Minutes of the eleventh meeting of the Patient and Client Council held on Tuesday 26 th January 2010 at 11.00 am, in the Council Chambers, Dungannon & South Tyrone Borough Council, Circular Road, Dungannon Present: Mr John Keanie (Chair) Mrs Maeve Hully (Chief Executive) Cllr Mrs Elizabeth Adger Mr Brian Compston Dr Paul Coulter Mrs Margaret Harte Mr Errol Hutchinson Miss Elaine Kelly Dr Sheila Kelly Dr May McCann Mrs Rena Shepherd Cllr Mrs Marion Smith Mrs Janice Smyth Cllr Trevor Wilson Ms Koulla Yiasouma Apologies: Prof Hugh McKenna Other Apologies: Mrs Louise Skelly, Head of Operations, Patient and Client Council In attendance: Mr Sean Brown Mrs Helen Mallen Head of Development and Corporate Services, Patient and Client Council Board Secretary, Patient and Client Council 01/10 INTRODUCTION Mr Keanie welcomed everyone to the eleventh meeting of the Patient and Client Council (PCC). 02/10 MINUTES A number of changes were noted to the minutes: a. Minute 96/09 (c) Dr Kelly had attended an event held the following by the Postgraduate Medical and Education Training Board. should read: Dr Kelly had attended an event held by the Postgraduate Medical and Education Training Board. Page 1 of 11
b. Minute 95/09 (c) Resettlement Programme At the previous Board meeting Dr McCann had asked that the notes of the meeting on the Resettlement Programme, held on 24 November 2009, be amended to show discussion about the possibility of looking at the phasing of the resettlement. On discussion of the amendment noted in the minutes, Dr McCann agreed to draft an alternative amendment for the Board Minutes of 15 December, and this will be presented to the Board for approval at the next Meeting. c. Notes of the confidential session held prior to the Board Meeting on 15 December 2009. This note was approved pending corrections to Members titles. 03/10 MATTERS ARISING a. Schedule of PCC Board meetings A schedule of Board meetings to June 2010 has been circulated to Members. As suggested by members at the last meeting this includes one evening meeting commencing at 7pm and one Saturday meeting. b. Complaints sub-group Mrs Hully confirmed that a number of Members have put themselves forward for this group. Mrs Skelly will report on this at the next meeting. c. Board Members Representation on Committees At the previous Board Meeting Ms Yiasouma had suggested that criteria be produced showing how Members are selected when a request is received for PCC representation. Mr Keanie explained that the officers had considered this and it has been difficult to establish as selection criteria will differ depending on the group seeking representation, the role required and the experience, interest and availability of individual Board Members. On discussion it was agreed that the process, rather than a set of criteria, for selection, needs to be defined. Members agreed that the following be included in this: When a request for representation is received, the initial decision, on whether a Member or Officer is most appropriate, will be made by Chair and Chief Executive Details of the request will be provided to Members, including the nature of the remit and the likely skills / experience that would fit the requirement Where there are more nominations received than the number required, criteria will be used for selecting the Member(s) based on the skills / experience requirements of the particular representation. Page 2 of 11
The Chair will agree the specific criteria to be used at this stage in discussion with the Chief Executive. If members are approached for representation directly they should advise the person to make the request via the Chief Executive s office Members representing the PCC should provide a brief report of meetings attended. 04/10 MEMBERS REPORT a. Western area The next meeting of the Western Health and Social Care Trust will be in April, which Mrs Harte hopes to attend. The Trust will meet seven times a year and Mrs Harte will feedback to the Board on her attendance. A meeting is currently being arranged for Mrs Harte to meet with the Chair and Chief Executive of the Trust prior to her attending her first Trust Board Meeting. Mrs Harte said that she has held a meet and greet with Mr Paul Cavanagh, the Commissioning Lead of the Western Local Commissioning Group (LCG). Mr Cavanagh had provided a draft copy of the Western LCG Local Commissioning Plan which outlines its priorities for 2010-2011. Mrs Harte provided this to Members for information. b. South Eastern Trust Board Meeting, 20 January 2010 Ms Yiasouma had attended this meeting and some of the issues discussed included: Efficiency Savings Hospital acquired infection and a recent Regulation and Quality Improvement Authority inspection report The increase in numbers