Section 0 - Cover 24 February 2006 - West Coast DHB · 24 FEBRUARY 2006 AGENDA AND ... • Medical...

West Coast District Health Board Te Poari Hauora a Rohe o Tai Poutini

BOARD MEETING

24 FEBRUARY 2006

AGENDA

AND MEETING PAPERS

EMBARGOED UNTIL CONSIDERED BY THE BOARD

WCDHB Meeting Papers Table of Contents 24 February 2006

TABLE OF CONTENTS

AGENDA KARAKIA BOARD MEMBERS’ DISCLOSURES OF INTEREST ABBREVIATIONS DRAFT MINUTES OF THE WEST COAST DHB MEETING HELD FRIDAY 20 JANUARY 2006 CHAIRMAN’S REPORT BOARD AND CHAIRMAN’S CORRESPONDENCE FOR JANUARY / FEBRUARY 2006 CHIEF EXECUTIVE’S REPORT FINANCE REPORT REPORTS FROM BOARD ADVISORY COMMITTEES • Hospital Advisory Committee • Community and Public Health Advisory Committee • Disability Services Advisory Committee • Audit, Risk and Finance Advisory Committee INTERSECTORAL FORUM MEETING HELD 9 FEBRUARY 2006 INFORMATION PAPERS • WCDHB Advisory Committee Members Terms of Appointment • Board and Advisory Committee Meeting Schedule to December 2006

WCDHB Meeting Papers Agenda 24 February 2006

AGENDA

FOR THE WEST COAST DISTRICT HEALTH BOARD MEETING TO BE HELD IN THE BOARD ROOM, CORPORATE OFFICE

GREYMOUTH ON FRIDAY, 24 FEBRUARY 2006 COMMENCING 9.30 AM

Karakia

1. Welcome

2. Apologies

3. Standing Orders

4. Disclosures of Interests

5. Minutes of the Meeting held Friday 20 January 2006

6. Matters Arising - Guidelines for Presentations to Advisory Committee Meetings

7. Chairman’s Report

8. Board and Chairman’s Correspondence

9. Chief Executive’s Report

10. Finance Report

11. Reports from Board Advisory Committees

12. Intersectoral Forum Meeting Notes, 9 February 2006

• 12.00 noon - Preparation for Marae Visit for the Board Meeting 7 April 2006

• Date of Next Meeting

• Information Papers

IN COMMITTEE OIA 1982 5.9(2)(i) Commercial NZPHDA Sch 3 cl 32(a)

• Minutes of the Meeting held Friday 20 January 2006

• Matters Arising

• Contract - West Coast PHO Second National Variation to the Primary Health Organisation

Agreement Version 17.0 Contract No. 571370/274599/07

• CHFA Compliance Certificate

WCDHB Meeting Papers Karakia 24 February 2006

KARAKIA

E Te Atua i runga rawa kia tau te rangimarie, te aroha, ki a matou i tenei wa Manaaki mai, awhina mai, ki te mahitahi matou, i roto, i te wairua o

kotahitanga, mo nga tangata e noho ana, i roto i tenei rohe o Te Tai Poutini mai i Karamea tae noa atu ki Awarua.

That which is above all else let your peace and love descend on us at this time so that we may work together in the spirit of oneness on behalf of the

people of the West Coast.

WCDHB Meeting Papers Disclosures of Interest 24 February 2006

BOARD MEMBERS’ DISCLOSURES OF INTERESTS

Member Disclosure of Interest Professor Gregor Coster Chairman

• Director - PHARMAC • Director - Cornwall Management Limited

Dr Christine Robertson Deputy Chairman

As self employed person, does work on contract for: • HealthPAC - regularly

Husband is Deputy Chair of the Board of Coast Care Trust and is a Justice of the Peace who undertakes judicial duties in Court. Also Alternate Controller for Civil Defence for the Grey District Council

Ms Robyne Bryant • Trustee - Board of Coast Care Trust • Negotiating Employment Contract with WCDHB

Mrs Julie Kilkelly • Member - Pharmaceutical Society Incorporated • Member - New Zealand College of Pharmacists • Director - Kilkelly Kartage Ltd • Trustee - West Coast PHO Board • Director - Olsen’s Pharmacy (2002) Ltd.

Mr Mohammed Shahadat • Principal Partner - Murdoch James and Roper • Trustee - West Coast Development Trust

Dr Malcolm Stuart • Employed by WCDHB as Head of Department, Anaesthesia and Consultant Anaesthetist

• National Committee - Australian New Zealand College of Anaesthetists

• Member - Association of Salaried Medical Staff

As a self employed person: • Medical Advisor - St John Ambulance Service

Mr John Vaile • Director - Vaile Hardware Ltd • Wife has an unresolved employment matter with WCDHB

Dr Carol Atmore • Employed by WCDHB as a General Practitioner at Greymouth Medical Centre and as GP Liaison Officer

• Member - South Link Health • Member – ASMS - Association of Salaried Medical Specialists

Mr Brian Wilkinson • Member – Pharmaceutical Society Incorporated • Justice of the Peace • Trustee - West Coast Development Trust

Mrs Glenys Baldick

• Chairman - Health Sector Welfare Society • Trustee - Nelson Hospital Equipment Trust

WCDHB Meeting Papers Abbreviations 24 February 2006

ABBREVIATIONS

# NOF Fractured Neck of Femur (broken hip) 1° Primary 2° Secondary 3° Tertiary A&E Accident & Emergency A+ Auckland Healthcare ADHB Auckland DHB ALOS Average Length of Stay ANDRG Australian National Diagnosis Related Group ASMS Association of Salaried Medical Specialists AT&R Assessment, Treatment & Rehabilitation Unit BDC Buller District Council BOPDHB Bay of Plenty DHB C&CDHB Capital and Coast DHB CAA Child Acute Assessment CAMHS Child & Adolescent Mental Health Service CAP Canterbury Association of Physicians CC Complications & Co-morbidity CCMAU Crown Companies Monitoring Unit CCN Clinical Charge Nurse CCU Critical Care Unit CD Clinical Director CDHB Canterbury DHB CEA Collective Employment Agreement CFA Crown Financing Agency CHA Crown Health Association CHL Canterbury Health Limited CICU Cardiac Intensive Care Unit CMDHB Counties Manukau DHB COMRAD Radiology Reporting System CPAC Clinical Priority Assessment Criteria CPHAC Community & Public Health Advisory Committee CSSD Central Sterile Supplies Department CTA Clinical Training Agency CWD Case Weighted Discharge DAO Duly Authorised Officer DAP District Annual Plan DDG Deputy Director General DHB District Health Board DHBNZ District Health Boards New Zealand DNA Did Not Attend DON Director of Nursing

WCDHB Meeting Papers Abbreviations 24 February 2006

DOSA Day Of Surgery Admission DRG Diagnostic Related Grouping DSAC Disability Services Advisory Committee DSD Disability Support Directorate DSP District Strategic Plan DSS Disability Support Services EAP Employee Assistance Programme ED Emergency Department EMT Executive Management Team ENT Ear, Nose and Throat ER Employment Relations FSA First Specialist Assessment GP General Practitioner HAC Hospital Advisory Committee HAHS Hospital and Health Services HBDHB Hawke’s Bay DHB HFA Health Funding Authority HHS Hospital & Health Service HMD Hospital Monitoring Directorate (former CCMAU) HNA Health Needs Analysis HOP Health of Older Persons HR Human Resources HTG Hospital Technical Group HVDHB Hutt Valley DHB ICD 9 International Code of Diseases ICU Intensive Care Unit IDF Inter District Flow IEA Individual Employment Agreement IEC Individual Employment Contract IPA Independent Practice Association (GP Group) IRF Inter Regional Flow ISDN Integrated Services Digital Network IT Information Technology KPI’s Key Performance Indicators LDHB Lakes DHB LMC Lead Maternity Carer MDHB MidCentral DHB MECA Multi Employer Collective Agreement MHAC Mental Health Advisory Committee MOH Ministry of Health MOSS Medical Officer Special Scale. A doctor with 4+ years post-graduate experience but not a

specialist MRT Medical Radiation Technologist NDHB Northland DHB NGO Non Government Organisation NICU Neonatal Intensive Care Unit NMDHB Nelson Marlborough DHB NZCM New Zealand College of Midwives NZNO New Zealand Nurses Organisation

WCDHB Meeting Papers Section 5 – Draft Minutes of Board Meeting 20 January 2006 24 February 2006 Page 1

DRAFT MINUTES OF THE WEST COAST DISTRICT HEALTH BOARD MEETING HELD ON FRIDAY

20 JANUARY 2006 AT 11.00 AM AT THE ASHLEY HOTEL, GREYMOUTH

PRESENT Gregor Coster

Christine Robertson Carol Atmore Glenys Baldick Julie Kilkelly Mohammed Shahadat Brian Wilkinson Malcolm Stuart John Vaile Robyne Bryant

IN ATTENDANCE Kevin Hague, Chief Executive Officer Wayne Champion, Chief Financial Manager Vikki Carter, Community Liaison Officer Carol Gaskell, Minute Secretary

APOLOGY Julie Kilkelly

1. WELCOME

The Chairman welcomed everyone to the first meeting of the New Year.

2. APOLOGY

An apology was received from Julie Kilkelly. Moved: Gregor Coster Seconded: Christine Robertson

Motion: “THAT the apology was accepted.” Carried.

3. STANDING ORDERS

The Chairman waived the Standing Orders unless there was reason to reinstate them later in the meeting.

4. DISCLOSURES OF INTEREST

The following points were added to the disclosure of interests: • Carol Atmore – Add: Member of ASMS.


• Glenys Baldick – Remove: Chairman – Junior Doctors in Training Round Table. • Robyne Bryant – Add: Negotiating Employment Contract with the West Coast District

Health Board

5. MINUTES OF THE PREVIOUS BOARD MEETING HELD FRIDAY 2 DECEMBER 2005

The following amendments were made to the Minutes of the meeting held 2 December 2005:

Page 1 - Disclosure of Interests – Add: Carol Atmore – A member of ASMS.

Page 2 – Review of Board Meeting Schedule in Line with the Ending of the Six Month Trial - Change to read: “… for their Committees. A majority of Board members felt that the six weekly instead of four weekly Board Meetings were effective.”

Moved: Brian Wilkinson Seconded: Mohammed Shahadat Motion: “THAT the Minutes of the West Coast District Health Board meeting held 2 December 2005 be adopted as a true and accurate record, subject to the above amendments.” Carried.

6. MATTERS ARISING

Discuss Frequency of DSAC Meetings The Board discussed the workload of the Disability Services Advisory Committee and the current frequency of meetings.

Moved: Gregor Coster Seconded: Brian Wilkinson Motion: “THAT the frequency of Disability Services Advisory Committee meetings be deferred and discussed at the May 2006 Board Meeting Schedule Review.” Carried.

Meeting at Te Tauraka Waka a Maui Marae (Bruce Bay) – 9 April Board Meeting Board Members were asked to supply information regarding travel and accommodation.

Pandemic Flu Planning – Progress Update The Board members have been supplied

with the latest version (Version 8) of the West Coast District Health Board’s Pandemic Influenza Plan. The Chief Executive provided a verbal update. He advised that the WCDHB’s plan meets the Ministry of Health requirements. The plan is in the form of a comprehensive and flexible manual and there are currently 16 workstreams devolved from the plan and these workstreams will be reporting to a Pandemic Planning Response Steering Group. The Steering Group currently comprises of; DHB staff, the Medical Officer of Health and Crown Public Health, St Johns, Regional Council Regional Emergency Management Officer with the intention of inviting the West Coast PHO to join the Steering Group.


The DHB is following the Ministry’s guidelines of “don’t panic – but take this seriously; minimise risk by practicing health hygiene; wash and dry your hands frequently, use tissues and dispose of these safely, ensure you have an emergency survival kit, vaccination etc.” The key message for the community is to let them know that the Health agencies have plans and are constantly working on these. The Media have had a copy of the latest plan and all media enquiries have been answered. A Board Member asked if the Community Pharmacies can be invited to join the Steering Group.

Action: Chief Executive Media Releases for Board Members A Board Member reminded the Chief Executive

that the Board had asked that they be informed before media releases are sent to the media. Email communication would be appropriate.

Community Communication on Health Issues - Cost For Quarterly or Six Monthly

Publications The Community Liaison Officer was asked to report on this. She advised that different options had been explored with a quarterly newspaper style publication costing around $10,000 and a six monthly issue costing between $5,000 and $6,000. A Board Member asked if sponsorship had been considered. The Community Liaison Officer advised that she is exploring co-production with health agencies such as Crown Public Health, Pharmacies etc. She advised it is envisaged that it would go to all households (14,000) and also be placed on our website. She advised that at a further report will be made to the next Board meeting. Board Members were invited to look at the material tabled and give their feedback to the Community Liaison Officer before the next meeting.

Action: Community Liaison Officer Board Members Profiles on Website The Community Liaison Officer asked Board

Members to pose for a head and shoulders photograph that can be used on the web site. A form will be sent out to Board Members asking for information that can be used for Board Members Profiles.

Action: Community Liaison Officer Board and Advisory Committee Members’ Manual Review A Declaration that Board

and Advisory Committee Members had received, read and understood the Manual is to be provide for Members to sign.

Action: Chief Executive

7. CHAIRMAN’S REPORT The Board Chair gave a verbal report to the Board. He acknowledged that the West Coast District Health Board’s PRiSM Project meets the “good information systems” expectations in the message delivered by the Hon. Pete Hodgson and that the Minister’s requirement to foster good relationships and trust between Boards and Provider, Boards and Departments and the Ministry of Health was a useful section of his messages for the Board to relay when furthering its relationships. The Intersectoral Forum meetings are a good example of what this Board is doing to improve relationships.

Moved: Gregor Coster Seconded: Christine Robertson

Motion: “THAT the Chairman’s Report be received.” Carried.


8. BOARD AND CHAIRMAN’S CORRESPONDENCE

Anthony Hill, DDG. DHB Funding and Performance, Ministry of Health, Opportunity to comment: Guidance to Departments in Relation to Crown Entities The Chair asked the Board members feedback comments on the Guidelines to ensure they can be returned to the Ministry by 5 February 2006. A discussion was held around the [Page 4] “Role of the Board” and the Chair will ask for clarification around point three in this list which could lead to confusion between the governance and management roles of Boards and their management. As well, the document refers only to appointed members. Guidance should also be given in relation to elected members. Clarity is also to be sought around the wording [Page 6] “… and persistent capability bids.”

Action: Board Chair

Hon Pete Hodgson, Minister of Health, Introducing Minister including strategies,

relationships and priorities for 2006/2007 The Board discussed the Minister’s letter and asked that the priorities are incorporated into our planning processes and planning documentation.

