Sally Cheshire (SC) Laura Roberts (LR) Kirstie Baxter (KB)

Minutes of the North West LETB Board meeting held on 29 August 2014
Chair:
Sally Cheshire (SC)
Present:
Laura Roberts (LR)
Kirstie Baxter (KB)
Mike Burgess (MB)
Jenny Cavalot (JC)
Sheena Cumiskey (SCu)
Wendy Fairfield (WF)
Jacky Hayden (JH)
Andy Maddox (AM)
Calum Pallister (CP)
Vince Ramprogus (VR)
Sue Reed (SR)
Anne-Marie Stretch (AMS)
Robin Talbot (RT)
Heather Tierney-Moore (HTM)
Jonathan Wood (JW)
Kathy Thomson (KT) – by teleconference
In Attendance:
Vic Wellings (VW)
Marie Rhodes (MR)
Apologies:
Jackie Bird
Ged Byrne
Kim Doherty
Andrew Foster
Nicky Ingham
Henry Ticehurst
1. Welcome and introductions.
SC welcomed the attendees to the meeting and introductions were made. SC
apologised that the last Board meeting, which had been scheduled for 27 June 2014,
had been cancelled due to the number of members who had been unavailable on
that day.
SC welcomed Vince Ramprogus to the meeting, and explained that VR had formally
taken Ged Byrne’s place on the Board as the designated HEI representative
following Ged’s appointment as the DEQ for HENW.
3. Declarations of Interest Register
HTM confirmed that she had been appointed as a Commissioner for the NHS
Confederation in a trustee role.
SC asked that if any declarations of interest arose in the future, the members should
inform Vic Wellings.
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4a) Minutes of the previous meeting
Kathy Thomson noted that she had been at the Board meeting on 4 April 2014, but
the minutes recorded incorrectly that she had sent her apologies.
The minutes were otherwise agreed as a true record.
4b) Previous actions
Aspire View: SC confirmed that this would be covered under the Managing Director’s
Update later in the meeting.
Shape of Training report: SC noted that JH would be presenting on this subject later in
the meeting.
QSGs: SC reported that a session on QSGs would be presented at the LETB Board
meeting in October 2014.
5. Updates from the LWEGs
 Cheshire
&
Mersey
–
8
July
2014
KT gave an overview of the membership review that had taken place recently, as
several new members had been appointed and other members had changed roles. The
remaining changes needed were to finalise the commissioning and primary care roles
within the LWEG and to look at patient involvement.
KT also reported that progress had been made on identifying use for the C&M
Forerunner Fund monies. AMS expanded on this, and explained that the C&M LWEG
had commissioned a Strategic Workforce Review for the whole of Cheshire &
Merseyside and that a Project Director had been appointed to scope this project
identifying the current workforce and key challenges for the future. AMS explained that
the work would complement the HENW Workforce Transformation programme.
 Greater
Manchester
–
11
July
2014
In Andrew Foster’s absence KB reported back from the latest Greater Manchester
LWEG meeting. She explained that a detailed discussion regarding the Forerunner
Fund bids had taken place. Bids had been capped at £75k, and many of the bids
submitted had been approved. Neil McLauchlan had been confirming the bids with the
providers.
 Cumbria and Lancashire
HTM reported that the C&L LWEG meeting scheduled for July 2014 had been cancelled
due to the number of members who were unavailable. HTM stated that members would
be surveyed to understand the reasons for lack of attendance to enable the LWEG to
maximise its effectiveness and engagement with stakeholders going forward.
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HTM confirmed that key issues for the C&L LWEG were:



The Forerunner Fund and how it fits with the Transformation Fund
Healthier Lancashire
Workforce implications in the acute sector, for example the development of the
out of hospital workforce.
6. Managing Director Update
LR presented the Managing Director Update paper, and asked members to share this
with their stakeholders.
i) Nursing and Midwifery Workforce Programme – Return to practice
LR highlighted that HEWM were leading on a national HEE Return to Practice campaign
which would be launched in September.
