1. business and industrial
2. paper industry

Health Education North West London - Board Meeting Agenda
15th April 2015, 08:30 – 11:00
st
Torrington Room, 1 Floor, Senate House, Malet Street, London
Item
Reference
1.
Welcome & Introduction
Oral
2.
Apologies: CM, CP, SH, SM,
Oral
3.
Register and Declarations of Interests
Paper A
4.
(page 3-9)
th
Paper B
6.
Approval of minutes of Board meeting on 4
February 2015
Matters arising from previous minutes not on
agenda
Board Action Tracker
7.
LETB Director’s Report
Paper D
(page 22-28)
Paper E
(separate)
5.
Item to receive – Mandate Refresh
(page 10-18)
Oral
Paper C
(page 19-21)
8.
The School of Occupational Health
9.
Board Assurance Framework
Presentation by
John Harrison –
Head of the
National School
of Occupational
Health
Paper F
10
Finance Report and Month 11 Financial Position
Paper G
(page 29-36)
(page 37-41)
11.
Budget 2015/16
Paper H
(separate)
12.
13.
Report on the 2015-16 workforce and education
planning activity
Leadership Academy Review
14
Committee and Forum Reports
a) Education Forum
• Chair’s Report
Oral - Ann Marie
Archard – Head
of Leadership
London
Oral
b) Public Engagement Committee (PEC) Report
• Chair’s Report
• PPE Strategy Review
• Item to receive – Approved minutes of
Developing people
for health and
healthcare
Oral
Oral
Paper I
(page 42-57)
Lead Director
Chair – Marcia
Saunders
Chair – Marcia
Saunders
Chair – Marcia
Saunders
Chair – Marcia
Saunders
Chair – Marcia
Saunders
Interim LETB Director
– Lizzie Smith
Interim LETB Director
– Lizzie Smith
Postgraduate Dean –
Julia Whiteman
Deputy Head of
Finance – Jane
Pauley
Deputy Head of
Finance – Jane
Pauley
Deputy Head of
Finance – Jane
Pauley
Interim LETB Director
– Lizzie Smith
Head of Professional
Development –
Catherine O’Keeffe
EF Chair – Jenny
Higham
PEC Chair – Sally
Malin
We are the Local Education and Training Board for North West London
1
PEC meeting held on 12th November 2015
Paper J
c) Integrated Assurance Committee (IAC)
• Chair’s Report
• Item to receive – Approved minutes of IAC
meeting held on 27th January 2015
Oral
Paper K
IAC Chair – Shelley
Heard
Oral
SAC Chair – Marcia
Saunders
Chair – Marcia
Saunders
(page 58-62)
(page 63-71)
d) Strategic Advisory Council (SAC)
•
15.
Chair’s Report
Any Other Business
Oral
Next Meeting: Wednesday 3rd June 2015, 08:30 – 11:00, Room 24, 2nd Floor Stewart House, venue to
be confirmed
Developing people
for health and
healthcare
We are the Local Education and Training Board for North West London
2
Health Education North West London
Board Paper Coversheet
Paper A
(Coversheet)
Meeting Date
15th April 2015
Paper Title
HENWL Board & Executive Members’ Register of Interests
Paper Number
A
Paper Author
Cheryl Crespo, Governance Officer
Author Contact
[email protected]
Lead
Marcia Saunders, Independent Chair
FOI Status
Public Domain
Paper Summary
The paper records relevant interests registered by HENWL Board
members and includes Executive team members’ declarations. The
current register includes all hosted teams.
Date paper completed
7th April 2015
Purpose
To record relevant interests and to formally review these at monthly
Board meetings in order to identify any potential conflicts of interests
Recommendation
That the Board reviews the updated register and members report any
changes to the Governance Officer
Where was the Paper
previously discussed
Last Board meeting held on 2nd of February 2015
What was the
outcome
Continuous declaration process as per policy
Strategic Objective
Links / EOF Links
Adherence to The Code of Conduct for NHS Managers and Nolan
Principles of Public Life is central to HENWL’s achievement of all its
objectives
Identified risks and
risk management
actions
To be kept under review at every Board meeting
Resource
implications
There may be training / organisational development implications. The
Register must be extended to all staff
Support to NHS
Constitution
Supports effective governance / transparency / NHS values and
behaviours
Legal implications
including equality and
diversity assessment
Failure to declare interests and manage appropriately could
jeopardise the integrity of decisions
HENWL
Board
15 April ‘15
3
Health Education North West London
Board Register of Interests
NAME
Role on Board
INTEREST(S)
DATE OF
DECLARATION
Lizzie Smith
Interim LETB Director
None to declare
Updated
13/04/2015
Shane DeGaris
Acute Trust CEO Member
•
•
•
Chief Executive, The Hillingdon Hospitals NHS Foundation Trust
Member of the Chartered Society of Physiotherapy
Board Member, Imperial College Health Partners
12/11/2012
Shelley Heard
Independent Member,
Assurance
•
Educational consultancy (SRRRH Consultancy Ltd.). I am a Director (and key worker) for
this educational consultancy. My priority work to date has been with the DH (CSO) on
Modernising Scientific Careers.
12/11/2012
Jenny Higham
HEI Member
•
•
•
•
•
Vice Dean and Director of Education, Imperial College Faculty of Medicine
Non-Executive Director, West Middlesex University Hospital NHS Trust
Governor of Chelsea and Westminster NHS Foundation Trust
Senior Vice Dean, Lee Kong Chian School of Medicine, Singapore
President, Health Sciences Academy (HSA)
25/06/2013
Updated
04/02/2015
Jeremy Levy, Director of
Multi-professional Education
& Quality
•
•
Consultant Nephrologist at Imperial College Hospital NHS Trust
Appointed as Director of clinical academic training programmes at Imperial College
Academic health science centre
25/06/2013
Updated
26/11/2014
Sally Malin
Independent Member,
Patient and Public
Engagement
•
Member, Independent Scientific Advisory Committee (ISAC), Medicines and Healthcare
products Regulatory Agency (MHRA)
Lay representative, HEE Medical Advisory Group - pecuniary
Husband, John Keenan, is Assistant Principal (Student Services) at Stanmore College –
familial
Lay Member, GMC Credentialing Working Group
Lay representative, MBBS curriculum 2020 Review Group, King's College
12/11/2012
Updated
21/11/2013
•
•
•
•
4
updated 09/05/2014
NAME
Role on Board
INTEREST(S)
DATE OF
DECLARATION
Claire Murdoch
Community/Mental Health
Trust CEO
•
•
•
•
Registered RMN – will therefore be likely to have a professional interest in nursing
Chief Executive, Central and North West London NHS Foundation Trust
Board Member, Imperial College Health Partners
Chair of Governors, Fortismere School
12/11/2012
updated 29/10/2013
Marcia Saunders
Chair
•
•
•
•
•
•
Member, Board of Governors and Pro-Chancellor, De Montfort University
Member, Independent Scientific Advisory Committee, (ISAC), MHRA
Lay Assessor, GMC
Director of Nursing - ICHT (part of Imperial AHSC)
Trustee – General Nurse Council Trust
Honorary Professional Appointments – Kings College, Bucks New University and Middlesex
University
12/11/2012
Nina Singh
HR Member
•
•
Director of Workforce at The Royal Marsden NHS Foundation Trust
Member, London Leadership Academy Reference Group
Andrew Howe
Public Health Member
•
HEE has mandate for workforce development for public health and thus funding could be
made available to Harrow’s public health team.
12/11/2012
Updated
04/02/2015
19/09/2013
Adrian Bull
Associate Member, AHSN
•
Managing Director – Imperial College Health Partners
21/11/2013
Tim Spicer
CCG Member
•
General Practitioner, Richford Gate, Medical Practice, W6 7HY which is a training and
teaching practice
Chair, Hammersmith & Fulham Clinical, Commissioning Group
Programme Medical Director, Shaping a Healthier Future
GP Principal and Partner, Brentfield Medical Centre
Member Harness Care, GP locality group Brent (service provider)
GP Trainer at Health Education England (formerly London Deanery)
Trustee – volunteer post at Brent Centre for young People (contracts with Brent CCG and
Brent Council)
17/01/2014
Janice Sigsworth
Joint Nursing Member
Carole Amobi
GP Educator Member
•
•
•
•
•
•
5
22/11/2012
Updated
04/02/2015
30/03/2014
NAME
Role on Board
Clare Parker
Associate Finance Member
INTEREST(S)
•
•
Shelley Dolan
•
Joint Nursing Member
•
•
DATE OF
DECLARATION
Employed as Chief Financial Officer, Central London, West London, Hammersmith &
Fulham, Hounslow and Ealing CCGs
Public Sector Director, appointed by Community Health Partnerships, West London Health
Partnerships Ltd (LIFT company for H&F, Hounslow and Ealing), Husband is Audit Chair
and Non-Executive Director, East of England Ambulance NHS Trust
24/11/2014
Chief Nurse at The Royal Marsden NHS Foundation Trust and Executive Director of Quality
and Governance
Health Research Authority, Chair of London Chelsea Research Ethics Committee
London Cancer Alliance, Clinical Director
10/02/2015
Executive Directors’ Interests
NAME
Executive Director role
INTEREST(S)
Julia Whiteman, Post –
graduate Dean
•
Elizabeth Jones,
Postgraduate Dental Dean
None to declare
Nigel Fisher, Associate
Dental Dean
•
Member of the Overseas Registration Panel, General Dental Council
Peter Briggs, Associate
Dental Dean
Raj Rajarayan, Associate
Dental Dean
Raj Rattan, Strategic
Associate Dean
•
•
•
Consultant in restorative dentistry at St George's Hospital
President-Elect and Council Member, British Society of Prosthodontics
Director at Dentist Provident Society (permanent health insurer for dentists)
•
•
GDS contract holder at dental practices in Bromley and Oxford
Senior Dento-Legal adviser providing services on a consultancy basis via Dental Protection
Ltd.
Lead Dean for Clinical Radiology, Nuclear Medicine and audio-vestibular medicine
nationally
6
DATE OF
DECLARATION
27/06/2013
Reviewed
24/09/2014
25/09/2013
Reviewed
14/01/2015
25/09/2013
Reviewed
13/01/2015
12/01/2015
26/09/2013
13/12/2013
Updated
17/02/2015
NAME
Role on Board
INTEREST(S)
DATE OF
DECLARATION
•
•
Catherine O’Keefe
Head of Professional
Development
Penny Morris
Education Lead,
Professional Support Unit
Tony Burch
GP Advisor
John Madsen
Head of Shared Informatics
Services
Executive advisor to Denplan providing consultancy services to Denplan
Providing consultancy services on e-learning and general professional issues to Healthcare
Learning company
• Member of arbitration panel at Dentists Provident Society
• Director of and providing consultancy and training services through I-Qed Ltd.
None to declare
29/01/14
•
Penny’s husband (Ernest Dalton) is a freelance facilitator providing educational developing
and communication skills training under his or his company’s trading name – Patient
Teacher PR.
15/10/13
Reviewed
02/10/2014
•
•
•
•
•
Portfolio GP
GPSI Older People, NHS Brent
Chair, Age UK Brent
Trustee, Chisenhale Dance Space, E3
Seconded from Health and Social Care Information Centre
12/11/2012
updated on:
29/01/14
30/01/2015
Steve Richards
Head of Business
Intelligence
None to declare
24/02/2014
Kavitha Saravanakumar
Head of Systems and
Development
Graeme Gunn-Roberts
Head of Business
Engagement
Stephen Loughran
Head of IT Services
None to declare
14/02/2014
None to declare
12/02/2014
None to declare
28/02/2014
Silvio Giannotta,
Quality & Commissioning
None to declare
25/03/2014
7
NAME
Role on Board
INTEREST(S)
DATE OF
DECLARATION
Manager (Medical & Dental)
Kathryn Jones
None to declare
09/04/2014
Mark Statham
Head of CPPD
•
26/03/2014
•
University of West London: Joint publication with Bob Gates, Professor of Learning
Disabilities. Lecturers and Students as Stakeholders for Education Commissioning for
Learning Disability Nursing: Focus Group Finding from a Multiple Method Study, Nurse
Education Today, Volume 33, Issue 10, October 2013
British Journal of Learning Disabilities: Reviewer for British Journal of Learning Disabilities,
Editor is Bob Gates.
None to declare
•
Employed by Solent Supplies – none to declare
21/05/2014
•
03/06/2014
•
•
•
Director of the Board of Trustees for the charity that runs the Mount Vernon Hospital
Postgraduate Centre
Clinical Lead MAP, CSA Examiner and News and Views Editor Innovait Journal at RCGP
GP Principal Partners Ridgeway Surgery, Harrow
None to declare
•
None to declare
18/07/2014
•
None to declare
18/07/2014
•
None to declare
21/07/2014
•
•
GP Partner, Independently contracted with NHS as primary care service (GMS) provider
An elected member of Ealing, Hammersmith and Hounslow Local Medical Committee, the
21/08/2014
•
Laura Emson
Senior Commissioning
Manager
Larna Smith
Procurement Lead
Clare Etherington
Head of Primary Care
Education & Training
James Cain
Senior Assurance Manager
Kamaljit Bungar
Commissioning Manager
Jason Luu
Contract procurement
Officer
Katherine Kalyan
Commissioning & Contract
Support Officer
Dr Ramesh Bhatt
Associate Director of
8
19/05/2014
27/05/2014
NAME
Role on Board
Education
HE NWL School of General
Practice
Dr Caroline Smith
Foundation School Director
NWTFS
Chandi Vellodi
Trust Liaison Dean, Speciality
Schools
David Sines
Primary Care Advisor
INTEREST(S)
•
•
statutory body that responsible for the scrutiny of GPs’ Terms and Conditions on behalf of
general practice and is consulted with by local CCGs
Share-holder in Ealing GP Federation – a provider organisation seeking service contracts
over and above GMS contract
None to declare
DATE OF
DECLARATION
22/08/2014
•
Employed as Consultant physician acute and geriatric medicine at the Royal Free London
Foundation Trust
26/08/2014
•
Bucks New University, Emeritus Professor and Healthcare adviser on mental health tender
until 30/09/14)
CLCH, Non-Executive Director
NHS North West London, workforce Advisor on non-medical Workforce projects
The Burdett Trust for Nursing, Trustee
01/09/2014
•
•
•
9
Health Education North West London
Board Paper Coversheet
Meeting Date
15th April 2015
Paper Title
Draft Minutes of the last Board meeting held on 4th of
February 2015
Paper B
(Coversheet)
HENWL
Board
15 April ‘15
Paper Number
B
Paper Author
Cheryl Crespo, Governance Support Officer
Author Contact
[email protected]
Lead
Marcia Saunders, Independent Chair
FOI Status
In public domain upon approval
Paper Summary
The paper contains the draft minutes of the most recent meeting held
on 4th of February 2015.
7th April 2015
Date paper completed
Purpose
The Board to review the minutes and agree them as a complete and
accurate record of the meeting
Recommendation
As above
Where was the Paper
previously discussed
Not formally discussed
What was the
outcome
n/a
Strategic Objective
Links / EOF Links
All objectives, in particular objective 1
Identified risks and
risk management
actions
n/a
Resource
implications
n/a
Support to NHS
Constitution
Supports the aim of openness and transparency and equitable access
to information
Legal implications
including equality and
diversity assessment
No direct implications identified, support available to facilitate equal
access to information; no formal assessment has been carried out
10
DRAFT
Minutes of the Health Education North West London Board Meeting
4th February 2015, 08:30 – 11:00
Bloomsbury Room, Ground Floor, Senate House, Malet Street, London, WC1E 7HU
Board Members:
Marcia Saunders, Independent Chair (MS)
Therese Davis Interim LETB Director NWL
Non-Executive Members:
Dr. Carole Amobi, GP Educator/Provider Member (CA)
Prof. Jenny Higham, HEI Member Imperial College(JH)
Dr. Andrew Howe, Public Health Member (AH)
Adrian Bull, Associate Member – Managing Director, West London Academic
Health Science Network (AB)
Prof Shelley Heard, Independent Member – Assurance (SH)
Professor Janice Sigsworth, Joint Nurse Director Member (JS)
Dr. Tim Spicer, CCG Chair, (TS)
Nina Singh, HR Director Member (NS)
In attendance:
Sir Stephen Moss, Non-Executive Director HEE Board(SSM)
Jane Pauley, Head of Finance (JP)
Kathryn Jones, Deputy Director of Education & Quality (KJ)
Lizzie Smith, Director of Workforce and Planning (LS)
Cheryl Crespo, Governance Support Officer
Clare Parker, Finance Director Member (CP)
Sally Malin, Independent Member – Public & Patient Engagement (SM)
Claire Murdoch, Community/Mental Health CEO (CM)
Shane DeGaris, Acute Trust CEO (SDG)
Dr. Julia Whiteman, Health Education Dean (JW)
Apologies:
Ref.
02/15.1
Item
Action
Welcome and Introduction
The Chairman welcomed everyone to the meeting and especially HEE Board
Non-Executive Director, Sir Stephen Moss who had recently taken on the role
of HEE NED Liaison for London and South East.
MS advised that the Board development sessions were now be called “Focus
sessions”. The Board meeting had been re-arranged to allow for full
consideration for the HENWL led National Migration Data Project [item number
02/15.7].
MS confirmed that Therese Davis would be taking up her new post as Director
for HENCEL as of the 1st of April and until then she would split her time
between the two LETBs.
MS announced the appointment of Shelley Dolan, Chief Nurse at
The Royal Marsden NHS Foundation Trust, as the Joint Nurse Director Board
member. A shared post with JS.
MS introduced Sir Stephen Moss who provided a brief overview of his career
and his role with HEE and the LETBs in LSE. HENWL was the first of the
LETBs that he had visited. He was keen to learn the dynamics and issues of
medical student commissioning to ensure that education, development and
11
leadership until advanced. HE was keen to know the LETBs’ specific issues
and how it works in practice.
MS reported on the following developments:
o
o
o
o
The new was imminent and major changes appeared unlikely
The Care Certificate was due to launch later in the month and it had
been progressing well with huge local engagement around the country.
A fuller update would be provided in a later agenda item as part of the
LETB Director’s report.
Benchmark pricing
Funding of extra resources in NHSE.
02/15.2
MS noted apologies as above.
02/15.3
Register and Declarations of Interests
MS reminded members to keep the register of interests up to date.
02/15.4
Approval of Minutes of Board Meeting on 03rd December 2014
The minutes of the meeting held on 3rd of December were agreed as an
accurate record.
Matters Arising from the Minutes
There were no matters arising from the previous minutes.
02/15.5
Board Action Tracker
Action 13/77 – Board Member Nomination
The new nurse member appointment had been confirmed and therefore this
action was closed.
Action 13/80 – Risk Reporting Review
The assurance framework including the approach to risk reporting would
remain under review, and development for improvement through the IAC in
collaboration of the regional team. This action would be kept open.
Action 13/81 – Mental Health Nursing Tender
The full report was included as part of the papers [item number 02/15.10]. The
action was closed.
Action 13/82 Strategic Advisory Council
The slides from their last meeting were circulated to Board members on the
02/02/15. This action would remain on-going.
Action 14/35 – Workforce Development Investment
Initial scoping had concluded and it was agreed the focus would be in
demography through Public Health data and how his could be incorporated into
12
KJ, AH
Workforce Planning. AH would be working with KJ and Miriam Samuel,
HENWL Education Fellow. A progress report on the initial stage of the project
would be presented to the April Board meeting. This action would remain open.
Action 14/23 – National Data Project
The findings of the project were to be covered during the meeting (agenda item
12). It was agreed that was closed.
The Board approved action closure as above and received the progress report.
02/15.6
HENWL Director’s Report
TD reported on the following key developments:
Beyond Transition
Consultation for Phase 2 had closed on the 9th of January and the HEE Board
had met on 27th of January to approve the plans. Staff anxiety had continued
while waiting for the outcome of the consultation, however; the scale of the
changes had been mitigated by careful action over the past year so there would
be relatively few changes. These would be implemented swiftly to avoid
disruption.
6.1 Nursing and Midwifery Placement Capacity
KJ reported on a limited time project that had started at the end of January to
identify ways to resolve placement capacity issues which was especially critical
in Child Nursing and Midwifery. In addition, it was intended to establish a clear
mechanism for managing placement and repatriation across the geography as
well as ensuring integration with the workforce education planning process.
The discussion focused on:
o
o
o
o
o
o
o
o
o
Disparities between commissioning and numbers of placements offered
in NWL
The need to understand which providers readily take students and those
that have difficulties and how the LETB can provide support to expand
some areas
To identify clear pathways and reconfiguration of placements
To ascertain if placements in other areas such as community and
Primary care are being explored
Historic reasons of why placements of specialist areas are being
repatriated to other parts of London
Need to unpick this challenge on the distribution of students as
particularly in paediatrics, training was concentrated to certain providers
Revisiting the tariff in some areas where students are re-distributed
Whether there would be any implications on nursing placements as a
result of the anticipated Willis report
Principles of equity between LETBs in London and forming fresh
arrangements to start in the coming September.
It was agreed that KJ would initiate a further discussion with Board members to
seek clarity on the scope of the placement capacity project.
13
A progress report on the implementation of the Care Certificate, Dementia and
AHP projects were noted.
KJ
6.2 Workforce and Education Planning
LS reported that initial discussions with HEE had started to take place to agree
a method and a timeline for the 2015 medical workforce planning process. NWL
had commenced a consultation with Trusts on future workforce and the
demand for new and innovative roles. An end of consultation meeting with key
stakeholders was planned for May 2015 to consolidate key themes and devise
LS
next steps.
6.3 Shaping a Healthier Future (SaHF)
LS reported that HENWL continues to support SaHF and Whole Systems
Integrated Care programmes. Both programmes are subject to a rigorous
assurance process by NHS England and HENWL had provided letters
describing the support HENWL had been providing to the programme, and
asserting that the changes to services would not impact negatively on training
across the patch.
A gap had been identified in the maintenance of the paediatric training rota and
as a result new Trust Grade roles would be developed that not only would
provide a safe delivery of service but also an attractive development
opportunity with excellent service rotations and HENWL supported leadership
programmes.
6.6 Physician Associates Project
LS confirmed that HENWL is one of two LETBs supporting a Hillingdon led
programme to bring experienced Physician Associates from America with the
aim to address gaps in the workforce and the challenges of patient ‘face-time’
particularly in Emergency medicine and Primary Care professions.
At the moment the demand was being tested and Buckinghamshire New
University and Brunell had both indicated an intention to launch education
programmes to train additional PAs in England.
