ANNEX 1
DRAFT
WELSH AMBULANCE SERVICES NHS TRUST
MINUTES OF THE OPEN MEETING OF THE TRUST BOARD HELD ON 18
SEPTEMBER 2014 AT ST PETER’S CIVIC HALL 1 NOTT SQUARE,
CARMARTHEN, DYFED, SA31 1PG
MEMBERS PRESENT:
Mick Giannasi
Mike Collins
Mike Coupe
Emrys Davies
Pam Hall
Judith Hardisty
Sara Jones
James Mycroft
Patsy Roseblade
David Scott
Jonathan Whelan
Chairman of the Board
Director of Service Delivery
Director of Strategy, Planning and Performance
Non Executive Director
Non Executive Director
Director of Workforce and Organisational Development (OD)
Director of Quality and Nursing
Non Executive Director
Director of Finance and ICT
Non Executive Director
Interim Director of Medical and Clinical Services
TRUST BOARD
REPRESENTATIVES:
Nigel Heal
Michael Jose
Nick Morgan
Steve Owen
Dawn Sharp
Staff Side Representative (RCN)
Staff Side Representative (UNISON)
Staff Side Representative (GMB)
Corporate Governance Officer
Corporate Secretary
APOLOGIES
Moaiwa Bin Sufyan
Nathan Holman
Roger John
John Morgan
Bleddyn Roberts
Elwyn Price Morris
Martin Woodford
Board Mentee
Staff Side Representative (GMB)
Staff Side Representative (UNITE)
Non Executive Director and Vice Chair
Staff Side Representative (UNITE)
Chief Executive
Non Executive Director
OBSERVERS
Donna Coleman
Liam Crowther
Sam Dentten
Wynne Evans
Michelle Evans
Barbara Hartley
Ray Hine
Stuart Ide
Ian Lewis
CHC Representative
NHSD – Senior Nurse Advisor
CHC Representative
CHC Representative
Community First Responder
CHC Representative
CHC Representative
Chief Ambulance Services Commissioner
Press (Carmarthen Journal and South Wales Evening Post)
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Rosemond Nelson
Pamela Parsons
Joan Phillips
Steve Roberts
Tony Wales
Ashley Warlow
Barbara Wilson
Steve Yelland
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CHC Representative
CHC Representative
CHC Representative
Community First Responder Co-ordinator
CHC Representative
CHC Representative
CHC Representative
CHC Representative
PROCEDURAL MATTERS
The Chairman opened the meeting by welcoming all and reminded the Board that the meeting
was being tape recorded. Pam Hall, Non Executive Director referred to Minute 39/14 and
indicated that the word retirement should be replaced with the word resignation in relation to
Bernadine Rees, Non Executive Director.
The Interim Medical and Clinical Director provided the Board with a brief update in terms of the
Emergency Medical Retrieval and Transfer Service (EMRTS).
RESOLVED: That
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(1)
the standing declaration of Mr Emrys Davies as a retired member of UNITE be
noted;
(2)
the minutes of the open and closed session of the Board held on 17 July 2014 be
confirmed as a correct record subject to the comment above;
(3)
the update in respect of the EMRTS be noted;
(4)
the urgent business approved by the Chairman and Chief Executive in consultation
with other Non Executive Directors since the last meeting (Ref 10/2014 –
Appointment of Medical Director) be ratified, and it be noted that Mr Brendan Lloyd
was due to take up employment with the Trust in November 2014.
PATIENT EXPERIENCE
Steve Roberts, Community First Responder (CFR) Co-ordinator provided Members with a brief
overview on the work conducted by CFR’s and introduced Michelle Evans, a CFR based in
Carmarthen.
Michelle Evans, presented Members with an introduction into CFR work and recalled a personal
experience which involved attending to a patient who was experiencing chest pains. Michelle
arrived on scene within minutes and discovered the patient in the recovery position and not
breathing. Michelle delivered two shocks to the patient using a defibrillator prior to the arrival of
the ambulance crew. The patient, following further treatment in hospital was now at home and
had made a full recovery.
Michelle added that the Satellite Navigation system currently in use only directed users, in some
cases, to the general area and that the introduction of Terrafix (a Mobile Data and
Communication System) unit would allow users to pinpoint with greater accuracy the exact
location of the call. The Director of Service Delivery and The Director of Finance and ICT
confirmed that the Terrafix system was part of a pilot scheme which was currently in
development and confirmed that this would considerably enhance the response times.
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The Board was further informed that following this incident, Michelle had been shortlisted for the
'Good Neighbour & Volunteer Award 2014’ by the Carmarthen Journal.
Steve Roberts added that CFRs had now completed further training in the provision of a more
effective airway to patients who presented with cardiac arrest and training in the application of
tourniquets.
Wynne Evans, Community Health Council brought the Board’s attention to the Co-Responders
located within Fire stations in Wales, in particular the locality of St David’s and asked for this to
be sufficiently resourced. Steve Roberts advised that further discussions were ongoing to
resolve this issue.
