Aneurin Bevan University Health Board. Executive Team Report

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1 Aneurin Bevan University Health Board 1 Introduction Executive Team Report The purpose of this paper is to provide the Board with an overview of current key issues locally and in NHS Wales through a report from members of the Executive Team of Aneurin Bevan Health Board. Not all members of the Team have provided content for the report as updates are also provided through other reports on the Board agenda. It also provides the opportunity to bring forward items to the Health Board to demonstrate in public, areas that are being progressed and achievements that are being made, which might not come through prior consideration by Health Board Committees or go directly to the Board as key discussion papers. This report is intended to ensure the Board remains up-to-date and also provides an opportunity to highlight areas that can be brought back for future agenda. 2 Executive Team Report 2.1 Notable Achievements and Acknowledgement of Successes Annual General Meeting Around 90 people attended the Health Board s Annual General Meeting at Ysbyty Ystrad Fawr on Wednesday 17 th September departments and services brought display stands to highlight some great work being carried out across the Health Board. David Jenkins, Chair welcomed everyone to the meeting and talked about how the Health Board had focussed on patient experience during 2013/14 and this had raised the standard of services. 1

2 Judith Paget, Chief Executive provided an overview of the Health Board s Annual Report for 2013/14 and highlighted that the organisation had continued to focus on putting patients at the heart of everything that the organisation does and that this was really important to the Health Board as we take forward our Clinical Futures Strategy and other key programmes of work. Judith Paget also talked about how hard staff had worked throughout the year in an extremely challenging environment to provide effective, safe, high quality and dignified care for local people. Alan Brace, Director of Finance provided an overview of the Health Board s Annual Accounts for 2013/14 and highlighted that it had been another challenging year, but the Health Board had achieved financial balance at the end of the financial year. Those in attendance were asked to make any comments or ask any questions with regard to the work of the Health Board and the questions received focussed on what would be the key priorities of the Health Board for future years. As part of the proceedings the Chair of the Health Board also launched the Public Health Wales Observatory interactive surveillance tool which reports on indicators relating to the health of children living in Gwent. The tool provides indicators for each local authority within the Health Board area showing the local authority s data alongside comparative information at the Health Board and Wales level. This has been produced as a pilot project as part of the surveillance work stream of the Public Health Wales Early Years Programme Sepsis Awareness Day 2014 On World Sepsis Day (13 September), Health Board staff joined NHS Wales in an international awareness campaign to reduce the potentially life-threatening illness. Dr Paul Mizen is an Acute Care Physician based at the Royal Gwent Hospital in Newport If sepsis isn t recognised or treated promptly, it can be fatal. Untreated, sepsis usually leads to multiple organ failure. However, the worst effects of sepsis can be countered with simple treatments, provided it is identified quickly. The sooner treatment is started the lower the risk of death and the harmful effects of sepsis can be reduced he said. 2

3 Aneurin Bevan University Health Board New Artwork for Nevill Hall Outpatients Gwent Arts in Health (GARTH) has linked up with Arts Alive and artist Tessa Wait to work on a new artwork for Nevill Hall Hospital. They came together in September to offer visitors, staff and patients the opportunity to contribute to a work that will replace the Dreamscape banners in Nevill Hall Outpatients this autumn. The banners have given staff and visitors hours of pleasure since their installation over 5 years ago, but the time has come to make something new for the space. Generous Donation for Pulmonary Rehabilitation Team Local patients will benefit from a generous donation from the Pulmonary Fibrosis Group. The Newport Pulmonary Rehabilitation Team received the 5,000 donation recently at Newport Velodrome. Sam Jones, Specialist Respiratory Nurse said We are so grateful to the Pulmonary Fibrosis Group. These funds will enable us to purchase equipment such as a laptop and projector that will enhance the educational courses we are able to provide for our patients. We also aim to purchase exercise equipment that patients can use at home and keep once the course has finished, thus enabling them to continue on with their exercise programme at home. The monies will also allow us to attend specific Pulmonary Rehabilitation courses and ensure the continued Professional Development of the Pulmonary Rehab team. Wards and Hospital Celebrate 300 Days Infection Free Staff on Bargoed Ward (2/2) in Ysbyty Ystrad Fawr reached 300 days without a single case of Clostridium difficile in September. Monnow Vale Hospital reached 300 days without a single case of Clostridium difficile. This is an excellent achievement and demonstration that high standards of infection control practices are in place. 3

