MINUTES OF THE BOARD MEETING
HELD ON WEDNESDAY 29th FEBRUARY 2012 IN THE TE WAIORA ROOM,
DHB ADMINISTRATION BUILDING, MCLEOD STREET, HASTINGS
AT 1.06 PM
Present:
Kevin Atkinson (Chair)
Barbara Arnott (apologies for lateness)
David Barry
David Davidson
Peter Dunkerley
Helen Francis
Denise Eaglesome
Dan Druzianic
Ngahiwi Tomoana
Apology:
Kirsten Wise
Diana Kirton
In Attendance:
Kevin Snee, Chief Executive Officer (CEO)
Warrick Frater, Chief Operating Officer (COO)
Peter Reed, Chief Financial Officer (CFO)
Andrew Lesperance, General Manager Planning and Performance
Members of the Executive Management Team
Member of the Media
Board Administrator Brenda Crene
KARAKIA
The Deputy Chair, Ngahiwi Tomoana opened the meeting with a Karakia.
Condolences were conveyed to Ngahiwi on the loss of his beloved father.
DECLARATIONS OF INTEREST
The Board Interests and Conflicts of Interest Register were noted with no amendments.
Denise Eaglesome advised she would be fulfilling the role as Mayor of Wairoa from 1st March 2012 for
three months.
CONFIRMATION OF PREVIOUS MINUTES
The minutes of the Board meeting held on 21 December 2011, were confirmed as a true and correct
record of the meeting.
Moved:
Dan Druzianic
Seconded:
Helen Francis
Carried
MATTERS ARISING FROM PREVIOUS MINUTES
Actions and progress from the previous meeting were noted. Verbal updates were provided as follows:
Item 2 – Operation Plan Monitoring 2011/12: GM Planning and Performance conveyed this was work
in progress, having a further two advisory committee chairs to meet with. This item would remain as
an action.
Item 8 – Disparities were noted in reporting PHOs and DHBs: GM Planning and Performance advised
that targets had now been aligned and in future the target would be shown in relation to the actual.
BOARD WORK PLAN
The Board Work Plan and the agenda items for the March 2012 meeting were noted.
Minor amendments to March’s work plan were actioned by the Board Administrator.
March 2012
Section 1
1
CHAIR’S REPORT
The Chair verbally advised of the following matters that have arisen since the previous meeting:
• A letter regarding skin lesion services in Napier had been received from Dr Paul Hendy. This
letter had been responded to, advising there were no changes and the service would continue in
its present form.
• Health Minister Tony Ryall provided a letter to all DHBs requiring attendance detail for Board and
Advisory Committee meetings to be competently reported in the respective DHB’s Annual Reports.
• The Ministry were researching targets for diagnostics with a view to setting some hard targets. If
this occurred, some work would be required to meet the ministers’ expectations.
Staff Retirements: Chair Kevin Atkinson conveyed his best wishes and thanks to those staff who
had/or were to retire after extended service to HB District Health Board or associated services.
Letters would be sent to those listed below acknowledging their service.
Actioned
Service
Date
Name
Job Title
Service
(yrs)
Retiring
Finance, Facilities &
Pamela O'Donnell Telephonist
Procurement
21
11-Dec-11
Rachel Wickham
Home Aid
Options HB
21
16-Dec-11
Sue Angland
Registered Nurse
Women Children & Youth
40
07-Feb-12
Occupational
Older Persons Health,
Alison Nelson
Therapist
Rehabilitation & Allied Health
29
29-Mar-12
Leadership Forum: The Chair was pleased with the (3rd) Forum held on 15 February at the Te
Aranga Marae (Flaxmere), and felt it had elevated to a whole new level. He advised that the survey
completed by participants (at the Forum) had been collated and averaged, and the responses were
very positive.
Survey Results follow (1=poor 5=outstanding) : 3.6 Format for the day; 4.2 The Venue; 4.4 The
Facilitator; 3.3 Planning Progress; 3.2 Progress of Vision & Values; 3.5 Progress with ICHS; 3.6
Agreement in Investment/Disinvestment; 3.7 Building Relationships and Trust.
Replacement of Disability Support Advisory Committee Member: Following the resignation of
Julie Hutchinson from the DSAC Committee (on 21/11/11), a replacement committee member was
required. Chairperson, Diana Kirton had recommended the appointment of Heather Campbell to this
Committee because of her vast experience and understanding of the mental health and addiction
sector. Heather’s background also shows operational, advisory experience, as well as a consumer-
focused outlook. Following discussion the recommendation was approved
RESOLUTON
That the Board:
Appoint Heather Campbell as a member of the Disability Support Advisory Committee for the
ensuing term.
Moved
David Davidson
Seconded
Helen Francis
Carried
CHIEF EXECUTIVE OFFICER’S REPORT
The Chief Executive’s Report was received and the following update provided covering the period to
31 January 2012.
Financial Performance
Financial performance for January has resulted in a favourable variance of $379k with an
unfavourable variance of $511k YTD. The CEO remained focused on achieving a planned surplus of
$2.0m by the end of the financial year.
2
Health Targets
HBDHB remain close to/or above target for the following: Shorter Stays in Emergency Department
(averaged close to the 95% target) Access to Elective Surgery (108.9%); Waiting times (the number
waiting longer than 5-6 months continued to fall for elective surgical procedures, however neurology
was an area of concern
). Shorter waits for cancer treatment radiotherapy (continued at 100%);
Immunisation (3 months to January 2012 sat at 95.4% which was a good result and above the target
of 95%); and better help for smokers to quit (at 92.5% was in the top half of the country, for the 3
months to January compared to the target of 95% - but still a way to go).
It had been disappointing to read in the local paper an article (29 February 2012) prompted by a local
GP regarding services/staffing. A replacement ENT surgeon was planned with the temporary gap
likely to be filled by a Locum, and combined with the good relationship with Royston there was no
problems perceived. The comment was from the GP was likely in response to a letter sent to GPs on
17 February 2012.
Dr Peter Foley as co-chair of the Clinical Council and a local GP expressed regret at the media item
and advised that there were other avenues open for GPs to voice/raise concerns. The CEO advised it
highlighted an issue with communications and an understanding of how the channels work.
Better Diabetes and Cardiovascular Services: Attending free annual checks was showing a
positive lift in the Maori community results with 104.6%.
The Chair congratulated the CEO, PHO and all staff for having performance measures in the top half
of ALL DHBs - a great achievement.
FINANCIAL PERFORMANCE REPORT FOR MONTH ENDED JANUARY 2012
An overview of the presented report was provided by the Chief Financial Officer, noting that a number
of recommendations had been addressed by the Finance, Risk and Audit Committee Meeting held that
morning (refer below).
RECOMMENDATION
That the Board:
That the Board note the contents of the Report.
Adopted
REPORTS AND RECOMMENDATIONS FROM COMMITTEE CHAIRS
Finance, Risk and Audit Committee Meeting – 29 February 2012
Peter Reed provided a brief overview regarding HBL who had negotiated an arrangement for all 20
DHBs. In principle the CFO was happy however there were several issues to work through.
Dan Druzianic advised the meeting that FRAC had considered the arrangements and draft resolution
at its meeting earlier in the day and recommended that the Resolution be adopted.
RESOLUTON
That the Board:
1. In relation to Health Benefits Limited (HBL) Banking and Treasury Collective
a) agree for management to follow up with HBL, the conditions of approval as noted in
the paper; and
b) approve in principle subject to the conditions noted in the paper.
2. Approve amendment of the CHFA Facility Schedule termination date to 31 December 2021.
3. Approve extending the BNZ Working Capital Facility to expire 1 December 2012
Moved Dan Druzianic
Seconded Peter Dunkerley
Carried
3
Hawke’s Bay Clinical Council – 8 February 2012
The Council’s co-chair Drs John Gommans and Peter Foley were in attendance. Dr Gommans
provided an overview of the Clinical Council Report provided:
• The Laboratory Services Committee provided an overview of: Vitamin D testing restriction feedback
(mainly positive); further reviews of “high cost” but “low value” testing; and test results distribution
processes.
• Council were pleased with the strategic direction of the Population Health Strategy however the
action plan required work. This was reflected in the recommendation to the Board below.
• The Draft Annual Plan 12-13 was reinforced.
• Establishing an Integrated Health Service for Hawke’s Bay (ICHS) posed two important questions
regarding who to lead and how we work, rather than the structures we work in. As consultation
progresses, no doubt these two issues will become clear. This was noted by the Chair.
• Service and Financial Improvement Programme (SFIP) was not discussed in detail but on reflection
as the SFIP progresses it is worth noting a comment made that “all financial decisions have clinical
implications” and “all clinical decisions have financial implications.”
• Council were pleased to receive the Clinical Indicators Report which had been developed with
some reporting provided monthly compared with a full report Quarterly.
• Nursing Workforce Development was noted and the team involved congratulated.
Barbara Arnott commented that she felt a high level of comfort with the simple report provided to the
Board each month. It ensured the support of many parties and removed/alleviated the element of
surprise in the clinical arena.
RECOMMENDATION
That the Board:
1. Note the contents of the report.
2. Note that the Clinical Council endorse the strategic direction, overarching principles and
priority focus areas only, in the DRAFT Population Health Strategic Plan 2012-2015.
Adopted
DISCUSSION PAPER
Establishing ICHS Services in Hawke’s Bay
GM Planning and Performance, Andrew Lesperance was in attendance for this paper which was
covered/discussed at the Leadership Forum on 15th February.
RECOMMENDATION
That the Board:
1. Note the feedback from the ICHS consultation process as presented at the Leadership
forum 15 February.
2. Note that this feedback will be released to the public as per the agreed consultation
process.
3. Note that a further paper will be provided to the board in April, detailing the next steps in
this development.
Adopted
4
MONITORING PAPERS
HBDHB Performance Framework Exceptions (Q2) 2011-12
This final Report was tabled at the meeting by Andrew Lesperance. The summary report had been
delayed as crucial data had not been received from the Ministry to meet internal reporting deadlines.
• Smoking advice: Since the publicly announced target announced in July 2011, the Chair noted that
GPs appeared to be under performing. The results show that smoking advice to their patients was
at 30% compared to the MOH target of 90%.
• Referring to “Improving mental health services using relapse prevention planning (Child and Youth
0-19 years) on page 82”: Non government organisations (NGO) appeared to be under performing.
The meeting was advised this was mainly a reporting issue (equating to around 20%), and that the
portfolio manager was following up.
Action GM P&P
• Referring to “Percentage of patients receiving ultrasound, MRI and CT services within timeframe”
on page 93”, the Chair referred to a letter from the Minister expressing concern that there were
patients who had waited up to 6 months for a scan. The COO advised there were no issues
technology wise, however there were some staffing/resource issues which needed to be worked
through.
• Referring to “Did not attend (DNA) rate across first specialist assessments” on page 94 of the
report showed a target of 7.5%, however DNA’s rate was sitting at 19.2% (for Maori) which the
Chair considered unacceptable. The Chair suggested that at its next meeting MRB discuss the
issue and suggest strategies to significantly reduce these rates.
Action MRB
Human Resource KPIs (Q2) 2011-12
An overview of the paper presented to the Board was provided by John McKeefry. The Board noted
the contents.
5
RECOMMENDATION TO EXCLUDE THE PUBLIC
RESOLUTION
That the Board exclude the public from the following items:
15.
Confirmation of Minutes of Board Meeting dated – 21 December 2012
- Public Excluded
16.
Matters Arising from the Minutes of Board Meeting dated 21 December 2012
- Public Excluded
17.
Report and Recommendations from the Committee Chair:
Finance Risk and Audit Committee – 29 February 2012
18.
2012/13 Annual Plan Outline Overview
Outline of Annual Plan with Statement of Intent 2012/13
19.
Roadmap for the Development of the 2012/13 Regional Services Plan
20.
Policy – Payment of fees and Expenses (HBDHB Committees, Advisory groups,
Stakeholder groups and project teams).
21.
New Community Pharmacy Service Model
22.
Overview of the Funding Envelope 2012/13
23.
Financial Performance Report for period ended January 2012
24.
Service & Financial Improvement Programme
Moved:
David Davidson
Seconded:
David Barry
Carried
The meeting closed at 3.30 pm
Signed:
Kevin Atkinson, Chair
Date:
6
link to page 7
MINUTES OF THE BOARD MEETING
HELD ON WEDNESDAY 28th MARCH 2012 IN THE TE WAIORA ROOM,
DHB ADMINISTRATION BUILDING, MCLEOD STREET, HASTINGS
AT 1.00 PM
Present:
Kevin Atkinson (Chair)
Barbara Arnott
David Barry
David Davidson
Peter Dunkerley
Helen Francis
Denise Eaglesome
Dan Druzianic
Ngahiwi Tomoana
Diana Kirton
Kirsten Wise
Apology:
-
In Attendance:
Kevin Snee, Chief Executive Officer (CEO)
Warrick Frater, Chief Operating Officer (COO)
Andrew Lesperance, General Manager Planning and Performance
Satish Makam, Finance Manager
Members of the Executive Management Team
Members of the public and media
Board Administrator Brenda Crene
KARAKIA
The Deputy Chair, Ngahiwi Tomoana opened the meeting with a Karakia.
DEPUTATION
Topic: Hydraulic Fracturing
Ann Michelle and Angela Hair, members of “Don’t Frack the Bay” were introduced and addressed
board members on the practice of “
fracking” (hydraulic fracturing), to extract gas and oil from deep
within the earth. Ann summarised issues with the practice in Taranaki over a number of years, and
raised concerns if the practice went ahead in Porangahau (Central HB). Their concern focused on
potential for health issues for the people living in/or around the area being exposed to chemicals from
the process
1, seeping into their water through underground aquifers. They also had concern about the
potential for earthquakes as a result. She provided an overview and examples of the practice and the
environmental issues/impacts worldwide. A copy of the detail presented was provided to the Board
Administrator following the meeting and is available on request.
DECLARATIONS OF INTEREST
The Board Interests and Conflicts of Interest Register were noted with no amendments.
CONFIRMATION OF PREVIOUS MINUTES
The minutes of the Board meeting held on 29 February 2012, were confirmed as a true and correct
record of the meeting.
Moved:
Peter Dunkerley
Seconded:
Dan Druzianic
Carried
1 Hydraulic Fracturing or “fracking” is the practice of extracting gas and oil from deep within the earth.
Extraction is achieved by drilling down into the earth for kilometres and then horizontally for kilometres
emitting water, sand and chemicals into the earth as part of the process. The practice has been
banned in some countries.
April 2012
Section 1
1
MATTERS ARISING FROM PREVIOUS MINUTES
Actions and progress from the previous meeting were noted. Verbal updates were provided as follows:
Item 1: Consultation on Mental Health and Addiction Services. The blueprint had been received and
was with members. Action removed.
Item 2: Operational Plan Monitoring: the process was well underway. Action removed.
Item 4. Governance Meetings : Advisory Committee TOR’s would be reviewed by the end of April
(detail included in the actions).
Item 5: Monitoring : Improving mental health services using relapse prevention planning (Child and
Youth 0-19 years) was in hand and the action removed.
Item 6: DNA Rates across first specialist assessments: MRB would hold a meeting to discuss this
within two weeks. As this was not new, there would be a lot of information available. Action
removed.
BOARD WORK PLAN
The Board Work Plan for the April 2012 meeting were noted.
CHAIR’S REPORT
In acknowledgement of service: Chair Kevin Atkinson conveyed his best wishes and thanks to
Judith Clark (Podiatrist) who had who had provided excellent services to the HB District Health Board
and was concluding her services on 29 March 2012. A letter would be sent to Judith acknowledging
her service.
Actioned
The Chair verbally advised of the following matters that have arisen since the previous meeting:
• A letter had been received updating 2012/13 funding advice.
The MOH advised the projected savings in the pharmacy budget would be replaced by new
initiatives. The new initiatives are as follows: Extend free GP care for children under six to after-
hours; Provide support for Child and Adolescence Mental Health Services; Implement the faster
cancer treatment initiatives; Support smarter home support services; Encourage greater pharmacy-
led care; Aged care residential bed day price subsidy; Services to establish effective dementia care
pathways
The Chair conveyed the need to be aware that pharmacy savings were one off and the cost of the
new initiatives would be ongoing (between $500-900k per year).
