AOD Patient’s Panel
Tuesday 22nd March 2011
11.00am
Boardroom, Stobhill Hospital
Present:
Daniel Connelly, NHS GGC
Lorna Gray, NHS GGC
James Ferguson
Jacki McIlraith
William Brady
Bill Milner
Heather Gartshore
David Paul
Apologies: Rory Farrelly, Director of Nursing
Meena Dutt
Deborah Macmillan
Tasneem Nadeem
Anne Marie Kennedy
James Duncanson
Dan Harley, NHS GGC
Alan Henderson
Eileen Ferguson
Anne Jack
Anne MacDonald
Eleanor McKendry
Rizwana Saeed
Barbara Walker
Kathleen Molloy
Alan McDonald
Alice McFarlane
Attending: Dr David Dunlop, Clinical Director, Beatson Cancer Centre
Pamela Joannidis, Lead Nurse, Infection Control
Alastair Bishop, Patient Management System Lead
1. Welcome and Introductions
Daniel welcomed everyone to the meeting and explained that there would
be a slight change to the agenda as Dr. David Dunlop was asked to attend
the meeting. Dr. Dunlop will be speaking first and the rest of the agenda
would follow as planned.
2. Changes to lung cancer services in North Glasgow
Dr. David Dunlop attended the meeting to update on changes to the above
service. He advised that there has been reorganisation of cancer services
in the West of Scotland over the last 8 years to try to improve the patient
journey and find the best fit for local delivery of services as much as
possible with certain treatment, such as radiotherapy, taking place in
Glasgow, at the Beatson Cancer Centre.
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Part of this work has been to create teams of doctors (consultants/
radiographers/ oncologists) who would look at each patient’s journey to
make sure that the correct input is going into planning the patient journey.
This will also mean patients have consultant-led input 52 weeks a year,
reducing any delays in diagnosis/ treatment as there is a team of
multidisciplinary consultants available to make decisions on the care of the
patient. In creating these teams, it means that the number of clinics can be
more streamlined, reducing the number of clinics from 40 to 33. In the
North of Glasgow, this means that lung cancer services in Stobhill and
Glasgow Royal Infirmary (GRI) can be merged where patients previously
attending Stobhill for their first appointment with an oncologist or thoracic
surgeon will now do so at GRI. However, diagnostic procedures will still be
at Stobhill and further treatment will be carried out in specialist areas as
before, e.g. the Beatson or Golden Jubilee National Hospital (GJNH).
David Paul asked if there would be a patient leaflet produced providing this
information for wider distribution. Dr. Dunlop advised that he would be
happy to do this, but also added that there has already been public
consultation on these changes, as well as patient representation through
the lung cancer Managed Clinical Network (MCN).
Heather advised that her personal experience of this service had been very
positive and Alan commented that good communication is essential and
that a clear pathway is defined, which these changes allow.
Kathleen asked about changes on the South of the city and Dr. Dunlop
advised that services in this area merged around a year and a half ago. He
added that these changes are for the benefit of the patient as they get rapid
access to specialists at the right time in their care – previously specialists
were spread too thinly to be as effective.
James asked how these changes affect referral to treatment times. Dr.
Dunlop advised that currently there is a target of 62 days from referral to
treatment for cancer services, and 31 days between decision to treat and
treatment starting. He advised that these targets are now being met due to
these changes.
Dr. Dunlop clarified that treatments will take place in specialist areas, for
example, the GJNH which specializes in cardiothoracic care will do surgery
on all lung cancer, and all radio/ chemotherapy will take place at the
Beatson for all lung cancers.
Dr. Dunlop offered to make regular updates on cancer services, which the
group thought would be useful.
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3. Update on Infection Control/ Healthcare Associated Infections
Pamela Joannidis attended the meeting to provide an update on Infection
Control and Healthcare Associated Infections (HAIs).
There are four main areas of work ongoing in the Infection Control Team:
 Audit programme – public partners have been involved in looking at the
process of audits on hand hygiene although not carrying out the audits
themselves. Audits previously focused on compliance, but this is being
developed to look at technique. There is also a separate body of work
on cleanliness monitoring, also involving public partners through
Elisabeth Sutherland.
The Infection Control Team carry out unannounced audits in every
clinical area once a year and provide an action plan after every visit.