Discussion focused on:
o
o
o
The need to clarify all the new roles such as nurse practitioner and PAs
and their contribution and how they complement each other
Service models for these roles are being planned but in the case of PAs
their impact had not yet been tested
Need to be built into the process and to have clarity of what is expected
of roles and of the service.
It was agreed that a simple chart would be drafted to reflect all the new roles
and what is anticipated that these roles would do.
6.7 London Ambulance Service (LAS)
LS highlighted that a number of initiatives had been taking place to support the
14
LS
LAS and its key intervention at the moment was to influence the significant
increase of Paramedic students in September 2015 which presented a problem
as paramedic degrees are not NHS commissioned but HEFCE funded.
LS
The Board received the LETB Director’s report.
02/15.7
Presentation of the finding of the National Migration Data Project
LS presented, on behalf of her team, a number of slides on the findings of cross
boundary Migration Data of students first destinations and later movement. LS
expressed her gratitude to the team and in particular to Helen Mansfield for her
leadership of the project.
LS confirmed that the information presented would be key to inform in the
LETBs’ planning activity and would be used to recognise trends in how the
LETB invests on its workforce.
The project had been commissioned by HEE and HENWL, it utilised data from
Higher Education Statistics Agency on Destination of Leavers of Higher
Education and Electronic Staff Records data to show in year movement and
focuses on non-medical workforce.
The data demonstrated that overall retention of newly qualified staff was lower
in London than in any other part of England. This however; was being rebalanced as the data showed inflows at later stages of their careers. The
information was significant to identify retention areas or the lack thereof. For
example: in child nursing NWL was at the bottom of the chart in retention of
newly qualified students yet if the data was analysed for London and South
East area, the score on retention was just above the national average. It was
also important to understand at what stage of their careers most of the
migration took place which gave strength to the argument of middle staff issues
in NWL.
The discussion focused on:
o
o
o
o
o
o
o
o
o
The dynamic between LETB boundaries in relation to professions
People are less likely to move once they settle on their careers
The apparent competition between schools that takes place
The need to focus on planning around repatriation and how to work
around it
Understanding that curriculum planning should accommodate NWL
churn
The possibility of agreeing Pan-London assessment tools to cut down
duplication and to enable commissions across boundaries to strengthen
student rotations
The need for all LETBs across the geography to agree to increase
commonalities
If the LETB should be utilising the data to apply pressure to the housing
agenda by engaging with local government
Economic gearing of strategic choice of short term incentives such us
discount on transport and long term incentives such as housing that is
affordable.
The Board congratulated Helen Mansfield and Lizzie Smith on the report
15
LS
and agreed to support the design of Phase 2 of the Migration project.
02/15.8
Board Assurance Framework and Risk Report
JP presented the Board Assurance Framework and the LETB’s principal
strategic risks and described the controls in place for mitigation.
JP drew attention to the following changes to the risk register:
o
Two new risks had been added: one in relation to Shaping a Healthier
Future and delays to decision making on service changes and the
impact this could have on learners due to tight timescales for
implementation. A further risk had been added on dental technical
support to the eWisdom Contract as UoL IT support could cease
imminently. Both risks are being managed and are currently rated
green.
o
An additional key risk had been identified. The previously rated amber
risk relating to Commissioning of the Psychological Service for Doctors
and Dentists. The procurement process had been delayed and there
were concerns on the safe transition of the service.
o
Seven risks were proposed for closure following advice from IAC as
mitigating actions had proven successful or the risk had diminished.
Discussion focused on the following:
o
Risk relating to GP Expansion had moved on rating from red to amber
and based on the action plan it was not clear whether the issue had
been managed successfully. It was proposed to split the risk into two,
one risk focused on the short term issue and another to focus on the
long term impact and the mitigation and risk ratings will be reviewed.
The Board received the risk report and approved closure of the risks proposed
for closure.
02/15.9
Finance Report and Year-to-date Financial Position
9.1 – Year-to-date Financial Position
JP confirmed an underspend on a number of areas at the end of month 9.
o
The underspend was attributable to a number of areas on the Future
Workforce budget including student support.
o
Running costs had shown an underspend of £172k due to vacancies
and previous restrictions on recruitment. As controls were no longer in
place, the team had taken action to rapidly recruit and fill all vacancies.
o
The overspend on Education Support was attributable to changes in
classification of activities from Future Workforce. There is underspend in
Future Workforce to cover it.
9.2 – 2014/15 Forecast Out-turn
As a result of a review recently carried out on non-medical forecast, a PanLondon forecasting error had been identified which had resulted in an additional
underspend of approx. £2.5m above previous forecasts. The Board Chair and
the IAC Chair had made the decision to include the additional funding into
Quarter 4 LDA as part of the Direct CPPD Workforce funding to be used by
Trusts to support LETB strategic priorities. The issue had been brought to the
attention of IAC in January and a Root Cause Analysis report had been
16
CO
requested for the next IAC meeting.
It was agreed that all forecast non-recurrent programme underspend of an
estimated £2m would be used to support SaHF-related activities. Delivery plans
were being drawn up by the Executive team.
9.3 Budget setting for 2015/16
Budgets for 2015/16 are being drafted and a draft position will be made
available to IAC in March.
HEE has proposed in the draft education and training tariff guidance for
2015/16 to reduce the undergraduate medical tariff by 1.9% in line with the
reductions to healthcare service tariffs. There were some concerns voiced
regarding the impact that this could have on undergraduate medical placement
providers.
9.3 – Key Financial Risks
o
The risk on HEE budget allocation for 2015/16 had reduced as the revised
funding allocation methodology was no longer planned for 2015/16. A key
risk around future budget allocation for 2016/17 remained.
o
There is risk that HENWL may fail to deliver a balanced year end position
and underspend in 2014/15 due to current information gaps on the
forecast.
The Board received the Month 9 financial position and finance report.
02/15.10
Workforce and Education Planning and Development of Investment Plan
LS indicated that an update on the investment plan had been included as part
of the LETB Director’s report previously noted.
10.1 – Mental Health Nursing Tender
LS provided a detailed report on the outcome of the Mental Health Nursing
Tender Project. LS reported her satisfaction with the fairness and transparency
of the process and named the preferred providers as University of West
London, Buckinghamshire New University and King’s College London.
The Board discussed the possibility of developing and agreeing a standard
assessment for school and provider to test the concept. This could be
introduced on a small specialty for NWL such as mental health.
The Board received the tender outcome report.
02/15.11
Pre-registration Commission Allocation
The Board received the report on indicative 2015/16 non-medical education
commissions allocations.
02/15.12
Education Forum Report
JH informed the Board that a programme was being drafted to ascertain
interest on developing a Postgraduate multidisciplinary module on PPE. The
conference had a provisional date of the 17th of June and would be called
‘Reciprocal Illumination’. Further details would be circulated to the Board as
soon as available.
17
SM, JH
02/15.13
Public Engagement Committee (PEC) Chair’s Report
PEC had been revising its guiding principles and refreshing its three year
strategy.
The final paper would be made available on the April Board meeting.
02/15.14
Integrated Assurance Committee (IAC) Chair’s Report
SH was pleased to assure the Board that the IAC had continued to provide
appropriate input and recommendations to the Board. The concern in relation to
finance forecast would be reviewed in detail at next IAC meeting.
The Board received the oral report for IAC.
12/14.15
Strategic Advisory Council (SAC) Chair’s Report
MS reported that SAC had started planning the awards ceremony which had
been scheduled for the 29th of June. An invitation would be sent to Board
members.
CC
The Board received the oral report.
12/14.16
Joint Planning and Assurance Committee
SH provided an oral report on the recent JPAC meeting that took place on the
2nd of February which she had attended on behalf of the Chair.
The meeting had focused its discussion on the LETBs’ approach to Community
Education Provider Networks. It was established that a common framework of
governance should be agreed with view of securing sustainability and to
diminish funding risks.
Other issues included: LETB support to Trusts in relation to quality, the risk of
CPD funding being detached from the LETBs and a common process for risk
escalation.
10/14.14
Any Other Business
The following agenda items were suggested for the April Board:
o
o
An update on the doctors in training transfer report as part of the
Occupational Health item
Current review of Leadership Academy.
CC
Next Meeting: Wednesday, 4th February 2015, 08:30 – 11:00, Bloomsbury Ground Floor, Senate House
18
Health Education North West London
Board Paper Coversheet
Paper C
(Coversheet)
HENWL
Board
Meeting Date
15th April 2015
Paper Title
Board Action Tracker
Paper Number
C
Paper Author
Cheryl Crespo, Governance Support Officer
Author Contact
[email protected]
Lead
Marcia Saunders, Chair
FOI Status
Available on HENWL website
Paper Summary
The paper provides a summary of all actions that have arisen from
previous Board meetings with progress and status updates. The
following two actions have been marked as completed: 14/21,
13/76,
Date paper
completed:
07th April 2015
Purpose
The Tracker articulates actions identified in previous Board meetings
and provides progress updates.
Recommendation
Board members are asked to review the tracker and approve closure
of actions marked ‘completed’.
Where was the Paper
previously discussed
Discussed with Executive team and action owners
What was the
outcome
Updated register as presented
Strategic Objective
Links / EOF Links
Supports good governance and transparency; particularly delivers
against Corporate Objective 1
Identified risks and
risk management
actions
No direct risks identified to date
Resource
implications
Business as usual
Support to NHS
Constitution
Supports Principles 6 and 7
Legal implications
including equality and
diversity assessment
No direct implications identified, no E&D assessment carried out
19
15 April ‘15
HENWL Board Action Tracker
ID
Source
Reference
Date
Subject Area
Action
Action Owner
Closure
deadline
Status
14/21
02/15.6
04/02/2015 March Board Focus
Session
The session focused on indentifying the priorities for investment
2015/16
Therese Davis
04/03/2015
Complete
14/22
02/15.6.1
04/02/2015 Placement Capacity
Project
To engage with relevant Board members on further discussion
around the scope of the placement capacity project
Kathryn Jones
15/04/2015
Open
14/23
02/15.6.2
04/02/2015 Workforce and
Education Planning
Board to receive feedback on the end of consultation meeting with Lizzie Smith
key stakeholders that was planned for May 2015 to consolidate key
themes and devise next steps.
03/06/2015
Open
14/24
02/15.6.6
04/02/2015 New roles
To provide Board members with a chart explaining the various new Lizzie Smith
roles, such as: nurse practitioner and PAs and their contribution and
how they complement each other
15/04/2015
Open
14/25
02/15.12
04/02/2015 Strategic Advisory
Council Awards
03/12/2014 Conflicts of Interest
Awards Ceremony date confirmed. Invitations to be sent to Board
members
To review JL work load to avoid potential conflicts of interests
Kathryn Jones/
Louise Adams
Therese Davis
Notes / Actions to progress closure
A successful event on investment priorities for the next
year, with engaging dicussion around areas affected by
service transformation
An update had been included as part of the LETB
Director report
Workforce consultation meetings are still ongoing.
Rather than arrange additional conference events for
stakeholders the outcome of the consultation will be
/
This action is being progressed
through the current
HENWL PA project and will be circulated to the Board
for information once complete.
15/04/2015 Open
31/03/2015
Complete
Date has been confirmed at the 29th of June after the
SAC Meeting, invitations will be circulated shortly.
JL workload and meeting attendance reviewed to
ensure no conflict of interest.
13/76
12/14.1
13/79
12/14.6
03/12/2014 SaHF
To engage staff and trainees who will be affected by the proposed
changes to Ealing Hospital throughout the planning discussions
Julia Whiteman
04/02/2015 Ongoing
13/80
12/14.6
03/12/2014 Quality
Chelsea and Westminsterallegations of bullying and undermining in
pediatrics to continue to be monitored
Julia Whiteman
04/02/2015 Open
13/80
12/14.7
03/12/2014 Risk Reporting
A review of Board/IAC risk reporting to take place to encourage
focus on major risks
04/02/2015 Open
13/82
12/14.12
03/12/2014 Strategic Advisory
Council
Board to receive the SAC slides on an ongoing basis
Jane Pauley/
Christian Oribio.
Therese Davis
Christian Oribio
14/45
10/14.19
01/10/2014 Education Forum
03/12/2014
Open
Next meeting has been scheduled for 5th of May,
Jeremy to provide an update at the June Board
meeting.
14/44
10/14.15
Open
details of the PPE conference to be provided to the
Board Secretary for wider circulation
14/43
10/14/13
01/10/2014 Patient and Public
To develop and present to the Board a more detailed plan to hold a Sally Malin & Jenny 03/12/2014
Engagement Conference conference in early 2015 to support the delivery of HENWL's Public Higham
and Patient Engagement Strategy
01/10/2014 Workforce & Education Opportunities to be scoped to develop a Recruitment Strategy for
Kathryn Jones
31/03/2015
Planning
North West London to be aligend with the annual investment plan
Open
HENWL feeding into nursing project led by NHS England
London Chief Nurse office, focused on vacancies and
overseas recruitment. Data collected from Trusts
January
14/42
10/14.14
01/10/2014 Annual Revalidation
14/35
07/14.9
14/34
07/14.9
A progress report on activities to date and future plans and activities Jeremy Levy
to be brought back to the Board
To seek clarity of various roles and responsibilities and a detailed
report to be brought back to the Board in due course
04/02/2015 Ongoing
Ongoing communications and face to face meetings.
Medical education Fellow appointed to contribute to
planning agenda.
Action plan in place with Trust. GMC have accelerated
issue to Enhanced Monitoring
Under development for improvement and will be
reviewed in line with new geography governance
arrangements
The Slides from the January SAC meeting were
circulated prior to the February Board meeting
Julia Whiteman
03/12/2014
Ongoing
23/07/2014 Workforce Development To discuss and jointly develop with Andrew Howe and Miriam
Investment
Samuel to develop the focus of future public helath work.
Katheryn Jones
04/02/2015
Open
A report to be provided to the Board on April.
23/07/2014 Workforce Development To discuss with Adrian Bull opportunities to develop joint activities
Investment
and projects in relation to whole systems integration demonstrator
projects
Jeremy Levy
01/10/2014
Open
ongoing discussions had taken place; JL to provide
report to Board in due course
20
ARR plan reviewed and being progressed with a
timeline for delivery. Report going to Board in June.
HENWL Board Action Tracker
ID
Source
Reference
Date
Subject Area
Action
Action Owner
14/29
06/14.5
04/06/2014 NIHR Funding
To report back to the Board on the new financials as a result of the
changes to the NIHR funding
14/23
04/14.12
02/04/2014 National Data Project
14/20
04/14.10
13/75
11/13.7
Status
Notes / Actions to progress closure
01/10/2014
Open
updates have been included in the LDA process but
uncertainty remained regarding timescales until
recruitment to academic posts would be completed
Progress on Phase 2 which would focus on increasing existing data Helen Mansfield
sets and influencing future data sets to be reported to Board in due
course
01/10/2014
Open
Work is underway with the Business Intelligence team
to strengthen the existing data sets and a detailed
report will be presented to the Board in due course
02/04/2014 Local Finance Network
To explore opportunities to establish a local Finance network in
North West London
Jane Pauley
01/10/2014
Open
Peter Holt leading on this from a regional level
27/11/2013 Performance & Quality
Assurance
Quality KPIs which are being developed by HEE to be presented to
the Board when finalised
Therese Davis
31/03/2014
Open
HEE is working on national KPIs, Helen Mansfield from
HENWL is working with HEE on the development of
these, we await these KPIs to move forward with
developing a scorecard for HENWL; HENWL will produce
a summary of achievements against the Mandate to IAC
in March. A summary to be circulated separately.
21
Jane Pauley
Closure
deadline
Health Education North West London
Board Paper Coversheet
th
Paper D
HENWL
Board
Meeting Date
15 April 2015
Paper Title
LETB Director’s Report
Paper Number
D
Paper Author
Lizzie Smith, Interim LETB Director
Author Contact
[email protected]
Lead
Lizzie Smith
FOI Status
Available via HENWL Website
Paper Summary
Date paper completed
This paper provides the Board with the LETB Director’s progress
report since the last Board meeting on 4th of February 2015. This
report includes direct reports from Directors and Professional
Development.
07th April 2015
Purpose
For information
Recommendation
For the Board to receive the report
Where was the Paper
previously discussed
It has not been discussed previously
What was the outcome
N/A
Strategic Objective Links /
EOF Links
Ongoing LETB Development and aligned to all corporate
objectives
Identified risks and risk
management actions
None
Resource implications
None – business as usual
Support to NHS Constitution
LETB Development and Authorisation; transparency and equal
access to information
Legal implications including
equality and diversity
assessment
None identified at this point; no E&D assessment has been
carried out
22
15 April ‘15
HENWL LETB DIRECTOR’S REPORT – Mach 2015
HEE National Report
Two HEE Senior Directors had taken up secondments in March 2015; Jo Lenaghan, Director of
Strategy and Planning as Chief Support Officer to an Arm's-Length Bodies and Janice Stevens,
Director for Midlands and East as Interim Chief Nurse at Barts Health NHS Trust in London. Interim
cover had been agreed with Rob Smith as interim Director of Strategy and Workforce Planning and
Paul Holmes, Director of South who would also be providing oversight to the Midlands and East.
The change of status to Non-Departmental Public Body (NDPB) became effective on the 1st of April
2015 and although it will not fundamentally alter HEE’ functions it is expected that it will provide the
education and training system that HEE supports with more stability, plus parity with other key
partners in the system, including NHS England.
HENWL Local Report
Following HEE Board’s decision in January to support the implementation of Phase 2 of Beyond
Transition, the LETB has been working on the enactment of the new structure and recruitment for
various posts is currently underway.
TD had commenced her full time role as LETB Director for HENCEL and recruitment for an Interim
cover as an initial six month secondment had been concluded with the appointment of Lizzie Smith
as the new Interim LETB Director for HENWL which became effective on the 1st of April 2015.
The Shape of Caring: A Review of the Future Education and Training of Registered Nurses and
Care Assistants, led by Lord Willis of Knaresborough was published by HEE on the 12th of March.
HENWL would be engaging in the consultation phase of the recommendations made and these
would be reflected on the delivery plans.
Forthcoming Board Dates:
o
Board Focus Sessions 6th May 2015: Mental Health
o
Board Meeting 3rd June 2015 with a presentation on Nurse Revalidation
23
Programme Report by Directors
Report from Catherine O’Keeffe, on behalf of Kathryn Jones, Deputy Director of
Education and Quality
Nursing and Midwifery Placement Capacity Project
The initial scoping for this project is currently underway with plans to share findings with colleagues
from HEIs and Trusts in HENWL at the end of April. The findings for the scoping study will clarify
placement capacity for HENWL regarding pre-registration nursing and midwifery commissions for
the academic year 2015/16, the critical specialities being Child Nursing and Midwifery although all
branches of nursing need to be considered. In addition to establishing capacity for commissions,
the study and subsequent discussions will enable HENWL to assure colleagues in the other LETBs
as to how and by when the numbers of current commissions that are placed in their geographies
are repatriated.
Bands 1 to 4 including care certificate
Eighty people including support workers from nearly 50 health and social employers in North West
London came together on 19th March for a successful conference jointly organised by HENWL and
Skills for Care NWL to prepare for implementation of the Care Certificate. The conference included
presentations on work CLCH are undertaking to deliver the Certificate, and HENWL led initiatives
regarding pilots to support general practice to implement the Certificate. The Royal Marsden gave
a presentation on how the Care Certificate had allowed the implementation of a common induction
for all their support staff. Workshop activities led by CNWL and HENWL explored assessment and
quality assurance.
Neonatal nursing
A mapping exercise to identify staffing pressures, opportunities for the development of existing
staff and approaches to recruiting and retaining new staff in NWL has now been completed. The
mapping document is current being review by neonatal steering group members. Key actions
identified to respond to the findings will be refined at the next steering group meeting in April. The
initiative also aims to recruit a team of nurses to provide education support for all units in NWL.
Difficulties have been encountered filling these posts related to the shortage in this specialty. A
second round of recruitment is however now in progress.
Dementia
HENWL’s activities related to HEE’s mandate to promote and increase the training of dementia
awareness within the NHS in England has included training over 17,000 staff on dementia
awareness and establishing a successful dementia network that meets regularly.
A collaborative project between the Point of Care Foundation and CLCH, on the development of a
training programme for staff where the programme production involves people with dementia, their
carers and local trainers, commenced in March. This innovative approach is based on an in-depth
scoping study and aims to provide opportunities for people with dementia, and their carers and
families to make a positive contribution to staff training programmes.
Primary Care Nursing Forum
The forum comprises of representatives from Community Trusts, the LMC, HEIs involved in
training Practice Nurses, Practice Nurses leads, NHS England and senior HENWL colleagues. The
forum overseas a range of HENWL funded initiatives that aims to increase mentorship, placement
capacity and professional development opportunities relating to Practice Nursing. The forum
24
members met in March to take part in a workshop examining progress over the past 18 months,
identifying challenges, achievements and aspirations. A draft strategy to further develop Practice
Nursing in NWL based on these discussions is being refined by the forum. The strategy will also be
inform by the combined report, recently received, of a NWL training needs assessment carried out
by the New Buckinghamshire University and the University of West London.
Report from Lizzie Smith, Director of Workforce and Development
Workforce and Education Planning
Update on the agenda
Plans are now well underway to launch the 2015-16 Workforce Planning activity. Trusts have been
briefed as part of the on-going workforce consultation exercise, and in addition Trust workforce
planners have attended a session introducing the process and timeline for 2015-16, specifically the
introduction of the e-workforce tool, an online portal for submitting the workforce data which is a big
technical advance on the previous spreadsheet based approach.
In addition to the routine workforce planning activity, a group of LETB representatives from across
London South East have been meeting to specifically consider how we might take a geographic
approach to medical workforce planning and education commissioning, recognising the value of
viewing the medical workforce forecasts over a larger geography. This group is working up a
proposal for 2015 planning which will be presented to the Board as part of the regular workforce
planning updates later in the year.
HENWL will again be hosting 2 stakeholder conferences to inform our planning activities, they will
be held on 16th July and 11th August.
Physician’s Associates project
HENWL are delighted to be one of the two LETBs in England who have agreed to support a
programme being led from Hillingdon Hospital to bring some experienced American Physician’s
Associates over to work in our health services in North West London. The programme is being led
by Nick Jenkins, an Emergency Medicine Consultant who is seconded to Hillingdon Hospital as
part of the NHS leadership programme. Employers have now firmed up their expressions of
interest and proposals will be considered by a panel before finalising which posts will be actively
recruited to. We hope to have PAs in post in North West London in the early Autumn.
