Minutes of Senior Nurse Group s1

APPROVED

NHS GRAMPIAN

Minutes of Senior Nurse Group held on Monday 19th July, 2010 Seminar Room, Summerfield House

Present

Elinor Smith (Chair), Director of Nursing & Quality Elaine Allan, Lead Nurse – School Nursing Sean Coady, Lead Nurse, Moray Amanda Croft, Divisional General Manager, Division 2 Jenny Gibb, Head of Nursing – Mental Health Heather Hardisty, Senior Service Manager, City CHP Mary McAuley, Head of Nursing, Children and Young People Jenny McNicol, Acting Head of Midwifery Rosemary Nixon, Service Manager Nursing (Woodend) on behalf of Frances Dunne Elizabeth Taylor, Lead Nurse, Aberdeenshire CHP

In Attendance

Lynn Adams, Lead Cancer Nurse (Item 10) Nadia Auld, Asst HR Manager, EPPMO Team (Item 10) Julie Fletcher, Divisional General Manager, Division 3 (Item AOCB) Fiona Gray, Programme Manager SCN/CQI (Item 5 ) Anne Millar, Workforce Information Analyst (Item 10) Eleanor Murray, Unit Nurse Manager (Item 6 ) Clark Paterson, Senior Finance Manger (Item 4.3) Jane Ormerod, Head of Professional and Practice Development (Items 5 & 9) Fiona Stewart, Nursing/Midwifery/AHP Workforce Manager (Item 4) Elaine Stirton, PA to Director of Nursing & Quality (Minuting Secretary) Angie Wood (shadowing Jenny Gibb)

Item Subject Action

1. Apologies

Frances Dunne, Linda Harper, Yvonne Wright

2. Minutes of meeting held on 14 June 2010

Accepted as an accurate record.

3. Matters Arising

3.1 Face2Face Suggestion - Update

Amanda Croft updated that this item had been positively received at the recent Acute Nurse Managers Meeting. Item to remain on Agenda for next meeting for more indepth update by Sheila Irvine. SI/EStirton

3.2 Mattress Audit - Update

No report available. Elinor Smith to email Stephanie Broadbent for update ES for next meeting.

Sean Coady confirmed that Charge Nurses in Moray are continuing to APPROVED

undertake monthly checks.

3.3 EPPMO – Update on Shift System

Jack Stuart briefly reported that the initial background work has been completed. Operational Units are continuing to gather further information. A number of interesting factors have emerged eg around short term sickness, 3 hour overlap within the three shift pattern, parental leave. The issue of parental leave in particular requires to be raised again with the Executive Team.

Jack Stuart agreed to forward paperwork of initial findings to Elinor Smith JS in due course.

4. Workload/Workforce Planning

4.1 Nurses workload workforce planning project

Fiona Stuart provided a concise update on the following items:

NMWWPP Reference Group The reference group last met on 13th May 2010. There was a demonstration of the NMWWPP tools available on the SSTS platform. Four tools are currently available; Professional Judgement, Adult In Patient, Neonatal and Mental Health. The Mental Health tool is still undergoing some final testing and has not yet been nationally launched. The Paediatric tool is due to be available in October 2010.

Collaboration is ongoing with the local SSTS system manager, the Workforce Information Group, SCN Programme Manager and SANE to develop access and implementation of the tools for NHSG following the outputs of SANE.

Fiona Stewart currently acts as support to the Clinical Leads on a number of Short Life Working Groups and plans are in hand to develop a local NHS Grampian Workforce Network in due course.

Clinical Nurse Specialists SLWG This group is currently testing the Children CNS tool in the Adult setting. Ten per cent of CNS across all Boards has been invited to participate. NHS Grampian has 15 participants (slightly more than 10%). A test of use of the tool was carried out in April and participants were asked to evaluate their experience. This evaluation has provided more information on how best to adapt the tool for use in the Adult setting and adjustments will be made prior to the next testing, due in September. Concerns regarding the resource intensive data collection have been made and electronic versions are being explored. Lynn Adams & Fiona Stewart are meeting with the NHS Grampian CNSs in August to go over the process for phase II.

A & E SLWG This group has now met twice and is in the early stages of planning, co- ordinating, facilitating and supporting the development of a multidisciplinary A&E workload measurement tool suitable for adults, adolescents and children. Currently reviewing literature and will scope current tools (AUKUH Acuity / Dependency Tool). NHSG now has medical representation on the group and plan to make links to other groups within NHSG – eg Radiography/ECC. APPROVED

Theatres SLWG One initial meeting held in December 2009. Chair now appointed and awaiting date of next meeting. The aim of the group is to see if they can produce a tool to measure workload and workforce to provide an efficient and effective Theatre Service across all Boards. Links to be made to the NES Modernising the Preoperative Workforce National Consultation. Similarly to A&E a review of current tools will be made.

