AOD Patient’s Panel

Thursday 6th October 2011

11.00am

Boardroom, Southern GeneralHospital

Present:Rory Farrelly, Nurse Director (Acute) James Ferguson Eileen Ferguson Anne Jack William Brady Anne MacDonald James Duncanson Heather Gartshore Deborah Macmillan David Paul Alice McFarlane Barbara Walker Kathleen Molloy Karen Kerr Dagmar Kerr Lisa Kerr Elaine Kavanagh Lorna Gray, NHS GGC Daniel Connelly, NHS GGC Dan Harley, NHS GGC

Apologies:Alan HendersonJacki McIlraith

Meena Dutt Alan McDonald Anne Marie Kennedy Kate Walker

Eleanor McKendryRizwana Saeed

Attending:Debbie Forsyth, MRSA Screening Project Manager

Tina Murray, Clinical Implementation Nurse

Pamela Joannidis, Lead Nurse, Infection Control

  1. Welcome and Introductions

Rory welcomed everyone to the meeting. Introductions were given around the table for the benefit of the new members who were welcomed to the group, Dagmar Kerr, Lisa Kerr and Elaine Kavanagh.

  1. MRSA Screening Programme

Debbie Forsyth provided an update on changes to the screening programme which are being rolled out across Greater Glasgow and Clyde, as a follow up a meeting she attended previously. So far, the screening programme has proved successful in terms of meeting Government targets and having a positive impact on infection rates.

Changes are now being made to the way that screening is carried out.

  • Patients will be asked to complete a paper based exercise first of all. This will filter for those who are more likely to have MRSA already on their skin. Only those people will be screened further by using swabs.
  • Patients will be screened at their pre-op assessment or on the ward if brought into hospital in an emergency. There are some patients who will automatically be swabbed if they are in high risk areas. These high risk areas have been changed to include orthopedics and intensive care but no longer include elderly care or dermatology.
  • Swabs taken from patients who appear to be a risk based on their paper exercise will now be taken from 2 areas – the nose and perineum. If patients refuse the perineal swab, they can do it themselves while supervised if able. Alternatively, a swab can be taken from the throat instead.
  • Swabbing in this area can be seen as quite invasive in comparison to the nose and throat, therefore taking this into consideration the team are auditing levels of patient refusal.
  • Tina gave a demonstration of how the nose and throat swabs would be carried out. She also advised of the treatment process for those who test positively.
  • A body wash is used once a day for 5 days and a nose ointment is used three times a day for the same 5 days. Patients do nothing for the next two days to check that treatment has been effective. Patients will then be retested, either locally at their GP clinic/ health centre; back in the pre-op clinic; or on the ward.
  • Patient communication materials have been developed nationally including banners, leaflets, and posters. These have been rebranded from the previous green colour to a blue. Roadshows will also be taking place to explain the changes to patients.

Questions

  • Are all the swabs throughout GGC the same?
  • Some are charcoal, some are gel but not big difference between them.
  • Rory added that it is important that all members take this information back to their relevant forums. They will be provided with copy of the presentation and other aids to help to do this.
  • How are those with literacy problems catered for as they wouldn’t necessarily understand the information leaflet given to them or be aware of these changes.
  • Nurses are confident in explaining swabbing and usually this would be enough.
  • In the general population, how many people already have MRSA on their skin?
  • Around 7% of the population already have MRSA on their skin without it doing them any harm.
  • Would a recent tattoo or piercing count as a recent cut/ open wound?
  • Only if infected/ weeping etc. Karen suggested this should be added as a prompt to nurses to ask about, as a patient would not necessarily see this as a wound.
  • Will any help be offered to those in nursing homes etc who are maybe not showered every day if they need to take this treatment? Would there be support for the staff in doing this?
  • No personal carers are being made available to assist in showering etc but carers groups have been included in presentations etc.

Debbie agreed that information packs will be sent out to the group. Some members expressed that this was still seen as a frightening subject, both due to the media publicity and some of the language used, for example ‘colonisation’.

David added that many information stalls still have the old leaflets displayed and asked about the timescale in withdrawing these and getting the more recent information displayed. Debbie advised that the leaflets have been rebranded but roll out is phased and will be complete by the end of December this year. After this time all older leaflets should be removed.

Elaine asked for the reasoning behind the use of the perineum as a swab site when the throat is acceptable as an alternative site, especially given that this is a more invasive test for the patients. Rory advised that this had been given a lot of thought, because of these issues, however detection rates when carrying out a nose and perineum test are at 82% compared to around 75.5% for nose and throat. This would mean that there is the potential for around 6.5% of patients not being detected if only used nose and throat tests, therefore there is a need to capture as many people as possible to reduce risk.

Bill asked if the information leaflets would be in GP surgeries as well. Debbie advised that this was done last year and would definitely be repeated this year. Kathleen suggested that this information could also be displayed on Solus screens.

Thanks were extended to Debbie and Tina for attending.

  1. Minutes and Matters Arising

Minutes of the previous meeting were agreed as an accurate record.

