Meeting documents

            Meeting: Health Scrutiny Sub-Committee (County Hall, Durham - Council Chamber - 02/04/2007 10:00:00 AM)

                  Item: A5 Healthcare Commission Annual Health Check: 2006/07 Declaration

         

---

Report of the Head of Overview and Scrutiny

Purpose

1. To receive a presentation from the NHS family in County Durham on their 2006/07 Health Check submissions to the Healthcare Commission (HCC).

2. To comment on performance of NHS Trusts serving County Durham as part of the Health Check process.

Information

3. Health check represents a major opportunity for Health Overview and Scrutiny Committees (OSCs) to have an influence on local health services.

4. Comments from JHOSC will be reproduced verbatim in the declaration and used by the Healthcare Commission to cross-check the veracity of the declaration.

5. NHS Trusts are measured against 24 core standards in 7 domains of:-

· Safety
· Clinical & Cost Effectiveness
· Governance
· Patient Focus
· Accessible & Responsive Care
· Care Environment & Amenities
· Public Health

(These collectively are seen as the basics of care - see APPENDIX 1)

6. Self-assessment by Trusts are submitted to Health OSC`s and judged against whether:- · Standards have been met without significant lapses
· Standards for which assurances received make it clear there may have been significant lapses
· Standards by which a lack of assurances leave the Board unclear as to whether there have been significant lapses


7. It is for Trust Boards to decide if a lapse is significant and not NHS managers. In coming to a decision, Boards consider the extent of risk to patients, staff and the public and the duration and impact of any lapse.

8. Whilst many core standards relate to detailed process, the Department of Health believes OSCs - together with Patient & Public Involvement Forums - can add to the total evidence base from their community-focussed work.

9. Feedback on 2005/06 (the first year of the new system) indicates a big response to this opportunity. Of 1,985 comments sent to the HCC, 807 were from OSCs. Comments, once weighted, were classified as: 49 ‘high’ quality intelligence, 1,245 ‘medium’ & 814 ‘low’.

10. To assist Councillors, the Health Care Commission (HCC) suggest OSCs focus on the following areas.:

· C13 - 16: Information and respect for patients and the complaints system
· C17: Involvement of patients & the public in planning, delivery and improving services. [This attracting most comment across all contributors in 2005/06]
· C22 - 24: Public health

The Process

11. The NHS Trusts will present their Annual Health Checks/Declarations to the Joint Health Overview and Scrutiny Committee (JHOSC) on 2 April 2007. The NHS will comment on each of the standards, declaring whether they are compliant or non-compliant.

12. Areas of non-compliance should be identified in a future work programme for the JHOSC so that the committee is able to monitor progress and consider the actions taken to address the particular issue.

13. The HCC has again not applied a rigid template, but it is suggested Members focus on activity they have been directly involved with. Advice would also be that all comment - whatever core standard it applied to - must be evidenced so the Committee can satisfy itself its verbatim comments accurately reflect experience.

14. To assist Members, information on what the JHOSC has looked at over the past 12 months is attached (APPENDIX 2).

15. It is suggested that a further opportunity to look in more depth at the NHS Trusts Annual Health Declaration be identified.

16. It is proposed that a special meeting of the Joint Health Overview and Scrutiny Committee meeting be convened on Friday 27 April 2007 (10am) to do this.

Recommendation

17. That the Joint Health Overview and Scrutiny Committee note the presentation on the Annual Health Care Declaration for each NHS Trust operating in County Durham.

18. That members of the committee receive the Annual Health Care Declaration for each NHS Trust in our area, with a view to commenting, informed by information received over the past 12 months at Joint Health Overview and Scrutiny Committee meetings.

19. That in order to ensure members have ample opportunity to digest the information and form a view, that a further meeting of the committee be arranged to feedback to the NHS Trusts the Joint Health Overview and Scrutiny Committee view on their respective Annual Heath Declarations.

