Present

Permanent Secretary: Una O’Brien
Director of Communications: Sam Lister
Director General, Transition for the Department of Health: Karen Wheeler
Managing Director, Transition – Public Health England: Anita Marsland
Director General, NHS Finance, performance & Operations: David Flory
Director General, Public Health: Felicity Harvey
Director General, for Policy, Strategy and Finance: Richard Douglas

 In Attendance

Director of Research and Development: Russell Hamilton
Director of Professional Standards: Gavin Larner
Director of Nursing: Vivienne Bennett
Director of Clinical Programmes: Gerard Hetherington
Director Health Inequalities and Partnerships: Mark Davies
Deputy Director – Head of Engagement & Change, Transformation Team: Jane Rintoul

Director of Finance, Strategy, Quality & Analysis and Chief Economist: Richard Murray (item 2)
Deputy Director of HR Policy, Diversity & Reward: Simon Claydon (item2)
Director, NHS Policy & Outcomes Group and Head of DH Policy Profession: Ian Dodge (item 3)
Head of Diversity, Karen Fonseka: (item 3)

Apologies

NHS Chief Executive: David Nicholson
National Director of Improvement and Efficiency: Jim Easton
Managing Director NHS Informatics: Katie Davis
Director General, Chief Nursing Officer: Sally Davies
Director General, Chief Nursing Officer: Christine Beasley
National Managing Director of Commissioning Development: Barbara Hakin
Director General, NHS Medical Director: Bruce Keogh
Director General, Social Care, Local Government & Care Partnerships: David Behan
Managing Director NHS and Social Care Workforce: Jan Sobieraj
Principle Private Secretary to the Permanent Secretary: Mayerling O’Regan

Secretariat

Deputy Director,  DH Secretariat, Stephen Waring
Team Members, DH Secretariat

No  Issue

1  Welcome & Introduction and Minutes and Action Note of March DHMC Meeting

The minutes and actions from the March meeting were agreed.

The Permanent Secretary welcomed the Director General for Public Health and the Director General for Transition for the Department of Health to the meeting in their new roles, and announced that the future DH’s top team was therefore now complete.

By way of introduction, the Permanent Secretary informed colleagues that:

• the Health and Social Care Act 2012 had passed through its Parliamentary stages, and attention could therefore be turned to implementing its provisions;

• the appointment of the Chief Executive of PHE had been announced before Easter;

• the recent slot-in and open competition process for staff recruitment had directly and indirectly affected almost everyone. The project bank had been set up to ensure that business critical work did not slip;

• the important work on the Mid Staffs Inquiry continued. There would be a report later in the year, and the Government’s response would attract much attention, not least from the media. DH therefore needed understand the challenges arising from it;

• the Department now needed to build up its relationship with key stakeholders, and this included with the future ALBs, in line with the outcome from the capability review and action plan.  We needed to invest time, effort and energy into this work.

2 DH Transition – Prioritisation of DH Resources

The Director of Finance, Strategy, Quality & Analysis and Chief Economist presented this item and explained the critical must do’s to the end of financial year, and that  by then staff changes should be finalised.

The exercise that his team had recently carried out meant identifying staff who could, if necessary be released to work temporarily in business critical areas.  This exercise asked DGs to identify work that could also be delayed in order to meet the requirement of the business critical areas.  DGs would need to agree in principle to identify risks in such areas and use this work as an ‘insurance policy’ to bridge the gap, so that business is not affected.

This exercise was not the reopening of WAP and GAP.  This was time-limited and was tailored to matching skills to posts to ensure business continuity.

The Deputy Director of HR Policy, Diversity & Reward and the Deputy Director, Head of Engagement and Change, Transformation Team updated the group on the project bank and staff securing their posts.

3  Clinical and Professional Advice

The Permanent Secretary introduced this item as the need to secure future arrangements for DH to secure the clinical and professional leadership it needs in the reformed system.

She also explained that we needed to do this in a way that was not duplicating or undermining others’ roles.

The Director of NHS Policy & Outcomes Group and Head of DH Policy Profession pesented a paper on the analysis that his team with Chief Professional Officers (CPOs) had carried out.  He informed DHMC that they had tried to simplify the overall outcome.  The Department would work with Commissioning Board colleagues to obtain professional advice, approaching CMO, CNO and other in-house clinical advisors.