• A letter had been received from the Minister regarding performance of all PHOs. Health Hawke’s
Bay sat at 19 out of 36 (19/36) for CVD Risk Assessment (in the past 5 years); Smokers advice to
quit and/or providing cessation support in the past 12 months (22/36); Two year olds who have
completed vaccinations (8/36). This was reasonably satisfactory but there was room for
improvement.
• A letter received from Roche Diagnostics regarding the blood glucose meters (brand) changes, was
warning of the health risks associated in changing people from one meter to another. Since receipt
of this letter it was understood over 3000 submissions had been received by Pharmac nationally.
Members of the Board acknowledged there would be a risk having a single supplier and it
appeared that Pharmac could not guarantee supply. Andrew Lesperance was monitoring this.
• The Chair, CEO and Dr Peter Foley plan to visit the Chatham Islands between 22-24 May 2012. A
visit was originally proposed (in late 2011) by the Island’s Mayor and CEO, to discuss the
practicality of fluoridating the Island’s water supply.
• A letter had been received from the MOH congratulating HBDHB as a sector leader in rationalising
Management/Administration FTE positions, proposing a further reduction of 3% in the forthcoming
year. A response to the Minister advised HBDHB were below the new threshold and there was
every intention to maintain that level going forward.
• In early March a letter had been received from Karina Collyns of Hastings who had health concerns
regarding water quality at Lake Tutira and a stream in Pakowhai used by the public regularly.
2
CHIEF EXECUTIVE OFFICER’S REPORT
The Chief Executive’s Report was received with the following update provided.
• A letter from the MOH on
Performance Results for Q2 was very positive for Hawke’s Bay, with
no performance issues or problems raised. An excellent result.
•
Health Targets as presented in the CEO’s report were taken as read. It was noted the detail was
in a more concise format which received favourable comment from board members. Note there
had been no CVD results since September 2011.
•
Financial performance for February 2012, showed a favourable variance of 186k with an
unfavourable variance of $325k YTD. The CEO advised confidently that the planned surplus of
$2.0m would be delivered.
•
Report of the Auditor General was well received with HBDHB rated highly with only two other
DHB’s ahead nationally. Attention was drawn to Maori health disparity and a focus on Asset
management (within the sector).
•
Better Sooner More Convenient Update:
Service Delivery Initiatives for the Skin Lesion Service noting the service continues but a different
arrangement would be put in place for the provision of that service.
The Wairoa Integrated Health Services Project continues to gain traction. The design of the
facility was being finalised and would go to tender in June 2012. Focus on providing work to the
Wairoa business and trades community has moved forward with a letter sent to local trades
people to register their interest in being involved in the tender process.
Facilities Developments were progressing with the Theatre 7 development, Endoscopy Suite and
the Renal Centre.
•
Serious and Sentinel Events Reporting
There had been seven events in Hawke’s Bay, with no increase in events in the past five years
since reporting commenced. Falls Minimisation has been and will continue to receive focus and
Hawke’s Bay were well on track to address concerns coming out of the national report. Clinical
Council would continue to monitor falls minimisation closely.
Diana Kirton advised she had attended a Mental Health Inpatient Unit Consultation meeting which
was very well done and a thoroughly enjoyable experience.
The Chair advised he had never in his time at the HB District Health Board seen such a favourable
report received from the Ministry of Health. He congratulated all concerned, advising it was a fantastic
effort.
FINANCIAL PERFORMANCE REPORT FOR MONTH ENDED FEBRUARY 2012
An overview of the presented report was provided by the Finance Manager, Satish Makam.
The Chair advised this was Satish’s last meeting as he was moving to another position out of the area.
Satish was thanked for his good work which was much appreciated and he was wished well in his new
role.
Summary of points raised:
• The finance system will shift to Oracle in accordance with the direction proposed by HBL in 2 to 3
years time, and a visit was planned on 4-5 April to obtain a better understanding of the impact of
this before the business case was finalised.
• Patient transport for February was one of the highest and was of concern. Initiatives were in place
to control the growth where possible.
• Capital expenditure for February was tracking at 39% of the Annual Plan. IT operations were
tracking behind, mainly due to the delay in implementation in CRISP (as this had not been paid
out to the region yet).
• Rolling cash flow: an area to note was cash available in short term investments (excluding Special
funds clinical trials) position each month. The cash available by end of June as per the current
3
forecast was $9.5m which is looking quite healthy. Peter Reed (CFO) had been working with MOH
to minimise the impact of capital charges through revenue banking arrangements.
• Diana Kirton queried Bed Days for Maternity on page 33 of the report and asked how accurate the
figures were. It was advised work was in hand to split the detail for a correct correlation as the
detail was blurred between the delivery suite, postnatal and antenatal.
RECOMMENDATION
That the Board:
That the Board note the contents of the Report.
Adopted
REPORTS AND RECOMMENDATIONS FROM COMMITTEE CHAIRS
Community & Public Health Advisory Committee Meeting (CPHAC) – 14 March 2012
The Chair of CPHAC, Barbara Arnott provided an overview of the report submitted.
•
Supporting Healthy Communities – Plan for achieving strategic priorities for Population health
from 2012-15 was certainly an important programme and one we must get right and receive
endorsement from the CPHAC.
•
Kahungunu Hikoi Whenua (KWH) Programme Evaluation – The Chair advised how impressed
she had been with the programme and with the positive achievements gained. KHW was showing
real results and engaging with targeted people in neighbourhoods where it mattered most. It was
felt this should continue in areas not yet targeted, including disparities. CPHAC members were in
full support for the KHW programme continuing. The HIHA programme was discussed briefly and
accruals may be available for the continuation of KHW, should Government funding be withdrawn.
Diana Kirton understood some HIHA funding had been ear marked for Child youth and early
maternal.
The CEO advised with a bit of work this could be pulled together fairly quickly advising the majority
of the funding appeared to be available for KHW. A financial position would be brought back to
the Board.
Action
•
ICHS in Hawke’s Bay – was continuing with the next steps outlined.
•
New CPHAC Committee Members: The Chair advised he had approached two PHO/community
representatives to join CPHAC being John Newland and Bayden Barber. With Board approval,
the appointments would take place immediately.
RESOLUTION
That the Board:
1. Note the contents of this report.
2. Endorse continuation of the Kahungunu Hikoi Whenua programme, regardless of whether
continued funding from Government is forthcoming or not. Financial detail would be provided
to the Board.
3. Approved the appointment of two PHO representatives John Newland and Bayden Barber as
members of the Community and Public Health Advisory Committee.
Moved
Barbara Arnott
Seconded
Denise Eaglesome
Carried
Hawke’s Bay Clinical Council – 14 March 2012
Dr John Gommans co-Chair of Clinical Council was in attendance. Dr Gommans provided an overview
from the meeting summarised as follows:
4
• Clinical Indicators - had been refined with monthly reviews occurring on several targeted areas.
Feedback on diabetes results has been inconsistent.
• Council were to focus on producing a detailed workplan.
• MOH ran a workshop in ED with some good ideas raised. Utilising some of the ideas raised would
assist in continuing to improve performance against target in this area.
RECOMMENDATION
That the Board:
Note the contents of this report.
Adopted
Maori Relationship Board (MRB) – 21 March 2012
Ngahiwi Tomoana, Chair provided an overview from the meeting summarised as follows:
• PHO presentation of CVD target: Contrary to the MRB Report, ethnicity data collection
breakdowns were available and this would be discussed outside the meeting.
Action
• Maori Diabetes and CVD demonstrations site pilot within Kaupapa Primary Care Settings: MRB’s
endorsement of the recommendations approved by the HBDHB’s Cardiac team must be
captured and actioned. Need to work with CEO and GM Planning & Performance on this.
Action
• “Did Not Attend” (DNA) specialist appointments would be considered at a special MRB meeting in
several weeks. MRB need to utilise the background detail available.
Action
• Kahungunu Hikoi Whenua Programme (KHW) Early Outcomes Report. This had already
considered and supported by CPHAC. MRB consider the KHW programme as the Olympic flame
for Maori Health and fully endorse CPHAC’s recommendation to the Board.
RECOMMENDATION
That the Board:
1. Note the contents of this report.
2. Note in particular MRB’s endorsement of the CPHAC recommendation to the Board that
funding for the KHW programme be continued, if necessary through divestments in other
areas.
Adopted
DECISION PAPER
Supporting Healthy Communities – A plan for achieving strategic priorities for population
health 2012-15
GM Planning and Performance, Andrew Lesperance was in attendance for this paper with Ana Apatu
(Senior Population Health Advisor) in support.
“Supporting Healthy Communities” is the three year planning framework for population health in
Hawke’s Bay and the Chatham Islands which aims to improve population health, especially the health
and wellbeing of Maori, Pacific and high needs communities.
CPHAC had endorsed the draft, and Clinical Council had also supported this but had commented on
the lack of an action plan and performance measures. Andrew advised that no changes had been
made to the document submitted to CPHAC or Clinical Council as this was a “high level” strategy
paper for the Ministry of Health to secure funding.
This was a combined initiative between Health Hawke’s Bay Ltd (HHB) and HBDHB which was seen
as a great platform for increased collaboration.
The HHB representative was unable to attend due to bereavement.
5
Recommendation
That the Board:
1.
Support and endorse the draft “Supporting Healthy Communities” (A Plan for Achieving
Strategic Priorities for Population Health 2012-2015) for implementation.
2.
Note the requirement for action plans and performance measures to be developed.
Adopted
RECOMMENDATION TO EXCLUDE THE PUBLIC
RESOLUTION
That the Board exclude the public from the following items:
13.
Confirmation of Minutes of Board Meeting dated – 29 February 2012
- Public Excluded
14.
Matters Arising from the Minutes of Board Meeting dated 29 February 2012
- Public Excluded
Report and Recommendations from the Committee Chairs:
15.
Community and Public Health Advisory Committee – 14 March 2012
16.
Clinical Council – 14 March 2012
17.
Finance Risk and Audit Committee – 28 March 2012
18.
Draft Regional Services Plan Update
19.
Draft HBDHB Annual Plan 2012/13 with Statement of Intent 2012/15
Moved:
Helen Francis
Seconded:
Diana Kirton
Carried
The meeting closed at 2.30pm
Signed:
Kevin Atkinson, Chair
Date:
6
MINUTES OF THE BOARD MEETING
HELD ON WEDNESDAY 24 APRIL 2012 IN THE TE WAIORA ROOM,
DHB ADMINISTRATION BUILDING, MCLEOD STREET, HASTINGS
AT 1.00 PM
Present:
Kevin Atkinson (Chair)
Barbara Arnott
David Barry
David Davidson
Peter Dunkerley
Helen Francis
Denise Eaglesome
Dan Druzianic
Ngahiwi Tomoana
Diana Kirton
Kirsten Wise
Apology:
-
In Attendance:
Kevin Snee, Chief Executive Officer (CEO)
Chris McKenna, acting Chief Operating Officer (COO)
Andrew Lesperance, General Manager Planning and Performance (GM P&P)
Peter Reed, Chief Financial Officer (CFO)
Members of the Executive Management Team
Members of the public and media
Board Administrator Brenda Crene
KARAKIA
The Deputy Chair, Ngahiwi Tomoana opened the meeting with a Karakia.
DECLARATIONS OF INTEREST
The Board Interests and Conflicts of Interest Register were noted with no amendments.
CONFIRMATION OF PREVIOUS MINUTES
The minutes of the Board meeting held on 28 March 2012, were confirmed as a true and correct
record of the meeting.
Moved:
Dan Druzianic
Seconded:
Diana Kirton
Carried
MATTERS ARISING FROM PREVIOUS MINUTES
Actions and progress from the previous meeting were noted. Verbal updates were provided as follows:
Item 1: The Board Work Plan was progressing.
Item 2: The Board and Committee Terms of Reference review was covered under Item 12. Action
removed.
Item 3: Following a Maori Relationship Board Meeting earlier in the day, an overview would be
provided under the “public” section of the agenda, not under “public excluded” section. Action
removed.
BOARD WORK PLAN
The Board Work Plan for the May 2012 meeting was noted.
May 2012
Section 1
1
CHAIR’S REPORT
The Chair verbally advised of the following matters that have arisen since the previous meeting:
• There were no pending retirements requiring acknowledgement at the meeting.
• An article reported by the Financial Times in the UK predicted there would be an oversupply of
20,000 junior doctors in the NHS by the end of the decade (2012). This is seen as an opportunity
for New Zealand.
• The Health and Disability Commissioner had advised that HBDHB rated number one (out of 20
DHBs) with the least number of complaints, 28.09 per 100,000 hospital discharges.
• All DHB Chairs received notification from the Minister of Health expressing his concern that DHB
staff were not engaging with primary care networks on the new Diabetes programme (replacement
for Diabetes Get Checked). The GM Planning and Performance advised the Board that HBDHB
was progressing well with the community lead being a Community and Public Health Advisory
Committee Member (Graeme Norton). The group meet six weekly.
• Health Workforce NZ advised that 2012/13 year funding for GP training had been distributed with
$6.6m allocated across 20 DHBs to fund the programme. Previously first year GP trainees were
remunerated by way of a non-taxable bursary.
• A letter has been received from Nellie Lim advising that she would be vacating the shop “Bedside
Manners” located inside the hospital. Management advised that Expressions of Interest had been
called for a new operator. The Chair would write to Nellie thanking her for the service provided.
Action
CHIEF EXECUTIVE OFFICER’S REPORT
The Chief Executive’s Report was received with the following update provided.
•
Health Targets: The shorter stay in ED result for March was 96% and was tracking at 97% April to
date. Elective surgery was ahead of plan by nearly 8%. With the media focus on waiting times, it
was important to note that our position is ahead of most DHBs in NZ (with four people waiting
longer than 6 months). The immunisation results at the time of the meeting had risen to 96% with
HBDHB the best in the country. Better help for smokers to quit had improved to 94.8% in April.
The Diabetes results were out of step for the quarter and GM Planning & Performance was asked
to check this.
Action.
•
Financial performance for the
financial year to date was tracking well to achieve the $2.0m surplus.
FINANCIAL PERFORMANCE REPORT FOR MONTH ENDED MARCH 2012
An overview of the presented report was provided by the CFO with the financial report taken as read.
The Board Chair, FRAC Chair and the CFO provided an overview of resolutions which required
attention following the FRAC meeting that morning.
Crown Health Financing Agency (CHFA) – Undrawn Funds
As CHFA would cease operating at 30th June 2012, the CFO recommended HBDHB should draw
down the balance ($6.5m) of the $42.5m facility available. The CFO advised the net cost of uplifting
the additional $6.5m from now until 15th March 2015 was approximately $29k.
The FRAC Committee Chair advised the Board the issue had been discussed at the Committee’s
meeting and they recommend the Board uplift the additional $6.5m prior to 30th June 2012.
2
RESOLUTION
That the Board
Approve uplifting the $6.5m undrawn CHFA facility by 30 June 2012 for an initial term expiring on 15
March 2015.
Note that the indicative borrowing rate is 3.18%
Moved
Dan Druzianic
Seconded
Kirsten Wise
Carried
Crown Health Financing Agency (CHFA) – Loan Rollover
The CFO advised that a $5.0m loan tranche had reached its term and recommended the tranche be
rolled over for a further five year term to expire on 15th March 2019. The interest rate offered was
3.98% which compared favourably to the average rate of the other five tranches of 6.02%
The FRAC Committee Chair advised the Board the issue had been discussed at the Committee’s
meeting and they recommend the Board approve rollover of the $5.0m CHFA loan tranche.
RESOLUTION
That the Board
Approve that the $5.0m tranche of the DHB loan expiring with the Crown Health Financing Agency be
rolled over with a new expiry date of 15 March 2019 at a rate of 3.98%.
Moved
Dan Druzianic
Seconded
Kirsten Wise
Carried
MOH grant for funding the Mental Health Inpatient facility
In 2011 the Minister of Health advised the Board that, as a result of issues associated with the old
Napier Hospital Site sale process, he had approved $5.0m of funding from the MOH to assist with the
proposed Mental Health Facility. The CFO advised the Board that they should accept the funding as
debt rather than an increase in equity as the ongoing cost of debt was significantly less than the
capital charge on equity.
The FRAC Committee Chair advised the Board the issue had been discussed at the Committee’s
meeting and they recommend that the Board accept the $5.0m as debt rather than equity.
RESOLUTION
That the Board
Approve that the funding granted to the Board by the Ministry of Health towards the new Mental Health
Facility be in the form of debt (i.e. a loan).
