to the structure of the LETB to meet the
required cost savings with minimal disruption to staff.
Board Development session 5 November
A very productive Board Development Session on Shaping a Healthier Future
led by Thirza Sawtell and her NWL CCG strategy team was held on the 5th of
November and a report from the session would be shared with the Board
members shortly. (See 6.2 below.)
LS/CO
London Dental School
LS explained that hosting of the Dental School would be moving to the London
SE geography under the leadership of Liz Hughes, Director of Education and
Quality for London and South East.
6.1 Care Certificate
KJ provided a brief report on the delivery of the Care Certificate in response to
requirements set out in the Cavendish Report. The strategy encompasses all
support worker roles and wider workforce development. Richard Griffin (RG),
Director of the Institute of Vocational Learning and Workforce Research at
Buckinghamshire New University presented a report on its implementation on
behalf of HENWL and the report would be circulated to Board members
presently.
CO
The national Care Certificate would be launched in 2015 and HENWL and
many NHS organisations including GPs were engaged in the testing of the
Care Certificate with Hillingdon Hospitals as the formal pilot site.
6.2 Shaping a Healthier Future (SaHF)
LS reported that HENWL continues to support SaHF implementation. As a
result of delays to the decision making timeline for the proposed changes to
Ealing Hospital from the end of March 2015 many of the arrangements HENWL
has been supporting to manage learners through transition are being urgently
revisited.
The SaHF programme has been attracting increased interest from the media
and politicians over the last few months with Michael Mansfield QC leading an
assessment of the impact of the two A&Es closures in North West London on
patient safety. There were potential delays of implementation which could affect
planning for staff and learners. The discussion of the group focused on:
o
o
Staff consultation under way to plan for future employment of the
current Ealing midwifery workforce
The need to balance the clinical service requirements alongside
educational requirements, to be as flexible as possible and to engage
staff and trainees who will be affected throughout the planning
discussions
6.3 London Ambulance Service (LAS)
LS reported on the ongoing intensive support being provided to LAS to help it
LS
overcome workforce and performance challenges. HENWL recently
participated in an NHS England Quality Roundtable event to ensure sufficient
and effective support ’ A further package of financial funding for 2014-2015 had
been agreed to support staff retention and other interventions, such as
arranging to triple the intake of pre-registration paramedic science student
numbers for September 2015. The importance of monitoring was stressed.
6.4 National Information Projects
The Board noted the update on the national work streams which HENWL leads
on behalf of HEE, including the national Audit of Information Flows, National
Data Project, National Postcode tool, National Migration Project and HEE
performance guidelines.
6.5 Postgraduate medical training quality issues
JW reported on 3 pieces of activity related to paediatric services.
o
o
o
Work had continued with Great Ormond Street Hospital to address a number
of quality concerns relating to patient safety and training related to levels of
supervision and support including supporting the decision made by HEE and
the GMC to relocate trainees from the beginning of 2015
JW reported on a recent conversation of concern with Chelsea and
Westminster FT based on the GMC National Training Survey. The situation
would be monitored
Two HENWL Trusts have been visited as part of a follow-through on the
Obstetrics & Gynaecology departments. Initial feedback established no
concerns, although there were a number of recommendations to address
inconsistencies.
JW
The Board received the LETB Director’s report.
12/14.7
Board Assurance Framework and Risk Report
JP presented the Board Assurance Framework that had been included with the
risk report and noted that the format could in future be subject to change as a
result of new arrangements within London & South East. She drew attention to
the following key risks:
o
Seven new risks had been added of which one was from the
Professional Development Department and two from the London Dental
School both not deemed high risks post mitigation. Two new finance
risks had been added to replace an existing risk regarding 2015/16
budgets and funding allocations, as well as a risk highlighting pressures
on hosted finance service resources resulting from vacancies and
resignations; a further risk had been added relating to the broadening
foundation programme relating to applying a consistent approach to
funding and tariffs across London
o
Nine risks were proposed for closure including: embedding quality and
commissioning as the services had transitioned effectively, the
submission of workforce demand forecast with 100% successful return,
staffing in professional development department and quality and
commissioning as the risks have been mitigated successfully and the
London Migration to Oriel programme was effective
CO
o
Risks identified as part of the Mental Health Nursing Tender programme
have been incorporated into a separate register as they are commercial
in confidence
o
Hosted Informatics Service and London Dental School risks would be
transferred into the new risk owner at the regional level as soon as
applicable.
