Fallside Road Bothwell G71 8BB Telephone:

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1 Lanarkshire NHS Board Kirklands Hospital Fallside Road Bothwell G71 8BB Telephone: Minute of Meeting of the Lanarkshire NHS Board held on Wednesday 27 September 2017 at 9.00am in the Board Room, NHS Lanarkshire CHAIR: PRESENT: IN ATTENDANCE: APOLOGIES: Mrs N Mahal, Non-Executive Director Mrs L Ace, Director of Finance Mr C Campbell, Chief Executive Mr P Campbell, Non-Executive Director Mr M Fuller, Non-Executive Director Councillor P Kelly, Non-Executive Director Mrs M Lees, Chair, Area Clinical Forum Dr A Osborne, Non-Executive Director Mr T Steele, Non-Executive Director Dr I Wallace, Medical Director Miss M Morris, Non-Executive Director Mr N J Agnew, Board Secretary Mr C Brown, Interim Head of Communications Mr P Cannon, Board Secretary Mr C Cunningham, Head of Commissioning and Performance, South Lanarkshire Health & Social Care Partnership Mr G Docherty, Interim Director of Public Health and Health Policy Mr C Lauder, Deputy Director of Strategic Planning and Interim MRR Project Director Ms J Hewitt, Director, North Lanarkshire Health & Social Care Partnership Ms H Knox, Director of Acute Services Mrs I Barkby, Director for Nurses, Midwives and Allied Health Professionals Mr C Sloey, Director of Strategic Planning and Performance Ms V De Souza, Director, South Lanarkshire Health & Social Care Partnership Mrs L Macer, Employee Director Councillor J McGuigan, Non-Executive Director 2017/09/117 WELCOME Mrs. Mahal welcomed colleagues to the meeting. She extended a particular welcome to Mr. Paul Cannon who was attending his first Board meeting as Board Secretary, and paid tribute to Mr. Neil Agnew, who was retiring as Board Secretary, and referred to his long and distinguished career with the NHS spanning over 40 years.

2 2017/09/118 DECLARATION OF INTERESTS There was one declaration of interest. Mrs. Mahal raised an interest in relation to agenda item 5 - NHSL / GSU University Proposed Governance Structure - as she is a Lay Governor on the Court of the Glasgow Caledonian University. In view of this interest it was noted that Mr. (Philip) Campbell, Board Vice Chair, had been invited to chair the meeting for that agenda item. 1. Noted the interest declared by Mrs. Mahal, and agreed that Mr. (Philip) Campbell would chair the meeting for item 5 - NHSL / GSU University Proposed Governance Structure. 2017/09/119 INITIAL AGREEMENT FOR THE REPLACEMENT / REFURBISHMENT OF MONKLANDS HOSPITAL The NHS Board considered a paper which set out a revised Initial Agreement (IA) for the replacement / refurbishment of Monklands Hospital. Members were reminded that the Lanarkshire Healthcare Strategy Achieving Excellence was approved by the Cabinet Secretary for Health and Sport on 28th April It contained a keynote proposal to prepare a business case for a major new development to replace the existing Monklands Hospital. The first step in preparation of a business case was the Initial Agreement (IA) document, which was endorsed by the NHS Board on 25th January 2017, and submitted to the Scottish Government Health and Social Care Directorate s Capital Investment Group (Health CIG). Health CIG subsequently asked for further consideration of a series of points within the IA. It was noted that the revised IA had been approved by the Monklands replacement / refurbishment Project Board (15th September 2017) and the Corporate Management Team (18th September 2017). The paper presented to the Board set out how the points raised by Health CIG had been addressed, and the Board was asked to approve the resubmission of the amended IA to the Health CIG. Mr. Lauder summarised the specific changes to the IA, in response to specific points made in Mr. A. Morrison s letter of 14 March 2017, and the Board s detailed responses were summarised in the covering paper. Mr. Lauder also highlighted that the Project Board had mitigated against any slippage in addressing these supplementary points by the continuation of two elements of the Outline Business Case (OBC) in advance of the final IA approval, namely clinical service modelling and the preparation required

3 for the options appraisal. Members welcomed this prudent approach and noted that the mitigating actions undertaken had ensured that the overall programme would be unaffected. Members also acknowledged the advice from Mr. Lauder about the ongoing challenges and risks attached to continuing to maintain the buildings and infrastructure at the existing Monklands General Hospital site. It was noted that the direct cost in preparing the Initial Agreement was 200,000 and this is included within the Capital Plan. The direct costs of preparing the OBC case will be incorporated into the Capital Plan and LDP for 2017/18/ /09/120 GOVERNANCE REVIEW 1. Approved the re-submission of the Initial Agreement to the Scottish Government Health and Social Care Directorate Capital Investment Group; and 2. Agreed to request a report on the outcome of that submission when available. The NHS Board considered a paper which set out the rationale for the Governance Review; the aims of the review; the approach taken, including engagement; key themes and recommendations. Mrs. Mahal outlined the rationale for the Review, and reminded Board members that this was undertaken to ensure that NHS Lanarkshire had effective and robust structures in place to deliver good governance and to underpin the implementation of Achieving Excellence, the Health and Social Care Delivery Plan and the Local Delivery Plan. The Board Chair had set up a Review Group comprising herself, the Board Vice-Chair, Board Secretary and Organisational Development support. The starting point for the Review was a substantial engagement exercise involving the use of a Survey Monkey questionnaire for completion by Board Members, CMT Members, and other committee attendees. The approach also included an analysis of learning from other NHS Boards based on personal observations from Non-Executive Director visits to 4 NHS Boards Governance Committees as part of a Non-Executive personal development initiative, and Feedback from the completion of the Audit Scotland Checklist for NHS Non-Executive Directors. The product of this work was presented to Board Members, CMT, and other senior officers at a Board Seminar held on 28th June 2017and a report on the Board Seminar was subsequently issued to all Board Members and CMT on 19th July In addition, the NHS Board Chair undertook a review of Non-Executive Director Committee Portfolios. This included one to one discussions with each Non-Executive Director as part of their annual appraisal process, about current and future assignments.

