| 1. |
Introduction |
| 1.1 |
In each year, the Eastern
Health and Social Services Council is required to deliver
a work plan for the coming year, indicating those areas
in which it will be active and how it will achieve its
core functions and objectives. |
| 1.2 |
Functions |
| |
The Councils core functions
are: |
| |
1.2.1 |
to monitor the provision
of health and social services |
| |
1.2.2 |
to advise HPSS agencies on the operation
of health and social services |
| |
1.2.3 |
to be consulted on major changes |
| |
1.2.4 |
to enter and inspect facilities |
| 1.3 |
Objectives |
| |
The
Council work plan is produced in the context of organisational
objectives agreed between the four Councils. These
are: |
| |
1.3.1 |
to increase visibility and accessibility
to members of the public |
| |
1.3.2 |
to monitor the health and social services
provided to the public |
| |
1.3.3 |
to advise on health and personal social
services policies, strategies and operation |
| |
1.3.4 |
to provide complaints assistance |
| |
1.3.5 |
to fulfil organisational requirements |
| |
1.3.6 |
to respond to local issues in the
provision of health and social services to the public |
| 2. |
Context |
| 2.1 |
This year’s work
plan takes place in the context of radical change. The
period covered by it ends with the abolition of the
Health and Social Services Councils and their replacement
by the new Patient Client Council. |
| 2.2 |
Patient Client Council |
| |
The Patient Client Council
differs from the Health and Social Services Council
in several major regards: |
| |
2.2.1 |
it is not a representative forum.
The members of the Patient Client Council are a small
number with responsibility for managing the organisation
and seeing that it delivers on its functions. Community
engagement, therefore, will need to take place as a
function of the Patient Client Council. It is not enshrined
in its structure. |
| |
2.2.2 |
it does not monitor or inspect Health
and Social Services. The new Regulation and Quality
Improvement Authority has responsibility for monitoring
and inspection. |
| |
2.2.3 |
it has a duty to inform the public
about the HPSS as well as to represent the public to
the HPSS. The new PCC is established to promote a dialogue
between the HPSS and an informed public and it has a
specific duty in this regard. The PCC will not be the
mechanism by which the HPSS is held to account. |
| |
2.2.4 |
it has a new function to promote patient
and public involvement in health and to be a resource
for the HPSS in doing so. This new function will require
the PCC to develop resources and expertise itself so
that it can be a resource for the HPSS in undertaking
and developing good practice in patient and public involvement. |
| |
2.2.5 |
there is a duty to engage with the
PCC. At present, there is no requirement on Trusts to
engage with the HSSCs at all. The Boards must consult
with the Councils. The PCC is named as one of the key
parties for consultation in general – along with
patients and the wider public. In particular, the DHSSPS
will consult with the PCC prior to approving Consultation
Schemes, which each HPSS body is required to produce. |
| 2.3 |
Commissioning and Providing
Arrangements |
| |
In addition to the changes
specific to the Patient Client Council, there are other
major organisational restructuring issues, which suggest
themes to be addressed by the HSSCs at regional level
and at local level: |
| |
Regional |
| |
(a) |
Relationship with
the Health and Social Services Authority |
| |
(b) |
Relationship with the Regulation and
Quality Improvement Authority |
| |
Local |
| |
(a) |
Relationship with Local Commissioning
Groups |
| |
(b) |
Relationship with Provider Trusts |
| 2.4 |
Change Management |
| |
An important part of the
context is that – during the period of the work
plan, the Council will be making arrangements for its
own dissolution and all necessary preparations for the
transfer of functions to the Patient Client Council
as appropriate. |
| 2.5 |
The work plan must take
account of this appropriately and of the following factors,
in particular: |
| |
(a) |
the potential for resources to be
diverted to dissolution work |
| |
(b) |
the potential for Council Members
to resign and not to be replaced |
| |
(c) |
the potential for staff members to
resign and not to be replaced |
| 2.6 |
Timetable |
| |
In September 2006, Council
agreed that, given the scale of change and its likely
impact on capacity and resources, that the work plan
then agreed by them would cover the period September
2007 to March 2008. |
| 2.7 |
It will be noted, therefore,
that several actions appearing in this work plan are
the continuation and/or completion of existing areas
of work as at March 2007. |
| 3. |
Key Themes |
| 3.1 |
The work plan for 2007/2008
is based around five key themes: |
| |
(a) |
Primary Care |
| |
(b) |
Patient and Public Involvement |
| |
(c) |
Mental Health and Learning Disability |
| |
(d) |
Service Reconfiguration |
| |
(e) |
Complaints Management and Advocacy |
| 3.2 |
Primary Care |
| |
For many people, the most
important HPSS relationship is with their GP. In addition,
the role of the GP will continue to develop through
the life of the plan at two levels: |
| |
(a) |
increased augmentation of services
provided at primary care level |
| |
(b) |
increased GP influence on commissioning
through new HSSA structures and new referral management
procedures |
| 3.3 |
For this reason, the Council
wishes to maintain a focus on the core relationship
between patient and doctor, with particular reference
to primary care. |
| 3.4 |
In 2006, the General Medical
Council published a new version of “Good Medical
Practice”. This new document stressed the concept
of the patient as a “partner in care” with
the doctor and gave a clear and authoritative description
of the good doctor. |
| 3.5 |
The
Council thinks it is important to test patient attitudes
to their doctors; to raise their awareness of the
basic standards applicable to their doctor and, therefore,
their reasonable expectations of the doctor as patients. |
| 3.6 |
To this end, therefore,
the EHSSC – in partnership with the General Medical
Council – will commission six public workshops
to explore patient experience of the medical profession,
to discuss the content of “Good Medical Practice”
and to explore issues arising – for patients –
from it. |
| 3.7 |
The result of this will
be a report on patients’ attitudes to and expectations
of their doctors intended to contribute to the ongoing
development of the patient/doctor relationship. |
| 3.8 |
Patient and Public Involvement |
| |
In 2006/2007, the EHSSC
began work in this area intended to contribute to the
promotion and development of Patient Public Involvement.