Jim Anderson, Resident, Richmond Street, Cobden, Proposals for community

accommodation for mental health patients The Chief Executive advised that another letter had been received from Mr Anderson just prior to the last Board Meeting and Board Members will receive a copy of this. In the letter Mr Anderson has put forward some proposals. The Chief Executive advised that the Mental Health Team has a copy of Mr Anderson’s letter and will consider this in line with the Mental Health Rehabilitation Review and report back to the February Board meeting.

Action: Chief Executive

Communications between the Public and the West Coast District Health Board

A Board Member expressed some disquiet that the Public may feel that they cannot approach the Board and must do this via the media. A suggestion was made that a section of the meeting time be put aside for Public comment ie a set time to deliver statements and comments with no expectation of response on the day. It was decided that this avenue is already available via the Advisory Committees for groups and organisations and that the workload for Board meetings is already time pressured. The Chair of DSAC was asked to provide some clear and workable guidelines for Community Presentations at meetings. It was noted that Standing Orders also allow for the formal presentation of submissions to the Board.

Action: The Chair DSAC Moved: John Vaile Seconded: Christine Robertson

Motion: “THAT the Board and Chairman’s Inwards Correspondence be received and the Outwards Correspondence be approved.” Carried.

9. CHIEF EXECUTIVE’S REPORT

The Chief Executive spoke to his report.


Buller Health The Chief Executive advised that there has been steady progress. The Board was provided with copies of recent Westport News coverage and the Chief Executive advised that he was disappointed at the tone of these articles, especially as a staff member was attributed as making comments that were a collective statement by the Buller Health Review Steering Group. In fact the staff member had not been interviewed. The report of the Steering Group is not a statement of the West Coast District Health Board’s position – it includes our staff and people from outside the organisation. Our key objective is that the public is well informed about Buller Health and that Martin Sawyers and Damien O’Connor have previously supported these objectives. A Board Member asked if the Buller Health Services Review Report was now a public document and was advised that it is and will be made available from the DHB Website. The Chair thanked the Chief Executive and the Chief Financial Manager for the community engagement carried out through the Buller Health Services Review and from their good management process. The Chair also commented that over the last six months the Westport News had reported well. Collaboration with other DHBs The Chief Executive advised that he had met with the CEO, Canterbury DHB and Jock Muir, General Manager Hospital and Speciality Services and the meeting covered a number of items including the Rural GP Training Scheme. Discussions were held around whether they could give preference to the trainees on the Rural GP Training programme when selecting Paediatric RMOs. This option is still open and Canterbury advised they would come back to us. Also discussed was a greater collaboration around Surgical Services and there was an agreement to explore collaboration for a wide range of clinical and non-clinical activities. This meeting was productive and Canterbury will generate a response that can be reported to the next Board meeting. A Board Member expressed the need to have something solid regarding the Paediatric RMO situation and asked that everything be done to progress this. The Board were asked if they had any further points of discussion from the Chief Executive’s Report. District Strategic Plan A Board Member expressed concern with the process of reviewing the DSP. After the Advisory Committees had made their comments it was felt that the draft District Strategic Plan should be made available to Advisory Committees to further review. The Chief Executive advised that timeframes were kept to but would endeavour to consider this for the next round. MeNZB A Board Member asked whether the Board had the resources to administer the Dose 4 for babies under six months. The Chief Executive advised that management can provide this service. Review on Pharmacy The Chief Executive advised that a report on the recent review of Pharmacy will go to the Hospital Advisory Committee who will report to the Board.

Moved: Gregor Coster Seconded: Malcolm Stuart Motion: “THAT the Chief Executive’s Report be received.” Carried.

The meeting broke for lunch at 12.30 pm

The meeting reconvened at 1.15 pm


10. FINANCE REPORT The Chief Financial Manager spoke to the Finance Report. He advised that the

West Coast District Health Board is now on early payment ($5.095m), which will give us $390,000 interest revenue. The Chair advised that we still have some risks around salaries and that the increased salary payments to nursing was approximately $200,000 and as a Board it is our responsibility to closely watch the bottom line. It was acknowledged that outsourcing locums is a financial risk and must be managed - if we don’t meet budget the early payment will be taken from us.

Directors’ Schedule The Deputy Chair advised that Board and Advisory Committee

Members can only be paid for 10 meetings a year. Up to the end of June for most Community members there is no scope to hold any extra paid meetings.

Moved: Mohammed Shahadat Seconded: Brian Wilkinson Motion: “THAT the Finance Report be received.” Carried.

11. REPORTS FROM BOARD ADVISORY COMMITTEES

11.1 Hospital Advisory Committee The Chair of the Hospital Advisory Committee spoke to her Report.

Barrier Free Audit A Board Member asked if the person who undertook the Barrier Free

Audit was qualified to do this. He was assured that this was the case. 11.2 Disability Services Advisory Committee

The Chair of the Disability Services Advisory Committee spoke to his Report.

11.3 Community and Public Health Advisory Committee

The Chair of the Community and Public Health Advisory Committee spoke to her Report and stated that she had an ongoing problem with timeliness, which resulted in the report having to be tabled. Sexual Health It was noted that sexual health is not covered under the West Coast PHO – 22 Contraception Contract. The Chief Executive advised that on studying the Contract this had only covered contraception and that this should be expanded. There is a performance review at the end of September and specifications will be looked to see whether or not there is funding in the Contract to expand the service. Greymouth Health Centre There is nothing further to report.

11.4 Audit, Risk and Finance Advisory Committee

The Chair of the Audit, Risk and Finance Committee advised that there was nothing to Report to the Board for this meeting.


Moved: Carol Atmore Seconded: Robyne Bryant Motion: “THAT the Reports from the Advisory Committees be noted.” Carried.

13. MINUTES OF A MEETING OF THE WEST COAST INTERSECTORAL FORUM HELD 1 DECEMBER 2005

The Chair of the Intersectoral Forum advised that the next meeting of the Forum will be held on Thursday, 9 February 2006. A Board Member asked who represented Buller at the Intersectoral Forum, the Chair advised that Martin Sawyers and Rosalie Sampson from the Buller District Council receive invitations.

Moved: Carol Atmore Seconded: Robyne Bryant

Motion: “That the Report from the Intersectoral Forum be noted.” Carried.

14. IN COMMITTEE Pursuant to Clause 32a, Schedule 3 of the New Zealand Public Health & Disability Act 2000 members of the public are to be excluded from the portion of the 20 January 2006 meeting of the West Coast District Health Board that relates to the following items on the grounds that the public conduct and discussion of the following items would enable the WCDHB to carry out, without prejudice or disadvantage, commercial activities granted by Section 9(2)i of the Official Information Act 1982. • Minutes of meeting held 2 December 2005 • Matters Arising from the Minutes of 2 December 2005 • Contracts

Moved: Christine Robertson Seconded: Malcolm Stuart

Motion: “THAT the Board move into Committee 1.45 pm.” Carried.

15. MOVING OUT OF IN COMMITTEE

Moved: Christine Robertson Seconded: Robyne Bryant

Motion: “THAT the Board move out of Committee at 2.50 pm.” Carried.

The Board spent 65 minutes in Committee


16. NEXT MEETING

Friday, 24 February 2006 at 9.30 am in the Boardroom, Corporate Office, Greymouth.

There being no further business to discuss the meeting concluded at 2.55 pm

WCDHB Meeting Papers Section 6 – Matters Arising Draft Minutes of Board Meeting 20 January 2006 24 February 2006 Page 1

MATTERS ARISING FROM WCDHB MEETINGS

Item No.

Board Meeting

Date

Action Item

Action Responsibility

Reporting

Status

Agenda Item Ref

6. 2 December 2005 Review of Board Meeting Schedule at the May Board meeting Board Members

6. 2 December 2005 Discuss Frequency of DSAC Meetings at the May Board meeting

Board Members

3. 21 October 2005 Discuss visit to Te Tauraka Waka a Maui Marae (Bruce Bay) at the February Board Meeting

Chief Executive / General Manager Maori Health Services

This is an Agenda Item

11.3 2 December 2005 Report on Community Communication on Health Issues – Cost Quarterly or 6 Monthly Publication

Chief Executive / Community Liaison Officer

11.3 2 December 2005 Collect Data for Board Members Profiles on Website Chief Executive / Community Liaison Officer

With Meeting Papers

6 20 January 2006 Influenza Pandemic Planning – Invite Community Pharmacies on to the Influenza Pandemic Planning Steering Group

Chief Executive Completed

8 20 January 2006 Letter from Anthony Hill, DDG Funding and Performance, MOH re Guidelines to Departments in Relation to Crown Entities. Write to Ministry for clarification around the three points the Board Members discussed

Board Chair

8 20 January 2006 Letter from Mr J Anderson, Resident, Cobden re Proposal for community accommodation for mental health patients. Report to the Board.

Chief Executive

8 20 January 2006 Communications between the Public and the West Coast District Health Board. Prepare guidelines for Community Presentations to Board or Advisory Committee Meetings.

Chair DSAC In the Board Papers


MATTERS REFERRED TO ADVISORY COMMITTEES FOR CONSIDERATION

Item No.

Board Meeting

Date

Committee

Item

There were no new items referred to Advisory Committees from this meeting.


GUIDELINES FOR PRESENTATIONS TO ADVISORY COMMITTEE MEETINGS

BACKGROUND At the January 2006 Board Meeting the Board requested clear and workable guidelines for Community Presentations at meetings.

PRESENTATION GUIDELINES 1. The Approach The Community Group or Organisation formally approaches the Chair of

the Committee with a request to present information. An agreement is reached around:

• the topic • date and time of the presentation. • the timeline is set for the presentation and for questions. (A suggestion is 20 minutes

for the presentation and 10 minutes for questions). 2. The Preparation The Community Group or Organisation liaises with the Minute Secretary

about resources that need to be available for the presentation and for any photocopying of resources that may be required. The resources are either distributed with the Meeting Papers or are tabled at the meeting by the presenter.

3. The Presentation The Community Group or Organisation, hands out any resources, and

answers questions. The Chair of the meeting thanks the Community Group or Organisation and a summary of the information shared is written in the Meeting minutes.

The Committee can make recommendations to the Board.

TO:

Chair and Members West Coast District Health Board

FROM: Chair, Disability Services Advisory DATE: 14 February 2006

WCDHB Meeting Papers Section 7 – Chairman’s Report 24 February 2006 Page 1

CHAIRMAN’S REPORT

The Chairman will give a written update at the West Coast District Health Board Meeting on Friday, 24 February 2006.

WCDHB Meeting Papers Section 8 – Board and Chairman’s Correspondence 24 February 2006 Page 1

BOARD AND CHAIRMAN’S CORRESPONDENCE FOR JANUARY / FEBRUARY 2006

Date Sender Addressee Details Response Date Response Details

There has been no correspondence since the January Board Meeting.

BOARD AND CHAIRMAN’S IN COMMITTEE CORRESPONDENCE FOR JANUARY / FEBRUARY 2006

Date Sender Addressee Details Response Date Response Details

WCDHB Meeting Papers Section 9 – Chief Executive’s Report 24 February 2006 Page 1

CHIEF EXECUTIVE’S REPORT

TO: Chair and Members

West Coast District Health Board FROM: Kevin Hague, Chief Executive DATE: 15th February 2006

STRATEGIC ISSUES District Strategic Plan Nothing new to report for this meeting. Primary Care Plan Nothing new to report for this meeting. Buller Health Gareth Rees has been seconded from his position with Buller REAP to work as Transitional Manager for Buller Health for a period of six months from 6th March. His tasks during this period will focus on putting the structural integration of the two services into practice on the ground, and developing a health services plan specific to Buller. During this period we will recruit for a permanent manager. PHO Contract Initial indications from the reconfigured governance and management arrangements of the West Coast PHO are extremely positive. I have been advised that the PHO had strong interest in its CEO position and I hope to be able to advise you of the successful applicant at the February meeting. Chapman Tripp remain on track for the redraft of the PHO Trust Deed. At the time of the February Meeting I will have met with John Ayling, Interim Chair of the PHO, and may have more to report arising from that meeting. I will also have met with representatives of South Link Health over any outstanding issues. Secondary Care Plan Initial work has begun involving both management and clinical staff in developing a service plan for Grey Base Hospital, including models of care and projected requirements for bed numbers. The Planning and Funding team will be taking a lead on this work, building on the work that was undertaken last year and in conjunction with new work being led by the Director of Nursing and Midwifery. Chronic Disease Management Plan Nothing new to report for this meeting. Child Health Plan Nothing new to report for this meeting.


Older Adult Health Nothing new to report for this meeting. Facilities Planning I expect to appoint a project leader shortly to coordinate and facilitate the considerable work that will be required in order to submit a business case to the National Capital Committee in August. In the meantime this work has already begun, focusing, in the first instance, on developing the models of care and projected bed numbers. A call also needs to be made quickly on how the HDU concept is to be progressed. The opening of the new clinic at Fox Glacier was, by all accounts, a great success. Thanks to all of those involved and particularly to the Deputy Chair and the GM Primary Care.

MAORI HEALTH Memoranda of Understanding with Papatipu Runanga Nothing new to report for this meeting.

Second West Coast Maori Health Plan Nothing new to report for this meeting.

EXTERNAL RELATIONSHIPS Intersectoral Forum The forum continues to produce immediate opportunistic gains and to gather momentum towards developing strategic significance. The most recent meeting had the broadest attendance yet, with the Department of Internal Affairs and the Department of Conservation attending for the first time. Agencies now involved are:

Buller District Council

Grey District Council

Westland District Council

Te Runanga of Ngati Waewae

Te Runanga o Makaawhio

West Coast Development Trust

Education West Coast

Tai Poutini Polytechnic

West Coast District Health Board

Ministry of Social Development

Department of Internal Affairs

Department of Conservation

The group has agreed to make youth a particular focus for collaborative activity and is currently scoping a range of projects, and making use of a range of resourcing opportunities.


Patients Patient satisfaction rate for the final quarter of 2005 was 87% but no new benchmarking is available. This rate is a little down on our usual results, but the difference is unlikely to be statistically significant.

General Public Nothing new to report for this meeting. A further report from the Community Liaison Officer on the possibility of a community newsletter is being prepared for your consideration.

Community-based health service providers Nothing new to report for this meeting.

Ministry of Health Grant Pollard has now been appointed as our new relationship Manager at the Ministry of Health (replacing Anne Gooch). We are still awaiting the outcome of review of our monitoring status. We expect to meet with the Ministry again shortly after the draft DAP has been submitted to agree the next steps in calculating the permanent basis for WCDHB funding, but the Ministry has not indicated that it wishes to take into consideration any matters other than those canvassed by the CHFA report (their deadline for adding new items was the end of 2005).