Moved
Dan Druzianic
Seconded
Kirsten Wise
Carried
Health Benefits Ltd Banking Arrangements
The CFO advised the Board that as a result of the Board approving the transfer of HBDHB’s banking
facility to Westpac last month, the Board was required to approve and execute the formal
documentation.
The FRAC Committee Chair advised the Board that the issue had been discussed at the Committee’s
meeting and they recommend that the Board approve the proposed resolution.
3
RESOLUTION
That the Board
1.
Approve the execution of the Agreement between HBDHB, Health Benefits Ltd and Westpac
NZ Limited titled Accession Deed, and notes the Accession Deed is in two parts – The Master
Agreement and the DHB Treasury Service Agreement.
2.
Confirms the Board Chair and FRAC Committee Chair be authorised by the Board to execute
the documents on behalf of the Hawke’s Bay District Health Board.
3.
Confirms the Chief Executive Officer, Chief Financial Officer and Acting Finance Manager
(Kevin Snee, Peter Reed and Phil Lomax) be authorised by the Board to give any notices and
other communications and take other action required in connection with the documents.
Moved
Peter Dunkerley
Seconded
Barbara Arnott
Carried
Audit New Zealand - Audit Fee Proposal
The CFO advised the Board they had received an Audit proposal letter from Audit New Zealand for the
Audit of HBDHB financial statements for the 2012 financial year. The CFO advised the Board the
increased fee allowed for an additional 81 hours of work to be performed on the 2012 audit. The
additional annual cost proposed was $10,274 per annum. The CFO conveyed he had compared the
fee to that paid by other similar sized DHBs and recommended the proposed fee be approved.
The FRAC Committee Chair advised the Board the issue had been discussed at the Committee’s
meeting and they recommend the Board approve the proposed fee.
RESOLUTION
That the Board
Authorise the Chairman of the Board (Kevin Atkinson) to sign the one year proposal for the provision
of external audit services from Audit NZ with a fee increase from $129,566 to $139,840.
Moved
Dan Druzianic
Seconded
David Barry
Carried
REPORTS AND RECOMMENDATIONS FROM COMMITTEE CHAIRS
Disability Support Advisory Committee Meeting (DSAC) – 11 April 2012
The Chair of DSAC, Diana Kirton provided an overview of the report and discussion including: Central
Region DHBs Benchmarking for Supporting Older People and a presentation on the Mental Health
Inpatient Unit (MHIPU) Model of Care (MOC). DSAC members requested discussions with targeted
groups prior to public consultation. A further presentation was well received on the National Mental
Health Blueprint. The Committee would write a letter of appreciation to John Key for the emphasis now
being placed on mental health services for youth.
There were no recommendations to the Board.
Hawke’s Bay Clinical Council – 11 April 2012
The co-Chair John Gommans was in attendance and provided an overview as follows:
The MHIPU MOC update was well received with support for the approach taken and progress to date.
The Maternity Quality and Safety Programme was discussed and further discussion took place on
clinical governance reporting structure. Clinical Indicator reviews were now a regular part of Council
meetings with a potential issue highlighted in ED triage which had been investigated.
There were no recommendations to the Board.
4
Maori Relationship Board (MRB) - Special Meeting – 24 April 2012
The Chair of MRB, Ngahiwi Tomoana updated members on the “Special Meeting” held that morning.
MRB had been requested to look into why Maori in particular, Did Not Attend (DNA) a large number of
specialist visits. Following discussion MRB could not pinpoint any specific reason for this as the DNAs
were spread across all health areas and included those from urban and rural locations.
Points raised:
• Were the more vulnerable moving addresses regularly and not receiving appointment notifications?
• Interaction with a Maori health provider could ensure greater connection to services if they were
involved in the referral.
• Each GP determines referral to a Specialist. Are assumptions made that a patient wants to be
referred and those assumptions are not challenged?
• With a “high definition video link” to Wairoa in the pipeline this may alleviate transportation issues
in some cases.
• Maori need to see health visits as a positive not a negative!
• Were patients aware of the importance of keeping specialist appointments?
• Were patients aware there was no cost involved, as the visit would be publicly funded?
MRB acknowledged there was an unacceptable amount of public money wasted through DNAs within
the Maori community in Hawke’s Bay and wished to investigate the matter further.
A request was made for a formal report back to the Board in three months (25 July 2012) which should
include but not be limited to the following: a) A definition of the DNA problem. b) Detail of the work
already undertaken by HBDHB to address the problem. c) Recommend further actions to be taken.
Action
Kahungunu Hikoi Whenua (KHW) Programme
With Healthy Eating Healthy Actions (HEHA) national funding re-defined to include “nutrition for
pregnant women and physical activity” MRB were confident there was a fit with the services provided
by the KHW programme. MRB provided the following recommendation to the Board.
1. HBDHB develop a comprehensive response to the MOH’s Request for Proposal for HEHA
funding immediately.
2. In doing so, engage with key stakeholders with a broad range of technical expertise and
develop and integrated approach across the life course and continuum of care. The proposed
stakeholder group to incorporate but not be limited to the following: the Healthy Populations
Group, KHW Team, Dianne Keip, Dr Russell Wills and Dr David Tipene-Leach.
Whilst seemingly a good fit, the CEO suggested taking the DHB’s available funding, work through
other funding and bring it back to the Board in three months time, whilst continuing to move KHW
forward. While KHW was very good at engaging with people, there was no evidence yet it improved
clinical outcomes. The programme needed to be evaluated (what, how, why) with the view to reducing
inequalities.
DECISION PAPERS
Board Committees – Terms of Reference
The Company Secretary, Ken Foote provided an overview of his report which appended reviewed
Terms of References (TORs) for the Advisory Committees.
Following discussion regarding extending committee member terms from one year to better align with
the Board, it was agreed to amend all TORs as follows:
Membership:
“Committee name” members are to be:
•
Appointed for any period that terminates no later than four months after the end
of the term of the HBDHB Board that appointed them. (Note: The full term of a
Board is three years).
•
Members may be reappointed by the ‘new’ Board.
The Chair of the Disability Support Advisory Committee had advised committee members at their last
meeting that advertising for new members would take place under the existing TOR.
The proposed TORs would now be reviewed by the respective committees over the next three months
and any suggested changes advised back to the Company Secretary.
5
RECOMMENDATIONS
That the Board:
1.
Agree the rationale and implications of the draft changes to the respective Terms of
Reference
2.
Modify the attached Draft Terms of Reference by changing the Membership provisions
relating to “term” as agreed above.
3.
Adopt these new Terms of Reference as ‘provisional’, pending discussion and feedback by
the respective committees.
4.
Request Final Draft Terms of Reference be referred back to the Board for final adoption
once consultation has been completed.
5.
Undertake a formal performance evaluation of each Committee in 12 months time, to
include a review on the value and effectiveness of these changes to the Terms of Reference
and the recent changes to meeting frequency.
Adopted
Licence to Occupy at HB Hospital – University of Otago Student Tutorial Room
Ken Foote (Company Secretary) on behalf of Warrick Frater (Chief Operating Officer) summarised the
report provided. There has been an agreement in place for some time to take students from Otago
University School of Medicine. Space is available and there is agreement between the parties, hence
approval through a formal Board Resolution was required.
RESOLUTION
That the Board:
Agree to provide the University of Otago with a licence to occupy an appropriate space designated for
trainee interns, for a total term of 18 years.
Moved
Helen
Seconded
David Barry
Carried
RECOMMENDATION TO EXCLUDE THE PUBLIC
RESOLUTION
That the Board exclude the public from the following items:
14.
Confirmation of Minutes of Board Meeting dated – 28 March 2012
- Public Excluded
15.
Matters Arising from the Minutes of Board Meeting dated 28 March 2012
- Public Excluded
Report and Recommendations from the Committee Chairs:
16.
Disability Support Advisory Committee Meeting – 11 April 2012
17.
Hawke’s Bay Clinical Council – 11 April 2012
18.
Finance Risk and Audit Committee – 24 April 2012
19.
Integrated Community Health Services Strategic Transition for Implementation
20.
Health of Older People – Home Based Support Services Plan
21.
Regional Services Plan V0.8
22.
Draft HBDHB Annual Plan 2012/13 verbal update
Moved:
Denise Eaglesome
Seconded:
Kirsten Wise
Carried
The meeting closed at 2.35pm
Signed:
Kevin Atkinson, Chair
Date:
6
MINUTES OF THE BOARD MEETING
HELD ON WEDNESDAY 27 JUNE 2012 IN THE TE WAIORA ROOM,
DHB ADMINISTRATION BUILDING, MCLEOD STREET, HASTINGS
AT 1.00 PM
Present:
Kevin Atkinson (Chair)
Barbara Arnott
David Barry
David Davidson
Peter Dunkerley
Helen Francis
Denise Eaglesome
Dan Druzianic
Ngahiwi Tomoana
Diana Kirton
Kirsten Wise
Apology:
-
In Attendance:
Kevin Snee, Chief Executive Officer (CEO)
Warrick Frater, Chief Operating Officer (COO)
Andrew Lesperance, General Manager Planning and Performance (GM
P&P)
Peter Reed, Chief Financial Officer (CFO)
Members of the Executive Management Team (EMT)
Members of the public and media
Minutes
Brenda Crene
KARAKIA
The Deputy Chair, Ngahiwi Tomoana opened the meeting with a Karakia.
DEPUTATION Topic: National Diabetes Conference 25-27 May 2012 (in Wellington)
Mr John Huggins was introduced and addressed board members on his recent Conference
attendance and provided an interesting presentation. Speakers at the Conference included
Steven Miller (Roche Diagnostics), Dr Bob Smith, Professor Jim Mann (Head of Diabetes
and Obesity Research in Dunedin) and Dr Peter Moodie (Pharmac Medical Director).
The pharmaceutical cost of diabetes for Pharmac presently was: $48.7 million of which
consisted of $4.0m for oral medicine; $19.7m for test strips; and $25.0m on insulin for both
type 1 and type 2 diabetics.
Pharmac’s focus was on the $19.7m which in their opinion was where cost savings could be
made by changing diabetic test meters (NZ wide). John was sceptical and advised the test
meter issues remain unresolved. The present meters were provided by Roche and in John’s
opinion the new meters were not as robust with a lot of questions to be answered including
good source of supply, back up stocks for warranty replacement, free switch over from other
types of meters to the new meters proposed.
John advised that Diabetes Hawke’s Bay, was one of eleven societies in New Zealand who
had not jumped aboard the Big “D” organisation and transferred their assets.
John was thanked for his presentation and a brief discussion followed.
July 2012
Section 1
1
DECLARATIONS OF INTEREST
The Board Interests and Conflicts of Interest Register were noted with no amendments.
Members were advised a review of the Conflicts of Interest Registers for respective
committees would get underway in an endeavour to streamline formats, forms and
procedures.
Action
CONFIRMATION OF PREVIOUS MINUTES
The minutes of the Board meeting held on 30 May 2012, were confirmed as a true and
correct record of the meeting.
Moved:
Dan Druzianic
Seconded:
David Barry
Carried
MATTERS ARISING FROM PREVIOUS MINUTES
Actions and progress from the previous meeting were noted.
In response to Item 6: John McKeefry corrected last month’s statement that “The Incubator
Programme was capturing data and tracking students enrolled.” It was correct to say that we
would be developing systems to track Incubator students and report back on this as part of
the next HR KPI report in August 12. We currently track to tertiary but not to employment.
BOARD WORK PLAN
The Board Work Plan for the July 2012 meeting was noted.
CHAIR’S REPORT
Staff Retirements: Chair Kevin Atkinson conveyed his best wishes and thanks to those
staff who had/or were to retire after extended service to HB District Health Board or
associated services.
Letters would be sent to those listed below acknowledging their service.
Actioned
Years
Name
Job Title
Service
Service
Date Retiring
Raymond Blewett
Plumber
Facilities
31
08-Jun-12
Dawn McCutcheon
Home Aid
Options HB
23
20-Jun-12
Jeanette Kenderdine
Clinical Nurse Manager
Rural & Community
27
29-Jun-12
James MacKenzie
Administration Officer
Options HB
17
29-Jun-12
Board members were advised that our Chief Financial Officer, Peter Reed would be retiring
before the next Board Meeting on 25th July. On behalf of the Board, Kevin Atkinson thanked
Peter for his outstanding contribution over the years and through some very challenging
times. He had appreciated the honesty, support and direction given during that period and
wished Peter a very happy retirement.
The Chair verbally advised of the following matters that have arisen since the previous Board
meeting:
• Ahuriri District Health had requested a further meeting which was schedule for 3 July
2012. Ngahiwi provided an apology. Those in attendance from ADH would be Des
Ratima, Tom Hemopo, Ranui Toatoa and Barry Wilson.
2
• A letter was received from the Ministry regarding Health of older people advising that
quality respite care services should be treated as a priority.
• On 19th June the Minister of Health released PHO league tables for quarter 3, which show
how each PHO was performing against the three national preventative health targets.
Performance of our local PHO was placed 17/35 for people who have had a CVD risk
assessment within the last 5 years, 9/35 for two year olds who have had their full
vaccinations, 22/35 for current smokers who had been given advice and/or smoking
cessation support. The Chair said that a conversation he had with John Newlands (PHO
Chair) indicated there would be a significant improvement in the result for quarter 4.
• Letter from the Minister of Health referring to the Government’s expectations for pay and
employment conditions. The letter emphasised that:
1. The cost of total remuneration movement, including pay increments and performance
based pay increases, must be taken into account when setting the financial envelopes for
remuneration and bargaining strategies.
2. Market relativity or cost of living adjustments will not suffice as the sole basis for pay
increases.
3. More detailed information on the nature of personnel cost movement is required fo state
sector agencies.
• A letter from the Auditor General advised that auditors would examine closely the
meaningfulness of the 1012/13 annual reports, and how well the Statement of Service
Performance (SSP) reflects the actual service performance for the year.
CHIEF EXECUTIVE OFFICER’S REPORT
The Chief Executive’s Report to 20 June was received and noted.
• HBDHB’s Annual Plan had been signed off by the Minister following some minor changes
to targets. The Minister had advised that the establishment of separate Maori and non-
Maori targets was unacceptable. However this did not mean that HBDHB would not
report on ethnicity health outcomes against the single target at a local level.
• To date, only two of the six Central Region Annual Plans had been accepted by the
Ministry (HBDHB and Mid Central).
• Health Targets as presented in the CEO’s report were taken as read. In terms of
performance HBDHB had no person waiting six months or more for their surgical
procedure or first specialist assessment with HBDHB being one of two DHBs in that
position. The focus was on achieving “no one waiting more than five months” which was
close to being achieved. Shorter Stays in ED were ahead of target for May however an
incident in June required review.
• The new Pharmacy contracts being negotiated were moving forward for signing by July
22nd, 2012. It was advised there had been and would continue to be discussions with
the Maraenui Pharmacy to ensure this vulnerable Pharmacy was not disadvantaged.
• The management team thanked the Board for their support over the past year,
acknowledging the very positive relationship between management and the Board.
Dr Snee introduced John McKeefry
VALUES / BEHAVIOURS (Tikanga Descriptors)
(GM Human Resources) who
MANAAKI – delivering high quality care to patients and
provided a brief presentation on the
consumers
Hawke’s Bay Health Sector Vision
and Value/Behaviours specifically
RANGATIRA – working together in partnership across
the sector
the Tikanga Descriptors.
AROHA ATU – showing respect for each other, our staff,
patients and consumers
PŪĀWAI AKE – continuously improving everything we
do.
3
• The work would be evaluated by a Maori language expert the following week.
• It was important to really understand what the vision and values really meant to bring to
life.
The next steps:
• The steering group would continue with plans to roll out the Visions & Values/Behaviours
to the health sector later in July 2012.
FINANCIAL PERFORMANCE REPORT FOR MONTH ENDED MAY 2012
The financial performance report for May 2012 was received. A summary of discussion in
addition to the report follows:
• The financial result for the month was close to budget with higher than expected costs
relating to inter district flows (IDFs) which were receiving focus.
• There had been a significant reduction in non acute rehabilitation contracts ie managing
people at the low cost end.
• In contrast those people who were access ACC contracts were being highly monitored
with some as a matter of course accessing specialist assessments and seeking surgery
on ACC.
