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DRAFT MINUTE of MEETING of the
ALLIED HEALTH PROFESSIONS COMMITTEE
Board Room, Assynt House,Inverness – 1.00 pm /
Tuesday 17 March 2009
Present: / Katherine Sutton, Radiography (KS) (In the Chair)Maria Dickson, Occupational Therapy (MD)
Ian Henderson, Orthotics (IH)
Jean McCulloch, Orthoptics (JM)
Margaret Moss, Nutrition and Dietetics (MM)
Kayrin Murray, Speech and Language Therapy (KM)
Rhiannon Pitt, Physiotherapy (RP)
Dougal Sim, Physiotherapy (DS)
Claire Wood, Occupational Therapy (CW)
In Attendance / Quentin Cox, Chair, Area Clinical Forum (QC)
Maimie Thompson, 18 Week RTT Project Manager (MT) - for item 2
Irene Robertson, Board Committee Administrator (BCA)
1. / APOLOGIES
Apologies were received from Diane Brawn, Judith Catherwood, Moira Duncan, Mary MacLeod, Heidi May and Derek Ritchie.
2. / 18 WEEK RTT TARGETS
The Chair welcomed Maimie Thompson who gave a presentation on delivering service redesign and transformation to improve access, quality and safety for patients across Highland. The programme was seeking to introduce, measure and performance manage the whole patient pathway. The expected outcome was, by December 2011, to provide a whole journey waiting time of a maximum of 18 weeks from receipt of referral from a GP to start of treatment. This work stream would also help support the delivery of a number of HEAT targets. In order to deliver on this agenda, Ms Thompson emphasised the need for people to embrace and support change, taking a whole system approach and using available data to inform and sustain change. There was an opportunity for people to review their practice and reflect on how they might do things differently to maximise efficiency and resources for the benefit of patient care.
In the ensuing discussion the Committee highlighted the need for effective data collection systems which would provide a clearer picture of service demand and activity to inform where change was required/could be achieved in both clinical and non-clinical practice. In this connection reference was made to time spent on administration. This work, if undertaken by the appropriate staff, would free up clinical staff to focus on clinical duties. JM advised that a national audit of Optometrics looking at non-patient contact time was currently being undertaken.
It was acknowledged that clinical practice needed to be examined with a view to ensuring consistency, efficiency and effectiveness across the board. The Professional Leads were keen to start scrutinising potential areas for improvement; booking systems was cited as one such area.
In order to effect change it was necessary to have an understanding of people’s roles, the services they provided and how they were delivered. Leadership was an important element in providing staff with a clear direction of travel towards achieving strategic aims and goals. And while individuals could change aspects of practice in their own areas of work it was also important to have a whole systems approach ensuring joined up working.
On behalf of the Committee KS thanked MT for her informative presentation.
MT left the meeting
Some further general discussion ensued on the various initiatives underway and the need to ensure effective communication across the organisation about the aims and objectives of these programmes. It was felt that the Lead AHPS had a responsibility to ensure that their staff were kept informed. The professions were also represented on the overarching 18 Week RTT Steering Group, and the NMAHP Strategy would bring together all the strands of work.
3. / MINUTES OF MEETINGS HELD ON 30 APRIL AND 18 NOVEMBER 2008
The Minutes of the meetings held on 30 April and 18 November 2008 were Approved.
Thanking everyone for attending, KS noted that recent meetings had not been quorate and she urged members to give the meetings a high priority. When setting the dates, every effort would be made to avoid clashes with meetings of other committees. It was also recognised that it was not always possible for members, particularly those working in some of the smaller departments, to nominate a deputy to attend in their absence. / BCA
4. / KSF RESOURCES FOR LEARNING AND DEVELOPMENT –
AHP SUBMISSIONS
The Committee was advised that a submission relating to falls prevention had been made, the outcome of which was not yet known. Discussion followed on the process for developing and submitting proposals for funding. The Committee emphasised the need for appropriate consultation on, and input to, any such submissions to ensure that they were included along with other proposals for consideration.
5 / INFECTION CONTROL UPDATE
CW spoke to her circulated report and associated papers, highlighting the following issues:
5.1 / HAI Reporting
A nationally agreed reporting template was to be used as the framework to report progress against the HAI agenda to Highland HS Board on a two monthly basis.
5.2 / Hand Hygiene
The rolling audit programme was continuing across all hospitals on a monthly basis. Action was being taken to address any areas of non-compliance identified. With effect from January 2009 the frequency of the national hand hygiene audits had been increased from quarterly to two monthly.
The launch of the Scottish Government’s Zero Tolerance Policy to Non-Hand Hygiene Compliance, was noted. NHS Highland would be producing a statement setting out its approach to non-compliance. Support and guidance would be offered to staff in the first instance, with a more formal process being applied in the event of continuing failure to comply. There was an issue around staff unable to comply because of dermatological conditions and it was recommended that advice be sought from Occupational Heath in these instances.
The need for public engagement was acknowledged to raise awareness of the importance of good hand hygiene practice. Discussions were also ongoing around signage in NHS Highland hospital premises, to raise awareness among, and ensure a consistent message was delivered to, health workers, patients and visitors. It was noted that a national awareness raising campaign was also underway.