OPERATIONAL MATTERS Dementia Unit The Canterbury DHB project management team are now facilitating this project for us and are proceeding to the more detailed architectural work. We are currently still on track to meet the project plan outlined in our case to the NCC, although the Minister has not yet signed off on the release of the approved capital, and this may lead to some delays. Collaboration with other DHBs Nothing new to report for this meeting, although by the time of your meeting I will have met with my counterpart at Nelson Marlborough DHB, with potential for collaboration on one of our agenda items. David Meates, CEO of Wairarapa DHB made an extremely positive contribution to our initial workshop on facilities redesign, and Cathy Cooney from Lakes DHB has also offered her assistance with this. Influenza Pandemic Planning The WCDHB has joined with the other South Island DHBs to develop a South Island wide approach to the planning and management of an influenza pandemic outbreak. This decision was taken so that each DHB could support and provide assistance to each other with regards to pandemic planning, and to ensure that the plans developed by each DHB are consistent and interoperable as part of any coordinated South Island wide response. Two meetings of the planning forum have been held so far this year, with meetings scheduled at fortnightly intervals. To date the planning forum has developed a coordinated patient care pathway for the management of pandemic influenza, and the associated aspects of this. Future meetings of the planning forum will focus on the mechanics of operating Community Based Assessment Areas and support requirements for staff. A steering group has been established to coordinate the health sector response to any potential pandemic on the West Coast, and has now met for a second time. The Minister of Health has indicated that he expects major pandemic preparation work to have wound up by about the middle of the year.


Reefton radiology While the overall process for examining the service needs of the Reefton community is continuing on schedule, the retirement of a staff member has forced the DHB and the Reefton community to examine future service provision options for x-ray immediately. The issue is not yet resolved. The essential problems relate to professional competence and occupational safety and health. The service must be operated by “a suitably qualified person”. The staff member who retired was not a suitably qualified person but was allowed to continue to practice because of her lengthy service. The probability of recruiting a radiographer for the Reefton position is vanishingly small, and the volume of work would be insufficient to maintain that person’s professional skills. Other possibilities would be for a doctor or registered nurse to be trained and to provide the service. In the case of a registered nurse, the licensee for the service (a Christchurch radiologist) would permit images of limbs and extremities only. These amount to four or five images per week, and the licensee is very doubtful as to whether image quality can be ensured with that small volume of work. The other complicating factor is that the chemicals involved in processing images using the Reefton equipment pose well-established risks to some people who are exposed to them. With the very small number of images (and likely to be reduced number) the chemistry becomes less stable and chemicals need to be replaced more often, increasing the frequency and duration of exposure to these potentially hazardous agents. A possibility may be that the Reefton GP could take over the licence for the service and undertake the training required to perform these x-rays himself. We are currently exploring what would be required to gift the existing x-ray equipment to him. We are also investigating whether trends in radiology equipment may ease this problem in future, making this a temporary phenomenon.

Author: Kevin Hague, Chief Executive – 15th February 2006

WCDHB Meeting Papers Section 10 – Financial Report 24 February 2006 Page 1

FINANCE REPORT

OPERATING RESULTS The monthly result for December 2005 is a deficit of $555k, which is $510k worse than budget ($45k deficit). The provider deficit of $467k is $312k worse than budget ($155k deficit). The governance and administration deficit of $3k is $9k worse than budget ($6k surplus). The funder arm deficit of $85k is $189k worse than budget ($104k surplus). The year to date (December) result is a deficit of $384k, which is $492k worse than budget ($108k surplus). The year to date provider deficit of $1,783k is $1,210k worse than budget ($573k deficit). The year to date governance and administration result is a surplus of $12k, which is $33k under budget ($45k surplus). The year to date funder arm surplus is $1,387k, $750k better than budget ($637k surplus).

REVENUE Revenue for the month of $7,691k is $44k worse than budget ($7,735k). Provider revenue of $4,934k is $78k lower than budget ($5,012k). The wash-up liability owed to the funder arm for underproduction against contracted volumes increased by $37k1 in the month of December. Funder revenue for the month of $6,966k, is slightly under budget ($7,046k) by $80k Year to date (December) revenue of $46,286k is $120k under budget ($46,406k), mainly due to reduced funding due to the change in capital charge rate (from 11% to 8%). This reduction is matched by reduced expenditure. Year to date provider revenue is $29,021k is down $1,046k on budget ($30,067k), primarily due to the wash-up liability owed to the funder arm for underproduction against contracted volumes of $766k1 and also due to reduced funding due to the 1 We have not assumed that overproduction will be offset against underproduction except for where a specific trade-off has been agreed between the funder and provider.

Financial Overview December 2005

Actual Budget Variance Variance Last Yr Actual Budget Variance Variance Last Yr Full Yr Full Yr Full Yr ActMonth Month Month YTD YTD YTD Forecast Budget Last Yr

REVENUEProvider 4,934 5,012 (78) (1.6%) 4,287 29,021 30,067 (1,046) (3.5%) 25,423 59,693 60,143 53,019Governance & Administration 86 89 (3) (3.6%) 96 523 535 (12) (2.3%) 549 1,071 1,071 1,114Funds & Internal Eliminations 2,671 2,634 37 1.4% 2,368 16,742 15,803 939 5.9% 14,796 31,857 31,607 29,041

7,691 7,735 (44) (0.6%) 6,751 46,286 46,406 (120) (0.3%) 40,768 92,621 92,821 83,174

EXPENSESProvider Personnel 3,225 3,036 (189) (6.2%) 2,645 17,667 17,859 192 1.1% 15,441 35,778 35,878 32,651 Outsourced Services 620 424 (196) (46.2%) 419 3,418 2,544 (874) (34.4%) 2,633 5,700 5,100 5,482 Clinical Supplies 528 505 (23) (4.6%) 507 3,073 3,030 (43) (1.4%) 2,822 6,153 6,053 6,065 Infrastructure 950 1,124 174 15.5% 1,023 6,178 6,739 561 8.3% 6,090 12,897 13,497 12,041

5,323 5,089 (234) (4.6%) 4,594 30,336 30,172 (164) (0.5%) 26,986 60,528 60,528 56,239

Governance & Administration 167 161 (6) (3.8%) 155 979 959 (20) (2.1%) 909 1,938 1,918 1,852Funds & Internal Eliminations 2,756 2,530 (226) (8.9%) 2,567 15,355 15,167 (188) (1.2%) 13,569 30,370 30,370 26,759

8,246 7,780 (466) (6.0%) 7,316 46,670 46,298 (372) (0.8%) 41,464 92,836 92,816 84,850

Net Result (555) (45) (510) 1134.7% (565) (384) 108 (492) (455.2%) (696) (216) 4 (1,676)


change in capital charge rate (from 11% to 8%) of $177k. This reduction is matched by reduced expenditure. Maternity fees for service are $42k under budget and ACC revenue is $68k under budget for the 6 months to December. Areas still with significant underproduction include orthopaedic surgery, paediatric surgery, paediatric medical, Inpatient ATR and Domiciliary Nursing. Compensating overproduction ($530k total) has not been recognised in our accounts as we have not changed the mix of services purchased by the funder arm. Areas of notable overproduction include general surgery and chemotherapy attendances. Year to date funder revenue $41,999k is $276k under budget ($42,275k). This also includes the effect of the reduced capital charge funding (matched by reduced costs).

EXPENSES Expenses for the month of December 2005 ($8,246k) were $466k higher than budget ($7,780k). Provider expenses for the month are over budget by $234k. Personnel costs are over budget ($189k). Nursing costs were $139k over budget, due to the payment of back pay to senior nursing

staff which resulted from the translation of salaries to new scales in the NZNO Nursing and Midwifery Collective Agreement (as a result of job scoping). The actual back-pay exceeded our accruals, as translation resulted in payments related to a wider range of staff than initially anticipated. Allied Health costs were $34k over budget, for the same reason.

Management and Admin personnel costs were $37k over budget as an accrual was made for settlement of PSA negotiations (previous agreement expired June 2005).

Outsourced services are above budget ($196k) as we have engaged locum medical staff (surgical and orthopaedic) and Bureau Nurses, due to an inability to recruit directly. Clinical supplies are $23k over budget for the month due largely to Pharmaceuticals which

were $35k over budget and X-ray Film, $6k over budget (this is offset by reduced IT costs as the PACS system is not yet operational). Infrastructure Costs were under budget for the month by $174k, with savings in maintenance,

IT, transport and financing costs. Funder arm expenditure is $109k over budget ($6,942k) for the month. Disability Support expenditure was $286k over budget due to back payments to rest homes. Year to date (December 2005) expenses were $372k over budget ($46,298k). Year to date provider expenses ($30,336k) are $164k over budget ($30,172k). Personnel costs are under budget ($192k) due to clinical vacancies. Outsourced services are above budget ($874k) as we have used locum staff to cover a number

of clinical vacancies. Clinical supplies are $43k over budget. Other clinical and client costs are $91k over budget due to increased air ambulance

transfers and increased spend on pharmaceuticals. Diagnostic supplies are $31k over budget due to the use of X-ray film due to the timing of

the PACS Project. Implants and prostheses are $86k under budget due to ACC elective work being slightly

under budget and under performance in acute orthopaedic volumes. Infrastructure and Non clinical Supplies are $561k under budget. Cleaning and orderly costs are $74k above budget. Facilities costs are $116k below budget due to the payment of a recent insurance claim.


IT and Telecommunications costs are $131k below budget due to the timing of capital expenditure (reduced depreciation as new items are still being implemented), and lower software charges (as the PACS system has not yet been implemented).

Interest costs are $356k under budget due to capital charge payments on our equity balance (as we did not require budgeted equity injections in 2004/05) and because the capital charge rate has been dropped from 11% to 8% and due to favourable changes in market interest rates.

Year to date funder arm expenditure is $1,026k down against budget primarily due to the wash-up liability from the funder arm ($766k) and decreased capital charge funding ($177k).

STATEMENT OF FINANCIAL POSITION The DHB’s CHFA loan is now shown as a fixed term liability, as was originally budgeted. We are in a strong financial position with a debt to debt + equity ratio of 46.6%

CASHFLOW At 31 December 2005 we had $6.3M in cash and short term investments, $4.1M more than budgeted, reflecting both our favourable 2004-05 financial performance and timing delays in the cash payment profiles for planned IT and infrastructure projects.

FORECAST At the moment we are forecasting a full year deficit of $216k, $220k worse than budget ($4k surplus). This forecast is based on our performance to 31 December 2005 ($492k worse than budget) and assumes that we will claw back a portion of our year to date overrun in outsourced services by reducing our use of locum surgical staff during the second half of the year.

CAPEX Approved capital expenditure (year to date December) of $695k is well within budget ($1,500k). Preliminary work is underway for a couple of large budgeted items that have not yet been submitted for approval (high dependency unit, emergency power generation, boiler upgrade).

DEBTORS Our current debtors balance is lower than budget indicating favourable collection performance.

ACCOUNTS PAYABLE Our Accounts Payable balance is higher than planned due to a change in the way we account for funding from the Ministry of Health.


IT PROJECTS – PACS (PICTURE ARCHIVING AND COMMUNICATION SYSTEM) All hardware associated with the PACS system is in place and working. We are now working with the software vendor to finalise installation arrangements.

IT PROJECTS – ISOFT (PATIENT ADMINISTRATION AND CLINICAL INFORMATION SYSTEM) The iSOFT software is now being installed on our hardware ready for superuser training and the software configuration phase of the project. Author: Chief Financial Manager – 26 January 2006

Approved: Acting Chief Executive – 26 January 2006


DHB CONSOLIDATED - STATEMENT OF FINANCIAL PERFORMANCE FOR THE MONTH OF DECEMBER 2005

Actual Budget Variance Variance Last Yr Act YTD Actual YTD Budget Variance Variance Last YTD Forecast Full Budget Last Full YrRevenueCore MoH Funding 6,894 6,947 (53) (0.8%) 6,041 41,560 41,680 (120) (0.3%) 36,589 82,861 83,361 74,912 Other MoH Funding 526 483 43 9.0% 373 3,164 2,891 274 9.5% 2,428 5,284 5,784 5,180 Patient / Consumer Sourced 198 235 (37) (15.7%) 252 1,068 1,410 (342) (24.3%) 1,330 3,320 2,820 2,175 Non Health Related 73 71 2 3.1% 85 494 425 69 16.2% 421 1,156 856 907

7,691 7,735 (44) (0.6%) 6,751 46,286 46,406 (120) (0.3%) 40,768 92,621 92,821 83,174

Payments to Providers 2,756 2,530 (226) (8.9%) 2,567 15,355 15,167 (188) (1.2%) 13,569 30,370 30,370 26,759

Personnel CostsMedical Personnel 570 586 16 2.7% 426 3,175 3,463 288 8.3% 2,583 6,641 6,941 6,120 Nursing Personnel 1,377 1,238 (139) (11.2%) 1,124 7,349 7,241 (108) (1.5%) 6,481 14,809 14,609 13,414 Allied Health Personnel 760 726 (34) (4.7%) 658 4,243 4,286 43 1.0% 3,857 8,579 8,579 7,883 Support Personnel 104 109 5 4.6% 111 600 643 43 6.7% 600 1,287 1,287 1,205 Management / Admin 495 463 (32) (6.9%) 413 2,812 2,735 (77) (2.8%) 2,412 5,481 5,481 5,019

3,306 3,122 (184) (5.9%) 2,732 18,179 18,368 189 1.0% 15,933 36,797 36,897 33,641

Outsourced Services 651 438 (213) (48.6%) 434 3,535 2,628 (907) (34.5%) 2,715 5,888 5,268 5,653

Clinical SuppliesTreatment Disposables 97 93 (4) (4.3%) 90 553 558 5 0.9% 525 1,119 1,119 1,103 Diagnostic Supplies 20 9 (11) (122.2%) 15 85 54 (31) (57.4%) 71 106 106 170 Instruments & Equipment 98 93 (5) (5.4%) 97 570 558 (12) (2.2%) 514 1,117 1,117 1,120 Pt Appliances, Implants, Prostheses 71 100 29 29.0% 71 514 600 86 14.3% 457 1,191 1,191 1,118 Other Clinical & Client Costs 242 210 (32) (15.2%) 234 1,351 1,260 (91) (7.2%) 1,255 2,620 2,520 2,554

528 505 (23) (4.6%) 507 3,073 3,030 (43) (1.4%) 2,822 6,153 6,053 6,065 Infrastructure CostsHotel Services, Laundry & Cleaning 212 228 16 7.0% 215 1,440 1,368 (72) (5.3%) 1,312 2,736 2,736 2,605 Facilities 255 291 36 12.4% 278 1,632 1,747 115 6.6% 1,575 3,491 3,491 3,487 Transport 92 107 15 14.3% 91 644 649 5 0.8% 573 1,296 1,296 1,223 IT Systems & Communication 81 106 25 23.2% 89 498 629 131 20.8% 549 1,269 1,269 1,084 Democracy 21 29 8 27.6% 25 138 174 36 20.7% 156 351 351 283 Professional Fees & Expenses 56 53 (3) (5.7%) 38 346 318 (28) (8.8%) 247 639 639 545 Other Operating Costs 288 371 83 22.4% 340 1,830 2,220 390 17.6% 2,013 3,846 4,446 3,505

