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Minutes of the NWC AHSN Board Meeting

Wednesday 11th February 2015, 2-4pm Board Room, S04, Vanguard House, Sci-Tech Park, Daresbury

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Present

Gideon Ben-Tovim (GBT) Chair, Chairman of NWC AHSN

Bruce Ash (BA) Vice Chair, NWC AHSN & ABHI representative

Dr Liz Mear (LM) Chief Executive, NWC AHSN

Lorna Green (LG) Commercial Director, NWC AHSN

Lisa Butland (LB) Director of Research & Innovation, NWC AHSN

Dr Bina Rawal (BR) Interim Associate Non-Executive Director, NWC AHSN

Tracy Bullock (TB) Chief Executive, Mid Cheshire Hospitals

Steve Bridge (SB) Assoc Director, Countess of Chester Hospital NHS FT for Tony Chambers

Dr Umesh Chauhan (UC) Research Lead, East Lancashire CCG

Jane Cloke (JC) Asst Director & Programme Manager, NIHR CLAHRC NWC

Nicola Allen (NA) NHS England Cheshire and Merseyside for Clare Duggan

Dr Alex Gaw (AG) Chair, Lancashire North CCG

Prof Tony Gatrell (TG) Faculty of Health & Medicine, University of Lancaster for Prof Neil Johnson

Aidan Kehoe (AK) Chief Executive, RLBUH NHS FT

Andrew Leeming (AL) Lancashire LEP for Andy Walker

Sally Spencer (SS) Assoc Director, Clinical Research, Lancashire Health Hub

Jane Rossini (JR) Cheshire & Merseyside Public Health England for Melanie Sirotkin

Harriet Lewis (HL) Associate of British Pharmaceutical Industry

Heather Tierney-Moore (HTM) Chief Executive, Lancashire Care NHS FT

Alan Welby (AW) Executive Director, Liverpool City Region LEP

Rosalind Way (RW) Director of Operations, Liverpool Health Partners

Professor Ken Wilson (KW) Medical Director, CRN

Tony Woods (TW) Head of Strategy, Liverpool CCG for Katherine Sheerin

In attendance

Tim Crowley (TC) Director, Mersey Internal Audit Agency (MIAA)

Shirley Harrison (SH) Project Manager, NWC AHSN (Minutes record)

Jeni Quirke(JQ) Communications Manager, NWCAHSN

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Apologies received

Jackie Daniel Chief Executive, University Hospitals Morecambe Bay FT

Dr Andy Davies Chair, Warrington CCG

Mark Gabbay Director, NIHR CLAHRC NWC

Laura Roberts Director North, Health Education England

Kathryn Thomson Chief Executive, Liverpool Women’s Hospital

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1.1 Welcome and Introductions Gideon Ben-Tovim (GBT), Chair, opened the meeting and welcomed all present. A warm welcome was extended to Dr Bina Rawal who was introduced as the new Interim NED, and Tim Crowley who has been commissioned by the AHSN to conduct a governance review of the NWC AHSN. GBT explained that TC was keen to talk later with a cross section of Board members as part of the review process. On behalf of the Board, GBT thanked Professor Tony Gatrell for his past service on the board. 1.2 Minutes of the previous Board Meeting (dated 14th January 2015)

The minutes of the previous meeting were agreed as a true and accurate record, subject to an amendment on page 7 under item 8 – it was noted there were 4 NHS England regional bodies rather than the 3 stated.

1.3 Matters arising from previous Board Meeting Page 4: LM reported that the comments of the Board had been submitted for the Healthier Lancashire Project and a letter of thanks had been received from Dr Chris Clayton. Page 7/item 8: LM reported she had met with Merseyside CCGs and local authorities and a telehealth project would be scoped up for joint working using the £775k transformation funding obtained with the support of the AHSN.

2. CEO Update LM reported as follows:

2.1 Funding

The AHSN had been successful in obtaining a £50k Health Foundation Grant to support it’s Mental Health workstream.

2.2 NWC AHSN Staffing Changes There was currently an advert out for a Communications and Stakeholder Engagement Director for the NWC AHSN that would close the following week.

