Minutes of Senior Nurse Group

APPROVED

NHS GRAMPIAN

Minutes of Senior Nurse Group held on Monday 11th October, 2010 at 1200 hours in Seminar Room, Summerfield House

Present

Jane Ormerod (Chair), Head of PPDU Elaine Allan, Lead Nurse - School Nursing Frances Dunne, Service Manager, Woodend Jenny Gibb, Head of Nursing Mental Health and Learning Disabilities Heather Hardisty, Senior Service Manager, City CHP Alison Hardy, representing Amanda Croft, Acute Sector Linda Harper, Associate Director - Practice Nursing & OOHS Clive Matthew, Management Trainee Mary McAuley, Head of Nursing, Children and Young People Jean McConville, obo Jenny McNicol, Midwifery Liz Taylor, Lead Nurse Central Aberdeenshire

In attendance:

Fiona Gray, Lead Facilitator Leading Better Care Sheila Irvine, Lead Facilitator Releasing Time to Care Carole Noble, Community Dietetic Dept Jack Stuart, EPPMO Team Mandy Young, EPPMO Team

Item Subject Action

1. Apologies

Clark Paterson, Sean Coady, Elinor Smith, Yvonne Wright

2. Minutes of meeting held on 13th September 2010

Accepted as a true accurate record.

3. Matter arising

3.1 EPPMO – Update on Shift System

To follow later.

3.2 Dashboard Exercise – Shire

(deferred to the next meeting).

3.3 Exchange Programme for Qualified Nurses

This item relates to a suggestion from a few meetings ago by Sheila Irvine in relation to proposed opportunities for swaps within the current workforce. This was met favourably within the Acute Sector. Sheila Irvine and Jane Ormerod are going to produce an SBAR which will be SI/JO circulated more widely for feedback before the next meeting. Something to consider in relation to this is where it would fit with the effective practitioner programme that NES are currently moving forward. APPROVED

3.4 Marsden Manual of Policies and Procedures

Jane had been asked by Elinor to look into the online Marsden Manual. We had previously considered it and there were IT problems in terms of local hosting or local support for the online manual. Jane again has asked for another quote from the Publishers and was hoping to get some contact around that quite soon and to investigate IT support. It was agreed that there would have to be good communication to staff around the purpose of the online system and how it fits in with any system where you can access evidence to support clinical practice and also around where the link would sit on the intranet in relation to other learning resources. Jane will continue to update the group. JO

4. Workload/Workforce Planning

4.1 SANE

Alison Hardy spoke about SANE on behalf of Amanda Croft. The report is now complete and will be out for consultation by the end of October. Mary McAuley requested clarity in terms of staff side representation during the SANE process. Alison clarified that staff side involvement had been taking place throughout the whole process. Discussion then progressed around recommendations and guidelines from SAW and how these would be implemented and it was clarified that each sector will take this forward. The Group agreed that clarity will be required in terms of shifting finance across the organisation if that is recommended and it was requested the item be on the Agenda for the next meeting and that we gain some EStirton direction from Elinor on her return from holiday. Another consideration ES will be the financial situation following the spending review.

4.2 Bank and Agency Spend

Yvonne had submitted apologies today, but referring to her report it confirmed that the acute sector are looking at utilising a local team, as also described in Alison Hardy’s report, bank usage in the acute sector is running at around 50 requests per week. Another bank item for noting is approval has been obtained for an NHSG nursing bank. Tensions remain in terms of winter pressures etc. There is a potential pilot going to be taking place for newly qualified staff nurses on the bank.

4.3 SBAR for Health Care Support Workers

Fiona Stewart spoke about the local NES information day she and Jane had recently attended around the review of standards for Health Care Support Workers. There are still some queries to be answered from NES and the Scottish Government regarding the length of time within which Health Care Support Workers have to meet the standards and there is also an issue around how bank staff will be included to meet set standards. Jane spoke about a learning point for her on the day was around induction being more about orientation and that is an issue of communication that we shall have to make sure we address in NHSG to ensure people understand what this is about. There are workbooks for the Health Care Support Workers and a competency framework and these are available at the moment from Jane or Fiona. There was some discussion how the induction standards and code of conduct apply to anyone in the organisation who is working in a support capacity for clinical practice so it is not just clinical people. There is potential for alignment to the e-KSF with all of this work so that people are not doing two separate things. The group then went on to speak a little bit around trying to reach APPROVED

