WHERE YOU CAN CONTACT US
Address: Ground floor
Park House
Greyfriars Road
Cardiff
CF10 3AF
Telephone: 029 20 377407
Fax: 029 20 665470
E Mail: cardchc@chc.wales.nhs.uk
Website: www.patienthelp.wales.nhs.uk
The office is normally open Monday to Friday from 9.00 am to 4.30 pm
A message may be left on the answerphone at any time
Cardiff Community Health Council 1 Annual Report 2000/01 Chairman’s Report - 2000-2001
The year, in the world of Community Health Councils (CHCs) in England and Wales, has been a tumultuous one. Indeed, at one point it looked very much as though this would be the penultimate Chairman’s Report written by this, or any other, Chairman in Wales. This, sadly, is to be the fate of Chairmen throughout the length and breadth of England. The new NHS Plan, published at the end of last summer, as it applies in England, abolishes CHCs. In the (admittedly biased) view of this Chairman, it was a rushed and not well thought out strategy.
Happily, in Wales, wiser counsels prevailed. Jane Hutt, Minister for Health and Social Services at the National Assembly, ordered a wide-ranging consultation process about the future of CHCs with all its partner organisations. As a consequence, CHCs are to be retained, although possibly with a slightly different remit. Whatever that might be, CHCs will remain where they belong, as advocates for patients in the NHS.
Having self-indulgently got the issue of the future of CHCs out of the way, I will turn to the work of the year.
Perhaps the most important piece of work this year, was the consultation on the proposals for an Acute Services Strategy Review presented by Cardiff & the Vale Trust. The forming of the new ‘super-Trust’ has provided opportunities for new initiatives and economies of scale. In one of the first schemes of its kind, a Patients’ Panel was set up with members from Cardiff, the Vale and Caerphilly. They had unprecedented access to information about the proposals and their views were listened to very seriously by the Trust. As a direct result, the upcoming Rehabilitation Strategy is being looked at again and separate consultations are to take place regarding Rookwood Hospital and CRI West Wing. Of course, the Patients’ Panel did not supplant the responsibilities of the CHCs, and after full formal consultation had taken place, the proposals were accepted.
A review of services in Eastern Cardiff took place, led by Cardiff Local Health Group (LHG), into which the CHC had considerable input. We look forward keenly to the implementation of strategies for improving the healthcare provision of people in Eastern Cardiff which the review identified.
A further important piece of work was the production, again led by Cardiff LHG, of a Health Improvement Programme (HIP). This identified specific healthcare needs and strategies to improve health in those identified areas. Once again, the CHC was intimately involved.
The CHC also undertook a consultation on the provision of a Mother and Baby Unit on the University Hospital of Wales site. This was to replace the one closed down on grounds of unsuitability at Sully Hospital, but as yet plans still have to be finalised. Later this year we will be holding consultations on such issues as a Mental Health Strategy, Rehabilitation Strategy and the futures of West Wing, CRI, and Rookwood Hospital.
On these and on other issues we will continue to find new strategies for consulting with the general public. We will again use the successful Patients’ Panel but we will also be striving to reach community groups. We will do this while working in tandem with new LHG Locality Groups. Hopefully this will better inform us of the opinions of local people.
Cardiff Community Health Council 2 Annual Report 2000/01 We have also been involved with the fledgling Cardiff Local Health Alliance that takes into account social and environmental issues as well as health.
During this year we have set up a ‘Junior’ CHC thanks to the hard work of our Chief Officer. Its members come from Llanrumney High School and Glan Hafren Sixth Form College. We hope to use this group to be able to gain insights into the thoughts of young people on health issues that directly affect them. While this initiative is in its infancy at present, it is hoped to extend it throughout Cardiff in future.
This year also will see two pieces of research work undertaken by the CHC. The main project will attempt to engage local people in the planning of future health schemes. Views on current local health action plans will be sought as well as the development of revised plans. These will then be submitted to the LHG and Health Authority. A second project will hopefully shadow patients’ experiences of healthcare at the University Hospital of Wales.
I am pleased to be able to report that our relationships with our partner organisations, the Health Authority, LHG, Cardiff & Vale Trust, Cardiff County Council, Velindre Trust and the University of Wales College of Medicine continue to deepen in both co-operation and understanding.
Our work with our Federation partner the Vale of Glamorgan CHC continues ever closer and should benefit the people of Cardiff and the Vale.
Once again I am indebted to Martyn Jenkins and his deputy, Margaret Adaway, for their support. It is a difficult task keeping lay people informed about technical NHS medical matters in a non-technical way. That they did so successfully is a tribute to them.
I would like to thank my deputies, Ernest Brent, whose move away from the area will sadly deprive us of his services in future, and Jane Green, whose services I’m happy to say will remain available to us.
Finally, I’d like to thank those members, unsung and overburdened, who have put in so much hard work this year. Only patients and their carers, and not always all of those, appreciate the efforts you have made on their behalf. But then, isn’t that why we become members in the first place?
Chairman, Cardiff CHC
Cardiff Community Health Council 3 Annual Report 2000/01 COUNCIL MEMBERSHIP 1.4.2000 – 31.3.2001
MEMBER APPOINTING BODY
Miss E M J Cooper MBE Welsh Assembly (appointed September 2000)
Ms M Phinnamore Welsh Assembly (appointed September 2000)
Mrs M Benedict Cardiff County Council
Mr C Bonnett Cardiff County Council (resigned September 2000)
Mr J Fletcher Cardiff County Council
Cllr Ms J A Gasson Cardiff County Council
Ms L Glaister Cardiff County Council (appointed January 2001)
Dr J Horton Cardiff County Council (resigned October 2000)
Mr W Kohnstamm Cardiff County Council
Mr G Moreton Cardiff County Council (Chairman)
Mrs N Nicholas Cardiff County Council
Cllr D Rees Cardiff County Council
Mrs Y Roblin Cardiff County Council (appointed January 2001)
Mr E Salley Cardiff County Council
Cardiff Community Health Council 4 Annual Report 2000/01 COUNCIL MEMBERSHIP 1.4.2000 – 31.3.2001 (Cont.)
