Western Health and Social Services Council

Mrs Frances Robson welcomed everyone to the 154th meeting of the Western Health and Social Services Council. She said she was chairing the meeting in the absence of Mr Paddy McGowan who was unable to attend due to another commitment.

She reminded members that there was a very full agenda and asked them to adhere to the agenda time slots.

Mrs Robson welcomed Mrs Arlene Cassidy Chief Executive Autism NI (previously known as PAPA and Ms Celina Robinson Chairperson Autism NI Fermanagh Branch and invited them to make a Presentation to the Council.

Mrs Cassidy thanked the WHSS Council for giving herself and Ms Robinson the opportunity to update the Council on the work of Autism NI (PAPA).

Mrs Cassidy said PAPA were the longest established and largest indigenous Autism charity in Northern Ireland.

She said it was a parent led organisation which provides strategic leadership, training, advocacy and support for the Autism Spectrum Disorder (ASD) community in Northern Ireland. This she said was done in a number of ways; including being the political voice for the ASD community.

Mrs Cassidy said she felt it was timely in updating the Council on their work as the prevalence rate for ASD which had tripled since 01-04 was now higher than the combined total of Downs Syndrome, Parkinson’s and Multiple Sclerosis.

She stated that the waiting time for diagnosis has reached 35 months; there was no regional strategy and the first funding from the DHSSPS for ASD became available in 2004.

Mrs Cassidy said there had been some recent opportunities to address the issue of Autism. There was she said the Bamford Review of Mental Health and Learning Disability, the Equal Lives Report (Learning Disability Committee) and the Adult Mental Health Committee Report.

Mrs Cassidy said there had been a failure to consult and the opportunity to influence had been lost. In the Bamford Review: Human Rights and Equality of Opportunity under the section “Unequal Access to Services”, there was no mention of Autism; under the section “Carers” despite highest stress levels there was no mention of Autism; under section “Education Rights” despite DENI’s Task Group Report “Admission of Injustice” in 2002, there was no mention of Autism or under the section on “Involuntary Detention” despite critical mistakes due to lack of expertise, there was no mention of Autism.

She said there needs to be an ASD Programme of Care; a NI Autism Strategy and a NI Autism Act.

Mrs Cassidy listed the activities Autism NI (PAPA) have been involved in since 2006:

Mrs Cassidy said it was their intention when addressing the Joint Committee on Education to lobby for funds to appoint a Cross Border liaison officer and to develop an All Ireland qualification to run alongside Middletown.

Mrs Cassidy concluded by saying Autism NI (PAPA) aim to continue the campaign for legislation for ASD, establish a cross party special interest group for Autism and develop political links with countries who already have legislation.

Mrs Cassidy said debates had indicated that Autism is on the agenda, but action was needed.

Mrs Cassidy asked the WHSS Council to support their call for an ASD Programme of Care, NI ASD Strategy, NI Autism Act.

Ms Robinson then gave a brief overview of the aims and activities of the Autism NI Fermanagh Branch.

Membership is made up of parents, individuals and professionals. Each month a newsletter written by the Chairperson, which includes campaign news, information concerning local issues and details of activity programmes is sent to the members.

An activity programme which involves events and fun days takes place every month for children and their families.

Ms Robinson said the Fermanagh Branch were in the process of starting a Saturday fun club for families which will be based in Enniskillen.

She said they have two meetings a month. A morning meeting is held on either the 1st Monday or 1st Wednesday of every month from 10.00am until 12 noon. An evening meeting is held between 8.00pm and 10.00pm on the 3rd Tuesday every month. Both are held in the Clinton Centre, Enniskillen.

The meetings give parents a chance to meet and discuss issues which are relevant to them and also issues concerning the group as a whole.

Ms Robinson said she is a member of The Western Health and Social Services Board Autism Strategy Working Party. The Working Party have produced a document which has been published in April 2007 and contains the plans for future service provision in the West of the Province.

Mr Billy Page said himself and his colleagues continue to raise the issue of Autism at meetings of Derry City Council.

Ms Reilly said she would raise the issue of Autism with the WHSC Trust at the Liaison meeting later in the afternoon.

Mrs Cassidy said she would welcome and appreciate any support the WHSS Council can give PAPA.

Ms Robson thanked Mrs Cassidy and Ms Robinson for their very comprehensive Presentations and wished them success in their plans for the future.