Specifically, it: |
| |
(a) |
made initial contacts for the provision
of PPI training locally |
| |
(b) |
commissioned research on innovation
in PPI |
| 3.9 |
In 2007/2008, the Council
will follow through on these actions by: |
| |
(a) |
launching the report with recommendations |
| |
(b) |
organising one day training on PPI |
| 3.10 |
The result of this will
be a report and a training initiative that begin the
process of development of PPI in response to the new
demands of legislation on HPSS bodies and increased
patient and public expectations of involvement. The
Council also hopes that this work will be of relevance
and interest to the incoming Patient Client Council
in developing its functions. |
| 3.11 |
Mental Health and Learning
Disability |
| |
Mental Health |
| |
In 2006/2007, the Council
followed closely the development and implementation
of responses to suicide and self- harm in North and
West Belfast. A wider theme emerging was that of more
general provision of services for Child and Adolescent
Mental Health. |
| 3.12 |
During – and as
part of this work – the Council made contact with
various Youth Forum in the area for each of which, mental
health and well-being was the first priority when it
came to health and social services. |
| 3.13 |
To
further develop this theme in 2007/2008, the Council
will: |
| |
(a) |
engage with Youth Forums in its area |
| |
(b) |
engage with new appointees to key
positions in Mental Health and Learning Disability in
the area, specifically: |
| |
|
| (i) |
Director of Mental Health and Learning
Disability, Belfast Trust |
| (ii) |
Director of Child and Adolescent Mental Health
Services (once appointed) |
| (iii) |
Regional Director of Mental Health and Learning
Disability (once appointed) |
| (iv) |
Organise a workshop that
bring together the members of the Youth Forums
and the relevant HPSS leaders to discuss the
development of Child and Adolescent Mental Health
Services |
|
| 3.14 |
The result of this will
be: |
| |
(a) |
a contribution to an established network
with which to engage with Children and Young People
on Child and Adolescent Mental Health Services |
| |
(b) |
raised awareness – for Children
and Young People - of these services and the key decisions
to be made on them in the short to medium term |
| 3.15 |
Learning Disability |
| |
During 2006/2007, the
situation of patients at Muckamore Abbey Hospital was
brought again to public attention. The longstanding
problem of continued delay to plans for discharge of
patients to more appropriate community settings has
been well-documented and the Council itself has been
criticised in the past for not paying attention to this
aspect of health and social care. |
| 3.16 |
With this in mind, and
given the commitments made by the Minister for Health
on these matters, Council will in 2007/2008 undertake
work designed to monitor progress and maintain awareness
of the needs of this group of people, their families
and carers. |
| 3.17 |
In 2007/2008, the Council
will: |
| |
(a) |
receive a briefing from HPSS on the
plans for resettlement from Muckamore Abbey Hospital
and their progress |
| |
(b) |
publish an accessible summary of the
plans and progress reports on the Council website |
| |
(c) |
undertake a formal Council visit to
Muckamore Abbey Hospital |
| |
(d) |
undertake a formal Council visit to
a community based scheme |
| |
(e) |
take the views of patients, carers
and families on progress |
| |
(f) |
feedback the outcome of these contacts
and discussions to HPSS |
| 3.18 |
The intended result of
this work is to contribute to sustained awareness and
attention to the delivery of services appropriate to
the needs of this group of people by HPSS and the public.