The Head of Diversity presented the final item on the agenda, the equality analysis of the findings from the interim analysis for transition to date.  It focused on the new DH structures and Governance Assurance Panel (GAP) process for determining the staffing profile for 2013/14.

The Head of Diversity agreed to return to DHMC at a later date to present the findings on the process of equality analysis within the Department on the recent open competition process.

4 AOB

4.1 The next meeting would be Wednesday 16th May 2012.

Present

Permanent Secretary Una O’Brien
Director General, Social Care, Local Government & Care Partnerships, David Behan
Director of Communications, Sam Lister
Director General, Transition for the Department of Health, Karen Wheeler
Managing Director, Transition -Public Health England, Anita Marsland
Director of Provider Delivery, Matthew Kershaw
Managing Director NHS and Social Care Workforce, Jan Sobieraj
Director of Health and Wellbeing, Elizabeth Woodeson
Director General, Transition for the Department of Health, Flora Goldhill
Director General, for Policy, Strategy and Finance, Richard Douglas

In Attendance

Director of Research and Development, Russell Hamilton
Director of Policy, Commissioning & Primary Care, Ben Dyson
Director of Nursing, Vivienne Bennett
Director of Clinical Programmes, Gerard Hetherington
Deputy Director of HR, Caroline Corrigan
Deputy Director – Head of Engagement & Change, Transformation Team, Jane Rintoul

Head of Capability and Relationships ALB Performance and Capability Unit, Helena Feinstein (Item 2)
Director Health Inequalities and Partnerships, Mark Davies (Item 2)
Director in-charge of RDA Transition and Closure Programme in BIS, Simon Edmonds (Item 3)
Principle Private Secretary to the Permanent Secretary, Mayerling O’Regan
Director, NHS Policy and Outcomes Group and Head of DH Policy Profession, Ian dodge

Apologies

NHS Chief Executive, David Nicholson
National Director of Improvement and Efficiency, Jim Easton
Managing Director NHS Informatics, Katie Davis
Director General, Chief Nursing Officer, Sally Davies
National Managing Director of Commissioning Development, Barbara Hakin
Director General, Chief Nursing Officer, Christine Beasley
Director General, NHS Medical Director, Bruce Keogh

Secretariat

Deputy Director,  DH Secretariat, Stephen Waring
Team Members, DH Secretariat

No  Issue

1  Welcome & Introduction and Minutes and Action Note of February DHMC Meeting

The minutes and actions from the February meeting were agreed without comment.

The Permanent Secretary explained that the purpose of the meeting was to take further steps towards the new financial year and what we need to do in the months ahead.

A key immediate objective for the Department would be build on positive relations with key partners in taking forward a common agenda for improving care services.

 2 System Change – DH & Partner Organisations Shared Leadership

The Permanent Secretary introduced this item and told members that the ‘DH and partner organisations shared leadership’ event had been successful.

 3  Discussion with Simon Edmonds – Director in charge of the RDA transition & closure programme

The Permanent Secretary welcomed Simon Edmonds, the Director in charge of the RDA transition programme in BIS, to discuss their Change Programme and any lessons that DH could potentially find useful.

4  Business planning and priorities for 2012-13

DH Internal Business Plan

Permanent Secretary thanked and congratulated everyone for their work on the Business Plan, which she said was highly readable.  She said we would need to engage Ministers before publishing it. She felt that it needed a timetable that would tell the story of the big key reform things and summarise the work that has been done.

5 AOB

5.1 The next meeting would be Wednesday 11th April 2012.

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
Rt Hon Andrew Lansley CBE MP, Secretary of State for Health and Chair
Rt Hon Simon Burns MP, Minister of State for Health
Paul Burstow MP, Minister of State for Care Services
Anne Milton MP, Parliamentary Under Secretary of State for Public Health
Earl Howe, Parliamentary Under Secretary of State for Quality (Lords)
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
Dr Catherine Bell, Non-Executive Board Member
Mike Wheeler, Non-Executive Board Member
Chris Pilling, Non-Executive Board Member
Professor David Heymann, Non-Executive Board Member

In attendance
John Stewart, Deputy Director – Quality, NHS Outcomes Framework & Listening Exercise (item 4 only)
Shaun Gallager, Director – Social Care Policy (item 4 only)
Karen Wheeler, Director – Transition Programme (item 5 only)
DH Secretariat
Principal Private Secretary to the Permanent Secretary
Private Secretary to the Secretary of State for Health

