kirkcaldy & levenmouth chp committee meeting tuesday 11...

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Kirkcaldy & Levenmouth CHP Committee Meeting

TUESDAY 11th NOVEMBER 2014 AT 1:30PM THE CHAMBERS, TOWN HOUSE, KIRKCALDY

1. Welcome and Introduction AR

2. Apologies for Absence AR

3. Declaration of interest – Committee members are asked to declare an interest in any of the Agenda items at this point and state what form that interest takes.

4. Minute of previous meeting held on 9th September 2014 AR PAGE 3-13

5. Presentation – ‘Dementia Post Diagnostic Support

Service’ Kathryn Quinn

PAGE 15

6. Matters Arising AR PAGE 17

7. General Manager’s Update MP PAGE 19

8. Associate Nurse Director Update NC PAGE 21

9. Improving Health

9.1 Teenage Pregnancy HB PAGE 23-28

10. Patient/Staff Experience

10.1 Staff Governance BA PAGE 29-50

10.2 PPF Reference Group (Verbal Report) NB PAGE 51

11. Planning For Service Improvement

11.1 Townhill Day Hospital MP PAGE 53-55

11.2 Fair Isle Clinic HB PAGE 57-83

12. Delivery & Efficiency

12.1 Financial Governance CP PAGE 85-89

12.2 NHS Fife Balanced Scorecard / CHP Workplan Comparison MP PAGE 91-95

13. Items for Information: (a) CHP Clinical Governance Group – 5th August 2014 PAGE 97-102

(b) Fife Health & Wellbeing Alliance Group - 24th September 2014

PAGE 103-106

(c) PPF Reference Group – 2nd May 2014 PAGE 107-110

(d) Local Partnership Forum – 10th September 2014 PAGE 111-115

(e) Dates of Committee Meetings/Development Sessions 2014/15

PAGE 117

14. Dates for Diary

Dates of Committee Meetings/Development Sessions 2015/16

PAGE 119

15. Additional Information MR ALASTAIR ROBERTSON, CHAIR,

KIRKCALDY & LEVENMOUTH CHP

V1.0

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MINUTE OF THE KIRKCALDY AND LEVENMOUTH CHP COMMITTEE MEETING HELD ON TUESDAY 9th SEPTEMBER 2014 AT 1.30 P.M. IN THE TOWN HOUSE, KIRKCALDY PRESENT: Mr Simon Little, NHS Non-Executive Board Member (Chair) Mr Nick Barber (MBE), Public Partnership Forum Representative Professor Ian Campbell, Education Representative Mrs. Nicky Connor, Associate Nurse Director Mr. Simon Fevre, Area Partnership Forum Representative Mrs Mary Porter, General Manager Dr. Stephen Rodgers, Registered Medical Practitioner (non-primary care) Representative IN ATTENDANCE Mrs Heather Bett, Clinical Services Manager, Sexual Health Service Mrs. Claire Dobson, Local Manager Clinical Services Mrs Carol Potter, Assistant Director of Finance Mrs Dorothy Guthrie, Admin Assistant K/L CHP (Minute) ACTION

29/14 WELCOME AND INTRODUCTION

Simon Little opened the meeting by introducing himself explaining that he was standing in as Chair for Alastair Robertson who was unavailable. The Chair welcomed the Committee members and thanked them for attending.

30/14 APOLOGIES FOR ABSENCE

Apologies were received from Mrs. Moira Dunsire, Mr. Ron Parsons, Mr. Alastair Robertson and Mr. Allan Shields. Cllr. Andrew Rodger had indicated that he hoped to arrive late. Dr. Rodgers left the meeting at 3.00 p.m.

31/14 DECLARATION OF INTEREST

There were no items raised.

32/14 MINUTE OF THE PREVIOUS MEETING

The Minute of the previous meeting held on 8th July 2014 was agreed as a true and accurate record of the meeting.

33/14 MATTERS ARISING

There were no items raised.

34/14 GENERAL MANAGER’S UPDATE

Mrs. Porter provided an update on the following items:

Clinical Director Post


Tuesday 11th November 2014 Agenda Item No: 4

MINUTE OF PREVIOUS MEETING HELD ON 9TH SEPTEMBER 2014

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ACTION

The advert has gone out and we have received two expressions of interest. Interviews will take place on 14th October and the committee will be informed of the outcome in due course. Medical Staffing The CHP is recruiting two substantive consultants in Rheumatology and Rehabilitation. Within Rheumatology there are currently 3 consultants and the new appointment will take the establishment up to 4. Dr. Sloan is currently working as a single handed consultant within the Fife Rehabilitation Service following the retiral of Dr. Carol Skelton. To help alleviate this situation applications have been received for a locum and these are currently with Dr. Sloan for appraisal. In addition an advert will be placed for a Practitioner Assistant for a fixed term of 6 months. We have already received an application for the consultant vacancy and are in the process of setting up interviews. Mrs. Porter has met with Dr. Sloan and discussed interim arrangements for the 6 weeks when he will be working alone. She is reassured by the arrangements put in place to cover this period. The Chair queried the current situation with regard to consultant recruitment. Mrs. Porter said that Rehabilitation was delighted to get an application so are not concerned however Rheumatology is more of a concern. Currently short term consultants have been covering the shortfall. Mrs. Bett said that the Rheumatology service has been carrying this post for about a year and we are not aware of any Scottish candidates at the moment. CHP Integration The Local Partnership Forums for Kirkcaldy & Levenmouth and Dunfermline and West Fife CHPs have been merged and the first joint meeting will take place tomorrow 10th September 2014. Cameron Hospital The repair work to the in-patient areas has now been satisfactorily completed and patients have been returned to their original wards. Health & Social Care Integration Sandy Riddell, Director of Health & Social Care took up his post last Monday. 1st September 2014. A joint development session for the 3 CHP Committees has been arranged for 14th October and Mr. Riddell has been asked to address the group.

The Committee noted the General Manager’s Verbal Report.

35/14 ASSOCIATE NURSE DIRECTOR’S UPDATE

Mrs. Connor explained that Alastair Robertson has suggested that an update by the Associate Nurse Director become a standing item on the Committee agenda and, therefore, provided the following verbal report. Update on Public Health Nursing

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ACTION

Mrs Connor reported that there have been considerable challenges with staffing for Health Visiting and School Nurses in terms of filling vacancies and recruiting. National work has taken place resulting in a commitment from the government to increase the number of Health Visitors being put through training. The additional investment will show an increase from 5 to 12 Health Visitors being trained this year. Work is ongoing with regard to School Nursing. Mrs. Connor said that this is a positive result as we move forward. Professor Campbell asked if the increase in Health Visitor numbers from 5 to 12 was restoring numbers of staff that had been cut. Mrs. Connor explained that there have been no cuts but, because of challenges in recruiting, we are sitting with a vacancy factor. There will be training for an additional 12 people next year to become qualified practice teachers and also additional training of health visitors next year. Mrs. Connor said that Health Visitors must be registered on the specialist part of the NMC registration and this training is essential. Nursing Workforce Planning Mrs. Connor advised that ongoing nursing workforce planning is taking place across Fife and recently the biggest workforce review across all 38 general wards has taken place. The result of the review has been considered through SMT and is still to be approved by Fife Health Board. Chair asked what this will show. Mrs. Connor said that one component part of the workforce Development Group will be how to develop and retain staff. Planned retiral and clinical hotspots, including midwifery, will be taken into account. Mr. Fevre asked how many staff do we require to meet the recommendation of the workforce tool. Mrs. Connor said that it is in the region of 16.00 WTE. However there will be some change in skill mix as well as additionality. The Director of Nursing will attend the Board Development Session later this month to outline what is required. Mr. Fevre said that the worry is money. Mrs Potter said that the Leadership and Development programme is to be rolled out for development Fife-wide. This includes Leading Better Care, Leadership Development Plan, Core Skill Sets and management training. Older People Inspection Mrs. Connor said that the upcoming inspection will focus on Acute Hospital and visit only Victoria Hospital. The CHPs will process any learning from the visit through NHS Fife and CHP Clinical Governance teams. The Chair asked if the forthcoming elderly inspection was planned. Mrs. Connor said that the last planned visit to Acute was less than favourable and this was followed by an unannounced visit. The next visit is the annual follow up to the planned inspection. Mrs. Porter said that there had recently been a joint inspection of Health & Social Care but this was different.

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ACTION

The Chair asked for examples of lessons learned from previous visits. Mrs. Connor said that Audits have been conducted around Food, Fluid and Nutrition in Community Hospitals. Governance Teams are considering the Older People Standards and work is currently in progress and planned. Mrs. Connor said there is a real need for understanding and we must engage with the workforce. We are clear what areas we wish to prioritise and meetings are taking place with Senior Charge Nurses and leaders. Mrs. Connor said that staff are being engaged and a lot of positive ideas are being identified. Career Development for Nursing Mrs. Connor said that there is currently exciting work going on around the development of career framework for nursing to promote career progression, aspirations and development. A working group of all disciplines of nursing is to be formed and it is hoped this can be launched in November of this year. Professor Campbell queried the direction this will take. Mrs. Connor said that this was about promoting both career progression and lateral movement. Professor Campbell felt there is not the same expansion of career posts in nursing. Although roles in specialist nursing have expanded, staff at this level have already met career aspirations. Mrs. Connor said that people can find it difficult to move from one specialty to another and this will be made easier, aligned with supporting academic qualifications and the national career framework. The Committee noted the Associate Nurse Director’s Verbal Report.

36/14 IMPROVING HEALTH

Delayed Discharge/Community Flow

Mrs. Dobson spoke to her paper which provided details from a Fifewide perspective and specifically for KLCHP. The paper gives an indication on what is being done on a day to day basis to maintain capacity and flow. A number of meetings are being held between Acute and CHPs coming together to ensure patients are in the right place and to ensure flow. Mrs. Dobson said that the CHP seemed to have been in a more stable place over the previous winter period but things have become more challenging since Easter and this trend has continued to date. She explained that reasons for delay are complex including delays in home care, awaiting Social Work assessments, housing etc. and, for some patients, it can be for more than one reason. Staff are aware that, at the heart of all this, we are dealing with vulnerable individuals and their relatives. In particular we are looking at Cameron Hospital each week and have seen an improvement in the number of delays through regular meetings between service managers and practitioners looking at what to do to address each situation.

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ACTION

ICASS – Mrs. Dobson explained that we are still facing challenges in the CHP around the number of patients we have in delay. and Hospital@Home has some spare capacity. Within the virtual wards and we are also challenged by vacancies. Staffing is improving but we are still looking to recruit a GP by combining with D&WF. We are also looking for a Consultant locum. No suitable candidates have shown interest in the GP post but we continue through local focus groups to try and attract someone. Mrs. Porter has asked for information on GP vacancies in Fife from the Primary Care Manager. Professor Campbell queried ICASS numbers since January. He said that, if the CHP manages a caseload of 100 admissions per day, this is a relatively small number. Is this good value for money and what is the readmission rate? Chair said that, over the last two years, admissions to hospital have gone up and, if there was no Hospital@Home this would be bigger. He said that we know that the evaluation of the service has been extremely positive and patients speak very highly of the service. Hospital@Home Professor Campbell asked how the consultant physician vacancy is being managed. Mrs. Dobson said that the Elderly service is flexing sessions and using other colleagues to cover clinics. Chair asked if there is a fixed quota per team across Fife. Mrs. Dobson said that we are aiming for a target of 60 patients across Fife. We are trying to flex the workforce but if we are lighter in KLCHP we contact colleagues in other areas to ask if we can be of assistance. Mrs. Dobson said that a number of actions came out of a recent ICASS Development session around capacity and geography throughout Fife. She said that we are now 2 years in and it is time to look at the structure and there is a lot of data to consider. Ms. Potter said that, in the past week, she has been shadowing a Clinical Nurse Manager in the Acute sector and has seen staff constantly having to be reminded about Hospital@Home. She asked if there is a communication problem. Mrs. Porter said that, when the Acute hospital was under pressure they stopped referring patients to Hospital@Home. In addition referrals from GPs had declined and it would seem appropriate to review communication with GPs in order to raise awareness of the service. Intermediate Care – the number of referrals continues and recruitment of healthcare support workers has helped the situation. VHK Discharge HUB – There are challenges with the volume of patients and the HUB continues to review its working methods. Short Term Assessment Enablement Beds (STAR) – This started slowly but, over the summer months, the beds have been well used. We are still working on an evaluation of use of these beds in conjunction with Joint

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ACTION

Improvement Team (JIT). Mrs. Dobson explained that patients suitable for these beds are medically stable and managed by GP cover. They are only for reablement and not for rehabilitation and there is no Allied Health Professional (AHP) allocation for these patients. Mr. Fevre said that it feels like we are merely using these beds as people holding areas and not achieving anything in trying to get them home. He believes patients would be able to get home quicker if they received rehabilitation and he has seen people sitting in one of these beds for six weeks. Mr. Little said that reablement is a fast track process to regain confidence and rehabilitation is much more intensive. Mrs. Dobson agreed that these patients do not require the skills of AHPs and there are support workers working on reablement. Mrs. Dobson explained that the STAR beds were acquired in conjunction with Fife Council and the Scottish Government. Change fund money is paying for the usage of these beds. Professor Campbell said that, in a recent NHS Fife Acute article there was no mention of STAR beds as a means for discharging patients. He suggested that details should be communicated to the press. Mrs. Dobson suggested that an evaluation would have to take place first. Chair said that Mrs. Dobson had provided a good paper with lots of detail however it does not give an assessment of what the answer is and only tells us what is going wrong. He said that we need to find the answer to whatever elements make capacity not flow. Mrs. Dobson said that we are working hard to improve where we efficiently move people. She said that the problem being experienced with housing is that demand is greater. She agreed there is a need to work more closely with different agencies including local authority. Ms. Potter said that all other health boards in Scotland are facing the same projection in dealing with frail and complex patients who are surviving longer than in the past. Dr. Rodgers said that this is not a problem that has a solution; it is ongoing and needs solutions. He said that we were given reshaping care money to achieve something but reshaping seems to be doing some of that but not all. He believes that we need to find a way of releasing funds in order to improve the situation. The committee was asked to note the current position and the amount of work being done to achieve the best outcomes.

37/14 PATIENT/STAFF EXPERIENCE

Annual Complaints Report

Mrs. Connor had brought the report to Committee for information and noting. NC said that complaints are becoming more complex involving different parts of the service. She said that “complaints by service” was similar to last year with the highest proportion from Mental Health. The other most common complaints are around clinical treatment and attitude however this shows a similar pattern to other areas.

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ACTION

Mrs. Connor said that data gathered on complaints by means of Datix goes back for discussion at Clinical Governance group. Adverse events are also reported and this has resulted in a huge amount of learning. The CHP Clinical Governance Group, which has representatives from all services, will discuss complaints over the past year and identify learning. It was noted that complaints had climbed steeply for Clinical Treatment, Attitude and Behaviour and Communication (oral). Mrs. Connor agreed that there had been an increase in numbers of complaints coming in. Chair pointed out that Attitude & Behaviour, Page 27, Chart 4 had too many categories and that this could be detracting from the basic issue of staff not treating patients with respect. Mrs. Connor said that the categories were taken from Datix but agreed these could be reduced to provide more clarity. Mrs. Connor said that more leadership training is taking place with charge nurses as this is the category that leaders will have to deal with. Mrs. Connor cited CBAS Training which includes walking the journey as the patient, more encouragement with good practice, challenging each other and how to have different conversations. Professor Campbell felt that compliments should be advertised along with details of donations from satisfied patients and relatives. Chair agreed that complaints need to be put into context alongside positive remarks. Mrs. Connor said that some compliments are reviewed at the Clinic Governance Group in recognition of good feedback.

