Present:
Rt Hon Andrew Lansley CBE MP, Secretary of State for Health
Rt Hon Simon Burns MP, Minister of State for Health (joined the meeting at 3:15pm)
Paul Burstow MP, Minister of State for Care Services (joined the meeting at 3:05pm)
Anne Milton MP, Parliamentary Under Secretary of State for Public Health (absent between 3:15pm and 4:15pm)
Earl Howe, Parliamentary Under Secretary of State for Quality (Lords) (joined the meeting at 3:00pm)
Una O’Brien CB, Permanent Secretary
Sir David Nicholson KCB CBE, NHS Chief Executive
Dame Sally Davies DBE, Chief Medical Officer
Richard Douglas CB, Director General – Policy, Strategy & Finance
David Behan CBE, Director General – Social Care, Local Government & Care Partnerships
Peter Sands, Lead Non-Executive Board Member
Mike Wheeler, Non-Executive Board Member
Dr Catherine Bell, Non-Executive Board Member
Chris Pilling, Non-Executive Board Member
Professor David Heymann, Non-Executive Board Member

In attendance:
DH Secretariat
Principal Private Secretary to Permanent Secretary
Principal Private Secretary to Secretary of State for Health

Secretary of State Welcome

1.    The Secretary of State welcomed members to the Board meeting.  No apologies had been received.

2.    The minutes of the previous meeting held in March 2012 were agreed as an accurate record of that meeting.

Permanent Secretary’s Report

3.    Una O’Brien presented her report, which was circulated in hard copy at the meeting.

4.    Full information on NHS performance was available in Sir David Nicholson’s annual report.  Performance was strong, although there were some underlying issues.  In public health, immediate efforts were focused primarily on ensuring that the Olympic and Paralympic Games went well.

5.    More information on business critical delivery and the financial situation was included in the performance report.  Arrangements were well in hand for winter planning in 2012/13, and this would be discussed at the next Board meeting.

6.    Transition continued with the additional confidence generated by the Health and Social Care Bill receiving Royal Assent.  A great deal of work was taking place to ensure people moves ran smoothly.  Under the banner of common purpose, work was being taken forward on managing financial risk, communications, organisation development and staff training.  This was supported by regular meetings between key leaders in the wider system.  The Department was now bringing more attention to transition within the Department itself.

7.    Una congratulated David Behan on his appointment as chief executive of the Care Quality Commission.  She thanked David for his work in the Department and his contribution to the Board.

8.    The Secretary of State then gave an update on the position with social care.  He also mentioned the recent day of industrial action called by the BMA.

Performance Report

9.    Richard Murray, Director of Finance, Strategy, Quality and Analysis, joined the meeting for this item.  Richard explained the new performance scorecard to the Board, and members commented on it.

10.    Richard then presented on performance in 2011/12.  Finance and performance had been mostly stable, or improving, over the year, but demand had been lower.  There had also been some reduction in the size of the provider workforce, driven by reductions in administration staff.  QIPP targets for 2011/12 had been met, although the challenge remained for future years.

11.    Richard Douglas then spoke on the financial position at year-end.

Audit and Risk Committee Report

12.    Mike Wheeler presented his report.

Risk

13.    Members discussed, in break-out groups, what they saw as the most important strategic risks facing the Department over the next 18 months.  Mike Wheeler explained that the results of the discussion would be used to inform a refreshed version of the Strategic Risk Register, in a new format.  The next meeting of the Audit and Risk Committee would discuss the process of risk management within the Department.

Health Sector’s Contribution to Economic Growth

14.    Giles Denham, Director of Medicines, Pharmacy and Industry, and Richard Carter, Branch Head – Industry Sponsorship, attended the meeting for this item.  Giles explained that the Department was working towards the delivery of the commitments set out in last autumn’s Growth Plan, as well as promoting the UK’s offering abroad.

15.    Work was underway to attempt to harness the procurement power of the NHS, identifying and supporting new products and focusing spend within the UK.  The NHS Commissioning Board had issued a call for evidence on ways this could be done.

