EAST DUNBARTONSHIRE COMMUNITY HEALTH …library.chps.org.uk/mediaAssets/CHP East Dunbartonshire/ED CHP... · Prescribing Team.ppt: 1: No Topic : Paper No & Time ... Project Manager

EAST DUNBARTONSHIRE COMMUNITY HEALTH PARTNERSHIP

COMMITTEE MEETING

To be held on Friday 30th September 2011 at 9.30am Corporate Meeting Room, ground floor, CHP Headquarters,

Stobhill Hospital, Balgrayhill Road, Glasgow G21 3UR

No Topic Paper No & Time

Associated paper

76 Welcome and Introductions CHP Chair

77 Apologies

09.35am

78 Minutes of CHP Committee Meeting held on 29th July 2011 CHP Chair

09.40am

11/53 Item 78.doc

79 Matters Arising

(i) Update on Progress of Reshaping

Older People’s Services Change Fund Lead Nurse

(ii) Prison Dental Service CHP Director

09.45am

11/54

11/55

Item 79 .pdf

Item 79ii) Updated OHD Prisons Paper 19

STANDING ITEMS

80 GG&C NHS Board Meeting CHP Director

10.00am

11/56

Item 80 Board Brief.pdf

ITEMS FOR DISCUSSION

81 Primary Care Framework Joint Occupational Therapist Lead Advisor

10.05am

11/57 Item 81 Annual report .doc

82 CVS Interface

Head of Planning & Health Improvement

10.25am

83 The Role of the Prescribing team & Prescribing Performance Management Prescribing Support Pharmacist

10.40am Item 83 Role of the

Prescribing Team.ppt

1

No Topic

Paper No & Time

Associated paper

84 Oral Health Directorate Strategic Group Minutes – August 2011 Standing item CHP Director

10.55am

11/58 Item 84 strategic group minutes 31 Aug

85 Oral Health Directorate

Waiting times target/Capital Plans and Childsmile Standing item OHD Interim General Manager

11.00am

11/59A 11/59B 11/59C

Item 85 Waiting listpaper OHD

Item 85 Oral Capital update - 18th Aug.do

Item 85ii) CS OHOG Report - 010911.doc

86 Oral Health Directorate

Flood at Glasgow Dental Hospital Update on liability position, progress with work and costs to date OHD Interim General Manager

11.10am

11/60 Item 86 Front Cover.doc

Item 86 GDH Flood 120911 dockm sept 1

PERFORMANCE MANAGEMENT

87 Finance Report -Month 5 Standing Item Head of Finance

11.15am

11/61 ITEM 87 Front Cover.doc

ITEM 87 Committee Report to August 201

88 Performance Improvement Report


11.30am

11/62 ITEM 88 Front CovePIR.doc

r ITEM 88 PIR September 11.doc

ITEMS FOR NOTING

89 HR Update / Staff Governance monitoring update Standing item Head of HR

11.45am

11/63 Item 89 HR Report for ED Committee - Se

90

CHP Committee Governance Arrangements CHP Director

12noon 11/64

Item 90 QPC 20-9 CHP Committee Gove

91 Public Partnership Forum Update

Standing item Public Partner Representative(s)

12.10pm

92

NHS GG&C Brief & Local Team Briefs - CHP & OHD for August & September 2011 CHP Director

12.15pm

11/65A 11/65B 11/65C 11/65D 11/65E 11/65F

ITEM 92A GG&C Brief.pdf

ITEM 92B TB August 2011.pdf

ITEM 92C OHD teambrief Aug.doc

ITEM 92D TB Sept.doc

ITEM 92E GG&C BrieSept 2011.pdf

f ITEM 92F OHD tb Sept.doc

2

No

Topic

Paper No

& Time

Associated Paper

93 Minutes of Meetings – Standing item a) Staff Partnership Forum - 13th July

2011 b) Public Partnership Forum - 14th July

2011 c) Partnerships Infection Control Steering Group – 14th July 2011 d) PEG Meeting – 15th June 2011

12.25pm

11/66A

11/66B

11/66C

11/66D

ITEM 93A SPF 13th July 2011.doc

ITEM 93B PPF Minutes 140711.doc

ITEM 93C PICSG Mins - 14 07 11.doc

ITEM 93D PEG Minutes 15th June.do

94 Any Other Competent Business

12.35pm

95 Date of next meetings: Committee Seminar 28th October 2011 Committee Meeting 25th November 2011

3

PAPER No 11/53

Minutes of East Dunbartonshire Community Health Partnership Committee Meeting held at 9.30am on Friday 29th July 2011, in the

Corporate Meeting Room, CHP Headquarters, Stobhill Hospital, 300 Balgrayhill Road, G21 3UR

MEMBERS PRESENT NAME DESIGNATION Ian Gordon Clinical Director, Vice Chair Annemargaret Black Lead Nurse Karen Murray Director Heather Gartshore Public Partnership Forum Martin Brickley Public Partnership Forum Ross McCulloch Staff Partnership Forum Gordon Thomson Public Partnership Forum IN ATTENDANCE Serena Barnatt Head of HR Sandra Cairney Head of Planning and Health Improvement James Hobson Head of Finance Michelle McLauchlan Interim General Manager (OHD) Ray McAndrew Associate Medical Director, (OHD) Mark Richards Head of Mental Health and Partnerships Liz Denny Project Manager Older People Services Dianne Rice Minutes

No Topic Action by 61 WELCOME & INTRODUCTIONS

Ian Gordon opened the meeting and thanked everyone for their attendance at the Committee meeting. Introductions were not necessary.

62 APOLOGIES Apologies were intimated on behalf of Ms. Rani Dhir, Cllr. Amanda Stewart, Adrian Murtagh, Ian Fraser and Dr. Graham Morrison. NOTED

63 MINUTES OF CHP COMMITTEE HELD ON 25 MARCH 2011 Paper 11/43 The minutes of the meeting held on Friday 27th May 2011 were approved as an accurate record.

1

PAPER No 11/53

2

No Topic Action by 64

(i)

MATTERS ARISING Update on progress with Reshaping Older People’s Services – Change Fund Liz Denny, Project Manager spoke to the tabled report on local progress with planning and implementation of proposals to transform Older Peoples’ services in East Dunbartonshire. The report highlights:

The establishment of the governance structure for the programme The funding available to support the change programme The process undertaken to develop and approve proposals for

change requiring funding The proposals which have been identified to be considered for

approval by the Programme Executive Group on 27th July 2011. The Executive Group has agreed in principle the proposals submitted, most of which require further development and reflection as they are progressed to implementation. Particular scrutiny is required in respect of the costs for each of the proposals, sustainability of each proposal and delivery of the outcomes described in each proposal. Annemargaret Black, Head of Primary Care & Community Services, identified that further work is required to develop a local Integrated Resource Framework, a Joint Commissioning Strategy, and an Older Peoples’ Strategy. The Committee acknowledged the significant amount and intensity of work involved to date. In response to a question from Gordon Thomson, Annemargaret Black described processes in place for evaluation of the work and a reflective session for the Programme Board members to consider whether the decision making process for funding allocations could have been improved. The Committee were asked to note the progress made and to receive further updates on progress. NOTED

(ii) Low Moss Update Annemargaret Black, Head of Primary Care & Community Services, spoke to the tabled report on progress with the development of the staffing model for Low Moss Prison Healthcare Services. Annemargaret highlighted specifically the inclusion of enhanced addiction casework to be delivered by the Core Healthcare Team. The Committee was advised that agreement has been reached with SPS to recruit to key posts during this financial year in order to progress operational planning prior to the Prison opening in March 2012.

PAPER No 11/53

3

No Topic Action by Dr. McAndrew reported on progress with development of the model for

dental services in each of the NHSGG&C Prisons but highlighted some financial uncertainties in respect of the budget available for the service, both revenue and capital. The Committee were asked to note the report. NOTED

(iii) Representation membership from PEG Dr. Ian Gordon advised that Dr. Graham Morrison has been elected to represent the Professional Executive Group (PEG) at the CHP Committee meeting. NOTED

(iv) Update on formal feedback from OPR Final Actions & OPR Letter Paper 11/44a, 11/44b Sandra Cairney, Head of Planning & Health Improvement, spoke to the letter outlining formal feedback from the CHP Organisational Performance Review on 23rd May 2011. Sandra highlighted the significant positive feedback from the report and also identified areas where further work is being undertaken over the course of this year, in particular progress on Triple P Parenting Strategy development, the development of an Older Peoples’ Strategy, Child Healthy Weight Interventions and a request from the Chief Executive for a detailed paper on dental services. Ross McCulloch asked for clarification about the statistics of sickness absence and this was provided. There was a discussion in respect of the prescribing data available for the CHP OPR identifying significant challenges with the data for a number of East Dunbartonshire Practices due to misallocation issues by PPA. It was reported that the misallocation issues were being addressed. The Committee were asked to note the report and to receive future reports updating on progress against the issues highlighted. NOTED

PAPER No 11/53

4

No Topic Action by 65 GG&C NHS BOARD MEETING

Paper 11/45 The Committee were asked to note the Core Brief from the June meeting of the Board. The CHP Director reported to the Committee the range of issues discussed at the June Board. The Board minutes are available on the Board website for Committee members who wish to read them in more detail.

Ross McCulloch raised questions about the political impact of savings plans on frontline services. The Head of Finance responded to the specific issues identified by Ross and the CHP Director advised of a partnership-wide process underway to develop a 3 year plan for savings across partnerships to attempt to minimise impacts on small services and establish a coherent approach. NOTED

66 AUDIT SCOTLAND REPORT Paper 11/46 Sandra Cairney, Head of Planning & Health Improvement, and James Hobson, Head of Finance, spoke to the Committee report and highlighted some issues in respect of the report, which gave a generic view and therefore cannot represent the details of local arrangements. The Head of Finance identified the responses specific to this CHP. The CHP Director advised that all CHPs would be required to submit similar reports to their Committees and develop action plans from the recommendations in the report. NOTED

67 ORAL HEALTH DIRECTORATE STRATEGIC GROUP MINUTES – JUNE 2011 Paper 11/47 Ross McCulloch requested Staff Side contribution to the Oral Health Directorate Strategic Group. This was agreed. Ross McCulloch asked for an explanation of the term “bundle” in the Finance Report section of the Committee. James Hobson provided an explanation of how allocations are now being made from Scottish Government to Boards, so a dental bundle allows flexibility within that service bundle but prevents virement from one service bundle to another. The Committee were asked to note the minutes NOTED

PAPER No 11/53

5

No Topic Action by 68 ORAL HEALTH DIRECTORATE WAITING TIMES TARGET / CAPITAL

PLANS AND CHILDSMILE Papers 11/48a, 11/48b, 11/48c Michelle McLauchlan, Interim General Manager, Oral Health Department, spoke to the report on waiting times. The Committee commended the continuing high performance in meeting waiting time guarantees. Michelle also reported on significant improvement in DNA rates following the introduction of the Referral Management Centre and patient focussed booking system. NOTED

69 ORAL HEALTH DIRECTORATE FLOOD AT GLASGOW DENTAL HOSPITAL Paper 11/49 James Hobson, Head of Finance, advised that the tabled report had been presented at the 5th July Quality & Performance Group of the Board. The CHP Director informed the Committee that work being carried out in the Lecture Theatre at Glasgow Dental Hospital will be completed for the agreed date and not disrupt student teaching. James Hobson advised that the Board had made an emergency capital allocation to allow the work to proceed. The Committee and the Board will be updated on the final liability position for the Board once this is known. The Committee were asked to note the report. NOTED

70 FINANCE REPORT – MONTH 3 James Hobson, Head of Finance provided a presentation for the Committee detailing budgets for each service within the CHP. The CHP is reporting an underspend of £7.9k for the first 3 months of the year against all budgets. The Oral Health Directorate has reported an underspend of £9.3k for the period to 30 June 2011 which is included in the overall underspend of £7.9k. The main financial challenges during the year are likely to be:- Prescribing expenditure; Achievement of savings targets; Successful realignment of budgets to meet the additional costs of the

recently opened Dental facility at the Royal Alexandra Hospital; and The impact of the Board’s overall financial position.

PAPER No 11/53

6

At this early stage of the year the CHP is on track to achieve a breakeven out-turn for 2011/12 and achieve savings targets of £803k for Oral Health Directorate and CHP. The CHP Committee is asked to note the financial performance for the first 3 months of the year.

James Hobson advised that for OHD there were likely to be some financial challenges in meeting the revenue costs associated with capital schemes, in particular the new Dental Centre at the Royal Alexandria Hospital. Dr McAndrew advised that there is currently work ongoing to review CSDS services and develop a strategy for the future service provision. This work may allow some CSDS locations to be consolidated, releasing premises costs to contribute to the new capital charges costs. NOTED

71 HR UPDATE / STAFF GOVERNANCE MONITORING UPDATE Paper 11/50 Serena Barnatt, Head of HR, spoke to the report tabled at the meeting. Serena advised that sickness absence is currently above the 4% target for both CHP and Oral Health figures combined. However, the CHP Director highlighted that the combined figure for CHP and OHD disguises the higher rate of absence in the CHP, as OHD is below the 4% target. Serena also informed that at the CHP OPR session she had been asked to separate statistics to show long and short-term sickness absence which she had included within her current report. Serena advised that she had recently been advised on a new eKSF target for personal development for individuals, she informed the Committee that she will be meeting with the KSF Team to see how this will be reported. The CHP Director asked if managers can monitor the quality of the development plans and if managers had been trained appropriately in techniques for appraisals. Serena advised that Janis Howie, Senior Learning & Education Advisor, could support managers with this. Discussion took place about staff engagement in personal development and it was suggested that Jane McKinlay, Senior OD Adviser, could update the Committee at a future meeting. Ross McCulloch advised that the investment that NHS Scotland have made in staff engagement has been recognised in national publications.

PAPER No 11/53

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No Topic Action by 72 PUBLIC PARTNERSHIP FORUM UPDATE

The Chair welcomed Martin Brickley as the new PPF representative at the Committee. The CHP Director informed the Committee of the sad death of the PPF member Bob McSorland and extended the Committee’s wishes to Claire Taylor for a return to good health. Heather Gartshore, PPF member, informed the Committee that at the last PPF meeting Julie Christie, East Dunbartonshire Council provided a presentation on the Dementia Network Pilot Project which is being developed to raise awareness of dementia. NOTED

73 NHS GG&C BRIEF & LOCAL TEAM BRIEFS – CHP & OHD for June / July 2011 Papers 11/51a, 11/51b, 11/51c, 11/51d, 11/51e The briefs were previously circulated for the Committee members’ information.

74 MINUTES OF MEETINGS Papers 11/52a, 11/52b, 11/52c, 11/52d Staff Partnership Forum – 11th May 2011 Public Partnership Forum – 12th May 2011 Partnership Infection Control Steering Group – 10th March 2011 PEG Meeting – 30th March 2011

The Committee were asked to note the above minutes for information. NOTED

75 ANY OTHER COMPETENT BUSINESS There was no other competent business to report.

76 DATE & TIME OF NEXT MEETING(S) Committee Seminar – Friday 26th August 2011 Committee Meeting – Friday 30th September 2011

East Dunbartonshire Community Health Partnership Reports cover 1 Title of paper

Change Fund Monitoring Report

2 Report by

Annemargaret Black

3 Date of Commitee Meeting

30th September 2011

4 Contact number

0141 201 4210

5 Email address

[email protected]

6 Agenda item number

79

7 Agenda paper number

11/54

EAST DUNBARTONSHIRE CHP

Purpose of Report: To update the Committee on progress of the Older Peoples Transformational Board Background An Older Peoples Programme Board was established in partnership with East Dunbartonshire Council (Housing & Social Work), NHSGG&C Rehabilitation & Assessment Directorate, Voluntary and Independent Sectors. Although the Programme Board was established specifically to take the Older Peoples Change Fund forward, it has since became a formal structure within community planning and reports to the Health, Care & Protection Group. The Programme Boards remit is to progress transformational change across the totality of older peoples service provision and has agreed, in partnership to progress the development of an Older Peoples Strategy, a Joint Financial Framework, and Integrated Resource Framework, Joint Workforce Planning and a Joint Commissining Strategy. The Programme Board has prioritised Change Fund investment work since being established and agreed strategic priorities.

mailto:[email protected]

Contained within this report are monitoring reports required by NHSGG&C and Scottish Government. These were submitted in August 2011 and include

A Financial Summary for approved proposals for change fund investment A Change Fund Performance Summary Government (Joint Improvement Team) Mid Year Change Fund Review East Dunbartoshire’s Change Fund Plan KPI Report Update report on General Programme Board progress

Recommendations:- The Committee is asked to note this report and agree to future updates

CHANGE FUND MONITORING REPORT AUGUST 2011 – EAST DUNBARTONSHIRE

1. INTRODUCTION

Attached are the reports for East Dunbartonshire:- A. Financial Summary for approved PID applications B. Change Fund Performance Summary C. JIT mid-year Change Fund Review D. East Dunbartonshire Change Fund Plan KPI Report – May 2011-08-17

The KPI report for May 2011 shows for East Dunbartonshire:- 1. Total number of bed days lost to delayed discharges (including AWIs) 659 bed days behind target

KPI. 2. Number of bed days lost to delayed discharges for AWI 283 bed days ahead of target KPI. 3. Number of delayed discharges for AWI 2 behind target KPI. 5. Number of unplanned acute bed days for people >65 years 393 bed days ahead of target. 8. Delayed discharges >6 weeks remain at 0.

2. PROGRESS ON CHANGE FUND PLANS

2.1 Project Structure & Process

A Programme Board has been established, with representation from key partners in Local Authority, Voluntary Sector and Independent Care Sector. The Programme Board invited proposals from all partners in the form of Project Initiation Documents. Of the 22 outline proposals submitted, 14 progressed to PID development and of these 10 were recommended to the Change Fund Executive Group for approval. The 10 PIDs approved by the Executive Group are described in the JIT mid year report (C). A number of these PIDs have been agreed in principle, subject to modifications requested by the Executive Group. The criteria for PID approval were weighted in favour of those proposals thought to potentially impact on reducing hospital bed days, supporting people at home and on building community capacity.

2.2 Start Dates

Programme implementation is in early stages but all partners are working with local HR Departments to ensure progression with recruitment to achieve the start dates identified in Report A attached.

2.3 Impacts

The Report (B) Change Fund Performance Summary identifies the dates for each PID with respect to when an impact from implementation of the proposal might expect to be seen. This report also identifies for each proposal the KPI area where we expect there to be an impact. At this early stage of implementation we are unable to make accurate assessments on the scale or the pace of impacts but would expect that for a number of the proposals we will be discussing with partners quantification of the impacts 3 months after the implementation date and reviewing any further modifications or remedial actions required for each proposal.

2.4 Finance

For 11/12 financial year £876,186 of the £1,218,000 Change Fund allocation has been committed to the 10 approved PID proposals. The £341,814 in year “slippage” for 11/12 will be discussed with partners at the August 26th Programme Board meeting, with a view to agreeing that £140,000 of the slippage in allocated to non-recurring activities, like telecare installations and aids and adaptations to accelerate return home for delayed discharges. The remaining £201,814 to be used as contingency to support costs identified with any modifications to the PIDs in line with Executive Group recommendations. All slippage to be used to accelerate progress on KPI targets. K E Murray CHP Director 17th August 2011

D – East Dunbartonshire CHP


Ref No.

Performance Measures Baseline 2009/10

April 2011 Actual

May 2011 Actual

May 2011 Target

Target 2011/12

Commentary

1 Number of acute bed days lost to delayed discharges (inc AWIs)

7,359 600 599 491 5,887

2 Number of acute bed days lost to delayed discharges for Adults With Incapacity

3,200 96 47 213 2,560

3 Number of delayed discharges for Adults with Incapacity

47 4 2 24 Target reflects 50% reduction on 2009-10.

4 Reduced ALOS for over 75s in mental health beds

176 N/A N/A N/A 107 Measure needs to be confirmed monthly reporting may not be most helpful.

5 Number of unplanned acute bed days for people 65 +

59,883 4,675 4,176 4,622 55,465

6 Number of unplanned acute bed days for people 65 + rate / 1,000 popu

3,083 241 215 N/A N/A Baseline re-calculated to reflect GGC residents in GGC hospital locations. Target reflects same % reduction applied to previous baseline.

7 Delayed Discharges (at census) N/A 15 16 0 0 As at 15th May 2011. There is a need to confirm patient cohort e.g. Acute only, Acute/MH.

The May figure refers to acute hospitals and includes all patients therefore differing from published data.

8 Delayed Discharge > 6 weeks N/A 0 0 0 0 Data source - published census data. 9 Delayed Discharge < 6 weeks N/A 13 9 0 0 Data source - published census data. 10 Delayed Discharge > 6 weeks

exception codes N/A 2 3 0 0 Data source - published census data.

11 Delayed Discharge < 6 weeks exception codes

N/A 0 4 0 0 Data source - published census data.

12 Number of emergency admissions 65+

4,547 377 391 N/A N/A

13 Number of emergency admissions 65+ rate / 1,000 popu

234 19 20 N/A N/A

14 Number of unplanned admissions by SIMD

SIMD Quintile 1 58 0 0 N/A N/A SIMD Quintile 2 258 13 13 N/A N/A SIMD Quintile 3 1,126 61 86 N/A N/A SIMD Quintile 4 778 77 60 N/A N/A SIMD Quintile 5 2,327 225 226 N/A N/A 15 Number of intensive home care

packages of 10+ hours. (per 1,000 popu 65+)

8.5 N/A N/A N/A 8.8 by Mar 11

16 Number of shared assessments 195 N/A N/A N/A TBC 17 Number of people receiving personal

care at home 88%

2008-09N/A N/A N/A 93%

18 Number of clients accessing Care and Repair services

1,721 2,035 N/A N/A 2,340

19 Number of patients with anticipatory care plans

TBC N/A N/A N/A TBC No Information currently in the system.

20 Number of patients with complex circumstances recorded on register


21 Uptake of Self Directed Support (direct payments)

80 102 (all ages)

N/A N/A 130

22 Number of people in care home placements

628 652 N/A N/A 652

23 Number of new admissions to care homes

TBC TBC TBC TBC TBC

24 Number of new admissions to care homes by SIMD

TBC TBC TBC TBC TBC

Number of new admissions to care homes by:

TBC TBC TBC TBC TBC

Male TBC TBC TBC TBC TBC 25

Female TBC TBC TBC TBC TBC 26 Number of carers accessing self

management training TBC N/A N/A N/A TBC

27 Numbers accessing housing adaptation

238 N/A N/A N/A TBC

28 Number who die at home or in homely setting


D – East Dunbartonshire CHP

A - East Dunbartonshire CHP CHANGE FUND

PID APPLICATIONS - FINANCIAL SUMMARY

GROUP JIT Ref TITLEPID

RECEIVEDSTART DATE CYE 11/12 FYE 12/13 FYE 13/14 FYE 14/15

£ £ £ £

Carers/Community Capacity 8 Befriending Plus √ Oct-11 7,500 15,000 15,000 15,0009 Voluntary Organisation (SPOA) √ Oct-11 46,000 92,000 92,000 92,000

Sub-Total 53,500 107,000 107,000 107,000

Indicative Allocation

Supporting People at Home 2 Anticipatory Care Link Team √ Oct-11 140000 140000 0 010 Care & Repair √ Oct-11 29,247 58,494 58,494 06 LTC/Self Management. √ Oct-11 18,576 33,169 0 07 Self Directed Support √ Sep-11 37,500 75,000 50,000 25,0001 Reablement Model √ Sep-11 372,000 372,000 177,000 177,000

Sub-Total 597,323 678,663 285,494 202,000


Institutional Care 3 AWI √ Sep-11 53,863 107,727 107,727 107,7275 Acute Integrated AHP Service √ Oct-11 71,000 118,000 118,000 118,0005 Acute OT/Physio W/E Working √ Oct-11

5 Acute Assess/Discharge OT/Physio √ Oct-11

Sub-Total 124,863 225,727 225,727 225,727


Dementia 4 Dementia Advisory Clinic √ Sep-11 42,500 85,000 67,000 67,000

Sub-Total 42,500 85,000 67,000 67,000


Programme PIDS Total 818,186 1,096,390 685,221 601,727

Project Mgt 11 Project Manager & Support √ Apr-11 50,000 60,000Non recurring Investment (year 1) Describe expenditure 0Contingency 0

Allocation to Vol. Orgs 8,000

Total 876,186 1,156,390 685,221 601,727Indicative Allocation 1,218,000 1,218,000 1,218,000 1,218,000

Unallocated/Overspend 341,814 61,610 532,779 616,273

Notes

3. Allocation of 'Slippage' will be discussed at next PB meeting 26/8/11

1. This schedule includes total figures from our (E/D) spreadsheet 2. The Acute 118k allocation reflects a 10% contribution for all 3 PIDs'

4 £140k of the non-recurring £341,814 to be considered for Telecare, Aids & Adaptations and Cross Sector Training (detail in the JIT).

Change Fund 8 LJ 20/09/201111:58

Partnership Name: East Dunbartonshire Date of Completion: 17/08/2011

Contact Name: Annemargaret BlackTel. No. 0141 201 4210 4th August 2011E Mail: [email protected]

Example Change Fund Investment/Proposal 1 Change Fund Investment/Proposal 2 Change Fund Investment/Proposal 3 Change Fund Investment/Proposal 4 Change Fund Investment/Proposal 5 Change Fund Investment/Proposal 6

Brief Description/Title of Investment area

Community Capacity Building . Encourage voluntary sector providers, faith group and community network

involvement in the provision of low level and preventative inputs. Includes community transport supporting access to alternative day opportunities and other opportunities

Reablement - redesign of homecare Anticipatory Care AWI -supporting MHO and legal support capacityDementia Advisory Clinic -outreach and inreach clinic to

support delivery of HEAT standards and National Dementia strategy including national standards

Acute- increase OOH AHP capacity to affect early discharge planning, increase Geriatrician capacity

Long Term Condition management - building capacity to improve pathways from prevention to complex care for

Older People - 1 year with 3 stream workplan

Progress to Date - select which stage this aspect of the plan has reached

Implementation Planning Planning Planning Planning Planning Planning

Original Change Plan submissionproposed spending (if itemised - see notes)

£100,000 £442,000 £131,138

Actual Allocation 2011/12 £70,000 £372,000 £140,000 £53,863 £42,500 £71,000 £18,576

Projected Spend to 30 September 2011

£15,000 £0 £0 £0 £0 £0 £0

Projected spend 2011/12 £50,000 £372,000 £140,000 £53,863 £42,500 £71,000 £18,576

Comments on forecast position/planned slippage? Please also note here any funding itemised under projected spend 2011/12 which has been added by the partnership to the Scottish Government Change Fund allocation

Recruitment timescales in one element of the project have delayed full implementation. Expecting to use somenon recurrent underspend to fund handperson services to

deliver increased preventative support in current year. Would seek some small carry over to continue

commitment for a full three years to the elements of the investment with staffing implications prior to cash release

elswhere as per local implementation plan

EDC working through HR negotiations and staff engagement however for full implementation in

September 2011 -Slippage to be invested in -year to improve performance against KPIs

Proposal has been indevelopment, requiring GP and partner engagement - Recruitment will be underway mid-

August -Slippage to be invested in- year to improve performance against KPIs. Proposal will require 12

months funding and then review

Slippage to be invested in year to improve performance against KPIs -No spend predictied until late September

Slippage to be invested in year to improve performance against KPIs

Slippage to be invested in year to improve performance against KPIs

Slippage to be invested in- year to improve performance against KPIs

What metrics are you using to identify impact in this area?