38/14 PLANNING FOR SERVICE IMPROVEMENT

Transfer of HIV Services

Mrs. Bett provided an overview of her paper which was self explanatory. She said that the redesign is now complete and patients have been transferred from Acute into the CHP. Previously patients were seen every 6 – 8 weeks by the Infectious Diseases consultant and they now only require to be seen every 6 – 8 months which is better for the patient and for capacity of the service. Mrs. Bett said that we are now also able to offer additional services particularly more support from pharmacy, dietetics and psychology in the early stages. HIV patients are often isolated and unable to discuss their illness with family or the wider community or with an employer. The redesigned service will aim to reduce the stigma of the illness and use funds allocated to give more support and less doctor input. The plan to take this forward is ongoing. Mrs. Bett said that there are risks around sufficient resources for drug costs and one or two patients who are not keen to move from Acute to a community setting and feel they need 6 – 8 weekly support. Work is ongoing with these patients. Professor Campbell asked if patients are referred from primary to acute care how is this service managed. Mrs. Bett said that they are managed through the CHP with primary care if admitted to Acute. She said that if Primary Care runs a clinic in an Acute hospital this will still come under Sexual Health. She said that clinics are run at Whyteman’s Brae and the

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ACTION

current cohort is around 100 patients. Mrs. Bett explained that when patients are admitted to Acute the BBV team will be informed as will Dr. Banerjee the consultant for sexual health who will give advice on specialist drugs. Otherwise management would fall under the general physician on call for that day. Professor Campbell suggested that this is a big responsibility for emergency care on-call medical staff. Chair suggested that Professor Campbell discuss this with Mrs. Bett outwith the meeting. Mr. Fevre pointed out an error under Item 3.3. i.e. 0.3 WTE Dietitian should be Band 6 and not Band 2. The Committed Noted Mrs. Bett’s paper and Chair said that he would be interested to know more as the service redesign develops.

HB

39/14 DELIVERY & EFFICIENCY

Financial Governance Ms. Potter presented the report to end July 2014 as there were no August figures available. The July position shows an overspend of £164k to date. There are two key variances i.e. Local Services and Rheumatology drugs. Local services overspend is the same position as previously. An exercise has been carried out to review anti-tnf drugs and we now have a budget for full year to reflect changes from last year. The two graphs contained in the report provide a pictorial view of pay and supplies actual spend. Professor Campbell asked about the cause for the overspend at Stratheden and Whyteman’s Brae. It was confirmed that £100k was spent on nursing for QMH, Stratheden and Whyteman’s Brae. MP explained that this was contributed to vacancies, employing bank staff and absenteeism. MP confirmed that, under Local Services, there are currently three complex care packages in the community that are being funded jointly by Health and Social Work and that these are ongoing. Efficiency Savings The CHP had £600k savings to find and at the end of 4 months identified £131k cash releasing efficiencies leaving £477k to be identified. A new Head of Efficiency and Productivity, Rose Robertson, has been appointed and she will be working closely with management accountants from each CHP. It was acknowledged that the sooner the CHP identifies some of its savings the better however Ms. Potter concluded that the thought process is drying up and that we need to have a different conversations with finance colleagues. She added that discussions around savings is ongoing at every NHS Fife Strategic Management Team (SMT) meeting. Ms. Potter said that the priority across NHS Fife is to identify just over half of the £6M target for this year. All finance managers are discussing how to take a different approach for the coming financial year in addition to

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ACTION

talks taking place at SMT. She said that major changes are required and finance managers will be looking at corporate services and redesign. Chair said that the analysis has been done, we know the problems and now need to move on to solutions. Capital Expenditure Report Ms. Potter said that the CHP had a budget of £1.5M for this year and, to date, £706k has already been spent on work at Cameron.

Rheumatology High Cost Drugs Review Mrs. Bett spoke to her paper and the action plan that has been prepared as a result of the review which took place a year ago. She said that the proposal to have pharmacy input has been taken forward. It has been agreed that an area with such a high level of drug usage should have a pharmacist as part of the team. Dr. Gibson has been raising this and the review highlights this need. Ms. Potter stated that there is no additional funding available for this post but it should be seen as an invest to save situation. She said that we may see costs coming down in line with this appointment but it is a work in process. The financial position shows that, even after additional £900k funding there remains a £105k overspend and a prediction would be £1.4M overspend by the end of the year. Since the proposal has been supported by the Prescribing Efficiency Group it was queried whether money could be used from the drugs budget. Professor Campbell asked if prescribing of these drugs has been evenly distributed amongst consultants. Mrs. Bett said that one consultant was slightly higher but that person did see more new patients. The service is attempting to restore that balance. Dr. Rodger said that, in terms of pharmacists, he is not sure such an appointment will provide savings. He said, where drugs are concerned, it is never an individual making a decision it is always a team. As there is no MCN for Rheumatology could this have been better done as a peer review. Mrs. Bett said that a pharmacist would have the ability to challenge prescribing practice and blood monitoring could be done more quickly by a pharmacist however this would save time and not money. With regard to the outlier situation Chair noted that it didn’t actually take into account patients moved from North East Fife to Tayside therefore is this a false figure? Mrs. Bett said that we are looking at repatriating patients from Tayside and will not be sending patients to Tayside in future. Mrs. Bett will go back and look at the figures. Chair asked what proportion of patients doesn’t meet the criteria and is it a big issue. Mrs. Bett said this is not a big issue which is more about evidence that hasn’t been recorded. Chair suggested that the appointment of a pharmacist would achieve a lot in the first instance but use of biologics in other services should be considered at a later date and

MP

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ACTION

therefore the post could be shared. Mrs. Porter said that we don’t yet have SMT approval to appoint to this post, only an agreement in principle from the Prescribing Efficiency Group. Mrs. Porter will be taking a paper on the proposal to SMT. The Committee noted the content of this report.

NHS Fife Balanced Scorecard/CHP Workplan Comparison 2014/15 Mrs Porter pointed out that the CHP Workplan is a live document and work in relation to achieving the CHP targets is ongoing. This CHP Workplan comparison to the Balanced Scorecard is the quarterly update as at June 2014. Table 1 in the paper shows where we are with targets and that we are off track with 6 out of 26 in the whole plan. It was noted that this includes both NHS Fife targets which relate to Kirkcaldy and Levenmouth and the CHP’S local targets. The report also gives an analysis of where we are off target. Breastfeeding at newborn - the target is 34% and, as in previous years we are slightly off target at 28%. This is being addressed by the Lead Nurse. Delayed discharge is as set out in to-day’s paper. Sickness Absence - despite a considerable amount of time being spent by managers and HR colleagues the 4% target figure has not been reached. This remains a priority for the CHP. Cognitive Behaviour – as stated in the paper the Mastermind Project (computerised Cognitive Behavioural Therapy) was rolled out in Fife in September. As we are currently slightly behind target we hope that this will allow us to make headway and hopefully meet the overall target by the end of the year. Outpatient attendance DNA rates – it is recognised that this cannot be tackled in isolation but needs a joint approach with Acute and GP colleagues. We are looking at new and innovative ways, including increasing use of technology to address this. Mrs. Porter summarised that there is nothing to be unduly concerned about, work is ongoing and the CHP is fully committed to attempting to achieve all targets. The committee was asked to note the report on the Balanced Scorecard/CHP Workplan.

40/14 ITEMS FOR INFORMATION

Clinical Governance Quality & Safety Group – 12th June 2014 Local Partnership Forum – 20th May 2014 PPF Reference Group - 2nd May 2014

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ACTION

Fife Health & Wellbeing Alliance Group – 11th June 2014 40/15 DATES FOR DIARY

Next Kirkcaldy & Levenmouth CHP Committee: Tuesday 11th November 2014, 1.30 p.m., Town House Kirkcaldy

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PRESENTATION – ‘DEMENTIA POST DIAGNOSTIC SUPPORT SERVICE’

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MATTERS ARISING

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GENERAL MANAGER’S UPDATE VERBAL

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ASSOCIATE NURSE DIRECTOR UPDATE VERBAL

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Tuesday 11th November 2014 Agenda Item No 9.1

IMPROVING HEALTH Teenage Pregnancy

1. PURPOSE OF PAPER

1.1 The purpose of the paper is to advise the K&L CHP Committee on the strategy to reduce Teenage Pregnancy rates in the Kirkcaldy and Levenmouth Area.

2. INTRODUCTION

2.1

As the Committee are aware the Teenage Pregnancy rate within K&L area exceeds the Fife and Scottish average.

2.2

Within the K&L CHP workplan an outcome measure has been set in relation to reducing the rate of Teenage Pregnancy consistently across the CHP to the Fife average.

2.3

One of the actions in relation to this outcome was to develop a strategy for K&L CHP to ensure that all aspects of the services were working towards a common goal.

2.4 The attached strategy (appendix 1) sets out areas of work which will be taken forward by Public Health Nursing and Sexual Health Fife in partnership with Fife Council and Voluntary Sector Partners.

3. RECOMMENDATION

3.1 The Kirkcaldy & Levenmouth CHP Committee is asked to:-

endorse the Teenage Pregnancy Strategy

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Kirkcaldy & Levenmouth Community Health Partnership

TEENAGE PREGNANCY STRATEGY 1. Outcome Within the Work Plan for Kirkcaldy and Levenmouth CHP, the following outcome

measure has been set in relation to teenage pregnancy.

Outcome

To reduce the rate of teenage pregnancy consistently

across the CHP to the Fife average (6.9 per 1,000)

2. Background 2.1 Whilst the teenage pregnancy rate for Under 16’s across Fife has been reducing

(see Diagram 1), there remain areas within Kirkcaldy and Levenmouth where the rate exceeds the Fife and Scottish averages (see Diagram 2).

Diagram 1 Diagram 2

2.2 The teenage pregnancy rate within an area is a barometer of the level of deprivation

within a community and a number of communities within Kirkcaldy and Levenmouth score poorly in relation to SIMD data, as well as teenage pregnancy.

Agenda Item 9.1-Appendix 1

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Within the Kirkcaldy Community Plan, four neighbourhood areas have been

identified using the SIMD data and their teenage pregnancy rates over the past 10 years mirror that:-

Gallatown and Sinclairtown

Templehall

Linktown and Inverteil

Burntisland Castle area Within the Levenmouth area, the areas of concern include Methil, Kennoway,

Buckhaven and Leven (see Diagram 3). Over the past 10 years, only seven interzones in Kirkcaldy and Levenmouth locations have been below the Fife average of 6.9 per 1,000.

Diagram 3

2.3 Whilst the focus is rightly on Under 16’s, the data is collected for Under 18’s

and Under 20’s and paint a similar picture for Kirkcaldy and Levenmouth, with both localities being outliers in Fife for both age groups.

3. Impact The impact of a teenage pregnancy, whether terminated or taken to full term,

is significant on a young person’s future prospects:- It can be detrimental to a young woman’s physical and mental health

and well being;

it limits education and career prospects;

it is linked with long term receipt of benefits, low income, low occupational status, divorce and large family size;

children born to teenage mothers suffer higher mortality rates and are more likely to live in poverty, engage in criminal behaviour and become teen parents themselves;

young men who become parents are twice as likely to live in social

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housing, receive benefits, have lower educational qualifications and earn less;

one fifth of teenage fathers have never lived with their child. Whilst there are mechanisms in place such as the teenage parent unit to

support teenage parents, the factors listed above indicate that in order to improve the outcomes for young people in Fife, the CHP should work to reduce teenage pregnancy.

4. Partnership Within Kirkcaldy and Levenmouth CHP there are a number of groups who are

working to reduce teenage pregnancy rates, however, two areas are leading this work:-

Public Health Nursing

Sexual Health Fife, incorporating Health Improvement These two areas have developed plans to take forward this key area of work

(see Driver Diagrams – appendix A & B). However, this work must be delivered in partnership with colleagues in Fife Council Education Service and Community Learning Development, along with voluntary sector partners.

5. Measures A number of measures of success have been set out within the attached

Driver Diagrams which will contribute towards the overall outcomes. 6. Consultation This Strategy will be shared with colleagues across Kirkcaldy and Levenmouth

CHP and external partners, including Education and Children’s Services. Heather Bett, Clinical Services Manager 22nd August 2014

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Agenda Item 9.1 - Appendix A

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Work in Partnership with Education and community partners to deliver against national and local policy. Fife Sexual Health & BBV Framework 2012-2015

Raise awareness of sexual health services at both local and national level. Participate in NHS Fife condom distribution scheme. Ensure clearly defined health improvement priorities aligned to corporate objectives, targets and strategic plans.

Ensure school nurses practice within local and national guidance and protocol and follow child protection guidelines relating to sexually active under 16 year olds.

Deliver sexual health drop ins in secondary schools offering support and guidance, condom distribution and pregnancy testing. Support Education staff to ensure young people feel confident to access sexual health services. Support education staff in tackling sensitive issues within schools.

Delivery of HPV as a core function. Operational procedure to ensure efficient and timely delivery of programme

Support and deliver HPV programme NHS Health Scotland

Regular team meetings to ensure staff confidence and highlight concerns/challenges

Commitment to ensure all staff have access to regular training updates.

Regular liaison with Education staff

National & Local data in relation to Sexual Health. SIMD Teenage Pregnancy Data (Scottish Government)

Workforce development and delivery plan that develops with service needs and makes efficient use of knowledge and skills. Young People Consultation. Narrative Evaluation. Teacher questionnaires.

Continuous quality improvement processes and robust evaluation. Staff Questionnaires. Feedback/ Reflective sessions

Delivery of single sex lessons to S3 pupils

Support and implement the sexual health strategy. Fife Sexual Health & BBV Framework 2012-2015

Safeguard Vunerable children and LAAC Getting it Right for Every Child (Scottish Government)

To support the delivery of a quality service which is intergrated across public health nursing and multi-agencies and will work to: Reduce unintended pregnancy rates by 2015 Reduce the rates of sexually transmitted infections by 2015 Increase Young peoples access to appropriate sexual health services. Ongoing Create a culture change surrounding sexual health and relationships. Ongoing Improve young peoples experiences of sexual health & relationship education. Ongoing

Outcome Primary Drivers Secondary Drivers Measures PDSA

Agenda Item 9.1 – Appendix B Driver Diagram: School Nursing: Sexual Health: Kirkcaldy & Levenmouth CHP

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1. INTRODUCTION

1.1 The Staff Governance Action Plan for Kirkcaldy and Levenmouth CHP has been

developed in partnership with local staff side representatives and seeks to improve the experience of staff working within the CHP.

1.2 The Plan has been adapted this year by the Local Partnership Forum to seek to make it

more meaningful and accessible to staff. The Plan has been amalgamated with Dunfermline and West Fife CHP plan as the Local Partnership Fora for the two CHP’s have merged.

1.3 The Action Plan is now a “living document” which is updated throughout the year

following LPF meetings to reflect progress towards improvement or to incorporate new initiatives. Examples of this include the communication with staff to share outcomes from the 2013 staff survey and the significant increase in staff completing the staff survey for 2014. Work continues to develop outcome measures which are both quantitative and qualitative which can demonstrate improvement in the staff experience.

2 Attached at Appendix 1 is the 6 monthly review of the combined Kirkcaldy / Levenmouth

CHP and Dunfermline and West Fife CHP Staff Governance Action Plan. This details the purpose, objectives and actions set by the Local Partnership Forum, together with timescales for outcomes and where appropriate the nominated lead individual and subsequent progress at September 2014.

2.1 This plan will form the basis of on-going review of Staff Governance activity for the CHP

to the end of year which is March 2015. 2.3 The end of the year review will also involve management, the Local Partnership Forum

and Area Partnership Forum and will be presented to the Committee once this is completed.

3. RECOMMENDATON 3.1 The Committee is asked to:

note the content of the Action Plan. Bruce Anderson Head of Partnership HR Directorate


Tuesday 11th November 2014 Agenda Item No: 10.1

PATIENT / STAFF EXPERIENCE

Staff Governance

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DUNFERMLINE & WEST FIFE / KIRKCALDY & LEVENMOUTH CHP

STAFF GOVERNANCE ACTION PLAN 2014-15

MID YEAR POSITION

Appendix 1

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STAFF GOVERNANCE ACTION PLAN 2014-15

A. WELL INFORMED

Leadership arrangements, at all levels, will ensure all staff has regular dialogue and communication and the opportunity to feed back on organisational issues.

