Western Health and Social Services Council

Minutes of One Hundred and Forty-seventh meeting of the
Western Health and Social Services Council
held in the Foyle Trust Headquarters/City Hotel, L’Derry
on Thursday 2 March 2006
at 10.00AM

Present: Western Health and Social Services Council:
Mr P McGowan (Chairperson)
Mrs V Brown Councillor W Page
Mrs S Hogg Mr D Sutherland
Mr I Maguire
Mr V McKelvey

Foyle Health and Social Services Trust:
Mr T Jackson (Chairperson)
Mrs G Durkan, Non-Executive Director
Mr E Friel, Non-Executive Director
Mrs B Hogg, Non-Executive Director
Mr J McKeever, Non-Executive Director
Mrs S O’Kane, Non-Executive Director
Mr J Lusby, Chief Executive
Mr J Doherty, Director of Social Care
Mr S Grant, Deputy Director of Finance
Mrs P Mahon, Director of Health Care
Mrs F McReynolds Director of Planning & Performance Mgmt.

Apologies: Western Health and Social Services Council:
Ms M Reilly (Chief Officer)
Miss M Burke Councillor R Lynch
Mr J Campbell Mr E McGrade
Councillor M H Durkan Mr R McIntyre
Councillor G Foley Ms M McKeague
Councillor M Hamilton Councillor S O’Brien
Councillor S Hume Ms F Robson
Councillor R Hussey Ms M Trimble
Councillor B Johnston

Mrs L Mitchell, Director of Finance
Dr A O’Hara, Medical Director
Mrs N Sheerin, Director of Personnel

In Attendance: Mrs M Gormley (deputising for the Chief Officer)
Mrs L Preston

Mr P McGowan opened the meeting by thanking Foyle Trust for the use of their premises for the Liaison meeting and said he welcomed the new integrated format for Liaison Meetings which he hoped would give members a better opportunity to interact with the Trust in a more open and transparent manner.

Mr Tony Jackson in his opening remarks welcomed Council members to the Trust particularly new members and commended the Council on its decision to integrate the Liaison meetings into the monthly Council meetings.

Mr Jackson said that while there is a good relationship between the Trust and the Council, the Trust welcomes the benefit of the Council’s robust challenge role.

Mr Joe Lusby then gave an overview of the Trust’s provision of services. He said the Trust provided services to Derry, Limavady and Strabane over an area of 1800 square kilometres with a population of 165,000. The Trust employed almost 4000 staff and invested in the region of £116million per annum in the provision of services.

Mr Lusby said the Trust provided services over five Programmes of Care:-
Older People Services
Family and Child Care
Learning Disability
Mental Health
Community Health Care including Physical and Sensory Disability Services

Mr Lusby gave a breakdown of how the £116million was spent:-
40% approximately on services for Older People
40% approximately on Mental Health, Learning Disability and Family and Child Care
10% Community Health Care
7% Physical and Sensory Disability Services

Mr Lusby said that over the past few years the Trust had set a number of priorities in terms of its infrastructure. One of the top priorities was Residential and Child Care services where the Trust had changed the context for the delivery of residential child care services by replacing one large Children’s Home with seven small family type units.

Mr Lusby said another priority for the Trust was the replacement of Stradreagh Hospital which had been achieved with the provision of a new state of the art Hospital known as Lakeview providing 43 in-patient assessment and treatment beds for adults and children with learning disability.

Mr Lusby gave an update on the current position with regard to the replacement of Gransha Hospital. The current Hospital is forty years old and despite investment each year the building looks and feels institutional. He said the Trust expected to have an announcement from the Minister within the next few weeks regarding the new Hospital and was optimistic of a positive outcome.

In relation to Ballycann Assessment Unit Mr Lusby said the Trust was in the process of re-submitting its Business Case to the Department for the fourth time. In the meantime significant monies had been invested to ensure the best use was being made of the accommodation which is available.

The Trust has been working with the Western Health and Social Services Board and General Practitioners to have outdated Health Centres replaced by Health and Care Centres and a new development in the Waterside is scheduled to open in 2007. The next priority is Great James Street Health Centre followed by work at Strabane and Limavady Health Centres.

Mr Lusby said the Trust had capital assets of £60-70million covering 80 facilities. He said the Trust had been fortunate over the past 4-5 years in being able to invest £5-7million annually to maintain and upgrade facilities. However this year due to financial constraints this investment would be reduced to approximately £1million.

Mr Lusby said that despite the annual investment of £5-7 million the Trust had a backlog of maintenance in the region of £30million.

Mr Lusby said the Trust had embarked on a Reform and Modernisation Initiative over the past few years and outlined the new developments which they were taking forward:-

Review of Family and Child Care Services – early intervention to avoid some of the crisis situations which families have to deal with. Mr Lusby said the Trust had turned around Family and Child Care services under an initiative called New Beginnings. He said there was still a considerable way to go and further investment was required but said delivery of the service was unrecognisable from what it had been a few years ago.

Review of Adult Mental Health Services - development of a strategy which had made huge inroads in terms of changing the context of the delivery of services. The Trust was trying to reduce the reliance on in-patient services to release monies for community services. The Trust currently has 56 in-patient beds and are proposing to reduce that to 30 thereby releasing £0.5million to invest in community services.

Review of Older People’s Services - Mr Lusby said the Trust was attempting to ensure that the investment of approximately 40% of its budget was producing the very best outcomes for older people. He said the Review was due to be finished by end of March 2006 which would identify the direction Older People Services will take over the next ten years.

Mr Lusby identified Service Improvement Projects – Speech and Language Therapy, Occupational Therapy, Podiatry and Shared Services which the Trust was investing in. He said the Trust had made significant moves forward but they were not complacent and agreed there was still room for improvement.

In conclusion Mr Lusby said that Mr John Doherty and Mrs Phil Mahon would provide some additional detail on Reform and Modernisation initiatives later in the meeting.