of elderly patients with fractures A presentation on patient services such as ambulance transfer, car parking and cleaning A presentation outlining what the Trust is doing on personal and public involvement (PPI). Ms Yiasouma said it will be important for the PCC to keep a watching brief on how patients are involved in the development and decision making processes for health and social care services. Mrs Hully confirmed that under legislation each Trust must develop a PPI scheme that will be monitored by the Department of Health, Social Services and Public Safety (DHSSPS). The PCC had input to the design of a template to be used by the Trusts to design their PPI schemes. The draft schemes were to be submitted by 31 December Page 3 of 11
2009 and the PCC will be involved in the review of the draft schemes which are to be agreed for implementation by 1 April 2010. c. Belfast Local Commissioning Group (LCG), 21 January 2010 Dr Kelly had attended this meeting. Four presentations on aspects of healthcare and wellbeing were made at the meeting as follows: Health Improvement, Knockbracken Healthcare Park, Belfast Trust, on improving health and wellbeing in South and East, Belfast and Castlereagh Inner South Neighbourhood Partnership on health issues, priorities and challenges in South Belfast. East Belfast Healthy Living Centre on their three strategic themes, reducing health inequalities, mental health and well being and the ageing population. South West Belfast Neighbourhood Renewal Partnership on health statistics, health issues and strategic plans to deliver health improvements. There was discussion about the level of commitment being sought from PCC representatives by LCGs. It was agreed that as the PCC has a major interest in the work and remit of the LCGs it should develop an approach to rationalise and maximise its input. In this context, Mrs Hully asked Members to consider if PCC staff should be providing representation at the operational level while Members represent at strategic level. She suggested that Local Area Managers undertake LCG representation and that they meet regularly with the Members representing the PCC on the Trust Boards. Ms Yiasouma suggested that it will also be important for the PCC Trust Board and LCG representatives to meet with the Local Advisory Committee (LAC) in order to communicate and co-ordinate local issues. On discussion, Members agreed that PCC representation at Trust Board should not only include asking questions about complaints, received but about evidence of good practice in order to get a true reflection of the patient experience. 05/10 FEEDBACK ON MEETING WITH MINISTER Mr Keanie, Mrs Hully and Professor McKenna had met with Mr Michael McGimpsey, the Minister for Health, Social Services and Public Safety, on 6 January 2010. Mr Keanie explained that they had outlined the organisational set-up of the PCC and the work being done on staff recruitment and office locations. They had also discussed a number of Page 4 of 11
completed and ongoing projects that the PCC have undertaken with the public. The Minister was apprised of the work undertaken by the PCC on Priorities for Action and this report will be widely circulated in due course. Mrs Hully said that the Minister reiterated his commitment to hearing the public, patient and carer experience. 06/10 FEEDBACK ON MEETING WITH THE HEALTH COMMITTEE The Chair and Chief Executive had met the Chair of the Health Committee and representatives from all parties prior to the Health Committee Meeting on 14 January 2010. At the 14 th January meeting, Mrs Hully had made a presentation to formally introduce and explain the remit of the PCC and Mr Keanie had highlighted the shift of balance in the recent work of the PCC, from organisational set-up tasks to more public-facing work.. The Committee was very interested in what the PCC are doing and said they will keep in close contact with the PCC, with the intention of working collaboratively on issues that are of particular interest to both parties. Dr Kelly said she had been in the public gallery and said that the remit and work of the PCC had been well presented by the Chief Executive and Chair. She said that Members of the Health Committee had asked many questions that drew out much detail and demonstrated a strong interest, by the Committee, in the work of the PCC. 07/10 LOCAL ADVISORY COMMITTEES (LAC) UPDATE a. Induction for LAC members An induction session for the members appointed to the LACs was held on 25 January in Lisburn. A second session will be held in Ballymena on 1 February. b. Representation by Board Members on LACs At the previous Board Meeting it was agreed that two Board Members should sit on each LAC. Mr Brown updated members on the current position: Mr Hutchinson will support Cllr Wilson on the Northern LAC As Cllr McGuigan has now resigned from the PCC, Ms Yiasouma will replace him as Chair of the Southern LAC. Mr Compston has offered to support Mrs Shepherd on the Belfast LAC Page 5 of 11
