Meetings

6.2a The Committee noted the letter from the Chair of the Public Accounts Committee.

8.1 Due to time constraints, the Committee was unable to consider the evidence received. However, the clerks will re-schedule this item for a future meeting.

Prof Trevor Purt, Chief Executive, Betsi Cadwaladr University Health Board

Dr Peter Higson OBE, Chair, Betsi Cadwaladr University Health Board

Geoff Lang, Executive Director of Strategy, Betsi Cadwaladr University Health Board

4.1     The Committee took evidence from Betsi Cadwaladr University Health Board on its Governance arrangements.

4.2     Dr Higson agreed to provide further information on:

·         the trail of discussions by the Board on Ysbyty Glan Clwyd including issues around recruitment;

·         ‘Well North’;

·         communications in relation to Ysyty Glan Clwyd, in particular the brochure;

·         the training of Board members; and

·         performance indicators.

1.1       The Committee considered the evidence received from BCUHB at the meeting held on 8 July.

1.2       Members agreed to undertake a wider piece of work on health board governance once the forthcoming report from the Auditor General on health finances  and key indicators of service performance has been published.

PAC(4)-20-14(paper 1)

4.1 Officials from the Wales Audit Office and Health Inspectorate Wales briefed the Committee on the joint report published on 4 July 2014.

PAC(4)-20-14(paper 2)

PAC(4)-20-14(paper 3)

PAC(4)-20-14(paper 4)

PAC(4)-20-14(paper 5)

PAC(4)-20-14(paper 6)

Research Brief

Dr Peter Higson – Chair, Betsi Cadwaladr University Health Board

Professor Trevor Purt – Chief Executive, Betsi Cadwaladr University Health Board

Geoff Lang – Executive Director Primary, Community and Mental Health Services, Betsi Cadwaladr University Health Board

Grace Lewis-Parry - Director of Governance & Communications, Betsi Cadwaladr University Health Board

5.1 The Committee scrutinised Dr Peter Higson, Chair, Professor Trevor Purt, Chief Executive, Geoff Lang, Executive Director Primary, Community and Mental Health Services and Grace Lewis-Parry, Director of Governance & Communications from Betsi Cadwaladr University Health Board on their governance arrangements.

5.2 Geoff Lang agreed to send further information on the following:

·       The total number of patient safety incidents in 2012-13 and how this data compares to previous years;

·       The clinical areas where the Welsh Government’s Delivery Unit is assessing performance.

6.1 Due to time constraints, Members agreed to consider the evidence received in private at the start of the meeting on 15 July 2014.

PAC(4)-07-14 (paper 3)

PAC(4)-07-14 (paper 4)

4.1 The Committee considered and noted the Welsh Government’s response to the Committee’s report on the Governance Arrangements at Betsi Cadwaladr University Health Board.

4.2 The Committee agreed that some of the Government’s responses required further clarity and agreed to raise these with the Director General for Health, Social Services and Children.

4.3 The Committee asked for a briefing paper on governance arrangements within NHS Wales and also on specialist health services. The Wales Audit Office agreed to provide this.

PAC(4)-31-13 paper 1

2.1 Members discussed the report and subject to a few amendments, agreed the report.

2.2 Members noted that the report will be published on 12 December in North Wales.

PAC(4)-28-13 paper 4

8.1 Time did not allow for this paper to be discussed. It was agreed that the Clerks would email the paper to Members asking for any views and Committee will return to it at the next meeting.

Betsi Cadwaladr University Health Board

Mary Burrows, Outgoing Chief Executive, Betsi Cadwaladr University Health Board

7.1 Shortly before the meetings began, Mary Burrows, Outgoing Chief Executive of Betsi Cadwaladr University Health Board, informed the Committee that she would be unable to attend the meeting.

7.2 Mary Burrows provided the Committee with written evidence and offered to answer any further questions in writing.

Welsh Government

PAC(4) 23-13 – Paper 1

David Sissling, Director General, Health and Social Services, Welsh Government

Dr Ruth Hussey, Chief Medical Officer, Welsh Government

Martin Sollis, Director of Finance, Welsh Government

5.1 The Chair welcomed David Sissling, Director General, Health and Social Care, Welsh Government; Dr Ruth Hussey, Chief Medical Officer; Welsh Government; and Martin Sollis, Director of Finance; Welsh Government.

5.2 The Committee scrutinised the witnesses.

Action points:

The Welsh Government agreed to provide:

·         Details on the cost of the Chris Hurst report.

·         The date that Chris Hurst left Welsh Government.

·         A note on the escalation process for concerns about Health Boards

·         The Terms of Reference for the report prepared by Allegra.

·         A note on salary protection spend by Betsi Cadwaladr University Health Board.

·         Clarity on core capacity and the impact that this has on scheduled care.