Mr John Doherty, Director of Social Care, reported on the Implementation of Mental Health Review.

Mr Doherty said one of recommendations of the Review Project Board was the establishment of a 24 hour Crisis Service which would replace the current 56 acute in-patient beds at Gransha and will include a 30 bed in-patient facility, an acute day care facility, a 24 hour crisis team with home treatment and an 8 bed community crisis house. He said all potential hospital admissions and other crisis situations would be referred to the Crisis Team for assessment.

Mr Doherty said that whilst the Crisis Services were being established the Trust was undertaking a refurbishment of the Clinics on the Gransha site.

A new Alcohol Service is planned at Damian House which would provide services for patients who are admitted with largely alcohol problems. In addition a staffed hostel and supported accommodation scheme in Limavady (Ballyclose) has just opened.

The Trust was in the process of a major workforce planning exercise to determine where staff would work in the new structures.

Mr Doherty advised that the Western Health and Social Services Board had provided significant funds to take forward the strategy. However, additional investment was required over the next five years and the Trust was working with the Board to secure the necessary funding.

Mr Lusby said this was the most significant initiative the Trust had undertaken in the field of mental health and the Trust was keen that it should progress in a timely fashion.

Mr McGowan congratulated the Trust on undertaking the Review but expressed concern at the timescales involved. He also felt there should be more Psychologists employed by the Trust and a move towards provision of smaller units.

Mr Lusby said the Trust was in the process of providing smaller inpatient facilities, but said the community infrastructure needed to be in place to enable the change to take place.

Mr Billy Page raised a concern regarding lack of facilities at weekends for young people, especially those with drug and alcohol problems.

Mr Doherty said that the Trust had submitted an expression of interest to provide an inpatient facility locally for young people, but had received a response from the Department that this development would not proceed at this point in time.

Mr Lusby reassured the Council that the Trust had developed Drug and Alcohol Services significantly but said there still were gaps in service provision.

Convene a meeting between Members of the Council’s Mental Health Sub-Group and Foyle Trust representatives to get an update on implementation of the Review.

Mrs F McReynolds reported that version four of the Business Case had been submitted to the Department and the outcome was awaited.

Mrs McReynolds said that during 2005 interim measures to improve sanitary facilities, patient privacy, corridor lighting and to provide a new activities room had been completed at a cost of £115,000.

Councillor B Page said the Council welcomed the opening of the new Hospital at Lakeview. He asked what were the full staffing requirements of the Unit, how many of the posts had been filled and what were the nursing staff requirements?

Mr John Doherty advised that the medical staffing complement for Learning Disability Programme of Care was 2 Consultant Psychiatrists, 1 Associate Specialist and 1 Senior House Officer. He said that in his opinion this was sufficient to provide the necessary cover for the New Unit. He advised that some staffing difficulties had arisen late in 2005 due to one member of staff leaving and staff sickness, but said these issues had now been resolved.

With regard to nursing, Mr Doherty said that staffing levels had been drawn up by senior nursing staff and these appeared to be working satisfactorily.

Mrs M Gormley asked for an update regarding assessment and treatment of children with Autism in the Trust?

Mrs Phil Mahon reported that the Trust continued to provide an assessment and diagnostic service with extra diagnostic sessions being provided by the medical team up to end of March 2006. The Trust has 140 clients on the waiting list with an approximate waiting time of two years. She said the Board had provided funding under the Health and Well Being Investment Plan in 2006/7 for the employment of an Early Intervention Therapist and this was in the process of being recruited.

Mrs Mahon reported on an Autism Services Steering Group which had been set up by the Western Health and Social Services Board which included key senior Managers from the Trust along with Parents and Western Education and Library Board representatives to oversee the actions of a Working Group which is taking forward training issues and developing a business case for development of the service.

Mrs M Gormley queried what the waiting time for intervention was following assessment.

Mrs Mahon said the Trust was ahead in terms of assessment but agreed that they were deficient in terms of treatment and that this has related to the fact that the Trust’s Commissioners had not provided any significant funding for treatment services. Nevertheless Mrs Mahon pointed out that the Western HSSB was developing a Strategy which would cover both assessment and treatment.

Mrs M Gormley queried if a Speech and Language service was provided to Autistic Children.

Mrs Mahon confirmed that a Speech and Language service was available to all children.

In response to a query from Mr Danny Sutherland as to when the Strategy would be published, Mrs Mahon said it was hoped work would be completed by September 2006.

Mrs M Gormley queried if the Trust provided a Twilight Nursing Service for children with severe disabilities?

Mrs Phil Mahon said twilight nursing services and children with complex needs were two separate issues. An intermediate care nursing service provided emergency nursing response between the hours of 8.30am to 11.00pm and children with complex needs are cared for by the community children’s nursing services.

Mrs Mahon said there was no funded service for these children but a case had been submitted to the Western Health and Social Services Board. In addition the Board in conjunction with the Trust was developing a respite care service for children with complex needs.

Mrs M Gormley said the Council was interested to know of the number of clients using Direct Payments and the Trust’s experience of administering the system.

Mrs Phil Mahon said at present the Trust had 10 clients using Direct Payments. She said the Trust have been providing staff training, production of information for patients and clients, and development of a form for Social Workers working with Carers and Clients but people were reluctant to become involved in the Scheme.

Mrs Gormley asked if the Trust employ a Carer Support Worker?

Mrs Mahon said the Trust had a Carer Support Worker and a Carer Support Forum which the Trust had developed meets regularly.

Mrs Gormley asked if the Trust monitors the scheme and whether clients have more flexibility through the Direct Payments scheme?

Mr Lusby said the Trust had applied the Department of Health and Social Services’ Guidance on Direct Payments which did have a certain amount of flexibility built in.

Mr Maguire said he was aware that Foyle Trust had undertaken a service improvement initiative which had led to a reduction in waiting lists/times and asked the Trust to describe the initiative and any other work being done to continue improving the situation?