Any Other Business

16.    No items of any other business were raised.

Present:
Rt Hon Andrew Lansley CBE MP, Secretary of State for Health
Rt Hon Simon Burns MP, Minister of State for Health (left the meeting at 3:10pm)
Paul Burstow MP, Minister of State for Care Services (left the meeting at 3:50pm)
Una O’Brien CB, Permanent Secretary
Sir David Nicholson KCB CBE, NHS Chief Executive
Dame Sally Davies DBE, Chief Medical Officer
Richard Douglas CB, Director General – Policy, Strategy & Finance
David Behan CBE, Director General – Social Care, Local Government & Care Partnerships
Peter Sands, Lead Non-Executive Board Member
Mike Wheeler, Non-Executive Board Member
Dr Catherine Bell, Non-Executive Board Member
Chris Pilling, Non-Executive Board Member
Professor David Heymann, Non-Executive Board Member

Apologies:
Anne Milton MP, Parliamentary Under Secretary of State for Public Health
Earl Howe, Parliamentary Under Secretary of State for Quality (Lords)

In attendance:
Principal Private Secretary to Permanent Secretary
Principal Private Secretary to Secretary of State for Health
DH Secretariat

Secretary of State Welcome

1.    The Secretary of State welcomed members to the Board meeting.  Apologies had been received from Anne Milton MP and Earl Howe.

2.    The minutes of the meeting held on 23 January 2012 were agreed as an accurate record of that meeting.

Permanent Secretary’s Report

3.    Una O’Brien presented her report, which was circulated in hard copy at the meeting.

4.    Una explained that business as usual performance was good for the time of year.  In relation to PIP breast implants, two reviews were underway.  The Information Tribunal hearing on release of risk registers had taken place on 5 and 6 March, and the Tribunal released their decision on 9 March.  However, the Tribunal had not yet given their arguments.

5.    The Health and Social Care Bill was nearing the end of its Parliamentary passage.  Events to develop a common purpose between the Department and its arm’s length bodies were taking place.

6.    On workforce matters, staff across the Department and the NHS had received letters telling them where the function they performed would be located in the new system.  In the Department, three new Directors General had been appointed.

7.    The Secretary of State gave an update on progress in social care.  The social care white paper was due for publication in early summer.

Performance Report

8.    Richard Murray, Director of Financial Planning and Allocations, attended the meeting for this item.

9.    Richard Douglas gave an update on the financial position and looked ahead to the future financial strategy.

10.    Richard Murray explained that performance against quality indicators was improving and QIPP targets were being met.

11.    It would be important to work with Monitor on procedures to deal with emerging problems at foundation trusts at an early stage.  Changes to Monitor’s remit set out in the Bill would support this.

12.    The issue of financial sustainability was discussed.  Strong management within provider organisations would be important in equipping them to deal with future challenges.

Report from Audit and Risk Committee

13.    Mike Wheeler gave a short report on the work of the Audit and Risk Committee.

Report from Executive Board

14.    The report was noted.

Live issues

15.    Peter Sands reported on the Board effectiveness evaluation that he had been leading.

Olympics preparation

16.    Helen Shirley-Quirk, Interim Director of Emergency Preparedness and Olympics, attended the meeting for this item and gave a presentation on preparation for the Olympics.  Helen explained that the Olympics and Paralympics would be a massive logistical exercise for the country, including the health sector.  LOCOG expected to provide approximately 95% of the Games’ healthcare requirements, but there remained important roles for the Department, Health Protection Agency and NHS.

17.    There were robust risk management arrangements in place at all levels.  There had been a number of assurance exercises in the NHS, with a final round over the next few months to sign off the NHS as being Games-ready.  In the Department, there was a new Crisis and Consequence Management Centre and expanded numbers of staff trained and ready to respond.

18.    Members discussed the content of the presentation, and were assured that robust plans were in place to deal with emerging issues.

Transition

19.    Karen Wheeler, Director of the Transition Programme, attended the meeting for this item.

20.    Karen explained that the Transition Programme had recently been reviewed by the Major Projects Review Group.  All the review’s recommendations were being followed up by the Department.

21.    In discussion, the following key points were raised:

•    The Department needed to focus now on transformation,

•    The Transition Programme needed to ensure the right people were in the right place at the right time.  This would become easier as new organisations took up more of their functions.

Any other business

22.    No items of any other business were raised.

Present

Una O’Brien, Permanent Secretary
David Nicholson, NHS Chief Executive (attended via VC in Leeds for items 1-4)
Sally Davies, Chief Medical Officer
Richard Douglas, Director General for Finance, Policy and Strategy
David Behan, Director General Social Care, Local Government and Care Partnerships

In attendance:

Mayerling O’Regan, PPS, Office of the Permanent Secretary
Ralph Coulbeck, Policy Advisor, Office of the NHS Leadership Team
Flora Goldhill, Director General, Transition for the DH (Item 2 & 4)
Stephen Waring, Deputy Director of Mental Health (Item 2)
Bob Alexander, Director of NHS Finance (Item 3)
Karen Wheeler, Transition Director (Items 3 & 4)
Integrated Programme Office (Items 3 & 4)
Simone Bayes, Deputy Director, Head of Research Regulation & Governance
System Regulation Senior Manager (Item 4)
David Harper, Director General, Health Improvement & Protection (Item 5)
Ben Masterson, Deputy Branch Head, Capital Investment Strategy (Item 5)
David Heymann, DH Board Non-Executive Member  (Item 5)

Secretariat

Siobhan Benita, Deputy Director, DH Delivery
Secretariat Member

1 Welcome and Introductions

1.1 The minutes of 6 October meeting were agreed with no amendments.

General Updates

1.2 The Permanent Secretary said the Departmental Board held on 26 October 2011 had gone well with the focus of much of the discussion on performance. 

