HEALTH: Report from April meeting of the NHSGGC Board

The Board of NHS Greater Glasgow and Clyde met on Tuesday, 25 April 2023. The full set of papers are here.  This summary sets out key decisions and issues considered at the meeting.

 Chair and Chief Executive’s Reports 

Health Board chair John Brown and Chief executive Jane Grant.

Chair, Professor John Brown CBE, reported on his key activities over the past two months. He hosted a visit by the new First Minister, Humza Yousaf, MSP, to the Gorbals Health and Social Care Centre. Along with the Chief Executive, he attended two meetings with Michael Matheson MSP, the new Cabinet Secretary for NHS Recovery, Health & Social Care.  He also attended a meeting between the new Cabinet Secretary and all NHS Board chairs which similarly focussed on how NHS Boards are responding to the challenges currently faced by the NHS.

The Chair also completed the recruitment process for two new Board Members, Mr Graham Haddock OBE and Dr Rebecca Metcalfe, both experienced and highly-regarded clinicians. Professor Brown has also continued to work on the external governance review of NHS Forth Valley, which is expected to continue until June.

Mrs Jane Grant, Chief Executive, reported that she had hosted Minister for Social Care, Wellbeing and Sport, Maree Todd MSP, at a visit to the Queen Elizabeth University Hospital Renal Transplant Unit.  She also chaired meetings of the national Best Start Implementation Programme Board and the Regional Cancer Advisory Board. Along with fellow Chief Executives, she had given evidence at a hearing of the Health, Social Care and Sport Committee as part of their scrutiny of health boards.

With Susanne Miller, Chief Officer, Glasgow HSCP, Mrs Grant visited Leverndale Hospital and was impressed by the person-centred care being given by the dedicated staff of the hospital.  Along with a number of colleagues, she had also met the Expert Panel appointed by the Scottish Hospitals Inquiry when they visited QEUH campus in March. Finally, she reported on a successful day bringing together clinicians and senior managers to discuss progress with Moving Forward Together, the Board’s clinical strategy.  This event was part of a number of sessions being held to engage with staff

Patient Story

Professor Angela Wallace, pictured right, Executive Nurse Director, presented the patient story.  In the video we hear from Mairi Lindsay who is a Speech and Language Therapist within Clyde’s Community Stroke Team and one of her patients, Andy Ward.

As part of his rehabilitation, Andy was referred to Clyde’s Community Stroke Team. Mairi visited Andy at home on a regular basis to help improve his communication skills. In his story, Andy gives an account of his recovery and the significant strides he has made with the support of Mairi.

Research and Innovation Annual Report

Dr Jennifer Armstrong, Medical Director, introduced Professor Julie Brittenden, R&I Director, to present the Research and Innovation Annual Report.

Professor Brittenden reported that there are currently around 1040 research studies underway across NHS Greater Glasgow and Clyde. In 2022, 402 new research programmes were started, with the team taking further steps to increase post-pandemic activity.

During the past year, the team has given significant focus to cancer research; overall patient recruitment to related trials has now fully recovered following the pandemic and is in line with 2019 figures.

Other key projects undertaken in 2022 include;

  • Research into whether an iron deficiency and the potential impact on patients with chronic heart failure
  • Potential new methods to treat patients with sepsis
  • A study into Crohn’s disease, in a bid to reduce remission rates in impacted adults
  • The success of vCreate Neuro which has delivered improvements in the care of adults and children with epilepsy and other neurological disorders
  • Digitalisation of Pathology and growth in Artificial Intelligence evaluation
  • Development of a licensed (Class I) A-I algorithm, which in pre-clinical studies, detected normal chest radiographs, or X-Rays, with over 95% accuracy.

Professor Brittenden paid tribute to her colleagues who have continued to adapt very well to some of the ongoing limitations brought about by the pandemic, whilst embracing innovation and giving clear focus to improving patient care.  Going forward into 2023, the vision is for NHSGGC to play our part in making the NHS the country’s most powerful driver of innovation through the development, testing and adoption of new technologies and treatments at scale.