Mrs P Mahon in response said that waiting times had been reduced by the Trust from 2.5 years to 8 months for the longest waiter. She said this had been achieved mainly through the establishment of an Assessment Clinic which simulated a home environment where clients’ mobility etc was assessed. The Clinic offered 24-25 appointments weekly. Currently an additional Saturday Clinic providing 12 extra appointments was operating until end of March 2006.

Mrs Mahon said the current waiting time for an appointment at the Assessment Clinic was 5-6 months. Where appropriate, clients attending the Assessment Clinic were provided with small aids at the Clinic whilst they waited for other equipment to be ordered and provided. She said the Trust was delighted with progress made to date and would continue to work to ensure that further progress is made. In response to a question from Mr Maguire, Mrs Mahon said that initiatives undertaken by Foyle Trust had been shared with staff in Sperrin Lakeland Trust.

Mr Maguire asked if the Trust was satisfied that Assessment Clinics were the way forward?

Mrs Mahon said there was no doubt that the Assessment Clinics had reduced waiting lists through quicker assessment and meeting clients’ basic needs whilst they waited for adaptations etc.

Mr Lusby said this was not the only initiative which the Trust had undertaken and reported on the introduction of a one point of contact telephone number and partial booking system. He said that by giving people choice the number of ‘Did Not Attends’ had been reduced considerably. The Trust also operated a telephone reminder system for clients attending the Assessment Clinic.

Mrs P Mahon said that the Trust had also given Administrative and Clerical staff a greater involvement in the service through training in dealing with queries.

Mr Jackson extended an invitation to Council Members to visit the Assessment Clinic.

Mr Maguire commented that very often Occupational Therapists were undertaking work which could be done by other staff and were therefore not making best use of their time. He asked if the Trust operated a rationalisation and monitoring system for waiting lists.

Mrs Mahon said that the Trust held monthly Waiting List meetings with Programme Managers to ensure that everyone was aware of what was happening.

Mrs F McReynolds said in addition to the monthly meeting a quarterly meeting with the Western Health and Social Services Board took place where assessment and treatment times are looked at.

Mr B Page queried if the Trust had been working with other Agencies on the issue?

Mrs P Mahon said the Trust had a close working relationship with other Agencies whereby the Trust is consulted on policies which affect the Occupational Therapy Service. She said the Trust would continue to work on developing those relationships.

Mrs Valerie Brown asked if Occupational Therapists from Sperrin Lakeland Trust had visited the Assessment Clinic?

Mr J Lusby said a series of Workshops had taken place over the past few years where anybody who wanted to learn of progress could attend. He said that the Trust would be happy to facilitate a local workshop if required.

Mrs M Gormley queried if the Trust had experienced any difficulties in changing the culture of staff to work differently?

Mrs Mahon said the Trust had found it easier than envisaged. She said that when results started to emerge staff realised that the new way of working was better and this was self-motivating for staff.

Mr Lusby had already covered this in his presentation but reiterated that the priorities for the Trust were the New Beginnings in Family and Child Care, Review of Older People’s Services and the continuation of Service Improvement Projects.

Mr S Grant reported that the Trust had faced a difficult year from a financial perspective not least in funding Agenda for Change. In October 2005 the Trust had contemplated an in-year contingency plan but fortunately this had not been necessary as additional funding for Agenda for Change had been received and the Trust now envisaged a year end break-even situation.

Mr Grant said the Trust continued to face financial pressures in other areas eg residential child care where the establishment of seven children’s homes to replace Harberton House had led to diseconomies of scale in the region of £200,000 per annum. He also reported that nursing costs of £200,000 had been incurred at Gransha Hospital through one very complex case requiring Intensive Care Services.

Mr Grant said the demand for domiciliary care continued to grow but the Trust had managed to remain within budget for the first time in a number of years. Other areas of pressure were – pharmacy costs, fuel costs and community equipment.

The Trust was also concerned about the Leaving Care Bill which came into effect in September 2005. To enable the Trust to fulfil the obligations of the Bill additional funding of £476,000 was required for 2006/7. He said the Bill and Agenda for Change would continue to be a challenge for the Trust.

Mr Grant said the Trust had demonstrated tight financial control throughout the year which will enable them to achieve a break-even position for the current year. This had been achieved through difficult decisions having been made at the beginning of the year eg by limiting investment in schemes and equipment and through Managers and staff exercising strict budgetary control.

Mr Danny Sutherland asked what was the extent of cutbacks in equipment and in the maintenance programme?

Mr Lusby said this year no transport vehicles had been replaced and the painting programme had been minimal however this could not be sustained for more than one year. Mr Lusby said that the backlog of maintenance for the 80 facilities owned by the Trust was in the region of £30 million.

Mr McGowan asked what were the areas of Unmet Need within the Trust and how did the Trust plan to deal with these?

Mr Lusby said the Trust had an opportunity throughout the year to feed pressure areas back to the Western Health and Social Services Board as well as an annual opportunity prior to the Board finalising its Health and Well Being Investment Plan. He said the Trust had met with the Board over the last weeks and presented to them all the pressures the Trust was dealing with. The critical ones for the Trust were – Domiciliary Care in terms of maintaining people in their own homes, Children with Complex Needs and Learning Disability Day Care.

With regard to Learning Disability Day Care Mr Lusby said that by June 2006 the Trust would have 29 children coming out of the Education System whose families would require support. He said the Trust’s Adult Training Centres were over subscribed and the Trust are concerned that they will not be able to cater for the needs of those leaving the education system.

Mr Lusby referred to an initiative undertaken within the Learning Disability Programme of Care where children coming out of the system were being tracked between now and 2014. This had identified the dependency of the children and therefore identified what the Trust needed to put in place in terms of care. This analysis had been fed through to the Western Health and Social Services Board but if there was no new investment there was nothing more the Trust could do.

