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  • PGB-15-47 Joint Quality Committee Minutes

    10.02.15

    PGB-15-47 Governing Body Meeting in Public 21 April 2015

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  • Quality Committee Meeting Minutes Tuesday 10 February 2015 13:00 hrs to 15:50 hrs

    The Board Room, Francis Crick House

    Present: Christina Edwards (CE) : Non-Executive Director NHS Nene CCG (Chair) Peter Boylan (PB) : Director of Nursing & Quality, NHS Nene & NHS Corby CCGs Sebastian Hendricks (SH) : Secondary Care Consultant, NHS Corby CCG

    In attendance: Richard Bailey (RB) : Deputy Head of Joint Commissioning, NHS Nene & NHS Corby

    CCGs (item 13) Jane Bell (JB) : Head of Nursing, NHS Nene & NHS Corby CCGs Alison Berlie (AB) : Complaints Manager, Arden & GEM CSU (item 10) Karen Cornick (KC) : Public Health Consultant, Northamptonshire County Council

    (items 1-3) Sue Freeman (SF) : Joint Commissioning Lead, Learning Disabilities, NHS Nene CCG

    (item 5) Alison Jamson (AJ) : Deputy Director of Quality, NHS Nene & NHS Corby CCGs David Knight (DK) : Senior Quality Improvement Manager, NHS Nene & NHS Corby

    CCGs (items 14-15) Kelly Morris (KMo) : Service Relationship and Health Protection Manager,

    Northamptonshire County Council (items 1-3) Matthew Spilsbury (MS) : Head of Performance, NHS Nene CCG (items 7-8) Helen Sutton (HS) : Minute Taker NHS Nene CCG

    1. Welcome and apologies for absence The Chair welcomed attendees and confirmed that due notice of the meeting had been given in line with the Terms of Reference and that the meeting was quorate. Apologies for absence were received from Matthew Davies (MD), Kathryn Moody (KM) and Joanne Watt (JW).

    2. Declarations of Interest There were no declarations of interest made by those present.

    3. Breast feeding initiation rates in Northamptonshire Karen Cornick (KC) and Kelly Morris (KMo) from Public Health, Northampton County Council (NCC), attended to discuss work being undertaken in relation to increasing breast feeding initiation rates in Northamptonshire. It was noted that KC and KMo, who were new in post, were keen to address challenges and issues in the county whilst working in partnership with health. KC had commenced working with Richard Bailey, Deputy Head of Joint Commissioning for NHS Nene and NHS Corby Clinical Commissioning Groups (CCGs). She had also established links with NHS England (NHSE) and Northamptonshire Healthcare NHS Foundation Trust (NHFT) regarding health visiting and family nurse partnerships with a view to reviewing and