Reduce unplanned acute bed-days for people aged 75 and over

zero delayed discharge over 6 weeks 50% reduction in bed days lost (AWI) in year 1 50% reduction bed bed days lost AWI within 1 year Reduction in unplanned bed days for 65 years + to

56,756 (2011/12) and 49,005 (2012/13)Reduction in unplanned bed days for 65 years + to

56,756 (2011/12) and 49,005 (2012/13)Reduction in unplanned bed days for over 65s'

Metrics Continued (if required) Increase in proportion of older people living at home Increase % of aged 65+ living at home by 30% 50% reduction of total bed days lost over 4 years. Reduction in ALOS in EMI beds for 75 years+ by 10%

from 09/10 positionIncrease number of intensive homecare packages 50% reduction of total bed days lost over 4 years. Number of anticipatory care plans

Metrics Continued (if required) Improved support for unpaid carers 100% of service users receiving complex care service

will have an anticipatory care planReduction in unscheduled admissions for 75 yrs +

Reduction in unplanned bed days for 65 years + to 56,756 (2011/12) and 49,005 (2012/13)

Increase numbers of 65 years + receiving re-ablement packages

50% reduction in bed days lost (AWI) in year Numbers uptaking self management education

Metrics Continued (if required)

Improvement on ‘Talking Points/Personal Outcome Approach’ measures of outcomes fully met (safety,

seeing people, things to do, living where want to live, respected)

Increase uptake of carers support - all carers will offered an opportunity for partnership in home care re-ablement

Increase number of patients with anticipatory care plans (baseline and target to be established)

Increase number of intensive homecare packages Increase number of people with access to telecare Reduction in unnecessary transitions in patients journeys Reduction in unscheduled care admissions

Metrics Continued (if required)95% of people with an assessed need for home care services or direct payments will receive re-ablement

service

Numbers of patients with complex circumstances leading to risk of admission to care or hospital recorded

on a register (baseline and target to be established)50% reduction of total bed days lost over 4 years. Increased independent living

Comment/IssuesYear one funding agreed in principle then review what

resource is released and review funding requirements for year 2 if proposal delivers desired results.

Recruitment starting August 2011. GP Practice meetings, implementation to be taken forward in

September/October. Costs not broken down in detail within Change Fund Plan previously

Costs not broken down in detail within Change Fund Plan previously. Links with anticipatory care proposal.

Will be operational in August with recruitment of O/Ts' & support staff in September 11.

Costs not broken down in detail within Change Fund Plan previously. Some KPIs still to be agreed in

partnership

Costs not broken down in detail within Change Fund Plan previously. Some KPIs still to be agreed

Trend analysis against unscheduled care admissions requires to be completed. Costs not broken down in

detail within Change Fund Plan previously

To be Decided 13 to 15Agreed PIDs 1 to 10 Change Fund Spend to Date 11 & 12

C ‐ East Dunbartonshire JIT Mid Year Change Fund Review

mailto:[email protected]�

Partnership Name: East Dunbartonshire

Contact Name: Annemargaret BlackTel. No. 0141 201 4210E Mail: [email protected]

Example





Implementation


£100,000

Actual Allocation 2011/12 £70,000


£15,000

Projected spend 2011/12 £50,000








Metrics Continued (if required) Increase in proportion of older people living at home

Metrics Continued (if required) Improved support for unpaid carers





Comment/Issues



Change Fund Investment/Proposal 7 Change Fund Investment/Proposal 8 Change Fund Investment/Proposal 9 Change Fund Investment/Proposal 10 Change Fund Investment/Proposal 11 Change Fund Investment/Proposal 12

Self Directed Support - personal budgets to achieve better personalisation outcomes

Befriending Plus - suppoting older people who do not meet EDC eligibility criteria - supporting people at home

for longer

Voluntary sector single point of access and capacity building

Care and repair Programme Management Voluntary Sector Engagment event

Planning Planning Planning Planning Delivery Review

£90,000

£37,500 £7,500 £46,000 £29,247 £50,000 £8,000

£0 £0 £0 £0 £20,000 £8,000

£37,500 £7,500 £46,000 £29,247 £50,000 £8,000



Further work to refine proposal required - process in place

October implementation

Year one allocation Includes £35,000.00 JIT investment to progress Older Peoples Service Transformation - An

additional £35,000.00 was invested for 6 months in 2010/11

50% increase in SDS in year one from baseline of 46Numbers of people recieving a befriending service

following dischargeNumbers of referrals from statutory services into

voluntary sector80 completed adaptations and 2000 small repairs Project Plan milestones delivered Event report and evaluation delivered

Reduction in local authority delivered services - need measure

Number of targetted referrals by Social Work Uptake os services within voluntary sectorReduction in ALOS in EMI beds for 75 years+ by 10%

from 09/10 positionJoint Older Peoples strategy delivered Informed content of some proposals

Numbers of people accessing the service Impact on people receiving a service175 completed home safety checks and 175 completed

home ssafety repairsJoint commissioning strategy in place

The exercise identified gaps in capacity of smaller to medium sized orgasnisations and quality improvement

needs in larger local organisations.

Impact for individuals receiving a service - personal outcomes

Reduction of unscheduled admissions IRF in place

120 completed cases

Slippage to be invested in- year to improve performance against KPIs. Costs not broken down in detail within

Change Fund Plan previously

Slippage to be invested in- year to improve performance against KPIs. Costs not broken down in detail within

Change Fund Plan previously. Personal outcome measures require to be defined

Slippage to be invested in- year to improve performance against KPIs. Costs not broken down in detail within Change Fund Plan previously. Personal outcome

measures require to be defined

Over life of Change Fund or 1 year - EDC to confirm Over life of change fund

Partnership Name: East Dunbartonshire

Contact Name: Annemargaret BlackTel. No. 0141 201 4210E Mail: [email protected]

Example





Implementation


£100,000

Actual Allocation 2011/12 £70,000


£15,000

Projected spend 2011/12 £50,000








Metrics Continued (if required) Increase in proportion of older people living at home

Metrics Continued (if required) Improved support for unpaid carers





Comment/Issues



Change Fund Investment/Proposal 13 Change Fund Investment/Proposal 14 Change Fund Investment/Proposal 15 Total

Telecare Aids & Adaptations Cross Sector Training

Potential spend from non-recurring 'slippage' Potential spend from non-recurring 'slippage' Potential spend from non-recurring ''slippage'

£150,000 £177,500 £50,000 £1,040,638

Decision by Programme Board 26.8.11 Decision by Programme Board 26 8 11 Decision by Programme Board 26 8 11 £876,186

£28,000

£876,186

B - East Dunbartonshire CHP Change Fund Performance Summary

EAST DUNBARTONSHIRE CHPPAGE 2

PID RECEIVED

EXPECTED IMPACT

DATE

GROUP JIT Ref. PIDs' impact on other KPIs'

Number of people in care homes

Number of people receiving personal care at home

Number of clients accessing Care and Repair services

Number of patients with anticipatory care plans (No information system currently in place)

patients with complex circumstances recorded on register (No information system currently in

Uptake of Self Directed Support (direct payments)

Number of people in care homes

Number of carers accessing self management training

Numbers accessing housing adaptation from both public and private sector

people with a palliative care package who die at home or in homely setting (No information

8 Befriending Plus √ Nov-11Carers 9 Voluntary Organisation(SPOA) √ Nov-11 √

Sub-Total2 Anticipatory Care Link Team √ Dec-11 √ √ √ √ √10 Care & Repair √ Dec-11 √

Supporting P 6 LTC/Self Management √ Dec-11 √ √ √ √ √ √7 Self Directed Support √ Nov-11 √1 Reablement Model √ Nov-11 √

Sub-Total3 AWI √ Nov-115 Acute Integrated AHP Services √ Dec-11

Instutional C 5 Acute O/T/Physio W/E working √ " √5 Acute Assess/Discharge √ "

Sub-Total4 Dementia Advisory Clinic √ Nov-11 √ √ √

DementiaSub-Total

Sub-Total

TOTAL


Oral Health Directorate Proposals for delivering dental services to prisons

2 Report by

Vince McGarry, Performance Planning Manager, Oral health Directorate


4 Contact number

0141 427 8307

5 Email address

[email protected]


79ii)


11/55


Purpose of Report: To describe the context and proposed model for delivering directly managed dental services in Barlinnie, Greenock & Low Moss prisons following transfer of responsibility for prison healthcare services from the Scottish Prison Service to NHS Health Boards. Background Dental services have previously been provided by contracted general dental practitioners on a separate, prison by prison basis. Government guidance indicates that while a contracted provider model may be retained, access to the general dental services payment system will no longer be possible and this has significant budgetary limitations that did not previously exist. The Oral Health Directorate has proposed a directly managed service model at activity levels recommended by guidelines. However a pro-rata reduction has been applied to indicate the activity that could be delivered and allow the service to remain within allocated budget. There is no scope within budget to deliver any additional health improvement activities without additional investment.

Recommendations:- The directorate recommends that the CHP note and support the proposed delivery model while also ensuring that the concerns regarding activity levels being lower than recommended guidelines are communicated via appropriate channels.


NHSGGC

ORAL HEALTH DIRECTORATE PROPOSALS FOR DELIVERING DENTAL SERVICES TO PRISONS

INTRODUCTION This paper is provided to give Oral Health Directorate’s detailed proposals for the delivery of a directly managed dental service provided by the NHS Community & Salaried Dental Service. It is divided into the following sections: 1.0 Summary 2.0 Pro Rata Delivery 3.0 Preferred Delivery 4.0 Preferred Activity 5.0 Preferred Staffing 6.0 Supplies/consumables 7.0 Decontamination 8.0 Waste Management 9.0 Maintenance 10.0 Specialist Support 11.0 Patient Records / IM&T This paper addresses revenue funding implications only. A separate paper will be prepared to describe the capital funding implications

IMPORTANT NOTES Activity: If services are to be delivered within proposed budgetary limitations then the directorate cannot commit to being able to provide the levels of service as recommended by guidelines or a like for like service with that currently delivered. Health Improvement: It should be noted that the delivery model in this paper does not accommodate any additional health improvement activities desired by guidelines associated with prison populations, such as Smile4Life (Homeless). Dental services are NOT currently involved in healthcare assessment as part of the prisoner admission process unless referred by the receiving medical practitioner. It should be noted that a recent consultation paper - DENTAL PRIORITY GROUPS STRATEGY - from the Chief Dental Officer proposes a core national oral health preventative programme for prisoners, which includes an oral health needs assessment. The consultation strategy indicates other locations where a number of ‘whole prisons’ health improvement approaches have been in place in health board areas such as Forth Valley. The consultation also references alignment with the national health promoting prisons framework. Additional investment will be required to deliver against any of these additional activities.

1.0 SUMMARY To meet a budget allocation of £170,500 the proposed activity and costs are indicated in the table below:

Barlinnie Greenock Low Moss Total Number of sessions per week 5 1 2 8

Senior Dental Officer £60,734 £12,147 £24,294 £97,174 Dental Nurse £18,534 £3,707 £7,414 £29,655

Total Staff Costs £82,821 £16,565 £41,411 £126,829

Total supplies/consumables costs £24,000 £4,800 £12,000 £40,800

TOTAL £106,821 £21,365 £53,411 £167,629 Additional revenue costs not included in the above Dental Appliances – continue to be funded by SPS Decontamination - estimated at approx £35,528 per year Radiological protection and clinical physics (equipment) support - unknown The directorate will not be able to provide a like for like service against current delivery within this budget.

2.0 PRO-RATA DELIVERY The directorate have been requested to provide a delivery model that meets a budget allocation of £170,500. NOTE: The directorate will not be able to deliver a like for like service with that currently delivered with this limitation in place. The preferred model is outlined in later sections however the activity and costs calculated on a pro rata basis are indicated in the table below:

Barlinnie Greenock Low Moss Total Number of sessions per week 5 1 2 8

Senior Dental Officer £60,734 £12,147 £24,294 £97,174 Dental Nurse £18,534 £3,707 £7,414 £29,655

Total Staff Costs £82,821 £16,565 £41,411 £126,829

Total supplies/consumables costs £24,000 £4,800 £12,000 £40,800

TOTAL £106,821 £21,365 £53,411 £167,629 Costs for improved decontamination - removed from the surgery - as required by Glennie regulations are not currently budgeted for. Centralising decontamination at Glasgow Dental Hospital decontamination unit are likely to be:

Barlinnie Greenock Low Moss TOTAL

Central Decontamination costs £22,205 £4,441 £8,882 £35,528 These costs DO NOT include transport.

3.0 PREFERRED DELIVERY 3.1 Activity

Using Department of Health guidelines for reference, the number of proposed sessions per week are:

Barlinnie Greenock Low Moss TotalNumber of sessions per week 6 1.2 3 10.2

3.2 Costs The Oral/Dental specific costs to provide a directly managed dental service at preferred levels for the three prisons within NHSGGC, costs are estimated as:

Barlinnie Greenock Low Moss Total Total Staff Costs £82,821 £16,565 £41,411 £140,797 Non-staff Costs £28,800 £5,760 £14,400 £48,960

TOTAL £111,621 £22,325 £55,811 £189,757 Additional revenue costs not included in the above Dental Appliances – continue to be funded by SPS Decontamination - estimated at approx £41,000 per year Radiological protection and clinical physics (equipment) support - unknown

4.0 PREFERRED ACTIVITY In the absence of Scotland specific guidelines, the Oral Health Directorate proposes to deliver services against the Department of Health guidelines contained within the ‘Strategy for Modernising Dental Services for Prisoners in England’, April 2003, (Department of Health, HM Prison Service) and that these should be adopted as a minimum. These guidelines suggest: “This [number of sessions] will also vary from each establishment, but research has shown that the oral health needs of prisoners is approximately four times greater than the general population. This suggests that there should be as a minimum, one dental session per week for every 250 prisoners.” The report titled: ‘Reforming prison dental services in England, A guide to good practice’ (July 2005, Office for Public Management funded by the Department of Health) continued to recommend this level. This position is also supported by the Scottish Association of Clinical Dental Directors. For the three prisons in NHSGGC, the recommended number of sessions per week is:

Barlinnie Greenock Low MossEstimated Prisoner numbers 1,500 300 750

Recommended sessions per week 6 1.2 3 A session is regarded as a minimum of 3 hours. NOTE: With community & salaried dental services placing a greater emphasis on restorative care (for which treatment will take longer to complete), it should be noted that the small increase in routine scheduled number of sessions per week are unlikely to have any effect on waiting times.

5.0 PREFERRED STAFFING 3.1 Clinical Preferred staffing model: Dental services should be delivered through a directly managed service to ensure best financial and clinical governance standards. The staffing commitment will involve one Senior dental officer, supported by a dental nurse per session. Service is proposed for 50 weeks with cover for required for annual and other leave. Therefore supporting funding is required for 1.2 WTE each of dentist and dental nurse. Annual costs for staffing, based on the activity identified above:


Sessions 6 1.2 3 10.2 Senior Dental Officer £62,901 £12,581 £31,452 £106,934

Dental Nurse £19,920 £3,984 £9,959 £33,863 Total Staff Costs £82,821 £16,565 £41,411 £140,797

The directorate understands that salaried and community dentists have not recently received, and are due to receive a salary increase through the national pay settlement process within the foreseeable future. Therefore these salary cost predictions may be underestimated. 3.2 Administrative Administrative support is already in place at Barlinnie. Waiting lists and new patient appointments are managed by health centre administrative staff. If this support structure is replicated in Greenock and Low Moss prisons there will be no need for further administrative support. If the oral health directorate is expected to provide additional administrative support for these prisons then this will incur additional cost.

6.0 SUPPLIES/ CONSUMABLES 4.0 Supplies/Consumables It is estimated that supplies/consumables costs, against preferred delivery, will be:


Total supplies/consumables costs £28,800 £5,760 £14,400 £48,960 4.1 Appliances As per the NPBPH (National Programme Board for Prisoner Healthcare) Information note regarding ‘Dental and Ophthalmic Appliances, process for remuneration post transition’, this document assumes “Prisons will retain responsibility for the payment for dental and ophthalmic appliances”, including lab costs for appliances. 7.0 DECONTAMINATION There is NO EXISTING revenue budget for decontamination. These costs will need to be met to comply with ‘Glennie’ requirements and new processes implemented by 31st December 2012. There is inadequate accommodation within Barlinnie and Greenock prisons and it will not be cost effective to employ additional support staff for a local decontamination unit within Low Moss prison for only three sessions per week. Therefore central decontamination is recommended for all three prisons, particularly with regard to the higher standards that can be achieved within an accredited central decontamination unit and the greater % of ‘at risk’ patients. Instruments from Barlinnie and Low Moss prisons could be processed at Glasgow Dental Hospital (GDH) central decontamination unit with a service for Greenock prison provided by the Inverclyde NHS Central Decontamination Unit. These costs require confirmation however the overall decontamination costs, against preferred delivery, are predicted to be:


Decontamination costs £24,000 £4,800 £12,000 £40,800 These costs DO NOT include transport. 8.0 WASTE MANAGEMENT Waste management is currently managed corporately within the health centre at Barlinnie prison. It is assumed this will continue to apply to all prisons and dental departments. NOTE: Amalgam disposal is arranged on an ad-hoc basis and will need to be agreed with the waste management contractor.

9.0 MAINTENANCE Equipment maintenance costs are currently borne by the prison service and funding would need to be identified to support this if the responsibility for equipment is to transfer to the NHS. This should include both routine and clinical physics support. This could be up to £1,000 per year. A more accurate estimate will only be possible if identifiable from within Prison Estates costs. 10.0 SPECIALIST SUPPORT 8.1 Radiological Protection Dental departments have intra-oral x-ray units and these are supported by a radiological protection advisor contracted by the prisons (for more than just dental). Clarity regarding future responsibility is required. 11.0 PATIENT RECORDS / IM&T The existing prison dental record system is paper based. NHS networking facilities are being installed in each of the dental departments within the three prisons and this will facilitate the introduction of the existing community dental services electronic patient record and management system – Carestream R4. Installation will incur a minimal one-off revenue charge of approx £600. Training of existing admin staff will be required however, as indicated above; additional resources will not be required. V McGarry Performance Planning Manager September 2011

Tuesday 16 August 2011

Introduction This issue of Core Brief reports from today’s Board meeting. ________________________________________________________________________ Closure of Lightburn Hospital The Board today approved recommendations to transfer elderly rehabilitation inpatient beds for the North and East of Glasgow from Lightburn Hospital to Glasgow Royal Infirmary and Stobhill Hospital resulting in the closure of Lightburn Hospital. This follows a four-month public consultation with more than 700 staff, patients, carers and other stakeholders. The recommendation will now go to the Cabinet Secretary for Health, Wellbeing and Cities Strategy for approval. A redesign of inpatient services means that more patients undergoing day hospital and outpatient services will now be treated at Glasgow Royal Infirmary. Specialist inpatient rehabilitation for patients who have had a stroke or need orthopaedic treatment such as a hip replacement will go to Stobhill. Visit: http://library.nhsggc.org.uk/mediaAssets/Board%20Papers/11-36.pdf NHSGGC press release: http://www.nhsggc.org.uk/content/default.asp?page=s930_29 Blawarthill continuing care beds The Board approved plans to move off the Blawarthill site and agreed to a proposal to move the ward to Drumchapel Hospital while longer-term planning on a final configuration of West Glasgow continuing care takes place. These proposals are now going to the cabinet secretary for consideration. Visit: http://library.nhsggc.org.uk/mediaAssets/Board%20Papers/11-37.pdf Trends in cancer incidence, prevalence and survival: implications for public health Dr David Morrison, director of the West of Scotland Cancer Surveillance Unit, presented a paper on trends in cancer incidence, prevalence and survival: implications for public health. Board members described it as a hugely important and well thought out paper and were impressed by the overview and information given on a range of cancers that can affect every part of our society. The paper noted the number of new cancers that will continue to increase for the foreseeable future mainly due to an ageing population along with the persisting importance of smoking on cancer incidence and the increasing importance of obesity, alcohol consumption and diet on common cancers. It was also noted that the incidence of malignant melanoma has also increased more than any other cancer and is the fourth commonest malignancy in women.

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You can view the paper in full at: http://library.nhsggc.org.uk/mediaAssets/Board%20Papers/11-35.pdf Scottish Patient Safety Programme Update In his regular update to the Board on the Scottish Patient Safety Programme and Healthcare Associated Infection medical director Brian Cowan highlighted the recent Healthcare Environment Inspectorate (HEI) unannounced visits to Glasgow Royal Infirmary and Gartnavel General Hospital. Dr Cowan said HEI unannounced visits now showed a significant shift in the inspections with more focus on individual interviews with staff on the wards. This was an opportunity to explore their knowledge of the environmental audit programme and infection control management. Work is ongoing to ensure all staff are aware of current programmes and policies. Visit: http://library.nhsggc.org.uk/mediaAssets/Board%20Papers/11-33A.pdf and http://library.nhsggc.org.uk/mediaAssets/Board%20Papers/11-34.pdf To view all of today’s Board papers visit: http://www.nhsggc.org.uk/content/default.asp?page=s109_9_11



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East Dunbartonshire Community Health Partnership Reports cover 1 Title of Paper

Primary Care Strategy Implementation

2 Report by

Gillian Notman


Friday 30th September 2011

4 Contact number

0141 355 2394

5 Email address

[email protected]


81


11/57


Purpose of Report: To update the Committee and CHP progress against NHSGG&C Primary Care Framework. Background: NHSGG&C developed a Strategic Primary Care Framework in January 2010 to support CHPs to deliver effective, high quality health services, to improve the health of local communities and reduce health inequalities. East Dunbartonshire CHP established a local Stearing Group to focus attention on the Board’s requirements and to ensure a local response was achieved.

Recommendations: Note the Annual Report Note key actions and outcomes delivered.

1


PRIMARY CARE FRAMEWORK

ANNUAL REPORT September 2011

2

CONTENT

Content

Page

1 Background

3

2 Aims

3

3 East Dunbartonshire CHP staffing

4

4 Demographics & inequalities

4

5 Community health profiles

5

6 Financial challenges

5

7 Access

6

8 East Dunbartonshire CHP action plan

8

9 Access and engagement

9

10 Resources

11

11 Primary care in NHSGG&C

12

12 Inequalities

13

13 Agreed direction & priorities for development

13

14 Leadership

14

15 Partnership

15

16 Research & development

16

17 Workforce

16

18 East Dunbartonshire CHP completed /monitored actions

17-20

3

PRIMARY CARE FRAMEWORK

EAST DUNBARTONSHIRE CHP ANNUAL REPORT 1. Background 1a. A Primary Care Steering Group was established to lead the process to develop a Primary Care

Framework for the NHSGG&C. Following extensive discussions with CH(C)Ps, direct engagement with independent contractors and feedback from PEGs SPFs and PPFs within local areas: a Primary Care Framework was developed and circulated in January 2010.

2. Aims 2a. The overall aim of the framework is to ‘deliver effective and high quality health services to act to

improve the health of our population and to do everything we can to reduce health inequalities’. This framework intended to give an agreed direction of travel, a context for future decisions and a consistent set of objectives. The document recognises that Primary Care is the heart of the NHS and that most clinical encounters take place within a Primary Care setting. The framework focuses on the role of the independent contractors – GPs, Pharmacy, Dentistry and Optometry and in the wider context of their role as part of multidisciplinary and multi agency teams of primary and community care services.

3. Local implementation process 3a. In line with the Board’s Primary Care Strategy, East Dunbartonshire CHP have engaged with staff

and Independent Contractors and established a local Primary Care Steering Group. Membership of this group includes representation from GPs across East Dunbartonshire CHP, the Clinical Director, Service Managers, PPF, Staff Partnership, Community Pharmacy and Community Nursing. Currently there are links with Optometry and Oral Health will be included following on from the recent change in management arrangements of the Oral Health Directorate

3b Our broad aims are:-

Services will be planned and delivered in partnership between the CHP, Acute Services, Local Authorities, Primary Care Contractors and members of the public.

There will be appropriate access to a range of services provided by Primary Care.

Patients will have access to primary care services according to need, which are planned, resourced and fit for purpose.

Patients will benefit from their care having identified pathways across the whole system of care which meets their needs.

Patients and public will be consulted on service redesign.

Understand East Dunbartonshire communities

4

4. Directly managed staff – East Dunbartonshire

4a. East Dunbartonshire CHP manages services which include:-

Community Nursing Children and Family service Community Rehabilitation Team Mainstream School Nursing Health Improvement Oral Health Clinical Pharmacy and Prescribing Allied Health Professionals Addiction services Community Mental Health services. Elderly Mental Health services Community Learning Disability service.

5. Independent Contractors 5a. Within East Dunbartonshire CHP there are 17 GP practices, 20 Optometrist practices, 24

Community Pharmacies and 25 Dental practices. 6. Demographics and inequalities 6a. East Dunbartonshire is a mixed urban and rural area which has a population of circa 104,680

people. Our geography has several small villages and urban areas including Milngavie, Bearsden, Kirkintilloch, Lenzie and Bishopbriggs. The population of East Dunbartonshire accounts for 2.0% of the total population of Scotland. In East Dunbartonshire, 16.3% of the population are aged 16 to 29 years (2009). This is smaller than the Scottish average of 18.6%. Persons aged 60 and over make up 25.3% of East Dunbartonshire. This is larger than the Scottish average of 22.9% being aged 60 and over. The male population aged 75+ is 3,485 whilst for females it is 5,424. East Dunbartonshire population for all over 85 is 2293 (Males 721, Females 1572). This high proportion of older people and the projected demographic increase in numbers challenges services to meet current needs and those for the future. Different models of service delivery require to be explored.

6b. East Dunbartonshire is an area of marked variance in deprivation and health outcomes. Of the

total population, 3.7 per cent live in the most deprived quintile while 54.4 per cent live in the least deprived quintile. The life expectancy of Hillhead is 69.3 years for males, 15 years less than Lenzie South where males have a life expectancy of 84.3 years

6c The population of East Dunbartonshire is ageing and this may place an additional demand for community health and care resources. Figures from the General Registrar Office for Scotland predict that the population of East Dunbartonshire will decrease, but its composition will change and there will be a much higher proportion of older adults.

6d This year we were committed to examine health inequalities across East Dunbartonshire. A

scoping project was undertaken to review existing data on Health Inequalities (HI) across the 28 intermediate zones of East Dunbartonshire, to identify the variance in the health between the best and worst areas and to report on this data in a meaningful way. The 2008 CHP profile for East Dunbartonshire was used as the source for health data using forty eight indicators.

5

6. Demographics and inequalities – cont…

Comparisons were made between each intermediate zone for selected indicators using both the relative and absolute variances. There were 4 - 5 areas which demonstrated far worse health than other zones (ranging from 27-3 indicators) These areas were Hillhead, Twechar, Kirkintilloch, West and East Clobber. This mapping exercise highlighted the wide-ranging diversity in HI within East Dunbartonshire CHP. It is hoped that the data from this scoping will inform the targeting of local health services, for example through promotion of current and future Local Enhanced Services (LES).

7. Community health profiles

7a Community Profiles for each intermediate zone within East Dunbartonshire have been completed.

The profiles consider services available, access to services and the main health issues for each area.

7b The CHP is working on significant needs assessment work which will inform future locality work

whether that is on a geographic, disease specific or needs led approach. Following completion of this work, the CHP will have meaningful engagement and discussion with GPs. This will assist us to understand universal service requirements and targeted opportunities.

7c The CHP are undertaking a participatory needs assessment using the Kings Fund Community

Orientated Primary Care validated methodology. This exercise will include GPs and other primary care professionals in determining the health needs of the population on a community basis. This will complement the spatial mapping and health inequalities gap analysis work we are currently doing.

8 Challenge to target resources 8a Given the increasing numbers of people living with a long term condition and the current financial

pressures, there are significant implications for healthcare resources. It is therefore essential that available resources are targeted to those most in need. Through shifting the balance of care, the CHP will encourage and is working towards greater partnership working between all the agencies involved in the provision of care. The CHP needs to deliver on core services whilst also develop anticipatory care and self management services. Examples of how this will be achieved include the following:-

Anticipatory assertive link team Self management – COPD courses, exercise classes, web based work

9 Financial Challenges

9a The Primary Care Framework will be implemented during a period where the CHP will face significant financial challenges as a result of the current financial climate in which public services will still be expected to deliver frontline services. The reduction in uplift funding for the NHS as a result of the Government’s public spending review will mean that scope for development and redesign of services will be challenging, as budgets will require to be reduced to maintain existing levels of service. Any redesign proposals will therefore require demonstrating that they are affordable. This will present a challenge but also an opportunity for public services to work together to align services to maximise the outputs from available resources. East Dunbartonshire CHP will be required to achieve a minimum of 2-3% saving year on year over the next few years and all budgets will require to be subject to ongoing review to ensure that maximum health gain is derived from the resources managed locally.