4 St Arvans ward Chepstow Hospital and Cedar Ward at County Hospital have both achieved over 300 days with no healthcare associated Clostridium difficile infections on the ward. Lead nurse for Infection Control, Liz Waters, said "Congratulations and huge thank you to all the staff who have worked really hard to ensure high standards of infection control practice are in place. This is providing a much safer environment for our patients. Congratulations to staff on D7E Royal Gwent Hospital Congratulations to D7E on achieving 100% compliance in the recent Community Health Council - September Bugwatch Audit. The audit examined compliance to key infection control standards across a number of wards at Nevill Hall Hospital and Royal Gwent Hospital. Though all areas performed relatively well, D7E was the only ward (of those sampled), to achieve a 100%. Liz Waters Appointed as Consultant Nurse Denise Llewellyn, Director of Nursing appointed Liz Waters, Lead Nurse for Infection Control to the post of Consultant Nurse, Infection Control. Congratulations to Liz on obtaining this post which was through a very stringent process. Practice Manager of the Year Sarah Emery, Practice Manager of Ystrad Mynach Surgery (Caerphilly North) won the Practice Manager of the Year Award at the NAPC (National Association of Primary Care) Annual Awards and Gala Dinner. The event was held at the Hilton Metropole Birmingham on the evening of 22 nd October Sarah received the Award from over 100 nominated managers from all over the UK. The awards celebrate the hard work and achievements of colleagues across Primary Care. 4

5 Aneurin Bevan University Health Board Royal College of Nursing Nurse of the Year Finalist Louise Rooney, Healthcare Manager at Her Majesty s Prisons in Usk and Prescoed is a finalist in the RCN Nurse of the Year. World Alzheimer s Day Staff in Ysbyty Aneurin Bevan, Ebbw Vale, transferred ward areas for patients to reminisce on World Alzheimer's Day (Sunday 21 September). The annual event provided an opportunity to focus on the great work going on to fight dementia, and to raise awareness among staff, patients and visitors with fun activities on the wards. Staff on Tyleri Ward recreated a 1950s suburban lounge and patients on Sirhowy Ward were treated to a day at the seaside. On Ebbw Ward they built their very own cinema and showed films throughout the week, including the 1942 classic Casablanca. Blaenavon Health and Resource Centre opens In early October the Blaenavon Health and Resource Centre opened to patients following a 12 month build period. The Resource Centre forms part of the Blaenavon Community Campus and is on the same site as the Blaenavon Heritage VC Primary School and Blaenavon Active Living Centre. The Campus as a whole is unique to the Gwent area as it will be the first fully integrated facility to be planned and developed in the Gwent area. Health services, Local Authority services including social care, Police, Leisure and Educational Services will all be provided on the Campus. In addition to the Resource Centre there is also a 130- place nursery, 450-place primary school, and community leisure facilities which opened last year. The campus will also include a wide range of community services including a Council Customer Care Centre, access to the police and community safety advice and advocacy services. 5

