Governing body - QPSAC committee May minutes

Agenda item 8.1
Meeting of South Norfolk Clinical Commissioning Group (SNCCG)
Quality and Patient Safety Assurance Committee Meeting (QPSAC)
10am – 1pm
Tuesday 6 May 2014
Meeting Room GF 1, Lakeside 400, Old Chapel Way, Thorpe St Andrew
Norwich, NR7 0WG
MINUTES
Chair: Dr Hilary Byrne, Governing Body Member, SNCCG (HB)
Attendees:
Ben Chirimunjiri
Heidi Davey
Howard Stanley
Linda Ellison-Rose,
Commissioning
Mark Gower
Safeguarding (MG)
Rowan Slowther
Simon Aldridge
Natasha Norman
Quality & Patient Safety Manager, Commissioning Support Unit (CSU) (BC)
Governance Support Officer, SNCCG (HD)
Senior Nurse for Adult Safeguarding (HS)
Clinical Quality and Patient Safety Manager, Care Homes, North East London
Support Unit (LER)
Designated Nurse, Looked After Children/Deputy Designated Nurse
Infection Control, Norfolk County Council (NCC) (RS)
Quality Improvement Lead, SNCCG (SA)
Note Taker: Project Coordinator, SNCCG (NN)
RS introduced Caroline Lester, the new member of the Infection Control Team, NCC
ITEM and TIME
1.
2.
3.
4.
5.
6.
Apologies
Sandra Corry (SNCCG)
Karen Ward (SNCCG)
Declarations of conflicts of Interest
None identified
Notification of urgent items
None identified
Items Exempt under the Freedom of Information Act (FOI)
Any patient identifiable information and commercially sensitive information.
Minutes of Previous Meeting – 18 March 2014
The QPSAC minutes from the previous meeting on Tuesday 18 March 2014 were
agreed and signed to be a true and accurate record.
Matters Arising & Action Log Notification of urgent items
 No matters arising identified.
 Action Log
Sonia to liaise with Hilary with regards to the action log update.
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7.
CSU Quality & Safety Report
BC presented the May 2014 Clinical Quality and Patient Safety Report highlighting,
 Norfolk Community Health and Care (NCH&C)
A summary of report was given by BC providing an overview of all the data captured.
Since the report has been produced there has been one SI relating to an Information
Governance issue for NCH&C. BC stated that he will provider further information at
the next QPSAC meeting.
ACTION: BC to provide an update at the June QPSAC.
SA raised a concern with LER that NCH&C and some Practices are not receiving
feedback following raising a QIR. LER stated she will investigate this further, SA to
provide LER with the name of the contact at NCH&C.
 Norfolk and Suffolk Foundation Trust (NSFT)
There were no SIs reported for SNCCG in March 2014 for NSFT. However there
were 4 QIR on SNCCG referrals. Further details evidenced in the report.
BC raised concerns that due to staffing changes in NSFT new staff may not be fully
aware of how to raise an SI/QIR and will address at the next NSFT CQRM.
MG raised the question ‘are adult and children SI separated’ as MG is conscious of
not having sight of all SIs relating to children. LER and BC are to add Mark to the
distribution list for future SIs.
ACTION: LER / BC to add MG to the distribution list.
 NNUHFT
BC provided an overview of the data in the report for NNUHFT.
 OOH/111
No SI, QIR or never events reported for March.
HB questioned if SC and KWa have an overview of all SIs. SA stated that although
he believes this to be the case he will check with SC and confirm.
ACTION: SA to follow up with SC to confirm SNCCG has sight of all SIs.

8.
James Paget, East Coast Community Health (ECCH), Queen Elizabeth
Hospital (QEHKLFT) and West Suffolk
HB requested that more information on the above providers is capture in Patient
Safety Reports. HB is aware that SC had had discussion with West Suffolk and HB
will follow up with SC for an update.
ACTION: HB to request an update from SC on West Suffolk.
Infection Control
RS provided an update on current Infection Control concerns.
 Clostridium Difficile (CDIFF) and Queen Elizabeth Hospital
The QEHKLFT has had a CDIFF outbreak, there has been an increase to 5 on each
ward. QEHKLFT have had intensive support from Public Health and other agencies
which has resulted in a decrease in figures for April. The main intervention has been
Hydrogen Peroxide fog used on 5 wards. The cost of each CDIFF case to the hospital
is £50,000 money which is claimed back by the relevant CCG. In this case the CCG
may consider using the monies to purchase a Hydrogen Peroxide fog machine.
QEHKLFT is in the process of mobilising a decant ward to enable a rolling rotation
programme.
2
The final CDIFF figures are 7 over the trajectory with 43 for SNCCG.
 Staffing
The Lead Infection Control Nurse has reduced working hours although there has
been an increase in the hours of the part time junior Infection Control Nurse. A
consultant remains on long term sick leave.
 MRSA
The current target is set at 0 but to date there have been two cases. A 0 target figure
has been set again for 2014/15.
 Care Homes - Harm Free Care
The Micro site for carers has been launched providing guidance of 3 harms but it is
generally felt that is not enough on its own due to the barriers for some on computer
access. There has been a poor induction system so an assessment tool has been
created. A pilot is happening over 9 cares homes 2 of which are in South Norfolk.
Each care home has had training on the correct use of the assessment tool.
Outcomes will be reported formally at the end of year. There will also be comparisons
with those homes who have not taken the pilot.
9.
RS confirmed the Public Health final end of year report will be published within the
next few weeks.
Care Homes Update
LER provided an overview of the presentation circulated highlighting;
HB raised the question of how we can get the CQC to work better with the CCG.
