Acute Operating Division (AOD)

Patient’s Panel

Friday 7th December 2012

Conference Room, ManagementBuilding

Southern GeneralHospital

Present:

Rory FarrellyNurse Director (Acute) – Chair

Kate Walker North-West Public Partnership Forum

Bill BradyEast Dunbartonshire Public Partnership Forum

Anne Marie KennedyEast Renfrewshire Public Partnership Forum

Alice MacFarlane South Public Partnership Forum

James FergusonDiabetes Managed Clinical Network

Elaine KavanaghInverclyde Public Partnership Forum

Daniel ConnellyNHSGGC Community Engagement Team

Dan HarleyNHSGGC Community Engagement Team

Lorna GrayNHSGGC Community Engagement Team

Apologies:

Anne MacdonaldNHSGGC Volunteer

Eileen FergusonDiabetes Managed Clinical Network

Barbara WalkerBetter Access to Health Group

Heather GartshoreEast Dunbartonshire PPF

Dagmar KerrAction for Sick Children (Scotland)

Lisa KerrYouth Voices

Martine McConnellInverclyde Carers’ Council

Attending:

Jim CrombieDirector of Surgery & Anaesthetics

Jane MurkinNation Person-Centred Care Programme Lead, Scottish Government

Toby Mohammed Head of Practice Development, Acute Services

Jonathan BestDirector of Regional Services

Eleanor McCollService Delivery Manager

  1. Welcome and introduction

Rory opened the meeting and introductions were made around the table.

  1. Matters Arising
    Visit to Ward 26 – Kate Walker provided feedback on the visit and said it was very positive, good staff interaction and the food was warm.
    Evaluation session – the session took place on 6th November with 7 members of the Panel participating. Kate Munro from the Community Engagement Team facilitated the session. The purpose of this was to assess the work of the group, how members are supported and if there are any areas that could be improved upon. This will be written up and will be presented at the next meeting, along with a suggested work plan based on the information given.
  2. Patients’ Rights Act
    Jim Crombie, Director of Surgery and Anaesthetics described the main principles of the Act and discussed in detail the section on Patients’ Rights and Responsibilities.
    Mr. Crombie spoke of the term ‘Reasonable Offer’ which is used within the Act. This reasonable offer for an appointment needs to provide a minimum of 7 days notice to the patient. Jim Ferguson advised that his experience of volunteering in the Patient Information Centre in Stobhill has shown difficulty in the current appointment system. Mr Crombie advised that they had discovered glitches in the mailing system, mainly with the carrier. This is now thought to be resolved and a quarterly reporting system is in place to monitor the system. ‘Mystery shoppers’ are also used to test postage times and to call the contact numbers provided on letters to ensure that they are going to the most appropriate place. In the last 3 months, there has been a huge improvement in the postage time etc.
    Jim Ferguson also added that there appears to be a delay between a patient seeing a consultant and the relaying of information back to their GP. Mr Crombie advised that there is a tracking system for the time in between this information being shared and this is monitored closely. A new system has been piloted whereby the consultant signs off the medical note which goes straight to an electronic portal and is then updated on the primary care file. This again removes the time considerations of the postal system.
    Anne Marie advised that in her role as a Community Transport provider who takes patients to their hospital appointments, there is difficulty in patients receiving letters on a Saturday for appointments that week as it is difficult to organise transport at that point. Specific issues such as this will be noted as these help to resolve any issues in the system.
    Alice suggested that there should be a reminder system in place for those patients who have yearly appointments. Mr. Crombie agreed, and advised that there is a pilot at the moment to look at Did Not Attend (DNA) rates which has shown that many people simply forget. It was felt by some that timings of letters are usually a problem also, i.e. they don’t arrive in time, and if this was resolved there would be a reduction in DNA rates. It was also noted that short notice of hospital appointments causes difficulties in booking patient transport. Rory advised that one of the things being audited is the relationship with the Scottish Ambulance Service (SAS) so this will be taken into consideration.
    The group thanked Mr Crombie for his time.
  3. Person Centred Care Programme
    Jane Murkin from the Scottish Government attended to discuss the above programme and answer any questions from the group.
    The involvement of patients and the public known as ‘Patient Focus & Public Involvement’ has traditionally seen the interaction as more of a ‘doing things to people’. The Person Centred Care programme aims to move that towards doing things with people and to look at the patient as an individual. This includes treating the ‘whole person’ and deciding on a patient pathway which is best for the patient rather than the professional. A large part of this work includes integration of all of the aspects of the quality strategy programmes into one overall policy. This is being done at Scottish Government level, but with recognition that it will need to be implemented within each Board’s own context.
    After discussing the programme content, Jane invited questions from the group.
  • Alice felt that groups such as the Patients Panel have been promoting this type of care for a long time and therefore it is good to see it being put into motion. She felt strongly that staff should treat patients as they themselves would want to be treated.
  • Rory commented that children’s services take a family-centred approach which could be adopted more in adult services. The quality agenda focuses a lot on older people as the main user of our services, with the thinking that if we can get it right for older people then we are 99% of the way there. There is a problem however in how to measure tangible outcomes in such a programme – a lot is already measured, but how is the data already collected being used?
  • Jim suggested there could be an assessment of staff personalities which could determine what department they work in. Rory felt that there needs to be focus on managing staff behaviour, rather than their personality. This is reflected in the changes to staff development tools which focus on required behaviours. There is also a move towards ‘values based recruitment’, however it is important that this works hand in hand with technical abilities.
  • Anne Marie was glad to see some integration of the policies.
  • Kate wanted to point out that respect works both ways and that patients can be rude also. The Patients’ Rights Act addresses this by setting out expected patient behaviours also.
  • Alice felt that the changes in how patients and the public have become involved in the health service over the last 10 years were extremely positive. Jane felt that now there had to be work in maximizing the will and energy of people to keep this going.
  • Elaine pointed out that it needs to be made easy to make complaints as the current system sometimes puts people off. Anne Marie felt it was important to promote the comments and feedback system rather than just complaints as it is just as important to stop a patient from needing to go down the complaints route at all.
    The group thanked Jane for attending and she agreed to come back later next year to provide an update.
  1. Reducing Noise at Night
    Toby Mohammed, Head of Practice Development, presented on this programme which came about as a result of the national Better Together Survey in which noise at night was highlighted as one of the lowlights.
    No detail was provided in the national survey about types of noise etc, therefore a project was undertaken to find out more through the use of:
  • Patient Interviews to find out what is causing the disturbance
  • A patient survey to quantify which of the issues discovered in the patient interviews caused the most disturbance for patients
  • A focus group to consider and identify potential solutions including ward-based protocols, patient notices and feedback to facilities management teams.
  • A staff survey to evaluate the feasibility of the suggested changes and test the difference they made.

