Luton CCG Board Patient Safety and Quality Committee Minutes

Transcription

1 Agenda Item 15g Luton CCG Board Patient Safety and Quality Committee Minutes Wednesday 29 October 2014, 10am to 12.30pm Meeting Room 1, The Lodge, 4 George Street West, Luton, LU1 2BJ Name Role (LCCG unless otherwise stated) Initials Present Apols David Foord Chair - Director of Quality and Clinical Governance Monica Alabi Assistant Clinical Chair MA Carol Hill Chief Officer CH Sarita Jain Lay Member SJ Kelly O Neill Assistant Director of Public Health KO Dr Anitha Prabhu Bolanthur GP APB Nicky Poulain Director of Commissioning and Integration NP Kamini Patel Quality Facilitator KP Karen Radley Quality Manager KR Clare Saunders Deputy Director of Nursing CS Kerrie Ward Head of Adult Safeguarding and Designated Nurse KW Alison Franklin Infection Prevention and Control Nurse AF Tess Dawoud Assistant Head of Medicines Optimisation TD Sandra Watts PA to the Director of Quality and Clinical SW Governance Part Attendance Item Comment Action 1. Apologies and Declarations of Conflict of Interest Apologies were received and noted from Alison Franklin (AF), Kelly O Neill (KO N). Kamaljit Bhangal (KB), Mark Morton (MM) and Adrian Cullen (AC) There were was one declaration of interest from APB as a GP in Luton and no conflicts of interest. 2. Minutes and Matters Arising not within Action Log The minutes from the last meeting held on Wednesday 24 September 2014 were reviewed and agreed as a true and accurate record. 3. Action Log Review All proposed updates to the actions were agreed and any other changes 1

2 to be added to the log to be sent out with the minutes. 4. Documents Received Urgent and Emergency Care review. KR to send a copy to Lisa Durant, Adrian Cullen and Mark Morton. Mental Capacity Act. KW to send KR Final Care Act Guidance Report. KR KW 5. CQUIN KP went through the development ideas around CQUIN, which included L&D Sepsis, Maternity Safety Thermometer and within that Mental Health. The committee agreed that KP/KR should speak with Nirali Patel with regards to information sharing about what quality of data is shared. KR/KP APB raised that within the Cluster, there is a Consultant (DME) who has direct access to all the GPs the pilot has been working well, but it was noted that so far Luton has not a hard Winter and therefore the need for the service has not been fully utilised. The next L&D CQUIN Development meeting is taking place Thurs 6 November. Next step meetings have been scheduled with L&D and Mental Health Community Providers. Meetings with Virgin (new Intermediate Care Provider) will be taking place separately. KP informed the Committee that all Service Specifications needs are being looked at before being shared with the new Providers. Tess to liaise with Karen and Kamini around these. KR/KP/TD 6. Procurement Update informed the Committee that the Due Diligence process with EFT and Virgin has started The announcement of the new Community Services Provider should be announced on Monday. Safeguarding Boards have requested updates on how far the process has got and what Providers have secured the contracts. There are some issues around Private Sector employment within Virgin, which is being looked into. 2

3 Keep risks to be brought to November meeting. Sally Morris (SEPT) informed that at present SEPT are not recruiting to any new Consultant and are filling these posts with Interim staff. to flag to East London Foundations Trust (ELFT) that there may be an issue when they take over the contract around recruitment. 7. Risk Register informed the Committee that there were two changes within the CSU Capacity Item closed Quality Impact Assessment stays open SJ asked what the risks are? explained that there risk is we don t effectively take on quality impact assessment, which are not featured as a core part of the training for LCCG. The solution is for Rod and to work on a joined business case around this Colposcopy SJ, raised whether there was adequate supervision for the said Consultant? confirmed that all procedures are being supervised and is comfortable that there are no immediate risks to patients. APB asked as commissioners are we convinced patients are safe with this consultant. not 100% convinced, but has been continuously assured by the L&D that consultant is being supervised. to send draft letter to CH for her meeting with Pauline. Carol Hill left meeting 8. Governance and Strategy 8.1 Performance and Quality Report stated there have been challenges receiving the report. There are a number of areas whereby Providers are not performing to a standard of quality and Contract Queries are not being raised. CS Friends and Family, CQUIN. Response rate and score L&D seem to have taken their foot of pedal, things are worse than last year. New Head of Maternity due to start. Will be discussed at next Quarterly Quality Meeting. CS KR Mixed Sex Accommodation Breach. CS and KR have both 3

4 identified breaches EAU & Theatre. These have been raised but not reported. Pat Reid said she would investigate, but nothing received. SJ asked how the breach is classed CS explained the process which includes where bays and toilet facilities are located. to speak to Nirali Patel to confirm who will be attending and presenting the report in the future. 9. Provider Quality 9.1 Quality and Safeguarding Site Visits KW informed the Committee that site visits were ongoing. KR is focuses on Nursing Homes and KR & CS on Hospital. received a letter Pauline Phillips from L&D who stated that they were under considerable pressure regarding beds occupancy. High number of patients medically fit for discharge. & CS visited last Friday and there were concerns around staffing issues. Out of Hours are under Care UK. KR has also visited the Urgent GP Clinic. APB asked if Paul Lindars reports to the PSQC stated he does but his report does not relate to site visits. TD reported on Flu vaccination. Practice GPs, guidance have been issued. said that if there are any issues, these need to be taken to Paul Lindars. 9.2 NHS England Area Team Quality Surveillance Group Report requested that any specific issues to be reported be sent to him. ALL 9.3 CCS Quality Report 9.4 SEPT Quality Report It was agreed by the Committee for the report to be received in November. KR 9.5 Nursing Home Exception Reporting Serious Concerns and Suspensions KW raised issues around Patients being discharged to a different GP than the one they had before they were admitted into Hospital. She feels this is a safeguarding concern. KW to discuss with. KW Four Care Homes, which are not commissioned by LCCG, are being put on Provider Performance. informed the Committee that the Area Team had raised concerns 4

