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NORTHERN IRELAND AMBULANCE SERVICE
Present:
Mr P Archer ChairmanMr L McIvorChief ExecutiveDr D McManusMedical DirectorMr F HughesNon Executive DirectorProfessor M Hanratty CBENon Executive DirectorMr B McNeillDirector of OperationsMr S MullanNon Executive DirectorMs R OHaraDirector of Human ResourcesMrs S McCueDirector of Finance
In attendance:
Mrs M CrawfordExecutive AdministratorMrs P McAllisterPersonal Assistant
1.0ApologiesMrs M Greer, Non Executive Director.
2.0Welcome and Format of the MeetingMr Archer opened the meeting by welcoming members of the public and Trust Board members and explained the arrangements for receiving questions from the public attending.
3.0Minutes of Previous Meeting of the Trust Board held on 22 January 2009
The Trust Board members unanimously accepted the minutes as a true and accurate record of proceedings. The minutes were adopted on the proposal of Mr Hughes, seconded by Prof Hanratty.
4.0Matters Arising
4.1Terms of Reference for Sub Committees of the Trust
A date has now been confirmed for the Trust Board workshop, which is to be held on the 6 May 2009 at the Comfort Hotel, Antrim. All outstanding issues will be considered and hopefully resolved at this time.
4.2Efficiency Savings and Comprehensive Spending Review Investment Equality Impact Assessment
The public consultation closed on the 13 February 2009 and 30 responses were received from various groups and individuals. These are now being reviewed and a final report will be issued April 2009.
4.3Update on Health Professions Council Accreditation Re-approval/Higher Education for Ambulance Personnel
The Trust is on course to submit the final submission to HPC within the timeframe set ie 6 April 2009.
Queens University won the tender for the delivery of a Post Graduate Certificate in Education for Ambulance Trainers. A further meeting with Queens University is due to take place next week in relation to a 3rd Level Mentorship programme.
Further discussion took place and the following comments were made:
Prof Hanratty indicated that clarification was required in relation to terminology used, in particular, accreditation or approval.
Ms OHara stated that NIAS required HPC approval of the IHCD accredited paramedic training programme. She further stated that the Trust is currently carrying out an options appraisal in relation to the move to a foundation degree in paramedic science.
NIAS is working nationally with other Ambulance services and are benchmarking best practice in this regard.
Prof Hanratty stated that the Department will need assurances that we have explored all avenues locally for the provision of 3rd level education.
Mr Mullan commented that a timetable with a more detailed programme would give Board members a better understanding.
Prof Hanratty stated that the Trust would need to be ready by 2010 and any advertisement would need to be specific.
Ms OHara advised that a lot of work was still to be progressed. It was also noted that the Department have responsibility for the education of Healthcare Professionals.
Mr McIvor stated that advice would be sought from Regional Supplies to ensure best value for money in any tender process.
Prof Hanratty questioned Regional Supplies expertise in this area.
Mr Mullan asked if a business case will be required.
Mr McIvor advised that the funding issue has been identified to the Department and that they acknowledge their role however, a business case may be required and ongoing engagement would clarify this.
Action:
An update is to be provided on a quarterly basis to include programme timetable. (Director of Human Resources)
5.0Chairmans Business5.1Visit to Castlederg Ambulance Station
Board members were impressed with the station at Castlederg and considered that good use had been made of the redundant hospital site. The station was noted to be clean and free of clutter. The nearest A&E hospital was 30 miles away and members wished to commend staff for the challenging work they do. Board members wished to thank staff for their friendly welcome.
5.2Chairmans Update
Mr Archer gave a brief outline of his diary commitments since the last board meeting.
Visited East Country Division.
Visited East City Division.
Visited Southern Division.
Chairman plans to visit all Divisions again during the year.
Met with Mrs Greer, Mr Hughes and Mr Mullan, Non-Executive Directors.