Contact: Feisal Jassat Tel: 0191 383 3506 feisal.jassat@durham.gov.uk

F IRST DOMAIN: SAFETY

Patient safety is enhanced by the use of healthcare processes, working practices and systematic activities that prevent or reduce the risk of harm to patients

Core Standard C1 Healthcare organisations protect patients through systems that:-

a. Identify and learn from all patient safety incidents and reportable incidents, and make improvements in practice based on local and national experience and information derived from analysis of incidents;

b. Ensure that patient safety notices, alerts and other communications concerning patient safety which require action are acted upon within the required timescales

Core Standard C2 Healthcare organisations protect children by following national child protection guidelines within their own activities and in their dealings with other organisations

Core Standard C3 Healthcare organisations protect patients by following National Institute of Clinical Excellence (NICE) interventional procedure guidance

Core Standard C4 Healthcare organisations protect patients, staff and visitors safe by having systems to ensure that:-

a. The risk of healthcare acquired infection to patients is reduced, with particular emphasis on high standards of hygiene and cleanliness, achieving year-on-year reductions in Methicillin-Resistant Staphylococcus Aureus (MRSA);

b. All risk associated with the acquisition and use of medical devices are minimised;

c. All reusable medical devices are properly decontaminated prior to use and that the risks associated with decontamination facilities and processes are well managed;

d. All medicines are handled safely and securely;

e. The prevention, segregation, handling, transport and disposal of waste is properly managed so as to minimise the risks to the health and safety of staff, patients, the public and safety of the environment

SECOND DOMAIN: CLINICAL & COST EFFECTIVENESS

Patients achieve healthcare benefits that meet their individual needs through healthcare decisions and services, based on what assessed research evidence has shown provides effective clinical outcomes

Core Standard C5 Healthcare organisations ensure that:

a. They conform to NICE technology appraisals and, where it is available, take into account nationally agreed guidance when planning and developing treatment and care;

b. Clinical care and treatment are carried out under supervision and leadership;

c. Clinicians continuously update skills and techniques relevant to their clinical work;

d. Clinicians participate in regular clinical audit and reviews of clinical services

Core Standard C6 Healthcare organisations co-operate with each other and social care organisations to ensure that patients’ individual needs are managed and met

THIRD DOMAIN: GOVERNANCE

Managerial and clinical leadership and accountability, as well as the organisation’s culture, systems and working practices, ensure probity, quality assurance, quality improvement and patient safety are central components of all activities of the healthcare organisation

Core Standard C7 Healthcare organisations:

a. Apply the principles of sound clinical and corporate governance;

b. Actively support all employees to promote openness, honesty, probity, accountability, and the economic, efficient and effective use of resources;

c. Undertake systematic risk assessment and management;

d. Ensure financial management achieves economy, effectiveness, probity and accountability in the use of resources (NOT INCLUDED IN DECLARATIONS);

e. Challenge discrimination, promote equality and respect human rights;

f. Meet the existing performance requirements (NOT INCLUDED IN DECLARATIONS) ;

Core Standard C8 Healthcare organisations support their staff through:

a. Having access to processes which permit them to raise, in confidence and without prejudicing their position, concerns over any aspect of service delivery, treatment or management that they consider to have a detrimental effect on patient care or on the delivery of services;

b. Organisational and personal developmental programmes which recognise the contribution and value of staff, and address, where appropriate, under-representation of minority groups

Core Standard C9 Healthcare organisations have a systematic and planned approach to the management of records to ensure that, from the moment a record is created until its ultimate disposal, the organisation maintains information so that it serves the purpose it was collected for and disposes of the information appropriately when no longer required

Core Standard C10 Healthcare organisations:

a. Undertake all appropriate employment checks and ensure that all employed or contracted professionally qualified staff are registered with the appropriate bodies;

b. Require that all employed professionals abide by relevant published codes of professional practice

Core Standard C11 Healthcare organisations ensure that staff concerned with all aspects of the provision of healthcare:

a. Are appropriately recruited, trained and qualified for the work they undertake;

b. participate in mandatory training;

c. participate in further professional and occupational developments commensurate with their work throughout their working lives

Core Standards C12 Healthcare organisations which either lead or participate in research have systems in place to ensure that the principles and requirements of the research governance framework are consistently applied

FOURTH DOMAIN: PATIENT FOCUS

Healthcare is provided in partnership with patients, their carers and relatives, respecting their diverse needs, preferences and choices, and in partnership with other organisations (especially social care organisations) whose services impact on patient wellbeing

