Issue - meetings

Further to the report, Matthew Cole (Director, Public Health) delivered a thought provoking presentation to the Board which brought to life some of the harrowing testimony from the Francis Report and the comments and reactions of key individuals, including; Sir Francis QC, Sir David Nicholson, and local Staffordshire campaigner Julie Bailey. The Board, in its debate on what its role is and contribution is to recommending the recommendations made by Francis. In particular its licence around the whole-system view. The following points were noted in the discussion:

·  The Board should give collective thought to how we arrive at an index of suspicion and when it is appropriate to call-time on a poor performing provider. How might the Health and Wellbeing Board take a leading role in ascertaining the index of suspicion through the triangulation of evidence?

·  Complaints must be listened to and taken seriously. Trends in complaints should be analysed and problems resolved with due diligence, with meaningful service change where necessary.

·  Professionals from across the health and social care economy and wider partnership need to be alert to standards of care and have the strength and resolve to report bad care that is witnessed.

·  Commissioners must change performance reporting so that it relates to the patient experience and gives a true account of quality. Furthermore, all contracts must contain quality levers and be vigorously monitored. Commissioners must cut bureaucracy and reporting issues to understand how patients view services and treatment.

·  All Health & Wellbeing Board member organisations confirmed that they did not have gagging clauses preventing whistleblowing.

·  Electronic surveying of patients upon discharge could be an effective means of collecting intelligence that can be evaluated and acted upon instantly.

·  Following publication of the Francis Report the North East London NHS Foundation Trust (NELFT) board begin every meeting with a patient story. The H&WBB was asked to think of other ways in which governance structures can bring through the patient voice.

·  The friends and family test is now being used as another way to test quality in the NHS.

·  The Board needs to take a leadership role and ensure that the post-Francis culture (paragraph 6.2 of the report) is enacted.

·  At Mid-Staffordshire a major problem was the lack of connection between clinicians and managers. Relationships between clinicians and managers are much closer in the outer North East London sector but there is still a need to guard against management issues getting in the way of good quality healthcare and clinical decision-making.

·  The Board considered what could be learned from previous failures of care in mental health.  The outcome has been at NELFT has been the introduction of a very organised patient engagement and representation of any local NHS or Foundation Trust.

·  The Board considered the role of the Council’s Health and Adult Services Select Committee and how its role can be strengthened and how it can perform better to avoid the mistakes and passivity of Staffordshire Borough and County Councils scrutiny committees. The Board noted that a separate report  ...  view the full minutes text for item 16