On behalf of the Board, the Chair thanked all staff contributing to clinical research and innovation within NHSGGC, including the eHealth team and other services who support the organisation’s endeavours.

Finance and Capital Plans 2023/24

Mr Colin Neil, Finance Director, presented the draft Finance and Capital Plans for 2023/24.

The financial plan highlights a deficit of £71.1m for 23/24 and a deficit of £79.8m and £54.5m for the following two financial years. This is on the assumption that recurring savings of £75m are achieved in each of the three years.

The overall financial challenge requires NHSGGC to maximise all opportunities on both a recurring and non-recurring basis in order to improve this position. Therefore it is important that there is a full review of all income and expenditure and all recurring and non-recurring opportunities are acted upon.

The Capital Plan for 2023/24 – 2025/26 takes account of all estimated capital resources available including national formula allocation, additional (project) specific funding and planned asset disposals. Estimated capital resources available to the Board for the three-year period are £105.9m, £64.1m and £64.4m respectively.

Key capital commitments included in the three-year capital plan include:

  • North East Glasgow Health & Care Centre – Building work is well underway at the new North East Health Centre to be complete by Autumn 2025/26, with a project cost of £71.6m, including £3.3m funded by Glasgow City Council
  • The Radionuclide Dispensary relocation project – this national service is currently going through the Business Case process.
  • West of Scotland Thrombectomy Service – two new Bi-Planars and a CT Scanner will be installed in 2023/24.
  • Radiotherapy Equipment Replacement Programme – This scheduled equipment replacement programme provides for high value single items of equipment and will fund a replacement programme for Linear Accelerators and CT Simulators
  • £1.02m upgrades of Renfrew, Linwood & Paisley (Anchor Mill GP practice) Health Centres.
  • £2.5m conversion of retail units at Milngavie and Bishopbriggs, to provide GP consulting rooms and enhanced local services within these communities providing primary care closer to home.
  • £3.5m has been allocated in 2023/24 to fund the planned new build Health Centre to support Dargavel Village. A further £1m of funding will be received from BAE systems to bring the total new build cost to £4.7m. Planned completion is in 2023/24.

The Board approved the finance and capital plans.

Performance Report

Mr Colin Neil, Finance Director, presented the Performance Report. Issues highlighted were:

  • Performance in relation to the number of CAMHS patients seen within 18 weeks of referral (85.3%) continued to exceed the planned position for the sixth consecutive month
  • Access to Psychological Therapies (86.1%) remained within the projected position of above 85%, which is marginally below the national target of 90%
  • There was a considerable improvement in the Cancer 31 day waiting times performance (94.9% in February 2023) compared to the previous reported position (89.5% in January 2023)
  • There continue to be no new outpatients waiting more than 104 weeks for a new outpatient appointment in February 2023
  • March 2023 provisional data shows the revised reduction target for March 2023 has been achieved for outpatients waiting more than 78 weeks
  • Whilst there has been a slight growth in the number of patients waiting more than 104 weeks for an inpatient/day case, the March 2023 provisional data shows the revised target for March 2023 has been achieved
  • Performance relating to A&E four hour waits remained a challenge during February 2023 due to the pressures of winter
  • Performance in relation to the overall number of acute and mental health delayed discharges remains a significant challenge.

The Board discussed performance in relation to the Cancer 62 Day Waiting Times which remained a key area of challenge. A number of factors have impacted on performance against this target, including a significant increase in the number of patients referred with an urgent suspicion of cancer, a reduction in diagnostic capacity as a result of the pandemic and staffing issues.  William Edwards, Chief Operating Officer, confirmed that the actions being taken were beginning to have a positive impact with some improvement in performance.  As there continued to be focus on treating patients with longer waits as well as those prioritised to be seen urgently, it was noted that it might take time for this improvement to be reflected in performance targets.

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