Welcome

1.    The Secretary of State welcomed members to the fifth formal meeting of the Departmental Board.

2.    The minutes of the Board meeting on 26 October 2011 were agreed as accurate.

Permanent Secretary’s Report

3.    Una O’Brien explained that performance overall was on track.  The modernisation agenda was at the expected point.  An unexpected issue had arisen in the form of problems with PIP breast implants.  Two reviews had been put in place: one to look at what had happened to understand any weaknesses in the regulatory system, and the other to look at what improvements needed to be made to the system.

4.    A good outcome had been reached with the Capability Review, and Una thanked non-executive Board members for their contribution.

5.    Staff in PCTs, SHAs and DH would receive shortly a letter with details of the future location of their current functions.  The Major Projects Group was reviewing the Transition Programme.

6.    Recruitment of additional non-executive board members for the NHS Commissioning Board, plus the chairs of Health Education England and NHS Trust Development Authority and the chief executive of Public Health England were well underway.  The Department was also well advanced in recruiting three new Directors-General.

7.    Earl Howe gave an update on progress with the Health and Social Care Bill.

Performance Report

8.    Richard Douglas explained that performance was broadly in line with the position set out in October.  An underspend was expected in both revenue and capital.

9.    There was discussion of the following points:

•    whether the expected underspend would materialise.
•    emerging financial issues at a small number of providers.
•    the issue of static demand for hospital-based care, as more services were provided in the community, and the effect on providers.
•    understanding the movements in non-pay costs and medical litigation claims.

10.    Members reviewed the Strategic Risk Register.

Audit and Risk Committee Report

11.    Mike Wheeler explained that the review of last year’s accounts had been completed.  The Audit and Risk Committee was meeting frequently to track progress with this year’s accounts.

Executive Board Report

12.    The report of the Executive Board was noted.

Live Issues

13.    The Board discussed the evolving situation in relation to faulty PIP breast implants.

Enabling Quality in the New System

14.    John Stewart, Deputy Director of Quality, NHS Outcomes Framework & Listening Exercise, and Shaun Gallagher, Director of Social Care Policy, attended the meeting for this item and spoke to their respective papers.

15.    During discussion, the following points were made:

•    it would be important to ‘triangulate’ information in order to arrive at a considered view of the quality of a provider.  Financial information could identify potential quality issues, and vice versa.
•    it would also be important to bring together all involved in assessing a provider’s quality: the provider itself, CQC and the commissioner(s).
•    clinical and professional requirements on quality should be aligned with organisational (regulatory) requirements, so they reinforced each other.
•    local intelligence about providers was important.  This was especially so in the social care market, where around half of the occupants of care homes funded their own care.
•    it was important to distinguish between idiosyncratic failures (due to individual circumstances) and systemic failures.  Dealing with these types of failures required different tools and processes.

Building a Common Purpose

16.    Karen Wheeler, Director of the Transition Programme, attended the meeting for this item and spoke to her paper.

18.    During the discussion, the following points were made:

•    the Department would seek to standardise its formal sponsorship arrangements with the arm’s-length bodies.
•    ‘behaviours’ would be important at all levels of each organisation.
•    it would be helpful to bring several organisations to discuss issues as well as having bilaterals.

Governance

19.    This issue would be discussed in more detail at a future meeting.

Any Other Business

20.    No items of any other business were raised.

Present

Permanent Secretary
Director General, Social Care, Local Government & Care Partnerships
Director General, Health Improvement & Protection
Director of Communications
National Director of Improvement and Efficiency
Director General, Transition for the Department of Health
Managing Director, Transition -Public Health England
Chief Medical Officer
Director, Transition Programme

In Attendance   

Director of Provider Delivery 
Director of Policy, Commissioning & Primary Care 
Director of Nursing 
Director of Clinical Programmes 
Director of Professional Standards 
Director of Financial Planning & Allocations 
Principle Private Secretary to the Permanent Secretary 
Deputy Director – Head of Engagement & Change, Transformation Team  
Head of Change Policy, Transformation Team (item 4.8)  
Interim HR Business Partner (item 4.5) 