Mr Lusby referred to the Board’s Health and Well-Being Investment Plan where the Board had received £7million over the past two years. He said the vast majority of that investment had gone to fund Renal Services, Intensive Care beds and Ear, Nose and Throat Services. He said services for Learning Disability, Mental Health and Children with Complex Needs had received very little investment.

Mr Lusby said another pressure was the Leaving Care Bill which was new legislation enshrining the rights of Young People to receive a service but it was not being funded or was funded on a limited basis. He estimated that £500,000 was needed for the Trust to meets its statutory requirements under the new legislation.

Mr McKelvey suggested that the Trust liase with the Western Education and Library Board as he considered they had a responsibility also.

Mr Lusby said another area of unmet need was Family Support in the Limavady area where the Trust had no provision. The Trust has been working over the past 1½ - 2 years with the Dry Arch Organisation who have been providing Family Support in the Limavady area on a non-recurring basis. He said if the Western Health and Social Services Board did not invest in the Limavady area the Trust was in danger of losing this service.

Mr Lusby said that all the areas of Unmet Need had formally been submitted to the Board.

Mr McGowan asked how the Trust was preparing for the implementation of the Review of Public Administration, in particular the amalgamation of the three Trusts in the Western Health and Social Services Board area into one Trust?

Mr Lusby said that the situation was incredible in terms of attempting to amalgamate three entirely separate organisations into one. He said that timescales for the implementation were unrealistic. The Trust had been awaiting a Human
Resources Framework Document which would describe how appointments were to be made and nothing meaningful could be done until this document was received. He said the Trust Board was meeting with the Permanent Secretary on 15 March 2006 when he hoped they would get more information on the way forward.

Mr Lusby said the challenge for the Trust was in maintaining a seamless service to the population whilst changes took place.

Mr B Page asked if there was a possibility that services would be centralised in Belfast?

Mr Lusby said there was a concern in terms of location of Organisations and around equity in the System.

Mr V McKelvey asked if there was a noticeable drift towards wastage in relation to early retirement etc?

Mr Lusby said that the Department had issued guidance on Vacancy Control whereby if a vacancy needed to be filled , this would be done on a temporary basis.

Mr V McKelvey felt there could be an issue in relation to quality of services during implementation of the Review.

Mr Lusby said that maintaining the quality of services was going to be a challenge for the Trust throughout this year whilst all the changes were ongoing. He said that front line services would be protected but said the Review would impact on supervisory levels, management levels, programme managers and administrative and clerical staff.

Mr I Maguire asked if the Trust had experienced problems in having to provide permanent contracts to staff who had been on temporary contracts for a period of two years?

Mr Lusby said it would be a difficulty which would have to be worked through. He said that Human Resources throughout the Board area were working on guidelines which will be applied to ensure consistency of approach across the Western Health and Social Services Board area.

C042/06 Learning Disability Daycare - Lack of Funding:

Mrs Valerie Brown said it was the Council’s understanding that the Trust was operating a waiting list for domiciliary care for the first time and asked for an update?
Mr Lusby said this had come about as a result of the demand for services outstripping available resources. He said that staff were ensuring that assessments were completed and those in greatest need were getting a service. The Trust continued to monitor the situation on a weekly basis.

Mr Lusby said the Western Board in conjunction with other Boards was reviewing the access criteria for domiciliary care services to attempt to get a consistent approach.

Mrs M Gormley asked if the Review of Older People’s Services would be looking at this issue?

Mr Lusby said the Review was looking largely at residential and hospital geriatric care. He went on to say the Trust spent around £5million per annum on domiciliary care but could not keep up with demand.

Mr Lusby said there were 60 on the waiting list across the Trust area, 30 of whom were in the Limavady area where difficulties in attracting homecare staff were being experienced due to the rurality of the area.

Mr B Page asked what systems were in place to manage people who left the grounds of the Hospital without the knowledge of staff and how families were reassured following such an incident that it would not happen again?

Mr Page went on to say he had been attempting to get answers to his query directly from Gransha Hospital over the past week but had been unsuccessful and therefore was raising it at the meeting.

Mr J Doherty expressed concern that Mr Page had not been able to make contact with the Hospital staff to have his concerns answered. He explained that there were two categories of patients ie voluntary and detained but said that staff should be aware of patients’ whereabouts at any time. He outlined procedures which are taken in the event of a patient leaving the premises.

Mr Doherty said the Trust was in the process of refurbishing clinics and a significant amount of that investment was security. Physically the alert systems should then be much improved and he said the Trust was trying to strike a balance between a place that is conducive to therapy and an acceptable level of security.

As there was no other business Mr McGowan thanked Foyle Trust for the frank discussion and debate.

Mr Jackson thanked Mr McGowan for his kind remarks and asked for the Council’s support in having the Trust’s Unmet Needs ie Day Care for Learning Disability, Children with Complex Needs, Domiciliary Care for Older People and Family Support in Limavady brought to the attention of the Western Health and Social Services Board at every opportunity.

Councillor G Foley
Councillor B Johnston
Ms F Robson

Mrs M McKeague joined the meeting at 3.00pm

C046/06 Mr McGowan welcomed members to the 147th meeting of the WHSS Council. He thanked those Members who had attended the Liaison meeting with Foyle Trust earlier in the day.

He expressed his concern at the timescales for implementation of Foyle Trust’s Mental Health Review and said this was an issue which would be pursued through the WHSS Council’s Mental Health Sub-Group.

Mr McGowan reminded Members that Ms Maggie Reilly Chief Officer was on annual leave and that Mrs Maureen Gormley, Business Support Manager, was acting up in her absence.

Mr McGowan offered condolences to Mrs Valerie Brown on the recent death of her mother-in-law. He said that the Council had also written to Mr Joe Brogan, Director of Pharmaceutical Services at the Western Health and Social Services Board, expressing sympathy on the death of his father.

