Healthcare Commission

Annual Health Check 2007/2008

Comments of the Tameside MBC Personal and Health Services Scrutiny Panel

Tameside and Glossop Primary Care Trust

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

On 26th September, representatives from the PCT informed the Panel that the PCT had been asked to review the Acute Trusts progress against the Dignity in Care Action Plan. The PCT had formed a Patient and Public Reference Group comprising key patient and public stakeholders including representatives from the Patient’s Forum, Tameside Hospital Action Group (THAG), Age Concern and a Councillor from the Personal and Health Services Scrutiny Panel. The aim of the group was to engage stakeholder opinion and to receive guidance and advice on the progress of the review.

The PCT had set up a project team to carry out the review. As part of the review, the project team undertook interviews with 15 inpatients and relatives/carers and 6 meetings with patients and relatives about their perceptions of the Hospital. Information was then gathered by the project team to identify a number of learning points for the Acute Trust.

On 12th March, the Personal and Health Services Scrutiny Panel received a report about Equitable Access in Primary Medical Services. The PCT were keen to involve the Personal and Health Services Scrutiny Panel in the consultation process and wanted to feedback on their initial plans.

The Panel found that the PCT had carried out extensive consultation with patients and the public and were involving them at a very early stage in the development. The Panel was very pleased to hear about a consultation leaflet that had been sent out in the local paper asking members of the public for their views on the plans. The PCT were involving representatives of the Patient and Public Involvement Forum in consultation over the development of the new service and the panel welcomed this approach.

Members of the Panel are very pleased with the nature of the relationship with the PCT over the year, which have been very mutually supportive.

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.

The Panel carried out a follow-up review on the provision of Dental Services in Tameside and received information from the PCT about the new Dental Access Centre and the Primary Care Centre. Members expressed concern over the availability of dental provision for people in wheelchairs, the Panel was informed that the PCT had made the new clinic accessible to people in a wheelchair and the Dental Access Centre had a hoist to lift patients needing dental treatment. The Panel found that the PCT were working well to address inequalities in dental access.

Members of the Panel found that the PCT had implemented a new domiciliary service which involved the provision of a central number an assessment of need and provision of dental service where necessary. The Panel was pleased to hear that the PCT had provided additional funding for dental domiciliary care services.

Tameside Hospital NHS Foundation Trust

These are the comments of the Personal and Health Services Scrutiny Panel in response to the Healthcare Commission’s Annual Health Check process. 

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

1. 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)

On the 18th October, the Panel received information from the Chief Executive, the Medical Director and the Director of Nursing from the Tameside Hospital NHS Foundation Trust about improvements to infection control. The Panel found that infection control had been effective with a 52% reduction in MRSA and a 35% reduction in C. Diff because a system of audits of hygiene and hand cleanliness had been introduced and an infection control champion appointed. £300,000 had been spent on various environmental improvements and a further £140,000 would be spent on further infection control measures. Members of the Panel are pleased with the improvements in infection control and the reduction in cases of Methicillin-Resistant Staphylococcus Aureus (MRSA).

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

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

On the 18th October, the Scrutiny Panel received information from the Chief Executive, the Director of Nursing and the Medical Director of the Foundation Trust about the implementation of the Action Plan for improvement in the provision of dignity and care at the hospital. Panel Members questioned the Trust’s representatives closely about the implementation of the Action Plan. The Panel were informed that special emphasis had been given to working with and empowering staff with a revised mission to make patient care at the heart of the hospitals activity. Staff had been involved in changes to employment practices, including signing a care and dignity declaration. A psychometric tool was being used to ensure that staff had the right values and behaviours and the hospital had received IIP accreditation.

The Panel feel that these measures have led to improvements in care and that staff are better trained to treat patients, their relatives and carers with dignity and respect. However, the Panel acknowledges that care for the elderly with dementia is still a challenge that has not been fully met and considers that the Hospital NHS Foundation Trust should focus on this to ensure that issues are resolved. The Panel feel that the action taken has been appropriate and wish to continue to monitor, with partners, the implementation of the action plan.

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

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

The Personal and Health Services Scrutiny Panel received a report from the Tameside Hospital NHS Foundation Trust Patient and Public Involvement in Health (PPIH) Forum regarding a visit made to Tameside Hospital NHS Foundation Trust on Monday 10th March. The report indicated that there were notice boards in the hospital containing PALS leaflets and information explaining the complaints procedure. However, the report reflected that there were too many leaflets on the notice boards and it was felt this hindered people from actually reading them. The Panel supports the views of the Tameside Hospital NHS Foundation Trust PPIH Forum that information about complaints procedures should be displayed clearly on notice boards.

