Key Notes and Action Points from SLA Review meeting between WHHT & Hertfordshire PCTs held on the 14th February 2008 at 2 p.m. – Royalty House, Watford

In attendance:	Andrew Moore, WHHT Head of Business Development
			Nick Evans, WHHT Director of Service Development 
			Ken Sharpe, WHHT Interim Director of Finance	
			Beverley Flowers, PCT Director of Commissioning
			Alan Pond, PCT Director of Finance
Clare Jones, PCT Senior Contracts Manager
Jane Rice, PCT Finance Lead
			Katrina Power, PBC Representative
			Ian Issac
			John Clegg StACom
			Gerard Bulger

Apologies		Mo Girach
			Andrew Parker

Note/Action	Responsible Lead	
1.   Minutes of previous Meeting
A&E dehosting – AM reported that trust are awaiting conformation that South Central will not be dehosting across borders.

Specialist Disaggregation – BF to forward on renal email to AM

PBC commissioning intentions were noted.

18 weeks – KP is producing templates for CATS activity. Meetings arranged with KG and AG/YG re C&B.

Hertsmere have requested details of patients on 18 week orthopedic waiters as Margaret Stockham is doing a piece of work to identify organisations with capacity. KP to provide a list of organisations to NE that may have capacity. BF/JW to visit Milton Keynes to see if any potential for work. PCT will only pay tariff plus MFF.   	BF/KP	
2. 07/08 Performance
AM ran through the performance report. 

JC questioned what was being done to address the high staff turnover. The trust has family friendly policies in place. There is a lot of uncertainty around the future of the HH site. Trust need to give more certainty to staff. There are jobs at the Watford site – although there are some staff who do not want to leave the HH site. The UCC will impact of numbers of staff – feel this will have a positive impact regardless of who wins the tender as the current staff have scarce skills so employment opportunities are good. A HR subgroup has been formed including members from both the PCT and trust. Neighbouring organisations are also re-organising and recruiting at the moment. This goes across areas were scarce skills and a glut of staff. Trust has been told that they can look to Europe only to fill vacancies. JC feedback is that the theatre staff at SACH suffering from lack of motivation & poor leadership. In the move of elective to SACH the trust lost 37 theatre staff. The trust acknowledges things weren’t implemented as well as should have been. Lack of staff cause capacity issues and affect trust’s ability to deliver next years SLA. There is no short term fix – changes to C&B could impact on demand.

	AM	
3. 18 week Performance
Need to clarify the comms around 18 week (and 26 week) breeches. Trust achieving 56% admitted care, setting profile to get to 85% by end of march and 90% by December. Non admitted – trust achieving 87% which puts Trust in upper quartile. Target is 90% by March.
		
4.   08/09 Planning
Concern around capacity to deliver next years requirements, particularly around orthopaedics. May need to expand the contract with Spire but this would be at tariff. AM is in the process of producing a bottom up plan of capacity. This should be available next week. Assumptions for modelling activity levels have taken into account CATS (both existing and planned), and 18 week allowance.

Work ongoing to disaggregate block. BF to ask APa to send out paper on disaggregation.

NETCARE – trust are not proceeding with this option due to cost pressures.

Spire – will sign up to the new national contract in October. BF will introduce SLA review meetings with the organisation.	BF/AM	
5.  CATs
KP has arranged meetings with the trust over the next couple of weeks to discuss direct booking onto waiting lists.

Trusts must treat all patients in turn – with the exception of urgents – to ensure meet 18 week targets. The key issue is where patients are on their 18 week pathway not how long they have been on a list. Direct booking is about getting people on the list without needed another outpatient appointment. Message should be given to the patients that they are on the list – should not be quoting confirmed dates for procedures.

Direct Access MRI – at the moment outpatient tariff includes MRI. PBR guidance suggests that this can be stripped out. AM/NE to look into the possibility of separate tariff. 

 	KP/AM/NE	
6. Any Other Business
AM provided an update of validation queries. Currently, the trust are working through the ‘not our patient’ PBC queries. These will be updated on PAS. Will then move onto remaining queries.

KP expressed concern that there has been no feedback on previous queries. CJ to confirm with DH that all queries have been forwarded to the trust. 
		
7.  Date & time of next meeting
13th March, 2-4pm Rm KS6 Royalty House.