WF asked whether shortages in primary care would be targeted and KB confirmed that
this was an important area for the campaign. Practice nurses and those nursing staff
converting from primary to secondary care would be covered, and this would be
advertised on HENW’s website.
WF suggested that any communication relating to return to practice should include the
confederations, who are likely potential employers. LR agreed, stressing that it was
important to consider small businesses as well as NHS trusts.
Action: KB to produce a full list of confederations.
SR asked whether a clause would be included in the contracts stating that if staff
members were not in employment after six months then they should return their
bursaries. JC confirmed there was no plan to include a clause of this kind, but that
HENW needed to look at the reasons why nurses were dropping out after six months.
SR highlighted that it was important to handle staff expectations, and to match individual
needs to each situation. LR agreed, and added that NHS trusts needed to look at ways
to retain staff.
VR suggested that it may be useful to carry out a joint recruitment drive with the
universities. LR explained that there is currently a large campaign being carried out to
recruit as many people as possible.
LR explained that she had not yet seen details of the geographical split of the 23,000
lapsed nurses who are potentially available to return to work, and so did not know how
many were in the North West.
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Nursing and Midwifery Workforce Programme – pre degree year of care
LR stated that Cohort 3 was due to start later in 2014 or early in 2015, and that
information regarding the bidding criteria and funding of places had been sent out
recently to Directors of Nursing. The Board agreed that it would be useful for HENW to
also send the criteria to Chief Executives and Directors of Human Resources.
Action: JC to send information regarding the bidding criteria and funding of
places for Cohort 3 of the Pre degree Year of Care to all Trust Chief Executives
and Directors of Human Resources.
ii) AspireView
LR confirmed that AspireView, HEE’s new reporting system, had been launched. The
first tranche of information related to key measurements including those for dementia
awareness, finance and staff attendance.
iii) Widening Participation Strategy
LR reported that a draft of the national HEE Widening Participation Strategy document
was now available on HENW’s website for comments - it covers the NHS, Local
Authorities and the public sector. SC explained that the strategy had already reached
ministerial level and expressed thanks to Mike Farrell for all the work that he had carried
out on this initiative.
iv) Care Certificate
LR confirmed that here had been a good deal of interest from local organisations who
wished to pilot the Care Certificate. SR welcomed the Care Certificate in principle, but
felt that it had less focus on patients and compassion in care. SR also highlighted that
there was no process of validation. JC explained that she was involved in discussions
with Dr Lisa Bayliss-Pratt (Director of Nursing – HEE) regarding the Care Certificate and
the Year of Care programme, and JC would welcome a discussion with SR on the
related work that she was carrying out.
v) Stakeholder Forum
LR encouraged members to attend the Stakeholder forum scheduled for 3 September
2014. The focus for the event was to be Education Commissioning.
vi) Beyond Transition
LR presented the final outcome paper relating to Beyond Transition, and confirmed that
all affected staff had been consulted with. Interviews were due to start during the week
beginning 1 September 2014.
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vii) Urgent and Emergency Care
LR confirmed that Urgent and Emergency Care would be discussed at the LWEG
meetings in September and October 2014, and would be a substantive agenda item at
the Board meeting in October 2014. The Board members were asked whether the views
expressed in Suzanne Hughes’s paper reflected the members’ own views and
professional experiences.
Several of the members explained that they had met with Suzanne Hughes and that the
general consensus was that the paper reflected their views. SCu felt that it would be
useful to see more information on the wider system, and to know what the system
should look like in the future.
JH emphasised that there was a strong need for middle grade doctors, as the numbers
of junior doctors were not producing sufficient middle grades. HENW would need to
consider whether to divert some of its own resources towards this area, or whether NHS
trusts’ own resources should be used. JH gave the example of audiological medicine,
and felt that if trusts did not need consultants in audiology then they should not be
trained.
