Issues of Significance and Approved Minutes of the Healthcare Professionals Forum meeting held on 9 November 2012

Transcription

1 Betsi Cadwaladr University Health Board Board Paper Item 13/ Subject: Summary or Issues of Significance Issues of Significance and Approved Minutes of the Healthcare Professionals Forum meeting held on 9 November 2012 Issues of significance discussed at the meeting on 9 November 2012 were as follows: Membership of HPF Dr Andy Fowell and Dr Berwyn Owen stood down as Chair/Vice Chair respectively. Election of Chair and Vice Chair to be co-ordinated in advance of HPF meeting on 11 January The Terms of Reference (as amended following discussion at HPF on 14 September 2012) were ratified. A progress report on Healthcare in North Wales is Changing was received. Strategic Theme / Priority / Values addressed by this paper Legislation or Healthcare Standard: Making it sound / making it happen Healthcare Standards 1, 24 and 27 Evidence base or other relevant information to inform decision (e.g risks) Consultation with others: Equality Impact Assessment (EqIA) Healthcare Professionals Forum members N/A Recommendations: The Board is requested to note the draft minutes of the HPF meeting held on 9 November 2012 Author(s) Presented by Llinos Roberts, Corporate Services Manager (Interim) Dr Berwyn Owen (Chair) Date of report 14 January 2013

2 Date of meeting BCUHB Coversheet v0.1 Disclosure: Betsi Cadwaladr University Health Board is the operational name of Betsi Cadwaladr University Local Health Board

3 Present: Healthcare Professionals Forum (HPF) Minutes of the meeting held on 09 November 2012 in the Boardroom, Llandudno Hospital Dr Berwyn Owen (BO) Ms Lorna Burdge (LB) Ms Joanne Kember (JK) Dr Eamonn Jessup (EJ) Mrs Janette Hamilton (JH) HPF Vice Chair / Hospital Pharmacy representative (Chair of meeting) Community Nursing and Midwifery representative Community Pharmacy representative Primary and Community Care Medical representative Hospital Nursing and Midwifery representative. In Attendance Mrs Barbara Jackson (BAJ) Mrs Grace Lewis Parry (GLP) Assistant Director Corporate Affairs Director Governance and Communication Apologies Dr Andy Fowell Mr Iain Mitchell Mr John Day Dr Sandra Sandham Mr Andrew Jones Mr Mark Scriven Mrs Llinos Roberts Chair HPF / Specialist and Tertiary Care medical representative Therapies Advisory representative Scientific Advisory representative Dental Committee representative Director of Public Health Medical Director Corporate Services Manager (Interim) 12/53 Welcome, Introductions and Apologies Dr Owen welcomed Mrs Janette Hamilton to the membership of the group as the Hospital Nursing and Midwifery representative. Mr Alton Murphy had been nominated by the Optometry committee to represent on HPF as Optometry representative It was noted the meeting was not quorate. 12/54 Declarations of Interest No declarations of interest were declared. HPF Approved Minutes v1.0 Page 1 of 7

4 12/55 Draft minutes of the meeting held on 14 September 2012 The minutes of the last meeting were submitted to the Health Board on It was noted that the Acting Head of Corporate Affairs had amended terminology under the chairman s report 12/42 and a typographical error was contained in item 12/44.5 i.e. agendad. The minutes of the meeting held on 14 September 2012 were agreed as a correct record, subject to the amendments above. 12/56 Matters arising and summary action plan 12/22 The action would be dealt with as part of 12/61 Unscheduled Care item. 12/ Llandudno MIU would have a role to drive forward models of care and sharing good practice within MIU services. 12/45.10 No further comments were received from the members, the Chair and Vice Chair forwarded comments on the Carers Strategy and Dignity pledge based on the discussion at the meeting. 12/57 Chairman s Report Dr Owen reported the following: 12/57.1 October Health Board meeting - The Board had received a patient story from the patient himself. He summarised his experiences under our care both good and challenging. His main focus was on the interface between Welsh Ambulance Services Trust (WAST) and the Emergency Department (ED), once in hospital he reported his care was good. 12/ It was acknowledged that issues are not just in ED. EJ expressed concerns regarding looking at unscheduled care in a piece meal fashion. GLP gave assurances that this was not the case. There was a discussion regarding challenges in Ysbyty Glan Clwyd (YGC) and actions being taken to address these, and the significant work being undertaken under 1000 lives. Progress has been made in recognising the deteriorating patient in both nursing and medical staff. 12/57.1.2Following discussion, it was felt that patient stories would not be helpful in the HPF however, it was acknowledged that consideration of the Francis report might be useful as a forum. 12/ LB suggested the HPF should consider how patients are managed in care homes who then present at ED. A discussion ensued recognised concerns and challenges to doing this within the HPF. It was agreed training for care home staff is key and actions are being taken to address this in areas such as POVA, use of syringe drivers etc. HPF Approved Minutes v1.0 Page 2 of 7

