APPROVED

NHS GRAMPIAN

Minute of the Area Clinical ForumMeeting

held on Wednesday 18 March 2015at 4.30pm

in the Foresterhill House Meeting Room, ARI site

Present:

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

Dr Craig Beattie, Chair, GP Sub Committee

Mrs Jackie Berry, Chair, Allied Health Professionals Advisory Committee (AHPAC)

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

Mr Chris Llewellyn, Chair, Area Healthcare Scientists Committee (HSC)

Mrs Ann Smith, Chair, Area Pharmaceutical Committee (APC)

In Attendance:

Mrs June Brown, Associate Nurse Director (GANMAC)

Dr Jackie Hamilton, GAAPAC Committee Member

Ms Gerry Lawrie, Deputy Director of Workforce (Item 8)

Mr Graeme Smith, Director of Modernisation

Ms Tracey Leete, Minuting Secretary

Item / Subject / Action
1. / Apologies
Mr David Corry, Chair, Area Optometric Committee (AOC)
Mrs Pamela Cornwallis, Vice Chair, AHPAC
Dr Nick Fluck, Medical Director
Mrs Elinor Smith, Director of Nursing & Quality
Ms Jenny Gibb, Vice Chair, GANMAC
Ms Lynne Lawrence, Vice Chair, APC
Mr Angus Lorimer, Vice Chair, GAAPAC
Mrs Jenny McNicol, Chair, Grampian Area Nursing & Midwifery Committee (GANMAC)
Dr Rebecca Riddell, Chair, GP Sub-Committee
Mr David Shaw, Chair, Grampian Area Dental Committee (ADC)
Mrs Kathryn Trimmer, Vice Chair, AOC
Mrs Susan Webb, Acting Director of Public Health
Mr Malcolm Wright, Interim Chief Executive
2. / Minute of meetingheld on 21 January 2015
The Minute of the previous meeting was approved as an accurate record.
3. / Matters Arising
3.1Review of ACF Constitution
Dr Moffat presented a final draft of the constitution following the review. The process has been led by a subgroup of ACF members and
has taken into account feedback from the joint meeting of clinical advisory committees on 16 December 2014, relevant sections of the HIS review published on 2 December, the ACF constitutions of other Boards and comments received from ACF members and Board members during February and March 2015.
The Committee discussed the ACF membership which will comprise the Chair and Vice Chair from each Advisory Committee. It was recognised that not all advisory committees have Vice Chairs at present and this would impact on individual constitutions. Dr Moffat explained that the constitution would be reviewed after one year, should it not be workable. Members present confirmed there had been no opposition from AMC, GANMAC, AHP, APC, HCS and GAAPAC to the amendments.
The process to elect the Chair and Vice Chair of ACF was also considered and it was agreed to clarify that any candidate who wishes to put themselves forward for either role should ask for someone to propose them and be seconded. It was also agreed to clarify that any members absent for 3 consecutive meetings would lose their membership, should they not send a deputy to attend.
The Committee agreed the final version, following the above minor amendments, and recommended that the Board approves the ACF constitution at the April 2015 Board Meeting.
Once the ACF constitution has been approved, it was agreed constituent advisory committees will review their individual constitutions over the next 3 months, ensuring that these are consistent with the ACF constitution.
Review of advisory committees’constitutions to be added to the next ACF agenda.
3.2Communication – ongoing developments
Ms Leete advised that HI-Net is still in a transitional stage and the HI-Net team are working with Scotland’s Health on the Web (SHOW) to transfer information to a brand new web site. Implementation of the new site, which will also include a private facility, is expected to take place in June 2015. Ms Leete has requested training in order to administer the ACF webpage.
Ms Lesley Hall, Assistant Board Secretary, is also working on improving communication links with the Boardand will provide an update for the next meeting.
3.3Mental Health Update
Mrs Brown advised that there have been no additional developments to report in mental health since the last meeting.
Item to remain on the agenda and Ms Gibb to provide an update when applicable.
3.4Developing and Improving the GMED OOHs Service
Amendments have been made to the draft GMED report, following recent GP Sub Committee and LMC meetings.
Mr Smith to contact Dr Hogg, Clinical Lead for Modernisation, to establish if a revised paper is available and what the next steps are and willcirculate an update to the Committee.
Item to remain on the agenda and invite Dr Hogg to a future meeting.
3.5Vale of Leven Report
Mrs Brown circulated the February Board paper for information following the last meeting. / HM
