DRAFT

NHS GRAMPIAN

Minute of Meeting of the Patient Focus and Public Involvement Committee held on Wednesday 4 February 2009 in the Conference Room, Summerfield House, 2 Eday Road, Aberdeen at 10.30 am.

PRESENT

Mrs Elizabeth McDade, Non-Executive Board Member (Chair)

Ms Jane Adam, Lay Member

Ms Elaine Brown, Service Planning Lead (tele-conferencing)

Mrs Maggie Emslie, Senior Communications Officer (Public Involvement)

Mr Nigel Firth, Equality and Diversity Manager

Ms Wilma Forrest, Lay Member

Mrs Laura Gray, Director of Corporate Communications (To item 6)

Cllr Bill Howatson, Non-Executive Board Member (To item 6)

Mrs Anne Inglis, Head of Learning and Development (To item 7)

Mr Charles Muir, Non-Executive Board Member

Ms Linda Oldroyd, Nurse Consultant Patient Safety and Patient Experience (for item 4)

Ms Liz Tait, Clinical Governance Manager (v/c)

ATTENDING

Mr Steve Graham, Scottish Health Council (on behalf of Natalie Keag and Christopher Third)

IN ATTENDANCE

Mrs Rosie Gauld, Minute Secretary

Item No

/ Issue /

Action

1 / WELCOME AND APOLOGIES
Mrs McDade welcomed everyone to the meeting.
Apologies were intimated on behalf of Lynn Boyd, Anne Brockman, Prof Rosemary Chesson, Bill Cowling, Dr Roelf Dijkhuizen, Sharon Duncan, Celia Gardiner, Natalie Keag, Eleanor Murray, Jane Ormerod, Dr John Reid and Christopher Third.
2 / MINUTE OF MEETING HELD ON 12 NOVEMBER 2008
The Minute was approved subject to the addition of Mr Nigel Firth under the list of those “Present.”
3 /

MATTERS ARISING

Nil.
4 / PATIENT EXPERIENCE
4.1 Patient Rights Bill Consultation Response
Copy of the NHS Grampian response to the Patients’ Rights Bill for Scotland had been circulated. This response was informed by feedback from the public at the Community Forum meeting held in November 2008. The Committee agreed to consider the local implications of the introduction of a Bill once more information was published during 2009.
4.2 Better Together – update
Linda Oldroyd reported that patient experience work was ongoing in lots of different ways, ie Back to the Floor Initiative for senior charge nurses and collection of patient stories. Currently a template was being designed to share experiences and facilitate organisational learning.
A patient experience pilot has been carried out in Ward 6 using a survey tool to gather patient experience on quality of nursing care. The pilot is being evaluated and if successful will roll out to other wards in Acute Sector initially.
Copies of the national “Better Together” programme update as at January 2009 would be circulated to all members. /

ME/RG

Mrs Oldroyd advised that she had met with Ann Smith, Learning & Development Facilitator and they were working together to involve carers to try and ensure that the experiences of carers and relatives were recorded and acted upon. With regard to child carers, work would be undertaken involving the Child Protection Quality Group. The question “Are you a Carer?” was included in the new Patient Admission Record card but did not always trigger action to address any of the carers needs.

