Health and Social Care

health and social care

WILTSHIRE INVOLVEMENT NETWORK

NOTES OF WIN CORE GROUP MEETING

Tuesday 9th August 2011

DEVIZES SPORTS CLUB, DEVIZES

Attendees:

Chairs:AF – Anna Farquhar Chair

JT - Jill Tompkins Vice Chair

PM – Phil Matthews Vice Chair

AK - Anne Keat Vice Chair

Core Group Members:

RH – Rodney Haverson

AH - Ann Haughey

PB – Peter Biggs

MW – Mary Wilson

IKM - Irena Kate Magil

DB - Debbie Burse

DE – David Evans

DR – Dorothy Roberts

NC – Neill Cadmore

ME - Martin Eggleton

JJ - Janet Jarmin

WIN Members:

Nigel Stovold

Mary Gray

Marian Maclean Ives

Zena Marshall

Anna Mead (Stroke Association)

Emma Heard (Stroke Association)

Bev Pace (Stroke Association)

Sandie Baker

Gregory Coombes (Friends of Melksham Hospital)

Sylvia Grist

Other Organisations:

LJ – Leonie Jarvill – Carers Support Wiltshire

BM – Benita Moore – SEAP

KM – Kevin McNamara – Great Western Hospital

IH – Isabel Harwood – SEAP

WIN Support:LW – Lucie Woodruff (WIN Administrator)

MF – Martin Fortune (WIN Support Officer)

MR – Mary Rennie (WIN Support Officer)

Apologies:Patricia Putland

Jetta Found

Sharon Daws

Jo Bell

Dot Kronda – WIN Officer

Julia Davey

Jenny Gibson

Valerie Davis

Bev Thompson

Chris Knight

Action
1. / Welcome and Apologies
AF welcomed everyone to the meeting.
Apologies were noted.
AF told the group that she had decided to resign as chair and asked for nominations for a new Chair. She suggested Phil Matthews. MW proposed and RH seconded.
AF said that she would like to remain vice chair and asked the group if they agreed with this. All in agreement.
Phil Matthews was duly elected new Chair and continued with the meeting.
2. / Declarations of Interest
None
3. / Public Participation
Mary Gray asked about parking for link transport drivers at the Great Western Hospital now that the new barriers are being fitted. Will they be able to access the car park?
PM told the her that the question was raised at the last meeting and Kevin McNamara had confirmed that all volunteer Link drivers will be issued with a pass that will allow them to park free of charge. Mary thanked PM for the answer.
4. / NHS Update from Dawn Hales
PM then introduced Dawn Hales. She gave the group the following update.
She explained that Wiltshire Community Services are now not a provider arm with NHS Wiltshire, but are now part of the Great Western Hospital. The delivery of services will continue throughout Wiltshire as before. The new Chief Executive of GWH will be Narissa Vaughan and she will take up post on the 3rd October.
Dawn then updated the group on issues raised at the Melksham Area Board meeting. These are:

• X-ray equipment at Melksham hospital – the equipment is broken and will be replaced.
• DVT Scanner – bought for the hospital. Concerns that it is not being used and patients having to go all the way to Bath for treatment. Dawn explained that there is no record of a DVT Scanner being purchased. A bladder scan was bought around the same time which is being used.
• Podiatry – Dawn is aware of WIN concerns and stated that PALs have received many complaints on this issue too. She pointed out that WCHS only commission toe nail cutting services to patients with a specialist medical complaint. This can be carried out privately through AGE UK at a small cost. She explained that the main concern with the service is the booking procedure. There is a new system being put into place to implement improvements and Dawn asked that patients bear with them. JJ, who is a governor at GWH, also told the group that GHW are working on this issue too and that personally she had not encountered any problems with the service.

Dawn then explained that they have to be as productive as possible with less funding, as everyone else is. They are committed to working towards the QUIPP programme (Quality, Improvement, Productivity and Prevention) and also working closely on all aspects of Social Care.

She told the group that 77% of patients admitted to hospital are returning home, with an average hospital stay of 21 days (target is 17 days). They want to support people back at home to stay at home. She then went on to mention they are trialling a pilot in West Wiltshire with Smallbrook Practice. They are working with 270 patients in care homes in the area, to improve patients care plans to ensure they include every detail of their life and how they live. These details include DNR orders, how the person copes with falls, and general health. 70 are complete with 200 left to do. The plan is to complete the remaining 3800 across the rest of the county by 2013. All patients have a comprehensive plan completed when discharged from hospital. These plans will then assist if a doctor or the ambulance service are called and then if the patient is readmitted to hospital. There will also be clear guidelines from the patient and their family.

MMI added that AGE UK has put together an End of Life book that is very comprehensive and could be integrated within the plan. MR added that the End of Life Care Team continued to implement and monitor many improvements and were aware of the booklet.