SaHF
Reconfiguration - Ealing (Midwifery, neo-natal nursing, O&G and Paediatrics)
We continue the work to support staff and learners through the service reconfiguration activity
related to the SaHF Service Reconfiguration. Most recently the focus has been on the impact of
likely to changes to Ealing maternity services. Due to the NHS England assurance process and
the timing of the election no decision will be taken by Ealing CCG on the service change until late
May. This does present some challenges to the movement of people, however many measures
have been put in place to support the changes, such as additional packages of development
support for midwives and ne-natal nurses, in order to maintain crucial people in the system.
25
Strategic meeting in June
A strategic meeting is planned for early June for SaHF leads to meet with some senior HENWL
stakeholders and staff. The purpose of the session is to discuss and debate the support from
HENWL to date, and think strategically about how we best continue to support the programme
moving forward.
Strategic workforce planning
The Consultation on Future Workforce sessions which are still underway across North West
London have provided some valuable insights and intelligence about workforce planning issues in
services now and looking ahead alongside the new health service vision for North West
London. As part of the HEE lead workforce and education planning process this summer we are
adapting the way we use information, in order to be able to develop a workforce plan for North
West London that responds to the wider service transformation agenda.
Supporting the London Ambulance Service
The project to significantly increase the paramedic science student intake in September 2015 is
progressing well. Education providers are confident that they will recruit in the region of 500 new
students compared to 330 last year. The plan is to increase this by a further 100 to 600 in the
following year; however London is experiencing a slight dip in application rates which education
providers report is as a result of London students being HEFCE rather than MPET funded, so not
getting fees paid or access to the NHS Bursary. We continue to work with the national HEE team
on the national agenda. 2 posts have now been advertised which will support the significant
amount of work required to identify new placement capacity for the additional learners.
We continue to work closely with LAS to monitor all aspects of their workforce retention and
development. International recruitment is still underway and they have successfully recruited in the
region of 200 paramedics from Australia and New Zealand with more recruitment planned in the
Spring and Summer. The London LETBs have funded a large amount of additional workforce
development activity to concentrate on retention and development of the existing workforce.
The LAS Chief Executive (Ann Radmore) has left the Trust, and Fiona Moore (LAS Medical
Director) is acting up into the CEO position.
National data projects
The HENWL led baseline audit of information flows delivered to the HEE Executive on the 3rd
February, presenting the key findings and a series of recommendations, which were approved in
advance of a detailed, fully costed plan. Efforts are now underway to conduct further analysis of
the project outputs, evaluating flows for the potential for normalisation/automation.
The national education provider data project is progressing well, achieving greater system
exposure through integration with the performance leads network, and efforts to acquire 2014
HESA and UCAS datasets are also nearing completion.
HENWL is continuing work to refresh the HEE Guidelines and definitions. We have worked with
representatives across the network and have a draft form of definitions that are robust, meaningful
and consistent. A paper produced jointly by HENWL and HEE central will be shared in due course.
26
Report from Julia Whiteman, Postgraduate Dean
Quality visits
On March 16th we held a “Conversation of Concern” visit to the Neurosurgery Department at
Imperial College Healthcare Trust accompanied by the GMC to investigate a range of concerns
including bullying and undermining, access to learning opportunities and working outside of the
European Working Time Directive (EWTD). The outcome was an immediate mandatory
requirement around the process for consenting patients for neuroradiological procedures and the
suspension of training at ST1 (3posts) with immediate effect. Detailed action plans for the more
senior trainees are being developed that will be closely monitored. The trust has put in processes
with immediate effect to address the immediate mandatory requirement and compliance with
EWTD. The department is under GMC enhanced monitoring. The draft report from the visit is with
the trust and once finalised will be available via the pan-London Quality and Regulation area on the
London Postgraduate Medical and Dental Education website http://www.lpmde.ac.uk/var/plqru
From now on all Quality Visit reports will be published on this part of the website.
Our Trust Liaison Dean and Head of Primary Care Education and Training led a Quality visit into
the Marsden and I am pleased to report that areas that had been flagged for action including
quality issues with the GP speciality training were found to be hugely improved.
GMC National Trainee Survey went live on March 24th. An update will be provided for the June
Board Meeting.
Medical workforce
The London LETBs are collaborating to agree a process for approaching medical workforce
planning for 16/17. HEE has published a plan that including a piece of work to review training
numbers across all specialties. This review will span 3 years with a detailed look at different
selected specialities each year.
GP recruitment
The fill rate at the end of round 1 is 100% for London. Applications for GP training were further
reduced from last year and fill rates across the rest of the country in particular HEEM and HENE
are low.
Postgraduate Dean standardised Job Description
The Postgraduate Dean Job Description has been revised and standardised across HEE to cover
a broader scope including clinical leadership responsibility for multiprofessional education and
training including undergraduate medical training. The new JD came into effect from April 1st.
27
Professional Development – Report from Catherine O’Keeffe, Head of Professional
Development
The Multiprofessional Faculty Development service runs several key advanced courses for
educators across London, including the Postgraduate Certificate in Teaching the Teachers in
Primary Care, a prerequisite for GP’s who wish to become GP tutors. The course is now also open
to Practice Nurses who wish to become nurse educators. A new cohort of 48 participants
commenced in March. Discussions are currently taking place with LETB Heads of Primary Care
and Postgraduate Deans regarding opening the course to other educators in primary care with the
aim of increasing supervision and mentorship capacity.
The Professional Support Unit (PSU) is further adapting its services to ensure that they align with
HEE’s mandate. A review of the Coaching and Mentoring service is about to be completed. The
recommendations of the review support realignment of the Coaching and Mentoring service to
focus on trainees and learners from other healthcare professions as well as postgraduate medical
and dental trainees. This recommendation is being implemented from 1st April. The PSU is
developing guidance and related resources to enable trusts to develop in-house coaching services
/ networks in order to promote locally owned, sustainable approaches to supporting staff.
Contact Details
Interim LETB
Director
Lizzie Smith
[email protected]
020-7862 8616
Education Advisor
Dr. Jeremy Levy
[email protected]
020-7862 8608
Deputy Director of
Education & Quality
Kathryn Jones
[email protected]
020-7862 8591
Postgraduate Dean
Dr. Julia
Whiteman
[email protected]
020-7866 6268
Head of Professional
Development
Catherine
O’Keeffe
Catherine.O’[email protected] 020-7862 8970
28
Health Education North West London
Board Paper Coversheet
Paper F
(Coversheet)
Meeting Date
15th April 2015
Paper Title
HENWL Risk Report
Paper Number
F
Paper Author
Cheryl Crespo, Governance Officer
Author Contact
[email protected]
Lead
Jane Pauley, Deputy Head of Finance
FOI Status
Available under FOI
Paper Summary
The paper contains the summary report of the key current risks and
an update on the current risk management process.
Date paper completed
18th March 2015
Purpose
The report and register were presented on the 26th of March 2015 to
the Integrated Assurance Committee for review, approval and
feedback
Recommendation
The Board to review and receive the current risk report.
HE NWL
Board
15 April ‘15
The Board to feedback any comments or questions to the
Governance Officer.
Where was the Paper
previously discussed
IAC 26th March 2015
What was the
outcome
IAC recommended the approval of closure of all risks proposed for
closure and the next steps in particular to the review of the Board
Assurance Framework process.
Strategic Objective
Links / EOF Links
To be determined
Identified risks and
risk management
actions
Legal accountability
Resource
implications
Initial proposals will be delivered from within existing resources.
Support to NHS
Constitution
Supports our aim to provide best possible value for money and to be
open and transparent
Legal implications
including equality and
diversity assessment
None directly identified, no formal assessment carried out
29
HENWL RISK REPORT
March 2015
1. Introduction
The review of the current risk register will remain as a standing item for both IAC and Board
meetings.
The main scrutiny of the risk register sits with the executive team and is focused on and organised by
the strategic/corporate objectives and their risks.
Following the IAC’s review, the Board will be provided with any comments from the IAC and on to
HEE as per the escalation process stipulated in HEE’s Approach to Risk Management.
2. HE NWL Risk Register Overview
The current risk register includes all risks rated 12 and above pre-mitigation as well as all new risks
and those proposed for closure including those identified by hosted services and Shaping a Healthier
Future.
a) Current Key Risks
PD06 – Commissioned Psychological Service for Doctors and Dentists: The procurement
process did not produce a successful bid. Concerns relating to the service changes had been
escalated by current providers and users and it had resulted in communications and reputational
risks. A decision was made to extend the current contract for an additional six months to allow time
for a further bidding round with greater flexibility around transfer costs.
b) New Risks
1 new (shaded green) risks been added to the register:
NWL48 - Quality and Commissioning Resources: There is a high risk that staff vacancies in the
Non-Medical Quality and Commissioning department will have an impact on delivery of its core
contractual obligations and that staff changes will result in potential knowledge loss. Mitigation
actions are being implemented to ensure that while recruitment takes place, the Medical Quality and
Commissioning team will provide cross-cover. The option of L&SE cross cover from other LETBs is
being explored.
c) Risks Proposed for Closure
10 risks (shaded pink) are proposed for closure:
Risk DLT22 - National Advice Centre for Postgraduate Dental Education (NACPDE): Funding to
the Royal College of Surgeons who host the NACPDE had been secured. A more proactive
approach for ensuring approval of the Single Tender Waiver in 2015/16 has been agreed.
Risk NWL13 - Engagement with Public Health: The LETB had been successful in incorporating
Public Health on its agenda and a robust engagement process had been integrated into HENWL’s
activities.
30
Eight Risks of the risks proposed for closure relate to the Informatics Service:
Risk HIS05 - Forward Planning - meeting LETB needs: Planning of demand and priorities was
successfully controlled through a number of measures and the integration programme established to
oversee London & SE includes IT systems which would have an overall responsibility for overseeing
priorities.
Risk HIS09 - Professional Development (PD): This was regarded as an operation issue that had
been sufficiently mitigated through the continuation of maintenance to all the micro sites, which will
eventually be moved to HEE central site as soon as it gets developed.
Risk HIS11- London Migration to Oriel [R01]: The ownership of this risk had been transferred to
the Operations team shortly after the system went live. This was confirmed on the Service Level
Agreement meeting on the 20th of January. All arising issues, risks and changes are being reported
from the business via the national Oriel helpdesk.
Risk HIS135 - London Migration to Oriel: The risk in relation to the implementation of the Oriel
system had been resolved and the system had gone live within the expected timeline.
Risk HIS136 - London Migration to Oriel [R10]: The funding of residual issues had been
addressed.
Risk HISM03 - Strategic Risk: With the appointment of a national Chief Information Officer (CIO),
there are now clear communication lines with HEE Central. A national IT hub that includes the CIO
and the Directors of Information Services for the geographical areas had been established, this
forum would discuss the developments/priorities.
Risk HIS141- Beyond Transition Vacancies: as part of the consultation of Beyond Transition
Phase 2a new structure had been approved and a permanent Head of Business Intelligence had
been appointed in January 2015 thus addressing the more critical gap in resources.
Risk HIS18 - Business Intelligence Resourcing and skills: A Head of Business Intelligence had
been appointed in January 2015 and provided longer term stability for the team.
3. Next Steps
o
o
o
o
IAC members to feedback any comments, queries or suggestions
The WEP team will be from the 1st of April reporting to Informatics Service and their risks will be
incorporated into the IT risk process and these will be reported at L&SE Geography level
As part of the implementation of Beyond Transition Phase 2, a national post for Risk Lead is
being recruited to and it is envisaged that this will have an impact on the national risk
management policy and process and any required changes emerging from this will be
incorporated in due course
The Board Assurance Framework will be reviewed by the LETB Director, Deputy Head of
Finance and the Chair and strengthened during the coming weeks.
31
Date Last Updated
20 March 2015
16 March 2015
02 March 2015
20 March 2015
20 January 2015
20 March 2015
20 March 2015
20 March 2015
13 March 2015
Date Last Reviewed
20 March 2015
16 March 2015
02 March 2015
20 March 2015
20 January 2015
20 March 2015
20 March 2015
20 March 2015
Accountable officer
Therese Davis
Therese Davis
Therese Davis
Therese Davis
Therese Davis
Julie Screaton
Therese Davis
Lead
Owner
Therese Davis
13 March 2015
• Recruitment in process for all band 7 roles
• Currently team has vacancies of 3x band 7 WEP
Leads
4 3
12 March 2015
• Successful recruitment to WEP Manager role
• Recruitment in process for all band 7 roles
12 March 2015
12
Therese Davis
Appointments have been made, so currently no gaps
Quality and Commissioning Manager
Senior Commissioning Manager
Contract and Commissioning Officer
Therese Davis
Appointments in process, should be in place in next 2
weeks- staff identified as principle BI Analysts
Recruitment currently in process - staff expected to be
in post early November. Staff member loaned to BI to
return to WEP early October. WEP manager has met
with LETB workforce leads to discuss and identify
priority projects.
• New interim appointment has been made to replace
Andrew Frith and also new Head of BI has been
appointed
20
Therese Davis
• Recruitment to senior post and band 6 officer is in
hand with interviews scheduled for the beginning of
April.
•
Cross cover arrangements are being implemented
within HENWL medical commissioning team. The
4 3
option of having an L&SE cross cover is also being
explored
• Process for ensuring leavers
provide handover with full documentation
Therese Davis
→
• Timeline of recruiting new staff through NHS Jobs,
recognising the notice period of new appointments.
• Knowledge loss
Jeremy Levy
12
• Delivery of 2015/16 Commissioning Activity
• Mobilisation of new providers of Workforce
Development Education and Training
• Effective implementation of a structured approach to
Workforce Development investment
Jeremy Levy
New
Need to progress with recruitment of:
3 1
Therese Davis
12
• Regular report to IAC and Board on progress on
• 2015-16 LETB budget still being worked up
allocation methodology and risks involved
• 2015/16 budgets issued to LETBs - main reduction of
£1.9% on UG medical tariff to be passed to provider
Trusts
• Final draft of budgets being completed for Exec
and Board review
16
• Rigorous budget management to ensure that all HENWL's resources are deployed
effectively in the delivery of HENWL's objectives
• Engagement nationally to ensure HEE financial model is fit for purpose and reflects all
costs borne by HENWL
• Representation of London LETBs on national working groups
Therese Davis
↓
• Exec Team to draft contingency plan for Board
approval (informed by previous Board discussions)
• Nationally funded project to gather evidence on
postgraduate migration broadly complete
• Feedback being submitted on developing
proposals and future development of financial
model
4 3
• HEE to define new group and its membership,
and possibly have London & South East
geographic representation
Jane Pauley
3
• Formal contingency plan not yet in place
• Evidence to support development of local case including detailed financial analysis - still to be fully
assembled
• Suitability of new national model to support allocation
changes not yet demonstrated
• Scope of likely change not yet established
• Board familiarity on financial planning issues
• No clarity regarding group to replace RSG and what
the membership of this group will be
Therese Davis
→
• Updates on HEE national finance discussions
• HEE recognition that further work needed before
implementation, as evidenced by:
• Delay in introduction of main changes until 2016/17
but this may slip further
• National funding of further research led by HENWL
16
• Engagement with HEE through key national groups (SLT, HoFs, DEQs).
• Engagement with the London Health Board and more widely with South London
membership to ensure the impact of any funding reductions are widely understood.
• Development of a contingency plan to address a range of possible financial scenarios
• Nationally funded project led by HENWL has demonstrated, from postgraduate
destination information, the degree of migration currently being experienced across
England and the need to ensure that this is recognised as part of the work on allocation
methodology
16
Julia Whiteman
12
• Finance team being re-organised to ensure all
areas are covered until full 'Beyond Transition'
team is in place
• Interims have been recruited
• Situation being monitored weekly by Finance
senior team
Julia Whiteman
→
• Recruitment delays due to current restrictions on
process
• Time lag in inducting new staff and interim staff
• Element of unpredictability with regard to the workload
impact of supporting national projects and phase 2 of
Beyond Transition
Jane Pauley
12
• Delivery of year-end position and balanced 15/16
budgets
• Monthly improvements in quality of financial
information provided
• Interim structure set up
• New organisational structure implemented and
vacancies filled
Therese Davis
4 3
• To review current working arrangements to maximise the effectiveness and efficiency
of existing resources
• Recruitment to vacancies under way
• LETB Finance teams are working differently on a temporary basis with hosted services
finance to support pan-London delivery
• New structure agreed with Transition plan, staff have been matched to posts and
interims covering gaps
Jane Pauley
→
Therese Davis
9
Review with Finance team as part of budget setting
for next year to achieve cost neutral status for
organisations
HENWL Exec regular updates, engagement with Heads • Financial impact not yet fully scoped
of Specialty School and discussions at JDOG
Jane Pauley
3 3
A sufficient number of posts have been identified to meet the GP expansion targets for
2015.
There are financial implications will impact primarily on 2016/17, a detailed analysis will
be completed to ensure a robust plan to mitigate this cost pressure is developed
Therese Davis
→
LETB team and L&SE finance team working to
address information gaps and assess and manage
the impact
Therese Davis
9
• Robust budget setting process, backed up by activity analysis and forward modelling • Financial contingency available to address unplanned Budgets in some key areas (e.g. bursary scheme
spending) based on estimates, which is being refined
• Further information sought and modelling updated for areas of uncertainty
variations in spending
and re-assessed in-year.
• Rigorous budget management and regular review by finance team, executive team,
• Key in-year review points identified
IAC and Board during the year
• Expenditure plans for 2014/15 to address any forecast or potential underspends have
been continuously reviewed and strengthened
• Continuous work with hosted Finance team on refining forecast position
Catherine O'Keefe
12th May 2014
3 3
• Effectve delivery of all workstreams and meeting of
corporate objectives
• Successful delivery of corporate objectives
• Safe transition into new organisational structures •
Revised structures have been approved
Review workload and identify business critical functions with JW and C'OK, considering
alternative models of delivery through HENWL core team and outputs from Q&C Away
Day.
• Director of IT recruiting a number of interim staff to cover vacant posts.
• Plan to shift WEP team member into BI to support and provide intelligence on process.
• Head of WEP team recruiting to interim Band 7 posts to cover vacancies and WEP
team member to be returned from BI (see risk WEP01) to cover the gap.
• Utilising a BI staff member currently on a contract for analyst tasks.
• Workload for team should be steady as coming to close of workforce planning cycle.
4 3
↓
• Regular meetings to ensure the impact of any changes to staffing are evaluated and
roles and responsibilities reallocated as appropriate
• Emphasis during consultation on importance of influencing national decisions to
ensure continued delivery of high quality outputs and meeting local objectives and
provider needs
• Continuous feedback and engagement with all staff
• Teams have been engaged in all phase 2 function review activities where possible
• Public Health engagement was added as part of
• Gap in agreeing common priorities with AHSN, Health
and Wellbeing Boards while Public Health action plan is • the annual objectives 14/15. Following meeting
with AH activities were scoped further by exec
being developed
• Actions to deliver against the Public Health and HWBB team and ideas were presented to SAC in January.
Board Development session on Public Health took 2 2
priorities to be incorporated in corporate objectives
place on November 2014 were priorities were
refresh and communicated to key stakeholders
agreed. The objective of HENWL to focus on
public health issues had been met and it remains
on its agenda.PROPOSED FOR CLOSURE
• Proposals for restructure regarding phase 2 functions •BT Phase 2 Complete. All staff to be on post by
review to identify how the new structure will address the 1st of April through internal processes and all
need to deliver HENWL priorities and opportunities to
vacancies will be advertised. Interim LETB Director
integrate with HEKSS
to communicate with all staff as soon as revised
structures have been approved for dissemination
3 2
• All staff members continue to be communicated
regularly by their line managers and by weekly staff
meetings.
16
Business Intelligence Resourcing
There is a risk that inadequate support/resource from Business
Intelligence department threatens the ability of the WEP team to deliver a
comprehensive Workforce Plan
WEP Team Resourcing - as WEP cycle workload increases. Lack of
support for LETBs during the workforce planning process 2015 due to
inadequate staffing in the WEP team and delays in recruitment.
• WEP Manager seconded out of role for 6 months.
• Understaffing for band 7 WEP Leads
6
• Public Health representation at SAC
• Links with Health and Well-being Boards
• Public Health Board member in Place
• Effective Public Health input to work of the Public
Engagement Committee (PEC)
• Public Health and HWBB agendae robustly
incorporated in 5-year strategy as appropriate
• HEE National working group
Date of last movement
Initial Risk Rating
Date Added
Impact
Likelihood
5 4
→
• Robust engagement with Public Health Director Board member established and
designated Board development session delivered on 17.09.14
• Public Health representation on the SAC in place
• Working with AHSN for joint engagement with Health and Wellbeing Boards (HWBB) JL attending HWBB meetings
• 2014/15 refresh of the 5-year strategy now reflects delivery against the public health
workforce strategy and the Health and Wellbeing Board agenda
• Engagement with national Public Health working group to be established
Vicky Lyons
WEP
London-wide
WEP01
O
Quality and Commissioning Resources
There is a risk that due to the imminent loss of a number of Non-Medical
Quality and Commissioning Staff, the LETB may not be able to sufficiently
deliver its core contractual obligations. There is a further risk that new
appointments may not have a sufficient understanding of education
commissioning within North West London.
4 4
4
• Lack of feedback from National meetings to team
members
• Uncertainty regarding HEE plans for further restructure
as part of phase 2 of Beyond Transition
Lizzie Smith
Quality & Commissioning
LETB
NWL48
O, Q
HEE Budget Allocation 2015-16
Although comprehensive revision of the current HEE allocation
methodology new appears extremely unlikely to be applied for 2015-16, a
resource reduction of £0.9m will be applied to workforce development
funding. There is also a risk of reduced resources based on the outputs of
HEE financial modellling and HENWL forecast outturn
4 4
→
• Evidence of LETB consultation and stakeholder
engagement
• MD members and senior leadership team at HEE
• National meetings
02 March 2015
Finance
LETB
NWL 47
F
HEE Budget Allocation Methodology (2016/17)
The revision of the HEE model for allocation of budgets to LETBs for
2016/17 and beyond could potentially result in a London-wide reduction of
approx. £100m-£200m p.a. This would represent a very significant impact
on commissioning and planning for 2016/17 and beyond and have
significant implications for HENWL's capacity to support transformation
and development.
