CHIEF EXECUTIVE`S REPORT

Transcription

1 Board Meeting 05/10/17 Open Session Item 4 CHIEF EXECUTIVE`S REPORT Malcolm Wright, Chief Executive 1

2 INTRODUCTION This is an important day for NHS Grampian with our Annual Review to take place this afternoon. We have important items on the agenda including the Workforce Plan, the presentation of the three Integration Joint Boards Annual Reports and the first of the new format Quality Report for the Board. ANNOUNCEMENTS Unscheduled Care Conference The annual Unscheduled Care Conference held on 29 August saw the highest attendance of around 130 delegates. It is a whole system event and features speakers and topics from health and social care across Grampian; this year the theme was Enabling the Workforce with a focus on supporting shared learning and collaboration across sectors and services. There were a number of presentations from Aberdeen City, Aberdeenshire and Moray which highlighted inspiring new ways of working. More inspiration came from Jason Leitch, Clinical Director of Healthcare Quality and Strategy, Scottish Government, the guest speaker. He had several messages including the importance of kindness and of thinking differently about how we can deliver healthcare today. A busy afternoon featured 4 different workshops and closing remarks were by Helen Maitland, the National Director for Unscheduled Care, who offered congratulations on such a successful event. Ending PJ Paralysis video Staff in Aberdeen Royal Infirmary are working hard to promote the benefits of staying active and independent in hospital. As part of this campaign a film, which was produced for the Unscheduled Care Conference, has broken all our records on social media. Since the launch on NHS Grampian's Facebook page on 29th August, there have been hundreds of thousands of views and lots of Twitter activity in response to: #ENDPJPARALYSIS This is a social media hash tag recognising the potential harm that comes from being inactive and waiting in hospital. As little as 24 hours of bed rest can have a detrimental effect on a patient with a loss of 2.9% muscle power: and not just in arms and legs but heart and lungs also. There is evidence that suggests patients who walk on the day of their admission go home sooner and patients who walk in the ward daily also recover quicker. The lead physiotherapist in acute has been working with all staff on the geriatric assessment unit to embed an active recovery ethos on the ward. This active recovery follows the Get UP, Get Dressed, Get Moving, Get Home headings. The aims are to have patients up sitting in a chair for meals and dressed and undertaking their own personal care as they would at home. The data around this is currently being analysed but it is clear that patients included in the programme walk substantially more than those who were not. The energy and enthusiasm to promote the active recovery idea has been really encouraging and further analysis will be done to see if average length of stay is less in this group. 2

3 Annual Quality and Safety in Healthcare - Powerful Conversations More than 200 delegates attended the 6 th Quality and Safety Event Powerful Conversations on 13 th June 2017 in the Suttie Centre. The event, organised in collaboration with the University of Aberdeen and Robert Gordon University, aimed to share knowledge and good practice about quality in healthcare. The delegates enthusiasm demonstrated their commitment and interest in learning and sharing quality initiatives. Dr Nick Fluck, Medical Director, opened the event and was followed by Dr John Harden, National Lead for Quality and Safety, Scottish Government who talked about realistic medicine and how to work in teams to improve the quality of care delivered. In the afternoon, Mr Rod Mountain, ENT Head and Neck Surgeon, NHS Tayside and Associate Postgraduate Dean shared his experience of working with the Design Industry, Students and Health Professionals and discussed the need to create the conditions for communication, connection, collaboration and culture to change how we deliver health and social care. There were 17 presentations in the Breakout Sessions and 21 posters were exhibited from over 45 submissions. The winning posters were: Kay Davies Active discharge after anaesthesia for paediatric day case patients. Ros Baker Physiotherapist led paediatric orthopaedic clinics. Jenny Gordon Breast feeding welcome scheme in Aberdeen City. Public Health contributed an oral presentation Power of brief conversation makes every opportunity count. This illustrated the role which NHS Grampian frontline staff can play routinely as part of an overall strategic approach to make every opportunity count for people who use public and third sector services. The presentation focused on current action in NHS Grampian and provided examples of tests of change underway with external partners. The approach reflects transformation as a process that adds value through volume, in this case of brief wellbeing conversations and signposting, with everyone doing a little people who provide services and people who use services - to make a positive difference. Health and Safety Executive (HSE) Improvement Notices Update In July 2016, the Health and Safety Executive (HSE) conducted workplace inspections in relation to three specific areas: skin, safer sharps and falls. As a result of the inspections, the Board was issued with 6 Improvement Notices and 6 contraventions. In December 2016, the Improvement Notices in relation to safer sharps were lifted, following progress towards better risk assessment, operating procedures and training. At a recent meeting with the HSE, the HSE indicated that given the progress within NHS Grampian, they are minded to lift the Improvement Notice in relation to falls at Dr Gray s Hospital and the Improvement Notice in relation to skin at Aberdeen Maternity Hospital. The HSE have reminded the Board that the Falls strategy needs to be embedded across all sectors of the Board. They noted the roll-out of the skin surveillance programme, which is in phase 3 of a 5 phase rollout programme and that there remains issues with the gloves used for certain tasks, which we have agreed to review. They have confirmed an extension to the Improvement Notice in relation to Manual Handling until the end of January 2018, 3

