Local Engagement Board

Thursday 13th June, 2.00pm – 4.00pm

Bangladeshi Community Centre, 30 Tatham Road, SR1 2QD

A G E N D A

1.45 - 2.00 Registration and refreshments 2.00 – 2.10 Welcome and Introduction from Dr. Gerry McBride (CCG East Sunderland Executive Lead)

• The new ‘CCG prospectus’ 2.10 – 2.15 Any questions? 2.15 – 2.30 CCG plans for the development of residential and nursing care.

Presentation, Wendy Kaiser (Programme lead for mental health & learning disabilities)

2.30 – 2.35 Any general questions on the plans for residential and nursing care ? 2.35 – 3.05 Discussion: if you or a relative were to use (or do use) residential or nursing care, what is important to you?

• In terms of the health care you would want to receive particularly from your GP?

• In terms of what type of information would you like to receive about health care?

• Are there other key issues the CCG should consider in developing health care for people living in residential and nursing care homes?

3.05 – 3.20 Key points from discussion 3.20 - 3.30 Sunderland Highlights and closing remarks: Dr. Gerry McBride 3.30 – 4.00 Networking opportunity 4.00 Close

DRAFT

Appendix A

Governing Body

NHS Sunderland CCG Organisation Structure

Dr Ian Pattison

Chair

Dr Iain Gilmour (Vice Chair)

Urgent Care Lead

Dr Gerry McBride

Governance/PPI Lead

Dr Henry Choi

Clinical Effectiveness Lead

Dr Jackie Gillespie

Prescribing Lead

Dr Val Taylor Gloria Middleton

Aileen Sullivan Lay Member

PPI

Pat Taylor Lay Member

Audit

Prof Mike Bramble Secondary Care

Clinician

Chris Macklin Chief Finance

Officer

David Gallagher

Chief Officer

Dr Geoff Stephenson

Medical Director

Ann Fox Director of Nursing,

Quality & Safety (shared with STCCG)

Debbie Burnicle Director of

Commissioning,

Planning & Reform

David Gallagher

Chief Officer

(VSM)

Dr Geoff Stephenson Medical Director

(VSM)

Locality Leads Elected GPs

Debbie Burnicle Director of

Commissioning,

Planning & Reform Band 8d

Ann Fox * Director of

Nursing, Quality & Safety

Dr Jackie Gillespie Medicines

Management (via Elected GP)

Dr Henry Choi Clinical

Effectiveness (via Elected GP)

Kathryn Headley PA to Chair and Chief

Officer Band 5 12

Lynda Smith PA

Band 4

Gillian Ronaldson PA

Band 4

Dr Ian Pattison

Chair

Eleanor Hardy

* PA

Band 4

* shared with STCCG

Chris Macklin Chief Finance

Officer

David Gallagher Chief Officer

(VSM)

Kathryn Headley PA to Chair and Chief

Officer Band 5

Debbie Cornell Head of Corporate

Affairs Band 8b

Deanna Lagun Head of Safeguarding (adults and children)

Band 8b

Sue Goulding Head of Quality & Patient

Safety Band 8c

(not yet in post)

Ann Fox

*Director of Nursing,

Quality & Safety (shared with STCCG)

Band 9

* Eleanor Hardy

PA (shared with Medical Director)

Band 4

Julie Whitehouse Patient

Experience Officer Band 7

Vacancy Clinical Quality

Manager Band 8a

Angela Farrell Clinical Quality

Officer Band 7

(not yet in post)

Sian Firth Named GP

Richard Scott Designated Nurse

Safeguarding Adults

Band 8a

Designated Nurse LAC

(employed by STFT) Band 7

Designated Doctor Child Death

(employed by CHSFT)

Designated Doctor LAC (employed by

CHSFT)

Designated Doctor LAC (employed by

CHSFT) * shared with STCCG

Claire Wolfe (37.5 hours) Admin Officer

Band 3

Jaclyn Hall (30 hours)

Admin Officer Band 3

Dave Chandler Head of Finance

Band 8d (not yet in post)

Suzanne Clarkson

Assistant Accountant Band 5

Lynda Smith

PA Band 4

Alan Collinson Craig Ellis

Glenda Laydon

Performance/Data Analyst Band 6 x 3

John Baker Graduate Trainee

Michael Anderson (37.5 hours) Admin Officer

Band 3

Steven Davison MSK / Patient Choice

Band 3 – 20 hours

Chris Macklin

Chief Finance Officer

(VSM)

