Minutes of NHS Grampian Audit Committee - Download as DOC by 1Eg9MBX


                                   NHS GRAMPIAN

                           Minutes of the Senior Nurse Group
                            held on Monday 08 February 2010
                       in the Seminar Room, Summerfield House

PRESENT                                        IN ATTENDANCE

Elinor Smith (Chair)                           Julia Lussier and Lynn Stout (Item 3)
Mary McAuley                                   Amanda Croft (Item 6.1)
Liz Taylor                                     Eleanor Morrison (Item 6.2)
Linda Harper                                   Fiona Gray (Item 8)
Jenny McNicol                                  Sheila Irvine (Item 8)
Yvonne Wright                                  Kathy Booth (Minuting Secretary)
Gregory Poon
Fiona Mackenzie
Sean Coady
Jane Ormerod

Item                                Subject                                       Action

       Elinor Smith opened the meeting and noted the apologies received
       from Elaine Allan, Clark Paterson, Jenny Gibb, Eleanor Murray and
       Frances Dunne.

 2.    MINUTES OF MEETING HELD ON 21 December 2009

       The Group agreed this was an accurate record of the discussions


       Julia Lussier, Transfusion Practitioner gave an interesting and very
       informative PowerPoint presentation (report and slides were
       circulated with meeting papers). Julia discussed the objectives for
       2009-10 and referred to the QIS clinical standards for Blood
       Transfusion.       She spoke on the theoretical training of safe
       transfusion practice and the practical competency assessments as
       endorsed by MHRA.           Julia and Lynn commented on the
       implementation within Grampian and of national and local audits on
       clinical effectiveness. Finally Julia reported on BBT successes and
       the challenges encountered. The most recurring challenges were
       clinical wastage and non-compliance with transfusion procedure.

                                         Page 1 of 8
Item                                Subject                                    Action
       Sectors to provide names to Julia and Lynn to ensure they manage         ALL
       to contact appropriate staff.

       Elaine Stirton to send copy of this minute once approved to Julia      E. Stirton
       and Lynn.


       4.1    Practice Education Facilitator for Care Homes - Update

              Jane Ormerod confirmed that Sharon Southern had been
              successfully appointed to the post of Practice Education
              Facilitator (PEF) for Care Homes with a start date of 1st
              March 2010. Jane, Belinda Evans and Alison McLennan to
              jointly support Sharon in her new role.       A workplan for
              Sharon will be set for the first three months and she will be
              based within PPD Unit.

       4.2    Training, Education and Care Commission – Update

              Jane Ormerod advised that she and Elinor Smith had a
              meeting with the Care Home representatives last week with
              the discussion mainly around newly qualified nurses working
              in Care Homes. Some discussion was on how to support
              them around Flying Start which was not available to Care
              Home Sectors or other independents.       Elinor and Jane to         ES/JO
              follow up and provide further update at next meeting of this


       5.1    SEND & CNO meetings:

              Elinor Smith gave a brief update from the SEND meeting
              held on 29 January 2010 and highlighted key issues as

              HEI Inspections – Susan Brimelow: Meetings had taken
              place with Chief Executives. New issues include unzipping
              of mattress covers to check condition of mattresses;
              patients’ clothes and Tissue Viability.

              Tissue Viability: This topic to be discussed at next meeting       ES
              of Senior Nursing Group in March.

                                        Page 2 of 8
Item                              Subject                                  Action
             Modernising Nursing in the Community: The newly formed
             Board had met. There is now more GP involvement. Some
             concerns about numbers in training. A framework is to be
             provided for Summer 2010.

             Elinor Smith gave a brief update from the CNO meeting
             held on 29 January 2010 and highlighted key issues as

             New Chief Nursing Officer: Ros Moore chaired her first
             meeting on 29 January 2010. She will be spending a day in
             Grampian on 30 March 2010 – Elinor to organise and send
             out details of arrangements later.       CNO priorities are
             Workforce plans, review of Community Nursing, HAI – SAB        ES
             targets and Student/Education provision.

             HAI:    IIIP (Infection, Improvement and Implementation
             Programme);       Advice and Guidance on Standards;
             Implementation and Improvement support – more
             information on Cohort care expected. Priorities for HAI are
             SABS, C.Diff, and Hand Hygiene.