Met with Mr Alan Gilbert, Chair of Northern Ireland Confederation in relation to the review of Senior Executive Salaries.
Introductory meeting with the Strategic Investment Board.
Met at NIAS with Chairs from South East Trust, Southern Trust, Belfast Trust and NHSSB.
Attended farewell function for EHSSB.
Attended 3 days mandatory training for members of Board.
Undertaking weekly meetings with the Chief Executive.
The Chairman has been in contact with the Public Appointments Unit regarding the appointments of new Non-Executive Directors, as there has been no appointments made to cover the existing vacancy or the vacancy which will occur in May 2009.
Members noted.
6.0Chief Executives Business
6.1
6.2
Chief Executives Update
Mr McIvor wished to pay tribute to the staff involved in the recent shooting incidents which took place in Antrim and Craigavon for their professionalism and care of the casualties.
Mr Hughes enquired if counselling is provided to staff who are involved in these types of incidents. It was advised that counselling is available to any staff who wish to avail of this service.
Members noted.
Invitation to meet with Health Committee - Efficiency Savings and Comprehensive Spending Review Investment Equality Impact Assessment
The Trust was given the opportunity to explain in detail NIAS proposals for efficiency savings to the Health Committee on the 26 February 2009. This meeting was well attended by members of the Health Committee who acknowledged the challenges faced by the Trust.
Members noted.
7.0Performance Reporting as at 28 February 2009 OPERATIONS
Mr McNeill updated members highlighting the following:
OP01 Mr McNeill was delighted to report that the Trust is on line to meet this target however the Trust is cautious as more demands are made on the service. Mr Mullan wished to commend the work done so far given the increase in activity.
OP02 Funding of 187k has been received from the Northern Board for PCS transport of fracture patients.
OP03 It has been difficult for the Trust to get a significant increase in cumulative targets, however the whole system is improving and should work more effectively.
OP04 Further work is required in this area to meet the target set.
OP05 Delivery of 28 A&E vehicles and 25 PCS vehicles has commenced.
OP06 Work is on target for the completion of Ballynahinch Station and Irvinestown Outpost is now fully functional.
FINANCE
Mrs McCue updated members on the financial position of the Trust highlighting the following:
FN01/FN02 The financial position as at 31 January 2009 indicates a deficit of 10k with the Trust forecasting a breakeven position by year end. Cash releasing efficiency savings required as part of the Comprehensive Spending Review remains an issue in the current financial year and will increase in 2009/10.
FN03 The business case for fleet replacement has now been conditionally approved and plans to introduce these new vehicles and dispose of out of standard vehicles are being developed.
FN04 94.6% of invoices are paid within the target set.
FN05 The total allocation of 6.7m has been prioritised against Fleet, Medical Equipment, Estate and IT.
FN06 FOI requests continue to be processed within legislative timescales.
The Board wished to commend staff for all their efforts.
Members noted.
MEDICAL DIRECTORATE
Doctor McManus updated members highlighting the following.
MD01 The business case for cardiac monitors/defibrillators has now been approved with the contract being awarded on the 5 March 2009 (error within report not 5 February 2009). A plan to roll out the new equipment has been agreed and will commence in April 2009.
MD02 A report from the review undertaken by The Cleaner Hospitals Campaign (CHC) has been received and an action plan has been developed. A workshop is being arranged for all Divisional and Station Officers to progress implementation.
A draft of the National UK Ambulance Service Infection Prevention and Control Guidelines are being reviewed by the Infection Control Group. Further feedback will be provided to Board members.
Prof Hanratty raised concerns regarding potential risk for infection to patients and inquired if NIAS had qualified staff involved in the development of the action plan. She further stated that no training in relation to this was noted within the training plan.
Doctor McManus advised that the Trust would require a Champion to take this forward; however no funding has been allocated to this area, which should be highlighted to the Commissioners. The Trust intends to formalise inspection and prevention control procedures and has sought advice from Lead Infection Control Specialists.