Clinical areas are scored, and if they receive a low score, they will be
visited again within 3 – 6 months to see that the action plan is being
implemented and that improvements are being made. Clinical areas also
have visits from the Healthcare Environment Inspectorate to look in
detail at cleanliness in acute areas.
 Surveillance programme – there is a national programme for
surveillance on HAIs, and NHSGGC monitors levels of HAIs and their
trends, particularly focusing on MRSA and CDiff. This data is displayed
on charts outside wards, however the group questioned how useful/
relevant this particular information is to the general public.
 Education programme – Infection Control training can be done both face
to face and online. There are also volunteer programmes and training for
public partners who take part. For staff, there is mandatory infection
control training at induction, and now there is also a mandatory 3 year
update.
 Policy development – there are many policies for all aspects of infection
control and all are available on the NHSGGC website, for example,
guidance on how rooms should be cleaned in between patients. These
need to be reviewed and updated regularly.
There are currently two public representatives on the Infection Control
Committees, but need to explore further how the work is steered. There
could be a role for the Patients Panel in providing information from a wider
public perspective. This will have to be looked at in more detail as to how to
link into this work and have a more active role.
Pamela took questions from the group:
 Barbara asked about nurses wearing uniforms outside hospital areas.
Pamela advised that there is no scientific evidence of risk from this,
therefore it is not strictly an infection control issue. There is however a
corporate policy on this and while compliance remains an issue, it is
being embedded with the national uniform policy.
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 James felt that healthcare leads need to provide strong leadership in
hand hygiene, starting with making hand gels widely available and
clearly visible. He added that people will not use them if they are not
obvious.
 Alan asked about used items left in toilets, for example, bottles/ basins
and blocked toilets. Recurring problems of this sort would be highlighted
during visits but Senior Charge Nurses are also given responsibility to
deal with these kinds of issues. Pamela also advised that they would
encourage patients to highlight such problems, although some members
felt that patients sometimes feel too vulnerable to raise such things. This
requires a change in staff attitudes where patients feel more comfortable
confiding in staff.
 Pamela asked for feedback on the charts which show the infection
monitoring data. Heather felt that the print is too small and that the
information is hard to understand. The group were largely unsure of the
purpose of the charts. Pamela advised that the HEI wanted these
displayed, however asked whether this was something the public want.
It was agreed that an action for the Patients Panel would be to look at
what information is relevant for the public and how this should be
displayed.
 David highlighted that there are too many resources/ leaflets etc and
that one booklet should be made available to members of the public,
which will also help keep it up to date and relevant.
 Anne pointed out that changing facilities are required at ward level if it is
expected that staff should change out of their uniforms to take home.
 The group felt that restricted numbers of visitors at beds is required, and
this needs to be enforced at a higher level, as Anne pointed out that
people need to keep in mind pressures on staff and potential abuse they
get. A balance needs to be struck between letting people have family
around them helping in recovery and restricting the numbers. Pamela
agreed that there visitor numbers presents challenges in cleaning but
also supervision.
 Eleanor asked about how staff should wash their uniforms and how
effective it is at removing any risk of cross infection. Pamela advised that
the materials used in uniforms can be washed safely at 40 and that
detergents used in homes will ensure they are cleaned properly. Pamela
added that all parts of the washing process, including rinsing, drying and
ironing are all part of the process to kill any infection. Any uniforms
which come into contact with fluids such as blood will be washed at the
hospital.
 Eileen asked about consultant compliance to hand hygiene and Pamela
advised that there had been particular work done with this group of staff
and audit figures show that this is having a positive affect.
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 Anne felt some frustration that these conversations seem to be
repeated. She felt that there needs to be some responsibility put back to
the public and staff need the confidence that they have the authority to
impose certain standards.
Dan suggested that Pamela comes back to show the results in HAI and
reflect on the fact that there are improvements.
In taking forward work with Pamela, it was agreed that the main areas for
the Patients Panel are looking at the data charts at ward level and in hand
gel placement/ promotion.
4. Alastair Bishop
Alastair Bishop is the Service Lead for the new Trakcare system which is a
computer system being implemented in all acute hospital in Greater
Glasgow and Clyde. There will be staged implementation starting with
Inverclyde Royal Hospital in May – June 2011 ending in North Glasgow
Summer 2012.