Progress was noted.
4.3 Involving the public and improving patient experience – visions and values
Copies of the presentation given to NHS senior staff at an Information Exchange event on 6 January 2009 had been circulated. Mrs Gray explained that a lot of work had been on-going over the last 12 months about revisiting the Healthfit Vision to see whether it was still appropriate or required updating. The conclusion had been reached that it was valid but some aspects of the organisation’s priorities were not significantly reflected in the Vision. This had resulted in the Information Exchange which was also an opportunity to explain the financial position and to seek feedback from staff. It had been a useful exercise and the responses from the event were being collated. The Strategic Themes were particularly highlighted. The vision and values would be further explained in a series of roadshows initially for staff. The topic will be explored with the public at the Community Forum meeting in May.
Mrs Forrest enquired why there was no mention of “Continuous Improvement” in any of the documentation. Mrs Gray explained that continuous improvement was not a specific point, but is included in the spirit of what was trying to be achieved. Much of it was about how the messages were conveyed to staff/public and attempts were being made to help people see how they contribute to the Vision and how everyone in the organisation was actually contributing to achieve it.
Mr Muir stated that continuous improvement is implicit in the work undertaken within the Clinical Governance Committee and he welcomed the fact that “Reducing Inequalities” is to be a strategic theme for NHS Grampian.
Mrs Adam commented that it was often the small detail that resulted in a negative patient experience and advised of a case where a patient had had to wait for an ambulance to take them home and the difficulties involved. This was noted.
Elaine Brown stated that in Elgin a piece of work had been developed on digital stories. This involved people speaking to a researcher who recorded their voice and was overlaid with pictures of their experience. It was agreed that it would be useful to hear some of them at a future meeting. / Future agenda
Mr Howatson stated that, in relation to the second slide “We are Working Towards ….” it was good to see the word “you” being used as it was very consumer friendly, helpful and focused. He thought the whole document was excellent and very constructive.
4.4 Feedback Service report
Copies of the Feedback Service report from 1 July to 30 September 2008 had been circulated with the agenda. It had been agreed with Dianne Donald, Risk Management Advisor (Violence & Aggression) and Team Leader that regular reports would be submitted to the PFPI Committee. The report provided an overview of the feedback received and included information about the evaluation of the new Feedback Cards which were introduced in April 2008. Any issues or questions should be directed to the Feedback Service via Maggie Emslie.
It was noted that as well as complaints, 99 compliments had been received. Committee members enquired if more detail about compliments could be included in future reports, as there is organisational learning to be gained from positive as well as negative feedback.
Mr Muir advised that a review of the Clinical Governance Groups was being carried out and the exercise had shown that there was a great deal of good practice.
5 / PUBLIC INVOLVEMENT AND CONSULTATION
5.1Consultation Template
The template was noted. The Tobacco Policy/Smoke Free topic was highlighted. The policy had been submitted to the Board meeting the previous day and been approved to go out for consultation. The policy had generated extensive media coverage. Copy of the consultation documents to be sent to committee members. / ME/RG
It was noted that other areas, eg Highland, Tayside, Greater Glasgow and Clyde were already smoke free. Contact had been made with the other Health Boards regarding how the policy had been endorsed and lessons would be learned with regard to what had worked in these areas and what had caused concerns. Negative media reporting was thought to be an issue. It was noted that there were smoking cessation workshops being run for staff. It was important that there was a degree of common sense and recognition that there were exceptional circumstances because of the nature of a particular patient’s condition or care pathway.
Mr Howatson stated that there were practical issues to be looked at and the report made it clear that there would be active support and informed debate. He strongly believed that there had to be leadership and part of the issue would be challenging the concepts around smoking.
The consultation period ended on 31 March 2009.
A review of services in AberdeenCity for children with complex needs is underway. Events have been organised with parents, stakeholders etc around an Option Appraisal exercise, the outcome of which will be submitted to the Board meeting in April.
It was noted that the Forres Redevelopment would be added to the list. /

ME

5.2Support to Major Change Programmes
A paper dated November 2008 submitted by Laura Gray to the Performance Governance Committee (PGC) was discussed. The PGC had highlighted a potential substantial risk around the capacity to provide adequate public and patient involvement and communication support to major change projects. The PGC had asked for a more detailed report and this was brought to the attention of the PFPI Committee. The recommendations of the paper were noted. PGC had accepted the recommendations and dialogue with Service Planning Leads and others would continue.
For some projects e.g. Aberdeen City Primary Care re-design the solution was to appoint a dedicated PFPI Officer. For other major change programmes, there are peaks and troughs of activity which the PFPI team are able to support but which requires them to continually review and re-prioritise work. The important point is to ensure that the Project Initiation Document (PID) could not be approved unless there was an appropriate communication and involvement plan included. Mr Graham stressed the importance for change projects to plan for resources to support public involvement.
5.3Grampian Health Plan – Consultation Process
There has been a change in the timetable and process for updating and developing the Grampian Health Plan. An update plan will be produced for this year 2008/09 and work will continue on developing a three year plan to cover the period 2010 – 2013. The draft 3 year plan will be submitted to the Board in October 2009 for approval prior to consultation. Useful pre-consultation meetings with the public and community groups had taken place in Fraserburgh and Aberdeen.
5.4 Public Partnership Forums

5.4.1Local Support Arrangements

Mrs Emslie had had discussions with Lynn Boyd about support for PPF development in the Aberdeenshire CHP locality. Lynn is to investigate the potential to join forces and link in with Community Planning structures. An audit of public involvement work would be undertaken in due course.
The newly appointed PFPI Officer for Primary Care re-design in AberdeenCity will help to move forward PPF developments in the City.

5.4.2National PPF Development Group Action Plan – January – June 2009

Noted, copies having been circulated previously with the agenda.

6 /

PATIENT, PUBLIC AND CARER INFORMATION

6.1Carers Information Strategy update
A paper was tabled which set out the following points:-
  • Carers Information Point formally opened on 12 January 2009 by Nicola Sturgeon
  • Information available from the Carers point and Health Point at the ARI Concourse and being developed in Dr Gray’s Hospital Out-Patient Department
  • Facilities will be staffed by NHS personnel
  • The information leaflet has been updated and distributed
  • New admission documentation for patients now includes questions about carers
  • Ann Smith had taken up the post of Learning & Development Facilitator (Carers) to support staff training
  • Carers Strategy monies have been allocated to several projects throughout Grampian that support the provision of information or training for staff.