• Insurance: Phil Lomax (Finance Manager) advised the new Collective National Insurance
Contract would be in place by 29 June 2012.
Insurance cover was lower and the premium cost would be higher (up around $900k or
88%) with excesses increasing significantly. DHBs were discussing plans to self insure
and share the losses (to keep costs down) however it appears the Government are not
currently open to this option.
The insurance premium would be advised by the Brokers the following week.
RESOLUTION that the Board:
Subject to approval in early July, endorse the insurance premium provided by the Insurance
Broker (Marsh)
Moved:
Peter Dunkerley
Seconded: Diana Kirton
Carried
• Finance would provide draft Annual Accounts to the August Board Meeting.
• Board members were advised they would receive related party disclosure forms for
completion. If there were any adjustments to be made, members were to get back to Phil
Lomax.
REPORTS AND RECOMMENDATIONS FROM COMMITTEE CHAIRS
Community and Public Health Advisory Committee (CPHAC) – 13 June 2012
Committee Chair, Barbara Arnott provided an overview of the report which was noted with no
recommendations to the Board.
4
Hawke’s Bay Clinical Council – 13 June 2012
Co-chair John Gommans was in attendance and provided an overview of the report provided
noting the following had been endorsed by Council:
• For palliative care leaders would develop a plan “Towards One Special Palliative Care
Service in Hawke’s Bay” that focused on the integration of specialist services to provide
more closely linked care to patients.
It was noted there was a shortage of palliative care physicians and Dr Gommans agreed
HBDHB did require an additional physician to work across the sector.
• In accordance with the Terms of Reference for the Hawke’s Bay Leadership Forum Sub
Group two representatives were appointed being Chris McKenna and Dr David Tipene-
Leach.
• Council supported/endorsed the Serious Skin Infections Project presented, and the next
steps.
Maori Relationship Board – meeting frequency
The Board noted the report and approved the change from bi-monthly meetings for the Māori
Relationship Board, to quarterly meetings with the next meeting to be held August 15, 2012.
Disability Support Advisory Committee (DSAC) Membership
Diana Kirton, Chair of DSAC advised that following expressions of interest invited by public
advertisement in early May 2012, and following a rigorous selection/interview process, the
following six selected candidates were provided for appointment to the DSAC Committee.
RESOLUTION that the Board:
• Appoint the following to the Disability Support Advisory Committee (DSAC):
Heather Campbell
Laureen Sutherland
Terry Kingston
Vaun McCormick
Diane Walsh
Andy White
• Thank outgoing members for their service and contribution over the past year.
Moved:
Diana Kirton
Seconded: Helen Francis
Carried
Board Administrator would check if there was a need to advise Minister’s office.
Actioned
DECISION PAPER
Hawke’s Bay Health Sector Leadership Forum
The paper provided was reviewed and would be tabled with the PHO.
5
RECOMMENDATION
That the Board:
Agree the Terms of Reference for the HB Health Sector Leadership Forum and Sub Group
Adopted
RECOMMENDATION TO EXCLUDE THE PUBLIC
RESOLUTION
That the Board exclude the public from the following items:
15. Confirmation of Minutes of Board Meeting dated 30 May 2012
- Public Excluded
16. Matters Arising from the Minutes of Board Meeting dated 30 May 2012
- Public Excluded
Report and Recommendations from the Committee Chairs:
17. Community & Public Health Advisory Committee – 13 June 2012
18. Hawke’s Bay Clinical Council – 13 June 2012
19. Finance Risk and Audit Committee – 27 June 2012
20. Central Hawke’s Bay Integrated Family Health Services
21. HBL Finance, Procurement and Supply Chain Business Case
22. Treasury Management Policy
23. Service and Financial Improvement Programme 2012/13
Moved:
Diana Kirton
Seconded:
David Davidson
Carried
The meeting closed at 2.10pm
Signed:
Kevin Atkinson, Chair
Date:
6
MINUTES OF THE BOARD MEETING
HELD ON WEDNESDAY 30 MAY 2012 IN THE TE WAIORA ROOM,
DHB ADMINISTRATION BUILDING, MCLEOD STREET, HASTINGS
AT 1.00 PM
Present:
Kevin Atkinson (Chair)
David Barry
David Davidson
Peter Dunkerley
Helen Francis
Denise Eaglesome
Dan Druzianic
Diana Kirton
Kirsten Wise
Apologies:
Ngahiwi Tomoana
Barbara Arnott
In Attendance:
Kevin Snee, Chief Executive Officer (CEO)
Warrick Frater, Chief Operating Officer (COO)
Andrew Lesperance, General Manager Planning and Performance (GM
P&P)
Peter Reed, Chief Financial Officer (CFO)
Members of the Executive Management Team
Members of the public and media
Minutes:
Kathy Shanaghan
KARAKIA
Tracee Te Huia, Director Maori Health, opened the meeting with a Karakia.
DECLARATIONS OF INTEREST
The Board Interests and Conflicts of Interest Register were noted with no amendments.
CONFIRMATION OF PREVIOUS MINUTES
The minutes of the Board meeting held on 24 April 2012 were confirmed as a true and
correct record of the meeting.
Moved:
Dan Druzianic
Seconded:
David Davidson
Carried
MATTERS ARISING FROM PREVIOUS MINUTES
Actions and progress from the previous meeting were noted. In response to item 3 regarding
the quarterly Diabetes results, the GM Planning & Performance explained the reason for the
difference was because the Ministry of Health’s figures showed a 12 month run chart,
whereas the DHB’s internal reporting was on a three month run. Board members were
informed that efforts were being made to standardise this for future results.
June 2012
Section 1
1
BOARD WORK PLAN
The Board Work Plan for the June 2012 meeting was noted. It was noted the HBL Finance,
Procurement and Supply Chain Shared Services Business Case would also be going to the
June meeting for Board approval.
CHAIR’S REPORT
The Chair advised of the following matters that had arisen since the previous meeting:
• A letter of appreciation had been received from the Chair of Capital & Coast DHB
formally thanking HBDHB for supplying that DHB with a copy of HBDHB’s Governance
Manual to help in the formulation of their own Governance Manual
• A letter had been received that morning from the Ministry of Health’s Target Champions
providing feedback on HBDHB’s quarter three Health Target results. Comments
provided were very favourable about progress made across all the indicators
• The highlight for the month was the Chair’s visit to the Chatham Islands, along with the
Chief Executive Officer and Chief Medical Officer – Primary Care. Key issues raised
during the visit included:
- The recent retirement of the general practitioner, with the Council and community
concerned as to the future of that service. In response, they were informed that
locums were being provided on three-monthly assignments for the remainder of the
year, however management was not in a position to commit to a permanent resident
doctor at this time
- The need to improve broadband on the Island as the internet connections varied.
- The termination of the Air Chathams service to Napier. A meeting was held with the
owner of Air Chathams to find out the reasons for this and to see if the service could
be reinstated. The following reasons were given for ceasing the service to Napier:
The relationship that the Chathams had with Napier in the past seemed to have
eroded over time.
In the past the flight was dependent on freight and tourists, however this had
become less and less over time.
The Chair said he had asked the owner of the airline to look at what the additional
costs would be to reinstate that service to Napier. Once those costs were known,
management would then consider the options available. He had also raised the issue
of developing a relationship to support their services with the Napier Mayor and CEO
of Unison Networks Ltd.
There was also a very good discussion with the Chatham Islands Council over a range of
issues, some of which included:
- Fluoridation – no particular concerns
- Accommodation for nursing staff and the need to make it more attractive for families
- Maintenance on the doctor’s facilities.
The Council indicated they would like the Chair and CEO to visit on a more regular basis
and the Chair gave a commitment to try and do that. He said it was important, therefore,
to look at the issues raised and develop some solutions before the next visit. It was also
intended to place an article in the local newspaper about the visit, the issues raised and
what was being done to address those issues.
• The Chair referred to Budget 2012 and noted that Health received the largest increase in
government spending compared to the other sectors. The main points of the Budget
were:
2
- Vote Health was $14.12 billion in 2012/13, the biggest investment ever.
- An extra $435 million had been made available to help fund cost pressures and new
initiatives.
- Health’s allocation was three times that of Education and five times that of Welfare.
- Around $47 million of savings and under-spends in Health had been shifted to higher
priority frontline public health services.
- The adjustment for the residential care exemption was changed from a flat increase
of $10,000 a year to an annual inflation adjustment in line with other aged-care
support adjustments.
CHIEF EXECUTIVE OFFICER’S REPORT
The Chief Executive’s report was received and noted. The CEO tabled a newspaper article
following the release of the quarter three 2011/12 Health Targets results which showed
HBDHB’s results as follows:
• Improved access to elective surgery: Scored 106 percent against a target of 100
percent, which meant 468 more people had elective surgery than a year ago.
• Shorter stays in emergency departments: Met 95 per cent target of patients admitted,
discharged or transferred within six hours.
• Increased immunisation: Improved on the 95 per cent target by one percent, hitting
96 per cent and being the second best performing DHB.
• Better help for smokers to quit: Improved against last quarter, reaching 93 per cent of
hospitalised smokers provided with help to quit.
• Shorter waits for cancer treatment: Remained at 100 per cent.
• New target of ‘more heart and diabetes checks’: HBDHB lying 10th nationally with 51 per
cent against a target of 60 percent.
FINANCIAL PERFORMANCE REPORT FOR MONTH ENDED APRIL 2012
The financial performance report for April 2012 was received and the following update
provided:
Insurance
The CFO advised the Board that Health Benefits Ltd (HBL) was in the process of negotiating
the insurance cover for DHBs for the 2012/13 year. At this stage HBL was advising a
potential increase on the 2011/12 premium of between 40 to 75%.
The FRAC Committee Chair advised that the issue had been discussed by the Committee
and recommended that the Board and FRAC Chairs be given delegated authority to approve
the insurance cover and cost when HBL had completed the negotiations.
Resolution
That the Board approve the Board and FRAC Chairs be given delegated authority to approve
the 2012/13 insurance cover and costs.
Moved:
David Barry
Seconded:
David Davidson
Carried
Allied Laundry
The CFO advised that the Board of Allied Laundry had requested the shareholders agree to
that company retaining any 2011/12 surplus greater than $240k for future capital purchases.
The $240k would be paid to shareholders as a dividend.
The FRAC Committee Chair advised the Board that the issue had been discussed at the
Committee’s meeting and it was recommended the Board approve the request.
3
Resolution
That the Board approve Allied Laundry’s request to retain any 2011/12 surplus greater than
$240k for future capital purchases.
Moved:
Peter Dunkerley
Seconded:
Dan Druzianic
Carried
REPORTS AND RECOMMENDATIONS FROM COMMITTEE CHAIRS
Hospital Advisory Committee (HAC) – 9 May 2012
The Chair of HAC, David Barry, provided an overview of the matters considered by HAC at
its meeting on 9 May. The resignation of David Marshall, Principal Dental Officer, with effect
from the end of July 2012, was noted and the committee resolved to recommend to the
Board that David Marshall’s contribution to health services be recognised appropriately.
Recommendation
That the Chair, on behalf of the Board, writes to David Marshall thanking him for his
contribution to oral health services in Hawke’s Bay and wishing him well in his retirement.
Adopted
Hawke’s Bay Clinical Council – 9 May 2012
Co-Chair, John Gommans, provided an overview of the matters considered by the Clinical
Council at its meeting on 9 May 2012. There were no recommendations to the Board,
however the Clinical Council:
• Endorsed the Hawke’s Bay Health Sector Vision and Values statement and the proposed
next steps in implementation
• Endorsed the Clinical Governance and Leadership Workplan Framework with Council
members taking specific portfolio roles
• Acknowledged HBDHB’s achievement having eliminated hospital-acquired intensive care
bloodstream infections in their patients for a whole year.
Maori Relationship Board (MRB) – 16 May 2012
Denise Eaglesome provided an overview of the MRB meeting where the findings in the
report “Did not Attend Rates (DNAs) at Hawke’s Bay Hospital” were discussed. At that
meeting, MRB:
• Endorsed the recommendations within that report, and
• Recommended the DHB establish a Kaiawhina position as a pilot for one year to assist in
reducing the DNA rates.
MRB also agreed to pass the report and recommendations to the Chief Operating Officer to
review and action as appropriate.
Action
DECISION PAPERS
Hawke’s Bay Health Sector Vision and Values
The GM Human Resources gave a presentation and overview of the process undertaken in
the development of the new Hawke’s Bay Health Sector Vision and Values/Behaviours.
The next steps included:
• Finalisation of the tikanga descriptors by 1 June 2012
• Presentation of the full Vision and Behaviours to the HBDHB Board and Health
Hawke’s Bay Board for sign off
• Continue with the Steering Group
4
• Finalise Terms of Reference for Phase II Vision and Behaviours implementation and
alignment actions with the Steering Group on 12 June 2012
Recommendations
That the Board:
1.
Approve the Hawke’s Bay Health Sector Vision and Values/Behaviours.
2.
Note and endorse the next steps in implementation.
Adopted
MONITORING PAPERS
Performance Framework Expectations (Quarter 3) 2011/12
This paper provided the Board with exception reporting on HBDHB’s performance on the
Statement of Intent (SOI) and the District Annual Plan (DAP). A summary dashboard
showing the position as at the end of this quarter for all indicators, was tabled.
The Chair expressed concern that this was the third quarter in a row where HBDHB was
running behind targets in a number of areas. He referred to the Better Help for Smokers to
Quit target and noted there had been no improvement from last month, despite the work that
was being done in this area. He pointed out that this was going to be a national target that
would be reported on quarterly and the Minister’s office would be focusing on this target.
Another area of concern was in relation to the Child and Youth target.
With regard to the Smokers to Quit target, the GM Planning & Performance advised that the
DHB had met with the CEO of Health Hawke’s Bay and offered the assistance of the DHB’s
Project Manger for Smokefree to train their staff and nurses in GP practices. While there
had been some uptake on that offer, it had been limited. It was also noted that some of the
biggest problems related to performance of providers contracted to the DHB.
The Chair asked the Chairs of the Advisory Committees to review the dashboard and identify
those targets specific to their committees and then discuss actions that needed to be taken
to achieve those targets.
Action Human Resources KPIs (Quarter 3) 2011/12
The GM Human Resources provided an overview of the paper presented to the Board, with
the following noted:
• Turnover in nursing staff had increased gradually.
• The number of staff with more than two years accumulated leave had decreased from
this time last year and was now sitting at under 100 staff.
• There had been no improvement in the percentage of staff who identify themselves as
Maori within HBDHB. The actual for April was 8.81% with a target of 9.73%. The Chair
suggested management have a discussion with Ngahiwi Tomoana about the ‘Corporate
Leaders’ project which had recently been launched, which aimed to place unemployed
Maori youth into jobs in Hawke’s Bay. The GM Human Resources said he had already
scheduled a meeting with Ngati Kahungunu Iwi Inc to discuss this. The Chair asked for
an update following that meeting.
Action
The question was raised as to whether there was any data on ethnicity in the Hawke’s
Bay workforce. It was thought that a survey had been undertaken last year as part of the
Turuki Maori Workforce Strategy and the GM Human Resources undertook to follow this
up and provide an update for the next Board meeting. Diana Kirton suggested
contacting the EIT as that organisation might also have some data.
Action
5
The GM Human Resources pointed out that education played a huge part in getting
Maori into the health sector and it was therefore important to encourage students to stay
at school longer. He referred to the work Incubator was doing to encourage secondary
students, particularly those of Maori and Pacific heritage, to pursue health careers. He
advised that all students enrolled in the Incubator programme were ‘tracked’ and
undertook to provide that information in the next KPI report.
Action
FOR INFORMATON / DISCUSSION
Hawke’s Bay Health Sector Leadership Forum Workshop – 15 February 2012
The report on the Hawke’s Bay Health Sector Leadership Forum workshop held on
15 February 2012 was noted.
The CEO tabled draft Terms of Reference (TOR) for both the Hawke’s Bay Health Sector
Leadership Forum and the Forum Sub Group, as discussed and agreed at the Forum
workshop. These draft TOR had been developed by the CEOs of HBDHB and Health
Hawke’s Bay Ltd (PHO).
The Board agreed with the TOR apart from requesting a change in the wording of the
membership section of the Sub Group TOR, ie:
“Membership”:
Two representatives from each of:
• HBDHB
• Health Hawke’s Bay Ltd
• Hawke’s Bay Clinical Council
• Maori Relationship Board
Individual members will be appointed by their respective organisations/
committees.”
