Minutes of the fifty-fifthmeeting of the Patient and Client Council

held on Tuesday 23 June 2015 at 1pm in the Conference Room,

Ormeau Baths, 18 Ormeau Avenue, Belfast BT2 8HS

Present:
Dr Maureen Edmondson (Chair)
Cllr Mrs Beth Adger
Mr Brian Compston
Mrs Liz Cuddy
Professor Hugh McKenna / Dr Sheila Kelly
Dr May McCann
Mrs Joan McEwan
Cllr Martin Reilly
Apologies:
Mr Bill Halliday
Mr Garrett Martin
Cllr Colin McGrath / Cllr Mrs Marion Smith
Mrs Seána Talbot
In attendance:
Mrs Maeve Hully, Chief Executive, Patient and Client Council (PCC)
Mrs Louise Skelly, Head of Operations, PCC
Mrs Helen Mallen, Board Secretary, PCC
Mr Paul Schofield, Research Manager, PCC (from 2pm to 3.10pm)
Mrs Lynne Charlton, Head of Nursing, Quality, Safety and Patient Experience, Public Health Agency (PHA)

52/15INTRODUCTION

Dr Edmondson welcomed everyone to the Board meeting of the

Patientand Client Council (PCC). She particularly welcomed Mrs Charlton who will attend PCC Board Meetings on behalf of the PHA.

Dr Edmondson asked that thanks be noted to Mrs Oriel Brown, Nurse Consultant, PHA, who had previously attended PCC Board Meetings.

53/15CONFLICTS OF INTEREST

There were no declared conflicts of interest in the items to be discussed on the Board meeting agenda.

54/15MINUTES OF THE LAST MEETING

The minutes of the meeting held on the 19 May 2015 were agreed as an accurate record of the meeting and signed by the Chair and Chief Executive.

55/15MATTERS ARISING

Dr Edmondson referred to the outstandingitems on the Matters Arising Sheet.

  1. Item 50/15 (e) NIAS Services in rural area

Mrs Skelly explained that NIAS have spoken to the PCC regarding new ways of working to improve the use of resources. Historically, if called, all ambulances transported patients to hospital. There will now be a number of options introduced, such as seeing and treating at the scene. NIAS have involved service users in developing the new ways of working.

  1. Item 50/15 (d) Child and Adolescent Mental Health Services (CAMHS).

Mrs Skelly confirmed that CAMHS are in the Commissioning Plan for 2015-2016 with more support for local CAMHS teams. Dr McCann also confirmed that CAUSE has funded an advocate/carer to work with CAMHS.

Mrs Skelly took the opportunity to update the Board on particular areaswithin the Commissioning Plan, on which she has submitted comment on behalf of the PCC. PCC Peoples Priorities underpins a number of the strategic priorities within the Plan but she has raised concern about the services which appear to be under threat due to funding constraints, including; developments in mental health services, future planning for elderly carers and also lack of service development in areas that have minimal or no service.

The Board noted the importance of good communication where services will be delivered in a different way.

Action:

1.Mrs Skelly’s paper on the comments submitted on the Commissioning Plan to be circulated to Board Members.

2.The Board to consider at the workshop in August, the PCC response to patient concerns regarding service change in light of agreed PCC guidelines.

  1. Item 42/15 ME/Fibromyalgia Patients

The PCC and service users met with the HSCB regarding relevant services. The Lead Commissioner has agreed to consider appointing a neurologist specialising in diagnosing and treating people with these conditions.

  1. Item 24/15 (b) Update on recommendations made in the PCC Food For Thought Report.

Mrs Hully had written to Mrs Brenda Creaney in April, as the Chair of the Nutrition Strategy Group in April, regarding issues raised by the Belfast LAC about patients getting help at mealtimes. The detailed response has not been received.

Action: Mrs Mallen will circulate the response, once received.

  1. Item 61/14 (a) Expert Panel, Transforming Your Care (TYC)

Mrs Skelly has written to Mrs Emma Holden asking if the Expert Panel is to be reconvened and if not, what systems are being put in place to provide reassurance to the public that whatever services are being changed are as good and as safe, if not better.

Action: Awaiting a response from Mrs Holden.

