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APPROVED

MINUTE OF THE MORAY COMMUNITY HEALTH AND SOCIAL CARE PARTNERSHIP

FRIDAY 10th December 2010

Spynie Dental Centre, Elgin

Present

Mr Charles Muir (Chair)NHS Grampian

Mr A Fowlie, General Manager MCHSCP

Mrs J Mackie, Head of Community CareMCHSCP

Mrs Elaine Brown, Service Planning LeadMCHSCP

Mrs Tracey Gervaise, Public Health LeadMCHSCP

Dr Jamie Hogg, Clinical LeadMCHSCP

Ms Gillian Grant, PharmacistMCHSCP

Ms Brigid Aitken, Endoscopy Nurse PractitionerMCHSCP

Mr James Walker, Community RepresentativeMCHSCP

Ms Anne Cheyne, Community Learning Disability TeamMCHSCP

Mr Mike Perera, Integrated Mental Health ManagerMCHSCP

Mr Bob Sivewright, Finance ManagerMCHSCP

Councillor Lee BellThe Moray Council

Mr Richard Donald, Acting Head of Educational SupportThe Moray Council

Mr Sandy Riddell, Director of Community ServicesThe Moray Council

Anne Slee, Integrated Learning Disabilities ManagerThe Moray Council

Helen Milnes,Interim Chief OfficerVoluntary Sector

In Attendance

Mr Ken Hamilton, Business Manager; Fiona McPherson, Communications Officer Moray Council; Liz Tait, Clinical Governance Coordinator; Peter Maclean, Health Intelligence; Sandra Gracie, Project Officer Older People’s Strategy; Sandy Thomson, Lead Pharmacist and Isla Whyte, Minuting Secretary.

Apologies

Apologies for absence were intimated on behalf of Mr Gordon Smart, General Dental Practitioner; Mr Simon Cole, Clinical Director; Mr Sean Coady, LSM – Nursing; Mrs E Bush, Director MVSO; Mrs Deborah O’Shea, Finance Officer; Mr Lloyd Griffiths, Optometrist; Cllr Ron Shepherd; Mrs Issie Graham, LSM – Dr Gray’s Hospital, Sheila Bruce, PPF, andMr Sandy Henderson, PPF.

  1. Welcome

The Chair welcomed members to the meeting and introduced Mr James Walker who has joined the CHSCP Committee as representative of the PPF. Mr Sandy Henderson, PPF, is also a new member of the CHSCP Committee but was unable to attend this meeting. The Chair intimated his thanks to Pauline Freeland and Sheila Bruce, who have both reached the end of their 3 year term as PPF representatives at the CHSCP Committee. Their contribution to the Committee was valuable and the Chair, on behalf of the Committee, wishes them well. The Chair thanked NHS Grampian, Moray Council and partner agency staff for their hard work and commitment during the winter weather over the last two weeks.

  1. Minute of the Moray Community Health and Social Care Partnership Dated
    17th September 2010

It was highlighted that Mr John Carney’s designation was recorded incorrectly. Minute will be updated to show designation as Head of Children & Families and Criminal Justice.

The Minute of the meeting of the Moray Community Health and Social Care Partnership dated 17th September 2010 was then approved as an accurate record of the meeting.

  1. Matters Arising

There were no matters arising.

  1. Performance

The performance report circulated confirms Moray’s performance at November 2010. ‘At a glance summaries’ for November were also circulated with papers.

Andrew Fowlie provided a brief overview of the current position to the Committee.

MCHSCP is currently meeting all government waiting time targets; pressure areas are orthopaedics and pain service. There are constant challenges to recruit and retain the optimum staff; there are currently some acute medical staffing issues which are being managed.

Grampian wide Maternity Services Review is ongoing.

Measures are being put in place to deliver against ABI targets and smoking cessation.

With regards to patient safety the MCHSCP continue to reduce infection rates in Moray. Dr Jamie Hogg outlinedan initiative that MCHSCP have agreed to take part in – funding from Scottish Government Health Department has been awarded to support work to improve the flow of communication from secondary care back to primary care ie information from an outpatient clinic back to GP accurately and quickly. Liz Tait and Sandy Thomson areleading on this piece of work.

Resource Management continues to be a significant pressure withinthe health and care system; a significant redesign of services will be required to manage effectively. Main pressure within Dr Gray’s Hospital is medical staffing which resulted in overspend to date due to a combination of factors. Nursing staffing also incurred an overspend which relates mainly to efficiency targets. Each of the 4 localities show overspend. Learning Disability and Mental Health / Addictions services for the Moray Council show an underspend. Older Peoples’ Service budget for the Moray Council is also showing an underspend. There is an underspend within admin and management in both The Moray Council and NHS Grampian.

Scottish Government are no longer are accepting Business Cases for capital developments over £3m. This in turn impacts on developments in Forres and Dr Gray’s Hospital.

Continue to develop the workforce through SAW process.