With this change in mind, the Board then discussed who the HBDHB representatives should
be.
Recommendation
That the Board appoint Helen Francis and Dr Kevin Snee to be the HBDHB representatives
on the Hawke’s Bay Health Sector Leadership Forum Sub Group.
Adopted
The CEO said the only other outstanding issue was whether to describe the Clinical Council
and Maori Relationship Board as HBDHB or Hawke’s Bay. His preference was the latter as
it had a broader representation.
It was noted the next Leadership Forum workshop was planned for September 2012.
6
RECOMMENDATION TO EXCLUDE THE PUBLIC
RESOLUTION
That the Board exclude the public from the following items:
17.
Confirmation of Minutes of Board Meeting dated – 24 April 2012 – Public Excluded
18.
Matters Arising from the Minutes of Board Meeting dated 24 April 2012 –
Public Excluded
19.
Chief Financial Officer’s Report – Public Excluded
Report and Recommendations from the Committee Chairs:
20.
Community and Public Health Advisory Committee – 9 May 2012
21.
Hospital Advisory Committee – 9 May 2012
22.
Hawke’s Bay Clinical Council – 9 May 2012
23.
Maori Relationship Board – 16 May 2012 (including DSAC)
24.
Finance Risk and Audit Committee – 30 May 2012
25.
Capital Plan 2012/13
26.
Maternity Services in Hawke’s Bay
27.
Regional Services Plan
28.
Hawke’s Bay District Health Board Annual Plan
29.
Service and Financial Improvement Programme 2012/13
30.
Car Parking
Moved:
Helen Francis
Seconded:
Dan Druzianic
Carried
The meeting closed at 2.05pm.
Signed:
Kevin Atkinson, Chair
Date:
7
MINUTES OF THE BOARD MEETING
HELD ON WEDNESDAY 25 JULY 2012 IN THE TE WAIORA ROOM,
DHB ADMINISTRATION BUILDING, MCLEOD STREET, HASTINGS
AT 1.04 PM
Present:
Kevin Atkinson (Chair)
Barbara Arnott
David Barry
David Davidson
Peter Dunkerley
Helen Francis
Denise Eaglesome
Dan Druzianic
Ngahiwi Tomoana
Diana Kirton
Kirsten Wise
Apology:
-
In Attendance:
Kevin Snee, Chief Executive Officer (CEO)
Warrick Frater, Chief Operating Officer (COO)
Andrew Lesperance, General Manager Planning & Performance (GM P&P)
Peter Kennedy, Finance Manager and Acting Chief Financial Officer
Members of the Executive Management Team (EMT)
Members of the public and media
Minutes
Brenda Crene
KARAKIA
The Deputy Chair, Ngahiwi Tomoana opened the meeting with a Karakia with board
members joining in as a mark of respect for “Maori Language Week”.
DECLARATIONS OF INTEREST
There were no amendments noted to the Conflicts of Interest Register which would be
circulated periodically to members.
CONFIRMATION OF PREVIOUS MINUTES
The minutes of the Board meeting held on 27 June 2012, were confirmed as a true and
correct record of the meeting.
Moved:
Dan Druzianic
Seconded:
Davod Barru
Carried
MATTERS ARISING FROM PREVIOUS MINUTES
Actions and progress from the previous meeting were noted.
BOARD WORK PLAN
The Board Work Plan for the August 2012 meeting was noted as was the Detailed Workplan.
August 2012
Section 1
1
CHAIR’S REPORT
Staff Retirements: Chair Kevin Atkinson conveyed his best wishes and thanks to those
staff who had/or were to retire after extended service to HB District Health Board or
associated services.
Letters would be sent to those listed below acknowledging their service.
Actioned
Years
Name
Job Title
Service
Service
Date Retiring
Margaret Lines
ACC Elective Services Manager
Elective & Surgical
21
18-Jul-12
Margaret Monk
Anaesthetic Technician
Elective & Surgical
35
20-Jul-12
Peter Reed
Chief Financial Officer
Finance
10
20-Jul-12
Andrew Potts
Electrician
Facilities
17
03-Aug-12
The Chair verbally advised of the following matters that have arisen since the previous Board
meeting:
• The Chair commented on the listeria outbreak advising that the Ministry for Primary
Industries was leading an enquiry into the listeria food source and their focus was
external to the Hospital (HBDHB). Their focus was on an external food supplier who
provides food to the hospital. It was a difficult time for the families and the Board
extended their condolences. The Chair also advised the importance of the “food safety”
message, especially for those with lowered immunity ie., elderly, the young and
especially pregnant women.
• With the retirement of Peter Reed (Chief Financial Officer) on 20 July 2012, there was a
need to appoint a replacement director as one of the two HBDHB appointed directors on
the Board of Allied Laundry Services Limited.
RESOLUTION
That the Board:
Appoint Ken Foote (Company Secretary) as one of the two HBDHB appointed directors on
the Board of Allied Laundry Services.
Moved
Kevin Atkinson
Seconded
David Davidson
Carried
• A meeting was held between the Chair and CEO of HBDHB and three directors/members
of Ahuriri District Health Trust (ADH). The Chair advised that issues between ADH and
the OTT partnership had been resolved. The Chair expressed concern at the slow pace
at which the development of an Oral Health Service Contract was progressing (for the
Ahuriri people). A timeframe was put in place to move this forward. It was accepted
HBDHB would hold and manage contract funding.
• Two letters had been received from the Ministry of Health, one related to the successful
completion of the District Plan for the next three years which was signed off by the
Minister. The other letter confirmed sign off of the Central Region DHB Regional
Services Plan.
• Health data released by the OECD outlined how well New Zealand’s health sector had
been funded compared with other countries. Between 2000 and 2009 NZ was 3rd best in
OECD countries and moved up one notch in 2010 to be 2nd best in the OECD (behind
Korea). This was noted as significant and the NZ Government must be commended for
growing funding in the health sector. The Chair said that we have a real responsibility to
ensure those funds are spent wisely. It was noted that nine countries in the OECD had
reduced their health spending in 2010!
2
• A letter was received from Hand Hygiene New Zealand, regarding a Hand Hygiene
Compliance Audit conducted in July 2012. The letter conveyed that 17 out of the 20
DHBs in the country had been audited with Hawke’s Bay ranking at 6th best out of 17 with
a compliance rate of 67.7%. The top DHB had a compliance rate of 73.7% The Chair
said he considered that this was a good result.
• The Chair acknowledged that following a request from the Community and Public Health
Advisory Committee (CPHAC) he wrote to the Mayor of Central Hawke’s Bay endorsing
continuation of fluoridation in the CHB water supply. This was actioned on 18 July 2012.
CHIEF EXECUTIVE OFFICER’S REPORT
The Chief Executive’s Report to 19 July 2012 was received and noted. Dr Snee was
satisfied with the health targets achieved during the year, particularly those that had been
focused on for some time which had exceeded expectations. There were several targets
however which would receive close attention being “helping smokers to quit” and “more heart
and diabetes checks” which should show some improvement in several months time.
The financial year commenced with a goal to achieve a $2.0m surplus and preliminary
figures show $2.1m was achieved - despite a significant variance in the middle of the year.
Of particular note, the new (interim) Pharmacy contracts in Hawke’s Bay had all been signed
at the time of the meeting and Hawke’s Bay had led the country in this regard. A great
achievement and congratulations to all those involved especially Portfolio Manager, Sue
Ward.
The Central Region Information System Project (CRISP) had recently appointed a very
capable Programme Director which would see this project get traction and move forward.
FINANCIAL PERFORMANCE REPORT FOR MONTH/YEAR ENDED JUNE 2012
Peter Kennedy the new Finance Manager was acting Chief Financial Officer (following Peter
Reed’s retirement the week prior). Peter Kennedy provided a brief overview of the financial
performance report for June 2012. A summary of discussion in addition to the report follows:
The interim financial result was $2.1 surplus. The published result sent to the Ministry would
be $2.6m which included end of year accounting adjustments.
The Chair noted the bequest of funds from the Estate of Percival Beattie towards the
construction and equipping of two new tutorial rooms within the Education Centre at HB
Hospital. Recognition would follow with appropriate naming rights and plaques provided
acknowledging the Trusts generosity and leaving a lasting legacy for the family.
REPORTS AND RECOMMENDATIONS FROM COMMITTEE CHAIRS
Disability Support Advisory Committee – 11 July 2012
Helen Francis (acting Chair of the DSAC in Diana Kirton’s absence) provided an overview of
the meeting. New DSAC members were welcomed to the group for the ensuing term. There
were no recommendations made for Board. Two very interesting presentations on:
a) Falls Management Initiatives; and
b) Improving the Nutritional Status of Community Living Older People. David Barry advised
the latter work had been assisted by the Medical Research Foundation and wished to note
their work had been referenced. This organisation relied heavily on philanthropy to
continue its work.
3
Hawke’s Bay Clinical Council – 11 July 2012
Co-chair of the meeting, Chris McKenna (Director of Nursing) was in attendance and
provided an overview of the report to the Board. Of particular note was an addition to the
“Membership” section in the Terms of Reference (TOR), to ensure that a wide range of
perspectives and interests were maintained within the total membership, ensuring in
particular that Maori health and rural health interests and expertise were reflected.
RECOMMENDATION
That the Board:
Approve the additional clause in the Membership section of the Terms of Reference
attached.
Adopted
Research and Ethics were discussed and this would be reviewed again by Council following
further investigation on how other DHBs manage these areas.
DECISION PAPER
Treasury Management Policy
The Chairman of FRAC, Dan Druzianic advised the Finance Risk and Audit Committee
(FRAC) had reviewed the paper in detail earlier in the day, and recommended that the Board
approve it.
RESOLUTION
That the Board:
Approve the revised HBDHB/OPM/087 Treasury Management Policy, noting it had been
updated to reflect the shared banking arrangement.
Moved Dan Druzianic
Seconded Peter Dunkerley
Carried
4
RECOMMENDATION TO EXCLUDE THE PUBLIC
RESOLUTION
That the Board exclude the public from the following items:
13. Confirmation of Minutes of Board Meeting dated 27 June 2012
- Public Excluded
14. Matters Arising from the Minutes of Board Meeting dated 27 June 2012
- Public Excluded
Report and Recommendations from the Committee Chairs:
15. Hawke’s Bay Clinical Council – 11 July 2012
16. Finance Risk and Audit Committee – 25 July 2012
17. Wairoa Integrated Health Services project – Business Case
18. HBDHB Policy: payment of Fees and Expenses
19. Vision, Values and Behaviours Workshop
20. 2012/12 Budget Presentation
21. Community Pharmacy Contract Update Presentation
Moved:
David Davidson
Seconded:
Helen Francis
Carried
The meeting closed at 1.42 pm.
Signed:
Kevin Atkinson, Chair
Date:
5
MINUTES OF THE BOARD MEETING
HELD ON WEDNESDAY 29 AUGUST 2012 IN THE TE WAIORA ROOM,
DHB ADMINISTRATION BUILDING, MCLEOD STREET, HASTINGS
AT 1.04 PM
Present:
Kevin Atkinson (Chair)
David Barry
David Davidson
Peter Dunkerley
Helen Francis
Denise Eaglesome (by video conference)
Dan Druzianic
Ngahiwi Tomoana
Diana Kirton
Kirsten Wise
Apology:
Barbara Arnott
In Attendance:
Kevin Snee (Chief Executive)
Warrick Frater (Chief Operating Officer (Chief Operating Officer)
Andrew Lesperance (General Manager Planning and Performance)
Tim Evans (Chief Financial Officer)
Members of the Executive Management Team
Members of the public and media
Minutes
Brenda Crēne
KARAKIA
The Deputy Chair, Ngahiwi Tomoana opened the meeting with a Karakia.
WELCOME
Tim Evans the newly appointed Chief Financial Officer (from the UK) was welcomed and
introduced.
DECLARATIONS OF INTEREST
There were no amendments noted to Conflicts of Interest Register.
CONFIRMATION OF PREVIOUS MINUTES
The minutes of the Board meeting held on 25 July 2012, were confirmed as a true and
correct record of the meeting.
Moved:
Dan Druzianic
Seconded:
David Barry
Carried
MATTERS ARISING FROM PREVIOUS MINUTES
Actions from the previous meeting were noted.
Item 1 Performance Framework Expectations was discussed with further time provided by
the Chair, to ensure all Advisory Committees had considered this topic. It was noted the
Hospital Advisory Committee (HAC) had already done so. The Board Administrator would
co-ordinate feedback from the respective Committee Chairs’.
Action
September 2012
Section 1
1
BOARD WORK PLAN
The Board Work Plan for the September 2012 meeting was noted.
CHAIR’S REPORT
Staff Retirements: Chair, Kevin Atkinson conveyed best wishes and thanks to those staff
who were to retire after extended service to HB District Health Board. Letters would be sent
to those listed below acknowledging their service.
Actioned
Years
Name
Job Title
Service
Service
Date Retiring
Diane Davidson
Systems Administrator
Finance
35
30 August 2012
Ian Larrington
Health Intelligence Analyst
Business Intelligence
36
14 September 2012
The Chair advised there were no matters to raise since the previous Board meeting.
CHIEF EXECUTIVE OFFICER’S REPORT
The Chief Executive’s Report to 22 August 2012 was received and noted.
A summary of points raised follows:
• Due to the retirement of David Marshall (after 50 years in dentistry), Robin Whyman had
been appointed as Principal Dental Officer/Clinical Director for Oral Health Services at
the DHB. Robin’s more recent roles included: Dental Manager, Principal Dental Officer,
CEO for NZDA and Oral Advisor for the Ministry of Health. Robin’s appointment would be
effective in January 2013.
• The Prime Minister John Key, officially launched (on 24 August 2012) the
commencement of construction on the $5.0m upgrade to Wairoa Hospital which would
transform the existing hospital into a purpose built integrated family health centre.
• A new General Manager of Integrated Care had recently been appointed. Kieran McCann
had a wealth of experience from roles in Ireland and New Zealand. More recently he had
been General Manager of Clinical Services at Wairarapa DHB, having worked with
models around integrated care. Kieran would commence his role in November 2012.
• The Executive Management Team (EMT) had visited Canterbury District Health Board in
mid August to view their plans for transformational change, following the devastating
Christchurch earthquake. The learnings from the visit, especially the enhancement of
Canterbury DHBs services into the community would be invaluable as Hawke’s Bay DHB
continue to refocus on working smarter, enhancing service delivery and moving towards
integrated care.
• An update on the Mental Health Inpatient Unit was received from Andrew Lesperance
who advised the Model of Care had been progressed, however timelines were
approximately three weeks behind.
• The programme for the HB Health Sector leadership Forum Workshop planned for the 5th
September would be issued to participants on 30th August 2012.
Actioned
FINANCIAL PERFORMANCE REPORT FOR MONTH ENDED JULY 2012
The Chief Financial Officer presented his first report for the first month of the financial year
2012/13 which showed a surplus of $228k compared with a budgeted surplus of $517k.
There were a number of cost pressures several of which were driven by activity, including
surgery demands
.
The 2012/13 budget did include $1.0m which was yet to be identified in the Service and
Financial Improvement program. This had been included as a line item.
2
Travel and accommodation costs had improved and it was pleasing to note that accrued
leave had dropped since the prior month.
REPORTS AND RECOMMENDATIONS FROM COMMITTEE CHAIRS
Hospital Advisory Committee (HAC) – 8 August 2012
Chair, David Barry provided an overview of the report which included support for Option 2 for
the development of additional facilities to improve Endoscopy Services in Hawke’s Bay for
increased efficiency and additional onsite capacity for HBDHB’s population.
Hawke’s Bay Clinical Council – 8 August 2012
Co-chair of Council, Dr John Gommans was in attendance.
Dr Andrew Heslop had been welcomed as a new member of Clinical Council and it was with
regret that Alistair More had resigned his position on Council and returned to Scotland.
The Endoscopy Services Business Case had been endorsed by Council noting the “need to
ensure ‘disparities’ received focus and was adequately addressed in service delivery”.
Council found the clinical aspects were not clearly defined and felt that before any facility
design/planning took place, there was a need for a robust Model of Care which addressed
inefficiencies and integration and also ensured “disparities” received adequate focus.
“Smokefree Hawke’s Bay First Steps 2012-2015 first steps” were fully endorsed by Council.