ME asked what the mechanisms are for review. Plan to do annual reviews in care homes and six monthly reviews in residential homes.

LJ (Carers Support Wiltshire) asked if the plan includes adequate pain relief for end of life care. They are working with the Out of Hours Service (Wiltshire Medical Services) and the neighbourhood teams who have EOL Care ‘just in case’ boxes for these occasions.

PB asked whether a living will would be taken into account if there was no plan in place. Dawn explained that the only DNR instructions that doctors and the ambulance service recognise is the official form within the care plan. This official form has to be signed by the patient and the doctor. There was then discussion around power of attorney and court protection and how this would be incorporated within the plan. DH will look into this and report back. She also pointed out that it is important for the patient to be clear and draw up these plans while they are of sound mind and able to make these difficult decisions.

PM thanked DH for attending the meeting and updating the group / DH to look into and report back.
5. / GWH Update
Kevin McNamara attended and gave an update.
The new Chief Executive, Narissa Vaughan, will be in post from 3rd October 2011.
In the last few months the Great Western Hospital has had a series of unannounced inspections by the CQC. Inspectors arrived in May and looked at privacy, dignity and nutrition. The process for CQC inspections in identifying any issues of concern is to rate them as minor, moderate or major issues. The CQC rated GWH with having moderate concerns relating to the patients privacy, dignity and nutrition inspection. One of the issues they identified was the use of extra beds on wards during busy periods meaning that the patient in the extra bed didn’t have access to some of the same equipment as other beds, for example, fixed curtains and call bells. GWH put together a detailed action plan within 10 days of the inspection with clear actions and measurable time scales. This has been done and the CQC are happy with these actions and has been advised by the CQC they no longer have these moderate concerns. Warminster and Trowbridge hospitals have also been visited recently both with good outcomes. KM is happy to supply the hospitals inspection action plans on request. The hospital has also been visited by the Patients Association and Swindon LINk. WIN are welcome to pay a visit too.
MW asked what percentages of patients from Wiltshire attend the GWH. 29%
The hospital is at the moments working on hospital discharge with a group of patients at the hospital. KM was asked why WIN had not been invited to be representatives if 29% of patients come from Wiltshire. KM stated that the way the Trust has sought user representation to date has been through the Trust’s Council of Governors and this is a mechanism that as an FT is very important to the Trust. He also pointed out that he is always happy to attend Core group meetings to keep WIN up to date.
PB asked some questions – following a report on maternity services stating that home births are important and the amount of midwives available to cope with rising birth rates, would he say that the ratio of pregnant woman to midwife was high or low? KM explained the r3ecommendation by the Royal College of Midwives is 1 midwife to 28 births and in fact the national average is 1 Midwife to 32 births. In Wiltshire it is 1 midwife to 31.3 births and at the GWH it is 1 midwife to 37-40 births. Last year across both maternity services at GWH and in the former WCHS over 9,400 babies were delivered safely. The trust have been actively recruiting midwifes over the last few years and this is still ongoing.
He then went on to ask KM about the Annual Patients Survey and the fact that the top 3 areas for improvement did not have a score out of 10 against them. Why was this and what is the trust intending to do about them? KM stated that, like the CQC reports, we take these surveys very seriously. As a result we develop actions plans for improvements on any areas we underperform. He was also happy to share these if WIN required.
All papers for the board meeting are published on the Trust website prior to the meeting, and WIN are welcome to attend the meeting and ask questions, but submitting the question before the meeting would help ensure the Trust has the right information o hand to answer questions. At this point Dawn Hales assured WIN that they would not get left behind, and pointed out that Jenny Barker, Director for Transition, was working hard on making the merger as smooth and seamless as possible. Win suggested that GWH trust has discussions about where representative from WIN and Swindon LINk can sit to assist GWH is consultation and decision making.
AH asked whether the GWH have improved your complaints procedure. KM explained that they almost one complaint a day and that they often relate to ‘customer service’ issues such as how patients are spoken to etc and less about the quality of clinical care the Trust provides. The Trust is focusing on on trying to get their staff to sign up to a set of values to treat patients in a specific way.
KM promised to take all issues away and report back.
PM thanks KM for his detailed update and suggested a separate meeting to discuss WIN representation within GWH. / KM to discuss where WIN can be involved
6. / Minutes from the Core Group meeting 21-06-11
The group went through the minutes.
Martin Eggleton had previously tendered his resignation for personal reasons. There had also been a misunderstanding. The Core Group therefore agreed to reinstate him
WIN concerns Form – AK explained the background behind the form. Members asked about where and whom the form can be obtained and where it must be sent after completion. Forms will be made available to Mary Rennie, Martin Fortune and Dot Kronda for outreach purposes. LW will have copies available and they will also be available to download from the WIN website. Completed forms will be sent to LW who will in turn pass them to the Chairs Group for further action. PB pointed out individual complaints and concerns should be addressed to PALs. Some members expressed concerns with PALs as an organisation. At this point Isabel Harwood (SEAP/ICAS) explained that WIN could signpost people to herself if they were having trouble with PALs as they are independent advocates.
DE explained that the OOH group that he is representative for, which was due to meet in July, will now meet on the 8th September and is now called the Wiltshire Medical Services Advisory Board.
7. / Minutes from the HIT Group meeting – 18-07-11
PB explained that the bullet points listed under matters arising would be of interest to the Core Group and said that if anyone had any questions he would be happy to answer them.
8. / Minutes from the Chairs meeting – 25-07-11
The planned Enter and View training was discussed. AK questioned if members needed to do this again and whether HealthWatch include a similar model? She was assured that the training would be relevant for HealthWatch. She also stated that WIN could only visit premises if an NHS bed was being used. JT offered to investigate if this were indeed the case. PM pointed out that anyone wishing to take part in the training must meet the criteria and have an up to date CRB check.
Age UK Wiltshire – PM assured the group that the chairs discussion on this matter was only regarding financial matters and in no way questioned the role that Mary Rennie carries out. MR stated that Jill Branson, Financial Manager for AGE UK Wiltshire has offered to discuss any financial matters with the WIN Chairs.
Sensory Impairment – PM explained that various meetings have taken place with different organisation and Wiltshire Council and information was gradually coming together in preparation for the Commissioning Meeting due to take place in September. As yet there is no confirmed date. MF had previously put together some analysis of the findings from the WIN Sensory Impairment event and it was agreed that the Wiltshire Vision Strategy Group should priortise these. MF and PM attend these meetings.
The Standing Operational Procedures were tabled at the meeting. Members went through them to check for any inaccuracies. They were then ratified. AF proposed and PB seconded.
9. / Minutes from the Outreach Group meeting – 01-08-11
The revised press release and letter totheeditor were tabled. Members reviewed both and approved them for publication, subject to the WIN Chair being named as Phil Matthews. AF proposed and PB seconded both.
Appointment of Press Officer – MW suggested RH. It was agreed that a job description for the post should be sought. RH stated that if he were appointed then he would have to be trusted to speak freely without having to run everything past the Core Group. It was suggested that the Chair’s approval to any comment should be sufficient. At this point RH decided not to take on the role. To be discussed further at the Chairs meeting.
MW then went on to suggest WIN hold a public meeting in Devizes following concerns from Devizes residents that they are unsure of the services being offered at Devizes Community Hospital and Out of Hours Services. Leonie Jarvill pointed out that this is the case across the county. People are unaware of what services are available at each hospital. It was suggested that WIN research all facilities available to the public across the County then hold a public meeting to let people know. This information will then be on the WIN website and published in the newsletter.
DE pointed out that Devizes Hospital and the Out of Hours services were two separate things and that if people had concerns with the Out of Hours service he could take them back to the Wiltshire Medical Services Advisory Group.
RH also wanted his thanks to LW noted for the work she had done on putting the website together. All present agreed that it was an excellent piece of work. / MR to amend and send out.
LW to add to the Chairs agenda
10. / Host Activity Reports
PB asked who Lisa Lewis and Sue Gumbleton were following letters of introduction sent to them from MF. MF confirmed that Lisa Lewis works for Doorway, an organisation for the homeless and Sue Gumbleton works for Alabare, another homeless organisation.
11. / WIN Member Activity Reports
PB invited questions about his activity reports but there were none.
12. / Policies amended by the HIT Group to be ratified by the Core Group