Discussion focused on the following:
o
o
o
o
The new risk related to the budget allocation and the likely impact of the
funding decision. HEE have has not yet been provided with a 2015/16
allocation by the Department of Health and there is a risk that it could be
reduced from 2014/15, particularly given the potential funding impact
following the Chancellor’s Autumn Statement
A risk related to resource and workload had an increased rating post
mitigation. KJ provided assurance that, since the last review, acting up
cover had been provided to manage the risk effectively and joint
working with other London LETBs is being explored
The requirement for an overarching pandemic risk is to be included on
the register
The risk register albeit comprehensive did not encourage focus on
major risks and what the Board required was a working Assurance
JP/CO/
Framework focusing on strategic objectives and major risks. It was
TD/MS
agreed that a review will be undertaken of risk reporting to the Board,
IAC and the executive team respectively, including the appropriate
levels of detail, review of ratings and also the broad issue of risk
tolerance.
The Board received the risk report and approved closure of all risks proposed
for closure.
12/14.8
Finance Report and Year-to-date Financial Position
8.1 – Year-to-date Financial Position
JP reported that there continued to be a small year-to-date underspend of
£167k at the end of month 7.
The underspend was attributable to classification changes by HEE,
underspends on future workforce due to phased spending and running costs
due to staff vacancies and the controls in recruitment as a result of spend
controls and approval processes. These were partly offset by an overspend on
education support and additional investment in Health Visitors. National
activities showed an overspend of £135k of which £109k related to the National
Cosmetics project funding which although approved, had not been received
from HEE yet. The remaining overspend relates to extension of the hosted
rehab engineering tuition funding beyond plan.
8.2 – 2014/15 Forecast Out-turn
The current forecast outturn showed an underspend of £140k which had been
agreed from planned running costs underspend. Detailed review on forecast
had been undertaken and an additional £3.2m underspend for programme
activities had been identified as a consequence of a number of uncertainties
including: student support mainly in non-medical forecasted expenditure which
would be finalised for period 8, issues with the GP registrars as detailed data
had not yet been confirmed and NIHR (Academic) posts LDA recharges
forecast being reviewed.
It was reported that as a result of a recent agreement between HEE and LAS
an additional £250K would need to be reflected in the LAS forecast plans.
The contingency budget had been shown as available in the forecast
calculation and the Workforce Development budget will be spent as planned.
JP reported that forecast non-recurrent programme funding available (currently
estimated at £3.2m) would be used to support SaHF-related activities.
8.3 – Key Financial Risks
o
A key risk around future budget allocation for 2015/16 and beyond
remained and JP confirmed the previously reported budget reduction of
£0.9m that would be applied to Workforce Development funding. There
also remained a risk of reduced budget based on the HEE national
allocation and financial modelling.
o
There is risk that HENWL may fail to deliver a balanced year end position
for 2014/15 due to the number of current uncertainties around spending on
some key areas. The Board was assured that this will be carefully
managed by the LETB Executive team.
The Board received the Month 7 financial position and finance report and noted
the risks as articulated above and in the risk report.
12/14.9
Workforce and Education Planning and Development of Investment Plan
LS presented an oral update on recent developments of the investment plan
which had been submitted to HEE on 29th October 2014.
HENWL had indicated plans to invest in non-medical learners and workforce,
across a range of professions and specialties who would be trained differently
with the skills and competencies to be employed in Primary and Community
Care roles such as: Pharmacy, Mental Health, Practice Nursing and Allied
Health Professions.
LS explained that a process is underway to review the affordability of the
England-wide investment plan for 2015-16, and that London is likely to need to
respond to some changes on proposed commissioning numbers.
Discussion focused on:




Challenges on evidence of a demand for the new roles
Reconciliation between the NHS 5 year forward view and HEE 15 year
strategy to ensure effective succession planning. A recognition of the
need for development of a short, medium and longer term strategy
Detailed conversations with providers on task and finish groups had
taken place to scope a comprehensive list of skills and requirements
needed for the new and innovative roles
Balancing the risks between available data and what is believed to be
needed for the future and the expectations of stakeholders.
The Board received the plan and requested a detailed report to be brought
back at its February Board meeting.