Small Wards Eunice Chisholm and Morag Mitchell originally attended this group. An observational study is taking place in July. NHS Grampian had nominated Wards, but these wards have not been included. Unfortunately Eunice and Morag are unable to continue with this group due to financial pressures and capacity. Aberdeen City CHP and Moray CHP had originally expressed an interest in this group. Clinical representatives have been nominated and the next meeting is scheduled for 30th July.

Community Benchmarking Profile This tool allows NHS Boards and CHPS to benchmark staffing profiles in the context of other indicators such as demography, morbidity and deprivation. For some time now it has been recognised that there are particular recording issues with the staff in post community nurse data, and in particular School Nurses. In order for the profile to be used to its full potential the on-going data quality issues need to be addressed. ISD visited NHS Grampian a couple of weeks ago and Eunice Chisholm and Fiona attended. Eunice to meet with Anne Millar, Workforce Information Analyst regarding cleansing of the community nursing data.

Weblink to Community Benchmarking Profile: http://www.workforce.scot.nhs.uk/index.html

Mental Health SLWG The tool is now on the SSTS platform and is undergoing some last minute adjustments and is not yet nationally launched.

Acute Admission Unit SLWG The proposed acuity tool was rejected by the group due to excessive data capture / resource intensity and it not being reflective of workload. The Chair of the group will be writing to the National Steering Group recommending the tool is rejected and seek clarification if any further work to develop an alternative tool is required. This group is now completed.

Education Toolkit A new work stream to look at adapting the NMWWPP Educational Toolkit to other staff groups is due to start. Betty Flynn has requested suggestions of other staff groups from the North of Scotland Workforce Learning Network to take back to the national group for discussion. From NHS Grampian’s perspective we have suggested development of a supportive toolkit for Nurse Manager / Lead Nurses.

Workforce Team Current focus is Workforce Information, and in particular supporting SAW with Xmas tree profiles comparing NHS Grampian with the Scottish Workforce in terms of AfC bands and looking at the shape of the workforce. APPROVED

Plans are in hand for this information to be available on CSI shared drive. More details should be available for the next meeting. FS

Work continues on the development of a Workforce Information Dashboard to allow areas to quickly access information on staff profile, absence, recruitment, quality indicators etc.

It is proposed to develop Workforce Surgeries to embed WF Planning capability across NHS G based on the 6 steps methodology.

4.2 SANE

Amanda Croft reported that the peer review was due for completion by the end of July and is currently on target. Responses to date have been really good with clear signs of commitment by many. There continues to be some confusion around the SANE process and the workforce tool highlighting that better education is still required. Work on preparing the final report will be initiated soon.

The note of the NHSG SANE Project Steering Group held on 30th June 2010 - attached for noting by the Group.

4.3 Bank & Agency Spend

Clark Paterson tabled recent figures, which continue to look positive.

Elinor Smith reported that Yvonne Wright has indicated that 50% of bank requests remain unfilled. Positions are still being advertised and ways of securing possible Scottish Government funding are being investigated.

Jenny Gibb highlighted that the appointment process appears to take a long time. Elinor Smith agreed to address this matter with HR. Jane ES/JO Ormerod indicated she would be happy to look at the induction process if required.

5. Leading Better Care and Releasing Time to Care

Jane Ormerod briefly summarised her paper entitled: SBAR communication: Implementing Clinical Quality Indicators (CQIs) as part of leading better care programme in NHS Grampian.

Fiona Gray highlighted that progress continues to meet government targets. More robust measures need to be established to ensure indicators are completed and the need for additional IT support was also paramount.

The group agreed that it was essential for SCNs to undertake CQI work and that this is not optional. Jane Ormerod and Fiona Gray were encouraged to continue the work as highlighted in the paper.

There still remains a lack of consistency of support from some managers. The Group agreed that more training sessions for Clinical Nurse Managers, perhaps in the format of a masterclass, may be beneficial to address this.