All staff receives information about their organisation at regular intervals.

All staff has access to communication systems including electronic mail and will be provided with appropriate training.

PURPOSE - WHY? OBJECTIVE -

WHAT?

ACTION - HOW? BY WHEN?

MEASURE - OUTCOME?

LEAD OBJECTIVE STATUS

REVIEW DATE

All staff are aware of the 2020 Vision and Quality Ambitions.

That staff have had the opportunity to contribute to the shaping of the future NHS Fife workforce.

Engage with staff to hear their views on how we achieve the Quality Ambitions for safe effective and person-centred care and progress towards the challenges in achieving the 2020 vision that everyone in the CHP’s is able to live longer, healthier lives at home or in a homely setting.

Through effective communication, which will include staff/team meetings, staff engagement meetings, Dispatches, and electronic communication staff will be informed and appraised of issues that are pertinent to them and the wider implication for service delivery.

As new discussion topics emerge, discussion groups will be arranged to allow staff to participate in the discussion about the future shape of the service they provide, within the content of the needs of workforce.

March 2015 Through the Staff Survey we should see an improvement in staff satisfaction.

Staff will feel better informed about the business of the organisation. As a result of being better informed staff will feel great “ownership” of the service they provide. During time they will feel valued both for their contribution to that local service and to the wider services within NHS Fife.

CHP General Manager

Co Chair, LPF

Service Managers

Staff

November 2014

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Ensure staff are aware of the Values of the Quality Ambitions.

General Manager, Associate Nurse Director and Governance Lead meeting with Service Leads and their teams.

Open Meetings with Staff – NHS Fife/ CHP Key Priority Area. November Staff Meeting dates have been identified and circulated. Staff involvement is outlined in the service improvement / delivery / work plans, LUCAP and Capacity Plan.

Opportunity to engage with staff to discuss the 5 priority areas as detailed in the NHS Scotland Everyone Matters: 2020 Workforce Vision (Implementation Framework and Plan 2014-15).

(This document has previously been issued to CHP staff.)

Staff will be able to report if they feel they are better informed, this should also be reflected in the staff survey.

December

2014

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PURPOSE - WHY?

OBJECTIVE - WHAT?


MEASURE - OUTCOME?


REVIEW DATE

To ensure that as communication to staff increases via email, all staff have access to a computer and the time to access email and intranet Ensure all staff have information and the opportunity to input into all Staff Governance activity.

Provide every CHP employee with an active NHS email account.

Provide CHP staff with access to a computer and time to check emails.

Ensure that where appropriate hard copies of newsletters are available for staff

CHP will promote the Staff Governance processes to all staff to ensure they understand both their own and the organisations responsibilities.

Request Managers ensure all staff who do not have active accounts establish them or, record that the employee has chosen not to have one. Ask staff who do not have access to active email accounts how they wish to receive information. Encourage service profiles to be updated on the intranet Promote Staff Governance activity during the Staff Engagement sessions, incorporate feedback into local plan Provide access to the Staff Governance standards, Staff Governance Action Plans, Agendae and Minutes of APF and LPF meetings and publish the NHS Fife and CHP Staff Survey Results.

March 2015

All staff who wish an NHS Mail account has one. Ensure hard copies of newsletters and communiqués are made available to staff. Ensure Service / Department profiles are up-to-date on the intranet. Provide timetable of Staff Governance activity throughout the year 2014/15. Provide feedback to staff on the National, NHS Fife and CHP Staff Survey results. Align CHP SGAP to results from staff engagement sessions. Q&As available to staff

CHP General Manager

Co Chair, LPF Service Managers Staff

November 2014

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PURPOSE - WHY?

OBJECTIVE - WHAT?


MEASURE - OUTCOME?


REVIEW DATE

Encourage all staff complete the NHS Scotland staff survey and ensure they are informed of results

Discussion of actions at LPF.

Promote what the LPF is and what it does.

Involve staff in change – NHS Fife/ CHP Key Priority Area.

Ensure staff have access to Minutes of LPF meetings. Encourage Managers to release Staff Side to work alongside managers at specific sessions to discuss Staff Governance and Staff Survey results. Hold staff engagement open drop in sessions on different sites within CHP with members of Management Team and Staff Side.

March 2015 The five NHS Fife actions from the Staff Survey results, together with local actions, are incorporated into this SGAP, which is a standing item on the agenda for discussion at each LPF. The format of the LPF Agenda now mirrors headings to those of the SGAP. Encourage staff to discuss openly and honestly with Managers and Staff Side the issues that are important to them. Review of SGAP performance at review dates.

CHP General Manager


November 2014

Ensure staff are aware of Getting Better in Fife agenda and the implications for their own areas of practice

To inform and support multi-disciplinary approach to this Actively encourage staff to promote their successes.

Discuss in local staff meetings and training sessions and ensure robust membership in various work streams Regular updates on Dispatches and CHP Staff Newsletter from the staff to the staff. Record and share number of compliments received within departments – Encourage sharing of Best Practice.

March 2015 Evaluate membership of work stream initiatives Local actions are reported on and feedback provided to staff during staff briefings and staff engagement sessions

November 2014

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Support the integration of Health and Social Care

Ensure that staff are aware of the newsletters and actions of various work streams.

Through the Joint Health and Social care Learning and OD group support multi-agency organisational and workforce development. Support the delivery of the Health and Social Care Integration Organisational Development Plan

Regular updates at staff engagement sessions. Hard copies of newsletters available

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B. APPROPRIATELY TRAINED - 2014-15 ACTION PLAN

Organisations will implement the Education, Training and Lifelong Learning Strategy Learning Together. There will be equity of access to training irrespective of working arrangements or profession. Resources including time and funding will be allocated to meet the training and development needs identified

locally.

PURPOSE - WHY?

OBJECTIVE - WHAT?


MEASURE - OUTCOME?


REVIEW DATE

To ensure all staff have the opportunity to consider their learning and development needs with their manager to ensure they are appropriately equipped to deliver high quality services to patients / service users.

All staff have a KSF Personal Development Plan.(PDP) and the opportunity to review annually

Established KSF/PDP systems are in place with annual reviews. Ensure local areas have a timetable for reviews to enable timely reviews to take place within a twelve month period. Review regular CHP RAG status reports provided. Introduce monthly reports by Service and consider local target schemes.

March 2015 All CHP staff have had at least one PDP review meeting with their line manager. Their PDP is agreed and signed off electronically Achieve 80%, it’s hoped each Department will increase by 25% between now and the year end. By ensuring staff have their education and training needs met, will contribute to the positive experience for patients. All new starts to clinical area will have an induction plan in place that provides an overview of the service and their contribution. Staff who are in a promoted post will have an induction plan tailored to meet their needs.

CHP General Manager

Co Chair, LPF. Service Managers Staff

November 2014

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PURPOSE - WHY?

OBJECTIVE - WHAT?


MEASURE - OUTCOME?


REVIEW DATE

To ensure CHP staff can meet their PDP learning requirements through the provision of accessible, flexible, cost effective and user friendly learning and development opportunities.

Within CHP, continue to develop our learning infrastructure, lifelong learning and e’learning capacity to optimise learning opportunity and equality of access.

CHP subject experts continue to work with Training Department to develop e’learning materials. Continue to encourage staff to undertake SVQ to support HCSW development. Encourage staff to attend PLT sessions and open service events to other disciplines.

Ensure staff can meet their PDP learning requirements. All staff will have attended any training to ensure that they can fulfil their clinical role. Via OD Department, the CHP will collate figures to understand the number of staff that are accessing e’learning materials.

CHP General Manager/Co-Chair, LPF

Service Managers / Staff

To ensure NHS Fife’s Leadership and Management capacity and capability is developed in line with organisational needs

The provision of targeted leadership and management development activities. To demonstrate equality of opportunity in relation to leadership training

Ensure the development and delivery of a range of Leadership and Management Development Programmes.

Collaborative Leadership Programme

Leading and Managing in Action Middle Manager Development Programme)

Foundation Management Programme.

March 2015 Number of programmes / participants Programme evaluation Number of participants from CHP attended

CHP General Manager


November 2014

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RCN Programme

Work with SCNs and managers of Admin & Clerical staff to identify development needs of individuals.

Work with staff to maintain NHS Fife HAI Standards.

All appropriate staff are aware of and appropriately trained to maintain HAI standards.

Service Managers

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C. INVOLVED IN DECISIONS WHICH AFFECT THEM

All staff have the opportunity to be involved in planning and development decisions which affect them.

A framework for partnership working including local and area partnership forums will exist to enable staff involvement through their trade union / professional organisation representatives.

Service developments will be planned in partnership with full consideration to workforce issues which will be costed and included as standard practice.


WHAT? ACTION - HOW? BY

WHEN? MEASURE - OUTCOME?


REVIEW DATE

Service development and organisational changes are planned and implemented in partnership with effective staff engagement.

To maintain effective involvement of staff and staff side organisations as key stakeholders in the CHP/area, through their involvement in service developments, redesigns and reviews and as a result, Patient Care Benefits.

To develop and maintain a culture and system of partnership, where two way communication is encouraged.

Ensuring the following are achieved:

Staff are consulted about changes at work.

Staff have the opportunity to put forward new ideas or suggestions for improvement in the workplace.

Staff feel confident that their ideas or suggestions will be listened to.

Staff are given the opportunity to attend staff briefing sessions on Health & Social Care Integration.

March 2015 & Ongoing

Staff Governance Self Assessment Tool evidences;

100% of PDP’s undertaken demonstrate true staff engagement (staff are consulted, listened to and contribute to service improvements).

Staff engagement is outlined in 100% of service improvement / delivery / workplans, LUCAP and Capacity Plan.

A reduction in patient complaints – target to be set

CHP / area General Manager Service Managers CHP / area General Manager PFPI Lead

H

H

H

H

November 2014

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To ensure that all staff are informed regarding key objectives of the organisation & their department.

To ensure staff feel encouraged, motivated and supported at work – NHS Fife / Key CHP Priority Areas.

Staff have a choice in what they do at work.

Patient care is a key priority.

CHP manager and Co-Chair of Local Partnership Forum will hold briefing sessions throughout CHP/area. Senior staff will frequently carryout walk-a-bouts, engaging with staff across CHP.

Evaluation of communication systems and processes demonstrate they are effective.

Evaluation of service improvement, delivery and redesign demonstrates safe and effective change management that has led to significant patient care improvements.

Improvement in attendance rates and staff feedback demonstrate engagement with staff across the CHP/area. Feedback from staff survey and briefing sessions indicate visibility of senior staff in clinical areas.

PFPI Lead Service Managers CHP / area General Manager

Co-Chair

CHP/area

General Manager

H

H

H

H

H

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D. TREATED FAIRLY AND CONSISTENTLY

NHS Scotland will be exemplar employer with best practice human resources policies and procedures in use.

Employees within NHS Scotland will be treated fairly and consistently with PIN Guidelines being exceeded or met wherever they work in the service.

Staff within NHSScotland can expect security of employment throughout the modernisation agenda and organisational change.

PURPOSE - WHY? OBJECTIVE - WHAT?


MEASURE - OUTCOME?


REVIEW DATE

To ensure that all staff are informed regarding their key contractual rights and can maximise their employment experience in NHS Fife through their awareness of and access to HR Policies as and when they may need them.

Ensure that all CHP staff have access to NHS Fife HR policies.

That these policies are regularly reviewed and are fit for purpose and meet or exceed both legal standards and the minimum standards set out in NHS Scotland Partnership Information Network (PIN) Policies.

Staff have access through the intranet on all HR policies. Local arrangements are in place for those who have no IT access Develop, implement and review HR policies on an ongoing basis using the HR review timetable. Ensure NHS Fife HR Policies meet or exceed the minimum legal standards for employment law and the standards established in the NHS Scotland PIN Policies and amend any which require revision.

Ongoing

Hard copies are available via line managers ensuring understanding of relevant policies Provide updates at APF and LPF of new or updated policies. Demonstrated knowledge / evidenced discussions through local Management Groups.

CHP General Manager

APF/LPF Staff Managers

March 2015

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Ensure the NHS Fife Intranet site provides easy access to the latest HR policies.

To ensure all Managers are informed regarding the consistent application of HR polices in the process of Management of Attendance

Support staff to attend work effectively and achieve the SGHD HEAT Standard of below 4% staff sickness absence

Improve sickness absence rates in all business areas by achieving lower monthly absence outturns than the 2013/14 figures. Ensure local managers implement all policies consistent and fairly. Provide appropriate training in Attendance Management by HR and Staff-side Colleagues in Long Term Absence, Complex Cases, Managing with Confidence and Refresher Training. Line Managers are encouraged to undertake routine referral to OHSAS and to undertake Return to Work Interviews.

March 2015

Active CHP Attendance Management Groups which meet bi-monthly. Evidence of shared learning through minutes of the group. Reporting of progress in standards and training through LPF, Local Management Groups and CHP Committees. Manager will attend attendance management training. Total Managers trained in last two years –

D&WF – 126

K&L - 27 Reporting of progress through local Attendance Management Groups and Audit.

Co Chair, LPF Service Manager Service Managers

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All staff returning to work following a period of absence will meet with Manager for face to face return to work interview.

Service Managers

Support staff to maintain their health allowing them to attend work effectively.

Support staff to attend work effectively and achieve the SGHD HEAT Standard of below 4% staff sickness absence.

Re-launch of Dignity at Work Toolkit to support staff and Promotion of the Stress at Work Toolkit. Employee booklet on “Sick Leave and what you need to know” was developed and circulated to all staff. Departmental information regarding Attendance shared.

March 2015

Reporting through local Management Groups and awareness sessions through Attendance Management Group. Promoted through Dispatches and available on Intranet. The distribution of this book was reported through Fife-wide Management of Attendance Group. Publicity returns posters to highlight figures monthly in ward/department to encourage morale.

All Service Managers

Staff

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E PROVIDED WITH AN IMPROVED AND SAFE WORKING ENVIRONMENT

Organisations will implement the Occupation Health and Safety Services Strategy ‘Towards a Safer, Healthier Workplace’.

Resources including time and funding will be allocated to meet the Health and Safety Strategy agreed and audited annually by the local Health and Safety Committee / Board or Partnership Forum. These resources will be applied on an equitable basis irrespective of working arrangements or profession.

NHS premises will be fit for purpose and the personal safety of patients and employees will be paramount in the design and operation of the service.


WHAT? ACTION - HOW? BY

WHEN? MEASURE - OUTCOME?


REVIEW DATE

A workforce with staff who have a healthy work life balance, are able to deliver the highest standards of care to patients and service users.