Training in Infection Control is provided to frontline staff which is a requirement nationally. Post Proficiency courses also covers this area.
Mr Mullan enquired about vehicle cleaning and was advised that ambulances are intended to be cleaned after every shift and are stood down once weekly for thorough cleaning.
MD03 Work is ongoing in this area.
MD04 5 clinical performance indicators have been developed however some refinement is required. Initial results are very good.
MD05 New pharmacy arrangements are being rolled out and are on track for year end. The manufacturing problem with morphine has now been resolved however there is now a problem with amoxin (the reverse drug). The introduction of morphine will be delayed until everything is place approximately April 2009.
MD06 Work is ongoing in this area. An action plan has been developed.
MD07 A pilot of secondary triage of Category C calls by Doctors in Ambulance Control commenced in January 2009 and an evaluation of the first months calls was undertaken, initial data is very positive.
HUMAN RESOURCES DIRECTORATE
Ms OHara updated members highlighting the following.
HR01 The Trust has achieved the target set which is a reflection of the good work carried out by the HR Team and Managers across the Trust.
HR04 Additional funding has been received for the appointment of a Complaints Officer for 1 year to assist with implementation of the new complaints procedure.
HR05 On track to achieve.
HR06 Page 3 of complaints appendix noting a name. This is to be removed from the report.
Members noted.
8.0Policies /Procedures
8.1
8.2
8.3
8.4Contract of Employment
A new contract of employment is to be issued to staff due to new terms and conditions under Agenda for Change. This document has been benchmarked against other trusts and meets legal requirements.
Some discussion took place regarding the Whistle Blowing section with Mr Hughes reporting the whistle to be silent at present.
The following comments were also made:
Mr Mullan raised the question of damages (Paragraph 14) when staff are injured. Ms OHara confirmed that the paragraph in question had been suggested by NIAS legal advisers, she agreed to review this paragraph with legal again.
Action: Ms OHara to review Paragraph 14 of the Contract of Employment with legal advisers.
Grievance Policy
No comments received.
Disciplinary Policy
On consideration Mr Mullan asked for clarification on the consolidation of minor disciplinaries. Ms OHara confirmed that in relation to the decision making protocol, panel members would consider the significance of a number of minor disciplinaries.
Action: Ms OHara to forward Mr Mullans comments to Management Side Chair of the Regional Joint Negotiating Forum for consideration at policy review stage.
Capability Policy
No comments received.
All Policies were approved by the Board on the proposal of Mr Hughes, subject to the comments noted.
9.0
For Noting
The following issues were highlighted:
Risk Management Committee Minutes held 4 December 2009
Risk Register risks are reviewed on a monthly basis.
Clinical Governance Committee Minutes held 4 December 2009
Clinical Performance Standards Audits show good compliance with the standards. This will inform practice and feedback will be given to staff on their performance.
Audit Committee Minutes held 4 December 2009
Minutes of ICT Steering Group to be presented to Audit Committee.
No major findings by Internal Audit.
External Audit plan under development and will be presented to Audit Committee.
Members noted.
10.0Application of Trust Seal
The trust seal has been used once since the last Trust Board Meeting for the following purpose:
A leasing agreement for 10 years for new Ballynahinch Station.
Members noted.
12.0Forum for QuestionsNo questions received from the floor.
13.0Any Other Business
No other business.
DatTiDate, Time and Venue of Next Meeting
The next meeting of the Trust Board will be held at Trust Headquarters on Thursday, 7 May 2009.
Mr Archer thanked those present for attending and called proceedings to a close.
Signed: __________________ _____
(Chairman)
Date: ____________
PAGE \* MERGEFORMAT 1
Minutes of a Meeting of Trust Board held on Thursday, 19 March 2009 at 1.30pm
in the Mellon Country Hotel, 134 Beltany Road,
Castletown, Omagh, BT78 5RA
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