The Minutes of the previous meeting held on 2 February 2006 were adopted on the proposal of Mr Ignatius Maguire and seconded by Mr Victor McKelvey.

Action Point: AP a/02/06 : Breakdown of allocation for New Local Hospital

Mrs Gormley reported that an e-mail had been sent to the Developing Better Services office on 16 February 2006 for further clarification and a response was awaited.

Action Point: AP b/02/06: Protocol for labelling of medication by Pharmacists

Mrs Gormley said the Chief Officer had written to Mr Joe Brogan, Western Health and Social Services Board’s Director of Pharmaceutical Services. He had replied saying that in addition to guidance already issued to pharmacists in the WHSS Board area regarding labelling of dispensed medicines, the DHSSPS would be issuing guidance to all pharmacists regionally and they will also consider guidance on information leaflets as part of this.

Action Point: AP c/02/06 Provision of Post Natal Rooms in Wards 15 and 55 Altnagelvin Hospital.

Mrs Gormley said a visit to the Maternity Ward and Postnatal rooms had been arranged. The visit will take place on 13 March 2006 and the Council will be represented by Miss Seana Hume, Ms Maggie Reilly and Mrs Maureen Gormley. She said that Altnagelvin Hospital had also indicated that a representative from Mother’s Voice would be invited to attend.

Action Point: AP d/02/06: Contact number for Mother’s Voice Group.

Mrs Gormley said that the Chief Officer had provided Mr Billy Page with a contact number received from Altnagelvin for the Mother’s Voice Group referred to at the Altnagelvin Liaison meeting.

Mr Billy Page said that he was also concerned that staff of the Maternity Unit did not know who Mothers’ Voice were.

Mrs Gormley shared information which she had got from Altnagelvin Trust’s website in relation to the Mothers’ Voice Group.

Mrs Gormley referred to the Oral Surgery Out-Patients Clinics in Omagh which are held on the first Monday of each month and which could potentially have to be cancelled due to Bank Holiday Mondays. She said this had been raised at the Liaison Meeting with Altnagelvin Trust on 12 January 2006 when the Chief Executive had given an undertaking to review these out-patient arrangements.

Mrs Gormley said the Chief Officer had written to the Chief Executive Mrs Way on 2 February 2006 asking for an indication of when changes would be made. A reminder was sent on 20 February 2006 but to date no response had been received. She said the situation was being monitored through the Council’s Waiting List Monitoring Group.

It was agreed to keep Oral Surgery Clinics on the Agenda until the matter was resolved.

Mrs Gormley said the Chief Officer had written to Mr Dominic Burke, Acting Chief Executive, WHSS Board on 20 February 2006 to determine, in the first instance, if the Board had any plans in the immediate or long term to provide more specialist nurses. She said a response was awaited.

Action Points: g/02/06 Altnagelvin’s Financial Position and New Developments DVD.

Mrs Gormley said a Workshop to discuss Altnagelvin Trust’s Financial Position and for new members to have an opportunity to see the DVD on developments on the Hospital site was being arranged. She said that Members would be notified when a date had been finalised.

Action Point: AP h/02/06 Invite to opening of the Renal Unit at Altnagelvin.

Mrs Gormley confirmed that the Council had received an invitation to the official opening of the Renal Unit at Altnagelvin by e-mail on 17 January 2006.

Action Point: AP i/02/06 GP held Waiting Lists – Musgrave Park.

Mrs Gormley said she had checked with Musgrave Park Hospital on 20 February 2006 and had been informed that the practice of GP held waiting lists was continuing. She was told that only one GP practice had sent in their referrals and the remainder were still holding them. She said that Musgrave Park Hospital staff understood that the Board had written again to GPs within the last 2 weeks.

Mrs Gormley had also raised this issue with Mrs Margaret Kelly, WHSS Board, at a meeting which she had attended the previous week. It had been confirmed by a General Practitioner in Fermanagh that the practice was still continuing. The matter was being pursued by the Western Health and Social Services Board and the Council would continue to monitor the situation and report back to the April meeting.

Mrs Gormley explained the GP slot system operating between Fermanagh GPs and Musgrave Park Hospital where Orthopaedic referrals were held at Practice level and not forwarded to Musgrave Park Hospital. She said that this meant the referrals were not getting proper prioritisation by the Orthopaedic Surgeons as they were unaware of them.

Mrs Gormley said GPs had been instructed by the Western HSSB to submit all referrals to Musgrave to be held centrally but to date the GP slot system is still operating. The Council would continue to monitor the situation.

Action Point: j/02/06 Meeting with Coolnagard Residents.

Mrs Gormley said a date for the meeting between Coolnagard residents and Sperrin Lakeland Trust representatives, chaired by Mr McGowan, Chair of WHSSC, had not yet been finalised but it was hoped to have the meeting at the beginning of April.

Action Point: k/02/06 Appointment of Non Executive Directors to Sperrin Lakeland Trust

Mrs Gormley said the Chief Officer had written to Mr David Best, Head of Public Appointments Unit at the Department asking:

1. Whether people local to the Sperrin Lakeland area were contacted in relation to the appointment of Non Executive Directors to Sperrin Lakeland Trust.

2.Whether any applications were received from people local to the Sperrin Lakeland area.

Mr Best had replied to confirm that everyone on the Departmental database, including all those from the Western Board area, were informed of the appointment opportunities and invited to express their interest in the posts. He also had said that there were some applications from people local to the Sperrin Lakeland area.

Mr McGowan said that Mr Best’s response appeared to be a contradiction of what the Minister had stated.

Mr I Maguire said from the evidence it appeared that the Minister had adopted a unilateral position on the matter.

Action Point: l/02/06Voluntary Car Services (NIAS):

Mrs Gormley said that a meeting between the Chief Officer, Chairman and Mrs Mary Hamilton, who is involved in the Voluntary Car Service, to prepare a paper on the issues around the Voluntary Care Services had been arranged for 10 April 2006.

