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1 Council of Governors Meeting 30 th April 2014 (CG/14/10) Council of Governors Report: Quality and Engagement Working Group Report Meeting held on 18 March 2014 Status: History: A paper for Information Regular report Sue Gallagher Governor QEWG notes
2 Council of Governors Meeting 30 th April 2014 A paper prepared by Steven Towndrow, Patient Experience Facilitator and presented by Sue Gallagher, Governor. Quality and Engagement Working Group Report 1.0 INTRODUCTION This report details the meeting of Patient Experience Working Group, which took place on 18 th March 2014 at St Thomas Hospital. 2.0 ATTENDANCE 2.1 The meeting was attended by: Sarah Allen (Patient Experience Manager), Devon Allison, John Burns, Andrea Carney (Patient & Public Engagement Manager), Yvonne Craig, Sue Gallagher (Lead), Julie Gifford (Assistant Director of Strategy), Sue Hardy, Ken Hayes Dawn Hill, Tom Hoffman, Jamie Keddie (Patient & Public Engagement Specialist), John Porter, Barry Silverman, Steven Towndrow (Patient Experience Facilitator), Jeff Whitear and Bryn Williams. 2.2 Also in attendance were Debbie Parker (Deputy Chief Nurse), Katrina Cooney (Deputy Chief Nurse - Workforce), Amanda Millard (Group Director of Operations), Peter Bennett (Head of Hotel Services) and Mary Newman (Director of Quality Improvement and Assurance) 2.3 Apologies were received from Gail Thompson, Noreen Ging, and Paula Young. 2.0 NOTES OF THE LAST MEETING 2.1 The notes were approved as an accurate record of the last meeting apart from Debbie Parker who had in fact sent apologies. The DCN s office was represented by Lis Puller at the meeting. 3.0 MATTERS ARISING 3.1 Matters arising (those items not listed on the agenda): a) Appointment reminder calls and call screening services Governors discussed the appointment reminder service. This was provided by switchboard staff using scripts provided by clinical teams which meant there were restrictions in discussing details of an individual case. Clinical centres could also make calls directly to patients without going via switchboard. Governors commented that there needed to be a telephone number that a patient could be given if wanting to query something about their appointment with the clinic. b) Governor attendance at the Cancer Programme User Reference group This Group was led by those who had used cancer services. After discussion it was not thought appropriate for Governors to attend but there were other opportunities to get involved in shaping cancer services such as quarterly public stakeholder events c) Mylife software trust investigation and possible future presentation Governors discussed mechanisms for capturing feedback in the form of case studies. It was noted that the Trust already had existing channels to collect qualitative data that QEWG notes
3 services could monitor and act upon. It was reviewing mechanisms for capturing case studies and Mylife would be one of the range of tools being examined. 4.0 UPDATE FROM THE QUALITY COMMITTEE 4.1 Governors noted this Committee s terms of reference and draft minutes for January s meeting. 4.2 Governors noted: Improved performance by the outpatient pharmacy now being run by Sainsburys. Improved infection control relative to last year. Actions to address staffing in District Nursing to mitigate serious shortages. Improved response times to complaints within the 25-day target but this remained a problem area Further work to try to meet cancer treatment targets within 62 days of GP referral. Work to improve patient experience in post-natal care. 5.0 UPDATE FROM ESSENTIA ON TELEPHONE SYSTEM, FOOD AND PATIENT TRANSPORT 5.1 The Group Director of Operations and Head of Hotel Services updated the meeting on progress in improving telephony services and presented operational performance data on nutrition and patient transport. 5.2 Telephony Governors noted: There had been issues with the voice recognition service the system used to get through to departments. The main issue was with keeping the staff directory up to date rather than the software, particularly the removal of ex-employees from the system. Developing Direct Dial In for external calls coming into the Trust was dependant on the switchboard being upgraded which was a major project for the next financial year. Suggestions were discussed for collecting up-to-date staff information from existing databases such as those used by IT, HR or Training departments. 5.3 Nutrition Governors noted; Feedback on food came via a number of sources including Near-time patient feedback (surveys) which staff could monitor at ward level. In the most recent National Inpatient Survey GSTT performed favourably against the London average on questions relating to nutrition. The recent PLACE visits had offered a good insight into the preparation and quality of food on the wards and there were numerous initiatives to improve the choice and quality of food underway The Nutrition Steering Group would help ensure that a diverse menu was available to cater for patients. 5.3 Transport Governors noted: Results of a telephone patient satisfaction survey showing positive results for Drivers assisting patients to and from their front door 97% of patients finding their driver friendly 93% of patients rating the service as good or very good. QEWG notes
4 Patient Transport was currently working within a contractual framework with set performance targets but: There had been a focus on collecting patients within 30 minutes of reporting ready to travel. A new contract for Patient Transport will have higher standards built-in, above and beyond those required by regulatory bodies such as Monitor. 5.4 Gail Thompson was thanked for her work in helping develop these new standards which would be of benefit to patients and for providing an informative report for governors despite being too unwell to attend. 6 UPDATE COMMUNITY COMMITTEE Governors noted: Changes to Community Services including the integration of children s community services with Evelina London s children s hospital services The Adult Local Services Development Committee (ALSDC) had replaced the Community Services committee and the Operational Services Development Board for Adult Local Services would report to the new Committee. Dawn Hill s concerns that governors needed to be given regular information about the issues of concern and changes in both the adult and children s community services and that this could be more difficult with two committees and the children s one being strategic and not including an operational remit. 