DWF and KL CHP contributes to NHS Fife Healthy Working lives award scheme, ‘Well at Work’ which supports the aim of achieving Silver Award status. (The overall outcome of Silver is that it enables you to demonstrate that your organisation has put in place the policies, procedures and practices which allow everyone to become engaged in protecting and improving their health, safety and wellbeing.) NHS Fife must; 1 Implement written policy/policies on alcohol and drugs which give employees

Staff Survey undertaken. A corporate action plan will be written with timescales and identified corporate

December 2014

October

2014

2013/2014

Staff survey completed December 2013 Report analysed and information provided by CHP and Corporate divisions. Report presented to Staff governance group. (2014) Staff will be provided with a corporate response to the points raised in the survey and issues raised by staff will be notified to relevant departments and services at corporate level Corporate action plan is in place and a portfolio of activity is being compiled

Janie Gordon

Dianne Williamson

Ongoing

January 2015

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clear guidance around the use of or under the influence of alcohol and drugs in the workplace. 2 Develop and implement documented policies/procedures on attendance management and integrate into existing policies. 3 Develop and implement documented policies/procedures on avoiding accidents, incidents and near misses in the organisation and integrate into existing policies. 4 Promote the benefits of a balanced diet and facilitate/enable opportunities for employees to eat more healthily. 5 Promote the benefits of physical activity and promote and/or provide opportunities to encourage employees to be/become physically active within and

leads. D&WF and KL CHP will ensure that healthy working lives silver award criteria as drafted into the corporate NHS Fife action plan is taken forward which will maintain and support bronze criteria outcomes and achieve silver award outcomes.

to enable submission in October for the Silver Award. This includes ensuring a range of policies are up to date and in place NHS Fife has hosted three health and safety events of which was supported and attended by DWF CHP. DWF and KL CHP have supported local healthy eating initiatives and information campaigns. Healthy eating campaign and quiz for staff. A Fife-wide communications group is established and responsible for the update of the well at work web pages and information to staff via other means such as notifications in payslips, well at work leaflet, regular emails and correspondence and updating of the notice boards (Carnegie Clinic, Lynebank Hospital and Linburn Road Surgery) DWF KL CHP activities are reported to this group

November 2013

Ongoing September 2014 Ongoing participation

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outwith work. 6 Provide managers and supervisors with training to increase their knowledge and understanding of mental health, wellbeing and stress in the workplace. Ensure managers are aware of their responsibilities in relation to employee support. The scheme aims to support our employees to achieve a healthy work-life balance. Ensure that all CHP staff have the opportunity and are encouraged to participate in Well at Work initiatives.

for inclusion on intranet. Updating notice boards with corporate information. Mental health, healthy eating, physical activity, highlighting staff policy DWF CHP hosted a PLT staff well at work day which promoted a range of health topics for staff including; physical activity, alcohol, drugs, sexual health managing weight and healthy eating for the individual and family. Two walks were led round the hospital grounds and a Tai Chi session was offered. In addition every staff member was offered a health check; involving blood pressures, screening for risk factors and mental health. Silver Award submission due for October 2014.

Ongoing September 2014 October 2014

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Staff are entitled to attend work without the fear of being verbally or physically abused

Ensure staff are trained on ways to deal with violence and aggression in the workplace.

Ensure staff record all incidents of violence and aggression incidents.

Ensure appropriate action is taken to protect staff from Violence and aggression in the workplace.

Ensure that staff are aware of recording mechanisms for ‘hate incidents’ and the support measures in place.

Ensure that staff have an outlined understanding of the issues within the Government Counter Terrorism Strategy, CONTEST and how it appertains to working with communities.

Ensure staff avail themselves to ARGUS & WRAP training as available.

Provide staff with training to manage Violence and Aggression. Provide training to staff on how to log incidents on Datix Web. Additional de escalation training Ensure staff who report incidents get feedback of the outcomes Disseminate corporate guidance. Disseminate corporate guidance compiled by Violence and Aggression Forum Respond to adverts place on Dispatches for available places.

March 2015

Produce reports from Datix Web to track the number of recorded incidents of Violence and Aggression against staff. Commit to a continued reduction in incidents and injuries. Report bi-monthly to LPF, report regularly to staff in local staff engagement sessions Monitor DATIX performance reports provided by Violence and Aggression Forum. Consider update reports as provided by Violence and Aggression Group. Violence and Aggression Forum to provide statistics of attendees across CHP.

Davina Clark H&S Advisor CHP General Manager

CHP General Manager

November 2014

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Ensure that staff are made aware of revised Corporate ‘Pledge’ to be re-circulated during November 2014.

Ensure that ‘White Ribbon’ is effectively marketed within CHP and that male members of staff are actively encouraged to attend training events.

Local awareness raising and marketing. Positively market White Ribbon and encourage attendance at seminars.

Support materials to be provided by the Violence and Aggression Forum. Seminars and materials to be provided by the Violence and Aggression Forum.

Develop and then implement annual local action plans for Health & Safety and HAI plans.

Infection Control Annual Rolling Work Plan addresses priorities in the NHSS HAI Delivery Plan. New HAI directives in CELs and CNO letters have individual action plans with progress and completion recorded on an HAI National Guidance Register. Action plans reported via the Infection Control Committee (ICC) to Clinical Governance Committee (CGC) An antimicrobial strategy drives prescribing guidance to reduce development of

National HAI HEAT targets (C difficile (CDI) and SAB/MRSA) MRSA Screening KPIs. Antimicrobial prescribing national HEAT target supporting indicators

March 2015 Monitor performance against National HAI standards by audit. Evidence implementation of the procedure for SABs and CDiff. Ensure staff are trained in accordance with NHS Fife Standards. The HAI Inspection Coordinating Group is responsible for taking forward work to ensure compliance with NHS Quality Improvement Scotland (NHS QIS) Healthcare Associated Infection (HAI) Standards (2008), in preparation for Healthcare Environment Inspectorate (HEI)

November 2014

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resistant organisms and CDI.

inspections. Work includes review of estates issues, training and education, clinical practices, equipment and cleaning. The group includes representation from Infection Control, Estates and Facilities, Clinical Directorates, CHPs.

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PATIENT / STAFF EXPERIENCE PPF Reference Group Verbal

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11th November 2014 Agenda Item No: 11.1

PLANNING FOR SERVICE IMPROVEMENT Townhill Day Hospital

1. INTRODUCTION 1.1

This amalgamation of services in West Fife is best considered within the context of an ongoing review of the usage of accommodation for clinical services. This review has been necessary to ensure that we are using our resources to the maximum benefit to patients.

2. BACKGROUND 2.1 From the 1980s until this year the Mental Health Services in Dunfermline and West

Fife have operated two Day Hospitals for Older People. Forthview Day Hospital has been based within Phase 1 of Queen Margaret Hospital and adjacent to other Mental Health Services including in-patient wards and community services. Townhill Day Hospital has been a stand-alone facility, situated one mile from Queen Margaret Hospital.

2.2 Although historically there does not appear to have been a specific strategy for

having two centres, the Day Hospitals have developed very differently. Forthview has offered a range of therapeutic and diversional activities for older people with a variety of diagnoses including those with functional and enduring disorders as well as those with cognitive impairment, including Dementia. Townhill has provided primarily a day care facility for a much smaller group of patients, all with significant Dementia.

2.3 In February 2014, in a change precipitated by an acute staff crisis, Forthview and

Townhill Day Hospitals were amalgamated. 3. ANALYSIS 3.1 Impact on Patient/Carers

The potential for any negative impact on patient and carers from the amalgamation was mitigated by the hard work and sensitivity of both nursing teams. Despite the short notice, the change was managed smoothly and effectively. Every carer was given written notification of the change which included an invitation to contact the Clinical Services Manager with any questions or concerns should that be necessary. Carers were given telephone, email and postal address details. No contact has been made subsequently by patients or carers.

3.2 There have been a number of positive outcomes of the amalgamation. Staff have worked with patients and carers to ensure that all patients have had a new health needs assessment. This identified those who were no longer able to cope at home with available services, as well ensuring a better match of need against the care

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being offered. In general, there has been a reduction in travel time for patients travelling by ambulance (which is most) because we now have only one destination and collection point. Clinical staff report that patients who previously attended Townhill are benefiting from the environmental stimulation and increased social interaction and that they are responding positively to the increased structure and group work provided under the Forthview model.

3.3 Activity

During the year 2013-14, there was an overall reduction of 40% of new patient referrals and a reduction of 15% in attendances. This trend of reducing referrals and attendances is part of a longer trend. It is also worth noting that of the cohort of 32 patients who had attended Townhill at the time of the amalgamation, 27 have now been discharged into other day care or residential settings within the community - assessed as better meeting their needs.

4. STRATEGIC SERVICE DELIVERY CONSIDERATIONS

4.1 Although always aiming to match local need with local provision, we are currently working hard to address some historical variance in the way mental health services are delivered. In Dunfermline/West Fife there is a slight anomaly in that we continue to have more resource committed to Day Hospital Care than in other parts of Fife. For example in the rest of Fife, Day Services are provided differently within North East Fife, where Day Hospital services have been reduced to a minimum in order to release resource into community services, whereas in Central Fife, Day Hospital staff also provide liaison to local care homes and support to young onset dementia sufferers. In many areas of Scotland, Mental Health Services no longer provide Day Hospital Care at all.

4.2 In recent years clinical opinion has changed somewhat in terms of Day Hospital care

for people with Dementia. There is a concern that removing people from the familiarity of their home can disorientate and distress those with significant cognitive impairment. Also that it is difficult to assess individuals, outwith an environment which is familiar to them, and in an environmental setting which is not capable of replicating the impact of, for example, diurnal variation on the condition. Having said that Day Hospitals still have much to offer older people in terms of assessment, care and treatment, as well as support to those who struggle with isolation and loneliness. They are also a valuable respite resource and will continue to make an increasing contribution to the psychological therapies agenda.

5. IMPACT ON OTHER SERVICES 5.1 Facilities – Amalgamation has enabled the release of Townhill’s Domestic Staff into

the QMH resource. Estates – At this time our Estates Department continue to maintain the Townhill site. Scottish Ambulance – Amalgamation reduces the volume of patient transport required to support the Day Hospital. Telecoms – At this time the phone lines remain live but telecoms management are keen to re-route to allow use of the resource.

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Report by: Graham Monteith Acting General Manager, Mental Health Service Kirkcaldy and Levenmouth CHP

6. ENVIRONMENTAL CONSIDERATIONS 6.1 Forthview is situated within Queen Margaret Hospital with adjacencies with Ward 1

Old Age, Admission Assessment Ward and Old Age CPN Services. It is close to the General Adult Day Hospital and Continuing Care Wards. It is supported by and contributes to the duty senior nurse system and has easy access to medical staff. Although it is contained within a relatively small space, it has an adequate variety and number of rooms to allow staff to work therapeutically with patients on a group or individual basis.

6.2 Townhill operates from an old building around one mile from Queen Margaret

Hospital. The building has numerous problems with heating and plumbing and its isolation creates obvious difficulties with service provision. It does not lend itself easily to providing a range of therapeutic interactions and is in fact a building which is no longer deemed fit for purpose.

7. CONCLUSION 7.1 Whilst the timing of the change has been accelerated by acute staffing shortages, the

amalgamation of the two hospitals appears to have been a success in that it has enabled an enhanced level of service to be offered to those patients whose needs are best met by an NHS Day Hospital service. The opinion of clinical staff is that the merging of the service has had clear clinical benefits for patients.

8. RECOMMENDATION 8.1 The Committee is asked to:-

• Note the content of this paper.

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Tuesday 11 November 2014 Agenda Item No 11.2

PLANNING FOR SERVICE IMPROVEMENT Consultation of the Future Provision of Services based at Fair Isle Clinic.

1. PURPOSE OF PAPER

1.1 The purpose of the paper is to advise the CHP Committee of a proposal to consult about the future provision of healthcare services currently provided from Fair Isle Clinic.

2. INTRODUCTION

2.1

Fair Isle Clinic provides the following community based services:- Child Health Occupational Therapy Children and Adolescent Mental Health Services (CAMHS) Speech and Language Therapy (SALT) Podiatry Services

Dental Services and a baby clinic were provided from this building however they have relocated in the last 12 months.

2.2 Whilst the services are located in Templehall, they provide services to patients from throughout Kirkcaldy.

2.3 For a number of years it has been acknowledged that Fair Isle Clinic does not provide an environment conducive to delivering quality services. Minor upgrades have been carried out as required, often after vandalism has occurred, but it is clear that a significant investment is required to make the building fully fit for purpose.

2.4 In addition, there are health and safety risks for the staff working in this location.

2.5 Due to the level of backlog maintenance, the current building is not fit for purpose and therefore a “do nothing” option is not appropriate. In order to identify possible options for future service provision, it is proposed to engage with stakeholders including service users and the general public.

2.6 Discussions have been held with the Scottish Health Council on how we should progress with a public consultation exercise regarding this potential service change.

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3. PUBLIC INVOLVEMENT & COMMUNICATION PLAN

3.1 There are a number of guidance documents relating to public consultation; Informing, Engaging, Consulting People in Developing Health and Community Care Services (CEL4 (2010)). This sets out the relevant legislative and policy frameworks for involving the public in the delivery of services. It clarifies the role of the Scottish Health Council; provides a step-by-step guide through the process of informing, engaging and consulting the public in service change proposals and explains the decision making process with regard to major service change and the potential independent scrutiny. National Standards for Community Engagement. The National Standards for Community Engagement (also available from the Scottish Community Development Centre) were launched in May 2005. They set out best practice principles for the way that government agencies, councils, health boards, police and other public bodies engage with communities. Healthcare Improvement Scotland/Scottish Health Council Major Service Change Guidance (2010). This Guidance sets out how NHS Boards should inform, engage, and consult their local communities about proposed service changes. This guidance aims to provide NHS Boards, and their communities, with a framework that will assist them in identifying potential major service changes. It is intended that the guidance will help Boards to stimulate discussion amongst key stakeholders to establish if there is a consensus view. Equalities Impact Assessment. An Equality Impact Assessment is a key tool in tackling inequalities, as well as ensuring that public sector organisations consult with the public regarding significant change and ensure that the plans of NHS Boards achieve their outcomes and mitigate negative impacts on individuals. EQIAs are legislated under the Equalities Act 2010, other documentation in support of the EQIA process include the Christie Report, NHS Quality Strategy, Equally Well and the Human Rights Act 1998.

3.2 In response to the above guidance the attached communication and engagement strategy and action plan has been developed (appendix 1).

4. RECOMMENDATION

4.1 The Kirkcaldy & Levenmouth CHP Committee is asked to:-

note the Communication and Engagement Strategy Plan.

REPORT BY: HEATHER BETT CLINICAL SERVICES MANAGER

http://www.scotland.gov.uk/Topics/Built-Environment/regeneration/engage/HowToGuide/NationalStandardspdf

http://www.scdc.org.uk/national-standards-community-engagement/

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Kirkcaldy & Levenmouth CHP

Fair Isle Clinic

Communication and Engagement

Strategy and Plan

April 2014 to June 2015

Agenda Item 11.2-Appendix 1

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1. AIM

The purpose of this document is to advise of a proposal on how we will review the services currently provided from Fair Isle Clinic. There have been a number of concerns about the accommodation at Fair Isle Clinic and its suitability to provide healthcare. However, the CHP Management Team acknowledges that it is in an area of deprivation and may have a particular importance to the community. Fair Isle Clinic currently provides the following community based services:- Child Health Occupational Therapy Dental Services Children and Adolescent Mental Health Services (CAMHS) Speech and Language Therapy (SALT) Baby Clinic Podiatry Services Whilst the services are located in Templehall, they provide services to patients from throughout Kirkcaldy. For a number of years it has been acknowledged that Fair Isle Clinic does not provide an environment conducive to delivering quality services. Minor upgrades have been carried out as required, often after vandalism has occurred, but it is clear that a significant investment is required to make it fully fit for purpose. In addition, there are health and safety risks for the staff working in this location.

2. OBJECTIVES The project’s main objective is to provide a fit for purpose environment for the above services. Due to the condition and age of the current building is not a fit for purpose environment. To ensure that we fully involve all key stakeholders in the development of the project and agree a preferred option for going forward.

To ensure that the staff and the local communities feel fully informed and involved in all the activities of this project, understand our roles and responsibilities and how we will work in partnership with our key partners and stakeholders. To ensure that the Fair Isle Project Team communicate in a clear, timely and meaningful manner, enabling staff and the local people to make informed decisions on the preferred option.

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3. PROJECT TEAM

A Project Team, Chaired by the Clinical Service Manager for Sexual Health, membership comprising of representatives from each of the services within Fair Isle, Estates & Facilities, Equality & Diversity Co-ordinator, the Scottish Health Council and the CHP Risk Manager/Lead for PFPI, has been set up to take this work forward. The Project Team have started work in their data collection, analysis, Equality Impact Assessment and Service Change Template. The completion of these pieces of work will inform how we develop our communication and engagement plan. The Project Team have prepared a National Standards for Community Engagement Mapping Exercise, Communication & Engagement Commitment Timetable, Project Work Plan and Timeline for this work to be completed. The reporting and governance arrangements for this project will be through Kirkcaldy & Levenmouth and Dunfermline & West Fife CHP Management Team and CHP Committees.

