NHS BOLTON CLINICAL COMMISSIONING GROUP Public Board Meeting AGENDA ITEM NO: 10. Date of Meeting: 31 st August 2018 TITLE OF REPORT:

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1 NHS BOLTON CLINICAL COMMISSIONING GROUP Public Board Meeting AGENDA ITEM NO: 10 Date of Meeting: 31 st August 2018 TITLE OF REPORT: AUTHOR: PRESENTED BY: PURPOSE OF PAPER: (Linking to Strategic Objectives) LINKS TO CORPORATE OBJECTIVES (tick relevant boxes): RECOMMENDATION TO THE BOARD: (Please be clear if decision required, or for noting) CCG Quality & Safety Committee Minutes Michael Robinson, Associate Director Integrated Governance & Policy Dr Jane Bradford, Clinical Director Clinical Governance and Safety For the Board to receive and review the minutes of the Quality and Safety Committee meeting held on 11 th July Delivery of Year 3 Locality Plan. Joint collaborative working with Bolton FT and the Council. Supporting people in their home and community. Shared health care records across Bolton. Regulatory Requirement Standing Item The Board is asked to approve the Minutes. The key points the Board is asked to note from these minutes are:- Liaison with Healthwatch in relation to ambulatory care. IPCC CDiff RCA update in the Autumn. Safeguarding SIF. COMMITTEES/GROUPS PREVIOUSLY CONSULTED: REVIEW OF CONFLICTS OF INTEREST: VIEW OF THE PATIENTS, CARERS OR THE PUBLIC, AND THE EXTENT OF THEIR INVOLVEMENT: EQUALITY IMPACT ASSESSMENT (EIA) COMPLETED & OUTCOME OF ASSESSMENT: CCG Quality & Safety Committee Conflicts of Interest are reviewed at every meeting. Patient views are not specifically sought as part of this report. EIA and an assessment is not considered necessary for the report. 1

2 MINUTES CCG Quality and Safety Committee Date: 11 th July 2018 Time: Venue: 9.00am 11.00am The Bevan Room, 2 nd Floor, St Peters House Present: In attendance: Minutes by: Jane Bradford Mike Robinson Bob Hunt Elaine Barker Diane Sankey Pam Jones John Tabor Nicola Onley Lynda Helsby Jayne Waite Kaleel Khan Kerry Lloyd Karen Spibey Jason Taylor Joanne Meaney (JM) Clinical Director Governance and Safety (Chair) (JB) Associate Director, Governance and Safety (MR) Lay Member, Public Engagement (ZA) Clinical Lead Mental Health (BH) Information, Healthwatch (EB) Governance and Risk Manager (DS) Associate Director of Safeguarding (PJ) GP (JT) Associate Director of Communication and Engagement (NO) Associate Director of Primary Care (LH) Quality and Safety Nurse (JW) Safeguard Adult lead (KK) Nurse Board member (KL) Communications Officer (KS) Lead Information Analyst (JTa) Personal Assistant Minute Topic No. 75/18 Apologies for Absence Apologies for absence were received from: Ben Woodhouse Pam Jones Paul Morris The Chair introduced Kerry Lloyd who has joined the CCG as Board Nurse Member. Members were reminded to send a deputy when they are unable to attend. 76/18 Declarations of Interest The Chair reminded committee members of their obligation to declare any interest they may have on any issues arising at committee meetings which might conflict with the business of NHS Bolton Clinical Commissioning Group. Declarations declared by members of the Quality and Safety Committee are listed in the CCG s Register of Interests. The Register is available either via the Board Secretary to Page 1 of 6