A protocol has been introduced for using on wards which is discussed at handover and is adopted from around 10pm to allow patients to sleep. This covers the main issues that were identified by patients including buzzer noise, infusion alarms, and staff talking.

A post-intervention patient survey was undertaken which showed that within the short time period, there were improvements made in terms of reducing these noises.

In terms of infusion alarms, NHSGGC is now looking at different ways to manage this noise, which also includes staff responding to the alarms quicker. Noise from trolleys is a maintenance issue which will involve facilities colleagues, however improving noise from other patients is a big challenge. There has so far been positive feedback from staff on the use of the protocol and this will now be rolled out further.

Next steps will be:

  • Roll out of protocol to all sites
  • Introduction of ‘noise reduction’ champions
  • Maintenance of equipment and risk assessment of infusion equipment
  • Further survey to test impact

The group asked whether patient information leaflets should include information on noise and suggest patients should bring earplugs/ eyemasks with them, or these could be made available on the ward. Also as part of the uniform policy, consideration should be given to the shoes worn by staff. A more detailed report will be available in the next couple of weeks. Anne Marie was glad to hear that a difference was being made and Rory agreed that progress was good, but there are still some challenges both within and out with our control.
It was noted that it was the staff aspect that patients were most upset about (i.e. hearing staff speaking too loudly) as opposed to other patients.
Bill asked whether anything had been used to monitor noise in areas. Toby advised that machines had been used, however they didn’t provide any detailed information. They are however being used in some areas to show staff what impact their noise has.

Toby will provide a copy of the final report.

  1. On the Move – Outpatients, Daycase and Ambulatory Care
    Jonathan Best, Director of Regional Services, provided an overview of this workstream of the ‘On the Move’ programme and the work underway in getting ready for the opening of the new South Glasgow Hospitals in 2015. The On the Move programme considers how the whole site will work together, and this particular section covers general outpatients; day surgery and pre-assessment; and renal dialysis.
    The main points of discussion included patient flow, signage and way finding to facilitate navigation through both the building and site. Transport and access is also included in this workstream through designing systems for getting people into hospital at drop off points and interaction with the Scottish Ambulance Services (SAS) on their Patient Transport Service (PTS). The SAS have been invited to join the Outpatients workstream.
    This group is planning how these outpatient services will operate in 2015, particularly looking at how to make the process more efficient which will be even more important due to the merger with those hospitals that will be closing (Yorkhill and the Western Infirmary). Jonathan invited questions from the group.
  • Elaine asked whether consideration had been given during discussions about drop off areas to people smoking at the front door. Alex McIntyre, Director of Facilities, is looking at this and is trying to have a physical presence at the front door to stop this. Jonathan also added however that the other side of the situation is that an alternative smoking area cannot even be offered in the hospital site due to the restrictions in the legislation
  • Signage and wayfinding – Jonathan advised that signage is just one aspect of way finding. While design of the signage etc won’t be discussed in detail today, the group will have the opportunity to be involved in this at a later stage.
  1. Self Check-In Kiosks

Eleanor McColl talked through the use of self-check in kiosks which are being considered for use in the new South Glasgow Hospitals. She also showed examples from a hospital in Birmingham that she visited to see how they worked.
Each outpatient letter will come with a bar code which will be scanned at the kiosks in the main foyer of the hospital. This will check them in and they can then wait to be called to their clinic. Patients will also be able to update personal information (e.g. address, contact numbers) using these kiosks. Kiosks can be programmed to each Board/ hospital’s own specifications, so there is an opportunity to work with the Patients Panel to determine what this might look like in GGC. There will still be a reception desk for those who prefer, or need, to use them.
There will be screens in the foyer area and patient names will appear on these screens when it is time for them to go to their clinic, based on when the clinician will be ready to see them. Some members of the group enquired how this fits with data protection. Eleanor advised that there are no data protection issues, however patients were less comfortable if more information was given, e.g. if the name of the department was stated as opposed to ‘Clinic A’ etc.
In the hospital Eleanor visited, they have undertaken a contract with the ambulance service that drivers will take patients into the hospital, help them with the check in and then take them to their clinic. Similar discussions could be held with the Scottish Ambulance Service.
If used, these systems will need to be extremely easy to use and very noticeable. Information will be recorded e.g. time of check in, time arriving at clinic and time seen etc. When asked about provision for those who can’t read, Eleanor confirmed that there will still be a reception desk and there could also be a role for volunteers in helping people to use this system.

  1. AOCB
    There was no other business to be discussed. Rory closed the meeting and wished everyone all the best for the festive period.

Date of Next Meeting:

The next meeting will take place on Monday 4th March 2013 at 10.30am in Conference Room, ManagementBuilding, Southern GeneralHospital

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