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4. COMMUNICATION & ENGAGEMENT PLAN

The Communication and Engagement Plan has been developed in line with the following national requirements: Informing, Engaging, Consulting People in Developing Health and Community Care Services (CEL4 (2010)) sets out the relevant legislative and policy frameworks for involving the public in the delivery of services. It clarifies the role of the Scottish Health Council; provides a step-by-step guide through the process of informing, engaging and consulting the public in service change proposals and explains the decision making process with regard to major service change and the potential independent scrutiny. The National Standards for Community Engagement were launched in May 2005. They set out best practice principles for the way that government agencies, councils, health boards, police and other public bodies engage with communities. A mapping against these standards is attached at Appendix 1. Our key objectives at each stage of our plan are:

Stage 1: Inform To explain the case for change, the project’s main objective is to provide a ‘fit for purpose’ environment for the services currently provided at Fair Isle Clinic. Stage 2: Engage To develop the options in partnership with all interested parties on how we can provide a ‘fit for purpose’ environment for the services currently provided at Fair Isle Clinic. Stage 3: Consult To undertake a three month consultation on the preferred option for providing the services currently provided at Fair Isle Clinic. To communicate the decision of the CHP Committees with an outline timetable for implementation.

http://www.scotland.gov.uk/Topics/Built-Environment/regeneration/engage/HowToGuide/NationalStandardspdf

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4.1 Who do we need to communicate and engage with?

Excellent communications and engagement with internal audiences, GPs, clinical members, our partners and the public will play a key role in securing agreement on the way forward for Fair Isle Clinic. The project team will need to foster close relations with four key groups:

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4.2 Key communications and engagement commitments 4.2.1 Timeline

Stage 1: Inform To explain the case for change, the project’s main objective is to provide a ‘fit for purpose’ environment for the services currently provided at Fair Isle Clinic.

Month Proposal

September & October

Meetings / Events with the stakeholders:

November Preparation of the feedback/information received to date. Preparation of the programme for the Option Appraisal Exercise

Communication message

To outline why we are undertaking this exercise To ensure we have involved all stakeholders in the development of this project To outline the process for option appraisal exercise.

Stage 2: Engage To develop the options in partnership with all interested parties on how we can provide a ‘fit for purpose’ environment for the services currently provided at Fair Isle Clinic.

Month Proposal

December Option Appraisal Exercise: one of two events Stage 1: brainstorming – identify and agreeing the options

January Option Appraisal Exercise: one of two events Stage 2: scoring the options and agreeing our preferred option to go to the CHP Committees Preparation of final consultation document


To discuss and agree impact of all options. To agree preferred option. To communicate preferred option.

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Stage 3: Consult To undertake a three month consultation on the preferred option for providing the services currently provided at Fair Isle Clinic. To communicate the decision of the CHP Committees with an outline timetable for implementation.

Month Proposal

February to April

Three month consultation period on the preferred option.

May & June Preferred option submitted to the CHP Committees and feedback to all the stakeholders outlined in 3.1


To outline the process of how a decision has been reached with regards to final option for consultation. To outline process for agreement on preferred option. To outline implementation plan and timescale for preferred option.

4.2.2 Communication & Engagement Commitment Timetable

A detailed Communication & Engagement Commitment Timetable of meetings and events has been prepared and will continue to be developed as part of the Communication & Engagement Plan.

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4.3 Communication Approach

There are number of ways in which we will communicate the development and progress of the project:

Incorporate briefings/updates in staff newsletters Briefing sessions for staff, interest groups, local councillors, patients and

carers, etc Posters and comments cards available at various briefing sessions Reports and updates to the various groups and committees within the CHPs. Press releases Question & Answer Sheet Public meetings as required in suitable local venues and at times to suit public Use of social media

5. EVALUATION

Evaluation of the Project will be undertaken at various stages and will be directed and supported by the Scottish Health Council.

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APPENDIX 1 Fair Isle Clinic Proposal Community Engagement Mapping Exercise The Involvement Standard We will identify and involve the people and organisations who have an interest in the focus of the engagement

Indicators

Questions to consider

Management actions

All groups of people whose interests are affected by the issues that the engagement will address are represented.

Who are we trying to engage? Are we in contact with them? If not what do we need to do to establish contact? Who can help us?

Audience – Internal & External Stakeholders Staff Staff Side (Trade Unions) Managers and Clinicians of other co-located

clinical services Local Independent Contractors Public Partnership Fora Equality Participation Network Current users of facilities Local population Local Councillors Local Groups – Community Council, Voluntary Organisations Yes – we need to link with existing structures – CVS Fife, PFPI Leads, CHP Management Teams, Local Partnership Forums, Council colleagues, GPs, etc

Agencies and community groups actively promote the involvement of people who experience barriers to participation.

Agencies and community groups are actively promote the involvement of people from groups that are affected but not yet organised to participate.

The people who are involved, whether from agencies or community groups: want to be involved have knowledge of the issues have skills, or a commitment to developing skills, to play

their role show commitment to taking part in discussions, decisions

and actions attend consistently have the authority of those they represent to take decision

and actions have legitimacy in the eyes of those they represent

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maintain a continuing dialogue with those they represent.

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The Support Standard We will identify and overcome any barriers to involvement

Indicators


Management actions

The participants identify what support each representative needs in order to participate

What barriers might stop the people we want to involve becoming engaged? What resources do we have to overcome these barriers? What others resources might we need? How can we access them?

Access Information provision Cost Event – Provided in a venue which meets all accessibility requirements, eg. disabled access, hearing loop system. Provision of expenses as per CEL 8 (2009) – travel expenses, carer costs Provision of information in a variety of formats – large print, other languages, etc.

There are no practical barriers to participants in community engagement, eg. transport, access to premises, communication aids

There are no financial barriers to participants in community engagement, eg. expenses, transport, carers costs,

Community and agency representatives have access to the equipment they need.

Impartial professional community development support is available for groups involved in community engagement.

Specialist professional advice is available to groups involved in community engagement.

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The Planning Standard We will gather evidence of the needs and available resources and use this evidence to agree the purpose, scope and timescale of the engagement and actions to be taken

Indicators


Management actions

All participants are involved from the start in: Identifying and defining the issues that the engagement

should address, and the options for how to tackle them Choosing the methods of engagement that will be used

What evidence to we have access to that tells us about the needs we are trying to address and the resources that could be used? What other evidence might we need to gather and how can it be done? What does this tell us about what the purposes, scope and timescale of the engagement should be and the actions we should take?

Planning how the engagement will develop Discussion at event during the sessions of how this can be developed further as part of consultation process. Identify any gaps – people or organisations that are not present – how we ensure they have an opportunity to be engaged with process.

Participants express views openly and honestly

Participants agree on the amount of time to be allocated to the process of agreeing the purposes of the engagement

The purpose of the engagement is identified and stated, there is evidence that it is needed, and the purpose is agreed by all participants and communicated to the wider community and agencies that may be affected.

Public policies that affect the engagement are explained to the satisfaction of participants and the wider community.

Participants identify existing and potential resources which are available to the engagement process and which may help achieve its purpose(s)

Intended results, that are specific, measurable and realistic are agreed and recorded.

The participants assess the constraints, challenges and opportunities that will be involved in implementing the plan.

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The participants agree the timescales for the achievement of the purposes(s)

The participants agree and clarify their respective roles and responsibilities in achieving the purpose(s)

Plans are reviewed and adjusted in the light of evaluation of performance.

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The Methods standard We will agree and use methods of engagement that are fit for purpose

Indicators Questions to consider Management actions

The range of methods used is: acceptable to participants suitable for all their needs and their circumstances appropriate for the purposes of the engagement

How, where and when could we establish initial contact? Which approach would be most likely to attract those we want to involve? Which would reduce barriers to the greatest degree?

Informing Preparatory work required to provide information which can be issued to people/organisations so that they can make a decision if they want to be involved in events, consultation, etc. Engaging Organised events to prepare options appraisal and scoring these options Consultation – 3 month period Prepare consultation document and summary document Prepare key questions you need answered (similar to scot govt response questionnaire) Final version to be issued using a variety of methods to gain feedback. Fife Direct Consultation Diary Public Partnership Forums Equality & Participation Network Peoples Panel Issue to other internal and external list through agreed structures. Attendance at local meetings for excluded groups,

Methods used identify, involve and support excluded groups

Methods are chosen to enable diverse views to be expressed, and to help resolve any conflict of interest

Methods are fully explained and applied with the understanding and agreement of participants

Methods are evaluated and adapted in response to feedback

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elderly forums, etc.

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The Working Together Standard We will agree and use clear procedures that enable the participants to work with one another effectively and efficiently

Indicators


Management actions

The participants will:

How do we feel and what will make us confident about working with one another? What procedures do we need to put in place to ensure that we are working well together, efficiently and effectively?

Option Appraisal Exercise Provision of information prior to attendance at these sessions – aims and objectives. Clear understanding prior to attendance to what is expected at the end of these sessions. If they note their interest to attend they will be sent further reading material prior to attendance at the session, so that they can participate fully in discussion – make best use of time available on the day. At the start of the session – explain ground rules. End of session – time to reflect and prepare a way forward (action plan) who does what and by when. Agreement at session on how we will communicate with everyone to agree the consultation document. Administration support: Prior to and after session – one point of contact to avoid confusion around arrangements etc.

Behave openly and honestly, there are no hidden agendas, but participants also respect confidentiality

Behave towards one another in a positive, respectful and non-discriminatory manner

Recognise participants time is valuable and that they may have other commitments.

Recognise existing agenda and community obligations, including statutory requirements.

Encourage openness and the ability for everyone to take part by: communicating with one another using plain language ensuring that all participants are given equal opportunity

to engage and have their knowledge and views taken into account when taking decisions.

seeking, listening to and reflecting on the views of different individuals and organisations, taking account of minority views.

removing barriers to participation.

Take decisions on the basis of agreed procedures and shared knowledge.

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Identify and discuss opportunities and strategies for achieving change, ensuring that: key points are summarised, agreed and progressed conflicts are recognised and addressed.

Manage change effectively by: focusing on agreed purpose clarifying roles and who is responsible for agreed actions delegating actions to those best equipped to carry them

out. ensuring participants are clear about the decisions that

need to be made. ensuring that, where necessary, all parties have time to

consult with those they represent. Co-ordinating skills Enhancing skills where necessary Agreeing schedules Assessing risks Addressing conflicts Monitoring and evaluating progress Learning from one another Seeking continuous improvement in how things are done

Use resources efficiently, effectively and fairly

Support the process with administrative arrangements that enable it to work.

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The Sharing Information Standard We will ensure that necessary information is communicated between participants

Indicators


Management actions

Information relevant to the engagement is shared between all parties.

What kind of information and how much will we need to share with one another? What methods of communication will work for all the participants?

Information to be prepared on why we are looking at Fair Isle Clinic. Information to be prepared on invitation to attend Option Appraisal sessions. If they note their interest they will be sent further reading material prior to attendance, so that they can participate fully in discussion. Make best use of time available on the day. Information to be prepared on how they can book a place and also to provide us with information to support them in participating on the day (any special requirements). Time to prepare information in other requested formats.

Information is accessible, clear, understandable and relevant, with key points summarised.

Information is made available in appropriate formats for participants.

Information is made available in time to enable people to fully take part and consult others.

All participants identify and explain when they are bound by confidentiality and why access to such information is restricted.

Within the limits of confidentiality, all participants have equal access to all information that is relevant to the engagement.

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The Working with Others Standard We will work effectively with others with an interest in the engagement to the wider community and agencies affected

Indicators


Management actions

The participants in the engagement:

Who else has an interest in what we are doing? How can we work together with them to our mutual interests?

Ensuring that we involve all our partners in the Option Appraisal sessions/consultation process.

Identify other structures organisations and activities that are relevant to their work.

Establish and maintain effective links with such other structures, activities and organisations.

Learn about these structures, activities and organisations, to avoid duplication of their work and complement it wherever possible.

Learn from others and seek improvement in practice.

Encourage effective community engagement as normal practice.

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The Improvement Standard We will develop actively the skills, knowledge and confidence of all participants

Indicators


Management actions

All those involved in the engagement process are committed to making the most of the understanding and competence of both community and agency participants

What skills or knowledge do we all need to make the engagement work? How will we support participants to develop skills and knowledge they need? What will help everyone to feel confident about participating?

All participants have: background information on why we are

undertaking the review of Fair Isle Clinic. what is involved in the option appraisal process how to use weighting criteria to score options tools to assist them to participate, hearing loop

systems, advocacy support, other languages or formats

clear understanding of what has to be

achieved. Staff supporting the sessions need to have additional support in relation to facilitation of group work.

All participants have access to support and to opportunities for training or reflection on their experiences, to enable them and others to take part in an effective, fair and inclusive way

Each party identifies its own learning and development needs and together the participants regularly review their capacity to play their roles

Where needs are identified, the potential of participants is developed and promoted

The competence and understanding of the engagement system as a whole is regularly evaluated by the participants as it develops

Resources, including independent professional support, are available to make the most of the competence and understanding of individual participants and the engagement system as a whole

There is adequate time for competence and understanding to be developed

Methods used to improve competence and understanding

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reflect diverse needs and are fit for purpose

Participants share their skills, experience and knowledge with community and agency colleagues

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The Feedback Standard We will feed back the results of the engagement to the wider community and agencies affected


Organisers of community engagement regularly feed back, to all those affected, the options that have been considered and the decisions and actions that have been agreed. This is done within an agreed time, to an agreed format and from an identified source

Who needs to know about what we will be doing and what results from it? How will we ensure that they get the information that they need?

All staff affected by any change Everyone involved to develop the options for consultation. Provide information through agreed structures/routes at the initial planning stage (how we recruited people to be involved). Ask people at events/sessions how they would like feedback.

Feedback on the outcomes and impact of these decisions and actions is provided regularly to communities and organisations within an agreed time, to an agreed format and from an identified source

Explanations about why decisions and actions have been taken are shared along with details of any future activity

The characteristics of the audience are identified to ensure that: relevant information is provided in understandable

languages relevant information is provided in appropriate languages a suitable range of media and communication channels is

used constructively

Information includes details about opportunities for involvement in community engagement and encourages positive contributions from groups and individuals in the community

Information promotes positive images of all population groups

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in the community and avoids stereotypes

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The Monitoring and Evaluation Standard We will monitor and evaluate whether the engagement achieves it purposes and meets the national standards for community engagement


The engagement process and its effects are continually evaluated to measure progress, develop skills and refine practices

How will we make sure that we are collecting information that will enable us to judge whether we are achieving what we set out to do?

Evaluation at Option Appraisal sessions: Did we meet all their needs in order to participate fully, provision of information, support, etc Numbers around invitations issued – how many actually attended. Follow-up evaluation (post – 1 month) sent to everyone involved. Consultation – how many responded. Information on the engagement will be entered on the VOiCE (Visioning Outcomes in Community Engagement) System recognised by the Scottish Health Council to share our practice in relation to community engagement. Involvement of the Scottish Health Council in organising and evaluation of sessions.

Progress is evaluated against the intended results and other changes identified by the participants (see Planning standard indicator 7)

The participants agree what information needs to be collected, how, when and by whom, to understand the situation both at the start of the engagement and as it progresses

Appropriate participants collect and record this information

The information is presented accurately and in a way that is easy to use

The participants agree on the lessons to be drawn from the evidence of the results and the changes that occurred

The participants act on the lessons learned

Progress is celebrated

The results of the evaluation are fed back to the participants and the wider community

Evidence of good practice is recorded and shared with other

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agencies and communities

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Report to Kirkcaldy and Levenmouth CHP Committee Financial Position to 30th September 2014 1. Introduction

1.1 This report provides an overview on the financial position for the CHP for the six month period to

30th September 2014.

