Appendix 1
EXECUTIVE MEMBER RESPONSE
NAME OF TOPIC GROUP: Community Nursing & Safeguarding Clients with Learning Disabilities
DATE OF SCRUTINY: 15 January 2013
TOPIC GROUP CHAIRMAN: Chris Mitchell
LEAD OFFICER: Sue Darker
SCRUTINY LEAD: Natalie Rotherham
EXECUTIVE MEMBER: Colette Wyatt-Lowe
Recommendations:
Executive Response:
e.g. To undertake a customer survey in the Autumn of 2013
e.g. To carry out the survey in September 2013
1.1 That awareness of HLT is increased among the general
population of Herts (3.4, 3.5, 4.5, 4.6)
Alison Fitzgerald Strategic Lead Nurse HCS
The HLT continually strive to raise their profile and have
negotiated with the Corporate Communications (HCC) that the
work of HLT (Purple Star Strategy) is a priority project and a
communication strategy has been agreed
Articles about the teams work have been in the local press and in
Horizons Magazine. An article is due to be published in Age
Matters
The team have secured a stall at Herts County Show and are
working with IMT Performance and Procurement to improve their
profile on Herts Direct as well as developing other marketing
strategies.
Road shows and events are an ongoing method of
communication and awareness raising including Public
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Involvement and stakeholder meetings.
1.2 That HLT ensure that the LD and carer community
unknown to social services is made aware of HLT (4.4)
Alison Fitzgerald Strategic Lead Nurse HCS
1.3 That CCGs assume the current PCT support of HLT and
take forward the development of HLT and Purple Strategy
(3.7, 3.9)
Alison Fitzgerald Strategic Lead Nurse HCS
1.4 That the work of HLT and the Purple Strategy is published
in the appropriate professional medical journals (4.1)
Alison Fitzgerald Strategic Lead Nurse HCS
1.5 It is imperative that the Purple Folder remains paper
based rather than electronic format (3.8, 4.3)
Alison Fitzgerald Strategic Lead Nurse HCS
1.6 ENHT works with the HLT to replicate the palliative care
and End of Life initiatives successfully working with
WHHT (3.10, 4.2)
Louise Jenkins
Health Liaison Team Lead Nurse and Clinical Supervisor
The Multi-Disciplinary Palliative Care group that exists in West
Herts is a joint venture between Health & Community Services
and West Herts Community Trust as this involves Specialist
Palliative Care colleagues and Community LD Nurses. The
Report recommends that East & North Herts Acute Trust should
set up the same group, but the responsibility would not lie with the
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See comments above in 1.1
An action plan and funding proposal for the Purple Star Strategy
was presented to JCT in March 13 and this was fully supported by
them. The team are progressing the agreed actions and will work
to establish links with the CCGs to further this work
The HLT are utilising a variety of methodology to chart the
development of the work including documentaries, films and
records of progress. Robust audit and evaluation of outcomes
built into the action plan will also support publication in the future
The service are ensuring that robust mechanisms are in place to
distribute the Purple Folder in a timely and efficient way to
support this imperative. The development of posters and leaflets
raise awareness about the availability of the Purple Folder in its
paper based format. Discussions about printing and distribution
of high quality replacement sheets are being held.
Hospital Trust but the Community Trust. We are actively pursuing
the setting up of such a group in East & North area but as the
services between the two sides of the county are set up very
differently this will take slightly longer.
The Palliative Care Tool shared by Shirley at the Scrutiny
Committee is a stand alone document which was compiled by all
the organisations and has been distributed widely. We will
continue to promote this countywide.
HCT response
Hertfordshire Community NHS Trust has worked closely with
Hertfordshire County Council and West Hertfordshire Hospitals
NHS Trust to establish the services in the west of the county. This
work has won national awards due to the improved working
across palliative care and end of life care for people with learning
disabilities.
HCT is working with East and North Herts Hospitals NHS Trust
and Hertfordshire County Council to replicate this good practice in
the rest of the county. This will involve working across clinicians
and a number of organisations including the two Trusts and local
hospices. HCT is committed to making this work well across
Hertfordshire and anticipate this could be in place by autumn
2013.
ENHT response
This recommendation is relevant to the community services for
end of life care for people with a Learning Disability. The
presentation given by the Health Liaison Service was about
community services and work in West Herts community not
specifically hospital end of life care. ENHT (East and North Herts
NHS Trust) was not asked to present any information on it’s end
of life strategy, or procedures, for this scrutiny event and were not
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present during the presentation by Shirley Dayton.
We have confirmed with the Health Liaison Team that the
presentation that was given was about community services.
Louise Jenkins, Acute Liaison Nurse has communicated with
Natalie Rotherham on 18 February to explain that the Multidisciplinary palliative care group in west Hertfordshire is a joint
venture between Health and Community Services and West Herts
community services, involving the Specialist Palliative Care team
and Community LD nurses.
The Health Liaison team are actively pursuing setting up a group
to replicate this in east and north Hertfordshire which would
involve Herts Community Care Trust, community LD nurses,
community palliative care services and the hospices in east and
north Herts. We understand that the Health Liaison team have
already made contact with Dr Traue in the Isabel and Garden
House Hospices to move this forward. ENHT will participate in
this group.
We would like to reassure the Scrutiny Topic Group that ENHT
does already have an end of life strategy in place which is used
for all patients, including patients with a learning disability. The
Trust also uses the Palliative Care Tool which was shared with
the topic group during Shirley Dayton’s presentation. The Health
Liaison team nurses are also involved in providing support, advice
and guidance to staff, patients or their carers where a patient with
LD is coming to end of life or has a life limiting condition, and this
would include where appropriate advance care planning for end
of life. In these circumstances the Liaison team work closely with
our medical and nursing teams and the Trust palliative care
teams.
Following receipt of the topic group report we have looked at the
Trust processes for end of care for people with LD with the
Liaison Nurses and with the palliative care team and can confirm
that the Trust does meet all ten quality markers for end of life care
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for people with learning disability as defined in the National end of
life care programme ‘The route to success in end of life care –
achieving quality for people with learning disabilities’. .
We can confirm that we have in place:

7 day/week palliative care service

Multi-professional palliative care team
Any other comments on the report or this scrutiny?
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