5 12/57.2 BCU Financial Position BO reported the challenge that BCUHB had declared to Welsh Government (WG) that at month 6, the Health Board is 19m in deficit. 12/ Martin Jones had been identified as Turnaround Director and will be focussing on eliminating waste holding Clinical Programme Groups (CPGs) and Corporate Departments to account. 12/ It was understood that there was a slight improvement in month 7. 12/57.3 Community Pharmacy - Joanne Kember had given a presentation on Community Pharmacy to a Health Board members development session. This was well received and well delivered, including a facilitated discussion to aid the Board s understanding regarding the role of this sector and the effect of their contract. 12/ The Forum discussed how as an NHS we can work together to better manage an ageing population within available resources across North Wales. 12/ Discussion was held on the subject of whether BCU is really clinically lead and if it was not working, the reasons why. Communication was identified as a key challenge across CPGs and sectors. Training for primary care independent contractors was also challenging. It was felt that Integrated training is the way forward. 12/ The forum agreed that clinical leadership is still the desirable way forward however difficult to deliver in the current climate. There were some concerns regarding the design of the structures in BCUHB and not criticism of the individuals involved. It was also felt that Clinical leadership is needed at all levels. 12/58 Members Update 12/58.1 Pharmacy JK reported the RPS in Wales had been in contact regarding understanding the role of the HPF. It became evident that there are variations in the HPFs across Wales. BCU HB HPF was recognised as being better developed in Wales. 12/58.2 General Practice - EJ reported that recruitment in general practice is becoming an increasing concern in North Wales. He also stated that there seemed to be an issue that individuals do not want to be partners in a practice but prefer to work as locums. The increasing age of current GPs was also a concern and these issues would affect development of the move from secondary to primary/community care. 12/ This issue has been brought to the attention of the Health Board. 12/ He also stated that rural areas were particularly challenging and the wider aspect of integration of practices in the future was discussed. The challenges in recruitment of Practice Nurses was also highlighted. HPF Approved Minutes v1.0 Page 3 of 7

6 12/59 Membership of Healthcare Professional Forum 12/59.1 Terms of Office Chair and Vice-Chair - election process 12/ The terms of office for chair and vice chair were due to expire in November AF had indicated that he did not wish to stand as Chair. BO reported he would also stand down as Vice-Chair and not seek an extension of this role, instead he would put himself forward for consideration as Chair as part of the election process. 12/ It was pointed out that should BO be elected as Chair the Vice-Chair could not be from the same discipline. The Forum discussed whether to invite the Vice-Chair to be Chair for only for a year s extension or for both to step down and elect new incumbents to the roles for the full period of time. It was agreed that both Chair and Vice-Chair would step down and an election process would be coordinated by the Corporate Affairs Team to appoint to each role incorporating clarity on the responsibilities for Chair and Vice-Chair. AF would continue to be a member of the HPF. LR/BAJ 12/59.2 Membership update. Mrs Janette Hamilton had been identified as the Secondary Care Nursing and Midwifery representative and Mr Alton Murphy as the Ophthalmology representative. 12/60 HPF Terms of reference for Ratification The amended version was discussed and ratified Unscheduled Care 12/61.1 It was reported that the document presented had been initially presented to Quality & Safety (Q&S) Committee and also utilised as a discussion tool with the Community Health Council (CHC). The paper acknowledged challenges in the current provision of Unscheduled Care. 12/61.2 The information was presented to HPF to offer some assurance that the Health Board takes the provision of unscheduled care seriously and identifies particular issues in Ysbyty Glan Clwyd (YGC). 12/61.3 A YGC intervention plan had been developed to drive improvement in YGC which was lead by the Executive Director of Nursing. Significant improvement has already been seen and work was ongoing to address medical recruitment issues, nursing leadership and role definition. 12/61.4 The document had been prepared at the end of August and presented the position at that time. It was reported that improvement had been shown and sustaining this was the challenge. 12/61.5 EJ queried how the 4 hour waits are measured and be aware of what interventions have been put in place to deliver the 4 hour wait. It was reported HPF Approved Minutes v1.0 Page 4 of 7