5 about the medicines service into Nursing Homes from Boots Pharmacy Service Update 9.7 CQC Quality Summit - CCS All actions which are being taken forward on the Contract Monitoring Performance. 10. Patient Safety 10.1 LSCB Annual Report 10.2 Safeguarding Children and Adults Exception Reports KW explained that the highest figures for Child Exploitation are between yr. old. There is a new safeguarding lead for SEPT for Adults. Final Care Act Guidance was published 23 October and comes into effect April KW gave an overview of the content of the Act. Linked attached for information: TD explained that within the Care Plan, PALS do assessments to ask patients why they cannot collect their medication. KW working with Health Watch and GPs around medication for the elderly. to give Pam Garraway information to KW. Training with Children and Adults ongoing. MCA funding has been received from NHS England. DOLS (Depravation of Liberty Safeguards) in Luton have gone up dramatically. KW and to meet to discuss how to utilise the funding. Child Exploitation and FGM (Female Genital Mutilation): The Committee received the report and noted its content. ME working closely with Local Authority and Police to look at information sharing with other Agencies. ME is also working on a pathway. OFSTED have been into CSC to inspect pathways in Luton 5

6 specifically to look at demographic reviews. has received from Sally Rowe a draft report which he will share at the next meeting. SJ raised 2.1 Development Activity. She stated that there is concerns UK wide with issues around taxi drivers. Networking how information is being spread. CS said that the LSCB are aware of this. said that the 3 Safeguarding Children s Board have been asked to look at this. SJ to pass informed regarding the FGM Conference on 2 December to ME. SW to close action on Action Log. SJ SW 10.3 Infection Prevention & Control Exception Report L&D zero cases up to September where after there was 1 case reported. CS stated that this information comes from national data. asked is data can be trusted? CS said the only way it could be falsified was if a patient shows any symptoms, then L&D would have to not test as once tested then information is logged. KR Ebola. 3 suspected cases turned out to be malaria. At Maternity Quality meeting Helen Lucas raised concerns regarding labouring women and the risk. Action: KR/CS to asked AF to go and speak to them about the risk. KR raised the issue Surgical Site Infection. AF to do feedback at next meeting. APB asked if there was training for GP on Ebola Outbreak. CS said Department of Health have sent round a lot of information around. stated any training would be sent from the Area Team. to communicate with Paul Lindars regarding GPs not receiving any training. KR AF 10.4 Mortality Quarterly Report KR explained that the report was not complete due to data collation from the L&D (see Action Log). 11. Patient Experience 11.1 Patient Experience/Stories Quarterly Report KR informed the Committee that due to YouTube being blocked they were unable to show the planned patient story. This paper is about one of the patient stories at an event. Tommy Whitelaw has a number of patient stories about dementia. See link below: 6

7 2011.blogspot.co.uk/ It was agreed to leave this a standing item and move to Core Business after Documents Received. SW 11.2 Geographical Data for Complaints explained to the Committee that he had received an from Iain Gear to which he stated that during 13/14 Diane Sollars did use Datix to record complaints & PALs, but the license for this came to an end in February and it was decided not to renew. They then started using a spread sheet, but there are only 3 contacts on there from March. Iain attempted to get data extracted from Datix, but ended up going round in circles trying to find out which IT department was responsible and what server any information may have been on and were unable to get anywhere. Iain did state however, all the information related to those complaints and PALs contact were also stored in paper form, which had been passed to Lynda Harris in Information Governance. to raise this with Rod While Cancer Patient Experience KP reported that the L&D have done ok in this area and there is no need for concern. as if Dr Anthea Robinson had she seen the paper? KP to share the paper with her. KP 12 Clinical Effectiveness 12.1 Medicines Optimisation Six Monthly Report TD stated that this report summarises the quality and safety of core business. The treatment of Rheumatoid arthritis includes using methotrexate. The L and D hospital use tablets first, but often increase and convert to injection which is given subcutaneously. Recent shared care guidelines have been approved with the GP taking over responsibility for prescribing and monitoring the s/c methotrexate injections. When patients were treated by the hospital, the hospital took the returned sharps containers from patients. There is currently no clear mechanism to this this in the community. The Meds opt team are in conversations with the council and NHS England on how we can manage this. However, there is a risk that is on the risk register, relating to this as currently the hospital is continuing to see these patients and not transferring care to the GP. 7

8 13. AOB KR reported that Bowel Scoping, screening for Bowel Cancer. Flexible Sigmoidoscopy from 1 st November Beds and Luton. KR the turnaround for reports is less than a week as the next meeting is in 3 weeks, therefore all concerned needed to be aware. 8