The Chairman thanked Michelle and Steve for their attendance and acknowledged the hard work
carried out by CFR’s.
RESOLVED:
That the patient story be noted and any lessons learned be taken forward.
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MINUTES OF COMMITTEES AND OTHER BODIES
Quality Delivery Committee held on 24 July and 21 August 2014
Emrys Davies, Non Executive Director provided Members with an overview of various issues
that had been discussed at previous QDC meetings and asked Members to agree to the Minutes
and the items as listed below;
RATIFIED
(1)
Minute 66/14 – Procedural Matters (24 July - open) – signing of CHC Protocol;
(2)
Minute 82/14 – Health and Safety Annual Report was received and noted; and
(3)
Minute 81/14 – Retirement and Induction Policies approved for adoption and
implementation (subject to minor adjustments) (21 August).
NOTED
(1)
Minute 6/14 – Business Continuity Policy (24 July – closed) – dealt with as a
separate agenda item on today’s agenda;
(2)
Minute 7/14 – Major Incident Plan (24 July – closed) – dealt with as a separate
agenda item on today’s agenda; and
(3)
Minute 85/14 – Quality and Assurance Framework – endorsed subject to minor
amendments however since that meeting it has been proposed that the framework
be further reviewed in the light of the impending overall review of Board structures
and be represented to QDC prior to being signed off by the Board at a subsequent
meeting.
RESOLVED: That the Minutes of the Quality Delivery Committee held on 24 July and 21
August 2014 and the recommendations contained therein be endorsed.
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Audit Committee open and closed held on 21 August 2014
David Scott, Non Executive Director asked Members to consider and agree to the Minutes and
items from the Audit Committee as indicated below.
RATIFIED
(1)
Minute 22/14 – the Clinical Audit and Effectiveness Programme;
(2)
Minute 24/14 – endorsement of the current version of the Corporate Risk Register
and the closer integration of the risk management process and the Annual
Delivery Plan; and
(3)
Minute 21/14 (closed) – approval of the Counter Fraud Annual Report.
RESOLVED: That the Minutes of the Audit Committee open and closed sessions held on
21 August 2014 and the recommendations contained therein be endorsed.
Strategic Transformation Board held on 10 July and 14 August 2014
(1)
Minute 52/14 – the approval and signing of the Interim Collaborative
Commissioning Agreement for 2014/15.
The Director of Finance and ICT provided the Board with an overview of the details regarding
the above Minute and asked the Board for approval.
RESOLVED:
That the Minutes of the Strategic Transformation Board held on 10 July and 14 August
2014 be endorsed, and specifically the above Minute be adopted.
Welsh Ambulance Services Partnership Team
RESOLVED:
That the Minutes of the Welsh Ambulance Services Partnership Team held on 3 and 30
June 2014 be received and noted.
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INTEGRATED PERFORMANCE REPORT (IPR)
The Board were given an overview by the Director of Strategy, Planning and Performance in
terms of the process involved in presenting the IPR and added that each Director would provide
a brief summary of their responsibilities within it.
The Director of Workforce and OD informed Members that the Human Resources section
contained within the IPR would be expanded to include any disciplinary cases and any
suspensions of staff exceeding three months.
The Director of Finance and ICT apologised to Members that the finance paper was distributed
after the main agenda which was due to the timing of the closing down of the Ledger and the
reporting timetable to Welsh Government.
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The Interim Director of Medical and Clinical Services informed the Board that it was his intention
that for the next meeting, the graphs would be presented in a format that would be more easily
interpretable.
The Chairman of the Board asked that a one page overview be provided by Directors which
highlighted in summary, easily identifiable information that portrayed the overall picture and
direction of the Trust in their particular area of responsibility. The Chairman acknowledged that
excellent progress had been made in terms of the IPR content and thanked all those involved for
their continued hard work in the process.
RESOLVED: That
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(1)
the update be noted; and
(2)
future reports provide a brief one page summary as described above.
STRATEGIC TRANSFORMATION PROGRAMME (STP) UPDATE
The Director of Strategy, Planning and Performance provided the Board with an update of the
programme and brought Members’ attention to the ongoing staff recruitment in terms of the
overall structure.
The Director added that there had been some critical changes within the overall plan which
necessitated further work in the areas as listed below:



Clinical and Service Delivery model;
Clinical Indicators; and
Integration of Clinical Leadership and General Leadership.
It was the intention of the Director that eventually there would be one plan which would
incorporate the Annual Delivery Plan, the Performance Improvement Plan and the Strategic
Transformation Plan which would show progress in terms of a Gant chart and have the project
illustrated in a more easy to read format.
The Director of Finance and ICT, following an enquiry from Pam Hall, Non Executive Director
with regard to the development of clinical indicators and the appropriate ICT investment,
informed the Board that there was significant ICT project development but these fell outside of
the STP.
