APPROVED

NHS GRAMPIAN

Note of Meeting of the Area Clinical Forum held

on Wednesday 8 September 2010 at 6.00pm

in the Conference Room, Summerfield House

PRESENT

Dr John Reid, Chair/Chair, Area Medical Committee

Mrs Linda Juroszek, Chair, Area Pharmaceutical Committee

Mrs Lynn Morrison, Chair, Allied Health Professions Advisory Committee

Dr David Fowler, Chair, GP Sub-Committee

Dr Izhar Khan, Chair, Consultants’ Sub-Committee

BY INVITATION

Mrs Elinor Smith, Director of Nursing

IN ATTENDANCE

Mrs Rosie Gauld, Administrator to the Professional Advisory Committees

Item No / Subject / Action
1 / Chair’s Welcome
Dr Reid welcomed everyone to the meeting and intimated that as the meeting was not quorate, requiring four constituent committees to be represented, only a Note would be taken.
2 / Apologies
Malcolm McPherson, Elizabeth Squires, Jennie Tait, Richard Carey, Dr Lesley Wilkie and Dr Roelf Dijkhuizen
3 / Minute of Meeting held on 30 June 2010
Amendments were made as follows:-
Item 9.1AHPAC – Second paragraph last sentence should read: It was suggested that this should be an agenda item for the eHealth Committee and Mrs Morrison would liaise with Mrs Juroszek.
Page 8 – Jenny Ross is Medication Safety Advisor
Page 8 - Second last sentence should read: Those nurses who entered the Nursing Home sector sometimes had difficulty in accessing support and supervision. NES had appointed a Practice Education Facilitator to support this.
Page 11 – Paragraph below Item 13.9 amend to read: It was suggested that Dr Fowler and Heather Kelman meet to discuss the issue.
The Minute was then accepted as a correct record.
4 / Matters Arising
4.1Dr Reid had still to contact Jenny Ross and would do so as soon as he had her contact details.
4.2Dr Reid had spoken with the Director of Finance regarding financial pressures. Mr Gall had explained that the finance team were amalgamating three divisions into one and he was confident that they would be able to deliver the changes with that complement of staff. It had been felt that they were doing a lot of work for the Scottish Government which impacted on NHS Grampian, but they would now focus on prioritising work for NHSG.
5 / “Future Approach to Governance”
Copies of a letter dated 20 August 2010 from Kevin Woods, and attached paper were circulated previously with the agenda.
It was agreed round the table that a lot of the content of the paper was already being done. Mrs Juroszek stated that the Quality Strategy had been discussed at a recent APC meeting, particularly around the changing role of the community pharmacist. This has impacted on all pharmacy support staff who now need the opportunity to further develop their skills to support the public health agenda. Being caring and compassionate is relevant to all frontline staff who routinely deal with the public
All community pharmacies must have systems in place to record dispensing errors but as with GP contractors, significant events are not shared, therefore at at present there is not the opportunity to learn as an organisation. DATIX is routinely used in hospital and primary care but is not currently available to contractors.
Mrs Morrison intimated that the AHPAC would be discussing the Quality Strategy the following day. She advised that there was work around Healthcare Support Workers and conduct etc. She would pass information on this to Mrs Juroszek.
Dr Khan advised that the Strategy had been discussed at the Consultants’ Sub-Committee in June. He stated that Datix was not used by clinicians as much as it should. They should be encouraged to do so. Of the small number of people who did report cases, three were concerned that there was no follow up. It was noted that within certain specialities, eg anaesthetics, Datix was part of their Job Plan.
Dr Reid stated that this paper and the Quality Strategy would feature in the Annual Review in November.
Dr Reid asked members to let Rosie Gauld have any comments on the paper by 15 October 2010 to enable an ACF response to the Chief Executive. / All
6 / Strategies:
6.1Quality
6.2Older People
6.3Long Term Conditions
Dr Reid advised that the three Strategies had been discussed at the national meeting of the ACF Chairs who had challenged these strategies being produced as it was felt that they overlapped.
It was noted that a Dementia Strategy was about to be launched.
A DNACPR Policy was to be launched on 1 October 2010 and this policy was linked to the Patient Care Strategy and Living and Dying Well. Implications for palliative care in hospital were quite significant as end of life decisions were included in the documents. It was noted that the DNACPR consent form had to be completed and sent with the patient to the hospital in the ambulance. A copy of the form would be sent to Dr Khan. / RG
7 / AHP Constitution
Copies were circulated with the agenda. Following a query about the one year term of office, members present accepted the revised Constitution. A copy would now be sent to Laura Gray and Lesley Hall for final comment/approval. / RG
8 / Annual Review, 8 November 2010
Dr Reid advised that this had been discussed at the ACF Chairs meeting in Edinburgh. No formal presentation was required but the review would include those issues already intimated. The meeting would deal with the agenda set by the Minister. Particular local issues would be welcomed and how the ACF interacts with the Board was important. He would like a mixed group of members to attend. Details of local successes would also be welcome, ie new pharmacy contract.
The Review would start about 9.00 am but final agenda was awaited.
ACF members hoping to be present, along with Dr Reid, were Dr Khan, Mrs Juroszek, Mrs Morrison, Dr Fowler and possibly Mr McPherson.
At the ACF Chairs meeting, Dr Kevin Woods had queried the level of interaction between ACF and GAPF. Both Dr Reid and Gordon Stephen were to give this consideration. It would also be useful to explore how the ACF and the constituent advisory committees could be more interactive with the GAPF.
Dr Khan advised that the officers of the Consultants’ Sub-Committee had agenda setting meetings with management representatives. Membership of the group included four management representatives, Dr Pauline Strachan, Dr Nick Fluck, Dr Roelf Dijkhuizen and Mr Vince Shields.
With regard to the GP Sub-Committee, Dr Fowler advised that, in the , a member of the Board had attended meetings and the group was keen to get feedback from and to the Board.
In discussion, it was suggested that all the advisory committees should be encouraged to have some kind of liaison with management and there was a need for Board members to link with the advisory structure. It was noted that Elinor Smith was the sponsoring Executive Director for GANMAC and AHPAC.
9 / Current Issues from the Advisory Committees:-
9.1AHPC
Mrs Morrison reported that work around SAW and the AHP review were continuing to cause anxiety amongst the professions. Communication around the process was felt generally to be poor.
9.2 / AOC
Nil.
9.3 / APC
Mrs Juroszek stated that the Chronic Medication Service was still not up and running but NHS Grampian had set up a robust Implementation Group. Dr Graham Gauld was the GP representative.
All IT issues were being resolved.
9.4 / GANMAC
As both the Chair and interim Vice Chair were unable to attend ACF, they had submitted written reports. On their behalf Dr Reid reported the following:
  • The group was currently going through the electoral process for a new Chair
  • The Maternity Review was ongoing
  • An announced HAI visit to RACH was due
  • The Shire CHP Night Nursing service had been reviewed
  • Part of the SANE process involved looking at Band 6 nurses in the Shire around Minor Injury and Casualty Units, which were about to be reviewed.
  • The next round of HEI unannounced visits were about to run across all Community Hospitals
  • There were issues in terms of staff being freed up for mandatory training and the consequent risk to the organisation, if staff who are practising are not updated. This was due to the financial pressures and delayed filling of vacancies.