3 the Governing Body or the CCG website at the following link: Bob Hunt declared an interest in item 93 as he is Trustee for Bolton Hospice. 77/18 Minutes from the last meeting held on 9 th May 2018 The minutes were approved as a correct record. 78/18 Matters Arising: Action List Update - DNR JB reported that this is in the process of being reviewed using Respect documentation and an update will be brought to a future meeting. 79/18 Communications and Engagement NO introduced Karen Spibey who has commenced as Communications Officer within the Comms Team and will be able to attend the Q&S meetings in Nicola s absence. NO tabled a copy, for information, of the Think summer publication which has been distributed to all schools for every primary schools child and GP practices. Members received a copy of the outcome of a CCG commissioned piece of work with Healthwatch Communication in neighbourhoods whereby Healthwatch undertook walks within the neighbourhood to seek comments and views. No informed members that the NHS 70 roadshow held on the Town Hall square had been a success and a write up the themes will be brought back to a future meeting. An NHS 70 pack had been distributed to each GP practice. NO to bring back a summary paper in relation to the themes from the NHS 70 roadshow 80/18 Healthwatch Update EB tabled a copy of the Healthwatch annual report for information. The 2018/19 priorities have been highlighted as mental health, carers, palliative care, communication, transforming primary care and health in the workplace. The dementia report has not been released and feedback is awaited on the urgent care report which is to be discussed at the UECB. Healthwatch are currently undertaking an audit on GP websites in relation to user-friendly access. EB tabled a copy of the Information advice and guidance report which details case studies of current work and suggested that this is received by Q&S as a regular item. JB reported that the Board had received an update recently regarding ambulatory care and asked if Healthwatch are planning to do any further work. It was agreed to arrange a meeting to discuss further JB/NO/EB. EB to provide a copy of the Information advice and guidance report as a standing item on the Q&S agenda Meeting to be arranged to discuss further work in relation to ambulatory care Jme to arrange and involve JB/NO/EB Page 2 of 6

4 Clinical effectiveness 81/18 Quality and Safety Nurse update The report provided an update in relation to the nursing homes. One home has been inspected recently by CQC, 5 require improvement, 3 have inadequate domains mainly around fire regulations and medicines management concerns. All the homes have been offered support by the CCG and the fire regulation concerns have now been addressed. Falls collaborative update the collaborative was established jointly with the Local Authority to identify what is most likely to cause a resident to fall and the learning that can be developed to share across homes. Each home has identified a Falls Champion and the first meeting has taken place. Pressure ulcer collaborative - a local forum to disseminate work being undertaken by GM and facilitate areas for local development with the aim to reduce the prevalence of pressure ulcers. Recent developments include a review of a new RCA tool for grade 3 / 4 pressure ulcers and facilitating learning from any lapses. Clostridium Difficile update the FT position at end of 2017/18 was 30 cases [for any one tested in Bolton]. The target as a whole is 80, actual number to date is 85. There are no specific themes emerging from primary care. JT indicated that there is no direct feedback given to practices. It was reported that Dr Lyon had previously updated through the clinical leads meeting and that any targeted feedback had been placed in the medicines newsletter. It was felt that an update from the IPCC in relation to RCAs would be useful and consideration for future audits the added value and may be focus on antibiotic stewardship. MR reported that as an outcome of the recent external review a comprehensive action plan has been developed which can be brought to the next meeting but there had been no significant issues identified. Mortality review Members received an update presentation in relation to the monthly returns from homes. There was variation across homes due to the interpretation of the audit question. There are some gaps in the data as not every home reports monthly. This exercise had been a joint supportive audit and there is one final meeting scheduled to take place. JT queried what the CCG are going to do with the information and it was reported that this was undertaken as part of the Care Home Excellence programme with homes, in terms of quality improvement. Members noted the update and acknowledge the concern that had been raised through monitoring and have received an appropriate level of assurance and recognise that this is a good example of learning with some excellent work undertaken by Jason. IPCC update in respect of RCAs at a future meeting MR/JW to action External review action plan to be discussed at the September meeting MR 82/18 Serious Incidents Report The report updated members in relation to patient safety incidents. There are 14 new serious incidents reported and the full detail was included in the report. The Trust has recently commissioned an external review and the CCG is seeking clarity and assurance from the Trust in relation to new incidents. Page 3 of 6