Ms Reilly said she had just received a message to say that a number of the Western Health and Social Care Trust Board Officers had been delayed and were unable to attend at the prearranged time. The Trust Officers had been attending a meeting in Omagh with the new Minister for Health. The Trust Officers asked the Council to consider slotting them in at a later time or if they preferred to reschedule a new date and the Trust would accommodate this. After discussions with Council members it was decided to defer the meeting and arrange a new date. This was due to the number of issues to be discussed and the limited time available.

Mr Page said a major issue which needed to be raised with the WHSC Trust was Mental Health Services for young people. He said there had been a high number of suicides in the Derry area in recent weeks.

It was agreed that Mrs Gormley would telephone members for details of other concerns which they wish to raise at the rescheduled meeting.

Action Point a/05/07

WHSS Council Liaison meeting to be rescheduled with WHSC Trust and Business Support Manager to contact members for details of their concerns.

The Minutes of the previous meeting held on 1 March 2007 were adopted on the proposal of Mr Michael Carten and seconded by Mr Michael McIvor.

Action Point a/03/07. Include Access to Out of Hours Mental Health Services on Agenda for WHSS Council meeting June 2007.

Action Point b/03/07. WHSS Council to monitor the implementation of the Foyle and Sperrin Lakeland Trusts Mental Health Reviews.

Ms Reilly referred to an issue raised at a previous meeting by Mr Ross Hussey in relation to children staying overnight at a local hotel following a Tonsillectomy.

She said a letter had been sent to Mr R McCartney, Head of Operations (Southern Sector) with questions requesting clarification on a number of concerns about this issue.

The Council received the Trust’s answers to these questions and these were read into the minutes:

No - only those children who did not meet the reasonable distance criteria (living over 30 minutes from Tyrone County Hospital).

Yes if a parent asked to come pre-operative night we would provide contact for B & B.

Would the children who were offered B & B have stayed in hospital overnight if the hospital had a paediatric ENT inpatient unit?

Yes (Following our review we have decided children who do not meet reasonable distance criteria will be treated as inpatient only).

Senior Management Team, ENT Staff, Staff of the Urgent Care & Treatment Centre, GP’s of the Western Area, Northern Ireland Ambulance Service.

When the parents attended the outpatient clinic, when the child was called for the procedure, at pre-assessment clinic and when they were being admitted to the ward.

What were the contact arrangements for parents of the children in B & B should there have been a medical concern?

All parents receive discharge guidelines on what to do in the event of an emergency (attached to letter).

Where were the children who were offered B & B from - Fermanagh/Tyrone/Derry/Cross Border?

Children living more than 30 minutes from Omagh, local Omagh children discharged home.

How many children who stayed in B & B required further care or treatment – where were they seen? e.g. TCH Urgent Care and Treatment Centre/by ENT Consultant/Erne Hospital/Altnagelvin Hospital.

What protocols are in place within the Trust for dealing with an ENT emergency?

Yes – these children are cared for in Ward 2A which is separate from adult ENT and this ward is child friendly and secure.

A copy of his response was issued to all members and because of the seriousness of the issue it was added as an Agenda item for the Liaison meeting with the Western Health and Social Care Trust.

Action Point d/03/07. Chief Officer to forward dates to Professor Burke for the 2007/2008 WHSS Council meetings.

Ms Reilly said a list of dates for future Council meetings had been sent to Professor Dominic Burke, Acting Chief Executive, Western Health and Social Services Board. Professor Burke acknowledged receipt of the dates and will get back to WHSS Council to confirm which dates he will be available to attend.

Action Point e/03/07. Chief Officer to invite Chief Executive, WHSC Trust to attend a WHSS Council meeting along with Chief Executive, WHSSB.

Date to be arranged when confirmation received of Professor Burke’s availability.

Action Point f/03/07. Chief Officer to invite Dr Dermot Hughes to attend Workshop on The Future of Pathology Services in NI.

Dr Hughes attended the WHSS Council Workshop on 14 March 2007 which was held to formulate a response to the Consultation on the Future of Pathology Services in NI. The Council’s response to the Consultation has been circulated to all members and copied to Dr Hughes for information.

Action Point g/03/07. WHSS Council to continue to monitor Speech and Language Therapy waiting lists.

Ms Reilly said following a meeting with Parents from Strabane in relation to Speech and Language Therapy Waiting Times, Foyle Trust had been asked to provide waiting list figures for assessment and therapy. The following information for the current caseloads was received:

Ms Reilly said Speech and Language Therapy remained an important issue and the length of time having to wait rather than the numbers waiting was of major concern to the Council.