2.3 AHSN support for 3 bids The AHSN were currently supporting 3 bids: 1 for a regional Vanguard site and 2 for Multi Specialty Community providers 2.4 AHSN Funding LM had spoken with NHS England regarding NWC AHSN funding for next year and was

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pleased to report it had been agreed that funding would be equalised between AHSNs, subject to tariff discussions

3. Investment Options Paper and presentation 3.1 Overview of Investment Options LG presented to the Board on bids submitted to the NWC AHSN for investment funding. In her introduction LG explained there had been 38 bids received. This was regarded as a very positive sign but the funding available was not sufficient to support all bids. LG explained how each bid had been scored against 10 criteria, with consideration given as to whether there was any matched funding and taking into account the three main elements of Innovation, Health and Wealth. Those bids that scored highest tended to have all of these factors but a number of bids considered can be incorporated within AHSN core business and/or potentially access other funding pots. The bid process was open to NHS organisations, LEPs, LAs, CCGs and Universities and had closed February 5th. £900k was available to support successful bids with a separate £200k for bids related to Patient Safety. 3.2 Call for Declaration of Interest At this point, GBT asked colleagues present to declare any interest in any of the projects to be discussed. He reported that the Investment Options paper had been reviewed earlier by the NWC AHSN Finance and Performance Committee. AW asked for clarity on the input of Board members at this stage and GBT confirmed this was an opportunity to enquire or challenge a decision on any bid. LG concurred, saying this was the final step in the bid approval process. LG then presented each bid in turn – a brief summary of each follows: (Members to refer to separate PowerPoint Presentation for more detail) 3.3 PROPOSED TO FUND Liverpool CCG Connected Health Innovation Partnering Platform-dedicated Plug and Play N3 aggregator for use by academia, NHS and SMEs to support growing digital economy by enabling digital technologies to link to and access NHS IT infrastructure. Proposed to fund £136,000 Rationale: Significant match from CCG and industry partners, good match with AHSN work streams relating to digital solutions, SMEs and the NHS. Q&A from Members Q: Would project learning be made available regionally? A:(LG) Yes. Comment (AW): This is part of the Liverpool City Region Plug and Play digital strategy. Mersey Care NHS Trust Mersey Care is investing £0.9m into a physical Centre for Recovery and Social Inclusion that will incorporate a range of social health innovations supporting integrated recovery pathways. This additional funding is to incorporate an Employment and Enterprise Hub within the centre.

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Proposed to fund £125,000 Rationale: An inclusive health and social project, working with people to improve health, provide training and education, supporting employers and employees, with a mental health improvement focus. Q&A from Members None Alder Hey NHS Foundation Trust Ongoing development of an Innovation hub, incorporating a hospital ‘living lab’ and co-creation space to be used for testing, simulations and training. Funding requested to enable transfer of the hub into the new hospital phase 1 building and avoid delay of approximately 1 year. Funding requested to fit out the concrete shell, walls, flooring, utilities etc. in order to show commitment to the project to secure other investment from corporates and charities. Looking to collaborate with Boston Children’s Hospital to become a key partner to industry for trials, co-creation and regulatory approvals work. Proposed to fund £280,000 Rationale: Fits with health, wealth and innovation. Strong relationship with Boston Hospital, a proven US model. Q&A from Members Q: (UC) Are we funding a building? A:(LG): We are funding the infrastructure of the Innovation hub to support the overall success of the project and activities therein. Q: (UC) What would be the outcomes by which we could judge this? A:(LG) It would be judged by the activity that supports innovations and networks. LM concurred, it was not a building as such being funded but its subsequent activity Q: (RW) What is the purposed of use of this resource if this is capital spend? A: (LG) There is the link to economic impact as well as innovation. Comment: (AW) Physical space for innovation is as important as well as linkage into wider patch. South Ribble Partnership A number of strategic partners including Chorley & South Ribble CCG, Lancashire CC, Lancashire Fire and Rescue, North West Ambulance, South Ribble Borough Council, Enterprise Lancashire, Lancashire Police and Progress Housing have discussed the potential for a joint working/co-located facility as a result of South Ribble Partnership’s cross-sector approach primarily for financial, service delivery and equality purposes. Proposed to fund £36,000 Rationale: Strong partnership links, strong match funding from other partners.