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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:
4.1AHPC
  • Observation from members regarding integration looking at older people which they believe has taken away from children services. (Mr Smith advised that children services are to mirror IJBs after April 2015).
  • Concerns regarding physiotherapy recruitment issues continue, particularly in Acute.
  • Graduate numbers are low (OT Aberdeenshire).
  • Work within AHPs on policy that will guide referrals through HCPC guidance.
4.2AOC
Mr Corry had circulated a briefing paper which included the imminent election for AOC committee members and Eye Health Network Update.
4.3APC
  • Prescription for Excellence – building capacity – plans to meet with GP Sub Committee regarding independent prescribing and developing teach and treat clinics. Still only first 18 months of 10 year strategy.
  • Two year funded pilot in Grampian with community pharmacists regarding UTIs, to alleviate impact on GMEDOOHs Service.
4.4GANMAC
  • New regulation – nursing and midwifery to revalidate with effect from 15 December 2015.
  • NMC published new code in December 2014 and to be actioned by end of March 2015 - more detail and up-to-date and a lot of safeguard.
  • Nursing and midwifery recruitment issues continue.
  • Return to practice programme with effect from May 2015.
  • HIS action plan - frontlinestaff have advised they do not feel engaged with actions and have not seen any changes. Mr Smith advised that face2face sessions are being arranged for staff throughout April and May 2015 and suggested the updated NHSG Improvement Programme needs to be circulated since the January 2015 version. Mr Smith to circulate the revised NHSG Improvement Programme to ACF for cascading.
4.5HCS
  • HCS National Delivery Plan to be published today by the Scottish Government. Mr Llewellyn to circulate.
  • Healthcare Science week this week – exhibits held at ARI 17-19 March 2015.
  • Regulation for non-registered bodies (HCPC) – Mr Llewellyn attending conference this week to find out more.
  • Discussion to reduce testing, improve flow.
4.6AMC
  • Professor Needham, Postgraduate Dean, was in attendance to discuss training in NHSG following issues highlighted in the HIS report.
  • Creation of a trainee doctors’ mess to be provided.
  • Assistant Medical Director for Education to be appointed.
  • HIS report – pending implementation plan and timescales.
  • Dr Riddell elected as AMC Chair with effect from 1 April 2015. AMC Vice Chair to be elected at 30 March 2015 meeting.
  • PMAC still has concern where it sits in the advisory structure so agreed PMAC to be represented on AMC and CSC.
  • Agreed to stop using the term ‘bed blocking’ in NHSG documents and minimise the term ‘decanting’.
  • Clinical Lead review – Director of Workforce has revised draft.
  • The Scottish Parliament to vote on Assisted Suicide (Scotland) Bill in April 2015 – lecture being held on Thursday 19 March 2015 at 6.30pm at the Med Chi.
Dr Moffat thanked Dr Khan for his contribution to the ACF as AMC Chair over the last 3 years.
4.6.1GP Sub Committee
  • Alan Gray, Director of Finance was in attendance to discuss primary care.
  • What we can learn from HIS report.
  • GPs asked to go on ambulance calls.
  • Integration Joint Boards.
  • How GPs can support pathways appropriately.
  • Prescription for Excellence.
4.6.2Consultants’ Sub Committee
  • All above AMC items were discussed.
  • BMA National Consultants Meeting has expressed concern regarding HIS report – contracts and job planning for consultants and NHSG linking revalidation to process.
  • New CSC Chair will be confirmed at next meeting.
  • Two new CS members elected.
  • Next CONNECT event will be held on 25 March 2015.
  • Dr Khan will continue to be a CSC member.
4.7GAAPAC
  • HEAT targets –Following receipt of letter from the Scottish Government about HEAT targets, there has been discussion about unintended consequences, including impact on staff morale and lack of early intervention or preventative work. Dr Moffat to include HEAT targets in ACF Board report.
4.8Director of Public Health Report
The latest report was circulated for information and included:
  • Health Promoting Health Service (HPHS) Campaign
  • Weight management.
  • Long acting reversible contraception.
  • Sexual health training for primary care.
  • Public health review.
  • Addressing health inequalities.
  • Reporting abortion report.
4.9.1ACF Report to the Board
January 2015 Report was circulated for information.