4 4
6
• Regular close dialogue with HEE through national meetings, e.g. Managing Directors
meeting, Heads of Finance meeting, Directors of Education & Quality meetings, etc.
• Executive team to identify key areas and plan appropriate actions
• New HEE structure and reporting lines to form closer links between LETB and HEE
national
• Regular briefing bulletins being produced for key stakeholders
20/3/15
Finance
LETB
NWL 46
F
Hosted Finance Service Staffing
There is a risk that high levels of vacancies and staff sickness in the
hosted finance team impacts on the LETB's ability to deliver to its financial
budgets
4 4
• BT Phase 2 Consultation Complete. Local
structures across the geography have been
established.
• The Director for L&SE has formal meetings with
3 2
HEE on a weekly basis and with LETB Directors on
a bi-weekly basis with an informal and formal L&SE
Executive group meetings
Actions plan to address Gaps (include updates)
15/1/15
Finance
LETB
NWL45
O
GP Expansion
There is a risk that HENWL is unable to identify sufficient number of posts
and funding which could impact on HENWL's ability to meet the HEE target
for GP expansion for 2014/15
12
Gaps in Control (C) or Assurance (A)
Movement
R
3 4
16
Assurance
Risk Rating
11
2014/15 Forecast Outturn
There is a risk that HENWL may fail to deliver a balanced financial yearend position for 2014/15, due to current uncertainties around spending in
some key areas.
4 4
9
Mitigating Actions
Impact
Likelihood
Finance
Primary Care & GP School
LETB
LETB
NWL43
NWL41
F, R, O
13 May 2014
HEE Restructuring
Current proposed timelines for HEE restructuring activities and changes to
senior management posts will affect capacity/motivation of stakeholders,
LETB managers and staff to engage in key activities, including workforce
and education planning and have negative impact on quality and standard
of deliverables, such as HENWL Investment Plan and continuity during
implementation of new structures and functions
LETB Operations
LETB
NWL36
R. F. O, Q
3 3
9 September 2014
Auth.
Condition
12
Engagement with Public Health
Given transition in Public Health it may be difficult to secure adequate
engagement with Public Health stakeholders to effectively deliver against
our business objectives
13 November 2014
Communications &
Stakeholder Engagement
LETB
NWL13
R, O
4 3
14 November 2014
ALL
Ability to influence national (i.e. HEE) decision-making
London LETBs may not be involved effectively or be able to influence
development of national plans and strategies which could lead to
compromised effectiveness of local implementation and result in less
effective local LETB activities.
14 November 2014
Strategy
London-Wide
NWL09
R, O, Q
Risk Description
13 March 2015
Objective
Category :
Reputational/ Financial/
Operational/ Quality
Workstream
Scope:
LETB/ London-wide/
National
Reference
HE NWL RISK REGISTER
• All posts to be filled by end April 2015
• Successful Cross cover arrangements with BI Team
32
Page 1 of 5
3 4
12
→
1 3
3
→
1 2
2
↓
2 2
4
↓
Therese Davis
12 January 2015
2 2
4
↓
28 October 2014
16 March 2015
16 March 2015
08 July 2014
16 March 2015
16 March 2015
16 March 2015
Therese Davis
Therese Davis
Lizzie Smith
Lizzie Smith
Lizzie Smith
Lizzie Smith
Jeremy Levy
Therese Davis
16 March 2015
14 January 2015
16 March 2015
14 January 2015
10 March 2015
Therese Davis
Therese Davis
Therese Davis
10 March 2015
10 March 2015
No gaps in controls or assurance on this item
10 March 2015
Notified Head of Finance and will need to advise Royal College of Surgeons that the
payment will be delayed.
Develop a robust Single Tender Waiver document to ensure payment can be made
without further delays.
Therese Davis
Support is in place, longer term plan to be identified and Continue to monitor situation and identify potential
finalised
alternatives
Action plan not required; risk sufficiently mitigated
and there are no controls/assurance gaps which
need to be addressed
Feb/15 - SMT has revised the RAG rating to green
and therefore
PROPOSED FOR CLOSURE
HIS to work with the PD team to provide solutions to
address the immediate issues by using existing
systems GRID, Synapse and the LMDE site.
The issue with the old technology will be removed with
the decision made by the executive team to replace
Empower/GRID with Intrepid
All the micro sites in LMDE site will get moved to HEE
central site as soon as it gets developed, we will be
unable to change this technology till this happens
because of the digital spend controls
Action plan not required; risk sufficiently mitigated
and there are no controls/assurance gaps which
need to be addressed
POTENTIALLY REMOVE THIS ITEM IN FAVOUR
OF THE PD TEAM RISK ENTRY ON
CORPORATE RISK REGISTER
PROPOSED FOR CLOSURE
10 March 2015
10 March 2015
03 February 2015
Combination of controls/process is providing sufficient There are no gaps in control of assurance on this item.
assurance of risk mitigations:
I.) Weekly HIS meeting to agree new work
requests/track progress
ii.) Bi-weekly Projects Portfolio Board to review
progress and handle risks/issues for any in-flight
projects
iii.) Focused Change Steering Groups with Operations,
GP School, Dental etc is actively controlling work
priorities with each of those teams
iv.) Updates to LEG, JDOG, HENWL Exec etc
providing visibility of priorities and progress
Feb/15 SMT meets weekly & reviews the risk register
as well as receive reports/incidents on an arising basis
should the issue/incident require SMT's attention.
Therese Davis
PROPOSED FOR CLOSURE - No further actions
needed at this time.
Risk is sufficiently mitigated and can be closed.
33
Jeremy Levy
On going negotiations continue with
NCEL/Eastman & DH on national level
The Information Directorate have identified the following actions:
Dental will meet regularly with the Information
Review and completion of Payment card Industry - Data Security Standards (PCI DSS Directorate to keep under review.
v3.0)
Self Assessment Questionnaire (SAQ) section A for third party payment systems. We
need to investigate how payments are handled across our organisation.
We need to independently carry out the assessment and gain a pass, as we cannot rely
on UoL.
There are no gaps in this assurance
It is also proposed that any residual risk gets covered
within the PD risk register
Jeremy Levy
• Agreement of funding reached for FY14/15
• Funding arrangements depend on quality information
• Effective reporting mechanism in place to demonstrate and current governance arrangements do not provide
full compliance and provision of good governance
sufficient robust information to proactively manage the
issue
Julia Whiteman
• HENWL Dental Dean to meet with Dean of Eastman (Dental School) and HENCEL's
DEQ to agree a process for information sharing and assurance
• A reporting process to be implemented to provide appropriate assurance and
information sharing
11 July 2014
3 3
Date Last Updated
→
UPDATE: STW signed off by Steve Clarke
4 4
Date Last Reviewed
12
n/a
Lizzie Smith
No gaps identified at this stage
Lizzie Smith
SaHF Progamme Board. HENWL Exec regular
updates, HENWL Board if mitigation is ineffective.
Elizabeth Jones
• Close working with SaHF programme to understand planned decision-making
timescales
• Ongoing communication with teams to keep them informed of likely decisions and
implementation plans
• Worked scenarios of how various outcomes will be managed
LEG 11/02 and deans 11/03 both endorsed the creation of an IS Steering Group with
wide stakeholder involvement, including a DNR plan for legacy systems as and when.
Following some detailed work on priorities by the HIS team we have determined an
agreed set of priorities for systems and enhancements, which is acceptable across
LETBs. Instead of formalising a single IS Steering Group, we have formalised smaller
focus groups eg Empower/Grid/Operations changes, and the GP School Change
Group, which seem to be much more effective at getting the work / priorities controlled
and delivered. In doing so we have introduced formal requests for work/enhancement
16 processes, using our Service Desk system, coupled with a weekly Senior Management
Team decision Group, plus a Projects Portfolio Group to track delivery progress. The
combination of these bodies, and regular updates on progress to LEG, JDOG is proving
to be effective, and so the exposure on this risk is minimised to an acceptable level.
Aug 2014 Update: The Empower/Grid groups are working well. But we propose to reestablish IS Steering Group as a decision making body to create more clarity going
forward.
Oct 2014 Update: Due to personnel changes across LETBs as a result of 'Beyond
Transition' the IS Steering Group has not yet been established However we continue
Aug/13: Concerns raised and on-going communications with Provider Development
colleagues. Secure existing data by continuing with generation of weekly/monthly data
reports and data cleansing activities. This coupled with paper and email archiving plus
regular server backups from IT should minimise loss of any data that can be identified
and then be re-entered.
Oct/13: Work with our partners to come up with a way of maintaining/moving out of old
9 technologies to manageable/maintainable platforms May/June14: Decision to support
PD with interim solution, and work with PD team to look at longer term options for
'proper' solution. Due to be implemented during middle of July/14. Will keep on the risk
register until the longer-term solution is formulated.
Accountable officer
4 3
Lead
→
Owner
4
n/a
Elizabeth Jones
No gaps currently identified as workstreams are under
way according to plan
Dental will liaise with finance to develop Single Tender
Waiver
2 2
Therese Davis
9
• Detailed planning with scenarios involving employing trusts so that contingencies e.g. SaHF Programme Board, HENWL Exec with
non-trainee input into rotas can be planned for.
communication to HENWL Board and Employing Trust
• 2 workshops have been held to discuss the implications of service changes on
clinical directorates if mitigation ineffective
doctors' postgraduate training. A further workshop for trainees was held on 22nd July
2014. Detailed future scenarios were produced for wider discussion in July 2014
To further support receiving Trusts during service transition and to avoid any impact on
trainee rotas, HENWL are supporting the development of staff grade posts in
Paediatrics through provision of CPD packages. This will meet recognised service
needs and ensure security for trainee rotas
Elizabeth Jones
12
→
Elizabeth Jones
12
6
Elizabeth Jones
12
Date of last movement
Initial Risk Rating
12
2 3
N/A
Elizabeth Jones
No gaps currently identified as workstreams are under
way according to plan
→
John Madsen
HENWL Board if mitigation is ineffective.
4
John Madsen
Early communication of planned changes to Trusts.
2 2
Jon Wilkinson
Professional Development (PD)
The current IS for professional development is built on old technology and
does not meet LETB needs. This will no longer be supportable given the
age and design of the legacy system. The impact of this could cause loss
of income, key data and also provide the business with an inability to
report on the information for management.
No gaps currently identified
→
Samantha Hobbs
Forward Planning - meeting LETB needs
There is a lack of a pan London LETB IS decision making forum. There is
a risk that while the LETBs are developing organisational knowledge and
the new organisation structure is a bit unclear on the new projects that will
be approved. This may affect the nature of the work load and demand
passed to Hosted Informatics Services (HIS). This may take the form of
short notice or unplanned requests by the LETBs for complex work
streams. This may affect HIS's capacity or capability to respond to these or
other LETB needs in a planned and timely manner. In addition older
operational systems (Empower, GRID2) are not not meeting the evolving
LETBs needs. They have been built on old technology and are restricted in
the longer termas they have been developed on platforms that are not
sustainable in the longer term.
3 3
• SaHF Programme Board
• HENWL Executive regular updates
• HENWL Board if mitigation is ineffective
• Regular dialogue with HEIs and service providers
4
Uncertainty re date for Ealing maternity closure
10 March 2015
National Advice Centre for Postgraduate Dental Education (NACPDE)
This is historic national funded service which provides information for
qualified dentists about working in the UK, general or specialist training, or
studying for a postgraduate degree or diploma in the UK. LDET is
responsible for sending the funds received from DH to Royal College of
Surgeons as they host the NACPDE. This FY2014/15 HEE retrospectively
asked for a Single Tender Waiver to support payment for this national
funded project, if STW is rejected national service will cease.
4 3
Assurance sought from Education Providers on how they plan to mitigate a reduction in
placement availability through flexing placement relationships with other North West
London Trusts. Possibly exploring where placements may need to take place outside of
HENWL's geography.
2 2
03 February 2015
O, Q
WPM Payment Method for eWisdom
eWisdom "piggy-backs", on to UoL because we use their payment system
(WPM) to process payments for course bookings, LDET does not have an
agreement with WPM and currently uses the MoU between Information
Directorate and UoL to use this service. UoL currently pay fines because
they are not complainant in their implementation of WPM. If UoL stop using
WPM, eWisdom will not have a service for processing payments.
3 4
• SaHF Programme Board
• HENWL Executive regular updates
• HENWL Board if mitigation is ineffective
• Regular dialogue with HEIs and service providers
• Assurance has been received from the NMC
regarding increased student placements at Northwick
Park Hospital
03 February 2015
F, O
National funding of Eastman (£3.7m)
Funding for national posts from the DH to the Eastman is currently hosted
by HENCEL and payments are made via the LDA contractual
arrangements with UCLH. There is a risk that the LDA process does not
provide sufficient assurance regarding post information, quality and
governance milestones which could result in the Dental School not being
compliant with relevant governance and quality requirements.
4 3
Explore through discussions with the university, the SaHF Team and the Trusts directly
to ascertain where additional placement capacity exists elsewhere in the system, i.e.
THH, NWLH, ICHT and WMUH.
Meetings were held with all current and future midwifery placement providers and a
solution has been agreed whereby all student midwives can continue to be placed with
employers in North West London.
HENWL has worked closely with the education provider, service providers and the
SaHF programme to ensure the solution is robust and all stakeholders have received
clear communications about change.
HENWL has funded various additional support (increased mentors and practice
educators) to ensure the educational experience is not compromised.
Actions plan to address Gaps (include updates)
Movement
Business Engagement
R, F, O
Delays in Decision-making about service changes
There is a risk that delays to decision-making regarding SaHF service
reconfiguration will impact negatively on learners due to potential tight
timescales between decision-making and implementation of change
Gaps in Control (C) or Assurance (A)
15
Stability of trainee rotas: There is a risk that the changes may impact on
the stability of trainee rotas and therefore services to trusts as the services
migrate. This will involve the movement of trainees and numbers needed
to sustain rotas could fall below minimum levels.
14 January 2015
WEP
Dental
Dental
Dental
R,F,O,Q
Systems and Development
Impact
Likelihood
3 5
15
Assurance
Risk Rating
Moving medical students between Trusts: There is a risk that moving
medical students between Trusts may impact on SIFT payments that follow
medical student placements. Withdrawal of SIFT payments from Trusts
could have signficant financial impact.
WEP
PG Medical
London Wide
London wide
London wide
London wide
London wide
5 3
15
Mitigating Actions
Impact
Likelihood
WEP
WEP
UG Medical
SaHF05
SaHF07
SaHF08
DTL 10
F
DTL21
Education provider stability: There is a risk that the stability of the
health faculty within the current education providers could be weakened if
the provider is no longer able to find placements for its students, thus
leading to potential decommissioning. Consequently, HENWL could be left
without a adequate training provision.
4 3
Q
DTL22
Date Added
WEP
UG Non-Medical
UG Non-Medical
Q, R
Q, R
HIS05
Midwifery placements: There is a risk that the closure of midwifery
services at Ealing Hospital could lead to a lack of placement availability
within the local health economy, where University of West London is the
only provider of students to Ealing Hospital. This could affect HENWL's
ability to effectively commission activity and could lead to placements
needing to take place outside the NWL health economy.
5 3
F
HIS09
Objective
Category :
Reputational/ Financial/
Operational/ Quality
Workstream
Scope:
LETB/ London-wide/
National
Reference
SaHF03
SaHF01
Q, R
Risk Description
Page 2 of 5
Oct/14 As a result of the loss of the BI Head we have
instigated a weekly review of the performance of the BI
team and would welcome input from Ops & Q&C
colleagues (via weekly Empower/Grid change
governance meetings.
Head of Systems and development has covered the
gaps and chairs the Empower/GRID steering group with
transparency on requests and tight controls on delivery
and deadlines
At this point we do not believe there are significant gaps
in the controls / assurance, although there is the
potential to increase visibility of improvements to Senior
Ops and Q&C teams via more formalised updates
There are some known data issues within the system
which gets addressed as and when found and raised
through a methodical apporoach. This was adopted
when an issue with NTN was raised by Operations
through the stock take exercise
No actions needed at this time, although will
consider improving the visibility of improvements
amongst Senior Ops and Q&C colleagues.
Oct/14 We have now started to increase the
visibility of those improvements to Senior Ops and
Q&C colleagues and will continue to do so.
Jan/15 Agreed to continue engagement with
business users to promote better system
interoperability, maintainability, streamlining, etc.
34
John Madsen
Elizabeth Chan
Date Last Updated
02 February 2015
02 February 2015
02 Feruary 2015
27 October 2014
27 October 2014
24 October 2014
Julie Screaton
Julie Screaton
Christian Oribio
12 January 2015
02 February 2015
No actions needed at this time.
Feb/2015 Head of BI has been appointed and is in
post since 19/January/2015, therefore SMT
PROPOSED THE RISK IS CLOSURE
12 January 2015
28 October 2014
16
We do not believe that there are any gaps in the controls
or assurance arrangements, as these are largely
internal. However we do not provide a routine
performance report to LEG or HENWL at this point, so
this is something that could be addressed to improve
transparency.
Oct 2014 Update: We believe the close scrutiny by the
Director of Informatics is sufficient to cover any gaps
and he will provide updates to LEG or HENWL as
needed.
A permanent Head of BI is now recruited to and a longer
term stability for the team
Date Last Reviewed
John Madsen
20
Oct 2014 Update: As a result of the loss of the Head of
the BI service we have instigated a weekly review of the
performance of the BI team.
A decision was made for the Head of Systems and
Devlopment to cover the Head of BI role as well in the
interim whilst a permanent replacement is found. This
established continuity in services
A detailed plan for the development of the resources
was undertaken to ensure the principal leads within BI
team are mentored to become the leader and be able to
achieve the quick wins. The team has undertaken
training sessions on core technology required to
support the rest of the business
Stephen Loughran
16
Oct/14 Update:
Risk is not yet mitigated whilst the Corporate
Business Continuity plans are still being
implemented. Actions related to extend data
recovery providers reduces the risk relative to last
month.
John Madsen
Whilst we believe there are no gaps in the controls
/ assurance, the situation where the national team
is the final decision making group does leave
London exposed to risks.. Next LEG meeting on
the 11 November to discuss the residual gap.
Feb/15 - LondonTransition to Oriel Project Board
agreed to close the project (10/Dec/14). All arising
issues, risks & changes are being reported from
2 2
the business via the national Oriel helpdesk.
Operations confirmed at the SLA meeing 20/Jan
that arising risks are now on their risk register. SMT
has revised the RAG rating to green and therefore
PROPOSED FOR CLOSURE
Elizabeth Chan
Internal controls are sufficient to govern the programme
of work, however the ultimate decisions on the Oriel
programme are for the national Oriel team, so we can
only 'influence'. However we are represented on the
Oriel national steering groups, we actively participate in
national PAG, and ROG. London LETBs are kept
informed of progress on Oriel at each LEG meeting (next
LEG meeting on 11 November), and decisions and
actions are fed into the internal Oriel steering group, and
the national team accordingly.
It is proposed that any residual risks gets covered within
the Operations risk register
Elizabeth Chan
London Transition to Oriel Project Project Board
overseeing the project and managing the risks and
issues with escalation through appropriate routes. The
London Migration to Oriel Project Board includes
representation from HIS, DEQs, Deans, Operations and
national Oriel team, to ensure appropriate consideration
of issues, and escalation as required. LEG is kept
updated on significant changes/risks/issues on a
monthly basis.
John Madsen
Results of the Gap Analysis in April 2014 indicated a potential impact in London of circa
600k (worst case) to handle work-arounds left by gaps in the Oriel system. The London
Oriel team is working hard to ensure that these gaps are minimised (see RISK HIS 11),
however there remains a risk that there will be additional funds required from within
LETB resources (unlikely at this point that Oriel / national team will provide). LEG is
being kept appraised of the latest position (post UAT).
April/14 - LEG informed of risks to LETB resources
May/14 - LEG informed of scale, post Gap Analysis, and interim funding agreed for Ops
backfill resources
July/14 - LEG update on progress, results of UAT (latest) and potential exposure
11/July - we consider that the risk of contingency invocation is now higher as a result of
the UAT over the last few weeks, London implementation team meeting next week to
identify where to invoke (will require LETB resources to do so)
Aug/14 - Some resources necessary to support workarounds in operation departments
post go live are being funded by HEE directly. However there are elements/operations
that IT will need to fund, but at this point it is difficult to quantify as the system is only in
its first few days of operation A paper is being drafted for LEG including these residual
July/14 The absence of an agreed DR / Business Continuity Plan (BCP) represents a
risk to the delivery of LETB services. Each LETB has appointed a governance lead. SL
working with each representative to assist and inform BCP plans.
July/14 We believe that this risk should be merged with risk SIS16 to create a combined
Disaster Recovery / Business Continuity Planning risk
Aug/14 We are working with the Business Continuity Group to establish LETB Business
Continuity Plans and these will be implemented accordingly.
Sept/14 Further to a review of current DR/BCP plans by Andrew Frith and Stephen
Loughran, action is with SL to contact DR Providers with a view to assisting with the
formulation / creation of a Business Impact Analysis document and ultimately assist SL
in writing the DR Plan. SL has begun discussions with Sungard (our DR provider) and
ULCC/Custodian. Since Oct/14 Sungard is now our selected provider.
Oct/14 For DR/BCP SL has continued discussion with Sungard. We have signed an
NDA with an alternative supplier allowing us to share current BCP plans so that they
can produce a site survey, etc. These potential solutions will give rise to a process we
need to follow (Staff interviews, BIA, recommendations for RPO, etc.) if we choose to
mitigate
Current mitigating action
Increased cross-team working within the BI team to share operational knowledge
between medical and non-medical Documentation of existing working practice. Broaden
pool for recruitment for senior roles. Staff training. Sharing of existing skills across
teams. Knowledge retained by few people, time needs to be put aside to transfer
knowledge. Skills not high enough (i.e. SQL, Stats Analysis), unfilled vacancy. Do not
have capacity, recruit, use paid on-going contractor
June 2014: due to continued recruitment problems for the higher grades we have 'acted
up' staff and plan to backfill BI roles from lower grades, introducing interns at the lowest
level. Migrating 'development' work to the system development team to increase BI
team capacity, and working to hand-back activities to the Operations team where
possible to increase longer term capacity. Also now outsourcing some of the work to
improve effectiveness eg ESR Warehouse build. As a result, we think that the risk is
reduced versus last report.
