Name

Minute number and issue

Reason

Interest

Councillor Dr Mahony

10. Quality Accounts

Locum General Practitioner

Personal

Councillor James

10b. PHNT Quality Accounts

Family member experienced a never event.

Personal and Prejudicial

Councillor Mrs Aspinall

10a. Express Diagnostics

Service User

Personal

Sue Kelley

General

CQC Representative

Personal

Councillor Mrs Bowyer

9. Adult Social Care – Local Account

Son is a member of the Learning Disability Partnership Board

Personal

(1)   to reappoint Sue Kelley of Plymouth Local Involvement Network as a co-opted representative to the panel for the municipal year 2012 – 13;

(2)   that further co-opted representatives would be appointed on an ad-hoc basis.

(a)   the coalition government has moved away from inspection regimes and scored judgments, including the abolition of the Annual Performance Assessment for Adult Social Care;

(b)   in the place of inspection regimes, a Local Account would be self-assessed and published by the council and there would be no central Government role in the assurance of the document;

(c)    local authorities have been encouraged to develop a Local Account for 2011, Recent Association of Directors of Adult Social Services (ADASS) guidance has suggested that all councils with social care responsibilities consider producing a short, accessible local account during 2011/12;

(d)   the Government had signaled that it did not intend to specify the content of a Local Account and that the account should be locally designed;

(e)   the process of producing a Local Account should be linked to the wider corporate business planning cycle. It is proposed that the Local Account would be published during July/August of each year, which allows sufficient time for information to be gathered and validated;

(f)     there was no prescribed method of approval or formal reporting for a Local Account, but initial guidance from ADASS suggests that Local HealthWatch would have a role in signing off the report.

(g)   the account was aimed at service users, carers, professionals and the general public;

(h)   there was an action plan with regard to surveying the views of those with physical, mental and learning disabilities. The department continually looked at new ways to engage. There was a learning disability partnership board in place and more users were being invited to sit on that board and challenge commissioners on their decisions;

(i)     about 900 adults with disabilities were in the care or the local authority, many in residential care. Around 80 people were supported in paid employment and the department planned to increase this in the future. The department was also working with assistive technologies and solutions for transport to increase access to employment opportunities;

(j)     the Plymouth Online Directory was an easy service to update and was cost effective;

(k)    the department spent less then average on individual care. However this reflected a combination of a number of different factors including unit costs for services. The figure did not include services provide by the department through other areas such as the Life Centre and libraries. The reported figure relied on a narrow focus on care packages;

(l)     all feedback received through the system was reflected in the number of complaints and compliments;

(m)the target to achieve for the percentage users on personal budgets was 60 per cent for 2011-12. This target was not reached. The department plans to have the remainder of service users, if appropriate, on the personal budgets by April 2013.

(a)   the company hoped to expand into out-patient cardiac services in the future. The company would also be looking to expand services into the community and outside of the Plymouth boundary;

(b)   the company believed that analytic services could be more efficiently provided by the private sector, allowing primary care services to receive analysis in a timely manner and make more appropriate referrals;

(c)    most patients referred to the service would wait ten working days for an appointment;

(d)   there was a 50% return on patient satisfaction questionnaires. The company would further develop the questionnaires to ensure that information could be gained from those with disabilities and those who do not have English as a first language;

(e)   the company hoped that investment made into an ‘image exchange portal’ would increase the efficiency of the exchange of analytical information between organisations.

(1)   to recommend that Express Diagnostics add reference to Plymouth, the city’s visions and priorities within the document;

(2)   to delegate the preparation of a statement for inclusion in the quality account to the lead officer in consultation with the Chair.

(a)   ‘never events’ were events caused by healthcare that should never happen. There are safeguards to ensure they never happen but when they did, it was important that they are acted upon. A number of previous events experienced in the trust were due to negligence around the World Health Organisation surgery checklist. Work has taken place to address this and the trust had been shortlisted for a prize for the safety of patients. Significant improvements have been made and trust is now a beacon of best practice;

(b)   the trust had experienced problems with ophthalmic services.  Additional resource had been provided to address this and reduce risk to patents. There had been a host of issues around administration and communication, but being a large organisation was not an excuse for not getting these things right.  A review of the entire clinical administration service, including public facing clinicians had been commissioned. The priority continued to be a high quality service for patients and clinicians but efficiencies could be gained through the review;

(c)    there could be a number of factors which could cause delays such as onward care, administration difficulties, a wait for drugs to be prepared and infections. The other major issue is moving patients on to other units or packages of care from community or social providers;

(d)   the document underplayed the partnership working that the trust was engaged in. The Community Transformation Board was successful in bringing together acute, social care and community health services. There had been major strides forward in the city;

(e)   the city vision and priorities were not reflected in the document, but the trust was aware of the challenges shared with partners and the trust was dedicated to engaging in  a community wide focus on prevention;

(f)     there were normal variations in the performance against National Targets and Regulatory Requirements.  There were many complex variables but the trust was committed to consistently and constantly improving in these areas;

(g)   the new Chair of the Board would be in place in the near future and there was an ongoing recruitment programme for the vacant non-executive seats at the Board.  A recruitment process was also underway for a Chief Executive. The Finance Director had been seconded to work on the Foundation Trust Application; there was an interim Operating Officer in place and an interim Chief Nurse.   Whilst the senior management team could appear to be weak, all posts had been covered by very able and fully competent staff from within the trust.

(a)   although the Quality Account did not go into detail  about the Child and Adolescent Mental Health service, the service was referenced within the document;

(b)   in the production of the Quality Account PCH had taken on board previous comments made by the panel, a particular attempt was made to create a document which aimed to be clear and easily understood by members of the public;

(c)    PCH was working closely with Plymouth City Council in the area of reablement;

(d)   locality working did not bring an inherent risk of silo working. PCH continued to have an strategic overview of the needs of the city, which would allow reallocation of resources where required;

(e)   there would be 48 new health visitors in the community following a national recruitment drive and additional resources being allocated for this purpose.

(a)   strategic goals had been in place for a number of years;

(b)   priorities for the coming year included engagement with frequent callers in order to reduce re-contact rates;

(c)    Derriford Hospital had been designated as a Major Trauma Centre, due to this designation SWAST practioners required enhanced skills as travel and time spent with patients had been increased;

(d)   initial problems were experienced by emergency helicopters when the airport closed.  Problems had been overcome and a site for the landing of Sea King helicopters had been established.

(1)   the Hospital discharge process;

(2)   an update on Child and Adolescent Mental Health Services.