1.3 The Permanent Secretary requested a discussion on social care at the next Executive Board meeting.

1.4 The Chief Executive of the NHS said Monday 31 October had been the first day of the new NHS Commissioning Board as a Special Health Authority. 

1.5 The Chief Medical Officer said a HSC report on Public Health had been published on Wednesday 2 November. 

2 Capability Review

2.1 The Permanent Secretary welcomed the Director General for Transition for the DH and the Deputy Director for Mental Health to the meeting.  The Deputy Director for Mental Health had only acquired responsibility for the capability review within the last week.  He presented to the Board the aim of the capability review, the evidence-gathering process, progress to date on staff workshops and stakeholder interviews, and key dates over the next six week period.  The Future Forum was recognised as a very positive step forward and a balanced narrative was now needed to describe the challenging journey that the Department was on, including the learning from the Future Forum.

2.2 The Permanent Secretary said we were in a very different place from the previous capability review; going through an extraordinary set of changes in a very complex system.     

2.3 Summing up, the Permanent Secretary thanked the Deputy Director for Mental Health for a helpful presentation.  It was a good time to have the capability review, with the Department going through a period of transition and massive change, and it was hoped the process would ensure we had the right capability in the Department going forward. 

3 End State Budgets

3.1 The Permanent Secretary welcomed the Director of NHS Finance to the meeting.  The Director of NHS Finance led the discussion and gave members an overview of the key issues in the paper that had been circulated before the meeting.  Board members discussed and commented on the proposals.

3.2 The Director General of Finance, Policy and Strategy, and the Director of NHS Finance, would now send a submission to Secretary of State setting out the proposed end state budgets.

4 Transition

4.1 The Director of Transition provided an update to the Board on the status report for the programme, which covered three reports on: the DH Transition Programme Board; Transition Board for Cross Cutting Functions and the NHS Future System Executive. 

4.2 The first meeting of the DH Transition Programme Board had been held on 13 October.  The Transition Board for Cross Cutting Functions had focussed on HR and estates, and the Director of Transition reported that good work was being done around these areas.  The NHS Future System Executive had not yet met, and its first meeting was planned for 8 November.

4.3 The Permanent Secretary thanked the Director of Transition for the helpful update. 

Transition Dashboard

4.4 The Executive Board had requested, at its last meeting, that a dashboard be produced giving a high-level depiction of progress within the Transition Programme.  The Transition Director had produced a first draft which was circulated to the Board in advance of the meeting.  The Board discussed and commented on the draft dashboard.

Shared Services

4.5 At the 6 October Executive Board, members had requested a more detailed discussion on shared services.  A paper had been circulated to staff in advance of the meeting.  The Director of Transition set out the programme of work underway across the DH and NHS on implementing shared back office services for the new system.

4.6 In taking forward the management changes, the Director General for Transition for the DH would ensure all gateway recommendations were agreed and completed, and services and delivery plans were developed and agreed before reporting back to the DH Transition Board.    

4.7 The Permanent Secretary requested the Executive Board return to this issue in the New Year. 

Health Research Agency (HRA)

4.8 The Permanent Secretary welcomed the Deputy Director of Research Regulation and Governance (RRG) and the System Regulation Senior Manager to the meeting.  The Deputy Director of RRG spoke to this item.  The Health Research Authority (HRA) would be established as a Special Health Authority on 1 December 2011, and would take on substantive functions from its establishment.  The HRA would protect and promote patient and public interests in research, working with other bodies to create a unified approval process and promote proportionate standards for compliance and inspection.  

4.9 A draft framework agreement had been developed and the Executive Board was asked to approve and agree for it to be sent to the Departmental Board for their approval prior to formal sign-off between DH and HRA. 

4.10 The Board were content with the framework agreement as it stood, and agreed for it to go to the Departmental Board.

5 Porton Down Business Case

5.1 The Permanent Secretary welcomed the Director General for Health Improvement & Protection, the Deputy Branch Head of Capital Investment Strategy, and the Non Executive Board Member of the Departmental Board.    The Executive Board on 6 October had considered the Health Protection Authority’s Outline Business Case for its laboratories currently at Porton Down.  The Board had requested further information before re-submitting to the Executive Board for decision.  The Deputy Branch Head of Capital Investment Strategy went through the options with the Board. 