MEMBER APPOINTING BODY
Mrs J Setchfield Cardiff County Council
Mrs E Clifton-Davies St John’s Ambulance
Mrs S Evans Soroptimist International
Mrs J J Green Cardiff Samaritans (Vice Chairman)
Mrs C Lutwyche Glamorgan Federation of Womens Institutes
Mrs D O Morgan-Rees Leckwith Tenants Association
Mr J D Salisbury SS Terra Nova Trust
Rev Ian Tutton Glamorgan Industrial Mission
Mr A Willis Wales Pensioners
Ms S Wright Gofal Housing Trust
Cardiff Community Health Council 5 Annual Report 2000/01 MEMBERS’ ATTENDANCE AT COUNCIL MEETINGS/ MONITORING VISITS 1.4.00 to 31.3.2001
COUNCIL MONITORING MEETINGS VISITS
Name Possible Actual Percentage Actual
Mrs M Benedict 11 6 54% 5
Mr C J Bonnett 4 2 50% 0
Dr E Brent 11 10 91% 5
Mrs L Clifton-Davies 11 9 82% 14
Miss E Cooper 7 7 100% 7
Mrs S Evans 11 8 73% 17
Mr J Fletcher 11 5 45% 6
Cllr Ms J A Gasson 11 6 54% 3
Ms L Glaister 3 2 66% 0
Mrs J Green 11 8 73% 5
Dr J Horton 5 4 80% 2
Mr M Javed 11 5 45% 2
Mr W Kohnstamm 11 9 82% 10
Mrs C Lutwyche 11 6 54% 6
Mrs D O Morgan- 11 4 36% 0 Rees
Mr G Moreton 11 11 100% 2
Cardiff Community Health Council 6 Annual Report 2000/01 MEMBERS’ ATTENDANCE AT COUNCIL MEETINGS/ MONITORING VISITS 1.4.00 to 31.3.200 (Cont.)
COUNCIL MONITORING MEETINGS VISITS
Name Possible Actual Percentage Actual
Mrs N Nicholas 11 6 55% 3
Ms M G Phinnemore 7 7 100% 2
Cllr D Rees 10 1 10% 0
Mrs Y Roblin 3 2 66% 5
Mr E Salley 11 0 0% 2
Mr J Salisbury 11 9 82% 6
Mrs Jane Setchfield 11 3 27% 0
Rev I Tutton 11 9 82% 11
Mr A Willis 11 7 64% 2
Ms S Wright 11 5 45% 0
Cardiff Community Health Council 7 Annual Report 2000/01 CHC REPRESENTATIONS
CHC REPRESENTATION HOLDER 2000/01
Bro Taf Health Authority
Board Meeting Chairman and Chief Officer
Joint CHC Meeting with Bro Chairman and Chief Officer Taf Chairman/Chief Executive
Clinical Governance Group Chief Officer
Cardiff Substance Misuse Team Mrs L Clifton-Davies
Mental Health Strategy Mrs Jane Green Implementation Team
Mental Health Local Steering Group Cllr Ms J A Gasson
Cancer Services Advisory Board Mrs Lyn Clifton-Davies
Emergency Admissions Local Chief Officer Action Team
HIP Board Chairman
Local Health Group
South Locality Steering Group lead member – Mr Javed
West Locality Steering Group lead member – Rev I Tutton
North Locality Steering Group lead member – Mrs M Benedict
Central Locality Steering Group lead member - Ms M Phinnemore
QED Locality Group lead member – Mr G Moreton
Board/formal meetings Chairman/Chief Officer
Public Participation sub group Mrs L Clifton-Davies
Cardiff Community Health Council 8 Annual Report 2000/01
CHC REPRESENTATION HOLDER 2000/01
HIP sub group Mrs L Clifton-Davies
Primary Care sub group Mrs Sali Evans
Prescribing sub group Cllr Ms J A Gasson
Services in Eastern Cardiff Sub group Mr G Moreton
Clinical Governance/Quality Group Mrs M Benedict
All Wales Ambulance NHS Trust
South East Regional/Gwent Chief Officer and Mrs L Clifton-Davies Bro Taf CHC Meeting
Monitoring Co-ordinator Mrs L Clifton-Davies
Velindre NHS Trust
Trust Board Mr M Javed
Monitoring Co-ordinator Mrs Nancy Nicholas
Cardiff & Vale NHS Trust
Service Monitoring
Medical/Surgical Directorates Rev Ian Tutton and Mrs S Evans
Womens/childrens/community/ Dr E Brent and Mrs N Nicholas dental directorates
Mental Health Directorate Mrs J Green and Cllr Ms J A Gasson
Elderly/Rehabilitation Services Miss Joan Cooper
Trust Board Chairman and Chief Officer
Cardiff Community Health Council 9 Annual Report 2000/01
CHC REPRESENTATION HOLDER 2000/01
Complaints Panel Chief Officer
Clinical Governance Committee Chief Officer
Chairman’s Quality awards Mr J Fletcher
St Davids Project Board Mrs Jane Green
Association of Welsh CHCs
Council Meeting Chairman and Chief Officer Deputy – Mrs C Lutwyche
Cardiff County Council
Health Alliance – core group Chief Officer - deputy Mrs Jane Green
Additional Representations
Bro Taf CHC Liaison/ Chairman Committee Chief Officer Mr J Salisbury Rev I Tutton
Junior CHC Steering Group Chief Officer Ms M Phinnemore
South Bro Taf Federal CHC Committee Chairman Vice Chairmen Chief Officer Cllr Ms J A Gasson
Llanedeyrn Health Centre Mr J Fletcher Patients Group
Financial Statement as at 31st March 2001 Cardiff Community Health Council 10 Annual Report 2000/01
The Council's allocation this year was £76014. In addition a bid was made to retain some of last years underspend. An additional allocation of £1872 was made. The total budget received was £77886 and a total expenditure incurred of £77743.01. An under/spend of £142.99 for the period is reported.
A further research project allocation of £5000 was made by the Assembly. There has not been any expenditure incurred, and an application has been made to carry over this allocation to the new financial year to fund two research projects.
The Council also established a Junior Forum this year. Funding from the Health Authority, Local Health Group and Drug and Substance Misuse Directorate has been given totalling £1500. The Forum has incurred expenditure of £340.05 during the year. This leaves a balance of £1159.95 to be carried over to the next financial year.
