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1 a Meeting of the Aneurin Bevan University Health Board Quality and Patient Safety Committee Will Be Held on Thursday 5Th Decem

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1 a Meeting of the Aneurin Bevan University Health Board Quality and Patient Safety Committee Will Be Held on Thursday 5Th Decem Agenda A meeting of the Aneurin Bevan University Health Board Quality and Patient Safety Committee will be held on Thursday 5th December 2019, commencing at 09:30am in Conference Rooms 1 & 2, Headquarters, St Cadoc’s Hospital, Caerleon AGENDA Preliminary Matters Attachment 09:30 1.1 Welcome and Introductions Verbal Chair 15 mins 1.2 Apologies for Absence Verbal Chair 1.3 Declarations of Interest Verbal Chair 1.4 Draft Minutes of the Committee Attachment Chair held on 16th October 2019 1.5 Action Sheet of the Committee Attachment Chair held on 16th October 2019 Governance 09:45 2.1 Revised Committee Terms of Attachment Chair 10 Reference mins Presentations 09:55 3.1 Patient Safety - Themes and Presentation Claire Bevan/ 30 Trends to Inform Improvements Dr Brendan Lloyd/ mins and Learning with WAST Darren Panniers, WAST 3.2 Safety and Patient Experience – Presentation Martine Price 20 Winter Plan mins 3.3 Quality & Safety in Presentation Chris Blyth/Jayne 30 Ophthalmology Roberts/Julie Poole mins Break (10 mins) 11.15 For Consideration 11.25 4.1 Quality, Safety and Performance Attachment Dr Paul Buss 15 Overview mins 4.2 Risk Assessment Overview Attachment Chair 10 mins Items for Quality Assurance 11.50 5.1 QPSOG Assurance Update from Verbal Peter Carr 10 Meeting held on 28th November mins 2019 1 Quality & Patient Safety Committee - Thursday 5th December 2019-05/12/19 1 of 259 Agenda 5.2 Clinical Audit Programme Attachment Kate Hooton 10 mins 5.3 Putting Things Right Progress Attachment Rhiannon Jones 10 Against Improvement mins Programme Final Matters/For Information 12.20 6.1 Any Other Business Verbal Chair 5 mins 6.2 Items for Board Consideration Verbal Chair 5 To agree items for Board mins consideration and decision 12.30 Date of Next Meeting Wednesday 5th February 2020, 09:00am, Executive Team, ABUHB Headquarters, Chair St Cadoc’s Hospital 2 2 of 259 Quality & Patient Safety Committee - Thursday 5th December 2019-05/12/19 Tab 1.4 Draft Minutes of the Committee held on 16th October 2019 1.4 Quality and Patient Safety Committee Thursday 5th December 2019 Agenda Item: 1.4 Aneurin Bevan University Health Board Minutes of the Quality and Patient Safety Committee held on Wednesday 16th October 2019 Present: Prof Dianne Watkins - Chair, Independent Member (University) Louise Wright - Independent Member Emrys Elias - Vice Chair Pippa Britton - Independent Member In Attendance: Judith Paget - Chief Executive Paul Buss - Medical Director Rhiannon Jones - Director of Nursing Peter Carr - Director of Therapies and Health Sciences Phil Robson - Special Advisor to the Board Claire Birchall - Director of Operations James Quance - Head of Internal Audit Kate Hooton - Associate Director, Patient Quality and Safety David Thomas - Assistant Director, ABCi Deb Jackson - Head of Midwifery and Associate Director of Nursing Sue Bale - Research and Development Director Jemma McHale - Community Health Council Gabrielle Smith - Performance Audit Lead, Wales Audit Office Alexander Crawford - Senior Planning & Service Development Manager Stephen Edwards - Deputy Medical Director Liz Waters - Associate Nurse Director Moira Bevan - Lead Infection Control Nurse Ceri Phillips - Consultant Pharmacist - Antimicrobials Garvin Jones - Senior Manager Legal Services Jyoti Singh - Consultant, Obstetrics and Gynaecology Rachel Williams - Committee Secretariat Apologies: Frances Taylor - Independent Member QPSC 1610/01 Welcome and Introductions The Chair welcomed members and officers to the meeting, and in particular welcomed guests and observers who were attending. QPSC 1610/02 Apologies for Absence The apologies were noted. 1 Quality & Patient Safety Committee - Thursday 5th December 2019-05/12/19 3 of 259 Tab 1.4 Draft Minutes of the Committee held on 16th October 2019 1.4 QPSC 1610/03 Declarations of Interest There were no Declarations of Interest made relating to items on the agenda. QPSC 1610/04 Minutes of the Meeting held on 12th June 2019 The minutes of the meeting held on 12th June 2019 were agreed as a true and accurate record of the meeting. QPSC 1610/05 Action Sheet – 12th June 2019 The Committee considered the Action Sheet from the meeting held on the 12th June 2019 and noted that all actions had been completed or were progressing. QPSC 1610/06 Revised Draft Committee Terms of Reference The Committee was presented with the revised Terms of Reference following the recent agreed changes to the Committee structure and membership at the Board meeting in May 2019. The Terms of Reference had already been reviewed by the Chair and Executive Leads and their comments had been incorporated. The Committee reviewed and discussed the content of the document. It was agreed that the wording of section 3.1J needed to be updated to ensure this captured the role and responsibilities of the Committee in regards to