9.1 – Mental Health Nursing Tender
LS provided a brief progress update on the evaluation processes of the bids
LS
and reported that the outcome of the procurement of pre-registration Mental
Health Nursing education and training would be confirmed on the 5th of
December, following a sign-off meeting between the Chair and the LETB
Director through Urgent Action as agreed by the October Board. The
announcement of the conclusion of the procurement exercise had been subject
to a week delay to ensure that changes made were legally robust, within a
strong governance framework and able to achieve the planned outcomes as set
out on the invitation to tender. Communications would be managed carefully to
protect interests.
It was agreed that an outcome report would be circulated to all Board members
once preferred bidders are announced (w/c 8/12/14).
LS
The Board received the progress report. The final outcome would be reported
to the Board at its next meeting.
12/14.10
Public Engagement Committee (PEC) Chair’s Report
SM provided an oral report on recent decisions and discussions of the patient
and public committee.
The slides of the Board Development session on Public Health had been
shared with the group and its members had begun to compile suggestions on
ways to take some of the ideas forward.
SM reported on the draft PPE strategy refresh, to comprise of four principles:




Continue to build on existing work, its values, mission and model
PPE strategy to be embedded by active participation
To strengthen the relationship with stakeholders and partner
organisations and to draw from other lay partners across NWL
To share good and emergent PPE practice locally, regionally and
nationally and to develop opportunities for learning.
It was suggested that PEC becomes involved with the Patient Safety Network
which may interested in a reciprocal assistance approach.
The Board received the approved minutes of the PEC meeting held on 11th
September 2014.
12/14.11
Integrated Assurance Committee (IAC) Chair’s Report
MS reported on the most recent IAC meeting held on the 21st of November and
confirmed that the Committee’s members were confident in the assurance it
was receiving from officers and its ability to advise the Board. Membership
might require review following implementation of Phase 2 of Beyond Transition.
The Board received the approved minutes of the IAC meeting held on 23rd
September 2014.
12/14.12
Strategic Advisory Council (SAC) Chair’s Report
MS reported that SAC continues to be well attended and successful in terms of:
engagement, and was no focusing iterative systematic feedback and
dissemination to ever wider stakeholder communities.
The 3rd November 2014 SAC meeting focused on enabling progress of the
SM
primary care strategy and increasing apprenticeships in north west London.
SAC slides would be circulated to the Board on an on-going basis.
CO
The Board received the oral report.
10/14.13
Education Forum Report
JW reported that the strategy for Education Forum had progressed
considerably and it was in the process of developing networks to have a
multidisciplinary discussion with others and to share information. The next
phase of its interdisciplinary approach would be led by Clare Etherington with
the intention of aligning more closely the different number of existing networks.
JW confirmed that the draft’s terms of reference had been agreed and its
membership was being reviewed to ensure that it engages a wide range of
people from across the area.
10/14.14
Any Other Business
MS announced that Stephen Moss would be the new HEE non-executive
director associated with the four LETBs on London and South East and one of
HENWL direct line to the centre. Stephen would be invited to attend an
upcoming Board meeting and would be allocated sufficient time for discussion
with the Board.
The Board considered possible options for Board Development sessions next
year. The Board agreed to have a mental health strategy session early in the
year and a nursing strategy session for mid-year.
The meeting ended at 10:45.
Next Meeting: Wednesday, 4th February 2015, 08:30 – 11:00, Bloomsbury Ground Floor, Senate House
HEYH Nov 14.46
MINUTES of the MEETING of the BOARD of
HEALTH EDUCATION YORKSHIRE and the HUMBER
Held on 20 November 2014 at the National Coal Mining Museum, Wakefield
Present:
Kathryn Riddle
Mike Curtis
Chris Bain
Steve Ball
Karen Bryan
Linda Crofts
Pam Dawson
Juliette Greenwood
Mike Holmes
Clive Kay
Philip Marshall
Steve Walmsley
Tony Weetman
David Wilkinson
In attendance:
Ria Agarwal
Jonathan Brown
Jo Dally
Mark Purvis
Laura Roberts
James Thomas
Jo-Anne Wass
Kathryn Winterburn
Ian Wragg
Apologies:
David Brown
Chris Butler
Sue Cannon
Sir Andrew Cash
Shirley Congdon
Julian Hartley
Sue Holden
Chris Long
Yvette Oade
Independent Chair
LETB Director, HEYH
Chief Executive, Rotherham, Doncaster and South Humber
NHS FT
GP Representative (South Yorkshire)
Pro Vice-Chancellor, Faculty of Health and Wellbeing,
Sheffield Hallam University
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
Chief Nurse, Rotherham NHS Foundation Trust
GP Representative (North and East Yorkshire and North
Lincolnshire)
Interim Chief Executive, Bradford Teaching Hospitals NHS FT
Director of Workforce and OD, Harrogate and District NHS FT
Deputy Chief Executive, Workforce and OD, Local Govt.