5.2 The Board were content for a submission on the Business Case to go to Ministers.

Present

Una O’Brien, Permanent Secretary (items 1-3)
David Nicholson, NHS Chief Executive (attended via VC in Leeds)
Sally Davies, Chief Medical Officer (joined the meeting at 10.45)
Richard Douglas, Director General for Finance, Policy and Strategy
David Behan, Director General Social Care, Local Government and Care Partnerships

In attendance:

Mayerling O’Regan PPS, Office of the Permanent Secretary
Ralph Coulbeck, Policy Advisor, Office of the NHS Leadership Team
David Harper, Director General, Health Improvement and Protection (Item 2 and 4)
Helen Shirley-Quirk, Director, Health Protection (Item 2)
Lyn Simpson, Director, NHS Operations (Item 2)
Karen Wheeler, Transition Director (Items 2 and 3)
Integrated Programme Office (Items, 2 and 3)
Flora Goldhill, Director General, Transition for the DH (Item 3)
Stephen Mitchell, Head of Governance (Item 3)
System Regulation Senior Manager (Item 3)
Andrew Sanderson, Deputy Director, Policy, Strategy and Finance (Item 3)
Ben Masterson, Deputy Branch Head, Capital Investment Strategy (Item 4)
Mike Wheeler, DH Board Non-Executive Member (Item 4)
David Heymann, DH Board Non-Executive Member  (Item 4)

Secretariat

Siobhan Benita, Deputy Director, DH Delivery

 1 Welcome and Introductions

1.1 The minutes of the 19 September meeting were agreed with no amendments. 

Capability Review – revised timetable

1.2 The Deputy Director of DH Delivery explained that the timetable for the Capability Review had changed following new advice from Cabinet Office.  Colleagues agreed that the challenge for explaining the findings of this review would not be the Department’s capacity per se but rather the context of the challenges ahead of us. The message it would be difficult to convey was that DH was on course to get there – but also that the journey was not yet over.. The Director General for Finance, Policy and Strategy said that the review could help to focus thinking on building capability for the future – not just concentrating on the transition period. 

1.3 There would be a discussion on the capability review at the October Departmental Board.  The Permanent Secretary said this would be a good opportunity to engage Board members in the process and suggested a session in which Board members could break into groups to assess capabilities and, in particular, what the requirements might be for the DH of the future. 

Progress on end state budgets

1.4 The Director General for Finance, Policy and Strategy explained that since the last EB discussion further work and analysis was being carried out on ‘end state’ budgets. Options would be put to the Chief Executive of the NHS and others to consider.  The EB would be asked to consider a further iteration of this work at the November meeting with a view to putting a submission to Secretary of State soon thereafter so that he could clear the budgets proposals alongside the publication of the operating framework at the end of November.  

2 Emergency Preparedness

2.1 The Director General for Health Improvement and Protection set the context for this item and explained that the key issues for today’s discussion were: i) assurance on emergency preparedness with regard to new clustering of SHAs and PCTs, and ii) winter planning related issues and emergency planning as it related to the Olympics and Paralympic Games next year.  

2.2 On the first of these issues, the Director of Health Protection said much work had been done on emergency preparedness during the transition period.   In the current PCT/SHA set-up people were clear on what was expected of them with regard to emergency planning and preparedness and there would be no major changes to the current arrangements until the new system came into force.  In the new clusters, there were 10 designated Emergency Preparedness leads and the Director of Health Protection met these on a monthly basis. 

2.3 A number of exercises had been run to test the responsiveness of these arrangements; these involved a number of agencies across the heath and care service.  More exercises were planned for the coming months. 

2.4 Planning for the Olympics had been going on for the past three years and was now moving up a gear as it entered the implementation and delivery phase.  The team were confident that the health service was well placed to deal with the Olympics period but they were, nevertheless, planning to probe key areas over the coming weeks including capability to manage the Olympics, an unexpected emergency event and maintain business as usual simultaneously. 

2.5 The first cross-government exercise on the Olympics had taken place ten days earlier and further ones were due in the run up to the event, with the next one planned for December with ministerial involvement.  Each of these would also help to test responses of the Department and NHS so would provide us with additional assurance on our state of readiness. 

2.6 Emergency preparedness and the Olympics was due to be discussed at a future Departmental Board meeting and the Permanent Secretary said that she would like that discussion to cover legacy issues as well, noting that emergency preparedness for the Olympics was encouraging. 