HT-M declared an interest in this project. Q&A from Members Q: (AL) Is this largely provisional on other funding being matched? A:(LG) Confident match funding will be forthcoming, if not AHSN funds will not be allocated. Comment: (AW) This is all about supporting innovations and inevitably there is a risk some projects might ‘fail’ but innovation is about trying things and learning from them.

Care Across Cheshire Pioneer Programme The proposal is to establish a Cheshire Learning and Improvement Academy (CLIA) – a scalable education and training resource to assist Cheshire in achieving systematic quality and improvement. Funding is requested for 1 wte to scope learning needs, establish procedures across partners and plan the set up of the Academy.

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Proposed to fund £100,000 - subject to a more specific outline of work and alignment with AHSN programme Rationale: Fits well with Innovation and Innovation Scouts programme

TB declared an interest in this project. Q&A from Members Q: (TW) Expressed concern regarding lack of match funding. A: (LM) Agreed – for this point to be noted. Q: (UC): This raises questions about the sustainability of the project. A: (LM) Agreed, nothing in application regarding ongoing funding. Comment: (TB) Benefits Realisation would be carried out as part the project to inform the way forward. Comment: (GBT) The AHSN does monitor the projects that we put resource into, and agreed, this is an important point of how to ensure sustainability. Action: NWC AHSN to take further into consideration issue of match funding and ensuring sustainability Sefton Council, Well North and Integro Healthcare Solutions A pilot project to run in Sefton initially, then Oldham and Doncaster - development of a digital tool based on the Semitae solution a framework technology for assessment and multi-agency support for troubled families already proven in Stockport using key workers. Rather than this model Well North works with whole communities to support them to find solutions to problems based on their own community and personal assets. ‘Predict’ will enable mobile assessments and identification of needs to engage with resources and support services to deliver social prescribing. Proposed to fund £88,000 Rationale: A North West Company, opportunity for AHSNs to collaborate in a multisite project with a public health focus. There has been a match in technology equipment contributed at no cost. Q&A from Members Q: (AW) How would this drive economic growth? Important to link into economy. A: (LM) Utilising a NW company and with the project having a public health benefit. A: (LG) The element of linking into industry providers is part of this project. Clatterbridge Cancer Centre (2 bids) Clatterbridge in the Community – implementation of Cancer Treatment at Home Service. Proposed to fund £25,000 - subject to further detail and commissioner support. NWC Genomic Medicine Centre - Leadership and project support for 100,000 Genomes

project. (3 P/T Consultants and 1 Project Manager) Proposed to fund: Approach CLAHRC and/or other Trusts to match 50%, NWC AHSN to provide 25% out of this call (£59,703) and 25% next year (£119.4k in total). Rationale: To support development of the region’s genomic centre, particularly given the recent success of winning the 100,00 Genomes Project bid.

Q&A from Members Comment: (AK) This is a building block in support of a very important project and if retrospective funding is not received further down the line, we will ask for return of investment. AK recognised that match funding would need to be provided by RLBUHT.

LG

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Comment: (GBT) The 100,000 genomes bid was successful largely due to its partnership working; we now need to support this to help the project get off the ground Q: (JC) Asked for more details to be provided about the project, acknowledging this is about delivery. Q: A question was asked about the scoring, whether there was a variance in weighting across the different criteria? A: (LG) Confirmed no weighting across different criteria. Clarified that this bid scored lower as less potential for growth but still considered an important project due to the focus on personalised medicines by the AHSN and LCR. Q: A question was asked over whether there might be scope for CLAHRC to undertaken evaluation?