    PGB-15-47 Governing Body Meeting in Public 21 April 2015

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  • optimising discussions around breastfeeding during anti/post-natal checks. With 74% of Health Visitors trained on breastfeeding and relationship building, work was ongoing to train 100% of staff and provide a rolling training programme to ensure skills were kept up to date. They were also working with School Nursing Teams via PHSE lessons and supporting the ‘Baby Friendly’ accreditation initiative. KC was working with children’s centres around implementation of the Baby Friendly accreditation process and this included a proposal to have breast feeding champions in each centre. A review of GPs undertaking on-line training was ongoing as well as discussions with the National Childbirth Trust in order to use their expertise to promote breast feeding within local communities. NCC social media platforms were being used to give consistent messages about the benefits of breast feeding and public health would be supporting national breast feeding week. Committee members noted the work being undertaken and suggested prioritising the three highest impact scheme in order to focus on areas that could achieve highly successful outcomes and promote breast feeding initiation. In this regard KC advised she attended the Breast Feeding Strategy and Maternity Northants Group meetings with a view to ensuring work was co-ordinated and progress made against action plans already in place. Progressing the Baby Friendly accreditation process in children’s centres was also a priority. With national targets not being met, it was important to understand people’s intention to breast feed before they entered hospital, and in particular there was a focus on young people who may not have personal experience of a relative breast feeding. By reviewing data available they could proactively steer their focus towards pertinent groups using knowledge regarding the demographic groups of women. Data indicated that although 77% of women initiated breast feeding in hospital, a reduction of approximately 6% had occurred by the time of discharge. JB was concerned that working with midwives had not been mentioned and stated that with the current infrastructure unable to support breast feeding numbers being as good as they could, the role of midwives (anti/post-natal) was critical with initiation as a woman breast feeding at 14 days post birth was more likely to continue. The Maternity Services Liaison Committee (MSLC – see item 13) could monitor and support initiatives to drive breast feeding initiation rates and it was noted that local authority representation was yet to be confirmed, although KMo advised an invitation to attend had been received. It was acknowledged that care pathways in maternity services had changed significantly over the last 20 years placing a greater focus on hospital midwives. However, women often left hospital within a short period of giving birth which shifted the focus for breast feeding initiation to anti/post natal care. Following discussion it was concluded that although work had commenced there was still a long journey ahead. Quality Committee members commented that public health were a critical part of driving the improvement of initiation rates, while continuing to work in partnership with health. It was suggested that a progress update against the implementation plan be submitted to the June meeting. Action: KC/KMo to provide a public health update on the breast feeding initiation rate implementation plan to the Quality Committee in June 2015.

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  • KC and KM left the meeting. 4. Patient Story

    AJ presented a patient story outlining the experience of an individual in a care home who had been moved to a new placement, with the assistance of a member of the quality team, following the closure of their home. The positive outcome of the move for the individual and their family was noted, as was the positive story about the work our teams were doing to make a difference and help people lead the best possible life from beginning to end. Action: AJ to arrange for the patient story to be shared with colleagues via the Care Homes Forum and CCG staff newsletter.

    5. Minutes of the previous meetings held on 9 December 2014 QC-15-01 The minutes of the meeting held on 9 December 2014 were approved as an accurate record.

    5.1 Matters arising There were no matters arising that were not already on the agenda.

    5.2 Action Log QC-15-02 The Action Log was received and reviewed. The following was noted: • Performance Data 0-9 year olds attending A&E (12/8/2014) A date for an audit of attendances and admissions of 0-9 year olds to both acute trusts was still to be agreed. This audit had been requested in order to gain a better understanding around the reasons why high numbers of children were attending, and being admitted to, hospital by accident and emergency (A&E). Northamptonshire was a national outlier for deliberate self-harm and a separate audit would also be required to understand the reasons for that. A three stage audit process had been agreed and was ongoing. Stage one had been completed. This had looked at the last twelve months of data for A&E attendance and emergency admissions for 0-17 year olds. Patterns had been established and trend analysis carried out with key messages and peak and troughs being found. Stage two had been a more focussed review with data analysis during a specific month of activity being undertaken; including age ranges, times of day, day of week, etc. The final stage would be to identify ten children from each trust and complete a case file audit on their admission, the reasons for it and whether it was the most appropriate option in the circumstances. The findings would be presented to the Board of Directors when finalised. • Internal Audit Clinical Governance Report: Serious Incident Policy (8.4.2014 item 11) National guidance was still awaited from NHS England. Concern was expressed regarding the delay. • Adult Safeguarding Awareness Training (9.12.2014 item 18) PB reported that a Workforce Committee had been set up. An inaugural meeting had been held and a review of mandatory training fell within the scope of the Committee. Accordingly, this action could be closed. The remaining actions and updates were noted.

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  • Sue Freeman (SF) joined the meeting.

    6. Transforming Care Programme update QC-15-03 SF presented a Transforming Care Programme for Learning Disability (LD) clients update. Committee members noted progress to date since the last presentation at the December 2014 meeting. The key points were: • The original five people remained in independent hospitals. The CCGs and

    Northamptonshire Healthcare NHS Foundation Trust (NHFT) clinical