Board Meeting 02/06/2016 Open Session Item 4 CHIEF EXECUTIVE`S REPORT Malcolm Wright, Chief Executive 1
INTRODUCTION Today`s Board meeting will consider a number of important strategic issues including the proposed Local Delivery Plan (LDP) for 2016/17, an update of Ante-Natal and Early Years component of the LDP as well as papers on the Clinical Services Strategy, the full business case for Inverurie, a consultation on dispensing doctors and Primary and Secondary prevention of ill-health. The Board will also be asked to consider a number of items of operational business including Performance and Health Care Associated Infection as well as considering the work of the Governance Committees of the Board. ANNOUNCEMENTS Medical Director Dr Fluck was delighted to welcome Dr Catherine Calderwood, Chief Medical Officer, to a visit to NHS Grampian. Following a meeting with the Chairman and Chief Executive, Dr Calderwood met with Dr Fiona McKay, Dr Richard Coleman and Dr Jamie Hogg, before travelling to the Maternity Hospital to give a lecture. On 23 May the GMC will be leading 2 workshops at the Suttie Centre, one aimed at Good Medical Practice and Confidentiality and the second regarding Boundaries and Social Media. There has been excellent interest from doctors in this event. On the same day, I will be looking forward to attending and speaking at the NHS Grampian Quality Event: Quality and Safety in Healthcare. NHS Grampian Mid-Year Review I received a letter from John Connaghan, NHS Scotland, Chief Operating Officer, capturing the outcomes of the NHS Grampian Mid Year Review held on 9 th February 2016. This confirms the generally improving performance of NHS Grampian along with ongoing challenges on which we are working closely with Scottish Government colleagues. Scotland`s first NHS Shop open on Foresterhill Campus ECC Foyer area is hosting the first NHS-run shop in Scotland. The new Aroma Convenience Store will be managed and operated by the NHS Grampian Facilities team and all profits will be reinvested in frontline patient care initiatives. The store is an extension of the popular Aroma café in the foyer of ARI s Emergency Department. It will be overseen by Health Facilities Scotland and we have partnered up with supply chain company, Simply Fresh to deliver what we think will not only bring an exciting new look to NHS Retail services but provide much more healthier choices for patients, visitors and staff, in line with the new Healthcare Retail Standards that the Scottish Government have recently introduced. The shop, called Aroma Convenience Store opened, Wednesday March 23 and will be open seven days a week. 2
The new store will follow Scottish Government Healthcare Retail standards, with at least 50% of food and 70% of drinks meeting their salt, fat and sugar content guidelines. All Cafés in NHS Grampian hold The Health Living Plus award which ensures a healthy balance of food is offered daily from all our NHS retail outlets. The store is open 8.30am to 7.30pm Monday to Friday, and 12 noon to 7pm at weekends. There are five Aroma outlets across ARI, the Dental School and the Aberdeen Community Health and Care Village serving on average 1400 hot drinks daily. Band 1 Review Following an internal review of Band posts in Laundry and Catering services, we have transferred most staff to Band 2 recognising additional duties being undertaken. Any staff not wishing to undertake additional duties remain on their original Band 1 grade. There is a national review of band 1 roles underway at the request of the Scottish Government to ensure that we have a consistent approach across Scotland. I am pleased to inform the NHS Grampian Board that we are well positioned nationally around this review and ahead of other boards around the deadline of October 2016 to have completed reviews across Scotland. Car Parking Permits Review Foresterhill Following a comprehensive review over the last 6 months around permit applications on the Foresterhill Campus, the process is now complete. This is the first review since 2012 and was required to ensure that the levels of access and parking onsite were safe. Everyone who submitted an appeal by the closing date of Monday 29th February has received an e-mail informing them of the outcome. All staff have been invited throughout April to pick up their new permits from a drop in centre at ARI, which made the process easier for staff collecting permits. In addition, we have also engaged with our partners to assist in the control and management of the site relating to civil parking remedies which supports the safe management of the campus and allowing access for staff and patients to park. Making every Opportunity Count (MeOC) The pivotal aim of MeOC is to implement - at scale - a common way of working to underpin the policy imperative of prevention, by providing a simple approach to the how. Making every opportunity count is suitable for all public and third sector services. MeOC is an inequalities sensitive three tiered approach to support prevention, selfcare and self management. Tier one involves a brief health conversation as part of routine practice to change expectations bit by bit, and contribute to cultural shift of people who provide, and people who use, services. It builds on the evidenceinformed work of NHS England, proof of concept at ARI, existing pockets of good practice in NHSG, and action towards the Health Promoting Health Service, 3
