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MINUTE of MEETING of the
ALLIED HEALTH PROFESSIONS COMMITTEE
Board Room, Centre for Health Sciences, Raigmore,Inverness – 9.00 am /
Wednesday 10 February 2010
Present: / Judith Catherwood, Associate Director (AHPs) (JC) (In the Chair)Diane Brawn, Radiotherapy (DB)
Iain Henderson, Orthotics (IH)
Lesley Hill, Art Therapy (LH)
Rhiannon Pitt, Physiotherapy (RP)
Dougal Sim, Physiotherapy (DS)
Mary Wilson, Podiatry (MW)(Videoconference)
In Attendance / Rosemary Almond, Lead Practice Education Facilitator (RA)
Rachel Hill, Clinical Effectiveness Manager (RH) (from 10.05am)
Brian Mitchell, Board Committee Administrator (BCA)
Rev Dr Derek Brown, Lead Chaplain
1. / APOLOGIES
Apologies were received from Maria Dickson, Heidi May, Jean McCulloch, Margaret Moss, Kayrin Murray, Katherine Sutton, and Claire Wood.
2. / MINUTE OF MEETING HELD ON 15 DECEMBER 2009
The Minute of the meeting held on 15 December 2009 was Approved.
The Committee Agreed that the following Item be considered at this point in the meeting. / BCA
9 / FLYING START POLICY
Ms Almond spoke to the circulated draft NMAHP Flying Start Policy document and associated algorithm, the aim of which was to ensure the scheme was fully implemented amongst all newly qualified NMAHPs within NHS highland and integrated as part of the Mandatory Training Policy currently being developed. All newly qualified practitioners with permanent, temporary and bank contracts would be required to start and complete the Flying Start programme in a twelve month period, and Line Mangers were required to support practitioners undertaking the programme. The programme itself was a national on-line activity first commissioned in 2005 and supported new staff in making the transition from student to qualified practitioner by building confidence and capability in their first year as an employee. At present Practice Education Facilitators were discussing the relevant requirements with trainees prior to qualification. The benefits for employers, newly qualified staff, and mentors/supervisors/KSF reviewers were also outlined. It was recommended that new staff receive 2 hours of protected learning time, and mentors set aside 2 hours per month.
During discussion it was stated that the programme, and its joined-up learning approach, would also be beneficial but not mandatory for those practitioners who were returning to practice, especially around issues relating to communication and understanding of roles etc. The programme would be applicable for all practitioners who had a requirement to be registered with the NMC or HPC, and where this was included within Core Job Descriptions.
After discussion, the Committee Agreed to support the draft NHS Highland NMAHP Flying Start Policy.
Ms R Almond left the meeting at 9.30 am
3. / MATTERS ARISING
3.1 Revised Joint NMAHP Committee Proposals
Ms J Catherwood spoke to a report outlining the final proposals for establishment of a joint NMAHP Committee with effect from April 2010. Substantive amendment from that previously considered and approved by the Committee included inclusion of matters relating to Research and Development being referred to the Workforce Planning and Development Delivery Group. Delivery Groups would meet and rotate on a monthly basis, with associated Sub Groups meeting quarterly. Ms Catherwood advised that, at their meeting held on 28 January 2010, the Area Clinical Forum had considered the proposal and raised a number of issues however it had been agreed that these be introduced and its effectiveness reviewed after a one year period. One key element would be relevant representatives giving clear, strong clinical advice to the Area Clinical Forum. In terms of membership and attendance, deputies should be used where necessary with a view to ensuring strong AHP representation at meetings. Final approval for the proposal would rest with the NHS Board.
After discussion, the Committee:
· Noted the revised proposals.
· Agreed that Committee arrangements be reviewed after one year.
3.2 Decontamination of Podiatry Instruments
There had been circulated report outlining the position with regard to arrangements relating to the decontamination of Podiatry instruments in North, Mid, and Argyll & Bute CHP areas. In the North CHP area a model had been proposed, but not yet agreed whereby Thurso and Golspie equipment would be transported to Inverness CSSD utilising porters and hospital transport. Wick staff would use the Wick LDU and in North West Sutherland the Podiatrist would use disposable equipment. In the Mid CHP area LDU’s in Lochaber and Skye & Lochalsh would be utilised. With regard to transport issues relating to the Fortrose and Beauly areas it had been proposed, from June 2010, that dentistry Local Decontamination Coordinators be utilised to deliver used and clean instruments by means of a pool car. This would necessitate a budgetary transfer from locality to dentistry and was being pursued with CHP Management and Finance accordingly. In the Argyll and Bute CHP area relevant issues had yet to be resolved and Mrs M Wilson advised that solutions would be required in both the Oban and Bute areas. It was stated that relevant funding would require to be discussed and identified.