RESOLVED: That
(1)
progress to date be noted;
(2)
the programme/project and change management resources now supporting the
project be noted;
(3)
the contents of the ‘reframed’ STP be noted; and
(4)
the development of an overarching change management framework and the
associated performance tracker be noted.
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NHS DIRECT WALES/111 SERVICE
The Director of Quality and Nursing provided Members with a brief summary of development of
the service and stressed that Health Information Triage was a key element of the Trust’s
aspiration to deliver unscheduled and emergency care.
The Director further added that there were ongoing discussions to ensure that the protected
resources required for this service to be delivered would be available.
The Director of Strategy, Planning and Performance stressed that this service was to strengthen
the Out of Hours primary care service and confirmed that a Service Level Agreement would be
implemented.
RESOLVED: That
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(1)
the support and stated ambition that the Trust provides the National platform and
hosts the future National 111/Out of Hours (OOH) Service be endorsed; and
(2)
it be noted that this will be a key part of the IBP development process the Board
starts this month.
IMPLEMENTING THE OUTCOME OF THE SOUTH WALES PROGRAMME THROUGH
ACUTE CARE ALLIANCES (ACAs) AND THE DEVELOPMENT OF THE SOUTH WALES
COLLABORATIVE
The Director of Strategy, Planning and Performance brought the Board’s attention to the
timelines involved and the implications for the Trust following implementation of the South Wales
Programme and added that the impact would affect six of the seven local health boards and
would cover all core services. The Director asked the Board to note that the programme was still
in the implementation stage and not in the execution stage. Assurance was given to the Board
that the Trust had the capacity and capability to track changes in terms of activity.
Emrys Davies, Non Executive Director referred to cross boundary working amongst Health
Boards and mentioned that this would have a significant impact on the governance
arrangements and the Trust’s performance. The Director of Strategy, Planning and Performance
asked the Board to note that the Trust would be able to track the changes and manage the
impact in terms of changes in clinical practice and cost; this was reiterated by Stuart Ide, Chief
Ambulance Services Commissioner who confirmed that the Trust should be involved in
discussions from the start.
Emrys Davies, Non Executive Director asked the Board to consider what the intentions of the
Alliances were and emphasised that the Trust’s involvement should follow a joint approach and
be expanded more.
James Mycroft, Non Executive Director referred to and applauded the simplicity of the Clinical
Model, however was concerned that due to the complexity of the programme, there was a
possibility that this may become more intricate than necessary. The Director of Strategy,
Planning and Performance stressed that the Local Health Boards required the Trust’s knowledge
with regard to ambulance and unscheduled care and the question posed was how the Trust
could deliver this without making it too elaborate.
The Director of Workforce and OD emphasised that the programme would not work unless there
was effective workforce planning. The Board were informed by the Director that there was still
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further detail required in terms of how the workforce would be taken forward and added that a
conference in Welsh Government to discuss the issue was imminent.
The Director of Finance and ICT brought the Board’s attention to the ongoing collaborative piece
of work, led by the Trust, which involved working closely with the Health Boards and recognised
the changes that this programme would bring which would be incorporated into the delivery of
the modernised Patient Care Service (PCS).
Pam Hall, Non Executive Director asked in terms of the realignment of services, in particular in
Shropshire, which would have an impact on the Trust, whether the Trust was also involved in
their developments and plans. The Director of Strategy, Planning and Performance and the
Director of Service Delivery gave assurance that the Trust was fully engaged with the cross
border issues.
RESOLVED: That
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(1)
the SWP legacy and handover statement be noted;
(2)
the governance arrangements for the ACAs subject to further consideration of the
organisation’s capacity to populate the proposed arrangements be noted and
approved in principle; and
(3)
the Director of Strategy Planning and Performance discuss with the SW
Collaborative the possibility of hosting a potential development session for the
Board given its refresh to ensure all Members were familiar with the background.
MAJOR INCIDENT PLAN AND BUSINESS CONTINUITY
The Director of Service Delivery informed Members that the Major Incident Plan and Business
Continuity Policy had previously been presented and discussed in detail at the last Quality
Delivery Committee meeting and were being submitted to the Board for formal ratification.
RESOLVED: That
(1)
the route through EMT and QDC and approvals be noted;
(2)
the specific circumstances requiring prior approval and retrospective referral for
ratification be noted; and
(3)
the Major Incident Plan and Business Continuity Policy be approved.
RESOLUTION TO MEET IN CLOSED SESSION
Representatives of the press and other members of the public were excluded from the
remainder of the meeting having regard to the confidential nature of the business to be
transacted in accordance with the requirements of Section 1(2) of the Public Bodies
(Admissions to Meetings) Act 1960.
Reports relating to the items of business in these minutes can be found on the Trust’s website,
www.ambulance.wales.nhs.uk
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