including the recent pilot by Allied Health Professionals on encouraging small steps for health. Tier two focuses on single issues in greater detail such as employability, alcohol and so on. Tier three helps people with more complex issues building on the learning from Keep Well. In addition to the Acute Sector, Aberdeen City, Aberdeenshire and Moray Health and Social Care Partnerships have each taken steps to begin to adopt tier one of the approach to make every opportunity count. NHS Grampian is leading by example. The approach is being implemented and embedded in three hospital settings - Aberdeen Royal Infirmary, Aberdeen Maternity Hospital and Royal Cornhill Hospital. In total there are 16 departments rolling out this brief intervention including 11 Outpatient Departments. 100% of staff in the Outpatient Departments of Aberdeen Royal Infirmary, where appropriate, signpost patients to relevant resources. This includes support for patients who have financial and social issues. There are 46 members of staff in the Outpatients Department. If each staff member signposts 10 patients per day, approximately 100,000 people will benefit from new opportunities to enable them to live as well as they can. A Grampian MeOC Group has been established to share learning, build a critical mass and maintain overall core principles, tailored to local needs. In April in conjunction with the Alliance, a national third sector agency supporting coproduction for self-management, an NHSG team led two workshops to develop workforce capacity and capability, helping colleagues from Local Authority, NHS and Third Sector to see the big picture and how the MeOC approach enables them to deliver on national and local outcomes, including those in NHSG s draft Clinical Services Strategy, mindful of the five must do, person-centred principles. Learning from Keep Well to make every opportunity count Keep Well (KW) is a national, inequalities-focused programme initiated by Scottish Government, and now in its final year of funding. From its inception in NHSG in 2008, we have taken a long term view on sustainability, embedding the principles of keeping well prevention and self-care in pathways and services in the community, enhancing awareness and understanding of the network of expertise and resources available within and across communities and strengthening appropriate links with GP Practices to signpost people who could benefit. We have developed a range of tools which practitioners can use, from a light touch wellbeing conversation through to the original, comprehensive KW health check with clinical markers, life circumstance and lifestyle questions. The common thread at the individual level is that each tool is a trigger. It enables the service provider to engage the person using services in issues of prevention and self-care, through signposting and referral. It facilitates connection with expertise predominantly on non-clinical issues of life circumstance or lifestyle which can best be addressed by the person, with relevant support, in the community. 4
The common thread at the systems level of enabling and nurturing a culture of prevention and self-care is being developed through a proof of concept initiated and now being rolled out within Aberdeen Royal Infirmary. This leading edge work led by clinical colleagues at ARI is also being adopted and adapted for specific initiatives with Community Planning Partners, under the auspices of Aberdeen City s Integration and Transformation Programme Board. There is more information about Making every Opportunity Count in this report. By taking the learning from KW, a form of support principally available in the community to those at high risk of preventable ill-health, we have been able to translate this into building simple, systematic processes within the hospital setting, and beyond, with the same read across messages. These will support systems and services to contribute to cultural shift in ways that are similar and which recognise the varying needs of service users and service providers. In these ways, NHSG has secured a lasting legacy from a nationally funded programme, a basis for continued signposting and referral to a network of expertise in the community, and recognised ways of working, systematically, to contribute to an increasingly preventive culture across partners in and out with the NHS. Health Working Lives (HWL) Awards The HWL ceremony in April featured 30 large and small businesses from across Grampian and from within NHSG, the Mental Health & Learning Disability (MHLD) Service, Aberdeen City Health and Social Care Partnership and Aberdeenshire Community Health Partnership. I was delighted to present this year s awards and gave Mental Health and Learning Disabilities Service their Gold Award, with Silver Awards going to Aberdeen City HSCP and Aberdeenshire CHP. Associate Nurse Director Jenny Gibb gave a talk about the Mental Health & Learning Disability Service s Journey to Gold to the audience. She said that an essential part of the success was for all 1,200 staff to think about HWL in everything they did. Among the activities she highlighted was smoking cessation: The SAS support specialist for staff has proven to be fantastic at one stage during our Bronze campaign we had a 95% success rate. The presentation included the new space dedicated to staff where they can have a quiet moment or relax in their break. Being active has also played a large role in attaining Gold, with walking meetings, football and golf, meanwhile our Keep Well health checks in March attracted a remarkable attendance. Fiona Murray, Public Health Co-ordinator who leads the Aberdeenshire CHP activity, said: Staff have made positive changes to their lifestyle, including losing weight and being more active. Their current pedometer challenge is proving very popular with 47 teams across health and social care taking part. This is the first time they have opened their activities to social care colleagues and are really proud of the response. Sandy Reid, Chair of the Aberdeen City HSCP HWL group, said: Among our many initiatives, the Lunch and Learns, including back pain, sedentary behaviour and stress management, They are now working towards Gold! 5
Launch of pictorial menus Pictorial menus were launched week beginning 9 May. Developed by the Speech and Language Therapy service that supports people with learning disabilities, this will support all patients to make food choices using a pictorial menu. This will be of great benefit to provide the person centred care we all strive to deliver and allow individuals with additional needs the opportunity to be empowered to choose their own meals. An initial pack is to be given to each adult ward area across the whole of NHS Grampian. Strengthening partnership working with SFRS; new NHS referral process for Home Fire Safety Visits A new referral process, aimed at keeping frail and vulnerable people safe from fire, has been developed by Scottish Fire and Rescue Service (SFRS) and NHS Grampian. SFRS recognised elderly and vulnerable people are being visited by health care professionals on a daily basis. These people are at greater risk from fire and may not have working smoke alarms. The pathway guides NHS Grampian staff through the potential risk factors: if they have clients who meet these criteria they can provide information about the free Home Fire Safety Visits or even refer them for a visit directly. Aberdeen Station Manager Gordon Riddell worked with Allied Health Professionals: initially Occupational Therapists but latterly with all community staff, including nurses, to set up the referral pathway. Though this initiative started in Aberdeen there is support from NHS staff and SFRS partners to roll this out across Grampian. NMAHP Professional Leaders Forum Senior nursing, midwifery and allied health (NMAHP) professional leaders met on 22 April to consider, as NMAHP professional leaders, how they foster and influence the NMAHP vision in NHS Grampian, achieve key professional objectives and identify and capture innovative opportunities. I gave the opening address and the group then heard from Theresa Fyffe, RCN Scotland Director who spoke to the group about considering the leadership journey in a new landscape, followed by Karen Strickland who presented on Magnet Hospitals and their principles. In the afternoon the professional groups focused on sharing best practice, networking and planning for the future. International Nurse s Day 12 May 2016 Nurses across NHS Grampian celebrated International Nurses Day by describing what they enjoyed and valued about being a nurse on social media. May 12 is Florence Nightingale s birthday and is used to raise the profile of nursing as a profession and its contribution to patient care. Amanda Croft, Director of Nursing, Midwifery and Allied Health Professionals sent a video message to all nurses thanking them for the excellent job they do. There was a large social media interest with many offers of thanks to nurses for the care they provide from patients, relatives and other professionals using the #thankanurse. 6