Apologies

Managing Director, NHS Informatics
National Managing Director of Commissioning Development
NHS Chief Executive
Managing Director, Provider Development
Director General, Chief Nursing Officer
Director General, NHS Medical Director
Director General, Policy, Strategy and Finance
Managing Director NHS and Social Care Workforce
Director General, NHS Finance, Performance & Operations

Secretariat

Deputy Director,  DH Secretariat
Team Member, DH Secretariat

Welcome & Introduction and Minutes and Action Note of DecemberDHMC Meeting

1.1 The minutes and actions from the December meeting were agreed without comment.

1.2   The Permanent Secretary explained that there were three items of particular importance on the agenda – maintaining business as usual, achieving strategic clarity, and developing the social care white paper. She also wanted to focus on maintaining business over the upcoming months, and to remind members that they needed to help staff through this period, for example by helping  them complete their statement of suitability.

1.3  Members noted the work underway to revise the quarterly SIC process and the timing for the commission and finalisation of the end of year assurance statements. They also endorsed the DH Code of Business Conduct, which was important for all staff to take into account.

1.4  On the EU Health Strategy, the Permanent Secretary proposed that the  Prime Minister’s Adviser for Europe and Global Issues and the Head of the European and Global Issues Secretariat (Ivan Rogers) from the Cabinet Office be invited to speak at an upcoming DHMC meeting to discuss progress on DH’s vision in the EU.

Capability Review

2.1  Members were updated on the Capability Review and the meeting between the Permanent Secretary and the Head of the Home Civil Service.  This review had been conducted differently from the previous one in 2007, when there had been no Non Executive Directors (NEDs) involved. This review had also benefitted from a high degree of engagement from staff. 

2.2  The Head of the Home Civil Service’s view had been that:

• DH’s assessment had honestly and fairly highlighted the areas for improvement; 
• his expectation was that any ambers in the risk register would be eliminated;
•  he had also commended the role of the NEDs in supplying constructive challenge to the process;
• the action plan needed to engage local government in taking forward the major projects review;

2.3  In implementing the findings of the Capability Review and its ten action points, DHMC would need to consider what action they should take in their directorates on leadership, strategy and delivery of their work plan; and how they would involve their staff in taking this forward. The Head of the Home Civil Service was particularly interested in actions on three fronts:

• building common purpose;
• working differently to achieve more;
• right people, right place, right skills.

2.4  The Director of the Transition Programme briefed members on the major projects review. There would be a panel meeting on 20 February to discuss outcomes and next steps. Three main findings from the review were:

• the HR link between Public Health England (PHE) and Local Government needed to be reinforced;
• programme and project management within organisations needed to be further strengthened;
• there remained a communication challenge to enable staff to see the purpose of the new organisation and their role in it.

2.5  Summing up the discussion, the Permanent Secretary said that it would be important to focus attention on one big improvement at any given moment as a way of maintaining momentum, whilst at the same time not losing sight of the fact that this represented a series of interconnected changes that required careful co-ordination and planning.

 Discussion with the Second Permanent Secretary at the Ministry of Defence

3.1  The Permanent Secretary welcomed the second Permanent Secretary at the Ministry of Defence, to discuss their Change Programme and any lessons that DH could potentially find useful.

3.2  He made the following points:

• there were points of similarity between the challenges that DH and MoD were facing;
• transformation had been an opportunity to improve programme and project management, and had created challenges in managing interfaces and integration, which in turn required strong leadership from their SofS;
• a common theme in all central government change programmes was ‘change in behaviours’.  There were also usually three tiers to change programmes, and typically the top tier was actively involved but the bottom tier not so much;
• such a set of difficult, interconnected problems resembled the perennial DH challenge in implementing any strategic change that involved high profile local reconfiguration  changes. This was often accompanied by structural reform that led to staff changes that could result in reduced morale in both DH and the NHS.

3.3   key lessons included:

• it was important to obtain buy-in from service chiefs;
• a coherent plan helped to maintain people’s energy and focus during a difficult time of transition;
• managing project and programmes require particular expertise, which sometimes needed to be brought in, to maintain both progress and credibility;
• the scale of the challenge needed to be acknowledged and dealt with, which required expectations to be managed, which meant that both stakeholder management and internal cultural change were vital.

