Auckland District Health Board Minutes

Transcription

1 Auckland District Health Board Minutes Minutes of the Auckland District Health Board meeting held on Wednesday, 12 September 2012 in the A+ Trust Room, Clinical Education Centre, Level 5, Auckland City Hospital, Grafton commencing at 2:00pm. 2 Attendance and Apologies The Chair opened the meeting at 2:06pm. Board Members Dr Lester Levy (Chair) Jo Agnew Judith Bassett Susan Buckland Dr Chris Chambers Rob Cooper Dr Lee Mathias Robyn Northey Gwen Tepania-Palmer Management in Attendance Ngaire Buchanan Joint Interim Chief Executive, General Manager Operations Dr Denis Jury Chief Planning and Funding Officer Susan Waters Executive Director Allied Health, Scientific and Technical Grant Barnett Acting Chief Financial Officer Greg Balla Director Performance and Innovation Margaret Dotchin Executive Director of Nursing Vivienne Rawlings General Manager Human Resources Hilda Fa asalele General Manager Pacific Health Ian Bell - Board Administrator Apologies Apologies had been received from Peter Aitken, Ian Ward, Dr Margaret Wilsher and Rosalie Percival. 3 Conflicts of Interest There were no declarations of conflicts of interest for any item on the agenda. Lee Mathias advised that she had been appointed Governance Advisor to Health Vision Limited. Rob Cooper had advised the Board Administrator that he was no longer Chair of Whanau Ora Governance Group or a member of the National Health Board. The Chair advised that Margaret Wilsher had been appointed to the committee to oversee the redevelopment of Christchurch Hospital. 4 Confirmation of Minutes 1 August 2012 Moved Gwen Tepania-Palmer; seconded Lee Mathias That the minutes of the Auckland District Health Board meeting held on 1 August 2012 be confirmed as a true and correct record.

2 5 Action Points 1 August 2012 The Well Child Tamariki Ora Providers: A page on Plunket including breast feeding statistics was tabled as an addition to the report. All the contracts were between the MoH and the providers and administered by the Ministry from whom the data was obtained based on quarterly reporting. There would be a further report to CPHAC which would be useful for the Child Health Plan. The allocation of resources between providers was variable and they were reporting performance rather than a target. The Board requested information on ADHB crèche facilities waiting list. A subsequent report has been distributed to the Board. 6.2 NZ Health Expenditure This was a snapshot on where the New Zealand health system fits in terms of OECD data. It was noted that the New Zealand public health system had been protected being near the top in gaining increased funding. Public health spending was a significant percentage of GDP. DHBs were required to make 2% efficiency gains annually to sustain their financial performance. Small changes in the funding have had a big impact on ADHB. 50% of the increased elective surgery requirement for the country had fallen mostly to ADHB and WDHB. 7.1 Chief Executive s Report There were a number of work streams on patient falls and pressure injuries. These included standardisation of assessment, measurement and also patients stories on the impacts and cost burdens of falls and pressure injuries. This is a focus in the Northern Regional Health Plan. ADHB was collaborating with Waitemata on these initiatives. There were some staff shortages in Allied Health and it was noted that the Ministry of Social Welfare are paying a differential for social workers. Transcription Services had experienced an unexpected increase in volumes and there was a proposal to increase transcription resources to align with the workload increases. The leave management reporting highlighted some gains but was still a considerable way from targets. At the end of September another 160 people will move from excess leave category due to management of their leave. There is a focus on a number of people with leave plans and those that would move into an excess position. This required stronger management and a change to the expectation in the organisation that leave is always taken at a time to suit. Management need to resolve the excess leave issue which should preferably be organised by the employee, but if not it would be imposed. It was not the DHB s policy to buy out the fourth week of leave, but rather to instil the discipline to take leave. Leave management also needed to be managed to have a patient focus so as not to interrupt services to patients. There was a summer plan for leave to be increased in the holiday period. It was acknowledged that some leave is difficult to manage, especially in critical services. HR is to advise if any manager is on the excess leave list. Advanced care planning is currently focused within the hospital, but is intended to go wider to include the primary care continuum and also to increase public awareness of advanced care planning. The provider arm targets had been discussed at the Hospital Advisory Committee. B4 School checks were now above target. A contract with an external provider for food for Meals on Wheels is about to be signed for one year to align with the national contracts. The price has increased slightly and there would be an increased co-payment. With the Primary Care business cases, GAIHN is progressing but Alliance Health Plus had experienced organisational difficulties which have substantially been resolved with a new Board and new management. One issue is sustainability of PHOs due to GP practice movement between PHOs which was being discussed between the 3 metropolitan DHBs with possible restrictions on practice movement being imposed. The National Health coalition had also experienced a