What does it mean for patients and carers?
 Joining up of systems across NHSGGC – replaces several separate
systems. Movement of patients between wards and hospitals will be
simpler using this one system for notes/ test results etc. Staff can also
be trained once and use same system everywhere.
 Better information available for NHS Staff – less need to ask same
questions repetitively and less need to repeat tests. It will be easier for
the right staff to have the right info at the right time.
 Letters for patients – appointment and discharge letters will be same no
matter what hospital/ clinic the patient is attending. A template of the
letters which will be generated by the system have been informed by
guidance in the accessible information policy, which was informed by
patient involvement.
The system will be introduced in stages to provide several opportunities to
make changes.
Alastair asked for any comments on the sample letters. The following
suggestions were provided:
 Letter should note if patient transport has been booked and phone
number for cancellation. Could also include the booking reference
number.
 Letter should clearly state what clinic patient is to attend.
 Directions/ map should be included.
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 Letters should be 1 page where possible, double sided if necessary
(which would require printer with that capability). It was also questioned
whether some of the additional information leaflets are needed, in
particular, the information about no smoking on hospital sites.
 Bullet points were suggested, however the accessible information policy
does not include these, and the information is quite concise anyway.
 A PTO/ arrow should be used to indicate there is a 2nd page.
 Information on hand gel/ hand hygiene could be included.
 First referral from GP should highlight any special requirements, e.g.
large print etc.
 There was discussion around the use of yellow paper, particularly for
those with dyslexia. Anne Jack suggested that this should be used as
standard, however Dan advised that there would need to be strong
evidence to support that this is required, as it would have huge resource
implications.
Alastair confirmed that this system will not be used by GPs, however the
system used by GPs (EMAS) and Trakcare will be able to share
information. Test results and letters generated through Trakcare will also
be available on the Clinical Portal for GPs to access.
Alastair advised that the final letters can be brought back to the group after
implementation and teething problems have been sorted out to show again.
5. Rules of Engagement
The rules of engagement will be reviewed at the next meeting. If anybody
would like another copy sent out then let Lorna know. This may include a
review of how the core meetings of the group are conducted. There are lots
of pieces of work in progress that are quite detailed, but there is only
enough time in these meetings to summarise this work in order to keep the
agenda relevant and to time.
6. Volunteering Policy
The introduction of this policy has some implications in volunteering for
public involvement groups like the Patients Panel, as opposed to traditional
volunteering duties (e.g. working at the tea bar/ volunteer driving etc). This
will mainly be around the payment of out of pocket expenses or providing
support as required by members. Dan asked that the group take the time to
read through the provided document for further discussion if required.
Part of the policy requires that registration forms are filled out. Forms will
be sent out to make sure that all details are up to date. There is also an
obligation to recruit members from a cross section of the community. In
order to review this, the Community Engagement Team has developed a
confidential monitoring form. Again, this will be sent out and Dan added
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that members are not obliged to answer any questions they don’t want to.
In order for the Patients Panel to become more closely involved in services,
for example if they are involved in mystery shopping, Disclosure Scotland
forms will be required. Dan and Daniel will clarify exactly what is required
and these would be paid for by the Health Board. Occupational Health
checks are also required as part of the Volunteering Policy, however Dan
will be taking further advice of this as it is felt this is not necessary for the
work of this group.
Dan and Daniel would like to meet with members individually to talk
through what needs/ requirements they have and these meetings will be
set up over the next month. Dan confirmed there was no fixed term set for
membership of this group.
7. Better Together Update
A separate seminar will be organized to discuss this detailed piece of work.
8. AOCB
 Review of NHSGGC website – the Communications Team are looking to
change their website and would like some input from the Patients Panel
on their proposed design. Daniel will send out a letter confirming the
date as soon as possible.
 New Victoria Sanctuary Dedication Ceremony – the ceremony is taking
place on Monday 28th March. The invitation was extended to members
of the group, however it is anticipated that this is mainly for people living
in the area of the New Victoria, and as such transport will not be
provided.
9. Date of Next Meeting
The next core meeting will be on Tuesday 7th June from 11.00am until
2.00pm. Venue to be confirmed.
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