The Committee Noted the position.
3.3 eHealth Update
Mrs M Wilson advised the Committee that relevant material relating to eHealth was regularly issued to members. She advised that activity relating to the introduction of a new Knowledge Network, to replace the eLibrary, was progressing. In this regard training was being provided through Raigmore Hospital and especially with regard to the use of the personal portal, this being a valuable aspect of the new system. At a recent meeting of the national eHealth group there had been discussion in relation to the MIDAS system, and at a local level it was stated that this would not be extended to AHP services at this time. Given that this was a modular system an element for AHP services could be developed through an appropriate programme and added as required. Ms J Catherwood advised that the eHealth service were committed to a strategic phased implementation of the MIDAS system, that this would be a large project within NHS Highland, and priority would be given to aspects relating to management information. Particular issues relating to introduction in Argyll and Bute CHP would require to be discussed further. One of the key aspects of MIDAS, once fully introduced would be the ability to access relevant local authority information and in this regard Ms R Pitt advised that the Integrated Care Team had already expressed an interest in seeing this element introduced.
The Committee otherwise Noted the position.
3.4 Maternity Services Committee Representation
The Committee Agreed to Defer consideration of this Item pending further discussion with Mrs H Bryers, Head of Midwifery.
3.5 Area Drug and Therapeutic Committee Representation
Ms R Pitt advised that she was to assume the representative role on behalf of the Committee and would discuss relevant issues with Ms S Pfleger. There were a number of associated groups relating to this Committee however not all would require AHP representation.
The Committee Noted the position.
3.6 Hand Hygiene and Environment Audit Tools
The Committee were advised that the relevant audit tools had been previously issued and should be utilised for surveillance audit activity etc.
The Committee so Noted.
3.7 Community Setting Equipment – Procedure Document
Ms J Catherwood advised that there was no longer access available to relevant CEL funding and that she would discuss with the Interim Infection Control Manager alternatives to creating an appropriate procedure document.
The Committee Noted the position.
/ JC
MW
JC
RP
ALL
JC
4. / PROFESSIONAL AUDITS, INCLUDING ACTIVITY ANALYSIS AND RECORD KEEPING AUDIT PLANS
Audits and Audit Tools
Ms R Hill spoke to a circulated report advising that the Clinical Effectiveness (CE) Team on the evolution of audit tools from paper to Excel-based systems. These tools are designed for independent use with a reporting facility now in-built in order that teams can reflect upon results and action plan immediately upon completion of the audit. Frontline staff would use their own results to make improvements and are encouraged to take a ‘continuous quality improvement’ approach. The CE Team had produced a tool guide book to support self sufficiency in this activity. Tools were provided to relevant Leads for onward transmission to staff and were also available for download via the Intranet. Feedback to date had indicated that this activity had supported improvements in relevant record keeping. In relation to AHP Groups it was advised that tools and respective audits were at various stages of implementation as outlined, with discussion continuing, and to take place, in relation to Physiotherapy, Dietetics, Podiatry, and Speech & Language Therapy services. On the point raised to other services using such a tool Ms R Hill advised that Radiotherapy already used a separate e-system and that those being developed would provide a better fit in some areas than others. In this regard a set of Standards for Record Keeping may be a beneficial approach to adopt. Ms R Hill stated that the aim was to achieve the maximum value from the process and as such there may be a requirement to consider audit results on a profession-wide basis. To support this approach a facility had been added into the design of the relevant tools to facilitate the merging of results, which could potentially on an annual basis be utilised to produce Highland-wide and operational unit based reports. The merged datasets could be returned to service Leads to allow them to conduct their own analysis although training may be required in this regard. On a general basis, to promote the system of continuous quality improvement and follow the methodology of other quality improvement programmes, it was recommended that staff undertake audits on a regular cyclical basis, with re-auditing timescales dependent upon results as outlined, on a 6 weekly; 3,4 or 6 monthly basis.