7 that the Executive on call is always aware of the position across North Wales and reports to WG daily on unscheduled care. 12/61.6 Joint working with GP Out of Hours (OOH) can help to support ED flow and increased clinical leadership is being facilitated 12/61.7 EJ reported challenges with getting results back in ED etc and there were challenges with IT support. 12/61.8 GLP highlighted the issue of where ambulances collect patients from and take them to. There was a reported concentration of people attending hospital from the Rhyl area which may be due in part to practices of WAST. Work to understand this further was on going and involved WAST, Primary Care and clinicians. 12/61.9 There was a discussion regarding the data in relation to utilisation of ambulances by GP practice. 12/61.10 BO questioned if the bed numbers were a contributing factor in this e.g. loss of beds in RAH. It was recognised there were multi faceted reasons to be explored. 12/61.11 GLP gave an explanation regarding the Category A incidents showing card 35, i.e. since December a GP call was now treated as a 999 call and elicits an 8 minute target thus changing the arrival patterns of ambulances at ED. EJ did not recognise this and believed the case to be still that GP calls wait 4 hours routinely. This position would be clarified with WAST. GLP 12/62 Healthcare in North Wales is Changing 12/62.1 The progress report was discussed. The public consultation closed on 28 October The Health Board was now working through the feedback received. The intention will be to hold a special Board meeting held in public in December to receive the feedback and agree the way forward. BAJ agreed to inform the HPF membership of the date when confirmed. BAJ 12/62.2 It was reported that the main analysis was being carried out by ORS, whom had designed and organised the questionnaire and held focus groups. The report was expected around the first week in December. 12/62.3 There was ongoing discussion with the CHC who were also preparing a report. 12/62.4 It was important that the HPF was assured that health professionals had been provided with opportunities to be consulted. The numbers of people attending public meetings was noted including the variety of ways of hearing views that were utilised. 12/62.5 It was stated that HPFs across Wales had not all been involved in the consultations within other areas. GLP assured the forum that BCU has done all HPF Approved Minutes v1.0 Page 5 of 7

8 it could to ensure the Health Board had followed the consultation guidance and this had been overseen by the Consultation Institute. 12/62.6 A question was raised regarding How would the changes proposed that were not consulted on be moved forward. GLP responded that for general surgery the service has been charged with doing further work to demonstrate how they could deliver a safe and sustainable service on 3 sites. The project board would report to the Board of Directors shortly, and if services could not be safely sustained on 3 sites then alternatives might need to be considered. 12/ EJ highlighted the challenges from the Deanery in supporting 3 hospitals. 12/63 Modernising Scientific Careers The item was deferred to the next meeting as JD was unable to attend. LR 12/64 Documents for Information 12/64.1 Briefing note regarding organisational structures/finance and unscheduled care was noted. 12/64.2 Key Issues October 2012 was noted. 12/65 Any Other Business 12/65.1 Membership attendance at HPF was raised. It was agreed that BAJ would arrange to review and consider ways to improve and ensure quorum. BAJ 12/65.2 It was reported that Mr M Scriven would remain off work for a period of time, therefore Dr Martin Duerden will be the Acting Medical Director. 12/ EJ expressed concern regarding staffing issues within the Medical Directors staffing levels. 12/65.3 BO suggested the revalidation of doctors be discussed at a future meeting 12/65.4 GLP suggested the Development of National Quality Triggers should be a future agenda item, possibly in March LR 12/65.5 JK suggested a further development session for the HPF members would be useful. 12/53 Date of Next Meeting 12/53.1 The next meeting of the Health Professionals Forum was scheduled to be held on January 4 th. The forum agreed this date should be rescheduled to 11 th January 2013 in a venue to be confirmed. Dr Owen thanked members for their attendance and input into the meeting. HPF Approved Minutes v1.0 Page 6 of 7

9 Summary Action Plan Name Action Deadline Dr Andy Fowell Barbara Jackson/ Llinos Roberts Grace Lewis Parry Barbara Jackson Llinos Roberts Barbara Jackson Llinos Roberts 12/26 Mr Scriven to contact Paul Birch, Assistant Medical Director, regarding this student accommodation 12/ Election process for Chair and Vice Chair to be coordinated by Corporate Affairs 12/61.11 Clarify with WAST the position relating to Cat A incidents showing as card 35 12/62.1 Inform the HPF membership of the date of the extraordinary Board meeting 12/63 Reschedule deferred item : Modernising Scientific Careers 12/65.1 Review the attendance of HPF members and consider ways to improve this and ensure quorum. 12/65.3 Include Development of National Quality Triggers to future agenda possibly March 2013 January ASAP Signed:. Chairman Date: BAJ/Mins HPF v1.0 Approved Disclosure: Betsi Cadwaladr University Health Board is the operational name of Betsi Cadwaladr University Local Health Board HPF Approved Minutes v1.0 Page 7 of 7