Part 1. Held on 4th July 2012 at 10.30am at 151 Buckingham Palace Road, London SW1W 9SZ. Professor Rory Shaw Non-Executive Director

Transcription

1 (THE AUTHORITY ) MINUTES OF BOARD MEETING Part 1 Held on 4th July 2012 at 10.30am at 151 Buckingham Palace Road, London SW1W 9SZ PRESENT: Professor Dame Joan Higgins Chair Mrs Nina Wrightson Non-Executive Director Mr Keith Ford Non-Executive Director Professor Rory Shaw Non-Executive Director Ms Catherine Dixon Chief Executive Mr Tom Fothergill Director of Finance IN ATTENDANCE: Mr John Mead Ms Alison Bartholomew Mr David Bell Mr Dean Cowley Mrs Helen Vernon Mrs Julia Wellard Technical Claims Director Risk Management Director Director of Human Resources Communications Manager Assistant Technical Claims Director Minutes OBSERVER: Ms Trudy Norris-Grey The Chair opened the meeting by welcoming everyone. 1. Apologies for Absence There were no apologies for absence. 2. Conflicts of Interest of Members There were no conflicts of interest to note by members. Page 1

2 3. Minutes of the Board Meeting held on 9 th May The Minutes of the Board Meeting held on 9 th May 2012 were APPROVED and a copy was signed by the Chair. 4. Matters arising from the Minutes of 9 th May 2012 of which notice has been given to the Chairman 4.1 Claims Report The Head of Clinical Claims had produced a paper detailing numbers of claims and age at incident which was circulated. The Board NOTED the matters arising. 5. Chief Executive s Report 5.1 Communications to Trusts We have now written to all Foundation Trusts providing them with information on their claims together with a list of frequently asked questions and, where applicable, an explanation of PPOs. Feedback has been very positive and we have received a number of requests for meetings. We have already visited a number of Trusts and attended group meetings of Trusts, which took place in Durham and Leeds. Mrs Wrightson attended the meeting in Leeds and commented that it was extremely helpful. It was AGREED to circulate a list of all Trust visits and Trust group meetings to the NEDs. Action: DC We are also in the process of sending out a letter and leaflet to all Chief Executives of Foundation Trusts which details headline figures from the Annual Report and explains some of the initiatives we are undertaking in relation to contribution setting and patient safety. 5.2 Annual Report The Annual Report has now been laid in Parliament and was published on 2nd July. A copy has been put on the NHS LA website. The Report will be circulated to appropriate key people and stakeholders. There has been some press interest with the main focus on 'no win no fee' solicitors and the comparison between claimant and defence costs. 5.3 Corporate Objectives Corporate Objectives for the NHS LA have been produced for the forthcoming financial year and thereafter. Two meetings have been held with staff to talk through them in more detail. The Corporate Objectives have also been shared with panel solicitors and DNV. Page 2

3 5.4 Programme Governance Ann Baillie had been invited to attend the meeting to give a presentation on the implementation of the Marsh recommendations and achievement of the NHS LA's Corporate Objectives. 5.5 Resources In order to achieve the work on delivering the Marsh recommendations and the NHSLA's Corporate Objectives, Panel firms are providing secondees to the Authority. 26 secondees will be assisting the clinical team and 3 assisting the non-clinical team over a period of several months. There will be some operational risks but these will be managed appropriately. There will also be an opportunity for existing staff to second to the TCU as the Assistant Technical Claims Director will be working solely on project management work for six months. This will enable projects to progress and also help in making time for the recruitment process. 5.6 Audits There have been no audits of panel firms since December As a significant time has passed it was felt that we need to make sure that Panel firms are performing appropriately and that they are cost effective. Therefore it has been AGREED to audit 10 Panel offices which have either not been audited in the past three years, or scored lowest at last audit, using the same approach and questions as before. This will also assist with the Panel tender process. 5.7 Patient Safety Group A number of recognised experts have been invited to a private meeting to discuss the Authority s approach to managing risk. The Chief Executive and Director of Finance had been in discussion with Deloittes about learning from their NHS database. The Board NOTED the Chief Executive's Report. 6. Finance Report 6.1 Audit and Risk Committee The Audit and Risk Committee meeting held on 31st May focussed on the audit of the 2011/2 final accounts and the NAO Management Letter. The Director of Finance, Financial Controller and the Finance Team were congratulated for their hard work in finalising the accounts. The Executive Summary of the Management Letter makes reference to the agreement of debtor and creditor balances between NHS LA and members which in Page 3

4 some instances show differences from what Trusts are showing in their accounts. The NAO are content with our figures. The Report also makes reference to a significant level of mis-statements. One relates to fixes needed on duplication of payments. Changes were made to the accounts and we await a revised Management Letter from the NAO in this regard. The Government Actuary s Department have reported that they are content with the level of advice provided by our actuaries. However, the Chief Executive and Director of Finance will report back to the Board in due course on this issue. Action: CE/DoF 6.2 Financial Reporting Management Accounts were presented as at 31 st May The position shows an overall underspend of 30 million against the NHSLA s resource limit year to date. The underspend is due to new claims recorded and a lower than forecast value of movements and a cumulative underspend against cash. The Director of Finance is content that the Authority will deliver against its financial targets in 2012/13. The administrative contingency budget, created in anticipation of delivery of the Marsh recommendations, is being used to recruit additional claims staff. The Corporate Objectives are linked in with the budget and any additional priorities which fall outside of the corporate planning process will be brought to the Board. It is possible that we will also need to approach DH for additional funding. 6.3 Claims Report The availability of after the event insurance products has increased over the years and this has led to an increase in clinical negligence claims. Data on claims funded by CFAs, ATE and legal aid was made available to the Ministry of Justice for the LASPO review and it was AGREED that this data would be circulated to the Board. Action: DoF There have been increases of 36% in clinical claims and 29% in non-clinical claims over the first two months of the financial year compared with the same period last year. It was suggested we could benchmark a cross section of EL and PL claims against external data and this will be pursued. A review of KPIs is being undertaken. This will include the question of how to drive forward performance in claims handling. Any new proposals will be discussed with the Board before seeking the agreement of DH. 6.4 FHS Appeals Unit Training on the new Pharmacy Regulations took place on the 18th June 2012 in Leeds. Page 4

5 There has been a decrease in applications received and this is likely to be due to pharmacies waiting for the new Regulations to come into force. We are therefore likely to see a spike in activity and we will need to make sure that we have the appropriate resource in place to deal with this when it happens, although there is uncertainty when this will be. There are governance issues in relation to the panel procedures which need to be addressed and it was AGREED that these need to be included on the internal Risk Register. Action: DoF/RMD The Board NOTED the Finance Report. 7. Technical Claims Unit Report 7.1 Discount Rate The Lord Chancellor's consultation has still not been launched. The Ogden Committee discussed the discount rate on 9th May and is moving towards recommending a split discount rate. However, discussions of the Committee have been temporarily suspended and there has been no indication of when they will recommence. 7.2 Joint Conference with Irwin Mitchell Arrangements for a follow-up conference are being finalised to take place in March Target audience will be Trust clinicians and the focus will be on prevention of claims. 7.3 Large Settlements We have recently seen higher settlements in brain damage cases. Explanations include longer life-expectancies and the increasing cost of care and rehabilitation. It was felt there needed to be a strategic discussion on this issue and it was AGREED that this would take place at the Audit and Risk Committee at its next meeting in September, and that there would be a more in depth discussion at the Board Awayday on the 4th October Action: DoF/KF The Board NOTED the Technical Claims Unit Report. 8. Programme Management Ann Baillie gave a presentation on the Programme Implementation Planning. A number of projects have been devised to assist the implementation of the Marsh recommendations and the NHS LA's Corporate Objectives. The projects are at different levels with some strategic and some operational. The projects and their leads are detailed below: Helen Vernon (Risk Management: Learning & Knowledge; Standards and Assessment and KPIs) Page 5