Full details of breakdown of costs are shown below:
OVER/ FIXED COSTS BUDGET EXPENDITURE (UNDER) SPEND
Salaries 45957 45989 32
Rates 3233 3233
Office Rent 10960 10952 (8)
Telephone Rental 995.66 995.66
Photocopier Rental 700 700
TOTAL 61845.66 61869.66 24
Cardiff Community Health Council 11 Annual Report 2000/01 Financial Statement as at 31st March 2001 (Cont.)
VARIABLE COSTS BUDGET EXPENDITURE OVER/ (UNDER) SPEND
Allocation 2000/01 15164
Carried Over Balance 1872
Office Expenses 451.36
Printing/Stationery 1433.63
Annual Subscriptions 1627
Photocopier Charges 489.59
Postage 942.62
Telephone Calls 1315.57
Office Equip Purchase 2364.07
Office Cleaning 592
Conference/Seminars 648.75
Miscellaneous 322.76
Members Travelling 1478.54 Expenses
Staff Travelling Exp 2423.10
Staff OT Costs 983.31
Electricity 566.05
Insurance 235
SUB TOTAL 17036 15873.35 (166.99) GRAND TOTAL (A+B) 77886 77743.01 (142.99)
CHIEF OFFICER'S REPORT Cardiff Community Health Council 12 Annual Report 2000/01
THE COUNCIL'S STRATEGY PLANNING ACTIVITIES
The Community Health Council has been heavily involved in a wide range of strategic planning and service development strategies during the last twelve months. The publication of the Welsh NHS Plan in February has necessitated a significant response on the refocusing of the work of Community Health Councils, particularly in relation to advocacy services for patients and public involvement.
The strategic work of the Council has focused, not only on the secondary and hospital sector, but increasingly on primary care. The members have welcomed the involvement and have made positive contributions on the public/patients behalf on a wide range of services.
Public Consultation
Three public consultations were held during the year :
1. Mental Health Services/Vale of Glamorgan
The Council was heavily involved in the development of Mental Health Services in the Vale of Glamorgan. Residents living in the western wards of the City rely upon these mental health services. Sully Hospital, as a mental health in-patient service, was condemned by the Hospital Advisory Service and community mental health services in the Vale were greatly underdeveloped. The proposals consulted upon by the Authority, included the development of a new Mental Health In-patient Unit at Llandough Hospital. The development of community services at Penarth and Barry. Whitchurch Hospital was to be used as an interim in-patient facility.
The Council approved the proposals following public consultation, stressing the need to develop services at Llandough Hospital within three years. The Council is currently monitoring the progress on the implementation of the proposals.
2. District General Hospital Services
The creation of the Cardiff & Vale NHS Trust in April 2000 has resulted in a major review of the configuration of acute services provided at both UHW and Llandough Hospital sites.
The Community Health Council, in collaboration with the Vale of Glamorgan and Gwent CHCs and the Trust, have established a Patient/Public Panel which has met on several occasions during the year. This has given the public an opportunity to influence health service planning. Services that have already been incorporated in this process, resulting in the production of a consultation document on service proposals, include: Thoracic medicine, Urology, Emergency General Surgery and Childrens Services. The CHC conducted a public consultation and approved the proposals which are currently being implemented in a phased approach.
Cardiff Community Health Council 13 Annual Report 2000/01 The CHC and the Patients Panel have been heavily involved in the review of Rehabilitation and Intermediate Care Services. This process is attempting to develop a comprehensive package of services that will be consulted upon in the Autumn of 2001.
The CHC has also undertaken work by way of Public Focus Groups in defining the role of intermediate care.
3. Mother/Baby Unit
The closure of Sully Hospital was precipitated by the immediate closure of the Mother & Baby Unit. Alternative emergency arrangements were established which included in-patient care being provided in Bristol. The Community Health Council agreed to a shortened period of public consultation and subsequently approved, in principle, the proposal to develop in-patient services at the Rawnsley Unit at the University Hospital of Wales.
The Council could not support the proposals on the basis of inadequate space and security issues. Further discussions on this service are scheduled to take place early in the new financial year.
Other Service Issues a. Mental Health Services
The Community Health Council has been represented on the Bro Taf Mental Health Project Board and the Cardiff Mental Health Steering Group. The development of Mental Health Services in Cardiff is a high priority and the Council has spent a great deal of time and effort in reviewing and developing mental health service models. When finalised the proposals will be formally consulted upon during 2001/2. b. Services in Western Cardiff
The funding to develop the new St Davids Hospital was eventually made available and tremendous progress to the site has been made. The new hospital is currently on target to be completed in December and opened for patients in January 2002.
However, members concerns regarding the provision of the interim arrangements until a similar development for residents of Eastern Cardiff and the lack of progress to develop such services, has taken a great deal of the Council's time.
Members were concerned that there was to be no loss in the total number of beds and that, as the Royal Hamadryad Hospital was likely to be needed for many years, facilities and the environment at the hospital would need to be improved.
Public Involvement Initiatives Cardiff Community Health Council 14 Annual Report 2000/01
The National Assembly for Wales has clearly outlined that members of the public should be encouraged to contribute to the planning of health services within their local communities. Community Health Councils are well placed to facilitate this and members of the CHC have developed two initiatives this year.
A Junior Forum has been established in collaboration with Llanrumney High School and Coleg Glan Hafren, modelled on CHCs. Young people aged between 14 to 20 have been encouraged to attend monitoring visits, health service provisions with members and to comment upon health services. The Junior Forum are currently responding to the Cardiff Local Action Plan relating to Teenage Health. They have also attended various workshops on drug/substance abuse, teenage health and conducted a Focus Group on organ retention. The initiative has also developed students all-round skills. (See appendix …)
In response to the organisational development within the Cardiff Local Health Group and the establishment of four Locality Steering Groups, the members agreed to an internal re- organisation that has resulted in six members being attached to each Locality Steering Group. The role of these members is to provide a community resource and to establish networks of local people to contribute, not only on the health service, but also community health service planning.
Baby Milk Sales at Tongwynlais Health Centre
The Council conducted a small user survey to establish the views on proposals to close the baby food sales service at Tongwynlais Health Centre. The Trust has agreed to maintain services until a suitable alternative solution can be found.