3.4 The Permanent Secretary felt there were similarities with DH’s Position, both Departments’ experiences were similar, with common themes such as the devolution of power to front line, the challenge of making big change happen in big organisations, and the need to change the behaviour of people who might not necessarily wish to adapt to new ways of working.

Business planning and priorities for 2012-13

4.1 The Permanent Secretary invited the Director of Financial Planning and Allocations to set out the challenges facing particular areas in DH during 2012, his thoughts on how colleagues could support this, and what he felt might be staff expectations of this process.

4.2  He said that the challenges of this business planning and prioritisation exercise were i) that some business areas suffered from the loss of key staff whose move had been prompted by organisational change; and ii) that some of the at risk areas had not been through the GAP/WAP process. There was therefore more work to be done in actively managing the process of matching workload to people.

4.3  DGs in the areas that had been through WAP/GAP should acknowledge that they were in a better position to help the others, by reprioritising their work, and freeing up resources. He could support DGs in this process. 

4.4  The Permanent Secretary felt that DGs needed to lead this process of reprofiling work.  This could include creating a separate ‘loan’ bank for transition teams, which would be an interim measure separate from the project bank.

4.5  The Permanent Secretary then turned to the Business Plan. She felt that at this point it was a reasonably good draft, but there were still some issues to resolve.  She highlighted the importance of finalising the business plan for the start of the financial year, and ensuring that it was aligned, and drew from, the Capability Review. 

4.6  The key challenges for the coming year would be in the area of building up our relationships with our external partners, an activity that should be main stream across the business. In particular, this meant using the business plan to shape the agendas of our external partners.

4.7  The final plan should be prepared for a subesequent DHMC meeting, and published on Delphi in April/May, alongside a worked up programme of staff engagement.

4.8   The Head of Engagement and Change, Transformation Team provided an update on the communication and staff engagement processes.  The plan for the next six months and beyond would focus on supporting staff with an uncertain future.  Messages needed to reflect this issue, and explain how staff could engage with the process of forming the new DH.  A greater effort would be needed to explain how the Department would be different. There were six key messages that needed to be communicated over this period:

• the timeline for changes, explaining how line managers would support staff through the process;
• what the new DH would look like;
• what its role and purpose would be within the reformed care system;
• our ambitions for what it will be like to work in the new DH;
• the offer to staff, setting out why they would want to work in the new DH;
• what this would mean for stakeholders and how we work with them.

 AOB

5.1 The next meeting would be Wednesday 14th March.

The meeting closed at 1pm

Present

Permanent Secretary
Director General, Social Care, Local Government & Care Partnerships
Director General, Policy, Strategy and Finance
Director of Communications
National Director of Improvement and Efficiency
Director General, Transition for the Department of Health
Director General, NHS Finance, Performance & Operations
Managing Director, Transition -Public Health England
Managing Director, NHS Informatics
Director, Transition Programme

In Attendance      

Director of Provider Delivery 
Director of Research and Development 
Director of Workforce Development 
Director of Clinical Programmes 
Chief Health Professions Officer 
Director of International Health & Public Health Delivery 
Head of Internal Communications 
Deputy Director of HR 
Deputy Director – Head of Engagement & Change, Transformation Team  
Deputy Director of DH Delivery (item 3) 
Principle Private Secretary to the Permanent Secretary

Apologies

Chief Medical Officer
National Managing Director of Commissioning Development
NHS Chief Executive
Managing Director, Provider Development
Director General, Chief Nursing Officer
Director General, NHS Medical Director
Director General, Health Improvement & Protection
Managing Director NHS and Social Care Workforce

Secretariat

Deputy Director,  DH secretariat

Welcome & Introduction and Minutes and Action Note of November DHMC Meeting

1.1. The minutes and actions from the November meeting were agreed without comment.

1.2. The Permanent Secretary explained that the purpose of the meeting was to: update members on the Autumn Statement including the medium–long term implications for DH; discuss the Capability Review self-assessment; and bring members up to speed with the process so far, keep a focus on the design of the new Department and take stock of HR processes with a look ahead to the first quarter of 2012/13.

1.3. She welcomed the new Director of Communications to the meeting.

Autumn Statement

2.1. Director General of Policy, Strategy and Finance introduced this item.  Forecast growth for the UK was projected to be on a slightly lower trajectory than hitherto assumed. Improvement would start in 2013.