Following the ordinary meeting, an Annual Review Meeting was held which reviewed a
number of operational aspects. In summary:
• Drs Foley and Gommans were unanimously re-elected to their roles as co-chairs.
• A review of membership was underway as the two year tenure of some initial Council
members would expire in September 2012. Nominations had been sought for the positions
and following panel review, the successful candidates would be ratified through the
September Board Meeting.
Action
Council conveyed thanks to the Board for their support of clinical leadership within the Health
Sector. The Board Chair reciprocated advising that Clinical Council was an integral part of
decision making and was working well.
Māori Relationship Board (MRB) – 15 August 2012
Ngahiwi Tomoana (Chair) advised MRB had received an excellent presentation from the
Children’s’ Commissioner Dr Russell Wills, on the B4 School programme and work planned.
MRB supported the recommendations for the provision of vision and hearing screening in
Kohanga Reo and endorsed the overall B4 School programme as a tool to improve
outcomes for tamariki Māori.
A Healthy Homes Programme update was provided including a new pilot entitled the
“Friendly Landlord Scheme”. As many Māori reside in rented accommodation with very little
insulation, this scheme focused on landlords being made accountable to suitably upgrade
their rental properties. The benefits of insulation were well known.
MRB had appointed Tatiana Cowan-Greening as their representative on the Maternity
Services in Hawke’s Bay Steering Group.
DECISION PAPER
Committee Terms of Reference Review
Ken Foote (Company Secretary) outlined the process to review of Committee Terms of
Reference (TOR) which commenced in April 2012. This review had been completed and was
presented to the Board for adoption. The only change noted was to the Māori Relationship
Board TOR as they moved from bi-monthly meetings to quarterly.
3
RESOLUTION
That the Board:
Adopt the attached updated Terms of Reference for the:
• Disability Support Advisory Committee
• Community and Public Health Advisory Committee
• Finance Risk and Audit Committee
• Hospital Advisory Committee
• Māori Relationship Board
• Appointments and Remuneration Advisory Committee
• Hawke’s Bay Clinical Council
Moved Kevin Atkinson
Seconded David Davidson
Carried
Improving Endoscopy Services – Business Case
Warrick Frater (Chief Operating Officer) was in attendance. He summarised the Business
Case advising the existing endoscopy facilities had physical limitations and constraints on
service provision, with no ability within the existing theatre suite to increase capacity during
standard operating hours.
• With population projections and increased demand forecasted there had been pressure
for some time due to lack of space.
• A new build could be undertaken without demolition of existing areas.
• Three endoscopy suites would be planned with two implemented initially.
• Board approval was sought which was subject to the availability of funds at the time
(2015/16 or thereafter).
• Chair, Kevin Atkinson provided wording which tightened the original Resolution.
RESOLUTION
That the Board:
• Note the endorsements from HAC and Clinical Council.
• Approve the business case in principle option B2 for the implementation of the Improving
Endoscopy Services project, subject to the availability of funding and final sign off by the
Board.
• Note a capital budget of approximately $8.716m (+/- inflation) would be required to
implement the Business Case.
• Note the next steps in the process were to review and confirm a Model of Care for the
service (including a focus on disparities), prior to the development of detailed designs.
Moved Helen Francis
Seconded David Barry
Carried
It was noted Endoscopy was not affordable unless HBDHB generated the surpluses in the
ensuring years. This project had lower priority than the Mental Health facility.
A discussion took place between clinicians in the room to clarify technologies.
4
FOR INFORMATION
Tū Mai Rā Quarterly Report
The Director of Māori Health provided a summary of the third quarter (January-March) Tū
Mai Rā report for 2011/12. Timing issues would be addressed to ensure timely presentation
of the report in 2013. Points raised at the meeting were summarised below:
• Of the 28 indicators reported on, 19 of those indicators were trending in the right direction.
• It was agreed that it would take the provision of several more quarterly reports to give a
more relevant indication of any significant trends.
• The Oral Health team were complimented for their work.
• Smoking – health benefits would be recognised going forward.
• A decline in the “Did Not Attend” figures was noted in Quarter 4. This was due to more
focus and involvement at the time appointments were set, and the subsequent follow up.
A pleasing result.
• The achievements made with diabetes annual checks should not go unnoticed.
• HBDHB were focusing on recruitment of Māori into health care areas.
• Good work was going on in the area of infant mortality with a noted drop in incidences.
Human Resource KPIs (Q4) 2011/12
John McKeefry (General Manager, Human Resources) provided an overview of the report
provided.
Reductions in accrued Annual leave were achieved following intensified focus.
HR services would drive forward the KPI partnership with Māori health and due to a large
data base this would include email focus groups.
The Incubator Programme (initiated by HBDHB) was now rolling out to other DHBs.
There would be intensified work with primary providers to ensure reporting was captured
each quarter. Chair, Kevin Atkinson requested a refinement be made to the chart showing
the net position and include the new leavers (ie, comings and goings) to see the balance.
Action
Performance Framework (Q4) 2011/12
Andrew Lesperance (General Manager, Planning & Performance) spoke to the paper tabled
at the meeting. The detail had been received from the Ministry, several days prior. In
summary:
• A fantastic effort, HBDHB had achieved 2nd place in NZ with immunisation.
• HBDHB were soon to receive a “Certificate in Outstanding Improvement in Elective
Surgery”, another amazing effort with thanks to all concerned.
• A highlight was the increase in breast screening for pacific women which had risen to
72% compared with 32% the year prior.
GENERAL BUSINESS
With no general business the meeting moved to Public Excluded.
5
RECOMMENDATION TO EXCLUDE THE PUBLIC
RESOLUTION
That the Board exclude the public from the following items:
18. Confirmation of Minutes of Board Meeting dated 25 July 2012
- Public Excluded
19. Matters Arising from the Minutes of Board Meeting dated 25 July 2012
- Public Excluded
Report and Recommendations from the Committee Chairs:
20. Hospital Advisory Committee Meeting – 8 August 2012
21. Finance Risk and Audit Committee – 25 July 2012
22. Regional Governance
23. Central Region Integrated Systems Plan (CRISP) Update
24. Presentation: BHDHB Organisation Development Plan
Moved:
Peter Dunkerley
Seconded:
Dan Druzianic
Carried
The meeting closed at 2.22pm
Signed:
Kevin Atkinson, Chair
Date:
6
MINUTES OF THE BOARD MEETING
HELD ON WEDNESDAY 26 SEPTEMBER 2012, IN THE TE WAIORA ROOM,
DHB ADMINISTRATION BUILDING, MCLEOD STREET, HASTINGS
AT 1.03 PM
Present:
Kevin Atkinson (Chair)
Barbara Arnott
David Barry
David Davidson
Peter Dunkerley
Denise Eaglesome
Kirsten Wise
Apology:
Ngahiwi Tomoana
Diana Kirton
Dan Druzianic
Helen Francis
In Attendance:
Kevin Snee (Chief Executive)
Warrick Frater (Chief Operating Officer (Chief Operating Officer)
Andrew Lesperance (General Manager Planning and Performance)
Tim Evans (Chief Financial Officer)
Members of the Executive Management Team
Members of the public and media
Minutes
Brenda Crēne
KARAKIA
Tracey Te Huia and the Executive Management Team opened the meeting with a Karakia.
DECLARATIONS OF INTEREST
There were no amendments noted to Conflicts of Interest Register.
CONFIRMATION OF PREVIOUS MINUTES
The minutes of the Board meeting held on 29 August 2012, were confirmed as a true and
correct record of the meeting.
Moved:
Peter Dunkerley
Seconded:
David Davidson
Carried
MATTERS ARISING FROM PREVIOUS MINUTES
Actions from the previous meeting were noted with the following comments summarised:
Action 1: All Committee Chairs would provide feedback on the Performance Framework
Expectations and identify those targets specific to their committees. Feedback by the
Company Secretary/Board Administrator would be formulated and provided to the November
Board Meeting.
Committee Chairs to note
Action 3: Clinical Council membership endorsed by the Board. A decision would be made
shortly and would be signed off by the Board Chair. Members would be advised at the
October Board Meeting.
Action
Action 4: had been actioned and detail would appear in the quarterly HR results. Remove
from the agenda.
October 2012
Section 1
1
BOARD WORK PLAN
The Board Work Plan for the October 2012 meeting was noted.
CHAIR’S REPORT
A summary of points raised follows:
• Allied Laundry Services Limited would hold their Annual General Meeting on 30 October
2012. Hawke’s Bay District Health Board were required to nominate their shareholder
representative(s) to attend this meeting.
RESOLUTION
That the Board:
Appoint the following shareholder representatives to attend the Allied Laundry Services
Limited Annual General Meeting:
• David Ritchie
Voting Rights Representative
• Ken Foote
Representative
Moved
Barbara Arnott
Seconded
David Davidson
Carried
• A contract for Peritoneal Dialysis Products and Services for a three plus two year right of
renewal contract had been signed under delegated authority and was noted by the
Board.
• A letter dated 31 August 2012 was received from the Minister Tony Ryall, acknowledging
efforts made by the sector to deliver on health targets. These related to improved access
to elective surgery, shorter waits for cancer treatment targets, and the under two year old
immunisation which nationally was at 93%, only 2% short of target.
The Minister stressed the need for strengthened relationships and better ways of working
with the primary care sector to speed progress and make gains with smokers to quit and
more heart and diabetes checks.
• Another letter from the Minister dated 11 September outlined Primary Health
Organisation (PHO) Health Target Performance for Quarter 4 of 2011/12. Immunisation
remained the best result, however no PHO nationally achieved the target for ‘better help
for smokers to quit”, with only six PHOs reaching the “more heart and diabetes checks”
target.
Succeeding with primary care targets would require an intentional integrated approach
and clear clinical leadership. DHBs have been requested to performance manage PHOs
not meeting expectations.
• A report provided by David Marshall now retired who was Principal Dental Officer/Senior
Dentist Oral Health Services, would be issued to the Board via email
Actioned. This
document included areas of benefit to the service, and the Chief Operating Officer had
responded and thanked David for his efforts. Any action on the points raised would be
deferred until Robin Whyman, the incoming Principal Dental Officer, commenced his role
in January 2013, had time to review/consider the points raised and develop an ongoing
strategy.
CHIEF EXECUTIVE OFFICER’S REPORT
The Chief Executive’s Report to 19 September 2012 was received and noted.
2
A summary of points raised follows:
• Emergency Departments (EDs) performance had deteriorated in August due to a
significant increase in activity and complexity, however this appears more manageable in
September. Nationally other EDs had experienced similar increases in August.
• Improved access to Elective Surgery was at 117% and this was achieved without the full
impact of the new Operating Theatre coming into operation.
• The waiting list for surgical procedures was decreasing which was encouraging. The
number of babies immunised at 8 months was now tracking at 88.9% which was above
the MOH target. Better help for smokers to quit “in the hospital setting” was above target
for the month however the Primary Care figures had a long way to go, to get to 90%
target. HBDHB would work with the PHO to focus on achieving a better result.
• A dip in financial performance was experienced in August, however it was anticipated we
would still deliver a $3m surplus which would enable us to deliver on improved services.
• There was a focus drive to improve children’s health and wellbeing, in particular to
reduce the incidences of Rheumatic Fever and child assault (family violence
programmes). Good results were being achieved in Primary Care and it was anticipated
to bring primary and secondary together into a single program.
• A lot of work had been undertaken, including extensive consultation which resulted in the
sector wide Vision and Values statement being agreed. This would guide us through the
years ahead in delivering service improvements to our customers.
OUR VISION
Tā mātau whakarehu
“HEALTHY HAWKE’S BAY”
EXCELLENT HEALTH SERVICES WORKING IN PARTNERSHIP TO IMPROVE THE
HEALTH AND WELL BEING OF OUR PEOPLE AND TO REDUCE HEALTH INEQUITIES
WITHIN OUR COMMUNITY
OUR VALUES / BEHAVIOURS
Ā mātau uarā, me tō mātau whanonga
TAUWHIRO – delivering high quality care to patients and consumers
RĀRANGA TE TIRA – working together in partnership across the community
HE KAUANUANU– showing respect for each other, our staff, patients and consumers
ĀKINA – continuously improving everything we do.
FINANCIAL PERFORMANCE REPORT FOR MONTH ENDED AUGUST2012
The Chief Financial Officer presented his report for the second month of the financial year
2012/13, which showed an adverse of $841 thousand variance for the month with cumulative
performance $1,068 thousand worse than plan. There were a number of cost pressures split
between funder and provider drivers which accounted for this result:
• Disability Support / Health of Older People: It was noted that in Hawke’s Bay we have
fewer people in residential care because we provide care/support to people within their
own homes. This was as planned but was being closely monitored.
• Personal Health / Inter District Flows (IDFs): In part cost overruns were due to some
complex issues requiring higher resourcing. This was being closely monitored. The
question whether Clinical Council could assist in this area was raised.
3
• ACC income had been down for some time.
• The Service and Financial Improvement Programme, a one day workshop was planned
in October provide a forum for ideas and reinvigorate focus on the existing programme.
Corrective management focus would be placed on the above areas.
The Finance Risk and Audit Committee (FRAC) received a presentation on “Establishing the
Balance”. A copy of this presentation (prepared by the CFO) would be issued to members.
Actioned
The CFO advised we were still forecasting for the planned surplus of $3.0m.
REPORTS AND RECOMMENDATIONS FROM COMMITTEE CHAIRS
Community & Public Health Advisory Committee – 12 September 2012
The report provided to members was taken as read with no further comment from the
Committee Chair Barbara Arnott, who advised comment would be provided under item 13 the
Smoke Free presentation.
Hawke’s Bay Clinical Council – 12 September 2012
Appointment of new Clinical Council Members:
Co-chair of Council, Dr John Gommans was in attendance and provided an overview to
members including an update on the Council membership review. There were a number of
Council members who were on Council as of right, however there were also a number of
positions which were tenure related and it was those positions which were under review.
Formal expressions of interest had been received and the appointments would be advised at
the October Board Meeting, however the Chair of the Board had delegated authority to
endorse the appointments once advised by the Council selection panel.
Hawke’s Bay Clinical Council was the first such Council put in place in New Zealand and this
trend was being mirrored in other DHBs. The Board were very appreciative and found the
Council of tremendous support.
Clinical Council members had circulated advice that they wished to be proactively engaged
earlier on significant projects. This would ensure project managers received maximum value,
tapping in early to their collective clinical expertise, perspective and influence. Where there
was a potential conflict of interest, an independent Clinical Council member would be brought
in.
It was advised that the Quality Accounts Programme being held in Wellington would be
attended by four representatives from Hawke’s Bay being: Dr John Gommans as Chief
Medical Officer; Dr Andrew Heslop as Chair of the Clinical Quality and Audit Committee
(PHO); Kaye Lafferty representing HBDHB Quality and Risk; and Andrew Lesperance as a
member of HBDHB Executive team.
Clinical Council had wholeheartedly agreed to be engaged in the HB Health Awards and one
key role was for quality initiatives.
DECISION PAPER
Smoke Free Hawke’s Bay 2025 - First Steps 2012-2015
Ana Apatu (Senior Population Health Advisor) and Carleine Receveur (Project Manager,
Smoke Free DHB) were in attendance for the presentation. The following key points were
noted:
• Three health targets
-
Secondary (95%)
-
Primary (90%)
-
Pregnancy (90%)
• Three key elements to meet this goal
-
Prevent the initiation of smoking
4
-
Increase the number of people quitting smoking
-
Protect our children from harm: no exposure to second or third tobacco smoke
(includes pregnancy and tobacco products)
• Underpinning key strategies
-
Ensure all interventions target Maori and Pacific
-
Adopt measures that drive significant increases in quit rates, and decrease the
number of young people that initiate smoking
-
Adopt a ‘whole of Hawke’s Bay community approach. There will be wide consultation
as part of the development of this plan and key stakeholders will be expected to sign
up to this plan to signal their commitment – ‘
Working Together’
• Ngati Kahungunu were definitely walking the talk with “no smoking” allowed in their
environs.
• Barbara Arnott as Chair of CPHAC endorsed the Smoke Free Strategy wholeheartedly.
• Leadership in this had to start with staff (existing staff and new employee screening was
discussed) and this included medical students.
• The Chair advised it was very objectionable having patients smoking at the front door of
the hospital!
