Agenda and minutes

The Chair welcomed Ben Knight, who had recently started work within Scrutiny, to the meeting. 

The Chair announced that Councillor John Doyle, Cabinet Member for Health and Social Care, had recently begun a healthy eating regime and had set himself a target to lose 3 stone by Christmas.  So far he had lost 8 pounds and was planning to set up a Just Giving webpage for anyone wishing to sponsor him on his endeavour to lose weight.

No declarations of interest were made at the meeting.

There were no members of the press and public present.

10.00 am

Brigid Reid, Claire Newey and Carole Lavelle gave a powerpoint presentation on how planning for Discharge started on Admission or the latter was avoided.

The presentation drew specific attention to:-

• Discharge Policy
• Golden Rules
• Rotherham InterQual Initiative
• Drivers for Change
• Proposed Solutions

Carole gave an overview of the InterQual system, which was a product provided to help in making the decision of whether to admit a patient into hospital and also when was the most appropriate time for them to be discharged.

They had been using the system since February 2009 to gather information in four pilot areas and it was their intention to continue collecting this data.

A question and answer session ensued and the following issues were raised and discussed:-

• Whether awareness training had been undertaken to enable staff to deal with patients who have communication difficulties.  Work had been undertaken in the past with Speak Up in relation to this and there had also been filming done by actors, role playing patient and staff which would be used for training purposes and the Trust would be happy to work with the National Autistic Society.
• The effectiveness of communication between the hospital and the ambulance service, with respect to patient transport on discharge. It was confirmed that work was being undertaken between the two services, to assist with communication and to streamline the service delivered to patients.
• A query was raised about hospital staff’s acceptance of the principles of ‘Right Patient, Right Place, Right Time’
• Concerns were raised about InterQual data being subjective.  It was confirmed that the questions asked were very specific to ensure everything was covered, but also there would still need to be a clinical judgement made and the patients/family perception would also be considered.
• It was noted that unless additional resources were provided for rehabilitation, the earlier discharge of patients could lead to additional burden being placed on carers.  In response, it was reiterated that the InterQual project is across Rotherham, including Social Services, who would support people at home.
• Who makes the final decision for discharging a patient?   A whole host of people play a part in discharging a patient, from the Consultant to Physiotherapists, Occupational Therapists etc.  It was confirmed that the statistics retrieved from InterQual would assist in making this decision.
• Reference was made to undertaking a “small qualitative study to measure patient and carers expectations”.  A query was raised as to why this wasn’t done at the beginning of the project.  Confirmation was given that this was not being done in order to feed into the data, but to work alongside it.
• How would the discharge procedure work for terminally ill patients?  A fast track system was in place to move patients to either their homes or to the hospice.

Members of the Panel thanked Brigid, Claire and Carole for their presentation and it was agreed that a further presentation be given in 18 months time.

10.50 am

Steve Turnbull, Head of Public Health gave presentation in relation to the Swine Flu pandemic.

The presentation drew specific attention to:-

• Understanding Pandemic
• What is a flu pandemic
• What causes pandemic flu
• Swine Flu – Case definition
• A/H1N1 Characteristics
• Who is at risk?
• Cases by Age and Sex
• How influenza spreads
• Implications
• Actions
• Planning Assumptions
• Vaccination
• National Flu Pandemic Service Helpline
• Other useful numbers

A question and answer session ensued and the following issues were raised and discussed:-

• The seasonal flu vaccination was due to be released in October 2009. Would this still take place and if it did would it have any impact on the vaccination for Swine Flu?  It was confirmed that the seasonal vaccination would still be available and should be taken by people as usual.  It would not have any impact on the injection given for swine flu and therefore if necessary could be given in conjunction with it.
• Whether it was necessary to have alcohol hand gel rubs in all public buildings.  Although it was agreed that these gels were effective, they were not necessary at the current stage of the pandemic and simple hand washing, done properly was sufficiently effective.
• The leaflets that were produced advertising the onset of swine flu and what to look out for were very informative, however it was felt that they were not very “user friendly” for people with autism or learning difficulties.  Would it be possible to produce these leaflets in a more easy to read format?  Confirmation was given that leaflets could be produced in various formats, so therefore did not envisage a problem with this request.
• What would happen if you didn’t have a “flu buddy” to go to the pharmacy for your vaccination?  It would not be a major problem as this could be undertaken by the GP services if necessary.
• It was felt that it was pointless for a patient to be given a vaccination once they had contracted swine flu, or had some of the symptoms.  Although this appeared to make sense, it was agreed that it could be that the patient had not actually got the H1M1 virus so therefore it would still be worth having the vaccination.

11.20 am

This item was deferred until the next meeting.

11.35 am

Consideration was given to the Forward Plan of Key Decisions for Adult Services for the period 1^st September 2009 to 30^th November 2009.

It was pointed out that Scrutiny would be looking at budget issues in its October meeting.

Resolved:- That the Forward Plan of Key Decisions for Adult Services for the period 1^st September 2009 to 30^th November 2009 be received.

11.50 am

Russell Wells, co-opted Member from the Autistic Society introduced a dvd which had been produced to raise awareness of autistic spectrum disorder and of an Autism Alert Card which was to be launched shortly.  He explained that the dvd had been passed to South Yorkshire Police to use within their training of officers throughout the Force. 

Members watched the dvd and agreed that it was most informative and helpful.

12.00

Consideration was given to the Adult Services Annual Report Summary 2008/09.

Improvements in performance with respect to responding to complaints within timescales continued.  98% of stage 1 complaints and 100% of stage 2 complaints had been responded to within the statutory timescales compared to 94% in respect of stage 1 last year and maintaining the 100% performance in relation to stage 2 complaints.

All customers were sent a satisfaction survey following the response to their complaints which showed that an increased number of people were satisfied with the outcome of their complaint, how it was handled and being kept informed of the progress made.  Over all 73% of customers were satisfied with the outcome of their complaints which had increased from 66% for the same period last year.  The number of people satisfied with being kept informed of the progress of the investigation and time taken to respond had also increased from 72% to 77%.  The number of customers expressing confidence in using the process again had also increased from 90% to 96%.

Since January 2009 the complaints process across the whole of NAS had fully incorporated the principles of personalisation.  The implications of this were that managers investigating and responding to complaints maintained contact with the customer throughout the process and agreed with them the outcomes that were being sought to resolve the issues raised.

Members queried whether there were any measures in place for monitoring and achieving a reduction in complaints.  It was confirmed that there had been a reduction from 228 complaints to 209 in the last 12 months.  However this was not necessarily due to people not expressing their displeasure, but more in line with the way in which they were handled and recorded. 

Reference was made to the number of complainants completing satisfaction surveys being very low and asked whether this would cause satisfaction rates to contain a large margin of error.  It was agreed that the lower number was not ideal and that efforts were being made to improve the number of people completing them.  In addition it was intended that in future telephone follow up calls would be made to find out why customers were not completing the survey.

A query was raised as to whether an audit was undertaken of people that did not complain, and whether this was because they did not know how to or whether they were genuinely happy with the service they were being provided with.  It was confirmed that the Complaints team did undertake as much as possible to follow up on users of the service to make sure everything was in order.

Resolved:- That the report be noted.

Resolved:- That the minutes of the meeting of the Panel held on 9^th July, 2009 be approved as a correct record for signature by the Chair.,

Resolved:- That the minutes of the meetings of the Cabinet Member for Health and Social Care held on 6^th July 2009, 20th July 2009 and 3^rd August, 2009 be received and noted.