1,005 1,185 180 15.2% 1,076 6,528 7,105 577 8.1% 6,425 13,628 14,228 12,732

Expenses Total 8,246 7,780 (466) (6.0%) 7,316 46,670 46,298 (372) (0.8%) 41,464 92,836 92,816 84,850

Surplus (Deficit) (555) (45) 510 (1134.7%) (565) (384) 108 492 455.2% (696) (216) 4 (1,676)


DHB PROVIDER ARM - STATEMENT OF FINANCIAL PERFORMANCE FOR THE MONTH OF DECEMBER 2005

Actual Budget Variance Variance Last Yr Act YTD Actual YTD Budget Variance Variance Last YTD Forecast Full Budget Last Full Yr

RevenueCore MoH Funding 4,267 4,339 (72) (1.7%) 3,726 25,061 26,034 (973) (3.7%) 22,089 51,318 52,068 46,170 Other MoH Funding 431 388 43 11.1% 255 2,594 2,323 271 11.7% 1,723 4,149 4,649 4,090 Patient / Consumer Sourced 198 235 (37) (15.7%) 252 1,068 1,410 (342) (24.3%) 1,330 3,320 2,820 2,175 Non Health Related 38 50 (12) (24.0%) 54 298 300 (2) (0.7%) 281 906 606 584

4,934 5,012 (78) (1.6%) 4,287 29,021 30,067 (1,046) (3.5%) 25,423 59,693 60,143 53,019

Personnel CostsMedical Personnel 570 586 16 2.7% 426 3,175 3,463 288 8.3% 2,583 6,641 6,941 6,120 Nursing Personnel 1,377 1,238 (139) (11.2%) 1,124 7,349 7,241 (108) (1.5%) 6,481 14,809 14,609 13,414 Allied Health Personnel 760 726 (34) (4.7%) 658 4,243 4,286 43 1.0% 3,857 8,579 8,579 7,883 Support Personnel 104 109 5 4.6% 111 600 643 43 6.7% 600 1,287 1,287 1,205 Management / Admin 414 377 (37) (9.8%) 326 2,300 2,226 (74) (3.3%) 1,920 4,462 4,462 4,029

3,225 3,036 (189) (6.2%) 2,645 17,667 17,859 192 1.1% 15,441 35,778 35,878 32,651

Outsourced Services 620 424 (196) (46.2%) 419 3,418 2,544 (874) (34.4%) 2,633 5,700 5,100 5,482

Clinical SuppliesTreatment Disposables 97 93 (4) (4.3%) 90 553 558 5 0.9% 525 1,119 1,119 1,103 Diagnostic Supplies 20 9 (11) (122.2%) 15 85 54 (31) (57.4%) 71 106 106 170 Instruments & Equipment 98 93 (5) (5.4%) 97 570 558 (12) (2.2%) 514 1,117 1,117 1,120 Pt Appliances, Implants, Prostheses 71 100 29 29.0% 71 514 600 86 14.3% 457 1,191 1,191 1,118 Other Clinical & Client Costs 242 210 (32) (15.2%) 234 1,351 1,260 (91) (7.2%) 1,255 2,620 2,520 2,554

528 505 (23) (4.6%) 507 3,073 3,030 (43) (1.4%) 2,822 6,153 6,053 6,065 Infrastructure CostsHotel Services, Laundry & Cleaning 210 226 16 7.1% 213 1,430 1,356 (74) (5.5%) 1,305 2,712 2,712 2,594 Facilities 255 291 36 12.4% 278 1,630 1,746 116 6.6% 1,574 3,490 3,490 3,478 Transport 91 101 10 9.9% 82 612 611 (1) (0.2%) 535 1,219 1,219 1,147 IT Systems & Communication 81 105 24 22.9% 89 495 626 131 20.9% 549 1,263 1,263 1,084 Interest 142 214 72 33.6% 198 923 1,279 356 27.8% 1,157 1,963 2,563 1,716 Professional Fees & Expenses 34 35 1 2.9% 28 228 210 (18) (8.6%) 160 423 423 352 Other Operating Costs 137 152 15 9.9% 135 860 911 51 5.6% 810 1,827 1,827 1,670

950 1,124 174 15.5% 1,023 6,178 6,739 561 8.3% 6,090 12,897 13,497 12,041

Expenses Total 5,323 5,089 (234) (4.6%) 4,594 30,336 30,172 (164) (0.5%) 26,986 60,528 60,528 56,239

Allocated from Governance & Admin 78 78 0 0.0% 78 468 468 0 0.0% 468 936 936 936 Surplus (Deficit) (467) (155) (312) 201.3% (385) (1,783) (573) (1,210) 211.2% (2,031) (1,771) (1,321) (4,156)


DHB GOVERNANCE AND ADMIN - STATEMENT OF FINANCIAL PERFORMANCE FOR THE MONTH OF DECEMBER 2005

Actual Budget Variance Variance Last Yr Act YTD Actual YTD Budget Variance Variance Last YTD Forecast Full Budget Last Full Yr

Revenue 86 89 (3) (3.6%) 96 523 535 (12) (2.3%) 549 1,071 1,071 1,114

Personnel CostsManagement / Admin 81 86 5 5.8% 87 512 509 (3) (0.6%) 492 1,019 1,019 990

Outsourced Services 31 14 (17) (121.4%) 15 117 84 (33) (39.3%) 82 188 168 171

Infrastructure Costs 0 Transport 1 6 5 84.4% 9 32 38 6 16.7% 38 77 77 76 IT Systems & Communication 0 1 1 100.0% 0 3 3 0 0.0% 0 6 6 0 Professional Fees & Expenses 22 18 (4) (22.2%) 10 118 108 (10) (9.3%) 87 216 216 193 Other Operating Costs 13 13 0 0.4% 9 85 78 (7) (8.6%) 66 157 157 162 Democracy 19 23 4 17.4% 25 112 138 26 18.8% 144 276 276 260

55 61 6 9.8% 53 350 366 16 4.3% 335 731 731 691

Expenses Total 167 161 (6) (3.8%) 155 979 959 (20) (2.1%) 909 1,938 1,918 1,852

Allocated to Provider (78) (78) 0 0.0% (78) (468) (468) 0 0.0% (468) (936) (936) (936)Surplus (Deficit) (3) 6 (9) (147.8%) 19 12 45 (33) (73.1%) 108 68 88 198

DHB FUNDER ARM - STATEMENT OF FINANCIAL PERFORMANCE FOR THE MONTH OF DECEMBER 2005

Actual Budget Variance Variance Last Yr Act YTD Actual YTD Budget Variance Variance Last YTD Forecast Full Budget Last Full YrPersonal HealthFunding Received 5,069 5,164 (95) (1.8%) 4,482 30,638 30,985 (347) (1.1%) 26,609 61,469 61,969 55,057 Provider Payments (4,892) (5,055) 163 (3.2%) (4,302) (29,209) (30,314) 1,105 (3.6%) (25,474) (59,913) (60,663) (52,506)

177 109 68 61.8% 180 1,429 671 758 112.9% 1,135 1,556 1,306 2,551 Mental HealthFunding Received 821 821 0 0.1% 795 4,926 4,923 3 0.1% 4,770 9,847 9,847 9,540 Provider Payments (799) (810) 11 (1.4%) (798) (4,879) (4,861) (19) 0.4% (4,775) (9,721) (9,721) (9,600)

22 10 12 110.3% (3) 47 63 (16) (25.1%) (5) 126 126 (60)Disability SupportFunding Received 955 955 0 0.0% 717 5,730 5,730 0 0.0% 4,867 11,460 11,460 9,679 Provider Payments (1,274) (988) (286) 28.9% (1,114) (6,008) (5,929) (79) 1.3% (4,894) (11,857) (11,857) (10,175)

(319) (33) (286) 864.2% (397) (278) (199) (79) 40.1% (27) (396) (397) (496)

Funds ManagementFunding Received 86 85 1 0.9% 86 516 512 5 0.9% 516 1,023 1,023 1,061 Interest on Funds Account 35 21 14 68.0% 21 189 125 64 51.2% 124 250 250 287

Allocation to DHB Governance (86) (89) 3 (3.6%) (86) (516) (535) 19 (3.6%) (516) (1,071) (1,071) (1,061)35 17 18 107.6% 21 189 101 88 86.9% 124 202 202 287

TotalsTotal Funds Revenue 6,966 7,046 (80) (1.1%) 6,101 41,999 42,275 (276) (0.7%) 36,886 84,049 84,549 75,624 Total Funds Expenditure (7,051) (6,942) (109) 1.6% (6,300) (40,612) (41,638) 1,026 (2.5%) (35,659) (82,562) (83,312) (73,342)Surplus (Deficit) (85) 104 (189) (182.0%) (199) 1,387 637 750 117.9% 1,227 1,487 1,237 2,282


DHB CONSOLIDATED - STATEMENT OF FINANCIAL POSITION AS AT DECEMBER 2005

Actual Budget Variance Variance Last Yr Act

Current AssetsCash 3,671 2,218 1,453 65.5% 10,354 Short term Investments 2,656 6 2,650 44166.7% 2,256 Debtors & Prepayments 6,779 6,961 (182) (2.6%) 1,878 Inventory 634 578 56 9.7% 593 Assets for Sale 205 207 (2) (1.0%) 210

13,945 9,971 3,974 39.9% 15,291 Non Current AssetsLand & Buildings 20,159 20,853 (694) (3.3%) 19,736 Equipment (incl IT) 5,345 5,827 (482) (8.3%) 5,430 Vehicles 48 78 (30) (38.5%) 91 Investments 2 2 0 0.0% 2

25,554 26,760 (1,206) (4.5%) 25,259 Current LiabilitiesAccounts Payable 8,246 4,288 3,958 92.3% 10,121 Employee Entittlements 4,852 3,917 935 23.9% 3,788 Current Portion of Term Loans 0 0 0 0.0% 11,286

13,098 8,205 4,893 59.6% 25,195

Net Funds Employed 26,401 28,526 (2,125) (7.4%) 15,355

Term LiabilitiesEmployee Entittlements 2,371 2,231 140 6.3% 2,165 Other Term Liabilities 11,201 12,301 (1,100) (8.9%) 6

13,572 14,532 (960) (6.6%) 2,171 Crown EquityCrown Equity 44,147 45,827 (1,680) (3.7%) 43,147 Retained Earnings (31,359) (31,879) 520 (1.6%) (30,006)Trust Funds 41 45 (4) (8.9%) 43

12,829 13,993 (1,164) (8.3%) 13,184

Net Funds Employed 26,401 28,525 (2,124) (7.4%) 15,355


DHB CONSOLIDATED - STATEMENT OF CASHFLOWS FOR THE MONTH OF DECEMBER 2005

Actual Budget Variance Variance Last Yr Act YTD Actual YTD Budget Variance Variance Last YTD

Operating ActivitiesOperating Receipts 7,554 7,735 (181) (2.3%) 12,890 45,669 46,405 (736) (1.6%) 45,400

Payments to Personnel 2,971 3,122 151 4.8% 2,706 17,585 18,368 783 4.3% 15,969 Payments to Providers 1,474 1,583 109 6.9% 1,353 8,754 9,480 726 7.7% 5,711 Interest & Capital Charge 90 212 122 57.5% 185 1,053 1,268 215 17.0% 1,899 Payments to Suppliers, GST, etc 2,594 2,637 43 1.6% 1,383 16,834 16,658 (176) (1.1%) 14,353 Operating Payments 7,129 7,553 424 5.6% 5,627 44,226 45,774 1,548 3.4% 37,932 Net Cashflow from Operating 425 182 243 134.1% 7,263 1,443 631 812 128.8% 7,468

Investing ActivitiesSale of Fixed Assets 0 0 0 0.0% 0 0 0 0 0.0% 0 Increase (Decrease) in Investments (750) 0 (750) 0.0% 0 (750) (1,250) (500) 40.0% 1,000 Purchase of Fixed Assets 391 505 114 22.6% 351 2,194 3,028 834 27.5% 1,056 Net Cashflow from Investing 359 (505) (636) 125.9% (351) (1,444) (1,778) 334 (18.8%) (2,056)

Financing ActivitiesFinancing ReceiptsEquity Injections 0 0 0 0.0% 0 0 0 0 0.0% 0 Loans Raised 11,195 800 10,395 1299.4% 0 (11,195) 1,100 (12,295) (1117.7%) 0

11,195 800 10,395 1299.4% 0 (11,195) 1,100 (12,295) (1117.7%) 0 Financing PaymentsRepaid Debt 11,195 0 (11,195) 0.0% 1 (11,195) 0 11,195 0.0% 70

11,195 0 (11,195) 0.0% 1 (11,195) 0 11,195 0.0% 70 Net Cashflow from Financing 0 800 (800) (100.0%) (1) 0 1,100 (1,100) (100.0%) (70)

Opening Cash 2,887 1,742 1,145 65.8% 3,443 3,672 2,266 1,406 62.1% 5,012 Net Cashflow 784 477 (1,193) (250.2%) 6,911 (1) (47) 46 (97.9%) 5,342 Closing Cash 3,671 2,218 (47) (2.1%) 10,354 3,671 2,218 1,453 65.5% 10,354


WEST COAST DISTRICT HEALTH BOARD DEBT REGISTERAS AT 27 JANUARY 2006

Lender's name CHFA CHFA BNZLoan Identified As Renewal Renewal OverdraftDebt Amount - face value $7,695,000 $3,500,000 $3,600,000Instrument type Term Loan Term Loan OverdraftFixed / Floating interest rate Fixed Fixed FloatingFixed rate 6.16% 6.36%Floating rate base and margin BKBM+0.225%Interest payment frequency Quarterly Quarterly DailyCovenants (Debt to Debt + Equity ratio) 55% 55% 65%Covenants (Interest Cover EBID) 1.3x 1.3x

Next Payment Due When 31/10/10 31/10/07 any time How much $7,695,000 $3,500,000 any amount

Next Rollover / Refinance Due When 31/10/10 31/10/07 How much $7,695,000 $3,500,000 Plan Refinance CHFA Refinance CHFA

5 year renewal 2-5 year renewal

October 2007 CHFA Term Loan Fixed 3,500,000$

Interest Rate HedgingThe West Coast DHB has closed out our 5 year interest rate swap, effectively fixing the interest rates of our CHFA loans by way offixed term loan agreements rather than by way of interest rate swaps.