4.9.2Items for next Board Meeting
  • Revised ACF constitution – now agreed and recommended for Board approval.
  • NHSG Improvement Programme consultation
  • Impact of Waiting Time Targets.
  • Health and Social Care Integration
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5. / Launch of Women’s Hospital and Cancer Centre – update
Mr Smith advised that 40 meetings are taking place January to April 2015 to determine the clinical strategy which has seen lots of engagement and the programme is on schedule.
NHSG is seeking names for the two new health buildings through a public consultation process, as current names are misleading.
Item to remain on the agenda. / HM/TL
6. / Health and Social Care Integrated Joint Boards (IJBs) – Integration Schemes for consultation
Mr Smith advised that the 3 IJB schemes have been approved by local authorities and will now to go to the Scottish Government for approval.
Mental Health Services to be delegated to IJB to host.
Advisory structures with IJBsand will need to see how workable.
The Committee previously agreed for this to be a standing item on the agenda. / HM/TL
7. / Update on current NHS challenges
Treatment Time Guarantee
Dr Fluck was not present to provide an update, however Mr Smith advised that waiting time targets are to be debated at the next Board Seminar and therefore it would be helpful to obtain views from the advisory structure.
The ACF recognised the value of waiting time targets and are aware that these are set as national priorities by the Scottish Government, however, clinicians from a broad spectrum of professional groups in both primary and secondary care, have raised concerns within the advisory structure about the unintended consequences of absolute priority being give to meeting targets such as TTG and HEAT targets. Members have highlighted that targets tend to skew clinical and financial priorities without necessarily improving the experience of patients. In relation to HEAT targets for psychological therapies and CAMHS, both of which are areas affected by recruitment difficulties, there is a significant impact on staff morale. In addition, the focus on targets effectively eliminates opportunities for preventative work or early intervention with mild or moderate mental health difficulties.
Whilst the ACF were fully supportive of the extensive ongoing work within NHSG to meet national waiting time targets, members would also welcome the opportunity to discuss and reflect on unintended consequences for patients, staff and the health and well-being of the wider population.
8. / iMatter
Mrs Lawrie, Deputy Director of Workforce, presented a paper regarding the NHS Scotland implementation of the iMatter tool to understand the experiences of staff in the workplace. iMatter is a diagnostic team tool which will run parallel to the current staff survey. The questions which form the iMatter questionnaire cannot be adapted and the tool will need a 60% return rate to enable a report.
NHSG will pilot iMatter in a number of corporate directorates including Workforce, Corporate Communication and Finance from April 2015 and these areas will be revisited next year when the tool is further rolled out to other areas. iMatter is being implemented across NHS Scotland and implementation to all NHSG employees is to be completed by December 2017.
The Committee raised concern regarding anonymity where there are small teams. Mrs Lawrie advised that small teams would be grouped together to form a reasonable size to ensure confidentiality and it would be the team that is best placed to decide what makes up a ‘team’ for the purpose of iMatter. She also confirmed that a ‘team’ will be a uni-professional group. This is currently being tested in smaller boards. It was also highlighted that results will not be automatically filtered to the manager and the team would have to agree to share higher.
The Committee thanked Mrs Lawrie for her attendances and noted the details of NHSG’s implementation of iMatter.
9. / Minutes
Recent minutes were circulated for information.
10. / AOCB
10.1 Access to medicines for patients: Consultation launched
Mrs Smith had circulated a March 2015 letter from the Scottish Government, to raise awareness of the “Access to medicines for patients” UK consultation launched.
AS agreed to attend a future AHP meeting to discuss further.
APC to submit a response. / AS
11. / Date of Next Meeting
The next meeting will be held on Wednesday 20 May 2015 at 4.30pm in the Meeting Room, Foresterhill House, Aberdeen Royal Infirmary.

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