10 Relationships 10a The majority of GP practices are represented and attend the GP forum which is held every two

months. At this meeting

6

operational issues are discussed in relation to CHP service delivery to ensure the best system of care and also to make sure GPs are kept up to date with local and wider service redesigns and where possible make joint decisions. The CHP fund GPs to attend this meeting. A number of pieces of work have been progressed involving closer working. GPs also sit on a range of planning groups including those for children and family services and mental health services.

10b Our Pharmacy partners have been involved in various projects including the establishment of a

medication protocol for home care workers and a smoking cessation project which has been evaluated positively. We are currently supporting them on the roll out of the chronic medication service. In addition, we have active dialogue with our Lead Pharmacist who attends the PEG.

10c With Optometry partners, we have developed some networks and links through joint working on

projects funded from the review of community eye care services (2006). Although there was an identified programme developed, challenges around the national contracts made this difficult to take forward. Our Lead Optometrist also attends the PEG.

10d When working with independent contractors there are a range of opportunities to allow them to

influence decision making within the CHP to ensure good governance. Within forums like the CHP Committee, the GP Forum, the Primary Care Framework group and the PEG; they are informed of organisational discussions and priorities for the CHP. We do however continue to have challenges in developing and sustaining relationships with General Dental Practices, although the Oral Health Directorate Clinical Director has recently started to attend the PEG. This is in part because engagement with local General Dental Practices is undertaken through the Oral Health Directorate structures.

10e We engage with Community Planning partners and have joint planning structures, joint operational

groups and joint integrated discharge groups in place. There is a commitment to progress further work on joint priorities within care groups. Over the past year the CHP management team have supported social work in the development of their business case towards the possible development of an integrated CHCP. This work has paused with the agreement of the NHS Board Chief Executive and EDC Chief Executive until national guidance is issued on health and social care integration.

10f The development of relationships with the RAD has been both limited and challenging, however,

there may be opportunities to address this as we take forward the plans identified through the Older peoples Transformational Change Fund. In terms of integration with the acute sector, the SMT and other staff contribute to 18 week RTT groups for heart, orthopaedic and gastroenterology and are involved in the heart and stroke managed clinical networks. There are some good examples of joint planning groups for example, the Integrated Discharge meetings. The introduction of the new QOF indicators in 11/12 will also allow for more opportunities for GPs and acute clinicians to meet to consider referral pathways for both planned and unscheduled care.

11 Access 11a The CHP endeavours to understand issues around access to services. It is essential that we

gather information from stakeholders on their experiences in accessing and the quality of services that was provided in order that we can reflect and build on this for future development. Examples in dealing with that include:-

A survey was completed with parents who attended Baby Clubs within East Dunbartonshire CHP,

to better understand their experience of attending this service. The outcome indicated that these clubs had a clear role to play in providing information, support and education to the parents in a way which recognised their specific needs and circumstances.

The Primary Care Mental Health Team undertook a survey to capture the feedback from local GPs on access to their service. There was a 75% response rate. The outcome of this was that the front end of service pathway was redesigned and that the waiting times for access to service was reduced from 20 weeks – 2 weeks.

We do however need to explore further barriers to access e.g. we propose undertaking a patient access survey for those who have received a service at the KHCC.

7

8

12 Primary care team 12a Our anticipatory care link team pilot will be implemented in 2011. We are currently working up a

whole systems proposal between East Dunbartonshire CHP and Acute, East Dunbartonshire Council Housing and Social Work, CVS, PPF, and Scottish Care. The anticipatory care link team will assess patients with chronic long term conditions who are at risk of hospital admission which could be prevented. Patients will be identified initially using SPARRA data and clinical judgement. For the purpose of this project, the anticipatory care link team will initially assess patients from one practice within the CHP which has expressed an interest in participating with the project. Our Clinical Effectiveness Lead has been exploring what types of predictive data could be used in ‘real time’ to support this project. Our anticipatory care link team may be able to promote potential opportunities for real time data collection. This project will provide us with the opportunity to extend the Primary Care Team within a GP practice

13 Outcomes related to the Primary Care Framework 13a. See appendix 1 for a detailed outcomes related work plan.

PRIMARY CARE FRAMEWORK ACTION PLAN 2011


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PRIMARY CARE FRAMEWORK – ACTION PLAN Area Action to achieve outcome/impact Actions for year 2

A) ACCESS AND ENGAGEMENT

A1 Capital planning scoping exercise of all premises

Outcome/impact: Patients will have access to a range of services in a more appropriate setting. Improved joint working between and across CHP and EDC workforce, as well as potential resource/utilities savings, achieved with move to KHCC. Current Action: A review is being undertaken of other premises to identify required improvements, closure and/or relocation of services. This includes therefurbishment of Lennoxtown Clinic and relocation of staff from Bishopbriggs to the Stobhill site. This work may achieve cost savings.

Exploration with EDC the possibility of developing Hub Initiative premises in Bishopbriggs and in Lennoxtown.

A2 Establish Single Point of Access (SPOA) for Rehab Team.

Outcome/impact: GPs will have a more streamlined referral route. Single Point of Access was implemented in May 2011 when the CHP Community Rehab Team (CRT) went live. To date there have been 267 referrals (May - July) through the system. All GP rapid response and support discharge referrals have been achieved as stated in the service criteria and within defined standards. Current Action: A review of the existing referral forms is being undertaken in partnership with GPs with a view to use of SCI gateway referrals

SPOA development with EDC

A3 Primary Care Mental Health Team audit of psychological therapies through GP practices

Outcome/impact: Patients will have improved access to the Primary Care Mental Health Team. The findings of the audit resulted in a front end of service pathway being redesigned which led to improved access; reducing waiting times from 20 weeks to two weeks (achieved a 75% response rate from GPs). Current Action: The service is implementing a self-referral pathway.

An evaluation of the impact of the self referral pathway

A4 Improve Single Shared Assessment processes in partnership with East Dunbartonshire Council

Outcome/impact: Patients will benefit from better co-ordination of services. A significant increase in the completion of SSAs within the CHP has been achieved. Within the last year there have been 167 shared SSAs completed from the CHP to EDC. In addition 228 SSA have been completed which have not been shared.

Recommendations from city-wide pilot to be embedded into SSA practice.

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Current Actions: Several local services are part of a city-wide pilot which is

currently being evaluated. Awaiting information. Within ED CHP, clarify and further develop protocols on

sharing of assessments with EDC. A5 New referral system

established with Citizens Advice Bureau.

Outcome/impact: The public will have improved access to financial inclusion services. Since January 2011, the Healthier Wealthier Child Programme has achieved 58 referrals of which 38 service users have had all their entitlements identified and will be in receipt of a total of £123,500.00 financial gain. Current Action: Embedding the Healthier, Wealthier Children in to the practice of the CHP frontline delivery teams.

Review to ascertain if the Healthier Wealthier Child Programme has been embedded in to mainstream services.

A6 Gather patients views on breastfeeding (UNICEF)

Outcome/impact: Parents will have access to appropriate information and will have more confidence in breast feeding. UNICEF Stage 2 was assessed and awarded across East Dunbartonshire Current Action: Assessment/reassessment for Stage 3 recently completed and awaiting formal report to confirm Stage 3 accreditation.

Continue to reapply for accreditation

A7 Website to be developed to sign post people to self management programmes and services.

Outcome/impact: Funding agreed with EDC to develop a self-management web-based service. Current Action: Mental health stakeholder event in October will help partners to determine information requirements and approach.

Self-management web site will evolve with information gathered from the LTC self management programmes.

A8 Patient Public Forum to contribute to consultations, be involved in service redesigns, assist in signposting/education and increase understanding of health services.

Outcome/impact: The PPF will have a raised profile, gained confidence and knowledge. Twelve members are now actively consulted on current and future service redesigns, as well as contributing to both NHS GGC & ED CHP committees. PPF are actively involved in GGC and national consultations regarding patient access to services e.g. information services at Stobhill, closure of Lightburn, walk-through assessments of new hospitals, ambulance services and NHS 24 Current Actions: Existing PPF priorities agreed by members and include working with GPs on supporting early diagnoses of dementia, access and community engagement.

Undertake a survey of PPF on their knowledge and skills.

Continue to expand reach of PPF & increase capacity and involvement of PPF members within national and local structures.

The CHP will ensure that public participation standards are achieved.

A9 Evaluate Primary Care services at Twechar

Outcome/impact: Patients will have better access to primary care services in Twechar through the introduction of a GP satellite service. Survey findings demonstrated a 90% uptake of appointments.

Evaluation of pharmacy-led medication service will commence in year 2.

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Current Action: Introduce a pharmacy-led medication review clinic

A10 Develop electronic framework - Children's Integrated Assessment Framework (IAF)

Outcome/impact: Patients will benefit from better co-ordination of services. 244 children have had an IAF completed within the last year Current Action: Achieved agreement to use SharePoint with EDC.

East Dunbartonshire will implement an electronic solution to support IAF. Deadline being finalised.

A11 Undertake a COPD audit to determine pathway development and access

Outcome/impact: The CHP have developed understanding on how they will approach the development of a Long Term Conditions (LTC) model. Recommendations from COPD audits have informed Change Fund priorities Current Action: Develop detailed proposals for self-management programmes

Implementation of the proposal for a collaborative approach for people with LTC

B) RESOURCES

B1 Undertake CHP admin/review to support service delivery.

Outcome/impact: Review findings informed changes to better meet current demand and capacity of clinical services Current Action: Phase three of review will explore PA capacity for senior managers with reference made to Board-wide recommendations ( 0.6WTE)

Review impact of admin redesign

B2 Develop a Podiatry Patient Information Management System

Outcome/impact: Information and communication for patients will improve. Current Action: Local scoping of available systems undertaken Awaiting guidance from NHSGGC&C

Await city-wide roll out of system CHP AHP services have been collecting data to national minimum standard for the last 2 years on paper-bsed systems. Although all the main fields are completed and are in accordance with the national minimum dataset, we do not have suitable IT systems to allow breakdown of demand/activity by source. IT systems for community AHPs are being considered by NHSGG&C

B3 Participate in review of District Nursing

Outcome/impact: DNs will have greater skill mix and different ways of working to support the current and future demand for the service. CHP contributed to the development of a GGC wide model for DN services in order that ED staff are more aware of their managerial role Current Action: There has now been a local process agreed for implementation. A local development programme has been set up to support DNs in their

Implement the Nursing redesign

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evolving operational and leadership roles. B4 Waiting times are analysed

using a demand and capacity model for Physiotherapy and Podiatry

Outcome/impact: A demand & capacity exercise completed illustrating an under resource to meet growing demand Current Action: Contribute to board wide AHP redesign to influence Resource Allocation Model (RAM)

Benchmark local Musculoskeletal physiotherapy service with other community services across GG&C

Demand & capacity of Podiatry to be reviewed in light of RAM allocation of redesign

C) PRIMARY CARE in NHS&C

C1 CHP will develop good practice related to child and adult protection

Outcome/impact: Staff awareness of procedures related to child and adult protection increased. (Targets of 100% of staff to complete training in child and adult protection has been met).

Current Action: Re-audit to see whether staff can report better confidence in responding to ASPA concerns (baseline data available).

Implement actions from audit.

C2 Achieve implementation of the Liverpool Care Pathway

Outcome/impact: All patients who are end of life will be placed on a LCP where anticipatory care for symptom management, patient/carer centred and evidenced based. Phase 1 of Post Implementation audit showed that all staff and GPs are compliant with pathway. Current Actions:

Engagement with GPs to be reviewed with clear actions related to MCN on Palliative care

Post Implement audit (phase 2) will be completed in Dec 2011.

Review GP Palliative Care Forum

C3 Maintain effective engagement at GP forum

Outcome/impact: All GPs within ED are informed/involved on local CHP service delivery and kept up to date with local and wider service redesigns. Current Actions include :

Involvement in the development of a model for anticipatory care.

Involvement on working with GPs on supporting early diagnosis of dementia

Continuation on structured engagement and joint working between GPs, community staff and CHP management on shared decision making on service delivery and use of resources.

C4 Promote the role of non- medical prescribing

Outcome/impact: Prescriber’s confidence in improving patient safety has increased due to the benefits from peer review support. Current Action: Non-medical prescribers peer review group in place for Practice Nurses, DNs, C&FSs, prescribing support pharmacists and a community pharmacist.

Structure for governance for Older Peoples Mental Health prescriber to be developed.

D) ANTICIPATORY CARE

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D1 Develop an Anticipatory Care

Model Outcome/impact: Older people with complex needs will be discharged from hospital earlier and it is anticipated there will be a reduction of unplanned admissions. Current Action:

Anticipatory care link team to be appointed. Seek agreement with GPs on sharing information on

vulnerable people register. Pilot to inform the implementation of the model

Anticipatory care team to be implemented and evaluated within the next year.

A new model of care will be embedded within generic practice to support a proactive approach to case management

E) INEQUALITIES

E1 Spatial mapping including community profiles to determine service provision across the Community Health Partnership and identify gaps and variables

Outcome/impact: Communities will benefit from joint working informed by the inequalities gap analysis and spatial mapping. There is now information on 28 data zone community profiles. Current Action: This will assist the CHP to influence a targeted approach to resources related to service delivery. The communities with the worst health outcomes have now been identified and service provision is being scoped in detail for the most deprived community.

‘Total Place’ initiative with EDC. Action & progress from this will be reported to the Scottish Government.

Combining spatial mapping with information from EDC will progress with the Hillhead area. This will include updating information on LESs and other primary and community services

E2 Undertake training for staff and undertake EQIAs within the CHP

Outcome/impact: Staff awareness of Mental Health Leads increased and required EQIAs completed within stipulated timeframe. EQIAs have been completed for the food co-op project, the youth health drop-in and the primary care strategy. Current Action: Key messages from the EQIAs are utilised to inform service provision.

EQIAs will be done for the CRT and the Older Peoples Mental Health Service

E3 Evaluate the effectiveness of the Baby Clubs.

Outcome/impact: Service users are able to influence the development of the Baby Club to meet their needs. The impact of the audit resulted in service users receiving additional opportunities for peer support. Current Action: Evaluation for those who have not accessed the service (phase 2) will be undertaken in September 2011

Implementation of recommendations from phase 2 audit

F) AGREED DIRECTION & PRIOROTIES FOR DEVELOPMENT

F1 Agreed joint set of Older Peoples priorities with Community Planning partners

Outcome/impact: Patients will benefit from jointly developed services. An Older People Transformational Change Plan has been agreed by all partners Current action: Develop an agreed suite of KPIs with partners for Change Plan.

Implementation of Change Plan projects which have been developed to reflect the priorities within ED CHP/EDC Performance staff are finalising reporting requirements on behalf of the Programme

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Board to ensure our proposals improve performance on KPIs. As the Older People’s Transformational Board is now part of Community Planning, performance updates by exception will be reported to the Health, Care and Protection group within the Single Outcome Agreement.

F2 CHP resource mapping with EDC to explore current resource allocation/spend & existing service provision, identify efficiencies & improve health outcomes for older people.

Outcome/impact: Change Fund proposal informed by initial resource mapping undertaken with partners Current Action: Agree with EDC the potential to become a pilot for the integrated resource framework.

Progression through the change fund projects.

F3 Develop a joint Older People Strategy and Commissioning Strategy

Outcome/impact: Older people will benefit from joined up, co-ordinated services informed by population needs assessment. Secured agreement with EDC to progress towards joint planning and strategy development Current Action: Governance arrangements are being established between partners to scope the extent of the strategy

Implementation of the Joint Older People Strategy and Commissioning Strategy

F4 Agree with partners year 2 priorities for development of primary care framework

Outcome/impact: Local partners priorities are set for primary care and community services Current Action: Work plan being developed by the ED locality steering group

Agreed direction and priorities for the development of primary care locally which are collectively reviewed and developed on an annual basis.

G) LEADERSHIP

G1 Identify and promote good practice within a model of professional leadership

Outcome/impact: Extended Senior Management Team will demonstrate good leadership practice within their teams Current Actions:

Evaluate the use/effectiveness of the project management tools (Project management course was delivered to 14 operational managers).

Explore leadership competencies for service redesign & develop shared learning opportunities for enhanced leadership capacity.

Consolidation of Myers Briggs work within teams. Staff who have learned skills from the Ready to Lead course

will lead service improvement work in addiction, the CRT, the C&F review & work in the PPF

Evaluate the effectiveness of leadership competencies on the delivery of service redesign and capacity.

Additional staff have been identified to undertake the Read to Lead course.

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G2 Learn from staff surveys and develop actions with Extended Senior Management Team (ESMT)

Outcome/impact: Staff feel more valued and engaged. (Local response rate on survey was 31% which was down 36% from 2008). Current Actions:

Specific priorities to be identified to tackle issues related to the results.

Engagement and involvement model to be developed to promote better dialogue with staff

Impact of actions identified from the staff survey are audited with staff.

G3 Contribute to rehab redesign in scoping out leadership models for local implementation

Outcome/impact: All staff within the CHP will have access to professional leadership Current Action: Professional and peer support to be scoped out

Implementation of professional leadership model for all staff within Community Rehabilitation Team.

G4 Develop the new health, care and protection partnership

Outcome/impact: The CHP plays a leadership role in the new Community Planning group. Relevant primary care priorities feature in the SOA Current Action: Scoping out priorities and KPIs and agreeing a joint performance framework.

Implementation of the new partnership arrangements.

H) PARTNERSHIP

H1 Implement the actions in the mental health investment plan with EDC.

Outcome/impact: Patients will have access to a broader range of services which will have a positive impact on individual and community mental health and well being Current Actions:

Community allotment project is planned to go live in March 2012

Evaluation of initial impact of the peer support will be developed.

Impact analysis on the value of the autism support team service users to be undertaken.

Health Improvement Practitioner to implement recommendations made from the spatial mapping exercise of current activity as it relates to a ‘mentally flourishing Scotland’.

Produce a mental health improvement plan with partners.

Monitor of impact that the various projects have on individual and community engagement

H2 Employability opportunities within the CHP development plan.

Outcome/impact: Patients will have access to financial inclusion services. Employment Clinic pilot (6mths) delivered 21 referrals to Job Centre Plus from clients with mental health addictions, LD and musculoskeletal conditions. CHP Food Co-op provided training/work experience opportunities for 22 volunteers which resulted in 10 Volunteers gaining qualifications &

Act on recommendations from the evaluation of the employment clinic

Work towards Food Coop becoming an independently community owned service

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certificates and two volunteers securing paid employment Current Actions:

Undertake an evaluation of Employment Clinic Expand number of local food co-ops within ED

.

H3 Pilot a model of peer support within community mental health services in order to support people with mental health issues.

Outcome/impact: Build capacity for a peer support model to be embedded into mental health services. Recruited 1 peer support worker. Currently received 10 referrals from local mental health teams. Current Actions:

Evaluation of pilot. Recruitment of second peer support worker. Further development of the peer support role within mental

health services.

Embed peer support model into mental health services.

H4 Medication protocol Outcome/impact: Patients benefit from medication being administered by Home Care workers. Numbers of people receiving medication through this project has doubled to 65 in second year. Current Action: Utilise the Clinical Governance Support Unit to undertake an audit to explore impact on patient and carers and other cost benefits.

Implement recommendations of medication protocol audit.

I) RESEARCH & DEVELOPMENT

I1 Engage with clinical governance including the Glasgow Clinical Research Facility to explore opportunities to undertake research in Primary Care.

Outcome/impact: Patients will benefit from evidence based clinical practice. Primary Care development will be informed by up to date research. 19 clinical effectiveness projects have been completed by ED CHP within the last year, examples include equipment audit within COPT, smoking cessation client survey & the identification of health care needs for adults with LD. Current Action: Locally five GP practices have declared an interest in being engaged in the GP affiliation programme

All Teams to have an active clinical governance work plan which identified work under themes of person centred, patient safety and effectiveness.

J) WORKFORCE

J1 Achieved rehab workforce plan using skills mapping

Outcome/impact: Workforce information will inform current and future skills/roles development Current Action: Training Needs Analysis to identify and deliver support to develop a fully integrated CRT service

Skills mapping to inform a long term workforce strategy for the Community Rehabilitation Team

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PRIMARY CARE FRAMEWORK ACTION PLAN 2010-2011

COMPLETED /MONITORED ACTIONS


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PRIMARY CARE FRAMEWORK – ACTION PLAN – COMPLETED/CONTINUING OBJECTIVES Objective Outcome/impact Status – completed or to be monitored 1 Audit of all GP practices on 48

hour access & advanced booking

Outcome/impact: Patients have access to GP services within a 48 hour time frame. Four audits completed. 94% of GPs were providing a good level of access. The 1 outstanding GP practice was offered advice and support but this was declined.

Completed.

2 Monitor QOF patient questionnaires and services. With GP patients, analyse the lessons learned and to address relevant issues

Outcome/impact: Patient feedback is listened to and remedial action taken if required. Practices have had their own individual feedback. Common theme was patient confidentiality issues especially at reception.

Completed.

3 Analyse the findings of dermatology and orthopaedic audits in primary care specific to GP practices.

Outcome/impact: GPs will have a more streamlined referral route. Audit provided information on referral patterns. Result of audit was that many practices were not aware of referral guidelines. This was fed back to all relevant practices.

Completed.

4 Explore locality structures with GPs

Outcome/impact: GPs are to develop a model of locality groups which create structured engagement/joint working between contractors and community staff. Options Paper for locality structures presented at GP forum. Outcome was that GPs wanted a single locality model

Completed.

5 Evaluation of A&E data Outcome/impact: The CHP will be more informed of patterns of A&E attendance

Completed.

6 Implement children & families RAM

Outcome/impact: C&F RAM resulted in a reduction in available resource for East Dunbartonshire. Skill mix introduced from current resource.

Completed.

7 Evaluate the Living Better COPD self management courses

Outcome/impact: Patient perspectives of living with COPD will influence the co-ordination of services. Recommendations to be consumed into the LTC change fund proposal

Completed.

8 Implementation of EMIS Outcome/impact: GPs have access to ‘real time’ patient information system First CHP to move on mass to new system. 16 GP practices have moved to EMIS, 1 remains with Vision.

Completed.

9 Agree phlebotomy service with GPs

Outcome/impact: GPs will have a more streamlined route to accessing a local phlebotomy service. A limited phlebotomy service is now in place. Agreement reached about criteria for DNs to undertake domicilliary blood tests

Completed.

10 Engage with GPs around protected learning events

Outcome/impact: ED CHP staff and GPs are aware of primary care developments and clinical effectiveness projects. PLT was used effectively to deliver primary care priorities. At recent PLT topics included workshops on diabetes, ABI, heart failure and emergency admissions. 116 attended (38 GPs) 88% felt that the workshops were very useful.

Monitor the value of PLTs under current cost restraints.

11 Implemented co-location of CHP staff in KHCC bringing greater access to IT systems

Outcome/impact: Improve joint working between and across CHP and EDC workforce, as well as potential resource/utilities savings, achieved with move to KHCC. All

Completed.

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staff have access to IT and in addition all joint teams have access to care first.

12 Clear articulation of Board’s objectives through individual eKSF

Outcome/impact: All staff have a clear focus on service and personal objectives through a standard process. Achieved HEAT target for eKSF of 80%.

Completed.

13 Monitor Scottish Care Information gateway referrals

Outcome/impact: Established an electronic referral system which is utilised across the NHS for sharing patient information. ED CHP on average achieving SCI referrals >95%

Completed.

14 Develop a budgeting system for prescribing which creates incentives for active local management

Outcome/impact: All GP practices will imprive prescribing through participation in the incentive scheme Current Action: 10 practices have achieved all 3 indicators and 7 practices achieved 2 out of 3 of the indicators.

Scheme to continue on into 2011/12 with additional incentives

15 Contribute to the GP prescribing Glasgow-wide audit of medication request from acute out patient.

Outcome/impact: Better understanding on workload shift activity between primary and secondary care. 82% of local GP practices under took audit, compared to GGC-wide average of 70% Current Action: There is a high level of formulary compliance. Review prescribing non-formulary items through the medicines utilisation effectiveness committee and through prescribing management indicators.

Audit complete

16 Vitality project Outcome/impact: Patients have access to physical activity programme to support self- management of long term condition and wider health benefits Current Action: Links between the CHP and vitality have been established. There are now 13 Vitality classes per week available in East Dunbartonshire targeting all 4 agreed levels of ability. For the period Apr-Jun 2011 there were a total of 2126 attendances.

Continues to be delivered in local sites

17 RAD rehab resource disaggregation on RAM principles

Outcome/impact: RAD RAM has resulted in a reduction in available resource for East Dunbartonshire Current Action: Risks have been identified and the impact on patient services will continue to be monitored

Complete

18 Service information leaflets developed for CHP workforce

Outcome/impact: Staff have improved access to service information Current Action: Service information leaflets reviewed and updated

Monitoring of leaflets.

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Role of the Prescribing TeamRole of the Prescribing Team &

Prescribing Performance Management

Kirsty Forbes

Prescribing Support Pharmacist

OverviewOverview

• The Prescribing Support Team

• Why is Prescribing on the Increase?

• Prescribing Budget Performance

• Role of Prescribing Team

• Pharmacist-Led COPD Clinic

• Summary

The Prescribing Support TeamThe Prescribing Support Team

Base:• CHP Offices, Stobhill Hospital

• GP Practices (17)

Team:• Lead for Prescribing & Clinical

Pharmacy

• 3 x Prescribing Support Pharmacists

• 1 x Pharmacy Technician

• Admin Support

Why Is Prescribing on the Increase?Why Is Prescribing on the Increase?

• New medications for treatable conditions

• Medication for previously untreatable conditions

• Implementation of evidence e.g. SMC / SIGN

• Shorter stay in hospital

• Emphasis on preventative treatment

• Increasing elderly population

• Screening for chronic diseases

• Increasing number of prescribers

• Increased patient expectation

Prescribing Budget PerformancePrescribing Budget Performance

• 20% of all NHS costs

• East Dun CHP budget = £16M

• 80% of all prescribing costs incurred in primary care

• Significant potential for waste - DoH estimates that ~10% of drugs prescribed are wasted

Role of Prescribing TeamRole of Prescribing TeamImproving cost effectivenessImproving cost effectiveness

• Cost - The money needed to buy an item

• Effective - Produces the intended results

• Cost-effective - Good value for the money paid

Effectiveness vs Cost EffectivenessEffectiveness vs Cost Effectiveness

Drug A Drug B

-96% Effective -90% Effective

-£10 / patient -£1 / patient

96 cures / £1000 900 cures / £1000

Improving costImproving cost--effectiveness of prescribingeffectiveness of prescribing• Generic substitution

• Therapeutic substitution (in line with GG&C Formulary etc)

Role of Prescribing TeamRole of Prescribing Team

Reduce inappropriate prescribing

BNF drugs less suitable for prescribing

Drugs of abuse

Antibiotics

Support delivery of local & national prescribing targets (through GP Contract & GG&C’s Rational Prescribing Incentive Scheme)

Provide GP practices with updates on prescribing costs & patterns (via the use of PRISMS - Prescribing Information Systems for Scotland)

Prescribing for what the patient needs not for what they want

Role of Prescribing Team Role of Prescribing Team cont.cont.

• Monitor prescribing in relation to formulary / guidelines

• Provision of prescribing advice to GPs, CPs, PNs, AHPs & other health care workers when required

• To promote Clinical Governance - safe use of medicines e.g. oral methotrexate; warfarin

• Guidelines / Formulary development

• Delivery of education & training for doctors, nurses, pharmacists & homecare staff

• Maintaining good support links e.g. CHP Prescribing Group & Non Medical Prescribing Forum

• Medication review clinics e.g. Pharmacist-led COPD clinic

PharmacistPharmacist--Led COPD ClinicLed COPD ClinicWhat is COPD?

• Chronic Obstructive Pulmonary Disease

• Leads to damaged airways in the lungs, causing them to become narrower and making it harder for air to get in and out of the lungs.