Carers (Scotland) Act 2016 Initial discussions have now taking place with the Scottish Government in relation to the implementation of the Carers (Scotland) Act 2016. This legislation will consolidate existing rights from other pieces of legislation as well as enshrining new rights for carers in law. It is expected that the provisions of the Act will commence from April 2017. A local briefing for NHS Grampian staff has been produced and can be found on the Corporate Communications Intranet site: Carers (Scotland) Act 2016 Staff Briefing March 2016. Carers Week 6 th - 12 th June 2016 National Carers Week takes place during the 6 th and 12 th June 2016. This year s theme is Building Carer Friendly Communities. We plan to target our own workforce with the aim of raising awareness and identifying staff members who may have an unpaid caring role in addition to their employment within NHS Grampian. These campaigns will take place at Summerfield House and the Aberdeen Community Health and Care Village and are being facilitated by Wendy Innocent, Health Promotion Services Manager. In recognition and support for carers week, colleagues from the catering department have kindly agreed to promote this campaign on the back of menu cards. Information will include signposting to healthpoint / carerspoint facilities and our commissioned carers support services. NHS Grampian Palliative and End of Life Network The Public Involvement Team is supporting the ongoing work of the Managed Clinical Network Support Manager in developing information for patients and carers, as part of the work of the network, which includes third sector organisations in the membership. An initial draft has been developed by a sub-group and Corporate Graphics will be approached to be involved in developing options for a sensitive design and colour scheme bearing in mind the subject matter. The aim is get drafts and options out to a wider consultation including the use of focus groups and distribution to the Public Involvement Network. Children s Home Care Service (CHCS) The Public Involvement Team has been supporting the CHCS team to find out what is important to the families who use this service, by meeting with the families and using the Storytelling method of public involvement. Out of the ten families who currently use the CHCS, eight wished to take part and met with a member of the Public Involvement Team. The families stories included; a description of their time using the home care service, their feelings about what had happened over this time and how it has affected them, their child and their family. After the meetings, insights from the stories were written up and shared with the families to ensure there was no misinterpretation. Six common key themes were identified about the service through the family s insights, which were: assessment, care at home, communication, management and leadership, staff training and uncovered shifts. To ensure the feedback received was as unidentifiable as possible, each family s insights were combined in one report, under the headings of each key theme. 7
'Storytelling' proved to be an excellent method of engagement for this service, as it recognises and respects the expertise that people have in their own lives. Valuable personal experiences were used to draw out important themes and issues. It was also a very empowering tool as it values unique personal experiences and has generated great insights into this service. CALENDAR North of Scotland Planning Group 16 th March 2016: I participated in a virtual meeting of the North of Scotland Planning Group where items discussed included Cancer Services in North of Scotland, National Clinical Strategy and Prioritisation of Regional Work Streams. NHS Grampian Area Partnership Forum 16 th March 2016: I co-chaired the meeting of the Grampian Area Partnership Forum. Items discussed included imatter, Abolition of Contracted Out National Insurance Rate and Health and Social Care Integration. Physician Associate Open Day 4 th April 2016: I participated in the Physician Associate Open Day at Aberdeen University and discussed their important new roles for the NHS. NHS Chief Executives Meetings 12 th /13 th April 2016: I attended NHS Chief Executives Meetings in Edinburgh. Items discussed included Finance Strategy and Direction, Workforce and Effective Prescribing. Telephone Meeting with Roddy Burns, Chief Executive, Moray Council 13 th April 2016: Telephone meeting with Roddy Burns, Chief Executive, Moray Council as part of our regular update. Senior Leadership Team Development Session 14 th April 2016: I participated together with my Senior Leadership Team colleagues on a development session to refresh the strategic risks for the organisation, to agree key roles and responsibilities and to agree revisions to the risk register. Visit by QUEST team to NHS Grampian 14 th April 2016: Linda Semple, leader of the National Quality and Efficiency Support Team (QUEST) visited NHS Grampian to present on their findings and to explore how QUEST can work with us to deliver improvement. Children and Young People`s Health Support Group Health and Social Care Integration Workshop 15 th April 2016: I led the Children and Young People`s Health Support Group Health and Social Care Integration Workshop held in Edinburgh. 8