2.2. It was challenging to predict what impact this might have on the Department but planning would continue to be based on the estimates of total public spending published by HM Treasury.

Capability Review

3.1. The Permanent Secretary opened this item and reminded members that the Department had undergone a Capability Review in 2007.  The initial Review had been tough but in the 2009 re-review it was recognised that the Department had undertaken positive changes.

3.2. The current review was different.  It was based on a self-assessment, without an external review panel, and the Department’s Non Executive Directors (NEDs) had been very involved in the process.

3.3. The Permanent Secretary felt that the findings were honest and scores reflected positives as well as areas that needed to improve.

3.4. The Permanent Secretary introduced the Deputy Director of DH Delivery who had been managing the Review  for the past month.  He said that senior staff and other colleagues had engaged well.  Feedback received had been robust and areas for improvement had identified actions with assigned owners who would be responsible for progress. 

3.5. Members agreed that progress against actions should be tracked using the Business Plan, Transition Plan and Transformation plan.

DH and System Design

4.1. The Director of the Transition Programme presented this item.  She told members she would not be covering specific issues of function mapping but rather the process of how it was managed.  She asked members to agree to the proposed rules for transitioning functions during 2012/13.

4.2. Members were told that a new group, the Design Coordination Group, was being established and the Director of the Transition programme invited nominations from DGs for each of the new bodies being created.

4.3. The Permanent Secretary said she liked the proposed rules and members agreed to sign up to them.

 People and HR Processes – take stock and look ahead to the first quarter of 2012/13 

5.1. The Director General of Transition for the Department of Health presented this item.

5.2. She updated members on the position of senior posts.  The process had pretty much finished and they were now focussing on displaced staff and   vacancies that needed to be filled.  The roles in the new DH structure would be filled using the HR Framework

5.3. She told members they were looking to set up a DG panel (as a sub committee of DHMC) to oversee the release of vacancies and staff moves, get a sense of what the needs were and to manage the HR risk over the next 12 to 15 months. 

Refreshed face to face

6.1. The Head of Internal Communications presented this item.  She told members that following the last meeting, 4 messages had been developed and sent out, 9 directorates had held face-to-face sessions for staff and there had been a high level of feedback.

6.2. She asked members for their thoughts on the new process.

AOB

7.1. The Director General of Social Care, Local Government and Care partnerships updated members on cross party talks on social care reform. The Secretary of State had met Andy Burnham MP and they would meet again in January / February 2012.  

7.2. The date of the next meeting was Thursday 15th February. 
  
The meeting closed at 1pm.

Present

Permanent Secretary
Director General, Social Care, Local Government & Care Partnerships
Director General, Policy, Strategy and Finance
Director General, Chief Nursing Officer
Director General, NHS Medical Director
Director General, Transition for the Department of Health
Director General, Health Improvement & Protection
Managing Director NHS and Social Care Workforce
Managing Director, NHS Informatics

In Attendance

Director, Transition Programme
Director of Research and Development
Director Public Health England transition
Director of Policy, Commissioning & Primary Care
Director of Provider Delivery
Head of Internal Communications
Deputy Director of HR
Interim HR Business Partner (for item 3)
Member of the Transformation Policy team (for item 2)
Deputy Director – Head of Engagement & Change, Transformation Team
Director Policy Support (for item 2)
Principle Private Secretary to the Permanent Secretary

Apologies

Chief Medical Officer
Director General, NHS Finance, Performance & Operations
National Managing Director of Commissioning Development
Director, Digital Communications and Information Strategy
Managing Director, Provider Development
Managing Director, Transition -Public Health England

Secretariat

Deputy Director,  DH secretariat

Welcome & Introduction and Minutes and Action Note of October DHMC Meeting

1.1 Members were welcomed to the meeting.  The minutes and actions from the October meeting were agreed without comment.

1.2 The Permanent Secretary explained that the purpose of the meeting was to keep the focus on the design of the new Department of Health.  She reminded colleagues that the aim of the Department was to achieve the best possible health and care outcomes for the people of England.  The Department of the future would need to have strong relationships with the NHS, social care and public health systems and would need to be focussed on outcomes and accountability.