a clear position regarding bands 2, 3 and 4 for NHSG and we agreed to form a small working group that will look at details around what people at each of these levels will do based on some of the work previously carried out by Eleanor Morrison. Fiona also spoke about some of the work ongoing nationally around workload tools and thanked the workforce and Frances Dunne, who were involved in the collection of data around small wards, principally at Woodend. She also spoke about the data collection tool for Clinical Nurse Specialists which she is working on with a small group locally. She also spoke about a workload tool being developed for A & E. Heather Hardisty also spoke at this point and reported back from a national meeting led by Fiona MacKenzie around workload and workforce for community and benchmarking tools will be circulated when available and there is a chance to influence the development of that took so that activities are accurately recorded and captured.

4.4 Workload/workforce issues

A report was given by Fiona Stewart who spoke about the 6-step methodology being implemented via workload workforce surgeries. The first one has already taken place for CHP staff. The remaining workshops are going to be taking place over the next 2-3 months across Grampian. The workshops do link SANE and SAW together. The workload/workforce process is an iterative process and all services following the workshops will work up an action plan on a standardised template for long term planning of workforce over the next 3 – 5 years. Discussion took place around capacity issues and other processes tying into the workforce surgeries and Fiona stressed that any data that is relevant can be transferred into the process which is aimed at management level. Fiona will continue to update the group on the surgeries. Fiona is still waiting to progress the Dashboard with e-health and it will probably be March before the workload/workforce Dashboard is up and running. In relation to nurse specialist data ISD are uplifting the cleansed data currently and it has to be reviewed each June on a manual basis. Issues still remain around job titles and descriptions and the group agreed that the system needs to be accurately populated for the correct information to be produced out of it.

4.5 Newly Qualified Nurses & Flying Start

Jane spoke about the current situation with newly qualified nurses and flying start. Nothing further to add only to emphasise the importance of trying to identify any potential posts for newly qualified nurses that could then be approved and used in conjunction with government funding and there was some discussion around how that would work.

4.6 Review of Advanced Practitioners and Specialist Nursing Posts

There is a group shortly meeting chaired by Linda Harper. A number of people on the group are involved in that work and this is based around a framework for advanced practice in NHSG. Jean McConville indicated that somebody from midwifery would be useful to have on that group as they are looking to implement advanced practice in midwifery and the roles of advanced practitioners. Jane Smith was suggested as a midwifery representative and Jane Ormerod will get in touch with her. JO

5. Leading Better Care and Releasing Time to Care

Fiona Gray had previously circulated an update for the group and highlighted specific things from that. The main one being some feedback from the last cohort of the Senior Charge Nurse Review and there is a APPROVED

perception of a lack of communication around information within the organisation relating to policies and that is communication from their managers and within the organisation in general. Discussion took place regarding improving communication to this group, specifically around one particular policy – the workplace adjustment policy was given as an example. It was agreed that the pace of change at the moment is phenomenal and there are issues around consistency. It was agreed to feedback to the Senior Charge Nurses that this was brought to the table of the Senior Nurse Group and we would ask them for their suggestions around communication and improving communication. It was also agreed that all staff are responsible to keep themselves up to date. The appendix to the Senior Charge Nurse job description was discussed in relation to bleep holding responsibilities and the intention to add that to the job description. Some feedback was given to Fiona around changes in text and that will be actioned. A letter will also be sent with the appendices and job description – currently being worked on with HR. Jenny Gibb raised an issue around feedback of CQI data and specific issues around one aspect and this will be discussed outside the meeting with Jenny, Jane JG/JO/FG and Fiona.

Sheila Irvine spoke about Releasing Time to Care and the specific position we are in at the moment. There are some very good pockets of work that have been happening with that. However there have been challenges in terms of capacity. Over the next couple of months Sheila will support individual Senior Charge Nurses and their teams in terms of taking forward some of the changes around releasing time to care and also in terms of devising and utilising a central means of collecting data that could inform on the progress. This is something we are currently having problems with. Sheila and Jack Stuart will meet outside the meeting to discuss SI/JS working together around stock control and procurement.