Clinical Audits. It was confirmed that the Committee would continue to receive an update on the Clinical Audit Programme twice a year, including assurance that the relevant action had been undertaken, and that any learning had been embedded within the organisation. The Committee would also address any specific concerns raised by National Clinical Audits and escalate where necessary. It was added that the Clinical Effectiveness and Strategy Group received and reviewed the results of all National Clinical Audits including the programme of risk based audits. It was noted that the Clinical Audit programme would be presented at the next Committee meeting. ACTION: Secretariat The Committee discussed patient experience and highlighted that this was not explicit within the Terms of Reference. It was suggested for another bullet point to be included within section 3.1 or for patient experience to be strengthened within section 3.1b. It was also agreed that the requirement for the Committee to have a work plan should be included within section 7. It was agreed for the Secretariat to discuss these changes with Richard Bevan and for the final version to 2 4 of 259 Quality & Patient Safety Committee - Thursday 5th December 2019-05/12/19 Tab 1.4 Draft Minutes of the Committee held on 16th October 2019 1.4 be presented at the next Committee meeting in December, following Board sign off in November 2019. ACTION: Secretariat/Richard Bevan QPSC 1610/07 Winter Plan – Reflections and Planning for Winter 2019/20 Claire Birchall and Alex Crawford gave a presentation on ‘Safe & high quality patient care during winter & beyond 2019/20’, including the current position, key themes and next steps. The following key points were noted: This year there had been a particular focus on integrating the Health and Social Care system to support people at home; Welsh Government guidance described a framework for delivery of key themes to support a whole system approach to Winter Planning and Delivery, The nine key themes provided the opportunity to work differently and collaboratively in partnership with the Local Authorities and 3rd sector; Learning from last year was essential to further improve and deliver models that worked; All themes would have a quality impact assessment, looking at patient safety and workforce; Measures had been put into place to optimise cross sector working such as increased levels of Advanced Care Planning and an increase in pharmacy late opening hours; National work was underway to open up more pathways for patients in crisis; A pilot was underway in the Emergency Department within the Royal Gwent Hospital to identify primary care demand and to help educate patients; Work would continue with St John Ambulance this year regarding falls to prevent unnecessary conveyance and admission; There were 4 national pathways to support discharge to assess; There had been a focus on the respiratory pathway, falls and other high risk groups; High level quality metrics would be regularly reported to Executive Team; The CHC would undertake a survey programme this winter to obtain patient feedback; There was a national piece of work underway to provide a centrally funded real time feedback system, with ability for alerts; 3 Quality & Patient Safety Committee - Thursday 5th December 2019-05/12/19 5 of 259 Tab 1.4 Draft Minutes of the Committee held on 16th October 2019 1.4 Learning from staff experience was essential and the core care staffing work had been successful; Executive Team would consider the first draft of the plan on 21st October 2019 in readiness for sign off by the Board and Regional Partnership Board in November. The Committee discussed discharge to assess and emphasised the need to continue education and supporting staff in having those conversations with families. It was noted that the 111 service would hopefully be a successful opportunity to ensure people were directed to the correct service to reduce strain on the health service. It was reported that work was ongoing with North Wales to look at available pathways and joint learning. The Committee discussed demand and capacity planning, including the timely access to social care packages. It was emphasised that the ability for the Local Authorities to resource the demands for winter posed a huge risk. It was noted that Local Authority workforce was highlighted as a key issue at the last Regional Partnership Board meeting, despite the domiciliary care events which had taken place. The Committee discussed the supply and demand of care workers. It was reported that discussions were underway with the Local Authorities to look at alternative opportunities including an apprenticeship programme approach. It was agreed for the Committee to receive a brief update at the next Committee meeting. ACTION: Secretariat QPSC 1610/08 Quality and Safety in Theatres Liz Waters and Stephen Edwards gave a presentation on ‘Quality & Safety in the Theatre Environment A Clinically-Led Review of Clinical Incidents’ including the background, key themes and actions. The following key points were noted: In 2010 the Who Surgical Safety Checklist was introduced.
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