1. Organisational - Agenda setting Need to influence the agenda setting - request items to be included Driven by sub group activities (minutes) Clear ground rules about who can request agenda items, with equity for all members. Balance to papers, who has been involved in preparing the information for the paper Each paper to enclose a summary (one sheet)

2. Organisational - Agenda setting (Cont) A fair order of presentations, with time for consideration Open dead line for the agenda Items for information only to be sent throughout the month, rather than sent in one bulk issue Have confidence to challenge

3. Organisational - Performance management Inform others about the Performance Management role of PCTs - National targets Lack of true devolved control over LDPs due to overspends of other PCTs within SHA - lack of PCT financial autonomy Individual performance management of all PEC members from the Chair PEC member job description with clear lines of responsibilities

4. Organisational - Tensions All sub groups should have terms of reference and a agreed life time. Clarity of process between the management team MT and PEC members Everyone to have clear roles and responsibilities that are understood by all PEC to ratify decision and management to implement them. Adopt a partnership approach - PEC & TM

5. Communication - Across Boundaries PCT to PCT Primary to Secondary Inter disciplinary and Interagency Partnership working at all levels –Patients/public/carers. We go to them. Development of Partnership boards Co-terminus organisations

6. Communication - Across Boundaries (Cont) Joint working groups - linked to NSF Joint Nursing Committee PEC nurse/AHP across PCOs network Protected learning time to network Effective and trusting relationships Understanding different cultures, values and perceptions

7. Communication - Effective Systems Team Briefing, staff meetings, Nurses Forums/AHP Forums Stakeholder days Clinical Strategy groups PEC members involvement in outside organisations – working groups, acute care, multi-agency Political Ward Forums E-mail, news letters,

8. Communication - Relevant Process Terms of reference for all groups Communication manager E-mail and Intranet

9. Capacity -Vision All PCTs should have one Must be grounded in reality Must be clear about what can be achieved Must fit the demography and epidemiology Must be consumer and service led.

10. Capacity - Time management and delegation Capacity v Demand - analysis after mapping exercise, Redesign services and roles Prioritise workload - What are you trying to achieve? Looking to delegate appropriately Leading does not mean doing - Say No Trust Dedicated time and Creative backfill Lap top /portable computer

11. Capacity - Appropriate use of resources Administration support Dedicated secretary for PEC members Avoid duplication of roles/areas of work Acute services over spending - more joint posts and developments to avoid this IT equipment

12. Capacity - Physical Work from home Use other agencies/organisations spare capacity –schools, churches, Local Authority Shared desks Review current space usage

13. Personal - Role clarity Job description Personal review/appraisal from the Chair Supervision, Mentoring, Shadowing and Networking Meeting with Directors (Primary Care/ Nursing /Operations Secretarial support

14. Personal - Learning needs Induction Mentorship Culture and political awareness Management training Personal development plans Clinical skills updating

15. Personal - Accountability and management Strengthen links with DoN and DPC Meeting with line manager re PEC activities Contact with staff groups for service information and patient care Feed back to staff groups