East Lancs Teaching Hospital Roll out of the easySHARE Glucose Monitoring tele-health system across East Lancs. Access to computer or telephone line, literacy in English, or IT literacy, not required. Patients receive reminder texts and treatment advice can be given by telephone, text or email. Proposed to fund £35,000 - subject to securing equal match by GMAHSN or CCG and detailed breakdown of use of funds. Rationale: Although East Lancs Teaching hospital sits in Manchester footprint, roll out of telehealth system would be across patch CCGs. Fits with digital workstream. Q&A from Members None University of Cumbria Application to fund a second phase development of the Cumbria Rural Health Forum established to address rural health and social care issues – activities include think tank, website improvements, quarterly forums, patient groups, SME engagement, conference, briefing papers and presentations/network events. Proposed to fund £15,000 - subject to securing equal match with NE and NC AHSN and more detailed costings and match from university. Rationale: A good match with our remit. Q&A from Members None LG advised the Board at this point that the 10 bids proposed to support so far, amounted in total to an overall investment of £900K. 3.4 PROPOSED FOR PSC FUNDING Liverpool Health Partners Building on the Acting for Patient Safety Francis educational package, funding is sought to further develop and disseminate more widely through improved IT infrastructure and evaluation to deliver a robust learning package that could be utilised across the NHS. Proposed to fund £38,854 - subject to the AHSN’s Assistant Director for Patient Safety becoming involved in the project. Rationale: Links closely with patient safety.

RW declared an interest in this project.

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Q&A from Members Comment: (TB) Correlates with work of Patient Safety Collaborative Lancashire Care NHS Foundation Trust Funding sought to pump-prime a crowd sourcing campaign to establish a Community Interest Company that will provide an agile platform to create and service the demand for Adverse Childhood Events (ACE) and ROUTINE Enquiry into Adversity in Childhood (REACh). Driving improvements in education, identification, response, evidence based interventions and scalability to achieve a sustainable change in practice.

HT-M declared an interest in this project. Proposed to fund £50,000 as a cornerstone of the fund Rationale: Clear link with patient safety Q&A from Members Comment: It was suggested more clarity was needed to ensure that this money is used for a cornerstone fund not for arranging crowd sourcing. Comment: (HT-M) One of the benefits of the REACh approach is that it can potentially work across all ages and encourage routine enquiry. Action: NWC AHSN to seek clarity on intended use of any funds allocated Cumbria CCG Implementing the Strata e-referral and resource matching software to address patient flow problems in South Cumbria and North Lancashire, with the aim of co-ordinating patient transitions between health and care organisations working across North Lancashire, a number of which have indicated their support.

HT-M declared an interest through Better Care Together Proposed to fund £115,000 Rationale: Links closely with patient safety Q&A from Members Q: This has already been running for 2 years, and questions were raised about sustainability. A: (HT-M) Planning stage with pathway design has been completed, the project is moving into the implementation stage. 3.5 PROPOSED FOR CORE FUNDING FROM NWC AHSN PROGRAMMES

North West Procurement Development Agency (NWPDA) Service level agreement with NWPDA to support procurement activities of the AHSN both locally and nationally and to sponsor the Excellence in Supplier Awards 2015. Proposed to fund £40,000 – from NWC AHSN Core Procurement Programme

Rationale: Fits well with core AHSN programme Q&A from Members None East Lancashire CCG Extension of Atrial Fibrillation detection pilot from 1 GP practice to 5 GPs, and 16 residential

Exec Team

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and care homes. CCG will fund clinical service costs and devices and AHSN funding used to pay UCLAN to carry out an evaluation and resource dissemination activities.

UC declared an interest in this project.

Proposed to fund £28,701 Rationale: Fits well with core AHSN programme on Stroke/AF and Neurological conditions Q&A from Members None 3.6 PROPOSED CORE PROGRAMMES WITHOUT FUNDING

LG outlined the following 3 bids, all strong bids, proposed to be taken forward as part of NWC AHSN core programmes, without any dedicated funding awarded from these infrastructure funds.