Upcoming Loan Repayments

(Excludes Overdraft and Lease Payments)


Fortnight Ended 25/01/2006 08/02/2006 22/02/2006 08/03/2006 22/03/2006 05/04/2006 19/04/2006 03/05/2006 17/05/2006

Opening Balance 2,397,506 (1,470,428) 1,441,971 (758,685) 1,459,543 (895,657) 1,679,348 216,586 (3,418,471)

Cash InRevenue 663,170 4,732,556 200,000 4,592,556 400,000 4,892,556 150,000 660,000 4,592,556 Loan Funds - - - - - - - 750,000 - Equity - 680,000 1,000,000 - - - - - - Asset Sales - - - - - - - - -

Cash OutPayroll Costs 1,050,935 981,129 1,081,129 880,000 900,000 949,551 1,012,762 984,986 1,053,121 Creditors Payments 2,382,641 675,489 1,500,000 700,000 1,600,000 300,000 600,000 1,600,000 700,000 GST 371,934 450,000 - 300,000 - 300,000 - 300,000 - PAYE / ACC 725,594 159,538 313,527 494,328 255,200 261,000 - 511,071 285,646 Loan & Interest Pmts - 234,000 - - - - - 234,000 - Capex - - 506,000 - - 507,000 - 1,415,000 -

Closing Balance (1,470,428) 1,441,971 (758,685) 1,459,543 (895,657) 1,679,348 216,586 (3,418,471) (864,682)

AssumptionsThis cash flow forecast is for the provider arm of the West Coast DHB onlyThat dementia unit construction will commence in January / FebruaryEquity in support of our 2004-05 deficit $680K will be received in JanuaryiSOFT and PACS are excluded from this cash flow forecast as funds have been set aside separately for these projects"Early Payment" funding of $5.087M has been received from the Ministry of Health but isn't shown in this cash flow forecast as it has been set aside for Debt repayment. (by way of investing it for fixed terms that expire when our core CHFA loan is due for renewal).

Note: Our Overdraft limit is $3.6M

WEST COAST DISTRICT HEALTH BOARDCASH FLOW FORECAST AS AT 12 JANUARY 2006


WEST COAST DISTRICT HEALTH BOARDDIRECTORS SCHEDULE

SUMMARY OF EXPENDITURE YEAR TO DATE TO 31 DECEMBER 2005Note: Figures GST Exclusive

Actual Budget VarianceAnnual Budget

Directors Fees 83,125 90,000 (6,875) 180,000

Directors ExpensesTravel Expenses 12,905 15,000 (2,095) 30,000Other 7,631 9,504 (1,873) 19,008Total 20,536 24,504 (3,968) 49,008

Advisory Committee Costs 28,116 17,502 10,614 35,004Community Consultation Costs 0 7,500 (7,500) 15,000

TOTAL EXPENSES 48,652 49,506 (854) 99,012

WCDHB BOARD OF DIRECTORS FEES & EXPENSES $131,777 $139,506 ($7,729) $279,012


NOTES 1 Net result as a percentage of Net Funds Employed

Provides a projected annual return on Long Term Funding based on current months performance.

2 Earning / Net Funds Employed

Provides a projected annual return, from normal operations, as a percentage of Long Term Funding, based on current months performance.

3 Debt to Debt + Equity Ratio

A measure that indicates the extent to which assets are financed by debt (excluding any overdraft balance). (This is consistent with the Bank of New Zealand definition of debt).

4 Interest Cover

Shows ability to meet interest expense from Operating Surplus. Calculated as: operating surplus before interest, capital charge and depreciation divided by interest expense.

Financial Performance Indicators for December 2005

Net result after tax $000 -555 -45 -565

Net Result/Net Funds Employed % (Annualised) % -25.2 -1.9 -44.2

Earnings* /Net Funds Employed % (Annualised) % -9.2 16.6 -11.9

Revenue/Net Funds Employed (Annualised) times 3.5 3.3 5.3

Debt** /Debt + Equity (BNZ definition) % 67.5 61.9 67.5

Debt*** /Debt + Equity (CFA definition) % 46.6 46.8 46.1

Revenue/Fixed Assets (Annualised) times 3.6 3.5 3.2

Interest cover times -3.4 5.0 -2.1

** Debt exclusive of Overdraft - Bank of New Zealand definition of Debt / Debt + Equity*** Arranged Debt inclusive of Overdraft - Crown Funding Agency definition of Debt / Debt + Equity

Month Actual

Month Budget

* Earnings = operating surplus/(deficit) before interest, capital charge, tax and depreciation.

Month Last Yr


GLOSSARY OF FINANCIAL TERMS Assets - Economic resources owned or controlled by the WCDHB, as a result of past transactions, for the entity’s future benefit.

Current Assets are those assets that are expected to be converted into cash in the next accounting period, i.e. within the next 12 months.

Non Current Assets are long-term assets that are held for use in the productive process and are not expected to be converted into cash in the next accounting period. CAPEX (Capital Expenditure) - The Purchase of non-current assets. Capital Charge – All DHBs are required to pay capital charge in order to recognize the cost of financial resources vested in them by the Crown. Capital Charge is levied at 11% per annum on the DHBs Crown equity balance. Capital charge is equivalent to the value of dividends and capital gains that shareholders would normally require from a private organization. Debt - An obligation of WCDHB to pay a sum of money within a specified time.

Debt to Debt + Equity Ratio - A measure that indicates the extent to which assets are financed by debt. (Excluding any overdraft balance). (This is consistent with the Bank of New Zealand definition of debt).

Equity (Owners Equity, Shareholders Funds) - A claim against the assets of the WCDHB. Represents a residual claim to all assets not claimed by holders of external liabilities. FTE - Full Time Equivalent employees

Interest Cover - Shows ability to meet interest expense from Operating Surplus. Calculated as: Operating surplus before interest, tax & depreciation divided by interest expense. Liabilities - An amount owed by WCDHB to non-owners. Current Liabilities are obligations to pay an amount or perform a service in the next accounting period, i.e. within the next 12 months. Non-Current Liabilities are those obligations requiring settlement beyond the next accounting period. Net Funds Employed - The total of Non current Liabilities plus Total Shareholders’ Funds.

NHPIDE (Nursing Hours Per Inpatient Day Equivalent) - Nursing Hours is the sum of total hours spent in direct patient care over each shift. Calculated as: Actual Nurse hours divided by total inpatient bed days.

Operating Surplus- Surplus attributable to ordinary and continuing operations. Leave Liability – The total amount of accrued leave benefits owing to employees. Covers Annual, Long Service and Parental leave as well as Retirement Gratuities and Lieu days owing. Author: Chief Financial Manager – 26 January 2006

Approved: Acting Chief Executive – 26 January 2006

WCDHB Meeting Papers Section 11 – Reports from Board Advisory Committees 24 February 2006 Page 1

REPORTS FROM BOARD ADVISORY COMMITTEES


HOSPITAL ADVISORY COMMITTEE

RECOMMENDATIONS TO THE BOARD

There are no recommendations to the Board from this meeting.

REPORTING BACK ON WORK PLAN AND BOARD REFERRED ITEMS 2006-2007 DAP

• HAC had a further opportunity to provide input into the DAP and did so. • A key issue which HAC believes the Board should address is that of dental services. HAC

suggests that the Board seek, from the CEO, a Dental Strategy/Contingency paper given that market forces and a scarcity of private dentists may leave the community vulnerable and the Board exposed to the flow on from poor oral health in the future.

• HAC members provided some suggestions to management on improving the process for committee input into the DAP, or more specifically associated planning activities, for years beyond 2006-2007

MAORI HEALTH PLAN

• A verbal report was given on progress • HAC was pleased to see the flip chart format being introduced to promote Tikanga Best

Practice • Some progress is being made in getting the HNA underway • There are still some issues around ethnicity data collection and further work is being

planned on this topic

TO:

Chair and Members West Coast District Health Board

FROM: Chair, Hospital Advisory Committee DATE: 10 February 2006


MONITORING THE PERFORMANCE OF THE PROVIDER ARM Matters from the CEO’s Report

• HAC was pleased to be advised that the final MO vacancy in ED has been filled • An update was given on the complexities associated with the provision of X-ray services in

Reefton. Management is continuing to work with community representatives to find acceptable and achievable solutions allowing access to X-rays.

• HAC noted that “no active recruitment” is being carried out for anaesthetists. While the service is currently being provided through a mix of strategies, it has been determined that “active recruitment” including advertising is not producing the desired results in terms of long term permanent appointments. Management intends working with the HOD Anaesthetics to develop a strategic plan to ensure service needs are met.

Financial Report While management was able to provide clear explanations for the financial result for

December and YTD, HAC was concerned that some of the issues may continue or recur (need for locum cover, costs associated with filling of staff vacancies) and wishes the Board to note this concern. HAC would like the Board to consider the following:

• The development of a plan to show strategies which will ensure that the provider

arm will reach year end on budget. and/or • The development of a robust case for an increase in the WC Adjuster It should be

noted that the upside of this situation is the provider arm’s ability to provide contracted service volumes in most clinical areas.

ESPI

The Ministry of Health ESPI data was received. While the WCDHB has again moved to third place in the rankings, HAC recognises that it takes very little to change this DHB’s status from red to orange to green and back again. For instance as the staffing issues are addressed in orthopaedics and general surgery, it is expected that some orange ratings will revert to green in subsequent reports given the greater stability in staffing. The WCDHB is shown in these reports to be performing exceptionally well and consistently.

ADVISORY COMMITTEE CONSIDERATION OF AN ITEM Nothing noted.

ITEMS OF INTEREST FOR THE BOARD TO BE AWARE OF Nothing noted.

Author: Christine Robertson, Chair of Hospital Advisory Committee – 10 February 2006


HOSPITAL ADVISORY COMMITTEE WORK PLAN 2005/2006 AS AT 10 FEBRUARY 2006

Mission Statement: To fund a continuum of quality health services aimed at providing improved health outcomes and maximise the independence

of people with disabilities.

Progress Objective Responsibility End Date Reporting Frequency

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To receive a report on relevant section for HAC

1. District Annual Plan – progress report GM Planning & Funding

Ongoing Quarterly Next Quarterly report to be included in February papers.

2. Maori Health Plan GM Maori Health Ongoing Quarterly √ Quarterly report included in November papers.

To develop

1. Asset Management Plan GM Operations 31/10/05 Quarterly √ Quarterly report included in November papers – in committee section.

2. Information Services Strategic Plan Chief Financial Manager

30/06/06 √ WCDHBs 2005 ISSP is complete but for delays by the MoH in completing the national IS components. HAC will have input into 2006 ISSP.



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3. Workforce Development HR Manager Ongoing Quarterly √ Workforce strategy groups gathering environmental data from DHB’s. Health Workforce Information Programme is on track, workshop scheduled for January. WCDHB workforce group is to meet in Feb/March.

4. 10 Year Strategic Site Plan Chief Financial Manager

Oct 2008 3 yearly √ The WCDHB is investigating options for a High Dependency Unit and / or reconfiguration of services in Greymouth following the 2005 Strategic Site Plan.

5. Secondary Care Plan GM Planning & Funding

Quarterly The development of the secondary care plan is now expected to be undertaken in tandem with the work being undertaken to review the future facilities needs for Grey Base Hospital (in particular), as this work cannot properly proceed without clarity on the models of care that will be used by WCDHB in the future.



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Provide input into

1. District Strategic Plan GM Planning & Funding

Oct 2005 Annually √ Completed.

2. District Annual Plan GM Planning & Funding

May 2006 Annually √ Underway – Board workshop on this to include Advisory Committee members on 20.01.06

3. Statement of Intent GM Planning & Funding

May 2006 Annually √

4. Annual Report Chief Financial Manager

Annually √

To monitor

1. Financial performance Chief Financial Manager

2. Provider performance to contract GM Operations

3. Productivity GM Operations

4. ESPI Indicators GM Operations

5. Recruitment and retention initiatives HR Manager On-going Quarterly √ New recruitment training package has been trialled, further work required before being implemented across key managers who recruit.



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Orientation undergoing changes to re-focus outcomes. Continue to have reasonable success in filling vacancies for key positions.

6. Barrier Free Audit implementation Chief Financial Officer

Included in December papers.

7. Exception Reports

To investigate/scope


DRAFT MINUTES OF THE HOSPITAL ADVISORY COMMITTEE MEETING HELD FRIDAY 10 FEBRUARY 2006 AT 9.10 AM IN THE BOARDROOM, CORPORATE

OFFICE, GREYMOUTH

PRESENT Christine Robertson, Chair

Brian Wilkinson Elizabeth Rock Richard Wallace Barbara Beckford Kathryn Cannan

IN ATTENDANCE Kevin Hague, Chief Executive Wayne Champion, Chief Financial Manager Wayne Turp, General Manager Planning & Funding Jane O’Malley, DON & Midwifery Gary Coghlan, General Manager Maori Health

APOLOGIES Gregor Coster, Chair Board Glenys Baldick, Deputy Chair Jenny Woods, Nurse Manager Perioperative Services Jenny Hanson, Nurse Manager Acute Care & Specialty Services Raewyn McKnight, Operations Support Co-ordinator

Karakia – Richard Wallace 1. WELCOME AND APOLOGIES

The Chair welcomed attendees to the meeting and apologies were received from Glenys Baldick, Gregor Coster, Jenny Hanson, Jenny Woods and Raewyn McKnight.

Moved: Brian Wilkinson Seconded: Barbara Beckford

It was RESOLVED to accept the apologies.


There were no amendments made to the Hospital Advisory Committee Members’ disclosures of interest.


DRAFT MINUTES

Page 4, item 7 – Buller / Grey GPs, amend first sentence to read “An update was provided about GPs and the committee was advised BMS will soon be up to the full complement of GPs.

Page 4, item 7 – Obstetrician & Gynaecologists, amend sentence to read “…..O&G

candidates being assessed and it is expected that an offer of employment is out this week”.

Page 5, item 7 – Primary Health Services, amend second paragraph, first line to read “The Acting Chief Executive also advised that MedTech….” And amend last sentence to read “The Acting Chief Executive also advised that the practices are working with PHOcus”.

Page 7, item 7 – Paediatric After Hours Cover, add sentence to the end of the paragraph “A new MO for ED has been appointed”.

Moved: Richard Wallace Seconded: Elizabeth Rock

It was RESOLVED to accept the minutes.

3. MATTERS ARISING

Seek further clarification from the South Island Advocacy Service on the figures provided to HAC at the Service’s presentation at the August 2004 meeting. The Chair and Barbara Beckford have discussed this and is to be removed from the Action and Responsibility list.

Refer monitoring of maternity figures to the Clinical Board for reporting to HAC on an annual basis. Due in June 2006.