5 Members were informed that BMI Beaumont failed to escalate a deteriorating patient which resulted in the issue of a Regulation 28. A full action plan from BMI has been implemented and a new process is now in place. JB reported that CCG representatives had recently met with the Coroner, who was receptive and found the meeting helpful, to discuss Regulation 28 and that primary care colleagues feel isolated at Coroners Court. A proposal was discussed that if a practice is required to attend a Coroner s Court that the CCG would support the practice to prepare prior to this and the Coroner agreed that post mortem reports could be made readily available if required. Discussion took place in relation to Regulation 28 and if the learning and process has changed and this can be shown that a Regulation 28 may not need to be issued. Members noted the update 83/18 Safeguarding Report The paper provided members with an update in relation to safeguarding issues across the Bolton Health Economy. The accompanying dashboard demonstrates the CCGs compliance against safeguarding standards. KK reported that is one new adult and safeguarding review underway and the domestic homicide review process is now complete in relation to DHRFA1 with a number of recommendations for primary care. Members noted the report. DOLs update KK reported that the system on authorisation will be changing and each health service Mental Health capacity lead will be required to authorise DOLs. Members noted the safeguarding reports. Members noted the DOLs update and the implications. 84/18 Safeguarding Audit KK reported that the audit had been undertaken as part of the BQC and practice managers had given feedback to seek assurance against safeguarding requirements in practices. This had been undertaken as an internal exercise prior to a national tool being implemented. The outcome of this audit will be used as learning for safeguarding team in relation to implementation of safeguarding requirements. Patient Safety 85/18 Safety Collaborative Updates See item 81/18 for the updates in relation to infection control, pressure ulcers and falls. Medicines Safety Collaborative Members received an update report from the July meeting which focussed on insulin and the outcome of discussions was to establish a series of Always Events in reference to Insulin and design a way to audit. Page 4 of 6

6 Members noted the update report. 86/18 LeDeR update The report provided an update on progress in the health economy with the Learning Disability Mortality Review programme. Five reviews are now complete and local learning shared. The next steps are to try to secure additional funding from NHSE, attempt to obtain more GP/family/carers views and feedback through local steering group and influence the commissioning of services, further engagement with local, GM and national LD groups and develop a pathway for patients unable to have diagnostics undertaken in primary care. 87/18 Infection Control External Review Bolton FT See item 81/18. The outcome of the external review will be brought back to the September meeting. Outcome of the external review to be an agenda item for September meeting. 88/18 CQC Report The provided an update on the CQC published reports from 1 April 30 June Members noted the report. 89/18 CQUIN update The report provided an update on Bolton FT performance against Q4 2017/18 which has been reported at 90%. There have been some challenges with the data and recording and this is being resolved. Internal CQUIN governance at the Trust is positive. 90/18 Patient Safety Conference feedback JB provided members with an outline of the key messages from the Patient Safety Conference to which 10 CCG representatives had attended. JB will feedback to a future clinical leads session. 91/18 GP Professional Reference Group annual update Members received for information a copy of the annual update of activity through the GP Professional Group. Members noted the report. Items for Information 92/18 Bolton Health Economy External Reports Log 93/18 GM Quality Board papers and dataset 94/18 Bolton Hospice Quality account for noting Page 5 of 6

7 BMI Quality Account for noting 95/18 Update from Associated Meetings: Bolton FT Quality and Performance Group RTT and patient waiting times additional resource is being commissioned to address this Cancer two week wait risk stratifying patients to appropriately manage risk. The minutes were noted. Bolton FT Quality Assurance Committee The minutes were noted. Infection Prevention Control Committee The minutes were noted 96/18 NICE Quality Standards Reviews The report updated members that a process is now in place to reviewed quality standards and attached log of the standards reviewed to date. It was agreed to arrange a meeting to discuss this process in more detail in relation to the aim and outcome. A meeting to be arranged to discuss quality standard reviews JB to action. 97/18 Any Other Business There was no other business. 98/18 Chair reflection on significant decisions/actions/risks that may need reporting to the Board through these minutes Liaise with Healthwatch in relation to ambulatory care. IPCC CDiff RCA update in the Autumn. Safeguarding SIF. 99/18 Time and Date of Next Meeting Agreed as 12 th September 2018 at 9am to 11am in the Bevan Room, St Peters House. Page 6 of 6

NHS BOLTON CLINICAL COMMISSIONING GROUP Public Board Meeting AGENDA ITEM NO: 14. Date of Meeting: 29 th June 2018 TITLE OF REPORT:

NHS BOLTON CLINICAL COMMISSIONING GROUP Public Board Meeting AGENDA ITEM NO: 14 Date of Meeting: 29 th June 2018 TITLE OF REPORT: AUTHOR: PRESENTED BY: PURPOSE OF PAPER: (Linking to Strategic Objectives)