• Major cause - smoking

• COPD patients often suffer from other health conditions & are prescribed multiple medications

• Improving care and outcomes for those with COPD - key target for DoH (http://gp.dh.gov.uk 8 Sept 2011)

PharmacistPharmacist--Led COPD Clinic Led COPD Clinic cont.cont.

Aims of the serviceAims of the service

• To compliment current COPD services within the GP practice setting

• Identification of all patients on the COPD register

• 20-30min pharmacy consultation for all patients -

(review of symptom control & management, assessment of inhaler technique, health promotion etc.)

• Home visits for housebound patients

PharmacistPharmacist--Led COPD Clinic Led COPD Clinic cont.cont.

BenefitsBenefits

• Minimising medication waste (over-ordering expensive inhalers & stockpiling of medication)

• Optimising inhaler therapy - reduces exacerbations, improves symptom control & quality of life

• Identification of medication issues (e.g. incorrect storage of medication etc)

• Cost saving initiatives

• Opportunity for improved interdisciplinary working within GP practices

SummarySummary

• Raising awareness of the importance of prescribing

• Think about the impact of prescribing and the potential for waste in your specific service areas

• Maintaining links with other services within Primary / Secondary care

• Good communication essential

Questions?


Oral Health Directorate Strategic Group Minutes

2 Report by

Karen Murray


30 September 2011

4 Contact number

0141 201 4217

5 Email address

[email protected]


84


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Purpose of Report: To provide the CHP Committee with an overview of key issues for the Oral Health Directorate Strategic Group at August 2011. Background The Oral Health Directorate Strategic Group meets bi-monthly to consider strategic issues for the Directorate and to srutinise progress against key performance areas for the Directorate.

Waiting Times Childsmile Programme Capital Developments Finance Oral Health Improvement

Recommendations:- The Committee are asked to note the minutes of the 31 August 2011 meeting of the Oral Health Strategic Group.

ORAL HEALTH DIRECTORATE

STRATEGIC GROUP

Wednesday 31 August 2011 at 4.00pm Board room, Glasgow Dental Hospital

MINUTES

Present:

Karen Murray (Chair), Director of Oral Health and East Dunbartonshire CHP Michelle McLauchlan, Interim General Manager Jeremy Bagg, Head of the Dental School Lorna Macpherson, Professor of Dental Public Health James Hobson, Head of Finance Ray McAndrew, Associate Medical Director (Dental) Aileen Duncan, Head of Planning and Health Improvement, OHD Tony Coia, General Dental Practitioner Isabel Diamond, General Dental Practitioner Kevin Jennings, Clinical Director, GDH Serena Barnatt, Head of HR, East Dunbartonshire CHP In Attendance: Linda Armstrong

ACTION 1. APOLOGIES Apologies were received from David Koppel and Vince McGarry. 2. MINUTES OF THE MEETING HELD ON 22 JUNE 2011

The minutes of the meeting held on 22 June 2011 were approved as a correct record.

3. MATTERS ARISING

(a) Oral Health Public Health Report Mrs Duncan said that the report was being finalised and would be available for the next meeting.

AD

4. CHILDSMILE UPDATE

Mrs Duncan gave the following updates from the meeting on 28 July 2011: Childsmile Core – 80% of Glasgow City schools are participating in the

toothbrushing programme. However there are 7 SIMD1 schools not participating. The education department have been offered £100k funding to assist but the expectation would then be for 100% compliance. The Director of Education wishes to negotiate this further.

Childsmile Practice – 162 general dental practices are participating, this equates to 65% of practices in NHSGGC. All practices have been notified that from 1 October, Childsmile will be included in the SDR. There is an evening event being planned for November for GDPs.

Childsmile School – Fluoride varnish applications have been completed in

144 schools from September 2010 – June 2011 targeting P1-3 children. From September 2011 P4 children will also be targeted.

Childsmile Nursery – From February 2011, 87 nurseries were targeted for fluoride vanish applications.

A ‘Childsmile Early Years Pathway Roll Out’ report been issued to CHCPs. From 1 October childsmile will be a mandatory field in the child health surveillance form competed by Health Visitors.

5. FINANCE UPDATE Mr Hobson advised that as at 31 July 2011 the Directorate reported an

underspend of £11.6k which is included in the overall underspend reported for the CHP of £4.8k He highlighted the main financial challenges for the year as: Prescribing expenditure Achievement of savings targets Successful realignment of budgets to meet the additional costs of the

recently opened facility at RAH The impact of the Board’s overall financial position Work is underway to review the structure of the chart of accounts in order to design an appropriate suite of finance reports. The will need to ensure that cost centres are aligned in a way that appropriately reflects service provision. The secondary care pay budgets are currently showing an overspend of £190.7k. The main area of overspend is pharmacy supplies. The Directorate has made a bid for additional funding from the Board’s allocation of access target funding to offset additional expenditure incurred in meeting national targets. It was noted that primary dental services are reporting an underspend. Plans have been identified to achieve recurring savings of £500k in 2011/12. Savings plans have now been allocated to individual budgets and budgets adjusted accordingly. Prof Macpherson noted that the 2012 savings identified a saving in dental public health and asked if this had been a strategic decision. Mrs Murray explained that this was currently a saving and the public health support would be reviewed again following the outcome of the national work on public health currently being undertaken. Mr Hobson said that the Directorate had a significant ongoing capital programme, the allocation of funding for which was detailed in the paper. The Board’s current capital plan for 201/12 also includes a specific capital allocation to develop the Alexandria Medical Centre which will include facilities for community dental services. He indicated that the position will change significantly as the year progresses as funding will be made available from the Board’s formula capital allocation to meet the costs of restatement arising from the flooding at GDH. In addition work is also ongoing with facilities to merge funding allocations to supplement the allocation for decontamination to enable the proposal to develop the Central

Decontamination Unit at GDH to proceed during 2011/12. The most significant financial risks for 2011/12 were identified as follows:

Prescribing expenditure Achievement of savings targets Successful realignment of budgets The Board’s overall out turn

6. HEADS OF PLANNING REPORT The content of the report was noted. Mrs Duncan highlighted the following: The Corporate Planning Group are producing a paper for 2010-13 aimed at

reviewing the strengths and weaknesses of the current planning arrangements and processes.

The latest Policy Update has been issued and copies are available from Mrs Duncan.

Following the self assessment using QIS methodology, NHSGGC has been identified as having a number of weaknesses in relation to the participation standards. A paper is being produced for the Quality Policy Development Group which will identify how to address these weaknesses and build on current strengths.

Mrs Duncan said she was currently collating comments on the Consultation on Oral Health and Nutrition Guidance for Professionals and will submit a response in due course.

7. CAPITAL UPDATE

In the absence of Mr McGarry the detail of the paper was noted for information.

8. WAITING TIMES

The detail of the paper was noted information. In particular Mrs McLauchlan highlighted the following: The waiting time for IP/DC cases is less than 6 weeks and for OP is less

than 7 weeks. DNAs – new patient DNA rates have decreased, but some additional work

is required to look at return DNA rates. There has been no additional activity required at GDH since May. Kelvin Suite – additional session were required in August to maintain the

National Guaranteed Waiting Time. GA Comprehensive list at RHSC- pre assessment clinics are being

reviewed and additional theatre sessions will be available if required Restorative Sedation Services at GDH – These sessions for adolescents

will no longer be available at GDH. Patients will be treated either within GDS or community. Letters have been issued to all GDPs to advise them of the change.

Following clinic redesign within the restorative department CONS and PROS clinic codes no longer exist. These have been replaced with Fixed and Removable prosthodontics (FRP) and ENDO clinic codes.

Photography – Plans to map out the patient journey via photography are underway. A two month review has started to quantify the numbers of patients requiring to be reappointed due to the opening hours of the service.

E-referral will have been rolled out across the service by the end of March

2012. 9. PRACTICE IMPROVEMENT GRANTS

The paper was noted for information. Mrs Murray said that strategically the central Decontamination projected needed to go ahead. This may be able to assist those practices who will not be compliant by the December deadline. Mrs Diamond highlighted an ongoing issue she had in relation to the washer/disinfector which was not working because of a problem with the water pressure. Mr Coia suggested that she report these issues to Julie Reilly.

10. SDAI

The paper giving the updated position in relation to the allocation of grants was noted for information. The group will now only consider requests from practices who do not have an LDU or are not DDA compliant as there are no access issues in NHSGGC.

11. HR UPDATE

Ms Barnatt reported that the absence rate for June 2011 was 3.23%, which is a slight decrease from last month. Ms Barnatt also said that the figures for the new national target for KSF which has been agreed are not yet available. These are linked to the NHS Quality Strategy and to PDP activities. Reports of the national target will be presented at the next meeting. There is also a new workforce information system being developed for the Board called the electronic employee support system.

SB

12. SCDS REVIEW Mr McAndrew said the review was progressing and expected the report to be

complete by the due deadline of end of October 2011. It was agreed that Emma O’Keefe would give a presentation on the review at the next meeting.

LA

13. ADULTS WITH INCAPACITY CONSULTATION Mr McAndrew said this was a unique opportunity to influence this and

encouraged all members to respond to the consultation.

14. ANY OTHER COMPETENT BUSINESS

It was noted that David McCall, Consultant in Dental Public Health officially

retired today. Mr Coia said that he had been involved in the pilot of the sedation practice

inspection. It had raised a couple of issues in relation to servicing of equipment. Mrs McLauchlan said that this was undertaken by Medical

Physics for the directorate. Mrs Duncan said that at a recent winter planning meeting they had identified

H1N1 as the flu strain this winter. Immunisation programmes are in place for staff.

Mrs McLauchlan confirmed that Tom Walsh and Craig Williams would attend the next meeting to discuss the directorate links to the Board infection control function.

LA

15. DATE & TIME OF NEXT MEETING The next meeting will be held on Wednesday 26 October 2011 at 4pm in Board

Room, Glasgow Dental Hospital.


Oral Health Directorate Waiting Times Target

2 Report by

Michelle McLauchlan


30th September 2011

4 Contact number

0141 232 9703

5 Email address

[email protected]


85


11/59A


Purpose of Report: To provide the CHP Committee with an update on the Oral Health Directorate position in relation to the maintenance of waiting time guarantees, capital plans progress and the Childsmile Programmes implementation. Background The Oral Health Operational Group meets monthly and is responsible for ensuring arrangements are in place within the Directorate for the implementation of strategy and policy. It also provides a forum to ensure that Directorate wide issues are raised, debated and discussed and that agreement on the way forward is achieved. The Group receives a range of reports on the main governance and development issues facing the Directorate and supports the delivery of these areas of activity, monitoring and overview of performance against key objectives. Recommendations:- Committee members are asked to note the contents of the reports.

1

2

ORAL HEALTH DIRECTORATE OHOG

7th September 2011

1. Inpatient/Day Case Waiting Times IPDC 8 week guarantee

Specialty True IPWL - Currently Waiting at 22nd of August 2011

Weeks Waited

Oral Surgery 0-4 Wks 4-6 Wks 6-7 Wks 7-8 Wks Total 18-Jul-11

Community Dentistry 12 0 0 0 12 7

Oral Surgery 17 8 0 0 25 27

Total 29 8 0 0 37 34

18-Jul-11 32 2 0 0 25 IPDC availability status There is currently one unavailable daycase for Oral Surgery due to social reasons.

2. Outpatient Waiting Times The maximum current wait is 7 weeks at GDH.

True OPWL - Currently Waiting at 22nd of August 2011

Weeks Waited

Specialty 0-4 Wks 4-6 Wks 6-7 Wks 7-8 Wks Total 18-Jul-11

Oral Surgery 161 4 0 0 165 250

Oral Medicine 225 9 1 0 235 373

Orthodontics 188 19 1 0 208 194 Restorative Dentistry 579 119 18 0 716 813 Paediatric Dentistry 324 27 3 0 354 418

Total 1477 178 23 0 1678 2048

18-Jul-11 1845 196 7 0 2048 Availability Status OP

Unavailable OPWL 22nd of August 2011

Currently Unavailable Unavailable OPWL Totals Medical Social PFB Total 18-Jul-11

Oral Surgery 3 18 8 29 69

Oral Medicine 4 13 12 29 44

Orthodontics 1 27 46 74 62 Restorative Dentistry 22 81 70 173 201 Paediatric Dentistry 0 9 18 27 28

Total 30 148 154 332 404

18-Jul-11 58 156 190 404

Dental Hospital – OP Actual DNA’s and DNA rates for new patients and return pts

Spec May-11 May-11 May-11 Jun-11 Jun-11 Jun-11 Jul-11 Jul-11 Jul-11

New

No of pts attended

DNA - No of pts

DNA rate (%)

No of pts attended

DNA - No of pts

DNA rate (%)

No of pts attended

DNA - No of pts

DNA rate (%)

Variance

CONS 320 41 11.36 234 17 6.77 155 18 10.40

ORAL MED 236 20 7.81 309 24 7.21 286 16 5.30

ORAL SURG 510 65 11.30 603 43 6.66 400 37 8.47

ORTHO 167 22 11.64 136 7 4.90 106 16 13.11

PAEDS 307 49 13.76 290 60 17.14 262 59 18.38

PERIO 127 14 9.93 138 8 5.48 131 10 7.09

PROS 102 7 6.42 114 7 5.79 64 9 12.33

Total 1769 218 10.97 1824 166 8.34 1404 165 10.52

Spec May-11 May-11 May-11 Jun-11 Jun-11 Jun-11 Jul-11 Jul-11 Jul-11

Return

No of pts attended

DNA - No of pts

DNA rate (%)

No of pts attended

DNA - No of pts

DNA rate (%)

No of pts attended

DNA - No of pts

DNA rate (%)

Variance

CONS 556 103 15.63 598 135 18.42 449 69 13.32

ORAL MED 342 78 18.57 466 81 14.81 434 64 12.85

ORAL ORTHO 133 12 8.28 121 11 8.33 56 8 12.05

ORAL SURG 703 155 18.07 937 176 15.81 791 140 15.04

ORTHO 1325 188 12.43 1357 192 12.40 1025 181 15.01

PAEDS 520 118 18.50 451 116 20.46 322 117 26.65

PERIO 268 42 13.55 255 42 14.14 227 45 16.54

PROS 516 83 13.86 567 64 10.14 364 50 12.08

REST 22 1 4.35 26 3 10.34 5 3 37.50

Total 4385 780 15.10 4778 820 14.65 3673 677 15.56

GRI – OP

True OPWL - Currently Waiting at 18th of July 2011

Weeks Waited


Oral Surgery 89 3 0 0 92 88

Total 89 3 0 0 92 88

18-Jul-11 88 3 0 0 88

There are currently 3 patients unavailable due to medical reasons and 1 due to social reasons.

3

Additional Activity (GDH)

Month Oral medicine

Oral surgery

Paeds Perio Restorative Orthodontics APIC Total

Apr 08 – Mar 09

497 1172 0 468 1062 403 45 3647

Apr 09 – Mar 10

0 166 0 531 1484 310 110 2601

Apr 10 – Mar 11

160 166 50 450 1570 98 28 2522

Apr-11 0 0 0 0 135 0 0 135

May-11 0 0 0 0 204 0 0 204

Jun-11 0 0 0 0 0 0 0 0

Jul-11 0 0 0 0 0 0 0 0

Aug-11 0 0 0 0 0 0 0 0

Total 2011/2012

0 0 0 0 339 0 0 339

Clyde OP – Orthodontics

True OPWL - Currently Waiting at 22nd August 2011

Weeks Waited


RAH 8 1 0 0 9 22

IRH 22 21 0 1 44 105

Total 30 22 0 1 53 127

18-Jul-11 77 24 12 14 127

RHSC OP

True OPWL - Currently Waiting at 22nd of August 2011

Weeks Waited


Paediatric Dentistry 34 5 3 0 42 23

Total 34 5 3 0 42 23

18-Jul-11 17 6 0 0 23 RHSC Dental Extraction Kelvin Suite

True WL - Currently Waiting at 22nd August 2011

Weeks Waited


Dental 74 131 42 15 262 319

Total 74 131 42 15 262 319

18-Jul-11 203 104 9 3 319

4

Dental Extraction Kelvin Suite Availability Status

Unavailable IP/DC Totals 22nd of August 2011

Currently Unavailable Unavailable

IP/DC Totals Medical Social Other Total 18-Jul-11

Dental 2 4 11 17 18

Total 2 4 11 17 18

18-Jul-11 3 15 0 18

GA Comprehensive care list RHSC

True WL - Currently Waiting at 22nd August 2011

Weeks Waited


Dental 37 0 4 0 41 48

Total 37 0 4 0 41 48

18-Jul-11 58 0 0 0 58

GA Comprehensive care list Availability Status

Unavailable IP/DC Totals 22nd of August 2011

Currently Unavailable Unavailable IP/DC Totals Medical Social Other Total 18-Jul-11

Paediatric Dentistry 12 2 0 14 15

Total 12 2 0 14 15

18-Jul-11 14 1 0 15

IS Waiting List Current wait time for IS treatment is 5 weeks and all pts have an appointment date. IV Waiting List The average wait time for IV treatment is currently 15 weeks; this may change depending on the number of appointments required. DNAs New patient DNA rates increased last month with the exception of Oral Medicine, the increase due to seasonal variation. Overall return DNA rates also increased slightly last month. There will be a DNA audit starting on Monday 5th September for one month period initially across all specialities. Kelvin Suite Additional sessions are required in September to maintain the National Guaranteed Waiting Time. Weekly meetings are taking please at RHSC between WLAC and RHSC staff to ensure smooth running of Waiting lists and theatre lists, so far 6 additional sessions in September have been made available to maintain the National Guaranteed Waiting Time. GA Comprehensive List Pre assessment clinics are being reviewed, all casenotes of patients currently awaiting Pre assessment are being reviewed by consultants in order to check if patients could be moved to a different waiting list and therefore reducing the patients journey.

5

6

Restorative Sedation services at GDH As at end of August restorative sedation for adolescents will no longer be provided within GDH, patients who require treatment under sedation will have this carried out within the Community Dental Service. Letters have been sent out to GDPs to advise them of this change. Any referrals received for sedation will be returned to referrer with covering letter advising where patient referrals can be sent. Changes to Restorative clinics Due to clinic redesign within the restorative department CONS and PROS clinics no longer exist, these have been replaced with FRP and ENDO clinic codes. As of the 1st August the specialties within Restorative Dentistry will now be Fixed and Removable Pros, Endodontics and Periodontology. GDH The waiting times for the following specialities Endodontics, Oral Surgery, Oral Medicine and Periodontology is currently 3 weeks therefore these waiting lists are being straight booked and no longer using PFB as the PFB procedure currently takes 3 weeks from start to finish in order to give the patients time to respond to the PFB invite letters.


Oral Health Directorate Capital Plans

2 Report by

Michelle McLauchlan


30th September 2011

4 Contact number

0141 232 9703

5 Email address

[email protected]


85


11/59B



Oral Health Directorate, Capital Update, Page 1 of 4

ORAL HEALTH DIRECTORATE

Capital Update – 18th August 2011 DENTAL CENTRES Project Progress Actions Required Estimated / Proposed

Completion Date Funding Source

Responsible Person

Royal Alexandra Hospital Dental Centre

Lab Significant variations between tenders received. To ensure tenders can be validly compared, the companies have been asked to revise their tenders confirming the following (if not already submitted):

a) Visual representation of their products

b) Detailed location layout

c) Quotation for alternative to stainless steel worktops

d) All necessary components of a dental technician workstation are listed.

Satellite clinic refurb: Activity levels suggest more detailed review of continuing to deliver from these sites required

Closing date: 29th July. Prepare report for Oral Health Strategic Group

Plan for works to take place late 2011. Plan for works to take place late 2011/early 2012 dependant on extent of works.

____________ Capital budget confirmed: Lab:£120K Satellite decon: £90k

V McGarry V McGarry / M Buchanan


Project Progress Actions Required Estimated / Proposed Completion Date

Funding Source

Responsible Person

Alexandria Health & Care Centre

Series of 1:50 room design meetings completed. Planning permission approved.

Directorate sign-off

Overall build completion estimated for end 2013.

PCCPMP Allocation £3,500K (under review)

V McGarry

PRIMARY CARE Project Progress Actions Required Estimated / Proposed


Responsible Person

Estates-level refurbishment (Dental Departments)

All necessary sites reviewed. Early actions: Drumchapel: Dental Chairs / lights being replaced early August. Townhead H/C: technical issues postponing installation date.

Complete reports on investment required to maintain, and link in with overall review of CSDS services

Formula Capital V McGarry

Intra-Oral X-ray Replacement

Sites where older x-ray arms requiring replacement have been identified (to make compatible with digital sensors) Sites affected – Theatres and non-Glagsow CDS Final list subject to future plans and timescales for each site

Link with capital component of CSDS review.

NCL or funding to be identified.

V McGarry



GLASGOW DENTAL HOSPITAL & SCHOOL Project Progress Actions Required Estimated / Proposed


Responsible Person

Prosthodontic Clinic Relocation

Design issues: Alternative layout developed and discussed in small-group meetings with key stakeholders. Funding sources/options identified. Final proposal prepared. Project board meeting to be convened mid September.

Proposed completion: To be confirmed

Funding sources identified.

V McGarry

DECONTAMINATION Project Progress Actions Required Estimated / Proposed


Responsible Person

Primary Care Decontamination Project Pan NHSGGC Programme to ensure primary care services (mainly dental and podiatry) meet Glennie decontamination requirements by end Dec 2012.

2nd draft of business case being prepared.

Revisions /checking to be completed for project board meeting on 7th September.

Start date: March 2011 Project length – 12 to 18 months

Revenue & capital implications (to be costed as part of project)

V McGarry (J Quinn)

CDU Expansion Funding sources identified. CDU design approved by A Stewart, Head of Decon.

Prepare final proposal for approval.

End March 2012 From: PCAT & Dental Decon Programme

V McGarry


Oral Health Directorate Childsmile Update

2 Report by

Michelle McLauchlan


30 September 2011

4 Contact number

0141 232 9703

5 Email address

[email protected]


85


11/59C



Childsmile OHOG Report – August 2011

1

Childsmile Operational Report – OHOG – August 2011

Childsmile Practice - GDP Recruitment

Out of 249 GDS practices in GG&C, 162 (65%) have enrolled in providing the Childsmile Practice Programme. A further 9 CSDS clinics have signed up to Childsmile Practice Programme.

The graph below highlights the growth in the number of GDP Practices enrolled/delivering the Childsmile Practice Programme since November 2009.

Childsmile Practice Recruitment

8390 95

108121

136144 147 149

162172

0

50

100

150

200

Nov-0

9

Jan-1

0

Mar-1

0

May-1

0

Jul-1

0

Sep-1

0

Nov-1

0

Jan-1

1

Mar-1

1

May-1

1

Jul-1

1

Month

Nu

mb

er

of

Pra

cti

ce

s

(GD

P/C

SD

S)

Number of Practices

The 162 GDP practices can be broken down into the following areas:


2

CH(C)P Area Number of Practices (June 2011)

East Glasgow 32

North Glasgow 26

South East Glasgow 21

South West Glasgow 14

West Glasgow 21

Renfrewshire 15

East Renfrewshire 8

East Dunbartonshire 12

West Dunbartonshire 13

The CSDS Clinics currently providing Childsmile are:


3

2.0 Childsmile Practice Activity

The overall Practice activity for the first and second quarter of 2011 is noted below:

Enrolments:

Fluoride Varnish:

Toothbrushing/FV Advice:

FV Applications

% of FV from Total Enrolments

Jan - March 2011 2687 26% April - June 2011 3105 23%

Health Centre

Bridgeton Health Centre

Govan Health Centre

Dumbarton Health Centre

Greenock Health Centre

Vale of Leven Hospital

Port Glasgow Health Centre

Drumchapel Health Centre

Townhead Health Centre

Parkhead Health Centre

Toothbrushing/Fluoride Advice

% of Toothbrushing/FV Advice from total enrolments



4

Dietary Advice:

Dietary Advice

% of Dietary Advice from total enrolments


2.1 Fluoride Varnish Applications – 2009/2010- 2011

The table below shows the number of fluoride varnish applications completed within the GDS and S&CDS settings from January 2009 to June 2011 inclusive.

This can be seen in direct correlation to the increase in the number of practices signed up to the Childsmile Practice Programme.

Quarter

Number of Fluoride Varnish Applications

(GDS+SCDS) Q1 - 2009 29 Q2 - 2009 73 Q3 - 2009 146 Q4 - 2009 285 2009 Total 533 Q1 - 2010 310 Q2 - 2010 404 Q3 - 2010 714 Q4 - 2010 1364 2010 Total 2792 Q1 - 2011 2687 Q2 - 2011 3105

Childsmile Practice - Ongoing Work

Childsmile information pack sent out electronically to non Childsmile practices prior to Childsmile going onto the SDR

Evening GDP Event to launch information regarding Practice Programme following inclusion of payments into SDR – expected November 2011

Dental Health Support Worker Event held on the 25th Aug 2011 – designed to increase knowledge and share information about best practice whilst encouraging increased activity within Practices. Evaluation completed and action plan devised.

Ongoing communication with Children and Families Teams via Operational Manager, including attendance at HV Team Meetings, DHSW’s meetings and CS Practice Administrator acting as central point of contact.

Implementation of Early Years Pathway impending

Childsmile F/V School Programme Targeted Group There are 309 primary schools in NHSGGC across 8 CHCP’s. The programme targets 144 schools. The programme commenced in April 2010 (Academic Year 2009/10) The table below indicates the targeted schools and number of children the programme has set out to reach.

Schools Summary Data

No. of CHCP Areas

Total No. of Schools

Total P1's Targeted

Total P2's

Targeted

Total P3'sTargeted

Total No. Targeted

Round 1(April 2010 - Oct

2010)8 141 4474 4353 0 8873

Round 2(Oct 2010 - April

2011)8 143 6447 6220 2827 11867

Round 3( April 2011 - June

2011)8 77 4129 3986 2764 7384

Grand Totals (R1-R3)

8 361 15050 14559 5591 28124

Please note, each ‘Round’ indicates 1 visit per school, for example: Round 1 = First visits for Primary 1 and Primary 2 children in targeted schools. Round 2 = Second visits for Primary 1, 2 and Primary 3 children in targeted schools

Childsmile School/Nursery Programme - Ongoing Work

Issue August 2011/2012 timetable to Education, OHAT’s, Children and Families Teams, School Nurses, GDP’s and relevant OHD colleagues

OHAT/CNN feedback and training session held on the 3rd Aug 2011 - designed to increase knowledge and share best practice, whilst feeding back detailed reports for each OHAT

EDDN/ OHE feedback and training session held on 8th Aug 2011 – designed to analyse detailed report per area, share best practice and create action plans for increasing consent and FV rates for upcoming visits.

Feedback to schools/nurseries relevant results from Round 1, 2 and 3

Childsmile Promotion Plan developed and implemented in Aug 2011 - Oral Health Educators and Extended Duties Dental Nurses created plan to promote Childsmile Core, Childsmile Schools and Nursery Programmes within targeted community locations i.e. Shopping centres, Health centres, Libraries, Language centres etc throughout NHSGGC, with the aim of increasing school Fluoride Varnish/Toothbrushing consent and uptake rates within targeted schools and nurseries, whilst promoting the key oral health messages.


5


6

Childsmile Core Programme As at June 2011, 97% of nurseries provide a toothbrushing programme within their establishment. All Nurseries including private and partnership, across NHSGGC have been offered resources and support by Oral Health Action Teams to provide toothbrushing programmes for all attending children.

Total number of nurseries providing a toothbrushing programme within their establishment.

CHCP Area Total number of Nurseries

Total number of Nurseries with Toothbrushing Programmes

Percentage of Nurseries with Toothbrushing

Programmes

East Dunbartonshire 51 49 96%

East Renfrewshire 31 31 100%

North East 75 70 93%

Inverclyde 33 33 100%

North West 91 90 99%

Renfrewshire 82 82 100%

South East 48 46 96%

West Dunbartonshire 33 33 100%

South West 47 44 94%

Total 491 478 97%


7

As at June 2011, 91% of children attending nurseries have valid consent to toothbrush. Total numbers of children attending nurseries with valid consent to toothbrush.