Provide a management response with the next completed Paediatric Society report. On receipt of Paediatric Society report in 2006.

Provide a quarterly report on the template for reporting on implications of the Barrier Free Audit. Due in March 2006

Analyse timeframe required to undertake a Maori Health Needs Analysis. The General Manager Maori Health advised that discussions have occurred with CDHB regarding the Maori Health Needs Analysis. He advised that this needs to be passed through Tatau Pounamu to the DHB and they meet 6 weekly.

CDHB, West Coast DHB and the South Island Shared Agency are all in discussion.

The General Manager Maori Health advised that this has been signed off at management level and providing the consultation process is complete, it is anticipated to undertake this process later this year coinciding with the National Maori Health Plan release (revised version).

The Chair advised that this would be placed on the agenda for the March meeting.

Action: Chair


Monitor for a six month period usage of the Inpatient Unit, Manaakitanga Due June or July 2006

Provide definition of West Coast DHB’s active review. Completed.

4. CORRESPONDENCE

There was no correspondence received for December / January. Chair’s Report to the Board

The Chair advised that it was queried by the Board as to the qualifications of the person undertaking the Barrier Free audit. The Board was reassured that the person undertaking this audit is appropriate to complete this task.

The Chair reiterated to committee members if they felt that any part of the Chair’s report to the Board is not correct that they advise the Chair accordingly to ensure that it is corrected.

A committee member queried the signage; she was advised that a whole project is being undertaken addressing all signage as part of the Barrier Free audit. A number of projects have been addressed to date improving West Coast DHB facilities. The committee were also advised that the use of Maori language on signs will extend wider.

Kevin Hague joined the meeting at 9.25 am

The Chair indicated that matters arising would be reviewed now that the Chief Executive has joined the meeting.

West Coast DHB turnover of staff The Chief Executive advised that he was expecting to have a report at this meeting, but unfortunately due to large work commitments of the HR Manager it is now anticipated to have a report at the next meeting.

6. WORK PLAN

The timetable includes an updated brief indicating where we are at with the objectives. 6.1 REPORT ON IMPLEMENTATION OF DAP

The Chair advised that this meeting provides another opportunity to review the DHB Planning Package 2003-2007 documents reviewed at the recent workshop (20 January 2006). The Chair has included agenda items that require further discussion.

A committee member indicated that the workshop exercise was exhausting.

Wayne Turp joined 9.29 am


The committee member continued to indicate how the workshop did not provide much of a chance to comment. These comments were taken on board; it was scheduled on this day with the Board meeting as it was a good opportunity to have all members present. It was suggested that perhaps in the future that all committee members are divided into smaller groups at the workshop. It was recognised by the committee members that they are aware of the short timeframes that management and staff have to work within.

A committee member queried whether the previous year’s DAP can be adapted. He was advised that it depends on the guidelines Government are requesting. If the questions/ guidelines are similar to the previous year the previous year’s DAP can be updated.

The Chair queried the Chief Executive and General Manager Planning & Funding whether the Chairs of each Advisory Committee should meet with them to establish whether there are items for each relevant committee to address.

The following comments were noted:

Improving Mental health Page 5, Guidance notes, Building and broadening the range, quality and availability of mental health and addictions services….not limited to, services for children and young people, older people, Maori and Pacific.

• A committee member suggested that it is important to have a suicide “post-vention”

among young people. If a young persons suicides it is important to to prevent a “contagion” effect.

• It was also suggested that it is important to establish a postnatal depression support

group • A committee member queried why Maori and Pacific have been listed as one. The

committee member was advised that the Pacific Island group is small so it has been included together.

• A committee member suggested that an area lacking is services for children who have

parents with a serious mental health illness. Where is the help for the children if the parent is admitted (this needs to be included).

• There is also a need to improve the West Coast’s focus on drug use.

Reducing inequalities • Training is being developed for reducing inequalities. A committee member advised

that she has some research literature which outlines what reduces inequalities. • There needs to be a focus on the disadvantaged populations. Quality and safety • No comments were made. Implementing Health Eating Health Action (HEHA) • A committee member advised that it is important to use strategies that will have an

impact; there is a huge body of evidence of what works.


• The committee were advised that West Coast DHB anticipates aligning with the PHO and CPH for HEHA.

• One committee member advised that HEHA also links into good mental health.

Implementing the New Zealand Cancer Control Strategy • One committee member advised that we need to look at cervical and breast screening

in more detail. • It was noted from one committee member that breast cancer contributes to a large

number of Maori deaths on the West Coast. Oral Health • Committee members discussed the potential issues surrounding oral healthcare in the

Community. It is envisaged that there may be workforce shortages in Westport. The committee were advised that West Coast DHB has money to subsidise children and adolescents but not adults. If there is no provider for this service within the Community it could have a flow on effect to the DHB. It was discussed that there needs to be a contingency plan if the market cannot attract dentists’ to the West Coast region.

• The Chair advised that she will bring this to the attention of the Board for future

discussion. Child and Youth focus, introduction of hearing testing for neonates • This is currently not performed at West Coast DHB as there is not the appropriate

specialist to undertake this. • It was suggested that the DHB foster Well Child Checks with Multidisciplinary teams

such as PHO, Plunket etc. • The General Manager Planning & Funding advised that plans are being developed for

child health.

Elective Services • The Clinical Quality Improvement Team (formerly Clinical Board) are conducting a

study to ensure procedures that are being completed at a tertiary hospital could not be undertaken at West Coast DHB.

Maori Health Plan • A large amount of work has been completed on the West Coast DHB website in

relating to promoting Maori Health and more is to be completed. • A flip chart has been designed for Tikanga Best Practice for the provider arm; this flip

chart has been approved by Iwi. The flip chart indicates to clinical staff the correct protocol required.

• There is still work to be completed as outlined in the Maori Health plan for recruiting

Maori staff. The current number of Maori staff is approximately 3%. • Ethnicity data collection still needs to be addressed as the overall result indicates that

there are low Maori population numbers accessing services.


• The Chair advised that she would advise the Board of the Tikanga Best Practice flipchart and the progress of the health needs assessment and ethnicity collection.

Asset Management plan • The Financial Manager updated the committee on the progress of the AMP. He

advised that the Ministry are currently in the process of establishing an AMP Review Committee. It is anticipated that an update maybe available March or April.

10 Year Strategic Site Plan • The Financial Manager advised that the first workshop has occurred. This workshop

looked at what the West Coast DHB should be doing in the future. The process is in the early stages and once the Ministry update is provided this 10 Year Strategic site plan can be reviewed. The Financial Manager advised that he will include a brief update in his Finance Report each meeting.

6.2 CHIEF EXECUTIVE’S REPORT

The Chief Executive reported on items of interest that are not included in the Chief Executive report. He advised that an A&E medical officer has been successfully recruited to the remaining FTE position. He also advised that a transitional manager has been appointed for Buller Health. Committee members were advised that the Buller Health report is available on the West Coast DHB website.

The other issue the Chief Executive addressed is the X-ray service in Reefton. He advised that there has been media attention regarding this issue. The Chief Executive provided background information. The employee who previously took x-rays for Reefton was an exception to the Health Practitioners Competency Assurance Act as they were unqualified but had been performing x-rays for approximately 24 years, so under these circumstances were provided an exemption. This issue needs to be addressed bearing in mind that a suitably qualified person needs to be acquired; the volume of x-rays taken is small which has an effect on maintaining competency; the x-ray equipment is quite old and requires chemical changes frequently as it is not utilised much which then has an undesirable result of exposure to harmful chemicals; the quality of images is not clear.

The committee were advised that there is no viable solution at this point of time but is actively been addressed

Anaesthetists A committee member queried why no active recruitment is underway. The committee was advised that there are difficulties; with no response to advertisements. The committee was advised that a planning session is to occur with management. The committee was also advised that full cover is in place with the use of locums from both South Africa and New Zealand.

Pharmacist The Operations Support Co-ordinator has been on leave so it is anticipated to provide a review of the pharmacy at the next meeting.

Primary Health Care The new format is gratefully received providing consistency for both practices. There was a query regarding capitation and GMS and clarification was sought as outlined in the Income Breakdown graphs.

Action: GM Primary Care


Smears YTD Clarification was sought about allocation for 700 smears and if this is exceeded whether payment is received for this.

Action: GM Primary Care

Moved: Brian Wilkinson Seconded Kathryn Cannan It was RESOLVED to accept the Chief Executive’s report.

Finance report

The overall DHB wide YTD deficit is $384k, $492k worse than plan. The monthly reported deficit is $555k, $510 worse than plan. The provider arm is behind plan, the YTD deficit $1.783 m, $1.2 m worse than plan. Two issues that have caused these deficits are due to the wash up liability to the funder arm and outsourced services, primarily locum costs.

The results from the Nurse and Allied Health negotiations are over budget; the reason for the nurses being over budget is due to miscalculations of the accrual for the NZNO MECA Senior Nurses translation. There is a greater number of staff affected than anticipated when the contract was signed. The Allied Health MECA negotiations has not yet been finalised and paid so accrual is occurring. The outsourced services for medical locums are over budget. The Chief Executive and Management are working together to actively managing results for the rest of the financial year.

The extra funding of $2.68 m is included in this budget. The Chair advised that she would flag this to the Board’s attention.

A committee member queried whether there is a specific trend. He was advised a trend identified is that back in August there was a lack of surgical staff which resulted in being behind target for outsourced services and that traditionally during December staff are on leave so locum expenditure increases.

The positive result from having an increase in outsourced locum costs is that the health service provision is being covered and no services are being reduced as a result of lack of staff.

Moved: Richard Wallace Seconded: Barbara Beckford It was RESOLVED to accept the Financial Report.

OPERATIONAL INDICATORS

Kathryn Cannan left at 11.04 am

ESPI New Formatted Report


The committee was informed that the report to be submitted by the Operations Support Co-ordinator and Elective Services Co-ordinator is still experiencing delays due to the time and availability of I.T staff that are currently unable to provide statistics.

ESPI The explanation at the beginning of the report is quite clear as to the results West Coast DHB received at the time of reporting.

7.1 KEY ISSUES / ITEMS OF INTEREST TO REPORT TO THE BOARD 7.1 Recommendations to the Board

Nil. 7.2 Seeking Approval for Further Consideration

Nil. 7.3 Reporting Back on Board Referred Items

• Dental Strategy for private workforce reduction • Tikanga Best Practice flip chart developed • Maori Health Needs Assessment update • ED MO successfully recruited • Reefton x-ray service • Anaesthetist advertisements no positive response. Management looking at plan to

address. • Finance year end budget over due to locum costs. Management working on plan and

addressing budget/higher West Coast adjustor.

8. NEXT MEETING

The next meeting is Friday 24 March 2006 and will commence at 9.45 am.

9. ATTENDANCE AND ADMINISTRATION FORMS

Actioned.

There being no further business to discuss the meeting closed at 11.10 am


MATTERS ARISING FROM HOSPITAL ADVISORY COMMITTEE MEETINGS

Item No.

Meeting Date

Action Item


Reporting Status

Agenda Item Ref

3 June 2005 Refer monitoring of maternity figures to the Clinical Board for reporting to HAC on an annual basis.

GM Operations Reporting back June 2006

7 October 2005 Provide a management response with the next completed Paediatric Society report.

Executive Managers On receipt of Paediatric Society report for 2006

7 October 2005 Provide a quarterly report on the template for reporting on implications of the Barrier Free Audit.

Chief Financial Officer March 2006

18 November 2005

Investigate West Coast DHB’s turnover of staff and compare to national figures – check timeframe of providing quarterly and annual reports.

Chief Executive Officer March 2006

16 December 2005

Check on progress of Secondary Care Plan. Chair March 2006

16 December 2005

Monitor for a six month period usage of the Inpatient Unit, Manaakitanga.

GM Mental Health / Primary

June / July 2006

10 February 2006 Discuss progress of timeframe to undertake a Maori Health Needs Analysis.

GM Maori Health March 2006

10 February 2006 Seek clarification on “income breakdown” graphs capitation versus GMS.


March 2006

10 February 2006 Seek clarification about allocation for smears and if exceeds allocation do we receive payment.


March 2006


MATTERS REFERRED BY THE WEST COAST DHB BOARD TO THE HOSPITAL ADVISORY COMMITTEE

Board Meeting

Date

Item


Reporting Status

Agenda Item Ref

9 September 2005

Receive report on results of laboratory consultation including comments from Clinical Board and any relevant individual staff members

GM Planning and Funding When consultation process is complete

9 September 2005

Receive annual report on implementation of smokefree policy GM Operations June 2006


DISABILITY SERVICES ADVISORY COMMITTEE

TO: Chair and Members

West Coast District Health Board FROM: John Vaile – Disability Service Advisory Committee Chair DATE: 12 February 2006

RECOMMENDATIONS TO THE BOARD Nothing noted.

REPORTING BACK ON BOARD REFERRED ITEMS Work Plan The committee will work with management on the Disability Plan, the work load is a contributing factor why the plan has not been completed. Health Of Older People Implementing the Health of Older People Strategy by 2010, this is on track, further discussion regarding the Abbeyfield initiative and the possibility of something similar being put in place on the West Coast. Transport As Chair of DSAC I have been approached by Grey Power about the problem their members are having to access Health Services. Both myself and the Manager of Planning and Funding will meet with Grey Power in the near future, regarding travel concerns, for Health Services.

SEEKING BOARD APPROVAL FOR FURTHER ADVISORY COMMITTEE CONSIDERATION OF AN ITEM Nothing noted.


ITEMS OF INTEREST FOR THE BOARD TO BE AWARE OF Nothing noted. Author: John Vaile – Chair Disability Service Advisory Committee – 12 February 2006


DISABILITY SERVICES ADVISORY COMMITTEE WORK PLAN 2005/2006 AS AT 3 FEBRUARY 2006



Progress Objective Responsibility Date Reporting Frequency

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3 Feb Quarterly Quarterly after 11/11/05

2. Maori Health Plan GM Maori Health Quarterly Chair to set time frame

To develop

1. Disability Plan / describe disability sector

GM Planning & Funding

June 06 Will be reported on six monthly

2. Advocacy Services GM Planning & Funding

Clarification being sought

Provide input into


Annually July/August


Annually December meeting

3. Statement of Intent GM Planning & Annually December meeting


Progress Objective Responsibility Date Reporting Frequency

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Annually July/August

To monitor

1. West Coast Improved Services for the Elderly (WISE)


2. Dementia Unit building CEO Each meeting A standing agenda item



DRAFT MINUTES OF THE DISABILITY SERVICES ADVISORY COMMITTEE MEETING HELD

3 FEBRUARY 2006 AT 8.50 A.M IN THE BOARDROOM, CORPORATE OFFICE, GREYMOUTH

PRESENT John Vaile, Chairman, WCDHB member Mohammed Shahadat, Deputy Chair, WCDHB member Elinor Stratford Maureen Frankpitt Gloria Hammond Patrica Nolan Ned Tauwhere

IN ATTENDANCE Wayne Turp, General Manager Planning & Funding Bianca Kramer, Minute Secretary

APOLOGIES Gregor Coster, Chair, WCDHB Kevin Hague, CEO Gary Coghlan, General Manager Maori Health Ned Tauwhere – for lateness

1. APOLOGIES, WELCOME

The Chair welcomed everyone to the meeting. The Chair waived standing orders.