Core Standard C15
Where food is provided healthcare organisations have systems in place to ensure that:

1. patients are provided with a choice and that it is prepared safely and provides a balanced diet
2. patients’ individual nutritional, personal and clinical dietary requirements are met, including where necessary help with feeding and access to food 24 hours a day.

On the 18th October, the Panel received evidence from the Chief Executive, the Director of Nursing and the Medical Director of the Tameside Hospital NHS Foundation Trust in relation to nutrition and hydration at the hospital as an aspect of the Dignity in Care Action Plan. An inspection had shown 95% compliance on the wards met the essence of care standard. The Panel were informed that protected meal times had been introduced, which did not mean that relatives could not visit if they were helping patients which their nutrition, but all mean that patients would not be disturbed during meal times.

The Personal and Health Services Scrutiny Panel received a report from the Tameside Hospital NHS Foundation Trust Patient and Public Involvement in Health (PPIH) Forum regarding a visit made to Tameside Hospital NHS Foundation Trust on Monday 10th March. The Report indicated that there was not a wide variety of choice of meals available for patients on Ward 43, primarily because it was a short stay ward. It found that patients on Ward 43 felt that the meals provided by the trust were not appetising and patients were under the impression that they received leftover food. The report recommended that the Trust consider meals on ward 43.

The Personal and Health Services Scrutiny Panel feel that the Tameside Hospital NHS Foundation Trust has improved its systems for the provision of food to patients but supports the views of the PPIH Forum that the Trust considers the quality and choice of food in ward 43.

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.

The Scrutiny Panel received evidence on 18th October from the Chief Executive, Director of Nursing and Medical Director of Tameside Hospital NHS Foundation Trust about the involvement of patients in improving the services provided by the hospital. An evaluation and questionnaire survey (prepared in consultation with Age Concern and the Centre for Public Health and Surveys at Salford University) had been sent to 500 patients and 175 questionnaires had been returned. The returns had shown a positive attitude towards the hospital with most people generally satisfied with their stay and treatment. The Foundation Trust would continue to take feedback from patients’ surveys about improvements to be made by the hospital. The Panel feel that the involvement of patients, their carers and others in the design, planning, delivery and improvement of healthcare services has improved.

Pennine Care NHS Trust

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

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

On 19th December, the Personal and Health Services Scrutiny Panel received information from the Director of Operations and the Service Director for the South Division from the Pennine Care NHS Trust about the proposed closure of Ward 38 at Tameside Hospital. The Panel was informed that 22 staff would be displaced from Ward 38 but would be redeployed within the organisation, probably either at the Crisis Resolution and Home Treatment Team or in adjacent wards. The Panel is pleased that the 22 staff will be redeployed and will continue to monitor the implementation of the plan.

On 20th February, the Panel received information from the Director of Operations and the Service Director for the South Division from the Pennine Care NHS Trust that there had been a delay in the closure of ward 38 but staff had already moved to new teams and services. The Panel was informed that the Trust was relying on bank and agency staff to cover empty posts in ward 38. The Panel was informed that all agency staff working in Ward 38 were suitably qualified and met the required standard of relevant legislation to work in mental health wards. The Pennine Care NHS Trust carried out local inductions with agency staff when they were appointed and there was continual monitoring of agency workers to manage risk. The Panel feel that the Pennine Care NHS Trust has satisfactory evaluation and monitoring procedures for the appointment of agency staff.

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.

The Pennine Care NHS Trust has attended two meetings of the Personal and Health Services Scrutiny Panel in three months and plans to attend the panel again for further updated information on the closure of ward 38. The Personal and Health Services Scrutiny Panel are satisfied with the level of involvement it has with the Pennine Care NHS Trust.

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

1. a safe and secure environment which protects patients, staff, visitors and their property, and the physical assets of the organisation.
2. support of patient privacy and confidentiality

The Pennine Care NHS Trust attended the Personal and Health Scrutiny on 20th February. The Director of Operations and Service Director for the South Division provided information to the Panel about the closure of ward 38 and the provision of additional in-patient beds in two adjacent wards, 35 and 36. The Pennine Care NHS Trust informed the Panel that in response to consultant concerns over space within the two wards, there would be an extra facility built to accommodate the additional beds. The Panel were pleased to find that the Pennine Care NHS Trust had responded to environmental concerns and will build additional capacity to provide the right environments for effective care.

The Director of Operations and the Service Director for the South Provision provided information at Scrutiny meetings on 19th December and 20th February regarding the Pennine Care NHS Trusts support of patient privacy. The Scrutiny Panel were concerned that the two adjacent wards would be mixed sex. The Pennine Care NHS Trust informed the panel that wards 35 and 36 would meet national standards for privacy and would have separate changing; bathing and treatment facilities in place. The Personal and Health Services Scrutiny Panel were pleased with the Pennine Care NHS Trusts support of patient privacy and hoped that this would extend to single sex wards as soon as possible.