Caroline Lester confirmed that NCC will visit all care homes highlighted at risk in the
report.
10.
The question was asked how General Practitioners (GP) can raise concerns and
what is the process for reporting their concerns. HB confirmed that there was no set
process for reporting although LER confirmed GPs do raise concerns formally. The
Committee agreed it would beneficial to include information in the SNCCG newsletter
as a joint article with Safeguarding.
ACTION: LER/HS/MG to draft an article for inclusion in the SNCCG newsletter.
Safeguarding
 Children
MG provided an update on Children’s Safeguarding;
MG confirmed the data for inclusion in the SNCCG Governing Body report has been
provided.
SystmOne Safeguarding
It is still proving a challenge to get into one Practice since the training was rolled out 9
months ago. Each CCG will now monitor Practices in their areas. Non-SystmOne
users are currently being investigated by Martin Baines as the fear is that EMIS users
are in danger of being left behind. Public Health is currently doing work on
information sharing, investigating EMIS & SystmOne. MG raised the current issue
with the system in that it only flags safeguarding for the individual child rather than the
household.
General Practice
2 questionnaires have been sent out to General Practice (GP) to gain a view if they
have regular meetings with the Health Visiting Teams.
3
Placements
MG raised that if, when commissioning care, the CCG needs to be cautious of how
the service is being delivered especially for specialist cases. It is the view that when
a placement is agreed, reviews are not being undertaken.
ACTION: SC to feedback at the June meeting
 Adult Safeguarding
HS presented the Quarter 4 report circulated
Generally when a care home has an issues we are not aware of which patients are in
the home or if their needs are being met. Care homes remain under pressure when
admissions are on a Friday and there is a feeling they feel pressured into taking these
patients.
 Quarter 4 Report Highlights
Domestic Abuse Training
HS confirmed the current training programme is currently going well.
Norfolk and Suffolk Foundation Trust (NSFT)
NSFT staff are having training around deaths reported. A memorandum of
understanding has been drafted between NSFT and the police to avoid the hindrance
and delays in responses and action.
11.
111
There have been very few Safeguarding issues being reported. There is currently a
piece of work being done to ensure data reported is accurate.
Quality Improvement Report
SA gave an overview of the 4 projects under the Quality Improvement work currently
being undertaken by the Quality and Patient Safety Team.
End of life IT System Trial (EPaCCS)
Pilot study launched utilising 4 GP Practices with SystmOne in place and also
SystmOne units in NCH&C, OOH/111 and 999 Ambulance has been initiated. A
highlight report is currently being prepared for initial recommendation to leadership
team.
Diabetes Pathway
8 work streams have been identified. There are currently discussions taking place
with industry partners regarding training for the service user.
Epilepsy Service
Work with NCH&C is now complete. Recommendations have been made to CCGs.
Cherry Tree - Benchmarking of the quality in Community Hospitals
The first phase of the project has been completed and the project team are currently
scoping phase two.
Other Work Stream
Pressure Ulcers
Three Pressure Ulcer workshops have been organised throughout the year and
proposed attendees number are positive.
 Session 1 – Independence and Wellbeing / Friday 6 June 2014
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12.
13.
14.
15.
16.
17.
 Session 2 – Prevention and Management / Friday 26 September 2014
 Session 3 - Wound and Infection / Thursday 11 December 2014
CQUIN and Quality Premiums
SA confirmed that due to the Quarter 4 results not currently being available there is
no new information to report.
Clinical Risk Register
SNCCG has recently undergone an internal audit which has highlighted the need for
a standard template. This template is currently being drafted with the support of the
SNCCG Governance Team. Further update at the next QPSAC in June.
Complaints/Freedom Of Information (FOI) Request
Complaints
There have been 5 formal complaints received for March/April three of which have
been raised by MP’s. The complaints are general in nature and do not indicate any
trends. However, Continuing Health Care (CHC) continues to be a concern with
these cases remaining open for longer and on occasion being reopened and
revisited.
FOI
A total of 13 FOI requests were received this month which is an average amount
HD confirmed that 100% of SNCCG staff have passed there Information Governance
training.
Feedback from CQRM
 NCH&C
ACTION: SC to provide and update via email to QPSAC.
 NSFT - AAT Service
BC confirmed that the current round of recruitment within NSFT should help with
current highlighted issues/concern with regards to the AAT Service.
 NNUH
Update at the June QPSAC
 OOH/111
SA provided an update on the meetings and hot topics confirming the meetings are
going well and are productive in the content.
Francis Action plan
QPSAC questioned if this meeting was the correct forum for the report and after
QPSAC where would the report be taken?
ACTION: SC to provide view with regards to the best forum for the report to be
received.
A.O.B
 Learning Disabilities
SC has met with HS and Clive Rennie to move the proposal of an LD CQRM meeting
forward.
ACTION: SC to provide an update for the next QPSAC meeting in June.
 QPSAC meeting dates circulated for information.
 Care Quality Commission – Press Release Circulated for Information
‘New map of Health-Based places of safety for people experiencing a mental health
crisis reveals restrictions in access for Young People’.
Date of next meeting:
Tuesday 3 June 2014 lakeside 400, GF 1.
Identified Items for the next Agenda
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The South Norfolk Clinical Commissioning Group Quality and Patient Safety Assurance Committee
(QPASC) minutes from 6 May 2014 were approved as a true and accurate record of the meeting.
Name
Signature
Date
Signed on behalf of South Norfolk Clinical Commissioning Group Quality and Patient Safety
Assurance Committee (QPASC) by the Chair, Hilary Byrne
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