• Communication and Engagement Strategy
• Equality and Diversity Policy
• Equality and Diversity Monitoring Form
• Volunteer Expense Policy
• WIN Concerns Form

These policies had been circulated to the members prior to the meeting. There was a short discussion around WIN representation and the £1 charge for having an expense claim paid by cheque with respect to the Volunteer Expense Policy. All matters were satisfied.
All policies were approved. Proposed by PB and seconded by AF.
13. / Any other business
PM thanked AF for all the work she had put in over the past year while she was Chair of WIN.
AF mentioned that she had received a letter from Andrew Kerr, Chief Executive of Wiltshire Council, apologizing to WIN for the way that the Council had handled the recent complaint. Discussion ensued about whether to take any further action with this. Chairs will discuss further at their next meeting.
PB proposed that WIN endorse the recent letter from the South East LINk’s that will be sent on to Rt HON Andrew Lansley MP stating concern about the proposed funding arrangement s for Local HealthWatch. All agreed.
Anna Mead from the Stroke Association then asked if WIN would be able to take up the issue of waiting times that stroke patients have to endure before being able to see a physiotherapist. PM said that WIN would be happy to do this and for Anna to email LW with all the details. The Chairs would discuss this at their meeting and decide on an appropriate action.
Meeting closed. / AM to email LW details, LW to add to chairs agenda.

Dates of future meetings –