6 The Deputy Health Minister Vaughan Gething visited the centre in early November 2014 to launch the new Primary Care Plan for Wales. Services will be enhanced so the vast majority of NHS care is planned and provided in the community, closer to people s homes, under the new four-year plan. The Deputy Health Minister was met by Chief Executive, Judith Paget and Vice Chair, Professor Siobhan McClelland and given a tour of the centre to meet staff. He then undertook media interviews to outline the Primary Care Plan and to explain how centres, like the Blaenavon Resource Centre, will have a key role in providing healthcare closer to local communities. Quality in Care Awards 2014 Aneurin Bevan University Health Board in partnership with Velindre Cancer Care received an award at the Quality in Care Awards at BMA House, London on 2 nd October The award was for the newly developed Cancer Associated Thrombosis Service that has been developed and came first under the category of Best Cross Organisational Partnership. Gold Award at the Chartered Institute for Public Relations Award Aneurin Bevan University Health Board has been commended for its general communication and engagement with former patients over possible Hepatitis C transmission from a healthcare worker. The Hepatitis C look-back exercise was awarded Gold in the Issues or Crisis Management category at the CIPR Pride Awards 2014, held on Friday 24 October. The CIPR Pride awards recognise the best communications work across Wales. The Hepatitis C look back exercise was described by the CIPR as a thoughtful and thorough campaign, which successfully communicated the possible issue of infection without causing panic or damaging the reputation of the Health Board. 6

7 Healthcare Financial Management Association Awards Health Board finance staff have been shortlisted for two awards in the HFMA 2014 awards. The Healthcare Financial Management Association (HFMA) has recently announced the shortlist for its 10th anniversary awards. The Health Board has been shortlisted for two of the eight awards that will be announced in December Finance Director of the Year Award Alan Brace Costing Award Finance Team for its work on developing Time Driven Activity Based Costing (TDABC) as part of the Health Board s approach to delivering prudent healthcare. From a 32-strong shortlist, made up of 26 different NHS organisations, Welsh NHS organisations are represented in three awards categories two from Aneurin Bevan University Health Board. Nursing Conference This year s Annual Nursing Conference was held on the 25th September 2014 attracting the largest number of Nurses, Health Care Support Workers and Student Nurses to date, as well as volunteers and representatives from the wider multidisciplinary team internally and externally. 300 people registered for the event. There were 60 posters on display and the Aneurin Bevan University Health Board Flu Vaccination Team were in attendance grabbing and jabbing attendees, to kick off the Flu campaign for The title of the Conference was The People Factor and was opened with a montage celebrating nursing and volunteer achievements and awards over the past year. Each formal presentation was jointly delivered by a Nurse and a patient, resulting in a very human and emotive approach. There was a diverse range of topics, emphasising the breath of nursing practice and its impact on patient experience, to include the specialties of: Learning Disabilities, Eating Disorders, Cancer Services, Critical Care, Discharge Planning and Community. The best oral presentation award went to Phil Hill, Advanced Nurse Practitioner and June Thomas for their presentation entitled Remembering Jack an emotional tribute to Jack a 15 year 7

8 old lad who died suddenly and unexpectedly from an undetected heart condition. Phil and June outlined their campaign to secure Automated Electronic Defibrillators in all Public Places. The afternoon session was opened with singing by the Dementia Choir, a highlight of which was I m forever blowing bubbles with audience participation and bubble blowing. There was an Oxford-style professional debate regarding Advanced Nursing Practice entitled Mini Doctor or Maxi Nurse with the audience voting for or against the motion. This was followed by the X Factor, with three bids presented: Flu Vaccination, Smoking Cessation and Venous Leg Ulcers, all of which were supported by the X Factor judging panel. The event was closed with a young dance troop from Risca showing their hip-hop skills complimented by a fire work display, which energised the audience and emphasised the importance of community engagement. The Conference was followed on Twitter and was incredibly well evaluated, with comments such as the best conference ever, I was thinking of leaving nursing but after today s conference I am proud and committed to remaining in post, I am so proud to be a nurse in Aneurin Bevan University Health Board. 2.2 GMS Access The table below provides an overview of current position in relation to the Health Boards A is for Access scheme. 5A (Access) "A's Total" 1A 0 2As 3 3As 6 4As 23 5As 52 1B 0 2Bs 0 3Bs 0 4Bs 3 5Bs 1 Total Practices 88 8