4 and have acknowledged the improvements in staff numbers having undertaken appropriate training and improvements in the number of musculo-skeletal injuries reported to Occupational Health. The HSE have also agreed in principle to extend the Immunisation Improvement Notice, acknowledging the difficulties created by the international shortage of Hepatitis B vaccine and to allow full implementation of the new occupational Health IT system. A further Improvement Notice in relation to ligature risks at Royal Cornhill Hospital was issued in July and there is an action plan in place to address this. The departmental organisational design is in its final stages and should be completed by October of The development and review of Tool Box Talks is ongoing to support the various identified learning needs in the organization. Partnership between Occupational Health & Safety, Learning & Development, and Health & Safety is ongoing looking at ways for staff to track and record their attendance at Tool Box Talk sessions. Training courses related to manual handling, violence & aggression, and fire continue to be offered across the organisation. The department has been heavily involved in recent months in assisting Mental Health and Learning Disability Services and Facilities and Estates with the HSE notice related to ligatures. Fit for Farming/National Farmers Union Scotland Continuing to work collaboratively with the National Farmers Union Scotland (NFUS) and following on from the successful launch of the Know Who to Turn to (KWTTT) mental health promotion campaign, NHSG Public Health s Health and Work team have now launched the Fit for Farming booklet. The booklet identifies a number of different health topics associated with working within the agricultural sector and gives helpful advice and signposting to local services. The booklet, originally developed and published in England by farmers for farmers, has up-to-date health information and advice in line with Scottish guidelines and legislation. Fit for Farming was officially launched by our Director of Public Health, Susan Webb, and Davie Winton, NFUS Regional Chairman for the North East. The launch was given extensive coverage in the local media, including press, radio, online and also extended live TV coverage by North Tonight News, resulting in maximum exposure. The booklet was also promoted and distributed at the annual two day Turriff Agricultural Show supported by NFUS. The Health and Work team displayed posters, handed out booklets and discussed health topics with those who work in the farming and crofting industry. Surveys were also handed out to the public attending the NFUS stand to follow up on the KWTTT campaign to gauge awareness and collect feedback. Susan Webb also met with the NFUS President Andrew McCornick, Vice Chairs, Director of Policy, Regional Chair and Manager at the Turriff Show to discuss the health and wellbeing of those working in the agricultural sector. The initial feedback from the booklet has been extremely positive. To continue promoting and raising awareness of health and wellbeing to this sector, Mrs Webb will also be heading a new monthly health column in the Press & Journals Farming supplement. 4

5 This new collaborative way of working to target business sectors which have not previously engaged with workplace health promotion, but could be associated with a higher risk of workplace health inequalities, is now to be tested within the fish processing sector through working collaboratively with the Scottish Seafood Association. New Sobering Thoughts in Aberdeenshire Aberdeenshire Alcohol & Drugs Partnership has launched a new social media campaign providing advice and information on alcohol consumption in a new and positive way. This campaign will help people make sensible and informed decisions about potentially harmful drinking and highlights the impact excessive drinking can have on their health. The Sobering Thought images aim to help people pause for thought, look at their alcohol intake and to better understand the impact of their personal alcohol use on their physical and mental health. The website which links to the campaign gives non-judgemental and interactive information. Top tips on how you can make small changes to your drinking habits for the better, are included showing that even a small reduction in the amount you drink has a number of feel good benefits for your health, including weight loss, improved sleep and increased mental well being as well as less effect on your wallet or purse. Hard copy materials will be launched at a Licensing Forum event in November in collaboration with Police Scotland. The Sobering thought campaign has been running for the month of September targeted to Aberdeenshire residents via Facebook and initial results after one week show good interaction and discussion with 38,746 impressions (i.e. number of times ads were viewed) and a reach of 20,813 people (Reach is the number of times that an ad achieved an outcome based on objectives). This is the first of our Sobering Thought messages on Social Media and evaluation will take place at the beginning of October to allow for any improvements and link with any new evidence such as the recently published Cochrane review looking at Personalised digital interventions for reducing hazardous and harmful alcohol consumption in community-dwelling populations. Stonehaven Renal Unit After five years of fundraising and 1million pounds raised to fulfil the dream of having a local renal dialysis unit in Stonehaven, work began last month. Dr Ann Humphrey, associate specialist at ARI's dialysis unit and lead fundraiser for the campaign should be commended. It has taken a long time to get to this stage, but outstanding fundraising campaign, which has seen a groundswell of goodwill from the local community, and indeed all over the Grampian region, has made this happen. Dame Anne Begg, Non Executive Board Member and chair of the NHS Grampian Endowments Committee was delighted that NHS Grampian's Endowment Fund has been able to contribute in order to get this project off the ground. The new 1.5million unit, which will be able to treat 24 patients a week when working on a full-time basis, is set to be finished next Spring. 5