Action Point: m/02/06: Western Health and Social Services Board - Managing Long Term Conditions.

Mr McGowan expressed concern at the make up of the Steering Group in that there was no user representation on it.

Mrs Sue Hogg considered there should be two user representatives on the Steering Group in order to keep the balance right.

Mr McGowan asked if the Western HSSC had been asked to participate in the Group. He said the Council could also strengthen the User voice.

Write to Western HSSB asking that the Steering Group on Managing Long Term Conditions include a User representative. Check if Western HSSC were invited to participate.

Action Point: n/02/06: Access to specialist drug treatments for Multiple Sclerosis.

Mrs Gormley referred to a copy of the Minister’s statement of 7 February 2006, which was enclosed in Members’ meeting packs, regarding plans to eliminate waiting lists for drugs to treat Multiple Sclerosis by March 2008. She said the Council strongly welcomed this initiative.

Mrs Gormley said the Chief Officer had written to Dr McConnell, Director of Public Health at WHSS Board asking for an update on the Board’s plans to implement the Minister’s decision. Dr McConnell had replied saying that the four Boards needed to work together to get a consistent plan across Northern Ireland and undertook to report back to the Council with further information as soon as possible.

Action Point o/02/06: Sperrin Lakeland Complaints and Clinical & Social Care Governance

Mrs Gormley said the Chairman had written to Mr John Compton, Acting Chief Executive, Sperrin Lakeland Trust asking him to confirm the Trust’s intention to ensure that the management of complaints and their outcomes will be part of the clinical and social care governance arrangements. She said Mr Compton had replied to confirm that the investigation of complaints and the application of learning that comes from them will be part of the scope and remit of the proposed new Clinical and Social Care Governance Directorate within the Trust.

Mr McGowan said that the Council needed reassurance that Complaints would come under the Clinical and Social Care Governance Directorate.

Mrs S Hogg felt it was very important that the route for complaints was very clear in order for the Trust to have any credibility.

Mr Victor McKelvey said the Trust needed an independent view on complaints. He said if complaints were submitted to the Trust then they were investigating themselves and he said this was not acceptable.

Mrs Gormley said that currently in all Trusts the Complaints Officer is employed by the Trust.

Action Point: AP p/02/06 Hip and Joints Initiative.

Mrs Gormley said it had been reported in the minutes of the February meeting that the Council had not been informed of the initiative prior to the Press Release. She now wished to record that in fact the WHSS Board had informed the Council by telephone on 20 February 2006 prior to the initiative.

Mrs Gormley said the Chief Officer had written to Dr Bill McConnell, Director of Public Health, WHSS Board on 20 February 2006 to raise Members’ questions in relation to the Hip and Joints initiative and a response was awaited.

Action Point: AP q/02/06 Critical Care Facilities.
Mrs Gormley said that the Chief Officer had written separately to Professor Dominic Burke, Acting Chief Executive, Western Health and Social Services Board, Mr Dean Sullivan, Director of Secondary Care, DHSSPS and Mr John Compton, Acting Chief Executive, Sperrin Lakeland Trust asking if a Level III Critical Care Unit would be provided in the New Acute Hospital.

Mrs Gormley said that to date a response has been received from Mr Compton only who has stated that the current plans for the new Acute Hospital facilitated Level II and Level III Critical Care. It was planned to have Level III care. Some of the patients will continue to require more specialised interventions in larger centres and will be transferred in accordance with clinical judgement. Mr Compton said the Trust was part of ongoing discussions with the Western Health and Social Services Board and wider DHSSPS regarding a network of critical care services. For example, the WHSS Board had a critical care subgroup considering the long-term requirements of the Western Area and the completion of that work was awaited. The letter said the Trust had also to take cognisance of a NI wide review of Critical Care Services in any future planning.

Mr McGowan proposed that following receipt of all responses the Council should ask for clarification on each Level of care.

Mrs Gormley said that the Chief Officer would raise the question of any plans to extend the ‘999’ Ambulance Service across the border at the next Local Ambulance Liaison Group meeting on 27 April 2006.

Mr V McKelvey referred to a Health Council meeting which Northern Ireland Ambulance Trust personnel had attended when an assurance had been given that there was cross border liaison.

Mr Gerard Foley referred to discussions at a previous meeting regarding the Ambulance Depot in Strabane and Castlederg. He reported that following an inspection it had transpired that the Strabane Depot was to be demolished.

Mr McGowan said that the Chief Officer was aware of this issue and the Council would continue to monitor this through the Local Ambulance Liaison Group.

Action Point: AP s/02/06 Location of new ambulance in Sperrin Lakeland Trust area.

The Chief Officer had written to the Western Board to ask:
1. Was an additional ambulance allocated to Sperrin Lakeland Trust area?
2. Where is the additional ambulance located?

The Board confirmed with NIAS that the additional 24/7 A & E cover was based in Omagh. Recruitment for this was underway and would require 12 staff who would graduate in September 2006. In the meantime, NIAS plan to provide additional cover by using existing staff on overtime.

Mr McGowan expressed concern that the already over-stretched staff would be asked to man the service until September 2006. He asked that the Chief Officer raise the issue at the Local Ambulance Liaison Group meeting on 27 April 2006.

Mr Danny Sutherland raised an issue which he had become aware of regarding ambulance service personnel reaching retirement age. He said he was amazed to learn that training for staff could not commence until personnel retiring had already left their post.

Chief Officer to raise these four issues at the next Local Ambulance Liaison Group meeting on 27 April 2006

Action Point: AP u/02/06: Autism

Mrs Gormley said a letter from Professor D Burke, Acting Chief Executive Western HSSB had been circulated to members. Members of the Autism group had expressed concern that actions arising from a meeting held in October 2005 had not been satisfactorily dealt with.

Mr McGowan proposed that the Council again write to the Board Chief Executive stating the need for an urgent meeting and also asking that he be in attendance at the meeting.