9 Although there are 6 practices that continue to have half day closures 3 practices have been given exceptionality following an exit poll undertaken by the Community Health Council, and 2 are currently under review. At present thirty GP practices provide the Extended Hours Local Enhanced Service resulting in an additional access of sixty five hours per week. One of these practices provides GP access every other Saturday morning. The Health Board has a formal Access Group with membership from the Primary Care and Networks Division, Community Health Council and Local Medical Council. The Access Group is looking to refocus using data from the A is for Access scheme but additionally utilising data provided by the practice and NCN development plans. The Health Board is looking to undertake a formal Quantum of Access review and will work with the Local Medical Committee and Community Health Council to agree Terms of Reference for this review. 2.3 My Health Online My Health Online (MHOL) is a national system available to all practices in Wales and allows patients to book appointments online, order repeat medications and update their general details such as change of address. MHOL is used by sixty eight practices and more practices are keen to implement MHOL following migration to new GP systems, primarily to enable them to deliver additional services to their patients. The benefits of practices and patients using MHOL include: Accuracy of repeat prescription data increased Patient resources (time/travel) increased Practice staff resources increased Availability of GP Practice time increased Do Not Attend (DNA) rates decreased Patient empowerment increased Fraudulent access to medication decreased/patient confidentiality increased The Health Board in conjunction with the NHS Wales Informatics Service undertook a case study with Wellspring Medical Centre in order to understand the experience of using MHOL from a patient and practice point of view. In summary, MHOL allows the patients to speedily book online appointments and order repeat medications without the need 9

10 to phone, or turn up to the surgery. Patients are able to see and book surgery appointments up to 3-4 weeks in advance, if they are made available by the practice. The Health Board is reminding practices to utilise online services more effectively and has aligned the 5As for Access for practices that use MHOL. However, the main issue with MHOL is with the low penetration number of patients using the system across some practices (less than 5% of practice population). This is possibly due to the lack of national publicising of the system, despite patients being made aware of the system locally in the practice. 2.4 Out of Area Local Enhanced Service The Health Board has been approached by Welsh Government to participate in a one-year pilot scheme to improve access to GP services for working people. The pilot is to run in the four cities within Wales, namely, Cardiff, Wrexham, Swansea and Newport. An out of area unregistered day patient is a person living outside the participating GP practice boundary area, but is present in the participating GP practice area for less than 24 hours (for example, as a commuter who travels into and out of the area each day) to whom the GP practice provides treatment, but wishes to remain registered with their current practice. Employees can attend a maximum of three appointments within the year. The Health Board in conjunction with the Local Medical Committee and Community Health Council have approved a Local Enhanced Service for three Newport based practices. Based on the proximity to the largest employers Gaer Medical Centre and St Bride s Medical Centre will see employees from the Intellectual Property Office and the Statistics Office. St David s Clinic will see employees from the Royal Gwent Hospital. Appointments will be available from 17 November The Health Board has agreed with the GP practices that they will not see patients who reside in the areas listed below as they can access their usual GP for an appointment: Newport Cwmbran Rogerstone Risca (up to Crosskeys) St Mellons 10

11 2.5 General Dental Services The Health Board continues to explore options to maximise access to General Dental Services which includes robust contract monitoring. There has been significant investment in General Dental Services over the past 18 months improving access across Gwent. The Health Board is maximising the potential of General Dental Services by commissioning services from General Dental Providers which were previously provided by Hospital Based services such as minor oral surgery. The Health Board s Oral Health Advisory Group monitors the Boards progress against its Local Oral Health Plan quarterly and the Health Board has been requested to submit a formal update to the Welsh Government by 31 December Welsh Government Funding for Primary Care Welsh Government announced an additional 3.5m funding for 2014/15 to improve Primary and Community Care, of which the Health Board has received 698,535. There were three categories for the bids: tackling inverse care law and poverty, developing the primary and community care workforce and delivering more eye care closer to home. 2.7 Revalidation Project The Nursing and Midwifery Council (NMC) have announced the organisations participating in the revalidation pilot project. Aneurin Bevan University Health Board is named as one of the pilot sites and the only organisation in Wales to be chosen. In response to the announcement, Professor Jean White, Chief Nursing Officer for Wales said Introducing the new system of revalidation is an important step for the professions and will help build public confidence in the professionals that care for him. I am delighted that Aneurin Bevan University Health Board will be testing the new approach in Wales and look forward to seeing the outcome from all of the pilots across the UK. It is in all our interests that the new system adds value, so robust testing by organisations and front line staff is essential. 11