6.1 Governors commented on: The value of further information on the changes and their impact on staff and services and the value of having a second governor attending the Adult Local Services Development Committee. Action: Director of Community Services to be invited to a future meeting to update the Group on the changes. Action: Any Governor interested in attending the ALSDC to speak to Sue Gallagher or John Porter [Subsequent to the meeting it has been agreed that Jenny Stiles will be the second governor attending this committee] 7 UPDATE FROM PATIENT TRANSPORT SERVICES USER GROUP 7.1 Governors noted; The written update on Patient Transport services provided prior to the meeting. The extensive work to improve the experience of those using transport services and the environment of the transport lounge. 8 QUALITY ACCOUNTS WORKSHOP 8.1 The Director of Quality Improvement and Assurance updated the group on progress in taking forward the Trust s Quality Accounts for the current year and year ahead..a brief update on development of priorities was given. 8.2 Governors noted: The current year s Accounts had focused on priorities arising from the Francis and Renwick reports with an emphasis on behaviours and how patients felt about services. The priorities for the year ahead would come under three main headings Safety, Clincal Effectiveness and Patient Experience. Nine priorities under the three headings detailed above were in development. It was noted that this should not detract from existing priorities such as reducing the number of pressure ulcers. The development of IT systems such as e-noting and e-prescribing would play an important role in achieving priorities. QEWG notes
5 Governors discussed: The recent Quality Accounts workshop which was considered a success and the general approach which was supported. Where children s services fitted in with the Quality Accounts process and the challenge in identifying performance in children s services as distinct from wider performance data and quality reporting. 8.3 The Director of Quality Improvement and Assurance responded that the Quality Accounts and priorities were Trust-wide and data collected on achieving goals established in the Accounts would include data on Children s Services. Action: Officers would discuss with colleagues the request of governors that references to services for children and specific services for the elderly be clarified in the Quality, Quality Accounts and Performance reports as ward and clinic names that may relate to them are not familiar to governors. 9 GOVERNOR ENGAGEMENT: PATIENT SAFETY 9.1 The Chair discussed the changing remit and scope of the working group, a change of name and a proposed seminar on patient safety. 9.2 Governors noted: The Group would be called the Quality and Engagement Working Group To make best use of members time and maximise time for more in depth discussion about two issues, ideally at least 30 minutes, the Group would operate under the following principles - it would be assumed that all members had read papers in advance of the meeting, and people presenting would be asked to be succinct in introducing the paper to allow maximum time for governor questions - the minute secretary would be asked to try to ensure the minutes were circulated within 2 weeks of the meeting - any corrections to the minutes to be raised immediately on receipt by to the chair and minute secretary, rather than at the next meeting - updates from governors sitting on various groups to be sent in bullet points to Sarah and Andrea for appending to the agenda for the next meeting. - Sarah and Andrea will seek to include in their regular report information about user involvement in services not represented around the table eg the maternity users group, SLIC, Children s services and cancer. 9.3 Governors concurred with this approach. 9.4 Governors discussed a proposed patient safety seminar and what this might cover. Topics suggested by Governors included: How the Trust stood in relation to media coverage of the NHS. What the best benchmarks for measuring safety were. What equipment and technology would do most to improve patients safety. How discharge and handover such as between hospital and community or between GP and hospital service impacted upon patient safety. How users and carers could be helped to have eyes and ears for the critical safety issues concerning their or their dependent s care and a voice that was respected unlike in Mid Staffs 9.5 Governors also noted the upcoming May 14 th Safety Connections conference focusing on patient safety being held at New Hunt s House, Guy s campus. Action: Members to submit ideas for Patient Safety Seminar to the secretariat. Action: Members to submit interest in attending the May 15 th Safety Connections event to the secretariat. QEWG notes
6 10 PATIENT EXPERIENCE AND ENGAGEMENT UPDATE REPORT 10.1 The Patient Experience Manager and Trust Patient and Public Engagement Manager summarised the key points from the report, which included:- National Inpatient Survey 2013 results. Areas of strength included involvement in care; provision of correct and clear information to patients on treatment and medicines and being treated with dignity and respect. Areas for improvement included information on arrival at a ward; opportunities to talk to a doctor or other staff member when needed and aspects of discharge. The Emergency Care pathway programme is currently focussing on user involvement by mental health service-users; arrival and orientation on the emergency floor and staff to patient communication. The Public and Patient Engagement Strategy currently is in development following an event in December and the efforts of working groups. A draft strategy would be available for comment prior to the June meeting John Burns and Devon Allison shared two concerning patient stories and discussion took place on the best way to capture these in the future, so that lessons could be learnt and actions taken to prevent any recurrence of similar circumstances. 11 ANY OTHER BUSINESS 11.1 Governors reflected on the recent PLACE visits to Guys and commented that: The visits were well-organised and gave an interesting overview of services. Those assessors who had the chance to take part in food tasting were complimentary Work Plan for the next year. Governors discussed the priority areas of work for the group to explore; Community Services- strength and integration Complaints-response, insights and feedback loop Outpatient care- variation in experience and efficiency Discharge arrangements- monitoring x variability across different services The Fit for the Future programme- User and carer input and impact Systematic ways for hearing patient narratives about their experience in the health and social care services and acting on areas for improvement/sharing good practice. Patient safety Patient engagement strategy -roll out Governors noted that all work should take account of children s care and Quality Account priorities. Action: The chair and officers would reflect the above priorities in the next year s scope of work document by the secretariat for the COG in April DATE OF NEXT MEETING The next meeting to be held: June 17th pm, Burfoot Court Room, Guy s Hospital Sue Gallagher April 2014 Governor QEWG notes
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