2. Allocation 2.1 The Financial Framework and budgets for 2014/15 were approved by the Board at their Special

Board meeting in March 2014. As further allocations are received during the year, adjustments are made to the individual budgets accordingly. The main budget allocation in Period 6 was Transfer from G&NEF MH SIG (£20k).

2.2 A total budget of £67,484k was available for Clinical Services for the year.

3. Revenue Expenditure 3.1 The CHP is showing an overspend of £344k against Managed Clinical Services, with Prescribing

showing an underspend of £45k, for the year to date. This information is summarised in the following table:-



DELIVERY & EFFICIENCY Financial Governance

Budget for

Year

Budget for

Period

Expenditure

for Period Variance %age

Previous

Month

Variance

£'000 £'000 £'000 £'000 % £'000

Admin & Bus Mgt 1,326 662 648 (14) (2.1)% (15)

Clinical Director 625 311 283 (28) (9.0)% (13)

Fife Wide Services 7,784 3,842 3,842 - 0.0% (41)

General Manager 436 103 95 (8) (7.8)% (5)

Head Of Nursing 1,495 744 712 (32) (4.3)% (26)

Local Services 14,117 6,936 7,076 140 2.0% 142

Mental Health Service 36,436 18,331 18,417 86 0.5% 93

Methadone Prescribing 384 192 188 (4) (2.1)% (3)

Rheum Anti Tnf Drugs 4,249 2,125 2,329 204 9.6% 148

Voluntary Organisations 632 265 265 - 0.0% -

Total Clinical Services 67,484 33,511 33,855 344 1.0% 280

Prescribing 19,786 9,811 9,766 (45) (0.5)% (18)

Total 87,270 43,322 43,621 299 0.7% 262

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Memorandum: Fife Wide - PMS Service and FHS

PMS 47,791 23,804 23,804 0

Dental 20,692 10,363 10,363 0

Ophthalmic 7,166 3,518 3,518 0

Pharmacy 11,402 5,660 5,660 0 3.3 Expenditure will be monitored against budgets throughout the financial year and the following

table summarises key variances reported against the individual budgetary areas. Further detailed reports are provided to the relevant managers via the CHP Management Accountants.

Service Variance Commentary

Admin & Business Mgt Pay Supplies

(£13k) (£1k)

(2.0%) (11.1%)

Pays are underspent within Business Management, due to vacant posts.

Clinical Director Pay Supplies

(£12k) (£16k)

(£5.9%) (15%)

Short term vacancy. There is a small underspend mostly due to Locum sessions being lower than budget.

Fife Wide Services Pay (£32k) (1.1%) An overspend within the Fife Rehab

Service is offset by vacancies within the Sexual Health service and Dietetics.

Supplies £32k 3.3% The overspend in supplies is due to the introduction of a new Hep C drug (£210k) offset by other drugs and supplies.

General Manager Pay Supplies

(£12k) £4k

(12.8%) 44.4%

Various over/underspends results in a small underspend in this area.

Head of Nursing Pay Supplies

(£35k) £3k

(5.4%) 3.1%

Vacant posts in MCN and LTC. Various small overspends.

Local Services Pay (£57k) (0.9%) Pays are underspent in Community

Nursing and AHP’s, partially offset by an overspend in Inpatient Nursing at both Cameron and RWMH due to service pressures.

Supplies

£197k

27.5%

The non pays overspend is due to recharges in respect of complex care packages in the community, in partnership with Fife Council, and an overspend in surgical sundries and equipment.

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Mental Health Pay £121k 0.7% The overspend in Pays is in nursing

and medical in QMH, Stratheden and Whytemans Brae.

Supplies (£35k) (2.0%) An overspend in referrals to Lothian for the CAMHS service is offset by various underspends across the service.

Methadone Prescribing Pay Supplies

(£4)

(2.1%)

Currently almost breakeven.

Anti TNF Drug Treatment

Supplies

£204k

9.7%

An overspend remains after an additional £900k funding has been allocated

Vol Orgs

Pay & Supplies

0

0

Is currently breakeven

3.4 An analysis of the overall monthly variance for both pay and supplies is provided in graphical format below.

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4. Efficiency Savings 4.1 The CHP was allocated a cash releasing savings target of £608k at the time of the approval of the Financial Framework. Achievement of this is required as a minimum, as well as delivering further non-cash savings to meet the Efficient Government target of 3%. 4.2 Total plans identified for the year were £131k, all of which was cash releasing and £65k of which

has been delivered at Period 6. 5. Capital 5.1 The Capital expenditure summary for the CHP to 30th September 2014 is shown in the attached

appendix. The specific allocation for Kirkcaldy & Levenmouth at this time is £1.565m. 5.2 The total expenditure against the overall allocation to Period 6 is £993k, relating largely to works at Stratheden and Cameron. 6. Recommendation The CHP Committee is asked to: Note the contents of this report CAROL POTTER Assistant Director of Finance 30th September 2014

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NHS FIFE - CHP's

CAPITAL PROGRAMME EXPENDITURE REPORT -

SEPTEMBER 2014

FOR FINANCIAL YEAR 2014/15

CRL Total Projected

New Expenditure Expenditure Projected

Funding to Date 2014/15 Variance

Project £ £ £ £

Stratheden - IPCU 500,000 173,638 500,000

Total K & LM CHP 500,000 173,638 500,000

CHP Statutory Compliance

Cameron Hospital - Balcurvie/Balgonie & Balfour Roofing 197,000 197,000 197,000

Cameron Hospital - Letham/Balcurvie Service Refurb 314,000 314,000 314,000

RWMH - Roof Refurbishment 184,000 75,000 184,000

Stratheden Hospital - Asbestos Removal 26,000 25,732 26,000

Stratheden Hospital - Decentralisation Project 11,933 11,933 11,933

Stratheden Hospital - Workplace Transport Ph3 62,000 62,000 62,000

Whyteman's Brae - Fire Hazard Rooms (Ravenscraig Ward) 40,000 40,000

Cameron Hospital - Security 6,000 6,000

Whyteman's Brae - Car Park & Barrier 10,000 10,000

Stratheden Hospital - Laundry Refurbishment 7,000 7,000

Total CHP Statutory Compliance 857,933 685,665 857,933

CHP Capital Minor Works

Stratheden Hospital - Lomond Ward 20,000 16,000 20,000

Whyteman's Brae Hospital - Reception Area 60,000 901 60,000

Cameron Hospital - Automatic Doors 15,000 15,000 15,000

Stratheden Hospital - Lindores Ward 45,000 35,000 45,000

Total CHP Capital Minor Works 140,000 66,901 140,000

CHP Capital Equipment

Hostess Trollies * 5 34,631 34,631 34,631

Contact Centre - IT 27,268 27,268 27,268

Total CHP Capital Equipment 61,899 61,899 61,899

CHP Condemned Equipment

Cameron Hospital - Dishwasher 5,213 5,213 5,213

Total CHP Condemned Equipment 5,213 5,213 5,213

TOTAL ALLOCATION FOR 2014/15 1,565,045 993,316 1,565,045

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DELIVERY & EFFICIENCY CHP Workplan/Balanced Scorecard 2014/2015

1. INTRODUCTION 1.1 1.2 1.3 1.4

As reported at previous CHP Committee meetings, the reporting of the CHP Workplan to the Committee changed, to mirror that of the CHP Balanced Scorecard progress reports, to the Board. It was also indicated that the CHP would provide comparative reports to the Committee on a regular basis. This is the second comparative report being presented to the Committee this year, in relation to the Balanced Scorecard and CHP Workplan for 2014/15. The attached (Appendix 1) is a comparative report which identifies the 12 key priority targets for NHS Fife which also specifically relate to the Kirkcaldy and Levenmouth CHP for 2014/15. This report highlights the CHP’s performance, as at September 2014, in comparison to NHS Fife’s performance. Within the CHP’s 2014/15 Workplan there are an additional 14 targets relating to the CHP’s local priorities and the performance in relation to these targets, is reported to the Committee at regular intervals. As outlined in previous CHP Workplan papers presented to the Committee, the Workplan is a ‘live’ performance tool, with refinement and improvement continuing throughout the year.

2. PERFORMANCE 2014/15 2.1 NHS Fife’s performance is assessed by the Strategic Management Team and

Kirkcaldy and Levenmouth’s performance is self assessed by the CHP Management Team, against criteria agreed with performance monitoring colleagues.

2.2 For monitoring purposes, NHS Fife and the CHP continue to use the “traffic lights”

system. The four traffic lights are:- ♦ Blue – Target achieved early; ♦ Green – On track to complete by agreed date;; ♦ Yellow – Not on track but within agreed tolerance levels; (Delayed) ♦ Red – Not on track and not within agreed tolerance levels.

2.3

Table 1 highlights NHS Fife and the CHP’s performance positions, in relation to the 12 targets, as at 30th September 2014.

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2.3.1 2.3.2 2.3.3

Table 1 NHS Fife Balanced Scorecard

CHP Workplan

Blue – Complete 0

0

Green On Track 4

2

Yellow – Likely to be Delayed

1

3

Red – Will not or unlikely to be met

7 7

The data in Table 1 identifies that Kirkcaldy and Levenmouth CHP are on track, at this stage, with 17% with the remainder of NHS Fife meeting 33%. There are three targets which are identified as Delayed on the CHP Workplan i.e., Targets 3.04, 4.07 and 4.13. These target’s performance are being monitored regularly and work is ongoing and action being taken to bring these targets back on track. There are also seven targets which are identified as ‘Red’ Not on Track as detailed below. It should be noted that these are the same targets identified as Red on the Balanced Scorecard as these are NHS Fife-wide targets and are being addressed on a CHP and NHS Fife wide basis. Target 1.03; Smoking Cessation - The first performance data for this target has recently become available and shows that there were 97 successful post-3 months quits by June. The target focuses on smoking cessation in the 40% most-deprived communities, for which the figure was 54, against a plan of 63. We are, therefore, behind at the moment. Target 2.01; Delayed Discharge – There were 62 patients in delay for more than 2 weeks at the September census. Of these, 32 patients had been in delay for more than 4 weeks. Although the overall number of patients in delay dropped slightly recently, the trend during 2014 suggests that achieving zero delays of more than 2 weeks by April 2015 is extremely unlikely. We continue to work with our partners to scope capacity and demand and to consider actions which will reduce the number of patients in delay and which ensure that patients are cared for in the right place. Target 2.03; HAI – Information for the 12-month period ending September indicates a SABs rate of 0.38 (against a plan of less than 0.36) and a C difficile rate of 0.28 (against a plan of less than 0.32). Were the low SAB numbers seen in August and September to be maintained until March 2015, NHS Fife would meet the 2015 HEAT target but this remains challenging in light of an anticipated seasonal upswing over the winter months. C difficile numbers are on track for the 2015 HEAT target and NHS Fife remains in the top-performing quartile of Mainland Health Boards for this measure.

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Report by: Mary Porter General Manager Kirkcaldy and Levenmouth CHP

Target 2.06; Sickness Absence – Kirkcaldy and Levenmouth CHP’s position as at September 2014 was 5.32% (against a target of 4%). CHP Management Team acknowledge ongoing permanent action is required to address this target and discussions are taking place, to actively engage groups with local management, to share best practice and organisational learning. Target 2.13; Reduction in Emergency Bed Day Rates For patients Aged 75+ by 2014/15 – Information shows that the Bed Day Rate for the 12-month period ending March was 4,864 against a plan of 4,317. Due to changes in bed coding, the end target for March 2015 is higher than the current plan (at 4,998) and it is anticipated that this is still achievable. Various actions are now being taken in the hope that these will support a long term reduction in the Bed Day Rate by reducing Emergency Admissions for the Age 75+ population. Achieving sustainable solutions to the number of patients delayed in hospital awaiting community services is also pivotal. Target 4.15; - Child and Adolescent Mental Health Services – Information identifies that only 73.5% of patients starting treatment in the 3-month period ending August did so within 18 weeks of referral. The plan at this stage was to have an achievement of 87% and this puts the end target of 90% by the final quarter of 2014 in some doubt. A thorough analysis of referral rate and capacity and a reorganisation of senior management has been completed. Introduction of stepped care is underway across areas and most recent data indicates there has been an increase in patients starting treatment. Target 4.17 – Faster Access to Mental Health Service - Information indicates that around 75% of patients referred to the Clinical Psychology Service were offered their first appointment within 18 weeks in the quarter ending June. There is good engagement within Mental Health and Psychology Services to work towards achieving this target. The developments in IT systems will produce improved reporting but service and referral pathway redesign may not achieve enough improvement before the end-target date. Pilot projects using FACE and TIARA electronic systems are being established.

3. RECOMMENDATION 3.1 The Committee is asked to:-

• Note the comparative report between the NHS Fife Balanced Scorecard and the CHP Workplan as at 30th September 2014.

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Kirkcaldy and Levenmouth CHP Appendix 1

Performance at a Glance Comparison – Balanced Scorecard/CHP Workplan 2014/15

ID No Target Target Origin

CHP Lead NHS Fife Balanced Scorecard September

2014

CHP Workplan

September 2014

1.02 Alcohol Brief interventions – we will aim to deliver 4,505 at least 95% of which (4,280) will be in priority settings.

NS GM On Track On Track

1.03 Smoking Cessation – we will aim to deliver 761 post 12-weeks smoking quits in the 40% most deprived areas of Fife.

NT NC Not On Track Not On Track

2.01 Delayed Discharges – We will aim to achieve no waits over 2 weeks

NT CD Not On Track

Not On Track

2.03 HAI – We will aim to reduce the rate of staphylococcus aureus bacteraemia (including MRSA) to 0.24 and the rate of C Diff infection in the over 15s to 0.32.

NT NC Not On Track

Not On Track

2.06 Sickness Absence – We will aim to achieve and sustain a sickness absence rate of no more than 4%.

NS MP Not On Track Not On Track

2.13 Reduction In Emergency Bed Day Rates for patients Aged 75+ by 2014/15 – We will aim to reduce the bed days rate to 4,998.

NT CD Not On Track Not On Track

3.04 Dementia – We will aim to have a QOF registered proportion of diagnosed patients consistent with the European measure of prevalence, all of whom will have a minimum of a year’s post-diagnostic support and a person centred support plan.

NT MP Delayed Delayed

4.07 Financial Performance – We will aim to operate within our agreed revenue and capital resource limit and meet our cash requirement.

NT MP On Track Delayed

4.13 18 weeks Waiting Time – We will aim to deliver a maximum 18 weeks RTT timescale.

HS HB On Track Delayed

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ID No Target Target Origin

CHP Lead NHS Fife Balanced Scorecard September

2014

CHP Workplan

September 2014

4.14 Drug and Alcohol Waiting Times – We will aim to have 90% of clients wait no longer than 3 weeks from referral to treatment.

NS GM On Track On Track

4.15 Child and Adolescent Mental Health Services – We will aim to have 90% of patients wait no longer than 18 weeks from referral to treatment for specialist CAMH services.

NT GM Not On Track

Not On Track

4.17 Faster Access to Mental Health Service – We will aim to have 90% of patients waiting no longer than 18 weeks from referral to treatment for Psychological Therapies.

NT GM Not On Track Not On Track

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MINUTE OF THE KIRKCALDY & LEVENMOUTH CHP QUALITY, SAFETY AND CLINICAL GOVERNANCE GROUP

TUESDAY 5TH AUGUST 2014 BOARD ROOM CAMERON HOSPITAL

Present: Nicky Connor, Associate Nurse Director, Kirkcaldy & Levenmouth CHP (Chair) Heather Fernie, Business Manager Judith Gemmell, Lead Nurse – for Claire Dobson Karen Gibb, Clinical Governance Lead Graham Monteith, Manager, Mental Health Services Lynne Parsons, Staff Side Representative In Attendance: Maureen Sullivan, PA to Associate Nurse Director

Action

1. WELCOME Nicky Connor welcomed everyone to the meeting. She introduced Karen Gibb who is joining the group as lead for Clinical Governance for K&L CHP and also D&WF CHP.

