WELSH AMBULANCE SERVICES NHS TRUST

WELSH AMBULANCE SERVICES NHS TRUST MINUTES OF THE OPEN SESSION OF THE MEETING OF THE QUALITY, PATIENT EXPERIENCE AND SAFETY COMMITTEE HELD ON 14 MAY 2...
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WELSH AMBULANCE SERVICES NHS TRUST MINUTES OF THE OPEN SESSION OF THE MEETING OF THE QUALITY, PATIENT EXPERIENCE AND SAFETY COMMITTEE HELD ON 14 MAY 2015 AT VANTAGE POINT HOUSE, CWMBRAN WITH VC LINKS TO HEADQUARTERS ST ASAPH PRESENT : Emrys Davies John Morgan Martin Woodford

Non Executive Director and Chairman Non Executive Director Non Executive Director

ED JMo MW

Director of Quality and Nursing Medical Director

SJ BL

Head of Planning and Performance (Joined during Minute 14/15) Partners in Healthcare Lead Staff Side Representative (RCN) Assistant Director of Quality and Nursing Staff Side Representative Welsh Language Officer (Via VC, HQ St Asaph) Business and Quality Manager Corporate Governance Officer Quality Clinical Practice & Improvement Lead Staff Officer, Operations (Via VC, for Action Log discussion only)

HB

Staff Side Representative Non Executive Director Non Executive Director Corporate Secretary

KC KD JMy DS

DIRECTORS: Sara Jones Brendan Lloyd IN ATTENDANCE: Hugh Bennett Leanne Hawker Nigel Heal Wendy Herbert Nathan Holman Melfyn Hughes Alison Kelly Steve Owen Jane Palin Jonathan Sweet

LH NHe WH NHo MH AK SO JP JS

APOLOGIES Kath Charters Kevin Davies James Mycroft Dawn Sharp 01/15

PROCEDURAL MATTERS The Chairman welcomed all to the inaugural meeting of the Quality, Patient Experience and Safety Committee meeting. The Committee were advised of the change in order of certain items on the Agenda in order to accommodate a presentation by the Quality Clinical Practice & Improvement Lead. RESOLVED: That the standing declaration of Mr Emrys Davies as a retired member of UNITE be noted.

Date amended 14 October 2015 1

02/15

MINUTES OF THE QDC MEETING HELD ON 31 MARCH 2015 Open Session The Minutes of the meeting on 31 March 2015 were confirmed as a true and accurate record. Matters Arising JMo referred to Minute 43/15 namely an update on funding in terms of the communications device for the Community First Responder (CFR) scheme. JS provided the Committee with details of the funding and advised the Committee of the pilot schemes which were due to be implemented in June 2015. RESOLVED: That the Minutes of the meeting held on 31 March 2015 be confirmed as a true account.

03/15

ACTION LOG The Action Log was considered by the Committee. The Actions as listed were addressed as required and the Action Log was updated to reflect the updates. It was further added that the Integrated Performance Report would also be presented to this Committee as well as the Finance Resources Committee. The Committee were updated by JS in terms of CFR desks being established within the Clinical Contact Centre. RESLOVED: That the actions considered in the Action Log be noted and actioned accordingly.

04/15

Chairmanship and Membership The Chairman advised the Committee of the Membership of the Committee. In terms of staff side membership, SO informed the Committee that following discussion with the Chief Executive and Staff side and whilst the work was concluded in respect of partnership infrastructure, there would be two representatives attending QuESt as an interim arrangement; namely Kath Charters and Nigel Heal. RESOLVED: That the Chairmanship and Membership of the Quality, Patient Experience and Safety Committee be noted.

05/15

Terms of Reference The Committee considered the initially agreed Terms of Reference at length noting that a process involving further comment was underway should the Committee require them to be changed. The following comments were raised.    

In terms of the decision making process – further clarity was required It was not a Committee function to develop policy The Committee should be clearly sighted on what Trust policies were A Chair’s working group proforma, which detailed actions between/referred to Date amended 14 October 2015 2

Committees, should be incorporated within the TOR RESOLVED: That (1) the Terms of Reference be accepted subject to the alterations as described; (2) the current draft, once finalised be presented to the Trust Board for approval. 06/15

Annual Governance Statement (AGS) The AGS had been circulated to Members who were asked to provide any comments by 21 May 2015. RESOLVED: That the end of year reporting documentation for onward transmission to Audit Committee at its meeting on 28 May be endorsed.

07/15

Safeguarding RESOLVED: That the transfer of the safeguarding function to the Director of Quality and Nursing with effect from 1 May 2015 be noted.