Aug 2014 Update: We are working through a re-structuring of the BI team to align skills
and capability with business needs and as a result we think that the risks can be further
reduced
Undertaking a number of actions to mitigate this risk:
I.) Implementation of greater system validation / quality control reporting
ii.) Enhancements to Empower/GRID will introduce some better processes which will
improve the overall quality of the data eg 'post validation tool'
iii.) Changes in the team structure will help manage and schedule resources more
effectively which will have a positive effect on the reporting/analysis we can generate
July/14 There are still risks, as the changes above are only just being implemented now,
so the level of risk is reduced only a little in this report.
Aug/14 We are making progress on Empower/Grid enhancements which improves data
integrity / quality. However there remains an on-going risk that the manual data
processing work that must be done by BI on Ops behalf, exposes the LETBs to data
errors. We will be introducing a new data controls framework in the next 6 months to
mitigate this risk further.
Oct/14 Update: With changes currently being made the risk is not yet sufficiently
mitigated, as there is much more work to do. We would expect this risk to start reducing
from Jan/15 onwards.
02 February 2015
Whilst we believe there are no gaps in the controls
/ assurance, the situation where the national team
is the final decision making group does leave
London exposed to risks.
Aug14: The risk does not impinge on HIS but
should transfer to the Operations Team Risk
Register.
Feb/15 - LondonTransition to Oriel Project Board
2 2
agreed project closure (10/Dec/14). All arising
issues, risks & changes are being reported from
the business via the national Oriel helpdesk.
Operations confirmed at the SLA meeing 20/Jan
that arising risks are now on their risk register. SMT
has revised the RAG rating to green and therefore
PROPOSED FOR CLOSURE
28 October 2014
28 October 2014
→
Internal controls are sufficient to govern the programme
of work, however the ultimate decisions on the Oriel
programme are for the national Oriel team, so we can
only 'influence'. However we are represented on the
Oriel national steering groups, we actively participate in
national Process Assurance Group (PAG), and
Requirements Operational Group (ROG). London LETBs
are kept informed of progress on Oriel at each LEG
meeting, and decisions and actions are fed into the
internal Oriel steering group, and the national team
accordingly.
It is proposed that any residual risks gets covered within
the Operations risk register
Corporate Business Continuity Group will oversee the There are no gaps in control of assurance on this item.
development of revised corporate recovery
HIS131 is now merged with HIS16
arrangements. At a lower level, the project activity to
build-in recovery scenarios is being governed by the
internal HIS Project Portfolio Board. Corporate visibility
of the recovery arrangements will be through LEG signoff
Accountable officer
4
London Oriel implementation Board is overseeing the
implementation of the mitigating actions and is meeting
bi-weekly to review progress on these matters.
Additionally, there are focused sessions within the
Operations team, and a communications plan which
ensures that all staff are aware of the changes.
Julie Screaton
Elizabeth Chan / John Madsen
2 2
Whilst we believe there are no gaps in the controls
/ assurance, the situation where the national team
is the final decision making group does leave
London exposed to risks.
Feb/15 - LondonTransition to Oriel Project Board
agreed project closure (10/Dec/14). All arising
issues, risks & changes are being reported from
the business via the national Oriel helpdesk.
Operations confirmed at the SLA meeing held on
20/Jan that arising risks are now on their risk
register. SMT has revised the RAG rating to green
and therefore
PROPOSED FOR CLOSURE
Lead
↓
Internal controls are sufficient to govern the programme
of work, however the ultimate decisions on the Oriel
programme are for the national Oriel team, so we can
only 'influence'. However we are represented on the
Oriel national steering groups, we actively participate in
national Process Assurance Group (PAG), and
Requirements Operational Group (ROG). London LETBs
are kept informed of progress on Oriel at each LEG
meeting, and decisions and actions are fed into the
internal Oriel steering group, and the national team
accordingly.
It is proposed that any residual risk gets covered within
the Operations risk register
Owner
4
London Transition to Oriel Project Project Board
overseeing the project and managing the risks and
issues with escalation through appropriate routes. The
London Migration to Oriel Project Board includes
representation from HIS, DEQs, Deans, Operations and
national Oriel team, to ensure appropriate consideration
of issues, and escalation as required. LEG is kept
updated on significant changes/risks/issues on a
monthly basis.
The project board is now closed with all risks/issues
escalated to the LaSEG by Operations
12
Date of last movement
2 2
April/14 Gap analysis conducted, resulted in series of Requests for Change (RFCs)
introduced into the national Oriel development/implementation with suppliers HICOM
and Deloitte. There remain a number of areas where 'workarounds' are being suggested
by the Oriel team, these are variously acceptable/bearable/unacceptable. Working
closely with the Oriel team to resolve those items we consider unacceptable. Major
sticking points are Dental, Plastics, and there is a review meeting with COPDEND on
15th July which is a trigger point for invoking 'contingency solutions', already lined up
with GTI solution and internal HIS development teams (for workarounds).
16 - Gap Analysis submitted to HEE 13-Mar-14
- 29/Apr/14 - Paper sent to LEG to prepare contingency funds to cover expected
increased costs
- Jul/14 - UAT testing commenced, RFCs to enhance R2 functionality to meet London
Requirements accepted
11/July - We consider that the risk of contingency invocation is now higher as a result of
the UAT in the last few weeks, London implementation team meeting next week to
identify where to invoke.
Aug/14 The National Team have resolved substantial functionality issues allowing the
The timescale is fixed at 1st September (Release 2) and end of December (Release 3),
so London implementation will just have to 'fit' this timetable. Our concern is that
London is changing circa 60% of its processes as it is not a current user of the HICOM
solution (Many other LETBs are existing users of one version or another of HICOM).
The mitigating actions to minimise this risk are:
- very early work on business process mapping and re-design (underway now)
- more intensive Operations team training (London has secured a good number of
training slots)
16 - Close working between the supplier HICOM and the London implementation team to
ensure that the new features being introduced into the system (whilst training and
implementation is under-way) are properly communicated and impact on business
processes more clearly understood (this is happening).
02 February 2015
John Madsen
4 4
→
Actions plan to address Gaps (include updates)
Legacy Systems - Data Integrity
Data integrity within the legacy systems causes great disruption to the
development work specifically in relation to
• limitations on data cleansing in legacy systems
• lack of understanding of impact of compromised data in the business
• poor processes maintaining currency of data in operational areas. Risk is
high
O,Q
9
John Madsen
5 4
3 3
John Madsen
Business Intelligence Resourcing and skills
Organisational Development has resulted in a loss of knowledge and skills
within the BI team. This leaves BI services short of key knowledge and
experience in a number of business spheres. There is also little
documentation of existing systems and processes. Difficulty in recruiting to
senior roles in the team means that both resources are stretched and that
key additional skills required for the functioning and development of the
service have not been acquired.
↓
Robin Garrett
Infrastructure
Business Intelligence
Systems and Development
London Wide
London wide
London Wide
HIS16
HIS18
HIS27
R, O, Q
4 4
4
Gaps in Control (C) or Assurance (A)
Disaster Recovery / Business Continuity
Current Disaster Recovery capabilities are inadequate. Plans and
resources need updating to support the planned recovery of systems.
There may be some cost implications which are not in current budgets.
There is no Corporate Business Continuity Plan - without a CBCP IT
Disaster Recovery cannot be appropriately scaled (c/f HIS16).
O,R,Q,
F
↓
Kavitha Saravanakumar
4 3
4
Assurance
London Migration to Oriel [R10]
There is no clarity as to how the additional resources required to
implement Oriel in London will be financed.
R,F,O,
Q
↓
02 February 2015
4 4
4
02 February 2015
R,F,O,
Q
2 2
28 October 2014
Operational / Information Systems
Operational / Information Systems
London wide
London wide
HIS136
HIS135
London Migration to Oriel
National timescales for the implementation of Oriel are impossible to meet
for the London LETB migration to Hicom
Movement
4 4
Risk Rating
R,F,O,
Q
Mitigating Actions
Impact
Likelihood
London Migration to Oriel [R01]
There is a risk that if the new national e-recruitment system does not
provide us with a sufficient level of functionality and that work-arounds
result in a significant increase in workload.
Initial Risk Rating
Impact
Likelihood
Date Added
Objective
Category :
Reputational/ Financial/
Operational/ Quality
Workstream
Operations / Information Systems
Scope:
LETB/ London-wide/
National
London wide
Reference
HIS11
Risk Description
Page 3 of 5
3 4
12
→
2 2
4
→
2 4
8
→
We do not believe there are any gaps in the
controls/assurance.
12 January 2015
04 March 2015
John Madsen
Kavitha Saravanakumar
Jon Wilkinson
12 January 2015
12 January 2015
06 March 2015
02 February 2015
28 October 2014
06 March 2015
06 March 2015
20 January 2015
Therese Davis
Julie Screaton
John Madsen
Andrew Frith
John Madsen
Andrew Frith
John Madsen
John Madsen
There are no additional actions that we need to
take at this time.
02 February 2015
Director of HIS to keep under review with Heads of
Team.
Oct/14 Update: Head of Systems Development is
overseeing the ESR work and is formally reporting
progress to HIS Director.
John Madsen
Sept/14 Project initiated to incorporate ESR data to Data Warehouse. There is a
requirement to recruit for two posts to ensure there is capacity in the team to move this
forward. Until we are able to take this project further forward we need:
1. To build resources within our BI function to support this process effectively
2. A clear detailed plan will need to be drawn up as part of the project
3. Engage with all stakeholders with the focus on 'historical data' being kept. These
12 measures will reduce the risk in the length of time to fill the posts.
Oct/14 We have now implemented the first stages of ESR data warehouse and are
continuing the programme to further consolidate Medical and Non-Medical repositories.
Therefore the risk is now reduced compared to our previous report.
John Madsen
HEE decision making is outside of LETB control.
However HIS internal project controls will ensure that
any arising risks will be responded to.
Andrew Frith
Project Board set up with HEE, comprising of HEE
Member, Philip Sutcliffe (Estates Advisor) and SL
(Head of Infrastructure). LETB MDs to be kept
informed.
Identify gaps by Departmental restructuring and
PDR. Work closely with other LETB IT depts to fill
shortages collaboratively.
Oct/14 Through the PDR process we identified the
skills gap and are working to resolve those with the
programme of training / procurement.
Kavitha Saravanakumar
There a number of actions that we are carrying out to mitigate this:
1. Usage of temp staff over the period
2. Usage of staff from Service Desk to help the move
3. UoL arrangements for sourcing key technical resources before Dec/14
4. Engaging HEE staff to assist in the move
5. Ensure that LETB MDs are exposed to decisions and commitments.
12 Oct/14 Further to reviewing office space and budget, HEE are to agree final sign off, SL
in discussion with Helen Jameson of NCEL to get agreement by 7/Nov. A Capital
Expenditure spend of £130K assigned to IT costs, includes a budget allocation to
provide a contractor/Intern to assist Infrastructure with the rollout of 65 new PCs and
related equipment.
04 March 2015
Oct/14 We do not believe there are any gaps in the
controls / assurance.
Oct/14 To maintain a regular interface to Martin
Hall at HEE Central IT. To discuss this with Peter
Holt and take appropriate actions
28 October 2014
Director of Information Management and HEE NWL
Managing Director to keep under review. Director of
HIS to keep under review with Heads of Team. The restructuring of the BI team will help to address some of
the skills shortage.
Oct/14 However Director of HIS to keep skills
development under review with Heads of Teams on a
monthly basis. ERFQ for 3rd party supplier is currently
underway and is to be completed by 24 November.
Dec/14 Reply Ltd won the e-RFQ. Finalising contract
call off terms and raising PO. Aiming to start subject to
Reply undertaking due diligence 7-9/Jan/2015.
There are no additional actions that we need to
take at this time.
06 March 2015
Director of Information Services to keep under review,
and updates to MD HENWL and LEG as needed
Oct/14 The Director of HIS to make an assessment on
a weekly basis of the effectiveness of these mitigating
actions and to escalate further if necessary.
Date Last Updated
Date Last Reviewed
Accountable officer
3 4
Director of Information Management and HEE NWL
Managing Director to keep under review for progress
on the mitigating actions. LEG scrutiny of
financial/resource pressures on SIS (eg recent LEG
updates from Director SIS), The newly formed HEE
Digital Assurance Group.
Oct14 Update: HEE London needs to see evidence of
movement on this within the next month. Need to feel
assured that decisions on local systems can be
properly contextualised nationally.
Mar15 Update : National CIO appointed with clear
communication lines for us with HEE Central. An IT huib
established to discuss the developments/priorities with
the other regional directors of information
Lead
↓
i.) influence the shape of the HEE strategy (actively doing this at the moment)
ii.) taken the decision to continue developing the existing systems (eg Empower / GRID)
and develop improvements which will add operational advantages, improve data quality
and resolve technical frailties.
iii.) A recruitment exercise will be carried out for either permanent or fixed term
contracts to plug essential skills gaps, and internal movements and 'acting up'
arrangements will be used to create space at the lower grades and/or space for
interns/juniors.
20 July 2014 Update: we have had some influence over HEE thinking, but the Beyond
Transition changes are getting in the way of useful dialogue. Our decision to
concentrate efforts on existing systems in the short-term is proving beneficial and
welcome, and there is sufficient resource to continue that through the remainder of the
financial year (we believe). Risk is reduced as a result of the above.
Aug 2014 Update: There is still no published HEE Information Strategy. This vacuum
greatly increases the difficulty in reaching informed local decisions about investment in
Systems and local Strategy, which in turn will now need be tabled to the newly formed
Digital Assurance Group Whilst we are actively involved in the development of the
Mitigating actions are:
I.) continual updates / briefing to IT team to reassure
ii.) changes to internal team structures / acting up arrangements to reward and
recognise those staff committed to the organisation
iii.) working more collaboratively with external partners such as KSS/EoE/Thames etc.,
to plug key skills gap and ensure work can continue
Oct/14 As of October because of the uncertainty caused by Beyond Transition this risk
has now materialised. The Head of BI has resigned and we are currently struggling from
20 HEE Central to get clearance to replace the role. The BI team can ill afford the loss of a
key resource at this point, as it is one of the most denuded teams in the directorate.
Given that this team manages a lot of the Rotations Data processes for the Operations
department, this represents a significant risk. There is also potential reputational risk in
relation to the London streamlining programme, which the Head of BI plays a significant
role in. We are now looking to provide some interim cover for this team using a
combination of Senior Managers and some external support.
Mar/15 Permanent Head of BI recruited to with the beyone transition stage 1 and 2
cleared
There a number of actions that we are carrying out to mitigate this:
Capacity Skills assessment, Mapping timetable of likely skill gaps versus key projects,
undertaking Professional services Business Cases for approval for key skills,
communicating with other LETB Heads of IT to identify collaboration opportunities. As
part of staff professional development and to cover staff involved in priority work / on
leave / sick, a number of staff will be trained in the key technical skills over the financial
year. There may be occasions in certain projects where the use of partnerships and
20 outside organisations may be required. In light of the restriction in the use of contractors
and the difficulty of the lead-time in securing approval due to DH/HEE approvals
process, we feel that this risk is now severe.
Oct/14 Director of HIS has agreed to make training funding available for all Informatics
Staff. This will plug the gap in individual skillsets. A procurement process is taking
place to select a 3rd party supplier to handle BizTalk Support and Development.
Owner
4
The controls are outside of the local LETBs control
Advise provided to business as and when there is a
requirement for new online channel through our
dedicated online channel manager
Re-used existing sites to maximise the usage of the
existing online channels
Oct/14 Continued dialogue and work with Martin Hall at The controls are outside of LETB control. We will
HEE Central IT to establish HEE decision timeline for
continue to lobby and work with Martin Hall (HEE) to
this issue and the potential affect on HEE London.
resolve this risk. We will also keep under review
internally as part of annual budget planning process
This will also be picked up with Peter Holt as our
regional head of Finance
35
Date of last movement
2 2
Oct/14 Currently we do not fall foul of any Government
controls and that we are openly communicating our
development intentions with colleagues in the Digital
Leaders Network to ensure that we:
a. Join up the thinking
b. Look for alignment opportunities
Jan/15 Since the introduction of the HEE intranet we
will re-visit our channel to customers/clients to ensure
fitness for purpose & alignment to other LETBs/HEE
organisations.
Mar/15 Feedback through the HEE Central team to
provide review on the digitals spend guidance
document
There are no additional actions that we need to
take at this time.
02 February 2015
R,F,O,
Q
There are no additional actions that we need to
take at this time
Feb/15 HEE Central has issed its letter in which the
board has approved the "implementation of Phase
of Beyond Transistion" accordingly SMT
Mar/15 Beyone transition stage 1 and 2 complete
with no significant resources affected
PROPOSED FOR CLOSURE
20 January 2015
London Wide
HIS145
Information Consolidation (Medical & Non Medical) - The data from
medical and non-medical systems are not consolidated to a single data
warehouse. This makes it difficult to answer business questions to deliver
multi-professional workforce planning and KPI reporting to LETBs.
We do not believe there are any gaps in the
controls/assurance. However this depends on the
success of the arrangements put in place.
20 January 2015
3 4
↓
Andrew Frith
HEE Move to Stewart House- From Dec/14 until Feb/15 HEE moving to
Stewart House. Infrastructure will have capacity issues to roll out PCs and
other Infrastructure Services required. All the telephone licensing will need
to be reviewed to ensure we have enough numbers to roll out. There is a
risk that we incur significant expenditure in advance of HEE committing to
the move. In addition HEE may use different systems which will require
similar upfront expenditure and staff resource.
4
Andrew Frith
R,F,O,
Q
5 4
There are no additional actions that we need to
take at this time, although consider increasing
visibility through LEG / Senior Ops team.
Mar/15 SMT agreed that appropriate progress has
now occured with the HEE CIO appointment and ongoing clarity of an IT stratetgy for our alignment.
SMT has revised the RAG rating to green and
therefore
2 2
PROPOSED FOR CLOSURE
Andrew Frith
R,F,O,
Q
The controls are outside of LETB control, but our internal
project controls will ensure that we pick up any risks
associated with Cabinet Office Digital Controls
Aug14 Update: Director of Informatics to draft principles
and decision framework for HEE Digitals Assurance
Group. This should enable us to influence and to
monitor / control outcomes more closely.
Mar15 Update : Director of Informatics to work with other
regional directors of information as part of the newly
established IT hub to address priorities and moving
towards one HEE strategy
Stephen Loughran
HIS
London Wide
HIS144
HIS143
Technical Skills Shortage - Information Directorate does not have
capability within the permanent team to cover BizTalk development, SQL
and SharePoint Administration and Statistical Analysis.
→
Andrew Frith
5 4
8
Stephen Richards
R,F,O,
Q
4 2
June/14 Cabinet Office Controls remain in place, and we do not have any greater clarity
about HEE position on web developments. Continue to operate websites and web
services 'at risk' therefore in the interim. We communicated our websites and costs to
HEE during June, as part of their routine review / assessment, but at this time we have
had no direct feedback to change our position.
Aug/14 The position with Digital Controls has changed. A new group [HEE Digital
Assurance Group] has been created. This group is taking responsibility for vetting and
approving projects. This has increased our risk to achieving agreement to undertake
20 potential digital projects. The risk is further exacerbated by lack of a HEE IS Strategy.
We are fully engaged with this group and are influencing the outcomes. We do not
believe there are any gaps in the controls or assurance mechanism although there
remains the risk that decisions remains outside of LETB control. Director of Informatics
to ensure that LEG is appraised of any specific matters as they arise.
Oct/14 HEE have had the first meeting in October of the Digital Leaders Network, to
ensure joined up thinking across LETBs in view of "One HEE". HEE London is actively
engaged with the Digital Leaders Network and continues to influence the thinking about
websites versus application systems on the Web As a result we think the risk of our
Further to recent conversation with HEE 1. They fully expect no changes to be made to
how we are licenced next year in 2014/15. 2. this is a reminder to review licencing one
year from now as current uplift to commercial pricing will be an extra £200K
July/14 Risk remains, but is considered to be static until greater clarity from HEE as part
of their IT strategy (due July/14).
Aug/14 HEE IT Strategy indicates the licensing will be under their control but does not
mention Educational Discounts. This will result in an uplift in costs to us and we will
require more funding. This will affect all HEE LETB IT Services. Contacted Martin Hall
20 (HEE) at recent HEE IT Strategy meeting and raised education discount advantage
issue - it was agreed to undertake further work together on this.
Oct/14 There is still a residual risk on this, however positive conversations with HEE
Central IT indicate that there may be cover for any cost of change to the Academic /
Commercial licensing model.
Jan/15 No change.
Actions plan to address Gaps (include updates)
06 March 2015
Beyond Transition
The Beyond Transition changes are causing some organisational instability
and raises risks of key staff leaving from the IT directorate. With a 30%
vacancy factor already in the team, any losses will be critical and will
probably disrupt operational services materially.
↓
Gaps in Control (C) or Assurance (A)
02 February 2015
5 4
4
02 February 2015
Strategic Risk
The risk here is that the expected HEE Information Strategy is not
developed, or not developed in time or is not suitable to meet London’s
needs. As a consequence we will have to continue to rely on some
information systems that are at or near end of life or operating on
unsupported platforms. We will not be able to progress the development of
information systems to support the transformation and efficiencies desired
by the LETBS and Education Providers and demotivation of staff will
increase.
2 2
02 February 2015
F, O, Q,
R
4 5
Movement
R,O.Q
Assurance
Risk Rating
Business Engagement
Information Management
Information Management
London Wide
London wide
London wide
HIS141
HSIM03
HIS30
Financial - We will not be able to sustain the educational discounts that
we obtained from Software Suppliers in the past as an education
establishment and part of the University of London beyond the end of the
current financial year.
Initial Risk Rating
Impact
Likelihood
5 4
Mitigating Actions
Impact
Likelihood
Digital Controls
HEE are currently in discussions with DH about digital controls imposed by
the Cabinet Office (Government Digital Service, GDS) which provide strict
guidance and approval on all digital spending by ALBs. Digital is defined
as ‘internet enabled’ and ‘external facing’. If development of our online
channels is deemed to meet this definition then we will face service
delivery and organisation reputation risks as continuing improvements and
developments to our sites could stagnate.
Date Added
Objective
Category :
Reputational/ Financial/
Operational/ Quality
Workstream
Business Engagement
Scope:
LETB/ London-wide/
National
London Wide
Reference
HIS28
R,O
Risk Description
Page 4 of 5
4 3
12
↓
3 3
9
→
4 4
16
36
12 January 2015
02 February 2015
12 January 2015
12 January 2015
Andrew Frith
Andrew Frith
12 January 2015
Andrew Frith
Andrew Frith
John Madsen
Meetings with providers and agreed
communications to users and other stakeholders.