Commissioning Support Service

SLA

Scott Watson Head of Contracting, Performance &

Business Intelligence Band 8c

Laurie Robson Lynsey Caizley

Claire Miller

Contract Manager/Accountant Band 8a x 3

Director of Commissioning,

Planning & Reform

Band 8d 03

Clare Nesbitt OD/Project Manager

Band 8b

Ailsa Nokes Head of Planning & Reform

Band 8c

Ian Holliday Head of Joint Commissioning

Band 8c

Joanne Leadbitter Tracey Davis/Karen Jobson

Project Coordinators Band 5 x 2

Natalie McClary Helen Turnbull

Planning Reform Officer Band 7 x 2

Vivienne Gray TITO Lead

Band 4

Janette Sherratt Joint Commissioning

Manager (Children) Band 8b

Rachel Lumsdon Joint Commissioning

Officer Band 7 (0.5 wte)

Michelle Turnbull Joint Commissioning

Manager (MH/LD) Band 8a

Alan Cormack Contracting Manager

(CHC) Band 8a

Lee Cooper Contracting Officer

Band 7

Julie Moore (16 hours)

Pam Gray (22.5 hours)

Admin Officer Band 3 14

Donna Bradbury David Robinson Daisy Phillips Michelle Grant Penny Davison

Locality Commissioning Manager Band 8a x 5

Dave Britton Linda Reiling

Locality Commissioning Officers Band 6 x 2

Margaret Horn

37.5 hours Admin Officer

Band 3

Urgent Care Reform Office

Rebecca Cassidy (22.5 hours)

Steven Davison (17.5 hours) Admin Officer

Band 3 Line managed by

Lynda Smith

Wendy Kaizer Mental Health

MOC

Gillian Ronaldson PA

Band 4

Locality Leads Elected GPs

Debbie Burnicle Director of Commissioning,

Planning & Reform Band 8d

Eleanor Hardy PA

(shared with Board/ Executive Nurse)

Band 4

Lynn Dobson (37.5 hours) Admin Officer

Band 3

Daniel Johnson Pharmacy Assistant

Band 5

Dr Geoff Stephenson Medical Director

(Clinical Effectiveness) wte 0.5

Dr Jackie Gillespie GP Prescribing Lead

(via Elected GP)

Dr Henry Choi Clinical Effectiveness

(via Elected GP) NB working closely with

Governance/Quality Team

Locality Leads / Elected GPs

Zahra Irannejad Chief Pharmacist

Band 8c

Cath McClelland Senior Medicines Optimisation

Pharmacist Band 8b

Better health for Sunderland

Development of healthcare in

residential & nursing care homes in

Sunderland

Better health for Sunderland

� A/E attendances & 4 hour breaches

� Hospital admissions & readmissions

� Ambulance handover times

� Clostridium difficile & MRSA rates.

Sunderland CCG areas for improvement

Better health for Sunderland

� 52 homes

� 2183 beds at 79% occupancy

� Complexity of registration-residential/nursing/elderly mentally

infirm nursing/acquired brain injury/younger people with dementia/young people with

disabilities.

� Inspection through CQC & Local Authority

monitoring of contracts.

Sunderland care homes

Better health for Sunderland

Proportion of Nursing Home Residents with

Conditions Recorded on the GP Record

Better health for Sunderland

� 240 residents in 9 nursing care homes

� 94 hospital admissions over year-82% as an

emergency

� 23% had 3 or more admissions

� £400,000

� Reasons – acute infection, swallowing &

nutrition, GI bleeds, Hip fracture.

South Tyneside health needs analysis

Better health for Sunderland

� Three or more physical health issues ie COPD,

� High levels of mental health issues ie cognitive

impairment, anxiety

� Length of stay about 20 months

Health needs of residents

Better health for Sunderland

� Nursing staff in care homes only.

� Primary care through GP practice

� Community nursing services

� Access to specialist services

Healthcare in care homes

Better health for Sunderland

� What experiences do you have of healthcare in

residential & nursing care?

� What is important to you and your relative about

the healthcare received?

� What information is important for families &

residents in relation to their healthcare?

Your views

Better health for Sunderland

� Dignity and respect

� Involve and communicate with families

� Confidentiality used to exclude families

� Not enough staff, lack of continuity, more training needed

� Is CQC standard available / high enough?