Both Dr Kelly and Cllr Smith have offered to support Dr Coulter on the South Eastern LAC. Mr Brown explained that the following vacancies still exist and in order to finalise the LACs he asked Members to advise him by Friday 29 January if they are interested in either of the following positions: A member to support Ms Yiasouma in her role as Chair of the Southern LAC A member to support Mrs Harte in her role as Chair of the Western LAC 08/10 REPLACEMENT OF BOARD MEMBERS Cllr Tim Atwood and Cllr Sean McGuigan have left the PCC to sit on their Local Commissioning Groups (LCGs). Mr Brown explained that he has been in touch with the Public Appointments Unit (PAU) to enquire on the status of replacements for these two Members. The PAU is currently having a review of its appointment process and has indicated that this coupled with the subsequent recruitment process could result in six to twelve months to appoint replacements. Members agreed that Mr Keanie should write to the PAU stressing that it is imperative that the PCC has its full complement of Members as soon as possible. As the two Members who are being replaced are political party representatives, Members could not understand why a reserve list is not in place to have permanent replacements appointed. Members said that Mr Keanie should emphasise the fact that the absence of these two representatives impacts on the representativeness of the PCC, particularly geographical representation. 09/10 FINANCE An overview of Finance, paper number 18, had been circulated with Board papers. Mr Brown explained that the PCC is currently underspent on its budget for 2009/2010, due to the time taken to appoint staff and find locations for local and regional offices. The PCC has to make a Ñ140,000 contribution to efficiency savings from its operations budget for 2010/11 and this figure may increase. The major strain for the future will be on the operational budget as accommodation is expensive, especially in Belfast with regard to rents and rates. An alternative site for the Belfast office has been identified and although it is 25 to 30% cheaper than the current premises it is in excess of the PCC business case allowance. Page 6 of 11
Despite best efforts, premises for the Antrim and Newtownards offices have still not been found. In the short term the Belfast, South Eastern and Regional office would be co-located in Belfast. From a financial perspective this would provide a value for money solution. However the search for new premises in Antrim and Newtownards would continue based on the agreed criteria. In response to a question from Mr Keanie, Mr Brown assured the Board that there are currently sufficient resources for the PCC to achieve the objectives it has planned for. A costed operational plan will be brought to the Board over the next couple of months. In response to members questions, Mr Brown confirmed that the PCC is not being disadvantaged compared to other HSC organisations in regards its budget. 10/10 POLICY APPROVALS Mr Brown explained that there is a lot of establishment and governance work to be undertaken which will involve a number of policies and procedures. Mr Brown will list policies coming on line and Members can receive full details on request Formal Board approval will be sought where necessary. Details of policies and procedures will be presented to the Governance and Audit Committee. A copy of the DHSSPS Guidance on the HSC complaints procedure, Complaints in Health and Social Care, Standards and Guidelines for Resolution and Learning had been circulated with Board Papers. Mr Brown explained that the documented procedure for the PCC for dealing with complaints about itself is consistent with this DHSSPS guidance. On discussion Members adopted and agreed the procedure pending the following amendments:- - Item 6. Complaints by third party. Ms Yiasouma asked that (for example brought by a carer) be added to this. - 3 days and 20 days changed to 3 working days and 20 working days Members recommended that for feedback purposes, comments/ compliments about the PCC be recorded in addition to complaints Page 7 of 11