Other Issues Cardiff Community Health Council 15 Annual Report 2000/01
The Cardiff Community Health Council has been actively involved in the following areas this year :
• Organ retention at the University Hospital of Wales
• Public vaccine availability
• TB Immunisation
• Sickle Cell & Thalassemia services
• Grangetown/Butetown Health Forum
• Local Health Alliance
• Health Social Care Charter for Wales
• Childrens Hospital
• Waiting Times
• Violent Patients Treatment
• Prescribing
• Primary Care Strategies
• Clinical Governance
• Research Projects
• Casualty Watch
• Secondary and Primary Sectors
• Patient Experiences/Public Perception of Health Service Planning
Responses to Consultation Documents
Cardiff Community Health Council 16 Annual Report 2000/01 • Pathfinder Health Improvement Programme
• Cardiff Local Health Action Plan
• www.betterwales.com.values/priorities/integratedspendingplans
• Regenerating our most disadvantaged communities
• Protecting children, supporting parents, physical punishment of children
• Promoting Health and Wellbeing
• Mental Health Act Commissioners Report
• Proposals for Sully Hospital
• Patient Transport Services
• UKCC Draft Strategy Public Involvement
• Health & Social Joint Planning
• Local Optometric Committee
• Treatment of Androgenetic Alopecia in the NHS
• GMC Revalidating Doctors
• GMC Core guidelines Good Medical Practice
• Maximising Clinical Performance
• Primary Care Strategy for Wales
• Human Genetics Commission
• Consultation Statutory Framework for Treatment of Impotence
• Strategic Framework Partnership Children Young People
THE CHC SERVICE MONITORING ROLE
Cardiff Community Health Council 17 Annual Report 2000/01 The Council once again maintained a very active monitoring schedule as you will see from the Schedule of Council visits undertaken during the year which is enclosed as Appendix …
The monitoring visit Co-ordinators' reports are detailed below.
Elderly/Rehabilitation Services - Miss Joan Cooper
Very encouraging visits were made early in 2000 to CRI West Wing and to two Community EMI Teams. We were impressed with the interchangeability of professional roles. We expressed concern for patients leaving the West Wing regarding continuity of programmes which were not available once the patient was discharged home. This is because there is only one physiotherapist for the whole of Cardiff and a two month waiting list to return to the various departments in the hospital.
We also visited Lansdowne Hospital where the ten bed unit for rehabilitation and continuing care for patients who needed a longer period of time from the UHW are located. Periods of stay vary to a few days to several weeks. Rehabilitation services could be increased if more physiotherapists, occupational therapists and speech staff were appointed.
The Royal Hamadryad Hospital was visited in December 2000 which showed adequate staffing and sensitive care given to patients and carers. However, there were only 12 patients in one ward and 12 empty beds. It was a shock to the CHC in January 2001 that carers were consulted just before Christmas and the 12 patients from this ward were transferred to Lansdowne with very little notice. This has meant that there is an empty ward at the Royal Hamadryad Hospital suitable only for older people or EMI patients needing continuing indefinite care.
A visit in March 2001 was then undertaken to see how these patients had settled into their new environment and we were impressed with the condition and care of patients on this ward. We spoke to a carer who visits his wife daily and are pleased to report that he was full of praise about all aspects of care.
Announced and unannounced visits have been undertaken to several wards at the University Hospital of Wales and Whitchurch Hospital to review patient care, ward conditions, staffing, catering and cleaning .
The CHC tries to protect and support the patient and the public and can have an important influence on planning of services. We shall continue to monitor services rigorously next year to achieve this aim.
Community Services - Dr E Brent
Cardiff Community Health Council 18 Annual Report 2000/01 The year 2000/1 presented many difficulties. It was not possible to carry out all the planned visits because Trust reconfiguration meant that there were delays in making all the necessary arrangements and, unfortunately, I was unavailable for some of the time due to illness. Nevertheless, there were some very important successes. There were as follows :
• The successful relocation of the Ely Clinic. This is now working happily and the traffic problem has also been resolved. It is hoped that signposting has also been improved.
• Some clinics have provided information pamphlets for patients. The information given deals with normal opening hours, transport and access. It is hoped that this information will be helpful to patients.
• The general standard of maintenance of buildings is high and patients are made welcome and comfortable. Unfortunately, at some clinics security and parking is still a problem.
Although as a whole, the service to patients is good there are still some serious concerns which have not been resolved. These are:
• Speech Therapy - There are still immense waiting lists and, as well as understaffing compared with the service in England, there is also a staff shortage. To date the service does not quality for additional monies to reduce waiting lists with no adequate response to the reason why.
• Sickle Cell Unit - There has not been any improvement in staffing and other resources for the Sickle Cell Unit. In fact the situation has deteriorated since 1979. The matter is now urgent because in many ways, the needs of the service has increased.
• Access for Disabled People - this is variable and I would have expected that, over the last five years, improvements would have taken place at all clinics.
• Equality - of quality of various services provided by the Trust is still variable. For example Physiotherapy and chiropody is provided well in some areas and is not so good in others. One of the main tasks in the future will be to look at comparability in service provision.
Briefing papers received from the Trust have improved this year but there is still a great deal of information requested at the visits which is still outstanding. We need to keep a monitoring brief in the future on the implementation of user forums; function and responsibilities of clinic managers; staff training; and patient satisfaction surveys.
Acute Services - Mrs Sali Evans and Rev Ian Tutton
Cardiff Community Health Council 19 Annual Report 2000/01 The visits undertaken during the year were very worthwhile. The one with the most impact was to the Chapel of Rest. The report highlighting the concerns was taken to the Chief Executive who did a personal tour of the services. As a result a Bereavement Group was set up which had a CHC representative.
We commended the work of the Cardiac Unit with reservations on the long waiting list and appropriate bed occupancy.
Bed Management proved enlightening as they work on 98% bed occupancy (it should be 85%).
Xray was interesting but some equipment had been in use for 30 years!
An unannounced visit to Maternity Services was very good and patients were very happy. We were astonished to find that babies of mothers who wished to smoke were left in a locked room on their own. This situation, we were told, was rectified immediately.
We also undertook a visit to Intensive Care at Llandough Hospital. The Department is still waiting for a High Dependency Unit, although one has been promised.
