APPROVED
NHS GRAMPIAN
Minute of the Area Clinical ForumMeeting
held on Wednesday 13 January 2016at 4.30pm
in the Foresterhill House Committee Room, ARI site
Present:
Dr Helen Moffat, ACF Chair and Chair, Grampian Area Applied Psychology Advisory Committee (GAAPAC)
Mr Chris Llewellyn, ACF Vice Chair and Chair, Area Healthcare Scientists Committee (HSC)
Dr Craig Beattie, Chair, GP Sub Committee
Mrs Jackie Berry, Chair, Allied Health Professional Advisory Committee (AHPAC)
Mrs Pamela Cornwallis, Vice Chair, Allied Health Professionals Advisory Committee (AHPAC)
Mr David Corry, Chair, Area Optometric Committee (AOC)
Ms Lynn Lawrence, Vice Chair, Area Pharmaceutical Committee (APC)
Dr Alistair McKinlay, Vice Chair, Consultants’ Sub-Committee
Mrs Jenny McNicol, Chair, Grampian Area Nursing and Midwifery Committee (GANMAC)
Dr Rebecca Riddell, Chair, Area Medical Committee (AMC)
Mrs Ann Smith, Chair, Area Pharmaceutical Committee (APC)
In Attendance:
Mr Steve Baguley, Clinical Director, eHealth (Item 5)
Dr Howard Gemmell, Public Representative
Mr Graeme Smith, Director of Modernisation
Mrs Susan Webb, Acting Director Public Health
Ms Else Smaaskjaer, Minuting Secretary
Item / Subject / Action1. / Apologies
Mr Niall Craig, Chair, Consultants’ Sub-Committee
Mrs Jenny Gibb, Vice Chair, Grampian Area Nursing and Midwifery Committee
Dr Amanda Croft, Director of Nursing, Midwifery and Allied Health Professions
Dr Nick Fluck, Medical Director
Mrs Susan Kinsey, Public Representative
2. / Minute of meetingheld on 11November2015
The Minute of the previous meeting was approved as an accurate record.
3. / Matters Arising
3.1Review of Advisory Committees’ Constitutions
Dr Moffat reported that the sub-group had met in December and had issued guidelines which are intended to assist advisory committees in the review of constitutions. Dr Riddell confirmed that AMC agreed a constitution at their meeting on 11th January. Constitutions have also been submitted from GP Sub-Committee, AOC, GANMAC, GAHPAC, APC, and GAAPAC. Mr Llewellyn reported that HSC plan to meet in the coming weeks and this will be a priority item on their agenda. Dr McKinlay noted that the Consultants’ Sub-Committee want to ensure the views of all groups of consultants across NHS Grampian are represented and they will then agree a revised constitution.
The Committee agreed that when completed and approved Advisory Committee Constitutions will be placed on the ACF page of the Hi-Net website.
3.2NHS Grampian Reputation and Positive Actions
The letter sent out from the Chief Executive, Employee Director and Chair of ACF has been discussed at recent advisory committee meetings. Dr McKinlay noted that the website is the public face of NHS Grampian and it is essential that potential staff feel encouraged to come and work in the organisation and live in the area. Dr Riddell reported that AMC would like the website and other materials to promoteNHS Grampian as an organisation which places value on both the delivery of services and the delivery of education. It would like to see the educational role of NHS Grampian and its links with the University of Aberdeen, RGU and Aberdeen College being highlighted.
Mr Gemmell suggested that as Corporate Communications now receive more feedback from posts on Feedback and Twitter than they do from newspaper articles, all communication mediums should be used to their full potential. Mr Baguley reported that the NHS Grampian website has been updated. The Committee welcomed this and hoped the opportunity has been taken to ensure that information for both staff and the public will be more accessible.
The Committee agreed that it will be helpful for Advisory Committees to forward their suggestions regarding positive news and positive promotion of NHS Grampian.
3.3Pathways to Secondary Care – Sub Group
Dr Beattie confirmed that discussions are still ongoing. Mrs McNicol reported that concerns had been raised at GANMAC regarding the non-recognition of some professional groups by some consultants, which is creating gaps in the process. Dr Riddell advised that the Acute Sector Associate Medical Director had attended a recent meeting of AMC and had been generally supportive to removing barriers inreferral procedures.
