11Am Meeting Room A

RMN PRA Short Life Working Group

21st July 2017 11am – Meeting Room A JB Russell House

Chair: Catriona Kent : Nurse Consultant, PSI Minutes Michelle Magennis: Business and Programme Manager (Corporate) Present: Jennifer Armour: PDN, Acute South Sector Lynne Scott: Interim Chief Nurse, South Sector Katrina Phillips: Head of Adult Services, North East Danny Lascelles: Violence & Aggression Lead Practitioner Toby Mohammed: Assistant Chief Nurse, NMAHP Julie Tomlinson: Professional Lead, Nurse Staff Bank

Apologies: Dallas Brodie: Consultant Liaison Psychiatry Joyce Brown: Chief Nurse, Clyde Sector Lyndsay Lauder: Head of People and Change Barbara Mc Menemy: NHSGGC Acute Addictions Manager Elaine Burt: Chief Nurse, Regional Services Eleanor Sommerville: Head of Nursing & Quality, Regional Services Ann-Frances Fisher: Interim Chief Nurse, North Sector

1. Welcome/Apologies Action

C Kent welcomed all present to the meeting and apologies were noted.

2. Minutes of previous meeting for approval – 23rd June 2017

The minutes were approved by the group.

3. Matters Arising

3.1 Queries from sectors

M Magennis advised that 2 queries had been received from North Sector colleagues for consideration by the group:

Query 1 related to the telephone numbers provided on the staff communication that was issued on Monday 3rd July 17. Specifically, nursing staff had contacted one of the numbers to request advice from a RMN and the person who answered the call did not appear to understand the request or how to access a RMN. K Phillips advised

PRA RMN SLWG – minutes and actions of 21st July 17 meeting/MM Page 1

that all of the numbers provided go through to a call centre and that staff calling for advice should ask to be put through to the ‘Duty Doctor’ rather than a RMN. K Phillips also reiterated the need for staff to be clear on the local escalation process and to ensure that all available options had been considered before making contact. All present agreed that the staff communication should be revisited and clarified further and C Kent and M Magennis agreed to revisit, amend and re- issue.

Action: C Kent and M Magennis to meet to amend the contacts section of the staff communication and re-circulate.

Query 2 related to concerns around challenges experienced by psychiatry colleagues in accessing a RMN for enhanced observations and how this would be resolved and managed if a similar situation arises in the future. K Phillips confirmed that if a patient is detained and is awaiting transfer to a Mental Health facility that it is Acute Service’s responsibility to provide the enhanced observations and if the patient has been transferred by Mental Health Services to an acute hospital as an in-patient it is Mental Health Service’s responsibility to provide the enhanced observations.

Action: M Magennis to contact North Sector colleagues to provide a response to the queries raised.

K Phillips also highlighted that it will be important for hospitals to monitor the frequency and the types of calls received by the Duty Doctor moving forward. The group discussed how this would be done and it was agreed that C Kent would make contact with Dr Michael Smith to discuss and action.

Action: C Kent to contact Dr M Smith to discuss data collection.

D Lascelles queried if staff in acute hospitals are aware of the new documentation to be used when a patient is being detained and if they were experiencing any challenges with this. L Scott confirmed that the new paperwork had been circulated to all medical and nursing staff and advised that there were some ongoing challenges with the completion of this which were being addressed locally.

3.2 Enhanced Observations Policy

D Lascelles informed members that since the last meeting he had met with Sharon Pettigrew and Samantha Mc Ewen to discuss the review of the Observation Policy. D Lascelles advised members that the NHSGGC Safe and Supportive Observation Policy will not be reviewed until after the national review and it is anticipated that an overarching NHSGGC Observation Policy for both Acute and MHS will then be developed. K Phillips and C Kent stated that they had some ongoing concerns with the review’s proposals in relation to observation levels and queried whether an overarching policy for both acute and MH was appropriate. After some discussion, it was agreed that an overall policy would be developed outlining the key principles with local protocols developed aligned to practice in specific contexts.

4. Education Update

Maybo Training

T Mohammed advised that 9 further training dates have been agreed between August and September 2017. 5 of the sessions are being delivered by in-house Maybo trainers and 4 are being delivered by external trainers. T Mohammed confirmed that the training to date had evaluated positively and that staff appeared to find it useful in terms of their practice. L Scott confirmed this and advised that numbers signing up for the additional training sessions in the South Sector were building and that they included a good mix of staff grade. Clinical Coordinators can also identify the trained Maybo staff via a database held on the shared drive.

T Mohammed advised that M Magennis will be coordinating the Maybo training moving forward and that there is now a facility for sectors to access and ring-fence a portion of their CPD funding to use for Maybo training.

Action: M Magennis to send a communication to all Chief Nurses to advise of the option to transfer CPD funding for Maybo training.

5. Update from Nurse Staff Bank

J Tomlinson advised that a communication had gone out to all RMNs from the Board Nurse Director requesting that they consider joining the bank and undertake shifts in acute in-patient wards when required.