08/15

PATIENT EXPERIENCE LH provided Members with an update from previous patient stories. The Chairman asked that an update be provided in terms of handing over patients to crews when there was a difficulty in locating addresses. This was to be provided at the next meeting. The Committee were advised of a story which involved a young child who had called 999 from home to inform the ambulance service that his mother was ill. There were several issues which had been raised following this call in terms of safeguarding. Members discussed the matter at great length and the following points were raised:  The Trust needed to revisit its methods when dealing with calls from children  Further education and training for call takers in terms of safeguarding was required  Escalation procedures required further examination RESOLVED: That the patient story and updates from previous patient stories be noted.

09/15

QUALITY DELIVERY PLAN 2014/15 – CLOSING REPORT JP presented for approval, the report which provided the year end position statement that was mapped to the Integrated Medium Term Plan 2015/18. RESOLVED: That the closing report be approved.

10/15

QUALITY IMPROVEMENT ASSURANCE FRAMEWORK 2014/15 – CLOSING REPORT Date amended 14 October 2015 3

The Committee were provided with an overview by JP in terms of how the Trust managed quality across the organisation and the report presented to the Committee was for completeness. RESOLVED: That the report be approved. 11/15

ANDREWS REPORT – CLOSING REPORT The paper was presented by JP which provided the Committee with confirmation in terms of the actions completed and with details of how any of the outstanding actions would be mapped out. Members discussed in further detail the way forward in completing the outstanding actions and it was confirmed by JP that the actions would be monitored through the Integrated Medium Term Plan (IMTP). In terms of Local Delivery Plans (LDP) and their effectiveness, Members requested a review be conducted and that by October 2015 an update on LDP’s be provided to the Committee. RESOLVED: That (1) the closing report be approved; (2) the outstanding actions within the Andrews report be reported to the Finance and Resources Committee; and (3) the Head of Planning and Performance provide an update on LDP’s at the October 2015 meeting.

12/15

STANDARDS FOR HEALTH INTERNAL ASSESSMENT REPORT 2014/15 JP presented the Standards for Health Internal Assessment report commenting that the report had been signed off by the scrutiny panel and was being presented to this Committee for approval. The following points were raised by Members:  The report should be shared with Health Inspectorate Wales  A note of thanks be recorded for Wendy Herbert and Jane Palin for their work The Chairman commented that a significant workload had been identified from this report and he asked for the Executive Team to provide assurance in terms of the timescales in achieving the work identified. JP informed the Committee that the information required would be mapped over to a template register and would be monitored going forward. As a point of clarity, SJ informed the Committee that the LDP was not confined to the Operational Heads of Service; all Directorates must have clear plans going forward. RESOLVED: That Date amended 14 October 2015 4

(1) the corporate recommendations contained in the Internal Assessment Report and agreed Leads, timescales and monitoring mechanisms be approved; (2) the decisions made at Scrutiny Panel regarding the robustness of the internal assessment and associated assurances be approved; (3) the next steps in relation to obtaining future improvements and assurances regarding the Health and Care Standards be agreed; (4) a review on progress be provided at the next meeting; and (5) a note of thanks be recorded for Wendy Herbert and Jane Palin for their work and leadership in producing this report. 13/15

DEVELOPMENT OF THE QUALITY IMPROVEMENT STRATEGY FOR 2015-18 PRESENTATION The Committee were given a presentation by JP on the development of the Quality Improvement Strategy (QIS) for 2015-18 which was available via the link below: Quality Improvement Strategy 2015-18 Presentation In terms of engaging staff with the strategy, Members were advised by JP that this was being addressed and staff would be informed accordingly. RESOLVED: That (1) the proposed content of the QIS prior to wider staff, service user and public consultation be discussed; (2) the QIS Plan on a Page document be approved; and (3) a Task and Finish Group with senior decision makers to develop the QIS Delivery Plan and Assurance Framework including measures and indicators be commissioned.