CHCP Area Total Number of Nurseries

Total Number of Children Attending Nurseries

Total Number of Children with valid

consents to toothbrush

Percentage of Children with valid

consents to toothbrush

East Dunbartonshire 51 3047 3005 99%

East Renfrewshire 31 2948 2948 100%

North East 75 5370 3810 71%

Inverclyde 33 1772 1772 100%

North West 91 5645 5224 93%

Renfrewshire 82 6302 6302 100%

South East 48 3062 2768 90%

West Dunbartonshire 33 2913 2913 100%

South West 47 3613 2832 78%

Total 491 34672 31574 91%

Schools Toothbrushing Programme report

As this is still very early in the academic year, not all school head teachers have indicated their participation in toothbrushing programmes this term.

The information below relates to head teachers who have indicated their schools will NOT be taking part this term.

Details of Schools indicating non- participating

SCHOOL INFORMATION

Area Number of schools

Number schools non - participating

GLASGOW CITY 144 50

EAST DUN 36 3

RENFREWSHIRE 49 5

WEST DUN 34 1

EAST REN 24 4

INVERCLYDE 22 5

TOTAL 309 68

Out of the 68 schools not participating 19 are in SIMD 1 and are all within Glasgow City

Action

OHEs are providing support to all schools by;

visiting schools to encouraging participation in toothbrushing programme delivering and picking up toothbrushing forms assisting with the delivery and pick up of fluoride varnish forms assisting with school and parent promotional visits assisting with toothbrushing programmes set up for the new term

List of schools and reasons for not participating sent to Head of Planning and Health Improvement for escalation to Senior CH(C)P and Education colleagues.


8


Glasgow Dental Hospital – Flood Damage, Progress Update

2 Report by

Karen Murray


30th September 2011

4 Contact number

0141 201 4217

5 Email address

[email protected]


86


11/60


Purpose of Report: To provide the Committee with an update on the progress in respect of the flood damage at Glasgow Dental Hospital. Background: During the evening of Monday 11 April 2011 there was a water escape from a filter that had been relocated as a temporary measure as part of the GDH infrastructure works. The flood damage was restricted to levels 1, 0 and basement levels of GDH. The original reinstatement costs were assessed at potentially £2.1m. Following the main strip out, drying out and equipment removals and as further and better information became available the costs were reassessed at circa £718k. The works have now progressed on the basis of revised estimates, tendered costs and equipment assessments and with reduced expenditure on some provisional items the cost liability is expected to be in the region of £467k as detailed below.

Recommendations:- The Committee are asked to note the current position and receive a further report once the liability position has been concluded.

Quality & Performance Committee 20 September 2011

Director of Oral Health and East Dunbartonshire CHP Paper No. 11/60

Glasgow Dental Hospital - Flood damage, progress update

Following agreement, in June 2011, to set aside funds for the flood damage reinstatement works and pursue the contractor’s insurers for all associated costs, works have now been completed and the areas occupied by University of Glasgow, NHS National Educations Services and post graduate teaching are all now operational with practical completion achieved on 2 August 2011. The main entrance door is still to be replaced over the course of September 2011. Recommendation: The QPC is asked to note the actions taken to facilitate reinstatement of the flood damaged areas within Glasgow Dental Hospital, and that negotiations remain ongoing with the contractor’s insurers, Zurich Insurance, for recovery of any allowable sums expended. 1 INTRODUCTION

During the evening of Monday 11 April 2011 there was a water escape from a filter that had been relocated as a temporary measure as part of the GDH infrastructure works. The flood damage was restricted to levels 1, 0 and basement levels of GDH. The original reinstatement costs were assessed at potentially £2.1m. Following the main strip out, drying out and equipment removals and as further and better information became available the costs were reassessed at circa £718k. The works have now progressed on the basis of revised estimates, tendered costs and equipment assessments and with reduced expenditure on some provisional items the cost liability is expected to be in the region of £467k as detailed below. The Board has made a claim in writing against APM Contracts for the damage reinstatement costs. It is understood that APM has made a consequential claim against one of its subcontractors Taylor & Fraser who, carried out the relocation of the filter identified as the source of the water leak. The contractor’s insurers are Zurich Insurance with Loss Adjuster Cunningham Lindsey appointed to act on their behalf. Separate independent expert reports have been commissioned by NHSGG&C and the Loss Adjusters with regard to establishing the cause of and liability for the water escape.

2. BACKGROUND

2.01 Infrastructure Works, Flood Incident & Damage A new water tank has been installed on Level 1 of the GDH. As part of the installation works and to assist with commissioning, it was agreed that APM could remove and reinstall a filter unit from the existing water tank on the roof of GDH to the new water tank on Level 1 as a temporary measure until a new filter unit was delivered to site.

Deleted: 18

The filter unit was relocated and installed on 6 April 2011 on Level 1. The filter unit and pipework were left under operating pressure from 9.30am on 11 April 2011. Sometime following end of normal operating hours on Monday 11 April 2011 the filter head partially opened and allowed water to escape until the water supply was isolated. The resultant flooding gave rise to damage to levels 1, 0 and basement of the GDH. The drying out exercise was completed at the end of May 2011 and then a full briefing, scoping and pricing document was prepared and issued for detailed costing of the required reinstatement works. Damaged equipment has been assessed by IT and other specialists identifying equipment that is salvageable and equipment that requires to be replaced. 2.02 Insurance Matters NHS GG&C have written to the APM Contracts and the appointed Loss Adjuster advising that it is the Board’s contention that the liability for the reinstatement cost of the damage is the responsibility of the Contractor due to an act or omission and/or negligence on their part arising from the works they were contracted to carry out. The opinion of the Independent Expert, commissioned by NHSGG&C, is that the liability for the damage sits with the Contractor and their subcontractor as all connections were not completed correctly and instructions to test the installation were not correctly followed when installing the filter unit. Alternative independent expert forensic reports have been commissioned by the insurers of APM Contracts and Taylor & Fraser. NHSGG&C are now awaiting confirmation of the areas of agreement between these experts, confirmation of the areas of difference and whether or not these are material to the failure of the filter. Potential areas of dispute may exist around the movement, installation, testing carried out and whether there was a significant difference in water pressure between the 9th and 1st floors of the GDH. NHS GG&C has advised the Loss Adjuster of the reduction in likely out-turn cost of the reinstatement works down from the initial estimate of £2.1m. Despite assurances to the contrary a written report has not yet been submitted by the insurers. 2.03 Reinstatement Programme An update on the reinstatement programme key milestones is:

Drying out to a level to allow scoping of works – 31 May 2011 Reinstatement Scope of Works agreed – 31 May 2011 Pricing information returned – 14 June 2011 Works commence – 18 July 2011 UoG Lecture Theatre completion – 25 July 2011 Works complete – 2 August 2011

All operational and clinical areas affected by the flood damage have been satisfactorily reinstated and are operating at normal capacity. The external door to the main Sauchiehall Street entrance was damaged by Strathclyde Fire and Rescue in their attempts to access the building. The roller shutter door was mended as a temporary measure and a replacement will be installed during September 2011. 2.04 Costs

All parties affected by the flood damage have been maintaining separate records of costs incurred that are directly attributable or as a consequence of the flood. The current cost estimates for the reinstatement works are identified in the table set out below and are a mix of actual costs incurred to date and provisional cost allowances: Flood Damage -Indicative Direct and Consequential Cost Summary Description Element £’s TOTAL £’s Strip out damage, emergency repairs, drying out – actual costs

73,000

Basement, Level 0 & Level 1 reinstatement works – tendered costs

187,000

Contingency 0 Works Sub total 260,000 All associated professional fees – 15% 57,000 VAT 63,400 SUB TOTAL - 1 380,400 380,400 Additional Cost Risk Elements Staffing 27,300 Structural 0 Removals 12,000 Decant 5,200 Asbestos removal 3,300 Equipment (NHS, NES, UoG) 24,000 Additional Elements Sub Total 71,800 VAT on above 14,360 SUB TOTAL – 2 86,160 86,160 TOTAL 466,560 3.00 Conclusion The Board will require to continue to make cost provision of a reduced sum, up to £467k, for the reinstatement works and consequential costs associated with the flood damage to GDH. The insurers have yet to provide a formal response on the claim made by NHSGG&C. A timeline for establishing the liability and thereafter the quantum of the claim has not yet been concluded . Communication from the loss adjustors for the contractor’s insurers was received on 13th September indicating that a meeting is scheduled for the week of 12th September with a sub-contractor’s loss adjuster to review the 3 forensic reports on the reasons for the flood. The insurers will respond to the Board’s claim following this meeting.

Karen Murray Director of Oral Health and East Dunbartonshire CHP Contact tel. No. 0141 201 4212


Finance Report

2 Report by

Head of Finance


30 September 2011

4 Contact number

0141 201 4774

5 Email address

[email protected]


87


11/61


Purpose of Report: Financial Monitoring Background Detailed in Executive Summary of report

Recommendations:- The Committee is asked to note the CHP’s financial performance.

East Dunbartonshire CHP

Finance Report for the period to 31 August 2011

2

Executive Summary

This summary report is prepared for each CHP Committee meeting and is designed to give the CHP Committee an overview of the CHP’s current financial position, year end out-turn forecast and progress towards achievement of cost savings targets. The report also includes an assessment of the potential impact of current and future financial risks on the CHP.

Detailed monthly financial reports are prepared by Management Accountants and issued to Heads of Service to facilitate financial monitoring and control. In addition, meetings are arranged with Heads of Service and their teams on a regular basis to discuss budgets and performance. On 1 August 2010 the CHP took on management responsibility for the Oral Health Directorate which was previously managed by the Board’s Acute Division. On 1 April 2011 the Oral Health Division’s chart of accounts was fully integrated with the CHP’s other budgets although separate budget reports are provided for the Directorate Management Team showing Oral Health expenditure.

The CHP is reporting an overspend of £92.1k for the first 5 months of the year against all budgets. The Oral Health Directorate has reported an underspend of £16.0k for the period to 31 August 2011 which is included in the overall overspend of £92.1k. CHP service budgets excluding prescribing are underspent by £11.9k.

The main financial challenges during the year are likely to be:

Prescribing expenditure;

Achievement of savings targets;

Successful realignment of budgets to meet the additional costs of the recently opened Dental facility at the Royal Alexandra Hospital; and

The impact of the Board’s overall financial position.

Further detail is provided on page 8 of this report.

As we approach the midpoint of the year the CHP is on track to achieve a breakeven out-turn for 2011/12 (excluding prescribing expenditure) and achieve savings target of £865k. However, this will be an extremely challenging year and the financial position will require to be very closely monitored during the remaining months of the year.

The CHP Committee is asked to note the financial performance for the first 5 months of the year.

3

Overall Financial Position

At 31 August 2011 the CHP’s revenue budgets show an overall overspend of £92.1k against a year to date budget of £32.8m.

Care Groups reporting overspend at this stage of the financial year are:

Accommodation & Administration Costs - £43.2k (includes an element of double running costs and non recurring property costs)

Community Mental Health Services - £4.9k

Learning Disability - £0.1k

Executive - £0.8k

The CHP has reported an overspend of £120k against primary care prescribing budgets for the period to 31 August 2011 representing the CHP’s share of the Board’s overspend of £1.5m The results for the first quarter of the year are currently being analysed but they appear to indicate that if the current trend continues the Board could incur an overspend of circa £1.9m for 2011/12.

In 2011/12 the Scottish Government has established a Change Fund of £70.0m to promote service improvements for Older People. The CHP in partnership with East Dunbartonshire Council and the Voluntary and Independent sectors will receive £1.2m of this fund and expenditure plans for this additional allocation have now been finalised for 2011/12.

4

Oral Health Service

From 1 August 2010 East Dunbartonshire CHP assumed responsibility for management of the Oral Health Service for NHS Greater Glasgow & Clyde. This is managed by a “hosting” arrangement where the CHP manages the service for the Greater Glasgow & Clyde NHS Board area.

With effect from 1 April 2011 the chart of accounts for Oral Health has been reassigned from the Acute Division to East Dunbartonshire CHP and is now reported as a Care Group within the CHP finance reports. Work is now under way to review the structure of the chart of accounts in order to design a more appropriate suite of finance reports for distribution to service managers within the Directorate. This work is due to be completed by November 2011.

At 31 August 2011 the Oral Health Directorate reported a surplus of £16.0k against a year to date net expenditure budget of £8.6m. Savings targets have been removed from budgets and at this stage the Directorate is reporting full achievement against this target although an element of this remains to be confirmed as recurring.

Within Secondary Care pay budgets are running ahead of budget by £136k mainly within medical staffing. In addition, non pay budgets are showing an overspend of £107k principally due to additional expenditure on instruments and sundries within the Glasgow Dental Hospital where pharmacy items are currently reporting an overspend of £177k. This is currently being reviewed to identify the underlying cause and assess the scope for remedial action.

Primary care budgets are showing a significant underspend in particular against pay budgets. The current exercise to review financial coding arrangements will include an assessment of whether budgets should be realigned to more accurately reflect current service provision.

.

Specialty

Annual Budget £000

YTD Budget £000

YTD Actual £000

Variance £000

Health Improvement 2,211.7 693.7 649.1 44.6

Primary Dental Services 11,123.0 4,306.3 4,052.0 254.3

Secondary Dental Services (GDH) 11,288.4 4,714.8 4,958.4 (243.6)

Administration 381.3 146.8 144.5 2.3

25,004.4 9,861.6 9,804.0 57.6

Recharge of Primary Care Costs to Non Cash Limited Funding (6,347.6) (2,477.1) (2,477.1) 0

Savings adjustments to be processed (17.9) (41.6) 0 (41.6)

Total 18,638.9 7,342.9 7,326.9 16.0

5

Savings (CHP)

Plans have been identified to achieve recurring savings with a full year effect of £309k in 2011/12. The above table shows the current position at 31 August 2011 where £116.4k of the recurring target is already being reported as fully achieved against a target of £126.8k. Tranche II savings of £31k will also require to be identified and delivered by the year end but outline plans for these are in place.

At this stage of the year it should be noted that item 2 above should be considered as being achieved non recurrently until the redesign process has been completed and the target for administration may need to be reviewed as at this stage it appears unlikely to be achieved in full.

However, notwithstanding the above comments the CHP is currently forecasting that the 2011/12 savings target will be achieved in full by 31 March 2012.

6

Savings (Oral Health)

Plans have been identified to achieve recurring savings with a full year effect of £500k in 2011/12. The above table shows the current position at 31 August 2011 where £208.3k of the recurring target is already being reported as fully achieved and plans are in place to achieve the balance by 31 March 2012. Tranche II savings of £31k will also be required to be identified and achieved by 31 March 2012.

However, at this stage of the year it should be noted that item 5 above should be considered as being achieved non recurrently until the posts in question are formally disestablished.

Progress towards achievement of the savings target will continue to be reported during the year as this will be a key factor in the Directorate’s ability to achieve a breakeven out-turn for 2011/12.

11/12 CYE

£000's

12/13 FYE

£000's

YTD Plan

YTD Actual

Forecast

1 Clerical Removal of vacancy Apr-11 G 34.0 34.0 14.2 14.2 34.0

2 Planning & HI Management restructuring Apr-11 G 45.0 60.0 18.8 18.8 45.0

3 AHP Removal of vacancy Apr-11 G 30.0 30.0 12.5 12.5 30.0

4 Health Education Non replacement of vacant posts (1.4 wte)

Apr-11 G 34.0 34.0 14.2 14.2 34.0

5 Medical Services Retirals/Vacancies (2 posts) Apr-11 A 250.0 250.0 104.2 104.2 250.0

6 Public Health Redesign following retiral of current postholder

Sep-11 G 57.0 57.0 23.8 23.8 57.0

7 Supplies budgets Review of budgets to identify areas for savings

Apr-11 G 35.0 35.0 14.6 14.6 35.0

8 Various Various non recurring measures Apr-11 A 15.0 6.3 6.3 15.0

500.0 500.0 208.3 208.3 500.0

Start Date

Risk Category (R/A/G)

Planned Cost Savings

TOTALS

Area of Focus Brief Description of Proposal(s)

7

Capital Programme

The Oral Health Directorate has a significant ongoing capital programme. The funding allocations as set out in the Board’s Capital Plan for 2011/12 are set out in the table above.

The Board’s current capital plan for 2011/12 also includes a specific capital allocation to develop the Alexandria Medical Centre which when completed will include facilities for community dental services.

This position will change significantly as the year progresses as funding will be made available to supplement the allocation for decontamination shown above to enable the proposal to develop a Central Decontamination Unit at the Glasgow Hospital to proceed during 2011/12.

At 31 August 2011 expenditure for the year to date was £337k.

Current Year Allocation

Spend to Date Balance

£k £k £k

Scheme

Dental Hospital - Phased upgrade 1,044.0 264.0 780.0

Royal Alexandra Hospital -Completion of Laboratory 170.0 - 170.0

Dental Equipment & Facilities 230.0 - 230.0

Decontamination - General Dental Practitioners 1,665.0 - 1,665.0

Flood Damage at Glasgow Dental Hospital 718.0 73.0 645.0

Total Oral Health Projects 3,827.0 337.0 3,490.0

8

Financial Risks

The most significant financial risks that will require to be managed during 2011/12 are:

Prescribing Expenditure – At this stage in the year prescribing expenditure is being reported as running £120k over budget for the CHP. The Board is currently reporting a prescribing overspend of £1.5m for the first 5 months of the year and the forecast year end position is currently an overspend of circa £1.9m;

Achievement of Savings Targets – At this early stage of the year savings targets are generally reported as being achieved. Full achievement of the CHP and OHD savings target will be important if the CHP is to achieve a breakeven year end position;

Successful realignment of budgets – The additional cost impact arising from the opening of the new dental facility at the Royal Alexandra Hospital has generated additional facilities costs. It will be necessary to review budgets to secure the funding required to meet the additional costs of the recently opened Dental facility; and

The Board’s overall out-turn – The Board’s most recently reported results for the period to 31 August 2011 showed a deficit of £4.0m against the budget for the year to date. The Board is forecasting a breakeven out- turn at this stage but to achieve this will be extremely challenging and will require full achievement of the Board’s savings target of £57.0m.

The CHP Committee will be updated on the financial position and the impact of existing and emerging risks at each meeting during the year.

East Dunbartonshire Community Health Partnership Committee Meeting - Friday 30th September 2011 Agenda Item Number: 88 Agenda Paper Number: 11/62 Report by Sandra Cairney Contact: 0141 201 3301 email: Sandra. [email protected]


Purpose of Report: To provide the committee with an update of the CHP performance against selected HEAT and GG&C targets. To give the CHP Committee members the opportunity to scrutinise performance and raise questions. Background The Performance Improvement Report forms part of the CHP’s routine performance mangement and reporting framework and is informed by a range of data. Recommendations:- The Committee are requested to note the contents of the report and consider any actions or recommendations from their review of the CHP performance data.

PIR Sept 11 1

Performance Improvement

Report

September 2011

Foreword The Performance Improvement Report (PIR) forms a part of the CHPs routine performance management and reporting framework and is informed by a range of data captured from electronic recording systems, audit or inspection data. The PIR is produced for every alternate Committee meeting and pays specific attention to our key targets and imperatives (HEAT targets, National Outcome Measures and local improvement targets). The intention is to develop a comprehensive performance monitoring system which informs service planning and development to achieve patient outcomes.

PIR Sept 11 2

CONTENTS

1 Acute Services 4 2 Adult Mental Health 5 3 Alcohol and Drugs 6 4 Children and Maternal Health 7 5 Long Term Conditions, Older People and Disability 8 6 Unplanned Care 9 7 Health Improvement 10 8 Effective Organisation, 11 9 Cancer 12 10 Quality 12 11 Sexual Health 12 12 Tackling Inequalities 12 13 Primary Care 13 14 Oral Health 14

PIR Sept 11 3

ACUTE SERVICES

Performance Measures As At E/D Actual 2010/11

E/Dun Target 2010/11

E/Dun Status

GG&C Actual

GG&C Status

E/Dun Direction of Travel

Reduce number of DNAs Jun11 9.8% 11.3% GREEN 13.8% RED ↑ Delayed discharge:

6 weeks Jun11 0 0 GREEN 21 RED ↑ < 6 weeks Jun11 19 N/A N/A 211 N/A ↑

Delayed discharge exception codes

6 weeks Jun11 4 N/A N/A 89 N/A → < 6 weeks Jun11 2 N/A N/A 12 N/A →

Delayed discharges, patients waiting over 6 weeks

0

5

10

15

20

25

30

35

NHSGGC 19 30 18 16 0 16 21 33

East Dunbartonshire CHP 0 0 0 0 0 0 0 0

Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11

Communication in place with East Dunbartonshire Council to discuss clients who are identified as being potential delayed discharges and regular integrated discharge meetings are held. East Dunbartonshire Social Work Department are currently trying to address the mental health officer (MHO) issues and interim funding has been approved through the Transformational Change Fund to increase the MHO capacity. This should improve performance with respect to the discharge of Elderly Mental Illness who are often subject to the Adults with Incapacty legislation.

PIR Sept 11 4

ADULT MENTAL HEALTH Performance Measures As At E/Dun

Actual 2010/11


E/Dun Status

GG&C Actual

GG&C Status


Reduction in anti-depressant prescribing (DDD per capita – GP list size)

Dec 10 32.02 N/A N/A 40.66 N/A ↓

Suicide Prevention Training Dec 10 51% 50% GREEN 36% AMBER ↑ Access to psychological therapies Delayed Discharge Adult Mental Health:

> 6 weeks June 11 0 0 GREEN 0 GREEN - < 6 weeks June 11 0 N/A N/A 0 N/A -

Delayed discharge exception codes > 6 weeks June 11 0 N/A N/A 0 N/A - < 6 weeks June 11 2 N/A N/A 12 N/A -

PCMHT Waiting Times Nov 10 4 weeks - - - - -

Anti-depressant DDDs (Defined Daily Dose) per Capita aged 15 years and over

0.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00

40.00

45.00

East Dun CHP 29.50 29.82 30.42 30.97 31.81 32.02

East Ren CHCP 34.53 34.71 35.10 35.49 36.16 36.33

NHSGGC 37.65 38.09 38.77 39.46 40.36 40.66

Oct 08 - Sep 09

Jan 09 - Dec 09

Apr 09 - Mar 10

Jul 09 - Jun 10

Oct 09 - Sep 10

Jan 10 - Dec 10

The trend for Defined Daily Dose (DDD) prescribing of anti-depressants continues to show a slight upward trend, which is consistent with the pattern across NHS GG&C and East Renfrewshire CHCP (as a comparator). Formulary compliance has been monitored by our prescribing team, and this shows a high level of compliance with the formulary across all practices. This information is reported to GP practices through individual practice prescribing review reports. 11 out of 17 practices participated in audit activity which focused on the impact of reviewing of patients who had been prescribed antidepressants for more than 15 months. This activity had a focus on patient safety and clinical effectiveness, helping ensure that our patients were receiving the correct drugs at the correct dose. Ensuring a review of this group also delivered a 5% reduction in DDDs and a 3% reduction in prescribing costs. As this audit only reported in March 2011, it is not clear what impact this will have on our next trend report. The PCMHT continues to perform well with regard to waiting times for assessment. Controlled self referral was introduced on 29th August 2011, which should further drive down the wait for assessment. The target for the team is to deliver a telephone based assessment within 3 working days of receipt of referral.

PIR Sept 11 5

ALCOHOL AND DRUGS

Performance Measures As At E/Dun

Actual 2010/11


E/Dun Status

GG&C Actual

GG&C Status


Drug Treatment: Referral to assessment date offered:

% <21 days Sept 10 93% 99% AMBER 95% AMBER ↑

Assessment to treatment date offered Sept 10 100% 96% GREEN 85% RED ↑ Number of Alcohol Brief Interventions

Apr-Jun 11

151 N/A 4423 N/A -

Number of HEAT staff trained to deliver ABIs

Mar11 44

Number of Non HEAT staff trained to deliver ABIs

Mar 11 33

Alcohol Fast Screening Tool Apr-Jun 11

1269 N/A N/A 16,067 N/A -

Proportion of GP practices signed up to deliver ABIs

2010/11 70.6% N/A N/A 71.5% N/A

Number of drug related deaths (per 100,000 pop)

2009 4.8 N/A N/A 16.7 N/A ↑

Reduce rate of alcohol related admissions

June 10 1.1 N/A N/A 2.6 N/A ↑

Alcohol Treatment: Referral to assessment date offered Sept 10 91% N/A N/A 82% N/A ↑

Referral to treatment date offered Sept 10 100% N/A N/A 81% N/A ↑

The CHP’s performance against the ABI target for the reporting year 2010-11 remained below the set target. The target for 2011-12 has not yet been set. Since the last report to the CHP Committee, one more practice has signed up to deliver ABIs, with 12 out of 17 practices now delivering this intervention. In partnership with East Dunbartonshire Council, we are working to build capacity to deliver ABIs through re-structuring the Glasgow Council for Alcohol input into East Dunbartonshire to focus more of this resource on ABI delivery. Finally, the CHP has expanded its ABI training capacity via the Health Improvement Team, which will help increase the numbers of frontline staff trained to deliver ABIs. We continue to perform well with our waiting times for referral to treatment and assessment to treatment for drugs. Alcohol treatment waiting times are now being formally reported and will become a HEAT target from March 2012.

Target

East Dun CHP

3000

2500

2000

1500

1000

500

0 Mar 11Apr 08 -

Dec 10Apr 08 -

Sep 10Apr 08 -

Jun 10Apr 08 -

Mar 10Apr 08 -

East Dun CHP 2,4102338212218351,644Target

14691410138913331070

ABIs Cumulative by Period for Year 2010-2011

PIR Sept 11 6

PIR Sept 11 7

CHILDREN AND MATERNAL HEALTH

Performance Measures As At E/Dun Actual 2010/11


E/Dun Status

GG&C Actual

GG&C Status


Number of children with completed IAF

167 ? ? N/A N/A

Breastfeeding: At birth Jun 11 57.7% N/A N/A 50.7% N/A ↓

At discharge Jun 11 46.3% N/A N/A 38.2% N/A ↓ At health visitors first visit Jun 11 37.6% N/A N/A 30.8 N/A ↓

6-8 weeks Jun 11 29.2% 44% RED 23.7% RED ↑ deprived Jun 11 19.2% 44% RED 15.5% RED →

Reduce the % of 3 – 5 year olds with decayed, missing or filled teeth

June 09 70% 60% GREEN 56% AMBER N/A

Number of 3 – 5 year olds registered with a dentist

Mar 11 83.5% 76% GREEN 86% GREEN N/A

Number of child fluoride varnishing applications

UNDER DEVELOPMENT -

Number of children completing 30% of child healthy weight intervention programme

Mar 11 13 25 RED 256 RED -

MMR: 24 months Mar 11 94.5% 95% AMBER 92.2% AMBER ↑

5 years Mar 11 94.5% 95% AMBER 96.6% GREEN ↓ Smoking in pregnancy Mar 11 10.5% 20% GREEN 16.3% GREEN ↑ Smoking in pregnancy most deprived quintile

Mar 11 32.4% N/A N/A 25.3% N/A ↑

Breast Feeding at 6-8 weeks

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

Exclusively Breastfed at 6-8w ks 31.4% 29.8% 29.8% 29.2%

15% most deprived data zones 19.4% 15.0% 16.3% 19.2%

Target 44% 44% 44% 44%

Oct 09-Sept 10 Jan 10-Dec 10 Apr 10-Mar 11 Apr 11-Jun11

Recently East Dunbartonshire CHP achieved UNICEF stage 3 award for breast feeding. We are awaiting the final report. The ACES programme has hosted 2 community programmes and a summer programme (awaiting confirmation of number completers from GG&C). One further community programme is being planned. The CHP has also hosted the Active Choices programme within local primary schools. 2 Sessions delivered to 4 schools with a total of 103 children completing the block of classes. It has been agreed to run one more session in 3 schools before end of calendar year. The programme is working to capacity; even with a key member of the staff resigning the delivery of the programme will continue as planned. Progress continues, CHP recorded the highest percentage of P1 children who have no sign of dental caries across NHS GGC in the latest P1 Dental inspection programme (NDIP) Partnership developed with Maternity hub to target pregnant woman who smoke has commenced and embedded itself into the service offered by the Cessation Team.