             Update on ePCR and DNA CPR: May/June 2010 roll out.

             Update on Midwifery: 20:20

             Elinor Smith gave a brief update from the NHSG Board           ES
             meeting held on 2nd February 2010 and highlighted key
             issues as follows:

             Annual Reviews: Went well.

             Communication Strategy: Ratified

             Performance Report: DNAs at RACH

             HAI Report:   Report was very positive around C.Diff,
             MRSA, Hand Hygiene and HEI Action Plan.

             Infection Prevention & Control Policy: Approved

       5.2   Stoma Appliance

             Elinor referred to the letter sent by Frank Strang of The
             Scottish Government to Directors of Nursing and Pharmacy
             concerning stoma care appliances and the requirement for

                                      Page 3 of 8
Item                                 Subject                                    Action
              Boards to set up a stoma care forum to include Board
              managers, clinical nurse specialists and patient
              representatives. NHS Grampian’s lead for stoma care was
              Roberta Eunson who retired very recently.       The new lead
              for stoma care is Hilary Young, Health Visitor, Bridge of Don
              Health Centre who will take this forward.


       6.1   SANE

             Amanda Croft reported the completion of 3 months work at
             the end of January in which every nursing team completed a
             rota planner database (an electronic tool/template developed
             by Clark Paterson, Senior Finance Manager - and is the same
             for every team) on establishments and shift patterns within
             individual nursing teams. Finance directorate are reviewing
             information supplied and Clark has advised a few of the
             nursing teams are ready for their Peer Review. The review
             panel to consist of two project team members, an expert in
             the field and a Finance representative. The purpose of the
             peer review is to challenge the consistency of numbers of
             staffing to ensure a safe establishment of qualified/unqualified
             staff and the different shift patterns. Amanda advised that six
             nursing teams were to be piloted before the end of February
             and all hospital teams to be completed by end of March 2010.
             Thereafter, Mental Health, Paediatrics, Primary Care and
             Community – because of different models. This project links
             into the Affordable Workforce.

             Amanda Croft to be invited back to this group at its April 2010     ES
             meeting to give a progress update.

       6.2   Healthcare Support Workers:

             Eleanor Morrison spoke of the Education Perspective -
             looking at different options within the educational framework
             such as accredited learning, in-house resources, resources
             within teams, in-house option delivery, training delivery
             accreditation, external courses ie HNC, Band 4 HND type
             level re NES framework (2 year course).

                                         Page 4 of 8
Item                                 Subject                                   Action

             Eleanor hoped that by beginning of March, the options would
             be more clear.

             On the Services Perspective – Eleanor advised that she’d
             had useful meetings with groups looking at the differences
             between the Band 2, Band 3 and Band 4 roles.              The
             exercise was proving to be most difficult differentiating
             between Band 3 and Band 4 roles. She advised that Nicola
             Sturgeon, Health Minister was looking for detailed projections
             and that NHS Grampian were struggling to find numbers
             because of redesign, reviews, SANE and vacancies.
             Eleanor tabled a definitions paper on the roles of the Bands
             and sought workforce projections and criteria. The group
             agreed that the priority was to develop arrangements for
             Band 2 and Band 3 HCSWs in the first instance.

             Further discussion took place around delegated caseloads.          ES
             Eleanor to review outcome of today’s discussion and report
             back to this group with her recommendation on how to take
             this forward.

       6.3   Bank and Agency Spend

             Clark Paterson was unable to attend the meeting today due to
             a Budgetary Event being hosted by Finance Directorate but
             he forwarded the following update:

             “Agency costs for the first nine months of 2009/10 are 50%
             (£488k) less than over the same period last year. The main
             reductions are in Theatres (£276k) and Care of Elderly
             (£102k) although Surgical Unit 2 costs are significantly higher

             Apart from ARI and Woodend Theatres, usage has been
             predominantly with BPI compliant agencies.

             Nursing WTE in December is above funded establishment by
             around 234 posts, with a year to date overspend of £6.2m.”