3 Transition

Transition Programme Update

3.1 The Director of Transition updated the Board on the transition programme.    Overall, good progress was being made against key milestones and the new programme governance arrangements were in place.  

3.2 Creating an overall system design narrative – with a simple description of how the different bits of the new system would work together – was a priority for the coming period. Individual framework agreements for the new organisations would come to EB for approval once they had been considered by the relevant transition boards.    This provided assurance that work on the new organisations was being approached in an integrated way. 

3.3 The Permanent Secretary thanked the Director of Transition and agreed that progress had been very positive. 

DH Design and role

3.4 The Director General for the Transition of the Department of Health spoke to the slides that had been circulated ahead of the meeting.  She explained that a lot of work had been undertaken since the previous EB discussion and, in particular, that there had been several useful seminars with Directors General, the results of which had been reflected in the material circulated to the Board. 

3.5 The Permanent Secretary explained that a number of other things relating to DH transformation had been progressed over the past few weeks, which included the appointment of a new Director of Communications, and recruitment for the Public Health England Chief Executive. 

NHS CB Authority Framework Agreement

3.6 The Director General of Finance, Policy and Strategy thanked the System Regulation Senior Manager and her team for their work on the Framework Agreement.  The document had been through a number of iterations and had, most recently, been approved by the governance and accountability workstream, which included colleagues representing the NHS Commissioning Board Authority.    This framework was the first one for the new organisations and provided a helpful sense of what others might be like as further organisations were established.   

3.7 The Permanent Secretary reminded colleagues that the Framework Agreement related to the NHS Commissioning Board special authority and covered the period from now to October 2012 only.   

3.8 Subject to the issues being raised at the meeting being addressed, the EB gave formal approval to the Framework Agreement. 

Accountability Statement

3.9 Moving on to a consideration of the Accountability Statement, the Permanent Secretary thanked the Head of Governance for all of his work on this and said that it had come a very long way from early drafts.  It required further work and she would provide her own comments on the latest draft.  Colleagues agreed to send comments to the Head of Governance as soon as possible, after which the Permanent Secretary would sign off a final version to be put to Ministers for approval.   

4 Porton Down Business Case

4.1 The Chief Medical Officer welcomed the two Non Executive Board Members to the meeting, and spoke to this item.  The Board discussed the proposed options of the  Porton Down Business Case.  Board members requested further work and detail on the options put forward before making a final decision on the way forward.

Present

Una O’Brien, Permanent Secretary
David Nicholson, NHS Chief Executive
Sally Davies, Chief Medical Officer
Richard Douglas, Director General for Finance, Policy and Strategy

In attendance:

Richard Murray, Director, Financial Planning and Allocations (Item 2 and 4)
Bob Alexander, Director, NHS Finance Performance & Operations (Item 4)
Karen Wheeler, Transition Director (Item 3)
Katie Davis, Managing Director NHS Informatics (Item 3)
Mayerling O’Regan, PPS, Office of the Permanent Secretary
Ralph Coulbeck, Policy Advisor, Office of the NHS Leadership Team
Integrated Programme Office (Item 3)

Apologies

David Behan, Director General for Social Care, Local Government & Care Partnership

1 Welcome and Introductions

1.1  The Permanent Secretary welcomed Board members.

2 Analysts in the Department and NHS Commissioning Board

2.1   The Director of Financial Planning and Allocations spoke to this item.   The Head of Profession for Statistics would be leaving the Department this Winter, and it would therefore be timely to have clarity on the scope and description of the post going forward.

2.2  Board members agreed to the recommendation put forward in the paper to the Board, and the Director of Financial Planning and Allocations would bring back a paper to November’s Executive Board, which would reflect the discussion.

3  The Way Ahead for Informatics

3.1  The Managing Director of NHS Informatics spoke to the slides that had been circulated ahead of the meeting.  The two main issues being looked at were i) devising the best approach for informatics in the new system reflecting the NHS reforms, and ii) addressing stakeholders’ concerns with the current arrangements.

3.2 The Managing Director would continue work on the future of informatics picking up issues raised by Board members in the discussion.

4  Finance

4.1 The Director of NHS Finance, Performance & Operations led the discussion and explained that the budgets of the new organisations would need to be pinned down as soon as possible.  He took members through the key issues and questions in the paper that had been circulated before the meeting.

4.2 The Director of NHS Finance, Performance & Operations would put a further iteration of the issues to EB members, in the form of a draft submission to Ministers within the next two weeks, which would cover the issues raised in the discussion.