PIR Sept 11 8

LONG TERM CONDITIONS, OLDER PEOPLE & DISABILITY

Long Term Conditions



E/Dun Status

GG&C Actual

GG&C Status


Increase the number of Single Shared Assessments completed and shared

TBC 93

- - - - -

Long Term Conditions – Crude discharge rate (per 100,000 pop)

↑

COPD Mar 11 407.9 N/A N/A 685.7 N/A ↓ Asthma Mar 11 140.0 N/A N/A 183.7 N/A ↓

Diabetes Mar 11 86.9 N/A N/A 150.6 N/A ↑ CHD Mar 11 1301.1 N/A N/A 1233.1 N/A ↑

Older People Increase the level of older people with complex care needs receiving care at home

Mar 11 17.9% 36.0% RED 34.6% RED ↑

Number of patients on GP register with dementia

Mar 11 593 N/A N/A 9,245 GREEN ↑

Emergency bed days for patients aged 65 years+

Mar 11 18,889 N/A N/A 240,221 N/A -

Disability Increase the number of health checks provided to people with a learning disability

18 21 RED N/A N/A

LTC crude Discharge Rates per 100,000 pop

0

500

1000

1500

COPD 357.3 369.7 414.6 413.6 407.9

Asthma 101.3 106.0 113.7 134.7 140.4

Diabetes 84.1 75.5 74.5 81.2 86.9

CHD 1244.7 1299.2 1262.9 1314.5 1301.1

Apr 09 - Mar 10

Jul 09 - Jun 10

Oct 09 - Sep 10

Jan 10 - Dec 10

Apr 10 - Mar 11

We are progressing Change Fund proposals that should start to see an impact on performance towards the end of the year. We will be working with the Dementia Network and local GPs as well as the Senior Forum to have a dialogue about early diagnosis of patients with dementia. This will also relate to the performance measure of the number of patients recorded as being diagnosed with dementia on the GP register The Planning Manager recently presented data on unscheduled admissions at the GP forum and we are progressing the anticipatory care project with GP colleagues to help reduce these.

UNPLANNED CARE

As At E/Dun

Actual 2010/11


E/Dun Status

GG&C Actual

GG&C Status


New A&E attendances crude rate per 100,000 pop

Jun 10-May11

1694 GREEN 2887 GREEN ↑

A&E attendances referred by GP (per 100,000 pop)

May 11 151 N/A N/A 274 N/A ↓

A&E Attenders by Site by Month

0

100

200

300

400

500

600

700

800

900

1000

SGH 42 43 46 62 56 38 43 52 63 53 70 65 62 58

GRI 194 209 206 219 213 207 193 237 256 225 566 702 765 652

Stobhill 914 879 780 825 843 770 778 711 755 641 323

STO MIU 576 505 429 483 494 466 419 363 461 476 549 523 518 576

WIG 611 546 480 483 455 416 416 428 452 449 457 431 476 451

May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11

Total* 2337 2182 1941 2072 2061 1897 1 49 8 1791 1987 1844 1965 1721 1821 1737

East Dunbartonshire A&E attendances per 100,000 are the lowest across GG&C and the annual figures continue to show an overall decline. The above graph illustrates monthly A&E attendances of East Dunbartonshire by hospital. There is clear rise in the attendances at Glasgow Royal Infirmary corresponding with the closure of the Emergency Department at Stobhill. Attendance trends will continue to be monitored to assess change in patterns of attendance at the Stobhill Minor Injuries Unit and the effect on attendances at A&E in Glasgow Royal.

*(The total figures correlate with those provided in the graph and do not include the very small number that attend other A&E departments across GG&C).

PIR Sept 11 9

HEALTH IMPROVEMENT


Actual 2010/11


E/Dun Status

GG&C Actual

GG&C Status


Smoking Cessation: Quit Rate at 4 weeks Jun 11 554 320 GREEN 8,190 GREEN ↑

Quit Rate in Acute Jun 11 36% N/A N/A 35% N/A ↓ Quit Rate in Community Jun 11 64% N/A N/A 57% N/A ↓

Quit Rate in Maternity Jun 11 69% N/A N/A 39% N/A - Quit Rate in Pharmacy Jun 11 26% N/A N/A 30% N/A ↑

% Quit Rate in Community

50

52

54

56

58

60

62

64

66

East Dun 65 60 64 64

GG&C 55 56 57 57

Apr 08-Mar 09 Apr 09-Mar 10 Apr 10-Mar 11 Apr 11-Jun 11

Cessation figures at 4 weeks continue to increase. The CHP partnership with the Maternity hub to target pregnant woman has commenced, and further exploratory work with the Community Mental Health Team has also embedded itself into the service offered by the Cessation Team. Targeted support within SIMD areas is continuing, through combination of 1:1 and group sessions, whilst colleagues in Pharmacy are working in partnership to provide a seamless service option for clients.

PIR Sept 11 10

EFFECTIVE ORGANISATION


Actual 2010/11


E/Dun Status

GG&C Actual

GG&C Status


Sickness absence: May 11 5.4% 4.0% RED 4.9% RED ↑ Short term May 11 28.7% N/A N/A 31.7% N/A ↑ Long term May 11 71.3% N/A N/A 62.9% N/A ↓ Staff with an e-KSF (CHP) Jun 11 68.58% 80% RED 71.76% RED ↑ Staff with an eKSF (OHD) Jun 11 71% 80% AMBER

0.0%

2.0%

4.0%

6.0%

8.0%

East Dun CHP 4.5% 4.7% 5.1% 4.1% 4.6% 4.7% 4.9% 5.4%

GGC 5.4% 5.6% 6.0% 6.2% 5.5% 5.1% 4.5% 4.9%

Target 4.0% 4.0% 4.0% 4.0% 4.0% 4.0% 4.0% 4.0%

Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11

Sickness absence is monitored monthly and managed on an ongoing basis. The HEAT target has now become a standard with the expectation that NHS Boards aim to achieve 4% sickness absence levels as the standard. Managers are continually supported in ensuring that absence is managed and staff are supported during periods of ill health. The Committee also receive a separate detailed report on attendance at each Committee meeting in support of Staff governance

Sickness Absence Rate

PIR Sept 11 11

CANCER



E/Dun Status

GG&C Actual

GG&C Status


Uptake of HPV vaccinations Routine Cohort (S2)

2009/10 92.3% N/A 90.6% N/A -

HPV vaccinations Routine and Catch Up Cohorts (S2; S4 & S6)

2009/10 90.0% N/A N/A 87.2% N/A -

Uptake of cancer screening programmes:

Cervical Jun 11 82.4 80% GREEN 80% AMBER ↓ Bowel TBC 60.2% 60% GREEN - Breast Mar 11 79.1% 70% GREEN 70.9% GREEN -

QUALITY: CREATING A PERSON CENTRED AND MUTUAL NHS



E/Dun Status

GG&C Actual

GG&C Status


% of complaints received and responded to within 20 working days

Jun 11 100% N/A N/A 69.3% GREEN -

SEXUAL HEALTH

Uptake of LARC (Long Acting Reversible Contraceptive)

June 10 0.15% N/A N/A 1.8% GREEN ↓

TACKLING INEQUALITIES

Number of quality assured EQIAs completed

Dec 10 4 4 GREEN N/A N/A -

PIR Sept 11 12

PRIMARY CARE


Actual 2010/11


E/Dun Status

GG&C Actual

GG&C Status


48 hour access to appropriate GP practice team

May 11 94.9% 90% GREEN 95.4% GREEN -

Advance booking to an appropriate member of GP Practice teams

July 10 92.9% 90% GREEN 89.2% AMBER -

SCI Gateway referrals May 11 95% 90% GREEN 93% GREEN - AHP Waiting Times: ↓

Podiatry May 11 0 N/A N/A Physiotherapy May 11 177 N/A N/A -

Dietetics May 11 0 N/A N/A -

AHP Waiting time graphs

Investing some non-recurring slippage to reduce physiotherapy waits. Podiatry services in ED are contributing towards the Board wide re-design of podiatry services with intention of building capacity and reducing management costs.

Number waiting over target of 9wks Waiting times in weeks

30025

25020

20015

15010

100

5

50

0

0Jul- Aug- Oct- Nov- Dec- Mar-

Dietetics 0 0 1 0 1 2 1 0 0 0 2 0

Physio 222 262 262 229 267 197 234 169 138 121 77 177

Podiatry 36 0 0 0 0 0 15 20 0 0 0 0

Jun-10 10 10

Sep-10 10 10 10

Jan-11

Feb-11 11

Apr -11

May-11

Dietetics 5 10 7 7 11 7 6 7 8 10 7 8

Physios 17 16 19 18 16 17 19 21 22 22 19 19

Podiatry 0 8 9 8 0 0 8 7 7 7 9 0

Jun-10

Jul-10

Aug-10

Sep-10

Oct-10

Nov-10

Dec-10

Jan- Feb-11 11

Mar- 11

Apr- 11

May- 11

PIR Sept 11 13

ORAL HEALTH

Performance Measures As At GG&C

2010 Actual

GG&C 2010/11 Target

GG&C Status

Direction of Travel

60% of all 5 year olds (P1) with no sign of dental disease 2010 58.2% 60% Amber

60% of 11 year olds (P7) with no sign of dental disease 2009 58.5% 60% Amber

100% of Nursery Schools participating in tooth brushing schemes in school year 2010/11

June 2011

97% 100% Amber

100% of Primary Schools in most deprived SIMD quintile participating in tooth brushing schemes in school year 2010/11

June 2011

88% 100% Amber

80% of 3-5 year olds to be registered with a dentist by 2010/11 Dec 2010

85% 80% Green

By 2010 increase child registrations to 85% (0-17 years) Dec 2010

84.2% 85% Amber

Increase adult (under 65 years) registrations to 65% by 2010 Dec 2010

71.9% 65% Green

Increase the numbers of elderly registered to 50% by 2010 (65-74) (75+)

Dec 2010

61.7% 52.7%

50% Green

All GDPs must be Glennie compliant by 31/12/12 Aug 11 90.3% 100%

Updated results for 2010/11 will not be available until Dec 2011.

Childsmile Core / Nursery and school toothbrushing Nurseries Nurseries 478 out of 491 (97%) provide a toothbrushing programme.

The 13 nurseries not offering a toothbrushing programme are unable/unwilling to participate due to time and staff constraints. Action taken:

Escalation to Director of Education by East Glasgow CHP Chairman Future plans include:

Audit of parent & school (participating and non participating) to identify barriers to toothbrushing programme Continuing with Gladigator oral health advice visits.

Schools 260 out of 309 schools are participating in the school toothbrushing programme ( 84% of NHSGG&C schools) For SIMD1 there are 15 out of 122 schools toothbrushing (88%). 15 SIMD 1 schools are not toothbrushing.

Actions taken to target non participating schools:

Operational Services Manager (Children) visiting schools to discuss options to get the programme started. List of schools and reasons for non participation sent to Head of Planning and Health Improvement and Quality Improvement

Officers for escalation to Senior CH(C) P and Education colleagues. Childsmile Practice GGC have recruited 162 GDPs to date. This is 65% of all practices in NHSGGC. Childsmsile Practices identified with low activity (approx 25 practices) were targeted in Spring 2011 with promotional visits via Childsmile Managers. A Childsmile Awareness event is planned for September 2011 where the unsigned dental practices will be invited to attend to increase their awareness of Childsmile and encouraged to sign on to become Childsmile practices. Childsmile Schools (Fluoride Varnish Programme) Round 1 (29th March – 26th October, 2010)

• The Childsmile School Fluoride Varnishing Teams completed the first round of varnishing for 141 schools between the 29th March and the 26th October 2010.

• We have provided varnishing services to the consented Primary 1 and 2 children within these schools covering 8 CHP areas.

• During this first round of applications we targeted 8736 children, received 5765 consents (66%) and varnished 4597

PIR Sept 11 14

PIR Sept 11 15

children (52%) Round 2 (27th October – April 2011)

• The second round of varnishing commenced on 27th October 2010, where 143 schools were targeted which included Primary 3 children.

• During this round of applications we targeted 11867 children, received 8452 consents (71%) and varnished 6630 children (56%)

Round 3 (April 2011 – Autumn 2011) • The 3rd round of varnishing commenced in April 2011 targeting 143 schools of p1, p2 and p3 children.

Total Results to Date • Total children targeted = 28137, Total number of consents returned = 19309 (69%), Total number of FV applications =

15402 (55%). Childsmile Nurseries (Fluoride Varnish Programme) Programme commenced 23 February 2011, initially targeting North Glasgow Nurseries and then being rolled out across NHSGGC for twice yearly fluoride varnish applications for 3 and 4 year olds as per 2014 HEAT target. A total of 87nurseries (18% of nurseries in NHSGGC) are included in the programme. These are feeder nurseries for the 50 schools identified as having the highest percentage of SIMD 1 children enrolled in P1 and P2. Total Children targeted: 5759 Total Consents returned:4028 (70%) Number of fluoride varnish applications completed: 2833 (49% of total children targeted)


HR Report

2 Report by

Serena Barnatt


30 September 2011

4 Contact number

01389812304

5 Email address

[email protected]


89


11/63


Purpose of Report: To provide the commitee with an HR update on:

1. Attendance Management 2. KSF

Background This paper provides the committee with an update on how the CHP is performing in relation to contributing to towards the NHS Boards target for attendance management and KSF Recommendations:- Committee are asked to note this report and receive further updates.

1. HR Update This paper provides the committee with an update on how the CHP is performing in relation to contributing towards the NHS Board’s target for attendance management and information relating to the KSF target. The committee are also asked to approve the use of the Staff Governance Monitoring Frameworks for East Dunbartonshire CHP and Oral Health Directorate. 2. Attendance Management The NHS in Scotland has an ongoing national target of 4 percent sickness absence across all services. The current absence rate for the CHP during May 2011 was 5.38 %. which is an increase on the previous month. The average for the CHP from start of current financial year was 4.67%.

CHP Overall OHD Only Month % % April 4.87 2.81 May 5.38 3.45 June 4.59 3.23 July 3.84 2.40 Average 4.67 2.97 As part of corporate reporting, the CHP has been asked to present a monthly breakdown of long and short term absence. This is will now be included in the Committee report also. These figures are an average for the CHP and is one of the performance measures used as part of OPR process. Break down of Long and short term absence for CHP Overall Month Long term % Short term % April 3.22 1.65 May 3.84 1.54 June 3.40 1.20 July 2.51 1.32

Break down of Long and short term absence for OHD only Month Long term % Short term % April 1.77 1.05 May 1.96 1.50 June 2.02 1.21 July 1.38 1.02 It is important to note with respect to the 4% target, the CHP will be assessed on its total staffing which includes the oral health directorate therefore we will be required to report absence in this way. The CHP and Oral Health will continue to monitor the level of sickness absence but reporting absence figures is only one facet of a number of measures the CHP/Oral Health is implementing to achieve this target. As a CHP we want to ensure appropriate methods are in place to support staff during ill health in line with positive supportive practices around Staff Governance and implementation of Healthy Working Lives locally. 3. KSF NHS Boards have recently been provided confirmation of the KSF/PDP targets. You will be aware that NHSGGC met the March 2011 HEAT target on KSF with a compliance rate of 85% (target 80%) and the CHP achieved 80%. As with previous HEAT targets, such as sickness absence, this now becomes a Service Standard. Tthe standard is as follows and will continue to be reported to SMT, SPF, Corporate Management Team for OPRs, Area Partnership Forum and the Staff Governance Committee:

Every employee covered by Agenda for Change has an annual KSF, PDP and Review meeting

with their manager/reviewer with summary information from that meeting recorded on e-KSF. The table below show the performance the CHP is making towards the service standard. Table 1 shows overall performance while Table 2 shows performance for OHD. Table 1: KSF/PDP position for CHP overall

Jun Jul Aug Sep Oct Nov Dec KSF % 57.5 65 68 PDP % 62 59 60.5 ED Trajectory % 80 80 80 80 80 80 80

Table 2: KSF/PDP position for OHD only Jun Jul Aug Sep Oct Nov Dec KSF review % 71 71 75 PDP % 59 59.5 61.5 ED Trajectory % 80 80 80 80 80 80 80

In addition to the service standard above, the Board’s performance will continue to be annually monitored by the Scottish Government Health Directorate. This will be achieved through a new target which is part of the Workforce Engagement measures within the Healthcare Quality Outcomes Framework; one of which will be: - The number of staff participating in learning and development activities as demonstrated by

agreed and completed PDP activities recorded on e-KSF. The expectation is that this indicator will increase over a 2 – 3 year period. There is no target to be achieved by a certain date. This information is expected to be gathered through the e-KSF tool and we await confirmation how this will be measured. Conclusion The committees are asked to note this update.


CHP Committee Governance Arrangements

2 Report by

CHP Director


30th September 2011

4 Contact number

0141 201 4212

5 Email address

[email protected]


90


11/64


Purpose of Report: To advise the Committee of the changes to Board Governance arrangements which include the establishment of the Quality & Performance Committee as a Sub-Committee of the Board and the requirement for CHPs to adopt core elements of reporting to each Committee. Background The Quality & Performance Commitee identified the importance of ensuring consistency in the way in which each Committee fufills its financial, service, clinical and staff governance responsibilities which each Commitee carries as a Sub-Committee of the NHS Board. Recommendations:- The Committee are asked to note:- The core content of reports to be provided in the annual reporting cycle. That the CHP Chair and Director will be invited once each year to report to the Quality &

Performance Committee on key issues described in Section 3 of the attached Report.


NHS GREATER GLASGOW AND CLYDE

QUALITY AND PERFORMANCE COMMITTEE 20 September 2011 Paper No. 11/63

CH(C)P COMMITTEE GOVERNANCE ARRANGEMENTS GUIDANCE ON CORE CONTENT TO CH(C)P COMMITTEES

1. BACKGROUND AND INTRODUCTION

1.1 The changes to Board governance arrangements including the recent establishment of the Quality and Performance Committee, as a sub-Committee of the NHS Board, raised the importance of ensuring consistency in the way in which the CH(C)P Committees fulfill the financial, service, clinical and staff governance responsibilities which they carry as sub-Committees of the NHS Board.

1.2 This paper proposes the core elements that CH(C)Ps should ensure are included in reporting to their Committees.

1.3 The Quality and Performance Committee will also provide a forum for discussion on CH(C)P performance as a regular part of its meetings.

1.4 In the case of integrated CHCPs, this paper covers only the NHS governance requirements.

2. CORE CONTENT - CHP COMMITTEE

2.1 Within an annual cycle of reporting to a CH(C)P Committee, the following core topics should be reported to Committee:

Item Frequency Key Dates

Process for developing the Local Development Plan

Annual Following issue of Planning Guidance - November

Draft Development Plan - Key service issues digest - draft financial and

workforce plan - final draft service/workforce

and financial plan

Annual for each element

November November January

Final Development Plan Annual March

Reports on financial performance, including revenue position and the annual budget column

All meetings N/A

Outcomes and action plans from OPRs 6 monthly Spring / Autumn

Item Frequency Key Dates

Outcomes of inspections and associated improvement plans for example HMIE and Mental Welfare Commission.

Ad hoc N/A

Plans and progress in relation to any significant services change

Ad hoc N/A

Reports from PPF Minimum 6 monthly

TBC

Clinical governance Annual Report and Action Plan Annual N/A

Progress against the Older People’s Change Fund, and any other areas of significant new expenditure

All meetings, until subsumed into planning and performance cycle

N/A

Regular performance reports incorporating progress on contribution to HEAT targets, and other key Board and CH(C)P performance indicators

Minimum – every other meeting

N/A

Outcomes of and action plans in response to patient or staff surveys

Ad hoc N/A

Risk Register - including risk assessment of equalities legislation

Annual N/A

Staff governance Twice each year TBC

3. CORE CONTENT - BOARD’S QUALITY AND PERFORMANCE SUB COMMITTEE

3.1 Once per year, each CH(C)P will be asked to discuss at the Quality and Performance Sub Committee: - key issues emerging from the CH(C)P Committee scrutiny of financial, service,

clinical and staff governance; - performance of the PPF and issues arising; - the outcome of the OPR - An overview of the most significant challenges and risks facing the CH(C)P.

3.2 The CH(C)P Chair and Director will be asked to attend the meeting to discuss this

material with other Committee members as they wish. 4. RECOMMENDATION

Committee members are asked to note the guidance on the core content to be reported to CHP Committee, and the role of the Quality and Performance Sub Committee.

Jo Gibson Head of Performance and Corporate Reporting

Issue – August 2011

Robert Calderwood, Chief Executive talks about:

Investment in capital programme Recent team briefs have focused on the development of our savings plans to improve efficiencies and achieve financial balance within the pressures that we face. Despite these challenges, we still continue to invest in new services and facilities and I was delighted recently to go to the new pharmacy distribution centre to see firsthand how the investment in this state-of-the-art technology is transforming the distribution of medicines to our hospitals sites whilst freeing up skilled pharmacists to work on wards. This is only one of a number of developments that have been completed in recent months. The new super-kitchen at the Inverclyde Royal Hospital, one of two that will provide all hospital catering services for NHSGGC, has also opened and around a hundred staff have now transferred into their new improved working environment. Other new developments include a modern endoscopy suite at the IRH, the opening of the first of four new multi-storey public and staff car parks at the Southern General, investment in new equipment including a second PET scanner at the Beatson and the new £18 million Barrhead Health and Social Care Centre which recently opened its doors to patients. This year alone NHSGGC is planning to spend £248 million on capital projects. In a period of eight years, from the opening of the Beatson in 2007 to 2015 when the new South Glasgow is completed, the Board will have invested around £2bn in new and modernised healthcare estate across our acute, primary care and mental health services.

Social media policy and code of conduct Colleagues will be aware that there is currently a ban on NHSGGC staff using social networking sites in the workplace. We do recognise the potential for these sites to offer opportunities for engaging with our patients and communities and the Board will be now taking forward the development of a policy on the use of social media, such as Facebook and Twitter, for corporate purposes. Colleagues may also be aware that there have been a number of instances where inappropriate information has been posted by NHSGGC employees on social media including cases where disciplinary action has resulted. It is therefore also our intention to develop a code of conduct on the personal use of social media by NHSGGC staff. The aim is for both polices to be implemented by early 2012 but in the meantime I would remind colleagues that the responsibilities and obligations as set out in our terms of employment and the Board’s code of conduct also apply in relation to our conduct on social networking sites. This includes the absolute requirement to maintain patient confidentiality at all times. On a more general note, as you will be aware, we have a legal obligation to ensure that the confidentiality and integrity, of data contained within our IT environment, is maintained. I would remind everyone of their responsibility to maintain an adequate level of IT security and for ensuring that they are suitably protected from security risks.

Robert Calderwood Chief Executive

Comments/feedback to:

[email protected]


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August 2011

VOLUNTEERING SUCCESS

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The CHP has recently been awarded the ‘Investing in Volunteers’ standard. This charter demonstrates commitment and success towards ensuring that those who volunteer with the CHP are supported and developed to the highest standard. On the evening of the 12th of July an event to recognise the achievements, commitment and contributions that volunteers have made to CHP, was held in the KHCC. Sixteen of the our 20 volunteers were in attendance to receive their award from Sandra Cairney, Head of Planning and Health Improvement and to be thanked for their contribution to the Youth Health Drop in Service – Ourspace, The Breastfeeding Peer Support Programme and the East Dunbartonshire Food Co-Op.

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ON THE COURSE – TO BETTER HEALTH

I grew up in a heavy industrial town in the north west of England where no one I met had ever played golf. It wasn’t until I met my husband that I was even aware of the game, and until recently, I only ever played, for fun, with my husband and son. About 5 years ago I joined a golf club for the first time and started to play regularly with other lady members and acquired a handicap so that I could participate in the ladies competition. I’ve never looked back, despite my high handicap (or possibly because of it!) I’ve even won a competition or two and reduced my handicap.

Karen Murray

CHP Director

DISTRICT NURSING REVIEW

GGC are currently undertaking a review of District Nursing Services, incorporating Releasing Time to Care, to determine the future service model. Within East Dunbartonshire a local implementation group has been formed and met for the first time on 04th July and agreed Terms of Reference and a Communication Strategy. The group includes a GP representative and the following DN representatives; Colette Connolly (Milngavie/Bearsden), Vivienne Davidson (Bishopbriggs) and Susan Walthew (Kirkintilloch/Lennoxtown). The Representatives are happy to discuss the content of the meeting with any interested staff or staff group and bring the views of the wider teams to the meetings. Leanne Connell, Practice Development Nurse for Adult Nursing will also be happy to discuss the work of the local group which has identified the current priorities as Absence Management, Band 6 Development Programme and eKSF.

FOND FAREWELL

The Health Improvement Team said a fond farewell to Meggan Jameson who has left to take up a post as a Volunteer Manager for a Charity based in Edinburgh. Our thanks and best wishes are extended to Meggan for all her hard work and dedication to her post. Meggan will not only be missed by the team but by the many partners and young people who she worked alongside. Good luck Meggan!

What I like about golf is being out in the fresh air, usually in lovely settings (the photograph is taken on the second tee at Traigh Golf Course in Arisaig with Eigg and Rhum in the background) and the opportunity to play with many different people over the course of a golf season. It’s a great way to take 3 hours out of a busy schedule and relax and walking the course keeps me fit and happy.

So why not try it! There’s never been a better time to join a club than at the moment and many clubs are looking for new members.

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STAFF GOVERNANCE FRAMEWORK

As you aware all staff across NHS Scotland were asked to complete a staff survey questionnaire. This process happens every two years and the results are then shared across Scotland and broken down into Board and Service areas. The survey is anonymous so all we receive are responses to each of the questions in the form of percentages. For East Dunbartonshire CHP we have always used the results to inform our Staff Governance Monitoring Framework which has been in place since 2007. This identifies what actions we plan to take forward as direct result of the survey results. This process is overseen by the Staff Partnership Forum and trade union and professional organisation representatives input into updating the framework. The latest monitoring framework has been agreed by the CHP Committee on Friday 29th July. Staff participation in completing the survey directly influence s what the CHP plan to take forward and that is why I am keen to encourage staff to continue to complete the staff survey every second year .

A priority area we have identified is staff engagement and this is something you will see being taken forward by the CHP in the forthcoming year. We are conscious the CHP response rate dropped this time round and there were some responses which identified areas which we could improve on. W e would like to look at these areas as a direct result of the survey results and the staff engagement sessions will be an opportunity for staff to be involved. There are also areas where we have improved and we would like to share these with staff and look at how we continue to develop. We are planning to ask team leads to ask their teams how you would like these sessions delivered.

A copy of the results and the monitoring framework will available on the CHP intranet site shortly.

Karen Murray

CHP Director

HOBSON’S CHOICE – SADDLE SORE AND PROUD!!

James said: “I had never cycled for 70 miles in a day before and the thought of doing it four days in a row made me a bit apprehensive but although it was tough in parts it wasn’t as hard as I thought it might be although despite the padded shorts and other precautionary measures I was a bit sore at the end of the trip.

“However, it was a real sense of achievement when we rode along the Seine into Paris. The next stage would be Paris to Munich next year and I would quite like to do that.”

When James Hobson announced that he was planning a cycle trip this month he didn’t mean around his native Newton Mearns.

For James, head of finance, has just returned from a more ambitious cyclethon travelling from London to Paris, covering 280 miles in four days!

He has also raised around £600 for two causes, the Royal National Institute for the Blind (RNIB) and St Mirren Basketball Club’s Under 18 team, his son is a member of the squad, who are fundraising to travel to the USA for a tournament in October.

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Amazingly he only revived his interest in cycling two years ago: “I have always really enjoyed cycling and I cycled a lot when I was a teenager basically we lived out in the country and it was the only way for me to get around.

“Then when I was a student in Belfast I used my bike to go to university from our flat and also used it sometimes to travel back home at weekends. However, after that work and kids and cars took over and for many years I didn’t even so much as own a bike.

“Two years ago a couple of my colleagues took advantage of the Board’s cycle to work scheme (the details are on Staffnet) to obtain new bikes and I thought it seemed like a good opportunity to get a decent bike at a good price.”

