Shetland NHS Board Board Headquarters

Upper Floor Montfield Burgh Road LERWICK Shetland ZE1 0LA

Telephone 01595 743060 www.shb.scot.nhs.uk

Shetland NHS Board Members

Date 7 July 2020 Our Ref Brd/ag8/20

Enquiries to Carolyn Hand Extension 3064 Direct Line 01595 743064 E-mail carolyn.hand@nhs.net

Dear Member

There will be a meeting of Shetland NHS Board on Friday 10th July 2020 at 2.00pm. To access this please click on “Join Teams Meeting” within your calendar invite for this meeting.

Yours sincerely

Carolyn Hand Corporate Services Manager

AGENDA

1. Apologies for Absence

2. Declaration of Interests

3. Action Minute Tracker from 26th June 2020 (attached)

4. COVID-19 Pandemic Briefing (Paper 20/21/16 attached)

5. AOB

6. Date of next formal meeting: Tuesday 18th August 2020 at 9.30am

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NHS Shetland Board COVID-19 Pandemic Action Minutes Action (A) / Information (I) / Decision (D)

26/06/20 2pm via Microsoft Teams

Attendees: Gary Robinson (Chair), Malcolm Bell, Colin Campbell, Lincoln Carroll, Natasha Cornick, Michael Dickson, Jane Haswell, Colin Marsland, Ian Sandilands. Apologies: Shona Manson and Edna Mary Watson. Mr Dickson represents all Executive and Stakeholder Board Members during the pandemic period who are not in attendance. Declaration of Interests: None

Action tracker (actions removed once they have been reported as completed)

Date / paper ref

Action Action Owner

Date closed

Comment

No.6 15/05/20

Internal auditors to be approached regarding conducting online training for NEDs.

LC ongoing Initial offer from auditors to conduct training in early June. Further discussion to be had by NEDs on what training requirements are.

Non Executive Board Member appraisals to be concluded and training plan created.

GR/LH

26/06/20 20_21_14

Media to be invited to public Board session in August.

CH/PM

Agenda / paper ref

A/I/D Discussion/Rationale Action Owner

Date closed

No. 4. (20/21/12)

I COVID-19 Pandemic Briefing

Mr Dickson provided an update on the current position. Of particular note:

The single care home outbreak in Shetland had now been declared over.

The social care portal was now live.

Whilst the position remained positive in terms of no new cases it was important to remain cautious and promote the usual messages about staying home as much as possible, good cough and hand hygiene and staying 2 metres apart.

The Scottish Government was working on distinct advice for Boards once tourism reopened on 15 July

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(for example how a Board would cope with a tourist who became unwell).

Mr Sandilands asked if there was any proposal for Northlink and Loganair to carry out temperature testing for visitors. Mr Dickson replied that it might reassure people but it was not that likely to pick up positive COVID-19 cases. Mr Robinson asked if there was any indication that the Scottish Government was looking at other islands and how they had successfully reopened. Mr Dickson was confident of this and said there was also local latitude, for example the face covering ask in local care settings had gone one step further in Shetland than elsewhere and asked for fluid resistant surgical masks rather than just face coverings. Mr Bell felt the ‘stay at home as much as possible’ key message on the second page of the report was not quite in harmony with the direction of travel with lockdown restrictions easing. Mr Dickson said the biggest risk was coming into contact with people, even at Stage 4 of the route map out of lockdown. Mr Dickson said Northlink had been extremely good in finding the best way to transfer shielding patients. An all island group was being pulled together so patients could get the best service wherever they were transferring from. Mr Sandilands felt this was important, particularly for those that needed to go further than Aberdeen, for example the Golden Jubilee National Hospital.

No. 5. (20/21/13)

I COVID-19 Safe Workspace Mr Dickson outlined the stages of the safe workspace discussion paper. It was clear at Stage 3 of the plan in the light of COVID-19 that hot desking could not happen so a blended working model between home and agreed shifts in the office environment would lead to desks sitting empty between times. It was expected that virtual rather than face to face meetings would continue, at least until 2021. Clearly a vaccine could change matters. The final stage of the paper outlined an office situation where it was more possible to drive the estate and sweat the asset with people not necessarily tied to a particular base – it was recognised this may not be truly possible until a new hospital was built. Mr Bell and Mr Campbell expressed their desire to return to face to face meetings when it was possible, and felt the virtual platform did not convey body language, or allow a quick follow up with colleagues. Mr Campbell continued that if staff became permanent home workers this might lead to a change in the substance of their contract. Mr

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Dickson agreed there was always benefit in some face to face contact and some areas such as interactive training were more of a challenge to deliver virtually, but whilst COVID-19 remained in circulation this was the organisation’s position. Mrs Hand advised there had been 110 responses to the home working survey put out in late May to early June with approximately 75 people working at home, and more working flexibly.