3 number of practice movements, including a group of corporately owned practices. The Maori Health Plan had been to the Senior Leadership Team and would be progressed to the Maori Health Gain Advisory Committee meeting. 7.2 Health Targets Immunisation rates were 95%. The target for heart and diabetes checks was challenging with work being undertaken with PHOs to get improvement, especially with ProCare. Lee Mathias advised of a developing project with VINZ in providing a card and voucher to visit GPs on completion of a vehicle check. This would be promoted by Buck Shelford and there would also be a focus on big employers. There were shifts in primary care from a transactional to a public health approach, although there were some data and system issues in practices. SIA funding, which amounts to $20m in the region, was to be focused to support the targets. Cardiac surgery was doing well and above target. The cardiothoracic surgical outcome database development was noted --this was an area where ADHB had more influence on outcomes rather than on long term conditions. It was noted that DHBs had put more money into primary care with no discernable change of outcomes, although Pacific had seen results of HVAZ working with churches in getting better health outcomes. PHOs had recognised this potential and supported the Pacific primary care nurses. 7.3 Te Runanga o Ngati Whatua The paper was the result of discussions with Ngati Whatua over the time since the removal of funding for MAPO, which had transferred into population-based funding. These discussions were recently more formal between Dr Dale Bramley and Ngati Whatua to acknowledge that resources are needed. In parallel with the merging of the Maori Health teams across the two DHBs, two positions are proposed for liaising with the Runanga and there would be further ongoing work with the Runanga and Maori Health, of which funding will be part of those discussions. The proposal was a response to a request to participate in planning and provide community input involvement recognising the Memorandum of Understanding and interaction with Maori providers and Maori PHOs. With this capacity the Runanga could participate i.e. in the localities discussion on what was needed to meet the needs of the community. They could also reach hard reach areas i.e. for immunisation. The source of funding was money budgeted for Maori Health purposes. The Chair advised that ADHB and WDHB were committed to the MoU. He suggested the appropriate process would be that this proposal go to the Maori Health Gains Advisory Committee to make a recommendation back to the Board. The paper to MHGAC should have more specific information on the activities and the Runanga s long term aspirations. It was also noted that not only had this paper not passed through the Maori Health Gains Advisory Committee, it had also not passed through the Audit and Finance Committee. Moved Jo Agnew; seconded Susan Buckland That the ADHB refers the proposal Supporting the Memorandum of Understanding with Te Runanga Ngati Whatua to the Maori Health Gains Advisory Committee to make a recommendation to the Board. That recommendation to be circulated for consideration.

4 8.1 Committee Recommendations Disability Support Advisory Committee The Board wanted any recommendations coming before it to have an economic context. This particularly applied to the Equal Employment Opportunities Commissioner s recommendations contained in Caring Counts Report. Moved Robyn Northey; seconded Judith Bassett That the ADHB notes the Disability Support Advisory Committee recommendation that it is critical that accessibility issues are addressed at the beginning of any planning for facilities to ensure access is built into the designs at the earliest stage. Moved Judith Bassett; seconded Robyn Northey That ADHB supports sending the Chair and Deputy Chair of the Disability Support Advisory Committee to the Stakeholder Summit planned for 3 October 2012, initiated by the Equal Employment Opportunities Commissioner. Moved Robyn Northey; seconded Lee Mathias That the ADHB notes the Disability Support Advisory Committee recommendation to the ADHB and WDHB Boards that they: Continue to implement the Health Passport across both DHBs Continue to work with Communications and Quality teams to improve the information that is going to patients and the way it is being communicated. Encourage staff to complete the Disability Awareness e-learning training to look at better ways to work with people with intellectual disabilities in health settings. Involve people with intellectual disabilities in consumer engagement and planning of services; and Make sure that people with high and/or complex needs are included in service planning. Community and Public Health Advisory Committee Moved Lee Mathias; seconded Gwen Tepania-Palmer That the Auckland District Health Board adopts the Public Consultation and Engagement Policy submitted to the Community Public Health Advisory Committee Audit and Finance Committee Recommendations Starship Children s Hospital: Moved Lee Mathias; seconded Robyn Northey That the ADHB Board approves $900k for funding to implement the Better Business case model to define the future scope, function and structure of Starship Children s Hospital.