6 Scott Henning (Legal Panel Retender) Debbie England (Contribution Setting) Steve Chahla (E-Portal, Delegated Authority and Investors in People) Esther Kaikai (Internal Risk Management) Ruth Symons (Information Governance) Sean Walker: (Extranet and Programme Change Management Terms of Reference have been produced for each project to identify the scope of what is to be achieved with dates of milestones. We have also implemented a programme governance structure which is separate from day to day activity. Each project has a distinct risk and issue profile. Risks identified are in relation to resource, timescales and implementation. For the latter, those projects which fall under this risk will be presented to the Board once a recommended approach has been agreed. Each project lead has a sponsor that will assist them. The biggest risk to the implementation of the programme is in relation to resources as it will impact on individuals day to day work. The Project Management Group which consists of all the project leads will meet on a regular basis and report back to the Project Steering Group which consists of the SMT and other Senior Managers. The Board NOTED the position. 9. Annual Report The Annual Report was published on 2nd July. In order to ensure that stakeholders in Trusts have access to messages in the Report an accompanying leaflet has been produced which focuses on the key issues and this has been circulated to all Chief Executives of Foundation Trusts. There has been some press interest as a result of the publication of the Annual Report in relation to rising claims and 'no win no fee' solicitors costs and it was agreed that in future we should produce a press release to coincide with the publication of the Report. The Board NOTED the position. 10. Internal Risk Management Annual Report 2011/12 The NHS LA Internal Risk Management Annual Report for 2011/12 was presented. The report details the internal risk management activities over the last financial year, including health and safety and information governance, and states that good practice has been maintained. The report was discussed and agreed at the last Audit and Risk Committee meeting in May. Page 6

7 It was noted that there had been a 24% increase in near misses and incidents reported compared with the previous year. It is likely that this is because staff are now more actively reporting incidents than before. The Board NOTED and AGREED the Internal Risk Management Annual Report for 2011/ Communications Update At the May Board meeting, it was agreed that our short term communication focus should be engaging with Trust Boards to help enable them to make informed decisions about whether to remain in the NHS LA schemes. We have written to the majority of Foundation Trusts with the final letters being sent this week. This has generated a number of requests for meetings and we have already met with a number of Trusts. We have also circulated a letter and leaflet detailing the key points in the Annual Report including our proposed work on learning from claims. We are actively looking at engaging with Trusts and our major stakeholders. Panel firms have included articles on the NHS LA in their newsletters and we are also expecting some coverage in the Health Service Journal. We will also be looking at attending meetings organised by panel firms and getting involved in conferences. We are establishing good relationships with Trusts at Chair, Chief Executive, Director of Finance and Risk Manager level but we may also need to focus upon Medical and Nursing Directors and Chairs of Audit Committees especially with regard to contribution setting. Our short term communications objectives, target groups and messages, with activity to date, were tabled. The Board NOTED the position. 12. Audit and Risk Committee Reports The following audit reports were presented: Review of work of LCP by GAD Internal Audit Annual Report for 2011/12 Follow Up Report Counter Fraud Annual Report for 2011/12 Fraud Awareness Staff Survey The Chief Executive and Director of Finance are taking forward the review of the work of our Actuaries. Page 7

8 There was some concern expressed about the Fraud Awareness Staff Survey. There was a low response rate, it was noted that half of the respondents did not know who the Fraud Officer was and 5 said they would not report a fraud if they were aware of one. The Chief Executive and Director of Finance are looking into this matter. The Board NOTED the audit reports. Action: CE/DoF 13. Any Other Business We are actively looking to fill the non-executive vacancy and the process will be managed by DH, which has taken over responsibilities from the Appointments Commission. 14. Date of Next Meeting The next Board meeting is scheduled for Wednesday 5 th September 2012 at 10.30am to be held in Boardroom 1 & 2 at 151 Buckingham Palace Road, London. Chair... Date.. Page 8