All the outstanding problems will be closely monitored during the coming year.
Ambulance Services - Mrs Lyn Clifton-Davies
Council completed two visits to ambulance facilities during the year. The first was to the new Control Room at Church Village, which had been transferred from the old East Glamorgan Hospital site. The main purpose of the visit was to see how changes had been made to the Patient Transport Services under the management of Mr Wayne Lewis. A most interesting and satisfactory visit.
The second visit was to Blackweir Ambulance Station. We identified problems with:
• shower facilities
• ORCON standards - although improving are still cause for concern
• patient discharge
• cleaning of ambulances
We also had successes:
Cardiff Community Health Council 20 Annual Report 2000/01 • we enabled ambulance staff to have influenza injections if they wished
• we arranged for a 'sin bin' to be provided on the road outside Blackweir Ambulance Station to facilitate better egress onto the main road for faster response times to urgent calls.
I hope we have made a positive contribution to the ambulance service. Our intention is to improve facilities for all and to bring concerns and commendations to the All Wales Ambulance Trust.
Mental Health Services - Mrs Jane Green
The past year has seen a beginning of the planning and consultation processes into how the Mental Health Services can be more effectively reprovided for the citizens of Cardiff.
This CHC supported the proposals to close Sully Hospital and our members have kept up to date on these moves.
In addition, we made a number of monitoring visits to Whitchurch Hospital too, where we looked at acute assessment wards, EMI wards and the Intensive Care Unit.
We were impressed by the huge improvements that have recently been made to the ICU and Ward East 4 and are also pleased that staffing levels are gradually being increased throughout the hospital.
However, the perennial concerns of cubicalising all the acute wards, plus the provision of step-up/step-down accommodation in the community, still needs to be addressed.
We sincerely hope these issues will be dealt with in the long-awaited public consultation document on the future of Whitchurch Hospital.
Cancer Services - Mrs Nancy Nicholas
During the year 200-2001 we decided to concentrate on a Project on Cervical Screening rather than the usual monitoring visits to services. The aim of the Project was essentially twofold -
1. To give information to members about the Cervical Screening service in Cardiff
2. To meet and talk with staff involved in all the stages of the screening process and also to the women patients who use the service. So far we have visited the Headquarters for Cervical Screening Wales in Cathedral Road and the Cervical Screening Administrative Department (CSAD) based in Churchill Way. These visits gave good background knowledge to the service.
Cardiff Community Health Council 21 Annual Report 2000/01
A visit to a well-woman clinic in Roath gave us the opportunity to meet patients for the first time and we also visited a GP surgery, with special permission from the surgery.
Visits so far have highlighted good practice in the service but they have also drawn attention to staff and patient concerns. This can only be for the good of a service which already has good standards and desires the best for its patients.
We expect to continue our interest in this field during 2001/2 and to finalise the Project we have also arranged to visit the Cytology laboratories and the colposcopy clinic based at Llandough Hospital and also to meet with Mr Alan Evans, the Clinical Director and lead colposcopist.
Our thanks to all staff and patients who have given their time and help to make this such an interesting Project to undertake.
Cardiff Community Health Council 22 Annual Report 2000/01 Complaints Report
The Cardiff Community Health Council provides free and independent support to Cardiff residents and service users who wish to make a complaint regarding treatment they have received from the Health Service.
Complaints are also a positive way of improving services and several complaints have resulted in changes to procedures and practices which have improved the quality of health services for the residents of Cardiff.
If a complaint is not resolved at the first stage (Local Resolution) a request can be made for an Independent Review. The Complaints Convenor will review the complaint and decide whether further action needs to be taken or an Independent Review Panel should be established.
Complainants can appeal to the Ombudsman about the failure to convene a Panel or if they are dissatisfied with the outcome of a Panel investigation.
Where possible, information is given on the procedure to enable individuals to pursue their complaint and these are not included in the figures below. Staff have actively supported new complainants in the following areas of the NHS complaints procedure:
Local Resolution 49
Requests for Independent Review 10
Independent Review Panels Held 6
Independent Review Panels Refused 3 (one awaiting a decision)
Referrals to Ombudsman 2
Accepted by Ombudsman 2
Complaints covered a wide range of issues including:
Clinical issues Dental care Waiting Lists/times Medication Communication problems Community Services Delay in Diagnosis Lack of care/treatment Misdiagnosis Maternity Services Discharge procedures Mental Health Issues Nursing Care Organ Retention Issues
Should anyone require advice on making a complaint, or any health issue, please contact the CHC office at any time.
Cardiff Community Health Council 23 Annual Report 2000/01
CARDIFF LOCAL HEALTH ACTION PLAN TEENAGE HEALTH
INTRODUCTION
Public involvement and participation is central to a number of policy and strategic direction (for example, Better Health Better Wales, 1998; NHS Plan, 2001; Bro Taf HIP 2000). One of the three key principles of the UN Convention on the Rights of the Child (DoH, 1999:2) is to involve young people in all matters affecting them. In recognition to such policies Cardiff Local Health Group (LHG) aims to positively promote its functions and involve young people in its work where appropriate. The opportunity to engage with Llanrumney Community Health Council (CHC) Junior Forum provides an excellent foundation for facilitating such involvement.
BACKGROUND INFORMATION
The CHC Junior Forum is a sub group to the Cardiff CHC and is supported by Cardiff LHG, Coleg Glan Hafren and Llanrumney High School. This initiative is the first of its kind in Wales and in support of this Jane Hutt attended its official launch in December 2000.
The CHC Junior Forum involves young people in decision-making processes by having a structure similar to the adult Community Health Council into which the young people can feed into. The young people have elected a Chairman, Vice Chairman and Secretary and a Terms of Reference has been established. The group consists of young people studying a GNVQ in Health & Social Care at Llanrumney High School and Coleg Glan Hafren. The work carried out by the CHC Junior Forum contributes towards credits in various modules of the GNVQ. The age range within the group varies between 14 years – 20 years. There are approximately 30 members in the group, with the majority of members from Llanrumney High School.