Mrs Webb queried whether this could be approached on a ‘case by case’ basis with a view to dealing with inappropriate referrals regardless of their source. She suggested that this could help identify whether there are issues regarding a clear understanding of the process rather than who is making the referral. Dr Beattie noted that it is difficult to establish new working practices in Primary Care if patients have to be referred back to their GP rather than being on a pathway which progresses them to the next stage. Dr McKinlay advised that the number of referrals which are refused is relatively small and suggested that informing consultants of changes to working practices in Primary Care would be helpful. Dr Moffat agreed, suggesting this could also provide assurances that appropriate governance procedures surrounding pathways are in place. In the meantime, any repeated patterns of refusal which are causing concern can be reported to the Medical Director.
The Committee agreed that there may be potential solutions through increasing the use of electronic systems as access rights for making referrals would only be given to appropriate staff.
The Committee agreed that the sub-group should continue to review good practice and consider how this can be taken forward.
3.4Health and Social Care Integration – Action Plan
Mr Smith distributed an updated action plan outlining the current position, agreed actions and outcome/target dates for key issues relating to Health and Social Care Integration. Dr McKinlay queried what the implications are for services which will be subject to ‘hosting’ arrangements. Mr Smith explained that the budgets for those services will be hosted by one of the IJBs and the General Manager will then report to the Chief Officer of the IJB which hosts it. All other reporting structures within the service will remain as they are.
Mr Smith emphasised the importance of maintaining good working relationships between the three IJBs and NHS Grampian to assist with maintaining coherence and equality in the delivery of services across the region. It is intended that disputes will be avoided by discussion and negotiation throughout the Strategic Planning Process. The processes for dealing with any that do arise will be included in the Memorandum of Understanding with each IJB. Mrs Webb noted that in the unlikely event of a dispute the North East Partnership Group will aid facilitation.
Mr Smith agreed that he will be happy to respond to any further queries from the Committee. / EHS
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4. / Updates from Advisory Committees, Director of Public Health and ACF Chair
Each committee provided an update of matters discussed at their recent meetingsand highlighted the following:
- The Director of Finance has presented AMC with an outline of the budget position for 2016/17. They had also discussed the importance of strong links with UofA, RGU and Aberdeen College.
- The GP Sub-Committee had considered how to get information regarding waiting times out to Practices and the challenges of accurately projecting average waiting times.
- Dr McKinlay reported that the main concerns at Consultants’ Sub-Committee related to recruitment gaps in academic medicine at University of Aberdeen. The Sub-Committee would like to know if there is any way they can work along with the University to look for solutions. The academic reputation of UoA is important and if it is weakened there will be implications for the reputation of NHS Grampian and for recruitment. Dr McKinlay requested that feedback to the Board from ACF include these concerns from CSC.
- Mr Smith advised that there are meetings between UoA and NHS Grampian and Mrs Webb suggested that there may be different ways of engaging with academic colleagues rather than through committees. She also confirmed that Education and Research is a topic for a future Board seminar.
- AOC had discussed the roles of the Eye Health Network and AOC. There are no clear boundaries between the roles of each organisation and this could be one of the reasons why AOC are finding it difficult to engage with optometrists and encourage attendance at meetings. The Committee agreed to look at ways of improving communications with optometrists.
- The key focus for GANMAC remains the new arrangements for revalidation which come into effect from April 2016. With regard to academic links Mrs McNicol reported that RGU have recently appointed a Professor of Nursing and Professor of Midwifery. GANMAC have welcomed these appointments as they provide developments for opportunity and also help to retain academics within the profession.
- Mrs Berry reported that the key topic at AHPAC had been guidance relating to professional leadership. The Committee had also considered the paper ‘Modernising Primary Care’ which looks at the role of AHPs as first point/post diagnosis alternative point of contact to support GPs and Primary Care. Mrs Berry agreed to circulate the paper to ACF members.