University of Lancaster Cross-sectoral innovation platform to nurture a shared innovation culture across NHS, LAs, businesses, service users, voluntary sector and academia. Proposed: Explore opportunities to collaborate with the Business School. Rationale: Strong link to NWC AHSN Innovation Scouts programme. Q&A from Members None

Cheshire and Wirral Partnership SME/Residential care plan - a project to deliver technological solutions to support and monitor physical and mental health needs in W Cheshire care homes. Proposed: No funding support at this stage - integrate into NWC AHSN Care Home programme planned for 15/16. Rationale: Similar activities started in Liverpool with eHealth cluster, CCG and Service providers - many elements could be shared. Q&A from Members None Blackpool Teaching Hospitals NHS Foundation Trust (in conjunction with Blackpool CCG and Fylde & Wyre CCG) Tele-health solution for dysphagia assessment and management. Proposed: No funding support at this stage - integrate into NWC AHSN Care Home programme planned for 15/16. Rationale: Strong fit with Care Home programme. Q&A from Members None 3.7 PROPOSED FOR REGIONAL REVIEW LG outlined 8 further applications around digital infrastructure in Lancashire and Cumbria, seeking a total of £2m, proposed to be taken forward for regional review:

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Chorley Public Service Reform Board - Digital solutions for patients at home University of Cumbria - Adopting digital health innovations at scale Cumbria Partnership - Better Care Together IT support Lancs Teaching Hospital - Integrated healthcare archiving platform University of Lancaster - Lancashire and South Cumbria Digital Health Network Lancs North CCG - IT infrastructure co-ordinated NWSIS - Regional App Store NWSIS - Clinical Mobility project Proposal for all: No funding – to be discussed and coordinated by Lancashire Digital Board Rationale for all: Scale and scope of projects too large for NWC AHSN, needs to be considered as part of a regional review and approach. This would not prevent AHSN support in the future if appropriate. Q&A from Members None. Overall consensus for this approach. 3.8 PROPOSED DECLINES LG proposed the following 12 applications, amounting a total of £2.63m, to be declined. There were no Q&As for this section. Wirral Hospital / Wirral Health & Social care - Digital records /Cerner ACO model Rationale: £500k requested and solely Wirral focused. Offer support for bid writing and targeting other funding streams. Clatterbridge Cancer Centre - Research Practitioner and Clinical Trials Assistant Rationale: Research project – suggest submission to CLAHRC Sefton MBC - Better off Working Rationale: Potential linkages between Sefton, South Ribble and Warrington projects, (£800k across the two). Offer support with identifying alternative funding and bid writing Warrington Council - Getting us ready for work and Getting work ready for us Rationale: Potential linkages between Sefton, South Ribble and Warrington projects, (£800k across the two). Offer support with identifying alternative funding and bid writing LHP - Industry Gateway Office Steering Group Rationale: AHSN to work with CRN to assess options for region wide approach, as per national instruction. Cumbria Partnership NHS Foundation Trust - Recruitment across Cumbria - a scheme to attract skilled workers to the region Rationale: Offer to support and drive collaborative approach with partners and industry - consider financial support once more certainty of match

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St Helens & Knowsley NHS Trust - Diabetes Cloud Rationale: This is not a novel concept and has been developed elsewhere. Agreed to introduce Map My Health, who work in this field. Majority of funding is for clinical staff. Not infrastructure or growth. Countess of Chester NHS Foundation Trust - Innovation Hub Rationale: Recently received funding, keep abreast of developments Walton Centre NHS Foundation Trust - Digital Ward Rationale: Trust specific Walton Centre NHS Foundation Trust Tele-neurology service Rationale: Trust specific LJMU - Research project /website one stop shop for asylum seekers and refugees Rationale: Too research focused, no sustainability of the approach suggested. Cheshire East Council - Alderley BioHub Rationale: Out of region