AIM
To enable young people to become involved with decision-making processes in relation to the health of young people in the South East of Cardiff
OBJECTIVES • To enable young people to achieve a better understanding of teenage health issues • To assist young people in identifying youth health issues in relation to South East Cardiff • To act as a forum for dissemination of health related information to both statutory and voluntary organisations and to their peers. • To integrate the work of the CHC Junior Forum with curriculum requirements • To increase practical skills amongst members of the CHC Junior Forum, for example, decision making and problem solving.
CONSULTATION OF CARDIFF LHAP
One of the key tasks for the CHC Junior Forum was to critique and review the Cardiff Local Health Action Plan – Teenage Health. To assist the group a series of workshops were planned and implemented. Initial work included a short briefing about Cardiff LHG – its structure and function and a summary of the LHAP. The following section highlights the feedback from the CHC Junior Forum:
1. CHC Junior Forum Perspective of Health
There is such a range of meaning attached to the notion of health that it is important to clarify what young people understand about health before they engage with the work of Cardiff LHG. With this in mind the group discussed their views of health and as expected there were differences of opinion. The younger members of the group (Llanrumney High School) clearly indicated that health was mainly influenced by an individual’s lifestyle for example, having a balanced diet and taking regular exercise. Whereas the members from Coleg Glan Hafron had an all-encompassing concept to the meaning of the word as they felt that it involved a variety of influencing factors, such as, ones lifestyle, social and economic status and the environment. The group discussed that all aspects of health are interrelated and that a holistic view of health is of greater value.
The identification of the varying aspects of health is a useful exercise in raising awareness of the complexities of the concept of health.
2. Comments about the LHAP
There was a general feeling amongst group members that the LHAP simply needed to adapt its language if health professionals intend to engage appropriately with young people. The language used in the LHAP is not readily accessible to the majority of young people. The overall comments from the CHC Junior Forum on the LHAP – Teenage Health include:
• It is important to clarify what young people understand about health • It’s very difficult for young people to understand • The lay out is confusing and there’s too much information. • Young people need support from a health professional to help understand it. • Cardiff LHG need to produce a user-friendly guide that clearly indicates why, how, where and when they plan to improve teenager health. • It should be summarised
To manage the task more effectively the group decided to break down the LHAP and review each section individually. Table 1 states the specific comments made by the group.
Table 1. Specific Comments
LHAP Target – Teenage Health Comments • It’s too general and needs to be clearer. Target A • They need to define ‘overall health’ as it has such a broad meaning and involves many things. ‘Improve the overall health status • It seems to be a very big task – can they actually of achieve ‘overall health’? teenagers in Cardiff’ • Not enough indication for young people as to ‘how’ Current / Identified Action they are going to improve the overall health of teenagers in Cardiff.
• Make a summary of the work that is being done and Suggestions for Improvement what they intend to do for young people to understand.
• Not a clear target at all. Target B • What does a health gain target mean? They assume that the reader (young person) is aware of such ‘Achieve the health gain target for things. low birth weight babies by • A big task because not all teenage pregnancies are a improving the sexual health of mistake teenagers in Cardiff’ • Sexual health isn’t just about pregnancy it includes for example, STI’s, HIV and mental well being
• Giving out condoms alone isn’t enough – young Current / Identified Action people need to be educated more in schools, colleges and youth services • The target needs to be re-considered Suggestions for Improvement
• This could be achieved but it depends on the action Target C taken.
‘Reduce the number of teenagers in Cardiff who misuse substances’
• There isn’t enough information given about the Current / Identified Action identified action • They talk about a drug strategy and assume that the reader would understand what they are going to do.
• More information is needed for the reader Suggestions for Improvement
DISCUSSION
Primarily the CHC Junior Forum has proved to be a useful mechanism to give young people the power to voice their views and ideas in decision-making processes that affect them. In addition the CHC Junior Forum represent the voice of young people in the S.E Locality of Cardiff and has proved to be an excellent approach for involving young people in the work of Cardiff Local Health Group. The comments and feedback from the CHC Junior Forum on the LHAP – Teenage Health has been disseminated and presented to the Cardiff Local Health Group Team meetings. This information has been passed onto the Cardiff Local Health Action Plan Steering Group who acknowledged that the young people identified a number of issues that perhaps need to be re-addressed.
The information in this report suggests that young people are capable of being involved in the work of health professionals, but the process needs to be interesting and creative. It is clear from the feedback that the momentum of this process reflects the aims and objectives. Each member of the CHC Junior Forum felt that their involvement in Cardiff LHG work was challenging and that support from a health professional was necessary for advice and guidance. The group stated that throughout the process they had acquired a number of skills and qualities, for example: • Being able to review and critique professional work concerning young people • Solving problems through group discussions • Developing work and discussing ideas with their peers • Expressing their point of view and opinion with others and listening to others opinions
Overall the involvement of the CHC Junior Forum with the work of Cardiff LHG has proved to be a positive experience for both parties.
CONCLUSION
Involving young people in the work of Cardiff LHG work proved to be a valuable experience for both the young people involved the Community Health Council and Cardiff LHG. However, when engaging with the public in particular, young people it is important to consider the varying perspectives between lay and professional people.
RECOMMENDATIONS
In order to develop and sustain the involvement of the CHC Junior Forum it is felt necessary that the following areas should be addressed: • Clearer aims, objectives and tasks should be set at initial meetings with a rough workplan and timescale • As an induction to the Junior Forum all members could participate in a training course that for example, providing practical guidance on effective team meetings, team work and committee skills
Kerry Morgan Youth Health Development Worker Martyn Jenkins Chief Officer Community Health Council
REFERENCE
• Bro Taf Health Authority (2000). Health Improvement Plan. Bro Taf Health Authority. Wales
• Cardiff Local Health Group (2000) Local Health Action Plan: improving health & health services in Cardiff. Cardiff Local Health Group. Cardiff
• Department of Health (1999) Convention on the rights of the child: Second report to the UN committee on the rights of the child by the United Kingdom Executive Summary. DoH. England
• National Assembly for Wales (January 2001) improving health in Wales: A plan for the NHS with its partners. Crown copyright. Cardiff
• Welsh Office (1998) Better Health Better Wales. The Stationary Office Limited. Wales
Annual Report - Chief Officers Activities 2000/1 Appendix …..