Now James cycles to work three or four days a week, a round trip of 24 miles, and also uses his bike to travel between bases: “It is just as quick as a car for getting around Glasgow and it saves me around £60 per month in petrol!”

He went on: I have found my general fitness has improved and I’m also much more alert and energetic and I believe there is firm evidence that cycling can have a positive impact on an individual’s general mental well-being.”

Pictured right: James in Paris after his successful cycle

WE NEED YOUR INPUT!! Please remember that the purpose of the Team Brief is for the sharing of local information and we are looking for any examples of good news or good practice within East Dunbartonshire CHP.

If you have a submission for, or any comments regarding the Team Brief, please submit this through your line manger or directly to [email protected]

PAPER No. 11/65C

If you have any items that you would like to have included in the Oral Health Directorate Team Brief, you can send these direct to Linda Armstrong, Clinical Governance Officer, [email protected]

tel: 0141 232 9701.

Issue – August 2011

ORAL HEALTH DIRECTORATE BRIEF Ministerial Visit to Bridgeton Health Centre A newly redesigned service to take away the fear of attending the dentist for autistic children was officially opened by Public Health Minister Michael Matheson on 14 July 2011. The service, at Bridgeton Health Centre has been developed by Lyndsay Ovenstone, Senior Dental Officer and Debbie Connelly, Health Improvement Senior for Oral Health, has received a positive response from patients. Congratulations to all those involved. Childsmile During July and August Childsmile clinical activity is reduced but the teams have been making excellent use of this time to engage with the wider communities and are planning and implementing a series of events. Extended Duties Dental Nurses have assisted with further training for Childsmile Nursery Nurses (CNNs) regarding the consenting progress for the schools/nursery programme. They have been distributing promotional packs which aim to increase fluoride varnish consent rates within schools/nurseries. Local supermarkets, libraries, health centres and language centres near the targeted schools/nurseries for the Fluoride Varnishing Programme will be targeted to increase awareness of the Childsmile Programme. An Oral Health Action Team (OHAT)/CNN feedback event is planned for 3rd Aug 2011, where detailed reports for each OHAT will be shared. A Childsmile Practice Dental Health Support Worker event is scheduled to take place on 24th Aug 2011. This is aimed at encouraging increased activity within practices. A General Dental Practitioner Childsmile awareness evening event is also being planned for mid September 2011. Scottish Public Services Ombudsman (SPSO) The SPSO Commentary for May 2011 has been released. It provides details of any health sector investigation reports laid before the Scottish Parliament. It also summaries the cases and highlights trends and issues brought out by the investigations. Any issues or learning points that are relevant to your areas should be shared with staff. A recent report, whilst not upholding the complaint, identified the following two issues which were regarded as poor practice: The reason for clinical decisions should be clearly documented. Abnormal results should not be communicated to patients or carers by non clinical staff. The full reports along with the Commentaries can be accessed on the Ombudsman website www.spso.org.uk/reports. Forthcoming Events Details will be issued shortly about the following events, so please note the dates for your diary: Clinical Governance Event: 9.00am – 4.00pm on Tuesday 22 November 2011, in the GTG Training Centre, Glasgow. PFPI Awareness Event: 1.30 – 4.30pm, Friday 7 October 2011, Lecture Theatre 1, the University Building, Glasgow Royal Infirmary. Professional Registration Registration will have been checked and recorded by all line managers last month. It is important that completeness of documentation and reports to CSMs are now submitted. Retirement - David McCall, Consultant in Dental Public Health David McCall, Consultant in Dental Public Health is due to retire on 31 August 2011, after 38 years service in the NHS. I am sure you would want to join me in acknowledging this achievement and wish him a long and happy retirement.

http://www.spso.org.uk/reports

PAPER No. 11/65D

September 2011

CHAIRMAN’S AWARD – WOODLANDS CENTRE GARDEN PROJECT

Congratulations to The Woodlands Centre Garden Project for achieving this year’s Chairman Award. This award recognises the project as being an excellent example of secondary care based health improvement with multiple benefits identified for clients. In addition to this, Nurses Allan Spencer and David Brown, who have facilitated the project on behalf of the team, have been nominated in the Nurses category by carers for their work on this project.

The official open day of the garden took place on Tuesday 23rd August and was a great success. Over 40 people attended which included clients and their carers, East Dunbartonshire CHP managers, Social Work managers, Fiona McLeod MSP as well as local councillors.

The day was also supported by Ceartas Advocacy, Carers Link, Alzheimer Scotland and the Healthy Habits organisations who are all very active in supporting the work of the Woodlands Centre.

Work on the project continues with the next steps being preparing the garden for autumn and sourcing glazing for the greenhouse. The clients are also beginning to work on a 2012 calendar which will double as a memory aid and will include important local contact numbers and service information.

If you would like further information on the Woodlands Centre Garden Project, please contact David

Brown on [email protected] or on 0141 232 7300.

UNICEF BABY FRIENDLY AWARD

East Dunbartonshire CHP's Health Visiting Team in Kirkintilloch and Bishopbriggs successfully passed the UNICEF Baby Friendly final assessment on 18th August 2011 and are now, along with the local GP practices, fully accredited.

The Baby Friendly Initiative is a worldwide programme of the World Health Organisation and UNICEF. It was established in 1992 to encourage maternity hospitals to implement the Ten Steps to Successful Breastfeeding and to practise in accordance with the International Code of Marketing of Breast milk Substitutes.

The Baby Friendly Initiative works with the health-care system to ensure a high standard of care in relation to infant feeding for pregnant women and mothers and babies. Support is provided for healthcare facilities that are seeking to implement best practice, and an assessment and accreditation process recognises those that have achieved the required standard.

The accreditation is subject to annual internal audit and an official re-assessment by UNICEF in two years time to ensure that the standards set continue to be met.

Congratulations go out to the staff within East Dunbartonshire for their ongoing work, commitment and enthusiasm in supporting breastfeeding mothers.

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http://www.unicef.org.uk/BabyFriendly/Health-Professionals/Going-Baby-Friendly/Maternity/Ten-Steps-to-Successful-Breastfeeding/

http://www.unicef.org.uk/BabyFriendly/Health-Professionals/Going-Baby-Friendly/Maternity/Ten-Steps-to-Successful-Breastfeeding/

http://www.unicef.org.uk/BabyFriendly/Health-Professionals/Going-Baby-Friendly/Maternity/The-International-Code-of-Marketing-of-Breastmilk-Substitutes-/

http://www.unicef.org.uk/BabyFriendly/Health-Professionals/Going-Baby-Friendly/Maternity/The-International-Code-of-Marketing-of-Breastmilk-Substitutes-/

http://www.unicef.org.uk/BabyFriendly/Health-Professionals/Going-Baby-Friendly/

http://www.unicef.org.uk/BabyFriendly/Health-Professionals/Going-Baby-Friendly/

Well done!

For further information please contact Jennifer Duffy, Infant Feeding Development Nurse, Tel: 07766085260 or email [email protected]

I returned to Glasgow three years ago after working in Wales for thirty years. Relocating meant I had a huge learning curve not only in relation to my new role with East Dunbartonshire CHP but also in getting to know the country I left when I was only 17 years old. I joined the Glasgow Hill Walking Group and despite the pain from muscles I hadn’t used in years, I really enjoyed getting physically fit at the same time as soaking up the most beautiful scenery in the UK. I have climbed quite a few Munros’ and Corbetts, as well as completing lots of coastal walks.

With my fiftieth birthday fast approaching and having never learned to ride a bike, this was a challenge I wanted to tackle. Last October I plucked up the courage, bought a bike and wobbled around Bellahouston Park until I could cycle in a straight line without falling off. I will never be an Olympic contender but just ten months later I’m reasonably proficient and have cycled along cycle routes across Kirkintilloch, Glasgow, the West of Scotland and as far as the Outer Hebrides. Walking and cycling are now weekly pursuits that keep me fit, encourage me to explore Scotland and recently have stimulated my new photography hobby.

Sandra Cairney


HEALTHY WORKING LIVES STAFF SURVEY Thank you to the 117 staff (47% of the CHP workforce) who completed and returned the recent Healthy Working Lives online health needs survey. The results have been compared with the 2007 survey and will be used to inform the HWL strategy and action plan. The main findings are given below. Compared to the previous survey more staff were aware of NHSGGC Occupational Health services but less were aware of services for confidential counselling. There was increased awareness of policies or statements of intent / information with the lowest awareness around mental health in the workplace. Workplace concerns were mainly for workspace, noise, lighting, temperature and equipment. There was high awareness for Health & Safety reporting but less staff knew for who was responsible for assessing staff H&S risks. More staff never consume alcohol and less have alcohol on 1-5 days per week. More accumulated 30 minutes of moderate physical activity per week on 5 days or more but less accumulated this amount on 1-4 days. Similar numbers to the previous survey had on average 5 or more portions of fruit and vegetables per day. Less smoked and more who smoked would like to cut down or stop smoking. Less staff knew if their employer promoted good

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PAPER No. 11/65D

practice by supporting staff who may be experiencing mental health problems. A higher percentage felt they could approach their employer for support.

The full report is available from [email protected]

WELL DONE!! The Children and Family Team would like to say a BIG well done to Brenda Walker, School Nurse for

being awarded the professional qualification of Specialist Community Public Health Nurse. Congratulations Brenda!

READINESS TO LEARN PILOT

Following the publication of Hall 4: A Refresh of Health for All Children (Cel 15, 2010), Greater and Glasgow & Clyde have taken the decision to implement a population wide assessment of all children at age 30 months. The focus of the assessment is to establish a child’s readiness to learn and will focus on assessing Speech and Communication as well as Behaviour and Family Functioning. To establish robust implementation plans for the introduction of the assessment, a pilot project has been undertaken in 4 sites throughout Glasgow and Clyde in August 2011 to test the operation and effectiveness of the contact. Wendy Mitchell, Senior Nurse supported by the PDN, Team Leaders and Health Visitors in East Dunbartonshire has taken the lead in the production of the guidance and evaluation documentation for the pilot. The contribution of Health Visitors during the pilot assessments undertaken at a particularly busy time of year is valued and recognised. This contribution will continue with the engagement of families and Health Visitors in meetings and focus groups in September 2011 to inform the research and evaluation of the project, the results of which will be shared when available. For further information about activities in the Children and Family Team of East Dunbartonshire CHP

please contact Jillian Taylor, Practice Development Nurse. [email protected]

PALLIATIVE CARE FORUM

The Palliative Resource Nurses within the CHP relaunched the Palliative Care Forum on the 24th August and would like to thank their colleagues from health, social work and the voluntary sector for attending. The Palliative Care Forum will provide updates from the Palliative Care Managed Clinical Network and will have an educational session within each forum. The Palliative Care Agenda for the CHP will also be shaped by the forum and therefore a wide diversity of representatives is required. The next Forum will be held on 16th November, 1pm at KHCC.

If you are interested in becoming involved please contact Leanne Connell, Practice Development Nurse, KHCC, 0141 304 7404.

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LET US INTRODUCE YOU TO THE COMMUNITY REHAB TEAM (CRT)….

The Community Rehab Team began working together, following the redesign of some Rehabilitation services for Adults and Older people, on 2nd May 2011. The redesign was brought about through the Delivery Frameworks from ‘Delivering for Health’ and ‘Coordinated, Integrated and Fit for Purpose’, which, alongside other strategic drivers, such as ‘Changing Lives’, requested transformational change in service provision to meet the changing demands of demography and financial constraints. The Community Rehab Team vision is to : ‘Provide a responsive, flexible approach to vulnerable people who require and can respond to rehabilitation; enabling increased levels of independence and avoiding unnecessary admissions to hospital or care home settings.’ The Team is locality-based within East Dunbartonshire CHP and is hosted within the joint Kirkintilloch Health and Care Centre; potentially optimising opportunities to work closely in partnership with Social work colleagues. The Team aims to provide high quality assessment and care management and a range of rehabilitative interventions, enabling self-care and self-management of Long Term Conditions, where possible. The Team are made up of a range of services coming together through the redesign process, such as: IRIS (support post- discharge and GP rapid response service and now known as the ‘Fast track’ element of the Team), Domiciliary Physiotherapy, Community Physical Disability Team and Community Older People Team. Referrals in to the Team from other CHP services should be on the attached referral form and accompanied by a Single or Standardised Shareable Assessment. http://www.chps.org.uk/content/default.asp?page=s594_33

There is a lot of work still to do around developing the Team into the type of service we want it to be and this is ongoing. This will include looking at referral forms and processes and procedures, in order

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PAPER No. 11/65D

that we can streamline what we are doing and how we are doing it and develop as a strong, cohesive Team. What do team members say? “The new service has given us all a great opportunity to learn and develop new skills from each other and it’s great to be able to tap into all the knowledge and clinical expertise that’s now held within the team.” What do patients say? An existing patient has described his experience as follows: “I am very pleased with the service – the staff have all been very attentive and I am impressed by the wide range of services offered by the team. They are very good, attentive staff” What do referrers say? Referrers have said, “It is great to have ease of access to the service and see more people gaining access as only 1 discipline now required to access the service. We look forward to developing relationships further between the teams.”

GOING THAT EXTRA MILE FOR CANCER RESEARCH

Quick question! Have you ever challenged yourself and then thought - what have I done? Over the past few weeks this thought has crossed our minds on more than one occasion. You may be wondering why that is and if so I urge to keep reading! Sadly, while growing up the word cancer was heard many times in our family. Charlotte’s dad Adrian, our Granda Bob and my Granda John all died from lung cancer. We along with many families have felt the pain and sense of loss that cancer can bring. This is where Cancer Research comes in… It is the world’s leading charity dedicated to beating cancer through research and has contributed to cancer death rates falling and continuing to fall in recent years. We have had the opportunity to celebrate the work of cancer research when Sara’s best friend Lynne was diagnosed and survived Skin cancer. The event… On Saturday 4th September we will be taking part in the Glasgow Half Marathon to help raise money for cancer research. We will not be alone in this challenge as many people will be standing beside us doing exactly the same thing. We knew however that a half marathon was not going to cut it and in order to reach our target we would have to pull out all the stops! So not only will we be taking part in the Glasgow half Marathon, Charlotte and I will also be taking part in the Shine Marathon Walk on September 10th!!! This is where you come in… We have learned from past experience that people are more than willing to donate their hard earned money to good causes. The only thing they want in return is a few hours of sweat, pain and torture! – This is where we come in. With your generous support we are hoping to raise £1500 for Cancer Research so it can continue with the amazing work it has been involved in. If you feel our efforts deserve a donation please visit our just giving page www.justgiving.com/sara-norman or fill in the sponsor sheet in the KHCC staff canteen and make your donation the old fashioned way!

Email: [email protected] Tel: 0141 355 2380

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http://www.justgiving.com/sara-norman


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REVISED NO SMOKING POLICY – AUGUST 2011

Following the recent review of the NHS GGC No Smoking Policy 2010, the document has been amended, based on the range of comments received. The revised policy can now be found on StaffNet on the following link:

http://www.staffnet.ggc.scot.nhs.uk/Info%20Centre/Health%20and%20Safety/Corporate%20Health%20and%20Safety/Pages/HSC_Policies_KW_230909.aspx

FOND FAREWELL

Christine Skivington, Diabetes Specialist Nurse, will be leaving on Friday 26th August to take up a new post as Diabetes Liaison for Scotland within the private sector. Christine has worked in the NHS for 36 years and has been a Diabetes Specialist Nurse for the last 21 years. She will be greatly missed by her patients and colleagues who would like to wish her well in her future post.

WARM WELCOME

The CHP HQ Planning & Performance Team would like to welcome Attiq Asghar to the team as the new Information Officer.

Attiq can be contacted on 0141 201 9724 or on [email protected]

WE NEED YOUR INPUT

Please remember that the purpose of the Team Brief is for the sharing of local information and we are looking for any examples of good news or good practice within East Dunbartonshire CHP. If you have a submission for, or any comments regarding the Team Brief, please submit this through your line manger or directly to [email protected]





Issue – September 2011

Prison healthcare On 1 November all prison healthcare services are being transferred to local health boards. This will see the services within Barlinnie Prison and Greenock Prison coming over to NHSGGC in the next few months and health services for Low Moss Prison being provided by our staff when the new prison being built there opens in March 2012. I’d like to take this opportunity to welcome the 63 healthcare professionals who will be transferring in to our health board from Barlinnie and Greenock Prisons. It’s expected we will be recruiting around 28 staff for the new Low Moss Prison. Flu This year’s seasonal flu vaccination clinics for staff start on Monday 3 October. As healthcare professionals we all have a responsibility to reduce the risk of passing flu on to vulnerable patients. I would encourage staff to take this opportunity to not only protect themselves and their families but their patients and colleagues too. Information about clinic times/venues is available on the homepage of StaffNet. Congratulations Congratulations to Dr Carole Allan, Consultant Clinical Psychologist who has been elected President of the British Psychological Society for 2011/12. Dr Allan is currently Professional Lead for Psychology across NHSGGC Partnerships and has worked for over 32 years in various service posts in Adult Mental Health and Addictions, as well as in training for clinical psychologists at the University of Glasgow.

Robert Calderwood Chief Executive

Comments/feedback to:

[email protected]

Robert Calderwood, Chief Executive talks about: Organisational change Our core aim has always been to meet the ever changing needs of patients in the most clinically effective and proportionate way. Some months ago we set out to take a system wide approach to drive this agenda forward as part of our quality improvement agenda. Since then our management teams have been working with staff partners, clinical teams and trades unions to identify some 390 local initiatives that will deliver such changes. Some of those initiatives are small in scale and others more significant – but all contribute to the goals of our agenda which is to improve the efficiency and quality of how we deliver services. We are all aware that change brings with it challenges. Change also brings with it opportunities enabling us to work smarter and more efficiently. Many, but not all, of the change programme initiatives will result in fewer staff being required to deliver the newly designed ways of service delivery. As detailed in the NHSScotland Workforce Projections published last week by government our workforce will decrease by some 800 this financial year as a result of our new ways of working. The result of one such investment is the £70m in the new centralised laboratory service with a contract due to be signed shortly that will deliver £17m of state-of-the-art lab testing equipment which will see fewer lab staff required in the future but an enhanced service in operation to support our health system. Change is inevitable, it is constant and it’s our task to ensure it is driven by a desire to deliver better quality care to patients and improved efficiency of resources.


PAPER No 11/65F

If you have any items that you would like to have included in the Oral Health Directorate Team Brief, you can send these direct to Linda Armstrong, Clinical Governance Officer, [email protected]

tel: 0141 232 9701.

Issue – September 2011

ORAL HEALTH DIRECTORATE BRIEF Trainee Dental Nurse Programme The Oral Health Directorate has recently recruited a new cohort of 20 trainee dental nurses on 1 September 2011. As a result of a recent evaluation of the training programme together with the extremely positive NEBDN examination results from 2010, the duration of the programme has been revised from 2 years to 18 months. In response to feedback received from all parties involved in the programme, there will be changes to time spent in clinical locations. The new format will be two 6 month rotations within the first year. The trainees from this cohort are expected to sit the NEBDN examination in November 2012. Roll out of e Referral Uninterrupted this is being rolled out to all General Dental Practitioners in a phased programme, due for completion in March 2012 across NHSGGC. The IT team are currently scheduling and implementing training for both GDPs and Community Dental Services. Forthcoming Events

Clinical Governance Event: 9.00am – 4.00pm on Tuesday 22 November 2011, in the GTG Training Centre, Glasgow.

PFPI Awareness Event: 1.30 – 4.30pm, Friday 7 October 2011, Lecture Theatre 1, the University Building, Glasgow Royal Infirmary.

A Childsmile Event for General Dental Practitioners not currently participating in Childsmile being planned for Oct/Nov, details to follow

IRMER Audit feedback event - date to be confirmed Chairman’s Award Congratulations to Debbie Connelly, Health Improvement Senior for Oral Health, East Glasgow CHCP who has been awarded the NHSGGC Chairman’s Award for her work on the newly redesigned service to take away the fear of attending the dentist for autistic children at Bridgeton Health Centre. Retirements Janet King, Senior Dental Nurse in Community retired on 30 August 2011 after 27 years service in the NHS. Helen Dickie, Senior Dental Nurse in Community is retiring on 30 September 2011 after 37 years service in the NHS. David Wray, Honorary Consultant in Oral Medicine retired on 31 August 2011 after almost 20 years service. Susan Winning, Consultant in Restorative Dentistry retired on 26 August 2011 after 30 years service in the NHS. I am sure you would want to join me in acknowledging these achievements and wish them all a long and happy retirement.

PAPER No. 11/66A STAFF PARTNERSHIP FORUM WEDNESDAY 13th July 2011 at 2.00pm

CHP H.Q, STOBHILL HOSPITAL, CORPORATE MEETING ROOM

Present: Karen Murray

Ross McCulloch Andrew McCready Diane Wilding

Serena Barnatt Annemargaret Black Louise Martin Mark Richards Laura Bryan Stephen Fullerton Marie Lowe

Director/ Co-Chair (KM) RCN Lead Stewart/Co-Chair (RMcC)UNITE Representative, GDH(AM) Senior HR Advisor (DW) Head of HR (SB) Head of Primary Care & Community Services(AB) Head of Administration (LM) Head of Mental Health (MR) Operational Support Manager OHD (LB) UNISON RCN (Shadowing RMcC)

In Attendance: Katrina Brown CHP Team Secretary

No. Topic Action

1. WELCOME AND APOLOGIES RMcC opened the meeting and welcomed all attendees. Introductions were made for the benefit of new members.

Apologies were received from James Hobson, Wendy Mitchell, Sandra Cairney, Anne McDaid, Audrey Murdoch.

2. MINUTES OF PREVIOUS MEETING

Minutes of previous meeting held on 11th May 2011 were agreed as accurate.

3.

MATTERS ARISING

i. ORAL HEALTH DIRECTORATE UPDATE LB advised that Workforce Planning Group had reconvened and were working towards updating the original plan which is due to expire in 2012/13. Work is underway in collating an overall staff list for OHD, encompassing Team Descriptions and Job Titles in order to map out the current workforce.

ii. OHD STAFF GOVERNANCE MONITORING FRAMEWORK

LB discussed paper with the group. RMcC advised Priority Areas should also be incorporated into this document, LB will liase with MMcL to get this added.

LB

iii ADMIN REVIEW UPDATE LM confirmed part 2 of the Admin Review is complete, part 3 will commence within the next few weeks this will look at 0.6% PA support. The 3rd part of the review will be concluded by 31st March 2012 with Staffside involvement. SF and AMcC expressed they would like to be involved in this review, LM will e-mail confirmation and dates.

LM

PAPER No. 11/66A Iv V

SAVINGS 2010/11 UPDATE RMcC met with MMcL and JH to discuss OHD savings plan and possible impact on service or workforce, staffside await dates from MMcL and JH to take forward. LB advised she will speak to MMcL and confirm date with RMcC. MR advised SC is compiling analysis which will show staff reduction and any impact it will impose. SB asked if this analysis is available could it be circulated to group. STAFF GOVERNANCE MONITORING FRAMEWORK UPDATE DW confirmed changes have been incorporated from the last SPF meeting, the group looked over the paper and RMcC endorsed.

LB

SC

Vi Vii Viii

CHANGE FUND UPDATE AB advised the group that PID proposals have been made. There are currently 30 proposals, however Senior Managers will be asked to individually score each proposal, this will then be submitted to Executives on 22nd July 2011. AB confirmed when the proposals are in place a recruitment plan will be drawn. RMcC raised his concerns over staff, SB confirmed all posts will go to redeployment in line with current policy. AB recommends staffside involvement when proposals has been accepted. KM advised when proposal is complete AB organise a meeting with RMcC and staffside to discuss. E-EXPENSES LM confirmed all service Leads attended training on 05th July. The system goes live on 01st September, LM will arrange and hold brief training sessions for staff. RMcC asked if staff was aware of this, LM confirmed all Team Leads have been e-mailed Guidance Notes. ACCOMODATION UPDATE LM reported the change to the dinning area at East Dunbartonshire CHP for District Nursing is progressing well and is now with Capital Planning. KM confirmed staff engagement had taken place by LM providing a drop in session for staff that currently use this area. Another room has been identified by LM and Carrie Jackson if required for seating area.

AB

4.

COMMITTEE UPDATE KM advised the next CHP Committee will be held on 29th July 2011, the items for discussion are, Reshaping Older People’s Service, Low moss Update, formal feedback from O.P.R, OHD – Flood, Finance Report Month 3, OHD Waiting Times Target, Capital Plans Childsmile and Audit Scotland Report. KM advised the group that Committee Agenda’s and papers can be shared as this information is available online.

ii. APF UPDATE

RMcC discussed the Agenda from 18th of May meeting with the group. RMcC advised the main areas for discussion on the day were Agile Working and Car Leasing. It emerged that Agile Working relies on IT systems being available and this is not always accessible. Staff also have concerns surrounding Car Leasing, MR advised as staff leases are nearing the end of term, Managers are signing off renewal however leases are on hold leaving staff unaware if a lease car will be available to them. ML advised no lease should be on hold. RMcC stated clarification needs to be made to staff. APF have set up a sub group to look at lease cars and the impact this will have on staff, current Management Team and Staffside are working together on this.

PAPER No. 11/66A

iii.

MENTAL HEALTH PARTNERSHIP MR confirmed MHP stands as is at present until meeting has been arranged to confirm new role.

iv. PEG

AB advised that appointing new and re-electing existing members to PEG is still ongoing. GN is currently working on a project to show financial progress in year 1, this will show what is available for years 2 and 3, this will then be submitted to PEG. RMcC had concerns surrounding E.Dun providing 30month pilot, AB confirmed Children & Families Team will be back to full service by end of July. AB will forward on brief of 30month pilot to RMcC.

AB

V. HEALTH & SAFETY UPDATE

LM and KM met with Elaine Whyte and all is well. Fire Training has been put on hold temporarily.

Vi. REHABILITATION & ENABLEMENT FRAMEWORK

AB advised the redesign of Home Service is still in transition. East Dunbartonshire Council have confirmed East Dun CHP will be involved in all future redesigns. It has also been noted that Rehab team have been receiving inappropriate referrals due to the redesign although staff are showing enthusiasm and motivation. RMcC highlighted feedback received from staff with regards to additional work for other area’s requiring weekend work. AB confirmed our staff do not do weekend work however RAD do offer overtime. KM advised this to be investigated by AB to ensure staff are not working over 48 hours per week.

AB

Vii. ATTENDANCE MANAGEMENT

DW advised the group the CHP is reporting 4.87% sickness absence for the month on April 2011. The average for the year ending March 2011 was 4.80%. The overall absence figure for the CHP includes Oral Health Directorate. Oral Health Directorate is currently reporting 2.81% sickness absence for the month of April 2011.

5.

CULTURAL CHANGE PROGRAMME Postponed until next meeting.

6. WORKFORCE PLAN UPDATE

LB confirmed OHD are in the process of updating, completion is due late 2011 early 2012. RMcC confirmed Learning and Education plan is developed although ongoing. RMcC advised the next formal review of OHD and CHP will be next year and SPF group would support this. SB advised the group SC is working on CHP Workforce Plan.

7. AOCB

KM confirmed she had spoken with MMcL with regards to the water supplies at GDH, a risk assessment has been completed showing the water storage is fine. LM advised that Business Objects has now moved to a new platform, BOXI, once LM has

PAPER No. 11/66A determined what reports are available and relevant for attendance management she will forward information onto ND.