6 Paediatric Inpatient Service at Dr Gray s Hospital From 18th August 2017, for a temporary period, the paediatric in patient service at Dr Gray s Hospital (DGH), Elgin, was temporarily redesigned to an ambulatory care service in response to significant shortages of trainee doctors. Significant effort has gone into increasing the number of trainee doctors through advertising for further locums; utilising trainees from other services; and working with the deanery to support the staff we have in post. Local staff within the services and the wider clinical community in Dr Gray s Hospital have been involved throughout these changes; the NHS Grampian Clinical Governance Committee has received a report prior to the change. We have communicated with local interest groups, local councillors, MPs and MSPs regarding the changes. The Acute Sector Senior Team is monitoring the situation closely and supporting the local team at Dr Gray s Hospital to develop robust escalation plans to mitigate ongoing staffing challenges. Dr Gray's Communication and Engagement Listening to the local community's wishes, a Facebook page has been set up to keep local people informed about the Ward 2 situation. This means they can ask questions or express their concerns directly to NHS Grampian. NHS News - Spring/Summer 2017 Edition - NHS Grampian s Public Involvement Team is in the process of creating the Autumn/Winter 2017 edition of NHS News, which will be the fourth bi-annual edition they have produced. This publication has been a great success and we believe we are the only Board in Scotland who produce a public newspaper with the main purpose of encouraging involvement and promoting healthier lifestyles. NHS News is just one of the ways that NHS Grampian shares information and opportunities with the public about local health services, and how to get involved. The team gets a fantastic response to their call for articles, not only from staff within NHS Grampian but also colleagues from the Health and Social Care Partnerships, and Third Sector Organisations. NHS News is distributed as a digital document through public involvement networks, Corporate Communication links, social media, public and staff facing websites and partner organisations, through local bulletins and newsletters. In previous editions we have published 5,000 newspapers which have been distributed to clinical sites and locations across Grampian. Due to the success of the paper, colleagues in Public Health are now working in collaboration with the Public Involvement Team, to ensure key healthy lifestyle messages are included in the publications. The Autumn/Winter 2017 edition will have an increased publication amount of 10,000 copies, to increase the number of people we can reach. The Spring/Summer edition of NHS News was viewed 754 times from 1 April to 14 October We undertook an evaluation of this edition and learned that 5% of 6

7 people felt we could have had more information in the paper but 95% thought it was about right and nobody felt it contained too much information. No one reported it was of little or no use, 58% said they found it useful and 42% said the paper was very useful. 58% said they passed the paper onto someone else to read. Multicultural Health and Wellbeing Forum - an NHS Grampian Public Involvement Forum NHS Grampian recognises the importance of involving people from a range of different backgrounds in its work. In order to help achieve this, and to ensure that the organisation is working inclusively, in October 2015 the Public Involvement Team developed the NHS Grampian Multicultural Health and Wellbeing Forum to provide a platform for communication, engagement and involvement. The Multicultural Forum is primarily community-led and is open to anyone who has an interest in issues that may affect people from minority ethnic backgrounds. Members of the Forum include representatives from the NHS, Health and Social Care staff, local Third Sector Organisations and members of local ethnic communities. Over the past year the Multicultural Forum has supported and delivered a range of activities to promote health and wellbeing and encourage positive engagement between NHS Grampian and the diverse communities in Aberdeen. This has been achieved by: Supporting and promoting opportunities for social, cultural and community development and participation Raising awareness around health and wellbeing issues which can affect people from minority ethnic backgrounds Training and other personal development opportunities Promoting social connectivity This complements the Public Involvement Team s work across a range of forums and organisations to support the engagement and involvement of people from diverse backgrounds and identities, including ethnicity, disability, gender, age, faith and sexual orientation. The Public Involvement Team also works in partnership with colleagues from all sectors and partnerships to support wider events and activities to ensure everyone has an equal opportunity to be engaged, consulted and involved in the delivery of local services. The NHS Multicultural Forum works in close partnership with the Aberdeen City Council Ethnic Minority Forum (EMF). The forums enjoy close links and work collaboratively towards achieving shared aims and objectives. The work of these forums could not be achieved without the contribution of all its members. The aims of the Equality Act 2010 are close to the heart of the work of the Forum and this is largely achieved by building relationships, attending events and creating meaningful opportunities for engagement and participation. 7