56/15ANNUAL ACCOUNTS 2014-2015, BOARD PAPER No. 366

Dr Edmondson welcomed Mrs Paula Daly from finance, Business Services Organisation (BSO).

Mr Brown presented the PCC Annual Accounts and Annual Report for 2014-2015 and referred to the following:

  • ASM, the external auditors, and the NI Audit Office (NIAO) have confirmed that there are no issues with regards to the accounts or the work undertaken since January. A formal Report to Those Charged With Governance (RTTCWG) will be released by the NIAO in due course and brought to the G&A Committee and Board
  • in year, the PCC had a surplus of £11,713. The breakeven target is 0.25% or £20,000, whichever is the greater
  • the Management Commentary on page 9
  • the Directors Report on page 21
  • the Remuneration Report on page 25
  • the Governance Statement on page 37

Mrs Daly explained that the draft accounts had been presented to the G&A Committee on 2 June and there has been no change in the financial position since then, with the PCC having a surplus of £11,713, meeting the breakeven position. Referring to page 77 of the report, Mrs Daly said that the PCC is the only HSC organisation to meet the 30 day prompt payment target for paying invoices.

In response to a question from Mr Compston in relation to the increased cost of transport on page 48, Mr Brown confirmed that he would be providing a breakdown of this in his Finance Overview, Board Paper 368.

On behalf of the Board, Dr Edmondson asked that thanks be noted to the G&A Committee and Mr Brown and his team in ensuring the breakeven position for the PCC. She thanked Mrs Daly for her work on preparing the PCC Accounts.

The Board approved the PCC Annual Accounts, Board Paper No. 366.

57/15LETTER OF REPRESENTATION, BOARD PAPER No. 367

The Chief Executive, as Accounting Officer, must provide a letter of representation to the Comptroller and Auditor General acknowledging her responsibility for preparing the PCC Annual Accounts.

The Board approved the letter of representation for sign off by the CE, to accompany the formal submission of the PCC Accounts to the NIAO. Board Paper No. 367 was approved.

58/15FINANCE OVERVIEW 2014-2015, BOARD PAPER No. 368

Mr Brown provided a more detailed breakdown of some of the costings in the Accounts.

  • Travel costs were £20,000 over the estimated cost. This was due to a change in mileage travel rates and a campaign with staff visiting over 600 HSC facilities, GP practices and pharmacists promoting the PCC;
  • Membership Scheme costs – mailshots have been reduced to four a year; and
  • Conference and courses.

Given the work of the PCC in reaching out to the public, travel around Northern Ireland is very necessary. The Board agreed that given pressures on budgets, costs of travel should be continually monitored and different ways of working strengthened, without reducing the effectiveness of the work with the public.

The Board discussed possible future pressures on discretionary spend and agreed that the PCC needs to consider its priorities for spending should further measures be necessary.

Any further reduction in budget could impact on the PCC’s ability to meet all of its objectives for 2015-2016. Dr Edmondson confirmed that should this happen the Board would revisit the already prioritised Business Plan objectives and agree what should be dropped or postponed forthwith.

Mr Brown asked that his thanks to Mrs Paula Daly, Miss Leigh Sanderson from BSO and Miss Orlagh Devlin, PCC be noted for the work required for the Annual Accounts.

Board Paper No. 368 was approved.

59/15GOVERNANCE UPDATE

a)BSO Shared Service Audit by Internal Audit (IA)

Dr Edmondson noted the ‘Limited’ assurance given by IA in relation to the BSO Payroll Shared Service and management of duplicate payments.

The Board agreed that the PCC would want assurance about what is being done to rectify the problems in the payroll and payments shared services.

Action: Agreed that the Chief Executiveshould write to Mr David Bingham, Chief Executive, BSO to raise concerns of the PCC and seek reassurance on improvements in these services.

b)PCC IAprogress Report 2014-2015,Board Paper No. 369

This paper provides on update on the IA plan for the year, including verification of the PCC’s Controls Assurance self-assessment on governance, financial management, risk management and research governance. All work has been completed and all had substantive compliance.Board Paper No. 369 was noted.

c)Year-end follow up on previous IA recommendations 2014-2015, Board Paper No. 370

There were no priority 1 findings and a satisfactory level of control. Board Paper No. 370 was noted.

d)Head of IA PCC Annual Report 2014-2015, Board Paper No. 371

This paper had been dealt with under the Governance Statement section of the Annual Accounts. Board Paper No. 371 was noted.

e)IA Strategy Plan 2013-2014 to 2015-2016, Board Paper No. 372

This paper outlines the final year of the IA Strategy Plan. Mr Compston has met with Mrs Catherine McKeown, HOIA, as required as Chair of the G&A Committee.