Health and Care Services are performing in a fairly positive way overall.

The Chair asked if the MCHSCP are continuing with ward and hospital visits in terms of infection control. Sandy Thomson and Liz Tait advised that a programme is in place at present of unannounced visits for Dr Gray’s Hospital and CommunityHospitals.

The Committee noted the service performance and risk management within Moray CHSCP as at November 2010.

  1. Pharmacy – Hospital and Community Progress in Support Health and Care Delivery

Sandy Thomson informed the CHSCP Committee of the increasing and developing roles of pharmacists in supporting health and care delivery in Moray (please see attached presentation).

Know where to turn leaflets were made available at the meeting, information can be found at

Andrew Fowlie emphasised the need to advertise the opportunities available and asked how one could join the chronic medication scheme. Gillian Grant advised that if there is no change in health status of a patient it makes sense to have a repeat prescription set up with local pharmacist. If a patient is interested in the scheme they would advise their Pharmacist who will carry out a risk assessment and register patient for the service if suitable. Once the required IT is set up the GP will be contacted to see if they accept medication to be given on a serial prescription – that discussion will take place between GP and pharmacist. Pilot in selected GP Practices will start in January 2012.

Members discussed the need to educate members of the public about the most appropriate places to go when looking for support with their health. Pharmacy now offers a 7 day per week service which the community need to utilise. Cllr Bell and Liz Tait vocalised their support in educating the public about when attendance at A&E is required and when perhaps a visit to their local pharmacist would suffice. Jim Walker asked what the role of public and patients is to communicate this message. Andrew replied there is an opportunity here for the public and local media to support health and care services especially during the winter period when the pressure on health and care services increases. Dialogue between the PPF, voluntary groups, pharmacies and the press will be initiated – Sandy Thomson agreed to take a lead on this with support from Jim Walker and others.

Helen Milnes asked what involvement NHS24 have had in this. Sandy advised NHS24 have been involved in the Know Who To Turn To campaign.

The Committee notedthe report and thankedSandy for presentation and interesting and informative discussion.

  1. Autism Services in Moray

Sandra Gracie gave a presentation around autism services in Moray (see attached).

Initial consultation with service users and parents/carers has created four main themes (detailed in Appendix 3) as areas where action needs to be taken to improve the lives of adults with autism in Moray. These areas are the high level targets of the joint strategy for adults with an Autistic Spectrum Disorder which Sandra is currently working on.

There is an increasing number of people being diagnosed with autism in adulthood, who didn’t have a diagnosis when they were children. There is very diverse range of needs. Need to skill up workforce and continue to learn more to improve services and become more autism friendly. Richard Donald advised educational services are working on a training model to accredit 3 schools with autism speciality.

Jim Walker would like to encourage the partnership to look at wider issues / broader issues using skills developed for autism services. Jane Mackie advised the reason for focusing on autism specifically is because it can be a difficult/complexissue for members of the public to understand. The process however can be replicated and used elsewhere ie the audit / consultation etc. Sandy Riddell welcomedthe good work done and encouragedthe partnership to continue to support to ensure it stays on track. The Committee notedthe progress made and agreed the recommendations set out in the report.

7. MOD Changes in Moray

Andrew Fowlie advised the MOD report is primarily here today to update Committee and to ensure members that the MCHSCP are working closely with the RAF Taskforce. The MCHSCP’s main risks are in relation to workforce – ie extended family members of RAF personnel who work within health and care services.

Human Resource services have tracked those who are employed with NHS. MCHSCP are working closely with colleagues in Edinburgh who are part of UK Defence Review. NHS Grampian Public Health Department have initiated a Health Impact Assessment (HIA). Tracey Gervaise is leading this locally and is working with Dr Lesley Wilkie and has input from Health Intelligence Team. The HIA circulated with papers is an outline paper and gives the scope of the work which will be complete by February 2011. The HIA is 75% complete at present and is scheduled to becompleted by end 2010. Tracey Gervaise would like to come back to Committee with final HIA next year. The Committee note and agree the recommendations.

  1. Children with Complex Needs and MIDAS in Moray

Andrew advised the Committee that Sean Coady prepared this report but unfortunately could not attend meeting this morning.

The Raeden Centre in Aberdeen is a Child Development Centre providing multi-disciplinary and interagency assessment, treatment and education for pre-school children with suspected or diagnosed difficulties such as physical / medical disability, developmental delay, and behavioural problems. Children attend from all over the city of Aberdeenand Aberdeenshire. Some Moray patients also attend but due to distance the MIDAS service was developed. There is to be a change in configuration of services provided in Aberdeen and there is a need for those children and families who stay in Grampian and Moray to be part of the change in services. Sean Coady is leading on this piece of work. The MIDAS service locally will also have to change to be in line with Grampian wide service changes. There is a financial constraint and the area is potentially facing disinvestment.

The Committee agreed to take item back to a future meeting to discuss further when Sean Coady is available.