14/15

PUTTING THINGS RIGHT (PTR) BL presented the report and highlighted the points as listed below:  A 4 week recovery plan had been developed  The approval process was being considered to make it less complex  There were areas which still required improvement The Chairman welcomed the following comments:  Was the Ombudsman aware of the Trust’s current situation in terms of Concerns? – the Ombudsman was aware that a review into Concerns was ongoing but as yet had not received the outcome of it.  The Committee should be provided with a better understanding of the reasons Date amended 14 October 2015 5

behind why Concerns were being raised. WH advised the Committee that the Organisational Learning Group (OLG) was focused on understanding what the reasons were behind the Concerns being raised and how it would implement changes to make improvements in dealing with Concerns.  The Trust needed to determine what it was learning from the data provided and be cleverer in presenting the themes behind the Concerns.  Could assurance be provided that work to improve the 30 day response deadline was being tackled. BL assured the Committee that this issue had been addressed as part of the PTR review and if implemented, a significant impact in this regard should be realised. The Chairman commented that the review was very much welcomed albeit overdue. In terms of metrics he encouraged that a review be conducted going forward to include metrics such as what the Trust had learnt and how it intended to resolve those lessons. RESOLVED: That (1) the PTR report for the month of March 2015 be received; and (2) the outcome of the PTR review be presented at the Committee meeting in July 2015 15/15

PUTTING THINGS RIGHT - REVIEW This was referred to in the previous Minute and it was confirmed that the findings of the review would be presented at the QuESt meeting in July 2015. RESOLVED: That the PTR review be presented in July 2015.

16/15

NATIONAL COLLABORATIVE COMMISSIONING: QUALITY AND DELIVERY FRAMEWORK FOR EMERGENCY AMBULANCE SERVICES (CQDF) The Committee were presented with the report by HB. The following comments were raised:  If a particular indicator does not produce an action why was it needed? – HB explained the indicators, in their current state, were useful and reasonable.  In terms of LDP’s, the IMTP and commissioning metrics there would be a degree of overlap, was it possible to demonstrate through the use of glide paths how the Trust was progressing? – HB advised the Committee that a balanced scorecard would display all the headline indicators and part of the ongoing work would be able to illustrate the relevant trajectories. The Chairman mentioned that in order to make more effective use of Non Executive Director’s time it would be practical that if a plan and a trajectory had been agreed and it was on course, then this Committee could focus on other matters in greater detail. Date amended 14 October 2015 6

RESOLVED: That (1) the summary of the Framework (Appendix 1 of the report) be noted; (2) the action taken by the Finance and Resource Committee, on behalf of the Board, authorising the Chair and Interim Chief Executive, to sign the Framework Agreement with the provisos that WAST would commit to improving performance on a month by month basis, but the standards, outcomes and measures stated in the Framework are defined as a benchmark for measuring improvement rather than targets for which WAST is accountable be noted; (3) the attached letter (Appendix 2) from the Chief Executive, to the Chief Ambulance Services Commissioner (CASC) be noted; and (4)

17/15

the developing arrangements for managing the ongoing collaborative relationship with the Commissioner team be noted.

SAFEGUARDING REPORT ON WAST PREVENT POLICY The Committee were presented with an overview of the draft policy by BL. WH advised the Committee that this was a standard policy and as part of an NHS organisation the Trust was obliged to follow it. RESOLVED: That (1) the draft Prevent Policy be accepted. (2) the Trust exercised its duty under the Counter Terrorism and Security Act 2015. (3) the Safeguarding Team continue to progress and disseminate as required by the Department of Health Prevent Agenda.

18/15

ITEMS FOR NOTING Welsh Health Circular – Health and Care Standards RESOLVED: That the contents of the Welsh Health Circular – Health and Care Standards be noted.

19/15

WELSH LANGUAGE SCHEME ANNUAL REPORT 2014/15 RESOLVED: That authority be delegated to the committee chair to approve the report for submission to the Trust Board.

20/15

ANY OTHER BUSINESS Work plan for the committee It was agreed that a fuller discussion of the QuESt work plan would take place at the next QuESt meeting. Date amended 14 October 2015 7

Vice Chair Members were in agreement that Kevin Davies be recommended to be invited as Vice Chair of the QuESt Committee. RESOLVED: That (1)

t he Committee work plan be discussed in greater detail at the next meeting: and

(2)

N on Executive Director, Mr Kevin Davies be invited to be Vice Chair of the Committee.

Terms of Reference JMo referred to Appendix one, last bullet point under the heading ‘To Obtain Assurance’ and asked the Committee to consider whether the Committee should be assured that staff have the appropriate equipment, infrastructure etc.. to carry out their job and shouldn’t that be part of the scrutiny level of QuESt. In terms of clarifying which Committee (QuESt or FRC) scrutinised a particular matter, it was agreed that further discussions be held at Executive Management Team for this to be resolved. RESOLVED: That (1)

B L and SJ refer this issue to the Executive Management Team; and

(2)

t he Corporate Secretary re-consider the Terms of Reference and schedule items for discussion at the next Chairs Working Group.

Reports relating to the items of business in these minutes can be found on the Trust’s website, www.ambulance.wales.nhs.uk

Date amended 14 October 2015 8

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