6.2Website update
Kevin McKinnon, Communications Officer with responsibility for communication content on the website was now in post. He would be undertaking the gradual process of developing the website and ensuring that the authors of web pages kept them up-to-date.
Mr Graham felt there was a need to flag up new information which had been added to the website.
6.3Appropriate access to unscheduled care
A paper dated February 2009 by Laura Gray was discussed. The paper explained that NHS Grampian was developing and piloting a social marketing campaign in association with the Leith Agency in Edinburgh who had been commissioned by the Scottish Government to work with Grampian on this national pilot. The campaign was building on work undertaken in England and draft marketing concepts had been produced, one of which involved patients turning a cube to make a choice, with the strap line, “Know Who To Turn To.”
The campaign was welcomed by the Committee members as extremely worthwhile and necessary. Mrs Forrest asked if the ultimate step would be taken to say if something did not work, this is what you do. Mrs Gray replied that there was a need to give people information about the next steps if something did not work – it was about getting the messages right and ensuring that the services are there to back up the messages we would be putting out to the public.
Mr Muir stressed the importance of patient safety, not only was the campaign important but the messages had to be sustained and continually re-enforced in the future and could be linked with the Patients’ Charter.
Other points made were that self-care could only be achieved through patient education; not everyone had the capacity to work through the system; there was a responsibility to direct people to the right place and right person; evaluation should concentrate on the hard to reach groups and getting everyone working together.
7 / Bill Howatson left the meeting at this stage.

EQUALITY AND DIVERSITY

7.1Language Line usage report Jan – Dec 2008
A paper dated 20 January 2009 by Nigel Firth, Equality and Diversity Manager was discussed. Mr Firth spoke to his paper which analysed the use of the Language Line telephone interpretation service within NHS Grampian. It was noted that NHSG had the most comprehensive Language Line coverage of any health authority in the UK. It is anticipated that in future numbers of people requiring language line services would decline as young people coming to the UK to live are picking up English language through the education system.
7.2Disability Discrimination Act involvement and consultation events
An event had been arranged at the Hilton Doubletree (formerly the Patio Hotel) which would include signers; palantypers, amplification for people with hearing impairment; wheelchair access and transport arrangements for all attending. All possible services would be provided for all aspects of disability, including a care facility so that carers could attend, secure in the knowledge that their charges were being well looked after.
7.3 Race Equality Scheme involvement and
consultation events
Mr Firth reported that since May 2004, approximately 50,000 migrant workers and their families had come into Grampian. During 2008, NHS Grampian had carried out three large involvement and consultation events. The events had been run simultaneously in give different languages, together with multi-lingual presentations and translated written material. All three events has been very well attended.
Anne Inglis left the meeting at this stage.
8 / ADVOCACY AND VOLUNTEERING
8.1Volunteering audit
A paper dated February 2009 by Laura Gray was noted.
9 / LEARNING, DEVELOPMENT AND ASSESSMENT
9.1Staff Learning and Development Group
No update available as the meeting arranged for 5th February 2009 had been cancelled. Mrs Emslie confirmed that staff training on PFPI had been given a priority this year, with two additional courses for Moray and Aberdeenshire staff.
9.2Training update
A paper would be prepared for the next meeting.
Mr Firth left the meeting. / Next agenda
9.3Scottish Health Council Assessment process 2008 - 09 and 2009 – 10
A letter dated 19 December 2008 from Richard Norris, Director, SHC National office was noted. The letter set out the final arrangements for reporting the Board’s progress in delivering the PFPI responsibilities as part of the 2009 cycle of Annual Review meetings. NHS Grampian was being assessed on six actions for 2008-09 as follows:-
Patient Safety and Stop Gel Go
MRSA Screening
Dental Action Plan
Smoke Free
Cancer Centre
Dr Gray’s Blueprint
Mrs Emslie had agreed a timetable and a process with the SHC Local office for agreeing and prioritising actions for 2009-10. The Committee endorsed this timetable and will agree the PFPI self assessment report for 2008-09 at its next meeting. / Next agenda
9.4National Review of Scottish Health Council
Discussion took place on a letter dated 8 December 2008 from Richard Norris, Director of the SHC National Office, together with a paper entitled “Function and Form: An Independent Review of the SHC – Summary of Findings and Recommendations by the Scottish Council Foundation and McCormick-McDowell”, copies of which had been circulated with the agenda. The PFPI Committee had been asked for their comments.
There were various issues for the SHC to consider, one of which was the suggestion of a major restructuring of the SHC and how it linked with NHS QIS. It was stated that the PFPI team and SHC had a good working relationship and overall added value to the process.
The PFPI Team would co-ordinate a response on behalf of NHS Grampian. /

ME

10 / ITEMS FOR INFORMATION
Nil.
11 / ANY OTHER COMPETENT BUSINESS
11.1Increasing the Profile of PFPI
Mrs Forrest had attended a meeting of the Professional Development Committee with the University. She had had a discussion with an NHS Consultant who had never heard about Patient Focus and Public Involvement but was interested to know more. Mrs Forrest queried whether this was an area which needed to be addressed. To this end it was suggested that this may be something that the Scottish Health Council could look at on educating staff on PFPI. Steve Graham would take it up with the SHC. /

SG

12 /

DATES OF MEETINGS FOR 2009