5.3 / Needle Stick Policy
An updated draft policy would be circulated shortly for comment.
5.4 / AHP Infection Control Action Plan
The Committee considered the updated action plan.
Section 2 Training
Bullet point 1 Hand hygiene training register to be maintained and updated weekly until all AHP staff are trained.
CW proposed that maintenance of the training registers should be through Lead AHPs on behalf of organisational units rather than centrally held records by profession. The Committee supported the proposal.
Bullet point 4 - Infection control training to be undertaken by all staff.
Guidance was awaited from the Hand Hygiene Group on the preferred training model to be used, whether the “Breaking the Chain” DVD or the NES online course.
It was commented that the focus to date had been on provision of training for clinical staff in ward areas. CW advised that consideration was being given to the training requirements of hospital staff outwith the ward environment, and community staff.
In response to a query about staff uniforms, CW advised that this issue had been referred to the Infection Control Professional Advisory Group who would be issuing a policy statement on dress code in due course.
5.5 / Inspections and Consultation Paper
The Committee noted the Scottish Government’s proposal to introduce an independent HAI Inspection Team.
5.6 / Scotland National Cleanliness Specification Monitoring Framework Independent Audit Report
The Committee noted the findings of the audit. Overall Highland had performed well against the Standards. A monitoring process was in place to maintain and improve cleaning standards and identify training requirements.
6. / ANTICIPATORY CARE: JUST IN CASE
CW updated the Committee on this initiative for end-stage palliative care patients which enabled health professionals, in collaboration with patients, their families and carers, to assess options around the provision of prescriptions that anticipated the needs of patients in their own home. This ensured that when symptoms developed, immediate and pre-prescribed treatment was available, thereby reducing distress and anxiety for patients, their families and their carers.
‘Just In Case’ had been piloted in three locations in Highland. The results of the pilot schemes had shown that pre-prescribed drugs were used in two thirds of the homes where anticipatory care was provided, and even where they were not used, they had served to reassure and relieve pressure on services. It was planned to roll out the initiative across the North Highland CHPS over the coming months. Discussions were taking place with colleagues in Argyll and Bute where patients were currently supported by specialist palliative care services from NHS Greater Glasgow and Clyde.
The Committee Noted the report. Comments on the scheme to be sent direct to the Project Manager, Ron Ward.
IH left the meeting
7. / KEEPING CHILDBIRTH NATURAL AND DYNAMIC (KCND) PROGRAMME
There had been circulated letter from Sara McLeod, Consultant Midwife KCND Programme, inviting nominations from a number of disciplines to serve on a local steering group which was being established to take forward the implementation of the Programme within the Highland area.
The Committee acknowledged the need for AHP involvement, specifically Dietetics and Physiotherapy, to identify relevant issues and to inform the development of a service model. In considering how to maximise representatives’ time, the Committee suggested that rather than having representatives attending meetings of the steering group, that Sara McLeod (SM) could link in with the specific Head of Service as required, alternatively SM could attend meetings of the Committee to update the members. It was also proposed to request copies of the minutes of the steering group meetings so that any issues could be picked up by the Committee and action taken accordingly.
The Committee:
· Agreed to recommend to SM that she liaise with relevant Heads of Service as necessary and to invite her to attend scheduled meetings of the Committee to update the members.
· Agreed to request copies of the minutes of the meetings of the steering group. / KS
8. / EXTERNAL COMMITTEE REPORTS
8.1 / Updates
There had been circulated the following reports:-
· eHealth
· Workload and Workforce Sub Group
With regard to eHealth CW outlined the ongoing work, noting that a workshop was to be held shortly from which an action plan would be developed to progress the NMAHP eHealth agenda in Highland. She advised that Mary MacLeod was now the AHP eHealth representative and would be taking forward this work.
The Committee Noted the reports.
8.2 / List of details
The Committee went through the list of external groups with AHP representation and agreed a number of amendments. BCA to update the list accordingly. / BCA
9. / PAPERS FOR INFORMATION
There had been circulated for information the following papers:-
· Minute of meeting of the Programme Board of the Service Improvement Group held on 03/10/08
· Nursing & Midwifery Education and Training Committee agenda and papers for meeting on 13/03/09
The Committee Noted the circulated documents.
10 / AREA CLINICAL FORUM
Mr Cox thanked the Committee for the invitation to attend today’s meeting. He explained that he hoped to visit all the constituent committees of the Area Clinical Forum (ACF) to tell them about its role, remit and core business. As Chair of the ACF, Mr Cox was also a member of the NHS Board and as such provided the Professional Advisory Committees with a route in to the Board to raise relevant issues.
Mr Cox advised that a National Conference of Area Clinical Forums was to be held on 26 May 2009 which would explore the current function and way ahead of the Area Clinical Forum, and he would like representatives from each of the Professional Advisory Committees to attend, if possible.
The Committee Noted the National Conference to be held on 26 May 2009.
11. / DATE OF NEXT MEETING
The next meeting will be held on Tuesday 26 May 2009 at 1.00pm in the Ante Room, John Dewar Building, Inverness.
The date was subsequently changed to Tuesday 5 May 2009. / BCA
The Meeting closed at 3.25 pm.
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