12 Aneurin Bevan University Health Board is committed to supporting the staff within the Health Board through the process of testing the system of revalidation, in order to ensure that every nurse and midwife within the organisation remains fit to practice to the highest standards. Being chosen as a pilot site will allow Aneurin Bevan University Health Board to be at the forefront of informing future regulation for nurses and midwives. 2.8 Visit from Northumbria Healthcare Foundation NHS Trust On the 11th November, six senior clinicians from Northumbria NHS Trust visited the organisation, to review the planning assumptions and clinical models for the Specialist Critical Care Centre and our wider Clinical Futures model within Aneurin Bevan. The team was led by their Medical Director, Dr David Evans and included clinicians from primary care, emergency and acute medicine, surgery and anaesthetics and follows on from a visit undertaken by our own clinical and planning team to Northumbria earlier in the year. Northumbria has many similarities with Aneurin Bevan not least of which is the geography, similar population size, demographics and importantly they organisation manages multiple community and hospital sites which will soon include a new Specialist Emergency Care Centre. This SECC has equally been 10 years in the planning and construction and will open next year. Throughout the day, the visiting team had the opportunity to interview many of our clinical, executive and planning team colleagues to assess how our current and future clinical services are likely to be shaped and how the will link with the SCCC. They also delivered an excellent lunchtime presentation on their own plans and future aspirations which was described by Professor Sir Bruce Keogh, the Medical Director from NHS England as seeing a glimpse of the future. Encouragingly, the team concurs that we are adopting the right clinical model for the future but identified plenty of opportunities for us to consider in the short /medium term. They have kindly agreed to produce a report highlighting their observations and have once again offered our clinicians the opportunity to visit again in the new year. 12

13 2.9 Ebola Update The emergence of Ebola virus a haemorrhagic fever with up to 90% mortality - in West Africa with imported cases in USA and Spain, has meant Welsh Government call for detailed plans to handle suspected cases of the disease from Health Boards. World Health Organisation figures in mid November confirmed, probable and suspected cases of Ebola worldwide to be 14,098 in Guinea, Liberia, Mali, Sierra Leone, Spain and the USA and in the 2 countries - Senegal and Nigeria - which have been declared Ebola free. The total number of deaths at that date was The Ebola Planning Group with representatives from all clinical Divisions involved, Executive Lead Director of Public Health, Chair Dr Liam Taylor, Wendy Warren and team, Liz Waters and team and supported by Dr Lika Nehaul and local Health Protection team from Public Health Wales have finalised a plan to address locally. All assessments will take place at the Royal Gwent Hospital with a group of staff that have had enhanced training. Anyone found to be positive for Ebola on blood testing will be transferred to the Royal Free Hospital as per national protocols. The planning has involved Welsh Ambulance Services NHS Trust and Powys Health Board as well as the Gwent Local Resilience Forum (5 Local Authorities, Police, etc) through Adrian Girvin. Drs Neil Carbarns and Elizabeth Kubiak have been fully involved on the laboratory aspects and Facilities Division on waste management. National pressure on Personal Protective Equipment supplies is being addressed with the aid of Welsh Government. The UK has some of the best public health protection systems in the world and the risk to the UK remains low. Enhanced screening arrangements for people travelling from the affected regions are now in place at Heathrow, Gatwick, Manchester and Birmingham airports and at Eurostar at St Pancras. 13

