Download Patient Participation Group Meeting

Minutes of the Patient Participation Group Meeting
Monday 24 November 2014
Present
Patients:- Mr Peter Hunt, Mrs Elaine McBride Mrs Eileen Hume and Mr Keith Lindsay
Mr David Rowlands – Consultant Obstetrics and Gynaecology and Associate Medical Director for
Strategy and Partnerships, Jo Goodfellow - Associate Director of Strategy and Partnerships – Wirral
University Trust Hospitals
Dr Helen Kini – GP Partner, Mrs Peta Murphy – Practice Manager
1. Apologies
Apologies were noted from Peter McQueen, Alan Jones, John Coleman, Joan Stanley, Richard
Llewellyn, Jean Dunn and Dianne Pollock
Everyone introduced themselves and Jo began by running through the issues already raised by the
Group.
2. The Orthopaedic Ward (Ward 10)
Elaine explained that she had been an inpatient on the Orthopaedic ward for 3 weeks last year and
had been concerned that there were not enough Nurses on Duty at night. This large ward - with up to
39 patients, including some who were elderly - had three nurses who were constantly busy helping
patients, yet more support was really needed especially as patients could not get out of bed to help
one another where possible. Elaine felt quite sorry for the staff. She also explained that sometimes
patients were glad to see a particular nurse come on shift and in other cases not so glad. Jo
explained that a review of skill mix as recently been carried out across the hospital and additional
resource put in where necessary. Often skill mix is very important with healthcare assistants able to
do some of the tasks and so free up nurse time for higher level clinical tasks. Mr Rowlands
highlighted the Friends and Family test feedback system now in use in the hospital and also outlined a
system he had seen used previously to very good effect whereby each ward had a feedback
noticeboard outside it upon which were recorded the views of the patients from the previous week. He
will take this back to the Trust.
3. The Surgical and Elective Admissions Unit (SEAL Unit)
Elaine had also noted a concern about lack of seating in the SEAL unit where her husband had to
stand for nearly half an hour prior to being admitted for elective care. Jo advised that she had raised
this with the Matron and Mr Rowlands suggested that the Trust could review the numbers of patients
brought in first thing in the morning to ensure the system has capacity to support these patients.
Elaine relayed the experience of a friend of hers who had gone in for a day case procedure recently
and felt anxious and unwelcome as the Receptionist checking her in did not even look at her. This
had increased her anxiety further. Mr Rowlands and Jo acknowledged the importance of “soft skills”
as well as efficiency in providing quality patient experience. They will feed this experience back to the
manager of the SEAL unit.
4. The Eye Clinic
Jo read out comments submitted by Joan Stanley that the eye clinic had improved considerably. This
feedback was most welcome and will be fed back to the eye clinic staff as they have done a lot of work
recently to improve the service and plan further work. Mr Rowlands explained that in future the eye
clinic staff at Arrowe Park may link up with those in Chester to carry out very specialist eye surgery,
sharing the costs of very expensive new equipment and sharing clinical expertise.
5. Hospital Matrons
Joan had also highlighted the role of Matrons in her comments and had expressed the view that there
were too many managers. Jo explained that the Hospital has brought Matrons back to their Wards as
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they acknowledge the strength of this role. Mr Rowlands added that managers are required to look at
risk issues, manage finance and staffing and deal with the internal market in the NHS and also to
analyse data. He outlined the view that in the future to make economies the internal NHS market,
whereby different care sectors charge others for what they do, will merge and lose the charging
boundaries thereby not needing so many finance and other managers. Jo made mention of the Vision
2018 work ongoing at present with the objective of integrating services and also encouraging people
to keep well. Helen stated that a Lifestyle Adviser had recently started working within the practice to
support patients to stop smoking and to eat well and exercise and we feel this is a positive
development for patient care.
6. The Hospital Communications Strategy
Eileen expressed the view that the hospital communications strategy was very effective and is getting
the right messages across to patients in the right way. She also said that she felt the practice is good
at patient contact with recall and review systems for patients who require chronic disease
management. The other patient group members agreed with this. Mr Rowlands explained that there
are strategic networks across Cheshire and Merseyside for services such as cancer and maternity
services to communicate at the wider level too. Jo added that Social Services are also much better
now at working with healthcare services. She mentioned the Integrated Community Care Teams
which are being developed on a political ward footprint to support patients at all stages of their care
pathway in a way that is integrated and over-arching.
7. The possible impact of next year’s General Election on changes in the service
Peter Hunt enquired about the effect of the forthcoming General Election, wanting to know if things are
likely to change if there is a change of political leadership. Mr Rowlands explained that his philosophy
is that in the health service we do things because they are the right thing to do and the money will
follow a quality service, rather than doing things that are politically and financially driven. He gave the
example of the 18 week maximum wait for a routine Outpatient appointment and emphasised that the
root of this is not the fact that it is 18 weeks but the fact that the time is a maximum of 18 weeks. By
being defined to this limited period it is a better measurement than in the past when patients have
waited 2 years for an appointment or have not known how long they may have to wait. It is the right
thing to do rather than a political target – so he is hopeful that a change in political leadership should
not have too great an effect on the work in progress.