After discussion, the Committee:
· Agreed audit tools on a set format, with individual service variation.
· Agreed all professions, excluding Chaplaincy, agree a schedule for the development of audit tools with the CE Team.
· Agreed the proposed re-audit frequency timescales, based on five individual records.
· Agreed an annual plan be established for data merge activity.
· Agreed that professions be advised as to the timetable for ‘Excel for Audit’ training events.
· Agreed consideration should be given to including audit activity as part of senior staff peer review processes.
Activity Analysis
Ms J Catherwood advised that audit tool results were to be utilised as part of the service redesign process for Physiotherapy and as such there was a requirement that this be the most up to date version available. Ms R Hill advised that work was continuing in this area and stated that amendments would be complete by the end of February 2010 to enable this to be used in the redesign process.
General Governance Arrangements for AHPs
As part of discussion, Ms J Catherwood stated that audit activity, and Risk Management arrangements, were to be developed as part of the governance arrangements for AHP services and sought advice on the support that may be available from the CE Team to support that activity. Ms R Hill advised that appropriate audit, and continual quality improvement tools could be developed to support this process. Introduction of web based system based around Scottish Patient Safety Programme activity may be useful by providing cross-system analysis. Ms R Hill suggested that she attend a meeting of Professional Heads of Service to discuss these elements in greater detail, although any activity would of course have to be prioritised along with other Team activity and workloads.
Incident Management
Ms J Catherwood referred to the DATIX Incident Management System, in particular data that may be beneficial in consideration of Risk Management mapping, and was advised that there was a range of information that could be extracted. Ms R Hill advised that a range of information was already provided to operational unit Clinical Governance Groups and this helped to provide focus particular areas of consideration such as Slips, Trips and Falls.
Ms R Hill left the meeting at 10.50am / RH
PHOS
PHOS
PHOS
RH
PHOS
RH
RH
5 / 5.1 NHS HIGHLAND BOARD MEETING AGENDA – 2 FEBRUARY 2010
There had been circulated Agenda relative to the NHS Highland Board Meeting held on 2 February 2010, the reports relative to which were available on the NHS Highland Internet site under the meetings page.
Ms J Catherwood drew the particular attention of members to Item 5.1 relating to the NHS Highland Strategic Framework 2010/2011 and advised that this was an emerging piece of work, including a commitment to development of a Clinical Strategy that would encompass all relevant organisational Plans relating to Workforce Planning, Finance etc. On the point raised Ms J Catherwood advised that as a member of the Corporate Team she would have the opportunity to feed into that overall Strategy, including through the AHP Strategy document recently established.
The Committee otherwise Noted the circulated Agenda.
5.2 FEEDBACK FROM AREA CLINICAL FORUM – 28 JANUARY 2010
Ms J Catherwood advised that at the recent meeting of the Area Clinical Forum there had been discussion relating to the creation of a Healthcare Science Forum, under the leadership of the Board Medical Director. There had also been consideration of draft Falls/Rehabilitation Strategies and associated resources etc.
The Committee so Noted.
6. / NHS HIGHLAND AHP STRATEGY – REPORT TO NHS BOARD
Ms J Catherwood spoke to the circulated report outlining an NHS Highland Strategy for the development and transformation of AHP Professions and Services to support NHS Highland Corporate Objectives and the Changing for the Better Agenda. Fulfilment of the proposed Strategy would involve a great deal of work over the coming three years and discussion was ongoing with the Business Transformation Manager on issues relating to appropriate resource identification and utilisation. The Strategy Plan would also be Risk Assessed.
The Committee Noted the NHS Highland AHP Strategy. / JC
7. / NHS AHP WORKFORCE MODELLING EXERCISE
Ms J Catherwood spoke to a circulated report outlining the results and feedback from NHS Boards from the national AHP workforce modelling exercise. The report detailed a summary for all professions, current NHS Board establishments, modelling results to 2011, and demand projections to 2011. There was also included an indication as to current vacancy levels and a summary of key workforce issues that had been identified. It was stated that this exercise would be undertaken on an annual basis and detail may be enhanced moving forward. The Committee were invited to consider the detail contained within the report.