Extension of current contract to allow time for a
further bidding round with greater flexibility around
TUPE.
13 March 2015
Escalation of concerns about changes to the service by
current providers and users has raised comms and
reputational risks.
Procurement process did not result in a viable bid. Partly
due to TUPE costs.
• Regular monitoring and review by Postgraduate Dean,
Head of Professional Development and Senior
Business Manager
• Effective progress monitoring and reporting in place
• Regular communication with Procurement Manager
13 March 2015
• Transition and handover needs stated specifically and clearly in the specification of
work being tendered
• Raise issue of safe transition with outgoing service providers, involve them in the
process early and maintain ongoing dialogue
• Plan in advance the parameters, actions, key players and communications involved in
managing the safe transition
• Work closely with Procurement partners to ensure compliance with procurement
protocols and mitigate against potential risks in the event of implementation delays
• Work closely with and keep LaSE and HEE Central colleagues updated on progress
with the procurement and engage with the legal teams as appropriate
• Develop options/scenario plans to address potential reputational risks and
implementation delays/potential gaps in service
13 March 2015
• Not clear yet how the increased demand for space with • None identified at this time
HEE moving in will be managed
13 March 2015
20
• Continue current practice of systematically trawling room/office availability – working
• Regular monitoring of meeting numbers and booked
flexibly around occupancy where possible.
locations.
• Continue ongoing dialogue with Facilities colleagues, particularly during proposed
• Logging/monitoring any incidents/concerns.
office moves, making the case for a dedicated consultation room space or other options
allowing more flexible use of space
• Escalate concerns to HENWL Executive.
• Explore options for making use of available HENWL space.
• Explore options for making use of other available space in Stewart House
Julia Whiteman
5 4
12
There are no additional actions that we need to
take at this time.
Julia Whiteman
Commissioned Psychological Service for Doctors and Dentists: A
procurement process has been initiated to commission a re-focused
psychological and occupational mental health service, to commence in
2015-16. Whilst the procurement is in progress there are some risks
associated with looking after the interests of potentially vulnerable clients
currently 'in the system'. There are also potential risks relating to planning
and managing a smooth handover and transition of service in the event of
a change in providers and also possible reputational consequences in the
event of any adverse reaction/challenge from outgoing providers which
could also impact on completion timeframes for the procurement and
delays in implementation of the new service.
4 3
Date Last Updated
↑
02 February 2015
20 January 2015
8
Samantha Hobbs
Space pressures resulting in safety and quality concerns for
confidential meetings with clients/service users: Lack of dedicated
departmental space and availability of rooms in the Events Centre is
creating administrative and service pressures for booking rooms for
meetings of a sensitive nature and confidential 1:1 consultations with
clients. The difficulties are likely to be amplified with the impending arrival
of additional HEE colleagues at Stewart House. There are risks to the
quality of service provided when there are complications/delays in locating
appropriate rooms for the meetings and also to the safety of PSU staff and
confidential information if rooms are allocated in ‘remote/out of the way’
locations e.g. Senate House.
Jan/15 Head of Infrastructure to keep under review with We do not believe there are any gaps in the
controls/assurance.
Director of HIS and other Team Heads. Consolidation
and upward reporting as necessary (via SMT weekly).
Date Last Reviewed
20 January 2015
Andrew Frith
4 2
There are no additional actions that we need to
take at this time.
Catherine O'Keeffe
Professional Develvopment
PD06
R, O, Q
4 4
HIS Director - current organisational Internet access:
1. 2 factor authentication - user password + RSA token
2. PWC undertook security assessment and found items to address
Jan/15 - systems & procedures need to be revised & specified and at the same time to
16 take on board new structure/roles/responsibilities to ensure that HIS is implementing
appropriate security measures. HIS to put in place a programme of review & updates
and maybe commission a third party supplier (eRFQ).
We do not believe there are any gaps in the
controls/assurance.
Samantha Hobbs
Professional Development
London-wide
PD04
O, Q
Cyber Security - we have a diverse range of information systems and
electronic communication channels which must be secure. The risk is that
they may be vulnerable to malicious or vexatious attack from outside and
inside the organisation leading to the loss and/or corruption or disclosure
of confidential information. The consequences of this range from
disruption, business process disruption to material and reputational
damage.
16
Jan/15 Director of HIS to keep under review with
engagement of the business (KSS, Ops, Quality, etc.).
Consolidation and upward reporting as necessary (via
SMT weekly).
Catherine O'Keeffe
R,F,O,
Q
4 4
10 November 2014
London Wide
London Wide
HIS148
HIS149
R,F,O,
Q
HIS Director leading on IG structures - urgently commission an independent review of
HEE's IG policies, procedures and maturity to identify necessary short and medium
term actions.
Accountable officer
Therese Davis
→
Lead
Andrew Frith
9
Owner
Kavitha Saravanakumar
3 3
There are no additional actions that we need to
take at this time.
Jan/15 In moving resources to Stewart House space is a premium - to alleviate this
contrainst we can digitise documentation/filing. Explore document management
suppliers capable of providing an appropriate solutions (eRFQ).
Information Governance (IG) - we have a large amount of data and
sensitive information about trainees. There is a risk that appropirate
policies and procedures are not currently embedded across the
orgaination which may result in loss of personal and sensitive information
about trainees. This would damage the individual's and lead to reputational
damage to the organisation and its partners and the NHS as a whole.
Date of last movement
→
Andrew Frith
Set up Project Board. Engaging with KSS lead
We do not believe there are any gaps in the
stakeholders with a clear Project Plan to take forward. controls/assurance.
Upward reporting to LEG as necessary.
Oct/14 Roadmap to be submitted to November LEG for
ratification. Project Board to oversee consolidation with
oversight / update to LEG on a periodic basis.
12
Stephen Loughran
HIS Director leading on organisational structures with SL and KS:
1. Project Board to be set up to manage the transition
2. Close monitoring of arrangements to ensure effective transfer of staff and services
within the timescale
3. Additional staff support requirements from KSS and across the LETBs
4. Development of a contingency plan in order that HIS IT Services incur minimum
12 disruption
5. Development of SLA with comprehensive KPIs.
3 4
John Madsen
Director of Information Management and HEE NWL
HEE decision making is outside of LETB control.
There are no additional actions that we need to
Managing Director to keep under review, HENWL HR & However HIS internal project controls will ensure that we take at this time.
pick up any risks.
Finance teams are fully involved. Upward reporting to
LEG as necessary
02 February 2015
3 4
Aug/14 Update:
1. Prioritise work
2. Buy in the short term skills and capacity only as required
3. Do nothing, only provide solutions/workarounds in support and maintenance of
everyday systems until 'Beyond Transition' completed as planned by April/15
4. Build partnership working with other organisations
5. Development of a Contingency Plan to ensure all essential work that can at least be
20 done
6. In order to make full use of staff resources, restructure HIS Dept to ensure the impact
on staffing is evaluated and that roles and responsibilities are reallocated as
appropriate.
7. Clear CSFs and KPI reporting with upward reporting to LEG as necessary
Oct/14 No change
02 February 2015
R,F,O,
Q
Actions plan to address Gaps (include updates)
Movement
HIS147
London Wide
KSS Merger - from Oct to Dec14 to merge IT Services and Infrastructure
with Kent Surrey & Sussex (KSS). This will involve supporting 130+ staff.
The risk increases with the level of services to be integrated and within the
timescale.
Gaps in Control (C) or Assurance (A)
Risk Rating
5 4
Assurance
Impact
Likelihood
London Wide
HIS146
R,F,O,
Q
Initial Risk Rating
Impact
Likelihood
Date Added
Objective
Category :
Reputational/ Financial/
Operational/ Quality
Workstream
Scope:
LETB/ London-wide/
National
Reference
Recruitment Freeze - 'Beyond Transition' has put a freeze on permanent
posts. This makes it difficult to provide the skills and capacity to update
systems or undertake new project work. This will also impact on HIS's
ability to meet all of its objectives.
Mitigating Actions
↑
Risk Description
Page 5 of 5
Health Education North West London
Board Paper Coversheet
Paper G
(Coversheet)
HE NWL
Board
Meeting Date
15th April 2015
Paper Title
HENWL 2014/15 Year to date Financial Position
Paper Number
G
Paper Author
Jane Pauley
Paper Author Contact
Details
[email protected]
Lead
Jane Pauley
FOI Status
Accessible under FOI
Paper Summary
This paper provides an update on the Month 11 year to date financial
position and on current financial issues.
Date paper completed:
8th April 2015
Purpose
To update the Board on the 2014/15 month 11 year to date financial
position and the 2014/15 forecast out-turn.
Recommendation
The Board is asked to:
• Receive the Month 11 financial position as set out in section 2
• Note the financial forecast and key issues identified in section 4
• Note the key risks set out in section 6
Integrated Assurance Committee 26th March 2015
Where was the Paper
previously discussed
15 April‘15
What was the outcome
Paper received
Strategic Objective
Links / EOF Links
Delivery of financial balance and effective financial governance
Identified risks and risk
management actions
• Risk that forecast underspend in 2014/15 is bigger than plan
• Amended allocation of LETB budgets 2016/17 could result in
adverse impact on HENWL
• Finance Department Resources under pressure due to vacancies
Relates to 2014/15 expenditure
Resource implications
Support to NHS
Constitution
Relates to HENWL financial resources for 2014/15
Legal implications
including equality and
diversity assessment
Financial stewardship and effective use of resources to achieve
maximum value for money. Legal accountability for public funds.
Equality and Diversity applicable to ensuring access to resources, no
formal E&D assessment has been carried out
Developing people
for health and
healthcare
We are the Local Education and Training Board for North West London
41
37
Paper G
HENWL 2014/15 Year to Date Financial Position
HE NWL Board
15 April ‘15
1.
Introduction
This paper provides an update on the Month 11 year to date financial position and on current
financial issues.
2.
2014/15 Month 11 year to date Financial position
Annual
Budget
Month 11 Year to Date
Budget
£'000
Actual
Variance Variance
%
£'000
Non-Medical
59,269
55,198
55,452
254
0%
-900
Undergraduate Medical
49,779
49,648
49,215
-433
-1%
-560
Postgraduate Medical & Dental
97,657
95,781
95,483
-298
0%
600
Student Support
23,104
21,178
20,186
-992
-5%
-1,080
Contingency, Programmes &Transition
13,864
9,412
10,169
757
8%
1,620
Future Workforce Total
243,673
231,217
230,505
-712
0%
-320
Workforce Developments
12,289
10,974
11,029
55
1%
0
Education Support
5,436
5,102
5,354
252
5%
320
Running Costs
3,561
3,152
3,037
-115
-4%
-140
National Activities
1,429
999
997
-2
0%
0
NIHR Academics
0
0
0
0
0%
0
266,388
251,444
250,922
-522
-0.2%
-140
NWL – TOTAL
£'000
Forecast
Outturn
M11
Underspend
The YTD variance is an underspend of £522k. A more detailed breakdown is shown in
Appendix 1. The key differences to plan are:
o
o
o
o
o
3.
There is a cumulative underspend of £712k on Future Workforce. The key components
as follows:
- Non-medical is showing a £0.2m overspend made up of £0.7m investment in
additional Health Visitors and £0.2m of additional transitional tariff funding plus
underspends of £0.5m on tuition and £0.2m on salary support.
- Undergraduate medical is underspent by £0.4m due to activity variation
- Postgraduate medical and dental spend services show a £0.3m cumulative
underspend. Overspends against NIHR recharge and less than full time trainees are
offset by underspends on GPRs and postgraduate programme budgets.
- Student Support is showing a £1m underspend in line with the latest forecast from
SBU.
Workforce Development is currently showing a £55k overspend because of expenditure
phasing.
The overspend of £252k on Education Support arises from the transfer of costs from
future workforce to align coding with HEE guidance. This is covered by Future Workforce
underspends.
Running Costs are underspent by £115k because of staff vacancies in hosted services
the impact of the controls in place in 2014 around filling them.
National Activities are breaking even.
2014/15 HE NWL Budget Movements
The annual budget as at Month 11 is £266.4. The budget movements since Month 9 are
shown in the table below.
38
Budget Movement Summary
HE NWL Budget at Month 9
E-portfolio budget moved to HEE National
Postgrad Medical Sexual Health funding
HE NWL Budget at Month 11
4.
£'000
266,361
-19
46
266,388
Forecast out-turn 2014/15
The out-turn position is still expected to show an underspend of £140k as per the Table in
section 2. This arises from planned running cost underspend. It also includes an overspend
on Education Support of £0.3m offset by Future workforce underspend.
Further detailed review has been done on the forecast following confirmation of final
Workforce Development funding agreements.
There is still some potential forecast variability:
a) Running costs budgets may underspend by more than target as non-pay expenditure
may slip (possible increased underspend)
b) Hosted funding for NIHR is being confirmed with HEE National (possible underspend)
c) Hosted budgets for National Activities are expected to breakeven but some slippage may
arise (possible underspend)
d) Postgraduate Medical budgets include forecast non-pay expenditure which may slip e.g.
Speciality Schools (possible underspend)
These issues are expected to be managed within the usual variation of year end finalisation.
Prudent assumptions have been made so that an additional underspend is most likely
outcome if expenditure does not go according to plan.
Forecasting Issues Root Cause Analysis
As reported to IAC there was an in-year error in NMET forecasting in M8 resulting in a
favourable forecast movement of £2.5m. A Root Cause Analysis (RCA) draft has been
prepared which is currently being reviewed by the L&SE Head of Finance. This will be
presented to IAC when finalised. The draft RCA contains an action plan which spans both
Finance and Commissioning functions and several key actions have already been
implemented to minimise the chance of similar errors happening again.
5.
Budget setting for 2015/16
An update on budget setting is included as a separate paper.
6.
Update on Key Financial Risks
a) Financial Management & Governance: Risk of breaching financial duties or
ineffective/delayed decision-making due to a lack of clarity around procurement rules
and authorisation of expenditure; there is also a risk that procurement rules may be
restricting purchasing options which could be limiting effective operations.
Mitigation: As part of the launch of the newly restructured Finance Department
guidance will be recirculated, manager training programmes is being prepared and HEE
advice on procurement is sought as required
39
38
b) HEE Budget Allocation 2015-16. Although comprehensive revision of the current HEE
allocation methodology is no longer planned for 2015-16, a resource reduction of £0.9m
will be applied to workforce development funding. There is also a risk of reduced
resources resulting from the funding settlement between HEE and DH.
Mitigation: The HEE budget at a National level was reduced by £30m; £13m of which
was made through 1.9% reduction to Undergraduate Medical tariff passed on to Trusts
and the rest funded through reductions to non-recurrent National budgets.
HENWL Workforce Development expenditure plans made in 2014/15 included plans for
reducing 2015/16 spend in line with the reduced budget.
c) Forecast Outturn 2014/15 There is a risk that HENWL may fail to deliver a balanced
financial year-end position and show an underspend in 2014/15 bigger than the planned
£140k underspend on running costs, due to current uncertainties around spending in
some key areas.
Mitigation: LETB team and L&SE finance team working to address risk areas,
assumptions have been prudent but not in the extreme.
d) Allocation of Budgets to LETBs from 2016/17 onwards is subject to review by HEE
and changes are expected following ongoing work to review budget setting principles.
This could have an impact on commissioning and planning and potentially destabilise
London providers.
Mitigation: London LETBs will continue to assemble appropriate evidence to test the
assumptions behind proposals that affect London Education funding. A contingency
plan will also be developed which addresses potential budget reductions
e) Finance Department Resources: Due to staff resignations, maternity leave and
sickness the London Finance Department has a number of vacancies. Recruitment was
delayed due to central restrictions on filling vacancies.
Mitigation: Temporary staff have been recruited and the team has been re-structured
temporarily pending permanent recruitment to the new London & SE Finance Structure.
Permanent recruitment is underway and the Finance Team merges on 1st May 2015.
7.
Recommendation
The Board is asked to:
•
•
•
Receive the Month 11 financial position as set out in section 2
Note the financial forecast and key issues identified in section 4
Note the key risks set out in section 6
40
39
Appendix 1
HENWL 2014/15 Month 11
Financial Summary
Future Workforce
Non medical
Future Non me1.1 Tuition
Future Non me1.2 Salary Support
Future Non me1.3 Tariff
Future Non me1.4 Health Visitor
Future Non me1.5 End of Life
Future Non me1.6 IAPT
Future Non me1.7 Other NMET
Non medical Total
Undergraduate medical & dental
Future Underg2.1 SIFT tariff
Future Underg2.2 SIFT Primary Care
Future Underg2.3 Dental
Undergraduate medical & dental Total
Postgraduate medical & dental
Future Postgra3.1 PGMDE LDA
Future Postgra3.2 NIHR recharge
Future Postgra3.4 GPR Sals
Future Postgra3.5 Public Health
Future Postgra3.6 Dental Vocational
Future Postgra3.7 Flexis
Future Postgra3.8 Darzi
Future Postgra3.10 Provider
Future Postgra3.11 savings target
Postgraduate medical & dental Total
Student support
Future Studen 4.1 Student Support NMET
Future Studen 4.1 Student Support Medical
Student support Total
Other Future Workforce
Future Other F5 Transition
Future Other F6 Contingency
Other Future Workforce Total
Future Workforce Total
Annual
Budget
In Month
Budget
In Month
Actual
In Month
Variance
YTD Budget
YTD Actual
YTD
Variance
35,961
13,519
5,218
1,982
411
890
1,290
59,269
3,097
0
292
0
0
18
5
3,410
3,041
-40
380
25
0
17
-3
3,420
-56
-40
88
25
0
-0
-8
9
32,883
12,545
5,218
1,982
411
871
1,290
55,199
32,427
12,375
5,413
2,668
411
871
1,287
55,452
-456
-170
195
686
0
-0
-3
253
47,493
2,285
0
49,779
112
0
0
112
-3
0
0
-3
-114
0
0
-114
47,362
2,285
0
49,647
46,966
2,250
0
49,216
-396
-35
0
-431
75,056
-2,000
10,595
1,285
2,638
3,991
373
5,719
0
97,657
-0
0
883
108
220
333
40
238
0
1,821
-52
90
911
-81
225
350
53
67
0
1,564
-52
90
29
-189
6
17
13
-170
0
-257
75,056
-2,000
9,712
1,177
2,418
3,658
333
5,426
0
95,781
74,976
-1,379
9,544
807
2,480
3,845
263
4,946
0
95,482
-80
621
-167
-370
62
186
-70
-480
0
-298
17,937
5,166
23,104
1,495
431
1,925
1,425
410
1,835
-70
-20
-90
16,442
4,736
21,178
15,674
4,511
20,186
-768
-225
-993
5,259
8,605
13,864
0
0
0
0
639
639
0
639
639
5,259
4,153
9,412
5,259
4,910
10,169
0
757
757
243,672
7,268
7,454
186
231,217
230,504
-712
Workforce Developments
WorkfoOther D7.1 Trust LDA Allocations
WorkfoOther D7.3 Indirect CPPD
WorkfoOther D7.4 Preceptorship
WorkfoOther D7.5 Apprenticeships
WorkfoOther D7.6 STeLI
WorkfoOther D7.7 Strategic CPPD
5,016
4,484
240
280
125
2,144
0
276
0
0
-0
0
0
333
0
0
0
0
0
58
0
0
0
0
5,016
3,976
240
280
125
1,337
7,418
3,610
0
0
0
0
2,402
-366
-240
-280
-125
-1,336
Workforce Developments Total
12,289
276
334
58
10,974
11,029
55
100
50
49
480
574
176
31
0
0
0
90
15
31
0
0
0
10
13
0
0
0
0
-80
-1
31
0
49
480
266
173
31
0
50
565
186
165
0
0
1
85
-80
-7
National Activities Total
1,429
136
54
-82
999
998
-1
Education Support
Educat Educati 9.1 LETB
Educat Educati 9.2 Hosted Services
Educat Educati 9.3 Educ Supp to Med Schools
Educat Educati 9.4 TPD
1,225
3,452
340
419
29
307
0
2
76
321
0
-23
47
14
0
-26
1,196
3,150
340
417
1,469
3,089
340
457
273
-61
0
40
Education Support Total
5,436
339
374
35
5,102
5,354
252
Running Costs
RunninRunnin 10.1 LETB
RunninRunnin 10.2 Hosted Services
2,445
1,116
164
85
183
78
19
-7
2,121
1,031
2,213
825
92
-206
Running Costs Total
3,561
249
261
12
3,152
3,038
-115
-5,785
5,785
0
266,388
0
0
0
8,267
1,397
-1,397
-0
8,477
1,397
-1,397
-0
210
-5,785
5,785
-0
251,444
-4,339
4,339
-0
250,923
1,446
-1,446
-0
-521
National Activities
NationNationa8.1 National Student Survey
NationNationa8.3 Return to Practice
NationNationa8.7 NACDPE
NationNationa8.8 Rehab engineering
NationNationa8.9 Data Projects
NationNationa8.10 Cosmetic Procedures Qualifications
NIHR
Non MNIHR 11.1 NIHR Income
Non MNIHR 11.2 NIHR Expenditure
Non MPET Total
Grand Total
41
40
Health Education North West London
Board Paper Coversheet
Paper I
(Coversheet)
Meeting Date
15th of April 2015
Paper Title
PPE Strategy: 2014/15 Review
Paper Number
I
Paper Author
Kathryn Jones, Louise Saul, Sally Malin
Author Contact
[email protected] [email protected] [email protected]
Lead
Kathryn Jones
FOI Status
Available on website
HE NWL
Board
15 April ‘15
Paper Summary
This report sets out progress in 2014/15 on implementation of the
PPE strategy and areas currently under development.
Recommendations for work 2015/16 are made for HENWL Board
consideration.
Date paper completed
February 2015
Purpose
For discussion and consideration of recommendations
Recommendation
Consider and accept recommendations set out in section 4 of the
paper.
Where was the Paper
previously discussed
This paper was discussed at PEC on 17 March and Patient Forum
on 2nd April.
What was the
outcome
PEC: The paper was on the whole well received. The following
suggestions were made and agreed by the group:
1. The paper should more clearly link back to the PPE strategy,
Including clear reference to what we said we would do and
where we are now.
2. A common structure for papers reviewing the strategy to be
adopted to allow clear audit trail
3. Partnership working: to develop this section and make more
clear the impact our partners have made on progress to date
4. An overview of how in the future agendas and work plans for
both PEC and PF should be constructed to reflect HENWL
strategy and business cycles, as well as the four themes
identified from patient feedback in the strategy.