Core Standard C13 Healthcare organisations have systems in place to ensure that:

a. staff treat patients, their relatives and carers with dignity and respect;

b. appropriate consent is obtained when required, for all contacts with patients and for the use of any confidential patient information;

c. staff treat information confidentially, except where authorised by legislation to the contrary

Core Standard C14 Healthcare organisations have systems in place to ensure that patients, their relatives and carers:

a. Have suitable and accessible information about, and clear access to, procedures to register formal complaints and feedback on the quality of services;

b. Are not discriminatory against when complaints are made;

c. Are assured that organisations act appropriately on any concerns and, where appropriate, make changes to ensure improvements in service delivery

Core Standard CI5 (NOT INCLUDED IN DECLARATION FROM NEAS) Where food is provided, healthcare organisations have systems in place to ensure that:

a. Patients are provided with a choice and that it is prepared safely and provides a balanced diet;

b. Patients’ individual nutritional, personal and clinical dietary requirements are met, including any necessary help with feeding and access to food 24 hours a day

Core Standard C16 Healthcare organisations make information available to patients and the public on their services, provide patients with suitable and accessible information on the care and treatment they receive and, where appropriate, inform patients on what to expect during treatment, care and after care

FIFTH DOMAIN: ACCESSIBLE & RESPONSIVE CARE

Patients receive services as promptly as possible, have choice in access services and treatments, and do not experience unnecessary delay at any stage of service delivery or the care pathway

Core Standard C17 The views of patients, their carers and others are sought and taken into account in designing, planning, delivering and improving healthcare services

Core Standard C18 Healthcare organisations enable all members of the population to access services equally and offer choice in access to services and treatment equitably

Core Standard C19 (NOT INCLUDED IN DECLARATIONS) Healthcare organisations ensure that patients with emergency health needs are able to access care promptly and within nationally agreed timescales, and all patients are able to access services within national expectations on access to services

SIXTH DOMAIN: CARE ENVIRONMENT & AMENITIES

Care is provided in environments that promote patient and staff wellbeing and respect for patients’ needs and preferences in that they are designed for the effective and safe delivery of treatment, care or a specific function, provide as much privacy as possible, are well maintained and are cleaned to optimise health outcomes for patients

Core Standard C20 Healthcare services are provided in environments which promote effective care and optimise health outcomes by being:

a. a safe and secure environment which protects patients, staff, visitors and their property and the physical assets of the organisation;

b. supportive of patient privacy and confidentiality

Core Standard C21 Healthcare services are provided in environments which promote effective care and optimise health outcomes by being well designed and well maintained with cleanliness levels in clinical and non-clinical areas that meet the national specification for clean NHS premises

SEVENTH DOMAIN: PUBLIC HEALTH

Programmes and services are designed and delivered in collaboration with all relevant organisations and communities to promote, protect and improve the health of the population served and reduce health inequalities between different population groups and areas

Core Standard C22 Healthcare organisations promote, protect and demonstrably improve the health of the community served, and narrow health inequalities by:

a. Co-operating with each other and with local authorities and other organisations;

b. Ensuring that the local Director of Public Health’s annual report informs their policies and practices;

c. making an appropriate and effective contribution to local partnership arrangements including local strategic partnerships and crime and disorder reduction partnerships

Core Standard C23 Healthcare organisations have systematic and managed disease prevention and health promotion programmes which meet the requirements of the national service frameworks and national plans with particular regard to reducing obesity through action on nutrition and exercise, smoking, substance misuse and sexually transmitted infections

Core Standard C24 Healthcare organisations protect the public by having a planned, prepared and, where possible, practices response to incidents and emergency situations, which could affect the provision of normal services


Feisal Jassat
2 April 2007






APPENDIX 2
List of issues considered by Health Scrutiny from 1/4/06 to present date.

3 APRIL 2006

5 JUNE 2006

3 JULY 2006

5 SEPTEMBER 2006

2 OCTOBER 2006

8 JANUARY 2007

5 February 2007




Attachments

 HCC list of issues JHOSC 2007 - 2 Apr.pdf;
 Core Standards Appendix 1 - 2 Apr.pdf;
 Health Care Commission Annual Health Check - 2 Apr.pdf