Ms Reilly said that on receipt of these numbers the Council had also requested figures for the length of time waiting which to date have not been received.

Ms Reilly said she will request waiting figures for the Southern Sector (old Sperrin Lakeland Trust area) of the Western Health and Social Services Trust.

Ms Reilly said she would copy the figures when received to all members and put the issue on the agenda for the June meeting.

Action Point AP: b/05/05

Copy of Speech and Language Therapy waiting figures to be requested and sent to all WHSSC Members. Item for June meeting agenda.

Action Point h/03/07. Chief Officer to invite Northern Ireland Ambulance Service (NIAS) to the WHSS Council meeting June 2007.

The NIAS have confirmed they will attend the Western Health and Social Services Council meeting on 15 June 2007 meeting. Agenda Item 15.

Ms Reilly drew members’ attention to a joint Council meeting organised for Wednesday 23 May 2007. She said there were two items on the agenda for the meeting. Members would receive an update from Dr Bernie Stuart about what was happening so far about the Patient Client Council. Ms Reilly said a Business Case drawn up by Dr Stuart in consultation with the four HSS Councils and others had been forwarded to the Department for approval.

She said there was now a crisis in NI in relation to access to NHS Dentists with almost every list for NHS Dentistry in the Western area closed.

Ms Reilly said the WHSS Board had said they were trying to address this issue and have prepared a Business Case for six Dentists who would be employed directly by the Board. These Dentists will be placed in areas where there is the greatest need. The WHSS Board are waiting on approval for the Business Case.

Mrs Brown said she was aware that the Orthodontist in Omagh was starting to remove children from his list and in two years parents will have to pay for this service.

Ms Reilly said she had received a copy of a letter sent by Mr Gordon McKenzie to the NI Commissioner, a number of MLAs, District Councillors and the WHSS Council. Mr McKenzie is a parent who advocates on behalf of a group of parents of children with Autism.

Mr McKenzie had previously acknowledged the positive role played by the WHSS Council in moving forward the concerns of parents.

In his letter he said that as a result of recent experiences of raising issues relating to Autism Services with both Health and Education the parents have concluded that Education needs a Council with similar powers to the Health and Social Services Council. He said the recent improvements in healthcare, were in no small part, as a result of meetings organised by the Chief Officer of the WHSS Council. These meetings provided parents with the opportunity to raise issues directly with Trusts and negotiate improvements in service provision. Letters to the Health Service were replied to within a reasonable period of time, he said, and issues raised were given serious consideration.

By contrast Mr McKenzie said Education representatives whom the parents had recently met with appeared to have no interest in the expertise gained by parents. Their attitude he said appears to be that “you are only parents” and “we know best”. He referred to the length of time it had taken to get a reply to a letter (which he also copied to the Council) and the absence of any serious consideration of the issues raised. He said there exists an arrogance among those in control of their Children’s education. His letter requested that serious consideration be given to finding a mechanism for improving the accountability of the Education system.

Ms Reilly thanked the members of the Council’s Autism Working Group who had given of their time to meet with the parents, Sperrin Lakeland Trust and the WHSS Board.

Ms Reilly referred to a joint letter that had been sent to the Minister from WHSS Council and a group of Strabane Parents of children with Speech and Language difficulties requesting a meeting. She said the Departmental Private Secretary had written to the WHSS Council and also directly to the parents on behalf of the Minister. He said assurances had been received from the WHSS Board that they were seeking to improve Speech and Language Therapy provision. The WHSS Board he said are working in collaboration with the new WHSC Trust to develop an action plan for the provision of Speech and Language Services.

The Departmental Private Secretary said he had hoped that he had answered the concerns raised in the joint letter. He gave a reassurance that the Minister attached great importance to the provision of Speech and Language services. He said the Minister was grateful to the WHSS Council for the interest they had taken but he did not feel it was appropriate to meet at this time. The Minister suggested that the Council continue to monitor the developments that are taking place.

Ms Reilly proposed that this issue would be put on the agenda for the Liaison meeting with the Western Health and Social Care Trust.

Action Point AP: c/05/07

Speech and Language Therapy provision to be put on agenda for Liaison meeting with WHSC Trust.