Mrs Gormley reported that she has contacted the parents of the Autism Group by e-mail to establish if any further progress has been made since the meeting with Board personnel. A response was awaited.

Mrs Hogg expressed concern to have learned at the meeting earlier in the day with Foyle Trust that there was a two year waiting list for children to be seen? She said that early intervention was vital otherwise Autism would become a big social problem.

Mr D Sutherland expressed concern that following diagnosis nothing was being done. He said what was the use of being diagnosed if no treatment was available.

Mr McGowan agreed and said it was important to get the Board to take on new and innovative ways of treatment.

Mr D Sutherland referred to the Strategy which was being developed by the four Boards and asked if parents were involved in that Strategy?

Mrs Gormley said that parents had been involved and at a meeting on 13 October 2005 the Board had undertaken to share their action plan and strategy with the Council.

Mrs Gormley said members of the Autism group would be informed when a date for the next meeting has been finalised.

Write to Chief Executive Western HSSB seeking an early meeting and inviting him
to be in attendance.

Mrs Gormley referred to the above Groups within Sperrin Lakeland Trust and confirmed Mr Joe Campbell’s nomination to the Adult PIP Group. Mrs Sue Hogg had agreed to being nominated to the Children PIP Group.

Action Point AP v/02/06 Mental Health Sub-Group.

Mrs Gormley said the Mental Health Sub-Group had met on 17 February 2006 and prepared a response to the consultation document “PSNI Procedures and Guidance for Dealing with Mentally Disordered Persons”.

Provide Mr Billy Page and Mrs Valerie Brown with copies of Council’s response to PSNI Procedures and Guidance for Dealing with Mentally Disordered Persons

Mr B Page referred to the issue he had raised at the meeting with Foyle Trust earlier in the day. He said he had been approached by three families who wanted to know what systems were in place to manage people who had left Hospital premises without the knowledge of staff. Families also wanted to have a reassurance that such incidents would not happen again. He said he had been attempting over the past week to get guidance from the Foyle Trust on the management of patients and to date had been unsuccessful.

Mr McGowan said that he was aware of an alleged reluctance by Carers and Users to be involved in the Northern Ireland Review of Mental Health Services as they felt their views were not being reflected in documents which were emerging. He said it was felt that professionals were dominating the outcome of the Review.

Mr Page expressed concern at the lack of facilities at weekends for young people presenting with drug and alcohol problems.

Mr McGowan said there was no child and adolescent provision outside Belfast. The only provision was within an Adult Secure Psychiatric Unit which he considered was damaging for the young people concerned.

Mr McGowan proposed to members that the Council re-convene the Mental Health Sub-Committee with a view to arranging visits to both Gransha and Tyrone and Fermanagh Hospitals in line with the Council’s ongoing Work Plan.

Arrange visits to Gransha and Tyrone and Fermanagh Hospitals by Mental Health Sub-Committee

The Chairman referred to the Project Team set up by the Department to develop proposals for the new Patient Client Council. Mr McGowan said he was representing the Western Health and Social Services Council with the Chief officer acting as Deputy. The first meeting would take place on Friday 10 March 2006.

Mr McGowan said the Executive Committee of Health and Social Services Councils, comprising the Chairman and Chief Officer of each Council, would continue to meet monthly to manage the transition from Health and Social Services Councils to Patient Client Council (PCC). He said the PCC would be a standard Agenda item at each meeting in order to keep members appraised of developments.

Mr McGowan said one of the developments coming from the last Executive Committee meeting was that Councils would need access to legal advice regarding the draft primary legislation required for the new Patient Client Council. He felt that the new PCC needed to have the right powers and legislation to make them an effective Advocacy Body. He said in this regard he was hoping to enlist the help of Council Member Ms Marilyn Trimble, who as a Barrister had some expertise in this field, in an advisory capacity.

Minutes of the Trust Board meeting held on 27 January 2006 and Agenda for a meeting to be held on 31 March 2006 were noted.

Minutes of the Trust Board meeting held on 2 February 2006 and Agenda for a meeting to be held on 2 March 2006 were noted.

Minutes of the Trust Board meeting held on 12 January 2006 and Agenda for a meeting to be held on 2 March 2006 were noted.

Mrs Sue Hogg, Mr Ross Hussey and Ms Maggie Reilly had visited Altnagelvin’s Cancer Unit on 3 February 2006. Mrs Hogg gave a report to Members on the visit.

Mrs Hogg said wide ranging discussions had taken place on issues such as how appointments were handled and how the system flowed. She said that the visiting team had met and were very impressed with Cancer Specialist Nursing staff.

Mrs Hogg said the one theme coming from the visit was the need for additional specialist nurses for colorectal and male cancers.

Mrs Gormley drew Members’ attention to a Joint Council Seminar on the Northern Ireland Response to the Shipman Inquiry Recommendations taking place on 13 April 2006 in the Glenavon Hotel, Cookstown.

Mrs Gormley asked Members to hold a full day in their diaries on that date as it is planned to update Members on the work of the PCC Working Group in the afternoon session. Full details of the events would be circulated to Members.

Mrs Gormley referred to the Integrated Clinical Assessment and Treatment Services (ICATs) which is due to be implemented from April 2006 for Ophthalmology, Orthopaedics, Urology and Plastics. The new system will reform out-patient services.

Mrs Gormley reported on an ICATs Steering Group meeting she had attended the previous week when she deputised for the Chief Officer who is a member of the Steering Group. She said that she felt it would be useful if a member of the Steering Group make a presentation to the Council at a future date to explain the new System. Members agreed.