Board Paper No. 372 was noted.

f)Risk Appetite, Board PaperNo. 375

An amended copy of Board Paper No. 375 was tabled at the meeting.

Action: Board Paper No. 375 as amended, was approved.

g)PCC Corporate Risk Register, Board Paper 376

Mr Brown explained that risks 3 and 5 are new risks. He said the Donaldson Report was noted as a solution to some of the risks listed. The Corporate Risk Register has been discussed with the G&A Committee and Mr Bill Halliday, Risk Champion.

Given the prospect of diminishing resources in the future, Mrs Cuddy proposed that the Corporate Risk Register come to the G&A Committee and Board on a quarterly basis. This was agreed.

Action: Corporate Risk Register approved and to be submitted to the G&A Committeeand Board on a quarterly basis.

h)G&A Committee Update 2014-2015, Board Paper No. 373

As Mr Compston had stepped out of the room earlier in the meeting Board Papers 373 and 374 were discussed on his return.

Mr Compston said that this report provides an update of the work completed by the G&A Committee and said that he hoped the Board are content with the work undertaken in this robust scrutiny role.

He confirmed that proportionate governance will be carried forward as an issue in the coming year.

Mr Compston also confirmed that he would be standing down as Chair of the G&A Committee on 30 June 2015, but would continue as a member of the Committee. He thanked the G&A Committee and Board for their support. Mrs Liz Cuddy was elected Chair of the G&A Committee from 1 July 2015 and the Board noted the appointment.

Dr Edmondson asked that the Board’s thanks be noted to Mr Compston for his commitment and diligence as Chair of the G&A Committee since inception of the PCC. Cllr Mrs Adger echoed this thanks on behalf of the G&A Committee and congratulated Mrs Cuddy on her appointment.

Board Paper No. 373 was approved.

(Mr Paul Schofield joined the meeting at 2pm)

i)G&A Committee Chairing and Membership, Board Paper No. 374

Mr Compston confirmed that the G&A Committee had asked for this paper to clearly set out the role of the G&A Committee, requirements for membership and Chair and the term of office.

Board Paper No. 374 was approved.

Action: An amendment to the G&A Committee section of the Standing Orders, reflecting term of office, to be brought to the next Board Meeting.

60/15 ACCOMMODATION PRINCIPLES, BOARD PAPER NO. 377

The current PCC office in Ormeau Baths, Belfast is on a lease held by the DHSSPS which expires in January 2017. The current PCC lease for its Ballymena office expires in July 2017. This paper outlines the principles which will need to be applied in finding new office space.

Accommodation must provide value for money and space utilisation.

The Board approved the principles for seeking accommodation as listed in Board Paper No. 377 but stressed that the following are very important:

  • The PCC must find permanent accommodation with no short-term moves.
  • Accommodation must be accessible to the public, including public transport.
  • Must have the ability to brand the area clearly as PCC as the public may not feel comfortable in entering HSC premises to seek help with a complaint against HSC.
  • Confidential space is crucial for speaking to clients/patients/service users.
  • If sharing space with other HSC organisations consider if dedicated space is available for staff breaks.

61/15PCC ANNUAL COMPLAINTS REPORT 2014-2015, BOARD PAPER No. 378

Mrs Skelly presented this report which represents a large amount of the PCC operational work.