In response to a query from Mr Carroll about visiting services, Mr Dickson said NHS Shetland was very much tied to NHS Grampian regarding recovery plans and the latter’s remobilisation seemed to be moving a little slower. A number of patient pathways were under review. On the positive side the Near Me platform had become much more widely accepted through the pandemic and this was beneficial to patients if it could spare them a journey, and also in financial savings for the Board. Mrs Haswell felt the virtual platforms supported locality working and agreed a blended working arrangement was key but with the default more to using technology wherever possible.

No. 6. (20_21_14)

I General Governance Update

Initial Draft Governance Map

Mr Dickson said this draft proposal was very much a first cut, and felt it had been a really useful exercise thus far. The diagram was not hierarchical but tried to illustrate the purpose of governance meetings under three key functional headings of quality, finance and sustainability and people and workforce. The next step was an operational discussion with EMT about the proposed map and the meetings that fed into these areas with the hope of streamlining as much as possible. Mrs Haswell felt the functions made it very focussed and clear, but the one area with cause for question was in regard to an integrated governance committee. Mr Dickson said staff were talking to internal and external auditors about the proposals, but what he wanted to achieve was to be able to provide assurance about the elements of integrated services that the Board was responsible for given the difficulties faced in the existing joint clinical and care governance committee. He felt the IJB should be seeking assurance that their directions were being delivered against, and this should come from NHS Shetland through an integrated governance committee and also through Shetland Island Council’s Policy and Resources Committee.

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Board members were generally in agreement with the direction of travel and liked the clear demarcation between doing and running the business. In response to a query, Mr Dickson said there would be no management restructure resulting from this exercise unless it became extremely obvious that a change needed to be made. The wish was to empower directorates and teams to make the changes they needed to make to move towards sustainable delivery. As the Board was aware, savings were becoming ever more difficult given the amount delivered in recent years, and once there was confidence the system was as efficient as it could be, the discussion could be had with the Scottish Government about what the cost envelope was against the funding arrangements. In response to Mr Campbell’s query about whether there needed to be an informal finance meeting in the governance map, Mr Robinson said it was his intention to have an informal meeting with the non-executive directors each Board cycle and there might be other areas that would benefit from less formal discussions also. In addition there would be a private meeting ahead of each public meeting once the governance arrangements reverted. Mr Sandilands commented that it was important individuals would be held to account in performance terms, and said there had been discussion at APF about there being 37 Band 8 managers in the organisation.

(20_21_15) D Temporary Revised Governance Arrangements

General EMT remained focussed on complex remobilisation

plans but had agreed August might be a suitable timescale for returning to a more typical Board business meeting. It was agreed to have one more agile Board meeting in July and then have a month’s break before reverting to the usual Business Programme that had been previously agreed.

The Board agreed the minor changes to the Temporary Revised Governance Arrangements document which Mrs Hand explained allowed more flexibility for standing committees to stand up again in the meantime should they wish to.

It was confirmed the media would be invited to the public session of the August Board Meeting, and that the sessions would be separate diary invites.

Mr Campbell asked that the performance indicators included some narrative for areas that were worse or declining.

CH/PM

Date of next meeting The last agile Board meeting will take place on Friday 10th July at 2.00pm

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Board Paper 20/21/16

COVID-19 Response

Board Briefing Date: 7th July 2020

Overview Coronavirus (COVID-19) is the illness caused by a new strain of coronavirus first identified in Wuhan city, China. It

can cause a cough and/or a fever/high temperature. Generally, coronavirus can cause more severe symptoms in

people with weakened immune systems, older people and those with long term conditions like diabetes, cancer

and chronic lung disease.

As at 7th July 2020, there remain 54 positive cases of COVID-19 in Shetland. One additional person tested positive

via a private test; this does not appear in our figures as it came through a non-NHS route.

Epidemiology Scotland

18,302 confirmed cases out 283,504 tested. 265,202 were confirmed negative

2,489 patients who tested positive have died

The chart above shows that although the rate of positive cases has reduced significantly, it has not yet stopped.

Shetland

54 confirmed cases out of 1264 tests undertaken.

7 deaths

31 women, 23 men

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Key messages We cannot say with certainty that COVID-19 has ‘gone away’ and that we won’t have future cases in Shetland,

particularly as travel, transport and workplaces open up. As we move into Phase Two, it remains essential that

physical distancing guidance continues to be adhered to, and that good hand and respiratory hygiene practices

continue to be followed.

The default position remains that in order to stay safe and protect others, we should:

stay at home as much as possible

only go outside for limited purposes

stay 2 metres (6 feet) away from other people

wash our hands regularly and as soon as we get home

wear a face covering on public transport and enclosed public spaces

self-isolate if we have symptoms and book a test.

As noted previously, the Contact Tracing Team in Shetland remains in place and ready to be deployed if we do

have any more positive cases.

Elizabeth Robinson

Public Health and Planning Principal

NHS Shetland