8 Mindfulness Mondays The Public Involvement Team launched Mindfulness Monday in January 2017, and has continued to offer these sessions on the last Monday of each month since. Mindfulness Monday consists of two free sessions; the first for members of the public, which includes people living with long term conditions, members of local condition specific support groups, such as the local Aberdeen Pain Management Support Group, and people in recovery referred by local organisations such as Aberdeen Drugs and Alcohol (ADA). The second session is for people who work for NHS Grampian or the Aberdeen City Health and Social Care Partnership (ACHSCP). Both the sessions are designed to create a space for people to leave their desks, or whatever it is they are doing, and engage in an activity that will help to benefit their own sense of health and wellbeing. The mindfulness sessions are offered with a view to empowering people to self practice, which in turn will support people to self-manage around issues such as sleeping difficulties, improving concentration, reducing stress, helping to relax the body and mind, and finding balance in daily life. Mindfulness techniques can also be used to help people living with chronic pain. The sessions are delivered at the Health and Social Care Village in Aberdeen. This means that people working directly with patients, families and carers have easy and convenient access to the sessions during their lunch break. In addition, the sessions welcome participation from staff working in local third sector organisations, including staff from Voluntary Service Aberdeen (VSA) who provide statutory support to unpaid carers across Aberdeen. Approximately 45 to 50 people attend the sessions each month. The sessions attract both regular participants and new ones in almost equal measure each month, meaning there are now over 150 people registered to receive information from NHS Grampian on public involvement opportunities. NHS Grampian Equality Outcomes Report The Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012 require that public bodies such as NHS Grampian must produce and publish a set of equality outcomes every four years. The equality outcomes must state what NHS Grampian wishes to achieve in the sphere of each of the 9 protected characteristics over the next four year period. Following extensive involvement and consultation, the NHS Grampian Equality Outcomes Report was finalised and posted on the NHS Grampian website in March 2017, well before the legal deadline of 30 th April The same Report was also produced for NHS Orkney. Aroma Cairngorm After closing for backlog maintenance works and refurbishment in February 2017, the Cairngorm Coffee Shop reopened on Monday 14 August as Aroma Cairngorm and is now warmly welcoming staff, visitors and patients to the newly refurbished area at the main entrance of ARI. Aroma Cairngorm is now a very attractive area to 8

9 relax in for breakfast, lunch, supper or simply snacks and refreshments. The Aroma team runs the service 7 days a week, 8am to 7pm Monday to Friday and from 11am to 7pm on weekends. Aroma is a wholly owned NHS coffee bar brand with all profits reinvested into NHS services. Lady Helen Parking Centre The new car multi storey car park on the Foresterhill Campus is progressing well with the majority of external cladding now in place. The lifts have been installed and the inner floors and ramps are virtually complete. Based on current predictions, the remaining structural and finishing work for the main car park structure will be complete early-mid September with the external roadways and landscaping scheduled to complete at the beginning of October Occupational Health & Safety The department is currently reassessing workflow and looking for areas to strengthen to improve service provision. There has been a reassessment of the external contracts that GO Health Services has been providing services to and some smaller contracts are not being continued. The goal is to improve service delivery to NHS Grampian. GO Health Services has been closely working with Recruitment to strengthen interdepartmental processes related to recruitment and preemployment screening of both internal and external candidates. Work continues regarding the immunisation clearance screening being done in relation to the Immunisation HSE notice. An upgrade to the current OPAS system is under way and the new eopas system should be up and running in early There is currently a global shortage of Hepatitis A and B vaccine. Staff members requiring these vaccinations are being recorded and they will receive appropriate vaccination, based on risk, as product becomes available. The roll out of the screening program for skin health continues which is putting continued pressure on the service to provide timely appointments for clinical assessments and screening. Workforce and Development With the NHS Grampian's values of caring, listening and improving it is vital that we have the right staff with the right skills in the right place at the right time to deliver safe, effective and person-centred care to the population of Grampian. The Nursing Midwifery Allied Health Professions (NMAHP) Workforce Manager, with input from Nursing and Allied Health Professions colleagues, has developed a dedicated recruitment and development website containing useful and informative content to aid the attraction of new and return to practice staff to the organisation. The site went live on 12 July 2017 and since then there have been 992 users totalling 1.1K sessions from Scotland to as far as New Zealand. The response to the website has been very encouraging so far. The site can be accessed via Take the Balance Challenge Campaign Allied Health Professions (AHPs) within NHS Grampian will be inviting the general public to take the Balance Challenge through September & October It is 9