2. KARAKIA

General Manager Planning & Funding


There is still one outstanding – will be followed up. Details were provided at the end of the meeting. Ned Tauwhere • Add, Chairman, Te Runanga O Ngati-Waewae • Add, Member, Te Runanga O Ngai Tahui • Add, Member, Pounamu Business Development Group

4. AGENDA CHECK

There following items were added to the agenda


• ACC – travel out of district • Information about Disability awareness • Children and Young persons committee • Reefton travel – x-ray • Transport

5. MINUTES OF THE PREVIOUS MEETING HELD 11 NOVEMBER 2005

• Item 7 – Disability Plan – last sentence amend to read as ‘in the next year’ • Item 8 – Avian Flu – Fifth paragraph amend to read as ‘Panicking people’

Moved: Maureen Frankpitt Seconded: Elinor Stratford

It was RESOLVED that the Minutes of the Disability Services Advisory Committee meeting held 9 December 2005 were a true and accurate record subject to the amendments above.

6. MATTERS ARISING / ACTION AND RESPONSIBILITY LIST

New member to provide Disclosure of Interest of Minute Secretary Not received as yet General Manager Maori Health to arrange possible visit by Roger Jolly to discuss Maori Disability Issues Not heard as yet. Is there anyone else who could come and talk – follow-up. The audit carried out at Grey Base and Buller Medical Services – was it compliant with “Barrier Free Audits” As with previous discussions, it was reiterated that a barrier free audit is a specialist area and if done properly, needs to be carried out by someone with the correct qualifications.

7. WORK PLAN

7.1 DAP Implementation Plan.

Ned Tauwhere entered the meeting at 9.01am

This is the second DAP Implementation Plan received and it was noted that there has been progress with a number of items coloured Red and Orange progressing. The General Manager Planning & Funding went through the report page by page identifying areas of specific interest to this committee

Page 10 – Suicide Prevention – it was noted that the number of West Coast suicides has reduced. Page 12 – Disability & Older People – it was noted that most points were still orange, indicating that things are not happening as fast as we would like, the status has improved though. Work load is a contributing factor. Page 13 – Disability & Older People – work is underway regarding residential accommodation. There are limited options for care for the elderly on the Coast as the


Rest Homes are fully utilised. Allied provide help keeping older people independent in their own homes. Shared accommodation for the elderly, at this stage models of this idea are being investigated. A committee member mentioned that in Australia there are paid co-ordinators to check on the elderly living in these shared environments. The DHB is keen to work in collaboration with other organisations to realise a suitable environment for the elderly in the community. Page 12 – Disability & Older People – General Manager Planning & Funding informed the committee that the Board had adopted the appropriate recommendations from the study commissioned by Buller District Council for Buller but not for Reefton. The public announcement has been made that Gareth Rees had been appointed as the Interim Manager for Buller Health, he has been seconded from Buller REAP for this period. Page 22 – Child & Youth Health Services – a committee member asked which community stakeholders were involved in the development of the Youth Health Strategy. There are a number of people involved including Plunket, DNs, Rata te Awhina. The Child & Youth Strategies will be two separate documents, with C&PH completing the Youth Health Strategy. It is hoped the Child Health Strategy will be presented to the Board at their May meeting.

7.2 Dementia Unit Update The Chair informed the committee that a Business Case has been presented to the MoH and the Board are waiting for this to be approved.

8. GENERAL BUSINESS

8.1 District Annual Plan 06/07 General Manager Planning & Funding reviewed what was discussed at the Board Work Shop held on 20 January. Strategic Context Page 6 – Implementing the Health of Older People Strategy by 2010 it was noted that a lot of things outside the DHB range. A number of houses Coast wide have benefited from the pilot scheme, for insulating houses of low income earners Health of Older People Page 8 – Implementing the Health of Older People Strategy by 2010 this is on track – further discussion regarding the Abbeyfield initiative and the possibility of something similar being put in place. 8.2 ACC – “Rule Changes hit sick” A newspaper article was shown to the committee regarding the changes in eligibility for travel assistance. A new policy effective from 1 February has funding for travel out of the district devolved to DHBs for administration. There has been some adjustment to the criteria for eligibility and boundary changes for districts. In some cases, this means more people will qualify for assistance, as previously this is still only a travel and accommodation assistance scheme. Peter McIntosh, Planning & Funding, is the regional liaison person.


8.3 X-ray Travel for Reefton Residents Maureen Frankpitt declared a conflict of interest and did not participate in the discussion. Due to the closure of the Reefton Radiology Unit, residents from Reefton and the surrounding areas now have to travel to Greymouth. The unit closed as the long serving radiologist has retired and the equipment is outdated with nobody available with the expertise to operate it. Anyone needing an x-ray will get one, as the Greymouth Radiology department has a radiologist on call 24 hours a day. It was commented on that people would have to cover their own costs of getting to Greymouth, if following the new eligibility criteria for travel. To follow with interest. 8.4 Transport The Chair had been approach by Grey Power. Both DSAC Chair and General Manager Planning & Funding will meet with Grey Power in the near future regarding travel concerns. General Manager Planning & Funding attended meeting of the Regional Transport Committee where the strategic plan was presented. The General Manager Planning & Funding commented that he was disappointed with the lack of social and health content, the majority of the content focusing on commercial needs. Work needs to be done with the committee in “what health has to do with roads”. 8.5 Upcoming Events

• The Disability Awareness Training Day will be held on Tuesday 4 May in Hokitika, at the Senior Citizens Rooms. This is the first time this has been held in Hokitika, is hoped that Council, DHB staff etc along with Runanga will participate.

• Super Expo will be held at the Regent Theatre on Tuesday 23 May.

8. NEXT MEETING

Friday, 17 March 2006, 8.30am, Boardroom, Corporate Office Greymouth

9. ATTENDANCE AND ADMINISTRATION FORMS

There being no further business to discuss the meeting concluded at 10.20am


COMMUNITY AND PUBLIC HEALTH ADVISORY COMMITTEE

TO: Chair and Members West Coast District Health Board

FROM: Carol Atmore – CPHAC Chair DATE: 13 February 2006

RECOMMENDATIONS TO THE BOARD Nothing noted.

REPORTING BACK ON BOARD REFERRED ITEMS Postgraduate GP training program The WCDHB needs a firm commitment from Canterbury DHB on the provision of 1 or 2 positions on the RMO paediatric rotation by the end of March 06, so that the Rural GP Training program can start in November 2006. DAP input Further discussion was had around the DAP planning process. These Further colonoscopies will need to be purchased to implement the national screening guidelines for people at high risk of bowel cancer. The surgical bus may be able to be used to help achieve this. Referred services spending A report was received from SISSAL regarding pharmaceutical expenditure for the West Coast, which included a comparative with other South Island DHBs. A comparative report with these DHBs over the last 5 years is being asked for, to see if our pattern of expenditure is different from other DHBs, to see if any lessons can be learnt from others’ experiences.

SEEKING BOARD APPROVAL FOR FURTHER ADVISORY COMMITTEE CONSIDERATION OF AN ITEM Nothing noted.


ITEMS OF INTEREST FOR THE BOARD TO BE AWARE OF

Inequalities training CPHAC and DSAC plan to have a combined inequalities training session as part of their regular meeting in March or April 2006.

Author: Dr Carol Atmore, Chair, Community and Public Advisory Committee – 13 February 2006


COMMUNITY AND PUBLIC HEALTH ADVISORY COMMITTEE WORK PLAN 2005 / 2006 AS AT 3 FEBRUARY 2006



Progress Objective Responsibility Next Due Date

Reporting Frequency

Beh

ind

On

Targ

et

Com

plet

e

Comment

To report on relevant section

1. District Annual Plan, including Maori Health Plan and Primary Mental Health Plan

GM Planning & Funding, GM Maori Health, GM Mental Health

April 06 Quarterly √ Maori health needs assessment is beginning

To develop

1. Child Strategy and Youth Health Strategy

Shona McLeod, Planning and funding analyst

March 06 Quarterly

2. Information Services Strategic Plan

Chief Financial Manager

March 06 Quarterly

3. Post graduate GP Training program

GM Primary Care Each meeting √ Need CDHB to commit to providing paediatric RMO post space for 1 or 2 West coast RMOs by end of March 06

4. Greymouth Health Centre GMPF/GM Primary March 06 Each meeting

5. Primary Care Plan GM PF March 06 Each meeting √ Draft Primary Care Plan should come to



Reporting Frequency

Beh

ind

On

Targ

et

Com

plet

e

Comment

next CPHAC meeting

Provide input into


Annually


April 06 Annually √ Done this meeting

3. Statement of Intent GM Planning & Funding

Annually


Annually

To monitor

1. Referred Services. Community laboratory and pharmacy


August 06 Six monthly √ Invite SISSAL to provide a comparative analysis between WCDHB and other DHBs over last 5 years

2. PHO a) Review criteria being

considered towards meeting (i) Aims of Primary

Care Strategy (ii) Contractual

obligations to the WCDHB

GM Planning & Funding/ PHO

April 06 Quarterly √ New MSO in place now

3. West Coast Public health Plan

CPH June 06 Six Monthly

4 Healthy eating Healthy GM Planning & June 06 Six monthly



Reporting Frequency

Beh

ind

On

Targ

et

Com

plet

e

Comment

Action Plan implementation Funding

5. Neighbourhood Nursing Project

DON April 06 Six monthly

6. Diabetes services through LDT report


March 06 Annually

7. Undergraduate medical student training program

Dr Wood, convenor Dec 06 Annually

8. Green prescription uptake GM PF August 06 Annually

9. Nicotine replacement therapy uptake

GM PF August 06 Annually

10. Healthline usage GM PF August 06 Annually

11. Breast screen Aotearoa uptake for WC women

GM PF August 06 Annually

12. National Cervical Screening Program uptake for WC women

Cervical screening co-ordiantor

August 06 Annually

13 Immunisation rates Planning and Funding

August 06 Annually

14. Sexual Health Janet Hogan, nurse manager

December 06 Annually


1. West Coast Community Dental Centre


2. The most efficient use of direct financial incentives

GMPF/CFM March 06 √ Report to come to next CPHAC meeting



Reporting Frequency

Beh

ind

On

Targ

et

Com

plet

e

Comment

and scholarships to recruit and retain health professionals.

3. Achieving parity of access for WC women at high risk of breast cancer

GM PF When work done

4. Breast feeding strategic plan development

GM PF When work done


DRAFT MINUTES OF THE COMMUNITY AND PUBLIC HEALTH ADVISORY COMMITTEE MEETING HELD 9

DECEMBER AT 10.35AM IN THE BOARDROOM, CORPORATE OFFICE, GREYMOUTH

PRESENT Carol Atmore, Chair Julie Kilkelly, Deputy Chair Barbara Beckford Sharon Ransom Barbara Greer Robyne Bryant

IN ATTENDANCE Wayne Turp, General Manager Planning & Funding Gary Coghlan, General Manager Maori Health Bianca Kramer, Minute Secretary

APOLOGIES Gregor Coster, Chair WCDHB Kevin Hague, CEO Cheryl Brunton Greville Wood

Karakia – Barbara Greer

1. APOLOGIES, WELCOME

The Chairman welcomed everyone to the meeting. Apologies were received from Gregor Coster, Kevin Hague, Cheryl Brunton and Greville Wood.

Moved: Julie Kilkelly Seconded: Barbara Greer It was RESOLVED to accept the Apologies.

2. STANDING ORDERS

The Chairman waived the Standing Orders.


The following amendments were made to Community and Public Health Advisory Committee Members’ disclosures of interest.


Julie Kilkelly • Amend to read – Member – NZ College of Pharmacists • Amend to read – Trustee – West Coast PHO • Add – Member – Pharmaceutical Society Inc Robyne Bryant • Amend to read – Employed by WCDHB as a midwife on a permanent Part-time basis

4. MINUTES OF THE PREVIOUS CPHAC MEETING HELD 11 NOVEMBER 2005

• Item 5.2 – Sexual Health, last paragraph amend to read “the PHO does not have a sexual health”

• Item 7.6 – last paragraph amend to read “the three Pharmacies in Greymouth conducted an externship programme for third year pharmacy students”

Moved: Carol Atmore Seconded: Robyne Bryant It was RESOLVED that the Minutes of the Community and Public Health Advisory Committee meeting held 9 December were a true and accurate record subject to the amendments above.

5. MATTERS ARISING

Investigation of most efficient use of direct financial incentives & scholarships to recruit and retain health professionals General Manager Planning & Funding was unable to give an update. The Chair requested that he ensure that the HR Manager provide CPHAC with a report on this issue for the next CPHAC meeting.

GM Planning & Funding PHO review document Removed, this review related to the old PHO management services organisation General Manager Planning & Funding to amend the content and layout for next committee meeting (Labs document). Report in papers Investigate letter regarding scholarships written by previous CEO The Chair will check for the correspondence

Chair Look into low uptake of annual diabetes review Remove – this information is part of LDT report which will be provided at the meeting scheduled for 17 March Regular West Coast DHB newsletter Remove – this was reported to last Board meeting, a business case is to be presented to the next Board meeting


A central filing area for ‘Community Profiles’ Remove – Planning & Funding are currently reorganising their filing system and ‘Community Profile’ will be included. It was suggested that the Chair write a letter to Plunket to see if copies of their community profiles would be available for inclusion.

Chair

General Manger Maori Health joined the meeting at 10.54am

Investigate ways to achieve parity with neighbouring DHBs for access to Screening mammography for high risk women 11 November – place back on the action and responsibility list for GM Planning and Funding Initiate communication with key stakeholders in Breast Feeding on the West Coast to work towards a strategic plan for promoting Breast Feeding on the West Coast. 30 September – place back on the action and responsibility list Breast Feeding (HEHA) – the application to the MoH for funding was successful. The next step is to speak to the PHO regarding the joint project. Sexual Health component of Under-22 contraceptive scheme of WCPHO The need for sexual health to be explicitly covered in the under-22 contraceptive scheme was discussed, and will be raised by GM Planning and Funding at negotiations with WCPHO in the near future. CPHAC Chair report:: Buller Health a committee member expressed concern around rumours that had been circulating regarding the closure of the maternity services in Buller, this information had been reported by the Media. General Manager Planning & Funding indicated that this was not part of the brief for Buller Health. In the Grafton Report, it was suggested that the current four beds should be reduced to two beds, not closing the service

Moved: Robyne Bryant Seconded: Barbara Greer

It was moved that the CPHAC Chair report be accepted Referred Services This is the first report in the new format. The graphs show current trends, highlighting the key issues. Page 1 – it was noted that the drug cost trends total excluding high growth drugs is

steady. Page 3 – the committee was informed that Simvastatin is a drug for controlling high

cholesterol and PHARMAC had recently widened access to the drug. With the access widened, growth trends follow in an upward fashion. Widening of access for this drug will save money in the long-term, and not all increased drug costs are bad.

