Agenda item

7.1

The Committee received a report from Jason Rowlands, Director of Planning, Performance and Governance, Sheffield Health and Social Care NHS Foundation Trust, on the Trust’s Draft Quality Account 2012/13.  The report set out details on the quality of the NHS services provided by the NHS Trusts, and was supported by a presentation by Mr. Rowlands and Tania Baxter, Head of Integrated Governance.

7.2

Members of the Committee and representatives of Sheffield LINk raised questions and the following responses were provided:-

·                     The provision of statistics regarding serious incidents in terms of safety, was not a mandatory requirement.

·                     Contact has been made with Sheffield LINk in order to arrange dialogue on the Quality Account.

·                     In terms of inspection visits by the Care Quality Commission (CQC), 11 such visits had been undertaken during the nine-month period commencing 1^st April, 2012, which had all been unannounced.  This equated to 11 visits out of approximately 25 to 30 care homes or wards.  Inspection visits in respect of Adult Social Care were undertaken on an annual basis, whereby such visits regarding other services were undertaken within a three-year period.

·                     In terms of the waiting times regarding access to health services by people with mental health issues, there had been a general acceptance by the Department of Health that such patients were not meeting the same access criteria as other patients, and that this issue would be addressed. 

·                     With regard to those health services being managed by the voluntary and/or faith sector, it had been identified that there was a need for some form of referral or advice service in terms of clients suffering from mental health, drug or alcohol problems.  The Trust had undertaken some work recently with housing associations on this issue.  It had been identified that the issue needs discussion through the Mental Health Partnership Forums, and that there was a need to identify ways of formulating dialogue on this issue.

·                     The figure of 396 people returning to work after accessing Improving Access to Psychological Therapies (IAPT) delivered in primary care, which equated to 18.6% of those seen by the service, were off work or not in employment at the beginning of their treatment.

·                     In terms of early intervention regarding mental health patients, it was the aim to fast-track such patients into mental health services to ensure that they are assessed at the earliest possible opportunity and, to help to ensure that their symptoms did not get any worse and cause any long-term damage to their health.

·                     With regard to intervention in terms of people suffering from dementia, there was a range of intensive community teams, who worked to keep sufferers in their own homes for as long as possible as evidence showed that there were better outcomes for those people supported in this way.

·                     The statistics relating to staff clearly indicated that the Trust had been successful in some areas, and not so successful in others.  A need to look at specific job-related training had been identified and an action plan was required in terms of dealing with those lowest performing areas.  With regard to staff working extra hours, they were simply asked, on the questionnaire, whether they had been asked to work additional hours, without having to provide any detail as to whether they were paid or unpaid hours.

·                     Work in connection with monitoring and reducing the number of falls from beds would be implemented in the forthcoming year, by the increased use of bed or floor sensors.

·                     In terms of Quality Objective 3 – to improve the identification and assessment of physical health in at-risk client groups, the Trust did refer to the importance of sleep, exercise and other factors when dealing with this issue.

·                     The reduction in the number of incidents reported where service users had been secluded had been attributed to staff training and the provision of improved care.  The Trust had undertaken a complete rethink on this issue, whereby staff had been trained to deal with incidents of violence in a more humane manner.  Steps had also been taken to improve the physical environment of wards or rooms in an attempt to provide a more calming atmosphere.

·                     Whilst it could not be confirmed, it was believed that the figure of zero in terms of the number of cases submitted with regard to enquiries into suicide and homicide by people with mental illness was simply due to the fact that no such enquiries had been concluded.

·                     Whilst some of the figures referring to incidents showed a downward trend, this was partly due to the fact that the figures for 2012/13 only related to the first nine months of that year.  It was therefore likely that in some categories, the addition of the statistics for the final three months would show a reverse in the trends.  With regard to the potential increase in violence, aggression and verbal abuse incidents, which was likely to show an upward trend, it was likely that a large number of incidents had resulted from the behaviour of a small number of patients.  The number of violent incidents in Sheffield was previously less than the national average.  The numbers of infection control incidents were considered to be far too low, and the Trust would like this figure to be higher in response to improved awareness and reporting.

·                     It was accepted that there were differences in the various types of in-patient services and that this should be taken into account when reading the Quality Account.  Some services held more information than others, therefore more targets were set for these services.

·                     There were plans to produce a more customer-friendly version of the Account, which would include explanations as to how the information and statistics had been gathered.

7.3

Members of the Committee and representatives of Sheffield LINk made the following comments/suggestions:-

·                     In terms of the provision of guidance regarding all Trusts, performance information should be provided for a three-year period, and should be consistent all the way through the Quality Account.

·                     There was a need for comparatives, in terms of national averages with regard to performance figures, so that people could make their own choices as to where they went to receive care.

·                     In connection with Quality Objective 3 – more emphasis should be placed on focusing on the diets and activity levels of those at-risk client groups, in terms of the assessment of their physical health problems.  Steps should also be taken to look at using an alternative to anti-psychotic drugs for such patients as they were known to result in problems of obesity.

·                     Steps should be taken to reduce the waiting times in respect of patients          accessing drug and alcohol services.

·                     The film on dementia should be available for other groups, such as this Committee and the Sheffield 50+ Group. 

·                     With regard to the statistics on the Memory Service, it is not clear whether these refer to new patients, new applicants or follow-up appointments for existing patients.

·                     There was a need to emphasis that the Quality Account was the result of consultation with Governors and service users.

·                     Consideration could also be given to placing more emphasis in the Quality Account on the Trust’s built environment, with more work being undertaken in terms of the capital issues, rather than revenue.

·                     The Trust should give consideration to making reference to how its internal structures work.

7.4

RESOLVED: That the Committee:-

(a)

notes the contents of the report now submitted, the information reported as part of the presentation and the responses to the questions now raised; and

(b)

requests (i) that the Director of Planning, Performance and Governance, Sheffield Health and Social Care NHS Foundation Trust, looks, in conjunction with the Primary Care Trust, at what steps could be taken to further reduce waiting times for memory management services, and for the Director to attend a future meeting of this Committee, in approximately three months time, to report on the Trust’s initial thoughts on this issue and (ii) in connection with the issue regarding the provision of assistance to those voluntary and faith organisations offering help and advice to patients with mental health or drug or alcohol problems, that this issue be referred the Health and Wellbeing Board to see if any such assistance could be provided.