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MINUTE of MEETING of the
ALLIED HEALTH PROFESSIONS COMMITTEE
AnteRoom, Assynt House,
Inverness – 1.00pm /

Wednesday21 November 2007

Present: / Katherine Sutton(Chair)
Diane Brawn (DB)
Jean McCulloch (JM)
Mary MacLeod (MMcL)
Margaret Moss (MM)
Pam Nicoll (PN)
Dougal Sim (DS)
Claire Wood (CW)
Heidi May (HM)
In Attendance / Irene Robertson, Board Committee Administrator (BCA)
Judith Catherwood, AHP Workforce and Workload Co-ordinator (North)
Helen Morrison, Associate Director (Clinical Workforce Development)
Lesley Anne Smith, Head of Clinical Governance and Risk Management
1. / APOLOGIES
None received.
2 / WORKFORCE PLANNING
Mary MacLeod introduced Judith Catherwood who gave a presentation on AHP workload and workforce planning, highlighting the four main areas of workforce planning and development, the variables in how the workforce was currently configured, the increasing pressures on the workforce and ways of relieving the pressures. The good practice that currently existed within Highland was acknowledged, however there were areas for development. In this connection Judith drew the Committee’s attention to the AHP Workload Measurement and Management Report, summarising its recommendations under the following main headings:-
  • Activity – develop a more robust system of measuring activity, linking in with the eHealth programme.
  • Capacity–develop an AHP workload infrastructure to support workforce planning, and build flexibility within existing capacity and budgets through a range of strategies.
  • Demand – identify where AHP expertise can be put to the most effective use in the patient’s journey.
  • Capability – role development and support, and succession planning to ensure a sustainable workforce.
  • Workforce Planning–introduce systematic and agreed methodologies to workload measurement and management. The AHP Workload Measurement and Management Steering Group had been established to support this work.
  • Quality and Outcomes – ensure that national guidelines and standards are incorporated into workload management systems.
There was a need to develop a mechanism for contributing to the national programme, to ensure that what was happening at local level tied in with the national agenda. Claire Wood advised that a considerable amount of work had already been done in Occupational Therapy in this connection which could perhaps be used to inform other Professions’ deliberations.
In the general discussion that ensued, the following points were made:
  • It was felt that a more flexible career structure needed to be developed that would be responsive to, and meet the needs of both patients and staff.
  • Some work needed to be done on developing the roles of junior staff.
  • There was a need to enhance communication around training and education.
  • Workforce intelligence needed to be improved, taking cognisance of the different requirements and issues pertaining to each of the Allied Health Professions.
  • Consideration should be given to succession planning for support workers.
  • Some cultural changes would be required to drive service redesign.
The Committee acknowledged the work that needed to be done to develop a coherent AHP workforce strategy, identifying what the priorities were and how thesemight link in with and influence the national agenda, at the same time ensuring that there was sufficient capacity within the organisation to implement the necessary changes.
On behalf of the Committee the Chairman thanked Judith for her informative presentation which she agreed to circulate to the members.
Judith left the meeting
The Committee Noted the recommendations of the AHP Workload Measurement and Management Report and the further areas of work identified to deliver on this agenda.
3 / SCOTTISH PATIENT SAFETY PROGRAMME
The Chairman welcomed Lesley Anne Smith to the meeting. Dr Smith outlined the aims and objectives of the Scottish Patient Safety Programme which would build on what had been developed in other healthcare systems internationally, and specifically through the Safer Patients Initiative to improve patient safety. The Institute of Healthcare Improvement had been commissioned to provide expert advice and to guide on the implementation of the programme in NHS Scotland. There were twelve planned interventions.
Pre-work required to ensure the successful implementation of the programme entailed:
  • Establishing a senior leadership team who would support change in both working practices and culture.
  • Establishing front line teams in four hospital sites – Raigmore, Caithness General, Belford and Lorn & Islands.
  • Forming a Patient Safety Implementation Group
  • Collecting baseline data
  • Preparing for first learning session
  • Establishing communication networks
The aim was to have all sites and all interventions implemented by the end of a two year programme. Work was still being done on some of the intervention ‘bundles’, a ‘bundle’ being a group of interventions related to a disease process that when introduced together result in a better outcome for patients. Although four sites had been selected in Highland, agreement had been reached with the Scottish Government for the programme to be introduced initially in Raigmore and thereafter rolled out to the other sites. The benefits of the programme included improved patient safety, reductions in length of stay, cost benefits, increased patient satisfaction, and increased improvement capability amongst staff.
The Chairman thanked Dr Smith for her comprehensive presentation.
Dr Smith left the meeting