PF:
Strategic Objective
Links / EOF Links
N/A
Identified risks and
risk management
actions
N/A
Resource
implications
A small budget has been set aside to support the policy in line with
HEE guidelines
42
Support to NHS
Constitution
The NHS aspires to put patients at the heart of everything it does.
Legal implications
including equality and
diversity assessment
None directly identified
43
HENWL Patient & Public Engagement (PPE) Strategy 2014-17
Evaluation of Progress 2014/15
1.
Introduction
The HENWL PPE Strategy was launched with Board approval in March 2014 and set out the approach
for using patient and public engagement to meet HENWL’s strategic priorities, in particular how we
can engage patients and public in improving patient care through strategic workforce planning and
education commissioning.
The HENWL Public Engagement Committee oversaw development of the strategy, which began with
an extensive review of existing channels for, and insights from, patient and public engagement in the
NHS in north west London. From this four patient priorities were identified as central for HENWL’s
PPE strategy: safety, dignity, communication and co-ordinate my care. The strategy outlines how
PPE will be incorporated into north west London’s service transformation programme, other core
business activities, project work and work with local partners.
This report sets out progress in 2014/15 on implementation of the strategy and areas currently
under development. Recommendations for work 2015/16 are made for HENWL Board consideration.
within our work.
2. Evaluation of 2014/15 workplan
2.1. Establishing patient voice in HENWL through the Patient Forum
To ensure patient voice informs HENWL Board decisions, the PPE strategy recommended
establishment of a Patient Forum. The Patient Forum held its first meeting in April 2014 and has
since met quarterly with a brief to support the Board in its annual work programme through sharing
ideas and building expertise, promoting collaborative working, showcasing good PPE work, and
promoting best practice.
Membership for the first year has included patients, carers, and executive leads for PPE in partner
organisations. Expenses have been claimable by members who have not been remunerated.
Agendas to date have covered:
•
•
•
•
•
•
ways of working
learning session: HENWL workforce planning and activity
HENWL investment plan and financial priorities for 2015/16
Learning session: how are safety and compassion embedded in commissioning the
district nursing workforce
Developing the public health workforce
Building HENWL’s profile in the local community: review of Annual Review for 2013-14
The Forum has also received and responded to requests for patient voice input on other HENWL
areas of work, including:
44
•
•
Allied Health Professionals (AHP) SHARP project, focusing on clinical leadership
capability and capacity of AHPs
Collaborative Clinical Education project at the Centre for Simulation and Engagement.
This project explores the concept of collaborative simulation for educating healthcare
professionals and patients
The group has developed a good working rapport and has contributed to development of the above
agendas. They have also shared information on PPE in their own organisations and networks to
broaden the shared expertise of the group. In addition, two forum members have visited Full of Life,
a charity run by another member.
Next steps
The Forum is now looking to expand its membership with wider service user representation. This will
support embedding patient voice through participation of patient representatives on each of the
HENWL forums as follows:
•
•
•
•
•
•
•
Primary Care and Community Forum
Education Forum
Student Forum
Practice Nurse Steering Group
Allied Health Professional Forum
Healthcare Support Worker Forum
Strategic Advisory Council
Patient representatives will in future be reimbursed for their time and travel expenses, in line with
HEE policy. The cost to HENWL for this has been scoped and will be budgeted for in 2015/16 budget.
A Patient Forum workplan for 2015-16 will be developed to ensure strategic relevance and timely
support to the Board.
2.2. Building PPE into HENWL CEPN and CPD projects
The Community Education Provider Networks (CEPN) adopted in HENWL bring together health and
social care service providers, community groups and education providers to develop learning
communities. Patient and public engagement is seen as key to success, and project bids are
evaluated by HENWL against criteria which include clear PPE.
An evaluation of Phase 1 (2014/15) HENWL CEPNs was produced in October 2014 and is included at
Appendix A of this document.
The HENWL PPE strategy listed investments in CPD projects focusing on PPE made in 2013/14.
Examples of three of these projects with outcomes to date is included at Appendix B.
Next steps
Evaluation of Phase 2 (2014/15) CEPNs is underway and a final report is due at the end of March
2015. A full list of Phase 2 CEPN projects is included in Appendix A.
45
2.3. Strengthening patient voice in HENWL business cycle and BAU
Shaping a Healthier Future is a programme which applies a whole systems approach to service
delivery in order to improve health care for people who live in North West London. HENWL enables
SaHF to support staff and learners through related transitions with the aim of promoting staff
retention and proactively enhancing the quality of education provided. Examples include investing in
the development of mentors in primary care, supporting the development of urgent care teams and
the introduction of new roles including Physicians Assistants and Care Coordinators. A
representative of SaHF is a member of the Patient Forum to support connectivity between patient
engagement through SaHF and HENWL.
The HENWL Board regularly receives reports from the Patient Forum and Public Engagement
Committee in order that patient views on workforce planning and the commissioning of education
and training can inform Board decisions.
Next steps
Ensure feedback for forums and PPE initiatives are integrated into workforce and financial planning
cycles, including monitoring, output and evaluation processes.
Identify additional opportunities for PPE in the commissioning of specific programme initiatives
2.4. Working with partners
HENWL contributes funding to the CLAHRC and an agreed programme of work focuses on early
years, breathlessness and frailty. PPE is central to CLAHRC design and delivery of this programme.
Connectivity between HENWL and the CLAHRC is provided through membership on the HENWL
Patient Forum, Public Engagement Committee and Strategic Advisory Countil of the CLAHRC.
Our local AHSN, Imperial College Health Partners, (ICHP) also has representation on the PEC and
Patient Forum.
Both the CLAHRC and ICHP provide updates on their work, share learning and good practice on PPE
and help identify areas for future joint work.
Next steps
1. Reciprocal illumination conference summer 2015
A conference is currently being planned to support the future development of PPE in north west
London, hosted jointly by HENWL and Imperial College. Employing the concept of ‘reciprocal
illumination‘, it will focus on delivery of better, safer care. In the context of the Five Year
Forward View it will showcase PPE in the four domains of healthy communities, service redesign,
patients as educators, and patients and research. The aims are to network and catalyse useful
relationships between lay people and professionals involved in PPE in north west London and to
explore future learning, development and support needs.
2. Patients as educators
46
We are proposing a review of Higher Education Institutions (HEIs) from which HENWL
commissions education and training, to scope current patient involvement in design and delivery
of educational programmes, and to identify scope for further development. This has been put
forward as a suggestion to the HENWL Education Forum for discussion at their next meeting
(May 2015).
3. Governance
Review terms of reference and membership of PEC and the Patient Forum to ensure that they
align and are complementary.
3. Changing context
3.1. Five Year Forward View
The Five Year Forward View, published in October 2014, sets out a clear direction for the NHS over
the next five years. Recognising a likely future mismatch between resources and patient needs of
nearly £30 billion a year by 2020/21, the document builds on a growing consensus about the nature,
scale and direction of changes required to propose action on the three fronts of demand, efficiency
and funding as follows:
•
•
•
•
•
•
•
a new relationship with patients and communities to address urgent need for improvements
in prevention and public health
far greater control for patients of their own health and social care
development of new models of care through local co-design and reshaping of services across
organisational boundaries
development of a modern workforce with effective use of the information revolution
strengthening of the NHS’ ability to undertake research and apply innovation
improved efficiency delivered through wider system improvements
transformational change and annual efficiencies matched by staged funding increases as the
economy allows.
HENWL is already closely involved in many of the areas of work indicated in the Five Year Forward
View, in particular through the local service transformation programmes. HENWL plays the lead role
in development and delivery of the workforce required for such change through workforce planning
and the commissioning of education and training. Discussion is underway about the development of
new approaches to workforce planning to address prevention and public health needs. Local codesign is integral to the Shaping a Healthier Future (SaHF) programme and the Integrated Care
Pilots. The Collaboration for Leadership in Applied Health Research and Care (CLAHRC), the
Academic Health Science Network) AHSN and Community Champions (networks that bring together
local people and services to improve health and wellbeing and reduce inequalities) are in the
forefront of developing new approaches to health improvement and innovation in partnership with
local patients and communities. Strong PPE underpins all of the above, and HENWL has an excellent
platform from which to contribute to realisation of the Five Year Forward View in North West
London.
47
3.2. Beyond Transition
HENWL, as part of HEE, also faces significant challenges. The requirement that HEE delivers a 20%
saving on running costs has been addressed through the Beyond Transition programme. New
geographical groupings of LETBs are being implemented with reductions at LETB level in executive
and clinical capacity. HEE is also reviewing its advisory structures with the aim of improving its own
efficiency in delivering the scale of workforce transformation envisaged in the Five Year Forward
View and indeed HEE’s own 15 year plan.
The implementation of Beyond Transition is nearing completion. HENWL will need to continue to
evolve and adapt its own ways of working so it can fulfil its remit to deliver local service
transformation and the Five Year Forward View with reduced executive and clinical capacity and as
yet unclear national/regional/local interfaces.
4. Recommendations for 2015/16
i.
Optimise contribution of Patient Forum to HENWL business cycle and to support the Board
ii.
Expand Patient Forum membership
iii.
Embed PPE further into HENWL through patient representation on all forums
iv.
Deliver Reciprocal Illumination conference in partnership with Imperial College
v.
Continue to work with HEE on development of interface between patient voice at local and
national levels
vi.
Scope patient involvement in curriculum design and delivery of HEIs commissioned by
HENWL
vii.
Raise profile of HENWL Patient Forum through website and newsletters
viii.
Refresh current PPE strategy 2014-17
Authors:
Kathryn Jones, Deputy Director of Education and Quality, HENWL
Louise Saul, Project Officer, HENWL
Sally Malin, HENWL
48
Appendix A: approved CEPN projects Phase 1 Evaluation
Bid
Chelsea &
Westminster
Hospital NHS
Foundation
Trust
Central London
CCG
Bid name
Summary
Impact on patients
Theme: dignity
Link to patient experience: works to improve patient experience as they
approach their expected end of life (EOL). Improved care from a range of
healthcare professionals.
End of Life Care
To establish a community learning
network by implementing a multiprofessional, blended experiential
learning programme for bands 1-5
healthcare workers from a range
of acute, community and specialist
care providers to improve their
skills and confidence in caring for
people as they approach their
expected end of life (EOL).
Developing a Whole Community
Educational Network for
Preventing and Managing
Pressure Ulcers
To build a learning network and
educational package, that
incorporates evidenced,
standardized, auditable
documentation, for the prevention
and management of pressure
ulcers for use by all NHS partners,
patients, unpaid carers,
domiciliary care and nursing
homes. To identify the
arrangements to sustain the
currency of the network and
materials.
49
Evaluation of Impact on PPE: sensitivities of the end of life care context
have precluded patient and public involvement in feedback Data
collected from patient stories has featured in the briefing event. Data
collected from patients regarding their priorities for characteristics of
health care professionals featured in the Phase 2 briefing event to inform
learning on compassion in care. This allowed an indirect link between
patients views and the learners and demonstrated patient viewpoints as
a priority to learners
Theme: safety
Link to patient experience: reduced incidents and hospital admissions
Evaluation of Impact on PPE: linked up with Peer Exchange Network.
Members of peer exchange are now taking an increasing leadership role
in developing the network and disseminating the education as well as
identifying further educational needs
Bid
Bid name
The Brent and Harrow CEPN for
Harness Care CoNarrative multiprofessional
operative Ltd
education in care homes
Imperial College
Healthcare
Connecting Care for Children
Summary
To explore needs and educate
carers and the multi-disciplinary
workforce serving Brent and
Harrow Care Homes.
• Care homes are hubs for
narrative-based multi-disciplinary
action learning sets.
• Innovative learner pairings and
on-going supervision consolidate
learning and form interdisciplinary relationships.
• These inform larger,
multiprofessional, patientfocussed learning events.
To co-design, develop and deliver
an innovative model of peerlearning and education within
General Practice Child Health Hubs
in three North West London CCGs.
This will be achieved through the
facilitation of multi-professional
case-based learning sets and the
implementation of a training
programme for Practice
Champions across the three Hubs.
50
Impact on patients
Theme: coordinate my care
Link to patient experience: aims to better understand the health needs
of the elderly population of Brent and Harrow. Improved service from a
range of healthcare professionals.
Evaluation of Impact on PPE: Engaged with relatives groups at the
beginning of the process to explain the project and to understand the
challenges in care homes. Relatives ideas directly informed the learning
agenda
Theme: coordinate my care
Link to patient experience: improving service provision through better
management of patients for example by providing treatment in
appropriate settings and better education and support for patients from
champions.
Evaluation of Impact on PPE: Service users were consulted in the
development of the child health outreach hub. There is PPI involvement
in feedback: at the end of each clinic an evaluation form is given to the
patient and their family addressing areas including: waiting times,
expectations, involvement in discussion and decisions, if they
understood explanations, if they would recommend the clinic to others.
The evaluation demonstrated how patients and public had engaged with
the concept of practice champions and with the simulation as a way of
engendering patient and public engagement with the asthma pathway
and as a way of supporting genuine co-production. This means that
Patients and the local community are directly engaged in shaping their
health care service and are involved in setting the learning agenda, as
learners and as educators
Bid
Imperial College
Healthcare
Bid name
Summary
Dementia networks, training and
awareness of dementia care have
been driven by national audits, the
national strategy and the
dementia CQUIN, but training
remains inconsistent across NW
London. This proposal aims to
work with Alzheimer’s Cafes,
Dementia workers in acute,
mental health and community
settings to deliver consistent
training
Link to patient experience: Standardising and consolidating training for
Dementia care and also information and resources available to dementia
patients, in order to enhance quality of care, and raise awareness of
patients’ needs.
Bid name
Summary
Impact on patients
‘Every Second Counts’ End of
Life Care: Programme extension
and expansion (Extension from
phase 1)
To extend the scope of the original
project ‘I Can Make a Difference’
End of Life Care Programme by
improving the e-learning aspect of
the programme into a standalone
multi-platform application and
extend placement officer support
for the programme to enable 3
cohorts to be completed.
Dementia Care
Impact on patients
Theme: Dignity
Evaluation of Impact on PPE: This CEPN evaluation is not complete.
Phase 2 CEPN Projects
Bid
Central London
Community
Healthcare NHS
Trust (Chelsea &
Westminster are
Lead
Organisation)
51
Theme: dignity
Link to patient experience: works to improve patient experience as they
approach their expected end of life (EOL). Improved care from a range of
healthcare professionals
Bid
Bid name
Summary
Impact on patients
Developing a CEPN for the
Buckinghamshire prevention and management of
pressure ulcers (Extension from
New University
phase 1)
To disseminate evidenced based
educational materials, through our
learning network, on pressure
ulcer prevention enabling patients
and carers to recognise who is at
risk, when they are at risk and
their role in pressure ulcer
prevention, providing access for
patients and carers to co-created
design solutions to pressure relief.
Brent and Harrow Narrative
Education for Care homes
Harness Care Coproject: Leadership and Legacy
operative Ltd
for Inter professional Learning
(Extension from phase 1)
We will lead and support
education for the Community
Healthcare team serving older
people in care homes. Using our
GPTPD, GP, LAS, Social care and
Hospice relationships we will
engage and train 8 Multi
professional, Educator- Leaders to
deliver narrative groups,
educational events and foster
patient and carer engagement
within the care home sector.
52
Theme: safety
Link to patient experience: reduced incidents and hospital admissions
Theme: coordinate my care
Link to patient experience: aims to better understand the health needs
of the elderly population of Brent and Harrow. Improved service from a
range of healthcare professionals.
Bid
Imperial College
Healthcare
Bid name
Summary
Connecting Care for Children
(Extension from phase 1):
1. Develop social media tools to
enhance powerful relationships
between patients and healthcare
professionals.
1. Use of social media to
enhance patient experience and
quality of care
2. Creating links with CAMHS
services and Child Health GP
Hubs
3. Developing practice
champions for Child Health GP
Hubs
Impact on patients
2. Create a system to connect
professionals who are supporting
child mental health issues, using
the GP surgery as the hub
3. Enable patients from the GP
practice to become champions for
child health, providing peer to
peer knowledge and co-designing
child health services in the GP
practice
An Allied Health Professions
Buckinghamshire
Innovative Learning Network for
New University
Falls Management (ALIGN)
The AHEDC, in partnership with
identified organisations, would
develop a CEPN for Allied Health
Professionals to share learning,
models and good practice in falls
management. The education and
learning model includes the
development of an online learning
platform, action learning, a circle
of innovation and innovation
champions in falls care.
West Middlesex
University
Hospital NHS
Trust [WMUH]
Poor perinatal mental health
[PNMH] is a leading cause of
maternal morbidity and mortality
in London. Our CEPN will address
this educational deficit by
providing a PNMH package for
women and community & hospital
Perinatal Mental Health
Education CEPN
53
Theme: coordinate my care
Link to patient experience: improving service provision through better
management of patients for example by providing treatment in
appropriate settings and better education and support for patients from
champions.
Theme: safety
Link to patient experience: sharing best practice to support integrated
falls care, support the prevention of falls and those at risk of falls and
subsequently requiring reablement and rehabilitation to meet both their
physical and mental health needs.
Theme: coordinate my care, safety
Link to patient experience: establishment of an accessible, women
focused, multi-professional learning package to improve the PNMH of
women. Facilitating a more positive mother-infant relationship and
optimise the longer term development of the child.
Bid
Imperial College
Healthcare NHS
Trust
Bid name
Creating a culture of continuous
improvement: Improving
Discharge Processes through
Quality Improvement Training
Summary
based healthcare professionals
[HCP] facilitated by healthcare
experts and service users [of
maternity and mental health
services].
To deliver a multi-disciplinary,
cross agency training programme
to provide staff at all levels with
Quality Improvement skills to
create a culture of continual
improvement, focused on
improving discharge processes.
This will be achieved through
targeted class-room teaching,
broader Quality Improvement
‘sprint’ workshops and spread
through Quality Improvement
Champions.
54
Impact on patients
Minimise the risk of maternal mortality (women with serious mental
illness are over represented in those women who commit suicide).
Theme: Coordinate my care,
Link to patient experience: improved patient experience as a result of
improved staff engagement and improved discharge processes.
Appendix B – CPD Projects progress to date
1. Imperial College Healthcare NHS Trust - Training cancer multi-disciplinary teams in
comprehensive geriatric assessment and management of geriatic conditions (and evaluation
of the elderly)
The Comprehensive Onco-Geriatric Service (COGS) has a growing presence in Imperial College
Healthcare NHS Trust. From inception six months ago, the service is now embedded within the
upper gastrointestinal (UGI) and lower gastrointestinal (LGI) multi-disciplinary (MDT) Cancer Teams,
and engaged with surgical teams from other specialities as the service gains recognition and
popularity throughout the Trust.
The UGI and LGI MDT teams have medical and onco-geriatrician representation at all MDT meetings
and a direct referral process for older or frail patients. 80 patients have been seen in a dedicated
COGS clinic and comprehensively assessed of functional reserve and frailty, cognitive and mental
capacity, social issues and forward planning. From the 80 patients seen to date, 78% were diagnosed
with cognitive impairment which may have gone undiagnosed without COGS.
Outpatient feedback forms show patients’ view of the clinic as:
•
•
•
•
•
•
Given enough information – 100%
Opportunity to ask questions – 100%
Worries taken on board – 100%
Now better prepared for surgery – 93%
Overall satisfied with appointment – 100%
Would you recommend this service to friends and family – 100%
Appointment summaries have provided detailed personalised peri-operative plans and guidelines for
optimisation of comorbidity.
Post-operatively, the COGS team have been on wards available for early response to medical
complications, providing education and training to junior doctors, liaising with therapists to oversee
rehab and peri-operative plan compliance, and advising on discharge planning. An inpatient surgical
liaison staff survey has shown substantial improvement in staff confidence in understanding the
discharge process, identifying social and occupational needs and the ability to get senior review, as a
result of COGS.
I understand the discharge process
Social and occupational needs…
Problems with mobility are…
Clear which team to contact
Easy to get senior review
Provides good medical management
Provides good surgical management
Current model of care meets all…
0
After %
Before %
20
40
55
60
80
100
Qualitative and quantifiable data on patient experience and quality of life will be viewed alongside
surgical outcome results to determine patient’s perception of COGS’, all of which is currently in the
collection phase.
2. Multi-disciplinary Communication Programme to improve Patient, Carers and Staff
experience at Imperial College Healthcare NHS Trust
The Macmillan 2013 Cancer Patient Experience survey highlighted that despite excellent clinical
outcomes the patient experience at Imperial College Healthcare NHS Trust needed to be improved.
The project funding was intended to deliver a suite of training packages to staff who assess cancer
patients, recognising that the patient pathways bring the patients into contact with a range of multidisciplinary staff across the organisation. The packages included:
1) Sage and Thyme – foundation level
2) Level 2 psychological support training “Breaking Bad News”
3) Advanced Communication Skills Training
The ultimate aim of the project was to improve patient experience for our Cancer patients. The Trust
uses the Macmillan values based survey as a marker of progress in a variety of areas. In our cancer
areas the response to “Did you find someone on the hospital staff to talk to about your worries and
fears?” went up by an average of 8.21% between September 2013 and August 2014. On wards
where over 60% of staff had received communications training in the year the response was up by
12.86%.
Our quarterly staff engagement survey shows that the training is having an impact on the staff
experience. In response to the statement “I have access to the learning and development I need to
do my current job well”, those staff working in the Surgery & Cancer division reported a 6% positive
increase in the last year.
3. Compassion in Care.
As part of Campaign One of the Central London Community Health Care(CLCH) Trust’s Quality
Strategy and in response to the Chief Nurse report ‘Compassion in Practice, Nursing, Midwifery and
Care Staff, Our Vision and Strategy’ (Cummings and Bennett, 2012), work is being taken forward
across the Trust to promote compassionate care. The Compassion in Care project was launched
across four pilot sites on 4th October 2013 and is led by Professor Hilary Shanahan (Compassion in
Care Co-ordinator) in collaboration with Professor Julienne Meyer at City University. The project
builds on lessons learnt from previous work undertaken by City University on dignity in care in acute
hospitals (www.city.ac.uk/dignityincare), best practice for older people guidance in hospital
(www.city.ac.uk/bpop) and promoting quality of life in care homes (www.myhomelife.org.uk) and
the compassionate care work of Dewar in Scotland. The Compassion in Care project aims to
promote compassionate care through appreciative, evidence-based and relationship-centred care
that focusses on making a difference to the lived experience of service users and carers (both paid
and unpaid). The Project Lead is working directly with frontline staff, in a range of different clinical
contexts, to support change projects, with a focus on the 6Cs (care, compassion, competence,
communication, courage and commitment) in line with the NHS England Compassion in Practice
vision and strategy (http://www.6cs.england.nhs.uk/pg/dashboard).