4.4.00 Llandough Car Parking/Susan Burnett 4.4.00 General Purposes Committee 6.4.00 Review NHS Complaints procedure 7.4.00 General Manager Cardiff LHG 12.4.00 Primary Care Services Old St Mellons 12.4.00 Bro Taf Health Authority 19.4.00 Patients Panel Programme Planning Meeting
2.5.00 Patients Panel
2.5.00 Welsh Association’s 4.5.00 AGM & Conference
5.5.00 Public Participation Sub Group 5.5.00 Violent Patients Working Group 5.5.00 Waiting Times Strategy Group meeting 8.5.00 Clinical Services Project Board 8.5.00 Health Alliance Meeting 10.5.00 Waiting Times Strategy Group 11.5.00 HIP Sub Group Cardiff Local Health Group 12.5.00 Chief Executive, Chairman/Bro Taf CHCs meetings 15.5.00 Bro Taf CHC Liaison Group 16.5.00 Emergency Admissions Local Action Group 17.5.00 Health Authority Board Meeting 17.5.00 Old St Mellons Branch Surgery Development 18.5.00 Regenerating Communities Workshop 20.5.00 Review Day 22.5.00 Clinical Governance Cardiff/Vale NHS Trust 23.5.00 Eastern Cardiff GP Locality Group 23.5.00 CHC Mental Health Interest Group 23.5.00 CHC Annual general Meeting 24.5.00 Clinical Services Strategy Group 26.5.00 Hydrotherapy Pool Action Group
1.6.00 CHC Structure Group 5.6.00 Senior Managers Liaison Group 6.6.00 General Purposes Committee 12.6.00 Presentation School of Nursing/Midwifery 13.6.00 Emergency Admissions Local Action Group 19.6.00 Local Health Alliance Seminar 20.6.00 Junior CHC Steering Group 20.6.00 Creating the Climate Workshop 21.6.00 Waiting Times Strategy Group 23.6.00 Health Alliance Core Group 23.6.00 Public Participation Sub Group LHG 27.6.00 Public Involvement Group – Bro Taf Health Authority 28.6.00 Clinical Services Strategy Meeting 30.6.00 Health Act Flexibilities Meeting
30.6.00 Bro Taf Health Authority meeting
3.7.00 Bro Taf CHCs Liaison meeting 3.7.00 Joint Meeting Cardiff LHG 4.7.00 Presentation G Grades, Surgery Services UHW 4.7.00 General Purposes Committee meeting 5.7.00 Clinical Governance Cardiff LHG 5.7.00 Bro Taf Health Authority 7.7.00 Presentation Chiropodists School of Medicine 7.7.00 Patients Panel Meeting 10.7.00 Junior CHC Steering Group 10.7.00 Senior Managers Cardiff & Vale NHS Trust 10.7.00 Chair/Chief Executive Bro Taf Health Authority 11.7.00 Commission for Health Improvement Workshop 12.7.00 Clinical Services Strategy/Public Consultation 13.7.00 Eastern Cardiff Presentation 13.7.00 I.T. Training/Web site management 14.7.00 Public Partnership Cardiff LHG 14.7.00 Public Consultation St Mellons 18.7.00 Primary Care Strategy Group National Assembly 19.7.00 Waiting Times Strategy Group 21.7.00 Acute Services Strategy Board 24.7.00 Mental Health Services 25.7.00 Emergency Admissions Local Action Team 28.7.00 St Mellons Forum
1.8.00 General Purposes Committee 3.8.00 Focus Group - New Patients Charter
4.9.00 Intermediate Care - Bro Taf Health Authority 6.9.00 Patients Panel Meeting 7.9.00 Chairman/Chief Executive Bro Taf Health Authority 8.9.00 Opening CT Scanner Llandough Hospital 11.9.00 Welsh Association Council Meeting 12.9.00 Federation Meeting/Welsh Assembly 14.9.00 Cardiff & Vale NHS Trust Board 15.9.00 Health Authority/Joint CHC Meeting 18.9.00 Clinical Governance Cardiff & Vale NHS Trust 19.9.00 Substance Misuse LAT 21.9.00 Junior CHC Coleg Glan Hafran 21.9.00 Opening Radio Glamorgan 22.9.00 Patients Panel pre-meeting on Childrens Services 25.9.00 Healthy living programme Grangetown/Butetown 25.9.00 Public Meeting on Acute Services 26.9.00 Federation Meeting south Bro Taf CHCs 27.9.00 Patients Panel on Childrens Service 29.9.00 St Mellons forum 29.9.00 Violent Patients Working Group
2.10.00 Waiting Lists working group
3.10.00 General Purposes committee 4.10.00 Public Participation Strategy Bro Taf Health Authority 5.10.00 Cancer Services Health Improvement Programme 6.10.00 Project Board St Davids Hospital 9.10.00 Senior Managers Liaison Meeting - Cardiff & Vale NHS Trust 9.10.00 Presentation Standing Conference Womens organisations 10.10.00 Emergency Admissions Local Action Team 11.10.00 Intermediate Care Workshop Bro Taf 12.10.00 Cardiff & Vale NHS Trust Board 12.10.00 Junior CHC Coleg Glan Hafren 13.10.00 Cardiff Health Alliance 13.10.00 Primary Care Strategy Group 19.10.00 Society of Chief Officers 20.10.00 Mental Health Project Team Vale of Glamorgan 27.10.00 Opening Cyber Café Whitchurch Hospital 30.10.00 General Purposes Committee 31.10.00 Rehabilitation Services Review 31.10.00 Federal CHC meeting - Consultation on Acute Services South Bro Taf
2.11.00 Junior Forum Llanrumney High School 3.11.00 Primary Care Strategy Group 6.11.00 Public Involvement Workshop 8.11.00 Health Authority Meeting 9.11.00 Cardiff & Vale NHS Trust Board meeting 14.11.00 Junior Forum Llanrumney High School 15.11.00 Planning Meeting, Cardiff & Vale NHS Trust 15.11.00 Eastern Cardiff Locality Group 17.11.00 Cardiff Health Alliance 20.11.00 Senior Managers, Cardiff & Vale NHS Trust 20.11.00 Grangetown/Butetown Regeneration health Sub Group 21.11.00 Primary Care Strategy Group 23.11.00 Launch Waiting Times Strategy 28.11.00 Research Group Meeting 29.11.00 Pharmacy Committee Opening Rotas 30.11.00 Bro Taf/CHC Focus Group - Intermediate Care