- GAPC had considered the GPhC Memorandum of Understanding. The Committee also discussed whether there is a need for an appropriate group where contractors can go with concerns around the professional conduct of colleagues. Mrs Smith also reported the recent success of the NHS Grampian pharmacists who were five out of the ten winners at the 2015 Scottish Pharmacy Awards.
- Dr Moffat reported that at recent meetings GAAPAC had discussed national workforce planning, HEAT targets, opportunities for innovation and plans for an area wide CPD event.
- HSC has not met recently but Mr Llewellyn noted that there are ongoing discussion between members regarding recruitment difficulties and concerns about the equipment allocation for next year. Mr Smith confirmed that expenditure on backlog maintenance does impact on the equipment budget but there will be an allocation for new equipment in 2016/17.
- The report previously circulated contained a summary of the key points relating to NHS Grampian from a range of Information Services Division publications. Mrs Webb explained that these publications are useful as it gives staff an indication of areas where NHS Grampian shows as an outlier and then possibilities for remedial action can be considered. She asked members of the Committee to forward any feedback or queries to Jillian Evans, Head of Health Intelligence
- Mrs Webb also highlighted how planning had contributed to the successful response to recent severe weather events.
Dr Moffat advised that the main ACF topics discussed at the Board meeting on 3rd December 2015 had been:
Evaluation and Awareness of New Way of Working in Primary Care.
Referral Pathways from Primary to Secondary Care.
Clinical Services Strategy.
Department of Public Health Annual Report.
November 2015 Report was circulated for information.
5. / Information Sharing/Visibility and Patient Safety
Dr Steve Baguley, Clinical Director of eHealth had previously circulated a paper which outlined the challenges in balancing the benefits of being able to access and share patient information with the risks that arise from that capability. He gave an overview of Information Governance, The Data Protection Act and the role of the Information Commissioner’s Office.
He noted the frustrations of colleagues and patients regarding shared access to records and agreed that with the advent of Health and Social Care Integration this isnowa more pressing matter. The Committee agreed that a new approach should be adopted which will ensure benefits to patients through joint access to their records whilst putting safeguards in place to ensure the security of their data.
Susan Webb noted the tensions in the current system but informed the Committee that a Information Sharing and Electronic Patient Record Development group has now convened to look at the range of information sharing issues related to the delivery of care across agencies. This group will oversee developments across the area, including NHS Grampian, IJBs and Local Authorities.
The Committee also asked for some clarity regarding consents and communications as there appears to be some myths and misunderstandings surrounding this. Mr Smith agreed that the new group will take advice from the ICO regarding appropriate controls and then look toward moving forwards.
The Committee agreed that a group to move this forward will be helpful and requested an update at a future meeting. / HM
6. / Delivery of Primary Care Services and Pathways to Secondary Care
The Committee agreed that this had already been discussed at Item 3.3
7. / Clinical Services Plan
Mr Smith had circulated the draft report from the Clinical Services Strategy Event which took place on 9th December 2015 along with an outline of timescales and a matrix of the key emerging themes. He reported that a series of events had led to identifying the key themes and it is now time to build on these. There will be a comprehensive consultation exercise during the first quarter of 2016 resulting in the formal sign off of the Clinical Service Strategy/Delivery Plan by NHS Grampian Board on 4th June 2016. This will be concurrent with the IJB Strategic Planning Process. Mr Smith informed the Committee that NHS Grampian and Partnership colleagues are working together to achieve consistency across the region.
Dr Riddell noted that development of the Clinical Services Strategy and the financial constraints outlined in the budget update to AMC should be considered together. Dr McKinlay noted that although there is general support for looking at different ways of working, innovation requires pump-priming to achieve success and it is also important that information is shared.
The Committee agreed that more time will be allocated to this at the next meeting in March. / HM
8. / Minutes
Recent minutes were circulated for information.
9. / Items for ACF Report to the Board
- Education and Links to University.
- Information Sharing.
- Willingness to Engage with Innovation.
- Pharmacy Awards.
10. / AOCB
None.
11. / Date of Next Meeting
The next meeting will be held on Wednesday 16 March2016at 4.30pm in the Committee Room, Foresterhill House, Aberdeen Royal Infirmary.
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