A number of Members said that the format of the report was very good and user friendly. On discussion a number of points were raised:

  • Although the format of the report is good, Members suggested that an Executive Summary should be produced as the report is long and some people just want the main points of the report. It was also suggested that it would be worthwhile to share this with medical, nursing and allied health professional students.
  • Consideration needs to be given to selecting the quotations in the report so that it truly reflects the themes in the report. In future reports it would be worthwhile seeing how many of the complaints which are not resolved are progressed to the Ombudsman.
  • In future it will be important to provide more information about the people who have been unhappy with the service. It is important to know if people that are dissatisfied are unhappy with the service they received from the PCC or the outcome of the complaint.
  • The report shows similar issues to previous years and it is disappointing to see the same systemic patient experience failures in relation to attitude, communication, treatment and care, a lot of which does not cost anything to change.
  • It is very important to engage with the Trusts around the data and what is being done to improve systemic issues.

There was discussion about how best to publish the Complaints

Report and raise the issues coming out in the report. In conclusion

Members agreed:

  • that the Complaints Report should be launched in July 2015. This is also to be shared with Trusts and educational training bodies and universities.
  • that the Annual Report Card which will be produced in September, will incorporate high level issues from the Complaints Report and other PCC work.

Dr Edmondson thanked everyone involved in producing the Complaints Reports. Board Paper No. 378 was approved.

62/15PERFORMANCE REPORT, BOARD PAPER 379

This quarterly report provides the Board with a performance update on the organisation covering the Business Plan achievement, finance and the strategic environment.

One objective in the Business Plan is now rated as red and Mr Brown explained that the implementation of the real time feedback system for patients and service users is now on hold as the DHSSPS has asked that all patient experience development work be suspended until a Patient Experience Framework is developed.

In response to a question from Dr Kelly, Mrs Skelly confirmed that the International Conference on ‘Societal Impact of Pain’ will be held to see what progress has been made sincethe Pain Summit.

Board Paper No. 379 was approved. The new format is working well.

63/15PROPOSED AMENDMENT TO STANDING ORDERS, BOARD PAPER No. 380

This paper outlines proposals to amend the PCC Standing Orders to reflect Board decisions in respect of:

a. The Research Committee reporting annually to the PCC Board.

b. The PCC Panels replacing Local Advisory Committee (LACs) for future engagement.

Mr Brown outlined the proposed wording for the amendments. In response to a question from Dr McCann, he confirmed that the panels convened for a specific issue, will be given the opportunity to highlight issues withinTrust areas.

Board Paper No. 380 was approved.

64/15CHAIRS REPORT

Dr Edmondson referred to the following in her report:

  1. NI Economic Outlook briefing, 27 May 2015
  1. Accountability Meeting planned for 25 June 2015

A letter has been received from Mrs Charlotte McArdle, Chief Nursing Officer, confirming that the PCC sponsor branch is now the Nursing, Midwifery and Allied Health Professionals Directorate. It is expected that Mrs McArdle will attend future Accountability Meetings.

The CNO has also written to the PCC confirming that she is involved in developing a Patient Experience Framework and that all major or regional patient experience developments should not be taken forward until the Framework is complete.

65/15ANY OTHER BUSINESS

  1. Public Meeting

Cllr Mrs Adger had been asked to announce at the meeting that a public meeting is being held on Wednesday 24 June in relation to proposals to close theRoddens Residential Care Home in Ballymoney. This was noted.

  1. Board Workshop 18 August 2015

A Board Workshop will be held in August to discuss a number of issues. It was agreed that Chief Executives from the Trusts should be invited to attend the workshop to discuss the learning from complaints and action being taken to address some of the systemic issues that re-occur each year.

  1. Invites to Board Meetings

Mrs Mallen confirmed that Mrs Valerie Watts, Chief Executive and Mr Michael Bloomfield, Director of Performance and Corporate Services, HSCB will attend the Board Meeting in September 2015. An invitation has also been extended to the Minister for Health to attend a future Board Meeting/Workshop.

d.Board Papers

Mr Brown indicated a potential cost effective digital system for Board papers. Members were positive about this move but said that the software must enable members to use their own devices and annotate papers, and it must be easy to move between papers on the device. It will be an ‘all or nothing’ move. Members will be able to view the system in August.

66/15DATE OF NEXT MEETING

The next meeting will be held on Tuesday 15 September 2015 at 1pm in the Conference Room, Ormeau Baths, Ormeau Avenue, Belfast BT2 8HS. The meeting closed at 3.30pm.

Signed ______Signed______

Date ______Date ______

Maureen EdmondsonMaeve Hully

Chair of PCC Chief Executive of PCC

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