1.3 The Permanent Secretary also reminded colleagues that the department was currently undergoing a  Capability Review and said that the three emerging themes were:

• Clarifying direction –  whilst the department had set out a clear direction on the new structures it needed to be stronger on its strategic ambition for health and care and this ought to be connected to excellent evidence, insight and analysis;
• Developing  people – the department had many strengths and skills but now needed to clarify how these would need to evolve and improve to aid DH in its new role;
• Collaboration and building common purpose – this was a very important  area, which needed to be understood at all levels of the department as well as across DH’s ALBs.

DH Design – general progress report since last meeting

DH Design and functions mapping

2.1 The Director General of Transition for the Department of Health presented this item.  She said that significant progress had been made since the last meeting.

2.2 The focus now was on designing the process for transferring functions and people and she would be in a position to update members on this work at the December meeting.

The Department of Health and the Commissioning Board: policy interface

2.3 The Director of Policy Support presented a paper on the DH and NHS Commissioning Board policy interface.  The boundary between the policies of Ministers and the NHS Commissioning Board and its operational response could not be easily defined.   In reality, individual Secretaries of State were likely to retain a great deal of discretion over policy making and the Department would support them in the best way possible.

2.4 The key difference between current arrangements and those in the new system was that the Department set policy for the NHS solely through the annual mandate.  This  should reduce the volume of policy material produced by the Department and was likely to move the Department to focus on more strategic and long-term matters.

HR Processes

3.1 On SCS appointments, the Director of Communications and DH Head of News post had now been successfully filled.   The new Director of Comms would be starting in December.  The DH Director of Nursing post had been advertised and had attracted a good field of candidates.  Following the HR processes, 7 SCS2 vacancies had been identified and 23 SCS 1&2 exits (under the VES scheme) would occur between October 2011 and March 2012.

3.2 The Director General of Transition for the Department of Health told members that the process would end by December.

3.3 Colleagues agreed that the handling of information about vacancies and potential function transfers was extremely important, particularly in areas where staff might be moving to new areas and/or to work for new Directors General.

3.4 With regard to informing staff about whether they had been slotted in or not, it was agreed that an integrated approach was needed that could provide the high-level picture and timetable as well as more bespoke information for people about their individual situation and options.

3.5 Staff who were in transition roles should be reassured that they would not find themselves disadvantaged in terms of future opportunities post transition.   Where it was clear that staff would be moving out of the department, but not until April 2013, getting the messaging and information right to keep engagement levels high was also crucial.

Staff engagement

4.1. The Permanent Secretary introduced this item and told members that staff participation in the staff survey had gone up since last year. Scores around pay and conditions had gone down, but these were civil service wide issues so there was a limited amount the department itself could do to mitigate these.

4.2 It was noted that there was definitely room for improvement but that DH remained broadly in line with the overall results for the rest of Whitehall.

Face to Face revised

4.3. The Head of Internal Communications talked members through a revised Face to Face process.  She said that following the last DHMC meeting she had spoken with some of the DGs about how this process could be refreshed and improved, Based on their input, the communications team would be producing a shorter core script and would focus instead  or 4 or 5 key messages to cascaded to staff.

4.4. Colleagues were reminded that “Face to Face” was a DG-driven process.  Comms would provide the raw material but it was down to senior colleagues to speak to their managers and ensure that the messages were passed on to all staff.

4.5. Members were shown an example of a refreshed Face to Face template, which they approved for use going forward.

Business Planning

5.1. The Deputy Director of HR asked members to note the proposed approach for business planning for 2012/13 and to approve the publication of the draft guidance.

5.2. The Permanent Secretary would review the document and provide feedback / steer on final amendments and the guidance should be published end November / early December.

AOB

6.1. None

The date of the next meeting was Thursday 15th December.   The meeting closed at 1pm

Present

Permanent Secretary
Director General, Transition for the Department of Health
Director General, Policy, Strategy & Finance
Director General, Health Improvement & Protection
Managing Director NHS and Social Care Workforce
Managing Director, Transition -Public Health England

In Attendance

Director, Transition Programme
Head of Internal Communications
Deputy Director, NHS Finance, Performance and Operations
Business Planning and DH Functions
Deputy Director of Business Planning and Organisational Development
Director of Provider Delivery
Director of Research & Development
Deputy Director of HR
Deputy Director – Head of Engagement & Change, Transformation Team
Chief Scientific Officer (item 2)
Director, Health Inequalities and Partnerships (item 4)
Director of Public and Patient Experience and Engagement
DH Non Executive Member
Section Head, Operational Management, CNO Directorate
Principle Private Secretary to the Permanent Secretary