Ms Reilly drew members’ attention to a Seminar on the Review of Access to Advocacy Services for Older Persons in Care Homes to be held on 13 June 2007 in Portadown. She said the Report of the audit carried out by the four HSS Councils and the Regulation, Quality and Improvement Authority will be presented at the Seminar.

Ms Reilly asked members to indicate if they planned to attend the Seminar on 13 June 2007.

Preston former Office Manager for the very generous gifts she had received from Members and Staff on her retirement.

Ms Reilly reminded members that the Western Health and Social Care Trust hold their Board meetings on the first Thursday of every month. She said she would encourage any Member to attend if the Trust Board meeting was on in their area and reiterated that Mr Paddy McGowan Chairman is the nominated representative for the WHSS Council. Ms Reilly had agreed to represent the Council if on occasions Mr McGowan was unavailable.

Ms Reilly said she had attended the May Trust Board meeting which she had found to be very informative. She said a major issue which had come to light following handing over to the new WHSC Trust was the overspend by Sperrin Lakeland Trust. The figure quoted at the meeting was £2.4 million but Trust Board members were told that this could rise following their own review of this overspend. Ms Reilly said what was concerning was that the original financial report had indicated Sperrin Lakeland Trust was in a breakeven position. The Trust Board were further informed that the overall deficit inherited by the new Trust from the three legacy Trusts was £15.4 million. This deficit is described as being caused by service pressures. Ms Reilly said this was a considerable amount to be in deficit before the Trust even begin to deliver services. She said the new Trust should not have to take on this deficit and she expected the Council would be very supportive of them on this issue. She proposed that a letter should be sent to the Department to raise this concern as well as the overspend by Sperrin Lakeland Trust.

Action Point AP: d/05/07

WHSS Council to write to Department to raise the Council’s concern in relation to the deficit inherited by the new WHSC Trust and the overspend by Sperrin Lakeland Trust.

Mr Ignatius Maguire said he had a concern where he was aware that at least one Dentist was urging his customers to take on a pricing plan. He asked the Chief Officer to raise the issue at the joint meeting on 13 June 2007 when discussing Dentistry.

C022/07 Update on review of member representation on Local Groups/Committees:

Members were issued with an update of member representation on local Groups/Committees.

Ms Reilly asked members to check the list and contact the Council Office if there were omissions.

A Monthly Activity Report was tabled for WHSS Council. Ms Reilly said the Council would report activity on a monthly basis as there may not be an end of year report to members due to the dissolution of the Health and Social Services Councils at 31 March 2008.

Ms Reilly said she had a concern that the number of complainants herself and Mrs Gormley were supporting had risen dramatically. She said they were supporting some very complex and difficult cases and they were seeing a month on month increase.

Mr Maguire asked the Chief Officer if there was any way in which members could support herself and the Business Support Manager in relation to complainants.

Ms Reilly thanked Mr Maguire for his offer but said due to the need to maintain complainants’ confidentiality it would not be possible to share the issues concerned and she felt it would be inappropriate to do so.

Ms Reilly said herself, Mr McGowan and Mrs Gormley attended an Accountability meeting with the Department on 19 April 2007. She said it was a very comprehensive and full report of the Council’s activities.

Ms Reilly said she represented the four Councils at the Annual Conference of the Association of Independent Monitoring Boards for NI (Prisons). She said legally as of April 2007 the Health Service provision within prisons is now the responsibility of Boards and Trusts.

Ms Reilly informed members that a date had been suggested for Pharmacy Practices Committee training but an officer of WHSSB was unavailable and a new date will be arranged and members contacted regarding their attendance.

Action Point AP: e/05/07

A new date to be arranged for WHSSC members to avail of training in relation to Pharmacy Practices Committee.

Ms Reilly said two dates 28th and 29th June 2007 had been arranged for training on FOI and DPA. She asked members to indicate which of the two dates best suited them to attend. She informed members that it was obligatory for them to attend training on FOI and DPA.

Ms Reilly said NIAS were attending the WHSS Council meeting on 15 June 2007 and to date she had received questions from two members to raise at the meeting. Members were issued with a copy of the questions. Ms Reilly reminded members to contact the WHSSC Office with any other issues they wish to have raised with NIAS at the meeting.

Ms Robson queried emergency planning and asked for this issue to be put on the agenda for the June meeting.

Mr Gerard Foley asked that the issue of Castlederg not having a 24 hour service be put on the agenda.

Mr Michael McIvor raised an issue about the Northland Road base which is shared by the Ambulance Service and the Fire and Rescue Service. He said he was concerned that both these organisations do not communicate with each other.