9.1 The Committee discussed the evidence received on the inquiry into the Governance Arrangements of Betsi Cadwaladr University Health Board.

4.1 The Committee considered the evidence on the Governance Arrangements at Betsi Cadwaladr University Health Board.

Betsi Cadwaladr University Health Board

Merfyn Jones, Outgoing Chairman, Betsi Cadwaladr University Health Board

Dr Lyndon Miles, Vice-Chair, Betsi Cadwaladr University Health Board

Grace Lewis-Parry, Director of Governance and Communications and Secretary to the Board, Betsi Cadwaladr University Health Board

Keith McDonogh, Chair of Finance and Performance Committee, Betsi Cadwaladr University Health Board

2.1 The Chair welcomed Merfyn Jones, Outgoing Chairman, Betsi Cadwaladr University Health Board; Dr Lyndon Miles, Vice-Chair, Betsi Cadwaladr University Health Board; Grace Lewis-Parry, Director of Governance and Communications and Secretary to the Board, Betsi Cadwaladr University Health Board; and Keith McDonogh, Chair of Finance and Performance Committee, Betsi Cadwaladr University Health Board.

2.2 The Committee scrutinised the witnesses.

Action points:

Betsi Cadwaladr University Health Board agreed to provide:

·         Further information on the categories and amount of re-charging made to cross-border Health Authorities.

·         Further information on the number of patients affected by the delay in elective procedures caused by the emergency expenditure controls in the final weeks of the 2012-13 financial year.

·         A note on when the Board and Quality and Safety Committee first became aware of concerns with the C Difficile outbreak.

·         A copy of the Health Board’s risk register.

·         Further information on actions undertaken by the Health Board to address Risk Adjusted Mortality Index (Rami) figures.

6.1 The Committee discussed the evidence received on the inquiry into the Governance Arrangements at Betsi Cadwaladr University Health Board.

Betsi Cadwaladr University Health Board

Geoff Lang, Acting Chief Executive, Betsi Cadwaladr University Health Board

Dr Martin Duerden, Acting Medical Director, Betsi Cadwaladr University Health Board

Angela Hopkins, Director of Nursing, Midwifery and Patient Services, Betsi Cadwaladr University Health Board

Helen Simpson, Director of Finance, Betsi Cadwaladr University Health Board

2.1 The Chair welcomed Geoff Lang, Acting Chief Executive, Betsi Cadwaladr University Health Board; Dr Martin Duerden, Acting Medical Director, Betsi Cadwaladr University Health Board; Angela Hopkins, Director of Nursing, Midwifery and Patient Services, Betsi Cadwaladr University Health Board; and Helen Simpson, Director of Finance, Betsi Cadwaladr University Health Board.

2.2 The Committee scrutinised the witnesses on the findings of the joint Wales Audit Office/ Healthcare Inspectorate Wales ‘An Overview of Governance Arrangements – Betsi Cadwaladr University Health Board’.

Action points:

Betsi Cadwaladr University Health Board agreed to provide:

·         Further detail on the frequency of meetings between the Chief Executive of the NHS in Wales and the Chief Executive and senior management at Betsi Cadwaladr University Health Board took place.

·         Further detail on the frequency of meetings between the Director of Finance at the Health Board and the current and former Finance Director at the Welsh Government.

·         Figures highlighting how many patients had their operations delayed as a result of the reduction in the number of elected procedures towards the end of the financial year based on the movement in performance standard.

·         Copies of the external reviews conducted by Chris Hurst in April 2012 and by Allegra in December 2012.

5.1 The Committee discussed the evidence received on its inquiry into Governance Arrangements at Betsi Cadwaladr University Health Board.

5.2 The Committee would take further evidence on its inquiry on Thursday 18 July 2013.

5.1 The Committee discussed the findings of the report ‘An Overview of Governance Arrangements of Betsi Cadwaladr University Health Board’ and agreed to conduct a short inquiry before the end of the summer term.

Huw Vaughan Thomas, Auditor General for Wales

Mike Usher, Wales Audit Office

Dave Thomas, Wales Audit Office

Kate Chamberlain, Chief Executive, Healthcare Inspectorate Wales

Mandy Collins, Healthcare Inspectorate Wales

2.1 The Chair welcomed Huw Vaughan Thomas, Auditor General for Wales; Mike Usher, Wales Audit Office; Dave Thomas, Wales Audit Office; Kate Chamberlain, Chief Executive, Healthcare Inspectorate Wales; and Many Collins, Healthcare Inspectorate Wales.

2.2 The Chair invited the Auditor General for Wales and Healthcare Inspectorate Wales to brief the Committee on the findings of their review ‘An Overview of Governance Arrangements – Betsi Cadwaladr University Health Board’.