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Present:
Mr P Archer ChairmanMr L McIvorChief ExecutiveMrs S McCueDirector of FinanceMr F HughesNon-Executive DirectorProf M HanrattyNon-Executive DirectorMr N McKinleyNon-Executive DirectorMr S ShieldsNon-Executive DirectorMr B McNeillDirector of OperationsMs R OHaraDirector of Human Resources
In Attendance:
Dr N RuddellAssistant Medical DirectorMrs M CrawfordExecutive AdministratorMs K BaxterSenior Secretary
1.0ApologiesMr S Mullan, Non-Executive Director
Dr D McManus, Medical Director
2.0Welcome and Format of the MeetingMr Archer opened the meeting by welcoming members of the public and Trust Board and explained the arrangements for receiving questions from the public attending.
3.0Minutes of the Previous Meeting of the Trust Board held on 7 May 2009Members accepted the minutes as a true and accurate record of proceedings on the proposal of Mr McKinley seconded by Mr Hughes subject to the following amendment.
Item 4.1 embraces should read as embracing.
4.0Matters Arising4.1NIAS Governance ArrangementsTrust Board members met recently to discuss governance arrangements which proved to be positive. Mr Archer plans to meet with Mr McIvor to progress.
4.2Efficiency Savings and Comprehensive Spending Review Investment ConsultationSee Item 7. 4.3Trust Delivery PlanThe Board were informed that no formal notification has yet been received, however the understanding is that the DHSSPS is broadly content with the plan. Once confirmation has been received the plan will be placed on the website.
5.0Chairmans Business5.1Chairmans Update
Mr Archer gave a brief outline of his diary commitments since the last board meeting.
Met with:
Health Minister on two occasions since the last Board meeting
Chair of the new Public Health & Social Well-being
Chair/CE of the Western Trust
Public Inquiry Team into the Outbreak of Clostridium Difficile a fact finding meeting where information was provided to the team on the role of NIAS.
Attended:
Ambulance Service Network meeting in Birmingham
Northern Ireland Confederation Conference
Special meeting of the Trust Board for the final accounts
Remuneration Committee
6.0Chief Executives Business6.1Chief Executives Update
Mr McIvor briefed members on current issues:
Met with:
Acting Permanent Secretary for an Accountability Review Meeting where NIAS was complimented on operational and financial performance on exceeding targets.
Mr Compton, Chief Executive of the Health & Social Care Board where again NIAS staff was commended for their performance. Some discussion also took place in regard to Ireland Air Ambulance.
Mr Archer also added the Boards endorsement and commended the Executive Team on NIAS performance.
6.2Swine Flu
The Incident Management Team is meeting weekly and preparations are in place to manage the situation. Dr Ruddell advised that it is likely that the number of people affected will increase, however NIAS are monitoring the situation and plans are in place to maintain service. Mr Shields enquired about the financial impact of swine flu. NIAS has incurred very little expenditure to date with some monies being used to train staff and purchase equipment. There may be additional costs if NIAS is required to cover staff absences with overtime. All resources will be directed to maintain control and frontline services to respond to life threatening calls.
7.0Consultation Proposals Efficiency Savings and Comprehensive Review InvestmentMr McIvor gave a presentation on the proposals for efficiency savings and reported that the final decision lies with the Minister for Health, Mr Michael McGimpsey. Once the proposals have been agreed a press release will be issued with the details of the efficiency savings to be placed on NIAS website.
Mr McIvor added that NIAS could not have delivered the efficiency savings in line with Ministerial directions without the additional investment.
The proposals were adopted by the Board on the proposal of Mr Hughes seconded by Prof Hanratty. It was noted that the adoption of the proposals was undertaken with a degree of reluctance by the Board, reflecting the concern expressed by respondents that the Ambulance Service was subject to delivery of efficiency savings.
8.0Performance Reporting as at 31 May 2009OPERATIONS
Mr McNeill updated members commenting that this is the first opportunity to look at performance for this year and advised that NIAS is currently exceeding the target. This has been due to changes put in place in frontline services, control and the additional RRV. NIAS is now realising the benefits. He also highlighted the following:
OP01 It was noted that staff and Managers are working hard to achieve targets.
OP02 1% short of target.
OP03 A shortfall has been noted, however staff working hard to achieve target. Work in this area is ongoing which should help to meet targets set.
OP04 Noted. Mr McNeill briefed members on the complex outfitting of vehicles.
OP05 Ballynahinch and Newry are now operational.
OP06 Currently being trialled for a few months at the Ulster Hospital which has proved successful. NIAS will be looking to expand and roll out programme. It was also noted that the introduction of mobile data will provide NIAS with an efficient service.
Prof Hanatty asked what the differences were for an infection control vehicle and regular vehicle. She was advised that the materials used are more expensive and that the compartment between driver and patient is sealed.
Mr McKinley asked if an infection control vehicle is stood down for cleaning once it has been deployed. He was advised the vehicle would be stood down for specialist cleaning as appropriate to the individual call.
FINANCE
Mrs McCue updated members highlighting the following:
FN01 The trust is forecasting a breakeven position with a deficit of 300k at the 31 May 2009
FN02 This has been delayed until approval of efficiency savings.
