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MInutes of the latest meeting

Minutes of the forty-second meeting of the Special Health Authority held at 2.30 pm on Monday, 12 September 2005 in Conference Suite 2, UKT, Bristol

Apologies

Apologies were received from Neil Goodwin, George Jenkins and Gurch Randhawa.

1. Declarations of interest in relation to the agenda
• 1.1 There were no declarations of interest made in relation to the agenda.
2. Report back from the Audit Committee Meeting held earlier
   • 2.1 Margaret Branthwaite reported back from the Audit Committee held earlier today. There were no outstanding items raised by the auditors although two issues were earmarked for the succeeding body. These were the outstanding Permanent Injury Benefit award and the need to place on record that the merger will change the risks faced by NHS Blood and Transplant and also the risks faced by UK Transplant as a sub-division of the new organisation. The Chairman confirmed that she would be writing to the Chairman of NHSBT with a synopsis of handover issues from this board to the NHSBT board.
3. Minutes of the Audit Committee meeting held on 27 June 2005 – UKTAUDIT (M)(05)2
   • 3.1 The minutes of the Audit Committee Meeting held on 27 June 2005 were accepted.
4. Minutes of the 40th meeting of the SHA held on 27 June 2005 - UKT(M)(05)5
   • 4.1 The Minutes of the meeting were agreed and signed as a true and correct record.
   • 4.2 Action points – UKT(AP)(05)6
   • 4.2.1 1The Acting Chief Executive reported that, following trials of the new national pay framework for the most senior NHS managers, the Department of Health had confirmed that the implementation is to be delayed pending the restructuring of the Primary Care Trusts and the Strategic Health Authorities.
   • 2 This item is noted at minute 5.5 below.
   • 4.3 Matters arising not separately identified

   • 4.3.1 Item 4.3.1. refers - In response to a request from Gilbert Park, the Medical Director agreed to follow up on the protocol on screening for pregnancy of female potential donors, which was with the General Medical Council for approval.

   • 4.3.2 Item 6.2.1. refers – The Medical Director updated the meeting on the work to revise the national kidney allocation scheme and on meetings with representatives from the units within the alliance which had expressed disagreement with the proposal. It was also noted that some local kidney patient organisations had registered their opposition to the views put forward by the National Kidney Federation on their behalf.
5. Finance and business planning
   • 5.1 Financial report to 30 June 2005 – UKT(05)50
   • 5.1.1 Members noted the report on the financial position as at the end of June 2005 for information.
   • 5.2 Financial report to 31 July 2005 – UKT(05)51
   • 5.2.1 The Director of Finance reported that funding levels remained the same as previously reported with cash limit drawings as expected and an overall net underspending of 115k against budgets. Spending plans are forecast to be achieved by 30 September with the appropriate proportion of the cash, budgets and balances transferred to the new organisation NHSBT on 1 October 2005.
   • 5.3 Financial report to 31 August 2005 – UKT(05)52
   • 5.3.1 A verbal report was given on the financial position at the end of August as timescales had meant the written report could not be included with the papers for this meeting. Although the overall net underspend had risen to £158k the situation had not changed significantly from July. Spending plans are still forecast to be achieved by 30 September within the appropriate proportion of the budgets. Members noted that uncertainties surrounding the restructuring might result in transitional costs.The Director of Finance confirmed that, as a sub-division of NHSBT, UKT would retain its own budget and cost centre, although the mechanics of this operation may be carried out elsewhere from 1 October 2005.
   • 5.4 Quarterly performance monitoring report: April to June 2005 – UKT(05)52
   • 5.4.1 The Acting Chief Executive gave a summary of the review of internal performance, which took place on 6 July 2005. Details of the progress against each target and performance indicator were noted. Good overall progress had continued to be made against all programmed targets for the quarter, despite additional pressures as a result of the Arms Length Bodies’ review proposals and Agenda for Change. In common with much of the NHS, UKT are unlikely to meet the target of 30th September 2005 for completion of Agenda for Change. UKT funded programmes are continuing to show strong overall performance and, as agreed, Donor Liaison Schemes are continuing to be wound down.On behalf of the non-executive directors, the Chairman congratulated the executive directors on consistently achieving a high level of performance and in lowering staff turnover and sickness absence during a particularly difficult time.
   • 5.5 Transplant Activity report – July 2005 – UKT(05)53
   • 5.5.1 The Director of Statistics & Audit summarised the activity report for July 2005. Activity for kidney, pancreas, liver and corneal transplants in the first four months of the year had exceeded corresponding numbers in the previous year. In addition the number of lung transplants was comparable to last year whilst the number of heart transplants was slightly lower. The report also showed that as a result of a surge in activity in July the numbers of non-heartbeating liver transplants exceeded those for the corresponding period last year.In comparison with the previous record year for activity (2003/04) the total number of transplants had increased by 10%. The Chairman congratulated the Director of Donor Care and Co-ordination and her team on these results.Alistair MacGilchrist emphasised that, despite these results, there were still problem areas, in particular donation rates in Scotland and the balance between the numbers of liver transplants being carried out and the number of patients being placed on the transplant list. As part of the remit of a sub-group of the Liver Advisory Group, the way in which livers are allocated nationally is to be reviewed.
6. Papers for approval