5  Governance – Transition Governance and Accountability: Key Issues requiring resolution and decision

5.1  Members agreed with all the questions and recommendations in the paper that had been circulated before the meeting.  The Deputy Director of Governance would submit the Statement of Accountability for formal approval by EB at the 6 October meeting.

Present

Una O’Brien, Permanent Secretary
David Nicholson, NHS Chief Executive
Sally Davies, Chief Medical Officer
David Behan, Director General for Social Care, Local Government & Care Partnership
Richard Douglas, Director General for Finance, Policy & Strategy

In attendance:

Mayerling O’Regan PPS, Office of the Permanent Secretary
Ralph Coulbeck, Policy Advisor, Officer of the NHS Leadership Team
Karen Wheeler,Director, Transition – for items 2-5
Jan Sobieraj, Managing Director NHS and Social Care Workforce – item 2
Simon Claydon, Deputy Director, HR Policy, Diversity and Reward – item 2
Candy Morris, SRO, Health Research Authority – item 3
David Harper, Director General, Health Improvement and Protection and Chief Scientist – item 3
Marc Taylor, Deputy Director, R&D Systems & Governance – item 3
Jonathan Marron, Public Health England Transition Team Member – item 4
Kathryn Tyson, Director of International Health and Public Health Delivery – item 4
Andrew Sanderson, Deputy Director Policy Strategy and Finance – item 5
System Regulation, Policy Strategy and Finance – item 5

Secretariat

Siobhan Benita, Deputy Director, DH Delivery
Secretariat, DH Delivery
Deputy Director, Transition Policy and Finance

Update

1.1 The Permanent Secretary welcomed Board members.  The EB minutes for August were agreed.

1.2 The Permanent Secretary confirmed that a huge amount of work had already been done for winter planning, and a stocktake had been requested in September with Secretary of State, Ministers, and other key players.  The Permanent Secretary agreed to the request by the Director General for Social Care, Local Government & Care Partnership for a future EB discussion on winter planning and capacity issues of care homes and social care services.

1.3 The Director General for Finance, Policy & Strategy announced the Resource Account had been signed-off by the Permanent Secretary.  The Audit and Risk Committee were reviewing the process and the reason for the delay in signing off the Account this year, and were planning carefully for next year to ensure the timetable was met.  The Permanent Secretary said it was important that any plans for next year were real, and achievable.

Transition Timeline Decisions

2.1 The Director of Transition introduced the Managing Director of the NHS and Social Care Workforce, in his capacity as the newly appointed Senior Responsible Officer for Health Education England, and then took the Board through the proposed timeline for establishing the NHS Trust Development Authority (NTDA) and Health Education England (HEE).   The timeline had been developed following discussions with the Chief Executive of the NHS and with the leads of the respective programmes.

2.2 The Board agreed with the proposed timelines for NTDA and HEE.

2.3 The Board discussed the importance of providing greater clarity for DH staff about their futures.  The Director of Transition confirmed that a more detailed plan would be discussed at the Department of Health Management Committee on 15 September.

2.4 The Permanent Secretary requested that the Department set specific objectives to give people as much clarity as possible about their futures, and consider providing individuals with personal letters to set out their position.

Health Research Authority

3.1 The Permanent Secretary welcomed the newly appointed Senior Responsible Officer of the Health Research Authority and the Deputy Director for Research and Development Systems and Governance (R&D SG).  The 2010 Review of Arms Length Bodies had proposed a Health Research Regulator to bring together research approval functions currently scattered across a number of organisations.  The Deputy Director of R&D SG set out the timetable, legislation required, roles and functions, and phases for setting up the Health Research Authority.

3.2 The Board confirmed that subject to revisions, the draft submission on the establishment of the Health Research Authority should be put to Earl Howe.

Public Health England

4.1 The Permanent Secretary welcomed the Director General for Health Improvement & Protection, the Director of International Health and Public Health Delivery, and a member of the Public Health England Team.  The Chief Medical Officer had recently taken on the role as Senior Responsible Officer to Public Health England (PHE).

4.2 The Director General for Health Improvement & Protection updated the Board on the on-going discussions around terms and conditions of service.

4.3 The Director of International Health and Public Health Delivery described to the Board the process in place to determine the future Public Health shadow and operational budgets in advance of the 2014-15 end state.

4.4 The Board confirmed the approach.  Whilst acknowledging the timetable was tight, the Permanent Secretary stressed the importance of moving with pace and requested that the issues be discussed with the Secretary of State at the earliest opportunity.

Governance

NHS Commissioning Board – draft Memorandum of Understanding and working draft of Framework Agreement

5.1 The Permanent Secretary thanked the Deputy Director of Policy, Strategy and Finance and the System Regulation Senior Manager for circulating working drafts of the Memorandum of Understanding and Framework Agreement to Board members.  The Board discussed the draft documents.

