The Royal Marsden NHS Foundation Trust
Patient and Carer Advisory Group
Tuesday 28 June 2016, Board Room, Chelsea, videolinked to Gordini Room, Sutton, 1830-2030
Present:
In attendance:Sarah Rushbrooke (Deputy Chief Nurse), Jatinder Harchowal (Chief Pharmacist), xx(Boots Store Manager, Sutton), xx(Boots Store Manager, Chelsea), Gemma Richardson (Safeguarding Lead)and Craig Mortimer (Quality Officer)
Action22/16 / Welcome from the Chairman
xx (Chairman) welcomed members and staff to the meeting.
xx was identified to observe and feedback at the end of the meeting.
23/16 / Notes of Friday 27 April 2016for agreement
The notes were agreed.
Matters arising
24/16 / 3/16: New café in Chelsea
Sarah Rushbrooke, Deputy Chief Nurse,reported that the proposed new patient café which was to replace the Friends’ shop and space in front of the chapel in Chelsea is not able to happen. The effect on the charity displays and fire management arrangements of moving the Friends’ shop to the main entrance is too great. The chapel lobby will be refreshed instead and the search for a suitable space for the café will continue.
25/16 / 16/16: Care Quality Commission inspection
Sarah noted that the Care Quality Commission is still requesting documents as it starts to draft its report following the inspection of the Trust in April.
Agenda items
26/16 / Pharmacy matters
Jatinder Harchowal (Chief Pharmacist), xx(Boots Store Manager, Sutton) and xx(Boots Store Manager, Chelsea) described how the recently introduced partnership between the Trust and Boots has improved the experience of patients attending the dispensaries in Chelsea and Sutton. The dispensaries are open from 0830 to1830. The partnership started on 1 July 2015. It took 6 months for the new arrangements to settle down. Waiting times have fallen from 40-50 minutes just after July to 23-24 minutes for prescriptions now. Discharge times have improved with 94-95% of discharge prescriptions completed within 60 minutes. Monthly quality meetings are held between the Trust and Boots staff. Work is underway to improve chemotherapy prescribing.
Boots have tried to address the points previously raised by PCAG about certain products displayed and sold in Sutton including discontinuing a slimming product. The bulkiness of incontinence productslimits the number that can be stored, but the gaps in the shelves will be reduced when manual ordering is introduced soon; restocking deliveries could then be made on Monday, Wednesday and Friday. There are three to four requests for pregnancy test kits each week. Members were asked what they would like to see sold from the dispensaries. The pharmacy service is based on Trust requirementsrather thanthose of Boots. PCAG would be welcome to ask in its surveys what patients want to see sold at Boots. The shutters that covered the retail shelves in Chelsea have been removed to display merchandise including products for pain relief, hay fever and cold and flu.
Delivery of medicines to local Boots stores so that patients can collect their medicines closer to home is to be introduced. This initially is for supportive medicines then possibly chemotherapy. The meeting was asked to consider how the service could be promoted to patients. A PCAG representative would be welcome to join the group overseeing the project. Oral drugs only are offered, but a pilot is starting for subcutaneous breast cancer chemotherapy drugs.
Boots staff are able to counsel patients about their drugs. They have access to a quiet room for privacy. The meeting suggested that another word be used instead of ‘counsel’ so that it is clear that the process is about discussing taking medicines, for example does the patient need swallowing aids and do they have a carer. Information about the actual drug is given by Trust staff elsewhere.
Trust pharmacists, the medical day units and wards are doing more to check that patients are taking their medicines correctly. / All
All
All
CM
27/16 / Care of people with dementia
Gemma Richardson, Safeguarding Lead, reported. The Trust launched its dementia strategy in May 2016. The strategy covers cancer specialist and community services. Dementia champions have been recruited from amongst staff as part of the process to make the Trust more dementia friendly. More than 100 dementia friends, originally developed by the Alzheimer Society, have also been recruited. The friends work to make the Trust more dementia friendly. Four wards, evenly split between Chelsea and Sutton, are being developed as dementia friendly which includes having accessible signage that uses pictures as well as words. Screens are used to help patients orientate by saying that they are at the Royal Marsden and it is night time/breakfast etc. Digital reminiscence packs that include old film clips, quizzes, music and loved ones’ messages are used to reassure patients when they are distressed. There is a patient and carer leaflet.
The Trust does not see many patients with dementia, but there may be others not known to the Trust who have memory loss.
28/16 / Seating for patients at the Wallace Wing entrance, Chelsea
xx reported. As a Friend of the Royal Marsden, Chelsea meet-and-greet volunteer at the Wallace Wing entrance,xx has noticed that some patients wait a long time until their transport arrives to take them home; they have nowhere to sit outside. It was agreed that there is a need for a joint Trust/PCAG review of the whole Wallace Wing entrance area inside and out to include seating, the snack bar, toilet facilities and information provision for people waiting for hospital transport. xx is to lead the PCAG project group which may involve a survey of how the space is used by patients and visitors. / LC
29/16 / PCAG handbook
xx asked for the meeting’s preference for the size of the handbook. A5 size was agreed. Craig Mortimer, Quality Officer, explained that he has spoken with the Trust’s marketing team about limiting the amount of trust styling of the handbook; the handbook is an internal PCAG document and will not be displayed or published. A decision from the marketing team is awaited about what approach is possible. / CM
Any other business
30/16 / Marking patients’ treatment milestones
xx asked the meeting to consider whether patients can somehow mark the end of their treatment. Recent examples shown on TV have been theritual disposalof clinical gowns when radiotherapy finishes or as in the US the ringing of a bell. The meeting expressed the view that milestones important to patients are very personal. And sensitivity is needed because there will be patients in the same areas receiving treatment for palliative reasons.One suggestion was for a day each year to be arranged for patients to return to the Trust to mark the end of their treatment. Or perhaps in partnership with the charity more patient stories can be associated with the Marsden March annually.
31/16 / Feedback about this meeting
xx related her impressions of how the meeting went. Sonia felt after the shaky start when the meeting was moved to another room because of the inability to get the videolink to work that people were genuinely engaging and listening. There were sporadic outbursts of speaking that were distracting when trying to listen to reports and discussions. There was a rich range of impressive ideas and every item was very patient focussed. It was a positive meeting with lots of opportunities to take things forward.
32/16 / Date of next meeting
Thursday 25 August 2016, Board Room, Chelsea, 1830-2030. No videolink