  • Membership forms – some still haven’t filled in their membership forms, Lorna has spare copies with her for anyone who needs to fill one out.
  • 1 to 1s – there are still a few more meetings to be arranged. Lorna will be in touch to organize these dates.
  • Constantly looking at membership to ensure representation across NHSGGC. Welcome to Elaine Kavanagh from Inverclyde PPF and also Lisa and Dagmar Kerr. A new member, Kate Walker has also joined from North-West PPF however she is unfortunately unable to attend today’s meeting.
  • Future meetings – a calendar of meetings for next year will be provided for the next meeting.
  • Do Not Attend information – it was raised that commonly there are no numbers to call re cancellation of appointments or there are difficulties getting through to clinics. It was suggested that someone from medical records will be asked to attend a future meeting.
  • Protecting Vulnerable Groups registration/ Occupational Health assessments – after looking at how these requirements can be applied for the purposes of our work, Dan and Daniel will be working though on individual activity basis. Advice will be taken from the Board’s volunteer manager about protecting members and the organization without going through a heavy bureaucratic process. Any members who already have a PVG number should let a member of the Community Engagement Team know. It was confirmed that Disclosure Scotland has been replaced by the PVG scheme, widening the groups included and providing more continuity as no need to go through full application process every time with PVG. Many areas of our work will not require to be covered by PVG, particularly because volunteers will usually be supervised at all times.
  • Patient Experience Work – meetings have been arranged for next week and February to update on the Patient Experience programme. Dan advised that next weeks meeting may have to be cancelled due to difficulties in getting staff representation from every area in the improvement programme. We will be able to confirm this by the end of today/ first thing tomorrow morning.
    In addition to this, a visit to the new Central Production Unit (unofficially titled the ‘Super Kitchen’ facility at InverclydeRoyalHospital has been organized so that members can see the process behind the work of the unit, which is one of 2 kitchens supplying food to NHSGGC hospitals. Numbers for this are limited but a second visit will be arranged in the New Year. The team will be in touch to confirm who will be going on the first visit as soon as possible. As a follow on from this, Dan would like to arrange for members to visit a ward to talk to patients about how the food is and see new process in action.
  • Continuing Care in the West – a stakeholder event has taken place and paper gone to the Board. Any further information will be updated when received.

  • Working Together Sessions – last meeting took place in July. These events were happening every 6 months, however there was a break due to bad weather etc. The next one will be in February and information will be sent out in due course.
  • Lightburn Hospital – Alice asked for an update on the current provision of food to Lightburn as discussed at the last meeting. Dan advised that he had forgotten to bring the information with him but would get back to Alice with regards to this.
    This led to a discussion about the LightburnHospital consultation. In response to comments made about rumours surrounding the future of the site, Dan confirmed that Lightburn is NHS owned estate and that no capital commitments have been made in relation to Lightburn. After a period of pre-consultation engagement and full public consultation, the Health Board took the decision to recommend closure of Lightburn. The final decision now rests with the Cabinet Secretary for Health.
  1. Volunteer agreement (formerly known as the Rules of Engagement)

Karen Kerr agreed at the last meeting to review the rules of engagement. It was agreed that these could be signed off at the next meeting to allow members to read them through properly beforehand.

Karen advised that she had used most of the original content but had changed the language used including the title to make it less confrontational and more of a partnership between members of the panel and NHSGGC staff. This would not be for members of the public for information about joining, only for those who have already agreed to join the group.

Karen asked for comments to go back to Dan by the end of October to allow her to make changes in time for the next meeting. Comments from the group were that from the first read it captures the main points very well and the language of it is excellent. This will be formally signed off at the December meeting.

5.Visiting Times Review

A working group was set up to look at standardising visiting times across departments and hospitals. This working group included public representation, including Anne from the Patients Panel.
Surveys are also being undertaken in all hospitals to ask patients, staff and visitors their opinions on visiting hours. The results of this will be reviewed and fed back to the group at the December meeting.

  1. Food Fluid and Nutrition
    This was touched on earlier with the visits to the Central Production Unit however Elaine Gordon who attended the last meeting will be coming back to a future meeting to update on food menus and menu planning.
    Alice commented that some people who are taken for procedures during meal times are not provided with food when they are back on the ward. Others advised that in come cases a snack is offered but not a hot meal. It was discussed that provisions on the ward have changed and sometimes there aren’t the facilities to reheat food, or make toast for example.
    Lisa advised that from her experience there needs to be more choice for those who need different texture diets and that more than one option should be given.
  2. Infection Control and Hospital Cleanliness
    Pamela and Daniel are taking forward work on 3 different areas:
  3. Statistics Graphs – these are put outside wards to reassure people about infection rates at that ward, however it has been raised that these are confusing and don’t mean anything to the general public in the way they are presented. Pamela is doing a review of the graphs and looking at how to convey the information in an easy to understand way.
  4. Newsletter around Infection Control and HEI visits – this will be used to increase communication around when and where visits take place and the feedback and results of the visits. A text version of the newsletter will be sent out to members for comments. It was also suggested that the recommendations and requirements set are added to this.
  5. Mock visits – Pamela and Daniel will create a remit of what these visits could involve to see if any of the Patients Panel would be interested in taking part in this area of work.

8. Date of Next Meeting

The next core meeting will be on Friday 16th December from 11.00am until 2.00pm. Venue to be confirmed.

1