2. APOLOGIES FOR ABSENCE Apologies were received from: Heather Bett, Claire Dobson, Simon Fevre, Julie O’Neill and Mary Porter.

3. PREVIOUS MINUTES (12TH JUNE 2014) It was agreed that the minutes were a true reflection of the meeting and were confirmed. Outstanding Actions from the Quality, Safety and Clinical Governance Group Meeting 20th February 2014. Action 2 – (20/02/14) – work still to be done and will be brought back to December meeting – action ongoing.


Tuesday 11th November 2014 Agenda Item No: 13a

ITEMS FOR INFORMATION CHP Clinical Governance Group 5th August 2014

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Action

Action 6 – (20/02/14) – information still to be clarified – action ongoing. Action 11 – (20/02/14) – listed as agenda item – action cleared. Action 12 – (17/04/14) – listed as agenda item – action cleared. Action 21 – (17/04/14) – a piece of work is to be commissioned – action ongoing. Action 22 – (12/06/14) – shared drive now available – action cleared. Action 23 – (12/06/14) – listed as agenda item – action cleared. Action 24 (i) – (12/06/14) – all action complete – action cleared. Action 24 (ii) – (12/06/14) – information awaited – action ongoing. Action 25 – (12/06/14) – report going to Committee – action cleared. Action 26 – (112/06/14) – report has gone to Committee – action cleared. Action 27 (12/06/14) – work ongoing – action ongoing. Action 28 (i) – (12/06/14) – work ongoing – action ongoing. Action 28 (ii) – (12/06/14) – event being organised – action cleared. Action 29 – (12/06/14) – paper to come to group in December – action ongoing. Action 30 – (12/06/14) – paper to come to the group in October – action ongoing.

4. 4.1

MATTERS ARISING Shared Drive Maureen Sullivan confirmed that the Shared Drive had now been set up based on the details provided by members. Barrie Higgins requested that his PA also be added to the list and Lynne Parsons will also be given access as a second staff side member.

ITEMS FOR DISCUSSION

5. GOVERNANCE

5.1 K& L CHP Quality, Safety and Clinical Governance Group Work Plan The K&L CHP Quality, Safety and Clinical Governance group noted the actions completed and the actions proposed.

5.2 Food, Fluid & Nutrition Report for the Period 2012 – 2014 The FF&N Report has come to this group for approval before being submitted to the CHP Committee. There were no comments received so the report was approved and will go to the CHP Committee in September.

HF

5.3 Information Governance Themed Report As a result of a request made at the last meeting a more detailed report has been prepared giving details under the key themes of:

Confidentiality, Communication or Consent

Patient Information

Access, Appointments, Admission, Transfer or Discharge

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Action

Nicky Connor spoke of lessons learned and action that needs to be taken and Lynne Parsons added that these results should be fed back to staff with any key lessons/learning coming back to this group for sharing. Nicky Connor said a more detailed discussion regarding missing records should be considered for the next meeting. Key Messages can also be agreed at the next meeting. Heather Fernie said there are mechanisms relating to how to review and share learning and she will bring examples to the next meeting. She also felt that a warning similar to Fairwarning could be introduced and she will take this to the Information Governance Group for consideration.

ALL

HF

HF

6. PERSON CENTRED

6.1 Better Together: Health & Care Experience Survey 2013 -14 (GP Results) The survey supports the 3 quality ambitions of Safe, Effective and Person Centred and the Appendix to the report provides detailed information relating to the results for the 18 GP Practices in the CHP as well as the overall CHP position. The K&L CHP Quality, Safety and Governance Group noted the report.

6.2 Patient Opinion: Briefing Paper This briefing paper was brought to the group to inform of the launch of Patient Opinion for NHS Fife. Patient Opinion is an independent social media website, founded in 2005, to receive feedback about health services. Nicky Connor advised that any key lessons arising from feedback would be brought to future meetings via Patient Opinion stories.

7. SAFE

7.1 CHP Risk Register

Risk 838 – Frailty Group being set up in Fife. Risk to be reviewed in December.

Risk 38 – advert for second Consultant has now gone out.

Risk 835 – update on position to be provided by Heather Bett.

Risk 39 – Graham Monteith actioning this – risk to be reviewed in 2 months.

HB

7.2 CHP Adverse Events Procedure This is a first draft which would support local implementation of the Fife policies, has come to the group for consideration. If anyone has any comments then they should advise Julie O’Neill within 14 days. The procedure will then

ALL

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Action

come back to the group in October for approval and to be updated in line with NHS Fife Adverse Events procedure.

7.3 Adverse Event Report: Year on Year Comparison This report gives the year on year picture and will start to identify trends. The group felt that the increase in reporting in relation to tissue viability came from better reporting and Lynne Parsons felt that it was likely to increase markedly in the next 12 months due to change being introduced into the reporting procedure. Karen Gibb suggested that some areas could be looked at in depth and the information drilled down – perhaps take one area at each meeting and look at the challenges – she will also look at the link to CQI data. Graham Monteith spoke of the need not to discourage reporting and the possibility of looking for centres of excellence – where people are doing well, what are they doing and how this can this be shared. Nicky Connor requested that all data be taken back to the Services for discussion and to look for areas for Tests of Change in:

Medication

Tissue Viability

Falls – primary will be placed on falls for inpatient area

KG

ALL

7.4 Infection Rate Data Report This is the 6 monthly report covering the period 01/01/14 – 30/06/14 and focuses on:

CDI cases identified within the CHP

SAB cases identified within the CHP

Outbreaks which occurred within the CHP

Karen Gibb advised that she is doing some work on c-diff in the community, which will report to Fife Infection Control Community. Fife has a large number of IV drug users and this affects the figures.

The K&L CHP Quality, Safety and Governance group noted the report.

7.5

Infection Control Arrangements (Training) Heather Bett has asked for this to be raised as the current Infection Control Nurse is retiring and she had concerns re ongoing training. Nicky Connor said that an advert was currently out for 2 Infection Control Nurses and some training may need to be cancelled until new arrangements are in place. Karen Gibb said that the possibility of e-learning was also being considered. This matter will be monitored.

7.6 SPSP: Inpatient and Community Nursing

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Action

Data discussed, and work is ongoing and this item will back to the group at a later date.

7.7 NHS Fife Reducing Harm Action Plan Nicky Connor spoke of the need to have a plan in place to share learning when harm occurs. She advised that work is ongoing with the NHS Fife Plan and it is proposed to invite the Fife Clinical Governance Team to the meeting to discuss this more fully.

NC

8. EFFECTIVE

8.1 Releasing Time to Care Nicky Connor said that work is ongoing in the CHP within mental health community nursing inpatient wards and staff can now choose the best modules to adapt to their local needs. Facilitators will be developing a position paper to got to SMT in due course.

8.2 Clinical Quality Indicator (CQI) Report This update on the Leading Better Care CQIs covers the period 01/01/14 – 30/06/14. This information will move in the future from Leading Better Care to Patient Safety. Judith Gemmell added that the CQI data also forms part of the ward profiles and there is now a Standard Operating Procedure outlining roles and responsibilities and an Action Plan is also in place, to support discussion at ward level regarding CQI and SPST. Nicky Connor referred to the Nursing Dashboard that is being produced and the pilots that are currently running, which will give access to detailed staffing information to all senior nurses in in-patient areas. The dashboard will be fully implemented after the pilots have been completed and will replace some of the data currently being produced via CQIs ward profiles.

9. CIRCULATED FOR INFORMATION ONLY

9.1 SPSO Reports – June 2014, July 2014 The reports were noted by the group.

9.2 HAIRT Report This is the report that was submitted to NHS Fife Board on 24.06.14. The report was noted by the group.

9.3 NHS Fife Complaints and Feedback Annual Report 2013 – 2014 The report was noted by the group.

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Action

9.4 Practice & Professional Development Annual Report 20123 – 2014 The report was noted by the group.

9.5 Cancer & Palliative Care Annual Report 2013 – 2014 The report was noted by the group.

9.6 Practice Education Facilitators Annual Report 2013 -2014 The report was noted by the group.

10. AOCB

1. Core Skills Training – Nicky Connor queried what information was available as to how many staff were trained in all areas, including; were there any risks – and if so what should be done? Judith Gemmell accepted that there were risks and Senior Charge Nurses were currently identifying gaps and would then look to target training. Karen Gibb added that access to training can be an issue and there were challenges in doing the training by e-learning. Nicky Connor said that following a review of induction no new staff should be waiting longer than 2 weeks and – the risk lies with the existing staff. will get all necessary training before they go on to the ward

2. CEL 32 – this CEL relates to the implementation of the Workforce

Workload Tool and Nicky Connor advised that the first stage has been completed and a report will be going to SMT and to the Board. The report will highlight the deficit identified in nursing numbers in in-patient areas.

11. Date and Venue of Next Meeting: Tuesday 16th October 2014 in Meeting Room 1, Cameron House

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Note of Meeting held on Wednesday 24th September 2pm to 2.30pm in Room 5, Rothes Halls, Glenrothes

UNCONFIRMED Present: Judy Hamilton, Edward Coyle, Vivienne Brown, Andrew Rodger, Tim Brett, Alan Burns, Julie Paterson, Claire Hynd (Fife Council – minutes)

Item

Action

1. 2.

APOLOGIES Apologies were received from Fergus Millan, Sandy Riddell (Julie Paterson attended in his place) and Carrie Lindsay who will be attending future meetings in place of Bryan Kirkcaldy. MINUTE OF PREVIOUS MEETING The minute of the previous meeting held on 11th June 2014 was agreed as an accurate record.


Tuesday 11th November 2014 Agenda Item No: 13b

ITEMS FOR INFORMATION Fife Health & Wellbeing Alliance Group 24 September 2014

Fife Health &

Wellbeing Alliance

Fife Council Councillor Judy Hamilton, Vice Chair Councillor Tim Brett Councillor Andrew Rodger Sandy Riddell, Director of Health and Social Care (tbc) Carrie Lindsay, Area Education Officer (Central) Education Service Vivienne Brown, Health Improvement Adviser Fife Voluntary Action Kenny Murphy Chief Executive

NHS Fife Alan Burns, Chair Chair of Fife NHS Board Chief Executive (tbc) Dr Edward Coyle, Director of Public Health Scottish Government Fergus Millan, Team Lead, Creating Health Team, Public Health Division

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3. 4. 5.

MATTERS ARISING Update on Actions 2014-15 Funding Awards – all funding award payments have been made to projects. Item 4 – suggestion of discussion at the policy advisory group (PAG) on links between housing and education services to help children affected by domestic violence – there will be a discussion at the PAG on the Family Nurture Approach early 2015. The learning from the FHWA funded WHIR project will be picked up as part of the same discussion. A meeting has been held to align indicators across Children’s Services Plan and the Health and Wellbeing Plan. Item 7 – progress on bullet point 3 ‘there should be more definite leadership and clearer connection with our own strategy groups’ was queried. This is covered in the improvement framework to be discussed in item 6 of the agenda. MEMBERSHIP OF FHWA The retirements of Stephen Moore and Bryan Kirkcaldy were noted and they were thanked for all their contributions. Future membership to be discussed under item 6 of agenda. Carrie Lindsay, Area Education Officer will replace Bryan Kirkaldy in the interim. Sandy Riddell, Director of Health and Social Care has indicated his intention to be a member of the Alliance. It was noted that there will likely be additional Alliance members from NHS Fife Board when new board members appointments are made. FHWA FUNDING 2015/16 ONWARDS A briefing paper was presented in response to the Alliance members’ request for progress around sustainability and information on future core funding. This had been prepared following discussion at the Co-ordination Group. The paper highlighted the current funding programme ends in 2015 and outlined a process for sustainability of the key projects identified in section 3.2 of the brief. Clarification was sought on the Fairer Scotland Fund (FSF) position. Vivienne has been liaising with Fife Council Funding and Monitoring Team who are carrying out the review of FSF. Currently there is no indication of how FSF will be allocated beyond March 2015, but partnerships need to assume it will no longer be allocated to them. Allocation of funds to the different localities is a possibility, in line with Fife Council de-centralisation agenda, but this is not yet confirmed. Currently FSF funding allows FHWA to operate a change fund for work around health inequalities. However, FHWA sees its developing role as one of leadership and influence, overseeing how health inequalities work is carried out across community planning partners, rather than running a funding programme. The paper outlined some transitional responsibility for FHWA, to ensure sustainability for projects which are achieving positive outcomes for disadvantaged groups.

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6. 7. 7.1

Decision Following discussion around the approaches laid out in the paper, members of the Alliance agreed that FHWA would top slice a percentage of its existing HIF and suicide prevention budgets towards continuation of the work of the projects. Initiatives, or their host organisations, would retain some accountability to FHWA for reducing health inequalities It will also feed into the FSF review that it has worked towards its funding programme finishing in March 2015, but proposing FSF awards to sustain key projects that are impacting on health inequalities in local communities. Members also felt that the Alliance should continue to have influence on FSF spend – for example food poverty and issues around food and health inequalities will continue to be an issue. The Alliance remitted to the funding group and co-ordination group to come up with a workable option for this approach. There needs to be further exploration of the use of remaining funding– perhaps commissioning services/agencies to run projects with a focus on mainstreaming new ways of working, along with resourcing development, training and events and evaluating new approaches. Vivienne will complete FHWA response for the FSF review and circulate to the Alliance and Co-ordination Group for comment. IMPROVING THE EFFECTIVENESS OF FHWA –REMIT AND ACTION PLAN The Alliance considered the proposed remit (September 2014) which was developed from discussion at the Improvement Service workshop and follow on meeting in July. Decision The Alliance agreed the remit and the need for a membership that will be effective in taking this forward. It was agreed that there needs to be further discussion to review membership and forums that will best support this influencing role. An additional sentence, strengthening the Alliance’s role in ensuring ways of working to reduce health inequalities are embedded and mainstreamed within community planning organisations, will be added. The action plan was noted but there was no time for further discussion. ITEMS FOR INFORMATION FIFE PARTNERSHIP BOARD - MINUTES OF MEETING The last meeting of the Fife Partnership Board took place on 2 September 2014. Minutes were not available for the meeting to discuss and will be circulated when available.

Fund. Group/ Co-ord Group FHWA VB FHWA VB

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7.2 7.3

FHWA E-BULLETIN The FHWA e-bulletin was circulated. DATE OF NEXT MEETING Wednesday 10th December 2014 – 10am to 12pm Committee Room 3, Fife House.

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KIRKCALDY & LEVENMOUTH CHP MINUTES OF THE PUBLIC PARTNERSHIP REFERENCE GROUP MEETING

HELD ON FRIDAY 2ND MAY, 2014, AT 2.00PM, IN MEETING ROOM 1, CAMERON HOUSE, CAMERON HOSPITAL

Present: Nick Barber George Sime

David Henderson Jack Carr Apologies: Alison Simpson Ron Parsons In attendance: Julie O’Neill George Cuthill Sharlyn Dobbie Sandra Anderson 1. WELCOME AND INTRODUCTION Action

Nick welcomed everyone to the meeting.

2. APOLOGIES FOR ABSENCE

Apologies were received from Alison Simpson and Ron Parsons.

3. MINUTES OF PREVIOUS MEETING HELD ON 24th JANUARY, 2014

Minute of the meeting held on 24th January, 2014 was approved as an accurate record.

4. MATTERS ARISING

4.1 Public Members as Non Executive Members of the Board

George Cuthill provided copies of the summary of research findings of the Evaluation of the Health Board Elections and Alternative Pilots to the group.