• This was not a policy failure it is a policing issue and all staff should be vigilant and use
smoke free messaging where appropriate.
• Vivid poster messaging had had a profound effect on some children to never smoke.
• Smoke Fee was the single most productive health initiative we can have according to Dr
John Gommans.
• Pregnant mums and their babies, 90% of whom were monitored through Plunket would
receive intensive focus.
Several staff members from Health Hawke’s Bay were in attendance and Liz Stockley
advised they were fully supportive and working hard towards the smoke free goal.
After discussion the Board adopted the following recommendation.
RECOMMENDATION
That the Board:
Endorse Smoke Free Hawke’s Bay 2025 First Steps 2012 -2015 for implementation.
Adopted
FOR INFORMATION
NZ Health Expenditure Challenges
Included for the Board’s information the letter and report from Tony Ryall, Minister of Health
was noted.
GENERAL BUSINESS
With no general business the meeting moved to Public Excluded.
5
RECOMMENDATION TO EXCLUDE THE PUBLIC
RESOLUTION
That the Board exclude the public from the following items:
15. Confirmation of Minutes of Board Meeting dated 29 August 2012
- Public Excluded
16. Matters arising from the Minutes of Board Meeting dated 29 August 2012
- Public Excluded
Finance Risk and Audit Committee Meeting Report of 26 September 2012
17. Regional Governance
18. Annual Report 2011/12
19. Maternity Services Consultation Plan
20. Preliminary Business Case – Paid Car Parking
Moved:
David Barry
Seconded:
Kirsten Wise
Carried
The meeting closed at 4.31 pm
Signed:
Kevin Atkinson, Chair
Date:
6
MINUTES OF THE BOARD MEETING
HELD ON WEDNESDAY 31 OCTOBER 2012, IN THE TE WAIORA ROOM,
DHB ADMINISTRATION BUILDING, MCLEOD STREET, HASTINGS
AT 1.00 PM
Present:
Kevin Atkinson (Chair)
Ngahiwi Tomoana
Barbara Arnott
Dan Druzianic
David Barry
David Davidson
Peter Dunkerley
Denise Eaglesome
Diana Kirton
Helen Francis
Apology:
Kirsten Wise
In Attendance:
Kevin Snee (Chief Executive)
Chris McKenna (acting for Chief Operating Officer)
Andrew Lesperance (General Manager Planning and Performance)
Tim Evans (Chief Financial Officer)
Members of the Executive Management Team
Members of the public and media
Minutes
Brenda Crēne
KARAKIA
The Deputy Chair, Ngahiwi Tomoana opened the meeting with a Karakia.
The Chair advised that Item 14 on the agenda “Meeting the Oral Health Needs of Nga Hapu
O Ahuriri – Options Paper” was removed and would be presented at future date, probably
December, to take this forward.
DECLARATIONS OF INTEREST
There were no amendments noted to Conflicts of Interest Register.
CONFIRMATION OF PREVIOUS MINUTES
The minutes of the Board meeting held on 26 September 2012, were confirmed as a true and
correct record of the meeting.
Moved:
David Davidson
Seconded:
David Barry
Carried
MATTERS ARISING FROM PREVIOUS MINUTES
Actions from the previous meeting were noted with the following comments summarised:
Action 1: Performance Framework Expectations. Discussions and feedback from the
advisory committees had been provided for HAC, DSAC and CPHAC. This detail was with
Andrew Lesperance GM Planning and Performance. MRB would discuss and provide
following their meeting on 21 November 2012.
November 2012
Section 1
1
BOARD WORK PLAN
The Board Work Plan for the November 2012 meeting was noted.
CHAIR’S REPORT
The Chair acknowledged Jill Holder (Quality and Risk) who had retired on 18 October after
35 years service to the District Health Board. A letter conveying the board’s best wishes and
thanks for the years of extended service would be sent to Jill.
Actioned
A summary of points raised follows:
• An article in the Dominion Post during October 2012 had advised that Hawke’s Bay
DHBs CEO received a $40k increase in salary this financial year (ie., a 10% rise). The
Chair advised this was a complete nonsense and the writer of the article must have been
very confused. The Chair advised the CEO had received a 2% increase per year, for the
past three years.
• Correspondence had been received from the Ministry of Health seeking an audit review
of patient accessible IT Systems. This would be reported on by the Finance Risk and
Audit Committee (FRAC) who had discussed the topic at their meeting earlier in the day.
• The Annual Accounts and Letter of Representation for Audit NZ had been signed by the
Chairs of the DHB and FRAC under delegation (by resolution at the September 2012
public excluded Board Meeting).
• In late September, a letter had been received from Peter Butler, Mayor of Central
Hawke’s Bay advising of the community’s decision to remove fluoride from their water
supply. Hawke’s Bay DHB were thanked for their assistance and input.
CHIEF EXECUTIVE OFFICER’S REPORT
The Chief Executive’s Report to 24 October 2012 was received and noted.
A summary of points raised follows:
• Performance in all areas (other than finance) were very positive ie., Shorter stays in ED,
Improved access to Elective Surgery, Shorter waits for cancer treatment, and increased
immunisation.
• Better help for smokers to quit in the Hospital environs was a highlight being very close to
target. An excellent result with thanks to the team involved to make this happen.
However, in the community (primary care) a drive to improve targets was being actively
managed.
• More heart and diabetes checks for quarter 4 had improved and were very close to
target. A positive result.
• Kieran McCann appointee to the new role of General Manager, Integrated Care Service
would commence on 12 November 2012.
• The Regional Services Program Update provided as an attachment to this CEO’s report
would be provided on a regular basis, to enable everyone to appreciate and understand
what was occurring at a regional level.
• HBDHB had received an “Outstanding Achievement in Immunisation Award” from the
Ministry. This was in recognition of outstanding performance on the nationwide
Immunisation health Target for 2011/12 to ensure that New Zealand children had the best
chance of health now and into the future. This was attributed to the excellent work
undertaken by the PHO, NGO sector as well as DHB staff.
2
FINANCIAL PERFORMANCE REPORT FOR MONTH ENDED SEPTEMBER 2012
The Chief Financial Officer presented his report for the third month of the financial year
2012/13, which showed a $328 thousand adverse variance for the month with cumulative
year to date performance $1,397 thousand worse than plan. The adverse variance trend
continued and reserves/contingencies had been used. This trend must be reversed with
renewed plans in place to bring this back into line including supplementary finance controls
taking away some budgetary freedoms without hitting front line services.
The main drivers of the variance on the
funder side were: health of older people, personal
and inter district flows and pharmacy. On the
provider side the main drivers were lower
ACC income, higher locum costs and under achievement of the service and financial
improvement programme.
• Inter District Flow costs come from two areas: acute and elective requirements.
Structures and service changes were being worked through and put in place which will
potentially enable us to influence and manage better. It was anticipated, with the likely
appointment of a Vascular Surgeon (in the New Year) that there would be a significant
drop in referrals out of Hawke’s Bay in this specialty.
• On page 32 of the finance report, it was noted funding for Kahungunu Hikoi Whenua was
not shown as a line item. Reassurance was provided that funding was split ie, partially
under the Maori Health line and the Population Health line, totalling $760k.
The Chair of FRAC, Dan Druzianic felt optimistic that the adverse financial trend could be
turned around. We do need to achieve savings to ensure planned service improvements and
capital builds could proceed going forward.
REPORT AND RECOMMENDATIONS FROM COMMITTEE CHAIRS
Disability Support Advisory Committee Meeting – 10 October 2012
Chairperson Diana Kirton conveyed an overview of the highlights which covered Health of
Older People (the two year journey looking at the Model of Care within the community),
Mental Health (the change to regional services agreed from 2013/14) plus an interesting
presentation on Ministry of Social Development (MSD) services.
A discussion on the Regional Services Programme supporting older Maori and Pacific people
in the central region 2012 was also considered by the committee.
HB Clinical Council – 10 October 2012
Co-chairs Drs John Gommans and Peter Foley were in attendance.
Dr Gommans advised the new Clinical Council member appointments from 1 October 2012
were: Robyn O'Dwyer (Clinical Nurse Primary Health Care), Dr Hannes Meyer (General
Practitioner), Dr Tim Frendin (Clinical Director) and Leigh White (Nurse Director/Specialist
Nurse with Sector wide role), with David Warrington joining Council in a temporary capacity
to cover the vacant position of Director of Nursing, Primary Care.
The next Quarterly meeting of Clinical Council (on 14 November) would include time
dedicated to discuss “Health of Older Persons Services”. A wider group would be joining the
meeting and Council would consider dedicating time in future on topics requiring specific
focus.
Council members were pleased to be involved in the Hawke’s Bay Health Awards,
particularly the shortlisting process where they found the quality of the entries to be
extremely high. Members don’t envy the judges in making the final decisions.
3
DECISION PAPERS
Governance Meetings – Schedule of Meetings for 2013
The contents of the report which included an overview of the background to setting the
Meeting Schedule for 2012/13 were noted. Ngahiwi Tomoana advised there may be a
change required to the MRB schedule. As the schedule may require adjustment, it was
adopted as a first draft and would be confirmed at the November 2012 Board meeting.
Action
HBDHB Shareholder Representative at TAS AGM
Ken Foote (Company Secretary) explained the requirement for HBDHB [as a Shareholder of
Central Regions Technical Advisory Services Limited (TAS)] to appoint a representative with
the following recommendation being adopted.
RECOMMENDATION
That the Board
Appoint Dr Kevin Snee as the HBDHB Shareholder Representative to attend and vote at the
TAS AGM, to be held on 8 November 2012.
Adopted
Meeting the Oral Health Needs of Nga Hapu O Ahuriri – Options paper
This paper had been removed from the agenda this month and would be presented again.
Action
FOR INFORMATION AND DISCUSSION
HB Health Sector Leadership Forum – Sub Group Action Plan
The contents of the action plan developed by the Sub-Group had been provided to show the
Board the actions being taken.
Action 5 to “Create a whole of sector approach to workforce and in particular Maori
participation in the health workforce” was noted by John McKeefrey (GM of Human
Resources) who would provide a snapshot for circulation.
Accountability Planning Timeline
Andrew Lesperance explained the purpose of this paper was to show the recommended
timeline for the 2013/14 accountability planning processes. Progress against this timeline will
be reported to the Board on a monthly basis until completed.
The Chair asked that this report (updated monthly) be included behind the Board Workplan in
the monthly Board papers.
Action
GENERAL BUSINESS
There being no general business to discuss, the meeting moved to Public Excluded.
4
RECOMMENDATION TO EXCLUDE THE PUBLIC
RESOLUTION
That the Board exclude the public from the following items:
17.
Confirmation of Minutes of Board Meeting dated 26 September 2012
- Public Excluded
18.
Matters Arising from the Minutes of Board Meeting dated 26 September 2012
- Public Excluded
Reports and Recommendations from Committee Chairs
19.
Finance Risk and Audit Committee – 31 October 2012 (tabled)
20.
Disability Support Advisory Committee – 10 October 2012
21.
Health Benefits Limited FPSC Programme
22.
Board Chair and Member Performance Appraisal
23.
Mental Health Inpatient Unit and Service Change Business Case Update
24.
Maternity Services Consultation (verbal update)
25.
Paid Parking Proposal (verbal update)
Moved:
Helen Francis
Seconded:
Peter Dunkerley
Carried
The meeting closed at 2.15pm.
Signed:
Kevin Atkinson, Chair
Date:
5
MINUTES OF THE BOARD MEETING
HELD ON WEDNESDAY 28 NOVEMBER 2012, IN THE TE WAIORA ROOM,
DHB ADMINISTRATION BUILDING, MCLEOD STREET, HASTINGS
AT 1.00 PM
Present:
Ngahiwi Tomoana (Chair)
Barbara Arnott
Dan Druzianic
David Barry
David Davidson
Peter Dunkerley
Denise Eaglesome
Diana Kirton
Helen Francis
Kirsten Wise
Apology:
Kevin Atkinson
In Attendance:
Kevin Snee (Chief Executive)
Andrew Lesperance (General Manager Planning and Performance)
Tim Evans (Chief Financial Officer)
Warrick Frater (Chief Operating Officer)
Members of the Executive Management Team
Members of the public and media
Minutes
Brenda Crēne
KARAKIA
The Chair, Ngahiwi Tomoana opened the meeting with a Karakia.
DECLARATIONS OF INTEREST
There were no amendments noted to Conflicts of Interest Register.
CONFIRMATION OF PREVIOUS MINUTES
The minutes of the Board meeting held on 31 October 2012, were confirmed as a true and
correct record of the meeting.
Moved:
Peter Dunkerley
Seconded:
Dan Druzianic
Carried
MATTERS ARISING FROM PREVIOUS MINUTES
Actions from the previous meeting were noted with the following comments summarised:
Action Item 1: A graphical representation for key performance indicators by Advisory
Committee was provided for 2013.
Action Item 3: The Advisory Committee Meeting Schedule for 2013 was provided. It was
noted the Hawke’s Bay Health Sector Leadership Forum date in early 2013 was yet to be
confirmed (options at the time of the meeting were 3 or 17 April 2013)
Action Item 4: The accountability planning timeline had been included behind the Board
Workplan and would continue to be updated.
December 2012
Section 1
1
BOARD WORK PLAN
The Board “Work Plan” for the November 2012 meeting was noted. It was advised the
Urgent/Acute Unplanned Care paper had been moved to February 2013.
CHAIR’S REPORT
In the absence of Chair, Kevin Atkinson there was no Chair’s report for the month of
November.
CHIEF EXECUTIVE OFFICER’S REPORT
The Chief Executive’s Report to 21 November 2012 was received and comments
summarised as follows:
• There had been a modest improvement in the financial position which required close
monitoring. There appeared to be no major performance issues and it was encouraging
to see targets being achieved.
• Progress had been highlighted in Integrated Care with the appointment of Kieran
McCann Deputy COO/Integrated Care Service Manager; progress with the Mental
Health Service revamp; the integrated role of the Chief Pharmacist, Co-ordinated primary
options for acute and elective care, Immunisation and Before School Checks. The latter
was noted as having taken out the “supreme award” at the HB Health Awards recently.
• The Hawke’s Bay Health Awards was a great success and such an event on the yearly
calendar showcases how well we all are working together across the sector.
• Appendices 1 summarised where the Central Region was headed regarding consistency
across the boards. This recognised the regional planning document in 2008 to develop a
high degree of integration across the regions, primary/secondary.
• Appendix 2 provided an update/overview of everything regional.
Confirmation on the location of the Mental Health Inpatient Unit was questioned. This will be
finalised as part of the business case which will be available for the Special DSAC Meeting
being held on 30 January.
Referring to page two of the regional services programme, a board member queried why
HBDHB appeared to be slightly out of kilter. This was a snap shot across the region to get
treatment in a timely fashion. In addition to the fact that HBDHB were fully automated
whereas other DHBs were utilising manual data which may not be as reliable, there were
differing services provided across the regions, including private practices with varying ranges
of automation (some very high tech). Nevertheless HBDHB always strives to improve.
An example of collaboration and service improvement was provided ie. HB radiology were
looking to update their technology and work closer with HBDHB. This would provide
economies of scale when purchasing equipment and working closely to ensure timely service
delivery.
FINANCIAL PERFORMANCE REPORT FOR MONTH ENDED OCTOBER 2012
The Chief Financial Officer presented his report for the fourth month of the financial year
2012/13, which showed a favourable variance of $136 thousand.
Three main negative areas showed improvement being: IDF outflows (plus $68 thousand);
Health of Older Persons (plus $20 thousand) and ACC revenues were higher than budget by
(plus $59 thousand).
• Persist with savings from the service and financial improvement programme (SFIP) and
focus on the supplementary programmes created were heading in the right direction.
• The goal was to streamline services and there was a need to ensure the public were
aware this was all about being effective and more efficient.
2
• There is a challenge in the Health of Older Person’s Care with more of a focus to provide
personal care (ie. nursing related care) over home support. This review was occurring on
an individual basis either over the phone or face to face.
• This area was a challenge as there is only one pot of money (which next year was
indicated to be less than 2%) and the demand on services would only increase. There
was a need to be prudent with resources and this included being honest and open with
the public.
• The public needed to be aware it was prudent from their personal health perspective to
receive alternative treatment wherever possible versus going to hospital.