14 The UK government, alongside the Wellcome Trust and Medical Research Council, has co-funded clinical trials of a potential vaccine being developed by GlaxoSmithKline. The Chief Medical Officer for England has confirmed that it is likely we will see a case of Ebola in the UK, and this could be a handful of cases over the next three months. She confirms that the public health risk in the UK remains very low and measures currently in place including exit screening in all three worst affected countries - offer the correct level of protection The UK has been leading the international response in Sierra Leone - we are assisting with the design and oversight of the building of Ebola Treatment Centres and Ebola Training Academy, command and control, an Ebola Treatment Academy, logistical support and sending a number of service personnel and equipment to help. Forty Welsh health care volunteers to Sierra Leone are expected back on Christmas Eve Healthcare Management Observership for Pakistan Military Corps Between 18th August and 15th November 2014 Aneurin Bevan University Health Board (ABUHB) had the pleasure of facilitating an observership for one of the Senior Healthcare Managers from Pakistan s Military Corps, Colonel Dr. Mohsin Qureshi. This is the first time ABUHB has been involved in facilitating such an experience which was co-ordinated by Kathryn Bourne, Head of Medical and Dental Workforce Services and Helen Knight, Senior Education and Development Manager. Colonel Dr. Qureshi is a Medical Consultant who works in a senior management and leadership role within the Pakistan Army. During his time with the Health Board, Colonel Dr. Qureshi accessed a number of learning and development opportunities within the organisation. In addition to formal internal meetings and committees Colonel Dr. Qureshi was able to take part in the enhanced clinical leadership programme. His contribution to this programme enhanced the learning experience for University Health Board staff as well as providing an experience for the Colonel. 14

15 Colonel Dr. Qureshi was able to attend a number of conferences and external All Wales meetings, which afforded him an opportunity to gain an overview of the NHS in Wales and to meet the Director General for Health and Social Services and the Chief Executive of NHS Wales. Colonel Dr. Qureshi provided three feedback events before he returned home, these included presentations to senior Health Board staff, Trade Union Partnership Forum (TUPF) and Aneurin Bevan Centre for Improvement. These provided an external view of our organisation and gave a flavour of life as a Healthcare manager in the Pakistan army. After addressing the TUPF, Colonel Dr. Quershi was presented with an achievement certificate and a small commemorative gift from the Health Board by our Chief Executive, Judith Paget. The Health Board will continue to ensure ongoing formal links with a view to further supporting the Colonel and assisting him in developing and skilling his own staff. 3. Consultant Appointments The outcomes from the Statutory Consultant Advisory Appointments Committees since the previous meeting are as follows: Appointment of Consultant Neonatologist The Health Board held interviews for the post of Consultant Neonatologist on Tuesday 23rd September The appointments panel comprised the following members: Representing the Chairman: Professor Janet Wademan, Independent Board Member, Aneurin Bevan University Health Board Representing the Chief Executive: Dr Gill Richardson, Director of Public Health, Public Health Team, Aneurin Bevan University Health Board Representing the Medical Director: Dr Stephen Edwards, Assistant Medical Director, Consultant in Anaesthetics, Aneurin Bevan University Health Board Representing the Clinical Director: Dr Siddhartha Sen, Consultant Neonatologist and Clinical Director, Aneurin Bevan University Health Board 15

16 Representing the Royal College: Dr Roshan Adappa, Consultant Neonatologist, Cardiff and Vale University Health Board Representing Cardiff University: Dr Shobha Cherian, Consultant Neonatologist, Cardiff and Vale University Health Board Representing Aneurin Bevan University Health Board: Dr Ian Bowler, Consultant Paediatrician, Representing the Divisional Director Mrs Sian Millar, General Manager for Family Services 1 applicant was interviewed for this post. The recruitment and interview process was conducted in accordance with Health Board policies and procedures. The appointments panel recommended Dr Murali Sridhar Natti for appointment to this post. 4 Conclusion and Recommendation: The Board is asked to receive this report for information. Report prepared and sponsored by: Executive Team Aneurin Bevan University Health Board November