4.2 Health & Social Care Integration A guide to Health & Social Care Integration in Fife was distributed to the


Tuesday 11th November 2014 Agenda Item No: 13c

ITEMS FOR INFORMATION PPF Reference Group 2nd May 2014

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group for their information. It was suggested to invite Doreen Bell to a future meeting to provide an update re Health & Social Care Shadow Board. Julie advised would add topic to workplan for future meetings.

JON 4.3 NHS Services in Kirkcaldy PPF member raised concerns about access to NHS facilities in Linktown /

Inverteil. It was noted this existing problem was identified in the CHP Clinical Strategy.

It was agreed that Julie would liaise with Mary Porter / Dr Anderson to see what plans have been agreed for Linktown / Inverteil.

JON

5. UPDATE ON MEETINGS ATTENDED

5.1 CHP Committee Meeting held on 11th March, 2014

Nick provided an update:-

Estates & Facilities Audit Report - Mr Higgins advised that the Scottish Government requirement is for Health Boards to achieve a Domestic score of over 90%, with NHS Fife looking for scores over 95%.

Reducing Medicines Waste in NHS Fife - Mrs Eastop gave a snap shot of a future project the “green bag” campaign which focuses initially on planned care, whereby patients take their own medication into hospital and it is checked for suitable use.

5.2 CHP Clinical Governance, Quality & Safety Group Meeting held on 17th April, 2014

Julie provided an update:- A number of services had presented their annual reports. A copy of the reports are available.

5.3 Health & Social Care Integration: 14th March, 2014

Nick Barber provided an update:-

Fife has progressed in setting up a public reference group, to review the communication material.

5.4 NHS Fife Clinical Governance Committee: 9th April, 2014

Nick Barber provided an update:-

This Board Committee is reviewing its terms of reference reporting framework etc, to ensure that it can be assured of the quality of care provided across NHS Fife.

6. PPF Annual Report Action

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Julie reported that this is our draft annual report outlining the activity for last year and would welcome any comments. It was noted that over the last year we have seen a significant drop in the number of projects the PPF have been involved with. Julie confirmed that once report is finalised it will be submitted to the CHP Quality & Safety Clinical Governance Group in June and the CHP Committee meeting in July.

All

7. Presentation by Heather Bett, Clinical Services Manager re Fair Isle Clinic Proprosal

Heather Bett informed the Group of the project proposal to review services provided at Fair Isle Clinic. Options were discussed:- Transfer to Whyteman’s Brae Hospital Question Would there be room for all services at Whyteman’s Brae Hospital if they were transferred from Fair Isle Clinic? Answer There is vacant space at Whyteman’s Brae Hospital, changes would need to done at this site to accommodate. There is value at co-locating all Mental Health activities to make a Mental Health Suite creating their own reception area. This would be more of a vocal point for Mental Health Services. New Building This would work in a different way. Design of building to be taken into account, to be more secure and less susceptible to vandalism. PPF I have a family member working within Dental Services and Member have been advised this service has moved out of Fair Isle Clinic. Answer Dental Services took the decision to move prior to this proposal. They already have other facilities / services in the local area. Question If there is a temporary move to Whyteman’s Brae, can you accommodate the services? Answer We would work with the services already provided at Whyteman’s Brae Hospital. Question What increase in traffic would there be as parking at Whyteman’s Brae is very well used? Answer Will take this into consideration and will work with the Travel Plan Co-ordinator to factor car parking into a survey with patients.

Action

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Question Is there any other alternatives in the local area? Answer This has been looked into before with other colleagues i.e Police Stations / Schools No options in this locality identified at this time.

8. ITEMS FOR INFORMATION

8.1 CHP Committee Minutes of 14th January, 2014

8.2 CHP Clinical Governance Group Minutes of 12th December, 2013 and 20th February, 2014

8.3 PFPI Standing Committee Minutes of 8th January, 2014

8.4 Health & Social Care Integration Minutes of 22nd January, 2014

8.5 NHS Fife Acute Services Division Committee of 22nd January,2014

8.6 Kirkcaldy & Levenmouth CHP Newsletter – Spring Edition

8.7 Press Release – Investment for Balgonie Ward

8.8 Relocation of Ravenscraig Ward, Whyteman’s Brae Hospital – Report to Board Group members suggested inviting Graham Monteith, Head of Quality Improvement to a future meeting.

9. Any Other Competent Business

There was no other business reported.

10. DATE & TIME OF NEXT MEETING

The next meeting will be held on 22nd August, 2014 at 2.00pm in Meeting Room 1, Cameron House, Cameron Hospital, Windygates.

11. Hand Hygiene Awareness Training by Margaret Selbie, Infection Control Nurse

In preparation for the National Hand Hygiene Awareness Week on 6th – 9th May, 2014, where PPF members agreed to assist the Infection Control Nurse to raise hand hygiene awareness with visitors and staff in Cameron Hospital, a training session was held with members from the PPF. Margaret Selbie provided a demonstration on how to use the Glow Box and to show how effectively they are cleaning their hands.

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Dunfermline and West Fife Community Health Partnership Kirkcaldy and Levenmouth Community Health Partnership The Unconfirmed Minute of the Combined Local Partnership Forum (LPF) Meeting held on Wednesday 10 September 2014 at 2.00pm in Conference Room 4, Lynebank Hospital, Dunfermline Attendance Listed in Alphabetical Order by Surname: Members Present: Heather Bett, Clinical Service Manager, Sexual Health Service Nicky Connor, Acting Associate Nurse Director Lesley Eydmann, CHP Localities Manager Simon Fevre, Staff-side Representative (Co-Chair) Geraldine Law, Physiotherapy Staff-side Representative Wendy McConville, Unison Representative Lisa Milligan, Service Manager, PCES Graham Monteith, Acting General Manager, Mental Health Lynne Parsons, Staff-side Representative Margaret Pirie, Learning Disability Service Representative Mary Porter, General Manager (Co-chair) Sandra Raynor, Human Resources Representative Jim Rotheram, Facilities Manager, D&WF CHP Lorna Sheriffs, Staff-side Representative (Co-Chair) Jackie Young, Service Manager, Community Child Health Services In Attendance: Vicki Chesher, Secretary (Minutes) Apologies: Bruce Anderson, Head of Partnership Claire Dobson, Local Clinical Service Manager Heather Fernie, Business Manager, K&L CHP Julie Foy, Staff-side Representative Marie Innes, Staff-side Representative Melanie Jorgensen, HR Representative Leigh Murray, RCN Representative Gillian Tait, RCN Representative Ritchie Watters, Senior Staff Nurse, RCN Representative


Tuesday 11th November 2014 Agenda Item No: 13d

ITEMS FOR INFORMATION Local Partnership Forum 10th September 2014

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ITEM ACTION 1 Welcome & Apologies Apologies noted above. 2 The Minute of the Previous Meeting – Dunfermline & West Fife CHP (D&WF)

12.03.14 & 14.05.14 & 09.07.14 The Unconfirmed Minute of the D&WF LPF Meetings held on 12 March 2014 and 14 May 2014 were confirmed as an accurate record. The Unconfirmed Minute of the D&WF LPF Meeting held on 9 July 2014 was confirmed as an accurate record by those present at the meeting, electronic approval from staff-side members not present at the meeting will be sought. Post-meeting note - The Unconfirmed Minute of D&WF LPF Meeting held on 9 July 2014 was confirmed as an accurate record. The Minute of the Previous Meeting – Kirkcaldy & Levenmouth (K&L) CHP 15.07.14

VC

The Unconfirmed Minute of the K&L LPF Meeting held on 15 July 2014 was accepted as an accurate record. M Porter advised Lynn Davies has resigned from the Group and on behalf of Members noted thanks to Lynn for her contribution to the Forum.

M Porter welcomed all to the first meeting of the Combined LPF and provided an overview on the reasons for coming together as one group and the benefits from doing so. The Group were asked for their views and discussion followed. The Group shared the view that there would be benefit from a larger attendance and enriched discussions on similar topics but did acknowledge that there may be topics that are specific to one area, and may need to note if the number of representatives from that particular CHP was low, that discussion was held but no decision taken. It was also agreed that this arrangement could be reviewed and previous arrangements reinstated if required. S Fevre has also discussed this change with Wilma Brown. In keeping continuity, administration support will be provided by Vicki Chesher. Post-meeting note – M Porter thanked Brenda Ward for previous administration support provided to Kirkcaldy and Levenmouth LPF. It was therefore agreed to move forward as a Combined Group.

3 Matters Arising from the Previous Minutes 3.1 Nursing & Midwifery Workforce Planning [D&WF LPF Minute 09.07.14 - Item 4.1] –

N Connor provided information on the work that is being undertaken in relation to Nursing & Midwifery Workforce Planning, highlighting the following -

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ITEM ACTION Health Visiting

A letter from Scottish Government outlined the commitment to a five year plan to develop Health Visiting. The ongoing challenge with recruitment is a National issue. In 2013 five Nurses were trained in Fife and in 2014 there will be 12 and it’s anticipated that the training of additional Nurses will commence 2015. N Connor explained staff are kept informed of developments and have the opportunity to meet and take forward collectively. CEL 32 (2011) There is a mandatory requirement to annually review the workforce tools. A timetable is in place to roll out across all main areas of Nursing Services. At present, there is no National tool for Learning Disabilities. The review of Adult General Inpatient Nursing Workforce has concluded and the recommendations will be discussed at the Strategic Management Team and NHS Fife Board. It was noted that discussion had also taken place at K&L CHP Committee. The review confirms the current nursing workforce for wards within, Cameron Hospital, Randolph Wemyss and Ward 7, Queen Margaret Hospital. In relation to staffing, M Porter assured members there are no concerns at this time and any disruption to staff will be minimal. Career Framework This framework provides a clear outline to promote and support a move through different areas of Nursing, allowing career progression. It was noted that there are limitations for Band 5 registration. It was queried whether Knowledge and Skills Framework (KSF) outlines will require to be updated. N Connor explained timelines have been removed, and will align with the National Career Framework. The Framework will be promoted at staff orientation, supervision and within some of the core objectives. There will also be a poster launch in clinical areas and wards. The campaign will use local staff. S Fevre advised discussion had taken place at the Area Partnership Forum regarding Workforce and need to be clear who you are appealing to in terms of setting as a marketing tool and that it fits with the Characteristics. N Connor explained she has discussed with the Equality & Diversity Lead and Wilma Brown. S Fevre also suggested she speak with Brian McKenna. Recruitment Workforce Planning Group The NHS Scotland values are explicitly outlined and this Group will look at the current competency base, will map out the work being undertaken in other Health Board areas and bring together to support recruitment.

NC

3.2 Intensive Psychiatric Care Unit (IPCU) [K&L LPF - Min 3.1] - S Fevre reported that

he had contacted the Royal College of Nursing (RCN) with regards to a local representative attending Operational Group meetings and a response is awaited. A copy of the Project Board meeting dates to be forwarded to S Fevre.

MP

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ITEM ACTION 3.3 eKSF [K&L Min 3.2] – M Porter advised that errors in the data had been highlighted

by H Fernie. In terms of training issues, it was explained by M Porter that a piece of work is being carried out across D&WF and K&L CHPs collecting data on core and general training in each department. This information will provide detail on what is considered core training as well as the percentage of staff trained etc. S Fevre explained the format of the questionnaire was difficult to translate with the information already held in his department and possibly others. M Porter advised that if the information is already held, this can be submitted in the format used with no need to transfer data to the questionnaire format.

3.4 Payment of Enhanced Hours whilst on Annual Leave [K&L Min 3.5] – M Porter

confirmed all data has now been submitted to Payroll who will endeavour to pay no later than October. M Pirie queried the status for D&WF. There are no outstanding matters pertaining to D&WF.

3.5 100% Business Use, Leased Car Scheme [K&L Min 3.6] – M Pirie advised that she had received queries from staff. S Fevre explained lengthy guidance has been issued, and if looking to promote suggested it be made more simplistic. S Fevre would be happy to provide guidance to staff if required.

SF

3.6 Staff Survey Results [K&L Min 4.2] – It was asked that staff be encouraged to

undertake the staff survey which is due to close in the first week of October 2014, paper copies are available if required. The response rate to date is 17%.

3.7 Violence & Aggression Management Forum [K&L Min 6.1] – S Fevre suggested Ian Bease input to the Violence and Aggression section of the Staff Governance Action Plan and it was agreed M Porter would contact Ian Bease regarding this.

MP

3.8 Bike Storage Facilities [K&L Min 4.11] – H Bett explained the approach to the staff

lottery for funding was unsuccessful. M Porter agreed to fund the cost of the bike racks but unable to fund the shelters. H Bett is looking into the requirements for successfully accessing staff lottery funds. It was noted that there are bike racks on the Lynebank Site.

4 Health & Social Care Integration – Localities Consultation Item removed from agenda as a presentation will be made at the Area Partnership

Forum. It was felt this forum would have been able to provide valuable feedback and M Porter agreed to follow up.

MP

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ITEM ACTION 5 Staff Governance Action Plan 2014/15

Discussion took place on how best to take forward the Staff Governance Action Plans (SGAP) for K&L and D&WF CHPs. The following points were noted:

agreed one plan would be taken forward covering both CHP areas, the K&L Plan would be used as the base. S Raynor will cross check the updated document with the D&WF Plan to ensure all relevant information is included;

each section to be reviewed and updated;

updates to be requested from identified person;

SR

it was felt the Plan currently looks like an overarching document and needs to have a more local focus;

format to be updated so easy to read;

document to be more meaningful, use practical examples and as a ‘live’ document is updated regularly;

results from Staff Survey to be included;

suggested that evidence is promoted for one or two key themes;

a joint response is required;

thoughts on how to take out and share with the workforce;

need to have clear actions, outcomes, measures etc;

V Chesher to clarify submission date for the 6-monthly review.

VC

It was agreed the Plan would be updated following discussion.

MP/VC

6 AOCB 6.1 Calaiswood School – S Fevre raised an issue on capacity issues at the school and

the impact on health staff. J Young provided information on the input from nursing and explained a report is being prepared. Once drafted, discussions will be required. M Porter requested she have sight of the report prior to submission and that a copy be shared with G Law. It’s hoped the report will be available late September but the date is not definitive. It was agreed to discuss out with this forum as it appeared there were wider issues.

MP/JY/GL

7 FOR INFORMATION

No items. 8 Date of Next Meeting:

Wednesday 12 November 2014 in Conference Room 4, Lynebank Hospital 1.00pm Staff Side 2.00pm Local Partnership Forum

Circulated: 15/10/14

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Kirkcaldy and Levenmouth CHP Dates for CHP Committee Meetings/Development Sessions 2014/15

Date Time Title Venue 9th December 2014

13.00 - 15.00pm

Development Session

To be confirmed

13th January 2015

13:30 - 16:30pm

Committee Meeting

Large Committee Room, Town House, Kirkcaldy

10th February 2015

13.00 - 15.00 pm

Joint CHP MT/Committee Development session

To be confirmed

10th March 2015 13:30 - 16:30pm

Committee Meeting

Large Committee Room, Town House, Kirkcaldy


Tuesday 11th November 2014 Agenda Item No: 13e

ITEMS FOR INFORMATION Dates of Committee Meetings / Development Sessions 2014/15

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Kirkcaldy and Levenmouth CHP Dates for CHP Committee Meetings/Development Sessions 2015

Date Time Title Venue April 2015 NO MEETING

12th May 2015 13:30 - 16:30pm

Committee Meeting

TBC

9th June 2015 13.00 - 15.00pm

Development Session

TBC

14th July 2015 13:30 - 16:30pm

Committee Meeting

TBC

August 2015 NO MEETING

8th September 2015

13:30 - 16:30pm

Committee Meeting

TBC

13th October 2015

13.00 - 15.00pm

Development Session

TBC



DATES FOR DIARY Dates of Committee Meetings / Development Sessions 2015/16

kirkcaldy & levenmouth chp committee meeting tuesday 11...

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