• Diana Kirton asked whether there was a way to demonstrate the cost differences
between the assistance at home cost versus remaining in hospital. Diana asked that an
analysis be brought back to the February Board meeting.
Action.
• The challenge was realising the benefit in financial terms. You may realise the difference
if you close the bed and invest in community care. It was an economic argument about
cost flowing from one part of the system to the other.
• The appointment of a Vascular Surgeon next year would stem the flow of IDFs
REPORT AND RECOMMENDATIONS FROM COMMITTEE CHAIRS
Hospital Advisory Committee (HAC) – 14 November 2012
Committee Chairperson David Barry provided an overview of the report from the HAC
meeting which included: high ED volumes (in the first quarter), the improved flow resulting
from the 7th Theatre opening, the project team set up to develop and focus on “Did Not
Attends”, the potential nursing resource crisis as well as the high caesarean rate evident in
Hawke’s Bay (which required further clarification).
Hawke’s Bay Clinical Council – 14 November 2012
Recognition had been received that Hawke’s Bay Clinical was one of three exemplar cases
of clinical governance and leadership nationally.
• Nursing and Midwifery Steering Group, clarification was sought as to how this was
progressing and where the Steering Group fits. This detail would be provided to board
member Helen Francis.
Action
• There appeared to be a broader issue as the Hawke’s Bay Clinical Council develops
and evolves, including how everything fits together, the elements of clinical leadership
and communication of the structure/role to the wider health sector.
Maori Relationship Board (MRB) – 21 November 2012
On behalf of MRB Chair, Ngahiwi Tomoana, Tracee TeHuia summarised the meeting as
follows:
• The Safe Sleep Action Project at the MRB meeting had received the results of a
successful audit undertaken by EIT which showed the positive results of this project, the
first of its kind in New Zealand.
Dr
David Barry was complimentary on the success thus far and was particularly keen to a
longer term evaluation. He asked that this be made provided to the board when
available
. Action
• Whanau Ora was being run in ten regions with “healthy outcome plans” completed for
around 8000 families.
• Regarding Suicide Prevention, two points raised by MRB were the need to be more
proactive around postvention, as well as the programme being more responsive to Maori.
• Before School Checks (B4SC) with focus on early childhood health, vision and hearing
screening in Kohanga Reo settings. There were 1200 children in Kohanga Reo’s in the
3
region and the question was how to best deliver services that would work with DHB and
Kohanga.
• Te Tuahiwi: MRB members would hold a workshop at NKII on 11 December to discuss
the next steps for developing an intersectoral approach across the Kahungunu region.
• Did Not Attends (DNAs) - Interventions tried, had not worked however progress was now
being made with a project being presently structured. Progress would be advised to MRB
and the Board in 3-4 months’ time. This piece of work would be linked to outpatient
redesign to improve DNA rates. Des Ratima had focussed on the provision of transport.
The COO advised it may be one issue but was too simplistic and he was keen to talk with
community leaders and utilise volunteers in the Maori community to assist clients and
ensure they attended to clinics.
• Denise Eaglesome advised the Wairoa Health Centre would make a difference and there
would be a drive to have younger family members encourage their elders to attend and
get checked.
• Tū Mai Rā Dashboards for Quarter 4 (2011/12) and Quarter 1 (2012/13) were provided
and Chair Ngahiwi Tomoana advised the results being achieved were impressive.
The contents of the report were noted.
MONITORING
Human Resource KPIs Q1 July-September 2012
John McKeefry, General Manager Human Resources was in attendance and provided an
overview of the quarterly report July to September 2012.
• Staff Ethnicity – The DHB has a target equating to 292 Maori staff within the HB health
sector. The gap is negative by 22 staff at the end of at 31 October 2012. An additional
paper was to the report and on page 28, point 10, it was noted that HR Services and
Maori Health would bring a breakdown of the current workforce and an action plan to
increase participation in the HB health sector, to the next Leadership Forum on 3 April
2012.
• More focus was required on nursing going forward due to the ageing workforce, those
leaving the profession as the economy picks up; as well as future demand increasing by
100,000 nurses in Australia.
Performance Framework Exceptions Q1 July-September 2012
Andrew Lesperance, General Manager, Planning and Performance spoke to the quarterly
paper provided performance highlights, achievements, areas of progress and areas of focus.
• As the Ministry’s rankings had not arrived in time, the “dashboard” was tabled at the
meeting with detail having been received prior. It was noted as incomplete however as
not all data had been received.
• Hawke’s Bay was ranked 3rd in the country for “Diabetes heart checks” as well as being
recognised for providing assistance to better help smokers to quit.
• The report provided was based on exceptions ie, where there was a need to focus more
attention or resource.
• Diana Kirton sought clarification regarding page 81, being advised that the comment was
under triage 2&3 and actually related to 4&5.
FOR INFORMATION AND DISCUSSION
Suicides in Hawke’s Bay
Dr Caroline McElnay (Director Population Health), Lisa Jones (Population Health Intelligence
Manager) and Mary Wills (Senior Portfolio Manager – Older Persons) presented information
on suicide trends and effective interventions for the prevention of youth suicides.
4
Official data often has up to a two year delay. Greg Macklow from the NZ Police was
acknowledged for his assistance in providing more up to date data.
What we have in place in Hawke’s Bay are prevention programs at all levels, including more
emphasis on gatekeeper training focused to train the trainers ie., church leaders and groups
in the community with influence. World Health Organisation evidence around intervention
shows the effectiveness of strong connections to family and community.
New Zealand’s suicide rate was the 2nd to highest for youth in the world. Societal differences
in the past 80 years have seen New Zealand youth suicides go up dramatically. Especially
since 1980s! Hawke’s Bay targets youth which aligns well with the Prime Minister’s request
for more initiatives that help youth.
Mary Wills would follow up on how suicide information was shared amongst practices
through “low down”
Action
As a Board it was important to be aware and understand the “trends”, the need for support
and the provision of effective intervention and follow up. There were a lot of national services
which are brought in when required.
Denise Eaglesome referred to services in Wairoa and the difficulty in accessing those
services. Mary would follow up however there were some very good counsellors available
Action. Adolescents need encouragement from family to seek help. Children and
adolescents were particularly vulnerable and Denise wanted to ensure there were initiatives
in place in the area as well as website access detail available. She was interested in the tools
especially in places like Wairoa College, to enable dialogue.
Action
GENERAL BUSINESS
With no general business the meeting moved to Public Excluded.
RECOMMENDATION TO EXCLUDE THE PUBLIC
5
RESOLUTION
That the Board exclude the public from the following items:
17.
Confirmation of Minutes of Board Meeting dated 31 October 2012
- Public Excluded
18.
Matters Arising from the Minutes of Board Meeting dated 31 October 2012
- Public Excluded
Reports and Recommendations from Committee Chairs
19.
Finance Risk and Audit Committee – 28 November 2012 (tabled)
20.
Hawke’s Bay Clinical Council – 14 November 2012
21.
Hospital Advisory Committee – 14 November 2012
22.
Chemistry/Immunoassay Analyser System Business Case
23.
2013/14 Budget Overview (presentation)
24.
Fluoridation
Moved:
Peter Dunkerley
Seconded:
Denise Eaglesome
Carried
The meeting closed at 2.25pm
Signed:
Ngahiwi Tomoana, Chair
Date:
6
MINUTES OF THE BOARD MEETING
HELD ON WEDNESDAY 19 DECEMBER 2012, IN THE TE WAIORA ROOM,
DHB ADMINISTRATION BUILDING, MCLEOD STREET, HASTINGS
AT 1.04 PM
Present:
Kevin Atkinson (Chair)
Ngahiwi Tomoana
Barbara Arnott
Dan Druzianic
David Barry
David Davidson
Peter Dunkerley
Denise Eaglesome (
via video conference)
Diana Kirton
Helen Francis
Kirsten Wise
Apology:
In Attendance:
Kevin Snee (Chief Executive)
Andrew Lesperance (General Manager Planning and Performance)
Tim Evans (Chief Financial Officer)
Warrick Frater (Chief Operating Officer)
Members of the Executive Management Team
Members of the public and media
Minutes
Brenda Crēne
KARAKIA
Deputy Chair, Ngahiwi Tomoana opened the meeting with a Karakia.
DECLARATIONS OF INTEREST
There were no amendments noted to Conflicts of Interest Register.
CONFIRMATION OF PREVIOUS MINUTES
The minutes of the Board meeting held on 28 November 2012, were confirmed as a true and
correct record of the meeting.
Moved:
Dan Druzianic
Seconded:
David Barry
Carried
MATTERS ARISING FROM PREVIOUS MINUTES
Actions from the previous meeting were noted with the following comments summarised:
Item 1: Review of Conflicts of Interest Registers. This would be finalised for the February
Board Meeting.
Item 2: An analysis demonstrating the costs (assistance at home versus hospital) would be
provided at the February Board Meeting.
Action
Item 3: Nursing and Midwifery Steering Group information had been provided. Action
removed.
Item 4: Safe Sleep Action Project Effectiveness. Request to update the Board when further
detail was available. Work in progress.
February 2013
Section 1
1
Action Item 5: Denise Eaglesome was happy with the response and this action would be
removed.
BOARD WORK PLAN
A revised Board “Work Plan” for was tabled. Due to the large number of proposals/business
cases for consideration at the February 2013, Board Meeting the “Work Plan” was reviewed
as follows.
The following papers remain in the February Board Meeting:
• Maternity Final Proposal
• Paid Parking Business Case
• Mental Health Inpatient Unit Business Case
Papers moved to the March Board Meeting:
• Urgent Acute Unplanned Care (COO/GM P&P)
• Central Hawke’s Bay Service Model (GM P&P)
• Women Child and Youth Strategic Framework (GM P&P)
It is important to NOTE that as soon as any of the above papers (or in fact any Decision
Papers) are in final form they will be emailed to the Board by the Board Administrator
Action.
ACCOUNTABILITY PLANNING TIMELINE
Timelines were noted.
CHAIR’S REPORT
Chair, Kevin Atkinson provided a verbal update, summarised as follows:
The Chair acknowledged Ivy Cairns (Nutrition and Food Service) who had retired on 8
December 2012, after 23 years service to the District Health Board. A letter conveying the
board’s best wishes and thanks for the years of service would be sent to Ivy.
Actioned
• Reference was made to a meeting of the NZ Institute of Health Management, with
Minister Tony Ryall in attendance, held 3rd December. The purpose of the meeting was
to look at the extent to which DHB governance structures were fit for purpose.
There was general agreement on number of fronts some of which included:
o Public interest in transparency was not well served in the current model.
o The current model having a majority of elected members was perceived as a
problem.
o Only a few DHB board members have qualifications to manage billion dollar
organisations.
o Evolving the model to a majority of appointed members would lift board performance.
The Chair said he would not be a surprised if the election system was tweaked prior to
board elections in 2013.
A copy of the media release would be made available to members.
• A letter had been received from Auditor General relating to a Performance Audit of
Regional Services Planning and Capital intentions within the Health sector. The result of
this audit would be welcomed.
• The Minister forwarded a copy of letter sent to the Chair of Health HB on their
performance for Quarter One. The letter sent to all PHOs across the country, sought
their assistance to focus and put effort into achieving national targets and objectives.
However Health Hawke’s Bays performance was encouraging across three indicators
and were in the top 1/3rd in country (out of 35 PHOs) being: 19th for Immunisation; 6th for
2
Smokers to quit in the primary setting; and 10th for Diabetes checks. A satisfactory result
with room for improvement.
• A letter had been received from the Children’s’ Commissioner, Russell Wills regarding a
report prepared by his expert advisory group on solutions to child poverty. In his letter he
stated that the report demonstrates that when we choose to invest in our young children,
the improvements in health, welfare and labour productivity outcomes were substantial
and predictable. The Report was available on the Commissioner’s website.
Solutions to Child Poverty – The Final Report available on:
http://www.occ.org.nz/
CHIEF EXECUTIVE OFFICER’S REPORT
The Chief Executive’s Report to 12 December 2012 was received, with comments
summarised as follows:
• The CEO was proud of the national recognition for the Hawke’s Bay Clinical Council
received nationally on 6 December at a function in Otago. Hawke’s Bays clinical
governance and leadership was one of the most improved in the country.
• One indicator Hawke’s Bay were doing very well on (ie 3rd best in the country), related to
problems occurring in clinical care when staff see an issue but don’t voice concerns.
Clinical Council can take a lot of credit for this result.
• Financially the DHB had seen a small improvement. There was a way to go but the
result was encouraging.
• As included in the report the following were referred to: Health of Older People, with
personal care demand; Mental Health Service Business Case to the Board in February;
an Integrated Family Health Service for Central Hawke’s Bay for presentation in March.
In response to a query from Deputy Chair, Ngahiwi Tomoana, Dr Gommans advised that
Mental Health services had regular meetings with police. More work was being done with
the channels in place, however sharing mental health records with police, was not possible in
the majority of cases, due to privacy issues.
The CEO’s report was taken as read.
FINANCIAL PERFORMANCE REPORT FOR MONTH ENDED NOVEMBER 2012
The Chief Financial Officer presented his report for the fifth month of the financial year
2012/13, which showed a favourable variance of $107 thousand.
The cumulative unfavourable result was $1,154 thousand. That equates to a surplus of $116
thousand where $1,270 thousand surplus was planned.
The main negative areas were:
• High pressure on IDFs was mainly due to an oncology wash up.
• CRISP IT program was an accrued spend.
Funder and health services were feeling pressure.
The focus was on making a surplus to ensure HBDHB could invest. The priority was the
Mental Health facility which was not at risk.
REPORT AND RECOMMENDATIONS FROM COMMITTEE CHAIRS
Hawke’s Bay Clinical Council – 12 December 2012
Clinical Council’s report to the Board was emailed prior, with copies tabled at the meeting
and available on the website
http://www.hawkesbay.health.nz/file/fileid/45457. Dr John
Gommans was in attendance on behalf of Dr Peter Foley (Chair) who was attending his
daughter’s graduation from Medical School in Australia.
3
• The Health of Older People’s Workshop was very well attended and deemed a success.
Council was planning similar focused workshops on various topics involving the wider
clinical community.
• Council endorsed in the paper and presentation on Women, Child and Youth Strategic
Framework. This paper would be presented to the Board in March 2013.
• Clinical Pathways: A business case reviewing options for a standard evidence based
way to streamline process and patient flow was expected in the New Year (dependant
on the availability of resources). This review would take into consideration what other
DHBs around the country were doing. The formulation of a system for Hawke’s Bay
would be invaluable in relationship building and integration across the health sector.
• Research and Ethics: A paper seeking the formation of a Clinical Research and Ethics
Committee to oversee research in the public health sector in Hawke’s Bay was
approved by Council. There was a lot of clinical research undertaken and it was felt a
more co-ordinated approach was required. To progress, a number of agencies would
be consulted to ensure there was coordinated integrated approach.
Dr David Barry was pleased with this decision and his invaluable input would be sought.
Eastern Institute of Technology (EIT) also have a requirement for research output which
worked well according to Diana Kirton.
GENERAL BUSINESS
Deputy Chair, Ngahiwi Tomoana provided an overview of the video trailer played to
members, and answered questions relating to the 20 month waka journey undertaken. The
waka had returned to NZ and would now be based in Napier.
Diana Kirton referred to funds applied to the Maori Workforce Development from Health
Workforce NZ and also the funding packages managed by the DHB as having made huge
differences with graduation numbers for Maori which was very positive for Hawke’s Bay and
in getting ethnicity numbers up within the health sector.
There being no further general business the meeting moved to Public Excluded.
RECOMMENDATION TO EXCLUDE THE PUBLIC
RESOLUTION
That the Board exclude the public from the following items:
13.
Confirmation of Minutes of Board Meeting dated 28 November 2012
- Public Excluded
14.
Matters Arising from the Minutes of Board Meeting dated 28 November 2012
- Public Excluded
Reports and Recommendations from Committee Chairs
15.
Finance Risk and Audit Committee – 19 December 2012 (tabled)
16.
Hawke’s Bay Clinical Council – 12 December 2012 (tabled)
17.
Regional Governance
18.
Regional IT Strategy
19.
Central Region Information Systems Plan
20.
Central Hawke’s Bay Service Model discussion
Moved:
Peter Dunkerley
Seconded:
Denise Eaglesome
Carried
4
The meeting closed at 2.00pm
Signed:
Kevin Atkinson, Chair
Date:
5
Document Outline