Ms Reilly proposed that herself Mr McIvor and Mr Page who also has concerns about the Northland Road site arrange to visit the site.

Action Point AP: f/05/07

Emergency Planning and lack of 24 hour service in Castlederg to be put on agenda for June Council meeting.

Action Point AP: g/05/07

WHSSC to make arrangements for a visit to the Northland Road Ambulance base by the Chief Officer, Mr McIvor and Mr Page.

Members were issued with an updated draft list of dates for WHSS Council monthly meetings up to March 2008. She asked members to diary these dates.

Mr McIvor said he would organise a venue in the Limavady Borough Council area for the Council meeting to be held on Friday 7 September 2007.

Ms Reilly said WHSS Council had received an anonymous letter regarding proposed changes to the Strabane/Limavady Out of Hours Service. The letter included a copy of an e-mail from Mr Eugene Dunn, General Manager, Western Urgent Care. The e-mail said the proposed cuts were to be implemented with effect from 1 July 2007.

As from the 1 July 2007 the effect of the cuts will mean that there will not be a Doctor in Strabane or Limavady bases between 6.00pm - 7.00pm and 11.00pm - 12 midnight Monday to Friday.

There will be reduced cover at all bases in Derry, Limavady and Strabane at the weekends.

The letter writer said these cuts were introduced without any appraisal of the effects on patient care, waiting times and public safety. There has been no public consultation or user involvement. The writer of the letter believed the issue should be brought to the public’s attention and would appreciate the help of WHSS Council.

Ms Reilly said she contacted WHSS Board for clarification. Mr Eugene Gallagher, Head of Primary Care and Family Practitioner Services said that across NI there is a shortfall in the amount of money that is required for the Out of Hours Service for this year. The Western area as with all areas have to make up the shortfall. Mr Gallagher said that Western Urgent Care had examined their statistics in terms of patient usage in the Strabane/Limavady areas. As a result they were able to determine that there was very low demand between 6.00pm and 7.00pm and 11.00pm to 12 midnight. Mr Gallagher said that making this two hour cut would have the least impact on patients.

Mr McIvor said that surgeries were held in Ballykelly on Monday and Thursday in the Drop in Well Centre and were manned by two Practices in the town. He said a letter came out approximately six months ago saying that they were looking at the possibility of closing the service down.

He said this is usually a very busy surgery and is used by mothers with young children. He said reasons given were the Doctor did not have medical records to hand or IT support.

Mr McIvor said he can appreciate both these reasons as being important but the fact of the matter is that in particular the army Headquarters have a very large population of people who have children and who have no transport and rely very heavily on these surgeries.

Mr McIvor said there is a notice in the surgery saying the Surgery will not be open during July/August. He felt they were starting to withdraw on a partial basis.

Action Point AP: h/05/07

Chief Officer to check with WHSS Board on the possible closure of Ballykelly surgery.

Ms Reilly drew members’ attention to the DHSSPS Press Release in their packs on the Comprehensive Spending Review 2007 – Efficiency Savings. This was in response to an article in the Irish News. The Health Minister Mr Michael McGimpsey said “The plans outlined in the article are not and will not be mine. Everything changed when the Devolved Administration was restored on 8 May”.

Ms Reilly on behalf of Members and Staff of the WHSS Council congratulated Member Mr Ross Hussey who has just completed an Open University Degree.

Mr Page said he had raised the issue of the swimming pool at Stradreagh with the WHSS Board. He said that the Board did not know that people with disabilities who had been using the Stradreagh Pool for over 30 years were not being accommodated at the new pool at Lakeview.

He said a family affected by this decision were in contact with Mr Trevor Millar, Director of Mental Health and Disabilities with WHSC Trust and have now been given the option of using Lakeview.

Mr Page said there was also a problem around the use of the Lakeview pool as they have only the services of a 0.2wte Physiotherapist.

Ms Reilly said there may be other families affected by this issue and the Council would contact Mr Trevor Millar.

Action Point AP: i/05/07

Date: Friday 15 June 2007

Place: Fermanagh District Council Offices

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

Mrs V Brown Mr M McIvor

Councillor M Carten Mrs M McKeague

Apologies: Mr P McGowan (Chairman) Councillor R Lynch

Councillor R Hussey Ms M Trimble

Councillor B Johnston

Mrs M Gormley

1 Press journalist in attendance