8. NEXT MEETING

Wednesday 14th September 1.00pm – Staffside pre-meet 2.00pm Full Meeting CHP HQ Stobhill Hospital

PAPER No. 11/66B

East Dunbartonshire Public Partnership Forum

Minute from the Meeting held in the

Woodhill Evangelical Church, Bishopbriggs

Thursday 14th July 2011, 9.30am

Present: John P. Kelly (JPK) PPF Chair / Service User

Martin Brickley (MB) Kirkintilloch Seniors Forum / PPF Vice Chair David Radford (DR) ED CHP

Heather Gartshore (HG) Contact Point / Kirkintilloch Community Council

Richard Thomson (RT) Kelvinbank Resource Centre Susan Petrie (SP) Addiction Recovery Centre (ARC)

Bob Donald (BD) Service User Jenny Proctor (JP) Contact Point Tom Friel (TF) Service User

Heather McKelvie (HMK) Carers Link Pat Baird (PB) PPF Member Volunteer Beatson McMillan Bill Brady (BB) Service User Gordon Thomson (GT) Ceartas

Beverley Lockhart (BL) ED Volunteer Centre Sandra Cairney (SC) Head of Planning & Health Improvement Attending: Julie Christie (JC) East Dunbartonshire Council Anthony Craig (AC) ED CVS Community Support Worker David Law (DL) Mental Health, Health Improvement Dianne Rice (DRice) ED CHP (Minutes)

Engaging local people in local health matters

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PAPER No. 11/66B


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Action

1. Welcome and Apologies

The group were welcomed to the meeting and introductions took place. Apologies were noted from David Paul, Jon Berry, Gina Livingstone, Shona Heath, Claire Taylor and Karen Murray.

The PPF were saddened to hear that fellow PPF member Bob McSorland had past away after a long battle with ill health. The PPF wish to pass their condolences onto Bob’s family. HG also advised that Claire Taylor had been admitted to hospital, the PPF wish Claire a speedy recovery and look forward to seeing her back at the PPF meetings.

2. Presentation – East Dunbartonshire Dementia Network Julie Christie, (Social Work Team Manager, Older People, East Dunbartonshire Council), attended the meeting and provided a presentation on the Dementia Network. JC explained the aim of the Network; is to raise awareness of Dementia and there has been leaflets and education packs devised to support this. JC highlighted a wide range of activities that the Networks’ partners are involved with; Peer Support programme / 1:1 support / Dementia Advisory Clinic / Awareness raising to GP’s / Awareness and training to Hospital staff, patients & carers. JC highlighted that a range of Dementia information is available on the Scottish Human Rights Website and the East Dunbartonshire Council website. The group were also advised that a Dementia Network website is in the process of being developed. Julie left some material for the PPF’s information and it was agreed that a library of information will be kept for the PPF at the ED CVS office. JC welcolmed the request from the Chair that the PPF have a representative on the Dementia Network to facilitate joint working. RT volunteered to be the representative.

3. Minute of Previous Meeting

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(i) Under item 9 Communications it was noted that the text was to be changed from “was not” to “were no”. The remainder of the minutes were agreed as correct.

DR

(ii) Matters Arising Dementia Convention

JPK will forward the information he has for the above to DR. Local Issues At the last meeting TF raised a question concerning continence services. DR has since spoken to the Lead Nurse, who advised that NHS GGC are to be involved in the national review of the services, undertaken by the Scottish Govt. There is a Continence Helpline (GET NUMBER) for any service user, who has a concern, to access, where individuals are paying for continence products they should contact their local continence nurse. Cleaning Services Monitoring Framework DR provided The Cleaning Services Update Report. Members agreed to ask CT (PPF rep on this group), to provide an overview of the work and progress, once she has recovered from her illness . Cleaning Standards are looking for additional PPF reps to join this monitoring group, contact DR if interested.

JPK

All

4. Standard Items for Noting

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The following minutes were circulated to the group for information purposes only CHP Committee Meeting Clinical Governance There were no minutes available for the Communications Group or the CHP Primary Care Steering Group. The group were asked to hand any reporting forms to AC who will take to the Officers Group. AC advised that there are stamped addressed envelopes available at CVS office and to contact him if required.

5. Proposed PPF Priorities 2011 / 2012 (i) Dementia DVD / Dementia Schools Project

Dementia DVD JPK advised that the North Dementia Forum appreciated the funding donated by East Dunbartonshire CHP PPF, he informed that they had 5,000 copes of the training notes made and are available to everyone. Dementia Schools Project The Chair informed the group that a few years ago Alzheimer Scotland had issued education packs to all Local Education Authorities but not all had been distributed or used. The North Dementia Forum had obtained a few copies for a successful pilot in North Glasgow in 2010 which had subsequently been extended to all Glasgow. It was agreed to try and have a similar pilot in East Dunbartonshire. DR agreed to pursue this with Gordon Currie, Head of Education, East Dunbartonshire Council.

DRice

DR

(ii) Care of the Elderly

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JPK advised that the Officers Group were looking at priorities for the PPF and asked if Care of the Elderly should be a priority for the PPF. The group agreed. Discussion took place around priorities and it was decided that the next meeting would be dedicated to deciding on priorities. The group were asked to send any ideas they may have to AC.

All

6. PPF Support Training

DR advised that he is still in discussion with Daniel Connolly regarding training courses, however, the Working Together course will take place on the 15th July of which 3 PPF members are attending. Newsletter AC advised that the newsletter is 90% complete and will be sent in August to all PPF members and GPs.

7. Communications (i) Feedback from meetings / seminars

HG advised that she hadn’t attended the previous CHP Committee meeting, however, she had requested that the Mental Health Re-organisation Presentation be sent to her to share with the group.

(ii) Feedback to East Dunbartonshire CHP Executive Members wished to raise a question relating to the actual

recorded numbers (by GP’s) of people with dementia compared with the estimated numbers provided by the Scottish Government

8. Other Issues No other issues were noted

9. AOCB There was no other competent business to report

Date & Time of Next Meeting Thursday 15th September 2011, 9.30am, Woodhill Evangelical Church

PAPER No. 11/66C

NHS GREATER GLASGOW & CLYDE

Partnerships Infection Control Support Group

MINUTES of

meeting held in Corporate Meeting Room , East Dunbartonshire CHP Offices, Stobhill Hospital

at 1.00 pm

Thursday 14 July 2011 PRESENT

Chair – Tom Walsh

TW

Infection Control Manager, NHSGGC

Sandra McNamee SMcN Assistant Director of Nursing Infection Control, NHSGGC Dr Eleanor Anderson EA Consultant Public Health Medicine, NHSGGC Maureen Stride MS Partnerships SICN, Clyde & Scottish Prison Service Rep Ann Kerr AK Lead Nurse Surveillance, Infection Control Catherine Brown CB Operational Services Manager, Oral Health Val Reilly VR Public Health Pharmacist, NHSGGC Kate Eunson KE Senior Nurse, North East & East Dunbartonshire MHS Michael Regan MR Assistant Hotel Services Manager, NHSGGC Elisabeth Sutherland ES Site Facilities Manager, Glasgow Dr John Henderson JH Clinical Director, Occupational Health, NHSGGC Margaret Millmaker MM Public Partner Representative Mari Brannigan MB Nurse Director, MHS

In Attendance Pauline Hamilton (Minutes), PA, Infection Control

Apologies Received

Dr Ian Gordon Dr Alison Balfour Carolyn McDermott

Item Action 1. Welcome & Apologies Tom Walsh welcomed everyone to today’s meeting as Dr Ian Gordon was on

annual leave. Round the table introductions were made for the benefit of Mari Brannigan as a new member and co-chair of the PICSG. Apologies were received from the above mentioned.

2. Minutes of the previous meeting held on 10 March 2011 The minutes of the previous meeting held on March 2011 were accepted without

amendment.

Matters Arising There were no matters arising.

3. Papers circulated to PICSG prior to meeting 3.1 BICC Minutes of 21.03.11 and 23.05.11

The Board Infection Control Committee minutes of 21.03.11 and 23.05.11 were distributed with the agenda and Tom Walsh informed the group that there were no exceptions to report that related to partnerships and that there were no items discussed at the BICC that had not also been discussed at the PICSG.

Page 1 of 5

PAPER No. 11/66C



Item Action 3.2 HAIRT Report (April and June 2011)

Ann Kerr updated the group on some of the contents of the HAIRT. Ann commented that the format of this report would change slightly in the coming months and that her team were working on populating this report. Ann asked Margaret Millmaker whether or not she felt that the content was still appropriate for members of the public and Margaret responded that as far as she could see the report read quite clearly and that she did not have any issues with the content. These bimonthly reports are submitted to the SGHD and are also published on the infection control website. All boards are required to submit their reports through the same process however NHSGGC decided to keep the Statistical Process Chart contained at the back of the document as this proves useful. It was decided at today’s meeting that these reports are forwarded with the PICSG minutes to the CHP Directors. Ann reported out of hospital infections for CDI and MRSA/ MSSA have gradually increased since reporting in this format notably 50% for CDI and 54.6% for bacteraemias. However both CDI and SABs HEAT Targets have been met. It was noted that mental health numbers are low and are therefore included in community hospitals data. The CDI and SABs reports are published monthly and must be in the public domain as soon as available.

AK

3.3 HPS CDI and SABs Report Ann Kerr informed the group that NHSGGC had met both their targets for

Clostridium difficile and SABs for 2011. The CDI continues to be below the new target which is 0.39 cases per 1,000 occupied bed days (OBD) but the SAB target of 0.26 cases per 1,000 OBD by 2013 would be much more difficult to achieve primarily because the number of out of hospital SABs was still a significant factor within the report and that actions to address problems of patients coming in with positive blood cultures from the community were limited at this time. Ann Kerr informed the group of the July HPS CDI and SABs Report which is also available on the infection control website. Ann reported that there has been a decrease in SABs of 13% when compared to same quarter last year. Scottish reduction of 29% and NHSGGC of 31% and that NHSGGC had achieved the lowest ever OBDs for CDI.

3.4 HAI Point Prevalence: CNO Letter A letter from Ros Moore, CNO for Scotland was distributed with the agenda

outlining the proposed repeat of the National Prevalence Study to take place in September / October 2011. Ann Kerr commented that her team were about to go on training in relation to the methodology requirements of the study. Sandra McNamee commented that other members of the infection control team including the hand hygiene co-ordinator had also committed time to try and complete this project. Sandra also commented that this was resource intensive and that outcomes would have to be fairly significant in order to support this type of prevalence survey on a yearly basis.

Page 2 of 5

PAPER No. 11/66C



Item Action 3.5 Hand Hygiene Audit Report (March 2011)

The National Hand Hygiene Report for March 2011 was distributed with the agenda. Sandra McNamee reported that NHSGGC had scored 92% and that all members of the infection control team including the hand hygiene co-ordinator continued to try and drive forward the hand hygiene message in all forums. Sandra informed the group that the alcohol hand gel product had recently changed and that this may also help with compliance.

3.6 AICP and Implementation Plan Tom Walsh informed the group that the Annual Infection Control Programme and

Implementation Plan distributed with the agenda used to be separate documents however Robert Calderwood had advised that both parts should be compiled as one document for clarity. Sandra informed the group that this was the first quarter report on the actions. There were no comments from the group. Margaret Millmaker referred to page 9 PFPI (newsletter). Sandra informed the group that Stefan Morton had completed this through the relevant groups and that the newsletter will be sent to Margaret.

SMcN

4. Cleaning Services Standards – National Cleaning Services Monitoring Performance Report

Elisabeth Sutherland provided an overview of the most recent Facilities Directorate Monitoring Framework for Domestic Services Cleaning Specification Reports for Clyde and Glasgow Partnerships which were distributed with the agenda. It was noted some of the scores were amber however actions had been taken in order to return the scores to green. Elisabeth Sutherland also highlighted the ongoing resource challenges around ICN input to the peer/ public review audits programme and Sandra McNamee confirmed that this should continue as previous and that Elisabeth should contact the lead nurses direct to arrange and escalate any challenges as necessary to Sandra. Elisabeth will forward the full year 2010 – 2011 published results report for distribution to the PICSG. Kate Eunson updated the group that cleaning schedule templates will be available on every ward to include individual needs and sign off chart. This is to be implemented in August by facilities to all ward managers.

ES

5. Infection Control Policies Update Sandra McNamee advised that the following policies had been formally

distributed for comment for final approval at the next Board Infection Control Committee on 25.07.11.

Group A Strep Policy Personal Protective Equipment Policy Shingles Policy Standard Precautions Policy Whooping Cough Policy SOP Cleaning of Near Patient Equipment

Sandra informed the group that all comments received on the policies had been incorporated into the newer versions.

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PAPER No. 11/66C



Item Action 6. Future governance arrangements for PICSG

6.1 Governance Accountability in CHP Tom Walsh advised that he had met with Mari Brannigan and Sandra McNamee

to discuss the implications of the allocation of Mental Health Services and in-patient beds across CHCPs. A paper had been produced and submitted to the CHCP Directors outlining the key responsibilities and drivers in infection prevention and control. The paper was agreed by the CHCP Directors with a revision to the PICSG membership to include a nominated lead from each CHCP. Tom Walsh also proposed that as an alternative the CHCPs may prefer to progress the Infection Control Programme and Implementation Plan through an existing governance or management group across the revised CHCP structure. The group agreed there was merit in this and Tom Walsh, Mari Brannigan and Sandra McNamee agreed to meet in early August to agree how to progress this. Tom Walsh asked the group if anyone was specifically representing a CHCP and no-one indicated that this was the case.

TW/MB/SMcN

7. Hand Hygiene Audits within MHS This item was deferred as Stefan Morton was not available to attend today’s

meeting. Stefan will provide an update on hand hygiene audits within MHS at the next PICSG on 15.09.11.

8. Partnership Activity Report (March/April and May/ June 2011) Maureen Stride provided an overview of Clyde activity detailed in the reports

which were distributed with the agenda. There were no particular comments or any issues raised.

9. Decontamination Update Dr Alison Balfour was not in attendance at today’s meeting to provide an update

on decontamination issues therefore this item was deferred to the next meeting.

10. Antimicrobial Prescribing Usage The paper forwarded with the agenda was not the most up-to-date version of

antimicrobial prescribing. Val Reilly therefore tabled the most recent version which will also be distributed separately to the group by e-mail. Val Reilly provided an overview, outlining the current types of prescribing within partnership areas across the board. It was noted that the group found this information to be helpful especially the graph format. Eleanor Anderson enquired if it would be possible for proportionate numbers to be included and Val said this is possible. This information is distributed to GPs, CHP Management Teams and quarterly for PICSG.

VR

11. New business since last meeting 11.1 Cleanliness Champions Time Limit

A letter from NES regarding Cleanliness Champions was distributed with the agenda notifying that Cleanliness Champions from this point forward would have six months to complete the programme. Any champions previously registered in the programme would be given until 30 November 2011 to complete the programme.

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Item Action

12. AOCB Tom requested that Eleanor Anderson forward the new pan flu plan sent out

for consultation in March to both him and Sandra McNamee. Kate Eunson agreed to develop MHS action plans suitable for HEI audit

which should be agreed at the PICSG. Margaret Millmaker raised issue regarding sharing of toys in GP practice

waiting areas and will let Tom Walsh know which GP practice this was for him to discuss with Ian Gordon.

Tom Walsh and Sandra McNamee had met with Michelle McLauchlan to discuss auditing of oral health treatment rooms. Sandra agreed to send list of sector ICNs to Catherine Brown.

Maureen Stride provided a prison service update and informed the group that informal audits had been carried out and that actions identified are already being worked on.

EA

KE

MM

SMcN

13. Date and time of next Meeting The next meeting will be held on:

Thursday 15 September 2011 1.00pm Corporate Meeting Room, East Dunbartonshire CHP Offices, Stobhill Hospital Future meeting date for 2011 Thursday 10 November

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CHP PROFESSIONAL EXECUTIVE GROUP MEETING WEDNESDAY 15th JUNE 2011, EXECUTIVE MEETING ROOM

PRESENT: Ian Gordon Clinical Director (Chair) (IG) Annemargaret Black Head of Primary Care & Community Services (AB)

David Brown Psychiatry Representative (DB) Carolyn Fitzpatrick Lead for Prescribing & Clinical Pharmacy (CF)

Ray McAndrew Oral Health (RMcA) Eddie McVey Lead Optometrist (EMcV) Iain MacDonald Pharmacist (IMcD) Graham Morrison GP Representative (GM) Fiona Munro RAD Team Manager (FM) Audrey Murdoch Lead AHP (AM) Gillian Notman Joint OT Lead Advisor (GN) Linda Peattie District Nurse (LP) Jean Powell GP Representative (JP)

ACTION 1 WELCOME & APOLOGIES

Apologies were received from Sandra Cairney, Caroline Horn, Fran McBride, Morven McElroy, Andrew Millar, Karen Murray, and Anna Stallard. IG opened the meeting by welcoming members. Introductions were made for the benefit of Fiona Munro who has joined the Group, following the completion of term of membership of Gillian Notman.

2.

MINUTES OF PREVIOUS MEETING & MATTERS ARISING The Minutes of the previous meeting held on 30th March were agreed as accurate, with the following amendments:- Page 2, first paragraph, GM requested a more detailed breakdown for over 85s, as

this group is increasing in number and it would be helpful to have information pertaining to this CHP. AB and GN to action.

AOCB Item 2 – date for launch of new service is 18th July. AOCB Item 5 – first bullet point should read Chronic Medication Service. Matters Arising i) PEG Membership & CHP Committee Representative

IG referred to the circulated PEG Terms of Reference, which states that tenure for membership is 2 years. He apologised that this had not been complied with and asked that members speak to constituents with a view to re-election or the appointment of a new member from their professional group. IG referred to the table on page 4, which showed the Standing Membership of the Group, and following discussion the following changes were noted:- Community Pharmacist Representative - Iain MacDonald General Dental Practitioner – remains vacant.

AB/GN

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Community Paediatrician representative – AB to discuss appointment of representative with Mark Feinman and Stephen McLeod.

AHPs – Audrey Murdoch, Fiona Munro and Caroline Horn. Psychiatrist - David Brown, will meet with colleagues for confirmation or new

representative Psychogeriatrician - FM to speak to Ashley Fergie to join group or suggest

nomination. Malcolm Campbell, Associate Clinical Director, to be added. AB to confirm 3 nursing representatives.

IG stated that once PEG membership had been updated and confirmed a fourth PEG representative, to replace Ross Ferguson, would be sought to join the CHP Committee. Presently IG, AB and AM attend on behalf of the PEG. IG will look at best way of selecting new Committee member once all new members are on board. ii) Optometry Update –

EMcV stated West Dunbartonshire would host all eye care services. Lead Optometrists from all CHPs had met to discuss the two refresher courses. Part 1 would act as a reminder of contractual obligations. Part 2, Optometry Services would take place during week-ends at Glasgow Caledonia University. It is hoped that funding will be provided by NES. He added that East and West Dunbartonshire were looking at alternatively running local learning network evenings with NES funding. If local venue for optometry learning networks was agreed, this would be held within CHP and he would speak to AB re funding. JP asked if these evenings were for Optometrists only, as she felt there could be a benefit for GPs. EMcV responded that primarily they were for the education of Optometrists, however, dependent on funding they could be opened up to a wider group of staff.

iii) Future Agenda Items – The following were agreed as future agenda items:- District Nurse Review Childrens Health Inequalities Mapping for East Dunbartonshire – Diane Davidson to be invited to

attend Self-referral to Adolescent Services (AB will discuss with partners and feedback

to PEG)

AB

DB

FM

AB

IG

EMcV

EMcV

AB

3.

STANDING ITEMS CHILDREN & FAMILIES SERVICES AB provided an update. The Board Strategy Group has been reformed to take forward the Healthy Childrens Programme. The CHP has agreed to take part in the Pilot Programme, for 30 months check. It is envisaged that this will take up 10% of Health Visitor activity in the long term and an audit will take place at the end of this month on current Health Visitor activity. Health Visitors will be required to illustrate activities they have been involved in, over the course of a week.

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GM stated his concern with regard to staffing capacity issues. AB agreed to discuss the concerns with the Senior Nurse for Children & Families to ensure the pilot did not impact on other services. SNIPS - AB advised that the CHP was working in partnership with Social Work to identify vulnerable children at the antenatal stage. AB advised that the Childrens Steering Group meeting was scheduled for next week and asked the Group whether they would wish to have sight of the minutes. Stephen McLeod will attend to talk about Redesign within Childrens’ Services and Eleanor Stenhouse will talk about Maternity Redesign. Social Work will be involved in discussion to ensure all Childrens Services are integrated. Following discussion with regard to the linking in of the Childsmile Initiative and the need to ensure that vulnerable children received the appropriate intensive care, it was agreed that RMcA would join the CPOG. RMcA stated that although there had been significant oral health improvement in children in the last ten years, there were major issues affecting the poorer parts of our community. JR to forward Childrens Steering Group Terms of Reference to RMcA. Following discussion, it was agreed that Minutes would be circulated to PEG, as AB was keen for GP Representatives to feedback to their professional groups. JP requested feedback with regard to antenatal depression. She felt in the past there was more opportunity to build up a relationship with the patient. AB advised that any issues should be discussed with Lisa McWilliams or Alison Blair, the GP reps on our Childrens Strategy Steering Group. PRIMARY CARE FRAMEWORK GN referred to the first Annual Report, which was circulated at the last PEG meeting, which detailed the breadth of work undertaken in the CHP area. The local Framework focuses on the role of independent contractors and how we can provide better pathways for service users. GN referred to the detailed outcomes-related Workplan, which shows the extensive work undertaken across all partnerships and highlighted the following examples:- PCMHT audit of psychological therapies through GP Practices resulted in better

access for patients to the triage stage i.e. reduced from 20 to 4 weeks. Evaluation at Twechar, generally very positive evaluation, with good reports from

patients. Inequalities – new model of peer support piloted within Mental Health. GN advised that although a little momentum had been lost, an email had been sent and a further meeting of the framework Group would be arranged to look at how this work links into the Development Plan. AB congratulated GN and stated that considering the amount of workstreams and challenges involved, she had done a very good job. With regard to Health Inequalities, GM asked whether there was a need for mapping areas of most importance, against what can be achieved, to ensure that there is enough funding for core areas. AB responded that this would be undertaken during the second year.

AB

JR

AB/JR

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Following discussion, it was agreed that the drawing up of core areas should be a function of the PEG group. It was agreed that GN would discuss with Jane McKinlay to ascertain whether this was something the OD Group could take forward. GN advised that we would require to marry this up with what we know about health inequalities. This could be included in working with contractors. AB advised that, as the delivery of the CHP Development Plan was included in our performance objectives, if there were concerns with the delivery of the PC framework this should be discussed at SMT. 18 WEEKS REFERRAL TO TREATMENT RMcA stated that Oral health were within 18 weeks target. AB invited FM to provide an update on the Community Rehab restructure. Transfer of service from Acute took place on 2nd May. A letter explaining the changes was sent out to all Practices in April. Referrals to the team can be made via telephone or letter. If a referral is received from another source, other than the GP, the GP will be notified of this. The new Rehab Team incorporates the functions of IRIS, COPT, Physical Disability and Dom Physiotherapy. It is predicted that referrals to the new service will be higher than the allocated staff resource as resource was allocated according to RAM rather than activity. This will be an ongoing challenge for the service. It has been recognised that the referral form is not ideal and this will be redesigned locally. The GP’s present concurred with this and GM has offered to comment and input on any redesigned referral form. CLINICAL GOVERNANCE UPDATE i) PLT Event – IG provided a brief summary of feedback from the 70 forms returned.

As there were 116 attendees, he stressed that it was important that feedback forms were returned. Initial feedback from returned forms was good, with 95.6% stating they found the event very or somewhat useful. Due to financial climate, IG stated that at present there were no plans for any further events.

CN/AB/JMcK

FM/GM

4. LIVING BETTER PRESENTATION GN referred to the circulated Pilot Site Report. Within East Dunbartonshire the Project looked at patients with COPD who were also suffering from mental health issues, from two GP sites (Kessington and Southbank Practices). This three-year programme finished in March of this year. 6-week courses were introduced in Milngavie, aimed at giving people with COPD the skills and knowledge necessary to better manage their condition and to look after their mental health. The report gives an overview of this course, an evaluation of the impact of the course on participants and a series of learning points and recommendations for future course delivery. Although participants were initially recruited through the Kessington Practice COPD register, due to low intake the invitation list was later extended to include patients registered with the Ashfield Practice. GN advised that the report, as well as informing on the stigma attached to living with COPD highlighted what patients themselves wanted. Interestingly this was shown to be low level support e.g. Better transport and support/peer/activity groups.

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Feedback showed that both patients and carers found the course valuable in learning self help strategies, particularly breathing and relaxation techniques. Tentative discussions are ongoing with regard to a further pilot. LP advised that from a DN perspective, she found the course valuable and was able to put into practice what she had learned from the course. JP advised that the social aspect of the course would also have a good impact on health GM stated that it was obvious that a lot of hard work had gone into this Project and asked whether this could be replicated for other groups. AB advised that with regard to Older Peoples Change Fund, it was emerging that money could be used to train volunteers in the future. GN advised that elements of the project would be included in the OPCF and would involve the voluntary sector.

5.

ORAL HEALTH STRUCTURE PRESENTATION RMcA provided an overview of Oral Health Structure. AB referred to a recent Channel 4 ‘Dispatches’ programme. This raised serious issues regarding clinical governance with General Dental Practitioners. RmcA advised on the current process and agreed to give a short presentation at the next PEG meeting. Issues regarding Dental Emergencies and Dentist CPP were also discussed and RmcA agreed to attend a future GP forum to address any issues/or GP concerns.

RMcA

IG/ RMcA

6. OLDER PEOPLES CHANGE FUND PLAN

AB advised that the Project Manager would attend the next PEG meeting to give a presentation. £1.2m of bridging finance had been made available to achieve transformational change over the next 4 years. IG stated that it was important to stress that this was not new money.

AB/JR

7. GP GMS CONTRACT – CHANGES TO QOF IG provided an update in relation tonew quality and productivity points (QP) within QOF:- Three elements being looked at are:-

i) Prescribing - CF and her team will meet with Practices to look at additional areas of prescribing

ii) Routine referral patterns within certain areas e.g. Orthopaedics, Neurology and Gastroenterology, to ensure these are consistent and within guidelines.

iii) Emergency Admissions Practices have been asked to ensure that internal meetings are arranged to consider these three areas and to identify issues which might influence these patterns. Each Practice will be required to develop an action plan. Locality based meetings will be arranged for late autumn, when Practices will come together with secondary care colleagues. The CHP will take the lead for these discussions. IG advised that it has taken some time for individual Practice data to be analysed and this should be received by Practices within the next few weeks.

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8. MINUTES OF SUB GROUPS The following Minutes were noted by the PEG: - SPF – 16TH March 2011 CG Executive Group – 8th March 2011 CG Sub Group – 8th March 2011 GP Forum – 20th April 2011

9 A.O.C.B i) AM advised that the Podiatry redesign proposal would entail the service being

divided into four quadrants. East Dunbartonshire CHP would be in the North East Quadrant. Each Quadrant would have a Podiatry Manager. The proposal will be presented to the APF in August.

ii) IMcD referred to the tabled figures regarding the Chronic Medication Services, and

provided the following update:-

EDCHP comparing well with East Renfrewshire. Although huge variations across EDCHP, we are doing comparatively well. All Health Boards are involved in the Pilot Study. Five Practices are involved in early doctors’ sites, although none within EDCHP. The Scottish Government are disappointed this was not moving ahead as quickly

as was hoped.

AB asked whether SPARRA patients and vulnerable patients could be linked into this Scheme. IMcD advised that at the moment Pharmacists were approaching patients and have started with the more routine patients e.g. thyroid etc. He advised that it would be helpful if GPs highlighted who might be appropriate for the Scheme. GM stated that if the Scheme focused on routine areas, this would leave more time for more complex medication reviews within GP practices. Following discussion with regard to Acute Sector discharges, where previously prescribed medicines had been stopped, it was agreed that notification and reason for this should be given to GPs. JP advised that this had been discussed at previous Area Medical Committee meetings but as yet no solution had been agreed.

iii) AB stated that when the Anticipatory Care presentation is brought to the PEG, the sustainability aspect should be discussed.

iv) JP stated that a patient had informed her that when calling the Physiotherapy

Services at Milngavie Clinic, the answer-phone service stated that it could take up to two weeks to return your call. AB to investigate. GM referred to the Working Health Service (for those employed in small businesses) and advised that this worked really well. Patients get a telephone triage and fast access to required services i.e. Physiotherapy.

v) In response to a request from IG, AB agreed to bring an update on Low Moss Prison

Model to future PEG meeting.

AB

AB

8. DATE & TIME OF NEXT MEETING - Wednesday 27th July 2011.