Emphasising the importance of the programme, Heidi May indicated that it would have to placed high on everyone’s agenda. Responding to the concerns expressed about staff’s capacity to absorb more work, HM proposed that the Clinical Governance Strategy Work Plan might be reviewed to identify pieces of work that could be shelved temporarily to enable staff to prioritise the safety programme.
The Committee Remitted to MMcL to review the Clinical Governance Strategy Work Plan and draw up some proposals as to the pieces of work that might appropriately be deferred to facilitate the implementation of the safety programme. The proposals to be considered at the next meeting and any decisions taken to be ratified by both the AHP committee and the Area Nursing and Midwifery Committee. / MMcL
4. / MINUTE OF MEETING HELD ON 25 SEPTEMBER 2007
The Minute of the meeting held on 25 September2007 wasApprovedsubject to the inclusion of Dougal Sim in the list of apologies.
5. / MATTERS ARISING
There were none.
6. / HAI
Heidi May summarised the findings of the NHS Scotland National HAI Prevalence Survey. The overall prevalence of HAI in all NHS Highland acute hospitals was similar to the overall prevalence in all NHS Scotland acute hospitals, and in the non-acute hospitals the rate in Highland was significantly better than the overall national prevalence.
HM then turned to Clostridium difficile and hand hygiene. The results of a recent audit of hand washing had identified that the overall rate of compliance in Highland was 59%. The national target required NHS Boards to achieve a compliance rate of 90-95%. Those areas in Highland that were currently non-compliant would therefore undergo intensive training and re-audit. HM advised how staff could access the training but recommended getting one member of staff trained up who could then roll out the training to other colleagues. She sought the Committee’s assistance in ensuring that all their staff would receive the necessary training within the next three weeks.
HM indicated that the statistics were showing an upward trend. There could be several reasons for this increase, it was acknowledged that this was a multifactorial issue. HM outlined the various measures being taken to try and reduce the rate of infection. An action group had been set up to lead on the work. The possibility of increasing isolation facilities at Raigmore was being explored; a prescribing pharmacist had been appointed – HM noted that Clostridium difficile was strongly related to the prescribing of broad spectrum antibiotics; testing would take place on a daily basis instead of every three days as at present; a care pathway was being piloted which would be rolled out across Highland; new instructions were being written up for medical staff to deal with patients with this infection; and patients would also have nutritional assessments.
In response to the point raised by Dougal Sim about laundering staff uniforms, HM indicated that the Laundry did not have sufficient capacity to clean every member of staff’s uniform. It had been shown that uniforms were not one of the main sources of infection. However, it had been agreed that the Laundry would wash the uniforms of staff, including AHPs, who worked in the areas with the highest rates of Clostridium difficile. HM advised that there was a national review of staff uniforms currently underway which would inform Highland practice both in the acute setting and in the community. An issue was raised around a lack of changing facilities. MMcL suggested that there was also a need to identify dedicated treatment rooms so that staff would not be required to travel widely throughout the hospital to see patients, the patients could be brought to them where appropriate.
The Committee:
  • Remitted to MMcL to prepare a progress report on hand hygiene training for consideration at the next meeting.
  • Agreed to receive an update from HM on the impact of the measures being taken to reduce the rate of infection.
/ All
MMcL
HM
7. / EXTERNAL COMMITTEE REPORTS
There was circulated updated list of AHP Committee representatives on external groups. Any further amendments to be notified to the Board Committee Administrator.
MMcL had circulated reports relating to the external groups on which she currently served. These were received and noted. / All
8. / AREA CLINICAL FORUM
A report of the last meeting of the Area Clinical Forum prepared by MMcL for the Committee’s information was received and noted.
9. / PAPERS FOR INFORMATION
A number of reports and minutes had been circulated with the agenda for the Committee’s interest and information.
Noting the various different attachments, the Committee felt that the agenda needed to be more formally structured and coordinated and suggested having alternate strategic/business meetings to allow adequate consideration to be given to relevant issues in the appropriate forum. It was proposed to have a facilitated session early in the new year to review the role and remit of the Committee, and to consider the structure necessary to support the work of the Committee and enable it to fulfil its function. Membership of and representation on the Committee would need to be reviewed to ensure the necessary input and support.
With regard to the chairmanship of the Committee, KS advised that she may have to consider demitting office due to pressure of work commitments.
10. / DATES OF MEETINGS IN 2008
There was circulated schedule of meetings to be held in 2008:-
  • 22 January
  • 18 March
  • 20 May
  • 22 July
  • 23 September
  • 18 November
The Committee Noted and Agreed the dates of meetings in 2008.
11. / DATE OF NEXT MEETING
The next meeting will be held on Tuesday 22 January 2008 at 1.00pm in the Ante Room, Assynt House, Inverness / BCA

The Meeting closed at 3.30pm.

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