5.2 The Permanent Secretary said that it would be very important to clarifyt our ambition and purpose, as there would be a number of new people working in the system. We needed to define the work that was required, and then set out a plan of proposed events and actions to help deliver our business.  The Board agreed that the Framework Document was progressing along the right lines.

Any Other Business

Cross Government Working on Ending Gang Violence

6.1 The Director General for Social Care, Local Government & Care Partnership reported that the first meeting of the Cross Government Working on Ending Gang Violence had been held on 24 August 2011.  The meeting was the first of a Permanent Secretary chaired cross government group on ending gang violence.  It was chaired by the Home Secretary.  An action plan was being developed to end gang violence and would report to Parliament in October.  A “Grass Roots Panel” looking at the reasons behind the disturbances would produce an interim report in December and a final report in March 2012.

Present

Una O’Brien, Permanent Secretary
David Nicholson, NHS Chief Executive
David Behan, Director General for Social Care, Local Government & Care Partnership
Richard Douglas, Director General for Finance, Policy & Strategy

In attendance

Karen Wheeler, Director, Transition
Policy Advisor, Officer of the NHS Leadership team

Apologies

Sally Davies, Chief Medical Officer

In attendance for item 3 

Stephen Mitchell, Deputy Director, Governance

In attendance for item 4 

Bob Alexander, Director of NHS Finance
Richard Murray, Director of Financial Planning and Allocations

Secretariat

Transition Programme Member
Corporate Management  Member
Transition Programme Member

Update

1.1 The EB minutes for July were agreed.

1.2 The Permanent Secretary introduced an item on secondments, which would  enable Department of Health staff to take up time-limited posts, on secondment, to help establish new organisations including the NHS Commissioning Board.  The Board agreed the principles set out in the paper, but requested further clarification on the scope, and the longer term approach. 

Transition Programme Standing items

2.1 The Transition Director introduced the Transition Programme status report.  The aim for future reports was to provide an overall sense of the programme’s progress.  The Director General for Finance, Policy & Strategy described this as becoming a report that allowed the Board to monitor the trajectory of the individual parts of the programme.  For future reports, the Board asked that the status of each programme be challenged more robustly.

2.2 At the request of the Permanent Secretary, the Transition Director updated the current issues of the programme, including Public Health England and the Department of Health Programme.

2.3 The Permanent Secretary requested that the need for legal services across the system be carefully considered.  The Chief Executive of the NHS confirmed that the NHS Commissioning Board would require legal advice and input.  The Director General for Finance, Policy and Strategy agreed to co-ordinate this requirement as part of the wider work on professional and clinical advice across the system.

Governance

3.1 The Transition Director introduced the item on revised governance for the Transition Programme.  This involved reconstituting the Transition Programme Board and introducing two new boards – the DH Transition Programme Board and the NHS Management Board for Transition. These Boards would report into the Executive Board and be held to account by the Executive Board.  The Permanent Secretary and the Chief Executive of the NHS would become Board sponsors, and agreed the Director General for Finance, Strategy and Policy would be the Senior Responsible Officer for the programme. 

3.2 The Deputy Director for Governance introduced the item on Transition Governance and Accountability.  The Memorandum of Understanding between the Accounting Officers was being revised to take account of changed internal governance structures.  The Board agreed that this would go to the Chair of the Audit and Risk Committee.

3.3 The Permanent Secretary requested a single comprehensive statement of accountabilities.  The Director General for Finance, Policy and Strategy said that this was being drafted and would be shared with Executive Board members.

Finance

4.1 The Board discussed the transition costs for the impact assessments and mitigation of risks, proposals for reducing overall financial risk, budget envelopes for end state bodies and PCT allocations.  The Board discussed the items and requested additional work before coming back to the Executive Board for further discussion.

Part 1: General Business

Present

Una O’Brien, Permanent Secretary
David Nicholson, NHS Chief Executive
David Behan, Director General for Social Care, Local Government & Care Partnership

In attendance

Shaun Gallagher Director, Social Care Policy

Secretariat

Siobhan Benita Deputy Director, Development and Delivery
Secretariat, Development and Delivery

Apologies

Sally Davies Chief Medical Officer
Richard Douglas Director General for Finance, Policy & Strategy

 Update

1.1. The EB minutes of 5 May 2011 were agreed.

1.2. The Permanent Secretary updated Board members on the status of the DH Resource Account for 2010/11.  Due to some outstanding issues the Resource Account would not be laid before Parliament before the summer recess.  Work was in hand to resolve the issues, however, so that an unqualified Account could be laid before Parliament immediately after summer recess.