FN03 Zero proceeds to date.
FN04 A target of 95% is required and the Trust is achieving 93.6% at present. It is hoped that this target can be achieved by year end.
FN05 It is hoped that there may be an opportunity for additional funds later in the year. Approval for the business case is required.
FN06 On track to achieve.
FN07 On track to achieve.
MEDICAL DIRECTORATE
Dr Ruddell updated members highlighting the following:
MD01 158 12 lead defibrillators have been rolled out. Paramedic-delivered Thrombolysis will be extended to all operational paramedics during 2009/10.
Mr Hughes requested clarity on the differences between the 3 lead and 12 lead defibrillators. Dr Ruddell advised that the 12 lead defibrillator provides a more detailed reading and is more capable of diagnosing heart disease. Mr Archer made an enquiry regarding the shelf life and was advised that there is a warranty for 5 years with the technology becoming obsolete after 7 years.
MD02 There has been no reported cases attributed to NIAS. The Infection Control Group meets on a monthly basis. Dr Ruddell referred to the letter from Mr Dickson, HCAI and Cleanliness Division where initial concerns in this area have been addressed. He welcomed the support of the Board for an expert specifically for infection control to be funded. Mr McIvor advised that while meeting with the Permanent Secretary he raised the issue of NIAS not having the funding to provide an expert in this area. He further added that this was also raised at the recent meeting with the Clostridium Difficile Inquiry Team.
MD03 The Trust is engaging with public representatives to bring forward the patient involvement agenda.
MD04 The pilot of secondary call triage by clinicians in Regional Emergency Medical Dispatch Centre has been running for six months and an evaluation will be carried out at the end of this month. Hospital delivered thrombolysis for stroke patients is being rolled out with Erne Hospital being the first. The target for all Trusts is March 2010.
MD05 Clinical Performance Indicators introduced are on a par with what is being carried out in the UK. This is paying dividends which is very positive, however there are still some areas where improvement can be made.
MD06 An error was noted within the report and it was advised that the pharmacy arrangements have not yet been rolled out in the Southern Division. Recruitment problems were also noted in the Belfast Trust.
MD07 Swine flu has been the focus in this area and the Emergency Planning team were commended for their work in this area.
Prof Hanratty stated that as Chair of the Clinical Governance Committee she would be progressing development of a Quality Assurance Framework around clinical performance. Pharmacy and training has also been raised at the Clinical Governance Committee meeting.
Dr Ruddell presented the Emergency Planning Report to members, which is self-explanatory. Mr Archer also commented that this report was useful as it informed members of the work in this area.
HUMAN RESOURCES
Ms OHara updated members highlighting the following:
HR01 On target to achieve Ministers target. A health and well-being initiative is being developed for preventive management and work is ongoing with Occupational Health.
HR02 On target to achieve. Mr Archer commented that he welcomed the investment for PCS training.
HR03 On target to achieve.
HR04 On target to achieve. A Project Manager for the implementation of the Knowledge and Skills Framework in Northern Ireland is currently out for recruitment.
HR05 An error was noted in the report. Number of complaints for May 2009 should read as 10. A Complaints Officer has been recruited for the roll out of training to all staff on the new regional complaints procedure.
9.0Human Resources End of Year Report 2008/09
This report highlights activity and reflects the workload of the HR Department. Ms OHara gave members a brief summary of the activity around the recruitment of staff.
Mr Hughes stated that the paper does reflect the workload and wished to congratulate staff on their efforts.
Prof Hanratty raised the question of quality assurance for the Training School. Ms OHara advised that Institute of Health Care Development (IHCD) quality assures the Training School which received an A rating.
10.0Healthcare Associated Infection (HCAI)
It was noted that the Board required clarification regarding the findings of the HCAI report. A letter from Mr Dickson, Lead Programme Manager, HCAI Cleanliness Division confirms that the risk is low for NIAS. Dr Ruddell was anxious to indicate that this is no source for complacency and NIAS will remain focused on this area. 11.0Policies / Procedures (for approval)
11.1Redeployment and Redundancy Policy
Ms OHara reported that this policy has been regionally agreed. This policy will also be reviewed by the Regional Staff Side Group. The Board will be apprised of any review.
The policy was approved on the proposal of Mr McKinley and seconded by Prof Hanratty.
12.0For Noting
12.1Minutes of the Risk Management Committee held 26 February 2009
Members noted.
12.2Minutes of the Clinical Governance Committee held 26 February 2009
Members noted.13.0Application of Trust SealTrust Seal has not been used since the last Trust Board. 14.0Forum for QuestionsNo questions received from the floor.15.0Any Other BusinessNo other business.Date, Time and Venue of Next MeetingThe next meeting of the Trust Board will be held at NIAS Headquarters followed by the Trusts Annual General Meeting on Thursday, 24 September 2009.
Mr Archer thanked those present for attending and called proceedings to a close.
Signed: __________________ _____
(Chairman)
Date: ____________
PAGE \* MERGEFORMAT 7
Minutes of a Meeting of Trust Board held on Thursday, 2 July 2009 at 1.30pm at the Rural College and Derrynoid Centre, Derrynoid,
Draperstown, BT45 7DW
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