Jo mentioned the demographic time bomb of everyone living longer plus the increasing challenges of
obesity, alcohol and respiratory illnesses and stated that the objective of the health service needs to
be to support people to stay well. A lot of good work is currently being done to support this. Elaine
highlighted the aortic screening service which is held once a week at a practice in Birkenhead. She
said it is an excellent service but provision levels need to be increased.
8. Parking
Eileen raised the issue she had emailed in over parking at the hospital which she said is a nightmare.
She also reminded everyone that over the Christmas period Sainsburys stop the park and ride bus
service. She acknowledged that C block at Arrowe Park had been demolished and Jo advised that
this will create 150 extra spaces for patients and visitors and 105 extra spaces for staff in the New
Year. Eileen explained that it is difficult to get to Arrowe Park and especially Clatterbridge on public
transport and this could be a bigger concern in future if rehabilitation and elective services were to be
based at Clatterbridge rather than at Arrowe Park.
9. Outpatient clinics
Jo noted the concerns Eileen had raised about the Outpatient clinics looking tired and in need of
attention. At this point mention was made of the current tendency to pass everything back to the
GPs, who are overloaded anyway. Mr Rowlands explained that when services are provided in
hospital they are billed back to the GPs’ hospital budgets so the GPs pay for all hospital activity and
there is an agenda to reduce what is done in hospital where possible by moving it out into the primary
care sector to save money within the healthcare economy where costs and demand just keep rising.
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10. Dementia care
Eileen explained about her volunteer work on the Dementia ward, highlighting the importance to this
patient group of having someone who can spend time talking to them to help and reassure them. She
praised the work the hospital have done with the memory café and other facilities but felt that some of
these could be better used to support dementia patients than they are at present. She mentioned that
patients awaiting discharge to care homes can block hospital beds. Mr Rowlands expressed the view
that the hospital is seen as the ultimate place of safety for elderly or frail patients yet often it is not the
best place for patients to be as there may be other more appropriate care settings to support them. Jo
highlighted the fact that the Trust has recently employed 2 Dementia Nurses on a couple of wards and
this has made a fantastic difference to the care provided to this client group. The Trust have asked for
further posts to be supported through the “Better Care Fund”. Mr Rowlands highlighted that this fund
is not “new money” but top sliced from the existing healthcare budget held by Wirral CCG. The Fund
is also providing additional support to the alcohol service from April 2015.
11. The Commissioning Support Unit (CSU)
Eileen also expressed concern over the Commissioning Support Unit (which provides support services
such as data analysis and IT support) as it has recently expanded to cover not just Cheshire and
Merseyside but also Warrington and she asked if this area would lose funding as a result. Mr
Rowlands explained that with all the cost cutting in the NHS it was necessary for the Commissioning
Support Units to be self-financing and they therefore had to become larger to mitigate the costs of
service provision. However he advised that we would not lose funding through these units as our
funding is per capita and is also based on risk and other factors.
12. The Surgical Assessment Unit
In discussion it was noted that the Surgical Assessment unit is very good. Although it is very busy the
staff are very kind and caring. It was also noted that staff throughout the hospital are very professional
and loyal to the hospital and will not denigrate it to patients despite all the reorganisations that have
gone on.
13. Possible small savings within the heath economy that could add up to a significant amount
Peter Hunt raised a concern on funding advising that he had attended the Outpatient clinics 6 times
this year, being requested on each occasion to bring a list of medication and a urine sample. He
collected a specimen bottle from the practice yet on attendance at the clinic found that they did not
require a sample. He suggested that the standard outpatient invite letter could be amended to request
urine specimens only when needed, such as perhaps for an initial appointment or in clinics where this
genuinely is required. This would save money on specimen bottles purchased by the practice. Whilst
this may only be a small sum (7p each) it was agreed that such issues should be considered within the
healthcare economy as many small savings still add up.
Peter also highlighted the issue of frequent bed moves during a hospital stay – involving changes of
linen again at cost of extra laundry. He also noted the fact that sheets with small holes in were thrown
into the laundry baskets probably to be re-laundered when they should be taken out of use.
14. Patients who smoke
Eileen asked if the hospital staff could prevent patients with drips standing outside the front entrance
to smoke. Jo explained that the hospital are proactive in challenging patients about their behaviour but
cannot override patient choice.
15. Services at Walton Hospital
Keith advised that he had not had a lot of contact with Arrowe Park hospital. However he felt that the
practice was superbly efficient as he had recently had an examination here by a GP and then his care
pathway for his treatment was all managed by telephone saving him needing to come back in to the
practice. He had been an inpatient at Walton and felt that the only thing they need to do is market
their service as although he was confident as to where he was going many other patients may not be
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confident to travel there. He said that the care was excellent and the Walton staff worked marvellously
as a team, knowing who their specialists were for each stage of the pathway and using them to best
effect.
Eileen flagged up the text reminder service the practice uses as an excellent system. Mr Rowlands
advised that hospital would be looking at using technology to share results with patients at an earlier
stage than a follow-up outpatient appointment as it could be a worrying time waiting for that
appointment.
As there was no other business to discuss the meeting was closed at 1345hrs and everyone was
thanked for attending.
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