� Good quality food / help with eating

� The right service at the right time

Amongst your family, friend and relatives, what is important to you in

terms of the healthcare you receive?

Better health for Sunderland

� What can be managed in the care home / requires specialist

attention

� What range of services are available from where

� Reassurance about what is NHS care and what you have to

pay for

� More information about which homes offer what & at what

standard

� Simple to understand, no jargon, nothing hidden

What sort of information would you like to receive about healthcare

Better health for Sunderland

� Link a GP practice to the home – regular visiting, early

diagnosis of problems

� Joined up thinking between services (GP, secondary care,

social workers, discharge plan, A&E, 24/7 team) – stop

bouncing in & out of hospital

� Offer assurances to people/families that staff are up to the

job and practice is safe.

� Keeping the family informed

� Continuity of care

� Adequate feeding support

What are the key issues the CCG should consider in developing health

care for people living in residential care homes?

1

Local Engagement Board

Thursday 13th June, 2.00pm – 4.00pm

Bangladeshi Community Centre, 30 Tatham Road, SR1 2QD

Discussion on Residential and Nursing Care:

the following points were raised

The Local Engagement Board (LEB) was attended by 10 members of the public. The main information topics and agenda are on the website, alongside the feedback below, offered by the public at the meeting. Of the 3 evaluation forms received words like: interesting, valuable, worthwhile were used to describe the event. Question 1: Amongst your family and friends what is important to you about the health care your receive?

• Dignity (quality of care)

• Interaction (lack of) between staff and patients / staff and family

• Not enough staff, not well paid, turnover

• Medication not administered

• Lack of right training i.e. not sufficiently skilled in how to care for different needs

• Homes ‘cutting corners’ to save money

• CQC (Care Quality Commission) reports – not widely known about

• Care depends on who is at the top of the tree

• Confidentiality issues (GP to inform family of medication – can be difficult to find out)

• Not enough socialisation, activities or entertainment.

• Timely – the right service at the right time

• Appropriate to the level of need

• Continuity – not bounced between staff and service

• Not isolated

• Be involved in planning of own care

• Patients in residential care (private environment ) need the same NHS services as others.

• Huge financial investments to live in nursing homes – sometimes have to sell house etc.

• Worries for the future – what will it cost?

• Quality – should be equable for all

• Should the assessment be independent e.g. age UK?

2

• Food quality, variety and quantity – poor

• Staff giggling & being disrespectful

• No-one about to help with toileting

• People falling – alarms inaccessible (now replaced)

• Homes that have ‘passed’ with CQC are still of poor quality. Is the standard high enough?

• It is everyone’s responsibility but this has gone on for years.

• Some seem t manage to get it right – why not others?

• Those who are mentally OK but physically not get a poor deal

• Management of nursing care through to palliative care

• Need a clear understanding (staff, patients & families) what can be managed in the care home

Question 2: What type of information would you like to receive about health care?

• Is there enough information available? Should be an information package available to residents

• Reassurance about what you have to pay for and what specialist NHS care is provided

• Simple – easy to understand

• No jargon

• Honest – nothing hidden

• Options / choice – what are they: nursing home; care at home; other alternatives

• Support in terms of what’s available – finance; carers; clubs

• Care plan: involved and informed throughout journey; include contingency planning

• Interventions / follow up – when out of hospital / care home are needs being met?

• Good coverage of basic needs

• Those who are mentally OK but physically not get a poor deal

• Management of nursing care through to palliative care

• Need a clear understanding (staff, patients & families) what can be managed in the care home

• Information on the condition / diagnosis and how to respond Question 3: What are the other key issues the CCG should consider in developing health care for people living in residential homes

• Linking GP practices with nursing homes

• Geography plays an important part in visiting

• Assurance & safety for all especially people in isolation

• Access to services (other than medical)

• Advanced care planning

3

• Joined up thinking between homes, GP, secondary care A&E, 24/7 etc.

• Regular GP support visit – catch things at an early stage e.g. UTI’s

• Joint decision making

• Discharge effectively managed

• CPN’s go the extra mile – go away and find out

• Staff should check how to address people – not assume they can use a first name

• General feeling is that in residential care you do not get access to the same range of community services.

• Podiatry – too infrequent. When should it be paid for privately?

• Homes prefer not to use an ambulance as they need to send a staff member – does this result in inappropriate care?