4 The themes that had emerged from the Governance Review and the Board Seminar discussion were summarised in the paper. It was acknowledged that there was a need to recalibrate Governance Committees, using KPIs, to enhance their ability to provide assurance; a known gap in focus and assurance on Public Health, Health Inequalities and Primary Care Governance; recognition that the Terms of Reference for the Acute Operating Management Committee should be refreshed to reflect a strengthened focus on Patient Safety and Quality, and to ensure that there is the required focus on alignment with the metrics of North and South Lanarkshire Integration Joint Boards in the delivery of Unscheduled Care and Delayed Discharges; a recalibration the remit and business of the Healthcare Quality Assurance and Improvement Committee; a review and refresh Governance Committee Chairs and membership. In addition, it was also recognised that this would afford an opportunity to strengthen the effectiveness of Board business arrangements and information flow and consider further ways in which NHS Board business can be made more accessible, including better use of the website and strengthening engagement with the public. 1. Noted the key themes from the Governance Review; 2. Noted that the actions and recommendations arising from the Governance Review will be aligned with the extant Board Development Action Plan; 3. Approved the changes to the Chairmanship and Membership of NHS Board Governance Committees, including the appointment of Philip Campbell as a member of the North Lanarkshire Integration Joint Board (Appendix 1); and Appendix 2 which outlines each Non-Executive Director s proposed portfolio; and note that these changes have been discussed by the NHS Board Chair with each Non-Executive Director; 4. Approved the setting up of a Governance Committee with a remit encompassing Population Health and Primary Care, and agree to receive draft Terms of Reference for approval in January 2018; 5. Noted that the frequency of meetings of the Governance Committees will be determined when the Terms of Reference for committees are reviewed; 6. Agreed an implementation date of January 2018 for the changes; 7. Agreed that an updated Code of Corporate Governance will be brought to the NHS Board in March 2018 in light of the changes to Governance Committees, and the associated requirement to review their terms of reference; and 8. Noted that Governance Committee Chairs should work with

5 Executive Director leads and the Board Secretary to implement the recommendations within the Internal Audit Annual Report on Governance Arrangements, issued to Committee Chairs and Executive leads by the Board Secretary on 29th June /09/121 NHS LANARKSHIRE / GLASGOW CALEDONIAN UNIVERSITY PROPOSED GOVERNANCE STRUCTURE Mr (Phillip) Campbell was invited to chair the meeting for this item recognising the potential conflict of interest declared by the Board Chair at the outset of the meeting, as a Lay Governor on the Court of Glasgow Caledonian University. He asked if Board Members were content to proceed with the Board Chair present, but not contributing, and this was agreed unanimously. The NHS Board then considered a paper which provided an update on the proposed governance structure for the Board s relationship with Glasgow Caledonian University. It was noted that a similar proposition will be presented to the Executive Board of Glasgow Caledonian University for approval. The decision by GCU to confer University status on NHS Lanarkshire had previously been reported to the NHS Board, along with a description of the mutual areas of interest that will be pursued through the Agreement. A Formal Strategic Partnership Agreement with GCU has been signed. Mr (Calum) Campbell highlighted the need to put in place appropriate governance around the Strategic Partnership Agreement. The paper provided is a graphical representation of the NHSL/GCU University Hospitals Proposed Governance Structure which assigned the primary governance responsibility to the NHS Board s Planning, Performance and Resources Committee. Mr (Philip) Campbell asked for additional information around branding and signage issues and Mr (Calum) Campbell indicated that the three main Acute Hospital sites will be provided with updated signage that would be future proofed to accommodate any similar agreement being reached with other Higher Education establishments in the future. Mr Fuller sought clarification on the slide presentation summarising the proposed departmental criteria, specifically the rating attached to the Research & Innovation Potential Collaboration (Long Term Conditions and/or Public Health) which it was agreed should be changed from essential to desirable to provide consistency across the ratings. 1. Approved the NHS Lanarkshire / Glasgow Caledonian University Hospitals proposed Governance structure; 2. Noted that the implementation of the Strategic Partnership Agreement will be the subject of ongoing dialogue between the Partners;

6 3. Agreed to change the rating on proposed departmental criteria, Research & Innovation Potential Collaboration (Long Term Conditions and/or Public Health) from essential to desirable; and 4. Agreed to receive further reports about the progress of the Partnership Agreement and its impacts. 2017/09/122 ANY OTHER COMPETENT BUSINESS There were no items raised. 2017/09/123 DATE OF NEXT MEETING 2017/09/124 CONCLUSION Wednesday 25th October 2017, at 9.30am, Board Room, Kirklands Hospital, Bothwell, G71 8BB Mrs. Mahal thanked Members and attendees for their contribution to the conduct of business. The meeting closed at 9.45am.