|
| 3.19 |
Service Reconfiguration |
| |
During 2006/2007, the
Council was involved in tow particular pieces of work
relevant to this theme: |
| |
(a) |
commenting on proposals to close 109
elderly care beds in order to reinvestment the money
in enhanced community services |
| |
(b) |
participating in a consultation on
the closure of two care homes for older people in order
to reinvest in community based services |
| 3.20 |
The Council took the view
that it understood and supported the strategic reconfiguration
of services in principle as long as – in each
case, patients and the public were assured that: |
| |
(a) |
there would be no net loss of volume
or capacity of service |
| |
(b) |
that there would be no diminution
in the quality of service |
| |
(c) |
that this would be clear and demonstrable
to patients |
| 3.21 |
To follow on from this
work in 2007/2008, the Council will: |
| |
(a) |
receive an HPSS briefing on the development
of community based services established with the saving
released by the closure of 109 beds |
| |
(b) |
monitor on a quarterly
basis with the relevant Trust, the implementation
of plans for the closure of two older peoples’
care |
| |
(c) |
promote and contribute to the setting
– by HPSS – of clear and measurable service
standards for community based services that are accessible
and understandable to patients and the public |
| 3.22 |
Complaints Management
and Advocacy |
| |
Aside from its routine
support for people with complaints, in 2006/2007, the
Eastern Health and Social Services Council – in
full partnership with the other three HSSCs –
undertook two pieces of work: |
| |
(a) |
a comprehensive response to the DHSSPS
consultation on a new Complaints Procedure |
| |
(b) |
a joint project in partnership with
RQIA to assess advocacy provision and needs in residential,
care and nursing homes for older people |
| 3.22 |
New Complaints
Procedure |
| |
The Councils hope that
– as a result of consultation responses by it
and others – that in 2007/2008, the DHSSPS will
revisit the proposed new complaints procedure under
a new process of which the HSSCs will be a part. |
| 3.23 |
This will not be the decision
of the HSSCs, however, and so detailed actions cannot
be described at present. However, the work plan needs
to take account of this matter and be prepared to allocate
resources to this work in year. |
| 3.24 |
Older Peoples’
Advocacy Project |
| |
The four Health and Social
Services Councils – in partnership with RQIA are
undertaking research into the availability and experience
of advocacy for people who are residents of care, nursing
and residential homes. |
| 3.25 |
This research will be
completed in the first quarter of 2007/2008with a planned
launch of the report at a regional seminar in June 2007. |
| 4. |
Routine EHSSC Activity |
| 4.1 |
In addition to all of
the above, the Eastern Health and Social Services Council
will be active in each of the following areas throughout
2007/2008: |
| |
(a) |
maintenance of monthly programme of
Council meetings. Each of the will focus on a key theme
complementary to the work plan and on a key relationship
within new HPSS structures particularly, the new Trusts
and Local Commissioning Groups |
| |
(b) |
programme of engagement with new Trusts
and Health and Social Services Authority. The EHSSC
has met with the new Chief Executives of the two Trusts
within its area and sought to agree with them, Council
involvement by the following means: |
| |
|
| (i) |
Consultation on and participation
in developing strategies for consultation and
patient public involvement |
| (ii) |
Consultation on and participation in developing
plans for complaints management |
| (iii) |
Attendance at monthly public Trust Board meetings |
| (iv) |
Chief Executive attendance – on a biannual
basis – at Council meetings
|
| |
With the Health and Social Services Authority,
the four Councils have
met with the Health and Social Services Authority
and requested a
quarterly four Council meeting with a member
of the HHSA Senior
Management Team.
|
| |
In addition to this, the EHSSC will be seeking
meetings with the
Chairs of the two LCGs within its area to discuss
possibilities for
ongoing engagement. This is likely to include
their attendance at a
Council meeting. |
|
| |
(c) |
Consultation Responses – as
required and, as often as is practicable and appropriate
on a Four Council basis |
| |
(d) |
Monthly meetings of the four Council
Chief Officers – to maintain and develop collaboration
and joint working |
| |
(e) |
Quarterly Four Council meetings –
these are currently scheduled for May 2007, October
2007 and February 2008 and will discuss dentistry, commissioning
and dissolution respectively. |
| |
(f) |
Complaints Management – the
EHSSC will maintain its service for people seeking support
in making a complaint |
| |
(g) |
Dissolution Plan – during the
year, the EHSSC will proceed with its necessary plans
to hand over its functions to an incoming PCC. |
| |
(h) |
Committee Memberships – the
EHSSC is a member of several committees and working
groups of the Board, particularly on primary care in
the area. |
| 5. |
Contingency Planning |
| 5.1 |
Given the current climate
of change, the EHSSC must make prudent arrangements
for the potential loss of staff and members in year
(see paras. 2.4 and 2.5). |
| 5.2 |
Given that the EHSSC
is a small resource, the loss of even one person –
particularly at a senior level will have major impact
on the capacity of the Council to deliver its functions. |
| 5.3 |
It should be noted, therefore,
that – in the event of the departure of a member
of staff – the work plan (paragraph 3) will be
reviewed and reprioritised. As far as is possible specific
items of work identified under the work plan, the actual
work will be undertaken by a consultant appointed for
the purpose in order that the work can be completed
in the absence of staff. |
| 5.4 |
The
following priority hierarchy will be followed if work
is required to be suspended due to lack of staff resources:
|
| |
| Priority |
Item |
| 1. |
Work programme related
specific projects without Consultant support |
| 2. |
Consultation Responses |
| 3. |
Committee Memberships |
| 4. |
Joint Council working |
| 5. |
Engagement Initiatives
with new structures |
| 6. |
Work programme related
specific project with Consultant Support |
| 7. |
Monthly Council Meetings |
| 8. |
Complaints Advocacy. |
|
