TRUST NAME: Westhertshospital Trust (WHHT)

Third party commentary: HertfordshireCounty Council Health Scrutiny Committee (March 2009)

TRUST NAME:WestHertsHospital Trust (WHHT)

BLUE = Mins (4 Feb)

RED = Mins (25 Feb)

C6: Health care organisations co-operate with each other and social care organisations to ensure that patients’ individual needs are properly managed and met

Child Protection: Access to paediatricians was good although where delays in access were experienced there were also delays in assessments. Obtaining a quorum at initial child protection conferences was an issue, with health professional attendance not always as good as it might be. It was noted that the Children’s Trust Partnership Board would be subject to scrutiny by the County Council’s Overview and Scrutiny Committee on 23 March 2009

There was a considerable amount of co-operation between CSF and health; this worked better in some areas than others. This was recognised by both CSF and health and work was underway to make improvements.

C6: Safeguarding Children – a review has been undertaken since the Baby P case and the Director of Nursing sits on Safeguarding Board.

End of Life provision of hospices beds is limited as is the ability to access at short notice. This is an area that the Medical Director is currently exploring with the hospices.

C13: Health care organisations have systems in place to ensure that:-

a)staff treat patients, their relatives and carers with dignity and respect

b)appropriate consent is obtained when required for all contacts with patients and for the use of any patient confidential information

c)staff treat patient information confidentiality, except where authorised by legislation to the contrary

All staff were encouraged to be PALS advocates. Also at C17

Confidentiality: On going tension existed around confidentiality between CSF and health. The issue of confidentiality was one of the more difficult areas of joint working. Both health and social care services worked to ensure confidentiality, however, the practical focus of their services did have different confidentiality requirements. Information sharing was an essential part of safeguarding children; the level of appropriate information sharing was part of an ongoing debate between partners. It was anticipated that the establishment of multi-disciplinary teams would help overcome some of these problems

C13a: WHHT has developed 9 Pledges with an evaluation framework. The retraining of front line staff has also included managers to ensure that patients dignity and privacy needs are met. End of Life and bereavement training being provided.

C13b: the Consent Policy is reviewed annually

C13 c Data security is more robust. The Trust reacts to incidents reported by patients and staff and changes procedures accordingly. From March 2009 all laptop computers will be encyrpted

C17: The views of patients, their carers and others are sought and taken into account in designing, planning, delivering and improving health care services

There remained a considerable delay between the holding of local resolution meetings (held between complainants and the Trust subject to the complaint(s)) and the issuing of the notes/minutes of those meetings (the guidelines suggested that these should be issued with 25 days; this was rarely met). West Herts Hospitals NHS Trust were noted as that Trust in the County where particularly long delays were still experienced. In response West Herts Hospitals NHS Trust confirmed that they would welcome meeting with PohWER/ICAS to discuss this further. Members welcomed this offer from the Trust

All staff were encouraged to be PALS advocates. Also at C6

National inpatient service: Work was ongoing around improving hospital discharge arrangements. The Trust and Carers in Herts were amongst those organisations working with the national centre and consultants on this. A pilot project was underway in 3 of the Trust hospital wards; 48 hours after discharge a patient received a telephone call inviting feedback. This had been positively received by users and had provided useful information for the Trust, which hoped to roll this procedure out across the whole Trust in due course

Members were pleased to hear that the Trust Board considered the ‘CLIP’ (complaints, litigation, incident and PALS) report on a quarterly basis, as last year the Topic Group had been concerned that trust boards did not consider input from PALS

PALS also received user/carer feedback from the PET (patient experience tracker) system (located on all wards) on a weekly basis. The PET was available in different languages and in Braille. Comment boxes were placed around trust sites. Listening Boards also provided user/carer feedback and information.

In September 2008 1600 patients were surveyed; analysis would reveal whether the data received reflected the national picture

At the Eric Shepherd Unit WHHT has reviewed patient pathways and adopted an approach better suited to Unit users.

C17: A discharge pilot includes arrangements for related services e.g. meals on wheels for patients returning home. This will be extended across the Trust.

WHHT uses feedback from patients or PALS on decoration of hospital wards and waiting areas which will help them to feel more relaxed.

C18: Healthcare organisations enable all members of the population to access services equally and offer choice in access to services and treatment equitably.

Promotion of PALS included attendance at external events, posters, leaflets etc located around trust sites and a new bedside guide (in which PALS details were provided)

Work undertaken jointly with Turning Point with substance misuses to lessen ‘revolving door’ patients has been extended over the last year to include the Hemel Hempsted site.

C18 Translation / interpretation services made available this can be both pre planned and at short notice.

C22: Health care organisations promote, protect and demonstrably improve the health of the community served, and narrow health inequalities by:-

(a) co-operating with each other and with local authorities and other organisations

(c) making an appropriate and effective contribution to local partnership arrangements including Local Strategic Partnerships and Crime and Disorder Reduction Partnerships

C22 Comprehensive Public Health strategy now in place and the Trust is looking at how obesity can be addressed

EXTRAS - these can be slotted under relevant CS or left as a note at the end. Members to discuss.

Most complaints/PALS contacts concerned communication. With regard to the evidence provided by PohWER on the delays experienced by complainants in receiving information following local resolution meetings, the Trust offered to meet with PohWER to discuss this further (see above). This offer was welcomed by the Topic Group.

C4c The Trust will declare not met for 2008/09, however members were assured that, in the view of the Health Commission, a good service is being provided

This year’s presentation was more informative and reflecting on the needs and objectives of the Topic Group