Jack Stuart spoke at this point around the situation with 12 hour shifts. He emphasised that 50% of units in NHSG were already working 12 hour shifts prior to the current work that was ongoing and there has been recent agreement that the core shift will be 12 hours, however this needs to be planned across the day in terms of capacity and breaks etc. The recommended pattern of breaks is based on 11 hours and two half hour unpaid breaks and two 10 minute paid breaks. Jack will pass the paper to Jane Ormerod to speak about training around rosters and the difficulties with consistency across the organisation and trying to implement some training to facilitate best practice in order to reduce costs across NHSG. There was some discussion around the need to ensure effective and efficient handover as part of any shift that staff were working and this would improve communication. In addition appropriate and effective care plans are necessary to supplement this.

6. HAI/HEI update

No further update from HAI/HEI at the present time.

7. Healthy Start in Grampian

Carole Noble came along to speak about the Healthy Start Scheme. See paper circulated previously. There was a fair amount of discussion around the roles of various professionals in this scheme in terms of distributing vitamins and the main point being that Carole was looking for help from the Group to distribute information to staff about the Healthy Start Scheme and it was agreed that this would be actioned by all Group members. APPROVED

8. Area updates – Main Points (also previously circulated)

Heather Hardisty spoke about presentation by Linda Oldroyd to the Senior Management Team in the City which was very well received and it was agreed that it needed to be filtered down to staff.

Mary McAuley spoke about looking at the workload/workforce plan and road testing it at RACH until Friday and it would be refined by the end of October.

Liz Taylor spoke about looking at the methodology and implementation of the SAW work and carrying out informal HAI inspections and they are moving forward in the Shire with reorganising MacMillan and Marie Curie for cancer care.

Jenny Gibb spoke about the rise in admissions to RCH with some very sick people.

Jane fed back about a day she had attended around the changes in the undergraduate programmes to all graduate entry to nursing (attached with this minute) and there was some discussion around how as an employer NHSG has to work with the local HEI, which we do currently, but think how we will move this forward in the future and the impact this will have on the workforce in terms of how we employ all graduates given the current changes in workforce band 3 and 4 and there is a need to work closely to think about how we move this forward. The presentations of the day which all group members might find useful will be on the NES website.

Updates from the Director of Nursing & Quality – please see previously circulated list. Group members have agreed to get back in touch with Susan Carr if they have any queries around Adult Support & Protection and the help she requires in relation to this item. It was agreed that we did need to develop an NHSG policy on the NMC referrals and it was agreed that we would have a go at doing a flow chart. Jenny Gibb asked that we do that and use appropriate signage information in flowcharts and Jane will distribute information around this. In relation to Clinical Nurse JO Specialists – there was some discussion around the work plans that were included with the Agenda from other parts of Grampian and it was agreed that we approach Lynn Adams to ask if she might do a position paper that ES/LA would help to take things forward in NHSG given the work she has already done on this. Some discussion around the joint declaration from the Senior Executive Nurse Group and we discussed it at the Nursing and Midwifery Strategy Forum. It was felt that the next version that will come out could be circulated more widely to teams and would be useful for giving the strategic position to teams in terms of the work that we need to do in NHSG. Jane spoke about the Practice Educator post which will be for specific work to be done around developing Band 5/6 level. This is a band 7 post. It will be funded substantively by NES. It will be line managed by the regional practice education co-ordinator and with a dotted line to practice and professional development unit. Jane will be taking this forward and will keep the group updated. There was some discussion around the background paper and the proposed health & care framework and the stakeholder group to take that forward and it was noted that there is no nursing representation on that group. Jane will ask Elinor whether this has been raised already – UPDATE Elinor is already on this group. APPROVED

9. AOCB

Mary McAuley spoke about the uniform group and the fact that team leaders do need to be in navy blue as well as Senior Charge Nurses, but indicated that there had been some problems with the dispensing of uniforms which has been fairly slow and Mary will feedback that Senior Nurses require these uniforms to be available. She also indicated that uniform policy will be approved at GAPF and there was considerable discussion around the uniform policy and various aspects of that.

10. Date and time of next meeting

Monday 8th November 2010; 1200 – 1600 hrs, Seminar Room, Summerfield House

Apologies noted from Liz Taylor

Apologies for absence to: Elaine Stirton, ext. 58680; [email protected]

*** Area Reports due by 2nd November please ***