10 part of a national campaign sponsored by the Active & Independent Living Improvement Programme where AHPs are seeking to start conversations with people who may be beginning to experience a decline in their strength and balance (predominantly people of 50+) which can present as a future falls risk. It is an opportunity to share the super six strength & balance exercises as a starter for all - a focused yet simple activity in falls prevention as well as signposting to local appropriate exercise groups and information. In addition it will highlight where people can seek further help, assessment & assistance. The Occupational Therapists & Physiotherapists within Aberdeen Health and Social Care Partnership (HSCP) have also joined forces with Healthpoint, Aberdeen Active Partnership and Aberdeen Library services: taking the challenge to people of all ages in a variety of settings and asking them to spread the message with friends & family. Falls are not inevitable and it is never too early to take steps to protect our strength & balance. Pilot of major trauma rehabilitation plan across the North of Scotland trauma network This is being piloted across the North of Scotland between 21 st August 2017 and 31 st January The goals of the pilot are to: 1. To trial the draft Rehabilitation Plan across the network by utilising with patients from a number of geographical locations across the North of Scotland. 2. To gain real time feedback on the draft Rehabilitation Plan as it is being utilised with patients and make necessary amendments. 3. Refine/adjust the Rehabilitation Plan before seeking an electronic solution to using it across the North of Scotland Trauma Network. For the pilot, AHP staff will be responsible for ensuring that the paperwork is completed at each step of the patient journey. A volunteer psychology assistant has agreed to support the pilot to ensure completion of the rehabilitation plan at each appropriate point and to assist in the transfer of the paperwork between services. An evaluation report from the pilot will be produced to inform further development of the rehabilitation plan. Chief Nursing Officer Strategy for Scotland Vision 2030 In July 2017, Professor Fiona McQueen, Chief Nursing Officer, chose Grampian to launch her vision and strategy - Vision She began the launch by meeting students and new graduates at Robert Gordon University. Moving from there to ARI, she met staff in Care of the Elderly and was shown the Welcome Ward in action. She congratulated the staff on their professionalism and their enthusiastic approach. 10

11 CALENDAR Ministerial Strategic Group for Health and Community Care 18 th July 2017: I attended the Ministerial Strategic Group for Health and Community Care in Edinburgh. Items discussed included performance under integration and delegated hospital budgets. Leadership and Talent Management Group 19 th July 2017: I participated in the Leadership and Talent Management Group. Items discussed included Values Based Recruitment, Performance Appraisal and Governance, communications and engagement. Innovation in Health and Life Sciences in Scotland Workshop 28 th July 2017: Together with the Chairman, I attended the Innovation in Health and Life Sciences in Scotland Workshop. The workshop included presentations on the Life Sciences Industrial Strategy, Higher education contribution to health science innovation and a UK model of health science innovation into NHS practice. NHS Scotland Regional Implementation Leads meeting 31 st July 2017: I attended the NHS Scotland Regional Implementation Leads meeting. Items discussed included Set Aside Budgets, the shape of Regional Delivery Plans and large scale System Transformation. Lesley McLay, Chief Executive, NHS Tayside visited NHS Grampian 1 st August 2017: Lesley McLay, Chief Executive, NHS Tayside visited NHS Grampian to spend the day work shadowing me and meeting senior colleagues. NHS Boards Chief Executives` Group 8 th August 2017: I attended the NHS Boards Chief Executives meeting. Items discussed included Paediatric Intensive Care, Diagnostic Steering Group and Waiting Times Performance. NHS Chief Executives Strategy Meeting 9 th August 2017: I attended the NHS Chief Executives Strategy meeting. Items discussed included update on Engagement, Governance and Financial Planning discussions, Health and Social Care Programme Board update, Improving outcomes and sustainability across the whole journey of care. Hospital at Home Briefing Session 15 th September 2017: I attended a briefing session on Hospital at Home (H@H) which was agreed by the Aberdeen City Health and Social Care Partnership in April 2016 to drive the transformation of models of service delivery for its citizens. It is a service that provides active treatment by health care professionals, in the patient`s home, of a condition that would otherwise require acute hospital in-patient care, always for a limited period. 11