Any Members interested in being involved in the development of policies and procedures were asked to contact Mr Brown. 11/10 CHIEF EXECUTIVE S REPORT The Chief Executive s report had been circulated to Board Members and was accepted as read. 12/10 OPERATIONS UPDATE a. Beyond Cancer Report Mrs Hully presented the Beyond Cancer Report to members as a summary of the comments obtained at the conference held on 16 June 2009. Copies of the report had been circulated to conference delegates. A follow up conference is being planned. Mr Keanie commended the report, said that it contributes to the growing body of work of the PCC, and welcomed the jargon-free way in which the report was written. In response to a question from Mr Compston in relation to the waiting times cancer patients had experienced in accident and emergency, Mrs Hully said that work has been initiated with the Cancer Centre on fasttracking cancer patients through accident and emergency. A group of senior staff including oncologists are looking at this issue and importantly the group has patient and carer representation. 13/10 INPUT FROM MEMBERS OF THE PUBLIC LAC Committee Member A member of the Western Local Advisory Committee asked if the LACs should meet with the Local Commissioning Groups. Mr Keanie explained that it had been proposed earlier that the PCC Trust Board and LCG representatives meet with the LACs and this will be pursued when all the representatives have been confirmed. There was discussion about what information needs to be given to the LAC Members and it was agreed that careful consideration will be given to this issue, to ensure that the information provided is consistent across all the groups. It was agreed that the Chairs of the LACs should be involved in this consideration. Page 8 of 11
14/10 COMMUNCIATIONS a. Communication in media There was discussion about how the PCC is made aware of any publicity and it was agreed that the process of capturing communications in the media will be considered. b. Advocacy Report (Board paper number 17) This summary report was provided with Board Papers. As Mrs Skelly was not at the meeting it was agreed that she should consider the following points, prior to bringing the paper back to the Board. A number of the case studies provided in the Report related to complaints about services at home. Mrs Smyth said that the PCC needs to consider how services not only differ across the Trusts in relation to cost and access, but how they differ across directorates within Trusts. Dr McCann said that she had recently received a letter which she has passed to Mrs Skelly, about mental health services being withdrawn when someone turns 65, as people currently move to older people s services at this age. Dr Coulter asked if quarterly reporting of activity can be split between Belfast and South Eastern Trust area in future. Mr Brown said that this will be split from 1 April 2010. Mrs Hully said that a lot of the issues raised during the consultation on the Priority for Action targets concerned problems with community and domiciliary care. This will be an area for the PCC to focus on in the coming year. Members provided examples of problems they have experienced with care in the community and highlighted the concern that there are major issues in the shift from care in hospital to care in the community and the budget available for this. c. Tenders Mrs Hully outlined the position with a number of tenders currently out on behalf of the PCC. Membership Scheme This had been approved and Mrs Hully will provide a presentation on the membership scheme at the February meeting. Page 9 of 11
Profile-raising a panel reviewed the submissions for this piece of work and a final decision on the contractor and sign off will be made by the end of February Website development a panel has reviewed the tenders and a final decision on the contractor will be made by the end of February. d. Representation by Members Mr Brown explained that there are two vacancies for representation by Board Members and asked that anyone interested in the following let him know by Friday 29 January 2010:- A member to replace Cllr McGuigan on the Governance and Audit Committee A member to replace Cllr Atwood as PCC representative on the Belfast HSC Trust Board. 15/10 ANY OTHER BUSINESS a. Social Services Cllr Mrs Adger referred to the findings of an independent enquiry into the fire in Omagh in 2007, which claimed seven lives. She asked if, in light of the failure of agencies in sharing information about Mr McElhill s history, the PCC would raise the issue of lack of social services on the ground. Ms Yiasouma said that she had heard an announcement on 25 January about a pilot scheme to examine relationships between the various agencies, such as social workers and the PSNI, in a bid to prevent repetition of the failings in this case. Page 10 of 11
16/10 DATE OF NEXT MEETING The next meeting will be held on Tuesday 23 February 2010 at 2.00pm in the Chamber Office, Cookstown District Council, Burn Road, Cookstown, County Tyrone, Northern Ireland, BT80 8DT Signed Date Signed Date John Keanie Chair of PCC Maeve Hully Chief Executive of PCC Page 11 of 11