1.3. The Permanent Secretary confirmed that DH would prepare earlier for the following year’s Resource Account process.  DH were required to consolidate NHS Foundation Trusts within the DH Resource Account for 2011/12, and the Account would need to be with the Comptroller and Auditor General earlier than in previous years.

Social Care

2.1 The Permanent Secretary welcomed the Director for Social Care Policy.  The session focussed on general reform issues, a forward look to winter, and a risk assessment by the Executive Board of those issues, and the Director General of Social Care, Local Government & Care Partnership took the Board through each of the items.

Reform

2.2 Following the publication of Andrew Dilnot’s report on 4 July, the Government had given the report a warm welcome, and stated that it would produce in Spring 2012 a White Paper and a progress report on funding reform. The White Paper would cover a broad agenda including issues such as law reform, greater personalisation, improving quality, developing the social care market, and integration with the NHS and other services.

2.3 The Permanent Secretary stated that the White Paper on Social Care would be significant for the whole system of health and care, and the discussion had been a helpful session to gather up ideas.

 Southern Cross

2.4 Southern Cross, England’s largest care home provider, had announced a restructuring plan on 15 June to restore its business to a position of sustainable financial viability, and the Director General of Social Care, Local Government & Care Partnership updated the Board on the latest position.

 Forward Look to Winter

2.5 The Director General of Social Care, Local Government & Care Partnership confirmed that winter 2010/11 had been broadly well managed, with numbers of delayed transfers of care mostly static when compared with previous years.  Arrangements would again be put in place for the coming year.
 

Part 2: Transition Business

The following people joined the meeting for part 2:

Flora Goldhill, Director General, Corporate Development Directorate
Karen Wheeler, Director, Transition
Ralph Coulbeck, Policy advisor, Officer of the NHS Leadership team

In attendance for item 4

David Harper, Director General, Health Improvement and Protection
Lyn Simpson, Director, NHS Operations

Secretariat

Transition Programme Member

Transition Programme

3.1 The Director of Transition updated the Board on the status of the Transition Programme, and the remaining decisions that needed to be made on the transition timeline.

3.2 On the establishment dates for NHS Trust Development Authority and Health Education England, the Director of Transition proposed to return to the Board for decisions in September.  The Chief Executive of the NHS supported this proposition.  The Permanent Secretary agreed that the decision should return to Executive Board in September, but emphasised the need for momentum to be maintained.

3.3 The Director of Transition updated the Board on plans for the Appointments Commission and the National Patient Safety Agency.

3.4 The Board agreed that the Managing Director of NHS Informatics should report back to a future Executive Board on proposals for Informatics.

3.5 The Director of Transition set out the priority objectives between now and April 2012; set out the forward look for key decisions which the Executive Board needed to take over the next two months; and reported on work in the programme to validate risks.  The Permanent Secretary charged the Director of Transition and the Integrated Programme Office to validate and challenge risks across the Transition Programme.

3.6 The Permanent Secretary congratulated the Director of Transition and her team as the Public Administration Select Committee’s report had praised the Department of Health’s change management and programme governance.

Emergency Preparedness

4.1 The Permanent Secretary welcomed the Director General for Health Improvement and Protection, and the Director of NHS Operations to the meeting to discuss Emergency Preparedness.

4.2 The Director General for Health Improvement and Protection outlined the proposed model for emergency preparedness and the role of the Director of Public Health.  The Permanent Secretary stated the importance of it being clear in an emergency who was in charge.  The Director of NHS Operations confirmed to the Board that there would be a scoping exercise over the summer. Previous incidents would be taken through the new system to look at how they would be dealt with.

Download NQB (12) 2nd Meeting (April) – minutes (PDF, 63K)

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Download NQB(12)(02)(01) – General Update (PDF, 26K)

Download NQB(12)(02)(01) – General Update – Annex (PDF, 105K)

Download NQB(12)(02)(02) – Review of CQC registration regulations (PDF, 56K)

Download NQB(12)(02)(03) – Dignity in care (PDF, 56K)

Download NQB(12)(02)(04) – Quality in the New System Architecture (PDF, 130K)

Download NQB (12) 1st Meeting (Feb) – minutes (PDF, 63K)

Download NQB(12)(01) – Agenda (PDF, 26K)

Download NQB(12)(01)(01) – Quality During and Post Transition (PDF, 48K)

Download NQB(12)(01)(02) – Public Health Quality Standards(PDF, 397K)

Download NQB(12)(01)(03) – Patient led inspections (PDF, 45K)