Members expressed concern that the correspondence had gone to all RMNs across the Board rather than to those currently registered on the bank, which is what had been agreed as an action from the previous meeting. C Kent queried which list had been used to distribute the communication as not all RMNs had received it and J Tomlinson advised that the distribution list had been provided by the Empower team. K Phillips advised that MH services are using a high number of RMNs from the bank and that there is a need to be thoughtful about how we approach RMNs to undertake additional shifts, particularly in acute services. J Tomlinson advised that the communication had not, to date, effected an increase in the number of RMNs signing up to the bank and confirmed that staff were made aware that they did not require the 4 day MH training to work on acute wards.

Members discussed the content of the Maybo training and the key differences between this training and the 4 day GSA training delivered to MH staff. T Mohammed confirmed that he had contacted Tayside and Forth Valley Health Boards to scope out their approach to this type of training and that both had confirmed that it focused very much on staff based in MH services. NHS Lanarkshire offer GSA training to both MH and acute staff, this is comprised of a training needs analysis followed by a 2 day training session which is further supported by a Learnpro module. All present agreed that this was a much safer option

and D Lascelles confirmed that he had a meeting scheduled with his manager to discuss a more streamlined approach to future staff training.

Action: D Lascelles to meet with line manager to discuss a more streamlined approach to Violence and Aggression training.

Recent RMN Usage

L Scott confirmed that PRA had been requested for one specific patient in the South Sector. D Lascelles confirmed that additional training had been provided to support the team and all present agreed that whilst there was an end point to this particular situation there would inevitably be others. J Tomlinson advised members that the cessation of PRA across all Boards is at different stages and that it is still possible to have 2 RMNs working on a ward, one employed by staff bank and the other, sourced from another Board, employed by Premium Rate Agency. As long as this continues it will present a challenge to recruitment. L Scott stated that the level of support that had been provided for the staff caring for the patient in the HDU at QEUH had been excellent and that this case clearly demonstrated that fact that there may well be specific instances when PRA will still be required. Members discussed the options that are considered before PRA is requested and agreed that the focus on PRA has brought about a much better standard of patient- centred care. Members reiterated the need to be careful about the type of language used in discussions about PRA cessation, which tends to be financially focused, to ensure that it is person-centred.

6. Draft SBAR

C Kent advised that she had been asked for an extension for the provision of comments on the SBAR by the Clinical Director in Renfrewshire. An extension was granted until the end of July.

7. Resource Pack

M Magennis advised that the PRA resource pack had been developed and was now located in a prominent position on the Nursing Portal to facilitate ease of access for staff. M Magennis also advised that a direct link to the resources had been provided in the staff communication to Acute Directors and Senior Managers. Feedback on the resource has been positive to date and J Armour agreed to develop a further set of short scenario-based presentations for the resource pack by the end of August. All present agreed that the resource pack should continue to be developed and promoted and that it should remain in a visible position on the site.

Action: C Kent/ J Armour/ M Magennis to meet to discuss development of the additional presentations.

K Phillips advised that she had received correspondence from colleagues in Psychiatry expressing concerns in relation to additional workload. K Phillips will develop a response to the concerns raised.

Action: K Phillips to respond to concerns raised by Psychiatry.

8. Future Actions and Monitoring Arrangements

C Kent advised members that Clyde Sector were now taking the cessation of RMN PRA forward with Psychiatry locally and queried whether another meeting of the SLWG was necessary. Members agreed that the issues should now be taken forward locally and that a paper presenting the outputs from the SLWG should be developed and forwarded to the Board Acute Interface Group.

Action: J Brown/ C Kent/ M Magennis to develop a paper on the outputs from the SLWG

In relation to the future monitoring arrangements, members decided that this did not sit with the MH Interface Group but should be monitored as part of local governance structures or the Board Acute Interface Group. M Magennis advised members that Joyce Brown, Chief Nurse for Clyde, had raised this with the Board Nurse Director and that discussions were ongoing.

Action: J Brown to clarify the reporting arrangements with the Board Nurse Director.

C Kent thanked all members for their attendance, input and support.

9. AOCB

None raised.

Summary of actions

 C Kent and M Magennis to meet to amend the contacts CK/MM section of the staff communication and re-circulate.

 M Magennis to contact North Sector colleagues to provide a MM response to the queries raised.

 C Kent to contact Dr M Smith to discuss data collection. CK

 M Magennis to send a communication to all Chief Nurses to MM advise of the option to transfer CPD funding for Maybo training. CK/MM  C Kent/ J Armour/ M Magennis to meet to discuss development of the presentations. KP  K Phillips to respond to concerns raised by Psychiatry.

 J Brown/ C Kent/ M Magennis to develop a paper on the outputs from the SLWG. ALL

 J Brown to clarify the reporting arrangements with the JB Board Nurse Director.