Interviews for Director of Acute Services 19 th April 2016: I chaired the interview panel for the role of Director of Acute Services and I am delighted to announce the appointment of Gary Mortimer as the new Director. Meeting between NHS 24 and NHS Grampian 21 st April 2016: Together with senior colleagues from NHS Grampian and the Chief Officers of the IJBs I participated in a discussion meeting with colleagues from NHS 24 including Angiolina Foster, Chief Executive. Executive Walkround of Muick Ward, Royal Cornhill Hospital, Aberdeen 21 st April 2016: Together with Raymond Bisset, Non Executive Director I did a walkround of Muick Ward at Royal Cornhill Hospital. Professional Leaders Forum 22 nd April 2016: I welcomed NMAHP colleagues to the Professional Leadership Forum. The aims of the session were to foster and influence our NMAHP vision and achieve key professional objectives and to identify and capture innovative opportunities. Aberdeenshire Child Protection Chief Officer Group Meeting 22 nd April 2016: I attended the Aberdeenshire Child Protection Chief Officer Group Meeting held at Woodhill House. Items discussed included Children and Young People (Scotland) Act, Joint Inspection of Children`s services and Integrated Children`s Services Plan. Meeting with Jim Savege, Chief Executive, Aberdeenshire Council 22 nd April 2016: Regular update meeting with Jim Savege, Chief Executive, Aberdeenshire Council. Healthy Working Lives Award Ceremony 22 nd April 2016: I was invited to attend the Healthy Working Lives Award Ceremony and presented the Bronze, Silver and Gold awards. Visit to Skene Medical Group 26 April 2016: Following an invitation from Dr Colin Hunter I spent a half day with the Skene Medical Group and sat in with GP and Nurse Practitioner consultations. Following this I met with the team at the Centre. Face 2 Face Staff Information Session at Inverurie Hospital 26 th April 2016: Together with Adam Coldwells, Chief Officer of Aberdeenshire IJB, I met with colleagues at Inverurie Hospital. A powerpoint presentation was shown and a question and answer session followed. 9
Aberdeenshire Performance Review Meeting 27 th April 2016: I had a meeting with Jim Savege, Chief Executive, Aberdeenshire Council and the finance directors from NHS Grampian and Aberdeenshire Council. Meeting with Dr Catherine Calderwood, Chief Medical Officer 27 th April 2016: Dr Catherine Calderwood visited NHS Grampian and met with myself and senior colleagues. Multi-Agency Independent Review Meeting 27 th April 2016: I attended a meeting for the Multi-Agency Independent Review. Meeting with Sir Ian Diamond, Principal, Aberdeen University, Prof Steve Heys, and Moir Lockhead 28 th April 2016: I attended a meeting with colleagues from Aberdeen University together with Professor Stephen Logan, Chairman and Dr Nick Fluck, Medical Director to discuss school strategy, integration and joint working. Volunteer Thank You Event 28 th April 2016: I attended an event at High Hilton Church to celebrate and thank volunteers who help NHS Grampian. Meeting with Richard Coleman, Director of Medical Education 3 rd May 2016: I met with Richard Coleman to discuss medical education and training. Face 2 Face Staff Information Sessions at Woodend Hospital 3 rd May 2016: Together with Laura Gray, Director of Corporate Communications, I met with colleagues at Woodend Hospital over two sessions. A powerpoint presentation was shown and question and answer sessions followed. Podcast Recording to colleagues 4 th May 2016: I recorded a podcast for viewing on NHS Grampian`s intranet. Topics discussed included Winter Planning, Integrated Joint Boards, Recruitment and Capital Expenditure. Moray Partnership Engagement Video Conference Meeting 4 th May 2016: I was involved with the Moray Partnership Engagement Video Conference Meeting with Geoff Huggins of Scottish Government, Roddy Burns, Moray Council and other colleagues of all 3 organisations. Items discussed included Progress on Strategic Commissioning Plan, Update on Partnership and Data including outcomes and indicators. 10
Aberdeen City Performance Review Meeting 4 th May 2016: I attend the Aberdeen City Performance Review Meeting together with Angela Scott, Chief Executive Aberdeen City Council, Judith Proctor, Chief Officer, Alan Gray, Director of Finance NHSG and Steven Whyte, Head of Finance. Items discussed included Performance and Finance. NHS Grampian Board Seminar 5 th May 2016: I attended the Board Seminar involving the Area Clinical Forum, Grampian Area Partnership Forum, lead clinicians and senior managers. Items discussed were Major Trauma Network, Health and Social Care Integration and Elective Care and Diagnostic and Treatment Centres. 11