5 Recovery from AuckPac: Moved Robyn Northey; seconded Lee Mathias That the ADHB Board notes that ADHB will file a claim with the liquidators of AuckPac Health Trust Board (AuckPac) in respect to misuse of Services to Improve Access (SIA) funding paid under a PHO agreement The Board asked for a background to SIA funding and how it is accessed. Retinal Screening: Moved Lee Mathias; seconded Rob Cooper That the ADHB Board approves the additional funding of $117,750 for the diabetes retinal screening project giving a total capital expenditure of $600,022. Bank Signatories Change to delegated Authorities: Moved Chris Chambers; seconded Robyn Northey That the ADHB Board seek the Minister s approval to amend the approved Delegated Authorities to allow officers of healthalliance NZ Limited to be appointed as signatories to ADHB s New Zealand bank account. Bank Signatories: Moved Robyn Northey; seconded Jo Agnew That the ADHB Board approves the following as signatories to the bank account with Westpac New Zealand Limited; Tania Parsons, Payroll Processing Specialist Mike Grattan, Payroll Systems Specialist Pat Butcher HR Information and Payroll Services Manager Gary Alpaugh, Payroll Systems Accountant Reg Booth, Reports Administrator Central Sterile Supply Department, replacement of 2 Cart Washers, 2 Multi Chamber Washers and 3 Steam Sterilisers: This was considered in public exclusion Finance Report Grant Barnett advised that it was early in the financial year and a conservative accounting approach is being taken including to the accrual of revenue. The result for August was $176k favourable for the month and $344k favourable year to date. Delivery had been high, being 7% over the contract. There had been a one-off impact in settling an interest rate swap. 11 GENERAL BUSINESS A+ Trust It was suggested that the Chair and Adminstrator of the A+ Trust be invited to the next meeting to improve the understanding of what the A+ Trust does and their progress.

6 12 PUBLIC EXCLUSION Moved Gwen Tepania-Palmer; seconded Susan Buckland AUCKLAND DISTRICT HEALTH BOARD RESOLUTION TO EXCLUDE THE PUBLIC FROM A MEETING OF THE BOARD Clauses 32 and 33, Schedule 3, New Zealand Public Health and Disability Act 2000 ( Act ) That, in accordance with the provisions of Schedule 3, Clauses 32 and 33, of the New Zealand Public Health and Disability Act 2000, the public be excluded for consideration of Items 12. The general subject of the matters to be considered while the public is excluded, the reason for passing this resolution in relation to each matter, and the specific grounds under the above clause for the passing of this resolution are as follows: General subject of each matter to be considered: Reason for passing this resolution in relation to each matter: Ground(s) under clause 34 for the passing of this resolution: 12.1 Confidential Minutes 1 August Employment Relations Update To enable the Board to carry on without prejudice or disadvantage commercial activities and negotiations: Official Information Act 1982 s.9(2)(i) and s.9(2)(j) That the public conduct of the relevant part of the meeting would be likely to result in the disclosure of information for which good reason for withholding would exist under s 9 of the Official Information Act NEXT MEETING The meeting closed at 4:15pm The next scheduled meeting is: 2:00pm, Wednesday, 24 October 2012 A+ Trust Room, Clinical Education Centre Level 5, Auckland City Hospital Grafton Signed as a true and correct record of the Auckland District Health Board meeting held on Wednesday, 12 September CHAIR: DATE: