APPROVED

NHS GRAMPIAN

Minute of the Area Clinical Forum Meeting

held on Wednesday 15 January 2014 at 5.30pm

in the Conference Room, Summerfield House

Present:

Mrs Linda Juroszek, Chair, Area Pharmaceutical Committee (Chair)

Mrs Jackie Berry, Chair, Allied Health Professions Area Committee (AHPAC)

Mr Norman Binnie, Chair, Consultants’ Sub-Committee

Mrs Pamela Cornwallis, Vice Chair, AHPAC

Ms Jenny Gibb, Vice Chair, Grampian Area Nursing & Midwifery Committee (GANMAC)

Dr Izhar Khan, Chair, Area Medical Committee (AMC)

Dr Helen Moffat, Vice Chair, Grampian Area Applied Psychology Advisory Committee (GAAPAC)

Dr Rebecca Riddell, Chair, GP Sub-Committee

Ms Ann Smith, Vice Chair, Area Pharmaceutical Committee (APC)

In Attendance:

Dr Roelf Dijkhuizen, Medical Director

Dr Chris Littlejohn, Public Health Consultant (Item 3)

Mrs Elinor Smith, Director of Nursing

Mrs Susan Webb, Deputy Director of Public Health

Ms Tracey Leete, Minuting Secretary

Item / Subject / Action
1. / Chair’s Welcome
The Chair welcomed everyone to the meeting and particularly Mrs Smithto her first meeting in her new role as Vice Chair of APC.
2. / Apologies
Mr Richard Carey, Chief Executive
Mr David Corry, Chair, Area Optometric Committee (AOC)
Mrs Jenny McNicol, Chair, GANMAC
Mr David Shaw, Chair, Grampian Area Dental Committee
3. / Self Care Framework
The Chair welcomed Dr Littlejohn who was invited to discuss the framework to support self-care and self-management in Grampian.
Dr Littlejohn introduced the draft framework (copy circulated with the Agenda) seeking the Committee’s assistance to disseminatewidely to all staff across the organisationfor consultation.
All staff working in the NHS, Local Authorities and Community and Voluntary Organisations across Grampian are invited and encouraged to participate in developing the framework from an early stage. The framework is intended to be a collective document which will develop over time.
Staff are asked to:
  • Provide fully inclusive feedback and contribution to help develop the framework.
  • Provide case studies from their area of work to identify examples of good practice.
  • Pilot the framework in their area of work.
The Committee discussed this item and highlighted weight management as an area to be explored along with 24 hour care. Dr Littlejohn confirmed that self-care is a big agenda and expressed the need to capture people who are undertaking this work and link everything together.
Mrs Berry advised that the framework had already been shared with AHP colleagues for feedback.
Committee members were asked to share the framework with their profession and feedback to Dr Littlejohn to co-ordinate.
Dr Littlejohn left the meeting. / ALL
4. / Minute of meeting held on 20 November 2013
The Minute of the previous meeting was approved as an accurate record.
5. / Matters Arising
(Dr Khan arrived 6.05pm)
6.AMC Letter to the Cabinet Secretary
Dr Khan confirmed that he had not received a response from the Cabinet Secretary to date regarding recruiting and retaining senior clinical posts in NHSG.
Dr Khan to chase response from Cabinet Secretary.
Dr Dijkhuizen highlighted that althoughHR are doing a lot of work around recruitment, there is constant pressure due to difficulties in recruiting to highly specialised posts, particularly in Grampian given the location and expense of the area.
Dr Khan also raised several local issues including external advertising, vacancy forms, IT and Payroll and advised that the AMC have invited the Acute Services General Manager to their next meeting to discuss Vacancy Control and the role of the Clinical Lead is also on the agenda.
The Chair to include in her Report to the Board that, when junior doctors take up post with NHSG, the organisation needs to provide appropriate induction, passwords and name badges. The Committee recommends there is clarity around who is responsible for this to ensureitis consistent each time.
7.Child Health 2020 Programme Board
The Director of Public Health has invited a member of the ACF to be part of the Child Health 2020 Programme Board which aims to meet quarterly. The draft remit was circulated to the Committee as a guide to identify the most appropriate ACF member.
Dr Khan queried if CAMHS is to be represented on the group. Mrs Webb confirmed that the Mental Health Services General Manager is a member of the Programme Board.
It was agreed Dr Riddell, previous Lead GP Child Protection, Aberdeen City CHP and Mrs Cornwallis, Lead S&LT will be joint ACF representatives on this group.
8.Unscheduled Care Update
The Grampian Unscheduled Care (USC) Programme December 2013 progress report was circulated for information.
Dr Dijkhuizen outlined the report and highlighted the A&E Attendance Rates by each Board in Scotland which show NHSG is improving and performing reasonably well in comparison to other Boards. However NHSG is currently liaising with local authorities regarding joint working for improving discharges and home care packages. Dr Dijkhuizen is currently liaising with NHS Lothian regarding similar issues.
The increase in the number of patients delayed in hospitals is having a significant impact on the flow of patients within acute care settings. There is continual pressure in the system for clinical staff, managers and domestic staff. Concerns have been raised around the challenge in maintaining the highest standards of care when patients are being boarded.
Whilst understanding the challenges around recruitment of care workers for both care in the community and for the provision of care in care homes and residential settings, the reality is that the resource sits with the local authority to provide this care. Additional wards have now been opened within the acute sector and this will impact on the NHS budget.
GPs are also concerned about the difficulties they face trying to maintain patients at home or dealing with discharges to the community within insufficient carer support. Whilst optimistic that the integration of health and social care will help to alleviate some of these issues, realistically this will require a significant change in the workforce and the way in which we support the frail elderly in the community.
The Chair will include the concerns regarding delays in the discharge of patients from Acute hospital settings in her report to the Board.
Dr Dijkhuizen advised that the Decision Support Unit is the same telephone number for advice after discharge and recommended that this be advertised at the next GP Sub-Committee.
Following a query from Mr Binnie, Dr Dijkhuizen clarified there is a winter plan each year which is approved by the Board but escalation plans to open beds is ad hoc and there is no predetermined plan. Dr Dijkhuizen will contact Dr Fluck and ask him to liaise with Dr Khan.
Lorraine Scott, Programme Manager for USC is currently liaising with Committee Chairs to attend all committees over the next two months to provide an USC update and seek views on progress to date, the 2014/15 action plan and workforce plan.
(Mrs Smith arrived 6.40pm and Dr Moffat left meeting at 6.50pm)
9.Meeting Dates and Times
The Committee agreed to change the date of the next meeting to ensure the Chief Executive’s attendance, given he is no longer available for the original date.
The Chair advised that the Board Executive Team isstill keen for Committee meetings to take place during office hours. Whilst the majority of members felt this was acceptable, the medical representatives advised that they would not be able to provide consistent attendance/clinical input if the time was changed to during the day. Wednesday night remains the preferred option.
Ms Leete to check the Chief Executive’s diary and offer alternative March date. / IK
LJ
RR/PC
LJ
RR
RD/IK
ALL
TL
10. / CEL 32 (2013) – Guidance on Choosing a Care Home on Discharge from Hospital
The Chair circulated new guidance which was discussed during Item 8 - see above.
11. / Advisory Structure Work Plan
The Chair will circulate a plan of what is expected from the Advisory Structure in order to provide advice to the Board. / LJ
12. / Director of Public Health Report
The latest report was circulated for information.
Mrs Webb highlighted the obesity care pathway has received a small amount of money for an adult pathway.
The group working on the HPHS have been tasked with providing key consistent messages that health professionals can discuss with patients. Key messages to be approved in February and taken back to ACF.
13. / Chair’s Update
The Chair gave a brief update on key events and issues since the last meeting which was highlighted in her summary paper.
14. / Updates from the Advisory Committees
Brief updates from the Advisory Committees covered the following areas:
  • AHPAC – Sub Group looking at Francis Report feedback and Conduct Policy with HR. Representatives meeting with Aberdeenshire regarding Integration. USC a priority.
  • AOC – HIS inspection on EHN 31 January.
  • APC – Consultation on the Control of Entry Arrangements and Dispensing GP Practices proposes changes which may incur costs to the Board.
  • GANMAC – NMC consultation on revalidation has huge implications for organisation and how eKSF is supported – implementation due 2015 and pilots meantime.
  • AMC – Acute restructure review - currently examining Clinical Lead role issues which could be improved.
  • GP-Sub – Consultation on the Control of Entry Arrangements and Dispensing GP Practices to be discussed at next meeting with Director of Pharmacy. Dr Angus Thompson also attending regarding reporting of x-rays.
  • Consultant Sub – Shared concerns regarding radiology. Audit work being undertaken with x-ray tests and results. Status quo with decanting from ECC. Issues with ID of junior doctors. Oncology issue being addressed. Letter sent to Chair of Board regarding bed situation and Chair of General Surgeons Committee going to discuss at AMC.

15. / Minutes
Recent minutes were circulated for information.
16. / AOCB
None.
17. / Date of Next Meeting
The next meeting will be held on Wednesday 19* March 2014 at 5.30pm in the Conference Room, Summerfield House.
*Note this is the new date.

1