1.12.00 South East Regional Committee Welsh Assembly 1.12.00 Bro Taf/CHC Annual Meeting 5.12.00 General Purposes Committee meeting 6.12.00 Launch Junior Forum 7.12.00 Public Participation Working Group 11.12.00 Senior Managers Cardiff & Vale NHS Trust 18.12.00 General Manager Cardiff LHG
4.1.01 Cardiff & Vale NHS Trust Planning Meeting 5.1.01 Gwent CHC Peer Review 8.1.01 Senior Managers Cardiff & Vale NHS Trust 9.1.01 Grangetown/Butetown Health Forum 10.1.01 Race Equality Trust/Health Alliance 11.1.01 Trust Board Cardiff & Vale NHS Trust
12.1.01 Project Team Mental Health 15.1.01 Clinical Governance Cardiff & Vale NHS Trust 17.1.01 Mental Health Steering Group Workshop 18.l.01 Meeting with Youth Worker Llanrumney Youth Project 18.l.01 S E Wales Ambulance/CHC regional meeting 19.l.01 Launch of LHG Locality Steering Groups 19.l.01 Race Equality Trust/Health Alliance Report 22.1.01 Opening Park View Health Centre, Ely 23.1.01 CHC Member training evening 25.1.01 Cancer Services Network 26.1.01 St Mellons Regeneration Forum 26.1.01 Public Involvement Group Cardiff LHG 26.1.01 Cardiff Health Alliance 30.1.01 Emergency Admissions Local Action Team 30.1.01 Special General Purposes Committee 31.1.01 Mental Health Project Board
1.2.01 Rehabilitation Review Workshop 2.2.01 Violent Patients Working Group 2.2.01 Chairman Cardiff CHC Junior Forum 5.2.01 Mental Health Services 5.2.01 Bro Taf CHC JLC 5.2.01 Cardiff & Vale NHS Trust Planning meeting 6.2.01 CHC Training seminar 7.2.01 Bro Taf Health Authority 7.2.01 Meeting organ retention Cardiff & Vale NHS Trust 8.2.01 Cardiff & Vale NHS Trust Board 8.2.01 Cardiff CHC Junior Forum 8.2.01 Cardiff & Vale NHS Trust Protocol meeting 9.2.01 NHS Complaints survey report 10.2.01 CHC Annual Review Day 12.2.01 Council meeting Welsh Association 13.2.01 Cardiff Carers Workshop 14.2.01 Increased flexibilities workshop 16.2.01 Primary Care Strategy Group 26.2.01 Llanedeyrn Patients Participation Group 26.2.01 Chairman, Chief Executive, Bro Taf Health Authority 27.2.01 Special meeting - Western Cardiff 28.2.01 Green Transport Project Group Cardiff & Vale NHS Trust
1.3.01 Staff Panel/Patient Panel Meeting Cardiff & Vale NHS Trust 2.3.01 Meeting lay member Cardiff LHG 2.3.01 Cardiff LHG 2.3.01 Public Participation Group, Cardiff LHG 5.3.01 Plaid Cymru Health Seminar 5.3.01 South Bro Taf CHC Federation meeting 6.3.01 Cancer Services Advisory Board, Bro Taf 6.3.01 GP Committee 7.3.01 Waiting Times Strategy implementation Group Cardiff LHG 7.3.01 Meeting Cardiff LHG CHC representatives on Locality Steering Group
8.3.01 Welsh Association CHCs workshop 9.3.01 Opening Paediatric Intensive Care Unit UHW 9.3.01 ALAS Project Board 9.3.01 CHC Project Group 12.3.01 Training Course PALS 15.3.01 Society Chief Officers 15/16.3.01 Substance Misuse Workshop 19.3.01 Senior Managers Liaison Meeting Cardiff & Vale NHS Trust 19.3.01 Clinical Governance Meeting Cardiff & Vale NHS Trust 21.3.01 Cardiff Local Health Group Partnership officer 21.3.01 Opening Diabetes Centre UHW 22.3.01 Patients Panel Rehabilitation Services 23.3.01 Welsh Consumer Council
Appendix …
Monitoring Visits Undertaken 2000/1
VENUE/SERVICE PROVISION DATE
Ward East 1A Whitchurch Hospital 22nd May 2000 Transplant and Nephrology Services, University Hospital of Wales 26th May 2000 (UHW) Unannounced to the Accident & Emergency Department and Ward C4 at 29th May 2000 UHW Orthopaedic Services at Llandough Hospital 22nd June 2000 South East Region Ambulance Control and Communications Centre 28th June 2000 Theatres, Day Surgery, Endoscopy and Critical Care at Llandough 11th September2000 Hospital Park View Health Centre 25th September 2000 Cervical Screening Wales 2nd October 2000 Thoracic and Cardiac Surgery Unit 10th October 2000 Wards East 2, East 4 and West 2 Whitchurch Hospital 23rd October 2000 Unannounced to the Chapel of Rest/Mortuary, UHW 25th October 2000 Rowan House, Ely 7th November 2000 Accident & Emergency Department, UHW 14th November 2000 Rehabilitation and EMI services at Lansdowne Hospital 15th November 2000 Blackweir Ambulance Station 23rd November 2000 Unannounced to Ward B7 (integrated medicine) UHW 29th November 2000 Review of services at Royal Hamadryad Hospital following closure of 7th December 2000 day hospital at weekends Cervical Screening Administration Department 11th December 2000 ALAS Wheelchair Services 11th January 2001 Urology Services, UHW 16th January 2001 Butetown Health Centre 24th January 2001 Unannounced to the Maternity Unit, UHW 29th January 2001 Wards East 1 and East 2A Whitchurch Hospital 30th January 2001 Well Woman Clinic at Roath Health Centre 16th February 2001 Unannounced to the additional bed provision at Rookwood Hospital 19th February 2001 Bed Bureau/Bed Management, UHW 26th February 2001 Unannounced to Ward C7, UHW 27th February 2001 Unannounced Ward A2, UHW 7th March 2001 Edward House, Lansdowne Hospital 8th March 2001 Radiology Services, UHW 12th March 2001 Paediatric Services UHW 22nd March 2001