Sean Coady reported that recent funding for 360˚ reviews had recently become available via Anne Inglis’s team. Senior Charge Nurses adapted a BttF report and undertook peer review of four key areas, linking with colleagues at Dr Gray’s, resulting in very positive outcomes. APPROVED

No report available. Update for next meeting. SI

6. HAI/HEI

6.1 Eleanor Murray Update

Eleanor Murray thanked group members for their continued support and updated the group on the following items:

Daily Patient Safety Briefing Roll-Out

Briefings have been progressing both at ARI and AMH throughout May and results have been very encouraging. The results of the recent audit are meantime awaited.

Triggering System Identifying Equipment is Clean

The plastic pocket/cards have been approved as product of choice. Roll out will be gradual as further staff education is required. Meantime work is progressing well.

Cleaning of Ward Equipment

Work has commenced on commodes for both non-infectious and infectious patients. Again staff education requires to be addressed. Plans in hand to progress quickly thereafter for hoists, drip stands and pumps.

A complete index to be devised in due course.

Clean/Dirty Areas in Wards

The Ward 19/20 model continues to progress.

Waste Segregation

Poster approval granted. Meantime awaiting supplies with a view to distribution by 10th September to RACH, ARI and Dr Gray’s. Priority being given to RACH in preparation for forthcoming visit. Stage 2 of programme to be supported by Ken Walker.

Re-audits of Acute Sector Wards

Over 30 re-audits now completed; the remaining few to be completed by the end of July.

Flow Charts

Meantime being developed for all processes.

6.2 Dashboard Exercise – Moray

Sean Coady tabled paperwork on the recent dashboard exercise for the development of a robust tool for Senior Charge Nurses based around performance. E Stirton to email copies to the Group in due course. EStirton

A meeting with Helen Robbins has taken place to discuss the development of a suitable database. APPROVED

Sean sought feedback from the Group regarding any possible missing items or views on how this tool could be possibly developed for the whole of Grampian. Jenny McNicol suggested a form of colour coding for areas of concern may be useful.

Liz Taylor agreed to provide a similar update for work in the Shire for the ET next meeting.

7. Updates from Areas

As per circulated/tabled reports covering both June and July.

8. Education Event – 18.6.10

Jenny Gibb reported this event was well attended, including representation from RGU. An Open-Space Methodology Tool was used. Jenny participated in two items:

 Transition of students through to becoming practitioners  Moral question around recruiting students when no jobs available.

Feedback on the event should be available soon and a follow-up event is planned for August. Jenny indicated she would be happy to attend.

9. SBAR for Health Care Support Workers

Jane Ormerod summarised her paper entitled: Health Care Support Worker Education and Development: A paper detailing options and recommendations for a framework in NHS Grampian. Group members were asked to spend time outwith the meeting to look at this in greater detail and provide feedback. ALL

The item to be discussed indepth at the August meeting under Workforce EStirton Section. 10. Clinical Nurse Specialists

Elinor Smith welcomed Lynn Adams, Nadia Auld and Anne Millar to the meeting.

Elinor Smith indicated that the role of the Clinical Nurse Specialist was currently being discussed at national/SANE and SAW fora. Group discussion highlighted that clarity of role definitions between the Clinical Nurse Specialist and Advanced Nurse Practitioner was required. Fiona Stewart tabled generic role profiles and Lynn Adams agreed to forward LA/ES further definitions via Elaine Stirton.

Anne Millar tabled a list of current postholders and asked group members ALL to feedback on accuracy within the next two weeks, giving details of name, specialty, location and pay number.

11. AOCB

Preparing Health Professionals for the Future – Julie Fletcher

Elinor Smith welcomed Julie Fletcher to the meeting. Julie tabled a paper recently produced by herself and Morag Bobacka to prompt some discussion around developing a new role to assist with the provision of a APPROVED

safe service to patients in view of recent EWTD and redesign of clinical, nursing and AHP roles. The purpose would be to develop a framework that staff from various clinical backgrounds could access easily.

The Group were supportive of the idea and suggested this piece of work should be scoped over the next 6 months with possible representation from Acute – Amanda Croft, Workforce – Fiona Stewart/Simon Shemilt, NES, an AHP representative, Linda Harper, Morag Bobacka, Jane Ormerod.

RPNE Implementation Roadshows

Details for noting only.

Board Lead for Newly Qualified Nurses

Elinor Smith highlighted this role used to be covered by Fiona MacKenzie and sought suggestions from the Group for a possible replacement. Amanda Croft suggested Yvonne Wright and Elinor agreed to email Yvonne to discuss. ESmith

12. Date and time of next meeting

Monday 9th August 2010; 1200 – 1600 hrs, Seminar Room, Summerfield House Apologies for absence to: Elaine Stirton, ext. 58680; [email protected]