  1. PPF – Working Agreement

The PPF in Moray has been in existence since 2005. Elaine Brown emphasised the importance of the PPF in developing our services.

Jim Walker advised the Committee that the PPF developed an initial Working Agreement when it first formed; this revised Working Agreement has been developed by PPF members. The Public Involvement Officer put a questionnaire to PPF and a sub group was formed to look at the Working Agreement in place. The key changes are set out on page 9, such as the Virtual PPF representative, PPF Core Group and the Roles and Responsibilities of the PPF Member. The PPF looked at whateach member was particularly interested in and when opportunities arise the Public Involvement Officer approaches those interested in that topic – however this not exclusive. The representative that takes part in a piece of work has to feedback to PPF Group who meets 10 times per year.

Alterations to the Working Agreement can be suggested at any meeting and revisions made provided these are supported by at least two-thirds of members present at the meeting. Anne Slee asked as a health and social care partnership the PPF covers more that patients alone, has suggestion of change of term / name been discussed? Elaine Brown and Jim Walker agreed that the term PPF can be discussed.

The Chair highlighted the importance of the PPF and confirmed the CHSCP Committee will support the work of the PPF fully. The Committee approve the Working Agreement developed by the PPF.

  1. The Moray GP Group

Dr Jamie Hogg presented the Moray GP Group Constitution to the Committee (attached). The Scottish Government have not yet decided future of GP contract, however, in preparation of potential changes the MCHSCP consulted with GPs and developed a new group which has a membership of GPs who have been nominated by their peers.

The group has met formally once and agreed to focus on 3 main areas for the next year:

1) Ensure safe, effective and timely care pathway for patients with acute coronary syndrome.

2) Complex care – improve anticipatory care planning.

3) Develop a model of care for frail elderly people.

The Moray GP Group is chaired by Dr Graham Taylor, based at Maryhill Practice. Dr Jamie Hogg asked if the CHSCP Committee could extend an invitation to Dr Taylor to join the Committee and represent GPs from across Moray. The Chair welcomedthe development of the Moray GP Group and the Committee agreed that a Dr Taylor or a substitute is invited to future meetings.

The Moray GP Group will meet every 2 months and between meetings GPs will meet with peers in their localities. Dr Hogg also meets Dr Taylor weekly.

Sandy Thomson advised of the benefits from a pharmacy perspective;as there is now aforum for changes to be heard this eliminates the need to go to each practice individually.

Dr Hogg and Dr Taylor should be notified of potential agenda items as they will set the agenda for meetings.

  1. Moray Lifescience Centre

Andrew Fowlie confirmed funding is in place for a Moray Lifescience Centre. It is hoped the centre will be built by end of 2012. Architect drawings were available to Committee members at the meeting for their information. MorayCollege, NHS and HIE are the first group of people in a rural area to develop the concept of a Lifescience area, to develop community based learning, develop own workforce and resilience in the community.

Andrew advised the Committee that now is the time to work on ensuringbest possible use of the building and how that might be achieved. The Centre will be owned by MorayCollege with shared use between college, health and care professionals, industry partners and the public, with a role in education, role in continuing professional development and role in supporting the public. The Centre will provide conference facilities, have a NES specification and a full clinical skills training unit. There is also space planned for 3 commercial partners to work alongside academics and staff to learn together, develop new process etc.

The Project Board hosted by MorayCollege will oversee delivery of the project. Elaine Brown will link with the design element and Ken Hamilton will link with operational element. There are approximately 30 members of staff who are currently interested in being part of the development of the Lifescience Centre.

Andrew presented a report to this Committee to provide an update and would now like to formally engage support in delivery of the Lifescience Centre. The Chair asked if the Lifescience Centre is about ensuring the MCHSCP continue to develop health and care services to support the community in the future. Andrew replied the training of people working in health and care settings (including those in their own homes – carers), mandatory training and development training all help to ensure future of health and care services in Moray in a purpose built centre. Dr Jamie Hogg asked how quickly we need to come up with the innovative ideas. Andrew advised that the first quarter of next year will be used to develop / review ideas and prioritise services. Elaine also stated that purpose of building requires to be decided quickly so it doesn’t impact on the delivery. MCHSCP wants to ensure the message will be spread across Scotland that Moray is the place to learn for those who wish to work in North of Scotland.

The Committee agree recommendations set out in the report.

  1. The Moray CHSCP and ArrowWebHospital, Nairobi

Liz Tait and Dr Jamie Hogg were invited by Carolyn Adams who is a UN volunteer to fly to Nairobito develop partnership working and services at ArrowWebHospital and ensure continuing professional development to enable staff to continue to work effectively in Nairobi. Liz Tait, Dr Hogg and Carolyn Adams were sponsored IHLFS to go to ArrowWebHospitalin Nairobi. The hospital has 15 bedsand also provides community outreach service to surrounding slum (see attached presentation).