             A copy of the NHSG Nursing Budget Spend Comparison
             2009/10 v 2008/09 was tabled at the meeting for information
             (attached).                                                        KB

                                         Page 5 of 8
Item                                Subject                                 Action
       6.4   Nurse Bank Arrangements – Update:

             Yvonne Wright reported that she was working with Jenny
             McNicol on integrating the AMH nurse bank. She also met
             with Mary McAuley and Linda Press regarding integration of
             Aberdeen CHP nurse bank. Currently recruiting to Theatres
             and ITU. Yvonne advised the NHS Grampian nurse bank
             was undergoing a redesign of service which is presently out
             for consultation with possible redeployment of staff. Moray
             nurse bank to be integrated soon into NHS Grampian Bank


       Gregory Poon spoke on his draft NHS Grampian Review of
       Community Nursing strategy paper which he reported was more of a
       position paper than a strategy. He commented on the rationale of
       the paper and its purpose. Gregory then gave a brief introduction
       into the current Community nursing services and reported that NHS
       Grampian was unsure of any advantage to patient care replacing
       population-specific care with generic working.     He went on to
       discuss the redesign and developments across the CHPS, giving a
       summary of redesign and development update within Aberdeen City
       CHP. Gregory gave examples of workplan and priorities for 2010
       including achieving HEAT Target H7 and CEL36.

       Gregory asked that Liz Taylor (Aberdeenshire CHP) and Sean           LT/SC
       Coady (Moray CHP) provide him with a similar position paper for
       their areas with a summary by the end of February. Gregory would      GP
       then add a conclusion to the paper and make ready for submission
       to the Nursing & Midwifery Strategy Forum meeting on 12th March.      ES


       Elinor invited Fiona Mackenzie and Jane Ormerod to report on
       Senior Charge Nurse Review and advised that this item would be a      ES
       permanent agenda item for this group.

       Fiona Mackenzie reported that she was working with Fiona Gray,
       Programme Lead which incorporated Releasing Time to Care
       following the same principle teaching and lectures. The 5th Cohort
       had started – two Charge Nurses from Acute Sector and a good
       range of participants from both Aberdeenshire and Moray.     Fiona
       Mackenzie advised that Eleanor Murray was to promote HAI
       responsibility into the Senior Charge Nurse role as a type of
       environmental audit work identifying gaps. Two poor areas widely

                                        Page 6 of 8
Item                                 Subject                                    Action
       identified were general facilities and kitchen facilities. These link
       into the HAI Scribe which comes under Gary Mortimer’s backlog
       maintenance reports.

       Fiona Gray advised most Charge Nurses had a good portfolio of
       evidence to be signed off by General Managers for their job
       descriptions. Some discussion was held regarding PPDU perhaps
       organising Portfolio Masterclasses for Facilitators. Timescale was
       around end of financial year 2010-2011. Multi-Sister Units were
       discussed around Ward 40, ARI; Theatres; A&E; Labour Suite; ITU;
       Neonatal and Out Patients.      Fiona Gray advised that another 5
       Cohorts to be arranged between end of February 2010 and end of
       March 2011.

       Sheila Irvine tabled a copy of her slide presentation on Releasing
       Time to Care – Cohort 2 around Facilitator and Training Information
       which started on 11 February 2010. Sheila went briefly through the
       presentation (copy attached).                                              KB


       Elinor Smith commented on how disappointed she was that only two
       area updates had been received for this meeting.

       Elinor gave clarity to the group advising that every month they            ALL
       should submit their area highlights on the agreed proforma template,    E. Stirton
       which is a requirement of their reporting accountability, and forward
       to the meeting secretary for distribution with the meeting papers one
       week in advance of meeting date. A brief update was given from
       the areas at the table.

10.    AOCB

          a) New Chair of Care of the Dying Group is Linda Oldroyd
          b) New Chair of Uniform Group is Mary McAuley.

       For next meeting
           Elinor Smith to invite Jenny Ross, Medicines & Safety                 ES
           Elinor Smith to draft programme for CNO visit on 30 March,            ES
             identify persons for 10 minute presentations and suggest
             allocation of places.
           Elinor Smith to invite Alison Hawkins, eHealth to March               ES
             meeting regarding social networking sites and patient

                                         Page 7 of 8
Item                             Subject          Action

       Date: 8th March 2010
       Time: 12.00 – 16.00
       Venue: Seminar Room, Summerfield House

                                    Page 8 of 8

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