Apologies

Director General, NHS Finance, Performance & Operations
Director General, Chief Nursing Officer
National Director, Improvement and Efficiency
National Managing Director of Commissioning Development
Managing Director, NHS Informatics
Chief Medical Officer
Director General, Social Care, Local Government & Care Partnerships
NHS Medical Director
Managing Director, Provider Development

Secretariat

Deputy Director,  DH Corporate Management
DH Secretariat

Welcome & Introduction and Minutes and Action Note of September DHMC Meeting

 1.1 Members were welcomed to the meeting.  The minutes from the September meeting were agreed without comment.  The actions from the previous meeting were all in hand.

1.2 The Permanent Secretary said that the DHMC remained focussed on DH and its staff.   Approximately 800 staff currently in the DH would be directly affected by the reforms, but everyone would be affected to some extent.  It was therefore vital that senior leaders remained engaged and connected with the DH design work.  This was especially true for senior staff in the NHS-facing directorates, whose staff looked to them for their information, reassurance and guidance.

1.3 Members were informed that two key appointments had been made since the last meeting: the Chair of the NHS Commission Board, and the DH Director of Communications.

DH Design & Functions Mapping

2.1 Committee members felt that good progress had been made on DH design and functions mapping since the last meeting.

2.2 On HR-related issues specifically, the Deputy Director of HR told colleagues that all directorates had submitted SCS1 profiles for the Workforce Assurance Panel (WAP), which had met in October.   Further WAP meetings had been scheduled for November and December.

2.3 The WAP had reviewed the proposed SCS 1 posts and had decided that there would be  a total of 149 SCS posts in 2012/13 reducing to 100 posts in 2013/14.  It was not yet fully determined how many of these posts would be slot-ins but it was likely to be somewhere in the region of 70-75 people. This would be confirmed by the Appointments Panel.

2.4 Overall, therefore, the DH was planning on a reduction of 66 SCS posts by the end of 2013/14, which amounted to about a 39% reduction in posts since end of August 2011. The modelling of the paybill reduction had not been completed. The reductions would be delivered through a combination of transfers and efficiency gains.

2.5 Letters would be sent to all SCS1 staff w/b 24 October following the outcome of the SCS1 appointments process.  On professional and clinical advice

2.6 The Director General for Policy, Strategy and Finance and the Chief Scientific Officer summarised the background and key considerations from the paper that had been circulated in advance of the meeting.  In the main, DH in the future would draw on advice from the NHSCB and PHE as the new centres of excellence.

2.7  Attendees agreed in principle with the notion of a “shared service” approach.  This would avoid cost-effective duplication and potential conflicting advice within the new system.  It would also send desirable signals about collaboration and common purpose in the new world.

Engagement with DH Staff

3.1 The Deputy Director of the Engagement and Change, Transformation Team introduced this item and explained that her team wanted to get a better understanding of how the DH could communicate and engage effectively with its staff.

3.2 Progress was being made, and a lot of work was already underway.  The Head of Engagement and Change said that the vision document that had been circulated to DH staff had been well-received.  The Director General for Transition for the Department had also undertaken lots of face-face engagement sessions over the past week and had now seen over 300 members of staff in person.

3.3 From September’s face-to-face feedback and other engagement excercises, the main messages from staff were:

• some staff were still not accessing the latest available information,
• the SCS had a crucial role to play in ensuring that consistent messages got out to all staff,
• a greater understanding of which channels of engagement were most effective would be very helpful but, in the meantime, there was consensus that face-to-face exercises at this time were incredibly important’
• SCS staff should come together on a regular basis so that they all had the most up to date information and could disseminate accurate and consistent messages to staff,
• staff engagement had to be a DG-led process, and staff would need clarity over where there was opportunity for them to influence outcomes.

3.4 A forward plan of staff engagement should be brought to DHMC in November setting out a structured approach and including month-by-month engagement objectives.

Stakeholder Management Strategy

4.1 The Director of Health Inequalities and Partnerships introduced this item.

4.2 Colleagues agreed broadly with the plan of activity proposed.

AOB and Close

5.1 The date of the next meeting was Thursday 17th November

The meeting closed at 1pm