Yorkshire and the Humber
Pro-Vice Chancellor for Medicine, University of Sheffield
Postgraduate Dean, HEYH
Physician’s Associate, Fisher Practice, North Yorkshire (for
item HEYH14/54)
Associate Director – Strategic Workforce Planning, HEYH
Corporate Governance Manager, HEYH (Secretary)
Director of GP Education, HEYH
HEE Director for North
GP, Fisher Practice, North Yorkshire (for item HEYH14/54)
OD Consultant, University of Leeds (observing)
Head of Leadership & Organisation Development, HEYH
Workforce Modernising Manager, HEYH
GP Representative (West Yorkshire)
Chief Executive, Leeds Partnership NHS FT
Director of Nursing, NHS West and South Yorkshire and
Bassetlaw CSU
Chief Executive, Sheffield Teaching Hospitals NHS FT
Pro Vice-Chancellor Learning and Teaching, Dean of School
of Health Studies, University of Bradford
Chief Executive, Leeds Teaching Hospitals NHS Trust
Director of Corporate Development & HR, York Teaching
Hospitals NHS FT
Chief Executive, Hull and East Yorkshire Hospitals NHS Trust
Medical Director, Leeds Teaching Hospitals NHS Trust
1
HEYH14/46
Welcome and Introductions
The Chairman welcomed all those present and specifically, Prof. Pam Dawson,
replacing Steven Ersser, to membership of the Board, and Dr Clive Kay, attending
his first meeting since having replaced Brian Millar. Mrs Riddle also introduced
Laura Roberts, HEE Director for North; and Ms Agarwal and Dr Thomas of the
Fisher Medical Practice, who were attending to present on Physicians Associates.
HEYH14/47
Apologies for Absence
Apologies were noted as above.
HEYH14/48
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.
HEYH14/49
Minutes of the Last Meeting
The minutes of the meeting of Yorkshire and the Humber LETB Board held on 16
September 2014 were approved as a correct record.
HEYH14/50
Matters Arising
There were no matters arising.
HEYH14/51
Working Together Across the North
Laura Roberts gave an overview of recent developments within HEE and progress
with respect to Beyond Transition, which had now entered the second phase and a
period of consultation.
Laura affirmed HEE’s support for LETBs and their very strong local voice and
engagement, working with providers and the wider health economy. She confirmed
that she would be working through LETB Directors so that a strong local interface
remained as before.
Having now attended Board meetings for the three northern LETBs, Laura said that
there was a great deal of commonality in the issues being raised, which confirmed
the importance of sharing and spreading the adoption of best practice.
The Board noted the invitation to participate in the consultation process for Phase 2
of Beyond Transition and to feedback any comments via Mike Curtis.
HEYH14/52
NHS Five Year Forward View: HEYH Workforce Transformation Programmes
2015/16
In the context of the recently-published NHS Five Year Forward View, Mike Curtis
set out the range of workforce transformation programmes currently in progress.
The Five Year Forward View had confirmed the need for transformational
approaches to securing future workforce and Mike explained that going forward he
would be inviting the Board to engage in discussions about the prioritisation of these
programmes to ensure that efforts were being focussed appropriately.
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Chris Bain was supportive of the approach outlined but commented that Trusts and
CCGs were still themselves in the process of reviewing their own strategies in the
context of the Five Year Forward View, including considering strategies for
workforce development in response to changes to the commissioning of future
services.
Linda Crofts commented that much of what was envisaged was predicated on the
up-skilling of staff in bands 1-4. Inconsistencies in qualifications and lack of parity
between health and social care could act as an impediment to the required progress
and impact on the delivery of services.
The Board noted the proposed approach to Workforce Transformation Programmes.
HEYH14/53
A Future Workforce Strategy for General Practice
The Board received a paper setting out the Future Workforce Strategy for General
Practice, with an accompanying presentation from Mike Holmes and Mark Purvis.