   • 6.1 Establishment of a Donation Advisory Group – UKT(05)54

     6.1.1 The Medical Director introduced a proposal to revamp the existing Transplant Co-ordinators Advisory Group in order to develop a Donation Advisory Group. This was due to the increasing need to develop the relationship between UK Transplant and the critical care clinical community. The group would also include representatives of tissue co-ordinator services. Current links with the intensive care community are in the form of consultant leads on the Donor Liaison Schemes but these positions will progressively disappear due to the phasing out of these schemes. A short-life working party, the Organ Donor Working Group, was established to provide informal advice on donor management issues arising from the potential donor audit. At its final meeting this group had also recommended the establishment of a group, which should “be used as a formal resource to offer advice to UKT on donor issues and should be formally incorporated as an advisory group”.Members endorsed the proposal put forward and noted that the Medical Director and Director of Donor Care and Co-ordination would be meeting with the President of the Intensive Care Society to identify the most appropriate arrangements. Work would take place shortly to define the membership of the group and it was hoped that the first meeting could be scheduled within the next four months.

   • 6.2 Chairmanship of OTAG – UKT(05)55
   • 6.2.1 Members received a report from the Medical Director advising that Mr Peter McDonnell had resigned as Chairman of the Ocular Tissue Advisory Group following his election to the position of Vice President of the Royal College of Opthalmologists. At the last meeting of OTAG, Mr Stephen Kaye, Consultant Ophthalmic Surgeon in Liverpool, was unanimously supported to succeed as Chairman and the Medical Director requested the approval of the Board to this appointment. Members endorsed the appointment with immediate effect.
7. Papers for information
   • 7.1 Energy consumption report – UKT(05)56
   • 7.1.1 The annual report on energy consumption for the Authority was received and it was noted that, whilst there has been an increase in staffing levels and support services over the period, energy consumption has reduced from the levels in 2000. Targets have been achieved or exceeded.
   • 7.2 UKT/NBA merger risk checklist – UKT(05)57
   • 7.2.1 The Director of IT&SS presented a further updated checklist of the progress and risks for the merger of UKT and NBA, together with a report from the project manager. It was noted that the proposal to maintain UKT, NBS and BPL as separate operating divisions of NHSBT reduces the risks as well as the number of key tasks to be completed. The Acting Chief Executive outlined to members the issue of the legal stance surrounding the provision of the service in Scotland. The Statutory Instrument and directions, which give the authority for NHSBT were laid before Parliament last week and, subject to there being no adverse comment from MPs, the Statutory Instrument will bring NHSBT into being as from 1 October 2005. This gives authority to provide a service to the whole of the United Kingdom, including Scotland. Members commented on the high risks involved with this issue. Members noted that no official announcement had yet been made on the appointment of non-executive directors to the Board of NHSBT.
8. Executive Directors' reports
   • 8.1 Chief Executive’s report
   • 8.1.1 The Acting Chief Executive reported on the latest position with the proposed organisational management structure and Board appointments for NHSBT. The proposed three divisions of NBA, UKT and BPL will retain their own identity and each will have a Managing Director who will sit as a voting director on the group NHSBT Board.A draft joint NBA and UKT strategic statement was tabled and members were asked to comment to the Acting Chief Executive by 19 September 2005.
   • 8.2 Director of Communications’ report – UKT(05)58

   • 8.2.1 The Director of Communications detailed the main aspects of the BBC Organ Donation Season, which was broadcast from Monday, 22 August to Saturday, 29 August 2005. As an exercise in raising awareness the season had proved extremely effective and the Chairman congratulated those involved. Additional web servers were organised to deal with the predicted response. In addition, extra call handling facilities were put in place and these are still in operation due to the high level of calls still being experienced. Over 75,000 requests to register were made following the broadcasts, although it is too early to tell how many of these are duplicate registrations. The Medical Director advised members of some negative reactions to the programmes and stressed the need to be aware of this type of publicity.Members noted that an enquiry had been received from another TV Channel to produce an organ donation mini-season.Five new public awareness TV fillers were launched in March 2005 by UKT. The Central Office of Information has reported a 32% increase on the same quarter last year in the number of organ donation fillers broadcast.Members noted the work which was continuing on the Organ Donor Register 10th Anniversary challenge as well as UKT activity at the British Transplant Games 2005 held in August at Loughborough.Due to the level of support and interest shown by students attending previous Freshers’ Fairs, UKT will be exhibiting at 15 universities this autumn.On Wednesday 7 December 2005 UKT is planning to celebrate the centenary of the world’s first successful cornea transplant and a number of agencies have put forward proposals for consideration.

   • 8.3 Director of Statistics & Audit’s report – UKT(05)59

   • 8.3.1 A joint proposal by UK Transplant and the Clinical Effectiveness Unit of the Royal College of Surgeons for the future arrangements for providing the clinical audit for UK liver and cardiothoracic services were noted. This proposal was submitted to NSCAG for approval and initial indications are that this will be accepted for implementation.
9. Any other business
   • 9.1 There were no other items of business to report.