9.5 / Healthcare Science Forum
Nil.
9.6 / AMC
9.6.1GP Sub-Committee
Dr Fowler reported the following:
  • On-going concerns around hospital departments moving work to primary care without prior discussion
  • Community nursing redesign
  • GMed service cuts – George McLean to attend next meeting

9.6.2Consultants’ Sub-Committee
Dr Khan advised that:
  • George McLean had attended to discuss GMed who have to make 5% efficiency savings. The proposed changes included review of the Turriff and Huntly centres. Stonehaven and Aboyne being covered from Banchory, thereby involving long distances to be covered from Braemar to as far as St Cyrus. There were apparently difficulties getting medical staff to cover weekends. Nurse practitioners would be used rather than GPs. There was overall concern about the changes. There were also concerns that changes were taking place whilst the consultation process was ongoing.

  • Funding for the Emergency Care Centre was secure
  • Rheumatology review was endorsed
  • He had met with Donnie Ross, Chair of GHAT who had been reassured that funding would not cease completely and there would be a big drive for fundraising.
  • Impending visit of Chair of the GMC
  • Failure by NHSG to deliver the discretionary points. Still not up to date, but it was essential by February 2011 that they were up to date.
  • SAW to be discussed at next meeting

10 / Chair’s Report
Dr Reid reported that the whole organisation was looking at financial constraints. The AIG had identified areas where the capital plan programme could be cut back.
At the Lothian Annual Review, the Minister had been asked which items she did not wish raised at the meetings, one of which was NRAC.
The Board Seminar had discussed Board development and the use of endowment funds.
11 / ACF Letter to the Board
Possible items to be included in the next letter to the Board were suggested as follows:
  • Communication between the advisory structure and the Board – already raised via the CEL (16).
  • Poor communication around SANE/SAW
  • Identification of money for voluntary severance
  • The impossibility of making savings without affecting services, one example being the renal service at night being stopped.
  • Issues to be presented to the Annual Review on 8 November 2010 (Members to e-mail Rosie Gauld with their items)
/ All
12 / Reports
12.1 / eHealth Committee – 21 May 2010
Mrs Juroszek reported that PMS was on track. However, there were issues with access to PACs images.
12.2 / Others
Mrs Juroszek advised that Dr Steve Bagguley had been appointed Director of eHealth as from 1 October 2010.
13 / Minutes
13.1 / OMT – 28 April and 23 June 2010
ACF Constituent Committees
13.2 / Area Medical Committee – No Minute
13.3 / Area Pharmaceutical Committee – 4 May 2010
13.4 / Area Optometric Committee – 17 March 2010
13.5 / Allied Health Professionals Committee – 13 May 2010
13.6 / GANMAC – 11 May 2010
13.7 / Area Healthcare Science Forum – No Minute
13.8 / GP Sub Committee – No Minute
13.9 / Consultants Sub Committee – 10 June 2010
Receipt of the above Minutes was noted.
14 / Items for Noting
Nil.
15 / AOCB
15.1Catering for Meetings
Dr Reid intimated that savings had to be made in terms of hospitality/catering for meetings. It was agreed by members present that sandwiches etc for ACF meetings would not now be required.
16 / Date of Next Meeting
As previously agreed, the next meeting would take place on 27 October 2010

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