SC explained that when the Strategic Health Authority was in existence, Aidan Kehoe
had produced a comprehensive report on urgent and emergency care in the North West,
and it would be useful if Suzanne Hughes saw this, to give a clear picture of the
situation two to three years ago. LR believed that Suzanne had a copy of this report, as
well as the work produced by Matthew Cooke (former National NHS Lead for
Emergency Medicine).
SC stated that it was the role of HEE and HENW to consider what the future urgent and
emergency medicine workforce should look like, and asked the Board members if they
felt there was anything that HENW could do to improve the current situation.
SCu felt that it was not for HEE to define what the system should be, but that it was
important to consider how to meet the needs of the population in different ways and to
keep staff morale as high as possible.
JW said that he had comments to make on this topic, and would give them direct to
Suzanne Hughes.
Action: JW to contact Suzanne Hughes to discuss Urgent and Emergency Care.
Action: VW to add Urgent and Emergency Care as a substantive item to the
agenda for the Board meeting scheduled for 31 October 2014.
viii) Tender for the Lead Employer Contract in Greater Manchester and Cumbria
and Lancashire
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LR confirmed that the tender for the Lead Employer Contract (for doctors in training) had
been published on HENW’s website with a request for feedback to be submitted. The
tender will then be issued nationally.
ix) Workplace agreement
LR confirmed that in relation to the workplace agreement, Manchester Medical School
had decided that it was important for them to be explicit with providers of undergraduate
medical student placements about the requirements placed on them. They also needed
to ensure that appropriate support mechanisms were in place, and if they were not, then
they would need to make provision elsewhere. JW added that the challenge for Trusts
was to ensure that they were meeting their obligations and providing the best training
possible.
7. Forerunner Funds Allocation Update
SC confirmed that HENW was taking a different approach to the use of Workforce
Development budgets than the majority of LETBs, and that the credibility of HENW’s
approach would need to be demonstrated with the success of the initiatives and value
for money of funds allocated. To this end HENW would be performance managing the
progress of projects and evaluating outcomes.
LR explained that an important principle was being established, which was the need to
embed effective decision-making at LWEG level.
LR also highlighted that each LWEG had followed a different approach where the
Forerunner Fund was concerned, and that it was important to have the right systems in
place, and for those involved to work constructively together.
CP confirmed that there had been no negative feedback from HEE towards the
Forerunner Fund approach adopted by HENW.
CP presented the paper ‘Update on Forerunner Fund initiatives across HENW – August
2014’, and explained that the paper showed the type of initiatives that had been
approved, and that HENW would know what the outcome of the bids was in
approximately six months’ time.
HTM explained that there were two important measures of success for the Forerunner
Fund – the product this year, and the production of a significant outcome that can be
shared across other regions in the future. SC emphasised that if an initiative works well
in one LWEG it should be rolled out across the North West.
SR suggested that it would be useful to hold a future event where colleagues could
share details of the work carried out under the Forerunner Fund initiatives, and so
inspire others. LR agreed, and suggested that this would be the focus of a future
Stakeholder Forum.
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HTM felt that if a specific product resulted from a Forerunner Fund initiative then AHSN
could help deliver the outcomes.
8. 2014 Workforce and Investment Plans
CP, JC and MB presented a summary of progress on the 2014 Workforce and
Investment Planning process, which was based on the annual workforce plan
submissions provided to date by Trusts across the North West.
CP explained the financial background, and confirmed that the ‘first cut’ of the financial
planning process was due by October 2014. The finance allocation for HENW for 201516 was not yet known. There had been a national benchmark price review, but the
outcome of this had not yet been shared.
Although the annual workforce planning process had in the past been fragmented, the
internal system was improving, and JC and her team were also keen to work with
stakeholders on this. The HENW Workforce Strategy team were also working with
colleagues in the PGMDE function to ensure alignment with medical workforce planning.