3.9 Motion to support Investment Proposals The Chair asked colleagues for their support of the investments proposed and invited comments on the extent of innovation, spread and potential in the proposals put forward. AL commented that he was satisfied that the bids had been scrutinised by the Finance Board and this Board. A question was asked whether those organisations/collaboratives that had submitted bids subsequently declined would be given constructive feedback on why their bids had been unsuccessful. LG confirmed this would be the case and would extend the original feedback deadline to accommodate this. AK enquired if the Board would see the scoring matrix. It was agreed to re-circulate the board presentation. A question was asked of the Chair whether GBT was happy with the range and spread of proposals. GBT confirmed he was indeed satisfied and felt there was a good range of small and large projects, of sufficient quality and interest across all sectors. BA concurred with GBT, noting that some of the smaller bids had potential to scale up and be therefore more successful. In addition, BA noted one third to one half of the bids had industry involvement with some contributing more resource, which was very welcome. HTM said she was very happy to support the recommendations and noted it was a real opportunity for learning, not just from this year’s bids but last year’s also. HTM enquired when would funds be issued. LM/LG gave assurances that funds would be forthcoming by end of this financial year. HL commented that only 1 successful bid was related to a Medicines project. LG responded that only 1 Medicines bid had been received and this had been funded. BR asked the Chair whether the NWC AHSN had sufficient resources to monitor both last year’s and this year’s funded projects? LM replied that the NWC AHSN had reported funding

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projects to the board on a quarterly basis and would establish a monitoring committee due to the amount of projects received. GBT added that a number of successful funding bids from 14/15 were celebrated at the NWC AHSN Celebration Event held December 11th, 2014. Action: NWC AHSN to review processes and agree how to incorporate learning captured from previous and ongoing funded projects and on feedback to the Board Action: PPT Summary of bids and scoring criteria to be circulated to the Board members along with minutes Members were asked to formally approve the investments proposed. The motion was passed unanimously, subject to the agreed actions being taken.

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SH/LG

4. Consultation on NWC AHSN Business Plan for 2015-16 It had been intended that table top discussions would take place at this point to allow Board members to debate and make recommendations towards the NWC AHSN proposed Business Plan. However, due to time constraints, LM presented to members the proposals in her report and asked members to discuss and feedback as a collective group. LM outlined the Business Plan format, highlighting 6 barriers to driving Innovation, Health and Wealth and explained that the Business Plan for 15/16 sought to address these challenges. LM asked members to consider each section and put forward any omissions or additions needed: 4.1 Clinical Priorities HT-M noted that there was a Mental Health component associated with all of the priorities named and suggested it should be made more explicit. It was suggested that the term Care Homes needed clarifying - LM responded this was a CQC-recognised term. A further comment on Care Homes was made, stating Care Homes was technically a subset of Frail Elderly. It was noted a large component of dementia care was inherent in the Clinical Priorities workstreams. JR commented that it was an exciting programme with the right amount of innovation present, but asked how did the Board’s decision align with its work on tackling health inequalities across the patch? LM replied that when the detail was being planned, this would be taken into account. LM outlined how the Clinical Priorities had been derived from consultation/ working with partners across the patch. A comment was made on the health and social issue of liver disease and alcohol abuse. BR asked whether there was any emphasis on prevention or early detection of disease. LM replied these were elements within the Patient Safety programme.

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4.2 Cross-Cutting Workstreams KW commented that there was a need to ensure that cross- cutting workstreams did not suffer from a lack of focus and reiterated that Mental Health sat with Clinical Priorities. 4.3 Active Collaborations It was suggested a link to other AHSNs was absent and needing inclusion. KW queried working with East Lancs Hospital Trust, as technically not within the NWC AHSN footprint. Action: LM to follow up HL noted only one Pharmaceutical company was mentioned. LM replied it was not an exclusive list but accepted this point. Similarly, listing of named Research Charities – members felt it was important to use a term that was all-inclusive. 4.4 Engagement Activities LM proposed that the NWC AHSN would in future not hold formal quarterly stakeholder events in future, due to the large number of events and network meetings that were planned. RW asked for the celebration event planned for the CRN and CLAHRC could be extended to other research bodies. LM advised the Board that the first draft of the Business Plan would be available by the middle of the following week for NHS England and would be ready for final approval by April’s Board meeting.

LM

5. Any Other Business None raised. The Chair thanked everyone for their attendance and contribution and closed the meeting.

Date of Next Meeting Wednesday, April 22nd, 2015 2pm to 4pm. Vanguard House, NWC AHSN Boardroom.