Date: 2 February 2006
Meeting: Chair/Chief Executive Sperrin Lakeland Trust
Venue: Strathdene House, Tyrone and Fermanagh Hospital
Nominated: Mr McGowan

Date: 3 February 2006
Meeting: Waiting List MonitoringGroup
Venue: Conference Room, Hilltop, Omagh
Nominated: Mr McGowan Mr Campbell Miss Lynch
Mr Maguire Mr McIntyre

Date: 3 February 2006
Visit: Altnagelvin Cancer Unit
Venue: Altnagelvin Area Hospital
Nominated: Mrs Hogg Mr Hussey

Date: 10 February 2006
Visit: National Appeals Panel
Venue: Quays Shopping Centre, Newry
Nominated: Mr McGowan

Date: 14 February 2006
Hearing: National Appeals Panel
Venue: Castle Buildings, Belfast
Nominated: Mr McGowan Mrs Brown

Date: 15 February 2006
Meeting: HSSCs’ Executive Committee
Venue: Templeton Hotel, Templepatrick, Co Antrim
Nominated: Mr McGowan

Date: 16 February 2006
Meeting: Sperrin Lakeland Trust Board
Venue: DBS Conference Room, Tyrone and Fermanagh Hospital, Omagh
Nominated: Mr Campbell

Date: 17 February 2006
Meeting: Mental Health Sub Group
Venue: Conference Room, Hilltop, Omagh
Nominated: Mr Campbell Mr Foley Mrs Hogg Mr McGowan Mr McGrade

Date: 24 February 2006
Meeting: WHSSC Business Support Manager (Pre Council meeting)
Venue: Drumquin, Co Tyrone
Nominated: Mr McGowan

Date: 24 February 2006
Launch: Contributing to Well-Being Addressing the Human and Community Consequences of Civil Violence
Venue: Library HQ, Omagh
Nominated: Mr Campbell

Meetings and Events attended by Chief Officer/Staff for period 02/02/06 – 01/03/06

Date: 2 February 2006
Meeting: Chair/Chief Executive Sperrin Lakeland Trust
Venue: Strathdene House, Tyrone and Fermanagh Hospital
Staff: Ms Reilly

Date: 3 February 2006
Visit: Altnagelvin Cancer Unit
Venue: Altnagelvin Area Hospital
Staff: Ms Reilly

Date: 3 February 2006
Meeting: Waiting List Monitoring Group
Venue: Conference Room, Hilltop, Omagh
Staff: Ms Reilly Mrs Preston

Date: 6 February 2006
Meeting: HSSCs’ Chief Officers
Venue: Lagan Valley Island Centre, Lisburn
Staff: Ms Reilly

Date: 6 February 2006
Meeting: Complainant
Venue: Health Centre, Lisnaskea, Co Fermanagh
Staff: Mrs Gormley

Date: 7 February 2006
Seminar: Review of Public Administration
Venue: Stormont Hotel, Belfast
Staff: Ms Reilly

Date: 7 February 2006
Meeting: Announcement on MS Drugs
Venue: MS Society Headquarters, Belfast
Staff: Ms Reilly

Date: 9 February 2006
Meeting: Acting Chief Executive WHSSB
Venue: WHSS Board Headquarters, Gransha Park, L’Derry
Staff: Ms Reilly

Date: 9 February 2006
Meeting: Complainant
Venue: Conference Room, Hilltop, Omagh
Staff: Mrs Gormley

Date: 9 February 2006
Seminar: Investing for Health
Venue: Manor House, Killadeas, Co Fermanagh
Staff: Ms Reilly

Date: 9 February 2006
Meeting: Complainant
Venue: Enniskillen, Co Fermanagh
Staff: Ms Reilly

Date: 10 February 2006
Meeting: Complainant (Case Conference)
Venue: Coleshill, Enniskillen, Co Fermanagh
Staff: Ms Reilly

Date: 10 February 2006
Meeting: Complainant
Venue: Enniskillen, Co Fermanagh
Staff: Ms Reilly

Date: 14 February 2006
Meeting: Records Management Working Group
Venue: Betty Chambers Room, Musgrave Park, Belfast
Staff: Mrs Gormley

Date: 15 February 2006
Meeting: HSSCs’ Executive Committee
Venue: Templeton Hotel, Templepatrick, Co Antrim
Staff: Mrs Gormley

Date: 16 February 2006
Meeting: HSSCs’ Chief Officers (Chief Executive HPSSRQIA)
Venue: Tidal Centre, Toome, Co Antrim
Staff: Mrs Gormley

Date: 17 February 2006
Meeting: Mental Health Sub Group
Venue: Conference Room, Hilltop, Omagh
Staff: Mrs Gormley

Date: 24 February 2006
Meeting: Integrated Clinical Assessment Treatment Services (ICATS)
Venue: WHSS Board Headquarters, Gransha Park, L’Derry
Staff: Mrs Gormley

Date: 24 February 2006
Meeting: WHSSC Chairman (Pre Council meeting)
Venue: Drumquin, Co Tyrone
Staff: Mrs Gormley

Date: 27 February 2006
Seminar: Embedding Patient Safety
Venue: NI Human Rights Commission Offices, Belfast
Staff: Mrs Gormley

Date: 1 March 2006
Meeting: Complainant
Venue: Conference Room, Hilltop, Omagh
Staff: Mrs Gormley

C054/06 Date, time and place of next Council Meeting:

Date: Thursday 6 April 2006
Please note this Council meeting will be held in two Venues:

1. Liaison Meeting with Sperrin Lakeland Trust at DBS
Headquarters , Tyrone and Fermanagh Hospital
10.00am - 12.30pm

and following Lunch in the Silverbirch Hotel

2. Re-convened Council Meeting in Silverbirch Hotel
Gortin Road, Omagh
2.00pm – 5.00pm

Western Health and Social Services Council
‘Hilltop’
Tyrone and Fermanagh Hospital
Omagh
Co Tyrone
BT79 0NS
Freephone: 0800 917 0222
Tel: 028 8225 2555
Fax: 028 8225 2544
Minicom: 028 8224 8389
Email: info@whssc.n-i.nhs.uk
Website: www.whssc.org