“Stable pharmacy expenditure could be obtained if a way of controlling the growth of these seven pharmaceuticals can be found”, - this comment in the report generated some discussion. It was mentioned that some of the seven pharmaceuticals listed were not drugs


usually prescribed at a primary care level. It was also noted that we do not want to control the prescribing of drugs that improve the quality of peoples lives. The Chair recalled that 10 years ago CDHB had higher prescribing rates than the West Coast, and the statistics now show a reverse in prescribing rankings. It was asked whether the West Coast statistics have risen, or have the other DHBs reduced their drug bill. The Chair asked that a comparison of pharmaceutical expenditure by South Island DHB over the last 5, or if possible, 10 years be provided. If certain DHBs have shown a reduction in their prescribing expenditure, there may be lessons there that our DHB can learn from. General Manger Planning & Funding is to clarify with Tony McDonald (author of the report) whether it is possible to separate the hospital and community statistics from the report. The Chair, Deputy Chair and General Manager Planning & Funding will meet to discuss the reporting style for future reports.

Chair, Deputy Chair & General Manager Planning & Funding

Rural GP Training Further to the Chair’s report contained in the meeting papers, the Chair gave a progress report received verbally from Dr Greville Wood. The current focuses in developing the rural GP training program are having the paediatric RMO runs approved by Canterbury DHB, and having a full program to offer potential candidates. RMO runs need to fit in with the Resident Doctors’ Association’s requirements.. The new RMO and Medical Student Coordinator is establishing the West Coast based RMO runs to fit in with the RDA’s requirements. Currently the new programme is being developed in anticipation of everything going ahead. As yet there has been no assurance from CDHB that the Paediatric RMO positions spoken about on earlier occasions will take place. The WCDHB needs a firm commitment from CDHB on these positions by the end of March, so that the Rural GP Training program can start in November 2006. Best Use of Direct Financial Incentives in Recruitment Deferred to next meeting. PHO Report The report supplied in the meeting papers is the final report from South Link Health. General Manager Planning & Funding has noted the issues and points raised and will discuss them with the new management service PHOcus on Health. General Manager Planning & Funding informed that committee that the relationship with PHOcus is progressing well. The Deputy Chair, who is also a Trustee of the WCPHO, informed the committee that the new Chair and committee are working well and she feels PHO will make progress quickly. General Manager Planning & Funding suggested that a representative from PHOcus on Health be invited to the CPHAC meeting when the next report is due, so any questions that might arise can be answered.

Chair


7. GENERAL BUSINESS

Work Plan General Manager Planning & Funding Progress Report General Manager Planning & Funding informed the committee that in future his reports will follow this format, highlighting key areas. Inequalities training – date for workshop for advisory committees was discussed. It was suggested that both CPHAC and DSAC combine for this training. General Manager Planning & Funding will organise a suitable time, it was suggested that the last hour of the next regular DSAC meeting and the first hour of the next regular CPHAC meeting would combine to allow the two hours for the training.

General Manager Planning & Funding Health Centre Nothing to update Work Plan The Chair distributed an updated copy of the work plan. This version combined the best elements of previous two versions. A lot of monitoring is covered in the DAP Implementation Report. A number of the previous reports schedule showing as being quarterly have been revised to either six monthly or annually. Between the reports, the General Managers associated with those reports could give verbal updates General Manager Planning & Funding and Chair to develop “new look” work plan further

General Manager Planning & Funding and Chair

Julie Kilkelly left the meeting at 11.51am

Pandemic Planning A committee member commented that decision makers at secondary level are sometimes not aware of what is available at primary and community level. Both Well Child providers and Maori Health Providers are interested in being involved in the WCDHB’s pandemic planning process. Chair will address this with CEO.

Chair

The Board is monitoring the pandemic planning process and progress on this will be reported on in the Chair’s report to CPHAC. DAP implementation report Deloittes who audited the non financial side of the DHBs activities said the DAP Implementation Report (Traffic Light) was far too detailed. It needs to be simplified and reporting points reduced. Comparing this report with the previous report, it shows a large number of points previously show as either ‘Red’ or ‘Orange’ have made progress. Key points from the discussion were:


• Please show the person’s title not name in the ‘lead person’ section • Progress is being made on the Maori Health Needs Analysis • It was noted that General Manager Mental Health/General Manager Primary Health’s

name was on the majority of the accountability points. It was discussed and the committee would like to show it’s support for the General Manager Mental Health/General Manager Primary Health receiving support in her Primary Health role as she does through her Operations Manager in her Mental Health role.

• Working with WCPHO on pharmaceutical and laboratory spending (Last two items on page 23) – Chair, Deputy Chair and General Manager Planning & Funding to talk to Anthony Cooke at PHOcus on Health Action Point, Chair, Deputy Chair, GM Planning and funding

• Electronic communication between primary and secondary care (Third item on page 24) – showing as orange, this is not yet happening. Request Chief Financial Manager to report to the next meeting scheduled for March 17

GM Planning and Funding

Break for 10 minutes – start back at 12.30pm

Robyn Bryant left the meeting at 12.21

On resumption, the committee was without a quorum. It was decided to continue with the meeting. DAP 06/07 GM Planning and Funding led continued discussions on the 06/07 DAP, further to the Board Workshop held on 20 January,. The following points were noted • Cost effectiveness – aspects of pharmacy and lab test ordering could be investigated

for savings. Improved IT communication between primary and secondary care would help avoid double ordering of some laboratory tests.

• Consultation – planned public consultation for April could have DAP on schedule • Improve regular communication – Intersectoral communication at an operational

level could be helpful. • WCPHO – The WCDHB will be asking the WCPHO to develop strategic plans along

side the WCDHB . Measuring success of PHO performance with only 1 PHO means we will either fail or succeed, no ‘partially’ category

• Healthy activity is important to emphasise • Youth health and things available for youth was identified as a gap by a committee

member, in the 8-20+. age group. C&PH surveys will highlight this further. (school to play a part in this)

• Post natal depression education has previously been identified as a gap by CPHAC, and hopefully will be included in C&PH’s new strategic plan.

• Personal health for those with mental illness was another area identified as a gap.


• Reviving implementation of WISE project was noted as a priority

• Inequality – transport – Maori Health needs assessment vital in this. Co-ordination of appointment times in Christchurch would be helpful. Investigation of whether pre-anaesthetic assessments could be done here would be helpful, as well as looking at what can be done at GP rather than a tertiary level,

• Cancer Control – this is a problem in terms of budgeting, as we are awaiting the findings of the Cancer Journey mapping project to know what the needs are

• Cancer Control - early diagnosis Increased purchasing for colonoscopies will be needed if national guidelines for screening for colorectal cancer in high risk people is to be implemented. Using the surgical bus in Westport for colonoscopies should be investigated.

• Oral health – what services over and above school dental services should we be responsible for?

• Hearing tests for neonates – some DHBs perform audiology screening on all neonates with a specialised machine.

• Workforce initiative – staff should be aware of MoH initiatives for training. The DHB website could be used to advertise these things

• Elective services – waiting times for tertiary services (e.g. rheumatology, Ear, nose and throat surgery) the main issue The DHB could investigate using GP with special interest or Nurse practitioners to help manage the waiting times for these sub-specialities.

CPHAC would like to review the draft DAP (as relevant to CPHAC) at its 28 April meeting.

8. NEXT MEETING

Friday, 17 March, 10.30 am, Boardroom, Corporate Office Greymouth

There being no further business to discuss the meeting concluded at 1.46 pm

WCDHB Meeting Papers Section 12 – Draft t Meeting Notes Intersectoral Forum Held 9 February 2006 24 February 2006 Page 1 of 1

INTERSECTORAL FORUM MEETING NOTES

The Minutes from the Intersectoral Forum held on 9 February 2006 will be tabled at the meeting on Friday, 24 February 2006.

WCDHB Meeting Papers Information Papers 24 February 2006

INFORMATION PAPERS

• West Coast DHB Board Advisory Committee Members Terms of Appointment

• West Coast DHB Board and Advisory Committee Meeting Table to December 2006 – Please note this timetable is Draft from May 2006 onwards.


WEST COAST DISTRICT HEALTH BOARD ADVISORY COMMITTEE MEMBERS TERMS OF APPOINTMENT

HOSPITAL ADVISORY COMMITTEE Member Date of Appointment Length of Term Expiry Date Dr Christine Robertson 7 February 2002

(Re-appointed 17 December 2004) For the period served as an appointed Board member. December 2007

Glenys Baldick 17 December 2004 For the period served as an appointed Board member. December 2007

Professor Gregor Coster (Re-appointed October 2004) For the period served as an appointed Board Chair. While Board Chair

Brian Wilkinson 17 December 2004 For the period served as an elected Board member. December 2007

Elizabeth Rock 13 June 2005 2 years 13 June 2007

Kathryn Cannan 1 May 2002 (Re-appointed 13 June 2005)

3 years 13 June 2008

Barbara Beckford 25 June 2003 (Re-appointed 4 March 2005)

1 year 25 June 2006

Richard Wallace 25 July 2005 3 years 25 July 2008


DISABILITY SERVICES ADVISORY COMMITTEE Member Date of Appointment Length of Term Expiry Date John Vaile 7 February 2002

(Re-appointed 17 December 2004) For the period served as an elected Board member. December 2007

Mohammed Shahadat 17 December 2004 For the period served as an elected Board member. December 2007


Gloria Hammond 1 May 2002 (Re-appointed 13 June 2005)


Maureen Frankpitt 1 May 2002 (Re-appointed 13 June 2005)


Elinor Stratford 1 May 2002 (Re-appointed 13 June 2005)


Patricia Nolan 18 July 2005 1 year 18 July 2006

Ned Tauwhare 25 July 2005 3 years 25 July 2008

COMMUNITY & PUBLIC HEALTH ADVISORY COMMITTEE

Member Date of Appointment Length of Term Expiry Date Dr Carol Atmore 17 December 2004 For the period served as an elected Board member. December 2007

Julie Kilkelly 7 February 2002 (Re-appointed 17 December 2004)

For the period served as an elected Board member. December 2007


Robyne Bryant 7 February 2002 (Re-appointed 17 December 2004)

For the period served as an elected Board member. December 2007

Barbara Greer 12 November 2003 (Re-appointed 4 March 2005)

1 ½ years 12 November 2006

Greville Wood Re-appointed 4 March 2005 3 years 3 March 2008

Cheryl Brunton Appointed (1 February 2005) 2 years (While holding position of Medical Officer of Health) February 2007

Sharon Ransom September 2004 3 years September 2007

Barbara Beckford Co-opted September 2004 Appointed 4 March 2005

3 years (from date of co-opt) 30 September 2007


WEST COAST DISTRICT HEALTH BOARD & ADVISORY COMMITTEE MEETING TIMETABLE TO JANUARY 2007

(NOTE: THIS TIMETABLE IS DRAFT FROM MAY 2006)

DATE MEETING TIME VENUE Friday 2 December 2005 Board 9.30 am Boardroom, Corporate Office, Greymouth

Friday 9 December 2005 DSAC 8.30 am Boardroom, Corporate Office, Greymouth

Friday 9 December 2005 CPHAC 10.30 am Boardroom, Corporate Office, Greymouth

Friday 16 December 2005 HAC 9.00 am Boardroom, Corporate Office, Greymouth

Friday 20 January 2006 Board 9.30 am Ashley Hotel, Greymouth

Friday 3 February 2006 DSAC 8.30 am Boardroom, Corporate Office, Greymouth

Friday 3 February 2006 CPHAC 10.30 am Boardroom, Corporate Office, Greymouth

Friday 10 February 2006 HAC 9.00 am Boardroom, Corporate Office, Greymouth

Friday 24 February 2006 Board 9.30 am Boardroom, Corporate Office, Greymouth

Friday 17 March 2006 DSAC 8.30 am Boardroom, Corporate Office, Greymouth

Friday 17 March 2006 CPHAC 10.30 am Boardroom, Corporate Office, Greymouth

Friday 24 March 2006 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 7 April 2006 Board 9.30 am Te Tauraka Waka a Maui Marae, Bruce Bay

Friday 28 April 2006 DSAC 8.30 am Boardroom, Corporate Office, Greymouth

Friday 28 April 2006 CPHAC 10.30 am Boardroom, Corporate Office, Greymouth

Friday 5 May 2006 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 19 May 2006 Board 9.30 am Westland District Council, Hokitika

Friday 9 June 2006 DSAC 8.30 am Boardroom, Corporate Office, Greymouth

Friday 9 June 2006 CPHAC 10.30 am Boardroom, Corporate Office, Greymouth

Friday 16 June 2006 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 30 June 2006 Board 9.30 am Boardroom, Corporate Office, Greymouth

Friday 21 July 2006 DSAC 8.30 am Boardroom, Corporate Office, Greymouth

Friday 21 July 2006 CPHAC 10.30 am Boardroom, Corporate Office, Greymouth

Friday 28 July 2006 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 11 August 2006 Board 9.30 am Boardroom, Corporate Office, Greymouth

Friday 1 September 2006 DSAC 8.30 am Boardroom, Corporate Office, Greymouth

Friday 1 September 2006 CPHAC 10.30 am Boardroom, Corporate Office, Greymouth

Friday 8 September 2006 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 22 September 2006 Board 9.30 am Westport (To be advised)

Friday 13 October 2006 DSAC 8.30 am Boardroom, Corporate Office, Greymouth

Friday 13 October 2006 CPHAC 10.30 am Boardroom, Corporate Office, Greymouth

Friday 20 October 2006 HAC 9.45a m Boardroom, Corporate Office, Greymouth

Friday 3 November 2006 Board 9.30 am Boardroom, Corporate Office, Greymouth

Friday 24 November 2006 DSAC 8.30 am Boardroom, Corporate Office, Greymouth

Friday 24 November 2006 CPHAC 10.30 am Boardroom, Corporate Office, Greymouth

Friday 1 December 2006 HAC 9.45 am Boardroom, Corporate Office, Greymouth

Friday 15 December 2006 Board 9.30 am Boardroom, Corporate Office, Greymouth

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