The Strategy was well-received by members. In the ensuing discussion, Linda
Crofts commented on the need to increase the transparency of routes into primary
care for nurses. Mike Holmes acknowledged this and added that support was also
needed for nurses wishing to make the transition from secondary care to primary
care.
Tony Weetman said there was a need to promote the development of multispecialty community providers. He suggested that a summit could be arranged to
bring together primary and secondary care to look at innovations that would support
the development of these models.
Karen Bryan confirmed that a core curriculum for advanced practice had been
developed that could be adapted to incorporate a pipeline into primary care.
It was suggested that there was also scope to encourage AHPs, such as
occupational therapists and physiotherapists, into primary care and for building
linkages with social care. Improving the interface between primary and social care
would make a significant impact.
There was agreement that the experience of good quality placements in primary
care enabled students to gain insight into routes, such as primary care, that they
may not otherwise have considered.
David Wilkinson commented that one of the challenges in attracting people to work
in primary care arose from the way in which primary care communicated about
itself. Much was made publically about the difficulties facing GPs, much less about
the rewarding aspects of general practice. Students considering career options
picked up on these negative messages.
Mark Purvis outlined the benefits of the data set now available as a result of the GP
tool. The availability of skills data would enable CPD planning and the identification
of pathways for career progression.
In response to a question from Steve Ball about how the Strategy would be
operationalised, Mike Curtis reported that NHS England and commissioners had
approached HEYH about the development of a joint strategy for Yorkshire and the
Humber. A summit had been proposed and Mike anticipated that this would result
in the development of a joint plan to enact the strategy.
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The Board endorsed the Future Workforce Strategy for General Practice.
HEYH14/54
Development of a Physicians’ Associates Programme
The Board received a presentation from Dr James Thomas, a GP from the Fisher
Medical Centre in Skipton about his Practice’s experience of employing three
physician’s associates. Ria Agarwal, one of the PAs at the Fisher Practice,
explained the training she had undertaken and described her experience working in
primary care.
In the ensuing discussion members asked about feedback from patients and
considered the challenges of attracting PAs to deprived areas.
Ian Wragg commented that a key factor in attracting PAs into primary care was the
experience of a high quality placement. Linda Crofts said that the same was true for
secondary care, where PAs were also highly sought after.
Only around 220 PAs were currently working in the UK. A number of education
providers in Yorkshire and the Humber were looking to develop courses. Posts
were most commonly graded as Agenda for Change 7-8a.
The Board thanked Ms Agarwal and Dr Thomas for their presentation.
HEYH14/55
LETB Director’s Report
The Board received and noted the report of the LETB Director, which included
updates in respect of the interim management structure within HEYH, plans to
establish a Transformation Programme Board and the response to the NHS
England review of the Leadership Academy.
HEYH14/56
Corporate Delivery Report
The Board received and noted the Corporate Delivery Report (CDR) for October
2014 and the Investment Plan for 2015/16
HEYH17/57
Quality Report
The Board received and noted an update on recent activity in respect of the Quality
agenda, including a summary of matters raised during the course of the GMC
Regional Review.
The Board also received and noted the Annual Revalidation Report for 2014.
HEYH14/58
HEYH14/59
Risk Management
i.
Corporate Risk Register 2014/15
The Board received the current iteration of the Corporate Risk Register and
noted the reduction to two risk scores.
ii.
Identification of Additional Corporate or Operational Risks
No additional items requiring inclusion on the Risk Register were identified.
GP Recruitment 2015: Appointments across Yorkshire and the Humber
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The Board received a report in respect of GP recruitment in 2015 and supported the
approach described, which was aimed at attracting trainees to locations that had
difficulties in recruitment.
HEYH14/60
Any Other Business
i.
Health Service Journal Awards
The Chairman was very pleased to report that Health Education Yorkshire
and the Humber’s Advanced Practice Scheme had been announced as the
winner of the HSJ Workforce award 2014.
It was agreed that a letter of congratulations be sent on behalf of the Board.
ii.
HEYH14/61
Sharon Oliver
The Chairman and the Board wished to record their gratitude to Sharon
Oliver for her very significant personal and professional contribution to the
work of the LETB.
Date of Next Meeting
The next meeting of Yorkshire and the Humber LETB was scheduled for 2.00pm on
Thursday, 22 January 2015 at the National Coal Mining Museum, Wakefield.
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