Agenda and minutes

(a)       Mr Nick Chard declared a personal interest in the Agenda as a Non-Executive Director of Health Watch Kent.

(b)       Councillor Michael Lyons declared a personal interest in the Agenda as a Governor of East Kent Hospitals University NHS Foundation Trust.

(a)       Following up one of the issues discussed at the previous meeting, the question was put to the Chairman as to the possibility of having a look at outpatient services at Deal Hospital. The Chairman responded positively and said it would be found a place on the Forward Work Programme.

(b)       RESOLVED that the Minutes of the meeting of 7 June 2013 are correctly recorded and that they be signed by the Chairman.

Sally Allum (Director of Nursing and Quality (Kent and Medway), NHS England), and Dr Steve Beaumont (Chief Nurse, NHS West Kent CCG) were in attendance for this item.

(a)       The Chairman welcomed the Committee’s guests and they introduced themselves and provided an overview of the topic with the aid of a PowerPoint which was shown in the meeting and also made available in advance of the meeting and contained in the Agenda pack Members had before them.

(b)       Dr Beaumont explained that in his previous career in the military, he had sent staff to Mid-Staffordshire Hospital and feedback mirrored the comments in the Francis Report about the hospital’s ‘unhealthy, dangerous culture’. However, it was also stressed that underneath there was still good nursing care provided. He went on to explain that along with the other Chief Nurses at Clinical Commissioning Groups (CCGs) across Kent, his priority was to address issues around quality of care. The Francis Report contained 290 recommendations and promoted a ‘board to ward’ approach to implementation. In the new NHS landscape, this was the equivalent to saying ‘CCG to provider’. Dr Beaumont explained that he would be visiting all providers, starting with the main Acute Trust in his CCG area (NHS West Kent CCG), Maidstone and Tunbridge Wells NHS Trust, and moving on to all others, including independent providers.

(c)        His CCG held their board meetings in public and there were PPGs (Patient Participation Groups), lay member involvement and patient satisfaction data on which to draw. There was a new complaints system in the NHS and information was available direct from providers as well as that which went direct to CCGs. In addition, the NHS Constitution underpinned everything which was done in the NHS. This covered actions by staff and patients as it was in effect a concordat. The NHS had to deliver safe care, but patients had a responsibility to turn up to appointments.

(d)       One particular area of data was highlighted, that around serious incidents and ‘Never Events.’ Members asked for some examples of what came under these terms and it was explained that the context defined what or was not a serious incident. An example was given of an incident where the patient was satisfied with the outcome of the treatment received, but which was still reported and classified as a serious incident. In this particular case a simple change was possible, reducing the chance of it recurring. The key aim was to get people to regard serious incidents as an opportunity for learning rather than to pinpoint somebody to blame. In places where there has been a defensive culture, events might be downgraded to avoid reporting. This was something which needed to change. Staff involved in a serious incident were debriefed. The other side of this was the importance of spreading best practice. These points were relevant to health and social care, with each sector able to learn from the other. The outcomes of the Berwick review were awaited and  ...  view the full minutes text for item 4.

(a)       The Chairman explained that, through the South East Health Scrutiny Network, he had taken part in a visit to the 111 call centre in Dorking along with the Researcher to the Committee. This had been an interesting and informative day and had also provided the opportunity to hear from South East Coast Ambulance Service NHS Foundation Trust about their future plans more broadly. Members responded positively to the suggestion that a similar site visit be arranged for them to the 111 call centre in Ashford.

(b)       The Chairman proceeded to then explain that a Forward Work Programme for the Committee was being developed and asked for suggestions as to what could be included. The specific request to consider outpatient and post-operative care in Deal was raised again. The request was also made as to whether it might be possible for the Committee to meet in Deal to consider the commissioning plans of the Thanet CCG. In response the Chairman and Researcher to the Committee explained that there had been correspondence between the Chairman and the Chairman of the Overview and Scrutiny Panel at Thanet District Council as to the ability locally to look at these plans. It was also stated that it was already the intention to consider the commissioning plans of CCGs as part of the regular work of the Committee and this would commence in September.

(c)        The need for Members to be better informed and trained on issues around the Francis Report was also raised as this was one area where the Committee needed to be on top of the subject. The Chairman said this was something which would be looked at.