JC clarified that the process had started in March when the providers had been given
the timescales for submission of workforce plans.
These were received in JuneAugust and ndividual provider plans were then used to produce a NW plan which will be
aggregated into a national plan for England in October/November, The plans state
what the providers are doing, and what they require from HENW/HEE in terms of new
commissions. JC added that the plans were always meant to be signed off at executive
level in Trusts before being submitted, but that this year there would be a higher level of
executive engagement in the process as well as involvement of commissioners.
The next stage in the process is that the figures are checked against the narrative and
wider context for each organisation, which is the stage that HENW is currently at. The
key aim is that demand for the next five years feeds into supply decisions.
HENW then submits its regional plan to HEE who will review them and either confirm or
challenge the information with the LETBs.
JC confirmed that this year’s workforce plan for the North West would be going to the
HEE Board in December 2014. The national plan would then be published by the end of
December 2014.
JC asked the Board members to consider whether they recognised the key themes that
HENW had summarised, and to inform HENW of any more that were either North West
wide, or LWEG specific. The LWEGs will receive detailed summaries of the submissions
for their geographical patches at the meetings in September for comment/agreement.
As the next Cumbria and Lancashire LWEG meeting is scheduled for 1 October 2014
(after the HEE submission deadline) the C&L submission will be reviewed by the LWEG
in time for the ‘second cut’ submission.
After the submission date, board members will be informed of developments and
outcomes.
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JC clarified that the aim for next year is to carry out as much preparation work as
possible in advance, and so be more pro-active, and to specify the type of areas to
invest in, which will be linked to the HEE Mandate.
JC thanked the organisations for the information that they had provided, and asked
Board members to inform her of any thoughts or considerations that could change
workforce planning for the future.
HTM asked who at the trusts HENW had spoken to at the confirm/challenge stage of the
process i.e. was it those who had submitted the information, or staff at a more strategic
level. MB confirmed that he would originally go back to those who had submitted the
plans, and involve other colleagues from the trusts if needed, but not necessarily those
at Board level. If there appeared to be a significant risk raised by the workforce plans
submitted, then MB confirmed that he would contact the Trust’s HR director.
SC added that more detail of the workforce plan process would be given at the
stakeholder forum on 3 September 2014.
Action: VW to circulate the slides from the presentation on the 2014 Workforce
and Investment Plans to all Board members, to allow them to share them within
their organisations.
9. The Shape of Training Report – Strategic Implications for Change
JH presented the Shape of Training Report, and the presentation slides were distributed
to all Board members on 29 August 2014.
JH highlighted the key messages and explained that she was conscious that in parts of
Cheshire, Cumbria and Lancashire there were difficulties recruiting doctors.
JH stressed that HENW was very well placed to consider how to influence the fourth
year of GP training to help ensure that in future GPs were better able to provide the
required standards of patient care. However, in the future there would be fewer doctors
in training overall, and there are potential threats to the output of the three North West
Medical schools.
JH also highlighted that HENW needed to give clear advice regarding the messages
that the current workforce was giving to the future workforce.
For the future, JH explained that the existing workforce would be involved in the
planning process for new consultants. The fourth year of GP training would also need to
be used very carefully to ensure that it was as useful as possible.
JH explained that there would be five workshops on the Future Shape of Training over
the next month, two of which would be hosted by HEE in London, and that key themes
and challenges would emerge from these workshops.
Action: JH to produce a general report regarding Shape of training for the Board
meeting in October 2014, including the key themes and challenges that came out
of the workshops.
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Action: JH to circulate outcomes from the Shape of Training workshops she
attends.
Action: VW to circulate the slides from the presentation on the Shape of Training
to all Board members, to allow them to share them within their organisations.
10. Any other business
No other matters were raised.
2. Next meeting
The next meeting was scheduled for 31 October 2014 at 3 Piccadilly Place.
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