56
A Compassion in Care model has been developed with bespoke values based outcome measures
which is being implemented in pilot areas through a training programme which has defined
Compassion in Care competencies for programme participants. Each of the Compassion in Care
Champions has identified their own evaluation methods specific to the aims and objectives of their
individual projects. These have included feedback from staff, patients, relatives and carers through
audits, questionnaires, pre and post observations, direct feedback, specific outcome measurement
tools (Palliative Care Outcome Score, The Challenging Behaviour Scale, The Cornell Scale for
Depression, The Quality of Interaction Schedule, sleep charts, staff sickness levels and staff/patient
diaries). The outcomes are being measured at various stages of the projects and have already
demonstrated: positive improved feedback from staff, patients’ relatives and carers.
57
Health Education North West London
Board Paper Coversheet
Paper J
(Coversheet)
Meeting Date
15th April 2015
Paper Title
Approved PEC Minutes: 12th November 2014
Paper Number
J
Paper Author
Lyndsey Carpenter, Project Support Officer
Author Contact
[email protected]
Lead
Sally Mallin, PEC Chair
FOI Status
Available on request
Paper Summary
Minutes from November 2014 PEC meeting, approved by PEC
members at March 2015 PEC meeting
Date paper completed
17th March 2015
Purpose
For information
Recommendation
To review and approved as an accurate record
Where was the Paper
previously discussed
17th March 2015
What was the
outcome
Paper was approved
Strategic Objective
Links / EOF Links
N/A
Identified risks and
risk management
actions
N/A
Resource
implications
Business as usual
Support to NHS
Constitution
The NHS is accountable to the public, communities and patients that
it serves.
Legal implications
including equality and
diversity assessment
N/A
HE NWL
Board
15 April 15
58
Minute of HE NWL Public Engagement Committee (PEC) Meeting
12th November 2014, 2pm to 4pm
HE NWL Meeting Room 1, Stewart House, Russell Square
Present:
•
•
•
•
•
•
Sally Malin, Independent Board Member – Public Engagement and Chair Public Engagement
Committee (PEC) (SM)
Marcia Saunders, Chair, HE NWL (MSa)
Andrew Howe, Director of Public Health, London Boroughs of Harrow and Barnet
Kathryn Jones, Deputy DEQ, HE NWL (KJ)
Amy Darlington, Director of Communications & Engagement, Imperial College Health Partners
(AD)
Miriam Samuels, Medical Education Fellow, HE NWL (MSam) – in attendance
Apologies:
•
•
•
•
•
Nina Singh, HR Director, West Middlesex University Hospital NHS Trust (NS)
Shane DeGaris, CEO, Hillingdon Hospital (SDG)
Therese Davis, Deputy Director HE NWL (TD)
Rachel Matthews, Programme Lead for Patient and Public Involvement, CLAHRC (RM)
Louise Adams, Project Officer (LA)
1.
Item
Declarations of Interest
None declared.
Action
2.
Minutes of PEC Meeting 11 September 2014
Approved.
3.
Matters arising and action tracker
The action tracker was reviewed and updated as follows:
14/12: Still open
ACTION: MSa to speak to Clare Etherington
14/17: To be covered under SM’s report under agenda item 4
ACTION: Closed
4.
PPE Strategy Beyond Transition and PPE in HENWL - for approval
SM gave a verbal update on the HEE Patient Advisory Forum meetings she
attended as a PAF member on 24 September and 5 November.
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MSa
Paper C was then discussed. SM reported that Shane De Garis had emailed
his view that the paper had merit but required considerable strengthening.
PEC agreed the paper’s approach but suggested it be redrafted for
circulation and further comment to include:
•
•
•
•
•
•
•
HENWL PPE values and vision
HENWL ‘PPE model adopted (patient, taxpayer, citizen)
HENWL PPE strategy and progress to date
Opportunities to develop closer PPE relationships with partner
organisations in support of Five Year Forward View and HENWL
Strategy
Additional lay partner capacity required to embed PPE across all
HENWL for a
Recruitment options for additional lay partners
Options to share good and emergent PPE practice locally, regionally
and nationally
Action: Rewrite the paper and circulate to PEC members for further comment
- SM
Action: HENWL to support SM in her national role on HEE PAF – Msa, TD,
KJ
Action: Consider recruitment options for more lay people to join HENWL
forums and the CEPN/CPPD strategies – SM/KJ
5.
SM
ALL
ALL
Report from Patient Forum 23 October 14
Noted.
PEC suggested that opportunities to build on the PF discussion of the future
public health workforce be explored through the Community Champions
network. ACTION - KJ
It was agreed that KJ should meet the social care lead for Harrow and Barnet
Local Authority to discuss social care workforce planning and how the system
can work together with healthcare going forward. – ACTION - KJ
PEC commented that the minutes from the last Patient Forum (PF) do not
clearly identify PF members comments. PEC suggested that the template
used for the PF should be reviewed and amended to a more user friendly
version, which allows members comments to be readily located and HENWL
response to same to be documented better – ACTION - LA.
PEC also suggested development of a recruitment and succession plan for
PF to ensure there is adequate lay representation on the group and to attend
other HENWL fora . – ACTION – SM/KJ
KJ
KJ
LA
SM/KJ
2|Page
60
6.
CEPN First Year report – to note
The report was well received with the following comments noted:
• Future CEPN annual reports should include impact evidence where
available
• With regard to the End of Life CPEN: further consideration should be
given as to options to source patient and carer views on end of life
care eg staff comments on issues raised by patients; potential for
approach to families’ at an appropriate stage, for example some
months after a bereavement
• An informal meeting for lay people who had been involved in Phase 1
CEPNs to share experiences of their involvement and identify PPE
learning, was proposed, possibly over a lunch
Action: SM/KJ to share above comments with Jeremy Levy and discuss
feasibility of implementation
7.
SM/KJ
Imperial College Health Partners update: Public and patient participation
framework
Imperial College Health Partners has created an e-learning toolkit. This
covers all stages from creating a roadmap involving patients to different
methods for recruiting patients to healthcare forums and projects. It is aimed
at all organisations who are looking for meaningful patient engagement on
groups.
PEC welcomed the toolkit as a valuable resource.
AD is interested in seeing if HENWL and Imperial College Health Partners
can further work together.
Action: KJ and AD to meet and review their organisations’ potential areas of
work to see if collaboration can reduce duplication and add value.
8.
KJ/AD
Patients as educators - discussion
PEC noted ‘Can Patients be teachers? Involving patients and service users in
healthcare professionals’ education’ , Health Foundation (2011).
PEC discussed the potential for a HENWL project to canvas extent to which
HEIs from which education and training is commissioned currently involve
patients and service users as teachers in healthcare professionals’ education.
It was agreed in the first instance that information already collected by
HENWL be reviewed for its coverage of same. ACTION - KJ
KJ
It was also agreed that the merits and potential design of such a project be
discussed with David Sines and with Jenny Higham. ACTION - SM
SM
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9.
AOB
PEC meeting dates for 2015 had been circulated and were noted.
Next PEC meeting: 17th March 2015, 9.30am – 11.30am, Holden Room, Senate House
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Health Education North West London
Board Paper Coversheet
Paper K
(Coversheet)
Meeting Date
15th April 2015
Paper Title
Minutes of the IAC 27th January 2015
Paper Number
K
Paper Author
Cheryl Crespo, Governance Officer
Author Contact
[email protected]
Lead
Shelley Heard – IAC Chair
FOI Status
Available via HE NWL website
Paper Summary
The paper sets out the minutes of the IAC meeting held on the 27th
of January. These minutes were approved as a complete and
accurate record.
Date paper completed
26th March 2015
Purpose
Item to receive
Recommendation
For information
Where was the Paper
previously discussed
The minutes were reviewed by IAC on the 26th of March
What was the
outcome
Approved minutes
Strategic Objective
Links / EOF Links
This paper delivers against Corporate Objective 1: “to ensure the
Board owns the delivery of the HEE accountability agreement,
oversees the delivery of the HEE Mandate and supports HEE
work plans”
Identified risks and
risk management
actions
Risks as noted in the risk report and risk register
Resource
implications
Business as usual
Support to NHS
Constitution
This paper supports the NHS commitment to being accountable to
the public, communities and patients through openness and
transparency
Compliance with Information Governance
Legal implications
including equality and
diversity assessment
HE NWL
Board
15 April ‘15
63
Minutes of the HE NWL Integrated Assurance Committee (IAC) Meeting
Tuesday, 27th January 2015, 09:00 – 11:00
Room G21A, Ground Floor, Senate House, Malet Street, London, WC1E 7HU
Present:
Shelley Heard, IAC Chair (SH)
Sally Malin, Independent Member – Public & Patient Engagement (SM)
Julia Whiteman, Postgraduate Dean (JW)
Clare Parker, Finance Director Member (CP)
In attendance:
Lizzie Smith, Director of Workforce & Development (LS)
Kathryn Jones, Deputy Director of Education and Quality (KJ)
Jane Pauley, Deputy Head of Finance (JP)
Christian Oribio, Board Secretary and Programme Manager (CO)
Cheryl Crespo, Governance Support Officer (CC) Minutes
Richard Griffin, Director of the Institute of Vocational Learning and
Workforce Research, Bucks New University (RG) for item 6 only
Apologies:
Marcia Saunders, HE NWL Chair (MS)
Claire Murdoch, Community / Mental Health Trust CEO Member (CM)
Therese Davis, Deputy Managing Director (TD)
Jeremy Levy, Clinical Lead (JL)
Item
1.
Action
Welcome and Introductions
SH opened the meeting and welcomed all attendees.
2.
Apologies
Apologies were noted as above.
SH noted that JL would now be attending on an exceptional basis due to his
new working arrangements.
3.
Review of minutes of the HE NWL IAC meetings held on 21st of
November 2014
The minutes of the meeting held on 21st of November were agreed as a
complete and an accurate record. There were no matters arising not
already on the agenda.
4.
Workforce and Education Planning and Development of Investment Plan
o
Pre-registration Commission Allocation
KJ presented a report outlining the allocation commissions for 2015/16 and
drew attention to the potential risk on placement capacity.
64
The paper indicated the process of how the commission numbers were
decided and reported that the following commissions had not been included:
clinical scientists, rehabilitation engineers, audiology on community, specialist
practitioners and 2nd Registration as most of these take part later on the
commissioning cycle or are led by other LETBs.
KJ reported that a placement capacity review for the area would be taking
place from February, with the objective of identifying any areas where
placements could be increased on the basis of the numbers of staff available
per provider and correlating number of students that would be needed.
Discussion focused on:
o
o
o
o
Capacity concerns for the Child Nursing and Midwifery programmes
as the learners tend to train outside of the NWL region and this was
seen to have a diminishing effect on the likelihood that the students
would work in NWL after finishing their studies. It was therefore
necessary to identify a base for these students within NWL, although
they would be expected rotate in and out of the NWL area to ensure
an enriched experience
Scope of the review was being managed by the Executive team at
HENWL through their weekly Delivery Meetings and a project
proposal had been drafted
The team acknowledged that some providers may need support to be
able to enhance placement capacity, e.g., supervisory capability.
Several meetings have taken place with the various Trusts to scope
out some of the barriers.
Physician Associates (PAs)
LS explained that St George’s University had been the only education
provider in London for Physician Associates to date but new providers are
now coming forward with plans to run courses from September 2016. In NWL
both Brunel and BNU have indicated an intention to launch programmes.
HENWL has been supporting two projects in relation to PAs:
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-
a review on the infrastructure and the future workforce demand in
England, led by HEE with input from Liz Hughes, Director of Education
and Quality for London and South East
Dr Nick Jenkins’ programme led by Hillingdon Hospital to bring in
experienced Physician Associates from the US to support employers
in getting the roles established while training takes place to foster a
new generation of home-produced PAs. The number depends on the
level of demand for posts expressed by employers
LS reported that Physician Associates in HENWL were necessary to reduce
the undisputed gap in the workforce and the challenges of patient ‘face-time’,
particularly in Emergency medicine and Primary Care professions. HENWL
aims to create a small supply of PAs for London and although there are
reservations on what the role can deliver, the programme is supported by
NWL stakeholders as it was recognised as a key element to help alleviate
65
some of the pressures on the workforce on those areas.
The discussion focused on:
o
o
o
The risk of undermining the work being done to develop nursing roles
The associated costs with bringing international staff over to England
Whether this could be regarded as a “quick fix” solution to the
problems with the medical workforce. There was a clear
understanding that the approach was a small part of a number of
initiatives that have been taking place to control the challenges
identified with the workforce in Emergency Medicine. Other initiatives
include: direct recruitment, establishing a clear career structure and
creating new attractive education and training programmes.
o
Mental Health Nursing Tender
LS presented a comprehensive paper on the process for procuring Mental
Health Nursing Education and Training.
LS explained that outcome letters had been sent to the named three
successful providers: The University of West London, Buckinghamshire New
University and King’s College London. Discussions with the education
providers had taken place to establish their placement settings, mobilisations
plans and to test their proposals with the expectation that contracts would be
signed at the end of January 2015 for service to commence in September
2015. As a result of these discussions it was determined that in take capacity
did not pose a serious risk.
o
Shaping a Healthier Future
LS provided an oral update on the latest development of the Shaping a
Healthier Future (SaHF) programme. HENWL had continued to work closely
with the programme team to provide some assurance to NHS England on
how the proposed changes to maternity services at Ealing Hospital were
being managed and a letter of support had been drafted outlining how
HENWL will ensure that there is no negative impact on learners as a result of
the changes being proposed.
LS confirmed that all learners affected, both medical and non-medical, had
been kept informed of the changes despite of the challenges due to the
staggered timeline of implementation as a result of delays on decision
making.
HENWL had been reviewing the implications of maintaining full paediatric
services at Ealing and had been working with programme partners to create
new roles and rotations to provide a stable service regardless of increased
activities by sharing across the various providers in the NWL area. Feedback
on the proposals had been very positive.
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5.
Finance Report, 2014/15 Year-end Financial Position and year-to-date
Financial Position
2014/15 Month 9 Financial Position
JP reported that there continued to be an underspend on running costs which
was £172k in Month 9 and non-running costs on programme spending is
expected to break even although there were some variances.
The underspend on running costs was attributable to staff vacancies in
hosted services and the recruitment controls and processes.
JP highlighted the following key issues:
o
It has proven problematic for finance to get the forecast right, and the
forecast has been under constant review.
o
A change on forecast data for non-medical commissions has recently
identified a significant additional unplanned underspend across the
London LETBs. The issues were identified at the end of November
and it had been proposed to add the funding into the Quarter 4 LDA
distribution to ensure that the funds were allocated for direct education
support. JL confirmed that the HENWL Executive and MS had been
kept informed of the issue.
Some of the planned underspend was being proposed to be spent in
SaHF activity and plans were being drawn up to invest on a range of
projects within the programme.
Budget setting 2015/16
Budgets for 2015/16 are being based on the Investment Plan submission and
the Beyond Transition staffing structures as recently agreed by HEE. There
are plans to provide a draft position of the budgets in February and for this to
be presented on the April Board.
The draft Education and Training tariff guidance for 2015/16 had been
published and the main changed proposed was a 1.9% reduction in the tariff
for Undergraduate Medical. The proposed reduction had been communicated
to providers and it was expected to result on a significant pressure on
Undergraduate Medical placement providers.
Discussion focused on:
o
Recruitment on undergraduate medical students had been seen to go
down in numbers due to penalties for over recruitment above the set
cap per medical school
o
The cuts on the funding for Undergraduate medical schools were
perceived as an issue that would need to be monitored and reviewed
with the Investment Plan
o
Early indications are that the London LETBs could be facing deficits in
their five year plans if investment continued as predicted and the need
to accept the risks of the impact of current commissioning decisions
o
It was noted that there had been a major issue arising out of
67
forecasting issues across London. These could have been potentially
avoided but were attributed to the number of vacancies on the finance
department.
It was agreed that a full report on the issues with forecasting, lessons learned
and results would be prepared for the next IAC meeting on March 2015.
The Committee received month 9 financial position and noted the key
financial risks as identified in the paper.
6.
Risks Register and Risk Review
JP drew attention to key risks as articulated in Paper C and recorded on the
risk register and highlighted the following:
o
o
o
o
A key risk relates to the Commissioning of the Psychological Service
for Doctors and Dentists. The current contract is subject to reprocurement. There is a risk associated with the care of clients during
the transition and also a risk of delays on the procurement exercise
and implementation of the new service.
Two new risks relating to the delay on the decision making on service
changes as part of the SaHF programme and a technical risk on the
support of the eWisdom contract.
Seven risks were proposed for closure as outlined on the paper.
There is risk on the allocation of LETB budgets for 2016-onwards
which are subject to review in HEE. London LETBs’ budgets could be
reduced.
JP reported that upon the full implementation of Beyond Transition structures,
risk reporting was expected to be reviewed and changed across HEE.
JW reported a new risk for Information Services on the problems on the Oriel
system. The issue had been highlighted to HEE and a new risk would be
included on the register.
The Committee received the risk report and approved closure of all seven
risks proposed for closure.
7.
Apprenticeship Programme Report
KJ presented this paper with RG on the NWL progress on the implementation
of the government initiative on increasing the number of Apprentices.
HEE agreed targets had proven challenging as the intention was to supply a
provision of apprentices at 4% of the workforce for 2015/16.
The primary objective of the HENWL programme was to provide sustainable
growth by providing the infrastructure around it and therefore a 2 year plan
had been developed to support sustainability.
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CO
The apprenticeship strategy for NWL is focusing on re-engaging with
employers who had previously employed apprentices in the past and to seek
out new opportunities by developing other areas such as: pharmacies,
facilities, decontamination, social care roles and general practice. Any
concerns with some employers had been addressed and the team appeared
to be confident that the target would be met.
The discussion focused on:
o
The possibility of increasing the number of band 4 higher apprentices
at foundation level and the demand for these is being reviewed
o
The connection between apprenticeships and the bands 1-4 workforce
initiatives and to the rest of the system. HENWL had been providing
on-going support to employers to facilitate the implementation of the
Care Certificate as a link for the various programmes.
The Committee received the report.
8.
Annual Revalidation Return (ARR)
JW presented an update report on progress with the delivering of the medical
revalidation action plan.
JW thanked IAC for requesting the ARR reports as this had shown that
revalidation should be at the centre of the agenda in terms of good
governance for the LETB.
The report included progress made against each deliverable for the panLondon ARR. All workstreams are being monitored through the live system
and biweekly meetings and deliverables were reported to be progressing on
target.
The discussion focused on:
o
Identifying quality concerns based on trends of serious incidents.
However, the numbers on serious incidents are probably too low to be
able to recognise patterns from them.
o
There are concerns relating to reporting disparities between providers
and the levels of inconsistency of what is being reported to the system
o
A reassurance that the majority of the concerns raised through the
system are known issues that have been recognised through quality
visits.
The IAC received the report and requested that this continues to be reported
to IAC on a quarterly basis.
9.
London Ambulance Service Report
LS provided an oral report on the latest developments of the London
Ambulance Service.
LS confirmed that Ann Radmore is no longer Chief Executive of LAS and has
moved to NHS England and that there was an interim cover arrangement
(Fiona Moore, existing LAS Medical Director).
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JW / CO
The workforce shortage remains critical and one of the key ideas used to
address the problem would be to double the intake of Paramedic students in
September to circa 600 in year 2015/16 in order to meet forecasted demand.
HENWL has been working with its network around LAS and four Universities:
Greenwich University, St George’s University, The University of Hertfordshire
and Anglia Ruskin University to facilitate the significant increase of student
Paramedics.
The main issue for London is that paramedic degrees are HEFCE funded at
the moment rather than NHS commissioned and therefore less attractive than
in other parts of the country where tuition fees and bursaries are paid for.
There is also there inconsistency on pay across the country. In addition there
are issues relating to leadership, retention and demand pressures.
A summit meeting had been scheduled for the 2nd of February to report on the
various initiatives that HENWL is proposing on behalf of the 3 London LETBs
to intervene and to continue to support LAS.
The Committee received the report.
10.
LETB Director’s report
JW provided an oral report on behalf of TD on key LETB developments.
Therese Davis, interim LETB Director for HENWL had been appointed as the
LETB Director for HENCEL. TD is due to in post on 1st April 2015. During
February and March she would be covering both LETBs as a transition into
the new role and a rota has been established for senior executive members to
provide cover for the LETB Director, which all agreed was working well.
HEE Board met on the 27th of January to review the outcomes of the
consultation. As part of the Beyond Transition Phase 2, the role of the Post
Graduate Dean was being reviewed but the job description had not yet
finalised, although it was clear that the role would become multi-professional.
The Postgraduate Dean at HENWL had received very positive feedback from
the GMC on the quality of the annual report and the number of issues that
had been closed this year. The GMC had also highlighted HENWL’s CEPN
work in integrated care as best practice.
A Board Development session is due to take place on the 4th of March and it
will focus on Primary Care.
11.
Public Engagement Committee (PEC) Report
SM reported on key items of the paper.
The PEC meeting in November undertook an annual stocktake and reaffirmed
its purpose as an Advisory and patient support Committee and is now
considering ways in which to become more effective in future.
The report suggested some principles to guide the work of the Committee
going forward and the Committee would be seeking assurance at the next
Board meeting that the principles were appropriate.
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There was recognition that there was a need to grow the patient forum and
this would be done in line with the HEE remuneration guidelines. HENWL had
identified a small budget to support this.
Jenny Higham and SM had been on discussion on the possibility of setting a
conference called ‘Under the Badge’ or ‘Reciprocal Illumination’ with the main
purpose of assessing if there is a market for setting up a Postgraduate
multidisciplinary module on PPE. The conference was expected to take place
in May and the media would be invited.
12.
Joint Planning and Assurance Committee
The next JPAC meeting was due to take place on the 2nd of February and SH
would be attending on behalf of MS. The main topic of discussion would
evolve around Community Education Provider Networks for each of the
LETBs within the geography.
13.
Other Business
There was no other business.
Next meeting: 26th March 2015, 09:00 – 11:00, Room 24, 2nd floor Events Centre, Stewart House,
Russell Square (venue to be confirmed)
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